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Your limb is torn off - now what? · Stuff You Should Know

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  Speaker 1: Brought to you by the all New Toyota Corolla. Welcome
• 0:04
  Speaker 1: to Stuff you Should Know front House, Stuff Works dot Com. Hey,
• 0:14
  Speaker 1: and welcome to the podcast. I'm Josh Clark and there's
• 0:16
  Speaker 1: Charles W Chuck Bryant, and this is stuff you should
• 0:19
  Speaker 1: know because Jerry's over there. Dame, are you doing, buddy?
• 0:23
  Speaker 1: Besides sick, I'm not sick. I'm just I've got a
• 0:27
  Speaker 1: little bit of a bug. But never well, no, do
• 0:30
  Speaker 1: you think that's the first step in Yeah, and being
• 0:33
  Speaker 1: sick is saying I'm sick. I definitely believe in psycho
• 0:37
  Speaker 1: semitic effects. Yea, you know the mine has an impact
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  Speaker 1: on the body. Well, if you can be a hypochondria,
• 0:42
  Speaker 1: actually you can do the officer right, Yeah, yeah, you
• 0:46
  Speaker 1: can will yourself in not being sick. Anyway, people, the
• 0:48
  Speaker 1: show must go on. And I just want to point
• 0:50
  Speaker 1: out how dedicated my partner here is to his craft. Well,
• 0:53
  Speaker 1: I also want to say I want to promise that
• 0:55
  Speaker 1: it's not going to be like the great six weeks
• 0:58
  Speaker 1: on this of No. You know gets that was back
• 1:01
  Speaker 1: in the old days, the unhealthy days. I smoked and everything. Yeah,
• 1:04
  Speaker 1: your body didn't know how to heal, so it was
• 1:06
  Speaker 1: enjoying nicotine. Now I'm just like I'm I'm not getting sick.
• 1:10
  Speaker 1: I said it to myself last night, and here I
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  Speaker 1: am better than you ever Josh two point oh, thank you.
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  Speaker 1: All right, let's do this okay, ready, Yeah, I got
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  Speaker 1: a story for you. I bet I know it. I'll
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  Speaker 1: bet you. Yeah. Yeah. You saw. His name is Everett
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  Speaker 1: Knowles Jr. But everybody called him Eddie two days in
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  Speaker 1: a why I find the unwholesome. Yeah, And I didn't
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  Speaker 1: know Eddie could be short forever it never heard that.
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  Speaker 1: I don't think it is. I think he just didn't
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  Speaker 1: like his name, Okay, because it seems like you should
• 1:40
  Speaker 1: call him every Yeah, heavy heavy Evie. Yeah, of the Biggie,
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  Speaker 1: the big So he was a little e though he's
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  Speaker 1: a little guy, tiny, like a little Elvis. That's right. Uh, well, Eddie,
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  Speaker 1: we'll call him Eddie because that's what he preferred to
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  Speaker 1: be called. Sure. He was walking home from school one
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  Speaker 1: day in Somerville, Massachusetts, which is a suburb of Boston,
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  Speaker 1: and he was walking along the railroad tracks and there
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  Speaker 1: just happened to be a train loaded with gravel hauling
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  Speaker 1: out of the area very slowly while he was walking
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  Speaker 1: alongside and said, you know what, I'm just gonna have
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  Speaker 1: a little thrill right now and grab onto this train.
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  Speaker 1: And he did. He successfully grabbed onto the train, was
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  Speaker 1: hanging with I believe his right arm. Yeah, and uh
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  Speaker 1: was having the time of his life just dangling there
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  Speaker 1: when he misjudged the distance between the train side of
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  Speaker 1: the train and the side of a tunnel and he
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  Speaker 1: was pulled into the tunnel support and smacked it and
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  Speaker 1: hung on for a second before he was dropped off
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  Speaker 1: of the train. The train kept going through the tunnel,
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  Speaker 1: leaving Eddie kind of crumpled and in a little shivering
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  Speaker 1: mass at the mouth of the tunnel. So he stands
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  Speaker 1: up and he grabs his arm. He's like, oh, my
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  Speaker 1: arm doesn't feel very good. And he starts walking toward town.
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  Speaker 1: And apparently he walked about a hundred yards uphill when
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  Speaker 1: some workers saw him and said, grab that kid, because
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  Speaker 1: he was covered in blood, he was staggering, he looked
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  Speaker 1: like he was out of he's clearly in shocks, and
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  Speaker 1: they grabbed it, ran and got a woman. Because at
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  Speaker 1: the time, this is nineteen sixty two, a woman was
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  Speaker 1: the only one who could provide any kind of initial
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  Speaker 1: emergency care um and a clerk at I believe some
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  Speaker 1: sort of warehouse um came out and started to apply
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  Speaker 1: pressure to this boy's wounds. But she had a little
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  Speaker 1: bit of trouble when she tried to close the wound
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  Speaker 1: with a tourniquet, she found that his arm wasn't attached
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  Speaker 1: to his body any longer, and he's just kind of
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  Speaker 1: holding it there. Very Luckily he was wearing a jacket,
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  Speaker 1: or else his arm would have been back at the
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  Speaker 1: mouth of the tunnel. Man. Can you imagine, like the
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  Speaker 1: guy's holding his arm basically to keep it from falling
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  Speaker 1: out of his jacket, although he didn't know that, you know, no,
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  Speaker 1: he didn't. He was in shock. Luckily, he was still
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  Speaker 1: lucid enough to like tell everybody who he was, where
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  Speaker 1: he lived, and uh. They called the the hospital, and
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  Speaker 1: the hospital scrambled some surgeons. But it wasn't until chuck
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  Speaker 1: um he got to the hospital and they started cutting
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  Speaker 1: his jacket off that they realized the extent of the damage.
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  Speaker 1: This kid's arm was torn clean off. But the operative
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  Speaker 1: word is clean, yeah, right. Because Eddie Everett Noels Jr.
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  Speaker 1: Of Somerville, mass On what May two became the first
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  Speaker 1: recipient of a full successful limb reattachments, first human recipient. Yeah,
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  Speaker 1: it's a good point. They had done that before dogs successfully,
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  Speaker 1: and they had they had done all the different surgeries
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  Speaker 1: that are required to reattach a limb, but they had
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  Speaker 1: never done all of them at once, like they'd reattach
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  Speaker 1: the nerves, they'd reattach bone, they've reattached blood vessels, but
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  Speaker 1: they had never had a full amputation and a human
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  Speaker 1: being successfully reattached. And um. From what I read, the
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  Speaker 1: doctor was I don't know about excited, but they had
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  Speaker 1: been looking for a case. I was because they thought, like,
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  Speaker 1: I think we can do this. We just need the
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  Speaker 1: right case right exactly, you know. And he called his
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  Speaker 1: buddy and he's like, I think we got one. Getting there,
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  Speaker 1: they got the They like you said, they'd successfully reattached
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  Speaker 1: artery's nerves, bone, that kind of thing, but never all,
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  Speaker 1: never the whole shebang. So they said, well, we know
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  Speaker 1: how to do this if somebody will just come along
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  Speaker 1: and present us with an arm pulled cleanly off, especially
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  Speaker 1: twelve year old, because that definitely worked at his advantage. Apparently,
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  Speaker 1: an artery when severed will plug itself up, especially in
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  Speaker 1: younger kids that plugging is way more successful and happens
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  Speaker 1: more quickly. So this kid just basically presented like the
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  Speaker 1: perfect case. The main artery, I guess his brachial artery
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  Speaker 1: leading out of his shoulder was a full like two
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  Speaker 1: inches out of the wounds. So like they had a
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  Speaker 1: lot to work with, and work they did. Uh. Yeah,
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  Speaker 1: and they the arm was on ice and they began
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  Speaker 1: working immediately. This is mass general, by the way, and um.
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  Speaker 1: They started with the arteries and veins, and then the
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  Speaker 1: nurse felt well, they all sort of sold color and
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  Speaker 1: they described as a glow kind of came back into
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  Speaker 1: the arm. This kid hopped the train, had his arm
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  Speaker 1: pulled up, and within two and a half hours they
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  Speaker 1: had gotten circulation back. Yeah. And the nurse scrabbed the
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  Speaker 1: hand and said, hey, it's warm. That's good thinking warm.
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  Speaker 1: She shook it, made it do the metal sign. Everybody
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  Speaker 1: in the operating theories laughing. Uh. The bone and the
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  Speaker 1: muscle and the nerve and the skin. Um happened in
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  Speaker 1: in later surgeries, and the I think the nerve. They
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  Speaker 1: made a pretty important decision at the time was to
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  Speaker 1: wait on that altogether, uh, and let it heal some
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  Speaker 1: more first, which is as it turns out, actually, as
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  Speaker 1: it turns out, most of this was sort of how
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  Speaker 1: they do it today, Like they perfected the process from
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  Speaker 1: that point through the seventies and in the eighties is
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  Speaker 1: when they really started like humming with limb reattachment. The
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  Speaker 1: only difference that I saw was and we'll get into
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  Speaker 1: it a little more, but um. They reattached the arteries
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  Speaker 1: first to get circulation, I guess, to keep from more
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  Speaker 1: and more tissue dying. Um. And then they reattached the
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  Speaker 1: bone by driving a screw and using a hammer. They
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  Speaker 1: nailed the screw into the marrow, and then reattached the
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  Speaker 1: arm bone. What is that femur? Now? Femurs in the leg?
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  Speaker 1: You think I would have looked this up already. Yeah,
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  Speaker 1: the upper arm bone. Then they drove that into the
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  Speaker 1: other end of the screw. Normally now though they do
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  Speaker 1: they retach the bone for supervide stability, so when you
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  Speaker 1: reattach the arteries and veins and stuff, they won't pull away. Yeah,
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  Speaker 1: and he uh, it was a success story because he
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  Speaker 1: ended up he was uh, he couldn't use that hand
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  Speaker 1: as his dominant hand any longer, which just said because
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  Speaker 1: he was a good picture. Yeah, but he um was
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  Speaker 1: able to eventually get enough use out of it to where,
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  Speaker 1: uh they said about like a left hander would have
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  Speaker 1: use of his right hand. So he just sort of
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  Speaker 1: had to switch that up. But for nineteen two that's
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  Speaker 1: pretty successful, especially considering in nineteen sixty was the very
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  Speaker 1: first microsurgery performed just two years previously at the University
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  Speaker 1: of Vermont. Oh yeah, go catamounts. But um, so microsurgery,
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  Speaker 1: that's really what we're talking about here. It's the use
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  Speaker 1: of a microscope to perform surgery. And when you're attaching,
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  Speaker 1: you're essentially sewing together little nerves and blood vessels like
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  Speaker 1: a millimeter in diameter. You need a microscope and a tiny,
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  Speaker 1: tiny little needle, right, and you're using tiny, tiny little
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  Speaker 1: sutra thread, which is about is is is big as
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  Speaker 1: a hair. That's the stuff you're using to to suiture
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  Speaker 1: these blood vessels back together. It's not no and it's
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  Speaker 1: an extremely involved um surgery, as you can imagine, but
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  Speaker 1: it's step by step. It's like, first you do the
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  Speaker 1: blood vessels, then you do the arteries um and you
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  Speaker 1: do muscles, ligaments, tendons, all this stuff, and you're doing
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  Speaker 1: it in this this process, but each each surgery, each
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  Speaker 1: part of the procedure is like an enormous surgery in
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  Speaker 1: and of itself. So like um, a limbery attachment, which
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  Speaker 1: is called um replantation. I thought it was gonna be
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  Speaker 1: called like limbery or something. Some people call it that.
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  Speaker 1: I'm a limist, the saucy. Your doctors call it limbery.
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  Speaker 1: But um, it usually is like as on a whole.
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  Speaker 1: The replantation surgery can last like an entire day. Yeah,
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  Speaker 1: it's it's intensive. Um And I read too that it
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  Speaker 1: uh the whole micro surgery. The concept of using a
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  Speaker 1: microscope for surgery was not accepted at first, Like the
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  Speaker 1: doctors and surgeons were like, now, like you, we can't
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  Speaker 1: do that. We have to look with our eyes. And
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  Speaker 1: so it had to be perfected sort of on the
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  Speaker 1: fringe by doctor by surgeons who are willing to like
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  Speaker 1: accept this might be the future and experiment in their basements.
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  Speaker 1: I guess so on hapless victim maybe or dogs. Yeah,
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  Speaker 1: I didn't get the and I didn't look it up,
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  Speaker 1: but I didn't get the impression from this article one
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  Speaker 1: way or the other how dogs lost their limbs to
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  Speaker 1: begin with, Like, was it accidental? And they're like, Okay,
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  Speaker 1: well this we'll reattach it. Or were they cutting dogs
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  Speaker 1: limbs off and then reattaching them, because I'm guessing it
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  Speaker 1: was probably the latter in it. Probably Yeah, I mean
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  Speaker 1: we've talked plenty about that kind of topic, because I mean,
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  Speaker 1: think about it. Why would dogs limbs be pulled off
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  Speaker 1: in any more frequency than humans limbs and hence present
• 10:51
  Speaker 1: more cases to practice on. I think they were cutting
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  Speaker 1: off dogs limbs and then reattaching, which is messed up. Yeah,
• 10:59
  Speaker 1: it is. So you were talking about microsurgery. What I
• 11:03
  Speaker 1: saw was replacing toes for thumbs got big sixties. That
• 11:09
  Speaker 1: was a big one. So you had a thumb on
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  Speaker 1: your foot or a big toe on your hands, big
• 11:14
  Speaker 1: toe on your hand, because apparently fifty to sevent of
• 11:18
  Speaker 1: all the utility in your hand is in your thumb,
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  Speaker 1: and if you're missing a thumb, you might as well
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  Speaker 1: just not have your hand. You don't need a big
• 11:25
  Speaker 1: toe quite as much. You can use a cane or
• 11:27
  Speaker 1: something like that thanks to your new toe thumb and
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  Speaker 1: um that that became perfected in the sixties toethumb. That's
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  Speaker 1: a good band name. And then uh in the seventies,
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  Speaker 1: um free flat tissue transfer became a big thing, which
• 11:43
  Speaker 1: is basically going to a part of your body, harvesting
• 11:47
  Speaker 1: an area of your body like under your thigh, your
• 11:51
  Speaker 1: abdomen um I think you're back, lower back, and then
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  Speaker 1: just basically taking the gap and sewing it back together. Right. Yeah,
• 12:00
  Speaker 1: so you have a scar, but you also have a
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  Speaker 1: portion of your body that's diminished in size um, and
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  Speaker 1: then taking that and using it to basically do what
• 12:09
  Speaker 1: we understand is a skin graft, which which requires microsurgery
• 12:13
  Speaker 1: as well. Um, it's just basically taking this part here
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  Speaker 1: and putting it back over here where there's a bunch
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  Speaker 1: of damage and reattaching all of the nerves and the
• 12:21
  Speaker 1: blood vessels and everything. Yeah, I saw when I was
• 12:23
  Speaker 1: looking up photos of this kind of thing, I came
• 12:27
  Speaker 1: across something that I had never seen before. And I
• 12:31
  Speaker 1: didn't I didn't get the story, but you could almost.
• 12:34
  Speaker 1: I mean I sort of gathered what was going on
• 12:35
  Speaker 1: just from the photo series. But someone was degloved on
• 12:40
  Speaker 1: the on their fingers basically from like the hand knuckles forward,
• 12:46
  Speaker 1: all the fingers had no skin, and they, from the
• 12:51
  Speaker 1: looks of it, they inserted it into an arm like
• 12:55
  Speaker 1: into a bicep the fingers and like they live there
• 12:59
  Speaker 1: for a while, like inserted under the skin of the arm,
• 13:04
  Speaker 1: and that that skin. They later would remove the fingers
• 13:09
  Speaker 1: and it came off as like a big flat skin
• 13:12
  Speaker 1: graph like sticking your hand in an envelope and uh,
• 13:15
  Speaker 1: eventually formed like webbed fingers and then fingers. That is crazy,
• 13:21
  Speaker 1: but like, I don't know, man, I just saw these photos.
• 13:24
  Speaker 1: I should have done. I mean, it doesn't really have
• 13:26
  Speaker 1: anything do with this, but it was just remarkable. They
• 13:28
  Speaker 1: see someone with their fingers stuck in their bicep under
• 13:32
  Speaker 1: the skin. Like, I'm having trouble visualizing this. I need
• 13:35
  Speaker 1: to see these photos. Yeah, I'll take about the show
• 13:38
  Speaker 1: out to you. Yeah, if you want to see some
• 13:40
  Speaker 1: really gross stuff, you can just google. Um. Microsurgery or
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  Speaker 1: replantation is another one. Yeah. Man, it's but amazing like
• 13:49
  Speaker 1: that they can. And I looked at so many of them.
• 13:51
  Speaker 1: I kind of got to that point where I was like, well,
• 13:53
  Speaker 1: this isn't gross. This is what the body looks like
• 13:56
  Speaker 1: without skin sometimes, and which is gross. Nuts. I wouldn't
• 14:00
  Speaker 1: grossed out bodies without skin or gross, I don't think so.
• 14:04
  Speaker 1: I think it's the beauty inside you couldn't desensitize my friend. Well,
• 14:09
  Speaker 1: before we get any further, Chuck, let's do a message break,
• 14:11
  Speaker 1: because I got some good stuff coming up. So Chuck,
• 14:21
  Speaker 1: we understand microsearcherry. Now it's frankensteiny in right. Yeah, you're
• 14:25
  Speaker 1: basically just sewing stuff together. Yeah, because I mean, like,
• 14:27
  Speaker 1: let's say you have a dead person who has a
• 14:29
  Speaker 1: great hand, and you have a live person who's got
• 14:31
  Speaker 1: a poor hand. You cut off the live person's hand,
• 14:34
  Speaker 1: cut off the dead person's hand and attached the live
• 14:37
  Speaker 1: or the dead person's hand and a live person. That's
• 14:40
  Speaker 1: that's Frankenstein and that's what they're doing. And it's pretty cool. Um,
• 14:45
  Speaker 1: But if this ever happens to you, if if say,
• 14:47
  Speaker 1: you have a poor hand in that it's no longer
• 14:50
  Speaker 1: attached to your wrist, han sucks, right, and it's all
• 14:55
  Speaker 1: crushed and damaged or whatever. No, no, no, let's say
• 14:58
  Speaker 1: it's intact. And you say, you know what, I think
• 15:02
  Speaker 1: through my shock that I might be a good candidate
• 15:04
  Speaker 1: for replantation of my hand. Yeah, what do you do? Well,
• 15:08
  Speaker 1: you want to call mine one one immediately, because that's
• 15:12
  Speaker 1: just the first thing you do. You get go ahead
• 15:13
  Speaker 1: and get folks on the way, or you can ask
• 15:16
  Speaker 1: someone with you to call nine one one. That's not
• 15:18
  Speaker 1: putting anyone out. Yeah, that's true. If you can't dial,
• 15:21
  Speaker 1: maybe you don't have hands, you can tell Sirie to
• 15:23
  Speaker 1: call nine one one. Yeah. I actually changed my series
• 15:27
  Speaker 1: to a dude, so it's not a her anymore, but
• 15:29
  Speaker 1: an englishman actually. Yeah, it's kind of fun, Reginald. I
• 15:33
  Speaker 1: don't know what his name is actually, but he'll say
• 15:36
  Speaker 1: stuff like, you know, I'll say call Josh and we'll
• 15:38
  Speaker 1: say ringing Josh. Oh yeah, instead of calling it. It's
• 15:42
  Speaker 1: classy kind of fun anyway. Um, you want to dial
• 15:46
  Speaker 1: mine one one, get them on the way, and then
• 15:48
  Speaker 1: immediately you want to just try and stabilize the patient.
• 15:50
  Speaker 1: You want to stop the bleeding, either with heavy pressure
• 15:53
  Speaker 1: or a tourniquet above the wound like a sixties female.
• 15:57
  Speaker 1: Yeah exactly. Uh. And once you get the patient, UM,
• 16:01
  Speaker 1: stabilize and they're not going to bleed out there in
• 16:03
  Speaker 1: the kitchen or wherever it is. Um, you want to
• 16:06
  Speaker 1: get the digit or the hand or the limb and
• 16:10
  Speaker 1: put it on ice, but not directly on ice. Put
• 16:13
  Speaker 1: it in a bag and then put that bag on ice. Yeah,
• 16:16
  Speaker 1: you want to pack pack it in ice, as much
• 16:19
  Speaker 1: ice as you can find, but you want to make
• 16:20
  Speaker 1: sure that in the bag that you put the hand
• 16:23
  Speaker 1: or the digit or whatever in there's no ice and
• 16:25
  Speaker 1: there's no water, because water causes it to shrivel, and
• 16:29
  Speaker 1: that means you won't be able to reattach it. Yeah,
• 16:31
  Speaker 1: and ice you can actually if I put if I
• 16:34
  Speaker 1: cut off my finger and I threw it in a
• 16:35
  Speaker 1: bucket of ice, it could actually get frostbite. Yeah, that's crazy,
• 16:39
  Speaker 1: That is crazy, but it's also pretty cool. And you
• 16:41
  Speaker 1: don't want frostbite on your because you know you won't
• 16:44
  Speaker 1: be able to use it anymore. Now. Frostbite is just
• 16:47
  Speaker 1: um dead tissue brought about by exposure to extreme cold.
• 16:52
  Speaker 1: That's right. So after the T shirt right there is
• 16:56
  Speaker 1: after you've got it on the ice, in the bag,
• 16:58
  Speaker 1: on the ice, you've call nine one one, you've got
• 17:01
  Speaker 1: the bleeding stopped. You want to cross whatever fingers you
• 17:04
  Speaker 1: have remaining and hope that you've got a good hospital
• 17:07
  Speaker 1: nearby with some surgeons that aren't doing much at the moment,
• 17:11
  Speaker 1: or who are willing to cancel their schedules and say
• 17:15
  Speaker 1: let's go do this. Yeah, get off the golf course.
• 17:17
  Speaker 1: So when you get to the hospital, there's some things
• 17:19
  Speaker 1: you can expect. If all of your surgeons have come
• 17:22
  Speaker 1: in from the golf course, they should be ready and
• 17:24
  Speaker 1: waiting for you. And um, like we said, first they're
• 17:27
  Speaker 1: going to reattach the bone to provide stability um for
• 17:31
  Speaker 1: the rest of the surgery. And there's probably still going
• 17:34
  Speaker 1: to be a little bit of a gap there because
• 17:36
  Speaker 1: they need to get in there. Um. And then they
• 17:39
  Speaker 1: start reattaching your your blood vessels. And just like with
• 17:44
  Speaker 1: Eddie Knowles, um, that just gets you know, the blood
• 17:49
  Speaker 1: flow going and essentially makes that limb alive once more well,
• 17:54
  Speaker 1: and it also keeps it from further dying. Um, because Chuck,
• 17:58
  Speaker 1: it turns out that like there is a a finite
• 18:00
  Speaker 1: amount of time, which is understandable, but we we are
• 18:04
  Speaker 1: aware of how much time a limb can just sit
• 18:06
  Speaker 1: around in the hot sun starting to go you know,
• 18:10
  Speaker 1: fit it. And there's so for example, um, if you
• 18:15
  Speaker 1: have a whole arm or a whole leg cut off,
• 18:17
  Speaker 1: remember death Proof, Yeah, that girl has her legs like
• 18:21
  Speaker 1: sticking out of the window and mad Mike is that
• 18:24
  Speaker 1: his name Russell when he hits him and her legs
• 18:28
  Speaker 1: goes Um, if she had survived and her leg just
• 18:33
  Speaker 1: laid there out at room temperature, Um, it could have
• 18:36
  Speaker 1: been good for six to twelve hours. I imagine you're
• 18:40
  Speaker 1: really pushing it at twelve hours. But if say you
• 18:44
  Speaker 1: have somebody who's like this leg needs to be put
• 18:46
  Speaker 1: on ice and does everything right, it could stay refrigerated
• 18:50
  Speaker 1: for four days and still be reattached. Yeah. Um. They
• 18:54
  Speaker 1: point out though in this article, ideally you're having that
• 18:56
  Speaker 1: surgery that day, but if you within hours, uh, within minutes,
• 19:01
  Speaker 1: they're talking. Ideally, Basically, the sooner the better. It's as
• 19:04
  Speaker 1: soon as they're ready to go, you should be ready
• 19:07
  Speaker 1: to go as well. But you're right, Um, if that
• 19:09
  Speaker 1: is not the case and you have uh some good
• 19:12
  Speaker 1: refrigeration going on, you can last for about four days. Yeah.
• 19:15
  Speaker 1: And apparently it's not even necessarily the skin tissue that
• 19:18
  Speaker 1: um that leads to problems and reattachment after being exposed
• 19:23
  Speaker 1: or room temperature. It's muscle degradation. Oh yeah, interesting. Uh,
• 19:28
  Speaker 1: So you you get there, you're getting your surgery done. Um,
• 19:32
  Speaker 1: you probably are going to expect to go through that
• 19:35
  Speaker 1: first long surgery phone reattachment, blood vessel, maybe some muscle
• 19:39
  Speaker 1: fiber and then sure, and then they'll say we'll put
• 19:43
  Speaker 1: the nerves off for later. Um, and then later on
• 19:46
  Speaker 1: down the road will be a skin graft of some kind,
• 19:49
  Speaker 1: like a UM free flap surgery like I was talking about.
• 19:53
  Speaker 1: And the free uh refers to the the free like
• 19:59
  Speaker 1: this part of this issue from your body has been
• 20:01
  Speaker 1: removed the donor site. Oh, it's not the cost of
• 20:04
  Speaker 1: the surgery, it's it's been cut free, right, And then
• 20:08
  Speaker 1: you have makes sense and then um, it really is
• 20:13
  Speaker 1: simpler than you think. It's reattaching, and hopefully everything takes
• 20:17
  Speaker 1: and you fight the infection off and you start the
• 20:20
  Speaker 1: rehab process, which um, it takes a long time, and
• 20:24
  Speaker 1: it's it's grueling and not fun. Uh. It can be
• 20:28
  Speaker 1: weird at first, uh, they point out in the article,
• 20:31
  Speaker 1: And be weird to look down and see your army attached.
• 20:33
  Speaker 1: But I imagine no weirder than looking down and seeing
• 20:35
  Speaker 1: your arm not attached. You know, it'd probably be a
• 20:39
  Speaker 1: comfort to see it reattached, But you're a jerk if
• 20:42
  Speaker 1: you're like, oh, it's kind of crooked. Yeah, but apparently
• 20:46
  Speaker 1: sometimes it can feel a little different, and uh, that
• 20:49
  Speaker 1: can be a little strange and off putting. It's not like, oh,
• 20:53
  Speaker 1: I'm just like I was before, right, you know, better
• 20:56
  Speaker 1: than ever? Um and Tom wrote this one my good
• 20:59
  Speaker 1: friend time chief. He said. He also talked about something
• 21:03
  Speaker 1: called cross transfer. This was mind blowing, which is basically
• 21:07
  Speaker 1: like if if just re plantation is Frankensteinian, this is
• 21:12
  Speaker 1: even more so. Yeah, I didn't quite get the purpose
• 21:16
  Speaker 1: of the hand. Uh, Basically, you're getting a a left
• 21:20
  Speaker 1: hand on your right arm. Let's say, so your thumb
• 21:24
  Speaker 1: and your pinkie would be in weird places, right, your
• 21:26
  Speaker 1: palms still facing the right direction, but switched. Yeah, yeah,
• 21:31
  Speaker 1: but what's what's the point of that if you have
• 21:33
  Speaker 1: a bad hand and a good hand. I don't know
• 21:35
  Speaker 1: if that's they only had like a left hand available
• 21:38
  Speaker 1: at the time. I don't know that one. I got
• 21:40
  Speaker 1: the other one where basically they take your lower leg
• 21:46
  Speaker 1: beneath your knee. So like if your upper leg is
• 21:48
  Speaker 1: damaged and your lower leg is fine, let's just say
• 21:50
  Speaker 1: your upper leg is wasted for whatever reason, but your
• 21:53
  Speaker 1: lower leg is fine. They'll cut it off the lower
• 21:56
  Speaker 1: leg and basically turn it around right, and then your
• 22:00
  Speaker 1: knee becomes locked. Your calf muscles then serve the function
• 22:05
  Speaker 1: that your thigh muscles used to and your knee joint
• 22:08
  Speaker 1: is now in your ankle, then you also are going
• 22:11
  Speaker 1: to be wearing a prosthetic obviously because you have no
• 22:13
  Speaker 1: thime muscles um, and you're turned around foot which is
• 22:18
  Speaker 1: now backwards. Is extra support for that prosthetic foot or
• 22:22
  Speaker 1: leg or limb? Wow, it's pretty cool. It's basically saying like,
• 22:26
  Speaker 1: how can we take this and use it to even
• 22:29
  Speaker 1: better utility now that its original purpose has been destroyed? Yeah,
• 22:32
  Speaker 1: it's pretty cool. Yeah. I tried to find photos of
• 22:34
  Speaker 1: a cross transferred hand, but I couldn't find any photos,
• 22:39
  Speaker 1: and weirdly, pictures of Madonna kept popping up. Does she
• 22:43
  Speaker 1: have something? I don't know, dude, Like I tried all
• 22:48
  Speaker 1: sorts of Google searches and she images of work kept
• 22:51
  Speaker 1: popping up, So I don't know. Maybe she's got two
• 22:54
  Speaker 1: left feet or something. She does not? What was that
• 22:57
  Speaker 1: in uh Waiting for Guffman? Uh? He literally had two
• 23:02
  Speaker 1: left feet. It's kind of a dumb joke, wasn't I
• 23:04
  Speaker 1: thought it was? Yeah, So, Josh, that's one way we
• 23:08
  Speaker 1: talked about microsurgery. But there's perhaps another even better way
• 23:12
  Speaker 1: which will cover right after this message break. All right,
• 23:21
  Speaker 1: so we've discussed how you can have surgery, but there
• 23:26
  Speaker 1: may be an actual way to regrow things. Yeah, this
• 23:29
  Speaker 1: is far, by far the more prefable of the two. Yeah,
• 23:32
  Speaker 1: like fingers, but not like you know, you can't lose
• 23:36
  Speaker 1: a whole finger and regrow. It's got to be above
• 23:38
  Speaker 1: the bone. Like let's say you get the tip of
• 23:40
  Speaker 1: your finger, like your fingernail cut off and you can't
• 23:44
  Speaker 1: find it. And even better, this just involves like dumping
• 23:47
  Speaker 1: a magic powder on that that wound. So if you
• 23:51
  Speaker 1: if you have your finger cut off below the nail,
• 23:54
  Speaker 1: right below the nail, which happened to a guy in Cincinnati,
• 23:57
  Speaker 1: um in two thousand and five who owned a hobby op. Yeah.
• 24:00
  Speaker 1: I used to love those places. Man, I go in
• 24:03
  Speaker 1: and be like, I just want all the model airplanes
• 24:06
  Speaker 1: and everything. Yeah, Eddie's Trick Shop in Atlanta was my
• 24:08
  Speaker 1: go to, which I've just discovered still exists, um, not
• 24:14
  Speaker 1: too far from my house. Is it a magic shop?
• 24:16
  Speaker 1: It's it's like everything, Like they had models and had
• 24:19
  Speaker 1: magic kits, they had you know, Whoopie cushions was sort
• 24:22
  Speaker 1: of like a catch all. Yeah. I liked both of those,
• 24:25
  Speaker 1: but I never went to one that was the same anyway. Um,
• 24:30
  Speaker 1: this guy, this hobby shop owner, as far as we know,
• 24:33
  Speaker 1: he sold no magic items. Um, he was demonstrating why
• 24:37
  Speaker 1: a motor was very dangerous in an RC plane. He
• 24:39
  Speaker 1: did a good job, I guess, and cut his finger
• 24:41
  Speaker 1: off and uh, apparently his brother was had something to
• 24:48
  Speaker 1: do with finger with tissue regeneration and said he was
• 24:51
  Speaker 1: in the biz. Yeah. The guy went to the doctor
• 24:53
  Speaker 1: the hospital, and doctors like, we'll give you a skin
• 24:56
  Speaker 1: graft to just kind of cover this weirdness. But um,
• 24:59
  Speaker 1: you know, you lost your finger. T s. And the
• 25:03
  Speaker 1: guy's brother was like, don't get the skin grap just yet.
• 25:05
  Speaker 1: Come over, I'll give you a beer, and um, I'm
• 25:09
  Speaker 1: gonna put some I'm gonna put some something that's called
• 25:12
  Speaker 1: extracellular matrix on your wound and let's see what happens.
• 25:17
  Speaker 1: And they did yea, and magic happened. Then it regrew.
• 25:21
  Speaker 1: The guy not only regrew his finger, he regrew apparently
• 25:26
  Speaker 1: not the bone, but very surprisingly the nail bed and fingernail,
• 25:31
  Speaker 1: which apparently, like you don't grow a nail bed back,
• 25:33
  Speaker 1: like even if you cut off just the tip of
• 25:35
  Speaker 1: your finger like that nail beds never growing back. This
• 25:38
  Speaker 1: guy's nail bed grow back. That's awesome. Extracellular matrix is awesome. Um.
• 25:44
  Speaker 1: That's basically like the glue that holds ourselves together. And um,
• 25:49
  Speaker 1: not just us, plants and animals and trees and they
• 25:52
  Speaker 1: all have it uh in it. Uh, it's functions outside
• 25:57
  Speaker 1: the body cells. That's why it's called extra cellular obviously.
• 26:00
  Speaker 1: And it's collagen. We talked a lot about collagen, the
• 26:03
  Speaker 1: protein that's um, you know, super good for all kinds
• 26:07
  Speaker 1: of things, especially Yeah, like you know it's in skin
• 26:11
  Speaker 1: cream and stuff like that. Um. So typically what they
• 26:15
  Speaker 1: use is, uh, this was a powder from pig bladder.
• 26:18
  Speaker 1: But um, I've seen I saw a video on the
• 26:22
  Speaker 1: New York Times site that showed how they do it today.
• 26:25
  Speaker 1: And this is mainly for um like, uh, let's say
• 26:29
  Speaker 1: you got you didn't want a skin graft for some reason,
• 26:33
  Speaker 1: or it wasn't possible to get a skin graft, and
• 26:35
  Speaker 1: you've you've lost all the skin on your thigh. It
• 26:37
  Speaker 1: would get a pig bladder and they they spread it
• 26:41
  Speaker 1: out and they remove all the cells. Basically, Yeah, because
• 26:45
  Speaker 1: this stuff doesn't have pig cells, No, it doesn't have
• 26:48
  Speaker 1: just harvested from a pig body. Yeah, but they still
• 26:51
  Speaker 1: remove the cells and all the DNA with like a
• 26:53
  Speaker 1: chemical bath, and basically what's remaining is the matrix. And
• 26:56
  Speaker 1: it ended up drying it out and it looks like
• 26:59
  Speaker 1: and cut it into she and it looks like a
• 27:00
  Speaker 1: sheet of like parchment paper and then they will put
• 27:04
  Speaker 1: that on your leg and it immediately just starts going
• 27:07
  Speaker 1: to work. Yeah. They used to think that extracellular matrix
• 27:10
  Speaker 1: was just something that provided structure for cells to grow around,
• 27:14
  Speaker 1: like a fetal in the fetus. Yeah, because if you're
• 27:17
  Speaker 1: if you're in the fetus and like something happens, you
• 27:20
  Speaker 1: lose a toe. If you are a fetus, if you're
• 27:23
  Speaker 1: in the fetal position, uh, in the womb and you
• 27:27
  Speaker 1: lose a toe, that toes growing back. Yeah, you know,
• 27:30
  Speaker 1: you grow a vestigial tail that goes away. Your feet
• 27:34
  Speaker 1: and hands start out being web so you're growing a
• 27:36
  Speaker 1: lot of stuff and then getting rid of it. But
• 27:39
  Speaker 1: you can also regrows stuff that you're not supposed to
• 27:42
  Speaker 1: lose up to the age of about two, and then
• 27:45
  Speaker 1: I think the general ideas that the extra cebular matrix
• 27:48
  Speaker 1: just kind of goes dormant in humans, right, but they
• 27:52
  Speaker 1: thought that it was just structure, and then they realize
• 27:56
  Speaker 1: that no, this is actually creating some sort of signal
• 28:00
  Speaker 1: to the rest of the body to say, hey, don't
• 28:03
  Speaker 1: scar regrow instead, and it goes and recruits stem cells
• 28:07
  Speaker 1: and says, come over here, and let's rebuild this finger.
• 28:10
  Speaker 1: This hobby shop accident was too ironic. Let's reward this
• 28:14
  Speaker 1: man with a regrum finger, and don't forget the nail bed.
• 28:19
  Speaker 1: That's what ex cell your matrix says to everything else. Yeah,
• 28:22
  Speaker 1: and it's uh, it's pretty cool. The problem with um,
• 28:24
  Speaker 1: why you can't normally just regrow a finger is because
• 28:28
  Speaker 1: when something like that happens, the trauma happens, your body
• 28:31
  Speaker 1: says it recognizes it, and the immune system kicks in
• 28:35
  Speaker 1: and it's gonna swell up and get inflamed and scar
• 28:39
  Speaker 1: tissue is gonna start to form, and extra cellular matrix
• 28:42
  Speaker 1: prevents the inflammation, prevents scar tissue from forming and basically
• 28:47
  Speaker 1: tells the body like, no, I'm just gonna grow like
• 28:49
  Speaker 1: normally r scar tissue, just regular old cells. But like
• 28:53
  Speaker 1: you said, after a certain age, it just goes away,
• 28:56
  Speaker 1: like we have the extra cellular matrix still, but it's
• 28:59
  Speaker 1: function or its ability to trigger regrowth is just becomes
• 29:05
  Speaker 1: dormant or something happens to it. And with this pick
• 29:09
  Speaker 1: ladder stuff, um, they're they're starting to wonder, is there
• 29:14
  Speaker 1: a way that we can just trigger this naturally in
• 29:16
  Speaker 1: the body. And if that's the case, then say hello
• 29:20
  Speaker 1: to regrowing a whole head. I mean, you never know,
• 29:23
  Speaker 1: because they pointed out that like deer can regrow antlers
• 29:27
  Speaker 1: and um, things like that, and they're so different than
• 29:31
  Speaker 1: us sellar cellularly right because as bone, cartilage, skin, um,
• 29:37
  Speaker 1: all those things are in your hand, your arm, your leg,
• 29:41
  Speaker 1: and you would need to regrow all those two for
• 29:43
  Speaker 1: something to really be considered regrown. You can't just regrow
• 29:49
  Speaker 1: the leg but not the bone. It'd still be impressive,
• 29:51
  Speaker 1: but you're like, it's kind of flopped in there. Have
• 29:54
  Speaker 1: you ever seen the picture that UFC fighter. He's like
• 29:57
  Speaker 1: kicking the guy and he breaks his own leg and
• 30:00
  Speaker 1: it's just like almost like a cartoon or mcgahey, Oh yeah,
• 30:05
  Speaker 1: well it's mcgahey. Yeah. Yeah, that's stuff. Um triggers the
• 30:09
  Speaker 1: old mirror neurons big time. Makes me weak. Uh So
• 30:14
  Speaker 1: that's basically it. I mean, they they've been experimenting with
• 30:18
  Speaker 1: war veterans, Iraqi war veterans. Uh. And actually the New
• 30:21
  Speaker 1: York Times video, I saw that it was a war
• 30:23
  Speaker 1: veteran who was having this done to his thigh. Yeah right,
• 30:28
  Speaker 1: I think it was skin and tendons and yeah, and
• 30:32
  Speaker 1: it was you know, it looked at an early but
• 30:34
  Speaker 1: it was functioning and that counts. You got anything else? No,
• 30:39
  Speaker 1: I think that's it. There's literally nothing else to say
• 30:42
  Speaker 1: about I agree, sir. All right. Uh well, then if
• 30:47
  Speaker 1: you want to learn more about replantation, you can type
• 30:50
  Speaker 1: that word into the search bar how stuff works dot
• 30:52
  Speaker 1: com and it'll bring up a couple of cool things
• 30:55
  Speaker 1: at the very least. Also, um, type in extracellular matrix,
• 30:59
  Speaker 1: which is pretty cool founding um, and that'll bring up
• 31:02
  Speaker 1: another article too. And uh, since I said those things,
• 31:05
  Speaker 1: it's time for listener. Now, that's right, I'm gonna call
• 31:10
  Speaker 1: this correction. You get these from time to time. We
• 31:14
  Speaker 1: like to read him from time to time. Hey, guys
• 31:17
  Speaker 1: and Jerry love the work you do. I love listening
• 31:19
  Speaker 1: to the show. I wanted to write in though, with
• 31:21
  Speaker 1: a correction regarding Lewis and Clark. I'm working towards my
• 31:25
  Speaker 1: PhD in art history, and i am particularly interested in
• 31:29
  Speaker 1: the history of medicine and disease. On the middle of
• 31:32
  Speaker 1: the show, Josh mentioned that the adventure party inadvertently discovered
• 31:34
  Speaker 1: syphilis had not been known to Europeans upen to that point.
• 31:37
  Speaker 1: This is actually not quite the case. Syphilis goes back
• 31:40
  Speaker 1: pretty far in European history. It was first documented in
• 31:43
  Speaker 1: the late fifteenth century after a conflict between France and Italy,
• 31:47
  Speaker 1: and remained an issue for europe peaking around the mid
• 31:50
  Speaker 1: nineteenth century. Nineteenth century. That yeah, he said, okay, Josh
• 31:57
  Speaker 1: did have part of it right though when he said
• 31:59
  Speaker 1: that the part do you blamed it on Native American groups?
• 32:02
  Speaker 1: Early on everyone wanted to blame the disease on everyone else.
• 32:04
  Speaker 1: No surprises here, But after that initial conflict, the French
• 32:08
  Speaker 1: referred to syphilis as the Neapolitan sickness, while the Italians
• 32:13
  Speaker 1: named it the French sickness, a trend that continued as
• 32:17
  Speaker 1: the stuff spread. You if you're interested, it's really fascinating stuff,
• 32:22
  Speaker 1: especially the cures that became popular. Mercury was a really
• 32:27
  Speaker 1: nasty one. History of Syphilis by Claude Katel is a
• 32:31
  Speaker 1: pretty good reference. He read a book called The History
• 32:34
  Speaker 1: of Syphilis somebody wrote a book called the History of Syphilis. Anyway,
• 32:39
  Speaker 1: just wanted and that was claude q u e accent
• 32:43
  Speaker 1: of good t e l. He's French. Isn't that what
• 32:48
  Speaker 1: that's called? I don't remember anymore. I don't either. Anybody
• 32:52
  Speaker 1: just wanted to work out. Yeah, that is from Catherine.
• 32:57
  Speaker 1: I'm sorry, Kathleen Pierce nice into disease. Thanks in paintings
• 33:03
  Speaker 1: about disease. I guess so thanks a lot for letting
• 33:06
  Speaker 1: us know that, Kathleen. I feel like I've been set straight. Uh.
• 33:09
  Speaker 1: If you want to set us straight, we like to
• 33:14
  Speaker 1: be corrected, right, Yeah, and nothing better. Uh. All you
• 33:20
  Speaker 1: have to do is tweet to us to initiate contact.
• 33:23
  Speaker 1: You can tweet to us using our handle s y
• 33:25
  Speaker 1: s K podcast. You can go onto Facebook. That's another
• 33:28
  Speaker 1: great way to contact us. Yeah, you can complain there. Uh.
• 33:32
  Speaker 1: We people love doing that. We're at Facebook dot com
• 33:35
  Speaker 1: slash stuff you should know. You can send us an
• 33:37
  Speaker 1: email to stuff podcast to Discovery dot com. And although
• 33:41
  Speaker 1: you can't complain, uh, you can enjoy our website Stuff
• 33:46
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• 33:53
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