Ray Fikes | Prosthetics and Hacking 3D Printers

Presenter  00:00

Hi everyone, we’ve set up this being an engineer podcast as an industry knowledge repository, if you will, we hope it’ll be a tool where engineers can learn about and connect with other companies technologies, people, resources and opportunities. So make some connections and enjoy the show.

Ray Fikes  00:18

Engineering has made it possible for me to have an idea one day and have it in my hand the next day.

Aaron Moncur  00:37

Hello, and welcome to another exciting episode of The being an engineer Podcast. Today we’re speaking with Ray Fikes, who for over 40 years has worked as a prosthetist at his company fixe brace and limb with more than 45 patents and patent pendings has been engineering solutions to solve the most challenging failed prosthesis cases. In addition to traditional techniques, Ray also has experience using cutting edge technologies such as 3d printers, laser scanners and CNC machines to develop prosthetic solutions. Ray, thank you so much for being with us today.

Ray Fikes  01:12

Oh, well, glad to be here.

Aaron Moncur  01:15

So tell us a little bit about your background and like how did you get into prosthetics in the beginning,

Ray Fikes  01:20

in 1980 I knew someone that was in the field, I came from a construction background and and knew that I didn’t want to pour concrete the rest of my life and and I was the actual financial backer for the company as a as a partner. So at that time, there was no it wasn’t even a baccalaureate program of educationally just three short courses. And then we we saw it evolve to two year four year programs, and now it’s at the masters level PhD being proposed, and, and, and I’m sorry to say that I’ve seen a drop in clinical prowess ever since

Aaron Moncur  02:09

that was how right Oh, my gosh.

Ray Fikes  02:13

Guess what’s being taught today is just not based in with good mechanics. I called them Jeopardy prostatitis, Jeopardy. orthotist. I have all the answers.

Aaron Moncur  02:28

But none of the practical experience. Yeah.

Ray Fikes  02:31

And one of your questions was about the art and science? And, boy, that’s such a good question. I mean, it’s a good question. For prosthetics. It’s a good question for 3d printing, he was even more profound with 3d printing, but the these candidates that we get out of school, it’s almost like you have to deprogram them. And let them know that the school that you went to, is the salt and pepper, this is the meal. And, and so there’s a little bit of deprogramming that goes along with it. But But, but the underlying important factor is that they have hand skills. You know, your bag of tricks can only be as deep as the things that you can actually make yourself.

Aaron Moncur  03:16

And I found that to be equally important in just the engineering, the r&d, the process development that we do here in pipeline, the engineers that know how to work with their hands, you know, these are the guys who maybe grew up working on their cars or fixing their bikes, or just doing mechanical thing building with their hands. You know, they’re the ones who progress the fastest.

Ray Fikes  03:42

Now, and it’s, I think that’s universal. Yeah, we find and especially in our field, because it’s, it’s so mechanical. And there’s a healthy relationship with engineering, for sure. I mean, with the number of patents that I have, and I’ve only pat a portion of the things that that have innovated over over the years, but that handoff from the prosthetic clinical world to the engineering world is a slippery one. I mean, your product can get engineered, and and it takes it to a level that, you know, allows people to run with to prosthesis in the Olympics. And that didn’t come from our field. That’s the marriage that we have with engineering. But there are there are a lot of a lot of areas that aren’t understood and, and, but it’s given me what I get in those situations. A different demeanor and an understanding of, you know, your needs. When you bring up a project to an engineer. You’re doing it for a reason because you can’t progress any further without them, but But you have to be, you have to know that, that there are certain boundaries clinically and physiologically that they have to be maintained. And sure, yeah, so your relationship just gets better and better. The more you appreciate engineering.

Aaron Moncur  05:17

Yeah. Well, you mentioned just a minute ago, the art versus science. I’m curious to dig into that a little bit. How much of prosthetics is art versus science? And and maybe how has that changed over the years? Because I imagine with technology, maybe, maybe it is more science now than it was in the past?

Ray Fikes  05:35

Oh, I think? I think it definitely is, I think it’s definitely more science now. Because we’ve gone from wooden legs, and rubber feet, to energy storing graphite, composite prosthesis that people run on. And if you will come to me, and you say, Well, I’ve just lost my leg and I want to run, I have to say, Do you want to jog or do you want to spread the news that specific, you know, because alignment wise, and we will get into alignment later this, that’s the biggest crisis in prosthetics is alignment. But I have, you know, the alignment for a sprinter is all forward center, gravity’s front of your feet. So I inherited a lot of amputees with these $8,000 feet that they’re supposed to be able to run on this was not well aligned correctly, you know, you’re never going to run on it. Without changing the fit of your socket. These are well it fits terrible. So you can’t say that. And because I tell my amputees hold a hold their arm like this and squeezed it. And I’ll challenge you to do the same thing. It doesn’t hurt when you squeezed it, that’s a good tight fit. But when you turn it just a little bit like that, you’ll feel you’ll feel the pain in your arm, they get it I get it just like that. And many times we take that socket that feels like it’s it doesn’t fit. With proper alignment, it fits fine.

Aaron Moncur  07:02

Interesting. And

Ray Fikes  07:05

it it kind of leads into what you you. There’s a lot of these things that you’ve asked that they’re all married together, but I don’t want to ramble and get ahead. But we’ll cover that. We’ll cover that issue later, because I know it’s gonna come up.

Aaron Moncur  07:20

Well, well, let’s start at the beginning. So let’s say I’m an amputee, I come to your clinic, I walked in the door, what what’s the process that that you and I go through? You know, looking for a prosthetic solution?

Ray Fikes  07:35

Well, the first thing that they have to be evaluated, categorized by pathology, a young person that loses their limb in a motorcycle accident, that’s almost completely different procedure is a completely different procedure and treatment plan for than someone that’s elderly, that has diabeetus, which is eight out of 10 amputees. It’s pandemic level.

Aaron Moncur  07:59

I mean, that’s that right? Eight out of 10.

Ray Fikes  08:03

From diabetes, yes. Wow. Yeah. epidemic. But we have to, so we have to categorize them, you know, you know, what category? Are we going to put them in, you know, activity wise, which speaks directly to what componentry that we’re going to put them in, you know, someone that’s lost their limb above the knee that young. They’re going to want to hydraulic computerized microprocessor knee?

Aaron Moncur  08:35

Oh, I didn’t even know that was a thing, microprocessor in the prosthetic. And what is that? What is it processing? What is

Ray Fikes  08:44

not my back? Not much as an engineer you, you’ll appreciate this, you know, and I’ll share, I’ll share an example with you. Quickly in 2002, I tried to buy a four terabyte hard drive. It was the size of a filing cabinet and it was $33,000. And, and now four terabytes changed, you can get on your phone for a few $100. But when Medicare assigns an ill code to a procedure like that, technology doesn’t come down. It’s frozen in time. I mean, it’s a it’s a really sore spot with me muck. My coffee pot has as much computing power as these knees do. And Medicare’s allowable for that is $16,000 Just for that code, just because it has a computer in it. Holy cow. So what does that do that relegates those really nice quality products to people that have good insurance, or rich, worthless workmen’s comp. And it’s a crisis but I don’t I don’t know how to resolve that other than, Oh, wait for the patents to term. Yeah, right. And then and then come in and take a knee that cost them $2,500 To make my cost on that knee is $40,000 my cost? I mean, I’m in I’m in a business to where to liken it to a car lot. How crazy would this be, you go to buy a car, and the guy says, we’ll pick one you like, and then drive off in it. Because Medicare, he says, we have to deliver it before we can build it. So I have to basically buy somebody a car, just to treat them. Wow, that sounds frustrating. When somebody says, What do you do for a living? I tell them I got a really bad finance company.

Aaron Moncur  10:49

Well, well, one of the areas your finance company specializes in is these failed prostheses, how do they commonly fail? And what are some things that you folks have done to reduce those failures?

Ray Fikes  11:04

Well, it’s and fail fail is in the process in the medical world just means it’s procedure fail. Prosthetic catastrophic failure, mechanical failure, is it’s pretty low. I mean, and there, again, kudos to the engineering world, the component parts that we use have been engineered. Extremely well, Russian titanium. That’s not That’s not milled, it’s forged. And they can get, they can get some other components that are zero rated to 220 pounds for they can get 500 pounds rating out of them just for that. Because because it the forged, that grain is not as disrupted. And so there’s not a lot of mechanical failure, the failed prosthetic procedure is because of different things. You know, unfortunately, more than half the people that do my profession surance shouldn’t be doing it. And another dynamic is that our field in our field, one company comprises over 50% of the market. And their clinicians are they have quarterly incentives. And it with any any artistic endeavor, I mean, the Mona Lisa wasn’t painted. And and that last brushstroke was it, come back and touch it up here, touch it up there, redo this redo that it’s no different in prosthetics, or anything else, you know, that has an art and a science to it. You know? So we have a situation where patients, our clinicians in those situations are faced with a need to remake that socket. It doesn’t fit like I want it to, but I’ll lose my job if I do.

Aaron Moncur  13:15

Interesting. So that’s a flip the priorities.

Ray Fikes  13:17

That’s a failed as a fail prosthesis.

Aaron Moncur  13:20

I see. I see what you’re saying.

Ray Fikes  13:24

And alignment is probably 70% of the reason.

Aaron Moncur  13:29

Okay. All right. So you’re talking about alignment being the 70% a large chunk of that problem? Or what other if you were to coin them engineering challenges? Does your team team face one, developing these prosthetics?

Ray Fikes  13:46

Well, the the biggest problem, the most profound problem in process prosthetics is that sockets don’t change, physically, but amputees do. I have one amputee, that that has over 20% volume increase in decrease within a 24 hour period. Wow, within one day, within one day, and I had to make him a very, excuse me a very special prosthesis. But I had to make him a number of them. You know, if you don’t, with my company, it’s about solving the problem not not filling a prescription and challenged by this problem that I’ve been faced with. And at my age, I love those, you know, I don’t care and I’ll lose, lose money sometimes trying different products, and I’ll lose money sometimes. But there’s where most of my patentable ideas come from, is you dig into a problem that other companies are not able to solve? And when you solve it, it’s really gratifying. But it’s can be profitable and patentable also, yeah,

Aaron Moncur  14:56

yeah. Very cool. All right. Well, I’m gonna Want to take a very short break here, share with the listeners that Team pipeline.us is where you can learn more about how we help medical device and other product engineering or manufacturing teams develop turnkey equipment, custom fixtures and automated machines to characterize, inspect, assemble, manufacture and perform verification testing on your devices. We’re speaking with Ray Fikes. Today owner at Fikes, brace and limb. So right you have kind of pioneered, I don’t know if pioneer this is the right word, but you have certainly developed new ways of using 3d printers for your field of prosthetics. How has 3d printing and 3d scanning changed the field of prosthetics engineering? Boy, that’s,

Ray Fikes  15:50

we’re gonna have to do another segment to to get all that it’s a long answer. And I I like the word pioneering but we, there’s, there’s, I’ve done a video for YouTube called removing the noise. Because someone comes to the 3d printing world and let’s get one of those 3d printers and just start printing things. And it’s, I can’t tell you all the problems involved in you probably already know, they, they have no CAD experience, they have no design experience. I have to take where we’ve been particularly successful is in teaching is I’m teaching other prostitutes 3d printing, but they’re learning from a clinician, not from a 3d printing company. And we’ve developed our own technique, we’ve we’ve developed pioneered some techniques and slicing, that’s particular to the vase mode printing world, we print sockets, we print vases, basically, you know, we’re not, we’re not concerned with, with with a bed finish, and infill. Because generally, we don’t use them, you know, we use them all the time. But, but for a socket. It’s basic, basically vase mode. And, but by using vase mode and, and machine mountain nozzles, we print PETG sockets that, that you can read a newspaper through, they’re extremely, extremely clear.

Aaron Moncur  17:29

And so really thin than others.

Ray Fikes  17:33

There’s actually I can print with a two millimeter nozzle, I can print seven millimeters wide. Really? Yeah, we’ve, we’ve learned how to do that and, and I can still see the blanching of the skin.

Aaron Moncur  17:46

So you’ve really hacked these 3d printers, then you’re not just taking an off the shelf 3d printer and letting it rip, you’ve done a variety of developments and improvements on these things to meet your needs. Right?

Ray Fikes  17:58

Yeah, firmware changes, thanks to will a guy who sent to me and nozzle and understanding what produces a clear with a clear PETG what actually makes it clear and design our nozzle nozzles around that. But but the real trick and the Pioneer pioneering efforts that we should be noted for is is is design is teaching how to design in Facebook, because when you’re printing something in vase mode, you’re printing an OBJ or STL file is solid rather than defining an inside and outside surface and and saying I want this socket to be this wide, it’s not going to be clear because you have an infill. So we we export a solid and we say give me a 2.4 millimeter circumference around that and there’s no that’s very easy, you know in three 3d printing world designing that you know, making a custom silicone mold that’s that you’ve just put a 2.4 millimeter exterior on this got to fit in the next one with a six millimeter gap. Designing and face for vase mode is is a real Mind Bender.

Aaron Moncur  19:32

I’m not familiar with the term base mode is that a setting on your 3d printers?

Ray Fikes  19:36

Okay. It only prints an exterior.

Aaron Moncur  19:41

Interesting, okay. And you can make a different thicknesses.

Ray Fikes  19:45

You can make a different thicknesses. We’ve introduced two phenomena called banding and stacking. And we use simplify. There’s there’s great slicers out there, but there again it’s art and Science you got it. What are you doing? Are you are you printing little octopus, our little boats you’re going to want to us very small point four millimeter nozzle and, and and you’re not going to be concerned with it. It’s an artistic piece. It’s it’s not a mandate, it’s doesn’t it’s crafting. The dividing line is manufacturing and crafting. Yeah. And so we use simplify slicer because of its multi process settings. And then we can take we can bring in multi stacked STL files and use multi processes on them. And we stack those multiple moles. It looks like one mold, but it gives it a layer just like almost like holding a mirror up to a mirror. There’s that many variations. So we so within one layer, we can print vase mode with an infill different layer heights, different temperature, different speed, all within one layer.

Aaron Moncur  21:10

Incredible. Well, besides 3d printing and scanning, what else has changed about prosthetics technology over the past 30 years.

Ray Fikes  21:20

A lot everything really. But the gosh, we in my career, there was wooden legs, and rubber feet. So the feet are all energy storing dynamic carbon graphite as we were talking about earlier, there’s microprocessor hydraulic model. There’s hydraulic feet, microprocessor ankles. The just the advent of composites, you know,

Aaron Moncur  21:55

yeah.

Ray Fikes  21:56

Fiberglass, you know, sockets are, you know, are carved out of wood anymore, like they were in the 70s and early 80s.

Aaron Moncur  22:05

That must have been so uncomfortable. I mean, out of wood.

Ray Fikes  22:10

Actually, you don’t need to find anybody now that has a point of reference to tell you. But in my career, I’ve had them say, Man, there was nothing like having a wooden socket after you sweated in it, it was really comfortable. Oh, interesting. But they’re, again, their point of reference where they don’t, they don’t they don’t have the advent of knowing the sockets that we make today. You know, yeah, yeah. But with, you know, it’s, that’s changed and, and, and in the wooden socket days, they wore socks, just wool socks, we call them stomp socks, okay. And as they would change in volume, a sock is not going to change. So they would have to add socks, take them off. And that was their interface and their hygienically that can become if you didn’t wash them, they’re become very abrasive. And, and, but now we use in the late 80s, the silicone liner became popularized. And at that time, up to that point for just a few years, we were making our own silicone liners, which and I do a lot of silicone now. It’s barbaric. The way we were doing it back then, but but now probably predominantly the PPE thermoplastic elastomer is is used, and the silicones that were the shore that we use. And with the silicone and the TPE, I have a lot of I can’t tell, I have to take a soldering iron to TPE melts and silicone doesn’t. So

Aaron Moncur  23:54

interesting. Going back to two 3d printing. I imagine these materials have to hold up to quite a bit of load, right? If they’re being used as a prosthetic. I mean, someone’s walking on it historically. And this is of course changing, of course with better 3d printing materials. But historically, 3d printed materials have not been the strongest how, how do you get your materials, your 3d printed materials to hold up to the abuse and the load that one would encounter when using it in a prosthetic?

Ray Fikes  24:28

That’s evolving problem and that we spend all of our time on the stacking and banding that I was telling you about? We’ve come up with some very sophisticated slicing techniques that add thickness. I only use and only teach 3d printing for diagnostic sockets. Because we want to clear initial fitting. We have to we’re dealing with soft tissue and bony tissue and We want to be able to see the blanching of the skin, we want to be able to see the stretch of the cloth over the silicone over those bony areas.

Aaron Moncur  25:09

But what does the blanching of the skin refer to? Well

Ray Fikes  25:13

take your fingernail and press on. It turns why? Yeah. Okay, you’re pressing the blood out over the bony areas, when I fit someone with a brace or a prosthesis, I want to see that blanching. So I’m fitting them from a vascular perspective.

Aaron Moncur  25:29

Okay.

Ray Fikes  25:31

We’ve got some force FSRs. I’ve used them for measuring some results, you know, force over these bony areas. And I’ve always been successful in relieving them using a clear diagnostic and a blanching technique, but I can tell you now definitively that it’s around five psi, over a bony bony area, like, bones in your feet that are protruding. That’s a four to five psi, you’re gonna get an authorization it’s gonna break down.

Aaron Moncur  26:08

So you want to you want to avoid blanching? Is that what you’re saying? Your your? Yes. Analyzing it to make sure that blanching does not occur. So under five psi or so that’s that’s your safe zone?

Ray Fikes  26:19

Yeah, you won’t see blanching with that, you know, and it’s taken me decades to be able to tell you that. Yeah, I knew that my technique work but now with when I started using FSRs FSRs are forced cents forces. Force resistance.

Aaron Moncur  26:37

Sensor sensor. Yeah, got it. Okay.

Ray Fikes  26:43

With force it, it. It can you get more of a dislike a strain gauge, if it gets more conductivity? And I think that’s how it works. But yeah, I forget where we were with all of that. But

Aaron Moncur  27:03

yeah, so as the force is distributed more evenly around the stump, the the amount of force being placed on any specific area of that stump goes down. And that’s what allows you to not get the blanching.

Ray Fikes  27:20

Right. Right. Right. And, and understand that, that when someone’s standing on in a socket that I’ve made for them, hydraulically. We have to support the weight comfortably, and still allow blood to flow. Yeah. Okay, a very bad fitting socket. There’s pain involved, and there’s gonna be authorizations, and there’s gonna be sores. So that’s the challenge. Yeah. Go ahead. On top of that, on top of that, you’ve doubled triple A criticality, by how much that particular patient changes in volume.

Aaron Moncur  27:56

Interesting. You have a really interesting product that I don’t think is available anywhere else, correct me if I’m wrong, but they’re called swim lens that give amputees the ability to swim again. How did this development come about? And what were some of the engineering challenges that you and your team had to overcome to make this a reality?

Ray Fikes  28:21

Well, as a prosthetist, when I became certified in scuba diving, I’ve got some, some fans. And boy, they were longer and I thought these are these are, these are great. I couldn’t hardly drive them, you know, propelled myself with them because they were stiffer and longer. And so after I understood the issue there, someone came up with a with an ankle that you could pull a pin and it would, it would articulate 90 degrees, and then you put a swim fin on top of that. So you got the length of the limb, the length of the swim fan, but their residual limb that they’re driving it with is only six inches long. And when I watched them, and you see them all the time, still to this day, because you’re right, they don’t play safe they can get the most from me, but it’s comical to me because they’re swimming and it and they’re not, they’re not propelling themselves with it at all. You know, it’s a three foot long combination that they’re driving with a six inch residual. Yeah. So we it’s, it’s actually very simple to do. We have one fan that in Meshmixer, we can scale it to whatever size and and we marry it once we get a fit on their prosthesis we use that that file, marry them up and then we we print them with pretty complicated slicing routine but and we had to develop a printer that would print 1000 millimeters tall And and that’s how they came about

Aaron Moncur  30:06

how have without giving away any of your trade secrets, of course, how have you developed these customized 3d printers? I mean, you buy something off the shelf and what you just take it apart and put it back together with new parts to make it do what you want it to do.

Ray Fikes  30:24

Yeah. You know, it was CNC, you know, the controller is, is the worth of the printer, the rest of the aluminum structure with it with 1000 millimeter tall bill like that we had to put timing gears on the X has dual lead screws for the z axis and we had to put a timing belt on top. Just to fine tune it. So we went through a learning curve with that.

Aaron Moncur  30:53

Yeah, very cool.

Ray Fikes  30:56

Well, our newest, our newest product is a it speaks to the strength of, of this clear socket that we’ve made we to make it clear, it’s plexiglass, it’s fragile. There’s not a clear plastic fits. It’s durable. But process like myself that want to see blanching, we insist on a clear fit, but we can’t let them leave with that. You know, just fall it can fall over from just a sitting position without a limit and it’ll break you know, so we’ve developed what we call a wrap and wrap. And they are laminations that are pre rolled with attachment, the attachment bolts in it, so you becomes out of a package. And you put it over over the the print, and it’s a UV cure resin that we’ve developed. And in 15 minutes, you got the beautiful they have the strength that we need of biped 300 pounders on him for six months.

Aaron Moncur  32:03

Wow. Okay, so it starts out as a 3d printed part. But then you wrap it with what did you call it some kind of resin based? Yeah,

Ray Fikes  32:12

we call them the rapid wrap, but they’re UV cure resin, pre pre packaged wraps with the attachment. So we can bolt bolt the foot onto it. Okay, and then that’s, that’s a diagnostic. You know, they’ll wear it until they’ve, like a new amputee will shrink a lot. And we can make a bunch of adjustments and then we’ll do their definitive. So the protocol for prosthetics is, as a new amputee, you’re gonna get a temporary one or a preparatory. Okay? Because some people shrink an unbelievable amount, they’ll lose half of the half of the volume half. Oh, that’s incredible. Well, they have postoperative swelling from the limb being cut off. I see. So and we want to get them up and walking. Yeah, some companies won’t start until they go through that shrinkage process. But 3d printing is so much cheaper and faster for me, doesn’t matter to me, I’ll get you and get you walking, and the sock is not gonna last you very long.

Aaron Moncur  33:13

And so after six months or so, whatever shrink is going to happen has largely happened. And then at that point, they get their, their permanent aesthetic, okay, and the permanent prosthetic is that also 3d printed or is that made of a different material altogether? Fiberglass, carbon fiber,

Ray Fikes  33:33

some people are doing that with nylon and carbon infused filaments. There are definitive sockets. The very drab we do we use epoxy. It’s a polyester or epoxy resin that doesn’t yellow and we do very high graphics. You’ve seen limbs, I’m sure with just unbelievable graphics on them. And 3d printing is just not there. I mean, I’m cheating my patient. I’m like I’m drunk on the technology. You’re gonna, you’re gonna get a 3d printed definitive when I can. I can make something that’s so so much stronger, lighter and better. Yeah, it’s just not there yet. So believe me a person can justify the money that they’re going to spend for 3d to get into the 3d printing world prosthetic Lee just with diagnostics, and foot orthotics and swim fans and there’s there’s things that you can do that you can’t do any other way like like this one fan, you can’t you can’t manufacture that any other way.

Aaron Moncur  34:40

And once they do get their, their final prosthetic what what materials that made out of the socket, at least the socket will

Ray Fikes  34:49

be made out of a braided carbon. Okay, and it comes in is tubular. And it’s the bias is on a 45 degree weave And you know, with carbon graphite engineer fiber orientations, everything. Yeah. And so when I’m like, I’d also make feet, you know, the, the, the, the carbon that I would lay up for socket is at 45 degrees to itself. And it’s extremely light, very thin, and, and strong are incredibly strong. But the feet I’ll make a running foot like Pistorius runs in the Olympics. And no one else does that. I mean, I don’t know if any other company that makes the feet, they buy them from the big manufacturers, but we built our own autoclave and they have to be autoclave. You can use a pressure mold, but you want one fiber to one molecule of resin was zero air, even at the molecular level to get that kind of strength out of it. So we understand, we understand 3d printing, we understand fiber orientations. And in making a couple of apart like that, it’s funny, it’s something that I may come to your firm for, because there’s a real need for for using 3d printer to dispense fibers for a limb like that, and we use it just for the layup you know the the epoxy would would be heated only enough to make it fluid enough to place those fibers so precisely exactly where you wanted them. Because I don’t know if you’ve ever made anything out of carbon graphite. With prepreg it’s a pain in the butt. It’s pinna, we don’t layer after layer, layer after layer, it’s Peel and Stick and it’s like taffy. Yeah. And if the laying something up is just a pain in the butt, but we should be using a printer for that. Yeah.

Aaron Moncur  37:07

Well, let me get one more question. And then we’ll we’ll wrap it up here. But within the context of of the space of engineering, what what’s one thing that frustrates you? And one thing that brings you joy? All right. That’s another deep one. Another second episode.

Ray Fikes  37:28

I think that what brings me joy is is I think if I already said it, you know, for 43 years of doing this from wooden legs and rubber feet to the you know, the materials and processes that have been afforded to me. Now that engineering is allowed. A guy with a lot of concepts is, especially with 3d printing, just to go I mean, I can I can think of something that I think engineering has made it possible for me to have an idea one day and have it in my hand the next day. Well said, yeah, there’s nothing like that, because I had a product that was actually medical device of the year in Brussels in France. And prototyping it, we had to make a plaster Paris tube, and then buy O rings and glue them to this every five millimeters to make a real structure. And with CAD today that takes me I mean, it took it took over a week to make the molds to make the shorts prototype. Yeah. And, and now I can I can I can make that same mold in about five minutes on on fusion 360 and print it overnight. And the next day, the amazing engineering has afforded that to me. Yeah.

Aaron Moncur  39:06

You know, there is one more thing I wanted to ask forgot about this one, you use 3d scanning as part of your process. We do 3d scanning and reverse engineering your pipeline as well. And we have a scanner that we use and some software that we use, but you are not using an industrial scanner, you found a much more cost effective solution that is accurate enough for your needs. Can you share a little bit about that? Sure.

Ray Fikes  39:33

Sure. You know, as an independent I am I’m cheap. You know everything that we every process that we’re using. I can you can pay a range of $4,000 to $60,000 and and it was no different with the scanner. I have a white light laser scanner that I paid $19,000 for. And now I’m using an iPhone with color Um, scanner is Colm be lucky call me here with combs scanner. It’s $700 prescription of subscription every year. And so you don’t you’re not buying anything, you know, I went by I’m an Android guy, but I’ve got an iPhone mini in my pocket. So I’ll carry two phones, but one of them’s my scanner.

Aaron Moncur  40:21

That’s amazing. And the accuracy is within I think you said within like a millimeter or something like that. Yeah,

Ray Fikes  40:27

yeah, I find that to be a big problem with, especially working with patients. When surface scans are done of limbs, we just take for granted that that that it’s accurate, you bring it into your, your proprietary software, mesh mixer, I use mesh mixer for everything is unbelievable, powerful program that we developed in our school, we developed a routine. So you, you import it with this data obj gives you like a photograph on top of your scan. And we take measurements. And once we import that, from the comb scan into our, you know, make sure that everyone you got to validate your scan metrics, you know, the lighting in the room, or, you know, there’s, especially with LiDAR, you know, scanning someone, a really bright window, you know, it’s it’s light and distance, it’s gonna affect it to a certain degree. But, but But suffice it to say whatever you’re using, bring it into your project and validate it. And we found that column scans are, I mean, they’re subject to, you’re measuring soft tissue with some calipers. And you can there’s compression to be considered. So we try not to compress. But what was that one? Two millimeters? And so wish I wouldn’t use it if it wasn’t accurate.

Aaron Moncur  41:56

Yeah, with an iPhone. That’s, that’s wonderful.

Ray Fikes  41:59

It’s so fun.

Aaron Moncur  42:02

I can hear the joy in your voice. Right. That’s great. So right, what’s the best way for people to get a hold of you?

Ray Fikes  42:08

Well, I live by email. So I empty my inbox every day. So right fikes@gmail.com. My Gmail

Aaron Moncur  42:16

simply are a YFIKES. Right? That’s correct. Well, I think we can wrap it up there. But I wanted to thank you for being on the show and sharing a little bit about what you do and how engineering has helped your world of prosthetics. Thank you so much, Ray. Sure. Appreciate it.

Ray Fikes  42:35

Well, I think the thanks is all mine. Because I’m living the dream. I’m a high tech dinosaur was trained in old school, but now I get to play with these digital digital techniques and great materials and process that you guys have developed. So thanks, engineering world.

Aaron Moncur  42:55

Well, on behalf of the engineering world, you are welcome. I’m Aaron Moncur, founder of pipeline design, and engineering. If you liked what you heard today, please share the episode. To learn how your team can leverage our team’s expertise developing turnkey equipment, custom fixtures and automated machines and with product design, visit us at Team pipeline.us. Thanks for listening