Neuromonics Fitting 1. Neuromonics Clinic Software and NOAH 4 New Patient Set-up How to Install the NeuroFit Software NB: Do not connect your device to the computer prior to installing the software for the first time • • • Forms & Items Needed at this Appointment 1. • • 2. • • Noah 4 must already be previously installed on your PC Log in to www.neuromonicsprofessional.com and enter your details (if you are doing this for the first time click on ‘Register’ below the log in box and enter your email address and username, a password will then be emailed to you) Click on the ‘Software and Firmware Download’ tab Click on ‘NeuroFit Installer’ which will run the setup wizard, then follow the prompts Patient Record Form: Fitting Tab document Results of Tinnitus Assessment Oasis Device portfolio: Oasis device -charged Headphones Battery charger and micro Universal Serial Bus (USB) cable • User Manual • Neuromonics Tinnitus Management Handbook • Warranty Card • • • 3. Neuromonics Clinic NeuroFit Software and NOAH 4 4. Computer [Type text] • When the installation has completed, click on ‘Close’ [Type text] CL10-‐0006 NOAH operation • Enter patient’s audiogram into Noah • Open the Neuromonics fitting module by clicking on the icon Importance of Customization • Maximize stimulation of auditory pathways • Stereo effect • Accounts for asymmetry in hearing levels • Allows more relief at a lower listening volume • Able to use treatment for sleep • Helps with relaxation Establishing a Serial Connection The software will automatically detect the connected device and display the type of device and the serial number. All changes made in the software are immediate and are automatically saved to the device Stage 1 • Designed to provide relief from tinnitus when using the treatment. • Helps in relaxation • High level of interaction with tinnitus • Relief and reduction of tinnitus awareness during listening sessions • Patient will have relief only while using the device. [Type text] When connection with the device is lost, ‘Not connected’ is displayed. To reestablish connection, check supplied USB cable and that device is turned on. The software will try to establish the connection automatically every 5 seconds. Alternatively, you can click on the [Type text] icon to re-establish connection. CL10-‐0006 Enter High Frequency Audiometry Values Stimulus • Signal and music customized to patient’s hearing profile • Customized stimulus “shower sound” is embedded in music • Two types of music Classical Baroque Contemporary • • Wide frequency Response 100 Hz - 12.5 kHz. Binaural The Neuromonics software will interpolate the 9, 10 and 12kHz values from the entered audiogram. If the patient’s measured levels differ from this, you can overwrite each of these values by highlighting the desired value and entering the correct value 2. Before Fitting the Oasis Device: Review Questionnaires Have the patient complete the following questionnaires just prior to their appointment: [Type text] • Expectations Questionnaire – for patient Review and discuss responses with the patient • Management Questionnaire – for patient Review and discuss responses with the patient [Type text] CL10-‐0006 3. Getting to Know the Oasis The Oasis device uses buttons to navigate through the menu structure and through sound files. Powering On the Oasis Device If the Oasis device is powered off, press down the middle button. The Oasis device powers on to the Menu screen. Connecting the Headphones The sounds played by the Oasis have been exactly matched to the spectral profile of the supplied headphones to ensure device usage is effective. Plug the supplied headphones into the headphone port on the top of the Oasis device. Headphone Port Beginning and Ending a Session There are four Neuromonics customized music tracks that have been programmed for listening sessions. To play a track: 1. Press the center Play button. The first track starts to play. 2. Press Play again to pause treatment. 3. To skip between tracks, press the << or >> button. When PLAY is pressed again, play resumes from the point where the track paused. If the device remains paused for five minutes, the device shuts off. If PLAY is pressed again while off, the Oasis device starts over by playing the first track Setting the Volume Each time you press PLAY at the start of a session, the volume starts at a minimum volume level. This is so that you set the volume to the correct level each time you listen to your Oasis device. To adjust the volume: 1. Press the +/- buttons on the Oasis device. See Figure 1. Each time you press a button, the volume increases or decreases incrementally. 2. Press the desired button until you reach a volume comfortable for you. Selecting a Track Center PLAY Button >> Forward << Back + Up - Down Each of the four music tracks lasts for approximately 60 minutes. You may prefer to listen to a variety of track or to a single track several times. You may find some tracks are more appropriate for certain listening times, for example when you are going to sleep or when you are working. Progressive Muscle Relaxation Track The Oasis device contains a selection that walks you through the steps of a progressive muscle relaxation exercise. Press Center PLAY button scroll to PMR selection, press PLAY. [Type text] [Type text] CL10-‐0006 Charging the Oasis Device: 1. Plug the supplied power cord into a power outlet. 2. Insert the charger plug into the Oasis device micro USB charging port (Figure 4). 3. Plugging the charger into the device automatically starts charging the Oasis 4. USB Port for Recharger device. You can verify this by viewing the “Charge Battery” icon on the main screen. Battery charging can take up to 10 hours. When charging is complete, the batter icon fills in completely and the normal charged icon will appear on the screen. Disconnect the charger and unplug from the power outlet. Setting the Date and Time 1. The current date and time is displayed on the home screen 2. Press and hold the Play button until the set-up menu appears (approx 5 seconds). 3. Using the +/- buttons, scroll down until the Set Date/Time Menu is highlighted. 4. Press the center Play button to access the Date/Time Menu 5. In the Date field press the +/- keys until the desired month is selected. By using the << and >> buttons, you can move to the Day field and repeat step number 4 to achieve the desired day. 6. Repeat step 4 to change the year. 7. To complete setting the time, return to the setup screen by advancing to the “Setup Menu” item, and then press the center button to return. Note: The Oasis device will automatically return to the main screen if no action is taken for approximately 30 seconds. Sleep Timer The Oasis device comes with a sleep timer so that you can play the Oasis device for 5 minutes up to 120 minutes. To change the sleep timer: 1. Press and hold the center Play button for approximately 3 seconds to access the set-up menu. 2. To select the Sleep Timer Menu, press the << or >> buttons until the Sleep Timer is highlighted. By pressing the << or >> buttons, the Sleep Timer will change from 5 to 120 minutes. 3. Select the desired sleep time, then scroll down to return to the Setup Menu. Note: The Oasis device will automatically return to the main screen if no action is taken for approximately 30 seconds. Single/Continuous Mode The Oasis device allows you to play your tracks in either a continuous fashion or a single time only. When selecting Continuous, the track sequence will repeat after the final track and start at the beginning once more. To Select Single or Continuous Mode: 1. Press and hold Play for approximately 5 seconds to access the set-up menu. 2. Press the +/- buttons until the desired mode is highlighted. Pressing the << or >> button changes the mode from Single to Continuous. 3. Select the desired mode, then scroll down to return to the Setup Menu. [Type text] [Type text] CL10-‐0006 4. Programming of Device Features Usage • Min. 2-4 hours per day when tinnitus Bothersome Procedure: Adjustment of various fitting parameters to be determined in conjunction with input from the patient regarding patient preferences and needs. Setting Startup Volume The volume at which the device starts playing • Duration: 6-8 mos. (varies depending on individual) • Use in small segments of time: 15, 30 or 60 minute time intervals • “Single” plays selected track then automatically shuts off. • “Continuous” plays all tracks in a continuous loop until device is powered off. Listening Volume • Set the volume to a comfortable listening level. (never set volume to an uncomfortable listening level) • Don’t be afraid to use more volume if you need it for relief. • Listening must always be pleasant & relaxing. • High volumes can take away from the relaxing aspects and can become frustrating. • Gradually turn down volume a few minutes before ending your treatment session to aide in relief contrast [Type text] ‘Current Volume’ refers to the volume at which the device is set at whilst it is connected to the software. Manually adjusting the volume on the device will be reflected on the slide bar ‘Start up’ volume is the volume which the device will start at each time it is turned on by the wearer. Ideally this should be set at the wearer’s threshold when listening to Track 3 Procedure: Using Track, adjust the volume up or down to find the level that the patient can just hear the music (threshold). Note setting: default or _______ [Type text] CL10-‐0006 Setting Audio Binaural Balance Up to ± 10 dB broadband volume difference between ears Suitable Activities when using the Treatment • Office Work • Reading • Writing • Going for a walk • On the internet • Hobbies (non-strenuous) • Traveling as a passenger • Crosswords • Work around the house • Shopping Contraindicated Activities: Procedure: Based upon patient input regarding perception of the acoustic stimulation in stereo, the Audio Binaural Balance can be adjusted to the right or left side in 2dB steps up to a maximum of 10dB. Adjustments can be made by either clicking and dragging the slider, or using the arrow keys on your keyboard. Note setting: default or _________ Headphone Selection • Driving • Straining to hear • Listening to television • Device may get wet • Exercising to raise your heart rate. Clicking on the drop down menu of the Headphone icon, allows the clinician to choose which headphones are selected for the patient. There is a choice of three (3) options: J5, Sony or Bose Track Adjustment The track being played can be played, paused, and the next or previous track can be selected [Type text] [Type text] CL10-‐0006 Noise Level Advanced settings Click on the Settings icon to open the Settings options When the instrument is Phase 1, the level of the white noise (neural stimulus) can be adjusted in 2dB steps to a minimum of -10dB and a maximum of +10dB from the default level. Note setting: default or _________ Phase Transition Programmed to Phase One* When the Phase Transition box is UNCHECKED, the device is programmed in Phase One When the Phase Transition box is CHECKED, the device is programmed in Phase Two *With the exception of patients with Reactive type tinnitus who will always have device programmed with the Phase Two Stimulus. Note Phase Transition Setting: __________ [Type text] [Type text] CL10-‐0006 Track Selection Clicking on the Select Tracks tab opens the window from which the clinician can select which tracks will be available. Click on the check box for the desired tracks, then click ‘OK’. Select up to 4 tracks. The tracks can be re-ordered by holding down the ALT key and dragging into the desired play order. Note Track Selections: _____ ______ _______ _____ 5. Determine Interaction Level Goal: To achieve high interaction (blending) at a comfortable listening level [Type text] • High Interaction Level: M: Volume (record on Neuromonics Fitting Form) Adjust to a comfortable level, where the treatment blends with their tinnitus • Degree of interaction (blending) achieved at this level [Type text] Low - Moderate - High - Complete CL10-‐0006 6. Tinnitus Management and Patient Advice Sheets Patient may benefit from basic advice and education on any one of the following issues: • Sleep • Diet and medication • Sound Level Exposure • Medication • Relaxation, including an explanation of the typical physiological response to relaxation music • Regular exercise strenuous enough to raise a sweat • Preventing tinnitus from disrupting activities and lifestyle The Clinician’s Guidelines CD includes several Patient Advice Sheets that you might find helpful to provide to your patient during the treatment process. For example, diet and medication can influence tinnitus and sleep. By modifying habits, your patient can take steps to decrease their tinnitus disturbance in addition to Neuromonics Tinnitus Treatment (e.g., reduce coffee intake, modify drinking habits, reduce excessive smoking). Handouts available on the Clinician’s Guidelines CD include: • • • • • • Changing the way you think about tinnitus Coping with environmental noises Diet and Medication Progressive Relaxation Training Sleep Stress and Relaxation 7. Counseling Expectations After Fitting, review and give to patient Documents located in Treatment Protocol: Patient Record • Starting the Neuromonics Tinnitus Treatment Key points when using the treatment NEUROMONICS, INC. 8774 YATES DR STE 220 WESTMINSTER, CO 80031 U.S.A. • Expectations of Neuromonics Tinnitus Treatment • Neuromonics Agreement Recommend patient sign Agreement Phone: 1-866-606-3876 Fax: 1-800-858-3031 E-mail: [email protected] • Warranty Registration Card (in Patient Information envelope with Oasis device) • Appointment Notes: Follow-Up Courtesy Call Date: _____________ Stage One Appointment Date: _____________ [Type text] [Type text] CL10-‐0006 [Type text] [Type text] CL10-‐0006
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