November 12, 2025 • 59 mins
This week on Sports Doc Talk, hosts Will Sanchez and Dr. Grant Garcia sit down with Dr. Wayne Weil, orthopedic hand, wrist, and elbow specialist, and yes, TikTok cooking sensation "seattlehanddoc"
From repairing complex hand injuries and pioneering minimally invasive techniques to becoming an unexpected social media star, Dr. Weil brings humor, humility, and precision to everything he does. Hear his insights on:
- The art of microsurgery and mentorship in medicine.
- Why “less invasive” often means “better recovery.”
- Thumb UCL injuries in athletes — and what the internal brace has changed.
- How a late-night Turducken video turned into 700,000+ followers.
- and much more...
Whether you’re an athlete, clinician, or just curious about how surgical skill translates to the kitchen, this episode has something for everyone.
Presented by The Recovery Shop: trusted by athletes and surgeons for innovative recovery solutions.
Visit sportsdoctalk.com for past episodes, transcripts, and info on becoming a future guest.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:17):
Welcome to Sports Doc Talk. I'm Will Sanchez, along with our
orthopedic surgeon and sports medicine specialist.
That man right there, Doctor Grant Garcia.
Doctor Garcia. Exciting.
We have a new show. We have a great guest.
But first and foremost, how are you?
I'm good. It's still sunny for another day
or two where summer's just stretching on in Seattle, so I
(00:39):
can't complain. Unfortunately, the Giants are
back to being terrible, which wedon't have to talk about today.
But the Seattle teams are doing well decently, so that's good.
Mariners won, so we're excited about that, I guess.
Yes, Let's not bring up why are we starting off the show with
the Giants? Doctor Garcia, man, you, you
know, it's always, you know what?
We need something doing this. We had one game, we had one
(01:01):
game. My Lord, all right, man, let's
get to people that really care about us because obviously
you're just trying to break my heart.
Let's talk about the good folks at the recovery shop, the shout
out to contact Mike B talk aboutthe recovery shot and why you
love them and our guests as well.
Loves them as well. Great.
Yeah. So we, we like them because
honestly, patients ask for a little bit extra sometimes and
(01:25):
it's challenging as a surgeon, you send them to, you know,
Amazon or online to look for their stuff.
So the option of having this forthe patients is really nice.
And the patients do appreciate it too 'cause it's all kind of
there together. And you have the nice machine,
which doctor Wah, I think just tried out one of the new elbow
devices, which is really nice for his patients.
That's really a, a niche that many of the companies can't
provide. So they're really happy with
(01:47):
them and I think the patients are really happy, which is more
important. So if you're a surgeon, reach
out to them. If you're a patient, you don't
have that option, reach out to them.
They can try to get your surgeonset up with it so that you can
have that opportunity. All right, let's get right to
our guests because we're keepinghim from getting dinner, and
that's a tease for something that we'll talk about later on.
(02:07):
Let's bring in the doctor, the hand, the wrist and elbow
specialist himself, Doctor WayneWilde.
Dr. Wilde, thank you for being on.
Thank you for hanging with us. And I apologize for Doctor
Garcia bringing up things to start off the show in a negative
way. How are you?
Doing great. Happy to be here.
Thanks for the invitation. Yes.
(02:28):
So for the viewers to introduce Doctor Winwall, he's a hand
surgeon and actually he's my partner and we do a lot of cases
together, complex elbow surgeries and he specializes in
hand, wrist and elbow and then dabbles with trauma as needed,
but really super specialized in the hand and nerve surgeries.
Also chief of orthopedics at theSwedish hospital system and
(02:51):
board of directors. And so he's got extensive title
and pro alliance as well as Pelto.
And he actually does family stuff as well on top of all
that. Huge list, so pretty impressive.
Well, thanks for coming on, really appreciate it.
I'm sure Will's gonna have lots of questions to ask, too.
For the viewers, do you think you can kind of give a quick
background? You know, I know you came from
New York. Talk about your stuff.
(03:13):
And, you know, now you're in Seattle.
So just give us a little update into who you are and where you
came from. Sure.
Yeah, I'm an East Coast guy. Originally grew up outside
Bethesda, MD, Ended up doing my College in Philadelphia and then
Med school and residency in New York City.
(03:35):
Then ended up out here for a hand surgery fellowship and just
kind of fell in love with the Pacific Northwest.
And one of our other partners, Doctor Shapiro, the shoulder
specialist here, I knew him fromNew York from he was a fellow
while I was a resident and he ended up recruiting me to stay
(03:55):
out here. And now 21 years later, I'm, I'm
still here in Seattle. We now have 5 kids.
And as Doctor Garcia mentioned, I've gotten involved in sort of
non practice stuff with being chief at Swedish and the board
(04:17):
positions at Reliance. And then I've still have my
practice where, you know, I really enjoy just treating
elbow, wrist and hand. And I do a lot of that, whether
it's, you know, sports injuries and, and younger folks or, or
(04:38):
degenerative stuff and older people arthritis stuff.
So kind of do a little bit of everything except maybe
sleeping, which I would like to do more of, but that's OK.
Can you tell us what first sparked your interest in hand
and and microvascular surgery? You know, how do you go along
(05:00):
that path and have that interest?
Yeah. So that really started in, in my
fourth year of residency as partof our residency program at NYU
and Hospital for Joint Diseases,we do a, a four month rotation
down in Baltimore, at, at Shock Trauma hospital down in
(05:23):
Baltimore. And at the time, there's a
surgeon there, Andy Eagle Seder and Dr. Eagle Seder to this day,
I think is the, the best surgeonI've ever seen operate just, you
know, I think, you know, for, for lack of a better descriptor,
(05:45):
you know, gift from God in termsof he could do anything.
And it was always perfect. And so he really got me
interested in, in microsurgery and kind of the rest is history
from there. So, so it's, I think, you know,
in a lot of our lives, you know,just exposure to, to a good
(06:10):
mentor really can pave the way moving forward in terms of
really career paths in general. And yeah, I think Doctor Eagle
Sater is really the, the, the person who got me interested in,
in, in what I'm doing today. And then, you know, Fast forward
(06:31):
a couple years, Doug Hannell at University of Washington, who I
did my hand surgery fellowship, another just phenomenal surgeon.
And, you know, dug in in a very similar way with doctor Eagle
Sater, you know, could fix anything and, and just an
(06:52):
incredible surgeon. And, and so, you know, having
the exposure to those two docs and big, you know, I, I stand on
the shoulder giants and you know, I, I, I certainly give a
lot of credit to those two guys for, for getting me to where I
am today. Wayne, I wanted, I want to bring
(07:16):
this up because I think that's probably your answer is going to
be this too. But you know, we see in the
office, we talk about, I do a lot of, you know, we talk about
the sport surgeries that I do, but I see you doing a lot of
really complex hand and wrist surgeries that not everybody
would want to take on, even as ahand surgeon.
Do you think I don't want to puttoo many words in your mouth?
Do you think that stems from that background you're talking
(07:38):
about? Or why do that?
Because like you could your private practice, you could just
do carpal tunnels and. Yeah.
Procedures. You don't have to do the hard
stuff, Why do you? Choose to, you know, maybe I'm
just a masochist, but I think that's true of kind of all the
guys in our practice. I mean, we could all just do the
simple stuff, but I think we allenjoy the challenge.
(08:04):
You know, for me personally, yeah, I enjoy doing carpal
tunnel surgery, but, you know, Iwould get bored if I just did
that all day long. And and, you know, for me, maybe
I'm blessed with the ability to do the hard stuff and I enjoy
(08:26):
doing it. And I think that serves A niche
for our patients in terms of, you know, we, we see a lot of
patients in our practice and, and, and you do as well where,
you know, they've bounced aroundto different docs in the
community and, and just for whatever reason, you know, I
(08:47):
haven't been able to, to get thecare that they need.
And, and so for me, it's, it's very gratifying to, to see a
patient who's maybe seen a few docs and, and has been told, you
know, we can't help you. You got to live like this for
the rest of your life or whatever it is.
And, and to be able to see them and say, actually, that's not
(09:10):
true. We can help you and I can make
you better. And I think, you know, that's
why we went into medicine is, isto make people better.
And, you know, it's very gratifying.
I think the, the, the more complicated AA problem is in a
(09:32):
lot of ways, it's even more gratifying to, to get to the
other side where, where you've made somebody better.
So, and again, I think, you know, going back to the
training, you know, both at Shock Trauma in Baltimore, both
at Harborview, I mean, we saw the craziest stuff you could
(09:53):
ever imagine, you know, horribleinjuries, you know, whether
it's, you know, explosives or industrial injuries or, or what
have you. And you know, those two guys in
particular, Hannel and Eagle Seder, they were just, you know,
always so calm, always had a plan and and able to execute it.
(10:15):
And I think having that kind of exposure where where you've
seen, you know, everything. So when somebody walks in the
door with something complicated,you know, you, you rely on your,
on your training and then your experience.
You know, I've been doing this now for 21 years, been in
(10:36):
practice. So I feel like, you know,
there's not much out there that I haven't seen.
And so that that makes me prepared to to take on the
complicated stuff. Awesome.
Do you? So I know we talked about this,
but the obviously we might switch gears a little bit, but
the coming from the complicated to maybe the more minimally
(10:58):
invasive stuff that you do. I know you're, you know, we know
you're one of the only surgeons in the area that does this sort
of endoscopic carpal tunnel, endoscopic cubital tunnel.
Will you talk a little bit aboutthose procedures for the
audience? And then what is the benefit in
your opinion of doing it this way?
I mean, it's also more challenging technically, but
obviously what's the benefit of the patient?
Why would you do that versus thestandard open?
(11:19):
Yeah. Well, I mean, the name of the
game in I think all of surgery is, you know, being less
invasive, less destructive to the tissues.
And that really, you know, helpsin the back end in terms of
there's less stuff to heal. Right.
(11:41):
Again, going back to my residency, you'll, you'll
appreciate this story. I was a third year resident and
scrubbed a case with the Doctor Who was He was the only one in
the NYU system still doing open AC LS and yeah, I'm shivering
(12:04):
by. The way I'm shaking, I'm having
like. You've probably never even seen
one. So, and, and this is now circa
2003. So at this point or 2000, 2001
at this point, you know, arthroscopic ACL surgery was a
(12:25):
standard thing. I mean, it's not like it was
brand new. People have been doing
arthroscopic AC LS for 1520 years probably at that point.
And so, yeah, so I scrubbed thiscase with this guy who's doing
open ACL and, you know, the whole knees filleted open and,
(12:47):
and I couldn't believe what I was seeing.
And I can't imagine what the recovery from that was.
And having had an ACL done on, on my own knee, arthroscopic
ACL, I mean, it's, you know, worlds apart.
And, and so that experience in particular was like, well, why
(13:12):
would I ever do something that that was that traumatic if I can
do it in a way that's, you know,not nearly as as destructive to
the surrounding tissues. And so, you know, in residency,
actually we started doing endoscopic carpal tunnel
(13:34):
releases and again, smaller incision, less tissue invasion.
And we'd have patients who, you know, had an open on one side
and then came back and had the endoscopic on the other side.
And they were like the every single one of those patients.
(13:56):
Couldn't believe how much easierthe recovery was with the
endoscopic. Just less pain, quicker return
to work, better function. And you know, the data is kind
of borne that out when you look at the recovery again, just less
pain, quicker return to Burke and better grip strength in the
(14:19):
first three months of recovery. The opens end up catching up in
the end and they do fine. And you know, at nine months,
one year, everyone's the the same.
But why have an operation that takes you nine months to recover
from when you can have the same operation, but it only takes
you, you know, three months? And so similar to to the ulnar
(14:45):
nerve, the cubital tunnel decompression, the ulnar nerve,
same idea is, you know, little incision.
We do everything from the insideout instead of the outside in.
And so again, you don't have to cut through any of the muscles
to get to where you want to be. And that just decreases the
(15:06):
amount of time for recovery and,and, and gets people going a lot
faster. And I think that's really the
exciting part in orthopedics where we're moving towards in
general is all the stuff we do is becoming less and less
invasive. You look at a hip replacement,
(15:28):
you know, you were in the hospital for a week when I was a
resident. Now we do hip replacements and
you go home the same day. Same with, you know, knee
replacements, you know, a lot ofthe, the cartilage stuff that
you're doing, all of it is, is really starting to become
(15:50):
outpatient surgery. I mean, even spine surgery is
moving to, to outpatient surgery.
And, and you look at the results, people do better when
they're home versus sitting in the hospital.
You know, you take the same operation, same person, your
risk for infections and, and, and worse outcomes are higher if
(16:13):
you stay in the hospital than ifyou go home.
So I think all of orthopedics and especially in my specialty,
you know, trying to do things ina minimally invasive way, it
just makes sense and it's betterfor the patients.
In a lot of ways it's more fun for the surgeon because we get
(16:35):
to play with cool new instruments.
Priority. That's the high priority there.
That's. Right.
You know, it's fun to go to the lab and kind of innovate and and
work with some of the companies that, you know, come up with
the, you know, novel ways to do things.
So I think it's sort of a win, win all the way around.
(16:59):
Will, can you pop that slide? I'm on the Nano.
I don't want to see because we're talking about we're in the
perfect example, Segway, go to the next slide here.
Let me just do it. Yeah, I have.
Yeah, Wayne, right there. Yeah.
So this is a, this is good. I mean, we don't have to do the
proprietary discussion here. I just there's a picture because
(17:20):
I know you've used this before. So for your minimally invasive
situation, when what would you use something small like this
for, right? Like the idea behind patients
are always curious like, well, how how small can you go?
I've seen you scope some pretty small joints and I would never
consider doing so. What are your uses of this?
And like, how do you help? What does it help you with?
(17:42):
So yeah, we've gotten to the point now where, you know, the
instruments have gotten small enough where, you know, in the
old days you could basically do a shoulder and a knee.
And, and we've now, you know, gotten to where we can basically
scope pretty much any joint in the body.
(18:05):
For the most part you can scope out to even the PIP joint,
proximal interphalangeal joint in the finger.
You can scope, you know, the base of the thumb.
That's probably the most common one that I, I do now because the
(18:27):
base of the thumb, the carpal metal carpal joint, that's the
one that becomes classically arthritic.
And so there's procedures now that we can do kind of like in
the knee where we do for arthritis, some clean out
procedures. So the instruments, not only the
(18:47):
camera, but also the different little shavers and the probes
and instruments that we use are,are small enough that they fit
in there. So you can really do kind of
what the large joint arthroscopists do, you know, the
stuff that you do in the knee and the shoulder Grant now, now
I can do to some degree in the base of the thumb and, and in
(19:12):
the wrist. And so we're, we're definitely
catching up. I would say to to the large
joint arthroscopist. And a lot of it just has to do
with the ability to to make the instruments smaller and smaller.
It's kind of like our computers and our iPhones and everything
(19:32):
else in the world. You know, the first iteration is
big and then as we get better with manufacturing and the and
the technology, it just gets smaller and smaller and smaller.
So then we can start really having a good time with this,
the small joint instrument, small joint Arthroscopy.
(19:57):
Would you say with this, I mean,when I first saw you do one of
those thumbs, I was like, this is crazy.
This is cool. Would you describe like were you
like that patient? You know, you when you do the
metacarpal, when you do the scope of the thumb or some
arthritis, What were you doing before for them?
Right, Because these are patients, they're not, they're
not old enough for. You or.
Any other thing? So what were you doing before?
(20:18):
Were you just? Is this added new surgery for
you? Yeah.
So, you know, I think of it likearrows in in your quiver, right?
And so you've got only a certainamount of arrows in the quiver.
And if you can have more arrows,that's awesome.
So for those patients, you know,that was like you're, you're 40
(20:42):
and 50 year olds with the early stage degenerative arthritis.
They've had, you know, splints and braces, but nobody likes
those because you need your thumb to actually live life and
do things. And so if you lock up your
thumb, you know, it's pretty miserable.
You can't really do much at all.You can't type on a computer,
(21:03):
you can't hold an iPhone. You know, you can't garden or
play tennis or whatever it is. So people don't tend to wear
them because they're, they really inhibit your activities.
So, you know, the the braces were sort of, yeah, you can wear
a brace, but nobody likes that. Then there's occupational
(21:25):
therapy, you know, to some degree, some patients find it
helpful, but it's not really solving any of the issues
internally. Then we move on to steroid
injections and sometimes those can be helpful.
PRP injections, sometimes those can be helpful and then you're
(21:46):
kind of stuck after that. There's not really any non
operative treatments that that are reasonable to do.
And then operatively then we start talking about joint
replacement, which you know, it's a big step for a 40 year
old to to undergo. And so now we're able to do a
(22:06):
procedure that can potentially buy people some time and put
off, you know, the eventuality of a joint replacement by
ideally 1020 years when it's more appropriate to do the joint
replacement as opposed to when they're 40 or 50.
So, so it's really opened up a whole new ability to treat
(22:27):
patients because otherwise it was, well, you're 45 years old
and we've tried everything. So either live with it or or
have a joint replacement. Whereas now I can say, well,
we've tried all the non op stuff.
We can now think about doing an Arthroscopy and kind of clean
stuff up for you. And ideally we'll buy another
(22:50):
1020 years and then you have your joint replacement, you
know, when you're 60 or 70. So it's been fantastic in, in
being able to, you know, treat patients in a in a much better
way as opposed to just telling them, well, live with it.
I had a question for you, talk about common hand and wrist
(23:13):
injuries, whether it's the pro and recreational athletes, and
what's your thoughts on some of these names, like the skier's
thumb or the jersey finger? You're from the East Coast.
I don't. Think the jersey.
Finger is what I'm thinking about is not the Jersey Shore.
So can you talk about that a little bit because the names are
absolutely fantastic in Jersey on the East Coast?
(23:38):
Yeah, no, it's so, you know, thehand world ends up with lots of
crazy eponyms. And as Grant knows, you know,
people call us the hand weenies.It's kind of the the it's the
reputation of the hand surgeons are kind of the nerdy guys who
(24:00):
are way into minutia. And you know, Doctor Eagle Sater
used to always say, you know, the leg is just a stupid weight
bearing joint, right? You can cut the leg off and put
a piece of wood and give someonea peg leg and they can walk.
But the hand, you know, that's awhole another kettle of fish,
right? You take somebody's hand off and
(24:22):
then they're really debilitated.So yeah, the hand world, we've
got all kinds of names for crazystuff, you know, skier's thumb,
which actually was a gamekeeper's thumb in the old
days. And not because you're you're
playing games, but keeping game,like small game, small animals.
(24:45):
So you know the farmers would bethe classic is snapping the
necks of rabbits with their handand over time the ligament of
the the ulnar collateral ligament of the thumb would
would basically just tear from overuse in all the years of
(25:07):
snapping rabbits necks. We'll pull that slide up, pull
this. Not the rabbits.
We don't have a rabbits. We don't have the dead rabbits.
No, no, hold the. Thumb.
Pull the thumb UCL up while it continues.
Keep going. Wait.
So Fast forward a couple of centuries and you know, skier's
(25:29):
thumb or mountain biker's thumb.You know, if you can imagine
you're holding the ski pole and you fall, your thumbs kind of
exposed out there and it gets wrenched back and, and it gets
torn, the ligament gets torn. Or if you're mountain biking,
same idea, your thumbs kind of exposed and you go over the
(25:50):
handlebars and kind of Superman out and your thumb gets yanked
back. So it ends up tearing the ulnar
collateral ligament, which is the the kind of I I tell people
that's the ACL of the thumb, right.
So if you tear your, your ulnar collateral ligament, what ends
(26:10):
up happening is, is, yeah, you can use your thumb and you can
move it. And you know, once the you're
you're recovered from the acute injury, but the, the cartilage
is going to be stressed in a waythat it was not built to be
stressed as the thumb kind of pivots abnormally when you're
(26:32):
power pinching and grasping. And so, you know, the reason to
repair the thumb UCL, kind of like the ACL is in a large ways
is to prevent arthritis from happening in a pretty short
amount of time with the cartilage damage that occurs
with, you know, in the knee, we call it pivoting where, where
(26:54):
you have these moments where, where the femur and the tibia
kind of shift on each other, thesame thing in the thumb.
So, so the goal and when we repair these is, is to restore
that stability to the joint so that the cartilage doesn't have
that abnormal stress on it. And and so folks can have, you
(27:17):
know, a good joint moving forward.
You know, looks like here we've got this slide with the internal
brace, which that's been, you know, in talking about sort of
minimally invasive surgery and innovation in, in, in surgery.
This has been a real game changer for us in the hand and
(27:41):
and really what it does is it allows folks to to start their
rehab basically, you know, the day after surgery in large part.
So in particular with thumb ulnar collateral ligament
repairs in the past before doinginternal braces, we would put
people in a cast for six weeks, sorry guys.
(28:06):
And after, after being in the cast for six weeks, they'd come
out and then they'd be really stiff.
And then you know, it takes another 6-8 weeks to get them
moving. And then once we got the moving,
then we'd add in strengthening. So, so the whole rehab process
(28:27):
was, was probably more like 4 to6 months.
Whereas now with the internal brace we, we can basically I get
people moving, I get people moving about five days after
surgery. So my protocol now is a post op
(28:49):
splint. They see the hand therapist, day
5 splint comes off, they get a removable brace and they start
working on range of motion. So that by basically six weeks
they have their full range motion and we've already started
working on some strengthening. So the total rehab program is
(29:14):
basically three months before back to normal.
So it's it's shortened their total rehab time by about 50%,
which is awesome. And we've seen some crazy ones,
right? You know, it's you're, I know
one of your friends is one of the guys that proponents of it
kind of taught it to many and into a lot of the pro athletes
(29:34):
somebody trained with. Yeah, yeah, lots of lots of pro
athletes now get the internal brace and you know, it's kind of
the way things evolve, right, is, you know, the the pros get
the the stuff 1st and then it kind of trickles down.
But at this point, I, I wouldn'tnecessarily even think about
(29:58):
doing the, the surgery without an internal brace because I
just, again, it's like an open, an open ACL versus arthroscopic
ACL or an open carpal tunnel versus endoscopic, you know,
people just get better faster. And, and, you know, in our
patient population here in Seattle, you know, people don't
(30:20):
want to spend, you know, months at a time either out of work or
not kayaking or not skiing or mountain biking or doing, you
know, the things that they love to do.
Vine for the listeners too. Oh, so I was going to say that
listeners too. It's also important that it's
now the gold standard online, right?
So people are looking this up. They're already coming to you.
(30:41):
We're in a tech heavy market. So it's not like, you know, open
ACL in New York is different animal in Seattle, you wouldn't
even see a patient in the office.
They wouldn't show up to your office knowing that you do open
ACLS. I mean, and this is we can say
Mike Trout, Bryce Harper. These are some names I've done.
I did. We actually worked with Curtis
Granderson when he had his UCL, Terry of Drew Brees.
(31:02):
I mean, it's pretty extensive. The list is pretty impressive.
People have had this surgery done.
So sorry, we'll keep going. Well, I was going to follow up
on that. You know, we're talking about
pro athletes and we know that they kind of endeavour this pain
threshold. What are some of the
ramifications if you have a pro athlete or a quarterback or a
golfer that puts off surgery when they need it, waiting for
(31:26):
the offseason or something like that?
What what are some of the repercussions or some of the
concerns when you have a high profile athlete that really
needs surgery? Yeah.
You know that, that that's, that's a great question.
And and sort of that intersection of medicine, sports
(31:46):
business, you start really having different forces at play,
right. In an ideal world, you know,
somebody has a torn ligament, you know, you get them in, you
fix them, they rehab. But you know, with, with these
high performance athletes who, you know, getting paid, you
(32:08):
know, millions of dollars to, toplay.
And these are all, you know, super competitive people too.
They, they want to play. They, they don't want to just
kind of ride the bench and, and,and miss out on a season.
So not only are they super competitive and want to, to, to
(32:33):
be out there, but the, you know,the teams want them out there,
the agents want them out there. So you definitely have to
navigate those forces. You know, when you're treating a
professional athlete or or high level college athlete, you know,
as a physician, I always just, you know, kind of harp back to
(33:01):
you got to do what's right for the patient.
And so, you know, I tell my patients, look, you can play,
you can grin and bear it. But there, there may be serious
consequences, you know, down theroad when we, you know,
ultimately fix it. If there's, you know, been
further damage, I might not be able to make you as good as you
(33:25):
once were because you've damagedthat joint to to a point where
now it's, it's it's, you know, asalvage operation versus an
operation where, where you're going to be, you know, basically
normal again. So you may play this year, but
you may not play, you know, for the rest of your career.
(33:45):
So, you know, and some of this has to do with just timing of
things, right? So, you know, beginning of the
season versus end of the season teams, you know, in the
playoffs, not in the playoffs. So, you know, you, you got to
kind of juggle all those factors.
(34:06):
But at the end of the day, I think as a doc, you know, my job
is to educate my patients. And it is a, you know,
ultimately it's, it's their decision.
You know, patient autonomy is important.
And I feel really strongly that,you know, if I give somebody all
the information that they need to make a decision that's that's
(34:31):
good for them, then I'm OK with whatever they, they decide.
But I'm not going to sugarcoat it.
I'm not going to tell them. Oh yeah, you can delay and
you'll be fine. You know, I tell them.
I tell them the truth. Yeah.
Not. True.
With that, I want to go back andI appreciate all your insights
(34:52):
on these. We talked about scoping, but the
wrist scope stuff that you do, especially with the TFCC and
some of the ligament stuff, likewhat sort of newer stuff you
talk about the wrist Arthroscopya little bit.
I mean that's the stuff that theminimally invasive stuff that
you're doing now, you're adding more things, right?
You're doing different things you weren't able to do before.
With the scope. Like what do you, what new stuff
are you doing with the wrist scope?
(35:14):
Then why is that beneficial to patients?
So, so yeah, with the wrist Arthroscopy and especially the
the TFCCC, which stands for triangular Fibro College
complex, that's why we call it TFCC because it's a pain in the
ass to say, but so, and that's apretty common injury from a fall
(35:35):
and people think of it as just awrist sprain.
It'll get better. But people often times will end
up with sort of chronic ulnar sided wrist pain, which is kind
of the pinky side of the wrist. And often times that that's due
to this tear of the TFCC, which again, I like to use the knee as
(35:57):
an example for folks, cuz everybody's heard of the
meniscus of the knee. The, the TFCC is kind of similar
in that it's the shock absorber for the ulnar side of the wrist
and helps with some stability ofthe wrist.
And so now that again we've gotten sort of minimization of
(36:17):
the instruments and anchors, we can start really doing much
better repairs of the TFCC as opposed to just cutting it out.
So you know like Doctor Garcia does in the knee in terms of
repairing the meniscus versus chopping it out.
(36:39):
Our ability now to, to do repairs is, is much, much better
than even five years ago where, you know, we were doing repairs,
but they were not so easy to do.And the default was always, you
know, just cut the minute, cut the TFCC out, which certainly
helps with pain relief. But you know, it's always better
(37:02):
to repair something then chop itout if you can.
So that's really been one of thebig innovations in terms of
wrist Arthroscopy. And then also on on the ligament
side working to to get some better repairs of those
(37:23):
ligaments arthroscopically is iscertainly in the works to to
work on instability issues in the wrist arthroscopically and
then you know start. Wayne would that be, would that
be like people that have unstable ligaments like they or
they tear like a mechanism that keeps will you describe that
briefly for the? Yeah.
(37:44):
So, so like potentially scaphoidLuminate ligament repairs done
arthroscopically again, the SL ligament very similar to ACL in
the knee. This is, you know, we have the
ACL of the thumb, that's the ulnar collateral ligament.
And then we have the ACL of the wrist.
(38:06):
That's the scaphoid lunate ligament.
And so, yeah, well, they can internally brace those.
Do you internally brace those don't get.
Well, too excited we're getting there.
So, so yeah, that's sort of the next iteration of things is, is
doing those repairs arthroscopically instead of open
(38:28):
and then also maybe doing some cartilage work as well and just
really being able to minimize all our surgeries that we're
doing open. So we are definitely pushing the
envelope all the time in terms of what what we can do.
(38:49):
When you do those scapeal lunateligaments, can you can you do
like an arthroscopic assisted like that's sometimes what I do
for some of my surgeries. Like you could see them go back
together so you don't have to doX-ray.
You really can see them touching.
The process, so that's, that's, I think you know, kind of the,
the, the spot that we're in now is, is arthroscopic assisted
(39:11):
really just kind of helps see, you know, where you are with the
joint surfaces and when you're closing them down.
And then you can even stress the, the, the joint and really
see that, you know, the, the ligament that you fixed is
(39:31):
stable and, and you can see, just see it much better than an
X-ray, right? You're looking directly at it
with the scope versus with an X-ray.
You know, you're just kind of interpreting, you know, the, the
shape of the bones and how they're relating.
But it's, it's better to see it directly.
(39:52):
Yeah. And for the listeners, you're
talking about the ankle, a lot of people with ankle fractures.
You see though nowadays all these newer surgeons like Doctor
Yee, we talk about are doctor they're scoping and they're
scoping the ankle with the fracture of the ankle, right.
So they're making sure that the cartilage is not too damaged or
in the knee. When we have a tibial plateau
fracture, sometimes we do an arthroscopic to see how well we
line the surfaces up because as you said, X-ray is only so good.
(40:15):
Plus it reduces X-ray time, which is always better for the
patients and for the surgeon nothaving to get fluoroscopy all
the time. Yeah.
So one of the things that you mentioned, yeah, I think in
fracture work, arthroscopic assisted is, is is awesome.
I will for wrist fractures just to raise fractures.
I'll put the scope in at the end.
(40:36):
Sometimes if I'm concerned aboutthe articular surface, the joint
surface to to just make sure that all the little surfaces
are, are well lined up because, you know, with fractures, the
the biggest thing is, is gettingthat joint surface smooth again.
You don't want to leave the joint surface with the giant
(40:57):
pothole in it because because that's where when people end up
with, you know, post traumatic arthritic problems is is because
the joint surface wasn't fixed properly.
I think that's excellent point because it's always hard to see
sometimes on these and you're filled with even smaller bones.
So for the listeners to hear that, like if you got some
issue, you know, that's something you talk to your
(41:18):
surgeon about, right? Like arthroscopic assisted is,
is the the new gold standard, You know, not in every case, but
in those challenging cases, it's, it's important factor to
have in order to preserve the joint, which is really where
we're going. It's going joint preservation.
I do knee joint, sometimes shoulder joint and you do hand
and wrist joint preservation. And so that's a key point
(41:38):
preservation because we don't want to be fusing and replacing
it. It's not not nearly as much fun
too, right? That's right.
Will, you were about to jump on something.
You had a question. Yeah.
No, just a quick question regarding, you know, anyone
that's listening that's either apatient or just nothing
personal. I really don't want to come see
you because I have a broken handor wrist.
(41:59):
So is there any hand exercises or stretches or anything that
that's been documented to kind of maybe reduce the risk?
Obviously if there's trauma, that's something else like
falling off a mountain and grabbing and twisting your arm
back. Are there exercises or or
stretches that you can utilize to unfortunately not go see you?
Yeah, yeah. Great question.
(42:21):
So in terms of, you know, I think just a holistic view of,
you know, our bodies in general,you know, there's clear data
that just, you know, use is goodsitting around on the couch
doing nothing. That's bad for it, right?
(42:42):
So, so being active and that I think is #1 the biggest benefit
to, to longevity in general. So, you know, if you look at
sort of those Blue Zone studies,you know, people who live on
hilly areas live longer, why 'cause they have to walk up and
(43:05):
down hills all day long, 'cause they're getting exercise.
So, so same thing with hands. And I think that's, you know,
true of any joint in our body isusing it, staying flexible,
working on your flexibility, working on your strength.
(43:25):
And ideally, you know, I think there's not, I would say one
specific exercise that's awesomefor you, you know, working on
your grip strength. And if you lead an active
lifestyle, you know, your hands will be exercised.
You know, it's the folks that, you know, sit around on the
(43:47):
couch watching TV all day. Those are the ones that I worry
about a lot more. Got you.
Thank you. What's we want in the sake of
time, make sure Wayne has get out of here eventually meet the
traffic The but one other I wantone other talk topic to talk
about really quickly and then a little bit of fun and then we
can get you out of here. Will you?
I know Mike Trout had this recently.
(44:07):
I've seen you deal with some of the baseball players on Mercer
Island teams, etcetera. This one happens a lot.
We hear this a lot and this ideaof removing the hook of handmade
or doing something. Can you describe it to, you
know, what's the most common person athlete you see with this
and then what's the kind of treatment regimen you normally
deal with? Yeah, no, these are is a great
(44:29):
photo actually. I just saw a patient today with
this injury, the most common baseball players.
And it's an interesting injury in that you would expect it's a
blunt force trauma, but it it typically happens on a on a
swing and a miss. So where where they strike out
(44:53):
and it's the rotation of the batthrough the follow through when
the the hook of the handmade fractures.
And so the hook of the handmade,as you can see here, acts a
little bit like a pulley on thatsmall finger flexor tendon.
(45:16):
And it, it has a reputation for,for not healing the blood supply
to theirs. Not great.
And so the, the treatment for this typically is just you
excise that portion. That's where that arrow is
(45:37):
pointing. So, so the top part or, or the
hook as opposed to the body of the ham aid and then you kind of
smooth out the the fracture zonebecause you don't want the
flexor tendon abraded by the, the, the bone that that's been
fractured. It kind of acts almost like a
(46:00):
saw on the, on the flexor tendon.
So, so you smooth out that fracture and, and it's an
operation that works really wellin terms of relieving pain and
getting people back to, to playing baseball.
Golfers can get it as well. And then the other sort of the
(46:23):
cohort of folks who who break their hook of the ham mate are
people who kind of use their hand like a hammer and are, are
banging on on their hand. You know, there's a board in
your porch that's a little bit up.
And so, you know, you smack the,the board down with your hand
and you can injure your handmatethat way.
(46:46):
But yeah, it's, it's interesting.
It's an interesting injury because, because you'd think it
was more of a blunt force injuryor, or you know, when, when in
baseball, when, when the batter connects with, with the ball,
but it's, it's actually when they strike out when it happens.
Is it the hand, Is it the bottomhandle of the bat that's rounded
(47:09):
that's coming through on the follow through and grabbing that
part of the hand is that? Some of that also is just the
force transmission, you know, asthe hands are turning over and
you've got the giant lever arm, which is the bat and it just
torques the the hand just in theperfect way to to break off the
(47:30):
hammer. Really common in in actually pro
baseball players. We see it kind of pretty
regularly. And you don't see it in.
Golfers, yeah, you see it with golfers too.
Usually with golfers it's more they hit, you know, a really fat
(47:50):
shot and their club gets stuck in the ground and then their
hands kind of rotate over it. But it but it's a gratifying
injury to treat because, you know, you just take out the hook
of the handmaid and and people get back really quickly so.
That's interesting. Awesome.
(48:12):
Yeah. So I guess.
Since you know, you're well known for all your hand
surgeries, but actually what theviewers don't may or may not
know if they're doctors or patients listening to this, you
actually are more popularly known for something else.
So as of now, you are now famousfor other things.
So I'd like to show the viewers and maybe a better understand
(48:34):
and hear the background story behind this.
Oh yeah, I'm so lonely. Yeah, this is this is my new
(48:56):
side game. And he's smiling the whole time.
Amazing. Well, pull up, pull up his
followers. The director in the background
reminded me to smile at all times.
That's. Pretty impressive.
(49:22):
I think it went up since we started the show when I told you
how many followers he had. It literally went up between
this entire show recording because Will just changed it.
Yeah, it's, it's gotten kind of crazy.
We yeah, this is something that's just kind of come out of
(49:44):
the blue for us. It was kind of a joke and
started actually December 1st last year after Thanksgiving.
We my wife is used to be a private chef.
So she's a, she's an awesome book and, and all our friends
and family know that she's amazing.
(50:05):
She should open up a restaurant,But her classic, classic
Thanksgiving is to die for. And, and it's our family
favorite. My wife was actually born on
Thanksgiving. So it's kind of a big deal for,
for our family. And she does this really
traditional Thanksgiving with, you know, giant Turkey.
(50:28):
Usually it's like a 2830 LB Turkey and you know, four
different pies and all the sidesyou could ever want.
You know, it's a massive undertaking.
And so this year she's like, we're not doing Thanksgiving.
I'm tired of it. And everyone, we were so
(50:49):
depressed because it's our wholefamily looks forward to it every
year. She's like, I want to make a
turducken. So for those of you who are John
Madden fans back in the old day,if you look up some of the
videos, John Madden in New Orleans, this comes back to the
(51:10):
turducken. And so turducken is, is
basically it's a Turkey and a, achicken and a duck all stuffed
inside the, the Turkey. And so my wife asked me to learn
how to debone the Turkey and chicken and duck.
(51:31):
And then so, you know, watched acouple videos on how to do it.
And so we, we made this turducken.
And at the end you, you basically you sew the Turkey
back together. So it looks kind of like a
Turkey again. And it's stuffed with the
stuffing and the chicken and the, and the duck and I don't
(51:54):
know why because we never video stuff or we haven't videoed
anything previously. We, we took this video and it
was like 3 in the morning. I, you know, just got back from
skiing. And so it's kind of an unhinged
video in general. But so we go to, we actually had
(52:17):
Thanksgiving at a friend's houseand there's about four other
families there. And we brought the turduck in
and, and one of the docs, actually one of the, the
families who were there, she's, she's a doc, but she all night
long was like, you got to post that video.
It's awesome. And so we made a TikTok account.
(52:41):
We just posted the video after being browbeaten all night and
the next morning we had like 4050 thousand views on this
video. My wife who works in social
media for skin care company, she's like, that's actually
(53:03):
really odd because you have no followers and you know, that's a
lot of views for a brand new, you know, account with no
followers. And so then we posted another
video and that got, you know, like another 5000 thousand views
pretty quickly. And so then we just started
(53:26):
posting these videos of of me cooking.
We and we called the account Seattle hand doc.
And, you know, Fast forward 11 months or 10 months, we, yeah,
we have, you know, 360,000 followers on Instagram, about
350,000 on TikTok. And it's become our, our, our,
(53:50):
you know, night time activity. Our, our, our, our second job
for both of us. So yeah, we we're now got to the
point where, you know, starting to get recognized by people out
and about and, you know, different companies are reaching
out to us to collaborate with them.
And so it's been really fun. I've actually learned a lot.
(54:14):
You know, you'd think as a surgeon I'd have good knife
skills, but when it comes to thekitchen and chopping onions,
mine are terrible compared to mywife's.
But I'm getting better in general.
In general you have to realize your wifes better.
Than you went pretty much everything.
Yeah, well, that goes without. You and I already have figured
(54:36):
that out. Yeah, knows that, yeah, no doubt
about it. But.
Yeah, it's been really fun because, you know, traditionally
my wife did all the cooking, I did all the cleaning, but now we
kind of do everything together. So it's, it's brought us
together to some degree. Although I screw up almost every
(54:57):
night and I get yelled at, but that's OK for the most part.
We're having a good time. And yeah, I've learned a lot.
And it's and it's, it's it's fun.
It's, it's, it's brought us together, which is really,
really the best part of all of it.
What's your highest views on a video so far?
(55:18):
Oh wow, we we've got I. I think it's still our Nachos
video, which is up. It might be 1214 million views.
Yeah, it's pretty crazy. And we, dude, when are you going
to have speed? When are you going to have speed
speed on? Your cooking show, you mean?
That's the key. He's all over the place.
(55:39):
Yeah. No, it's it's be awesome.
What do you, what do your kids think about this?
I mean, they've got to be like. Mom and dad is rocking it.
I mean, you know that the younger generation, they're on
it now. This is supposed to be, so
that's. Been.
On there, but what do they thought it's?
Been interesting to to see that so.
So we have 5 kids. So I think that's part of the
(56:00):
draw in terms of, you know, our,our account.
So our two college kids, you know, from the get go, they
were, they were all in and they thought it's awesome.
My, at the time they were in middle school.
Now they're, they're freshmen inhigh school with twins.
(56:21):
They were horrified, You know, like can't you know, 'cause you
know, when you're 131415 years old, Yeah.
Nothing your parents do is cool,right?
You just your parents are, you know, the worst people ever.
And then my junior, now senior in high school, he was kind of
(56:41):
lukewarm on it. And so but now the kids have
have gotten around to having a good time with it and we pulled
them in on some of the videos. The the three older kids are
definitely more into it than than the youngest, the twins,
(57:01):
but we can cajole them into a video to here and there.
And actually my daughter Charlotte, one of her videos I
think has about 4 million views.So she's a rock star.
But yeah, it's been fun. It's, it's, and I've learned a
lot in terms of just the whole social media world and
(57:24):
influencers. And to me, that's one of the
things that I, I found most interesting is just that, you
know, it's a lot of work. And, you know, I used to kind of
poo poo the idea of the social media and influencers.
And, you know, you look at people like the Kardashians or,
(57:45):
or Jake Paul and, and Mr. Beast and you know what they're doing.
And you know, someone who's was basically uneducated, like me
would would just say, well, that's ridiculous.
You know, why, why do they have so many?
You know, why are they making millions of dollars doing this
stuff? And, and now that I've, you
know, just just scratched the surface of, of this whole social
(58:10):
media world, you know, I get it.You know, they, they have a
product that you know, people enjoy and, and they work at it.
I mean, you know, they're putting up content every day.
It, it is a no doubt about it. And so for me, that's, that's
been kind of fascinating to to come through that experience to,
(58:35):
to really have an appreciation for for what people are doing
out there. So as we saw that we we went too
long, we. Have exactly a minute and 22
seconds before we have to stop because of the one hour social
media limit. So you did a good job Wayne.
You worked it out. Awesome.
Thank you so much, Doctor Wayne Wildstand.
(58:55):
A Seattle hand doctor, orthopedics surgeon, hand rest
and elbow specialist, TikTok influencer, you name it, they've
got too many titles. If not, we'll spend the next 5
minutes talk about the titles. Most importantly, thank you for
spending some time with us and educating the listeners and
patients and everyone. So once again, thank you for
(59:17):
your time and have a good night.Awesome.
Thanks guys. Appreciate it.
Been fun. Thank you very much.
See you all. Bye bye.
Welcome to Sports Doc Talk. I'm Will Sanchez, along with our
orthopedic surgeon and sports medicine specialist.
That man right there, Doctor Grant Garcia.
Doctor Garcia. Exciting.
We have a new show. We have a great guest.
But first and foremost, how are you?
I'm good. It's still sunny for another day
or two where summer's just stretching on in Seattle, so I
(00:39):
can't complain. Unfortunately, the Giants are
back to being terrible, which wedon't have to talk about today.
But the Seattle teams are doing well decently, so that's good.
Mariners won, so we're excited about that, I guess.
Yes, Let's not bring up why are we starting off the show with
the Giants? Doctor Garcia, man, you, you
know, it's always, you know what?
We need something doing this. We had one game, we had one
(01:01):
game. My Lord, all right, man, let's
get to people that really care about us because obviously
you're just trying to break my heart.
Let's talk about the good folks at the recovery shop, the shout
out to contact Mike B talk aboutthe recovery shot and why you
love them and our guests as well.
Loves them as well. Great.
Yeah. So we, we like them because
honestly, patients ask for a little bit extra sometimes and
(01:25):
it's challenging as a surgeon, you send them to, you know,
Amazon or online to look for their stuff.
So the option of having this forthe patients is really nice.
And the patients do appreciate it too 'cause it's all kind of
there together. And you have the nice machine,
which doctor Wah, I think just tried out one of the new elbow
devices, which is really nice for his patients.
That's really a, a niche that many of the companies can't
provide. So they're really happy with
(01:47):
them and I think the patients are really happy, which is more
important. So if you're a surgeon, reach
out to them. If you're a patient, you don't
have that option, reach out to them.
They can try to get your surgeonset up with it so that you can
have that opportunity. All right, let's get right to
our guests because we're keepinghim from getting dinner, and
that's a tease for something that we'll talk about later on.
(02:07):
Let's bring in the doctor, the hand, the wrist and elbow
specialist himself, Doctor WayneWilde.
Dr. Wilde, thank you for being on.
Thank you for hanging with us. And I apologize for Doctor
Garcia bringing up things to start off the show in a negative
way. How are you?
Doing great. Happy to be here.
Thanks for the invitation. Yes.
(02:28):
So for the viewers to introduce Doctor Winwall, he's a hand
surgeon and actually he's my partner and we do a lot of cases
together, complex elbow surgeries and he specializes in
hand, wrist and elbow and then dabbles with trauma as needed,
but really super specialized in the hand and nerve surgeries.
Also chief of orthopedics at theSwedish hospital system and
(02:51):
board of directors. And so he's got extensive title
and pro alliance as well as Pelto.
And he actually does family stuff as well on top of all
that. Huge list, so pretty impressive.
Well, thanks for coming on, really appreciate it.
I'm sure Will's gonna have lots of questions to ask, too.
For the viewers, do you think you can kind of give a quick
background? You know, I know you came from
New York. Talk about your stuff.
(03:13):
And, you know, now you're in Seattle.
So just give us a little update into who you are and where you
came from. Sure.
Yeah, I'm an East Coast guy. Originally grew up outside
Bethesda, MD, Ended up doing my College in Philadelphia and then
Med school and residency in New York City.
(03:35):
Then ended up out here for a hand surgery fellowship and just
kind of fell in love with the Pacific Northwest.
And one of our other partners, Doctor Shapiro, the shoulder
specialist here, I knew him fromNew York from he was a fellow
while I was a resident and he ended up recruiting me to stay
(03:55):
out here. And now 21 years later, I'm, I'm
still here in Seattle. We now have 5 kids.
And as Doctor Garcia mentioned, I've gotten involved in sort of
non practice stuff with being chief at Swedish and the board
(04:17):
positions at Reliance. And then I've still have my
practice where, you know, I really enjoy just treating
elbow, wrist and hand. And I do a lot of that, whether
it's, you know, sports injuries and, and younger folks or, or
(04:38):
degenerative stuff and older people arthritis stuff.
So kind of do a little bit of everything except maybe
sleeping, which I would like to do more of, but that's OK.
Can you tell us what first sparked your interest in hand
and and microvascular surgery? You know, how do you go along
(05:00):
that path and have that interest?
Yeah. So that really started in, in my
fourth year of residency as partof our residency program at NYU
and Hospital for Joint Diseases,we do a, a four month rotation
down in Baltimore, at, at Shock Trauma hospital down in
(05:23):
Baltimore. And at the time, there's a
surgeon there, Andy Eagle Seder and Dr. Eagle Seder to this day,
I think is the, the best surgeonI've ever seen operate just, you
know, I think, you know, for, for lack of a better descriptor,
(05:45):
you know, gift from God in termsof he could do anything.
And it was always perfect. And so he really got me
interested in, in microsurgery and kind of the rest is history
from there. So, so it's, I think, you know,
in a lot of our lives, you know,just exposure to, to a good
(06:10):
mentor really can pave the way moving forward in terms of
really career paths in general. And yeah, I think Doctor Eagle
Sater is really the, the, the person who got me interested in,
in, in what I'm doing today. And then, you know, Fast forward
(06:31):
a couple years, Doug Hannell at University of Washington, who I
did my hand surgery fellowship, another just phenomenal surgeon.
And, you know, dug in in a very similar way with doctor Eagle
Sater, you know, could fix anything and, and just an
(06:52):
incredible surgeon. And, and so, you know, having
the exposure to those two docs and big, you know, I, I stand on
the shoulder giants and you know, I, I, I certainly give a
lot of credit to those two guys for, for getting me to where I
am today. Wayne, I wanted, I want to bring
(07:16):
this up because I think that's probably your answer is going to
be this too. But you know, we see in the
office, we talk about, I do a lot of, you know, we talk about
the sport surgeries that I do, but I see you doing a lot of
really complex hand and wrist surgeries that not everybody
would want to take on, even as ahand surgeon.
Do you think I don't want to puttoo many words in your mouth?
Do you think that stems from that background you're talking
(07:38):
about? Or why do that?
Because like you could your private practice, you could just
do carpal tunnels and. Yeah.
Procedures. You don't have to do the hard
stuff, Why do you? Choose to, you know, maybe I'm
just a masochist, but I think that's true of kind of all the
guys in our practice. I mean, we could all just do the
simple stuff, but I think we allenjoy the challenge.
(08:04):
You know, for me personally, yeah, I enjoy doing carpal
tunnel surgery, but, you know, Iwould get bored if I just did
that all day long. And and, you know, for me, maybe
I'm blessed with the ability to do the hard stuff and I enjoy
(08:26):
doing it. And I think that serves A niche
for our patients in terms of, you know, we, we see a lot of
patients in our practice and, and, and you do as well where,
you know, they've bounced aroundto different docs in the
community and, and just for whatever reason, you know, I
(08:47):
haven't been able to, to get thecare that they need.
And, and so for me, it's, it's very gratifying to, to see a
patient who's maybe seen a few docs and, and has been told, you
know, we can't help you. You got to live like this for
the rest of your life or whatever it is.
And, and to be able to see them and say, actually, that's not
(09:10):
true. We can help you and I can make
you better. And I think, you know, that's
why we went into medicine is, isto make people better.
And, you know, it's very gratifying.
I think the, the, the more complicated AA problem is in a
(09:32):
lot of ways, it's even more gratifying to, to get to the
other side where, where you've made somebody better.
So, and again, I think, you know, going back to the
training, you know, both at Shock Trauma in Baltimore, both
at Harborview, I mean, we saw the craziest stuff you could
(09:53):
ever imagine, you know, horribleinjuries, you know, whether
it's, you know, explosives or industrial injuries or, or what
have you. And you know, those two guys in
particular, Hannel and Eagle Seder, they were just, you know,
always so calm, always had a plan and and able to execute it.
(10:15):
And I think having that kind of exposure where where you've
seen, you know, everything. So when somebody walks in the
door with something complicated,you know, you, you rely on your,
on your training and then your experience.
You know, I've been doing this now for 21 years, been in
(10:36):
practice. So I feel like, you know,
there's not much out there that I haven't seen.
And so that that makes me prepared to to take on the
complicated stuff. Awesome.
Do you? So I know we talked about this,
but the obviously we might switch gears a little bit, but
the coming from the complicated to maybe the more minimally
(10:58):
invasive stuff that you do. I know you're, you know, we know
you're one of the only surgeons in the area that does this sort
of endoscopic carpal tunnel, endoscopic cubital tunnel.
Will you talk a little bit aboutthose procedures for the
audience? And then what is the benefit in
your opinion of doing it this way?
I mean, it's also more challenging technically, but
obviously what's the benefit of the patient?
Why would you do that versus thestandard open?
(11:19):
Yeah. Well, I mean, the name of the
game in I think all of surgery is, you know, being less
invasive, less destructive to the tissues.
And that really, you know, helpsin the back end in terms of
there's less stuff to heal. Right.
(11:41):
Again, going back to my residency, you'll, you'll
appreciate this story. I was a third year resident and
scrubbed a case with the Doctor Who was He was the only one in
the NYU system still doing open AC LS and yeah, I'm shivering
(12:04):
by. The way I'm shaking, I'm having
like. You've probably never even seen
one. So, and, and this is now circa
2003. So at this point or 2000, 2001
at this point, you know, arthroscopic ACL surgery was a
(12:25):
standard thing. I mean, it's not like it was
brand new. People have been doing
arthroscopic AC LS for 1520 years probably at that point.
And so, yeah, so I scrubbed thiscase with this guy who's doing
open ACL and, you know, the whole knees filleted open and,
(12:47):
and I couldn't believe what I was seeing.
And I can't imagine what the recovery from that was.
And having had an ACL done on, on my own knee, arthroscopic
ACL, I mean, it's, you know, worlds apart.
And, and so that experience in particular was like, well, why
(13:12):
would I ever do something that that was that traumatic if I can
do it in a way that's, you know,not nearly as as destructive to
the surrounding tissues. And so, you know, in residency,
actually we started doing endoscopic carpal tunnel
(13:34):
releases and again, smaller incision, less tissue invasion.
And we'd have patients who, you know, had an open on one side
and then came back and had the endoscopic on the other side.
And they were like the every single one of those patients.
(13:56):
Couldn't believe how much easierthe recovery was with the
endoscopic. Just less pain, quicker return
to work, better function. And you know, the data is kind
of borne that out when you look at the recovery again, just less
pain, quicker return to Burke and better grip strength in the
(14:19):
first three months of recovery. The opens end up catching up in
the end and they do fine. And you know, at nine months,
one year, everyone's the the same.
But why have an operation that takes you nine months to recover
from when you can have the same operation, but it only takes
you, you know, three months? And so similar to to the ulnar
(14:45):
nerve, the cubital tunnel decompression, the ulnar nerve,
same idea is, you know, little incision.
We do everything from the insideout instead of the outside in.
And so again, you don't have to cut through any of the muscles
to get to where you want to be. And that just decreases the
(15:06):
amount of time for recovery and,and, and gets people going a lot
faster. And I think that's really the
exciting part in orthopedics where we're moving towards in
general is all the stuff we do is becoming less and less
invasive. You look at a hip replacement,
(15:28):
you know, you were in the hospital for a week when I was a
resident. Now we do hip replacements and
you go home the same day. Same with, you know, knee
replacements, you know, a lot ofthe, the cartilage stuff that
you're doing, all of it is, is really starting to become
(15:50):
outpatient surgery. I mean, even spine surgery is
moving to, to outpatient surgery.
And, and you look at the results, people do better when
they're home versus sitting in the hospital.
You know, you take the same operation, same person, your
risk for infections and, and, and worse outcomes are higher if
(16:13):
you stay in the hospital than ifyou go home.
So I think all of orthopedics and especially in my specialty,
you know, trying to do things ina minimally invasive way, it
just makes sense and it's betterfor the patients.
In a lot of ways it's more fun for the surgeon because we get
(16:35):
to play with cool new instruments.
Priority. That's the high priority there.
That's. Right.
You know, it's fun to go to the lab and kind of innovate and and
work with some of the companies that, you know, come up with
the, you know, novel ways to do things.
So I think it's sort of a win, win all the way around.
(16:59):
Will, can you pop that slide? I'm on the Nano.
I don't want to see because we're talking about we're in the
perfect example, Segway, go to the next slide here.
Let me just do it. Yeah, I have.
Yeah, Wayne, right there. Yeah.
So this is a, this is good. I mean, we don't have to do the
proprietary discussion here. I just there's a picture because
(17:20):
I know you've used this before. So for your minimally invasive
situation, when what would you use something small like this
for, right? Like the idea behind patients
are always curious like, well, how how small can you go?
I've seen you scope some pretty small joints and I would never
consider doing so. What are your uses of this?
And like, how do you help? What does it help you with?
(17:42):
So yeah, we've gotten to the point now where, you know, the
instruments have gotten small enough where, you know, in the
old days you could basically do a shoulder and a knee.
And, and we've now, you know, gotten to where we can basically
scope pretty much any joint in the body.
(18:05):
For the most part you can scope out to even the PIP joint,
proximal interphalangeal joint in the finger.
You can scope, you know, the base of the thumb.
That's probably the most common one that I, I do now because the
(18:27):
base of the thumb, the carpal metal carpal joint, that's the
one that becomes classically arthritic.
And so there's procedures now that we can do kind of like in
the knee where we do for arthritis, some clean out
procedures. So the instruments, not only the
(18:47):
camera, but also the different little shavers and the probes
and instruments that we use are,are small enough that they fit
in there. So you can really do kind of
what the large joint arthroscopists do, you know, the
stuff that you do in the knee and the shoulder Grant now, now
I can do to some degree in the base of the thumb and, and in
(19:12):
the wrist. And so we're, we're definitely
catching up. I would say to to the large
joint arthroscopist. And a lot of it just has to do
with the ability to to make the instruments smaller and smaller.
It's kind of like our computers and our iPhones and everything
(19:32):
else in the world. You know, the first iteration is
big and then as we get better with manufacturing and the and
the technology, it just gets smaller and smaller and smaller.
So then we can start really having a good time with this,
the small joint instrument, small joint Arthroscopy.
(19:57):
Would you say with this, I mean,when I first saw you do one of
those thumbs, I was like, this is crazy.
This is cool. Would you describe like were you
like that patient? You know, you when you do the
metacarpal, when you do the scope of the thumb or some
arthritis, What were you doing before for them?
Right, Because these are patients, they're not, they're
not old enough for. You or.
Any other thing? So what were you doing before?
(20:18):
Were you just? Is this added new surgery for
you? Yeah.
So, you know, I think of it likearrows in in your quiver, right?
And so you've got only a certainamount of arrows in the quiver.
And if you can have more arrows,that's awesome.
So for those patients, you know,that was like you're, you're 40
(20:42):
and 50 year olds with the early stage degenerative arthritis.
They've had, you know, splints and braces, but nobody likes
those because you need your thumb to actually live life and
do things. And so if you lock up your
thumb, you know, it's pretty miserable.
You can't really do much at all.You can't type on a computer,
(21:03):
you can't hold an iPhone. You know, you can't garden or
play tennis or whatever it is. So people don't tend to wear
them because they're, they really inhibit your activities.
So, you know, the the braces were sort of, yeah, you can wear
a brace, but nobody likes that. Then there's occupational
(21:25):
therapy, you know, to some degree, some patients find it
helpful, but it's not really solving any of the issues
internally. Then we move on to steroid
injections and sometimes those can be helpful.
PRP injections, sometimes those can be helpful and then you're
(21:46):
kind of stuck after that. There's not really any non
operative treatments that that are reasonable to do.
And then operatively then we start talking about joint
replacement, which you know, it's a big step for a 40 year
old to to undergo. And so now we're able to do a
(22:06):
procedure that can potentially buy people some time and put
off, you know, the eventuality of a joint replacement by
ideally 1020 years when it's more appropriate to do the joint
replacement as opposed to when they're 40 or 50.
So, so it's really opened up a whole new ability to treat
(22:27):
patients because otherwise it was, well, you're 45 years old
and we've tried everything. So either live with it or or
have a joint replacement. Whereas now I can say, well,
we've tried all the non op stuff.
We can now think about doing an Arthroscopy and kind of clean
stuff up for you. And ideally we'll buy another
(22:50):
1020 years and then you have your joint replacement, you
know, when you're 60 or 70. So it's been fantastic in, in
being able to, you know, treat patients in a in a much better
way as opposed to just telling them, well, live with it.
I had a question for you, talk about common hand and wrist
(23:13):
injuries, whether it's the pro and recreational athletes, and
what's your thoughts on some of these names, like the skier's
thumb or the jersey finger? You're from the East Coast.
I don't. Think the jersey.
Finger is what I'm thinking about is not the Jersey Shore.
So can you talk about that a little bit because the names are
absolutely fantastic in Jersey on the East Coast?
(23:38):
Yeah, no, it's so, you know, thehand world ends up with lots of
crazy eponyms. And as Grant knows, you know,
people call us the hand weenies.It's kind of the the it's the
reputation of the hand surgeons are kind of the nerdy guys who
(24:00):
are way into minutia. And you know, Doctor Eagle Sater
used to always say, you know, the leg is just a stupid weight
bearing joint, right? You can cut the leg off and put
a piece of wood and give someonea peg leg and they can walk.
But the hand, you know, that's awhole another kettle of fish,
right? You take somebody's hand off and
(24:22):
then they're really debilitated.So yeah, the hand world, we've
got all kinds of names for crazystuff, you know, skier's thumb,
which actually was a gamekeeper's thumb in the old
days. And not because you're you're
playing games, but keeping game,like small game, small animals.
(24:45):
So you know the farmers would bethe classic is snapping the
necks of rabbits with their handand over time the ligament of
the the ulnar collateral ligament of the thumb would
would basically just tear from overuse in all the years of
(25:07):
snapping rabbits necks. We'll pull that slide up, pull
this. Not the rabbits.
We don't have a rabbits. We don't have the dead rabbits.
No, no, hold the. Thumb.
Pull the thumb UCL up while it continues.
Keep going. Wait.
So Fast forward a couple of centuries and you know, skier's
(25:29):
thumb or mountain biker's thumb.You know, if you can imagine
you're holding the ski pole and you fall, your thumbs kind of
exposed out there and it gets wrenched back and, and it gets
torn, the ligament gets torn. Or if you're mountain biking,
same idea, your thumbs kind of exposed and you go over the
(25:50):
handlebars and kind of Superman out and your thumb gets yanked
back. So it ends up tearing the ulnar
collateral ligament, which is the the kind of I I tell people
that's the ACL of the thumb, right.
So if you tear your, your ulnar collateral ligament, what ends
(26:10):
up happening is, is, yeah, you can use your thumb and you can
move it. And you know, once the you're
you're recovered from the acute injury, but the, the cartilage
is going to be stressed in a waythat it was not built to be
stressed as the thumb kind of pivots abnormally when you're
(26:32):
power pinching and grasping. And so, you know, the reason to
repair the thumb UCL, kind of like the ACL is in a large ways
is to prevent arthritis from happening in a pretty short
amount of time with the cartilage damage that occurs
with, you know, in the knee, we call it pivoting where, where
(26:54):
you have these moments where, where the femur and the tibia
kind of shift on each other, thesame thing in the thumb.
So, so the goal and when we repair these is, is to restore
that stability to the joint so that the cartilage doesn't have
that abnormal stress on it. And and so folks can have, you
(27:17):
know, a good joint moving forward.
You know, looks like here we've got this slide with the internal
brace, which that's been, you know, in talking about sort of
minimally invasive surgery and innovation in, in, in surgery.
This has been a real game changer for us in the hand and
(27:41):
and really what it does is it allows folks to to start their
rehab basically, you know, the day after surgery in large part.
So in particular with thumb ulnar collateral ligament
repairs in the past before doinginternal braces, we would put
people in a cast for six weeks, sorry guys.
(28:06):
And after, after being in the cast for six weeks, they'd come
out and then they'd be really stiff.
And then you know, it takes another 6-8 weeks to get them
moving. And then once we got the moving,
then we'd add in strengthening. So, so the whole rehab process
(28:27):
was, was probably more like 4 to6 months.
Whereas now with the internal brace we, we can basically I get
people moving, I get people moving about five days after
surgery. So my protocol now is a post op
(28:49):
splint. They see the hand therapist, day
5 splint comes off, they get a removable brace and they start
working on range of motion. So that by basically six weeks
they have their full range motion and we've already started
working on some strengthening. So the total rehab program is
(29:14):
basically three months before back to normal.
So it's it's shortened their total rehab time by about 50%,
which is awesome. And we've seen some crazy ones,
right? You know, it's you're, I know
one of your friends is one of the guys that proponents of it
kind of taught it to many and into a lot of the pro athletes
(29:34):
somebody trained with. Yeah, yeah, lots of lots of pro
athletes now get the internal brace and you know, it's kind of
the way things evolve, right, is, you know, the the pros get
the the stuff 1st and then it kind of trickles down.
But at this point, I, I wouldn'tnecessarily even think about
(29:58):
doing the, the surgery without an internal brace because I
just, again, it's like an open, an open ACL versus arthroscopic
ACL or an open carpal tunnel versus endoscopic, you know,
people just get better faster. And, and, you know, in our
patient population here in Seattle, you know, people don't
(30:20):
want to spend, you know, months at a time either out of work or
not kayaking or not skiing or mountain biking or doing, you
know, the things that they love to do.
Vine for the listeners too. Oh, so I was going to say that
listeners too. It's also important that it's
now the gold standard online, right?
So people are looking this up. They're already coming to you.
(30:41):
We're in a tech heavy market. So it's not like, you know, open
ACL in New York is different animal in Seattle, you wouldn't
even see a patient in the office.
They wouldn't show up to your office knowing that you do open
ACLS. I mean, and this is we can say
Mike Trout, Bryce Harper. These are some names I've done.
I did. We actually worked with Curtis
Granderson when he had his UCL, Terry of Drew Brees.
(31:02):
I mean, it's pretty extensive. The list is pretty impressive.
People have had this surgery done.
So sorry, we'll keep going. Well, I was going to follow up
on that. You know, we're talking about
pro athletes and we know that they kind of endeavour this pain
threshold. What are some of the
ramifications if you have a pro athlete or a quarterback or a
golfer that puts off surgery when they need it, waiting for
(31:26):
the offseason or something like that?
What what are some of the repercussions or some of the
concerns when you have a high profile athlete that really
needs surgery? Yeah.
You know that, that that's, that's a great question.
And and sort of that intersection of medicine, sports
(31:46):
business, you start really having different forces at play,
right. In an ideal world, you know,
somebody has a torn ligament, you know, you get them in, you
fix them, they rehab. But you know, with, with these
high performance athletes who, you know, getting paid, you
(32:08):
know, millions of dollars to, toplay.
And these are all, you know, super competitive people too.
They, they want to play. They, they don't want to just
kind of ride the bench and, and,and miss out on a season.
So not only are they super competitive and want to, to, to
(32:33):
be out there, but the, you know,the teams want them out there,
the agents want them out there. So you definitely have to
navigate those forces. You know, when you're treating a
professional athlete or or high level college athlete, you know,
as a physician, I always just, you know, kind of harp back to
(33:01):
you got to do what's right for the patient.
And so, you know, I tell my patients, look, you can play,
you can grin and bear it. But there, there may be serious
consequences, you know, down theroad when we, you know,
ultimately fix it. If there's, you know, been
further damage, I might not be able to make you as good as you
(33:25):
once were because you've damagedthat joint to to a point where
now it's, it's it's, you know, asalvage operation versus an
operation where, where you're going to be, you know, basically
normal again. So you may play this year, but
you may not play, you know, for the rest of your career.
(33:45):
So, you know, and some of this has to do with just timing of
things, right? So, you know, beginning of the
season versus end of the season teams, you know, in the
playoffs, not in the playoffs. So, you know, you, you got to
kind of juggle all those factors.
(34:06):
But at the end of the day, I think as a doc, you know, my job
is to educate my patients. And it is a, you know,
ultimately it's, it's their decision.
You know, patient autonomy is important.
And I feel really strongly that,you know, if I give somebody all
the information that they need to make a decision that's that's
(34:31):
good for them, then I'm OK with whatever they, they decide.
But I'm not going to sugarcoat it.
I'm not going to tell them. Oh yeah, you can delay and
you'll be fine. You know, I tell them.
I tell them the truth. Yeah.
Not. True.
With that, I want to go back andI appreciate all your insights
(34:52):
on these. We talked about scoping, but the
wrist scope stuff that you do, especially with the TFCC and
some of the ligament stuff, likewhat sort of newer stuff you
talk about the wrist Arthroscopya little bit.
I mean that's the stuff that theminimally invasive stuff that
you're doing now, you're adding more things, right?
You're doing different things you weren't able to do before.
With the scope. Like what do you, what new stuff
are you doing with the wrist scope?
(35:14):
Then why is that beneficial to patients?
So, so yeah, with the wrist Arthroscopy and especially the
the TFCCC, which stands for triangular Fibro College
complex, that's why we call it TFCC because it's a pain in the
ass to say, but so, and that's apretty common injury from a fall
(35:35):
and people think of it as just awrist sprain.
It'll get better. But people often times will end
up with sort of chronic ulnar sided wrist pain, which is kind
of the pinky side of the wrist. And often times that that's due
to this tear of the TFCC, which again, I like to use the knee as
(35:57):
an example for folks, cuz everybody's heard of the
meniscus of the knee. The, the TFCC is kind of similar
in that it's the shock absorber for the ulnar side of the wrist
and helps with some stability ofthe wrist.
And so now that again we've gotten sort of minimization of
(36:17):
the instruments and anchors, we can start really doing much
better repairs of the TFCC as opposed to just cutting it out.
So you know like Doctor Garcia does in the knee in terms of
repairing the meniscus versus chopping it out.
(36:39):
Our ability now to, to do repairs is, is much, much better
than even five years ago where, you know, we were doing repairs,
but they were not so easy to do.And the default was always, you
know, just cut the minute, cut the TFCC out, which certainly
helps with pain relief. But you know, it's always better
(37:02):
to repair something then chop itout if you can.
So that's really been one of thebig innovations in terms of
wrist Arthroscopy. And then also on on the ligament
side working to to get some better repairs of those
(37:23):
ligaments arthroscopically is iscertainly in the works to to
work on instability issues in the wrist arthroscopically and
then you know start. Wayne would that be, would that
be like people that have unstable ligaments like they or
they tear like a mechanism that keeps will you describe that
briefly for the? Yeah.
(37:44):
So, so like potentially scaphoidLuminate ligament repairs done
arthroscopically again, the SL ligament very similar to ACL in
the knee. This is, you know, we have the
ACL of the thumb, that's the ulnar collateral ligament.
And then we have the ACL of the wrist.
(38:06):
That's the scaphoid lunate ligament.
And so, yeah, well, they can internally brace those.
Do you internally brace those don't get.
Well, too excited we're getting there.
So, so yeah, that's sort of the next iteration of things is, is
doing those repairs arthroscopically instead of open
(38:28):
and then also maybe doing some cartilage work as well and just
really being able to minimize all our surgeries that we're
doing open. So we are definitely pushing the
envelope all the time in terms of what what we can do.
(38:49):
When you do those scapeal lunateligaments, can you can you do
like an arthroscopic assisted like that's sometimes what I do
for some of my surgeries. Like you could see them go back
together so you don't have to doX-ray.
You really can see them touching.
The process, so that's, that's, I think you know, kind of the,
the, the spot that we're in now is, is arthroscopic assisted
(39:11):
really just kind of helps see, you know, where you are with the
joint surfaces and when you're closing them down.
And then you can even stress the, the, the joint and really
see that, you know, the, the ligament that you fixed is
(39:31):
stable and, and you can see, just see it much better than an
X-ray, right? You're looking directly at it
with the scope versus with an X-ray.
You know, you're just kind of interpreting, you know, the, the
shape of the bones and how they're relating.
But it's, it's better to see it directly.
(39:52):
Yeah. And for the listeners, you're
talking about the ankle, a lot of people with ankle fractures.
You see though nowadays all these newer surgeons like Doctor
Yee, we talk about are doctor they're scoping and they're
scoping the ankle with the fracture of the ankle, right.
So they're making sure that the cartilage is not too damaged or
in the knee. When we have a tibial plateau
fracture, sometimes we do an arthroscopic to see how well we
line the surfaces up because as you said, X-ray is only so good.
(40:15):
Plus it reduces X-ray time, which is always better for the
patients and for the surgeon nothaving to get fluoroscopy all
the time. Yeah.
So one of the things that you mentioned, yeah, I think in
fracture work, arthroscopic assisted is, is is awesome.
I will for wrist fractures just to raise fractures.
I'll put the scope in at the end.
(40:36):
Sometimes if I'm concerned aboutthe articular surface, the joint
surface to to just make sure that all the little surfaces
are, are well lined up because, you know, with fractures, the
the biggest thing is, is gettingthat joint surface smooth again.
You don't want to leave the joint surface with the giant
(40:57):
pothole in it because because that's where when people end up
with, you know, post traumatic arthritic problems is is because
the joint surface wasn't fixed properly.
I think that's excellent point because it's always hard to see
sometimes on these and you're filled with even smaller bones.
So for the listeners to hear that, like if you got some
issue, you know, that's something you talk to your
(41:18):
surgeon about, right? Like arthroscopic assisted is,
is the the new gold standard, You know, not in every case, but
in those challenging cases, it's, it's important factor to
have in order to preserve the joint, which is really where
we're going. It's going joint preservation.
I do knee joint, sometimes shoulder joint and you do hand
and wrist joint preservation. And so that's a key point
(41:38):
preservation because we don't want to be fusing and replacing
it. It's not not nearly as much fun
too, right? That's right.
Will, you were about to jump on something.
You had a question. Yeah.
No, just a quick question regarding, you know, anyone
that's listening that's either apatient or just nothing
personal. I really don't want to come see
you because I have a broken handor wrist.
(41:59):
So is there any hand exercises or stretches or anything that
that's been documented to kind of maybe reduce the risk?
Obviously if there's trauma, that's something else like
falling off a mountain and grabbing and twisting your arm
back. Are there exercises or or
stretches that you can utilize to unfortunately not go see you?
Yeah, yeah. Great question.
(42:21):
So in terms of, you know, I think just a holistic view of,
you know, our bodies in general,you know, there's clear data
that just, you know, use is goodsitting around on the couch
doing nothing. That's bad for it, right?
(42:42):
So, so being active and that I think is #1 the biggest benefit
to, to longevity in general. So, you know, if you look at
sort of those Blue Zone studies,you know, people who live on
hilly areas live longer, why 'cause they have to walk up and
(43:05):
down hills all day long, 'cause they're getting exercise.
So, so same thing with hands. And I think that's, you know,
true of any joint in our body isusing it, staying flexible,
working on your flexibility, working on your strength.
(43:25):
And ideally, you know, I think there's not, I would say one
specific exercise that's awesomefor you, you know, working on
your grip strength. And if you lead an active
lifestyle, you know, your hands will be exercised.
You know, it's the folks that, you know, sit around on the
(43:47):
couch watching TV all day. Those are the ones that I worry
about a lot more. Got you.
Thank you. What's we want in the sake of
time, make sure Wayne has get out of here eventually meet the
traffic The but one other I wantone other talk topic to talk
about really quickly and then a little bit of fun and then we
can get you out of here. Will you?
I know Mike Trout had this recently.
(44:07):
I've seen you deal with some of the baseball players on Mercer
Island teams, etcetera. This one happens a lot.
We hear this a lot and this ideaof removing the hook of handmade
or doing something. Can you describe it to, you
know, what's the most common person athlete you see with this
and then what's the kind of treatment regimen you normally
deal with? Yeah, no, these are is a great
(44:29):
photo actually. I just saw a patient today with
this injury, the most common baseball players.
And it's an interesting injury in that you would expect it's a
blunt force trauma, but it it typically happens on a on a
swing and a miss. So where where they strike out
(44:53):
and it's the rotation of the batthrough the follow through when
the the hook of the handmade fractures.
And so the hook of the handmade,as you can see here, acts a
little bit like a pulley on thatsmall finger flexor tendon.
(45:16):
And it, it has a reputation for,for not healing the blood supply
to theirs. Not great.
And so the, the treatment for this typically is just you
excise that portion. That's where that arrow is
(45:37):
pointing. So, so the top part or, or the
hook as opposed to the body of the ham aid and then you kind of
smooth out the the fracture zonebecause you don't want the
flexor tendon abraded by the, the, the bone that that's been
fractured. It kind of acts almost like a
(46:00):
saw on the, on the flexor tendon.
So, so you smooth out that fracture and, and it's an
operation that works really wellin terms of relieving pain and
getting people back to, to playing baseball.
Golfers can get it as well. And then the other sort of the
(46:23):
cohort of folks who who break their hook of the ham mate are
people who kind of use their hand like a hammer and are, are
banging on on their hand. You know, there's a board in
your porch that's a little bit up.
And so, you know, you smack the,the board down with your hand
and you can injure your handmatethat way.
(46:46):
But yeah, it's, it's interesting.
It's an interesting injury because, because you'd think it
was more of a blunt force injuryor, or you know, when, when in
baseball, when, when the batter connects with, with the ball,
but it's, it's actually when they strike out when it happens.
Is it the hand, Is it the bottomhandle of the bat that's rounded
(47:09):
that's coming through on the follow through and grabbing that
part of the hand is that? Some of that also is just the
force transmission, you know, asthe hands are turning over and
you've got the giant lever arm, which is the bat and it just
torques the the hand just in theperfect way to to break off the
(47:30):
hammer. Really common in in actually pro
baseball players. We see it kind of pretty
regularly. And you don't see it in.
Golfers, yeah, you see it with golfers too.
Usually with golfers it's more they hit, you know, a really fat
(47:50):
shot and their club gets stuck in the ground and then their
hands kind of rotate over it. But it but it's a gratifying
injury to treat because, you know, you just take out the hook
of the handmaid and and people get back really quickly so.
That's interesting. Awesome.
(48:12):
Yeah. So I guess.
Since you know, you're well known for all your hand
surgeries, but actually what theviewers don't may or may not
know if they're doctors or patients listening to this, you
actually are more popularly known for something else.
So as of now, you are now famousfor other things.
So I'd like to show the viewers and maybe a better understand
(48:34):
and hear the background story behind this.
Oh yeah, I'm so lonely. Yeah, this is this is my new
(48:56):
side game. And he's smiling the whole time.
Amazing. Well, pull up, pull up his
followers. The director in the background
reminded me to smile at all times.
That's. Pretty impressive.
(49:22):
I think it went up since we started the show when I told you
how many followers he had. It literally went up between
this entire show recording because Will just changed it.
Yeah, it's, it's gotten kind of crazy.
We yeah, this is something that's just kind of come out of
(49:44):
the blue for us. It was kind of a joke and
started actually December 1st last year after Thanksgiving.
We my wife is used to be a private chef.
So she's a, she's an awesome book and, and all our friends
and family know that she's amazing.
(50:05):
She should open up a restaurant,But her classic, classic
Thanksgiving is to die for. And, and it's our family
favorite. My wife was actually born on
Thanksgiving. So it's kind of a big deal for,
for our family. And she does this really
traditional Thanksgiving with, you know, giant Turkey.
(50:28):
Usually it's like a 2830 LB Turkey and you know, four
different pies and all the sidesyou could ever want.
You know, it's a massive undertaking.
And so this year she's like, we're not doing Thanksgiving.
I'm tired of it. And everyone, we were so
(50:49):
depressed because it's our wholefamily looks forward to it every
year. She's like, I want to make a
turducken. So for those of you who are John
Madden fans back in the old day,if you look up some of the
videos, John Madden in New Orleans, this comes back to the
(51:10):
turducken. And so turducken is, is
basically it's a Turkey and a, achicken and a duck all stuffed
inside the, the Turkey. And so my wife asked me to learn
how to debone the Turkey and chicken and duck.
(51:31):
And then so, you know, watched acouple videos on how to do it.
And so we, we made this turducken.
And at the end you, you basically you sew the Turkey
back together. So it looks kind of like a
Turkey again. And it's stuffed with the
stuffing and the chicken and the, and the duck and I don't
(51:54):
know why because we never video stuff or we haven't videoed
anything previously. We, we took this video and it
was like 3 in the morning. I, you know, just got back from
skiing. And so it's kind of an unhinged
video in general. But so we go to, we actually had
(52:17):
Thanksgiving at a friend's houseand there's about four other
families there. And we brought the turduck in
and, and one of the docs, actually one of the, the
families who were there, she's, she's a doc, but she all night
long was like, you got to post that video.
It's awesome. And so we made a TikTok account.
(52:41):
We just posted the video after being browbeaten all night and
the next morning we had like 4050 thousand views on this
video. My wife who works in social
media for skin care company, she's like, that's actually
(53:03):
really odd because you have no followers and you know, that's a
lot of views for a brand new, you know, account with no
followers. And so then we posted another
video and that got, you know, like another 5000 thousand views
pretty quickly. And so then we just started
(53:26):
posting these videos of of me cooking.
We and we called the account Seattle hand doc.
And, you know, Fast forward 11 months or 10 months, we, yeah,
we have, you know, 360,000 followers on Instagram, about
350,000 on TikTok. And it's become our, our, our,
(53:50):
you know, night time activity. Our, our, our, our second job
for both of us. So yeah, we we're now got to the
point where, you know, starting to get recognized by people out
and about and, you know, different companies are reaching
out to us to collaborate with them.
And so it's been really fun. I've actually learned a lot.
(54:14):
You know, you'd think as a surgeon I'd have good knife
skills, but when it comes to thekitchen and chopping onions,
mine are terrible compared to mywife's.
But I'm getting better in general.
In general you have to realize your wifes better.
Than you went pretty much everything.
Yeah, well, that goes without. You and I already have figured
(54:36):
that out. Yeah, knows that, yeah, no doubt
about it. But.
Yeah, it's been really fun because, you know, traditionally
my wife did all the cooking, I did all the cleaning, but now we
kind of do everything together. So it's, it's brought us
together to some degree. Although I screw up almost every
(54:57):
night and I get yelled at, but that's OK for the most part.
We're having a good time. And yeah, I've learned a lot.
And it's and it's, it's it's fun.
It's, it's, it's brought us together, which is really,
really the best part of all of it.
What's your highest views on a video so far?
(55:18):
Oh wow, we we've got I. I think it's still our Nachos
video, which is up. It might be 1214 million views.
Yeah, it's pretty crazy. And we, dude, when are you going
to have speed? When are you going to have speed
speed on? Your cooking show, you mean?
That's the key. He's all over the place.
(55:39):
Yeah. No, it's it's be awesome.
What do you, what do your kids think about this?
I mean, they've got to be like. Mom and dad is rocking it.
I mean, you know that the younger generation, they're on
it now. This is supposed to be, so
that's. Been.
On there, but what do they thought it's?
Been interesting to to see that so.
So we have 5 kids. So I think that's part of the
(56:00):
draw in terms of, you know, our,our account.
So our two college kids, you know, from the get go, they
were, they were all in and they thought it's awesome.
My, at the time they were in middle school.
Now they're, they're freshmen inhigh school with twins.
(56:21):
They were horrified, You know, like can't you know, 'cause you
know, when you're 131415 years old, Yeah.
Nothing your parents do is cool,right?
You just your parents are, you know, the worst people ever.
And then my junior, now senior in high school, he was kind of
(56:41):
lukewarm on it. And so but now the kids have
have gotten around to having a good time with it and we pulled
them in on some of the videos. The the three older kids are
definitely more into it than than the youngest, the twins,
(57:01):
but we can cajole them into a video to here and there.
And actually my daughter Charlotte, one of her videos I
think has about 4 million views.So she's a rock star.
But yeah, it's been fun. It's, it's, and I've learned a
lot in terms of just the whole social media world and
(57:24):
influencers. And to me, that's one of the
things that I, I found most interesting is just that, you
know, it's a lot of work. And, you know, I used to kind of
poo poo the idea of the social media and influencers.
And, you know, you look at people like the Kardashians or,
(57:45):
or Jake Paul and, and Mr. Beast and you know what they're doing.
And you know, someone who's was basically uneducated, like me
would would just say, well, that's ridiculous.
You know, why, why do they have so many?
You know, why are they making millions of dollars doing this
stuff? And, and now that I've, you
know, just just scratched the surface of, of this whole social
(58:10):
media world, you know, I get it.You know, they, they have a
product that you know, people enjoy and, and they work at it.
I mean, you know, they're putting up content every day.
It, it is a no doubt about it. And so for me, that's, that's
been kind of fascinating to to come through that experience to,
(58:35):
to really have an appreciation for for what people are doing
out there. So as we saw that we we went too
long, we. Have exactly a minute and 22
seconds before we have to stop because of the one hour social
media limit. So you did a good job Wayne.
You worked it out. Awesome.
Thank you so much, Doctor Wayne Wildstand.
(58:55):
A Seattle hand doctor, orthopedics surgeon, hand rest
and elbow specialist, TikTok influencer, you name it, they've
got too many titles. If not, we'll spend the next 5
minutes talk about the titles. Most importantly, thank you for
spending some time with us and educating the listeners and
patients and everyone. So once again, thank you for
(59:17):
your time and have a good night.Awesome.
Thanks guys. Appreciate it.
Been fun. Thank you very much.
See you all. Bye bye.
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