Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Thursday, October 27, 2016

Engineer, Heal Thyself

"I'm just a curious individual. Since I could walk, I've had a screwdriver and a spanner in my hand I'm an engineer. My whole life has been spent asking the question, 'How do we improve this?' Is there a better way?"
"My example is pretty extreme, but it makes the point that pretty much every patient can make a contribution to the health-care system. Even the least intellectually competent of us can say, 'I don't like how that doctor treated me' or 'I found that form difficult to fill in'. If you get that feedback, you can improve things."
"I thought to myself, 'This is an engineering problem'. I asked [the surgeon], 'Why aren't we scanning the aorta. CAD-modelling it, then rapid-prototyping a model and using that to make a support? He just said, 'What?'!"
"I'd love to say I did this for philanthropic reasons, but that would be total crap. I was terrified. For me, it was about self-preservation."
"It was incredible to meet a surgeon who was actually prepared to admit there were things about his job that he didn't know."
"I didn't think I did have the solution. I don't think I have the arrogance and the ego. I just thought, 'Holy s---, I've got to do something'."
Tal Golesworthy, British Chemical Engineer
Tal Goldsworthy, a British engineer from the coal industry, holds a copy of the brace that he designed to fix his own faulty aorta after speaking at a medical conference in Ottawa Wednesday, October 26, 2016. (Darren Brown/Postmedia) Assignment 125131
Tal Goldsworthy invented the device that saved his own life.  Darren Brown / Postmedia

He was terrified and he was desperate to 'do something' with his chemical engineering background, to come up with a solution that would negate the necessity for him to have open-heart surgery to correct a condition he was born with. Tal Golesworthy was born with Marfan syndrome, an inherited disorder of the body's connective tissue. That disorder had the potential to stretch and rupture his aorta. He knew, throughout his life, that sooner or later he would be faced with his condition turned desperate.

He had become accustomed to submitting to regular scans of his heart for the purpose of measuring the amount his aorta was stretching as a result of Marfan syndrome. Scans indicated in 2004 that the situation was reaching a level clearly dangerous to his longevity. A cardiologist was consulted to find out what could be done about his condition. Open-heart surgery was the response, a radical procedure once rare, now commonplace for heart bypasses and valve replacement, for example.

The details of the procedure caused his heart to literally palpitate with fear. His body temperature would be drastically lowered to 18C while he would be connected to a cardiopulmonary bypass machine and his heart stopped. Breathing tubes would be plunged down his throat. A surgery that would take hours would ensue. Recovery would take months. And afterward, he would need to take blood thinners to ensure that a blood clot wouldn't develop to cause a stroke.

(This is simplified, of course. And it's just as well to remember that aspirin is a blood-thinner and millions take aspirin in small doses daily as a heart attack and stroke preventive.)

So Mr. Golesworthy's brain went into overdrive, and he spoke to the surgeon of potential alternatives, a treatment that would bypass the need for that open-heart surgery. Private investors such as friends helped to fund his research and he underwent 30 hours of MRI scans to fine-tune mapping techniques. A computer-aided design professional helped to create a "bespoke" computer model, used to create a plastic copy of his aorta. That copy was used as a platform to tailor a woven, lightweight synthetic mesh that doctors could secure his aorta with, by wrapping it with the mesh.

The result was his invention, ExoVase, to reinforce the aortic artery. It has, to date, been used in six countries; the United Kingdom, Belgium, Poland and New Zealand. The U.S. Food and Drug Administration has placed the device on its study list which could eventually result in its acceptance for use in North America. So far, 80 patients have received his invention. One of them a boy of eleven. Unfortunately, one patient died post-surgery as a result of the surgeon inadvertently cutting an artery during the operation.

As for Mr. Golesworthy, his own aorta now is stable enough that he's been able to put a halt to the annual scan meant to measure its diameter. And he was a guest speaker at a conference called Strategy for Patient-Oriented Research, hosted by the Canadian Institutes of Health Research, meant to examine how doctors and the health-care system, by listening to ideas and responses from the patients they serve, can improve their protocols and outcomes.

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