Episode 10 Operation Ouch!

'He's Dr Chris.'

'And he's Dr Xand.'

'Yup, we're twins.'

'Do you know just how brilliant your body really is?

'Well, now's the time to find out.'

'We'll be uncovering the ins and outs of what you're made of.'

It's harder to speak.

'We'll be doing awesome experiments...'

HIGH PITCHED VOICE: You sound ridiculous.

LOW VOICE: Pipe down, Squeaky.

'..as we push our own bodies to the limits...'

OK, here we go.

'..to show you all the incredible things your body can do.'

Oh, no!

Hang around cos this is going to be fun.

Coming up today...

on Operation Ouch.

'What's this man going to do with this hot water bottle?

'We take an amazing journey through Chris' guts.'

That feels very private

-to look inside your stomach and see your sweets.

-Yeah!

'And I take on a surgical challenge.'

It's wet and it's covered in blood and it looks very,

it looks very serious.

'Don't worry, those organs aren't real. But first...'

In the UK, over five million people

have to visit the Emergency department every year.

But some cases are more complicated than others.

'At Royal Manchester Children's hospital, 10-year-old Yasim

'was rushed to Accident & Emergency

'after he slipped and landed on his elbow.'

After I fell, my elbow looked swollen.

'This is the good elbow, and this is the swollen elbow.

'Now, how did this happen?

'It was break time, and Yasim was racing

'with his friend and his twin brother.

'Yasim sped toward the finish line. He could see the ribbon approaching.

'He dreamt of winning, nice trophy, bit big,

'when suddenly he skidded, flew through the air

'and landed on his elbow.

'The race to the hospital was on.'

'Ouch. And what about the other race, the one with your friends?'

They said we could finish it off when I get better.

'Or they could just say you won that one, don't you think?'

'First stop is the X-ray department where radiographer takes some X-rays

'to see what's going on with Yasim's troublesome elbow.'

OK, that's all done.

'Enter Dr Ibrar Majid. He's here with the results.

'What's the verdict, Dr Ibrar?'

This is your X-ray. You've broken your elbow

and you need an operation, I think, to fix this.

'Oh, dear. Yasim won't be lifting a trophy for a while.

'He needs an operation

'because part of his bone has come away from where it's supposed to be.'

The reason why it's moved off it is because there's lots of muscles

that are attached to this bone which pulled the bone away.

'Look at that. That's a bit of loose bone!'

Tomorrow, we'll do an operation

where we'll push the bit of the bone that's broken back,

and with some wires fix it.

It's really important that we fix this because if we don't fix it

there's a risk that he can lose some function around his elbow.

-'So, ARMED with this information...'

-'Terrible joke!'

-'..fair enough,

'Yasim goes back to the ward and gets a visit from his family.

'But his brother, Hudafer,

'is particularly worried about the operation.'

I might feel it cos he is my twin brother.

'Ah yes, some twins think they can feel the other's pain.'

'I think you'll be all right,

'because Yasim will be fast asleep during his operation.'

'Speaking of sleep, I think it's about time

'your brothers and sisters left you to get some rest.'

Good luck, Yasim. Stay brave for tomorrow, yeah?

'We'll be back later to find out how Yasim's operation goes.'

'This is our lab, where we're going to put our bodies to the test

'to show you how your body works.'

Ow, that really hurt!

'Just don't try anything you see here at home.'

'Today we're looking at digestion.'

We're going to follow the journey that food makes through Chris' body,

and in order to do this I need to get Chris to swallow a camera.

This camera. It's a mini camera pill, and Chris is going to eat it.

And it's not just a camera. There's lights,

a battery and a radio transmitter in here.

And what flavour is it?

-Camera flavour.

-My favourite.

It's a new bit of kit that doctors use

to look at problems with people's insides.

So we're going to go on a journey from my mouth

all the way through my digestive tract.

Let's go!

'It's going to take approximately eight hours for the pill

'to make its way from Chris' mouth, through his body,

'until it comes out in his poo.'

'And the first phase of the journey is getting into the stomach,

'and this only takes seven seconds.'

It's amazing how quickly it's gone into your stomach, isn't it?

Yeah, it goes like that, doesn't it?

And you can feel that, when you drink cold water

-you can feel it go cold in your stomach.

-Yeah.

'Here are live pictures from the inside of my stomach.

'The ridges you can see are muscle.

'That's what pushes the food you eat through your digestive system.'

So there's lots of space in your stomach. It's basically

a muscular bag where food is stored while it's cleaned by stomach acid.

Chris, now I want you to eat some sweets,

and we'll be able to see them in your stomach. Here's some water.

'These sweets will now make their way down to my stomach.

'Here they'll spend a couple of hours being swished around

'and washed clean. It's a bit like a washing machine.'

That's the reason you have acid in your stomach.

It's not to break down food,

it's to kill bacteria that might cause disease.

And you might think it's a bit dangerous to have

a bag full of strong acid in the middle of your body,

but actually the stomach is coated with kind of thick protective mucus

and that stops the acid attacking the stomach.

'So let's see if we can spot those sweets.'

Yay! Ha-ha!

'There we go. Two of them, side by side.'

That feels very private

to look inside your stomach and see your sweets.

Yeah!

So the sweets and the camera will now be cleaned in Chris' stomach acid

before being pushed out of the stomach through the sphincter muscle.

'The next stop in my digestive system is the small intestine.'

This is where the action really happens.

'There are the sweets from earlier,

'and you can see the furry lining of Chris' small intestine.

'It's made up of tiny finger-like things

'that help to break down food.'

The small intestine's where food gets digested,

and it gets mixed up with chemicals called enzymes that digest the food.

'And that's what we can see from these live pictures inside Chris.

'All that yellow liquid is the mixture of food, bile and mucus,

'and you can also see the blood vessels

'on the walls of the small intestine.'

The reason the blood supply's so good here is because

this is where your body gets what it needs out of the food. It gets all

the nutrients and it gets all the protein, the fat, the carbohydrates.

And then this sort of sludge here

is a mixture of bile and the food that you can't digest

and the mucus will go into the large intestine.

That's where it gets turned into poo.

This is like tomorrow's poo.

'On to the final destination for the camera pill,

'the large intestine. And that means it's poo time.'

The large intestine is the final bit of your intestines.

It runs like this along here, out here and out your bum.

The camera is now in much thicker liquid

and the main function of the large intestine

is to take the liquid out of this and make a solid poo.

It's still quite liquid, isn't it?

But there are much more solid bits in it now.

In fact, I think the camera is now kind of up against the next poo

that I'm going to have and it's going to become part of that.

It's a very high tech way of looking at your poo.

Yes, I think it would be much easier to wait till it came out,

but then we wouldn't get to see my lovely healthy gut.

'Hmm. Lovely isn't quite the word that springs to mind

'but seeing live images from the inside of Chris' guts

'has been pretty amazing.'

'From the moment you swallow your food, just like the camera pill,

'it will take eight hours to travel a total distance of nine metres

'from your mouth to your stomach, then from your small intestine

'to your large intestine, until it's ready to be pushed out as poo

'and ending up in the loo, which is where that camera pill is headed.'

'Did you know?'

'Wow, that's amazing and so is this.'

'An ordinary gym, with ordinary weights

'and ordinary people lifting them.'

'Well, except one person.'

'This man may hold the world record

'for the most weight squat-lifted in 24 hours,

'but he's also got an even more amazing body skill than that.'

'Erm, is that a hot water bottle?'

'Yep, and just wait to see what he can do with it.'

'This is Shaun Jones, and he's mastered the unusual art

'of blowing up hot water bottles until they...

'..explode.

-'That is one powerful set of lungs.'

-'It certainly is.'

'Shaun holds the world's record for the fastest hot water bottle burst.'

'But why does he do it?'

I first started to do the hot water bottle burst

in a training programme to enhance my training power.

'Blowing up a thick plastic hot water bottle

'is 50 times more difficult than blowing up a party balloon.

'So, how does Shaun's amazing body do this?'

'Well, although he makes it look easy,

'Shaun has the incredible ability

'to expand his lungs more than the average person,

'filling them with loads more air.

'And then the super-strong muscles in his chest, diaphragm and tummy

'means that he can blow out air with so much force he can do this...'

'And it's taken years of training to get this quick at it.'

Usually we train twice a day, morning and night,

and we usually do about three or four hot water bottles per day.

'People who have a large lung capacity like Shaun

'can get more oxygen into their body faster.'

'But don't try this yourself. It's best left to the experts.'

'Now that's amazing.'

'Still to come...'

'Xand shows you what's inside some real bones...'

So it looks like rock,

but actually, your bones are as alive as any other part of your body.

'We show you a trick to amaze your friends.'

'And I get stuck in with a team of surgeons.'

It's wet and it's covered in blood and it looks very serious.

'It's OK, though, it's just a dummy. But now...'

Let's head down to the Accident & Emergency department

to see how our patient is doing.

'Back at Manchester it's time to check in with Yasim

'and his broken elbow.'

'He'd been running races at school

'when he tripped and fell on his elbow.'

'X-rays showed that part of one of the bones in his elbow

'had broken loose and he's got to have an operation

'to put it back in place.'

'So how are you this morning, Yasim?'

I'm feeling scared of the operation. I think it might hurt.

'Don't worry because you'll be getting some special gas

'that will make you sleep through the whole thing.'

So, we'll start off with strawberries.

'Strawberries? This is no time for a picnic.'

'Xand, he's talking about strawberry-flavoured sleeping gas.'

I want you to take some nice deep breaths through that.

'Anyway, as Yasim settles in for a snooze,

'the operating team start work.'

'First, the doctors have to put the bone back.

'To make sure the bone doesn't move,

'the wires are inserted into the elbow.'

'Now prepare yourself, cos this could look a bit icky.

'Told you.'

'After checking everything's in place...'

It looks good, actually.

'..the doctors replace the wires with temporary screws.'

'More blood shots coming up...'

'The screws will make sure Yasim's elbow sets

'in the correct position and will be removed once everything has healed.

'All that's needed now is a few stitches.'

'The operation's been a success, and a couple of hours later,

'Yasim's awake and he can't remember a thing.'

I feel happy because, erm, before it I was a bit scared.

'Don't worry. It's all behind you now.

'But what about that brother of yours?

'He was worried HE'D feel the pain. It's a twin thing.

'So, did he?'

I had a headache and my leg started to wobble.

'Your leg started to wobble?

-'Did you feel any pain in your elbow, though?'

-No.

'Oh, OK. So what about the racing, Yasim?'

I'm going to stop running for a while

and watch my friends run instead.

'Good plan, although from that top it doesn't look like your twin's

'ready to hang his running shoes up just yet.'

'But after a bit of TLC from everyone,

'Yasim is ready to go home.'

'We've got loads of amazing body tricks to show you,

'and with this one, your friends won't believe how strong you are.'

-What are you doing?

-I've got my hand on my head.

-Take it off.

-Make me.

XAND GROANS

-Is it glued?

-I'll show you. It's very easy.

-Ohh...

OK, I'll get it off.

This is a really great trick that you can do too on anyone,

no matter how strong they are.

You simply put your fingers on top of your head and press down.

'It's simple. Your bicep muscle is so strong it locks into position,

'and no-one can move it until you decide to relax it.'

I know what it is.

My brother has developed superhuman strength.

'Now it's time for us to hit the hospitals to show you what goes on.'

'On Operation Ouch, we've seen loads of different surgeries.

'If you've ever had an operation,

'you'll know that surgeons are the highly skilled doctors

'who work in operating theatres,

'fixing things that go wrong with the body.'

So how do surgeons know what to do? Well, just like everyone else,

they need to practise, but they can't do that on real people,

so they practise their surgical skills on dummies.

That's plastic models, not dummies like Xand.

'I'm going to get hands on with a training surgery

'in this special pop-up operating theatre,

'designed to look and sound like the real thing.

'The man in charge of it all,

'and with the perfect name for the job, is Professor Roger Kneebone.'

So what do you think I can expect when I go in there?

When you go in there you're going to be going into an operation

that's already started and I think what will happen is that you'll find

because you've gotta do stuff because you've gotta do

surgical stuff and you've gotta focus on doing that,

that's where your attention will be

and you'll pretty quickly lose sight of the fact that it's a simulation

and you'll think it's real.

So I'm very curious to find out if that is true. At the moment

I feel like, I know it's a silicon dummy, I know it's fake blood,

I know there isn't a life at stake,

and I'm just not expecting to get all that worried about it,

but maybe, as you say, I will sort of buy in.

We'll see.

'So I'm going to be operating on these fake organs,

'but how well will I work as a surgeon under pressure?

'With all this equipment and a proper surgical team

'this is going to be a real test.

'And the woman who'll be assessing my surgical skills

is experienced surgeon

Dr Laura Coates.'

So Laura, what am I going to be doing today?

We're going to get you into theatre,

you're going to be doing the operation

and the dummy is a 13-year-old boy that's had a handlebar injury

to his tummy and he's come into A&E with lots and lots of pain.

He's had a scan that shows that

there might be some mischief going on inside his belly

and we want to find out what that mischief is.

So you're going to be assessing me.

What are you going to be looking for?

You need to take the lead on looking for the problem in a systematic way

and then finding the problem

and dealing with it in a calm, controlled manner.

'No pressure, then.

'First things first, I need to get scrubbed up.

'This is a vital part of preparing for surgery,

'to make sure the operating theatre, including me,

'is completely bacteria free,

'so I don't pass on any germs to the patient.

'So, here we go. Let's see how I get on.'

I'm not used to this position,

this is the lead surgeon position, isn't it? OK.

Yeah, absolutely. You're taking charge.

This is extremely realistic, isn't it?

Yeah, have a feel of it.

'Although this is a dummy, the organs are surprisingly real.'

It feels a lot like real human tissue, it's really extraordinary.

It's wet and it's covered in blood and it looks very serious.

You know, if this was a real person we opened up the abdomen

and this is what we saw, it'd be very worrying, wouldn't it?

'If the patient was well, there wouldn't be this much blood,

'so I need to work quickly to check if any of the organs in the abdomen

'have been damaged and find out where all the blood is coming from.'

So I'm going to divide the abdomen into the four quadrants.

-I'm going to start in the top left quadrant.

-Absolutely.

So this is the spleen I'm feeling. The top of the spleen feels intact.

OK, so move on down to the bottom.

'Now I've given the all clear on the spleen,

'I need to move quickly onto the liver and then the bowels.'

Can we have a large swab, please?

Quite a lot of blood coming up from here.

'I still haven't found the source of the bleeding,

'and the patient is losing a lot of blood.

'If this was a real surgical situation it would be very serious.

'So I need to find where the blood is coming from and stop it fast.'

This patient is losing a huge amount of blood.

'Oh, there it is, I've found it. It's in the lower bowel.

'So this instrument that looks like a pair of scissors

'is actually a metal clip that's grabbed the blood vessel

'and stops it bleeding temporarily.'

Excellent - well done.

Having found the artery and clipped it, we can't leave this

big metal clip inside the patient,

so we need to tie off the artery.

Now I have to tighten these knots to make sure

we've stopped the bleeding permanently.

OK, the knot's not quite tight enough.

My surgical tie. No, that's come off. OK.

So although I know this is a dummy, the force of habit of seeing

that much blood, which looks very real squirting out of the patient,

is very exciting. I don't know if you get used to it,

but that was - I had a real sense of urgency about having to

quickly do something and also that slight sense of,

cos I'm not a surgeon, of not really knowing exactly what I'm doing.

But I'm pleased to say my 13-year-old dummy

has made a perfect recovery.

Phew.

'And I'm glad you were working on a dummy too, Chris.

'Best to leave the real life-saving operations to the trained experts.'

What I was amazed at how realistic it felt,

so I was very stressed while we were looking for the bleeding,

and then when we clipped it off, I just felt this big sense of relief.

I really bought into -

this wasn't a dummy, this was a real patient and we needed to stop it.

So overall, how did I do?

The things you did well were the systematic approach,

you did things in order, very logically,

and you did things very thoroughly,

looking for a problem in one quarter,

then another, then another and then you found where the bleed was.

Anything I didn't do right?

It did take you a little while to stop the bleeding once you found it

but you did get there eventually, and I think with

more practising here, you'd do that really quickly in real life.

So that's the point of training somewhere like this is that

you build up a bank of experience without doing it on the patients.

For new surgeons, the opportunity to experience a realistic operation

like that is a brilliant way of preparing to operate

on real people and save lives.

How much does the average adult skeleton weigh?

Is it as much as - one car tyre?

Five BMX bikes? Or 15 bricks?

The answer is - one car tyre.

Our skeleton only makes up about 15% of our overall body weight.

The rest is our muscles, guts and blood.

And talking of skeletons, now it's time for Investigation Ouch!

So what do you think the inside of a bone looks like?

This is an animal's thigh bone and I'm going to cut it in half

and show you.

And you can see how amazingly strong bone is by the fact that

I have to use a saw to cut through it.

Aw! There we go. Now look at that, that's perfect.

So it looks like rock

but actually your bones are as alive as any other part of your body.

Inside the bone is a web of fibres,

and that's what gives bones their amazing strength.

These spongy fibres can absorb lots of pressure,

meaning our skeleton is one of the toughest parts of our body.

So bones are incredible but they're also incredibly complex

and in here, engineers are growing them.

Meet engineering expert Dr Michelle Oyen.

She's so interested in the structure of bones that she's built these

robots made out of Lego so they can make artificial bones in a lab.

Michelle, why are bones so amazing?

Bone itself has really fantastic physical properties,

especially for something of its weight or density.

It's really stiff, it's really strong and it's really tough -

resistant to breaking.

So Michelle, what are you doing here?

We're dipping a screw into four different beakers,

two of them just have water,

and the other two have some protein from your body and also some calcium

in one jar and in the other jar, we have some chemicals called phosphate.

So the little piece of metal there is being dipped in these liquids

but you're getting a solid bone out of it?

Yeah, it's forming, it's growing itself as we dip,

so we go over and over and over again and the layer gets thicker

and thicker and thicker.

So why are you doing this?

For surgeries, you could take a screw which are used in surgeries

when you have broken bones to hold your bones together,

but the biological cells in your body don't really like the metal,

and so if you put a bone coating on the screw,

then those cells would basically not see the metal.

But Michelle is an engineer and thinks she can take her

home-grown bones and make something much more spectacular.

We're interested in building things and so we think it's got

a lot of applications for maybe making skyscrapers.

That's amazing - you're actually taking the inspiration from

the human skeleton to do something completely different with it.

Absolutely, and it makes sense

because we've evolved over millions of years

and this is the structural material that holds us up,

so it absolutely makes perfect sense

that we might be able to make new things where it's holding them up.

In fact, remember the web-like pattern of fibres

we saw inside the bone earlier?

Well it's this same pattern which was the inspiration behind the

structure of a very famous landmark - the Eiffel Tower in Paris.

Isn't it amazing to think that one day,

we could actually be living in buildings made out of bone!

But these are small beginnings and after 24 hours,

this is the result of the robot's work in the lab.

So it really looks like a real bone, doesn't it?

Yep, because it's made of the same stuff.

This tiny bone is the final product

and it's almost exactly the same as the bones in your body,

but there's one crucial difference - it's not alive - it's inanimate.

The bones in your body have living cells in them that allow them

to grow and mend if you break them.

Yeah, man!

Medical teams always expect the unexpected.

Let's see how they deal with this patient.

14-year-old Chloe has come into Accident & Emergency

with an irritated eye.

I got something sharp in my eye. My vision's all blurred.

I can't see anything at all.

Can't see anything at all - how on earth did this happen?

Chloe was minding her own business, walking to class,

head in the clouds... There they are - nice.

When a massive tornado crashed through the walls

and made its way towards her.

Really?

Not exactly, Chris, there was a gust of wind,

but it was strong enough to blow something sharp into her eye.

Ooh, there it goes.

Now that has to hurt. Ouch.

If there's something in your eye, you could go blind, couldn't you?

Well, maybe not blind, Mum.

Let's get Professor Simon Carley in to take a look.

Look up to the sky if you can.

OK. Does it feel like there's something in there?

Yeah, at the top.

Chloe's eye is so sore that it keeps closing,

so Professor Simon puts some special drips in to numb it,

which means she can keep her eye open and he can take a closer look.

If you look with a normal light, this all looks actually pretty good.

I can't see any bits and bobs in there at the moment.

No bits and no bobs. That's always good.

But if there is anything in there, the eye's got a little sneaky

habit of trapping it under your top lid and every time you blink,

it scrapes the front of your eye and drives you nuts.

So what I'd like to do is flip the eyelid inside out,

and have a look on the inside.

Not for the squeamish but it's the only way to get under that lid.

Told you - time for some eyelid peeling.

Professor Simon holds up the eyelid and in the twinkling of an eye,

or at least a bit of a flick from side to side, he finds...

Looking at underneath here, I can't see anything

..nothing.

There's probably nothing stuck in there

but you've still got the sensation something's there,

and that usually means there's a scratch.

Your eyes might be small

but they're actually one of the most complicated parts of your body.

To protect them, your eyeballs are covered in a thin see-through

layer of skin called the cornea.

When you get something in your eye,

sometimes the cornea can get scratched.

And this is what Professor Simon thinks has happened to Chloe.

But just to be sure, he wants to do one more test.

He puts a special drop into Chloe's eye which means that under

an ultraviolet light, any scratches on the cornea will show.

Argh, that's scary! Turn the lights back on.

Xand, you're such a baby.

It's a good thing I'm here to keep an eye on you.

We could leave that to Chloe, I suppose.

What you can see through the microscope is

something's been trapped underneath the eyelid,

and it's been scratching the surface of the eye.

So it's good news that there's no major damage to Chloe's eye,

but Professor Simon has got some treatment to make

the irritation more comfortable.

We'll give you a cream for your eye. Your body will heal that

in a matter of days, it will be fantastic,

and it will just get better and will look fine.

It will function fine and you'll be fine.

So Chloe will be back to normal in no time,

which means she can head home.

Bye, Chloe... Bye?

Next time - we take a look at our poo.

Oh, Chris, that's awful.

It does smell bad.

Chris joins an air ambulance rescue team.

And Xand gives blood and finds out where it goes.

Behind me are 800 bags of live human blood.

So we'll see you next time on Operation Ouch!

Subtitling by Red Bee Media Ltd