Monday, 2 July 2007

BTE or Bodyworn...??

This will allways be a question when the child starts with CI, and even more so when the child has bilateral CI.

When Lotte was one of the first to be implanted bilaterally, the Freedom had just been developed and even though she got "Freedom" on the inside, the outside was the old Nucleus. So the only bodyworns available to us (Lotte) were the "big" cases, and two of them would have been massive.

(I believe the one on the right is the bodyworn at the time....)

So, the Ci-team proposed to use the BTE's, but after picking them up 15 times an hour (per ear...), we decided that on the ear would not work. 2 coils and 2 BTE's that can loosen and fall off is too much to handle....
(Also, Lotte allways pulled off the HA's and we were not looking forward to a similar behaviour with the CI's'. In retrospect, she has never taken off the CI's. We have been fortunate with that..)
Being the engineer in the family, I clipped off the fingers of an old wollen glove, put the BTE's in the fingers, a safetypin through it and pinned them on the shoulders of Lotte...
That worked fine, without too much falling off of the coils. Plus, no need to hang the BTE on the ear.... That is allways secured (and can allways be found..)

We tried a couple of time times to put it behind the ear, but the combination of earsize and BTE-size is not compatible. Doublesided tape etc. could work, but Lotte really disliked that solution. After all, she is used to the ears on the shoulder, so why bother?

To give an impression of the difference, here are two pictures. One with the bodyworn, one with the BTE's on the shoulder..
....... vs .......

Coil+Earhanger+Bodyworn ....... vs ....... Coil+BTE (click to enlarge)
So, for the last 2-1/2 years she has worn them on her shoulders and without any problems. This includes playing outside in the sand 50% of the time when she's at the kindergarten, and the BTE never failed and was never lost. Also, the staff there can just put the coil on when Lotte for some reason cannot do it herself or simply forgets (in the beginning she would just not bother. Nowaday, she immediately puts them on..). There's no hastle with tape, glue, ear-hangers that go in the ear or caps.

As mentioned, the only thing that can fall off is the coil-piece, but soon she figured out how to put that back. Actually, that is a small disadvantage. By putting them back herself, she is putting some tension on the coil-cable, but the are pretty strong.

Remember, there's nothing on her ear, nothing in the ear, nothing on the head, except for the coil. The BTE's are safe on her shoulders.
We were worried about the BTE's under the coat for example (scratching sounds), but she has no problems with hearing when they are under the coat. Guess the coat id holding the BTE's steady so there is no scratching.)

Advantages:
* You will never loose the BTE. It's secured,
* Only the coil can fall off. The child can put it back her/him-self,
* Much lighter than the bodyworn,
* Still accessable (sp?) for the parent to change programs,
* BTE's are spaced out wider than the ears, so (I think) perception where sound comes from is better,
* We use a safetypin to attach it to the clothes so it can easily be changed from one piece to another,
* No need to buy/make special pockets in clothing, just 2 little bags with safetypins,
* When raining the BTE's will be under the clothes. (and as said, she'll still hear without problems), when there's much wind, it will also be protected from that, not causing weird sounds,
* ...... I'll think of some more - to be added later
* ...... You'll think of some more - Put it in a comment, and I'll add it.

Disadvantages:
* Possibly: Sound has to be picked up from the shoulders, (but that does not seem to affect her hearing capability. She hears a pin drop on the table... literally!),
* Possibly: Scratching sound when a coat is worn over the BTE's but we have not seen any problems,
* Cannot use rechargable batteries,
WRONG! - got info (See comments) that they are available.... only in Canada and USA??? Not here, but we will be working on it !!
* There's strain on the coil-wire when the child puts it back her/him-self, (but in the last 2-1/2 year only 1 failed.),
* There will be holes in the clothes when the fabric is thin, (but how long do these cloths last anyway..),
* ...... I'll think of some more - to be added later* Possibly: Localising sound after hearing it, initially cannot be done by turning head. The shoulders would need to turn. But like with us, we allready know where it comes from when we turn our head...
* ...... You'll think of some more - Put it in a comment, and I'll add it.
Do want to mention, that recently we started to use the BTE on the ear.
We have a feeling, call it a hunch, that Lotte wouldn't like to have the BTE's pinned on her bare skin, so at bedtime, straight out of the bath-tub or from the shower, we put the coils with the short wires on the BTE and hang them on the ears. She's OK with that but still prefers to wear them on the shoulders. But she needs to get used to it anyway.

14 comments:

OCDAC said...

Your blog is a valuable testament to the evolution of the deaf society. As the deaf society evolves, they shed some of their past so they can gain wonderful opportunities to participate in all aspects of our society.

Just keep the blog going, just keep the blog alive.

Richard Roehm
The Orange Deafie Blog

Cloggy said...

Well, you give me too much credit.... There's not much about Deaf society.... but then again, thats where your blog comes in.

Thanks for the comment.

..... and keep blogging!

Mom to Toes said...

Great post!

Lotte's experience with wearing the BTEs on her shoulders is what gave us the confidence to do the same with Erin.

I highly encourage parents to go the same route... it is so much easier on the child not to have such a bulky item on their tiny ears.

Drew's Mom said...

Cute picture of the little boy with his BWP's! :)

I think it is an individual decision as to which way to go, BTE or BWP's, that have many considerations:

1. Child's age (how soon before they can tell you there is a problem vs. easy screen on BWP's)
2. Bilateral vs. unilateral (sound localization is more difficult with pinned to shirt/shoulder)
3. Rubbing/static noise
4. Team approach (i.e. audiologist, parents)

We were 100% against the BWP's until our audiologist suggested we consider it. I am happy we did. It is very easy to keep his coil and ear pieces on with a pilot cap and I can access his processors without removing any of the head gear to make sure they are working and on the correct program, and I love the lock feature. Plus, he looks super stylish with the pockets! You don't have to sew pockets, you could use the harness, but we are fornuate to have someone sew the pockets.

I will always say to choose what you and your child feel most comfortable with. We really felt more comfortable with the BWP's because we elected to go simultaneous and really wanted Drew to localize sound early on and thought it would be harder with them on the shoulders. Plus our audiologist felt like BWP's were a better choice, and we took her opinion in the highest regard.

There are so many things to consider...And yet another hard decision for us parents to make!

Cloggy said...

Drew's mom,

He is cute! I hope he can stay next to Lotte.

It is an individual choice, and after trying both (we sometimes used the BWP as backup), we made ours.

Just some comments regarding the points you made,
1. Child's age...
Lotte has never been able to indicate something was wrong, until 6 months ago.... BTE or BWP would be the same...
2. Bilateral vs. unilateral ......
Lotte has been bi-lateral from the start. She localises sounds without problems. But I agree, localising with the ears is more natural since one would move the head to further localise a sound...
3. Rubbing/static noise..
We thought this would be a problem, it turns out it is not...
4. Team approach (i.e. audiologist, parents)
That, we noticed. They asked us to try the BTE's on the ears. When I asked them "why?" they did not have a good answer. I think it is a human way of thinking that hearing should be done with the ears, or something really close to it. Hearing from the shoulders is "weird".

Nicole said...

This kind of posting on your Blog is so great for us other parents who's kids wear their BTE's on the sholder. It's nice to know that we are not alone in this "sholder hearing" world! :>

One question about your disadvantages - why can't you use rechargable batteries? Aiden has his Cochlear Freedom BTE pinned to his ear (by the way, we have found that a slightly retrofitted "Ear Gear" hearing aid cover works great as a case for the BTE to attach the safety pin to) and it takes rechargable or disposable batteries. Is that model not available to you?

Also, sometime this month in Canada, Cochlear is releasing a BTE and case (apparently it's a clear plastic case with an alligator type clip) especially designed for wearing a BTE on the sholder. Have you heard of this? We are to be getting one in the mail any day now. When we do, I'll take a picture, put in on Aiden's Blog, and let you know how it workds! Have you heard of this new design there?

Cloggy said...

Thanks for the info,

The batteries, I have yet to see such small rechargable batteries...

About Cochlears new BTE-case...
First time I heared about it. will have a look for it.
When you get it, send a picture.. (cloggy2000@yahoo.com). I am looking forward to see it...

aaron said...

I really enjoy reading your blog. It particularly interested me as I am also the parent of a daughter with cochlear implants. Can you add my site to your list of links?

Good Luck with everything,
Aaron
Aaron@hearingpocket.com
www.hearingpocket.com
http://hearingpocket.wordpress.com

Nicole said...

Yes! You can certainly put a link to Aiden's "Where's My Implant" post on Lotte's Blog. In fact, you have my permission to link to any part of Aiden's Blog. I think that it is so great that we are able to share our stories - no matter how far apart we live!

Nicole said...

Hi again,
I have been thinking a lot about your BTE or Bodyworn post. I guess it's a subject that's close to our hearts :> I have a couple more disadvantages to add to your list.

1. We had Aiden and his brother Noah at the beach the other day. Of course, they were both running around in bathing suits playing in the sand. But, Aiden spent the day without his Implant on because we had nothing to secure the BTE to. (I agree with you - he probably wouldn't like it on his skin!). I kept thinking that, if we could make the BTE work on his ear, we would have been able to talk to him.
2. The safty pin solution. It seemed like such a good idea! - That is until, when we were riding in the car, Aiden removed his BTE and broke the safty pin apart. Of course, we didn't have another pin with us. While we were out I kept thinking - I can't believe that Aiden's can't hear me because I don't have a safty pin. Since then we keep extra pins EVERYWHERE!! :>

Of course, even with these small disadvantages, we still love the sholder option as opposed to the bodyworn ....

Cloggy said...

Thanks for the OK.
Aidens Blog is allready in the links, but I thought I could make a direct link to the post....

Had a look at the chargeble batteries... Yes! no to get them here in Norway!

Cloggy said...

Nicole,
Regarding your disadvantages:
With water, we use a harnes (designed for the BWP) to hang Lotte's BTE's on. But when they would have been on the ear, I would still be afraid they would fall into the water....

And the safetypin... like you are doing. Having an extra one at hand solved it. And with the BWP and the earpiece, there are also a lot of thing to break....

Thanks for your comments...
(And is the house still for sale?)

Nicole said...

It's funny that you can't get the batteries in Norway, and we can get them in Canada. I took a picture of Aiden's battery options and emailed it to you just so you can at least see what they look like! They don't last nearly as long. We get about 1.5 days on the rechargeables and 4 days with the other.

The harness is a great idea for pinning on the BTE at the beach (thanks for the hint!). I would certainly take it off when he ventures near the water - but right now he's pretty happy to play in the sand.

And, yes, the house is still for sale. I was actually just thinking about putting up a post about our saga of trying to move to a city that is closer for Aiden's therapy. Selling our house has, so far, proved to be the hardest aspect of that. We have had lots of interest, but only one offer so far (and no sale resulted). Someone will come along who loves our house - we do so they must be out there!!!

PS: LOVE the new videos. I'm going to try and figure that out for Aiden's Blog too....

Dyniece said...

I wanted to add (since I started doing this myself) that some other pro's to doing this is that if you are a heavy sweater, you don't have to worry about your sweat getting into the processor (even though Cochlear advertises the Freedom as being water resistant, I don't take chances.) Its also very handy when doing activities where it could potentially fall off - like bike riding, or playing other sports.

(Some) Milestones

  • 2013-08: Grade 6
  • 2012-08: Grade 5
  • 2011-08: Grade 4
  • 2011-03: BTE's on the ear
  • 2010-08: Grade 3
  • 2009-08: Grade 2
  • 2008-08: Mainstream School (6y. old)
  • 2006-10: All-hearing Kindergarten (4y. old)
  • 2004-11-22: CI activated (27 m. old)
  • 2004-10-04: Bi-lateral CI (26 m. old)
  • 2003-08: Deaf/HOH/CI Pre-school/"DEAF" Kindergarten (12m. old)
  • 2003-07: HA's fitted (11 m. old)
  • 2003-06: Diagnosed deaf. Start sign-language (10m. old)
  • 2002-11: Suspicion loss of hearing (4 m. old)
  • 2002-08: Born - A fierce LION
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