Abstract: A medicament delivery device includes a housing; a hollow plunger rod; a dose drum concentrically arranged between the housing and plunger rod and movable when setting and delivering a dose; and a plunger rod driver. The driver includes a hollow ratchet arm drum movably arranged within the plunger rod and fixed to the dose drum, with the arm drum and rod releasably coupled; a dose activator having a longitudinal rod movably arranged within and releasably coupled to the arm drum; a dose setting knob fixed to the dose activator and releasably coupled to the arm drum; and a resilient element arranged between the arm drum and dose activator that biasses them in a direction decoupling the longitudinal rod from the arm drum and coupling the knob with the arm drum, such that during dose setting, turning the knob forces the arm drum and dose drum to rotate together.

Abstract: A tissue penetration device includes a magnetic source that produces a controllable magnetic field in a magnetically active region adjacent the magnetic source. A magnetic member is disposed at least partially in the magnetically active region. A permanent magnet is disposed at a proximal end of the magnetically active region for zeroing the position of the magnetic member while the tissue penetration device is inactive.

Abstract: A syringe is provided with an assembly received on the distal end for adjusting the penetration depth. In embodiments, the assembly includes a collar attached to the syringe hub which moves with respect to the needle between axial positions depending on the desired needle penetration depth. The adjustable penetration depth syringe is useful in the context of self-administered drugs such as insulin, where a longer length needle is needed to fill a syringe from a vial, but a shorter penetration depth is preferred for administering a subcutaneous injection.

Abstract: A dual lumen cannula is provided for conveying a fluid into an injection site through an inner lumen of the cannula. Fluid pressure is relieved from the injection site via a plurality of egress ports located along an outer lumen of the cannula.

Abstract: A tamper-evident syringe tip cap is provided and includes an outer housing with an outer shell, and a tip cover secured to an upper end of the outer shell. An inner core has a female Luer lock fitting, a spindle projecting vertically from the fitting, and a sleeve matingly engaging the spindle and being constructed and arranged for releasably securing the outer housing to the inner core. The outer housing is movable relative to the inner core between a first, pre-activated position and a second, activated position.

Abstract: A nebulizing device includes a medicament storage module, a nebulizing unit, and a first waterproof gasket. In the medicament storage module, a coupling part is connected with an outer surface of a tubular sidewall and aligned with an outlet of the tubular sidewall, and includes an extension wall and a first recess where the nebulizing unit is disposed. The first waterproof gasket is disposed within the first recess and located on a side of the nebulizing unit farther from the outlet. In the first waterproof gasket, a first opening is disposed adjacent to the nebulizing unit, a second opening is disposed opposite to the first opening and located on a side of the first opening farther from the nebulizing unit, the size of the second opening is greater than that of the first opening, and the annular wall structure is connected to the first opening and the second opening.

Abstract: A system and a method for generating a respirable dry powder aerosol (15) from a liquid solution or liquid suspension at a respirable dry powder aerosol volume flow (91). A liquid aerosol generating nozzle (3) generates from the liquid solution or liquid suspension a liquid aerosol (13) that is diluted by dilution gas (4) and dried in a cylindrical evaporation chamber (6) to generate a dry powder aerosol (14) that is subsequently concentrated by a cylindrical single linear slit aerosol concentrator (9). The system and method may include heliox as a gas, specifically dilution gas (4), for enhancing both the drying process in the cylindrical evaporation chamber (6) and for enhancing the concentration efficiency, but also as a nozzle gas (2) for enhancing generating the liquid aerosol (13) from the liquid solution or liquid suspension.

Abstract: Handheld carboxy therapy applicators are disclosed. In one implementation, a handheld carboxy therapy applicator includes a heater module, a humidification module, and a hypodermic needle. The heater module is configured to receive a flow of gas and to warm gas within the flow of gas. The humidification module is in fluid communication, such as in a serial connection, with the heater module. The humidification module is configured to receive the flow of gas from the heater module and to humidify the gas within the flow of gas. The hypodermic needle is in serial connection with the humidification module. The hypodermic needle is configured to receive the flow of gas from the humidification module and to inject the flow of gas into a tissue of a patient.

Abstract: A system and method for communicating data from a medical device to a lighting device is provided. The system may include the medical device, the lighting device, and/or one or more interface devices. The medical device may be configured to transmit data to the lighting device, which for example, may include information relating to the medical device, dosage information, diagnostic data, medical device training feedback, health monitoring information, and/or air quality information. The lighting device may be configured to receive data from the medical device and control one or more lighting characteristics based on the received data. A characteristic of the light may include one or more of color, color temperature, intensity, flashing or steady-state, on or off, and/or the like. The system may provide for a home based adherence and/or compliance monitoring system, in which a patient's interaction with a medical device may be monitored and an alert/indication provided.

Abstract: The invention relates to pharmaceutical active substances, active substance mixtures and formulations for use as an aerosol in propellant-containing [1.1.1.2-tetrafluoroethane (HFC-134a) or 1.1.1.2.3.3.3-heptafluoropropane(HFC-227)] metered-dose aerosols and the metered-dose aerosols for administering these active substances, active substance mixtures and formulations.

Abstract: A PAP device for generating a supply of pressurized gas to be provided to a patient for treatment includes a housing, a core including a motor and at least one impeller, and a vibration isolation system to support the core within the housing in a flexible, vibration-isolated manner.

Abstract: A pressurized flow of breathable gas is delivered to the airway of a subject in accordance with a therapy regimen. The therapy regimen may be designed to maintain oxygenation of the subject. The therapy regimen dictates levels of fraction of inspired oxygen and/or positive end expiratory pressure to maintain a therapeutically beneficial level of oxygenation in a feedback manner. Within the therapy regimen, changes made to fraction of inspired oxygen and/or positive end expiratory pressure automatically and dynamically are constrained by user configured constraints such as the maximum incremental change, amount of time between adjustments, or the maximum rate of change This may provide a level of customization of the automated control of the therapy regime for individual subjects.

Abstract: An improvement for existing breathing therapy machines which seeks the optimum therapy pressure using an auto-adjust algorithm.

Abstract: A manually actuated, self-inflating bag valve mask provides users with a positive pressure ventilation device that reliably provides a proper tidal volume to the patient and controls the rate of ventilation of the patient. The bag valve mask is lightweight, compact, durable, and quickly deployable in the field. The device is preferably operable with one hand and can be configured for use in low-light environments.

Abstract: An airway device includes an airway tube having a first end surrounded by a laryngeal cuff which includes a back dorsal portion, a front face portion and a tip portion. The front face portion is shaped to form an anatomical fit over the laryngeal inlet of a patient, and to form a seal with the laryngeal inlet of the patient. The tip portion includes an annular sealing bulge which is adapted to wedge into an upper esophagus region of the patient. The annular sealing bulge improves sealing of the tip of the laryngeal cuff in the upper esophageal region of the patient. The annular sealing bulge is preferably formed from a soft polymeric or other plastics material with a Shore hardness of between 40 and 000 on the A scale, and allows for better sealing with a more variable range of upper esophageal anatomical features.

Abstract: An air delivery system for providing a supply of air from a source of air at positive pressure to an interfacing structure located at the entrance to the airways of a patient includes a manifold adapted to connect with the supply of positive air pressure and at least one tube connected to the manifold and adapted to deliver the supply of air to the interfacing structure. Each tube is structured to allow movement between an open phase in which the tube allows the passage of air and a collapsed phase in which the tube is collapsed. Each tube is structured such that weight of a typical patient's head against bedding apparel is sufficient to collapse the tube from the open phase to the collapsed phase.

Abstract: A nose adapter (2) and system, for use in noninvasive respiratory support, has a proximal end, for coupling to the nose, and a distal end for coupling to a ventilation device. An inspiratory channel (6) and an expiratory channel (7) extend between the proximal and distal end. The distal ends of the channels terminate in a respective connection adapter (30, 31) for connecting ventilation tubes (4). The proximal ends of the inspiratory and the expiratory channels are bent inwards 90° such that the openings of the channels face each other. A cylindrical tube element (34), rotatably held between the openings, has a through-opening in the cylindrical circumferential surface of the tube element. A connection nozzle (13) connects to a prong or a nose mask and is formed on the outer face of the rotatable tube element (34), in alignment with the through-opening, such that the connection nozzle can pivot.

Abstract: A connecting system for connecting a ventilation tube to a respiratory humidifier (1) is provided, wherein the ventilation tube comprises an electrical line and the respiratory humidifier (1) comprises a housing (2) and a liquid container (4), the connection system including a first connection element (6) arranged on the liquid container (4); a first electrical contact element (24) arranged on the housing (2); and a second connection element (14), which can be connected to the ventilation tube (7, 9) and comprises a second electrical contact element (16), which can be connected to the electrical line of the ventilation tube (7, 9); wherein the first connection element (6) and the second connection element (14) can be connected to each other in a first connecting direction in such a way that, by establishment of the pneumatic connection of the ventilation tube (7, 9) to the liquid container (4), the electrical connection of the first contact element (24) to the second contact element (16) is produced.

Abstract: A mask for delivering breathable gas to a patient at positive pressure to treat sleep disordered breathing, may comprise: a rigid mask frame having a bore and an interfacing structure, the interfacing structure being located on the rigid mask frame and along a peripheral edge of the bore, said mask frame having no built-in or integral headgear attachment points; a sealing cushion provided to the rigid mask frame and adapted to form a seal with the patient's face, the rigid mask frame and the sealing cushion together forming, at least partly, a breathing cavity; and a headgear connector adapted to engage the interfacing structure with a snap-fit, said headgear connector including a pair of lower headgear clip anchors adapted to be engaged with respective ones of a pair of tower headgear clips to attach a pair of lower side straps, said headgear connector including a fixed forehead support.

Abstract: A liquid-container/ventilation-tube kit for a ventilation system that includes (a) a ventilator, (b) a respiratory humidifier having a housing and a liquid container, the housing having a pair of first electrical contact elements, (c) a first inhalation tube extending from the respiratory humidifier to a Y-piece, (d) a second inhalation tube extending from the ventilator to the respiratory humidifier, and (e) an exhalation tube extending from the Y-piece to the ventilator, the kit including the liquid container having a pair of first connection elements for removable connection of the first and second inhalation tubes thereto, and a pair of second connection elements each attached to a respective one of the first and second inhalation tubes and by which each of the inhalation tubes is pneumatically connected to a respective one of the first connection elements along a first connecting direction, each second connection element having a second electrical contact element that is positioned and arranged such that

Abstract: Modified medical syringe with a flow regulator for the administration of anaesthesia, which allows for anaesthesiologists to handle the needle, control continuous aspiration and administer the anaesthetic with a single hand, thereby preventing intravascular injections. It comprises a flexible tube, designed to be introduced inside the barrel, which supplies the anaesthetic; a cylindrical body located on the rod, equipped with a protuberance along a semicircle located on the proximal side of the body and a through-hole wherein one end of the flexible tube may be introduced; a cylindrical cap located inside the syringe barrel, equipped with a longitudinal groove along its cylindrical side, which is designed to house the aforementioned flexible tube; a preloaded spring around the rod located between the cap and the support disk; and a pressurization device connected to the flexible tube.

Abstract: A urinary catheter may include a catheter shaft and a connector coupled with the proximal end of the catheter shaft. The connector may have a first arm ending in a fluid outlet configured to allow urine to flow out of the urinary catheter and a second arm with an aperture and ending in an inflation inlet used for introducing inflation fluid into the urinary catheter. The catheter may further include a primary lumen, an inflation lumen, a retention balloon mounted to the catheter shaft proximal to a fluid inlet and over a distal filling hole, and a pilot balloon mounted on the second arm of the connector over the aperture. The pilot balloon inflates at an inflation pressure that is higher than the inflation pressure of the retention balloon and lower than a predetermined pressure threshold.

Abstract: Apparatus, systems, and methods are provided for delivering a lead or other instrument into a patient's body using a tubular device including a proximal end, a distal end sized for introduction into a body lumen, and a lumen extending therebetween, thereby defining a longitudinal axis. The tubular device includes a sidewall surrounding the lumen including a reinforcing layer embedded in one or more layers of base material, and a slittable seam in the sidewall extending from the proximal end partially towards the distal end substantially parallel to the longitudinal axis. In addition, slitter devices are for slitting, splitting, or opening the slittable seam. Methods are also provided for making catheters or other tubular devices including slittable, e.g., re-welded longitudinal seams that may be preferentially slit, split, or otherwise opened.

Abstract: A method of dissecting tissue includes inserting a magnetized catheter into a urethra; magnetically pushing a tool away from the urethra with the magnetized catheter; and dissecting tissue posterior of the urethra with the tool.

Abstract: Embodiments of the invention include an introducer for introducing interventional catheters into the vasculature comprising a distal tip, a proximal end, a structural layer, an inner layer, and an outer layer. Other embodiments are also included herein.

Abstract: A catheter assembly includes a pull wire and a control member subassembly, wherein the pull wire is secured to a post of the subassembly that may extend through a slot of a handle, and an engagement feature of the subassembly, being supported by an elastically deformable support of the subassembly resting on a railway of the handle, confronts a mating feature of the handle to interlock therewith, responsive to the support being un-deformed. The post, engagement feature, and support may be integrally formed together in a single-piece component, wherein the engagement feature may be one or two rows of teeth formed in a surface of an upper portion of the component, and the support may be a pair of flexible cantilever beam members of a lower portion of the component. Furthermore, the mating surface and railway may be integrally formed in an inner surface of a shell of the handle.

Abstract: Deflectable catheters, systems, and methods of using deflectable catheters are described herein. An embodiment of a deflectable catheter comprises an elongate member, a handle, and a wire member. The elongate member has a shaft and a flexible member. The shaft defines a first lumen and a second lumen and the flexible member defines a passageway. The flexible member is attached to the shaft such that the passageway defined by the flexible member is in communication with each of the first lumen and second lumen defined by the shaft.

Abstract: Disclosed herein is a variably flexible pipe including at least one flap member having variable flexibility and a tube formed of an elastically deformable material and accommodating the at least one flap member, and a manipulator having the same. The at least one flap member may include a plurality flap parts and a connection part to which one side of each of the plurality of flap parts is connected, and the tube changes pressure applied to the plurality of flap parts according to a controlled change of the inner pressure of the tube, thereby causing the variably flexible pipe to be effectively selectively maintained in a deformed state.

Abstract: A catheter system includes an elongate catheter having a lumen extending at least partially therethrough, and a leading catheter end segment, a guidewire positionable within the lumen of the catheter, and fastening structure supported adjacent the leading catheter end segment. The guidewire and the catheter are adapted for relative movement. The fastening structure is dimensioned to selectively engage the guidewire to secure the guidewire with respect to the leading catheter end segment such that movement of the guidewire causes deflection of the leading end segment with respect to the longitudinal axis.

Abstract: A self-propelled device for locomotion through a lumen, comprising a set of serially arranged inflatable chambers, the end ones of which expand at least radially when inflated. Connecting passages provide fluid communication between each pair of adjacent chambers. A fluid source is attached to one of the end chambers. The connecting passages are such that the fluid inflates the chambers in a sequence, beginning with the chamber closest to the source, and ending with the chamber furthest from the source. The same sequence occurs when the chambers deflate, beginning with the chamber closest to the source, and ending with the chamber furthest from the source. The fluid source can either be a fluid supply tube, extending to a supply outside the lumen, or it can be built-in and carried by the device. The device can crawl either along the lumen wall or on an inserted guide wire.

Abstract: Some embodiments of a medical device anchor system include an anchor device that receives a medical instrument (such as a catheter or the like) and secures the instrument in place relative to a skin penetration point. In some circumstances, the anchor device may allow the anchor device to be used after medical instrument is already in place without the need for a second penetration point for the anchor device.

Abstract: A positioning method for balloon coating by which the thickness and morphological form of a drug in a coating formed on a balloon can be suitably set. This method is a positioning method for balloon coating for forming a coating layer containing a water-insoluble drug on an outer surface of a balloon of a balloon catheter. The positioning method includes a positioning step in which a dispensing tube is moved, from a state of non-contact with the balloon, in a direction intersecting the extending direction of the dispensing tube, and an opening portion-formed end portion side of the dispensing tube formed at its end portion with an opening portion for discharging a coating solution is thereby placed in contact with the outer surface of the balloon.

Abstract: A device and system are disclosed for selective inflation of an inflatable body, such as a balloon, received through an oral cavity and into the esophagus of a patient. The inflatable body is operably coupled to a pressurized fluid source. The inflatable body has a relatively flexible portion and a relatively inflexible portion. When pressurized fluid is delivered to the body to inflate the body, the flexible portion expands more than the inflexible portion, resulting in asymmetrical expansion and movement of the esophagus away from the ablation site to avoid accidental injury while performing a procedure on the patient's left atrium. This movement may be opposite from or directly away from the heart or, alternatively, may be sideways relative to the heart to a location in which the esophagus is interposed between the ablation site and the phrenic nerve.

Abstract: Medical systems are described herein. More particularly, the disclosure relates to medical systems, methods, and kits useful in providing the diameter of a balloon during the performance of a procedure. An exemplary medical system comprises a balloon catheter, an inflation device, and a measuring device having one or more indicia. Each indicium of the one or more indicia has a form that corresponds to the nominal value of a balloon diameter.

Abstract: A balloon catheter is provided for dilating hardened stenoses. The balloon catheter has dilation elements integrally formed on the outer surface of the balloon. The dilation elements have cross-sectional shapes that improve the performance of the balloon catheter.

Abstract: The present invention provides a method and apparatus for treating a vascular occlusion and preventing or reducing ischemic consequences of such an obstruction. The medical device of the present invention may include an elongate body defining a proximal end and a distal end, where the elongate body may also define an injection lumen, an exhaust lumen, and a guidewire lumen. A first expandable element may be coupled to the elongate body, where the first expandable element is in fluid communication with the injection lumen and the exhaust lumen. Further, a perfusion path may be disposed within the elongate body, and a sheath may be movably disposed about at least a portion of the elongate body. The medical device may further include a second expandable element disposed about the elongate body, as well as second inflation and exhaust lumens.

Abstract: A balloon catheter having a balloon with a shape for treating a vessel at a bifurcation, includes an oblique proximal end of the balloon, and a catheter shaft which is at least partially eccentric to a central axis of the balloon. Markers used for longitudinal and rotational alignment are included on the catheter shaft. A torque transmission element may be used for transmitting torque from the stiff proximal segment of the catheter to the distal flexible balloon segment of the catheter.

Abstract: A catheter, and preferably a urinary catheter, is disclosed, comprising an elongate shaft with a catheter insertion end and a flared connector connected to the elongated shaft opposite to the catheter insertion end. The flared connector forms a catheter connector end. Further, a gripping sleeve is fixedly connected to the flared connector, and arranged to enclose at least part of, and preferably essentially the whole, flared connector, apart from the catheter connector end. Hereby, a standard catheter can easily be customized for various use situations and users with different needs, in terms of e.g. gripping and manipulation possibilities. A method for producing such a customized catheter is also disclosed.

Abstract: The present invention provides for a drug delivery device. The device can comprise at least one core with a first active pharmaceutical ingredient (API), coated with a first layer that is permeable or semi-permeable to the API, coated with a second layer that is impermeable to the API, and having a delivery window to allow passage of the API through the device and into body fluids or tissues. The device can also have a wicking material to modify the rate of transport of the API into the body fluid or tissues.

Abstract: A method of manufacturing a conical-projections-sheet packaging body includes forming a plurality of conical-recess parts on a conical-projections forming sheet; forming, by supplying a conical-projections material to the conical-projections forming sheet, a conical-projections sheet including a base sheet and a plurality of conical projections formed on a surface of the base sheet and disposed inside the plurality of conical-recess parts; forming a plurality of sets of the conical-projections forming sheets and the conical-projections sheets by punching out the conical-projections forming sheets and the conical-projections sheets; and using a package member to package a set of the conical-projections sheets and the conical-projections forming sheets tightly adhered to one another. Thus, the plurality of conical projections of the conical-projections sheet are protected.

Abstract: A power-injectable access port suitable for injecting contrast media therethrough at a rate of at least 1 milliliter per second. The access port includes a housing, a septum, a reservoir, and an outlet stem in fluid communication with the reservoir. The power-injectable access port is structured for accommodating a pressure developed within the reservoir of at least 35 psi. The septum may include a radiopaque material forming a selected pattern when an x-ray is taken through the septum. The pattern may identify the access port as capable of accommodating injection of contrast media at a rate of at least 1 milliliter per second and/or as capable of accommodating a pressure developed within the reservoir of at least 35 psi. The pattern may identify the location of the septum following implantation of the power-injectable access port.

Abstract: An electrode array assembly with a frame that is foldable or bendable on which electrodes are disposed. The frame includes laterally spaced apart bridges. Tabs extend laterally outwardly from the bridges Electrodes are disposed on the tabs. Beams, also part of the frame, extend between the laterally adjacent bridges. The frame can be folded around the beams so as to cause the laterally spaced bridges to at least partially overlap. When the beams are so bent, the electrode array can be disposed in an access cannula that has a diameter less than the width of the unfolded array.

Abstract: The disclosure relates to a lead including a connector for connection to a generator, a demultiplexing circuit receiving at its input on the first conductors of the electrical control signals from the control bus and whose output is connected to a plurality of second conductors contained in the lead and connected to the lead electrodes. The lead further includes a gate and connection circuit component having a body forming a support for an integrated circuit for demultiplexing and defining a set of connection cavities with the second conductor distributed at the periphery of the body around a general axis of the body, and a plurality of connecting elements embedded in the body material, and emerging at an element region and supporting the circuit at respective cavities. The gate and connection circuit component is advantageously made of ceramic-metal.

Abstract: A microlead, of an overall diameter less than 0.5 mm, includes a plurality of at least eight conductor wires individually insulated and twisted together. Each conductor wire includes an electrically conductive core microcable and an insulation layer surrounding the core microcable and having at least one exposed area to form a detection/stimulation electrode of the microlead. The microlead further includes a central support structure shaped as a surface of revolution, which may be free of conductor wires and of central lumen. The conductor wires are configured in one or more layers of twisted peripheral conductor wires carried by the central support structure and circumferentially distributed thereon.

Abstract: A lead is configured and arranged for brain stimulation. The lead includes a proximal end and a distal end. The proximal end includes a plurality of terminals disposed at the proximal end. The distal end has a non-circular transverse cross-sectional shape and includes a plurality of electrodes disposed at the distal end. A plurality of conductive wires electrically couple at least one of the plurality of electrodes to at least one of the plurality of terminals.

Abstract: The disclosure provides techniques for parameter-directed shifting of electrical stimulation electrode combinations. An external programmer permits a user to shift electrode combinations, e.g., along the length of a lead or leads. The external programmer accepts shift input and causes an electrical stimulator to shift electrode combinations as indicated by the input. Different sets of electrodes may have different electrode counts. For example, an array of electrodes carried by one lead may have a greater number of electrodes than an array of electrodes carried on another lead. The disclosure provides techniques for shifting electrode combinations among leads with different electrode counts. For example, an external programmer may execute shifts in a series of shift operations, where the number of shift operations along the length of a lead having a greater electrode count is greater than the number of shift steps along the length of a lead having a lesser electrode count.

Abstract: A hand held electrostimulation device has a handle having a first side member and a second side member. At least one first electrode is provided on the first side member and at least one second electrode is provided on the second side member. The first side member is longer than the second side member, which is connected with the first side member at a position intermediate the ends of the second side member. The handle is configured so that a user can cause relative movement of the first and second side members from a rest position and is resiliently biased to return to the rest position to cause relative movement of the first and second electrodes to massage skin engaged by the electrodes while applying electricity to the skin via the electrodes.

Abstract: In some examples, the disclosure relates to a systems, devices, and techniques for delivering electrical stimulation therapy to a patient. In one example, the disclosure relates to a method including delivering a series of pulses with alternating pulse polarities to a gastrointestinal tract of a patient. The series of pulses includes at least a first pulse of a first polarity, a second pulse of a second polarity, and a third pulse of the first polarity, where the first, second and third pulses are delivered in direct succession and in that order. The first and second pulses are separated by a first time delay and the second and third pulses are separated by a second time delay. In some examples, each of the first and second time delays depend on the frequency that the series of pulses are delivered.

Abstract: A device for implantation into a scalia tympani of a cochlea is disclosed. The device comprises blocks and compliant elements interconnecting the blocks with one of the compliant elements disposed between each pair of adjacent blocks. The compliant elements impart flexibility to the device in a plane of curvature of the cochlea and impart stiffness to the device out of the plane of curvature of the cochlea. The device further comprises piezoelectric elements with at least one of the elements disposed the blocks. Each piezoelectric element comprises at least one piezoelectric sensing unit and at least one electrode for transmitting the electrical signal to the auditory nerve. The device further comprises communication lines for transmitting an electrical signal through the device with one of the communication lines disposed between each pair of blocks and parallel to the compliant element.

Abstract: A method, including the action of operating a sense prosthesis, such as a retinal implant, according to a first operating regime while the recipient has a first fatigue level, and operating the sense prosthesis according to a second operating regime while the recipient has a second fatigue level that is greater than the first fatigue level.