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Cochlear Implant – What Is It and Who Should Get One? (or Two?)

 In Podcast

Dr. Mark Syms

Dr. Mark Syms is a Neurotologist/Otologist and the Founder of the Arizona Hearing Center. He is one of the first physicians in the country to be board-certified in neurotology and is currently a national leader in hearing technology. After nearly two decades of experience treating ear problems, Dr. Syms has helped thousands of people improve their quality of life.

Dr. Syms graduated with honors from Boston College before earning his medical degree from Jefferson Medical College. He completed his fellowship training at the House Ear Clinic in Los Angeles, one of the world’s premier surgery organizations. Today, Dr. Syms frequently gives lectures on neurotology both nationally and internationally. He is also an extensively published author, a member of numerous professional organizations, and the host of his own podcast, ListenUp!

Here’s a glimpse of what you’ll learn: 

  • Dr. Mark Syms explains what a cochlear implant is
  • Common myths or objections people have about cochlear implants
  • Who is a bad candidate for a cochlear implant?
  • Who is a good candidate for a cochlear implant?
  • Why patients should study and learn more about cochlear implants

In this episode…

One way to solve the problem of hearing loss is through the use of hearing aids. Hearing aids work by amplifying or increasing the volume of sound passing through the ear. This improves the clarity of words and the sound of consonants.

However, for some people, hearing aids do not solve hearing loss—no matter how loud the sound gets. In such cases, it is advisable to seek medical help from a professional to evaluate whether or not the patient should get a cochlear implant. Cochlear implants stimulate the hearing nerves inside the ear to restore both clarity and loudness of sound.

Dr. Mark Syms, the Founder of the Arizona Hearing Center and host of ListenUp!, gets interviewed by Dr. Jeremy Weisz, the Co-founder of Rise25, about using cochlear implants to fix hearing loss. Dr. Syms starts by explaining what a cochlear implant is, and then he differentiates between a good and a bad candidate for the implant. Stay tuned.

Resources Mentioned in this episode

Sponsor for this episode…

This episode is brought to you by the Arizona Hearing Center.

The Arizona Hearing Center is a cutting-edge hearing care facility providing comprehensive, family-focused care. Approximately 36 million Americans suffer from some sort of hearing loss, more than half of whom are younger than the age of 65. That’s why the team at the Arizona Hearing Center is focused on providing the highest-quality care using innovative technologies and inclusive treatment plans. 

As the Founder of the Arizona Hearing Center, Dr. Mark Syms is passionate about helping patients effectively treat their hearing loss so that they can stay connected with their family and friends and remain independent. He knows first-hand how hearing loss can impact social connection and effective communication. By relying on three core values—empathy, education, and excellence—Dr. Syms and his team of hearing loss experts are transforming the lives of patients. 

So what are you waiting for? Stop missing out on the conversation and start improving your quality of life today!    

To learn more about the Arizona Hearing Center, visit https://www.azhear.com/ or call us at 602-307-9919. We don’t sell hearing aids—we treat your hearing loss. 

Episode Transcript

Intro  0:04  

Welcome to the Listen Up podcast where we explore hearing loss communication, connections and health.

Dr. Mark Syms  0:17  

Hi, Dr. Mark Syms here, I’m the host of the ListenUp podcast where I feature top leaders in healthcare. We have Jeremy Weisz here, from Rise25, who has done 1000s of interviews with top healthcare experts. And we flipped the script, and he’s going to be interviewing me. Before we get started, I want to give a big shout out to Dr. Art Mollen, who was a great guest, and you’ll be getting his podcast which will be out by now. You can go look at the list and listen to it. It’s a great podcast about longevity. It’s really interesting, and he was an awesome guest, I want to thank him for being on the podcast.

Jeremy Weisz  0:50  

I look forward to listening to that one. Dr. Syms, you know, longevity? I think about that a lot, because it’s really about long term health, and how do we stay healthy for a longer period of time. But before we talk about today’s topic, we’re going to be talking about a specific procedure, and explaining it because you get a lot of questions around this procedure. And frankly, you know, people should know about it if they’re, if they’re having specific types of hearing loss or other issues. So before we get into that this episode is brought to you by the Arizona Hearing Center. You know what Dr. Syms does, he helps patients to effectively treat their hearing loss so they can connect better with their family and friends. And you know, Dr. Syms, you say this all the time. It’s not about your hearing, it’s about being independent, right. And the reason I know you’re so passionate about helping patients is because you lost your brother, Robbie twice, and people can listen to that full episode of what I’m referring to. But he lost from radiation from his brain tumor, and then again, when he passed away. And d you are the ENT, you’ve performed over 10,000 ear surgeries over the past 20 years. So you can check out the Arizona Hearing Center at azhear.com. He also authored a book “Listen Up”, so you go to listenuphearing.com. Today’s topic is the sexiest topic I could think about which is cochlear implants. Okay. And first of all, what we’ll talk about, are you a candidate, how do you know if you need one, but first just talk about what is a cochlear implant.

Dr. Mark Syms  2:26  

So Jeremy, It’s good to see you. So the big thing is, is it the way you lose your hearing, you can lose two things, you can lose your ability to perceive based on volume. And you can also lose your ability to have clarity. Now sometimes people lose clarity because they get a high tone hearing loss. And they can’t hear the consonants, which are the parts of words that give the meaning. And so for those people, there are what we would call traditional hearing aids that will give you those consonants back and then your clarity is restored. But some people no matter how loud, we make it, they still don’t get clarity. And so that hearing loss comes from degeneration of the nerve endings inside of your hearing organ, those are called hair cells. Because when we look at them under a microscope, they look like hairs, right? And so, in some people, when they degenerate, no matter how loud, we make it, they still don’t understand. And so those are the people who we talk about a cochlear implant. The reason is, is a hearing aid makes things louder, drives the eardrum harder, drives the three bones a hearing harder and presented to the hearing organ louder, to then go through those receptor cells. If those receptor cells or hair cells are so broken that no matter how loud, you make it, you can’t understand hearing, it’s not gonna work for you. So what a cochlear implant does is it puts a bunch of little wires inside of the hearing organ. And it directly stimulates those hearing nerves beyond the broken receptors. And so you bypass the broken part of the system rather than a hearing aid that tries to drive through it. And when you do that, you can restore both clarity and loudness with the device. So really, it’s people who have hearing technology but still don’t have understanding. That’s basically who we’re targeting the cochlear implant.

Jeremy Weisz  4:23  

And most people think, Oh, I have hearing loss, I need you to hear it. They don’t even realize, Oh, I can get this thing called the cochlear implant that your earring is poor enough? Yes.

Dr. Mark Syms  4:33  

And so one of the things we will do is maybe you know, we’re not a hammer and everything’s a nail. We want to get the technology that fits you best. So, if the preliminary hearing examination indicates it, we’ll go ahead and do further testing to determine if your cochlear implant candidate. Got it.

Jeremy Weisz  4:51  

I’m wondering if we’ll talk about some cases and some may be good candidates for the case and maybe bad candidates for this type of technology. But What are some myths around cochlear implants or objections you get from patients?

Dr. Mark Syms  5:07  

I think the biggest objection, frankly, and it is realistic, but I’m not sure it’s a big objection is the surgery that you actually have to get surgery. So people really get worked up about that. And I kind of understand it. The surgery itself is 45 minutes to an hour. It’s outpatient surgery, you come in and out that day, the pain is controlled with ibuprofen. And so which is just Motrin, or Advil, what I would say is, yes, there’s a procedure and yes, you have to be healthy enough. But the gains of what this technology does is amazing and worth it. So, you know, one of the things is, when cochlear implants first started, you know, every one of them was a miracle. And now what I say is, it’s a miraculous technology, that’s no longer a miracle, because it happens often. And so the people you talk to say, what would you say to somebody who’s afraid of getting a surgery, they say, You’re crazy, go get it, you can hear better, you’ll reconnect, you’ll be able to hear you’ll be more social, your spouse won’t have to translate for you. You can have conversation, it brings your life back and you know us life it brings back your spouse, because they’re the ones who are answering the phone ordering at the restaurant, you know, answering the door translating for you liaising with your family, all of those things that the hearing loss causes is a problem.

Jeremy Weisz  6:25  

Yeah. I mean, the I also want someone who’s done 10,000 10s of 1000s of these, you know,

Dr. Mark Syms  6:33  

1000s of years. Yeah,

Jeremy Weisz  6:35  

yeah. Yes. Um, so are there any other objections that people have besides surgery? And it’s an outpatient procedure? Are people usually satisfied with that? Well,

Dr. Mark Syms  6:49  

yeah, I mean, what I would say is, is that I don’t know if it’s an objection, but the biggest concern that we have, and we spend a lot of time in our Cochlear Implant Center, is making sure that patients have appropriate expectations. And so making sure that the technology can do for them what they expect it to do, and that they have realistic expectations. And so, a good part of so when a patient is diagnosed or evaluated and found to be from a hearing point of view a candidate, we spend the next couple of months, educating them and counseling them and getting them up to speed to really understand what the cochlear implant can and can’t do for you. So one of the objections people will say is, well, I don’t want to. And what I always say is, is when they come in, and they say, I don’t want a cochlear implant, I would say you don’t know enough to know you want one. And you don’t know enough to say you don’t want one. And so we have an online course, where we help people and we will talk to them and take them through a process where we educate them about the cochlear implant, so they can come to a well educated, well informed decision, like, is this what I want to do? Is this what I should be pursuing?

Jeremy Weisz  8:03  

Did they come in saying that, like they’ve researched it on their own? Or is this after you’ve talked to them a little bit, um, have,

Dr. Mark Syms  8:11  

you know, oftentimes, you know, one of the things about hearing losses, sometimes it’s the patient that’s coming to the table, but oftentimes, it’s a family member, a spouse, or a child bringing an older parent in. So they’re the, you know, I always say, you know, even with other surgeries, it’s amazing, like, I’ll say, so I need to have surgery, and then somebody spouse will say, yeah, I think we get surgery, and I always go, it’s very easy for a spouse to consent. For the surgery, obviously, the patient has come to them. So they have, you know, I mean, I think saying I don’t want a cochlear implant really speaks of the mystery, right? There’s a lot of things people don’t want when they don’t understand it and don’t know about it. So our particular process really is we are educational, heavy, we want people to understand what they’re getting themselves into.

Jeremy Weisz  8:56  

So let’s walk through a good candidate and bad candidate. So let’s start with a not good candidate, called John, for instance.

Dr. Mark Syms  9:04  

So I think, you know, John, one of the things so what I will tell you is the patients we see are probably two characteristics of a non ideal cochlear implant candidate. One is somebody who doesn’t actually want to go through the process to understand what they’re getting themselves into. And so to kind of use is getting married, right, like, so that’s somebody who wants to meet somebody and get married the next day. And for some people that works out, but typically, that’s not a good indicator of a successful marriage, right? And so you want to get to know your significant other better and get engaged and go through that whole process. So you know, what you’re getting yourself into. And so if John is not willing to go through that process, that’s a problem in itself. The other thing becomes if John has unrealistic expectations, and then the third and probably the most common is we have a lot of people come in and say I want to get a coke. They’re in planning. And so the underlying question is why. And so the reason is they don’t hear well. And so what we do is what I call deconstruct their hearing, we want to see, you know, you’re hearing when you have when you’re hearing impaired you’re hearing is the sound that you’re being presented, you’re hearing technology in a hearing aid that whole process, and then your ear and then your brain. Well, believe it or not, the most common problem is people don’t have hearing aids that are working right. So one of the reasons John is not a good candidate is because his functional hearing is bad, but his hearing is good enough that he doesn’t qualify. So his problem is not that he’s not cochlear implant countering his problem is, frankly, he’s got poor hearing aids that don’t do the right work. And so one of the things we do is our processes we analyze people’s hearing aids themselves, to see that’s why one of the tests that we do to determine if your cooker implant candidate is this, we take our own hearing aids and program them appropriately to your hearing loss. Why because two out of three hearing aids walk in the door or not, then we test your two years together, we don’t test each ear singularly. Because when you function, you function with your two ears together, and you actually do better with your tears together than you do with EG, then we put you in some background noise. And then we read you a list of words, and we determine whether or not you can understand. And so some people come in doing terribly, we put our hearing aids in and they do well. So then we’ve actually located the problem is not your ears, it’s your technology. And so we are deconstructing their hearing spirit. So John’s not a bad guy. He’s just not a good cochlear implant candidate.

Jeremy Weisz  11:40  

And now the good candidate will call her Jane Doe.

Dr. Mark Syms  11:43  

Jane is the exact So getting back to the testing, you put the hearing aids and you put a little bit of background noise and you read her list of words and she does not get she gets less than 40% of those words, right. So even in an ideal hearing aid and rehabilitation, she does not have good understanding. She’s also somebody who wants to take ownership of the process herself and learn about it, figure out whether or not it’s what’s it’s going to do, what the aftercare involves, in other words, what her investment is in terms of getting to learn to hear. So the cochlear implant will present the information to your brain. And then you have to learn how to reprocess that information. So there is an investment on a patience part and an understanding of that beforehand. So I always tell people like, Look, this isn’t like, you know, you put the newest version of Windows in your brain and it boots up and it runs. I mean, there is a rehabilitative process. And you have to buy in on that if you’re going to get a cochlear implant to sit at home by yourself and not talk to anybody Now listen to anything, you’re never going to get better at it.

Jeremy Weisz  12:47  

Yeah, yeah. I love how you say deconstructing hearing loss because you’re really separating out the pieces so you can properly diagnose what the actual issue is, as opposed to just a one size fits all you have hearing loss, you should get a hearing aid, right. And so

Dr. Mark Syms  13:04  

That’s one of our big differences, right is we can give you, whatever you, we figure out what you need, not what we have, because we have everything. So it’s a lot easier when you have everything.

Jeremy Weisz  13:13  

You know, Mark, I want to

Dr. Mark Syms  13:17  

Let’s see here.

Jeremy Weisz  13:19  

I want to point people at one last question, but I want to point people towards your website, easy here.com. And check it out and check out listenuphearing.com. Last question. Dr. Syms is, is there anything else that we did not talk about? That we should mention about cochlear implants or the procedure itself?

Dr. Mark Syms  13:41  

Um, you know, I mean, what I would say is, you want to be at a place you want to get your hearing care to place, that’s an option for you. And it’s really, you know, so the way I look at it is, hey, you’re going to learn about your hearing, you’re going to learn how you’re going to hear better. If you or somebody who’s taking care of you from a hearing point of view mentions it, I think you should learn more about it. There’s a lot online, actually, there’s a chapter in the book, “Listen Up” about cochlear implants as an alternative technology. And so, you know, fundamentally, we want people to reconnect, to maintain their independence, have great vibrant social relationships and have less frustration with their family. And for many people, their employment or somebody you know, might be a color, so you don’t know if you don’t learn more about it. And so what I would tell people is there’s very little downside about having a conversation and getting more information. So it doesn’t mean you’re committed to surgery. So, you know, I always tell people just because you’re learning about a cochlear implant, this isn’t like a car like you drive it off the lot and it’s yours or you have a closing date on your house. I mean, you get a time of due diligence and that’s actually why I use the marriage analogy because you know, when you get engaged, then you get to know your your significant other better and like for quickly Your implants, your wedding days, the surgery day, and then afterwards is living with your spouse, which is the rehabilitative part that’s really matters. And so one of the things I say to patients and the surgery day is like your wedding day is a day you make a lot of big deal about but you don’t really remember very much. And because it’s a day, not a lifetime. And so this is really about that after part of being married to a cochlear implant and having a great relationship and really hearing better and functioning better.

Jeremy Weisz  15:28  

Love it. Everyone, check out azhear.com, listenuphearing.com Thanks, Dr. Syms.

Dr. Mark Syms  15:34  

Thanks, Jeremy.

Outro  15:38  

Thanks for tuning in to the Listen Up podcast. We’ll see you again next time. And be sure to click subscribe to get updates on future episodes.

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