Continuing Advocacy for Patients with Hearing Loss

鈥淎s I began to speak and heard my own voice, it was as if clouds were parting. Similar to when you鈥檙e on an airplane and start the descent to landing. You鈥檙e surrounded by clouds and then suddenly you catch glimpses of land between the cloudsLike experiencing something very familiar but not knowing what it was. When I realized the 鈥榝amiliar鈥 was to hear actual words, it was beyond exciting. It was a revelation.鈥

That鈥檚 how Toni Iacolucci,describes having her hearing restored after a successful cochlear implant procedure. She鈥檇 not heard a single word in 15 years--including the sound of her son鈥檚 songwriting and drumming.听

Although听changes听in her hearing听became听noticeable听in her early 20s,听Toni realizes听she probably began to change her behavior to accommodate the听hearing听loss as a child.

Dealing with her own hearing loss

鈥淲henever I was with more than one person, I would 鈥榖ack out鈥 or stay on the periphery of conversations,鈥澨she听recalls. 鈥淚 also wanted to have one best friend, not two or three.鈥

When听Toni听got older,听her听friends began to notice she wasn鈥檛 hearing them.

鈥淒ue to the fear and stigma of hearing loss, I was unable to admit I couldn鈥檛 hear,鈥 she says.

Toni spent much of her 20s searching for听a听specialist who might help 鈥渃ure鈥 her hearing loss.听Denial of her hearing loss was no longer an option and Toni realized she needed to get a hearing aid.

鈥淚 was fitted for the device and given no information that would help me to understand and live with my hearing loss,鈥 Toni says.

She spent hours running and listening to music, and one day couldn鈥檛 hear music from her right ear. She thought the headset might be broken and reversed it. Nothing.

鈥淎ll of a sudden, fear hit me鈥.I realized I had completely lost the hearing in my right ear,鈥 Toni says. 鈥淭errified, I took a cab to the hospital and was given a CT scan.鈥

The scan didn鈥檛 show abnormalities, and Toni wasn鈥檛 shown her medical record, which indicated that she should be evaluated with an MRI to see if she was suffering from an听, a type of non-cancerous听tumor that arises from a cranial nerve connecting the ear to the brain. These slow-growing tumors can cause symptoms, including hearing loss, as they progress.

That loss worsened in Toni鈥檚 left ear when she听wanted听to hear her then-teenage son, Gian, perform in a school music program. She didn鈥檛 wear ear protection in her left ear so she could hear as much of his performance as possible.听Although the cause of Toni鈥檚 sudden deafness is not known, over the course of the following week, she lost what was left of her hearing in her left ear.听听

She made an appointment with an听audiologist听and was immediately hospitalized for one week, and was given steroids to try to restore some of her hearing.

鈥淚t did not work,鈥 Toni says.听I left the hospital trying to fathom my new life as someone who was profoundly deaf.鈥

Then came news from two audiologists and two cochlear implant surgeons, who told Toni that she was no longer a candidate for their services.听

鈥淢y auditory nerve had been compromised by the tumor [finally discovered in 2002], and my tumor would have to be monitored,鈥 Toni听says. In addition, the technology at the time would not allow MRI鈥檚 for people who had cochlear implants.

She lived in silence for five years, until a friend听finally听advised Toni to use a powerful hearing aid so she might have some hearing in her left ear. Toni set aside her skepticism and scheduled an appointment with Joseph Montano, Ed.D., Professor of Audiology in Clinical Otolaryngology at WCM, whom she鈥檇 met through her membership and work with the听听(HLAA), the nationa鈥檚 leading听organization that serves as a support network for people with hearing loss.

鈥淚 knew听Dr. Montano听was very supportive of his patients and willing to try anything that might work,鈥 Toni says. 鈥淗e cautioned me that the results might be minimal at best. I appreciated his honesty and received a new hearing aid two weeks later. As it turned out, the hearing aid was life-changing for me.鈥

Though unable to discern words, Toni no longer felt like she was living in a soundproof booth. And, although Toni gave up her career in social work because of her hearing loss,听she听became an inspiring advocate for people with hearing loss.

Advocating for others with hearing loss

鈥淢y current work is completely focused on advancing effective communication in medical settings for people with hearing loss,鈥 Toni says.

She speaks with hospital staff and administrators to boost awareness about hearing loss; advises hospitals on changes they can adopt to promote communication with patients with hearing loss; and participates in focus groups to offer data that supports changing policies and procedures to support people with hearing loss.

Toni also highlights her own personal experience with access.听听In January 2021, Toni successfully underwent cochlear implantation, led by Dr. George听Alexiades; this is a surgical procedure where small electrodes are placed in the inner ear and a device is worn on the ear or head that allows a patient to hear.听听After explaining her need for accommodation for her cochlear implant surgery and making the request for it, the care team at NYP/WCM provided听听听(CART).听 This enabled her to understand and accurately respond to the many questions asked by the nurse and anesthesiologist during her pre-surgery experience.听

With the COVID-19 pandemic in full swing,听Toni knew she鈥檇 be without her son in the hospital when she awoke from her surgery. She didn鈥檛 know, however, that a WCM nurse would be sitting at the foot of her bed, typing on a laptop. Toni recalls feeling 鈥渁 sense of dread,鈥 knowing she鈥檇 have to try to understand the nurse鈥檚 questions.

The nurse turned the laptop around so I could see the screen,听and in the largest, boldest, most readable fonts, it said, 鈥楬ello, Toni, how are you feeling?鈥 I can鈥檛 tell you what a life-changing experience this was for me,鈥 Toni says. 鈥淩eceiving accommodation is often a struggle听and certainly a relief when provided, but this was the first time a hospital had anticipated my communications needs and provided access听without听a request.鈥

The nurse continued to type questions for Toni throughout her recovery.听Previously she would have had to rely on her son Gian to repeat everything, as she was used to speechreading him. The accommodations enabled Toni to understand the questions听accurately; preventing any miscommunications that could lead to further complications.

The cochlear implant activation process, three weeks later, was nearly 3 hours long and very involved; It was somewhat tedious as her and听WCM audiologist听Haley Bruce,听Au.D., CCC-A.听worked through adjustments, hearing lots of beeps, as well as understanding and responding to questions.

Finally, the moment came when Toni鈥檚 implant was activated; it was extremely emotional and celebratory for her and her son. By the time the activation was completed and all of the instructional guidance was reviewed, Toni was completely exhausted. Having CART access was essential and important during this activation because if Toni had to rely on speechreading alone, it would have been very difficult听for her to be听able听to understand the process accurately.

Regaining her own hearing

Now Toni is embarking on her new chapter.

鈥淚鈥檓 still feeling a range of emotions,鈥 she says. 鈥淚鈥檓 sometimes fearful I鈥檒l be plunged back into deafness. I never realized how much deafness had impacted my life until I began to pull away from it.鈥

And, as Toni continues her advocacy for patients with hearing loss鈥攁dvocating for the use of transparent masks when possible, to allow speechreading, pocket talkers (a type of assisted listening听device),听and CART鈥擳oni feels both the pang of survivor鈥檚 guilt about having regained her hearing, and optimism about the future.

She adds: 鈥淚 believe that this will evolve into my being even more passionate and active in my advocacy efforts.鈥