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Man saves wife’s sight by 3D printing her brain tumor

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Re: Man saves wife’s sight by 3D printing her brain tumor

#91

Post by endtime »

Shinkei wrote: post #88

Wow... I really hope I didn't get to this thread too late that this just gets buried. This is a classic example of hyperbolic reporting to try and show physicians as some kind of incompetent lot whereas this 'guy working in his basement with passion and talent' figured out how to hack the entire field of Medicine. The fact is, nearly all Meningiomas are treated this way because they are overwhelmingly benign and the…

Whether or not physicians are incompetent doesn't seem to address the result of the very first thing they did:

> So although the first doctors told them to wait, Balzer and Scott sent the MRI results to a handful of neurologists around the country. Nearly all of them agreed that Scott needed surgery.

I've had great doctors and terrible doctors, and the notion that the guy who graduated bottom of his class in medical school can always do better than a smart guy with an internet connection just doesn't pass muster in my experience. Of course some folks take this too far in the other direction, and I have a couple (mainstream, establishment, non-alternative, affiliated-with-big-hospitals) doctors whom I trust very much...but your blanket dismissal of "guy working in his basement" sounds, well, motivated.

Re: Man saves wife’s sight by 3D printing her brain tumor

#92

Post by Shinkei »

jpmattia wrote: post #15

> Balzer used Photoshop to layer the new DICOM files on top of the old images, and realized that the tumor hadn’t grown at all — the radiologist had just measured from a different point on the image. Think about the some of the implications of that statement for a while. It really is no wonder that the softer sciences have a reproducibility problem.

Softer sciences? It was simple human error, not a failing of the science itself. I've made a more extensive post separately, but in short... regulations have slowed the advances that could prevent this kind of human error.

Re: Man saves wife’s sight by 3D printing her brain tumor

#93

Post by Shinkei »

endtime wrote: post #91
Shinkei wrote: post #88

Wow... I really hope I didn't get to this thread too late that this just gets buried. This is a classic example of hyperbolic reporting to try and show physicians as some kind of incompetent lot whereas this 'guy working in his basement with passion and talent' figured out how to hack the entire field of Medicine. The fact is, nearly all Meningiomas are treated this way because they are overwhelmingly benign and the…

Whether or not physicians are incompetent doesn't seem to address the result of the very first thing they did: > So although the first doctors told them to wait, Balzer and Scott sent the MRI results to a handful of neurologists around the country. Nearly all of them agreed that Scott needed surgery. I've had great doctors and terrible doctors, and the notion that the guy who graduated bottom of his class in medical…

>A handful of Neurologists around the country.

But this is where we don't get the whole story; A handful of Neurologists could also be wrong but still have consensus. I want to see the reasoning behind their decisions because if an incomplete history was fed to these physicians, then of course they would come to the same conclusions. There could be selection bias, confirmation bias... all kinds of confounds that went into this. It's the classic '4 out of 5 doctors recommend X,' a statement that's meaningless.

Again, as I've said in a longer comment in this thread, there is a spectrum of competence in ANY field, but Medicine is very unique because there is a lot of broad knowledge that goes into the decision making process. Our jargon is immense for a reason, there's a lot of data that must be integrated. Whenever I read an article like this, I know I'm not getting the whole story because certain facts don't line up. Not to mention, I'd like to see the actual Pathology report because I don't buy the whole 'invading' the optic nerve statement. It sounds like something a surgeon would say immediately after the procedure like, "Wow, I'm glad we decided to do this, otherwise it would've been bad." It's screaming of confirmation bias.

Re: Man saves wife’s sight by 3D printing her brain tumor

#94

Post by toomuchtodo »

tsax wrote: post #70
jkokenge wrote: post #40

Earlier quoted context omitted.

It seems that health care professionals don't have a nuanced problem solving attitude. They make a diagnosis, see how this diagnosis fits into a preconceived treatment bin, then just solve from that position without understanding what's different, what's unique to each case. And, in their defense, they probably just don't have the time for that extra work. That's where I see technology as most useful....how to automa…

I come from a long line of docs, though I'm a software dev. Let me tell you that the vast majority of patients can easily be sorted into these pre-formed category bins. Rare conditions are rare by definition. Most of medicine is dreary repetition.

> Most of medicine is dreary repetition.

Hence why we can automate away most of the problems with it.

Re: Man saves wife’s sight by 3D printing her brain tumor

#95

Post by mzs »

mcmancini wrote: post #19

I coauthored a paper a few years ago on the intra-observer variability of measurements of brain tumors when using the bidimensional product. An increase of 25% in the BP is taken as an indicator of brain tumor progression. We found that the intra-observer variability is so high, you can get that 25% increase purely by chance. The first recommendation of the medical team, to wait and see, is understandable.

A terrible aspect to this is that the criteria from utilization management often list a minimum tumor size or showing growth and that same technique is used.

Re: Man saves wife’s sight by 3D printing her brain tumor

#96

Post by mzs »

Shinkei wrote: post #93
endtime wrote: post #91

Earlier quoted context omitted.

Whether or not physicians are incompetent doesn't seem to address the result of the very first thing they did: > So although the first doctors told them to wait, Balzer and Scott sent the MRI results to a handful of neurologists around the country. Nearly all of them agreed that Scott needed surgery. I've had great doctors and terrible doctors, and the notion that the guy who graduated bottom of his class in medical…

>A handful of Neurologists around the country. But this is where we don't get the whole story; A handful of Neurologists could also be wrong but still have consensus. I want to see the reasoning behind their decisions because if an incomplete history was fed to these physicians, then of course they would come to the same conclusions. There could be selection bias, confirmation bias... all kinds of confounds that went…

The reason may have been that they tend to grow slowly but considering her age it was likely to grow. Another alternative to monitor or surgery may have been radiation, but again age plays a part. In the end it is supposed to be an informed decision by the patient after exploring all treatments. In this particular case there may have been high risk of leaking CSF with risk of meningitis for example with the new approach used. But we do not have all the details, it's exciting though anytime there is a new approach other than craniotomy developed.

Re: Man saves wife’s sight by 3D printing her brain tumor

#97

Post by Gatsky »

Karunamon wrote: post #77
stefantalpalaru wrote: post #32

Alternate title: Man encourages his wife to go through unnecessary surgery for a benign and symptomless meningioma after she had an unnecessarily complicated thyroid removal in order to avoid a 4cm scar on her neck. Oh, he also made a shitty 3D model of her skull in the process.

Did we read the same article? The neurosurgeon discovered that the tumor was starting to entangle her optic nerves, and told her that if she had waited six months, she would have had severe, and possibly permanent, degradation of her sight. Because I'd really like to think you're being this insensitive out of ignorance, rather than malice.

I have to say that MRI is usually very good at detecting optic nerve impingement, so this 'crucial' point which is reported third hand deserves some skepticism.

Re: Man saves wife’s sight by 3D printing her brain tumor

#98

Post by ivanca »

Shinkei wrote: post #88

Wow... I really hope I didn't get to this thread too late that this just gets buried. This is a classic example of hyperbolic reporting to try and show physicians as some kind of incompetent lot whereas this 'guy working in his basement with passion and talent' figured out how to hack the entire field of Medicine. The fact is, nearly all Meningiomas are treated this way because they are overwhelmingly benign and the…

>"skill is in their muscle memory "

Muscle memory (Fine motor memory in this case) only develops for movements that are repeated many times per day, usually in continuous succession, such as typing, piano playing, guitar fingering, etc.

Medicine is extremely imprecise, and is understandable because our bodies are extremely complex machines; but pretending is not imprecise is doing medical science a disservice.

Just as a data point some doctors believe Fibromialgia is a fake disease, that is completly psychological, but the reason for this is because they cannot test pain and pain (and sleepiness) is the only symptom in that disease. The proble is that pain is still something subjective, even for things like amputation there is no way to actually measure pain, we just know is painful because when it happens the amputee screams -or faints-. But despite being -arguably- the most important measure in medicine we still don't know how to measure it beyond what the patient says.

Also, other reason we know is imprecise is because people recovers from things doctors didn't believe it was possible to recover (e.g. https://www.youtube.com/watch?v=KbVpCc_r9Sw)

Re: Man saves wife’s sight by 3D printing her brain tumor

#99

Post by Gatsky »

I can't be sure from just a photo, but the I suggest that the procedure wasn't completely without side effects. Her left eye is not symmetrical with the right, and the left eyebrow is elevated. This could represent some degree of peri-orbital muscle dysfunction due to the procedure damaging the nerves that supply those muscles. This could improve with time, not sure how long after the surgery this photo was taken. Even if it doesn't, you could say it is a minor side effect compared to losing your vision, but as Shinkei and others have pointed out, it isn't clear whether the vision was really in danger. Takes some of the shine off I suppose...

Re: Man saves wife’s sight by 3D printing her brain tumor

#100

Post by Shinkei »

ivanca wrote: post #98
Shinkei wrote: post #88

Wow... I really hope I didn't get to this thread too late that this just gets buried. This is a classic example of hyperbolic reporting to try and show physicians as some kind of incompetent lot whereas this 'guy working in his basement with passion and talent' figured out how to hack the entire field of Medicine. The fact is, nearly all Meningiomas are treated this way because they are overwhelmingly benign and the…

>"skill is in their muscle memory " Muscle memory (Fine motor memory in this case) only develops for movements that are repeated many times per day, usually in continuous succession, such as typing, piano playing, guitar fingering, etc. Medicine is extremely imprecise, and is understandable because our bodies are extremely complex machines; but pretending is not imprecise is doing medical science a disservice. Just a…

I'll concede almost everything you've said, especially regarding our knowledge of 'psychosomatic' diseases and pain.

However, I watched part of that video and the moment you hear "doctors said I would never walk again," your skepticism alarm should go off immediately.

There is a huge spectrum of spinal cord injury and some are reversible, some are irreversible and then there's a huge uncertain territory in between. Usually these cases are the result of miscommunication between a doctor and patient. Of course, it could be that their initial doctor was incorrect or incompetent... but I think miscommunication is a lot more common.

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