One month after surgery, patients return for implant "hook-up." On the first day of activation, a headpiece is placed on the patient’s head and the speech processor is connected to a computer. The speech processor is programmed by the computer to provide effective stimulation for the patient. This is customized for patients so they hear important sounds (and not uncomfortable sounds).

Most people are disappointed on the first day. Voices do not sound normal. They are reported as sounding mechanical or warbled (like voices under water), garbled, scratchy or raspy, or any combination of these. It can take up to six months to fully adjust to a cochlear implant.

Full programming or mapping of the implant takes about eight appointments during the first three months following hook up, with follow-up appointments at three months, six months and annually thereafter.