3D Printing: Medical Applications | Michael Balzer and Pamela Scott | TEDxCibeles
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0:12 - 0:16Michael Balzer: Hola.
That's about the extent of my Spanish, -
0:16 - 0:17(Laughter)
-
0:17 - 0:22but I learned one new word yesterday,
and that's cráneo, skull. -
0:23 - 0:27I'm the guy who created my wife's skull
-
0:27 - 0:32to save her life, her eye
and even her soul. No, not really. -
0:33 - 0:38I was part of a team of Pamela,
two surgeons and technology, -
0:38 - 0:44kind of, as I call it, the healer,
the magician and the warrior, -
0:45 - 0:50and together we defeated the pain
and suffering that was in her. -
0:51 - 0:54We'd like to invite you into our story.
-
0:58 - 1:02Pamela Scott: When I was 16 years old,
my mother died of a brain tumor. -
1:02 - 1:05And of course, this impacted me
very deeply. -
1:05 - 1:08But it also left me
with a tremendous interest -
1:08 - 1:13and passion in understanding
health and medical research. -
1:13 - 1:19Now we live on a very small community
in the Central Coast of California. -
1:19 - 1:22It's halfway between Los Angeles
and San Francisco. -
1:23 - 1:27We have very limited
specialty medical services there, -
1:28 - 1:31which is difficult for anyone
who has a serious illness. -
1:31 - 1:35Major medical centers
are at least 4 hours away. -
1:36 - 1:39Now, I'd like to talk to you
about my pain. -
1:39 - 1:43Imagine having the worst headache
you've ever had. -
1:43 - 1:49And imagine having that headache go on
24 hours a day, 7 days a week for months. -
1:51 - 1:55In the summer of 2013,
this is what I was experiencing. -
1:55 - 1:59I went to my primary care physician,
she had no idea what was wrong. -
1:59 - 2:03I went to emergency rooms,
they had no idea what was wrong. -
2:03 - 2:06So I was referred to a local neurologist
-
2:06 - 2:09who was very well thought of
and respected, -
2:09 - 2:11and he diagnosed me with migraines,
-
2:11 - 2:14kind of classic
but severe migraine syndrome. -
2:14 - 2:19So, he prescribed a very
complicated regimen of pills. -
2:19 - 2:23I took so many pills.
I had trouble keeping track of them. -
2:23 - 2:27I also had injections,
I had inhalant medication. -
2:27 - 2:30But the headaches kept getting
worse and worse over the months, -
2:30 - 2:33until finally I could not sleep at night.
-
2:34 - 2:39There were no imaging studies done,
nothing was ordered by the doctor. -
2:39 - 2:41No MRI, no CT scans.
-
2:41 - 2:44And so we really never had
a very good idea -
2:44 - 2:46what was going on inside my head.
-
2:46 - 2:47MB: So, she came to me and said,
-
2:47 - 2:50"Can you come with me
to see this neurologist? -
2:50 - 2:53He's not listening to me.
I'm still having a lot of pain." -
2:53 - 2:56So, I did and sure enough,
he was very adamant -
2:56 - 2:59to keep the same treatment going.
-
2:59 - 3:01So, I had to tell him,
-
3:01 - 3:05"You know her mother died
at the age of 53 of a brain tumor. -
3:05 - 3:08Humor me, let's do an MRI."
-
3:09 - 3:11He paused. I guess
he was somewhat surprised -
3:11 - 3:13that I would say that.
-
3:13 - 3:16And he relented and ordered the MRI.
-
3:16 - 3:19PS: Now there are two types of MRIs.
-
3:19 - 3:23One is a standard MRI
which is fast and easy, -
3:24 - 3:27but it doesn't give very much information.
-
3:27 - 3:31The other one is a better MRI,
and it's done with contrast dye. -
3:32 - 3:36My doctor only ordered the first MRI
even though he said, with that, -
3:36 - 3:38there was absolutely
no reason to do it, -
3:38 - 3:42no clinical information
that he thought would be important. -
3:43 - 3:47We did that MRI and I got a report
back from the radiologist -
3:47 - 3:51that indicated there was something wrong
in this part of my skull. -
3:51 - 3:56The radiologist recommended
that we have the second type of MRI -
3:56 - 3:59in order to determine
more specifically what that was. -
3:59 - 4:02My doctor, the neurologist,
refused to do this -
4:02 - 4:07and said I should continue the medication,
all the pills that weren't working, -
4:07 - 4:10go home and come back
to see him in a year. -
4:10 - 4:13This was entirely unacceptable to me.
-
4:13 - 4:17So, I went back to my primary care doctor,
and she looked at the report, -
4:17 - 4:21and she ordered the better MRI
with contrast dye. -
4:21 - 4:26And, to my surprise it did turn out
that in fact I had a brain tumor. -
4:34 - 4:36MB: This is the report.
-
4:36 - 4:40It's difficult to read but essentially
it identifies the size of her tumor. -
4:40 - 4:44To put it in perspective,
this was the size of the tumor. -
4:44 - 4:46About the size of a golfball.
-
4:46 - 4:49This was lodged
between her eye and her brain. -
4:50 - 4:53There's also some other
medical jargon here, -
4:53 - 4:55but I'm somewhat of a visual guy.
-
4:55 - 4:58So I created this
to help me understand it. -
4:58 - 5:02I took my own measurements;
I circled the area where the tumor is. -
5:02 - 5:05Now this is an MRI, bone does not
show up in MRI, it's dark. -
5:07 - 5:11If you notice right above her left eye
is a very dark space that's the tumor. -
5:11 - 5:15But it also indicates the type
of tumor, a bony tumor. -
5:16 - 5:20PS: I think we all are uncomfortable
when we think about our deaths, -
5:20 - 5:24but there's always been something
that has frightened me more than death. -
5:24 - 5:27And that's the thought
of having brain damage: -
5:27 - 5:29no longer being myself
-
5:29 - 5:31because that's what had happened
to my mother. -
5:31 - 5:34The problem with the location
of this tumor -
5:34 - 5:38was that it was under the frontal lobe
of the brain. -
5:38 - 5:41Now, the frontal lobe
is where we have our intelligence, -
5:41 - 5:46our reasoning, our memories,
it's the seat of our personality, -
5:46 - 5:48it's what makes us unique.
-
5:49 - 5:53I went to two local neurosurgeons,
and both of them said -
5:53 - 5:55that I really should consider
the tumor inoperable -
5:55 - 5:57because in order to remove it,
-
5:57 - 6:00they would have to do
an ear-to-ear craniotomy, -
6:00 - 6:03so cutting my skull open,
remove a piece of the skull, -
6:03 - 6:08and then, because of the location
of the tumor, apply traction -
6:08 - 6:13to try to lift it or move the brain aside
in order to reach the tumor. -
6:13 - 6:17Now, by doing that, both doctors said
there was a very high possibility -
6:17 - 6:20I would have brain damage from this.
-
6:20 - 6:22One doctor said
I may never be functional again, -
6:22 - 6:26I may never be normal,
I may never leave the ICU. -
6:27 - 6:29This was not acceptable to me.
-
6:30 - 6:34The other problem was
that if I did not remove the tumor, -
6:34 - 6:36the tumor could continue to grow
-
6:36 - 6:39and would grow up
into the frontal lobe there. -
6:39 - 6:42So I would have
the same outcome ultimately -
6:42 - 6:45although we don't know how soon.
-
6:45 - 6:47I needed to do something different.
-
6:47 - 6:49I was anxious, yes.
-
6:49 - 6:51So, I went to the Internet
-
6:51 - 6:54which of course
we have to be careful about. -
6:54 - 6:57It comes with the caveat
because how much information, -
6:57 - 7:01particularly medical information,
on the Internet is good information? -
7:01 - 7:04I'm going to guess about 10%.
-
7:04 - 7:0690% of it - Facebook, no;
-
7:06 - 7:09forums, no -
not good information. -
7:09 - 7:14But I discovered that all major
medical centers have websites -
7:15 - 7:19that you can go to
and find so much information -
7:19 - 7:23you can read about the newest techniques
in treating so many different diseases, -
7:23 - 7:26and they talk about the special
treatments that they have, -
7:26 - 7:32along with providing links to videos
and other information that is reputable. -
7:32 - 7:35So, this is what I did,
and I learned so much. -
7:35 - 7:40I also learned that there was something
called a "distant patient program". -
7:41 - 7:43I had never heard of this before.
-
7:43 - 7:45And many of these
university medical centers -
7:45 - 7:50will do an evaluation of your case
by looking at your records -
7:50 - 7:51that you can send to them.
-
7:51 - 7:53So you don't actually have to go there
-
7:53 - 7:56and their team of physicians
will go over your situation, -
7:56 - 8:00discuss it together,
develop a provisional diagnosis -
8:00 - 8:04or their best guess about what it is
and then determine the best treatment -
8:04 - 8:08that they would have to offer
at their clinic or their hospital. -
8:08 - 8:11And then they would call you on the phone,
and discuss that with you. -
8:11 - 8:14So I thought this was
a wonderful thing to do, -
8:14 - 8:16and that's what I began doing.
-
8:16 - 8:19MB: Now, everybody handles
anxiety differently. -
8:19 - 8:24Pamela handles it with research,
research and more research, -
8:25 - 8:27and she would come to me
with this research. -
8:27 - 8:29"Can we get this?"
"Can we get that?" -
8:29 - 8:33I have a IT background,
so I accumulated a lot of information. -
8:33 - 8:37In fact, we had a white binder
about 10 centimeters thick -
8:37 - 8:42of documentation, reports, scans
that I created that she would take -
8:42 - 8:45to all the local surgeons, physicians
throughout California. -
8:46 - 8:48However, we also needed
to send this information -
8:48 - 8:51throughout the rest of the country.
-
8:51 - 8:54So it was my responsibility
to use email, facsimiles -
8:55 - 8:59even the web portals that somebody's
medical systems put together -
8:59 - 9:01in order to present this information.
-
9:01 - 9:04But I also do something else.
-
9:04 - 9:06I started a 3D print company.
-
9:06 - 9:08I also started a podcast.
-
9:08 - 9:12In one of my episodes, I had talked
about a Malaysian neurosurgeon -
9:12 - 9:19who printed a 3D skull and brain,
and used that for practice surgery. -
9:19 - 9:23Now [in] Malaysia, [they] can't use
cadavers, it's illegal, -
9:23 - 9:25so I could understand
the reasoning for that. -
9:25 - 9:29Coincidentally, ironically,
Pamela had a brain tumor, -
9:30 - 9:32and I thought to myself,
-
9:32 - 9:35"Wouldn't it be neat
if I could apply these skills -
9:35 - 9:38that I have just learned
to be able to help her?" -
9:38 - 9:42So, I went to work but immediately
I ran into roadblocks. -
9:42 - 9:47This software is horrendously expensive,
and it's also for the medical community. -
9:47 - 9:50One, I'm not in the medical community.
-
9:51 - 9:53Two, I don't have a lot of money.
-
9:53 - 9:57So, like Pamela I used the Internet
and did a lot of searching. -
9:57 - 10:00And I came up with two open-source
research programs -
10:00 - 10:02that allowed me to do what I needed to do.
-
10:02 - 10:05One of them was from Brazil,
part of their Technology Center. -
10:05 - 10:08The other one was from a research company
on the East Coast. -
10:08 - 10:10Through the two of these things,
-
10:10 - 10:13after a couple of weeks of training -
that I trained myself - -
10:13 - 10:15I came up with this.
-
10:15 - 10:18This is a 3D volume render.
-
10:18 - 10:23On the right hand side
you see a bunch of slices. -
10:23 - 10:26These are CT scans.
Bone shows up very well in these. -
10:26 - 10:28There's about 300 of them.
-
10:28 - 10:31All together they rendered
this skull here. -
10:31 - 10:35Now, the skull by itself is great
for Halloween, but nothing more. -
10:35 - 10:38So, there're other powerful tools in here.
-
10:38 - 10:40They're called ROI
or "regions of interest," -
10:40 - 10:44and they virtually allow me
to slice the skull in half. -
10:44 - 10:46And I did it right over the left eye,
-
10:46 - 10:50and you can see not too clearly the tumor,
-
10:50 - 10:52and I'll highlight it a little bit here.
-
10:52 - 10:56As you can see there is the tumor.
-
10:56 - 11:01Now the magic behind this kind of software
is that I can rotate it, -
11:01 - 11:04so here's an animation
where I cut it in half -
11:04 - 11:07so that I can look inside this skull.
-
11:07 - 11:10A few years back
I would have had to kill Pamela -
11:10 - 11:12in order for this to happen.
-
11:12 - 11:14No, I'm trying to save her.
-
11:14 - 11:19So because of technology, I now
have the ability to look inside there. -
11:19 - 11:23And I'll circle it here,
again, there's the tumor, -
11:23 - 11:26Now I said earlier that I 3D print,
-
11:26 - 11:28so I wanted to take this
to the next level. -
11:28 - 11:31It's great to be able to look
at this stuff on a computer, -
11:31 - 11:34but wouldn't it be great
if I could actually touch it? -
11:34 - 11:39So I went to work, the same software
gave me the ability to create a model -
11:39 - 11:41that I applied to a printer.
-
11:41 - 11:44So, here is a time-lapse image.
-
11:44 - 11:49Obviously if you've ever worked
with a 3D printer, they're not this fast. -
11:49 - 11:53It took about 8 to 12 hours
to create this skull. -
11:53 - 11:57Now this is kind of creepy,
kind of reminds me of the Terminator. -
11:59 - 12:02However, this is that 3D printer,
-
12:02 - 12:05and this, a year and half ago,
-
12:05 - 12:09is the time-lapse that I created,
and this is the skull. -
12:09 - 12:11Don't you think it kind of looks like her?
(Laughter) -
12:11 - 12:13I like the cute little nose here.
-
12:13 - 12:19Now, the reality is we want to look
inside of it , so here is the tumor. -
12:20 - 12:23We can actually touch this tumor.
-
12:23 - 12:26I was extremely excited about this,
so I ran to her and said, -
12:26 - 12:29"Look, I've got your skull here!
Here's your tumor." -
12:29 - 12:32She greeted me with a look of horror.
-
12:32 - 12:35I thought to myself, "Why?"
-
12:35 - 12:38but then it dawned on me,
for the first time she came away -
12:38 - 12:43with what was inside her
causing her all that pain. -
12:44 - 12:47But what does Pamela do?
Research. -
12:48 - 12:51PS: I had found something miraculous
-
12:51 - 12:54and something that most doctors
were not familiar with, -
12:54 - 12:55and had never heard of.
-
12:55 - 12:58There were 2 major medical centers
-
12:58 - 13:00on the East Coast,
so across the country from us, -
13:00 - 13:03that have developed
a new surgical technique -
13:03 - 13:05for the kind of tumor that I had.
-
13:05 - 13:06It was perfect.
-
13:06 - 13:08One was Johns Hopkins Medical Center,
-
13:08 - 13:11the other one was the University
of Pittsburgh Medical Center. -
13:11 - 13:14In this procedure, groundbreaking,
-
13:15 - 13:21there would be a team of a neurosurgeon
working with an oculoplastic surgeon. -
13:21 - 13:26They would make a tiny incision,
truly tiny in the crease of my eyelid, -
13:26 - 13:30and then the neurosurgeon
would go over the eye -
13:30 - 13:34and directly into the tumor
to remove it in very tiny bits, -
13:34 - 13:38small increments,
over the course of several hours. -
13:38 - 13:42Thus I would have no craniotomy,
no movement of my brain, -
13:42 - 13:45and this would eliminate
the risk of brain damage. -
13:45 - 13:49I was very excited about this,
and I really wanted it done. -
13:49 - 13:53Now UPMC could get us in
within a few weeks, -
13:53 - 13:56so I went ahead and scheduled
the surgery there as soon as I could. -
13:56 - 13:58MB: So a few weeks later,
we got on a plane, -
13:58 - 14:01and we went to Pittsburgh, Pennsylvania.
-
14:01 - 14:04The next day she had some labs done,
and we had an opportunity -
14:04 - 14:08to talk to the surgeons, in particular
the neurosurgeon Dr. Gardner. -
14:08 - 14:11So I asked him because I had sent him
one of these skulls, -
14:11 - 14:13and said, "What do you think of it?"
-
14:13 - 14:14He kind of chuckled, he said,
-
14:14 - 14:16"We passed it around
in one of our meetings." -
14:16 - 14:21He said, "We thought it was extremely cool
how we can look at something, touch it," -
14:21 - 14:25because normally all they had
was some images and some text documents, -
14:25 - 14:28so they were able to touch it,
now we had a fellow with him, he said, -
14:28 - 14:32"The huge potential of using this
for education is enormous -
14:32 - 14:36because now we can take data
from a patient immediately -
14:36 - 14:39and apply it into a tangible model
and use that -
14:39 - 14:42as the Malaysian neurosurgeons
use for practice." -
14:45 - 14:47PS: My surgery was very successful.
-
14:48 - 14:52This photograph was taken
10 days after the surgery. -
14:52 - 14:56The surgeon had encouraged me,
to get up and walk every day, -
14:56 - 15:00and so I was walking a little bit
and Mike's idea on day 10 -
15:00 - 15:03was that we would go a half mile
and walk to a museum -
15:03 - 15:05and then walk around the museum.
-
15:05 - 15:06So this is what we did.
-
15:06 - 15:08MB: It was a great museum.
PS: It was. -
15:08 - 15:10And you would never know
-
15:10 - 15:12that I had had brain surgery
10 days earlier -
15:12 - 15:16unless you peeked
under those big dark glasses, -
15:16 - 15:18and then you might think
that I had an affinity -
15:18 - 15:23for purple eyeshadow on just one eye,
but no one had any idea. -
15:23 - 15:26And 5 hours after this photo was taken
-
15:26 - 15:28I was back on a plane to California,
-
15:28 - 15:33and 10 days after that,
I was back at work in my office. -
15:33 - 15:38Pain-free, no impairments whatsoever,
driving my car and absolutely fine. -
15:38 - 15:41MB: This is an object that rotates.
So I did 2 things. -
15:41 - 15:46I did 2D resolution images,
and I also did a 3D scan of her head -
15:46 - 15:49and sent that to them,
so they can rotate it, -
15:49 - 15:52zoom in on it, look at it
from different angles. -
15:52 - 15:55This allowed us not to ever
have to go back to Pittsburgh -
15:55 - 15:59because they and all the information
at their fingertips. -
15:59 - 16:02I see huge potential in this:
long distance surgeries -
16:02 - 16:06and long distance postoperative checkups.
-
16:07 - 16:12PS: Now, this is a close-up photograph
of both my eyes, 2 months after surgery. -
16:12 - 16:16There's no photoshop,
no make-up, completely natural. -
16:16 - 16:19Can you tell which eye
had a brain tumor removed? -
16:19 - 16:21MB: That one.
PS: You're always wrong. -
16:21 - 16:22(Laughter)
-
16:24 - 16:28Now, I am a psychotherapist by profession,
dealing with people -
16:28 - 16:31who are going through difficulties
going through traumas and stress. -
16:31 - 16:35They often ask me,
"How do you cope? What do I do?" -
16:35 - 16:38I like to use a metaphor
of inner archetypes, -
16:38 - 16:42the characters within us
that are through mythology and literature, -
16:42 - 16:44and I always talk about
having an inner healer, -
16:44 - 16:47having an inner warrior,
having an inner magician, -
16:47 - 16:50and how do we bring
those resources up out of ourselves. -
16:50 - 16:53And there are times perhaps
when we're too depleted -
16:53 - 16:56and we have to seek
those resources externally. -
16:56 - 16:58And this is a wonderful thing to do.
-
16:59 - 17:05Now, Mike and I obviously dream big,
and I like to think of my life as a book, -
17:06 - 17:09and I am the author of the story.
-
17:09 - 17:12It's an adventure story,
and it's not always fun, -
17:12 - 17:15but it's always a very interesting story.
-
17:15 - 17:19And I hope at the end of my life
that I can hold up this book and say, -
17:19 - 17:22"I am very happy with the way
this turned out." -
17:22 - 17:26MB: I hope I'm a protagonist in your book
and not an antagonist. -
17:26 - 17:30However, in my book
she is one of the heroes. -
17:30 - 17:33She went through a lot
of pain and suffering. -
17:33 - 17:36I was not going to cry so soon -
-
17:41 - 17:43(Applause)
-
17:43 - 17:44thank you -
-
17:47 - 17:52but she persevered
where other people have not. -
17:52 - 17:55She is a warrior to me.
-
17:55 - 18:01But I also want a special note
to the two surgeons, notably Dr. Gardner -
18:02 - 18:05and the technology
and the people behind it. -
18:07 - 18:12CT scans just came out,
MRIs were still on the drawing board -
18:13 - 18:16that's when her mother fell into a coma.
-
18:19 - 18:24They determined that it was a brain tumor
from the CT scan, but it was too late. -
18:25 - 18:29I wonder today
how that story would turn up. -
18:30 - 18:31Thank you.
-
18:31 - 18:33(Applause)
- Title:
- 3D Printing: Medical Applications | Michael Balzer and Pamela Scott | TEDxCibeles
- Description:
-
This talk was given at a local TEDx event, produced independently of TED Conferences.
Save someone's life from a brain tumor, through 3D printing technology.
Michael Balzer is the founder of ‘slo 3D creators’, a 3D print, scan, design and education studio located in San Luis Obispo, California. In providing services for those who need their ideas produced in tangible form, or existing tangible objects converted to a digital form, he works with students, artisans, engineers, architects, manufacturers, and inventors to take their ideas to next level.
Pamela S. Scott has served the residents of San Luis Obispo County as a therapist in private practice since 1991. She has worked for non-profit & county social service agencies, as well as being a part of a multi-disciplinary treatment team.As a therapist, it’s her job to look for creative solutions to all kinds of problems.
- Video Language:
- English
- Team:
- closed TED
- Project:
- TEDxTalks
- Duration:
- 18:53
Ivana Korom approved English subtitles for 3D Printing: Medical Applications | Michael Balzer and Pamela Scott | TEDxCibeles | ||
Ivana Korom edited English subtitles for 3D Printing: Medical Applications | Michael Balzer and Pamela Scott | TEDxCibeles | ||
Ivana Korom edited English subtitles for 3D Printing: Medical Applications | Michael Balzer and Pamela Scott | TEDxCibeles | ||
Ivana Korom edited English subtitles for 3D Printing: Medical Applications | Michael Balzer and Pamela Scott | TEDxCibeles | ||
Maki Sugimoto accepted English subtitles for 3D Printing: Medical Applications | Michael Balzer and Pamela Scott | TEDxCibeles | ||
Maki Sugimoto edited English subtitles for 3D Printing: Medical Applications | Michael Balzer and Pamela Scott | TEDxCibeles | ||
Maki Sugimoto edited English subtitles for 3D Printing: Medical Applications | Michael Balzer and Pamela Scott | TEDxCibeles | ||
Maki Sugimoto edited English subtitles for 3D Printing: Medical Applications | Michael Balzer and Pamela Scott | TEDxCibeles |