A Mom Ate 5 Day Old Sushi For Dinner. This Is How Her Brain Shut Down. JC is a 34 year old woman, presenting to the
emergency room, with insomnia, sensory deficits, and psychosis. Her husband, Jonathan, tells the admitting
nurse that she had a psychotic episode the night before, bent over and curled up on the
floor, before suffering urinary and fecal incontinence. She hadn’t slept for at least the last 3
days. About 9 months ago, JC had some trouble. She got home late from work. She didn’t have any food in her fridge and
everything was closed. She found some sushi in her fridge, that she
bought from the gas station a few days ago. She wasn’t sure if it would be ok, but she
hadn’t eaten all day. And she knew she wouldn’t be able to sleep
that night if she didn’t have anything to eat. Immediately after eating the 5 day old gas
station sushi, JC felt good. It slid down smoothly, and she didn’t really
even need to chew it. 5 day old leftovers were always a little sketchy
in her mind, especially if it was from the gas station. And the fish did taste a little sour, but
just put some more soy sauce on it to mask it out, she thought. This 5 day old, gas station sushi was so uneventful,
she didn’t even remember eating it. As the days passed, life was normal for JC. But about 5 months ago, and 4 months after
that night, JC started having insomnia. She’d go to bed at 11pm, but would toss
and turn. She’d close her eyes, but nothing would
happen. And she could watch as the sun would rise
at 7am. The day following her sleepless night would
be filled with anxiety and confusion. She would feel like her heart was beating
in her neck. She dreaded night time, knowing she could
end up watching the sun rise again the next morning.
 It was around this time that JC would periodically
feel her stomach cramp. It would come and go, and she could feel it
jiggle and shake. Sometimes, it’d be followed by the loosest
and most watery stool she had ever had her in her life. She told her husband that it felt like a fish
was flapping around in her belly. 
JC wasn’t sure if she was just too stressed,
or whatever was going on with her sleep. She tried melatonin. She tried essential oils and special teas. Some nights she’d sleep OK, but there was
no consistency. Nothing made any sense. JC started seeing little bugs crawl around
the walls. She couldn’t see them directly in her field
of view, but they would hang around on the sides of her eyes. She could see little creatures creep and crawl
around. She was so exhausted from her insomnia that
she wasn’t sure if it was because of the sleep depravation, but as the days passed,
those bugs on the walls started crawling underneath her skin. One night, while JC was wide awake, she couldn’t
feel her hands and feet. And as she got up from bed, she felt her pants
were wet, as a warm fluid started rolling down her leg, becoming colder the further
it dripped down. She realized it was urine, but she had no
idea how she let it happened. In the urgent care clinic, 7 months after
eating the 5 day old sushi, JC did appear to be healthy. Just looking at her, doctors couldn’t find
any immediate problems. Her diet was OK, maybe a little aggressive
in the calorie deficit, but she exercised regularly. Her blood tests all returned normal. The urgent care doctor didn’t really want
to tell her that it was all in her head. You know what, maybe you’re stressed, and
we can give you some magnesium to help you sleep, he said. Stress causes insomnia. It causes urinary incontinence. JC’s young, she’s healthy, she’s not
pregnant. Medicines might cause additional side effects,
so the doctor was convinced: cognitive-behavioral was the best solution here. JC could maybe sleep one night a week still,
so there was some hope. And nobody ever mentioned anything about some
days old sushi JC ate for dinner one night, because JC herself didn’t even remember
she had eaten it. As she expected, the cognitive-behavioral
therapy did absolutely nothing for her insomnia. One night, her husband saw her mumbling to
herself in the corner. She was shaking, and her pants were wet. As she passes out and starts having a seizure,
Jonathan calls for 911, and she’s brought to the emergency room where we are now. At examination, doctors weren’t entirely
sure what was happening. But looking at her blood underneath a microscope,
doctors find that JC had macrocytosis. Macro meaning large. Cyto meaning cell but in this case, referring
to red blood cell, and osis denoting an abnormal state. Abnormally large red blood cells. But not only were they large, she overall
had less red blood cells than normal, something known as anemia. An meaning without and emia meaning presence
of blood. Without enough red blood cells to carry oxygen
to her organs, this could explain why she was so exhausted over the last several months. But if those blood cells are bigger than normal,
then maybe they could hold more oxygen than normal, so it should all even out, right? Doctors find that JC’s red blood cells aren’t
just larger than normal, they never fully matured. Some of her white blood cells were malformed. Something was wrong with their nucleus. And because the nucleus is where the DNA and
genetic material is, this means that JC has a problem that would cause her blood cells
to be immature, but something’s wrong. Anemia by itself usually can’t cause neurologic
problems. JC doesn’t just have insomnia, she can’t
control her bladder. She has hallucinations and delusions. And an exam finds that she has sensory ataxia. A meaning without and taxia meaning order. Sensory meaning her awareness of the position
and movement of her body. This was combined with impaired reflexes,
all of this pointing to some potential neurodegeneration on JC’s part. If her blood cells aren’t properly formed
because something’s wrong with her ability to make DNA, then something similar could
be happening to her nerve cells too, meaning the anemia and neurodegeneration are happening
because of the same problem. And when cells aren’t maturing properly,
this could be because of a nutritional deficiency. Doctors note that JC was slender. She had indents in her cheeks which could
mean potential malnourishment and she was less than 70 percent of her calculated ideal
body weight, a clinical measure based on height. Her husband confirms that over the last several
months, she decreased her daily intake from 2 meals, down to just breakfast in the morning
that would sometimes only be a cup of coffee. Even after she started dieting several months,
she just simply ate less every day. In the step-down unit, doctors looked closer
at another blood test. Most nutrient levels were normal, but her
vitamin B12 level, was really low, telling doctors exactly what they need to know. Vitamin B12 is a nutrient needed by humans. Our bodies don’t make it so, we need to
source it from our diet. And its impact in the body is indirect. DNA is made inside the cells, so that genetic
material can be passed down when cells reproduce. Vitamin B12 is important in creating (Adenine
and Guanine, purines) DNA backbones. So when there isn’t enough of B12, proper
DNA isn’t made. Red blood cells in the body live for 120 days
before they’re broken down and new ones are made. Everyday when you have a stomach movement,
the fecal matter is brown as a result of red blood cell breakdown. And in JC’s case, if the proper DNA isn’t
created, then her new blood cells don’t form properly, explaining her macrocytosis. In the mitochondria, powerhouse of the cell,
vitamin B12 promotes ATP production, which cells use for energy. If B12 isn’t present, energy production
is disrupted, but even worse, different chemicals start building up. The nerves need lots of energy to function,
so they use a lot of ATP. Build up of these different chemicals start
forming in the fatty myelin sheath, which helps transmit electrical signals all throughout
the nervous system. As these chemicals accumulate and build up
because vitamin B12 isn’t there to make the right chemicals, they start eating away
at the myelin, degrading it, causing neurodegeneration (subacute combined degeneration). She can’t sleep because of the nerve damage. She’s delusional, psychotic, and hallucinating,
because of the nerve damage. Doctors give JC vitamin B12 injections, to
kickstart her recovery. As the days go by, JC starts to recover and
become herself again. She’s able to sleep well again, for the
first time in several months. Doctors recommend she take supplemental Vitamin
B12 by mouth and move off her restrictive diet, as they discharge her from the hospital. Over the next several weeks, things seem to
go well for JC. She’s eating more, and her quality of sleep
is OK, but not great. Two months later, she had her first sleepless
night, again. She started taking more and more vitamin B12
gummies. But then the bugs started crawling underneath
her skin again. And she started hallucinating, again, all
of this, while taking more and more of the vitamin gummies that the doctors had told
her to take. She starts to believe that the vitamins weren’t
really her problem as she develops delusions again. And finally as she has another seizure, she’s
brought back to the emergency room again. At examination this time, doctors find macrocytosis
again. They check her blood, and even though she’s
been eating more food than before, and taking those gummies, her vitamin B12 levels were
less than 10% the normal value. If she’s eating more now than before, and
taking actual vitamin supplements, then why are her b12 levels be low? She’s eating it, so that’s not the problem. So maybe she’s not absorbing it. It doesn’t look like she has any problems
with her stomach, so, if GI tract hasn’t been damaged, then could there be something
living in her GI tract that’s consuming all of her vitamin B12? At this thought, doctors took a look in JC’s
stool. In it, they found eggs measuring about 40
by 60 micrometers long. It wasn’t just a couple eggs, there were
thousands. This was in addition to segments that probably
broke off of what appeared to be a species of tapeworm. Doctors asked JC if she had eaten some grains
recently. Sometimes, grains can be contaminated with
rodents, and insects. Actually, it’s almost impossible to have
completely clean food, so there’s a good chance you’ve eaten some “objectionable
matter contributed by insects, rodents and birds.” But some tapeworm parasites can live in infected
insects, which can make their way into contaminated grains. This could be what infected JC, but she was
dieting. She didn’t eat carbs often. And as doctors asked her this, she remembered
the 5 day old gas sushi she ate, more than 9 months ago. The stomach cramps. The loose stools that followed them. The feeling of a fish flapping around in her
belly. All of this pointing to a giant tapeworm that
has been living, and reproducing inside of JC, that came from some contaminated fish
of 5 day old gas station sushi. Doctors identify the tape worm as Diphyllobothrium
latum, one of the largest tapeworm known to infect humans, that can grow up to 30 feet
long into the intestines. This species, has a unique affinity for vitamin
B12, and is well known to compete with the human host for the nutrient. Because JC had already been at risk of having
low B12 because of her heavy calorie restriction, this only made her situation worse, when a
parasite started to grow inside of her, and prevent her from getting any vitamin B12. Because the tapeworm was in her small intestines
by the part where it joins in to her stomach, it would suck out all the B12 from food she ate, so
when she received B12 injections in the hospital, it looks like she started to get better probably
because the injection went right into the blood, and not through the gut, where the
parasite could extract B12, like it did in the gummy vitamins she ate afterwards. As the B12 stores in her liver started to
become depleted, and they were probably already low because of how she ate before the 5 day
old sushi, her nerves started wasting away, because wrong chemicals were made in the cells,
without vitamin B12. Those wrong chemicals built up, and slowly
ripped apart her nerves. It started with insomnia, then she couldn’t
feel her hands and feet. Then she saw bugs crawling on the walls, before
they started crawling under her skin, and before her psychosis, sensory ataxia, and
her seizures. Medicine was given to remove the parasite. Even if the tape worm can lay over 1 million
eggs per day, and live 10 years in the human gut, all it takes is a single dose of anti-parasitic
medicine to cure JC. The medicine forces calcium into the worm,
causing its muscles to cramp up, paralyzing it. With the tape worm’s defenses down, the
immune system finally recognizes it, and attacks it as the worm slips out of the intestines,
and out of the body. And as JC started her full recovery, she was
finally able to have a good night’s sleep, again. Thanks so much for watching. Take care of yourself. Watch out for those gas station sushi leftovers. And Be Well.
Would the tapeworm have been less of a threat on day two instead of day five? Seems like it's the presence of the worm at all that would determine transmission and not it's age (unless dead).
I wish they would address the fact that she never went and saw a GP. Could she not afford it? All those continued problems and she never once called the doc and said I’m getting worse.
So did she shit a 30 foot tapeworm?
7:10 MITOCHONDRIA- THE POWERHOUSE OF THE CELL
She sacrificed herself to the God of Comedy. Laughs aside, I'm amazed that nothing actually happened for days - I ate 12 hour old sushi once and within 90 minutes my guts were telling me they wanted a divorce.
This whole video has me scared to eat anything now.
I had a tapeworm in 2005 after eating raw steak tartar. I lost about 40lbs during this period of time and had cramps and bowel problems. I also started getting the thingly soles and hands. It was in me almost 6 months before I was diagnosed. I didn't feel any stomach movements but the cramps were nuts.
Yo this guys videos make me wanna go to med school and flunk out
Was it because the sushi was already bad? did the '5 day old' part even matter if the sushi already had a parasite in it/parasite egg? Asking for a friend.