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HearPeers January 2023 GoogleMeet hosted by Mary Beth for Med-El CI users, families and those considering a Med-El CI


Mary Beth

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Sorry I dropped out without saying goodbye - terrible network issues that kept freezing then eventually crashed. Hopefully better next time 😉

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@Kylie

I missed you!  
 

I had just asked you a question and you vanished like poof!

 

The question was…. If you were offered a CT scan and a frequency allocation MAP through OTOPLAN, would you want to try it knowing it would take time to adjust to and possibly your old favorite MAP may not sound the same afterwards?

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2 minutes ago, Mary Beth said:

@Kylie

I missed you!  
 

I had just asked you a question and you vanished like poof!

 

The question was…. If you were offered a CT scan and a frequency allocation MAP through OTOPLAN, would you want to try it knowing it would take time to adjust to and possibly your old favorite MAP may not sound the same afterwards?

Yep I'd give it a go. 

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@MED-EL Moderator

Is there research data yet on using anatomy based fitting for frequency allocation based on CT scan and OTOPLAN for already established CI users?  Is there a benefit even for those of us who have adjusted to our MAPs?

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@Mary Beth @Lauren @Joan@Kylie

Okay - you convinced me check on it!

I wasn't offered the 2nd CT - I would definitely take them up on it if it was offered but it is more of a matter asking my Audi.  That request (pestering?) worked to get my pre-op CT and then have it passed on to Med-El for an Otoplan.  Paid off big time to get a longer electrode array than my surgeon's default of the 28 mm.

Don't want to make myself into a pest in the clinic.

Also, I don't know if a post-op CT scan it would be covered by insurance covered.  My pre-op CT is useful for surgery.  After surgery, insurance might be skeptical that it was medically necessary.  I would pay a couple hundred of dollars for it but not a thousand dollars if it is not covered by insurance.  (I don't know what the current funny money billing for CTs is.)

--------------------

Also, you all convinced me to try more gadgets and do more rehab today.

I tried my Rondo 3 for rehab but had a little difficulty with connectivity. I have post-activation meetings tomorrow with Med-El and will try to sort it out there.

Went back to the Sonnet 2 with the Max battery.  Doesn't feel much heavier on the ear but is longer.  Given how I'm currently using AudioLink, that seems reasonable.  Also, when my DL Coil comes off, the heavier weight of the earpiece with the Max battery seems to keep it all up and not falling on the ground.

 

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Keep us posted @Tim

Some surgeons use a during surgery or immediately following surgery image to verify the electrode position.  Both of my surgeons used X-ray images during surgery.

I have had post CI CT imaging of my cochleas twice.  Once as part of a research study and once when non auditory sensations were making it difficult to MAP my left side.  I did not pay for either time so I do not know the cost.

I recently had a different kind of CT scan and the cost to my insurance was several thousand dollars.  So it is wise to be careful and ensure it will be covered by insurance.

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On 1/30/2023 at 4:11 AM, Mary Beth said:

@MED-EL Moderator

Is there research data yet on using anatomy based fitting for frequency allocation based on CT scan and OTOPLAN for already established CI users?  Is there a benefit even for those of us who have adjusted to our MAPs?

Hi @Mary Beth, thank you for your question.

Here you can read one of the latest studies on the topic: One Click Is Not Enough: Anatomy-Based Fitting in Experienced Cochlear Implant Users - PubMed (nih.gov) 

Kind Regards,

Giulia

 

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Just a following up to the discussion about getting a post-op CT scan.

I asked my Audi about a post-op CT and she said the following:

------

I spoke with Dr. XXX [surgeon] and MEDEL prior to our activation to determine the need for a post-op CT. My recommendation at this time is to see how programming goes using other subjective and objective measures before advocating for a CT. A main reason is our concern that it's not considered medically necessary and there's a question if insurance will cover the scan. I was happy to hear the potential benefits of the post-op CT is less about clarity of speech and more about overall quality of sound, and the benefits of which can be realized any point post-operatively. Let's see how things go in the coming weeks and we can always revisit the scan. If you would strongly like to pursue the scan, despite the possibility of it not being covered by insurance, we can discuss further as well.

------

They work a lot with my insurance company and it seems like they would have a good feel for their approvals.  I agree with what others said - if it were offered, I would take them up for it but I have nothing unusual anatomically and the surgery seemed to go very well so it seems like the insurance would have a legitimate argument about medical necessity.

Seems like something to talk about with the surgeon before surgery for future recipients. 

If improvement stalls out early or there are problems with mapping, it may be a better case to be made to insurance.

Tim

 

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Thanks @Tim for asking the question and for sharing your audiologist’s response. Definitely food for thought, especially with the unknowns about insurance coverage. 

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@Ricky W

Is your post op CT scan being done so that it can be run through OTOPLAN for anatomy based fitting frequency allocation for each electrode or for another reason?

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It's just a normal scan of the temporal bones that I'm aware of. 

Chapel Hill has me in a clinical trial that is doing device location based mapping as well.

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@Ricky W

yes I have heard Margaret Dillon present on that study and @Royis in it as well.  Very interesting stuff.

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Margaret Dillon is the one I'm working with on the trial.

The regular audiologist are always a different person every time I go.

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