Interview with Nathan Schepker MED-EL, Patient Support Manager and Cochlear Implant Recipient

AO/Beck: Hi Nathan, thanks for taking the time to speak with me today.

Schepker: Hi Doug, nice to finally get together!

AO/Beck: Nathan, please tell me a little about your education, and how you came to be an employee of MED-EL?

Schepker: I graduated from college in 2000 with a degree in International Business from Mary Washington College in Virginia. I started working for MED-EL between my junior and senior years, and I basically served as an intern at MED-EL for that summer. I went around the country to different trade shows, state meetings and exhibitions addressing cochlear implant issues and speaking with people about my implant experience. I really started to enjoy the work and the information exchange - and so when I finished college, I came back to work here full-time.

AO/Beck: Nathan, I am not quite sure what you do as the Patient Support Manager, can you please tell me about that?

Schepker: Sure. My position is such that the goal is to provide programs for cochlear implant candidates, and for MED-EL users to help provide a support network for people entering the cochlear implant arena, and for those who are already into it, but need more information and direction. In other words, I correspond with, and coordinate information flow between MED-EL, the candidates and the patients. I try to help people understand what an implant is, what it's all about, what they can expect and whatever else they need.
Sometimes I help put candidates and their families together with cochlear implant users, and this is very gratifying. We also have the Hearing Companions program, which is a network of volunteer MED-EL users, and they are available to help people get through the process and to share their stories. We sometimes are able to match up people who are actually quite local to each other. These are really important services.

AO/Beck: Do you also help coordinate cochlear implant candidates and implant centers?

Schepker: Yes, I do. Sometimes people are looking for local audiologists or surgeons, and I can help direct them to the appropriate professionals. Sometimes there are small support groups of cochlear implant patients that just like to get together and talk about their experiences, problems and solutions, and I try to help as best I can in bringing these people together. I also help individuals-both candidates and implantees- locate community resources that might be available for them in there area, such as these support groups or organizations.

AO/Beck: Nathan, I know that you too, are a cochlear implant patient. Can you tell us a little about your personal cochlear implant?

Schepker: Sure. I was actually born with hearing loss and they suspect it was probably moderate-to-severe at birth. My hearing loss wasn't detected until I was almost two years old, because there was a question as to my speech development, which is why they started to investigate my hearing! Anyway, by the time my hearing loss was detected, it was a profound hearing loss. I was fitted with hearing aids right away and I wore hearing aids throughout my education. I went to a preschool and kindergarten for the deaf and I learned to sign there. I was mainstreamed in the first grade with an oral interpreter and I stayed mainstreamed throughout college. By the time I graduated I had had oral interpreters, note-takers, FM systems and a lot of support from speech therapy too.

AO/Beck: Nathan, how old were you when you received your cochlear implant?

Schepker: I was 20 years old when I was implanted. It was between my sophomore and junior years of college. My implant was in 1998.

AO/Beck: I probably should point out to the readers that you are in North Carolina and I am in Texas, and we're communicating over the telephone, virtually without repeats or problems while wearing your implant.

Schepker: Yes, I use the phone all the time - every day! In fact, using the telephone is one of the best things for me, regarding using a cochlear implant. The fact that I can use the phone is amazing - it really opens up the world to me.

AO/Beck: What has been the biggest surprise for you regarding your implant? In other words, was there any one thing that just really went way above and beyond your expectations with the cochlear implant?

Schepker: That's really a difficult question...if I had to pick one thing, I would just say sound in general. Now what I define as a sound is clear and easy to listen to. But, when I was first hooked-up, I wasn't really able to identify sound as sound. Early on, it was just a sensation in my head. I knew what sound was - or at least I thought I did, and that sensation through the cochlear implant wasn't sound. I had a 110 dB loss, which is way past profoundly deaf, so maybe the sounds I was used to weren't quite right either. Anyway, as a week or two became three and four weeks, the sound started to make sense, very slowly at first. But eventually my brain started to recognize the sensations the cochlear implant was providing as sound, and it was amazing to start identifying sounds as related to a certain object or event. I never heard high frequencies until I got my cochlear implant, and at first, the high frequencies kind of overrode all of the sounds I was hearing, everything sounded high pitched and it was very hard to listen to the sound easily. It was pretty confusing. In fact, it was almost like I was hearing two versions of each sound at the same time- the high pitched and the low pitched. But eventually, the high-frequencies and the low frequencies began to blend together into a whole and complete sound that began to make sense.

AO/Beck: What was the approximate time frame from the time your cochlear implant was activated, until sounds started to make sense?

Schepker: Actually associating sounds with basic sound sources took about 3 to 4 weeks, but it took longer for speech sounds to make sense and to be clearly understood. It was probably about three months before I could understand speech without lip-reading. Music took a while too. I love music and I used to listen to it with my hearing aids, but with the cochlear implant I am better able to get the harmonics and sometimes I get the melody too. I just started playing guitar a few months ago, and I can now tune the guitar and play a few chords by ear while wearing my cochlear implant. So it gets better all the time, and I always work on my listening skills to become a better listener.

AO/Beck: Nathan, what can you tell me about the aural rehabilitation process, as someone who has gone through it?

Schepker: The most important thing is to have reasonable expectations. Some people expect that as soon as they get their cochlear implant activated, everything will be great. That happens sometimes, though rarely, and more often, it takes time and practice. If the expectations are too high, that sets up the individual for failure. Everyone reacts differently to a cochlear implant and no two experiences are alike. It's best not to compare your experience with others, but to compare to how you were performing before you got the implant. That's a better indication of how you, personally, are doing. It is also important not to set a time frame for certain achievements, such as, I want to hear on the phone in 6 months. You can't be rushed or timed in this manner, because that's simply not how the brain adapts.

AO/Beck: Supposing someone wants to get in touch with you, what's the best way to do that?

Schepker: They can write to me at my email address, nschepker@medelus.com, and I'll be happy to get in touch with them.

AO/Beck: Thanks Nathan. I appreciate your time.

Schepker: Thank you too, Doug. It's been fun.


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