Speaker 1: Welcome to you stuff you should know from house Stuff
Speaker 1: Works dot com. Hey, and welcome to the podcast. I'm
Speaker 1: Josh Clark in the Dynamic duo Chuck Bryant, two Men,
Speaker 1: eight lambs. Yeah, that's us. Yeah, I guess so I
Speaker 1: hadn't really thought about it. We're fully intact. Yeah, and
Speaker 1: I think, Um, I think missing a limb or a
Speaker 1: finger or a toe or anything. Sure, um if, I guess,
Speaker 1: it's not something you think about until after it happens,
Speaker 1: and then it probably becomes one of the central folk
Speaker 1: I of your life. Do you know anyone missing a one? Uh? No,
Speaker 1: As a matter of fact, I don't, do you. Uh yeah.
Speaker 1: I worked with a guy at my last job who
Speaker 1: had an accident, biking accident with a truck. Not true,
Speaker 1: Not true, Go ahead. I just had to remind myself,
Speaker 1: Uh of what. Oh my brother in law's father has
Speaker 1: a part of partial finger amputation. Oh yeah, well this
Speaker 1: this fan's his arm, the whole arm. Yeah. What happened? Um,
Speaker 1: biking on the side of the road and oncoming truck
Speaker 1: the side view mirror basically clipped him at the armpit
Speaker 1: and did it take it clean off or I don't know.
Speaker 1: I'm not sure. I guess if it would have taken
Speaker 1: it clean off, they probably would have done a replantation. Yeah,
Speaker 1: we talked about Yeah, so this is a I guess
Speaker 1: the follow up in a mini suite. I like to
Speaker 1: think of it as a part of a larger suite.
Speaker 1: We've done broken bones, Yeah, we've done um replantation. I
Speaker 1: think it's called your limbs torn off? Now what? Uh?
Speaker 1: And then this one how amputation works. Yeah, that's a
Speaker 1: good it's a good nice sweet What else can we
Speaker 1: possibly add to that? I don't know, because we're gonna
Speaker 1: cover uh, sexual fetishes around limb loss and phantom limb pain,
Speaker 1: and so I think that's that's all encompassing, sir. I
Speaker 1: think this will finish it off, miss hedbird well encompassingly.
Speaker 1: Really that was one of his bits. Uh, Chuck, Yes,
Speaker 1: have you surely I know that you've heard of Aaron Rollston. Yeah,
Speaker 1: we saw the movie and everything. There's a hundred twenty
Speaker 1: seven hours, right, um, yeah, I think that's right the
Speaker 1: name of the movie. Yeah, I'm doubting it all of
Speaker 1: a sudden, the number of hours. Yeah, good movie. Did
Speaker 1: you see it? Oh? Yeah, it was great. Yeah, James
Speaker 1: Franco is just like, I'm doing so great in the
Speaker 1: middle the movie, didn't He look at the camera, He's like,
Speaker 1: aren't aw I like that guy? Yeah? I do too,
Speaker 1: But he likes himself as well. Yeah. And hey, Danny Boyle,
Speaker 1: he makes a great movie. Is that Who directed that? Yeah?
Speaker 1: Like he's all over the map, like genre wise, And
Speaker 1: I really have appreciation for people that don't make the
Speaker 1: same movie over and over, you know, hats off for that.
Speaker 1: Um have you seen her? Yeah? I just saw it.
Speaker 1: That's a good movie. I was surprised that how good
Speaker 1: it was. I thought it was. I loved it. Yeah,
Speaker 1: So okay back to hundred twenty seven Hours. That movie
Speaker 1: by Danny Boyle is about a real life incident that
Speaker 1: happened to a guy named Aaron Ralston in two thousand three.
Speaker 1: In May of two thousand three, he was a and
Speaker 1: I take it he still is a real like outdoorsy
Speaker 1: go getters or can't keep me down kind of guy,
Speaker 1: very independent spirit, so much so that he went canyoning
Speaker 1: by himself, um, in May of two thousand three, and
Speaker 1: while canyoning, there was a uh shift with one of
Speaker 1: the boulders that he was leaning on. Or next two
Speaker 1: or something, and he slipped down into a crevas so
Speaker 1: what it was, and a boulder landed on top, wedging
Speaker 1: his arm in there yet Okay, I haven't seen the
Speaker 1: movie in a little while. Plus I wasn't there when
Speaker 1: it happened. Um, and so he's he's trapped like alone,
Speaker 1: no cell service, I firem or correctly. Um, he was
Speaker 1: just totally screwed as much as a person could be screwed.
Speaker 1: The one saving grace that Aaron Ralston had. The two
Speaker 1: saving graces that Aaron Ralston had was a pocket knife
Speaker 1: and nerves of steel. Yeah. I'm glad you said that
Speaker 1: because I was like, if he doesn't say intestinal fortitude
Speaker 1: or something like that, then I have to add a
Speaker 1: third thing. Yeah, because I mean there's not I don't
Speaker 1: think that that many human beings can pull that off.
Speaker 1: So we should say for those of you who haven't
Speaker 1: seen the movie, you should see it anyway. But he
Speaker 1: cuts his own handoff, He cut a portion of his
Speaker 1: arm off. He did what's called a lower extremity amputation.
Speaker 1: Oh I thought that'd be an upper upper. Yeah, that's
Speaker 1: what I meant. I was thinking lower on the arm
Speaker 1: and stupid. But um, Yeah, he without any sedation whatsoever,
Speaker 1: after having gone about five days without water, a few
Speaker 1: days without water. He was trapped there for five days
Speaker 1: with no hope that he was going to be helped
Speaker 1: us out in the middle of nowhere. Um, he broke
Speaker 1: his arm. And then after he broke his arm, he
Speaker 1: cut through the skin and the tendons and the muscles
Speaker 1: and all the sinew around, you know, through the break
Speaker 1: and the bones, and then cut his his lower arm off. Yeah.
Speaker 1: And remember he had dulled his knife from trying to
Speaker 1: chip away at the stone for days and I forgot
Speaker 1: about that. Yeah, So if he had have done it initially,
Speaker 1: it would have been easier. So he had like this
Speaker 1: dull blade. Yeah. Yeah. Man, it's a tough scene to
Speaker 1: watch for sure, but I think they handled it well
Speaker 1: and it's a great story. Yeah. And he is like, oh,
Speaker 1: I should say also, we should finish it. He hiked
Speaker 1: out six six miles before he finally found somebody to
Speaker 1: drive him to the hospital. Yeah, and I think he
Speaker 1: even stopped and did a little like splunking along the
Speaker 1: way or something like that. No, he went straight to
Speaker 1: the hospital. Well, he was probably doing all sorts of
Speaker 1: outdoors the activities right afterwards, he's like, I said, one
Speaker 1: of those people you can't keep down. But um, in
Speaker 1: this article, it's a pretty good article about amputation. UM.
Speaker 1: The author makes the point that Aaron Ralston's is a
Speaker 1: great example of amputation in that UM it's a blast
Speaker 1: resort typically, like you don't just go this, try amputation
Speaker 1: and then we'll go from there. It's like if we
Speaker 1: don't amputate, you're going to die usually. So it also
Speaker 1: he also provides the um the point that your your
Speaker 1: life doesn't end when you undergo an amputation. That's right,
Speaker 1: Like there's all sorts of things that kind of get
Speaker 1: you back on track, and it's a lot of work
Speaker 1: and it's the suck thing to happen, I imagine. But
Speaker 1: when you do have UM limbs amputated, your life isn't
Speaker 1: over basically. And well we'll talk about that too, But UM,
Speaker 1: you want to get into amputation. I want to talk
Speaker 1: about the history of this stuff. Uh yeah, man, it's
Speaker 1: UM history is like all old medical history involving surgery.
Speaker 1: It's pretty grizzly. UM. It dates all the way back
Speaker 1: to ancient times. They found archaeological proof that they performed
Speaker 1: their procedure many many many years ago, about seven thousand
Speaker 1: years ago, they found a grave really who had had
Speaker 1: his lower arm amputated, head healed. Yeah. What they found
Speaker 1: the differences though, back then they were moving dead tissue,
Speaker 1: tissue that was already dead because they didn't know how
Speaker 1: to stop bleeding at the time, so they obviously couldn't
Speaker 1: cut any healthy blood flow, any arteries or blood vessels, right,
Speaker 1: so they had to cut off tissue that was just
Speaker 1: like you said, already dead. There wasn't any blood flowing
Speaker 1: to it, no blood. Uh. And then of course in
Speaker 1: Rome in Greece they were smart and they advanced the
Speaker 1: process and actually, uh were the first to tie off
Speaker 1: these blood vessels. Is that called legating? Yeah, okay, like
Speaker 1: ligature marks, yeah yeah yeah um. And that would stop
Speaker 1: the blood flow, and they did a good job with that.
Speaker 1: But it seems that people forgot about that and they
Speaker 1: didn't do that for another few hundred years afterwards. And
Speaker 1: not only did they forget about that, the Romans and
Speaker 1: the Greeks both used um wine and vinegars an aseptics
Speaker 1: during surgery too, and just lost that too. I wonder
Speaker 1: if that worked. I think probably better is better than
Speaker 1: nothing other than um so, like I said, they forgot
Speaker 1: for a couple hundred years or a few hundred and
Speaker 1: then and started cauterizing wounds instead, which, as we all know,
Speaker 1: is burning a blood vessel shut, dipping it and boiling oil.
Speaker 1: It's one way, or just the old hot poker treatment.
Speaker 1: Um yeah, just awful, It's like and then say hello
Speaker 1: to this hot boiling oil. Wow. I wonder how well
Speaker 1: it worked, though, I mean, at least as far as
Speaker 1: keeping the person alive and staving off infection. I mean
Speaker 1: I think that I don't know about the infection part,
Speaker 1: but back then, I think they just wanted to keep
Speaker 1: someone alive. Do you remember Rainbow three when he gets
Speaker 1: shot in the side and he cauterizes his wound by
Speaker 1: pouring some gasoline in and lighting and I don't remember
Speaker 1: that he did that. Yeah, this like blue flame like
Speaker 1: shoots through his abdomen and he goes it's the best
Speaker 1: acting still one's ever done. Wow. I don't know that
Speaker 1: I agree with that, but it's impressive. You should watch it.
Speaker 1: See what you think. Okay, okay, I put first blood
Speaker 1: on my I saw that in my list, But I
Speaker 1: haven't heard any chiding yet. On your list of hundred
Speaker 1: greatest movies of all time. That's right, um, but Rainbow
Speaker 1: three was not on there. It was still pretty good, Okay,
Speaker 1: I'll check it out. Remember he was fighting with the Taliban.
Speaker 1: The mujah Hadeen was at the middle. There are the
Speaker 1: freedom fighters that he was helping fight the Russians. I
Speaker 1: actually don't know if I saw Rainbow three now that
Speaker 1: I think about it. Um, all right, So amputation advanced,
Speaker 1: of course over the years after the cauterization um debacle
Speaker 1: and in wartime or after wartime with no surprise is
Speaker 1: when they made a lot of these advances, especially in
Speaker 1: France with a surgeon name, a military surgeon name Ambroyce Parae.
Speaker 1: I don't know if he's related to Michael or not,
Speaker 1: but um he uh. Of course, with gunpowder and bullets
Speaker 1: and cannonballs and things we saw like injuries like we've
Speaker 1: never seen before. Yeah, we can. We can thank those
Speaker 1: things for advancement of amputation. Totally successful amputation. Um. So
Speaker 1: that was one of the big reasons that Parae was effective.
Speaker 1: And he was basically the first guy to bring back
Speaker 1: the legating he rediscovered it. Yeah, in which is said
Speaker 1: that it took that long from ancient Rome to somebody
Speaker 1: be like, oh, what if we just like tied these
Speaker 1: things shut? Now, burn it right, really got the hot
Speaker 1: oil already already, it's too late for your advancement. And
Speaker 1: that is how fond was born. Like, we got the
Speaker 1: hot oil ready, he said, we don't need it. Put
Speaker 1: some meat on a stick and have at it. Oh no,
Speaker 1: you thought I was talking about like body parts. No, no, no,
Speaker 1: I'm not a monster. Um. Then I thought it was
Speaker 1: funnier when you were a monster. Then the tourniquet was
Speaker 1: invented in sixteen seventy four, which kind of surprises me
Speaker 1: that because that seems more rudimentary than any of this
Speaker 1: another bonehead invention. Yeah, like, why don't you know, you
Speaker 1: you come up with this stuff before you cut people's
Speaker 1: limbs off, it would be nice. And then anesthetic of course, uh,
Speaker 1: in the forties with anesthetic gas went a long way
Speaker 1: towards performing these surgeries, you know, with that lot of pain. Yeah.
Speaker 1: And here in the Western world, the American Civil War
Speaker 1: was a huge, dude springboard to um understanding amputation amputation techniques.
Speaker 1: They might as well call it the amputation War just
Speaker 1: from sheer volume of amputations. A lot of doctors who
Speaker 1: got their nickname sawbones from amputating, sawing through bones and
Speaker 1: all that. Um, just the number of amputations that they performed,
Speaker 1: formed this body of knowledge that carried on after the war. Yeah,
Speaker 1: fifty thousand, more than fifty tho amputations in the Civil War.
Speaker 1: And this this is also hard to believe, but I
Speaker 1: guess it's hard to go back in time and realize
Speaker 1: if they just didn't know something, they didn't know it yet.
Speaker 1: It seems like a no brainer now that keeping a
Speaker 1: surgical environment clean should just be an eate and a surgeon.
Speaker 1: But back then they didn't know that. They didn't understand
Speaker 1: bacteria like they do now. They didn't know germs. Yeah,
Speaker 1: and so it was like a stamp of experience to
Speaker 1: have a bloody surgical gown. So surgeons would like purposefully
Speaker 1: not change their clothes and things because they were like, hey,
Speaker 1: look at my bloody gownd eight amputations today beat that, yeah, exact,
Speaker 1: pepper John. Um. They would doll some the chloroform soaked rag,
Speaker 1: put on the tourniquet and slice through everything and then
Speaker 1: like you said, get out the old saw bones all
Speaker 1: and uh, take care of business. Basically, and then we
Speaker 1: just toss the limb onto a pile, which grew pretty quickly. Yeah,
Speaker 1: and there's plenty of old photographs of limb piles from
Speaker 1: the Civil War. Yeah. One out of four patients died
Speaker 1: uh in those days after an amputation, and that doubled
Speaker 1: if it didn't happen in the first twenty four hours. Right,
Speaker 1: But a lot of people's lives were saved battlefield amputations. Yeah,
Speaker 1: and most of those I think we're probably um bacterial
Speaker 1: due to infection and not necessarily like just bleeding outer
Speaker 1: or a mistake or something, right, which we should say
Speaker 1: at this point. The whole reason to amputate is because
Speaker 1: you often have a wound or a diseased part of
Speaker 1: your body UM that's creating dead tissue, and that site
Speaker 1: of dead tissue is a really great place for becked
Speaker 1: a real infections to take root and take hold. The
Speaker 1: problem with the bacterial infection is that it tends to
Speaker 1: spread towards the rest of your body. So the point
Speaker 1: of amputation almost across the board is to prevent the
Speaker 1: spread of infection in the rashest way possible, which is
Speaker 1: why amputations typically are just the last resort. You're trying
Speaker 1: to stop this infection from spreading. And if you literally
Speaker 1: separate it from the rest of the healthy body, that
Speaker 1: should do the trick, and it frequently does. Yeah, and
Speaker 1: I think the final advancement, well not final advancement, of course,
Speaker 1: it's still advancing. But the last big advancement was was
Speaker 1: with the infections and a British surgeon named Joseph lister
Speaker 1: Um was known as kind of the father of antiseptic surgery.
Speaker 1: Oh yeah, no, way, of course it is. I never
Speaker 1: put those two together. Boom. Did he make any money
Speaker 1: off that? Like, was it actually his company or did
Speaker 1: they just I don't know. Interesting, So he was the
Speaker 1: first guy. He used something called carbolic acid, which is listering.
Speaker 1: Probably is. They used it back then to prevent wood
Speaker 1: rot and to treat sewage, so I guess they just
Speaker 1: knew it was good for for stopping bacteria. I'll be
Speaker 1: that caught aizes wounds. Yeah, and uh he would spray
Speaker 1: it on surgical tools and incisions and dressings and even people,
Speaker 1: uh in the surgery room. He would spray them with
Speaker 1: it and then he would he was the first distress
Speaker 1: handwashing and clean gloves and things like that. So hats
Speaker 1: off to you, Mr Lister. Dr Lister, Well, he was
Speaker 1: one of those people who like made up a handful
Speaker 1: of human beings who have saved billions of people's lives
Speaker 1: just from their innovations and their insights. Um. So amputation,
Speaker 1: it's been around for a while, and that's just surgically amputation.
Speaker 1: There's evidence of amputation for um religious self sacrifice as
Speaker 1: far back as like thirty thousand, forty thousand years ago. Um,
Speaker 1: it was very for a long time. It was a punishment.
Speaker 1: That um word amputatio or amputasho is a Roman for well,
Speaker 1: it's a punishment. It's synonymous with punishment, and it meant
Speaker 1: like you had your hands chopped off, Like if you
Speaker 1: steal something you then symbolically they would cut off your hand. Yeah,
Speaker 1: and then it was even amputation is even inscribed as
Speaker 1: a punishment in the first written law, the Code of Hammurabi.
Speaker 1: If you were a doctor and you lost the patient,
Speaker 1: well you should lose one of your hands. That was
Speaker 1: the code. That just makes this so counter to trying
Speaker 1: to make doctors better. You know, yeah, we want you
Speaker 1: to be a better doctor, so we're gonna remove one
Speaker 1: of your hands. You're worried about tort law. Think about
Speaker 1: how good you have it now. Um. So, like you said,
Speaker 1: the reason, Um, there are a couple of reasons you
Speaker 1: would get an amputation. Uh. One is disease and the
Speaker 1: other is um injury like my friend with the truck,
Speaker 1: like some kind of catastrophic injury. UH damages It doesn't
Speaker 1: necessarily always like rip your arm off, but it damages
Speaker 1: it to the point where there's no blood flowing there
Speaker 1: and the tissue was dying beyond the point where it
Speaker 1: can be rescued, essentially. And it might be a truck,
Speaker 1: it might be a bullet wound, Um, it could be well. Basically,
Speaker 1: any traumatic injury, a fire, a burn, a severe burn
Speaker 1: is considered a traumatic injury. Yeah. Blood flow is big.
Speaker 1: If it's not flowing, then problems happen. You're gonna have
Speaker 1: a stroke. If it stops blowing, you're gonna lose an arm.
Speaker 1: And it stops slowing. So if your blood flow is
Speaker 1: cut off for too long, then you're in big trouble. Right,
Speaker 1: And it's not just a traumatic injury disease. UM, there's
Speaker 1: plenty of diseases that see a lessening of blood flow,
Speaker 1: like um arterio, sclerosis because plaque build up and blood vessels.
Speaker 1: When it builds up enough and enough, those blood vessels hardened,
Speaker 1: and the amount of blood flow through those vessels diminishes
Speaker 1: so much that the tissue that those blood vessels feed
Speaker 1: Uh dies. Um. There's something called peripheral artery disease, which
Speaker 1: is the result of a lack of blood flow leading
Speaker 1: to dead tissue. Uman. Diabetics. Yeah, you you join that
Speaker 1: with diabetes, which has the tendency to also kill nerve
Speaker 1: endings neuropathy. Uh. And then all of a sudden, you
Speaker 1: can't feel so when you cut yourself, so you cut
Speaker 1: your foot or something like that, Um, you don't feel it,
Speaker 1: So you're more prone to cuts, and it takes longer
Speaker 1: to heal because of the lack of circulation, And all
Speaker 1: of a sudden, you have an infection that possibly turns
Speaker 1: gangrenous and threatens your entire life. Yeah. And in the US,
Speaker 1: ninety percent of amputations are as a result of this
Speaker 1: disease scenario. Um. Whereas if you're under fifty, UM, traumatic
Speaker 1: injury is a leading cause of amputations. Yeah. So like
Speaker 1: you know, you're out rudding your bike, I'm on a
Speaker 1: mountain road, or your Aaron Ralston in Your Mountaineering and Utah.
Speaker 1: You know, I would call that a traumatic injury getting
Speaker 1: your hampined under a boulder for sure, man, can you imagine?
Speaker 1: And they did a good job in the movie. But
Speaker 1: as it sets in, like what the deal is because
Speaker 1: at first he was like, oh man, yeah, like let
Speaker 1: me get out of this, or trying to move the
Speaker 1: boulder was like nothing, and then all of a sudden,
Speaker 1: you think I might die of starvation. Yeah, and then
Speaker 1: you it just goes over to the knife, like, man,
Speaker 1: I wish I hadn't adulled it. So then there's cancer,
Speaker 1: which we haven't mentioned. Um. There are a couple of
Speaker 1: ways that it could lead to amputation. Obviously just damage
Speaker 1: to your body tissue. Um. But also like you said,
Speaker 1: to keep a malignant tumor from spreading around, sometimes they
Speaker 1: will just lop it off. And apparently those amputations from
Speaker 1: cancer have diminished tremendously over sure that gator two. Um.
Speaker 1: But unfortunately those from disease have increased. Yeah, it's dropped
Speaker 1: by over the past twenty years amputations overall. No, just
Speaker 1: from for answer, traumatic injury and cancer. UM. So I
Speaker 1: don't know people are being safer and their recreation if
Speaker 1: that has something to do with it or not, or
Speaker 1: they're yeah, we might have better trauma or better reattaching
Speaker 1: to UM. But yes, you're right. It has increased because
Speaker 1: of at least in the the United States, largely due to obesity,
Speaker 1: so much so that this article was from UM maybe
Speaker 1: two two thousand and six something like that, and it
Speaker 1: says that one out of every two hundred Americans is
Speaker 1: an amputee. That's not right anymore. No, it's actually even
Speaker 1: more one out of from what I could find, a
Speaker 1: hundred and seventy six Americans, so it's one point seven
Speaker 1: million people, one out of hundreds. That seems like a
Speaker 1: lot of people. Yeah, but that counts digits and things
Speaker 1: that you don't think about, you know, like someone lost
Speaker 1: a thumb, because I hear that, and I'm like, why
Speaker 1: don't I see that more on a daily basis. You
Speaker 1: don't work in the industrial arts. Yeah, that's true. I
Speaker 1: don't work in a factory with lots of saws and chains,
Speaker 1: and yeah, that's good point. You got Alaska about every
Speaker 1: like third person has a limb that's missing. You don't
Speaker 1: see a lot of the podcasting field. UM, so we're
Speaker 1: gonna prepare you for surgery. Dr Clark right for this message. Break. Wait,
Speaker 1: I'm doing the surgery right always. Okay. So preparing for
Speaker 1: amputation surgery is like every surgery. Initially, you're gonna have
Speaker 1: a lot of meetings because they want you to be prepared,
Speaker 1: and you're gonna have everything very explained very well, and
Speaker 1: what you can expect before, during, and after, just like
Speaker 1: with all surgery. How what kind of anesthesia they're going
Speaker 1: to use? Um, Yeah, it's not always general anesthesia. I
Speaker 1: knew this would stand out to you too. Yeah, I
Speaker 1: would not want to be awake. No, knock me out,
Speaker 1: cut my toe off, I don't care. Yeah, I'd better
Speaker 1: be out. Well, actually, I take that back. If it
Speaker 1: was like a just a digit, I could stomach that.
Speaker 1: Not me. I don't know. If I'd watch it. At
Speaker 1: the very least, I wouldn't would be boring. I think
Speaker 1: it'd be fascinating. Well, I mean you couldn't see anything.
Speaker 1: You'd just be sitting there like these guys are cutting
Speaker 1: my finger off right now. I think it'd arrange a
Speaker 1: mirror or something. I used to get that at the dentist.
Speaker 1: I used to request a mirror, so I could look
Speaker 1: at what they were doing. I think, just because it
Speaker 1: fascinated me and to keep an eye on Yeah, exactly.
Speaker 1: So Yeah, they say sometimes you just local anesthetic to
Speaker 1: to carry out a amputation. That's nutty. Um, if it's
Speaker 1: a limb, I don't think they would do that. No,
Speaker 1: that's got to be generalized. Yeah, because I think like
Speaker 1: if you weren't under your blood pressure would advise to
Speaker 1: dangerous levels. This good point. Yeah. Uh, if you're gonna
Speaker 1: get a prosthetic device, you might meet beforehand with your prosthetics, uh,
Speaker 1: to measure you out and kind of talk about what
Speaker 1: you're looking for post surgery, and um, then you're gonna
Speaker 1: you know, then it's go time. I guess it is
Speaker 1: kind of go time. The well, the surgeon is gonna
Speaker 1: want to figure out exactly where to cut ahead of time.
Speaker 1: It's not like how about here they actually measure blood
Speaker 1: flow to the area, um, to see what tissues still
Speaker 1: receiving you know, circular, a healthy amount of circulation. Yeah,
Speaker 1: they don't want to leave any bad tissue behind. No,
Speaker 1: but they want to get as much of the bad
Speaker 1: tissue as they can, which is what you just said.
Speaker 1: But they also want to leave intact as much healthy
Speaker 1: tissue as possible, which is why they measure and they
Speaker 1: try to find that line of demarcation where they should cut. Yeah,
Speaker 1: they said, especially around the joints. Uh. They want to
Speaker 1: preserve all the healthy stuff they can because, uh, if
Speaker 1: your joint is working, then that's gonna help you out
Speaker 1: with your prosthetic limbits. Oh yeah, if they if they
Speaker 1: can do anything to save a joint, they're gonna leave
Speaker 1: it intact um. So they figure out where to cut.
Speaker 1: They try to leave a joint as intact as possible.
Speaker 1: And this is all the non emergency variety exactly. Yeah,
Speaker 1: like all of this planning and everything, it goes out
Speaker 1: the window when you come in with a shotgun blast
Speaker 1: your lower leg exactly. Um, they're gonna be like, we
Speaker 1: need to amputate. We have to do this quick. And
Speaker 1: they do. And you don't have to meet with anybody.
Speaker 1: That's the plus side meetings. Um. Some of the techniques
Speaker 1: they use it are actually let's just go ahead and
Speaker 1: walk you through the process, all right, so everyone please.
Speaker 1: The article points out that the first thing they cut
Speaker 1: through is the skin, right, They cut through the imaginary
Speaker 1: barrier and the air above the skin. First, technically, of
Speaker 1: course you're going to cut through the skin and you
Speaker 1: want it to heal quick. And they said leave an
Speaker 1: appropriate scar, which doesn't mean for cosmetics, like don't you
Speaker 1: don't leave your your initials as a scar or something.
Speaker 1: You know. What they mean is they don't want to
Speaker 1: leave a scar where it might rub up against the
Speaker 1: prosthetic or something and cost problems. Yeah, that can't be good. Um.
Speaker 1: So they cut through the skin and pretty soon after
Speaker 1: that they meet muscle. Mr muscle, and this makes up
Speaker 1: the bulk of what they're cutting through. And I only
Speaker 1: like within the last year so realized that muscle is
Speaker 1: what steak is. Did I tell you this? Yeah? You
Speaker 1: told me. It's just crazy to me. Like I I
Speaker 1: used to be like, okay, so you got muscle, you
Speaker 1: have the skin, you have the what's the steak? And
Speaker 1: then I realized, like, oh, muscles the steak. Yeah. I
Speaker 1: was like, I'd make a good steak. Now you'd be sinewy,
Speaker 1: so I'd make a good steak. So with with muscle
Speaker 1: there there, they want to they have to cut through it,
Speaker 1: but they want to save a little bit of length
Speaker 1: of it as much as possible. Yeah, Um, that's your
Speaker 1: padding basically, Yeah, they're gonna fit it around the bone
Speaker 1: at the bottom. It is, it's the padding on the bottom,
Speaker 1: the exposed part of the the residual limb, which is
Speaker 1: what the stump is called. You shouldn't call people's residual
Speaker 1: limb stumps, is that true? Yeah? Well why do they
Speaker 1: use it? Fifty times in this article? They finally get
Speaker 1: to the point where they're like the residual limb, which
Speaker 1: is the preferred term. I think my friend called his stump.
Speaker 1: Oh yeah, I mean, if you have an amputated limb,
Speaker 1: you can call it whatever you want. Right. It's like
Speaker 1: you can't pick on my brother, Well, only I can
Speaker 1: pick up my brother. Okay, it's along the same line.
Speaker 1: So we've cut through the skin the muscle. No, you've
Speaker 1: got your nerves. Oh man, I know it sends a
Speaker 1: chill up my spine thinking about it. Um, you have
Speaker 1: to cut through the nerves out of slee and then
Speaker 1: what they want to do, you're gonna have you know,
Speaker 1: where you cut the nerve is going to be a
Speaker 1: nerve stump. Now that's okay to call it a stumps.
Speaker 1: The nerves exactly, Um, and they still carry signals of
Speaker 1: pain sometimes even, and so they do their best to
Speaker 1: minimize what we're gonna talk about next, which is phantom
Speaker 1: limp pain, by sewing nerving things into the tissue around
Speaker 1: it and even cutting it off, cutting the nerves off
Speaker 1: higher up than the amputation site to try and prevent that. Um.
Speaker 1: But thanks to you in that article you sent me,
Speaker 1: we learned that phantom limb pain actually occurs in the
Speaker 1: majority of patients who lose their limbs. I didn't know
Speaker 1: that it sounded like a rarity to me. No, I
Speaker 1: think it's like, um, I think it's like not a
Speaker 1: given necessarily, but I think that it's very common. Should
Speaker 1: we go ahead and cover it now? And then yeah,
Speaker 1: finish up with the surgery. Yeah. So, like you said,
Speaker 1: when you when you cut fanstom up right right, still um,
Speaker 1: when you cut a nerve um fiber um, you're it's
Speaker 1: still even though there's a stump and there's it's not
Speaker 1: connected to anything anymore down there, it can still transmit
Speaker 1: information to the brain and it still does. And your
Speaker 1: brain has been it's developed this certain kind of arrangement
Speaker 1: of neurons. Say that have to do with your lower leg.
Speaker 1: Your lower left leg is in this one region of
Speaker 1: your brain. And the thing is, when you amputate your
Speaker 1: lower left leg, your brain doesn't really get the news
Speaker 1: that it's not there anymore, or at least at the
Speaker 1: very least, it confuses it. It does and it makes
Speaker 1: the brain think that you have a lower left leg still,
Speaker 1: but you're just not using it. Or your brain has
Speaker 1: this technique for telling you when it's like you need
Speaker 1: to use your limbs or get up or move around
Speaker 1: or do something UM. And that's by sending a painful
Speaker 1: sensation from the leg to the brain to you to
Speaker 1: experience it. And when that leg is not there and
Speaker 1: your brain thinks it still isn't you're not using it,
Speaker 1: then what you have is something called phantom pain. Yeah,
Speaker 1: and that can be. It's not just like, oh it
Speaker 1: hurts a little bit, UM, it hurts a lot apparently
Speaker 1: UM burning aching sensations as if the hand is being
Speaker 1: crushed in the ice. So say some And here's the
Speaker 1: bad news is that it is UM chronic and once
Speaker 1: it happens and persist, it's there like it's tough to
Speaker 1: get rid of UM. In fact, I think they only
Speaker 1: I think this article they said they only UM these
Speaker 1: other post surgeries to limit that are only effective for
Speaker 1: a few months and it usually returns, and so they
Speaker 1: usually don't even do those surgeries unless you're terminal. Yeah,
Speaker 1: and apparently chuck jugs don't necessarily do a lot like
Speaker 1: a paint. Yeah, like it can't help. I think you
Speaker 1: get used to it and it's still not really helping
Speaker 1: very much. So they have some pretty interesting radical treatments
Speaker 1: that apparently work. And one of the best ones is
Speaker 1: a mirror box. So you like have a box that
Speaker 1: you put your hand into and then your residual limb
Speaker 1: into in the same box, and the mirror the mirrors
Speaker 1: inside basically make it look like you have two limbs,
Speaker 1: both intact facing the correct way, and then you move
Speaker 1: the intact one and it looks like your residual limb
Speaker 1: is now moving, and you basically your eyes sends the
Speaker 1: signal to the brain exactly, and you trick your brain
Speaker 1: into thinking like, Okay, I'm moving my limb. You can
Speaker 1: stop sending me the pain signals now. And it works
Speaker 1: for a lot of people. Yeah, And even more amazing
Speaker 1: is they don't even know if they need a mirror box.
Speaker 1: They think simply um imagining using that limb could work
Speaker 1: like golfing. Yeah, Like, so just imagine you're you're swinging
Speaker 1: a golf club with your phantom with your limb that's
Speaker 1: not there anymore, and they think they can actually work. Yeah. Um.
Speaker 1: They're also trying to figure out how to uh, re
Speaker 1: plastic size the brain so that it can, um, it
Speaker 1: can rearrange itself to basically be aware that there's no
Speaker 1: limb there any longer, and it says it can ignore
Speaker 1: sensory signals from that area. What they're doing is is
Speaker 1: they're working on the brain now instead of the site
Speaker 1: of the amputation, like the physical site. They thought it
Speaker 1: was the psychosis for a little while. Um that that
Speaker 1: it was basically just like people had such a deep
Speaker 1: lamentation of the loss of their limb that they were
Speaker 1: suffering this this form of psychosomatic experience. But now they're like, no,
Speaker 1: this is real. We have seen it. Um. There's also
Speaker 1: stimulation of the nerves around the area, um, which kind
Speaker 1: of confused the pain signals so they don't make it
Speaker 1: to the brain. It's pretty amazing, Yeah, but it's it's
Speaker 1: a real thing, and apparently it's awful. Yeah, it's it's
Speaker 1: way more common than I thought that was like my
Speaker 1: biggest surprise in all this. I thought it was like, oh,
Speaker 1: that's super rare, But apparently it's kind of rare if
Speaker 1: you don't experience phantom in pain. So back to the
Speaker 1: operating room, we should probably get back in there. He's looking,
Speaker 1: he looks fine. Do you have any junior mint on you?
Speaker 1: That's okay, I'm very nice. Uh So, now you've cut
Speaker 1: through the skin, you've cut through the muscle, You've cut
Speaker 1: through the nerves and done all your work to try
Speaker 1: and make sure that the nerves are not going to
Speaker 1: cause fandom pain as much as you can much as
Speaker 1: you can. Now you have to cut the blood vessels. Yeah, right,
Speaker 1: and you want to legate them or cauterize, right, probably
Speaker 1: legate them if you don't want to, although I'm sure
Speaker 1: there's cauterization too as well. And I think if you're
Speaker 1: trapped in the woods or something, there might be no
Speaker 1: but I think like they even have like a um,
Speaker 1: little tools to cauterize blood vessels, wood burning set kind
Speaker 1: of yeah. Yeah. Um. And either way, you're gonna stop
Speaker 1: the flow of blood out the open end of these
Speaker 1: blood vessels now, because that's not good. Um, I mean,
Speaker 1: you tie this off and you want to avoid as
Speaker 1: many blood vessels as you possibly can. Um that don't
Speaker 1: need to be amputated because they still bring blood to
Speaker 1: the healthy tissue, and blood's chuck full of nutreats, which
Speaker 1: is how these things just tissue keeps alive. It's right.
Speaker 1: And then there's only one thing left, my friend, man,
Speaker 1: that's the old bone. So they get out the old
Speaker 1: bone saw and um, when you cut the bone, like
Speaker 1: you said, you you're gonna wrap the muscle around it.
Speaker 1: So you want a nice smooth surface. You don't want
Speaker 1: any kind of jagged edges. So they're gonna smooth it out.
Speaker 1: I don't know what they use. Probably some kind of sander.
Speaker 1: They sand it down. Remember start start low with your
Speaker 1: sand paper number and work your way up. Oh is
Speaker 1: there more grit in the lower numbers? More grit? Like
Speaker 1: an eighty sand papers super rough, and like a two
Speaker 1: is super fine, super fine. I think that's right. Sure
Speaker 1: I got this wrong. I'm gonna I think you're right. Okay,
Speaker 1: it makes sense yea um, but yeah, you really want
Speaker 1: to smooth out that bone because it's it's going to
Speaker 1: keep um the amputation site from healing. If it's a
Speaker 1: jagged edge just rubbing up against muscle and nerves and
Speaker 1: blood vessels and all, that's not good. So you have
Speaker 1: it nice and sanded, You arrange the muscles around it,
Speaker 1: and then you tie the skin off. When you close
Speaker 1: the skin um and frequently if they think that there
Speaker 1: there's a high risk of infection, they'll just kind of
Speaker 1: temporarily close the skin. Were leaving a tube to drain
Speaker 1: the um almost inevitable liquids that build up um. And
Speaker 1: then if if they watch it and you're like, no
Speaker 1: infection comes along, then they'll permanently sew it up. And
Speaker 1: of course for the next several weeks you're gonna be
Speaker 1: closely monitored for infection. Uh. They're not gonna leave you alone.
Speaker 1: They're gonna bother you every single day, probably checking on
Speaker 1: your uh what was the word, not stomp, residual limb,
Speaker 1: residual limb, your your reside. Occasionally they will take off
Speaker 1: the wrong limb. Should we go ahead and talk about this. Yeah,
Speaker 1: just in October of two thousand thirteen in Brazil, guy
Speaker 1: got it the wrong leg removed and the daughter said, hey,
Speaker 1: you removed the wrong leg. So they said, you're right
Speaker 1: and they removed this other leg and now you own
Speaker 1: this hospital and now he has no legs. That's crazy.
Speaker 1: And it said the family plans to sue. I'm sure. Um,
Speaker 1: my dad got a knee replaced, and I went and
Speaker 1: visited him before the operation, and he had um, like
Speaker 1: no written on his on the kneecap that he is
Speaker 1: supposed to remain intact. No. I think one of the
Speaker 1: nurses did for him or something. I think it's kind
Speaker 1: of typical. Well, it's one of the things they do.
Speaker 1: I read this article from two thousand ten, UM. And
Speaker 1: this is in Colorado alone. This is not nationwide or
Speaker 1: anything over six and a half years. UM. In Colorado alone,
Speaker 1: they operate it on the wrong patient at least twenty
Speaker 1: five times and on the wrong body part hundred and
Speaker 1: seven times. And um, that's a six and a half
Speaker 1: year period. They studied close to thirty thousand medical records,
Speaker 1: and UM. All the mistakes, of course, are traced back
Speaker 1: to miscommunication. It's never apparently anything but that, right. It's
Speaker 1: never the doctor was super drunk. No. Uh. And a
Speaker 1: lot of times it's not even the surgeon. We should
Speaker 1: point out, Um, it's a support staff for other doctors
Speaker 1: that make this mistake throw them under the buff. But
Speaker 1: so there's a thing now the American Academy of Orthopedic
Speaker 1: Surgeons is an initiative called Sign your Site, which exactly
Speaker 1: what you're talking about, UM, well sort of it. The
Speaker 1: surgeon actually initials the surgical site UM for you to
Speaker 1: see and and say, yes, this is the bad leg. Yeah,
Speaker 1: and you can be like, you're the one who told
Speaker 1: me that I have to lose my leg, isn't uh.
Speaker 1: And then the Joint Commission is nonprofit group UM, and
Speaker 1: they have a protocol now called a time out. A
Speaker 1: presurgery time out is where literally everyone just pauses and goes, okay,
Speaker 1: this is what we're doing, right, this is right correct, right,
Speaker 1: that's smart. Yeah. I'm surprised it wasn't the protocol anyway,
Speaker 1: but I'm glad it is now. Well, you know, doctors
Speaker 1: are all go go go with their jargon and their
Speaker 1: white coats and all that they got to hit the
Speaker 1: golf course, get drunk, listen to us. So so it
Speaker 1: does happen, and so you can you can write it
Speaker 1: on your own leg, or you can ask for the
Speaker 1: time out or whatever. Well I think they should give
Speaker 1: you the time out either way, it's not as rare
Speaker 1: as you think. All right, So, um, let's say that
Speaker 1: they've successfully amputated the correct leg. Uh, there's a recovery
Speaker 1: period as well. Um. You know the little white bandage
Speaker 1: that's like a like a cap, like an inverted cap. No, well,
Speaker 1: let's call the compression bandage. Oh yeah, sure, it's like
Speaker 1: athletes wear him now like a compression sleeve. Right, this
Speaker 1: one doesn't have a hole on one side. Sure, you
Speaker 1: know what I mean. Um, And the compression raises it
Speaker 1: increases the blood pressure around the site, um, which helps
Speaker 1: bring infection. It reduces swelling of course, yeah, um, which
Speaker 1: is a big deal. And then also you, um, you
Speaker 1: will be moved about quite a bit while you're in
Speaker 1: the hospital recovering because they want to keep your leg circulating,
Speaker 1: your blood circulating, and not not necessarily your leg. I
Speaker 1: just always think of a leg amputation. Really yeah, that's
Speaker 1: a good arm, probably because my friend, oh yeah yeah. Um.
Speaker 1: So once you get home, you're gonna start meeting with
Speaker 1: the therapist, because physical therapy is a big deal. And
Speaker 1: it's not just maintaining motion in your residual limb, but
Speaker 1: also bulking up the other parts of your body. They're
Speaker 1: gonna have to kind of step in a little bit
Speaker 1: to make up for that, um, that shortfall. Yeah, and
Speaker 1: apparently aside from just strength training, they do real world training,
Speaker 1: Like you know, you gotta get out of and dress
Speaker 1: yourself without your left leg, so let's see you do it.
Speaker 1: Um do it. And I don't think we mentioned either
Speaker 1: there's you might meet with a a brain therapist before
Speaker 1: and after as well a psychiatrist, yeah, to help you
Speaker 1: along because it's a it's a weird thing to not
Speaker 1: have a limb anymore. Yeah, I'm sure there's almost mandatory
Speaker 1: counseling for something like that. Yea, probably because I'm sure
Speaker 1: also like even if you go into it like all right,
Speaker 1: I can do this, I'm good with this. I think
Speaker 1: very few people come out of it with the kind
Speaker 1: of a plalm and and just go get them spirit
Speaker 1: of people like Aaron Ralston or the girl from Georgia
Speaker 1: who had um necrotizing fasciitis who like just managed to
Speaker 1: keep her spirits up. I think it's probably very easy
Speaker 1: to sink into a post surgery depression and that would
Speaker 1: need to be have an eye kept on it. Um,
Speaker 1: if you go through all this physical therapy and you
Speaker 1: go through your psychiatry therapy and you're doing great. It's
Speaker 1: actually a brain therapist. Brain therapist. I like that better. Um,
Speaker 1: you will be. Uh. You may have to work with
Speaker 1: your prosthetics if you want a prosthetic limb. And these
Speaker 1: days they're not one size fits all like the old days.
Speaker 1: Like here, you know, here's this wood leg longer than
Speaker 1: you might want, but that's okay exactly. These days are
Speaker 1: gonna fit it very much for you, longer than you
Speaker 1: might want it. Uh, they're gonna fit it for you.
Speaker 1: It's very much tailor made. They've come. Like the advancements
Speaker 1: in prosthetics is just unbelievable. We might could do a
Speaker 1: show on that alone. Oh, they'd make the sweet beautiful. Um.
Speaker 1: There was also another treatment for phantom pain that had
Speaker 1: to do with prosthetics, and it was there's prosthetics that
Speaker 1: basically jack into your nerves, nerves and so like you
Speaker 1: still use the same nerves that used to make your
Speaker 1: lower leg move, but now it makes your prosthetic move
Speaker 1: and apparently your brain is fine with that. Yeah. I
Speaker 1: mean we covered some of this and um uh human augmentation.
Speaker 1: Oh yeah, remember a while ago, like these prosthetic limbs
Speaker 1: now that are hardwired. Did we do that? Is I
Speaker 1: don't remember that episode? No, not not the podcast when
Speaker 1: you or a live speaking thing with you know these
Speaker 1: prosthetic limbs that are hardwired into your brain so that
Speaker 1: you can think pick up apple and it picks up
Speaker 1: an apple. Right, that's right? Yeah remember that. Yeah, so
Speaker 1: when when you're like, lower leg is moving, your brain
Speaker 1: apparently doesn't care whether it's flesh and blood leg or
Speaker 1: prosthetic leg, as long as it's moving, then that can
Speaker 1: help treat phantom pain as well. Yeah. So, Chuck, you
Speaker 1: imagine you're a single guy and you you lose the
Speaker 1: lamb you're okay, I'm just saying a mansion, you are,
Speaker 1: you lose a lamp that every day you have a
Speaker 1: wonderful wife, I know, I'm just kidding. And you you
Speaker 1: lose your left leg, you think that your chances of
Speaker 1: ever getting a date probably just go up in smoke, right,
Speaker 1: Some people might think that that will cut that down.
Speaker 1: It's not necessarily true. Yeah, there's just a lot of
Speaker 1: people out there there like that. Yeah, you may become
Speaker 1: a lot more attractive to certain people, specifically people who have.
Speaker 1: Do you want to say this one? Which one? Is
Speaker 1: it appo or acro acro acro tomophilia. Yeah, that's an
Speaker 1: actual There is appo tim nophilia, which is uh, we've
Speaker 1: talked about this before with body integrity identity disorder, when
Speaker 1: you want to remove a limb from your own body. Yeah,
Speaker 1: that is app no appo tim nephelia. Like I just
Speaker 1: feel like incomplete with all my four limbs and I uh,
Speaker 1: I want a limerod moved and their doctors that will
Speaker 1: do that. Yeah. And there's a lot of um, a
Speaker 1: lot of controversy lumping that into a paraphilia because the
Speaker 1: if someone is attracted to the idea of living without
Speaker 1: a limb, it's very rarely sexually. Most of the time
Speaker 1: it's a form of hero worship, or they want to
Speaker 1: be challenged more in life, or they have like you
Speaker 1: just said, a real identity disorder that where they've always
Speaker 1: envisioned themselves paralyzed, where they've always envisioned themselves as a
Speaker 1: double double amputee and they feel less than whole by
Speaker 1: being whole. Yeah, it's not any different than a transsexual
Speaker 1: saying they were born in the wrong body. Yeah, they
Speaker 1: bear a striking resemblance. Yeah, so the B I I
Speaker 1: D and uh what was theophilia? Yeah, are are one
Speaker 1: and the same. But it really shouldn't be a paraphilia. Now,
Speaker 1: the other ophelia acrotomophilia, that should be a paraphilely because
Speaker 1: that is a sexual attraction to people who are who
Speaker 1: um amputees or who are paralyzed. Yeah. If you haven't
Speaker 1: seen that David Cronenberg movie Crash, I have not. You
Speaker 1: haven't seen. No, Well that's what it's about, boxing Helena.
Speaker 1: Oh yeah, boy, that was awful. I haven't seen it.
Speaker 1: It was bad. I just know about it. It's like
Speaker 1: notoriously bad. I've got to see it. Then. Um, yeah,
Speaker 1: there's so. I mean, there is some reference to this
Speaker 1: in popular culture, but it was only I think five
Speaker 1: and the first case of that was put Forth. Yeah. Um,
Speaker 1: so it's a relatively new and then going to great
Speaker 1: links to amputate your your own limb is even newer
Speaker 1: than that. Um. There was a Scottish doctor in two
Speaker 1: thousand who very famously amputated the healthy legs of two
Speaker 1: men and when he caught a huge contract Percy. Yeah,
Speaker 1: he stood by it, though he did he said he
Speaker 1: thought about it for eighteen months, and when he finally
Speaker 1: did it, he had decided that it was by far
Speaker 1: the most humane thing he could possibly do in this situation,
Speaker 1: because these men were suffering by having their intact legs. Yeah,
Speaker 1: and they say, I don't know if it's true, but
Speaker 1: some of them contend that no amount of mental of
Speaker 1: brain therapy can help. It's like they've got to get
Speaker 1: rid of that limb right or paralyze themselves. And a
Speaker 1: lot of people do take it on themselves. There was
Speaker 1: a man who went down to Mexico in the nineties
Speaker 1: I think he was seventy three UM to have an
Speaker 1: amputation surgery in a hotel and died of gang green
Speaker 1: as a result. Another guy successfully amputated his own leg
Speaker 1: with a log splitter. People will will go to great
Speaker 1: lenks and do what we would consider self harm, whereas
Speaker 1: they're really like fulfilling their identity. So it raises that question, like,
Speaker 1: in that specific situation, is medicine harming people by carrying
Speaker 1: out these amputations cleanly and professionally or are you just
Speaker 1: giving into somebody's delusions and and really making things worse. Yeah,
Speaker 1: supposedly the evidence is after surgery. These people feel good,
Speaker 1: they feel great, they feel the way that they're supposed
Speaker 1: to feel supposedly, so it's hard to argue that you're
Speaker 1: doing them harm by carrying out the surgery. Yeah, and
Speaker 1: again those are two very different things. The wanting to
Speaker 1: remove your own limb to feel like a complete person
Speaker 1: is not in the same as the sexualization and attraction
Speaker 1: to um. Like in Penthouse magazine. Remember in this article.
Speaker 1: What article was this? By the way, it was an
Speaker 1: Atlantic article from two thousand, Yeah, called The True Self.
Speaker 1: It's really good. Oh was it? I don't I thought
Speaker 1: it was something else, but yeah, or no, maybe that
Speaker 1: was a subheading, but it was. It was a great article. Um.
Speaker 1: And it's nothing new the sexual side of things. Um.
Speaker 1: Going back to this dude, Richard von Kraft Ebbing, he
Speaker 1: was a researcher of UH sexual pathology and he started
Speaker 1: categorizing and cataloging six and UM, I don't know if
Speaker 1: it was a book or just a medical journal called
Speaker 1: Psychopathia Sexualist and of course everything from bestiality and necrophilias
Speaker 1: in there. But to Stravi SMI's Apparently des Cartes had
Speaker 1: a thing for um. Women with crossed eyes that I
Speaker 1: didn't know that. I didn't know that either, But there
Speaker 1: are sexual things all the way back then, Um, this
Speaker 1: year old engineer was excited by the sight of a
Speaker 1: woman's disfigured feat. Um, and another guy pretended to be
Speaker 1: crippled or lame is what they called it back then. Yeah,
Speaker 1: and apparently that's still a thing. Like if you go
Speaker 1: onto the web and start looking up across acrotomophilia, you're
Speaker 1: gonna find there are pretenders, people who use wheelchairs and
Speaker 1: leg braces and crutches even though they don't need them. Yeah. Um,
Speaker 1: and there are frequently people who are also deemed wannabes
Speaker 1: who are I guess pre event amputees. Yeah, they're still
Speaker 1: in tect that they don't want to be. And then
Speaker 1: there's devoteeshia. Yeah, those are the sexual the ones who
Speaker 1: want to be with amputees because it's sexually aroused by
Speaker 1: them exactly. Yeah, and it's big on the internet. Yeah,
Speaker 1: it's um, this article points out, and there's probably been
Speaker 1: more medical research on it since then. But he points
Speaker 1: out that in legit medical circles there's not a lot
Speaker 1: of information, but if you get on the internet, there
Speaker 1: are all kinds of chat rooms in places where you
Speaker 1: can find amputee porn. Yeah, if that's what your thing is. Hey,
Speaker 1: that's such a thing is I can't really see anything
Speaker 1: wrong with it. I was surprised though, by the one
Speaker 1: how the people that it's not sexual but they just
Speaker 1: want to be challenged more. It's pretty interesting. Yeah, I
Speaker 1: wonder if that kind of falls into a um the
Speaker 1: category of munch housands where they want they want the
Speaker 1: sympathy or at it, attention or something like that that
Speaker 1: comes with being paralyzed or being being an amputee. I
Speaker 1: think pretenders for sure. Yeah, like if you're walking around
Speaker 1: on crutches and you're just fine, you're you're looking for attention.
Speaker 1: But yeah, like you said, there are some people out
Speaker 1: there who report wanting to lose the body part because
Speaker 1: they want to be more physically challenged. Alright, we should
Speaker 1: do one on paraphilias sometimes. I've always wanted to. Is
Speaker 1: that just any kind of sexual fetish everything? That's everything?
Speaker 1: And there's a lot of them out there. Yes, basically,
Speaker 1: any weird thing you can come up with, there's a
Speaker 1: paraphilia for it. Yeah, but you're right, Yeah, like I
Speaker 1: liked never mind, I think it's a good way to
Speaker 1: end this one. If you want to learn more about amputations,
Speaker 1: you can type that word into the search part how
Speaker 1: stuff works dot com. And uh, let's see. Since I
Speaker 1: said search part, that means it's time for a listener mail. Ah. Yeah,
Speaker 1: this is kind of long, but it's appropriate. Um, I'm
Speaker 1: gonna call it h one testicle down? Was there an amputation?
Speaker 1: Not so much? Let's see is from Rich Uh. This
Speaker 1: came off the Castration podcast and he says, Guys, when
Speaker 1: I was about twelve years old, I got kicked in
Speaker 1: the grapes but particularly violent classmate appearance. Took me to
Speaker 1: the hospital and after a bunch of tests, determined I
Speaker 1: had testicular torsion. It's when uh, male's testicles twist around
Speaker 1: inside the scrotum, essentially twisting the wires that connected to
Speaker 1: your inner workings, and it cuts off the blood supply.
Speaker 1: Like we said, it's not any good. You don't want
Speaker 1: to cut off the blood supply. Um tissue does That's right. Uh.
Speaker 1: It was too late to save his injured testicles, so
Speaker 1: they set a date for surgery to remove it, but
Speaker 1: it wasn't until the end of August, apparently because there
Speaker 1: was no rush because it didn't like make any worse. Oh,
Speaker 1: there'd be a rush if it happened to me, I'd
Speaker 1: be like, look, just get this over with. Oh I know. Ah.
Speaker 1: So he said he was stuck in bed for an
Speaker 1: entire summer, and his family didn't have working air conditioning
Speaker 1: yet either, and his scrotum was the size of a grapefruit. Walking, moving, laughing,
Speaker 1: or even breathing heavily caused some of the worst pain
Speaker 1: of experienced. Uh. So he had the surgery, and it
Speaker 1: said I had two purposes, one to remove the injured
Speaker 1: and now useless testicle, and too to affix the remaining
Speaker 1: healthy testicle the inside of the scrotum to prevent the
Speaker 1: possibility of future torsion. So he felt a lot better
Speaker 1: physically after the surgery, but it was very hard to
Speaker 1: cope mentally and socially. I think I only told my
Speaker 1: closest friends what had happened. I told the rest of
Speaker 1: my school that I had knee surgery or something. I
Speaker 1: felt incredibly embarrassed. Um and remember I was at the
Speaker 1: most awkward, puberty ridden age for something like this to
Speaker 1: happen to my private parts, I know. Uh. Then two
Speaker 1: things happened. The first thing was acceptance. I don't remember
Speaker 1: if anything in particular brought it on, but I distinctly
Speaker 1: remember the day where I finally thought to myself, you
Speaker 1: know what, who cares? And at that moment, testical grew
Speaker 1: back twice the size is before. Uh. Then I did
Speaker 1: something that still surprises me now that I think about it.
Speaker 1: I opened an a o LL instant messenger, Um this
Speaker 1: is back in the day, of course, uh and picked
Speaker 1: out one of my high school friends at random and
Speaker 1: told them before I could chicken out. As soon as
Speaker 1: I told this random person, I felt a huge weight
Speaker 1: lift off my chest. And then the second thing was surgical.
Speaker 1: I opted for elective surgery to put in a fake ball,
Speaker 1: a neudical, a noudical, a human nudical, human utical, or
Speaker 1: a prosthesis made of silicon silicone. It was mainly for
Speaker 1: cosmetic purposes, and I was happy to that I did it.
Speaker 1: Even now, you can't really tell a difference unless you
Speaker 1: touched them and want somebody's in that situation where they
Speaker 1: could feel the difference. It really doesn't make a difference anyway,
Speaker 1: wink wink. So he says, now he is very proud
Speaker 1: to have one real testical and one fake one. And
Speaker 1: he went on and to write about how like to
Speaker 1: tell the kids out there, Hey, if something like happens
Speaker 1: to you, then you know it's not the biggest deal
Speaker 1: and you're still a complete person. And he wonders if
Speaker 1: he would have even gotten the nuticle if he would
Speaker 1: have been older, you know, and not been at that
Speaker 1: awkward age. Yeah, he says, he probably didn't think like
Speaker 1: he would happen. He doesn't regret it, right, Uh, he
Speaker 1: doesn't regret it. He says, I'm really proud of it.
Speaker 1: And Uh, I wonder how many of your listeners only
Speaker 1: have one testical for a little crown on it every
Speaker 1: once in a while. That is Rich and Rich. Thank
Speaker 1: you for your courage and trying to tell people, especially kids. Yeah,
Speaker 1: way to go, Rich, you know something into the world.
Speaker 1: I mean, that is a rough thing to go through. Yeah. Man, well,
Speaker 1: hats off to you, Rich, crowns off. Uh, if you
Speaker 1: want to be brave like Rich, you can tell us
Speaker 1: about something that you overcame in your life. We love
Speaker 1: hearing about stuff like that. Um, you can twee to
Speaker 1: us at s Y s K podcast. If it's a
Speaker 1: very short story, You can join us on Facebook dot com,
Speaker 1: slash stuff you Should Know, You can send us an
Speaker 1: email to stuff Podcasts at Discovery dot com, and you
Speaker 1: can join us at our home on the web, stuff
Speaker 1: you Should Know dot com. For more on this and
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