- Today I'm looking
at some of the most unique medical conditions
and surgeries caught on camera.
Some of these, I've never even heard of.
They're so rare.
Also, huge thanks to ShipStation for sponsoring this video.
Let's get started.
- [Narrator] Disa is a small agricultural town
in Northwest India.
13-Year-old Shrea lives here, with her extended family.
But 18 months ago, Shrea found herself
at the center of a medical mystery.
- [Interpreter] One evening she sat here
and complained her ear was hurting.
When I checked, I found an ant.
- When I look inside my patient's ears
using an otoscope, I find unique things.
A lot of times, it's pieces of cotton from using Q-Tips
which I tell them not to put deep inside their ears.
But there have been insect parts
or even insects that I've seen inside people's ears, so
that's not totally unusual.
- [Narrator] Shrea had been sleeping
on the floor and in the summer, ants are common.
- [Interpreter] After that, more
and more ants were appearing.
It was painful and itchy.
- Not only is it painful and itchy,
but you're gonna hear the ants moving around in there.
It can drive a person mad.
- [Interpreter] MRI and CT scans were taken
as Dr. Talsania searched for somewhere
within the soft tissue or bone
around Shrea's ear where an ant may have laid eggs.
- Like in the eustachian tube?
- [Narrator] But incredibly,
the scans showed nothing unusual.
Then, after nearly eight months,
just as suddenly as they first appeared, the ants vanished.
In that time, about 1,000 ants had been removed
from Shrea's ear. - Wow.
- [Interpreter] I don't know why they aren't coming anymore.
When I read all the medical science books, no one knows why
and how the ants entered her ears in the first place.
- There must be some kind
of hygiene issue where the ants were able to enter the ear
and they sat in some sort of crevice
behind a part of the ear and were able to lay some eggs.
And when those eggs were hatching, the ants were coming up.
- [Narrator] The Da Silva family never misses an opportunity
to get together.
They're excellent musicians and dancers,
but, it's something in their genes
that truly sets them apart.
- Oh, polydactyly.
- [Narrator] 14 Members of the Da Silva family,
have six fingers on each hand and six toes on each foot.
- They must have some kind of gene that encodes for this.
- [Interpreter] Anna Carolina, she has six.
Jao, my son, has six.
- Wow.
- [Narrator] Today the family's celebrating the arrival
of a baby boy.
His father, Alessandro, has six fingers.
- It's gotta be some kind of dominant gene
because it's being passed
onto it seems, like every member of the family.
So it's some kind of autosomal dominant gene.
- [Narrator] So like his older brother, he had a 50% chance
of inheriting the six finger gene.
- [Doctor] Let's count them.
One, two, three, four, five and six.
- [Interpreter] My brother is going to have six fingers.
- Gotta love the ultrasound probe.
- [Narrator] The Da Silva family's hands are all fine
and functional, and they find six fingers can be an asset.
- [Interpreter] The coolest thing
about having six fingers is being able
to hold a lot of things at once.
- Yeah, I can't imagine
that being a major detriment in any way, really.
Maybe for things designed
for people with five fingers, like gloves,
it might be complicated to find a set of gloves.
So you might have to use mittens.
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All right, let's get back to these conditions.
- [Narrator] 17-Year-old Workitu, lives
in Addis Ababa, Ethiopia.
She looks like a typical teenager,
but has spent much
of her life hiding an unusually rare physical condition.
Workitu was born with an extra set of arms
and legs, limbs from a parasitic twin
that died in her mother's womb.
- Okay, so when they say parasitic twin,
the reason they say it
that way, it sounds like there's some kind
of illness going on,
but what's in reality has happened is,
you had an underdeveloped
or non-fully-developed twin happen inside your body
or on the outside of your body that didn't have any organs
and essentially, is surviving off of the energy
and lifeblood off the single body.
- [Narrator] Workitu grew up thinking her body was normal,
although her parents insisted she cover herself
with long dresses.
Workitu was 11-years-old when she found out
that her body was different during a school sports class.
- That's gotta be difficult if you're the only one
in your class experiencing something like this,
you're gonna feel like an outlier
and you're gonna need support
from your friends and family,
and maybe even medical professionals.
- [Narrator] The Cure Hospital
in Addis Ababa is Ethiopia's leading children's hospital.
It's specializes in treating common deformities
like cleft palate.
But doctors there, had never taken
on a case as complex as Workitu's.
- I mean, in many cases this is a surgical procedure
that can be done,
and would probably help the individual significantly, if not
for anything, the musculoskeletal support.
Remember, carrying excess weight of limbs
on your body is not comfortable
for the biomechanics of walking, let alone standing.
- [Narrator] After three weeks of tests,
the doctors decided they could operate.
The limbs of the parasitic twin would be amputated.
Surgery of this kind had never been attempted in Ethiopia.
- The only option that you have
for treating this problem is surgery.
- Yeah, it's surgery with an amputation
and then some kind of embolization of the arteries
to prevent the person from bleeding out.
- So we have to do as many imaging studies as we can
to be able to document
in our minds, exactly what the anatomy is
as close as possible.
- That's why a lot of times
when patients request a CT scan, an MRI, we have to agree
that the reason we're doing these scans is
for the purpose of getting surgery.
Because in many instances, getting an MRI
to get a diagnosis doesn't help you
in any way other than making a diagnosis for the surgeon.
- [Surgeon] We started first with the rudimentary arms
because we thought that would be easier
and actually, that came off
as easy as it possibly could have.
Then we moved down to the lower part
which is where the pelvis was
where we were going to remove her legs.
And this was a little bit more challenging.
- I can imagine this being challenging
'cause you gotta navigate the host
or patient's organs and circulatory system.
Remember, her body has been feeding these limbs, blood rich
in oxygen so that there is these extra arteries
that need to be severed.
But you also need to make sure you're not severing arteries
that could be also, contributing to her health.
And sometimes, with patients
that have what they're referring
to as a parasitic twin, they can have one
of these fully inside their body
and sometimes, we can't even know
if this is what's known as a teratoma,
which is a type of tumor that has all different types
of cell lines in it, hair, fingernails, bones, et cetera.
Or is it truly a parasitic twin?
- [Interpreter] I used to work
in a plastic-packaging factory,
operating an extruder machine.
- [Narrator] An extruder machine grinds
and melts plastic materials
to create tubing, plastic sheets and films.
- [Interpreter] I was assisting the machine operator.
My hand was dragged into the cylinder.
I held my arm and screamed.
I could feel the tip of my fingers inside it.
It was an agonizing moment.
- [Surgeon's Interpreter] The night shift called me
and explained that they had a case
where they were likely to amputate.
- So in many instances
when you have a hand injury, especially a crush injury,
unless you have a super sub-specialized hand surgeon,
you will just go forward with the amputation.
Even in our ERs here in the Northeast, if you have a patient
with a a bone injury of the hand,
you generally don't call the general orthopedist.
You call a hand surgeon.
- [Narrator] Dr. Brandao planned
to surgically insert Carlos' left hand inside his abdomen
to allow his body to regrow torn flesh and nerve tendons.
- [Surgeon's Interpreter] We made an incision
on the side of his abdomen.
This created a space in between the skin
and muscle to tuck his hand where it would connect
with live tissues, creating a neovascularization.
- We have seen this happen with burn patients before.
I haven't seen this happen
with a trauma situation like this.
- [Narrator] For six weeks, Carlos endured the physical
and mental anguish of having the affixed hand.
- I just don't understand the purpose
of this, outside of growing the skin
because if the bones are broken
and crushed, what is the goal here?
- [Surgeon's Interpreter] The abdomen fat
and skin got attached to his hand
and created vascular links.
Here we can see the x-ray of Carlos's open and closed hands.
We noticed the mobility of the remaining fingers.
Now the thumb, which is almost
in its entirety, has reasonable movement.
- [Carlos' Interpreter] Today, I can feel
all fingers separately.
It's a bit hard to move them because they're all joined,
but I can move them one at a time.
But I have faith that it will look like a normal hand
in the future.
- I mean, I'm sure
that there's other hand specialist surgeons
that could probably change
at least, the appearance of this hand
and to make it more functional.
In instances like this by the way,
you don't just also do surgery, you also work
with not just a physical therapist,
but an occupational therapist 'cause you need
to make use of the hand.
And occupational therapy focuses
on those fine motor movements like buttoning a shirt.
- [Narrator] Bahia, Brazil.
In 2009, a pair of healthy twin brothers were born here,
Atur and Artur, but in a one in 200,000 chance,
they were conjoined at the waist.
- So conjoined twins can happen
in different parts of the body.
You can be joined in the lower portion
of the spine, the longer portion of the spine,
the head, even the upper body.
We used to use the term "Siamese twins,"
because of case that occurred in Siam,
which is now Thailand, by the way.
We've moved away from that
and are now calling them conjoined twins
because they're literally attached,
and in most cases, surgical separation is an option.
This can get quite complicated in certain instances
because some of these twins actually share organs
or blood vessels,
and if these are vital organs
that you can't split or separate,
that obviously becomes more problematic
and the surgery becomes more dangerous.
- [Narrator] Surgeons prefer to separate conjoined twins
before their first birthday,
but Artur and Atur were too weak
and didn't have enough skin to cover their wounds.
For the past five years,
the boys have endured 15 procedures intended
to grow extra skin using silicon expanders
and finally, they've grown enough extra skin
for the operation to proceed.
- [Surgeon's Interpreter] In their abdomen,
they share one liver, the large and small intestines.
There is only one bladder and one set of genitals.
- So this is gonna be tough
because the liver, maybe, you can separate.
The intestines, maybe, you could separate.
But bladder, what do you do?
- [Narrator] Atur will have a permanent catheter
so he can urinate, as well as a colostomy bag.
- A catheter is gonna allow for the passage of urine.
The colostomy bag is gonna act as the rectum
and essentially, store stool that you can empty.
- [Narrator] Although the operation is over,
Dr. Khalil knows that recovery is going
to be a major hurdle.
Atur is alert and has been responding well,
even managing small conversations with his parents.
But Artur is weak and is fighting a fever.
- [Surgeon's Interpreter] Sadly, Artur had
a very severe inflammatory syndrome.
He wasn't responding well to any medication
and he passed away.
- Which happens in a lot of these cases, unfortunately.
- [Narrator] Two years have passed
since Atur and Artur were separated.
- [Interpreter] This skateboard was made by my father.
Look, it's just a board and he covered it in foam.
- He looks like he's developing well
in terms of his muscular structure, his verbal skills.
- [Interpreter] His recovery is surprising.
He's a child that almost has a normal life.
He has a physical disability,
but it doesn't keep him from anything.
- So he does have a normal life.
Maybe a unique life, but a normal life.
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As always, stay happy and healthy.
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