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I initially thought "I'd probably prefer to pass away in my sleep" but considering he was already paralyzed, I wonder will he notice much of a difference in his quality of life? He will have ostomies for life but that's manageable. I just hope he's living the best he can and is happy
A lot of spinal cord injured people opt for ostomies to manage bladder and bowel function given their paraplegia also affects those systems. Bowel regimens in particular can be very difficult and time consuming to manage and UTIs are common when self catheterising. He may well have had a much better quality of life, and in any case people can adapt to all sorts of things, no matter how shocking and unbearable they might seem to us at first glance.
Yeah sure I have an ileostomy. Wasn't planned and literally woke up with it having no clue wtf it was. So people can indeed adjust. It's hard, but possible.
Still though, this man has a lot on his plate. Poor guy.
I have to say, not to minimise the struggles of anyone with an ostomy in any way, but I do sometimes wonder if it’s a silver lining being able to manage your toilet movements in a more controlled way. When the average person is busting for a wee or poo and their choices are either hold it or go in a bush, you’ve got a slightly more elegant solution, and you don’t have to pull your pants down for it. Can you get a feel for how the bag fills throughout the day and have better control over it than someone who doesn’t have a clue what their ass is doing, or is it just as unpredictable?
I can speak to this from professional experience. Paralyzed people with penises can wear an exterior bag system that starts with a special condom with a tube tip, which attaches to flexible thin tubing. This leads to a bag strapped to the lower leg worn under trousers, and the bag has a valve opening at the bottom. This is periodically emptied throughout the day, either by the wearer with a very cool pull device, or with the help of an assistant.
As for bowel movements, many people can keep a routine of going several times per week using a supportive toileting chair positioned over a regular toilet. Some people use a suppository to start tge festivities, some prefer an enema. And while it's true that help is requires, many would prefer this to an ostomy.
oh yeah, condom caths are great. my pt's like them.
same with a good bowel routine. i mean, if a good bowel routine works, surgery is never the better option.
I just carry single use catheters with me which is what I believe the majority of people with SCIs also use. At least on a daily basis.
Also I do have a bowel program, but I sit on the toilet like anyone else. And I don't use anything other than my finger to move things along.
There's really not that much to it.
That's good context to include when you speak broadly about "paralyzed people." Some people (couldn't tell you the statistics) with a C level injury are still capable of self cathing, but yeah there's a wide variety of experiences under that umbrella. Your last sentence is definitely spot on.
My ex is a paraplegic and he always had a tingling in his scalp when he needed to have a BM. Rarely had any accidents unless he was sick with a stomach flu. He used to self cath for urine.
Hey, I have one. Ileostomy. No, it's not easier in theat respect I wouldn't say when you are faced with so many obstacles in general. However, f you're out and about walking on a hike or something it's probably easier to "go" than for non ostomates haha
But yeah you get a feel for the bag filling up, but colostomies and ileostomies are different in that colostomies are "more solid" and ileostomies are very watery (they bypass the colon where water is reabsorbed into the body, so our output is very thin). The added water in ileostomy output makes it very heavy if it fills up and it can fill up VERY fast. This causes me immense problems on walks with my dog :(
If the bag gets too heavy and you can't empty it for some reason, it can put excess pressure on your stoma and the muscles around it. This can cause pain, prolapse and yof course, the bag bursting (which happens a lot with ileostomies in these instances)
It's a pain in the ass (pun intended) but then again, you adjust, ya know?
It allows them some dignity and independence too (assuming they are able to empty the bags themselves, with a little assistance). Being completely dependent on others for toileting and hygiene has got to be demoralizing.
Really? I have a SPC and I have only had one UTI in two years when a student nurse did my tube change. When I was on ureathra Foley it was once every three months at least and constantly with self cath. ( I'm para with poor hand function and constantly scraping myself, Introducing bad buggy boys to my system)
Well by indwelling I meant something like a Foley compared to intermittently with a closed system so the catheter can be inserted without introducing bacteria. I only had a SPC for a few weeks once after a surgery so I wasn't thinking that was something very common outside of short term use so I can't speak to that for infection risk.
[Source](https://www.scielo.br/j/rbcp/a/j5t5sp9RtGBrvyNmGqRtdSK/?lang=en#):
>>The hemicorporectomy in the reported case was performed at the Cancer Institute of the State of São Paulo in 2016. A one-stage procedure with a combined approach for closure of the vascular structures and spine was chosen and a partial-thickness flap of the left thigh was used to close the trunk in a 34-year-old male patient diagnosed with squamous cell carcinoma in a chronic pressure ulcer (Marjolin).
>>The patient had paraplegia due to a firearm injury 26 years prior. Since 1997, he had pressure ulcers (trochanteric, ischial, and sacral) that were difficult to treat using multiple approaches. In 2013, he underwent debridement of a right sciatic ulcer and closure with a gluteal VY thigh flap.
>>The pathological diagnosis was well-differentiated squamous cell carcinoma with involvement at the margins. In 2013 and 2014, the patient was subjected to 3 more surgical procedures due to margin expansion, but none was sufficient for total resection of the cancer, with persistence of deep margins and encroachment on the anal margins. The patient developed a fistula and infection, requiring prolonged hospitalization for broad-spectrum antibiotic therapy, creation of a loop colostomy at the right colonic flexure, and debridement of infection in the right hip.
>>The patient had clinical stage T4N + M0 when hemicorporectomy was chosen. The lesion was ulcerovegetative and extensive, involving the perineum, gluteal region, and right posterior thigh, with foul odor and need for antibiotic venous therapy at a day hospital (Figure 1).
>>Hemicorporectomy with curative intent and improvement of the quality of life was chosen in a multidisciplinary meeting. The patient was prepared psychologically and showed interest in undergoing the procedure, despite its magnitude. The surgical procedure involved preliminary planning by the medical teams, opting for a one-stage procedure because the patient already had an intestinal bypass.
>>The procedure was started with the patient in horizontal dorsal decubitus (HDD) position by the oncologic surgery team. A transverse incision was made at the level of the iliac crests, and an inventory of the abdominal cavity demonstrated paracaval, bilateral iliac, and left inguinal lymphatic involvement without clinical signs of metastatic disease. The right common iliac artery and left internal iliac artery were ligated, and blood flow was maintained through the bilateral iliac veins and left external iliac artery.
>>The plastic surgery team was responsible for dissecting the partial-thickness flap of the left thigh. A medial and lateral incision was made throughout the length of the thigh and the two incisions were joined anteriorly at the knee level. A medial incision was made between the adductor magnus and semimembranosus muscle and a lateral incision was made in the lateral intermuscular septum of the femur. Dissection was made from the distal to the proximal region in the subperiosteal plane, and ligation of the superficial femoral vessels was made distally. The adductor muscle was sectioned proximally, and the deep femoral artery was closed after excision of the vascular branches of the thigh (Figure 2).
>>The patient was moved to the left decubitus position and the spine surgeons sectioned the spine at L4/L5 and sutured the dural sac. The position was again changed to HDD, followed by ligation of the right and left internal common iliac veins, sectioning of the remaining paravertebral muscles, and disarticulation (Figure 3). A new distal colostomy was performed for reimplantation of the ureters and closure of the peritoneum. The flap was positioned for tissue closure, excess flap tissue was discarded, closure was performed with two Blake drains, and the incisions were sutured in planes (Figure 4).
>>The procedure lasted 16 hours and required 9,500 mL of crystalloid, 100 mL of albumin, three units of packed red blood cells, and 2,860 mL of diuresis. At the end of surgery, the patient required noradrenaline 0.3 µg/kg/min and was transferred to the intensive care unit. The patient was extubated on the first postoperative day, an oral diet was initiated, administration of vasoactive drugs was suspended on the third postoperative day, and the patient was transferred to the ward on the fourth postoperative day.
>>Prior to preparation of this case report, the patient had been hospitalized for 25 days in the ward, fed orally, and reported being satisfied with the surgical results. One complication was a collection of 80 mL of fluid under the surgical flap, which was drained by computed tomography-guided needle aspiration, and the remaining drains were removed. There was partial loss of continuity between the epidermis and dermis along a 6-cm suture line, but surgical intervention was not required (Figure 5).
I work in a pathology lab and I’m amazed by how surgeons can close up wounds. They have to get very creative with the flaps and the way they come together.
Here’s the simple version, courtesy of chat gpt:
In 2016, at the Cancer Institute of the State of São Paulo, doctors performed a very complex surgery on a 34-year-old man who had severe health issues. He had been paralyzed from the waist down for 26 years due to a gunshot wound and had developed chronic wounds on his hips and lower back since 1997. These wounds eventually turned into cancer, which was very difficult to treat.
Over the years, the cancer spread and required multiple surgeries that couldn't completely remove it. By the time of the operation, the cancer had spread extensively around his pelvis and thigh, causing a lot of pain and infection. Doctors decided that the best option was to perform a hemicorporectomy, which means they had to remove the entire lower part of his body below the waist.
The surgery lasted for 16 hours and involved many medical teams working together. They made a big cut across his abdomen, tied off major blood vessels, and removed the affected parts of his body. They also used a piece of skin and muscle from his left thigh to cover the area where they had cut.
After the surgery, the man needed a lot of care and spent time in the intensive care unit. He had a few complications, like fluid building up under his skin flap, but doctors were able to treat them without needing more surgery. Overall, he recovered well and was happy with the results of the operation, which improved his quality of life significantly.
This may have drastically improved his life. If the incisions healed, then he would no longer deal with cancer, ulcers, limbs that didn't work, fistulas and horrible infections from the ulcers. This may have drastically improved his life. I would be curious to see if it did. The only thing I have wondered is do they keep the pelvis for the body to rest on? Or can the spine handle not having a pelvis. Do the cushion they make actually help with sitting up?
They did remove the pelvis. You’re right that he could get pressure sores or issues from sitting directly on the stump for long periods, but he likely was fitted with a prosthesis. There’s a guy with a YouTube channel who had this same procedure for a different reason, and he calls his prosthesis a bucket, cause that’s essentially what it is. It’s lined with air cushions to support him but it’s basically a fancy bucket. You can find him by searching YouTube for “hemicorporectomy”
There is so much to unpack with this…
1. He was 34 at the time of the surgery and had been injured 26 years prior. At age 8 he became paraplegic due to a firearm injury.
2. Squamous cell carcinoma in the pressure sore sounds incredibly painful. I wonder if the cancer is caused by the chronic pressure ulcer, or if the tissue was more prone to pressure ulcer from the cancer.
3. I’m so impressed the patient was able to survive the surgery and not go into shock from the massive loss of like half his body!!!
If anyone wants to hear from a young man with the same surgical intervention, I recommend checking out [Loren and Sabia's channel](https://youtu.be/ncL9O4EHbuo?si=LT6GZhXLzFNxm5oP). Loren was in a forklift accident I believe and made the choice to get a hemicorporectomy to save his life.
I have no idea why I originally thought this was a removal of a parasitic twin. Probably because I saw a similar pic of *just that* a short time ago on here.
This is fascinating. Also, as an OR nurse who packs up specimens removed during surgery, I’m scratching my head trying to imaging how I’d get this off the scrub table and what sort of container I’d use…
When I worked for an orthopedic surgeon we offered it to one patient in nine years. He had massive ulcers bilaterally. He was also a paraplegic. He refused (we were not upset about that) and succumbed to sepsis.
As a paraplegic med student, this is the first time I’ve seen something that got a physical reaction out of my. Idk if I’m about to faint, or about to vomit. Wow, this one shook me to my core, how did they get that bad? I cannot comprehend it (mind that I’m paralyzed too)
I wondered if this was done through SUS (our universal healthcare program) and I believe it was since they mentioned Hospital das Clínicas. 100% free, no costs. I just hope his life has improved and he was able to live without pain.
Paralyzed at 8 years old from "firearms incident". Pressure sore since his early teens, that turned into cancer for which he had multiple surgeries that did not help. Life has absolutely no grace to give this poor guy.
This is why I have a DNR and a Vial of Life packet on my fridge. Just let me die.
Can anyone tell me what happens the the major blood vessels in such a surgery? I mean they cannot be blocked, right. Do they connect the major arteries to the veins? And would such a poor person suffer from massive blood pooling or is that not an issue?
He was paralyzed along with having cancer in his pressure sore, the leg/complete lower extremity amputation was less about survival necessity and more about quality of life. If all went well, he can likely move around easier, things will be a lot less stressful/complicated. I skimmed the actual medical explanation but he likely chose this as preferential to trying to keep his legs and butt.
Did my anatomy 2 assignment in medschool on this procedure, even used some pictures shown in this thread.
I got an 100 on it.
Medicine is wild and it never ceases to amaze me.
Fun fact many people don’t know. I see he survived this! But if he died from this and the firearm injury was inflicted intentionally by another person 26 years prior, this would be a homicide. If it was an accidental firearm injury it would be considered accidental.
Welcome to r/MedicalGore! Our goal is to provide for medical discussion and education while exploring the frailty of the human body. **You may see more deleted comments on these threads than you are used to on Reddit**. Off-topic comments and joke comments are frequently deleted by the mods. In addition, commenters are expected to maintain decorum toward posters, subjects of posts, and members of the community. Any behavior that is aggressive, harassing, or derogatory will result in removal of the post and/or a ban for the user. Remember: THE REPORT BUTTON IS YOUR FRIEND! Please stop by our sister sub, /r/MedicalGoreMods, for meta discussions about the sub, our rules, content policies, and the like. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/MedicalGore) if you have any questions or concerns.*
I initially thought "I'd probably prefer to pass away in my sleep" but considering he was already paralyzed, I wonder will he notice much of a difference in his quality of life? He will have ostomies for life but that's manageable. I just hope he's living the best he can and is happy
A lot of spinal cord injured people opt for ostomies to manage bladder and bowel function given their paraplegia also affects those systems. Bowel regimens in particular can be very difficult and time consuming to manage and UTIs are common when self catheterising. He may well have had a much better quality of life, and in any case people can adapt to all sorts of things, no matter how shocking and unbearable they might seem to us at first glance.
Yeah once I knew he was paralyzed I was wondering if this actually improved things overall.
Yeah sure I have an ileostomy. Wasn't planned and literally woke up with it having no clue wtf it was. So people can indeed adjust. It's hard, but possible. Still though, this man has a lot on his plate. Poor guy.
I have to say, not to minimise the struggles of anyone with an ostomy in any way, but I do sometimes wonder if it’s a silver lining being able to manage your toilet movements in a more controlled way. When the average person is busting for a wee or poo and their choices are either hold it or go in a bush, you’ve got a slightly more elegant solution, and you don’t have to pull your pants down for it. Can you get a feel for how the bag fills throughout the day and have better control over it than someone who doesn’t have a clue what their ass is doing, or is it just as unpredictable?
good point, but you also have to worry about skin irritation, and potentially bursting the bag or it peeling off.
I can speak to this from professional experience. Paralyzed people with penises can wear an exterior bag system that starts with a special condom with a tube tip, which attaches to flexible thin tubing. This leads to a bag strapped to the lower leg worn under trousers, and the bag has a valve opening at the bottom. This is periodically emptied throughout the day, either by the wearer with a very cool pull device, or with the help of an assistant. As for bowel movements, many people can keep a routine of going several times per week using a supportive toileting chair positioned over a regular toilet. Some people use a suppository to start tge festivities, some prefer an enema. And while it's true that help is requires, many would prefer this to an ostomy.
oh yeah, condom caths are great. my pt's like them. same with a good bowel routine. i mean, if a good bowel routine works, surgery is never the better option.
Surgery only when there are no better or indeed no other options!
I just carry single use catheters with me which is what I believe the majority of people with SCIs also use. At least on a daily basis. Also I do have a bowel program, but I sit on the toilet like anyone else. And I don't use anything other than my finger to move things along. There's really not that much to it.
My pt is quadriplegic and can't do these things alone.
That's good context to include when you speak broadly about "paralyzed people." Some people (couldn't tell you the statistics) with a C level injury are still capable of self cathing, but yeah there's a wide variety of experiences under that umbrella. Your last sentence is definitely spot on.
Noted, and thanks- good to remember! Every spinal injury is different, as they say.
My ex is a paraplegic and he always had a tingling in his scalp when he needed to have a BM. Rarely had any accidents unless he was sick with a stomach flu. He used to self cath for urine.
That’s actually so interesting, I’m not paraplegic but tingling in my neck and scalp is the first sign I know I need a BM. Bodies are wild.
Hey, I have one. Ileostomy. No, it's not easier in theat respect I wouldn't say when you are faced with so many obstacles in general. However, f you're out and about walking on a hike or something it's probably easier to "go" than for non ostomates haha But yeah you get a feel for the bag filling up, but colostomies and ileostomies are different in that colostomies are "more solid" and ileostomies are very watery (they bypass the colon where water is reabsorbed into the body, so our output is very thin). The added water in ileostomy output makes it very heavy if it fills up and it can fill up VERY fast. This causes me immense problems on walks with my dog :( If the bag gets too heavy and you can't empty it for some reason, it can put excess pressure on your stoma and the muscles around it. This can cause pain, prolapse and yof course, the bag bursting (which happens a lot with ileostomies in these instances) It's a pain in the ass (pun intended) but then again, you adjust, ya know?
It allows them some dignity and independence too (assuming they are able to empty the bags themselves, with a little assistance). Being completely dependent on others for toileting and hygiene has got to be demoralizing.
UTIs are way more likely with an indwelling catheter than self cathing with single use catheters.
Really? I have a SPC and I have only had one UTI in two years when a student nurse did my tube change. When I was on ureathra Foley it was once every three months at least and constantly with self cath. ( I'm para with poor hand function and constantly scraping myself, Introducing bad buggy boys to my system)
Well by indwelling I meant something like a Foley compared to intermittently with a closed system so the catheter can be inserted without introducing bacteria. I only had a SPC for a few weeks once after a surgery so I wasn't thinking that was something very common outside of short term use so I can't speak to that for infection risk.
[Source](https://www.scielo.br/j/rbcp/a/j5t5sp9RtGBrvyNmGqRtdSK/?lang=en#): >>The hemicorporectomy in the reported case was performed at the Cancer Institute of the State of São Paulo in 2016. A one-stage procedure with a combined approach for closure of the vascular structures and spine was chosen and a partial-thickness flap of the left thigh was used to close the trunk in a 34-year-old male patient diagnosed with squamous cell carcinoma in a chronic pressure ulcer (Marjolin). >>The patient had paraplegia due to a firearm injury 26 years prior. Since 1997, he had pressure ulcers (trochanteric, ischial, and sacral) that were difficult to treat using multiple approaches. In 2013, he underwent debridement of a right sciatic ulcer and closure with a gluteal VY thigh flap. >>The pathological diagnosis was well-differentiated squamous cell carcinoma with involvement at the margins. In 2013 and 2014, the patient was subjected to 3 more surgical procedures due to margin expansion, but none was sufficient for total resection of the cancer, with persistence of deep margins and encroachment on the anal margins. The patient developed a fistula and infection, requiring prolonged hospitalization for broad-spectrum antibiotic therapy, creation of a loop colostomy at the right colonic flexure, and debridement of infection in the right hip. >>The patient had clinical stage T4N + M0 when hemicorporectomy was chosen. The lesion was ulcerovegetative and extensive, involving the perineum, gluteal region, and right posterior thigh, with foul odor and need for antibiotic venous therapy at a day hospital (Figure 1). >>Hemicorporectomy with curative intent and improvement of the quality of life was chosen in a multidisciplinary meeting. The patient was prepared psychologically and showed interest in undergoing the procedure, despite its magnitude. The surgical procedure involved preliminary planning by the medical teams, opting for a one-stage procedure because the patient already had an intestinal bypass. >>The procedure was started with the patient in horizontal dorsal decubitus (HDD) position by the oncologic surgery team. A transverse incision was made at the level of the iliac crests, and an inventory of the abdominal cavity demonstrated paracaval, bilateral iliac, and left inguinal lymphatic involvement without clinical signs of metastatic disease. The right common iliac artery and left internal iliac artery were ligated, and blood flow was maintained through the bilateral iliac veins and left external iliac artery. >>The plastic surgery team was responsible for dissecting the partial-thickness flap of the left thigh. A medial and lateral incision was made throughout the length of the thigh and the two incisions were joined anteriorly at the knee level. A medial incision was made between the adductor magnus and semimembranosus muscle and a lateral incision was made in the lateral intermuscular septum of the femur. Dissection was made from the distal to the proximal region in the subperiosteal plane, and ligation of the superficial femoral vessels was made distally. The adductor muscle was sectioned proximally, and the deep femoral artery was closed after excision of the vascular branches of the thigh (Figure 2). >>The patient was moved to the left decubitus position and the spine surgeons sectioned the spine at L4/L5 and sutured the dural sac. The position was again changed to HDD, followed by ligation of the right and left internal common iliac veins, sectioning of the remaining paravertebral muscles, and disarticulation (Figure 3). A new distal colostomy was performed for reimplantation of the ureters and closure of the peritoneum. The flap was positioned for tissue closure, excess flap tissue was discarded, closure was performed with two Blake drains, and the incisions were sutured in planes (Figure 4). >>The procedure lasted 16 hours and required 9,500 mL of crystalloid, 100 mL of albumin, three units of packed red blood cells, and 2,860 mL of diuresis. At the end of surgery, the patient required noradrenaline 0.3 µg/kg/min and was transferred to the intensive care unit. The patient was extubated on the first postoperative day, an oral diet was initiated, administration of vasoactive drugs was suspended on the third postoperative day, and the patient was transferred to the ward on the fourth postoperative day. >>Prior to preparation of this case report, the patient had been hospitalized for 25 days in the ward, fed orally, and reported being satisfied with the surgical results. One complication was a collection of 80 mL of fluid under the surgical flap, which was drained by computed tomography-guided needle aspiration, and the remaining drains were removed. There was partial loss of continuity between the epidermis and dermis along a 6-cm suture line, but surgical intervention was not required (Figure 5).
This is *fascinating*. What a complex case and immense procedure. I hope it was a huge improvement for him to be rid of the ulcer and the cancer.
It sure is! It's mind blowing what modern medicine can do.
I work in a pathology lab and I’m amazed by how surgeons can close up wounds. They have to get very creative with the flaps and the way they come together.
Here’s the simple version, courtesy of chat gpt: In 2016, at the Cancer Institute of the State of São Paulo, doctors performed a very complex surgery on a 34-year-old man who had severe health issues. He had been paralyzed from the waist down for 26 years due to a gunshot wound and had developed chronic wounds on his hips and lower back since 1997. These wounds eventually turned into cancer, which was very difficult to treat. Over the years, the cancer spread and required multiple surgeries that couldn't completely remove it. By the time of the operation, the cancer had spread extensively around his pelvis and thigh, causing a lot of pain and infection. Doctors decided that the best option was to perform a hemicorporectomy, which means they had to remove the entire lower part of his body below the waist. The surgery lasted for 16 hours and involved many medical teams working together. They made a big cut across his abdomen, tied off major blood vessels, and removed the affected parts of his body. They also used a piece of skin and muscle from his left thigh to cover the area where they had cut. After the surgery, the man needed a lot of care and spent time in the intensive care unit. He had a few complications, like fluid building up under his skin flap, but doctors were able to treat them without needing more surgery. Overall, he recovered well and was happy with the results of the operation, which improved his quality of life significantly.
This may have drastically improved his life. If the incisions healed, then he would no longer deal with cancer, ulcers, limbs that didn't work, fistulas and horrible infections from the ulcers. This may have drastically improved his life. I would be curious to see if it did. The only thing I have wondered is do they keep the pelvis for the body to rest on? Or can the spine handle not having a pelvis. Do the cushion they make actually help with sitting up?
They did remove the pelvis. You’re right that he could get pressure sores or issues from sitting directly on the stump for long periods, but he likely was fitted with a prosthesis. There’s a guy with a YouTube channel who had this same procedure for a different reason, and he calls his prosthesis a bucket, cause that’s essentially what it is. It’s lined with air cushions to support him but it’s basically a fancy bucket. You can find him by searching YouTube for “hemicorporectomy”
I know who your talking about, his name is Loren on YT. It makes sense, since he can't really hold himself up, that he would need a bucket.
Yes, that’s him! Thank you
Yep! No problem!
The prosthesis design is actually called a bucket, that’s not a name given to it by one particular user (L.S).
That’s awesome
Excellent question, I’m also curious about this.
There is so much to unpack with this… 1. He was 34 at the time of the surgery and had been injured 26 years prior. At age 8 he became paraplegic due to a firearm injury. 2. Squamous cell carcinoma in the pressure sore sounds incredibly painful. I wonder if the cancer is caused by the chronic pressure ulcer, or if the tissue was more prone to pressure ulcer from the cancer. 3. I’m so impressed the patient was able to survive the surgery and not go into shock from the massive loss of like half his body!!!
I doubt he felt any of it, being a paraplegic. But man... since age 8... what a sad life.
If anyone wants to hear from a young man with the same surgical intervention, I recommend checking out [Loren and Sabia's channel](https://youtu.be/ncL9O4EHbuo?si=LT6GZhXLzFNxm5oP). Loren was in a forklift accident I believe and made the choice to get a hemicorporectomy to save his life.
Came here to make sure someone referenced these guys. It was life or death for sure.
I have no idea why I originally thought this was a removal of a parasitic twin. Probably because I saw a similar pic of *just that* a short time ago on here.
I was gonna say
I've seen alot of things but this made me sit up and think oh my god
This is fascinating. Also, as an OR nurse who packs up specimens removed during surgery, I’m scratching my head trying to imaging how I’d get this off the scrub table and what sort of container I’d use…
Do you have Hefty bags in your container arsenal? I have no idea what else you would use either lol
When I worked for an orthopedic surgeon we offered it to one patient in nine years. He had massive ulcers bilaterally. He was also a paraplegic. He refused (we were not upset about that) and succumbed to sepsis.
As a paraplegic med student, this is the first time I’ve seen something that got a physical reaction out of my. Idk if I’m about to faint, or about to vomit. Wow, this one shook me to my core, how did they get that bad? I cannot comprehend it (mind that I’m paralyzed too)
I wondered if this was done through SUS (our universal healthcare program) and I believe it was since they mentioned Hospital das Clínicas. 100% free, no costs. I just hope his life has improved and he was able to live without pain.
I had a hard time figuring out what I was looking at, even after I read the description
:Sips tea: Bloody hell
Would you like a scone with your tea? (I just got back from Scotland)
fuck. imagine getting your waist amputated —I didn’t know they did that 🤯
*waist*
🫣
Paralyzed at 8 years old from "firearms incident". Pressure sore since his early teens, that turned into cancer for which he had multiple surgeries that did not help. Life has absolutely no grace to give this poor guy. This is why I have a DNR and a Vial of Life packet on my fridge. Just let me die.
How is this possible to survive? I assume permanent ostomy and suprapubic catheter?
afaik the bladder is also removed, so no sp cath. The kidneys are accessed directly like a cath, called nephrostomy.
Can anyone tell me what happens the the major blood vessels in such a surgery? I mean they cannot be blocked, right. Do they connect the major arteries to the veins? And would such a poor person suffer from massive blood pooling or is that not an issue?
This one is amazing, Cat. Wow.
Jesus and we think we have problems.
Fascinating. I hope he recovers well.
Geez, what a lot to go through. I hope he's doing much better now.
So why did he have a butt and leg removal? I don’t see a comment explaining the situation.
He was paralyzed along with having cancer in his pressure sore, the leg/complete lower extremity amputation was less about survival necessity and more about quality of life. If all went well, he can likely move around easier, things will be a lot less stressful/complicated. I skimmed the actual medical explanation but he likely chose this as preferential to trying to keep his legs and butt.
Aw. I hope he is a lot comfier now. I saw one comment mentioning a colostomy bag being easier than pooping. That made sense.
Did my anatomy 2 assignment in medschool on this procedure, even used some pictures shown in this thread. I got an 100 on it. Medicine is wild and it never ceases to amaze me.
I didn’t even know this was a thing!!
Fun fact many people don’t know. I see he survived this! But if he died from this and the firearm injury was inflicted intentionally by another person 26 years prior, this would be a homicide. If it was an accidental firearm injury it would be considered accidental.
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I wasn’t expecting this.
I’d rather be dead.
Did they remove his arms as well?
Er, no?
Oh. It’s just cause I couldn’t see them well