If you are considering signing up for cryonics, you've probably spent some time educating yourself on the subject. You have presumably weighed the different pros and cons and sought answers to some basic questions: how the procedure works, how much it costs, and how far we are from revival. 

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If you have come this far, you may have noticed how “fast response” is often mentioned as a key factor in quality cryopreservation. What does this mean? And what can your cryonics provider, the standby team, and yourself do to ensure that your cryopreservation starts without delay?

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Human Cryopreservation Procedure Explained

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It all begins when a member of a cryonics organization (such as Tomorrow Bio), due to the aggravation of some illness, starts showing signs of impending death. If this were a person who had other plans for their "afterlife," things would go completely differently. But, since the person in question has decided to give themselves a chance at an extended life, there is a whole procedure to follow as death approaches.

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First, the patient themselves, family members and/or physicians should alert the cryonics organization that will take care of the cryoprocedure. We at Tomorrow Bio have SST teams available 24/7. This means that at any time we get the emergency call, we will be ready to respond. The team will do everything in its power to arrive at the site before the actual declaration of legal death. Usually, a few days before - to be on “standby” and able to promptly begin the procedure.

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Once legal death has been pronounced, the patient's temperature needs to be lowered. At the same time, the team utilizes a mechanical chest-compression device to provide cardio-pulmonary support (CPS) and a range of medication. These two initial aspects are crucial for high quality cryopreservation. In fact, they prevent a process called ischemia from taking over.

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How Ischemia Works

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Ischemia itself comes from the Greek 'ischein', which means to hold back and '-emia', which refers to blood. It’s defined as inadequate supply of oxygenated blood to one or more parts of the body. This can be caused by a blockage of the vessels supplying the area (common effect of arteriosclerosis) or by cessation of cardiac activity. Simply put, when the heart stops beating and pumping blood, the body's cells do not get the oxygen they need to function.

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But what exactly happens to cells when they run out of oxygen? Let's start with a fundamental notion: how cells use oxygen. Through breathing, oxygen is inhaled into the lungs, enters the pulmonary veins and is then pumped to all 37 trillion cells in our body by the heart. It’s a continuous cycle that, to be poetic, we can call life.

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Each cell needs oxygen to go through the so-called cellular respiration. This process allows cells to break down food and get the fuel necessary to survive. During cellular respiration, glucose and oxygen are converted into carbon dioxide and water, and the energy is transferred to an organic compound called adenosine triphosphate (ATP). This way, food is converted into energy the cells can use.

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Once the supply of oxygen stops, our cells need an alternative way to meet the demand for energy. First, the activity changes from aerobic (with oxygen) to anaerobic (without oxygen). However, when even this is no longer possible, the cells enter a state called “autophagy” — from the Greek for “self-eating''. Basically, when starved, cells start consuming their own proteins, until they finally die.

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How Standby Teams Stop Ischemic Damage

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That said, the standby team needs to do everything possible to minimize cell death-especially as it relates to the brain. After all, while it shouldn’t be a problem to rebuild an arm, brain damage will likely be more difficult for future medical technology to fix. The fewer brain cells die, the more security we have that the information needed for your future revival has been preserved.

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So let us return to the two points above. Why do we lower the temperature and provide CPS?

• By lowering the body temperature, we put the cells in a state of hypothermia. Hypothermia decreases the metabolic rate by 5% to 7% per 1 C decrease in core body temperature. When the metabolic rate drops, the cells’ need for oxygen drops with it. This means that simply lowering the temperature allows the body to have little or no cellular damage (in optimal cases) for a longer period of time.
• The mechanical chest-compression device, on the other hand, prevents oxygenated blood from stagnating and instead pumps it to all cells and helps in cooling more efficiently. This can be used for as long as needed. Only when the temperature is low enough, and the standby team is ready for the perfusion procedure, will the device be removed.

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How Does Tomorrow Bio Ensure the Fastest Possible Response?

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In ideal cases, providing a fast response is relatively simple. If the standby team is nearby at the time of legal death, and this is declared without delay, the procedure can start immediately.

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Of course, things don't always work out the way we would like. In some cases, for example, death may occur suddenly. Although statistically most deaths occur in the hospital, it’s essential for every cryonics organization to have emergency notification plans in place. At Tomorrow Bio we equip our members with a wristband that carries our phone number. We also provide emergency cards to give to relatives or close people so that they know how to intervene if something unexpected were to happen. Finally, we are developing a notification app that will allow us to check on our members periodically.

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Our standby teams are on call at all times, day and night. We have specially built a standby ambulance for field cryoprotection, in case our members can be reached by car. We also have portable cryopreservation kits that can be carried by plane, ship, or even private medical jet if necessary.

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Things You Can Do to Avoid Delays

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Finally, there are a few things you can do to try to ensure a fast response-and thus high-quality cryopreservation.

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Aside from avoiding extreme sports and informing us in case you want to take a trip to a remote Pacific island or need to undergo an operation, you can prepare yourself from a legal and organizational standpoint. 

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• First, wear the wristband with our emergency number. Some people have gone so far as to tattoo it, but we are not asking you to do that. Just wear the bracelet.

• Second, give the emergency cards to your family and friends and inform them of your choice to be cryopreserved. If you want some tips on how to do this, we have the article for you.

• Third, write a last will. We recommend that you use our template and that you have it in English (you can translate it into your language if necessary, but the English version should be the official one). Formalizing at the notary is not obligatory but can help ensure relatives won’t be able to oppose (and delay) the procedure. This usually doesn't happen but, better safe than sorry.
• Lastly, create a Patient Advance Directive (PAD). Again, we suggest that you use our template. In some cases, a PAD allows us to get notified faster. If you were to enter the hospital unconscious, doctors would check your PAD.

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Wondering where to find all these amazing items? Once you sign up as a Tomorrow Bio member, you receive a Welcome Box in the mail. Inside, we have prepared for you several useful tools for your cryopreservation. Whatever happens, we’ve got you covered.

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Conclusion

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Human cryopreservation is a procedure that allows us to preserve a human body indefinitely. Yet, often a few minutes can make the difference between a high-quality or mediocre procedure.

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We at Tomorrow Bio are prepared for any eventuality. We will get to you quickly and begin the procedure with as little delay (and level of ischemia) as possible.

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Do you want to get to know more about us and our services? Schedule a call and ask us all your questions. If you are already convinced, you can always sign up here. We can’t wait to send you your Welcome Box.