Fat tears are rolling down Eva Riggs’ tiny face, and even with a pacifier stuck between her pink lips, she’s sobbing hysterically.
The 1-year-old’s parents, though, are choked up with happiness — beaming smiles and wet eyes.
In this moment, which has shattered little Eva to pieces, she heard her parents’ voices for the first time in her life. She heard her 4-year-old brother say, “It’s OK,” and the chime of a xylophone sitting on the floor at Children’s Hospital in Aurora.
Eva was born deaf. After 14 silent months, audiologist Jennifer Kolb switched on the toddler’s cochlear implants, sending noise through electrodes surgically implanted in her inner ears.
A growing number of deaf babies are receiving cochlear implants soon after their first birthday — the Food and Drug Administration has approved the surgery for children as young as 12 months. For parents, that second the sound clicks on is overwhelming, nearly indescribable.
And for kids, especially those who receive implants about the same time hearing children typically learn to talk, it’s usually terrifying but offers the chance to grow up with normal speech, even the potential to play the piano.
“To be able to give a child a gift of hearing and be able to open up a whole new world for them, it’s very gratifying,” said Dr. Patricia Yoon, Eva’s surgeon. “You see them turn toward the sound for the first time ever. It’s a pretty incredible thing to witness.”
Traumatic start
On the October day Eva’s implants were activated, Kolb gave her parents a five-second countdown. Everyone stared at the content, easy-going child with bright blue eyes, a whisper of blond hair and an angelic face — hoping she would laugh when noise tickled her ears.
But her face turned to a scowl, even though the first sounds flooding in were low volume. Soon Eva was burying her head in her mother’s shoulder, clinging in fear, as her parents — Meghan and Justin Riggs — signed with their hands and told her, “This is good. You’re OK.” Eva calmed for a second, sniffling, but lost it again with one look at the audiologist — somehow she knew Kolb was responsible for this.
“Her crying is more reassuring to me than anything, really, to know it’s working,” Meghan Riggs said. After a while, Justin handed his daughter a cracker and walked her out of the room, hoping a change of scenery would quiet her.
They wondered how long it would take for the clearly traumatized little girl, now making the hiccuping gasps that come after a hard cry, to adjust. Eva, in her jean skirt and black leggings, clutched her polka-dotted blanket even tighter when the ear pieces got anywhere near her.
Ignoring the signs
Eva didn’t pass the newborn hearing test on the day she was born, Aug. 19, 2008. But her parents weren’t worried — lots of infants don’t pass because they have fluid in their ears.
Meghan and Justin tried to ignore other signs. They told themselves their daughter was a hard sleeper; that’s why she had never been awakened from a nap by a loud noise. They figured she was easily distracted by toys; that’s why she didn’t turn toward them when they called her name.
“If she was facing away from us, we could be screaming at the top of our lungs and there would be no response,” Meghan said. “But we didn’t want to see her as anything less than perfect.”
The Riggses grabbed onto what they thought was proof she could hear. There was the time Eva, sleeping in her car seat on the living room floor, startled when someone sneezed. They know now it was the vibration of their pastor’s foot stomping as he sneezed, not the noise at all.
When she was 9 months old, Eva was sedated at Children’s Hospital so doctors could monitor her brain while sending sound waves into her ears through headphones. Her brain didn’t react, meaning she was deaf.
Meghan, though, was prepared for good news, confident the audiologist would tell them they had removed fluid from Eva’s ears and she could hear.
“I remember being in the gift shop looking at noisemaker toys,” Meghan said. “When she told us that Eva had profound hearing loss, it really hit me like a ton of bricks because I didn’t prepare myself for that.”
Weeks later, the Riggses left their home, church and Justin’s job as an electrician in Rapid City, S.D., to move to Denver, near the hospital’s internationally known Bill Daniels Center for Children’s Hearing. Now they live in a modest apartment a few miles from the hospital. Justin is struggling to find work.
“We took it for what it was, and we grew together as a family,” Meghan said. “God wouldn’t give us this if he didn’t think we could handle it.”
Another test determined Eva’s auditory nerve worked, making her a candidate for cochlear implants. Eva’s hair cells — thousands of tiny hearing receptors that normally would vibrate in her cochlea, in the inner ear — are damaged or absent.
Surgeon Yoon placed Eva’s cochlear implants during an eight-hour surgery Sept. 21. Magnets were embedded under Eva’s skin behind each ear, allowing 3-inch, oval devices with microphones and sound processors to stick to her head.
When Eva grows more hair, it will hide the devices wrapping around her ears.
Sound is picked up through the microphones, turned into electrical signals and sent through her scalp to the internal device. Inside, 22 electrodes — substitutes for the damaged hair cells — carry the signals to the auditory nerve, which takes them to the brain.
It’s likely to take months for Eva to distinguish between her mom and dad’s voices, to hear a slam and know it was the door, to associate a bark with a dog. Newborns have months to absorb such information, long before they talk.
People with cochlear implants, which were approved for 1-year-olds in 2002, do not hear the same broad range of frequency as a hearing person. The sounds Eva heard during the first few days after the Oct. 13 activation of her implants were metallic buzzing and beeps. Every few days, her audiologist ramped up the frequency.
“Calling her name or shaking a rattle, it sounds the same at first,” said audiologist Kolb. “She’s going to need to hear Dad talking and see him, so she can sort of map her brain.”
Some kids laugh or stare, bewildered, when Kolb turns on sound for the first time. Most cry.
“We have no way of telling them this is coming,” she said. “It’s going from nothing to everything in a few seconds.”
Children’s Hospital surgeons will place 28 cochlear implants this year, twice as many as last year.
Cochlear implants are controversial in the deaf community. Not all parents of deaf children want their child to have implants, but “it’s turning into the option of choice for a lot of families,” Kolb said.
The hospital has a team that includes family consultant Stephanie Olson, who is deaf and got a cochlear implant about three years ago, to help parents decide.
Having a deaf consultant, whose hearing device is hidden under her brown hair, gives parents a powerful sense of calm.
“It’s reassuring for families — the hopes and dreams are still there; they didn’t lose them,” Olson said. “Their child can still do what they hoped for.”
Implant surgery, which costs about $35,000 just for the equipment, typically is covered by insurance.
The technology is far more advanced than a hearing aid, which only can amplify the sound a person already hears.
“If you view deafness as an ailment . . . then it is curing deafness,” surgeon Yoon said.
Guy and Tenley Williams are proof.
Both of the Williams children received implants at Children’s.
Their parents, Lindsay and Steve Williams of Columbus, Mont., had hoped Guy, now 6, who got one implant at 13 months and the second at age 3, would catch up to his peers by fourth grade. But in kindergarten this year, “he’s right at the top of his class,” said his mom. “It’s beyond amazing to us.”
Guy’s speech is nearly perfect; he just doesn’t pronounce M’s and T’s crisply. And in a crowded room, his parents sometimes have to tap him to get his attention.
Little sister Tenley, 17 months, whose implants were activated in July, already says three words: baby, kitty and hello.
Steve Williams was born deaf and communicates through lip-reading, sign language and text messages. At 31, he is now considering getting cochlear implants.
“He is happy that he has been successful in his time, but it was hard to overcome,” his wife said. “Any way we can make our children’s lives easier, he’s happy to do so.”
Successful experiments
Two weeks after Eva’s “hearing birthday,” the Riggses tried an experiment.
Four-year-old Myles hid behind his parents’ bed and kept calling her name. Eva was sitting on the floor down the hall, in the living room. Slowly, pausing occasionally to listen, she crawled all the way to her brother.
Another day, Meghan was feeding Eva a bite of “shipwreck” casserole, pretending the spoon was an airplane and inflecting her voice up and down. Eva copied the inflection, “Ah-ah-ah.” Another first.
“She used to be very silent,” Justin Riggs said. “There was no reason to make a sound. I could have sworn she was copying the sound of a rooster the other day.”
Eva wears her implant devices nearly all the time now, except when she’s sleeping. It took her only a few days to take them without tears. Now, when she wakes up from a nap, she taps her ears, asking her parents to turn on some sound.
Other 14-month-olds learned to babble at 6 months and by now are saying their first words. The Riggses expect Eva will catch up within six months or so.
For now, it’s small things that are huge to them — how she turns her head to look when someone laughs, claps her hands when her dad plays his guitar, makes a grumpy, annoyed noise when her brother messes with the drum she is banging.
Throughout all the appointments, the surgery, the “hearing birthday” that terrified her, the Riggses hoped they were making the right decision. Eva told them, in her own way, they are.
Last Thursday, after one of her new “ears” had fallen off while she was playing, Eva tried to stick it to her baby doll’s head.
Tears instantly filled Meghan’s eyes.
“It brings me joy to know that it’s something that she understands,” she said. “She wants to take care of her baby in the same way that she is being taken care of.”
Jennifer Brown: 303-954-1593 or jenbrown@denverpost.com
