Cochlear implants help Westminster resident hear again

Phyllis Shotwell was watching TV when she sneezed three times.

Then the world went silent.

She screamed. She didn't know what was happening: Was she having a stroke? Why couldn't she hear?

The otherwise healthy 88-year-old woman had grown used to only hearing out of her right ear for the majority of her life. It was OK, because she could get along just fine with one working ear (and for her, this meant she could still hear her "boys," the Orioles, play ball). But seeing mouths move yet hearing nothing, that was new.

At Greater Baltimore Medical Center in Towson Oct. 2, the Westminster resident held a lengthy conversation with her niece and audiologist without having to read their handwritten words off a whiteboard. That's because in January she had an electronic device implanted behind her ear that lets her hear - and better than she has in years.

The U.S. Food and Drug Administration approved cochlear implants for adults in 1985 and for children in 1990, according to the American Speech-Language-Hearing Association.

Yet, a large portion of people who would qualify for the surgery don't know about it, according to Regina Presley, an audiologist at GBMC. Infants, seniors and all ages in between with moderate or profound hearing loss could be eligible for the surgery, she said.

Most children who receive implants are aged 2- to 6-years old. Receiving the device early helps children hear and absorb the speech and language skills their sponge-like brains would ordinarily pick up during this developmental stage, according to the National Institute on Deafness and Other Communication Disorders.

The first cochlear implant was designed in the 1970s and was mainly used to better facilitate lip reading, according to Matt Goupell, a Department of Hearing and Speech Sciences assistant professor at the University of Maryland, College Park. They provided some perception of sound, he said, but they couldn't transmit enough for a user to decode actual speech.

In the early 1990s, cochlear implant researchers found a way to encode sound with the implant's electrical pulses, which drastically improved the device, he said.

"Since then, there's been some incremental increases, and there's been lots of changes just with technology and the implants getting smaller," Goupell said. "They're more robust. They don't fail as often. Things are moving forward, but the last big revolutionary step was '91, in my opinion."

About 219,000 people worldwide have received cochlear implants as of December 2010, according to the U.S. Food and Drug Administration. About 42,600 adults and 28,400 children in the United States have undergone the surgery. GBMC implants this device in about five to 10 Carroll County residents per year, Presley said.

Shotwell's decision to receive a cochlear implant was a family affair. She watched videos with captions about the device. Her family researched and researched.

"The ultimate decision was hers," said her niece, Marcia Barth. "We would support her with whatever decision she chose."

In January, a device that is essentially a micro-computer with two wire tails was inserted into the back of her ear; it's the receiver/stimulator, according to the University of Miami School of Medicine's Cochlear Implant Center. It's a magnet that attaches to a magnetized hearing aid-looking device that's hooked around the ear's exterior.

The external device translates sounds into signals that are sent to the internal device. It has a micro-computer called a sound processor, a microphone, magnet and a battery, according to the Cochlear Implant Center's website.

For about a month, the swollen area around the incision is given time to heal before the device is activated. It's a month of worry. It's a month of suspense.

On Feb. 23, Shotwell calmly sat in an office at GBMC with Barth.

As Presley brought her back into a small office room, Shotwell said out loud, "The sun is shining; it's got to be a good day. Let's go."

The device was activated, and Presley turned to Barth.

"Say something," she said.

"Did you say something?" Shotwell replied. She'd heard sound.

The three shared a cry, one of the good ones.

Now Shotwell not only watches but listens to her Orioles on TV. She goes to bingo games. She sits at a table filled with family and follows the conversation.

Shotwell's case is one of the best, Presley said. She responded quickly to activation, most likely because she had hearing before. Her brain already knew how to interpret the sounds.

The medical center wants to get the word out that the ear-shaped device can help many hard of hearing. Now GMBC uses Shotwell as an advocacy case for cochlear implants, Presley said.

Bedecked in Orioles garb, Shotwell heard Presley say she was the prime example. And she agreed.