tech talk

Waiting for Tech

Waiting for new technology to arrive on the scene feels like a new phenomenon. At least, at the rate that it has been going in the past ten years or so. Growing up, I don’t remember waiting for the new iPhone every year. But I do, now. I’m not the type to whine and moan about our world becoming a place where we’re addicted to the newest technology, because I have found that you’re either interested in the newest and greatest gadget, or you’re not, and it doesn’t have to rule your life.

That being said, it’s interesting that LJ is in a situation where she’s waiting on technology before she gets the CI. In May, Advanced Bionics came out with some  upgrades that were approved in the States, upgrades that have been OK’d by the rest of the world for a year or so. (That darn FDA! Keeping us safer, but taking a lot more time doing it?) The biggest improvement is the newest implant device, which they are calling the Hifocus MidScala Electrode. The names that AB comes up with are super-confusing to me, still, but from what I gather this electrode is smaller, less intrusive to the cochlea (which means that there is a larger chance that the operation won’t affect LJ’s natural hearing), and more “future proof”. It has 16 current sources, where other companies offer up to 22, but they advertise this thing called current steering, which is a bit complicated to wrap my head around. From what I understand, the electrodes fire at different current levels, which stimulate sections of the cochlea differently, better approximating what is happening in a hearing person’s ear. Instead of more electrodes firing only in one place in the cochlea, the current steering tech sends the more current to where the sound frequency might be, and less through electrodes nearby, which might provide a fuller sound?

Once again, I’m hoping that anyone that knows far more about this than I do can chime in and educate others as to the function of these devices. And I’ll certainly be learning a lot more as I go along…I’m really excited to be able to correct my ignorant self in the future.

So that’s the new implant, and it’s great timing for it to be out and approved a month before the operation. However, the downer is that there is also a new processor that has been released everywhere but here, and as of today (July 6, ’13) it hasn’t been approved. Lindsay got an email from the audiologist asking her to choose which processor(s) she wanted to start out with by next Monday. Otherwise, she’d have to postpone the surgery, because they have to have one processor in hand for post-op.

The new processor is the awkwardly-named Naída CI, but it really looks like a huge upgrade to their last over-the-ear model, the Harmony CI. It’s smaller, comes in nicer colors, has a better microphone. With add-ons, it has a sync capability to Bluetooth devices. It’s also the first device that is coming out of the Advanced Bionics/Phonak collaboration; Phonak being one of the leading hearing-aid companies, there is talk of the two companies being able to build a cochlear implant/hearing-aid hybrid and will especially be nice for those that either are bi-laterally implanted or have a CI in one ear and a hearing-aid in the other. LJ doesn’t have Phonak hearing aid, but could get one in the future. This is another reason she went with Advanced Bionics; at this point in time they just seem to be ahead of the game.

This Naída CI is the obvious first choice to go with, but the danger is that it won’t come out in time…at this point, less than 20 days away. And she has to tell Mickie the Audiologist which processors she wants to start with by Monday. The original plan was to get two of the same processor, so that parts can be interchangeable (batteries, cables, etc.), but there is no point in getting two of the older processors. Once she starts using one, it can’t be returned.

Mickie suggests that she get one of the current processors, and choose a certificate that can be traded in for the newer one when it’s ready. The only other AB option is the Neptune. Completely waterproof, it’s built for highly active people (and marketed mainly to kids, who are more active, I suppose) and people who like long baths. Lindsay only falls into one of those categories, so the Neptune wasn’t really a viable option, at first. But if the Naída takes longer to come to the States, it might be a good start. There are other nice things about the Neptune, besides it being able to be sweated on: it doesn’t have an over-the-ear element to it (which would be a nice thing for her since she’s lived with OTE hearing aids for her entire life), it can be worn a bunch of ways (with clips and headbands and even a lanyard), and it can be color-coordinated to her outfit with a series of snap-on covers. Sexy.

LJ asked for my advice and I really couldn’t help. So I went to the source.

Edie Gibson is an Audiologist and Senior Consumer Specialist at Advanced Bionics. She also lives in Atlanta, and it was great to hear her slight Southern accent when I talked to her on the phone. I was able to ask her any question Lindsay and I had about the three processors AB offered at this time, and really appreciated her frank and candid answers. Edie told me that the advances offered in the new processor (the Naída) were so great it just made sense to wait for it to be approved by the FDA and take the chance that it’ll be ready by her “turn on” day. And that it’s currently an option to pre-order two certificates that can be traded in for the new processor, and not have to have an older one at all. IF it takes far longer for the FDA to say “yes” to the Naída, Lindsay can still choose one of the older processors and it’ll be in her hands the next day. Probably the Neptune, for both bath-times and the color-matching options.

So we’re set. After the operation there is a two week healing time before you can attach a processor to her implant, so hopefully the timing will work out. Crossing fingers! If someone reading this has any pull with the FDA, would you mind putting in a good word for approving the Naída CI Q70 for us?

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2 thoughts on “Waiting for Tech

  1. ben.lachman@gmail.com says:

    Something in here made me postulate something based on my own experiences with a Cochlear Implant. You spoke of Hifocus Midscala electrodes, which offer a far more nuanced pathway identification system than was previously possible.

    I want to say that I believe that will be one of the most stunning parts of all of this because when I had my implant turned on, I only had seven out of 21 electrodes working and they were as basic as you can get, despite being top of the line technology in 1986. Listening with that implant under those parameters was like watching TV with the contrast set all the way to high and only black/white shades appearing on the screen. You can see shapes, faces, speed, but you have very little information otherwise. Oftentimes it just looks like a jumble of randomly moving pixels.

    That’s about how my experience was with my CI. Despite that, I was able to decipher some of the gibberish and allow for myself an unprecedented level of auditory feedback that, in turn, allowed me to improve my own speech skills, which I consider to be a critical component of my successful interactions with this world.

    This part: “but they advertise this thing called current steering, which is a bit complicated to wrap my head around. From what I understand, the electrodes fire at different current levels, which stimulate sections of the cochlea differently, better approximating what is happening in a hearing person’s ear. Instead of more electrodes firing only in one place in the cochlea, the current steering tech sends the more current to where the sound frequency might be, and less through electrodes nearby, which might provide a fuller sound?” blew my mind because it basically is telling me that Lindsay will more than likely be able to receive enough information to comprehend spoken speech after extensive listening therapy. This is a very good thing and if I can achieve similar results and benefit from similar advancement in technology, I would be thrilled.

    As it is, I have a 25 year old implant in my head that’s most likely become so ossified and sunk into my skull that it’s now a permanent fixture. We considered replacing it but we have to go through the process first, which dictates testing out what we have first and then going from there.

    I look forward to working with Pamela, whom Lindsay has been working with.

    good luck! Both of you can call me if you guys have any questions.

    Benjamin Lachman

    • Matt says:

      Ben,

      Thanks for the thoughts and words. To think that you literally have one of the very first implants OK’d for children is AMAZING, even if it was more of a frustration and disappointment to you.

      Lindsay’s surgery was difficult, and this week after being turned on hasn’t been all cake, but she’s very hopeful that with fine-tuning of the processor and lots of practice she will get to a point where she can make out words without lip reading…and the newest processor is supposed to help even more.

      The iPad app that Advanced Bionics has in the App Store is functional, but just barely…I want to have a crack at re-designing it! I know you’re looking into software/hardware involving cued speech-I’d love to help in any way I could!

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