Hearing with high-tech help

From: Hagerstown Morning Herald, MD - Oct 4, 2004

by CHRIS COPLEY

chrisc@herald-mail.com

Michael Kade Fotta is a normal 3-year-old boy. He plays baseball with his dad. He plays with toy cars. He loves watching monster trucks.

But on the back of Michael Kade's head, just behind his right ear, is a small, blue disk with a cord trailing down to a harness. The electronic-looking apparatus is Michael Kade's window to the roar of big trucks and the crack of a baseball bat - to the entire world of sound.

Michael Kade is profoundly deaf. On their own, his ears cannot detect sound. But he is learning to "hear" with high-tech assistance - a cochlear implant, a device surgically placed in his inner ear that directly stimulates the nerves that brings audio signals to the brain.

Sound, then silence

"Micheal Kade was not born deaf," said Kerri Fotta. "At his first birthday, his hearing was perfect. He couldn't have been bubblier. He responded to everybody."

But within a few months, the Fottas became concerned.

"We noticed at about 14 months that you had to stomp on the floor or touch him to get his attention," said Michael Fotta.

The Fottas, of Fairplay, visited physicians in Hagers-town and Baltimore to find out a cause for their son's condition. No definitive cause was found. Michael Kade appeared healthy, except for his hearing loss.

Kerri Fotta tried to recall anything that might have affected his hearing. Was it his birth, when he was briefly deprived of oxygen? Was it the severe ear infection at about 15 months that caused green goo to ooze out his ear? Was it the days-long high fever Michael Kade suffered at 12 months?

The cause remained unknown. But the fact was that by 17 months of age, audiologists at Greater Baltimore Medical Center said the boy was profoundly deaf. The Fottas were devastated. Michael Kade was their only child.

"I thought my son's life was over," Kerri Fotta said.

Coping with deafness

The Fottas tried powerful hearing aids to help his hearing. They also began to learn American Sign Language and teach it to Michael Kade.

Michael Fotta said the hearing aids seemed to offer little or no help for his son. Sign language was fine for family communication, but Kerri Fotta fretted about Michael Kade's future. ASL is widely used among America's deaf citizens, but the Fottas wanted their son to be able to function with the benefits of hearing in modern American society.

Then the Fottas heard about cochlear implants and felt renewed hope.

Although hearing people may view implants as a way to bring a person with severe hearing loss something like "normal" hearing, James Tucker, superintendent of Maryland School for the Deaf in Frederick, Md., said implants are controversial among people who are deaf.

"There are a great variety of opinions among deaf individuals regarding pediatric cochlear implants," Tucker said via e-mail. "I for one see cochlear implants as an opportunity for a deaf individual to improve his or her hearing. I always encourage parents to do an extensive research on the benefits and risks of a cochlear implant surgery."

Since deaf people must function in the hearing culture, Tucker said most deaf people are essentially bilingual, fluent in ASL and written English.

The Fottas wanted their son to be able to blend as seamlessly as possible into modern, American (hearing) culture.

"Without the implant, he'd never be able to order at McDonald's (drive-in) or order a pizza over the phone," Kerri Fotta said. "For us, there was no question."

Surgery was 'horrible'

The cochlear implant was developed with funding from the National Institute on Deafness and other Communication Disorders. According to the NIDCD's cochlear implant Web page (at www.nidcd.nih.gov/health/hearing/coch.asp), the device does not restore normal hearing, but it provides signals that can be used to communicate. Intensive training is required to make sense of the signals.

Implants are commonly placed in children between 2 and 6, according to the NIDCD. Adults can benefit from implants, but younger children seem to respond more successfully, researchers say.

After months of preparatory work - CAT scans, health screenings, psychological tests - Michael Kade qualified for the implant. His surgery took place in September 2003 at Johns Hopkins Medical Center in Baltimore. Recovery was not smooth.

"The surgery was horrible," Kerri Fotta said. "He had some complications - his inner ear bled. Michael and I took turns sleeping at night. We didn't want to let him sleep without keeping an eye on him."

The road to hearing is still difficult for Michael Kade. For the past year, the Fottas have taken their son to Johns Hopkins Medical Center every week - sometimes several times a week - for testing or speech therapy. Twice a week, they also visit Anna Massey, a speech language pathologist with Total Rehab Care in Hagerstown.

Massey is impressed with his progress.

"He's made pretty remarkable progress for the time since the implant," Massey said. "To develop language, they need to be exposed. Now he's speaking two- and three-word utterances. That's pretty incredible."

Life is good, not perfect

Kerri Fotta acknowledged there is a downside to the implant. The exterior unit is not completely waterproof. So Michael Kade must wear a hood or carry an umbrella in the rain. And the unit comes off when the boy takes a bath.

The biggest complaint the Fottas have is with the stigma that goes with Michael Kade wearing an electronic device on his head. People stare. Little children pluck the external unit off Michael Kade's head. Sometimes the Fottas hear rude or cruel comments.

The comments sting, Kerri Fotta said. But the Fottas don't think their son is different.

"We treat him like a normal 3-year-old," Michael Fotta said.

It's not an easy life, but the Fottas are happy with their decision. They believe the cochlear implant is good.

"At Hopkins, we've had parents come up to us and ask us if it's worth it," Michael Fotta said. "You have to go through a surgery and that's pretty bad. But it's definitely worth it."

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