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The DIY Dialysis Machine

Posted by samzenpus on Wed Aug 06, 2008 02:03 PM
from the oh-so-cleansing dept.
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Millie Kelly was born with a condition that required an immediate operation. During this operation her kidneys started to fail and since she was too small for dialysis machines, doctors told her parents that she was unlikely to live. Luckily for Millie, Dr. Malcolm Coulthard and a colleague tried to build a much smaller kidney machine on their own and they were successful. Her mother said, "It was a green metal box with a few paint marks on it with quite a few wires coming out of it into my daughter - it didn't look like a normal NHS one." The girl was hooked up to the machine over a seven day period to allow her kidneys to recover. Two years later, her mother Rebecca says she is "fit as a fiddle." You should see what Dr. Coulthard can build using a postage stamp, a tuning fork, a lawn chair and a jellyfish.
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  • WTF? (Score:5, Insightful)

    by Anonymous Coward on Wednesday August 06 2008, @02:06PM (#24501039)

    Don't put pictures with stories unless you're going to take being a news organization seriously, with you know, editing and responsibility.

  • Unless (Score:5, Funny)

    by Capt James McCarthy (860294) on Wednesday August 06 2008, @02:06PM (#24501055) Journal

    Chewing gum was used, he's got nothing on Macgyver.

  • Wow (Score:5, Insightful)

    by Anonymous Coward on Wednesday August 06 2008, @02:08PM (#24501077)

    Sadly, this would have never happened in the US. The malpractice liability would be too great.

    • Re:Wow (Score:5, Interesting)

      by UnknowingFool (672806) on Wednesday August 06 2008, @02:37PM (#24501571)

      You might be right there that in the US there are obstacles to cutting-edge medicine. At Toronto's Hospital for Sick Children, they've been doing cross blood type transplants for years [cbsnews.com] for newborns. At first one would think that it violates a rule of basic organ transplants that the blood types must match. But what they've found is that newborns have not yet developed the antibodies that would cause rejection. The first child to have the operation was 7 as of the report in 2004.

      These kinds of transplants were necessary because of the scarcity of donor organs and only performed when there were no other options. First of all, most parents, understandably, do not want to/do not think to donate the organs of their new infant out of grief. Secondly, most newborns die of diseases that might cause them to be eliminated for consideration. Lastly, infants when born are different sizes and their organs also vary in size. Getting a suitable organ that was an exact blood and size match is extremely difficult.

    • Re:Wow (Score:5, Interesting)

      by jbeaupre (752124) on Wednesday August 06 2008, @02:53PM (#24501819)

      Not really. It is judged against standard of care. If, as in this case, the standard of care is to wait for the patient to die, then anything that doesn't make things worse could be ok.

      On a related note, I worked on a dialysis project. The method was so simple, cheap and easily duplicated (unpatentable), we couldn't figure out how to justify working on it as a company (and we really tried). So we donated the research and a large wad of cash to an outside researcher we had hired as a consultant. He was enthusiastic because he was tired of traditional methods failing his patients (literally telling parents their kids had a week to live). I have no doubt that he would seriously consider using this alternate method rather than watch a patient die, and this is a method far less proven than traditional dialysis. And I firmly believe parents would be eternally grateful for him taking the chance. If this doc ever thought of liability, it was the liability of losing a bit of his soul if he didn't do everything he could for a patient.

    • Re:Wow (Score:5, Interesting)

      by Marillion (33728) <ericbardes@gmailERDOS.com minus math_god> on Wednesday August 06 2008, @03:53PM (#24502745)

      Well, yes and no.

      Quite often pediatricians are at the mercy of the equipment makers. One of the doctors at the pediatric hospital where I work explained an example: They bought an MRI machine. The machine needs to know the patient weight so that it can make adjustments to energy levels accordingly. The machine as installed refused to allow patient weights under about 6 pounds (3kg). They went back and forth with the manufacture. The manufacturer was like "Who's under 6 pounds?" The hospital was like "We have a level 3 neo-natal intensive care unit. On any given week, we have dozens of patients under six pounds."

      • Re:Wow (Score:4, Insightful)

        by MobyDisk (75490) on Wednesday August 06 2008, @02:21PM (#24501319) Homepage

        Caps would be great, but there is something fundamentally wrong with society if someone could sue the doctor when the child was going to die anyway.

        In theory, there would be no standing to sue under the good samaritan laws.

        • Re:Wow (Score:5, Insightful)

          by EvanED (569694) <evaned@gmailPLANCK.com minus physicist> on Wednesday August 06 2008, @02:27PM (#24501401)

          In theory, there would be no standing to sue under the good samaritan laws.

          Except for the fact that they are being paid to provide care, which means that the Good Samaritan laws don't apply.

          See Wikipedia [wikipedia.org]: "As a result, medical professionals are typically not protected by Good Samaritan laws when performing first aid in connection with their employment."

          I still think they would be able to get away with it given the proper contracts, otherwise you wouldn't see other "last ditch" attempts.

      • Re:Wow (Score:5, Insightful)

        by UdoKeir (239957) on Wednesday August 06 2008, @02:41PM (#24501629)

        We had tort reform for just such a thing here in Texas. Neither my insurance premiums nor healthcare costs have been reduced.

      • Re:Well, maybe, but (Score:5, Informative)

        by VJ42 (860241) * on Wednesday August 06 2008, @03:50PM (#24502667)
        This happened here in the UK, we have the NHS [wikipedia.org]. Indeed this appears to have been done by a doctor working in the NHS.
          • by 19061969 (939279) on Thursday August 07 2008, @01:57AM (#24507093)

            "Problem is you're in England. You're stuck with socialized health care."

            First, it's the United Kingdom, not England. Second, a national health service is not "socialised medicine". Socialised medicine is just perjorative spin used by heavy investors in healthcare to ensure that their profits remain uninterrupted. What the NHS is, is a national health service funded by tax contributions. Roads in the US are paid for by taxes. Does this mean you have a "socialised transport network"? Third, if you don't want to use the NHS, you can go private and be seen immediately, in the UK. There are plenty of private healthcare facilities along with various plans, insurance policies etc. Fourthly, the NHS appears to deliver higher quality treatment for a lower cost than in the US and for many conditions (eg, cancer) there is no waiting. Still, who cares about the health of a nation when shareholder value is booming? There is also no wrangling with insurance companies or having to remortgage your house or borrow vast amounts of money with little realistic hope of paying it back.

            Having lived in countries with both a NHS and with entirely private healthcare, I can say from sore personal experience that I would take the NHS every time.

  • by loonicks (807801) on Wednesday August 06 2008, @02:08PM (#24501081)
    now i trust there will be a whole slashdot article category devoted to these girls? i, for one, welcome our new humanoid dialysis-building overlords.
  • Oh come on... (Score:5, Insightful)

    by snl2587 (1177409) on Wednesday August 06 2008, @02:08PM (#24501097)
    Is the picture really worth a thousand words? I think the summary is more than enough.
  • by philspear (1142299) on Wednesday August 06 2008, @02:09PM (#24501101)

    You should see what Dr. Coulthard can build using a postage stamp, a tuning fork, a lawn chair and a jellyfish.

    Indeed, I SHOULD see that. What the hell DOES the good doctor make out of those things?!?

    • by DeadDecoy (877617) on Wednesday August 06 2008, @02:13PM (#24501189)
      Doctor Who?
    • by sm62704 (957197) on Wednesday August 06 2008, @02:39PM (#24501599) Journal

      I was rather disappointed. Samzepus goes for some cheap nerdy laughs while neither he nor the article said anything about how a Dialysis machine works, or why a conventional one can't be used on a 6lb baby. Wikipedia says [wikipedia.org]

      In hemodialysis, the patient's blood is pumped through the blood compartment of a dialyzer, exposing it to a semipermeable membrane. The cleansed blood is then returned via the circuit back to the body. Ultrafiltration occurs by increasing the hydrostatic pressure across the dialyzer membrane. This usually is done by applying a negative pressure to the dialysate compartment of the dialyzer. This pressure gradient causes water and dissolved solutes to move from blood to dialysate, and allows removal of several litres of excess fluid during a typical 3 to 5 hour treatment. In the US, hemodialysis treatments are typically given in a dialysis center three times per week (due in the US to Medicare reimbursement rules), however, as of 2007 over 2,000 people in the US are dialyzing at home more frequently for various treatment lengths.[2] Studies have demonstrated the clinical benefits of dialyzing 5 to 7 times a week, for 6 to 8 hours. These frequent long treatments are often done at home, while sleeping but home dialysis is a flexible modality and schedules can be changed day to day, week to week. In general, studies have shown that both increased treatment length and frequency are clinically beneficial.[3]

      Rather than the picture of the mom and her kid, I think a diagram of how one works [wikipedia.org] would be a lot more helpful.

      Not only was the summary bad, TFA was bad as well. Why couldn't a conventional dialysis machine be used? It doesn't say.

      Is there a doctor in the house?

      • by Otto (17870) on Wednesday August 06 2008, @03:14PM (#24502143) Homepage Journal

        Not only was the summary bad, TFA was bad as well. Why couldn't a conventional dialysis machine be used? It doesn't say.

        Is there a doctor in the house?

        Probably not enough blood in the patient.

        Using a dialysis machine means taking a fair amount of blood out of the body, running it through a bunch of tubes, and putting it back.

        This effectively adds a lot of extra volume to the blood system as a whole. Adults can spare some without effect, but children and babies are much smaller, and so you have to have a much smaller device which doesn't have as much volume in it.

  • by vecctor (935163) on Wednesday August 06 2008, @02:10PM (#24501141)

    The picture of the patient is nice and all but the interesting part is the machine, right? I'd like a clear picture of that instead ...

  • Award, and Patant. (Score:5, Interesting)

    by scubamage (727538) on Wednesday August 06 2008, @02:18PM (#24501271)
    The doctors deserve to receive some sort of notice from whatever professional association they belong to, and also a Patent for the smaller size machine that they created. Thats some pretty amazing work - and they already have a human test trial to back it.
  • by zerofoo (262795) on Wednesday August 06 2008, @02:37PM (#24501563)

    put my menial, insignificant, network admin job into perspective. Dr. Malcolm Coulthard is a brilliant man, and he is saving lives.

    We should all try to be like this man.

    -ted

  • Not News (Score:5, Funny)

    by Thelasko (1196535) on Wednesday August 06 2008, @02:45PM (#24501685) Journal
    MacGyver did it in season 5 episode 5 "Second Chance" way back in 1989. He must have taped it and copied MacGyver's design.
  • by hey! (33014) on Wednesday August 06 2008, @02:59PM (#24501923) Homepage Journal

    It's got to take serious balls to whip something like this up and plug somebody's baby into it, even if the baby was going to die.

  • Get a grip people (Score:5, Insightful)

    by msoori (614781) on Wednesday August 06 2008, @04:09PM (#24502959)
    This is a great story and its sad how people are making rude comments about the mom. If you had a dying child, you were helpless and couldn't do anything to help save the child, you'd be like that too. So, please be a bit more sensitive about others. Regardless, this is something that can save the life of these insensitive people's children too if needed (if they are able to reproduce in the first place!) Give the guy some credit doing the best as a doctor to save a life.
      • I thought women put on weight during pregnancy?

        Only if you count the baby. This idea that women gain ten pounds during pregnancy is a fallacy that was propogated, in part, by an early belief in the medical establishment that women needed to gain weight for a healthy pregnancy. Once that idea was disproven, fewer women forced themselves to gain weight during pregnancy.

        In fact, most women only experience a mild increase in food intake while pregnant. My understanding is that it's more important to pay attention to sudden food cravings, as those are often signs of missing minerals and vitamins. (e.g. my wife wanted bananas while she was pregnant)

        • by B Nesson (1153483) on Wednesday August 06 2008, @02:48PM (#24501741)
          It was my experience when I became a vegetarian that paying attention to cravings was just good practice in general. Not necessarily caving in to them all the time, but to this day, if I'm really craving a bean burrito, I know I could probably use more protein.
          • by cream wobbly (1102689) on Wednesday August 06 2008, @05:05PM (#24503655)

            Just want to add weight and detail to this. My wife and I are vegan, and we both pay attention to our cravings. Not that we get them very often, because our diet is varied and nutritionally rich. Of course, while my wife was pregnant, she had seemingly odd cravings -- "get me veggie jerky or leafy greens" was one of the strangest, until we realised they both have very high iron content. What were stranger still though were my parallel cravings, and later lack of appetite. We're convinced it's a survival trait for bonded pairs: male senses pregnant female craves something, craves it himself, goes fetch, can't eat, gives away.

            Humans are pretty awesome apes.

        • by geekoid (135745) <dadinportland.yahoo@com> on Wednesday August 06 2008, @02:51PM (#24501779) Homepage Journal

          That's not true.
          A healthy woman who is the normal weight for her height can gain 25-35 pounds. This is normal.
          Baby weighs 5-10 pounds.

        • by hansamurai (907719) <hansamurai@gmail.com> on Wednesday August 06 2008, @02:52PM (#24501805) Homepage Journal

          What? When a woman is pregnant she is not only carrying a baby, but a very large uterus, enlarged breasts, and probably other stuff that I can't remember. Maybe your wife only gained the baby's weight but that honestly sounds unhealthy for the mom and child as she was net losing weight during the pregnancy due to other things adding necessary mass.

          And if you could tell me what minerals and vitamins are in chocolate fudge brownies (my wife's latest craving at 7 and a half months) I'd love to know.

          Maybe you have info to back your claims up, but none of this is in line with my current experience.

          • When a woman is pregnant she is not only carrying a baby, but a very large uterus, enlarged breasts, and probably other stuff that I can't remember.

            I'm counting that toward the baby weight as most of that stuff will be gone as soon as the baby is born.

            Here's the Mayo Clinic page on weight gain during pregnancy. [mayoclinic.com]

            Here's the breakdown:

                    * Baby: 7 to 8 pounds
                    * Larger breasts: 1 to 3 pounds
                    * Larger uterus: 2 pounds
                    * Placenta: 1 1/2 pounds
                    * Amniotic fluid: 2 pounds
                    * Increased blood volume: 3 to 4 pounds
                    * Increased fluid volume: 2 to 3 pounds
                    * Fat stores: 6 to 8 pounds

            Here's the information on how much your caloric intake needs to increase:

            If you start out at a healthy weight, you need to gain only a few pounds in the first few months of pregnancy. You can do this with an extra 150 to 200 calories a day, about the amount in 12 ounces of calcium-fortified orange juice or a serving of low-fat yogurt. A normal appetite will typically provide these calories.

            Steady weight gain is more important in the second and third trimesters -- especially if you start out at a healthy weight or you're underweight. This often means 3 to 4 pounds a month until delivery. An extra 300 calories a day might be enough to help you meet this goal.

            Emphasis is mine.

            The expectation is that once the baby is born, the remaining weight will disappear on its own through a normal diet. Much of the extra fat put on supports breast feeding of the child. Once weened, many women actually find themselves slightly lighter than they were before, even if they were not overweight. (Which is also what happened to my wife. ;-)) I've heard some women refer to pregnancy as a good way to shed the pounds. I don't recommend it, but it does seem to work.

        • by drerwk (695572) on Wednesday August 06 2008, @03:07PM (#24502055) Homepage
          Sorry AKA - very much depends on starting size.
          http://www.babycenter.com/pregnancy-weight-gain-estimator [babycenter.com] Pregnancy weight gain estimator
          Estimate for my wife:

          You should gain roughly 25-35 lbs. during your pregnancy. Over the last two trimesters you should gain about 4 lbs. every 4 weeks. How it breaks down If you gained the average of range above, this is where the weight would go (totals are rounded): Maternal: Uterus 2.39 lbs. Breasts 1.0 lbs. Blood 3.09 lbs. Water 4.15 lbs. Fat 8.27 lbs. Subtotal 18.89 lbs. Fetal: Fetus 7.5 lbs. Placenta 1.6 lbs. Amniotic Fluid 1.97 lbs. Subtotal 11.07 lbs. Total 29.96 lbs.

          And even though you are posting on /. - I'll trust the baby center site over your own experience.

    • by fumblebruschi (831320) on Wednesday August 06 2008, @02:33PM (#24501499)
      If you'd RFTA (but why should you be different?) you would have seen that the UK, just like the US, does indeed have miniature dialysis machines designed for children. However, this child -- weighing less than six pounds at birth -- was too small to use them. Not just the UK ones -- she was too small to use any existing dialysis machine anywhere in the world.

      So, had this happened in the US, she would have been OK, just as long as she had a doctor who was willing to spend his own time and his own money inventing a new machine and building it himself in time to save her life.
      • STFU (Score:5, Insightful)

        by an.echte.trilingue (1063180) on Wednesday August 06 2008, @02:35PM (#24501529) Homepage
        I have mod points, but I would rather say something.

        That is a beautiful woman with a happy, healthy child child. Get out of your make-believe Hollywood world and into the real one. I for one, saw the picture and thought it was sweet.
      • by sjbe (173966) on Wednesday August 06 2008, @02:55PM (#24501845)

        Hate to feed the trolls here.

        Hate to break it to you but YOU are a troll.

        But if you're going to post a picture, at least have it be of an medium attractive woman.

        I always find it amazing that guys who are rather hideous themselves (Howard Stern I'm looking at you) seem to feel it is their job to criticize the appearance of women. It's especially comical here on a website devoted to nerd news where most of the readership wouldn't have any idea how to please a woman [google.com]. Here's a clue - no one cares what your ugly ass thinks of someone else's appearance. If you feel the need to criticize you had better be a model yourself. Given that you are posting here on Slashdot that's pretty unlikely - so kindly shut the hell up.

        • by Anonymous Coward on Wednesday August 06 2008, @03:30PM (#24502389)

          ...you had better be a model yourself. Given that you are posting here on Slashdot that's pretty unlikely...

          As a 26 year old model and C coder, and grandmother of three, I am offended by your comment.

          • by sjbe (173966) on Wednesday August 06 2008, @05:27PM (#24503865)

            i had some pretty awful pizza last night but since i'm not a chef I can't really say anything about it.

            Sure you can because the chef can do something about how he cooks. Bad cooking can be a mistake and can be corrected. But if you call someone ugly in public because they didn't win the genetic lottery THEN you are just an ass.

    • Re:too big? (Score:5, Informative)

      by 0100010001010011 (652467) on Wednesday August 06 2008, @02:39PM (#24501595)

      There might have been a minimum flow required to push blood across the cleaning medium. Given how small she was, she might not have had enough blood in her entire body to even use the larger machine.

      An electrical analogy: Say you have electrons you want to flow from A to B. If you use a wire too thick in diameter all the current is going to go into resistance of the wire. This girl's current source wasn't powerful enough to drive electrons through the wire, so the doctor swapped in a thinner wire.

      And since this is slashdot, a car analogy: Turbo chargers work by using exhaust air to spin a turbine which spins a compressor to compress incoming air. If you put a massive turbo on a small car, there wouldn't even be enough air to spin the blades. So you have to get a smaller turbine.

      • Re:too big? (Score:5, Insightful)

        by onkelonkel (560274) on Wednesday August 06 2008, @03:14PM (#24502153)
        Your electrical analogy is as good as any slashdot analogy. It would, however, make a lot more sense if you swapped thicker/thinner, since that is how resistance works.
    • by Bearpaw (13080) on Wednesday August 06 2008, @02:53PM (#24501809)

      ...you should see what miracles occur when you're not oppressed by an onerous "single-payer" socialist-welfare-state "health" care system like the NHS.

      Infant mortality rate in the US: 6.3 per 1,000 live births
      Infant mortality rate in the UK: 4.9 per 1,000 live births

      Personally, I'd rather not see the "miracle" of more dead babies.

      • by meringuoid (568297) on Wednesday August 06 2008, @04:48PM (#24503491)
        and to rub it in a bit more, the USA spends a higher percentage of it's GDP than any other country (something like 15% I believe), and the UK spends just 6% of it's GDP on healthcare.

        You've got to be kidding. They spend MORE than we do? I'd got the idea that they put up with having no health service because it meant they could spend more money on, er... I think the term they use is 'defending freedom'. I'd never imagined they spent anything like as much. I mean, the common wisdom in the UK is that the NHS is a colossal money pit. The American system is even more expensive?

        Jesus. So, 15% GDP in the US, versus 6% in the UK... and adjust for the higher per capita wealth of the US... that's just horrible. Where the hell is all the money going?

        • by GameMaster (148118) on Wednesday August 06 2008, @05:01PM (#24503627)

          It's going to our emergency rooms. All the people without decent health insurance are forced to rely on emergency room care for medical issues that could be handled, at a vastly lower cost, by a general practitioner. Also, they tend to let what start out as minor medical issues progress far longer because they can't afford to get them treated until an emergency room would deem it bad enough to deal with. That's the hidden reason why socialized healthcare ends up saving money overall, you get to take advantage of preventative medicine and catch issues early before the cost to treat them skyrockets.

          • EMTALA (Score:5, Insightful)

            by raygundan (16760) on Wednesday August 06 2008, @06:10PM (#24504287) Homepage

            You're absolutely right. EMTALA essentially created universal healthcare in the US by making it illegal for an emergency room to refuse to treat someone based on their ability to pay. This is (in my opinion) a worthwhile goal, but one which is terribly inefficient with health-care money if not backed by a socialized healthcare system at the same time.

            If you've got no healthcare, but get sick, you can roll into the ER for free treatment. Of course, ER care is an order of magnitude more costly than care from a family doctor, and does not include checkups, history, or preventative care that could have avoided the issue in the first place. It also requires that you wait until your condition is far enough gone that it constitutes an emergency, likely making things more difficult and expensive to treat.

            So we pay for healthcare for everybody, except we do it as inefficiently as possible, tying up ER doctors, nurses and facilities with things that should have been taken care of at a tenth the cost elsewhere, earlier, and without occupying a bed somewhere at a facility designed for broken bones and heart attacks, not festering infections you should have had cleaned up a year ago.