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Photograph by Skye Dunlap
Hear, Hear: In three months time, Cindy Butler could recover 70 percent of her hearing.
Sounds and Sensibility
A cochlear implant is helping Cindy Butler learn to hear again
By Jessica Lyons
Cindy Butler, a determined business-woman with curly brown hair, smiling eyes and a ski-jump nose, throws up her hands in anticipation, her mouth open and eyebrows raised. Her smile's hopeful, but nervous. It's a sunny Friday morning, and Butler's hoping that today she will get her hearing back again.
About a month ago, Butler, 43, underwent surgery at O'Connor Hospital. The surgeon implanted a tiny computer and a magnet under the skin above her left ear and inserted a stringy electrode array into her inner ear.
She's the first San Josean to receive a cochlear implant, and one of about 28,000 people worldwide. Today, the implant will be turned on and Butler can't help but have high expectations.
Butler will receive a microphone headpiece that magnetically attaches to the implant, and a speech processor, a pocket-sized microcomputer that converts incoming sound into electrical codes and sends these codes to the hearing nerves in the brain.
Butler can hear loud noises, but unless she's lip-reading, the sounds are unintelligible to her. It's been that way since she was 10 years old. Deafness runs in her family--Butler's mother, sister and brother all suffer from serious hearing loss. All began wearing hearing aids at about age 5. They all read lips, however, and Butler speaks clearly. It's hard for onlookers to tell that her hearing is impaired.
"I don't want to sound like I'm deaf," Butler says. "I want to do better. I want to sound clear."
Once the implant is "opened," the first noises Butler will hear will be audio pulses of varying intensity and pitch. Husband Don; 3-year-old daughter Amy; Butler's surgeon, Jennifer Maw; a team of audiologists from the Hearing Institute; and an Advanced Bionics rep will be the first to see Cindy hear. And one lucky reporter.
"Let's party," Butler says, and the beeps start rolling.
The room falls silent except for the sound emanating from the computer monitor. At first, Butler can't hear anything, but as the pitch rises, her eyes widen and she nods her head. Clinical audiologist Philip Ives asks Butler how the volume sounds.
"I don't want to blast you," he says.
"I want to go all the way up to the edge," she responds, clapping. She never complains that the sounds are too loud.
After balancing the electrodes' sound levels, Ives turns the device back on, this time to see if Butler can hear speech. Does she want to take a break first? She doesn't. She waits expectantly, and so Ives speaks to her: "Can you hear me?" he asks. But all she can hear are loud, high-pitched beeps. She's not waiting for quite the radical transformation that I'd expected, but frustrated tears suggest she had hoped for more. "I'm just so anxious," she says.
The mood in the room has changed from joyous expectancy to somber realism. This is normal, the doctors assure her. Cindy Butler hasn't heard high frequency sounds for nearly 40 years. Her brain simply doesn't remember how to understand speech. The procedure is not a magic trick. There's no bright red switch to flip. Butler doesn't get to close her eyes and hear her husband say "I love you," although that's probably what I was expecting.
"I can hear myself beeping as I talk, but I can't understand a single word," she says about the implant. "It's so hard to explain what I'm hearing. ... I expected it to be clearer, easier. I never thought it would be this ... weird."
After three hours, voices sound slightly clearer to Butler, and she begins to cheer up.
"You're going to have to talk to me a lot," she tells her husband. "I need practice."
In three months' time, the doctors tell her, most patients reach 70 percent audio understanding without lip reading.
When I talk to Butler five days later, I can hear from the lilt in her voice that progress has been made. "I'm having way more fun now than I did five days ago when I was hooked up," she says.
Keys jangling, soda fizzing, clocks ticking, and 3-year-old Amy's and 6-year-old Michael's feet padding across the kitchen floor are all new and exciting sounds. The best part, Butler says, is that all these sounds make sense.
Understanding words remains difficult--Butler still relies on lip-reading--but she's practicing and improving daily.
Butler closes her eyes and Don says words: "popcorn," "cowboy," "apple." Then Cindy repeats what she heard. For the most part, she gets the words right.
One of her favorite sounds, however, comes from an electronic keyboard, a birthday present from Don.
"He gave it to me because I really like music, but before [the cochlear implant] when I tried to play, I couldn't differentiate between the sounds of the keyboard," Butler remembers. "All the sounds, the high notes and the low notes, were the same."
When she returned home from the Hearing Institute five days ago, worn out from the procedure, Butler took a nap. After waking, she sat down at the keyboard to play.
"I was just amazed at the crisp sound and the clarity from each key," she says. "Now I can start appreciating the sound of music."
Butler has been practicing on the keyboard ever since. She's planning to learn "Amazing Grace."
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Willow Glen, California Since 1992
