Nairobi Cochlear Implant Mapping Appointment

I had a CI appointment scheduled at Kenya’s new CI center that set up last fall. I think the next nearest CI centers are in Greece and South Africa. I started my PC journey thinking I wouldn’t get a chance to visit a CI center for two years since there wasn’t a CI center in Kenya when I first arrived.

I am comfortable with where my left CI is currently at (implanted in 2009) but have had issues with the right CI (implanted in 2011). There are times when the right CI sounds so quiet that I’m not even sure if it’s on.

There wasn’t a sign language interpreter scheduled for the appointment as expected. Peace Corps did suggest at a last minute notice (5 minutes before I was to leave for the appointment) that one of their staff who knows KSL could go with me.

The CI center had said they would just communicate with me through writing. I was not fully comfortable communicating through a staff interpreter who I had never used, who had never heard of CIs, and would have to use KSL (not my first language). I fully appreciated their offer and may take them upon that if I have an appointment for another reason but when presented with two options of communication…

1) KSL
2) Written English

I am going to pick written English over KSL every single time simply because KSL is not my first language. In fact I would pick written English over ASL because ASL is not my first language either (SEE2 is).

The audiologist was nice and was willing to write back and forth with me at first. As the appointment went on the focus shifted from giving me the best MAP to why I didn’t use my speech and her attempting to communicate with me orally and not writing.  She seemed more concerned about my speech than programming my CIs.

The MAP process was…….interesting…… This is a new center, they do not have many patients, and the audiologist wasn’t very experienced.

Basically, the CI MAP process takes quite a bit of time. The audiologist checks each electrode (I have 22) one at a time or in small groups. The audiologist asks you to tell her/him when you first hear the beep (this takes focus because they start at extremely quiet volumes) then they continue to increase the volume until it’s at a comfortable loud level.  This is done for each electrode, one at a time.

Then the audiologist asks you to listen to two different sounds at a time and ask if the volume sounds the same. This is tricky too because you have to focus on the actual volume even though the pitch may be different. This is usually done around 5-10 times with different pitches.

The process is repeated for the second CI. Then sometimes they take additional steps to make sure both CIs are balanced and “working together.”

The audiologist started off with making my whole left CI MAP louder instead of checking the electrodes individually which caused the painful stimulation in my neck that I’ve had issues with. I then told the audiologist to just leave my original program on and that I was more concerned about the right CI than the left CI.

The audiologist then chose 2 or 3 electrodes at TOTAL RANDOM and selected maximum levels at TOTAL RANDOM.

This was just too of an inexperienced process and it all seemed so random without me giving any direct feedback…..I became so nervous with this process that I cut the appointment short and made sure both of the original programs were still on my processors.

I….am concerned about how the mapping process has been done for the other patients at this CI center. The audiologist was friendly and I think she wanted the best for me but just did not know what she was doing at all.