The first thing that most people notice about my husband, Adam, is not his geeky sense of humor or even his boyish good looks but rather the small apparatus that’s implanted behind his right ear. What is often mistaken for a Bluetooth device or Cochlear implant is actually a Oticon bone anchored hearing aid, or BAHA for short.
I’m often asked what it’s like to live with a BAHA and frankly, I can’t answer that question because I’m not the one living with a hearing impairment. To offer a better understanding, I recently sat down with Adam and discussed the history behind his surgery and his thoughts on life with a BAHA. This is his story.
Adam has suffered with the health of his ears and his hearing throughout his entire life. As a child, he had multiple tube procedures to help with chronic ear infections. “By the time I was a teen, I’d probably had at least three sets of tubes,” Adam recounts.
During a routine exam in his pre-teenage years, the doctor discovered a cholesteatoma, a destructive and expanding growth that when left untreated can cause severe infections and hearing loss, in one of Adam’s ears and scheduled emergency surgery. By the time Adam reached his twenties, he’d already had nine surgeries on his ears between tubes and clearing out infections.
“At one point, I had an infection that was working its way toward my inner ear which was going to do a lot of damage. The doctors put me on antibiotics. I had a PICC line inserted in my left arm. I would literally sit in class and pull out a lunchbox with an ice pack in it, pull out my collapsible IV bag holder, and hook up an IV in the back of class for about 30 minutes to an hour. I did that three times a day for a couple of weeks.”
At 18-years-old, Adam decided to join the Navy. He failed his entrance hearing exam miserably so he couldn’t join immediately. “I had to get a hearing waiver and have one of the tubes removed from my ear before I could join the Navy. It took months to get all the paperwork filed and passed. In the meantime, I went to a technical college just to be able to stay on my dad’s health insurance.”
In August 2006, Adam finally shipped off to boot camp. About six weeks into his eight-week training, the doctors reevaluated Adam’s hearing with another test which he failed. He was given the opportunity to drop out of boot camp and return home but he refused and finished his training.
Years went by without any major health problems for Adam. Then in 2010 while he was preparing for an extended overseas deployment, Adam began experiencing pain and discharge in his ears. He went to the ER at NAS Jacksonville where he was prescribed a round of antibiotics and a mild pain reliever. Doctors told Adam to get a referral to see an ENT specialist from his command but Adam’s superiors are suspecting he has cold feet about the impending deployment and refused his requests to see a specialist.
During this deployment, Adam experienced two incidences of being in the wrong place at the wrong time that drastically altered his hearing health and left him with ringing ears for weeks. Fortunately, Adam made it back home from deployment without any other incidences but the damage to his ears had already been done. Once on land, it took Adam months to finally get the referral he needed to see a specialist. After multiple trips to various doctors, x-rays, CAT scans, and MRIs, Adam finally got answers.
“They sat me down and said you’re going to lose all of your hearing in your right ear, which was the better of the two ears at that point. That was pretty disturbing news to get when you’re 22-years-old.”
As it turns out, the infection Adam developed pre-deployment was another cholesteatoma which ultimately took over a majority of the healthy tissue in his ear leaving Adam’s hearing permanently impaired.
“If they would have listened to me and caught the cholesteatoma earlier, it would have just been a minor surgery. But between the deployment and the run-around with the doctors, it took almost a year before I was able to receive the help I needed.”
Adam was referred to Dr. Green at Jacksonville Hearing & Balance Institute where he was introduced to the bone anchored hearing aid system. A bone anchored hearing aid (BAHA) is a surgically implanted hearing aid that stimulates the cochlea by transmitting sound through bones in the skull, bypassing the outer and middle ear. The final cholesteatoma surgery would leave Adam completely deaf in his right ear. To avoid a lapse in hearing, Adam was scheduled to have the elective BAHA surgery first and once that healed, he would have the required cholesteatoma surgery. After another month of shuffling paperwork and arguing with Navy doctors, Adam finally had the forms he needed to schedule his BAHA surgery.
Adam arrived to the hospital for his BAHA surgery around 7:00 am for pre-op the day of his BAHA surgery. Doctors drilled a hole into the bony plate behind Adam’s right ear and implanted the abutment, a titanium anchor that would hold his BAHA processor. By noon, Adam was home recovering.
At the same time Adam was scheduled for surgery, he was also up for reenlistment in the Navy. “The corpsman said he wouldn’t sign my paperwork to reenlist because I wasn’t medically cleared for reenlistment. This was the same corpsman that refused to let me see a specialist before deployment.”
Adam was able to reenlist and received orders to Submarine Base Kings Bay in Georgia just over the Florida border. “I still had pending surgeries so I needed to stay in the area. I was really lucky to receive really good orders to Kings Bay.”
Once the abutment healed, Adam was fitted with the processor. “It takes about three to five tries to get the software tuned right to your hearing. They start out tuning it to the bone conduction hearing test then depending on what changes you need to make.”
Now that Adam had been fitted with the BAHA, he could finally have the surgery he needed to remove the infection. As predicted, the cholesteatoma surgery left Adam severely hearing impaired and doctors couldn’t guarantee that Adam would ever be able to hear normally again. “I couldn’t hear anything without my BAHA and even then it was a struggle because I was still tuning and getting used to the device.”
Once the cholesteatoma surgery was completely healed, Adam was scheduled for a third surgery to put tiny metal implants in his left ear to mimic the bones that were removed. This surgery helped Adam regain 25% of his hearing in his left ear.
These days Adam’s hearing is still severely impaired without the use of his BAHA, though he is able to carry on a conversation in a quiet environment without his BAHA. “I don’t hear speech normally like other people. It’s hard for me to process speech. If someone yells, ‘Adam!’ that is a loud, projected clear voice. If I can’t follow a conversation, I have to predict what they’re talking about using context clues. I also don’t have any directional hearing. Everything comes from my right side.”
But the most difficult adjustment that Adam has had to make isn’t getting used to the apparatus, it’s the questions from other people. “They warned me, especially as a young male, that the BAHA might hinder my relationships. Truth be told, it really has not affected me one bit as far as relationships are concerned. But the constant questioning from strangers has left me a little bitter.”
During the three years we’ve been together, I have never thought about Adam’s hearing impairment or BAHA has a hindrance on our relationship. But I have witnessed first hand the rude and insensitive questions from strangers. To me, asking Adam what “that thing” is on the side of his head or details about his hearing impairment is like asking a stranger how they ended up in a wheelchair or lost their limb.
As technology continues to advance, Oticon Medical continues to update the BAHA with features like Bluetooth compatibility and improved hearing capabilities. Adam continues to see doctors at Jacksonville Hearing & Balance Institute on a regular basis and will be eligible for an upgrade on his BAHA next year. His hearing is not predicted to improve any farther but he’s adjusted well to life with his BAHA.
EDIT: A couple of people have confronted me about my comments regarding Adam getting questions about his BAHA and I need to clarify myself. If someone has a general curiosity about Adam’s hearing aid, he is glad to give them a quick explanation. He is very eager to educate those who want to learn. But when an adult comes up and literally asks him “WTF/WTH is that thing on your head?” (it happens all the time!), he gets very defensive. Children have an innocent curiosity and Adam likes to tell them about his robot parts. Just be tactful and respectful with your questioning. Hope this clears things up!