A Bigger World

From: Iowa Falls Times Citizen - Iowa Falls,IA,USA - Oct 13, 2004

By:LaDona Roelfs , News Reporter

IOWA FALLS-The older she got, the smaller her world became. She couldn't hear music, she had trouble talking on the phone; she couldn't even hear the microwave beep. She became more introverted, more self-conscious of her impairment.

During her early teenage years, Denise Retleff was gradually losing her hearing and doctors and audiologists didn't know why. By age 28, she was considered "legally deaf." She tried but the hearing loss was degenerative, hearing aids were not successful.

Life was a challenge for Retleff. She was working and trying to raise two children, Nicole and Bryce, now 16 and 22 respectively.

"At age 4, Nicole already knew she had to take mommy's face and turn it toward her to be heard," Retleff remembered.

Retleff's job working on the line at Boyt grew increasingly difficult as conversations became almost impossible. She looks back at that time in her life and sees how withdrawn and isolated she had become.

"I was embarrassed at having to ask people to repeat things two or three times, so I just avoided conversations," she said. "I was introverted and people thought I was just shy. It was very frustrating."

The first step In 1991, a television news program about a newly developed cochlear implant triggered an interest and prompted Retleff to seek more information. An audiologist in Mason City referred her to an Iowa City specialist to look into the possibility of such a solution.

Certain criteria have to be met for the surgery as an implant is not appropriate for everyone. Each individual comes into the process with his or her own personal biological history that influences the success, or not, of an implant. For example, the age when the hearing loss began, how long had there been a total loss, current age and the status of the inner ear and the hearing nerve. All of this, as well overall good health, is a necessity.

A hearing ear The visible outer portion and ear canal funnel sound inward. From there, in the middle ear, the eardrum and three tiny bones vibrate from sound waves. Within the inner ear, the fluid-filled cochlea contains thousands of tiny sound receptors called hair cells. The hair cells sway with sound waves in the fluid-filled space. Thousands of little nerve pathways transmit sound information from the hair cells up to the hearing center of the brain.

The hair cells in Retleff's cochlea had for some reason died and were not able to transmit the sounds.

Hearing with an implant The cochlear implant provides a new mechanism for hearing when a hearing aid is not enough. It is the only medical technology able to functionally restore a human sense - hearing. Unlike a hearing aid that amplifies sound to make it loud enough for an impaired ear, a cochlear implant bypasses the damaged part and sends sound signals right to the auditory nerve.

In 1992 Retleff received her first cochlear implant. Even though it only restored hearing in one ear, it was a success.

The cost was a major factor in the process. "There was a lot of red tape, but I ended up getting a government grant," she said. "I had to agree to testing for clinical trials and reporting for quite a while. But it was worth it."

"I changed after I got the implant. I wanted to do more with my life," she said. "I didn't want to work on a line somewhere all my life. I had been a nurse aid, then went to Ellsworth and became an LPN in 2000 and worked at Franklin General Hospital." Continuing her training at Iowa Central, Retleff received an RN degree, and in April passed her state boards. Today this "new" Retleff just started a position as a skilled rehab nurse at Mary Greeley Medical Center in Ames.

Little things changed. "One time after I had my first surgery, Bryce was playing a video game and I asked him to turn it down," Retleff said, smiling. "He looked at me in surprise and laughed, commenting that was the first time I'd ever said anything like that to him."

Speech improved. Because her hearing did not totally fail until she was an adult, there was a "hearing memory" which made speech easier. Retleff did not have to completely relearn how to talk. "But my friends and family admitted that before my first surgery my speech had become progressively more difficult to understand," she said.

The final step Because the implant for her left ear was so successful, Retleff was eager to have the right ear also hearing. "I could hear so much better (with the first), but it was not balanced hearing yet," she said. "I had said if I could get one done, I'd get a second one in a heartbeat. But it was really cost prohibitive, $50,000," Retleff said. When she discovered her insurance would cover the cost, the second cochlear implant was scheduled for July 23, 2004.

The 12 years between the first and the second surgeries made a big difference in the technology of the processor and implant. The first processor is more like a small pager that Denise wears on her belt. Wires are attached from it to a transmitter behind the ear where it is magnetically attached to the implant. The second one is complete in the transmitter unit attached to the back of her ear, and covered by her hair which she is anxious to have grow after the recent surgery.

On Aug. 18, following four weeks of healing, the electrodes for the new processor were activated and she could hear ... fully and wonderfully.

"Music is fantastic! I feel like I am much more socially minded now. I am not nearly as shy, getting more confidence in myself," she said. "It was like waking up an old friend when that second ear could hear. It had probably been 25 years since I could hear from that ear. It doesn't just come back the minute the implant is done. It's a process of improvement every day. The sound is enhanced all the time. At first the birds were just noises, then one day the 'noise' was a song - and it was wonderful."

©Iowa Falls Times-Citizen 2004