Hearing, Part 3: The Cochlear Implant, cont’d

RECAP: The microphone on the earpiece picks up sound waves, and via the analog-digital-converter, translates them into a stream of 1s and 0s. This stream is first sent to the Automatic Gain Control, which increases volume of quiet sounds and decreases volume of loud sounds, and then to the Bandpass filters, which separates the signal into frequency groups. The output from these filters get processed by Allison’s MAP, which adjusts frequency levels according her individual needs and preferences.

The processor’s work is now complete and the signal is ready to be sent to the internal computer. Recall that the earpiece/processor is connected via a wire to the external headpiece, which is held in place – on Allison’s head, resting atop the internal piece – magnetically. So the processed signal is sent from the earpiece along this wire to the headpiece, at which point it needs to pass through the skin.

According to Michael Chorost, “[t] he obvious way to send information through unbroken skin is by radio waves, so the headpiece is a miniature radio transmitter, broadcasting the data to the implant using AM waves.” I mean – duh! – Obvious! Everyone knows this is possible because electricity and radio are manifestations of the same underlying force.

Okay. So the external headpiece turns signal into AM radio waves and transmits them through the skin to the internal computer. This internal computer picks up the AM radio waves and converts them back into an electrical impulse carrying digital data. (At the same time, the internal computer is sending a message, via FM radio waves, to the external headpiece saying Everything is working on this end! Which is why, when Allison takes off the headpiece, a little light starts blinking, indicating a disruption in communication.)

Wait a minute. The earpiece is run off rechargeable batteries, but how is the internal computer powered? It is powered by the radio waves. (I know all this information isn’t necessary to understanding the basics of a CI, but I just thought it was cool.) When radio waves come into contact with a wire, a flow of electricity is generated. So within the internal casing, there’s a small coil that picks up the incoming radio signal, and in doing so, creates enough electricity to run the internal computer and the electrode array.

Which brings us back to the next step in the process. The internal computer is wired to the electrode array inside of Allison’s cochlea. The electrode array it is a strip of silicone with an array of 24 tiny platinum plates, or electrodes. (An electrode is just something that conducts electricity.) The silicone strip is about 1 ½ inches long, less than a millimeter wide, and is inserted into Allison’s cochlea.

Side note 1: The electrode array is handmade by an electrician looking through a microscope. The skills involved in making them require at least three months of training and finishing two electrodes a day is considered a good pace.

Side note 2: When the array was first developed, it was too stiff and would often damage the cochlea when it was inserted. In trying to fix this problem, it was made softer, but then it wasn’t stiff enough to feed into the spiraling cochlea, and the surgeons couldn’t get it to go in. So the story goes that one day, one of the scientists involved in developing the implant was on vacation at the beach with his family. He had found a shell that was similar to the cochlea in its spiral structure, and was feeding a blade of grass into it when the solution occurred to him: the electrode array needed to be stiff at the end, like the blade of grass, but soft at the other end so as to not damage the inner ear!

So the incoming electrical impulse (having been converted from the AM radio waves) tells the internal computer to ‘fire’ the electrode in the cochlea, which stimulates the auditory nerves. The auditory nerves send the message to the brain, but this is outside the realm of the CI. (There’s nothing wrong with Allison’s auditory nerve – never has been.)

So – done and done. And done quickly – this whole process, from microphone to auditory nerves, takes ¼ of a millisecond.

Wow. Really super cool awesome shit.

Hearing Part 3: The Cochlear Implant

Nineteen days ago, Allison underwent surgery for a Cochlear Implant (CI). 

Six days ago, the implant was 'hooked up' – the computer in her head was turned on. 

To say it was a miracle would be doing a disservice to the engineers and computer scientists who developed, and are continuing to develop, the device's hardware, its software, and its underlying technology. To say it was magic would be overlooking the doctors who perfected the surgery, the first patients who willingly underwent the surgery in spite of great unknown risks, and the audiologists who continue to make it all come together. For these people – the scientists, engineers, programmers, surgeons, audiologists – the fact that my sister can hear after 38 years is not magical, not a miracle. Rather, it's the result of decades of hard work, commitment, and perseverance. Quite simply, Allison can hear because people she never knew dedicated their lives to a cause greater than themselves. So one big clap for them!

But I am getting ahead of myself. 

First, the implant:

There are three main components to the CI – A) the processor, which she wears hooked on her ear, much like a hearing aid without the ear mold; B) the external head piece, which attaches to the internal piece via a magnet; and C) the internal electronics implanted in her head, just under her skin.

How these three pieces work together is a bit more complicated, so let's start with an incoming sound and follow it to the brain.

The microphone is located on the processor, the piece that fits behind her ear, and it works kind of like an ear drum, except instead of a membrane, it's a piece of metal backed by a plastic plate. When the metal piece vibrates from the sound, it induces a charge in the plastic, a process of converting sound continuously into electricity. This electric charge, having preserved all the information of the sound, is now ready for processing. 

First stop is the analog to digital converter. Michael Chorost, author of Rebuilt, describes it like this: Imagine the incoming electric charge as a river. The converter samples, or 'dips a figurative finger' into, this river 17,000 times per second. Each time, volume and pitch are measured and converted into 1's and 0's, which is a digital representation of the sound wave. Incomes electric charge and out goes a stream of numbers.

Next comes the Automatic Gain Control subroutine (subroutine is just a computing term that means 'a set of instructions designed to perform a frequently used operation within a program'). What this does is take the enormous range of sound that occurs in the natural world and squeeze it down into a manageable format. *I will go into greater detail about this process in a later post, as explaining why a CI needs an AGC depends on an understanding of how sound works as well as how the un-impaired ear deals with it. For now, suffice it to say that the difference between very quiet sounds and very loud sounds is much, much greater than we comprehend it to be.

From the Automatic Gain Control, the signal is sent through a set of filters that separate the sound according to frequency (frequency is the vibration rate of the sound wave, which determines its pitch. That is, if the wave is vibrating slowly, we hear a low sound, and if the wave is vibrating quickly, we hear a high sound.) These are called Bandpass filters. I'm not exactly sure how many there are in Allison's implant. In 2005, when Chorost published his book (from which I take a lot of my information), his implant had sixteen different filters.  Regardless, what the filters do is separate the signal into different frequency groups, which allow the signal to be manipulated according to frequency. You can think of it like an EQ on your stereo. You can boost the lows if you want more bass (yeah, baby!), and pull the highs down if you don't like how the drummer is playing her symbols. (But please keep in mind, drummers are people too.)

Once the sound is filtered, then, it is customized according to individual needs and/or preferences. This is called a MAP, and each person's MAP is unique. According to Amy Gensler, Allison's audiologist, there are many factors that determine how a MAP is programmed. One factor is how the individual's hair cells were damaged. Going back to how the inner ear works, recall the inner and outer hair cells that line the inside of the cochlea. The hair cells at the basal end, near the middle ear, correspond to high frequency sounds and the hair cells at the apical end, the end point of the spiral basically, correspond to low frequencies. This means, of course, that how and what Allison heard (after Spinal Meningitis but before the implant) depended, in large part, on which hair cells were damaged, and how badly.  

Okay, so now that we have a processed signal, it is ready to be sent up the wire to the external head piece. 

To be continued . . ..

Hearing Part 2: Allison’s Ears

Hearing Part 2: Allison’s Ears

As I mentioned in the Prologue, Allison contracted bacterial Meningitis when she was almost four-years-old. Specifically, she had Hib Meningitis, a type of bacterial meningitis caused by Haemophilus influenzae type b.

Meningitis is an infection of the tissue or membranes (meninges) that surround the brain and spinal cord. The illness often starts with a respiratory infection, the bacteria from which then travels through the blood to the brain and spinal column. Most people survive without any lasting effects, but for others, these bacterial organisms continue on through the cerebrospinal fluid into the inner ear, usually resulting in damage to the hair cells lining the inside of the cochlea. These hair cells (explained in a previous post, “Hearing Part 1”) are a vital bridge from the outside world to the brain. They take the mechanical sound waves coming into the ear and convert them, via chemical messengers, into electrical impules that the brain can understand. 

The extent of the damage to the inner ear varies from individual to individual. For Allison, it was severe – profound hearing loss in both ears, with the hair cells in her left ear totally and completely wiped out. There was nothing to be done and a hearing aid would not help. The hair cells in her right ear, though, faired a little better. She was able to hear a little bit with a good hearing aid turned up to the loudest setting. 

In spite of this, Allison was very lucky. First of all, her language skills and vocabulary were extraordinary. Tested at four-years-old, she was speaking on the level of an average six-year-old. And second, she was really, really smart (which she still is, of course). For example, long before my parents knew she was deaf – even before she left the hospital, my mother recalls – Allison began asking only yes or no questions. Reading lips came easily to her and she quickly picked up anything and everything Lil, her first teacher, showed her.

Wearing a hearing aid in her right ear, reading lips, paying attention to body language – this was how Allison functioned for over 33 years. Then, about seven years ago, things began to change. She started having trouble understanding our mother on the phone, our mother being, basically, the only person she could really understand on a phone in the first place. She began having more and more trouble understanding strangers, and finally, she could no longer enjoy music at all. 

This change wasn’t entirely unexpected. This happens to people who lose their hearing the way she did, from Meningitis or Rubella or Measles – in their late thirties, they begin to go completely deaf.

And this is where Allison found herself until two weeks ago, when she got her cochlear implant. 

She’s been recovering, and doesn’t feel too great, but tomorrow, they power on her processor. 

They turn on her new ear. 

4 – 3 – 2 – 1 . . . and you’re on the air, Allie!

I love you, we love you, and you’re going to do great. 

Update: Post-Op Check Up

Allison had very brief appointment with Dr. Slater this afternoon. He looked in her ears and checked the incision for signs of infection.

Everything looks fine, he said.

Allison asked about her lingering nausea and headaches, the soreness in her neck.

That's normal, he said.

And what about the incision itself? What about this bump? she asked, fingering a spot just behind her right ear lobe.

He explained that in time, as the wound heals, the area surrounding the incision would smooth out. 

What about your sense of taste?

It's still off, she said. Nothing tastes the same.

It's the nerve [the cranial nerve that transmits the sense of taste to the brain]. It's is still irritated and might take a few months to calm down.

Then he had to run, he said. We weren't surprised. His waiting room was packed with people, all there to see him. It was so crowded, in fact, that when we first got there, Allison and the kids and I all had to sit on the floor.

Is this it? Are we going to see you again? Misha asked. 

There were seven of us in all, including the doctor, in a room that was most definitely not normally used as an examination room. Allison sat in an overstuffed armchair, the only chair available, while the rest of us stood. There were two low tables pushed up against the walls on either side of the chair, and they were covered in small bottles of clear liquid which seemed to be organized by the colored-coded striping on their labels. Tallulah, Finn, and Joy had become very interested in these bottles. 

Shoo! he said to the kids, affectionately swatting them away from the tables. Shoo! He turned back to Allison and Misha.

No, not if you don't need to. But you can come by anytime. He smiled. I'm always here.

We shook hands and he was on his way.

Hearing Part 1: How We Hear

  An elementary explanation of how the human ear works:

–      sound waves travel down the ear canal to a thin membrane called the eardrum; 

–      the eardrum vibrates, and these vibrations pass through the three tiny bones of the middle ear into the cochlea;

–      the tiny hair cells that line the inside of the cochlea move in accordance with these vibrations;

–      this movement stimulates the auditory nerve;

–      the auditory nerve carries the signal to the brain.

A slightly more complex explanation:

1. Catching Sound  

The part of the ear that’s responsible for catching the sounds of the outside world is called the outer ear, and it is comprised of just two things, the ear (technically called the ear lobe), and the ear canal. The ear lobe captures vibrations in the air (sound waves) and directs these vibrations down the ear canal to the eardrum, a thin membrane stretched tightly across the entrance to the middle ear.

2. Amplifying Sound  

The middle ear is a small, air-filled cavity, with the eardrum on one side and the entrance to the inner ear on the other (called the oval window). The three tiny bones of the middle ear receive the vibrations from eardrum, amplify them, and deliver them to oval window, which is on the outside of the cochlea. 

3. Converting Sound

The cochlea is the actual organ of hearing. It begins at the oval window and curves around into a shape resembling a snail shell. There are three liquid filled canals inside of the cochlea, separated from one another by thin membranes, and inside one of these canals is the Organ of Corti.

Now this is where we get to the good stuff.

The Organ of Corti contains three things: inner hair cells (hairs that move when certain wave lengths hit them), outer hair cells (which inhibit the movement of the inner hairs), and something called the basilar membrane, which transmits the fluid vibrations to these hairs. (Yes, this will be important later. It will be on the test.)

4. Sending Sound

And finally, these hairs stimulate the auditory nerve, which sends the information to the brain.

* * *

Put far more succinctly:

“When sound waves from the world outside strike the eardrum, it vibrates. These vibrations from the eardrum pass through the three bones of the middle ear and into the inner ear through the oval window. Action of the oval window causes fluids in the cochlea to create waves where they disturb the basilar membrane. Inner hairs attached to the basilar membrane convert the waves into electrical impulses that are transmitted to the brain by the auditory nerve. The hair cells are critical to hearing; it is the inner hairs that move in the Organ of Corti fluids, and translate the fluid movements to chemical messengers that can in turn be converted to electrical impulses that the brain understands.”  

–– (http://www.hearingcentral.com/howtheearworks.asp)

Other websites from which I gathered information, as of June 17, 2012

http://www.ndt-ed.org/EducationResources/HighSchool/Sound/humanear.htm

http://www.medicinenet.com/script/main/art.asp?articlekey=21685

Update: Delay of Game (Mine)

Allison is recovering according to schedule, and next week – the big hook up! Dr. Slater will check her incision on Tuesday afternoon, and then Thursday morning, the audiologist, Amy Gensler, will turn on Allison's ear! More on this soon. The delay, then, has nothing to do with Allison or the implant, but rather on my reporting of it. Last Wednesday, I sat down at a coffee shop in the Bed-Stuy neighborhood of Brooklyn and began a new post. I intended to address why Allison was the perfect candidate for a cochlear implant (CI), but found that I needed to first explain how a CI works. How a CI functions, though, is best understood in relation to how natural hearing functions (more specifically, how Allison heard after her mechanisms for hearing were damaged). But natural hearing and the workings of the inner ear cannot really be explained without a proper consideration of the nature of sound itself – in other words, how or why sound travels in waves. And what is a wave, anyway? Then I turned over a glass of green tea on my laptop. Tea spilled around the keys and drained down onto the motherboard. Fortunately, my hard drive escaped unscathed, but the computer is trashed. So as I wait for Tekserve to transfer the data from my hard drive to a new, external drive, I am busy trying to understand waves. I'll keep you posted.

The Big Day, Part 2

The surgery will take less than two hours. Joe stays at the hospital while Misha and I go get something to eat. We decide on Los Polomas, mostly because it’s close, but also because they have margaritas. We sit outside in the shade. It's only 90 degrees and feels cool compared to the 98-degree scorcher the day before. We order our drinks – frozen for her, on the rocks for me – and although I hate to see anything go to waste, I can’t finish but half of mine.

It’s been about an hour by the time we get back. Misha drops me off and leaves to run a few errands; I find Joe upstairs in the waiting room, asleep on a loveseat, Allison’s shirt bunched up under his head. When he wakes up we talk for a while, not about anything in particular. It’s nice. Given the mayhem three teenage boys and Joy manage to produce around their house, we don’t usually find ourselves in a position to just sit and talk.

Suddenly Dr. Slater is before us. He sits in his dark blue scrubs and says that everything went well. Perfect, no problems, Allison did great. She’s already in recovery. A nurse will come out and get you soon. He has his bag with him – I assume after four procedures, he’s finished for the day – so we shake hands, thank him, and bid farewell. Then we wait. Misha comes back and we tell her we spoke to Slater.


We wait. We’re anxious. A nurse finally calls out “Allison Gay?” I pick up my ‘camera bag’ with one hand – a canvas tote Allison lent me with her name embroidered on the side, in bright orange – and with the other hand, I grab the hard case carrying my three wireless microphones. Joe and I walk back to recovery, which happens to be the area just outside the curtained-off pre-op room she was in earlier. (It’s a small hospital.) Allison’s lying down, still hooked up to her IV, her head back, her eyes closed. She doesn’t look so hot. I don’t tell her this. (Okay, she looked fine, considering, but she looked like she was in a LOT of pain.) I smile and rub her feet. She can barely open her eyes. I'm reminded of a picture of myself: I’m standing in my living room, my midwife supporting me on one side, and Rob on the other – hour 33 of my labor with Tallulah.

Leaving the Hospital

I return to the waiting room to switch places with Misha. She goes back and I sit down and pull out my notebook. Before I can even get a pen in my hand, though, my mother’s walking toward me saying that it’s time for Allison to go home. Huh? She’s only been in recovery, I don’t know, 20 minutes. Misha shrugs, shakes her head, goes to get the car. I gather up my things and go back through the doors that say 'Hospital Personnel Only'. Joe and I follow the nurse who pushes Allison in a wheelchair. Misha and the car are waiting when we come outside. Allison, still delirious, reaches up to a spot on her neck just under the incision. She pulls her hand away and there’s blood on it. The nurse dabs it with gauze. Needless to say, we feel a little rushed.

At home in bed, she’s in excruciating pain. It still hurts too bad to open her eyes, and the pain medicine prescribed to her, hydrocodone, doesn’t seem to be working. Not that this is exactly surprising – no one said transforming into a cyborg would be easy. It’s just that the doctors and nurses had so much to say about the nausea. Yes, she’s nauseated, but nausea pales in comparison to feeling like your skull’s been cracked open. Should we call the hospital? Dr. Slater? Allison decides just to take another dose. Not too long after, she’s feeling a little better. She can at least open her eyes and speak.

I take the kids to buy flowers for Allison. They were worried when they first saw her come in the house and go upstairs to her room, especially since Joe was carrying her. I don’t think they knew exactly what was going on, but they certainly knew something was very, very different about the way she was acting, the way we were all acting, for that matter. And we were acting different in a wrong way, not in a happy-let’s-party way. We all reassured them that Allie is just feeling bad and needs to rest, but kids know far more than what we tell them.

At Whole Foods, the kids fight over who gets which flowers, but soon it's settled: Joy chooses white roses, Tallulah chooses red roses, and Finn picks yellow.

Recovery begins.

The Big Day, Part 1

Wednesday morning, June 6, 2012, Allison’s house: I show up at 8:30 with my kids, Finnegan and Tallulah, hoping to get some candid, informal, day-of-surgery footage. Allie’s up and dressed, as is her husband, Joe, and their 5-year-old daughter, Joy. A relatively normal morning unfolds. The three little ones stay occupied with each other as I get the camera out and plugged in. My parents arrive and begin discussing the final things that need to get taken care of before Allison goes in for surgery – a few bills to mail, some loose ends to tie up from the kids’ school year. Allie starts a new pot of coffee. Her three boys – Kyle, Hayden, and Grant – wake up and join us, one by one.

At 9:50, we head out. I ride with Allie and Joe, Misha follows in her car. The Hospital at Westlake Medical Center is on the west side of town, at the intersection of Bee Cave Road and Loop 360, which in my mind is where the hill country goes from a crawl to a full sprint. The rocky hills are covered by limestone and scraggly, shrubby live oaks – squat trees holding onto what little topsoil the flashfloods haven’t wash away.

The medical complex is extensive and sprawling, but mostly made up of clusters of low-lying, limestone buildings. It is the opposite of institutional, and looking at it from the street, you’d never guess there was anything more than dentists and physical therapists tucked into the shady recesses. We wind around until we find building L, park, and look for the entrance, which is far from obvious. On the third floor, we finally find registration, but are turned away. Allie and Joe didn’t bring their insurance card. (Many thoughts on our healthcare system could be inserted here.) Misha drives to the house to get it.

We wait in waiting room. It’s 10:20 by the time she returns and 11 by the time Allison is taken back for prep.

I get to go with Allison because I’m her sister, but also because, as I explain to the nurse, I’m shooting video for a documentary. I assure her that I’m not a filmmaker (carrying only a small, Canon dv recorder, this is not a hard thing to do). She’s still skeptical, so I promise not to get her in the frame. I shoot a little, but mostly I keep Allison company and translate when she doesn’t understand a question.

Allison in pre-o

Paper robe, open to the back; her clothes and shoes in this plastic bag; lie down in the bed. IV in and blood pressure recorded; Are you allergic to any medications? (a question she ends up being asked three or four times by the time she goes in for surgery). The nurse is in and out a few times before the anesthesiologist arrives.

The anesthesiologist arrives, introduces himself, and begins looking over her file. He asks a few questions, and then says, And it's the left ear that's receiving the implant, correct? I tell him that no, it's the right ear, and then watch him turn a poorly written R into an unquestionable R. I turn and tell Allison what just transpired, and we both smile nervously and laugh as he starts to explain all the medications Allison will get.

Anesthesiologist, Dr. Larry Armstrong

First, something to make her sleepy, given through her IV. Then the general anesthesia to knock her out, also through the IV. She’ll be intubated to help her lungs keep working, and through this tube she’ll breath a mixture of oxygen and something to help keep her asleep. During surgery, through her IV, she’ll get two medications to help with nausea as well as a narcotic for pain. Dr. Slater will also numb the area behind her right ear with a local anesthesia. Oh, one more thing. Behind your left ear you’ll get a small patch to help with nausea, the anesthesiologist says, the same thing people take for motion sickness. You can keep it on for up to three days, but when you take it off, make sure you wash your hands immediately. He laughs. Otherwise, if the medication gets in your eyes, your pupils will dilate completely and should you end up in an emergency room, they’ll think something serious is going on in your brain.

Joe comes back to meet us. It’s noon. Misha stays in the waiting room. We wait. And wait. And wait. At 12:30, Joe reminds me that her surgery was originally scheduled for 1:45 and suggests that perhaps the nurses don’t know her surgery was changed to noon. I go to the nurses’ station and ask. Dr. Slater is running a little late, one of them says. It will be twenty minutes, at least, from the time his current patient comes out.

I relay the news and Allison asks, rhetorically, Then why did we have to get here so damn early? Because they wanted you here, Joe says. 

I decide to change places with Misha so she can see Allie once more before she goes in, but by the time I get to the waiting room, I’ve already gotten a text from Joe: time to go. It’s 12:58. I tell Misha to go back to the double doors that say Hospital Personnel Only, and follow the foot print stickers on the floor. Allison will be on the left.

Dr. Patrick Slater, right before surgery

Back Story, in brief

Midsummer, 1973: my parents and sisters were living in Texarkana, Texas. Allison was three-and-a-half and Michelle was two-and-a-half. I was in utero, my parents expecting me in a few weeks. My mother, then, was very pregnant and it being July in east Texas, she was very hot. Fortunately, being a teacher at the community college, she was on summer break.

Allison had been sick for a few days with symptoms that suggested she had the flu – high fever, chills, nausea, vomiting, headache – but her sleepiness and lethargy, as well as her lack of improvement, impelled my mother to call the doctor. Bring her in to the clinic, they said, so she brought her in.

Dr. Rory – our fabulous, chain-smoking, tall pediatrician who kept his glasses perched atop his shiny bald head – listened to my mom describe Allison’s symptoms as he lay her down on the examination table. Then, in one simple but crucial move, he lifted her head. And there it was – her knees lifted as he pulled her chin to her chest. I think it may be Spinal Meningitis, he said, and he was right.

She spent ten days in the hospital and came home weak and frail. She wobbled a little when she walked, my mother noticed. And another thing, was she hearing everything okay? A week later, at an otolaryngologist in Shreveport, Louisiana, Allison’s hearing was tested and she was diagnosed with profound hearing loss. She was getting nothing from her left ear, and only a tiny bit from her right. There’s nothing you can do, they told my parents. It’s permanent. Go home and come back to see us in six months.

Oh, and my mother was still pregnant, but as she claims to this day, I would just have to wait.

My parents left Shreveport devastated, of course, but they did not take the doctor's advice. They did not sit back and do nothing. Instead they went to the Callier Center for Communication Disorders in Dallas, who suggested putting hearing aids on both ears immediately, which they did. My parents contacted The John Tracy Clinic in Los Angeles, and my mother started working with them via correspondence. Allison started going to a deaf class at the Temple Memorial Treatment Center in Texarkana, and she began working with a speech therapist. My parents contacted everyone they could think of and even considered moving to L.A.

In a stroke of good luck, though, one of my parents’ friends, a woman who knew of Allison’s situation, was in the right place at the right time. Listening to the radio one night in her lake house in Arkansas, she heard a story about Lil Blakesly, a deaf educator who had just moved to Hot Springs, 90 minutes away. She was working at nearby Henderson State University in Arkadelphia, and had established a preschool for deaf children. The friend wrote Lil’s name down and passed it along to my mother.

My mother called Lil and Lil said she’d drive down to Texarkana to meet the family. How’s Saturday? Lil asked. My mother said Saturday wasn’t good because she was having a baby. How’s Monday?

So I was born on Saturday and Lil came on Monday.

Lil was perfect. It was a miracle, my mom says. So my parents agreed to close in the garage and start a small, informal preschool for Allison, Michelle, and three other kids, and Lil agreed to commute five days a week to be their teacher.

Update

Had successful pre-op appointment w Dr. Slater at 2 pm. Everything good to go for surgery Wednesday. Don't know what time surgery will actually be, though. We don't find out until tomorrow, when they order the day's procedures.

Interview with Amy Gensler, the audiologist, isn't until 4.

Prologue

For all those who don't know what's going on . . .

Allison is having cochlear implant surgery this coming Wednesday, June 6, performed by Dr. Patrick Slater of Austin Ear Clinic. I have been documenting the process, meaning I've interviewed Allison and Mike and Pete as well as the surgeon, and I've videoed her appointments, including her audiogram. There is another appointment tomorrow, Monday, June 4, a pre-surgery check to make sure her ears are clear. I will be there and will stay after to interview Amy Gensler, the audiologist. I’ll continue on after the surgery through rehabilitation – for how long, I’m not exactly sure. I’m guessing this will depend mostly (or entirely) on Allison.

There is no exact plan for what I’ll do with the footage, but I imagine putting together a video documentary. Maybe it will end up being a simple thing, an account for posterity, part of our family’s history. On the other hand, maybe we’ll end up with something more formal, more polished. I guess we’ll see.

Regardless of how the documentary turns out, though, I will forever be grateful for the chance to be part of this monumental venture. Everyone involved has been gracious and generous, honest and kind.


Thank you.

I’m hoping I’ll be able to quickly bring everyone up to speed with the next four or five posts, and from there perhaps I can stay more current.