Cochlear Implant Surgery: Tips for Surgery and Activation

After weeks or months of googling, appointments/evaluations with audiologists, doctors and surgeons, and after weighing all the pros and cons, you’ve decided to move forward with cochlear implant (CI) surgery for your child. It’s natural to feel a mix of emotions!

In this post, you’ll get tips on preparing yourself, your child, and your family for this big milestone. I’ll share with you what I shared with a listener of the All About Audiology Podcast who messaged me on Instagram.

She wrote:

“I have all the feelings! This is for my 2 year old daughter. Any tips on what to bring to the hospital, what to expect immediately after surgery and the first 24 hours or so. Also, what to expect within the first month with all the mapping and SLP appointments. This has been in progress for about 5 months now so I feel mentally prepared for what we’re in for. Now just trying to wrap my head around the details.
I also just want to thank you for your podcast. I found it right after we decided to go the CI route and the information has been invaluable and truly a life saver for this crazy season of life.
a listener of the All About Audiology Podcast, sent in this question via instagram

My response:

Yes! It sounds like you are very prepared and aware of the journey ahead. It’s not easy to send your precious girl into surgery.

Talk to the surgeon or hospital team about the immediate wake up protocols. Most pediatric hospitals make it very comfortable for the family to be close when the child wakes up. Your child may seem “out of it” at first, maybe queasy, coughing and likely crying, just from being so tired and in an unfamiliar place.

Your hospital stay is important to plan for; make sure to bring along

comfortable pajamas that open from the front- not the kind that pull over the head
books, activity book, or stickers
a beloved water-bottle, or cup with a straw
lots of her favorite snacks
her favorite stuffed animal or blanket

Whatever she likes and will feel safe and comfort to have! Make sure to pack that for yourself as well: charger, insurance card, snacks, change of clothes.

It can actually be very anticlimactic since you will have a couple of weeks without knowing if the surgery was a “success” in fact you might not really know for several months after switch on.

“Switch On” or “Activation” of the Cochlear Implant Processor

The first mapping appointment may be very confusing, or even seem boring to your child. You won’t necessarily get a grand reaction to the sounds, like you may have seen on those viral videos. Sometimes, children just cry, or seem really uncomfortable or scared. They might not know what anyone wants from them and get frightened. Do your best to stay calm, but know that whatever your emotional response is- it’s ok! Again bring a favorite (quiet) toy, especially one that has a sensory aspect to it- something she can squeeze, pull, or stretch.

Progress may be very slow or quicker depending on lots of factors unique to your daughter. At first, the biggest priority is keeping the device on her head for as long as possible. In the beginning, you can start out with 20 minute bursts and slowly build up to at least 8-12 hours per day. We like to use the expression “all waking hours” when we talk about how long the CIs should be on and working.

Your audiologist will walk you through all the steps of caring for and maintaining the devices, including batteries and cleaning. Make sure to leave the appointment knowing how get the device on your child’s ears properly. My favorite tip is to take a photo or even a short video on your phone. This way you’ll have it to refer back to if you can’t remember, and you can share it with other caregivers, family members, teachers, or day-care staff so everyone is on the same page.

Getting the implant is an essential first step, but there’s more to learning to listen than simply having the devices on. It’s important to provide many opportunities for listening and engagement. You can’t rely only on “incidental learning” or them “picking it up”. Formal and consistent auditory input is needed as well, so working with a speech-language pathologist who has experience with children who have CIs is crucial.

Get ready for lots of singing, reading together, and narrating life!

Have you heard the episode with Valli Gideons? She talks a lot about her way of narrating life with her two children who are cochlear implant users. You may also find the episode about Auditory Verbal Therapy interesting.

Remember that your daughter is so much more than this surgery, or this device. It is a very big part of your lives, and a big decision you’ve made. Remember the hugs and kisses, the bruises and the artwork too. Breathe in and out every time you feel the pressure rising.

You can always reach out to me with any questions.

Sending you warm wishes for good health and lots of support along your journey,