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Transcript
00:00Injuries, accidents, and illnesses
00:02from some of the biggest YouTubers you watch.
00:04Let's get started.
00:05Pee-woop.
00:07Listen.
00:08I'm listening, Casey.
00:09Talk to me, man.
00:11That's a crunchy knee.
00:12My knee sounds one-to-one the same.
00:16Okay, maybe not that bad.
00:17This is the moment of truth.
00:19The radiology center's right there,
00:21and they're gonna like,
00:22they're gonna look inside my knee.
00:24He went like this as if they're gonna do an ultrasound,
00:26which is unique, because most people get an MRI.
00:28Usually provides better imaging
00:30for the deeper ligaments within the knee.
00:32I haven't been totally irresponsible.
00:34The minute I felt a pain,
00:34I went to a guy, a running specialist.
00:36He taught me some stretches.
00:37I've been doing it.
00:38When he said a guy,
00:39I hope he means someone medically certified, right?
00:41No, I shouldn't even be able to run.
00:43I have no business running.
00:44I broke my leg about a decade ago.
00:46I broke it in 27 places.
00:4827 places.
00:49Is this right here?
00:51This is all metal.
00:52You know, our femurs actually have better
00:54tensile strength than steel and concrete.
00:57It's kind of cool.
00:58The doctor told me,
00:59Casey, you're never gonna be able to run again.
01:01But I was 26 years old then,
01:04and there's no way I was gonna let that doctor tell me
01:06I was never gonna run again.
01:10I run.
01:14I'm pretty sure every video that Casey has made
01:18when he was in his like, peak Casey era,
01:20he was running.
01:21So, listed out to you briefly,
01:24are basically what I see on the MRI, two things.
01:29I do wish that he told the doctor he was recording him.
01:31Yeah, it's something called a plica.
01:33It's a piece of tissue that connects on your kneecap,
01:36and it connects also to your IT band,
01:40and it pulls your kneecap out of alignment,
01:41and it causes cartilaginous wear and tear.
01:44Just to kind of fast forward,
01:46you can run, and you can even run now.
01:48I'm not worried.
01:49So it's basic, this part of the knee
01:51that gets inflamed sometimes through overuse.
01:54Kind of is a weird diagnosis,
01:56but it's basically a series of overuse and inflammation
01:59that is very, very treatable.
02:00Popping, cracking is not always dangerous,
02:03which is why I tell my patients
02:05that unless it's combined with other symptoms,
02:08in most cases, it's nothing to worry about.
02:10And in that moment, I squat down
02:12and let them hear my knees, which are pain-free.
02:14A little basketball action, two on two.
02:18Okay.
02:18Oh, I was gonna say knee gave out,
02:20but then he cracked his head on the hoop.
02:22Oh my God, oh my God, oh my God, oh my God.
02:23That's bad, that's bad.
02:25Remember, the scalp bleeds a lot
02:27because there's a lot of vital capillaries in this area.
02:30You could see it on the image.
02:38The superficial damage is not what I would be worried about.
02:41Why I'd be worried is we wanna make sure
02:42there's no fracture, and we also wanna make sure
02:44there's no swelling inside or a concussion.
02:47It really didn't hurt that bad.
02:48I just think that it's all the adrenaline.
02:50Like I wasn't in like serious pain,
02:52and then I haven't had any headaches since it happened.
02:55Well, not being in serious pain in the moment
02:57is not unusual.
02:59It's also really dangerous,
03:00and why athletes wanna rush back in
03:03after they have a concussive hit to the head.
03:05In fact, we even see behavior changes
03:08in athletes who experience a concussion.
03:10The most painful part was probably
03:12they jabbed the needle into my skull.
03:14The needle is for lidocaine,
03:16so he doesn't feel the staples.
03:17Which was painful, and then they stapled my skull,
03:20which was also painful.
03:21In many instances, we say don't even use the lidocaine.
03:25Let's just do the staples,
03:26because it probably will hurt less, and less pokes too.
03:28You guys ready?
03:29Ready.
03:30Ready.
03:31All right, let's go.
03:32As everyone shows up to do the stunt,
03:33in the middle of the lake.
03:34Oh my God!
03:35Oh my God!
03:38I feel like YouTube videos have gotten to the point
03:41where it's how extreme can we be
03:43in order to maximize the clickability of the video?
03:46And that could be good,
03:47but then it could also create a lot of problems.
03:50I just jumped out of a plane 20 times.
03:53What's the worst that could happen
03:55if I swing from a rope over a one foot deep lake?
03:58Oh my God!
04:06Oh my God, not only did he make contact with the thing,
04:10but then he also fell with his leg like that.
04:12There's actually a very common injury
04:14called the Liz Frank injury
04:16that happens when you get tossed off a horse,
04:18but your leg is still attached in the stirrup.
04:20And that reminds me of that.
04:22I wonder if that's the injury that he had.
04:24When I woke up in the hospital, I was in shock.
04:26I was in a lot of pain.
04:27I tore some ligaments in my leg.
04:28I broke my foot.
04:29I broke my hip.
04:30I shattered my skull in nine places.
04:32I shattered my eye socket.
04:33I almost lost my eye.
04:34Yeah, getting hit in the orbit is a very problematic injury
04:38because there's a lot of tissue behind those bones.
04:41There's the nasoethmoid area,
04:44the lacrimal area where your tears come from,
04:47the muscles that attach to that area,
04:49which make up your face
04:51and the muscles that control your orbital movements,
04:54your eye movements.
04:55These are all attached to those bones.
04:58And if there's enough damage,
05:00those muscles can change so much
05:02so that your whole facial appearance can change,
05:04its functionality can change,
05:06your ability to breathe and cry can change.
05:08These are big things for a human's,
05:11not just development, but I guess quality of life.
05:13But wow, brutal injury.
05:14Glad to see that he's up in his feet and training now.
05:17Last I saw, he was actually training with Casey Neistat,
05:19who we just saw earlier.
05:20A bunch of friends and I woke up super early one day
05:23to be overachievers
05:24and go to an interactive programming workshop.
05:26We all get there and things are going smoothly.
05:28I'm enjoying several delicious pastries
05:30at no expense to myself,
05:31but oh, starting to feel a little gurgly.
05:34My bowels were making a movement.
05:36Bowels moving means like you're gonna go to number two.
05:40Actual burbling inside your stomach is called borborygmi
05:44and not a bowel movement.
05:46Fun fact.
05:47Later, my roommate was talking to his then girlfriend
05:49and she was like,
05:50uh, that sounds a lot like appendicitis.
05:52You should take him to the hospital.
05:54Well, I mean, just being nauseous and having diarrhea
05:58does not alone point to appendicitis.
06:01If you have pain on the right lower quadrant
06:05and nausea, fever, vomiting, all these things,
06:08that could be indicative.
06:09Hey, Andy, we should go to the hospital.
06:14At the hospital, I'm asked a bunch of questions.
06:16Where does it hurt?
06:17How long has it been hurting?
06:18When did this start?
06:19These are really good questions.
06:21It's called OPQRST and each one
06:23stands for something specific.
06:25And then the doctor told me,
06:26I think you have appendicitis.
06:28We're gonna have to move you to urgent care.
06:29That's kind of backwards.
06:30Urgent care is not as urgent as emergency room care.
06:35Urgent care is like the middle ground
06:37between primary care, like in an office setting where I work
06:40and an emergency room.
06:41But appendicitis is most definitely emergency room,
06:43not urgent care.
06:44In the hospital, they take me to the scanner room.
06:46They needed to look inside of my sweet bod
06:49to assess the situation and to see how dire it was.
06:51We look in those situations
06:54to see if the appendix is inflamed, enlarged.
06:56If it has ruptured, where is the area that's being affected?
07:00And also we're trying to diagnose
07:01if it is in fact appendicitis.
07:02In many instances, it's not appendicitis.
07:04It could be something in a related organ,
07:06perhaps diverticulitis,
07:08which is an inflammation of the intestine
07:10through these out pouchings that exist over time.
07:12You have like little bouts that pouch out.
07:14That's called diverticulosis.
07:16And then from there,
07:17you can get an infection, diverticulitis.
07:19If they put you under for surgery,
07:21you need to have your stomach empty.
07:23Otherwise it can be dangerous.
07:24Again, not sure why.
07:26Well, the reason why is when you're sedated,
07:28you don't have access to your gag reflex
07:30so that if you do vomit,
07:32you could aspirate whatever that you're vomiting
07:35directly into your lungs.
07:36And that's problematic.
07:37That could cause infection, inflammation, lung failure,
07:40very dangerous stuff.
07:41To pump the stomach,
07:42you have to have a tube pushed down your throat.
07:45It's a long piece of plastic
07:46that you have to continuously swallow down
07:49until it reaches your stomach.
07:50And then they can turn it on
07:52and get all of this stuff out of your stomach.
07:54What he's describing here is a nasogastric tube
07:57that goes through your nose and goes into your stomach.
07:59And we could put it on suction.
08:01What's interesting about these devices
08:02is that you don't want it to have it
08:04to be permanently on suction
08:06because then it could actually attach itself
08:08to the wall of the stomach
08:09and then cause damage to that wall.
08:10So you want to do something known as intermittent suction
08:12where it's suctions, let's go.
08:14So it loosens off the wall if it gets caught
08:16and then it's suctions again and then let's go.
08:18Intermittent suction is usually the safer way of doing it.
08:20And then I woke up.
08:21Appendix-citic, appendix-less.
08:23I'm scared.
08:24Post-appendectomy.
08:27Hello.
08:28Hi.
08:29It's time for me to share one of my most deepest,
08:32darkest, saddest stories that I ever held inside
08:38and not told anyone in over 15 years.
08:41That's right.
08:42I broke my ass.
08:44His tailbone, his coccyx or his ischial tuberosities.
08:47Problem is I get really, really, really motion sick
08:51or seasick and anyone that gets seasick,
08:53you know how awful it is.
08:54Yeah, that's basically an over-activation
08:57of those semicircular canals
08:59where if you have hyperactivation of it,
09:02it can trigger you to feel nauseous.
09:04So I bought this motion sickness tablet
09:06which is supposed to help with it.
09:08A lot of these motion sickness tablets
09:09that people buy over the counter
09:11are usually antihistamine based
09:13and those are drowsy.
09:15They're sedating.
09:16They do work rather quickly
09:17on the motion sickness component.
09:19I was gonna sit down.
09:21Everything was fine.
09:22It was a beautiful sunny day.
09:23We were all drinking beer.
09:25Alcohol free, of course.
09:27I landed on a bench.
09:28I'm somehow doubtful of that.
09:29But the problem with that is you're combining
09:31a lot of sedatory effects.
09:33You have someone who is motion sick
09:36so their balance is already off.
09:37You have someone who is taking antihistamine probably
09:40which causes sedation.
09:42And then they're drinking alcohol
09:43which is also a depressant.
09:44You have all three things working against you there.
09:46We had to go to the hospital.
09:48We did the scan to confirm that yes, indeed,
09:51there was a crack in my ass.
09:53I wanna know what the ass crack is.
09:56If this is a true coccyx fracture
09:58which is a tailbone fracture,
09:59coccydynia or pain of the coccyx from a fracture
10:03does not really get treated surgically
10:06unless there's a major dislocation or displacement.
10:08It's just rest, sitting on one of those donut pillows
10:11and pain control.
10:12And pain control for coccydynia is really, really tricky.
10:15It's really painful, really uncomfortable.
10:18So on Tuesday, I told my sister
10:20that I thought I had a blood clot in my arm.
10:21I was like, hmm, something is wrong.
10:23Oh yeah, there's definitely something happening
10:25but it looks like there was something worn
10:27on the right arm.
10:29And there's definitely a discoloration, there's swelling.
10:31Yeah, there's definitely something happening
10:33that's causing increased pressure in that arm.
10:35Woke up the next morning,
10:35was supposed to record a podcast,
10:37decided that, hmm, we have a serious issue.
10:39The veins are starting to break in my shoulder.
10:42This arm is so swollen.
10:43I looked ripped.
10:44That type of venous swelling is telling us
10:47that there's some sort of obstructive process happening
10:49that the veins can't be drained outward.
10:52Unlike arteries, which are a little bit muscular,
10:54veins are thin walls.
10:55So they don't have the ability to push the blood out.
10:59The way veins allow blood to pass through them
11:02is by having little valves that are one-way valves
11:06where when the heart beats, the blood goes up.
11:08And then when the heart relaxes,
11:10the valve closes and prevents the blood from backflowing.
11:13Now, if there's a lot of pressure
11:15or there's not a lot of room for the blood to travel
11:18because of a blockage,
11:19those valves start becoming incompetent
11:22because the veins with their thin walls start to swell.
11:26And that's what likely was happening here.
11:28But now that we need to figure out
11:29and move up the chain of the body
11:31to figure out where that obstruction is coming from.
11:34My sister races me to the emergency room.
11:37I'm there, they do an ultrasound.
11:39They find a blood clot.
11:40So what we do is called a duplex ultrasound
11:42that allows us to see venous blood flow.
11:44And we can act by giving medications to thin clots,
11:48to bust clots,
11:49or perhaps go in and remove the clot surgically
11:52or minimally invasively.
11:53Oh, they wrote deep vein thrombosis.
11:56That's a diagnosis that needs to be acted on urgently
11:59because if that clot becomes dislodged,
12:01it can get shot into the pulmonary system
12:03where it then creates a pulmonary embolism.
12:05We're gonna have to do a thrombectomy,
12:07which is where they take a catheter
12:09and shove it into your vein
12:10and pump medicine into the clot.
12:13That's what we were talking about
12:14when I said minimally invasively.
12:16We do that.
12:17We go in, they put the catheter
12:18and they decide that they're gonna do this drug
12:20called TPA to dissolve it.
12:22I didn't know what that was.
12:23I was freaking out.
12:24TPA stands for tissue plasminogen activator.
12:27This is something we give in strokes.
12:28The risk factors to it is bleeding.
12:30Bleeding in the brain, incredibly dangerous
12:32because it's very hard to control.
12:33Bleeding in the arm, dangerous,
12:34but you can control that surgically.
12:37Definitely tricky substance to give
12:38and you wanna give it just in the area
12:41where it needs to be.
12:42In the brain, you kind of have to send it there.
12:44Here, you can be a little bit more accurate
12:46and deliver it directly to the spot where you need it.
12:49Here we are, third time's a charm.
12:51We go back in and this, thankfully, worked.
12:55There she is, clot free, woo!
12:59And with that being said.
13:00Well, my biggest question here is why did the clot form?
13:03Because DVTs that are unprovoked
13:06deserve to be worked up
13:08because there are very specific reasons
13:10why we expect clots to form.
13:11Like if you're immobilized for a long period of time
13:14and you're in bed and you're not moving,
13:15that could be a risk factor.
13:16If you took a really long plane ride,
13:18that could be expected.
13:19But if there's nothing that you did
13:21that should cause a clot,
13:22you should be investigating why that is happening.
13:25That evening, after they said that the clot was gone,
13:27it was dissolved, I started having chest pains,
13:30shortness of breath.
13:31I started getting a little worried
13:32and something did not feel right.
13:34I felt something like traveling.
13:36The thing that you want to really monitor
13:36in situations like this is EKG changes
13:39to see if the heart starts acting in any specific way.
13:42If you're seeing patterns of pulmonary embolism
13:44where the clot has traveled into the lungs.
13:46And then also to see if the heart is struggling anyway
13:48by drawing serial troponins, which are cardiac enzymes.
13:52These are byproducts that are released
13:54by the cardiac muscle of the heart when it is damaged.
13:57And that usually happens
13:58when the heart's not getting enough blood flow,
13:59usually due to a blockage.
14:01The girl's been unhooked from the heparin,
14:03which means I now have to take pill form.
14:05But hey, I had a pulmonary embolism,
14:08which means a piece of the blood clot broke off
14:11and went to my lungs.
14:12Yeah, that can happen as a result of the thrombectomy.
14:14As we said earlier,
14:15you are on medication for a period of time.
14:18Once the workup returns for reasons
14:21why you would be at risk for developing another blood clot,
14:23and that's all negative,
14:24then after a period of time,
14:25you can come off the blood thinning medication.
14:27If there is a reason why you are high risk for clots,
14:30you may have to stay on that medication.
14:32I have something called thoracic outlet syndrome.
14:34It comes in three kind of variations
14:36where there isn't enough space between your rib
14:39and the vein, the nerve, or the artery
14:42to kind of pass through.
14:43The area that she's talking about in thoracic outlet
14:46is between the clavicle, the first rib,
14:49and most importantly,
14:50the muscles called the scalenes of the neck,
14:53specifically the anterior and middle scalene of the neck.
14:56What you have there is a little triangle
14:58where the brachial plexus travels through,
15:01which is the nerves that travel out to your arm
15:03and give sensation and muscle control to your arm,
15:06as well as the subclavian artery and vein.
15:09So what she has is very rare,
15:11but it sounds like there's compression happening
15:13of that subclavian vein.
15:15Therefore, you have more likely a chance
15:18for a clot to form in that area.
15:20Amazing that she was able to share all that,
15:22survive it, give a really good medical explanation.
15:25Wow, shout out iJustine.
15:27Incredible sea survival stories.
15:29Click here, animated, narrated, really interesting.
15:32Click here to check that out.
15:34And as always, stay happy and healthy.
15:36♪ Happy hip hop music ♪