For a toddler, the world is truly a playground. There are always new things to see, do and hear. But for Carissa Kee, from Temecula, her world suddenly changed; it went dark and silent when she was 19 months old.
Last summer, Carissa had an alarmingly high fever for three days and suffered a seizure when her mom, Cristina, rushed her to a hospital close to home. After a few hours in the emergency department in which she was given IV fluids and underwent a spinal tap, she was transferred via ambulance to Rady Children’s Hospital-San Diego. Unconscious for the first three days of her three-week stay in the Pediatric Intensive Care Unit (PICU), Carissa was diagnosed with pneumococcal meningitis.
Meningitis, inflammation of the protective membranes that cover the brain and spinal cord, is typically caused by infection, viruses or bacteria.
“When she finally woke up, we didn’t know that she couldn’t hear,” said Cristina. “She had us fooled because sometimes she was responding to our comments, but she must have already been reading lips and understanding gestures. Other times, we thought she was just not listening.”
It took about 10 days before Carissa’s parents and doctors determined she was not showing the beginning stages of the “terrible twos.” Instead, she was completely deaf as a result of the meningitis.
“They did an audiogram and discovered she had lost nearly all the hearing in both ears,” says Scott Kee, Carissa’s dad. “We were devastated by the news.”
Unable to talk or hear, Carissa was quickly evaluated by Dr. Daniela Carvalho, director of the Hearing Program and surgeon for the Cochlear Implant Team at Rady Children’s.
In the short time since Carissa had been admitted, Carvalho saw enough scar tissue forming in Carissa’s ears to determine quick action was necessary to give her the best chance at hearing again. She recommended bilateral cochlear implants for Carissa.
“Dr. Carvalho really helped us deal with the terrible news and provided us with hope that she had an alternative that would help Carissa to hear again,” says Scott. “It was difficult, though, because we knew that we only had one chance to make a decision to go ahead with the implants. If we waited it might be too late.”
Unlike hearing aids which amplify sound, cochlear implants translate sounds into electrical signals which are sent directly to the cochlea, bypassing the outer and middle ear. They are complex devices, made up of several parts. One part of the implant is a small electrode that is surgically inserted into the cochlea. It carries electrical signals to the auditory nerve which then sends the sound signal to the brain.
As time goes on, meningitis can cause scar and bone tissue to build up making it increasingly more difficult for surgeons to place a cochlear implant.
“In Carissa’s case we worked very quickly to complete her surgery before any more scar tissue could build up,” says Carvalho. “Meningitis can affect the brain in such devastating ways; we were really trying to minimize its effects on this little girl.”
On August 1, 2008, Carissa underwent surgery in which Carvalho implanted two cochlear implants, just one month after she became sick and was initially hospitalized.
Approximately three weeks after her surgery, Carissa’s implants were “activated” by the audiologists. They use a computer to “map” or program the cochlear implant.
During a mapping session, the implant is adjusted to account for the individual’s threshold for deciphering pitch, loudness and tempo.
Carissa’s progress and recovery has been nothing short of amazing, according to Carvalho.
“She was a typical toddler who was talking, singing, hearing and learning so much on a daily basis,” says Carvalho. “Then one day out of the blue her entire world went mute. It had to be terribly frightening for such a small child. Yet she came through it so well and is making great progress.”
After her ordeal, Carissa spent her first month out of the hospital re-learning things that she once knew how to do. She was like an infant all over again. She attended physical therapy up to three times per week to learn how to walk, talk, and run again.
“She came through it all really well,” says Cristina. “She was in therapy for about two and a half months, but after the first month she was walking, which was a dramatic change since she couldn’t even hold her head up when she got out of the Hospital. She is now running and talking again.”
Carissa recently graduated from speech therapy and is enjoying her new found world again. She loves to watch Dora, twirl, dance, sing and draw.
“Right now she is talking a lot, all the time,” said Cristina. “She’s had a long road to recovery but she is doing great now. You’d never know how sick she was.”
The San Diego Union-Tribune Kids’ NewsDay, October 2009