Balls and Walnuts
more than you ever wanted to know
Thirteen tools of my trade
Now with Linky Lurveâ„¢!
I don’t think it’s my imagination that I’m not posting as frenetically as usual. Work seems to be nastier lately, and some evenings I have little more than patients on my mind. I suppose this explains today’s Thirteen. An image-intensive (and tardy) thirteen . . . below the cut.
1. Killian nasal speculum. Useful for polyp-grabbing, booger-picking, and all-around nose-peering. Also good for doing pelvic exams on Bride of Chucky.
2. McIvor mouth gag. Rubber ball gags have their time and place, but don’t work well in a surgical suite. The ball blocks access to the surgical field.
With a McIvor, the curved metal ‘strap’ pushes down on the tongue while the strong wire loop keeps the mouth open. This is our workhorse mouth gag for tonsillectomies.
3. Ear specula make ear-mining fun! And before you ask — No, I can’t see through to the other side. Jeez. Some people.
4. But you couldn’t do much ear-mining without an ear microscope, easily my most expensive piece of equipment. Useful for taking out teensy weensy sutures, looking at odd skin lesions with magnification, or setting ants on fire.
Ever wonder how we take cockroaches out of people’s ears? With an alligator, of course!
5. Alligator forceps, to be exact. So named because the jaws open and close like an eensy weensy alligator! In addition to cockroaches, alligators are great from removing all sorts of foreign bodies from people’s ears and noses: artificial fingernails, ants, lumps of crack cocaine, cotton balls, fragments of mud mask, and Silly Putty.
All true stories, by the way.
But you can’t remove beads with an alligator forceps — for that, you need a Rosen pick. Sorry, no pictures; imagine a slender metal rod tapering to a curved point. Insert curved point into bead-hole and pull. Et voila!
6. And have you ever wondered how we stop nose bleeds? Complicated answer, really, but one thing we use is a nasal tampon:
True fact: like those other tampons, these tampons can give you toxic shock, too.
7. The Stryker saw is a vicious-looking tool.
You may have seen this in any number of horror movies. This one comes from a web page entitled, “How Autopsies Work.” Doubtless Tam has spent some quality time here 🙂
We use a smaller version of this to cut into the frontal bone for an operation known as a “frontal sinus obliteration.” This is truly one of the more gruesome operations I know how to do. To gain access to the frontal sinus, I make a coronal incision (ear to ear, across the top of the head), peel the scalp and forehead downward, then use the Stryker saw to slice into the frontal bone.
Oh, it’s fun.
8. Hammers and chisels and flesh, oh my!
From Rhinoplasty or Nasal Surgery, How is it Performed?
I use the hammer and chisel on most septoplasties. Always fun watching the OR staff blanch when I go tap, tap, tap right down the middle of someone’s head.
But sometimes, all a patient needs is a good, fat shot.
9. Syringes.
One of these days, I’ll have to buy one of these antique syringes. It would be sooo useful, next time I get a whiner in my chair. Oooh, you don’t like nasal sprays? Well, we could always GIVE YOU A SHOT!
My blog persona and my office persona are quite different. I’m a nice guy in the office. Really.
10. Trach tubes.
eBay lists this as an antique, but we still use stainless steel trach tubes identical to this one:
Can’t beat ’em for durability or cleanability. But where would I be without . . .
11. Tongue depressors.
You can get them flavored, but they cost about ten times as much. So suck it up and say AAAH already!
12. We use silver nitrate sticks to cauterize small bleeding vessels — usually in the nose, but I have used these for bleeding ears, too.
Word to the wise: if you go to your local ER with a nosebleed and the ER doc comes at you with one of these, make DAMN sure she has numbed up your nose first. These mother-effers hurt.
Last but not least, the one tool which has come to symbolize my profession:
13. The head mirror. She looks like a Sim, doesn’t she?
These buggers are a pain in the ass. When I first came to Crescent City, I moved into the office used by our town’s previous ENT. He had installed hanging, naked 200 watt bulbs so that he could use his head mirror. Those bulbs were dangerous!
So I said, screw that, I don’t want my patients getting second degree burns every time they brush up against my damned light bulb. And I bought one of these:
Oooh, baby. Several hundred dollars’ worth of fiberoptic goodness. Sure, when I wear it no one ever says, “Mommy, look at the funny ENT!” like in those old head-mirror days. No. They whine, “What’s that?” And the younger ones usually just scream.
It’s 11:30 PM and I am only now finishing this bloody Thirteen. Would you believe I thought this would be an easy topic? And I’ve been working on it, off and on, all day. Amazing!
I’m pissed, though. I wanted to show you the Rowe Disimpactors and I couldn’t find a picture.
So, yes, I know it’s Friday for you already, but get in the spirit of things. Leave a comment and I’ll give you the love.
Noxcat is a codpiece artist. Who knew!
Kate’s list of writer-bloggers . . . oh, let’s just call them woggers.
(and, Kate, I’m afraid that’s a Friday Fifteen.)
Cintranista Steven Felty dishes on Jenna Bush
and
Dean pimps Erin’s female ejaculation raffle. Again. Stop it already — I want to win!
Lyvvie, you’re hotter than all those beeeyotches.
Da Nator’s got Teh Hottest scrubs!
. . . and Darla has Teh Rules of beta reading.
Protected Static gives you the dope on how to foil sploggers
Erin wants to give away some liquid love
D.
I HATE silver nitrate sticks!!! The dialysis clinic uses them to cauterize my catheter exit site when it’s weeping, and yes, they do hurt! (Frequently more than the original complaint.)
omigod, no wonder you want to visit mistress matisse.
but I don’t know if it would work out becuase you’re so obviously a top in the SMBD world!
The Killian Speculum and the Alligator Forceps look like they could be used to determine Ann Coulter’s sex as well. You could use the speculum to dialate Ann’s cloaca and the forceps as a probe!
Also the wooden tongue depressor is not my favorite thing. Can’t they be made out of flavored gluten like a dog treat?
also I have my 13 up but they’re nowhere near the neighborhood of amazing like yours.
Wow. A Rowe Disimpactor.
That sounds like:
A: something I would use in my biz, where I deal with rows and rowcounts and cardinality.
“I’ve got a problem,” they’d say, raising their hands in supplication, their tearstained faces begging my data supplication.
“Let me get my Row Disimpactor!” I’d cry.
You know what? Part of what I do is write tools for the management of databases, and I’m going to call one of them the Row Disimpactor.
B: something out of a sci-fi novel. Dr. Rowe, with his Disimpactor, attempts to take over the world! Ok, that’s an old plot.
I never knew a simple tampon could save someone’s life. I’ll remember that the next time I’m around a barroom brawl; it would give me great pleasure to shove a tampon up some bloke’s nose and watch him sitting there with a string hanging out his nose. I may have to write that into a story somehow because it’s just priceless. Could one use diet cola to expand the tampon?? I imagine it would be extra stingie up the nose. Would a person having a tampon inflated up their nose sneeze a lot?
I stuck a bean down my ear canal when I was five; I wanted super hearing like the Bionic Woman – I’m sure I’ve told you this before…anyways, I had my ear syringed instead of having a crochet hook inserted in my ear. It was awesome! It sounded like I had Niagara Falls in my head. Never forgot it.
Now, did the person with the fake fingernail lose it up her nose or in her ear canal?
Noxcat, the nurse COULD, if she were nice, put a bit of lidocaine jelly on the granulation tissue before burning it with silver nitrate. Just a thought.
Kate, mmmmm Mistress Matisse mmmmm. No, with her I would definitely be a bottom.
Steven, I understand from my wife that the New Plan is to ignore Ann. If we all ignore her, she’ll go away.
Dean, Rowe Disimpaction Forceps are used to pull out the middle third of the facial skeleton after a severe crushing injury (what’s known as a LeForte fracture). They look like fireplace tongs, except they’re curved to fit into the oral cavity on the downside, straight to fit the nasal cavity on the upside. Insert one on each side, clamp down, and pull. Absolutely brutal.
Lyvvie, it would make a superb story. And the fingernail was in the ear canal. Very ouchie.
This was fun! Show us more!
Also, I agree we should ignore Ann Coulter, so she goes away. Her whole raison d’etre is being bad to get attention.
But I got a good giggle out of the comment about her “cloaca.” I think my turtles might be offended, though.
P.S.: I like the way tongue depressors taste. Makes me think of popsicles and shop class…
Yeesh. One of these days, I’m going to learn not to click on your links.
Da Nator, some genitalia doesn’t bear thinking about.
Darla, which one bothered you? Because if it was the ball gag, I chose the tamest link I could find. And I looked at many.
Folks, bear with me on the linky love. I’m in the office, and this computer is so laggy I just scrapped twenty minutes of linky love-work by accident. I’m going to wait until I get home to finish that part of my work.
Ah, such sacrifices in the name of Art. It warms my heart to see such devotion to one’s Muse… 😉
Why, why, why, do you do this to us? Why?
This sort of thing really gets up my nose.
Begging the question: How often, and how sick are you of being (in fun) referred to as “Treebeard”?
Speaking of art, static, check out tonight’s post.
Erin, I could say the same of you. Why, why spray us with bodily fluids?
Yeah, I know. Cuz Dongley lives for it.
Microsaur, I know who Treebird is, but why should anyone call me that? *puzzled*
To quote “Extras” …. “Are you having a laugh? Is he having a laugh?”
“Treebeard“ for those few cave-dwellers unaquainted with the patriarchal Ent.
Oh, jeez. DUH. I’m slow today.
But to answer your question, you’re the first person to make that joke. I’m not kidding.
Hoom, hmmm… (We’ve been reading the LotR to The Boy as bedtime stories, and we’re just wrapped up the levelling of Isengard by the Ents – Gandalf just chewed Pippin’s arse for looking into the palantir… Doug’s way too hasty to be an Ent.)
To call it ‘foiling’ sploggers is kind, Doug – at best, I’m settling for opportunities to kick ’em in the nads as best I can.