Vim & Vigor - Spring 2018 - University of Virginia - 50

hen Kate Berger arrived
in Chatham, Virginia,
for work, the streets
were empty. She saw
no pedestrians, no cars driving by.
The town was on lockdown because of
a tornado warning, but Berger hadn't
heard the radio alert.
Berger had become a master at compensating for her hearing loss. Yet situations like these made her realize just
how serious her condition had become.
"My hearing loss was impacting my
safety and my quality of life," says
63-year-old Berger. "I would come
home exhausted because I had to read
lips all day long. All I wanted to do was
tune out."
Berger's impairment was also jeopardizing her successful career. She had to
use a device on the computer to make
phone calls to constituents during her
term as Pittsylvania County supervisor.
If one of her colleagues called her by
name without tapping her on the shoulder, she would walk right by. And when
she turned her back to her math class at
Danville Community College, she could
not hear if one of her students asked
a question.

SLOW FADE

Hearing aids were an effective solution
for Berger for many years. She got her
first pair at age 26 when she was pregnant with her first child. By the time
her second son was born just a couple
of years later, her hearing loss had
doubled, from a 25 percent loss to a
50 percent loss.
"My doctors weren't sure of the exact
cause; I had no family history," she
says. Berger was referred to the famed
House Ear Institute in California, where
Howard House, MD, determined otosclerosis had caused her hearing loss.
The condition causes abnormal bone
growth in the ear and is especially

SP RIN G 2 0 1 8

common among Caucasian women, who,
for reasons unknown, often experience
rapid hearing loss during pregnancy.
Dr. House prescribed sodium fluoride
supplements, which stalled Berger's
hearing loss temporarily. But over time,
the side effects became unbearable, so
she stopped the treatment.

HEAR HERE

By 2011, Berger was using the strongest
hearing aids available, but they were
not strong enough to allow her to hear
clearly. A referral to UVA Health System
to treat a stubborn ear infection led her
to the solution she was looking for.
"I'd heard about cochlear implants
in the past, but I just thought, 'Maybe
someday. I hope I don't get that bad,'"
says Berger. After testing her hearing,
UVA otologist/neurotologist and surgeon Bradley Kesser, MD, determined
that an implant was a good option. "At
that point, I couldn't understand any
words without lip reading," says Berger.
UVA began offering cochlear implants
when the devices were introduced in the
1980s. Since then, the technology has
advanced significantly.
"When the device first came out,
the sound quality was poor," says UVA
clinical audiologist Amber Kiser, PhD.
"Wearers couldn't discern between
music and voices. But now implants
allow many patients to listen to music
or talk on the phone, so they can interact seamlessly with others. Newer
devices even have Bluetooth technology, so patients can transmit sounds
wirelessly from their phones directly to
their implant."

JOYFUL NOISE

Berger received her first cochlear
implant in her right ear in 2011, followed by the second in 2017. "Patients
can do well with one implant," says
Kiser. "But speech quality and the

ability to localize sound-determine
where it's coming from-improve
with two."
The surgery to implant the receiver
into the middle ear is a two- to threehour outpatient procedure that is
done under general anesthesia. Once
the incision heals-about four weeks
later-audiologists attach a processor
outside of the skull using a magnet. "I
had read that it takes time for the brain
to process how to interpret this new
sound," says Berger. "When Amber put
on the [processor] for the first time,
her voice sounded like a combination
of Darth Vader and Mickey Mouse. But
I realized that I was understanding
the words."
Berger returned to UVA multiple
times in the months after her implant
surgery to program the processing
device as her hearing changed. "I progressed faster than most because I wore
my implants all day, every day," she
says. "Now voices sound more natural.
I can hear the radio, birds on the golf
course and I can enjoy music again and
use a regular phone; some people don't
get to that point."
With the second implant, Berger says
the process went even faster and her ability to communicate has improved greatly.
"It's made a tremendous difference,"
she says. "I am able to monitor my voice
level, and my speech is better, too."
Berger has been using her newfound
voice to spread the word about the benefits of cochlear implants. "Kate is a
very giving person and has discussed
her life's journey-to hear, not to hear,
and then to hear again-to our first-year
medical students at UVA for the last six
years," says Dr. Kesser.
"People stop me regularly to ask me
about my implant, and I'm happy to tell
them about my experience," says Berger.
"If I can help one other person hear better, it's worth it." ■

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