UNC Adult Cochlear Implant Program.Cochlear Implant Journal
Contents
1. Welcome to the adult cochlear implant program at UNC We made this journal to help you through the steps of getting a cochlear implant Many people with hearing loss have lived in quiet for a long time People with a cochlear implant may hear sounds they have not heard in years We know getting a cochlear implant is a big choice Out goal is to help you make this choice and provide as much information as possible The UNC cochlear implant program started more than thirty years ago We ate one of the biggest cochlear implant programs in the United States Many people come to us from other states We do about one hundred adult cochlear implant surgeries evety year We wotk with all three cochlear implant companies These companies are Advanced Bionics Cochlear and Med El There are steps to getting and doing well with a cochlear implant The steps involve a team approach This team includes you your family audiologists speech language pathologists nurses and doctors The goal of this team is to help you do your best with a cochlear implant Getting a cochlear implant is a journey to hearing better We will work as a team to help make this journey as smooth as possible Patients often ask how much better they will hear with a cochlear implant This is a good question Results can range from hearing sound simple detection to understanding speech in a noisy background Results depend on a number of things Some of t2. PROGRAM 4 ONE MONTH APPOINTMENT We start this appointment in the test booth We will test you with your cochlear implant You will listen to soft sounds and speech These scores will be compared to your past scores Testing gets harder as you progress We will then check the inside piece We will reprogram the speech processor NEW PROGRAMS PROGRAM 1 PROGRAM 2 PROGRAM 3 PROGRAM 4 THREE MONTH APPOINTMENT DATE We will begin this appointment in the test booth We will test you with your cochlear implant You will listen to soft sounds and speech These scores will be compared to your old scores We will then check the inside piece We will reprogram the speech processor NEW PROGRAMS PROGRAM 1 PROGRAM 2 PROGRAM 3 PROGRAM 4 SIX MONTH APPOINTMENT We will begin this appointment in the test booth We will test you with your cochlear implant You will listen to soft sounds and speech These scores will be compared to your old scores We will then check the inside piece We will reprogram the speech processor NEW PROGRAMS PROGRAM 1 PROGRAM 2 PROGRAM 3 PROGRAM 4 ONE YEAR APPOINTMENT Congratulations You have now had your cochlear implant for one year From now you will only need to schedule follow up visits for once a year But you can make
3. THE EVALUATION PROCESS e Hearing Test o Audiologist hearing specialist will go over your hearing history O Test your hearing with and without hearing aids Test your speech understanding with and without hearing aids e Medical Check O A doctor who specializes in ears will go over your medications and health history or x ray will most likely be done to look at the inside of your ear The doctor will talk about surgery procedure and risks WHO IS A COCHLEAR IMPLANT CANDIDATE Moderate to profound sensorineural hearing loss sensory neural when there is damage to the inner ear or to the nerve pathways from the inner ear to the brain in both ears Little or no benefit with hearing aids Clear understanding of cochlear implantation and end results Commitment to process and follow up appointments COCHLEAR IMPLANT AUDIOLOGY EVALUATION CHECKLIST Case History Unaided Audiogram Unaided Speech Reception Threshold Unaided Word Recognition Score Aided Audiogram Aided Speech Reception Threshold Aided Speech Perception Testing Review of Test Results Cochlear Implantation Discussion Devices Processor Wearing Options Battery Options Color Options Warranty Follow Up Schedule Use of Hearing Aid in other Ear MRI Compatibility differs between manufacturers Meningitis Vaccination Recommendation Auditory Rehabilitation Therapy Options THE AUDIOGRAM Pitch Hzl 4000 Normal hearing Mild hea
4. should be no cost to repair replace external parts does not apply to accessories 34 These parts are normally shipped via Fed Ex DO NOT throw the bad parts away The company will want the bad parts back Your replacement equipment will come with a pre paid pre addressed Fed Ex label Use this label to ship the broken patts back to the company IF YOU ARE OUT OF WARRANTY If you are out of warranty there will most likely be a cost to you to replace or repair patts In some cases insurance plans may cover some of this cost Requests normally have to be approved through insurance first This means the process of repairing or replacing equipment may take longet If you have Medicare e Contact the company to figure out what parts need to be replaced You can order these parts from the company The company should contact you when insurance approval has been received They will let you know if and how much money you owe Medicare normally covers 80 of the cost of a repair or replacement Parts can normally be shipped to your home Again you will need to ship the broken equipment back to the company If you have Private Insurance e The company may be able to ask for approval from your insurance provider but you may have to pay up front If your insurance approves you may get repaid from the insurance providet All three companies offer extended warranty The price of these service contracts varies It is in your b
5. equipment With each day with each week you will heat and make out mote sounds as you listen Learning to listen again and understand what you are hearing takes time and practice Be patient Your family and friends should speak to you normally They do not need to raise their voices Having others read books magazines and newspapers aloud are good ways to practice listening Listening to books on tape while you follow along in reading is a good way to practice on your own Please ask your audiologist for other ways or ideas that you can learn and practice at home COCHLEAR IMPLANT INITIAL ACTIVATION ORIENTATION CHECKLIST EQUIPMENT O Identification of external parts O Processor Control Unit cable headpiece coil battery pack Device operation amp troubleshooting Equipment care amp maintenance Batteries Accessories Use of remote control if applicable Ordering parts amp batteries o Manufacturer versus online www microbattery com DOCUMENTS Manufacturer registration User manual ID card o Warnings amp Precautions Caution of MRI differs between manufacturers O Manufacturer patient information insurance forms RECOMMENDATIONS O Read user manual before next visit O Wear device all waking hours Check magnet site If redness or swelling occurs call your ENT surgeon Try to work through all programs 23 EXTERNAL EQUIPMENT Please refer to your Company s User Manual for ins
6. in PRE CARE for further testing if needed o Blood work Electro cardiogram EKG and chest X Ray CXR if needed o Results are looked at before surgery You may have visits with other doctors This will be needed if you have a medical problem that may be complicated by being put to sleep for surgery Imaging of temporal bone will be taken if not already done The temporal bone is the part of your head where your organ of hearing is located Be ready to be at UNC Hospitals for several hours 13 PRE SURGERY INFORMATION e PRE CARE will call the last day before your surgery If your surgery is on a Monday they will normally call on the Friday before PRE CARE will tell you what time you should come for surgery The call will not be before 3 00 PM Adult cochlear implant surgeries happen in the Ambulatory Care Center ACC or Main operating room on UNC s hospital grounds Tell us if you ate sick or have a fever within three days of surgery O Youcan reach the ENT clinic at 919 966 6484 Do not take aspirin or medications that have aspirin within 2 weeks before your surgery day Do not eat after midnight before your surgery You may drink small amounts of clear liquids up to 2 hours before your arrival time DAY OF SURGERY Report to your surgery location You will be taken to the pre op area Your family will be taken to a waiting area The outpatient surgery will last about 2 3 hours The doctor will ta
7. processor is put behind your ear The outside magnet coil is put on your head The outside magnet and the inside magnet connect to each other The coil is connected to the speech processor by a transmitting cable Next the programming or mapping of the speech processor begins The speech processor is connected to the audiologist s computer Individual electrodes of the implant are stimulated You will hear a series of beeps You will hear different pitches or tones The audiologist will measure your response to these sounds We are trying to figure out the levels that are loud but comfortable We may also measure sounds that are very soft After measuring these sounds the speech processor microphone is turned on This will let you hear sounds that are around you including speech The volume will be turned up slowly Hearing speech through your cochlear implant may sound unnatural at first The sound you hear on the first day of listening is different for every patient For some speech may sound like beeps For others speech may sound like a voice Typically if it sounds like a voice it is not a normal voice Patients often describe speech as sounding mechanical cartoonish Mickey Mouse Donald Duck The quality of sound will get better with time and practice Finally your map is saved to the speech processor We will counsel on how to use troubleshoot care for and maintain your outside
8. Hill DIRECTIONS FROM THE EAST e US 15 501 turns into South Columbia e Take I 40 West to exit 273A e Take NC 54 West to Chapel Hill e Take US 15 51 South to Manning Drive Street Turn right on Manning Drive Parking for the Hospital is in the Dogwood Deck garage The Dogwood deck garage is 3 10 of a mile on the right Turn right on Manning Drive Parking for the Hospitals is in the Dogwood Deck garage DIRECTIONS FROM THE NORTH Tie Dogwood eck dile f 15 501 left e Take NC 86 South rom US 15 501 on the left e NC 86 turns into Martin Luther King Boulevard Jr Boulevar DIRECTIONS FROM THE WEST Turn right onto Cameron Avenue 2nd light after Franklin Street Turn left right away onto Pittsboro Street e Take NC 54 East to Chapel Hill e Exit at Columbia Street US 15 501 e Turn left onto South Columbia Street Go left when the road splits e Turn right on Manning Drive Go South Columbia Street to Parking for the Hospitals is in the Dogwood Deck garage The Dogwood Deck garage is 9 10 of a mile from US 15 501 be on Manning Drive Parking for the Hospitals is in the Dogwood Deck garage The Dogwood deck garage is 3 10 of a mile on the right DIRECTIONS FROM THE SOUTH Take US 15 501 North to Chapel Hill DIRECTIONS FROM THE NORTH DIRECTIONS AMBULATORY CARE CENTER ACC US 15 501 turns into South Columbia Street Turn right on Manning Drive Turn ri
9. PROGRAM 1 PROGRAM 2 PROGRAM 3 PROGRAM 4 WHAT TO DO IF YOUR EQUIPMENT BREAKS At some point your outside equipment may stop working When this happens your equipment may need to be repaired or replaced Please keep in mind that you should have back up equipment that you can use You received this back up equipment at your initial activation It should be in your kit So hopefully you will never have to be off the air Please take the following steps 1 Pull out your user manual Look over the troubleshooting section 2 If you cannot fix the problem yourself call or email your cochlear implant company They can help you troubleshoot the problem and workout what parts need to be replaced All companies have audiologists who can respond quickly We ask that you call your company first before calling the clinic This will likely save you time and help in getting you back to hearing more quickly ADVANCED BIONICS 1 877 829 0026 COCHLEAR HEAR ALWAYS 1 800 483 3123 MED EL 1 888 633 3524 3 Call the clinic at 919 490 3716 if you are still having a problem Ask for a cochlear implant audiologist If we are not available please leave a message Tell us what is happening and which parts and serial numbers you are having problems with We will contact you as soon as possible IF YOU ARE IN WARRANTY The company can send replacement parts to your home If you are in warranty there
10. Please read your user manual and bring any questions you have to your next appointment You will return for your next follow up appointment in 2 3 weeks NEW PROGRAMS PROGRAM 1 PROGRAM 2 PROGRAM 3 PROGRAM 4 AUDIOLOGY FOLLOW UP VISITS e You will learn and adjust with the cochlear implant more quickly in the beginning For this reason a lot of mapping changes are needed in the first year We will see you for multiple follow up testing and mapping sessions in the first year O 2 weeks after initial activation O 1 month after initial activation 3 months after initial activation O 6 months after initial activation 12 months after initial activation After one yeat patients are normally seen once a yeat These yearly visits are important We want to make sure you continue to do well with yout cochlear implant TWO WEEK APPOINTMENT You have now heard many new sounds You may have many questions It may help to write all of these down That way we can make sure to answer them during your appointment We will start in the test booth You will listen for some soft sounds and speech We will then check the inside piece We will also reprogram the speech processor Changes are made to the programs at every appointment This helps you hear more sound as you learn to listen with the cochlear implant NEW PROGRAMS PROGRAM 1 PROGRAM 2 PROGRAM 3
11. UNC ADULT COCHLEAR IMPLANT PROGRAM COCHLEAR IMPLANT JOURNAL fl UNC HEALTH CARE TABLE OF CONTENTS CONTACT amp CLINIC INFORMATION Welcome Letter Adult Cochlear Implant Team Reference Clinic Contact Information Parking Information S Driving Directions GETTING STARTED Evaluation Process Audiology Evaluation Checklist The Audiogram ALL ABOUT SURGERY Pre Surgery Information Day of Surgery Risks with Surgery AFTER SURGERY Post Surgery Information Warnings with a Cochlear Implant Personal Recotd of Cochlear Implant Information What to Expect at Initial Activation Initial Activation Checklist External Equipment Reference Initial Activation gt Routine Follow up Appointments Two Week Appointment One Month Appointment Three Month Appointment Six Month Appointment One Year Appointment Two Year Appointment Three Year Appointment FUTURE REFERENCE K What to do if your Equipment Breaks Bilateral Cochlear Implantation Tips for Traveling with a Cochlear Implant oo fe S fe S fe Cochlear Implant Companies fe Device Warranty Information MENINGITIS VACCINATION Meningitis Vaccination Information AURAL REHABILITATION Aural Rehabilitation NOTES Notes WELCOME
12. an appointment before that if needed We will begin this appointment in the test booth We will test you with your cochlear implant You will listen to soft sounds and speech These scores will be compared to your old scores We will then check the inside piece We may reptogram the speech processor NEW PROGRAMS PROGRAM 1 PROGRAM 2 PROGRAM 3 PROGRAM 4 TWO YEAR APPOINTMENT We will begin this appointment in the test booth We will test you with your cochlear implant You will listen to soft sounds and speech These scores will be compared to your old scores We will then check the inside piece We may reprogram the speech processor NEW PROGRAMS PROGRAM 1 PROGRAM 2 PROGRAM 3 PROGRAM 4 THREE YEAR APPOINTMENT Today s appointment should be scheduled just before the end of your warranty if applicable Your warranty may be three years ot five years This depends on your cochlear implant company We will look at all of your equipment to make sure it is working properly The equipment that is not working it will be replaced through the company We will begin this appointment in the test booth We will test you with your cochlear implant You will listen to soft sounds and speech These scores will be compared to your old scores We will then check the inside piece We may reptogram the speech processor NEW PROGRAMS
13. ce magnet and cable and charger The T mic is covered for 1 year The rechargeable batteries are covered for 90 days Cochlear Corporation offers a 5 year warranty for the sound processor transmitting cable coil and Remote Assistant The battery holder for disposable batteries and the rechargeable batteries are covered for 1 year MED EL offers a 5 year warranty for the external sound processor transmitting cable coil battery packs all types rechargeable batteries and Fine Tuner Parts are replaced due to normal wear and tear only The warranty for the outside parts starts the day you get your equipment A one time replacement for loss and damage beyond repair is offered during this warranty period You can buy coverage through the company after the three year warranty ends The warranty for the inside part starts the day of your surgery Cochlear implants are man made medical electronic devices The internal devices are made to last a long time but they may not last a lifetime All three CI companies offer a 10 year warranty for the inside piece MENINGITIS VACCINATION Dear Cochlear Implant Candidate We are writing to tell you about getting a vaccination shot for an infection called meningitis Shots can help protect you from pneumococcal infections This infection may become meningitis It is an infection in the fluid around the brain and spinal cord Meningitis is serious and life threatening The Foo
14. d and Drug Administration Centers for Disease Control and health departments looked at meningitis rates with children with cochlear implants They found children with cochlear implants at a higher risk for getting meningitis than those without We believe this is important for adults as well That is why it is suggested that adults with cochlear implants get the recommended shots to help reduce their chance of getting meningitis There are two main types of meningitis viral and bacterial Bacterial is the more serious type Two types of bacterial meningitis have been found in people with cochlear implants These types ate Streptococcus pneumonia Pneumococcus and Haemophilus influenzae type B The symptoms treatment and results depend on the cause of the infection The Center for Disease Control recently changed the guide for meningitis shots for adults with cochlear implants The new guide is for users to get both the 23 valent pneumococcal polysaccharide vaccine Pneumovax 23 PPSV23 and the 13 valent pneumococcal conjugate vaccine Prevnar 13 PCV 13 Please talk to your doctor about the shot and your case Keeping this infection from happening is important Please get this shot before your surgery You can get this shot from your general doctor or your local county health department For more information please visit the Center for Disease Control s website at http www cdc gov mmwr preview mmwrhtml mm6140a4 htm s cid m
15. ece A treatment for some types of cancer Ionizing radiation will hurt the inside piece If you have a medical problem or question please contact your cochlear implant doctor COCHLEAR IMPLANT INFORMATION Date Implanted CI Company Ear Implanted Processor Type Speech Processor Serial Number s Warranty ends Doctor Contact Number Nurse Contact Numbet Audiologist s Contact Number Contact E mail Fax Numbet WHAT TO EXPECT AT INITIAL ACTIVATION You can keep using your hearing aid in the other ear until you come to your initial activation visit This is when you get the outside part of your implant and start to hear sound At this visit we will ask that you not wear your hearing aid in the other ear After several months with your new implant you may go back to wearing your old hearing aid also For some patients we may talk about getting a second cochlear implant About two to four weeks after surgery you will be fit with the outside part of the cochlear implant This time allows your ear to heal The main outside piece is called the speech processor It has to be mapped or programmed for you to hear sound through the cochlear implant During the first six months of hearing with your implant reprogramming or remapping is done about five times As your hearing and understanding with the cochlear implant gets better less reprogramming visits are needed To begin the speech
16. est interest to buy an extended warranty when the original warranty ends Please contact your cochlear implant company for more information BILATERAL COCHLEAR IMPLANTATION Views on having a cochlear implant in both ears bilateral cochlear implantation have changed a lot in recent years It is more common to implant both ears If a patient has limited benefit from a heating aid in the other ear we may talk about the option of a second cochlear implant If a patient still has usable hearing in the other ear we may recommend a hearing aid in this ear along with the cochlear implant This decision is unique to each patient Research shows that two ears are better than one In order for a patient to do his her best bilateral cochlear implantation may be recommended There are several benefits of having two cochlear implants Better speech understanding in noise Being able to know where sounds come from localization Never being without sound If the internal or external parts from one cochlear implant side need repair or replacement patient can still hear with the other side Most insurance providers support bilateral cochlear implantation Determining candidacy for bilateral cochlear implantation would be made by the CI team CI audiologist surgeon and patient family Certain criteria must be met in order to be considered a candidate for a second side implant Successful and consistent use of the first device Active part
17. four hours in any of the Handicapped Parking spaces located directly in front of the Memorial Hospital entrance Additional handicapped spaces ate located in the Dogwood Parking Deck Handicapped accessible shuttles service these spaces If you need assistance from the parking deck please contact the attendant via the call box phones http www unchealthcare org site transportation Patient o20and 9 620 Visitor o20Pa rking AT SATELLITE CLINIC Patients and visitors may park in lot outside of clinic There is no cost to park at this location UNC Hospitals Hearing amp Voice Center at Carolina Crossing DIRECTIONS UNC HOSPITALS HEARING amp VOICE CENTER AT CAROLINA CROSSING PHONE 919 490 3716 From I 40 West take exit 273A You will merge onto 54 West Will cross over I 40 Get in right lane Stay straight through first light Farrington Road Stay in right lane lane will end making you turn right Turn right onto Nelson Highway Hwy 54 Access Service Road Clinic will be on the LEFT 3 story light red brick building From I 40 East take exit 273 Turn right onto 54 West Get in right lane Stay straight through first light Farrington Road Stay in right lane ane will end making you turn right Turn right onto Nelson Highway Hwy 54 Access Service Road Clinic will be on the LEFT 3 story light red brick building DIRECTIONS UNC HOSPITALS DIRECTIONS FROM THE SOUTH e Take US 15 501 North to Chapel
18. ght on West Drive Turn right on Mason Farm Road The ACC entrance is miles on the left The parking lot is around the building Take NC 86 South NC 86 turns into Martin Luther King Jr Boulevard Turn right onto Cameron Avenue 2nd light after Franklin Street Turn left right away onto Pittsboro Street Go left when the road splits Go straight across South Columbia Street to be on Manning Drive Turn right on West Drive Turn right again on Mason Farm Road The ACC entrance is 1 4 mile on the left The parking lot is around the building DIRECTIONS FROM THE EAST Take I 40 West to exit 273A Take NC 54 West to Chapel Hill Take US 15 51 South to Manning Drive Turn right on Manning Drive Turn left on West Drive Turn right on Mason Farm Road The ACC entrance is 1 4 miles on the left The parking lot is around the building DIRECTIONS FROM THE WEST Take NC 54 East to Chapel Hill Exit at Columbia Street US 15 501 Turn left onto South Columbia Street Turn right on Manning Drive Turn right on West Drive Turn right again on Mason Farm Road The ACC entrance is 1 4 miles on the left The parking lot is around the building EVALUATION PROCESS THE GOAL OF A COCHLEAR IMPLANT EVALUATION Decide if getting a cochlear implant is a good option for you Go over test results Make suggestions based on results Give information about cochlear implant technology Answer questions
19. hese are a person s hearing history history of hearing aid use and access to spoken language For all patients success with a cochlear implant requires wearing the device practice and returning for follow up visits Thank you for choosing UNC to help you through this journey to better hearing We look forward to working with you in the future Let s begin ADULT COCHLEAR IMPLANT TEAM DOCTORS Harold Pillsbury MD FACS Professor gt Chair Department of Otolaryngology Head and Neck Surgery Craig A Buchman MD FACS Professor amp Chief Department of Otolaryngology Head and Neck Surgery Oliver F Adunka MD Associate Professor Department of Otolaryngology Head and Neck Surgery NURSES Kristen Jewell RN Clinical Nurse Dr Buchman Dr Adunka CLINICAL AUDIOLOGISTS Marcia Clark Adunka AuD CCC A Director of Audiology Clinical Audiologist English R King AuD CCC A Clinical Coordinator of Adult Cochlear Implant Program Clinical Audiologist Ellen J Pearce AuD CCC A Clinical Audiologist RESEARCH AUDIOLOGIST Margaret T Dillon AuD CCC A Assistant Professor Department of Otolaryngology Head and Neck Surgery CLINIC INFORMATION UNC HOSPITALS HEARING amp VOICE CENTER AT CAROLINA CROSSING 2226 Nelson Highway Suite 102 Chapel Hill NC 27517 Audiology Appointments 919 490 3716 Audiology Fax 919 490 5818 UNC DEPARTMENT OF OTOLARYNGOLOGY HEAD AND NECK SURGERY Tw
20. icipation in follow up care No physical contraindications for placement of the implant any medical reason for not getting implant i e CT scan results Medically cleared for surgery Realistic expectations and commitment to follow up appointments TIPS FOR TRAVELING e Take extra parts like a back up speech processor battery pack coil and cables with you in case of emergency Take plenty of batteries disposable or rechargeable If you use rechargeable do not forget your battery charger and adapter if needed Remember to take your drying jar or Dry amp Store box with you so you can put your processor in it overnight This is important if you will be somewhere with high humidity Will anything happen to my cochlear implant when I walk through airport secutity Not normally You should leave your speech processor on so you can hear what is going on around you If your processor is set on the telecoil T setting you may hear some buzzing This is normal If the metal detector alarm goes off what should I do Metal detectors and scanners will not hurt the inside piece or outside speech processor If you pass through the security metal detector your cochlear implant may set the alarm off If the alarm goes off security may use a handheld wand to screen you The wand will not harm your cochlear implant but it will beep when it passes over your implant Show your patient ID card and explain that you have a hea
21. lk to your family after the surgery After you wake up you will be taken to the recovery area Your family will be able to come to your bedside The nurse will be watching you as you continue to wake up O Checking yout vital signs level of consciousness bandage Recovety times can vary Plan to spend 23 hours in the hospital This means an overnight stay You will leave with a bandage dressing over yout ear O The nurse will give you instructions on how to care for your ear at home A prescription for an antibiotic and pain medication will be given to you Please tell the doctor any medications you cannot take RISKS WITH SURGERY RISKS WITH COCHLEAR IMPLANT SURGERY Loss of natural or residual hearing in implanted ear Greater chance for infection in the fluid around the brain and spinal cord known as meningitis Facial nerve stimulation involuntary facial twitching Swelling Inflammation Pushing or thrusting out Extrusion O Soreness redness breakdown of skin in area around device Failure of implanted device Greater chance for infection in the fluid around the brain and spinal cord Meningitis Please find full information regarding meningitis vaccination on last pages of CI journal RISKS WITH ANY EAR SURGERY Numbness tenderness around the ear Neck pain Injury to the facial nerve Taste change dry mouth or a metal taste in mouth Leak of inner ear fluid Perilymph or fluid that surrounds the brai
22. m6140a4_ w AURAL REHABILITATION You got a cochlear implant and had it turned on Now you need to learn how to listen and understand all of the new sounds coming from your implant Reseatch has shown that adults make faster progress in their understanding of speech and sounds using a treatment called Aural Rehabilitation Aural Rehab What is Aural Rehab also called Auditory Therapy In Aural Rehab you will learn how to listen and understand the new sounds that come from your cochlear implant Aural Rehab can improve your skills when talking with others Improving these skills may help you feel more secure with your implant Aural Rehab includes exercises that help you Understand the difference between sounds and whole words Understand new sounds that have not been heard before Read along and follow someone else s speech while they read aloud Notice when you ot someone you are talking to does not understand what is said Learn when to change your setting to improve your understanding Learn how to set up the phone to work with your implant Enjoy music Learn how your implant affects the people around you and help your family and friends learn about your implant Make your speech more clear Learn and practice skills that will make you more comfortable when talking UNC Health Care has a great staff of speech language pathologist SLPs that offer Aural Rehab to our patients with cochlear implants The first step is to meet wi
23. n Cerebrospinal Dizziness Vertigo Ringing in the ears Tinnitus Local complications such as blood fluid or infection at or near surgery site Rashes skin reactions GENERAL RISKS e Post surgery pain scarring bleeding and infection e Risks associated with being put to sleep problems with the heart lungs kidneys liver and brain due to general anesthesia POST SURGERY Please call the doctor s nurse or the triage nurse if you have questions once you are home If you have questions after clinic hours 8 30 4 30 M F please call 919 966 4131 This is the UNC Hospital main telephone number Ask to speak to the ENT doctor on call You may have a sore throat for a few days You may have dry mouth or a metal taste for a few weeks after surgery But this may last longer Start with clear liquids at first Then try to eat solid food Try not to eat hard or crunchy foods the first week A stiff neck or pain in your neck can last for a few weeks after the surgery Lack of feeling numbness or stiffness around your ear is normal This can last for a few months Your ear may stick out for a few days from swelling It should go back to normal as your eat heals Call right away if clear liquid starts dripping from your nose Dizziness can be normal for a little while after surgery Do not take off the bandage unless told by the doctor Do not get the bandage wet The bandage will catch any drainage and help stop b
24. o Clinic Locations NC NEUROSCIENCES HOSPITAL Ground Floor 101 Manning Drive Chapel Hill NC 27514 CAROLINA CROSSING 2226 Nelson Highway Suite 101 Chapel Hill NC 27517 ENT Appointments 919 966 6483 for both locations 919 490 3280 Carolina Crossing ENT Fax 919 843 9361 Neurosciences 919 490 5818 Carolina Crossing PARKING AT UNC HOSPITALS MAIN CAMPUS Patients and visitors may park in the Dogwood Parking Decks or the Ambulatory Care Center parking lot at a cost of 1 50 an hour part of an hour to a maximum of 8 to park your vehicle for a full day Coupons are available to Patients and Visitors in the Hospitals Parking Office for 8 each These coupons will allow Patients or Visitors to enter and leave the deck multiple times during the day without acquiring extra charges The Hospitals Parking Office is located in the building in front of N C Children s Hospital Valet Parking is available to all patients and visitors to any of the Hospitals and the Clinical Cancer Center Valet is located in the building in front of the N C Hospitals The cost for valet parking is 10 Valet coupons can be purchased from the Valet Cashier and come in books of five and cost 45 Payment for the Dogwood Deck or Valet can be made by cash credit or debit card Visitors and Patients may contact the Hospitals Parking Office for long term parking options at 919 966 1031 Handicapped Parking is available for up to
25. r anything with an on off switch The FAA views a cochlear implant in the Hearing Aid category If you have a remote control for your speech processor this should be turned off or not used during this time How can I listen to the in flight music or watch a movie You can plug your speech processor into the plane s audio system You would need to use your audio cable accessory See your user manual on how to connect the Audio Adaptor Cable to your speech Further questions regarding the TSA s guidelines for airport screening and how it relates to your hearing loss and cochlear implant may be found at www tsa gov traveler information travelers disabilities and medical conditions Resource http www cochlear com wps wcm connect us recipients recipient support nucleus nucleus 5 living with your device traveling tips COCHLEAR IMPLANT COMPANIES Advanced Bionics Corporation 28515 Westinghouse Place Valencia CA 91355 http www advancedbionics com us 1 877 829 0026 Cochlear Hear now And 105 Cochlear Corporation 13059 E Peakview Avenue Centennial CO 80111 1 800 483 3123 hearLIFE MED EL MED EL Corporation 2511 Old Cornwallis Road Suit 100 Durham NC 27713 http www medel com us 1 888 633 3524 DEVICE WARRANTY INFORMATION In warranty means there is no cost to repair or replace broken parts e Advanced Bionics offers a 3 year warranty for the sound processor headpie
26. ring loss Moderate hearing loss r3 X v vi et Y 3 Severe hearing loss Profound hearing loss Loud Audiogram Source http www medel com us audiogram An audiogram is a picture which shows the softest levels you can hear tones that you listen for during a hearing test range from low pitch to high pitch The loudness of the sound is measured in decibels dB The pitch or frequency of the sound is referred to in Hertz Hz This picture shows how your hearing differs from normal hearing and the degree of hearing loss that you have in each ear PRE SURGERY SCHEDULING e An ENT surgery scheduler will set up these visits for you Pre op with ENT doctor Surgery Post op with ENT doctor e An audiology scheduler will set up your initial activation This is when you get the outside part and start to hear sound with the implant You will get a call after you get home from hospital O This is normally scheduled two to three weeks after surgery O You may wear your hearing aid in the opposite ear e Please make sure your phone number email and address are correct in hospital system Hospital staff may need to contact you PRE OP VISIT e Your pre op visit will start in the ENT Clinic The doctor will check your medical history The doctor will talk about risks of surgery Consent forms will need to be signed Your questions will be answered You will also be seen
27. ring implant Tell them that the speech processor is a hearing device that you must wear in order to hear through the implant What should I do with my back up speech processor when I fly Turn your spare speech processor OFF and keep it inside a carry on bag Place the bag onto the conveyer belt at airport security Never place your processor right onto a conveyer belt Static electricity may build up and harm your MAP or program The x ray machine should not affect your MAP if the processor is turned off Note A low level x ray is used to screen carry on luggage The x ray will not harm your processor or the MAP Never put your spare processor into checked bageage as this could expose it to damaging Will my implant send signals that can interfere with the plane s navigational instruments Your implant cannot get in the way of the plane s systems Your implant sends out radio frequency RF signals They are very short range less than five feet from the outside coil Your remote assistant or Fine Tuner if applicable does send out high frequency radio waves and should be turned off during take off and landing If your remote does not have an off switch do not use it Like other electronic devices should I turn off my speech processor during take off and landing No Cochlear implant patients DO NOT have to turn off their speech processors when instructions are given to turn off cell phones music players o
28. th the SLP for an evaluation At this appointment the SLP will check what skills you have and what skills you need help with by testing e How you make speech sounds How you understand speech Your memory Your reading and writing skills Your listening skills How well you can understand someone talking without being able to see their lips We encourage all patients to make an Aural Rehab evaluation appointment with one of our speech language pathologists to learn what this therapy can offer you You can make an appointment at UNC Hospitals Hearing amp Voice Center by calling 919 490 3716 There are also some free resources available online which you can listen and practice with at home Some of these programs include q e Angel Sound is a free upgraded version of Sound and WAY Beyond an auditory rehabilitation program based on CAST technology and distributed by Cochlear Americas Available at http angelsound tigerspeech com The Listening Room sponsored by Advanced Bionics has free activities and resources to support the development of speech language and listening Available at SoundScape sponsored by MED EL has interactive listening activities for various age groups Available at http www medel com us show4 index id 255 titel SoundScape Approved Pt Education Committee 10 1 2013 ER HDF 3829
29. tructions on how to use yout remote if applicable as well as care and maintenance of your external unit AB Naida CI Q70 Universal Headpiece COCHLEAR Coil amp Magnet CP910 Nucleus 6 Sound Processor Battery Module Sound Processot Power Source Cable MED EL OPUS 2 Control Unit Coil Cable Battery Pack INITIAL ACTIVATION DATE This visit is 2 3 weeks after surgery It will be about two hours long Today you will heat through the cochlear implant At this visit we will ask that you not wear your hearing aid in the other ear You will be fit with your outside equipment speech processor battery pack transmitting cable and coil headpiece A program or is made by measuring sounds that you hear through the cochlear implant This is done while connected to audiologist s computer You will hear different pitches or tones as each electrode is stimulated We will increase the volume of each tone until it is a loud but comfortable level You may also listen for sounds that ate very soft We will turn on the microphone We will ask you to tell us what you are hearing You may hear anything from bells to speech This is normal We will talk about many things today We will teach you how to use troubleshoot care for and maintain your equipment We know that you may not remember everything We will complete product registration and talk about warranty information
30. uildup of fluid Pinkish drainage is normal Call right away if bright red drainage is found The doctor will take off the bandage at your first post op visit to look at the site POST OP VISIT You will come back about one week after surgety to have your bandage taken off by the doctot The doctor will make sure site is healing well and there 1s no sign of infection The audiologist may check the inside piece to make sure it is working Also done in the operating room at time of surgery O This only takes a few minutes WARNINGS WITH COCHLEAR IMPLANT Be careful when playing sports and in certain activities contact sports bicycling and rollerblading without a helmet Try not to hit head during activity football soccer etc Weat a helmet for sports like riding a bicycle If the inside piece is not working then you may need another surgery This is called a revision surgery The US Food and Drug Administration FDA does not allow or limits certain imaging MRI magnetic resonance imaging with a cochlear implant This differs between manufacturers Please check with your doctor or audiologist The use of high frequency electric current to cut tissue during surgery Electrosurgery and electroshock therapy can permanently hurt the device Electrically induced heat Diathermy or spinal cord stimulation neurostimulation cannot be used over the implant This can hurt the cochlear tissue and the inside pi
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