Staying Fit
Joyce Purnick underwent a cochlear implant at age 73, enabling her to hear conversations again.
STEPHANIE DIANI
Fifteen years ago, about to turn 60, I began to lose my hearing — gradually, then precipitously. Within a decade I was functionally deaf, increasingly isolated and edging toward depression. Today I hear surprisingly well, thanks to a cochlear implant (CI) — a surgically embedded bionic ear and a technological miracle, which is not a word I use lightly. My CI restarted my stalled life. It could do the same for so many people like me. Yet only an estimated 5 to 7 percent of eligible adults in the U.S. who could benefit from a cochlear implant have the device in one or both ears. And as of December 2019, only about 736,000 registered devices had been implanted worldwide.
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Hearing aids help many people but are less useful when hearing loss becomes too severe. That’s when cochlear implants could be a remedy. Yet they are still a bit mysterious and are misunderstood, especially by older people wary of surgery. As we live longer, late-onset hearing loss is a serious health problem for our aging population, one that may even contribute to cognitive decline.
Our brains need stimulation, and we need communication. Cochlear implants provide both. Infants as young as 6 months and adults of advanced age can be candidates for the surgery if they have no underlying disease and a healthy auditory nerve. The decisive factor that makes you a candidate: Your hearing loss is so severe that you struggle to communicate even with hearing aids. “Hearing is a major mode of communication,” observes J. Thomas Roland Jr., my surgeon and chairman of the Department of Otolaryngology — Head and Neck Surgery at NYU Langone Health. “If you give that back to someone, the brain is rocking again. It is doing what it is supposed to do.”
Realizing I had hearing loss
It began one night when I was watching Mad Men, the go-to TV series of the mid-2000s. I could barely make out the dialogue. Why would AMC tolerate such bad sound, I wondered? Then I could not follow the eulogies at a friend’s memorial service, began to struggle at the movies and on phone calls, and despaired about not being able to hear my young grandchildren. I was going deaf, and AMC had nothing to do with it. I consulted with doctors, took test after test, bought increasingly powerful hearing aids. Both ears tested below par, the left worse than the right — a serious hearing loss attributed to an antibiotic overprescribed in my childhood, and aging.
Hearing loss, a challenge at any age, throws a sharp curve at those who lose hearing later in life. We have no coping mechanisms — no sign language, no lipreading, and our friends and family relate to us as if we could still hear.
A recently retired journalist, I had always been outspoken. But hearing only an occasional word, I routinely withdrew. I learned the neutral smile, the noncommittal “hmmm,” the agreeable nod. Weary of asking people to repeat things, I often faked it — pretending to hear what I did not — or lapsed into silence.I had to find another way. Like most people, I knew little about cochlear implants. They were not approved by the U.S. Food and Drug Administration until 1984, then permitted only for the profoundly deaf.
“Awareness is poor,” I learned from William Shapiro, the codirector of NYU Langone’s Cochlear Implant Center. He cited studies showing that only 18 percent of the general public is somewhat familiar with implants, and only two-thirds of audiologists — the very people who fit and sell hearing aids. None of the three audiologists I saw when my hearing was tanking mentioned implants; they just pushed for expensive new bells and whistles that would have been as helpful to me as sunglasses at night.
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