CHEYENNE, Wyo. | Robert McCartney has struggled with progressive hearing loss for more than 20 years, likely a result of transporting minerals in and out of deafening coal mines for decades.
"It was just constant noise in the construction mining business," he said.
With the often underwhelming assistance of hearing aids, McCartney, 76, and his wife, Mary, 75, accepted their lot in life. The couple, now married for 52 years, continued to perform the daily labors of love required of Wheatland farmers.
But for the past few years, friends of the couple grew concerned that the man's hearing loss was beginning to isolate him from the larger community.
"We have a circle of close friends, and they were commenting to me that he is withdrawing," said Mary McCartney. "He sits and smiles, but we know he does not hear us.
He lost his sense of humor, and couldn't interact with people well."
When the two stumbled upon a television commercial detailing the benefits of cochlear implants during a quiet night in, they leaped at the opportunity.
"Hearing aids just don't do it for me," Robert McCartney said. "They may help you hear, but they don't always help you understand and participate."
On July 6, Robert McCartney became the first patient to be fitted and activated with a cochlear implant in a Wyoming clinic.
Although Cheyenne audiologist Ruby Zubrod, with Brant Audiology and Tinnitus, has performed the activation aspect of the procedure in Wyoming since 2011, she was forced to send patients to Denver for surgical implantations.
Ear, nose and throat specialist Robert McLean joined the Cheyenne Regional Medical Group last year from Amarillo, Texas, with years of experience in cochlear hearing aids.
McCartney was his first patient in the state.
"The technology has been used since the 1980s, but it just has not been done in the state of Wyoming ever," McLean said.
Cochlear implants provide a second line of defense for patients who do not benefit from traditional hearing aids.
Rather than amplifying sound, the implant stimulates the auditory nerve directly. The device operates by connecting a pair of external and surgically implanted internal pieces magnetically.
The external component of a cochlear implant contains a microphone, speech processor and transmitter, while the internal device includes a receiver planted under the skin on the temporal bone with electrode arrays.
The receiver then converts signals to electrical pulses, producing clarity some patients cannot achieve through hearing aids.
The surgical procedure, while fairly non-invasive, can take anywhere from two to four hours, and can be risky. One of the most severe risks is injury to the facial nerve. The nerve lies close to where the surgeon places the implant.
"It is a fairly tricky surgery," McLean said. "The facial nerve is right there, so if I slip, the patient would wake up with a paralyzed face. That is why not just every doctor does this. It can be nerve-wracking."
Years ago, there were strict regulations on who could qualify for the implant, but after extensive research, those guidelines have relaxed substantially. Children as young as 10 months old and aging adults usually make the best candidates.
"Back then, you had grandpa struggling with hearing aids, but he did not qualify for implants yet," McLean said. "After five or 10 years, he would finally qualify, and his life would completely change. We would see the onset of cognitive decline because grandpa was sitting in the corner with no one talking to him because it is such a difficult thing to do. So the government relaxed the criteria."
McLean said the procedure has changed countless lives.
"I had a patient in Colorado who was the pillar of the community in a true sense," he said. "She had 20 elderly people she drove to doctor's appointments, and so many people relied on her. She was really struggling to maintain that position of service, but when we put in the cochlear implant, she was back in the running."
Zubrod said there is still work to do, and Robert McCartney's hearing will gradually improve over time.
"They are just at the beginning of their journey," she said. "This is just day one, and we will be seeing a lot of each other. The next few months will be a big change in his hearing."
The McCartneys said the procedure will give them a new lease on life. As Zubrod activated the device, the two thanked doctors through tears.
"There are no birds that make any noise except my turkeys and my peacocks," Robert McCartney said. "Those are the only birds I have heard for a long time."