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Why don’t surgeons provide recommendations?


JohnL
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I just met with my surgeon. I explained that I had done a lot of research but was interested in his preference for manufacturers. He said “your preference is my preference “. So I asked for his recommendation. He wouldn’t tell me. Why won’t they provide a recommendation?  Based on my research the features and functions of the Cochlear line of processors is better for me but I believe the implant is the most important component and I can’t get an answer as to who makes the best implant. Frustrating!

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@JohnL

That is a common experience in the US.  Many CI centers provide info on all three FDA approved CI brands and then it is up to us.

You have researched all three brands.  It seems like you have joined online groups and asked CI users for their experiences.

Make a choice that seems right for you.  I wish you the best no matter which CI brand you choose. 

Feel free to keep asking questions.

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@JohnL

I agree with you that the most important component is the internal component.  (For Med-El that is the Synchrony now in the US.). External processors and accessories etc change every few years.  Hopefully the internal component will last us for life.

 

Research a bit about backward compatibility.  (Which brands make future processors that continue to work with older internal units).  I had assumed all brands did this and was surprised to find out that is not the case.  Med-El is backward compatible.  (I learned that after the fact so I just got lucky with that.). I have two friends with another brand who can not upgrade to that brand’s current processor because it will not work with their older internal units.  This will become important to us in time.

 

There are websites that list recalls.  You can see which companies have had recalls and how many recalls.

 

The advanced technical questions are difficult to find answers to.  Like......which internal processors have the greatest ability to use future features and which internal units are basically maxed out.  

 

One of the biggest problems is trying to find info that compares the three brands which was not funded by any of the brands.  Objective, unbiased research.

 

Have you had an opportunity to meet any adult CI users in person yet?  Which part of the US are you from?  I live in the northeast corner of New York State.

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I hadn’t thought about the issue of maxed out internal units. Is that a large problem?  

I live in Massachusetts and have met one CI user that has a Cochlear Inc. implant. She was just upgraded to their nucleus 7 processor and loves it because of its iPhone compatibility. 

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@JohnL

I have had my CIs for almost 4 years and I am still learning about the engineering of this amazing technology.  The amount of “room” to take advantage of future advancements in processing varies between brands.  You may understand the online research about it better than me.  It is a factor to consider.

Direct from iPhone for all audio in true stereo is what I am eager to experience.  I LOVE separate right and left sound for music!  So far, I don’t think any brand offers that yet.  Not just the same sound going to two sides but true stereo like using headphones with separate audio tracks to left and right.  It is on my wish list.  Smile.

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I have not been able to find research on the topic or capacity - nor am I sure I’d understand it 😀. The surgeon has said if I chose med el he would use a soft, flexible electrode array - he described it as a wet noodle!  Based on your knowledge is there a lot of capacity in that array?

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@JohnL

I think of capacity in the internal implant (Synchrony) and how it delivers the stim to the electrode array.

I believe Med-El uses a separate current driver for each electrode.This allows electrodes to be stimulated simultaneously, etc.

I am no where near an expert on the engineering of our implants, although I enjoy reading about it.

 

Trust your CI team and your instincts.  And commit to the aural rehab to get the most from your CI.

 

I have a flex28 electrode array in my left ear and it is awesome.

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I have the flexsoft electrode and am happy with it. Still noticing improvements bit by bit at the 2 year mark.

My audiologist steered me towards Med El due to my love of music although my centre provides all the brands. It was felt (at the time, maybe different now) that Med El handles music a bit better than the others.

so the music, ease of an mri if I ever need one, and backwards compatibility made the choice fairly easy for me at the time.

Good luck!

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I had to make my decision.  I have a document that compares the three major brands, but it's really mostly technical stuff that wasn't easy for me to see what the practical outcome was.

I just learned something yesterday - I have Flex28 on both sides.  But my first implant apparently was placed so that there was no contact with the last electrode to the nerve endings, and it was turned off.  I had no idea.

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@Mary Featherston

Electrode 1 (deep inside the cochlea) or electrode 12 (just inside the cochlea)?

 

It is not unusual for CI users to have electrodes turned off for various reasons.  Fortunately the frequency bands assigned to each electrode automatically shift and all frequencies are still covered.

I have electrodes turned off too.

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@Mary Beth, it's 12.  Apparently if it dangles outside the cochlea you won't hear, and I wasn't.

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@JohnL

JohnL, I am just slightly past you in selecting a device company.  I must have MRI capability.  That reduced my choices to Med-El or Advanced Bionics. I used written documents provided by my clinic,  mostly to augment web based content for the respective companies.  And, I Googled a lot.  Google helped me investigate for FDA recalls, sanctions, etc.  Med-El,  to me, had better docs and an excellent web presence,  plus no sanctions or recalls (that I could find).  Good luck.

C T Lexx

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@Mary Featherston

That is more common than you may think. Any electrodes outside of the cochlea are turned off.  And sometimes electrodes inside the cochlea are turned off.

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Weird I can open it from the HearPeers post.  It's just a pdf.

@Hicksy or @JohnL could you try?  Or if you'd like the document just let me know your email address, I can send it.

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5 minutes ago, Mary Beth said:

Yes, that's it. Only it's from last year, so if John finds it useful, this link is the one to use.

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Thanks. I have seen that comparison chart previously. However, I’m not smart enough to know what all that engineering stuff means. I can’t tell whether one implant is better than another based on that data. But thanks for trying. 

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@JohnL

Trust yourself and your team.  Choose which brand seems like the best fit for you.  CIs are life changing.

Wishing you the best.

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@JohnL - what Mary Beth said.  I am happy that I chose Med-El.  I like both the Sonnets and Rondo2s, and I'm satisfied that my implant is a solid choice - the number of options for electrode arrays and the MRI safety, combined with backwards compatibility for processors, sold me, and I'm happy.

But I have a friend who has Advanced Bionics she's equally happy.  As is, I think, Daniel - right?? @Daniel the Stranger

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Hi @Mary Featherston!! that's right, I'm very happy, the only thing you got wrong is that I'm a He, not a She! 😂

Sorry for being away for too long, too many things happened over here, School got rid of one staff member in our office, plus my boss is on paternity leave, so I have been kind of busy these days. Last December I got family visit from Mexico and we travelled a bit around Australia and we went to New Zealand as well for a week.

School is going to be very busy at least until mid February, so I hope to participate a some degree until then. 

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On 1/17/2019 at 8:41 AM, JohnL said:

I just met with my surgeon. I explained that I had done a lot of research but was interested in his preference for manufacturers. He said “your preference is my preference “.

That was exactly my experience not only with my surgeon but also with my Audiologist. I was happy with that. I also have to say that in some way they steered a little bit towards Cochlear because it is an Australian company. Unfortunately it was the last option on my list.

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Daniel

why was Cochlear the “last option on your list”?  And if you chose them, are you happy with your choice?

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