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Transcript
00:00Zach from the Try Guys got married,
00:02but he also had a terrible medical experience
00:04that we need to talk about.
00:06You may have seen me on Eat the Menu with Keith,
00:08but it's time to tackle Zach's medical concern.
00:11Let's get started.
00:11Be whoop!
00:13I stabbed myself with a four and a half centimeter
00:14shard of glass in the leg a month before my wedding.
00:17Why did he do that?
00:18I'm hoping this was an accident.
00:20So I take some picture frames
00:21and I decide to tuck them behind this treadmill
00:24that we never use.
00:25Treadmills are so incredibly dangerous.
00:28Obviously, I've seen how many injuries they cause,
00:30but I feel like many people have seen
00:32how many injuries they cause and serious ones
00:34because of the huge situation surrounding Peloton
00:37throughout the pandemic when they released their treadmill
00:39and actually young children
00:40were getting caught underneath them.
00:42So I'm power walking on the treadmill.
00:44I'm at the end of my 35 minutes
00:46and my legs are going back and forth, back and forth.
00:51I know where this is gonna go.
00:53And back, boom.
00:56I feel this electric shock just radiate,
01:00shoot through my foot.
01:01I feel a thousand tiny needles stab the bottom of my foot.
01:07I would later learn that this feeling
01:09is the shard of glass rubbing up against my nerve.
01:13Nerve pain is very unique.
01:15It's like electric, it spreads, it radiates.
01:17There's this tiny piece of glass sticking out of my leg.
01:20We remove the glass, we stop the bleeding
01:23and we go, okay, I think it's okay.
01:26But it's not okay if there's a cut,
01:27you still should get it treated
01:29because that's significantly deep of a cut
01:31and it's with a non-clean surface.
01:33So if a patient comes into my office with that,
01:36we decide whether or not the patient would benefit
01:38from an updated tetanus vaccine or a booster.
01:41So there's things that we need to keep in mind here,
01:43especially with the depth that I imagine it happened with.
01:46Four and a half centimeters shard of glass in my leg.
01:49I'm gonna make this part as quick as possible
01:51because we were at UCLA ER for 18 hours.
01:55And they have me in this makeshift room
01:56which is in the lobby
01:58with just like paper curtains around me.
02:00That's not, like that sounds terrible obviously for Zach.
02:03But in reality, a lot of our inner city hospitals,
02:06especially the ERs are so filled up
02:08that we have people in the hallways
02:10with no curtains, with no privacy.
02:12I'm getting x-rays, I'm getting CAT scans,
02:15I'm getting something called contrast
02:16which makes your CAT scan more effective,
02:18which also makes you feel like you're peeing yourself.
02:20That's fun.
02:21Contrast is basically an agent
02:23that you insert into your blood vessels
02:25through an IV and it then allows us
02:27to get a better visualization
02:29when we're looking for things that require blood supply.
02:31And then three different bedside doctors come
02:34and they go, I think I can give this a shot.
02:36And they just numb me and are wiggling around inside my leg
02:39trying to get the fricking piece of glass out.
02:42So I don't know what exactly the area,
02:44it's hard to tell from that image
02:45where the shard of glass is,
02:47but the fact that it's near his Achilles tendon
02:50makes me worried.
02:51It makes me worried for functionality of the tendon.
02:54Obviously the Achilles tendon is very important
02:56when we're walking.
02:57It's what allows you to push off and take that step,
02:59gives your calf muscle attachment to the foot.
03:01But also because of its depth,
03:03you have a lot of blood vessels there,
03:05nerves, as well as bone.
03:07That can lead to an osteomyelitis
03:09which is an inflammation due to an infection of the bone.
03:12And that requires IV antibiotics
03:14and an extended hospital stay.
03:16And we're going, hey, maybe we should go into the,
03:18go to the surgery team.
03:19And they're like, I got it, I got it.
03:21Surgery team or maybe the ortho team.
03:25And then they're like, oh, I don't got it.
03:26Three times.
03:28Ouch.
03:29The surgery team comes by and they say,
03:31hey, we're bringing you upstairs.
03:34Time to cut you open.
03:35I wake up from the greatest nap of my life.
03:39And I immediately text my friends and family this photo
03:43and say, I lived bitch.
03:45That's a confident person right there.
03:48The next few weeks would be spent icing
03:50and elevating and resting.
03:53During this time, Maggie was taking great care of me.
03:54My friends were taking care of me.
03:56I believe he was also in a previous video
03:59talking about how he has an autoimmune condition.
04:02I got diagnosed with ankylosing spondylitis.
04:05Where he was taking a medication
04:07that could potentially make you immunocompromised
04:09or immunosuppressed so that it could raise the chance
04:13of you developing an infection.
04:14I actually had to get off my medicine.
04:16That's something that I wasn't able to fit in the video.
04:18It is the most wound healing inhibiting medicine
04:23that you could ever be on.
04:24So for two months, I had to get off my medicine
04:27which caused a whole other slew of problems
04:29with my arthritic symptoms.
04:33But it also caused a lot of complications
04:36for the healing itself.
04:38Oh no.
04:39I'm just gonna cut to the chase
04:40and tell you it got infected.
04:43The skin is big and puffy and red and oozing.
04:47It's likely that a cellulitis has formed
04:49as a result of a post-operative complication.
04:51In patients who have recently undergone medical procedures
04:54or have spent time in the hospital,
04:56we consider those patients to be high risk
04:58for the development of cellulitis from MRSA
05:01which changes the type of antibiotics that you choose
05:04because MRSA means methicillin-resistant staph aureus.
05:09And in those situations, you need to use a medication
05:13like doxycycline or clindamycin
05:15that have some MRSA coverage.
05:18Your boy was growing not one but two infections.
05:22Two bugs inside my leg.
05:24Very cool.
05:25MSSA.
05:26All right, so this is interesting.
05:27He has MSSA which is methicillin-sensitive
05:31which means that you don't need to use
05:33the two antibiotics I mentioned earlier.
05:35It's one that is sensitive to other antibiotics,
05:38the ones we use more commonly.
05:40And serratia.
05:41It's serratia, not sore.
05:43Did you call me out for spelling serratia wrong?
05:47Serratia is usually what we call an opportunistic
05:50or nosocomial infection
05:52which means opportunistic that when you're immunocompromised
05:55like if you're on a medication for an autoimmune condition,
05:58you're undergoing chemotherapy.
06:00When you have a dropped immune system,
06:02a weaker immune system,
06:03that's when that bacteria is able to overcome
06:05your body's natural defenses.
06:07And then nosocomial means that you get it in the hospital
06:10because that's where that bacteria tends to be more found.
06:12These are not things that you would generally need
06:14to even worry about as a patient.
06:15This is more so for us when we get our cultures back,
06:18we actually grow this bacteria in a culture, in a medium,
06:23and then the report will tell us which bacteria is present
06:26and then what antibiotics this bacteria is resistant to
06:30and sensitive to so we can choose the right approach.
06:33And generally when someone is very sick in the hospital,
06:36like really sick,
06:37we start with a very broad set of antibiotics
06:39meaning broad so that they work on many different bacteria.
06:43We call them big guns in the hospital.
06:44And then once we get the cultures and sensitivities back,
06:47we can then narrow down the spectrum of activity.
06:51And the reason we do it this way is very strategic.
06:54I'll kind of do like a war reference.
06:56If you're using an antibiotic
06:58that treats all types of bacteria,
06:59it's like you're dropping a giant nuke.
07:00So lots of collateral damage to the human body.
07:03If you find out what the cultures sensitivities are,
07:05you can do a very targeted like laser guided strike
07:08and it goes right to the source of the bacteria
07:10and there's much less collateral damage.
07:12Okay, let's speed run this.
07:13I get another CAT scan.
07:14I have a hematoma
07:15and a big old cluster of infection in my leg.
07:17So hematoma is not surprising
07:19given the fact that there was so much blood loss.
07:21Hematoma is essentially a walled off section of blood.
07:24It can happen after trauma.
07:25Not to mention three pieces of glass
07:28they missed the first time.
07:29I get another surgery.
07:30I live bitch part two.
07:32They flush the wound out.
07:33They put this thing called a Pemrose.
07:34It's like a forbidden boba straw
07:36sticking out of my leg.
07:39It helps the wound drain and not get infected again.
07:41When wounds don't drain well,
07:43what happens is your body wants to naturally protect itself
07:46from the infectious agent
07:48and it creates a section around the infection.
07:51It creates like a pocket.
07:52That's what basically an abscess is.
07:54But when that happens,
07:55now you're stuck with that pocket of bacteria
07:57that can A, grow,
07:58or B, if it ruptures at any moment,
08:00it can be a surgical emergency.
08:01So that if you keep a drain in,
08:03all the bad stuff can keep coming out of your body
08:06while your body continues to fight off the infection.
08:08My wonderful wife had to pack my wound every single day.
08:12I had a four and a half centimeter hole in my leg.
08:16We wanted to keep that open.
08:17We didn't want it to heal over on the top.
08:19So she would take a sterilized Q-tip
08:22and some sterilized gauze and like poke,
08:26poke into my hole twice a day, every day,
08:28including on our wedding day.
08:30This time they keep me in the hospital for four days.
08:33At this point,
08:34I started filming a little more at the hospital
08:36because I was bored.
08:39Hey, I'm Pete.
08:40All right, so his pulse is quite high there, 94.
08:43Not sure if he's developing a fever
08:45cause that can make your pulse go up
08:46or he's just excited being on camera,
08:48but definitely a 94 for a comfortable resting pulse
08:52is a bit high.
08:52Finally, we got my antibiotic
08:54and we think I'm gonna get to go home today.
08:57The real fun starts three days after that
09:00when I start developing
09:02a fever.
09:03Oh no.
09:04When I have a patient leave,
09:06I give them things that they should anticipate,
09:08but also if things occur, what to do.
09:11And the first thing is if a fever starts,
09:13you gotta come right back or call us right away
09:14because that is a sign that there's some kind of infection
09:17or new infection happening.
09:18I am running a fever,
09:19which is a bad thing to be running
09:22if you've been fighting two infections inside your body
09:24and you're immunocompromised.
09:26There's this fear of the infection
09:28reaching your bloodstream
09:29and you entering something called sepsis.
09:32Yeah, so sepsis is definitely a concern.
09:35So sepsis and septicemia are two different things.
09:38Septicemia is when you start getting the bacteria
09:41actually or an infection in your bloodstream.
09:43Now, sepsis is the reaction of your body to the septicemia
09:48where your body almost like overreacts,
09:50causes this huge inflammatory cascade
09:53where your blood vessels ultra dilate,
09:55your blood pressure starts dropping,
09:57potentially driving you to septic shock,
09:58which can cause organ failure, increased clotting.
10:01You could see why there's an emergent situation
10:04about to occur.
10:05And to complicate things,
10:06I spent the day having diarrhea more times than I can count.
10:10And that's also problematic
10:12because he's been on so many antibiotics at this point.
10:14It puts you at a high risk
10:15for developing Clostridium difficile infection,
10:17which is also known as C. diff
10:19because one of the biggest risk factors for C. diff
10:21is taking antibiotics.
10:23The only way to know is to get a sample of the stool
10:26and send it out for C. diff toxin testing.
10:29We get to the emergency room.
10:32My heart rate was 130 when I was sleeping.
10:36So notice I was already paying attention
10:38to his heart rate before,
10:39but now it's going even higher
10:40because something's going on metabolically in his body.
10:43Part of that is his fever.
10:44When you have an infection and your fever is elevated,
10:47your pulse also goes up
10:48corresponding to your body temperature.
10:50Also, when you're dealing with an infection,
10:52your body requires more blood flow,
10:54the heart works harder.
10:55My white blood cell count, usually around nine,
10:58was 14 the first time I was infected.
11:00Now it's at 26.
11:02So that is very high and that's a sign
11:04that there is now a significant infection
11:06somewhere in the body.
11:07I cannot stop pooping.
11:11They make me give them a sample of the poop
11:14and they send me into the bathroom
11:15with a jar and a Popsicle stick.
11:19And when I tell you that this was not something
11:21that was Popsicle stickable,
11:2512 days out from my wedding at this point.
11:27So I am diagnosed not with sepsis,
11:29not with a reoccurrence of my infection,
11:31but with something new.
11:33I have C. diff.
11:35C. diff is basically a super infectious diarrhea bug.
11:39It's something that you commonly can get
11:41when you're on too many antibiotics.
11:44And now you have the big bad poop disease.
11:47The reason why antibiotics are a risk factor
11:49for the development of C. diff
11:50is because when you take antibiotics,
11:52you kill all the competing bacteria in the gut
11:54and the antibiotics don't kill the C. diff,
11:56so the C. diff multiplies
11:58and therefore becomes a predominant strain,
11:59causing infection, all these problems.
12:01It's super contagious.
12:02So anyone who comes in here has to wear a special guard.
12:05Hand sanitizer doesn't work because it is a spore.
12:09You have to wash your hands with soap and water.
12:12This is absolutely true.
12:13So any patient in the hospital
12:15that is being tested for C. diff
12:17or has already tested positive for C. diff
12:19gets put on something known as contact precaution
12:21where everyone puts on a gown
12:23because the way that this is spread
12:24is through contact, basically touching it,
12:26and then bringing it to your mouth.
12:28And as he said correctly,
12:30alcohol-based hand sanitizers don't work on the spore
12:32and you actually have to physically wash your hands.
12:35The medicine, god damn, medicine is great.
12:38And I am feeling so good, I am ready to go home.
12:42But because this story needs another turn,
12:46my insurance company will not approve.
12:49What?
12:49My medicine, I can't go home without my medicine.
12:52I got discharged from the ER.
12:54We go downstairs, we pack up.
12:57We're ready to go home.
12:58Then go to the pharmacy and they go,
12:59oh, your insurance hasn't approved this.
13:02You're not allowed to leave.
13:03And we're like, oh, we've been discharged.
13:04And they're like, well, no, no,
13:06you shouldn't have been discharged.
13:07You gotta go back upstairs immediately.
13:09And we go, hey, funny thing,
13:10I'm actually not allowed to leave yet.
13:12And the nurse looks at me and he's like,
13:13I checked you out already,
13:15so you're gonna have to go back to the waiting room.
13:18And I'm like, good sir, I can't go back
13:21to the waiting room.
13:22That's gonna be an eight-hour wait
13:23where I'm exploding out of my wounded buttocks.
13:27I can't go back.
13:28So they were trying to tell me
13:29that I had to go back to the waiting room,
13:31get readmitted, do the whole thing all over again.
13:34Spread C. diff across the entire hospital.
13:37Give it to everybody.
13:38So just so people know, the treatment for C. diff,
13:41especially for what looks like to be a non-severe case,
13:43it's hard to know exactly,
13:44but for the treatment for a non-severe case of C. diff,
13:47the medication that we use is vancomycin or fidaxomycin.
13:51Ironically, vancomycin, we usually only give through IV
13:54because when you take it orally,
13:56it doesn't get absorbed into your bloodstream.
13:59And as a result, if you have an infection somewhere
14:00and you take vancomycin,
14:02it won't get to where the infection is.
14:03However, if your infection is in the gut,
14:06vancomycin is perfect to be taken orally
14:08because it stays in the gut
14:09and treats your infection in the gut.
14:11There are obviously surgical situations
14:13where you need to act and do like a colectomy
14:15and actually take a part of the colon out.
14:17That's how bad C. diff can get.
14:18You can develop something known as toxic megacolon,
14:20very serious complication.
14:22But one of the unique things that we do
14:23to treat recurrent bouts of C. diff,
14:26which can happen in many patients,
14:27is doing a fecal transplant
14:29where you actually go with a colonoscope
14:31and put fecal matter from a family member
14:33directly into the colon.
14:35That brings in a wide variety of bacteria.
14:37As a result, they compete with the C. diff
14:40and the cure rates are actually pretty high.
14:41Side effects are pretty low and it works for many people.
14:44For three of these days, I am stuck in the emergency room
14:47because I don't think people realize this.
14:50Hospitals never recovered from COVID.
14:53And I don't just mean people getting sick from COVID,
14:56which yeah, is still a thing, is still happening,
14:59but it's just this backlog of patients
15:02and more people getting sick.
15:04This isn't even just a COVID issue, by the way.
15:06This has been an issue.
15:07And that's why the biggest issue early on with COVID,
15:11like the first two months,
15:12where we saw our hospitals get just beyond overwhelmed,
15:14like they were already overwhelmed.
15:16Now they were getting beyond overwhelmed.
15:17We need to figure out what's going on.
15:19Let's lock down and figure out what's happening
15:21because otherwise, if our healthcare system
15:23completely breaks, then everyone is screwed.
15:26The ER hallways, not the rooms,
15:28the hallways are lined back to back to back with beds.
15:31Everywhere you can see, every square inch of that place.
15:34And I'm stuck in the ER
15:36because the rest of the hospital is filled.
15:38It's called code red census.
15:40And the problem is also more hospitals continue to close.
15:44And as a result, it puts more strain on the other hospital.
15:48Nurses are burnt out.
15:49They are quitting.
15:50Hospitals are understaffed and overworked.
15:53So many of my nurses were traveling nurses
15:55who this was their first day in California,
15:58let alone this hospital.
15:59I mean, they didn't know where things were.
16:01They're just trying their best.
16:02The American health system is failing us.
16:05I know we like to really shit
16:07on the American healthcare system.
16:08And it is a disaster.
16:09I say it all the time.
16:10I just came back from France.
16:11I did a trip there presenting with Google and the WHO.
16:14And I spoke to a lot of their medical creators,
16:16doctors, nurses.
16:17They have their own problems, very similar to this,
16:20but on the other end of the spectrum
16:21because they're a nationally funded healthcare system.
16:23I talked to my colleagues in the NHS.
16:25They talk about the disaster
16:27that they're having with underfunding.
16:28People in Canada are having their own struggles.
16:30This is a problem universally,
16:32granted for different reasons.
16:34And I'm not saying that they're all equal.
16:35The problem is across the world.
16:37We need to really figure out this inequity that exists
16:41and stop the commercialization of healthcare,
16:43at least in this country.
16:44Finally, for the third time in a month,
16:47I was discharged from the hospital
16:50with seven days to go until my wedding.
16:53It was time to get married.
16:55Hey guys, so news update from the hospital.
16:59I'm out.
17:00Yeah, get me out of here.
17:02Let's go.
17:03I was able to walk down the aisle,
17:05dance the night away
17:06and have a party beyond my wildest dreams.
17:10But my ankle did swell up like crazy
17:13the next morning after from dancing.
17:14Ah, oops.
17:16That's from gravity, not just from dancing,
17:18just from standing.
17:18Actually, the dancing probably decreased the swelling.
17:21I got very lucky with how it went.
17:23I haven't really needed physical therapy.
17:25I've been able to just kind of work
17:26the strength back myself, so.
17:28Please be careful.
17:29That's the only message I'll leave here.
17:31We need you to continue staying happy and healthy.
17:35Despite the happy ending, that was a heavier video.
17:38So how about a laugh with a little bit of medical memes?
17:40Click here to check that out.
17:41And as always, stay happy and healthy.
17:43And congratulations to Zach.