Bristol CI Timeline

This information has been provided by other CI users to help you know what to expect when undergoing cochlear implant (CI) assessment at Bristol. Please note that this content is only a guideline, and that your own experience will likely vary. It usually takes about a year from referral to surgery and activation.

We would really appreciate your letting us know if any of this information is outdated or incorrect; please email us at cisouthwest@yahoo.co.uk


BRISTOL CI TIMELINE

1. Referral to the CI centre from your local Audiology Unit or GP

(followed 6 to 8 weeks later by)

2. Initial Assessment - meet with the CI audiologist, discuss CI, do some hearing tests, and answer questions about yourself and your hearing history. Based on this initial evaluation you may be asked back for a full cochlear implant assessment to find out if you are a suitable CI candidate. 

Note: If you live a long way from the CI centre, it is sometimes possible to combine appointments on the same day, or to have appointments at midday or in the afternoon if that helps you to get to Bristol and back in one day -- let the CI team know of your personal situation and what works best for you. It is not always possible but they do try to accommodate you when they can.

3. Full Assessment (minimum 6 months)
Expect to receive several different appointment letters in the mail (not necessarily in this order, and you may not be asked to complete all of these steps): 

A. Hearing Assessment 
B. Speech and Language Assessment 
C. MRI Scan - with or without injection
D. Vestibular/Balance Testing
E. Psychological Assessment
Once you have completed the CI assessment, the CI team meets to discuss your case and decide whether you are suitable for a cochlear implant.

4. Meeting with surgeon and full CI team
This is your opportunity to meet the consultant and the CI team. They will first tell you what their decision is and the reasons for their decision. They may advise that a particular ear be implanted and will tell you why. Usually at Bristol you get to choose the CI you want (Advanced Bionics, Cochlear, or Med-El) -- you will be taken to another room where you can see the sample external processors and accessories and choose which one you think is best for yourself and your lifestyle. 

5. CI Surgery
Once you have been approved for a CI, the national NHS guidelines (NICE) suggest that you should have to wait no longer than 18 weeks for CI surgery. In practice expect to wait a month or two to receive your surgery date (in an appointment letter), then a month or two for the surgery. Do let the CI team know if certain times of year (school holidays etc) are better for you to have the surgery, they may be able to accommodate you.

A. Meningitis Vaccine and Bloodwork - you will receive a letter asking you to make an appointment with your GP to have the meningitis vaccine and bloodwork done; your GP's office will receive a letter with instructions for the doctor or nurse.

B. Pre-op appointment If you live close to the hospital you may be asked to come in for a pre-op appointment; however if you live a good distance from the CI centre you may do some of the pre-op via email or phone, and then meet with the registrar when you get to the hospital the night before surgery. 

Note: Candidates who live close to Bristol often go to the hospital the morning of the CI surgery and then get to go home the same day, while candidates who live several hours away are often asked to stay in the hospital the night before, and sometimes the night of surgery. Do be prepared and pack a bag even if you expect to be an outpatient; it is not uncommon to be asked to stay in hospital overnight, especially if you are feeling nauseous or dizzy after surgery.

C. CI Surgery normally takes between 1 and 3 hours. It is good to take it easy for the first few weeks after CI surgery; most people plan to take 2 weeks off work. Many people feel rough the first few days, and then start feeling better after the first week; other people experience side effects and find it takes them longer to recover (most people feel OK 4 weeks after surgery). 

6. Activation
Generally one week after surgery you receive an appointment letter in the mail with the dates of your first few mapping appointments.

A. "Switch-On" appointment -- approximately 4 weeks after surgery
This appointment can take up to three hours. Usually the audiologist starts you out slowly, so you may not hear that much the first week ... the sound and stimulation will be increased in the following weeks.


B. First mapping (programming) appointment 1 week later - usually one to two hours.
C. Second mapping appointment 3 weeks later (1-month mapping appt) - usually one to two hours.
D. 3-month mapping appointment - one to two hours.
E. 6-month mapping appointment - one to two hours.

Once you have a relatively stable map, the CI team will probably leave it up to you to contact them if you have problems or think you may need a new mapping. 

If you find that you're not hearing as well as you were previously, or things seem quieter, it may be time to get a "tune up" ... email the CI team and request a mapping appointment. 

7. Follow-Up

A. 1-year anniversary review - hearing tests, new mapping, and some prelingually/long time deaf may be asked to do a follow up video.
B. 2-year anniversary review

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