Joyce Jobse can still remember the day when a teacher told her she’d never be able to learn.
“I am not dumb!” she responded with the self-confidence that belied years of teasing and lapsed learning due to progressive hearing loss and taking time out to work on the family farm.
Jobse walked out and never went back to that school. She spent the next six decades struggling to work and raise a family as her hearing further lessened, exacerbated by lack of health care and years of missed opportunities.
This summer, for the first time in years, the 74-year-old grandmother who had been completely deaf since 2019 heard the birds chirping and a breeze blowing through the trees in her yard thanks to a new cochlear implant.
“I didn’t know what it was. … I was scared,” Jobse said, laughing at her reaction to previously unknown sounds.
Now, three months since she underwent surgery at University Hospital to implant an electronic medical device under her scalp that restores her ability to perceive sounds and understand speech, Jobse is learning to hear all over again.
But even in more recent years, the obstacles in her path were many. After nearly a lifetime without hearing and the resulting struggle to read, write, talk and maintain relationships with her family, more delays in getting help came about due to other health issues and the COVID pandemic.
During that time, what little hearing she had faded away. Hearing aids were no longer an option.
A primary care doctor sent her to be evaluated by an audiologist and hearing specialist.
In May, Dr. Brian Perry, a neurotologist at UT Health San Antonio and University Health, surgically implanted the device that allowed Jobse to stash the whiteboard she had come to rely on for communication and talk and hear again.
Unlike a hearing aid, which delivers amplified sound acoustically, a cochlear implant bypasses damaged hair cells in the cochlea of the ear and stimulates nerve fibers directly through electrical current. For that reason, hearing aids also do not improve speech understanding the way a cochlear implant can.
The first single-channel cochlear implant was introduced in 1972, according to the American Speech-Language-Hearing Association.
The device is now widely used by people of all ages whose hearing needs are beyond what hearing aids can provide. Of the 200,000 people in the United States with a cochlear implant, 70,000 are children, Perry said.
Perry, who completed his residency training at Duke University Medical Center in 1997, has performed about 3,000 cochlear implants during his career. In private practice in San Antonio, he did about 80 to 100 implants a year.
University Hospital began doing cochlear implant surgeries in March 2022 and has performed 17 since, eight of them for adults who have undergone the procedure this year.
Jobse’s challenges, starting in childhood, are not uncommon, he said.
Symptoms that mimic those of someone with a learning disability. Left untreated, hearing loss can lead to further speech and language delays, difficulty learning and slowed social maturity.
Jobse left high school early to work on her family farm, married early and worked as a janitor, at a bakery and a pet store while raising two children. She coped by reading lips, relying on a hearing aid and speaking to others at full volume.
But because of her limited education, writing and reading anything, including closed captioning on a screen, was difficult.
While cochlear implants have been around for many years, it’s also not unusual that Jobse would have had to wait so long for help, Perry said.
“Unfortunately, I see this all too often. People are not guided to getting the help that they need,” he said.
Many people, like Jobse, have dealt with hearing loss for so many years, they don’t bother to seek help, Perry said. “The advice should be, if you’re not happy with the hearing that you have, you should be evaluated by somebody [an audiologist or otolaryngologist] who can offer you something else.”
Jobse’s team of health care providers, and a family member, say her hearing and understanding are slowly improving.
For a year, she will see the audiologist monthly for testing and to calibrate the implant to her specific needs. She’s making good progress, said Jennifer Frank, an audiologist at University Health.
“She’s able to sit here and talk to us without a whiteboard — that’s huge,” Frank said.
Her brain is still adjusting. Testing in a sound booth also showed Jobse is recognizing more words than ever before. The most recent round of tests had her hearing and repeating 18% of words correctly with others like “coin” heard as “corn” and “ride” as “life.” Only six out of the 50 words Jobse repeated were incorrect.
Jobse’s grandson, Richard Cook, cares for her and transports her from the far South Side of San Antonio to her medical appointments. His was the first voice she heard after the implant began to work.
Along with much better hearing, Cook also sees his grandmother having fewer bad spells of vertigo, or losing her balance.
“It’s good to see her talking with people. She’s a people person, so it really improves her mood,” Cook said. One day, as she ate, Jobse asked him, “Richard, can you hear yourself eat?”
Another time, Jobse thought her shoe was broken, he said, because she could hear her own footsteps.
It can take up to six months or longer to get the full benefits of a cochlear implant, Perry said, but the best judge of how she’s doing so far is that she’s happy.
Jobse smiled from ear to ear and squealed when the cochlear implant first began to work. She laughed in jubilation and reached to hug Frank.
“I can hear, y’all! I can hear.”
Disclosure: UT Health San Antonio and University Health are financial supporters of the San Antonio Report. For a full list of business members, click here.
