November 13, 2008

A DIY Attempt In Telemedicine

Summer of 2006, but not quite Bryan Adams' Summer of 69. A hot and humid day typical of the tropics. A man in his 40's was trying hard to beat the 'sands of time'. He had chores he needed to complete within a short deadline. He finished them successfully, but was exhausted and sweating profusely.

On reaching home he felt an uneasy sensation. He was acutely aware of his heart beating irregularly, what we call palpitations. No one was home at that moment, what would he do now? He thought a way out, whereby, he could transform his subjective feelings (symptom) into an objective rendering, so that he could share his sensation with his medical colleagues. Clearly a ECG (EKG) was the best option, but he didn't have a device at home. So, he went on his own ingenious way.

He pulled out the microphone jack off his computer, and negotiated its 'male plug' into a funnel plastic funnel
computer microphone, micand pulled it out through the apex (figure shown), approaching from the base to the apex. After the plug came out of the funnel, he pulled the wire gently out till the microphone was fitting snugly (no visible air-gap) within the funnel wall ( a plastic or rubber funnel is the best). He then plugged the jack back in to the computer and switched the computer on.

Next, he checked (enabled) microphone option in the sound configuration and opened Windows Movie Maker. Clicked 'tools' then chose 'narration' mode and placed the rim of the funnel on his chest. As expected, the program faithfully digitized his aberrant sounds (through its analog to digital converter, built-in within the computer) and recorded them. Upon completion of the recording, he played it back using Windows Media Player. Hell, the sounds suggested he definitely had some problem, and a real 'objective' one at that. In the visualization option, 'bars' even 'showed' his sounds. He decided to email 'the file' to his colleague as an attachment.

An ECG was done.

The guy was having Premature Ventricular Complex as the ECG revealed. Perhaps anxiety and stress coupled with electrolyte disturbance had their toll. No antiarrhythmic medications were given (in fact, they are often avoided in this situation). Just a sedative-anxiolytic for a couple of days cured the condition completely.

Premature ventricular complexes arise due to ectopic generation of beats and faults in cardiac conduction pathway. I have covered them in detail elsewhere. As of now, the sound files are here (1MB) and here (597K). Some unwanted sound due to mechanical friction is present. But our purpose is served well.

I'll let you in with a little secret. That guy was me :-)

Last modified: July 11, 2009

N.B. [This is JUST an experimental device. Undue emphasis may be avoided]
Reference: hyper-links, unless specifically mentioned

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