The MyoSen Patient Monitor
The MyoSen Patient Monitor is a small device, which uses telemetry to collect data from the MyoSen Muscle Stimulator and display it to the patient to support him, to adapt his daily routine, so that he gets most benefit from the therapy.
The user interface consists of a single button and the device does not need any user maintenance apart from replacing the batteries.
When the button is pressed, the patient monitor builds up an encrypted radio connection to the muscle stimulator. The stimulator sends recent data and immediately shuts down the connection to save energy.
The collected data is then shown for one minute. The display may be turned off immediately by pressing th button twice or the display preiod may be extended for one more minute by pressing the button once.
Each connection reduces battery life for the stimulator. Therefore after each transfer, the next connection is blocked for five minutes. For special purposes (setting the local time using the magnet switch), another connection my be enforced by pressing the button twice.
The display shows the data status at connection time. There is no update with prolonged viewing.
The status line gives an overview of operating state of the muscle stimulator.
On the left, irregularities are indicated: A heart symbol with an exclamation mark warns about internal errors.
A crossed out heart symbol warns, that the stimulator has been deactivated due to an internal error condition. In both cases, the patient should contact his physician immediately.
In the center, the internal local time of the stimulator is shown. The time shown may deviate considerably (minutes) from the actual time due to inaccuracies of the internal realtime clock. Your physician can adjust the internal time using his MyoSen Programmer. Further the internal time may deviate due to a change in the time zone or due to the change from/to daylight saving time. The implant can be configured to allow according adjustments by the patient using the magnet switch.
Right to the local time, the current operating mode of your stimulator is indicated. A sun symbolizes activity mode; a moon rest mode. Together with his physician, the patient can adapt the time schedule for these modes to fit his daily routine. Additionally, the implant can be configured, so that the patient may change the operating mode using the magnet switch.
On the far right, the battery status of the patient monitor is shown.
Other Warning Symbols
The are more indicators informing about system conditions: When the internal power sources of the stimulator are running low, the ERI indicator ( ) is shown. In this case, the Patient should contact his physician about planing a replacement operation.
When the power capacity reaches a critical level, the IFI indicator ( )is shown. The patient should in this case contact his physician immediately.
The pulse saving indicator ( ) is shown, when the stimulator has reduced the muscle support to protect the muscle.
The connection fail symbol ( ) is only visible, when the radio connection to the stimulator cannot be established. This may happen due to interference with other radio equipment or may occur, when the monitor is placed to distant from the implant. When this indicator is shown, the rest of the display is dimmed because in this situation the readouts are not updated. Should this condition persist, the patient should contact his physician.
Long Term Indicator
The assisting muscle, like any other muscle, needs exercise to remain healthy, but it should not be overused. The long term indicator for muscle usage helps the patient, to keep the balance. A solid bar pointing to the left warns, when the capacity of the muscle is exceeded permanently. A striped bar, pointing to the right shows, that the muscle may benefit from more exercise. This indicator changes slowly, but it is important to avoid large deviations, so one should not hesitate to see his physician, when significant readings show up here.
The pulse gauge helps the patient, to optimize his daily routine. It consists of a large scale, comparable to the fuel gauge of your car, augmented by a differential indicator formed as an solid or grey arc. The scale indicates pulse balance. The number of pulses available for 24 hours is equally distributed over the day and is continuously added to the reading. The actually used pulses are subtracted and the result is shown. When the demand for heart support is low during rest, the number of available pulses exceeds the number of actually used pulses and and a reservoir of pulses is built up, thus the gauge reading is increased. During high demand for support, more pulses are used, the consumption outgrows the supply and the reading is decreased. At midnight the gauge is set to the neutral position. In the morning, the reading should be in the positive range. During the day, this reservoir is used, the reading will reduce to negative values and in the evening, when the patient rests again, approximate again the neutral position. The difference remaining after 24 hous will contribute to the long term indicator. When the total consumption matches the available number of pulses, the indicator will end up in the starting position after 24 hours. With an equally distributed heart support, the indicator would remain at the neutral position; the larger the difference between heart support in rest phases and activity phases is, the larger the readings of this indicator will be. The arc indicates the difference between the actual reading and the average reading for this time of day (indicated by the green hand, which is not shown in the device) Since the actual reading is higher, the arc is shown in grey.The differential indicator hows the deviation of the actual pulse balance from the average pulse balance for the same time of day. So it constitutes a hint to the patient, if he should be more (grey arc to the left) or less (black arc to the right) active, to make up for a balanced day.
The Patient Monitor in daily Use
Let us have a look at a typical patient using our monitor. His implant has been adapted by his physician, so the long term muscle usage is stable. Our patient usually begins his day by
driving to his office by car. But this morning, he decides to use his bicycle. Arriving at the office, his monitor shows an unusual high use of the muscle. This difference persists until afternoon. Our user has an appointment at the tennis ground for the evening.
He knows, that cycling to the match and, after the match home will even increase this deficit today. Yet knowing, that he will have a quiet weekend, he decides, that this will compensate the muscle overuse today. So he will not be worried by the readout, not even by the pulse saving indicator showing up after his ride home and by the slight change of the long term indicator next morning. This would be different, when a long hiking tour would be due on the weekend, then it would have been prudent, to avoid three subsequent days of heavy muscle use.