My cochlear implant makes me feel like a cyborg, but I'm proud of it

This First Person column is written by Kaja Montgomery, who lives in Toronto. For more information about CBC's First Person stories, please see the FAQ. 

I had been wearing flesh-coloured hearing aids since I was three. It wasn't until 30 years later, when I saw my eldest son's giddy enthusiasm at being able to choose any colour for his own hearing aids, that I abandoned the camouflage. We couldn't hide our hearing aids, so we might as well be bold, have fun and wear them with pride. 

Just before my 45th birthday, I went to my audiologist complaining that my right hearing aid wasn't working properly. He explained that the hearing aid was fine but my hearing in my right ear had deteriorated to the point that a hearing aid could no longer help. I followed through with his referral to the cochlear implant clinic expecting to be refused. I teach, I dance, I play the flute. I was shocked when the hospital confirmed that I would make an excellent candidate for a cochlear implant. 

My surgeon described a cochlear implant as the most successful medical prosthesis available: "A miracle." 

Still, I hesitated. If I am being honest, I delayed getting a cochlear implant because I was worried about how I would look. I envisioned giant plastic knobs sticking out of the side of my head. But when I started to realize that I was missing large pieces of conversation and that I was refusing social invitations to go out with friends, I decided to get the surgery.

My surgery took place in July 2020. A curved incision was made at the back of my right ear, and an array of sound-detecting electrodes was attached to my cochlea. The implant was placed behind my ear, between my skin and skull. The electronic device stimulates the auditory nerve through the electrodes, allowing me to hear.  

I was in and out of the hospital within a day, but the surgery left me with low energy and I had constant dull pain around the wound. For two weeks, I could not lie on my incision. I would jerk awake as I unconsciously tried to roll over to my right side. Each morning, I woke up tense and unsatisfied.

My mom, a retired nurse, taught my kids precise handwashing technique and how to maintain a sterile work area so that they could help me clean my wound daily and apply ointment. They did her proud.  

Activation day arrived. The swelling around the implant had finally reduced enough to bear the weight of the processor. But I felt apathetic. Due to pandemic restrictions, my family could not be by my side and it would not be the emotional hugs-all-around moment I hoped for. Still, I was relieved when I saw how small the processor was: about the size of a soup spoon and a quarter-inch thick. The device magnetically adheres to the internal part of the implant adjacent to my ear. 

I was extremely disappointed when the processor was turned on. My audiologist's voice sounded computerized. I had assumed that I would immediately be able to understand speech, but even staring intently at her mouth, I could barely make out words. She, on the other hand, was delighted. Many people only hear beeps when their implants are activated. The fact that I could distinguish any words on the first day was promising. I now understood the necessity for three months of auditory retraining. 

Almost as soon as I got home, my head started to hurt. It felt like someone was pressing into a bruise continuously. I wore my processor diligently for the rest of the day and the next, before, finally, I had to take it off. My head was in a vice grip and I was exhausted by the pain. The following day I had an emergency appointment. My audiologist lowered the strength of the processor magnet to reduce the pressure on my tender head. 

Unfortunately, the headaches continued. I was supposed to wear my processor all day and complete two hours of auditory retraining with the implant side, but I could only manage half-an-hour each day. I felt panicked that I was losing time. I had been told the first three months after the surgery were the most vital period for the brain to relearn to hear.

The following week, when my audiologist adjusted my processor, the pain finally dissipated and her voice became slightly less electronic. I walked out of the hospital with a bounce in my step and some hope.

Auditory retraining involves helping the brain pair meaning to the incoherent patterns of sounds that are coming through the implant electrodes. For hours a day, I listened to TED Talks with closed captions and audiobooks while reading the text. In the beginning, I felt like all voices were going through Stephen Hawking's original speech synthesizer. They became more human over time, but, having started my retraining with British audiobooks, everyone sounded like they had a British accent.

One day, I decided to try to understand my kids using only my implant. It was disturbing. I could barely comprehend what they said, but the scariest part was that I could no longer recognize their voices. In a vocal line-up, they were now indistinguishable from their peers. 

That night, my boys, both with hearing loss themselves, undertook my auditory retraining. They covered their mouths and mimicked an audiological exam. 

"Say airplane." 

"Say helicopter." 

We laughed and had fun. And this was the best I could offer them to normalize a complicated experience that might one day be theirs.

By September, my audiologist created different programs on my processor with incremental increases of volume. This extra boost allowed me to understand most of an audiobook solely through my implant. I could also pick up the individual personalities of voices. One month into my auditory retraining, and I was already hearing better than before my surgery.

When my incision healed, I also cut my hair short again. In preparation for my surgery in 2020, I had grown out my hair because I wanted to be able to cover my wound. But I hated long hair. I felt like it made me look frumpy and boring. My implant showed with shorter hair, but I didn't care. If someone looks at me and sees only my hearing loss, that's on them. A friend of mine asked why I don't brush my hair back to cover my implant. Why? Because I am a cyborg and proud.

The surgery and retraining has been worth it. Three years later, I continue to be grateful every day for my bionic technology. On my most recent birthday, my youngest son gave me a new processor cover for my implant that doesn't blend in with my hair. Nestled in my dark hair, the image of a white cat playing with a red ball of yarn is centred on the pale blue oval implant cover. Each morning before I walk out the door I push away my hair to make sure everyone can see it.

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