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Music to Her Ears

A former Miss America deciphers sounds with the aid of a cochlear implant.

Surrounded by family, Heather Whitestone McCallum is moved to tears as she hears her first sound after being deaf for nearly 30 years.
The first sound Heather Whitestone McCallum hears is reminiscent of a truck backing up. "Beep, beep, beep," she whispers, imitating the noise by opening and closing her hand. Then while McCallum's eyes are glued to the floor, audiologist Jennifer Yeagle claps her hands once loud and hard. A stunned 1995 Miss America raises her head, looks briefly at Yeagle, who sits facing her, and puts a hand to her mouth. She barely has a chance to recover from her shock when Yeagle claps once more. Whitestone bends over, cries soundlessly and whispers, "I heard that."

It was Sept. 19, and McCallum, who has been deaf for nearly 30 years, was hearing for the first time with the aid of a cochlear implant, an electronic device that gradually improves sound detection and speech recognition. The first woman with a disability ever to be named Miss America, McCallum wasn't bothered that she was unable to hear her name announced as the contest winner. But when one of her sons fell last year while playing in the backyard of her Atlanta home and she couldn't hear his cries for help, she began to explore the possibility of the implant. Months later, at the advice of a friend who had her implant performed here 10 years ago, McCallum consulted Hopkins hearing specialist John Niparko. This summer, she became one of the nearly 700 people who have received cochlear implants at Hopkins since 1987.

Her case was especially challenging because McCallum, 29, has been profoundly deaf since she lost her hearing at the age of 18 months after contracting meningitis. She has communicated by reading lips, wearing a hearing aid in her left ear and, thanks to years of exhaustive speech therapy conducted by her mother, speaking. Because she had been deaf for so long, her doctors didn't know how responsive she would be to the electrical signals transmitted by the device - even the simple sounds they routinely use to test after the implant is activated.

Still, the former Miss Alabama had a lot going for her. She was resilient and resourceful. She had mastered ballet, which taught her to understand the rhythm of music and words for her speech therapy sessions. And though she hated those daily lessons with her mother (the two toughest questions she was asked were "How are you?" and "How old are you?" because the spoken phrases sound so similar), they too proved beneficial to being a candidate for the implant. "Her training with her mother is a very important piece of the puzzle, because she has learned how to make sense of the world of sound using the timing and rhythm of speech as cues," says Niparko, director of otology, neurotology and skull-base surgery.

Niparko and his team surgically implanted the device on Aug. 7, but it wasn't activated for about six weeks to ensure McCallum had recovered from surgery. A microphone and speech processor, worn over the ear, translates sound to an electrical signal. The information is then passed through the skin to a receiver, surgically implanted beneath the skin. The receiver transmits the information along a wire to the electrodes in the inner ear, bypassing damaged hair cells and stimulating the auditory nerve, the ear's connection to the brain. The brain then interprets the restored sensory input.

The evening after McCallum's computerized device was activated, she heard the running of tap water while she brushed her teeth at her downtown hotel, the spritz of her hair spray and the slam of a car door. She realized, too, that she could turn her head in the direction of voices. It will take some time, however, before McCallum will fully understand the voices of her young sons, ages 3 and 18 months. But one week after her activation, McCallum informed Yeagle and Niparko that she was overwhelmed by the conversation she heard between her sons at breakfast. Still, she will have to return to Hopkins for therapy and fine tuning of the implant, says Yeagle. The ability to effectively use the implant for many complex listening tasks can take anywhere from months to years.

"Sound is now competing for the space that other senses have controlled for years in someone like Ms. McCallum. Speech is comprised of a complicated set of sounds," Niparko explains. "Like many important things in life, it takes training." But McCallum's ability to absorb and dissect noises and voices, he said, will increase daily.

In describing the new sounds she had heard to a roomful of reporters the morning following her activation, McCallum said, "There is a gift for you everyday."




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