Family-Oriented Care for Hearing Loss at Columbia
Megan Guallpa was talking swimming lessons with her audiologist, Megan Kuhlmey, AuD. Guallpa had fun at swimming, but her cochlear implant was an obstacle.
Guallpa, eight years old, a resident of Queens, New York, has been turning to Dr. Kuhlmey, the director of cochlear implants and pediatric audiology at Columbia University Irving Medical Center, since she was three. Affectionately known as “Dr. Megan,” Dr. Kuhlmey has supported the Guallpa family through a succession of Megan’s health and hearing challenges: recurring ear infections, ear tubes, hearing aids, speech therapy.
“Megan is a fantastic kid, and Maria is awesome,” Dr. Kuhlmey says of Maria Guallpa, Megan’s mother. “Successful hearing care happens through a close collaboration between patient, family, and the care team.”
Dr. Kuhlmey, Maria, and Megan put their heads together. Megan had to remove the external earpiece to get in the pool, but without it, she had trouble hearing and following the instructor. Cochlear implants are small devices that take on the role of the inner ear to help provide a sense of sound. An external earpiece transmits sound signals to an internal receiver that sends electrical pulses straight to the brain.
“We’re going to get you that waterproof device,” said Dr. Kuhlmey. “Swimming is important.”
Whether the patient is young or old, cochlear implants require commitment and a team effort.
“It takes a village of highly-trained providers to ensure that a cochlear implant user succeeds ,” says Ana Kim, MD, director of cochlear implantation and chief of the Division of Otology/Neurotology and Skull Based Surgery. “Village consisting of audiologist, the deaf educator, speech language pathologist, surgeon, and of course the cochlear implant patient, the family, teachers - everyone pulling together, coordinating care and support.”
For Megan, the work began soon after she was born, when she was diagnosed with hearing loss. With the help of hearing aids, she did well—her hearing loss was more significant in her right ear than her left, and thanks to her outgoing personality, nothing held her back. But by the time she entered grade school, every time she got sick, both ears would become blocked with fluid.
“A cold would make her completely deaf,” says Maria. “She had trouble hearing at school.”
Eventually, Dr. Kuhlmey recommended a cochlear implant for her right ear. The Guallpa family hesitated. Maria had long hoped Megan’s hearing loss would not turn out to be so severe. But when her hearing continued to decline, they agreed to meet with Dr. Kim.
“Dr. Kim has been so good to us,” Maria says.
Dr. Kim oversees a growing and successful cochlear implant program at Columbia. Since she took over nine years ago, the program has expanded from four implants annually to over 100 implants in 2024 and is recognized internationally as the premiere center of excellence for cochlear implants and hearing-related research.
Together, Dr. Kim and the Guallpas went over Megan’s options and the family’s concerns.
Pursuing a cochlear implant is a big decision. Unlike a hearing aid, which amplifies sound, an implant bypasses the portion of the inner ear that is involved in her hearing loss and creates a new connection directly with the auditory nerve.
“I was a little worried,” says Manuel Guallpa, Megan’s father. “She could still hear something [before the procedure]. After the procedure, will she not be able to hear anything?”
In the end, the family decided to move forward. The implant procedure went smoothly, and Megan has been making terrific progress ever since. She is learning steadily at school and finds it easier to engage with her friends and classmates socially.
“It was one of the best choices we have made,” Manuel says.
“She hears better, and she has more access to speech,” says Maria. “This is something that not a lot of kids have access to.” In particular, she says, “the support team to develop the language.”
It takes time and effort for the patient to get used to a new source of auditory information, and to learn how the new sounds relate to speech. Megan has been working with Dr. Kuhlmey to master the technical side of the implant, and she continues her work with a speech language pathologist as well as a the teacher of the deaf.
“We couldn’t have been in better hands,” Maria says. In fact, the family was so pleased with the outcome, they wondered if Dr. Kim and Dr. Kuhlmey could help Manuel’s father. Manuel Guallpa, Sr., had experienced hearing loss in one ear as a young man. Now he was approaching 90 years old, and his hearing had been getting worse. He was withdrawing from his family.
“He didn’t want to talk to anybody,” says the younger Manuel.
They brought him to see Dr. Kuhlmey, assuming his advanced age would rule out a surgery. But she felt he would benefit from a cochlear implant.
Age-related hearing loss is linked to earlier cognitive decline, dementia, and depression. When hearing aids no longer help, cochlear implant can help restore speech and sound back to the patient. As long as the brain can handle the technology and the patient is motivated, age is just a number and should not preclude anyone from pursuing the cochlear implant option.
Manuel, Sr. had the procedure earlier this year and is doing well.
“Dr. Megan is amazed,” says the younger Manuel. “His recognition of words is better than expected.”
Megan is pleased to have something unique in common with her grandfather, and she continues to see the benefits of her own cochlear implant. With the new waterproof device, she was finally able to hear what her swimming instructor was saying in the pool. Before she knew it, she was swimming. A few months later, the work paid off on vacation in Florida.
“I wish I had recorded her reaction,” Manuel says of seeing Megan at the beach. Her face changed as she walked into the waves. “I thought I would never be able to hear the sounds of the ocean,” she said.
“It’s been a game changer for Megan,” Maria says, “and the same thing for her grandfather. I know we have a long journey to go, but I know we’re not going to be alone.”