Having made the big decision to go ahead with cochlear implant surgery, I was anxious to proceed as quickly as possible.

The next step was to visit my surgeon, Associate Professor Catherine Birman, of Sydney’s Macquarie University Hospital, who was going to perform the operation.

Liz Efinger switch on day

I felt positive about this, as she had been highly recommended and was very experienced in this type of operation. The meeting went well and I was excited to finally have a date for the procedure. I could see no reason to wait any longer and as I had organised an overseas holiday, I was very anxious to pack in my initial appointments and the first few mappings before going away. Suddenly it all felt very exciting.

The day of surgery arrived fairly quickly. In the end, I was quite laid-back, just anxious to get over the hurdle of the operation well, so that I could start working on getting my hearing tuned into the implant. As the big day arrived, a friend kindly drove me to the hospital where the surgery was performed. I spent two nights there as I lived by myself.

After the procedure, the surgeon told me she was delighted with the results of the operation and informed me that all electrodes were working and now I just had to heal. The rest was up to me and the audiologists.

The wound healed without any problems and I only needed a bit of pain relief in the first week. I must admit it was all rather tender and sore – especially where the processor was implanted. Recovery was routine but it took a lot out of me. I slept a lot, which was probably what I needed to do. It was a bigger procedure than I expected, and it really required the full two weeks of postoperative recuperation.

I was naturally filled with anticipation when that long-awaited ‘switch on’ day arrived. Finally, I was at the threshold of ‘a new life’! A close friend, Julie, and also my old audiologist Roger Lovegrove came along with me for the momentous occasion.

First, we went through the whole routine of setting up my new equipment which seemed to go without a hitch. I heard lots of strange sounds but nothing even slightly resembled anything like words and I was told to be patient and it would hopefully all happen. Admittedly, this was good advice as I tend to want things to happen yesterday!

I was not disappointed that I couldn’t immediately understand anything through the new implant. I honestly didn’t expect to hear much and would have been absolutely amazed if it had been otherwise. Nevertheless, by the next day, something seemed to be happening.

I felt as if what I heard through my implanted ear was adding to the hearing through the hearing aid on my ‘good’ side. In other words, I seemed to be getting some sort of binaural hearing, even though, on its own, the left ear was hearing nothing but gobbledygook.

Liz Efinger first cochlear implant mapping session

Liz Efinger’s first cochlear implant mapping session

I can only describe the sound on that side as a monotone, like underwater noises that did not seem to relate to speech but just seemed strange and annoying. On the upside, the binaural experience was different and exciting. I had not heard anything worthwhile through my left ear for about 15 years, and now one day after ‘switch-on’ I had this wonderful sensation of hearing on both sides, even if only slightly. In fact, when I disconnected myself from the processor, I didn’t like the sensation at all. The hearing level definitely dropped.

My spirits lifted. Something was working! There was still a long road to travel but I felt I was on the way. I had a week to practice hearing and listening before my first mapping date. To summarise, I don’t think very much changed in this week. I started working on a few exercises which I got from an app I had downloaded. This was hard, and I didn’t do too well with it. In fact, one day I thought things had improved a bit, and then the next day I seemed to take a couple of steps backwards.

The second mapping day arrived. I received a couple of pieces of extra equipment – one was to allow me to connect to Bluetooth, and listen to my mobile phone and iPad. In addition, there was an extra external microphone to help me hear in noisy situations, which was not immediately connected at this stage.

A very exciting thing happened on day eight after the ‘switch-on’. When speaking on the phone with a friend, I asked her to talk with me while I had the phone up to the microphone on the cochlear implant – and – I recognised some words instead of the jumbled mess of sounds I had come to expect! I was over the moon that things were already happening.

In truth, since then it has been a somewhat rocky road. After my second mapping, I was a little shattered that what I was hearing seemed worse than ever. I had an afternoon when I felt like throwing the implant in the bin and was very upset as it was going to be another two weeks until the next appointment.

However, with trepidation, I did wear it the next day, and for a whole weekend of choir rehearsals. Somehow it wasn’t so bad after all. I realised I had to be patient and take it one day at a time. Progress in between mappings was slow. The ‘Donald Duck’ noises I initially heard continued to talk to me in the background and adjusting settings to try to balance this was problematic.

At week four after ‘switch-on’, I still struggled to understand the jumbled speech I was hearing. It was a case of persevering day by day and hoping that suddenly the words would be there. People said to me, “So can you hear perfectly now?” which was annoying but they didn’t understand that it doesn’t work like that. It’s a long process of the brain learning how to decipher the sounds.

On the third mapping day, I had a bad morning hearing many unpleasant sounds. However, the day before I had a very positive singing lesson. My teacher said she could definitely hear a difference and felt I was actually distinguishing between half notes. Her feedback encouraged me enormously.

The mapping went well, changes were made and I noticed a definite improvement. I felt I was really on the way even though things went up and down on a daily basis. I was told by my audiologist that my implanted ear would eventually become my dominant ear and the other one would act as a support. I had never dreamed of that happening.

I persevered with the various suggested exercises, including reading aloud. I also used my excellent Sennheiser headphones on the cochlear ear, blocking out the other side as best I could and listening hard for comprehension.

I was fortunate to have an extra mapping just before a choral event I was due to take part in. My audiologists made some adjustments to my processor and I hoped it would make participation in the music events enjoyable. And so it was. The choral festival was pleasant and I felt I could participate to a point.

However, after another mapping session and some more adjustments, I hit a low point. I felt despondent that Liz Efinger with Assoc Prof Catherine Birmanprogression had stopped. I am now five days since that last session, which I felt went well – a number of changes were made and I started to feel more upbeat about my imminent trip – a bridge holiday to Europe and a cruise across the Atlantic, via Iceland to New York.

I know there will be difficulties as I am aware I still have a long way to go. There will be ups and downs and the hearing via the cochlear is still weird but on occasions when I might hear a person standing on my cochlear side actually speaking, or when I block my ‘good’ ear and listen hard to speech on the television or radio, and I can almost understand the speech – well – I call these my ‘WOW’ moments!

Originally published in HearingHQ magazine Dec 2015