Building a diagnosis (from 1000 miles away)

When Daniil Maskileison picked up a development job through Gigster, he had no idea how much impact the project would have on his own life.

Maskileison was tasked with developing an app for an audience of age 50 and older to help monitor for peripheral artierial disease (PAD).

According to a study released in The Lancet, PAD affects about 12-20 percent of Americans age 65 and older. The disease causes a narrowing of some of the body’s main arteries. It usually has the biggest impact on the legs. The most common symptom is pain in the legs while walking, which can be alleviated with rest.

Despite how many people the disease affects, there hasn’t been a comprehensive study of the origins of PAD. That means healthcare workers are unsure whether screening for PAD would help prevent it. It was this realization that inspired Dr. Oliver Aalami, a surgeon at Stanford Medicine to start looking for a solution.

Aalami realized that the popularity of smartphones and the rise of wearable technology might hold the key to this problem. He started working on what would eventually become VascTrac, an app to help research and screen for peripheral arterial disease. Aalami eventually turned to Gigster, which is when Maskileison entered the picture.

Learning The Ropes

“I started to look more into specs, and actually the more I read, the more excited I was about the gig,” Maskileison says about being offered the job.

He became VascTrac’s product manager. Diving into the work acquainted him with the red tape surrounding medical data. There are many regulations around collecting information and all that data must be encrypted. But as he dug deeper into the problem, he gained a more thorough understanding of the disease and its symptoms.

“The most important piece of data is how much a person can walk without stops,” he says.

“So basically if the person suffers from this condition, he or she will have to—if they walk . . .  they have to stop because they can’t tolerate the pain in their lower extremities.”

The team set to developing an app that monitors how frequently a person walking needs to stop and rest.

“I remember one of our first calls, I asked ‘[at] which moment should we notify the user that she or he should see a doctor?'” Maskileison says.

“Interestingly the answer was that we don’t really know for now, because the research is so limited. It’s hard to research all this, it’s expensive. So basically if this app will really have the reach that we are hoping to have, then just in a month we will have more data than all the research that’s available on this.”

He is quick to point out that the data will be limited and won’t include precise medical information. But he says the walking metric is believed to be the most important one for diagnosing PAD.

A Lucky Coincidence

Maskileison calls what happened next a coincidence. But there’s no doubt that it was a lucky one.

He lives and works in a town a thousand miles away from where his parents are, so they try to connect regularly on Skype. The family speaks Russian to one another, keeping up his parents’ connection to their homeland.

“So I was just having a Skype call with my parents who live in a different city, and I’ve asked my father if he is okay, if his health is okay. Usually he doesn’t complain.”

His father isn’t one to make a fuss, but luckily Maskileison’s mother overheard the conversation.

“My mother saw our call, and she interrupted, and said, ‘you know what, Dad just stopped on the street,’ so I immediately knew what it was.”

The Diagnosis

Maskileison didn’t know the Russian translation for the disease, so it took him a little while to figure out how to explain the problem to his parents. But eventually he was able to let them know what was going on and the doctors were able to confirm his diagnosis.

In hindsight, Maskileison says the likelihood of doctors misdiagnosing the problem was pretty high. If the problem isn’t caught soon enough, it can ultimately lead to surgery. But if the disease is recognized in its early stages it’s much easier to treat. Getting out of the house for a walk, coupled with some inexpensive drugs can be enough.

“Regular strolls are actually the most recommended way of dealing with disease.”

He says patients need to train themselves to walk through the pain.

Positive Prognosis

His father is now doing well and is glad his son was able to diagnose him.

“It’s very good that we were able to detect this at the very early stages, I believe,” says Maskileison. “If it were undiagnosed for a year, who knows how it could turn out. I insisted that he should walk at least a half an hour a day, and he follows my orders. Doctor’s orders.”

The whole experience has brought Maskileison even closer to the project.

“I think I’ve become more compassionate to our users,” he says. “I immediately had more ideas on how we can actually use this app. Not only to track the symptoms of the disease, but also provide training [for the users].”

“I realized even before this that we are doing good stuff. I think everybody on the team was quite excited to participate.”

Perfect Timing

Still, Maskileison doesn’t find the story that exciting. It’s just “a coincidence,” after all. But when pressed a little bit he smiles and reflects.

“The timing, I mean, it was perfect,” he says.

Ever the realist though, he adds “but to have someone in your family who suffers from this disease is quite probable.”

If you’re looking to build a project of your own, Gigster can help.

Tyler Trumbull

Ty splits his time between Canada and Mexico. He’s been writing for Gigster since early 2016 where he really enjoys learning and sharing clients’ stories. He plays banjo in one of Mexico’s only country bands, wishes he could write like Thomas Pynchon, and is generally a fan of the Oxford comma.