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COCHLEAR IMPLANT: Who needs it? How does it help (part 2)
COCHLEAR IMPLANT: Who needs it? How does it help? This is part 2 in the Cochlear implant series and you can read the first part here.
Cochlear implants appeared rather gimmicky when they first arrived. With misconceptions around its use, most people were apprehensive. Even doctors were doubtful. It promised everything, would it deliver?
What were the fears with a cochlear implant?
*It can’t help, if you are born hearing challenged.
*It doesn’t help in speech development.
*It will make the child alienated.
*It’s no good for old people with hearing problems.
So what are the answers? Read on.
The Story from deaf to hearing, is it magic?
Cochlear implants started in the second half of the 1980s.
Riddled by misconceptions and hype it was handicapped by the need for really motivated children and parents.
But like all life-changing things, the cochlear implant stood the test of time with flying colors.
Children who were helped by a cochlear implant make us smile.
They tell us how they hear. How do they understand speech? It’s through their words that we learned about life, from no sound to a noisy world.
Who does it help?
- Children
- Post-lingual deafness in all age groups
- Old people with profound age-related hearing loss.
- In Auditory Dys-synchrony
Cochlear Implant in Children
Postlingually deaf children.Children who have already developed speech and have lost hearing due to some disease like meningitis.
Best Age of cochlear implantation: before two and a half years. But it has been done as early as one year of age.
7 years is a watershed zone, after which Prelingual deafness has variable results.
The longer the child has an implant, the better is the speech recognition scores. When the duration of use of the implant is the same, results are better with a lower age of implantation. The rate of expressive and receptive language learning is similar to that of hearing children.
Role of cochlear implant in presbycusis
Presbycusis or age-related hearing loss is also helped with cochlear implantation. It’s useful for the elderly with profound hearing loss, which cannot be helped with a hearing aid.
A world without sound can be lonely. More so in the aged population.
10% of normal ganglion cells ( approx.3500 cells ) are needed to recognize and understand speech.
The successful hearing outcome is seen with useful hearing. This helps in the hearing rehabilitation of the aged.
Depression, anxiety, and social isolation in both elderly and people with decreased hearing make life more difficult.
Some criteria:
Pure tone audiometry(hearing test) of 70 decibels or more for those planning for implantation in children and adults.
Cochlear implant in Auditory Dys-synchrony
You must be wondering”Auditory what”?
Auditory neuropathy or auditory dys-synchrony is complex. Children have variable hearing abilities.
What do Tests show in Auditory Dys-synchrony?
Normal middle ear functions, otoacoustic emissions present. But Brainstem evoked response Audiometry is unresponsive. This means sounds pass from outside to the ear up to the nerve of hearing, like a hearing person. But the communication between this nerve and the brain is distorted. The sound reaches the brain scrambled and makes no sense.
Why does this happen?
The sensory cochlear hair cells responsible for firing electrical signals in response to sound, do so dys-synchronously. That’s random without the syncing needed for understanding the generated sound.
Plain English: the rhythm of the electrical firing, is not right for your brain to pick up as words.
The action potential doesn’t develop properly in the cochlear nerve. This causes hearing loss. This is variable depending on. the degree of dys-synchrony.
Initially believed that hearing aids and auditory amplification would be useless. But some children benefit from hearing aids too.
Cochlear implantation can restore synchrony by, by-passing cochlear hair cells and stimulating the auditory nerve directly and synchronously.
The theory is good. But research continues for strategizing treatment, in Auditory Dys-synchrony. Whether a cochlear implant will help in auditory dys-synchrony is decided case to case.
The next burning question:
1 implant or 2 implants: One ear or both ears?
With 2 implants pros:
Better speech understanding.
This is more obvious in a noisy environment. Better sound localization, the direction of sound detection possible only with hearing in both ears.
Cons of 2 bilateral implants:
Most importantly the cost.
The dedication required for several years of necessary post-implant speech training and follow-up. It’s definitely not easy.
Where do we stand now?
Some governments cover the cost.
Few individuals can afford the cost of the best grade of the implant for both ears.
The government is realizing the cost of the implant is value for money. It is less than the years of disability support a person will need.
In children should you use up both ears?
Over the years as technology improves, maybe they’ll be better options?
Should you give up the present for the future many questions still need answers
Can there be a significant bilateral vestibular injury?
With excellent imaging, experienced surgeon, and God’s blessing this is rare.
Is it cost-effective?
The benefits outweigh the potential harm for many cochlear implant candidates. Like with all new medical innovations, it’s a long journey to perfection. We are still far from perfect in this cochlear implant journey. But we are far ahead than 10 years back. Light years away from 50 years back.Where there was no hope…There smiles a child with a cochlear implant who is hearing.
Updated May 2022
Cochlear Implant: What you need to know(Part 1)
Cochlear Implant: Who needs it? ( Part2)
Sharing is good Karma!
Childhood obesity :What happens to your baby’s body(part 4)
When I write about children’s health issues my hubby (he is a Pediatrician and a pediatric nutritionist ) helps me with all the research.
This time while writing the #Daily chatter challenge he suggested I start writing about childhood obesity.
The last 10 days of festivities and good food made writing about healthy diet difficult.
But now when we are taking a break before Diwali it’s going to be easier to write healthy.
While eating during festivals if you don’t want to lose the results of all your hard work ,it’s important to practice moderation.
Now with Bijoya Dashami sweets ,Lakshmi pujo and Kali pujo/Diwali all coming up in line we need a game plan.
How to Practice healthy even while feasting.
- Enjoy the goodies but don’t go crazy.
- Drink plenty of water.
- Cucumbers throughout the day Lighter meals
- Avoid deep-fried .Opt for grilled ,pan-fried and tandoori items
- Go light on the added cream,cheese and frills that all fast food restaurant offer.
- It’s better to avoid buffets because you always over eat.
- Eat a healthy breakfast
- Catch up on exercises.
- Meditate
- While going for Bijoya carry a tiffin box .Shamelessly stuff it with all the extra sweets you would like to eat but is more than your daily limits.Take it home .Enjoy 1 treat each day.
If it was eat ,eat, eat and occasionally pray during the last few days.
Now before Diwali it should be
Sleep,Pray ,exercise, eat in moderation.
Why discuss childhood obesity with festival food?
Because children learn from us ,adults. When they see us eating without control,they think it’s okay.
But it’s never a good idea to have bad food habits.
What they learn in childhood ,will affect their health as children and adults.
The saddest part is children can have the same health problems that adults do with obesity.
It’s important we know what the children have to undergo .That way we can make better choices for us and them.
So what are the symptoms that indicate excessive weight to be a medical problem?
Problems with breathing and respiration
What doe the child complain?
*Snoring, gasping ,daytime sleepiness,morning headache
*Shortness of breath,night-time or exercise cough
Medical condition :Asthma,Obstructive sleep apnea
Gastrointestinal problems:
Complaints :Irregular bowel movements
Binge eating,night-time snacking
Gall bladder diseases
Fatty liver
Eating disorders
Hormonal or Endocrine problems:
Type 2 Diabetes
Menstrual irregularities,Polycystic ovarian syndrome
Others: joint pains involving knees ,feet ,skin changes
When children are overweight ,certain guidelines help detect whether their growth in height, will help control the problem.
System assessment is important for timely referral to specialists .
When I was a child the last thing in my mind, during Durga Pujo was controlled diet.
Nowadays everyone is more aware.
Teach your children healthy choices so,they can enjoy good food without feeling guilty .They are smart .They will understand.
As parents you have the power in your hand.
Did you make healthy choices while feasting?
Comment below to let me know .
I am taking part in the #ubc #blogboost .This is day 11 post
Ultimate blogging challenge with Blogchatter #DailyChatter
From the Childhood obesity series:
If baby is a picky eater blame yourself:Healthy eating habits in children (part 1)
Picky eater : When you need to worry(part 2)
Childhood obesity :The control is in your hand(part 3)
Read my Ultimate guide to feeding your preschooler
Sharing is good Karma!
Childhood obesity :The control is in your hand
When I was researching data about childhood obesity my hubby was doing an ecourse on pediatric nutrition. Sharing notes ,we realized childhood obesity like adult obesity ,doesn’t only depend on food.
Food choices are important
Amount of food is important.
But another thing which was staring us in the eye was lifestyle.
If you have read about the two hit theory regarding adult disease in my post
You will understand the second trigger most is often lifestyle.
Childhood obesity important to be addressed because it’s a health hazard . When we teach our children to embrace their bodies and stop obsession with their weight and how they look .It’s important to be clear about healthy body image.
Just like focusing on how they look doesn’t help Not giving attention to the cause of the issue has lifetime implication.Obesity is unfortunately not a physical disease.It’s a psychological problem.Parents need to have a long hard look at themselves
Causes of childhood obesity is multiple and multifactorial.
Broad classification is possible if you insist on it.
2 major divisions
Exogenous :Environment ;lifestyle and psychosocial .Definitely more common
Genetic susceptibility
Endogenous :Endocrine disorders like hypothyroidism ,Prader -Willi syndrome ,single gene diseases (congenital leptin deficiency :leptin is your satiety hormone.
This sounds good while writing a paper.Definitely not useful while treating the problem.
Viruses ,gut microbes,excessive stress (second hit) are all under investigation.
Most promising results are with the reversible causes of obesity
They include :
- Circadian rhythm
- Sleep medications
- Stress
- Psychosocial
- Sedentary behaviour
- Lack of physical exercise
- Dietary behaviour
Currently these are the focus of treatment as well as hocus pocus.
When children are obese in childhood their fat cells become fat.Even when they lose weight or fat from theses cells.The size of the cell remains the same.
Makes these children prone to weight gain.
From one year of age ,there is a difference in the rate of adipocyte development in obese and non obese children.
Problems and complications:
- Snoring,daytime drowsiness
- headache
- Shortness of breathing
- Binge eating
- Limb or join pain
- polyuria
- menstrual irregularities .
When you gave birth ,you signed up for a lifelong battle.That to teach her /him to be healthy, wealthy and wise.
So if you are not at your best, weight wise,it’s important you take a look in th mirror.Make an action plan for yourself before you talk to your child.
I am taking part in Ultimate blogging challenge with Blogchatter
#DailyChatter
UBC day 7
Sharing is good Karma!
Picky eater : When you need to worry
When my baby girl Rai was 6 months old we started her on all sorts of mashed food.From 6 months to 1 year it was a constant battle of experimental baby food. From 1 year to 2 years some more experiments and finally we have a balance.
Once while travelling my daughter refused to have anything ,except plain white rice and milk.Then I realized ,children have a difficult time adjusting to new food.Because….its NEW!
Imagine giving a vegetarian, a nice stir fried octopus for dinner.
Not a good idea right.
Baby’s growing up on milk have essentially a bland diet.
Veggies lack taste and texture when given boiled.
Fish chicken eggs can be smelly.
Their tender taste buds can’t handle spices.
They are fighting a battle too.
The only way to win is to persevere.
They need to learn to stop being afraid of food .To enjoy their food.Make the right choices.Making positive food choices early in life,helps them cope even away from home .
When will you call a child picky eater?
Picky eaters have strong food preferences. They have a persistent unwillingness to try new food.
Can it cause problems with nutritional status?
Yes it will cause nutritional deficiencies
50% of 19 to 24 month old children are picky eaters.Because of this , they will be avoiding micronutrient rich foods like fruits and veggies This will affect the growth of your child.
2 main problems
1)Failure to thrive .With physical and mental.development not upto the mark according to age .
2)If children develop unhealthy eating habits .This may lead to adult eating problem and health issues.
When you need to worry?
*If your child is less than 1 year:Height weight and developmental milestones need to be checked monthly.Because your baby grows ,even while you watch.The first year of life is very important.You worry, if there’s no significant positive change in the monthly assessment.
*If your child is more than 1-year-old :
Height needs to be checked every 6 months.
If child is not growing in height then that’s a cause for concern.Its a sign of chronic protein energy malnutrition.
Weight needs to be checked every 3 months .
If your child doesn’t gain weight or gains too much.Both is cause for concern.
No weight gain is due to lack of adequate dietary protein energy .
Excessive weight gain, gives rise to malnutrition of obesity.Where there is excess calories in the diet.But it lack important macro and micronutrient .
When your child shows signs of micronutrient deficiencies:
- Paleness of body.
- Repeated skin infections.
- Has repeated cold and cough
- Suffer from mouth ulcers etc.
- Is cranky
- Has little energy to play
When you don’t need to worry?
- Baby is happy ,active with good growth.
- Both height for age and weight for age is within normal limit.
What’s Neophobia?
Neophobia is the tendency of children to initially reject new or novel food.
You will have to give new food 10 to 16 times before they accept them.
Tips for parents before starting new food
- Start new food 1 at a time.
- Give gaps of 3 to 5 days before starting another new food .
- New foods should be stopped in the event of diarrhea /vomiting /rashes.These may be due to food allergy.
- During complementary feeding your baby will like softer and smoother textured foods.Gradually replace with thicker food items
- Don’t give up.Just because your baby refuses something once don’t lose heart.Make it taste different. Make it look different .A variety of food tasting is important for babies to get a taste for it.
My baby girl started her animal protein journey with fish. She refused chicken for the longest time.But mutton she liked from a pretty young age( around one and a half years)
I didn’t touch chicken throughout my pregnancy. Did you know mothers diet in pregnancy determines a child’s food habit?
She loves her eggs too.Boiled fried or poached.
I have noticed for all animal proteins she likes crunchy which will then melt in the mouth (She loves a crunchy Ilish fry).Not chewy or oily.
Since she liked the crunchy texture and I burn stuff while cooking I went and bought an air fryer.I wrote about it here.
The airfryer keeps the taste intact and the food doesn’t lose its colour ,with a fraction of the calories.
Want Super tips to deal with fussy eaters?
Read my Ultimate guide to feeding your preschooler
If baby is a picky eater blame yourself:Healthy eating habits in children (part 1)
Childhood obesity :The control is in your hand(part 3)
Childhood obesity : Healthy eating habits & You (part 5)
I am taking part in the #ubc #blogboost Ultimate blogging challenge with Blogchatter #DailyChatter
Sharing is good Karma!
If baby is a picky eater blame yourself:Healthy eating habits in children (part 1)
You can’t make your child eat healthy!Your child likes only junk food.
You are worried about childhood obesity.What your child eats will not only help in developing their physical and mental health ,but also influence their health as adults.This is a problem which is more complex than just tempting him/ her with new recipes.
Did you know it’s not just what your child eats now, that’s to blame.It’s also your diet, during pregnancy,breastfeeding
and afterwards.
In this case, moms have all the power, to change the baby’s food choices.
When I was pregnant I wouldn’t eat chicken for the entire 9 months. I had nausea throughout my pregnancy and hated cooking.The smell of jeera ,garam masala made me want to puke.
But I still enjoyed fish ,eggs and mutton .As long as I didn’t cook them.
Veggies and fruits were always a large part of my diet .So was milk.
When I ate to keep healthy, I always remembered that these nutrients were building my baby one cell at a time.
Most of the child’s health and Immunity depends on food.But there was one more important reason to eat healthy.
What exactly does the mother’s diet do?
It does 3 important things
#Builds the flesh and blood baby
#Builds the immunity of the baby
#Builds the baby’s food choices.
Most attention is paid to the first two.Because they are unquestionably important .
What’s not discussed is the 3rd one.
Mommy’s complain of baby’s being picky eaters.But you have to recap ,what you loved having ,when you were pregnant.That’s how you can handle the picky eater baby now!
Sounds weird right?
How can a mother build a baby’s healthy taste in food ?
You have 2 full-proof tools, in your mommy tool box.Both are free .
#1 Choose healthy eating options during pregnancy
Your child develops her palate or food preferences in the womb.
Food odours are due to certain chemical components.
These compounds specially those with strong distinctive smell and taste ,are detected in the amniotic fluid.Garlic, cumin,other spices have distinctive chemicals which brand the amniotic fluids.
The developing baby swallows amniotic fluids in the womb.
Sense of taste and smell is functional during fetal life
Helps develop the food preferences after birth.
The mother’s diet is an interesting way of, building up food tastes in the unborn baby.
It’s one of the most important way to prepare the infant’s solid food choices later in life.
#2 Your breast milk and your food choices
After birth of baby ,what you eat as a mommy ,flavours the breast milk.
If you want your baby to have healthy eating habits,you must eat healthy .Include a variety of nutritious food in your diet.It is the best way to make your baby learn healthy eating ,even when breastfeeding
Prenatal and early postnatal flavor exposure helps baby develop his/her food preferences.
The child enjoys the different flavors in solid food more enthusiastically ,when complementary feed is started.
So mommy eat well.Before during and after pregnancy.
What did you eat most often when you were pregnant?
Did you eat junk food ?
Feeding your preschooler:Ultimate guide
