WEBVTT - How Amputation Works 0:00:01.080 --> 0:00:04.240 Welcome to you stuff you should know from house Stuff 0:00:04.280 --> 0:00:12.760 Works dot com. Hey, and welcome to the podcast. I'm 0:00:12.840 --> 0:00:18.400 Josh Clark in the Dynamic duo Chuck Bryant, two Men, 0:00:19.280 --> 0:00:23.319 eight lambs. Yeah, that's us. Yeah, I guess so I 0:00:23.360 --> 0:00:26.400 hadn't really thought about it. We're fully intact. Yeah, and 0:00:26.440 --> 0:00:30.120 I think, Um, I think missing a limb or a 0:00:30.200 --> 0:00:34.240 finger or a toe or anything. Sure, um if, I guess, 0:00:34.240 --> 0:00:36.479 it's not something you think about until after it happens, 0:00:36.520 --> 0:00:38.800 and then it probably becomes one of the central folk 0:00:38.920 --> 0:00:43.200 I of your life. Do you know anyone missing a one? Uh? No, 0:00:43.440 --> 0:00:45.440 As a matter of fact, I don't, do you. Uh yeah. 0:00:45.479 --> 0:00:47.600 I worked with a guy at my last job who 0:00:47.960 --> 0:00:52.760 had an accident, biking accident with a truck. Not true, 0:00:53.040 --> 0:00:55.800 Not true, Go ahead. I just had to remind myself, 0:00:56.520 --> 0:01:00.480 Uh of what. Oh my brother in law's father has 0:01:00.560 --> 0:01:04.240 a part of partial finger amputation. Oh yeah, well this 0:01:04.440 --> 0:01:08.760 this fan's his arm, the whole arm. Yeah. What happened? Um, 0:01:08.800 --> 0:01:11.720 biking on the side of the road and oncoming truck 0:01:12.720 --> 0:01:17.200 the side view mirror basically clipped him at the armpit 0:01:18.400 --> 0:01:21.000 and did it take it clean off or I don't know. 0:01:22.040 --> 0:01:23.640 I'm not sure. I guess if it would have taken 0:01:23.640 --> 0:01:27.600 it clean off, they probably would have done a replantation. Yeah, 0:01:27.760 --> 0:01:30.759 we talked about Yeah, so this is a I guess 0:01:30.760 --> 0:01:33.640 the follow up in a mini suite. I like to 0:01:33.640 --> 0:01:35.479 think of it as a part of a larger suite. 0:01:35.520 --> 0:01:41.320 We've done broken bones, Yeah, we've done um replantation. I 0:01:41.360 --> 0:01:44.200 think it's called your limbs torn off? Now what? Uh? 0:01:44.240 --> 0:01:47.480 And then this one how amputation works. Yeah, that's a 0:01:47.480 --> 0:01:50.080 good it's a good nice sweet What else can we 0:01:50.120 --> 0:01:53.480 possibly add to that? I don't know, because we're gonna 0:01:53.480 --> 0:01:59.960 cover uh, sexual fetishes around limb loss and phantom limb pain, 0:02:00.320 --> 0:02:04.560 and so I think that's that's all encompassing, sir. I 0:02:04.560 --> 0:02:09.280 think this will finish it off, miss hedbird well encompassingly. 0:02:09.520 --> 0:02:15.320 Really that was one of his bits. Uh, Chuck, Yes, 0:02:15.760 --> 0:02:20.080 have you surely I know that you've heard of Aaron Rollston. Yeah, 0:02:20.360 --> 0:02:22.480 we saw the movie and everything. There's a hundred twenty 0:02:22.480 --> 0:02:26.639 seven hours, right, um, yeah, I think that's right the 0:02:26.720 --> 0:02:28.200 name of the movie. Yeah, I'm doubting it all of 0:02:28.240 --> 0:02:31.720 a sudden, the number of hours. Yeah, good movie. Did 0:02:31.720 --> 0:02:33.760 you see it? Oh? Yeah, it was great. Yeah, James 0:02:33.760 --> 0:02:36.320 Franco is just like, I'm doing so great in the 0:02:36.320 --> 0:02:39.160 middle the movie, didn't He look at the camera, He's like, 0:02:39.200 --> 0:02:42.839 aren't aw I like that guy? Yeah? I do too, 0:02:42.880 --> 0:02:46.200 But he likes himself as well. Yeah. And hey, Danny Boyle, 0:02:46.240 --> 0:02:49.040 he makes a great movie. Is that Who directed that? Yeah? 0:02:49.360 --> 0:02:52.240 Like he's all over the map, like genre wise, And 0:02:52.240 --> 0:02:54.960 I really have appreciation for people that don't make the 0:02:54.960 --> 0:02:57.600 same movie over and over, you know, hats off for that. 0:02:58.720 --> 0:03:01.200 Um have you seen her? Yeah? I just saw it. 0:03:01.639 --> 0:03:04.600 That's a good movie. I was surprised that how good 0:03:04.639 --> 0:03:07.280 it was. I thought it was. I loved it. Yeah, 0:03:07.560 --> 0:03:10.120 So okay back to hundred twenty seven Hours. That movie 0:03:10.320 --> 0:03:13.200 by Danny Boyle is about a real life incident that 0:03:13.240 --> 0:03:16.240 happened to a guy named Aaron Ralston in two thousand three. 0:03:16.560 --> 0:03:20.160 In May of two thousand three, he was a and 0:03:20.600 --> 0:03:23.760 I take it he still is a real like outdoorsy 0:03:23.840 --> 0:03:26.079 go getters or can't keep me down kind of guy, 0:03:26.800 --> 0:03:30.280 very independent spirit, so much so that he went canyoning 0:03:30.280 --> 0:03:34.200 by himself, um, in May of two thousand three, and 0:03:34.440 --> 0:03:39.160 while canyoning, there was a uh shift with one of 0:03:39.200 --> 0:03:42.600 the boulders that he was leaning on. Or next two 0:03:42.720 --> 0:03:46.360 or something, and he slipped down into a crevas so 0:03:46.440 --> 0:03:49.560 what it was, and a boulder landed on top, wedging 0:03:49.600 --> 0:03:51.840 his arm in there yet Okay, I haven't seen the 0:03:51.840 --> 0:03:53.960 movie in a little while. Plus I wasn't there when 0:03:53.960 --> 0:03:58.440 it happened. Um, and so he's he's trapped like alone, 0:03:58.680 --> 0:04:02.600 no cell service, I firem or correctly. Um, he was 0:04:02.680 --> 0:04:05.800 just totally screwed as much as a person could be screwed. 0:04:06.680 --> 0:04:09.720 The one saving grace that Aaron Ralston had. The two 0:04:09.760 --> 0:04:13.600 saving graces that Aaron Ralston had was a pocket knife 0:04:14.520 --> 0:04:17.840 and nerves of steel. Yeah. I'm glad you said that 0:04:18.200 --> 0:04:20.560 because I was like, if he doesn't say intestinal fortitude 0:04:20.640 --> 0:04:22.640 or something like that, then I have to add a 0:04:22.680 --> 0:04:26.680 third thing. Yeah, because I mean there's not I don't 0:04:26.720 --> 0:04:29.760 think that that many human beings can pull that off. 0:04:30.960 --> 0:04:32.880 So we should say for those of you who haven't 0:04:32.880 --> 0:04:35.440 seen the movie, you should see it anyway. But he 0:04:35.520 --> 0:04:38.760 cuts his own handoff, He cut a portion of his 0:04:38.920 --> 0:04:42.480 arm off. He did what's called a lower extremity amputation. 0:04:42.960 --> 0:04:45.440 Oh I thought that'd be an upper upper. Yeah, that's 0:04:45.440 --> 0:04:47.720 what I meant. I was thinking lower on the arm 0:04:47.760 --> 0:04:53.400 and stupid. But um, Yeah, he without any sedation whatsoever, 0:04:54.000 --> 0:04:56.640 after having gone about five days without water, a few 0:04:56.680 --> 0:04:59.200 days without water. He was trapped there for five days 0:04:59.760 --> 0:05:01.640 with no hope that he was going to be helped 0:05:01.720 --> 0:05:04.720 us out in the middle of nowhere. Um, he broke 0:05:04.800 --> 0:05:09.080 his arm. And then after he broke his arm, he 0:05:09.320 --> 0:05:12.839 cut through the skin and the tendons and the muscles 0:05:12.839 --> 0:05:16.320 and all the sinew around, you know, through the break 0:05:16.360 --> 0:05:20.760 and the bones, and then cut his his lower arm off. Yeah. 0:05:20.800 --> 0:05:23.960 And remember he had dulled his knife from trying to 0:05:24.040 --> 0:05:27.279 chip away at the stone for days and I forgot 0:05:27.320 --> 0:05:29.239 about that. Yeah, So if he had have done it initially, 0:05:29.480 --> 0:05:32.640 it would have been easier. So he had like this 0:05:32.760 --> 0:05:35.400 dull blade. Yeah. Yeah. Man, it's a tough scene to 0:05:35.440 --> 0:05:37.320 watch for sure, but I think they handled it well 0:05:37.360 --> 0:05:41.480 and it's a great story. Yeah. And he is like, oh, 0:05:41.640 --> 0:05:44.000 I should say also, we should finish it. He hiked 0:05:44.040 --> 0:05:50.080 out six six miles before he finally found somebody to 0:05:50.520 --> 0:05:52.880 drive him to the hospital. Yeah, and I think he 0:05:52.920 --> 0:05:55.960 even stopped and did a little like splunking along the 0:05:55.960 --> 0:05:57.880 way or something like that. No, he went straight to 0:05:57.880 --> 0:06:00.640 the hospital. Well, he was probably doing all sorts of 0:06:00.839 --> 0:06:03.440 outdoors the activities right afterwards, he's like, I said, one 0:06:03.480 --> 0:06:06.320 of those people you can't keep down. But um, in 0:06:06.320 --> 0:06:11.120 this article, it's a pretty good article about amputation. UM. 0:06:11.240 --> 0:06:14.359 The author makes the point that Aaron Ralston's is a 0:06:14.400 --> 0:06:19.520 great example of amputation in that UM it's a blast 0:06:19.560 --> 0:06:22.960 resort typically, like you don't just go this, try amputation 0:06:23.000 --> 0:06:26.159 and then we'll go from there. It's like if we 0:06:26.200 --> 0:06:30.640 don't amputate, you're going to die usually. So it also 0:06:30.800 --> 0:06:34.960 he also provides the um the point that your your 0:06:35.000 --> 0:06:38.600 life doesn't end when you undergo an amputation. That's right, 0:06:38.680 --> 0:06:40.280 Like there's all sorts of things that kind of get 0:06:40.360 --> 0:06:41.920 you back on track, and it's a lot of work 0:06:41.920 --> 0:06:44.359 and it's the suck thing to happen, I imagine. But 0:06:44.520 --> 0:06:49.240 when you do have UM limbs amputated, your life isn't 0:06:49.279 --> 0:06:53.000 over basically. And well we'll talk about that too, But UM, 0:06:53.160 --> 0:06:54.640 you want to get into amputation. I want to talk 0:06:54.640 --> 0:06:57.760 about the history of this stuff. Uh yeah, man, it's 0:06:57.880 --> 0:07:03.760 UM history is like all old medical history involving surgery. 0:07:03.800 --> 0:07:07.360 It's pretty grizzly. UM. It dates all the way back 0:07:07.360 --> 0:07:10.960 to ancient times. They found archaeological proof that they performed 0:07:10.960 --> 0:07:14.680 their procedure many many many years ago, about seven thousand 0:07:14.800 --> 0:07:17.800 years ago, they found a grave really who had had 0:07:17.800 --> 0:07:21.320 his lower arm amputated, head healed. Yeah. What they found 0:07:21.360 --> 0:07:25.040 the differences though, back then they were moving dead tissue, 0:07:25.080 --> 0:07:28.360 tissue that was already dead because they didn't know how 0:07:28.400 --> 0:07:32.560 to stop bleeding at the time, so they obviously couldn't 0:07:33.360 --> 0:07:37.240 cut any healthy blood flow, any arteries or blood vessels, right, 0:07:37.280 --> 0:07:39.160 so they had to cut off tissue that was just 0:07:39.280 --> 0:07:41.920 like you said, already dead. There wasn't any blood flowing 0:07:41.960 --> 0:07:45.160 to it, no blood. Uh. And then of course in 0:07:45.360 --> 0:07:49.000 Rome in Greece they were smart and they advanced the 0:07:49.480 --> 0:07:53.480 process and actually, uh were the first to tie off 0:07:53.560 --> 0:07:57.240 these blood vessels. Is that called legating? Yeah, okay, like 0:07:57.320 --> 0:08:01.000 ligature marks, yeah yeah yeah um. And that would stop 0:08:01.040 --> 0:08:03.400 the blood flow, and they did a good job with that. 0:08:03.520 --> 0:08:06.920 But it seems that people forgot about that and they 0:08:06.920 --> 0:08:09.880 didn't do that for another few hundred years afterwards. And 0:08:09.920 --> 0:08:13.400 not only did they forget about that, the Romans and 0:08:13.480 --> 0:08:17.560 the Greeks both used um wine and vinegars an aseptics 0:08:17.640 --> 0:08:21.120 during surgery too, and just lost that too. I wonder 0:08:21.120 --> 0:08:24.480 if that worked. I think probably better is better than 0:08:24.520 --> 0:08:27.840 nothing other than um so, like I said, they forgot 0:08:27.880 --> 0:08:29.600 for a couple hundred years or a few hundred and 0:08:29.600 --> 0:08:34.600 then and started cauterizing wounds instead, which, as we all know, 0:08:34.720 --> 0:08:38.680 is burning a blood vessel shut, dipping it and boiling oil. 0:08:38.800 --> 0:08:42.680 It's one way, or just the old hot poker treatment. 0:08:43.600 --> 0:08:49.319 Um yeah, just awful, It's like and then say hello 0:08:49.360 --> 0:08:54.160 to this hot boiling oil. Wow. I wonder how well 0:08:54.200 --> 0:08:56.240 it worked, though, I mean, at least as far as 0:08:56.320 --> 0:08:59.360 keeping the person alive and staving off infection. I mean 0:08:59.400 --> 0:09:01.200 I think that I don't know about the infection part, 0:09:01.240 --> 0:09:03.160 but back then, I think they just wanted to keep 0:09:03.160 --> 0:09:05.640 someone alive. Do you remember Rainbow three when he gets 0:09:05.679 --> 0:09:08.440 shot in the side and he cauterizes his wound by 0:09:08.480 --> 0:09:11.360 pouring some gasoline in and lighting and I don't remember 0:09:11.360 --> 0:09:15.120 that he did that. Yeah, this like blue flame like 0:09:15.160 --> 0:09:19.000 shoots through his abdomen and he goes it's the best 0:09:19.000 --> 0:09:21.760 acting still one's ever done. Wow. I don't know that 0:09:21.800 --> 0:09:24.920 I agree with that, but it's impressive. You should watch it. 0:09:24.960 --> 0:09:28.200 See what you think. Okay, okay, I put first blood 0:09:28.200 --> 0:09:30.320 on my I saw that in my list, But I 0:09:30.320 --> 0:09:32.839 haven't heard any chiding yet. On your list of hundred 0:09:32.880 --> 0:09:36.559 greatest movies of all time. That's right, um, but Rainbow 0:09:36.600 --> 0:09:39.280 three was not on there. It was still pretty good, Okay, 0:09:39.360 --> 0:09:42.040 I'll check it out. Remember he was fighting with the Taliban. 0:09:42.080 --> 0:09:44.040 The mujah Hadeen was at the middle. There are the 0:09:44.080 --> 0:09:47.240 freedom fighters that he was helping fight the Russians. I 0:09:47.240 --> 0:09:49.000 actually don't know if I saw Rainbow three now that 0:09:49.040 --> 0:09:53.560 I think about it. Um, all right, So amputation advanced, 0:09:53.800 --> 0:09:57.920 of course over the years after the cauterization um debacle 0:09:58.679 --> 0:10:04.199 and in wartime or after wartime with no surprise is 0:10:04.240 --> 0:10:06.680 when they made a lot of these advances, especially in 0:10:06.720 --> 0:10:11.480 France with a surgeon name, a military surgeon name Ambroyce Parae. 0:10:12.760 --> 0:10:14.320 I don't know if he's related to Michael or not, 0:10:15.720 --> 0:10:20.440 but um he uh. Of course, with gunpowder and bullets 0:10:20.480 --> 0:10:23.600 and cannonballs and things we saw like injuries like we've 0:10:23.640 --> 0:10:26.120 never seen before. Yeah, we can. We can thank those 0:10:26.160 --> 0:10:34.040 things for advancement of amputation. Totally successful amputation. Um. So 0:10:34.200 --> 0:10:38.079 that was one of the big reasons that Parae was effective. 0:10:38.559 --> 0:10:43.360 And he was basically the first guy to bring back 0:10:43.960 --> 0:10:51.040 the legating he rediscovered it. Yeah, in which is said 0:10:51.040 --> 0:10:54.520 that it took that long from ancient Rome to somebody 0:10:54.679 --> 0:10:57.360 be like, oh, what if we just like tied these 0:10:57.400 --> 0:11:00.720 things shut? Now, burn it right, really got the hot 0:11:00.720 --> 0:11:03.960 oil already already, it's too late for your advancement. And 0:11:04.040 --> 0:11:07.000 that is how fond was born. Like, we got the 0:11:07.040 --> 0:11:09.960 hot oil ready, he said, we don't need it. Put 0:11:10.000 --> 0:11:12.400 some meat on a stick and have at it. Oh no, 0:11:12.520 --> 0:11:15.840 you thought I was talking about like body parts. No, no, no, 0:11:16.320 --> 0:11:20.160 I'm not a monster. Um. Then I thought it was 0:11:20.200 --> 0:11:23.640 funnier when you were a monster. Then the tourniquet was 0:11:23.679 --> 0:11:26.280 invented in sixteen seventy four, which kind of surprises me 0:11:26.360 --> 0:11:28.959 that because that seems more rudimentary than any of this 0:11:29.120 --> 0:11:32.320 another bonehead invention. Yeah, like, why don't you know, you 0:11:32.320 --> 0:11:34.440 you come up with this stuff before you cut people's 0:11:34.480 --> 0:11:38.679 limbs off, it would be nice. And then anesthetic of course, uh, 0:11:38.720 --> 0:11:41.960 in the forties with anesthetic gas went a long way 0:11:42.080 --> 0:11:46.520 towards performing these surgeries, you know, with that lot of pain. Yeah. 0:11:46.880 --> 0:11:49.760 And here in the Western world, the American Civil War 0:11:49.920 --> 0:11:56.480 was a huge, dude springboard to um understanding amputation amputation techniques. 0:11:56.520 --> 0:11:58.680 They might as well call it the amputation War just 0:11:58.760 --> 0:12:01.760 from sheer volume of amputations. A lot of doctors who 0:12:01.840 --> 0:12:05.960 got their nickname sawbones from amputating, sawing through bones and 0:12:06.280 --> 0:12:11.520 all that. Um, just the number of amputations that they performed, 0:12:11.800 --> 0:12:16.120 formed this body of knowledge that carried on after the war. Yeah, 0:12:16.120 --> 0:12:19.480 fifty thousand, more than fifty tho amputations in the Civil War. 0:12:20.160 --> 0:12:23.080 And this this is also hard to believe, but I 0:12:23.080 --> 0:12:25.480 guess it's hard to go back in time and realize 0:12:25.520 --> 0:12:27.240 if they just didn't know something, they didn't know it yet. 0:12:27.600 --> 0:12:29.960 It seems like a no brainer now that keeping a 0:12:30.040 --> 0:12:34.559 surgical environment clean should just be an eate and a surgeon. 0:12:34.840 --> 0:12:36.720 But back then they didn't know that. They didn't understand 0:12:36.720 --> 0:12:39.600 bacteria like they do now. They didn't know germs. Yeah, 0:12:39.720 --> 0:12:44.280 and so it was like a stamp of experience to 0:12:44.480 --> 0:12:48.439 have a bloody surgical gown. So surgeons would like purposefully 0:12:48.520 --> 0:12:51.680 not change their clothes and things because they were like, hey, 0:12:51.679 --> 0:12:56.280 look at my bloody gownd eight amputations today beat that, yeah, exact, 0:12:56.280 --> 0:13:01.520 pepper John. Um. They would doll some the chloroform soaked rag, 0:13:01.960 --> 0:13:05.360 put on the tourniquet and slice through everything and then 0:13:05.360 --> 0:13:07.360 like you said, get out the old saw bones all 0:13:08.200 --> 0:13:11.240 and uh, take care of business. Basically, and then we 0:13:11.400 --> 0:13:15.280 just toss the limb onto a pile, which grew pretty quickly. Yeah, 0:13:15.440 --> 0:13:18.520 and there's plenty of old photographs of limb piles from 0:13:18.559 --> 0:13:21.640 the Civil War. Yeah. One out of four patients died 0:13:22.440 --> 0:13:25.920 uh in those days after an amputation, and that doubled 0:13:26.240 --> 0:13:28.400 if it didn't happen in the first twenty four hours. Right, 0:13:28.480 --> 0:13:33.800 But a lot of people's lives were saved battlefield amputations. Yeah, 0:13:33.800 --> 0:13:36.760 and most of those I think we're probably um bacterial 0:13:37.600 --> 0:13:41.040 due to infection and not necessarily like just bleeding outer 0:13:41.120 --> 0:13:43.200 or a mistake or something, right, which we should say 0:13:43.240 --> 0:13:46.840 at this point. The whole reason to amputate is because 0:13:47.920 --> 0:13:50.880 you often have a wound or a diseased part of 0:13:50.880 --> 0:13:55.120 your body UM that's creating dead tissue, and that site 0:13:55.240 --> 0:13:59.840 of dead tissue is a really great place for becked 0:14:00.000 --> 0:14:03.400 a real infections to take root and take hold. The 0:14:03.440 --> 0:14:06.080 problem with the bacterial infection is that it tends to 0:14:06.080 --> 0:14:09.920 spread towards the rest of your body. So the point 0:14:09.920 --> 0:14:13.640 of amputation almost across the board is to prevent the 0:14:13.679 --> 0:14:18.000 spread of infection in the rashest way possible, which is 0:14:18.000 --> 0:14:22.120 why amputations typically are just the last resort. You're trying 0:14:22.160 --> 0:14:25.000 to stop this infection from spreading. And if you literally 0:14:25.040 --> 0:14:27.920 separate it from the rest of the healthy body, that 0:14:27.960 --> 0:14:32.080 should do the trick, and it frequently does. Yeah, and 0:14:32.160 --> 0:14:35.000 I think the final advancement, well not final advancement, of course, 0:14:35.000 --> 0:14:38.480 it's still advancing. But the last big advancement was was 0:14:38.640 --> 0:14:42.520 with the infections and a British surgeon named Joseph lister 0:14:43.320 --> 0:14:49.520 Um was known as kind of the father of antiseptic surgery. 0:14:50.200 --> 0:14:54.880 Oh yeah, no, way, of course it is. I never 0:14:54.920 --> 0:14:58.120 put those two together. Boom. Did he make any money 0:14:58.120 --> 0:15:00.240 off that? Like, was it actually his company or did 0:15:00.240 --> 0:15:03.800 they just I don't know. Interesting, So he was the 0:15:03.840 --> 0:15:07.520 first guy. He used something called carbolic acid, which is listering. 0:15:08.280 --> 0:15:11.160 Probably is. They used it back then to prevent wood 0:15:11.240 --> 0:15:13.680 rot and to treat sewage, so I guess they just 0:15:13.760 --> 0:15:16.600 knew it was good for for stopping bacteria. I'll be 0:15:16.800 --> 0:15:20.360 that caught aizes wounds. Yeah, and uh he would spray 0:15:20.360 --> 0:15:24.760 it on surgical tools and incisions and dressings and even people, 0:15:25.360 --> 0:15:27.280 uh in the surgery room. He would spray them with 0:15:27.280 --> 0:15:31.520 it and then he would he was the first distress 0:15:31.560 --> 0:15:36.000 handwashing and clean gloves and things like that. So hats 0:15:36.040 --> 0:15:39.120 off to you, Mr Lister. Dr Lister, Well, he was 0:15:39.160 --> 0:15:42.200 one of those people who like made up a handful 0:15:42.240 --> 0:15:48.040 of human beings who have saved billions of people's lives 0:15:48.040 --> 0:15:53.640 just from their innovations and their insights. Um. So amputation, 0:15:53.720 --> 0:15:56.240 it's been around for a while, and that's just surgically amputation. 0:15:56.280 --> 0:16:02.040 There's evidence of amputation for um religious self sacrifice as 0:16:02.080 --> 0:16:06.000 far back as like thirty thousand, forty thousand years ago. Um, 0:16:06.000 --> 0:16:08.280 it was very for a long time. It was a punishment. 0:16:08.360 --> 0:16:14.960 That um word amputatio or amputasho is a Roman for well, 0:16:14.960 --> 0:16:17.880 it's a punishment. It's synonymous with punishment, and it meant 0:16:17.960 --> 0:16:20.280 like you had your hands chopped off, Like if you 0:16:20.360 --> 0:16:23.880 steal something you then symbolically they would cut off your hand. Yeah, 0:16:24.240 --> 0:16:27.600 and then it was even amputation is even inscribed as 0:16:27.600 --> 0:16:31.960 a punishment in the first written law, the Code of Hammurabi. 0:16:32.560 --> 0:16:35.080 If you were a doctor and you lost the patient, 0:16:35.400 --> 0:16:37.280 well you should lose one of your hands. That was 0:16:37.320 --> 0:16:41.120 the code. That just makes this so counter to trying 0:16:41.160 --> 0:16:44.000 to make doctors better. You know, yeah, we want you 0:16:44.040 --> 0:16:45.880 to be a better doctor, so we're gonna remove one 0:16:45.920 --> 0:16:48.920 of your hands. You're worried about tort law. Think about 0:16:48.920 --> 0:16:53.080 how good you have it now. Um. So, like you said, 0:16:53.120 --> 0:16:55.640 the reason, Um, there are a couple of reasons you 0:16:55.640 --> 0:16:59.400 would get an amputation. Uh. One is disease and the 0:16:59.400 --> 0:17:03.040 other is um injury like my friend with the truck, 0:17:03.680 --> 0:17:09.760 like some kind of catastrophic injury. UH damages It doesn't 0:17:09.800 --> 0:17:12.400 necessarily always like rip your arm off, but it damages 0:17:12.440 --> 0:17:15.520 it to the point where there's no blood flowing there 0:17:15.560 --> 0:17:17.480 and the tissue was dying beyond the point where it 0:17:17.520 --> 0:17:20.600 can be rescued, essentially. And it might be a truck, 0:17:20.640 --> 0:17:25.160 it might be a bullet wound, Um, it could be well. Basically, 0:17:25.160 --> 0:17:28.480 any traumatic injury, a fire, a burn, a severe burn 0:17:28.600 --> 0:17:32.080 is considered a traumatic injury. Yeah. Blood flow is big. 0:17:32.680 --> 0:17:35.800 If it's not flowing, then problems happen. You're gonna have 0:17:35.800 --> 0:17:38.880 a stroke. If it stops blowing, you're gonna lose an arm. 0:17:38.920 --> 0:17:42.080 And it stops slowing. So if your blood flow is 0:17:42.119 --> 0:17:44.800 cut off for too long, then you're in big trouble. Right, 0:17:44.800 --> 0:17:48.040 And it's not just a traumatic injury disease. UM, there's 0:17:48.040 --> 0:17:52.639 plenty of diseases that see a lessening of blood flow, 0:17:52.720 --> 0:17:57.760 like um arterio, sclerosis because plaque build up and blood vessels. 0:17:58.200 --> 0:18:01.359 When it builds up enough and enough, those blood vessels hardened, 0:18:01.840 --> 0:18:05.399 and the amount of blood flow through those vessels diminishes 0:18:05.720 --> 0:18:09.240 so much that the tissue that those blood vessels feed 0:18:09.720 --> 0:18:14.560 Uh dies. Um. There's something called peripheral artery disease, which 0:18:14.600 --> 0:18:17.800 is the result of a lack of blood flow leading 0:18:17.800 --> 0:18:22.239 to dead tissue. Uman. Diabetics. Yeah, you you join that 0:18:22.280 --> 0:18:25.880 with diabetes, which has the tendency to also kill nerve 0:18:26.040 --> 0:18:28.800 endings neuropathy. Uh. And then all of a sudden, you 0:18:28.840 --> 0:18:31.520 can't feel so when you cut yourself, so you cut 0:18:31.560 --> 0:18:34.640 your foot or something like that, Um, you don't feel it, 0:18:34.720 --> 0:18:37.040 So you're more prone to cuts, and it takes longer 0:18:37.080 --> 0:18:39.719 to heal because of the lack of circulation, And all 0:18:39.720 --> 0:18:42.560 of a sudden, you have an infection that possibly turns 0:18:42.560 --> 0:18:46.080 gangrenous and threatens your entire life. Yeah. And in the US, 0:18:46.240 --> 0:18:49.520 ninety percent of amputations are as a result of this 0:18:49.720 --> 0:18:56.600 disease scenario. Um. Whereas if you're under fifty, UM, traumatic 0:18:56.640 --> 0:18:59.639 injury is a leading cause of amputations. Yeah. So like 0:18:59.720 --> 0:19:02.399 you know, you're out rudding your bike, I'm on a 0:19:02.400 --> 0:19:06.480 mountain road, or your Aaron Ralston in Your Mountaineering and Utah. 0:19:06.560 --> 0:19:09.359 You know, I would call that a traumatic injury getting 0:19:09.359 --> 0:19:13.560 your hampined under a boulder for sure, man, can you imagine? 0:19:13.920 --> 0:19:15.280 And they did a good job in the movie. But 0:19:15.359 --> 0:19:17.840 as it sets in, like what the deal is because 0:19:17.840 --> 0:19:21.000 at first he was like, oh man, yeah, like let 0:19:21.000 --> 0:19:23.600 me get out of this, or trying to move the 0:19:23.640 --> 0:19:26.520 boulder was like nothing, and then all of a sudden, 0:19:26.520 --> 0:19:30.359 you think I might die of starvation. Yeah, and then 0:19:30.440 --> 0:19:32.880 you it just goes over to the knife, like, man, 0:19:33.240 --> 0:19:36.480 I wish I hadn't adulled it. So then there's cancer, 0:19:36.520 --> 0:19:39.080 which we haven't mentioned. Um. There are a couple of 0:19:39.080 --> 0:19:41.960 ways that it could lead to amputation. Obviously just damage 0:19:42.000 --> 0:19:44.920 to your body tissue. Um. But also like you said, 0:19:44.960 --> 0:19:50.280 to keep a malignant tumor from spreading around, sometimes they 0:19:50.280 --> 0:19:55.480 will just lop it off. And apparently those amputations from 0:19:55.960 --> 0:20:02.320 cancer have diminished tremendously over sure that gator two. Um. 0:20:02.359 --> 0:20:08.639 But unfortunately those from disease have increased. Yeah, it's dropped 0:20:08.680 --> 0:20:12.560 by over the past twenty years amputations overall. No, just 0:20:12.680 --> 0:20:17.080 from for answer, traumatic injury and cancer. UM. So I 0:20:17.080 --> 0:20:19.960 don't know people are being safer and their recreation if 0:20:19.960 --> 0:20:21.520 that has something to do with it or not, or 0:20:21.560 --> 0:20:25.879 they're yeah, we might have better trauma or better reattaching 0:20:25.920 --> 0:20:31.000 to UM. But yes, you're right. It has increased because 0:20:31.040 --> 0:20:34.600 of at least in the the United States, largely due to obesity, 0:20:34.840 --> 0:20:38.960 so much so that this article was from UM maybe 0:20:38.960 --> 0:20:43.080 two two thousand and six something like that, and it 0:20:43.160 --> 0:20:45.320 says that one out of every two hundred Americans is 0:20:45.359 --> 0:20:49.240 an amputee. That's not right anymore. No, it's actually even 0:20:49.240 --> 0:20:51.800 more one out of from what I could find, a 0:20:51.880 --> 0:20:55.320 hundred and seventy six Americans, so it's one point seven 0:20:55.320 --> 0:20:58.840 million people, one out of hundreds. That seems like a 0:20:58.840 --> 0:21:02.120 lot of people. Yeah, but that counts digits and things 0:21:02.119 --> 0:21:04.520 that you don't think about, you know, like someone lost 0:21:04.520 --> 0:21:07.560 a thumb, because I hear that, and I'm like, why 0:21:07.600 --> 0:21:10.200 don't I see that more on a daily basis. You 0:21:10.280 --> 0:21:13.280 don't work in the industrial arts. Yeah, that's true. I 0:21:13.320 --> 0:21:17.439 don't work in a factory with lots of saws and chains, 0:21:17.520 --> 0:21:20.840 and yeah, that's good point. You got Alaska about every 0:21:20.920 --> 0:21:23.760 like third person has a limb that's missing. You don't 0:21:23.760 --> 0:21:28.159 see a lot of the podcasting field. UM, so we're 0:21:28.200 --> 0:21:33.800 gonna prepare you for surgery. Dr Clark right for this message. Break. Wait, 0:21:33.840 --> 0:21:43.520 I'm doing the surgery right always. Okay. So preparing for 0:21:43.640 --> 0:21:47.480 amputation surgery is like every surgery. Initially, you're gonna have 0:21:47.520 --> 0:21:52.200 a lot of meetings because they want you to be prepared, 0:21:52.280 --> 0:21:56.040 and you're gonna have everything very explained very well, and 0:21:56.119 --> 0:21:59.240 what you can expect before, during, and after, just like 0:21:59.280 --> 0:22:01.560 with all surgery. How what kind of anesthesia they're going 0:22:01.600 --> 0:22:05.280 to use? Um, Yeah, it's not always general anesthesia. I 0:22:05.359 --> 0:22:07.399 knew this would stand out to you too. Yeah, I 0:22:07.400 --> 0:22:10.760 would not want to be awake. No, knock me out, 0:22:10.880 --> 0:22:13.840 cut my toe off, I don't care. Yeah, I'd better 0:22:13.880 --> 0:22:15.960 be out. Well, actually, I take that back. If it 0:22:16.040 --> 0:22:18.159 was like a just a digit, I could stomach that. 0:22:18.760 --> 0:22:20.880 Not me. I don't know. If I'd watch it. At 0:22:20.880 --> 0:22:24.399 the very least, I wouldn't would be boring. I think 0:22:24.440 --> 0:22:26.760 it'd be fascinating. Well, I mean you couldn't see anything. 0:22:26.800 --> 0:22:28.679 You'd just be sitting there like these guys are cutting 0:22:28.720 --> 0:22:30.840 my finger off right now. I think it'd arrange a 0:22:30.880 --> 0:22:33.280 mirror or something. I used to get that at the dentist. 0:22:33.320 --> 0:22:34.879 I used to request a mirror, so I could look 0:22:34.920 --> 0:22:36.879 at what they were doing. I think, just because it 0:22:36.880 --> 0:22:40.480 fascinated me and to keep an eye on Yeah, exactly. 0:22:41.480 --> 0:22:44.680 So Yeah, they say sometimes you just local anesthetic to 0:22:44.680 --> 0:22:49.800 to carry out a amputation. That's nutty. Um, if it's 0:22:50.000 --> 0:22:53.080 a limb, I don't think they would do that. No, 0:22:53.280 --> 0:22:55.359 that's got to be generalized. Yeah, because I think like 0:22:55.400 --> 0:22:58.800 if you weren't under your blood pressure would advise to 0:22:59.000 --> 0:23:01.800 dangerous levels. This good point. Yeah. Uh, if you're gonna 0:23:01.800 --> 0:23:06.680 get a prosthetic device, you might meet beforehand with your prosthetics, uh, 0:23:06.720 --> 0:23:08.720 to measure you out and kind of talk about what 0:23:08.760 --> 0:23:14.639 you're looking for post surgery, and um, then you're gonna 0:23:15.080 --> 0:23:18.919 you know, then it's go time. I guess it is 0:23:18.960 --> 0:23:21.680 kind of go time. The well, the surgeon is gonna 0:23:21.680 --> 0:23:25.080 want to figure out exactly where to cut ahead of time. 0:23:25.119 --> 0:23:28.560 It's not like how about here they actually measure blood 0:23:28.560 --> 0:23:32.640 flow to the area, um, to see what tissues still 0:23:32.680 --> 0:23:36.280 receiving you know, circular, a healthy amount of circulation. Yeah, 0:23:36.280 --> 0:23:38.359 they don't want to leave any bad tissue behind. No, 0:23:38.560 --> 0:23:40.520 but they want to get as much of the bad 0:23:40.560 --> 0:23:43.879