1
00:00:23,333 --> 00:00:25,773
You were riding
your bike and you hit
a pothole, is that correct?
2
00:00:25,802 --> 00:00:26,772
Yeah.
3
00:00:26,803 --> 00:00:28,973
That is
a long handle.
4
00:00:29,005 --> 00:00:30,345
And that’s stuck in her leg.
5
00:00:31,808 --> 00:00:34,308
The pain was so bad
that I was laying
on the floor.
6
00:00:34,344 --> 00:00:36,514
Oh, what is that?
7
00:00:36,546 --> 00:00:39,116
Something’s going on
and we have to figure it out.
8
00:00:42,018 --> 00:00:43,548
I have these really bad
tonsil stones.
9
00:00:45,689 --> 00:00:47,619
There you go.
10
00:00:47,657 --> 00:00:51,027
I had a lady who
apparently has a fake nail
in her ear.
11
00:00:51,061 --> 00:00:52,391
Sorry.
12
00:00:52,429 --> 00:00:55,159
I think we’ve all played
Operation when we were
little kids.
13
00:00:55,198 --> 00:00:56,828
Ah! Did you get it?
14
00:00:56,866 --> 00:00:58,436
It’s really stuck
in there.
15
00:01:09,412 --> 00:01:10,882
My name is
Dr. Larry Melleck.
16
00:01:10,914 --> 00:01:13,254
I’ve been practicing for
over 40 years.
17
00:01:13,283 --> 00:01:17,083
Pediatrics, emergency medicine
and board certified in
all three of those.
18
00:01:17,120 --> 00:01:19,890
What I really love about
this job is the stimulation,
19
00:01:19,923 --> 00:01:23,093
like the challenge,
I like being at the top
of my game.
20
00:01:25,028 --> 00:01:29,608
In my career, I’ve seen just
a spectrum of different types
of penetrating injuries.
21
00:01:29,633 --> 00:01:32,833
But I think one of the more
dramatic ones that
I’ve ever seen
22
00:01:32,869 --> 00:01:35,669
was a teenager who presented
in the emergency department
23
00:01:35,705 --> 00:01:38,375
with a bike brake handle
stuck in her leg.
24
00:01:38,408 --> 00:01:42,318
It was the entire bike brake
handle that was buried
into her leg.
25
00:01:43,980 --> 00:01:46,780
So, you were riding
your bike and you hit
a pothole, is that correct?
26
00:01:47,784 --> 00:01:48,954
How old are you?
27
00:01:49,786 --> 00:01:50,656
15?
28
00:01:52,922 --> 00:01:56,722
My name is Jasmine Hay.
I’m in the United States Army.
29
00:01:56,760 --> 00:01:59,890
So, I was in
Aiken, South Carolina
with my friend.
30
00:01:59,929 --> 00:02:03,359
We decided that we were
gonna go ride bikes around
the neighborhood.
31
00:02:03,400 --> 00:02:05,200
So, she was like, "Oh,"
you know, "let’s race."
32
00:02:05,235 --> 00:02:06,475
So, I was like, "Okay."
33
00:02:06,503 --> 00:02:09,973
So, we’re racing.
She turns off.
34
00:02:10,006 --> 00:02:12,316
So I go to look and like,
"Where she at?"
35
00:02:12,342 --> 00:02:14,812
So, I turn around, like,
turn my whole body.
36
00:02:14,844 --> 00:02:16,414
And I hit the pothole.
37
00:02:17,580 --> 00:02:18,680
I blackout.
38
00:02:19,349 --> 00:02:20,949
I was like, "Oh, my goodness."
39
00:02:20,984 --> 00:02:24,624
And I see like, half of the
bicycle brake
40
00:02:24,654 --> 00:02:26,594
inside of my leg.
41
00:02:26,623 --> 00:02:28,323
There was these people
that were out there
42
00:02:28,358 --> 00:02:29,968
and they seen the whole thing.
43
00:02:29,993 --> 00:02:32,433
They’re like,
"Oh! That’s deep!"
44
00:02:32,462 --> 00:02:34,492
So, when the ambulance
finally come,
45
00:02:34,531 --> 00:02:36,961
they couldn’t take the whole
bike to the hospital.
46
00:02:37,000 --> 00:02:40,070
So they got a saw to cut
me from the bike.
47
00:02:40,103 --> 00:02:42,503
So, I’m getting burnt from
the sparks from the saw.
48
00:02:42,539 --> 00:02:43,769
I’m screaming.
49
00:02:43,807 --> 00:02:46,247
Finally, they got me
disconnected from the bike
50
00:02:46,276 --> 00:02:47,776
and put in me in
the ambulance.
51
00:02:49,546 --> 00:02:51,446
So, we’re on
the highway.
52
00:02:51,481 --> 00:02:53,181
So, I’m feeling every bump.
53
00:02:53,983 --> 00:02:55,183
My leg is like,
54
00:02:55,819 --> 00:02:56,779
it’s throbbing.
55
00:02:59,289 --> 00:03:00,949
I’m just giving
her a tourniquet.
56
00:03:00,990 --> 00:03:02,460
- Okay.
- Just in case we need it.
57
00:03:02,492 --> 00:03:03,762
In case it starts
to bleed.
58
00:03:03,793 --> 00:03:05,963
I walk in the room
and I see Jasmine,
59
00:03:05,995 --> 00:03:08,535
and surprisingly,
she’s very calm.
60
00:03:08,565 --> 00:03:11,605
I mean, right here,
sartorius just cut on
from here...
61
00:03:11,634 --> 00:03:12,834
all the way to there.
62
00:03:12,869 --> 00:03:15,129
That’s gonna be our
challenge today,
is to get that out.
63
00:03:16,506 --> 00:03:18,276
As I’m looking at this,
64
00:03:18,308 --> 00:03:20,018
what’s racing through
my brain here is like,
65
00:03:20,043 --> 00:03:22,013
"That is a long handle,
66
00:03:22,045 --> 00:03:23,685
and that’s buried in her leg.
67
00:03:25,148 --> 00:03:26,888
If I pull that out,
68
00:03:26,916 --> 00:03:31,186
and it’s ruptured a major vein
or a major artery,
69
00:03:31,221 --> 00:03:33,821
am I just gonna see
a spurt of blood coming out
70
00:03:33,857 --> 00:03:35,297
and she starts to hemorrhage?"
71
00:03:35,325 --> 00:03:38,395
Right under the sartorius
is where the SFA lies.
72
00:03:38,428 --> 00:03:41,298
If this goes medially
towards it
73
00:03:41,331 --> 00:03:42,831
that could hit the
SFA vessel.
74
00:03:42,866 --> 00:03:44,736
It does go laterally,
we got an X-ray.
75
00:03:44,768 --> 00:03:46,578
- Yeah.
- And it shows it’s pretty superficial.
76
00:03:46,603 --> 00:03:48,743
They’re trying to
figure if I need to go
to surgery,
77
00:03:48,772 --> 00:03:50,902
they’re trying to figure out
if they can just pull it
straight out.
78
00:03:50,940 --> 00:03:53,340
They’re trying to figure out
all these things because
looking at it,
79
00:03:53,376 --> 00:03:54,576
it just looks bad.
80
00:03:55,912 --> 00:03:57,842
I was like, "Well, can y’all
put me to sleep?"
81
00:03:57,881 --> 00:04:00,411
He’s like, "No,
it’s a possibility you could
bleed out."
82
00:04:00,450 --> 00:04:02,550
That’s not what you wanna
hear at 15.
83
00:04:02,585 --> 00:04:05,595
Once there’s
a foreign body that’s
impaled the skin,
84
00:04:05,622 --> 00:04:07,552
the body’s gonna react
to that.
85
00:04:07,590 --> 00:04:10,060
Those foreign bodies bring
along with them bacteria
86
00:04:10,093 --> 00:04:12,393
that can actually cause
serious infections
87
00:04:12,428 --> 00:04:15,358
and bacteria that gets
into the bloodstream
causes shock.
88
00:04:17,634 --> 00:04:19,204
Jasmine’s hurting.
89
00:04:19,235 --> 00:04:23,245
I’ve got my child life
specialist who are helping out
trying to distract her.
90
00:04:24,908 --> 00:04:26,448
I’m used to managing pain.
91
00:04:26,476 --> 00:04:31,186
But to hear Jasmine crying
and frightened just kinds of
tears me up inside.
92
00:04:32,749 --> 00:04:35,719
Part of the brake handle
had actually clamped on
to the skin.
93
00:04:35,752 --> 00:04:38,752
They were pulling
my skin along with the brake.
94
00:04:40,924 --> 00:04:42,464
And that’s when I
started screaming.
95
00:04:42,492 --> 00:04:45,262
It’s caught on the skin there.
96
00:04:45,295 --> 00:04:47,065
I feel everything.
97
00:04:47,096 --> 00:04:49,406
I’m gonna give some lidocaine
for the skin.
98
00:04:49,432 --> 00:04:52,432
It’s become obvious we have to
deal with the pain.
99
00:04:52,468 --> 00:04:54,628
We had to provide
additional anesthesia.
100
00:04:56,139 --> 00:04:59,469
Because of my concerns about
the potential damage
101
00:04:59,509 --> 00:05:01,109
that this may have caused,
102
00:05:01,144 --> 00:05:02,884
I consult my colleagues
103
00:05:02,912 --> 00:05:05,452
to have them come and assist
with the removal of this
foreign body
104
00:05:05,481 --> 00:05:09,151
in the event of some obvious
complication as we
pull it out.
105
00:05:14,691 --> 00:05:17,221
- There we go.
- Nice and easy. It’s gone.
106
00:05:17,260 --> 00:05:19,660
Once we remove
the brake handle
and open that up,
107
00:05:19,696 --> 00:05:21,136
it came out very easily.
108
00:05:21,164 --> 00:05:23,364
And then, I just had like,
this huge hole
109
00:05:23,833 --> 00:05:24,833
in my leg.
110
00:05:24,868 --> 00:05:26,108
Like, it was big.
111
00:05:26,135 --> 00:05:27,575
That didn’t go
in the vessels.
112
00:05:27,604 --> 00:05:28,974
Yeah,
she is lucky.
113
00:05:30,206 --> 00:05:31,976
Thank you. Good job.
114
00:05:32,008 --> 00:05:33,278
- I’m just gonna wash it out.
- Yeah.
115
00:05:33,309 --> 00:05:34,469
So we’ll irrigate that.
116
00:05:34,510 --> 00:05:38,280
My goal is, do minimal damage
and let her heal quickly.
117
00:05:38,314 --> 00:05:40,514
I was like,
just beyond happy.
118
00:05:40,550 --> 00:05:42,010
Beyond grateful for them.
119
00:05:44,354 --> 00:05:46,694
I’d say it took probably
about like, six months
120
00:05:46,723 --> 00:05:49,463
for me to finally like,
heal it altogether.
121
00:05:49,492 --> 00:05:52,532
And then, now I just got
an indentation on my leg
122
00:05:52,562 --> 00:05:54,832
that everybody asks
if I got shot
123
00:05:54,864 --> 00:05:57,764
because it looks like
a bullet mark in my leg.
124
00:05:57,800 --> 00:05:58,660
So, yeah.
125
00:05:58,701 --> 00:06:00,671
Now, I have not rode
a bike since.
126
00:06:00,703 --> 00:06:03,473
I will not touch a bike.
Will not look at a bike.
127
00:06:04,040 --> 00:06:04,870
No.
128
00:06:12,348 --> 00:06:14,048
My name’s Kayla Shiflett,
129
00:06:14,083 --> 00:06:16,683
and I live in
Anniston, Alabama.
130
00:06:16,719 --> 00:06:18,949
So, I was 12 weeks pregnant
131
00:06:18,988 --> 00:06:21,118
and my baby was fine.
132
00:06:21,157 --> 00:06:22,867
I had a okay pregnancy.
133
00:06:22,892 --> 00:06:25,162
And then,
I felt some pressure.
134
00:06:25,194 --> 00:06:26,694
And then it got
worse and worse.
135
00:06:26,729 --> 00:06:29,799
And then one day,
it got so bad
136
00:06:29,832 --> 00:06:33,832
that I was throwing up,
it was just so painful.
137
00:06:33,870 --> 00:06:36,640
I really thought that I needed
to go to the hospital.
138
00:06:36,673 --> 00:06:38,203
I really thought that I was
having a miscarriage,
139
00:06:38,241 --> 00:06:39,741
but I wasn’t bleeding.
140
00:06:39,776 --> 00:06:41,876
When I got to
the emergency room,
141
00:06:41,911 --> 00:06:44,381
the pain was so bad that
I was laying on the floor.
142
00:06:46,215 --> 00:06:47,585
All right, here we go.
143
00:06:49,552 --> 00:06:51,222
My name is George Crawford.
144
00:06:51,254 --> 00:06:53,994
I am a board certified
general surgeon
145
00:06:54,023 --> 00:06:57,023
and I’ve been practicing
for 20 years.
146
00:06:57,060 --> 00:07:00,060
After talking to Kayla’s OB,
147
00:07:00,096 --> 00:07:02,406
we decided to get her
prepped for surgery.
148
00:07:02,432 --> 00:07:05,362
The biggest concern is,
she had appendicitis.
149
00:07:05,401 --> 00:07:08,171
Appendicitis can not only be
dangerous to the mother,
150
00:07:08,204 --> 00:07:11,044
it can be dangerous to
her unborn child.
151
00:07:11,074 --> 00:07:14,874
You can see on this ultrasound
of the child,
152
00:07:14,911 --> 00:07:16,781
that there’s blood flow
in the uterus,
153
00:07:16,813 --> 00:07:18,713
there’s blood flow
outside the uterus.
154
00:07:18,748 --> 00:07:21,418
So, it looks like the baby
is fine.
155
00:07:21,451 --> 00:07:23,781
What we are now thinking is
156
00:07:23,820 --> 00:07:26,290
if this is either
the appendix,
157
00:07:26,322 --> 00:07:29,692
or something going on
with the ovary.
158
00:07:29,726 --> 00:07:31,896
It was really scary
because my doctor said,
159
00:07:31,928 --> 00:07:35,238
"We really gotta do this
quickly because if your
appendix ruptures,
160
00:07:35,264 --> 00:07:37,264
it’s your life
and your baby’s life."
161
00:07:39,002 --> 00:07:41,702
So in her situation,
it was deemed an emergency.
162
00:07:41,738 --> 00:07:44,078
So, instead of meeting her
in the emergency room,
163
00:07:44,107 --> 00:07:45,917
she was asleep in
the operating room.
164
00:07:45,942 --> 00:07:48,942
And five minutes later,
we were getting her
taken care of.
165
00:07:48,978 --> 00:07:50,608
- Grasper, please.
- Yes, sir.
166
00:07:50,646 --> 00:07:53,656
Is this
an ovarian problem
or is this appendicitis?
167
00:07:53,683 --> 00:07:58,123
Appendicitis is the most
common non-obstetrical surgery
168
00:07:58,154 --> 00:07:59,994
that we see in pregnant women.
169
00:08:01,257 --> 00:08:02,497
All right. Let’s get it done.
170
00:08:08,798 --> 00:08:09,838
There we go.
171
00:08:12,602 --> 00:08:14,502
So, stuck my scopes in,
172
00:08:14,537 --> 00:08:16,077
start looking around.
173
00:08:16,105 --> 00:08:18,775
And it’s obviously not
her appendix.
174
00:08:18,808 --> 00:08:20,918
Her appendix is normal.
It’s kind of flopping
right there. It’s like,
175
00:08:20,943 --> 00:08:23,183
"Hey," waving at you,
"it’s not me,
it’s somebody else."
176
00:08:25,782 --> 00:08:28,012
Oh, what is that?
177
00:08:28,051 --> 00:08:30,681
But off to the side,
you see this huge mass.
178
00:08:30,720 --> 00:08:33,450
Something’s going on,
and we have to figure it out.
179
00:08:34,323 --> 00:08:35,393
Oh, wow.
180
00:08:35,425 --> 00:08:37,695
So this is a real bigger
problem than I thought.
181
00:08:56,846 --> 00:09:00,056
Oh, what is that?
182
00:09:00,083 --> 00:09:02,583
Kayla comes in with
right lower quadrant
abdominal pain.
183
00:09:02,618 --> 00:09:04,278
We take her to
the operating room
184
00:09:04,320 --> 00:09:06,290
expecting to
find appendicitis,
185
00:09:06,322 --> 00:09:08,652
and we find something
completely different.
186
00:09:11,260 --> 00:09:13,390
When we get in there,
we find something stuck
187
00:09:13,429 --> 00:09:15,559
on her abdominal wall
on that right side.
188
00:09:15,598 --> 00:09:18,128
There’s really not supposed to
be anything over there.
189
00:09:18,167 --> 00:09:19,507
We gotta get it out.
190
00:09:19,535 --> 00:09:22,175
It looks like she’s probably
gonna have what’s called
a teratoma.
191
00:09:24,640 --> 00:09:27,140
A teratoma is just
one of these cells
192
00:09:27,176 --> 00:09:29,916
that had gotten stuck
in the ovary,
and over time,
193
00:09:29,946 --> 00:09:32,086
it’s slowly grown
with the patient.
194
00:09:32,115 --> 00:09:35,415
The reason she’s having pain
is because it’s just
twisted a little bit
195
00:09:35,451 --> 00:09:37,681
and it didn’t have a good
blood supply.
196
00:09:37,720 --> 00:09:40,420
The appendix looks normal
so I know that’s not
the problem.
197
00:09:40,456 --> 00:09:43,126
But kind of out of the side
of my eye, I see
198
00:09:43,159 --> 00:09:45,189
the ovary is big and purple.
199
00:09:45,228 --> 00:09:46,998
And it’s not supposed
to be that color.
200
00:09:47,029 --> 00:09:49,459
So, I know that
that’s a problem.
201
00:09:49,499 --> 00:09:51,929
This thing doesn’t have
natural blood supply.
202
00:09:51,968 --> 00:09:55,508
So, that death of tissue
is what causes pain.
203
00:09:55,538 --> 00:09:57,648
And then we end up
having to take it out.
204
00:09:57,673 --> 00:10:00,973
The mass was so big that
it twisted the ovary
205
00:10:01,010 --> 00:10:03,180
and she was losing
blood supply to it.
206
00:10:03,212 --> 00:10:04,982
So, that’s why she was
having the pain
207
00:10:05,014 --> 00:10:07,114
because she’s not having
blood supply to her ovary.
208
00:10:07,150 --> 00:10:10,650
And I know that it’s something
that we have to take out
at this time,
209
00:10:10,686 --> 00:10:14,456
because if you wait,
the ovary dies,
210
00:10:14,490 --> 00:10:16,190
she can get septic from that,
211
00:10:16,225 --> 00:10:17,425
and then the baby dies.
212
00:10:17,460 --> 00:10:21,330
So, now I gotta figure out
how to take the teratoma out
213
00:10:21,364 --> 00:10:23,764
without injuring the baby.
214
00:10:25,501 --> 00:10:27,071
There we go.
215
00:10:27,103 --> 00:10:29,173
Brenda, make sure they get
suction set up, please.
216
00:10:35,578 --> 00:10:37,518
As soon as I open it up,
217
00:10:37,547 --> 00:10:40,587
you can see a lot of the fluid
starting to leak out.
218
00:10:40,616 --> 00:10:42,826
It’s not toxic,
it’s not infected.
219
00:10:42,852 --> 00:10:44,922
So, we’re not worried about
her getting sick from it.
220
00:10:44,954 --> 00:10:48,754
But what we will do is
make sure we get as much
as we can suctioned out.
221
00:10:48,791 --> 00:10:50,761
A teratoma is a tumor
222
00:10:50,793 --> 00:10:53,493
that can have anything in it.
223
00:10:53,529 --> 00:10:56,699
When we say ’anything’,
it can have bone, hair,
224
00:10:56,732 --> 00:10:58,262
skin, teeth.
225
00:10:58,301 --> 00:11:01,971
It can have functioning organs
or part of functioning organs.
226
00:11:08,277 --> 00:11:11,687
We have to get
all of the content
227
00:11:11,714 --> 00:11:14,014
from the teratoma
suctioned out of her
228
00:11:14,050 --> 00:11:16,420
because if we leave
something in,
229
00:11:16,452 --> 00:11:18,022
then the mother can get sick,
230
00:11:18,054 --> 00:11:20,054
and then, the baby
gets threatened,
231
00:11:20,089 --> 00:11:21,819
and it’s not
a successful operation.
232
00:11:24,060 --> 00:11:27,430
So we’ll suction out
the content, put it in a bag,
233
00:11:27,463 --> 00:11:30,503
and hopefully be able to
squeeze it out through
one of these incisions.
234
00:11:31,834 --> 00:11:33,974
And what it looks like,
235
00:11:34,003 --> 00:11:36,803
is she’s gonna have a little
bit of hair in here,
236
00:11:36,839 --> 00:11:38,539
and maybe a little bit
of bone.
237
00:11:38,574 --> 00:11:40,444
Because I can feel
something hard.
238
00:11:42,245 --> 00:11:44,415
Now, when I’m taking it out,
I do make a hole in it,
239
00:11:44,447 --> 00:11:46,457
and you can see hair
sticking out of it.
240
00:11:46,482 --> 00:11:48,582
So, once you see the hair
sticking out of the mass,
241
00:11:48,618 --> 00:11:49,828
you know it’s a teratoma.
242
00:11:57,860 --> 00:11:59,890
So what we’re trying to do now
243
00:11:59,929 --> 00:12:02,799
is just peel the teratoma
244
00:12:02,832 --> 00:12:05,162
away from her normal ovary.
245
00:12:10,339 --> 00:12:12,639
What this does is
gives her the opportunity
246
00:12:12,675 --> 00:12:15,315
to have a successful pregnancy
247
00:12:15,344 --> 00:12:16,644
after this child.
248
00:12:17,847 --> 00:12:20,587
So hopefully, we can get
all this stuff out
249
00:12:20,616 --> 00:12:22,656
and it just makes it easier
for her in the future.
250
00:12:23,653 --> 00:12:25,383
There we go.
It’s coming apart now.
251
00:12:27,690 --> 00:12:31,460
Okay, so I’mma go ahead
and suction out all of this
fluid content,
252
00:12:31,494 --> 00:12:34,194
get all of this tissue
in the bag.
253
00:12:34,230 --> 00:12:37,730
And hopefully, I’ll be able to
get it out through
one of these incisions.
254
00:12:53,749 --> 00:12:54,579
There we go.
255
00:13:01,524 --> 00:13:02,864
That’ll be it.
256
00:13:02,892 --> 00:13:05,392
We’re able to get it out
through a pretty
small incision.
257
00:13:06,262 --> 00:13:07,492
All right, let’s see.
258
00:13:07,530 --> 00:13:08,690
Put it in here.
259
00:13:08,731 --> 00:13:10,531
And some pickups.
260
00:13:10,566 --> 00:13:12,506
All right, guys.
I think we’re done here.
261
00:13:12,535 --> 00:13:14,105
Looks like there’s
no bleeding.
262
00:13:15,204 --> 00:13:19,144
You can have anything
in a teratoma.
263
00:13:19,175 --> 00:13:21,245
So, it’s kind of like
a present when you find one,
264
00:13:21,277 --> 00:13:22,987
because the first thing
you wanna do
265
00:13:23,012 --> 00:13:25,482
is open it up and see
what’s in it.
266
00:13:25,514 --> 00:13:27,914
So, when I open it up,
I was like, "Oh?
267
00:13:27,950 --> 00:13:30,420
Okay, that’s a tooth."
268
00:13:30,453 --> 00:13:33,193
And then, there was
another tooth.
And there was bone.
269
00:13:33,222 --> 00:13:36,392
And it was just kind of like,
"Okay. So this is
a real teratoma."
270
00:13:36,425 --> 00:13:39,265
This was kind of the one
we read about in
medical textbooks.
271
00:13:39,295 --> 00:13:40,565
Oh, it’s pretty cool.
272
00:13:40,596 --> 00:13:43,436
There’s also a little bit
of hair in it.
273
00:13:43,466 --> 00:13:46,236
But this one’s pretty cool
’cause you don’t see them
too often,
274
00:13:46,268 --> 00:13:47,498
with a tooth.
275
00:13:47,536 --> 00:13:50,506
And you can see that’s
firmly attached to
this hair,
276
00:13:50,539 --> 00:13:51,939
where it’s not coming off.
277
00:13:51,974 --> 00:13:53,574
That one actually has ridges.
278
00:13:53,609 --> 00:13:55,609
So, it has roots
and everything.
279
00:13:55,644 --> 00:13:56,914
So, that is one good tooth.
280
00:13:56,946 --> 00:13:58,386
And there’s some other.
281
00:13:58,414 --> 00:14:00,384
There is like molar
or something back here.
282
00:14:00,416 --> 00:14:02,386
One of them is actually
stuck in the jaw.
283
00:14:02,418 --> 00:14:04,428
I didn’t expect to find
a teratoma.
284
00:14:04,453 --> 00:14:07,523
What I was thinking that we
would find is an appendicitis.
285
00:14:07,556 --> 00:14:09,026
But in this case,
286
00:14:09,058 --> 00:14:10,928
I pulled teeth out of
some lady’s belly.
287
00:14:10,960 --> 00:14:12,360
So, it was actually
pretty cool.
288
00:14:12,395 --> 00:14:14,195
Teeth? Ugh, gross.
289
00:14:14,230 --> 00:14:15,160
It was so gross.
290
00:14:15,197 --> 00:14:17,137
So, like, my first
impression was that,
291
00:14:17,166 --> 00:14:20,106
"Okay, was that like, a baby
that didn’t form right?"
292
00:14:20,136 --> 00:14:21,476
Or like, what happened?
293
00:14:21,504 --> 00:14:24,074
But Dr. Crawford actually
explained it to me
294
00:14:24,106 --> 00:14:27,376
that like, really just like,
one of my eggs just
went haywire
295
00:14:27,410 --> 00:14:31,280
and formed this teratoma,
just started making
baby parts.
296
00:14:31,313 --> 00:14:33,783
Initially when
she came into
the emergency room,
297
00:14:33,816 --> 00:14:35,956
he was worried that she was
having a miscarriage.
298
00:14:35,985 --> 00:14:38,625
It works out that she wasn’t,
which is fantastic.
299
00:14:38,654 --> 00:14:40,794
And this child can go on
to grow
300
00:14:40,823 --> 00:14:44,463
without any problems,
and hopefully, she’ll have
a healthy, safe delivery.
301
00:14:44,493 --> 00:14:47,393
I’m glad that we got this
out of her and it’s not
stuck in there anymore.
302
00:14:47,430 --> 00:14:48,290
She should be good.
303
00:14:50,933 --> 00:14:54,103
I had a lady who
apparently had a fake nail
in her ear.
304
00:14:54,136 --> 00:14:57,976
If she moves,
there’s potential to
damage her ear.
305
00:14:58,007 --> 00:14:59,617
Sorry.
306
00:14:59,642 --> 00:15:02,342
I think we’ve all
played Operation when
we were little kids.
307
00:15:02,378 --> 00:15:03,988
You know, when it get
that buzzer going...
308
00:15:05,114 --> 00:15:06,954
...the intensity
that that evoked.
309
00:15:06,982 --> 00:15:08,582
And that’s not even real.
310
00:15:08,617 --> 00:15:10,157
Ah, did you get it?
311
00:15:31,907 --> 00:15:33,317
Hey, this is
Crystal Gay.
312
00:15:33,342 --> 00:15:36,112
I’ll get that prescription
sent into your pharmacy.
313
00:15:36,145 --> 00:15:38,385
I’m Crystal Gay.
I’m a physician assistant
314
00:15:38,414 --> 00:15:40,984
at Ear, Nose and Throat
Institute in Atlanta, Georgia.
315
00:15:41,016 --> 00:15:43,856
The PA is pretty much
the backbone of the operation.
316
00:15:43,886 --> 00:15:46,026
We see patients
just like they do,
317
00:15:46,055 --> 00:15:48,625
um, treat just like
they do, prescriptions.
318
00:15:48,657 --> 00:15:51,667
I communicate very well
with my patients and,
319
00:15:51,694 --> 00:15:53,564
I mean, they know a lot
about me and I just...
320
00:15:53,596 --> 00:15:54,866
I’m an open book to them.
321
00:15:54,897 --> 00:15:57,737
And if they have something
I’ve had, I relate that
to them.
322
00:15:57,766 --> 00:16:00,906
So, if they’re happy with
their visit, now,
that just makes your day.
323
00:16:00,936 --> 00:16:03,206
All right. Thank you.
Have a good weekend. Bye.
324
00:16:05,374 --> 00:16:07,074
So, we have a patient
coming in
325
00:16:07,109 --> 00:16:10,209
that apparently has a nail
in her ear.
326
00:16:10,246 --> 00:16:12,986
I don’t know what kind
of nail, I don’t know how
long it’s been in there,
327
00:16:13,015 --> 00:16:14,555
I don’t know how it got
in there.
328
00:16:15,518 --> 00:16:17,058
So, we’ll see.
329
00:16:17,086 --> 00:16:18,556
- Hi!
- Hi.
330
00:16:18,587 --> 00:16:20,557
- How are you today?
- Good.
331
00:16:20,589 --> 00:16:23,419
So, tell me what’s going on?
What brings you in to
see us today?
332
00:16:23,459 --> 00:16:27,429
Yesterday, I was trying to
scratch my ear with this
little finger of mine...
333
00:16:27,463 --> 00:16:28,293
Mm-hm.
334
00:16:29,865 --> 00:16:32,835
part of a nail, half of it,
like, a little bit of it,
335
00:16:32,868 --> 00:16:34,068
- went inside my ear.
- Okay.
336
00:16:34,103 --> 00:16:36,003
And did you try to
get it out yourself?
337
00:16:36,038 --> 00:16:37,198
I did try.
338
00:16:37,239 --> 00:16:40,339
At night, I put some oil
and slept on the same side.
339
00:16:40,376 --> 00:16:42,016
- Mmm-hmm.
- But I don’t think it came out.
340
00:16:42,044 --> 00:16:44,214
Okay, is it hurting
or does it feel full?
341
00:16:44,246 --> 00:16:46,056
It feels kind of a little full
342
00:16:46,081 --> 00:16:48,781
and I can tell there’s
something going on
in my ear. Like...
343
00:16:48,817 --> 00:16:51,557
Okay. Well,
let’s take a look.
344
00:16:51,587 --> 00:16:54,227
I actually don’t think
I’ve seen a fingernail before.
345
00:16:54,256 --> 00:16:56,866
I mean, it makes sense if
you’re scratching your ear
and you have
346
00:16:56,892 --> 00:16:59,762
the fake nails that it can
come off and pop off
347
00:16:59,795 --> 00:17:01,135
in your ear if you’re really
getting at it.
348
00:17:01,163 --> 00:17:02,063
Yep.
349
00:17:02,665 --> 00:17:04,435
I can see it’s in there.
350
00:17:04,466 --> 00:17:06,036
It doesn’t look like
a fingernail,
351
00:17:06,068 --> 00:17:07,268
but you can definitely see it.
352
00:17:07,303 --> 00:17:09,233
Let me see if I can see it
on my other camera
353
00:17:09,271 --> 00:17:10,641
so you can see it too.
354
00:17:23,285 --> 00:17:24,385
Okay.
355
00:17:24,420 --> 00:17:26,590
- Can you see it?
- Yeah.
356
00:17:26,622 --> 00:17:29,052
I called my friend,
she’s like, "Oh, when you
go home,
357
00:17:29,091 --> 00:17:31,561
just put oil and sleep
on the same side."
358
00:17:31,594 --> 00:17:33,094
Okay,
look in the phone.
359
00:17:33,128 --> 00:17:36,428
So, I slept on the same side.
But you know how when you’re
in a deep sleep,
360
00:17:36,465 --> 00:17:40,635
I think I must’ve turned on
the other side and it went
way deep inside.
361
00:17:40,669 --> 00:17:41,969
Yeah,
you can see it.
362
00:17:42,004 --> 00:17:43,844
It’s taken up the whole
ear canal.
363
00:17:43,872 --> 00:17:45,502
It’s like a tongue.
364
00:17:45,541 --> 00:17:48,011
So, to remove foreign objects,
365
00:17:48,043 --> 00:17:50,143
most of the time we use
an operating microscope.
366
00:17:50,179 --> 00:17:52,849
And we can use forceps,
367
00:17:52,881 --> 00:17:54,451
we can irrigate some things,
368
00:17:54,483 --> 00:17:55,913
and then, we have suction.
369
00:17:55,951 --> 00:17:59,591
So we can suction pus,
or a foreign body,
370
00:17:59,622 --> 00:18:00,852
or wax out of the ears.
371
00:18:05,628 --> 00:18:09,668
It’s gonna be a little tender coming out.
372
00:18:10,899 --> 00:18:13,669
So, I have to really
concentrate at this point.
373
00:18:13,702 --> 00:18:17,972
And be intentional about
every decision that I make.
374
00:18:18,007 --> 00:18:19,007
If she moves,
375
00:18:19,575 --> 00:18:21,015
flinches, coughs,
376
00:18:21,043 --> 00:18:23,513
even just...
just jerks a little bit,
377
00:18:23,545 --> 00:18:26,155
there’s potential to damage
her ear,
378
00:18:26,181 --> 00:18:28,111
scratch the ear canal
and then it bleeds.
379
00:18:28,150 --> 00:18:30,020
And the ear canal bleeds
like crazy.
380
00:18:30,052 --> 00:18:32,682
There’s potential to perforate
her eardrum,
381
00:18:32,721 --> 00:18:34,551
which also hurts and bleeds.
382
00:18:36,692 --> 00:18:38,792
- Ah!
- Sorry.
383
00:18:38,827 --> 00:18:41,497
I think we’ve all played
Operation when we were
little kids
384
00:18:41,530 --> 00:18:44,030
and the intensity that
that evoked...
385
00:18:45,167 --> 00:18:47,907
...you know, you don’t wanna
get that buzzer going.
386
00:18:47,936 --> 00:18:49,746
And that’s not even real,
387
00:18:49,772 --> 00:18:51,302
and you’re, you know,
stressed out about it.
388
00:18:51,340 --> 00:18:53,910
So, this is much bigger scale.
389
00:18:53,942 --> 00:18:55,012
Very serious.
390
00:18:55,044 --> 00:18:57,914
Okay. Almost got it.
391
00:18:58,547 --> 00:19:00,017
You didn’t get it?
392
00:19:00,049 --> 00:19:02,079
Well, yeah.
It came closer to me,
393
00:19:02,117 --> 00:19:03,457
but I gotta grab it.
394
00:19:04,920 --> 00:19:07,990
So, I would try to grab it
and I had a really good
hold of it,
395
00:19:08,023 --> 00:19:09,323
and I thought it was gonna
come out.
396
00:19:09,358 --> 00:19:10,728
But then, it wouldn’t
come out.
397
00:19:10,759 --> 00:19:13,659
The lacquer that was
actually on top of the nail,
398
00:19:13,696 --> 00:19:15,766
when I grabbed it,
it was just going through
that lacquer.
399
00:19:15,798 --> 00:19:17,168
So, it was like just
pinching it,
400
00:19:17,199 --> 00:19:18,459
it wasn’t grabbing it.
401
00:19:19,868 --> 00:19:22,728
- Oof!
- Think if you can turn your head this way right there.
402
00:19:22,771 --> 00:19:24,841
- Did you get it?
- Not yet.
403
00:19:28,410 --> 00:19:29,740
It’s really...
404
00:19:29,778 --> 00:19:33,178
- Did you get it?
- No, I’ll let you know when I get it.
405
00:19:33,215 --> 00:19:36,555
It’s really stuck in there.
You went pretty deep.
406
00:19:36,585 --> 00:19:38,385
The ear canal
is super sensitive.
407
00:19:38,420 --> 00:19:40,120
I’m just gonna take a look.
408
00:19:40,155 --> 00:19:43,225
And if you touch it,
it’s easy to bleed.
409
00:19:43,258 --> 00:19:44,618
Is it even moving?
410
00:19:44,660 --> 00:19:45,860
Yeah, I can grab it.
411
00:19:45,894 --> 00:19:48,294
It’s just not wanting to
come out because it’s stuck.
412
00:19:48,330 --> 00:19:51,060
You have to be very careful
because if you scrape it
or scratch it,
413
00:19:51,100 --> 00:19:52,430
it’s gonna hurt.
414
00:19:52,468 --> 00:19:55,738
And then people are
gonna jerk and that’s...
You don’t want that.
415
00:19:55,771 --> 00:19:58,441
The only thinking that I do
that makes adults cry is
416
00:19:58,474 --> 00:20:00,544
really anything that has
to do with the ear canal.
417
00:20:00,576 --> 00:20:02,946
- Did you get it?
- No.
418
00:20:02,978 --> 00:20:06,108
So, I’m trying to get
a better view.
419
00:20:11,353 --> 00:20:14,493
Okay. I think I know
what it’s doing here.
420
00:20:15,524 --> 00:20:16,964
Gosh.
421
00:20:16,992 --> 00:20:18,692
You okay, Mary?
422
00:20:20,295 --> 00:20:21,495
Oh, come on.
423
00:20:23,365 --> 00:20:24,705
You don’t have any, um...
424
00:20:26,268 --> 00:20:30,438
You just feel like some
drum’s hitting your ears.
425
00:20:30,472 --> 00:20:33,472
The alligator’s
literally just eating through
the nail.
426
00:20:33,509 --> 00:20:35,709
It’s like cutting through it.
427
00:20:38,380 --> 00:20:39,310
Yeah.
428
00:20:40,215 --> 00:20:41,785
Or Cetacaine,
whatever we have.
429
00:20:45,721 --> 00:20:48,121
If I’m not able to
get this thing out,
430
00:20:48,157 --> 00:20:50,527
then it’s gonna
be inflamed,
it’s gonna get worse.
431
00:20:50,559 --> 00:20:53,489
We’re gonna have to,
most likely, get her into the
operating room and remove it,
432
00:20:53,529 --> 00:20:57,359
uh, surgically. Which,
I’m really hoping we don’t
have to go that route today.
433
00:20:59,535 --> 00:21:01,035
All right. Little spray, okay?
434
00:21:02,204 --> 00:21:04,944
It’s a numbing agent.
But it’s pretty strong.
435
00:21:04,973 --> 00:21:06,773
It works pretty quick too.
436
00:21:06,809 --> 00:21:08,369
Okay, I’m not trying
to pull it out.
437
00:21:08,410 --> 00:21:10,910
I’m just looking and seeing
if I can move it around
a little bit.
438
00:21:16,351 --> 00:21:18,321
Can you tell if it’s
numbed up a little?
439
00:21:18,353 --> 00:21:20,853
Whatever you’re using,
it’s not gripping it.
440
00:21:20,889 --> 00:21:23,889
No, I’m not trying
to grip it, I’m trying to
move it.
441
00:21:23,926 --> 00:21:25,896
It looks like it’s loose.
It looks like it wants to just
442
00:21:25,928 --> 00:21:28,168
be grabbed and brought out.
443
00:21:28,197 --> 00:21:29,967
So, I tried twisting
it around.
444
00:21:29,998 --> 00:21:32,028
And twisted it and it
started to come out.
445
00:21:35,204 --> 00:21:37,304
I was getting really excited
and then it stopped again.
446
00:21:37,339 --> 00:21:38,399
Okay. Forceps.
447
00:21:46,849 --> 00:21:49,879
It was nerve-racking
for a little bit.
It was really stuck.
448
00:21:55,390 --> 00:21:56,220
Got it.
449
00:21:57,125 --> 00:21:58,765
Oh, gosh.
450
00:21:58,794 --> 00:22:00,694
So, I had to
move it around so I could get
451
00:22:00,729 --> 00:22:02,689
more of the actual nail.
452
00:22:02,731 --> 00:22:05,431
And pull it and twist it
around and pull it out.
453
00:22:05,467 --> 00:22:07,337
So that was a little painful
but um,
454
00:22:07,369 --> 00:22:09,429
the ear canal is super
duper tender.
455
00:22:10,739 --> 00:22:11,599
Yeah, but...
456
00:22:13,542 --> 00:22:14,372
Yeah.
457
00:22:19,114 --> 00:22:22,414
You can see the, um,
eardrum now, like...
458
00:22:22,451 --> 00:22:25,181
so you can tell the difference
in what you were looking at
before and now.
459
00:22:25,220 --> 00:22:26,280
Oh, Jesus.
460
00:22:26,321 --> 00:22:28,051
Will I put the nails again?
461
00:22:30,726 --> 00:22:33,436
I can’t believe it.
It happened so quick.
462
00:22:33,462 --> 00:22:36,432
It was really
stuck in there. I thought
it would be a lot easier.
463
00:22:36,465 --> 00:22:38,805
I don’t know if I need
to keep this or just trash it.
464
00:22:40,102 --> 00:22:42,032
I know, it’s a souvenir.
Do you want to keep
the souvenir?
465
00:22:42,070 --> 00:22:42,900
No.
466
00:22:50,979 --> 00:22:53,779
- Thank you so much. You saved my life.
- You’re welcome.
467
00:22:53,815 --> 00:22:55,485
- You’re welcome.
- Thanks.
468
00:22:55,517 --> 00:22:57,487
Somebody is really happy,
it makes me really happy
469
00:22:57,519 --> 00:22:59,119
because that’s what we’re
here for.
470
00:22:59,154 --> 00:23:02,654
You don’t wanna go to work
and not feel like you’ve
helped anybody all day long.
471
00:23:02,691 --> 00:23:04,621
- Thank you so much.
- You’re welcome.
472
00:23:10,999 --> 00:23:13,329
You know,
the nice part about
general surgery is
473
00:23:13,368 --> 00:23:15,268
it’s always full of surprises.
474
00:23:15,304 --> 00:23:19,244
I remember a case where
I treated a lady that had been
475
00:23:19,274 --> 00:23:21,944
involved in a accident
15 years earlier
476
00:23:21,977 --> 00:23:24,017
and she had a bullet
stuck in her back.
477
00:23:38,694 --> 00:23:41,534
My name is Erica Miles
and I’m a certified
nursing assistant.
478
00:23:42,030 --> 00:23:44,600
Um, back in 2005,
479
00:23:44,633 --> 00:23:47,373
when I was in high school,
after a football game,
480
00:23:47,402 --> 00:23:49,632
my friends and I were
waiting on our rides.
481
00:23:49,671 --> 00:23:52,371
And we end up being
innocent bystanders
482
00:23:52,407 --> 00:23:55,477
caught in the middle of
two groups of people
shooting at each other.
483
00:23:59,348 --> 00:24:01,288
I end up getting shot
in the back.
484
00:24:01,316 --> 00:24:03,186
I felt the burning sensation.
485
00:24:03,218 --> 00:24:05,848
They said that it was
too close to my spine
at the time.
486
00:24:05,887 --> 00:24:07,957
And they didn’t wanna
take it out.
487
00:24:07,990 --> 00:24:11,290
As long as it’s
not in a vessel or a joint,
488
00:24:11,326 --> 00:24:13,236
we usually leave them alone
and take them out when they
489
00:24:13,261 --> 00:24:15,161
either cause pain
or discomfort.
490
00:24:15,197 --> 00:24:17,307
People get shot all the time
and we never remove bullets.
491
00:24:17,332 --> 00:24:18,502
That’s kind of a TV thing.
492
00:24:18,533 --> 00:24:20,303
We leave all bullets in,
493
00:24:20,335 --> 00:24:23,345
unless they are stuck
in a vessel or a joint.
494
00:24:23,372 --> 00:24:27,372
The reason why is,
we usually will cause
a bigger problem
495
00:24:27,409 --> 00:24:29,139
going in to get it.
496
00:24:29,177 --> 00:24:31,817
The body will get rid of it
on its own,
497
00:24:31,847 --> 00:24:33,887
the majority of the time.
498
00:24:33,915 --> 00:24:36,215
The problem is,
when it gets to the surface,
499
00:24:36,251 --> 00:24:37,921
that’s when it starts
to cause pain.
500
00:24:39,254 --> 00:24:40,694
In her,
501
00:24:40,722 --> 00:24:43,522
this started causing
significant amount of pain.
502
00:24:44,459 --> 00:24:46,219
So we decided to take it out.
503
00:24:47,596 --> 00:24:50,066
I never felt it moving
throughout the years
504
00:24:50,098 --> 00:24:51,658
in my back. Um...
505
00:24:51,700 --> 00:24:54,330
Never thought about it.
It never bothered me
506
00:24:54,369 --> 00:24:58,169
until the night I felt it on
the surface of my skin
507
00:24:58,206 --> 00:24:59,706
and I knew that’s what it was.
508
00:24:59,741 --> 00:25:03,381
I was actually scared
’cause I knew that shouldn’t
have been in that place,
509
00:25:03,412 --> 00:25:05,442
it was at the top portion
of my back,
510
00:25:05,480 --> 00:25:07,710
and it moved down
to the lower portion.
511
00:25:07,749 --> 00:25:09,179
So I was scared.
512
00:25:09,217 --> 00:25:12,887
Once you
cut it open, you can see
the cavity already here.
513
00:25:12,921 --> 00:25:15,091
Because they body’s been
trying to get rid of it.
514
00:25:15,123 --> 00:25:18,693
Over my entire career,
I’ve probably seen
515
00:25:18,727 --> 00:25:21,797
maybe 300-500 gunshot wounds.
516
00:25:21,830 --> 00:25:24,230
And of those,
the strangest one
517
00:25:24,266 --> 00:25:26,066
was a gentlemen that got
shot in the head.
518
00:25:26,101 --> 00:25:29,101
He had a bullet in the middle
of his brain
519
00:25:29,137 --> 00:25:32,647
and had a little bit of blood
leaking out of the hole.
520
00:25:32,674 --> 00:25:35,114
We were trying to decide
when we were taking him
to the operating room,
521
00:25:35,143 --> 00:25:37,583
do an emergency craniotomy,
all this other stuff.
522
00:25:37,612 --> 00:25:39,482
And over the next
couple of hours,
523
00:25:39,514 --> 00:25:41,314
he woke up, he was doing fine.
524
00:25:41,349 --> 00:25:42,179
So we left it.
525
00:25:42,851 --> 00:25:43,681
So...
526
00:25:45,087 --> 00:25:46,157
That’s it.
527
00:25:48,356 --> 00:25:49,896
That’s a bullet extraction.
528
00:25:49,925 --> 00:25:51,895
Looks more like a 9...
529
00:25:51,927 --> 00:25:55,137
Not anything big like
a .40 caliber.
530
00:25:55,163 --> 00:25:58,763
- Unlike the movies, we don’t have...
- Mmm-hmm.
531
00:25:58,800 --> 00:25:59,860
Um...
532
00:26:00,769 --> 00:26:02,329
a metal basin to drop it in.
533
00:26:08,777 --> 00:26:10,117
But yeah.
That’s a bullet.
534
00:26:12,547 --> 00:26:14,657
After the surgery,
the recovery was fine.
535
00:26:14,683 --> 00:26:17,483
Um, I didn’t have any
issues or concerns.
536
00:26:17,519 --> 00:26:19,149
I healed like normal.
537
00:26:19,721 --> 00:26:21,151
I was okay.
538
00:26:21,189 --> 00:26:23,659
So, what we are
gonna do, we’re gonna put
one stitch in it,
539
00:26:23,692 --> 00:26:25,922
just to help
the healing process.
540
00:26:25,961 --> 00:26:28,791
But as far as closing
the hole up,
541
00:26:28,830 --> 00:26:31,100
we traditionally just let
them close up on their own.
542
00:26:31,133 --> 00:26:32,003
You have like, a...
543
00:26:33,201 --> 00:26:34,401
small stitch maybe.
544
00:26:39,841 --> 00:26:41,871
I’m so grateful
for Dr. Crawford.
545
00:26:41,910 --> 00:26:44,680
I’m just glad that I wasn’t
in any pain
546
00:26:44,713 --> 00:26:46,753
and I’m just glad that
the bullet was out of my back.
547
00:26:49,417 --> 00:26:51,857
Like, I start coughing
and stuff because I’ll start
gagging on something.
548
00:26:51,887 --> 00:26:55,297
And these little white things
kept coming out.
Like, hard balls.
549
00:26:55,323 --> 00:26:57,323
They smell like Sulphur
and like, just ick.
550
00:26:57,359 --> 00:26:58,819
All right.
Let’ see these things.
551
00:26:58,860 --> 00:27:02,830
They look...
552
00:27:02,864 --> 00:27:05,904
Ear wax and the removal of
ear wax is an art form.
553
00:27:05,934 --> 00:27:07,204
Got a little wax in there.
554
00:27:07,235 --> 00:27:08,905
Not all wax is the same.
555
00:27:08,937 --> 00:27:10,877
There we go.
Look at that!
556
00:27:10,906 --> 00:27:12,046
My head feels lighter.
557
00:27:12,073 --> 00:27:13,873
It can be like,
that long.
558
00:27:13,909 --> 00:27:17,439
Walk around like
I’m cute and that is
just like, ew.
559
00:27:32,260 --> 00:27:34,430
You can have
a seat right here and then...
560
00:27:34,462 --> 00:27:37,062
I’m Destiny Moon.
My tonsils are like,
561
00:27:37,098 --> 00:27:39,228
a bajillion sizes bigger
than they should be.
562
00:27:39,267 --> 00:27:41,407
And I have a super bad
gag reflex.
563
00:27:41,436 --> 00:27:43,746
Like, I start coughing
and stuff because I’ll start
gagging on something,
564
00:27:43,772 --> 00:27:45,872
and these little white things
kept coming out.
565
00:27:45,907 --> 00:27:47,647
Like, hard balls.
566
00:27:47,676 --> 00:27:49,776
They smell like Sulphur
and like, just ick.
567
00:27:49,811 --> 00:27:52,711
So, I was googling it
and found out that they
were tonsil stones.
568
00:27:52,747 --> 00:27:55,917
The most I’ve ever had
come out of my throat
was like, 15-ish.
569
00:27:55,951 --> 00:27:58,621
I don’t know if you’ve ever
seen the aquarium, like,
pebble stones,
570
00:27:58,653 --> 00:28:00,293
like in fish tanks,
it’s like that.
571
00:28:00,322 --> 00:28:02,292
And it’s awful.
572
00:28:03,792 --> 00:28:05,592
Hello, how are you?
573
00:28:05,627 --> 00:28:07,167
- Destiny, right?
- Yeah.
574
00:28:07,195 --> 00:28:08,835
I’m Mark.
Nice to meet you.
575
00:28:08,863 --> 00:28:10,663
So, what’s going on
with you today?
576
00:28:10,699 --> 00:28:13,429
Um, my family doctor said that
I needed to come up here
577
00:28:13,468 --> 00:28:15,268
’cause I have these
really bad tonsil stones.
578
00:28:15,303 --> 00:28:16,973
And that I needed to get them
checked out.
579
00:28:17,005 --> 00:28:19,405
Do they cause you any
problems? Do they hurt?
580
00:28:19,441 --> 00:28:22,471
- I can’t swallow water without choking. Like, bad.
- Okay.
581
00:28:22,510 --> 00:28:24,410
All right. How long has this
been going on for?
582
00:28:24,446 --> 00:28:26,246
My entire life. But it started
getting really, really bad
583
00:28:26,281 --> 00:28:28,081
when I was pregnant
with my son,
584
00:28:28,116 --> 00:28:30,586
who’s now three.
585
00:28:30,619 --> 00:28:34,119
Do they cause you any
other issues like pain,
bad breath
586
00:28:34,155 --> 00:28:36,995
things like that at all?
587
00:28:37,025 --> 00:28:38,295
- The bad breath, I’m assuming.
- Okay.
588
00:28:38,326 --> 00:28:40,166
The tonsil stones smell
when they come out.
589
00:28:40,195 --> 00:28:43,165
- So, I’m just assuming.
- Yes, unfortunately they do smell very bad.
590
00:28:43,198 --> 00:28:45,438
Crypts are like holes
in the tonsils.
591
00:28:45,467 --> 00:28:48,307
Uh, kind of like if you think
about how the moon looks.
592
00:28:48,336 --> 00:28:50,806
And then the holes,
they produce keratin,
593
00:28:50,839 --> 00:28:53,769
and then that, you know,
the epithelial cells,
594
00:28:53,808 --> 00:28:57,708
bacteria, just debris, kind of
mixes together and forms
those little stones.
595
00:28:57,746 --> 00:28:59,946
And then they stick in there
until you pop them out.
596
00:28:59,981 --> 00:29:04,621
Tonsil stones can be anywhere
from a size of a grain
of sand to...
597
00:29:04,653 --> 00:29:07,493
I’ve seen some tonsil stones
about the size of
a pinky nail.
598
00:29:07,522 --> 00:29:08,592
So, pretty large.
599
00:29:10,892 --> 00:29:13,222
All right. You can go ahead
and remove your mask if you’re
fine with that.
600
00:29:13,261 --> 00:29:14,831
Worst case scenario is,
601
00:29:14,863 --> 00:29:17,063
the definitive treatment is
to remove the tonsils.
602
00:29:17,098 --> 00:29:20,028
And unfortunately, that’s not
a pleasant procedure.
603
00:29:20,068 --> 00:29:23,408
You have a little bit of
a deviated septum but your
nose otherwise looks great.
604
00:29:23,438 --> 00:29:25,008
All right, let’s see
these things.
605
00:29:25,040 --> 00:29:26,640
Big ah. Look right up
here for me.
606
00:29:26,675 --> 00:29:30,645
So about three plus tonsils
and definitely very cryptic.
607
00:29:30,679 --> 00:29:32,739
- You can see the holes in the tonsils.
- Sorry.
608
00:29:32,781 --> 00:29:35,081
- Do you have a bad gag reflex?
- Yes, awful.
609
00:29:35,116 --> 00:29:37,886
Then what I’m gonna do
is, I’m gonna spray some stuff
in your throat.
610
00:29:37,919 --> 00:29:40,819
- It’ll numb it up and blunt the gag reflex.
- Okay.
611
00:29:40,855 --> 00:29:43,225
- Unfortunately, it tastes really bad.
- Ugh.
612
00:29:44,893 --> 00:29:48,333
- Understatement.
- Yes.
613
00:29:48,363 --> 00:29:50,263
All right. Let’s see if
we can do this.
614
00:29:50,298 --> 00:29:53,328
So, look up here,
just a little bit.
Just like that.
615
00:29:53,368 --> 00:29:56,438
So, you can see one right
over here on the left side.
616
00:29:56,471 --> 00:29:58,901
- Oh, yes. Oh, you’re fine. You’re fine.
- Sorry.
617
00:30:00,809 --> 00:30:02,709
There’s one small one.
618
00:30:03,545 --> 00:30:04,885
- You good?
- Ah!
619
00:30:04,913 --> 00:30:07,153
Oh, sorry.
620
00:30:10,418 --> 00:30:12,918
- Oh, sorry.
- Look at this.
621
00:30:12,954 --> 00:30:15,724
All right, so I’m gonna
turn this way,
just a little bit.
622
00:30:19,594 --> 00:30:21,064
- Told you it was really bad.
- No, it’s okay.
623
00:30:21,096 --> 00:30:24,236
Tonsil stones have
a very foul smell.
624
00:30:25,166 --> 00:30:27,536
Similar to a dead animal.
625
00:30:27,569 --> 00:30:28,669
Like roadkill.
626
00:30:30,105 --> 00:30:31,545
They’re not pleasant.
627
00:30:31,573 --> 00:30:33,403
- Oh, goodness.
- Smells bad.
628
00:30:36,077 --> 00:30:37,587
So, with tonsils like yours,
629
00:30:37,612 --> 00:30:40,812
the only good treatment is
gonna be just removing
your tonsils.
630
00:30:40,849 --> 00:30:44,319
- Now, it’s not a fun surgery. So, fair warning.
- Yeah.
631
00:30:44,352 --> 00:30:46,482
Destiny came in
with tonsil stones.
632
00:30:46,521 --> 00:30:49,091
Unfortunately, no way
to fix this problem
633
00:30:49,124 --> 00:30:51,624
without just taking
the tonsils out at this point.
634
00:30:51,659 --> 00:30:53,259
Certainly should help
the swallowing
635
00:30:53,294 --> 00:30:54,894
and the discomfort back there
as you have.
636
00:30:54,929 --> 00:30:57,599
But the good news is,
you won’t ever have
a tonsil stone again.
637
00:30:58,767 --> 00:31:02,007
She’ll suffer for 10-14 days
to get it out.
638
00:31:02,036 --> 00:31:05,576
So when someone is willing
to do that, you know it’s
probably significant enough.
639
00:31:05,607 --> 00:31:07,417
In the long run,
it’s usually worth it
for them.
640
00:31:07,442 --> 00:31:09,972
No tonsils, no tonsil stones.
641
00:31:17,285 --> 00:31:18,825
Hello!
642
00:31:18,853 --> 00:31:22,693
I’m Lynn Guan and I’m
a physician assistant
at the ENT Institute.
643
00:31:22,724 --> 00:31:24,924
- Good morning, Ms. Moralski.
- Hello, how are you?
644
00:31:24,959 --> 00:31:26,689
- Good. How are you?
- I’m good.
645
00:31:26,728 --> 00:31:30,608
Even though I specialize in
all things ear, nose
and throat related,
646
00:31:30,632 --> 00:31:34,172
I find myself spending
a lot of time looking
in people’s ears.
647
00:31:34,202 --> 00:31:36,432
All right, so what’s going
on today?
648
00:31:36,471 --> 00:31:38,001
Oh, well.
I had a little...
649
00:31:38,673 --> 00:31:39,943
Little problem hearing.
650
00:31:39,974 --> 00:31:42,674
I don’t know what it’s,
you know, what it’s about, whatever.
651
00:31:42,710 --> 00:31:44,840
And I thought I should
come in, have it checked out.
652
00:31:44,879 --> 00:31:46,679
All right. Well,
let’s take a look inside.
653
00:31:46,714 --> 00:31:51,284
Everyday at the ENT Institute,
I see something that’s stuck
in patients ears
654
00:31:51,319 --> 00:31:54,189
Most of the time, it’s wax.
655
00:31:54,222 --> 00:31:58,492
- So, this side has quite a lot of wax in here.
- Okay.
656
00:31:58,526 --> 00:32:02,696
I’d say I probably see
a little under a 100
ear wax cases a month.
657
00:32:02,730 --> 00:32:05,900
So, the wax is a bit hard
on this side.
658
00:32:05,934 --> 00:32:09,534
She had just a harder,
more firm type of ear wax.
659
00:32:09,571 --> 00:32:12,871
So I used a tool we call
an alligator forcep
660
00:32:12,907 --> 00:32:15,417
to gently peel away
the layers of the wax
661
00:32:15,443 --> 00:32:17,243
from the side of
the ear canal.
662
00:32:17,278 --> 00:32:18,808
You ready to see this piece?
663
00:32:20,915 --> 00:32:23,555
- So, here’s what we have!
- Oh, my gosh!
664
00:32:23,585 --> 00:32:26,685
- Look at this here. So, that’s a good one there.
- Oh, wow.
665
00:32:26,721 --> 00:32:28,651
- Wow.
- So this is what came out of your ear.
666
00:32:28,690 --> 00:32:31,590
- So, you can see just how long it’s been there.
- Yeah, no wonder I can’t hear.
667
00:32:31,626 --> 00:32:33,496
- By how hard it is. Can you hear better now?
- Yeah.
668
00:32:33,528 --> 00:32:35,668
- Yeah, I really can. It’s amazing.
- Good.
669
00:32:35,697 --> 00:32:37,337
Wow.
670
00:32:37,365 --> 00:32:40,235
Ear wax and removal of ear wax
is an artform.
671
00:32:40,268 --> 00:32:41,578
You got a little wax in there.
672
00:32:41,603 --> 00:32:43,203
Not all wax is the same.
673
00:32:43,238 --> 00:32:45,248
We’re gonna get it out
for you.
674
00:32:46,474 --> 00:32:48,514
Does that feel a little bit
more open?
675
00:32:48,543 --> 00:32:49,643
No, it feels good.
676
00:32:49,677 --> 00:32:52,587
No wonder sometimes
he has selective hearing.
677
00:32:52,614 --> 00:32:56,754
With regard to ear wax,
it’s something that’s
genetically determined.
678
00:32:56,784 --> 00:32:58,584
And I always jokingly say,
679
00:32:58,620 --> 00:33:00,420
"It’s another thing you can
blame on your mother."
680
00:33:00,455 --> 00:33:02,495
They are really,
completely clogged.
681
00:33:03,925 --> 00:33:05,325
The motherlode. Here we go.
682
00:33:05,760 --> 00:33:06,890
There we go?
683
00:33:06,928 --> 00:33:09,368
That’s like a hole in one,
to get it out in one piece.
684
00:33:09,397 --> 00:33:11,407
- Hi, Crystal. Nice to meet you.
- Nice to meet you.
685
00:33:11,432 --> 00:33:13,432
So, tell me what’s been
going on with your ear.
686
00:33:13,468 --> 00:33:15,808
So when I first started
doing ENT,
687
00:33:15,837 --> 00:33:19,047
I guess I really didn’t
realize that there was
gonna be ear wax,
688
00:33:19,073 --> 00:33:22,473
and it was a little
off-putting.
689
00:33:22,510 --> 00:33:24,440
Okay. Got a big bit out.
690
00:33:24,479 --> 00:33:26,609
- But there’s more.
- Oh, my God!
691
00:33:27,282 --> 00:33:28,882
That is crazy.
692
00:33:28,917 --> 00:33:31,957
If you’ve never had it
cleaned out, and you’re used
to the way your ears feel
693
00:33:31,986 --> 00:33:33,356
when they’re full,
694
00:33:33,388 --> 00:33:35,958
you don’t know that there’s
a problem until you are
about deaf.
695
00:33:35,990 --> 00:33:38,820
- More of the same.
- Oh, my goodness.
696
00:33:38,860 --> 00:33:40,260
What in the world?
697
00:33:41,296 --> 00:33:42,136
There.
698
00:33:42,664 --> 00:33:44,664
Oh, ew.
699
00:33:44,699 --> 00:33:46,059
Huh.
700
00:33:46,100 --> 00:33:48,430
Oh, my God.
I walk around like I’m cute,
701
00:33:48,469 --> 00:33:51,239
and that is just like, ew.
702
00:33:51,272 --> 00:33:54,012
Everybody is like,
703
00:33:54,042 --> 00:33:55,842
Oh, my God, I feel
so much better.
704
00:33:55,877 --> 00:33:58,847
It’s like a weight lifted off.
Like, I’m telling you,
705
00:33:58,880 --> 00:33:59,840
say something.
706
00:34:03,284 --> 00:34:06,084
Some of it can be
really thick.
707
00:34:06,120 --> 00:34:07,990
This was wax out of that
one ear.
708
00:34:09,390 --> 00:34:11,660
Sometimes it smells.
709
00:34:11,693 --> 00:34:14,093
There was
a gentleman with
an ear infection
710
00:34:14,128 --> 00:34:17,498
and I could smell his ear
from the doorway.
711
00:34:17,532 --> 00:34:19,002
- You see that wax?
- Yes.
712
00:34:19,033 --> 00:34:20,473
Okay, we’re gonna
clean that out.
713
00:34:20,501 --> 00:34:25,301
It’s not uncommon to pull out
a huge piece in one sitting.
714
00:34:25,340 --> 00:34:27,140
Here we go,
look at that!
715
00:34:27,175 --> 00:34:29,615
- Wow, my head feels lighter.
- Does it feel lighter?
716
00:34:29,644 --> 00:34:31,514
It can be like, that long,
717
00:34:31,546 --> 00:34:33,086
and that thick.
718
00:34:34,382 --> 00:34:37,152
And it’s just like, oh, wow.
719
00:34:37,185 --> 00:34:39,355
- Wow.
- So, this is the big old guy
720
00:34:39,387 --> 00:34:40,757
that came out of your ear.
721
00:34:42,590 --> 00:34:46,190
- So there’s more of that pulled out over here.
- Oh, wow.
722
00:34:48,229 --> 00:34:51,659
She is packed
full of ear wax.
723
00:34:51,699 --> 00:34:54,399
I actually had a guy,
had to see him
every six weeks.
724
00:34:54,435 --> 00:34:55,375
Really.
725
00:34:55,403 --> 00:34:57,243
We called him
the candlestick-maker.
726
00:34:59,007 --> 00:35:01,217
Oh, your...
clean as a whistle.
727
00:35:01,242 --> 00:35:05,982
I know you guys all wonder
what happens to everything
that goes through that suction
728
00:35:06,014 --> 00:35:07,354
and through that
mysterious tube,
729
00:35:07,382 --> 00:35:09,752
but it all goes into
a cannister.
730
00:35:09,784 --> 00:35:12,424
It is full of all kinds
of loveliness.
731
00:35:12,453 --> 00:35:15,253
Everything from
ear wax, drainage,
732
00:35:15,289 --> 00:35:18,419
fungus, bacteria, blood,
733
00:35:18,459 --> 00:35:19,689
all that good stuff.
734
00:35:23,965 --> 00:35:26,835
Gotta relax.
735
00:35:26,868 --> 00:35:28,638
Open your eyes.
736
00:35:39,547 --> 00:35:42,057
So, in this bag,
they’ll put your shoes
and your
737
00:35:42,083 --> 00:35:44,553
gown goes on like this.
738
00:35:44,585 --> 00:35:46,455
I’m here to get
my tonsils taken out
739
00:35:46,487 --> 00:35:49,457
and deal with the tonsil
stones that are building
in the back of my throat.
740
00:35:49,490 --> 00:35:52,190
It’s nerve-wracking
and I’m stressed out, nervous.
741
00:35:52,226 --> 00:35:53,966
I just want to get
the surgery over with
742
00:35:53,995 --> 00:35:56,235
because the tonsils are awful.
743
00:35:56,264 --> 00:35:58,434
- Destiny? I love that name.
- Yes.
744
00:35:58,466 --> 00:36:01,036
It’s fantastic. But I love the hair more.
745
00:36:01,069 --> 00:36:03,429
I’m Dr. Jeffery Gallups.
I’m the Medical Director of
746
00:36:03,471 --> 00:36:05,371
the Ear, Nose
and Throat Institute.
747
00:36:05,406 --> 00:36:07,776
One of the most anxious times
for a patient
748
00:36:07,809 --> 00:36:10,369
is that morning,
that day of surgery.
749
00:36:10,411 --> 00:36:12,911
So, I always try to lighten
the mood a little bit.
750
00:36:12,947 --> 00:36:16,217
- You have much pain from it?
- Yeah. A lot of discomfort at least.
751
00:36:16,250 --> 00:36:17,720
Well, that’s gonna be gone.
752
00:36:17,752 --> 00:36:19,982
Everyone knows someone
that’s had a tonsillectomy.
753
00:36:20,021 --> 00:36:22,121
And you think, "Oh, it’s
a fairly benign procedure."
754
00:36:22,156 --> 00:36:24,626
But it has its
own complications.
755
00:36:24,659 --> 00:36:28,489
So we wanna be very selective
about why we’re doing this.
756
00:36:28,529 --> 00:36:30,559
Dr. Bovenkerk’s
taking care of you today.
757
00:36:30,598 --> 00:36:32,598
I’ll be in the room
but not performing
the surgery.
758
00:36:32,633 --> 00:36:35,133
- I’m excited for you. Great to meet you.
- Yeah, awesome. Thank you.
759
00:36:35,169 --> 00:36:37,839
The number one complication
of a tonsillectomy
is bleeding.
760
00:36:37,872 --> 00:36:39,672
One of the other complications
761
00:36:39,707 --> 00:36:41,577
is when you take tonsils out,
762
00:36:41,609 --> 00:36:43,509
sometimes it creates
more swelling
763
00:36:43,544 --> 00:36:46,284
than the tonsils created
at the time.
764
00:36:46,314 --> 00:36:47,784
Now, this is temporary,
765
00:36:47,815 --> 00:36:50,515
but if you have that,
then you could suffocate.
766
00:36:51,719 --> 00:36:53,519
Hello, hello, Destiny.
767
00:36:53,554 --> 00:36:55,254
Hi! Dr. Bovenkerk.
768
00:36:55,289 --> 00:36:57,619
Nice to meet you.
769
00:36:57,658 --> 00:36:59,918
This is just oxygen.
We’ll have you start taking
those nice,
770
00:36:59,961 --> 00:37:01,591
deep breaths in and out.
771
00:37:01,629 --> 00:37:04,299
Put your chin up towards
the ceiling for me, perfect.
772
00:37:04,332 --> 00:37:06,302
You’ve been on any
vacations lately?
773
00:37:06,334 --> 00:37:08,004
No, need one.
774
00:37:08,035 --> 00:37:09,305
You need one? Okay.
775
00:37:09,337 --> 00:37:11,447
- Well, you’re gonna get one now.
- Yep.
776
00:37:11,472 --> 00:37:15,172
Starting
the medication now to help you
drift off to Gatlinburg.
777
00:37:16,911 --> 00:37:17,911
Enjoy that nap.
778
00:37:23,551 --> 00:37:26,281
This is a MacGyver retractor.
779
00:37:26,320 --> 00:37:30,320
It does a really good job of
keeping the mouth
nice and open.
780
00:37:30,358 --> 00:37:32,668
My tonsils, they’ve always
been a problem.
781
00:37:32,693 --> 00:37:34,893
I’m super excited to get
the surgery over with.
782
00:37:34,929 --> 00:37:37,629
And I’m really hoping that
we can get it out today.
783
00:37:37,665 --> 00:37:40,035
Look at that.
Oh, yeah.
784
00:37:40,067 --> 00:37:42,377
Plenty to grasp on to there.
785
00:37:42,403 --> 00:37:43,303
I agree.
786
00:37:43,337 --> 00:37:45,207
Tonsils can be very deceiving.
787
00:37:45,239 --> 00:37:47,669
So when I looked in her mouth,
it was huge.
788
00:37:47,708 --> 00:37:49,408
And inflamed.
789
00:37:49,443 --> 00:37:51,643
Looks like they’ve
been bleeding.
790
00:37:51,679 --> 00:37:53,039
You know, they’re just raw.
791
00:37:53,080 --> 00:37:55,750
That is a really
good indicator
792
00:37:55,783 --> 00:37:59,323
for somebody who needs
their tonsils removed.
793
00:37:59,353 --> 00:38:03,223
So, she has
cryptic tonsils with those
crypts and crevices.
794
00:38:03,257 --> 00:38:05,267
And they’re enlarged as well.
795
00:38:05,293 --> 00:38:08,363
In the tonsil itself,
are called crypts.
796
00:38:08,396 --> 00:38:11,436
And it’s where food
has been pushed
797
00:38:11,465 --> 00:38:14,175
into these little holes
in the tonsils.
798
00:38:14,202 --> 00:38:16,502
And after a while,
they become thick.
799
00:38:16,537 --> 00:38:18,777
Kind of like sand
on the beach.
800
00:38:18,806 --> 00:38:21,076
Then after that,
they become stones.
801
00:38:21,108 --> 00:38:24,008
I’ve seen stones as this big.
802
00:38:24,045 --> 00:38:25,445
Look like a spearhead.
803
00:38:25,479 --> 00:38:27,409
In fact, I still have that one
in my desk drawer.
804
00:38:30,117 --> 00:38:33,127
We’re gonna put
a catheter into the nose,
805
00:38:33,154 --> 00:38:36,624
gives me a little better
exposure of the tonsils.
806
00:38:36,657 --> 00:38:40,067
We can start to see these
white-ish, yellow-ish
particles here.
807
00:38:40,094 --> 00:38:42,034
Those are the tonsil stones.
808
00:38:42,063 --> 00:38:45,463
Sometimes they are the size
of garbanzo beans.
809
00:38:45,499 --> 00:38:48,099
The next thing
is, retract the tonsil.
810
00:38:48,135 --> 00:38:50,035
It’s against the side
of the wall of the throat.
811
00:38:50,071 --> 00:38:51,741
So, we want to stretch it,
812
00:38:51,772 --> 00:38:54,172
so that we can really
cut it off.
813
00:39:01,315 --> 00:39:04,785
And it seals the vessels
as it removes the tonsil.
814
00:39:04,819 --> 00:39:07,949
You know, it’s like cutting
through butter with
a hot knife.
815
00:39:15,263 --> 00:39:18,333
So, this is her
right tonsil.
816
00:39:18,366 --> 00:39:22,906
Quite a few of those
little tonsil stones right on
the surface here.
817
00:39:22,937 --> 00:39:25,607
You can go ahead
and pass that.
818
00:39:25,640 --> 00:39:29,010
And we’ll get to work on
the left tonsil.
819
00:39:47,495 --> 00:39:49,635
And the left tonsil.
820
00:39:50,298 --> 00:39:52,708
Really enlarged tonsils.
821
00:39:53,501 --> 00:39:55,931
One of the scariest times is
822
00:39:55,970 --> 00:39:58,640
when they remove the tube
that assists them
823
00:39:58,673 --> 00:39:59,773
to keep the airway open.
824
00:39:59,807 --> 00:40:02,477
The surgeon many times
suctions the stomach.
825
00:40:08,349 --> 00:40:13,019
Because after you take
the tube out of the throat
from surgery,
826
00:40:13,054 --> 00:40:15,894
if they were to
vomit or cough,
827
00:40:15,923 --> 00:40:17,793
and their stomach’s
full of fluid,
828
00:40:17,825 --> 00:40:20,835
they will cough that up
and potentially aspirate it,
829
00:40:20,861 --> 00:40:22,791
or suck it back
into their lungs.
830
00:40:22,830 --> 00:40:25,400
And then you’ve got
a real emergency.
831
00:40:25,433 --> 00:40:26,833
And that is it.
832
00:40:27,668 --> 00:40:28,968
Fantastic.
833
00:40:29,003 --> 00:40:30,633
Destiny?
834
00:40:30,671 --> 00:40:32,071
Destiny, you’re all done.
835
00:40:39,046 --> 00:40:42,316
There you go. Cough it up.
836
00:40:42,350 --> 00:40:45,020
Destiny, you’re just
waking up, okay?
837
00:40:46,454 --> 00:40:48,824
Hey, Destiny.
Can you open your eyes?
838
00:40:48,856 --> 00:40:51,096
As you can see,
she’s trying to fight this
back a little bit.
839
00:40:51,125 --> 00:40:53,925
Won’t open her eyes,
she’s not responding to them.
840
00:40:53,961 --> 00:40:56,061
You know, she’s biting
a little bit on the tube.
841
00:40:56,097 --> 00:40:59,737
They’re trying to get this out
and she’s totally unaware
any of this at this point.
842
00:41:05,806 --> 00:41:07,376
- Here we go.
- Try to relax.
843
00:41:07,408 --> 00:41:09,248
- Okay?
- Perfect.
844
00:41:11,145 --> 00:41:12,615
Welcome back.
845
00:41:12,646 --> 00:41:15,356
It’s hard for me to not
put myself in their position
846
00:41:15,383 --> 00:41:18,123
’cause I had my tonsils out
when I was a kid and I still
remember it.
847
00:41:18,152 --> 00:41:21,452
She’s gonna wake up.
She’s gonna have
a very sore throat.
848
00:41:21,489 --> 00:41:23,049
She’s gonna be groggy.
849
00:41:23,090 --> 00:41:24,960
But after the grogginess
goes away,
850
00:41:24,992 --> 00:41:27,792
it’s gonna be the worst
sore throat she’s ever had.
851
00:41:27,828 --> 00:41:29,458
But it’s gonna cure
the problem.
852
00:41:31,098 --> 00:41:33,898
I’m way
too excited, ’cause I just
want everything to be better.
853
00:41:33,934 --> 00:41:36,604
And I might actually be
able to like, eat food and
854
00:41:36,637 --> 00:41:39,047
enjoy food again.
That would be super great.
855
00:41:43,277 --> 00:41:46,117
Fish hooks are
a nemesis for patients.
856
00:41:48,015 --> 00:41:50,055
She has a bead
stuck in her ear.
857
00:41:50,084 --> 00:41:53,524
A bead of a beanbag.
So I tried to get it out.
858
00:41:54,588 --> 00:41:55,718
Could it be popcorn?
859
00:41:55,756 --> 00:41:58,596
Popcorn
in her ear?
860
00:41:58,626 --> 00:42:00,626
No! It’s a bead.
861
00:42:00,661 --> 00:42:02,591
Pop, there’s goes the nail.
862
00:42:02,630 --> 00:42:05,900
[] I’ve seen a few nail gun
injuries like this.
863
00:42:05,933 --> 00:42:09,403
You can see it’s actually
in there pretty good.
864
00:42:09,437 --> 00:42:14,317
You could hear it rip though
a little bit of tendon
or tissue.
865
00:42:14,341 --> 00:42:17,611
He just has
a ball of sort of jelly mucus
that’s just
866
00:42:17,645 --> 00:42:19,585
stuck there and it’s just
never gonna come out,
867
00:42:19,613 --> 00:42:20,983
unless we remove it.
868
00:42:21,015 --> 00:42:22,955
Here we go. Wow.
869
00:42:22,983 --> 00:42:23,853
That is just...
870
00:42:25,953 --> 00:42:27,793
That is just cool,
look at that.
871
00:42:27,822 --> 00:42:29,452
There is this pleasant lady
872
00:42:29,490 --> 00:42:32,690
she’s got a huge stiletto heel
873
00:42:32,726 --> 00:42:34,996
stuck smack into her face.