One Month After Cochlear Implant Activation

The first few days and weeks after cochlear implant activation is a crucial period filled with new auditory experiences and adjustments. It's a time when your brain begins to adapt to sounds it may not have encountered in years, if ever. This phase is essential for fine-tuning your hearing through a series of fittings with your clinician. Understanding what to expect and how to best prepare can make this transition smoother and more rewarding.

Discover tips and insights on how to navigate the initial few weeks post-activation.

Experiencing New Sounds After Cochlear Implant Activation

Once your cochlear implant audio processor is activated, your brain will be bombarded with many new and different sounds, and it will take time to learn what they mean. Hearing implant recipients report different experiences after their processors have been activated. Some hear beeps, buzzes, or clicks. Some hear speech. Others say they feel a sensation rather than hear a sound. Hearing clearly and understanding sounds takes time. The amount of time needed is different for everyone.

It’s important to wear your audio processors all waking hours, even when you are on your own, so your brain has consistent input and can more rapidly make sense of the new sounds. All auditory experiences are exercise for the brain and help you interpret sounds more efficiently over time. The timeline to achieve maximal speech perception varies for everyone, but rehabilitation (listening practice) has been shown to improve speech, music, and/or environmental sound perception and/or adaptation to hearing in challenging, noisy settings [1].

Fine-Tuning Your Hearing With Cochlear Implant Programming Appointments

During each appointment, the hearing professional will monitor your listening ability and adjust the cochlear implant’s programs to ensure ongoing optimal hearing. The main objective of these adjustments is to make sure sounds are natural—soft sounds should be soft, medium sounds should be medium, and loud sounds should be loud.

Tips for Effective Programming Appointments:

Keep a listening journal and document various speech, musical, and/or environmental sounds you hear in different environments: at home, work, restaurants, or in the car. Describe how the sounds seem, how comfortable they sound, and whether you’ve made any new sound discoveries.
High-pitched sounds might initially seem unpleasant because you have not heard them for so long, and this is expected, but if any sounds seem too loud, uncomfortable, or painful, inform your clinician immediately rather than waiting for the next programming appointment.
Monitor your audio processor settings. Note whether you use or prefer specific programs or MAPs and features like wind noise reduction or microphone directionality. This feedback is valuable for more optimal adjustments. The MED-EL HISQUI19 Hearing Implant Sound Quality Index, which is a free downloadable rehabilitation resource, may be helpful for tracking sound quality for you over time as well as suggesting conditions to practice listening in.

Practicing Hearing After Your First Cochlear Implant Programming Appointment

Practice is crucial after cochlear implant activation. Sounds may seem different initially, but this is normal. The best way to enhance hearing and listening skills is through regular practice.

Practice Tips:

Begin by listening to environmental sounds at home. Walk around and notice sounds such as the clock ticking, water running, or the sounds of Note what you can hear from outside too: traffic, birds, footsteps, etc. Even when you are at home on your own in a quiet room, there are sounds around. Listening to environmental sounds will gradually familiarize your brain with them.
Listen to familiar audiobooks, podcasts, or speech recordings. Start with clear and slow speech before progressing to normal conversation speed. Repetition is key to improving speech recognition.
Watch familiar TV shows, movies, or online videos with subtitles. This will help you connect spoken words with their written counterparts, enhancing your comprehension skills.
If you have them, use assistive listening devices to help you hear in different environments. These devices can help amplify specific sounds, making it easier to discern speech in noisy settings.
When you are with family and friends, regularly practice having conversations with them and read aloud to them. Inform them of your hearing journey so they can speak clearly, at a moderate pace, and with repetition, if needed, to help you understand better.
Ask your clinician for specific recommendations and tailored tips to practice your listening skills, and check out our tips and tricks for adults and parents.
Check out Smart Tips for Cochlear Implant Users, a downloadable brochure with some good general information for you and for sharing with others.
The MED-EL downloadable resource: Adult Rehabilitation Kits Introductory Activities is designed for a new listener in the days immediately following activation of the cochlear implant system.
Or download the ReDi app to practice on your own at home.

Long-Term Tips After Cochlear Implant Activation

As you gain more experience with your cochlear implant, you will feel more confident in a wider variety of listening conditions, but some listening situations will still present challenges, especially in noise. It’s important to help others understand your needs. You can ask them to speak in a clear voice and more slowly—but without shouting.

You can also remind them to face you when they speak to you, avoid covering their mouth, and move closer. Often, CI recipients find themselves in less-than-optimal listening situations. Misunderstandings are a normal part of conversation for everyone, so rather than guessing, let people know when you don’t understand.

Review and Reflect on Progress

Schedule consistent follow-ups with your hearing professional to monitor progress. As your listening skills improve, your processor settings may need adjustments.
Review your listening journal/to identify patterns in hearing experiences and track progress, and bring it to your appointments.

Engage in Diverse Listening Environments

Continue to explore different environments and listening conditions inside and outside your home, in the car, and in your local community.
Attend gradually larger social gatherings with increasing degrees of background noise.
Listen to various musical genres to discover which ones you enjoy listening to most. MED-EL has curated a playlist on Spotify which might be a good place to start.

Join Support Groups

Connect with other users by sharing experiences and tips in forums or support groups.
Stay up to date about new features and advances in cochlear implant technology.

By following these tips and staying in contact with your hearing professional, you can maximize the benefits of your cochlear implant and enhance your hearing journey. MED-EL is here to support you and provide guidance, with plenty of resources and activities that help you enjoy sound again and adapt to your new hearing implant.

References

^[1]
Harvey, E., Melin, S., Doerfer, K. et al. Auditory Rehabilitation Following Cochlear Implantation. Curr Otorhinolaryngol Rep 12, 76–81 (2024). https://doi.org/10.1007/s40136-024-00510-8

MED-EL

One Month After Cochlear Implant Activation

Experiencing New Sounds After Cochlear Implant Activation

Fine-Tuning Your Hearing With Cochlear Implant Programming Appointments

Tips for Effective Programming Appointments: