Carolyn Sienicki started wearing hearing aids in kindergarten. Her hearing loss “affected how I learned in the classroom, the ease of forming new friendships and relationships, and how people perceived and responded to me.”
After 40 years of “honed coping strategies and expensive new hearing aids” that were no longer doing the job, she decided to take the next step: getting cochlear implants. She received the first in November 2014 and the second last September. They changed her life. The “What Joy in Sound!” painting (left) she created and gifted to her surgeon, Michael Ruckenstein, MD, of Otorhinolaryngology, illustrates the difference that hearing has made.
The cochlea plays a key role in our ability to hear. Its delicate hair cells send neural signals to the brain via the auditory nerve. When these cells are damaged, no signals reach the brain. The cochlear implant comprises an internal electrode – which is surgically implanted in the cochlea – as well as an internal receiver and an external processor with a microphone. Sound enters the implant through the microphone and travels, via special FM sound waves, into the internal receiver which sends it to the electrode. This, in turn, stimulates the auditory nerve which sends the sound to the brain stem and then the brain.
Driving home after her first implant was activated, “I was waiting in traffic to turn and heard a tick-tick-tick sound,” Sienicki said. Having no idea what it was, she pulled off to the side of the road, thinking something must with wrong with the implant. The sound disappeared. She then signaled to get back on the road. There it was again. “I realized the car’s turn signal makes a sound!” she said.
Activating the implant doesn’t immediately lead to perfect hearing, said Hannah Kaufman, AuD, CCC-A, coordinator of HUP’s Implantable Hearing Devices Program. “The brain has forgotten how to hear normally, to tune out sounds,” she said. “Patients become overwhelmed in a noisy environment trying to separate the speaker from the background sounds.”
Relearning how to hear requires hours of work, but “along the way there have been all these little, unexpected moments when I realize I’m hearing something for the first time in my life,” Sienicki said, for example hearing the birds sing, her daughter’s breathing as she falls asleep, and food sizzling.
The idea for her painting came after the second implant. Leaving Penn, she noticed that there was not a cloud in the sky. “It mirrored how I felt, as if someone had taken a paintbrush and put the blue back for me,” she said. Picturing the cochlea as the sun, she painted two strands of 22 circles each to represent the electrode in each ear. “I put a memory of an unexpected moment in each circle. It was really hard to narrow it down to just 44.”
Now hanging in Audiology, the painting inspires other patients undergoing their own cochlear implant processes. “They recognize sounds on the painting that they too have just heard for the first time,” Kaufman said. On their first visit after activation, patients bring in a list of what they can now hear. “Most put down three or four things, but then they see the painting and they’ll tell me, ‘I hear that, too!’ It’s a sense of comradery and relatability.”
Bottom photo: Shown here with daughters Sarah (l) and Erin, and husband Jim, Carolyn Sienicki feels “my biggest joy has been hearing their joy.” Photo credit: Jennifer Starr.