New Payment Option for Cryonics Institute Members

Because several CI members have expressed interest in using life insurance to pay for their standby arrangements, we have decided to offer this option in addition to our other prepayment plans. During December we made the necessary changes to our legal documents in collaboration with Ben Best and David Ettinger, and the revised versions took effect as of January 1st, 2006.

At www.suspendedinc.com you will find two charts that show the new funding possibilities, plus a link to the CI web site where the documents are available for inspection. Since some misconceptions about the funding of standby-transport procedures may still persist, we have written a feature for the next issue of The Immortalist explaining the advantages and disadvantages of the various options.

Our web site now includes the full text of our contractual agreement with the American Cryonics Soicty. Thanks to Edgar Swank for the PDF file conversion. We continue to be the sole provider of standby-transport procedures for ACS. A recently revamped web site at http://americancryonics.org provides details about their organization.

During an October meeting with Tanya Jones and Steve Van Sickle at Alcor, we discussed the possibility of Suspended Animation providing assistance in future Alcor cases. While no formal contract was signed, Steve and Tanya agreed in principle that if Suspended Animation personnel have comparable training, they could act in the same capacity as Alcor Cryotransport Technicians. In addition, we made an informal agreement to enable use of the Suspended Animation ice bath and Thumper for Alcor cases in which we become involved.

Suspended Animation subsequently received Alcor’s Florida standby kit, which is now stored at our facility in addition to our own standby-transport equipment.

Since Suspended Animation can provide help for Alcor members only at Alcor’s discretion, we must remind Alcor members that they cannot request our participation directly from us at this time.

The prototype of our new ultra-portable ice bath (U-PIB) was completed in mid-October, just in time for two quick demonstrations in Arizona and California. The U-PIB is overweight at 65 lbs (including carrying bag and wheels) but future copies should be about 20 lbs lighter, as aluminum will replace stainless steel in the end sections while thinner gauges of stainless will be used in the body of the bath.

The ice bath survived three transits through the airline baggage handling system. Despite its weight, one 60-year-old person in average physical condition was able to take the bath from Fort Lauderdale, to Scottsdale, to Los Angeles, and back again. The only significant vulnerability turned out to be its central hinges, one of which was slightly bent when the bath was dropped on one corner. The hinge was easily straightened and has been protected with a simple add-on part for future deployments.

The U-PIB was shown at Alcor and at a small meeting of Southern California standby team members, along with the new Suspended Animation meds container, which has been designed to simplify the process of administering medications. The equipment received unanimously positive reviews, although of course everyone agreed that the U-PIB should be lighter.

When Hurricane Wilma started heading toward Florida near the end of October, we were concerned to see that its predicted path intersected almost precisely with our location in Boynton Beach. Sure enough, on the morning of October 24th, we found ourselves near the eye of this exceptionally large and powerful hurricane.

During 2004 we had acquired a 5500-watt gasoline-powered generator and six five-gallon cans. We believed this would be sufficient to sustain our refrigeration equipment during a four-day power outage, which we regarded as probable, based on past experience. (Note, our refrigerators are used only for ice, medications, and perfusate; no patients or organs are stored at our facility.)

Wilma surprised local residents by striking with so much force, many wooden poles carrying high-voltage power lines were literally snapped in half. We sustained no significant physical damage at our facility, but when we toured the local streets the next day, we saw very clearly that restoration of power was likely to take a week or more.

Worse still, the area affected by the power outage extended almost without a break from 75 miles south of us to 75 miles north, knocking out all the gas stations. We had to make two road trips to refill our gas cans in areas farther north where fuel was still plentiful, and our generator ran non-stop for eleven days and nights.

The lesson is obvious: We will need larger reserves of fuel before the next hurricane season, and a larger generator that is designed for long-term use and has sufficient power to sustain refrigeration, computers, lighting, and our operating room during power outages. We will be pursuing this goal during the early months of 2006.

Following the departure of our welder, Gregg Criswell, we have hired Peter Nagyfy, a highly experienced crafts person who has been greatly enhancing the workshop and lab areas of our facility. Pete also will be building the second U-PIB and will help us to convert our future transport vehicle. His versatilility and extensive practical knowledge are extremely valuable.

Since our engineer, Robert Pruss, decided to take a job elsewhere, we spent some time discussing the best way to replace him. Ultimately we placed two ads, one on monster.com and the other on the Miami edition of Craig’s List, in which we itemized all the tasks that are facing us and asked applicants to tell us how many of these tasks they were capable of addressing. We felt that this was the best way to find a “multitasking” individual, and we received some interesting responses.

After reviewing many resumes and cover letters we interviewed four candidates, and from this short list we chose Gary Battiato, a process engineer who has prior experience at pharmaceutical and biotech companies such as Wyeth and Biogen. Gary is especially knowledgable in the area of tubing circuits, and will be taking over a large part of the work that we face as we develop semiautomatic perfusion systems and liquid ventilation. Gary joins us as a full-time employee on January 9th.

Our first choice for a short-range vehicle capable of collecting cryonics cases is a Dodge Sprinter, a van that is unique in that it offers more than six feet of headroom. The Sprinter is rather narrow, and like most vans and trucks it is not air conditioned in the load area. Still, we believe it may serve our needs for local work.

We made a field trip during October in which we visited several Dodge dealers and took with us a wooden framework that unfolded to replicate the footprint of our U-PIB. We proved conclusively that we could bring the U-PIB into the van through the side door, which offers a significant advantage. In at least one case that we know of, an ambulance lift-gate was incapacitated by a vehicle parking close behind it. A side door, on a vehicle with a relatively low floor, allows the possibility of alternate access via a ramp from the sidewalk.

To test this concept we constructed a wooden ramp inside our warehouse area. Two people were able to push our U-PIB up the ramp, loaded with 400 lbs to simulate a hypothetical 300-lb patient with 100 lbs of ice and water. Still, we would prefer a system which just one person could manage, and this seemed implausible until we considered the possibility of using a winch. Two days later, a winch was delivered, and pulls the U-PIB up a 10-foot ramp in 30 seconds. The winch also reduces the risk of water slopping or splashing out of the bath, since it will exert a very constant, even tension.

A lightweight framework which would lift the ice bath without tilting it at all is now under consideration. In the meantime we have been assessing all possible vehicles. A typical “box truck” is heavy, high off the ground, and does not offer any standard options for air-conditioning the load area—unless we buy the kind of unit that is designed to maintain fruit and vegetables a few degrees above freezing. Clearly this is too powerful (and unnecessarily expensive) for our needs. A box truck does have useful stowage space underneath its box-shaped cargo section, but usually it lacks a side door.

At first sight a “step van” of the type used for deliveries by UPS or FedEx looks better suited to our needs, but the design of this type of vehicle has not been significantly modified in 30 years. Very few have air conditioning in the load area, and they tend to be noisy and uncomfortable for lengthy journeys. Safety is also a consideration, since the all-aluminum body provides virtually no rollover protection for anyone traveling in the rear with the patient.

A final possibility is the type of shuttle-bus which collects people from air terminals and conveys them to car-rental lots or hotels. Buses are built low to the ground, allow the option of rear access as well as side access, offer as much floor area as a box truck, provide a comfortable ride, are designed to protect passengers, yet are still capable of carrying a substantial load. Their air-conditioning systems are built to cool the entire interior, and the vehicles are easy to drive.

We are reaching some final decisions regarding our purchase of a vehicle, and should have a report on this in our next newsletter.

The following news items are from Mathew Sullivan.

During my years working for Alcor Foundation, I participated in the development of a container system for bags of organ preservation solution which are deployed for use in remote cases. At Suspended Animation we are building on past experience to develop a new system which has a larger capacity, is more robust, and uses pre-sterilized medical-grade reservoir bags.

The previous generation of bags was purchased from a company that packages milk. “Milk bags” are vulnerable as a result of the plastic material being thin and relatively easy to puncture, and they have a cap with a nipple for the tubing that can pop off if not properly cared for. Once the cap is removed and replaced it becomes highly susceptible to coming off thereafter.

In addition, the various parts such as tubing, filters, and connectors are ordered individually and assembled, after which they must be sterilized with ethylene oxide.

We have placed an order for medical-grade bags that are much stronger and do not have a cap that can pop off, resulting in a lower probability of failure. The bags will be manufactured in a clean room and shipped to us ready to go with all the necessary tubing, filters, and clamps in a package that has been re-sterilized using gamma radiation. Also the bag is being increased in size from 20 to 30 liters in response to feedback from standby personnel who have reported that the additional perfusate is desirable for thorough blood washout.

A new container system is being developed for the new bags.

The proverb that “oil and water don’t mix” is not actually true. They can be forced to merge as an emulsion—if you have the right equipment for the job. You can see a vivid demonstration if you click the video link at www.silverson.com.

This is relevant for us because we need to mix an organ preservation solution and, in the future, will be mixing large quantities of a vitrification solution, requiring special equipment. We have decided to purchase the type of high-shear batch mixer which is shown in the link cited above.

A lower-cost alternative would be a “process” disperser, but experience suggests that belt-driven equipment of this kind is not ideally suited for lab work. The high shear batch mixer which we have ordered has a direct drive and is more in line with pharmacological production. Components which tend to accumulate under the blade with traditional mixing are eliminated because the mixer draws up the components from the bottom and mechanically shears the product. Also, this mixer minimizes aeration which is of concern for such components as Glutathione, which oxidizes readily.

The change from glycerol cryoprotection to that of vitrification for whole body patients has increased the time to make cryoprotectant from a few hours to approximately 15 hours due to technical challenges and the need to make multiple batches. Previously, MHP2 4x concentrate was made and then diluted with glycerol and filter sterilized with little difficulty. Our hope is that this new mixer will allow us to make cryoprotectant in a single batch in an effort to return to the mixing times of the past and avoid delays for local cases where making up fresh cryoprotectant may be preferred. Due to the challenges of production, we will start out with small batches and progress to larger ones as our skill level grows. We have also purchased an Osmette A Automatic Osmometer to better analyze and ensure quality production of our solutions.

While the design of our Air Transportable Perfusion kit was based initially on the configuration developed at Alcor by Fred Chamberlain, Hugh Hixon, Steve van Sickle, and myself, the version at Suspended Animation has gone through a series of changes partly dictated by the limited size of ethylene oxide sterilization equipment to which we have access.

We have now revised the Suspended Animation design to incorporate collective experiences and make some improvements. There were a variety of changes made, including moving the bypass line into the surgical field where it is closer to the surgeon rather than the perfusionist, reconfiguring the manometer setup to ensure proper functioning and make it more easily visible, and upgrading to a leukocyte-reducing filter. We are also hoping to upgrade to heparin-coated tubing and connectors if we can reconcile their use with ethylene oxide sterilization.

In an effort to align ourselves with OSHA requirements, we have been in contact with our local chemical and biohazard disposal companies, purchased fire cabinets, eyewash stations, signage, and have been making updates to our MSDS books.

Our field kits have received some upgrades such as larger sized med kits, safety angiocatheters, and the ResQPOD which notably increases circulation during CPS. More information on the ResQPOD can be found at the following link: http://www.advancedcirculatory.com/cet/prodfeatures.htm

In support of the activities above our activities have ranged from chemicals to make MHP2 and meds, scales for weighing chemicals, tubing pack supplies, a washer and dryer, and eliminated latex gloves for nitriles in an effort to decrease the odds of making team members permanently allergic to latex, to the installation of glove and towel dispensers. The lab has been organized and cleaned in support of chemical production and analysis. There is still plenty of work to be done, but we are making progress.