Rob, of Fighting Monsters With Rubber Swords, has a young daughter who is about to experience the new challenges of middle school.  Schuyler communicates using an assistive  device, and  Rob writes about how the über-cool iPad may help to bridge a portion of the gap between Schuyler and her peers — a gap which he, like many similar parents, sees widening as time goes on.

The social benefits of an assistive device that looks like something anyone would want aren’t to be minimized, but I was also intrigued by a post written by Asthma Mom (via Rob’s twitterfeed), who imagines how an iPad might be used as a physician’s aid:

Now picture the pediatrician or ER doctor whipping out an iPad, showing you a video of a bronchospasm-induced coughing fit, and saying, “Does your kid ever sound/look like this? Because this is asthma.”

Or imagine if your pediatrician could play recordings from the R.A.L.E. Repository of Lung Sounds, instantly and right there in the examining room, so you can understand exactly what kind of respiratory symptoms to listen for at home.

Yes, you could leave the ER, and check out the videos and sounds on your home computer (and probably will, if you’re sent home with links, or search yourself).  But the potential of the iPad, or future devices like it, exists in its hand-held nature, and its bright, readable screen.

Patient education is a critical component of effective medical management, and one that is increasingly poorly implemented, if it’s addressed at all.  Sending patients home with scantily, or badly, written brochures is not really an optimal approach.  Being able to access visual and audio aids in partnership with a medical educator is a whole different story.

Sharing information on a laptop is theoretically possible, but isn’t practical in most medical settings; they’re too cumbersome and too awkward to hand off from one person to another.  The monitor your doctor increasingly spends his or her time staring into during your office visit isn’t any more sharing-friendly, anchored as it is on a desk or table in front of the doctor.

The iPad changes all that; multiple viewers  can see the screen as easily as a shared piece of paper, and, if a closer look is needed, it can be handed back and forth as easily as a trade paperback.  (Maybe more easily, as there are no pages to manage.)

It will be interesting to see how utilization of the iPad (and its eventual imitators) plays out; those of us with special interests of all sorts might want to keep a close eye on developments.

Best of all, say users, a Segway, unlike a wheelchair, allows face-to-face interaction.

Sounds like a great, feel-good post doesn’t it? Maybe — but it turns out that the obstacles these vets face aren’t the ones you’d expect. Because Segways go much faster than a power chair and appear to represent a greater threat to pedestrians, many cities (liberal, people-loving San Francisco, among them) have banned them. So have other venues: Disney World and at least one Barnes and Noble store in Arizona, among them.

Disney’s argument seems to be that the scooters haven’t been certified as ADA assistive devices; it’s unclear how retailer objections will play out. A Segway disability-use permit — like the parking placards issued by every state — would seem to be a simple, logical solution to the question of identifying scooter drivers with a disability, but hey, I’m only thinking logically here. While the world sorts this out, riders might want to pack a doctor’s note and see if some courteous information exchange can get them to that latte.

Segways aren’s for everyone with a disability. Though they can be modified in various ways, their use depends on considerable motor skills, along with a dose of good judgment. (Speed is increased or decreased by leaning forward or back; forgetting this can have serious consequences.) Those who use them particularly cite the advantages of being able to travel upright for longer periods of time, and the ease of getting where power chairs just don’t like to go. There’s a certain cool factor, too. Unlike a power chair, they’re likely to inspire some admiring glances; this assistive device is coveted by people without disabilities, as well.

Segway image from Flickr

According to the NEJM article, Mlle. Dinoire “the patient is very satisfied with the results of the transplant”. She is able to eat, drink, and speak normally; it is said that, with make-up, her surgical scars are no longer evident. The results do appear to be remarkable:

The picture on the left is NOT a post-transplant image; it’s from 2001, four years before the face transplant, when Mlle. Dinoire was 34 years old. The middle picture is from November, 2006, one year post-transplant. The right picture is of Mlle. Dinoire in June, 2007, eighteen months post-transplant, showing her natural face, without make-up.

The post-surgical journey has been difficult. Mlle. Dinoire has suffered several bouts of rejection and one of kidney failure. She has battled infections; she must, of course, take immune-suppresents for the rest of her life. The return of functional abilities has exceeded expectations, though. This chart (left), from the New England Journal of Medicine, tracks the changes throughout the first six months; her abilities now far exceed those noted here.

Mlle. Dinoire’s case is controversial for many reasons. One of her doctors initially reported that she had attempted suicide; Mlle. Dinoire herself confirmed this in an interview with a London newspaper. Her injuries occurred when her dog was trying to rouse her from unconsciousness following the drug overdose. (Her donor did commit suicide, adding another layer of emotional complexity to the case.)

Mlle. Dinoire, a single mother, has a history of depression, and had been unemployed for a year prior to the incident. Criticism has been leveled at her doctors, who, some feel, may have chosen a particularly vulnerable patient for this historic operation.

Long-term, the physical problems alone may prove overwhelming. Notes The Washington Post:

Maria Siemionow, director of plastic surgery research and training at the Cleveland Clinic, which has been planning to do face transplants, expressed concern about Dinoire’s “unexpectedly aggressive immune response.” Scientists need better ways to prevent rejection of large, complex tissues such as faces, she said.

Siemionow, along with others, also expresses concern about the psychological implications; no psychological study has been published in connection with Mlle. Dinoire’s treatment.

British filmmaker Michael Hughes has made a documentary of the surgery; Mlle. Dinoire allegedly signed a deal for movie rights to her story earlier this year, netting (according to one account) over $400,000 (USD). The Hughes documentary is reviewed here (in French).

Whether Mlle. Dinoire’s pioneering venture will prove worthwhile over time remains to be seen. The potential scope of this experiment is breathtaking, yet it cannot help but recall the innocence and irony of Miranda’s words in Shakespeare’s Tempest:

O brave new world
That has such people in’t!

Related:

The Tin Noses Shop

The Origins of Plastic Surgery

Once the show has aired, the rest of us can click here to watch it on the Internet. The program will be available for a week after the original air date. This link is to the London ‘Inside Out’ main page; you may have to scout around a bit to find the exact link for this particular episode.

Laptop Laidback is made for people who prefer to (or must) use laptops while reclining. The table has a broad, stable stance; a ledge holds the laptop in place. Both angle and height are adjustable, and the unit folds flat for storage or transportation.

According to the site, the legs adjust in 5 degree increments — that’s the kind of fine-tuning that can keep wrists and arms happy.

Click on “Product” from the home page for technical information. You’ll need to scroll down to see the full list of specifications.

Thanks, Paul!

The energy produced from the forward motion of the person wearing the prosthesis is stored in the power-assisted spring, and then released as the foot pushes off. Additional mechanical energy is also added to help momentum.

The prosthesis, called PowerFoot One, contains a small, computer-assisted motor which lets the person using it expend 30% less energy than required by conventional prostheses. It’s also lighter in weight and more flexible than current models. MIT expects it to be marked publicly in 2008.

Thanks to medGadget

Read more at MIT News

We provide a wide variety of services that are mostly accessed with a web browser. People visit Google from a large number of browsers and platforms; in addition, we also understand that every user is special and may have special needs. Accessibility at Google is about making sure that our services work well for all our users — independent of your needs and abilities at any given time.

You can view the complete list here. A certain amount of web expertise may be necessary to use the information, but anyone who hasn’t kept up on Google’s various expansion efforts may be surprised at how much more there is to explore beyond the familiar search engine.

Each of the i-LIMB’s digits are individually powered; myoelectric controls are used to control the hand. The manufacturer says that function is intuitive for users of previous generation myoelectric prostheses, minimizing the adjustment phase.

Sensitivity is considerably enhanced, even compared to previous myoelectric devices. All five digits are fully articulated, and a rotating thumb offers a greater range of grip possibilities.

Sgt. Juan Arredondo, who lost a hand in Iraq, now uses an i-LIMB.

“I can pick up a Styrofoam cup without crushing it,” said Sgt. Arredondo. “With my other myoelectric hand, I would really have to concentrate on how much pressure I was putting on the cup. The i-LIMB hand does things naturally. I can just grab the cup like a regular person.”

Maintenance is a departure, too — each digit can be removed independently if necessary for repairs, meaning that it isn’t necessary to go without the whole prosthesis for a prolonged period while repairs are done.

Via medGadget

Arredondo quote and additional information on the Touch Biotronics website

A UK article calls the legs “bionic”, but it looks as if they may be a bit less complicated than than that; English-language media reports are a bit unclear as to exactly how the prosthesis works. Whatever the actual nature of the device, this is clearly a case where an indomitable will and human ingenuity have resulted in an astonishing reclamation of one man’s life. Kind of makes Heather Mills’ prothesis look like a bit of frippery, doesn’t it?

Via medGadget

There’s no power source — the X-Finger is designed to move in response to activity in the residual finger:

The replaced phalanges will follow the natural bending pattern of a finger. Combined lateral and vertical flexion/extension movements can be independently and immediately restored.

Pretty impressive, what? But there’s more!

The X-Finger will allow the user to regain complete control of the articulation of the device simply by moving their residual finger. Benefits will include typing; playing a musical instrument or anything that requires the full dexterity of a hand.

Each is custom made. Didrick Medical, purveyors of this wonderful device, will evaluate each person’s situation without charge, utilizing the charmingly low-tech technique of reviewing a faxed photocopy of the hand in question.

Read more at medGadget

Update 6/3/2007: Image with hand (without cosmetic silicone cover) added