Programming Changes

I'm excited to say that we are transitioning into doing Audrena's programming here at USD's clinic, rather than driving more than 2 hours each way to Boys Town. While we love Boys Town, it's just more convenient to do things here. We already have a standing appointment every week for Aural Rehabilitation, so Audrena gets speech therapy and audiology services as needed. I have said it many times before, and I'll say it again. USD is very fortunate to have Dr. M (whom we just call by her first name, J.). She is an asset to this entire area because we just don't have a wealth of people who know cochlear implants, and the icing on the cake is that she is just great.

Last week we met with J. to get Audrena's new ear mold for her hearing aid, and we had hoped to do some work in the sound booth. Audrena is not getting the /s/ ("sssss"--think "snake"), so we knew she needed some adjustments to her programming in the high frequencies. As it turned out, Audrena was ready for a nap and in no mood to be in the booth. J. did some other nerve measurements, called NRIs, and because Audrena wouldn't cooperate for any other testing, she made adjustments based on those. When Boys Town had done their threshold testing in the operating room, they told us that electrodes 15 & 16 may or may not be useable. So because those electrodes handle the high frequencies like the /s/, and because they still were not testing good for J., she changed the programming to turn them off. As she explained, that would shift those high frequencies down to electrode 14. This would hopefully give Audrena access to those sounds that she was not previously hearing. She also made some changes to Audrena's M levels, which doesn't mean much to those who don't understand implants.

Over the weekend, we watched to see if Audrena seemed to be hearing better, specifically the /s/. I got responses from her just a couple times, and only in really quiet situations. So we probably will need to keep working on things. J. wants to see Audrena when she is sleeping to perform some testing on a reflex in her inner ear. It's hard for me to explain because, while I understand the basics, it's still a bit above my head. Basically, there is a reflex that happens in the ear in response to sound, and that reflex is pretty golden for programming CIs for a small child. It corresponds almost exactly to where the levels need to be set. I'm not sure when we'll attempt that, but I do know Audrena will have to be really tired. We would have to rock her to sleep and hope she stayed asleep when they stick the piece in her ear. It was a challenge for the first ABR, and she's older now, so it will be interesting. We'll see what J. thinks on Thursday and go from there.

In the meantime, "uh oh" and "more" are regular parts of Audrena's vocabulary now. She also gets really excited to see dogs and barks in response. Her "woof woof" is not very pronounced yet, but she's trying. She has begun to vary loudness and pitch as well, which is great. K. is starting to use the speech hoop now for discrimination in therapy sessions since Audrena was doing so well without it.

I also just got word from surgery scheduling that the CT scan is scheduled for March 7, 2013. Let's hope for an all-clear! We can't wait till Audrena can have two "ears."