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[Music] welcome to another episode of talking with docs Im dr. Paul salvo and Im dr. Brad weenie on todays episode Id like to say Im thankful after Canadian Thanksgiving for the Sun being out yeah it is a nice day finally okay so we got a tricky case today for a tricky Tuesday this is generally someone who is medically unwell they have a lot of comorbidities and a lot of people will ask us in the office or even email us saying am I too sick for a total knee or a total hip replacement yeah what do you tell them Paul yes you are no I usually go through the whole risk benefit ratio with them and then help them make their own decision as to whether or not its safe to proceed ultimately the final decision is made by either an internist or RNs attaced because theyre their medical sickness often will make the surgery a little more difficult but the other risks are more docHub okay lets go look at the x-ray okay so here are the x-rays of our patient today who I need to talk me a