OVER MY HEAD

June 17, 2017


Over My Head is an extremely rare look into the workings of an injured brain from a doctor’s perspective.  It is a true story of a young doctor’s battle to overcome a debilitating head injury and build a new life.  The book is an inspiring story of how a medical doctor comes to terms with the loss of her identity and the courageous steps (and hilarious missteps) she takes while learning to rebuild her life. The author, a 45-year-old emergency-room doctor and clinical professor of medicine, describes the aftermath of a brain injury eleven years ago which stripped her of her beloved profession. For years she was deprived of her intellectual companionship and the ability to handle the simplest undertakings like shopping for groceries or sorting the mail. Her progression from confusion, dysfunction, and alienation to a full, happy life is told with restraint, great style, and considerable humor.

I’m not going to spoil the story for you but eleven (11) years ago, Dr. Claudia L. Osborn was riding her bike with a roommate, Dr. Marcia E. Baker.  It was a beautiful Saturday afternoon in Detroit with just about perfect weather.  Due to a fairly narrow road, they were riding in tandem with Marcia in front and leading the way.  A car made a right turn onto the road they were riding and swung much too wide to avoid hitting the ladies.  Marcia saw the car first and managed to navigate to the shoulder of the road where she “dumped” her bike.  Claudia was not that lucky.  The car hit her head on. She traveled over the hood, over the cab, over the trunk and landed on her head.  She was taken to the emergency room but the damage had already been done.

The beginning of her post trauma period is consumed with behaviors we so often see in this population; denial, depression, and frustration.   I am sure the medical profession has patients coming in after such an injury with unrealistic plans to return to exactly the same life they had beforehand?  Their all- consuming drive is to go back to who they were, to the life they lived before the injury, when in reality all around can see that will not happen.  However, everyone around is afraid of what will happen if they ever give voice to these concerns.  So there emerges an unspoken conspiracy to not put voice to the facts that serve to block the full return to a former life, in fear that these comments might be as traumatic as the actual injury was.

One symptom above all seemed to override nearly everything in Dr. Osborn’s recovery and this was a profound short-term memory deficit.  What many consider a simple errand, buying two or three things at the store turns into nightmare after nightmare for her.  In those instances when she would get to the correct store, she might find the first thing she had set out to purchase, then end up not remembering the other two things she needed.

Claudia might actually remember to get all the things into her basket to realize at the checkout counter she had not brought her money, or not being able to find her car after getting all of those things done correctly and having to wait until the parking lot cleared out to find her car.

Although from Michigan, Claudia ended up enrolling in a treatment program at the Head Trauma Program of New York University’s Rusk Institute, which included physiatry and allied rehabilitative specialists.     This book clearly demonstrates the roles that others play in working her acceptance of the new person who emerged after the head injury as well as helping to deal with her severe depression.

Those important in Claudia’s life serve as tremendous examples about what to do and not to do in supporting and helping an affected person.  Her mother is very supportive from the beginning but demonstrates many of the expectations that it will be ok in time and life will return to the way it was before.  Claudia also has an amazingly understanding life partner who seemed to know just the right times to back away and give Claudia the time and distance to discover who she was.  Accepting these evolving expectations from their relationship allowed them to come through the event and long recovery still together.  So often this is not the story.   As soon as it becomes evident that the injured party will not return to whom they were before the injury, the physically undamaged person leaves the relationship.    This story is a powerful message to those life partners and family of head injured patients everywhere about life after such an injury.

I can definitely recommend this book to anyone who has personally had a head injury or to anyone who has had a family member with a serious head injury.  For that individual, a “new normal” must be sought and accepted.


Biomedical Engineering may be a fairly new term so some of you.   What is a biomedical engineer?  What do they do? What companies to they work for?  What educational background is necessary for becoming a biomedical engineer?  These are good questions.  From LifeScience we have the follow definition:

“Biomedical engineering, or bioengineering, is the application of engineering principles to the fields of biology and health care. Bioengineers work with doctors, therapists and researchers to develop systems, equipment and devices in order to solve clinical problems.”

Biomedical engineering has evolved over the years in response to advancements in science and technology.  This is NOT a new classification for engineering involvement.  Engineers have been at this for a while.  Throughout history, humans have made increasingly more effective devices to diagnose and treat diseases and to alleviate, rehabilitate or compensate for disabilities or injuries. One example is the evolution of hearing aids to mitigate hearing loss through sound amplification. The ear trumpet, a large horn-shaped device that was held up to the ear, was the only “viable form” of hearing assistance until the mid-20th century, according to the Hearing Aid Museum. Electrical devices had been developed before then, but were slow to catch on, the museum said on its website.

The possibilities of a bioengineer’s charge are as follows:

The equipment envisioned, designed, prototyped, tested and eventually commercialized has made a resounding contribution and value-added to our healthcare system.  OK, that’s all well and good but exactly what do bioengineers do on a daily basis?  What do they hope to accomplish?   Please direct your attention to the digital figure below.  As you can see, the world of the bioengineer can be somewhat complex with many options available.

The breadth of activity of biomedical engineers is significant. The field has moved from being concerned primarily with the development of medical devices in the 1950s and 1960s to include a wider ranging set of activities. As illustrated in the figure above, the field of biomedical engineering now includes many new career areas. These areas include:

  • Application of engineering system analysis (physiologic modeling, simulation, and control to biological problems
  • Detection, measurement, and monitoring of physiologic signals (i.e., biosensors and biomedical instrumentation)
  • Diagnostic interpretation via signal-processing techniques of bioelectric data
  • Therapeutic and rehabilitation procedures and devices (rehabilitation engineering)
  • Devices for replacement or augmentation of bodily functions (artificial organs)
  • Computer analysis of patient-related data and clinical decision making (i.e., medical informatics and artificial intelligence)
  • Medical imaging; that is, the graphical display of anatomic detail or physiologic Function.
  • The creation of new biologic products (i.e., biotechnology and tissue engineering)

Typical pursuits of biomedical engineers include

  • Research in new materials for implanted artificial organs
  • Development of new diagnostic instruments for blood analysis
  • Writing software for analysis of medical research data
  • Analysis of medical device hazards for safety and efficacy
  • Development of new diagnostic imaging systems
  • Design of telemetry systems for patient monitoring
  • Design of biomedical sensors
  • Development of expert systems for diagnosis and treatment of diseases
  • Design of closed-loop control systems for drug administration
  • Modeling of the physiologic systems of the human body
  • Design of instrumentation for sports medicine
  • Development of new dental materials
  • Design of communication aids for individuals with disabilities
  • Study of pulmonary fluid dynamics
  • Study of biomechanics of the human body
  • Development of material to be used as replacement for human skin

I think you will agree, these areas of interest encompass any one of several engineering disciplines; i.e. mechanical, chemical, electrical, computer science, and even civil engineering as applied to facilities and hospital structures.


At one time in the world there were only two distinctive branches of engineering, civil and military.

The word engineer was initially used in the context of warfare, dating back to 1325 when engine’er (literally, one who operates an engine) referred to “a constructor of military engines”.  In this context, “engine” referred to a military machine, i. e., a mechanical contraption used in war (for example, a catapult).

As the design of civilian structures such as bridges and buildings developed as a technical discipline, the term civil engineering entered the lexicon as a way to distinguish between those specializing in the construction of such non-military projects and those involved in the older discipline. As the prevalence of civil engineering outstripped engineering in a military context and the number of disciplines expanded, the original military meaning of the word “engineering” is now largely obsolete. In its place, the term “military engineering” has come to be used.

OK, so that’s how we got here.  If you follow my posts you know I primarily concentrate on STEM (science, technology, engineering and mathematics) professions.  Engineering is somewhat uppermost since I am a mechanical engineer.

There are many branches of the engineering profession.  Distinct areas of endeavor that attract individuals and capture their professional lives.  Several of these are as follows:

  • Electrical Engineering
  • Mechanical Engineering
  • Civil Engineering
  • Chemical Engineering
  • Biomedical Engineering
  • Engineering Physics
  • Nuclear Engineering
  • Petroleum Engineering
  • Materials Engineering

Of course, there are others but the one I wish to concentrate on with this post is the growing branch of engineering—Biomedical Engineering. Biomedical engineering, or bioengineering, is the application of engineering principles to the fields of biology and health care. Bioengineers work with doctors, therapists and researchers to develop systems, equipment and devices in order to solve clinical problems.  As such, the possibilities of a bioengineer’s charge are as follows:

Biomedical engineering has evolved over the years in response to advancements in science and technology.  This is NOT a new classification for engineering involvement.  Engineers have been at this for a while.  Throughout history, humans have made increasingly more effective devices to diagnose and treat diseases and to alleviate, rehabilitate or compensate for disabilities or injuries. One example is the evolution of hearing aids to mitigate hearing loss through sound amplification. The ear trumpet, a large horn-shaped device that was held up to the ear, was the only “viable form” of hearing assistance until the mid-20th century, according to the Hearing Aid Museum. Electrical devices had been developed before then, but were slow to catch on, the museum said on its website.

The works of Alexander Graham Bell and Thomas Edison on sound transmission and amplification in the late 19th and early 20th centuries were applied to make the first tabletop hearing aids. These were followed by the first portable (or “luggable”) devices using vacuum-tube amplifiers powered by large batteries. However, the first wearable hearing aids had to await the development of the transistor by William Shockley and his team at Bell Laboratories. Subsequent development of micro-integrated circuits and advance battery technology has led to miniature hearing aids that fit entirely within the ear canal.

Let’s take a very quick look at several devices designed by biomedical engineering personnel.

MAGNETIC RESONANCE IMAGING:

POSITION EMISSION TOMOGRAPHY OR (PET) SCAN:

NOTE: PET scans represent a different technology relative to MRIs. The scan uses a special dye that has radioactive tracers. These tracers are injected into a vein in your arm. Your organs and tissues then absorb the tracer.

BLOOD CHEMISTRY MONOTORING EQUIPMENT:

ELECTROCARDIOGRAM MONITORING DEVICE (EKG):

INSULIN PUMP:

COLONOSCOPY:

THE PROFESSION:

Biomedical engineers design and develop medical systems, equipment and devices. According to the U.S. Bureau of Labor Statistics (BLS), this requires in-depth knowledge of the operational principles of the equipment (electronic, mechanical, biological, etc.) as well as knowledge about the application for which it is to be used. For instance, in order to design an artificial heart, an engineer must have extensive knowledge of electrical engineeringmechanical engineering and fluid dynamics as well as an in-depth understanding of cardiology and physiology. Designing a lab-on-a-chip requires knowledge of electronics, nanotechnology, materials science and biochemistry. In order to design prosthetic replacement limbs, expertise in mechanical engineering and material properties as well as biomechanics and physiology is essential.

The critical skills needed by a biomedical engineer include a well-rounded understanding of several areas of engineering as well as the specific area of application. This could include studying physiology, organic chemistry, biomechanics or computer science. Continuing education and training are also necessary to keep up with technological advances and potential new applications.

SCHOOLS OFFERING BIO-ENGINEERING:

If we take a look at the top schools offering Biomedical engineering, we see the following:

  • MIT
  • Stanford
  • University of California-San Diego
  • Rice University
  • University of California-Berkley
  • University of Pennsylvania
  • University of Michigan—Ann Arbor
  • Georgia Tech
  • Johns Hopkins
  • Duke University

As you can see, these are among the most prestigious schools in the United States.  They have had established engineering programs for decades.  Bio-engineering does not represent a new discipline for them.  There are several others and I would definitely recommend you go online to take a look if you are interested in seeing a complete list of colleges and universities offering a four (4) or five (5) year degree.

SALARY LEVELS:

The median annual wage for biomedical engineers was $86,950 in May 2014. The median wage is the wage at which half the workers in an occupation earned more than that amount and half earned less. The lowest ten (10) percent earned less than $52,680, and the highest ten (10) percent earned more than $139,350.  As you might expect, salary levels vary depending upon several factors:

  • Years of experience
  • Location within the United States
  • Size of company
  • Research facility and corporate structure
  • Bonus or profit sharing arrangement of company

EXPECTATIONS FOR EMPLOYMENT:

In their list of top jobs for 2015, CNNMoney classified Biomedical Engineering as the 37th best job in the US, and of the jobs in the top 37, Biomedical Engineering 10-year job growth was the third highest (27%) behind Information Assurance Analyst (37%) and Product Analyst (32%). CNN previously reported Biomedical Engineer as the top job in the US in 2012 with a predicted 10-year growth rate of nearly 62% ‘Biomedical Engineer’ was listed as a high-paying low-stress job according to Time magazine.  There is absolutely no doubt that medical technology will advance as time go on so biomedical engineers will continue to be in demand.

As always, I welcome your comments.


It really does creep up on you—the pain that is.  Minimal at first for a few months but at least livable.  I thought I could exercise and stretch to lessen the discomfort and that did work to a great degree.  That was approximately seven (7) months ago. Reality did set in with the pain being so great that something had to be done.

In the decade of the eighties, I was an avid runner with thoughts of running a marathon or even marathons. My dream was to run the New York City and Boston Marathon first then concentrate on local 10 K events. After one year I would concentrate on the Atlanta marathon—at least that was the plan.  I was clocking about twenty to thirty miles per week with that goal in mind.    All of my running was on pavement with three five miles runs on Monday, Wednesday and Friday and a ten-mile run on Saturday.  It did seem reasonable. I would drive the courses to get exact mileage and vary the routes just to mix it up a little and bring about new scenery.  After several weeks, I noticed pains starting to develop around the twenty-five miles per week distances.  They did go away but always returned towards the latter part of each week.   Medical examinations would later show the beginning of arthritis in my right hip.  I shortened my distances hoping to alleviate the pain and that worked to some extent for a period of time.

Time caught up with me.  The pains were so substantial I could not tie my shoe laces or stoop to pick up an article on the floor.   It was time to pull the trigger.

TOTAL HIP REPLACEMENT:

In a total hip replacement (also called total hip arthroplasty), the damaged bone and cartilage is removed and replaced with prosthetic components.

  • The damaged femoral head is removed and replaced with a metal stem that is placed into the hollow center of the femur. The femoral stem may be either cemented or “press fit” into the bone. One of the first procedures is dislocating the hip so femoral stem may be removed.
  • A metal or ceramic ball is placed on the upper part of the stem. This ball replaces the damaged femoral head that was removed.
  • The damaged cartilage surface of the socket (acetabulum) is removed and replaced with a metal socket. Screws or cement are sometimes used to hold the socket in place.
  • A plastic, ceramic, or metal spacer is inserted between the new ball and the socket to allow for a smooth gliding surface.I chose to have an epidural so recovery would be somewhat quicker and the aftereffects lessened.  I do not regret that choice and would recommend that to anyone undergoing hip replacement.  One day home and I’m following my doctor’s orders to a “T”. Doing everything and then some to make sure I touch all of the bases.  I was very tempted to pull up “U”- TUBE to see how the surgery was accomplished but after hearing it was more carpentry than medicine, I decided I would delay that investigation for a year-or forever.  Some things I just might not need to know.

    Sorry for this post being somewhat short but the meds are wearing off and I need to “reload”.  I promise to do better in the very near future.

DIALYSIS PUMPS

February 8, 2017


I entered the university shortly after Sir Isaac Newton and Gottfried Leibniz invented calculus. (OK, I’m not quite that old but you do get the picture.) At any rate, I’ve been a mechanical engineer for a lengthy period of time.  If I had to do it all over again, I would choose Biomedical Engineering instead of mechanical engineering.  Biomedical really fascinates me.  The medical “hardware” and software available today is absolutely marvelous.  As with most great technologies, it has been evolutionary instead of revolutionary.    One such evolution has been the development of the dialysis pump to facilitate administrating insulin to patients suffering with diabetes.

On my way to exercise Monday, Wednesday and Friday, I pass three dialysis clinics.  I am amazed that on some days the parking lots are, not only full, but cars are parked on the roads on either side of the buildings. Almost always, I see at least one ambulance parked in front of the clinic having delivered a patient to the facilities.  In Chattanooga proper, there are nine (9) clinics and approximately 3,306 dialysis centers in the United States. These centers employ 127,671 individuals and bring in twenty-two billion dollars ($22B) in revenue.  There is a four-point four percent (4.4%) growth rate on an annual basis. Truly, diabetes has reached epidemic proportions in our country.

Diabetes is not only one of the most common chronic diseases, it is also complex and difficult to treat.  Insulin is often administered between meals to keep blood sugar within target range.  This range is determined by the number of carbohydrates ingested. Four hundred (400) million adults worldwide suffer from diabetes with one and one-half million (1.5) deaths on an annual basis.  It is no wonder that so many scientists, inventors, and pharmaceutical and medical device companies are turning their attention to improving insulin delivery devices.   There are today several delivery options, as follows:

  • Syringes
  • Pens
  • Insulin Injection Aids
  • Inhaled Insulin Devices
  • External Pumps
  • Implantable Pumps

Insulin pumps, especially the newer devices, have several advantages over traditional injection methods.  These advantages make using pumps a preferable treatment option.  In addition to eliminating the need for injections at work, at the gym, in restaurants and other settings, the pumps are highly adjustable thus allowing the patient to make precise changes based on exercise levels and types of food being consumed.

These delivery devices require: 1.) An insulin cartridge, 2.) A battery-operated pump, and 3.) Computer chips that allow the patient to control the dosage.  A detailed list of components is given below.  Most modern devices have a display window or graphical user interface (GUI) and selection keys to facilitate changes and administrating insulin.  A typical pump is shown as follows:

insulin-pump

Generally, insulin pumps consist of a reservoir, a microcontroller with battery, flexible catheter tubing, and a subcutaneous needle. When the first insulin pumps were created in the 1970-80’s, they were quite bulky (think 1980’s cell phone). In contrast, most pumps today are a little smaller than a pager. The controller and reservoir are usually housed together. Patients often will wear the pump on a belt clip or place it in a pocket as shown below. A basic interface lets the patient adjust the rate of insulin or select a pre-set. The insulins used are rapid acting, and the reservoir typically holds 200-300 units of insulin. The catheter is similar to most IV tubing (often smaller in diameter), and connects directly to the needle. Patients insert the needle into their abdominal wall, although the upper arm or thigh can be used. The needle infusion set can be attached via any number of adhesives, but tape can do in a pinch. The needle needs to be re-sited every 2-3 days.

pump-application

As you can see from the above JPEG, the device itself can be clipped onto clothing and worn during the day for continued use.

The pump can help an individual patient more closely mimic the way a healthy pancreas functions. The pump, through a Continuous Subcutaneous Insulin Infusion (CSII), replaces the need for frequent injections by delivering precise doses of rapid-acting insulin 24 hours a day to closely match your body’s needs.  Two definitions should be understood relative to insulin usage.  These are as follows:

  • Basal Rate: A programmed insulin rate made of small amounts of insulin delivered continuously mimics the basal insulin production by the pancreas for normal functions of the body (not including food). The programmed rate is determined by your healthcare professional based on your personal needs. This basal rate delivery can also be customized according to your specific daily needs. For example, it can be suspended or increased / decreased for a definite time frame: this is not possible with basal insulin injections.
  • Bolus Dose: Additional insulin can be delivered “on demand” to match the food you are going to eat or to correct high blood sugar. Insulin pumps have bolus calculators that help you calculate your bolus amount based on settings that are pre-determined by your healthcare professional and again based on your special needs.

A modern insulin pump can accomplish both basal and bolus needs as the situation demands.

The benefits relative to traditional methods are as follows:

  • Easier dosing: calculating insulin requirements can be a complex task with many different aspects to be considered. It is important that the device ensures accurate dosing by taking into account any insulin already in the body, the current glucose levels, carbohydrate intake and personal insulin settings.
  • Greater flexibility:  The pump must be capable of instant adjustment to allow for exercise, during illness or to deliver small boluses to cover meals and snacks. This can easily be done with a touch of a button with the more-modern devices. There should be a temporary basal rate option to proportionally reduce or increase the basal insulin rate, during exercise or illness, for example.
  • More convenience: The device must offer additional convenience of a wirelessly connected blood glucose meter. This meter automatically sends blood glucose values to the pump, allowing more accurate calculations and to deliver insulin boluses discreetly.

These wonderful devices all result from technology and technological advances.  Needs DO generate devices.  I hope you enjoy this post and as always, I welcome your comments.

ESOPHAGEAL MOTILITY TEST

February 2, 2017


If you ever ever hear these words used relative to an investigation your doctor wants you undertake—RUN AWAY.  I say this advisedly because I just experienced this test due to issues I was and am having with acid reflux.  The first test was a barium swallow with pill.  This was not so bad and took a fairly short period of time. The motility test is definitely a horse of a different color.  Let’s examine the motility test and take a look at what all is involved.

ESOPHAGEAL MOTILITY:  We start first with a definition as follows:

An esophageal motility disorder is any medical disorder causing difficulty in swallowing, regurgitation of food and a spasm-type pain which can be brought on by an allergic reaction to certain foods. The most prominent one is dysphagia.  Dysphagia is the medical term used to describe difficulty swallowing. … In contrast, dysphagia is a symptom that only occurs when attempting to swallow. Globus can sometimes be seen in acid reflux disease, but more often, it is due to increased sensitivity in the throat or esophagus. There are several very popular over-the-counter medication to mitigate acid reflux.  Just a few are. 1.) TUMS, 2.) Alka-Seltzer, 3.) Milk of Magnesia, 4.) Pepto-Bismol, 5.) ZANTAC, 6.) Pepcid, 7.) Tagamet, and 8.) Prilosec OTC.  These medications work and work well but I really wanted to get an answer as to WHY I was having the reflux.  For this, testing was necessary.

The tubular esophagus is a muscular organ, approximately 25 cm in length, and has specialized sphincters at proximal and distal ends. (That upper and lower portions of the esophagus.) The upper esophageal sphincter (UES) is comprised of several striated muscles, creating a tonically closed valve and preventing air from entering into the gastrointestinal tract. The lower esophageal sphincter (LES) is composed entirely of smooth muscle and maintains a steady baseline tone to prevent gastric reflux into the esophagus.

Esophageal motility disorders are less common than mechanical and inflammatory diseases affecting the esophagus, such as reflux esophagitis, peptic strictures, and mucosal rings. The clinical presentation of a motility disorder is varied, but, classically, dysphagia and chest pain are reported. This was my case, chest pain accompanied with reflux after every meal. Before entertaining a diagnosis of a motility disorder, first and foremost, the physician must evaluate for a mechanical obstructing lesion. This is the motility test.

THE PROCEDURE: The procedure takes about forty-five (45) minutes from start to finish.  Please note, the patient, in this case ME, is fully awake so commands may be received and followed.

  • The nurse will verify that you had nothing by mouth in the last 6 hours prior to the test. It is a fasting test.  I also took none of the medications I normally take A.M. This is very important.
  • Your nostril and throat is numbed with a topical anesthetic while you are sitting upright. This topical anesthetic BURNS LIKE HELL and gives the sensation your nostril is stopped up. It actually is I suppose.
  • A thin flexible tube about one-eighth inch in diameter (approximately the size of pencil) is then passed through the nostril, down the back of the throat into the esophagus and the stomach, while the patient swallows water.  (Are you getting this?)  The nurse snakes a tube with thirty-six (36) pressure-sensing rings or holes through your nose and down your throat right into the upper portion of your stomach. OH by the way—you feel it all the way down!
  • The tube has holes in it that sense pressure along the esophagus. It will be positioned in different areas of your esophagus. The nurse moves the tube as the test progresses.
  • With the tube inside the esophagus, you will lie down on your left side.  This is to prevent ingesting bile and aspirating that into your lungs if it does occur.  (Now do I have your attention?)
  • The nurse will give you small sips of water during the test to record the progression of the swallow.  Each sip is metered and measured using a syringe. Five Ml, ten Ml, etc etc.
  • The contractions of the esophageal muscle will be measured at rest and during swallows.
  • Pressure recordings are made while the tube is in place and as the tube is slowly withdrawn.
  • The results of the manometry test are displayed as a graph with a wave pattern that can be interpreted to determine if the esophagus is functioning normally.  The digital image on the left below will indicate the location of the tube and on the right, the pressure spikes as you swallow. During the test, I started coughing and had difficulties in calming down.  With each cough, the tube would rattle around and bounce right and left hitting the walls of my esophagus.  Really great feeling.
  • Since your throat was numbed, you have to wait one hour after completion of the test before you can eat or drink anything. This is to protect you from burning your throat or choking.

esopheus

The actual display on the monitor looks like the images below.  Again, location on the left and pressure on the right.

image

I will certainly say this; the nurse was very patient with me as the tube was inserted and withdrawn.  The insertion feels like someone trying to slip a garden hose through the eye of a needle. One of the most uncomfortable feelings I have ever had. I am told some patients simply cannot tolerate the test and have to bail out.  It really was a struggle for me but I decided I needed an answer more than I needed immediate relief.

The technology monitoring the pressure is fabulous and very accurate.  As it turns out, my problem seems to be with the lower sphincter valve. It does not close tightly enough to prevent acid reflux.  I have no idea as to what the “fix” might be.  I find that out on 14 February.  I suppose that information will be my Valentine’s Day present.  I can promise you two things: 1.) Ain’t no way I’m repeating the test—ever and 2.) if I have to live on Prilosec for the rest of my life I will.  No surgery.


One of the items on my bucket list has been to attend the Consumer Electronics Show in Las Vegas.  (I probably need to put a rush on this one because the clock is ticking.)  For 50 years, CES has been the launching pad for innovation and new technology.  Much of this technology has changed the world. Held in Las Vegas every year, it is the world’s gathering place for all who thrive on the business of consumer technologies and where next-generation innovations are introduced to the commercial marketplace.   The International Consumer Electronics Show (International CES) showcases more than 3,800 exhibiting companies, including manufacturers, developers and suppliers of consumer technology hardware, content, technology delivery systems and more; a conference program with more than three hundred (300) conference sessions and more than one-hundred and sixty-five thousand attendees from one hundred1 (50) countries.  Because it is owned and produced by the Consumer Technology Association (CTA)™ — formerly the Consumer Electronics Association (CEA)® — the technology trade association representing the $287 billion U.S. consumer technology industry, and it attracts the world’s business leaders and pioneering thinkers to a forum where the industry’s most relevant issues are addressed.  The range of products is immense as seen from the listing of product categories below.

PRODUCT CATEGORIES:

  • 3D Printing
  • Accessories
  • Augmented Reality
  • Audio
  • Communications Infrastructure
  • Computer Hardware/Software/Services
  • Content Creation & Distribution
  • Digital/Online Media
  • Digital Imaging/Photography
  • Drones
  • Electronic Gaming
  • Fitness and Sports
  • Health and Biotech
  • Internet Services
  • Personal Privacy & Cyber Security
  • Robotics
  • Sensors
  • Smart Home
  • Startups
  • Vehicle Technology
  • Video
  • Wearables
  • Wireless Devices & Services

If we look at world-changing revolution and evolution coming from CES over the years, we may see the following advances in technology, most of which now commercialized:

  • Videocassette Recorder (VCR), 1970
  • Laserdisc Player, 1974
  • Camcorder and Compact Disc Player, 1981
  • Digital Audio Technology, 1990
  • Compact Disc – Interactive, 1991
  • Digital Satellite System (DSS), 1994
  • Digital Versatile Disk (DVD), 1996
  • High Definition Television (HDTV), 1998
  • Hard-disc VCR (PVR), 1999
  • Satellite Radio, 2000
  • Microsoft Xbox and Plasma TV, 2001
  • Home Media Server, 2002
  • Blu-Ray DVD and HDTV PVR, 2003
  • HD Radio, 2004
  • IP TV, 2005
  • Convergence of content and technology, 2007
  • OLED TV, 2008
  • 3D HDTV, 2009
  • Tablets, Netbooks and Android Devices, 2010
  • Connected TV, Smart Appliances, Android Honeycomb, Ford’s Electric Focus, Motorola Atrix, Microsoft Avatar Kinect, 2011
  • Ultrabooks, 3D OLED, Android 4.0 Tablets, 2012
  • Ultra HDTV, Flexible OLED, Driverless Car Technology, 2013
  • 3D Printers, Sensor Technology, Curved UHD, Wearable Technologies, 2014
  • 4K UHD, Virtual Reality, Unmanned Systems, 2015

Why don’t we do this, let’s now take a very brief look at several exhibits to get a feel for the products.  Here we go.

Augmented Reality (AR):

Through specially designed hardware and software full of cameras, sensors, algorithms and more, your perception of reality can be instantly altered in context with your environment. Applications include sports scores showing on TV during a match, the path of trajectory overlaying an image, gaming, construction plans and more.  VR (virtual reality) equipment is becoming extremely popular, not only with consumers, but with the Department of Defense, Department of Motor Vehicles, and companies venturing out to technology for training purposes.

augmented-reality

Cyber Security:

The Cyber & Personal Security Marketplace will feature innovations ranging from smart wallets and safe payment apps to secure messaging and private Internet access.  If you have never been hacked, you are one in a million.  I really don’t think there are many people who have remained unaffected by digital fraud.  One entire section of the CES is devoted to cyber security.

cyber-security

E-Commerce:

Enterprise solutions are integral for business. From analytics, consulting, integration and cyber security to e-commerce and mobile payment, the options are ever-evolving.  As you well know, each year the number of online shoppers increases and will eventually outpace the number of shoppers visiting “brick-and-motor stores.  Some feel this may see the demise of shopping centers altogether.

e-commerce

Self-Driving Autonomous Automobiles:

Some say if you are five years old or under you may never need a driver’s license.  I personally think this is a little far-fetched but who knows.  Self-driving automobiles are featured prominently at the CES.

self-driving-automobiles

Virtual Reality (VR):

Whether it will be the launch of the next wave of immersive multimedia for virtual reality systems and environments or gaming hardware, software and accessories designed for mobile, PCs or consoles, these exhibitors are sure to energize, empower and excite at CES 2017.

vr

i-Products:

From electronic plug-ins to fashionable cases, speakers, headphones and exciting new games and applications, the product Marketplace will feature the latest third-party accessories and software for your Apple iPod®, iPhone® and iPad® devices.

i-products

3-D Printing:

Most 3D printers are used for building prototypes for the medical, aerospace, engineering and automotive industries. But with the advancement of the digital technology supporting it, these machines are moving toward more compact units with affordable price points for today’s consumer.

30-d-printing

Robotic Systems:

The Robotics Marketplace will showcase intelligent, autonomous machines that are changing the way we live at work, at school, at the doctor’s office and at home.

robotics

Healthcare and Wellness:

Digital health continues to grow at an astonishing pace, with innovative solutions for diagnosing, monitoring and treating illnesses, to advancements in health care delivery and smarter lifestyles.

health-and-wellness

Sports Technology:

In a world where an athlete’s success hinges on milliseconds or millimeters, high-performance improvement and feedback are critical.

sports-technology

CONCLUSIONS:

I think it’s amazing and to our credit as a country that CES exists and presents, on an annual basis, designs and visions from the best and brightest.  A great show-place for ideas the world over from established companies and companies who wish to make their mark on technology.  Can’t wait to go—maybe next year.  As always, I welcome your comments.

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