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Getting ready for a cochlear implant surgery Part 5 Initial Stimulation for Adults and Children: With the surgery done, you are ready to begin the exciting part of the journey to hearing by turning on your AB cochlear implant system for the first time. Approaching the initial stimulation session, everyone wants to know if they will hear right away, what it will sound like, and if they will understand speech and music. Parents wonder if their children will be immediately aware of sounds and voices around them. Every person is unique—with different medical and hearing histories and life experiences. What you will hear depends on many factors, such as how long you have had hearing loss, how much sound you have heard in the past, and other medical and physiological factors affecting the inner ear and auditory nerve. Everyone also responds differently to what they hear at first. HOW WILL IT SOUND? At first, speech and sounds from the environment can sound or feel like vibrations, clatter, or garbled noise. Some people can recognize speech right away, but it might sound high pitched like a “Mickey Mouse” voice, or mechanical and artificial. To others, it may start out sounding natural, just like they remember. Very young children may not have any association or comprehension of sound, so they may not know right away that they are hearing. For adults with long-standing hearing loss, the brain may have been deprived of meaningful sound for a very long time, in some cases since birth, which requires time to learn or re-learn how to hear and identify sounds. It is important to realize that the initial experience of hearing with a cochlear implant system does not set the stage for what sounds you will hear and interpret after a period of listening and practicing. High pitches (frequencies) are usually the first sounds people with hearing loss lose. When high frequencies are first heard again, it can make sounds come across as unnatural or “tinny.” It takes time for these sounds to become natural.