Thursday, July 2, 2009

Let's get technical, technical.

I've been meaning to post about Seth's gear in a little more depth, and a recent comment spurred me on...thanks! First off, I need to say that this is a walk through by me, and I am not all that technical. So don't swear by the names or explanations I give. I don't represent the company that manufactured Seth's Cochlear Implants, Advanced Bionics, but I sure do like them! Point is, this is a laypersons perspective, and as such, may not be completely technically correct.

With Cochlear Implants, there are two major pieces of equipment. The first is the internal implant, which is inside Seth's head, embedded in his skull. It consists of a magnet and a computer chip, which is housed in titanium to protect it, then padded in silicone. There is an electrode array that is spiraled through his cochea. The nickel in the below picture gives you an idea of the size of the internal implant.
Now, onto the outer piece of equipment, the processor. Ava's friends call these his jetpacks. I labeled the below picture to make it a little more clear.

Processor Details

The bottom half of the processor is a rechargeable battery. On the top half, you have a sensitivity dial, which adjusts the sensitivity of the microphone that transmits sounds to Seth's internal implant. In loud situations, the sensitivity could be lower, in order to catch only the louder sounds, or it could be turned up in order to catch a wider range of sounds. The Status LED blinks red when the processor is on but disconnected from the internal implant. When the processor and internal implant are connected, the LED blinks green when it processes sounds. The Program toggle switch is used to switch between various maps. For instance, Seth has two programs that are designed for every day listening, and one that is designed for listening in loud environments. That program is quieter, so when sounds are bother Seth, we can change his program to turn it down.

Here is a picture of a Processor disassembled. Pretty simple...the battery slides onto the processor, the T-Mic twists onto the aux post, and the headpiece clips in. The T-Mic routes the microphone into the ear canal so that sound is heard in a more natural way.

labeled processor

Here's what it looks like all put together.

Processor Together

Here it is on Seth! The headpiece magnet attaches to the magnet in the internal implant, and the processor fits behind the ear. This is the way that the majority of Cochlear Implant users where their device. It allows for great localization of sound, you don't have a lot of cables to deal with, and it's light. However, when you have a baby who was implanted at 8 months of age, this set up is a little overwhelming, which is why you've never seen a picture of Seth set up this way before.

Seth Processor Labeled

In the past, you had two wearing options. The above set up, called a BTE (Behind the ear) or a body worn set up, which consists of bulky processors worn in a harness on the child's back. We weren't a fan of either for Seth, so we started out, on the advice of our awesome audiologist, altering the set up to fit Seth. We used cables and headpieces designed for the body worn processor along with the BTE Processors pinned to Seth's shirt in a modified set of Ear Gear. It wasn't the prettiest set up, but it worked for us.

Then came our trip to California to visit Advanced Bionics! In addition to getting to tour the factory and see cochlear implants and processors being made by hand in the good old US of A, we got to see just what Advanced Bionics has been working on lately...and try it out! AB has been working to offer more wearing options for their pediatric consumers and bilateral users, and since Seth is both of those things, I love it!

Soon, the headpiece cables will be available in multiple lengths, making it possible to wear the BTE processor at Ear level, clipped to a collar, or pinned to a shoulder. Like what we were doing before, but prettier. There's also some large number of color caps you can interchange to either blend in or stand out. We like to stand out.

Headpiece Cables

If you look really closely here, you can see the outline of Seth's implant. It's placed at an angle just behind his ear.


Putting the headpiece on is easy, even if you can't see the actual implant. As you bring the magnet to his head, you'll feel a little magnetic pull. Set the magnet in place, and there you go!


Once attached, it still comes off easily. If the magnet is too strong, it can damage the skin, so it is very easy for a baby to yank it off. When Seth was first implanted, he pulled his right magnet off all the time. Now that he's realizing that he loses out on sound when he pulls it off, he doesn't do it as much, unless he's ready for a nap. Then all bets are off! The new style headpiece we're using also's lighter and thinner, so I don't think it bothers him so much, and the edges are rounded, which keep it from being knocked off as much when he rubs his head on things. But I won't lie...we pop magnets back on his head about 100 times a day. But that's why I love our wearing option...the magnet is the only piece of equipment on his head. If he was wearing the processor behind his ear, we would be replacing both items a hundred times a day, and that gets really old, really fast.


So how do we keep the processor off his head and make our lives easier? Why, with the KinderClip. This is the device we're trialling for AB right now. When it's commercially available, it will be an alternative wearing option for those who don't want to go with a BTE or body worn configuration. Here it is disassembled, just like the processor above.

KinderClip Apart

The KinderClip system is simple. In addition to the processor and battery, which are the same as in the BTE configuration, it replaces the shorter headpiece cable with a longer one, and replaces the ear hook with an aux cover to protect the metal post that the earhook attach to. In this set up, there is no need for an ear hook. It utilizes the microphone that is on the processor. The additional piece of equipment is the actual KinderClip, a plastic clip that the processor clips into so that you can clip it to a shirt. Or whatever you want, I guess!

KinderClip Together

Here it is all put together. You'll see a black clip at the bottom...I use that to clip any excess cable to Seth's shirt so that it's not just flopping around. In the below picture, you can see it all on Seth.

KinderClip Seth

This works for us perfectly. I have yet to have the KinderClip fall off his shirt, even when he is rolling around and playing on the floor, and when he falls asleep or goes into the car, I can easily unclip the processors for safekeeping. For us, it's all about making life as simple as possible and letting Seth be Seth, not a kid with tons of equipment. We want to make sure he has lots of time every day to be a kid, and not waste any replacing gear over and over or taking time to fit something on him. This way, it's quick and easy. Clip it to his shirt and pop the magnet on his head, and off we go!

I know that's all really just aesthetics and convenience, though. How does Seth actually hear with this stuff? Really well, actually. Sound goes into the microphone and is transmitted through the processor into the internal implant. At some point along the way, sound is encoded into electronic something or other, then sent through the electrode array through his cochlea and inner ear to his brain, and by the time he hears it, it's recognizable to him. Believe it or not, there's no lag time for all of that to happen, either. If I call his name, he turns immediately.

He can hear whispers if he wants to, and can also be a selective listener like his brother and sister if it suits his fancy or he's busy with his toys. He repeats sounds we make, babbles (loudly) and so far, he can say Mama, Bye Bye, Ball, More, and Puppy appropriately (meaning he's not just imitating them, he's attached meaning and understand what each word means). Ball is by far his favorite. We hear him scream ball roughly 3259845 times a day.

In other words, Seth is pretty much just a typical 11 month old with some cool jetpacks on his shirt. While he'll always be a deaf kid, he also functions very well in the hearing world thanks to his cochlear implants. In many ways, things will get harder as life gets louder and more complicated, as he is expected to follow lectures in school and conversations between several friends at once. But I have no doubt that he will work hard and exceed all of our expectations, once again.

Please feel free to ask any questions...we love sharing about Seth's CI's.


Nati @ I will praise Him said...

No questions, just wanted to say thanks for sharing! This is really neat and I'm so happy that Seth got this opportunity! He'll do just fine, like you said! He's got a really awesome family!!! :-)

Audrey said...

Great job explaining everything! I might use this in the future on my blog. Anytime people learn that I work with deaf kids, I immediately have to explain that no, I don't sign. I start explaining and the person's eyes gloss over.

Elyse said... questions here! You did a great job at explaining each detail. I wish instruction manuels did this well :)

Sherri said...

That was a great explanation of the equipment! I have explained it 3459098375983 times to family and friends how Dylan's implant works...perhaps I will send them a link to this post instead :)

BTW, Dylan received his second cochlear implant two days ago in his right ear! He is recovering slower this time, but all appears well. Activation will take place the end of July-please keep us in prayer!

Mandy Hornbuckle said...

That's WAY COOL!!!

WendyCarole said...

Thank you for such an informative explanation.
I have only worke dwith children with regular hearing aids and a teacher microphone. Technology is certainly moving forward.

Madison Sanders said...

Interesting post! Technology is always advancing, so there's no telling how far hearing implant technology will come in the next few years.

Anonymous said...

THANKS! (I asked the question before.) You did a GREAT job of explaining and the close-up pictures were helpful in understanding how it all works. It's SO amazing! I still get a little tear in my eye when I think of the video of Seth hearing your voice for the first time...the look on his face was priceless. This is all truely a miracle and it's been such a blessing to watch your journey.

Sonya said...

That is so neat!!

Emily said...

Wow...modern medicine never fails to amaze me. What a miracle given to us. Thanks for sharing about how all this works!!

Emily said...

Oh, and I'm amazed how it doesn't seem to phase Seth at all...although I guess he's had a little while to get used to it!

Cathy said...

That is amazing how science is coming up with such innovative ways to help. How many colors do you have of the magnet? Love the pics, too.

Tricia said...

Thanks for is cool seeing another brand up close. We get to see Med-El all day long!

We basically chose Med-El because of the options a young child has for wearing it. There is a straight processor/battery pack that safety pins on the shirt. We destroyed a whole lot of shirts with those pins, but man it was worth it. Even with the Baby BTE option Med-El has, we have had to been creative over the years with how she wears them. We have attached them to barrettes and to headbands. Now Emmi uses a skeleton earmold attached to the processor. It holds the processor snug on her head. So much easier. I also know a lot of the kids in her class use toupe tape to keep their processors on.

I should take some pics of all the different things we did to keep her wearing it through the years and post them on her blog!

Courtney said...

No questions I just wanted to say thank you:) I knew an implant helps the wearer hear but that is all I knew. Now I know so muchmore and the best part is that Seth can hear ...if he

Anonymous said...

Thank you so much for sharing all this helpful information. I have heard of the implant but have really never seen it taken apart. May the Lord continue to bless you and your precious family. Together you are awesome in His love. You are in my prayers, Bev

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