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To “Adriana” With Love

Martin
September 22, 2018

September 18, 2018. Its Tuesday, and my life it’s about to change forever… but first sorry for the delay in posting new stuff,  the last couple months, were busy, hardcore and full of work. Its’ been a while since my last Post (VET Prosthetics… Still coming up to publish the entire Process…). Between some Consumer Products Design ( a bottle) and full time Prosthetics design has been too difficult to keep track with the blog.

After my former apology, let’s begin…

This very week my life has changed forever, honestly, I didn’t realize the outcome or the significant impact of  technology until the last Tuesday. 3:00 PM was the time for the surgery, her name is “Adriana”, and my relationship with “Adriana” until this day, was entirely based on CAD, Why?  Because for the past two weeks, I spend at least 120 hrs. with her Skull, (a Digital One &  3d Printed One) to be more explicit, a CT Scan, an STL File, and a 3D Surface Model, was my entire connection with her. By the time I was thinking about tolerances, 5 axis machining, boundary conditions, endmill & ball end cutters, 3d Printing, cutting compensation, fixture design, tolerance and fitting, G54, axis interpolation, coordinate systems, and how to connect 5 different design stages in a very unique way to make a design possible for manufacturing. (3D CAD / CAM Jargon). This very Tuesday my insides just change forever.

    

“Adriana” survived a cerebral aneurysm, her blood vessels inside a vain rapture in her brain, which led into a serious condition called subarachnoid hemorrhage, producing a massive cerebral edema.  She was taken to ER and during the  surgery, the doctors had to practiced her a  decompressive craniectomy to save her life, but during the procedure  she lost  ¼ Skull bone from the right hemisphere, after 1 year with no bone, (she rejected her first PMMA Implant ) she suffered collateral effects, the Atmospheric pressure directly in her brain caused part of the right hemisphere to collapse,  she lost the ability to speak and control the left side of her body, “Adriana” was tired and don’t want any other treatment. Her only choice was a custom-made Implant. But again her choices were limited, today only six companies in the world manufacture this sort implant.

2:50 PM arriving to the OR, I saw 3 surgeons holding up what will be “Adriana’s” head implant in their hands, and suddenly the real meaning of what is about to happen just “click” in my mind. 3:00 PM sharp. She arrived at the OR, It’s  the first time we met, I saw her arriving with the nurses, just wave my hand to her and said hello, she didn’t replied, I don’t blame her (another surgery and by the time I didn’t knew she can’t speak). But she was there, not a CT Scan, not a 3D model, I saw “Adriana”, the wife, the mom, the daughter, the person itself, and I just realized this is it  “It is for real”, in the computer world we have the blessing of the Undo command, in the real life there is no Undo,   you have one shot… so make it count.  Suddenly a nurse turns the litter and saw the damage in her skull, I was speechless… (I saw her skull digitally a million times before, I know every little detail, every curvature degree, every angle, but seeing her for the first time… the practice is over, and I just keep telling to myself… It is going to work, it is going to work, We tested a million times in the computer, (In GRANTA, theres a big sign in the wall that says:  “In CAD we trust!”).  Imagine design something with 0.05 mm tolerance fit, with no access to the part itself, imagine driving a car as fast as possible, just with instruments and data, there is no room for error, one mistake and it’s the end, it’s the human skull, you can’t just cut the tissue and take measurements, we depend entirely of digital data.

                

  

 

4:00 PM, surgery begins, around 1 hour took to prepare her for the implant, the surgeons start cutting the hair and scrubbing some antiseptic solution, she was in deep anesthesia and the procedure begin, took around 45 minutes to the surgeons to separate the tissue from the bone and expose the skull damage, I recall a nurse making a bet, “It won’t fit” she said… “It’s too small, bet you a Diet Coke in the MD Lounge that we are going to stay in surgery at least 6 hours, making the fit” , and the critical moment start… “ Pass the Implant” one of the surgeons ordered the nurse, so she took the implant from the sterile bag and what they call the “presentation” start, the surgeon just insert the implant in the skull and guess what…? the implant just fit perfectly… the nurse said.  “I guess you won a Soda”. (Something I learned with the Doc. Carlos, Monroy, is never bet a soda with him, I recall a discussion making and adjustment in the cutting simulation…was about a wall thickness compensation and I loose 2 diet sodas for 0.015 mm instead of 0.020 mm… he won by a hair ) Rapidly and the surgeons started marking the perforation points in the skull to fix the implant, took them about 5 minutes to drill holes in skull to fix, 10 more to secure the implant and another 10 minutes to stitch the tissue around the defect… 2.5 hours to open and  close and took “Adriana” to Intensive Care. A surgical procedure that take around 6 to 8 hours with regular PMMA Implants  performed in less that 3 hours, they called up a new record. And everyone starts asking how that happened? (and certainly, describing it how to make that happen will take me an entire day to explain the process to the staff). At the end the nurses said It’s a beautiful thing “this custom-made implants you made” they called a piece of Art, and I’m telling to myself, “better called them a piece of fine engineering”. (Funny thing they keep calling me “Doctor”, and I’ keep  telling them “I’m not a Doctor, I’m an Engineer”). Dr. CAM If you like. (Thanks for the cool nick name Daniel Huamani)

                                                                                                                         

 

Friday After two days in intensive care “Adriana” was taken to her room, and we made a quick stop in the hospital today to see her, she was with her family and they ask her if she remember us?. She answer no, I don’t. Her mom replied;  “They were with you at the surgery, they designed and manufactured your implant”. She just cries and keep saying… thank you!, (you could imagine the rest), one or two tears came from my eyes. She recovered the ability to speak and move her hands, recovered her face, and the most important thing she recovered her identity, as simple as hugging her husband, talk to her mom, watch her face again in the mirror and recognize the person in front. And I just keep thinking how simple things in life matter so much, and the rest of us kind of always take it for granted, for others like “Adriana” could mean everything…. just to see her smile is priceless.

From that moment my life changed forever, from seeing just 3D data, and thinking in CAD mode, to witness the power of technology and the impact in people’s life. After leaving the hospital I’m still shocked… can’t believe what we just did for her. In all my years of professional life experience (+10 Automotive, +6 Autodesk, -1 as entrepreneur) have never accomplish a project so significant and powerful than helping “Adriana” to improve her life quality. and i’m glad I’m going to have a chance to know her better when finishes rehabilitation therapy.

 

To “Adriana”, thank you for the greatest lesson in my life, and for giving me the chance to tell your story

To Ford & VW , thanks for all the training and experience accumulated all over the years in critical design & manufacture projects.

To Autodesk, thanks for all the access to groundbreaking technologies, the opportunities to learn from other manufacturing industries across the globe and all the friends I left behind. Special Thanks to Randy Twiddy , Andrew Ward , Cory Barrette, Matt Lemay & Lucas Ewing , you’re a big part of this. Without your help, non of this would be possible.

To Autodesk Foundation, HUGE !  thanks for helping fired up this amazing adventure, Ann Koh, Kellan Hays, Oliver Gould & Christine Stoner and rest of the team that I might be forgetting at the moment

To PhD Carlos Monroy, thanks for sharing with me your world’s vision about design & engineering,  was my privilege worked closely with the great GRANTA TEAM in Mexico City,  you are the Genius behind this amazing company, and a wonderful human being.

 

PD. Coming up the Spanish Version, I need some sleep !

Facts:

  • Only 5 companies in the world manufacture custom made implants. GRANTA is the #6 in the world, #2 in America, and it’s based in Mexico City.
  • Due to the costs, and high technical complexity custom-made implants may cost around 30,000 USD in Mexico, most of them were previously manufactured in Switzerland, Patients today have an affordable option. with a significant cost reduction since all design and manufacturing is made locally.
  • 1 of every 3 patients with PMMA Implants will reject due to the material conditions in sanitization procedures,
  • Most PMMA Implants are molded in the surgery rooms at the time of the procedure, exposing the opened body to long surgery periods and risking the patient to post surgery infections.
  • More than 10 different Autodesk Manufacturing applications were used in the development of the Implant, from Fusion 360 / NetFabb/ Inventor/ Powershape/ Powermill /Nastran In-CAD among other technologies including 3D Printing with  /SLA /FDM/PolyJet  technologies, 3D scanning, Reverse engineering, CT Scan, & CNC 5 Axis milling were used during “Adriana’s” Implant

Martin

Martín trabajó para Autodesk durante 2011 - 2018, su rol como Sr. Technical Sales ayudó a compañías de manufactura y diseño a desarrollar el máximo potencial, mediante el uso de herramientas y tecnologías avanzadas de Autodesk en Latinoamérica. Es Instructor Certificado de Autodesk Inventor desde el año 2011, (ACI) y Evaluador Certificado (ACE) desde 2012. ha impartido Conferencias y Clases maestras en distintos foros, como Autodesk Univeristy (Las Vegas). Autodesk University (Mexico) Semana Nacional del Emprendedor (México), entrenamientos en diseño de productos en distintos países como; Chile, Argentina, Colombia, Estados Unidos y Alemania. Martín es Ingeniero Mecánico y Diseñador Industrial, cuenta con cerca de 10 años de experiencia en la industria Automotriz, previamente diseñando herramental (Tool & Fixture) para FORD , en la linea de producción y posteriormente desarrollando superficies Clase A para interiores y Exteriores en automóviles, en Volkswagen. Desde 2018, es consultor independiente para distintas Industrias de Manufactura en distintos sectores implementando tecnología y metodologías disruptivas para diseño y manufactura, como 3D Printing / Maquinado en CNC en 5 ejes / Escaneo de superficies 3D y reconstrucción de superficies complejas / Realidad Aumentada y Realidad Virtual. Actualmente mantiene un fuerte vinculo con la industría automotriz, y desarrolla flujos de trabajo y procesos de diseño para la industria biomédica en el desarrollo de Prótesis para Craneoplastía, Órtesis para amputación de miembros inferiores y superiores, y guías quirúrgicas para neurocirugía y cirugía maxilofacial.

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We use Bing to deploy digital advertising on sites supported by Bing. Ads are based on both Bing data and behavioral data that we collect while you’re on our sites. The data we collect may include pages you’ve visited, trials you’ve initiated, videos you’ve played, purchases you’ve made, and your IP address or device ID. This information may be combined with data that Bing has collected from you. We use the data that we provide to Bing to better customize your digital advertising experience and present you with more relevant ads. Bing Privacy Policy
G2Crowd
We use G2Crowd to deploy digital advertising on sites supported by G2Crowd. Ads are based on both G2Crowd data and behavioral data that we collect while you’re on our sites. The data we collect may include pages you’ve visited, trials you’ve initiated, videos you’ve played, purchases you’ve made, and your IP address or device ID. This information may be combined with data that G2Crowd has collected from you. We use the data that we provide to G2Crowd to better customize your digital advertising experience and present you with more relevant ads. G2Crowd Privacy Policy
NMPI Display
We use NMPI Display to deploy digital advertising on sites supported by NMPI Display. Ads are based on both NMPI Display data and behavioral data that we collect while you’re on our sites. The data we collect may include pages you’ve visited, trials you’ve initiated, videos you’ve played, purchases you’ve made, and your IP address or device ID. This information may be combined with data that NMPI Display has collected from you. We use the data that we provide to NMPI Display to better customize your digital advertising experience and present you with more relevant ads. NMPI Display Privacy Policy
VK
We use VK to deploy digital advertising on sites supported by VK. Ads are based on both VK data and behavioral data that we collect while you’re on our sites. The data we collect may include pages you’ve visited, trials you’ve initiated, videos you’ve played, purchases you’ve made, and your IP address or device ID. This information may be combined with data that VK has collected from you. We use the data that we provide to VK to better customize your digital advertising experience and present you with more relevant ads. VK Privacy Policy
Adobe Target
We use Adobe Target to test new features on our sites and customize your experience of these features. To do this, we collect behavioral data while you’re on our sites. This data may include pages you’ve visited, trials you’ve initiated, videos you’ve played, purchases you’ve made, your IP address or device ID, your Autodesk ID, and others. You may experience a different version of our sites based on feature testing, or view personalized content based on your visitor attributes. Adobe Target Privacy Policy
Google Analytics (Advertising)
We use Google Analytics (Advertising) to deploy digital advertising on sites supported by Google Analytics (Advertising). Ads are based on both Google Analytics (Advertising) data and behavioral data that we collect while you’re on our sites. The data we collect may include pages you’ve visited, trials you’ve initiated, videos you’ve played, purchases you’ve made, and your IP address or device ID. This information may be combined with data that Google Analytics (Advertising) has collected from you. We use the data that we provide to Google Analytics (Advertising) to better customize your digital advertising experience and present you with more relevant ads. Google Analytics (Advertising) Privacy Policy
Trendkite
We use Trendkite to deploy digital advertising on sites supported by Trendkite. Ads are based on both Trendkite data and behavioral data that we collect while you’re on our sites. The data we collect may include pages you’ve visited, trials you’ve initiated, videos you’ve played, purchases you’ve made, and your IP address or device ID. This information may be combined with data that Trendkite has collected from you. We use the data that we provide to Trendkite to better customize your digital advertising experience and present you with more relevant ads. Trendkite Privacy Policy
Hotjar
We use Hotjar to deploy digital advertising on sites supported by Hotjar. Ads are based on both Hotjar data and behavioral data that we collect while you’re on our sites. The data we collect may include pages you’ve visited, trials you’ve initiated, videos you’ve played, purchases you’ve made, and your IP address or device ID. This information may be combined with data that Hotjar has collected from you. We use the data that we provide to Hotjar to better customize your digital advertising experience and present you with more relevant ads. Hotjar Privacy Policy
6 Sense
We use 6 Sense to deploy digital advertising on sites supported by 6 Sense. Ads are based on both 6 Sense data and behavioral data that we collect while you’re on our sites. The data we collect may include pages you’ve visited, trials you’ve initiated, videos you’ve played, purchases you’ve made, and your IP address or device ID. This information may be combined with data that 6 Sense has collected from you. We use the data that we provide to 6 Sense to better customize your digital advertising experience and present you with more relevant ads. 6 Sense Privacy Policy
Terminus
We use Terminus to deploy digital advertising on sites supported by Terminus. Ads are based on both Terminus data and behavioral data that we collect while you’re on our sites. The data we collect may include pages you’ve visited, trials you’ve initiated, videos you’ve played, purchases you’ve made, and your IP address or device ID. This information may be combined with data that Terminus has collected from you. We use the data that we provide to Terminus to better customize your digital advertising experience and present you with more relevant ads. Terminus Privacy Policy
StackAdapt
We use StackAdapt to deploy digital advertising on sites supported by StackAdapt. Ads are based on both StackAdapt data and behavioral data that we collect while you’re on our sites. The data we collect may include pages you’ve visited, trials you’ve initiated, videos you’ve played, purchases you’ve made, and your IP address or device ID. This information may be combined with data that StackAdapt has collected from you. We use the data that we provide to StackAdapt to better customize your digital advertising experience and present you with more relevant ads. StackAdapt Privacy Policy
The Trade Desk
We use The Trade Desk to deploy digital advertising on sites supported by The Trade Desk. Ads are based on both The Trade Desk data and behavioral data that we collect while you’re on our sites. The data we collect may include pages you’ve visited, trials you’ve initiated, videos you’ve played, purchases you’ve made, and your IP address or device ID. This information may be combined with data that The Trade Desk has collected from you. We use the data that we provide to The Trade Desk to better customize your digital advertising experience and present you with more relevant ads. The Trade Desk Privacy Policy
RollWorks
We use RollWorks to deploy digital advertising on sites supported by RollWorks. Ads are based on both RollWorks data and behavioral data that we collect while you’re on our sites. The data we collect may include pages you’ve visited, trials you’ve initiated, videos you’ve played, purchases you’ve made, and your IP address or device ID. This information may be combined with data that RollWorks has collected from you. We use the data that we provide to RollWorks to better customize your digital advertising experience and present you with more relevant ads. RollWorks Privacy Policy

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