WEBVTT - SYSK Selects: Your limb is torn off - now what? 0:00:00.240 --> 0:00:03.320 Hi there everyone, it's me Josh and for this week's 0:00:03.400 --> 0:00:06.440 s Y s K Selex, I've chosen so your limbs 0:00:06.480 --> 0:00:10.719 torn off. Now what. It's a great classic episode filled 0:00:10.760 --> 0:00:14.760 with neat stories about things like exposed innards and sewing 0:00:14.880 --> 0:00:17.560 muscles together. It's a good one and it has a 0:00:17.600 --> 0:00:20.280 really great intro, if I do say so myself. It's 0:00:20.320 --> 0:00:27.960 from January, so enjoy. Welcome to Stuff you Should Know, 0:00:28.200 --> 0:00:36.680 a production of My Heart Radios How Stuff Works. Hey, 0:00:36.720 --> 0:00:39.120 and welcome to the podcast. I'm Josh Clark, and there's 0:00:39.159 --> 0:00:41.920 Charles w Chuck Bryant and this is stuff you should 0:00:41.920 --> 0:00:45.560 know because Jerry's over there, King, are you doing buddy? 0:00:45.640 --> 0:00:49.440 Besides sick, I'm not sick. I'm just I've got a 0:00:49.479 --> 0:00:52.919 little bit of a bug. But well do you think 0:00:52.960 --> 0:00:55.920 that's the first step? And yeah, and being sick is 0:00:56.000 --> 0:01:01.200 saying I'm sick. I definitely believe in psycho somad effects. 0:01:01.720 --> 0:01:03.880 You know, the mine has an impact on the body. Well, 0:01:03.880 --> 0:01:05.920 if you can be a hypochondria, actually you can do 0:01:05.959 --> 0:01:09.360 the opposite, right, yeah, yeah, you can will yourself into 0:01:09.440 --> 0:01:12.080 not being Anyway, people, the show must go on, And 0:01:12.240 --> 0:01:14.199 I just want to point out how dedicated my partner. 0:01:14.240 --> 0:01:16.720 Here's to his craft. Well, I also want to say, 0:01:16.800 --> 0:01:18.520 I want to promise that it's not going to be 0:01:18.600 --> 0:01:22.520 like the great six weeks of No. You don't get 0:01:22.840 --> 0:01:25.440 that was back in the old days, the unhealthy days. 0:01:25.600 --> 0:01:27.640 I smoked and everything. Yeah, your body didn't know how 0:01:27.640 --> 0:01:30.440 to heal, so it was enjoying nicotine. Now I'm just 0:01:30.520 --> 0:01:32.920 like I'm I'm not getting sick. I said it to 0:01:32.959 --> 0:01:35.160 myself last night, and here I am better than you 0:01:35.280 --> 0:01:38.240 ever Josh two point oh, thank you. All right, let's 0:01:38.240 --> 0:01:41.399 do this, Okay, are you ready? Yeah, I got a 0:01:41.440 --> 0:01:43.760 story for you. I bet I know it. I'll bet 0:01:43.760 --> 0:01:49.040 you know. Yeah. You saw. His name is Everett Knowles Jr. 0:01:49.800 --> 0:01:52.920 But everybody called him Eddie two days in a why 0:01:53.680 --> 0:01:56.200 I find the unwholesome. Yeah, and I didn't know Eddie 0:01:56.320 --> 0:01:58.560 could be short forever never heard that. I don't think 0:01:58.560 --> 0:02:00.800 it is. I think he just didn't like his name, Okay, 0:02:01.280 --> 0:02:04.080 because it seems like you should call him every yeah 0:02:04.240 --> 0:02:11.080 or heavy ev yea of the big ee something. So 0:02:11.480 --> 0:02:14.120 he was a little either. He's a little guy, tiny 0:02:14.200 --> 0:02:18.079 like a little Elvis. Uh. Well, Eddie, we'll call him 0:02:18.120 --> 0:02:20.200 Eddie because that's what he preferred to be called sure. 0:02:20.880 --> 0:02:25.080 He was walking home from school one day in Somerville, Massachusetts, 0:02:25.120 --> 0:02:28.320 which is a suburb of Boston, and he was walking 0:02:28.360 --> 0:02:30.959 along the railroad tracks and there just happened to be 0:02:31.040 --> 0:02:37.080 a train loaded with gravel hauling out of the area 0:02:37.880 --> 0:02:40.040 very slowly while he was walking alongside, and said, you 0:02:40.080 --> 0:02:42.760 know what, I'm just gonna have a little thrill right 0:02:42.760 --> 0:02:46.120 now and grab onto this train. And he did. He 0:02:46.240 --> 0:02:50.200 successfully grabbed onto the train, was hanging with I believe 0:02:50.280 --> 0:02:54.800 his right arm. Yeah, and uh was having the time 0:02:54.800 --> 0:02:58.000 of his life just dangling there when he misjudged the 0:02:58.040 --> 0:03:01.880 distance between the train side the train and the side 0:03:01.880 --> 0:03:06.960 of a tunnel and he was pulled into the tunnel support, 0:03:07.320 --> 0:03:10.960 smacked it and hung on for a second before he 0:03:11.080 --> 0:03:13.520 was dropped off of the train. The train kept going 0:03:13.560 --> 0:03:16.880 through the tunnel, leaving Eddie kind of crumpled and in 0:03:17.000 --> 0:03:22.960 a little shivering mass at the mouth of the tunnel. 0:03:23.919 --> 0:03:26.000 So he stands up and he grabs his arm. He's like, oh, 0:03:26.080 --> 0:03:28.919 my arm doesn't feel very good, and he starts walking 0:03:29.360 --> 0:03:32.680 toward town and apparently he walked about a hundred yards 0:03:32.800 --> 0:03:37.160 uphill when some workers saw him and said, grab that kid. 0:03:37.800 --> 0:03:40.280 Because he was covered in blood, he was staggering, he 0:03:40.320 --> 0:03:42.280 looked like he was out of He's clearly in shocks. 0:03:42.360 --> 0:03:45.360 They grabbed it, ran and got a woman, because at 0:03:45.400 --> 0:03:47.800 the time, this is n two, a woman was the 0:03:47.840 --> 0:03:51.080 only one who could provide any kind of initial emergency care. 0:03:51.960 --> 0:03:55.360 Um and a clerk at I believe some sort of 0:03:55.400 --> 0:03:59.040 warehouse um came out and started to apply pressure to 0:03:59.080 --> 0:04:03.440 this boy's wound. But she had a little bit of trouble. 0:04:03.840 --> 0:04:06.440 When she tried to close the wound with a tournique, 0:04:06.960 --> 0:04:11.080 she found that his arm was an attached to his 0:04:11.200 --> 0:04:13.920 body any longer. He's just kind of holding it there. 0:04:14.040 --> 0:04:16.080 Very Luckily he was wearing a jacket, or else his 0:04:16.160 --> 0:04:18.480 arm would have been back at the mouth of the tunnel. Man. 0:04:18.520 --> 0:04:22.000 Can you imagine, like the guy is holding his arm 0:04:22.000 --> 0:04:25.320 basically to keep it from falling out of his jacket, 0:04:25.360 --> 0:04:27.159 although he didn't know that, you know, no, he didn't. 0:04:27.200 --> 0:04:30.040 He was in shock. Luckily, he was still lucid enough 0:04:30.040 --> 0:04:33.080 to like tell everybody who he was, where he lived, 0:04:33.440 --> 0:04:38.000 and uh. They called the the hospital, and the hospital 0:04:38.080 --> 0:04:41.560 scrambled some surgeons. But it wasn't until chuck Um he 0:04:41.680 --> 0:04:44.360 got to the hospital and they started cutting his jacket 0:04:44.400 --> 0:04:47.240 off that they realized the extent of the damage. This 0:04:47.360 --> 0:04:51.440 kid's arm was torn clean off. But the operative word 0:04:52.040 --> 0:04:57.919 is clean. Yeah, he's right, because Eddie Everett Knowls Jr. 0:04:58.480 --> 0:05:03.839 Of Somerville, Mass On what May nineteen sixty two, became 0:05:03.880 --> 0:05:08.440 the first recipient of a full successful limb reattachments, first 0:05:08.480 --> 0:05:11.520 human recipient. Right. Yeah, it's a good point. They had 0:05:11.520 --> 0:05:15.000 done that before dogs successfully, and they had they had 0:05:15.040 --> 0:05:19.400 done all the different surgeries that are required to reattach 0:05:19.480 --> 0:05:21.839 a limb, but they had never done all of them 0:05:21.880 --> 0:05:25.119 at once. Like they'd reattach the nerves, they'd reattach bone, 0:05:25.680 --> 0:05:28.640 they'd reattached blood vessels, but they had never had a 0:05:28.640 --> 0:05:33.520 full amputation and a human being successfully reattached. And um. 0:05:33.720 --> 0:05:36.120 From what I read, the doctor was I don't know 0:05:36.120 --> 0:05:39.080 about excited, but they had been looking for a case 0:05:39.880 --> 0:05:41.720 because they thought, like, I think we can do this. 0:05:41.760 --> 0:05:44.120 We just need the right case, right exactly, you know. 0:05:44.160 --> 0:05:45.480 And he called his buddy and he's like, I think 0:05:45.520 --> 0:05:47.920 we got one. Get in there. They got the They 0:05:48.080 --> 0:05:51.440 like you said, they'd successfully reattached artery's nerves, bone, that 0:05:51.520 --> 0:05:54.160 kind of thing, but never all never the whole shebang. 0:05:54.480 --> 0:05:56.680 So they said, well, we know how to do this. Yeah, 0:05:56.839 --> 0:05:59.000 if somebody will just come along and present us with 0:05:59.040 --> 0:06:02.840 an arm pulled leanly off, especially a twelve year old, 0:06:02.880 --> 0:06:06.800 because that definitely worked at his advantage. Apparently an artery 0:06:06.880 --> 0:06:11.000 when severed will plug itself up, especially in younger kids. 0:06:11.000 --> 0:06:13.960 That plugging is way more successful and happens more quickly. 0:06:14.400 --> 0:06:17.359 So this kid just basically presented like the perfect case. 0:06:17.720 --> 0:06:20.360 The main artery I guess it is brachial artery leading 0:06:20.360 --> 0:06:22.360 out of his shoulder was a full like two inches 0:06:22.960 --> 0:06:25.640 out of the wounds. So like they had a lot 0:06:25.720 --> 0:06:28.599 to work with and work they did. Uh yeah, and 0:06:28.640 --> 0:06:33.080 they the arm was on ice and they began working immediately. 0:06:33.120 --> 0:06:36.640 This is mass general by the way, and um, they 0:06:36.680 --> 0:06:42.960 started with the arteries and veins, and then the nurse felt, well, 0:06:43.000 --> 0:06:45.760 they all sort of saw color and they described as 0:06:45.760 --> 0:06:48.039 a glow kind of came back into the arm. This 0:06:48.120 --> 0:06:49.840 kid hopped the train, had his arm pulled off, and 0:06:49.880 --> 0:06:53.800 within two and a half hours they had gotten circulation back. Yeah, 0:06:53.880 --> 0:06:56.400 and the nurse scrabbed the hand and said, hey, it's warm. 0:06:56.440 --> 0:06:59.359 That's good, spink and warm. She shook it, made it 0:06:59.400 --> 0:07:02.800 do the metal sign everybody in the operating theory is laughing. 0:07:04.279 --> 0:07:06.600 The bone and the muscle and the nerve and the 0:07:06.640 --> 0:07:11.320 skin um happened in in later surgeries, and the I 0:07:11.320 --> 0:07:13.480 think the nerve. They made a pretty important decision at 0:07:13.480 --> 0:07:17.000 the time was to wait on that altogether, uh, and 0:07:17.080 --> 0:07:19.480 let it heal some more first, which is as it 0:07:19.520 --> 0:07:22.120 turns out. Actually, as it turns out, most of this 0:07:23.080 --> 0:07:26.040 was sort of how they do it today. Like they 0:07:25.720 --> 0:07:30.640 perfected the process from that point through the seventies and 0:07:30.640 --> 0:07:32.760 in the eighties is when they really started like humming 0:07:32.760 --> 0:07:36.360 with limb reattachment. The only difference that I saw was 0:07:36.560 --> 0:07:39.200 and we'll get into it a little more, but um. 0:07:39.240 --> 0:07:42.000 They reattached the arteries first to get circulation, I guess 0:07:42.000 --> 0:07:45.480 to keep from more and more tissue dying. Um. And 0:07:45.520 --> 0:07:48.640 then they reattached the bone by driving a screw and 0:07:48.760 --> 0:07:51.960 using a hammer they nail the screw into the marrow. 0:07:52.600 --> 0:07:56.679 And then reattached the arm bone. That what is that femur? 0:07:57.400 --> 0:07:59.680 No femurs in the leg the leg You think I 0:07:59.720 --> 0:08:04.840 would looked this up already, Yeah, the upper arm bone. 0:08:04.960 --> 0:08:07.640 Then they drove that into the other end of the 0:08:07.800 --> 0:08:11.600 crew normally now though they do they reattach the bone 0:08:11.640 --> 0:08:15.320 for supervide stability, so when you reattach the arteries and 0:08:15.400 --> 0:08:18.320 veins and stuff, they won't pull away. Yeah, and he 0:08:18.480 --> 0:08:21.000 uh it was a success story because he ended up 0:08:21.040 --> 0:08:24.160 he was uh he couldn't use that hand as his 0:08:24.200 --> 0:08:26.400 dominant hand any longer, which just said because he was 0:08:26.400 --> 0:08:29.160 a good picture. Yeah, but he um was able to 0:08:29.200 --> 0:08:32.880 eventually get enough use out of it to where, uh 0:08:32.920 --> 0:08:35.839 they said about like a left hander would have use 0:08:35.880 --> 0:08:38.040 of his right hand. So he just sort of had 0:08:38.080 --> 0:08:41.839 to switch that up. But for nineteen sixty two, that's 0:08:41.840 --> 0:08:47.720 pretty successful, especially considering in nineteen sixty was the very 0:08:47.800 --> 0:08:53.760 first microsurgery performed just two years previously at the University 0:08:53.760 --> 0:08:59.199 of Vermont. Oh yeah, go catamounts. But um, that's dedication 0:08:59.400 --> 0:09:02.000 so microso surgery, that's really what we're talking about here. 0:09:02.000 --> 0:09:05.760 It's the use of a microscope to perform surgery. And 0:09:05.800 --> 0:09:10.040 when you're attaching, you're essentially sewing together little nerves and 0:09:10.080 --> 0:09:14.720 blood vessels like a millimeter in diameter. You need a 0:09:14.720 --> 0:09:17.319 microscope and a tiny, tiny little needle, right, and you're 0:09:17.400 --> 0:09:21.199 using tiny, tiny little sutra thread which is about is 0:09:21.200 --> 0:09:25.199 is as big as a hair. That's the stuff you're 0:09:25.240 --> 0:09:28.079 using to to suture these blood vessels back together. It's 0:09:28.080 --> 0:09:33.160 not catgut, no, And it's an extremely involved um surgery 0:09:33.200 --> 0:09:35.600 as you can imagine, but it's step by step. It's 0:09:35.640 --> 0:09:38.160 like first you do the blood vessels, then you do 0:09:38.280 --> 0:09:43.480 the arteries, UM, and you do muscles, ligaments, tendons, all 0:09:43.480 --> 0:09:47.319 this stuff, and you're doing it in this this process. 0:09:47.720 --> 0:09:51.400 But each each surgery, each part of the procedure is 0:09:51.440 --> 0:09:54.840 like an enormous surgery in and of itself. So like UM, 0:09:55.160 --> 0:09:59.800 a limb reattachment which is called um replantation. I thought 0:09:59.800 --> 0:10:03.640 it was be called like limbery or something. Some people 0:10:03.720 --> 0:10:06.439 call it that. I'm a limberist. The saucier doctors call 0:10:06.480 --> 0:10:09.800 it limbery, but UM, it usually is like as on 0:10:09.880 --> 0:10:14.000 a whole. The replantation surgery can last like an entire day. Yeah, 0:10:14.000 --> 0:10:17.079 it's it's intensive, UM And I read too that it 0:10:17.400 --> 0:10:20.440 uh the whole micro surgery. The concept of using a 0:10:20.440 --> 0:10:24.480 microscope for surgery was not accepted at first, Like doctors 0:10:24.480 --> 0:10:27.720 and surgeons were like, no, like you, we can't do that. 0:10:27.920 --> 0:10:30.240 We have to look with our eyes, and so it 0:10:30.240 --> 0:10:33.280 had to be perfected sort of on the fringe by 0:10:33.360 --> 0:10:35.920 doctor by surgeons who are willing to like accept this 0:10:36.000 --> 0:10:39.280 might be the future an experiment in their basements. I guess, 0:10:39.280 --> 0:10:43.520 so on hapless victim maybe or dogs. Yeah, I didn't 0:10:43.559 --> 0:10:45.280 get the and I didn't look it up, but I 0:10:45.280 --> 0:10:49.040 didn't get the impression from this article one way or 0:10:49.080 --> 0:10:53.199 the other how dogs lost their limbs to begin with, Like, 0:10:53.360 --> 0:10:56.160 was it accidental and they're like, okay, well this we'll 0:10:56.200 --> 0:10:58.280 reattach it. Or were they cutting dogs limbs off and 0:10:58.320 --> 0:11:01.400 then reattaching them, because I'm guessing it was probably the 0:11:01.480 --> 0:11:06.400 ladder probably. Yeah, I mean we've talked plenty about that 0:11:06.480 --> 0:11:08.360 kind of topic because I mean, think about it. Why 0:11:08.440 --> 0:11:11.880 would dogs limbs be pulled off in any more frequency 0:11:11.920 --> 0:11:15.520 than humans limbs and hence present more cases to practice on. 0:11:15.679 --> 0:11:18.160 I think they were cutting off dog's limbs and then reattaching, 0:11:19.480 --> 0:11:23.640 which is messed up. Yeah it is. So you were 0:11:23.640 --> 0:11:28.680 talking about microsurgery. What I saw was um replacing toes 0:11:28.800 --> 0:11:32.680 for thumbs. Got big sixties. That was a big one. 0:11:33.000 --> 0:11:35.680 So you had a a thumb on your foot or 0:11:35.720 --> 0:11:37.880 a big toe on your hand, big toe on your hand, 0:11:38.840 --> 0:11:42.080 because apparently fifty to seventy of all the utility in 0:11:42.120 --> 0:11:43.920 your hand is in your thumb. And if you're missing 0:11:43.920 --> 0:11:46.080 a thumb, you might as well just not have your hand. 0:11:46.800 --> 0:11:48.920 You don't need a big toe quite as much. You 0:11:48.920 --> 0:11:50.760 can use a cane or something like that. Thanks to 0:11:50.840 --> 0:11:55.040 your new toe thumb and um that that became perfected 0:11:55.080 --> 0:11:57.560 in the sixties toe thumb. That's a good band name. Yeah, 0:11:58.240 --> 0:12:02.240 And then in the seven these um free flat tissue 0:12:02.280 --> 0:12:06.720 transfer became a big thing, which is basically going to 0:12:06.800 --> 0:12:11.760 a part of your body, harvesting an area of your 0:12:11.760 --> 0:12:16.920 body like under your thigh, your abdomen um, I think 0:12:16.960 --> 0:12:20.360 you're back, lower back, and then just basically taking the 0:12:20.400 --> 0:12:23.480 gap and sewing it back together, right, so you have 0:12:23.520 --> 0:12:26.720 a scar, but you also have a portion of your 0:12:26.720 --> 0:12:29.600 body that's diminished in size. Um, and then taking that 0:12:29.679 --> 0:12:32.320 and using it to basically do what we understand as 0:12:32.360 --> 0:12:36.839 a skin graft, which which requires microsurgery as well. Um, 0:12:36.880 --> 0:12:39.680 it's just basically taking this part here and putting it 0:12:39.760 --> 0:12:41.520 back over here where there's a bunch of damage and 0:12:41.559 --> 0:12:45.200 reattaching all of the nerves and the blood vessels and everything. Yeah. 0:12:45.240 --> 0:12:48.880 I saw when I was looking up photos of this 0:12:48.960 --> 0:12:51.960 kind of thing, I came across something that I had 0:12:52.000 --> 0:12:55.120 never seen before. And I didn't. I didn't get the story, 0:12:55.160 --> 0:12:57.600 but you could almost. I mean I sort of gathered 0:12:57.679 --> 0:12:59.720 what was going on just from the photo series. But 0:13:00.080 --> 0:13:05.240 up someone was degloved on the on their fingers basically 0:13:05.600 --> 0:13:10.040 from like the hand knuckles forward. All the fingers had 0:13:10.160 --> 0:13:14.480 no skin, and they from the looks of it, they 0:13:14.520 --> 0:13:19.520 inserted it into an arm, like into a bicep, the 0:13:19.600 --> 0:13:23.640 fingers and like they lived there for a while, like 0:13:23.880 --> 0:13:28.640 inserted under the skin of the arm, and that that 0:13:28.760 --> 0:13:32.160 skin they later would remove the fingers and it came 0:13:32.200 --> 0:13:35.360 off as like a big flat skin graph like sticking 0:13:35.360 --> 0:13:39.440 your hand in an envelope, and uh, eventually formed like 0:13:39.559 --> 0:13:44.080 webbed fingers and then fingers. That is crazy, But like, 0:13:44.160 --> 0:13:46.839 I don't know, man, I just saw these photos. I 0:13:46.840 --> 0:13:48.640 should have done. I mean, it doesn't really have anything 0:13:48.640 --> 0:13:50.840 to do with this, but it was just remarkable they 0:13:50.880 --> 0:13:55.200 see someone with their fingers stuck in their bicep under 0:13:55.240 --> 0:13:58.040 the skin. Like, I'm having trouble visualizing this. I need 0:13:58.040 --> 0:14:00.920 to see these photos. Yeah, I'll dick him up the 0:14:00.960 --> 0:14:02.920 show to you. Yeah, if you want to see some 0:14:03.000 --> 0:14:06.680 really gross stuff, you can just google. Um. Microsurgery or 0:14:06.880 --> 0:14:10.719 replantation is another one man it's just nasty stuff out, 0:14:11.080 --> 0:14:13.640 but amazing like that they can. And I looked at 0:14:13.640 --> 0:14:14.880 so many of them. I kind of got to that 0:14:14.880 --> 0:14:16.560 point where I was like, well, this isn't gross. This 0:14:16.640 --> 0:14:20.000 is what the body looks like without skin sometimes, and 0:14:20.120 --> 0:14:24.080 which is gross. Nuts. I wouldn't grossed out bodies without 0:14:24.080 --> 0:14:27.440 skin or gross. I don't think so. I think. I 0:14:27.480 --> 0:14:31.520 think it's the beauty inside. You couldn't desensitize my friend. Well, 0:14:31.560 --> 0:14:34.160 before we get any further, Chuck, let's do a message break, 0:14:34.160 --> 0:14:53.160 because I got some good stuff coming up. So, Chuck, 0:14:53.920 --> 0:14:57.880 we understand microsurgery. Now it's frankensteiny in right, Yeah, you're 0:14:57.920 --> 0:15:00.440 basically just sewing stuff together. Yeah, because I mean, like, 0:15:00.520 --> 0:15:02.680 let's say you have a dead person who has a 0:15:02.680 --> 0:15:04.480 great hand and you have a live person who's got 0:15:04.480 --> 0:15:06.640 a poor hand. You cut off the live person's hand, 0:15:06.840 --> 0:15:09.760 cut off the dead person's hand, and attached the live 0:15:09.960 --> 0:15:13.000 or the dead person's hand and a live person. That's 0:15:13.120 --> 0:15:18.000 that's Frankensteinian. That's what they're doing. And it's pretty cool cool. Um, 0:15:18.040 --> 0:15:20.320 but if this ever happens to you, if if say 0:15:20.480 --> 0:15:23.600 you have a poor hand and that it's no longer 0:15:23.640 --> 0:15:27.840 attached to your wrist. Yeah, that hand sucks, right and 0:15:27.880 --> 0:15:30.880 it's all crushed and damaged or whatever. No, no, no, 0:15:30.960 --> 0:15:33.720 let's say it's intact. And you say, you know what, 0:15:33.800 --> 0:15:36.760 I think through my shock that I might be a 0:15:36.800 --> 0:15:41.360 good candidate for replantation of my hand. What do you do? Well, 0:15:41.640 --> 0:15:44.880 you want to call nine one one immediately, because that's 0:15:44.920 --> 0:15:46.480 just the first thing you do. You get, go ahead 0:15:46.480 --> 0:15:48.840 and get folks on the way, or you can ask 0:15:49.040 --> 0:15:51.640 someone with you to call nine one. That's not putting 0:15:51.680 --> 0:15:54.480 anyone out. Yeah that's true. If you can't dial, maybe 0:15:54.480 --> 0:15:56.240 you don't have hands, right, you can tell Sirie to 0:15:56.280 --> 0:16:00.000 call nine one one. Job. Yeah, I actually changed my 0:16:00.080 --> 0:16:01.760 series to a dude, so it's not a hurt anymore 0:16:02.200 --> 0:16:05.440 to an englishman. Actually, yeah, it's kind of fun Reginald. 0:16:06.480 --> 0:16:08.720 I don't know what his name is actually, but he'll 0:16:08.760 --> 0:16:11.240 say stuff like, you know, I'll say call Josh and 0:16:11.280 --> 0:16:14.560 he'll say ringing Josh, oh yeah, instead of calling Yeah, 0:16:14.600 --> 0:16:18.720 it's classy, kind of fun. Anyway, Um, you want to 0:16:18.840 --> 0:16:20.600 dial nine one one, get them on the way, and 0:16:20.640 --> 0:16:23.560 then immediately you want to just try and stabilize the patient. 0:16:23.600 --> 0:16:26.440 You want to stop the bleeding, either with heavy pressure 0:16:26.640 --> 0:16:32.240 or a tourniquet above the wound like a sixties female. Yeah, exactly. Uh. 0:16:32.280 --> 0:16:35.080 And once you get the patient um stabilize and they're 0:16:35.080 --> 0:16:37.320 not going to bleed out there in the kitchen or 0:16:37.360 --> 0:16:40.400 wherever it is. Um. You want to get the digit 0:16:40.600 --> 0:16:44.200 or the hand or the limb and put it on ice, 0:16:44.280 --> 0:16:46.800 but not directly on ice. Put it in a bag 0:16:47.160 --> 0:16:49.480 and then put that bag on ice. Yeah, you want 0:16:49.480 --> 0:16:52.080 to pack pack it in ice as much ice as 0:16:52.080 --> 0:16:53.440 you can find, but you want to make sure that 0:16:53.520 --> 0:16:55.960 in the bag that you put the the hand or 0:16:56.000 --> 0:16:58.800 the digit or whatever in there's no ice and there's 0:16:58.800 --> 0:17:02.160 no water because wall or causes it to shrivel, and 0:17:02.240 --> 0:17:04.600 that means you won't be able to reattach it. Yeah, 0:17:04.640 --> 0:17:06.720 and ice you can actually if I put if I 0:17:06.760 --> 0:17:08.639 cut off my finger and I threw it in a 0:17:08.680 --> 0:17:12.120 bucket of ice, it could actually get frostbite. Yeah. That's crazy. 0:17:12.240 --> 0:17:14.480 That is crazy, but it's also pretty cool. Yeah. And 0:17:14.480 --> 0:17:17.480 you don't want frostbite on your because you know you 0:17:17.480 --> 0:17:19.600 won't be able to use it anymore. Now. Frostbite is 0:17:19.680 --> 0:17:24.560 just um dead tissue brought about by exposure to extreme cold. 0:17:25.240 --> 0:17:28.600 That's right. So after the teacher right there. It is. 0:17:29.320 --> 0:17:31.399 After you've got it on the ice, in the bag 0:17:31.520 --> 0:17:33.880 on the ice, you've called mine one one, you've got 0:17:33.880 --> 0:17:37.240 the bleeding stopped. You want to cross whatever fingers you 0:17:37.280 --> 0:17:39.880 have remaining and hope that you've got a good hospital 0:17:39.920 --> 0:17:43.159 nearby with some surgeons that aren't doing much at the 0:17:43.200 --> 0:17:47.439 moment or who are willing to cancel their schedules and 0:17:47.480 --> 0:17:50.040 say let's go do this. Yeah, get off the golf course. 0:17:50.440 --> 0:17:52.400 So when you get to the hospital, there's some things 0:17:52.400 --> 0:17:55.600 you can expect. If all of your surgeons have coming 0:17:55.680 --> 0:17:57.719 from the golf course, they should be ready and waiting 0:17:57.720 --> 0:18:00.480 for you. And Um, like we said, for they're going 0:18:00.480 --> 0:18:04.399 to reattach the bone to provide stability um for the 0:18:04.440 --> 0:18:07.480 rest of the surgery. And there's probably still going to 0:18:07.560 --> 0:18:09.479 be a little bit of a gap there because they 0:18:09.480 --> 0:18:12.880 need to get in there. Um. And then they start 0:18:12.920 --> 0:18:20.000 reattaching your your blood vessels, and just like with Eddie Knowles, um, 0:18:20.040 --> 0:18:22.560 that just gets you know, the blood flow going and 0:18:22.720 --> 0:18:27.479 essentially makes that limb alive once more, right well, and 0:18:27.680 --> 0:18:31.359 it also keeps it from further dying. Um. Because Chuck, 0:18:31.400 --> 0:18:33.679 it turns out that like there is a finite amount 0:18:33.680 --> 0:18:37.280 of time which is understandable, but we we are aware 0:18:37.320 --> 0:18:39.800 of how much time a limb can just sit around 0:18:39.880 --> 0:18:44.360 in the hot sun starting to go you know, fit it. Yeah, 0:18:44.800 --> 0:18:48.240 and there's so for example, Um, if you have a 0:18:48.400 --> 0:18:53.200 whole arm or a whole leg cut off, remember death Proof. Yeah, 0:18:53.240 --> 0:18:55.159 that girl has her legs like sticking out of the 0:18:55.160 --> 0:18:58.879 window and mad Mike is that his name Kurt Russell? 0:18:59.600 --> 0:19:03.760 When he some and her legs goes. Um. If she 0:19:03.800 --> 0:19:07.239 had survived and her leg just laid there out at 0:19:07.320 --> 0:19:10.879 room temperature, um, it could have been good for six 0:19:10.920 --> 0:19:13.959 to twelve hours. I imagine you're really pushing it at 0:19:14.000 --> 0:19:18.560 twelve hours. But if say you have somebody who's like 0:19:18.640 --> 0:19:20.360 this leg needs to be put on ice and does 0:19:20.400 --> 0:19:23.720 everything right, it could stay refrigerated for four days and 0:19:23.800 --> 0:19:27.879 still be reattached. Yeah. Um. They point out though in 0:19:27.920 --> 0:19:30.880 this article, ideally you're having that surgery that day. Yeah, 0:19:31.160 --> 0:19:36.240 but if you within hours, within minutes, they're talking ideally Basically, 0:19:36.240 --> 0:19:38.680 the sooner the better. As soon as they're ready to go, 0:19:38.880 --> 0:19:41.640 you should be ready to go as well. But you're right, Um, 0:19:41.680 --> 0:19:44.200 if that is not the case and you have uh, 0:19:44.440 --> 0:19:47.200 some good refrigeration going on, you can last for about 0:19:47.200 --> 0:19:49.600 four days. Yeah, and apparently it's not even necessarily the 0:19:49.600 --> 0:19:55.000 skin tissue that um that leads to problems and reattachment 0:19:55.040 --> 0:19:59.480 after being exposed or room temperature. It's muscle degradation. Oh yeah, 0:19:59.600 --> 0:20:03.240 interest thing. Uh. So you you get there, you're getting 0:20:03.240 --> 0:20:07.760 your surgery done. Um, you probably are going to expect 0:20:07.800 --> 0:20:10.920 to go through that first long surgery bone reattachment, blood vessel, 0:20:11.160 --> 0:20:15.520 maybe some muscle fiber and sure, and then they'll say 0:20:15.800 --> 0:20:18.840 we'll put the nerves off for later. Um. And then 0:20:19.240 --> 0:20:21.199 later on down the road will be a skin graft 0:20:21.240 --> 0:20:25.240 of some kind, like a UM free flap surgery like 0:20:25.280 --> 0:20:30.199 I was talking about. And the free uh refers to 0:20:30.280 --> 0:20:33.240 the the free like this part of this tissue from 0:20:33.280 --> 0:20:36.200 your body has been removed the donor site. Oh, it's 0:20:36.240 --> 0:20:40.760 not the cost of the surgery, it's it's been cut free. Right, 0:20:41.240 --> 0:20:45.520 And then you have that makes sense and then UM, 0:20:45.560 --> 0:20:48.880 it really is simpler than you think. It's reattaching and 0:20:49.080 --> 0:20:52.760 hopefully everything takes and you fight the infection off and 0:20:52.920 --> 0:20:56.560 you start the rehab process, which, UM, it takes a 0:20:56.600 --> 0:21:00.480 long time, and it's it's grueling and not fun. It 0:21:00.520 --> 0:21:03.639 can be weird at first. Uh. They point out the 0:21:03.680 --> 0:21:05.560 article and be weird to look down and see your 0:21:05.720 --> 0:21:08.320 army attached. But I imagine no weirder than looking down 0:21:08.320 --> 0:21:11.960 and seeing your arm not attached. You know, it would 0:21:11.960 --> 0:21:14.560 probably be a comfort to see it reattached. But you're 0:21:14.560 --> 0:21:17.080 a jerk if you're like, oh, it's kind of crooked. Yeah, 0:21:17.600 --> 0:21:21.400 but apparently sometimes it can feel a little different, and 0:21:21.600 --> 0:21:24.280 uh that can be a little strange and off putting. 0:21:25.160 --> 0:21:28.600 It's not like, oh, I'm just like I was before, right, 0:21:28.720 --> 0:21:31.600 you know, better than ever? Um and Tom wrote this 0:21:31.600 --> 0:21:35.440 one my good friend time chief, he said. He also 0:21:35.480 --> 0:21:39.040 talked about something called cross transfer. This was mind blowing, 0:21:39.119 --> 0:21:43.880 which is basically like if if just re plantation is Frankensteinian, 0:21:44.240 --> 0:21:47.680 this is even more so. Yeah, I didn't quite get 0:21:48.760 --> 0:21:53.000 the purpose of the hand. Uh, Basically, you're getting a 0:21:53.000 --> 0:21:56.080 a left hand on your right arm. Let's say, Uh, 0:21:56.200 --> 0:21:59.159 so your thumb and your pinky would be in weird places, right, 0:21:59.200 --> 0:22:03.840 your palms still facing the right direction, but thumb is switched. Yeah. Yeah, 0:22:03.840 --> 0:22:06.280 but what's what's the point of that if you have 0:22:06.440 --> 0:22:08.439 a bad hand and a good hand. I don't know 0:22:08.480 --> 0:22:10.920 if that's they only had like a left hand available 0:22:10.960 --> 0:22:13.280 at the time. I don't know that one. I got 0:22:13.320 --> 0:22:18.080 the other one where basically they take your lower leg 0:22:18.840 --> 0:22:21.359 beneath your knee. So like, if your upper leg is 0:22:21.440 --> 0:22:23.240 damaged and your lower leg is fine, let's just say 0:22:23.240 --> 0:22:25.800 your upper leg is wasted for whatever reason, but your 0:22:25.800 --> 0:22:28.919 lower leg is fine. They'll cut it off, the lower 0:22:29.000 --> 0:22:33.320 leg and basically turn it around right, and then your 0:22:33.359 --> 0:22:38.160 knee becomes locked. Your calf muscles then serve the function 0:22:38.200 --> 0:22:41.080 that your thigh muscles used to, and your knee joint 0:22:41.119 --> 0:22:43.720 is now in your ankle. Then you also are going 0:22:43.760 --> 0:22:46.560 to be wearing a prosthetic obviously because you have no 0:22:46.680 --> 0:22:51.000 thime muscles um and you're turned around foot which is 0:22:51.000 --> 0:22:55.680 now backwards. Is extra support for that prosthetic foot or leg, 0:22:55.720 --> 0:22:59.560