Thursday, 16 February 2012

Discovery

Unpredictability is an inherent part of trauma - you never know someone is going to get shot or stabbed, you never know when someone will crash their car, when someone will get hit by a train, or when someone will fall off a roof.  And when someone DOES get injured and I need to take that person to the operating theatre, I usually don't know the extent of their internal injuries until I'm already inside them.  Part of the fun of trauma surgery is finding out what's wrong and then fixing it.  It's about discovery.  It's the same sense of adventure that prompted Erik the Red, Marco Polo, and Vasco da Gama...sort of.  Ok, maybe not.

But some discoveries just aren't fun at all.  Take for instance a 19 year old woman who was referred to me for abdominal pain.  Gallstones?  No.  Stomach ulcers?  Not at all.  Appendicitis, perhaps?  Not even close.  Her favourite pastime was inserting sewing needles into her abdomen.  That's right - she took these...

 ...and pushed them through her abdominal wall until they were completely inside her.  How many?  Oh, about 14 or 15 at last count.  She chuckled a bit as she told me she just lost count.

Amazingly, none of them had done any real damage (other than some hideous scarring on her abdomen).  But now she had decided that she wanted them out because they were starting to hurt.

I said no.  Flat out, hands down, open and shut, definitive NO.

"But how can you leave them inside her??" I hear you asking.

If you haven't read my post about leaving bullets in, you can read about it here.  We don't usually remove foreign bodies in the abdomen, and this is much more dangerous - for me - than removing a bullet.  I looked carefully at her abdominal X-ray:
(Unfortunately, that's not her actual X-ray...she had a few more needles than this person.)

I then told her that there are at least 15 needles inside her, and any one of them could injure me (if I stick myself) or her (if I push the needle into something).

"But what can I do?" she asked me.

Go see a psychiatrist and get some ibuprofen.  In that order.

14 comments:

  1. Wow. Was she emo or something?

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  2. Sounds like some sick form of self harm acupuncture

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  3. I have a question based on personal experience. Isn't it true that foreign objects can cause infections?

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    Replies
    1. They can, but often the body can fight off whatever bacteria were on the object when it was inserted. I'm sure these sewing needles weren't sterilised before she inserted them, but yet she never got infected.

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  4. Lmao!! I absolutely love all of your blogs. Keep them coming. :)

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  5. i get the part about not removing foreign objects if they are not causing immediate danger, but how would the situation change if that woman got pregnant? wouldn't those needles post a thread to the babies life?

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    Replies
    1. Someone that stupid shouldn't be allowed to have children.

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    2. Oh, but they still do... the stupidest people have the most children!!

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  6. So, if someone pushed on her stomach where the needles had been inserted- could they possibly push the needles in farther?

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  7. This is hard for me to wrap my head around. Obviously you thought it would be more dangerous to take them out than remove them, so I'm assuming she can still lead a "normal" life? I'd be afraid they'd poke something.

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  8. Forgive the question,wouldn't certain moves that put stress to the abs force the needles deeper?

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    Replies
    1. Not really. Once the needles are there, the body walls them off with fibrous tissue.

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  9. "But now she had decided that she wanted them out because they were starting to hurt."

    No fucking shit. You didn't think of that *before*?! Like maybe, "What if I decide I don't want this needle in me someday? Maybe I shouldn't be inserting sharp foreign objects into my body." At least she came for professional medical help, though, instead of opting for a really strong magnet.

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