How I Learned to Love My Cochlear Implant.

In 2013 in my first book, “Shouting Won’t Help,” I wrote about the difficult experience I had adjusting to a cochlear implant I received in 2009. That section was excerpted in Bloomberg View and it is still easily available online.shoutingwonthelp

I often get letters from people who have seen the article and are worried by the information in it. They write to ask if they should get a cochlear implant. (Needless to say, this is a question only they and their medical professionals can answer.) Part of the concern stems from the Bloomberg title, “Cochlear Implants Are Miraculous and Maddening.” If you read the article carefully, as I just did, you won’t see me damning cochlear implants. But you will see me raising some caveats.

I am 100 percent in favor of getting a cochlear implant if you qualify for one, and if your hearing aid no longer works for you. I am also 100 percent in favor of aural rehabilitation after the implant. If your implant center doesn’t offer aural training, look for it elsewhere. A speech language-pathologist is one possible provider. There are many online training programs, the best known of which is L.A.C.E. This is a graduated program that starts with speech at a decibel level you can hear (this is determined before you start the program) and gradually increases the noise level in the background. I have written about aural rehabilitation previously on this blog, and you can find other suggestions there.

So how did I come to love my cochlear implant after my initial tepid embrace?

The first answer is practice. I have taken formal and online aural rehabilitation courses. I’ve worked one on one with a speech language pathologist. I listen to recorded books and then read the text to make sure I’ve gotten it right.

The second answer is consistent use. I wear the implant all day every day.

The third answer is technology. The cochlear implant I got in 2009 was not nearly as sophisticated as the replacement implant I got in 2014. (Most implant companies upgrade the external processor every five years.)

The fourth answer is support. I am active member of the Hearing Loss Association of America. We meet regularly and we share tips and experiences. I am always learning new things about hearing.

The fifth is to have reasonable expectations. Is my hearing perfect? Far from it. I need assistive listening devices and captions to hear in a group. I use captions to watch TV. I use captions at movie theaters. I say “What?” a lot. But I live an active daily life in the hearing world, and rarely feel disabled.

But without my cochlear implant I would hear almost nothing. My hearing loss is progressive and the hearing in my hearing-aid ear continues to drop. I am already planning for a second cochlear implant. I qualify now (many times over) but my hearing aid is adequate and this is one area where I follow my own advice: If you can still hear with a hearing aid, hold off on a cochlear implant.

If your hearing aid is no longer adequate, start your research. I have written a great deal about cochlear implants and with every writing my optimism grows. The paperback version of “Shouting Won’t Help” is more upbeat on cochlear implants than the hardcover was. My 2015 book “Living Better with Hearing Loss” offers more updated information than the earlier books, and also reflects my comfort and satisfaction – and gratitude! – for having a cochlear implant.


For more information on living with hearing loss, see my books on

TV Captions – Read Them and Laugh, or Weep

Live TV captioning is terrible! I don’t think anyone would disagree. But caption spoofs also provide some levity during this lengthy and grim election season. And YouTube offers quite a few.

Bouton Blog: Bad TV Captioning
Closed captioning for the hard of hearing can sometimes be bewildering. — Getty Images 


“Bad Lip Reading” is a YouTube channel that takes clips from movies, TV shows and news stories and dubs them with captions that match the speakers’ lips. This is possible because only 40 percent of the sounds of speech are visible on the lips. The letters b, p and m , when spoken, look exactly the same. This is why you generally need at least a bit of hearing – as well as attention to the speaker’s facial expressions and to the context of the sentence – to read lips at all accurately.

It’s also why they are so easy to spoof by dubbing in what seem like the words the candidates are saying by the movement of their lips.

Bad Lip Reading created this version of the first Republican Debate It’s been watched more than 18 million times —  quite a few of them by me because I laugh every time I watch it. The first Democratic Debate: is equally funny but has only about 8 million views. Does this say something about YouTube viewers?

Or you might enjoy “DEBATE NIGHT!” — A Bad Lip Reading of the first 2016 Presidential Debate

Or, if you’d prefer more poetic reflective humor, take a look at “PRESIDENTIAL POETRY SLAM” — A Bad Lip Reading of the Second Presidential Debate

For people with hearing loss, those laughs sometimes come when we don’t want them — namely from the bewildering closed captioning that appears on just about any live TV.

It can be a challenge to figure out what these garbled captions mean. In my book, “Shouting Won’t Help,” I listed some examples of captions I have seen in the past:  “The boy ate the bridge.” “Can you hear the garbage?” “He liked to eat morphine.” “Blahmahsan boar genie” – this last meant to be Lamborghini.

More often, you can’t even see the captions because they overlap with the network’s own on-screen information, like a speaker’s name and title. Sometimes if the speaker has a heavy accent, the network provides its own captions, which overlap with the TV set’s captions.  And networks like MSNBC and CNN put so much other written information on the screen, that reading captions becomes impossible.

TV closed captioning was developed for those who are deaf or hard of hearing to give them full access to programming. The Federal Communications Commission (FCC) rules  on captioning quality require that captions be:
•  Accurate: Captions must match the spoken words in the dialogue and convey background noises and other sounds to the fullest extent possible.
•  Synchronous: Captions must coincide with their corresponding spoken words and sounds to the greatest extent possible and must be displayed on the screen at a speed that can be read by viewers.
•  Complete: Captions must run from the beginning to the end of the program to the fullest extent possible.
•  Properly placed: Captions should not block other important visual content on the screen, overlap one another or run off the edge of the video screen.
The rules distinguish between pre-recorded, live, and near-live programming and explain how the standards apply to each type of programming, recognizing the greater hurdles involved with captioning live and near-live programming.
The problem is that the rules are not enforced. The FCC requires caption accuracy, but if you watch any live TV – news, sports – you will know that they are often woefully incorrect.
As for being synchronous, captions usually lag 3 to 5 seconds or more behind what the speaker is saying.
In addition, when the caption system runs into a problem, it repeats the same nonsensical garble over and over again and then finally quits.
And, as I noted above, most captions are at the bottom of the screen, where they compete for space with information on the person speaking, or a running news tape, as many cable channels have. Try deciphering the captions in all of that.
On the other hand, judging by some of the insults being flung during the final weeks of this campaign, perhaps it is better that we don’t know exactly what some people are saying.

The post first appeared on AARP Health on November 3, 2016.

Living Better jpeg

Katherine Bouton is the author of “Living Better With Hearing Loss: A Guide to Health, Happiness, Love, Sex, Work, Friends … and Hearing Aids,” and a memoir, “Shouting Won’t Help: Why I — and 50 Million Other Americans — Can’t Hear You”. Both available on