 Luke Kwan, a member of Good Good Golf suffered a very, very bad injury and he just put out a video and today we are going to talk about it. Welcome back to the channel, everybody. For those of you who are new around here, my name is Michael, aka Dr. Chalini, and I'm a board certified diagnostic and interventional radiologist. Now, many of you probably know by now that I have this little addiction recently and that addiction is golf. And coming with that addiction is my absolute obsession with a new golf YouTube channel called Good Good Golf in all of the players that are in Good Good Golf. And if you haven't seen Good Good Golf, go check them out. They are a phenomenal YouTube channel that basically just plays golf for a living. Six guys, all they do is play golf. And recently they have added a new member of the Good Good Golf squad named Luke Kwan. He is a pro golfer for the corn fairy tour or the tour just before you get to the PGA Tour, a phenomenal golfer. And I've watched probably like 20 videos of him play now. He's amazing. And I wish I was him because he's so good at golf. But unfortunately, we are not going to be talking about golf today. Rather, we will be talking about the injury that Luke Kwan suffered recently. And he put out a video talking about that injury. And today we are going to react to it, talk about it, and maybe educate you all a little bit. We'll see. Let's get into it. So I will link Luke Kwan's video down in the description box below so you can go check it out and go support his channel. And I will also link Good Good Golf down below as well so you can check out their channel. If you're interested in golf and you haven't watched these guys, you're missing out. So let's get into Luke Kwan's video. Now, before we get into this, I do know that he suffered a head injury. So I haven't seen this whole video, but I am kind of anticipating what's going to happen given his age and that he suffered a brain injury. I'm not going to give it away, but I already have a little foreshadowing giving how many patients I've seen in their 20s suffer brain injuries. But we'll see. So basically to summarize what he was saying is he had his head outside of the golf cart. I'm not sure why. Maybe he was just jokin' around. Maybe he was feeling the air on his face or whatnot and they came across a bridge. Maybe he wasn't paying attention and he just nailed the side of the bridge and hit his head on the bridge. When you suffer a head injury like this, you're kind of shocked because you don't really know what happened and you don't know the severity of it. And obviously your brain jars a little bit inside your skull when this kind of thing happens. It's very interesting to hear him say how he had no idea what happened after he hit his head so hard. And that's pretty common. I somehow played seven holes after that point. I don't remember a single shot that I hit. I basically know everything I need to know based off of the history he's given right here. And he even popped this up on his video here, which is very astute of him, the Lucid Interval. So basically when somebody hits their head really hard and suffers a brain injury, if they have something called an epidural hematoma, which I'm assuming what he had, you may lose consciousness briefly, but then you have this Lucid Interval that may last up to a couple hours even where you're not really sure what's going on, but you basically appear normal and can function normally, but don't really know what's going on or the severity of your brain injury. And then eventually that Lucid Interval wears off and you may go into a coma or become unconscious. And that's the scary part about the Lucid Interval because you suffer a very bad brain injury and then you feel fine, like nothing happened. And you're like, oh, okay, maybe it wasn't that bad, but it actually really is that bad. It's actually very bad because you're experiencing that Lucid Interval. So he played seven holes of golf. That's like two hours worth of golf after he suffered this very bad brain injury in this Lucid Interval. It's crazy. I guess after seven holes, I for some reason felt like not playing anymore. The crazy part to me is how he didn't even have a scalp laceration or wasn't bleeding or anything because when you suffer such a severe brain injury like this, you would expect there to be some sort of superficial cut, scrape, hematoma, swelling, bleeding down the face. The scalp is very vascular and anytime you cut the scalp even a little bit, it bleeds like crazy. So it's very odd to me how he had no symptoms external that you could see. Well, my intention was to go drive back to the hotel that I was at, which is about 40 minutes away. He thought I was going to go back to our college golf facility, which is like a two minute drive. I don't even know how I drove back to the hotel in that mental state that I was in. That is so unsafe and anything could have happened to him because he basically had no idea what he was doing. He just in his mind felt like he needed to get back to the hotel room because he was tired, which is a common symptom of having such a bad brain injury. He could have gone unconscious, passed out while driving behind the car and things could have ended way worse for him and other people, which would have been way worse than the way the story ended up. He probably stared the hell out of the people at the front desk. Is this guy going to fall asleep and not wake up in front of me here in the lobby? Probably not the smart thing to do, but I mean he was in his lucid interval. He didn't really know what he was doing. Then I was just kind of taking a nap in the hotel. I don't know why this whole thing made me feel really sleepy, but I felt really sleepy. I just wanted to go to sleep and the excruciating headache would not go away. I keep harping on this because for one, this is like a classic case. This is on every one of our board exams through medical school, residency and on into becoming a radiologist. Actually, this is just a very classic example of what happens when you have this particular injury, which we'll get into in a minute. You basically just already know what he had. Finally, my girlfriend came up to okay, see told me that I should go to the ER. Why do the women always tell us men that we need to go to the ER? I feel like Andrew Anna would be like, Michael, you're going to the ER right now. Comment below if you've had a patient encounter where the wife or girlfriend makes the guy go into the ER or go into the clinic or whatever. Comment below. I know everybody has seen that. No, like there's no way I'm going to put myself through, you know, that much debt and all that money that would be associated with getting a neurosurgeon and all this stuff. This is another reason why people don't want to seek medical care in the US is because it is very expensive. And sometimes at the expense of your own life, you will not seek medical care. And he almost didn't go to the hospital for a severe and life threatening condition, even with insurance is expensive. I don't know what triggered my mind to say this at the time, but I was like, okay, screw it. Let's just go to the ER took me in for a CT scan. I was trying to Google a CT scan and I couldn't really find one that was as bad as mine. I don't know if that means because if it gets as bad as mine, you're usually dead or what? I don't know. But basically a quarter of my skull was like had internal bleeding. Yes. So this is what I was waiting for here. So basically what he has is an epidural hematoma and he had classic symptoms leading up to that CT scan that would kind of lead you down the path of an epidural hematoma being asked. He almost lost consciousness while he hit his head in which thereafter, his neurological status kind of slowly declined. So this CT is showing basically that bulging, all that bright stuff is blood. And what happens in these injuries is essentially you have the stroll and then you have an artery running along that stall. And then you have the fibrous covering that surrounds your brain called the dura. They're all kind of smushed together like a sandwich. You can't get between those spaces. But what happens when you injure it and have this epidural hematoma, you fracture the stroll and what that does is basically it lacerates the artery that runs along that stroll starts bleeding in bulges out and creates a space out of something that wasn't a space. When you have a ruptured artery, there's nothing to stop the bleeding. It's just constantly pumping at a very high pressure and filling that space. Eventually that bleeding will stop itself by tamponading itself off, so to speak. Basically, that space will get so much blood in it that the pressure from that blood can't get any more. And it just kind of pushes on that artery and stops the bleeding itself. The problem with this bleed is that it's pushing on the brain. And when you have anything pushing on the brain, there's nowhere for the brain to go. So it just kind of smushes on itself and can even herniate downwards into the spinal canal where your spinal cord is. When all this happens, you can compress on the nerves, you can compress on the brainstem, you can cause lack of blood flow to certain parts of the brain, cause a very massive stroke and you may not even wake up from this. That's how serious this epidural hematoma can be. When something is this large, you have to go to surgery, you have to go in, scoop out that brain because all of that bright stuff is basically just a giant jelly clot that you have to scoop out. Once you do that, you can relieve the pressure from the brain. The brain can kind of slowly fill the stroll cavity and go back to normal. Assuming you didn't wait too long or have any catastrophic long-term effects that may have been a result of this smushing on the brain. Smushing is the technical term, by the way. I'll show you guys kind of the scarring that's going on here. So he had a big kind of frontal temporal, some neurosurgeon in the comments going to be like, no, that's not the right flap. But he has a big frontal scar there, which they basically had to open up his stroll, retract his scalp and go in and scoop out that clot. So this was a pretty big and emergent surgery that he had. And the fact that he's even talking like days later like this, like he's normal, is insane. They were like audibly saying out loud, like, holy cow, there's a lot of blood pulled up in his brain. Brittany at this point is hearing all this stuff and is like, oh God, I wonder how bad this is. He's actually very fortunate because they base how well you will do after an operation like this based on how you presented before the operation. Preoperatively, your neurological status is the greatest prognostic indicator of how you will do after the surgery. So for him, he essentially had a mortality rate of approximately 10% or it could have been easily as high as 20% preoperatively because he was in such a neurological decline and unconscious prior to the operation. Apparently I had some seizures at the time. I think I had like, I was told like seven seizures and apparently two of them were serious. Seizures are a common symptom of a traumatic brain injury. And what I think he's saying by severe seizures are just seizures that weren't responding to conventional medications or they were refractory or he was in status epilepticus, which is a very serious form of seizures. When there's as much blood forming in my brain as much as I did, there's kind of only one another place that the brain can go. Your brain just kind of goes down in your spine. And once that happens, it's pretty much game over. He hit the nail in the head there. And that's one of the major things I look for when I see any traumatic brain injury come into the ER, because I read these CTs on a daily basis, obviously. And if I see any blood or if I see a stroll fracture, the next thing I look for is any sort of herniation or smushing of that brain downwards, compressing on the brainstem or even herniating down into the spinal canal or bottom of the scroll base. If I see that, that is a pretty bad sign, as in the patient probably has a poor prognosis, especially if it's been a long time since the patient has had symptoms. Another problem was is that they were trying to get me over to the there's another hospital that's like maybe 15 minutes away, because this current hospital that I was at the first time, they didn't have a neurosurgeon. So this is a common problem too. A lot of smaller community hospitals don't have very subspecialist surgeons on call at all times. A good rule of thumb for knowing if a hospital has a neurosurgeon on call is if they are a level one trauma center, you can do rule level one trauma centers in your area. By definition, they have to have a neurosurgery on call because that's where all the worst traumas go to at all hours of the day. And there is always a neurosurgeon on call that amount of blood that was pulled up in my brain, like it's kind of hard to tell what the results going to be. Also, like there's things like with long term effects, like some people apparently have some sort of seizures or problems or something like in the next like two or three years. And some people was like, they just live their rest of their life as if nothing even happened. He's absolutely 100% correct. You can kind of guess based on the presenting symptoms and what you see on imaging and what you see in the OR, but you actually don't know. He may be completely normal. Only one way to tell is to just wait and see. This whole thing kind of happens and I get out of surgery and three weeks go by and I'm waiting for the hospital bill to come. And I'm just like, just dreading it because I'm like, Oh my God, it's going to be so much money. And somehow it comes out to like be less than like $5,000. How is that possible? I thought it was going to say like $300,000 because he spent so many nights in the ICU. That adds up really quickly. Plus a huge neurosurgery. I was genuinely so surprised about it. I was like, I almost just didn't really think that was it. I thought there was like more coming, but it was really just $5,000, which is so wild to me. I think someone from OU gave me a big donation or something like that. I don't know exactly who or if it's someone I know or I don't know. I need to look into that a little bit more. And I don't know. I just really want to thank that person for helping me out so much. Wow. That's incredible. Incredibly fortunate, incredibly lucky. And that's awesome. He came out with just $5,000 bill, which is obviously a lot, but compared to what it should have been, not even close. So that is it. Hopefully you all enjoyed this video. Shout out to Luquan. I could not be happier that you have made such a speedy and excellent recovery after such a catastrophic injury. Incredible. I wish you all the best. To wish you all the best with golf. I hope you continue making golf videos because you are quickly becoming mine and my brother's favorites. So we expect to see a lot of play from you on Good Good Channel going forward. Let me know what you thought of this video. Let me know if you learned anything. And as always, comment below if you have any questions. I will try to answer them. Follow me on Instagram and TikTok if you don't already. And I'll see you all on the next video. Bye.