michael balzer: hola.that's about the extent of my spanish, (laughter) but i learned one new word yesterday,and that's crã¡neo, skull. i'm the guy who created my wife's skull to save her life, her eyeand even her soul. no, not really.
3d printing services los angeles, i was part of a team of pamela,two surgeons and technology, kind of, as i call it, the healer,the magician and the warrior, and together we defeated the painand suffering that was in her. we'd like to invite you into our story.
pamela scott: when i was 16 years old,my mother died of a brain tumor. and of course, this impacted mevery deeply. but it also left mewith a tremendous interest and passion in understandinghealth and medical research. now we live on a very small communityin the central coast of california. it's halfway between los angelesand san francisco. we have very limitedspecialty medical services there, which is difficult for anyonewho has a serious illness. major medical centersare at least 4 hours away.
now, i'd like to talk to youabout my pain. imagine having the worst headacheyou've ever had. and imagine having that headache go on24 hours a day, 7 days a week for months. in the summer of 2013,this is what i was experiencing. i went to my primary care physician,she had no idea what was wrong. i went to emergency rooms,they had no idea what was wrong. so i was referred to a local neurologist who was very well thought ofand respected, and he diagnosed me with migraines,
kind of classicbut severe migraine syndrome. so, he prescribed a verycomplicated regimen of pills. i took so many pills.i had trouble keeping track of them. i also had injections,i had inhalant medication. but the headaches kept gettingworse and worse over the months, until finally i could not sleep at night. there were no imaging studies done,nothing was ordered by the doctor. no mri, no ct scans. and so we really never hada very good idea
what was going on inside my head. mb: so, she came to me and said, "can you come with meto see this neurologist? he's not listening to me.i'm still having a lot of pain." so, i did and sure enough,he was very adamant to keep the same treatment going. so, i had to tell him, "you know her mother diedat the age of 53 of a brain tumor. humor me, let's do an mri."
he paused. i guesshe was somewhat surprised that i would say that. and he relented and ordered the mri. ps: now there are two types of mris. one is a standard mriwhich is fast and easy, but it doesn't give very much information. the other one is a better mri,and it's done with contrast dye. my doctor only ordered the first mrieven though he said, with that, there was absolutelyno reason to do it,
no clinical informationthat he thought would be important. we did that mri and i got a reportback from the radiologist that indicated there was something wrongin this part of my skull. the radiologist recommendedthat we have the second type of mri in order to determinemore specifically what that was. my doctor, the neurologist,refused to do this and said i should continue the medication,all the pills that weren't working, go home and come backto see him in a year. this was entirely unacceptable to me.
so, i went back to my primary care doctor,and she looked at the report, and she ordered the better mriwith contrast dye. and, to my surprise it did turn outthat in fact i had a brain tumor. mb: this is the report. it's difficult to read but essentiallyit identifies the size of her tumor. to put it in perspective,this was the size of the tumor. about the size of a golfball. this was lodgedbetween her eye and her brain. there's also some othermedical jargon here,
but i'm somewhat of a visual guy. so i created thisto help me understand it. i took my own measurements;i circled the area where the tumor is. now this is an mri, bone does notshow up in mri, it's dark. if you notice right above her left eyeis a very dark space that's the tumor. but it also indicates the typeof tumor, a bony tumor. ps: i think we all are uncomfortablewhen we think about our deaths, but there's always been somethingthat has frightened me more than death. and that's the thoughtof having brain damage:
no longer being myself because that's what had happenedto my mother. the problem with the locationof this tumor was that it was under the frontal lobeof the brain. now, the frontal lobeis where we have our intelligence, our reasoning, our memories,it's the seat of our personality, it's what makes us unique. i went to two local neurosurgeons,and both of them said that i really should considerthe tumor inoperable
because in order to remove it, they would have to doan ear-to-ear craniotomy, so cutting my skull open,remove a piece of the skull, and then, because of the locationof the tumor, apply traction to try to lift it or move the brain asidein order to reach the tumor. now, by doing that, both doctors saidthere was a very high possibility i would have brain damage from this. one doctor saidi may never be functional again, i may never be normal,i may never leave the icu.
this was not acceptable to me. the other problem wasthat if i did not remove the tumor, the tumor could continue to grow and would grow upinto the frontal lobe there. so i would havethe same outcome ultimately although we don't know how soon. i needed to do something different. i was anxious, yes. so, i went to the internet
which of coursewe have to be careful about. it comes with the caveatbecause how much information, particularly medical information,on the internet is good information? i'm going to guess about 10%. 90% of it - facebook, no; forums, no -not good information. but i discovered that all majormedical centers have websites that you can go toand find so much information you can read about the newest techniquesin treating so many different diseases,
and they talk about the specialtreatments that they have, along with providing links to videosand other information that is reputable. so, this is what i did,and i learned so much. i also learned that there was somethingcalled a "distant patient program". i had never heard of this before. and many of theseuniversity medical centers will do an evaluation of your caseby looking at your records that you can send to them. so you don't actually have to go there
and their team of physicianswill go over your situation, discuss it together,develop a provisional diagnosis or their best guess about what it isand then determine the best treatment that they would have to offerat their clinic or their hospital. and then they would call you on the phone,and discuss that with you. so i thought this wasa wonderful thing to do, and that's what i began doing. mb: now, everybody handlesanxiety differently. pamela handles it with research,research and more research,
and she would come to mewith this research. "can we get this?""can we get that?" i have a it background,so i accumulated a lot of information. in fact, we had a white binderabout 10 centimeters thick of documentation, reports, scansthat i created that she would take to all the local surgeons, physiciansthroughout california. however, we also neededto send this information throughout the rest of the country. so it was my responsibilityto use email, facsimiles
even the web portals that somebody'smedical systems put together in order to present this information. but i also do something else. i started a 3d print company. i also started a podcast. in one of my episodes, i had talkedabout a malaysian neurosurgeon who printed a 3d skull and brain,and used that for practice surgery. now [in] malaysia, [they] can't usecadavers, it's illegal, so i could understandthe reasoning for that.
coincidentally, ironically,pamela had a brain tumor, and i thought to myself, "wouldn't it be neatif i could apply these skills that i have just learnedto be able to help her?" so, i went to work but immediatelyi ran into roadblocks. this software is horrendously expensive,and it's also for the medical community. one, i'm not in the medical community. two, i don't have a lot of money. so, like pamela i used the internetand did a lot of searching.
and i came up with two open-sourceresearch programs that allowed me to do what i needed to do. one of them was from brazil,part of their technology center. the other one was from a research companyon the east coast. through the two of these things, after a couple of weeks of training -that i trained myself - i came up with this. this is a 3d volume render. on the right hand sideyou see a bunch of slices.
these are ct scans.bone shows up very well in these. there's about 300 of them. all together they renderedthis skull here. now, the skull by itself is greatfor halloween, but nothing more. so, there're other powerful tools in here. they're called roior "regions of interest," and they virtually allow meto slice the skull in half. and i did it right over the left eye, and you can see not too clearly the tumor,
and i'll highlight it a little bit here. as you can see there is the tumor. now the magic behind this kind of softwareis that i can rotate it, so here's an animationwhere i cut it in half so that i can look inside this skull. a few years backi would have had to kill pamela in order for this to happen. no, i'm trying to save her. so because of technology, i nowhave the ability to look inside there.
and i'll circle it here,again, there's the tumor, now i said earlier that i 3d print, so i wanted to take thisto the next level. it's great to be able to lookat this stuff on a computer, but wouldn't it be greatif i could actually touch it? so i went to work, the same softwaregave me the ability to create a model that i applied to a printer. so, here is a time-lapse image. obviously if you've ever workedwith a 3d printer, they're not this fast.
it took about 8 to 12 hoursto create this skull. now this is kind of creepy,kind of reminds me of the terminator. however, this is that 3d printer, and this, a year and half ago, is the time-lapse that i created,and this is the skull. don't you think it kind of looks like her?(laughter) i like the cute little nose here. now, the reality is we want to lookinside of it , so here is the tumor. we can actually touch this tumor.
i was extremely excited about this,so i ran to her and said, "look, i've got your skull here!here's your tumor." she greeted me with a look of horror. i thought to myself, "why?" but then it dawned on me,for the first time she came away with what was inside hercausing her all that pain. but what does pamela do?research. ps: i had found something miraculous and something that most doctorswere not familiar with,
and had never heard of. there were 2 major medical centers on the east coast,so across the country from us, that have developeda new surgical technique for the kind of tumor that i had. it was perfect. one was johns hopkins medical center, the other one was the universityof pittsburgh medical center. in this procedure, groundbreaking,
there would be a team of a neurosurgeonworking with an oculoplastic surgeon. they would make a tiny incision,truly tiny in the crease of my eyelid, and then the neurosurgeonwould go over the eye and directly into the tumorto remove it in very tiny bits, small increments,over the course of several hours. thus i would have no craniotomy,no movement of my brain, and this would eliminatethe risk of brain damage. i was very excited about this,and i really wanted it done. now upmc could get us inwithin a few weeks,
so i went ahead and scheduledthe surgery there as soon as i could. mb: so a few weeks later,we got on a plane, and we went to pittsburgh, pennsylvania. the next day she had some labs done,and we had an opportunity to talk to the surgeons, in particularthe neurosurgeon dr. gardner. so i asked him because i had sent himone of these skulls, and said, "what do you think of it?" he kind of chuckled, he said, "we passed it aroundin one of our meetings."
he said, "we thought it was extremely coolhow we can look at something, touch it," because normally all they hadwas some images and some text documents, so they were able to touch it,now we had a fellow with him, he said, "the huge potential of using thisfor education is enormous because now we can take datafrom a patient immediately and apply it into a tangible modeland use that as the malaysian neurosurgeonsuse for practice." ps: my surgery was very successful. this photograph was taken10 days after the surgery.
the surgeon had encouraged me,to get up and walk every day, and so i was walking a little bitand mike's idea on day 10 was that we would go a half mileand walk to a museum and then walk around the museum. so this is what we did. mb: it was a great museum.ps: it was. and you would never know that i had had brain surgery10 days earlier unless you peekedunder those big dark glasses,
and then you might thinkthat i had an affinity for purple eyeshadow on just one eye,but no one had any idea. and 5 hours after this photo was taken i was back on a plane to california, and 10 days after that,i was back at work in my office. pain-free, no impairments whatsoever,driving my car and absolutely fine. mb: this is an object that rotates.so i did 2 things. i did 2d resolution images,and i also did a 3d scan of her head and sent that to them,so they can rotate it,
zoom in on it, look at itfrom different angles. this allowed us not to everhave to go back to pittsburgh because they and all the informationat their fingertips. i see huge potential in this:long distance surgeries and long distance postoperative checkups. ps: now, this is a close-up photographof both my eyes, 2 months after surgery. there's no photoshop,no make-up, completely natural. can you tell which eyehad a brain tumor removed? mb: that one.ps: you're always wrong.
now, i am a psychotherapist by profession,dealing with people who are going through difficultiesgoing through traumas and stress. they often ask me,"how do you cope? what do i do?" i like to use a metaphorof inner archetypes, the characters within usthat are through mythology and literature, and i always talk abouthaving an inner healer, having an inner warrior,having an inner magician, and how do we bringthose resources up out of ourselves. and there are times perhapswhen we're too depleted
and we have to seekthose resources externally. and this is a wonderful thing to do. now, mike and i obviously dream big,and i like to think of my life as a book, and i am the author of the story. it's an adventure story,and it's not always fun, but it's always a very interesting story. and i hope at the end of my lifethat i can hold up this book and say, "i am very happy with the waythis turned out." mb: i hope i'm a protagonist in your bookand not an antagonist.
however, in my bookshe is one of the heroes. she went through a lotof pain and suffering. i was not going to cry so soon - (applause) thank you - but she perseveredwhere other people have not. she is a warrior to me. but i also want a special noteto the two surgeons, notably dr. gardner and the technologyand the people behind it.
ct scans just came out, mris were still on the drawing board
that's when her mother fell into a coma. they determined that it was a brain tumorfrom the ct scan, but it was too late. i wonder todayhow that story would turn up. thank you.
