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Every year, thousands of
hospital visits are made
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00:00:27,537 --> 00:00:30,747
because things are stuck
inside the body.
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- [woman 1] Did you get it?
- [doctor] Not yet.
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It’s really stuck in there.
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You can see it and...
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It’s actually in
there pretty deep.
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No matter what it is...
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or how it got there,
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either way, we
have to get it out.
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Seen a lot of crazy stuff.
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[woman gasps]
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Wow! This mucus was
literally stuck there
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probably month to years.
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[doctor 2] Well,
look at all that.
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If you snort drugs
into your nose,
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the cartilage can die
and end up with a huge crusty
hole in your nose.
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One of the worst noses
that you’re gonna see.
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[doctor 3] Yeah, just pull to
the BB
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- right up to the surface.
- Okay.
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[man 1] Lightbulbs, beer
bottles, sports equipment,
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animals.
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The arm, of like,
a little doll.
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Fairly large cockroach.
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My skin crawls
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every time I see someone with
a bug in their ear.
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I don’t know if that’s
the back or a wing
or something.
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Even Christmas ornaments.
And it just gets worse
from there.
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Surgery is nice because
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it’s one of the few
specialties in medicine
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where you actually
get to fix people.
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- You’re a good dude.
- [man 2] Thank you, man. I appreciate it.
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If they’re happy with their
visit, that just makes
your day.
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Thank you so much.
You saved my life.
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[doctor] Here we go!
Look at that.
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[receptionist] Hello.
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- How are you? Good.
- [Shasleen] I’m good, how are you?
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I just need to check my
grandfather in for an appointment.
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All right.
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My name is Shasleen.
His name is Badruddin.
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We are from India.
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My grandfather
doesn’t speak English.
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So, I’m here to translate
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from English to Hindi.
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[Badruddin speaking hindi]
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He thinks that there’s
something inside his ear.
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A bug or something.
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So, he just wants to
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feel better and just
get this bug removed.
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[nurse] You can follow me.
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[Shasleen speaking hindi]
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I’m Dr. Dan Carothers.
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I am a ear, nose
and throat physician.
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I practice in
Atlanta, Georgia.
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I’ve been here for
about ten years
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and I treat adult
and pediatric
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otolaryngology.
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- [Daniel] Hey, guys.
- [Shasleen] Hey.
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I’m Dr. Carothers.
Let’s take a look in your ear.
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My skin crawls
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everytime I see someone
with a bug in their ear.
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Typically, it’s a cockroach.
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A cockroach has spiny legs
and it’ll kinda get stuck
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in the ear canal.
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That’s pretty
terrifying actually.
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[Shasleen] Yeah, so he was
saying that something was
bothering his ear.
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[Daniel] Oh, yes.
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This is a cockroach. I think.
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All right, sir.
We’ll get this out.
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We’re gonna get the other
room ready, okay?
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[speaking hindi]
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I look in the ear and...
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way down in the ear canal,
there’s like...
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this wing that’s
covering the entire body,
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almost like Batman’s cape.
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That’s very, very close
to the eardrum.
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In order to remove that,
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we need to go
to the other room.
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It has a little
three-millimeter telescope
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that I could place
into the ear canal
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to figure out, you know,
what this thing is
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00:04:03,586 --> 00:04:04,726
and get it out.
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[Daniel] We’ll get this
nightmare over for you, okay?
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Just have a seat, right here.
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00:04:09,425 --> 00:04:11,825
Depending on the type of bug
that gets in your ear,
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if it had sharp pointy parts,
in its legs like a cockroach,
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it could actually poke
through your ear drum.
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The bug as it crawls in,
has no way to turn around.
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And so, it just wants
to keep going forward.
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You just wanna get it out
of there as soon as possible.
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So, Mr. Parpiya,
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can you tell me again
exactly what happened?
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Did this occur at night time
when you were sleeping
or what?
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Sleep in the morning.
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[Shasleen] He was taking
a nap in the afternoon.
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00:04:36,486 --> 00:04:38,696
Okay. So, you were in bed?
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00:04:38,721 --> 00:04:39,621
- [Badruddin] Yes.
- Okay.
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00:04:41,057 --> 00:04:42,727
So, he said that
he was just...
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00:04:42,759 --> 00:04:44,459
scratching it
and he felt it, like...
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- Right. Crawling around.
- ...inside. So, yeah.
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Oh my gosh! Wow!
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[Badruddin] I have onion...
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- He said he put onion juice and oil.
- Onion juice.
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Onion juice?
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00:04:52,268 --> 00:04:53,468
Always when his ear hurt,
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he just put onion juice in
there and it works.
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Onion juice? I was
immediately surprised
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at like, you know what
did he do? Just go...
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make some...
juice some onions?
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Or did he have it for, you
know, for cooking purposes?
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I wasn’t sure.
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00:05:05,849 --> 00:05:07,579
But as I think it turned out,
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it was like an ancient Indian
remedy for ear problems,
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as his granddaughter told me.
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So, you made a little brew
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and then you put
it in your ear
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and then it stopped moving?
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- [speaking hindi]
- Okay.
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[Daniel] It appears to be...
It’s not moving. So.
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I think you took
care of that part.
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Let’s take a look.
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So, if you wouldn’t
mind telling him,
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that this part of the ear
canal is pretty sensitive.
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And I’ll do my best to not
have it hurt at all
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but these little creatures,
they’re a little sharp.
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He needs to stay
as still as possible, okay?
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[Shasleen speaking hindi]
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- He said he’ll bear it.
- Okay.
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He seems tough.
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So, I’m gonna go in here
with my little camera
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and we’re gonna take a look
inside the ear canal.
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So, there’s like
a antenna or a leg.
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- [Shasleen] I can’t.
- [both giggle]
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I mean, I couldn’t look at
it, ’cause it was really...
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I don’t know, gross?
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[Daniel] So, I don’t know if
that’s the back or a wing
or something.
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But we’ll go for
the shell I think.
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All right.
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So, I’m gonna use
these tiny alligator forceps
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to remove the bug.
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I’m using a very
small telescope,
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so I’m able to also
put instruments
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inside of his ear.
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And there is an
instrument that we call...
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an alligator,
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which, we probably should find
a better name for that.
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’Cause every time I ask
for an alligator,
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people kind of
are like, "What?"
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So, it looks like a very
small grasping instrument
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and it’s delicate
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and you’re able to grab
small things out of the ear.
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[Daniel] All right.
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[Shasleen]
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[all giggling]
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[Daniel] This looks
like a wing right here.
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Here, can you...
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[Shasleen] Is that it?
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[Daniel] No, no, no.
Unfortunately, it’s not
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agreeing to come out
in one piece.
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When you go in there
and you grasp this bug,
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you’re hoping to get
the whole thing out at once
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but you know, you grasp it
and you just hear this like,
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crackling like it’s like
potato chips or something.
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You know, the little bug legs
and I get nothing.
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And I have to go back
in for more pieces.
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[Shasleen speaking hindi]
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[Daniel] Is this a house fly?
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- Or a bee? What is that?
- [Shasleen] It’s a bee.
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- I guess it’s a bee.
- [Daniel] What in the world?
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[Shasleen] Oh, my God!
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[Daniel] What is this thing?
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[Badruddin speaking hindi]
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[Badruddin] Honey bee.
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[Shasleen] No, it’s
not a honey bee.
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I don’t think it’s
a honey bee.
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[Daniel] When I took it out,
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I mean, the bug
was sort of like...
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a mass of just wetness.
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I don’t know if you have
like a small dog,
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but if your small
dog gets wet,
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it kinda looks like a rat,
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so you have no idea
what it really is.
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[Daniel] I did
not expect that.
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You know what
this probably is?
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I bet this is a moth.
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- [Shasleen] A moth?
- [Daniel] This looks like a moth.
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00:08:03,693 --> 00:08:05,663
Yeah, then that would
make more sense.
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- So...
- [Shasleen] How did a moth go in there?
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I did have a patient
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once that a fly, somehow,
in the hospital, flew...
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up her nose.
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It laid eggs
inside of her nose.
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Come behold the next day,
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maggots were coming
out of her nose.
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That’s probably the grossest
thing I’ve ever seen
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in the nose, to date.
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But that’s not gonna
happen in the ear.
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What had happened
is that she’d gotten
a dental abscess
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00:08:32,488 --> 00:08:35,348
which is the smelliest kind of
sinus infection you can have.
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And I think that’s what
attracted the flies.
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I can hear.
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00:08:39,062 --> 00:08:40,762
Yeah, you can hear now, yeah.
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00:08:40,797 --> 00:08:41,997
[Shasleen] He can hear now.
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He’s very happy altogether.
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00:08:44,367 --> 00:08:46,037
Do you wanna keep this
for your memoirs?
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00:08:46,069 --> 00:08:48,269
- Yes.
- No, dude. Throw it away.
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00:08:48,304 --> 00:08:50,774
At the family get
together on Sunday.
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00:08:50,807 --> 00:08:52,547
Everyone’s gonna
hear about this.
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00:08:56,212 --> 00:08:58,782
All right, sir. This will
never happen again.
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00:08:58,815 --> 00:09:00,115
- Okay?
- [Shasleen] Hopefully.
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00:09:00,149 --> 00:09:01,109
- Let’s hope.
- Thank you.
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00:09:01,150 --> 00:09:03,220
Glad I could help.
You guys have a good day.
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00:09:03,252 --> 00:09:05,022
- You do, too. Thank you so much.
- Yes, we’ll see you anytime.
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00:09:05,054 --> 00:09:06,694
- All right?
- [Shasleen] Yeah, thanks.
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00:09:06,722 --> 00:09:09,062
If he didn’t come in to
see us, that would be there
215
00:09:09,092 --> 00:09:10,622
ten years from now, okay?
216
00:09:10,660 --> 00:09:13,190
That thing was not coming out.
It was totally stuck.
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00:09:13,229 --> 00:09:15,829
But it’s a little terrifying
to have a bug in your
ear, I think.
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00:09:25,108 --> 00:09:26,478
[Brittany] My
name is Brittany.
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00:09:26,509 --> 00:09:29,739
I am 28 years old and I live
in Odenville, Alabama.
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00:09:29,779 --> 00:09:31,079
We’re in cow country.
221
00:09:31,114 --> 00:09:33,514
I’m not into cows.
I’m more of a dog person.
222
00:09:33,549 --> 00:09:34,849
I can’t put them on
a leash or anything.
223
00:09:34,884 --> 00:09:36,454
They can’t be trained at all.
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00:09:38,721 --> 00:09:40,591
I was definitely like
three years single.
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00:09:40,623 --> 00:09:41,453
And so I was--
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00:09:44,260 --> 00:09:45,590
[chuckles]
227
00:09:45,628 --> 00:09:47,188
I ordered like a vibrator.
228
00:09:49,599 --> 00:09:51,759
It was like blue
and it had like three balls
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00:09:51,801 --> 00:09:53,831
and a little vibrator
on it and...
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00:09:53,870 --> 00:09:55,840
I was so excited, as soon
as I got it in the mail,
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00:09:55,872 --> 00:09:57,302
I was like, "Oh,
I’m done. I’m gone."
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00:09:58,107 --> 00:09:59,217
And I was just gonna relax.
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00:09:59,775 --> 00:10:00,945
But, no.
234
00:10:03,112 --> 00:10:04,742
And then you just don’t have
that many hands
235
00:10:04,780 --> 00:10:05,710
and you’re by yourself
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00:10:16,125 --> 00:10:18,225
So, I panicked for like,
20 minutes in there.
237
00:10:18,261 --> 00:10:21,031
And I could feel it
vibrating in my back.
238
00:10:21,063 --> 00:10:23,633
I never would have thought,
my butt was like a vacuum.
239
00:10:23,666 --> 00:10:25,636
What normal
person thinks like...
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00:10:25,668 --> 00:10:27,868
I thought there was like
a wall or something, you know,
241
00:10:27,904 --> 00:10:30,304
to keep things from...
Like, I don’t know.
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00:10:30,339 --> 00:10:32,339
Definitely is not a wall.
So, be careful.
243
00:10:38,114 --> 00:10:41,754
So, it sounds like
this young lady lost...
244
00:10:41,784 --> 00:10:44,224
a foreign body in her rectum.
245
00:10:44,253 --> 00:10:45,623
I’m not sure what
she was doing but
246
00:10:45,655 --> 00:10:49,025
she lost her vibrator and it
kinda got sucked up.
247
00:10:49,659 --> 00:10:51,259
My name is George Crawford.
248
00:10:51,294 --> 00:10:53,994
I am a board certified
general surgeon.
249
00:10:54,030 --> 00:10:56,800
I practice in
Aniston, Alabama.
250
00:10:56,832 --> 00:11:00,232
And I’ve been practicing
about 15, 20 years.
251
00:11:00,269 --> 00:11:02,599
That includes
bariatric surgery,
252
00:11:02,638 --> 00:11:05,138
vascular surgery, as well
as trauma surgery.
253
00:11:05,174 --> 00:11:06,314
Little bit of everything.
254
00:11:06,342 --> 00:11:07,642
[nurse] It’s like
chicken liver...
255
00:11:07,677 --> 00:11:09,447
Chicken liver.
256
00:11:09,478 --> 00:11:12,008
So, you know, the nice part
about general surgery is,
257
00:11:12,048 --> 00:11:13,758
it’s always full of surprises,
258
00:11:13,783 --> 00:11:15,113
whether it’s
the emergency room
259
00:11:15,151 --> 00:11:18,081
or someone being
referred to you in a clinic.
260
00:11:18,120 --> 00:11:20,620
In the emergency room,
a lot of times, we see...
261
00:11:20,656 --> 00:11:23,166
stuff that you kinda would
never really think.
262
00:11:23,192 --> 00:11:25,692
People get shot in the leg,
people get...
263
00:11:25,728 --> 00:11:28,358
a piece of wood
stuck in their arm.
264
00:11:28,397 --> 00:11:30,037
General surgery is kind
of like the one night stand
265
00:11:30,066 --> 00:11:30,966
of medicine.
266
00:11:31,000 --> 00:11:32,630
I mean, you really see people.
267
00:11:32,668 --> 00:11:34,998
You find out what’s wrong with
them, you fix them,
268
00:11:35,037 --> 00:11:36,007
and then, they’re done.
269
00:11:36,038 --> 00:11:37,338
- [George] Hello.
- [Brittany] Hi.
270
00:11:37,373 --> 00:11:38,843
[George] Hey, George
Crawford. How are you doing?
271
00:11:38,874 --> 00:11:40,614
It’s just not what I
planned for the day.
272
00:11:40,643 --> 00:11:42,013
[George] Realistically,
if you think about it,
273
00:11:42,044 --> 00:11:44,214
the rectum is designed
to keep poop off the floor.
274
00:11:44,247 --> 00:11:47,157
So, if you put something
far enough up,
275
00:11:47,183 --> 00:11:49,153
it will go, suck it right up
276
00:11:49,185 --> 00:11:51,855
and if you don’t have a string
on it or something to be
able to get it,
277
00:11:51,887 --> 00:11:53,327
it can get pretty high
278
00:11:53,356 --> 00:11:55,126
and you end up in
the emergency room,
279
00:11:55,157 --> 00:11:56,227
looking at me.
280
00:11:56,259 --> 00:11:57,859
There are two
ways to take it out.
281
00:11:57,893 --> 00:11:59,793
One, is to make a big
incision in your belly,
282
00:11:59,829 --> 00:12:01,789
kind of open it up and milk
it down that way.
283
00:12:01,831 --> 00:12:03,531
We’re gonna
try to not do that.
284
00:12:03,566 --> 00:12:04,836
So, there are two muscles.
285
00:12:04,867 --> 00:12:06,307
One is the internal sphincter
286
00:12:06,335 --> 00:12:08,235
and one is
the external sphincter.
287
00:12:08,271 --> 00:12:09,741
The external
splinter is the one
288
00:12:09,772 --> 00:12:11,002
that you kinda squeeze
your butt cheeks
289
00:12:11,040 --> 00:12:12,740
and holds everything together.
290
00:12:12,775 --> 00:12:16,345
The internal is involuntary.
So, it just kinda...
291
00:12:16,379 --> 00:12:19,709
squeezes on its own, when it
feels pressure, it relaxes.
292
00:12:19,749 --> 00:12:22,549
What we’re gonna do this time
is we’re actually gonna go in
293
00:12:22,585 --> 00:12:24,485
the same way
that you put it in,
294
00:12:24,520 --> 00:12:26,050
with a couple of
long instruments
295
00:12:26,088 --> 00:12:29,358
kinda blowing your colon up
and then, pull it out.
296
00:12:29,392 --> 00:12:31,522
And then, if we can
pull it out that way,
297
00:12:31,560 --> 00:12:33,330
we’ll be able to get
you out of here today.
298
00:12:33,362 --> 00:12:34,392
Okay.
299
00:12:34,430 --> 00:12:35,760
[George] The nice part
about being a surgeon
300
00:12:35,798 --> 00:12:37,728
is being able to take you
take her to
the operating room,
301
00:12:37,767 --> 00:12:39,237
we get to put her to sleep.
302
00:12:39,268 --> 00:12:41,898
She’s comfortable.
She doesn’t feel any pain.
303
00:12:41,937 --> 00:12:43,677
We can go in and do
what we gotta do.
304
00:12:43,706 --> 00:12:46,276
All right, young lady. We got
everything squared away.
305
00:12:46,309 --> 00:12:47,609
We’ll get you taken care of.
306
00:12:47,643 --> 00:12:50,013
So, at this point,
we’re just kinda like...
307
00:12:50,046 --> 00:12:52,446
not worried about
exactly what you did
308
00:12:52,481 --> 00:12:54,111
or what you did with it,
309
00:12:54,150 --> 00:12:56,620
it’s really more how do
we get you taken care of
310
00:12:56,652 --> 00:12:58,422
and get you home,
311
00:12:58,454 --> 00:13:00,894
so that we can continue to
take care of everybody else.
312
00:13:01,324 --> 00:13:02,324
All right.
313
00:13:02,958 --> 00:13:03,988
Thank you, sir.
314
00:13:10,299 --> 00:13:12,159
[George] Can you let the table
up for me, please, mam?
315
00:13:13,002 --> 00:13:14,072
Let’s get it done.
316
00:13:14,103 --> 00:13:15,233
Grasper, please?
317
00:13:15,271 --> 00:13:16,101
[nurse] Yes, sir.
318
00:13:17,807 --> 00:13:21,277
Quick list of the things that
I’ve pulled out of a rectum.
319
00:13:21,310 --> 00:13:23,640
Bunch of dildos,
shampoo bottles.
320
00:13:23,679 --> 00:13:25,279
Beer bottle one time.
321
00:13:25,314 --> 00:13:28,054
One of those little change
purses that you squeeze.
322
00:13:28,084 --> 00:13:30,924
I did pull a crack pipe
out of lady’s butt one time.
323
00:13:30,953 --> 00:13:33,493
She got arrested
for smoking drugs
324
00:13:33,522 --> 00:13:35,892
and she put the crack
pipe in her butt
325
00:13:35,925 --> 00:13:37,195
to hide it from the cops.
326
00:13:38,794 --> 00:13:41,164
[George] You can
see the vibrator.
327
00:13:41,197 --> 00:13:43,507
And it’s actually in
there pretty deep.
328
00:13:43,532 --> 00:13:46,102
When I compare this to what
I saw on the X-RAY,
329
00:13:46,135 --> 00:13:50,405
it looks like it’s not
just a small vibrator.
330
00:13:50,439 --> 00:13:51,839
It’s actually about
eight inches long.
331
00:13:51,874 --> 00:13:53,914
The metal part that
we were looking at,
332
00:13:53,943 --> 00:13:56,813
is really just the battery
and the motor.
333
00:13:56,846 --> 00:13:59,916
So, we’re gonna do now,
is kinda go around it
with the camera
334
00:13:59,949 --> 00:14:02,749
to see if she caused any
damage up higher.
335
00:14:02,785 --> 00:14:05,455
You know worst case scenario
is if you stick something
336
00:14:05,488 --> 00:14:06,358
in your rectum,
337
00:14:06,389 --> 00:14:08,619
it actually goes
through the rectal wall.
338
00:14:08,657 --> 00:14:11,527
If that’s the case, you
actually have a hole
in your rectum
339
00:14:11,560 --> 00:14:14,530
and poop or whatever is
leaking into your abdomen.
340
00:14:14,563 --> 00:14:16,563
And it just gets
worse from there.
341
00:14:18,300 --> 00:14:20,270
[George] So, it’s actually
in there pretty deep.
342
00:14:20,302 --> 00:14:22,802
We’re almost up into
the sigmoid colon.
343
00:14:22,838 --> 00:14:24,668
This just became
a bigger emergency.
344
00:14:32,681 --> 00:14:34,151
[George] So, it’s actually
in there pretty deep.
345
00:14:34,183 --> 00:14:35,953
We’re almost up into
the sigmoid colon.
346
00:14:35,985 --> 00:14:38,685
We don’t see any
evidence of perforation.
347
00:14:38,721 --> 00:14:40,421
So, there’s no
hole in the colon.
348
00:14:40,456 --> 00:14:42,596
So, Brittany came into
the emergency room
349
00:14:42,625 --> 00:14:45,125
after having a vibrator
stuck in her rectum
350
00:14:45,161 --> 00:14:47,261
for about five or six hours.
351
00:14:47,296 --> 00:14:49,536
We’re now, taking her
to the operating room
352
00:14:49,565 --> 00:14:50,765
to get it out
353
00:14:50,800 --> 00:14:53,200
because it’s gone too high for
us to be able to remove it,
354
00:14:53,235 --> 00:14:54,675
while she’s awake.
355
00:14:54,703 --> 00:14:56,043
[George] Patient doing okay?
356
00:14:56,071 --> 00:14:56,971
[nurse]
357
00:14:57,006 --> 00:14:58,106
[George] Great, thank you.
358
00:14:58,140 --> 00:14:59,670
I can see why
she lost her grip.
359
00:14:59,708 --> 00:15:01,938
This thing looks
like it’s silicon
360
00:15:01,977 --> 00:15:03,817
and the ring is
pretty slippery.
361
00:15:07,149 --> 00:15:08,479
There’s no bleeding.
362
00:15:08,517 --> 00:15:10,227
So, I don’t think she
caused any injury
363
00:15:10,252 --> 00:15:12,522
that’s gonna require
more of an operation.
364
00:15:12,555 --> 00:15:14,925
So, what I’m gonna do now, is
just grab it with my grasper,
365
00:15:16,058 --> 00:15:18,658
and then just kinda
slowly got it back,
366
00:15:18,694 --> 00:15:20,494
looking at it to make
sure that we’re not...
367
00:15:20,996 --> 00:15:22,236
injuring anything.
368
00:15:23,766 --> 00:15:24,606
Yeah, got it.
369
00:15:26,235 --> 00:15:28,535
So, we’ve got it to the end.
So, we’ll just pull it out.
370
00:15:35,578 --> 00:15:37,088
I’m glad that we
got this out of her
371
00:15:37,112 --> 00:15:39,012
and it’s not stuck
in there anymore.
372
00:15:39,048 --> 00:15:40,558
[George] Surgery
went fantastic.
373
00:15:40,583 --> 00:15:42,553
We were able to pull it
out through her rectum.
374
00:15:42,585 --> 00:15:44,425
The inside of her
rectum looks great.
375
00:15:44,453 --> 00:15:45,653
So, there was no holes,
376
00:15:45,688 --> 00:15:47,498
no tears and no bleeding.
377
00:15:47,523 --> 00:15:50,193
So, I don’t think she will
have any residual problems
378
00:15:50,226 --> 00:15:52,496
with this and I think
she’ll be able to...
379
00:15:52,528 --> 00:15:54,398
go party another day
without any problems.
380
00:15:58,234 --> 00:16:00,374
[Brittany] The reason
that I shared this story,
381
00:16:00,402 --> 00:16:02,402
and the reason that
I’ve said it so many times,
382
00:16:02,438 --> 00:16:03,508
people are so interested in,
383
00:16:03,539 --> 00:16:05,739
is because you need to
educate yourselves on...
384
00:16:05,774 --> 00:16:07,244
sticking things
inside of your body
385
00:16:07,276 --> 00:16:09,386
because they will go somewhere
and they will get stuck.
386
00:16:09,411 --> 00:16:11,111
[George] All right, Bren.
She should be good.
387
00:16:11,146 --> 00:16:11,986
That’s it.
388
00:16:12,481 --> 00:16:13,381
[Brittany]
389
00:16:15,818 --> 00:16:17,458
and you’re not prepared
for something like that,
390
00:16:22,258 --> 00:16:24,398
Like I would’ve never thought
in a million years, an orgasm
391
00:16:40,276 --> 00:16:42,616
[Lynn] My name is Lynn
and I’m a physician assistant
392
00:16:42,645 --> 00:16:44,445
at the ear, nose
and throat institute.
393
00:16:44,480 --> 00:16:46,480
I have been working
in otolaryngology
394
00:16:46,515 --> 00:16:48,055
for the past one to two years.
395
00:16:48,083 --> 00:16:49,783
And this is actually
my first specialty
396
00:16:49,818 --> 00:16:51,948
out of finishing PA school.
397
00:16:51,987 --> 00:16:54,427
My favorite thing
about working an ENT,
398
00:16:54,456 --> 00:16:57,966
is removing all things that
are stuck in the ear
and the nose.
399
00:16:57,993 --> 00:17:00,293
Today, we have Devon
and his wife in the office
400
00:17:00,329 --> 00:17:03,229
and Devon has not been able
to hear well out his ear
401
00:17:03,265 --> 00:17:04,805
for the past several months.
402
00:17:04,833 --> 00:17:07,433
On top of that, Devon
has had a hearing loss
403
00:17:07,469 --> 00:17:10,469
for years already, that has
been affecting his speech.
404
00:17:10,506 --> 00:17:12,476
So, we’re gonna take
a look inside his ear
405
00:17:12,508 --> 00:17:14,948
and see what’s causing
him to lose its hearing.
406
00:17:16,679 --> 00:17:19,109
- [Lynn] Hello, Mr. Preston.
- [Devon] Hey.
407
00:17:19,148 --> 00:17:21,318
- [Lynn] How are y’all doing today?
- [Devon] Good.
408
00:17:21,350 --> 00:17:23,780
[Devon]
409
00:17:23,819 --> 00:17:25,849
[Lynn] When you can
hear again, huh?
410
00:17:38,400 --> 00:17:39,770
[Lynn] So, what I’m
actually gonna do is,
411
00:17:39,802 --> 00:17:42,032
I’ll show you what the inside
of your ear looks like.
412
00:17:42,071 --> 00:17:42,901
[Devon]
413
00:17:46,642 --> 00:17:48,372
[Lynn] Well, look at all that.
414
00:17:48,410 --> 00:17:51,510
That’s just all wax inside.
415
00:17:51,547 --> 00:17:53,287
So, we can’t see any eardrum.
416
00:17:53,315 --> 00:17:56,385
- It’s just all a lot of wax inside, huh?
- Yeah.
417
00:17:59,254 --> 00:18:00,294
[Devon] This is crazy.
418
00:18:00,322 --> 00:18:01,792
[Lynn] Looking inside
Devon’s ear,
419
00:18:01,824 --> 00:18:03,964
I just see a wall of dark
420
00:18:03,993 --> 00:18:06,293
brown, gooey,
dry looking ear wax
421
00:18:06,328 --> 00:18:08,688
that’s completely
blocking the ear drum.
422
00:18:08,731 --> 00:18:10,501
Looks like it’s actually
completely almost
423
00:18:10,532 --> 00:18:12,762
petrified onto the side
of the ear canal.
424
00:18:16,672 --> 00:18:19,472
[Lynn] It’s a hard
place to look inside.
425
00:18:19,508 --> 00:18:21,468
A build of ear wax over time
426
00:18:21,510 --> 00:18:23,010
can occlude the ear canal
427
00:18:23,045 --> 00:18:25,715
and give you what’s called
a cerumen impaction.
428
00:18:25,748 --> 00:18:29,928
This can lead to dizziness,
hearing loss, ear pressure
429
00:18:29,952 --> 00:18:31,422
and as the years go on,
430
00:18:31,453 --> 00:18:33,853
it gets to be very hard
to remove as well.
431
00:18:33,889 --> 00:18:37,259
So, imagine almost
a fossilized ear
wax in the ear.
432
00:18:37,292 --> 00:18:41,392
So, same thing over here.
A lot of wax inside.
433
00:18:43,298 --> 00:18:45,398
In otolaryngology, or ENT,
434
00:18:45,434 --> 00:18:47,234
we have a number
of different tools
435
00:18:47,269 --> 00:18:50,199
to help us remove ear wax
from patients’ ears.
436
00:18:50,239 --> 00:18:52,139
One of my favorites
is the suction.
437
00:18:54,043 --> 00:18:56,113
[Lynn] So, what I’m gonna use,
is a loud suction.
438
00:18:56,145 --> 00:18:57,515
So, it’s a vacuum.
439
00:18:57,546 --> 00:19:00,186
It essentially forms
a vacuum with just air.
440
00:19:00,215 --> 00:19:02,515
It allows you
to gently peel off
441
00:19:02,551 --> 00:19:04,551
the wax from the side
of the ear canal,
442
00:19:04,586 --> 00:19:05,786
and out of the patient’s ear.
443
00:19:05,821 --> 00:19:06,891
You ready?
444
00:19:08,257 --> 00:19:09,627
[Lynn chuckles] Okay.
445
00:19:12,961 --> 00:19:13,791
I’m sorry.
446
00:19:14,963 --> 00:19:16,733
Suction’s going in.
447
00:19:20,102 --> 00:19:21,802
- Doing okay?
- [Devon] Yeah.
448
00:19:28,410 --> 00:19:30,310
After I used my suction
on his ear,
449
00:19:30,345 --> 00:19:32,385
I noticed that there’s
still quite a bit of wax
450
00:19:32,414 --> 00:19:33,914
that’s remaining inside.
451
00:19:33,949 --> 00:19:37,579
The suction only works if we
have really soft ear wax.
452
00:19:37,619 --> 00:19:39,889
If it’s been inside
for too long,
453
00:19:39,922 --> 00:19:41,152
so that it becomes hard,
454
00:19:41,190 --> 00:19:43,160
the suction really
is not strong enough
455
00:19:43,192 --> 00:19:45,122
to remove the wax
from the ear.
456
00:19:45,160 --> 00:19:48,260
So, I decide to use
my irrigation instead.
457
00:19:48,297 --> 00:19:51,567
[Lynn] So, what we’re gonna do
now, is we’re gonna flush
the ear out.
458
00:19:51,600 --> 00:19:54,600
I think we’ll have you
hold it up to your ear
459
00:19:54,636 --> 00:19:56,906
and there’s a little pocket,
where your ear...
460
00:19:56,939 --> 00:19:59,269
That’s perfect. Yeah.
You’re ready?
461
00:19:59,308 --> 00:20:00,178
- [Devon] Yes.
- [Lynn] Okay.
462
00:20:01,276 --> 00:20:04,186
So, it’s gonna be some
warm water here.
463
00:20:07,549 --> 00:20:08,779
[Devon grunting]
464
00:20:11,687 --> 00:20:13,557
- [Lynn] Doing great.
- [Devon] Yes.
465
00:20:14,790 --> 00:20:16,120
[grunting]
466
00:20:16,158 --> 00:20:17,368
[Lynn] Doing great.
467
00:20:17,392 --> 00:20:18,662
What does it feel like?
468
00:20:18,694 --> 00:20:20,694
[Devon] It feels... [screams]
469
00:20:21,530 --> 00:20:23,200
[speaking indistinctly]
470
00:20:25,167 --> 00:20:28,807
[Lynn] I got a big chunk
of wax out of there.
471
00:20:28,837 --> 00:20:30,507
I’ve seen all sorts
of different things
472
00:20:30,539 --> 00:20:31,839
come out of the ear.
473
00:20:31,874 --> 00:20:34,444
Harder ear wax, flaky ear wax.
474
00:20:34,476 --> 00:20:36,116
Wet and goopy ear wax.
475
00:20:36,145 --> 00:20:39,715
Colors ranging all the way
from bright lemon yellow
476
00:20:39,748 --> 00:20:42,308
to almost have
a black-ish looking color.
477
00:20:42,351 --> 00:20:45,181
I’ve seen wax mixed with
puss inside the ears,
478
00:20:45,220 --> 00:20:46,890
wax mixed with fungus,
479
00:20:46,922 --> 00:20:50,062
bugs come out of ears that
have almost disintegrated
480
00:20:50,092 --> 00:20:51,992
overtime as well.
481
00:20:54,696 --> 00:20:58,006
[Lynn] There’s another big old
piece of wax coming out
his ear.
482
00:21:04,773 --> 00:21:07,013
There’s our big old
piece there.
483
00:21:07,042 --> 00:21:09,882
Look at this big old piece
of wax we got here.
484
00:21:10,712 --> 00:21:12,142
That’s what came
out of your ear.
485
00:21:12,181 --> 00:21:14,011
[Devon]
486
00:21:14,049 --> 00:21:15,879
[Lynn] I’m always
happy to remove
487
00:21:15,918 --> 00:21:18,558
bigger chunks of ear wax
from patients’ ears.
488
00:21:18,587 --> 00:21:21,497
It’s almost satisfying,
just seeing so much relief
489
00:21:21,523 --> 00:21:23,023
from the patient for it.
490
00:21:23,058 --> 00:21:25,658
[Lynn] So, now if I do this,
can you hear this?
491
00:21:25,694 --> 00:21:26,764
- Yeah.
- [Lynn] Yeah.
492
00:21:26,795 --> 00:21:28,595
Now on this side if I do that,
can you hear that?
493
00:21:28,630 --> 00:21:29,760
- [Devon] Yeah.
- [Lynn] Yeah, good.
494
00:21:29,798 --> 00:21:31,728
- And it sounds about the same on both sides?
- Yeah.
495
00:21:31,767 --> 00:21:33,537
[Lynn] Perfect.
496
00:21:33,569 --> 00:21:36,369
I recommend for patients
not to use cotton swabs
497
00:21:36,405 --> 00:21:37,675
to clean their ears,
498
00:21:37,706 --> 00:21:40,016
just because the cotton swab
only gets to the tip of
the wax.
499
00:21:40,042 --> 00:21:41,942
Kind of like the tip
of an iceberg.
500
00:21:41,977 --> 00:21:45,187
The rest of the wax just gets
pushed down further inside,
501
00:21:45,214 --> 00:21:48,084
kind of like packing
the wax like brown sugar.
502
00:21:48,116 --> 00:21:50,586
That’s when it can
damage the ear drum
503
00:21:50,619 --> 00:21:53,889
and it makes the wax really
hard to remove as well.
504
00:21:53,922 --> 00:21:57,192
The longer you wait, the more
wax that your ear makes
505
00:21:57,226 --> 00:22:00,066
and the harder it is
to get that wax out.
506
00:22:00,095 --> 00:22:03,035
If y’all wanna come back
every, say six months or so,
507
00:22:03,065 --> 00:22:05,565
then we can get your ears
cleaned out for you.
508
00:22:05,601 --> 00:22:07,701
That way, we don’t
let it build up
509
00:22:07,736 --> 00:22:10,006
to the point that it starts
affecting your hearing.
510
00:22:10,339 --> 00:22:11,939
[Devon]
511
00:22:13,575 --> 00:22:16,145
[Lynn] Of course, of course.
That’s what we’re here for.
512
00:22:16,812 --> 00:22:18,812
[Devon]
513
00:22:28,190 --> 00:22:29,090
[Devon chuckles]
514
00:22:36,999 --> 00:22:39,029
I was going outside
to check the mail.
515
00:22:40,802 --> 00:22:42,432
[man 2] That’s an impressive
splinter there.
516
00:22:44,439 --> 00:22:45,269
[woman 2] Oh my God!
517
00:23:02,124 --> 00:23:03,624
[chatter]
518
00:23:05,794 --> 00:23:06,834
I’m Dr. Larry Mellick.
519
00:23:06,862 --> 00:23:08,562
I’m an emergency
medicine physician
520
00:23:08,597 --> 00:23:11,567
and I work at the University
of South Alabama Hospitals,
521
00:23:11,600 --> 00:23:13,000
here in Mobile, Alabama.
522
00:23:14,002 --> 00:23:16,602
They call us, sometimes,
adrenaline junkies.
523
00:23:16,638 --> 00:23:19,468
We really thrive
on some excitement.
524
00:23:20,842 --> 00:23:21,672
[woman] Come in.
525
00:23:23,111 --> 00:23:24,441
And so, just everyday,
526
00:23:24,479 --> 00:23:26,709
you never know what you’re
gonna see in the emergency department.
527
00:23:28,350 --> 00:23:30,520
Today, we’ve got a young
girl that comes in
528
00:23:30,552 --> 00:23:33,292
with a massive splinter in
the bottom of her foot.
529
00:23:34,523 --> 00:23:35,923
It’s buried in there.
530
00:23:35,958 --> 00:23:38,468
So, I’ve got my job
cut out for me.
531
00:23:42,664 --> 00:23:46,204
So, this is not your
average run of the mill...
532
00:23:46,568 --> 00:23:47,468
splinter.
533
00:23:47,502 --> 00:23:48,832
[Auhamalai] Yeah.
No, it’s pretty big.
534
00:23:50,172 --> 00:23:52,472
It just feels like
somebody just stabbed me.
535
00:23:53,642 --> 00:23:55,972
Like, straight up like,
stabbed me.
536
00:23:56,011 --> 00:23:59,811
It’s not uncommon to have
patients with splinters.
537
00:23:59,848 --> 00:24:03,048
It’s less common to have
splinters that large.
538
00:24:04,186 --> 00:24:05,356
[Larry] Can you tell
me your story
539
00:24:05,387 --> 00:24:06,857
as to what happened today?
540
00:24:08,924 --> 00:24:11,994
So, it happened when I was
going outside to check
the mail.
541
00:24:13,428 --> 00:24:14,858
[screams]
542
00:24:14,896 --> 00:24:17,706
And that got in
my foot randomly.
543
00:24:17,733 --> 00:24:19,803
Then, I was screaming.
I was like, "Mom, mom!"
544
00:24:19,835 --> 00:24:21,035
I mean, I was worried.
545
00:24:22,938 --> 00:24:24,248
I didn’t know...
546
00:24:24,272 --> 00:24:25,902
what steps I needed to take
547
00:24:25,941 --> 00:24:28,971
and I wanted to make sure
she had the best care.
548
00:24:29,011 --> 00:24:30,011
That’s why we came here.
549
00:24:30,045 --> 00:24:31,745
[Larry] Well,
we’ll get this out.
550
00:24:31,780 --> 00:24:33,250
[woman] Thank you. Good deal.
551
00:24:33,281 --> 00:24:36,151
Those foreign bodies
bring along with them bacteria.
552
00:24:36,184 --> 00:24:38,384
They can actually
cause serious infections,
553
00:24:38,420 --> 00:24:39,420
cellulitis
554
00:24:39,454 --> 00:24:41,554
and bacteria that gets
into the blood stream
555
00:24:41,590 --> 00:24:43,590
causes shock and sepsis.
556
00:24:43,625 --> 00:24:45,095
Obviously, we’re gonna
have to numb her up.
557
00:24:45,127 --> 00:24:45,967
[Auhamalai] Okay.
558
00:24:53,602 --> 00:24:56,702
And we’re gonna have to
protect her from the pain
559
00:24:56,738 --> 00:24:58,738
of just getting
the numbing medications.
560
00:24:58,774 --> 00:25:01,744
So, we’re gonna use a vapor
coolant to spray on that.
561
00:25:03,245 --> 00:25:04,885
[Auhamalai] So,
it should be pretty numb.
562
00:25:04,913 --> 00:25:06,953
Do you feel if I like
manipulate it, moving around?
563
00:25:06,982 --> 00:25:08,052
[Auhamalai] Not really? Good.
564
00:25:08,083 --> 00:25:09,353
Let me know if you
can feel anything,
565
00:25:09,384 --> 00:25:11,054
if it even hurts, okay?
566
00:25:11,086 --> 00:25:13,456
Not much of a difference. It’s
still pretty stuck in there.
567
00:25:14,756 --> 00:25:17,226
[Larry] Splinters can be
really hard to get out.
568
00:25:17,259 --> 00:25:20,129
My goal is to minimize pain
in the children I work with.
569
00:25:23,932 --> 00:25:25,232
[Auhamalai] Do you
feel any of that?
570
00:25:25,267 --> 00:25:26,267
I don’t feel anything.
571
00:25:27,102 --> 00:25:29,002
- I’m happy.
- [Larry] Good, good.
572
00:25:36,778 --> 00:25:38,008
[Larry] That is one tough one.
573
00:25:39,481 --> 00:25:41,381
[Larry] The wood
just breaking apart,
574
00:25:41,416 --> 00:25:43,656
making our job
a 100 times harder.
575
00:25:46,788 --> 00:25:47,888
[Larry] Yeah, I mean,
576
00:25:47,923 --> 00:25:49,223
don’t open it all the way up.
577
00:25:49,257 --> 00:25:51,927
Okay. Give yourself
a little bit more of a point
to assess.
578
00:25:56,498 --> 00:25:57,808
[Auhamalai] Couldn’t
feel any of that?
579
00:25:57,833 --> 00:25:59,163
- [patient] No, sir.
- Good.
580
00:25:59,201 --> 00:26:01,131
[speaking indistinctly]
581
00:26:01,169 --> 00:26:02,469
[Auhamalai] That’s it.
It’s coming out.
582
00:26:05,006 --> 00:26:06,276
- Here you go.
- [Larry] You got it.
583
00:26:06,308 --> 00:26:07,478
Can I take a picture of it?
584
00:26:07,509 --> 00:26:08,539
[Larry] Yeah, take it.
585
00:26:08,577 --> 00:26:10,017
[woman] Think we need to get
our porch replaced?
586
00:26:10,045 --> 00:26:12,385
[all giggle]
587
00:26:13,348 --> 00:26:14,848
[Auhamalai] So,
there’s some of it.
588
00:26:14,883 --> 00:26:16,013
[Larry] It’s not in one piece
589
00:26:17,018 --> 00:26:19,648
but I think we got it all out.
590
00:26:19,688 --> 00:26:21,628
I’m just glad it’s over
with and she’s good.
591
00:26:21,656 --> 00:26:22,626
Yeah, yeah.
592
00:26:23,558 --> 00:26:24,818
[Larry] How was it?
593
00:26:24,860 --> 00:26:26,460
It actually didn’t
hurt at all.
594
00:26:26,495 --> 00:26:27,665
Except for the first part.
595
00:26:27,696 --> 00:26:28,666
[Larry] Okay.
596
00:26:28,697 --> 00:26:30,707
Yeah, once we got your
numbed up, you did good.
597
00:26:30,732 --> 00:26:32,702
Thank you.
I appreciate your help.
598
00:26:32,734 --> 00:26:34,604
[Auhamalai] Now, we’ll just
rinse it up really good.
599
00:26:34,636 --> 00:26:37,676
[Larry] Yeah, just irrigate
the heck out of that then.
600
00:26:37,706 --> 00:26:41,046
The potential for leaving
debris in there was good.
601
00:26:41,076 --> 00:26:44,516
So, we took a catheter with
sailing hooked up to it
602
00:26:45,313 --> 00:26:47,213
and just irrigated
it thoroughly.
603
00:26:48,650 --> 00:26:51,150
To confirm that we didn’t
leave any debris in there,
604
00:26:51,186 --> 00:26:53,856
we got the ultrasound machine
and we got a really good look.
605
00:26:55,724 --> 00:26:57,094
[indistinct]
606
00:26:59,161 --> 00:27:01,061
[Larry] Yeah,
it looks super clean.
607
00:27:02,430 --> 00:27:03,500
We got everything
out of there.
608
00:27:03,532 --> 00:27:06,562
So, it was a success
in that regards.
609
00:27:06,601 --> 00:27:09,671
Unfortunately, a lot of these
are just freak accidents that
610
00:27:09,704 --> 00:27:12,674
you would never have
thought was gonna happen
611
00:27:12,707 --> 00:27:14,077
until it does.
612
00:27:14,109 --> 00:27:16,139
Really, it’s been just
very crazy to me
613
00:27:16,178 --> 00:27:17,848
and it’s a cool story.
614
00:27:17,879 --> 00:27:21,009
Like, it’s probably
never gonna happen again.
615
00:27:21,049 --> 00:27:21,949
Let’s hope not.
616
00:27:31,526 --> 00:27:33,936
What you’re seeing
with Trish is about...
617
00:27:33,962 --> 00:27:36,232
one of the worst noses
that you’re gonna see.
618
00:27:38,266 --> 00:27:40,376
It’s so damaged from
previous infections.
619
00:27:41,903 --> 00:27:45,743
I mean, basically, crusted
from one side to the other.
620
00:27:45,774 --> 00:27:49,414
It just turns into sort of
this rubber cement
glue in there.
621
00:28:17,606 --> 00:28:18,876
[Trish] My name is Trish.
622
00:28:18,907 --> 00:28:22,617
I’m here because I’ve
constantly had sinus infections
623
00:28:22,644 --> 00:28:25,544
and I couldn’t breathe for
a couple of years now.
624
00:28:25,580 --> 00:28:26,950
Morning, Trish.
How are you today?
625
00:28:26,982 --> 00:28:28,282
[Patricia] Good today.
How are you doing?
626
00:28:28,316 --> 00:28:29,286
[Daniel] All right, good.
627
00:28:29,317 --> 00:28:32,227
My infection in my
nose came from
628
00:28:32,254 --> 00:28:34,424
bad habits,
picking in my nose,
629
00:28:34,456 --> 00:28:35,856
illegal drugs and stuff.
630
00:28:36,992 --> 00:28:40,632
So, I was doing bad
things long time ago
631
00:28:40,662 --> 00:28:42,962
that made me to
have to come here.
632
00:28:42,998 --> 00:28:44,908
And have two surgeries.
633
00:28:44,933 --> 00:28:46,973
Just to kind of, recap,
634
00:28:47,002 --> 00:28:48,902
when I saw you
for the first time,
635
00:28:48,937 --> 00:28:50,447
you had had previous
sinus surgery
636
00:28:50,472 --> 00:28:53,172
and then inside of your nose,
was completely blocked.
637
00:28:53,208 --> 00:28:55,278
- Yes.
- You had absolutely no...
638
00:28:55,310 --> 00:28:56,510
ability to breathe.
639
00:28:56,544 --> 00:29:00,314
So, I’ve been seeing Trish
since about last fall.
640
00:29:00,348 --> 00:29:02,148
And as a result of...
641
00:29:02,717 --> 00:29:04,127
some misspent youth,
642
00:29:04,152 --> 00:29:06,922
she had a really bad
situation with her nose.
643
00:29:06,955 --> 00:29:08,595
She had scarring
and there was a...
644
00:29:08,623 --> 00:29:10,923
very large septal perforation
that was crusting
645
00:29:10,959 --> 00:29:12,859
and she couldn’t breath
through her nose at all.
646
00:29:12,894 --> 00:29:15,134
And we did a sinus surgery.
647
00:29:15,163 --> 00:29:17,633
She’s a lot better but I don’t
know if she’s ever gonna be
648
00:29:17,666 --> 00:29:20,106
able to have a completely
normal nose.
649
00:29:20,135 --> 00:29:22,135
[Daniel] What we
were able to do is,
650
00:29:22,170 --> 00:29:24,540
kind of reduce
the turbinate size
651
00:29:24,572 --> 00:29:25,802
open things up
652
00:29:25,840 --> 00:29:28,110
and I think you did
great after that.
653
00:29:28,143 --> 00:29:29,343
Yeah.
654
00:29:29,377 --> 00:29:31,217
And then, we had a little bit
of a... two steps backwards
655
00:29:31,246 --> 00:29:33,486
with a little bit
of an infection.
656
00:29:33,515 --> 00:29:35,115
Right now, I think
what we’re dealing with
657
00:29:35,150 --> 00:29:36,450
is just a little
bit of crusting.
658
00:29:36,484 --> 00:29:39,124
- Yes.
- So, we’ll kind of just clean things out so you can...
659
00:29:39,154 --> 00:29:40,794
- breathe a little better, okay?
- Okay.
660
00:29:40,822 --> 00:29:42,822
I think one of the most
important things
661
00:29:42,857 --> 00:29:45,697
just to feel well is to be
able to breathe through
your nose.
662
00:29:45,727 --> 00:29:48,637
And if you snort drugs
into your nose,
663
00:29:48,663 --> 00:29:50,463
that shrinks
the blood vessels.
664
00:29:50,498 --> 00:29:53,528
And the cartilage, which is
in the middle of the nose,
665
00:29:53,568 --> 00:29:55,068
doesn’t have any blood supply.
666
00:29:55,103 --> 00:29:58,143
And when you take
that blood supply away,
667
00:29:58,173 --> 00:30:02,313
the cartilage can die and end
up with a huge, crusty hole
in your nose.
668
00:30:02,344 --> 00:30:03,414
And it can be quite serious.
669
00:30:04,512 --> 00:30:07,482
Looking inside, you can
see there’s kind of...
670
00:30:07,515 --> 00:30:11,325
discolored mucus
and scabs and crusting.
671
00:30:11,353 --> 00:30:12,853
[Daniel] What you’re
seeing with Trish,
672
00:30:12,887 --> 00:30:16,127
is about one of the worst
noses that you’re gonna see.
673
00:30:17,959 --> 00:30:20,429
It’s so damaged from
previous infections.
674
00:30:20,462 --> 00:30:25,332
I mean, she has basically
crusted from one side
to the other.
675
00:30:25,367 --> 00:30:28,077
So, there’s some crust
in here, that will clean out.
676
00:30:28,103 --> 00:30:30,033
They kind of just get stuck
677
00:30:30,071 --> 00:30:32,501
because of... the membrane’s
a little bit raw.
678
00:30:32,540 --> 00:30:34,670
You know, like, some people
have to get their ears cleaned
679
00:30:34,709 --> 00:30:35,809
with ear wax.
680
00:30:35,844 --> 00:30:37,844
You know, her nose gets
clogged with dried up mucus
681
00:30:37,879 --> 00:30:38,709
and crust.
682
00:30:39,948 --> 00:30:41,788
All right, just tell me
if this is uncomfortable.
683
00:30:41,816 --> 00:30:44,126
We’re not gonna numb this
up ’cause it’s really just
684
00:30:44,152 --> 00:30:45,452
kind of a loose...
685
00:30:45,487 --> 00:30:46,557
scabs that are in here.
686
00:30:49,624 --> 00:30:52,624
I don’t know if you’ll like
ever be completely
rid of this.
687
00:30:52,660 --> 00:30:55,460
We’ll get you on a schedule
to sort of clean things
out intermittently.
688
00:31:06,007 --> 00:31:09,777
In cleaning her nose out,
what we’re finding in there,
689
00:31:09,811 --> 00:31:11,911
is just a combination
of scabs and mucus
690
00:31:11,946 --> 00:31:14,916
and bacterial sort
of colonization.
691
00:31:16,918 --> 00:31:20,588
It just turns into sort of
this rubber cement
glue in there.
692
00:31:20,622 --> 00:31:22,292
If you take that out
in one piece,
693
00:31:22,323 --> 00:31:24,093
it will literally bounce.
694
00:31:24,125 --> 00:31:27,735
You can be holding it and it
will be like, doink, you know.
695
00:31:27,762 --> 00:31:29,532
And that’s so satisfying
to get that out.
696
00:31:33,168 --> 00:31:36,978
So, we’re moving this from
the margin of the septal perforation.
697
00:31:43,678 --> 00:31:45,008
Sorry if that’s
a little uncomfortable.
698
00:31:53,021 --> 00:31:54,991
So, the nose produces
a lot of mucus.
699
00:31:56,191 --> 00:31:58,021
Most people don’t realize
how much it is...
700
00:31:58,059 --> 00:32:00,529
It’s like a court or something
like that a day and it...
701
00:32:00,562 --> 00:32:02,332
it kinda just gets dried up.
702
00:32:04,632 --> 00:32:06,462
So, your nose really
can’t clean itself
703
00:32:06,501 --> 00:32:09,671
like it could before and so...
704
00:32:09,704 --> 00:32:11,604
You know, we have to do
this intermittently
705
00:32:11,639 --> 00:32:13,669
just to kind of get
you back to...
706
00:32:14,509 --> 00:32:15,539
being able to breathe.
707
00:32:19,314 --> 00:32:20,144
So, we’ll get this...
708
00:32:21,382 --> 00:32:23,112
cleaned out and then
we’ll get another culture
709
00:32:23,151 --> 00:32:25,481
and we’ll see if we’re still
dealing with the staff infection
710
00:32:25,520 --> 00:32:26,420
that we had before.
711
00:32:36,931 --> 00:32:38,361
Still a little bit
raw in here.
712
00:32:48,443 --> 00:32:50,643
So, this right here is the...
713
00:32:50,678 --> 00:32:52,508
septum and there’s
supposed to be
714
00:32:52,547 --> 00:32:54,987
a wall here and this
is just all open.
715
00:32:55,016 --> 00:32:56,416
You’ve lost, I don’t know,
716
00:32:56,451 --> 00:32:58,721
80 per cent or more
of your septum.
717
00:32:59,721 --> 00:33:01,421
One last little scab here.
718
00:33:02,924 --> 00:33:04,594
I think her prognosis
is actually
719
00:33:04,626 --> 00:33:07,036
quite good with regard
to function breathing
720
00:33:07,061 --> 00:33:08,891
and her ability to smell
and those types of things.
721
00:33:08,930 --> 00:33:12,160
But just her way back
when remote history
722
00:33:12,200 --> 00:33:13,730
of intra-nasal drug use,
723
00:33:13,768 --> 00:33:15,198
it destroyed her nose.
724
00:33:17,472 --> 00:33:20,072
And you know, that’s something
you end up having to live with
725
00:33:20,108 --> 00:33:21,318
forever, unfortunately.
726
00:33:21,910 --> 00:33:23,170
Okay.
727
00:33:23,211 --> 00:33:24,581
All right.
We’re pretty much done.
728
00:33:24,612 --> 00:33:25,682
Looking good.
729
00:33:25,713 --> 00:33:27,383
- Feel great.
- [Daniel] Yeah.
730
00:33:27,415 --> 00:33:29,055
[Patricia] So, I’m breathing
better now.
731
00:33:29,083 --> 00:33:30,553
There’s no more crust.
732
00:33:30,585 --> 00:33:34,225
The next step is life.
I’m gonna live right.
733
00:33:34,255 --> 00:33:35,795
Keep my nose clean.
734
00:33:37,325 --> 00:33:38,795
And do better things.
735
00:33:38,826 --> 00:33:40,066
Thank you so much.
736
00:33:40,094 --> 00:33:41,464
Good. We’ll see you
in a few weeks, okay?
737
00:33:41,496 --> 00:33:42,566
[Patricia] Okay, thank you.
738
00:33:48,670 --> 00:33:50,800
I’ve got a 16-year-old
young man,
739
00:33:50,838 --> 00:33:53,968
who’s got an earring stuck
in his right ear lobe.
740
00:33:54,008 --> 00:33:56,638
The back of the earring
is totally embedded
741
00:33:56,678 --> 00:33:57,888
in the ear lobe.
742
00:33:57,912 --> 00:34:00,382
[Larry] Here it comes.
743
00:34:00,415 --> 00:34:01,655
Am I causing you
too much pain?
744
00:34:02,784 --> 00:34:04,284
We may have to
get side cutters.
745
00:34:16,931 --> 00:34:18,101
Hey, what do you got?
746
00:34:18,132 --> 00:34:20,672
Oh, I’ve got a 16-year-old
young man,
747
00:34:20,702 --> 00:34:24,072
who’s got an earring stuck
in his right ear lobe.
748
00:34:24,105 --> 00:34:26,145
He noticed it’d been hurting
about a week ago...
749
00:34:26,174 --> 00:34:28,644
- [Larry] Okay.
- ...and then his mom took a look at it last night
750
00:34:28,676 --> 00:34:30,686
and she says the back
of the earring
751
00:34:30,712 --> 00:34:32,912
is totally embedded
in the ear lobe.
752
00:34:32,947 --> 00:34:34,057
Okay.
753
00:34:34,082 --> 00:34:35,812
We’re probably gonna have
to really dig this thing out
754
00:34:35,850 --> 00:34:36,750
- and...
- [Larry] Okay.
755
00:34:36,784 --> 00:34:38,284
He has a pretty
high pain tolerance
756
00:34:38,319 --> 00:34:41,749
because I’ve tried to push it
out without any numbing medicine.
757
00:34:41,789 --> 00:34:44,189
I think we will need to numb
it up to really get it out.
758
00:34:46,861 --> 00:34:48,691
[Zion] My name is Zion Hill.
759
00:34:48,730 --> 00:34:51,030
I attend BC Rain high school.
760
00:34:51,065 --> 00:34:53,935
And I’m trying to get
my earring removed
761
00:34:53,968 --> 00:34:55,998
that’s been bothering
me for a couple of days.
762
00:34:56,037 --> 00:34:57,477
Just ready to get it out.
763
00:34:57,505 --> 00:34:59,505
[Kimberly] I tried
to get it out.
764
00:34:59,540 --> 00:35:01,770
So, I cleaned it and I looked
at and I was like,
765
00:35:01,809 --> 00:35:02,969
"No, this..."
766
00:35:03,011 --> 00:35:04,781
I didn’t see the back
of the earring
767
00:35:04,812 --> 00:35:06,412
and then, when
I flipped the ear,
768
00:35:07,348 --> 00:35:10,618
it was like embedded
inside of the hole.
769
00:35:10,652 --> 00:35:12,352
He was like, "[screaming]."
770
00:35:12,387 --> 00:35:15,357
He was so loud that
it was hurting, so...
771
00:35:15,390 --> 00:35:17,050
I was like, "Okay, let’s...
772
00:35:17,091 --> 00:35:18,191
go to the hospital."
773
00:35:20,361 --> 00:35:21,561
I’m Dr. Larry Mellick
774
00:35:21,596 --> 00:35:24,506
and I’ve been practicing
emergency medicine
775
00:35:24,532 --> 00:35:26,002
for over 40 years.
776
00:35:26,034 --> 00:35:28,474
And I work at the University
of South Alabama.
777
00:35:28,503 --> 00:35:30,303
Today, I have Zion,
a neat young man,
778
00:35:30,338 --> 00:35:32,748
who presents here
with an earring that is...
779
00:35:32,774 --> 00:35:34,914
embedded in the back
of his ear.
780
00:35:34,942 --> 00:35:37,482
Usually, these things are
fairly easy to get out.
781
00:35:37,512 --> 00:35:40,012
Put a little topical numbing
medicine on there,
782
00:35:40,048 --> 00:35:42,718
and pop it out the back
and you’re done.
783
00:35:42,750 --> 00:35:44,150
So, we’re gonna see...
784
00:35:44,185 --> 00:35:45,885
that this is an easy
one to get out
785
00:35:45,920 --> 00:35:47,550
or if there’s gonna
be challenges.
786
00:35:47,588 --> 00:35:49,148
[Larry] Hey, Zion.
787
00:35:49,190 --> 00:35:50,560
So, are you a football player?
788
00:35:50,591 --> 00:35:52,161
- Yes, sir.
- [Larry] You are? Okay.
789
00:35:52,193 --> 00:35:53,063
How’d I guess?
790
00:35:53,094 --> 00:35:54,564
How long is this
been stuck in there?
791
00:35:54,595 --> 00:35:58,005
[Zion] For... It’s been
hurting for about
a week or two.
792
00:35:58,032 --> 00:36:00,102
[Larry] I’m just doing
a little inspection
here on this.
793
00:36:00,968 --> 00:36:03,668
So, as I examine Zion’s ear,
794
00:36:03,705 --> 00:36:06,745
this just isn’t your
average stuck earring.
795
00:36:06,774 --> 00:36:08,174
This is something
a little bit more
796
00:36:08,209 --> 00:36:09,439
complicated.
797
00:36:09,477 --> 00:36:11,717
It might be an early
infection even, too.
798
00:36:11,746 --> 00:36:14,556
Because it’s little red
and it’s swollen.
799
00:36:14,582 --> 00:36:16,082
[Zion] Before
the season started,
800
00:36:16,117 --> 00:36:18,787
it wasn’t hurting as
bad as it is now.
801
00:36:18,820 --> 00:36:21,450
But since the season started,
with my helmet,
802
00:36:21,489 --> 00:36:24,019
and it just banging on it
and banging on it.
803
00:36:24,058 --> 00:36:25,718
It was just like,
gots to get it out.
804
00:36:25,760 --> 00:36:27,290
[Larry] One of my challenges
with Zion is that,
805
00:36:27,328 --> 00:36:29,728
he’s a tough guy,
he takes a lot of pain.
806
00:36:29,764 --> 00:36:32,034
He gets banged up
in football practice
807
00:36:32,066 --> 00:36:35,036
and he has some discomfort
when the helmet hits
that earring.
808
00:36:35,069 --> 00:36:38,199
That... He doesn’t dwell on it
and he just moves on.
809
00:36:38,239 --> 00:36:40,139
And that looks like
it’s infected the
810
00:36:40,174 --> 00:36:43,214
ear lobe is actually
significantly swollen.
811
00:36:43,244 --> 00:36:45,544
A little bit red,
inflamed looking.
812
00:36:45,580 --> 00:36:47,580
And then, behind the ear lobe,
813
00:36:47,615 --> 00:36:50,455
it’s really, what we call, macerated.
814
00:36:50,485 --> 00:36:52,225
It’s really kind of torn up.
815
00:36:52,253 --> 00:36:55,453
And kinda what I would expect
if someone’s a football player,
816
00:36:55,490 --> 00:36:56,990
wearing a helmet, having...
817
00:36:57,024 --> 00:36:58,164
an earring in place.
818
00:36:58,192 --> 00:37:00,892
It’s obviously buried
in there, really deep.
819
00:37:00,928 --> 00:37:02,588
So, that’s gonna be
kind of a challenge, I think,
820
00:37:02,630 --> 00:37:03,490
to get it out.
821
00:37:03,531 --> 00:37:04,931
So, we have
a couple options here.
822
00:37:04,966 --> 00:37:06,966
One of my options
is basically...
823
00:37:07,001 --> 00:37:10,101
to actually inject the longer
acting numbing medicine,
824
00:37:10,138 --> 00:37:11,908
but that’s a little
bit more painful
825
00:37:11,939 --> 00:37:14,639
and if I can just
get by with simply
826
00:37:14,675 --> 00:37:17,115
putting some topical
medication on there,
827
00:37:17,145 --> 00:37:18,745
that’s the direction
I wanna go.
828
00:37:18,780 --> 00:37:20,110
On the other hand,
829
00:37:20,148 --> 00:37:21,858
you’re a lot bigger than I am.
830
00:37:21,883 --> 00:37:22,953
And so,
831
00:37:22,984 --> 00:37:25,684
if I hurt you, you gotta
promise, not to hurt me.
832
00:37:25,720 --> 00:37:27,490
[chuckles] I keep teasing you.
833
00:37:27,522 --> 00:37:28,852
All right, so what
I’m gonna do next,
834
00:37:28,890 --> 00:37:30,620
is I’m gonna go ahead
and clean that off.
835
00:37:31,292 --> 00:37:32,592
Good, good, good.
836
00:37:32,627 --> 00:37:34,967
Okay, Zion, this can
get really cold.
837
00:37:34,996 --> 00:37:36,866
And can be
uncomfortable but just...
838
00:37:36,898 --> 00:37:38,308
be patient with me.
839
00:37:38,332 --> 00:37:40,902
[indistinct chatter]
840
00:37:44,238 --> 00:37:45,968
[Larry] I think we will
probably put him
841
00:37:46,007 --> 00:37:47,877
on some antibiotics
for a couple days.
842
00:37:49,844 --> 00:37:51,484
Okay. It’s nice and frosty.
843
00:37:51,512 --> 00:37:52,782
There’s a number
of different ways
844
00:37:52,814 --> 00:37:54,054
I can approach this.
845
00:37:54,081 --> 00:37:57,111
And what I generally
find works best
846
00:37:57,151 --> 00:37:59,321
is to put some topical
numbing medicine
847
00:37:59,353 --> 00:38:00,583
on top of that.
848
00:38:00,621 --> 00:38:03,321
Then, I also have a vapor
coolant, which is
a freezy spray.
849
00:38:03,357 --> 00:38:05,067
Then work fast.
850
00:38:05,092 --> 00:38:06,122
[nurse] I’m gonna apply this.
851
00:38:06,160 --> 00:38:07,860
It’s like a really
thick lotion
852
00:38:07,895 --> 00:38:10,665
around the top
of the earring here.
853
00:38:10,698 --> 00:38:13,298
[Larry] If Zion had never told
his mother about this,
854
00:38:13,334 --> 00:38:14,874
and didn’t come in today,
855
00:38:14,902 --> 00:38:18,672
and just allowed this earring
to stay buried there,
856
00:38:18,706 --> 00:38:19,976
body’s gonna respond to that,
857
00:38:20,007 --> 00:38:23,017
the body’s gonna try
and take it out itself.
858
00:38:23,044 --> 00:38:25,514
And that’s gonna be
an inflammatory reaction.
859
00:38:25,546 --> 00:38:29,316
And with inflammatory
reactions come
secondary infections.
860
00:38:29,350 --> 00:38:31,150
Some patients
come in with a...
861
00:38:31,185 --> 00:38:33,985
pericarditis, which is
a big word, meaning,
862
00:38:34,021 --> 00:38:35,891
that the cartilage
is now infected.
863
00:38:35,923 --> 00:38:39,423
Those are even more
complicated problems.
864
00:38:39,460 --> 00:38:40,660
So, the longer it’s in there,
865
00:38:40,695 --> 00:38:42,995
there’s gonna be a very
unattractive scar
866
00:38:43,030 --> 00:38:44,860
and that’s part of the reason
we need to get it out.
867
00:38:44,899 --> 00:38:46,359
We need to get it out now.
868
00:38:46,400 --> 00:38:47,870
[Larry] Does that feel
a little bit number?
869
00:38:47,902 --> 00:38:49,872
Now that we put this
medicine on there?
870
00:38:49,904 --> 00:38:50,774
[Zion] Oh, yes, sir.
871
00:38:50,805 --> 00:38:51,645
[Larry] It does, okay.
872
00:38:52,974 --> 00:38:55,014
You can see that, right?
That baby right there.
873
00:38:55,042 --> 00:38:56,742
I think it will poke
through, nicely.
874
00:38:56,777 --> 00:38:58,517
The worst case scenario
would actually having to
875
00:38:58,546 --> 00:38:59,886
take a blade, that will
go in there and...
876
00:38:59,914 --> 00:39:03,184
and open up the back and we’ve
done that on occasion too.
877
00:39:03,217 --> 00:39:06,087
The problem is,
as ear lobe gets more swollen,
878
00:39:06,120 --> 00:39:08,550
then, it gets harder
and harder to...
879
00:39:09,123 --> 00:39:10,023
find.
880
00:39:10,057 --> 00:39:11,927
Especially if it’s
a small earring.
881
00:39:11,959 --> 00:39:13,019
[Larry] All right, here goes.
882
00:39:13,060 --> 00:39:15,190
I’m just gonna see if I can
just poke that baby
883
00:39:15,229 --> 00:39:16,089
right off through there,
884
00:39:16,130 --> 00:39:17,830
without causing
you too much pain.
885
00:39:19,433 --> 00:39:20,263
Here it comes.
886
00:39:20,902 --> 00:39:22,372
Here it comes.
887
00:39:22,403 --> 00:39:24,343
It’s on there
but it’s coming...
888
00:39:29,810 --> 00:39:30,980
We’re making progress.
889
00:39:35,850 --> 00:39:38,120
If I have to stop and re...
890
00:39:38,152 --> 00:39:40,252
spray you with
that cold stuff, I can.
891
00:39:40,922 --> 00:39:42,622
But I’m just about there.
892
00:39:42,657 --> 00:39:44,427
[nurse] And it screws on.
893
00:39:44,458 --> 00:39:46,388
[Larry] Yeah. So, there it is.
There it is. You got it.
894
00:39:46,427 --> 00:39:48,337
- I think that--
- [nurse] Oh, it screws on. Okay.
895
00:39:48,362 --> 00:39:50,392
Yeah.
896
00:39:50,431 --> 00:39:52,461
- [Larry] It’s coming.
- [nurse] Here we go.
897
00:39:52,500 --> 00:39:53,960
[Larry] That baby
was buried in there.
898
00:39:55,636 --> 00:39:56,836
You know,
these football players,
899
00:39:56,871 --> 00:39:57,971
they don’t feel any pain.
900
00:39:58,005 --> 00:39:59,505
[giggles]
901
00:39:59,540 --> 00:40:01,440
[Larry] Okay.
So, I got it out.
902
00:40:01,475 --> 00:40:03,575
All right, so let me
see if I can just...
903
00:40:03,611 --> 00:40:05,611
Lefty-loosey,
righty-tighty, right?
904
00:40:08,115 --> 00:40:10,155
This is like bent,
a little bit.
905
00:40:10,184 --> 00:40:11,424
[Larry] The backing
of this earring
906
00:40:11,452 --> 00:40:13,782
is a screw on type earring
and I can’t unscrew it
907
00:40:13,821 --> 00:40:15,621
because the stem is bent.
908
00:40:15,656 --> 00:40:17,766
And obviously, I can’t
pull it out the front.
909
00:40:17,792 --> 00:40:19,692
And I can’t pull
it out the back.
910
00:40:19,727 --> 00:40:21,997
So, I need to figure
out what to do next.
911
00:40:22,029 --> 00:40:23,159
[nurse] We might
have to cut it.
912
00:40:23,197 --> 00:40:24,207
[Larry] Yeah.
913
00:40:24,231 --> 00:40:26,261
Would you be upset
if I just cut this off?
914
00:40:26,300 --> 00:40:27,930
- [Zion] You talking about the earring? No.
- Yeah.
915
00:40:27,969 --> 00:40:29,429
[Larry] Okay, good
enough, all right.
916
00:40:29,470 --> 00:40:31,400
Let me go grab
some tools here.
917
00:40:32,873 --> 00:40:35,513
My next choice
is to cut it off.
918
00:40:36,210 --> 00:40:38,210
I don’t necessarily have
919
00:40:38,245 --> 00:40:40,855
a lot of tools for
that sort of thing
920
00:40:40,881 --> 00:40:43,181
but I’ve learned
over the years that
921
00:40:43,217 --> 00:40:45,887
a good side cutter,
a good wire cutter,
922
00:40:45,920 --> 00:40:49,150
comes in valuable sometimes
in the emergency department.
923
00:40:49,190 --> 00:40:51,290
I’m gonna do the freezy
spray one more time.
924
00:40:51,325 --> 00:40:53,825
Because I wanna minimize
the discomfort here, but...
925
00:40:53,861 --> 00:40:56,061
Let me know if it
bothers you, so.
926
00:41:11,912 --> 00:41:12,742
[Larry] Got it.
927
00:41:13,280 --> 00:41:14,110
Came out.
928
00:41:15,082 --> 00:41:16,852
You know, I hated to think
I might have been
929
00:41:16,884 --> 00:41:18,984
beaten by an earring
but we got it.
930
00:41:19,020 --> 00:41:20,550
I love victories like this.
931
00:41:20,588 --> 00:41:22,658
And you know,
it was a little bit concerning
932
00:41:22,690 --> 00:41:25,690
that we weren’t gonna be
able to easily get this off.
933
00:41:25,726 --> 00:41:27,096
Your earring.
934
00:41:27,128 --> 00:41:29,938
And you know, obviously,
I don’t wanna consult
any of my...
935
00:41:30,631 --> 00:41:31,861
specialty colleagues.
936
00:41:31,899 --> 00:41:33,199
I need to do this myself.
937
00:41:33,234 --> 00:41:34,604
But we were successful here.
938
00:41:34,635 --> 00:41:36,005
Unfortunately,
I had to cut it.
939
00:41:36,037 --> 00:41:38,077
I mean, if you had decided,
"Look, hey, I’m just gonna...
940
00:41:38,105 --> 00:41:40,845
I’m gonna do a nose piercing,
instead of my ear",
941
00:41:40,875 --> 00:41:42,515
you could have reused it,
but you know,
942
00:41:42,543 --> 00:41:44,143
guess we’re out of luck now.
943
00:41:45,613 --> 00:41:47,183
[Kimberly] I think
he’s done with you.
944
00:41:47,214 --> 00:41:48,054
[Zion] Yeah.
945
00:41:49,250 --> 00:41:51,050
[Kimberly] I’m proud
of him, he did a good job.
946
00:41:51,085 --> 00:41:52,485
I’m glad he’s feeling better.
947
00:41:53,087 --> 00:41:54,457
I was worried.
948
00:41:54,488 --> 00:41:56,548
’Cause he’d been in
pain for a while now.
949
00:41:56,590 --> 00:41:58,220
So, I’m glad it’s over.
950
00:41:58,259 --> 00:41:59,619
I’m glad you’re
feeling better.
951
00:41:59,660 --> 00:42:02,430
All right, thanks, Zion.
You’re a good sport.
952
00:42:02,463 --> 00:42:04,063
- [Kimberly] Thank you.
- [Larry] Appreciate it.
953
00:42:07,968 --> 00:42:10,098
That’s just stuck
in your sinuses.
954
00:42:10,137 --> 00:42:12,447
This mucus was
literally stuck there
955
00:42:12,473 --> 00:42:13,973
probably months to years.
956
00:42:14,008 --> 00:42:15,618
[Lynn] This was wax out of
that one ear.
957
00:42:15,643 --> 00:42:20,313
[woman] Walk around like
I’m cute, but that is just eeew.
958
00:42:20,347 --> 00:42:23,787
Our cannister is full
of all kinds of loveliness.
959
00:42:23,818 --> 00:42:26,928
[Lynn] From ear wax,
to puss, to fungus.
960
00:42:26,954 --> 00:42:28,154
To foreign bodies.
961
00:42:28,189 --> 00:42:30,289
[man] A ER physician
tried to pull it out
962
00:42:30,324 --> 00:42:32,164
and it’s actually
in there pretty good.
963
00:42:32,193 --> 00:42:33,663
[man 2] Ah,
there goes the nail.
964
00:42:33,694 --> 00:42:35,334
[man 3] The immense
pain at that point,
965
00:42:35,362 --> 00:42:37,832
it really felt like my
muscles ripping out.