All cochlear implants are not the same

30 07 2011

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If anyone tells you “all cochlear implants are the same”, ask them what they mean!

They are not the same, they work differently, have different technology, they are even different from day to day in how the user functions with them. They are only the same in that they all provide useful hearing. Some of the technology is much older, some of it is much more advanced.   The engineering is different, and the capability for internal upgrades is not the same.  The processing speeds are much different,  The “sound windows” are different … one has a wide dynamic range and the other doesn’t. Huge differences in stimulation rates and processing speeds. There is a lot to know about the differences.   It’s like knowing about a computer.  It IS a computer!

When you go to buy a computer you compare the specs… and you should do the same before you get a cochlear implant.   Any car will get you from point A to point B.   The difference is in the engine, and in a CI, the difference is in the internal parts and internal engineering.  The important part by far is what gets surgically implanted in your head.

Josephine talks about the differences between two brands of cochlear implant, from Cochlear Americas and Advanced Bionics.

My family has two cochlear implant users. We have different brands. We live the difference. We both notice it. Not our imagination. One of us has Advanced Bionics, and one of us has Cochlear Corporation. We both use the latest programming from our companies. We are both long term users (over 5 years). We are both post-lingual.

I am the AB user. My husband is the Cochlear user. I have my dynamic range set on 70. This is not as high as it goes, but I like 70. My husband has his dynamic range as high as it can go. He’s got it about 45. That doesn’t mean much unless you know how that might work out in daily living.   I can hear the doorbell when he can’t.    I can hear the phone ring when he can’t. He has to be closer to hear certain things. As long as he’s close enough he can hear fine.

AB’s software has a feature called “Auto Sound”. I put my processor on in the morning and don’t fiddle with it all day and all night. The software makes the changes for me as I go from situation to situation. My program is called Fidelity 120-S. This means I am using a program that offers 120 pitches, using advanced virtual technology and my electrodes fire in a sequential manner. AB’s electrodes each have an independent power source that allows for sophisticated programming.

AB also offers a alternative choice in how the electrodes fire called “PAIRED” firing. Two electrodes fire at the same time. Some people have a strong preference for one over the other. AB is the only company that offers a choice in this.  My software has all the features of my husband’s program, only they are built into the software instead of being manual. I can use all 16 of my electrodes at the same time.

My husband uses Cochlear’s main program called ACE. Most people with Cochlear have this program. It is a traditional program that has been around since the 90’s. It is not an automatic program. There are different settings for different situations. They all have names, like Beam, ADRO, Zoom etc. Depending on what we are doing, he will manually switch to the best program for that setting. Once he has manually switched, (sometimes he has to try each one to see which is best) all is well. It’s important that he remember to switch back to the “all purpose” program.   If he forgets to do that, his hearing will be wrong for the next situation. He has gone all day on the wrong program and didn’t have his best hearing.

Not everyone with Cochlear does all this switching around.   One woman I talked with said she “should” be changing programs, but she is lazy and she knows she is not utilizing her hearing as much as she could.   Cochlear’s N5 has a remote control that will help with switching programs.

In a nutshell, I don’t have to work at all to have my best hearing and my husband has to work to get his best hearing.

I think the main difference between the programs and companies is how the electrodes fire and how many electrodes are actually used at the same time. It’s not how many electrodes you have, it’s what they can do.  More can be less, and less can be more. It’s one of those things people have no clue about.

My husband’s programs use 8, 10 or 12 electrodes in a sweep. So, although he has 24 electrodes (two are for grounding purposes) he cannot use all the 22 electrodes at the same time. His maximum (called Maxima) is 12 at a time. The more electrodes his program uses during a sweep, the shorter his battery times.  People who get very good times on their disposable batteries are most likely using a smaller Maxima program.

We both talk on the phone. I use AB’s T-mic. This is a special microphone that AB designed and patented. I have this mic set on 100%.    I pick up the phone and put it to my ear and talk.   Doesn’t matter which phone. I also have the T-coil if I want to use it. I rarely use it for the phones, I don’t need it, but it’s there if I want it.

My husband uses T-coils for the phone and he also likes assistive technology such as neck loops and FM systems.  He uses his CI in a similar way he used his hearing aids. He can pick up the phone and hold it to his ear, however he needs to find the “sweet spot” which is usually above his ear. I don’t need to find the sweet spot…the T-mic is already in my ear canal and I hold the phone like a normal hearing person.   I really prefer to hear my voice when I am on the phone.  My husband had his T-coil set so he can hear his voice some, but he still shouts on the phone.

I use rechargeable batteries. I use the smaller batteries called “SlimCels”.  I get a full day on one charge. This is usually 17-18 hours. I like using rechargeable batteries. If I were to use hearing aid batteries, I was told that my programs are so powerful, three of them would only last about 10 hours.  That’s quite a few disposable batteries!    I have a larger battery also, I get approximately 30 hours on that for one charge.

Some rechargeable users of any brand of cochlear implant will need to change the battery during the day, depends on various things, but knowing you are due for a change gives you a fresh battery for the evening anyway.  I think that’s a good piece of mind knowing you are in charge of your hearing and don’t have to worry about a battery dying.

My husband uses disposable batteries and has rechargeable batteries also. He gets 2-4 days on the disposable hearing aid batteries, the more he hears during the day, the shorter his battery time.  His best hearing is with the super powerful batteries from the company.

Yes, in a pinch he can go to the store and get hearing aid batteries. But the sound quality is not as good as the Power One batteries from the company. His rechargeable battery lasts about 12 hours.

Insurance pays for our batteries, rechargeable or disposable. It’s easier to get the rechargeable batteries covered because they are considered “durable medical equipment”.

An important thing about using rechargeable batteries is that you know how long it’s going to last and can plan the day and night without worrying a battery is going to go out on you.  With the disposable hearing aid batteries, yes, they do last longer than rechargeable batteries, but you don’t necessarily know when they are going to die.   I am rarely the person changing my batteries in restaurants or wherever we are.  My husband hears some warning beeps and that’s his advance notice.  We can be anywhere, and we have to stop what we are doing for him to change.

Disposable hearing aid batteries are considered “hazardous waste” in most states in the U.S.  these days and have to be disposed of the same way you dispose of other types of batteries.  Take them to a disposal center…NOT in the trash!   We have quite the pile of batteries to dispose of.

Music, I enjoy music with 120 pitches right now and that was a huge improvement after I upgraded to F120-S software.    My husband has 22 pitches, his music enjoyment is only so-so. He doesn’t have a passion for it. But that’s not to say another person wouldn’t.  He does say music sounds weak and tinny.  I wish that was different for him.

Cochlear says they have “160 pitches” but they don’t have anything like that in a wearable processor or program. I hope that will happen. I want my husband to have more pitches to enjoy.  He’s been waiting for a new software program since 2003.

AB did the same sort of pitch testing that Cochlear did for their “future” 160 pitches and AB users in trials were recognizing up to 470 pitches. This is not a developed program either…but I sure hope it will be!

I have been upgraded with new software and hardware several times over the years.  AB focuses on both major software improvements in addition to the updated external devices.   Cochlear focuses more on improving the external device with improved microphones and things of that nature.

With a software upgrade from AB (using your own processor) there is no charge…it’s free!   Yes, you just go for a mapping, and if there is a new software upgrade out, you can have it at no charge other than your normal co-pay if you have one. The software improvements are substantial and in every instance of a major software upgrade from AB, they have delivered improved hearing for their users.

Both companies come out with improved external devices every few years.  When a new BTE or other processor comes out it’s NOT at all free.  There are usually trade in programs, but the bottom line is you pay out of pocket for these things.  They usually cost $7,000-$8,000 or more.  Most insurance won’t even consider upgrading a person for an external device until they have had it for over 5 years and the next generation device delivers a substantial improvement over the last one.  Insurance usually denies the upgrade and most people have to appeal and fight for the next generation BTE.

I think AB’s free software is a major value!  Most people have no idea that this is the case and don’t take future costs into consideration in choosing a CI. AB’s newest software upgrade is called ClearVoice. It’s a “smart” program enhancer that recognizes speech and drops out other repetitive sounds (traffic sounds for example) so we can hear speech better in noise. This will be free for me when it’s approved in the U.S.

Nope, the different CI companies are not providing the same product.  They are not all the same, don’t function the same way. It’s important you know what you are getting and it’s also important to know you should have a choice in the matter. It should be your choice, it’s your body, your hearing, and your future.

A bilateral mixed-brand cochlear implant user comments on StratMed, which is also interesting reading!

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33 responses

30 07 2011
andy

I think this must have been written by AB’s marketing department!

30 07 2011
Admin

Would I do that?! You know I’m as fair as poss. If anyone else is wearing two brands or has two similar users in the family, and wishes to contribute here, you’re more than welcome to do so.

30 07 2011
andy

It’s just that it is a very difficult thing to quantify. I don’t have anywhere near the amount of technical information that you have and I certainly haven’t been offered a discussion about the relative merits of each company.
I thought that AB had the superior spec of the machines I was offered but I was advised that the Cochlear one was the better of the two. The point is how significant are these differences?

30 07 2011
Admin

Great question Andy. I am posting something shortly (when time permits) which looks at this issue in depth. There are a number of more important factors to evaluate and these will be highlighted.

30 07 2011
deafa

yep, It depends how long a person was deaf , use hearing aids, etc. or how often he used it in certain ways.

I have cochlear N24 and I can hear my doorbell just fine across the other side of the house.

30 07 2011
Admin

I wonder if it depends on the type of doorbell? Mind you, I have to experiment with this myself – I’ve only heard one doorbell with my CI.

30 07 2011
deafa

dunno, I can hear the microwave or oven beeping from the other room too, or dog bark outside, or cars splashing in the rain (if the house is quiet) but I don’t always understand speech (I”m born deaf and wore ha’s all my life) and I can’t hear siren unless it is next to me.

really, I think it depends on how one person process the sounds and mapping, and maybe it does have to do with the CI but I wouldn’t count on it if each person have various results from it

30 07 2011
Catherine

Love this!!!!

30 07 2011
Leapoffaith

well I’m an AB user and I love it and for me it gives me ‘perfect’ hearing. Music sounds natural as it was before I went ‘deaf’. Even babies crying which did sound odd at first..is natural sounding now.

Hearing aid users are interested in hearing ( excuse the pun ) my experiences, but tend to be put off by the size of the thing. I had the very same concerns before I went cyborg and now it’s like no way would I want to go back to my deaf prison.

30 07 2011
andy

How long have you had it?
I am only on Month 9 so still in the running in period!

30 07 2011
Admin

Music was perfect for me at 3 months after activation. I did listen to my iPod every day though – I did lots of practice.

30 07 2011
andy

I could hear music well enough to recognise familiar tunes at Xmas but the finer details are still developing. I can hear music better now than at Xmas.

What I am having trouble with is the drums. When I play I can obviously feel what notes I am playing. But the CI doesn’t render them quite the same as they feel. It is really rather odd and it puts me right off. So I have had to pretty much dismantle my technique and start again.
There seems to be a slight time delay in the CI which doesn’t quite jig with what I am feeling. It’s taking ages to work through this.
The good news is that if I take the CI off I can hear enough through my hearing aid to be able to let rip big style. But using the CI slows me down. It’s really rather odd!
Mind you I do play some fairly complicated beats, both hands and both feet at once.

30 07 2011
Admin

Oh yes, the time delay is called Pulses Per Second, or stimulation rate. The faster this rate is, the more accurate the timing will be processed through the implant. The rate varies from brand to brand. I think taking the CI off is probably the easiest way to deal with this for drumming … but don’t you need to hear the music as well?

30 07 2011
Dawn

Thank YOU! This was very helpful to read and a great comparison. Having two different companies sure does push the envelope on creating new technology and enhancements for the future.

30 07 2011
Admin

A more detailed and technical comparison of the 4 CI brands is coming soon.

30 07 2011
Leapoffaith

Had mine for 10 months..not had to go back for any tune up since January..my 3 month listening assessment. My experiences tells me if one has the memory..and the right technology then that’s all one needs.

30 07 2011
Admin

I just want to clarify, I’m not starting a brand war, as has been alleged elsewhere. I’m just trying to bring together comparisons that users have experienced – which is very rare. I would love to be able to try one brand, then the next, then the next, and pick the one I prefer. I am not going to react in the same way to each brand, but there will be one that I will prefer. It’s important for us to be aware of the differences and choose the brand that is best for us – which could be any one. They are not all the same.

31 07 2011
pinklam

It’s great you can hear with your AB implant. That doesn’t mean everyone with the same brand implant has the same experience.I know people who received Cochlear CI’s after their AB’s failed and did much better, as well as vice versa. I find the fact that her husband can’t hear the doorbell and phone ringing very concerning. With my Cochlear CI I can hear down to 5 dB, and that certainly includes the doorbell and phone ringing. It is sad that anyone should feel the need to put down another brand. I know people who do well and people who do not so well with all of 3 brands, and we should instead be working together to help each other, not putting down one another’s technology. Furthermore, Cochlear ADRO program is used to hear in *all* situations. I never need to change programs, and Cochlear does frequently come out with software upgrades. The remote itself has gone through 3 software upgrades since I’ve had it, and I’ve also received multiple hearing upgrades as well. You can’t say you’re not trying to start a brand war when you’re basically making it out to sound like AB is perfect and Cochlear has all these flaws. I need not remind you that AB isn’t even currently available on the US market. Inflammatory posts like these serve no productive purpose.

2 08 2011
Admin

Actually, I am not putting down other brands. I’m sorry if what you’re reading is not what you want to hear. I am simply the messenger presenting facts. I have said (if you read back) that I am more than happy to publish other stories, but no one has sent theirs in – I don’t particularly care which brands they have or which one is ‘better than the other’. They are all different. That is the point of the article. I personally know people who are hearing better with their Cochlear CI than I am with my AB CI, and I am very pleased for them. Yes, I can hear with my AB implant, but I’ve never said that others have the same experience. I certainly don’t ‘feel the need’ to put down someone else, and yes it is sad when others feel the need to do that. You make a lot of assumptions…. I am simply reporting facts. By sharing information, we can discuss and learn. That doesn’t mean it’s a put-down. That doesn’t mean it’s a brand war. It’s just that you see it that way. Now THAT is sad. Inflammatory? No….. just Facts. If you don’t like it..you can click on that tiny lil x button in the upper right hand corner.

AB isn’t on the market because of the FDA process which takes time. It was *voluntarily* taken off the market as a precaution. There are just as many failures with other brands – just check the MAUD database. AB is on the market here. If it wasn’t, I would have chosen one of the other brands when I was implanted 2 weeks ago. Give me CI hearing over hearing aids or complete deafness any day.

26 08 2011
Donna

Your opinions are not facts – they are opinions, your point of view, your subjective observations. This does not equal facts.
My opinion of this site is that it is very damaging and incredibly biased towards AB. Candidates, recipients and hearing professionals are not getting fully researched and referenced facts here – they are getting your perspectives.

I just hope you will not live to regret when people get an AB implant because of this and they need to do yet another recall – volunatary or not!! Recalls mean that the safety of the person has been compromised – it does not lessen the seriousness of the matter if the company makes it a voluntary or unvolunatary recall – both of which AB have had!! My friend had an AB device and had to be contacted by her clinic to come in to discuss her options with AB’s last recall. She was devastated! She opted to be reimplanted with a device from Med El and is doing much better than she ever did with her AB device.

I hope you will see fit to leave my information on your site this time instead of deleting it which you did last time, as I am simply presenting “facts” like you!

11 09 2011
Admin

Donna

My blog is written with 2 strands – (1) facts about cochlear implants and (2) my own personal story. I make it quite clear when a post is my personal story. My site is biased towards AB in that I wear an AB processor. I cannot write a personal story about any of the other brands. It is very useful for people to know about what it is like to have a cochlear implant from a users perspective, no matter which brand it is. CI recipients can choose whichever brand they like. It is their responsibility to undertake due diligence, and research behind the marketing hype, which is what I have put on my blog as facts to help others and empower them to make a more informed decision. I would still urge readers to do more research elsewhere and not to stop here. It is hard to know what information to look for and to know what the differences are between brands. All brands work well, but one brand may suit an individual better than another.

A recall means that the company recalls the unimplanted devices from the medical centers. It doesn’t mean that functioning devices are explanted. If that were the case, then every one of AB’s 28,000 latest generation implants would have to be removed. The dangerous (or unacceptable) situation is when a company is aware of a problem, and does not issue a recall. That means that new patients will receive devices with a known problem, and will experience a higher failure rate as a result of the company’s decision not to recall the implants.

Is this the post you allege was deleted? https://funnyoldlife.wordpress.com/cochlear-implants/choosing-a-brand/#comment-6506 It was the only other post that came from you. As you can see, it was published. If you think I deleted your post, then I invite you to resubmit it.

31 07 2011
CJ

I have had 3 cochlear freedom implants and had 3 very different experiences and go as far as using the telephone to family with each implant albeit with some difficulty. I could however understand family with my back turned and achiever 99% in open set and CNC tests. I tried ACE, Speak, CIS mono-polar +1, mono-polar +2, mono-polar +3,and bi-polar from narrow to wide pulse widths. I had dynamic ranges from 25 to 145 and had over 200 MAPps until my auditory nerves degenerated and my implants stopped producing any sound percept within the compliance range. I received and read the medical papers describing the interface between VIII nerve and the electrode array and modes of stimulation and was surprised to learn there is no difference between implant brands that will influence patient outcome and speech perception. Differences often relate to condition of cochlear, relative position of nerve to electrode array, cause of deafness implant technique, other contra-indications of the patient, all of the above.

6 09 2011
Piyush B. Joshi

I am fully agree with CJ. I think, there are some other factors besides the technology differences also influence the results like condition of cochlea, auditory nerve, insertion of array, quality of training/therapy, mental health etc.

6 09 2011
Admin

Oh absolutely. All these things are so important!

31 07 2011
Chris Hamilton

Do you think the difference in you and your husband’s ability to recognize useful sounds (on the psychological end) has a strong difference in the ability of the implant? For example, I am better able to recognize sounds that used to pass me by when I first got the implant.

31 07 2011
Sun Melody

Well, each case is unique, including the type of loss and the time that the ear was inactive even with hearing aids. Deaf at 18 months, my loss is bilateral and profound did the Cochlear Implant in 2007 at age 23. It is not very common for a person just out of the activation process and start to hear low frequency sounds, the cicadas, the birds sing and hear the sea out here on the coast of Portugal Lusitanian. Being able to discriminate the sounds in words, I have always done since I have linked to the world of sounds. I can see words and talk to the phone, no matter the brand because as in all existing brands they make only 10% Software and the remaining 90% we are learning we improve the adaptation of the CI. Summary: Each case is unique.

Note: I had no chance to choose which brand of cochlear implant for me, because as the IC is offered by the Portuguese state, through clinical, implanted me with the Nucleus Freedom.

31 07 2011
Richard Roehm

The Orange County Deaf Advocacy Center http://www.deafadvocacy.org gets all excited whenever there is news of babies with hearing loss getting cochlear implants and news that parents are opting to get their child with hearing loss cochlear implants. We have a rich website that supports the reasoning for cochlear implants http://www.tinyurl.com/deafbabies with plenty of heart warming videos and this website beats out other websites that promote cultures of dependency and zeals of living in a dark closed deaf society. The best life journey for babies with hearing loss begins with sound, listening, and then speaking.

1 08 2011
Anon

Two children enter kindergarten with two different teachers. At the end of the year, one is reading at a third grade level while the other is not reading at all. Using your logic, we can pin the blame on the difference in progress solely on the difference in teachers. Yet, I would bet that if we looked at other children in each classroom, we’d find a wide variety of differences in reading abilities with the same teacher.

1 08 2011
Andy

Despite those people who try to undermine the usefulness of cochlear implants their use continues to grow. This is because they are quite simply the most effective hearing aid yet devised.
I have been told that as of a couple of weeks ago 60% of the pupils at Mary Hare School have cochlear implants. I realise this is an international blog so I will just explain that Mary Hare is the premier school for deaf people in the UK and many would say in the world.

It is a boarding school for children with significant levels of deafness and has always had outstanding results although when I was there is was more like an Army camp! Things have moved on and the school is now totally different. I am told that when pupils leave they have a comprehension rate for speech of about 85% which is about the level of a HOH person. Mary Hare’s academic achievements speak for themselves.

There is reams of solid compelling evidence for parents of profoundly deaf children having them fitted with a CI. The operation while not trivial is of massive help to children when they come to acquire speech and learning and the results consistently reflect this. The conclusion that any sensible person must come to is that the risks of the CI process are more than outweighed by the advantages.

It’s still a heart-stopping decision for any parent though and we could well do without harbingers of gloom and doom.

17 08 2011
@nnci

Finally some true user-experienced comparisons with different Cochlear Implant brands! Interesting to read even though it’s sort of 2 years too late. 🙂

But something surprised me, and got me curious. I’m also using the Advanced Bionics Harmony, with Fidelity 120-S and all the recent updates. But my rechargable batteries never last more than 8-9 hours. You say yours last 10 hours longer! Are you using Harmony, and the batteries that come with the implant? I’m just wondering if I’ve missed out on some better batteries, or there’s some setting that drains battery life. My batteries usually have the worst timing to go empty, and it’d be nice not to have to take the battery charger with me everywhere I go if I plan to stay a day or two.

11 09 2011
Andy

@Donna. Your message is too extreme, calm down. All Tina has done is write about what she knows.
I remarked what I did because it read very one sided but that doesn’t mean that it was a gross lie or was designed to deliberately mislead people. I just thought that it dealt with all the pro’s and none of the cons.
It is still a useful report and if someone with a Cochlear implant whose partner has an AB then it would be interesting to read it the other way round.

11 09 2011
CJ

Well being fair looks as though others have recalls too..

Medical device maker Cochlear Ltd has announced a voluntary recall of its line of its unimplanted Nucleus CI500 implant range, after a recent increase in the failures in its CI512 product.

The recall comes despite the rate of failures occurring at less than one per cent since the CI512 was launched in 2009.

“In an abundance of caution Cochlear has issued a voluntary recall of the Nucleus CI500 range of cochlear implants while it further investigates the cause of this issue,” the group said in a statement.

Cochlear said the financial impact of the recall was difficult to predict at the current point in time.

Should a failure occur, the implant will shut down safely without injuring the recipient, the company said.

“In the event of a Nucleus CI512 series implant failure recipients may be re-implanted with the Nucleus Freedom implant range which remains available.”

10 01 2014
Étienne Lavigueur

«AB did the same sort of pitch testing that Cochlear did for their “future” 160 pitches and AB users in trials were recognizing up to 470 pitches. This is not a developed program either…but I sure hope it will be!»

I realy appreciate if you could give me were you have seen this =)
I will have my CI very soon and I already choose AB, but… I wanna know the more before <.<

Thank's! 😉

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