00:00:00 Both her ears are not functioning. Both

00:00:02 her ears are dead. She's not able to

00:00:05 hear anything.

00:00:06 They literally cry in our OPD room and

00:00:10 they ask [music] this one more question.

00:00:12 Doctor, will my daughter speak ever

00:00:15 again? Will [music] she be able to

00:00:18 hear voices at any time? Parents have to

00:00:21 take a leave from their work.

00:00:22 >> [music]

00:00:23 >> They have to travel very long distance

00:00:26 and India traffic is something which is

00:00:28 very horrible. So, that's something

00:00:30 which is very, very [music] devastating

00:00:33 for many parents. It turns the family's

00:00:35 smartphone into [music] that equipment.

00:00:37 So, no longer do they need to come all

00:00:39 the way in. Instead of their cochlear

00:00:41 implant being a [music] medical device,

00:00:44 it makes it into a cool, high-tech

00:00:46 gadget.

00:00:46 >> I was [music] imagining Cyborg in

00:00:48 Justice League or how does Iron Man

00:00:51 hear? He answers everything. With AB, we

00:00:52 work off 120 channels [music] and what

00:00:55 that means is we can get up to 466

00:00:58 distinct pitches. Because they've got an

00:01:00 implant in the head already. Can we

00:01:03 measure the brain responses to sound to

00:01:05 see how that child [music]

00:01:07 or an adult is reacting to the sound?

00:01:10 It's in the early phases, but we can

00:01:11 actually get objective

00:01:13 scientific information [music]

00:01:15 to see is the brain adapting to the

00:01:18 sound.

00:01:19 >> I'm going to remove this wait and see

00:01:21 option from the equation at all. It is

00:01:23 [music] providing all the mothers a

00:01:25 mental peace of mind stating that yes,

00:01:28 my child is hearing. Hello. Namaste. I'm

00:01:31 Dr. Sriram, pediatric ENT and cochlear

00:01:34 implant surgeon. As a hearing

00:01:35 restoration surgeon, I've had the

00:01:37 privilege of performing hundreds of

00:01:39 cochlear implant surgeries, but most

00:01:41 importantly, I've witnessed first hand

00:01:43 the transformative power of these

00:01:45 cochlear implants on the life of kids.

00:01:48 Through this podcast, I'm going to cover

00:01:50 what to look for when you're choosing a

00:01:52 cochlear implant system, what are the

00:01:54 advantages, what are the advanced

00:01:56 technologies that are available in order

00:01:58 to ensure that your child hears

00:02:01 perfectly and speaks with clarity? To

00:02:04 address this, we have Mrs. Jade Donnan,

00:02:07 clinical specialist, education and

00:02:09 training manager for the entire Asia

00:02:11 Pacific countries

00:02:13 from Advanced Bionics, based in greater

00:02:15 Sydney, Australia. Jade is a true

00:02:18 intersection between human biology and

00:02:21 high-end engineering.

00:02:23 Jade, it's wonderful to have you with

00:02:25 us. I'm really excited to be here with

00:02:27 you today. The work that you're doing to

00:02:29 elevate clinical standards within India

00:02:32 is truly impressive, and I'm excited to

00:02:33 talk about some of the things that we've

00:02:35 been doing along with you to support you

00:02:36 on that journey. So, Jade, let's talk

00:02:38 about the clinical journey. I know in

00:02:41 Australia the healthcare system is

00:02:42 highly structured, but it's not the same

00:02:44 in our country, India. Parents, they In

00:02:47 fact, they are very young couple. They

00:02:49 get their kids around 2 and 1/2 years, 3

00:02:51 years old. They look very devastated.

00:02:54 They say, "Doctor,

00:02:56 my child was not responding to sounds at

00:02:58 all. So, we got her hearing evaluation

00:03:01 done, and it turned out to be both her

00:03:03 ears are not functioning. Both her ears

00:03:06 are dead. She's not able to hear

00:03:08 anything." They literally cry in our OPD

00:03:12 room, and they ask this one more

00:03:14 question.

00:03:15 "Doctor, will my daughter speak ever

00:03:18 again? Will she be able to hear voices

00:03:21 at any time? Will she be able to go to

00:03:23 normal school?" And now, Jade, from your

00:03:26 point of view, as a clinical specialist,

00:03:28 how does the rehab system differ in our

00:03:31 country when compared to other developed

00:03:34 nations like yours? And is there any

00:03:36 advanced technology in such a way that

00:03:38 to help these patients get that mental

00:03:41 peace of mind because we don't have

00:03:43 newborn hearing screening and early

00:03:45 intervention. It's a just a developing

00:03:47 nation. It's a really, really good

00:03:50 point. We're really lucky in Australia

00:03:51 to have a very well-developed newborn

00:03:54 hearing screening process. That means

00:03:56 that the little bubs are going to be

00:03:57 found to have that hearing loss so early

00:03:59 that we can start with the early

00:04:00 intervention. They're implanted early

00:04:03 and essentially every week they're going

00:04:05 to have appointments with a specialist

00:04:07 on their hearing therapy to learn to

00:04:09 hear sounds and learn to speak. We're

00:04:11 really, really fortunate in Australia to

00:04:13 have that and it is a little bit

00:04:14 different here in in India. Yes. We know

00:04:17 that there isn't always the access or

00:04:19 the ability to have so many regular

00:04:21 appointments with a trained therapist

00:04:23 and because of that the family takes

00:04:25 such an integral role in the the hearing

00:04:27 rehabilitation. True. So what we see is

00:04:30 that the mothers and the grandparents,

00:04:32 they are the ones who almost become the

00:04:34 therapist. So what we invest in in our

00:04:37 tools and our resources is ways to help

00:04:40 the families become that therapist, to

00:04:42 do these listening activities within the

00:04:45 home to support that child to to get to

00:04:48 where they need to be to hear meet the

00:04:50 hearing milestones

00:04:52 and then to hear like their other

00:04:54 children at school. Wow, that's truly

00:04:56 amazing. What you said is perfectly

00:04:58 right. In our country we have the

00:05:00 opportunity, we are blessed in such a

00:05:02 way that grandparents also become

00:05:05 therapists. We have that extreme

00:05:07 support. And is there any technology you

00:05:10 could help these grandparents to

00:05:12 understand very easily and do the

00:05:14 weightlifting from your side? 100%. I

00:05:17 think it's really important that there's

00:05:18 this this marriage of having the great

00:05:21 technology to remove the barrier that's

00:05:24 there. They can hear the sound well and

00:05:26 then couple that with the therapy to be

00:05:28 able to build those skills. And of

00:05:30 course Advanced Bionics is a technology

00:05:32 company. We have lots of technologies

00:05:35 that are designed to bring access to the

00:05:37 sound to be able to build those hearing

00:05:39 skills. There's so many that we could

00:05:41 talk about. I think if we start with

00:05:43 just some of the fundamentals, we have a

00:05:45 technology called the T-mic. So this is

00:05:47 a microphone that sits at the entrance

00:05:49 of the ear canal and it's a really

00:05:52 simple thing. We kind of take it for

00:05:54 granted that a microphone needs to be

00:05:57 precise technology. It needs to be a

00:05:59 good quality microphone, but also the

00:06:01 placement of that microphone is really

00:06:03 important. So, with a T-mic sitting at

00:06:05 the entrance of the ear canal, it's

00:06:07 capturing sound the way that the normal

00:06:09 ear captures sound and it's passing that

00:06:11 through to the child to hear. There's a

00:06:13 few other technologies as well that kind

00:06:15 of come together to give that that

00:06:17 access to sound. So, another of the

00:06:19 technologies that we have that works

00:06:20 together with a T-mic is the input

00:06:23 dynamic range. With Advanced Bionics, we

00:06:25 have the widest input dynamic range.

00:06:28 What that means is that our system can

00:06:30 capture the really soft sounds, so the

00:06:32 whispers, the different sounds in the

00:06:34 house, up to the louder sounds. And

00:06:36 that's really important cuz if we're

00:06:38 thinking about incidental learning, so

00:06:40 child's just learning about the

00:06:42 environment, the different sounds, as

00:06:44 well as speech, we need to hear those

00:06:46 really soft sounds and the loud sounds.

00:06:48 So, having the widest input dynamic

00:06:50 range in cochlear implants is an

00:06:52 important facet and all works together.

00:06:55 So, you mean the T-mic, which is

00:06:58 patented from Advanced Bionics, and also

00:07:01 the wider input dynamic range. I think

00:07:04 that's an industry level. You are the

00:07:06 highest among the industry level.

00:07:08 Perfect.

00:07:09 >> That's right.

00:07:09 >> And really thank you for doing the heavy

00:07:11 lifting for developing nation nations

00:07:13 for like our country. And because you

00:07:15 mentioned about the home learning, the

00:07:19 home environment where even grandparents

00:07:21 can help them, let me ask you one

00:07:23 commonly asked question, Jade. They ask

00:07:26 me, "Doctor, because the technology

00:07:28 technology is so good that why can't we

00:07:30 go with one implant on one ear? Why

00:07:33 should we go for both the ears? Is one

00:07:36 implant really enough, Jade?" It's a

00:07:37 natural question. We get this question a

00:07:39 lot. When I was in clinic, I would hear

00:07:41 this a lot too. The reality is, as you

00:07:44 know, Dr. Rao, we are born with two ears

00:07:47 and our brain is designed to listen with

00:07:49 two ears. When we are limited to input

00:07:52 of sound with just one ear, it's much

00:07:54 harder for our brain to make sense of

00:07:57 the sound and to learn to hear the

00:07:59 speech and everything in our

00:08:00 environment. So, two ears really does

00:08:03 make a big difference. The way that

00:08:05 Advanced Bionics approaches this is that

00:08:07 we always look at the two ears working

00:08:09 together. So, it could be two cochlear

00:08:11 implants, it could be a cochlear implant

00:08:12 and a hearing aid. Everything we do is

00:08:14 looking at a person as a whole. That

00:08:17 child has two ears, let's optimize them

00:08:20 and get them to hear together.

00:08:22 So, you mean to say it's not just about

00:08:24 the volume. It's about the clarity

00:08:27 against the chaos. So, Jade, do you have

00:08:30 any extra advanced technology in such a

00:08:33 way that because you know, in India,

00:08:35 when most of the kids that I operate are

00:08:38 pediatric kids. And our schools are

00:08:40 designed in such a way that we have

00:08:43 fans.

00:08:44 Rooms are very noisy. And in fact,

00:08:48 we have almost 30 to 40 kids in each

00:08:52 classroom. So, I understand that you

00:08:54 have wider the highest input dynamic

00:08:57 range of sound. But is there any

00:08:59 advanced technology more than that other

00:09:01 than creating a volume in such a way

00:09:04 that there is some noise canceling,

00:09:06 something like that? Most definitely.

00:09:08 So,

00:09:09 again, because Advanced Bionics is an

00:09:10 innovative company, we've come up with

00:09:12 lots of different technologies. They

00:09:14 work together, but I'll try and pull a

00:09:16 couple apart here to kind of explain how

00:09:18 they work to help a child in the

00:09:19 classroom. One technology that we have

00:09:22 is called ClearVoice. This is one that

00:09:25 we are so proud of cuz it's the only

00:09:27 sound coding strategy that's got an a

00:09:28 superiority rating from the FDA. It's

00:09:32 ClearVoice. ClearVoice. So, that's a

00:09:34 pretty big deal. We're very proud of it.

00:09:36 What it does, what it means for

00:09:37 families, is that it's always listening

00:09:41 to the sounds in the room, and it's

00:09:42 going to automatically adapt for that

00:09:44 child. So, they don't have to do

00:09:45 anything, the parents don't have to

00:09:46 worry, the teachers don't have to worry.

00:09:48 But, what it's going to do is as soon as

00:09:50 the the sound is raising in that

00:09:51 classroom,

00:09:53 as you said, the ceiling fan, the other

00:09:54 kids, the class next door, the traffic

00:09:57 outside, it's hearing that, and it's

00:09:59 going to reduce that noise to be able to

00:10:01 highlight the speech more. And that's so

00:10:03 important for the child. Uh whether

00:10:05 they're hearing with one ear or two

00:10:06 ears, we need these extra technologies

00:10:09 to be able to give them more speech and

00:10:12 less noise, so they can really focus on

00:10:14 what's important, which is the learning.

00:10:16 And what we really see with technologies

00:10:18 like this is its impact on the brain.

00:10:21 When we are straining to listening in in

00:10:23 noise,

00:10:25 even for people with normal hearing, we

00:10:27 have to focus harder. We kind of we you

00:10:29 can see it in our eyes, we are

00:10:30 straining. If we can relax all of that

00:10:33 for the child's brain, it gives them

00:10:35 more capacity to focus on the learning

00:10:37 in front of them, to focus on their

00:10:39 reading, to focus on their mathematics.

00:10:41 It just allows them to be a child like

00:10:44 everyone else in the classroom. So, this

00:10:46 is, you know, the amazing technology,

00:10:49 but the impact is that the kid can just

00:10:50 be like every other child. If I can tell

00:10:52 you a little story about Clear Voice,

00:10:55 when we first when we first released

00:10:57 this, we were doing some clinical

00:10:58 testing with it. This is many, many

00:11:00 years ago now, and we came up with

00:11:02 something that we called the Clear Voice

00:11:03 Eyes. And this is because of the way the

00:11:05 technology works, there's about a

00:11:07 3-second delay before it turns on. So,

00:11:10 it's listening to the room, it's seeing,

00:11:11 "Okay, there's noise." And then 3

00:11:13 seconds later, it switches on. So, when

00:11:15 you're looking at someone with a hearing

00:11:17 loss listening with our technology,

00:11:19 they're focused really hard. They're

00:11:21 trying to hear the speech away from the

00:11:24 noise. Then the technology comes in, and

00:11:26 you see this

00:11:28 relief in their face. Their eyes relax,

00:11:30 their face relax, often their body

00:11:32 language relaxes well. And this is like

00:11:35 the physical version of the technology

00:11:39 turning on. We can actually see it

00:11:41 playing a role. And this is why

00:11:43 we've had this technology for years, but

00:11:45 it really sticks with me cuz it's a

00:11:46 physical change that we can see in the

00:11:49 child or in the adult when we're turning

00:11:52 this technology on. So, we know that

00:11:54 it's impactful. We know it's making a

00:11:56 difference. It's picking out the speech

00:11:58 more, but it's enabling them to relax,

00:12:00 not be so fatigued at the end of the

00:12:02 day, get through that whole school day.

00:12:04 And I know the school days in India are

00:12:06 long days as well. We need them to

00:12:09 listen for a long time. So, these

00:12:11 features that are not just improving the

00:12:13 speech, but also just relaxing the

00:12:16 brain, these are really important for a

00:12:18 child to excel in the classroom. Yeah.

00:12:21 So, you mean to say that rather than

00:12:23 struggling to understand speech, there

00:12:26 will be an effortless hearing.

00:12:30 I can say effortless listening

00:12:32 without any effort. That's fantastic.

00:12:35 If I could add to this as a surgeon

00:12:38 myself,

00:12:39 um if you

00:12:41 look into the physics of sound, that's

00:12:44 what we read earlier. I always tell my

00:12:46 patients this. A single cochlear implant

00:12:49 is definitely a boon for kids.

00:12:53 But this works in silence. In the noisy

00:12:56 environments, a single cochlear implant

00:12:58 is not enough. Brain needs to perform

00:13:02 three-dimensional auditory scene

00:13:04 analysis. It requires three-dimensional

00:13:07 auditory input. It could be because of

00:13:09 the head shadow effect. It could be

00:13:11 because of the binaural summation. It

00:13:14 could be because of the binaural squelch

00:13:16 phenomenon, what you call it as

00:13:18 suppression phenomenon. Finally, I would

00:13:20 like to convey to the parents this way

00:13:22 that and research very strongly supports

00:13:25 this state. Even you know about this. In

00:13:27 hearing, 1 + 1 is not equal to 2. 1 + 1

00:13:32 is greater than 2. And that's the point

00:13:35 they need to note. Finally, it should be

00:13:38 an effortless listening rather than

00:13:41 struggling to hear and finally

00:13:43 exhausting at the midday itself. So,

00:13:46 Jet, because we are in this flow of

00:13:49 where binaural stimulation is important,

00:13:52 bilateral implantation is important. Let

00:13:55 me ask you a complex situation where

00:13:58 people do come and meet me. Some kids,

00:14:02 they have some amount of residual

00:14:04 hearing on one ear. Residual in the

00:14:06 sense where somewhere around 70

00:14:08 decibels, moderate to severe hearing

00:14:10 loss. And on the other ear, they may

00:14:12 have profound loss that's somewhere

00:14:14 around 90 decibels of hearing loss. So,

00:14:16 in these situations, what we usually

00:14:18 advise is to go ahead with the bimodal

00:14:20 ear. Where I'm going to implant do

00:14:22 implant on the profound hearing loss.

00:14:25 And perform and ask them to use a

00:14:27 hearing aid on the

00:14:29 other ear which has moderate to severe

00:14:31 hearing loss.

00:14:32 Now, the common question that parents

00:14:34 ask me is, Jet, "Doctor, because we are

00:14:37 using two devices on both the ears, will

00:14:40 the brain be able to understand this?"

00:14:42 How can we answer this? It's a pretty

00:14:44 common question again, and it's a bit of

00:14:45 a tricky one. Traditionally, the way

00:14:47 that a cochlear implant and a hearing

00:14:49 aid work is really different. So,

00:14:51 essentially, we are putting two

00:14:53 different sounds into the one brain and

00:14:56 expecting that brain to make sense of

00:14:58 it. That's a challenging task. We know

00:15:01 our brains are amazing. We know that

00:15:03 kids' brains in particular are really

00:15:05 plastic and they're able to adapt to

00:15:07 things, but it takes more work. It makes

00:15:10 us more tired. So, if we think about

00:15:12 this like an example of

00:15:15 watching a movie. So, say we're watching

00:15:17 a movie screen and half of it is in

00:15:19 black and white. And then the other half

00:15:22 of it, we've got 4K, maybe it's even in

00:15:25 3D. So, we've got two different kinds of

00:15:27 sounds or two different kinds of visions

00:15:29 in this example.

00:15:31 We can watch it and we can make sense of

00:15:33 it, but we are going to be focusing so

00:15:34 hard to figure out what's going on that

00:15:37 it just is draining.

00:15:39 It's the same with our ears. If we're

00:15:41 listening with two different radio

00:15:43 stations, it's hard to pull them

00:15:45 together. So, that was the traditional

00:15:48 challenge we had with bimodal, that the

00:15:50 acoustic and the electric just weren't

00:15:52 really coming together in the right way

00:15:54 or an easy way for the patients. But,

00:15:57 what Advanced Bionics has done is we've

00:15:58 come out with a linked hearing aid that

00:16:01 actually connects with cochlear implant.

00:16:03 >> So, you mean linked hearing aid? You

00:16:05 mean to say one side with the hearing

00:16:07 aid they are going to get the acoustic

00:16:09 hearing and the other side with the

00:16:11 cochlear implant they are going to get

00:16:14 the electrical hearing. But, Jade, uh

00:16:17 as a surgeon by myself, I know it's very

00:16:20 difficult to sync these both together.

00:16:22 And I know Advanced Bionics has come up

00:16:24 with this linked hearing aid.

00:16:27 But, will all the implant companies

00:16:30 follow the same principle? Anyhow, brain

00:16:33 requires some time to adjust this one.

00:16:34 Is there any technology that these two

00:16:37 work together? Why did they give this

00:16:39 name of link for this? Yeah, and so

00:16:42 that's the important thing that we

00:16:43 worked so long on to battery bring the

00:16:46 hearing aid and cochlear implant

00:16:47 together and link them as one system.

00:16:50 So, with Advanced Bionics, they're not

00:16:51 two different devices working on their

00:16:53 own doing different things. We have the

00:16:56 Phonak Marvel Link hearing aid and then

00:16:58 we have our Marvel CI, and they actually

00:17:01 work together as a pair. So, they're not

00:17:03 just listening to the same sounds,

00:17:05 they're actually treating them in the

00:17:07 same way. So, what that means for that

00:17:09 one hearing brain, cuz we still only

00:17:11 have one brain even though we have two

00:17:13 ears, it means that the the signals that

00:17:15 are coming in, when there's noise, both

00:17:18 devices hear their noise and they use

00:17:20 the same kind of technology to treat it

00:17:22 and help get rid of the noise, focus on

00:17:25 the speech. So, they're working in the

00:17:26 same way at the same time. So, that

00:17:28 truly

00:17:30 brings the the clearest signal together

00:17:32 and this is all part of again,

00:17:35 giving less strain to our brains.

00:17:38 So, with Advanced Bionics, the way that

00:17:40 we've implemented bimodal is different

00:17:42 to how all the other companies are

00:17:43 approaching it at the moment. So, our

00:17:46 Naida Link hearing aid and our Marvel CI

00:17:49 or Sky CI actually work together. Mhm.

00:17:52 How that really works is they've got the

00:17:54 same brain. They use the same chip and

00:17:56 they use something called AutoSense OS.

00:17:59 This is the technology that is

00:18:01 essentially the software within them.

00:18:03 So, they're using the same software to

00:18:05 listen to the room and make the same

00:18:08 decisions about how much noise there is,

00:18:11 when to turn things on and off, and when

00:18:13 to put the right sounds through to that

00:18:15 child. So, this is completely unique in

00:18:18 the industry. We are the first and only

00:18:20 to have a linked system where both

00:18:22 devices use the same chip and are able

00:18:25 to actually share that information

00:18:26 together. And this is the kind of thing

00:18:29 that not only makes it easy because you

00:18:31 don't need to change programs on both

00:18:33 things, they work together, but it makes

00:18:35 it easy for the brain cuz it's getting

00:18:37 one more synced signal together. True. I

00:18:40 think this is the reason why Jade,

00:18:42 because kids they cannot tell about

00:18:44 this, but for adults and for teenagers

00:18:47 who have been using hearing aids for

00:18:49 pretty long time, the most common

00:18:51 complaint is that, "Doctor, I'm able to

00:18:53 hear the volume. If you increase the

00:18:56 volume also, I'm very normally able to

00:18:59 hear the voices, but the clarity is

00:19:01 missing." That is what they say.

00:19:04 And the minute I implant on one side and

00:19:07 put a link hearing aid on other side,

00:19:10 within 1 month Jade, you'll not believe,

00:19:12 they say that "Oh my god, my hearing is

00:19:15 so much better. I It's so crisp. The

00:19:19 clarity is so crisp. I would have chosen

00:19:21 this implant earlier only. Now

00:19:24 everything makes sense with AutoSense

00:19:26 OS."

00:19:27 >> [laughter]

00:19:28 >> I definitely remember that from clinic

00:19:30 as well. So, before we had these linked

00:19:32 hearing aids, patients who would get

00:19:34 bimodal, they would just say it was off

00:19:36 sync. It wasn't working together. Um

00:19:38 they would explain things like it's it's

00:19:40 like two different radio stations and it

00:19:42 just doesn't seem to make sense.

00:19:44 But once we have this linked bimodal, it

00:19:47 just makes them feel more comfortable

00:19:49 and they often say it just they feel

00:19:51 they don't feel off center anymore. They

00:19:53 feel more in balance.

00:19:54 >> Are there any other companies also doing

00:19:56 the same kind of thing? I think they

00:19:58 have to buy a hearing aid separately and

00:20:00 implant separately. They do not have

00:20:02 this something with their sister

00:20:04 company.

00:20:04 >> This is correct. So, only Advanced

00:20:06 Bionics have a true linked system that

00:20:08 the hearing aid and the cochlear implant

00:20:10 are specifically designed to work

00:20:12 together and actually talk to each

00:20:14 other. So, we can talk to apps. So, we

00:20:16 have one great simple app where a family

00:20:18 could turn things up and down for both

00:20:20 devices. But in top on top of that, the

00:20:24 devices talk to each other and that's

00:20:26 how we can optimize the sound more and

00:20:28 give the the best sound input to try and

00:20:30 get the best hearing and and speech

00:20:32 outcomes as well. Wonderful. Amazing.

00:20:34 So, it's just like a

00:20:36 single ecosystem. That's right.

00:20:38 Fantastic. So, now Jade, uh let me ask

00:20:41 you about the teenagers. This is a

00:20:45 specific, completely different group. I

00:20:48 remember one smart guy, he was asking

00:20:50 me,

00:20:51 "Doctor, I study very well. I don't mind

00:20:54 wearing this implant at all.

00:20:56 I have very good hair. I can cover it

00:20:58 up. My only concern is this. All my

00:21:02 friends, they have mobiles, they have

00:21:04 laptops. They wear this headset and they

00:21:07 look very cool. In fact, they do gaming,

00:21:11 they attend online classes,

00:21:13 they do their homework on these laptops.

00:21:16 But I always feel I am a left out with

00:21:19 that. Hmm. Is there any way that this

00:21:22 advanced technology can fit this teenage

00:21:25 group in such a way that they don't feel

00:21:28 that they are wearing a medical device?

00:21:30 It should just look cool, like a cool

00:21:32 gadget. Is there any technology

00:21:35 available that way?

00:21:36 Yes, you're right. For teenagers,

00:21:38 fitting in with their friends is one of

00:21:40 the most important things to them. And

00:21:42 one of the biggest changes I've seen in

00:21:44 cochlear implant technology in the last

00:21:46 few years is wireless streaming. Oh. The

00:21:49 way that we've implemented it with AB is

00:21:52 universal Bluetooth connectivity. What

00:21:54 that means is that that teenager can

00:21:56 connect to any different type of device

00:21:58 that has Bluetooth technology in it. So,

00:22:01 when we think about mobile phones, we're

00:22:03 not just designing things to work with

00:22:05 an iPhone or a few phones. We've got

00:22:07 made for all. It will connect to Android

00:22:10 phones as well as iPhones. So, this

00:22:12 teenager who's on the bus on the way

00:22:14 home from school can be listening to

00:22:16 their Spotify. They can be taking calls

00:22:18 through WhatsApp. Everything else that

00:22:20 their friends are doing, they can do it,

00:22:22 too. So, it's essentially turning their

00:22:23 cochlear implant into a high-tech

00:22:26 earbud. So, it is something cool. It is

00:22:28 something that does help them fit in

00:22:30 with their peers. The other thing that

00:22:31 we've done when we've implemented

00:22:33 universal Bluetooth connectivity into

00:22:35 the Marvel CI is that we've included

00:22:37 hands-free calling. So, with any other

00:22:39 cochlear implant, if that teenager wants

00:22:41 to take a call on that bus or at home,

00:22:44 wherever they are, they still have to

00:22:46 get their phone out of their bag and

00:22:48 lift the phone up to hear to use the

00:22:50 microphone so the other person can hear

00:22:52 them. The Advanced Bionics Marvel CI or

00:22:54 the Sky CI, we're actually using the

00:22:56 microphones on the ear. So, they can

00:22:58 keep that phone in their bag. They can

00:23:00 keep it on the other side of the room.

00:23:02 They can have that phone call just by

00:23:04 answering it on the ear, chatting away

00:23:06 with their friends, and no one even

00:23:09 knows that they're on a phone call. So,

00:23:10 these are again are the really cool

00:23:12 things that make you able to be a teen,

00:23:15 be just like your friends, and access

00:23:17 all of this technology that's just part

00:23:20 of our lives now.

00:23:22 And then the other thing that I think of

00:23:23 is really important is you mentioned

00:23:25 gaming consoles. There's so many hobbies

00:23:28 that rely on sound and streaming.

00:23:31 There's also education that relies on

00:23:33 it. So, the other way that's the other

00:23:36 thing that's really important with

00:23:37 universal Bluetooth connectivity is

00:23:39 connecting to other devices. So, not

00:23:41 just a phone, connecting to the laptop

00:23:43 at school, connecting to the iPad at

00:23:45 home, connecting to a gaming console,

00:23:48 anything that's got Bluetooth, they can

00:23:50 directly connect with their cochlear

00:23:52 implant and hear that sound just like

00:23:54 their other friends can, or even easier

00:23:57 cuz they don't even need to put a

00:23:58 different set of headphones on. They've

00:24:00 already got the technology. So, instead

00:24:02 of their

00:24:03 cochlear implant being a medical device,

00:24:06 it makes it into a cool uh high-tech

00:24:09 gadget. Wow. This

00:24:12 universal Bluetooth is a totally game

00:24:15 changer, Jade. Mhm. In fact, the way

00:24:18 that you were mentioning, I was

00:24:19 imagining

00:24:21 that cyborg in

00:24:23 Justice League or in Star Wars or how

00:24:26 does Iron Man he answers everything,

00:24:27 yeah. Yes, go ahead. Yeah. It It's the

00:24:30 future, but it's here now for our

00:24:32 cochlear implant recipients. That's

00:24:34 really wonderful, Jade. Now, because we

00:24:36 are talking about these teenagers, for

00:24:37 them music is something which is

00:24:40 cool. Do you have any technology in such

00:24:42 a way that it can also capture these

00:24:44 microtones of the music? Yes. So,

00:24:47 another technology that AB has worked

00:24:49 really hard on is our current steering

00:24:50 technology. So, traditionally music is

00:24:53 actually quite a complex sound. It's

00:24:55 quite hard for a implant to pull apart

00:24:58 all the important pieces of music and

00:25:00 pass them through. What we've done with

00:25:02 Advanced Bionics is we've created a

00:25:04 specific technology to get more of the

00:25:07 music information or more of the

00:25:08 spectral information. So usually a

00:25:11 cochlear implant would work off 12 or 22

00:25:14 channels. With AB we work off 120

00:25:17 channels and what that means is we can

00:25:18 get up to 466

00:25:21 distinct pictures. Wow.

00:25:23 >> And this is what's really important for

00:25:25 music, picking out all the fine details.

00:25:28 So to be able to really enjoy and get

00:25:31 the emotional side of music, we need all

00:25:33 this extra information. So that's like

00:25:35 the subtle pitch information. We also

00:25:38 need the difference between the big loud

00:25:40 drums and then the soft sounds as well.

00:25:43 So all of this comes together and with

00:25:45 our current steering technology, we can

00:25:47 pull that apart to give that richness

00:25:50 and texture back to music.

00:25:52 >> Mhm. And then because it's easier to

00:25:54 listen to and more enjoyable to listen

00:25:56 to, they can

00:25:57 get the the musical they can get the

00:26:00 emotional aspect of the music as well.

00:26:02 What's this current steering technology,

00:26:04 Jed?

00:26:05 Can you just explain to normal people

00:26:08 what this is, current steering

00:26:10 technology? Sure. It's something very

00:26:12 complex that our engineers have worked

00:26:14 on, but if I try and explain it simply,

00:26:17 what we do is instead of just activating

00:26:19 one electrode at a time in the cochlea,

00:26:22 what we can do with our system because

00:26:24 of what's in the implant, we can

00:26:26 actually turn two electrodes on at the

00:26:28 same time. So what we can do with that,

00:26:31 it's a bit fancy work, but essentially

00:26:33 we can actually create what we call

00:26:34 virtual channels. We can move the

00:26:36 current around more in the cochlea. So

00:26:39 instead of just be able to give a few

00:26:42 different tones. So if you think about

00:26:43 maybe like that little first keyboard

00:26:45 you get as a kid, it's got 12 or 20

00:26:47 keys. You can play a few different keys.

00:26:50 But with this it's more like we have a

00:26:52 grand piano. So, we have more different

00:26:54 pitches, more distinct tones that we can

00:26:57 pass through to the the patient so that

00:26:59 they can hear that sound and hear the

00:27:01 music in a more richer way. Yeah. Now,

00:27:04 that makes sense. If you look into the

00:27:06 physics of sound also, if you look into

00:27:08 the cochlea, cochlea is designed in such

00:27:11 a way that there is a tonotopic gradient

00:27:14 where the lower frequencies are at the

00:27:16 apex and higher frequencies. And

00:27:18 definitely, if an implant is able to

00:27:22 replicate that, that will be wonderful

00:27:25 because it's not about the physical

00:27:26 number of contacts. It's not about the

00:27:29 physical contact electrodes. It's about

00:27:32 the number of pitches that you're going

00:27:34 to provide. And that's what makes music.

00:27:38 Grab that microtones.

00:27:41 Now, Jade, let's just shift the gears a

00:27:43 little bit. Getting an implant surgery

00:27:46 is the simplest one. It hardly takes for

00:27:48 about 45 minutes and everything is done.

00:27:50 But the most common problem faced by

00:27:53 many parents of these little kids is

00:27:55 that they have to get these kids very

00:27:58 regularly to the centers for something

00:28:01 called mapping programming. And to get

00:28:04 those kids, it may look very simple.

00:28:07 Getting those kids to the center,

00:28:09 getting mapping programming done, it

00:28:11 hardly takes 20 minutes to half an hour.

00:28:14 It may look quite simple, but if you

00:28:16 look at it in depth, they have to visit

00:28:19 once in every 3 months for about one

00:28:21 entire year. And this continues

00:28:23 throughout their lifetime. We call this

00:28:26 as mapping sessions. For this,

00:28:29 getting the kids to the center,

00:28:31 parents have to take a leave from their

00:28:33 work. They have to travel very long

00:28:36 distance.

00:28:37 Initially, it sounds okay. Hardly 20

00:28:40 minutes, 30 minutes. But doing all this,

00:28:43 traveling, leaving work, and getting

00:28:46 their kids

00:28:48 booking an appointment, and making them

00:28:50 sit there with all the wires connected

00:28:53 is something which is very, very

00:28:55 difficult for parents. I've seen them

00:28:57 directly.

00:28:59 Now, is there any way that you could

00:29:01 help people, parents like them, so that

00:29:04 they can shift all this, they can remove

00:29:07 all this, and directly focus on their

00:29:09 work, and make it quite simple? Yes,

00:29:11 thankfully, we've we've talked about a

00:29:13 few different technologies, and a lot of

00:29:16 them have been about how to improve the

00:29:18 signal, how to help people hear more.

00:29:20 The remote programming technology that

00:29:22 we've brought in recently, this is

00:29:24 probably one of my favorite technologies

00:29:26 because it actually changes the way how

00:29:28 we can deliver care. It actually starts

00:29:30 to democratize cochlear implant care, so

00:29:33 that it's not just those who are close

00:29:35 to the clinic, it's not just those who

00:29:37 um you know, have enough family support

00:29:39 to get the kids in and out for all of

00:29:41 these appointments. We can start to have

00:29:43 a more patient-centric approach. So,

00:29:46 what we have with Advanced Bionics is

00:29:48 called the remote support app. And with

00:29:50 this app, which is for Android or

00:29:52 iPhone, so really simple for many people

00:29:55 to use,

00:29:56 it essentially turns what would be

00:29:58 usually that really big, expensive

00:30:01 equipment that's sitting in at the

00:30:02 hospital, it turns the family's

00:30:04 smartphone into that equipment. So, no

00:30:07 longer do they need to come all the way

00:30:08 in to access that equipment. And then

00:30:10 you, or the other professionals, can

00:30:13 stream in through Wi-Fi, through the

00:30:15 cloud, talk to the patient,

00:30:18 and essentially anything that would be

00:30:20 done in the programming appointment, the

00:30:22 mapping appointment in clinic, can now

00:30:24 be done through the phone. So, this

00:30:27 completely changes how we can provide

00:30:29 care to patients.

00:30:31 Like you said, there are so many

00:30:32 barriers to getting into an appointment,

00:30:34 whether it is just the struggle to get

00:30:36 the child there, whether it is taking

00:30:38 the time off work, losing money, sitting

00:30:41 in the traffic, which I experienced

00:30:42 yesterday. There's so many barriers, and

00:30:46 this it's a simple app, and it can just

00:30:48 revolutionize how we're providing that

00:30:50 care. Is the app easy to use? Can even

00:30:53 grandparents, parents, everyone can use

00:30:56 that?

00:30:56 >> Definitely. I think this is something

00:30:57 that our engineers over the recent years

00:30:59 have really focused on, making sure that

00:31:02 not just that we have the best

00:31:03 technology, but it's also really easy to

00:31:05 use. So, the interface of the app, it

00:31:08 just has a couple of screens that you

00:31:09 connect, you click into that, you're in

00:31:12 a waiting room. It'll say, "We're

00:31:13 waiting for your professional." And then

00:31:15 once the professional's there, it'll

00:31:17 just open. And it essentially just looks

00:31:19 like a voice a face FaceTime call for

00:31:22 the recipient. They see the face of the

00:31:24 professional, they can talk, so they can

00:31:26 do the lip reading. It uses the

00:31:28 speakerphone, so the family are involved

00:31:30 as well. It's not just streaming to that

00:31:32 child, which could be confusing for the

00:31:34 caregivers. It's putting the sound into

00:31:36 the room, so everyone can be involved in

00:31:37 that appointment. The family can still

00:31:40 answer questions to the therapist,

00:31:42 and everyone's in that appointment. Very

00:31:45 much like if they were in the room, just

00:31:46 without having to go on that long

00:31:48 journey to get there. Wow, that's

00:31:50 something which is revolutionary, I can

00:31:52 say. But yet, because this is such a

00:31:53 fantastic thing what engineers have

00:31:56 discovered, so is this accessible

00:31:59 for all the generations? For example, if

00:32:02 I operated on a child somewhere around 5

00:32:05 years or 6 years ago, can they also use

00:32:07 this technology? Yes. So, the remote

00:32:10 support app is backwards compatible for

00:32:12 those who have had their implants for

00:32:13 some time.

00:32:14 >> It's backward compatible. So, we need

00:32:16 the Marvel CI sound processor or the Sky

00:32:19 CI sound processor to connect with the

00:32:21 remote support app.

00:32:23 But they could have an implant back to

00:32:25 our CI 2 implant. We've had that implant

00:32:27 for almost 25 years. They can still

00:32:30 access this great technology. And again,

00:32:32 this is why technologies like this

00:32:34 excite me, because we're able to help

00:32:36 people who have been implanted for so

00:32:38 long, but we also know that people we're

00:32:40 implanting now are going to have access

00:32:42 to these amazing technologies that we

00:32:44 haven't even thought of yet, but they're

00:32:46 going to come in the in the future and

00:32:47 we're going to be able to bring them

00:32:49 back into our implants.

00:32:51 Cuz the way that our engineers have

00:32:52 designed our implant, if we think of the

00:32:54 Ultra 3D implant, our current implant,

00:32:57 we define that as a smart implant. We

00:33:00 define as future-ready because we know

00:33:02 it's got the capability to deliver these

00:33:04 future technologies that we're still

00:33:06 working on or we haven't thought of yet.

00:33:08 They'll come to the patients and they'll

00:33:10 be able to give them more benefits into

00:33:12 the future. Wow, that's fantastic. Why

00:33:15 did they ask this question is because

00:33:17 Jade, I also work with other companies

00:33:19 where

00:33:20 uh some of the parents they were so

00:33:22 anxious that, "Doctor, I got my child

00:33:25 implanted 6 years ago, but now I'm not

00:33:28 able to use the most recent advanced

00:33:31 technologies that they have gotten. Now,

00:33:33 for me to access that, I need to change

00:33:34 my implant." That's what they are

00:33:36 mentioning. They're really stressed out

00:33:39 with that and that's the reason I asked.

00:33:41 The thing that Advanced Bionics is doing

00:33:44 is something which is a total

00:33:46 game-changer, Jade, because us as a

00:33:48 developing nation, for us

00:33:50 the amount of money that we are spending

00:33:53 on this implants is huge even for a

00:33:56 middle-class person or for a high-end

00:33:58 person. So, it should be in such a way

00:34:00 that it is the technology that you are

00:34:03 inventing or discovering should be

00:34:05 useful

00:34:07 for everyone who gets an implant. Once

00:34:09 the implant is done,

00:34:11 that's all. It should be that way and we

00:34:13 sincerely thank all the scientists who

00:34:16 have done scientists and engineers for

00:34:18 this specific backward compatibility,

00:34:21 which is a USB of Advanced Bionics. I

00:34:24 think this remote programming is a kind

00:34:26 of boon for working people like us,

00:34:28 right? Yeah, the interesting thing when

00:34:30 we started to launch this in Australia,

00:34:32 we were really thinking about it for for

00:34:35 something to help that geographical

00:34:37 distance. So, Australia has really big

00:34:39 distances, just like India does. And we

00:34:42 were thinking, "Oh, this is just

00:34:43 something for people who live a long way

00:34:45 away." But as we started to train the

00:34:47 clinics on this, as we started to talk

00:34:49 about it more, we also realized for

00:34:51 ourselves that this is just as important

00:34:54 for someone who lives in the middle of

00:34:55 the city. For the busy professionals,

00:34:58 they only have a half-hour lunch break,

00:35:00 if they get a lunch break. So, they

00:35:03 might not want to take half a day off to

00:35:04 come on in for an appointment. The busy

00:35:07 families who are trying their hardest to

00:35:09 give their their children the best head

00:35:11 start in life, they have lots of

00:35:13 different activities to go to. Taking

00:35:15 half a day off school for those kids is

00:35:18 a big deal, as well as like we've

00:35:20 discussed with the the loss of income

00:35:21 and time out. So, it really is not just

00:35:24 something about overcoming distance.

00:35:26 It's something that just makes it easier

00:35:28 to access care for everyone. And if I

00:35:30 think about a story that happened when

00:35:33 we first launched remote programming in

00:35:35 Australia, we just had the Marvel CI,

00:35:37 and there was this beautiful little boy

00:35:39 who has some complex needs. He just had

00:35:41 his Marvel CI upgrade, so he got two new

00:35:43 Marvel CIs. Very excited little boy. Um

00:35:46 and it was a great appointment, and the

00:35:48 family went home. When they got home,

00:35:50 the mother realized that they the

00:35:52 audiologist had forgot to turn on one

00:35:54 feature, which is the flashing LED

00:35:56 light. And that's just something that

00:35:58 helps the mom know the device is

00:36:00 working, my kid is hearing okay. But the

00:36:02 audiologist forgot to turn that on. So,

00:36:04 in the world before remote programming,

00:36:07 that family would have had to call the

00:36:08 clinic the next day, cuz it's out of

00:36:10 hours already, try and reschedule an

00:36:12 appointment, who knows when they can get

00:36:14 that appointment, in a couple of weeks,

00:36:16 maybe. Then, on that couple of weeks

00:36:19 day, the mom has to take more time off

00:36:21 work, the kid has to take more time off

00:36:22 school.

00:36:23 That's how it would have had to work.

00:36:26 However, [clears throat]

00:36:26 because we had remote programming, the

00:36:29 very next day at 4:00, once the kid had

00:36:31 finished school, the audiologist

00:36:33 connected with the family through the

00:36:35 remote support app. It took about all of

00:36:38 2 minutes. They turned the feature on,

00:36:41 said hello, checked everything was doing

00:36:43 okay, and that was it. Oh, wow. So, the

00:36:47 the impact for that family, you can't

00:36:50 underestimate that. Um as as a mother

00:36:52 yourself and myself, it takes a lot to

00:36:56 to move kids around and to do all the

00:36:58 things that we need to do for our

00:36:59 children. The way that technology can

00:37:02 just simplify life is just That's one of

00:37:05 the things that blows me away, and I'm

00:37:07 really passionate about what we can do

00:37:09 to now reach more people and make it

00:37:11 easier to access the care for cochlear

00:37:13 implants.

00:37:14 That's That sounds great. Uh

00:37:17 as I said, it's really revolutionary. It

00:37:20 completely changed the game. Jade, you

00:37:22 were telling about the light blinking

00:37:24 for that little boy, and they could

00:37:27 understand that the implant is working.

00:37:30 That's fantastic. Um let me tell you

00:37:32 what recently happened

00:37:34 in my hospital.

00:37:36 There was this

00:37:37 young person. He works in a bank.

00:37:41 He got his implant done,

00:37:43 but he was not coming for regular

00:37:45 therapy sessions at all. He didn't have

00:37:47 time because he is a working individual.

00:37:50 He got his implant done mainly because

00:37:52 whenever people are talking to him, the

00:37:54 clarity of sound was missing in spite of

00:37:56 using hearing aids. Now, because he's

00:37:58 already post-lingual, he already

00:38:00 developed his speech. He just wants to

00:38:02 track his progress how much this implant

00:38:05 is benefiting him. That's his main

00:38:07 thing. Rest everything is already

00:38:09 post-lingual, so he knows everything. Is

00:38:12 there any way that we could help people

00:38:15 like this rather than coming for the

00:38:17 therapy center and attending therapies?

00:38:20 Anything that could track their progress

00:38:22 at their workplaces only? Yes. So, we

00:38:25 have the AB Listen Fit app, and that was

00:38:28 specifically developed to empower people

00:38:31 on their hearing journey. So, it gives

00:38:33 them the tools in their pocket, in their

00:38:35 phone, to be able to test their hearing,

00:38:38 to be able to see, "Am I still hearing

00:38:39 the soft sounds?" They can do some tests

00:38:41 in different languages to make sure that

00:38:44 they're still hearing well. So, someone

00:38:46 like that who maybe one day they're just

00:38:48 thinking, "Oh, I'm not sure if I'm

00:38:50 hearing well today." They can do a

00:38:52 really quick check, and then they can

00:38:53 get the feedback, "You're still getting

00:38:55 the same results. Everything is okay."

00:38:57 Or on the other side, they can do that

00:38:59 test and go, "Ooh, something's changed.

00:39:01 I better go back into the clinic now.

00:39:04 Now I can prioritize that." So, it helps

00:39:06 give them the insights and the tools to

00:39:09 know how to manage their hearing

00:39:11 themselves without having to go in every

00:39:14 6 months if they don't need to. If

00:39:16 things are good, they can have the power

00:39:19 to take charge of their hearing

00:39:20 themselves. Yeah, that's fantastic. Now,

00:39:23 because he's an adult, he can just use

00:39:25 this AB Listen Fit app. How about kids,

00:39:28 Jade? They'll not be able to track their

00:39:30 progress by themselves. How can kids

00:39:32 track this? Yeah, that's something that

00:39:34 we're working on. So, the AB Listen Fit

00:39:36 app can be used with teenagers up to up

00:39:38 to 13 years of age, and it can also be

00:39:41 used with a family support.

00:39:43 But, the kid will need some kind of

00:39:45 language.

00:39:47 So, what we have uh now is the AB Listen

00:39:49 Fit app, but we are working on future

00:39:52 technologies as well. So, you would know

00:39:54 that we're working on a cortical study.

00:39:56 So, we're in the research phase at the

00:39:57 moment, and what we're trying to

00:39:59 understand is because we've got an

00:40:01 implant in the head already, can we

00:40:03 measure the brain responses to sound to

00:40:06 see how that child, or an adult, is

00:40:09 reacting to the sound. So, what we can

00:40:11 do is, and it's it's in the early

00:40:14 phases, but we can actually get

00:40:15 objective scientific information to see

00:40:20 is the brain adapting to the sound

00:40:22 that's being shared. So, is that kid

00:40:24 learning to listen? So, that's pretty

00:40:26 powerful. So, we're still in the

00:40:28 research phase. We're partnering with

00:40:30 clinics like yours to make sure we're

00:40:32 gathering enough information to know how

00:40:34 to implement it in our technology, but

00:40:36 that's something that's coming in the

00:40:37 future cuz we know that every parent is

00:40:40 going to want to know every day, is my

00:40:41 kid hearing okay? Is Are they actually

00:40:44 learning to hear? Is their brain

00:40:46 developing?

00:40:47 We're on on track to be able to see that

00:40:49 objectively with our Corticals. That's

00:40:52 fantastic. Actually, thank you so much

00:40:54 for collaborating with Dr. Ausi ENT

00:40:56 Hospital for this fantastic research

00:40:59 study. Um because this is something

00:41:02 which

00:41:03 uh

00:41:03 has been there in my mind since quite a

00:41:06 long time.

00:41:07 Because parents keep asking me the same

00:41:09 question over and over again.

00:41:11 Doctor, is my child hearing? Doctor, is

00:41:15 my child hearing? The only answer that I

00:41:18 give them is let's wait and see.

00:41:21 Your child is definitely going to hear.

00:41:23 That's what most of the time we used to

00:41:25 tell. Now, I'm not going to say that.

00:41:28 I'm going to remove this wait and see

00:41:30 option from the equation at all.

00:41:33 This is because most of the cochlear

00:41:36 companies, cochlear implants are

00:41:38 designed in such a way that there's

00:41:40 something which is blinking here and we

00:41:42 understand that the implant is working

00:41:43 and then we do intraoperatively see arm

00:41:46 and x-ray to check whether the electrode

00:41:48 is within the cochlear or not.

00:41:51 And also, we do neural response imaging

00:41:54 and state that yes, implant is

00:41:57 functioning well. Functioning of the

00:41:58 implant is well, but is this sound

00:42:02 reaching the brain or not? Is the child

00:42:05 able to understand the sound or not?

00:42:08 Is the child's brain developing or not

00:42:10 on par with others? These are the

00:42:13 questions that are not answered and that

00:42:15 is what fascinated me. Now we are at a

00:42:18 situation where through the reverse

00:42:21 telemetry the implant itself will tell

00:42:25 us, we call this as electrically evoked

00:42:28 cortical auditory potential e-cap

00:42:31 values.

00:42:32 We can assess

00:42:34 whether the sound is reaching the brain

00:42:36 or not.

00:42:37 How is the brain development of a child

00:42:39 who underwent cochlear implant surgery

00:42:42 happening?

00:42:43 And this is something which is amazing.

00:42:45 It is providing all the mothers a mental

00:42:48 peace of mind stating that yes, my child

00:42:50 is hearing.

00:42:52 I can see that latency graphs which are

00:42:54 there

00:42:55 is improving day by day.

00:42:57 And thanks to all the engineers and

00:42:59 scientists who have

00:43:01 designed this and sincere thanks to

00:43:02 Advanced Bionics for collaborating with

00:43:04 us on this project.

00:43:06 Hoping for the best and the best results

00:43:09 out there. Thank you for having me with

00:43:10 you today. I always learn a lot every

00:43:12 time I'm with you. This is the perfect

00:43:15 end to my trip here in India. This has

00:43:17 been a very exciting thing to be part of

00:43:20 and I'm excited to share more about this

00:43:22 with other professionals as I go home to

00:43:24 Australia as well. Thank you Jade. That

00:43:27 was an incredible deep dive into entire

00:43:31 cochlear implant journey. Thank you so

00:43:33 much for taking your time and providing

00:43:35 your valuable insights being a clinical

00:43:38 specialist and education and training

00:43:40 manager for the entire Asia Pacific

00:43:43 region and training our parents also,

00:43:46 our Indian parents also to take an

00:43:48 informed decision when choosing a

00:43:50 cochlear implant.

00:43:52 Now in case if you have any questions

00:43:54 regarding cochlear implants or hearing

00:43:56 technology, feel free to put your

00:43:59 questions in the comment section below.

00:44:01 We'll try to answer as soon as we can.

00:44:04 Namaste.