Big Tongue

[George K]

One of the more serious adverse reactions to a certain type of blood pressure medications is angioedema - a swelling of the mouth and tongue. It is something that people who take ACE inhibitors should be aware of.

I've seen it serious enough to require a trip to the OR and a tracheostomy.

But this...wow.

[taiwan_girl]

[Horace]

I have a very big tongue. Once I showed it to a rando at a party and he asked me if I pick up girls with it. True story. I never showed it to anybody again.

[George K]

@Horace Becky was a nurse in the OR who had an exceptionally long tongue.

One day, a surgeon told her, "You could make some woman very happy."

[jon-nyc]

The scary thing, well one of them, is that guy is incapable of breathing through his mouth. If his nose gets stuffed up he needs a trache.

I remember when I was sick I would occasionally wake up hypoxic because my nose would be stuffed up and I’d be breathing through my mouth. So the nasal cannula delivering oxygen was in the wrong place.

[George K]

@jon-nyc it's worse than that.

The swelling goes posteriorly, obstructing the pharynx all the way back against the back of the throat. You lose the airway altogether.

As far as the airway goes, there are a couple of solutions.

1. If the swelling isn't to bad, and you expect it to get worse, you might, might, be able to intubate the patient.

2. If #1 isn't an option, you might, might, be able to insert what's called a "supraglottic airway" or "LMA." This is a device that's inserted through the mouth and wedges itself against the esophageal opening, providing a path for air to get into the larynx and trachea. See picture below.

3. If neither of those is an option, the only solution is a tracheostomy. I had one patient like that. Scared the shit out of everyone.

[Jolly]

Woman's definition of a bastard: A man with a three-inch dick and a ten-inch tongue, and all he wants to do is screw.