Robert Long, 57, of Alexandria, Virginia, had always had excellent hearing—an attribute critical for his job as a litigation attorney who has argued 18 cases before the U.S. Supreme Court. But all that changed in his late 40s, when a condition his doctors struggled to diagnose left him with progressive hearing loss. He wore one hearing aid, then two. Eventually, even with the aids, his hearing declined so much that it threatened his career.

“I love my job, and I really wanted to continue doing it,” Long says. His hearing loss was also beginning to impinge upon family and social contacts. “I told my wife once that it felt like I was on a ship headed out to sea, but everyone else was still on shore. I was losing contact.”

After about five years of steadily declining hearing, he sought help from head and neck surgeon John Carey, who told him that he was the perfect candidate for a cochlear implant (CI).

Although news stories often focus on children or young adults as the prototypical CI patients, middle-aged and older adults are two of the fastest growing demographics for receiving these devices, explains Howard Francis, who directs the Johns Hopkins Listening Center. CIs are critical for very young patients, who are in the midst of developing language. But these devices have also proven pivotal in helping adults such as Long maintain their involvement in professional and social pursuits.

Last year, Long underwent surgery to have a CI implanted in his right ear.

About a month after surgery, Long’s audiologist, Andrea Marlowe, activated his CI. “I could immediately hear my wife sitting across the room, asking if I could understand her,” he remembers.

Not all patients have the same kind of immediate success that Long experienced, Francis explains. Although at least 95 percent of patients have improvement in their level of hearing and understanding speech, age, length of hearing loss and the amount of hearing deficit can predict how well a patient’s CI will work for them.   

A key to achieving the best outcomes is auditory rehabilitation, which helps patients learn to use their CI over time. Although many centers offer CI surgery and auditory rehabilitation is widely offered for children, Johns Hopkins is unusual in making this service available for adults as well, Francis says.

“We find that adults, and particularly older adults, have their own needs that can be addressed with this useful service,” he adds.

Long’s CI has allowed him to continue practicing law, including arguing cases in court. If hearing in his left ear continues to decline, he plans on getting a CI in that ear too.

“Hearing loss is a serious loss,” Long says. “After my experience, I’d do a second CI without hesitation.”