Sam, now aged 8, received his first implant (a Nucleus ESPrit 3G) in May 2001, having been deafened by pneumococcal meningitis in December 1999.

He received a sequential bilateral implant (a Nucleus Freedom) in September 2007; this was funded by our local NHS Primary Care Trust (Lambeth).

Sam had done reasonably well with his original implant. However, all that we had read suggested the benefits of binaural hearing to be significant, not only in terms of being able to localise sound and hear better in noisy conditions, but more generally in the overall quality and 'feel' of sound. And, with two implants, there is still one if the other fails - Sam does not sign at all and so relies on his implant to communicate.

We started to collect evidence to send with a funding application, and approached Sam's implant centre (Great Ormond Sreet) simply to ask if they would support our application. However, they very kindly offered to make the application for us, and did so the very next day. Much to our surprise (and that of Great Ormond Sreet, I suspect), the PCT approved the application immediately (both for a bilateral and an upgrade of Sam's original implant, i.e. from the 3G to a Freedom).

We seem to have been very lucky. As to why, we can only speculate. Certainly, our numbers came up in the postcode lottery. So I guess my advice would have to be: don't be deterred by people telling you that hardly anyone gets NHS funding for a sequential bilateral - if you don't ask, you certainly won't get.

Switch-on was on 17 October 2007, i.e. three months ago at the time of writing (30 January 2008).

Sam appears (to both us and his school teachers) to be identifying the direction of sound, and he is noticeably more willing and able to engage in family and other group conversations (e.g. around the dinner table). Also, he appears to us to be more confident generally, and to find listening easier.

Well, constant checking that the Freedom hasn't switched itself off has been very important! The Freedom's reliability is poor, due to a deeply flawed connection between its two modules (the processor unit, and the controller/battery unit). Within 5-6 weeks of switch-on the connection on Sam's had become so weakened by normal every day handling (i.e. Sam putting it on his ear and taking it off, and us changing batteries) that the slightest twisting would cause the whole unit to switch off, and after 2 months the implant centre had to replace it. This appears to be a common experience with the Freedom, resulting from poor design and road testing by Cochlear. There is wide consensus that the Freedom processor is by far the best of the bunch, but of course that is only true when it hasn't switched itself off.

Because of this problem with the Freedom, we have so far declined the external upgrade of Sam's original implant (i.e. from the ESPrit 3G to a Freedom), despite having been granted funding for it.

Sam loves having his bilateral, and has done since the day of switch-on. That day, on the way out of Great Ormond Sreet, I asked him if he liked his new implant. "Yes", he said, removing the Freedom from his ear. "If I take this new one off, I can still hear with my old one. But it's better with two". As Sam's ability to perceive speech and even identify sounds with the bilateral alone was of course somewhat limited at that point (and still is), I can only assume that he immediately felt some other benefit of binaural hearing, such as externalisation.