Cool video making the rounds showing how Cochlear Implants sound to people with hearing. Skip to 2:45 for the juicy stuff.
Great article found by the head of my research division (aka Eliza), it’s about Dr. William House, the creator of the Cochlear Implant:
I love stories like this: entrepreneurs who “buck the trend” to bring something meaningful to the world. It’s interesting to hear some of the opposition he originally faced, like this quote:
The responses from fellow doctors, however, stung. They claimed he was money hungry, House said.
Working for technology startups the large majority of my career, i’ve been fortunate to work with some pretty creative and intelligent people working on creating something new the world has never seen. Still, never have I worked in medical research – this is an area that really makes a difference. I often wonder what my life would have been like if I went down that path instead.
The article mentions a memoir of Dr. House, The Struggles of a Medical Innovator: Cochlear Implants and Other Ear Surgeries: A Memoir by William F. House, D.D.S., M.D.
Might be a good book to add to my Christmas reading list. If anyone has already read this (or adds it to their own list), I’d love to hear your reactions.
Back in August I posted about one of the major current drawbacks to Cochlear Implants: the inability to effectively pick up music (see Cochlear Implants and Music).
Tonight I read an interesting blog about a new algorithm devised by researchers at the University of Washington in Seattle that “vastly improves the sound quality of existing implants to the point where music sounds like something other than a random clamor”. You can see the full post here.
This is both an encouraging and scary statement. Scary in that music perception is still SO bad, but encouraging in that this problem can be attacked through software upgrades. Pretty crazy if you think about it. Imagine receiving an email asking you to “download the latest upgrade of your implant software to…hear guitar music!”
I have no doubt something like this will be exactly what happens in the future. With the CI implant surgery being so invasive, requiring infant anesthesia and an overnight hospital stay…TWICE (once for each ear), minimizing the need for future surgery is critical.
This emphasizes the value in getting a processor that has room for future software upgrades. While I’m sure Fiona will no doubt need a physical upgrade again later in her life, the advantages of upgrading must be very compelling to go through the surgery process again. Fortunately the processor companies also realize this and have placed the bulk of the processing hardware outside of the implant area itself, allowing for many upgrades without new surgery.
Still, it is inevitable internal upgrades will likely be needed again down the road as the nerve stimulation apparatus becomes more sophisticated. My hope is Fiona’s second round of implants will happen when we’ve finally achieved the “completely internal” implant.
Still a long way off, but I’m sure it will happen in her lifetime.
The wave of innovation continues, Yay capitalism!
If you’ve been following my posts for some time now, you’ll recall I’ve referred to the Big 3 Cochlear Implant companies: Advanced Bionics, Cochlear and Med-El. Back in August I posted about the new release by Advanced Bionics of the Naida CI Q70 implant.
Looks like now it’s Cochlear’s turn with the release of their new “Nucleus 6” sound processor. Here’s the press release.
As with Advanced Bionics, the trend continues towards smaller implants, better compatibility with wireless devices, and more upgrade room for the future. The last part is especially important since you don’t want to have a new surgery every time you upgrade.
This press release has a lot of “forward looking” statements which makes me wonder if its “not quite ready” yet, but i’m sure time will tell.
Cochlear will continue its history of breakthroughs in innovation with future upgrades to the Nucleus 6 Sound Processor. The new chip is designed for the next generation SmartSound processing, which leverages new algorithms that focus on speech and reduce background noise, as well as third generation wireless accessories that do not require any neck worn loops.
We’ll definitely have a tough decision next March. Competition is good.
For those who don’t know, last January I threw caution to the wind and joined an early stage technology startup called Zoompf with my good friend Billy Hoffman (an avid follower of this blog). When you start a technology company, you quickly learn the value of following industry newsletters, setting up a hundred Google Alerts, diving head first into all forms of social media, and just altogether getting “plugged in” to the industry. I’ve learned A LOT about this in the last 8 months.
When Fiona was diagnosed with profound hearing loss, i quickly applied these new skills to the Cochlear Implant industry as well. In my earlier post about The Big Business of Cochlear Implants, I called out 3 leaders in the space: Cochler, Med-El, and Advanced Bionics.
Today, my various alerts fired off en masse about a new product release by Advanced Bionics: their new Naida CI Q70 Cochlear Implant. (Yeesh what a name, “Hey we’re all technical and futuristic”…). Eliza and I have actually been following development of this implant closely as we’ve heard of people holding out on their CI surgery to get this new implant since it was a big leap forward. This implant may be a big contender in our choice for Fiona when she’s eligible next year.
I’m still learning more about the details, but here are the specs from their marketing department:
- 55% improvement in speech understanding in noise1 when AB ClearVoice* and Phonak UltraZoom features are used together
- 100% wireless connectivity streaming from consumer electronics by leading brands, including Apple, Samsung, and Nokia
- All-new Binaural VoiceStream Technology designed for improved hearing in noise
- Bimodal streaming media can be streamed to a compatible Phonak hearing aid and a Naída CI sound processor at the same time!
- 40% smaller than the previous behind-the-ear sound processor incredibly lightweight for barely noticeable on and off-ear comfort
- First-ever bilateral feature for easy use and peace of mind each processor can be programmed for both ears so the best ear can still hear if a second processor is misplaced
- Compatibility with AB performance innovations, including ClearVoice, AutoSound, HiRes Fidelity 120*, and HiRes Optima Sound Processing
- All-new, discreet T-Mic 2 microphone
There’s a lot of marketing speak in here, but my interpretation is basically this: “Our sound quality is a lot better, and it’s a lot smaller.”
How real is this, I don’t know. We’re looking forward to learning more from independent sources. Advanced Bionics is also coming to Atlanta on November 3rd to give an information session on the new technology, so Eliza and I will be attending.
We may have to choose an implant for Fiona as early as next February, so we’re watching this one closely. Stay tuned…
Today was Fiona’s first auditory speech therapy session at the Auditory Verbal Center of Atlanta, the same great center I posted about last month. Now that Fiona has her hearing aids, the plan is to visit the AVC every 2 weeks to help train her to make sense of limited sound, and to train mom and dad on how to grow her skills between sessions.
Since Fiona is just 3 months old, and her hearing aids are of limited benefit, the goal initially is basic “sound awareness”. Training Fiona to respond to limited sounds, and to acclimate her to the therapy routine. After she gets her Cochlear Implants (6-9 months away), the therapy will intensify to a weekly regiment focusing on improved speech recognition and language development, with the ultimate goal of complete integration with hearing children by preschool! Kick ass.
The AVC will be a regular fixture of our lives for the next 3-4 years, so today’s session was primarily informational meet and greet. As we entered the lobby, I chuckled at the “chocolate ears” available for sale. They looked pretty yummy I must say, but in any other context I’m not so sure…
We met our therapist Jennifer, but found out later she will be leaving the center soon, so we’ll be settling in on a new therapist next time. After 40 minutes of extensive Q&A (“does fiona make cooing sounds”, “does she recognize laughing sounds”, “does she mimic your facial impressions”, etc.), we got down to the fun part.
We turned on Fiona’s hearing aids, then Jennifer then took out a series of toys to “clang” behind Fiona’s head, looking for responses.
In this picture you can see her pounding what looked like a pool paddle with a plastic mallet:
The good news is that Jennifer detected slight responses to some of the sounds.
I still have trouble myself differentiating an actual response from random “baby faces”, so I asked for tips on how to differentiate. Jennifer recommended focusing on the eyes (look for sharp movement of the pupils), the eyebrows (furrowing), and abrupt movement of the head. Still, at 3 months old there’s no foolproof way, so you need to keep with it.
She then brought out other toys to try different sounds, including the legendary cowbell! While I (barely) resisted the urge to make “More Cowbell!” jokes, we watched for some time, but did not see much of a reaction. Its possible Fiona was getting tired, though.
So we left the center with homework to get some noise making toys and practice testing her awareness of sound. We must be the only parents in America who are actually SEEKING OUT noisy toys for our child. Should be a fun trip to Toys R Us – I see lots of toy drums and cowbells in our future!
And on that note, I leave you with…More Cowbell!
Today we continued our survey of Atlanta’s healthcare system by visiting the Children’s Healthcare Of Atlanta Egleston location. Egleston is actually 10 minutes away from our house on the Emory campus, so the drive was short and pleasant. I also think this may well be the 7th hospital we’ve visited in the last 2 months. Perhaps I should start a hospital ratings website when this is all done…
As I mentioned last week, the goal for today was for Fiona to receive an MRI to better diagnose the root cause of her hearing loss. When we entered the lobby it was quite clear to me this was hands-down the nicest hospital I’ve ever been inside. Nicer still then the Scottish Rite location I blogged about a few weeks ago. Beyond the immaculate cleanliness and “newness” feeling to everything, it had a very airy architecture sprinkled liberally with technology and relaxing “aquatic” artwork (aquariums, water sculptures, etc.). I shudder to think of the cost.
The lobby, if you can even call it that, was pure child nirvana showing not one, not two, but THREE different kids programs on different TVs. See if you can spot them all below.
As we sat waiting (not long mind you), I noticed a funny looking room off to the side: it had open glass, 7 or so microphones, and various pictures and posters on the wall. My curiosity got the best of me, it was clearly a studio of some sort, but what was it doing in a hospital?
Well it turned out it was a studio donated by Mr. American Idle himself, Ryan Seacrest (kindof obvious in retrospect, but it was so out of place for me in that context). Apparently they use it for various interviews with celebrities and fund raising events for the hospital. I of course asked what celebrities they’ve seen – most are sports stars I wouldn’t know (not because they aren’t famous, but because I’m lame and don’t watch sports), but they also had a recent interview with…
…wait for it…
the “Biebs” himself, hunky teenage heartthrob Justin Bieber. OMG LOL OMG TTYL! Life is just TOO good!
So Justin Bieber you say? Well that was just too much to resist, so I had to get Fiona’s picture in front of his cardboard likeness. I’m sure she will grow up to have absolutely no clue who this is, and my what a shame that would be…
Celebrity gawking aside, we were soon escorted to our own private room by way of the “butterfly” elevator. Apparently the Wonka Glass Elevator was out of service today.
We soon got down to serious business. Since Fiona is so young, she had to be sedated for the procedure. We watched a short Simpsons-like “so you’re about to be sedated” video, and then the nurses prepared Fiona for her IV. Mom and the nurses were fantastic, but clearly this was not Fiona’s favorite part of the day.
Humor aside, I won’t lie: it was pretty sad watching your baby get sedated. You feel so powerless to help your child, and worried silly something will go wrong. The staff, though, was fantastic at setting us at ease and assuring us she was in the best of hands.
They soon took away Fiona in a gurney to get the MRI done. We were not allowed to follow, which was probably for the best, so we had about an hour to kill. The nurses gave us two options: we could hang out in our private room (which had cable TV, of course), or we could walk around the hospital and they’d call us when it was time to come back.
We chose to walk around – first grabbing some lunch at the cafeteria. The food was decent by hospital standards, and far better then the Northside cafeteria I frequented during the delivery. Eliza was also in heaven as they had Chick-Fil-A sandwiches.
We had more time to kill, so then strolled around the hospital garden. Yep, the hospital garden. The flowers smelled quite nice.
By this time Eliza was rightfully abusing me for taking so many pictures, but I had to joke since we hardly get out of the house now, this was the closest thing we’ve had to a vacation in 12 months. Kindof a funny commentary on how much our lives have changed over the last year.
As we returned, Fiona was soon carted back in. The procedure went great, but we won’t get the results for 3-5 days. Sorry for those who’ve read this far looking for the results, but you’ll have to come back to hear more.
Fiona woke up about 10 minutes later, and we were able to go home probably 20 minutes after that. As I’m writing this now, she’s continuing to sleep in the corner. A traumatic 5 hour day at the hospital for little miss Fiona, but all is well and she’s sleeping it off now.
More to come on Wednesday when Fiona gets fitted for hearing aids. The busy week continues…
Another good find by Eliza. This video shows the running diary of a baby girl born with profound hearing loss. Over the 8 minutes you can see her progress from birth, through hearing aids, to the CI surgery and finally to integration into the hearing world. An eerily similar parallel to our upcoming journey.
The progression is really interesting to watch:
To frame the context: Fiona is now 10 weeks old and will be getting her hearing aids next Wednesday.
Since my last post was a bit of a downer, I wanted to post something more upbeat today.
Eliza and I have been following this great Facebook page called Roberta’s Cochlear Implant Journey. Roberta is an adult who had the Cochlear Implant surgery done a few weeks back on June 7th.
After undergoing the CI surgery, it’s standard practice to heal a month or so before activation of the implant. Roberta’s activation is this Monday.
Can you imagine the anticipation? 30 Christmas days all in one.
It’s fun and addicting to share in Roberta’s excitement as she counts down to the big day. It’s also interesting to hear the well articulated thoughts of an adult going through this process, since we know we won’t have that luxury with Fiona.
I can’t wait to read more about Roberta’s activation on Monday. She sounds like a remarkable woman.
Today was a good day.
This morning we packed Fiona into the car and headed out to the Auditory Verbal Center (AVC) in the North Druid Hills area of Atlanta. Maybe a 20 minute car ride without traffic.
The AVC specializes in speech and development therapy for infants and children with severe to profound hearing loss. They are not a doctor’s office nor do they perform medical procedures. Instead they focus on the training and development of both children and their hearing parents. The AVC is not a state sponsored program, but strives to be affordable and bills through insurance when possible.
We’ve been looking forward to this visit ever since hearing about it from our friend Zoe. We’ve since heard nothing but good things about the program, and did not leave disappointed.
As we waited in the waiting room with Fiona, Eliza and I had our first experience with children with Cochlear Implants. I won’t lie, it was a little disturbing at first to see young children with small devices attached to their heads. It breaks your heart and makes you feel sad – until you see they are getting along just fine and it’s really no big deal to them.
We were then escorted back into the facility to talk to one of the therapists. I’m not sure what I was expecting – maybe the standard “patient room” with the paper-wrapped bed and a model of the ear on the counter, or perhaps just the standard office with a desk and a dilbert calendar.
Instead, we were brought into what looked like a “family room” with couches and toys everywhere. We were immediately set at ease.
We talked about an hour with the therapist, and ran down a laundry list of questions. We were pretty encouraged by what we heard. By catching Fiona’s loss at such a young age, they have every expectation she will be fully integrated with her hearing peers at PRESCHOOL! Preschool, can you imagine that?
We talked through the process of therapy and got some great details. The flow will likely look something like this:
- On July 2nd we do the hearing retest with the Audiologist at Scottish Rite. (See my earlier post abouts about the ENT and the Hearing Test). Assuming nothing new surfaces there, Fiona will be fitted for hearing aides.
- Soon after she gets her hearing aides, we will begin sessions with AVC. They ask us to come in once a week with Fiona, where they will go through new lessons each week that we then take home to reinforce the following week. I personally am looking forward to checking out their massive treasure trove of fire trucks and airplanes.
- Early lessons focus on major sound distinctions, deep uhhs versus high ahhhs, with cause/effect association to make associations. As the child shows progress, the distinctions between sounds gets narrower and narrower until they reach early speech levels.
- Since Fiona has “severe to profound” loss, its not expected she will hear many of those distinctions, but its rare the child will hear absolutely nothing. They do expect Fiona will get at least some benefit out of this process prior to getting CIs though.
- Once she is eligible for the implant (1 year old), she will resume therapy afterwards with full focus on catching up her auditory speech skills to those of other children at her age. Because this is so young, the catch-up time is now quicker then ever.
- The expectation is she will “graduate” into classrooms with hearing children by kindergarten, and likely even preschool. At that point, her education would proceed at the same pace as her hearing peers. (of course i’m pushing for calculus by 2nd grade ;->).
The AVC is a proponent of integrating deaf children with hearing children, as that reinforces the development of strong language skills. They are NOT a proponent of using sign language after the CI is received, as that weakens their training methods and prolongs the learning of their auditory skills. This is somewhat at odds with what we researched earlier in my post The Great Sign Language Controversy, so clearly we have more research ahead of us. Like most of you, we are learning this as we go along and are still filling in all the pros and cons here.
On our way out we met Samantha and Jonathon from the AVC videos I posted earlier, both of which have Cochlear implants. We had a great conversation and quickly forgot anything was different, it was like any other conversation. It was incredible. Made us feel like we were making a big F’n deal over nothing.
We’ll still have our ups and downs I know, but this helped a lot. Today was a good day.