As the youngest among eight siblings, Ang Boon Su was a happy kid growing up in Tanah Merah, Kelantan.
He did well in school, and like most teenagers, took his five senses for granted until he developed a viral fever at 15.
Within a week, he realised he was having difficulty hearing in both ears.
“I was in boarding school at Pengkalan Chepa and couldn’t understand what the teacher or other students were saying.
“One day, I totally couldn’t hear anything.
“I thought my hearing would come back, but it never did and that came as a shock,” recalls the 42-year-old.
Tenacious, he continued schooling, and soon, word went around that there was a deaf boy in school.
Kids mercilessly bullied him and some teachers even called him “Pekak (deaf)”!
“Some of the teachers knew I couldn’t hear, but didn’t do anything to help me.
“So I had to work 10 times harder to keep up in school, and in Form Four, I decided to drop out,” he shares.
Depressed, Ang returned home for three months before his parents enrolled him in a normal school, which didn’t cater to deaf students either.
There was also no avenue for him to pick up sign language.
Thankfully, a teacher noticed his problem and promptly took Ang for treatment at Hospital Universiti Sains Malaysia in Kubang Kerian.
He was then referred to Hospital Canselor Tuanku Muhriz (HCTM) in Kuala Lumpur (then known as Hospital Universiti Kebangsaan Malaysia), which had started a special cochlear implant programme in 1995.
First in South-East Asia
At the end of 1996, Ang, then 16, had an electronic device surgically implanted in his left inner ear, becoming Malaysia’s and South-East Asia’s first cochlear implant recipient.
The device consists of a sound processor, a microphone (worn as a headpiece behind the ear), an internal coil (surgically implanted in the skull) and electrodes (implanted in the cochlear).
The microphone captures the incoming sound, which is transformed by the processor into electrical signals and transmitted to the electrodes.
The signals from the electrodes then stimulate the hearing nerve, which sends information about the sound to the brain.
After months of speech therapy and aural rehabilitation, Ang was able to communicate again and went on to graduate from university with a degree in agriculture before pursuing his post-graduate teaching degree.
That was 25 years ago.
Today, Ang is a lecturer at the Institute of Teachers Education, Dato’ Razali Ismail campus in Kuala Terengganu.
“Funnily, I initially didn’t want to study agriculture because I thought I would end up as a farmer!
“But now, agriculture has become one of my hobbies and I have a nursery in Tanah Merah where I grow durians and coconuts,” says the father of three.
Time for an upgrade
Ang is grateful to be able to have a second shot at hearing, and life is definitely more meaningful as he can do just about everything a normal person can.
He shares: “Yes, the implant helps me hear, but it cannot compare to normal hearing.
“I’m only hearing from one side so when people call me on right side, I can’t always tell which direction the voice is coming from.
“If a student talks softly or I’m in a noisy environment, I still find it hard to hear.
“When I can’t hear well, I will write or lip read, but now during Covid-19, it’s hard to lip read with a mask.”
He removes the microphone when he bathes or sleeps at night.
For short afternoon naps, he leaves it on.
“If I don’t hear anything, I can sleep well! I don’t have to pick up the phone,” he jokes.
Initially, Ang’s wife, whom he met in university, would scold him when he took off his microphone at night.
Ang says: “It’s uncomfortable to sleep long hours with it and my wife asked me, ‘What happens if there is an emergency at night?’
“I told her to just wake me up!
“My children know how important my hearing aids are, so whenever I come out from the bathroom after a shower, they will quickly bring the device to me.”
A few years ago, he tried to do another implant on the right side and applied for government funding, but was unsuccessful.
On the plus side, technology has evolved since he was first fitted with his device.
As such, Ang was recently fitted with an upgraded sound processor, which has built-in technology that lets him stream sound directly from a compatible Apple or Android device using an app.
It’s the world’s smallest and lightest behind-the-ear hearing solution, and it enables him to connect with people wirelessly.
Called the Nucleus 7 Sound Processor, it is designed to mimic the function of a human ear – sort of like a bionic ear.
“The new design is smaller and more comfortable to wear,” he shares.
“It’s also convenient and easy to use, especially the rechargeable battery – I can now charge two batteries (one for use and one spare) using one charger.
“The sound quality is also better.
“I can now directly connect my laptop and handphone with my sound processor; I can hear my students better during the virtual classes and can answer them more confidently.”
Having to rely so much on technology means that he has to remember to bring along spare parts whenever he travels.
Once, he was visiting Indonesia when not only did he break his spectacles, but his sound processor also malfunctioned and he didn’t have any extra batteries.
It was a double whammy as he could neither see or hear, making communication extremely difficult!
Implant young
According to consultant otorhinolaryngology surgeon and HCTM Cochlear Implant Programme head Professor Dr Goh Bee See, HCTM has performed more than 630 cochlear implant surgeries.
Eighty-five percent of those procedures were on children below the age of 12.
She says: “We now can implant as young as nine months old and we created history by doing this (bilateral simultaneous procedure, i.e. putting two implants at one go) in our country last August.
“The programme is progressing very well.”
For children, the ear is the doorway to the brain.
With no hearing, the brain becomes quiet because there is no input, which explains why there is no output.
“There is no problem with the vocal chords, hence for babies born with hearing loss, the earlier the intervention, the better, so that the child can hear like his peers.
“Don’t wait until they are two or three years old to implant!
“Our brain needs to be ‘tuned’ early in life, so when the baby starts babbling at around one year old, that’s the right time to get an implant,” she advises.
The medical team will assess the suitability of candidates and this takes time.
Prof Goh adds: “We’re also implanting for single-sided deafness (unilateral hearing loss) where hearing aids cannot help.
“When they can only hear in one ear, they are happy, but they will have problems with direction and noise pollution, and cannot concentrate.
“For children with no hearing or speech, hearing with both ears has better input to the brain.”
For the old too
Most people are unaware that implants are an option for all age groups, and can also be performed on the elderly, especially if they are independent and depend on their vision and hearing to socialise.
However, for adults who are not active and not motivated to hear again, then hearing aids are enough.
We all need to hear clearly the range of frequencies in our speech spectrum, hence cochlear implants are indicated for severe to profound hearing loss.
Prof Goh explains: “At some point, there might be progressive hearing loss and hearing aids may no longer be beneficial – that’s when the elderly come and seek help, and they can consider an implant.
“The sounds are different as these are electrical signals.
“What we hear with our natural ear are acoustic signals, so the hearing aid is like an amplifier.
“Similarly, cochlear implants are not natural, however, with a small child, the brain will adapt and take it as the normal sound.
“Technology is so good these days that you can actually check your battery levels from your mobile phone app without removing the sound processor.
“The device is easy to handle as long as you spend some time to learn.”
HCTM’s oldest cochlear implant patient was 79, but not many in this age group come forward for the treatment as cost may be a barrier.
The price for the entire procedure ranges from RM80,000 to RM90,000.
But the implant is for life and doesn’t need to be replaced.
“The surgery is tedious as we need to look for the nerve and the cochlear using a microscope, as the implant electrode that enters the cochlear is less than 1mm.
“It takes around two to three hours, depending on the complexity of the case.
“Patients only need to spend three days at the hospital, and the sound processor can be switched on two weeks after.
“For children, they need to be managed by a tertiary hospital because they need a team to look after them,” says Prof Goh.
Already a subscriber? Log in
Get 20% OFF The Star Digital Access
Cancel anytime. Ad-free. Unlimited access with perks.
