An ear surgeon can perform a cochlear implant in about an hour and a half. (The patient goes home the same day and has a few days of minor discomfort.) After 3 to 4 weeks—when the skin has healed—the device is activated and the patient can begin hearing.

But the initial device activation is just the first step, says Dr. Hildrew. At first, the electrical sounds a patient hears through the implant can be like listening to the “garbled sounds of Charlie Brown’s teacher,” he says. “Our adult patients have spent their entire lives hearing acoustically, with sound traveling through the air from someone’s voice to their ear.”

Patients with cochlear implants are instead hearing by means of electronic stimulation. “If perfect hearing is like listening to a live orchestra, a cochlear implant is more likely to hear only a single instrument. It can be pleasing, but it lacks the complexity,” he says. “The true strength of a cochlear implant is in hearing speech and language. While it may take practice to learn what these new sounds mean, the more you use it, the better you get. Also, the more one works with their audiologist, the more personalized the programming can be. This is why telehealth visits can be so helpful.”

As more people start to resume a life that includes going to an office and, perhaps, traveling, Narron will resume the cochlear implant reprogramming routine she had prior to the pandemic—only with one exception: She will now also offer remote sessions.

Whether done remotely or in person, the process is complex. “We need to synchronize the sounds they are hearing with what they remember those sounds to be,” Narron says. This may mean adjusting the device’s performance to suit the patient’s sensitivity to low sounds or very loud sounds, for instance. “Because we are delivering an electrical current, we work up to it, and that’s really why we have all the follow-up visits,” she says.

Narron makes changes using what can be described as an equalizer bar with sliders that go up and down to control intensity. Each channel is set to a different frequency, and a new patient is started at low levels that are adjusted as they learn to take in a new type of auditory information and begin to tolerate it better.

The patient may wear a hearing aid in their other ear to help them with Narron, who also watches their body language on a video communicate screen for additional feedback.