A cochlear implant is a small electronic device that can help improve the hearing of people with severe, irreversible hearing loss. Although a cochlear implant does not restore normal hearing, it can allow a person to hear and understand more speech than was possible with a hearing aid. For a child, this could mean an opportunity to develop listening and speech skills and the potential to attend school with hearing peers. For adults, a cochlear implant could reduce social isolation and improve communication.
The cochlear implant is a device that is placed in the inner ear. The implant system has three primary parts:
The brain interprets this signal and it is recognized as sound. The small headpiece and transmitter is held in place by a magnet coupled the implanted stimulator, under the skin.
Tests are done to determine if a child is a candidate for a cochlear implantation. Patients are selected based on medical and hearing histories and test results as well as findings. The evaluation, which differs slightly for children and adults, includes the following: *
Implant surgery is performed under general anesthesia and takes about three hours. During the operation, a surgeon will anchor a receiver-stimulator device in the temporal bone in the skull and insert what is called an "electrode array" into the cochlea, the small snail-shaped structure in the inner ear that contains the hearing organ. First, an incision is made behind the ear to expose the temporal bone. The surgeon then positions the implant component against the bone. A hole is made in the temporal bone with a microscopic drill, allowing the surgeon access to the cochlea. A small hole is made in the wall of the cochlea and the electrode array is gently guided into the cochlea. The internal receiver is secured in place on the skull bone with sutures and the incision is closed. A sterile dressing is placed on the incision.
To qualify for a cochlear implant, patients must meet the following criteria:
Adults age 18 and older have:
Children age 1 to 17 must have:
Following surgery, patient will return home for four weeks to allow time for swelling to subside and the incision to heal. After several days, the incision may be wet during bathing or showering.
The externally worn speech processor is activated about four weeks after surgery. The processor converts speech into a special code for each user. The activation and programming is performed at the Hospital. Programming for each implant is customized for the patient and takes about six hours over a two-day period.
Visit at regular intervals for device checks and re-evaluation. During these visits, the implant and equipment are checked and performance is measured. Re-testing generally occurs at one, three and six months and one year following the initial device fitting. Then, semi-annual or annual evaluations are performed. Each session for adults involves about three hours.
Benefit from a cochlear implant usually improves with time but can't be guaranteed. Rehabilitation after surgery is key to maximizing the benefits of the cochlear implant. Most people with these implants are able to engage in hearing activities, such as listening to a Walkman, enjoying a movie, using a phone and participating in social activities. The motivation is critical to the success of the implant. Use the device during all waking hours, Listen, speak and interact with others as much as possible, Utilize visual cues when adjusting to the implant, but gradually decrease the use of visual cues when ready, Ask others to identify unfamiliar sounds so they become familiar.
Many people have questions about cochlear implants, how they work and what to expect from the surgery. Here are some common questions and answers-
Will a cochlear implant restore normal hearing for people who are deaf?
No, a cochlear implant does not restore normal hearing. It is a communication tool but not a "cure" for deafness. When hearing functions normally, parts of the inner ear convert sound waves into electrical impulses. These impulses are sent to the brain, where they are recognized as sound. A cochlear implant simulates that process. An implant, supplemented with listening therapy, can help people recognize sound, including speech.
Are there risks in cochlear implant surgery?
Risk is inherent in any surgery requiring general anesthesia. However, the surgical risks for cochlear implantation are minimal and most patients require only a one-day hospital stay and have no surgical complications.
Will I need more surgery as new technology becomes available?
The implanted unit is designed to last a lifetime. The externally worn speech processor, which is responsible for converting sound into code and sending the information to an internal unit, is dependent on software that can be upgraded as technology improves.
Will my child outgrow the internal device and require a new one?
No, the cochlea is fully formed at birth and the skull structures achieve almost full growth by age 2. The electrode array is designed to accommodate skull growth in children. Should I wait for new cochlear implant technology? No, the design of the surgically implanted receiver and electrode array has changed relatively little during the history of cochlear implants. However, speech-coding strategies, which are responsible for delivering the signal to the internal unit and are stored in the externally worn speech processor, have improved significantly over the years. The speech processor can incorporate new technology when available.
Can people with cochlear implants identify environmental noises as well as speech?
Cochlear implants provide a wide range of sound information. Performance in speech perception testing varies among individuals. With time and training, most patients understand more speech than with hearing aids and many communicate by telephone or enjoy music.
Can people with cochlear implants swim, shower and participate in sports?
Yes, people with implants can swim, shower and participate in virtually all types of sport activities when they are not wearing the external equipment. The only restriction relates to skydiving and scuba diving because significant changes in air pressure are not advised. Participation in all other athletic activities is unrestricted, although protective headgear is always recommended. In case you have a concern or query you can always consult an expert & get answers to your questions!
What Is Rehabilitation?
A comprehensive intervention for patients with chronic diseases who are symptomatic and often have decreased daily activities.
It is designed to
Optimize functional status
Reduces health care costs
Stabilises or reversing systemic manifestations of the disease
Address morbidities and their consequences through education and exercise
Why Rehabilitation is the Need of Hour
Chronic Disease Era
Associated Mental Health Concerns with Chronic Diseases.
Continuity in Healthcare delivery system
Who Can Benefit?
Chronic respiratory disease symptomatic with optimum drug therapy
Chronic cardiovascular diseases with breathlessness despite optimum intervention and drug therapy
Chronic neurological diseases
Chronic orthopedic diseases, pre & post operative conditions
Pre Natal and Post Natal Conditions
Chronic and Acute pain conditions
Alcohol Deaddiction & Smoking Cessation
What are Consequences of advanced chronic disease?
Peripheral Muscle dysfunction
Respiratory muscle dysfunction
What are the components of Rehabilitation program?
Proper education of Disease process
Breathing and Relaxation techniques
Medications, devices & specific therapy
What are the Possible Benefits?
Improved Exercise Capacity
Reduced perceived intensity of dyspnoea and stress
Improve health-related QOL
Reduced anxiety and depression
Improved limb function and ADL’s
Benefits extend well beyond immediate period of training
For a successful rehabilitation program, it requires an efficient coordination and teamwork of medical professionals, which includes:
Nursing Attendants and health care workers
Wellness Coach and Psychologists
Cardiac rehabilitation (rehab) is a medically supervised program that helps improve the health and well-being of people who have heart problems. Rehab programs include exercise training, education on the heart and healthy living, and counselling to reduce stress and help you return to an active life.
What is the duration of this program?
As per the requirement of the patient, the program duration can vary from 6 to 8 weeks to lifelong.
What can one achieve through this program?
The goal of this program is to prevent and limit the physiological and psychological effects of cardiac illness and to improve the overall cardiovascular fitness and health of the patient. This is accomplished by developing individualised program which cover exercise, education and lifestyle modification, tailored to the individual needs and abilities of the patients.
Who requires Cardiac Rehabilitation?
People with the following cardiac diseases require cardiac rehabilitation:
·Coronary Artery Bypass Surgery
·Stable Angina Pectoris
·Two Or More Documented Classical Risk Factors For Coronary Heart Disease
·Stable Chronic Heart Failure
·Peripheral Vascular Disease
·Diabetes Mellitus (Type II)
·Valvular Heart Disease
What are the facilities for Cardiac Rehabilitation at SAANS?
SAANS Foundation has a dedicated cardiac rehab facility, complete with exercise equipment, i.e., treadmills, ergocycles, steppers and cross trainers; a gymnasium for pre-class warm-up and resistance training classes; Human Performance Labs for fitness testing; and a dedicated area for patient education.
The cardiac rehabilitation team
Phase I (Initial Phase)
This is an inpatient program. It begins with pre-procedure counselling and continues immediately after coronary artery grafting or stenting and post-angina or myocardial infarction. Its aim is to initiate early mobilisation (out of the bed) to reduce the effects of de-conditioning, along with patient education about heart disease. This is continued with a walking and exercise program at home or till the patient returns back to the hospital for Phase II.
Phase II (Conditioning Phase)
This consists of a comprehensive program to modify the risk factors for heart disease and consists of exercise, stress management, smoking cessation, behaviour modification, nutritional advice and patient education about the risk factors of heart disease. The aerobic exercise program can begin as early as 2 weeks after an uncomplicated infarction, angina and stenting or 4 weeks after a complicated infarction or bypass grafting. This is conducted in the form of group sessions or classes consisting of the three steps of initial stretching exercises, conditioning phase of aerobic training on the treadmill, ergo cycle, stepper or cross trainer (along with strengthening exercises) followed by the cool down phase. One session usually lasts for 60 to 90 minutes. It takes a frequency of 3 to 5 times a week to complete 20 sessions. Initial sessions are conducted with electrocardiographic monitoring. The behaviour management and nutritional component runs along with the exercise program. All sessions are physician monitored and are conducted by trained staff.
Phase III (Maintenance Phase)
This aims at continuing the benefits gained by patients during the second phase. It consists of the continuation of the aerobic exercise program but at a lesser frequency of about 2 to 3 times a week at home/in a gymnasium/at a hospital.
What is Pulmonary Rehabilitation?
Pulmonary Rehabilitation (Rehab) is a medically supervised program that helps to improve the health and well being of people who have pulmonary problems.
Rehab programs include endurance training, chest therapy, education on lung hygiene and healthy living, counseling to reduce stress & trigger factors and smoking cessation thus helping you return to an active and healthy lifestyle.
Who requires Pulmonary Rehabilitation?
People with following diseases require Pulmonary Rehabilitation:
Chronic Obstructive Pulmonary Disease (COPD)
Interstitial lung diseases
Obesity and Breathing Disorders
Combined cardio-pulmonary diseases
SAANS Foundation has a dedicated Pulmonary Rehab facility with separate areas for postural drainage, oxygen therapy and Non Invasive Ventilation, nebulisation and telemetric ECG monitored exercise systems i.e. ergo cycles, stepper and cross trainer; a gymnasium for pre-class warm-up and resistance training classes; Lung function testing labs; and a dedicated area for patient education.
A multi-disciplinary team consisting of
Physiatrists (rehab physician)
Physical and Occupational Therapists
Psychologists and Wellness Coach
As per patient requirement, the program duration can vary from 4-6 weeks to lifelong.
The goal of this program is to prevent and limit the physiological and psychological effects of pulmonary illness and to improve overall cardio-pulmonary status and health. This is accomplished by developing individualized programs of exercise, education and lifestyle modification that are tailored to individual needs and abilities.
Phase I (Initial)
This is an inpatient program which starts at the time of hospitalization. It aims to initiate early mobilization to reduce the effects of de-conditioning. It consists of oxygen therapy, chest wall manipulation, nebulization, postural drainage, breathing exercises and incentive spirometry to improve oxygenation. This is continued with a walking and exercise program at home or till patient return back to the hospital for Phase II.
Phase II (Conditioning Phase)
This consists of a comprehensive program to modify the aggravating factors for lung disease along with endurance training. This consists of chest care, aerobic exercise, stress management, smoking cessation, behavior modification, nutritional advice and patient and family education. The Phase II can begin after stabilization of the early symptoms. This is conducted in the form of group sessions or classes, one session usually last for 60-90 minutes. Frequency is 3-5 times a week to complete a total of about 20 sessions. Initial sessions of aerobic training are conducted with electrocardiographic monitoring. All sessions are physician monitored conducted by trained staff.
Phase III (Maintenance Phase)
This aims to continue the benefits gained by patients during Phase II. It consists of continuation of the aerobic exercise program but at a lesser frequency of 3 times a week at home/in a gymnasium/at a hospital.
What is Musculoskeletal Rehabilitation?
Musculoskeletal Rehabilitation involves maximising your function and potential so that you can return back to the community as soon as possible after any injury.
Who requires Musculoskeletal Rehabilitation?
People with following problems require Musculoskeletal Rehabilitation:
·Acute or chronic musculoskeletal pain
·Post fracture stiffness and reduced function
·Loss of a part of limb
·Repetitive strain injury
·Prolonged bed rest with generalised weakness (deconditioning syndrome)
Complex MSK Management
The Complex MSK Management specialises in treating patients who have significant functional mobility and movement impairments related to the musculoskeletal system such as, arthritis, osteoporosis, de-conditioning syndrome, post-operative complications and diabetes mellitus with associated neurological and cardiac conditions. Patients receive physical and occupational therapy, balance & gait training and education to improve their level of independence in daily living.
Multiple Trauma Management
Multiple Trauma Management provides rehab to people who have sustained multiple fractures and other injuries e.g. in a motor vehicle accident. The admission criteria are two or more active orthopedic medical conditions, multiple injuries / fractures as a result of trauma, physically ready to participate in the entire rehab process with cognitive ability to learn new activities and follow direction. These patients will be managed by a multi-disciplinary team taking care of post trauma stress disorder, pain management, mobility and activities of daily living.
The Sports Rehab provides comprehensive care to people with shoulder joint and rotator cuff injuries, tennis and golfers elbow, hand injuries, anterior cruciate ligament tears, hamstring and ankle sprains who are engaged in outdoor sports like cricket, football, basketball, volleyball, etc. leading to significant pain, strength, movement & mobility impairments. The latest technology available at the centre - multi-joint dynamometer and gait and motion analysis gives significant input in managing these conditions allowing early return to the sporting activities.
Repetitive Strain Injury (RSI) Management
The RSI Management aims to manage patients who present with chief complaints of neck or back pain or any other cumulative trauma disorders due to overuse. Patients will be evaluated by an inter-disciplinary team and comprehensive rehabilitation activities will be provided with pharmacotherapy, electrotherapy, exercise programmes, ergonomic advice, behaviour and relaxation techniques, trigger point injection procedures and education.
Amputation Management caters to the need of upper and lower limb amputation due to traumatic, ischemic, diabetic or other conditions. It offers comprehensive programme beginning with pre-amputation counselling, immediate post-operative pain reduction & temporary prosthesis, permanent prosthesis fitting & training and management of late early & late complications. The programme aims to reintegrate the person back into the society.
As per patient requirement, the programme duration can vary from 2-12 weeks.
Seeing someone who used to do all their activities on their own turn to someone who needs help even with small things like going to the bathroom can be very difficult.
The lungs are vital organs in that they are essential to supply oxygen to the entire body. If the various organs do not receive adequate oxygen, their function can be impaired. Therefore, lung function needs to be maintained. Lung function can be impaired by chronic conditions like COPD and bronchiectasis. In both these, the overall ability of the lungs to take in adequate oxygen is reduced. Therefore, the lungs need to be rehabilitated so that they can improve their ability to function better. These exercises are aimed at the following:
It has been proven beyond doubt that in addition to medications, physiotherapy plays a vital role in improving lung function over a period of time. Depending on the actual condition of the patient, a physiotherapy program is drawn up. Initially, the therapist will guide the patient and/or the caretaker with the various exercises. Over a period of time, the caretaker and the patient can do these on their own. The intent of these common exercises is to improve breathing efficiency, clear mucus, and improve overall lung function.
It has been proven beyond doubt that with no side effects (unlike medications), physiotherapy improves the overall quality of life in people with COPD.