Elective Home Surgery

It's a rare day at work that I don't see dozens of surgical implants, ranging from staples to artificial femurs. Most of these devices were left behind by surgeons to control bleeding, reattach bits of organs, fix a fracture or to completely replace some body part.

However, some of the hardware we see in patients has been self-placed. This usually amounts to some type of body piercing, which is usually of little consequence to most physicians. However, for patients about to undergo an MR scan, we keep a close lookout for metal piercings, since they can occasionally interfere with the scan. This interference is due to the local magnetic field that is induced in even non-ferromagnetic metal objects when placed in the powerful magnetic field of the scanner. In the case of a ferromagnetic piercing, the scanner could exert enough pull on the implant to actually rip it out of the patient's soft tissues.

Knee MR with metal artifact in distal femur.

Occasionally, patients come in with large intrarectal objects, some of which have to be removed surgically. Most of us who routinely read emergency room images have long since become jaded by this type of thing.

It is therefore refreshing to learn of new ways in which people continue to push back the envelope of body modification. One object that I just learned about is the JewelEye, an adornment designed to be implanted within the conjunctiva of the eye. I haven't yet seen a pierced eye locally, but now that I know it exists, I will, so to speak, keep an eye out for one.

My own body mods are pretty much limited to nail clippings and haircuts. Therefore, most of my experience with this is going to remain vicarious. However, I must say that I'm impressed with the energy and dedication that some people devote to self body modification. For example, I once worked with a surgeon who performed his own vasectomy. Alas, most of the people out there doing body mod don't seem to be as well-trained as he was.

Some of the lengths (and shortenings) that people put themselves through and through themselves can be graphically seen on the BMEzine site. The Elective Home Surgery FAQ page hosted on that site contains an impressive amount of content for the would-be auto-surgeon. However, it also contains some equally impressive omissions:

Q. Why do I need to close wounds?

A. (coming soon)

Q. How can I control bleeding?

A. (coming soon)

Q. Things are looking bad. When should I call the ambulance?

A. (coming soon)

When the next bizarre implant case shows up at work, I will console myself with the following: elective home radiology seems to be a lot rarer than home surgery. I'm not sure I really want to know what a dedicated amateur might accomplish with, say, a barium enema kit, a high pressure injector and a portable X-ray machine.