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Why my optimism about bionics has faded

Though I still get excited when I see footage of bionic exoskeletons and limb supports — devices that promise greater ability to the disabled and superhuman strength and endurance to all — I doubt that anyone I know will benefit from them in the next 20 years. My optimism is dimming with my current experience trying to obtain a new leg brace. Currently, I’m wearing the brace on the left below. It’s a fine brace, though its technical advancements over Forrest Gump’s braces are mostly in materials, padding metal with plastic and replacing buckles with Velcro.

legbraces

That brace model must have particularly long legs. I need to extend the calf section to diminish sliding, and with the thigh portion compressed as far as possible, the brace nearly stretches from my ankle to my crotch. Also, since I’m a human female and my legs have curves, the dials at the hinge float away from the sides of my knee. This is the brace I was given in the hospital post-surgery and it’s actually very helpful for stability. However, it’s difficult to walk with a natural gait while wearing it, and to venture into TMI territory, it’s damn hard to get my pants down far enough when I have to pee.

It’s been three months since my surgery and my only remaining movement restriction is no impact: no hopping, skydiving, competition Double Dutch, etc. The stretched ligaments around my knee make it wobbly and it has a tendency to hyper-extend, so my surgeon wants me to wear a brace all the time. I rarely wear it in the house because it’s a pain, but I wear it whenever I go shopping, walking the dog, picking apples in the yard, or whenever my attention could drift for a moment and allow my leg to collapse again. I’d happily wear it more if it was a few inches shorter and fit better.

To that end, my surgeon has written two prescriptions in an attempt to get me a smaller, custom-fit, hinged knee brace. That’s not as simple as you’d think. The one local orthotic provider who would do it doesn’t accept my health insurance and gave me a quote above $900. I’ve spoken with four others in my area and their responses boiled down to: they don’t have a low profile brace option for a tibial plateau fracture, they don’t care that I’m 3 months post-surgery and my doc wants me to have a smaller brace, but they’d be happy to sell me a brace similar to the one I already have. A couple of the people I talked with treated me like I was a whining, non-compliant patient who needed to be spoken to in short, carefully-pronounced words. The one I spoke with this morning insinuated that the problem was insurance. I have a diagnosis that connects to a certain code and that code goes with a certain range of braces, and flexibility is not an option.

What remains is for me to find a brace online and pay for it out of pocket. The braces that I think my surgeon has in mind are too expensive ($550 and above) but I can find some in the $200-300 range that might work. The key features I need are a hinge that prevents hyper-extension and a rigid frame to maintain alignment. I hate to spend more when we’ve paid off the high deductible on our insurance plan for the year, but I don’t see another option.

If it’s this difficult to get a medical device when the product isn’t cutting edge technology — in the US and with good health insurance — how can I be optimistic about wide usage of bionics beyond the military and industry? I read articles like this 2010 piece from Fast Company, Bionic Legs, i-Limbs, and Other Super Human Prostheses You’ll Envy, and I have such mixed feelings. The article cites a gruesome profit motive for creators of kickass prostheses: the increasing number of lower limb amputations due to skyrocketing incidence of diabetes. Awful. But then I think about how medical costs are inflated, looking at things like the prices for knee braces like the one I need,and I wonder how many of those diabetic patients will even have a chance at the sparkly new technology. Diabetes and poverty are positively associated, so many of the people expected to need amputations are also those with the most restrictive health insurance, least ability to shop around for a doctor, and often, challenges with time and transportation that make treatment compliance more difficult. My father-in-law had a prosthetic leg. It was a heavy, uncomfortable, painful piece of crap. My guess is that’s what most poor and many middle-class amputees can expect for many years to come.

I now look at the thrilling videos of bionic prosthetic developments the way I look at Top Gear supercar reviews. I can appreciate the science, technology, and design that went into them, and I can envy the few that get to have them, but I don’t expect to see any in my neighborhood.

 
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Posted by on September 22, 2015 in Health - Mental & Physical, Transhumanism

 

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Watching “The Incredible Bionic Man”

Yesterday I watched The Incredible Bionic Man on Netflix. It’s a strange Smithsonian Channel documentary from 2013: a group of scientists gathered state-of-the art bionic parts and assembled them into a “man”. The results aren’t completely successful, but as a mainstream introduction into what’s possible in bionics now and coming in the near future, it’s not bad. Here’s the trailer.

There were a few things I liked. The main doctor in the film — Dr. Bertolt Meyer — has a bionic hand. His reaction when he tries a new prototype is fantastic.  A scientist making bionic ankles reveals that he has two bionic legs and claims he wouldn’t want real ones if a wish could grant them. “Normal bodies are boring.” And, the film does bring in someone to be the voice of ethics, to ask questions about human life extension, whether it’s ok if only the rich can afford bionics, and what we will do when people want to remove undamaged parts to upgrade to bionics. He doesn’t answer them, but at least he raises them.

On the other hand, the show overuses the concept of Frankenstein’s monster.  The central idea of building a man from bionic parts — would it have some sort of life? — is quite silly, though effective for showing just how many parts of the human body can be replaced by machines. The short section where they had the creature talk, probably using text-to-speech, was not as funny as they seemed to think it was.

I love my prosthetic hip joint so much that I’ll confess, I daydream about having all my other problematic parts replaced.  Left elbow, left shoulder, whole right foot, maybe the other hip, and hey, can you do something about the tendon in my right hand that keeps getting tendonitis?  However, my father-in-law had a prosthetic leg and it was terribly awkward, uncomfortable, and often painful. The bleeding edge tech in this documentary is not available to most people, nor will it be soon.

Take a look if you have Netflix or you can see a few more short clips on the Smithsonian Channel page about the show.

 
 

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Wednesday films: NOVA ScienceNow on humanoid robots

I was thinking about robots this morning, but I couldn’t choose just one video to share.  So, below are two videos from NOVA ScienceNow: a documentary from last year about the future of humanoid robots, and a program segment that profiles Cynthia Breazeal — founder of JIBO — and her work to develop friendly robots at MIT.  Careful clicking away the overlay ads on the first video (ugh! sorry) and the second video should start at the 28:13 mark; you might need to sit through a few seconds of another segment before the player gets there.

 

 
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Posted by on February 4, 2015 in Our Robot Overlords

 

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Dean Kamen introduces mind-controlled prosthetic arm

Though this has been the prosthetic hand top in my thoughts for the past few weeks, it might be supplanted.

Jaime Lannister's golden hand

Sure, the Segway is the butt of many jokes, but Dean Kamen still impresses the hell out of me. My RL stepson had a rare period of initiative and teamwork when he participated in the FIRST Robotics Competition that was founded by Kamen. Kamen has been devoted to inventions to improve the quality of life for people who face physical challenges for decades.  Now, the Luke arm (yes, named after another amputee familiar to many of us) developed by his company, Deka Research & Development, just received FDA approval. What makes this arm unique? It’s a hell of a lot more useful than the gear the Kingslayer is rocking.  It’s bionic, mind-controlled, and capable of dexterity and pressure delicacy that other models lack.

The Luke arm has been in development for a long time —  Kamen spoke about the arm in a 2007 TED talk — and with a target userbase of disabled veterans, DARPA provided $40 million in funding toward the project.

I find it inspiring to see this sort of manual dexterity in a prosthetic, and not only because I get to spend a lot of this month in physical therapy for a shoulder injury. We’ve come a long way since replacement simply for aesthetics or the crudest of functionality. I’m hopeful that pushing the standard higher for top-notch, cutting edge prosthetics will have a bar-raising effect so that even those who aren’t wealthy or in special populations (veterans, athletes) will see the quality of their options improve.

 
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Posted by on May 12, 2014 in Health - Mental & Physical

 

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Robotics for mobility assistance

A mind-controlled exoskeleton piloted by a paralyzed person is scheduled to make the ceremonial opening kick at the World Cup this June. There is some skepticism in the article I linked, but it could bring the idea of assistive robotics to a huge audience.

There are a number of companies and research organizations working on robotic walking solutions, some seeing them as useful in rehabilitation therapy, to augment strength for healthcare, military, and manufacturing uses, or to replace a wheelchair.

HAL by Cyberdyne

HAL by Cyberdyne

I’ve embedded a couple of demonstration videos that focus on mobility below. This is of personal interest, since I’ve used a wheelchair and still use a cane when I’ll be walking for more than an hour, and I’d like to see a future where a supportive external device could keep me upright and mobile.  I’d much rather be on my own feet than in a medical scooter or chair, as long as possible.



 
 

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Cybalthon 2016

Via io9, the first championship for tech-assisted athletes will be held in Zurich in 2016. Awards will be given both to the “pilot” of the prosthesis (the parathlete) and the company/organization that provides the winning device. Prototypes as well as commercially available devices can be used.

Perhaps competitions like this can drive technical innovation in cybernetic prostheses like the new Formula 1 rules are spurring innovation in automotive energy use. I certainly hope so.  Read more at the official Cybathlon website.

 
 

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Prosthetic history

io9 published a photographic history of prostheses yesterday, going back to an iron arm from the 1500s. Some of them are quite beautiful, like this Victorian hand:

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Mechanical and electronic enhancement of the human body fascinates me.  I’m interested in how the prosthetic part is (or is not) incorporated into a person’s proprioception and sense of self. I’m curious about the possibilities for enhancement beyond human standard abilities.

I have a hidden prosthetic: an artificial hip joint. It’s purely mechanical and attached to my bones. I walk a little strangely and my hip is often sore, but that was true before the surgery too. The process of incorporating the prosthetic into my selfhood was barely different from accepting a dental filling as part of my tooth; it’s invisible to me and except for when I notice some stiffness or that eight inch scar, I forget about it.  That’s dramatically unlike someone with an external prosthesis.

Like the experience of presence in a virtual world, incorporating a prosthetic is the extension of the self into the inanimate, mechanical or digital. However, I think there’s a risk in getting too philosophical about it, as that’s not a uniquely human characteristic. We successfully equip a wide variety of animals with prosthetic limbs. Perhaps we’re simply designed to make the best of the situation in which we find ourselves.

 

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