The Conference at Paris
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Daril Atkins
Nov 18, 2009, 12:20:51 PM11/18/09
to Anaplastology
Paris was tolerably cold, drizzly and windy, The BCCA is working with
everyone to get the certification process right and is trying to make
that process clear. Those of us who were present offered our feedback
which was duly noted. I can understand the current difficulty of
accommodating quite a few of those who come only with experience and
may have a problem with the eligibility process. However the BCCA
seems willing to consider case by case without compromising the
process. It seems appropriate to congratulate them for their efforts.
In particular I would like to thank Juan for his willingness to
listen.
Anne Marie our new President obviously took a lot of pains to make
this an outstanding conference in all its aspects. The scientific
programmes were well planned to include the whole spectrum including
the application of art and the purely clinical and technical.
Beginning with Margot Cooper, President of Limbs and Things, and
Elisabeth Daynès,the Paleoartist, showed us another aspect of the
application of our knowledge and skills, just as the wonderful
exhibition organized by the AEIMS (European Association of Medical and
Scientific Illustrators). Finally on the third day the workshops too
covered the range of our art & science, from glass blown ocular
prosthesis to state of the art technology as applied in our field.
I just wish more Anaplastologists from the USA, Canada, UK, and Europe
could have attended, particularly those from the IASPE. Just as I wish
those from the Orient, though few in comparison, could have come too.
However everyone will have had their own reasons and constraints, yet
would like very much to know what happened and what pinnacle we may
have reached.
You must pardon me for my grouse, which consists of wondering after
every conference that we don't seem to have come closer to providing
access to the disfigured in the third world. We will hear a lot of
cluck clucks for the misfortune of such patients, about how the know
how or resources are lacking, about how dissatisfied we will be to
provide anything compromising our notions of quality, or how
technology will drop the cost, etc. To all this I can only say, go out
there in a pro bono, but take nothing with you in terms of resources.
All you will need is your very own resourcefulness, your creativity
and your ability to try very hard to understand the situation.
Lastly, the practice of generosity to all those within, on, or around
the periphery of our practices, regardless of their shortcomings,
their falling short of quality standards, their choice to prefer
manual methods rather than technology, or those who try their best to
use surgical methods. All of us are likened to the strands in a
fabric which has changing patterns. Everyday the patterns change with
this interlocking of different sets of skills, knowledge, needs and so
on. We are indeed one fabric, like it or not.
everyone to get the certification process right and is trying to make
that process clear. Those of us who were present offered our feedback
which was duly noted. I can understand the current difficulty of
accommodating quite a few of those who come only with experience and
may have a problem with the eligibility process. However the BCCA
seems willing to consider case by case without compromising the
process. It seems appropriate to congratulate them for their efforts.
In particular I would like to thank Juan for his willingness to
listen.
Anne Marie our new President obviously took a lot of pains to make
this an outstanding conference in all its aspects. The scientific
programmes were well planned to include the whole spectrum including
the application of art and the purely clinical and technical.
Beginning with Margot Cooper, President of Limbs and Things, and
Elisabeth Daynès,the Paleoartist, showed us another aspect of the
application of our knowledge and skills, just as the wonderful
exhibition organized by the AEIMS (European Association of Medical and
Scientific Illustrators). Finally on the third day the workshops too
covered the range of our art & science, from glass blown ocular
prosthesis to state of the art technology as applied in our field.
I just wish more Anaplastologists from the USA, Canada, UK, and Europe
could have attended, particularly those from the IASPE. Just as I wish
those from the Orient, though few in comparison, could have come too.
However everyone will have had their own reasons and constraints, yet
would like very much to know what happened and what pinnacle we may
have reached.
You must pardon me for my grouse, which consists of wondering after
every conference that we don't seem to have come closer to providing
access to the disfigured in the third world. We will hear a lot of
cluck clucks for the misfortune of such patients, about how the know
how or resources are lacking, about how dissatisfied we will be to
provide anything compromising our notions of quality, or how
technology will drop the cost, etc. To all this I can only say, go out
there in a pro bono, but take nothing with you in terms of resources.
All you will need is your very own resourcefulness, your creativity
and your ability to try very hard to understand the situation.
Lastly, the practice of generosity to all those within, on, or around
the periphery of our practices, regardless of their shortcomings,
their falling short of quality standards, their choice to prefer
manual methods rather than technology, or those who try their best to
use surgical methods. All of us are likened to the strands in a
fabric which has changing patterns. Everyday the patterns change with
this interlocking of different sets of skills, knowledge, needs and so
on. We are indeed one fabric, like it or not.
John and Christine Felser
Nov 18, 2009, 2:24:41 PM11/18/09
to anapla...@googlegroups.com
Daril,
Thank you for your report and perspectives on the Paris conference,
from on who did not attend! I am intrigued as to how to work on patients
from the third world, be it travel there with transportable lab supplies, or
establish a cooperative work with indigenous providers, which might both
treat patients and train technicians.
Sincerely,
Christine Felser
John and Christine Felser
265 Candlebrook Rd.
King of Prussia, PA 19406
USA
"We walk by faith, not by sight". II Cor. 5:7
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19:26:00
Thank you for your report and perspectives on the Paris conference,
from on who did not attend! I am intrigued as to how to work on patients
from the third world, be it travel there with transportable lab supplies, or
establish a cooperative work with indigenous providers, which might both
treat patients and train technicians.
Sincerely,
Christine Felser
John and Christine Felser
265 Candlebrook Rd.
King of Prussia, PA 19406
USA
"We walk by faith, not by sight". II Cor. 5:7
You received this message because you are subscribed to the Google Groups
"Anaplastology" group.
To post to this group, send email to anapla...@googlegroups.com.
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19:26:00
Daril Atkins
Nov 20, 2009, 2:31:44 AM11/20/09
to Anaplastology
Hello John and Christine,
To begin with, may I request you to view a power point presentation
titled 'AAA 2007' in the FILES category of this site. This is my
keynote presentation at the Washington DC annual in 2007. The synopsis
would read as "India is taken as an example from among the developing
countries because of the wide disparities in the distribution of
wealth. Access to health care facilities for the super rich, upper,
middle, lower income groups would vary depending on its availability
in the public or private sector; depending on location; depending on
costs; depending on coverage; etc on the one hand. While on the other
hand, statistics show that being in the low income group would
influence literacy, which could influence late detections of malignant
tumors, which may warrant radical resections. Further to that,
continued treatments by way of radiation, chemo and frequent clinical
examinations would require the postponement of reconstructive
procedures, which in turn indicates a restoration camouflage. The
majority of such unfortunate souls have a very low sustenance level,
which begins with nutrition, shelter and clothing. They would be
inclined to use water, first in drinking, cooking, then personal
hygiene at the minimum. Their humble homes will not have a fridge or
an air conditioner, whereas a fan would be a luxury."
Would you John and Christine, recommend a medical silicone prosthesis,
retained by osseointegrated implants or by a medical adhesive?
If yes, do you think that the patient we are talking about, would be
able to maintain the level of hygiene mandatory in the case of
osseointegrated implants, or if medical adhesive is used, could he
prevent its shelf life from shortening? If the answer is no, then we
need to rule out medical silicone polymer as the final product
material. In this scenario, our patient is from the low income group,
perhaps close to the poverty line, but living in the urban areas. Can
you imagine the same patient living in a rural area?
The three tier system that I had proposed in 2007, consist of a
facility capable of providing state of the art, conventional and
indigenous technologies, to serve and allow access to any level. Thus
the super rich, upper income groups could opt for the state of the art
technology, and will pay international prices, from which part of the
profits are channeled to the development of indigenous technology
products. The development of restorative camouflages using indigenous
technology is a virgin area and could prove to be an exciting
challenge.
Take a second look at our current product, namely the medical silicone
polymer prostheses. It has an average life time of two years, it
discolors, and frays. I am aware that all these are being addressed
and some, like for example Dr. Robert Erb, among several others have
become adept at intrinsic coloration.
Pardon this elaborate explanation, which in itself remains incomplete
due to its many facets. However I for one, believe that the indigenous
technologies need to be developed in third world countries, whose
populations are exploding. The WEST as you already know has embraced
medical silicone polymers as THE final product material, and have
created a technological system around it. In my humble opinion, this
is a faulty strategy which anchors the profession (like the proverbial
elephant). Okay lets go to that arena. In the near future, we are
looking at a system whereby the final product will be 3D printed in
its final form (perhaps at home by the patient). So it may become
necessary to look at materials which lend themselves to that
technique. Or perhaps it may be necessary to change the silicone
formula to enable it to be printed. But let me leave all that to those
on that wagon.
Once again, please peruse my presentation "AAA 2007"
Daril Atkins
On Nov 18, 11:24 pm, "John and Christine Felser"
> For more options, visit this group athttp://groups.google.com/group/anaplastology?hl=.
>
> - Show quoted text -
To begin with, may I request you to view a power point presentation
titled 'AAA 2007' in the FILES category of this site. This is my
keynote presentation at the Washington DC annual in 2007. The synopsis
would read as "India is taken as an example from among the developing
countries because of the wide disparities in the distribution of
wealth. Access to health care facilities for the super rich, upper,
middle, lower income groups would vary depending on its availability
in the public or private sector; depending on location; depending on
costs; depending on coverage; etc on the one hand. While on the other
hand, statistics show that being in the low income group would
influence literacy, which could influence late detections of malignant
tumors, which may warrant radical resections. Further to that,
continued treatments by way of radiation, chemo and frequent clinical
examinations would require the postponement of reconstructive
procedures, which in turn indicates a restoration camouflage. The
majority of such unfortunate souls have a very low sustenance level,
which begins with nutrition, shelter and clothing. They would be
inclined to use water, first in drinking, cooking, then personal
hygiene at the minimum. Their humble homes will not have a fridge or
an air conditioner, whereas a fan would be a luxury."
Would you John and Christine, recommend a medical silicone prosthesis,
retained by osseointegrated implants or by a medical adhesive?
If yes, do you think that the patient we are talking about, would be
able to maintain the level of hygiene mandatory in the case of
osseointegrated implants, or if medical adhesive is used, could he
prevent its shelf life from shortening? If the answer is no, then we
need to rule out medical silicone polymer as the final product
material. In this scenario, our patient is from the low income group,
perhaps close to the poverty line, but living in the urban areas. Can
you imagine the same patient living in a rural area?
The three tier system that I had proposed in 2007, consist of a
facility capable of providing state of the art, conventional and
indigenous technologies, to serve and allow access to any level. Thus
the super rich, upper income groups could opt for the state of the art
technology, and will pay international prices, from which part of the
profits are channeled to the development of indigenous technology
products. The development of restorative camouflages using indigenous
technology is a virgin area and could prove to be an exciting
challenge.
Take a second look at our current product, namely the medical silicone
polymer prostheses. It has an average life time of two years, it
discolors, and frays. I am aware that all these are being addressed
and some, like for example Dr. Robert Erb, among several others have
become adept at intrinsic coloration.
Pardon this elaborate explanation, which in itself remains incomplete
due to its many facets. However I for one, believe that the indigenous
technologies need to be developed in third world countries, whose
populations are exploding. The WEST as you already know has embraced
medical silicone polymers as THE final product material, and have
created a technological system around it. In my humble opinion, this
is a faulty strategy which anchors the profession (like the proverbial
elephant). Okay lets go to that arena. In the near future, we are
looking at a system whereby the final product will be 3D printed in
its final form (perhaps at home by the patient). So it may become
necessary to look at materials which lend themselves to that
technique. Or perhaps it may be necessary to change the silicone
formula to enable it to be printed. But let me leave all that to those
on that wagon.
Once again, please peruse my presentation "AAA 2007"
Daril Atkins
On Nov 18, 11:24 pm, "John and Christine Felser"
>
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> 19:26:00- Hide quoted text -
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>
> - Show quoted text -
Kuldeep Raizada, Ocularist
Nov 20, 2009, 3:16:30 AM11/20/09
to anapla...@googlegroups.com
--------------------------------------------------------------------------------------
Kuldeep Raizada, Ph D,Clinical Ocularist & Anaplastologist
Department of Ocular and Orbital Prosthesis
LV Prasad Eye Institute,
Hyderabad, INDIA.
E-mail: ocul...@gmail.com
Mobile: (91)-984 919-3447
Office: (91)-40-3061-2332
Fax:(91)-40-2354-8271
Web:www.lvpei.org
------------------------------------------------------------------------------------------
John and Christine Felser
Nov 20, 2009, 9:32:58 AM11/20/09
to anapla...@googlegroups.com
Thank you so much, Daril, and I have retained your 2007 information. I
learned silicone technology from Dr. Erb, and we continue to work together
on patients. The indigenous tier is of the greatest concern to me, because
of the great need (although all needs are valid) and the great challenge. I
appreciate your response.
Sincerely,
Christine Felser
Version: 8.5.425 / Virus Database: 270.14.61/2497 - Release Date: 11/19/09
19:42:00
learned silicone technology from Dr. Erb, and we continue to work together
on patients. The indigenous tier is of the greatest concern to me, because
of the great need (although all needs are valid) and the great challenge. I
appreciate your response.
Sincerely,
Christine Felser
19:42:00
Paul Tanner
Nov 20, 2009, 11:38:03 AM11/20/09
to anapla...@googlegroups.com
Daril,
Currently there is no material that feels and looks like human skin. I use silicone because I believe it is the best material, as do most. It is not the easiest to work with. It is not the easiest to procure either though. This may be our biggest challenge. I have colleagues in developing countries that use acrylic prostheses. This is an art as well, but less expensive and more available. I have also seen people make their own prostheses out of bandages, metal, and wood. I find it hard to believe that people paying "international" prices would somehow fund the poorest people. It sounds wonderful but will not work. One thing that I would like to see happen is training around the world. I, as well as others have lined up volunteer missions where we train people while working with their patients. One important questions is- who do we train?
I know you see the profession going in a different direction. However, the future is what we make of it today. Just so you know, I do not use much technology in my clinic. When it becomes practical and affordable to me, I'm certain I'll buy it. I'm grateful for those that are currently doing research in the area. It is their hope and mine that a greater good will come from doing so.
Paul
-----Original Message-----
From: Daril Atkins [mailto:darila...@gmail.com]
Sent: Friday, November 20, 2009 12:32 AM
To: Anaplastology
Subject: [Anaplastology] Re: The Conference at Paris
Currently there is no material that feels and looks like human skin. I use silicone because I believe it is the best material, as do most. It is not the easiest to work with. It is not the easiest to procure either though. This may be our biggest challenge. I have colleagues in developing countries that use acrylic prostheses. This is an art as well, but less expensive and more available. I have also seen people make their own prostheses out of bandages, metal, and wood. I find it hard to believe that people paying "international" prices would somehow fund the poorest people. It sounds wonderful but will not work. One thing that I would like to see happen is training around the world. I, as well as others have lined up volunteer missions where we train people while working with their patients. One important questions is- who do we train?
I know you see the profession going in a different direction. However, the future is what we make of it today. Just so you know, I do not use much technology in my clinic. When it becomes practical and affordable to me, I'm certain I'll buy it. I'm grateful for those that are currently doing research in the area. It is their hope and mine that a greater good will come from doing so.
Paul
-----Original Message-----
From: Daril Atkins [mailto:darila...@gmail.com]
Sent: Friday, November 20, 2009 12:32 AM
To: Anaplastology
Subject: [Anaplastology] Re: The Conference at Paris
Kuldeep Raizada, Ocularist
Nov 20, 2009, 2:14:47 PM11/20/09
to anapla...@googlegroups.com
Dear Paul: I agree with you, very true about the technology and its affordability,
I miss this year meeting and most likely i will be there in florida meeting
regards
Kuldeep
I miss this year meeting and most likely i will be there in florida meeting
regards
Kuldeep
To unsubscribe from this group, send email to anaplastolog...@googlegroups.com.
Daril Atkins
Nov 21, 2009, 12:35:08 PM11/21/09
to Anaplastology
Paul
It will not be up to those that can afford the state of the art tier
to pay for the poorest people. They will pay a high price for
restorations made using the state of the art technology, period.
However included in that price will be a percentage that is channeled
into development of, and the cost of making a restoration for the poor
patients using indigenous technology. If you will be patient enough I
will prove that it will indeed work. In your volunteer missions, you
say you train people while working with their patients. May I ask as
to what technology you train them to function with?
Your last poser "..who do we train?" reminds me of a discussion I had
during the Washington DC sortie. My contention was that in the third
world the most culturally appropriate technology could possibly become
a reality by means of 'deprofessionalization' which means that you
would seek out local village crafts persons, and re train them to use
their own resources and skills to fashion restorations.
Consider my presentation (pardon me for referring to my presentations,
if only to suggest that I did mention...) in Toronto where I pointed
out that our patients have more choices now than they had in the past,
and they will have more choices in the future. The choices or in some
cases surgical advances, consists of replantation or transplantation
of parts of the hand, ear, nose in case of traumatic loss. Once again
in surgical advances, reconstruction of the ear or nose. Then again
consider that with early detection and awareness the number of those
who may need gross resection will decrease and so will workloads.
While surgical advances and other related medical technologies may
make such disfigurements unnecessary. Futuristic technologies such as
tissue engineering and regeneration may be around the corner to come
to the rescue of those with loss or absence of external body parts.
All in all it points to a decrease in workloads. And this scenario
will happen eventually in the West to begin with where systems are in
place to allow access.
In contrast, developing countries in the third world will take a
longer time to get there, and so will have larger workloads. Even at
present such workloads as we see at present is greater in volume than
in the West. It is for this reason that I am recommending the three
tier strategy. True enough that training is necessary because a
workforce is needed. While currently visitors to India come to train
candidates in this art and science, the focus is on 'how the West does
it' and the system will also include the relevant retention methods.
Fine as it goes. But that strategy essentially aims at the upper tier,
and if applied to the lower tier it is faced with potential failures.
This happened in the early seventies. I would be most obliged for your
opinion in the light of what is mentioned in my response.
Daril Atkins
> For more options, visit this group at- Hide quoted text -
>
> - Show quoted text -...
>
> read more »
It will not be up to those that can afford the state of the art tier
to pay for the poorest people. They will pay a high price for
restorations made using the state of the art technology, period.
However included in that price will be a percentage that is channeled
into development of, and the cost of making a restoration for the poor
patients using indigenous technology. If you will be patient enough I
will prove that it will indeed work. In your volunteer missions, you
say you train people while working with their patients. May I ask as
to what technology you train them to function with?
Your last poser "..who do we train?" reminds me of a discussion I had
during the Washington DC sortie. My contention was that in the third
world the most culturally appropriate technology could possibly become
a reality by means of 'deprofessionalization' which means that you
would seek out local village crafts persons, and re train them to use
their own resources and skills to fashion restorations.
Consider my presentation (pardon me for referring to my presentations,
if only to suggest that I did mention...) in Toronto where I pointed
out that our patients have more choices now than they had in the past,
and they will have more choices in the future. The choices or in some
cases surgical advances, consists of replantation or transplantation
of parts of the hand, ear, nose in case of traumatic loss. Once again
in surgical advances, reconstruction of the ear or nose. Then again
consider that with early detection and awareness the number of those
who may need gross resection will decrease and so will workloads.
While surgical advances and other related medical technologies may
make such disfigurements unnecessary. Futuristic technologies such as
tissue engineering and regeneration may be around the corner to come
to the rescue of those with loss or absence of external body parts.
All in all it points to a decrease in workloads. And this scenario
will happen eventually in the West to begin with where systems are in
place to allow access.
In contrast, developing countries in the third world will take a
longer time to get there, and so will have larger workloads. Even at
present such workloads as we see at present is greater in volume than
in the West. It is for this reason that I am recommending the three
tier strategy. True enough that training is necessary because a
workforce is needed. While currently visitors to India come to train
candidates in this art and science, the focus is on 'how the West does
it' and the system will also include the relevant retention methods.
Fine as it goes. But that strategy essentially aims at the upper tier,
and if applied to the lower tier it is faced with potential failures.
This happened in the early seventies. I would be most obliged for your
opinion in the light of what is mentioned in my response.
Daril Atkins
>
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