GREENVILLE - First came clicks.
And finally, words, as 4-year-old Sophie Garris heard sound for the first time in more than a year when her new cochlear implant was activated.
"Sophie, can you hear me?" asked her tearful mom, Lesli Garris.
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The little girl with the copper-red hair looked over at her mom, gave her a big smile and nodded as the room erupted in cheers.
Sophie was born with an inner ear abnormality that caused progressive nerve damage resulting in hearing loss that would have left her totally deaf in a year or so, said Dr. John T. McElveen Jr., who performed the first pediatric cochlear implant late last week at Greenville Hospital System's Children's Hospital.
"The earlier we implant these children, the better they do as far as speech and language development," he said. "It opens things up for them. They can be mainstreamed into normal schools and take on jobs like hearing people."
Sophie has been wearing hearing aids since she was 15 months old. That was when her parents realized she wasn't hearing everything.
"When we first found out, we didn't know she was going to lose more hearing over time," said her father, John Garris, 38, who works in sales. "It's so traumatic when you find out that your daughter has a disability. It was one of the worst moments. It's your baby."
The implant was done on Sophie's left ear. And while she still has some hearing in her right ear, that's fading, too.
"She misses out on things. It's difficult," said Lesli Garris, 35, a stay-at-home mom. "And as it stands, she would have deaf speech, really thick."
During the 90-minute operation, McElveen implanted a quarter-sized electrode array in Sophie's inner ear through the mastoid bone. It connects via magnet to a processor she wears behind her ear that sends signals through the skin to mimic normal hearing, he said.
Complications from the surgery can include facial nerve damage, infection and temporary dizziness, but are rare, he said.
Though the operation took place Oct. 29, the wound had to heal before the implant was switched on, he said.
On Thursday, audiologist Dr. Erin Blackburn programmed the device, first sending a variety of clicks, beeps and other sounds to Sophie's implant as her parents, maternal grandparents and sister, Gracie, watched in anticipation.
Over and over, the little girl nodded each time she heard a sound, putting colored wooden blocks onto pegs to mark each success.
"What's your favorite color?" asked Blackburn. "Blue," Sophie announced.
McElveen, of the Carolina Ear and Hearing Clinic in Raleigh, has performed about 600 cochlear implants.
For the past two years, he has been coming to Greenville about once a month to perform the surgeries. He has operated on 18 adults here. Sophie is his first pediatric patient here, though others are planned.
Being able to have the surgery close to home meant a lot to the Garrises, who live in Greer.
"I have a 1-year-old, too, and it just makes such a difference to be able to come right around the corner for this," Lesli Garris said. "It's a hardship to drive two hours every time."
Now she hopes Sophie, who attends a preschool for hearing-impaired children, will be able to sing Christmas carols with the family, hear the musical ornaments on the tree, and eventually be able to attend kindergarten with hearing children.
"Today, her left ear was dead. And for her to have hearing in it - it's just a gift," she said.
"I'm just so happy that our prayers are answered," said her beaming father. "It's the best Christmas gift."