In his mid-life, around 40 years old, he was being fed via a PEG directly into his stomach because he couldn’t even swallow his own saliva, let alone food. The paralysis in the right side of his face meant that he drooled so much that he needed a bib to keep his clothes reasonably dry.
Almost two years earlier the man had had a stroke. His miserable circumstances had not improved and now he was depressed and felt really low. This wasn’t the first such patient that Mary Hägg had met, and she was frustrated.
This is the story of how the embryo of the neuromuscular training device IQoro was created by a tenacious researcher with a theory for a completely innovative treatment. A new treatment that would take 20 years, and literally two generations, to take its place in healthcare.
Mary had studied neurology, and she was convinced that current treatment methods were insufficient and took too long to give results. At that time she worked as a hospital dentist treating patients with orofacial difficulties – including the legacy of stroke.
– It was taking too long for both the patient and for me to get started with treatment. This led to frustration all round when my patients were poorly, for example after a stroke and when their worlds had already been turned upside down. Help needs to be available right away, says Mary.
She saw the opportunity in this man to test her theory in practice and help him in a more effective way than had previously been possible.
She had a hypothesis – which we’ll come to soon – and she saw the opportunity in this man to test her theory in practice and help him in a more effective way than had previously been possible.
When the patient returned for his check-up 6 weeks later, the transformation was total. The results exceeded all expectations.
– Imagine my surprise when I met my patient again. He was a different man: with a radiant face grinning widely, he had no saliva dribbling down his chin, and no bib on his chest. Mary tells the story and, despite the years that have passed, you can see that the memory brings powerful emotions flooding back to her. She recalls her tears of joy.
– He sat up straight in his wheelchair with obvious pride that struck me to the core and he told me that he could now eat normally via the mouth. He could even safely swallow thin, flavoured drinks, she continues.
The lust for life had returned, and the family had regained hope.
– The patient’s doctor had planned to remove his PEG a month later. His wife spoke about how their lust for life had returned, and how the family had regained hope.
What had happened was no miracle. The man had just tested the first prototype of IQoro. But it would be another 20 years before the device was available to the general public.
First, Mary had to prove scientifically how this transformation had been achieved.
Treatments before IQoro
To understand Mary’s frustration, it is perhaps necessary to describe the treatments that were then available.
At that time a clinician would construct an individually-fitted palatal plate with metal protrusions, to treat swallowing difficulties.
It didn’t feel good having to ask the patient to wait that long to start treatment.
– It would take at least two weeks before it was ready to use. It required a mould of both the patient’s upper and lower jaws and my design of how the plate was to be constructed. These were then sent to a specialist dental technician who built the device. Then training could start: 1½ hours per day of tongue movements according to my prescribed instructions, says Mary as she describes the complex process.
– It didn’t feel good having to ask the patient to wait that long to start treatment. Just making the dental moulds of the patient’s jaws was often distressing enough for someone who could not swallow.
That then, was what normally awaited a patient who arrived at a clinic.
But Mary Hägg had a theory that would lead to the development of the IQoro neuromuscular training device and its treatment regime.
We know that the mouth is an important part of the children’s development and of learning and understanding their world
If you have children, you perhaps remember how they loved to put everything they could into their mouths. We know that this an important part of their development and of learning and understanding their world, says Mary.
– Could the mouth then also be the key to restoring functions when something goes wrong later in life: a bit like the ‘reset factory settings’ button we find on machines? For example when a stroke knocks out many of our everyday, but crucial functions – like the ability to breathe, eat, smile and talk.
The first prototype
Admittedly, Mary had never tried converting her theory into a concrete patient intervention before. But she had worked with the theory long enough, and practical construction had started.
I shared my theory and ideas with the patient under strict secrecy but, of course, I could promise him nothing.
– I had already constructed a prototype of IQoro myself in my clinic. I shared my theory and ideas with the patient under strict secrecy but, of course, I could promise him nothing. The man and his family thought that they had little to lose; they signed a secrecy agreement and took the IQoro prototype home with them.
He started to train according to instructions that are almost identical to those we use today: 3 pulls of 10 seconds each, 3 times per day before mealtimes. Because the man was so ill and weak, he needed assistance to help keep his lips sealed against the device during the forward-pull.
The next generation made IQoro a reality
From the time that the man burst, beaming, into his check-up visit, to the point where IQoro was an approved, internationally patented product, took more than 20 years.
In the summer of 2014 IQoro was launched on the market by the newly-formed private company MYoroface AB. A story for another day!
Many clever innovations never get further than the desk drawer.
– Had it not been for my daughters, Ylvali Gerling and Linn Hägg, that built the company to help more and more people to treat the underlying causes of their problems, my innovation would not have helped many more than those that I met personally through my own clinic, Mary admits.
If researchers don’t find the right contacts in industry with experience of sales and marketing, many innovations never get further than the desk drawer.
– If that had happened I would one day have turned in my grave, she says. Of course she says it with a smile, but you can’t help feeling that she means it!