I have just realised that Dr Glaucomflecken must put an awful lot of effort into simply revising body medicine, which he will never have had to use in his own practice, simply to make medically accurate jokes that most of us don't understand. And after this realisation my already high respect for this man has gone up even further.
Or maybe he wanted to make good use of a bunch of things he was forced to learn that are useless/irrelevant for his work. But yeah.. he likely had to revise them for accuracy.
@@aditsu to be fair the kidney bone is connected to the eye bone. See a lot more keratoconjunctivitis sicca and periorbital edema in folks with kidney disease (though he may not care about the latter I'm sure patients still come to him because of it)
This is my theory. Ortho didn't think his orders were right, but he figured it would summon a nephrologist he could trick into admitting his patient for him.
Laughed heartily at this. The medicine punch card gag was underrated! I guess summoning Nephro is a toss up between incorrect IV fluid orders and inappropriate Lasix orders. Now we really need a sketch where Ortho just becomes a technical competent bone genius for a split second to manage an ortho problem then revert back to being a bumbling dudebro once it has been solved. Just a change of pace from all the "bullying" done to our precious intellectual punching bag. 🤣
Yessssssssssss!!! Something like a complex polytrauma that needs reconstruction surgery. My ortho basically rebuilt my radius which was bone dust after my accident
Yep, true. (Many) orthos really are this dumb, but hand them a newborn with a crumpled foot and with just two little cuts, some bandaging and two years time they turn it into something the kid can walk on. They can be artists as well.
Architects, too. My own ortho pieced together the distal end of my tibia from the three pieces it broke into, and put a titanium rod into a somewhat shattered fibula. Screws, wire(?), and some kind of cage were involved, I think. It seemed to be an interesting engineering feat. I love my bone bro. He's smart at what I need him to be.
Right? I think it's super sweet how Ortho clearly made Salt Bro feel seen and validated, by speaking directly to how real and personal his fondness for his little bean buddies really is 😆 Ortho Bro has his doofy side but he's always so wholesome and empathetic to everyone
@@dr.floridamanphd I know several, half spend all their time in the gym, and the others look like they could pull off a Bill Gates look alike contest without any costumes
It's a funny stereotype but orthopaedic surgery is consistently in the top 3 most competitive specialties, pretty much everyone matching is near the top of their class, so it is a 'nerdy' specialty to some degree. Working out is pretty much a requirement aswell, ever tried hammering 2 femoral nails in? Very hard work, need good strength and stamina for complex cases.
I love the nephrologist using empty salt cans as amplifiers to hear incompetent clicks 🤣 Also poor Ortho! I love his humility when nephrologist asks "Don't you know what that leads to?" and ortho is like "You know I don't, salt bro 😕"
My X was a dialysis patient and also had multiple heart surgeries. It was amazing how EVERY TIME the hospital messed up on the fluids and totally overloaded him with IV fluids. Then, when admitted as a heart patient, they would never take into account his kidney needs and would order a heart friendly diet that was totally at odds with requirements to dialysis patient needs. As his patient advocate, it was a full-time job to not let the hospital do more harm - even going so much as to constantly remind them they couldn't use his dialysis arm for blood pressure or for blood draws.
It's how I explain AKIs to patients. Your kidneys are a little sad because they didn't get enough water, but we'll try to perk them up a bit. Your kidneys are sad because they didn't like the medications you had. Try not to use nurofen in the future, ok?
@D S "Your kidneys got tired of being overworked and underpaid, and thus have been quiet quitting. If you don't treat them nicely, they may decide to retire early and we will need to subcontract the labor to a dialysis machine, which is too generic for your unique needs and not a good long-term strategy. If it gets to that point, you will need a new bean buddy from another body. We try not to get to that point, because your body is highly suspicious of any new employees and we have to shut down half your security personnel to keep your new bean buddy and yourself alive"
another specialist got superpower as well, like Neurologist could see how neutrotransmitter transmitted and with that see the future of someone thought
Nah... neph isn't being kind.... sometimes its just not worth the effort and easier to do it for them. (I love my orthopods and not such a fan of my nephs!)
At first I was gonna ask “why doesn’t he just show them what they’re supposed to do?” But… then I saw it was Ortho, and decided to retract my question.
I just had this on in the background while i was doing other things and hearing ‘IT MAKES THE KIDNEYS SAD’ while not playing attention is probably the best thing ever xD
I had an open fracture 2 months ago so had to have an operation. I had to literally stop myself from calling the surgeon "Ortho" and the anesthesiologist "Anesthesia"!
@@redsoxfan5240 🤣 No, we are both female, but I'd had some pain medicine that made me a little loopy, so I really had to stop myself from saying "Anesthesia!" when the guy approached me!
@@aslansown Why stop yourself? If they know Dr. Glauc, you know you're in good hands. If they don't... RUN [i.e. hobble away as quickly as what sounds like a painful injury will allow]. That and/or share the brilliance with them
@@noodle3218 I got the feeling they were called in on a day they aren't usually there. The surgeon was wearing shorts and said she had been playing with her kids. They were both all business!
Wow this is insanely accurate lmao. I just finished my first week on Nephro service and the amount of time we spent trying to change fluids and fluid rate is amazing- its also amazing how Nephro is consulted and then no one follows Nephro's recs and wonders why their patient is still acidotic.
I can't wait for the grand reveal that ortho knows all this stuff already since their program admission criteria is so high but they purposefully make themselves look this way in order to make others do their work for them.
I knew it, I literally went "it'll be bone bro" and he appeared! Ortho being so clueless but so earnest when he realized it'd make the bean buddies sad
The depth your characters have is honestly amazing. The interpersonal dialogue and the emotional complexities are all captured and packaged into a bite-sized video. This is a piece of art. Thank you and please keep making content.
I can't get over how much I love every single one of these characters. I could write character essays on all of them. I wonder if down the line after everyone dogs on Ortho Bro for being 'dumb' for so long, a situation about bones comes up and he finally gets his moment to shine and everyone gains a newfound respect for him.
I don’t think it’s going to be a newfound respect- they all know how good bone bro is with bones, but because most observed bone problems usually don’t* (note- not a doctor, wild guessing here) have impacts on most other specialties, bone bro just gets the reputation as ‘the one who always needs help/fucks things up for the rest of us’; I have no doubt that specifically Doc PhysibroTheraBro has the greatest of respect for bone bro.
Right legs are not supposed to bend backwards into a ball and look like a pretzel. 22 yrs ago mine did. I got into a fight with a bridge. 12 hrs later I had rods and screws hip to knee knee to ankle. Crushed 6" of thigh bone compounded the tib and fib. UofL Trauma dude said amputate or experiment? I was in ICU for a while still got the leg.
I just love these so much I'm a combat medic in the army and they all make me think how much I wanna continue in the medical field and just run away from it all at the same time
Take a break after you separate. If it is real the siren's call will lure you back. You know the feeling, you pick up a medical article or see something on TV and notice your pulse rate increases in a good way? Ya, that. So many jobs in medicine these days, full contact, remote, IT, sales. Be good to yourself when you choose, more apt to be long term and happy. Best of luck to you!
@@kathleensmith8365 u r right about the siren.. Even when I am on the road. Siren makes me go like ok next patient.. Then I have to remind myself.. Chill lady u r off duty. 😂
ortho being excessively laid back about non-ortho related subjects(including all other medicine, i assume) and yet unfairly likeable and pleasant to be around fits with every orthopedic surgeon i've met irl
I’m going through a hard time right now as an adult dealing with an aneurysmal bone cyst diagnosis. It is typically seen in Peds, and it basically has two groups of radically different treatments depending on whether the closest expert on the condition is an Orthopedic Surgeon or an Interventional Radiologist. It would be interesting to see a skit about this or a similar condition that has two very different treatments based on which specialist is in charge of it. I would love to see them argue haha
I can sure identify! I always get conflicting recommendations from my various specialists. Or recommendations where the specialist doesn't take some aspect of my condition into consideration. Most recently, I'm having bad headaches, but I'm taking the max dose of NSAIDs for my weight, which leaves Tylenol or opoids for pain. I really hate taking opoids, so I was taking 500mg every 6 hours. I told my rheumatologist and he says that's no problem, adults can take up to 3000mg per day. I just ignored it because he had obviously forgotten I only weigh 80lbs, and also take other meds (like statins) that affect the liver. You pretty nearly need a medical degree to defend yourself from our medical system these days. Lol Healing thoughts sent your way! 😊
My gran was recently diagnosed with kidney cancer and had to go to the hopital for a surgery consultation before the actual surgery and i just wanted to thank the local nephrologist, oncologist, surgen team and anesthesia for being awsome and giving her the best treatment possible.
We’re learning about fluids in Vet Tech school and it’s so complicated. Though I am happy to report I understood most of what he said. Maybe I’ll understand more next semester!
It takes an iterative process to get these things. Like the face on ortho -- you can't just slam them with ALL the info all at once. You need some info to form the foundation so people can understand and appreciate the next part and so on. Some is foundational to understanding the rest. For me, it was developmental processes (pregnancy, prenatal/neonatal)...
Here's the thing, you learn a lot of these things with experience. Then you read books and you understand why you're putting in certain orders. You might even be able to suggest better alternatives. Inj. N.S. 500 mL IV Inj. R.L. 500 mL IV Inj. GNS 500 mL IV over 24 hours is a good starting base. 1500 mLs per day is maintenance for the average sized adult. The actual way of calculating the maintaining fluids requirements is by Holliday Segar's formula, which is 4 mL/kg/hr for the first 10 kilograms, 2mL/kg/hr for the next 10 kilograms and 1mL/kg/hr for every subsequent 10 kilograms. Add more if deficits are present. Reduce if the pt. has cardiac or renal insufficiency. Always mind the electrolytes and the anion gap! Inj. NS 1000 mL IV stat (fast) is the trauma fluids bolus order before a blood transfusion. (Dosage of NS is 20-30 mL per kg over the first hour) You typically need to infuse 3 times the volume of isotonic crystalloid than the blood loss. You'll naturally get more and more adept at modifying such orders with time. Hope it helps. Best wishes.
Just don't give LR to patients with hypercalcemia, and don't give NS to burn patients and you'll be ahead of the curve lol. And if you give more than 1 or 2 units of any crystalloid in cases of massive bleeding where patients need blood products you're gonna have more serious problems than hypovolemic shock.
I felt the bond the nephrologist has with the salt all the way to my soul, as he gently clutched it and listened for incompetent clicking( i literally heard violins). Its the greatest love story i have ever know. Lmfao, Flacken strikes again.
@@zarifzaman6381 your blood likes to be at a specific salt level because of a lot of things like osmosis of water into the cells (I think idk I genuinely have zero medical qualifications for anything and I don’t plan on getting some 😎) your kidneys are filters for your blood and so the more hypertonic, or hypotonic the saline level in your blood is it’ll either suck up or add too much water to your blood. And the thing the nephrologist mentioned about the acidosis thing is I think because your blood also needs to be at a specific pH level, and the disassociation of excess chlorine ions makes your blood more acidic. That nephrologist dude has to be very particular about managing the salt levels in peoples bodies (again I could be totally wrong I have zero medical background on anything I’m literally a meteorologist) hope this helps. :))))))
Dr. G, you are the BEST!. I have walked those shoes so many times....Med Student, Ortho Resident, Ortho Attending. Could help from laughing sooooooooo many times. New favorite for me. Thank you for your hard work...You are the video supplement to House of G d book. What a pick me up......thank you
I can't think of how to better demonstrate my support and appreciation of your videos than to suffer through this 5 minute advertisement without clicking 'skip ad'. I'm loving this interaction between bone bro and salt bro!
They put so many fluids into me for tib fx repair I asked for a catheter. "We've never had someone ASK for a catheter before" turned into "I've never seen anyone fill so many bags in one day"
@@punchkitten874 LOL! I’d ask for one, too! The crappy part is you have to be able to pee within six hours after it’s out or they won’t let you leave 😫
I have chronic kidney problems (Thanks, Lupus!) and from now on I will be calling my kidneys my Little Bean Buddies every single time I have to talk about them. I am actually looking forward to my next appointment with my GP so I can use the term. Thanks, Ophthalmologist Bro! I love you now, forevermore.
My brother is a PharmD and he worked in a transplant ward, so his main job was fixing all the medication orders. Because a lot of people getting transplants are already on multiple meds to keep them alive and then they get the anti-rejection medication, and then if there is anything else that goes wrong like infection, illness, hypertension, etc. Doctors order stuff all the time that can’t go with what the patient is already on. He also fixed stuff for babies a lot because there are serious calculations involved for certain medications that depend on accurate weight by grams of the baby. He also fixed TPN orders. He got to be part of the care team for a face transplant (I think it was the 22 in the world, or something like that). He really enjoyed his time in that hospital.
Thats really impressive and so cool that he enjoyed what he did.. my favorite class was pharmacology but ended up not going into pharmacy as I thought that the insurance stuff would drive me crazy ... but yeah a hospital would've been more patient care.. and much more interesting.
Saline does the job we want it to do: it makes the exsiccated kid feel marginally better and it makes the parents stop bitching about "no proper treatment". For this particular purpose, ringer is far too expensive and unnecessary. For support infusion therapy, we make our own fluid with -blackjack and hookers- sugar and potassium.
I had appendicitis, basically couldn’t even take a full swallow of water without throwing up, and the dehydration was what finally scared me to going to the ER. I THOUGHT I had a stomach bug that would go away. Anyway, it ruptured and I had an open appendectomy, and for a couple days I, apparently, wasn’t getting enough fluids. Like I was very thirsty and the docs were concerned I wasn’t peeing, they catheter’d me twice and got like a few ccs of the most concentrated urine. My mom, a family practice physician, flipped out when I told her that (she went to sleep at a hotel and the catheter thing happened while she was gone), I could hear her yelling from the bed. The attending apologized to me for the “misunderstanding” and the hospitalist took over, like supposedly a resident had erred or something, I didn’t really follow it. All that to say, I wish nephro bro was real
House wine or house special at my hospital. Which is quite annoying when 3/4 of your nurses are new and are too scared to ask what that means. or remember to look up compatibility with all the components for ivp or piggyback meds.
He’s not wrong. It was weird I’m a Canadian nurse and worked in the US and I saline locked my fresh post op hip right away as she was drinking and peeing well and only lost 200ml blood during her surgery. The nurses thought it was so weird I did that without a doctor’s order! I couldn’t believe that I didn’t have my own autonomy for basic shit like saline locking a pt. Anyways, I just prefer my pts to not get fluid overloaded or disrupt their pH and electrolyte balanced thank you very much. Luckily didn’t get written up
