Living With Thalassemia Inspired the Creation of an Anemia Detection App

Editor’s Note: This article is for informational purposes only. You should not use it to replace any professional medical advice, diagnosis, or treatment of any health issues. Any questions about your blood health should be directed toward a physician, hematologist, or other licensed healthcare professional.

Sanguina’s Chief Technology Officer, Rob Mannino, knows first-hand how important medical advancements can be.

It’s not uncommon for children, dogs, or cats to make unscheduled Zoom cameos, but for Rob Mannino’s team the interruption is often a life-saving procedure.

“Everyone at my company has a story of when they first saw me at a transfusion where I was interrupted…to have a new blood bag hung up,” Rob, Sanguina’s chief technology officer, says. “It’s jarring at first, but I think everyone gets used to it, and then we just kind of go about our day.”

Rob has a rare blood disorder called beta thalassemia major. As a result, he needs to undergo monthly blood transfusions to stay alive. Each transfusion requires as many as five blood donations. 

Work calls are just one of the ways he’s able to pass the time during the hours-long transfusions. “It’s the easiest thing to do while I’m stuck in the chair.” 

But there’s another thing that motivates Rob to keep working, even from the hospital — and that’s his goal of providing accessible health screening tools to people just like him.

“My main motivation for getting up every day and logging on to my computer and going to work is that goal to get AnemoCheck mobile into patients’ hands,” he says. “I am 100% focused on that.”

What is Thalassemia?

Thalassemia is a genetic blood disorder that causes patients’ bodies to have less hemoglobin than normal. There are two types: alpha and beta, and the type and severity depend on which genes are affected, according to the Mayo Clinic. It should be noted that both parents must possess the thalassemia gene for it to be passed onto a child

Rob’s chronically low hemoglobin means his body can’t produce blood like most people.

“So all of the blood in my body comes from donations,” he explains. The red blood cells from those donations, though, die off and he’s unable to replenish them due to his condition. 

“It’s just the body’s natural process that removes dead red blood cells just like it does for everyone else,” he says. “I just can’t replace them.” 

Thalassemia can be mild and not require any treatment, but for some–like Rob–it could require a lifetime of medical attention. But what that looks like has changed over the years. 

‘I Really Want to See That Happen’ 

Rob knows first-hand how important medical advances are to patients like himself. As a child, he had to take a medicine to help with iron overload in the body (a consequence of the transfusions) that came in the form of a pump. 

“I would have to inject myself as a little kid, which, as you can imagine, would not always go very well and I would have lots of bruises,” he says. “I had missed doses and it was generally a very uncomfortable experience. The pump was bulky and loud. It would keep me up at night. It would limit the amount of positions I could sleep in.” 

As medical technology became more refined, the pump got smaller and quieter and when Rob was in high school it became available in pill form. “So I went from having to stick myself with a needle, have an injection over the course of 10 hours every night to just taking a pill once a day in the morning, which just made significant improvements to my quality of life and just made me so much happier.” 

Rob and Wilbur worked together to create Anemocheck mobile to help monitor conditions like thalassemia
Rob and Wilbur with an early version of AnemoCheck Mobile in 2019.

His personal experience inspired him to find ways to help people just like him. So when he got a chance to work alongside Dr. Wilbur Lam, a hematologist and professor at Georgia Institute of Technology’s Department of Biomedical Engineering, he had to accept it. 

“I wanted to do research with him because his research field was exactly what I was interested in, and he treats patients just like me,” he says. 

His research focused on the paleness of people’s fingernails, and how that might correlate with anemia. Paleness is a symptom of anemia. He thought there could be a way to check the paleness of one’s fingernails with a smartphone camera and determine their hemoglobin levels.

As it turned out, Rob was the perfect person to test his theory on. 

Right after his transfusions Rob has high hemoglobin because he just received a bunch of new red blood cells, but as the month goes on that number drops as the red blood cells die off. 

“I was actually able to take pictures of my fingernails and then get regular blood draws and see how the color of my fingernails was correlating with my actual blood hemoglobin levels,” he recalls. “And we noticed that there was a correlation there.”

His research also looked into adjusting the algorithm for different smartphone cameras’ exposure times, brightness, and shutter speed. All that work led to the creation of AnemoCheck Mobile, the first smartphone app to instantly estimate your hemoglobin levels with just a fingernail selfie. 

Rob’s new mission is to get the app into people’s hands so they can take a more proactive approach to their health. 

“I want to see this idea that I had become a real physical thing and actually help people,” he says. “I really want to see that happen.” 

How AnemoCheck Mobile Can Help People with Anemia or Thalassemia 

Rob receives different amounts of blood every month depending on where his hemoglobin levels are at the time—but how much is put aside for him isn’t an exact science. 

“My medical team pretty much guesses what my hemoglobin level is going to be, and that’s how they decide how much blood to give me,” he says. That may cause the procedure to be delayed if they don’t have enough for him, which can result in him feeling even more fatigue, or blood being wasted if too much is reserved for him (excess units, unfortunately, can’t always be reused for other purposes). 

AnemoCheck Mobile gives him a better idea of where his hemoglobin levels are so he can work alongside his team to make more informed health decisions.

“I could much more accurately schedule these things and coordinate with my care team to make sure that I was getting exactly what I needed when I needed it,” he says. 

He hopes other patients find similar success using the app

“I will be satisfied if I have any amount of individuals using the app and it’s improving their lives in some way,” he says, “whether it’s helping them manage a transfusion schedule, or helping them understand why they’re feeling the way they’re feeling with anemia, or helping them just track and manage a condition that they know about. That will make me happy.” 

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