WEBVTT 00:00:00.000 --> 00:00:00.500 align:middle line:90% 00:00:00.500 --> 00:00:03.650 align:middle line:84% Thank you guys all for coming, fantastic turnout. 00:00:03.650 --> 00:00:06.320 align:middle line:84% I'm Chet Moritz from the Center for Neurotechnology. 00:00:06.320 --> 00:00:08.610 align:middle line:84% I'm going to introduce Jon Schlueter in just a moment, 00:00:08.610 --> 00:00:09.840 align:middle line:84% but I have a couple of announcements 00:00:09.840 --> 00:00:11.460 align:middle line:84% that I'm obligated to make because, of course, 00:00:11.460 --> 00:00:13.910 align:middle line:84% we have to thank our sponsors and all the usual things, 00:00:13.910 --> 00:00:14.410 align:middle line:90% right? 00:00:14.410 --> 00:00:18.930 align:middle line:84% So we have a group on the webcast, welcome. 00:00:18.930 --> 00:00:20.873 align:middle line:84% And Scott will read out your questions, 00:00:20.873 --> 00:00:21.790 align:middle line:90% if you have questions. 00:00:21.790 --> 00:00:24.050 align:middle line:84% So please do post those, type those in. 00:00:24.050 --> 00:00:26.550 align:middle line:84% This is sponsored by the Center for Neurotechnology National 00:00:26.550 --> 00:00:31.650 align:middle line:84% Science Foundation ERC and also by the DO-IT ADEPT program. 00:00:31.650 --> 00:00:33.900 align:middle line:84% And so thanks everybody for coming. 00:00:33.900 --> 00:00:36.150 align:middle line:84% I'm going to put in a tiny little plug to the students 00:00:36.150 --> 00:00:38.530 align:middle line:90% I talked to Tuesday. 00:00:38.530 --> 00:00:41.340 align:middle line:84% Thank you for filling out the survey, 21 responses, 00:00:41.340 --> 00:00:42.178 align:middle line:90% you guys rock! 00:00:42.178 --> 00:00:44.470 align:middle line:84% I just need you to do one more thing and that's sign up 00:00:44.470 --> 00:00:45.387 align:middle line:90% for focus groups. 00:00:45.387 --> 00:00:47.220 align:middle line:84% So we already have like four or five people, 00:00:47.220 --> 00:00:49.165 align:middle line:90% we just need like a couple more. 00:00:49.165 --> 00:00:51.540 align:middle line:84% So please do that by the end of the week, more free food. 00:00:51.540 --> 00:00:53.290 align:middle line:84% We need to know how much free food order. 00:00:53.290 --> 00:00:55.410 align:middle line:84% That's why we need you to just sign up for the focus group. 00:00:55.410 --> 00:00:57.390 align:middle line:84% You just got another email from Erica, I think, with the link. 00:00:57.390 --> 00:00:59.973 align:middle line:84% The first link might have been broken-- we apologize for that. 00:00:59.973 --> 00:01:01.425 align:middle line:84% That's all I'm going to say there. 00:01:01.425 --> 00:01:02.800 align:middle line:84% And then I want to spend the rest 00:01:02.800 --> 00:01:06.940 align:middle line:84% of the time introducing who's become a good friend, Jon. 00:01:06.940 --> 00:01:10.800 align:middle line:84% Jon has been in our study of spinal stimulation-- 00:01:10.800 --> 00:01:14.010 align:middle line:84% some of you have seen his videos with what the results of that 00:01:14.010 --> 00:01:14.940 align:middle line:90% study was-- 00:01:14.940 --> 00:01:18.240 align:middle line:84% but really the point of today is to hear about Jon's experience 00:01:18.240 --> 00:01:19.950 align:middle line:84% and to have a dialogue with everyone, 00:01:19.950 --> 00:01:24.900 align:middle line:84% so-- get your questions about how Jon's life has evolved 00:01:24.900 --> 00:01:30.212 align:middle line:84% over the last 13 years and what we could do as neural engineers 00:01:30.212 --> 00:01:31.420 align:middle line:90% to make his life even better. 00:01:31.420 --> 00:01:33.587 align:middle line:84% I think that's really the topic of the conversation, 00:01:33.587 --> 00:01:36.923 align:middle line:84% but also how has his experience been, 00:01:36.923 --> 00:01:39.090 align:middle line:84% does he feel like he's in control of this stimulator 00:01:39.090 --> 00:01:39.840 align:middle line:90% when it's running? 00:01:39.840 --> 00:01:41.170 align:middle line:90% I know our ethics people-- 00:01:41.170 --> 00:01:43.128 align:middle line:84% I know you guys have questions cued up already. 00:01:43.128 --> 00:01:44.280 align:middle line:90% I don't need to prime you. 00:01:44.280 --> 00:01:45.655 align:middle line:84% But that's really the goal, and I 00:01:45.655 --> 00:01:49.195 align:middle line:84% think you'll really enjoy hearing Jon's story 00:01:49.195 --> 00:01:51.070 align:middle line:84% and you'll really enjoy interacting with him. 00:01:51.070 --> 00:01:52.770 align:middle line:84% I know when I'm in the room with Jon 00:01:52.770 --> 00:01:54.190 align:middle line:90% it puts me in a better mood. 00:01:54.190 --> 00:01:56.270 align:middle line:84% So we call that microexpressions, right? 00:01:56.270 --> 00:01:58.290 align:middle line:84% Not microaggressions, but microexpressions-- 00:01:58.290 --> 00:02:00.202 align:middle line:84% just these little bits of optimism 00:02:00.202 --> 00:02:02.160 align:middle line:84% that can kind of lift everybody up in the room. 00:02:02.160 --> 00:02:05.010 align:middle line:84% So without any further ado, I want to give Jon about 5, 00:02:05.010 --> 00:02:07.980 align:middle line:84% 10 minutes to just tell you about what's going on for him 00:02:07.980 --> 00:02:10.760 align:middle line:84% and then we'll open it up to Q&A for the rest of the hour. 00:02:10.760 --> 00:02:11.260 align:middle line:90% Jon? 00:02:11.260 --> 00:02:13.920 align:middle line:90% 00:02:13.920 --> 00:02:15.190 align:middle line:90% Thank you all for being here. 00:02:15.190 --> 00:02:20.143 align:middle line:84% First of all, as a beneficiary of technology 00:02:20.143 --> 00:02:21.810 align:middle line:84% I'm just really grateful that you're all 00:02:21.810 --> 00:02:24.480 align:middle line:90% interested, for sure. 00:02:24.480 --> 00:02:28.450 align:middle line:84% I guess the main ingredients of my story-- 00:02:28.450 --> 00:02:31.030 align:middle line:84% pun intended-- I hit a low point 13 years ago. 00:02:31.030 --> 00:02:35.140 align:middle line:84% I misjudged the bottom of a pool and broke my neck in the pool 00:02:35.140 --> 00:02:38.260 align:middle line:84% and floated to the bottom and woke up a week 00:02:38.260 --> 00:02:42.110 align:middle line:84% later with a breathing machine and a feeding tube. 00:02:42.110 --> 00:02:45.720 align:middle line:84% That was 13 years ago and that's where we started. 00:02:45.720 --> 00:02:49.400 align:middle line:84% So I'm thankful for that, just to be here. 00:02:49.400 --> 00:02:56.480 align:middle line:84% I guess to wrap it up I pursued exercise-based recovery 00:02:56.480 --> 00:02:57.990 align:middle line:90% the first five years afterwards. 00:02:57.990 --> 00:03:00.010 align:middle line:84% I really thought if I tried hard enough 00:03:00.010 --> 00:03:01.590 align:middle line:90% I would be walking again. 00:03:01.590 --> 00:03:04.210 align:middle line:84% That's all you ever hear when you 00:03:04.210 --> 00:03:05.960 align:middle line:84% break your neck-- if just try hard enough, 00:03:05.960 --> 00:03:06.960 align:middle line:90% you'll be walking again. 00:03:06.960 --> 00:03:10.810 align:middle line:84% And well, five years into that I kind of ran its course, 00:03:10.810 --> 00:03:12.960 align:middle line:84% I ran out of money and motivation. 00:03:12.960 --> 00:03:18.070 align:middle line:84% I was able to get things back, I could walk a little tiny bit 00:03:18.070 --> 00:03:21.200 align:middle line:84% and then nothing came back and I kind of 00:03:21.200 --> 00:03:23.700 align:middle line:84% just-- you start to get your head around things that nothing 00:03:23.700 --> 00:03:25.500 align:middle line:84% is going to come back and that's how life's going to be 00:03:25.500 --> 00:03:26.600 align:middle line:90% and you move on. 00:03:26.600 --> 00:03:29.860 align:middle line:90% 00:03:29.860 --> 00:03:33.110 align:middle line:84% I'm really wrapping things up here-- 00:03:33.110 --> 00:03:37.018 align:middle line:84% so I've been here at the UW this whole time. 00:03:37.018 --> 00:03:38.310 align:middle line:90% That's where I get all my care. 00:03:38.310 --> 00:03:41.790 align:middle line:84% I'm part of the Center for Paralysis that they have 00:03:41.790 --> 00:03:44.580 align:middle line:84% and they got to hold of me last year 00:03:44.580 --> 00:03:48.610 align:middle line:84% about the possibility of being in the trial. 00:03:48.610 --> 00:03:49.533 align:middle line:90% I'm pretty picky now. 00:03:49.533 --> 00:03:50.950 align:middle line:84% I wouldn't be part of any trial, I 00:03:50.950 --> 00:03:53.770 align:middle line:84% wouldn't be part of a stem cell trial or something that 00:03:53.770 --> 00:03:57.250 align:middle line:84% was going to give me an unknown result. This one 00:03:57.250 --> 00:04:00.130 align:middle line:84% really made sense to me I've used- I guess 00:04:00.130 --> 00:04:02.250 align:middle line:90% we'll talk about what it is. 00:04:02.250 --> 00:04:06.730 align:middle line:84% It's basically an electrical e-stim that goes over my injury 00:04:06.730 --> 00:04:08.110 align:middle line:90% and forces the communication. 00:04:08.110 --> 00:04:10.900 align:middle line:84% I guess that's putting it in layman's terms, 00:04:10.900 --> 00:04:11.900 align:middle line:90% but it made sense to me. 00:04:11.900 --> 00:04:16.630 align:middle line:84% And so I was excited about it and I started the process 00:04:16.630 --> 00:04:19.441 align:middle line:90% and I was selected. 00:04:19.441 --> 00:04:20.399 align:middle line:90% It was an honor for me. 00:04:20.399 --> 00:04:24.720 align:middle line:84% I took it as a professional job, basically. 00:04:24.720 --> 00:04:27.060 align:middle line:84% Long story short, over the course 00:04:27.060 --> 00:04:29.940 align:middle line:84% of four months I got what I would say 00:04:29.940 --> 00:04:31.920 align:middle line:84% is a lot of notable recovery back. 00:04:31.920 --> 00:04:34.950 align:middle line:84% So 13 years into a spinal cord injury, 00:04:34.950 --> 00:04:37.470 align:middle line:84% where the conventional wisdom is probably not 00:04:37.470 --> 00:04:39.910 align:middle line:84% going to get anything back at this point, 00:04:39.910 --> 00:04:41.580 align:middle line:90% I started getting stuff back. 00:04:41.580 --> 00:04:44.520 align:middle line:84% At the end of four months I've got 00:04:44.520 --> 00:04:47.550 align:middle line:84% enough dexterity in my left hand that I 00:04:47.550 --> 00:04:52.390 align:middle line:84% can play an instrument again and do all the time now. 00:04:52.390 --> 00:04:55.678 align:middle line:84% There's a list of things that happens-- 00:04:55.678 --> 00:04:57.470 align:middle line:84% recoveries that happen that we'll get into, 00:04:57.470 --> 00:05:00.650 align:middle line:90% but that's the gist of it. 00:05:00.650 --> 00:05:03.597 align:middle line:84% Without getting too much into injury life, 00:05:03.597 --> 00:05:04.430 align:middle line:90% that's why I'm here. 00:05:04.430 --> 00:05:08.210 align:middle line:90% 00:05:08.210 --> 00:05:08.960 align:middle line:90% That's great, Jon. 00:05:08.960 --> 00:05:10.070 align:middle line:84% Do you guys, do you want to-- does 00:05:10.070 --> 00:05:12.020 align:middle line:84% anyone have a burning question you want to just throw out? 00:05:12.020 --> 00:05:14.210 align:middle line:84% If not, we'll ask Jon to go into more details, 00:05:14.210 --> 00:05:15.720 align:middle line:84% give you guys more stuff to hang on. 00:05:15.720 --> 00:05:18.630 align:middle line:90% 00:05:18.630 --> 00:05:20.060 align:middle line:90% Yeah, please. 00:05:20.060 --> 00:05:21.060 align:middle line:90% I appreciate your story. 00:05:21.060 --> 00:05:24.620 align:middle line:84% I'm really curious, where were you [INAUDIBLE] 00:05:24.620 --> 00:05:28.163 align:middle line:90% where were you four months ago? 00:05:28.163 --> 00:05:29.580 align:middle line:84% And how long were you in that-- it 00:05:29.580 --> 00:05:34.610 align:middle line:84% sounds like there was a period of just stagnation. 00:05:34.610 --> 00:05:36.580 align:middle line:90% No progress. 00:05:36.580 --> 00:05:39.040 align:middle line:84% I have what's called an incomplete injury, 00:05:39.040 --> 00:05:41.470 align:middle line:84% and so I'm injured at my neck level 00:05:41.470 --> 00:05:44.153 align:middle line:84% but I've got enough signal that goes through 00:05:44.153 --> 00:05:45.445 align:middle line:90% that I'm almost like a stroke-- 00:05:45.445 --> 00:05:48.950 align:middle line:90% 00:05:48.950 --> 00:05:51.690 align:middle line:90% don't say victim-- survivor. 00:05:51.690 --> 00:05:52.490 align:middle line:90% Thank you. 00:05:52.490 --> 00:05:54.780 align:middle line:84% Or my left side works better than my right side. 00:05:54.780 --> 00:05:57.280 align:middle line:84% My right side is almost nothing and for-- 00:05:57.280 --> 00:05:59.430 align:middle line:90% to answer you question-- 00:05:59.430 --> 00:06:00.870 align:middle line:90% this hand did nothing. 00:06:00.870 --> 00:06:02.580 align:middle line:84% This was just an appendage to me. 00:06:02.580 --> 00:06:04.223 align:middle line:84% I almost forgot about my right side. 00:06:04.223 --> 00:06:05.640 align:middle line:84% That's how it gets because I could 00:06:05.640 --> 00:06:08.490 align:middle line:84% function with my left side and this side just almost 00:06:08.490 --> 00:06:09.080 align:middle line:90% disappeared. 00:06:09.080 --> 00:06:10.140 align:middle line:90% It's weird. 00:06:10.140 --> 00:06:12.650 align:middle line:84% I would like-- you can do little tricks. 00:06:12.650 --> 00:06:15.060 align:middle line:84% If I pull my wrist back, I can get a grip like that. 00:06:15.060 --> 00:06:17.690 align:middle line:84% So I would just do it, kind of fake it through. 00:06:17.690 --> 00:06:20.873 align:middle line:90% So for, 13-- 00:06:20.873 --> 00:06:23.290 align:middle line:84% I mean, I got a little recovery back in those early years, 00:06:23.290 --> 00:06:24.850 align:middle line:84% but for 13 years I've basically been 00:06:24.850 --> 00:06:28.840 align:middle line:84% able to do macro movements with this hand, kind of fake it. 00:06:28.840 --> 00:06:31.660 align:middle line:84% I can do like-- but I couldn't do fine motor skills. 00:06:31.660 --> 00:06:35.020 align:middle line:84% I could stand up a little bit, I could use the tone in my legs 00:06:35.020 --> 00:06:36.910 align:middle line:84% and to activate, I could stand with a walker 00:06:36.910 --> 00:06:39.395 align:middle line:84% for about a couple of minutes, then I got to sit back down. 00:06:39.395 --> 00:06:40.290 align:middle line:90% That's about it. 00:06:40.290 --> 00:06:42.970 align:middle line:90% 00:06:42.970 --> 00:06:44.170 align:middle line:90% I've been blessed, actually. 00:06:44.170 --> 00:06:46.960 align:middle line:84% I have had no pain that a lot of people with my injury 00:06:46.960 --> 00:06:49.120 align:middle line:84% has to deal with their whole life. 00:06:49.120 --> 00:06:50.720 align:middle line:84% It was something that was kind of-- 00:06:50.720 --> 00:06:52.750 align:middle line:90% it was on my mind. 00:06:52.750 --> 00:06:54.250 align:middle line:84% I didn't have too much reservation 00:06:54.250 --> 00:06:56.167 align:middle line:84% to be in this trial, but that was one of them. 00:06:56.167 --> 00:06:57.515 align:middle line:90% I didn't want to activate pain. 00:06:57.515 --> 00:06:59.890 align:middle line:84% Because that can be-- you talk to people in wheelchairs-- 00:06:59.890 --> 00:07:01.432 align:middle line:84% some people would rather give up pain 00:07:01.432 --> 00:07:03.400 align:middle line:84% than walk to start off with, right? 00:07:03.400 --> 00:07:09.220 align:middle line:90% 00:07:09.220 --> 00:07:13.450 align:middle line:90% Yeah, yeah. 00:07:13.450 --> 00:07:16.870 align:middle line:84% So up until that point I have done just about everything. 00:07:16.870 --> 00:07:21.610 align:middle line:84% I've done every rep and exercise, day after day, 00:07:21.610 --> 00:07:22.720 align:middle line:90% after year after year. 00:07:22.720 --> 00:07:27.310 align:middle line:84% I was confident I've maxed out my exercise ability to recover. 00:07:27.310 --> 00:07:32.410 align:middle line:90% 00:07:32.410 --> 00:07:35.840 align:middle line:84% I guess that's the special thing that we've got. 00:07:35.840 --> 00:07:39.430 align:middle line:84% In four months, to get any movement at all, 00:07:39.430 --> 00:07:40.738 align:middle line:90% I didn't expect anything. 00:07:40.738 --> 00:07:42.280 align:middle line:84% I was hoping maybe a little something 00:07:42.280 --> 00:07:45.030 align:middle line:90% would happen in this hand. 00:07:45.030 --> 00:07:46.910 align:middle line:90% I don't know what to say. 00:07:46.910 --> 00:07:48.160 align:middle line:90% I've said this so many times-- 00:07:48.160 --> 00:07:50.580 align:middle line:84% I could not bend my wrist like this. 00:07:50.580 --> 00:07:53.770 align:middle line:84% I couldn't touch these two fingers for 13 years together. 00:07:53.770 --> 00:07:56.850 align:middle line:84% I couldn't bend this finger down. 00:07:56.850 --> 00:07:59.220 align:middle line:84% Internal things happened like my heart rate went up. 00:07:59.220 --> 00:08:01.380 align:middle line:90% I had a real low heart rate. 00:08:01.380 --> 00:08:06.150 align:middle line:84% So every morning I go through this low blood pressure 00:08:06.150 --> 00:08:07.320 align:middle line:90% fainting kind of-- 00:08:07.320 --> 00:08:10.580 align:middle line:84% not literally fainting, but if I didn't take care I would. 00:08:10.580 --> 00:08:11.940 align:middle line:90% That's gone. 00:08:11.940 --> 00:08:14.580 align:middle line:84% My heart rate's gone up 10 beats. 00:08:14.580 --> 00:08:15.793 align:middle line:90% I sweat again when it's hot. 00:08:15.793 --> 00:08:18.210 align:middle line:84% That's something you don't realize-- you get a spinal cord 00:08:18.210 --> 00:08:20.073 align:middle line:90% injury, you stop sweating. 00:08:20.073 --> 00:08:22.240 align:middle line:84% There's all kinds of internal things that shut down. 00:08:22.240 --> 00:08:25.294 align:middle line:84% It's not just you lose your walking. 00:08:25.294 --> 00:08:26.830 align:middle line:90% Related to that, can I-- 00:08:26.830 --> 00:08:29.185 align:middle line:90% I have a spinal cord injury. 00:08:29.185 --> 00:08:32.455 align:middle line:84% [INAUDIBLE] Particularly, bowel and bladder function? 00:08:32.455 --> 00:08:34.740 align:middle line:90% Could you? 00:08:34.740 --> 00:08:37.665 align:middle line:84% Improvement in bladder function, notably. 00:08:37.665 --> 00:08:42.770 align:middle line:90% 00:08:42.770 --> 00:08:45.730 align:middle line:84% I've always-- this is a wheelchair thing, bowel 00:08:45.730 --> 00:08:47.230 align:middle line:84% and bladder stuff, nobody ever wants 00:08:47.230 --> 00:08:48.982 align:middle line:90% to really talk about publicly. 00:08:48.982 --> 00:08:50.440 align:middle line:84% Sooner or later we got to go there. 00:08:50.440 --> 00:08:50.800 align:middle line:90% [LAUGHTER] 00:08:50.800 --> 00:08:52.646 align:middle line:84% Bruce goes straight there on the first question! 00:08:52.646 --> 00:08:53.688 align:middle line:90% Thank you for doing that. 00:08:53.688 --> 00:08:56.620 align:middle line:84% Might as as well get it over with. 00:08:56.620 --> 00:08:59.740 align:middle line:84% So I've always had like some incomplete ability 00:08:59.740 --> 00:09:02.410 align:middle line:84% to control those functions, but they definitely 00:09:02.410 --> 00:09:03.750 align:middle line:90% improved, yes, for sure. 00:09:03.750 --> 00:09:06.880 align:middle line:90% 00:09:06.880 --> 00:09:09.642 align:middle line:84% And talking a bit about motor functions, what about-- did you 00:09:09.642 --> 00:09:11.980 align:middle line:90% lose any sensory function? 00:09:11.980 --> 00:09:12.480 align:middle line:90% No. 00:09:12.480 --> 00:09:15.500 align:middle line:90% 00:09:15.500 --> 00:09:17.840 align:middle line:84% I don't know that I really gained any. 00:09:17.840 --> 00:09:20.242 align:middle line:90% I've had a certain amount of-- 00:09:20.242 --> 00:09:22.700 align:middle line:84% I've always been able to feel somewhat in my hands and legs 00:09:22.700 --> 00:09:23.200 align:middle line:90% somewhat. 00:09:23.200 --> 00:09:24.940 align:middle line:90% I didn't-- not really. 00:09:24.940 --> 00:09:28.860 align:middle line:90% 00:09:28.860 --> 00:09:30.097 align:middle line:90% No. 00:09:30.097 --> 00:09:31.180 align:middle line:90% I didn't lose any, either. 00:09:31.180 --> 00:09:35.900 align:middle line:90% 00:09:35.900 --> 00:09:39.770 align:middle line:84% I've talked to other people who have this internal stimulator 00:09:39.770 --> 00:09:41.600 align:middle line:90% that looks similar. 00:09:41.600 --> 00:09:44.100 align:middle line:84% He had the one that goes on the outside of your body, right? 00:09:44.100 --> 00:09:45.978 align:middle line:90% Yeah. 00:09:45.978 --> 00:09:51.690 align:middle line:84% [INAUDIBLE] talks about getting almost instantaneously 00:09:51.690 --> 00:09:53.580 align:middle line:84% feeling trunk strength come back. 00:09:53.580 --> 00:09:58.110 align:middle line:90% Was that an issue for you, too? 00:09:58.110 --> 00:09:59.685 align:middle line:84% Should I be repeating this questions? 00:09:59.685 --> 00:10:00.560 align:middle line:90% We talked about that. 00:10:00.560 --> 00:10:01.352 align:middle line:90% We probably should. 00:10:01.352 --> 00:10:03.360 align:middle line:90% That might help, yeah. 00:10:03.360 --> 00:10:05.220 align:middle line:90% Yeah, for our online viewers. 00:10:05.220 --> 00:10:05.760 align:middle line:84% Thanks for reminding us, I had completely 00:10:05.760 --> 00:10:06.720 align:middle line:90% forgotten to do my job. 00:10:06.720 --> 00:10:08.100 align:middle line:84% So for the people online we're supposed 00:10:08.100 --> 00:10:09.058 align:middle line:90% to repeat the question. 00:10:09.058 --> 00:10:12.500 align:middle line:84% Do you want to do that or should I do it? 00:10:12.500 --> 00:10:14.510 align:middle line:90% The question being could I-- 00:10:14.510 --> 00:10:20.180 align:middle line:84% would the technology, could I feel trunk strength? 00:10:20.180 --> 00:10:24.000 align:middle line:90% Yes, so there is a-- 00:10:24.000 --> 00:10:25.560 align:middle line:84% we do a thing where we put it on just 00:10:25.560 --> 00:10:28.710 align:middle line:84% to test the thresholds so we turn it up higher than what 00:10:28.710 --> 00:10:29.940 align:middle line:90% the actual therapy is. 00:10:29.940 --> 00:10:33.783 align:middle line:84% And when that happens my abs flex like a six pack. 00:10:33.783 --> 00:10:34.510 align:middle line:90% [LAUGHTER] 00:10:34.510 --> 00:10:37.070 align:middle line:90% It's serious, I mean really. 00:10:37.070 --> 00:10:39.930 align:middle line:84% And even with it on therapeutic it's really cool. 00:10:39.930 --> 00:10:46.280 align:middle line:84% It feels-- where I'm injured the nerves affect, say, 00:10:46.280 --> 00:10:46.970 align:middle line:90% to my fingers. 00:10:46.970 --> 00:10:50.090 align:middle line:84% And you can tell where they don't work anymore. 00:10:50.090 --> 00:10:51.890 align:middle line:90% You can just feel the potential. 00:10:51.890 --> 00:10:55.190 align:middle line:84% It's a buzz and you can feel like there's something-- 00:10:55.190 --> 00:10:56.870 align:middle line:90% it's hard to explain. 00:10:56.870 --> 00:10:59.180 align:middle line:84% You can feel where the potential for movement would be 00:10:59.180 --> 00:11:01.830 align:middle line:84% and, yes, you do feel it all the way through. 00:11:01.830 --> 00:11:06.798 align:middle line:84% We weren't focused on it because this therapy was on upper arms, 00:11:06.798 --> 00:11:08.090 align:middle line:90% so we wouldn't really go there. 00:11:08.090 --> 00:11:10.790 align:middle line:84% But yeah, I could definitely tell, for sure. 00:11:10.790 --> 00:11:15.040 align:middle line:84% And that's just at the neck as opposed to-- 00:11:15.040 --> 00:11:18.670 align:middle line:90% You never had the 00:11:18.670 --> 00:11:19.192 align:middle line:90% The lumbar. 00:11:19.192 --> 00:11:20.900 align:middle line:84% Was it placed anywhere else on your body? 00:11:20.900 --> 00:11:25.200 align:middle line:84% No, just injury, above and below the injury. 00:11:25.200 --> 00:11:29.370 align:middle line:84% And it was just focused on the upper extremity so. 00:11:29.370 --> 00:11:32.352 align:middle line:84% In this room do they all know how the technology works? 00:11:32.352 --> 00:11:33.310 align:middle line:90% That's a good question. 00:11:33.310 --> 00:11:36.020 align:middle line:84% Twenty-one of them do because we just talked about it on Monday. 00:11:36.020 --> 00:11:36.682 align:middle line:90% [LAUGHTER] 00:11:36.682 --> 00:11:38.140 align:middle line:84% I think some of my other colleagues 00:11:38.140 --> 00:11:40.420 align:middle line:84% have seen it presented too many times, 00:11:40.420 --> 00:11:42.800 align:middle line:84% but if anybody has questions, feel free to just ask, 00:11:42.800 --> 00:11:45.202 align:middle line:90% hey, what was-- 00:11:45.202 --> 00:11:46.660 align:middle line:84% yeah, for the online audience we'll 00:11:46.660 --> 00:11:47.920 align:middle line:90% just a little bit about it. 00:11:47.920 --> 00:11:50.440 align:middle line:84% So the study Jon was in was called 00:11:50.440 --> 00:11:52.780 align:middle line:84% transcutaneous electrical stimulation. 00:11:52.780 --> 00:11:55.510 align:middle line:84% Transcutaneous is a fancy word for through the skin which 00:11:55.510 --> 00:11:58.300 align:middle line:84% means the electrodes just stick like little stickers 00:11:58.300 --> 00:12:00.700 align:middle line:84% onto the skin on the back of Jon's neck right above 00:12:00.700 --> 00:12:03.100 align:middle line:84% and below the part of his neck that was injured. 00:12:03.100 --> 00:12:06.070 align:middle line:84% Then we use a very high frequency waveform 00:12:06.070 --> 00:12:07.660 align:middle line:84% to pass the energy through the skin 00:12:07.660 --> 00:12:09.160 align:middle line:84% without causing too much discomfort. 00:12:09.160 --> 00:12:11.990 align:middle line:84% Jon can describe what it feels like. 00:12:11.990 --> 00:12:14.350 align:middle line:84% And we try to activate either the spinal cord directly 00:12:14.350 --> 00:12:16.270 align:middle line:84% or the nerves very near the spinal cord 00:12:16.270 --> 00:12:17.800 align:middle line:90% that enter the spinal cord. 00:12:17.800 --> 00:12:21.550 align:middle line:84% And using that we try to get the spinal cord more excitable 00:12:21.550 --> 00:12:23.500 align:middle line:84% and then Jon has to do a ton of hard work 00:12:23.500 --> 00:12:25.330 align:middle line:84% practicing while that spinal cord is more 00:12:25.330 --> 00:12:26.938 align:middle line:90% excitable to see any benefits. 00:12:26.938 --> 00:12:28.480 align:middle line:84% And do you want to tell how it feels? 00:12:28.480 --> 00:12:31.650 align:middle line:90% 00:12:31.650 --> 00:12:35.710 align:middle line:84% It can feel how you wanted to make you feel. 00:12:35.710 --> 00:12:38.088 align:middle line:84% The therapeutic dose, I keep saying 00:12:38.088 --> 00:12:39.630 align:middle line:84% it feels like Pop Rocks on your neck. 00:12:39.630 --> 00:12:40.672 align:middle line:90% That's what it felt like. 00:12:40.672 --> 00:12:42.390 align:middle line:84% It feels like you have Pop Rocks-- 00:12:42.390 --> 00:12:46.940 align:middle line:84% it's strong enough that I know when it turns off 00:12:46.940 --> 00:12:48.950 align:middle line:90% because my head jerks back. 00:12:48.950 --> 00:12:50.570 align:middle line:84% It definitely pulls on your muscles. 00:12:50.570 --> 00:12:53.620 align:middle line:90% You know it's on. 00:12:53.620 --> 00:12:55.910 align:middle line:84% I miss it, to be honest with you. 00:12:55.910 --> 00:12:56.410 align:middle line:90% It's like-- 00:12:56.410 --> 00:13:00.050 align:middle line:90% 00:13:00.050 --> 00:13:02.250 align:middle line:84% Like one of those massages that kind of hurts 00:13:02.250 --> 00:13:03.500 align:middle line:90% but feels good when it's done? 00:13:03.500 --> 00:13:05.160 align:middle line:84% Yeah, it might hurt a little more. 00:13:05.160 --> 00:13:06.120 align:middle line:90% OK, a little more than. 00:13:06.120 --> 00:13:06.500 align:middle line:90% [LAUGHTER] 00:13:06.500 --> 00:13:08.270 align:middle line:84% I'm thinking like the really intense massage 00:13:08.270 --> 00:13:09.560 align:middle line:90% where you're like, ow, ow, ow! 00:13:09.560 --> 00:13:10.622 align:middle line:84% But then when it's done you're like, gosh, 00:13:10.622 --> 00:13:10.960 align:middle line:90% that feels so much better. 00:13:10.960 --> 00:13:12.002 align:middle line:90% Yeah, it's like that one. 00:13:12.002 --> 00:13:17.580 align:middle line:90% 00:13:17.580 --> 00:13:18.470 align:middle line:90% Sorry, I got lost. 00:13:18.470 --> 00:13:20.950 align:middle line:84% No, it's good, this one's got one. 00:13:20.950 --> 00:13:23.420 align:middle line:84% Out of all the different results or benefits, 00:13:23.420 --> 00:13:28.940 align:middle line:84% which one was the most valuable to you? 00:13:28.940 --> 00:13:36.452 align:middle line:84% The most valuable-- the hand function that I got. 00:13:36.452 --> 00:13:37.910 align:middle line:84% And it's not only the hand function 00:13:37.910 --> 00:13:43.670 align:middle line:84% that I got that I can use, it really unlocked my head, 00:13:43.670 --> 00:13:44.170 align:middle line:90% I guess. 00:13:44.170 --> 00:13:46.587 align:middle line:84% It's like I'd kind of given up that anything is going to-- 00:13:46.587 --> 00:13:48.790 align:middle line:84% I've accepted, I guess, you kind of have to. 00:13:48.790 --> 00:13:51.640 align:middle line:84% Nothing's coming back, so to re-unlock 00:13:51.640 --> 00:13:53.215 align:middle line:90% that things are possible? 00:13:53.215 --> 00:13:56.210 align:middle line:90% 00:13:56.210 --> 00:13:58.520 align:middle line:84% It's not much, but say my thumb here-- 00:13:58.520 --> 00:14:03.170 align:middle line:84% I have not moved that in 13 years. 00:14:03.170 --> 00:14:05.430 align:middle line:84% I believe now wholeheartedly if I can do this, 00:14:05.430 --> 00:14:07.340 align:middle line:90% then I can get to here. 00:14:07.340 --> 00:14:09.920 align:middle line:90% I know I can get to here. 00:14:09.920 --> 00:14:12.540 align:middle line:84% So not only did it unlock a lot of physical things, 00:14:12.540 --> 00:14:14.810 align:middle line:90% mentally I'm a different-- 00:14:14.810 --> 00:14:16.300 align:middle line:90% I'm at a different spot. 00:14:16.300 --> 00:14:19.195 align:middle line:90% Yeah, hand for sure, function. 00:14:19.195 --> 00:14:21.982 align:middle line:90% 00:14:21.982 --> 00:14:24.440 align:middle line:84% Kind of going with that-- what were your expectations going 00:14:24.440 --> 00:14:28.565 align:middle line:84% into this study and how have those changed with everything 00:14:28.565 --> 00:14:30.120 align:middle line:90% you've gone through? 00:14:30.120 --> 00:14:31.850 align:middle line:84% So, expectations going into the study 00:14:31.850 --> 00:14:34.660 align:middle line:84% and how they've changed with everything you've gone through. 00:14:34.660 --> 00:14:37.590 align:middle line:84% I expected, to be honest, nothing, 00:14:37.590 --> 00:14:41.310 align:middle line:84% because that would be status quo. 00:14:41.310 --> 00:14:43.900 align:middle line:84% I was blown away because we got, pretty quick, 00:14:43.900 --> 00:14:45.630 align:middle line:90% we got some little twitches. 00:14:45.630 --> 00:14:49.480 align:middle line:84% And that, again, just for my head was gigantic. 00:14:49.480 --> 00:14:51.060 align:middle line:90% And where it's going to go-- 00:14:51.060 --> 00:14:52.810 align:middle line:84% what was the second part of your question? 00:14:52.810 --> 00:14:57.750 align:middle line:84% I mean, I guess I just wanted to know what is your outlook? 00:14:57.750 --> 00:15:01.890 align:middle line:84% That anything is-- we're back to anything being possible. 00:15:01.890 --> 00:15:05.300 align:middle line:84% That's big, instead of just accepting that-- 00:15:05.300 --> 00:15:09.530 align:middle line:84% you have to understand, when we were injured 13, 00:15:09.530 --> 00:15:11.530 align:middle line:84% 15 years ago, it's like there is a little window 00:15:11.530 --> 00:15:12.363 align:middle line:90% they would give you. 00:15:12.363 --> 00:15:15.097 align:middle line:84% They'd say about two years is what you had and after two 00:15:15.097 --> 00:15:16.930 align:middle line:84% years, probably nothing's going to come back 00:15:16.930 --> 00:15:20.750 align:middle line:84% and if it does it was some stroke of luck or whatever. 00:15:20.750 --> 00:15:21.890 align:middle line:90% Now, I don't know. 00:15:21.890 --> 00:15:23.510 align:middle line:90% I just have-- 00:15:23.510 --> 00:15:25.260 align:middle line:84% I don't have a fixed attitude anymore. 00:15:25.260 --> 00:15:26.630 align:middle line:90% I don't know what-- 00:15:26.630 --> 00:15:28.370 align:middle line:90% I believe more can come. 00:15:28.370 --> 00:15:31.020 align:middle line:90% 00:15:31.020 --> 00:15:35.010 align:middle line:84% My anxiety comes from that things won't make FDA approval 00:15:35.010 --> 00:15:36.473 align:middle line:90% and I won't be able to use it. 00:15:36.473 --> 00:15:39.494 align:middle line:90% [LAUGHTER] 00:15:39.494 --> 00:15:40.877 align:middle line:90% Can I ask a question over here? 00:15:40.877 --> 00:15:43.960 align:middle line:90% 00:15:43.960 --> 00:15:46.450 align:middle line:84% I was interested to hear you say that you're not interested 00:15:46.450 --> 00:15:50.342 align:middle line:84% in the stem cell things in part because you don't-- 00:15:50.342 --> 00:15:52.050 align:middle line:84% there's so much mystery, you don't really 00:15:52.050 --> 00:15:52.980 align:middle line:90% know what will happen. 00:15:52.980 --> 00:15:56.400 align:middle line:84% So I'm curious, why this one and would it 00:15:56.400 --> 00:15:59.880 align:middle line:84% matter if it was implanted rather than outside your skin 00:15:59.880 --> 00:16:03.840 align:middle line:84% or implanted somewhere else in your body? 00:16:03.840 --> 00:16:05.460 align:middle line:90% Personally, it does matter. 00:16:05.460 --> 00:16:07.830 align:middle line:84% Because I've got-- my answer might 00:16:07.830 --> 00:16:09.417 align:middle line:84% change if I had less hand function 00:16:09.417 --> 00:16:11.250 align:middle line:84% and I might be able to put more on the line. 00:16:11.250 --> 00:16:16.530 align:middle line:84% But where my life was, I wouldn't be willing to risk it. 00:16:16.530 --> 00:16:19.730 align:middle line:90% 00:16:19.730 --> 00:16:21.318 align:middle line:90% Even if I was guaranteed-- 00:16:21.318 --> 00:16:22.610 align:middle line:90% I don't know, it's hard to say. 00:16:22.610 --> 00:16:24.440 align:middle line:84% I guess I think even if I was guaranteed 00:16:24.440 --> 00:16:27.670 align:middle line:90% these results, I still-- 00:16:27.670 --> 00:16:29.600 align:middle line:84% it's a big commitment to rip your neck open 00:16:29.600 --> 00:16:30.620 align:middle line:90% and get implants. 00:16:30.620 --> 00:16:35.900 align:middle line:84% I respect anybody who wants to do that it's just, no. 00:16:35.900 --> 00:16:39.020 align:middle line:84% And that's what appealed to me was that I've used e-stim 00:16:39.020 --> 00:16:41.390 align:middle line:90% before in physical therapy. 00:16:41.390 --> 00:16:44.950 align:middle line:84% I get the technology and it just made sense to me. 00:16:44.950 --> 00:16:45.950 align:middle line:90% And they did a good job. 00:16:45.950 --> 00:16:47.420 align:middle line:90% I expressed I had concerns. 00:16:47.420 --> 00:16:49.640 align:middle line:84% I didn't want to fire up pain again. 00:16:49.640 --> 00:16:51.000 align:middle line:90% I didn't know what. 00:16:51.000 --> 00:16:53.940 align:middle line:90% But it was-- 00:16:53.940 --> 00:16:56.550 align:middle line:90% I was reassured, the whole team. 00:16:56.550 --> 00:16:59.280 align:middle line:84% Once I knew the facts, I was pretty undaunted. 00:16:59.280 --> 00:17:04.139 align:middle line:84% The first time that I had it on, though, it was kind of a trip. 00:17:04.139 --> 00:17:05.369 align:middle line:90% How so? 00:17:05.369 --> 00:17:09.930 align:middle line:84% Well, because we did the tolerance test first, 00:17:09.930 --> 00:17:12.119 align:middle line:90% which takes you pretty high. 00:17:12.119 --> 00:17:15.450 align:middle line:84% I'm talking like you're like slapping your hands 00:17:15.450 --> 00:17:17.700 align:middle line:84% and I kind of wondered what I was doing. 00:17:17.700 --> 00:17:18.930 align:middle line:90% Sounds a little scary. 00:17:18.930 --> 00:17:21.569 align:middle line:84% But after that, I guess I miss it. 00:17:21.569 --> 00:17:25.540 align:middle line:84% I would put on right now if I could. 00:17:25.540 --> 00:17:28.990 align:middle line:84% And have the benefits-- they last even though you're not now 00:17:28.990 --> 00:17:30.910 align:middle line:90% getting the stimulation? 00:17:30.910 --> 00:17:32.060 align:middle line:90% That was a concern. 00:17:32.060 --> 00:17:37.370 align:middle line:84% Like do you put in all that work because this is hard work. 00:17:37.370 --> 00:17:38.740 align:middle line:90% It's more like-- no, it is. 00:17:38.740 --> 00:17:40.360 align:middle line:90% It's like tedious work. 00:17:40.360 --> 00:17:46.327 align:middle line:84% It's like playing with preschool toys and you can't do it, 00:17:46.327 --> 00:17:48.910 align:middle line:84% but you're going to do it anyway for hours and hours and hours 00:17:48.910 --> 00:17:49.840 align:middle line:90% until something works. 00:17:49.840 --> 00:17:53.680 align:middle line:84% And then what something works means something twitched. 00:17:53.680 --> 00:17:56.170 align:middle line:90% So it's a daunting process. 00:17:56.170 --> 00:18:00.950 align:middle line:90% 00:18:00.950 --> 00:18:02.780 align:middle line:90% I missed your question. 00:18:02.780 --> 00:18:03.447 align:middle line:90% How did it last? 00:18:03.447 --> 00:18:04.405 align:middle line:90% How did it last after-- 00:18:04.405 --> 00:18:06.200 align:middle line:84% The lasting effects did last, is the thing. 00:18:06.200 --> 00:18:09.050 align:middle line:84% We just had-- so the trial went for four months 00:18:09.050 --> 00:18:14.400 align:middle line:84% and then I've been checking up and I have a standardized set 00:18:14.400 --> 00:18:16.110 align:middle line:90% of exercises that I do. 00:18:16.110 --> 00:18:19.490 align:middle line:84% And I've preserved, if not increased, all my strengths. 00:18:19.490 --> 00:18:21.360 align:middle line:84% It hasn't gone away, it's awesome. 00:18:21.360 --> 00:18:23.730 align:middle line:84% So here we are, I just had it like two weeks ago. 00:18:23.730 --> 00:18:27.325 align:middle line:84% I could do everything that I couldn't do when I started. 00:18:27.325 --> 00:18:28.200 align:middle line:90% That's in two months. 00:18:28.200 --> 00:18:31.200 align:middle line:84% That's two months after the end of the intervention. 00:18:31.200 --> 00:18:32.937 align:middle line:84% We'll do one more check in three months, 00:18:32.937 --> 00:18:35.520 align:middle line:84% and that's usually where we stop following so you can get back 00:18:35.520 --> 00:18:36.687 align:middle line:90% to your life if you want to. 00:18:36.687 --> 00:18:40.860 align:middle line:90% And who knows where the line is. 00:18:40.860 --> 00:18:43.420 align:middle line:84% I still do all those exercises at home. 00:18:43.420 --> 00:18:46.537 align:middle line:84% I don't want to lose anything, so I seriously-- 00:18:46.537 --> 00:18:48.120 align:middle line:84% if you drive by my house there's a man 00:18:48.120 --> 00:18:50.785 align:middle line:84% inside playing with preschool toys. 00:18:50.785 --> 00:18:54.370 align:middle line:90% [LAUGHTER] 00:18:54.370 --> 00:18:57.520 align:middle line:84% Tell us about your guitar yesterday. 00:18:57.520 --> 00:19:02.680 align:middle line:84% Well, that's kind of my success story, what I got out of it. 00:19:02.680 --> 00:19:04.870 align:middle line:84% I played guitar before this injury 00:19:04.870 --> 00:19:08.247 align:middle line:84% and I had enough hand function to just make it frustrating. 00:19:08.247 --> 00:19:10.330 align:middle line:84% I could pick it up and I could maybe do some stuff 00:19:10.330 --> 00:19:11.340 align:middle line:90% and I just-- 00:19:11.340 --> 00:19:14.800 align:middle line:84% I never wanted to play it again, really. 00:19:14.800 --> 00:19:16.008 align:middle line:90% Once I got this finger back-- 00:19:16.008 --> 00:19:18.133 align:middle line:84% this finger used to be straight, it would not bend. 00:19:18.133 --> 00:19:20.387 align:middle line:84% So this is part of this therapy, this started to work 00:19:20.387 --> 00:19:21.970 align:middle line:84% and, again, I started getting it back. 00:19:21.970 --> 00:19:25.900 align:middle line:84% I play guitar now every day, every morning, every night. 00:19:25.900 --> 00:19:28.000 align:middle line:84% I play probably four hours a day. 00:19:28.000 --> 00:19:30.450 align:middle line:84% I wore out my jack last night, is what he's getting at. 00:19:30.450 --> 00:19:35.260 align:middle line:84% I play it so much that I wore out the circuitry last night. 00:19:35.260 --> 00:19:38.950 align:middle line:84% And that's really cool, too, because it's 00:19:38.950 --> 00:19:41.220 align:middle line:84% something to have something taken from you 00:19:41.220 --> 00:19:43.630 align:middle line:84% and when you get it back you appreciate it a lot more. 00:19:43.630 --> 00:19:46.300 align:middle line:90% 00:19:46.300 --> 00:19:47.925 align:middle line:84% Now it's more like I don't think, gosh, 00:19:47.925 --> 00:19:48.925 align:middle line:90% should I go play guitar? 00:19:48.925 --> 00:19:50.560 align:middle line:84% It's like I get to play it and so I do. 00:19:50.560 --> 00:19:53.613 align:middle line:84% I play it all the time, it's awesome. 00:19:53.613 --> 00:19:55.530 align:middle line:84% That's been my favorite thing that's happened. 00:19:55.530 --> 00:19:59.814 align:middle line:90% 00:19:59.814 --> 00:20:03.180 align:middle line:84% In that time when you felt you were stagnating what do 00:20:03.180 --> 00:20:06.797 align:middle line:84% you wish were different about the environment. 00:20:06.797 --> 00:20:07.880 align:middle line:90% What resources you had or. 00:20:07.880 --> 00:20:12.990 align:middle line:90% 00:20:12.990 --> 00:20:14.740 align:middle line:84% I'm just going to paraphrase the question. 00:20:14.740 --> 00:20:15.657 align:middle line:90% It's a great question. 00:20:15.657 --> 00:20:18.020 align:middle line:84% So it was asked during the time that Jon was stagnating 00:20:18.020 --> 00:20:20.437 align:middle line:84% what resources, what environment could have been different 00:20:20.437 --> 00:20:21.857 align:middle line:90% or did he wish was different? 00:20:21.857 --> 00:20:25.440 align:middle line:90% 00:20:25.440 --> 00:20:28.260 align:middle line:90% Boy, everything is would be-- 00:20:28.260 --> 00:20:31.730 align:middle line:90% 00:20:31.730 --> 00:20:34.250 align:middle line:90% boy, how do you-- 00:20:34.250 --> 00:20:35.840 align:middle line:90% I mean, everything is like-- 00:20:35.840 --> 00:20:38.510 align:middle line:90% 00:20:38.510 --> 00:20:40.910 align:middle line:90% Accessibility is a big one. 00:20:40.910 --> 00:20:42.250 align:middle line:90% It's hard to quantify this. 00:20:42.250 --> 00:20:47.280 align:middle line:90% 00:20:47.280 --> 00:20:52.188 align:middle line:84% Everything becomes specialty, everything from cars to-- 00:20:52.188 --> 00:20:52.980 align:middle line:90% I would just take-- 00:20:52.980 --> 00:20:54.390 align:middle line:90% I say this not even jokingly-- 00:20:54.390 --> 00:20:57.120 align:middle line:84% I would take a pair of hand rims that worked in the rain, 00:20:57.120 --> 00:20:58.320 align:middle line:90% for instance. 00:20:58.320 --> 00:21:01.767 align:middle line:84% There's so many sticking points to-- 00:21:01.767 --> 00:21:02.850 align:middle line:90% I call it wheelchair life. 00:21:02.850 --> 00:21:05.388 align:middle line:90% 00:21:05.388 --> 00:21:07.930 align:middle line:84% Boy, that's a hard question to answer, to be honest with you, 00:21:07.930 --> 00:21:11.050 align:middle line:90% because there's so many. 00:21:11.050 --> 00:21:16.260 align:middle line:84% If you mean it in terms of what you can do-- 00:21:16.260 --> 00:21:19.244 align:middle line:84% No, I think that for example hand rims 00:21:19.244 --> 00:21:19.685 align:middle line:84% that people who are designing for people with disabilities 00:21:19.685 --> 00:21:20.028 align:middle line:84% don't really think of like wheelchair accessibility 00:21:20.028 --> 00:21:20.861 align:middle line:90% and stuff like that. 00:21:20.861 --> 00:21:30.030 align:middle line:90% 00:21:30.030 --> 00:21:33.210 align:middle line:84% Just accessible housing, for instance. 00:21:33.210 --> 00:21:35.220 align:middle line:84% I mean, I'm in a good situation now, 00:21:35.220 --> 00:21:37.200 align:middle line:90% but that took forever to get. 00:21:37.200 --> 00:21:40.950 align:middle line:84% Just the world is not wheelchair friendly, period. 00:21:40.950 --> 00:21:44.300 align:middle line:84% Boy, I wish I had a better solid answer for you. 00:21:44.300 --> 00:21:47.310 align:middle line:90% I will-- I'll get back to you. 00:21:47.310 --> 00:21:50.820 align:middle line:84% There's a long list of things that could be made better. 00:21:50.820 --> 00:21:53.490 align:middle line:84% Start with the rims because in Seattle once it rains, 00:21:53.490 --> 00:21:54.385 align:middle line:90% it's over. 00:21:54.385 --> 00:21:55.260 align:middle line:90% You can't go outside. 00:21:55.260 --> 00:21:58.860 align:middle line:90% 00:21:58.860 --> 00:22:04.020 align:middle line:84% After your stimulation and then having stimulation stopped, 00:22:04.020 --> 00:22:07.950 align:middle line:84% do you feel that we should have a better way of continuing 00:22:07.950 --> 00:22:09.550 align:middle line:90% such a program? 00:22:09.550 --> 00:22:13.880 align:middle line:84% Like the FDA has the approval process, but [INAUDIBLE].. 00:22:13.880 --> 00:22:18.724 align:middle line:84% So do you feel that we should have two tracks for approval 00:22:18.724 --> 00:22:22.520 align:middle line:90% or some way of accelerating it? 00:22:22.520 --> 00:22:25.040 align:middle line:90% That would be amazing. 00:22:25.040 --> 00:22:28.654 align:middle line:84% I wish I could sign my rights away and I would just-- 00:22:28.654 --> 00:22:29.570 align:middle line:90% [LAUGHTER] 00:22:29.570 --> 00:22:31.760 align:middle line:84% Yeah, I mean I would be on it now 00:22:31.760 --> 00:22:33.830 align:middle line:90% because I've experienced it. 00:22:33.830 --> 00:22:36.363 align:middle line:84% Nobody really knows what the long term effects 00:22:36.363 --> 00:22:37.780 align:middle line:84% are going to be, like what's going 00:22:37.780 --> 00:22:40.380 align:middle line:90% to happen 40 years from now. 00:22:40.380 --> 00:22:42.210 align:middle line:90% Yeah, it's frustrating. 00:22:42.210 --> 00:22:45.030 align:middle line:84% The FDA process is really frustrating. 00:22:45.030 --> 00:22:47.010 align:middle line:84% I mean, selfishly, it's like I have 00:22:47.010 --> 00:22:49.650 align:middle line:84% this technology I know works and it's behind a door 00:22:49.650 --> 00:22:51.410 align:middle line:90% and I can't get at it. 00:22:51.410 --> 00:22:55.083 align:middle line:84% I'm thankful that it happened and yet I 00:22:55.083 --> 00:22:56.000 align:middle line:90% can't have it anymore. 00:22:56.000 --> 00:23:01.450 align:middle line:84% It's weird, so that's I guess a big part of why I'm here. 00:23:01.450 --> 00:23:03.560 align:middle line:84% Yeah, I don't know what the answer there would be, 00:23:03.560 --> 00:23:06.845 align:middle line:90% but yes, for sure. 00:23:06.845 --> 00:23:08.220 align:middle line:84% It's hard, too, because you don't 00:23:08.220 --> 00:23:13.120 align:middle line:84% want to propagate something that's not safe. 00:23:13.120 --> 00:23:14.830 align:middle line:90% I get it. 00:23:14.830 --> 00:23:18.970 align:middle line:84% So I don't know what the answer there is. 00:23:18.970 --> 00:23:22.460 align:middle line:90% Yes, is the answer. 00:23:22.460 --> 00:23:25.150 align:middle line:90% Can I ask a follow up on that? 00:23:25.150 --> 00:23:29.260 align:middle line:84% How precise does the location have to be? 00:23:29.260 --> 00:23:31.810 align:middle line:84% Because there are always do-it-yourself-- 00:23:31.810 --> 00:23:33.670 align:middle line:90% not that I'm recommending it-- 00:23:33.670 --> 00:23:35.827 align:middle line:84% I'm not repeating that into the microphone. 00:23:35.827 --> 00:23:38.320 align:middle line:90% [LAUGHTER] 00:23:38.320 --> 00:23:40.000 align:middle line:84% How much precision is there about 00:23:40.000 --> 00:23:43.480 align:middle line:84% exactly where the electrodes are placed in order to have 00:23:43.480 --> 00:23:45.493 align:middle line:90% the benefit that you found? 00:23:45.493 --> 00:23:47.410 align:middle line:84% You want to ask Fatma to answer that question? 00:23:47.410 --> 00:23:49.060 align:middle line:90% Yeah, I defer to the experts. 00:23:49.060 --> 00:23:53.070 align:middle line:90% I was looking to the back for-- 00:23:53.070 --> 00:23:57.420 align:middle line:84% Based on the [INAUDIBLE] so we can easily 00:23:57.420 --> 00:24:17.791 align:middle line:84% find [INAUDIBLE] so we put around [INAUDIBLE] 00:24:17.791 --> 00:24:26.640 align:middle line:84% and we put the other one just up about [INAUDIBLE] You can find 00:24:26.640 --> 00:24:37.194 align:middle line:84% more precise points, but [INAUDIBLE] but it 00:24:37.194 --> 00:24:39.450 align:middle line:90% doesn't have to be [INAUDIBLE]. 00:24:39.450 --> 00:24:54.830 align:middle line:90% 00:24:54.830 --> 00:24:57.860 align:middle line:90% So the trial was four months? 00:24:57.860 --> 00:25:01.190 align:middle line:84% How quickly throughout the trial were you seeing quick changes 00:25:01.190 --> 00:25:01.920 align:middle line:90% and improvements? 00:25:01.920 --> 00:25:04.070 align:middle line:84% For example, you talked about your index finger 00:25:04.070 --> 00:25:05.570 align:middle line:84% and how it was essentially straight. 00:25:05.570 --> 00:25:08.530 align:middle line:84% So how quickly through it were you able to go straight 00:25:08.530 --> 00:25:09.680 align:middle line:90% to bending it? 00:25:09.680 --> 00:25:11.760 align:middle line:90% How quickly was it coming? 00:25:11.760 --> 00:25:14.510 align:middle line:84% So it was four months, the first and third month 00:25:14.510 --> 00:25:20.080 align:middle line:84% was physical therapy only to isolate it. 00:25:20.080 --> 00:25:23.090 align:middle line:84% You know, that first month of just physical therapy only was 00:25:23.090 --> 00:25:25.950 align:middle line:84% a little bit eye-opening because I did get a little bit of-- 00:25:25.950 --> 00:25:28.610 align:middle line:84% that first month without the technology I got a little. 00:25:28.610 --> 00:25:31.130 align:middle line:84% There was a little bit of movement still to get out. 00:25:31.130 --> 00:25:34.330 align:middle line:90% 00:25:34.330 --> 00:25:36.700 align:middle line:84% We progressed to the point where I could pick up 00:25:36.700 --> 00:25:39.370 align:middle line:84% a ping pong ball with these two fingers 00:25:39.370 --> 00:25:42.415 align:middle line:84% and then we we'd go down in scale and we got to a diameter 00:25:42.415 --> 00:25:45.500 align:middle line:84% where I couldn't pick it up anymore. 00:25:45.500 --> 00:25:46.590 align:middle line:90% The video shows this. 00:25:46.590 --> 00:25:48.980 align:middle line:84% As soon as they put that on and turned it on, 00:25:48.980 --> 00:25:52.670 align:middle line:84% it was like pinch, I could pinch that thing all day long. 00:25:52.670 --> 00:25:56.130 align:middle line:84% So instantly there was a little bit of instant. 00:25:56.130 --> 00:25:58.690 align:middle line:84% And the other stuff, that first-- 00:25:58.690 --> 00:26:03.620 align:middle line:84% well the second month of trial, within the next immediately. 00:26:03.620 --> 00:26:08.410 align:middle line:84% And we just-- almost without fail, I feel like-- 00:26:08.410 --> 00:26:09.940 align:middle line:84% every single session, if we focused 00:26:09.940 --> 00:26:12.100 align:middle line:84% on something that had potential-- like my thumb, 00:26:12.100 --> 00:26:13.767 align:middle line:84% there's a little potential-- by the time 00:26:13.767 --> 00:26:15.980 align:middle line:90% it was over it was more. 00:26:15.980 --> 00:26:17.930 align:middle line:90% I mean, it's like do the math. 00:26:17.930 --> 00:26:20.730 align:middle line:84% I was only allowed to do it for the trial three times a week. 00:26:20.730 --> 00:26:21.810 align:middle line:90% What if I did all day? 00:26:21.810 --> 00:26:24.170 align:middle line:90% I don't know. 00:26:24.170 --> 00:26:31.810 align:middle line:84% So, quickly, and when the gains would show up, they would stay. 00:26:31.810 --> 00:26:36.760 align:middle line:90% I would very rarely lose them. 00:26:36.760 --> 00:26:40.250 align:middle line:90% Yeah, it's amazing. 00:26:40.250 --> 00:26:43.460 align:middle line:84% My question is actually exactly related to that. 00:26:43.460 --> 00:26:47.990 align:middle line:84% How much have you found that you have lost some function based 00:26:47.990 --> 00:26:52.030 align:middle line:84% on, compared to maybe what gained right after therapy? 00:26:52.030 --> 00:26:54.270 align:middle line:90% And in that sense, what is-- 00:26:54.270 --> 00:26:58.490 align:middle line:84% if for example it's not [INAUDIBLE] you don't receive 00:26:58.490 --> 00:27:00.800 align:middle line:84% that stimulation anymore, what is the-- 00:27:00.800 --> 00:27:03.600 align:middle line:84% how far is the expectation that you 00:27:03.600 --> 00:27:08.752 align:middle line:84% would lose some of that ability that you have gained? 00:27:08.752 --> 00:27:10.460 align:middle line:84% I don't know if there was any expectation 00:27:10.460 --> 00:27:12.770 align:middle line:90% I would lose it, necessarily. 00:27:12.770 --> 00:27:14.810 align:middle line:84% I mean, there was some hope that once 00:27:14.810 --> 00:27:18.085 align:middle line:84% the nerves started talking that that strength could 00:27:18.085 --> 00:27:19.460 align:middle line:84% build on strength, and that seems 00:27:19.460 --> 00:27:20.752 align:middle line:90% to have been what has happened. 00:27:20.752 --> 00:27:23.320 align:middle line:90% 00:27:23.320 --> 00:27:24.110 align:middle line:90% That has happened. 00:27:24.110 --> 00:27:27.600 align:middle line:84% I mean, since the trial has done my hands have gotten stronger. 00:27:27.600 --> 00:27:28.870 align:middle line:90% I just keep working them. 00:27:28.870 --> 00:27:34.308 align:middle line:84% I think they're lasting gains, I hope. 00:27:34.308 --> 00:27:38.660 align:middle line:90% [INAUDIBLE] 00:27:38.660 --> 00:27:40.820 align:middle line:84% Maybe at the very, very, very tip 00:27:40.820 --> 00:27:43.400 align:middle line:84% of the spear I might get a little bit 00:27:43.400 --> 00:27:47.540 align:middle line:84% more movement with it on, but as far as doing-- 00:27:47.540 --> 00:27:49.550 align:middle line:90% I could pick up a-- 00:27:49.550 --> 00:27:51.020 align:middle line:84% I could do everything I was doing 00:27:51.020 --> 00:27:52.145 align:middle line:90% all the time along the way. 00:27:52.145 --> 00:27:54.910 align:middle line:84% I just proved this two weeks ago at the tests, too. 00:27:54.910 --> 00:27:58.550 align:middle line:84% The standardized tests is things like picking up 00:27:58.550 --> 00:28:02.365 align:middle line:84% coins and putting them in a slot or picking up a key 00:28:02.365 --> 00:28:03.990 align:middle line:84% and putting it in a lock, for instance. 00:28:03.990 --> 00:28:07.663 align:middle line:84% Simple kind of stuff that is when you can't do it, 00:28:07.663 --> 00:28:08.330 align:middle line:90% you can't do it. 00:28:08.330 --> 00:28:09.920 align:middle line:90% Can I follow up? 00:28:09.920 --> 00:28:11.123 align:middle line:90% Absolutely. 00:28:11.123 --> 00:28:12.540 align:middle line:84% I was thinking about this earlier. 00:28:12.540 --> 00:28:14.790 align:middle line:84% Has this given you more independence? 00:28:14.790 --> 00:28:17.808 align:middle line:84% [? You've got ?] [INAUDIBLE] and you're relying-- 00:28:17.808 --> 00:28:20.350 align:middle line:84% do you feel like you have more mobility and more independence 00:28:20.350 --> 00:28:20.810 align:middle line:90% because of this? 00:28:20.810 --> 00:28:21.810 align:middle line:90% Yeah, I mean one thing-- 00:28:21.810 --> 00:28:24.380 align:middle line:90% 00:28:24.380 --> 00:28:25.660 align:middle line:90% driving, for instance. 00:28:25.660 --> 00:28:31.440 align:middle line:84% I've used a driving pin which is like a steering wheel adapter 00:28:31.440 --> 00:28:33.340 align:middle line:84% device so I can use it, whatever. 00:28:33.340 --> 00:28:34.590 align:middle line:90% And I don't use it anymore. 00:28:34.590 --> 00:28:35.490 align:middle line:90% I don't need it. 00:28:35.490 --> 00:28:39.095 align:middle line:84% So it's like there's enough strength in this hand that 00:28:39.095 --> 00:28:40.950 align:middle line:84% didn't make me more independent per se, 00:28:40.950 --> 00:28:43.900 align:middle line:84% but yes, overall it does, actually. 00:28:43.900 --> 00:28:46.662 align:middle line:90% 00:28:46.662 --> 00:28:49.120 align:middle line:84% My wife could tell you there's probably like 20 things less 00:28:49.120 --> 00:28:50.710 align:middle line:84% I ask for help for a day, especially 00:28:50.710 --> 00:28:52.330 align:middle line:90% in opening little things. 00:28:52.330 --> 00:28:53.440 align:middle line:90% So yeah, sure. 00:28:53.440 --> 00:28:55.588 align:middle line:84% Every little bit helps and that's 00:28:55.588 --> 00:28:56.630 align:middle line:90% what I kind of reiterate. 00:28:56.630 --> 00:29:00.770 align:middle line:84% It's like the prize is to go run and jump again, 00:29:00.770 --> 00:29:05.240 align:middle line:84% but every just little half level, every half vertebrae 00:29:05.240 --> 00:29:08.262 align:middle line:90% makes a big difference. 00:29:08.262 --> 00:29:09.720 align:middle line:84% I guess something you don't realize 00:29:09.720 --> 00:29:13.410 align:middle line:84% until you lose your spinal cord that how 00:29:13.410 --> 00:29:14.970 align:middle line:84% your interaction with life depends 00:29:14.970 --> 00:29:17.550 align:middle line:90% on all your vertebrae firing. 00:29:17.550 --> 00:29:19.440 align:middle line:84% So every half one that I get back, yeah, 00:29:19.440 --> 00:29:23.355 align:middle line:84% it makes life more enjoyable for me, for sure. 00:29:23.355 --> 00:29:25.593 align:middle line:84% Here's a question for Chet or your team 00:29:25.593 --> 00:29:27.060 align:middle line:90% if anyone wants to answer this. 00:29:27.060 --> 00:29:29.230 align:middle line:84% Could you talk about the varieties of response 00:29:29.230 --> 00:29:30.882 align:middle line:90% that you see? 00:29:30.882 --> 00:29:33.905 align:middle line:84% Like how many patients have you worked with and what's 00:29:33.905 --> 00:29:36.120 align:middle line:84% happened, and especially he's talking 00:29:36.120 --> 00:29:37.620 align:middle line:84% about keeping these things afterward 00:29:37.620 --> 00:29:43.000 align:middle line:84% and it sounds like you're really meticulous about working it. 00:29:43.000 --> 00:29:45.730 align:middle line:84% So what happens when people don't? 00:29:45.730 --> 00:29:47.730 align:middle line:84% So I'll answer just because I'm close to the mic 00:29:47.730 --> 00:29:51.330 align:middle line:84% and then Fatma's there, so she can come up and chime in. 00:29:51.330 --> 00:29:53.730 align:middle line:90% Jon is our seventh participant. 00:29:53.730 --> 00:29:56.280 align:middle line:84% We have two more in process right now, eight and nine. 00:29:56.280 --> 00:29:59.040 align:middle line:84% We've worked with a total of nine people. 00:29:59.040 --> 00:30:01.500 align:middle line:84% Everybody has improved in something 00:30:01.500 --> 00:30:03.130 align:middle line:84% except for one individual who chose 00:30:03.130 --> 00:30:05.130 align:middle line:84% to withdraw from the study after the first month 00:30:05.130 --> 00:30:07.290 align:middle line:90% for personal reasons. 00:30:07.290 --> 00:30:09.150 align:middle line:84% Almost everyone has improved in their hand 00:30:09.150 --> 00:30:13.560 align:middle line:84% strength or dexterity and almost everyone 00:30:13.560 --> 00:30:16.770 align:middle line:84% has improved in some type of autonomic function, 00:30:16.770 --> 00:30:18.930 align:middle line:84% but in that case it's been different for just 00:30:18.930 --> 00:30:20.470 align:middle line:90% about every single person. 00:30:20.470 --> 00:30:23.178 align:middle line:84% So Jon talked about his heart rate and about sweating. 00:30:23.178 --> 00:30:24.720 align:middle line:84% I think that's the only person I know 00:30:24.720 --> 00:30:27.420 align:middle line:84% of that's had that particular result. 00:30:27.420 --> 00:30:30.075 align:middle line:84% One gentleman had a dramatic improvement in bladder function 00:30:30.075 --> 00:30:31.590 align:middle line:84% and was able to actually stop using 00:30:31.590 --> 00:30:34.530 align:middle line:84% intermittent catheterization as a result of two times 00:30:34.530 --> 00:30:36.937 align:middle line:90% through our study. 00:30:36.937 --> 00:30:39.270 align:middle line:84% I'm trying to think of some of the other ones we've had. 00:30:39.270 --> 00:30:40.920 align:middle line:90% We haven't had blood pressure. 00:30:40.920 --> 00:30:42.098 align:middle line:90% Fatma can help me out. 00:30:42.098 --> 00:30:43.890 align:middle line:84% Almost stable, so it wouldn't have changed. 00:30:43.890 --> 00:30:47.850 align:middle line:90% 00:30:47.850 --> 00:30:48.750 align:middle line:90% Sure. 00:30:48.750 --> 00:30:51.572 align:middle line:84% Their blood pressure was already OK. 00:30:51.572 --> 00:30:52.530 align:middle line:90% Heart rate improvement. 00:30:52.530 --> 00:30:54.570 align:middle line:84% We've had some people that have gotten sensation 00:30:54.570 --> 00:30:56.898 align:middle line:90% back well down their trunk. 00:30:56.898 --> 00:30:58.440 align:middle line:84% That's actually one of the few things 00:30:58.440 --> 00:31:00.300 align:middle line:84% that-- and almost everything has persisted 00:31:00.300 --> 00:31:02.100 align:middle line:84% beyond the stimulation, up to three months, 00:31:02.100 --> 00:31:03.810 align:middle line:84% even up to six months in one case 00:31:03.810 --> 00:31:05.910 align:middle line:84% where we're able to measure at six months. 00:31:05.910 --> 00:31:08.280 align:middle line:84% But sensation actually came back our way. 00:31:08.280 --> 00:31:10.230 align:middle line:84% So one gentleman got normal sensation 00:31:10.230 --> 00:31:12.608 align:middle line:84% only back to his navel from his collarbone, 00:31:12.608 --> 00:31:14.400 align:middle line:84% but it came back halfway to his nipple line 00:31:14.400 --> 00:31:16.898 align:middle line:90% after the stimulation stopped. 00:31:16.898 --> 00:31:18.940 align:middle line:84% That's probably the most clear example, actually. 00:31:18.940 --> 00:31:20.648 align:middle line:84% Scientifically, it's kind of cool, right? 00:31:20.648 --> 00:31:22.450 align:middle line:84% There's this causality with stimulation. 00:31:22.450 --> 00:31:25.570 align:middle line:84% Almost everything else goes up, reaches a new plateau, 00:31:25.570 --> 00:31:26.860 align:middle line:90% and essentially stays there. 00:31:26.860 --> 00:31:29.072 align:middle line:84% I mean, it might fade just a little bit 00:31:29.072 --> 00:31:31.030 align:middle line:84% or what often happens is it actually overshoots 00:31:31.030 --> 00:31:32.530 align:middle line:84% a little bit right after stimulation 00:31:32.530 --> 00:31:34.750 align:middle line:84% and then comes back to the same level it was 00:31:34.750 --> 00:31:36.886 align:middle line:90% at the end of the stimulation. 00:31:36.886 --> 00:31:37.832 align:middle line:90% Does that makes sense? 00:31:37.832 --> 00:31:39.540 align:middle line:84% There's a little bit of an after effect-- 00:31:39.540 --> 00:31:41.360 align:middle line:84% It doesn't go back to where it was before? 00:31:41.360 --> 00:31:42.030 align:middle line:90% Never seen that. 00:31:42.030 --> 00:31:44.482 align:middle line:90% 00:31:44.482 --> 00:31:45.940 align:middle line:84% But everybody's a little different. 00:31:45.940 --> 00:31:47.728 align:middle line:90% How activity-based-- 00:31:47.728 --> 00:31:49.270 align:middle line:84% That's the other point I want to make 00:31:49.270 --> 00:31:51.160 align:middle line:84% and Jon can reinforce me on this. 00:31:51.160 --> 00:31:53.590 align:middle line:84% Part of the reason Jon has done so well 00:31:53.590 --> 00:31:57.880 align:middle line:84% is that he's so motivated and so dedicated to practicing 00:31:57.880 --> 00:32:00.258 align:middle line:84% using his hands, whether he has a stimulator running 00:32:00.258 --> 00:32:02.800 align:middle line:84% at the time or whether he's at home afterwards playing guitar 00:32:02.800 --> 00:32:05.320 align:middle line:90% for however many hours a day. 00:32:05.320 --> 00:32:07.450 align:middle line:84% His wife is incredibly supportive, 00:32:07.450 --> 00:32:10.720 align:middle line:84% she buys the preschool toys that we use, 00:32:10.720 --> 00:32:12.640 align:middle line:84% and so he has them at home, including-- 00:32:12.640 --> 00:32:13.602 align:middle line:90% And makes me use them. 00:32:13.602 --> 00:32:14.810 align:middle line:90% And makes you use them, yeah. 00:32:14.810 --> 00:32:16.150 align:middle line:90% Oh, so it's not your motivation! 00:32:16.150 --> 00:32:17.020 align:middle line:90% Now we're getting the secret. 00:32:17.020 --> 00:32:17.520 align:middle line:90% [LAUGHTER] 00:32:17.520 --> 00:32:18.995 align:middle line:90% OK, that's what I thought! 00:32:18.995 --> 00:32:20.620 align:middle line:84% So those of you guys who are old enough 00:32:20.620 --> 00:32:22.000 align:middle line:84% to remember friendship bracelets, 00:32:22.000 --> 00:32:23.770 align:middle line:84% remember those teeny tiny little beads 00:32:23.770 --> 00:32:25.360 align:middle line:90% on the friendship bracelets? 00:32:25.360 --> 00:32:28.560 align:middle line:84% Jon went from barely able to pick up a ping pong ball, 00:32:28.560 --> 00:32:31.060 align:middle line:84% to pick up a marble-- you saw a video on that-- you have not 00:32:31.060 --> 00:32:33.393 align:middle line:84% seen the video of him picking up those tiny little beads 00:32:33.393 --> 00:32:35.793 align:middle line:84% that I can barely see for the friendship bracelets. 00:32:35.793 --> 00:32:37.460 align:middle line:84% He can do that with his right hand which 00:32:37.460 --> 00:32:39.940 align:middle line:90% is his more challenged hand. 00:32:39.940 --> 00:32:41.440 align:middle line:84% And so that-- but I don't know if we 00:32:41.440 --> 00:32:42.648 align:middle line:90% would have come up with that. 00:32:42.648 --> 00:32:44.350 align:middle line:84% Maybe Fatma brought in those beads, 00:32:44.350 --> 00:32:46.543 align:middle line:84% but Jon's got them at home, he's practicing at home. 00:32:46.543 --> 00:32:48.460 align:middle line:84% Because let's face it, how often do you really 00:32:48.460 --> 00:32:50.200 align:middle line:84% need to put a coin in a slot anymore? 00:32:50.200 --> 00:32:52.783 align:middle line:84% I mean that's like a retro test, or even a key in a slot. 00:32:52.783 --> 00:32:54.700 align:middle line:84% You can't just talk to your lock and it opens? 00:32:54.700 --> 00:32:56.860 align:middle line:90% I mean, come on. 00:32:56.860 --> 00:33:00.598 align:middle line:84% But friendship bracelets, those are always going to be cool. 00:33:00.598 --> 00:33:03.400 align:middle line:90% [LAUGHTER] 00:33:03.400 --> 00:33:04.350 align:middle line:90% A couple more. 00:33:04.350 --> 00:33:05.760 align:middle line:90% Yes, Scott. 00:33:05.760 --> 00:33:10.910 align:middle line:84% So this comes from part of a question from Barbara. 00:33:10.910 --> 00:33:12.900 align:middle line:84% She's curious to know do you feel 00:33:12.900 --> 00:33:15.180 align:middle line:84% if your participation in this study 00:33:15.180 --> 00:33:18.240 align:middle line:84% has helped them develop the technology 00:33:18.240 --> 00:33:21.075 align:middle line:84% or use it better or anything of that nature? 00:33:21.075 --> 00:33:23.703 align:middle line:90% 00:33:23.703 --> 00:33:25.620 align:middle line:84% It's a question for me, but I just took a bite 00:33:25.620 --> 00:33:26.828 align:middle line:90% so you have to try to answer. 00:33:26.828 --> 00:33:28.740 align:middle line:90% [LAUGHTER] 00:33:28.740 --> 00:33:30.420 align:middle line:90% I would think so. 00:33:30.420 --> 00:33:32.130 align:middle line:84% I don't know how to answer to that. 00:33:32.130 --> 00:33:35.710 align:middle line:84% It totally has and part of what it has helped with 00:33:35.710 --> 00:33:38.320 align:middle line:84% is realizing the importance of the practice 00:33:38.320 --> 00:33:39.423 align:middle line:90% and the motivation. 00:33:39.423 --> 00:33:41.590 align:middle line:84% We kind of always knew the stimulator alone probably 00:33:41.590 --> 00:33:42.215 align:middle line:90% wouldn't do it. 00:33:42.215 --> 00:33:45.070 align:middle line:84% Someone was going to have to do at least the exercise with us, 00:33:45.070 --> 00:33:49.243 align:middle line:84% but John's recovery is so far beyond average for a study 00:33:49.243 --> 00:33:51.160 align:middle line:84% and we think we're starting to figure out why. 00:33:51.160 --> 00:33:53.380 align:middle line:84% It's not just that you're a miracle worker, 00:33:53.380 --> 00:33:56.868 align:middle line:84% it's that you do a ton of work outside of the study. 00:33:56.868 --> 00:33:59.410 align:middle line:84% And so we've now started to talk about designing home therapy 00:33:59.410 --> 00:34:03.040 align:middle line:84% programs, teletherapy programs to motivate other people who 00:34:03.040 --> 00:34:05.260 align:middle line:84% might not be as intrinsically motivated or as 00:34:05.260 --> 00:34:07.750 align:middle line:84% supported at home so they can continue 00:34:07.750 --> 00:34:10.433 align:middle line:84% to get those hours of practice even if they're not 00:34:10.433 --> 00:34:11.350 align:middle line:90% sitting there with us. 00:34:11.350 --> 00:34:12.130 align:middle line:84% Because we don't think the stimulator 00:34:12.130 --> 00:34:15.190 align:middle line:84% needs to be running anymore based on what Jon taught us. 00:34:15.190 --> 00:34:18.548 align:middle line:84% You said at one point you felt potentiated for six hours 00:34:18.548 --> 00:34:19.840 align:middle line:90% after each stimulation session. 00:34:19.840 --> 00:34:21.730 align:middle line:84% And by potentiated-- Jon can tell us-- 00:34:21.730 --> 00:34:24.310 align:middle line:84% but I think it means the spinal cord was more awake, 00:34:24.310 --> 00:34:27.645 align:middle line:84% had more capacity to do things, more ability to move. 00:34:27.645 --> 00:34:29.770 align:middle line:84% So we want to take advantage of that now and that's 00:34:29.770 --> 00:34:31.870 align:middle line:84% a direct result of your participation in the study 00:34:31.870 --> 00:34:34.989 align:middle line:84% and also you're opening up about your experience 00:34:34.989 --> 00:34:37.690 align:middle line:84% that's helped us think about how we could better help people 00:34:37.690 --> 00:34:38.500 align:middle line:90% in the next round. 00:34:38.500 --> 00:34:43.630 align:middle line:90% 00:34:43.630 --> 00:34:47.820 align:middle line:84% So my question is is the hand function itself 00:34:47.820 --> 00:34:54.239 align:middle line:84% more valuable than the ability to do tasks with utility of it 00:34:54.239 --> 00:34:56.850 align:middle line:84% because there are people who are working on, let's say, 00:34:56.850 --> 00:35:00.060 align:middle line:84% brain-computer interfaces where you would compose something 00:35:00.060 --> 00:35:03.090 align:middle line:84% with your mind to do a task that's a useful task, right? 00:35:03.090 --> 00:35:06.230 align:middle line:84% So it's very practical and you're 00:35:06.230 --> 00:35:11.160 align:middle line:84% getting it done, but just the motion and the function 00:35:11.160 --> 00:35:12.690 align:middle line:84% of your hand even if it's not doing 00:35:12.690 --> 00:35:15.270 align:middle line:84% something that's directly useful, 00:35:15.270 --> 00:35:16.610 align:middle line:90% is that more important to you? 00:35:16.610 --> 00:35:19.900 align:middle line:90% 00:35:19.900 --> 00:35:22.520 align:middle line:84% Is hand function more important than completion of the task? 00:35:22.520 --> 00:35:23.665 align:middle line:90% [INAUDIBLE] 00:35:23.665 --> 00:35:25.540 align:middle line:84% If you could have a robot do the task for you 00:35:25.540 --> 00:35:26.832 align:middle line:90% or if you could do it yourself. 00:35:26.832 --> 00:35:32.452 align:middle line:84% If I-- if both my hands were like my right hand 00:35:32.452 --> 00:35:34.410 align:middle line:84% and they were both just twitching a little bit, 00:35:34.410 --> 00:35:41.280 align:middle line:84% then yeah, it would be more important to get the task done. 00:35:41.280 --> 00:35:42.450 align:middle line:90% With me there's-- 00:35:42.450 --> 00:35:46.680 align:middle line:84% I crossed the threshold where I can do it myself. 00:35:46.680 --> 00:35:51.450 align:middle line:84% In my case it's more important to have a hand function, 00:35:51.450 --> 00:35:52.590 align:middle line:90% meaningful hand function. 00:35:52.590 --> 00:35:54.070 align:middle line:90% I think I get what you mean. 00:35:54.070 --> 00:35:57.550 align:middle line:84% It would be a different story if both my thumbs were just 00:35:57.550 --> 00:35:59.550 align:middle line:84% twitching like this one and I could do anything. 00:35:59.550 --> 00:36:03.323 align:middle line:90% Then, yeah, that sounds awesome. 00:36:03.323 --> 00:36:04.990 align:middle line:84% You know, in spinal cord injuries you'll 00:36:04.990 --> 00:36:06.625 align:middle line:90% find they're all case by case. 00:36:06.625 --> 00:36:08.500 align:middle line:84% I don't think there's any two people that got 00:36:08.500 --> 00:36:11.560 align:middle line:90% the same story or the same-- 00:36:11.560 --> 00:36:14.572 align:middle line:84% so I don't know how to aggregate that. 00:36:14.572 --> 00:36:17.030 align:middle line:84% But I would assume people who have less hand function, that 00:36:17.030 --> 00:36:18.863 align:middle line:84% would be more and to get the job done, yeah. 00:36:18.863 --> 00:36:23.490 align:middle line:90% 00:36:23.490 --> 00:36:27.710 align:middle line:84% Well, I think just from the beginning 00:36:27.710 --> 00:36:31.880 align:middle line:84% when I was first injured I recovered very substantial. 00:36:31.880 --> 00:36:34.650 align:middle line:90% 00:36:34.650 --> 00:36:40.400 align:middle line:84% Just the ability to do something for myself, whatever it was, 00:36:40.400 --> 00:36:43.738 align:middle line:90% was really important. 00:36:43.738 --> 00:36:47.350 align:middle line:84% And having somebody else do it or some robotics to do it. 00:36:47.350 --> 00:36:50.220 align:middle line:90% 00:36:50.220 --> 00:36:51.580 align:middle line:90% Like, if it was a last-- 00:36:51.580 --> 00:36:55.050 align:middle line:90% If that's all it was-- 00:36:55.050 --> 00:36:57.430 align:middle line:84% Yeah, there is something empowering 00:36:57.430 --> 00:37:00.320 align:middle line:84% about being able to do it yourself, whatever it is. 00:37:00.320 --> 00:37:03.050 align:middle line:90% 00:37:03.050 --> 00:37:06.090 align:middle line:84% Part of being human, I think, right? 00:37:06.090 --> 00:37:08.238 align:middle line:90% Yeah. 00:37:08.238 --> 00:37:10.530 align:middle line:84% One over here and then we'll come back to [INAUDIBLE].. 00:37:10.530 --> 00:37:12.950 align:middle line:84% Yes, you talk about a lot about all the great things that 00:37:12.950 --> 00:37:14.025 align:middle line:84% are happening with this technology, 00:37:14.025 --> 00:37:15.895 align:middle line:84% but was there anything that you didn't like? 00:37:15.895 --> 00:37:19.010 align:middle line:90% 00:37:19.010 --> 00:37:23.350 align:middle line:84% There were-- I had some things to-- 00:37:23.350 --> 00:37:25.430 align:middle line:84% I had a bad case of hives, for instance. 00:37:25.430 --> 00:37:27.880 align:middle line:90% It gave me arm hives really bad. 00:37:27.880 --> 00:37:31.830 align:middle line:84% That was-- nothing, you know, I just took it all-- 00:37:31.830 --> 00:37:33.750 align:middle line:84% Nothing was that-- I mean, that's negative, 00:37:33.750 --> 00:37:37.240 align:middle line:84% arm hives-- but everything else I just took it as part of, 00:37:37.240 --> 00:37:40.510 align:middle line:84% no, it was all kind of exciting to me, to be honest with you. 00:37:40.510 --> 00:37:43.800 align:middle line:90% And the more I went into it-- 00:37:43.800 --> 00:37:48.305 align:middle line:84% yeah, no, actually I just had a pretty good attitude about it. 00:37:48.305 --> 00:37:50.180 align:middle line:84% That's because I wasn't experiencing anything 00:37:50.180 --> 00:37:51.640 align:middle line:90% too bad, other than the hives. 00:37:51.640 --> 00:37:53.260 align:middle line:90% I didn't have the pain. 00:37:53.260 --> 00:37:56.480 align:middle line:84% If I'd started getting pain I'd have a different answer 00:37:56.480 --> 00:37:58.920 align:middle line:84% for you, but it was just all a positive experience for me. 00:37:58.920 --> 00:38:01.390 align:middle line:90% 00:38:01.390 --> 00:38:03.140 align:middle line:84% So let's talk a little bit about the hives 00:38:03.140 --> 00:38:05.223 align:middle line:84% because I want to know more about your experience. 00:38:05.223 --> 00:38:07.473 align:middle line:84% We've talked about it, before I want to hear from you. 00:38:07.473 --> 00:38:09.640 align:middle line:84% So I recall that it happened about the same time you 00:38:09.640 --> 00:38:12.130 align:middle line:84% started sweating again below the injury, is that accurate? 00:38:12.130 --> 00:38:12.920 align:middle line:90% Yeah. 00:38:12.920 --> 00:38:14.690 align:middle line:90% So we reported this to IRB. 00:38:14.690 --> 00:38:15.980 align:middle line:90% This was an adverse event. 00:38:15.980 --> 00:38:18.230 align:middle line:84% Jon developed a rash on his arms and it was 00:38:18.230 --> 00:38:19.550 align:middle line:90% an uncomfortable rash, right? 00:38:19.550 --> 00:38:22.430 align:middle line:84% It was something you needed topical cream to treat. 00:38:22.430 --> 00:38:24.020 align:middle line:90% Yeah, all the way up and down. 00:38:24.020 --> 00:38:25.110 align:middle line:90% Yeah, exactly. 00:38:25.110 --> 00:38:27.770 align:middle line:84% And so, it was unexpected at the time, not something 00:38:27.770 --> 00:38:29.888 align:middle line:90% we'd ever seen before. 00:38:29.888 --> 00:38:30.930 align:middle line:90% Fortunately, it resolved. 00:38:30.930 --> 00:38:32.240 align:middle line:84% It's sounds like when you saw your physician, 00:38:32.240 --> 00:38:33.867 align:middle line:84% she gave you an over-the-counter-- not even 00:38:33.867 --> 00:38:34.784 align:middle line:90% a prescription, right? 00:38:34.784 --> 00:38:37.940 align:middle line:84% She just had over-the-counter Benadryl cream or something 00:38:37.940 --> 00:38:39.620 align:middle line:90% to treat it. 00:38:39.620 --> 00:38:40.610 align:middle line:90% Then it just went away. 00:38:40.610 --> 00:38:42.360 align:middle line:84% And it went away, but the sweating stayed. 00:38:42.360 --> 00:38:43.440 align:middle line:90% And never came back. 00:38:43.440 --> 00:38:44.120 align:middle line:90% Never came back. 00:38:44.120 --> 00:38:44.960 align:middle line:90% Sweating stayed. 00:38:44.960 --> 00:38:49.310 align:middle line:84% So scientifically, though, it was kind of cool for us 00:38:49.310 --> 00:38:53.000 align:middle line:84% because it was like, hey, we restarted Jon's autonomic 00:38:53.000 --> 00:38:55.850 align:middle line:84% nervous system and he started sweating and he got this rash-- 00:38:55.850 --> 00:38:57.120 align:middle line:90% that wasn't great-- 00:38:57.120 --> 00:38:59.870 align:middle line:90% but it was temporary. 00:38:59.870 --> 00:39:01.610 align:middle line:90% Well, also that the hives were-- 00:39:01.610 --> 00:39:05.630 align:middle line:84% I have a strong family history of them-- 00:39:05.630 --> 00:39:07.160 align:middle line:90% great thing to be-- 00:39:07.160 --> 00:39:13.700 align:middle line:84% but my dad can call them up at will depending on what he eats. 00:39:13.700 --> 00:39:17.450 align:middle line:84% And so it's kind of you might think it's something 00:39:17.450 --> 00:39:19.585 align:middle line:90% that was in me. 00:39:19.585 --> 00:39:21.710 align:middle line:84% Like what you were saying, it was an autonomic kind 00:39:21.710 --> 00:39:23.210 align:middle line:84% of response that happened that I was 00:39:23.210 --> 00:39:27.360 align:middle line:84% like genetically predisposed to be experiencing anyway. 00:39:27.360 --> 00:39:29.860 align:middle line:84% So it was like you were saying, it was kind of a good thing. 00:39:29.860 --> 00:39:30.400 align:middle line:90% It's weird. 00:39:30.400 --> 00:39:31.900 align:middle line:84% Scientifically, it's kind of like we 00:39:31.900 --> 00:39:34.345 align:middle line:84% unlocked Jon's natural predisposition to have hives. 00:39:34.345 --> 00:39:35.130 align:middle line:90% [LAUGHTER] 00:39:35.130 --> 00:39:37.660 align:middle line:84% It might not have been the goal we were all shooting for 00:39:37.660 --> 00:39:40.810 align:middle line:84% and thankfully they resolved, but from a scientific point 00:39:40.810 --> 00:39:42.610 align:middle line:84% of view it's like, wow, that's powerful, 00:39:42.610 --> 00:39:44.830 align:middle line:84% that that stimulator doesn't just make his hand move better, 00:39:44.830 --> 00:39:46.330 align:middle line:84% it doesn't allow him to sweat again, 00:39:46.330 --> 00:39:47.472 align:middle line:90% but actually brings back-- 00:39:47.472 --> 00:39:49.930 align:middle line:84% I wouldn't go so far as to call it an autoimmune response-- 00:39:49.930 --> 00:39:52.720 align:middle line:84% but it's could be kind of like that, right? 00:39:52.720 --> 00:39:57.460 align:middle line:84% It runs in your family, it came back briefly. 00:39:57.460 --> 00:39:59.685 align:middle line:90% It's an adverse event, right? 00:39:59.685 --> 00:40:01.060 align:middle line:84% And it's now in the consent form. 00:40:01.060 --> 00:40:05.422 align:middle line:84% It says "this technology may give you hives". 00:40:05.422 --> 00:40:06.880 align:middle line:84% And it'll be in the packaging slip, 00:40:06.880 --> 00:40:09.707 align:middle line:84% probably, if this is ever approved by the FDA, which is-- 00:40:09.707 --> 00:40:11.290 align:middle line:84% and that's why you read that long list 00:40:11.290 --> 00:40:12.550 align:middle line:84% and it's important to read that long list, 00:40:12.550 --> 00:40:14.590 align:middle line:84% because it could happen to you and Jon helped us 00:40:14.590 --> 00:40:15.882 align:middle line:90% discover that this is possible. 00:40:15.882 --> 00:40:19.316 align:middle line:90% 00:40:19.316 --> 00:40:23.236 align:middle line:84% Question about-- and maybe [INAUDIBLE] 00:40:23.236 --> 00:40:29.710 align:middle line:84% is about people with neuropathy, has the stimulation 00:40:29.710 --> 00:40:34.035 align:middle line:84% affected that positively, negatively? 00:40:34.035 --> 00:40:35.160 align:middle line:90% Fatma, can you help me out? 00:40:35.160 --> 00:40:37.410 align:middle line:84% I don't feel like we've had anyone with neuropathy. 00:40:37.410 --> 00:40:41.033 align:middle line:84% You can come all the way up and talk to the mic if you want. 00:40:41.033 --> 00:40:43.200 align:middle line:84% The question was people with peripheral neuropathy-- 00:40:43.200 --> 00:40:44.180 align:middle line:84% I have to repeat it anyway, Bruce, 00:40:44.180 --> 00:40:45.472 align:middle line:90% because the mic has to here it. 00:40:45.472 --> 00:40:46.970 align:middle line:90% Central neuropathy. 00:40:46.970 --> 00:40:47.790 align:middle line:90% OK, right. 00:40:47.790 --> 00:40:50.727 align:middle line:84% Central neuropathy, sure So neuropathic pain? 00:40:50.727 --> 00:40:53.310 align:middle line:84% So people who have-- some people who have spinal cord injury-- 00:40:53.310 --> 00:40:55.320 align:middle line:84% have what's known as neuropathic pain. 00:40:55.320 --> 00:40:58.530 align:middle line:84% It's a really incipient, nasty, nasty pain. 00:40:58.530 --> 00:41:00.780 align:middle line:84% It doesn't respond in normal kinds of pain medication. 00:41:00.780 --> 00:41:04.980 align:middle line:84% Actually, it only responds really to THC in most cases. 00:41:04.980 --> 00:41:07.890 align:middle line:84% And it can be debilitating and it's not the kind of thing 00:41:07.890 --> 00:41:09.750 align:middle line:90% we want to kick off, for sure. 00:41:09.750 --> 00:41:12.690 align:middle line:84% So Fatma, do you recall, has anyone had this kind of pain, 00:41:12.690 --> 00:41:15.024 align:middle line:84% has it gotten better, has it gotten worse? 00:41:15.024 --> 00:41:26.010 align:middle line:84% [INAUDIBLE] used to treat the [INAUDIBLE] 00:41:26.010 --> 00:41:30.320 align:middle line:84% in spinal cord injured patients but any type of [INAUDIBLE].. 00:41:30.320 --> 00:41:35.700 align:middle line:90% 00:41:35.700 --> 00:41:40.780 align:middle line:84% So I don't have any experience if [? it can ?] 00:41:40.780 --> 00:41:44.490 align:middle line:84% help [INAUDIBLE] pain or [INAUDIBLE].. 00:41:44.490 --> 00:41:50.060 align:middle line:90% 00:41:50.060 --> 00:41:52.050 align:middle line:84% I was worried about developing it. 00:41:52.050 --> 00:41:54.670 align:middle line:90% That was my concern. 00:41:54.670 --> 00:41:55.562 align:middle line:90% I have it. 00:41:55.562 --> 00:41:58.274 align:middle line:90% 00:41:58.274 --> 00:42:00.336 align:middle line:84% If it got worse, that would really-- 00:42:00.336 --> 00:42:02.060 align:middle line:90% It would be a non-starter. 00:42:02.060 --> 00:42:04.200 align:middle line:90% Yeah, exactly. 00:42:04.200 --> 00:42:06.980 align:middle line:90% Thanks for sharing that. 00:42:06.980 --> 00:42:09.520 align:middle line:90% That was exactly my question. 00:42:09.520 --> 00:42:11.560 align:middle line:84% Have you-- because you had mentioned the pain-- 00:42:11.560 --> 00:42:15.560 align:middle line:84% [INAUDIBLE] has this stimulation in your trials, 00:42:15.560 --> 00:42:19.512 align:middle line:84% have you brought that on in any way? 00:42:19.512 --> 00:42:20.720 align:middle line:90% You implied that you haven't. 00:42:20.720 --> 00:42:21.960 align:middle line:90% Thankfully we haven't, right? 00:42:21.960 --> 00:42:23.418 align:middle line:84% That would probably stop the trial. 00:42:23.418 --> 00:42:25.835 align:middle line:84% That would be that kind of-- especially it was persistent. 00:42:25.835 --> 00:42:27.610 align:middle line:84% If the pain started during the stimulation 00:42:27.610 --> 00:42:29.943 align:middle line:84% and didn't resolve when the simulation was discontinued, 00:42:29.943 --> 00:42:31.700 align:middle line:84% I think the technology would be shelved. 00:42:31.700 --> 00:42:33.480 align:middle line:84% And that's the only sort of pain that you were worried about, 00:42:33.480 --> 00:42:34.298 align:middle line:90% Jon? 00:42:34.298 --> 00:42:36.090 align:middle line:84% Or were you worried about just some other-- 00:42:36.090 --> 00:42:39.710 align:middle line:90% No, it's that kind of pain. 00:42:39.710 --> 00:42:41.750 align:middle line:84% I'm lucky, that's a pretty typical story 00:42:41.750 --> 00:42:43.040 align:middle line:90% for a spinal cord injury. 00:42:43.040 --> 00:42:44.750 align:middle line:90% It's just a burning-- 00:42:44.750 --> 00:42:47.590 align:middle line:84% I've heard it described many ways, and it sounds awful. 00:42:47.590 --> 00:42:49.390 align:middle line:84% Maybe, Bruce, if you don't mind describing 00:42:49.390 --> 00:42:50.390 align:middle line:90% the quality of the pain? 00:42:50.390 --> 00:42:51.950 align:middle line:84% Because I think people don't really appreciate it 00:42:51.950 --> 00:42:53.158 align:middle line:90% until they hear it described. 00:42:53.158 --> 00:42:56.500 align:middle line:84% A lot of time for me-- and it does vary-- 00:42:56.500 --> 00:43:00.270 align:middle line:84% but now that I'm talking about it, I feel it. 00:43:00.270 --> 00:43:02.320 align:middle line:84% Sorry, maybe you don't need to describe it? 00:43:02.320 --> 00:43:06.710 align:middle line:84% I'd say it's moderate, but really it's the feeling 00:43:06.710 --> 00:43:09.935 align:middle line:84% like your foot goes to sleep or something, that tingly, pins 00:43:09.935 --> 00:43:11.950 align:middle line:90% and needles. 00:43:11.950 --> 00:43:16.530 align:middle line:84% Everywhere, I kind of have a line diagonally 00:43:16.530 --> 00:43:18.410 align:middle line:90% across my chest. 00:43:18.410 --> 00:43:21.305 align:middle line:84% It's in my right arm and also my left hand. 00:43:21.305 --> 00:43:25.910 align:middle line:84% This side is much stronger and below that line is pretty-- 00:43:25.910 --> 00:43:29.780 align:middle line:84% it's tingly and it goes up and down. 00:43:29.780 --> 00:43:37.898 align:middle line:84% Sometimes it's cold, sometimes-- occasionally-- it wakes me up 00:43:37.898 --> 00:43:39.802 align:middle line:90% at night. 00:43:39.802 --> 00:43:40.754 align:middle line:90% But that's life. 00:43:40.754 --> 00:43:43.550 align:middle line:84% That's a good description, and I think everybody's is different. 00:43:43.550 --> 00:43:46.850 align:middle line:84% I've heard it described as a searing, burning, stabbing pain 00:43:46.850 --> 00:43:49.070 align:middle line:84% right at a band level of the injury. 00:43:49.070 --> 00:43:53.420 align:middle line:84% Obviously the tingling, numbness, annoying buzzing-- 00:43:53.420 --> 00:43:55.560 align:middle line:84% but it's very-- it doesn't respond to opioids, 00:43:55.560 --> 00:43:57.980 align:middle line:84% it doesn't respond to over the counter. 00:43:57.980 --> 00:43:59.350 align:middle line:90% It's just there. 00:43:59.350 --> 00:44:02.230 align:middle line:84% I take ibuprofin which takes the edge off at least. 00:44:02.230 --> 00:44:04.790 align:middle line:90% That's good. 00:44:04.790 --> 00:44:06.490 align:middle line:90% I experimented with CBD, THC. 00:44:06.490 --> 00:44:09.470 align:middle line:90% 00:44:09.470 --> 00:44:11.860 align:middle line:84% That's actually much better for spasticity. 00:44:11.860 --> 00:44:13.671 align:middle line:90% Interesting. 00:44:13.671 --> 00:44:15.910 align:middle line:90% Almost miraculous. 00:44:15.910 --> 00:44:16.950 align:middle line:90% For neuropathy-- 00:44:16.950 --> 00:44:19.228 align:middle line:90% Not so much? 00:44:19.228 --> 00:44:21.270 align:middle line:84% And I think everybody is different because I know 00:44:21.270 --> 00:44:23.920 align:middle line:90% [INAUDIBLE] doesn't, or-- 00:44:23.920 --> 00:44:26.890 align:middle line:84% the THC is the only thing that works for pain 00:44:26.890 --> 00:44:29.622 align:middle line:90% and nothing else will touch it. 00:44:29.622 --> 00:44:33.960 align:middle line:84% Do you have spasticity issues as an affect of that? 00:44:33.960 --> 00:44:34.990 align:middle line:90% It helped. 00:44:34.990 --> 00:44:41.370 align:middle line:84% Yeah, my spasticity kicks in when I sleep or try to sleep. 00:44:41.370 --> 00:44:43.080 align:middle line:90% I just don't sleep, it's awful. 00:44:43.080 --> 00:44:46.580 align:middle line:84% And that is one thing that's crept back. 00:44:46.580 --> 00:44:50.550 align:middle line:84% When, on the trial, I was sleeping like a baby, actually. 00:44:50.550 --> 00:44:51.720 align:middle line:90% It really improved my sleep. 00:44:51.720 --> 00:44:53.880 align:middle line:84% It gave me-- my legs are what do it. 00:44:53.880 --> 00:44:54.390 align:middle line:90% They kick. 00:44:54.390 --> 00:44:56.057 align:middle line:84% They kick hard, they kick as hard as you 00:44:56.057 --> 00:44:57.550 align:middle line:90% could kick your leg. 00:44:57.550 --> 00:44:59.910 align:middle line:84% It usually happens about 20 minutes after I fall asleep. 00:44:59.910 --> 00:45:02.330 align:middle line:84% They'll just kick and you're wide awake. 00:45:02.330 --> 00:45:04.160 align:middle line:90% And that helped my sleep. 00:45:04.160 --> 00:45:06.770 align:middle line:84% And now that has started to return just a little bit. 00:45:06.770 --> 00:45:11.660 align:middle line:84% My sleeplessness is starting to come back a little bit. 00:45:11.660 --> 00:45:13.080 align:middle line:90% That's why I'm a little off. 00:45:13.080 --> 00:45:14.497 align:middle line:84% Thanks for sharing that, actually. 00:45:14.497 --> 00:45:16.820 align:middle line:84% We should follow up on the time course of that, 00:45:16.820 --> 00:45:18.770 align:middle line:84% because we've seen the spasticity take a while 00:45:18.770 --> 00:45:20.645 align:middle line:84% to respond initially-- like a couple of weeks 00:45:20.645 --> 00:45:21.620 align:middle line:90% into the trial-- 00:45:21.620 --> 00:45:23.260 align:middle line:84% before the specificity changes and then 00:45:23.260 --> 00:45:24.862 align:middle line:84% it lasts for a couple weeks after. 00:45:24.862 --> 00:45:26.570 align:middle line:84% That's true, that's the one thing-- maybe 00:45:26.570 --> 00:45:31.060 align:middle line:84% to Kate's question-- it does seem to come back to normal 00:45:31.060 --> 00:45:34.160 align:middle line:84% to pre-treatment levels is the spasticity. 00:45:34.160 --> 00:45:36.620 align:middle line:84% But it did changes, that's a good point, though. 00:45:36.620 --> 00:45:38.470 align:middle line:90% The arc changed. 00:45:38.470 --> 00:45:40.360 align:middle line:90% It increased to that at first. 00:45:40.360 --> 00:45:44.583 align:middle line:84% It was really severe, especially when I would lay down. 00:45:44.583 --> 00:45:46.000 align:middle line:84% Something happens when I lay down. 00:45:46.000 --> 00:45:48.580 align:middle line:84% It's like my tone pattern sets in. 00:45:48.580 --> 00:45:53.190 align:middle line:84% But I would feel like a lightning rod that first month. 00:45:53.190 --> 00:45:55.210 align:middle line:84% I kind of forgot about that, actually. 00:45:55.210 --> 00:45:58.140 align:middle line:84% And then it resolved, too, for the better. 00:45:58.140 --> 00:46:00.020 align:middle line:84% And I had three months of some of the best 00:46:00.020 --> 00:46:03.430 align:middle line:90% sleep I've had in 13 years. 00:46:03.430 --> 00:46:04.930 align:middle line:84% What we've noticed in other people-- 00:46:04.930 --> 00:46:07.460 align:middle line:84% and Jon I thinks situation parallels this-- 00:46:07.460 --> 00:46:11.850 align:middle line:84% the specificity gets stronger initially, but either more 00:46:11.850 --> 00:46:13.782 align:middle line:84% productive or less often or something. 00:46:13.782 --> 00:46:15.240 align:middle line:84% It's like you'll have one big spasm 00:46:15.240 --> 00:46:17.250 align:middle line:84% at the beginning of the night and then no more, 00:46:17.250 --> 00:46:18.817 align:middle line:90% but that big spasm is bigger. 00:46:18.817 --> 00:46:20.400 align:middle line:84% So that, depending on your priorities, 00:46:20.400 --> 00:46:21.630 align:middle line:90% that could be a bad thing. 00:46:21.630 --> 00:46:24.565 align:middle line:90% Yeah, it's hard to explain. 00:46:24.565 --> 00:46:26.940 align:middle line:84% I mean, something happens when you put two hours of power 00:46:26.940 --> 00:46:29.070 align:middle line:90% on your neck. 00:46:29.070 --> 00:46:30.190 align:middle line:90% The power hour! 00:46:30.190 --> 00:46:31.310 align:middle line:90% The two hours of power. 00:46:31.310 --> 00:46:31.935 align:middle line:90% Two-hour power. 00:46:31.935 --> 00:46:38.770 align:middle line:84% Do you see as a treatment for [INAUDIBLE] periodic refresher 00:46:38.770 --> 00:46:43.770 align:middle line:84% things or some day might actually these things become 00:46:43.770 --> 00:46:45.320 align:middle line:84% commercially available and you just 00:46:45.320 --> 00:46:47.460 align:middle line:90% have follow-up things to do. 00:46:47.460 --> 00:46:49.230 align:middle line:90% Yeah, that's one option. 00:46:49.230 --> 00:46:51.870 align:middle line:84% Obviously, we're not involved in the commercialization 00:46:51.870 --> 00:46:54.490 align:middle line:84% ourselves, but the company that we work with has two models. 00:46:54.490 --> 00:46:56.310 align:middle line:84% One is to give it to physical therapists 00:46:56.310 --> 00:46:58.770 align:middle line:84% and just use it in parallel with the treatment that's 00:46:58.770 --> 00:46:59.967 align:middle line:90% happening in the clinic. 00:46:59.967 --> 00:47:01.800 align:middle line:84% That's probably how it'll initially roll out 00:47:01.800 --> 00:47:03.248 align:middle line:84% because then there's supervision, 00:47:03.248 --> 00:47:05.040 align:middle line:84% therapists are doing the treatment any way, 00:47:05.040 --> 00:47:06.790 align:middle line:84% they can get reimbursed for the treatment, 00:47:06.790 --> 00:47:09.090 align:middle line:84% even if the device isn't reimbursable yet. 00:47:09.090 --> 00:47:11.550 align:middle line:84% But then the dream is-- and if it turns out to be really 00:47:11.550 --> 00:47:12.540 align:middle line:90% safe-- 00:47:12.540 --> 00:47:15.420 align:middle line:84% and need these maintenance doses that some people at least 00:47:15.420 --> 00:47:18.810 align:middle line:84% would be able to be reimbursed by Medicare, Medicaid, et 00:47:18.810 --> 00:47:19.310 align:middle line:90% cetera. 00:47:19.310 --> 00:47:21.870 align:middle line:84% Take these home and I don't know how often 00:47:21.870 --> 00:47:24.840 align:middle line:84% you'd need to use it, maybe not every day, maybe once a week. 00:47:24.840 --> 00:47:26.220 align:middle line:90% Or maybe all the time. 00:47:26.220 --> 00:47:27.360 align:middle line:84% Maybe you'd want to use it all the time, 00:47:27.360 --> 00:47:29.040 align:middle line:84% maybe you put it on for specific tasks. 00:47:29.040 --> 00:47:31.160 align:middle line:84% It's so cool because it's so portable 00:47:31.160 --> 00:47:34.183 align:middle line:84% and you can put it on your own neck, basically. 00:47:34.183 --> 00:47:35.100 align:middle line:90% You can figure it out. 00:47:35.100 --> 00:47:36.578 align:middle line:90% It's just this little case. 00:47:36.578 --> 00:47:38.370 align:middle line:84% The last time I was here for the last event 00:47:38.370 --> 00:47:42.180 align:middle line:84% I was able to play guitar for a couple hours with it on. 00:47:42.180 --> 00:47:45.330 align:middle line:84% I'm not kidding, I was better at guitar that night. 00:47:45.330 --> 00:47:47.400 align:middle line:84% It just accentuates whatever you try 00:47:47.400 --> 00:47:52.290 align:middle line:84% to do with it, in my experience anyway. 00:47:52.290 --> 00:47:55.000 align:middle line:84% I want to know if a person that doesn't have an injury 00:47:55.000 --> 00:47:56.270 align:middle line:90% puts it on, how does that go? 00:47:56.270 --> 00:47:57.270 align:middle line:90% Have you tried that? 00:47:57.270 --> 00:47:59.670 align:middle line:84% We won't put it anyone's neck who doesn't have an injury, 00:47:59.670 --> 00:48:01.000 align:middle line:84% but we will put on the back of your arm 00:48:01.000 --> 00:48:02.583 align:middle line:84% if you want to see what it feels like? 00:48:02.583 --> 00:48:03.617 align:middle line:90% We've done that demo. 00:48:03.617 --> 00:48:05.450 align:middle line:84% You want to know what it's like on the neck. 00:48:05.450 --> 00:48:08.510 align:middle line:84% I want to know if enhances motor activity. 00:48:08.510 --> 00:48:11.890 align:middle line:90% Does it have a similar effect? 00:48:11.890 --> 00:48:13.670 align:middle line:90% It's possible. 00:48:13.670 --> 00:48:15.918 align:middle line:84% No one-- well Yuri [INAUDIBLE] tried it 00:48:15.918 --> 00:48:18.460 align:middle line:84% on the lumbar cord of a couple of people who weren't injured. 00:48:18.460 --> 00:48:20.730 align:middle line:84% That was published in 2015, but I 00:48:20.730 --> 00:48:23.230 align:middle line:84% don't think they asked them to do anything interesting other 00:48:23.230 --> 00:48:25.605 align:middle line:84% than they saw that the legs would start to cycle if there 00:48:25.605 --> 00:48:26.830 align:middle line:90% was no gravity involved. 00:48:26.830 --> 00:48:29.375 align:middle line:84% The legs would start to make this walking rhythm, which 00:48:29.375 --> 00:48:31.057 align:middle line:90% is kind of cool. 00:48:31.057 --> 00:48:32.890 align:middle line:84% CPG activated the central pattern generator. 00:48:32.890 --> 00:48:34.480 align:middle line:90% I wager it would. 00:48:34.480 --> 00:48:36.150 align:middle line:90% I think it would. 00:48:36.150 --> 00:48:38.863 align:middle line:84% I think it's got a lot of applications. 00:48:38.863 --> 00:48:40.780 align:middle line:84% It's an amplifier for your spinal cord, right? 00:48:40.780 --> 00:48:42.580 align:middle line:84% Because I was a rock climber before this. 00:48:42.580 --> 00:48:45.970 align:middle line:84% I'm sure if I had this on you could grip harder 00:48:45.970 --> 00:48:47.590 align:middle line:90% and you could-- 00:48:47.590 --> 00:48:49.780 align:middle line:90% so for aging and what not-- 00:48:49.780 --> 00:48:53.390 align:middle line:84% I don't want to speak where I shouldn't speak. 00:48:53.390 --> 00:48:55.698 align:middle line:84% But I think, yeah, I would love for my grandparents 00:48:55.698 --> 00:48:56.490 align:middle line:90% to wear this thing. 00:48:56.490 --> 00:48:58.032 align:middle line:84% I think it would help their strength. 00:48:58.032 --> 00:49:00.625 align:middle line:90% I don't know how it couldn't. 00:49:00.625 --> 00:49:02.983 align:middle line:84% Well, you've suggested two possible markets 00:49:02.983 --> 00:49:03.650 align:middle line:90% for the company. 00:49:03.650 --> 00:49:04.230 align:middle line:90% [LAUGHTER] 00:49:04.230 --> 00:49:05.340 align:middle line:84% Which is really important, actually, 00:49:05.340 --> 00:49:06.660 align:middle line:84% because spinal cord is a small market. 00:49:06.660 --> 00:49:08.400 align:middle line:84% It's a good thing it's a small market. 00:49:08.400 --> 00:49:10.350 align:middle line:84% Between the ab roller that you described 00:49:10.350 --> 00:49:11.765 align:middle line:90% earlier, the Ab-a-tron! 00:49:11.765 --> 00:49:12.690 align:middle line:90% And guitar players. 00:49:12.690 --> 00:49:14.780 align:middle line:84% And now the guitar players, rock climbers, and now 00:49:14.780 --> 00:49:17.140 align:middle line:84% though the older adults-- that's where my ears really lit up. 00:49:17.140 --> 00:49:18.360 align:middle line:90% I was like, that's a market. 00:49:18.360 --> 00:49:21.111 align:middle line:84% Baby boomers-- baby boomers are a market. 00:49:21.111 --> 00:49:25.290 align:middle line:84% How sensitive are the devices and how do you 00:49:25.290 --> 00:49:27.640 align:middle line:90% see the cost going down? 00:49:27.640 --> 00:49:28.140 align:middle line:90% Sure. 00:49:28.140 --> 00:49:30.600 align:middle line:84% So what little bit I know from the company, 00:49:30.600 --> 00:49:33.060 align:middle line:84% the current prototypes I think cost about $10,000 00:49:33.060 --> 00:49:34.710 align:middle line:84% to produce because they're kind of one 00:49:34.710 --> 00:49:38.490 align:middle line:84% off, alpha units, just the materials, right? 00:49:38.490 --> 00:49:41.160 align:middle line:84% The company's model right now-- this is going to sound bad 00:49:41.160 --> 00:49:42.880 align:middle line:90% at first, but bear with me-- 00:49:42.880 --> 00:49:44.520 align:middle line:84% the company's model is to actually, 00:49:44.520 --> 00:49:46.800 align:middle line:84% because the volume is so small, and they 00:49:46.800 --> 00:49:49.200 align:middle line:84% have to stay in business to provide these and make them 00:49:49.200 --> 00:49:53.910 align:middle line:84% better over time, is to actually sell them at a very high markup 00:49:53.910 --> 00:49:57.150 align:middle line:84% but to get insurance to cover all that. 00:49:57.150 --> 00:49:59.670 align:middle line:84% So a current TENS unit or FES unit 00:49:59.670 --> 00:50:02.650 align:middle line:84% is already like $6,000 to $10,000 00:50:02.650 --> 00:50:06.330 align:middle line:84% of clinical-grade stimulator and insurance 00:50:06.330 --> 00:50:08.340 align:middle line:90% covers essentially all of it. 00:50:08.340 --> 00:50:11.280 align:middle line:84% And so their goal, because this is more sophisticated 00:50:11.280 --> 00:50:14.040 align:middle line:84% and delivers 10 times the power and probably has 10 times 00:50:14.040 --> 00:50:16.440 align:middle line:84% the results, is to be not 10 times more 00:50:16.440 --> 00:50:18.455 align:middle line:90% expensive but double or triple. 00:50:18.455 --> 00:50:20.580 align:middle line:84% But not to gouge the person with spinal cord injury 00:50:20.580 --> 00:50:22.330 align:middle line:84% or the clinic, but rather to just 00:50:22.330 --> 00:50:25.080 align:middle line:84% charge a market medical device market 00:50:25.080 --> 00:50:28.773 align:middle line:84% value that allows them to maintain 00:50:28.773 --> 00:50:29.940 align:middle line:90% their solvency as a company. 00:50:29.940 --> 00:50:32.148 align:middle line:84% Because we've seen some pretty sad examples of people 00:50:32.148 --> 00:50:35.040 align:middle line:84% like Hunter Peckham's company failing economically, not 00:50:35.040 --> 00:50:35.600 align:middle line:90% functionally. 00:50:35.600 --> 00:50:37.180 align:middle line:84% He has an implanted muscle stimulator 00:50:37.180 --> 00:50:38.430 align:middle line:84% called the Freehand which lets people 00:50:38.430 --> 00:50:40.305 align:middle line:84% do all kinds of great things that their hand. 00:50:40.305 --> 00:50:42.570 align:middle line:84% It's no longer offered because the company 00:50:42.570 --> 00:50:44.452 align:middle line:90% failed economically. 00:50:44.452 --> 00:50:46.410 align:middle line:84% Actually, the company that acquired the company 00:50:46.410 --> 00:50:48.420 align:middle line:84% that he started and then the company that acquired them 00:50:48.420 --> 00:50:49.950 align:middle line:84% decided not to continue marketing it 00:50:49.950 --> 00:50:51.700 align:middle line:84% because they weren't making money on it. 00:50:51.700 --> 00:50:53.795 align:middle line:84% So these things can happen beyond the control 00:50:53.795 --> 00:50:55.670 align:middle line:84% of the original inventors, beyond the control 00:50:55.670 --> 00:50:56.730 align:middle line:90% of researchers. 00:50:56.730 --> 00:50:58.900 align:middle line:90% So that's their goal. 00:50:58.900 --> 00:51:03.090 align:middle line:84% But again, it's not to gouge Jon out of $20,000, 00:51:03.090 --> 00:51:05.700 align:middle line:84% it's to let Medicare, Medicaid, and private insurance 00:51:05.700 --> 00:51:07.860 align:middle line:84% pay the $20,000, which they're happy to pay 00:51:07.860 --> 00:51:10.440 align:middle line:84% for your surgeries, for your scanning, 00:51:10.440 --> 00:51:12.570 align:middle line:84% for all the other things that you're already doing. 00:51:12.570 --> 00:51:14.190 align:middle line:90% So that's how we envision it. 00:51:14.190 --> 00:51:17.740 align:middle line:84% I mean we as in the people I've talked to at the company. 00:51:17.740 --> 00:51:21.150 align:middle line:84% But you had another question about who else would buy it, 00:51:21.150 --> 00:51:22.250 align:middle line:90% or was that just the cost? 00:51:22.250 --> 00:51:27.180 align:middle line:84% It was more about the costs involved [INAUDIBLE].. 00:51:27.180 --> 00:51:28.980 align:middle line:84% Yeah, there's another option, right? 00:51:28.980 --> 00:51:31.530 align:middle line:84% I mean, the device itself is going to cost $500 in materials 00:51:31.530 --> 00:51:32.460 align:middle line:90% to make. 00:51:32.460 --> 00:51:35.430 align:middle line:84% So the other option is to sell it for $500 or $1,000 00:51:35.430 --> 00:51:37.030 align:middle line:90% and go for quantity. 00:51:37.030 --> 00:51:39.797 align:middle line:84% But I think that would only work if you turn out to be right 00:51:39.797 --> 00:51:41.880 align:middle line:84% and then it helps rock climbers and guitar players 00:51:41.880 --> 00:51:45.060 align:middle line:84% and people who sit on the couch and want six packs. 00:51:45.060 --> 00:51:47.940 align:middle line:84% Then maybe you could make it a consumer device 00:51:47.940 --> 00:51:50.097 align:middle line:90% and cost to be exempt, I think. 00:51:50.097 --> 00:51:51.930 align:middle line:84% If I'm not speaking out of term for the FDA. 00:51:51.930 --> 00:51:55.320 align:middle line:84% It's a device that doesn't have a medical indication, 00:51:55.320 --> 00:51:56.430 align:middle line:90% it just has-- 00:51:56.430 --> 00:51:57.645 align:middle line:90% it's electrically safe. 00:51:57.645 --> 00:51:59.270 align:middle line:84% And then people with spinal cord injury 00:51:59.270 --> 00:52:03.002 align:middle line:84% could buy it on a website and choose how they want to use it. 00:52:03.002 --> 00:52:04.710 align:middle line:84% So those are totally different strategies 00:52:04.710 --> 00:52:07.290 align:middle line:84% in terms of regulation and cost and claims 00:52:07.290 --> 00:52:08.940 align:middle line:90% about medical benefit. 00:52:08.940 --> 00:52:10.440 align:middle line:84% There's lots of questions over here, 00:52:10.440 --> 00:52:12.190 align:middle line:84% I'll let you guys sort out who goes first. 00:52:12.190 --> 00:52:20.355 align:middle line:84% So [INAUDIBLE] have you noticed a difference in cognition 00:52:20.355 --> 00:52:21.317 align:middle line:90% at all? 00:52:21.317 --> 00:52:25.650 align:middle line:90% 00:52:25.650 --> 00:52:31.940 align:middle line:84% Only in terms of attitude and just opening up, 00:52:31.940 --> 00:52:34.070 align:middle line:84% which shouldn't be underscored, actually. 00:52:34.070 --> 00:52:41.110 align:middle line:84% I mean-- do you mean in terms of do I think-- 00:52:41.110 --> 00:52:42.401 align:middle line:90% doing math quicker? 00:52:42.401 --> 00:52:43.363 align:middle line:90% [LAUGHTER] 00:52:43.363 --> 00:52:45.416 align:middle line:84% [INAUDIBLE] your thoughts or critical thinking, 00:52:45.416 --> 00:52:46.249 align:middle line:90% analytical thinking. 00:52:46.249 --> 00:52:49.630 align:middle line:90% 00:52:49.630 --> 00:52:52.840 align:middle line:84% I would think maybe just indirectly just based on more 00:52:52.840 --> 00:53:00.850 align:middle line:84% positive mindset and kind of indirectly, but not directly, 00:53:00.850 --> 00:53:01.420 align:middle line:90% I don't-- 00:53:01.420 --> 00:53:04.900 align:middle line:90% I'm not reading faster. 00:53:04.900 --> 00:53:08.230 align:middle line:84% So in the rehabilitation literature 00:53:08.230 --> 00:53:09.730 align:middle line:84% I've been reading a lot there's kind 00:53:09.730 --> 00:53:12.190 align:middle line:90% of like two big camps I see. 00:53:12.190 --> 00:53:18.820 align:middle line:84% One camp is this rehabilitation through stimulation, actually 00:53:18.820 --> 00:53:20.680 align:middle line:90% more biological processes. 00:53:20.680 --> 00:53:22.960 align:middle line:84% And then there is this camp where 00:53:22.960 --> 00:53:29.230 align:middle line:84% it's kind of exosuit where they have assistive devices 00:53:29.230 --> 00:53:31.930 align:middle line:84% to help model [? gaits. ?] So my question to you 00:53:31.930 --> 00:53:37.520 align:middle line:84% as an end user do you see one as more valuable than the other 00:53:37.520 --> 00:53:41.140 align:middle line:84% if both could theoretically task? 00:53:41.140 --> 00:53:43.400 align:middle line:84% Yeah, I think they work together. 00:53:43.400 --> 00:53:44.850 align:middle line:84% I mean, I think it's going to be-- 00:53:44.850 --> 00:53:48.220 align:middle line:84% I kind of consider both of those, like your exoskeleton, 00:53:48.220 --> 00:53:50.665 align:middle line:90% it could be used as a therapy. 00:53:50.665 --> 00:53:53.320 align:middle line:90% 00:53:53.320 --> 00:53:59.200 align:middle line:84% With a stimulation and an exoskeleton 00:53:59.200 --> 00:54:00.650 align:middle line:84% that's be like shooting two birds. 00:54:00.650 --> 00:54:05.173 align:middle line:84% It's like doing the exercise and doing the motions. 00:54:05.173 --> 00:54:07.090 align:middle line:84% So yeah, kind of two separate questions again. 00:54:07.090 --> 00:54:10.450 align:middle line:84% I would take the exoskeleton, sure, like in the meantime. 00:54:10.450 --> 00:54:14.480 align:middle line:84% But then I would love to use it with that to make it mine. 00:54:14.480 --> 00:54:17.070 align:middle line:90% Like in the end, yeah. 00:54:17.070 --> 00:54:22.000 align:middle line:84% It's weird, it's like I would still I would want my own body 00:54:22.000 --> 00:54:24.370 align:middle line:84% back over like an Iron Man suit, quote-unquote, 00:54:24.370 --> 00:54:26.960 align:middle line:90% like you're saying. 00:54:26.960 --> 00:54:31.134 align:middle line:84% But I wouldn't turn an Iron Man suit down if you've got one. 00:54:31.134 --> 00:54:34.375 align:middle line:84% I have a question for you, Dr. Moritz. 00:54:34.375 --> 00:54:37.876 align:middle line:84% So does this theory or concept work 00:54:37.876 --> 00:54:41.710 align:middle line:84% with other types of stimulation besides 00:54:41.710 --> 00:54:44.695 align:middle line:84% The concept of exercise training and plasticity and things? 00:54:44.695 --> 00:54:48.330 align:middle line:90% I guess the concept [INAUDIBLE]. 00:54:48.330 --> 00:54:49.805 align:middle line:84% Sure, I think it definitely does. 00:54:49.805 --> 00:54:52.180 align:middle line:84% We certainly think that's how epidural stimulation works, 00:54:52.180 --> 00:54:52.730 align:middle line:90% right? 00:54:52.730 --> 00:54:54.840 align:middle line:84% You turn the stimulator on, it's not a magic cure, people 00:54:54.840 --> 00:54:56.380 align:middle line:84% have to do a lot of rehabilitation 00:54:56.380 --> 00:54:58.780 align:middle line:84% to get benefits from epidural stem. 00:54:58.780 --> 00:55:00.670 align:middle line:84% There's less studies and brain stimulation 00:55:00.670 --> 00:55:01.810 align:middle line:84% but it does appear that there are 00:55:01.810 --> 00:55:04.120 align:middle line:84% ways to stimulate the brain that can change connections 00:55:04.120 --> 00:55:05.050 align:middle line:90% within the brain. 00:55:05.050 --> 00:55:07.060 align:middle line:84% It's been applied less to people with injuries. 00:55:07.060 --> 00:55:08.560 align:middle line:84% But in the basic science literature, 00:55:08.560 --> 00:55:10.018 align:middle line:84% that's looking pretty convincing. 00:55:10.018 --> 00:55:12.310 align:middle line:84% So I don't think this is just a spinal cord phenomenon. 00:55:12.310 --> 00:55:14.290 align:middle line:84% I think it's probably a central nervous system 00:55:14.290 --> 00:55:16.892 align:middle line:84% phenomenon to the extent of the peripheral nervous system can 00:55:16.892 --> 00:55:18.850 align:middle line:84% have plasticity probably applies there as well. 00:55:18.850 --> 00:55:22.629 align:middle line:90% 00:55:22.629 --> 00:55:24.545 align:middle line:90% I was just going to ask. 00:55:24.545 --> 00:55:27.419 align:middle line:84% So you mentioned that there are multiple patients. 00:55:27.419 --> 00:55:29.814 align:middle line:84% So if you're looking at degree of completeness 00:55:29.814 --> 00:55:32.035 align:middle line:84% You said he had an incomplete injury. 00:55:32.035 --> 00:55:36.940 align:middle line:84% I guess, where does Jon rate in the completeness of injury? 00:55:36.940 --> 00:55:40.630 align:middle line:84% Yes, so Jon he's just C. So how do the people 00:55:40.630 --> 00:55:42.370 align:middle line:90% compare in terms of injury? 00:55:42.370 --> 00:55:44.650 align:middle line:84% So we rate things on a scale of A, B, C, 00:55:44.650 --> 00:55:48.130 align:middle line:84% and D. Most people in the room are 00:55:48.130 --> 00:55:51.460 align:middle line:84% Es with the exception of our esteemed guests. 00:55:51.460 --> 00:55:54.530 align:middle line:84% John is a C which means he can move a little bit 00:55:54.530 --> 00:55:56.235 align:middle line:90% and he can feel a little bit. 00:55:56.235 --> 00:55:57.610 align:middle line:84% We've work with people who are Ds 00:55:57.610 --> 00:55:58.810 align:middle line:84% which means they can move a little bit more 00:55:58.810 --> 00:56:00.250 align:middle line:90% and feel a little bit more. 00:56:00.250 --> 00:56:01.960 align:middle line:84% And we work with people who are Bs 00:56:01.960 --> 00:56:05.410 align:middle line:84% which means they can't move at all below the level of injury 00:56:05.410 --> 00:56:08.420 align:middle line:84% but they can feel something below the injury. 00:56:08.420 --> 00:56:10.910 align:middle line:84% Those people return when it is one of the two people 00:56:10.910 --> 00:56:14.000 align:middle line:84% one withdrew from the study the other one finished the study 00:56:14.000 --> 00:56:16.590 align:middle line:84% and was able to return movement of their fingers 00:56:16.590 --> 00:56:18.810 align:middle line:90% it was very weak. 00:56:18.810 --> 00:56:20.907 align:middle line:84% And only functional and combined with other types 00:56:20.907 --> 00:56:22.490 align:middle line:84% of tricks like the tinnitus the script 00:56:22.490 --> 00:56:23.818 align:middle line:90% that John was talking about 00:56:23.818 --> 00:56:25.235 align:middle line:84% We have not worked with anyone who 00:56:25.235 --> 00:56:28.490 align:middle line:84% is Asia A, although the epidural stimulation literature now 00:56:28.490 --> 00:56:30.420 align:middle line:84% has a number of people who are Asia A. 00:56:30.420 --> 00:56:32.150 align:middle line:84% So no movement, no sensation, considered 00:56:32.150 --> 00:56:35.030 align:middle line:84% the most severe type of injury, who began to move again 00:56:35.030 --> 00:56:37.070 align:middle line:84% even on the first day of stimulation 00:56:37.070 --> 00:56:39.372 align:middle line:84% and some never gained impressive ability 00:56:39.372 --> 00:56:41.330 align:middle line:84% to make stepping movements and things like that 00:56:41.330 --> 00:56:43.190 align:middle line:90% with many months of rehab. 00:56:43.190 --> 00:56:46.400 align:middle line:84% So I think the stimulation, that's implanted or not, 00:56:46.400 --> 00:56:50.250 align:middle line:84% can help people from where they are go to the next step. 00:56:50.250 --> 00:56:52.880 align:middle line:84% But I can't say qualitatively that one 00:56:52.880 --> 00:56:55.282 align:middle line:90% is better than the other 00:56:55.282 --> 00:56:57.740 align:middle line:84% You might see more function-- if someone starts with a more 00:56:57.740 --> 00:57:00.073 align:middle line:84% function-- you might push them to a step that looks more 00:57:00.073 --> 00:57:01.910 align:middle line:84% functional but it's also pretty inspiring 00:57:01.910 --> 00:57:04.250 align:middle line:84% to take someone who can't move at all below the wrists. 00:57:04.250 --> 00:57:05.860 align:middle line:84% Firsts you seen their thumb and fingers start to twitch 00:57:05.860 --> 00:57:07.277 align:middle line:84% and eventually you see them making 00:57:07.277 --> 00:57:09.680 align:middle line:84% measurable-- you know, four newtons of pinch force. 00:57:09.680 --> 00:57:11.420 align:middle line:84% That's not a lot but it's a lot better 00:57:11.420 --> 00:57:13.115 align:middle line:84% than zero movement and zero force. 00:57:13.115 --> 00:57:15.835 align:middle line:90% 00:57:15.835 --> 00:57:18.300 align:middle line:84% Of the nine patients you've had is there 00:57:18.300 --> 00:57:20.620 align:middle line:84% a correlation between the degree of benefits 00:57:20.620 --> 00:57:23.320 align:middle line:84% and the timeframe from when the injury happens 00:57:23.320 --> 00:57:25.888 align:middle line:90% to clinical trial time? 00:57:25.888 --> 00:57:27.930 align:middle line:84% There's not and that's the most interesting part. 00:57:27.930 --> 00:57:29.940 align:middle line:84% So Jon is 13 years post-injury now, 00:57:29.940 --> 00:57:31.940 align:middle line:84% this is the farthest out that we've worked with. 00:57:31.940 --> 00:57:34.822 align:middle line:84% And his recovery I would say is one of the best 00:57:34.822 --> 00:57:36.530 align:middle line:84% and we've worked with people one year out 00:57:36.530 --> 00:57:38.452 align:middle line:84% and they've had recovery, too, but different. 00:57:38.452 --> 00:57:40.910 align:middle line:84% And we've worked with people who are four to five years out 00:57:40.910 --> 00:57:42.890 align:middle line:84% that's pretty typical, three to five, 00:57:42.890 --> 00:57:45.080 align:middle line:84% and there's no correlation which is really exciting. 00:57:45.080 --> 00:57:47.517 align:middle line:84% Because as John mentioned when you're injured 00:57:47.517 --> 00:57:49.100 align:middle line:84% the doctor tells you first six months, 00:57:49.100 --> 00:57:50.650 align:middle line:84% if you're going to get anything back it's 00:57:50.650 --> 00:57:53.275 align:middle line:84% going to happen in the first six months, maybe for another year 00:57:53.275 --> 00:57:55.530 align:middle line:84% after that and then whenever you have at that point, 00:57:55.530 --> 00:57:56.227 align:middle line:90% you're done. 00:57:56.227 --> 00:57:58.102 align:middle line:84% And we're now starting to learn that it's not 00:57:58.102 --> 00:58:00.010 align:middle line:84% that the spinal cord is done, it's 00:58:00.010 --> 00:58:03.080 align:middle line:84% that reimbursement for insurance, reimbursement 00:58:03.080 --> 00:58:04.020 align:middle line:90% for physical therapy-- 00:58:04.020 --> 00:58:06.080 align:middle line:90% I'm totally serious. 00:58:06.080 --> 00:58:08.130 align:middle line:84% You get intensive rehab for three to six months, 00:58:08.130 --> 00:58:10.130 align:middle line:84% that's where the gains happen and your insurance 00:58:10.130 --> 00:58:12.710 align:middle line:84% company stops paying, and most people can't 00:58:12.710 --> 00:58:15.050 align:middle line:84% afford therapy services and that's where they plateau. 00:58:15.050 --> 00:58:16.610 align:middle line:84% Unless you're John and then you keep 00:58:16.610 --> 00:58:18.360 align:middle line:90% working super hard on your own. 00:58:18.360 --> 00:58:21.000 align:middle line:84% Or unless you're Bruce and you go and fly to Florida. 00:58:21.000 --> 00:58:23.930 align:middle line:84% It's been months doing gait training on your own dime 00:58:23.930 --> 00:58:26.168 align:middle line:84% and then you walk out of there with crutches. 00:58:26.168 --> 00:58:27.960 align:middle line:84% Not everyone's going to have those results. 00:58:27.960 --> 00:58:30.140 align:middle line:84% But it takes that personal investment 00:58:30.140 --> 00:58:32.870 align:middle line:84% to keep getting the therapy services, which is kind of sad. 00:58:32.870 --> 00:58:34.570 align:middle line:84% It's a sad commentary on our system. 00:58:34.570 --> 00:58:36.380 align:middle line:84% And the mindset goes downhill, too. 00:58:36.380 --> 00:58:38.248 align:middle line:84% It's like six months after injury, 00:58:38.248 --> 00:58:40.040 align:middle line:84% you're like, I'll be walking in six months. 00:58:40.040 --> 00:58:42.720 align:middle line:84% And two years-- and after two years-- 00:58:42.720 --> 00:58:45.260 align:middle line:84% it's hard to get your head around that. 00:58:45.260 --> 00:58:47.540 align:middle line:90% The data that you've been told. 00:58:47.540 --> 00:58:50.060 align:middle line:90% Nothing's going to happen. 00:58:50.060 --> 00:58:53.750 align:middle line:84% In some ways it was easier 13 years because I've learned 00:58:53.750 --> 00:58:57.430 align:middle line:90% to be a lot easier on myself. 00:58:57.430 --> 00:59:00.410 align:middle line:84% A lot more gentle from myself than was earlier. 00:59:00.410 --> 00:59:02.990 align:middle line:84% So it's not so maddening for me to sit and do 00:59:02.990 --> 00:59:04.190 align:middle line:90% something for two hours. 00:59:04.190 --> 00:59:05.760 align:middle line:90% I just laugh at my so anymore. 00:59:05.760 --> 00:59:09.510 align:middle line:84% I don't care I used to be, it's so frustrating. 00:59:09.510 --> 00:59:12.490 align:middle line:84% If you were to sit and try to pick up your heart, whatever, 00:59:12.490 --> 00:59:14.680 align:middle line:84% for two hours and not do it, you'll 00:59:14.680 --> 00:59:17.702 align:middle line:90% clear the table at some point. 00:59:17.702 --> 00:59:18.660 align:middle line:90% So maybe that's helped. 00:59:18.660 --> 00:59:20.910 align:middle line:84% I think my mindset is just better now, too. 00:59:20.910 --> 00:59:21.830 align:middle line:90% It's no big deal. 00:59:21.830 --> 00:59:23.850 align:middle line:84% I'll sit and played something for four hours 00:59:23.850 --> 00:59:26.865 align:middle line:90% if it takes the time. 00:59:26.865 --> 00:59:29.330 align:middle line:90% We kind of got off there. 00:59:29.330 --> 00:59:30.780 align:middle line:90% It's the attitude. 00:59:30.780 --> 00:59:33.478 align:middle line:90% It's something like. 00:59:33.478 --> 00:59:35.020 align:middle line:84% Some of questions of of the questions 00:59:35.020 --> 00:59:39.730 align:middle line:84% of how things the mindset has changed that's part of it. 00:59:39.730 --> 00:59:42.300 align:middle line:90% 00:59:42.300 --> 00:59:43.532 align:middle line:90% Did you have a question? 00:59:43.532 --> 00:59:45.240 align:middle line:84% [INAUDIBLE] has been waiting for a while. 00:59:45.240 --> 00:59:48.072 align:middle line:90% 00:59:48.072 --> 00:59:49.028 align:middle line:90% I had a question. 00:59:49.028 --> 00:59:52.374 align:middle line:84% I was wondering, you spend so much time playing guitar 00:59:52.374 --> 00:59:54.290 align:middle line:90% throughout the day. 00:59:54.290 --> 00:59:56.130 align:middle line:84% I wonder, has that, in itself, explained 00:59:56.130 --> 00:59:57.172 align:middle line:90% your exeptional recovery? 00:59:57.172 --> 00:59:59.380 align:middle line:84% If you do something enough you've rewired your brain. 00:59:59.380 --> 01:00:07.320 align:middle line:90% 01:00:07.320 --> 01:00:10.280 align:middle line:84% Yeah, it certainly doubles as a physical therapy device 01:00:10.280 --> 01:00:12.530 align:middle line:84% and [INAUDIBLE] made that point, that was a good point 01:00:12.530 --> 01:00:13.520 align:middle line:90% that I didn't realize. 01:00:13.520 --> 01:00:16.340 align:middle line:84% But yeah, because you're always using some part of your brain 01:00:16.340 --> 01:00:19.580 align:middle line:84% when you're doing physical therapy, like the not fun part. 01:00:19.580 --> 01:00:22.670 align:middle line:84% And it kind of pairs the musical part, yeah, sure. 01:00:22.670 --> 01:00:28.010 align:middle line:90% 01:00:28.010 --> 01:00:30.491 align:middle line:84% I just was wondering if that had been explored at all from 01:00:30.491 --> 01:00:35.080 align:middle line:90% a research standpoint . 01:00:35.080 --> 01:00:37.930 align:middle line:84% That's a really cool point, Wayne. 01:00:37.930 --> 01:00:40.310 align:middle line:84% There are therapy tools, like people 01:00:40.310 --> 01:00:42.050 align:middle line:84% play Guitar Hero to try to motivate 01:00:42.050 --> 01:00:43.250 align:middle line:90% people to do home therapy. 01:00:43.250 --> 01:00:45.350 align:middle line:84% There's a music club that David Reinkensmeyer 01:00:45.350 --> 01:00:48.147 align:middle line:84% invented which is basically sensors on a glove. 01:00:48.147 --> 01:00:50.480 align:middle line:84% You touch your fingers together to make different notes, 01:00:50.480 --> 01:00:53.635 align:middle line:90% again in a gamefied environment. 01:00:53.635 --> 01:00:55.760 align:middle line:84% It's a really interesting idea to think of actually 01:00:55.760 --> 01:00:57.177 align:middle line:84% how the musical part of your brain 01:00:57.177 --> 01:01:01.310 align:middle line:84% pairs with both motivation and movement 01:01:01.310 --> 01:01:03.352 align:middle line:84% and whether there's an amplified benefit to that. 01:01:03.352 --> 01:01:05.060 align:middle line:84% It's certainly something you enjoy doing, 01:01:05.060 --> 01:01:06.395 align:middle line:90% so I think that helps a lot. 01:01:06.395 --> 01:01:08.520 align:middle line:84% The fact that you enjoy doing it, so you do it more 01:01:08.520 --> 01:01:10.562 align:middle line:84% and then you get a higher dose of therapy and you 01:01:10.562 --> 01:01:13.140 align:middle line:84% get the dopamine surge that reinforces the plasticity. 01:01:13.140 --> 01:01:14.540 align:middle line:90% We know that's true. 01:01:14.540 --> 01:01:18.300 align:middle line:84% Any time you do a movement or a sport, whenever you enjoy it, 01:01:18.300 --> 01:01:20.490 align:middle line:84% your brain is wired to learn how to repeat that 01:01:20.490 --> 01:01:22.300 align:middle line:90% over and over again. 01:01:22.300 --> 01:01:25.510 align:middle line:90% So that's really important. 01:01:25.510 --> 01:01:29.750 align:middle line:84% It does-- it has improved my hand as a therapy device, 01:01:29.750 --> 01:01:31.530 align:middle line:84% though, because there are songs I 01:01:31.530 --> 01:01:36.940 align:middle line:84% can play now that I would have had no business even trying. 01:01:36.940 --> 01:01:38.920 align:middle line:84% Recently, I just learned another one. 01:01:38.920 --> 01:01:42.500 align:middle line:84% I try to learn a new song a day, to be honest with you. 01:01:42.500 --> 01:01:45.068 align:middle line:84% And it's the same way a guitar works with a normal hand. 01:01:45.068 --> 01:01:47.610 align:middle line:84% If you play guitar, all songs are hard when you first try it, 01:01:47.610 --> 01:01:49.152 align:middle line:84% but then they start to become easier. 01:01:49.152 --> 01:01:54.054 align:middle line:84% That's what happens, so yeah, I've gotten better. 01:01:54.054 --> 01:01:56.940 align:middle line:90% What song? 01:01:56.940 --> 01:01:57.720 align:middle line:90% Sugar Magnolia. 01:01:57.720 --> 01:01:58.680 align:middle line:90% [LAUGHTER] 01:01:58.680 --> 01:02:03.155 align:middle line:90% My most recent one. 01:02:03.155 --> 01:02:05.860 align:middle line:90% 01:02:05.860 --> 01:02:10.710 align:middle line:84% I have a question about independence 01:02:10.710 --> 01:02:13.540 align:middle line:84% and the physical changes you described 01:02:13.540 --> 01:02:16.620 align:middle line:90% and shift in mindset as well. 01:02:16.620 --> 01:02:19.920 align:middle line:84% Have you noticed any changes in your dynamics 01:02:19.920 --> 01:02:24.970 align:middle line:84% with certain friends [INAUDIBLE] like that. 01:02:24.970 --> 01:02:27.750 align:middle line:84% Well, being able to jam with friends 01:02:27.750 --> 01:02:30.820 align:middle line:90% has made a big difference. 01:02:30.820 --> 01:02:34.350 align:middle line:84% And yeah, it's hard to quantify my thoughts, 01:02:34.350 --> 01:02:37.670 align:middle line:84% because I'm generally positive or whatever. 01:02:37.670 --> 01:02:43.460 align:middle line:84% But it's an imperceptible change, yes, and unlock 01:02:43.460 --> 01:02:45.480 align:middle line:90% and-- it's hard to explain. 01:02:45.480 --> 01:02:50.330 align:middle line:84% I just put my mind on one direction like I keep saying. 01:02:50.330 --> 01:02:53.300 align:middle line:90% It's acceptance, I guess. 01:02:53.300 --> 01:02:55.560 align:middle line:84% And there's a lot of unempowering thoughts 01:02:55.560 --> 01:02:57.560 align:middle line:84% that come with that kind of mentality. 01:02:57.560 --> 01:02:59.470 align:middle line:84% Of just like accepting and, oh whatever, 01:02:59.470 --> 01:03:03.000 align:middle line:84% I'm just going to be an observer for the rest of my life. 01:03:03.000 --> 01:03:05.340 align:middle line:84% So yes, imperceptible, yes for sure, though. 01:03:05.340 --> 01:03:08.817 align:middle line:84% Yeah, it does change the dynamics, the quality-- 01:03:08.817 --> 01:03:10.650 align:middle line:84% it's imperceptible, it's not like my friends 01:03:10.650 --> 01:03:12.710 align:middle line:90% became like super awesome. 01:03:12.710 --> 01:03:15.510 align:middle line:84% But in a way I guess maybe it's my confidence or something. 01:03:15.510 --> 01:03:18.310 align:middle line:90% It's hard, but yes. 01:03:18.310 --> 01:03:20.780 align:middle line:84% I say yes, but I have a hard time telling you exactly how, 01:03:20.780 --> 01:03:25.425 align:middle line:90% but yes, for sure. 01:03:25.425 --> 01:03:26.800 align:middle line:84% And it helps, too, with my family 01:03:26.800 --> 01:03:31.330 align:middle line:84% and what not because I've been pretty driven now for 13 years. 01:03:31.330 --> 01:03:34.630 align:middle line:84% To walk or bust, it's kind of like get over it a little bit. 01:03:34.630 --> 01:03:36.283 align:middle line:90% I feel it kind of like-- 01:03:36.283 --> 01:03:38.700 align:middle line:84% I never felt any bad, I don't know what I'm trying to say. 01:03:38.700 --> 01:03:42.570 align:middle line:84% But I'm I feel validated a little bit. 01:03:42.570 --> 01:03:44.820 align:middle line:84% After all this, even if it's just a knuckle, 01:03:44.820 --> 01:03:50.910 align:middle line:90% I feel like full speed ahead. 01:03:50.910 --> 01:03:52.170 align:middle line:90% It's hard, yeah. 01:03:52.170 --> 01:03:53.150 align:middle line:90% It's a good question. 01:03:53.150 --> 01:03:58.540 align:middle line:90% 01:03:58.540 --> 01:04:01.060 align:middle line:84% Is there anything else you want to chat with Jon about 01:04:01.060 --> 01:04:02.800 align:middle line:84% or should we wrap it up and we can maybe 01:04:02.800 --> 01:04:06.240 align:middle line:90% do some one-on-one stuff. 01:04:06.240 --> 01:04:07.090 align:middle line:90% Sound good? 01:04:07.090 --> 01:04:10.009 align:middle line:84% Help me give Jon a huge round of applause. 01:04:10.009 --> 01:04:16.195 align:middle line:90% [APPLAUSE] 01:04:16.195 --> 01:04:17.820 align:middle line:84% I'm just going to make an announcement, 01:04:17.820 --> 01:04:19.350 align:middle line:90% and then we'll wrap it up. 01:04:19.350 --> 01:04:21.250 align:middle line:84% If you do need to head out, it could really 01:04:21.250 --> 01:04:23.000 align:middle line:84% help us if you could sign in today so I've 01:04:23.000 --> 01:04:26.180 align:middle line:84% got a sheet I'll keep by the door if you're willing, 01:04:26.180 --> 01:04:28.000 align:middle line:90% that would be great. 01:04:28.000 --> 01:04:29.180 align:middle line:90% Thanks, Scott. 01:04:29.180 --> 01:04:31.250 align:middle line:84% Awesome, and thank you, Jon, for sharing with us. 01:04:31.250 --> 01:04:32.650 align:middle line:84% Thank you all for being here and listening. 01:04:32.650 --> 01:04:34.930 align:middle line:84% Anyway, if you want to chat with Jon one-on-one on your way out, 01:04:34.930 --> 01:04:37.560 align:middle line:84% please stop by, grab a-- there's a couple half cookies left. 01:04:37.560 --> 01:04:39.505 align:middle line:90% I tried not to eat them all. 01:04:39.505 --> 01:04:40.880 align:middle line:84% I have to tell you a funny story. 01:04:40.880 --> 01:04:44.140 align:middle line:84% So Scott always does these videos.