 So, our next speaker is a biohacker, a blogger, body mod artist, and a nurse. He's collaborated on projects ranging from insufferable peptides that extend REM sleep all the way to non-Newtonian armor implants. He actually hosts the annual event Grind Fest in Tecachapi, California. I probably butchered that, I apologize. A little fun fact about him, he actually placed third in the biohack village oxytocin poker tournament and he performed an implant on transhumanist presidential candidate Zoltan Isvan. Now here to present his talk on biohackers dot i, ladies and gentlemen, Jeffrey Tibbetts. Alright, I'm the first one to try out this mic. It's good? Awesome. Okay, so how's it going? I'm a biohacker and I have done a few high profile grinds. So a number of people in this room and I were on an MTV show snorting a peptide called VIP that rat models have shown can radically alter circadian rhythms. It didn't do much to our sleep cycles but we did find that it seriously boosted visual memory function on two methods of testing. We're still crunching the numbers on that study but I think I had a lot more fun last DEF CON where we all snorted the oxytocin. That's the so-called trust or bonding hormone and we did this up in a hotel room and then competed in a poker tournament. I've also done some pretty cool work with nerve growth factors and we found that introducing NGF at the point of incision when implanting a magnet actually increases sensitivity and provides a better result in terms of ability to perceive fields. So essentially we're groups like Grindhouse Wetwear or Cyber Eyes or Dangerous Things are focusing really on creating technology to place in the body. My focus tends to be on ways to alter a person's physiology or anatomy and which is basically the antithesis of my day job. As a registered nurse and ER my objectives bringing people back into normal limits. I'm fortunate that I still get to be involved in it with all the cool new devices being developed because you always need someone willing to cut you open and shove things inside. So I've done hundreds of procedures at this point ranging in complexity from the quick poke of an RFID injector like you see Zoltan getting here to bilateral armory implants running the length of the recipient's shins. As far as I can tell everything I do is legal and falls under laws pertaining to body modification. I mean I think it's legal. Of course saying something's legal doesn't necessarily mean it's safe which is the focus what I'm going to talk about today. I've been active in the granny community pretty much since its exception and it's only lately that I've really been willing to admit even to myself that someone's gonna die okay and something's gonna go wrong and somebody will die. Okay so grander's a community radically commuted to radically altering the body and so sometimes it's treatments like transcranial magnetic or direct current stimulation or it could be through the use of previously untested chemicals like VIP. Often it takes the form of implanted devices. All these approaches come with risks. What I'm gonna focus on today is why despite all the risks being taken a grinder hasn't died yet. All right if you didn't know about Tim Cannon and Circadia prior to this DEF CON I'm sure you know now people have had a lot to say about his project and not all of it was positive. I'm gonna read three comments that I found about Tim. So I guess if you want fleshing bacteria sepsis and such get one stuck in your body at a shop shop. This comment the assumption underlying this type of comments that we're all incompetent and with a total disregard for sterile technique and safety. Trust me this isn't the case. I don't know why but media folk love to record arguments and family drama but they always stop recording during the hours spent cleaning and autoclaving. You idiots need to look more into potential side effects prior to doing these things. So on top of being incompetent we're also totally ignorant. Despite the months and in some cases even years that we spend on projects people assume we know nothing at all and once again this is not the case. That's my favorite. Yeah when it comes to something like cutting somebody's body open skin open and putting some foreign object into the skin then it should be done by professional people not just people at home. I like this one because it acknowledges that yes somewhere out there has the skill to do this stuff but it's not us right. I think the best way to address these concerns is by showing exactly how much knowledge and skill goes in even the most basic procedures. So first off yes there are grinders that are performing procedures in their garages okay. Let's take a look at one that's kind of cut off but still as you can see in the slide that all the walls are non porous they're wipeable there's a HEPA filtered air supply. There's overhead surgical lighting and there's also a non porous wipeable procedure chair off to the left where you can't see there's a scrub sink there's a patient monitor there's an electrosurgical unit over stuck in the corner an IV pump there's biohazard biohazard disposal bin a sharps disposal bin I'm still working on putting oxygen in an air supply. Yes this garage is not on par with an OR found in a hospital but it's better than most procedure rooms that you find in clinics to be honest okay and the most important aspect of this entire room though is that it's designed to be easily clean okay and cleanliness is usually a critic's first point of contention clean is not good enough right. Contrary to popular belief operating rooms are not sterile the best you can hope for is disinfected people mix up all the time sterilization and disinfection and antisepsis so antiseptics are cleansers that reduce the number of pathogens on the skin grinders use either a mixture of 70% alcohol with a 4% chlorhexidine gluconate or a podon iodine 12% to disinfect the incision site either works I prefer chlorhexidine because it has a residual action okay in terms of disinfectants they are chemicals which kill the majority of infectious agents on the surface we use a 1 to 10 dilution of bleach for surfaces and quaternary ammonia for more delicate items like equipment and tubes and cords and things right in terms of sterilization this is sterilization is the elimination of all life you got to sterilize anything that touches the incision site like tools and gauze this is my Ritter M9 022 works by bringing tools to 121 calcius at a pressure of 15 psi for 30 minutes so of course just having these tools and supplies doesn't mean you're using them right and someone could totally still claim that we're incompetent based off of this but if I took the time to really explain how to scrub in and disinfect the environment and you know the use of the ultrasonic baths and enzymes and protectants prior to auto-claving we never actually make it to my point so we are using them correctly so really I mean are we competent I know we're competent as the guys working in the hospital or because I know those guys and I was trained by those guys okay and are we ignorant well I guess the question I have is why aren't operating room sterile there was a grinder project a few years back where some people made a chamber and the recipient would place his hand in the box and the whole procedure is performed by an artist reaching through this like gloved aperture right they would fill the entire chamber with a vaporized disinfectant like immediately before doing the procedure right I couldn't find a picture of this but what what I did find a picture of though it works yeah okay oh too far there we go this is a hydrogen peroxide vapor system being made by a company called bioquel and it's being trialed at John Hopkins I'd say no we're not ignorant on the contrary we're right at the forefront if not beyond what the medical field is already doing I mean this is being trialed John Hopkins way we had a few years back someone already trying the same type of idea okay anyways our next consideration is analgesia I can't use some of the methods because of where I live but plenty of granders can and do the gold standard is infiltration of lidocaine because because a lot of procedures we do are in distal areas of poor circulation we use 2% lidocaine without epinephrine epinephrine is great in other areas because it constricts blood flow and this keeps the lidocaine in the area longer and it actually decreases bleeding so like in fingers and ears though it can restrict blood flow enough to cause necrosis so we're doing a technique we generally most grinders are using technique yeah there we go called a flexor tendon sheath nerve block that's where you take a 25 gauge needle and you insert it at about 45 degrees just distal the polymer crease okay this blocks the entire finger for as long as an hour and a half in places where we can't use infiltration people usually opt for a topical lidocaine gel 5% gel applied for an hour and a half can provide a degree of analgesia as well I feel personally that this method takes too long and people still complain of pain this is an issue in medicine as well a few people like it and stuck with an IV there is a project product called emla cream which can be applied beforehand enough the site the problem though is takes so long to be effective physicians seldom even bother with it you know some kids sometimes get it that's about it and so we've been trialing a method of administration called I onto for recess I on a for recess is uses 120 milliamps to actively push lidocaine through the skin okay using I on a for recess we've gotten far we've gotten far better control of pain is little 30 minutes you know and this is something I've never heard of actually being used in the medical field okay so once again you know are we competent yeah we're using the same methods the same safe methods that you'd find at a hospital setting and are we knowledgeable yeah we're actually pushing beyond we're innovating at this point you know in terms of controlling bleeding we control bleeding with tourniquets do you know first aid kits don't even come with tourniquets anymore the improper use of a tourniquet can lead to some really serious problems these problems are usually because they're too much pressure or leaving them on for too long for a procedure like a magnet though we don't have to worry about pressure if we use a project product intended for fingers devices like T rings is a T ring they apply less force and additional tourniquet and they let us work without blood to obstruct our view in other yeah in terms of time you don't even get a change in your lab values indicating muscle damages occurred until about the 30 minute mark and two hours is considered the point at which lasting damage starts to occur okay most procedures we do take maybe 10 minutes tops okay and for more invasive procedures we do use surgical tourniquets this approach requires a lot more specialized knowledge we had to pay attention to details like the proper limb occlusion pressure and we have to be really careful about recording time but I'm going to skip over those details pretty much the name of brevity because but I don't want you to confuse this emission is being due to incompetence or ignorance okay so where are we have a disinfected procedure area and sterile tools we have a clean procedure site and clean hands we're pain-free bleeding is controlled so we must be start cutting where we cut the priority of course is avoiding blood vessels and nerves okay then we worry about trying to minimize scarring in terms of let's see skin has a grain kind of like how wood does the collagen fibers are naturally oriented in one direction called Langer's lines okay you can get these really cool topological maps showing the direction of collagen you also have to take in consideration the direction of maximum skin tension okay this is a different set of anatomical skin lines called Crazl's lines plastic surgeons usually place incisions that are parallel to relax skin tension lines those are known as Borges lines and unless there's a nearby natural wrinkle that would hide your incision instead so basically choosing incision site to maximize aesthetics is more difficult than you would think for example it's not a great pick but okay so I switch out a north star implant for my friend Berger she's in back right here and when we switch out the north star oh by the way she really digs scars anyways and she explicitly gave me the okay to try a different approach anyway so I incised parallel to Langer's lines hoping to minimize the scarring on her hand and I didn't really account for the skin tension on the skin so when it was healing you know whenever she moved her hand around it was providing it was pulling on the incision site right so basically because I didn't account for the tension on the skin it was constantly pulling and I was really disappointed because the incision ended up scarring worse so if you can see right here this is actually along this line this is the original incision point right here and right here is the incision that I made when I was switching them out so it's I mean this one is like a the original one is about a year of healing further along than this one but still I think that it's going to end up being a bigger scar overall so it's kind of one of these things where we're still we're still playing with it and trying to figure out the best approaches and but it's it's not something that we're I would say we're ignorant about okay so you know once again are we ignorant or incompetent in this area I'd say it's a wash I've seen beautiful work done by both plastic surgeons and body modification artists at the body hacks conference I got to hang out with Russ Fox sees like a god in the body mod community his works beautiful and I'll be the first to admit I'm not at his level of competency I've also gotten to sit through a number of procedures performed by one of the top plastic surgeons in the LA area there's no way I can do what either of them do okay that said people don't come into me and make them pretty yeah what people expect is the safe place placement of a safe device which is something that grinders are competent to provide so in terms of incisions how we make the incision depends on what we're doing objects in glass capsules like tritium fireflies or outfits can be placed using injector so for other implants we use a 15 or 11 a scalpel blade or a number three handle a scalpel's head with a pencil held with a pencil grip in the dominant hand while the non-dominant hand provides tension on the skin we make the incision slightly larger than the object to be implanted when you get below the dermis connective tissue tears easily the artist chooses between blunt or sharp dissection you can separate connective tissue with a probe but I found blunt dissection causes more trauma increases healing time so I usually offer sharp dissection of the scalpel sharp dissection comes to the risk of cutting through an important structure so if I'm working in an area I'm less familiar with I like to go with blunt the point of separating the tissues to create a pocket for the implant to sit in it's best to create a pocket that it's somewhat larger than the device you want because you want skin laxity you want enough give in that area so that you can approximate the incision without it being under tension see this one shows up hey okay so bagelhead are you guys familiar with what this is it was basically a year or two back there was a physician who started posting on the biohack forums and he suggested we try a technique that's called fluid dissection it's like the bagelhead thing right here what you're doing the idea is you put fluid under the area under pressure and it creates the pocket for you so in this case that's just normal saline that was done with an IV needle and you fill up the area and you push with your thumb in the middle you know it pretty much the saline reabsorbs within six to eight hours anyways so his idea was that we could do like how you do a TB test you know and I've done this hundreds of times as a nurse you know you have when you're doing a TB test you're actually doing an interdermal injection you're gonna go into the skin do a little injection it makes a bubble his idea was essentially that we could make this big saline fluid pocket that way and then just cut right into it slip the magnet in like no problem you know I was somewhat critical of it sorry I recorded a video where I tried out the fluid dissection method three different times in three different areas and and it didn't work at all okay the weird thing though was what when I posted what I found okay so I went up and I posted what I found the guy just like flipped his shit okay despite giving him credit and only posting the video as a direct response to the thread he started he accused me of plagiarizing his work okay he sort of never help us again and quit the forums okay so why would I plagiarize a technique that doesn't work you know seriously wonder if it worked out if he would have still been upset you know I think the real easy issue may have been an ego bruised by someone with like one fifth of his credentials demonstrating that he's wrong okay so closing the incision we use a non-absorbable suture like polypropylene with a third three eighths curvature reverse cutting needle I taught a class during grime fest a few years back on suturing and the three techniques we practice were simple interrupted running sutures and horizontal mattresses performed with an instrument tie so these types can be used probably 90% of the procedures we're doing and we're just not doing anything complicated enough to require a larger repertoire the techniques then removed we let a small amount of blood out fleshing out the wounds then we apply pressure for a minute and the bleeding stops the wounds then dress using sterile strips initial healing takes around three weeks during which the focus is on controlling inflammation using ice and ibuprofen okay sutures are pulled sometime between day three and seven after which sterile strips are kept on to prevent the site from reopening collagen fibers reinforce the wound after a month and although wound maturation remodeling can take more than a year again for the sake of brevity I'm emitting a lot of information that I would consider essential let's go then as much focus as I put into talking about the safe and as much focus we put into safe implantation the insertion of ice is actually the simple part it'd be easy to stand here for another hour speaking exclusively about bio compatibility community is constantly brainstorming new types of coatings and ways to apply them medical devices like pacemaker usually coated in either a biocompatible alloy like titanium nitride or a polymer like perylene the simplest bio hacks don't require even these when injectable outfits were first being marketed I was concerned because they're encapsulated in glass my concern and the concern of probably a lot of people is that if the glass breaks in your body it seems like it could cause harm so I was involved in the testing of this idea and what we found is it takes so much force to break these things that if it happens the glass is the least of your worries I mean sure it'll break if you drive over your hand right okay another concern I've seen pop up over and over as research indicating that arphids implants can cause tumors so there are journal articles about this rats and mice particularly the types used in labs are particularly prone to tumors so these studies have shown that as much as many as 10% of the rats developed a harmless tumor near the arphid capsule they're called post injection sarcomas well you don't realize that these sarcomas are cure and occur in murine models regardless of whether the arphid is there or not it happens in cats too okay it's because it has something to do with the animals the ability to handle oxidative stress cats just sometimes get tumors if you poke them with a needle it's like a seed of menopent what's poisoned to a cat isn't necessarily poisoned to us okay dogs on the other hand they seldom ever get post injection sarcomas that's why I only found one case study ever about a dog they found a this type of tumor in right we put hundreds of thousands of arphids in dogs these studies they just can't be applied to human applications I've never heard or seen of an arphid being rejected and breaking inside of someone or causing a tumor to form okay most projects however they don't fit in glass so early work like the circadia and really work like circadia use silicone it's material that's been safely used by the body mod community for years it has its disadvantages though and we've almost entirely replace it with titanium niotide and perylene the same coatings as biomedical devices I subscribe to a journal that discusses bio coatings and I came across an article talking about a method developed which could apply a layer of diamond when I contacted the guy responsible for the research he helped me produce a batch of neodymium iron boron magnets coated in diamonds out of the ten I've been planted only two have had problems we haven't yet determined these problems were related to a defect in manufacturing a problem with diamond coatings are simply because of events related to healing but this is another example of the biohacking community not only matching the diligence required in medical devices but striving to exceed them okay there are many considerations that go into making implant I'm not even qualified to address I know there's a lot of work regarding appropriate batteries it's obviously something equivalent you know it's obvious something equivalent to a Samsung bursting into flames under the skin could be lethal but there are more subtle issues like outgassing okay bottom line is we don't expect our implants to fail but we have to engineer them so that if they do they do so harmlessly and we have to perform tests to determine if we succeeded in making them safe for devices to be approved by the FDA you need ISO 10 9903 certification this requires cytotoxicity testing like direct contact tests or agar diffusion tests sensitization assays are used to turn whether materials gonna cause hypersensitivity or an allergic reaction skipping through some of this just get to the point basically with these tests we have no obligation to do these tests we have we're not we're not in any way obligated by the FDA or anyone to essentially be forming these tests and yet we still are I mean if you look at what Brian House has done they've done these cytotoxicity tests if you look at some of the stuff we've done with the different coatings and just different stuff I mean we're doing the majority of tests with I think what we're missing pretty much nobody does multi-generational tests to see if you know four generations down the road there's going to be problems but I mean with the majority of materials we're working with it's already been done you know with the exact same materials and yet we're still repeating these tests just because in the community we're just so we put so much emphasis on trying to create a safe product to do this the right way okay so despite how something is how simple something like a magnate implant seems to be it requires a lot of work and a lot of research this is work renders are doing in skills we're learning are we competent absolutely there may be a safer and better way to do these things but if there is I'm willing to bet grinders will be amongst the first to put them into practice are we ignorant no we we study and practice our craft without being blinded by ego should we wait for those who consider themselves be professionals to give us their blessing look no surgeon is going to be willing to do the things we're doing medicine returns the body to state we consider normal it's not the pursuit of becoming more than human and body modification community is similarly unsuitable biohacking is rooted in cooperation and collaboration there are great guys like Hayworth and Russ Fox but money modification in general is poisoned by an unwillingness to collaborate okay this is fine we're talking about nipple piercings but grinders are already working on designs for brain computer air-facing you know I want the skills to place a multi electrode array and expand on the type of work heaven warwick did 15 years ago I don't know any physicians willing or body modification artists capable of doing this there are no masters there are no professionals if we're not skilled enough the only option is to become better at what we do okay so why is it I'm convinced someone's going to die one minute well I did good I'm almost there okay in 2011 there was a BMG case report titled body piercing with fatal consequences men in his 50 died from a mesenteric infarct what that is is basically he had a belly button piercing and it migrated inward right cut off blood flow I've seen about three of these in my career what happens is you know they have some kind of GI upset they open them up for exploratory and their entire gut is already just gray and dead there's nothing to do you sew them back up until I'm sitting by your family you know within a day they're vomiting feces and they die it's terrible okay and obviously this is not this is sorry this is not an exception you know there are case after case of people dying from you know all kinds of things with piercings but it's not just piercing that's not the only thing that scares me you know I mean I should read that I'm convinced someone is going to die because there are between two and four deaths a year on average in the US from people shaking vending machines okay people take every precaution or meticulous about after I mean it's still risk man people are some day it's a numbers game and somebody is going to die the problem with this the problem with this is that there's going to be that backlash from the first inevitable death right so far the media has been kind to us right everything we do I mean like people been doing piercings for into antiquity and yet we put a stupid magnet in and it's like they're cyborgs man they're you know they're like innovating that no no we're not really doing that amazing stuff but you know the way they're pitching us is being you know we're doing this amazing or we're doing something different than everyone else problem with that is this when somebody dies that's just going to blow up in our face I mean the way it's going to work is is that same sensationalism that blew it up as a hundred fold of us doing these things it's also going to be you know my god these dangerous people doing these dangerous things and we know what they're going to say about it what it's going to be is they're going to say we're ignorant and we should have looked into the risks of what we're doing they're going to say we'll all get sepsis and flesh eating bacteria you know they're going to assume we're incompetent they'll say procedures like this should be left to someone else someone who has the knowledge and competency to do it right right okay so less than a minute damn I mean come on guys it goes like this I'm done right yeah okay now whatever okay real quick I'm done look we drive cars around right and we think it's okay even though look at the number of deaths that occur from cars no one's saying we're going to stop driving because it's too dangerous right beyond that even beyond necessity there's you know people smoke you smoke cigarettes you know it's killing this many people and yet we it's acceptable in society you know we smoke cigarettes but what we're doing it's also risky but you know what it's a risk we're taking because we believe in it we're trying to create a future you know we're doing something that's meaningful and so I don't have anything to say about really the backlash when the first grinder dies we're screwed but I'll tell you what I do know I do know that that person that first dies they died doing something they believe in they died doing something that they researched and knew the risks and they did it anyways and they died in a way that they thought was meaningful yeah so that's all I got to say thank you