15-Year-Old Boy Fitted With Robotic Heart 241
An anonymous reader writes "What do you do when a 15-year-old boy is close to death and ineligible for a heart transplant? If you're Dr. Antonio Amodeo you turn to an artificial solution and transplant a robotic heart, giving the boy another 20-25 years of life. The Italian boy in question suffers from Duchenne muscular dystrophy, which rapidly degenerates the muscles and eventually leads to death. Having such a disease renders the boy ineligible for a heart transplant, meaning almost certain death without an alternative solution. Dr. Amodeo found such an alternative in the form of a 90-gram, fully-robotic heart that took 10 hours to fit inside the boy's left ventricle. It is a permanent solution offering as much as 25 years of life and is powered by a battery worn as a belt."
Artificial hearts (Score:2)
Such a heart was a big part of one of the worst episodes of Star Trek: the Next Generation [memory-alpha.org] evar!
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Oh, I should also point out it was a big part of one of the best episodes [memory-alpha.org] evar too.
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That brings up another point; how come Paramount hasn't put ST:TNG up on iTunes? Everything else Trek is there
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That wasn't in Samaritan Snare.
25 years is permanent? (Score:2, Troll)
Re:25 years is permanent? (Score:5, Insightful)
because they seem to be wholly serious on their usage of the term "permanent"... which would imply to me that it should be lasting a heckuva lot longer than until he's forty.
He has a form of muscular dystrophy. They can't replace all his other muscles too and he'll eventually succumb to other problems related to MD. When you're one foot inside Death's doorway at 15, a solution that keeps you alive until ~40 is pretty darn permanent.
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Too bad we are not closer to the prosthetic body idea from Ghost in the Shell. Even if in the experimental stages, this boy might sign up for the chance at a longer life.
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This is one of the first steps to such a device. It's pretty damn amazing. I guess the "only" thing you'd need when it comes down to it, is something that replaces the whole body, provides sugar to your brain, and links up to the brain or the top portion of the spine. I wonder how the brain would react when it can no longer control or receive information from the heart and the various chemical systems around the body, and whether those things need to be emulated to stop your brain from spazzing out..
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He has a form of muscular dystrophy. They can't replace all his other muscles too and he'll eventually succumb to other problems related to MD.
True. This is an unusual case of muscular dystrophy, because in the most common forms, Duchenne's and Becker's, they have heart muscle abnormalities, but they don't have heart failure. A bigger problem is failure of the muscles that drive the lungs, which is a common cause of death.
Muscular dystrophy affects all the muscles in the body. It's usually due to a mutation in the dystrophin gene. Dystrophin is the protein that connects the actin protein to the muscle cell membrane http://jennyndesign.com/DMD/phys [jennyndesign.com]
Re:25 years is permanent? (Score:5, Insightful)
I would think that a medical solution that qualifies as "permanent" ought to be one that would at least have the capability of lasting long enough for a normal human life span
On the other hand, it's also something they aren't going to be looking to replace before it's in danger of wearing out.
A blue tarp is a 'temporary' solution to a damaged roof. Fixing the roof and replacing the shingles is a 'permanent' solution, in that you're not normally going to be replacing the shingles again until they're damaged or wear out.
I'm a bit surprised, last I remember they only had the one artificial heart and it was a 'complete' solution, not something that fits in one valve chamber.
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Not allowed by my HOA. It would have to be a beige tarp.
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Your HOA statement violates the /. basement dwelling tenants. Please turn in your card.
I guess next your going to start talking about wives and children. poser.
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I'm a bit surprised, last I remember they only had the one artificial heart and it was a 'complete' solution, not something that fits in one valve chamber.
Since that time, a variety of Left Ventricular Assist Devices [wikipedia.org] have been invented and put in use. I'm guessing that's what the reporter means by "robotic heart". Unlike the Jarvic, it isn't intended to be a full replacement, but by scaling down the ambition a bit, it has been much more successful.
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Where does it say that the heart is only good for 25 more years? It says that he can expect to live another 25 years. That's how long until they estimate the rest of his body will give out.
Also, there's nothing to stop them putting in another heart.
When they say "permanent" they are mainly drawing a distinction between this and early artificial hearts, which were only stop-gap measures to last until a real transplant heart could be found; typically people on them only had a few days or weeks until they di
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What it basically means is that now it won't be his heart that kills him.
It'll be his lungs, or his intestines, or his stomach, or what have you.
His disease is not limited to his heart, it degenerates all the muscles in his body at the same time. The heart is simply the most critical piece, and was therefore nearing critical failure faster than anything else.
The boy is still not going to get a full life unless a cure is found. However, since he doesn't have his heart to worry about any more, he can expect
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The important word here being "can". There's no guarantee that this heart won't give up, be rejected, or otherwise fail to do its job way before than.
In fact, I'd be pleasantly surprised if this boy lives until the ripe age of 20 -- he's a guinea pig, and can only hope for the best. I salute him for his gamble, trading
Re:25 years is permanent? (Score:4, Informative)
Yes, I believe you missed the part where the disease he has causes the muscles in his body to stop working. It's a fairly safe bet the muscles that work his lungs or digestive system... or pretty much any other part of his body... will stop working before this heart fails. Someone with this disease is "lucky" to make it to twenty.
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the disease he has
This is a side note, but muscular dystrophy is a genetic disorder. I know a lot of people call that kind of thing a 'disease' but that term implies a virus, bacteria, or other etc external agent (even the government spraying Agent Orange) came along and caused it. That doesn't happen with MD. He was just made that way so his condition should be labeled accordingly: a disorder. As in, not ordered correctly.
your concept of disease (Score:3, Informative)
To be more precise disease is where the body's functions are changed resulting in disruption of vital functions. But if the body was always this way nothing has changed so I could see how you might think it's not a disease. But officially MD is a disease. The definition also applied to things like heart disease, which often has a genetic cause.
I suspect that the word "disease" has some connotations for you that don't exist for the rest of us, perhaps you should educate yourself further with a simple diction
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I know a lot of people call that kind of thing a 'disease' but that term implies a virus, bacteria, or other etc external agent (even the government spraying Agent Orange) came along and caused it.
Actually no. Historically "dis ease" as in lack of ease, or discomfort. Which would seem to apply to heart failure. Every modern definition applies either at one end to a unique set of symptoms, or any unique pathological condition resulting in those symptoms.
Its like arguing that people often talk about species of insects, therefore they can't talk about species of bacteria.
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'disease' but that term implies a virus, bacteria, or other etc external agent
The word comes from the 14th century [etymonline.com], before viruses and bacteria were known to be separate causes of sickness than genetic disorders. More importantly though, most people do seem to refer to genetic disorders as diseases. So I'd say no it doesn't.
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With that prognosis, it sounds like an early heart failure is the better way out. I can't imagine having a complete skeletal muscular failure, so you're stuck in bed. Respiratory failure and now you're on a machine to keep you breathing. A feeding tube because you can't swallow. Catheterized and colostomy to capture your waste when you lose control of those functions. Sometimes lucky isn't so lucky for anyone involved.
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It's a lifetime guarantee.
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Nor was I attempting to be funny by objecting at their usage of the word permanent... I was merely puzzled as to how something that could be given ANY particular duration in terms of the amount of time it would last to be a permanent solution. While a permament medical solution may very mean only for the rest of one's life, the term implies that it would last even longer than t
It's life (Score:2)
Everything you do is a stop gap measure - we're not immortal.
Permanent in this case means the same as it does for me or you - until death. Which in this poor kid's definition is most likely shorter than what you or I will get. It's the last artificial heart he'll ever need. So for him, we can say it's permanent. He'll be buried with it.
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EVEYRTHING is a laughing matter. Ask the Jews who survived the Holocaust if they cracked jokes while interned.
Laughter is good medicine too. You should try some of it.
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Normally, such a device will be implanted either to keep the patient alive (hopefully) long enough for a transplant to become available, or to give their own heart time to rest and recover (we now know that can happen), then it will be removed (explanted).
By permanent they mean not to be explanted later, but to remain for the rest of his life.
As Magarity points out, with his form of MD, one may last a lifetime.
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Battery on a Belt (Score:5, Funny)
Re:Battery on a Belt (Score:5, Insightful)
How do you go through life knowing that you are relying on a muscle to beat regularly, every second or two at least, almost without interruption, for more than 2,207,520,000 seconds? Such a minute, weak mass of carbon in a soulless universe, somehow managing to keep itself together for that long... and so many things could go wrong, both within and without.
Yet the majority, while young, neither seem nor need to give it a second thought.
Re:Battery on a Belt (Score:5, Funny)
Dude... I'm counting my heartbeats now. ...
I think the gap between the last two was a little slower.
I hate you.
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>I'd freak out if my heart were powered by something strapped around my waist.
Instead its a muscle powered by a complex metabolic process that requires you to eat food, get proper nutrition, etc. Oh, if you eat the wrong foods it fails early and painfully. Enjoy!
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I'd freak out even more if I were going to die because my heart was gradually eating itself.
Perspective, man, perspective!
Re:Battery on a Belt (Score:4, Insightful)
"I'd freak out if my heart were powered by something strapped around my waist."
Better hope you don't get frisked by an overzealous cop, or a rough TSA agent. There was a /. story many years ago about a guy who sued claiming they tore his "prosthetics" off.
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So to you, the option is to die while waiting for science-fiction to pan out? I'm glad you're that comfortable with your mortality, but it sounds to me this kid will settle for what's possible with today's cutting-edge technology.
I wish I could feel better about this... (Score:3, Informative)
Re:I wish I could feel better about this... (Score:4, Insightful)
Why can't you? Increasing your risk of blood clots or bleeding problems is a lesser problem than "Your heart is about to fail completely."
If anything, feel sorry for the fact that he still has muscular dystrophy.
Sounds like a left ventricular assist device. (Score:5, Informative)
I have only read the linked articles, but the description sounds like a left ventricular assist device, or LVAD. This is a pump that helps the heart push blood, rather than replacing the heart, which is what I generally think of when people talk about artificial hearts. It sounds like the innovation here is the size, its use in a child, and the length of time they plan to use it, since it is generally used as a bridge to transplant.
I think they are optimistic in thinking they can get 25 years, since we really haven't evolved the material science to have implantable devices for that long without provoking clot formation or scarring, but it sounds like they didn't have a lot of options here.
Re:Sounds like a left ventricular assist device. (Score:4, Informative)
I was on a LVAD for a couple weeks. Luckily, my ventricle became stable enough to get off before a transplant was needed. I have two artificial valves and an aortic graft. I was told I could only be on the LVAD for 30 days before having a transplant, and I am 31. I can't imagine an LVAD being used to sustain life for 20-25 years. Besides, the actual LVAD machine is quite large, unless they have portable ones that I am not aware of. I can't see someone leaving the hospital with one.
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They've improved a lot in a short time. They can be left in longer as well.
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They don't have to play it up, it's entirely accurate: technically the boy is now a cyborg. Simple as that.
In fact, people with pacemakers and artificial hips are technically cyborgs, too.
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I agree; it sounds exactly like an LVAD. I'm similarly dubious about the long-term prospects for this particular patient with this particular device, but perhaps it will buy him enough time for improved technology to become available, whether that's a truly reliable artificial heart or, far better, gene therapy to cure the underlying muscular dystrophy.
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I agree with everyone that it sounds like a LVAD, one caveat is this with regard to studies and mortality - historically speaking LVADs were used (and still are) and a bridge to transplant, however, they have been explored as "destination therapy". That is, giving them to people who have no real shot had a transplant. The mortality is bad, but consider these people are on their last legs of life, and 6 months, a year etc..is better than certain death. I am not familiar with their use in the pediatric popula
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It looks like the kid got lucky - some doctors are willing to try highly experimental (and/or totally "unapproved") techniques that give the patient better odds of surviving in the medium term than doing nothing, even if it carries a higher risk of the patient dying in the short term. When you're faced with pretty-much certain death in the short term anyway, a little extra risk isn't much compared to the potential benefits.
As for mortality, the mortality for even ideal heart transplant patients isn't great.
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The illustration behind the surgeon in the article looks a lot like an impeller-driven left ventricular assist device. It's not an artificial heart, but could, conceivably, be half of one. In the old days, when most VADs were pulsatile, they could effectively replace a non-functioning ventricle and produce pulsatile flow, very much as the heart does. However, they were bulky and had their own problems. Pulseless, continuous flow, impeller-driven pumps are less likely to develop clots on surfaces, which wil
If only ... (Score:2)
We'd gotten this treatment for the Tin Man. It would have saved him an awful lot of trouble, what with having to go to the Emerald City and all.
Plug behind left ear... (Score:2)
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Article (and doctor) says that it's powered by a plug that inserts behind his left ear. Does that mean he has a power cable running from his head to his chest? How did they implant that?
It's not terribly difficult to run the wire under the skin up the neck to the ear. Better question is why would you? Convenience? Keeping it outside of the typical shirt? Why not use an inductive transfer?
They also said the implant itself fits into the left ventricle. So is the pump basically just powering half of heart,
That's enough to pump the blood through the body. Better than no working heart at all; and, leaves the original there to do what work it can. Although this doesn't sound like exactly the same device, they've been around for a while: see ventricular assist device.
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Inductive transfer is both untested in terms of human use (I think), and you want something that can stay Firmly in place, not fall off if you happen to change your shirt.
Repo Men? (Score:2, Interesting)
Dick beat him to it (Score:2)
Sounds like they just implated a LVAD Left Ventricle Assist Device, Dick Cheney just had one implated a couple of months ago.
Your robot heart is bleeding out (Score:2)
I imagine it to be much like this.
http://www.youtube.com/watch?v=aRcXULN6mp4 [youtube.com]
(can't believe that's actually relevant.)
Warning: robot gang fight.
Journalist BS filter (Score:2)
"Implanted an artificial heart" somehow got translated into "Transplanted a robot heart" ?
Standard Procedure (Score:2)
I wonder if in the future, this type of procedure will be standard. Say you hit 55 and the stats say you'd be better off just replacing the heart instead of taking the risk of a heart attack.
I could see this happening. And with millions getting the treatment every year, costs would likely go down 2-3% with HMOs pocketing the rest of the savings.
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To conserve resources please go end yourself now.
Robotic pencil sharpener, robotic can opener, etc. (Score:5, Insightful)
I know I should lighten up, but I really resent the decay of the term robot. Robots are autonomous devices. They were so when the term was first used in Rossum's Universal Robots.
A mechanical heart is not a robot. It only does work for you in a purely physics definition. (If you allow a physics definition of work for robot, then a lever that bends slightly is a robot -- it reacts to the amount of weight put on it by bending and it does 'work' for you.)
This heart is a mechanical device. It ends there. It is not a robot.
Similarly, remote-controlled devices, no matter how cool, are not robots. You are controlling them. They are not autonomous. We are not fighting the war in Afghanistan with robots. Stop saying that.
This pisses me off not because it's devaluing a term I think will be important someday, when we actually do have robots, but because it reflects a growing (or was it always there?) stupidity amongst the populace. They know what a robot is on a macro level, but they have no idea what this heart is on the most basic mechanical or control level. They don't understand machines of any sort, electronics of any sort, or fine distinctions of logic. They don't think about things and they're more interested in what sounds cool than what's correct.
Years ago, I put an extra question on all our screening tests for job applicants in computer jobs (networking, IT, etc). It was "How does a light bulb work?" The number of people who left the answer blank, answered "I don't know" or answered incorrectly was staggering. Not surprisingly, the people who knew enough to be considered for the computer job also generally knew how a light bulb worked and tended to answer the question in detail with something close to glee.
They constituted a vanishingly small percent of the applicants.
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and the record for the most detailed (and correct) report of how a lightbulb works is???
Robotic? (Score:2, Insightful)
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Why is this "robotic" and not just "mechanical" ?
Because journalism schools no longer value "accuracy" where "sensationalism" will suffice.
It's like a newspaper headline that says "Unemployment literally explodes in 4th quarter". The fact that their using words incorrectly, and thereby spreading non-factual information, is less important than grabbing attention.
Only thing really new is his age (Score:3, Insightful)
The Device appears to be a Javik 2000 VAD (Score:2)
http://www.jarvikheart.com/basic.asp?section=Jarvik+2000 [jarvikheart.com]
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There was talk about a child's version being tested. I think that this might be just that. The adult version is a bit bulky.
Raven called... (Score:2)
Yeah, 25 potential years but... (Score:5, Interesting)
Duchenne Muscular Dystrophy is a progressive, irreversible muscular disorder where the muscle cells literally pull themselves apart due to the lack of a key membrane-stabilising protein, Dystrophin.
So now this boy's heart can't give out for 25 years, you're then only consigning him to die of suffocation as his diaphragm does.
Oh no, ventilator. Well, let's wait for his oesophagus, colon and eye muscles to go...
But he's still alive, just locked into an immobile, artificially ventilated body with a heart that will never stop.
That seems worse than the natural alternative to me.
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So, they gave him another 2-3 years of reasonable life with an acceptable heart, before his lungs give in. That's still better than "die now." He doesn't have to stay all of that 25 years as a plant, but he can still get as much as he can from what "reasonable quality" of life is left.
And then, when his lungs begin to fail, he will just pull the plug.
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Duchenne. See summary. He won't live past 40 w/ current med.
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So people keep pointing out, and yet it ducks the perfectly valid question that is raised by the vague wording of the article.
Since his condition could well kill him in less than 20-25 years even with this heart, a lot of us suspect that the 20-25 year figure has to do with the life of the device. Yet if that means that a person (maybe not this person) could live out a term limited only by other factors by having a new heart implanted every 20 years, I'd think you'd say so rather than suggesting that the d
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in 20 years a better one will be put in and the ol (Score:2)
in 20 years a better one will be put in and the old one may need to be replaced any ways better to replace it before it fails!
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Then it isn't a permanent solution is it?
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No, in 20 years his lungs will have given out, or his stomach ceases to function, or his intestines fail, or his large arteries collapse.
A pump that lasts 20 years is trivial, and medical devices are generally of extremely high quality, so you can bet your ass that pump isn't going to wear out in 20 years.
Instead of his heart failing at fifteen, something else will fail at 35. That's what it means. It's permanent, and it's going to extend his life by 20 years.
It's the boy who is going to wear out by then,
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The disease looks like one that will kill him by the age of 25-30 in any case.
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His life expectancy doesn't exceed forty.
I'd call it a permanent solution in that they won't be seriously looking to replace it anytime soon, even if something marginally better comes along.
If, by some miracle, he lives beyond forty and is still in suitable shape for the surgury, they'll likely swap it out for an updated version.
In this case 'permanent' means 'best lasting fix currently available'. You put temporary fixes in while waiting for the permanent fix to be ready.
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http://en.wikipedia.org/wiki/Duchenne_muscular_dystrophy [wikipedia.org]
He's got Duchenne Muscular Dystrophy. Living to 40 is exceptionally rare, and most people who have this disease don't live to be 30. Sadly, by the time he gets anywhere near 40, another system that cannot be replaced/augmented as easily will probably have failed. The pump they installed will almost certainly outlast him, sad as that concept is.
Still, he was just a few days from death according to the article. Even if he only makes it a few more yea
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40 is probably close to the median life span, so I'm not sure I wouldn't call it "normal" -- just maybe, less than optimal in a country that has the ability to transplant a robotic heart into someone.
Re:I guess I'm not surprised (Score:5, Insightful)
Well, if you remember in "Bicentennial Man", he slowly perfected artificial human organs, until there wasn't much that couldn't be replaced.
I'm a bit surprised at the 20 to 25 year claim. I thought it wasn't more than a year or so ago that artificial hearts, though promising, were never practical for long-term use. At best they were a stop gap measure between the original heart failing, and getting a real flesh donor heart.
I went looking for more information. The most detailed I could find was this 2006 news story [washingtonpost.com]
It sounds like they're offering the kid a very optimistic view of life. The article is very short on information, like specifics on the device (who makes it, what it's called, what testing has been done, what have the long term animal trials shown, etc). I'm sure they're very good engineers and doctors, but it would be nice to have more information before people start really believing that they can have an artificial heart with a MTBF of 20 to 25 years.
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The *heart* have a lifespan of 20-25 years. But the kid, with his Duchenne dystrophy have anyway a much shorter lifespan. The only thing is that his heart will not be the limiting factor now.
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Yes, even if your heart doesn't go Duchenne's doesn't stop degrading your muscles.
It used to be that kids with it would die before the age of 12.
Now many reach 20.
there have been big improvements in treatment but 40 is extremely unlikely.
muscles like those in the heart and lungs degrade more slowly than others but they still degrade and eventually he'll suffocate or some other muscles he needs to live will go.
Unless they can build him a robotic lung as well and robotic throat muscles etc he's still going to
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in 20-25 years (Score:3, Insightful)
Comment removed (Score:4, Insightful)
Re:I guess I'm not surprised (Score:5, Insightful)
You are absolutely correct that no one can know how he will choose faced with these possibilities. These are hard choices that no one can truthfully predict how they will decide until faced with them in real life.
As a doctor, I guess for me it is something I face on a more daily basis. I see old people who have full-blown dementia, are physically bed-ridden and incontinent and yet sometimes their families want me to do anything to save their loved ones and make them healthy. It never ceases to amaze me how people can be so out of touch with reality.
If it were my parents (which I know that one day it will be), I would like to know when to stop and let them just die without anymore suffering.
So yes, I understand this is a hard choice for a 15y old child and his family and, frankly, I can understand why they chose to cling to any small shred of hope. I just hope that their doctor presented the situation truthfully and didn't paint the child's prospects too positively before the operation (unlike the summery).
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The #1 thing that all conscious things fear is death.
Don't anthropomorphise trees and fish. It upsets them.
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A friend of my sister ended up in a state like that. I don't recall the disorder right off, but it wasn't pretty.
The onset was like the common cold. That became pneumonia. He was hospitalized, and over the next few days, he ended up in a vegetative state. He had no sort of motor control at all. It was to the point where he couldn't even twitch a finger or toe. He couldn't speak. He couldn't see because his eyes wouldn't focus or track, or even blink. He could hear, but couldn't reac
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http://www.carmatsas.com/ [carmatsas.com]
To my know it's the only company with a fully implantable artificial hearth. It a French company created by the inventor of the artificial hearth valve.
Plus the product specification totally match the article: http://www.carmatsas.com/?page_id=56&lang=en [carmatsas.com]
The videos are over there: http://www.carmatsas.com/?page_id=12&lang=en [carmatsas.com]
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Sorry, i'm wrong.
It's not their product, you need to let the pop-up show up, the message in french shortly state that it wasn't their tech but a more classic mechanical heart assistance and not a full prosthetic replacement.
P.S. WTF did they use pop up in the first place ?
This is not news (Score:2)
Well maybe it is; the fact that the heart is permanently (well, for a couple of decades anyway) implanted is.
My cousin had an infection in her heart and almost died. She lived without a heart for six months, the blood pumped by man-made machinery. This was almost ten years ago.
As to the line between human and robot/artificial life form is getting thinner, I don't agree; there are a LOT of cyborgs walking around. I'm a cyborg; the lens in my left eye is an artificial device that can focus as well at all dist
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I would love to see artificial hearts jump the demand/supply/research curve into a product which more people can use. My family does have heart disease. My father survived a heart attack at 63 and the next one is just a matter of time. His father died at 58. We have found the cure for cancer ;(
I suppose if you don't have a degenerative problem like this boy, exercise is still the best way out. Now if I could only get my dad to walk rather than drive...
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I know that there is no formal definition for this but I would prefer to reserve the word cyborg for those with active prosthesis.
Its a bit like AI. My wife's car can decide when to use its lights and windscreen wipers but oh no, thats not artificial intelligence because we know how it works.