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Speaker 1: M Hey everybody, it's Josh and for this week's select,

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Speaker 1: I've chosen our two thousand fifteen episode on therapeutic hypothermia.

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Speaker 1: It sounds weird and boring and it's a really super

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Speaker 1: science EPP. But sometimes sometimes those can be the best ones.

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Speaker 1: This topic is super interesting. It's a look at how

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Speaker 1: science can stave off death and hopefully it's the direction

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Speaker 1: that modern medicine is heading. Plus, if you get bored,

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Speaker 1: you can thrill the hearing us. Try to say cellular

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Speaker 1: level here or there. It's hilarious. Enjoy. I command you.

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Speaker 1: Welcome to Stuff you Should Know, a production of I

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Speaker 1: Heart Radio. Hey, and welcome to the podcast. I'm Josh Clark.

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Speaker 1: There's Charles W. Eager Beaver, Chuckers Bryant ready to get

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Speaker 1: its therapeutic hypothermia on. Yeah, baby, I'm chilling. Yeah, moving

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Speaker 1: at a glacial paste today, right, I am um, I'm

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Speaker 1: sorry for that. That was actually a poke at the

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Speaker 1: author of this article. Yeah, that's uh. That stood out

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Speaker 1: to me as well. I'm not telling you Jerry's over

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Speaker 1: there and stuff you should know. No, I'm done. Um. Yeah,

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Speaker 1: we were goofing off about this article and how stuff works.

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Speaker 1: That there were way too many cold puns for my liking.

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Speaker 1: There was a lot of puns, you know, a lot

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Speaker 1: lots of them. Yeah, this article stinks of punt it reeks.

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Speaker 1: So how you doing, man, how you feeling? I'm good? Uh,

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Speaker 1: it seems there's a sickness going around the office. Yeah,

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Speaker 1: which I thought we knew here in two thousand and

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Speaker 1: fifteen that if you're sick, you don't come into work,

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Speaker 1: especially when you have a liberal telecommune policy right like

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Speaker 1: we do. I realized, Um, I realized that people need

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Speaker 1: to come in and shoot video and recording all that.

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Speaker 1: But come in, you do that, and you leave, and

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Speaker 1: you wear like a plague doctor's mask the whole time

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Speaker 1: you're here too. Yeah. I mean, I have a biohazard

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Speaker 1: suit at my desk, but has a RiPP in it.

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Speaker 1: Anyone can wear it, has a ripping. It's very small

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Speaker 1: rental and cleaning fee. You're going to take a blood

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Speaker 1: sample of mine wearing that thing. And it occurred to

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Speaker 1: me as you were about to put it on, like

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Speaker 1: I don't know where that thing has been, Like, that's

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Speaker 1: a real biohazard suit and Chuck's going to use it

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Speaker 1: to open my skin. Yeah, this sounds very odd. Um,

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Speaker 1: we don't just do this in the office. We did

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Speaker 1: our blood Types episode live here in Atlanta, and we

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Speaker 1: actually took Josh's blood type on stage because you didn't

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Speaker 1: know it. No, I when we recorded the version in

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Speaker 1: the studio, I genuinely did not know it. Yeah, so

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Speaker 1: I took your blood on stage. You trusted me. I

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Speaker 1: did not wear the contaminated suit. No, you. You just

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Speaker 1: used your dirty hands with no like rubber gloves or anything.

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Speaker 1: Look at you. You're fine ish and you know your

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Speaker 1: blood type now, which was a positive like Jarius, So

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Speaker 1: we should release that whole live show. Is a just

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Speaker 1: a special yeah little bonus. Yeah bonus. That was the

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Speaker 1: word I was looking for. There's something special about it.

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Speaker 1: It's just a bonus. That was special. Yeah, it's a

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Speaker 1: good idea. Look for that soon people. So, uh, today, Chuck,

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Speaker 1: we're talking about therapeutic hypothermia and I am very excited

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Speaker 1: about this. This is my idea of this article. Yeah, Um,

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Speaker 1: it's pretty neat. I don't remember. I guess I first

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Speaker 1: heard of it from that Mosaic article that we both

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Speaker 1: read to the big sleep awesome article. And uh, if

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Speaker 1: you haven't figured out by now we have started to

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Speaker 1: on the podcast page for each episode, put related links

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Speaker 1: on there on our site stuff you should know dot com,

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Speaker 1: so that articles on there. There's a bunch of other

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Speaker 1: stuff on there too that will cover UM. But be

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Speaker 1: sure to check out that mosaic article. It's very neat

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Speaker 1: um and that article first introduced me to the concept

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Speaker 1: of therapeutic hypothermia or medically induced hypothermia as another another

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Speaker 1: term for it. I don't prefer target targeted temperature management.

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Speaker 1: That sounds yeah corporate, Yeah, very corporate. You know the

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Speaker 1: HMO term for it, like we'll we'll call it this

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Speaker 1: because it'll less than the likelihood that we'll get sued

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Speaker 1: or something exactly. Yes, yeah, I agree. But it's been

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Speaker 1: around for a while, and the the idea that exposing

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Speaker 1: people to lower temperatures to allow for better medical interventions,

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Speaker 1: which is the whole basis of therapeutic hypothermia UM, has

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Speaker 1: been around at least since the Napoleonic Wars. Yeah, it's

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Speaker 1: pretty neat. I was interested to find that out. They

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Speaker 1: noticed way back when in the eighteen hundreds early eighteen hundreds,

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Speaker 1: uh that troops in battlefield trauma, wounded soldiers would the

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Speaker 1: ones who were not kept warm and cozy by the

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Speaker 1: fire or in their tents, right, they're just left out

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Speaker 1: on the battlefield and the coals. Yeah, they actually fared better.

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Speaker 1: And they were like, wait a minute, is uh And

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Speaker 1: of course they had no idea at the time what

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Speaker 1: was going on. No, they're like, did you notice that? Yes,

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Speaker 1: I did notice that the heart well back to our brandy, Yeah,

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Speaker 1: pretty much. But they did notice that the ones who

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Speaker 1: were warm did a lot worse than the ones that

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Speaker 1: were left out in the cold, which is super interesting. Yeah,

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Speaker 1: But the the real investigation into what was going on

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Speaker 1: there didn't start until the thirties with a guy named

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Speaker 1: Dr temple Faye, and he was actually the first guy

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Speaker 1: to write about using therapeutic hypothermia. I think in n

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Speaker 1: was the first paper about it. But he was using

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Speaker 1: it for a full decade or so before then, basically

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Speaker 1: putting his patients in ice baths, opening the windows to

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Speaker 1: their room during the winter, and um, just basically using

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Speaker 1: any means he could to lower the temperature for I

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Speaker 1: think I think he had he was using in a

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Speaker 1: traumatic brain injury patients. Yeah, and I'm sure he did

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Speaker 1: a lot of explaining along the way to family members

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Speaker 1: that were like, hey, can you close the window and

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Speaker 1: warm up my husband here? And that. He was like,

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Speaker 1: all right, you wanted to I think back then too,

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Speaker 1: he was like, it's the thirties and this guy is

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Speaker 1: a traumatic brain injury. Really, there's nothing I can do

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Speaker 1: to make it worse, the prospects worse, So why don't

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Speaker 1: you just lighten up their family member? So there was

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Speaker 1: another pioneer in the fifties named Dr Peter safar Um

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Speaker 1: s A f A R. And he actually began experimenting

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Speaker 1: around with this in the e er as well, trying

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Speaker 1: to reduce tissue injury uh and brain image from a

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Speaker 1: lack of blood flow. Uh. And this was mainly at

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Speaker 1: the time in like stroke patients, cardiac arrest patients and

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Speaker 1: what we'll talk more about it. There's all sorts of

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Speaker 1: well not all sorts. There are several uses like cases

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Speaker 1: where you would want to use this and UM ranging

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Speaker 1: from cardiac arrest to like a gunshot wound to I think,

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Speaker 1: what is the infant situation? Come again, it is called chuck.

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Speaker 1: It's a type of encephalofy were ummic encephalofy. Yeah, where

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Speaker 1: your natal basically the blood flow the lack of blood

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Speaker 1: flow to the brains cut off for whatever reason, like

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Speaker 1: maybe the umbilical cord gets rappidly on the baby's neck

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Speaker 1: or what have you. Um, it leads to a swelling

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Speaker 1: in the brain, and they started using it to medical

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Speaker 1: the hypothermia to treat that. That's right, And that was

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Speaker 1: in the fifties, right, Yeah, the fifties and sixties is

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Speaker 1: when Dr Safar was doing his work. So this this

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Speaker 1: is all kind of going on on the side and

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Speaker 1: um experiments into hypothermia had kind of a bad name

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Speaker 1: thanks to the Nazis, and a little bit also the

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Speaker 1: Japanese and World War Two. But the Nazis, especially at

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Speaker 1: Dock how the concentration camp or the death camp there

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Speaker 1: um experimented using unwilling human subjects. Uh, they experimented on

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Speaker 1: the effects of hypothermia in people's bodies. They did all

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Speaker 1: manner of horrible, grizzly, gruesome stuff for they recorded the

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Speaker 1: data and there was a long debate over the years

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Speaker 1: over whether that data could be ethically used. And on

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Speaker 1: one hand, people were saying, no, it's the Nazis. They

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Speaker 1: used unwilling subjects. Is it amounted to torture in the

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Speaker 1: name of science, and I just used air air quotes, right.

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Speaker 1: And then other people said, well, wait a minute, these

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Speaker 1: people died, um whether and we're whether they wanted to

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Speaker 1: or not. They were made to be these test subjects

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Speaker 1: and they gave their lives. We can honor them at

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Speaker 1: least by using the data that was cold from it. Well,

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Speaker 1: once they really dug into the data that the Nazis

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Speaker 1: had accumulated, it was just like rank amateurs performing scientific experiments.

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Speaker 1: They followed like almost no protocol. They did terrible record

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Speaker 1: keeping of descriptions of subjects and things like that. So um,

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Speaker 1: it's almost like you just have to toss it out

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Speaker 1: because you just can't trust it scientifically the data. But

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Speaker 1: but the idea that people were exposed forcibly to hypothermic

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Speaker 1: conditions kind of gave hypothermia a bad name. So these

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Speaker 1: guys experimenting with the stuff, it was fringe science for

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Speaker 1: a while. Yeah, and then it started to come into

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Speaker 1: the mainstream and then everybody said, well, wait a minute,

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Speaker 1: hypothermia has all these bad side effects. Let's just table

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Speaker 1: it for now. Yeah. In the in the fifties to

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Speaker 1: NASA was doing a lot of work during the Space

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Speaker 1: Race because the idea was and this is really sort

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Speaker 1: of two parts. There's the the modern day uh cooling

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Speaker 1: like that's not freezing somebody basically, and then we also

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Speaker 1: have what's called suspended animation, which we'll get too later.

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Speaker 1: Those are totally different things, totally different things, but they

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Speaker 1: follow the same process initially, right yeah, um, well sort of,

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Speaker 1: I mean the methods are different, but the same idea

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Speaker 1: basically is to slow the body down, sown the heart rate,

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Speaker 1: slow down everything, your metabolism. Yeah. Um. But NASA was

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Speaker 1: doing this because they put a lot of money into

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Speaker 1: it because they thought two things. One you could protect

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Speaker 1: astronauts from cosmic rays and the other is basically straight

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Speaker 1: up alien like we can freeze people on long journeys

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Speaker 1: into space and then unfreezing when they get there, which

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Speaker 1: is not just alien. That's a bunch of sci fi movies.

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Speaker 1: But there was a doctor named James Lovelock back in

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Speaker 1: the day who was um freezing hamsters until they froze

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Speaker 1: and then basically until he couldn't hear heartbeat frozen, yeah,

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Speaker 1: they were clinically dead. Yeah, and then they would he

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Speaker 1: would put a little, uh, a little hot teaspoon against

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Speaker 1: their belly and warm him back up, and he found

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Speaker 1: that they were actually okay, and he was able to

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Speaker 1: revive them some of them. Well sure, yeah, I'm sure

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Speaker 1: there were losses along them, but I mean even one

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Speaker 1: coming back to life and seeming normal again, it is

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Speaker 1: pretty significant. It's a significant finding, Yeah, because basically the

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Speaker 1: idea was planted all of a sudden that hypothermia can

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Speaker 1: kill you or it can preserve you and keep you

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Speaker 1: from dying in an extreme situation, right, which is kind

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Speaker 1: of counterintuitive. Like you think of people who undergo hypothermia

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Speaker 1: or you know, being exposed to extremely cold temperatures, they're dead.

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Speaker 1: I mean, we've all seen the shining, we know the end. Yeah,

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Speaker 1: But apparently there's a rule of thumb among the er

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Speaker 1: physicians and staff that there's no such thing as a

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Speaker 1: cold dead body. I thought it was measured twice cut once.

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Speaker 1: It's a little different. That's for the surgeons. Um, No,

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Speaker 1: there's no such thing as a as a cold dead body.

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Speaker 1: You're only dead when you're warm and dead, right, Because well,

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Speaker 1: there's been some some cases throughout the years. The one

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Speaker 1: that spectacular one. Yeah, this lady um was she with

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Speaker 1: Norwegian on a boggenhorn. Um, I don't even know what

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Speaker 1: that is. It's not an oom out, it's a single

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Speaker 1: circle above that A. That's a it's a very Norwegian. Yeah,

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Speaker 1: death metal band name totally. Uh So she was skiing

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Speaker 1: and um, actually I think she was Swedish, but she

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Speaker 1: was on holiday skiing in Norway. Um fell headfirst into

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Speaker 1: a frozen stream and was trapped under ice, submerged for

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Speaker 1: eighty minutes, stopped breathing, heart stopped. Yeah. I mean she

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Speaker 1: was well known. She didn't drown. They thought she drowned

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Speaker 1: until they reheated her. Ten days they reheated her and

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Speaker 1: she was fine, Like weeks and months later she fully recovered.

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Speaker 1: And basically, if you're underwater warm water, you have a

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Speaker 1: few minutes at most. But what they discovered was if

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Speaker 1: you actually go into hypothermia, it can preserve your body. Um,

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Speaker 1: which was amazing and a big breakthrough into like, hey,

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Speaker 1: maybe we can use this right. Yeah, she was one

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Speaker 1: of a few a handful of people and we'll talk

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Speaker 1: about some others too, but um, that what researchers into

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Speaker 1: hypothermia I've learned and why they figured out that they're

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Speaker 1: you're not cold and dead you're just warm. And debt

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Speaker 1: is that it's not the the the addition of cold

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Speaker 1: or the exposure to cold that kills you. It's warming

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Speaker 1: back up in the wrong way too rapidly under the

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Speaker 1: wrong circumstances stances that that's what can kill you. Yeah,

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Speaker 1: it seems like it's a very fine line between well,

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Speaker 1: we'll talk about the process, but you have to do

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Speaker 1: it just right on the cooling side and the warming

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Speaker 1: side if you want to be successful right exactly. You know,

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Speaker 1: it's they haven't quite figured it all out yet. This

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Speaker 1: is in the very uh nascent stages. Still. It is

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Speaker 1: ridiculously primitive and and to the point where it's kind

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Speaker 1: of like if you're a doctor experimenting with this, you

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Speaker 1: you would be like, there's a d chance that your

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Speaker 1: dad is going to die under normal circumstances. We have

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Speaker 1: this one radical technique we can try that might help.

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Speaker 1: Can we try this? And that that that whether they

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Speaker 1: had lives or dies after being given medical hypothermia, he's

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Speaker 1: still going to end up as like the subject of

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Speaker 1: a major paper that would be written, because that's where

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Speaker 1: it's at right now. Yeah, And I read one doctor

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Speaker 1: said that they they think they pretty much know, it's

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Speaker 1: super possible and we'll work, he said, But it's the

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Speaker 1: the doing of it that's just really really hard. Exactly. Yeah,

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Speaker 1: I mean like it makes a complete sense intuitively, we

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Speaker 1: understand like what it's doing. It's just yeah, the fine tuning,

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Speaker 1: the nuance behind it that it's still kind of mysterious.

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Speaker 1: The most brilliant doctors say, it's just really hard. He said,

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Speaker 1: it's really dog gone hard to do. It kind of

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Speaker 1: makes you go, yeah, you know, is that the quote?

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Speaker 1: He know, his quote was, it's really dog gone hard.

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Speaker 1: And then my quote was, but we'll talk about medical

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Speaker 1: hypothermia and what it is specifically, uh, in just a

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Speaker 1: minu alright, so therapeutic hypothermia. Hypothermia is basically when you

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Speaker 1: lower the body temperature for various reasons to keep it alive.

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Speaker 1: And right now, what they're mainly doing now, this isn't

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Speaker 1: the second wave, which is freezing somebody. This is just

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Speaker 1: cooling a body before and after surgery to help them

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Speaker 1: increase their chances of survival. Basically, right, your your body. Um,

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Speaker 1: and they're doing that now on this side, they're just

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Speaker 1: not doing the other quite yet on humans. Yes, um,

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Speaker 1: so under normal circumstances, your body maintains a normal core

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Speaker 1: body temperature, normative temperature because what it's called, right, and um,

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Speaker 1: that's somewhere between like nineties in nine point six degrees

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Speaker 1: is a normal human core body temperature. And all of

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Speaker 1: this is and dude, do you remember and like when

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Speaker 1: I went on that crazy, weird metaphysical tangent and does

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Speaker 1: the body replace itself? Somebody wrote in and said, check

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Speaker 1: this article out, like here's a really great explanation of

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Speaker 1: why things live, where life comes from. And it was this, um,

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Speaker 1: this idea, it's a physics based idea of life and evolution.

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Speaker 1: And it says that because of entropy, because of one

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Speaker 1: of the laws of thermodynamics, that atoms will arrange themselves

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Speaker 1: in a way that they can take in energy and

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Speaker 1: dissipate heat in a really efficient manner. And so of

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Speaker 1: course they're gonna atoms are eventually going to arrange themselves

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Speaker 1: into life. It just makes total sense. Right, So, being

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Speaker 1: living things like we are, we take in energy and

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Speaker 1: we dissipate heat, and that's what forms our core body temperature. Right.

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Speaker 1: With therapeutic hype of thermia, what you're doing is lowering

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Speaker 1: the metabolic rate through the addition of cold, and so

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Speaker 1: we put out less heat, and by doing that, we're

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Speaker 1: also lowering our energy demand, so that that that little

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Speaker 1: engine that's going all the time and our cells and

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Speaker 1: our body in general gets slowed down. And it's not

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Speaker 1: altered in any way except for the speed and the

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Speaker 1: energy consumption. It's just slowed down. It's doing everything slower.

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Speaker 1: And you can do that simply by lowering the temperature

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Speaker 1: of the person. Yeah, and it's it's not just lower,

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Speaker 1: it's um it doesn't need to be faster. Does that

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Speaker 1: make sense, Like the heart beat slower because it doesn't

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Speaker 1: need to beat any faster, not like your body is struggling.

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Speaker 1: Your body is still doing fine. It's just reducing the

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Speaker 1: demand for stuff like blood flow and neurotransmitter action and

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Speaker 1: stuff like that exactly. And ultimately, what your heart does

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Speaker 1: is pumps blood. And what your blood has this, among

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Speaker 1: other things, oxygen, and your cells need oxygen to carry

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Speaker 1: out these metabolic processes to burn energy, right, So if

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Speaker 1: they need less, then your heart doesn't have to beat

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Speaker 1: as much. It's like you said, it's just the normal processes,

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Speaker 1: but on a much slower scale. Pretty awesome stuff. It is,

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Speaker 1: and it's just through the application of colder temperatures. Oh yeah,

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Speaker 1: and in this case UM, and we'll get to how

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Speaker 1: to do it. But in this case you're not I

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Speaker 1: mean you're literally cooling the body with like ice packs

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Speaker 1: and cold blankets and stuff like that pre surgery and

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Speaker 1: post surgery. It's not the suspended animation one that we'll

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Speaker 1: get to when they're actually like pumping frozen saline through

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Speaker 1: your pains. No, there are, but there are some UM

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Speaker 1: techniques for medically induced hypothermia that do put in like

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Speaker 1: chilled saline to chill your body down very quickly. But

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Speaker 1: it's not like replacing your blood. Yeah yeah, yeah, I

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Speaker 1: hear you. So there's a couple of applications at this point.

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Speaker 1: End the cases are either involved intervention or prevention, and

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Speaker 1: intervention is when they're trying to prevent further damage from

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Speaker 1: an incident like a stroke or cardiac arrest or sort

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Speaker 1: of the two main ones UM and then preventative wise,

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Speaker 1: it's to extend operating time because back in the day

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Speaker 1: you could not operate on UM. Well, back in the

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Speaker 1: day you couldn't stop the heart to operate on it. No,

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Speaker 1: which was I do remember we did like this day

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Speaker 1: in history about the first guy to ever do open

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Speaker 1: heart centuries of Black surgeon in Chicago the early twentieth century,

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Speaker 1: I think, and he did an emergency open heart surgery

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Speaker 1: with a beating heart. That guy was totally awesome, champion. UM.

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Speaker 1: This was the case for a very long time, and

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Speaker 1: you couldn't stop the heart. They finally invented a machine

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Speaker 1: UM that basically does the work of the heart and

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Speaker 1: the lungs, called the Heart Lung machine. Exactly where you're

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Speaker 1: transferring blood through this machine and UM, it's removing c

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Speaker 1: O two, it's adding oxygen, and it's pumping it back

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Speaker 1: into the body while the heart and lungs are stopped.

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Speaker 1: Revolutionized open heart surgery. There's problems with it. One of

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Speaker 1: the problems is um when the blood comes back in

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Speaker 1: the body, since it's been through this machine, it may

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Speaker 1: have picked up some sort of foreign in bacteria, and

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Speaker 1: the immune system sometimes mounts an attack on the blood.

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Speaker 1: So this this machine poses its own problems. And alternatively,

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Speaker 1: an alternative method for stopping the heart or slowing the

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Speaker 1: heart is to use medically induced hypothermia. So that's an intervention, no,

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Speaker 1: a prevention preventative use of medically induced hypothermia. But intervention

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Speaker 1: is another way, like you said, and it can have

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Speaker 1: to do a stroke or heart attacks or cardiac arrest. Right,

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Speaker 1: aren't those two different things? I think so technically, but

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Speaker 1: in some sort of cessation of the heart pumping blood.

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Speaker 1: And the big problem with that it doesn't really matter

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Speaker 1: whether your hand is getting blood for a while. The

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Speaker 1: big problem that comes from a heart attack is your

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Speaker 1: brain not getting blood for a while. Right, So here's

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Speaker 1: what happens when blood stops flowing into your brain. Right,

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Speaker 1: And we we covered this somehow in the How Dying

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Speaker 1: Works episode. Yeah, the dying process. Okay, because it's not

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Speaker 1: a it's not a black and white thing. Uh, you're

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Speaker 1: not alive and then you're dead. It's comes in many

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Speaker 1: many stages. And we talked about the stages of death. Yeah,

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Speaker 1: so there's when what they've discovered is that, yeah, you're

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Speaker 1: not like I'm alive and now I'm dead. Is what

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Speaker 1: we covered in the How Dying Works episode? Right, Like

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Speaker 1: dying in your sleep? I mentioned that the other day.

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Speaker 1: How like nobody dies in their sleep. That's just a

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Speaker 1: nice thing. That's a nice way to say they died

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Speaker 1: in their bed. Yes, overnight, overnight, Yeah, exactly. Um so, yeah,

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Speaker 1: there's with medically induced hypothermia, they've been able to extend

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Speaker 1: that that time between when you appear to be dead

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Speaker 1: and when you're actually dead, and by extending that time

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Speaker 1: they can intervene UM better. And Yeah, even a little

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Speaker 1: bit of time can go a long way. So one

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Speaker 1: of the one of the things that medically induced hypothermia

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Speaker 1: has been shown to really help is what's called return

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Speaker 1: of spontaneous circulation after uh, you have a heart attack.

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Speaker 1: The problem is is your heart and lungs can your

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Speaker 1: cardio pulmonary system can start working again, but you might

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Speaker 1: not regain consciousness. And in that case, that's a sign

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Speaker 1: that your brain may be in trouble, your cognitive function,

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Speaker 1: you may be suffering brain damage at that moment. Yeah,

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Speaker 1: And isn't the stat one and ten cardiac arrest outside

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Speaker 1: of a hospital has a like goes on to live

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Speaker 1: like a without brain damage. Yeah, ten, only because you

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Speaker 1: have a very small window and that window is usually

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Speaker 1: longer than it takes to get to the hospital. Right,

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Speaker 1: So if they bring you in and you are showing

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Speaker 1: signs of um r OSC without return to consciousness, too um.

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Speaker 1: They may induce medical medical hypothermia. And the reason why

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Speaker 1: is the heart pumps blood, and blood contains things including

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Speaker 1: oxygen right um. And one of the organs that uses

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Speaker 1: probably the most oxygen of all, is the brain, and

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Speaker 1: the brain uses its oxygen to um burn energy. Basically,

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Speaker 1: it uses it to oxidize glucose. And when it does that,

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Speaker 1: the reason it does is because you're neurons, your little

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Speaker 1: neural cells that fire. The way they fire is because

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Speaker 1: their chemical battery, their chemical battery with the stored potential charge,

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Speaker 1: and they do that by keeping a lower concentration of

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Speaker 1: electrolytes inside the cell than outside. So this difference creates

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Speaker 1: the electrical charge that your neurons used to fire. Right

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Speaker 1: on normal circumstances, that's all well and good, but when

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Speaker 1: they stop, when they stop getting oxygen, they can switch

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Speaker 1: to anaerobic mode for a little while, so they're still

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Speaker 1: burning energy, but they're like, you need to start breathing again,

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Speaker 1: because this is not very efficient. It's like the like

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Speaker 1: when the emergency lights go on exactly exactly. So um.

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Speaker 1: As a byproduct of anaerobic um respiration, you get the

402
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Speaker 1: stuff called lactic acid. Lactic acid in and of itself

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Speaker 1: isn't bad, but it can build up. One of the

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00:24:23,480 --> 00:24:26,920
Speaker 1: other things that happens to when these um when this uh,

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Speaker 1: when that runs out, is the difference between electrolytes inside.

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Speaker 1: Now inside the cell stops like it, it evens out,

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Speaker 1: and now all of a sudden you have things like calcium, potassium,

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Speaker 1: sodium coming in and out of the cell as much

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Speaker 1: as they please, and the cell is like, what is

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Speaker 1: going on? This isn't good and releases its store of glutamate.

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Speaker 1: And glutamate is a neurotransmitter that excites neurons, and again

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Speaker 1: in very small amounts, totally fine, it's needed. But when

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Speaker 1: a neuron just freaks out and dumps all that into

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Speaker 1: a synapse, it sets off that neuron and all these

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Speaker 1: other neurons and makes them go totally crazy, and it

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Speaker 1: also um lowers their structural integrity. So all of a

417
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Speaker 1: sudden you have neurons going nuts, dumping their contents everywhere,

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Speaker 1: and then creating also free radicals, which are um atoms

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Speaker 1: with unpaired electrons, and they run up against the cellular

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Speaker 1: structure and the cell walls and start borrowing electrons from

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Speaker 1: those atoms, and that weakens the structure even more so,

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Speaker 1: even more stuff gets dumped out into the inter cellular matrix,

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Speaker 1: and you have a problem. This is a really big

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Speaker 1: problem in and of itself. Right, you're still with me, Okay,

425
00:25:36,720 --> 00:25:39,760
Speaker 1: that's what happens when you stop getting blood flow. It's

426
00:25:39,880 --> 00:25:42,159
Speaker 1: just as bad, if not worse, when you start getting

427
00:25:42,160 --> 00:25:44,800
Speaker 1: blood flow again, because you have all these damaged cells.

428
00:25:45,080 --> 00:25:47,439
Speaker 1: You have dead cells. And when you have dead cells

429
00:25:47,440 --> 00:25:49,919
Speaker 1: that have dumped their contents, one of the roles that

430
00:25:50,000 --> 00:25:53,200
Speaker 1: your white blood cells, your immune system plays is to

431
00:25:53,280 --> 00:25:56,360
Speaker 1: come clean up dead cells because that's toxic stuff. That's

432
00:25:56,359 --> 00:25:57,960
Speaker 1: bad stuff, and you need to get it out of

433
00:25:58,000 --> 00:26:01,280
Speaker 1: your body. So when blood flow reach turns again, all

434
00:26:01,320 --> 00:26:03,560
Speaker 1: of those white blood cells come to the site of

435
00:26:03,640 --> 00:26:07,159
Speaker 1: this problem, your brain, and they start cleaning up. Well.

436
00:26:07,200 --> 00:26:10,800
Speaker 1: When they do, and inflammatory reaction happens, and all of

437
00:26:10,880 --> 00:26:13,119
Speaker 1: a sudden you have swelling in your brain and the

438
00:26:13,160 --> 00:26:17,840
Speaker 1: process gets even worse. So these these um structurally challenged

439
00:26:17,960 --> 00:26:22,000
Speaker 1: neurons don't just erupt immediately. They do immediately, but it

440
00:26:22,040 --> 00:26:25,159
Speaker 1: can continue for hours and days afterwards. And all of

441
00:26:25,200 --> 00:26:30,359
Speaker 1: this happens from a heart attack. But by applying cold

442
00:26:30,359 --> 00:26:34,479
Speaker 1: temperatures and bringing hypothermion and somebody you can actually stop

443
00:26:34,520 --> 00:26:37,359
Speaker 1: this process. You can stop the glutamate from ever being dumped.

444
00:26:37,400 --> 00:26:41,440
Speaker 1: They're finding and so give time basically for your brain

445
00:26:41,520 --> 00:26:44,480
Speaker 1: to to rebuild itself in the way it needs to

446
00:26:44,920 --> 00:26:48,320
Speaker 1: by lowering that metabolic rate that your your neurons need.

447
00:26:49,320 --> 00:26:53,000
Speaker 1: That's what it does for for a heart attack, cardiac arrest.

448
00:26:53,680 --> 00:26:55,919
Speaker 1: They're definitely two different things. I looked it up and

449
00:26:56,000 --> 00:26:57,919
Speaker 1: someone's gonna say, you guys should do a podcast on

450
00:26:57,920 --> 00:26:59,679
Speaker 1: that because you don't know what you're talking about. Right,

451
00:27:00,119 --> 00:27:03,200
Speaker 1: it's coming. So probably after that we should take a

452
00:27:03,200 --> 00:27:05,640
Speaker 1: little break, huh, I think. So you want to get

453
00:27:05,640 --> 00:27:09,600
Speaker 1: some tea, yeah, and uh we'll be back with more

454
00:27:09,720 --> 00:27:31,400
Speaker 1: cool stuff. All right, So how is this magic done?

455
00:27:32,480 --> 00:27:36,320
Speaker 1: It's pretty easy. Actually, yeah, it's easy in theory. But

456
00:27:36,359 --> 00:27:40,720
Speaker 1: there are generally three stages UM for therapeutic hypothermia, and

457
00:27:40,760 --> 00:27:45,119
Speaker 1: they are induction, maintenance, and rewarming, and they are all

458
00:27:45,240 --> 00:27:49,160
Speaker 1: very carefully monitored and have to be done just right. Uh.

459
00:27:49,200 --> 00:27:52,040
Speaker 1: So when they go to cool the patient, um, they

460
00:27:52,040 --> 00:27:55,480
Speaker 1: will first thing you'll do is sedate them because shivering. Uh,

461
00:27:55,600 --> 00:27:57,680
Speaker 1: shivering is the body's way of trying to stay warm.

462
00:27:57,760 --> 00:28:00,320
Speaker 1: Like your body wants to be warm, is going to

463
00:28:00,400 --> 00:28:03,560
Speaker 1: do everything it can until you die, like Jack Nicholson

464
00:28:03,840 --> 00:28:07,320
Speaker 1: outside the maze and the shining exactly to stay warm. Yeah,

465
00:28:07,320 --> 00:28:09,560
Speaker 1: and you can't have a body shivering because number one,

466
00:28:09,600 --> 00:28:13,760
Speaker 1: it fights off that hypothermia you're inducing, right. Number two,

467
00:28:13,840 --> 00:28:16,440
Speaker 1: that uses a lot of energy, which is what you're

468
00:28:16,480 --> 00:28:19,199
Speaker 1: combating right there. You're trying to slow the metabolic right,

469
00:28:19,240 --> 00:28:21,520
Speaker 1: not increase it, right, and you want a patient that's

470
00:28:21,520 --> 00:28:24,160
Speaker 1: still as well. Like one of the problems I've seen

471
00:28:24,280 --> 00:28:28,480
Speaker 1: is the problem with doctors like performing in these conditions

472
00:28:28,520 --> 00:28:30,960
Speaker 1: because like stop squirming. Well that too, and they have

473
00:28:31,000 --> 00:28:34,200
Speaker 1: to keep the room very cold. It's not like they're

474
00:28:34,200 --> 00:28:36,119
Speaker 1: in like an eighty degree room and they're trying to

475
00:28:36,200 --> 00:28:38,840
Speaker 1: keep them like everything is cold. So the doctors have

476
00:28:38,920 --> 00:28:42,760
Speaker 1: to perform under those circumstances too, so they may shiver themselves.

477
00:28:42,800 --> 00:28:45,440
Speaker 1: But to keep the patient from shivering, they just solve

478
00:28:45,480 --> 00:28:48,520
Speaker 1: that problem by injecting them with the paralytic exactly, so

479
00:28:48,520 --> 00:28:51,960
Speaker 1: now they're nice and still they're cooling down. Uh. The

480
00:28:52,040 --> 00:28:54,640
Speaker 1: cheap way to do it, which is um and they're

481
00:28:54,640 --> 00:28:57,760
Speaker 1: not doing it because it's cheap, but um ice packs

482
00:28:57,800 --> 00:29:02,040
Speaker 1: basically armpits growing chest. They're basically wrapping your legs up

483
00:29:02,080 --> 00:29:05,560
Speaker 1: and everything they can with ice packs, and that's just

484
00:29:05,560 --> 00:29:10,000
Speaker 1: gonna cool you down pretty quickly. Um. Like you said,

485
00:29:10,000 --> 00:29:13,880
Speaker 1: they will sometimes use like catheters or a chilled saline solution.

486
00:29:14,280 --> 00:29:17,680
Speaker 1: Those are more invasive and more dangerous. They also work

487
00:29:17,720 --> 00:29:20,400
Speaker 1: a lot quicker. Yes, very much. And I think they

488
00:29:20,400 --> 00:29:24,040
Speaker 1: want to cool people down pretty quickly too, um, which

489
00:29:24,080 --> 00:29:25,880
Speaker 1: is I don't think they want to do the cooling

490
00:29:25,880 --> 00:29:28,280
Speaker 1: parts slow. No, And that's a really good point. I'm

491
00:29:28,280 --> 00:29:31,720
Speaker 1: glad you brought that up. Especially if you're bringing a

492
00:29:31,840 --> 00:29:36,959
Speaker 1: patient's body down, um to a really low temperature, you

493
00:29:37,040 --> 00:29:40,080
Speaker 1: have to protect against ice crystals forming in the cells

494
00:29:40,560 --> 00:29:43,480
Speaker 1: because that can erupt your cells and that's a whole

495
00:29:43,480 --> 00:29:46,640
Speaker 1: set of other problems. Right, So if you bring the

496
00:29:46,840 --> 00:29:50,800
Speaker 1: temperature down very quickly, you can prevent ice crystals from forming,

497
00:29:50,920 --> 00:29:54,080
Speaker 1: that's right, because they require time to form. Yeah, if

498
00:29:54,120 --> 00:29:56,520
Speaker 1: it's so, if it's super fast, they won't they won't form.

499
00:29:56,600 --> 00:29:59,720
Speaker 1: That's the impression I have. Okay, So during the maintenance phase,

500
00:29:59,760 --> 00:30:02,560
Speaker 1: it's you know exactly how it sounds, are just maintaining

501
00:30:03,040 --> 00:30:07,040
Speaker 1: that temperature, keeping a very close eye again, using these

502
00:30:07,360 --> 00:30:11,160
Speaker 1: cold water packs or forced cold, forced air blankets and

503
00:30:11,200 --> 00:30:16,240
Speaker 1: things like that. Um huh, they sound kind of cool,

504
00:30:16,280 --> 00:30:18,640
Speaker 1: the forced cold their blanket that. Yeah, they'd be nice

505
00:30:18,680 --> 00:30:22,360
Speaker 1: for these Atlanta summers. Get ahold of one of those. Uh.

506
00:30:22,400 --> 00:30:24,280
Speaker 1: And there are a lot of risks along the way.

507
00:30:24,800 --> 00:30:29,320
Speaker 1: Arrhythmia is a very big risk. Uh. And electrolytes leaving

508
00:30:29,360 --> 00:30:33,280
Speaker 1: like potassium, which is necessary for the heart muscle to

509
00:30:33,520 --> 00:30:36,600
Speaker 1: function as it should. Um, so they're they're pumping the

510
00:30:36,640 --> 00:30:41,000
Speaker 1: electrolytes back into you because you're losing them. So again

511
00:30:41,040 --> 00:30:44,440
Speaker 1: they're just maintaining everything. And then the rewarming part has

512
00:30:44,480 --> 00:30:48,320
Speaker 1: to be done very very slow. Uh, otherwise you know,

513
00:30:48,520 --> 00:30:52,000
Speaker 1: very bad things can happen. And we're talking um point

514
00:30:52,120 --> 00:30:58,560
Speaker 1: to seven to point nine degrees per hour fahrenheit fahrenheit

515
00:30:58,720 --> 00:31:01,680
Speaker 1: point one five to point five degrease celsius per hour. Yeah,

516
00:31:01,720 --> 00:31:05,400
Speaker 1: those super very slow rewarming process, that's right. But if

517
00:31:05,400 --> 00:31:08,840
Speaker 1: you've got a good forced air blanket, you can really

518
00:31:08,880 --> 00:31:12,840
Speaker 1: control the warming. You get a good brand, not some

519
00:31:12,960 --> 00:31:15,600
Speaker 1: off brand. And again they're not like, oh well if

520
00:31:15,640 --> 00:31:20,760
Speaker 1: we um, if we heat the person back up at

521
00:31:21,000 --> 00:31:24,560
Speaker 1: point one five degree celsius per hour, then this is

522
00:31:24,600 --> 00:31:27,720
Speaker 1: what's going to happen. On a cellular level, like they're

523
00:31:27,720 --> 00:31:30,480
Speaker 1: not quite there yet. They just know that that's the

524
00:31:30,560 --> 00:31:34,200
Speaker 1: sweet spot for rewarming somebody, So chuck. One of the

525
00:31:34,280 --> 00:31:41,600
Speaker 1: really um problematic side effects with rewarming a person is um. Yeah,

526
00:31:41,840 --> 00:31:43,760
Speaker 1: they're like, why you start to get gaming while you

527
00:31:43,760 --> 00:31:49,320
Speaker 1: were under um is uh blood clots. So when you're

528
00:31:49,440 --> 00:31:52,840
Speaker 1: when your blood stops pumping because your metabolic rate is

529
00:31:52,920 --> 00:31:57,560
Speaker 1: so low, the blood inside you starts to form clots

530
00:31:57,600 --> 00:32:01,640
Speaker 1: thanks to your red blood cells and your platelets and um.

531
00:32:01,760 --> 00:32:03,560
Speaker 1: When you warm back up, all of a sudden, you

532
00:32:03,560 --> 00:32:06,200
Speaker 1: have clots all over your body. And that's a real

533
00:32:06,320 --> 00:32:08,719
Speaker 1: problem that that alone can kill you. And that's part

534
00:32:08,760 --> 00:32:11,920
Speaker 1: of the problem with the rewarming process. But it turns

535
00:32:11,920 --> 00:32:16,440
Speaker 1: out that investigation into animals that hibernate, they found that

536
00:32:16,680 --> 00:32:20,400
Speaker 1: animals have some sort of technique to where their red

537
00:32:20,440 --> 00:32:23,800
Speaker 1: blood cells just kind of disappear, and then once the

538
00:32:23,800 --> 00:32:27,239
Speaker 1: animal comes out of hibernation, it reappears. They don't even

539
00:32:27,280 --> 00:32:29,360
Speaker 1: know where they go, no, but they do know that

540
00:32:29,360 --> 00:32:32,120
Speaker 1: they don't get rid of them somehow and then regenerate

541
00:32:32,240 --> 00:32:35,520
Speaker 1: some other ones because their reappearance is so fast that

542
00:32:35,760 --> 00:32:39,040
Speaker 1: they just think the body somehow absorbs them and then

543
00:32:39,120 --> 00:32:41,920
Speaker 1: releases them again. Yeah. And the other really cool thing

544
00:32:42,640 --> 00:32:44,840
Speaker 1: and we're kind of into hibernation right now, which we'll

545
00:32:44,840 --> 00:32:49,240
Speaker 1: talk about in more detail, but um, white blood cells. Uh,

546
00:32:49,480 --> 00:32:53,120
Speaker 1: Hibernators remove white blood cells from their blood and storm

547
00:32:53,120 --> 00:32:55,360
Speaker 1: in the lymph nodes and then about an hour and

548
00:32:55,400 --> 00:32:58,880
Speaker 1: a half after these animals awake, they reappear. And this

549
00:32:58,920 --> 00:33:02,479
Speaker 1: has a couple of functions. One is, when you're an

550
00:33:02,520 --> 00:33:06,560
Speaker 1: animal undergoing hibernation, Uh, your immune system is going to

551
00:33:06,600 --> 00:33:09,320
Speaker 1: be compromised because as white cells are in storage. Right,

552
00:33:09,840 --> 00:33:12,600
Speaker 1: that's a problem. Yeah, it's a problem. But just knowing

553
00:33:12,640 --> 00:33:15,880
Speaker 1: that animals can do these neat little tricks with their

554
00:33:15,920 --> 00:33:20,120
Speaker 1: platelets and white blood cells, uh, could have like big

555
00:33:20,120 --> 00:33:22,680
Speaker 1: effects on us if we can figure that out for ourselves.

556
00:33:22,760 --> 00:33:25,720
Speaker 1: Well yes, specifically also chuck, because remember when we were

557
00:33:25,720 --> 00:33:29,880
Speaker 1: talking about, um, your your neurons dying. Yeah, and when

558
00:33:29,920 --> 00:33:33,720
Speaker 1: you reperfuse, when you bring blood back to the brain again,

559
00:33:33,880 --> 00:33:35,520
Speaker 1: one of the things that brings with it is those

560
00:33:35,520 --> 00:33:38,040
Speaker 1: white blood cells and they start going on the attack.

561
00:33:38,560 --> 00:33:40,200
Speaker 1: So if you can figure out how to take white

562
00:33:40,200 --> 00:33:43,440
Speaker 1: blood cells out of the equation, it's going to reduce

563
00:33:43,520 --> 00:33:47,560
Speaker 1: things like post warming swelling, which can give you brain

564
00:33:47,600 --> 00:33:50,400
Speaker 1: damage itself. Yeah, and you talked about the heart lung machine.

565
00:33:50,640 --> 00:33:52,920
Speaker 1: One of the big dangers with that machine is a

566
00:33:53,040 --> 00:33:57,320
Speaker 1: septic sepsis. And if you have those uh white blood

567
00:33:57,360 --> 00:33:59,640
Speaker 1: cells stripped away, then you're not going to be at

568
00:33:59,720 --> 00:34:02,600
Speaker 1: risk for that, right and um, they'll be able to

569
00:34:03,520 --> 00:34:06,440
Speaker 1: uh hang on to blood longer. Right now. Blood donations

570
00:34:06,480 --> 00:34:10,319
Speaker 1: can only be kept a weak um it goes rank quick, yeah,

571
00:34:12,040 --> 00:34:17,400
Speaker 1: and um transplant organs can be UM basically cryo protected

572
00:34:18,000 --> 00:34:21,200
Speaker 1: for longer too, which is pretty neat. So uh, I

573
00:34:21,200 --> 00:34:23,279
Speaker 1: guess we should talk about hibernation for a minute because

574
00:34:23,280 --> 00:34:26,360
Speaker 1: it's one of the neatest things in nature. I think,

575
00:34:26,719 --> 00:34:32,640
Speaker 1: uh in torp or basically torpor short periods of hibernation

576
00:34:33,000 --> 00:34:36,000
Speaker 1: reduced body temperature and inactivity. And when you link a

577
00:34:36,040 --> 00:34:41,120
Speaker 1: bunch of torpors together, that's full on hibernation. So yeah,

578
00:34:41,520 --> 00:34:46,200
Speaker 1: it's also like a like hibernation light too, Yeah, you

579
00:34:46,239 --> 00:34:48,319
Speaker 1: know what I mean, Like you can you can be

580
00:34:48,920 --> 00:34:52,200
Speaker 1: I think a bear inners torpor where it's it wakes

581
00:34:52,280 --> 00:34:54,279
Speaker 1: up like every once in a while and eats or

582
00:34:54,560 --> 00:34:57,640
Speaker 1: poops or does something. And then there's some animals where

583
00:34:57,680 --> 00:35:00,640
Speaker 1: you can just shake them like this and they will

584
00:35:00,680 --> 00:35:04,359
Speaker 1: not wake up and they're in full on hibernation. Yeah,

585
00:35:04,360 --> 00:35:06,440
Speaker 1: and the animals have to prepare for this. They just

586
00:35:06,440 --> 00:35:09,760
Speaker 1: don't go betty by and stay asleep for a long time. First,

587
00:35:09,800 --> 00:35:14,000
Speaker 1: they become diabetics basically by gorging on food and becoming obese.

588
00:35:14,040 --> 00:35:18,960
Speaker 1: It sounds familiar, uh and um, but it doesn't affect

589
00:35:19,000 --> 00:35:21,680
Speaker 1: like humans does. It doesn't make them unhealthy, like their

590
00:35:21,719 --> 00:35:24,719
Speaker 1: body knows it's preparation for hibernation, knows what to do

591
00:35:24,800 --> 00:35:29,640
Speaker 1: with it exactly. Plus they're probably also eating unprocessed foods too,

592
00:35:29,800 --> 00:35:32,040
Speaker 1: which I think makes a difference. Yeah, you know, I

593
00:35:32,080 --> 00:35:36,560
Speaker 1: think so. Um, they don't atrophy like humans do. Like

594
00:35:36,600 --> 00:35:38,560
Speaker 1: when we lay around in bed, we don't our muscles

595
00:35:38,560 --> 00:35:42,800
Speaker 1: will atrophy. Um. Animals can go months and months without moving.

596
00:35:43,000 --> 00:35:46,839
Speaker 1: Spectacular spectacular. It also kind of suggests that humans aren't

597
00:35:46,880 --> 00:35:51,080
Speaker 1: supposed to hybridate. Yeah. Well, although you know, when they

598
00:35:51,080 --> 00:35:53,759
Speaker 1: found some of these frozen people, they start to think

599
00:35:53,800 --> 00:35:57,399
Speaker 1: maybe human hibernation isn't such a bad thing. Um. Their

600
00:35:57,480 --> 00:36:00,839
Speaker 1: lungs when you hibernate, become covered at the really thick

601
00:36:00,880 --> 00:36:05,560
Speaker 1: like mucacy uh deposits um. It basically looks like a

602
00:36:05,640 --> 00:36:09,960
Speaker 1: human with asthma, but it's you know, a protective measure. Again. Uh,

603
00:36:10,000 --> 00:36:12,279
Speaker 1: they go in their brains kind of um go into

604
00:36:12,320 --> 00:36:15,880
Speaker 1: a stage that looks like early Alzheimer's. Again, not a

605
00:36:15,880 --> 00:36:20,279
Speaker 1: bad thing, it's just preparation. Uh. And it's weird. I mean,

606
00:36:20,280 --> 00:36:24,360
Speaker 1: it looks like animals are almost dying when they're preparing

607
00:36:24,360 --> 00:36:28,000
Speaker 1: for hibernation. Well some cases, and sometimes they do, especially

608
00:36:28,000 --> 00:36:30,640
Speaker 1: when they're forced to come out of hibernation and then

609
00:36:30,680 --> 00:36:35,400
Speaker 1: go back in. Their energy stores aren't aren't built for

610
00:36:35,480 --> 00:36:37,799
Speaker 1: that kind of thing, like, so they probably will die

611
00:36:37,840 --> 00:36:39,839
Speaker 1: because they'll start to death because it required so much

612
00:36:39,920 --> 00:36:43,319
Speaker 1: energy to wake back up again. Or they're also vulnerable

613
00:36:43,400 --> 00:36:47,920
Speaker 1: to predators too. Yeah, good point, which makes you wonder, like,

614
00:36:47,960 --> 00:36:50,360
Speaker 1: what's the point of hibernation, And the point is, well,

615
00:36:50,440 --> 00:36:53,960
Speaker 1: it's they don't have enough energy to go elsewhere when

616
00:36:54,000 --> 00:36:57,399
Speaker 1: temperatures get cold, so they just kind of shut down

617
00:36:57,400 --> 00:37:02,040
Speaker 1: their metabolic demand when food becomes years. Yeah and um,

618
00:37:02,080 --> 00:37:05,640
Speaker 1: for the longest time, we didn't think that any um

619
00:37:05,880 --> 00:37:10,440
Speaker 1: uh primates could hibernate until two thousand four when they

620
00:37:10,440 --> 00:37:16,040
Speaker 1: found a lemur from Madagascar that could hibernate and uh,

621
00:37:16,120 --> 00:37:20,160
Speaker 1: well at least go into the regular torpor hibernation light

622
00:37:20,560 --> 00:37:23,359
Speaker 1: still and they said, we share about nine of our

623
00:37:23,400 --> 00:37:26,319
Speaker 1: genes with the lemur, and they said it's basically like

624
00:37:26,360 --> 00:37:29,080
Speaker 1: our cousin. Yeah, I mean that. The doctor basically said

625
00:37:29,120 --> 00:37:31,960
Speaker 1: it would be really remarkable if the ability to hibernate

626
00:37:32,040 --> 00:37:35,880
Speaker 1: light within that two that we don't have, So basically

627
00:37:36,360 --> 00:37:38,319
Speaker 1: humans may have more of an ability to do this

628
00:37:38,360 --> 00:37:41,520
Speaker 1: than we think. It would just have to be medically induced. Well,

629
00:37:41,600 --> 00:37:44,000
Speaker 1: you know who demonstrates that very well, Chuck. Who's that?

630
00:37:44,400 --> 00:37:47,600
Speaker 1: A man named mitsu take Uchi Koshi. Oh, yeah, we

631
00:37:47,640 --> 00:37:49,840
Speaker 1: talked about him. What do we talk about him? And

632
00:37:49,920 --> 00:37:53,279
Speaker 1: was it cryogenics episode? It was a long time ago.

633
00:37:53,320 --> 00:37:57,680
Speaker 1: I do remember that one. Yeah, that's a good one.

634
00:37:57,719 --> 00:37:59,480
Speaker 1: That was a good title. But yeah, I remember this

635
00:37:59,520 --> 00:38:03,200
Speaker 1: guy though. For so. He is a Japanese man who,

636
00:38:03,280 --> 00:38:07,120
Speaker 1: at age thirty five, was hiking with some friends in

637
00:38:07,200 --> 00:38:11,200
Speaker 1: Japan and he decided to turn back by himself to go,

638
00:38:11,760 --> 00:38:14,359
Speaker 1: I don't know, get something out of his car, and

639
00:38:14,480 --> 00:38:18,880
Speaker 1: he wandered off and apparently in a meadow, um tripped

640
00:38:18,920 --> 00:38:20,960
Speaker 1: over a rock and fell and hit his head on

641
00:38:21,000 --> 00:38:26,000
Speaker 1: another rock and laid there in exposed to these cold

642
00:38:26,000 --> 00:38:30,359
Speaker 1: temperatures on this mountain for twenty four days, and he

643
00:38:30,440 --> 00:38:33,400
Speaker 1: was found basically in a state of hibernation. His body

644
00:38:33,440 --> 00:38:39,400
Speaker 1: temperature was through the floor and um, he had almost

645
00:38:39,440 --> 00:38:43,480
Speaker 1: no pulse. His temperature was seventy one degrees which is

646
00:38:43,520 --> 00:38:47,520
Speaker 1: twenty two degrees celsius. That's his body temperature. That's pretty

647
00:38:47,560 --> 00:38:51,200
Speaker 1: that's like a hypothermic state. And he was in this

648
00:38:51,360 --> 00:38:55,640
Speaker 1: weird kind of state of suspended animation for twenty four days.

649
00:38:55,680 --> 00:38:59,640
Speaker 1: He went without food, water, nothing, just laying there um

650
00:39:00,040 --> 00:39:03,439
Speaker 1: living in some weird way until he was rescued and

651
00:39:03,520 --> 00:39:07,160
Speaker 1: returned to um complete normalcy. Yeah, it's like the lady

652
00:39:07,280 --> 00:39:10,000
Speaker 1: the skier who was frozen, not nearly for as long.

653
00:39:10,040 --> 00:39:13,360
Speaker 1: But these cases where humans bodies are defying what we

654
00:39:13,400 --> 00:39:16,399
Speaker 1: thought they could do, you can give us insight into, like, hey,

655
00:39:16,440 --> 00:39:18,520
Speaker 1: how do we manipulate this for good? How do we

656
00:39:18,640 --> 00:39:21,920
Speaker 1: use this to get to the stars. Alright, So I

657
00:39:21,960 --> 00:39:24,680
Speaker 1: mentioned earlier that NASA was kind of leading the charge

658
00:39:24,760 --> 00:39:31,120
Speaker 1: for UM this really cool suspended animation where you're basically

659
00:39:31,160 --> 00:39:35,960
Speaker 1: freezing a person like Han Solo um in carbonite. Yeah,

660
00:39:35,960 --> 00:39:39,000
Speaker 1: except it's not carbonite. It's not exactly like that, but

661
00:39:39,440 --> 00:39:42,160
Speaker 1: it's it's sort of like that. Actually, it's not like

662
00:39:42,160 --> 00:39:47,080
Speaker 1: that at all. Right, um And where NASA dropped off,

663
00:39:47,200 --> 00:39:49,600
Speaker 1: the U. S. Army picked back up with some funding

664
00:39:50,960 --> 00:39:56,880
Speaker 1: because they basically said on the trauma hospitals during wartime

665
00:39:57,440 --> 00:40:01,480
Speaker 1: are chaos because you're trying to to save a person.

666
00:40:01,520 --> 00:40:03,480
Speaker 1: You're trying to treat their immediate wound, you're trying to

667
00:40:03,520 --> 00:40:06,200
Speaker 1: stabilize them, you're trying to make them better, you're trying

668
00:40:06,200 --> 00:40:09,080
Speaker 1: to prevent blood loss. It's it's not an easy thing

669
00:40:09,120 --> 00:40:11,160
Speaker 1: to do. It's not like mash you know, where they

670
00:40:11,200 --> 00:40:13,680
Speaker 1: just make it look super simple. Right, Well, everybody's drunk

671
00:40:13,719 --> 00:40:17,120
Speaker 1: on homemade gin. Yeah, so they're thinking, Um, I wonder

672
00:40:17,120 --> 00:40:19,160
Speaker 1: what that stuff tasted like I always wondered. But they're

673
00:40:19,160 --> 00:40:21,560
Speaker 1: still they seem to like it pretty much pretty well

674
00:40:21,680 --> 00:40:24,239
Speaker 1: because they didn't have anything, I know, but they really

675
00:40:24,280 --> 00:40:26,319
Speaker 1: seemed to enjoy it well. The way they handled it

676
00:40:26,320 --> 00:40:28,520
Speaker 1: was very much like a fine martini. But you know,

677
00:40:28,560 --> 00:40:31,399
Speaker 1: it's just like swill. I don't know they were at

678
00:40:31,400 --> 00:40:33,800
Speaker 1: it for several years. Yeah, that's true. We'll have to

679
00:40:33,840 --> 00:40:36,360
Speaker 1: ask Allan all of the um Man, I'd love to

680
00:40:36,400 --> 00:40:39,279
Speaker 1: meet that guy. Oh yeah, one of my heroes. For attention,

681
00:40:39,440 --> 00:40:43,040
Speaker 1: Alan all the reach out to us. So Chuck can

682
00:40:43,080 --> 00:40:45,040
Speaker 1: meet too, that would be great. My brother met him,

683
00:40:45,400 --> 00:40:49,719
Speaker 1: I'm sure he did. Probably gets Christmas cards, phone, No,

684
00:40:49,760 --> 00:40:51,160
Speaker 1: but he did get a picture with him, which is

685
00:40:51,200 --> 00:40:54,560
Speaker 1: pretty neat. It's nice. Um, So where was I? Oh, yeah,

686
00:40:54,680 --> 00:40:58,840
Speaker 1: mash operating rooms. Yeah, because if you're a doctor, even

687
00:40:59,400 --> 00:41:02,239
Speaker 1: in a battle field hospital, you're like, I want a

688
00:41:02,280 --> 00:41:04,799
Speaker 1: coffee break too, and so to be like, I don't

689
00:41:04,840 --> 00:41:07,040
Speaker 1: have time for this guy right now. Freeze him to

690
00:41:07,160 --> 00:41:11,319
Speaker 1: have that ability that would be magnificent. Or if you

691
00:41:11,400 --> 00:41:14,600
Speaker 1: did have time for the guy, but you literally didn't

692
00:41:14,600 --> 00:41:18,600
Speaker 1: have time to fix these horrific wounds that he came

693
00:41:18,640 --> 00:41:21,399
Speaker 1: in with, you could also say, freeze him to buy

694
00:41:21,400 --> 00:41:24,440
Speaker 1: me some time, and that will let will give you

695
00:41:24,600 --> 00:41:29,239
Speaker 1: the time to basically operate on this guy and completely

696
00:41:29,239 --> 00:41:33,520
Speaker 1: repair heart or his brain or what have you. Um.

697
00:41:33,520 --> 00:41:36,440
Speaker 1: And that's what medically induced hypothermia does. It's just it

698
00:41:36,480 --> 00:41:39,160
Speaker 1: buys you time for either the body to heal itself

699
00:41:39,160 --> 00:41:41,720
Speaker 1: in ways we don't understand, or for you, the surgeon

700
00:41:41,800 --> 00:41:46,799
Speaker 1: to sew somebody up who without hypothermia would just be

701
00:41:46,880 --> 00:41:50,560
Speaker 1: a lost cause. Yeah. There's a doctor named Sam Tishrman

702
00:41:51,080 --> 00:41:55,480
Speaker 1: from the University of Maryland chirps working with the University

703
00:41:55,480 --> 00:42:02,439
Speaker 1: of Pittsburgh. UM, what are they panthers? University of Pittsburgh,

704
00:42:02,680 --> 00:42:06,640
Speaker 1: pitt panthers. I think so that sounds right. It does,

705
00:42:07,480 --> 00:42:11,600
Speaker 1: we'll go with panthers. Panthers. Uh. If I got that right,

706
00:42:11,600 --> 00:42:14,719
Speaker 1: I'm so sorry, Pittsburgh. We'd love you. UM. But he

707
00:42:14,840 --> 00:42:19,280
Speaker 1: is working hard to UM basically UH put patients into

708
00:42:19,440 --> 00:42:24,680
Speaker 1: severe hypothermia or suspended animation. And they're calling this emergency

709
00:42:24,719 --> 00:42:28,359
Speaker 1: preservation and resuscitation. And this is the one that they

710
00:42:28,400 --> 00:42:32,680
Speaker 1: haven't yet experimented on humans. They think they're pretty close,

711
00:42:32,760 --> 00:42:35,120
Speaker 1: but this is the one where they flushed the body

712
00:42:35,239 --> 00:42:40,799
Speaker 1: with freezing cold saline solution UM, which prevents ice from forming. Yeah,

713
00:42:40,800 --> 00:42:44,120
Speaker 1: and it's worked on dogs, and I think it works

714
00:42:44,160 --> 00:42:46,799
Speaker 1: on dogs. Got work on humans. Well, they did some

715
00:42:46,880 --> 00:42:51,200
Speaker 1: experiments on pigs too, because one of the one of

716
00:42:51,239 --> 00:42:54,120
Speaker 1: the things they think they can do where it's not

717
00:42:54,160 --> 00:42:57,200
Speaker 1: like if you've had a hard cardiac arrest or a stroke,

718
00:42:57,320 --> 00:43:00,520
Speaker 1: but again with trauma like a gunshot, you just can't.

719
00:43:00,800 --> 00:43:03,319
Speaker 1: And I didn't I never knew this. You can't resuscitate

720
00:43:03,320 --> 00:43:06,360
Speaker 1: a person with CPR that's had blood loss due to

721
00:43:06,400 --> 00:43:09,920
Speaker 1: trauma it's completely different than cardiac arrest. Why because it's

722
00:43:09,920 --> 00:43:13,080
Speaker 1: a close circulatory system has been opened. I have no idea.

723
00:43:13,239 --> 00:43:15,800
Speaker 1: I bet that's it. Because of the dropping blood pressure.

724
00:43:15,800 --> 00:43:18,920
Speaker 1: It's just not working. It's like sucking through a straw

725
00:43:19,239 --> 00:43:22,120
Speaker 1: that has a hole beneath your lips. Like a lot

726
00:43:22,160 --> 00:43:24,400
Speaker 1: of it's escaping, A lot of the air's escaping, so

727
00:43:24,480 --> 00:43:26,960
Speaker 1: you can't get as much draw. Yeah, I guess that

728
00:43:27,000 --> 00:43:28,879
Speaker 1: makes I bet that's what it is. All right, Well

729
00:43:28,920 --> 00:43:33,160
Speaker 1: we'll probably find out. Um, but with ellen all with

730
00:43:33,200 --> 00:43:35,480
Speaker 1: trauma like a gunshot wound or something, or a stab

731
00:43:35,520 --> 00:43:39,440
Speaker 1: wound where you've lost so much blood you're dying. Um.

732
00:43:39,480 --> 00:43:43,759
Speaker 1: This is when they're using these super super cold temperatures. Um.

733
00:43:43,800 --> 00:43:46,880
Speaker 1: It's a tube inserted into the a orda literally And

734
00:43:46,880 --> 00:43:50,279
Speaker 1: they've done this on pigs. In two thousand six, they

735
00:43:50,320 --> 00:43:55,880
Speaker 1: examined um deep profound and ultra profound freezing of pigs

736
00:43:56,560 --> 00:44:00,200
Speaker 1: who had uncontrolled bleeding wounds. And I imagine and then

737
00:44:01,640 --> 00:44:06,719
Speaker 1: imagine they induced those as well. Piggy grad student. Yeah,

738
00:44:06,760 --> 00:44:09,040
Speaker 1: there's one creep post doc to get to do you know,

739
00:44:09,080 --> 00:44:14,520
Speaker 1: all the stabbings. Um, that's why I'm here. I'll get Ronnie.

740
00:44:15,080 --> 00:44:18,080
Speaker 1: Um and they found that the ones who went underwent

741
00:44:18,120 --> 00:44:21,640
Speaker 1: the most profound hypothermia had the highest survival rates, like

742
00:44:21,680 --> 00:44:25,040
Speaker 1: those French soldiers on the battle exactly. And then in

743
00:44:25,040 --> 00:44:27,640
Speaker 1: two thousand they did the same thing with dogs, except

744
00:44:27,640 --> 00:44:32,480
Speaker 1: that why they weren't stabbed, it was dogs and cardiac arrest. Um,

745
00:44:32,520 --> 00:44:34,520
Speaker 1: they may have induced that too though, come to think

746
00:44:34,560 --> 00:44:37,040
Speaker 1: of it, they'd be like, do you want this bone?

747
00:44:37,040 --> 00:44:40,600
Speaker 1: Now you can't have it. But they used ice cold

748
00:44:40,640 --> 00:44:43,319
Speaker 1: ceiling in that case, and their chances of survival with

749
00:44:43,360 --> 00:44:47,960
Speaker 1: no brain damage really increased. So, um, it's you know,

750
00:44:48,000 --> 00:44:50,480
Speaker 1: there are risks though it's not the easiest thing to do,

751
00:44:50,560 --> 00:44:54,799
Speaker 1: like we said, and um, I know pneumonia was one

752
00:44:54,800 --> 00:44:57,960
Speaker 1: of the risks for years, um, even with just the

753
00:44:58,000 --> 00:45:04,080
Speaker 1: regular cooling, right. Uh. Yeah, pneumonia slowed heart rate. Apparently

754
00:45:04,120 --> 00:45:07,040
Speaker 1: you can enter hyperthermia while you're being rewarmed, Like you

755
00:45:07,120 --> 00:45:10,440
Speaker 1: get way too hot, your body temperature increases too dramatically.

756
00:45:11,280 --> 00:45:13,960
Speaker 1: There's a lot of problems that. Blood clotting is still

757
00:45:14,080 --> 00:45:16,759
Speaker 1: an issue and probably will be for a while. Yeah.

758
00:45:16,760 --> 00:45:19,319
Speaker 1: With Tishrmann's case, trying to use humans though, there's a

759
00:45:19,360 --> 00:45:23,160
Speaker 1: couple of problems. Um. One is they have to get

760
00:45:23,200 --> 00:45:26,200
Speaker 1: consent from a person to undergo an experiment like this,

761
00:45:26,920 --> 00:45:29,120
Speaker 1: but you can't give consent when you're wheeled in there

762
00:45:29,840 --> 00:45:32,880
Speaker 1: unconscious from a cardiac arrest. So what he's trying to

763
00:45:32,920 --> 00:45:35,920
Speaker 1: do is just spread the word, literally, just spread the

764
00:45:35,920 --> 00:45:39,480
Speaker 1: word to the citizens in his area that there's this thing,

765
00:45:40,040 --> 00:45:42,560
Speaker 1: and if your husband or wife has the cardiac arrest,

766
00:45:43,320 --> 00:45:47,440
Speaker 1: ask for the cold treatment where we completely pumped their

767
00:45:47,440 --> 00:45:51,640
Speaker 1: blood out and replace it with frozen sailine. Using cold sailine.

768
00:45:51,719 --> 00:45:53,920
Speaker 1: It's pretty amazing, it is. And you know, there's a

769
00:45:53,920 --> 00:45:56,640
Speaker 1: lot of people who are still very skeptical of the

770
00:45:56,719 --> 00:46:02,040
Speaker 1: idea that medically induced hypothermia can actually work, but there's

771
00:46:02,160 --> 00:46:04,960
Speaker 1: also a growing body of studies that show that it

772
00:46:05,040 --> 00:46:07,360
Speaker 1: does that has a significant impact. Like there were a

773
00:46:07,400 --> 00:46:10,120
Speaker 1: couple there were several in two thousand two that really

774
00:46:10,120 --> 00:46:13,280
Speaker 1: broke the thing open where it was like, these people

775
00:46:13,320 --> 00:46:15,719
Speaker 1: have a twenty five percent chance of recovery without it,

776
00:46:16,080 --> 00:46:18,600
Speaker 1: they have a fifty or seventy five percent chance of

777
00:46:18,640 --> 00:46:23,200
Speaker 1: recovery with it, And that's really tough to ignore. It's amazing,

778
00:46:23,600 --> 00:46:28,520
Speaker 1: amazing stuff into the future, Chuck, let's go. If you

779
00:46:28,560 --> 00:46:31,200
Speaker 1: want to know more about medically induced hypothermia. Check out

780
00:46:31,200 --> 00:46:33,319
Speaker 1: our podcast page for this episode. It's got a bunch

781
00:46:33,360 --> 00:46:37,560
Speaker 1: of cool links and you can type therapeutic hypothermia in

782
00:46:37,640 --> 00:46:39,480
Speaker 1: the search part how stuff works dot com and it

783
00:46:39,520 --> 00:46:43,120
Speaker 1: will bring up this article of puns. And Uh, since

784
00:46:43,160 --> 00:46:48,279
Speaker 1: I said search parts, time for listener mail, I'm gonna

785
00:46:48,280 --> 00:46:52,480
Speaker 1: call this um Josh's theory on satire. Remember that we

786
00:46:52,520 --> 00:46:58,000
Speaker 1: talked about that in the very recent show Clowns CNN. Uh.

787
00:46:58,120 --> 00:47:00,200
Speaker 1: Do you want to summarize your position real quick that

788
00:47:00,320 --> 00:47:03,640
Speaker 1: maybe satire is just a release and does it affect change?

789
00:47:04,040 --> 00:47:05,800
Speaker 1: Is that the nuts and bolts of it. Yeah, Basically

790
00:47:05,840 --> 00:47:09,120
Speaker 1: it lets the populace who's angry let off steam at

791
00:47:09,160 --> 00:47:13,680
Speaker 1: the leadership without actually forcing the leadership to change. All right,

792
00:47:13,760 --> 00:47:15,279
Speaker 1: So that brings us up to speed. And this is

793
00:47:15,280 --> 00:47:18,319
Speaker 1: from Chelsea. Uh. She said, I just started listening under

794
00:47:18,320 --> 00:47:20,800
Speaker 1: a year ago when a change in jobs landed me

795
00:47:20,920 --> 00:47:23,040
Speaker 1: with a twenty five minute walk to and from work

796
00:47:23,040 --> 00:47:26,560
Speaker 1: every day. I think she's in dublin. Um, she says,

797
00:47:26,640 --> 00:47:29,200
Speaker 1: I find myself laughing out loud at your repartee. And

798
00:47:29,280 --> 00:47:31,920
Speaker 1: my boyfriend is affectionately started referring to you as my

799
00:47:32,000 --> 00:47:35,000
Speaker 1: nerd friends. But he's a listener. Now to it sounds

800
00:47:35,040 --> 00:47:38,959
Speaker 1: like Dublin I'm actually writing in regard to Josh's theory

801
00:47:38,960 --> 00:47:41,640
Speaker 1: on satire. It's a really interesting point, an angle I

802
00:47:41,719 --> 00:47:44,520
Speaker 1: had not considered myself. I think though, that there's another

803
00:47:44,520 --> 00:47:46,839
Speaker 1: way to look at it, which is that satire has

804
00:47:46,880 --> 00:47:49,160
Speaker 1: the ability to plant the seed of dissent in a

805
00:47:49,160 --> 00:47:51,839
Speaker 1: non threatening way and thus can eventually be a force

806
00:47:51,880 --> 00:47:54,719
Speaker 1: of change. For example, someone may not be aware of

807
00:47:54,760 --> 00:47:57,680
Speaker 1: a particular foible of a leader. That satirist points it

808
00:47:57,680 --> 00:48:00,600
Speaker 1: out in a funny way. Now that someone has an awareness,

809
00:48:00,600 --> 00:48:03,360
Speaker 1: without feeling preached at, and has it in their mind

810
00:48:03,760 --> 00:48:06,800
Speaker 1: the next time the leader does something untoward, or perhaps

811
00:48:06,800 --> 00:48:09,000
Speaker 1: they were just uh, they were aware of said foible,

812
00:48:09,480 --> 00:48:12,360
Speaker 1: but the satirists opened their eyes to just how ridiculous

813
00:48:12,640 --> 00:48:15,000
Speaker 1: and or dangerous it is. So while there's certainly a

814
00:48:15,000 --> 00:48:17,920
Speaker 1: possibility satire connect as a placation or a way of

815
00:48:17,960 --> 00:48:20,719
Speaker 1: letting off steam, there's also a very real possibility that

816
00:48:20,760 --> 00:48:23,680
Speaker 1: can spark be the spark that ignites an eventual change.

817
00:48:23,920 --> 00:48:25,920
Speaker 1: It is a good point. Yeah, that's from Chelsea and

818
00:48:26,000 --> 00:48:30,080
Speaker 1: Morgan Hoffman. Thanks a lot, Chelsea Morgan Hoffman of Dublin, Ireland.

819
00:48:30,120 --> 00:48:34,200
Speaker 1: Probably h well, she just said Dublin, Dublin, Georgia. I'm

820
00:48:34,200 --> 00:48:37,480
Speaker 1: gonna go ahead and assume Ireland. Yeah, and boyfriend, yes,

821
00:48:37,719 --> 00:48:40,560
Speaker 1: thank you both for listening. We appreciate it. Uh. And

822
00:48:40,640 --> 00:48:44,280
Speaker 1: if you have a counterpoint, or your own theory or hypothesis,

823
00:48:44,400 --> 00:48:46,759
Speaker 1: or just want to say hi or whatever, you can

824
00:48:46,800 --> 00:48:49,200
Speaker 1: tweet to us at s y s K podcast. You

825
00:48:49,200 --> 00:48:51,480
Speaker 1: can join us on Facebook dot com slash Stuff you

826
00:48:51,480 --> 00:48:54,279
Speaker 1: Should Know, UH, you can send us an email to

827
00:48:54,480 --> 00:48:57,680
Speaker 1: Stuff Podcast at how Stuff Works dot com, and as always,

828
00:48:57,760 --> 00:49:00,400
Speaker 1: joined us at our luxurious home on the web, Stuff

829
00:49:00,440 --> 00:49:05,239
Speaker 1: you Should Know dot com. Stuff you Should Know is

830
00:49:05,239 --> 00:49:08,120
Speaker 1: a production of I Heart Radio. For more podcasts my

831
00:49:08,160 --> 00:49:11,440
Speaker 1: Heart Radio, visit the I Heart Radio app, Apple Podcasts,

832
00:49:11,560 --> 00:49:16,239
Speaker 1: or wherever you listen to your favorite shows. H