Episode Transcript
[00:00:00]
Jill Brook: Hello fellow POTS patients and wonderful people who care about POTS patients. I'm Jill Brook, your hyperadrenergic host, and today we have an episode of POTS Matters with the engineers slash inventors slash founders of the Uplift compression device for POTS. Kishen Mitra and Sameer Kunte were engineering students at Duke University when they started this project and they've since surveyed POTS patients about their needs, created novel compression devices, co authored peer reviewed journal articles, presented at conferences, and become real experts on compression for POTS.
Kishen and Sameer, thank you so much for being here today.
Kishen Mitra: Yeah, thank you, Jill.
Jill Brook: So can you start by just letting our audience get to know you a little bit more as people, since we're a close little community. Maybe Sameer, you can start and just, I don't know, tell us a little bit about who you are and and then we'll get into how you came into the POTS space.
Sameer Kunte: Yeah, a little bit about me. I'm actually a [00:01:00] fourth year medical student at Duke University School of Medicine. I have an interest in cardiology and hope to kind of eventually go into that direction. I got kind of involved with this project through word of mouth. They just needed some help with research and kind of the medical aspect of things.
That's how I got started on helping out with this group.
Jill Brook: Very cool. And Kishen?
Kishen Mitra: Yeah, my name is Kishen Mitra. I recently graduated from Duke with my degree in Biomedical Engineering, and I sort of got involved with Uplift back in 2023 through the Design Health Program, and my interest lies kind of in bringing technologies from benchtop to bedside, as they say, so really trying to understand how the devices that we're developing in the labs
can be really useful for patients and understanding all the steps that are needed in between and along the way. And so that's how we got connected with the School of Medicine and we're able to expand our team and, and have people like [00:02:00] Sameer.
Jill Brook: Very cool. And can you talk more about how you guys got involved with dysautonomia and POTS research? Because obviously there's not enough of it going on. Is this like a big hot thing at Duke? Or how did this get started?
Kishen Mitra: Yeah. So like, like I said we have an interdisciplinary program at Duke called Design Health. And one of the main faculty that spearheads that those efforts is Dr. Eric Richardson. And when I connected with him back in early 2023, he mentioned to me that one of the growing areas of focus in the program was in POTS and NOH research, or I should say more generically, dysautonomia.
And at that time, I didn't necessarily understand why or appreciate the importance of that. But as I started to read more into the literature and work with a lot of clinicians over in the Department of Cardiology, I, I began to interact with even some patients. [00:03:00] And and I should mention that our, our previous team, before I had even joined Uplift, had published a case report on a, a very simple compression device that they had developed to kind of show the potential of extracorporeal compression on alleviating symptoms in NOH.
So then like I mentioned, through conversations with some of the faculty in the Department of Cardiology and with patients, more importantly, we were able to understand that, especially the POTS population, was very open, was first of all very engaged, and second of all very open to wanting to try out novel solutions and novel products that can hopefully improve their lives on a day to day basis.
Jill Brook: Very cool. Okay, so Kishen maybe you can tell us like, about the origination of your team's research. Where did you start? What did you do? How did you come upon the device that you landed [00:04:00] on?
Kishen Mitra: Sure. Yeah, so, so the benefits of compression garments as one of the non pharmacological therapies for POTS had been suggested in the literature and is becoming more and more prominent in recent years. But, but really one area that was a gap that our team found was really information about what end users or really patients and their caregivers think about a lot of the commercially available products that exist.
So we, our first goal really before we even started, you know, getting our hands on prototyping and making products, was understanding the problem and then, you know, that's, that's a big first step that kind of tees you up for success down the road. So, what we did is we collaborated with the Syncope Clinic at Duke, which is affiliated with the Division of Cardiology,
as well as Dysautonomia International one of the larger nonprofits to conduct a nationwide [00:05:00] survey study and investigate what patients think about these existing products. So that was sort of, the origination of how Uplift came to be. So, we collected information on patient demographics, their specific medical history, and most importantly, their experiences with their previous compression garments they've used.
And in order to sort of standardize the data a lot of our a lot of our questions were on a Likert scale. So we were able to kind of understand for the main buckets of compression products out there, so within medical compression, there's leg compression and abdominal compression and then there's also non medical compression for things like shapewear and that sort.
We were able to compare those head to head and we actually shared those findings at the 2024 Dysautonomia International Conference in Chicago and recently submitted the full manuscript to to a journal for, [00:06:00] for this study. So, so that was kind of the first efforts that we took towards understanding the problem and wanting to develop a solution for it.
Jill Brook: So that's interesting to me because I know that for me personally, it took me years of trial and error to find compression that I actually liked, and it wasted so much money. I'm curious, what, what did people say in your survey about compression devices?
Kishen Mitra: So I can, I can give a rundown of some of the main takeaways and like I said hopefully in the show notes we'll be able to include a link to the the full published study, but some of the main findings that, from our end, were that although abdominal compression tends to, to be more effective in patients compared to leg compression, generally POTS patients reported using leg compression a lot more than and, and really, we, we speculate there's probably a plethora of reasons to explain this.
The, the most simple one being [00:07:00] that it's much more common, and frankly, it's, it's more comfortable, right, compared to, to wearing in a tight abdominal compression garment for the entirety of a day. And, and when we take a step back, we also understood that overall, the existing compression products in the market
by far do not meet the needs of this population. So the average Likert scale ratings on a scale of 1 to 5 showed that rarely was the average rating above a 3. 5 for really an array of design parameters that we considered, ranging from ease of use to cost effectiveness to comfort and aesthetic appeal.
And, and to give some, some simple statistics for the purpose of this conversation, about 98 percent of participants tried at least one form of compression garment, but really the most alarming figure was that less than 10 percent found compression to be an, an [00:08:00] effective approach for managing their symptoms overall.
And, and the reason that's so, alarming is, is because it shows the disparity in terms of, like you mentioned, Jill, patients willingness to try these products and, and sometimes many of these products to, compared to really what the outcomes are, which is quite suboptimal at this time. So, we think that one of the major factors that's contributing to this ineffectiveness in these products is, is the lack of proper fit.
And what I mean by that is a lot of the existing compression products that are in the market are not really developed and tailored towards the needs of patients with POTS. So, these current compression garments oftentimes focus on other conditions like deep vein thrombosis or also known as DVT or post operative needs.
So after bariatric surgery, there's some of those abdominal binders that are commercially sold. But those sort of products, from a human [00:09:00] centered design standpoint, just naturally don't align with, with the sort of features that patients with, with POTS need. So, really the takeaway of that, that survey study that we carried out and what we hope to relay, both through this, this podcast today and, and through overall publication of the paper is that there's really an urgent innovation needed in product design for adjustable dynamic compression garments alongside, you know, patient education initiatives.
So, one, one thing that we found anecdotally is that many patients and their family members are not necessarily the most aware about the efficacy of abdominal compression, which Sameer can talk about soon. And the reason I say that is after graduating from Duke, I, I, I've continued my involvement with the community through the Dysautonomia International you know, [00:10:00] volunteering events and that sort, and I've, I've had a chance to speak with community members outside the clinic, so, you know, through a lot of the local events we've hosted, and many times, they'll say, Oh, you know, I wasn't really aware that abdominal compression is something I should try.
You know, I've really stuck with leg compression. I didn't find it to be super helpful. And that's the reason why I stopped trying compression overall, you know? And so, it's important that we, apart from pushing innovation, we also pair that with appropriate patient expectation, setting their expectations about what they can sort of, realize from, from trying out abdominal compression in particular, or perhaps a combined therapy of abdominal compression and leg compression as opposed to just leg compression.
Jill Brook: That sounds important. Sameer, can you talk more about like the physiology of compression and what patients should expect and what kind of help that can give somebody with POTS?[00:11:00]
Sameer Kunte: Yeah, of course. So, whenever you're changing body position, going from laying down or sitting down to standing up, there's a lot of steps that your body takes place to make sure that your blood pressure stays at a pretty even keel level. And one of the first things that happen when you stand up is, of course, gravity pulls a lot of fluid, being your blood, down towards your feet.
There's some studies that show that nearly 700 milliliters of blood can actually drain down to your legs and to your abdomen. That's a pretty significant volume of blood that's not going back to your heart. So most people, even people without dysautonomia, will experience some small drops in their blood pressure after standing up.
Then what your body does as a result is it'll kick in the adrenergic system and do things like clamping down in your blood vessels or increasing your heart rate to really make up for that drop in your blood pressure. But what we see in people with orthostatic hypotension is that their blood pressure doesn't come back as high as it should be and then people with POTS is that their blood pressure, that their heart rate comes too high and as a result they get the [00:12:00] tachycardia that we see in POTS.
What we're hoping that we can do with abdominal compression and the reason why it's recommended for people with dysautonomia is that it helps to move that blood that's sitting stagnant in the abdomen. And by moving that blood, you can return it back to the heart and prevent some of those early blood pressure drops and prevent things like the reflex increase in heart rate that we see in POTS, or even prevent that drop in blood pressure
to an excessively low, low level that we see in orthostatic hypotension. Some kind of extra important things that we think like more patients should be knowing about is that abdominal compression on its own isn't necessarily helpful. There's a certain magnitude that we know is needed to be therapeutic.
So over 40 millimeters of mercury, that's the pressure level that we know based off of studies tends to be enough to kind of liberate that fluid in your abdomen that is otherwise stagnant in patients. And also we know that there's a lot of other comorbidities to be aware of in patients with dysautonomia.
Things like May Thurner Syndrome. May Thurner Syndrome is [00:13:00] essentially a condition in which your blood vessels that drain your legs, get crushed by your aorta, which is the main blood vessel feeding blood to your body. And as a result, and as a result, some people can have issues with draining blood from the left side of their leg.
So, lower abdominal compression and leg compression may not be a great use for some people with POTS as nearly 69 percent of people with POTS have this syndrome. So, it really needs to be kind of mindful of some of the other comorbidities that people have. Another example why people with POTS may not tolerate abdominal compression is because there's a huge, kind of, comorbidity of GI disturbance in people with POTS.
Nearly 30 percent of people with POTS are diagnosed with IBS and some 14 percent are diagnosed with gastroparesis. So, you have to imagine if people are having these other comorbidities, they may not do well with these other types of compression, which may explain such a high rate of failure amongst patients that we've seen
Jill Brook: So, okay, so did you say that you need approximately 40 millimeters of mercury of [00:14:00] compression in the abdomen in order to liberate the fluids? Because that's a lot. I know from wearing my own medical grade compression, that, that is a very tight fit. That is so snug that it's like difficult to get on.
Sameer Kunte: That's correct. There's there's been some, yeah there's been some previous studies that show that around 50 or 40 millimeters of mercury is kind of the benchmark to hit when it comes to magnitude of compression.
Jill Brook: So that's really good to know. So some of us who've been maybe, I want to say, just mailing it in with the Under Armor compression shorts that are maybe comfy and they compress, but they're not compressing anywhere near tight enough to get maximum impact.
Sameer Kunte: Potentially that's not to say that lower levels of compression don't help move some of that blood. I'm sure your Under Armors kind of garments that aren't medical garments quote unquote would help move some of that blood. But that's the main reason why in this study survey we made the distinction of medical compression garments because these are garments that are proven to be [00:15:00] able to provide the magnitude of compression,
that based off of the research will move that blood enough to kind of prevent side effects. And we think this is also probably a large reason why a lot of people who are trying abdominal compression even may not be getting the benefits that they hope to get.
Jill Brook: Okay, fascinating. And I think that is it Dr. Raj's work that has proven that the abdominal compression is more important than the leg compression for most POTS.
Sameer Kunte: It was, yeah, it's not just Dr. Raj, there's been other studies as well, even looking at healthy participants. If you take a healthy participant and do a tilt table study with them, you'd expect most people to have a drop in their blood pressure. But what we've shown in the past is that even amongst healthy individuals without dysautonomia, abdominal compression is superior to leg compression or even knee high stockings at preventing some of those drops in blood pressure, and we've seen that also with patients with POTS.
Jill Brook: And this might be a silly question, but you mentioned patients with May Thurner Syndrome, and we've discussed that on this podcast, so we're [00:16:00] really glad to know that you're thinking about that too. For somebody who does not have May Thurner Syndrome, does compression that tight not affect the ability of the blood to get back up out of the legs.
Sameer Kunte: We wouldn't necessarily think so, mainly because there are going to be some kind of compensatory effects with your blood when it comes to the blood vessels constricting, to make sure that that blood can get past the area of restriction or compression that you're adding to your abdomen. Our main goal and kind of the main goal of other types of abdominal compression is not necessarily to prevent the blood flow coming up from the legs, but rather there's a lot of veins and blood vessels in your abdomen that feed a lot of your organs.
That is where a lot of the blood pooling happens. So by liberating that blood and moving it back to the heart, that's how we're trying to prevent things like the tachycardia that you see after standing up.
Jill Brook: Interesting, and I'm just thinking aloud here because this is such a [00:17:00] fascinating topic, but I wonder if some of the people who have gastroparesis especially may be related to overly stretchy, floppy, tissues like the, the EDS patients. I almost wonder if it could help digestion to be wearing compression garment, because it might keep some of those tissues from stretching as much.
I don't know. I know that there's probably no data.
Sameer Kunte: It's possible. I think also something we want to be mindful of is at the very least, if somebody's struggling with bloating, then abdominal compression maybe won't make them feel better. I think a large part of the reason that some of these patients have GI symptoms is related to like what you mentioned, it could be some mixed connective tissue effects.
Also, there's a large component of small, small fiber neuropathy in patients with POTS, as well as some different autoimmune conditions that could be impacting. But it's definitely a lot of different kind of factors that kind of play into this.
Jill Brook: Okay. So this sounds like it makes your job really tough to account for all these different things [00:18:00] that could be going on. So what happened after the survey?
Kishen Mitra: Yeah. So, like, like Sameer mentioned, we were able to understand that abdominal compression is important, but there's a lot more that goes on beyond just the, the basic science, right? So, it was evident that really within even the existing abdominal compression devices that are in the market the, the key concern amongst patients with POTS, it was that these garments were, were not comfortable, right?
So like, like we alluded to earlier wearing this for a long period of time can induce other symptoms which in turn may kind of offset any potential benefit you get from wearing that abdominal compression to mitigate the symptoms of syncope. So what, what we did next is we, we really outlined what the need statement was and and where, where our product that we envisioned to develop [00:19:00] would be positioned in the market.
So Uplift is a novel, novel abdominal compression garment that has the capability to engage and disengage and also can maintain that therapeutic 40 mercury millimeters of pressure to better support the, the needs of patients. So, one thing that we talked about earlier was that, number one, a lot of the existing products that are sold don't necessarily market what magnitude of pressure is being applied.
So, end users don't have an idea of, you know, really what that compression is, or if they do market the magnitude of compression, it's, it's typically in a range. And, and the reason I bring that up is because the amount of pressure that the user will feel will likely differ depending on their body.
So where Uplift comes in is, first of all, you're able to understand through our technology, kind of, the different [00:20:00] levels of pressure that are being applied, and also you're able to adjust that depending on your, your needs. So another thing we found is that every patient sort of differs in, in their needs in terms of the amount of pressure required to alleviate their symptoms.
So, the, the whole thesis behind this device is that we'll give patients the opportunity to engage the pressure whenever they need but this won't necessarily be something that is, is tightly wound around them and makes them super uncomfortable for, for like the entirety of the day. And so after, after we understood where Uplift comes in, we were fortunate to be awarded some startup funding through our institution and also through support from the Christensen Foundation.
And we began to perform testing and competitive benchmarking of the existing products. So, we formally tested out [00:21:00] the our, our hypotheses behind, you know, the amount of pressure that these products apply and how comfortable they are. So each of our team members actually took turns trying out these different devices ourselves, or I should say products and, and rating how, how comfortable or uncomfortable we felt.
So we tried our best to put ourselves in the, in the shoes of what it's like to, to be a patient with POTS, who, who in certain cases has to wear these devices frequently. And at the same time we were interviewing patients in the clinic, so like I mentioned we were super fortunate to have a very close relationship with the Cardiology Department at Duke.
And they were gracious enough to let us come in throughout the year and really just talk with patients candidly about what their needs are, beyond just their symptoms, but what rather they can see [00:22:00] as a, as a viable solution because as engineers, sometimes we want to develop what we think is best, but we also sometimes need to consider what is best for the end user especially for, for these, these kinds of products.
And so, we interviewed patients formally, but we also kind of had informal conversations by showing patients some preliminary sketch designs that we had, and we were able to understand what their preferences were, and ultimately, it, it boiled down to sort of, two types of compression, so, some patients mentioned that they would prefer to have sort of this localized pressure.
If they were to use abdominal compression, they would prefer to have this quote unquote point pressure that that doesn't necessarily you know, engage throughout the entire circumferential area, but just locally engages you know, the abdominal area. And then in other cases, some patients mentioned that they [00:23:00] prefer what we call global compression, which is abdominal compression kind of in a circumferential manner.
So, this kind of alludes, leads, leads us into the next part of our conversation, which is sort of the different iterations that, that we developed over time, because that's another beauty of this product. It wasn't super linear. We had to take twists and turns along the way, because it was a lot of balancing our design skills with what, you know, patients need or want at the end of the day.
So, all that to say we came down to different iterations of the product. One was more of a, what we called a point pressure device. One was more of a quote unquote global pressure device. And, and we should mention that both of these had the capabilities of applying that therapeutic 40 mercury millimeter pressure.
Just the mechanism was slightly different in that, you know, one of them targeted a [00:24:00] very centralized area, small area, whereas the other one applied that pressure around the entire patient's sort of waist or a little bit above their waist. So, so that's kind of what happened next after the survey study in terms of some progress we made on the design side.
Sameer Kunte: I think kind of one of the most important things is that although we've made different types of devices, it's the same kind of few core tenets that we've kept the same. So one of them being, being able to apply 40 millimeters of mercury, providing users with the feedback that they know exactly how much pressure they're applying, and then the amount of pressure they apply
is directly controlled by the user. So regardless of the size of your body, you're able to provide the same exact amount of pressure. And then the final really big thing that we incorporated is the ability to adjust the pressure and turn it on and off. So ideally, the most important time for a user when it comes to having pressure around their abdomen is when they're changing their body position, because that's when you see a [00:25:00] lot of that blood pooling happen, and that's when you want to stop it. So by being able to turn it on when you stand up, you can hopefully prevent your symptoms.
And then if you're staying standing up, ideally you shouldn't need compression as much anymore. So then you can turn it off and you can prevent a lot of the issues with discomfort. You can prevent a lot of the issues with issues with the GI symptoms that overlap. And overall that should make it for a much more comfortable experience for users.
Kishen Mitra: Yeah, that's a great point, Sameer. So, so, basically, you know, although we had different form factors, the, the overarching goals were, were really the same, which is, which was to be able to provide adjustable compression. All of these devices were concealable, so they could theoretically be worn under, underneath your clothing, and then all of them were comfortable when disengaged.
So this goes along with the concept that Sameer just mentioned of when you are just standing up or when you are just sitting, you don't need that pressure to constantly be engaged. You can disengage the [00:26:00] device and the idea is that it'll sort of feel much more comfortable as opposed to if you had a tightly worn abdominal binder around you all the time.
Jill Brook: So that's huge. Yeah, I definitely see, and I did not realize that, that maybe you only need the compression as you are getting into that upright position and maybe adjusting to it. But if you've been there a while, you could back off. I definitely see the appeal of that. Wow. And just to be clear, so you've been doing all these different iterations of different kinds of compression devices, and I think you are testing them along the way and getting user feedback along the way.
Is the goal to eventually create a product that people can buy? Or is it, is this mostly scientific learning about just compression in general? Or what's the ultimate goal that you're headed towards?
Sameer Kunte: I think our ultimate goal is first and foremost making sure that our devices work. We want to make sure that we [00:27:00] do right by patients with POTS and get actual data to back up and say, Hey, our devices are effective for patients who are going from lying down to standing up to prevent things like increases in their heart rate, drops in their blood pressure, symptoms overall.
And then the long term goal of us is to create a commercially available product. We want to back up the science that we generate and create something that will hopefully make the lives of these POTS patients much better by reducing their symptoms and improving their quality of life.
Kishen Mitra: Absolutely. Echoing what Sameer said, we, we would like to first. really characterize the physiological responses that are occurring. So it's important from our end to really make sure that the science is validated. And, and once that happens, you know, we'll, we'll be confident in taking our next steps. We ultimately hope to really bring this, this product to market as, as a medical device.
So this would be marketed it as medical compression, and we would like to, you know, register as an FDA Class 1 [00:28:00] device. I should mention that our, our technology has been patented. So, so now we're sort of in the, the process of conducting clinical trials which, you know, happy for us to, to discuss further later on in this, this discussion.
Jill Brook: Well, yeah, absolutely. So, so what have you found so far from the devices that you've tested?
Sameer Kunte: Yeah, so one of the most important things for us is really kind of contributing to the scientific literature and that first meant really starting with patients who are quote unquote healthy patients, so patients without dysautonomia. I mentioned before how we kind of understand the mechanism of how our body gets used to changes in body position.
And there's actually been some studies in healthy individuals using abdominal compression that have shown that abdominal compression can help blunt some of those changes in heart rate that we see when we stand up. But what we want to know is to go a step further. And find out beyond just having abdominal compression, how did the surface area abdominal compression, so how big we were compressing around your abdomen, but also the [00:29:00] amount of abdominal compression, how that really changed those parameters in healthy individuals.
And that's a study that we actually did just this last year. We did it on healthy college individuals. We had them, we had them do an active stand trial. So basically what that is, is that you have someone lay down and then stand up and then during that time you take measurements of their heart rate and blood pressure.
And then what we had them do is do a series of active stand trials once with nothing on as a control, and then a couple of times with different types of abdominal compression. So once we did it with a belt that was pretty thick, think of a belt that's maybe like four or five inches tall and wraps all the way around your abdomen and provides 40 millimeters of mercury of compression
all the way around the abdomen. So it's pretty tight. And then we also had our quote unquote point pressure device. So basically what it is, is it's a small harness that you wear and it provides a small one inch squared amount of pressure to your upper abdomen. So it's more like a jab to your upper gut rather than a belt all the way around your abdomen, but it's a [00:30:00] similar amount of pressure.
And kind of the interesting things that we found is that first and foremost, both of our abdominal compression treatments were able to blunt those heart rate increases compared to control. So we were able to do what we wanted to achieve, and that's basically that the abdominal compression was able to maintain people's blood pressures and stop their heart rate from rocketing up, which indicates to us that this is probably going to be an effective treatment in patients with POTS and just further validated our device.
But what was also interesting is that there was not that much of a difference between the two types of abdominal compression. So whether you're wearing this four inch tall belt all the way around your abdomen or having this small coin sized piston pushing into the top of your abdomen, you're seeing reliable results when it comes to making sure your heart rate stays up.
There were some small differences between both types of abdominal compression and that's something we're still trying to parse out through the data. We have some theories that that smaller kind of [00:31:00] coin sized compression in your upper abdomen might be acting on some of your nerves. So there's something called the splencolic nerve in your abdomen and by working on that maybe that helps to change how much your blood vessels are constricting and dilating,
which may further help you to return blood to your heart. But a lot of that is kind of unclear as of now, so definitely more research in the area is needed, as is needed in many other areas across dysautonomia and POTS.
Jill Brook: Yeah. Oh, that's totally fascinating. You know, I'm curious. We had spoken recently to Daniel Lee, who had invented the Lumia device that you've probably heard of that measures blood flow to the head. And one thing that was interesting that he said was that blood flow to the head does not necessarily correlate with blood pressure.
So basically the blood pressure in your arm is not necessarily the blood pressure in your head. And so, it would be interesting to find if if you used both to see what effect abdominal compression [00:32:00] had on both of those things.
Sameer Kunte: Absolutely, and I think that's something that we, we really want to think about in the future as well is, how do we get better about measuring blood pressure where it matters? Because like you said, blood pressure in the arm may not equal blood pressure to the head or the organs where we're kind of feeling these symptoms.
But also, can we get better about how quick we're measuring these changes? A lot of these changes that happen after you stand up are happening in the first couple seconds. So, measuring heart rate is pretty easy because that continuously changes and we can measure it pretty reliably with, you know, conventional things like a pulse ox that you wear on your finger that'll measure your heart rate as well as your oxygen saturation pretty quickly.
But a lot of the blood pressure cuffs that we use, say, in the clinic, those take some time to give you a reading. That can take up to a minute or even longer. So you might be missing out on a lot of good data there on changes that in blood pressure that people are having, that other things like more invasive blood pressure monitors may be better at, but we just can't use them because they're invasive and may not be the best for a study.
Jill Brook: Yeah. [00:33:00] Oh, it's great that you're thinking about all these things. Okay. So what's next? What else are you up to?
Sameer Kunte: So kind of the next big picture for us is doing a similar study, but in patients with POTS. So what we were able to show is that abdominal compression had an effect in healthy individuals, but we want to make sure that we can actually show that the patients that we want to treat were having a similar effect.
So the study overall will be very similar. We'll still be doing active stand trials, having participants stand up, measuring their heart rate and blood pressure, and then having them either do it with nothing, with no abdominal compression, or using our different types of abdominal compression that we have available.
The main thing we're curious about, of course, is, you know, how effective are our devices? We hope that our devices are more effective than nothing, and that way we can kind of advance our devices forward to hopefully make them consumer available one day. But further answering that question of, we know abdominal compression is effective in general, but how do we make the most efficient form of abdominal compression available?
Is that through a [00:34:00] mechanism that is all the way around the abdomen? Is that through a smaller mechanism? And if both are effective, can we offer different options to people such that maybe someone who struggles with, you know, gastroparesis can use a lower profile option for them. Meanwhile, someone who is, requires a lot more compression than others will use a larger profile of abdominal compression.
So hopefully that data will kind of help us tailor products in the future to make sure that patients have as many options as possible.
Kishen Mitra: Yeah. And in addition to, you know, elucidating the physiological responses, another angle that we're taking in this next clinical trial that we'll be performing with POTS patients is collecting data around the symptomatic relief, because another theory that we have is that, you know, like, like you mentioned, and it's actually such a small world, I know Daniel Lee, and I had a chance to connect with him at the Dysautonomic International Conference, and the work they're doing with the Lumia is absolutely incredible and, and, you [00:35:00] know, it's funny you mentioned that, because the responses vary so much from patient to patient in the context of the vital signs, so like heart rate and blood pressure.
You know, it's, it's awesome that they're tracking the blood flow and, and, you know, I encourage everyone to listen to that podcast. I gave it a listen myself actually before our own conversation, but that's why from for our clinical trial, we're, we're also trying to understand the overall symptomatic relief because this will be one of those products that we hope will definitely benefit you know, mitigating the symptoms physiologically, but overall we, more importantly, the goal is to be able to just achieve any form of symptomatic relief, whether that also be from a psychological standpoint, right?
So just do patients feel more at ease when, when they're wearing the device. So, I just thought I'd add that to everything Sameer has mentioned that we'll, we'll also be collecting data on that half. We're excited [00:36:00] to see how the two play out and whether there's a relationship between those two.
And then finally, on the design standpoint the next steps for Uplift have been you know, interpreting the results of the clinical trial that we just concluded and then also, you know, continuing our iterations. So our most recent prototype is actually a cinching like design, and we took inspiration from corsets.
Which as many of the listeners in the audience may be familiar is an essential element of fashion that dates back to the 20th century during the Renaissance period. And the reason we're, we're going back in time is because the design behind the corsets is appealing when it comes to adjustability.
So, we're able to leverage cinching paired with an adjustable buckle like mechanism that we've developed to achieve those distinct levels of [00:37:00] compression. And it's actually this most recent iteration that I just discussed that is being implemented in the upcoming clinical trial in the POTS patients, which we're anticipating will start in early 2025.
So pretty, pretty exciting things going on into both from the, you know, a design lens as well as clinical lens. And, and that's the beauty of Uplift as a product. As a team is we, we have members spanning across all the disciplines and we sort of have different work streams and yeah, and we're super, super happy to, to, you know, collaborate and, and make, make steps forward.
Jill Brook: Well, this is exciting and it's fun now. I mean, probably some other audience members are like me now imagining that scene from Gone with the Wind when Scarlett O'Hara has her maid pulling and pulling at her corset strings, trying to get them as tight as possible, and to think that now a high tech medical device [00:38:00] company is coming back to that
thinking is, is kind of fun. Okay, so I'm sure people are excited to learn more. Where can they find you online? We'll link to it in the show notes, but where can people find you and what else should they know? Any, any final thoughts?
Kishen Mitra: Yeah, so, so, I think the best way to stay updated on sort of the, the research front is through our, our LinkedIn page, which I would encourage everyone to check out in our show notes and give a follow. We will be updating our findings from the literature and, and kind of discussing Uplift each step along the way.
We're also in the early stages of developing a website, which we, we are happy to share with the audience. And yeah, and then, you know, from a clinical standpoint, Sameer, do you have any, any remarks you'd like to share?
Sameer Kunte: No, I think the big thing for us is just continuing to get data on how our devices work, continuing to help [00:39:00] with the literature overall, the scientific community, and hopefully get more people kind of interested in that kind of research and hopefully one day create a device that, you know, can help with patients.
I think our ideally, we don't think Uplift is going to be the end all be all. We don't think it's going to be the one treatment that patients use, but ideally it's something that they can add to their arsenal to help manage this chronic illness that's really affects a lot of people.
Kishen Mitra: And I think that Sameer brings up a great point there that we, we should clarify that this will not necessarily be all, you know, all encompassing solution for treating POTS right? So, so, you know, that we're, we're far from there, but we, we'd like to kind of present this as another management strategy for patients who haven't necessarily been successful with trying other non pharmacological approaches, specifically in the realm of compression.
You know, we're aware that there's other, you know, lifestyle changes and things like fluid, fluid and salt intake that can help, but oftentimes, [00:40:00] specifically in the bucket of compression you know, like through our conversation, hopefully it's clear that there are some major gaps and, and lack of satisfaction from a patient and of, of the products out there.
So we're hoping that Uplift will be, you know, another, another pathway for, for patients to give compression a chance. And also, you know, really relaying that message that there is a need for novel solutions and we hear you and, and we hope that, you know, we'll be one of many teams in the coming years to to develop new compression garment technologies
specifically for patients with autonomic dysfunctions.
Jill Brook: Well, fantastic. Thank you so much. We're very excited to have your brain power and your creativity and your innovating working on our behalf, and that would be a huge deal just to make our existing compression more comfortable, [00:41:00] much less more successful, or able to just be used here and there as needed.
That sounds like big leaps forward to me. So, thank you and good luck, and we'll be excited to keep following your, your work from here.
Kishen Mitra: Yeah. Thank you for your time, Jill. And you've been a wonderful host and, and super welcoming. And we're, we're glad to connect with the POTScast community and share all the work we've done over the past two years.
Jill Brook: Right on. Awesome. Well, thanks a million and okay listeners, that's all for today. We'll be back again next week, but until then, thank you for listening, remember you're not alone, and please join us again soon.
