We had a full schedule and still there was no nap to be had!

• Li-Li and I met with Dr. Terrell Clark to discuss going bilateral
• We met our wonderful new audiologist, Jennifer Harris (We’ll miss Jill, but Jennifer is GREAT and came from working at Li-Li’s school some years ago: TLC! And I can’t believe I forgot to take photos)
• Jennifer conducted booth testing without processor and then with hearing aid in left (unimplanted) ear
• Jennifer checked our equipment and found which of our 3 cords is the horrible faulty babyworn cable that trashed two lovely processors in a month and contacted Cochlear Americas for replacement of the cable and a lost magnet
• Li-Li received a brand new mapping:
  1. Everyday listening program with ADRO: for home, classrooms, music
     makes seamless adjustments as the sounds around her change. The individual channels representing quiet sounds (like a soft violin) are turned up, while loud sounds (like a car horn) are softened, so Li-Li can enjoy a comfortable listening level in any situation.
  2. Noise program (with AutoSensitivity): for noisy environments, crowds, restaurants
     Microphone sensitivity is automatically adjusted based on the “noise floor” of the surrounding environment. The noise floor is the level to which sound decreases during breaks in speech. This softens the background noise making it easier to participate in conversations in noisy environments.
  3. Everyday listening program with ADRO (same program as #1, just easy to cycle to)
  4. Quiet listening program with ADRO + Whisper: for bedtime stories, hiking outside, watching TV
     Whisper boosts softer sounds, such as crickets chirping or someone speaking in the distance that would otherwise be too quiet to distinguish—like a pair of binoculars zooming in on a small object, making it larger and easier to see. It brings the softer sound “closer” so that Li-Li can hear it better, while other louder sounds remain moderated as with her everyday listening program.

Some really interesting results (although I have to ask for the results and the new audiogram for specifics): her implanted right ear has retained much of its residual hearing and remained close to her levels tested last August — a huge surprise to us as we’d heard she would likely lose this as a result of the surgery itself or the body’s defensive reaction (ossifying bone) shortly after! And even more surprising: hearing in her unimplanted left ear has deteriorated significantly in a year, so she likely no longer hears jet engines without a hearing aid.

More on our very complicated and difficult bilateral discussion/decision later, but I think we’re OK to go according to the CI team and planning for surgery this summer!

Do we schedule a second implant now and reap the near term benefits of localization and better hearing in classrooms?  Or wait 5, 7, or possibly 10 years until medical technology offers less invasive surgery, better approaches to stimulating or even regrowing the nerve?

We want Li-Li to receive every opportunity that we can make possible when it comes to her language development. She’s in ASL (American Sign Language) class at home and gets wonderful ASL immersion at school and our parent-infant program every day. She has a cochlear implant on the right side and takes auditory rehabilitation sessions four times a week both at school and with our early intervention program. And at home we reinforce both language models with a whole lot of interaction.

We are interested in proceeding with implant #2, given the truly amazing results we’ve seen with #1. There are benefits to having a second implant: among these are the ability to localize sound, better hearing in noisy environments. The drawbacks are considerable, though, and we’ve identified two big issues:

• Risks inherent in any surgery: Although we are confident that our surgical team does everything possible to mitigate those risks and has a spotless record, we are, of course, terrified of putting Li-Li through surgery yet again — it’s a gruesome thing to consider for a little one. We know that there are always risks with surgery, there’s no getting around that.
• Future Technology: There are so many new approaches to implant technology and surgical methods for implantation that are currently in research stages. Research being done at Vanderbilt University describes its minimally invasive surgical methods as the ‘LASIK of cochlear implants’. According to the Economist, researchers have developed a prototype “thin film” electrode that can stimulate the cochlea in up to 128 different places (beyond the 22 - 24 electrodes in current CIs), they are working on technology that penetrates the auditory nerve and stimulates the nerve fibers directly, and devices that secrete drugs to encourage nerve growth and even ones that stimulate nerves using an infra-red laser. Implant manufacturers are working on new electrode designs with high electrode counts, so we’ll soon see a new generation of implant technology.

I wonder if we should consider holding off on #2 to receive the next generation implant later.

With the first implant, the urgency was clear to us: as a profoundly deaf child in a hearing home (even with ASL as her primary language), to have the most effective shot at spoken language acquisition during that critical window of time between 0-3 when babies’ brains are most elastic and they develop communication, we needed to make it possible for her to hear as quickly as possible. But I’m not clear if there’s an urgency to getting a second implant.

I’m researching every study I can get my hands on to determine what we would be giving up (in terms of language development, auditory stimulation, ability to adapt to a second implant, etc.) by not getting the second implant for what may be years until the new approaches are available to the public. Current CI surgery is less certain to damage the cochlea than in years past, but I also want to know if there’s any risk that a second implant would damage parts of the cochlea that would otherwise be utilized by newer technology.

Li-Li has her 6 month evaluation coming up in a month — can medical technology keep up with us?

Sounds like a good idea

Mar 6th 2008 From The Economist print edition

Biomedical technology: As cochlear implants improve, people who use older versions of the technology could face a difficult choice

Michael Chorost

YOU could call it the upgrader’s dilemma. When it comes to buying a new mobile phone, computer or DVDplayer, should you buy the latest and greatest model now, since it offers new features that your old model lacks? Or should you wait for the next version of the technology that will be along next year and threatens to make today’s gear seem suddenly old-fashioned? Now imagine that upgrading the item in question requires you to have surgery. That, in a nutshell, is the predicament that people with cochlear implants may soon be in.

Read the full article.

You Passed 8th Grade Math

Congratulations, you got 10/10 correct!

Could You Pass 8th Grade Math?

There are all manner of things in this world that baffle me, but a few stand out — usually physics-related. I attribute that total density and inability to comprehend all things physics, my slapshot chess skills, my poor driving ability and my teenage rebellion to Dad, who, being a physics guy, tried to instill in me a love for the staples of life: math, physics and chess. And then foolishly attempted to teach me to drive the family Thunderbird. And by the way, it was his faulty gene pool that resulted in a daughter born without depth perception. I would have preferred his nose. Somehow quantum physics, Shrodinger’s cat and rebellion against authority are intertwined in my head and intersect in one concept: parallel parking.These are subjects that I will never question in public. I may say aloud that the cat is alive, but secretly know it’s dead. I accept that the extra dimensions of string theory need to be curled up, silly (but don’t really understand why). Like saying we live in a “Democracy” — I’ll call it that because it sounds so pretty, but really, does that make any sense at all? I prefer to pay extra to park in a garage when I hit the Big City because someone might hit my new Prius if I park on the street. And the last time I questioned physics was in a group discussion amongst a pack of flight attendants on a long delayed Eastern airlines flight from Lima, Peru to Miami in the late ’80s.I had fallen under the influence of the now most dangerous professor in America, erstwhile Cranky English Literature 101 Canon Explaining TA, at the University of Virginia, had tossed my full-ride ROTC (Marine Corps) scholarship to the winds (and so went my tuition — ooops, that depth perception problem). What to do with myself for 8 months before the next school year began? Staying home and spouting my newly formed opinions about the world would surely eliminate any possibility of parental support. I wanted to travel, I was fearless and accustomed to the uniform, I thought I could speak Spanish and French (after all, it was on my resume), and I had no funds.Coffee, tea, or milk? Abrocharsen sus cintarones, por favor! Welcome to Eastern Airlines, non-stop to Cali, Columbia, Port au Prince, Haiti, San Salvador, Lima, Santo Domingo, Caracas! Oh, and of course, there was Boston, new home of The on again, off again Boyfriend. Non-stop it was!As were the complex intellectual discussions. Music, art, literature, and … my downfall: physics. Late at night, coming home from Cali, we stood in the blue light of an L1011 galley and struggled with a question: if the airliner were cruising along at speeds averaging 800 kph, and one of us intentionally leapt into the air, would that person be instantly slammed up against the bulkhead at rapid speed?

We froze. I started to laugh, tensed my muscles and prepared to leap. And I still don’t know if it was the oh so intentionally tight Christian Dior skirt (“Ladies, uniforms are designed to be close-fitting. Otherwise, in an unplanned or hard landing, your clothing would be instantly ripped from your body, and you would no longer be seen as an authority figure in the rescue operation!”) or the same mind-numbing fear that grips me everytime I face down a parking spot, but something stopped me.I didn’t want to die that way — not before my 21st birthday. and not in Coach. But many years later, thanks to my dear friend — The Boyfriend who became the Colleague and is now neither — who told that tale at a Boston roofdeck cocktail party, that violent shattering of carefully coiffed flight attendant against the bulkhead was merely a whisper against the wall of humiliating laughter from the cadre of well-educated, well-heeled folks who tell business persons and politicians alike what to do.That’s why I just don’t get why ice is slippery, I don’t parallel park, and I’m not asking any questions — out loud.

According to one theory, proposed by psychologist Geoffrey Miller at the University of New Mexico, Albuquerque, women prefer funny men because their wit reveals an active and healthy brain - and a fine set of underlying genes. “It’s a very powerful and reliable way to show creativity and intelligence,” Miller says.If this theory holds true, a woman choosing a funny man as a partner is more likely to have genetically healthy children who will survive and reproduce themselves. This so-called sexual selection could, in some circumstances, favour women who like humorous men, and men who like women with an appreciation for humour.

Well, John does tell some awfully long jokes, and you know what they say …

Within a large concrete room, hewn out of a mountain on a freezing-cold island just 1000 kilometres from the North Pole, could lie the future of humanity.The room is a “doomsday vault” designed to hold around 2 million seeds, representing all known varieties of the world’s crops. It is being built to safeguard the world’s food supply against nuclear war, climate change, terrorism, rising sea levels, earthquakes and the ensuing collapse of electricity supplies. “If the worst came to the worst, this would allow the world to reconstruct agriculture on this planet,” says Cary Fowler, director of the Global Crop Diversity Trust, an independent international organisation promoting the project.

Mine is hewn out of a mountain on an island and has chickens, too. Or maybe it’s more like a boat shaped like a floating Conestoga wagon.