The Brad Weisman Show
The Brad Weisman Show
Carpal Tunnel Syndrome with Dr. Nate Tiedeken
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Ever wondered how a bus ride to an Ed Sheeran concert could lead to an enlightening conversation with an Orthopedic Surgeon? Join us as we welcome Dr. Nate Tiedeken, who shares his expertise on the widespread issue of carpal tunnel syndrome. Discover what causes that nagging wrist pain and learn about practical solutions like using a hand brace at night. If you spend long hours at a computer or have been dealing with persistent wrist discomfort while sleeping, this episode offers invaluable insights.
Step into the rigorous world of medical school and orthopedic specialization with Dr. Nate. From grueling study schedules and the transition from medical school to residency, to the meticulous process of choosing a subspecialty in hand, elbow, and shoulder surgery, Dr. Nate’s journey is nothing short of inspiring. Hear about the growing trend of subspecialization in modern medicine and the significance of comprehensive diagnostics in his field. This is a must-listen for anyone curious about what it takes to become an orthopedic surgeon.
Prepare yourself for gripping tales from trauma calls and the balance of family life in Dr. Nate's career. From a patient with an axe in his back to a severe gunshot wound complicated by wound botulism, these stories underscore the critical importance of thorough examinations and quick thinking in high-pressure situations. Wrapping up, we talk about my own nerve conduction test adventure and share exciting plans for a live 200th episode. Don't miss this episode packed with medical wisdom, real-life drama, and a sneak peek into the life of an orthopedic surgeon.
"I'm so happy to share with you all, my friend, Dr. Nate Tiedeken! He's an orthopedic surgeon that specializes in hand, elbow and shoulders. I started getting Carpal Tunnel and luckily it could be remedied for now with a brace to wear at night. His reputation is amazing and I'm sure you'll really enjoy this lighthearted chat about 14 years of school, his amazing wife and kids and the crazy stuff he has seen being a doctor!" - Brad Weisman
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Welcome to The Brad Weisman Show (formerly known as Real Estate and YOU), where we dive into the world of real estate, real life, and everything in between with your host, Brad Weisman! 🎙️ Join us for candid conversations, laughter, and a fresh take on the real world. Get ready to explore the ups and downs of life with a side of humor. From property to personality, we've got it all covered. Tune in, laugh along, and let's get real! 🏡🌟 #TheBradWeismanShow #RealEstateRealLife #realestateandyou
Credits - The music for my podcast was written and performed by Jeff Miller.
from real estate to real life and everything in between. The brad weisman show and now your host, brad weisman. All right, here we go. Another show. This is going to be a good one. This is going to be a fun one. I think this is the first time, hugo, that we have a doctor in the house all right.
Speaker 2:Yeah, I think it is. We're moving up, we're moving up we are moving up.
Speaker 1:That's right, man. Yeah, we have a doctor in the house. All right, yeah, I think it is. We're moving up, we're moving up. We are moving up, that's right, man. Yeah, we have a doctor in the house today, which is amazing, and he, you know, I met this guy on a bus going down to see a concert, and I think the concert was Ed Sheeran, if I'm not mistaken, and we became friends instantly, while the bus was running out of gas, of course. But no, we have Dr Nate Teetigan here. I'm going to call you Nate Is that right.
Speaker 2:Yeah, nate, nate's my name.
Speaker 1:All right, that's right. You know it's funny. We met going down to Ed Sheeran, had a great time, awesome time, and what's really interesting is after that I started coming out with Caral tunnel. I is there something?
Speaker 2:that you put in my drink, Was it I did? I mean, eventually everyone's going to get it, so you might as well just get it now. You know, I mean that's it was funny.
Speaker 1:I meet an orthopedic surgeon right and all of a sudden I start having problems with my wrist. I'm like what is going on, like how does this work, you know? But no, it's cool. And thank God I did meet you, because I did start having a little bit of an issue, and that's why we have you on today is to talk a little bit about carpal tunnel. It's something that comes up a lot. I know my brother and my and my dad both have had the surgery. I thought I was heading in that direction but you actually helped me out and you, you, you diagnosed the, what it was like right away and you gave me the hand brace. What did do? Like I don't have any issues anymore.
Speaker 2:Well, I have other issues, but not that we don't have enough time, I think, to talk about all those, but listen. First of all, thanks for inviting me here. This is awesome I mean, I feel like a real famous person.
Speaker 1:Well, you are.
Speaker 2:I was. You know, like when you come home and you know my mom comes home.
Speaker 1:It's such a big deal. Yes, yes, yes. When dad comes home, it's always like oh, you're home, You're home.
Speaker 2:I've come home every day of your life.
Speaker 1:Or when you're already there for 10 minutes and they realize you're there.
Speaker 2:I come home today and I tell them that, oh you know, listen, I'm going to go do a podcast.
Speaker 1:Yeah right.
Speaker 2:I'm going to live my daughter's great.
Speaker 1:She wants me to wear that is awesome I want to thank you for making me the cool I should start charging for this.
Speaker 2:You know, I mean, start charging for that. No, but great, this is actually pretty cool.
Speaker 1:So, uh, thank you guys having me, yeah, no problem. So, yeah, what did you? What did? What happens with your wrist? What goes on there is it? You know and I wrote in my notes here is it computers is I?
Speaker 2:I think you said sometimes the way you sleep like doing this so carpal, carpal tunnel, very simple, is just a pinched nerve in your wrist. Okay, the wrist has one nerve that travels through a very tight tunnel, gotcha, so we call it the carpal tunnel because it's the wrist tunnel. That nerve, as it starts to get pinched, can have symptoms in your fingers. So the symptoms usually are tingling, numbness, worse at night because when we sleep, we all sleep with our fists clenched.
Speaker 2:So, we're flexing our wrists at night, right? So if your nerve is already getting a little pinched at night when you're sleeping, you pinch it more because you're flexing your wrist. So the brace is the easiest way of treating it, because you put a brace on at night. So when you can't protect your position, it protects it for you, it doesn't pinch it at night.
Speaker 1:Unbelievable. So very mild carpal tunnel can be treated with a brace. So so it. So is it. It's not started from at night. Is it because I think of the mouse? You know that we're using a mouse. Is that where what irritates it during the day, and then all of a sudden you go to sleep and it's worse? Or is it just it's always happening?
Speaker 2:at sleep we used to think we knew why it happened, so we don't't.
Speaker 1:Now we don't know anything Kind of like the egg thing we were talking about. Eggs are good for you, now they're not good for you. The white is good, but now the yolk's bad, and you switch it every five years, exactly. It just keeps people working and it keeps the egg people in business too.
Speaker 2:It's the art of medicine, right? That's what we think is. We do know that there are several other medical issues that can lead to carpal tunnel, such as diabetes.
Speaker 1:Oh my gosh, Really Diabetes can lead to it.
Speaker 2:Overweight can lead to it Because your body rides at a little bit of a higher inflammatory rate, so your body's a little more inflamed than someone who isn't diabetic or isn't overweight. Right, that can affect your nerves, that can affect your tendons, and so we see a higher instance of carpal tunnel in diabetic patients.
Speaker 1:Interesting.
Speaker 2:But that's not the only thing. I mean people who are on the computer all the time. That used to be one of the things we thought caused it. Now we're not so sure.
Speaker 1:But a lot of times with manual labor type positions it's very common to get it at an earlier age because of all the vibrations and everything that goes through those nerves Like a jackhammer guy oh for sure, yeah, I was going to.
Speaker 2:That's one I would think would be very abusive, very abusive. By the way, I don't do that often, yeah.
Speaker 1:Just so you know, that's not where mine came from. I just want to make that very clear. But no, that's interesting. And what do you do to treat that then? You gave me the brace. For me it worked. You said, like a lot of people, it doesn't always work.
Speaker 2:No, some people. It depends on how severe your carpal tunnel is, and so, depending if it's a mild case of carpal tunnel or a wrist brace and some gentle stretching may be all you need, everybody can start there, but after that you would try to start thinking about doing either injections of cortisone Cortisone is an anti-inflammatory steroid. You'd put it right in the carpal tunnel with a needle. Why does that sound like it doesn't feel good. I feel nothing.
Speaker 2:You don't even feel bad. No, it doesn't even feel bad. I'll apologize before. Yeah, of course, of course.
Speaker 1:And the needle's this thick by the way, it's a little bigger, a little thicker than that.
Speaker 2:Oh my God. Cortisone can help lower inflammation and hopefully that'll return the nerve and calm it down. Yeah, If you're very severe, the next step would be talking about surgery or a carpal tunnel release. Yes, that's the one of the most common procedures done in orthopedics. Yeah, you see.
Speaker 1:I think about my brother had both of his done. You know my dad had one done and he said, once you get it done, it's amazing that the it's pretty quick. He thought it felt pretty good, God willing, God willing, it all depends on the severity some people have constant numbness because their nerve is a pinch so long.
Speaker 2:I always counsel patients you're never going to get a hundred percent back at that point because the nerve's already damaged. Oh wow, when you start to feel numbness, your nerves damaged.
Speaker 1:Yeah, so I just got the tingling a lot. Yes, I was getting and it was, and it was interesting. When you said, um, are you getting on these fingers, I'm like, yeah, that's weird. How do you know that? Yeah, I went to school for a while for that, just a couple days, not that long. It's amazing, amazing. Well, I appreciate the help because I I'm no longer and, what's nice, I kept the brace just in case. Yep, you know, if it starts flaring up again, I'll start wearing at night.
Speaker 2:I think at nighttime was my issue, because I actually cuddle a pillow at night, and that's at night is the most common time to have it and people really notice it, because during the day, if you notice it, what do you? Do you change your position?
Speaker 1:You shake your right, right yeah.
Speaker 2:And you alleviate that increase in pressure. Correct At night, you can't, until your brain wakes you up.
Speaker 1:It's like oh my goodness we're losing a hand here. So yeah, and you know it takes a the brain not let me know before it got to the arm. Those are frightening times, when you're waiting and you're like, oh my gosh, is it ever going to come?
Speaker 2:back and you just wait there anxiously for about a minute.
Speaker 1:Yes, and you're like, oh, yeah, yeah, because you think I'm done, this is it, my hand is over, it's done, Unbelievable. So obviously you went through a lot of school to get this. What was amazing when I how much schooling is incredible, because I think you started in 2006 was your undergrad, right, 2002. 2002, you started, so 2006 you graduated, okay. Then you go to a Temple University Yep, um for medical school from, so that you graduate in 2010. Okay, so then it goes orthopedic residency from 2010 to 2015. Yep, and then you go to really concentrate on the hand and upper extremities, right, that's kind of how it works, that's how I'm thinking, and that was 2015 to 2016. Yep, I did that out in Pittsburgh, so that was-.
Speaker 1:So, you started in 2002. Yep and ended in 2016. Yep, that is a lot of.
Speaker 2:That's a lot of school, it's a lot of school, it's a lot of school. And Did it go quick?
Speaker 1:lot of. That's a lot of school. It's a lot of school, it's a lot of school. And did it go quick? No, no, I like the honesty, because a lot of people went so fast. It's very slow. It's, it's slow. What's the hardest part?
Speaker 2:the hardest part is medical school that's the first.
Speaker 2:That's that first section so you go, I mean college was fun. I mean yeah, oh well, of course. Yeah, I mean, you know, everybody gets to study something different in college, and for me, medicine. You don't really study medicine in college. You study biology, chemistry, biochemistry. So I thought biology was the easiest one out of all those three, so I picked that one. But it's tough seeing your, your buddies, your business majors like having a nice fun time on the weekend and I'm studying the life cycle of a pine cone. So, knowing I'm never going to use that, again, are there pine cones on my wrist?
Speaker 1:If there was, it would make college work. That could be the problem. Maybe there's a pine cone on my wrist Could be. So you're doing that. While they're done, they're out partying. Everybody got very good at throwing a Frisbee.
Speaker 2:They're done, they're out partying Everybody got very good at throwing a Frisbee? I didn't, yeah, you know. And they used to leave little notes on my desk in the library Like hey, this is before cell phones. Oh my gosh, isn't that crazy. Yeah, so the way you talk with people, they leave notes at the desk. I would usually sit in the library.
Speaker 1:Yeah, and that's oh, it's amazing. So you go through. Basically it's 14 years then, Am I right? Yeah?
Speaker 2:so the first four years, I think, were the hardest, because medical school is difficult. Everyone else has kind of moved on with their life. Now they have jobs and they're doing other things and you're still kind of studying, still in school. Residency is your first job. So after you graduate medical school you are a doctor who doesn't know how to do anything. That's good.
Speaker 1:That's great to hear yeah, that's that. No, but you're right though. Yeah, because you did it all. You did it all, but now, all of a sudden, you're now, you gotta actually do it so you're an md, yeah, after those four years.
Speaker 2:Then you decide what you want to go into and that's where you pick your different specialty. And you have to pick that your last, your third year of medical school. Okay, so you have to. So you knew right away orthopedic surgeon. I knew I wanted to be an orthopedic surgeon when I was in high school. Oh my gosh, now your dad was a doctor. Right, he's an ophthalmologist. Ophthalmologist, so he did eyes. Yep, and he was. I remember when, when I told my guy I think I want to go into medicine too, I think I want to do orthopedics, he said like no, no, you need to do eyes. He wanted you to do eyes. I don't know if I could do that eyes are kind of yeah.
Speaker 2:So he's like, come, come, come and shadow me for a day yeah, right, right because he was actually an eye surgeon and I remember, oh, eye surgeon, wow. And so I remember I went in and saw his surgery and I was like I don't think, I can yeah, eyeballs are not really attractive either no and also think I always think they're going to pop if you do something with them. I'm the same way.
Speaker 1:Don't you remember the cow I used to do surgery on in school? If you was a pig guy, well, I thought ours was a cow. I don't know, but I remember popping that thing and the juices went everywhere and I'm like, just imagine if my eye popped.
Speaker 2:I mean, that'd is better. And you do shoulders too, yeah, and you do elbows. So I I had shoulders. Is that we do?
Speaker 1:Okay, that's they teach us that in the last year, I wouldn't doubt that.
Speaker 2:Yeah, that's the first step. That's good, that's good. When I was in Pittsburgh, I did a year fellowship. So after you go through your residency, where you decide what kind of doctor you want to be, you can then super subspecialize with another year of training. So for me, I chose hand subspecialize with another year of training. So for me I chose hand, elbow and shoulder. I mean, I still practice general orthopedics, so I still do a lot of trauma work, ankle fractures all things, but my specialty would be hand, elbow, shoulder, and that's what most people do.
Speaker 1:Then they pick a specialty, they pick something that's their thing. That's what you're going to do.
Speaker 2:Medicine is getting more and more subspecialized. So in the past we used to have the jack-of-all-trades where someone would do 40 different things in orthopedics. It's really come down to a lot of. If you want your knee replaced, this is your guy got you want your shoulder replaced? This is this is the guy. Yeah, very rarely now will somebody replaces your knee, replace your shoulder. So it's for better or for worse. I, I don't. It's, I think, more annoying, because if you had your kneecap up here, it would look really weird, it would be tough, it would be a tough day, yeah, really weird. You wouldn't be able to move it as much yeah exactly, exactly.
Speaker 1:Yeah, but that's interesting, very interesting. So what is your favorite part of doing what you do? Is it, is it the surgery part? I mean, obviously you're meeting the cut the your patients I say customers because of real estate, but uh, your your patients and stuff but is there a surgery that you're like? You know, I enjoy doing this type of surgery because the guy that just worked on my father-in-law, yeah, he loves doing the shoulder, shoulder replacements or whatever that was called I.
Speaker 2:I loved orthopedics because for me it's very black and white. Yeah, it's broken or it's not oh there's no real right in between right, it can be a lot of gray.
Speaker 2:Yeah, I'm not. I don't do well in gray, yeah, so for me it was black and white. This looks good, this isn't. This is torn, this isn't. We can catch it and it's fixed. So I would say I think one of the the best times as a physician is just interacting and talking with people. Yeah, surgery is the very, very rare opportunity to help someone. But afterwards surgery is a very small part of medicine. It's the aftercare, the months afterwards of therapy that you're putting a patient through to get back where they want. Orthopedics is interesting in that we're not really saving lives. We're saving lifestyles.
Speaker 2:That's an interesting way to look at it.
Speaker 1:That's a great way to put it. It's a great way to put it.
Speaker 2:I try not to take myself too seriously as an orthopedist. I mean, I'm not cracking people's chests open.
Speaker 1:Maybe we should have got a different doctor. You should have Maybe like a cardiologist or something. That's what I told you.
Speaker 2:I said with a real doctor is an orthopedist now, that's gonna be an asterisk, I think there to be honest we'll bring a real one in next time I know real ones. No, it's all right, yeah, I know, dr traer I mean, I could have brought him in.
Speaker 1:I could have brought people in no, this is great, this is great. So going on. So you specialize in, obviously, the wrist, everything, basically everything up here yep, yeah, and that's I.
Speaker 2:I think the arm is a really cool thing. I mean, interact with your world, that's how we do everything. Hand surgery was always a very fun topic for me too, cause you see so much, there's so many different injuries to the hand too, so it's not like you're seeing the same thing every day that when you're working. So it's amazing.
Speaker 1:It's really cool, so let's go. One of the things I want to talk about. The other thing that I see a lot is the rotator cuff issues. Yes, and that's actually sometimes just wear and tear almost all the time, is it almost? So it's not an injury If you fall.
Speaker 2:Right and you hurt your shoulder. Yes, that can be what we would call an acute rotator cuff tear. Okay, it happened, you tore it. It's off Gotcha, but a times these are degenerative tears, degenerative changes over the shoulder. The shoulder is the most mobile joint in the human body. Is it really so?
Speaker 1:I mean, you can bring it back here.
Speaker 2:You can't bring your hip back. I hope, no. I hope years ago I could, maybe not now, uh, but the shoulder is subject to a lot of wear and tear and so shoulder pain is is a lot of people fear shoulder pain. It comes in your arms like I don't know what it could be. It could be, but a lot of times it can just be inflammation in the shoulder. You have to look at the neck. Sometimes neck pain can be presenting as shoulder pain. So it's very important not to just focus on one thing too. But if you look at some of these studies out there, after the age of 40, like 50% of people have a degenerative rotator cuff tear. They don't even know about, wow. So that native rotator cuff tear, they don't even know about. Wow. So that's why you got to be careful and people get an mri and everyone's so nervous. Oh, it said I had a partial tear.
Speaker 2:Well, it might have been there for a while yeah so, and a lot of times the body doesn't tell you no because you can accommodate well, I think you looked.
Speaker 1:You looked at my, I think you looked at my x-ray in my back. Remember we, yeah, and you were like you there was, it was all good down here where I'm having problems. But at the top you're like, are you feeling anything up here? I'm like, no, it feels good up there. And you're like, well, you have a little bit of compression up there. I'm like, well, that's weird, but that's the way it is.
Speaker 2:Your body just adapts to things. Right, but eventually I call it your body will eventually fall off the cliff.
Speaker 1:Oh, great, great. This is where I feel.
Speaker 2:But what happens is, even with carpal tunnel right, people will be like I don't understand, I didn't have this yesterday.
Speaker 1:I have it today.
Speaker 2:Your body can accommodate for so long, and then it— and then it— that's it. It fires Right. So your nerve can still function just as fine with 50% working, but after 50%, that might be it. That might be it, yeah.
Speaker 1:So it's a very positive conversation. Huh yeah, it's a very positive conversation.
Speaker 2:huh, yeah, you brought on orthopedics, I'll tell you what.
Speaker 1:And the eight ball says bring another doctor in. It's good stuff to know though.
Speaker 2:It is great stuff to know.
Speaker 1:So tell me, you brought some toys, yeah.
Speaker 2:I did.
Speaker 1:I love this. So this is actually the shoulder. So this is your humerus, humerus.
Speaker 2:This is the ball part Comes up ball, part comes up of your shoulder, got it, and so you know you told me to bring something in, so I got nervous.
Speaker 1:I didn't know I mean, no, I love it orthopedic, don't do too much entertainment he actually brought in his rector set is really what he brought in and it looks like he's like yeah, nothing to really prepare, just bring this this, just bring this. I said, if you could bring a live bone if you bring somebody's leg into the into the do you have any tricks you can do? I said I'm an orthopedist. I got no. Do you juggle? Do you juggle no? So that's actually, if the bone was broken, that's what you would do.
Speaker 2:Yeah, so if you have a traumatic injury to the shoulder, we would put a plate and screws on it. And so this is just an example of one of the titanium plates that we use in orthopedics to put bones back together. Unbelievable Now the bone state, the basically Now the bone stays. Basically, the plate is showing the bone where to go. Yep, in six to eight weeks your bone will naturally heal. But you want to show it where to heal. That's all surgery. That's what it is. Traumatic injury in orthopedics.
Speaker 1:You're showing the bone. Do you take those pins and stuff out then, or no, not this one that stays in, unless it bothers someone because it's so close to the bone.
Speaker 2:Usually you don are some plates that you do take out. Um, if they're because they rub yep, yeah, because you're talking about the wrist one.
Speaker 1:You have a wrist one here, whatever that is, yeah yeah, so this is the other one I brought in.
Speaker 2:I got nervous about all the homework assignments, oh my god, look at that, look at those screws.
Speaker 1:So this, did you get that at lowe's? You could actually. It's pretty amazing.
Speaker 2:So that's a wrist that you said, a really bad wrist break so if you really really broke your wrist and you couldn't fix it a traditional way, you would actually put this on top of the wrist. So then the wrist will just give time to heal. It'll hold the bones in a specific position so it's not collapsing because the weight of your hand will actually push your bones down. Get out of here. So you want to hold the hand up and this almost becomes your new wrist until the bone heals. Then you take it out.
Speaker 1:amazing and that's when you take out. You see that this is one you take out. Yeah, this is what I'm always amazed is that do you actually use drills to do that? Use drills, oh yeah, yeah, not like a black and decker.
Speaker 2:It's not like maybe, maybe, maybe no, but it's like it's a drill, you're using a drill, it's a drill, it's. And sometimes the drills run out of batteries, oh gosh.
Speaker 1:And then the surgery takes a little longer.
Speaker 2:We're going to need a new battery.
Speaker 1:We're going to need a new battery. Well, I'm sure they have those very well accessible.
Speaker 2:Always have a backup battery. Always have a backup battery.
Speaker 1:Absolutely Every time I'm doing surgery, I do.
Speaker 2:I have a in emergency room. Nurses see all kinds of things. What is the strangest thing that you've seen people? Oh my. So when I was, when I was a medical student at temple, we were rotating through the er. So as a student, you you're basically just shadowing, yeah right, but at a temple that's why I went there is they would let you get involved more because they're very low on staff. It's inner city, north Philadelphia, I mean, it's a very it's a violent place and they had a. I unfortunately didn't see this, but my co-medical student was on trauma call that night and a guy came in, complained of back pain, sat down in the waiting room. Now you complain of back pain in the waiting room. You're probably going to be there for a little while. Yeah, you always say heart attack.
Speaker 1:Yes, I always say heart attack.
Speaker 2:You don't have to be a doctor to know that.
Speaker 1:No, yeah, I know that I could have a hangnail. Oh, the chest, the chest, having some shortness of breath here. I'm just screwed. Yeah, but you'll get through that time, yeah, exactly.
Speaker 2:So he goes and they write down back pain and put him down. Oh yeah, okay, and he's sitting in the waiting room and he collapses and in his back was a ax. Oh my gosh, oh man, he had gotten to a fight and someone had axed him in the back. And he didn't say anything like that, he was just back pain, anything like that. He was just back pain, just back pain. He didn't lie.
Speaker 1:No, he didn't, he was truthful, he definitely hurt, he was truthful.
Speaker 2:There was a pain there. So I mean, those are like the kind of stories that you see, wow, and that's more, that's more trauma, right, that's that's more. Really. You see, you think he was in shock. You see, uh, yeah, yeah, he was in shock.
Speaker 2:Like I said, I wasn't there no, I know, but you would think that's he's not even yeah but I mean the things that you would see when you're training, because when I trained I wanted to train in an area that saw a lot of stuff, so when it came out you weren't really scared. I remember when I trained in North Philadelphia it was a lot of gun violence. A lot of gun violence I mean like wartime gun violence, ak 47 injuries to the thigh. Big time Gangs were rampant in North Philly at that time.
Speaker 2:When I when I trained in North Philadelphia, it was more dangerous to be a policeman in North Philadelphia than to be a soldier in Iraq. Oh my gosh.
Speaker 1:That's terrible.
Speaker 2:That's how bad, that's amazing. So we had a kid come in who was shot in his ankle and so he had an open. He had an ankle pain. Oh, he had bad ankle yeah.
Speaker 1:Bad ankle pain.
Speaker 2:So the the treatment is. You know, when you have an, that's technically an open fracture so you need to take him to the operating room, make sure you clean it out.
Speaker 1:It's a big deal.
Speaker 2:Yeah, right, big deal. So he's. You know, when you worry about infection with those, that's anything out of a puncture. He ended up getting an infection Right, and so you have to wash the infection out. Wash them out, and so I was. I was working with an attending, or my boss at the time, who was a dedicated foot and ankle surgeon. That was his specialty. He was notoriously one of the harder attendings to work with. High expectations, very short fuse sometimes, and so I remember we walked into the room where this gentleman was and we were talking to him and the gentleman wouldn't open his eyes to talk to my boss. He was early in the morning. We're rounding at six in the morning. He's not opening his eyes, okay. And so I know where this is going, because I've worked with him. For like this is not going to be good.
Speaker 1:This is not going to go.
Speaker 2:well, this is not going well, please, sir, open your eyes, like I'm like gently tapping. Yeah, like this. This guy needs to wake up. Yeah, he doesn't, oh boy. And my attending is like open your eyes when you're talking to me. And I was like, oh boy, and, as the resident, it's your job to just make sure everybody's okay. Put it together. So he leaves in a huff. And I'm talking to the kid, I'm like hey man why don't you open your eyes?
Speaker 1:Yeah?
Speaker 2:Open your. You mean, you can't open your eyes. Man, you're 22 years old, open your eyes, because I can't open my eyes. He goes I, I just can't do it. I'm like this isn't right. I'm like, yeah, like, so, like something. And it's always like and you don't need to be a doctor to have that sixth sense. Right, yes, something's not right. Yeah, like and like. I said, I'm not a real doctor, so I need to get one in there, so you're just practicing. Oh, I call people smarter than me and I said listen, you got to look at this, sometimes with his eyes, why?
Speaker 1:don't you call your dad. He knows I should have.
Speaker 2:Yes, that's actually a good point, yeah, so this. So the smarter doctors come in and like, yeah, something's not right here, and I'm like, well, we got to do something. I when he's talking, he's trying to open his eyes. Okay, that's weird, very weird. And so I'm like this isn't right. I don't know if he's playing a joke on us. Yeah, probably not. Long story short, we find out that he actually has wound botulism. Oh no.
Speaker 2:So, botulism, if you remember, is the toxin where it can cause paralysis. Yes, yes, yes, it stops your breathing. Oh, that's not good. And then we all know what happens after that. Yeah, there is. So, oh my gosh, the people that's why I can't open his eyes. That's why I can't open his eyes Now. My boss was extremely mad and continued to be mad because this guy wouldn't open his eyes. This guy had wound body.
Speaker 1:He wound botulism.
Speaker 2:He had a real problem, and your guy doesn't give a rip if he has botulism. He just like open your damn eyes. He's like you can still have botulism and open your eyes. I'm like I don't think he was faking it. That's unbelievable. So wound botulism is so rare it's seen once a year in the United States. Oh my gosh. And he got it. And he got it. He got it on my when I was supposed to be. Well, you learned, though. Look at that. You learned, I mean.
Speaker 1:I get, that's a tough way to learn, that is a tough way to learn Holy mackerel. But you see, that's a good story, that's a great story.
Speaker 2:Open your eyes when you're open your eyes. Oh man, To this day, when I see that attending, I'm like hey. I'm glad you're opening your eyes when you're talking to me.
Speaker 1:So let's talk about um, your family. Yeah, beautiful family you have. You have three boys and one girl. Three boys, uh, they're always dressed to the nines. I mean my wife's doing unbelievable. Seriously, they're the best dressed kids ever. We, we love it in fact our kids will and not making fun of them at all. Our kids are always like waiting to see what they have on like, because it's always like really nice, they always look really good, they're really they're cute kids, good kids too.
Speaker 2:I gotta give credit to my wife on that, and she's amazing.
Speaker 1:So we I have a picture here of you when you got married. Oh yeah, and I was saying earlier that you look a lot different and she looks the same.
Speaker 2:She looks the same, yeah.
Speaker 1:Now, she was Miss Pennsylvania. She was Shannon was Miss Pennsylvania 2009.
Speaker 2:Yeah, incredible, right, 2009. So did you know her? You knew her. Then we were dating, you're dating unbelievable, I give. I actually credit her for getting me into my residency program, because when she was doing the miss pennsylvania pageant, I was interviewing at this residency program and when she won, it was orthopedics is still about 90 male. And so they said, well, well, your, your girlfriend is in residency too. I'm like, oh yeah, she just, she just actually won Miss Pennsylvania, and they couldn't believe it. Yeah, and they took me into their program.
Speaker 1:Oh, that's awesome.
Speaker 2:So nothing to do with my merits there you go, nothing to do with it.
Speaker 1:And look, my wrist is fine.
Speaker 2:Like I said. They're like oh, that's great man, yeah, you can together. That's awesome. And graduated the same year, which was nice for us, Did you do?
Speaker 1:doctor talk at home. Any doctor talk Like you know, like sitting there going well, I had this today and I did this today. We'll throw the idea Brad was in and we shocked the hell out of him. Did you tell her that one by? And we got to wrap this up real soon because you and I could talk for another hour. But seriously, I go in there, hugo, right, and he goes. We're going to do this electrical thing to just to make sure your nerves are okay in your hand, right? So I call my dad, who I know had carpal tunnel. He's like ooh, that's a really uncomfortable thing.
Speaker 1:It's not fun. It's not fun. I'm like are you kidding me? So I came into his office no lie, I come into his office, talk to his secretary and I go. I said do I really have to get this done? It's really not, I'm really not into this. And he comes out and he goes just get nerves work. He comes back in the room and I thought he was kidding. He goes oh, you're gonna have to do that again. I thought he was kidding, he wasn't kidding.
Speaker 2:I was like turn up the voltage a little bit on this, please Come on. But you know what? It wasn't that bad. It wasn't that bad, it's just uncomfortable. Yeah, I know what you feel.
Speaker 1:She said that she did say, it's not that bad.
Speaker 2:I'm like, just do it to me, I want to see what. It is Not that bad. I haven't had her do it to me again but my, my but mine was not that it was not that bad, it wasn't that bad.
Speaker 1:It wasn't that bad, so I want to thank you for coming in here today man I really appreciate.
Speaker 2:Awesome, very cool. Well, you'll have to come back.
Speaker 1:Hopefully you can come back for the we're doing September 19th. It's going to be the 200th episode. It will be live. I'm getting guests that have been on the show before to come in. We're going to actually have some drinks and some adult beverages that we can actually do on the show and have people coming in and out. It'd be fun.
Speaker 2:That'd be great. I really appreciate you having me Absolutely.
Speaker 1:Thanks so much. And the company that you have. There's five doctors there, five surgeons or whatever right, yeah. And it's Integrated Surgical Specialists. Right, yep, and you're right here in Y Missing in the area we're in Y Missing.
Speaker 2:We have an office in Pottsville, too Awesome.
Speaker 1:So anybody from up north who's listening Awesome that, look us up, okay, awesome, awesome, awesome. Thanks so much. I appreciate it, man. Thank you All. Right, there you have it. If you're looking for somebody to fix your elbow, your wrist, your shoulder or anything, actually, in his office there's a bunch of doctors and they do knees, they do ankles, they do all kinds of stuff. So if you have any issues at all, go to Integrated Surgical Specialists and they will take care of you. I know they will, for sure. All right, that's about.
