Somewhat Silent

A Newcomer Asks

9 Responses to “A Newcomer Asks”

1. Sara (User Verified) :
   April 13th, 2006 at 11:48 pm

   John, Welcome! Natalya will be the best person to answer these questions, but I’ll throw my two cents in- Have you tried non-surgical options already? Always make sure you thoroughly exhaust those options first. But you probably already know this.

   I’ll let Natalya finish answering the rest for you.

2. barakta (User Verified) :
   April 14th, 2006 at 4:52 pm

   Hi John,

   I’m Natalya and I think I am the only BAHA user on here so will firstly recommend two places where you can get other peoples perspectives - including people local to you in Canada. I’m based in the UK and I know things are different for us.

   I moderate/run a mailing list on Yahoo for BAHA users (http://www.yahoogroups.com/groups/BAHA_ppl). You can use email or the web-based discussion forum. A Yahoo ID is required, membership is granted immediately upon joining, giving you access to message boards, files, photographs, links etc. Your first post will be moderated by kim or myself to check you aren’t a spammer - but otherwise content is not restricted.

   There is also BAHA-users-support which a friends of mine run (http://www.baha-users-support.com/) which has a web-based discussion forum. I think you need to create an identity, but otherwise there is no restriction on access to the message boards. The files, links and pictures are on the main website itself - you’ll probably still seen out of date incorrect version of my story which I’m in the process of rewriting.

   I’ll do my best to answer the questions you post here with what I know. You don’t mention what your hearing loss was caused by - so I’m guessing that is the long story. The BAHA is mainly indicated for single-sided-deafness(SSD) where there is either some nerve-function left (conductive deafness), or to provide a microphone for the left side which will be processed by the inner ear on the right (contralateral stimulation of the cochlea).

   You don’t mention whether you know what the surgery entails, so I’ll assume you don’t know and try and outline it - if this is something you already know then apologies in advance. If my information differs from yours, take yours because mine may be out of date or not specific to your area/hospital/doctor.

   These days the surgery is often carried out in a one-stage local anaesthetic procedure taking between 30 and 60 minutes. Some surgeons do still prefer to use a general anaesthetic on all patients - some only use generals for children or people who specifically request it. Occasionally the surgery is carried out in two-stages especially on young children, or other people for whom it is medically indicated. The procedure has changed substantially from 1991 when I had my surgeries - a three stage procedure done under two generals and a local anaesthetic.

   The procedure itself varies between doctors, basically at some point a small hole is drilled 2-3mm into your skull behind your ear somewhere and a ‘washer’ type thing will be inserted into it. This is the bit which osseointegrates with the bone. Osseointegration is an extremely funky biochemical process where the titanium of the implants bonds with the bone (it is the only metal to do this!). The abutment is screwed into that (either during the one stage procedure, or later in a two stage). The area of skin surrounding the abutment - 2-3cm in diameter will have all the hair follicles removed to prevent them growing into the abutment itself. Eventually a healing-cap, dressings and bandages will be placed over the whole site and sometimes a pressure bandage is worn for 24 hours.

   Different doctors/hospitals have different preferred procedures - do feel free to ask about their methods and discuss why they are chosen. My doc and I had a very interesting discussion about part of the procedure and why he deviates slightly from the norm. Your doc should be able to justify his choices and explain the procedure more clearly and coherently than I have.

   I will now attempt to answer your questions - I don’t apologise for my custom verbosity. I know you guys use kilometers (sensible) but kilometerage doesn’t sound as good as milage! I also use ’sound processor’ and ‘hearing aid’ interchangably. The term ’sound processor’ is used to try and make insurance companies pay for it. B.A.H.A used to be an acronym (I believe it is now ‘baha’ but I continue to use BAHA) which stands for ‘bone anchored hearing aid’. If it was ’sound processor’ it would be a BASP! Then again I still spell sulphur with a ‘ph’ cos I’m weird/stubborn like that!

   1. Any life style changes (I HATE that term) required? i.e. swimming, showers or athletic persuit limitations? (Will it help cure my slice?)

   Well as with any hearing aid you will not be able to wear the BAHA (it is a hearing aid which requires minor surgery to use) in wet situations. So it’ll need to be taken off for baths/showers/swimming/wet activities. As for other sports the only one I know which is not recommended is rough-rugby as there would be some risk to the abutment (external part of the implant).

   Shorter term you may be advised not to play certain sports for 2-15 weeks after the surgery. There is a clip-latch which allows you to attach the BAHA to your clothes via a ‘thin cord’ so that if the BAHA becomes detatched it doesn’t get lost. Most people I know who do sports/cycling/running in it use this with no problems.

   I don’t know what “your slice” means - it sounds colloquial and I’m not as fluent in Canadian as I should be . Ahh, golf (I don’t speak or play that either), I just asked my girlfriend who demonstrated - I have no idea but do ask on the other forums, there must be some golfers who know!

   2. Could I expect any improvement with directional location?

   In theory yes. From what I have read of other people who got a BAHA for SSD the sound from the BAHA sounds a wee bit tinny (a hearing aid will NEVER beat ‘normal hearing’ so if something is on their BAHA side it sounds different. The new Divino model of BAHA (hearing aid) has a directional mic mode which some people like, and some don’t.

   Whatever directional hearing the BAHA would give you, there would be a learning curve of up to two years for you to fully acclimatise to the different way of hearing. I only have one BAHA, and I have a bilateral hearing loss, so can’t actually say anymore on stereo or directional hearing from experience. I have also been deaf from birth, so never experienced ‘normal hearing’.

   3. Any particular maintence required on the external abutment or processor?

   There is initial caring for the abutment/implant site immediately after implantation, you will be given detailed care instructions by your hospital. Exact milage on care instructions will vary between individuals at different hospitals. Basically it boils down to keep it dry for two-four weeks (cunning tricks exist to help you wash your hair - with another person helping). Stitches removed (if any) after two-six weeks. General careful washing once every day or so (find a balance) with a soft cloth or specially provided ‘toothbrush’ and wound care.

   Approx 10-15% of people get a minor infection, and go back to their doctor for treatment - usually an antibacterial cream such as ‘bactrin?’ - again milage varies here. Very occasionally people do have more serious problems. I only know of one who had to not use the BAHA completely, everyone else was able to get their problems sorted everntually.

   The abutment and internal metal bits take about 12-15 weeks to osseointegrate enough to use the ’sound processor’. After this time, all being well after some very basic tests to ensure the abutment is secure your audiologist will fit you with the ‘hearing aid/sound processor’ and tune it to the best audiological settings. You will then be able to leave the hospital hearing the sounds of birds tweeting and whatever else you’ve not been able to hear since October. It takes a while to get used to new sounds, and recognising old ones via a hearing aid. One lady I know says she still asks her husband what things are on a regular basis.

   Longer term, the abutment and implant area don’t need too much maintainence. Basically wash it when you wash your hair, get someone to check it every few days to make sure there is no build up of dead skin cells - if so use the soft toothbrush to clean it. Detailed care instructions should also be provided by the hospital - with the usual varying milage. As long as it doesn’t get a serious knock (hairbrush bangs and hairdressers clinking it with scissors don’t count!) it should be alright. If you have any concerns about this your hospital should advise on appropriate steps - if in doubt don’t hesitate to ask. I’ve had mine for 14 years now, and never had a single problem with my abutment from a damage point of view.

   The sound processor will have a three to five year warranty from Cochlear (manufacturer) and is like any other hearing aid (sorry sound processor) in that it doesn’t like getting wet, may object to being dropped and should be kept out of direct sunlight. If you live in a humid climate then a dry-box is not a bad idea for keeping the sound processor in overnight. After three-five years you will have to pay for your own repairs presume but I don’t know how this works in Canada cos the NHS handles all that for me.

   There is a slightly higher risk of the sound processor getting knocked out of the abutment than a normal BTE is of being knocked out entirely. It is connected by a ’snap lock’ coupling which is designed to eject the hearing aid upon most sorts of impact to protect the skull. Most often the sound processor gets knocked out when changing clothes, or when annoying relatives hug you and clank it. This should not be unduly painful and the hearing aid usually survives impact. I am using the 12 yr old model (for audiological reasons) and it has survived impact onto concrete a few times now. The modern Compact and Divino models may be more delicate - you’d have to ask on those forums.

   In the last few years I have taken care to take my sound processor out when it is raining heavily, this does seem to have extended its life between repairs. Some hearing aids object to changing weather extremes, especially warm to cold, I usually give mine five mins to adjust when it’s cold. Occasionally my batteries don’t work well (Zinc Air CP44 675s) but I am told lithium batteries may solve this problem. I will report back when I’ve tried them.

   Generally, has it been worth the effort?

   Yes! For me, absolutely. The alternative was an alice-band bone conductive aid which pressed against the side of my head. Without my sound processor in I hear effectively nothing, especially not speech. I can only use a BTE on one side, and I am likely to get infections - one BTE isn’t enough for me. For an SSD person I can’t say as much, I hear mixed reports from 100% useful, to 50% useful - although only one person I know says it wasn’t worth it at all. You should be aware that expectations can be too high - realistic expectations will make for a better appreciation of the final result.

   However I do concur with Sara. Do check out your other options as well as the BAHA. The BAHA system is not the cheapest or easiest option out there. I have heard of a few other devices which may be suitable for you at lesser cost or intervention. For the cost/effort you may benefit from a standard BTE aid (I don’t know enough about your long story to know) which would be cheaper to buy, maintain and use.

   Some alternatives include: http://www.retroxhearing.com/ which is a little titanium tube implanted in your ear immediately behind it. The transear system http://transear.com/ - which seems to have a vibrator where the earmould would normally go. I link to these and a Widex open earmould system on the BAHA_PPL links but don’t know much more about them. Occasionally people decide investigating one of these is best for them, and I am all for that. I love my BAHA, but for me there is no real alternative and I think all choices should be checked out - hence my setting up BAHA_PPL 5 years ago.

   Please do not hesitate to ask me more questions, and do post to one or both of those other places that I linked to. There are people with more up-to-date and personal experience more like your own who would be able to give you a personal perspective. If you do post to the places, I’d advise you to explain the cause of your hearing loss, whether it’s conductive, cholestoma, acoustic neuroma, unknown etc etc - that information will affect who replies and what they say - and it saves them all asking you for clarification.

   Right I’m going to shut up now. I promise.

3. lette :
   April 14th, 2006 at 5:45 pm

   wow Im commin to you for info on stuff in future

4. hohprof (User Verified) :
   April 14th, 2006 at 5:53 pm

   Hi John - and welcome. As you can see, you’ve come to the right place for a genuine expert on BAHAs

5. barakta (User Verified) :
   April 14th, 2006 at 6:24 pm

   *grin*

   /me is flattered!

6. barakta (User Verified) :
   April 14th, 2006 at 7:19 pm

   Lette: Anytime, you know where I am, just ask and I shall do my best.

7. Sanctum1972 :
   April 15th, 2006 at 11:10 am

   Welcome John..and all…and to the ladies .

8. Sanctum1972 (User Verified) :
   April 15th, 2006 at 11:16 am

   oh, and one more thing, if you do find making phone calls a challenge after your assimilation with BAHA or fitted with a hearing-aid, you can alternatively get a Blackberry from RIM. And it is an addictive device to tinker with .
   Chat on Yahoo/AIM, texting, or check email on the go…what fun.

9. CJ :
   May 6th, 2006 at 4:20 pm

   John, I have to warn you it will not improve your golf! I had surgery BAHA 2 1/2 weeks ago and the nurse said I could play golf this Saturday. She was wrong, I couldn’t play at all - I’ve never had such a bad game in all my life. I think I had about 8 complete air shots - that is not normal for a 21 handicapper! So - for goodness sake, spend the money on new golf clubs instead - and remember to duck whenever someone shouts 4 because you never know where it’s coming from!!

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