Tuesday, July 27, 2010

One Month!

Just a quick post to celebrate a milestone: four weeks ago today, I started on this crazy hearing adventure of mine. Already a whole month! Where does the time go?

These weeks have been simultaneously thrilling and hard-won, eye-opening and frustrating. They've taken me through a roller coaster of emotions, discoveries, and novel experiences. But, now that the worst days are past, I feel like Dorothy in The Wizard of Oz, stepping breathlessly into a world of Technicolor. The more time I spend with the CI, the more I find it dynamic and thrilling. And the world of hearing is so new and wonderful that, without it, I indeed feel like I've stepped back into dark sepia tones. (Don't get me wrong, the silence is still reassuring; it's the hearing aid that suddenly feels disappointing, like a glass of flat soda.) I much prefer Oz to dust-bowl Kansas!

These splashes of color have already changed my life in startling, concrete ways. I've discovered the joys of driving with music blasting in the car. I'm constantly plugged into some audio device, be it an iPod or a book on tape. Subtle sounds that I never heard before, I'm now taking for granted. With surprise, I discover that listening to people's voices is really improving my lipreading. I smile more often, fascinated by the smallest of things. I seem to be becoming a freer, happier, more confident person. Already I'm wondering how introverted I really am, and how much of my personality has been shaped by circumstance. Yes, I am still the same person I was several weeks ago, yet at times I find myself almost unrecognizable.

And this is still only the beginning. I'm willing to let this ride take me where it will - bring on tomorrow!

Saturday, July 24, 2010


How odd, having a magnet stuck to my head. The researchers who developed CIs were certainly ingenious about the whole concept of electrical-signals-transmitting-sound, but I wonder if they realized how much of a pain the external processor can be.

Now, hearing aids are relatively easy: stuff the earmolds in, turn the thing on, go on your merry way. In a sense, the CI is even easier – it eliminates the hassle of getting earmolds fitted, for instance – but it's introduced a whole new set of logistical complications I’m still adjusting to. First of all, every time the external magnet sticks to its twin on my head, it completes the circuit, rocketing me from silence into full-blown sound. Sounds simple enough, but the ensuing ROAR makes for many noisy surprises. If only I could ease the magnet into place, rearrange my hair, get comfortable, and then turn it on. This, unfortunately, isn’t possible. As soon as the magnets touch, the power of Magneto takes over, and all constraints are off – brace yourself! I cope by turning the volume way down before unleashing Magneto, but sometimes this backfires and I find myself gasping like I’ve been plunged into a tub of icy water.

Once the CI has been on for a few minutes, though, I settle naturally into the thrum of the sound. It’s as if my nerves need time to get humming, to remember what all this means. That is, until the magnet falls off. Wait, why did everything go quiet all of a sudden? I’ll wonder, only to feel an unmistakable cord and object dangling against my neck. Dang. It doesn’t take much sometimes. Pulling a shirt on, straightening a stray wisp of hair, flicking my fingers so they catch on the cord anchoring the magnet to the processor. When Magneto comes unanchored, I stick it right back on, only to feel myself jolt back into the world of sound. ROAR. Sometimes I switch earhooks (from the one I use for audiobooks and music to the standard T-Mic), only to find that the volume is so loud it's making my face contort in shock. No harm done, once I shift down to quieter places, but not pleasant either.

Magneto may be all-powerful, but hold on when I'm exercising? Never! Stretching, running, biking, working outside – all of these have introduced problems, and I've concluded that CIs just weren’t designed for athletes. Headbands help keep the thing on, even if the result looks strange, a bulge on the side of my head like I'm sprouting an abnormally large goose egg. Hats and helmets don't fit too well anymore, what with that magnetic bump, but I've found ways to cope. We tailored my riding helmet to have a groove on one side, where the magnet nestles inside (although it still tends to shift around, screeching and then going suddenly quiet, when I'm on my horse). I'll have to keep working on that.

Not only Magneto insists on parting ways when times get tough - my BTE processor does, too. It's at least twice as big and heavy as my hearing aid, something which made my ear cartilage sore at first. And, since there's no earmold holding it in place, when it decides to tumble to the ground, there's no stopping it. Tilting my head to rest on my hand, bending down to pick up something, the aforementioned forms of exercise - all of these are enough to make the BTE jump ship. (Interestingly, sometimes it's only Magneto, along with headband, that keeps the whole thing from crashing on the floor.) I'm determined not to become sedentary because of these new challenges, though!

So what do I think of myself as Magneto? I admit, getting used to this new self-image has been an adjustment. I glance in the mirror and see someone who looks like she’s been plugged into a computer, silver and glinting. Literally bionic. I didn’t like the look at first – it’s more obtrusive and space-age than hearing aids – but if I can hear and function well, who really cares? Amusingly, I’ve already been asked by strangers and passersby, “Is that a cochlear implant?” They ask it with an air of fascination. No one was ever this curious about hearing aids, I suppose because they're associated with the elderly and senile. The CI, on the other hand, is cutting-edge. The conversations that arise are interesting, and I realize that I'm settling into the role of CI poster child. Who'd ever have thunk?

Tuesday, July 20, 2010

Hello, Donald

I feared this might happen. Everyone around me has turned into a duck.

Let me explain. My brain, getting better and better at processing the input from the CI, has suddenly discovered something that wasn’t there before: high-pitched sounds! The hearing loss I was born with eliminated the higher sound frequencies from my world, meaning I was always inherently biased toward low-frequency sounds. These deeper noises in the environment were always clearest to me, because they stimulated the section of the cochlea where I had the most residual sensory cells. Hence the reason I always preferred men’s voices before the CI. Higher frequencies, on the other hand, fell on the section of the cochlea’s basilar membrane where I was almost completely deaf. The only way I could perceive any kind of high-pitched noise was through artificial means: the programming on my hearing aids altered the sound to fit within the lower-frequency window in which I could hear. Now, with the CI, I’m able to hear the pure tones from the high-frequency section of the cochlea, and those high-pitched sounds are roaring – or, more accurately, squeaking – through my head for the first time.

Which means that, right now, everyone sounds like Mickey Mouse. Or Donald Duck. (I can’t endorse this description, having never heard Donald Duck before and even since the CI, but it seems hysterically accurate.) My family, friends, coworkers, strangers on the street: all their voices are cartoonish, tinny, squeaky like they’re inhaling from helium tanks. I’ve discovered that my brain, obsessive single-minded creature that it is, dwells on novelties. The lower frequencies aren’t that new, so it fixates on the higher pitches in the sound spectrum – Wait, what’s that?

A person’s voice, I tell it. Can’t you be normal?

It ignores me and says, Quack!

My days with Donald started about a week and a half ago, but have become more prevalent since. I speak and hear myself squeak – quack, quack! My house is crawling with ducks. The anchorwomen on the local news are ducks – something I noticed coming out of my room this morning, long before I saw the television. Even big, burly men speak to me with tinny quacking voices, and I struggle to keep a straight face. Admittedly, the effect fades once I turn up the CI volume and my brain becomes too stunned by sound to care whether it’s high- or low-pitched (which seems to be a line I’m treading these days).

The good news about Donald is that he shows the surprising leaps I’m taking in sound discrimination. Single-word listening exercises, as long as the sounds aren’t too closely related, have accelerated to where they’re sometimes wonderfully easy. As in, little-concentration-required, laugh-out-loud easy. This is a relief, because during the first weeks with the CI I often found myself exhausted, frustrated, and anxiously wondering if this chaos would ever make sense. I’ve never had so many consecutive stressed-out days in my life.

But at the same time, I’ve never felt so stimulated, so curious about the workings of the world.

The best news thus far: after borrowing them from a friend, I’ve started listening to the Harry Potter books on CD. This is something that I never could have done with hearing aids, and something that marks a huge step up in my abilities with the CI. Finally, I'm hearing well enough to follow speech for a sustained period of time, and these audiobooks are a great opportunity to practice. Harry and I have a long history – like many others from my generation, I was a huge fan when I was younger – and even now he still has something to teach me. I’ve heard countless accolades for Jim Dale’s Grammy Award-winning reading, and now it was time to hear it for myself. And let this deaf girl tell you, it’s quite good. I find the different voices fascinating, though at the beginning they tended to throw me off. My personal favorites are Dumbledore and Ron; Hermione is still somewhat difficult, while I find Malfoy and the Dursleys a hoot. (Of course, they all tend to sound like ducks!) The first day or two of listening required the greatest adjustment, seeing as all I’d been doing was children’s books. My brain would get tired after two pages and lose its place. Now, though, I can listen to one or two chapters at a time, without expending the same intense attention and energy. Sometimes I read ahead of the narrator’s voice, close my eyes, and just listen to the rhythm and flow of the words.

And imagine that, three weeks ago, I started with electric jolts!

Thursday, July 15, 2010

A Word is a Word

Ice cream, baseball, hotdog, toothpaste, bluebird, rainbow. All right? Go.

“Hotdog.” Hotdog.

“Baseball.” Bluebird? No, baseball? Yes!

“Toothpaste.” Toothpaste.

“Hotdog.” H – hot – yes, hotdog, again.

“Ice cream.” Ice cream!

This has been me, listening, for the last two days. And, as you see, I’m getting them right! These common auditory testing words, which I’ve seen and listened to, over and over, in more hearing tests than I can remember, are finally fitting together. While I was able to distinguish them reasonably well with hearing aids, considering how little I had to work with, the CI has allowed me to jump to a new level. For the first time in my life, I’m starting to feel confident about what I’m hearing. It’s unbelievably self-affirming. Once I’ve learned words like these, the sound flows in, and oftentimes I know what it means! Much less guesswork, uncertainty, and even embarrassment for not understanding. The words are themselves, as clear in their identity as a fork or knife on the table, though of course it takes practice to sort through and recognize the sounds.

My family has been composing and working through lists of words since my remapping on Monday. This tune-up mainly consisted of increasing the neural input for each of the electrodes, finding a new (louder) level that I found comfortable. Since my turn-on two weeks ago, I’ve made a big jump up in stimulation, and the audiologist was a little concerned that it’d be too much and I’d make myself nuts. I feel very sane, though, and already the adjustment has made a difference. Music, for the first time, is starting to sound not only likeable and rhythmic, but actually a little bit beautiful. The tinkling notes dance through my head, dynamic and more complex, less staticky depending on the song. I’ve heard new sounds like the tone that accompanies the “walk” signal across the street – I never knew what blind people experienced! (The feeling is mutual, I guess.) The windowshades in my house zip as they go up and down. Sliding doors rattle in their frames as a breeze blows through the hallway. The car bumps and rumbles across the asphalt, objects clacking in the back seat. I rubbed my hands together the other day and jumped at the light "zzzzzt" they made. Whoa.

Concerning speech, I still have a ways to go, but I’m thrilled that I’m making progress. The higher frequencies like “shhhh” and “sssss” still sound nearly like mirror twins, as do “f” and “v” and other pairs of closely related cousins. I know the theoretical differences, but have yet to integrate them into my baby ear. The lists we make are arbitrary, groups of words with the same number of syllables and – just for the heck of it – a common theme. Furniture, kitchen utensils, office supplies, animals. The words make little sense at first. With each new list, I need to take the time to learn each new word, to differentiate it from its counterparts, but once I practice it becomes clear and natural. This process of learning, I admit, has been frustrating as well as wonderful: I keep wondering if I’m going to have to learn every word, one by one, like this. (A common joke lately: I should start reading myself the dictionary.)

But it’s happening, slowly. A word is a word is a word!

Saturday, July 10, 2010

Order from Chaos

It's coming in baby steps, but with each day my hearing gets better and better. I keep marveling at the ability of the brain to adapt and rewire itself. My brain has somehow filed away an amazing number of sounds in only eleven days, and now I'm approaching a much more cohesive portrait of what the world sounds like. Still imperfect, still grainy and somewhat mechanical-sounding, but cohesive. What is essentially the staccato note of a nerve firing, over and over, is being interpreted, smoothed, and woven into a larger tapestry. I'm beginning to accept the presence of sounds new to me, and even to expect them, all while I listen for new noises. Which include: Myself chewing - and very loudly, I might add. Myself fidgeting and tapping my foot on the floor. The whir of the computer. The swish of clothes as I walk. Notes on the piano, high high low. Words suddenly fitting together as I hear them read from the storybook page. My current CI volume is maxed out, and I'm hungry for more - which is great since I fly back to CA tomorrow for a re-mapping on Monday!

This entire process is essentially order emerging from chaos. And it happens with little conscious effort on my part, besides attention and practice. It's all my brain figuring out this new stimulus, and starting to do that with poise instead of going haywire. (Now there's actually space inside my head for me to think, which is nice.) Imagine how many new synapses it must have formed since last week. And consider the fact that the 16 electrodes, or even the 120 virtual electrodes, of the implant are nothing compared to 16,000 normal auditory hair cells. If I "hear," it's all because of brain integration. I'll say it again: brains are remarkable, remarkable things!

At the same time, I keep wondering if the new connections I'm making are overriding older ones. I'm curious if that auditory cortex space that I'm learning how to use (heretofore almost useless, since I heard so little for so many years) was previously storing other information. Where would that information go? What was that part of my brain being used for? Surely it can't just have perched there, inert, for 20 years. Perhaps that's part of why CIs are harder for older congenitally deaf recipients to adapt to - the established nerve connections don't want to let go of their "free" storage space!

(The auditory cortex, highlighted here, must keep lighting up inside my skull! Check out the awesome source article, which discusses music and auditory memory, at http://www.dana.org/news/brainwork/detail.aspx?id=766.)

Of course, it's technology that makes all this possible, and once you start it's hard to go back. And, it seems, many people who are implanted never do. I had breakfast with a longtime friend earlier this week, and we discussed the decline of sign language and Deaf culture, mostly because of the advances of CIs. The Deaf community that was present several decades ago, a community which arose from the small group of people sequestered together in institutions because they could not function in the hearing world, is diminishing. With anger and resentment, surely, but still diminishing. Technology has opened up other options, and many people with hearing losses can now leave sign language behind in order to negotiate their mainstream world with success. For my part, I don't know what I would do without the high-tech advances that connect me to my world - not just CIs, but email and the Internet and Skype and smartphones. (This deserves its own post at some point.)

Anyway, when I met my friend a few days ago she asked me if, sometime in the near future, I'd prefer she stop signing to me. I was startled. Despite the roaring noise taking over my skull, I hadn't considered the possibility that sign language could be no longer necessary between us. That it could become a relic of my past. But she was right; it could happen. "No, keep signing," I told her.

Similarly, I had coffee with another longtime friend this morning. He has gradually lost his hearing over the course of his life, and was worried that with the CI I would stop signing to him. He explained that a few of his deaf and hard-of-hearing friends have taken that path, and nowadays brush sign language aside because they only want to speak. Immediately, I saw a side of the CI debate that I hadn't fully grasped before. And it provides its own chaos, its own dilemma. What happens to those without CIs who are left behind? When their communal sign language declines, they must feel abandoned, betrayed, confused. Where do they go, when they want to form relationships, but when they can communicate with fewer and fewer people, however hard they try? The worst part of being deaf is this painful isolation and limitation - which I know all too well. What happens when your world becomes even more limited, when those who used to sign no longer do?

These questions surrounding sign language are complex, but my feelings are in line with what I've written before. It doesn't have to be sound or silence. Either-or. Regardless of what happens with the CI, sign language will hold a place in my heart that spoken words cannot describe. Many of my closest and most valued relationships have been cultivated in its presence. It has shaped my perceptions and the flow of my thought. It reassures me and allows me to relax, just as I imagine someone else might feel upon hearing the native accents of his homeland. Like all languages, it has a history and a personal significance that extends beyond its practical use. However far I dive into the world of hearing, I cannot let these things go.

Even as I take delight in the brain, in sound, and in technology. Since I'm still straddling that fence, I'd best find a comfortable place to sit.

Monday, July 5, 2010

Grow, Brain, Grow

I have reverted to my childhood. Well, sort of. With each day that goes by, it becomes clearer to me that my CI ear is a baby ear, and that I must treat it accordingly. This means several things:

1. Not expecting it to sound like the natural hearing in my right ear, either in smoothness or coherence
2. Teaching it everything - and I mean everything - about the world, step by step
3. Being willing to accept and explore the surprises it discovers along the way

It's day seven, and I have made tremendous progress since the electric-shock feeling of first being turned on. I'm hearing much more, the sounds are more dynamic and complex than their initial one-dimensional jolts, and I'm having an easier time making connections between what's happening around me and what I'm hearing. However, I still have a long way to go. Environmental sounds still sound staticky and mechanical, and the sound quality with my CI is sorely lacking - though the sound quantity isn't! Being a perfectionist, and being used to my world sounding and feeling just so, this irritating robotic-noise soup is hard for me to handle.

That said, I did not expect the first weeks with my CI to be easy. Now is where the real work starts. Beginning with children's books! I checked out four books on tape from the public library last week, sat down with my sister's boom box, and proceeded to listen to them until the entire house was probably begging for me to stop. I can now practically recite Goodnight Moon by heart - not that that's an accomplishment! (It's amazing how much longer and more exciting these books seemed when I was young.) I've scoped out the territory, though: children's books on tape tend to be fraught with music, background noises, and corresponding sound effects. That's all very well for getting hearing kids excited about reading, but for me it's obnoxious and not at all helpful! Having a real live person read to me is better - now if only those pages wouldn't crackle when I turn them.

I'm hoping to progress to beginning chapter books and novels - actual novels! - soon, but it depends on how quickly my brain grows those nerve connections. To boost the expansion of my auditory cortex, I've been working on a variety of other exercises. I recruit unsuspecting family members and have them read three or four words to me at random while I try and piece together how on earth the noises emitting from their throats are connected. It's easiest to start with words with different syllable numbers - for instance, banana and corn - but I've been able to progress to a set of, say, four one-syllable words. Harder even is words that have very similar sounds, or words that only differ by a single phoneme. Advanced Bionics has a downloadable computer module, as well, that has similar exercises in flashcard form. I sit in my room for hours at a time, listening to the computer say "shoe" over and over again. (Most discouraging was the realization that, while I'm currently only getting 3 out of 5 correct answers with my CI, my score with my right hearing aid alone is a perfect 5/5! Although I guess I do have 20 more years of practice with that ear...)

The sounds are not at all like what I hear with hearing aids. They're louder and more distinctive, and I hear more of them, but as of now they make no sense. Only my knowledge of phonetics, gained from 18 years of speech therapy and even an introductory linguistics class in college, has allowed me to make any kind of progress. I guess by process of deduction: the noise at the end of that word was especially sharp and explosive, so it must be a stop. Or, that was a high-frequency buzz, so it's some kind of fricative or sibilant. It's a taxing intellectual process. I have no idea how other congenitally deaf people could handle it without a prior history of speech therapy. Astonishingly, though, I've discovered that I'm now hearing all of the sounds in a word, sharp and individual, whereas before I only heard some of them - and often left off sounds at the end of a word as a result. The CI is giving me all of the pieces, as fragmented as they currently are. The problem is putting those pieces together into a whole.

Other exercises I've done: distinguishing between higher and lower notes on the piano, which I find surprisingly easy. Listening for the doorbell versus a knock at the front door - something which drives both my dogs insane! Distinguishing between male and female voices. Contrary to before my CI, I now find that female voices sound clearer and more intelligible (I've always preferred those deep bass male voices, having very little residual high-frequency hearing). Listening to even more music. The vocals and other instruments are coming through now, wheezy and staticky, not just the beat. Listening to two minimal-pair words and distinguishing whether they're the same or different. Taking walks or just sitting somewhere and having someone point out the various noises in the environment. (New discoveries: the clock ticking, my dog panting, water running from the faucet, myself chewing or swallowing, someone dropping something or making a noise from across the room.) My baby ear is growing!

Friday, July 2, 2010

Bang, Boom, Click

The battle of wills has started. Either I'll adjust to my CI and take off to amazing feats unknown, or it'll drive me insane. Jumping from hearing almost nothing, to pounding sound, all of the time, is a huge adjustment, to say the least.

To describe how I felt all day yesterday, and part of today: Harassed. On edge. Miserable. Overwhelmed. This cool video sums it up (might want to turn down the computer volume first):

When I turn on my CI, my entire body tenses. I'm being bombarded with noise, as jagged and unrelenting as sharp rocks or mountain peaks. What I hear no longer sounds like electric jolts or tones, more like harsh, static clicks. My skull is a metal can, and someone's shaking dice in it, playing Yahtzee. Rattle, rattle, rattle, BANG! This change is good, because it means the sound quality is slowly improving (only three days in!). But it's also bad, because I can't stand it. All day long, I'm being ground to a pulp, and the feeling of it is hideous.

I went back into the office yesterday, thinking that it'd at least be a quiet environment. Boy, was I wrong. I turned on my computer and started typing, and it was as if someone had set off an avalanche. A thousand stones tumbled off a cliff, banging and clattering down into my mind. After thirty seconds, I stopped and panted. Even the mouse made unbearably loud noises - click, click, click! I turned the scroll wheel to navigate a webpage - clickclickclickickickck! This went on all day. Whir. Click. Bang. Shhhh. Click. Roar! Utterly peeved and agitated, I would sit back in my chair to try to give myself a reprieve - and then immediately jump and tense when I heard myself exhale. Who knew my breathing was so loud? When my coworkers came in to talk to me, their voices shook my skull - boom boom boom. By the end of the day I was impossibly stressed, tensing and holding my breath so I wouldn't make a sound, inhaling before launching into another round of typing. When the phone rang, I almost leaped to unplug it and throw it out the window. I felt like vomiting, screaming, passing out, bursting into tears, or all four. Shut up!

Today has been a little better. Between yesterday afternoon and this morning, I've discovered some new sounds: birds squabbling in the trees by my front porch, cicadas buzzing in harmony, the dog next door barking incessantly. My horse is big and loud: crunching carrots by my head like a tyrannosaurus, clopping across concrete so hard I'm surprised it doesn't crack, snorting, whinnying whenever she sees me come out the door. I'm suddenly understanding her fear of flapping plastic bags. They do sound like monsters! In my house, the air conditioning is a constant buzz, and the refrigerator never stops rumbling. When I read I startle myself every time I turn a page and hear the rustle of paper. Clothes audibly slip on and off. How is it possible for that teeny little button to make a sound? Dresser drawers, doors creaking, keys rattling. It's inescapable.

But by far the highlight of my CI experience so far - music! I figured out this morning how to plug my sister's iPod into an adapter hook on my CI processor, and proceeded to rock out for the next hour and a half. I can only hear the bass and beat right now, but I could listen to it all day. Unlike the chaotic noises all around me, music is rhythmic, pleasing, and purposeful. How was I to know it was so nice? Right now, it's the only thing that I can listen to and actually enjoy. Everything else is a jumbled, nausea-inducing mess. I see more iPod days in my future, but in the meantime, I hope the other sounds clear up fast!

Thursday, July 1, 2010

Sounds, Sounds Everywhere

I'm on! My CI is activated! As I write this, my left ear is just under three days old, and I'm already realizing that the world is an unbelievably noisy place. I hardly know where to start - as I expected, my life has been turned on its head, and I'm at a loss for words. Let me back up and track the first two days, from the beginning.

Tuesday, June 29

5:10am: I jolt awake with my heart pounding, and immediately remember that today is the day. Of course, there's nothing I can do about it before the sun has risen, but that doesn't slow my pulse.

6:45am: I finally stop feigning sleep and jump out of bed. I feel relaxed and normal from my shower on through breakfast, but I'm consciously counting down the hours.

10:15am: Killing time around campus, enjoying the beautiful weather. One of my friends texts me and tells me it's the moment of truth. She thinks I should be scared to death. I'm not, though. Only curious and excited. What do I have to be afraid of?

11:00am: I arrive at the otolaryngology clinic for my first appointment of the day, a follow-up with my surgeon. He's a little late, and when I see him I have a sudden flashback to lying in a hospital bed with a gown on. Was that only two and a half weeks ago? He looks at the small pink scar behind my ear, runs his fingers over it, and tells me it's healed perfectly. Then he looks me in the eye and says, "Today will be your worst hearing day. You won't like it, it won't sound like what you expect, so don't be disappointed, okay? It'll only get better." I nod. This is what I've read from other CI patients, and I've been trying hard not to have expectations. But at the same time, I wonder what I've signed myself up for.

11:45am: Lunch. My mom and I wander around a bookstore. The hours have turned into mere minutes. I'm antsy.

1:00pm: It's time. My audiologist greets me in the waiting room and we walk back to her office. As soon as we enter, I see the Advanced Bionics box on her desk, propped open and waiting. My name is written on a sticky note on the side, and I realize that today marks my entrance into a new world. The audiologist tells me what my surgeon did two hours ago, that today will be the worst day, that I might not hear very much at first, that it won't make sense. Again I nod and say that's fine. I can tolerate whatever comes, right?

The box is chock-full of goodies. In addition to the actual hardware, there are cords, chargers, carrying cases, accessories, instructions, extras. We begin by taking the external processor out. The audiologist explains how the buttons and controls work, how it connects to the magnet and to the T-mic that curls around the top of my ear, how the heavy battery clips on at the bottom. It's very straightforward, not too unlike a hearing aid. When I take the fully-assembled behind-the-ear (BTE) into my hands, though, I realize just how big and heavy it is - probably twice as heavy as what I've been used to. The audiologist plugs the BTE into a computer, instead of a battery, and puts it on. I marvel at having something stuck to the side of my head, and wonder out loud if a refrigerator magnet would stick. The thought is ridiculously amusing.

The audiologist launches the Advanced Bionics programming software on her computer and runs a few tests. "You probably won't feel anything yet," she says - but, actually, I do. Like a sudden ping, an electric surge rushes through my body. I jump and say, "Wow, that was weird." Her eyebrows raise in surprise. Some more programming, adjusting the levels of different frequencies. I wait in silence, feeling tense. She looks at me and then presses the button on her screen.

Immediately - another electric pulse, this one stronger, running from my head all the way down to my shoulderblades. My whole body convulses in shock. I think I grip the desk and blink. "That was really weird," I say again. She smiles and nods.

We continue, testing different frequencies and trying to find a level that is neither mild nor overwhelming. Jolt, jolt, jolt. It's all the same, a universal tone - or, rather, a physical feeling. I don't know how to describe it, even two days later. It's not a sound, not a beep like I was told I might hear, though I can see why someone would label it as that. It's, quite simply, the feeling of a nerve firing in my head, over and over. I feel like someone's placed an electrode inside me and is shooting electricity through my body, the action potentials rushing down the same synapse - like a tetanus. It's not painful, just incredibly strange. I've become a giant human battery.

We finish programming my BTE at a level of "sound" that feels comfortable, then the audiologist takes it off and unplugs it from the computer. After replacing the computer plug-in with the regular battery, she hands it back to me. "Put it on," she says. My hands are fumbling; this is very different than hearing aids. I manage to wiggle the ear hook into the right place, then reach up along my head to where the internal processor should be. As soon as the magnets make contact, I feel an intense rush of electricity. It's like a shock. I jump, almost falling out of my chair, then the feeling eases, replaced by a pulse whenever there's a sound. The audiologist sits back, covers her mouth, and tells me to raise my hand whenever I hear her say something. Pulse. Pulse. Pulse. This is not sound at all - I don't know what the heck it is, but it's not what I expected. I don't know how anyone could expect this. I'm seriously weirded out.

2:20pm: Out of the clinic and walking around, officially bionic. We run an errand on campus, and when the clerk starts typing I turn my head and stare. The sound of the keys is surprisingly sharp and loud, like dice rattling inside my head. It's almost unbearable. In the car my mom turns on the radio and I realize that the CI fires along with the beat. It's the first time I've ever been so keenly interested in music. Even when we get out of the car, I find that the CI is firing all the time, and I often don't know why. I realize that, quite possibly, I'm becoming aware of sounds I've never heard before.

4:00pm: I go through the Advanced Bionics box the audiologist gave me and discover that, when I touch it, everything makes a sound. The plastic rustles - pulse, pulse, pulse! The light switch clicks - jolt! The zipper unzips. Pulse! I take a drink and hear myself swallow, the water coursing down my throat. Freaky. I walk and hear my footsteps. Sounds are everywhere!

4:50pm: We wander around the mall for a while, taking in the different sounds. I shut off my hearing aid, and with the CI none of the environmental noise makes sense. I'm still a live wire. Slowly I try to increase the volume. Whenever I do this, my head spins like it's going to burst with the power surge. I gasp like I'm coming up for air.

6:00pm: I meet some friends, and later we go out for dinner. My head is thundering with nerve impulses. It makes my eyes blurry, makes it hard to lipread.

10:30pm: Finally, I shut the CI off. By this time I'm utterly exhausted. Pulse, pulse, pulse. It never stops. Lipreading has required all of my strength and focus, which the electric jolts try to tear away, and I feel like I'm floating outside myself, in the land of the surreal. I read the CI instruction manual before bed. Never have I been so appreciative of silence. Is it possible that any of this pulsing mess will ever make sense?

Wednesday, June 30

7:30am: Showered and dressed, I pick up my CI to put it on - do I dare? Just like yesterday, when the magnets touch, I jump at the shock. When I'm combing my hair, the magnet falls off and I curse silently, then ease it back into place - zap! Will I ever get used to this? It's going to give me a permanent bad hair day.

10:00am: Time for my follow-up with the audiologist. She's impressed by the noise tolerance I've attained, and the fact that I can distinguish different sounds - even if it still just feels like electric jolts. I've also stopped feeling the sound all the way down my neck to my shoulderblades; it's localized to my head. We reprogram the BTE, and this time go way up in volume compared to yesterday. She asks me if I can distinguish between the different frequencies, but I can't. It's still the same uniform sensation of nerves firing, whether the pitch is high or low. There's no true quality of sound yet at all - only an awareness of sound being there. It's like computer code, 0 or 1. 0: no sound. 1: sound. Argh.

We test with a few different vowels and consonants, seeing if I can differentiate them. I don't do too badly for my second day, though the whole time I feel like I'm grasping at straws. I have an especially hard time making out the high-frequency speech sounds like "ssss" and "shhhh," though I'm hoping this will come soon. Despite the power of the implant, the sound quality is still much better with my hearing aid. The audiologist tells me about different exercises to do at home, and we discuss the different things I might hear, how I might progress. We're starting simple, with distinguishing three-syllable from one-syllable words. I already find this easy - just count the pulses! Ba-na-na.

12:00pm: I have lunch and see a few more friends, still trying to ignore the strange tones echoing in my head. Lipreading is still difficult, but I fare very well considering.

3:15pm: Heading to the airport in the car, I find myself needing to turn on the radio. This is not normal for me - with hearing aids, I only perceive music as garbled, annoying noise, and have always insisted, "Turn it off!" while driving. But the beat, which I can now hear and follow with my CI, is new and surprisingly appealing. I actually like it! I focus on it as hard as I can, letting it guide my thoughts. So good.

4:30pm: Airports are noisy places! I try to sit and read, but keep getting distracted by - I don't know what. Sound. I can distinguish between a voice over the intercom versus general background noise, which is something. My body already feels the physical toll, though. My head is bursting. At least I managed not to set off all of the airport security metal detectors with my hardware.

7:00pm: On layover in L.A. I hear a cascade of noises - luggage wheels clicking by, people's footsteps, the click of stiletto heels, a group of men laughing a few feet away. It's fascinating, but makes me nauseous. I keep clenching my head in my hands and wishing it would stop. Is the world never silent? I'm beginning to realize why people like music - surrounded by these constant random clashings and commotions, music is an escape, a reassurance, a pleasure. It's an auditory input that I can control. Even though I've never listened to an iPod in my life, I wish I had one now.

9:30pm: On our second flight of the day. The friendly flight attendant asks about my Advanced Bionics box, attempts to make conversation, but I'm too exhausted to lipread and don't understand more than three words. Unexpectedly he looks at me and signs, I love you! It's the only thing he knows. I grin and laugh.

11:30pm: Finally back home, and the CI is still pulsing. I feel like I'm inhaling the sound and holding it in the core of my chest. It resonates through my whole body. It drowns out my thoughts, consumes my being. All I can do, on the car ride home, is sit numbly and surrender to it.

12:15am: I turn the CI off, leaving only my right hearing aid, and heave a sigh of relief. The fog has lifted, I've returned to myself. But I immediately notice something strange. Though the CI is loud and unrelenting and exhausting, like an overbearing bull in the china shop of my mind, in comparison my hearing aid sounds flat. Disappointing. Mouse-like. Hearing without the CI, it's as though all the texture, all the liveliness of the world, has been steamrollered and squeezed out. What I hear with the hearing aid is sound compressed into a very narrow window, not allowed to sprawl out, romp, and ricochet as it would please. Though I've had more than enough of hearing for today, I almost long to turn the CI back on, if only for that startling and rich stimulation. But, when I go to bed and try to fall asleep, my head is still ringing. Pulsing. Insisting on the memory of what it's like to hear. Resisting the silence.