Rethinking How Blood Work Is Done

The Wall Street Journal has a fascinating interview today with Elizabeth Holmes, the founder of a new company that has rethought how we do blood work for medical diagnosis.

Her company, Theranos, has certified phlebotomists for taking patient's blood, but instead of taking vials and vials of blood, they just take a pinprick worth--1/1,000 of a typical draw--from the tip of your finger.

Moreover, unlike with conventional blood work testing, "only about 62% of tests that doctors order are ultimately carried out,"partially because there is still not enough blood drawn, but with Theranos the tests are able to be done with only small drop sample sizes. 

With advanced, patented technology, Theranos does the tests (blood, urine, other) faster--in 4 hours or less, rather than in days, so you, the patient, can get the results quicker, and treatment for your condition sooner.

Moreover the results are said to be more precise to within a 10% variation--in contrast to typical labs tests that are within plus-or-minus 30% allowable error--a 60% error range!

With faster and better technology, Theranos helps your doctor to make a more accurate diagnosis and provide targeted treatment. 

The testing results are provided securely and electronically to the doctors in this very cool dashboard (pictured above) in which blood measurements can be quickly and easily seen on a scale of low-to-high, as well as whether something is deficient, insufficient, or at toxic levels. 

Also, Theranos provides trending of results over time, so the physician can quickly see whether the patient's condition is worsening or improving, and can make treatment decisions accordingly. 

And when the doctor releases the results, you'll be able to logon and see them for yourself as well. 

Further, Theranos is committing to conduct the blood work at a 50%-off discount on Medicare fees--they are saying, "we want to bill you at less than you're willing to reimburse."

I really like when someone bold and bright like Elizabeth Holmes comes along and breaks the old broken paradigms--really rethinking how something could/should be done better. 

In general, it often seems that the medical field is change/risk adverse (like with adoption of electronic health records), but Ms. Holmes has brought a better, faster, and cheaper testing and diagnostic process to all of us.  

I noticed that Theranos has a very impressive roster on it's board, including former Secretary of States Henry Kissinger and George Schultz and former Secretary of Defense, William J. Perry to name just a few. 

Theranos seems to be the company to watch in this medical diagnostic laboratory field. 

No more scary big needles--just a pin-prick and a few drops of blood...that's blood worth taking and testing. ;-) 

(Source Photo: Theranos Website)

Rethinking How Blood Work Is Done

Technology Heals

My wife took this photo today at The Drupal for Government Conference at NIH.

The man in the photo was not only participating in the conference, but also taking notes on his Apple Macbook Air. 

It is incredible how technology is helping us do our jobs and be ever more productive.

This is the vision of technology taking us beyond the natural limits we all have and face. 

I remember a few years ago when I was in the hospital for something and feeling bad about myself, and my wife brought me a laptop and said "Write!"--it was liberating and I believe helped me heal and recuperate.

I wonder if hospitals in the future will regularly provide computers and access to patients to not only keep them connected with their loved ones, but also let them have more options for entertainment, creativity, and even productivity, to the extent they can, while getting well.

Kudos to this gentleman--he is truly a role model and inspiration for us all. 

(Source Photo: Dannielle Blumenthal)

Technology Heals

Uh-Oh Trouble

So I'm "middle age"...and all of a sudden the last few months I am having trouble reading.

I haven't worn glasses for over 14 years--since I had the Lasik procedure done. 

Now, at the optometrist, he tells me, "Oh everyone ends up getting glasses whether you had Lasik or not."

He says: "Usually, people need reading glasses starting between the ages of 42-45."

Crud...back to those darn things again. 

I remember in 1999 when I had Lasik, it was still a pretty new procedure, but my best friend and his wife had just gotten it and convinced me to go for it too.

Well, it wasn't what I expected and when they clamped my eye open and the doctor tells me to stare at a the little red light as the laser comes up to my eye...I was thinking to myself...this is NUTS!

But it actually went from bad to worse. 

As the doctor starts working on the first eye, all of a sudden, he goes, "Uh-oh!"

What type of doctor is this that says oh-uh, and what in G-d's name did he do to me. 

Well, he composes himself after pulling away and finishes, but then stops and says he'll talk to me afterwards. 

As it turns out, as he pulled on the eye, something called the epithelium, a piece suddenly flaked off the eye. 

Nothing seriously actually happened--no ill sides effects, but those 2 words while under the laser, "Uh-oh," really sent the shivers up my spine. 

Let's just say, while I am glad I didn't have to wear glasses these last 14 years, the experience was a little traumatic.  

I remember one other time in my life--when I experienced the Uh-oh moment--this time, I was actually the one uttering the Uh-oh. 

It was right after I got married, and we had this cool idea that I would give my wife a haircut.

So, I start cutting and I'm thinking hey, this isn't so hard...and it's fun...and we also get to save money (hey, we were just starting out in life). 

Then, I keep cutting and cutting not realizing how much I was taking off...at one point, my wife starts getting antsy and she says, "So how's it going (knowing that something wasn't right)?"

Then it hits me, I suddenly blurt out the big "Uh-oh! 

My wife goes, "What did you do?"

Of course, I started to worry and couldn't get myself to really say and instead I just start cracking up. 

Then she knew I had really messed up...and boy was I in trouble then.

Uh-oh is a phase you never want to hear or say...it means trouble has arrived. ;-)

Uh-Oh Trouble

With Surgical Precision

This is awesome--the iKnife ("Intelligent" knife) for cutting away cancer, can also detect the cancerous cells. 

I had previously heard about dogs being able to sniff cancers such as lung, ovarian, and skin--but never a surgical knife doing this. 

With the iKnife, a surgeon can use a electrosurgical knife to cut/burn away cancerous tissue, but even better yet, this knife sucks away the smoke containing the vaporized tissue to a mass spectrometer that analyzes the particles and is said to be 100% accurate (so far) in detecting cancerous tissue (from those that are normal).

This is critical because it can be lifesaving in guiding surgeons not to miss any of the cancer (and therefore also helps avoid repeat surgeries) as well as not removing unnecessary tissue that is not cancerous. 

Dogs can help alert us to hidden cancers within and the iKnife can help remove them with greater precision and success. 

Hopefully, with G-d's help, one day we won't need either anymore. ;-)

With Surgical Precision

Living Longer, But With Worse Quality Of Life

Watching my parents age over the years has been hard--and very painful. 

They are good people--they've worked hard all their lives (nothing was just given to them), they are devoted to serving G-d, and they are loved by their family, friends, and community. 

They have lived a good life and we are grateful for every day.

Yet as they are getting older, the body like anything physical, starts to get sick and break down. 

Both my parents have serious illnesses, and in the last two years my mom has become almost totally disabled and is moving from a rehab center to a nursing home this coming week. 

I read this week in the Wall Street Journal, what I've been watching with my own eyes...we are living "longer, but not healthier lives."

Over the last 2 decades, life expectancy has risen 3 years to 78 years, but unfortunately only 68 of those, on average, are in good health--meaning that people suffer for about ten years with various disabilities.

What is amazing is that people are being pressed to retire later in life with an increase in age to receive full social security benefits to 67 by 2022--giving the average person a healthy retirement to enjoy of just 1 year!

With the average working household having less the $3,000 in retirement savings, things are not looking too good for Americans to retire young and enjoy their healthy years either. 

Additionally, despite longer living, in the last 2 decades, the U.S. fell from 20th place to 27th place in 34 member nations of the Organization for Economic Co-operation and Development (OECD) for life expectancy and quality of life.

The leading causes of death remain heart disease, cancer, and stroke.  And disabilities are being driven by back, muscle, nerve, and joint disorders. 

Seeing with my own parents, the deteriorating quality of life and true suffering as they age, I am left questioning the real wisdom of keeping people alive, when the quality of life has so deteriorated as to leave them in pain and misery. 

While no one wants to lose their loved ones--the emptiness is devastating--at the same time, watching them endlessly and needlessly suffer is worse. 

I see my mom clutching her wheelchair, always in various states of discomfort and pain, and less and less able to help herself, in almost any way--it is tragic. 

So I ask myself is it also unnecessary and wrong? 

I call it forcing people alive. We keep people going not only with extraordinary measures, but also with day-to-day medicines and care that keeps their hearts pumping, their lungs breathing, and their brains somewhat aware. 

The patients are alive, but are in a sense dying a long and painful death, rather than a quick and painless one. 

I love my parents and mom who is suffering so much now, and I don't want to lose her, by does really caring for her mean, at some point, letting her go.

I tell my dad, "I just want mom to have peace"--no more suffering!

For the average person, 68 years of health is too short, but 10 years of disability and suffering may be too long. 

We use advances in technology and medical breakthroughs to keep people alive. But what is the cost in pain and disability, and even in cold hard dollar terms for a nation being gobbled up by deficits, longevity, and miserable disease and disability? 

People are living longer but at a significant painful price! 

Is this real compassion and empathy or a senseless fight with the Angel of Death? 

(Source Photo: here with attribution to wwwupertal)

Living Longer, But With Worse Quality Of Life

The Five Phases Of Medicine

In many respects, medicine has come a really long way, and yet in other ways it seems like it still has so far to go. 

For example, while antibiotics are used to routinely treat many bacterial infections, there are few antiviral treatments currently available--and we are left with the proverbial, "take two aspirin and call me in the morning."

Similarly, heart attacks, strokes, cancers and so many other ailments still take their victims and leave the bereaving family asking why?

In thinking about medicine, there are five major historical phases:

1. Do nothing: Get hurt or ill, and you're as good as dead. You shudder at the words "There is nothing we can do for you." Average lifespan for folks, 30s.  If you're lucky (or wealthy), you may make it into your 40s or even reach 50. 

2. Cut it: Diseased or damaged limb or body part, chop it off or cut it out surgically.  I still remember when the people in my grandparents generation called doctors, butchers. 

3. Replace it: When something is kaput, you replace it--using regenerative medicine, such as stem cell therapy (e.g. for bone marrow transplants or even for growing new tissue for teeth) and bioprinters (like a 3-D printer) to make new ones. 

4. Heal it: Envision a future with self-healing microbes (based on nanotechnology) in the blood and tissues that detect when a body part is dangerously ill and deploys repair drones to fix them.  There is no need to cut it off or replace it, you just fix it. And perhaps with DNA "profiling"(don't like that word), we'll be able to tell what a person is predisposed to and provide proactive treatments. 

5. Eliminate it: Ok, this is way out there, but could there come a time, when with technology (and of course, G-d's guiding hand) that we can eradicate most disease. Yes, hard to imagine, and with diseases that adapt and morph into other strains, it would be hard to do--but that doesn't mean it's impossible. 

I still am shocked in the 21st century with all the medical advances and technology that we have that the doctors still say for everything from routine colds, to viruses, sores, growths, and more--"Oh, there's nothing we can do for that." 

Yet, there is what to look forward to for future generations in terms of better medicine and perhaps with longer and better quality of life.

My grandfather used to say, "No one gets old without suffering"--let's hope and pray for less and less suffering with future medical technology advances. ;-)

(Source Graphic: Andy Blumenthal)

The Five Phases Of Medicine

The Materiality of Super Strength Graphene

Scientific researchers in Britain, Norway and the U.S. are bringing us a major breakthrough in material science—by developing a “super strength” substance called graphene.

According to the Guardian (26 December 2012), graphene has “unmatched electrical and physical properties.” It’s made of an “atom-thick sheet of carbon molecules, arranged in a honeycomb lattice,” and promises to revolutionize telecommunications, electronics, energy industries, not to mention the untold applications for the military.

- Conductivity:  Transmits electricity a million times better than copper
- Strength: The strongest material known to humankind, 200 times that of steel (Sciencebuzz)
- Transparency & Flexibility:  So thin that light comes through it; more stretchable than any known conductor of electricity

Just a few of the amazing uses graphene will make possible (some of these from MarketOracle):

- Home windows that are also solar panels—clear off that roof and yard
- TV in your windows and mirrors—think you have information overload now?
- Thinner, lighter, and wrappable LED touch screens around your wrists—everyone can have Dick Tracy style
- Medical implants and organ replacements that can “last disease-free for a hundred years”—giving you that much more time to be a helicopter parent
- Vastly more powerful voice, video and data and palm-size computers—giving the average person the “power of 10,000 mainframes”
- Both larger and lighter satellites and space vehicles—imagine a skyscraper-size vehicle weighing less than your “patio barbecue grill”!
- Tougher and faster tanks and armored personnel carriers with the plus of an invisibility cloak—even “Harry Potter” would be jealous

The potential is truly amazing, so whomever thinks that the best technology is behind us, better think again. Better yet, soon they’ll be able to get a graphene brain implant to help them realize what they’ve been missing. ;-)

(Source Photo: here with attribution to University of Maryland)

The Materiality of Super Strength Graphene

A Trip To The Science Museum

We went to the Ft. Lauderdale Museum of Discovery and Science—it was quite impressive.

Outside, where you enter, there is a huge clock -tower contraption with overhead slides and rolling balls, and water turning wheels on the side—it’s a “what is it” (exactly) moment and you know you're there. 

We hit the space exhibits first—I entered a simulator for a jet fighter cockpit, managed to take off with relative ease, but soon crashed, flipping it upside down—oops a little too much thrust.

The NASA exhibits were cool such as the MARS rover and colony mockups. And the Styrofoam wings that you can put on in a wind chamber and see how aerodynamically you are (or are not) was fun. 

Next up was the medical exhibits—we put together a puzzle of full body x-rays (“the shin bones connected to the...”), maneuvered a Da Vinci surgical robot arms, and zapped tumor cells with a mock laser.  

Oddly placed but interesting was the Gecko exhibit—with different colorful species hanging upside down and sideways with their suction cup feet. Couldn’t help thinking, which of them had been selling car insurance on those always-on Geico commercials or maybe this is the place they send them when they don’t perform on cue? 

Going through the exhibit on levers and pulleys, I used between 1-6 pulleys to lift a large stack of cinderblocks—and for the fewer pulleys, I thought good thing I had some Wheaties in the morning for breakfast, so I wouldn’t be embarrassed pulling on the ropes. 

The minerals, gems, fossils, corals, and dinosaur displays were somewhat meager, but were nicely laid out and a decent representation to get the idea.  

There was also an IMAX theatre with a 3-D movie and those crazy glasses you have to wear to watch these—but the cartoon playing wasn’t the action and adventure I was looking for. 

One of the exhibits’ I enjoyed the most was the fish—of all types—some favorites were a huge purple-like lobster, the playful otters, the bobbing water turtles and many others.

We also stood inside a mammoth replica of a shark and took turns hanging out of its mouth—and feeling what it was like to be Jonah and the whale.

There was also a weather news station, where you get to playact newscaster, and we used the TV cameras and tele-prompters to give updates of everything from hail storms to wild fires—now, I know how they always seem to know just what to say and when--so perfectly. 

Another cool display had to do with sustainability and the environment—with a robot sitting in the middle of piles of trash and recyclables—not sure why he was there though—was he trying to decide what to recycle and reuse?

I don’t believe that I saw anything significant on alternative energy or on general computers and the Internet—and if there wasn’t anything particualr on these, I would definitely like to see them added.

Overall, good job Ft. Lauderdale—worth the trip—and thank you for spreading a love of science with all. 

(Source Photo: Andy Blumenthal)

A Trip To The Science Museum

Sniffing Out Cancer

A few years ago, researchers found that Dogs could actually identify people with cancer at a 99% accuracy rate by simply smelling human's breath. 

One of the problems with this diagnostic method though is that hospitals and doctors offices have not been inclined to house and care for these animals in medical facilities treating people.

Technology to the rescue and this one has no dog in the fight...

The Metabolomx is a computing machine with attached breathing tube that can be rolled over to a patient who breathes into it for just 4 minutes to can get a diagnose on the spot.

This is very different from current methods and is without painful and intrusive tests (such as biopsies) or waiting weeks for lab results to come back and be read by your doctor.  

The machine captures and analyzes the chemistry of the person's exhaled breath in the form of aerosolized molecules and determines it's "smell signature".

According to Bloomberg BusinessWeek (5-11 March 2012), by comparing the sample smell to the biomarkers for cancer, the Metabolomx has already achieved an 80% success rate for detecting lung cancer.

A newer version of the machine is 100 to 1,000 times more sensitive, which should greatly improve accuracy, hopefully hitting at or above 93%, which will make it viable for commercial use.

The Metabolomx is envisioned be able to detect and differentiate between various types of cancer such as lung, breast, colon, and more. 

Moreover, this technology is not limited to just cancer--but other companies such  as Menssana are testing it with tuberculosis and pediatric asthma.  

Further, another benefit of the Metabolonx is that is can not only be used to diagnose cancer, but to signal reduction or elimination of the cancer with various treatments.

I hope the next step for technology like the Metabolomx is to not only detect the cancer, but be able to "zap it" and rid it from our bodies--then we'll have a technology that can really snuff out the cancer.

Sniffing Out Cancer

Replacing Yourself, One Piece at a Time

Here is a wonderful idea to help people who use prosthetics--a smartphone built right in to the artificial limb.

What was once a challenging task to hold a smartphone and make calls, write emails and texts, or just search the web is now just a push of a button or voice command away.

This is a user-centric and functional integration of technology with medical science to help those who have either lost limbs or been born without them.

While a step forward for the disabled, perhaps this is also a move towards future technological augmentation of regular body parts as well.

What was once a tattoo or body piercing on the periphery may soon become an implanted smartphone in the body part of your choosing.

The concept reminds me of the MTV show "Pimp My Ride" where run-of-the-mill cars are completely made over into new awesome vehicles by stripping them and rebuilding them with better, cooler parts.

Is this where we are going with our human bodies--where one day we are an old beat-up minivan only to have our parts swapped out and replaced with biotechnology to become a new hotrod convertible once again.

Now we are moving from leveraging technology for medical purposes to tinkering with our our physical bodies, using technology, for preference.

Yes, this is already being done with facelifts and other cosmetic surgery, but how about replacing entire body parts not because they are diseased, but because you want or can afford an upgrade?

Lot's of exciting and scary implications to think about with this one--as our body parts become replaceable almost like legos--snap on and off.

In the future, becoming a better, stronger, faster person may not be just a function of what you do, but how much you can afford to replace.

Replacing Yourself, One Piece at a Time

Anatomy, The Google Way

The new Google Body Browser (released 16 December) provides an incredible view into the human anatomy.

Here is the link to the download.

This is the a long way from the classic Anatomy of the Human Body by Henry Gray (1918).

I'm looking forward to seeing the hologram version some day soon.

All this may just be cool enough to make me want to go back and become a M.D.!

Anatomy, The Google Way