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July 31, 2003

Sounds good to him: Man hears his first noises after cochlear implant turned on

From: Framingham Metro West Daily News, MA - Jul 29, 2003

By Jennifer Lord / News Staff Writer Tuesday, July 29, 2003

The last of a three-part series

WORCESTER -- Bill Holt jumped and put his hand over his heart in shock.

Reaching out to touch his wife, Mary Jane's, hand, he said slowly, "I felt it first but I thought I heard something. A little."

Mary Jane clutched his hand and husband and wife briefly exchanged a look as the little room at the University of Massachusetts Sounds of Life Center filled with gasps from the small crowd gathered for just this moment.

After a month for his surgical sutures to heal, the small cochlear implant inside Bill Holt's head was starting to work.

The Framingham resident, 48, has been completely deaf since a virulent ear infection knocked out hearing in his left ear.

In June, a cochlear implant was surgically installed on his right side, which hasn't had hearing since his childhood when a series of infections left him deaf in that ear. Now it was July 14, a new holiday for the Holts to celebrate: activation day.

Bill, as usual, was the most outwardly calm. "Excited, anxious, curious -- all of the above," he said as he waited for Dr. Sarah Poissant, audiologist and clinical and research director at the center. "Mary Jane is more nervous than I am."

Granddaughters Bailey Horne, 3, and Jordan Harding, 2, did their best to keep their family's mind off the big question: Would grandpa be able to hear again? They garlanded their parents and grandparents with leis, giggling and shrieking with delight.

"He's going to wish he couldn't hear," joked daughter Jennifer Harding, shushing Jordan as her voice reached a high pitch of excitement.

It was the family's hope that the first thing Holt would hear after activation was the sound of Jordan's voice. His youngest granddaughter wasn't speaking back in December, when a double ear infection knocked out the remaining hearing in his left ear.

Poissant ushered in the family, scrambling up enough chairs for the crowd, which also included daughter Melissa Horne and son Joshua Holt. Bailey and Jordan were barricaded in a corner, where they happily investigated a set of animals from the room's toy cabinet.

"I fully expect Bill to be able to hear today, but it may sound like noise to him," Poissant said. "He may not understand speech or we may sound like Mickey Mouse to him. That's OK. It doesn't mean the implant isn't working."

Most patients start to hear voices normally within a few weeks, as the brain adjusts to the new signal, and "mapping" sessions with the audiologists refine the signal.

What the implant will not do, she cautioned, is restore normal hearing. Holt may not be able to discern different voices for some time and he may find music to be frustrating rather than enjoyable.

After choosing a dark brown earpiece from the color selection, Holt tried to magnetically attach the transmitting coil to his scalp, fighting with his grown-back thick hair.

Poissant then hooked him up to her computer, which displayed a series of 24 vertical lines, each cross-hatched with short horizontal red and green lines. The lines, as she tested each channel, would represent how loud and how soft Holt would be able to process sound, she explained.

"I'm going to start nice and slow," Poissant promised Holt. "I don't want to hit you with something too hard."

At first, Holt jumped with each sound, explaining they startled him. Gradually, he got more used to the sensation, nodding and pointing on a chart whether he felt each noise was too loud or too soft. Several times, he reached out and patted Mary Jane's hands in reassurance.

"It's a strange sound. Wow," Bill said.

"Grampy's hearing now," Melissa explained in a whisper to Bailey. "He's hearing music."

"From the boo-boo on his ear?" Bailey asked. The family laughed nervously as Holt, oblivious to the discussion, nodded more frequently as Poissant ran through the channels again.

"Ah, that's too loud," Holt said, slapping his hand on the desk. " Wow ... OK, that's good."

Jennifer and Melissa urged their daughters forward as Poissant indicated that she was ready to turn Holt's implant on to hear sounds from the outside world. Despite promptings, Jordan shook her head and sought shelter back with her mother, refusing to speak out of sudden toddler shyness.

"Whoa! What am I hearing?" Holt asked. "Who's mumbling out there."

"Can you hear us?" Mary Jane asked.

"Oh, it's strong," Holt said. "But I'm hearing. I'm hearing something. I just can't make it out. It sounds like somebody mumbling in the background. It doesn't seem to coordinate with anyone's lips."

Poissant reassured him that it was a normal reaction.

"It's a brand new sound," she said. "Your brain has never heard it before. We're just going to leave it on and let you listen for a few minutes."

She had Holt slowly count to 10 and his eyes widened.

"I think I'm hearing my own voice," he said, stunned.

His children choked back tears.

"Mommy, don't cry," Bailey said.

"She's happy," sobbed Melissa. "She's happy."

"I can hear my voice," Holt repeated. "I couldn't hear it before."

Something else had changed as well. Although his voice had been clear during his months of hearing loss, the implant's activation made him subconsciously realize he had been talking louder than normal. Poissant pointed out that he was now noticeably talking lower and also reading her lips better than he had been at the start of the session.

The key to regaining the ability to understand voices was practice, Poissant added. She recommended that Holt read out loud to himself or have his wife read to him.

"I don't even know what to say," Mary Jane said to her husband. "It's been so long and I have so much to say."

"You sound like yourself," he responded.

Poissant was surprised that he was already starting to pick up voices.

"It's been so long since you heard in that ear. I think that's a positive thing," she said.

The exterior portion of the implant must be removed at night to let his skin breathe. The processor's batteries last only three days -- the Holts can expect to need up to 300 batteries a year.

Holt will also have to periodically go through "mapping" sessions to adjust his processor as his brain learns to use its new sense.

Holt gave his wife a grin, leaned over and gave her a long kiss and hug.

"I love you," she said into his new hearing ear.

"I love you, too," he said. "And I heard that."

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