ESTEEM Hearing Implant for SNHL

esteem

#21

About the same as I do your relentless promotion of Starkey because you work for a Starkey dealer.

He’s hardly the first, or last celebrity to endorse a product for money. Advertising may get me to look at a product but I don’t make decisions based on celebrity endorsements and I don’t know anyone who does.


#22

Don, we’ve had this discussion so often, including PM, and yet you still seem confused. I talk about Starkey because that is where I have chosen to specialize. So I answer questions that patients ask based on how I would help them using the tools that I am most familiar with. That doesn’t mean that it’s the only way to help a patient, just the way I would approach it in a hypothetical scenario where they came to see me. I get dozens of PMs thanking me for my advice and time, and in real life I actually do help hundreds of people every year.

I chose to work with Starkey because they have given me the best ability to help my patients over years in practice and thousands of patients. I didn’t simply get a job and then start singing from the company hymn book, because I have a brain and professional ethics.

The difference though is that I am a hearing professional who has personally seen the great things that Starkey has helped make possible. I make my recommendations based on years of experience and training, along with first hand success stories. Rush is a celebrity who is promoting a product because someone paid him more money in a month than most people make in five years.

Yeah, no one makes decisions based on celebrity endorsements, that must be why product placement, sponsorship and celebrity marketing is a multi billion dollar industry.

I’m not criticizing this man for taking the money, I’m just saying he has no credibility since he doesn’t use it, isn’t trained in the field as a hearing professional, and is being paid an astonishing amount of money to say what he says about it.

But nice job on turning a discussion into an ad hominem, really contributes positively to this forum. Would you like to insult my mother too? Or I could PM you my phone number and you can prank call me in the middle of the night.


#23

Sorry I misunderstood, ZCT.

Don,

ZCT promotes Starkey and their associated brands because, in his experience, they are currently the best solution for most hearing losses. I agree that they are at least one of the better solutions available.

If ZCT’s posts irritate you so much, there is always the option in your CP to ignore his posts.


#24

It was a discussion? My apologies. I thought it was your usual hate-filled rant at anyone not on the far left.


#25

Come on Prodigy, not you too. :slight_smile:

Yes, that’s one option, but one can disagree and argue without being irritated, yes?


#26

After following this thread I thought I would throw in my 2 cents. I am as right wing as you can get, however, if I lived in ZCTs area he would have been my choice for my Wi aids. I believe that he is passionate and caring and I respect his knowledge as I do of all of the professionals on this site. I don’t believe he would turn me away just because we are on opposite ends of the political spectrum. We would not spend any time discussing our personal policies which are just that, personal, and nothing to do with the business at hand.


#27

True, we can disagree. ZCT’s left leaning view do not agree with my views much of the time, but I just ignore them. Those views are not usually closely related to the main topics of this forum anyway.

I echo the views of DFPope expressed in the post above this.


#28

Thank you, very kind.

And if I turned away Republican patients, working as I do mostly in the South, I’d probably be working about one day a week!

I accept any political position that is not hate filled (such as racism or homophobia), but I respect views that can be backed up with logic and reason, even if I do not agree with them.

As for patients, I avoid political discussions like the plague ditto religion. Simply not a good idea to get into those kinds of discussions with the public, and not relevant to the job in hand.

And when I mention the four United States Presidents who have worn Starkey hearing aids, I am careful to mention two Republicans and two Democrats, so as not to initiate a political issue. In fact it usually just ends up with the patient joking that politicians never listen anyway, so why would they need aids?


#29

Reagan was reported to have been fitted with two Starkey aids back in the 80s.

Truth was,

he only wore one aid. His actual comment was " put one in my right ear,I don’t want to hear any more from the left than I already do"


#30

Ha ha!!!

N


#31

Just saw this thread…wow that thing looks super invasive and quite frankly in my opinion not really worth it. Sorry :frowning:


#32

It is invasive. It is ear surgery. But there are people who have had GREAT success with it. A simple YouTube search will give you a few videos of patients hearing with it for the first time. One is actually coded as a CI activation, but I met her in person and it’s actually a unilateral ESTEEM device.

dr.amy


#33

Hi Dr. Amy, could you please give your professional opinion on the link below please? Thank you :smiley:

Otokinetics, Fully Implantable Hearing System (FIHS). If it works, then I for one would be more than willing to give it a go, I know it is just in the development stage, but it may or may not be a way forward for some and it does seem to have a lot of potential… I would imagine that after viewing their video, surgery should not be overly complicated?

Cheers Kev

http://www.otokinetics.com/index.html


#34

Hey Kev. Funny you asked ME about this device because I personally know the founder, Dr. George Lesinski. He is an ENT surgeon here in Cincinnati. He’s both a brilliant surgeon and a genuinely nice guy. My best friend is one of his Audiologists.

The only big issue I have with the FIHS is that it is advertised as appropriate for sensorineural hearing losses, which it is not, in my opinion. The device does not answer the telltale issue with sensorineural hearing loss - distortion caused by damaged hair cells in the cochlea. When development began, open fit hearing aids were in development stages, so occlusion was still an issue for patients with better low frequency hearing. Feedback management systems at that time were rudimentary compared to the systems we have now, so feedback was a legitimate issue back then. Given the huge developments in open-fit technology and feedback management, there is simply no reason to recommend the FIHS device for sensorineural hearing loss. You would still have distortion caused by the damaged hair cells, making speech understanding a challenge. This system simply bypasses the middle ear, it DOES NOT address any deficits originating from the inner ear anatomy or hearing nerve, and therefore is NOT a good option for patients with sensorineural loss.

Now conductive hearing losses are another story entirely. Conductive cases are where this device can really make a difference. For any patient whose hearing loss is due to damaged anatomy in the middle ear (ear drum, ossicles) the FIHS will bypass that damaged anatomy altogether and use the implant to translate sound waves to the inner ear. I think this device is a much better alternative to the surgical options currently being used.

Traditionally, if there is an issue with the eardrum (extreme scarring or chronic draining ear), a bone anchored hearing aid is used. This can be surgically implanted or worn with a headband. While BAHAs work relatively well, the FIHS will work just as well, is MUCH more cosmetically appealing and doesn’t represent a huge cost difference.

If there is an issue with the ossicles, a prosthetic ossicle is built and replaces the damaged bone. This is the most common treatment currently. This issue with this surgical option is that the bones or prosthesis is so small and delicate, that its constant movement in response to sound wears it down, and they usually have to be replaced after a number of years. What I like about the FIHS, is that it bypasses the eardrum and ossicles completely, but with a sturdier device that so far hasn’t seemed to have the reliability issues that traditional prosthesis have. So I suspect that it will last much longer. It also does not introduce any additional disadvantages (that I can foresee) over a traditional prosthesis.

In order for a device to address distortion (difficulty with speech understanding) in cases of sensorineural hearing loss, it has to address the damaged hair cells, which this device just simply doesn’t do. But GREAT alternative for patients with conductive hearing loss.

dr.amy


#35

Thank you Dr. Amy:D

Yeah, my thoughts were much along the same lines as yours… I just needed you to confirm them as you are the expert and I am only an amateur! I can see there is a huge potential for conductive losses! I have a few friends with BAHA’s, funny thing is, none of them use digital… They have all tried them, but they all reverted back to analog, they tell me they could never ever get used to digital and can’t abide them!

One thing I would say is, this FIHS might be excellent for people with a mild/moderate loss, whom perhaps do a lot of sport of the aquatic kind or they have cosmetic issues? Mind you, I guess it depends how deep your pockets are:D

For me, if these FIHS gave me a 10% + increase in clarity over high end aids then I would have to seriously consider them? Just being able to virtually forget about HA’s, not worrying about the rain, stepping into a shower etc… would be a sheer delight:D I guess we will just have to see how the develop?

Thank you again, Cheers Kev;)


#36

I agree, Kev. I’d like to see how these things develop. And to speak to the cost issue - once things like this are developed fully, insurance is more likely to cover some of the cost because it requires surgery. I suspect that it would be handled like CI surgery, where you have to wear aids for 6 months or so, and have to show only marginal improvement in order to qualify.

Great question!!

dr.amy


#37

Thank you Dr. Amy;)

Here in the UK, the NHS deal with “Cochlear Implants”, but they keep on moving the goalposts! Trying to keep costs down methinks? I have inquired a few times about C I’s, when I was in the “Severe” threshold, they told me I had to be in the “Severe/Profound” with good word discrimination! When I reached the “Severe/Profound”, they said I had to have poor word discrimination, for some reason my word discrimination is excellent, given my loss, perhaps this is because I started using HA’s almost within weeks or a couple of months of my initial sudden hearing loss… I’m glad in a way, because there is no going back and who knows what may develop? The good thing I can say is, every-time I go there and ask about C I’s, they hit me with the best aids they have got, most probably they just want to get rid of me as you are no doubt aware, I can be a bit of a pain in the proverbial lol :smiley: There are 13 audiologists at my local NHS, most of them duck and dive when they see me, but someone has to draw the short straw!:smiley: Tis actually quite amusing as they can’t fob me off… The last time I was in there for 3 hours, I told them what the problem was within the first 5 minutes, but they knew better, but I was proved correct… As with many professionals but certainly not all, many have this aloofness and talk down to you, tis nice when the end up with egg on their face, brings them down a peg or two! They can never seem to apologize either for keeping you sat there for 3 hours, especially if it is some smart ass like yours truly whom told you in the first place, you cant do that with this software…:wink:

Cheers Kev:D


#38

LOL Kev, at least you do have a sense of humor about it, which many don’t.

It frustrates me that they keep moving the goalposts on you. Here in the states, developments in CIs have actually opened up candidacy a great deal. Especially with hybrid CIs that help preserve better low-frequency hearing. They still require a 6 month hearing aid trial run, which I think is absolutely necessary, given the permanency of hair cell destruction with CI implantation.

But here also, if your speech understanding scores with amplification are too good, then it’s a no-go for the CI. And altho it frustrates alot of patients, the reason is because we would rather preserve the hair cells in hopes that a better alternative is developed down the road. If we just go ahead and implant, the hair cells are lost, and if something better develops - we are out of luck and there is no going back.

A couple of years ago, hybrid CIs didn’t exist and better low frequency hearing was sacrificed in the exchange for improving speech understanding with an implant. I’m not necessarily disagreeing with this, it was the only option at the time. But if we would have waited just 2 or 3 years, we could have done both - improved speech AND preserved low frequencies.

But I can certainly empathize with your situation and frustrating that would be.

dr.amy


#39

Yeah Dr. Amy, I think if you can laugh at yourself, then any adversity you face, you take it on the chin! I’m a kinda patient person, probably comes from fishing, I love fly fishing for Brown Trout or Sea Trout… perhaps I have had a life full of laughter and tears in equal measure, the stories I could tell of my life journey are hilarious, yet sometimes tinged with sadness, I have crammed 10 lives into one and then some LOL :smiley: Have I had a ball, yeah I can’t complain, life has been good to me and my hearing loss is but a tiny part of that journey, tis a thing of nothing!

I thank you for your kind thoughts, they are much appreciated.

Someone once wrote these fine words and I do try to live by them… Most of the time LOL :smiley: :smiley: :smiley:

God grant me serenity to except the things I cannot change, courage to change the things I can and wisdom to know the difference…

Cheers Kev;)


#40

safety standards in testing were reduced. I would not trust any internally implanted devices.
here is 1 of thousands of examples where if more rigorous testing was required it would not have happened. FDA approved the device using company research in that FDA does not have enough funding to independently and "THOROUGHLY"study the device. They were meant to do there own testing but no funding means FDA can’t actually do the job they formed to preform.
http://www.wfaa.com/news/local/Medical-device-failure-leads-to-heartbreaking-expense-111647134.html

check the following one out in that its related to cochlear implants…


http://oto.sagepub.com/content/early/2012/01/13/0194599811434272.abstract
the extreme end is you could actually die if the internal hearing device failed, example: infections, looks like there was a lot of it in the companies own research, if they put that many warnings of possible things that could go wrong.

Id suggest staying with external devices or use sign language etc. At least with this path you know how to deal with it from a life time of experiences built up. That experience level we take for granted and don’t realize just how valuable it is.

we don’t have the experience of coping with dealing with internal medical device failures. which can cause serious life quality issues.

I would especially pay attention to where the parts are made… like Indonesia or china eek:eek: in the last 2-4 years anything electronic or mechanical from china has died on me in 90 days or less almost all instances right after warranty expired.

only thing to last longer was computer and just shy 2 years the fans are dying 2 different size case fans, 2 graphic card fans that is 4 out of 7 fans but the one on power supply is from pc power and cooling that fan special case so make that 4 out of 6 fails from china.

not once did a fan die on me when I had made in the USA. or japan.

sony claimed PS3 last average 8-10 years mine lasted 2 years that is in mostly dust free environment out in the open on a pedestal for ventilating room. point of this is that the company who makes esteem says every 5 year for battery probably be more like 2-3 years especially if the device is on long hours say 17hr a day or more.

what happens if you got hit in the head?? or car accident object in motion stays in motion till hit by outside force. I get hit in the head a lot like say walking in to a door. or what if you went to the concert and decided to jam shaking head back and forth… scrambled ears anyone??? hee hee.

guess the point is is if your willing to die to be able to hear and willing to put your life in the hands of company that doesn’t give a shit about you once you forked your $$ over, then go for it.

I sound bitter because I have been burned by EVERY major corporation i have done business with within the last year or two. This is NO joke and I am not being irrational about it. I am in process of going to the grassroots and local businesses only. I have a permanent boycott/banned list of companies Will not do business with. In the hearing side of it “Resound” was added to the list. If uncle sam isn’t looking over the company shoulders they won’t stand behind their products. its becoming individuals versus corporations/multinationals WE THE INDIVIDUALS ARE LOOSING…