Questions about Med-El

[violinmemories]

I am new here so I apologize in advance if this post is not in the right section. After three years I've qualified for a CI, I'm excited at the prospect of hearing again, by hearing I don't mean just words and phrases but music again. Music has always been a very important part of my life as my late father was a professional violinist. I grew up listening to music and sadly even though I can still pick out the violin parts it's not as vibrant sounding as it once was.

 

I have several questions for those that have Med-El:

 

1) I've noticed that sounds, words and music use to be well rounded (3-D if you will) with regards to tones and pitches rising and falling with each breath. Recently, I've noticed that hearing anything is more flat and one steady tone and pitch (monotone). Will Med-El help restore the 3-D sounds that I remember hearing?

 

2) I'm not fond of carrying a remote around with me, I've got fears of leaving it somewhere. Sticking it in my jeans and throwing the jeans in the wash (only to remember too late that the remote is being washed), what do I need a remote for? Will I need to carry it with me all the time? Do the CI's have volume adjustment controls on the processor like my Phonak hearing aids do?

 

3) Is there room to add more technology in the future, or am I stuck in a current strategy without the possiblity to "upgrade"? With the "upgrades" to better technology in the future, is it done externally via the processor or do I need to go through another implant surgery to get upgrades?

 

4) Are the signals in the implant all activated at the same time? Or are only a few actually turned on and used at any given time?

 

5) What is the difference between the different processors? Is one better than another??

 

I have an appointment coming up in two weeks to talk to another surgeon who implants Med-El but I want to get first hand knowledge from people that have Med-El and actually use them daily.

 

Thanks,

 Meredith

[kaztrekie]

Hi welcome to the forum

I had not yet been activated with my implant its on the 10th but will give you what answers I can

Though the best person would be your audiologist and surgeon who know your

Hearing and what would help you best,

Music : ok I for one hope this brings back the music I love.very few sounds will be instant if any because it will

Take you time to learn and regonisie them again I know a lot of people with CID now enjoy music

Play instruments etc.

The remote : this has various differant settings on it 4 buttons which house your best programms

You start off with one button set for everyday use and others will be added as you progress for differant situations

But most people stick with one setting and hardly use the others it all depends on progress and what you are happy with.

Signals: they will activate the implant but will start will very few sounds depending again on you

And what you are comforable with programming sessions at Addenbrokes whe I am going

Start of with the activation one day and then another programming session the next

And then the following week etc

Programming and equipment sessions follow empty you dairy after you get your activation date.

Upgrades: the processes can be upgraded as technology progesses the implant is the latest one and will have very little

Progess if any its the processor they can adjust as needed

As for other makes you would have to see what is best for your hearing as everyone's journey is differant

I hope I have answered

Most of your questions feel free to ask me anymore when I am activated I will be able to tell you

What it is like

Good luck with your journey

Karen

[masona]

 

Meredith Segal quoted:

I have several questions for those that have Med-El:

 

1) I've noticed that sounds, words and music use to be well rounded (3-D if you will) with regards to tones and pitches rising and falling with each breath. Recently, I've noticed that hearing anything is more flat and one steady tone and pitch (monotone). Will Med-El help restore the 3-D sounds that I remember hearing?

 

Not sure what you mean by 3-D, I'm guessing what we called stereo sounds? At the end of the day and if you got no choice then the Cochlear Implant does put BTE hearing aids in the shade

 

2) I'm not fond of carrying a remote around with me, I've got fears of leaving it somewhere. Sticking it in my jeans and throwing the jeans in the wash (only to remember too late that the remote is being washed), what do I need a remote for? Will I need to carry it with me all the time? Do the CI's have volume adjustment controls on the processor like my Phonak hearing aids do?

 

You don't have to and there are many users who don't bother, just got switch on yesterday and I'm carry the remote control for a few weeks just for information for my implant centre with difference programmes the audiologists need to know, to start with they give you 4 difference volume level if it's get too much and which level volume you prefer for them to adjust for the next appointment.

 

3) Is there room to add more technology in the future, or am I stuck in a current strategy without the possiblity to "upgrade"? With the "upgrades" to better technology in the future, is it done externally via the processor or do I need to go through another implant surgery to get upgrades?

 

Yes I was told it's upgradeable

 

4) Are the signals in the implant all activated at the same time? Or are only a few actually turned on and used at any given time?

 

I was born profound deafness therefore they are only given me a small set amount of difference sounds so my brain can learn to hear them clearly then the next appointment they will give me more and so on I will get all the maximum sounds available over a period of a few weeks.

 

5) What is the difference between the different processors? Is one better than another??

 

Difference need for difference deafness level including difference electrode arrays for difference shape and size of your cochlear, my deafness better hearing is at the back of the cochlear therefore they used a soft electrode arrays to reach the the end of the cochlear for the maximum sounds, I now have all 12 electrode points working.

 

 

I have an appointment coming up in two weeks to talk to another surgeon who implants Med-El but I want to get first hand knowledge from people that have Med-El and actually use them daily.

 

Write down everything you can think of as you may forget what to ask when you're there!! What I did I email loads of question to the audiologists before seeing the surgeon. They were very helpful even though there were 67 questions I wanted to know!

 

[Matt]

Meredith,

I am a huge music lover - just not mainstream stuff. When I was switched on I spent a lot of time trying to listen to music but for me the first month or so was not very good and I did wonder if it would improve. I actually thought I put the wrong CD in the player when I was trying to find one of my favourite tracks - I didn't recognise the song.

Well, I am glad to report that I am absolutely loving music and have been to lots of live shows of various genres. My audi and I had a play around with a program for music after a couple of months but I found my main program was just as good. At my last review I saw the local Med El rep with my new audi and we set up quite an unusual program for REALLY LOUD music which I tried out the other day and it was pretty good.

I think the more you listen to music the better you'll get, I know I am still improving.

Good luck with whatever you decide.

 

Matt

[jadepedro]

Hi again Meredith.

 

I'll try to reply to (some of) your questions based on my conversaton with MedEl representatives. I also encorage you to contact the brands representatives in addition to your surgeon. For me has been very valuable as they are willing to help with any doubts.

 

 

2) I'm not fond of carrying a remote around with me, I've got fears of leaving it somewhere. Sticking it in my jeans and throwing the jeans in the wash (only to remember too late that the remote is being washed), what do I need a remote for? Will I need to carry it with me all the time? Do the CI's have volume adjustment controls on the processor like my Phonak hearing aids do?

It seems that many people plays around a short time and when confortable, they don't need to carry it anymore, anyway, it's a personal preference. And about volume adjustment controls, to my knowledge, OPUS 1 has controls on CI, but OPUS 2 don't. Rondo is based on the same electronics as OPUS 2, it's just a different way to wear a CI.

3) Is there room to add more technology in the future, or am I stuck in a current strategy without the possiblity to "upgrade"? With the "upgrades" to better technology in the future, is it done externally via the processor or do I need to go through another implant surgery to get upgrades?

Yes, there is room for more technology in the medium term (I expect 10 - 15 years as much) that will be available either through new "programs" applied to existing processors or new processors.  After that... who knows what is going available. Just look back to what was available 15 years ago.  From less consuming circuitery, that could allow for your own body produce enough  power to feed implants and becoming completely implantable, (http://ibmresearchnews.blogspot.com.es/2013/01/nanocircuits-flex-tech-muscle.html),  to light enabled cochlear implants (http://www.unews.utah.edu/old/p/022211-4.html), and of course, truly healing technology (http://hearinglosscure.stanford.edu/blog/   https://www.youtube.com/watch?v=InJJmZeP4jc).

My opinion is that only when a big leap will be available, it will deserve a new surgery. Anyway, I think that today, CI are marvelous so it's time to take advantage of it! (specially true when speaking about children)

Some people says that AB has the most powerful electronic, but as always, take this and all what I write here with a pinch of salt as I'm far from being an expert. Medel has the longest electrode array, that allows for complete coverage and reaching the most apical region of the cochlea. MedEl and AB have the ability for current steering approaches (multiple electrodes firing at the same time which enable for "virtual channels", see AB explanation here (splitted in two lines, put it together in your browser)

http://www.advancedbionics.com/content/dam/ab/Global/en_ce/documents/libraries

/Professional%20Library/AB%20Technical%20Reports/Sound%20Processing/AB_HiRes_Fidelity_120_Sound_Processing_report.pdf) .

Cochlear is able to fire just one at a time, but it could be that firing adjacent electrodes in a fast sequence could produce similar results. Nevertheless, this approach have implications. If this is a real advantage or not, it's hard to say. Also, the physical way in which current is fired (trifasic, bifasic, monofasic) could have implications on the available strategies for transmiting sound as some of them could allow for faster recovery of the stimulated cells, and Medel offers several working modes. The algorithm used for encoding (which is mainly handled by outside processor) will have impact on the quality you perceive and many strategies are available for any  brand. Medel has released the fsp strategy (more on this on http://www.medel.com/data/downloads/MAESTRO_US/FocusOn_FineHearing.pdf) which looks for better fine structure perception. If you want to know how fine structure affects speech in noise and music recognition , I suggest somebody with enough hearing to play with auditory chimeras (http://research.meei.harvard.edu/chimera/speech_noise.htm).

4) Are the signals in the implant all activated at the same time? Or are only a few actually turned on and used at any given time?

As far as I know, the number of activated electrodes at the same time depends on the strategy chosen by your audi from the available ones, but rarely all of them will be activated at the same time. Note that even when we say they are activated one after the other, is just a small fraction of a second between them , As I've commented above, both MedEl and AB are able to fire several at the same time. Problem here is that depending on the inter-electrode spacing, undesired interaction can also appear. So just by simply adding more electrodes, firing them faster or at the same time doesn't necesarily means better hearing. This is the field in which all the brands struggle trying to find the most effective way to use current technology capabilities. Most of the human signal processing mechanism is still unknown and what it can seem a good approach could fail in practice, and of course, each person is different...

5) What is the difference between the different processors? Is one better than another??

If you mean between brands, yes there are some differences. Maybe this site can help you http://cochlearimplanthelp.com/journey/choosing-a-cochlear-implant/

 

For me it's not just which processor is the universaly the best, but a trade off between all the components and what do you value the most between electrodes, electronic, current available processors, reliability, customer care, availability on your clinic or whatever you can imagine. In my case, the less aggresive electrodes is what I value the most, but it's just my preference.

It's your personal priorities list what will lead you to one or other brand and model, that will be the best... for your needs

 

If I can help you further, just let me know.

 

Best wishes,

Javier