So next we're going to demonstrate what caloric testing would look like. You do this testing to look at each ear individually as far as a right side and the left side. Typically you do this with warm air and cool air here at the pediatric miscibility testing center. We also can do it with water as well as some of our other sites. Like I said this is going to identify right ear versus left ear through any reduction in that vestibular system and either side or maybe both sides relatively reduced. So we'll get John setup who's going to demonstrate what this might look like, then we'll show some eye movements after. All right so I'm just going to put these goggles on you John. Like I said they're just stay still so wear goggles and we'll take a look at your eyes here in a second. Once I get these connected. Then just like we demonstrated before, we want to make sure we have nice good pictures of our eyes and we'll just focus on one of the cameras here. Actually focus the cameras on them. Yes. John all I'll have you do is just lay down this wedge with your head up here, and then I'll bring out it's a little foot rest and we will take a baseline recording of just in this position. So 30 degrees is where that vestibular system is at rest and the way it's oriented. That's why we have them on a little bit of an inclined so we try not to get any response from those inner ear systems. Always just going to put him in the dark to take away those points that he could fixate on, and then we'll just take your recording here for just a few seconds. So let's say we keep those eyes nice and big John just like you have them. We're just looking straight out her effect and we're just looking that we don't see any of those eye movements that we generate in the chair. We don't want to see those at a baseline. If we see those at a baseline, that lets us know something active is going on, on the inner ear system instead of being at rest. I'm just going to adjust the goggles one more time. Just so you can get both eyes in, good. So the next part that will do is we will demonstrate what that caloric or that air feels like in the ear. So I'm just going to position our ear irrigator here. We'll start with warm air in the left ear, and when we do that caloric testing, all we're doing is it looks just like an otoscope and there's air that's being forced through the tip here that will end up being directed at the patient's ear drum. As we do that, we're raising the internal temperature of that endolymph and generating a current. Warm air gives a different response than the cool air, that's why we typically do both sides. We do this here at U of M for 90 seconds, and after that 90 seconds, we will have the patients open their eyes and we should hopefully see some of those eye movements generated. John I'm just going to rest my arm on your shoulder here. You don't have to do anything just keep those eyes closed for the moment and after 90 seconds or so, I'll have you open them. I'm just going to place this in his ear. Well let's take a look in and then we'll stay here for a 90 seconds or so. What we'll do next is, we'll switch around and we'll go over to the left ear because currently you're in the right ear, and we'll do the same thing with warm air on that side, and then we'll switch and do cool air in both ears as well. John when that air goes in your ear, you can have your eyes closed. Like I said, I'll have you open your eyes I'll say," eyes open" and we'll have you do is just start naming some different things. I'll have you start naming girls names starting with the letter A and that's just to keep your brain occupied so that we don't get any of that fixation of those eye movements. Just letting it get to the right temperature that it needs, and a few seconds here. So we do the cool air at 24 degrees centigrade, the warm air we do at 40 degrees centigrade. Here we go. You can have your eyes closed John or go for a little bit here. Here's what that air feels like one, two and three. If you just keep taking nice deep breaths John, you start to feel a little dizzy, that's okay. I'll have you open your eyes John and a few seconds, I'll have you start naming those things. You have about five more seconds. All right eyes nice and big. How're you name a girl's name with the letter A. [inaudible] Eyes nice and big. Eyes open how about the letter B? Bethany. How about the letter C? Any Ds? How about an E? And F? Yes good job. I've got an F? That's okay how about a G? That's all right any Ms? [inaudible] How about any Ns? Eyes nice and big, Perfect. You're doing a great job. In a few seconds you're going to see a red light come on, when that red light comes on just stare straight at it. It may look like it's moving a little bit, but just keep focusing right on and they'll start slow and everything down. We'll just keep that light on what it helped bring that response down. You are doing a great job just keep taking nice deep breaths. Does that make you feel a little bit dizzy at all John? Like you're moving? A little bit. A little bit. So we're done with that part. Let's take the cover off the goggles so you're going to see a little bit of light. That should help that response settled back in.