Firing up the system
Powering the new implanted IST-16 for the neural prosthesis
Many times we don’t know what we miss until we lose it. In other words, we don’t always appreciate what we have until it is gone. Sure, there are a few exceptions, like lost weight, extinguished debt or even a cancerous tumor; surely you can add to the list. But for the most part, we get comfortable with the extras that we have and don’t realize their value until we have to live without it.
That is how I felt about the IST-16. Sure, I still have the original system, the IRS-8, implanted although not all electrodes attached to the eight channels still work. With limited muscles of the old eight channels I could do some exercises but they were weak. I could stand but only for less than two minutes. So, technically, the standing system still worked but the performance was nothing like it was coupled with a working IST-16. Yes, I missed the IST-16.
So here I was only a couple of days post surgery and still feeling a little sore. They released me to the Z-house next to the hospital which is so much better than a hospital room. Enter members of the research team, a physical therapist and an engineer with technical gear in hand. “We are going to fire up the system.” Yes, before leaving to go home for the weeks of recovery, the team wants to make sure the system is working. It was only a few days ago, during the surgery, they turned it on and tested the channels in the operating room. However, the true test is whether or not it still works once everything is closed up and I’m awake. Anything could go wrong in the time from when the surgeons stitched up the incisions to when I’m getting up and moving around.
We get into position. The engineer opens up the cases housing the testing equipment and the physical therapist helps me transfer onto my back for testing. Appears the testing external control unit otherwise known as the ‘clicky-box’. This piece of test equipment earned its name as it is an external control unit that allows the engineer to change the setting for each channel individually on the fly by pressing the buttons that click. It allows for testing of thresholds and parameters to customize the optimum setting for each electrode and channel of stimulation. For today, the clicky-box is used just to turn each channel on to make sure it is still working.
First, we test the original IRS-8. Even though the original system was not touched during the surgery, we wanted to be sure that it was still functional. We place the external coil on the skin over the IRS-8 and plug it into the clicky-box. The right side is first. Channel by channel the engineer identifies the applicable muscle and the PT positions my body. We start with the right quad muscle.“On and off.” I hear while looking diligently at the muscle.
It never gets old, looking at my paralyzed muscles contract with the stimulation. I’m taken back to the first time I was implanted with the IRS-8 in 1999. Then, still in the hospital bed, the research team tested the system post surgery then too. That feeling of watching my quad muscle contract and kick my leg out straight was simply exciting. Ever since the accident that left me paralyzed I’ve had this yearning to be able to see the muscle work again, functionally. Over the years, I’ve learned that a muscle twitch is not enough. If you can have a slight movement of a muscle but you can’t use it, it just isn’t enough. In fact, that can become more frustrating than functional.
Eighteen years later here we are once again watching the quad muscle contract and kick my leg straight, but this time there was also a sense of relief. Even though the muscle was weak from disuse, the IRS-8 was still working. That means we at least came away from the surgery without losing any of the functions that I had with the system going into the surgery. We proceed to test each of the eight channels. Relief; no loss but did we make any gains?
Next was the replacement IST-16. We place the coil over the bandaged incision on my right abdomen. Again, we begin with the right side and the first channels for the quad muscles. “On and off”, I hear while we all watch the right leg. It kicks out; weak but it still works. Testing each channel, on and off, for each of the 16. Still the muscles are weak from disuse, but all parts of the system are working. Weakness can be solved with exercise, but the fact that we can control each connected electrode means we now have a functioning system.
Surprisingly, I’m the cautious one of the group. After previously losing the use of the IST-16 and now having a new system that works, I’m hesitant to jump in and start exercising the muscles attached to the new channels. Why? I want my body to heal around the replaced implant and connectors. Perhaps that patience is unnecessary. But, in the meantime, I am able to still exercise using the original IRS-8.
With some further programming by the engineer, I’m sent home for several weeks of limited movement, wound care, and light stimulation exercise with the IRS-8. But there are restrictions: no standing, no abdominal twisting and no heavy lifting until the incisions heal. Now, it’s in my hands to be patient with the healing process, diligent against infection and disciplined to exercise using only the original IRS-8. The time will come to use the IST-16 but that time is not now.
