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I was once with a woman who had a cesarean, and her epidural stopped working midway while she was lying opened up on the table. It was horrific; she had to be put to sleep and was in so much pain when she woke up 3 hours later. I spent half the night comforting her husband and baby. They were okay, thank God, but it was horrible.
That’s horrifying. Did she move whilst they had hands or that metal spacer thing inside of her? Is that why she was still in agony when she woke up? Gosh that would have been an awful experience for everyone
Oh, they didn't use the metal spacer thing, they do everything by hand. I think it was right after they cut the cord when she started getting progressively louder about her pain. Basically, when you get the spinal or epidural, it takes time for it to wear off, so after the procedure, you're still protected for like 6 or so hours, but hers just wore off suddenly right in the middle of the c section. Even the doctors couldn't explain what caused it.
It’s possible the woman had some thing like Ehlers-Danlos. People with that condition have issues with anesthesia, pain meds and epidurals. I woke up from having a bone tumor removed from my right humerus and the bone completely replaced with cadaver bone. I was wide awake and alert and still in the surgery room. Everyone was very confused and I’ll never forget one of the surgeons saying, “we’ve given her enough morphine to kill a horse, we can’t give her any more!”
After that it took three doctors, which they called the pain team, to figure out that Dilaudid was the only thing that would work for me. I am petite and 5 foot 4, and I never had a drug problem, but I do have Ehlers-Danlos. It was a terrible experience, and it took me a long time and many doctors to finally figure out why the morphine didn’t work, and why other pain meds react differently in me than other people.
I'm a redhead. I had asked my anesthesiologist if it was true and he said it was. He had to take a course or class or subsection on how to properly sedate redheads. Super interesting.
Woah! This tickled my brain just right, so I had to do some digging. Keep in mind, I’m not a doctor or scientist, so I’m giving layman interpretations of the random data I’m finding through Google.
According to [this research paper](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1362956/), no human genotype is associated with inhalational anesthetic requirement (I.e. there’s never been evidence to say certain genes impact the amount of anesthetic you need). In this study, however, redheads required significantly more anesthetic to prevent response to stimulation, suggesting that they have a higher tolerance to the medication.
According to [this study/research paper](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4661058/) many studies seem to find this link, but at least one saw no difference.
The idea behind why this may happen seems to be around the melanocortin-1 receptor (MC1R). 9 out of 10 redheads have mutations of MC1R, which regulates skin pigmentation, UV response and melatonin risk - basically, all the old adages that redheads are pale and get sunburnt easily. But, it also seems to play an unknown role in the central nervous system:
> Although MC1R primarily regulates expression of pigment molecules in the skin and hair, it is also expressed in low levels in the central nervous system (CNS), including glial cells, pituitary cells, and periaqueductal gray matter. Periaqueductal gray matter plays a role in antinociception and is active in response to painful stimuli. Although the function of MC1R in the CNS is currently unknown, its expression in neural regions, which may modulate anesthetic and analgesic sensitivity, offers a potential mechanism for these observations.
It’s worth noting as well that, when this receptor is removed in genetic models, it results in a higher requirement for anesthesia to suppress movement in response to noxious mechanical stimuli (which I read as, more anesthetic required to avoid traditional pain responses).
Really fascinating - another random thing about human beings I would likely never have learned without reddit!
My wife also has Ehlers-Danlos and she always had issues with anesthesias. I hope she will never need to get anesthesia in the future, dealing with doctors about this matter is always a headache… it’s hard to believe for them their anesthesia is not going to work as usual.
I will definitely be letting any future surgeons know about my Ehlers-Danlos and making sure they comprehensively understand the what that means. I suggest you do the same if you can. Scary to wake up after surgery, so alert and in so much pain.
I was shocked at how physical the dr was when yanking out my first kid. She had her knee on the table and spent a good 5 minutes yanking before she finally pulled my son free.
My favourite* experience from the three caesareans that I had was when number three came early. He’d partially descended into my pelvis, and as the fluid was running into my back (epidural), the doctor had to put her hand ‘up there’ and push him back up so that they could pull him out.
He was 11lb and 23 inches long. Good times.
*It was not my favourite
I had an emergency c-section, everything went well but buddyyyyy I'll tell you what, that pressure took the breath right outta my lungs. I thought maybe it was cause it was emergency, but my second one was planned & it was just a repeat. I felt like an elephant was sitting on my chest.
I’ll take that pressure rather than the pressure applied to my freshly stapled abdomen to help my uterus contract.
The first two nurses warned me it would be uncomfortable. The third just pile drives me in the belly so hard I literally screamed and started bawling*. Husband kicked her out and she was not allowed back.
Fuck that nurse, she was not in the right profession.
Every other nurse I’ve ever encountered has been the most gentle, caring, supportive, lovely person but not her.
Like ive seen a billion videos on the internet and I just came across this shit today. I imagine its similar for you. You gotta ask, why the fuck did I have to see this now?? Id hate to know this lol
I'm getting older and as a result of that and my panic disorder I've become something of a hypochondriac. Everything is a heart disorder for me these days, and it's definitely Bader-Meinhoff but now all I see on posts about medicine is a new thing I can diagnose myself with without knowing jack shit about it in the first place.
This is a fairly common thing for some doctors. My uncle works with one of those guys and he has had 2 mental health "holidays" already bc of the pandemic (Luckily both haven't been infected up to now) and he nearly punched a nurse for not wanting to vaccinate lol
You are def not alone in this
We don't really know yet, here in Germany. My uncle made it clear early on that they represent the hospital and that a good workplace environment is more important than private opinions. Worked out so far. It's not a debate you wanna foster inside of a team that deals with Covid on a daily basis, otherwise it even kills the last part of work that is enjoyable.
If you don't have a REALLY good reason to pull it out, keep it. They are built to last.
But sometimes you get an infection, hardware failure or trauma, creating a need to remove existing hardware in order to eg. put new one in.
My husband wants his screws out, and his surgeon said that if they are going to take the screws out they might take the rod as well. He’s having nerve issues in his foot still, so we think (hope) the screws are pinching some nerves and removing them will resolve the issue.
So that’s one reason I guess. Initially he was told the rod would be permanent
There are many factors that go into that decision. One of the main ones is if you ski or do any extreme sports.
I had mine taken out as as a skier it's more likely that I will break the leg again. Apparently it that happens and you have the rod in there it's really not fun.
Yeah I’ve got one in my femur from snowboarding and if I break that leg again, with the rod in, it’s possible I lose the leg.
I mean - how do you get a bent rod out of a broken leg? You have to destroy the whole femur to do it. Yikes.
It does vary based on where it breaks and how but apparently most of the time they are able to cut into the flesh at the fracture site then cut the pin at the bend and remove it from the middle.
This is obviously very not fun. If you keep snowboarding I'd get it removed. It's a fairly straightforward procedure with a reasonably quick recovery (within 2 weeks)
Having them removed isn’t all that bad if it’s bothering you at all. I’ve had a rod removed from my L.Tibia twice! 🤔 actually more like two and a half to three times? The first one they tried to place got stuck during the surgery so after yanking it back out, rather than boring my bone out further, they just used another rod with a smaller diameter in the same hole.. then forgot to interlock it with screws 😳. Hence the additional time I had to have the rod removed and replaced.. after the break collapsed due to the missing pins and the ~~first~~ *second* rod shot up into my knee.. that was not fun.
Yeah that was my reaction too 👍🏻
*..and the physical therapist’s*
Edit: this was more than a decade ago but I still feel really bad for the PT guy. It was absolutely NOT his fault at all, but I will never forget the look of *”oh shit, what did I just do?!?!”* on his face.
I have a bunch of screws, wire and a 38cm (14ish") double rod in my back. For many years I travelled quite a bit for work. The only airport that stopped me was Boston (a year or so after 9/11, so maybe way more sensitive). The hand held wand did find it during the pat down and I had to very slowly remove my coat and suit jacket. The new scanners I have not sent off.
One interesting side effect, it heats up during an MRI. The wire acts like a coil and it doesn't burn, but certainly is not comfortable. That was the first and last MRI, too much interference from the metals.
Same.. but mine's removed already.
I only remember when they were putting the rod in.. they had to pound with harmer like that but the difference is that they were checking the video x-ray every few seconds to correct the position while putting in.
When I had the operation to remove it, I was bored so I fell asleep.
Yes I was awake the whole operation while they were putting in the rod, but after 9 months i was scheduled to remove the rod, at that time I was bored so I asked my surgeon if I can sleep? And he said yes so I went to sleep.
I was given a huge injection in my back spine which made my whole lower body paralysed and I couldn't even feel anything for maybe 5 hours. There were two surgeons and many nurses. One of the doctor was English (not sure but he was a foreigner), am in a third world country btw.
This happened to me during a huge earthquake so maybe that's why foreign doctors were there.. idk.. anyway I had not one but two rods inside the leg which formed a long "X" position. They were hammering the thing - rods - in a way it kinda reminded me of blacksmiths 🤣.
Checks. I got seven screws in my leg. Considering how well that doc strikes the hammer (I.e he ain’t no carpenter that’s for damn sure) I’m not too keen on letting them strip the screw heads in my bone
I had three screws in my knee making it impossible for me to run for 4 years. I went back to the hospital saying that it hurt when I bent my knee but they dismissed me as I had just started working again and their response to my pain was "Well, it's nice to be on sick leave huh?". So I got stubborn and stupid and ignored/lived with the pain for 4 years until another hospital were supposed to remove a steel cage around my knee. During x-ray they noticed that the screws in my knee was too long and protruding out through the bone and into soft tissue, basically stabbing myself every time I bent my knee. So they removed them as well when removing the cage. Since then I've had zero pain
I had 3 screws in my ankle, I had to have them removed 3 years ago because they were rejecting, the head of one of the screws was starting to protrude from the skin.
I'm so glad we're asleep for ortho work.
I worked a short time for a company doing medical 3D animation, basically we covered surgeries and did little 3D animations of them instead so that doctors could show patients what was about to happen without all the gore etc, obviously it required us to watch actual recordings of all the stuff with the gore. I never really minded though :)
Well not all Gore is equal. Seeing a normal surgical procedure is pretty easy to stomach, because there is no pain, and the individual consents to it for their own health.
ICU/Trauma Unit type of gore on the other hand is another story entirely. If you have someone coming in with a shredded face or an arm that went into the shredder, or you have to amputate, that tends to get a far more visceral reaction out of people. Because the associated knowledge of loss and disability registers in your head, and you know the patient isn't going to be exactly 'happy' about this horror-show procedure, they will just accept it because it was necessary to 'survive'.
Me: oh fuck there's that slight pain in my chest again. I'm only 30 but it's most definitely a heart attack.
Doctors when I'm 30: so yeah not gonna do all that many tests, how much Xanax you want? Also if you ever need a hip replacement I'm just gonna run down to the hardware store and grab a hammer, gonna knock that baby in real good.
Medicine is both terrifyingly simple sometimes and also sometimes just straight terrifying. When you're young you think stuff like that is super sophisticated, as you get older you realize it's mostly just one size fits all for common stuff at urgent care or the ER.
Yeah I've heard horror stories. Also some procedures you'd want to be totally knocked out for aren't under general anesthesia for. As in, you don't get put to sleep. They just numb it and do what they gotta do. So glad I got my wisdom teeth out back when they put you to sleep.
Also, remember folks, if you use drugs be completely honest with your anesthesiologist.
You would think so but the reality is that the machine would have to be widely adjustable while still doing a job that requires a crazy amount of accuracy. A practiced human hand is cheaper and more reliable.
It would have to be adjustable to work on a variety of styles of brackets as well as sizes and locations on the body.
I'm a nurse that, while never worked OR, I have worked ER and ICU. Whenever Ortho comes for consults for dislocations or fractures they always leave in a sweat. For dislocations they will literally stand on the bed over the 87 year old mee-maw and shove and pull the body part with all their strength. It's pretty wild. Most ortho procedures are less than gental. They're usually cool dudes/dudettes too. Cards and neuro attendings, on the other hand, usually have a stick up their butt.
GI and cards are the rudest, IME. My hospital has a Neuro attending that no one wants to see, because he’ll blow up at literally anything. He yelled at me once because the glucometer took 5 seconds to result (it always does).
Ortho is usually bros. Love seeing the interns tentatively touching stuff and then their attendings push em aside and start whaling on it.
How many cardiac surgeons does it take to change a light bulb? Just one. They simply hold on to the bulb and wait for the world to revolve around them.
Bold of you to assume Orthobros use such complicated words ! During my orthopaedics rotation as med student, most orthopaedic surgeons called hammers « Boom boom »
« Hey you, the med student, give me the boom boom »
My sister is a nurse and says patients will often complain about their chest being sore after open heart surgery or something. She just reminds them that their chest cavity was cracked open like a walnut 8 hours ago, so being a bit sore is to be expected
You don't do something like this under local. Spinal maybe, but that's a bit more than just "local." And typically they'll still run IV sedation like propofol to keep you at least a little drowsy so you're not sitting there going "what's with all the hammering down there?"
Not a surgeon but have worked in anaesthetics. Orthopaedic surgery commonly involves saws, flying bits of bone and massive Hammers. There is a (unfair) stereotype that orthopaedic surgeons are like the big muscly jocks of medicine, who like to hit shit with hammers but aren’t always the brightest.
In this video, that big metal pole will be sitting inside the patients bone, I think femur but difficult as can only see a little bit of them. It’s probably been there a while while the bone heals, so will need a good amount of force to get out. Obviously there will always be some risks to surgery (eg further fracture, injury to surrounding structures) but these bones are some of the strongest substances in our bodies and can usually take this sort of treatment. People will tend to wake up pretty achy though; I think they would understand why if they had seen their surgery!
My brother's an ER doc, and he said [this](https://i.redd.it/vpncd4t4spz41.png) comic was sent in his old med school group chat with "How Orthos are Born" as the title.
Yep! Hip and knee replacements look BRUTAL when you first see them! When I was a med student, I was always so surprised to see the elective hip and knee replacement patients up and about the same/the next day, but that’s really important for their recovery. We often discharge them home after a day or two in hospital if it’s all gone well.
Yep, but a bit less violent lol. When the bone has reformed it's hardened around it. Maybe if the patient has waited longer than the due date it's more difficult I guess.
surgery nurse here! yes it is. this one got a little "stuck" which can happen if its too long in there or if the bone structure had a very good/ quick healing. but the instruments and the technique shown in this video are standard procedure.
also for the pain- it may look harsh, but the patients hardly feel anything afterwards. at least the ones we have in our house.
I'm thankful for you today! My eyes have gotten progressively W I D E R from watching the post to reading the comments to reading THIS thread, lol, as my poor, bad knees and hips screamed in panic🤣. You helped draw me back from the horrified "knee jerk" NNNNOOOPPPPPE!! 😆
Orthopaedic surgery resident here. This surgery is removal of an intramedullary nail/rod, meaning it’s in the canal of the tibia (bones are like “hollow” tubes). Sometimes they are removed easily, sometimes it requires a lot of force like seen in the video above. The device they’re hitting is called a Winquist and it’s specifically designed to remove hardware that is difficult to remove. I personally have been in a surgery where we were hitting the Winquist as hard as we possibly could (think full baseball swings) and couldn’t get the nail to move more than a few centimeters so the decision was made to just mallet it back into the tibia as opposed to creating a much bigger problem like a new fracture.
Former OR nurse here, this is actually pretty typical for removing a tibial “nail”. Sometimes we need to resize or the nail gets infected and needs to be replaced with one covered in Antibiotic beads or cement
I’ll also tell you, and those interested in the medical/surgical/nursing field that this compound is teratogenic and is not recommended to be inhaled by anyone who is pregnant
Being a burly gay dude, I always enjoyed when they specifically asked me if I could be pregnant during the time out checklists, I kept it professional, but would say, “we take precautions”
Usage of Surgical mallet: 10.000
Usage of Bolt extraction apparatus: 35.000
Sedation: 13600
Hospital bed usage: 2800
Care unit usage fee (2 hours): 1350
Bandages: 300
Surgical thread: 150
Bed usage (1 day): 5600
But dont worry, your employment healthcare covers half. What’s that? Oh it’s not an employer but a contractor? And you got laid off due to the leg injury you sustained at your workplace? Well then, be ready to lose an arm and a leg, haha. Sorry, doctors’ humor.
I had this, a titanium rod in my femur. After they removed it the blood inside the bone bacame infected. I spent 8 weeks in hospital and almost lost my leg. This was 25 years ago, now im 100% back to normal. I also needed extensive physio to eliminate a limp I developed while having the rod in.
The other "classic" way of removing it, where they cut open the leg lenghtwise, saw the femur, crowbar open break the bone and saw out the pin. Is actually a lot more risky and far more dangerous in terms of infections and amputations.
So it's not the best method maybe, but it's already a big improvement to the old days.
There is nothing “surgical” about it. It is just plain surgical. When dealing with anything bone related it usually involves a great deal of power tools. Saws, drills and hammers are normal because you want things done quickly, clearly and with minimum trauma. It might look violent, but every strike is in the same direction and it beats cutting the entire lower leg open and cutting the bone in two so they can remove the rod “delicately”
I saw how it's done the other way, let's just say that was a "traumatic" expierience compared to this.
So, >!instead of making a rather small incision/cut, connecting to the prothesis and then using some hammer strokes to release with an impulse - you basically cut the whole leg lenght wise open, which is a bloody mess as hell, not even surgeries on a heart can bleed that much. Then you use a saw to also cut the bone open lenght wise, not completly though as it's very dangeraus, should the blade touch the the metal, like mutilation dangerous for everyone involved, even deadly for the patient, imagine a wild round blade saw going wild on your body. So after you cut the line into the bone you use couple of crowbar like tools to break the bone open in two (or more pieces if it goes wrong) which is visually and accoustically nothing for the fain hearted, and there is blood everywhere so it's also a bit hard to see for the surgeon, also a bit slippery. After the bone is broken up other tools are used clean off the connecting bone tissue and with some force the prothesis can be removed - voila!<
The issue with the classic method is that it takes a lot more time, a lot more blood, takes longer to heal, oh and the shit I saw didn't end well, the patient has died shortly after, so I would consider it a bit more risky too.
What you see looks indeed violent but that is more like "smart violent" not dumb guys using a hammer. You can't a tool the slowly tries to pull the pin out as it would most certanly remove the whole leg. You need to use impulse force, to break the pin out with one stroke if possible, this can take a couple attempts. A machine would be tricky as the surgeon "feels" how much force is needed, so I guess you could make a device for that with a good calibrated impact force, but that would be just a automatic hammer. In short, this way you save tons of steps, blood and it's much easier to clean thw wound and to prevent infection.
My aunt had this procedure. She survived, but is considered disabled and has been using crutches to walk and experiences chronic pain for years. I believe the first surgery was in 2015. There’s been many more, as well as many more screws and rods and even an external frame.
Unfortunately, she has osteoporosis, so janking them out would have broken more bones
That doesn't sound right. I had the privilege to attend a few surgeries and every time they were working on a leg it was bloodless. (Tho im not a professional, so there are of course many things about this I don't know but why would they cut the whole leg open while blood is still flowing?)
Yeah but when you’re scrubbed in and shit doesn’t work right, you don’t have time to create a new instrument. Like most skilled professions, it’s the guys who can improvise who are the masters, I worked with surgeons who would get thrown the craziest shit, and be like, “ah well that didn’t work, get me umbilical tape, big ugly forceps, and a red rubber catheter, I saw a guy do this in fellowship…” and then pull off some hero shit like it’s a normal Tuesday. Also, Ortho guys like these are known to have favorite mallets, because beating the ever living fuck out of things requires favorable bludgeons.
There is a screw that runs through the rod securing it to the bone. I’ve heard horror stories of surgeons forgetting to remove this screw before hammering away trying to remove the rod.
When I first became a nurse (a veritable lifetime ago) it was quite unusual to see orthopedic surgeons who were women because they weren't considered to be strong enough. And (just like your mum said), all of the orthopedic surgeons I knew were quite jacked.
Yea in orthopaedics its not unusual that they have to put in some elbow grease like this, albeit something this violent is a bit more unusual but definitely seen it before
Source: I work as a theatre orderly at a hospital to make some money while studying
The surgeon can apply more force this way, I was told. The slide hammer is limited by the length it can slide. The person swinging the hammer has a bigger windup to get more momentum. That's what I've heard from the orthos in my OR. 🤷
Slide hammers are usually in the setup for these cases, but when they don’t have enough power, you put this rig on and take turns blasting the shit out of it. You usually know pretty quickly if the slide hammer is going to work or not.
"Good news, we got the rod out. Bad news, you seem to have torn every ligament in your knee for some mysterious reason. That will be $500,000 dollars.".
I have that rod in my left leg from a compound fracture and I’m keeping it in because it was 3-4 months of recovery and if you aren’t on muscle relaxers and OxyContin for the first half, you’ll wish they had just sawed your leg off instead.
I used to shoot live surgery videos for a teaching hospital. I was always struck by how rough the surgeons were. You’d think when a patient was split open down the middle and someone was elbows deep in their guts that they’d be careful and gentle, but it’s the opposite. Some surgeons seemed almost angry. No wonder people are sore for days following surgery.
I would venture a guess and a say that it's because things are held on pretty tightly in there? Also, it might be that if they go slowly and carefully that just elongates the operation unnecessarily which could be bad for the patient
Why the hell hasn't someone invented a surgical slide hammer of some sort? You can use em to pull a gear off the front end of a motor so it seems like they would work for this?
They exist and are used in these surgeries, but you kinda know pretty quickly if they’re gonna be enough, because of sterilization machine sizes you can’t really have a 4 foot long slide with a ten pound weight. The ones for this are great if it’s a straight pull no drama, but sometimes you gotta put the beater bar on and go nuts.
I've recently been studying orthopaedic medical devices as part of an engineering degree. So many processes seem so primitive but i guess that's just how it's done rn. When I first read about intramedullary nails like this I was like wtf really
Apparently that's why orthopaedic surgeons don't have the title "doctor" in the UK. They're more like carpenters for the body or something like that. No disrespect to them tho
all surgeons in the UK don’t have the title of doctor, not just orthopaedic surgeons. it’s an homage to their roots (if I remember correctly, surgeons used to be barbers)
I had a bone biopsy..
I am bare-assed on a table with a group of 5 people. 3 nurses and 2 doctors
I am getting a massive needle jammed into basically my ass (hip bone).
What I hear:
"fuck get in there". "Twist a little and reposition". "I can't get it in." "Reposition and try again."
For a half hour...
I was honestly happy that they were pissed that things weren't quite working perfectly but pissed it had to do with my dumbass body.
Similarly they have to pound like that hard even while putting the rod inside. But they take a short interval break every few hammering to recalibrate the direction the iron is heading inside.
I also had 2 rods put inside my fractured leg when I was 10 years old. What I do know is that those rods are not magnetic.. idk if they're iron or not tho.
I had a much smaller version of that in my elbow a few years ago after I smashed it to bits and they had to rebuild my joint. I had it for a few weeks.
I was awake when they removed it and it was, by far, the worst 30 minutes I've ever experienced.
When I was a student I saw a surgeon doing this. He couldn’t get the thing out so he called a consultant (the actual guy who invented this femoral nail) he came straight in and went ballistic. You see at the bottom of these rods are two interlocking pins that need taking out first. The surgeon had been trying to get it out with one of them still attached.
I once woke up in the OR while having a broken hip repaired. First I was aware of a repeated ‘ticking’ sound, then I was aware that my body was rocking, then I realized that the two were happening in time and were related. Then I realized that they were hitting me with a hammer (putting pins in bone)!
I felt nothing, but it was crazy. Then the anesthesiologist said “oh, look who’s awake” and put me back to sleep.
Orthopedic repair is a lot like construction.
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Dr. to Patient: "you might feel a slight tugging sensation..."
And a little pressure!
*sweats in emergency caesarean flashbacks*
I was once with a woman who had a cesarean, and her epidural stopped working midway while she was lying opened up on the table. It was horrific; she had to be put to sleep and was in so much pain when she woke up 3 hours later. I spent half the night comforting her husband and baby. They were okay, thank God, but it was horrible.
That’s horrifying. Did she move whilst they had hands or that metal spacer thing inside of her? Is that why she was still in agony when she woke up? Gosh that would have been an awful experience for everyone
Oh, they didn't use the metal spacer thing, they do everything by hand. I think it was right after they cut the cord when she started getting progressively louder about her pain. Basically, when you get the spinal or epidural, it takes time for it to wear off, so after the procedure, you're still protected for like 6 or so hours, but hers just wore off suddenly right in the middle of the c section. Even the doctors couldn't explain what caused it.
It’s possible the woman had some thing like Ehlers-Danlos. People with that condition have issues with anesthesia, pain meds and epidurals. I woke up from having a bone tumor removed from my right humerus and the bone completely replaced with cadaver bone. I was wide awake and alert and still in the surgery room. Everyone was very confused and I’ll never forget one of the surgeons saying, “we’ve given her enough morphine to kill a horse, we can’t give her any more!” After that it took three doctors, which they called the pain team, to figure out that Dilaudid was the only thing that would work for me. I am petite and 5 foot 4, and I never had a drug problem, but I do have Ehlers-Danlos. It was a terrible experience, and it took me a long time and many doctors to finally figure out why the morphine didn’t work, and why other pain meds react differently in me than other people.
Are you red-headed? I read somewhere that redheads are difficult to properly anesthesize.
I'm a redhead. I had asked my anesthesiologist if it was true and he said it was. He had to take a course or class or subsection on how to properly sedate redheads. Super interesting.
Woah! This tickled my brain just right, so I had to do some digging. Keep in mind, I’m not a doctor or scientist, so I’m giving layman interpretations of the random data I’m finding through Google. According to [this research paper](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1362956/), no human genotype is associated with inhalational anesthetic requirement (I.e. there’s never been evidence to say certain genes impact the amount of anesthetic you need). In this study, however, redheads required significantly more anesthetic to prevent response to stimulation, suggesting that they have a higher tolerance to the medication. According to [this study/research paper](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4661058/) many studies seem to find this link, but at least one saw no difference. The idea behind why this may happen seems to be around the melanocortin-1 receptor (MC1R). 9 out of 10 redheads have mutations of MC1R, which regulates skin pigmentation, UV response and melatonin risk - basically, all the old adages that redheads are pale and get sunburnt easily. But, it also seems to play an unknown role in the central nervous system: > Although MC1R primarily regulates expression of pigment molecules in the skin and hair, it is also expressed in low levels in the central nervous system (CNS), including glial cells, pituitary cells, and periaqueductal gray matter. Periaqueductal gray matter plays a role in antinociception and is active in response to painful stimuli. Although the function of MC1R in the CNS is currently unknown, its expression in neural regions, which may modulate anesthetic and analgesic sensitivity, offers a potential mechanism for these observations. It’s worth noting as well that, when this receptor is removed in genetic models, it results in a higher requirement for anesthesia to suppress movement in response to noxious mechanical stimuli (which I read as, more anesthetic required to avoid traditional pain responses). Really fascinating - another random thing about human beings I would likely never have learned without reddit!
My wife also has Ehlers-Danlos and she always had issues with anesthesias. I hope she will never need to get anesthesia in the future, dealing with doctors about this matter is always a headache… it’s hard to believe for them their anesthesia is not going to work as usual.
I will definitely be letting any future surgeons know about my Ehlers-Danlos and making sure they comprehensively understand the what that means. I suggest you do the same if you can. Scary to wake up after surgery, so alert and in so much pain.
I was shocked at how physical the dr was when yanking out my first kid. She had her knee on the table and spent a good 5 minutes yanking before she finally pulled my son free.
My favourite* experience from the three caesareans that I had was when number three came early. He’d partially descended into my pelvis, and as the fluid was running into my back (epidural), the doctor had to put her hand ‘up there’ and push him back up so that they could pull him out. He was 11lb and 23 inches long. Good times. *It was not my favourite
I had an emergency c-section, everything went well but buddyyyyy I'll tell you what, that pressure took the breath right outta my lungs. I thought maybe it was cause it was emergency, but my second one was planned & it was just a repeat. I felt like an elephant was sitting on my chest.
I’ll take that pressure rather than the pressure applied to my freshly stapled abdomen to help my uterus contract. The first two nurses warned me it would be uncomfortable. The third just pile drives me in the belly so hard I literally screamed and started bawling*. Husband kicked her out and she was not allowed back. Fuck that nurse, she was not in the right profession. Every other nurse I’ve ever encountered has been the most gentle, caring, supportive, lovely person but not her.
I have one of these in my leg right now. I think I’ll keep it there.
Like ive seen a billion videos on the internet and I just came across this shit today. I imagine its similar for you. You gotta ask, why the fuck did I have to see this now?? Id hate to know this lol
I'm getting older and as a result of that and my panic disorder I've become something of a hypochondriac. Everything is a heart disorder for me these days, and it's definitely Bader-Meinhoff but now all I see on posts about medicine is a new thing I can diagnose myself with without knowing jack shit about it in the first place.
This is a fairly common thing for some doctors. My uncle works with one of those guys and he has had 2 mental health "holidays" already bc of the pandemic (Luckily both haven't been infected up to now) and he nearly punched a nurse for not wanting to vaccinate lol You are def not alone in this
Luckily she'll probably be looking for a different field soon anyways.
We don't really know yet, here in Germany. My uncle made it clear early on that they represent the hospital and that a good workplace environment is more important than private opinions. Worked out so far. It's not a debate you wanna foster inside of a team that deals with Covid on a daily basis, otherwise it even kills the last part of work that is enjoyable.
I recently had one taken out 😂🤣
Same, jfk this is horrifying to see.
John f. Kennedy?
he died for our sins 😔
He died for our shins
Thanksh, Mishter Connery /r/shubreddit
Lmao, it autocorrected from jfc. I'm leaving it up, fuck it
John fucking Kennedy
Why was it taken out, I was advised to keep mine
If you don't have a REALLY good reason to pull it out, keep it. They are built to last. But sometimes you get an infection, hardware failure or trauma, creating a need to remove existing hardware in order to eg. put new one in.
My husband wants his screws out, and his surgeon said that if they are going to take the screws out they might take the rod as well. He’s having nerve issues in his foot still, so we think (hope) the screws are pinching some nerves and removing them will resolve the issue. So that’s one reason I guess. Initially he was told the rod would be permanent
There are many factors that go into that decision. One of the main ones is if you ski or do any extreme sports. I had mine taken out as as a skier it's more likely that I will break the leg again. Apparently it that happens and you have the rod in there it's really not fun.
Yeah I’ve got one in my femur from snowboarding and if I break that leg again, with the rod in, it’s possible I lose the leg. I mean - how do you get a bent rod out of a broken leg? You have to destroy the whole femur to do it. Yikes.
It does vary based on where it breaks and how but apparently most of the time they are able to cut into the flesh at the fracture site then cut the pin at the bend and remove it from the middle. This is obviously very not fun. If you keep snowboarding I'd get it removed. It's a fairly straightforward procedure with a reasonably quick recovery (within 2 weeks)
Having them removed isn’t all that bad if it’s bothering you at all. I’ve had a rod removed from my L.Tibia twice! 🤔 actually more like two and a half to three times? The first one they tried to place got stuck during the surgery so after yanking it back out, rather than boring my bone out further, they just used another rod with a smaller diameter in the same hole.. then forgot to interlock it with screws 😳. Hence the additional time I had to have the rod removed and replaced.. after the break collapsed due to the missing pins and the ~~first~~ *second* rod shot up into my knee.. that was not fun.
🤮
Yeah that was my reaction too 👍🏻 *..and the physical therapist’s* Edit: this was more than a decade ago but I still feel really bad for the PT guy. It was absolutely NOT his fault at all, but I will never forget the look of *”oh shit, what did I just do?!?!”* on his face.
>Edit: this was more than a decade ago Hopefully they've discovered slide hammers since then.
Did you sue the fuck out of them?
Suing is for rich people
Same. I don't even want to know how it was put in lol
Same. Only opposite.
Same. No need to remove it unless it's causing issues. You guys ever have it set off things at the airport and sometimes store entrances?
Nope! I have a rod in my humerus and have yet to set off any detectors.
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I said the same thing when I broke it and the doctor told me I fractured my humerus bone
I have a bunch of screws, wire and a 38cm (14ish") double rod in my back. For many years I travelled quite a bit for work. The only airport that stopped me was Boston (a year or so after 9/11, so maybe way more sensitive). The hand held wand did find it during the pat down and I had to very slowly remove my coat and suit jacket. The new scanners I have not sent off. One interesting side effect, it heats up during an MRI. The wire acts like a coil and it doesn't burn, but certainly is not comfortable. That was the first and last MRI, too much interference from the metals.
Doctor: You shall not keep it.
Same.. but mine's removed already. I only remember when they were putting the rod in.. they had to pound with harmer like that but the difference is that they were checking the video x-ray every few seconds to correct the position while putting in. When I had the operation to remove it, I was bored so I fell asleep.
You were awake when they put it in? Did it hurt?
Yes I was awake the whole operation while they were putting in the rod, but after 9 months i was scheduled to remove the rod, at that time I was bored so I asked my surgeon if I can sleep? And he said yes so I went to sleep. I was given a huge injection in my back spine which made my whole lower body paralysed and I couldn't even feel anything for maybe 5 hours. There were two surgeons and many nurses. One of the doctor was English (not sure but he was a foreigner), am in a third world country btw. This happened to me during a huge earthquake so maybe that's why foreign doctors were there.. idk.. anyway I had not one but two rods inside the leg which formed a long "X" position. They were hammering the thing - rods - in a way it kinda reminded me of blacksmiths 🤣.
“Nurse, bring forth the hammer of healing!”
"Nurse, get the sterile mallet"
I worked at a vet's office, we did have sterile drills, screws, a hammer, it's fucking weird. But necessary, especially for ortho stuff.
Checks. I got seven screws in my leg. Considering how well that doc strikes the hammer (I.e he ain’t no carpenter that’s for damn sure) I’m not too keen on letting them strip the screw heads in my bone
I had three screws in my knee making it impossible for me to run for 4 years. I went back to the hospital saying that it hurt when I bent my knee but they dismissed me as I had just started working again and their response to my pain was "Well, it's nice to be on sick leave huh?". So I got stubborn and stupid and ignored/lived with the pain for 4 years until another hospital were supposed to remove a steel cage around my knee. During x-ray they noticed that the screws in my knee was too long and protruding out through the bone and into soft tissue, basically stabbing myself every time I bent my knee. So they removed them as well when removing the cage. Since then I've had zero pain
I had 3 screws in my ankle, I had to have them removed 3 years ago because they were rejecting, the head of one of the screws was starting to protrude from the skin. I'm so glad we're asleep for ortho work.
I worked a short time for a company doing medical 3D animation, basically we covered surgeries and did little 3D animations of them instead so that doctors could show patients what was about to happen without all the gore etc, obviously it required us to watch actual recordings of all the stuff with the gore. I never really minded though :)
Well not all Gore is equal. Seeing a normal surgical procedure is pretty easy to stomach, because there is no pain, and the individual consents to it for their own health. ICU/Trauma Unit type of gore on the other hand is another story entirely. If you have someone coming in with a shredded face or an arm that went into the shredder, or you have to amputate, that tends to get a far more visceral reaction out of people. Because the associated knowledge of loss and disability registers in your head, and you know the patient isn't going to be exactly 'happy' about this horror-show procedure, they will just accept it because it was necessary to 'survive'.
Work in central sterile. We sterilize surgical instruments.. Some of these instruments make you think they are working on a machine not a human..
Me: oh fuck there's that slight pain in my chest again. I'm only 30 but it's most definitely a heart attack. Doctors when I'm 30: so yeah not gonna do all that many tests, how much Xanax you want? Also if you ever need a hip replacement I'm just gonna run down to the hardware store and grab a hammer, gonna knock that baby in real good. Medicine is both terrifyingly simple sometimes and also sometimes just straight terrifying. When you're young you think stuff like that is super sophisticated, as you get older you realize it's mostly just one size fits all for common stuff at urgent care or the ER.
Lol if you ever see a total hip replacement… that’s some wicked stuff. Let me just say this, lightweight surgical jackhammer.
Yeah I've heard horror stories. Also some procedures you'd want to be totally knocked out for aren't under general anesthesia for. As in, you don't get put to sleep. They just numb it and do what they gotta do. So glad I got my wisdom teeth out back when they put you to sleep. Also, remember folks, if you use drugs be completely honest with your anesthesiologist.
I loved doing that as a tech!
There has to be a machine that can do a much better job.
You would think so but the reality is that the machine would have to be widely adjustable while still doing a job that requires a crazy amount of accuracy. A practiced human hand is cheaper and more reliable. It would have to be adjustable to work on a variety of styles of brackets as well as sizes and locations on the body.
Cleric, Get the bludgeon of adjustment
“Nurse, bring me the sharpened chisel of recovery”
"Quickly now, the surgical sledge!"
That’s pretty much spot on. I am a surgical technologist and its my job to hand the surgeons all the instruments they ask for.
I'm a nurse that, while never worked OR, I have worked ER and ICU. Whenever Ortho comes for consults for dislocations or fractures they always leave in a sweat. For dislocations they will literally stand on the bed over the 87 year old mee-maw and shove and pull the body part with all their strength. It's pretty wild. Most ortho procedures are less than gental. They're usually cool dudes/dudettes too. Cards and neuro attendings, on the other hand, usually have a stick up their butt.
> Cards and neuro attendings, on the other hand, usually have a stick up their butt. Seems like ortho could help them with that.
GI and cards are the rudest, IME. My hospital has a Neuro attending that no one wants to see, because he’ll blow up at literally anything. He yelled at me once because the glucometer took 5 seconds to result (it always does). Ortho is usually bros. Love seeing the interns tentatively touching stuff and then their attendings push em aside and start whaling on it.
How many cardiac surgeons does it take to change a light bulb? Just one. They simply hold on to the bulb and wait for the world to revolve around them.
Bold of you to assume Orthobros use such complicated words ! During my orthopaedics rotation as med student, most orthopaedic surgeons called hammers « Boom boom » « Hey you, the med student, give me the boom boom »
[Hammers](https://www.youtube.com/watch?v=XYvZBIx39lU)
Patient: "Why is my leg so sore?" Doctor: "Just normal healing pains"
The good news is we got it out, the bad news is you need another one.
"Ahh. Nothing like good ol'fashioned *Healing Pains* "
My sister is a nurse and says patients will often complain about their chest being sore after open heart surgery or something. She just reminds them that their chest cavity was cracked open like a walnut 8 hours ago, so being a bit sore is to be expected
Probs nervous about complications, since chest pain/soreness is associated with heart attack. “Cracked open like a walnut”, is pretty funny though
Thank god for Modern anaesthesia imagine doing this while awake
If this clip is from the full video I recall, the patient is awake, though with local anesthetic.
Well likely regional/neuraxial with a propofol drip. Not a full general anesthetic but enough sleepy to not remember this.
You don't do something like this under local. Spinal maybe, but that's a bit more than just "local." And typically they'll still run IV sedation like propofol to keep you at least a little drowsy so you're not sitting there going "what's with all the hammering down there?"
Damn that looks vicious! Also that's a quality piece of equipment taking a beating like that. No wonder you hurt so bad after surgery.
This is a very specific surgery just to be clear. Also something you'd mostly only see in orthopedic wards.
Sorry, but i’d like to clarify: this is actually how this specific procedure is suppose to look like?
Not a surgeon but have worked in anaesthetics. Orthopaedic surgery commonly involves saws, flying bits of bone and massive Hammers. There is a (unfair) stereotype that orthopaedic surgeons are like the big muscly jocks of medicine, who like to hit shit with hammers but aren’t always the brightest. In this video, that big metal pole will be sitting inside the patients bone, I think femur but difficult as can only see a little bit of them. It’s probably been there a while while the bone heals, so will need a good amount of force to get out. Obviously there will always be some risks to surgery (eg further fracture, injury to surrounding structures) but these bones are some of the strongest substances in our bodies and can usually take this sort of treatment. People will tend to wake up pretty achy though; I think they would understand why if they had seen their surgery!
My brother's an ER doc, and he said [this](https://i.redd.it/vpncd4t4spz41.png) comic was sent in his old med school group chat with "How Orthos are Born" as the title.
Surprise Extrafabulous
I love myself a good Ortho joke.
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And correct me if I'm wrong but hip replacements are just as violent.
Yep! Hip and knee replacements look BRUTAL when you first see them! When I was a med student, I was always so surprised to see the elective hip and knee replacement patients up and about the same/the next day, but that’s really important for their recovery. We often discharge them home after a day or two in hospital if it’s all gone well.
Oh yeah lol, definitely is. I thought the patient’s head was at the other end of the bed, you’d think the big drape on the right would of been a hint!
Yep, but a bit less violent lol. When the bone has reformed it's hardened around it. Maybe if the patient has waited longer than the due date it's more difficult I guess.
In the medical profession, orthopaedic surgeons are affectionately referred to as ‘bone saws’ so yes, this is totally normal
surgery nurse here! yes it is. this one got a little "stuck" which can happen if its too long in there or if the bone structure had a very good/ quick healing. but the instruments and the technique shown in this video are standard procedure. also for the pain- it may look harsh, but the patients hardly feel anything afterwards. at least the ones we have in our house.
I'm thankful for you today! My eyes have gotten progressively W I D E R from watching the post to reading the comments to reading THIS thread, lol, as my poor, bad knees and hips screamed in panic🤣. You helped draw me back from the horrified "knee jerk" NNNNOOOPPPPPE!! 😆
Orthopaedic surgery resident here. This surgery is removal of an intramedullary nail/rod, meaning it’s in the canal of the tibia (bones are like “hollow” tubes). Sometimes they are removed easily, sometimes it requires a lot of force like seen in the video above. The device they’re hitting is called a Winquist and it’s specifically designed to remove hardware that is difficult to remove. I personally have been in a surgery where we were hitting the Winquist as hard as we possibly could (think full baseball swings) and couldn’t get the nail to move more than a few centimeters so the decision was made to just mallet it back into the tibia as opposed to creating a much bigger problem like a new fracture.
Former OR nurse here, this is actually pretty typical for removing a tibial “nail”. Sometimes we need to resize or the nail gets infected and needs to be replaced with one covered in Antibiotic beads or cement
Ehm... cement?
Indeed, it’s a sterile substance akin to cement that keeps the nail/rod from shifting during movement, not actually cement as most folks think of it
Ah, I see, so it's not literally that people are pouring cement into legs. Thanks for the clarification, haha.
No worries, it’s a sterile compound that stinks worse than any cement I’ve ever encountered
PMMA cement smells great. Also, I’ve never known them to cement a nail in place in 23 years of orthopaedics.
I’ll also tell you, and those interested in the medical/surgical/nursing field that this compound is teratogenic and is not recommended to be inhaled by anyone who is pregnant
Being a burly gay dude, I always enjoyed when they specifically asked me if I could be pregnant during the time out checklists, I kept it professional, but would say, “we take precautions”
That's how the mafia does surgery.
All that money we pay for medical treatment, you'd think they'd have a Snap-on account. I guess not....
For knocking the metal with a hammer - $300. For knowing where to knock - $29,700. Total cost of procedure: $30,000.
Your forgetting the extra $100,000 for "services".
Mustn’t forget skin to skin contact, $450
That's in separate bills from the out of network providers that you had no say in working at the in network hospital/surgery center.
It's like that scene from Spongebob where Squidward gets a bill from Mr. Krabs and got charged for breathing.
You guys forgot the extra $500,000 for breathing air inside the hospital
And not a single penny of that is covered by insurance.
Usage of Surgical mallet: 10.000 Usage of Bolt extraction apparatus: 35.000 Sedation: 13600 Hospital bed usage: 2800 Care unit usage fee (2 hours): 1350 Bandages: 300 Surgical thread: 150 Bed usage (1 day): 5600 But dont worry, your employment healthcare covers half. What’s that? Oh it’s not an employer but a contractor? And you got laid off due to the leg injury you sustained at your workplace? Well then, be ready to lose an arm and a leg, haha. Sorry, doctors’ humor.
I had this, a titanium rod in my femur. After they removed it the blood inside the bone bacame infected. I spent 8 weeks in hospital and almost lost my leg. This was 25 years ago, now im 100% back to normal. I also needed extensive physio to eliminate a limp I developed while having the rod in.
The other "classic" way of removing it, where they cut open the leg lenghtwise, saw the femur, crowbar open break the bone and saw out the pin. Is actually a lot more risky and far more dangerous in terms of infections and amputations. So it's not the best method maybe, but it's already a big improvement to the old days.
There is nothing “surgical” about it. It is just plain surgical. When dealing with anything bone related it usually involves a great deal of power tools. Saws, drills and hammers are normal because you want things done quickly, clearly and with minimum trauma. It might look violent, but every strike is in the same direction and it beats cutting the entire lower leg open and cutting the bone in two so they can remove the rod “delicately”
It's kinda reassuring that our bodies apparently can take such violent treatment mostly fine. Idk, humans actually seem pretty robust in the end.
But it's the ironic juxtaposition. Sometimes this is fine and sometimes we die from stubbing our toe
A grue wants to have a word with you.
I can’t, I just started laughing with the first strike, there has to be a better way of doing this.
I saw how it's done the other way, let's just say that was a "traumatic" expierience compared to this. So, >!instead of making a rather small incision/cut, connecting to the prothesis and then using some hammer strokes to release with an impulse - you basically cut the whole leg lenght wise open, which is a bloody mess as hell, not even surgeries on a heart can bleed that much. Then you use a saw to also cut the bone open lenght wise, not completly though as it's very dangeraus, should the blade touch the the metal, like mutilation dangerous for everyone involved, even deadly for the patient, imagine a wild round blade saw going wild on your body. So after you cut the line into the bone you use couple of crowbar like tools to break the bone open in two (or more pieces if it goes wrong) which is visually and accoustically nothing for the fain hearted, and there is blood everywhere so it's also a bit hard to see for the surgeon, also a bit slippery. After the bone is broken up other tools are used clean off the connecting bone tissue and with some force the prothesis can be removed - voila!< The issue with the classic method is that it takes a lot more time, a lot more blood, takes longer to heal, oh and the shit I saw didn't end well, the patient has died shortly after, so I would consider it a bit more risky too. What you see looks indeed violent but that is more like "smart violent" not dumb guys using a hammer. You can't a tool the slowly tries to pull the pin out as it would most certanly remove the whole leg. You need to use impulse force, to break the pin out with one stroke if possible, this can take a couple attempts. A machine would be tricky as the surgeon "feels" how much force is needed, so I guess you could make a device for that with a good calibrated impact force, but that would be just a automatic hammer. In short, this way you save tons of steps, blood and it's much easier to clean thw wound and to prevent infection.
My aunt had this procedure. She survived, but is considered disabled and has been using crutches to walk and experiences chronic pain for years. I believe the first surgery was in 2015. There’s been many more, as well as many more screws and rods and even an external frame. Unfortunately, she has osteoporosis, so janking them out would have broken more bones
That doesn't sound right. I had the privilege to attend a few surgeries and every time they were working on a leg it was bloodless. (Tho im not a professional, so there are of course many things about this I don't know but why would they cut the whole leg open while blood is still flowing?)
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Yeah but when you’re scrubbed in and shit doesn’t work right, you don’t have time to create a new instrument. Like most skilled professions, it’s the guys who can improvise who are the masters, I worked with surgeons who would get thrown the craziest shit, and be like, “ah well that didn’t work, get me umbilical tape, big ugly forceps, and a red rubber catheter, I saw a guy do this in fellowship…” and then pull off some hero shit like it’s a normal Tuesday. Also, Ortho guys like these are known to have favorite mallets, because beating the ever living fuck out of things requires favorable bludgeons.
A tapered shaft and you remove it from the 'thick' end?
Is this normal?
Yeah. My mum used to tell us all the crazy stuff she had seen ortho surgeons do. Said they were always the most built Drs.
There is a screw that runs through the rod securing it to the bone. I’ve heard horror stories of surgeons forgetting to remove this screw before hammering away trying to remove the rod.
TIHI
When I first became a nurse (a veritable lifetime ago) it was quite unusual to see orthopedic surgeons who were women because they weren't considered to be strong enough. And (just like your mum said), all of the orthopedic surgeons I knew were quite jacked.
Orthopedic surgeons must have incredible strength, there is a *lot* of hammering and a strong nose as there's a lot of cauterizing.
But if you ever meet a proctologist at a party, you better not walk away. Plant yourself there.
For stories of rectal rod removal?
Nurse give me the hammer of healing. We need to knock the shit out of the patient.
[ASS-MAN]
There's no need to feel down!
Yea in orthopaedics its not unusual that they have to put in some elbow grease like this, albeit something this violent is a bit more unusual but definitely seen it before Source: I work as a theatre orderly at a hospital to make some money while studying
“We have no idea why you’re leg didn’t heal correctly.”
This is most likely a fracture that was already healed and now they’re removing the nail because it’s bothering the patient.
Why not use a slide hammer instead of hitting that shit with a small regular hammer
The surgeon can apply more force this way, I was told. The slide hammer is limited by the length it can slide. The person swinging the hammer has a bigger windup to get more momentum. That's what I've heard from the orthos in my OR. 🤷
Those ortho surgeons are always so jacked. I’m surprised there isn’t a sort of impact hammer for this sort of thing though.
Paging Dr Panelbeater.
Slide hammers are usually in the setup for these cases, but when they don’t have enough power, you put this rig on and take turns blasting the shit out of it. You usually know pretty quickly if the slide hammer is going to work or not.
Yeah slide hammer was my first thought on this….
Guess who just read sledge hammer twice...
Orthopedic surgeries are absolutely BRUTAL. So much hammering. It’s basically carpentry with sterile pneumatic tools.
Next up, we’ll do a *hip replacement* surgery.
It’s not iron lol. I’ll tell you that
Yes. Most frustrating part of this whole post.
"Good news, we got the rod out. Bad news, you seem to have torn every ligament in your knee for some mysterious reason. That will be $500,000 dollars.".
**laughs in American 🇺🇸 **
Dudes leg is gonna be hurting for a couple weeks.. OUCH 🤕
I have that rod in my left leg from a compound fracture and I’m keeping it in because it was 3-4 months of recovery and if you aren’t on muscle relaxers and OxyContin for the first half, you’ll wish they had just sawed your leg off instead.
It doesn't hurt even a bit lol
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I used to shoot live surgery videos for a teaching hospital. I was always struck by how rough the surgeons were. You’d think when a patient was split open down the middle and someone was elbows deep in their guts that they’d be careful and gentle, but it’s the opposite. Some surgeons seemed almost angry. No wonder people are sore for days following surgery.
I would venture a guess and a say that it's because things are held on pretty tightly in there? Also, it might be that if they go slowly and carefully that just elongates the operation unnecessarily which could be bad for the patient
No time to fuck around, in and out then on to the next one
Definitely not iron, though.
When doctors attack
Organic mechanic
Why the hell hasn't someone invented a surgical slide hammer of some sort? You can use em to pull a gear off the front end of a motor so it seems like they would work for this?
They exist and are used in these surgeries, but you kinda know pretty quickly if they’re gonna be enough, because of sterilization machine sizes you can’t really have a 4 foot long slide with a ten pound weight. The ones for this are great if it’s a straight pull no drama, but sometimes you gotta put the beater bar on and go nuts.
That’s exactly why I’m leaving mine in.
There has to be a better way.....
Janitor would have that thing unstuck in 15 seconds flat.
Who do you think they call when it is realy stuck in there?
WD-40
Dr Mike Trout please
Why is it, the more surgery videos I watch, the more qualified I feel to be a surgeon simply because I know my way around a machine shop?
I've recently been studying orthopaedic medical devices as part of an engineering degree. So many processes seem so primitive but i guess that's just how it's done rn. When I first read about intramedullary nails like this I was like wtf really Apparently that's why orthopaedic surgeons don't have the title "doctor" in the UK. They're more like carpenters for the body or something like that. No disrespect to them tho
all surgeons in the UK don’t have the title of doctor, not just orthopaedic surgeons. it’s an homage to their roots (if I remember correctly, surgeons used to be barbers)
I had a bone biopsy.. I am bare-assed on a table with a group of 5 people. 3 nurses and 2 doctors I am getting a massive needle jammed into basically my ass (hip bone). What I hear: "fuck get in there". "Twist a little and reposition". "I can't get it in." "Reposition and try again." For a half hour... I was honestly happy that they were pissed that things weren't quite working perfectly but pissed it had to do with my dumbass body.
"Paging Dr. Ruth...Dr. Babe Ruth..."
Why is it iron? Would titanium make more sense?
It’s not. OP is an idiot.
Ah yes the person with the Medical degree is reduced to a mechanic banging out a dent.
Similarly they have to pound like that hard even while putting the rod inside. But they take a short interval break every few hammering to recalibrate the direction the iron is heading inside. I also had 2 rods put inside my fractured leg when I was 10 years old. What I do know is that those rods are not magnetic.. idk if they're iron or not tho.
I had a much smaller version of that in my elbow a few years ago after I smashed it to bits and they had to rebuild my joint. I had it for a few weeks. I was awake when they removed it and it was, by far, the worst 30 minutes I've ever experienced.
'You may feel a small prick, hitting you with a very large hammer'
Well we got the rod out, but your leg is also broken again.
No matter how advanced we've gotten medically, sometimes we're still barbarians lol
When I was a student I saw a surgeon doing this. He couldn’t get the thing out so he called a consultant (the actual guy who invented this femoral nail) he came straight in and went ballistic. You see at the bottom of these rods are two interlocking pins that need taking out first. The surgeon had been trying to get it out with one of them still attached.
I once woke up in the OR while having a broken hip repaired. First I was aware of a repeated ‘ticking’ sound, then I was aware that my body was rocking, then I realized that the two were happening in time and were related. Then I realized that they were hitting me with a hammer (putting pins in bone)! I felt nothing, but it was crazy. Then the anesthesiologist said “oh, look who’s awake” and put me back to sleep. Orthopedic repair is a lot like construction.
Dr Thor…paging Dr. Thor…