Every year, thousands of hospital visits are made
because things are stuck inside the body.
- [woman 1] Did you get it? - [doctor] Not yet.
It’s really stuck in there.
You can see it and...
It’s actually in there pretty deep.
No matter what it is...
or how it got there,
either way, we have to get it out.
Seen a lot of crazy stuff.
[woman gasps]
Wow! This mucus was literally stuck there
probably month to years.
[doctor 2] Well, look at all that.
If you snort drugs into your nose,
the cartilage can die and end up with a huge crusty hole in your nose.
One of the worst noses that you’re gonna see.
[doctor 3] Yeah, just pull to the BB
- right up to the surface. - Okay.
[man 1] Lightbulbs, beer bottles, sports equipment,
animals.
The arm, of like, a little doll.
Fairly large cockroach.
My skin crawls
every time I see someone with a bug in their ear.
I don’t know if that’s the back or a wing or something.
Even Christmas ornaments. And it just gets worse from there.
Surgery is nice because
it’s one of the few specialties in medicine
where you actually get to fix people.
- You’re a good dude. - [man 2] Thank you, man. I appreciate it.
If they’re happy with their visit, that just makes your day.
Thank you so much. You saved my life.
[doctor] Here we go! Look at that.
[receptionist] Hello.
- How are you? Good. - [Shasleen] I’m good, how are you?
I just need to check my grandfather in for an appointment.
All right.
My name is Shasleen. His name is Badruddin.
We are from India.
My grandfather doesn’t speak English.
So, I’m here to translate
from English to Hindi.
[Badruddin speaking hindi]
He thinks that there’s something inside his ear.
A bug or something.
So, he just wants to
feel better and just get this bug removed.
[nurse] You can follow me.
[Shasleen speaking hindi]
I’m Dr. Dan Carothers.
I am a ear, nose and throat physician.
I practice in Atlanta, Georgia.
I’ve been here for about ten years
and I treat adult and pediatric
otolaryngology.
- [Daniel] Hey, guys. - [Shasleen] Hey.
I’m Dr. Carothers. Let’s take a look in your ear.
My skin crawls
everytime I see someone with a bug in their ear.
Typically, it’s a cockroach.
A cockroach has spiny legs and it’ll kinda get stuck
in the ear canal.
That’s pretty terrifying actually.
[Shasleen] Yeah, so he was saying that something was bothering his ear.
[Daniel] Oh, yes.
This is a cockroach. I think.
All right, sir. We’ll get this out.
We’re gonna get the other room ready, okay?
[speaking hindi]
I look in the ear and...
way down in the ear canal, there’s like...
this wing that’s covering the entire body,
almost like Batman’s cape.
That’s very, very close to the eardrum.
In order to remove that,
we need to go to the other room.
It has a little three-millimeter telescope
that I could place into the ear canal
to figure out, you know, what this thing is
and get it out.
[Daniel] We’ll get this nightmare over for you, okay?
Just have a seat, right here.
Depending on the type of bug that gets in your ear,
if it had sharp pointy parts, in its legs like a cockroach,
it could actually poke through your ear drum.
The bug as it crawls in, has no way to turn around.
And so, it just wants to keep going forward.
You just wanna get it out of there as soon as possible.
So, Mr. Parpiya,
can you tell me again exactly what happened?
Did this occur at night time when you were sleeping or what?
Sleep in the morning.
[Shasleen] He was taking a nap in the afternoon.
Okay. So, you were in bed?
- [Badruddin] Yes. - Okay.
So, he said that he was just...
scratching it and he felt it, like...
- Right. Crawling around. - ...inside. So, yeah.
Oh my gosh! Wow!
[Badruddin] I have onion...
- He said he put onion juice and oil. - Onion juice.
Onion juice?
Always when his ear hurt,
he just put onion juice in there and it works.
Onion juice? I was immediately surprised
at like, you know what did he do? Just go...
make some... juice some onions?
Or did he have it for, you know, for cooking purposes?
I wasn’t sure.
But as I think it turned out,
it was like an ancient Indian remedy for ear problems,
as his granddaughter told me.
So, you made a little brew
and then you put it in your ear
and then it stopped moving?
- [speaking hindi] - Okay.
[Daniel] It appears to be... It’s not moving. So.
I think you took care of that part.
Let’s take a look.
So, if you wouldn’t mind telling him,
that this part of the ear canal is pretty sensitive.
And I’ll do my best to not have it hurt at all
but these little creatures, they’re a little sharp.
He needs to stay as still as possible, okay?
[Shasleen speaking hindi]
- He said he’ll bear it. - Okay.
He seems tough.
So, I’m gonna go in here with my little camera
and we’re gonna take a look inside the ear canal.
So, there’s like a antenna or a leg.
- [Shasleen] I can’t. - [both giggle]
I mean, I couldn’t look at it, ’cause it was really...
I don’t know, gross?
[Daniel] So, I don’t know if that’s the back or a wing or something.
But we’ll go for the shell I think.
All right.
So, I’m gonna use these tiny alligator forceps
to remove the bug.
I’m using a very small telescope,
so I’m able to also put instruments
inside of his ear.
And there is an instrument that we call...
an alligator,
which, we probably should find a better name for that.
’Cause every time I ask for an alligator,
people kind of are like, "What?"
So, it looks like a very small grasping instrument
and it’s delicate
and you’re able to grab small things out of the ear.
[Daniel] All right.
[Shasleen]
[all giggling]
[Daniel] This looks like a wing right here.
Here, can you...
[Shasleen] Is that it?
[Daniel] No, no, no. Unfortunately, it’s not
agreeing to come out in one piece.
When you go in there and you grasp this bug,
you’re hoping to get the whole thing out at once
but you know, you grasp it and you just hear this like,
crackling like it’s like potato chips or something.
You know, the little bug legs and I get nothing.
And I have to go back in for more pieces.
[Shasleen speaking hindi]
[Daniel] Is this a house fly?
- Or a bee? What is that? - [Shasleen] It’s a bee.
- I guess it’s a bee. - [Daniel] What in the world?
[Shasleen] Oh, my God!
[Daniel] What is this thing?
[Badruddin speaking hindi]
[Badruddin] Honey bee.
[Shasleen] No, it’s not a honey bee.
I don’t think it’s a honey bee.
[Daniel] When I took it out,
I mean, the bug was sort of like...
a mass of just wetness.
I don’t know if you have like a small dog,
but if your small dog gets wet,
it kinda looks like a rat,
so you have no idea what it really is.
[Daniel] I did not expect that.
You know what this probably is?
I bet this is a moth.
- [Shasleen] A moth? - [Daniel] This looks like a moth.
Yeah, then that would make more sense.
- So... - [Shasleen] How did a moth go in there?
I did have a patient
once that a fly, somehow, in the hospital, flew...
up her nose.
It laid eggs inside of her nose.
Come behold the next day,
maggots were coming out of her nose.
That’s probably the grossest thing I’ve ever seen
in the nose, to date.
But that’s not gonna happen in the ear.
What had happened is that she’d gotten a dental abscess
which is the smelliest kind of sinus infection you can have.
And I think that’s what attracted the flies.
I can hear.
Yeah, you can hear now, yeah.
[Shasleen] He can hear now.
He’s very happy altogether.
Do you wanna keep this for your memoirs?
- Yes. - No, dude. Throw it away.
At the family get together on Sunday.
Everyone’s gonna hear about this.
All right, sir. This will never happen again.
- Okay? - [Shasleen] Hopefully.
- Let’s hope. - Thank you.
Glad I could help. You guys have a good day.
- You do, too. Thank you so much. - Yes, we’ll see you anytime.
- All right? - [Shasleen] Yeah, thanks.
If he didn’t come in to see us, that would be there
ten years from now, okay?
That thing was not coming out. It was totally stuck.
But it’s a little terrifying to have a bug in your ear, I think.
[Brittany] My name is Brittany.
I am 28 years old and I live in Odenville, Alabama.
We’re in cow country.
I’m not into cows. I’m more of a dog person.
I can’t put them on a leash or anything.
They can’t be trained at all.
I was definitely like three years single.
And so I was--
[chuckles]
I ordered like a vibrator.
It was like blue and it had like three balls
and a little vibrator on it and...
I was so excited, as soon as I got it in the mail,
I was like, "Oh, I’m done. I’m gone."
And I was just gonna relax.
But, no.
And then you just don’t have that many hands
and you’re by yourself
So, I panicked for like, 20 minutes in there.
And I could feel it vibrating in my back.
I never would have thought, my butt was like a vacuum.
What normal person thinks like...
I thought there was like a wall or something, you know,
to keep things from... Like, I don’t know.
Definitely is not a wall. So, be careful.
So, it sounds like this young lady lost...
a foreign body in her rectum.
I’m not sure what she was doing but
she lost her vibrator and it kinda got sucked up.
My name is George Crawford.
I am a board certified general surgeon.
I practice in Aniston, Alabama.
And I’ve been practicing about 15, 20 years.
That includes bariatric surgery,
vascular surgery, as well as trauma surgery.
Little bit of everything.
[nurse] It’s like chicken liver...
Chicken liver.
So, you know, the nice part about general surgery is,
it’s always full of surprises,
whether it’s the emergency room
or someone being referred to you in a clinic.
In the emergency room, a lot of times, we see...
stuff that you kinda would never really think.
People get shot in the leg, people get...
a piece of wood stuck in their arm.
General surgery is kind of like the one night stand
of medicine.
I mean, you really see people.
You find out what’s wrong with them, you fix them,
and then, they’re done.
- [George] Hello. - [Brittany] Hi.
[George] Hey, George Crawford. How are you doing?
It’s just not what I planned for the day.
[George] Realistically, if you think about it,
the rectum is designed to keep poop off the floor.
So, if you put something far enough up,
it will go, suck it right up
and if you don’t have a string on it or something to be able to get it,
it can get pretty high
and you end up in the emergency room,
looking at me.
There are two ways to take it out.
One, is to make a big incision in your belly,
kind of open it up and milk it down that way.
We’re gonna try to not do that.
So, there are two muscles.
One is the internal sphincter
and one is the external sphincter.
The external splinter is the one
that you kinda squeeze your butt cheeks
and holds everything together.
The internal is involuntary. So, it just kinda...
squeezes on its own, when it feels pressure, it relaxes.
What we’re gonna do this time is we’re actually gonna go in
the same way that you put it in,
with a couple of long instruments
kinda blowing your colon up and then, pull it out.
And then, if we can pull it out that way,
we’ll be able to get you out of here today.
Okay.
[George] The nice part about being a surgeon
is being able to take you take her to the operating room,
we get to put her to sleep.
She’s comfortable. She doesn’t feel any pain.
We can go in and do what we gotta do.
All right, young lady. We got everything squared away.
We’ll get you taken care of.
So, at this point, we’re just kinda like...
not worried about exactly what you did
or what you did with it,
it’s really more how do we get you taken care of
and get you home,
so that we can continue to take care of everybody else.
All right.
Thank you, sir.
[George] Can you let the table up for me, please, mam?
Let’s get it done.
Grasper, please?
[nurse] Yes, sir.
Quick list of the things that I’ve pulled out of a rectum.
Bunch of dildos, shampoo bottles.
Beer bottle one time.
One of those little change purses that you squeeze.
I did pull a crack pipe out of lady’s butt one time.
She got arrested for smoking drugs
and she put the crack pipe in her butt
to hide it from the cops.
[George] You can see the vibrator.
And it’s actually in there pretty deep.
When I compare this to what I saw on the X-RAY,
it looks like it’s not just a small vibrator.
It’s actually about eight inches long.
The metal part that we were looking at,
is really just the battery and the motor.
So, we’re gonna do now, is kinda go around it with the camera
to see if she caused any damage up higher.
You know worst case scenario is if you stick something
in your rectum,
it actually goes through the rectal wall.
If that’s the case, you actually have a hole in your rectum
and poop or whatever is leaking into your abdomen.
And it just gets worse from there.
[George] So, it’s actually in there pretty deep.
We’re almost up into the sigmoid colon.
This just became a bigger emergency.
[George] So, it’s actually in there pretty deep.
We’re almost up into the sigmoid colon.
We don’t see any evidence of perforation.
So, there’s no hole in the colon.
So, Brittany came into the emergency room
after having a vibrator stuck in her rectum
for about five or six hours.
We’re now, taking her to the operating room
to get it out
because it’s gone too high for us to be able to remove it,
while she’s awake.
[George] Patient doing okay?
[nurse]
[George] Great, thank you.
I can see why she lost her grip.
This thing looks like it’s silicon
and the ring is pretty slippery.
There’s no bleeding.
So, I don’t think she caused any injury
that’s gonna require more of an operation.
So, what I’m gonna do now, is just grab it with my grasper,
and then just kinda slowly got it back,
looking at it to make sure that we’re not...
injuring anything.
Yeah, got it.
So, we’ve got it to the end. So, we’ll just pull it out.
I’m glad that we got this out of her
and it’s not stuck in there anymore.
[George] Surgery went fantastic.
We were able to pull it out through her rectum.
The inside of her rectum looks great.
So, there was no holes,
no tears and no bleeding.
So, I don’t think she will have any residual problems
with this and I think she’ll be able to...
go party another day without any problems.
[Brittany] The reason that I shared this story,
and the reason that I’ve said it so many times,
people are so interested in,
is because you need to educate yourselves on...
sticking things inside of your body
because they will go somewhere and they will get stuck.
[George] All right, Bren. She should be good.
That’s it.
[Brittany]
and you’re not prepared for something like that,
Like I would’ve never thought in a million years, an orgasm
[Lynn] My name is Lynn and I’m a physician assistant
at the ear, nose and throat institute.
I have been working in otolaryngology
for the past one to two years.
And this is actually my first specialty
out of finishing PA school.
My favorite thing about working an ENT,
is removing all things that are stuck in the ear and the nose.
Today, we have Devon and his wife in the office
and Devon has not been able to hear well out his ear
for the past several months.
On top of that, Devon has had a hearing loss
for years already, that has been affecting his speech.
So, we’re gonna take a look inside his ear
and see what’s causing him to lose its hearing.
- [Lynn] Hello, Mr. Preston. - [Devon] Hey.
- [Lynn] How are y’all doing today? - [Devon] Good.
[Devon]
[Lynn] When you can hear again, huh?
[Lynn] So, what I’m actually gonna do is,
I’ll show you what the inside of your ear looks like.
[Devon]
[Lynn] Well, look at all that.
That’s just all wax inside.
So, we can’t see any eardrum.
- It’s just all a lot of wax inside, huh? - Yeah.
[Devon] This is crazy.
[Lynn] Looking inside Devon’s ear,
I just see a wall of dark
brown, gooey, dry looking ear wax
that’s completely blocking the ear drum.
Looks like it’s actually completely almost
petrified onto the side of the ear canal.
[Lynn] It’s a hard place to look inside.
A build of ear wax over time
can occlude the ear canal
and give you what’s called a cerumen impaction.
This can lead to dizziness, hearing loss, ear pressure
and as the years go on,
it gets to be very hard to remove as well.
So, imagine almost a fossilized ear wax in the ear.
So, same thing over here. A lot of wax inside.
In otolaryngology, or ENT,
we have a number of different tools
to help us remove ear wax from patients’ ears.
One of my favorites is the suction.
[Lynn] So, what I’m gonna use, is a loud suction.
So, it’s a vacuum.
It essentially forms a vacuum with just air.
It allows you to gently peel off
the wax from the side of the ear canal,
and out of the patient’s ear.
You ready?
[Lynn chuckles] Okay.
I’m sorry.
Suction’s going in.
- Doing okay? - [Devon] Yeah.
After I used my suction on his ear,
I noticed that there’s still quite a bit of wax
that’s remaining inside.
The suction only works if we have really soft ear wax.
If it’s been inside for too long,
so that it becomes hard,
the suction really is not strong enough
to remove the wax from the ear.
So, I decide to use my irrigation instead.
[Lynn] So, what we’re gonna do now, is we’re gonna flush the ear out.
I think we’ll have you hold it up to your ear
and there’s a little pocket, where your ear...
That’s perfect. Yeah. You’re ready?
- [Devon] Yes. - [Lynn] Okay.
So, it’s gonna be some warm water here.
[Devon grunting]
- [Lynn] Doing great. - [Devon] Yes.
[grunting]
[Lynn] Doing great.
What does it feel like?
[Devon] It feels... [screams]
[speaking indistinctly]
[Lynn] I got a big chunk of wax out of there.
I’ve seen all sorts of different things
come out of the ear.
Harder ear wax, flaky ear wax.
Wet and goopy ear wax.
Colors ranging all the way from bright lemon yellow
to almost have a black-ish looking color.
I’ve seen wax mixed with puss inside the ears,
wax mixed with fungus,
bugs come out of ears that have almost disintegrated
overtime as well.
[Lynn] There’s another big old piece of wax coming out his ear.
There’s our big old piece there.
Look at this big old piece of wax we got here.
That’s what came out of your ear.
[Devon]
[Lynn] I’m always happy to remove
bigger chunks of ear wax from patients’ ears.
It’s almost satisfying, just seeing so much relief
from the patient for it.
[Lynn] So, now if I do this, can you hear this?
- Yeah. - [Lynn] Yeah.
Now on this side if I do that, can you hear that?
- [Devon] Yeah. - [Lynn] Yeah, good.
- And it sounds about the same on both sides? - Yeah.
[Lynn] Perfect.
I recommend for patients not to use cotton swabs
to clean their ears,
just because the cotton swab only gets to the tip of the wax.
Kind of like the tip of an iceberg.
The rest of the wax just gets pushed down further inside,
kind of like packing the wax like brown sugar.
That’s when it can damage the ear drum
and it makes the wax really hard to remove as well.
The longer you wait, the more wax that your ear makes
and the harder it is to get that wax out.
If y’all wanna come back every, say six months or so,
then we can get your ears cleaned out for you.
That way, we don’t let it build up
to the point that it starts affecting your hearing.
[Devon]
[Lynn] Of course, of course. That’s what we’re here for.
[Devon]
[Devon chuckles]
I was going outside to check the mail.
[man 2] That’s an impressive splinter there.
[woman 2] Oh my God!
[chatter]
I’m Dr. Larry Mellick.
I’m an emergency medicine physician
and I work at the University of South Alabama Hospitals,
here in Mobile, Alabama.
They call us, sometimes, adrenaline junkies.
We really thrive on some excitement.
[woman] Come in.
And so, just everyday,
you never know what you’re gonna see in the emergency department.
Today, we’ve got a young girl that comes in
with a massive splinter in the bottom of her foot.
It’s buried in there.
So, I’ve got my job cut out for me.
So, this is not your average run of the mill...
splinter.
[Auhamalai] Yeah. No, it’s pretty big.
It just feels like somebody just stabbed me.
Like, straight up like, stabbed me.
It’s not uncommon to have patients with splinters.
It’s less common to have splinters that large.
[Larry] Can you tell me your story
as to what happened today?
So, it happened when I was going outside to check the mail.
[screams]
And that got in my foot randomly.
Then, I was screaming. I was like, "Mom, mom!"
I mean, I was worried.
I didn’t know...
what steps I needed to take
and I wanted to make sure she had the best care.
That’s why we came here.
[Larry] Well, we’ll get this out.
[woman] Thank you. Good deal.
Those foreign bodies bring along with them bacteria.
They can actually cause serious infections,
cellulitis
and bacteria that gets into the blood stream
causes shock and sepsis.
Obviously, we’re gonna have to numb her up.
[Auhamalai] Okay.
And we’re gonna have to protect her from the pain
of just getting the numbing medications.
So, we’re gonna use a vapor coolant to spray on that.
[Auhamalai] So, it should be pretty numb.
Do you feel if I like manipulate it, moving around?
[Auhamalai] Not really? Good.
Let me know if you can feel anything,
if it even hurts, okay?
Not much of a difference. It’s still pretty stuck in there.
[Larry] Splinters can be really hard to get out.
My goal is to minimize pain in the children I work with.
[Auhamalai] Do you feel any of that?
I don’t feel anything.
- I’m happy. - [Larry] Good, good.
[Larry] That is one tough one.
[Larry] The wood just breaking apart,
making our job a 100 times harder.
[Larry] Yeah, I mean,
don’t open it all the way up.
Okay. Give yourself a little bit more of a point to assess.
[Auhamalai] Couldn’t feel any of that?
- [patient] No, sir. - Good.
[speaking indistinctly]
[Auhamalai] That’s it. It’s coming out.
- Here you go. - [Larry] You got it.
Can I take a picture of it?
[Larry] Yeah, take it.
[woman] Think we need to get our porch replaced?
[all giggle]
[Auhamalai] So, there’s some of it.
[Larry] It’s not in one piece
but I think we got it all out.
I’m just glad it’s over with and she’s good.
Yeah, yeah.
[Larry] How was it?
It actually didn’t hurt at all.
Except for the first part.
[Larry] Okay.
Yeah, once we got your numbed up, you did good.
Thank you. I appreciate your help.
[Auhamalai] Now, we’ll just rinse it up really good.
[Larry] Yeah, just irrigate the heck out of that then.
The potential for leaving debris in there was good.
So, we took a catheter with sailing hooked up to it
and just irrigated it thoroughly.
To confirm that we didn’t leave any debris in there,
we got the ultrasound machine and we got a really good look.
[indistinct]
[Larry] Yeah, it looks super clean.
We got everything out of there.
So, it was a success in that regards.
Unfortunately, a lot of these are just freak accidents that
you would never have thought was gonna happen
until it does.
Really, it’s been just very crazy to me
and it’s a cool story.
Like, it’s probably never gonna happen again.
Let’s hope not.
What you’re seeing with Trish is about...
one of the worst noses that you’re gonna see.
It’s so damaged from previous infections.
I mean, basically, crusted from one side to the other.
It just turns into sort of this rubber cement glue in there.
[Trish] My name is Trish.
I’m here because I’ve constantly had sinus infections
and I couldn’t breathe for a couple of years now.
Morning, Trish. How are you today?
[Patricia] Good today. How are you doing?
[Daniel] All right, good.
My infection in my nose came from
bad habits, picking in my nose,
illegal drugs and stuff.
So, I was doing bad things long time ago
that made me to have to come here.
And have two surgeries.
Just to kind of, recap,
when I saw you for the first time,
you had had previous sinus surgery
and then inside of your nose, was completely blocked.
- Yes. - You had absolutely no...
ability to breathe.
So, I’ve been seeing Trish since about last fall.
And as a result of...
some misspent youth,
she had a really bad situation with her nose.
She had scarring and there was a...
very large septal perforation that was crusting
and she couldn’t breath through her nose at all.
And we did a sinus surgery.
She’s a lot better but I don’t know if she’s ever gonna be
able to have a completely normal nose.
[Daniel] What we were able to do is,
kind of reduce the turbinate size
open things up
and I think you did great after that.
Yeah.
And then, we had a little bit of a... two steps backwards
with a little bit of an infection.
Right now, I think what we’re dealing with
is just a little bit of crusting.
- Yes. - So, we’ll kind of just clean things out so you can...
- breathe a little better, okay? - Okay.
I think one of the most important things
just to feel well is to be able to breathe through your nose.
And if you snort drugs into your nose,
that shrinks the blood vessels.
And the cartilage, which is in the middle of the nose,
doesn’t have any blood supply.
And when you take that blood supply away,
the cartilage can die and end up with a huge, crusty hole in your nose.
And it can be quite serious.
Looking inside, you can see there’s kind of...
discolored mucus and scabs and crusting.
[Daniel] What you’re seeing with Trish,
is about one of the worst noses that you’re gonna see.
It’s so damaged from previous infections.
I mean, she has basically crusted from one side to the other.
So, there’s some crust in here, that will clean out.
They kind of just get stuck
because of... the membrane’s a little bit raw.
You know, like, some people have to get their ears cleaned
with ear wax.
You know, her nose gets clogged with dried up mucus
and crust.
All right, just tell me if this is uncomfortable.
We’re not gonna numb this up ’cause it’s really just
kind of a loose...
scabs that are in here.
I don’t know if you’ll like ever be completely rid of this.
We’ll get you on a schedule to sort of clean things out intermittently.
In cleaning her nose out, what we’re finding in there,
is just a combination of scabs and mucus
and bacterial sort of colonization.
It just turns into sort of this rubber cement glue in there.
If you take that out in one piece,
it will literally bounce.
You can be holding it and it will be like, doink, you know.
And that’s so satisfying to get that out.
So, we’re moving this from the margin of the septal perforation.
Sorry if that’s a little uncomfortable.
So, the nose produces a lot of mucus.
Most people don’t realize how much it is...
It’s like a court or something like that a day and it...
it kinda just gets dried up.
So, your nose really can’t clean itself
like it could before and so...
You know, we have to do this intermittently
just to kind of get you back to...
being able to breathe.
So, we’ll get this...
cleaned out and then we’ll get another culture
and we’ll see if we’re still dealing with the staff infection
that we had before.
Still a little bit raw in here.
So, this right here is the...
septum and there’s supposed to be
a wall here and this is just all open.
You’ve lost, I don’t know,
80 per cent or more of your septum.
One last little scab here.
I think her prognosis is actually
quite good with regard to function breathing
and her ability to smell and those types of things.
But just her way back when remote history
of intra-nasal drug use,
it destroyed her nose.
And you know, that’s something you end up having to live with
forever, unfortunately.
Okay.
All right. We’re pretty much done.
Looking good.
- Feel great. - [Daniel] Yeah.
[Patricia] So, I’m breathing better now.
There’s no more crust.
The next step is life. I’m gonna live right.
Keep my nose clean.
And do better things.
Thank you so much.
Good. We’ll see you in a few weeks, okay?
[Patricia] Okay, thank you.
I’ve got a 16-year-old young man,
who’s got an earring stuck in his right ear lobe.
The back of the earring is totally embedded
in the ear lobe.
[Larry] Here it comes.
Am I causing you too much pain?
We may have to get side cutters.
Hey, what do you got?
Oh, I’ve got a 16-year-old young man,
who’s got an earring stuck in his right ear lobe.
He noticed it’d been hurting about a week ago...
- [Larry] Okay. - ...and then his mom took a look at it last night
and she says the back of the earring
is totally embedded in the ear lobe.
Okay.
We’re probably gonna have to really dig this thing out
- and... - [Larry] Okay.
He has a pretty high pain tolerance
because I’ve tried to push it out without any numbing medicine.
I think we will need to numb it up to really get it out.
[Zion] My name is Zion Hill.
I attend BC Rain high school.
And I’m trying to get my earring removed
that’s been bothering me for a couple of days.
Just ready to get it out.
[Kimberly] I tried to get it out.
So, I cleaned it and I looked at and I was like,
"No, this..."
I didn’t see the back of the earring
and then, when I flipped the ear,
it was like embedded inside of the hole.
He was like, "[screaming]."
He was so loud that it was hurting, so...
I was like, "Okay, let’s...
go to the hospital."
I’m Dr. Larry Mellick
and I’ve been practicing emergency medicine
for over 40 years.
And I work at the University of South Alabama.
Today, I have Zion, a neat young man,
who presents here with an earring that is...
embedded in the back of his ear.
Usually, these things are fairly easy to get out.
Put a little topical numbing medicine on there,
and pop it out the back and you’re done.
So, we’re gonna see...
that this is an easy one to get out
or if there’s gonna be challenges.
[Larry] Hey, Zion.
So, are you a football player?
- Yes, sir. - [Larry] You are? Okay.
How’d I guess?
How long is this been stuck in there?
[Zion] For... It’s been hurting for about a week or two.
[Larry] I’m just doing a little inspection here on this.
So, as I examine Zion’s ear,
this just isn’t your average stuck earring.
This is something a little bit more
complicated.
It might be an early infection even, too.
Because it’s little red and it’s swollen.
[Zion] Before the season started,
it wasn’t hurting as bad as it is now.
But since the season started, with my helmet,
and it just banging on it and banging on it.
It was just like, gots to get it out.
[Larry] One of my challenges with Zion is that,
he’s a tough guy, he takes a lot of pain.
He gets banged up in football practice
and he has some discomfort when the helmet hits that earring.
That... He doesn’t dwell on it and he just moves on.
And that looks like it’s infected the
ear lobe is actually significantly swollen.
A little bit red, inflamed looking.
And then, behind the ear lobe,
it’s really, what we call, macerated.
It’s really kind of torn up.
And kinda what I would expect if someone’s a football player,
wearing a helmet, having...
an earring in place.
It’s obviously buried in there, really deep.
So, that’s gonna be kind of a challenge, I think,
to get it out.
So, we have a couple options here.
One of my options is basically...
to actually inject the longer acting numbing medicine,
but that’s a little bit more painful
and if I can just get by with simply
putting some topical medication on there,
that’s the direction I wanna go.
On the other hand,
you’re a lot bigger than I am.
And so,
if I hurt you, you gotta promise, not to hurt me.
[chuckles] I keep teasing you.
All right, so what I’m gonna do next,
is I’m gonna go ahead and clean that off.
Good, good, good.
Okay, Zion, this can get really cold.
And can be uncomfortable but just...
be patient with me.
[indistinct chatter]
[Larry] I think we will probably put him
on some antibiotics for a couple days.
Okay. It’s nice and frosty.
There’s a number of different ways
I can approach this.
And what I generally find works best
is to put some topical numbing medicine
on top of that.
Then, I also have a vapor coolant, which is a freezy spray.
Then work fast.
[nurse] I’m gonna apply this.
It’s like a really thick lotion
around the top of the earring here.
[Larry] If Zion had never told his mother about this,
and didn’t come in today,
and just allowed this earring to stay buried there,
body’s gonna respond to that,
the body’s gonna try and take it out itself.
And that’s gonna be an inflammatory reaction.
And with inflammatory reactions come secondary infections.
Some patients come in with a...
pericarditis, which is a big word, meaning,
that the cartilage is now infected.
Those are even more complicated problems.
So, the longer it’s in there,
there’s gonna be a very unattractive scar
and that’s part of the reason we need to get it out.
We need to get it out now.
[Larry] Does that feel a little bit number?
Now that we put this medicine on there?
[Zion] Oh, yes, sir.
[Larry] It does, okay.
You can see that, right? That baby right there.
I think it will poke through, nicely.
The worst case scenario would actually having to
take a blade, that will go in there and...
and open up the back and we’ve done that on occasion too.
The problem is, as ear lobe gets more swollen,
then, it gets harder and harder to...
find.
Especially if it’s a small earring.
[Larry] All right, here goes.
I’m just gonna see if I can just poke that baby
right off through there,
without causing you too much pain.
Here it comes.
It’s on there but it’s coming...
We’re making progress.
If I have to stop and re...
spray you with that cold stuff, I can.
But I’m just about there.
[nurse] And it screws on.
[Larry] Yeah. So, there it is. There it is. You got it.
- I think that-- - [nurse] Oh, it screws on. Okay.
Yeah.
- [Larry] It’s coming. - [nurse] Here we go.
[Larry] That baby was buried in there.
You know, these football players,
they don’t feel any pain.
[giggles]
[Larry] Okay. So, I got it out.
All right, so let me see if I can just...
Lefty-loosey, righty-tighty, right?
This is like bent, a little bit.
[Larry] The backing of this earring
is a screw on type earring and I can’t unscrew it
because the stem is bent.
And obviously, I can’t pull it out the front.
And I can’t pull it out the back.
So, I need to figure out what to do next.
[nurse] We might have to cut it.
[Larry] Yeah.
Would you be upset if I just cut this off?
- [Zion] You talking about the earring? No. - Yeah.
[Larry] Okay, good enough, all right.
Let me go grab some tools here.
My next choice is to cut it off.
I don’t necessarily have
a lot of tools for that sort of thing
but I’ve learned over the years that
a good side cutter, a good wire cutter,
comes in valuable sometimes in the emergency department.
I’m gonna do the freezy spray one more time.
Because I wanna minimize the discomfort here, but...
Let me know if it bothers you, so.
[Larry] Got it.
Came out.
You know, I hated to think I might have been
beaten by an earring but we got it.
I love victories like this.
And you know, it was a little bit concerning
that we weren’t gonna be able to easily get this off.
Your earring.
And you know, obviously, I don’t wanna consult any of my...
specialty colleagues.
I need to do this myself.
But we were successful here.
Unfortunately, I had to cut it.
I mean, if you had decided, "Look, hey, I’m just gonna...
I’m gonna do a nose piercing, instead of my ear",
you could have reused it, but you know,
guess we’re out of luck now.
[Kimberly] I think he’s done with you.
[Zion] Yeah.
[Kimberly] I’m proud of him, he did a good job.
I’m glad he’s feeling better.
I was worried.
’Cause he’d been in pain for a while now.
So, I’m glad it’s over.
I’m glad you’re feeling better.
All right, thanks, Zion. You’re a good sport.
- [Kimberly] Thank you. - [Larry] Appreciate it.
That’s just stuck in your sinuses.
This mucus was literally stuck there
probably months to years.
[Lynn] This was wax out of that one ear.
[woman] Walk around like I’m cute, but that is just eeew.
Our cannister is full of all kinds of loveliness.
[Lynn] From ear wax, to puss, to fungus.
To foreign bodies.
[man] A ER physician tried to pull it out
and it’s actually in there pretty good.
[man 2] Ah, there goes the nail.
[man 3] The immense pain at that point,
it really felt like my muscles ripping out.