- [Man] This is a tweet that came out the following day.
- All right, I'm ready for the tweet.
Let's open it.
Oh, pooped.
Hey guys, welcome to another episode
of the Wednesday Checkup.
Today, we're going to be talking
about Markiplier's recent plight with the medical system.
He had some abdominal stuff going on
which has been troubling him for about half a decade.
But in order to do this,
I had to bring in a sub sub sub specialist.
Welcome to the channel, Dr. Austin Chiang.
What's going on, buddy?
- Hey Mike, thank you so much for having me.
My subspecialty is actually in gastroenterology
which is digestive diseases.
But then within that, I'm also an advanced endoscopist
where I do more complex procedures.
- You are also a TikTok specialist.
(dance music)
- Hey guys, thank you guys so much
for caring about what's going on right now.
I just wanted to give you a small update.
Yesterday, I did have to get surgery done.
I have what's called a small bowel obstruction, or I had.
It was formed by a scar tissue
from my previous surgeries that I had
before I started YouTube.
- You wanna talk about this Nasogastric tube, pSN?
- Yeah.
As you can imagine, if there's a blockage in the bowel,
there's no place for food or liquids to pass through.
And even if somebody isn't eating anything by mouth,
the stomach for instance
is naturally screening a lot of fluid.
And even if you think about our mouth
and the saliva that we make
that we're constantly swallowing, that has no place to go.
This tube serves to suction out that liquid
so that it actually has a place to go.
And it doesn't just build up.
- It sounded like he was saying
was that he was having the small bowel obstruction
to translate into common English terms
is his small intestine
which comes right off of the stomach, had an obstruction.
He explained that it was from his prior surgery.
There was probably some scar tissue that essentially
closed off the intestine, preventing food
and the liquids from traveling down.
And as a result, you start vomiting profusely.
You feel awful.
Your stomach starts expanding.
You're bloating.
You're uncomfortable.
No matter what medicine you give to a patient,
unless you either open up the blockage
or take all the contents
of the stomach and the GI system out of the body,
you're not gonna stop vomiting.
So putting in these NG tubes in patients
like this was the number one way to relieve the symptoms
and to buy time in order to get them to the procedure.
- Hey guys, I am at the hospital right now.
I'm fine.
I've got an NG tube in my nose right now
which drains stuff out of my stomach
because I have a small intestine blockage.
Man, this is unexpected.
Came out of nowhere, but I'm fine.
It's nothing life threatening.
I don't even think I'm gonna need surgery this time.
They're just going to suck it out of me.
And hopefully that fixes the problem.
- In five years, two small bowel obstructions.
Is that common?
I mean, I know there are recurrences
especially once you've had an intestinal obstruction before
and surgery and adhesions, but in his age, is that,
have you seen patients like this?
Is it often?
- You know, I've seen patients like this,
but there's no predicting when about obstruction
can happen again after it's happened once.
If it's due to the scar tissue that we were talking about.
Sounds like he might not need surgery this time around.
So I don't exactly know if it's the same cause
of obstruction again.
I wonder if there's something else going on.
Like maybe something we call an ileus
where the intestine is just slow to move.
And in that case, it just needs time
to kind of get going again.
And we don't wanna add more food or liquid to it.
And it will sort of, we have to figure out
why that ileus is happening
but you know, a little bowel rest might help.
- This is cool for the audience to know.
They're probably wondering if he can't eat, he can't drink,
how is he supposed to stay hydrated?
How is he supposed to get calories?
You wanna take us through the ways that we can do that?
- That's the main way we do that really
is through the IV, through a vein.
We're able to provide fluids that way.
We're able to sometimes even provide nutrition.
Some people have issues that prevent them
from being able to eat for months on end.
And sometimes people have to be on IV nutrition
for a long time.
- I've got good news.
The NG tube has been taken out
of my nose and my gut because that's what it does.
We did a bunch of tests this morning.
A lot of x-rays and a lot of scans
and some contrast to see if things were moving through me.
And it seemed like things were moving through okay.
Which is good.
So the doc said we're gonna take it out
and observe a little longer.
I'm still not allowed to eat anything.
But the doc said that if I can have a bowel movement
then everything is on the up and up.
- We're waiting for the bowel movement.
We're waiting for the flatulence.
It's funny because literally
as a med student and as a resident early on,
you're documenting like no flatulence as of yet.
Like you're waiting for that moment.
What's interesting to me
is he mentioned the contrast that they're doing
I guess, like swallow studies
or is that something you usually do with SBOs?
- Yeah.
I think that if we're suspecting
that it's gonna clear up on its own,
then we can get an x-ray and have them drink contrast.
And that contrast will basically be traced through
the intestine and make sure it's getting past
the point of blockage.
- [Man] This is a tweet that came out the following day.
- All right, I'm ready for the tweet.
Let's open it.
Oh, he pooped.
Actually I think I saw this trending.
Didn't this trend on Twitter?
- [Man] #hepooped.
- #hepooped.
Isn't it funny to celebrate a bowel movement?
Like people don't think that that happens
but doctors celebrate poops.
What do we got?
- [Man] The tweets inspired some memes.
- Okay, we got some memes.
Congratulations.
This certificate is to commend Mark Edward Fishbach
for passing a bowel movement award
in the third of December.
This is a certificate of poop.
You never thought that would come into the conversation.
- I wasn't sure if I was supposed to come in anyway
because I didn't know if it was gonna be a problem
but they said they were glad I did.
And this is how I know the bowel obstructions
are extra dangerous is because they said, if I waited,
that's usually how people die from bowel obstructions.
I wasn't in any danger of dying because I came in way early.
It's usually people that have these kinds of pain
for bowel obstructions and they wait
like a day or two days just to go in.
Like if you've got some weird stomach pain, go see a doctor.
Like it's probably nothing
but it could also be your intestines exploding.
- Okay.
I don't want people to think if their stomach hurts
for a few hours, their intestines may explode.
- So that's why I think it's so important
to have a primary care doctor,
because if you have an established relationship
with a doctor outside of an emergency setting,
and you can contact that doctor and say,
is this okay?
Is it okay to not run to the emergency room right away?
- That's exactly what I would say.
That basically it's a triage component
that people don't appreciate as much.
'Cause they don't think about it.
It's natural not to think about it.
But we have like a 24-hour answering service
like most offices do.
That I tell my patients like, look.
If this continues into tonight
or gets worse randomly in the middle of the night
and you're not sure of what to do, call our number.
We'll have a resident who's on call, give you a call back.
They'll help triage of whether you can wait
until an urgent care appointment in the morning.
Or do you have to go to the ER now
'cause we can talk through the symptoms.
We can talk through your history.
You know, in his case, knowing that he has a history
of small bowel obstructions, it is wise
to come in earlier than later.
But maybe in someone who, you know,
ate some food and is having some diarrhea
and some nausea for four hours,
maybe they don't need to rush to the ER.
Especially if they have access
to a good primary care doctor.
- The first time that it went down
or the nurse tried to get it down, it went into my lungs.
(laughs)
Let me tell you.
Getting a lube covered plastic tube
shoved in your lungs ain't fun at all.
And it was, I felt so bad for the nurse.
I ended up like, I felt bad for the nurse.
Like, you know, she shoves it down
into my throat and I'm just like.
Then she pulls it out a little bit, not all the way.
So it's like still in my nose.
And I'm like.
I think that was in my lungs.
And she's going like, no way that was in your lungs.
I'm like lady, I'm not gonna sue you or anything.
Look, I'm just telling you, I'm not an expert at the inside
of my lungs or other fields that went in my lungs.
- Oh my God.
STAT portable chest x-ray, please.
- You know, if he's coughing
and he's not able to tolerate the tube placement,
it could have gone down the wrong pipe.
After you reached the back of your throat
it splits into your esophagus and then the wind pipes.
So there is a possibility that the two may have, you know,
at least temporarily gone down the wrong tube.
- Well that's why, right?
Like one of the parts of placing an NG tube
is then listening for the stomach,
for the lungs and making sure you don't hear it
in the lungs and you hear it properly in the abdomen.
Maybe putting a little bulb on there
and squeezing some air in.
But if he's already
like can't-ish, struggling to breathe,
I feel like that's a good enough sign
for me clinically to know
that I'm not doing the right thing.
- It was so weird having the internet celebrate me
having a bowel movement.
I can't believe I was.
I knew it was gonna be kind of like that but I had no idea.
It was like, you guys are gonna make a trend
on Twitter or something like that. (laughs)
He pooped!
- We are officially Markiplier fans here.
Shoutout Mark.
We're glad you're doing well.
If you ever want to do a try not to laugh
medical challenge with us, we're game.
Dr. Chiang, thank you so much for joining us.
All of Dr. Chiang's information
is gonna be linked down below.
Check out all of his social channels.
He's an absolute rock star, accurate info.
He deals in not only in the hospital side of medicine
but also the social media side of medicine.
What goes into that?
Training other doctors.
Truly amazing work.
And if you wanna see another great video,
check out my video here
on the harsh reality of being 800 plus pounds.
Actually the gentleman in this video is the pinned comment.
Click here, and as always, stay happy and healthy.
(jazz music)