Cochlear implant / Hearing Loss

How to adapt to the COCHLEAR IMPLANT: life saving tips

The day of the activation of your Cochlear Implant arrived? Of course I would write tips for adapting to the cochlear implant. Adaptation to CI is a process, and you should face it without feeling anxious and comparing yourself with other people. Be patient! The initial sound might be weird, and the revelation of how noisy is the world can be a little disturbing.

This post brings some very useful hints for you to adapt to the Cochlear Implant and navigate this road in the best possible way.

  • this post was translated to the English by Isabella Vitória Ramalho

Read the instruction manual of your cochlear implant

It seems silly to give such a hint, but few people bother to calmly read the manual. The audiologist responsible for programming your implant will teach you many things about it on the day of the activation.

However, remember that among the anxiety, nervousness and the amount of new information,  it will be difficult to memorize all the instructions you’ll need to remember later.

The CI brands have explanatory videos on their Youtube channels on how to put the battery and the antenna cable, how to use the remote control, how to pair with devices via Bluetooth, how to change the program or configure the volume, and many other things.

Reading the manual will prepare you to deal with any problem with your hearing device! So, get to work! 🙂

First months after the activation…

Always carry with you the remote control of your speech processor to change the sound volume in different environments or switch between different programs.

Walked into a very noisy restaurant and felt disturbed? Turn down the volume. Are people’s voices too loud? Turn down the volume. Is it hard to hear that particular sound? Turn the volume up and see if it improves.

Having the control always at hand during the adaptation phase will help you have more hearing comfort.

The time usage of a cochlear implant is one of the keys to improving the sound your brain receives. Therefore, it is preferable to turn down the volume in case of hearing discomfort than to turn off the CI. Turning it off and giving up wearing it at the slightest sign of difficulty or discomfort are not smart attitudes.

My speech processor falls out of my ear: what can I do?

Sometimes the CI (especially in kids) keeps falling out of the ear and this interferes with adaptation. We have some tricks that might help you! 🙂

  1. Hair tape: cut a small piece of the hair tape and stick it on the speech processor before placing it behind your ear. This tape has high fixation and ensures that the CI remains in its place.
  2. Speech processor ear hook: some models come with different ear hooks and may have different sizes. Try them on until you find one that fits your ear well.

What about the cochlear implant magnet?

When the magnet is weak, the coil becomes loose and might fall easily. In that case, report it to your medical team so that they can exchange the magnet for a stronger one.

The ideal magnet is neither loose nor tight. Each person has a different thickness of skin, so the strength of the magnets may differ.

I feel pain in the coil/magnet area!

After wearing your CI the whole day, you may feel some sensitiveness in the area – which is normal during the adjustment period. Over time, this feeling disappears. If the sensitiveness is too strong, talk to your ENT doctor.

If the sensitivity is tolerable, turning off the IC and taking it off for a while can help. Only you know your limits.

It is very important to pay attention to your magnet strength. If the magnet is stronger than necessary for your skin, this will cause pain and/or redness in the area from excessive pressure.

Ask for someone to see it and check if the area is red or bruised. If you are experiencing these symptoms, decrease the magnet strength and report it to your medical team.

Some speech processor models have a magnet threading system to move it away from the skin, decreasing its strength. However, in some cases, that might not be enough, and it will be necessary to change the magnet to one with less strength.

In the case of users of one-piece speech processors, it is not possible to thread the magnet.

But there is a trick to decrease the magnet strength and bring more comfort: to stick on the back of the magnet a round foam paper or Band-Aid, which can be glued on top of each other, creating layers.

Know your body and its limits

Sometimes, the initial stage of adaptation to the CI might bring physical and mental fatigue, as well as a headache. After a busy day filled with auditory effort, if you feel exhausted, turn off the CI and let your brain take a rest.

New programs, which in general are more powerful, can make us tired and irritated during the first days of use. That’s normal. The audiologist usually keeps the former mapping in your CI just in case, and also to let you keep up with your evolution and compare the differences in awareness of sounds between one map and another.

Remember: every time you spend many days disliking the new mapping, the best option is to return to the audiologist and make new adjustments.

What can I do to improve the sound of my CI?

Although we repeatedly say that you should forget your expectations, every new Cochlear Implant user keeps them high.

The magic formula for sound improvement is: wearing time + patience + auditory training + new mappings.

CI usage time

Just as no one loses 30kg in a month if they decide to lose weight, no one happens to magically hear and understand everything they hear after countless years of hearing deprivation.

You can start by using the CI for a few hours every day, but your goal should always be to use it from the time you wake up until the time you go to sleep, taking it off only to take a shower.


Be patient with your progress and don’t compare yourself to other people. Each case is unique! Each person is unique, and has its own rhythm and result! Celebrate every small daily gain.

Auditory training

Your brain needs to learn to interpret the different new stimuli from your Cochlear Implant, so auditory training is essential for your evolution. What is auditory training? Listening to music, reading and listening to audiobooks, watching movies with subtitles, paying attention to the environment around you, training words, phrases, and much more!

If you can, find an audiologist who is a hearing training specialist and do auditory exercises with them. Not everyone needs individualized hearing training sessions, but at first, they are of great help to any new user.

Cochlear Implant Mapping:

It is the programming that a specialized speech therapist will do on your cochlear implant. New mappings/programmings mean access to new sounds, louder and more refined.

In the first year of usage of the Cochlear Implant, the recommendation is to have a new mapping every month or two. To evolve and get better results, you will need to make new adjustments from time to time.

In the second year, the period between each new map is likely to be longer. Tip: when leaving the mapping appointment, book the next appointment in advance.

The day of the new CI mapping has come…

  • Write a diary with notes of your positive and negative perceptions and show it to your audiologist;
  • Talk about the possibilities of different programs and filters for different hearing scenarios with your audiologist (each CI brand has its peculiarities);
  • Always ask to keep your old map in your CI, just in case (if you don’t get used to the new programming) and for comparison.

I feel uncomfortable when turning on my CI!

Some people report discomfort when turning on the Cochlear Implant after spending a long time in silence. Some models provide the possibility of turning on the sound at a low volume that will automatically increase until it normalizes.

That helps to refine the sensation of turning on the Cochlear Implant, since the sound arrives softly, little by little. Talk to your audiologist about this possibility.

An easier way to solve this discomfort, if and when it happens, is to turn on your implant in a quiet environment.

For instance, in your bedroom, with closed doors and windows. After a few minutes, you move to another room, with more noise, and get used to it.


Get your family, friends and audiologist involved in your adaptation. Explain what helps you, what annoys you, and how they can collaborate with the process.

If you have the opportunity to have a speech therapist who is a hearing training specialist involved at this early stage, you may have access to reports on your progress.

With this, the professional who makes your maps will have great material on hand to create new strategies to improve your hearing!

After the mapping, they can make a report so that the speech therapist can evaluate the changes in your map and draw up an auditory training based on it.


Look for an online support network. To adapt to the Cochlear Implant in the best way, the sound must be comfortable, and you must feel confident and share your doubts, fears and progress with people who have walked in your shoes before. Enjoy the world and explore the new sounds! Good luck!


About Author

Paula Pfeifer é uma surda que ouve com dois implantes cocleares. Ela é autora dos livros Crônicas da Surdez, Novas Crônicas da Surdez e Saia do Armário da Surdez e lidera a maior comunidade digital do Brasil de pessoas com perda auditiva que são usuárias de próteses auditivas.

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