Megan’s Story: Family-Oriented Care for Hearing Loss

Although Megan Guallpa enjoyed taking swimming lessons, her cochlear implant was an obstacle. So she turned to her longtime audiologist, Megan Kuhlmey, AuD, for help.

Megan, an 8-year-old from Queens, New York, has been working with Dr. Kuhlmey, 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 the many challenges of a child and family living with hearing loss.

“Megan is a fantastic kid, and Maria is awesome,” Dr. Kuhlmey says of Maria Guallpa, Megan’s mother. “Successful hearing care for a child happens through a close collaboration between patient, family, and the care team.”

For Megan, that care involves a cochlear implant, which is a small device that is surgically placed under the skin behind the ear and takes on the role of the inner ear. An external earpiece receives sound, converts it to an electrical signal, and transmits it to an internal hardware. The signal is relayed to the hearing nerve and ultimately to the brain.

Using a cochlear implant in the water, however, presents challenges. Megan had to remove the external earpiece to get in the pool, but without it, she had trouble hearing the instructor. So Dr. Kuhlmey, Maria, and Megan put their heads together to find a solution.

“We’re going to get you that waterproof device,” said Dr. Kuhlmey. “Swimming is important.”

The path to better hearing

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 has a successful outcome,” says Ana Kim, MD, Medical Director of Cochlear Implantation and Chief of the Otology/Neurotology and Skull Based Surgery Division. “Village consisting of audiologist, educator, speech language therapist, cochlear implant surgeon, and of course the patient, the family, teachers—everyone working 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, 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, which had the worst hearing loss. 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.

Since 2016, Dr. Kim has served as director of Columbia’s growing Cochlear Implant Program, which has expanded from four implants annually to over 100 implants in 2024. It is also recognized nationally and internationally as the premier 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 ear 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, adding her appreciation for the team support Megan receives to develop language. “This is something that not a lot of kids have access to.” 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 therapist. “We couldn’t have been in better hands,” Maria says.

All in the family

In fact, the family was so pleased with the outcome, they wondered if Dr. Kim and Dr. Kuhlmey could help Megan’s grandfather, Manuel Guallpa, Sr., who lost hearing in one ear as a young man. Now he was approaching 90 years old, and his only hearing ear was getting worse due to age-related hearing loss. With the hearing loss, he was withdrawing from his family and social activities. “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,” says Dr. Kim. “When hearing aids no longer help, cochlear implant can help restore sound and speech understanding 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 with Dr. Kim in 2024 and is doing well. “His recognition of words is better than expected,” says the younger Manuel.

A brighter future

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 our family,” Maria says.