Meeting Your Cochlear Implant Surgeon – What To Expect At The Cochlear Implant Consultation

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You’ve made it this far in your cochlear implant evaluation journey. Your surgical consultation is coming up. Not all ENT do cochlear implant surgery. Therefore, the cochlear implant surgeon may be someone different from your current ENT doctor.

You know what it’s like starting over with a new doctor. Or if you’ve known this doctor for ages, are your nerves going to get in the way? What questions are you going to ask? You might think that some questions are silly or too small to matter. That’s not true! Every question is important.

Read below to learn tips to help you be prepared to meet your cochlear implant surgeon. If you want to learn more about my cochlear implant journey, hop on over to Cochlear Implant Journey

What To Expect At The Cochlear Implant Consultation – Surgeon Edition

Hearing Aid Accommodations

The reason you are seeing a cochlear implant surgeon is because you don’t hear well. These days, masks are taking away our visual cues to help fill in missing conversational gaps. Check out my Confidence & Hearing Loss post on how to advocate for yourself in situations like this. Anxiety levels are likely higher during this time. Refer to the list of my top 3 recommendations below on how to reduce your anxiety or hearing loss concerns.

Top 3 tips for hearing loss advocacy at your surgical consultation:

  1. Bring your remote microphone or assistive listening device (if you have one) to help hear the surgeon better. If your hearing aids don’t help you enough or you don’t have an assistive listening device, try a pocket talker. A good pocket talker can be found on Amazon.
  2. Bring a friend or spouse. These days due to COVID-19 (Feb. 2021) hospital clinics are only allowing the patient in by themselves. Sometimes a caregiver is allowed. As a deaf or hard of hearing person you have the right to request additional support. Click here for more information on your ADA rights.
  3. Ask if they can provide written material that covers the basics of cochlear implantation, the treatment, and recommendations. Patients typically retain ~20% of what is said during an appointment. 

BONUS: I know I said top 3, but I’m going to add a bonus. If your consultation is via telehealth, be sure to reach out ahead of time to make sure your access needs are known. Will they be able to provide captions? Can you use a third party app to help transcribe the meeting? I personally use AVA transcribe when I know I will need additional help hearing.

Medical History

The surgeon will meet you to go over you or your child’s medical history. If you are meeting the cochlear implant surgeon for the first time, they may have some additional medical workup orders to place. 

For children, recommended tests may include:

  • Genetic testing
  • Testing for infections
  • Electrocardiogram (EKG)
  • Imaging (CT or MRI)

Recommended specialists may include:

  • Genomic medicine (genetics)
  • Ophthalmology (eye/vision specialists)
  • Developmental pediatrician

Imaging

Imaging studies may or may not have been completed at this point. If it hasn’t, that’s okay, the ENT will get that set up for you. If you have completed the MRI or CT scan, the surgeon will review the imaging results with you. The surgeon will review if there are any abnormalities and a discussion will take place to discuss next steps. 

It is possible your ENT may not recommend a CT scan based on your hearing history. Go with your gut on this one. I wanted to know for sure if my anatomy was normal or not. The etiology of my hearing loss is unknown, so the scan could have possibly have given me answers. 

My CT scan was normal. 

Vaccinations

The Otologsit will also review your vaccination schedule

  • Cochlear implant specific vaccination recommendations (see below)

CDC Cochlear Implant Vaccination Guidelines

Prevnar (PCV13) vaccination recommended for all patients who have or are candidates for cochlear implantation.

Pneumovax (PPSV23) vaccination recommended after the age of 2 who have or are candidates for cochlear implantation.

For more information, please visit the CDC website: https://www.cdc.gov/vaccines/vpd/mening/hcp/dis-cochlear-gen.html

Cochlear Implant Manufacturer – Does the ENT Have a Say?

Short answer, yes, they will either make a recommendation or they will say it’s your choice. We know research has shown that all three manufacturers have good outcomes. It’s a matter of listening to the professional’s recommendation and then gathering your own evidence. The two together will be how you make your decision. Sometimes it’s an easy decision and sometimes it is one of the hardest decisions you’ve had to make. 

If you have abnormal anatomy, your doctor may or may not have a recommendation for how to proceed. That can be anything from no implant, to modified custom internal devices, to proceed as usual. Fortunately, the manufacturers do a good job of making it possible for most ‘questionable’ candidates to get a cochlear implant. 

Based on their experience, the Otologist may make a recommendation, which is mostly an honest opinion from a surgical perspective. You may receive a recommendation from the Audiologist as well. This recommendation may have to do with surgical preference, manufacturer contracts, features specifically designed for a patient like yourself, or some other reason. 

Okay, How Do I Prepare for My Cochlear Implant Consultation?

Get your notebook out.

You will need a place to jot down all of your questions prior to the days leading up to your appointment. Do research online to find answers to your questions on your own. Keep in mind, not everything on the internet is correct. Writing down questions helps you remember what specific questions you had for the surgeon. I know every time I go to the doctors, I’m a little nervous, especially if it has to do with surgery! I may have one or twenty questions! Write the questions down so you don’t forget to ask the doctor at that moment. This ensures all your questions are answered during the appointment. As Alexander Graham Bell said,

“Before anything else, preparation is the key to success.”

Alexander Graham Bell

Narrow down your questions.

Now that you have a list of questions and you’ve done your own research, start to narrow down the questions to maybe 3-5 questions. The really important ones. The nitty-gritty. This will ensure you get your most important questions answered while respecting the surgeon’s time. 

Check with your manufacturer representative or the Audiologist.

The surgeon may not have all of the details of processor accessories or which colors they come in. Save those questions for the company representative or your Audiologist. Please, do however let your surgeon know which company you picked and which color or accessories you choose! They’re always interested to know how the cochlear implant will change your life for the better.  

Conclusion: So, get your notepad out (iPhone notes, spiral bound, microsoft word, google doc, etc.) and jot down all of your questions. Brain dump. We’ll narrow down the questions to ~5 of your most important questions for the surgeon. Review the questions and assess if these questions need to be directed to the manufacturer rep or your audiologist.

Let your surgeon know which company you ended up choosing and what accessories you’re most looking forward to!

What Specific Questions Should I Ask?

Here is the list of my Top 5 questions I recommend asking your cochlear implant surgeon: 

  1. How long does cochlear implant surgery take?
  2. Is cochlear implant surgery reversible?
  3. What are the complications of cochlear implant surgery?
  4. How is the cochlear implant surgery performed?
  5. What happens after the cochlear implant surgery?
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