Ask Dr. Drew - Heart Transplant Denied Due To Vaccination Status: Dr. Arthur Caplan on Bioethics & David Ferguson – Ask Dr. Drew – Episode 79

Episode Date: March 14, 2022

David Ferguson Jr. was denied a heart transplant after declining to take the COVID-19 vaccine, prompting protestors to rally in support. The Boston hospital, Brigham and Women’s, says that this vaccination requirement is standard policy to improve the survival chances of transplant patients, whose immune systems are compromised upon release. But many believe that denying Ferguson’s transplant violates medical ethics and reduces his life to a pawn in a political battle between anti-vaxxers and medical experts. Dr. Arthur Caplan – author & professor of Bioethics at NYU – joins Ask Dr. Drew to discuss the ethical questions surrounding Ferguson’s case. Dr. Arthur Caplan is the Drs. William F. and Virginia Connolly Mitty Professor of Bioethics at New York University Langone Medical Center and the founding director of the Division of Medical Ethics. Dr. Caplan is the author or editor of thirty-five books and more than 800 papers in peer reviewed journals. His most recent books are “Vaccination Ethics” and “Policy and Getting to Good: Research Integrity in Biomedicine.” Follow Dr. Caplan: https://twitter.com/arthurcaplan  [This episode originally aired on Feb 10, 2022. Watch the video from this episode at drdrew.com] Ask Dr. Drew is produced by Kaleb Nation ( https://kalebnation.com) and Susan Pinsky (https://twitter.com/FirstLadyOfLove). SPONSORS • REFRAME – Since the beginning of the pandemic, nearly 1 in 5 Americans has reported consuming an unhealthy amount of alcohol, but only 10% of them are actually getting the help they need. Reframe is a neuroscience-based smartphone app that helps users cut back or quit drinking alcohol. Use the code DRDREW for 25% off your first month or annual subscription at https://drdrew.com/reframe • BLUE MICS – After more than 30 years in broadcasting, Dr. Drew’s iconic voice has reached pristine clarity through Blue Microphones. But you don’t need a fancy studio to sound great with Blue’s lineup: ranging from high-quality USB mics like the Yeti, to studio-grade XLR mics like Dr. Drew’s Blueberry. Find your best sound at https://drdrew.com/blue  • HYDRALYTE – “In my opinion, the best oral rehydration product on the market.” Dr. Drew recommends Hydralyte’s easy-to-use packets of fast-absorbing electrolytes. Learn more about Hydralyte and use DRDREW25 at checkout for a special discount at https://drdrew.com/hydralyte  • ELGATO – Every week, Dr. Drew broadcasts live shows from his home studio under soft, clean lighting from Elgato’s Key Lights. From the control room, the producers manage Dr. Drew’s streams with a Stream Deck XL, and ingest HD video with a Camlink 4K. Add a professional touch to your streams or Zoom calls with Elgato. See how Elgato’s lights transformed Dr. Drew’s set: https://drdrew.com/sponsors/elgato/  THE SHOW: For over 30 years, Dr. Drew Pinsky has taken calls from all corners of the globe, answering thousands of questions from teens and young adults. To millions, he is a beacon of truth, integrity, fairness, and common sense. Now, after decades of hosting Loveline and multiple hit TV shows – including Celebrity Rehab, Teen Mom OG, Lifechangers, and more – Dr. Drew is opening his phone lines to the world by streaming LIVE from his home studio in California. On Ask Dr. Drew, no question is too extreme or embarrassing because the Dr. has heard it all. Don’t hold in your deepest, darkest questions any longer. Ask Dr. Drew and get real answers today. This show is not a substitute for medical advice, diagnosis, or treatment. All information exchanged during participation in this program, including interactions with DrDrew.com and any affiliated websites, are intended for educational and/or entertainment purposes only. Learn more about your ad choices. Visit megaphone.fm/adchoices

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BetMGM operates pursuant to an operating agreement with iGaming Ontario. Thank you for being here today. A very special day. Dr. Arthur Kaplan has come back. Art Kaplan, one of my favorite guests. He's the Dr. William F. and Virginia Connolly Middy Professor of Bioethics at the New York University Langone Medical Center. Founding Director of the Division of Medical Ethics. Dr. Kaplan is the author or editor of 35 books, more than 800 papers, peer-reviewed journals, and his most recent books, Vaccination Ethics and Policy. I see you all on the restream, and I'm watching you also over at Clubhouse. We probably

will not take calls, so I don't know. Dr. Kapanoia has about 30 minutes with me here, but I will be taking some calls, I suspect, after that. Our laws as it pertained to substances are draconian and bizarre. A psychopath started this. He was an alcoholic because of social media and pornography, PTSD, love addiction, fentanyl and heroin. Ridiculous. I'm a doctor for f***'s sake. Where the hell do you think I learned that?

I'm just saying, you go to treatment before you kill people. I am a clinician. I observe things about these chemicals. Let's just deal with what's real. We used to get these calls on Loveline all the time. Educate adolescents and to prevent and to treat. If you have trouble, you can't stop and you want help stopping, I can help. I got a lot to say. I got a lot more to say. Since the beginning of the pandemic, nearly one in five Americans has reported consuming

an unhealthy amount of alcohol. Could be you, but only 10% of them are actually getting the help they need. Reframe is a neuroscience-based smartphone app that helps users cut back or quit drinking alcohol altogether. Using evidence-based tools, techniques, and content, Reframe guides users through a personalized program to help them reach their goals. Comprised of daily tasks, a comprehensive toolkit, a community forum, and accountability guides, Reframe is a modern, accessible, and affordable resource that can help anyone looking to reevaluate their relationship with alcohol.

Reframe is backed by Harvard University and Emory University Schools of Medicine, and it is ranked the number one alcohol reduction smartphone app worldwide with over 350,000 downloads. With Reframe, there's no stigma, just science, no labels, just support. To learn more, go to joinreframeapp.com slash drdrew. Use the code drdrew for 25% off your first month or your annual subscription. That's at join reframe app.com slash Dr. Drew. So please welcome Dr. Art Kaplan. Hey Drew, thanks for having me. Very good.

It is a privilege as always, as always. So before we get into some specific questions I have, I'm just wondering if you have any updated thinking. Last time we talked, I think we were talking about mandates and the ethics around that. But has your thinking changed in any way that you sort of think to yourself, I've moved in my thinking for some reason? Yeah, a little bit. I understand that people are getting tired of masks. And I hear it in the debates where I am in Connecticut and the New York area. Some parents are just saying

they're done with masks, they don't want to do any more masks. They worry about the impact on the kids' psychosocial development. I don't know that there's much evidence that masking harms kids. Maybe you've seen stuff too. I haven't seen much, but you know, I trust parental intuition on this a little bit too, in terms of what they see in their own kids. So look, the tool that I think is our best weapon is vaccination. And it's three shots, not two. I haven't changed my mind about that. Does it keep you from getting infected? Not that. Does it keep you from getting infected? Not much. Does it keep you from being dead?

Yes. And so that's the tool we want to use. I'm also disappointed if we're going to start unmasking, which I think we are. Some people at the CDC can argue about it, but I think that's over. State after state is abandoning their mask mandates. It would be nice if we had more testing. I don't know about the listeners, but I haven't gotten my four free tests yet from Joe Biden.

Remember the test kits? I applied, nothing here. I might add, you know, four tests would be nice. How about four tests a week? I mean, what you really want to do is test nice. How about four tests a week? I mean, what you really want to do is test people and say, if you're positive, stay home, and you'll protect other people that way. And that's the smart thing to do. We cannot seem to get our act together around tests. So I've tuned up the volume on that gripe.

And there's a bit of good news. We have some antiviral pills coming. They're not here yet, but they're coming. And, you know, we worked our way out of HIV with pills breakthrough. And really, I think when we get that, that signals late at the end of the tunnel, we're out of this thing. Yeah, I agree with a lot of what you said. I, you know, from an, I'm trying to stay in sort of an ethical domain. One of the ethical questions I've had is this, what you sort of raised about testing generally the thing about Omicron is that the rapid tests and the tests you can do in the home are literally all over the place they are all over the place they are extremely non-predictive if you're negative and they're also non-predictive of much if you're positive except having had the illness so it worries me that we start relying on these tests that are that are sort of inaccurate but it does raise my question which is we have much more sophisticated tests out there for checking neutralizing

antibodies and nuclear capsid antibodies and really coming up with a, a, a spec, a spray, a spectrum that we could, if we worked at standardizing, we could be able to establish relative immunity from whatever vaccine, natural immunity. And there's been no movement in that direction. That's been stunning to me. We have the test out there. They've just not invested the time and the energy and sort of coming up with really good test that we standardize and say, yes, you have a high probability of immunity. No, you don't. Be careful or get another vaccine, whatever it might be.

How can we be two plus years into this thing and not have solid testing? And it's not that the science doesn't exist. It does. Yeah. Part of the answer is Trump. Part of the answer is Trump. He put all the chits on vaccines you know it was vaccines we're going to vaccinate our way out didn't spend much on anything else uh biden has done nothing i think to accelerate uh the availability of reliable testing you know with the sort of half-baked tests that are out

there, what you really got to do is get a positive, you know, three in a row, get a negative three in a row, you know, and get my single test. That's why I'm sneering about, you know, what do you mean we get four tests each for the next six months? So morally, I think our leadership let us down here. You need emphasis on vaccine okay with masking during the heyday of covid okay with the antivirals but let's manufacture them and make sure they're affordable and let's still make the push on testing i keep thinking god forbid what if we get another weirdo variant showing up here uh from somewhere yeah yeah we need tests yeah yeah i i agree so so you see that same that's how that's how i sort of see that landscape

i i also see an ethical problem in the antivirals in that they they are extremely efficacious they are available they They are free. The government has already bought them all, and they've just done a terrible job of distributing them. I almost had a patient die because I couldn't get him the antivirals I needed. They just developed a website where you can look at local pharmacies and see who has what. Thank God they have done that, but that is a new thing. To me, that was one of the scandals of this whole outbreak. You know, we're triaging, I'm told, at NYU. I'm not in the ICU direct, but my students are there.

My former students are there, and they say they have some antibody, not antivirals, but the antibody that works. But it's really down to rationing, which is, again, we don't want to be in a rationing situation either with antivirals mask issue and all the effort that is being put into, you know, hold the line on masks. If you're going to fight a rear guard action and you're going to lose, then I'd rather move on to the manufacturer, distribution, affordability, education. People need to know that they're out there for this stuff than continuing to haggle the last war's battle. Yeah. And you mentioned education. That to me is the other magnificent shortfall in this entire thing,

that we've just done a horrible job. I'm actually developing deep sympathies for people that are absolutely exercised about, like I'm listening to a peter attia podcast where he said he had to adjudicate he went to adjudicate in a family where the parents were triple vaxxed good but just freaked out that the son wasn't vaccinated and the son had reasons for not wanting to and whatever and he asked a simple question of the father goes what do you figure your son's risk of hospitalization and death is if he doesn't get vaccinated? Oh, it's definitely 50%. It's 50%. That is a public health failure. That is a public health abject failure. And I feel bad for those people. Those are the

same people that are fearful. We've just created this group that is just extremely afraid of everything and cannot properly assess their risk their risk and, you know, how to move safely in the world? Well, you know, part of the issue is we stink at risk. So when you're trying to explain risk to people, you need to bring in metaphors. It's like, well, this, get vaccinated. You're going to cut your risk from sort of the chance of you being in a car accident to the chance of you getting hit as a pedestrian crossing the street. I'm making this up. I'm just looking for metaphors. Right. A lot of people would be happy to live with risks that they understood, too, were variable according to the group right my risk is not your risk it's not my kids risk is not the immunocompromised person's risk so there are

different reasons for prudence and caution but we treat it also as one size fits all that's confusing makes people misunderstand what's going on yeah that's exactly right. One second. Chris, we did get that. I'm making her a note here. This is another point. Last time we talked, you really educated me about how the vaccine has to, or any interventions, has to really benefit the individual. That's sort of a primary ethical parameter. Am I getting that correctly? Did I understand that right? Well, you certainly want to make the case that to get vaccinated, it's in your interest. That leads most

people to behavior. You can also say it helps others. That's nice, but I think that's a little more frosting on the moral cake, as they say. The driver is what's in it for me. That's what a lot of people want to know. So I wonder about.

Go ahead, I was just going to say, so it isn't just I'm going to save myself and I'll get vaccinated, it could be I want to save grandpa, so I'm going to get vaccinated because grandpa can't. He's too sick or too immune suppressed. So I'll do what I can, masking, vaccinating to keep, you know, the virus out of the house because it's important to me to have grandpa. So I don't mean to say it's only self-regard that drives why people do things, but self-regard can extend. I care about my family. I care about my kids.

You know, I heard something something drove me nuts recently people were starting to say they're not sure they should get rabies vaccines for their dogs because they've become so turned off by vaccine messaging that they don't know if they're safe it's like it's safe don't kill your pet yeah yeah this is this is how we're going to get into big, big trouble. This is what everyone's fearful of, that the backlash on vaccines generally is going to be. And on health sort of just the participation with the health care system is going to be bizarre going forward. I am terrified we're going to see people try to turn back childhood vaccination. The anti-vax movement got strong.

There's a lot of distrust out there. You know, it's one thing to argue about how effective and what's the big risk of COVID if you're relatively healthy or young. It's another thing to say, you really don't want hepatitis. It's bad to have measles. It isn't good to have mumps. It really isn't a good idea to have's bad to have measles. It isn't good to have mumps. It really isn't a good idea to have a variety of bad childhood diseases. The evidence there is strong. We've

got the data. I think you and I are going to be talking about this in six months. I'm afraid that's true. That's one of my great, one of my many fears. But back to education, I feel like, I worry if there's an, I wonder if there's an ethical issue with the over-the-top preoccupation with this one illness to the disregard for other things. For instance, let me just bring up some basic data. For a 15 to 25-year-old, this is again Atiyah's data, for overdose, suicide, motor vehicle accident, and homicide, those are all 10 times more likely than a COVID death. And yet none of those things are being aggressively addressed. It's particularly not the suicide and the overdose issues, which are running amok because of the interventions on COVID. How do we get that balance back? Yeah, you do need the balance. There's no doubt about that. Look, COVID's been terrible. Certainly 900,000 USA deaths in two years is

nothing to sneer at. That's a lot of deaths, many of which I think could have been prevented. But it doesn't mean that cancer been prevented but it doesn't mean that cancer went away it doesn't mean that you don't need to get your breast exam or your colonoscopy i constantly am hearing from people now who say i delayed surveillance for cancer i was diagnosed at a later stage you know they're going to face a bigger risk of disability and death because of that there are plenty of people i mean we didn't have the i feel silly telling you this but we didn't have the world's greatest mental health system to begin with now oh my god with people we were we were yeah we were in

trouble and now we are just it's it's sort of absurd it's like like it's like you got to be kidding the way it is now. Yeah. I completely agree with you. What are we going to do about suicide? What are we going to do about depression? What are we going to do about dysfunction because it can't work? We weren't doing great with addiction and all the rest of it before COVID. Now we've got this.

And I consider that one of the great moral failures of American health care. We talk about parity with mental health and physical health. We say that we take the mental health side seriously. You just look at the opioid crisis and the numbers harmed and hurt and dead there. We are hypocrites. We do not still take mental health seriously. And I'm sorry to tell you that because I know you understand this very well. Well, no, and I appreciate it. I appreciate it because I've heard the same rhetoric

for primary care. We're going to empower primary care and we're going to have equity. I've been through three waves of equity for mental health services. What they always leave out, to make the equity, all they have to do is say the physician opinion determines the course of treatment rather than the insurance resources criteria. That's all you got to do. And you have parity.

It's so interesting. I never had any trouble scaring the crap out of insurance companies invoking minor medical problems to keep people in a psychiatric hospital but their real needs for treatment the psychiatric needs were completely disregarded get them out of here it's really something else it's just beyond i mean beyond again one more complaint just so listeners hear about it and again you know this well but i want people to understand in most situations you can hold somebody with a mental illness for 48 hours who fixed anybody from a

mental illness in 48 hours freud i don't know who i mean nobody so nobody nobody nobody ever said nobody has serious efforts at treatment i'm not saying you have to lock people away in snake pits but how about 30 days 60 days somebody's seriously mentally ill and you know where the big mental health system is now it's on the streets in the prisons that's a hundred percent 100 100 and there are laws preventing physicians from intervening in these medical illnesses. And here's the other thing. Again, this is another massive ethical failing, particularly in my state. All the oversight committees, there's not a physician anywhere.

It's literally like being oversight, oversighting a hospital filled with sick people and no doctors are allowed to get involved at all. That is disgusting to me. Not only is it ethically inappropriate, it's just guarantees failure. These are serious, dangerous,

complicated medical illnesses and you won't find a single physician, say in Lhasa, here in Los Angeles. It's too much. It's beyond. It's really beyond.

How could people possibly know what they need to do? How could they possibly know? They have no experience treating these people. And you see people again and again and again harming themselves, being the victims of crime, exploited, trafficked. It isn't just confined again to,

let's fix up your mental illness. It's a whole world of cascading issues yep i look at american cities and say how could i mean people bitterly complained about lockdowns bitterly went crazy yep yep how can we have these homeless populations in droves all over our cities i mean what kind of quality of life is that for them for us uh you know it's it's it's i'm gonna say it it's worse than the lockdowns but we don't treat it in the spirit of what you asked as a priority it's just oh well they're there and we'll step over them on the way to work or something oh no no no you you gotta understand there's active prevention from helping them you

are not allowed to help them that's the part that's insane but you know it they they've been labeled homeless therefore if you give them a home it's all done it's over so the problem is get them a home and unfortunately i wish it were that easy my god would that be great um we only have you for a few more minutes i want to to bring up this controversial topic of the transplant patient, Mr. David Ferguson, who was not vaccinated. I'm sure this is a really interesting case that you've thought a lot about. I'm wondering how you think about it. And when I think about it, I got to say, I remember back in the days when, for instance, alcoholics couldn't get liver transplants because the assumption was they would ruin the transplant and they weren't far off. I mean, it's so that we have a long history of having criteria for access to these limited resources we call transplant organs. And this

one got a lot of attention. I just love to hear your thoughts about it so I'll confess I I've been around transplant a long time I've helped make up some of the rules that we use to allocate people need to understand organs for transplant exceedingly scarce there are probably today 9 000 people waiting for a kidney probably a couple thousand waiting for a heart there will be many more deaths than transplants on any given day. So you've got a scarce resource. I was drawn to think about it because it's rationing and you got to make hard choices. Everybody should sign their donor card. Everybody should be a willing organ donor. It really makes a difference. But tomorrow morning, we will still not have all the organ donors we need. So we've tried to come up with principles to distribute the organs.

And one overall principle is get the best bang for the buck. See who will live most likely if you give them the scarce organ. Try to save the most lives. Try to save the most years of life by transplanting. By the way, that means age comes into the picture. We don't flip a coin between 80-year-olds and 18-year-olds. If you need a heart at 18, you're going to go ahead of the 80-year-old because you have a much better chance of living a longer life with that heart. I agree with that. It's nothing I would disagree with. It's tragic. It's sad for the 80-year-old but there it is as you know too we also disqualify people because

they smoke heart transplant programs are not going to take active smokers they're going to make you undergo some kind of cessation program if you're abusing addictive drugs you're not coming in there are a number of lifestyle things, even basic hygiene, to tell you the truth, because it leads to infections and death post-transplant. You have to take all these medicines to keep the organ working. So in a nutshell, what does vaccination have to do with this? It turns out if you get vaccinated before your transplant you build up some immunity and the doctors can work with that after the transplant if you get exposed to covid or by the way the flu or by the way tetanus or the measles or any other infectious disease people are and have been for years been

told you got to get all the vaccines you can because you're going to be immune compromised. You're going to be vulnerable post-transplant because you got to tune down your immune system to keep the transplant working. So what happened to this guy is he said, I want to do it. Brigham and Women's Hospital in Boston said, then there are other people who are willing to be vaccinated. They're going to go ahead of you. And in fact, if you won't do it at all, we're not even going to list you, not because they

hated him or discriminated against him. They knew they had a waiting list of many who were vaccinated and he wouldn't get an organ anyway. Does that make sense? Yeah, yeah, it makes a lot of sense. And I would argue, I knew that was going to be your reasoning. And I would argue that I've actually been sort of impressed that many transplant programs have lightened up on the drug addicts and alcoholics and even smokers to give them a chance to show motivation at getting

well and dropping these behaviors, which is a leap of faith, a leap of faith. Right. With those folks, what you see is this. If I'm still actively really heavily drinking, I'm not going to the liver program. But if I can show they made a sincere effort at sobriety, maybe I was sober for six months, most of the programs just started to move in that direction. All right, you know, we'll list you. We'll take a chance. It's a little hard to be partially vaccinated or a little bit vaccinated uh so you don't quite see that but

again i haven't given up on the guy in boston i would be talking to him every day saying look the odds are better for you if you vaccinate not just covet but flu or whatever think about it again think about it again what they did with him by What they did with him, by the way, is they gave him an LVAD. This is a device for listeners that maintains your ventricular function. It's a partial artificial part. The autonomous thing. I don't know how long he'll be able to go with

that, but it bought him a little time. And I'm certainly willing to go in there and argue with him every day. You need to get the best chance you can with these scarce cards. I'm not going to give up on them. but uh you know if i'm looking down the list and there's four people vaccinated they're not smoking they're not obese and they're not a variety of other things i know who the organs go into yeah i i i i'm it's an unfortunate you know sort of uh of alchemy. It's just an unfortunate.

Stoichiometry really is what it is. It just has to be until there's more available organs. So if you're upset by this, people. I can jump in and say two things. One, if you're upset by it, don't tear up your organ donor cord. Get more people to sign it. Sign them. Sign them.

Exactly. Sign them. Yeah, exactly. The other other thing is you know this you know this drew we are trying something at nyu and a few other places are trying to we're trying to develop pigs as sources of organs that's how desperate we are genetically engineering these pigs to be sources of hearts and kidneys and i think that's a pretty desperate path to follow. I don't oppose it. I've been supportive of it as we try it here. That's how bad things are.

We're trying to use animals to save people. Yeah. Yeah. Let me ask this one last question. I know you've got to run here, which is, will the advent of widespread antiviral therapy that we have a track record with showing excellent efficaciousness, would that change the alchemy, the equation for this guy? A hundred percent. So you could move and simply say, I'm not worried about COVID anymore. Or if I have a broad spectrum antiviral and I can kill the cold and the flu or whatever it is. Yes. I mean, the point isn't get married to COVID vaccines. The point is get immunity to infectious diseases before we throw you into a situation where you're going to die from infectious diseases at a much higher rate. So you can do it by antibodies, do it by pills. I don't really care.

That makes perfect sense to me. Well, listen, Art, thank you for stopping by. I know you've got to go to another appointment. It's always a pleasure to get a tune-up from you. Thank you so much for having me. Any upcoming publications we should look for? Actually, there's something coming very soon on a subject we'll talk about someday, which is how do we determine racial identity in America? You know, Whoopi Goldberg got sent away for contemplation.

And you see the NFL now says it wants diversity. And it's all over the place. So I've got something coming out soon. I'll send it to you. I'm trying to wrestle with this a little bit. Please. I think there are two areas we've got to really dig in. That is one of them. And the other is the sort of Eurocentric, sort of self-centric view of the world we all maintain and how to be sensitive to

other people's points of view uh really said not not talk about it really pay attention and i've said repeatedly that it was frederick douglas the great orator from around the civil war that that broke dropped the scales from my eyes his if you read his language, you'll all of a sudden understand how our field of vision is a few feet in front of our face. And that's about it. All right. Well, thank you, sir. We'll talk soon. And good luck.

Very good. Thank you. All right. And you betcha. And Caleb, I think what we'll do is I'm going to come back and take a bunch of calls that's my next plan off clubhouse uh let me look quickly at restream i'm going to take a little break oh is there a bunch of uh are we getting t-board keyboard tough guys toms out there are there people that are uh trolling y'all uh uh i can't quite keep up uh good good job on the sobriety there uh okay it's just tom being the keyboard tough guy now okay good we'll keep doing so and chris i

you heard me say that um we got uh the package but susan you haven't opened it yet have you the mermaid dress no i was cleaning the garage. Yes, yes. When I brought it in, I saw that. All right. Take a little break and back with your calls after this. Let's talk about our friends at Hydrolyte. I can't say enough about Hydrolyte.

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And I'm looking at some of the other people coming up here. Hold on. I sent some interesting requests to Michelle, Susan. Just long shots just to see if people would come on and talk about stuff. For instance, you know the girl on Euphoria that's cheating with the best friend's boyfriend ex-boyfriend she put up a long post about some bullying and how women treat her and stuff and i thought this would be a really interesting topic so she's she's getting bullied when she's off the show she's getting bullied i i don't quite get all the details such a good job being an actress and she's getting playing a part she's getting bullied because she came on essentially, this is the best I can make of it because it all seemed

really awful. She was getting bullied for no reason from female peers. She came on, she'd had a rough day or something. She came on without makeup and said, look, this is really awful. You shouldn't do this to me. Then a wave of people came in telling her she's ugly. And apparently she reacted to that. And then that created another wave of losers and trolls. And so she, you know, was sort of trying to express, I think she's trying to make, take the position that, uh, women on women, uh, acrimony is sort of out of control right now on social media. i thought you know she did such an interesting job on that show it'd be interesting person to talk to right yeah that'd be great yeah it's like it's like people are so open with their feelings about you know how they

feel about you like i forget her name uh she plays the cassie let's see look it up cassie she plays cassie isn't that the name cassie on you for and by the way i cannot recommend i'm wondering where it's going that show i hope they don't end in a bad bad place uh this is she what's her name don't forget to get your dr drew bobblehead at dr.com slash shop use the code drew and get five dollars off proceeds go to hillsides thank you for that uh we're not talking about zendaya who also again that one of the questions i have for is how do Use the code Drew and get $5 off. Proceeds go to Hillside's. Thank you for that. We're not talking about Zendaya. Again, one of the questions I have for her is how do you people maintain that level of intensity across hours of television?

It's just like, to me, that's like breathtaking that these performances, all of them, so many of them. Well, I still can't find her name. But anyway. can you eat cilantro yes not today i'm prepping for a colonoscopy i know lucky how are you feeling uh good let's uh get to the phones uh actually i feel really good i'm sort of uh learning better how to do this without destroying myself uh stacy i think is the name i pulled up there let's see if i can get her up yeah stacy what's going on oh she brought up cilantro i have that gene where it tastes like soap to me oh that's interesting do you know this susan there's certain percentage i know

i know that cilantro i am not that person and i love to but i did the I did that 23andMe where you spit on the thing. And they said that I would think it tasted like soap. And I said, that's not true. Oh, that's interesting. But at Costco, they have cilantro lime shrimp. I was thinking of getting that for Sunday. All right, do it. I'm in.

I'm totally in. You two are so cute. Everyone's giving us a peek into our life every minute of every day why don't we just run cameras why don't we just run cameras in here just put a bunch of robotic cameras they just watch us watch me order my food online oh my goodness that's so funny i feel like i'm listening to my parents talk it's cute i mean i'm a parent too that's the thing it's like we're it's okay we're old all right what's going's fun. Okay. We're old. All right. What's going on?

No, I'm 40. I'm old too. Anyway. Okay. But you triggered me there with the, I hate that word, but with the cilantro,

cause my sister and I both can't eat it, but, um, and we're married to, uh, an Indian and a Latino. Nice. So cilantro is like a part of daily life.

And you're in Puerto Rico. Is that you? Yeah. Yeah. Yeah. Yeah. Okay. So I wanted to say uh well there's a lot of things I could say but I'm going to go back to earlier in the conversation with the doctor um with regards to the vaccines I can recall you know I wanted to understand I don't understand I mean I can't even go to a dentist right now without my third vaccine where I am.

So I'm going to fly back to the mainland to see a dentist. I'm going to get the third vaccine, but I just haven't done it. And you have to have it. But I remember not being able to work as a nurse unless you got the flu vaccine. Or you had to wear a mask for eight six months out of the year yeah but people get the polio vaccine like what is that freak out mess why people are freaked i it's really kind of interesting isn't it that's a great way to kind of frame this which is that we know this vaccine works. We know all these vaccines works. I think there's kind of two things that we could,

I can think of solutions more than I can think of why the freak outness is so bad. We could come up with more vaccine choices, Covaxin, Novavax. If we had more choices, a lot of the resistant would take it. Now, that's not necessarily rational. I understand. And there's a, I mean, you know, they were very fearful of the new technology. They were fearful of the pressure that was being applied that didn't feel right to them. But it'd be really easy to educate more appropriately and to provide more options in vaccine therapy.

It would be so easy, it seems to me, to really break the logjam a little bit. Can I just add one? I agree. And one more point based on Dr. Kaplan's point. Like, why are we so focused on this and not focused on the fact that our children are being like mate like we're being we're traumatizing our children i know well that listen that was like that's kind of what i

was pointing out to him that there there are you know in in under five year olds you're 11 times more likely to die in a motor vehicle accident than of covid. Under 15 to 25, you're 10 times more likely to have suicide or overdose. And yet we're doing things that increase the risks of those things that are vastly more problematic for these kids. And that's the part that I'm just struggling with these days. How is your daughter doing with her assimilation? She doing well she's doing well she's um we're she's but she's also repeating the same behavior she did in the states because we were in florida which i thought was ridiculous and now i'm like whoa that was not really like now it's ridiculous but she's still kind of like trying to stay in her room but i I think it's more of a language barrier, but we're going to put her in a school.

But the problem is, you can't even go into a drive-thru without a mask. It's the paranoia. I almost don't want her to experience it. Wow. How am I going to traumatize her more? Well, we'll see, you know, as some of these states are now starting to pull back on the mask mandates, we'll see if people start to get more sane with it. Here's, if you listen to my interview with Dr. Monica Gandhi a couple of days ago, the

data on masks are super clear. They have one utility. They're not good on a mass basis. They don't do the job on a mass basis. They can protect an individual from another person over prolonged contact with an N95 or that whole class of masks. So if you are at risk, if you're old, and you want to protect yourself, not other people, it does not protect other people. That's just the way it is. Wear it.

But to have the mask mandate doesn't stand up to scientific scrutiny. And that's just simply the case right now. So I don't know. I don't know. Especially as this thing is falling, falling, falling, and we have antivirals, and we have so many other things we can do. It just is making no sense. So I feel your pain there in terms of what it's doing to the kids is that what made you call today yeah yeah it just his comment yeah i was listening in

and he was talking well just regard with regards to mental health and people have so many problems already and i i agree that this is a problem. Coronavirus is a problem. Of course. It's hurt a lot of people. My mother-in-law. Of course. But, I mean, we have to weigh the risk-benefit. Right.

So you're talking, were you a nurse practitioner in addition to being a nurse? No, I'm just an RN. Okay. A BSN from, yeah. But maybe it's your day. Somewhere you were making decisions, I can tell just by talking to you. And that risk-reward decision-making, did you work in an ICU or something? Or ER?

Correct. I was a critical care nurse, but I also was a director of nursing for a nursing home that we did a flu. We had to shut down for the, like, yeah. But I know what you did in the ICU. I know when you're, you know, you got 12 pressers going and, you know, all the fluid management and the ventilator management, you were making minute-to-minute risk-reward analysis, constant, constant. And that makes you very good at that. And someone who is good at that, I'm imagining you're watching the public health officials do no risk reward analysis and it drives you crazy yes sir yeah that's what i guess dr mommy right thank you thank you jeans thank you jeans all right yeah and look for i think susan is your pod coming up soon with uh the boys and me

yeah there's oh my gosh there are two there are two or three um i would call them exceptional appearances by susan coming your way i love it except i love that interaction like three or four between us because they don't want me to get people to get tired of me yeah i think i know no don't worry there's a lot going on over there worry. There's a lot going on over there. Trust me. There's a lot going on in Austin. And Susan is a big, big, big part of it. I'm trying to get. No, Susan, we love you. And I know, Stacey, people that get, people are all, I want to bring Christina into that mix, too, because people are also sort of in, we're talking about your mom's house now, which is, if those of you aren't a part of that, I do suggest you check that out.

But they're interested in how the four of our relationships work. And I'm trying to bring that element in. And plus the two boys in the booth. We went out to dinner one time. What do you mean? With Christina and Tom? Well, you went on where my mom's at and crashed that website, essentially. And that's what led you. It's funny. Yeah. Stacey.acy sorry i'm cutting you off that's fine it's fine go ahead no it's just fun because christina says you know like women she talks about how women don't watch her show or she doesn't um hear the women but yes we love it it's like makes it free to burp in front of your husband like it makes it okay makes it free to burp in front of your husband. Like it makes it okay for your husband to burp in front of you or to talk

about bowel issues or to talk about whatever. Wait a minute. Did you say, did you say Christina doesn't, doesn't hear from the female fans? Is that what you said? She talks about how like normal moms don't watch her show. I've heard her say that.

I think she's being funny. I think she'd oh my gosh we're there i have never met a more enthusiastic group than the normal moms from your mom's house they really are extremely enthusiastic everybody and i think she's hard to tell when she's kidding when she's not she's so so sharp but you know they're in austin yeah so she doesn't really have you know they're in austin yeah so she doesn't really have guests unless they're in austin on where my mom's at yeah well i'm lobbying to get you in there no but i mean it's just like i i think her shows now are more just her because well no you know she's sort of done what i've done is she's brought the booth boys into her show yeah and so it's it's interesting we got it look this thing is constantly moving and morphing and growing and changing and that's the great news she needs to

continue that yeah continue with the big but like they're fun i love the interaction all right it's if they're okay with it and i'll pass on to someone else everyone is good to all of it we're all we're all having a good time we're going back in march we're going back in a couple weeks we have a we have a few shows we have a history of taking the Booth Boys out to dinner for steak, but I don't think we're going to be able to pull this off because we're going out during South by Southwest. We'll do something else. We're going to do a

surgical strikeout. I talked to Annie. I want to see how he's feeling. He goes, great. When he's coming back, let's go out and party. Oh, geez. Well, we'll do something else then. Maybe that's the thing. You're still trying to get the... Well, I don't want to have a spoiler okay don't spoil it we're trying to drag susan uncomfortable environment let's just put that that way i don't know it seems so long far away i am trying to bring up um kj2022 2022 uh if he wants to come in.

As usual, what I will do... Oh, here he is. James, what's going on? Hey, what's up, man? Hey, man, I want to support your bobbleheads, but if they stop bobbling, will I get my money back? Susan, this is my wife's deal, so I claim no part of this.

How about that? Well, if you put him on the hood of your car, it'd be fine. No, no, no, no. If they stop bobbling, like if it's a faulty bobblehead, what do they do? What do they do? I don't know. You'll have to call me. Okay.

I'll get you a bobbly one. Contact at drdrew.com. There you go. Okay, yeah. My thing is, you know, I live in Georgia. So this was like kind of the first state to reopen. Yeah. So we've always had the thing of basically being able to, you know, you can wear a mask or you don't wear a mask.

Most people wear a mask still, you know, like when we walk in restaurants or grocery stores and stuff like that. So my question is, is with you have Pfizer, Moderna, and they have been working on a vaccine. So I guess it's like two questions. One is a lot of people that don't take the vaccine. What I hear is they're scared of what might happen down the road because most vaccines have been you know took taken five ten years or more yeah it's taken other years so most people are feeling like it might be some type of side effects yes i think that is one of the reasons which is why and and they'll usually point by the way are you in atlanta yeah i'm in atlanta because we we've been atlanta a couple times during the pandemic and we were out at the lakes a couple times also.

And if you get out of Atlanta, you don't see any more masks. They just stop. They just stop. So I am sympathetic to people being fearful of a new technology. I get it. And here's what I would tell them. We have like Covaxin, which is a more, it's an attenuated live virus, and you will expose your immune system to the whole virus,

not just the spike protein, because people will get very worked up about just the spike protein showing up in parts of the body where it doesn't belong. There are ways to educationally address people's fear and concerns about the vaccines by giving them more vaccine options, different technologies, different ways of doing it. And we have just done a horrible,

horrible job of addressing that. We have not educated, we have shamed, and we have also not addressed why people don't trust the medical system. There's a lot of good reasons that certain populations don't trust us. Not their fault, our fault. And we should be very honest and transparent about that. And transparency is probably the other thing that we do the worst. Lots of transparency

might help get us through this. Thanks, James. I've got a bunch of calls I've got to get to. This is our buddy Joe. Joe, I haven't heard from you in a while. I'm going to get you up here. There you are, buddy. What's happening, man what's happening man hello dr drew how are you doing how you feeling i'm good i'm doing very well just very busy hi susan i hope you're having a great day thank you very busy doing work are you you didn't lose your you didn't leave your job no no no i i did okay doing other work. Okay, good.

Doing other work. All right, good. So I'm just trying to, and I'm also trying to get out a little bit. Good. Trying to get out a little bit more. So my assignments with my psychologist is to get myself out more. Fabulous. And I've kind of forced myself to work sporting events, again, that involve crowds.

Fabulous. But the thing is, I'm going to be wearing a P100 respirator, at least for this season. Because having not been exposed, and we've discussed this already, having not been exposed for two years, really into mass crowds. Now, I had a birthday party last weekend that had 11 people. So that was pretty good. So, Joe, how about your other vaccines? Have you had the Pneumovax, Prevnar, flu, shingles, all the rest? No.

And first off, at what age do you get shingles? I thought you get shingles when you're like 60. I'm not 60. How old are you now? I'm 41 get shingles when you're like 60. I'm not 60. How old are you now? I'm 41. Oh, you're in your 40s. Okay. So, yeah.

Thank you. Thank you for making me feel old. Well, no, I knew you weren't 60, but sometimes they will give it in the 50s. And I was thinking with your stuff, maybe, maybe. But no, not in your 40s. No, no. Right. Right.

No, no. And I would definitely consider, I would more than likely get the shingles shot because shingles is very, very painful. Yes, it is. It's awful. But you still got time. You still got plenty of time. Don't rush that. It's a nasty vaccine too. It's not a fun one. It's a two-parter. No, no. Right. That's what I've heard. Also, it's not what could be very nasty is colonoscopies. And I wish you all the best with that. Thank you. That's up tomorrow. I actually, I'm getting to the point where I almost don't mind this anymore. I sort of create, I sort of quasi dread it and, but I'm getting good at it because I do it every year and I delayed it this year and that made me feel good. And you know, I take, I do propofol. I do propofol. It sounds like I do heroin. I take, I'm given, I've administered. The only time he's mellow, he feels so good.

I've administered propofol for this, for this, these events. And it's always a very intriguing experience. It's, it's every time it's the same thing. It's the anesthesiologist, usually somebody I know, we're chatting and he goes, are you ready? Here we go. Boom, gone. That's it. Just pow.

Gone. And the speed with which that stuff operates just fascinates me. I have to ask you for lots of jewelry when I pick you up. I'm not. It doesn't leave me specifically groggy, Caleb. I have to ask Susan, is there any chance we could try to get a bobblehead, a Dr. Drew bobblehead that sings the national anthem? Oh, my God, you guys. All right, Joe, I'm putting you back in the audience.

All right, have a great day. Get out. Get out there. I'm telling you. Be around people. Thrive. Go forth. It's important.

It's really important to get out there. Okay, I'm trying to get through everyone's calls here, so please bear with me. This is Khalid, I believe. Khalid. Yes, sir. Yes, sir. What's happening? Thank you very much for giving me this opportunity. So I'm Khalid from Church Africa.

I'm speaking right now from Africa. What part of Africa? What part? Chath. Okay. In middle Africa. Okay. Chad, got it.

Got it. Yeah. I'm learning English. I just like to improve my listening skills with you miss dr. Joe you are doing you're doing a great job frankly English is not a is not an easy language I've been working on my French lately and I'm amazed I think is French are you French and Arabic are your native tongues? Which one is yours?

Yeah, we have two languages. Our official language are French and Arabic. And which one did you speak as your maternal language? Both, sir. Both? Oh, sir. Both? Oh. Yeah. On peut pratiquer le français quand même.

Bien sûr, monsieur. Oui, c'est bien ça. Je l'aime beaucoup. J'ai bien... J'ai beaucoup de... J'ai envie de parler français. Je dois parler français. Je n'ai jamais l'occasion. I want to speak French. I must speak French. And I never have the opportunity.

So, I beg you. I beg you. So, for English... Thank you. So sexy. Yeah. For English, are you planning to travel and go to English-speaking countries? Yeah, I would like to visit usa well near future you would be

welcomed i guarantee it uh i thank you very much how are how are people doing in the central africa regions as it pertains to coven to tell you the truth um we have very normal life here so people live normally and and some people don't believe the existence of oh my goodness that's interesting yeah well when you come here you'll see the opposite opposite, but I want you to come visit us. And do me a favor. I'm going to put you back in the audience. Don't just go to one city. This country is like multiple different countries.

Make sure you check out some different regions and different cities, and you will be more than welcome to join us here. So we appreciate that. Again, I'm just blowing through the calls here. I'm watching guys on restream thank you for your calls people and this is uh anna anna what's going on hi dr drew or bonjour bonjour so i just um wanted to um say thank you for you know um you know pushing forward with this stuff and being very pragmatic about the situation. I'm someone who is very struggle with trusting the medical field, even though I do believe

there's many good doctors out there. I finally made a doctor's appointment soon. I just want to share that perspective of why I'm not anti-vax. I'm definitely pro-flu vax because that helped me. But it's just I just want accountability with my doctor when I meet them.

That's all I ask. who will establish a relationship with you, get to know you, understand your risk tolerance, your goals, your preferences, and make decisions with you given that context. If it's somebody that just, what's your complaint and looking at their computer, that's not going to go very well.

That's not going to meet your needs, I'm afraid. And unfortunately, there's too much of that. There's way, way, way too much of that. Yeah, because I took care of my dad dying from lung cancer when I was 16 while my mom was working. And, you know, I know it's a very aggressive cancer. And it was, you know, self-imposed.

I mean, he was a smoker. So I learned very early about the pros and cons of the medical field, you know. And people are imperfect, you know. So it's just, it's just. How old are you? If you don't mind me asking. I'm 34 now. I'm 34 and I didn't want to become a nurse. You want to become a nurse? Is that what you said? No, I wanted to become a nurse when I was younger, but I know how competitive it is too.

And I know there's also a lot of people in the industry who are in it for the wrong reasons too, you know? Yeah. But our nursing colleagues are, I cannot say enough but but yes you you're the good news is under 50 you don't have to worry about much in most cases i mean you you know do see a doctor if you get significant symptomatology but you know at 50 is when it becomes really important to start the screening the really aggressive screening uh regular screening now obviously aogram, a pap smear, whatever your particular risk factors and issues are need to be assessed in terms of getting your screening underway. But gosh, you know, my thing is healthy young adults, the more time they spend away from the medical system, the better.

Okay. Okay. But I'm the one that has like infertility issues too. So that's why I'm going to see doctors for that. What kind of issues? I'm sorry. What do you have? Infertility. Oh, okay.

Well then do that. That needs to be that. Look, there's a, that's a vast area. There's a lot to be done. Keep, keep a positive attitude.

This is my, my recommendation. Acute positive attitude and in success, expect to be treated like an incubator, not like a person. I'm stunned at what they put women through without warning how disruptive it is. And women are so motivated. They're so taken with the desire to complete the process. They just leap into it but just make sure somebody is sympathetic to what you experience that's all you just need support as

you go through it okay yeah and last question is regarding traveling since you've been traveling a lot and that's one of the reasons why i want to where vaccines will help i feel like um i i am polish i was born here but I want to go visit because of COVID I wasn't able to visit like family I haven't been able to visit Valley for a while and like a lot of them are really old and I think some of them did die from covet too but it was they're open like the late 80s 90s age range and they live in small villages out there so I don't want to come over here from California and then possibly you know wreak havoc over there. Is there any concern? I mean, it's not zero concern, right?

Look, the trend line is extremely good right now. The case rate is falling precipitously. So you don't have to worry so much about carting something from here over there, number one. Number two, the travel is more the issue. Are you going to get exposed to somebody during the travel? But again, you can't protect yourself with an N95

mask, not others, yourself. And so it makes perfect sense to me that you'd be testing, wearing a mask carefully. Are you vaccinated? Not yet. I'm looking for a doctor first. And again, you might want to wait for some of these newer vaccines that are coming online. I don't know. That's up to you. But discuss that with your doctor. And yes, if you're going to

do that kind of trial, you want to be back. Well, they won't let you move around without a vaccine. So you kind of have to. You know what I mean? Interesting. Yeah. Okay. So, okay. All right. Sounds good. Good luck. Thank you so much. Bye. Uh, again, some more calls here. Uh, okay. Josh, give you a chance here. Josh, what's up? Yes, sir. Not much. Um, I wanted to talk about Heather McDonald. Um, I watched the YouTube video and what struck me was what was going through her mind. Nothing. She had no blood. She had no blood pressure for a second and collapsed. She had zero blood pressure.

That's why she collapsed with such force. force and a young healthy adult sudden loss of blood pressure has a diagnosis attached to it that does not happen just oh well now you can whether it's pot syndrome from the vaccine or the covid or whether it's a cardiac arrhythmia or whether it's a vascular event it has a cause and unfortunately they were not coming up with any specific diagnosis yet. She wasn't really worked up for all that stuff, and she's not really interested in it. But it really brings up the point about COVID that autonomic instability, sudden significant elevations in blood pressure and drops in blood pressure are not uncommon. And if you feel, if you've had COVID or if you've already been vaccinated, you feel lightheaded, you feel weird, sit down, lie down,

stay well hydrated. Do not go on long drives. This is a serious, serious medical problem. And can, as you see, lead to these falls. People that have just swooned or are fainting, whatever, they fall forward and they put their hands in front of their face and they remember falling down. Heather, and presumably Saget as well, collapsed backwards with sufficient force to fracture the skull. Both of them. that is a medical problem period that's how that happens and so you know it needs more it needs a an explanation and so

there you go that was the scariest part for me i'm not talking about seeing how hard she fell oh no because it reminded me of whenever i slipped and fell after that surgery a year or two ago. Do you remember? Yes. It was after my second surgery, and I was out of the hospital fine, and then I had gotten up in the middle of the night and went to the bathroom. And somehow in that space of time, I fell. I think I dropped my phone in the dark, tried to find it, and then I fell and slipped over. And my wife basically found me at 4 a.m. And I thought I had gone blind.

Like I couldn't see anything. It was blacked out. And I thought I had been out gone for like 10 minutes until the nurse explained, no, you people don't pass out for 10 minutes like that. It was basically like a minute or two. No, no. It was, it was, it was way scarier than the surgery. And so, and so let me ask, it's actually a very important question. What had you finished urinating or started urinating when you passed out?

It was after. It was immediately after. Yeah. Because I was leaving the bathroom. That has a name. That is called post-micturation syncope. And it's a common cause of syncope. And having had surgery, being on meds, all that stuff added to it.

Liquid diet. Yeah. All that. There's something that happens after urinating that your pressure will drop. That happens to some people. Again, if you looked up post-micturation syncope, you will find it in Google. I remember that was the first question Susan asked me. It was whenever we told her. Did you just finish peeing? That's what Drew wants to know. Because she knew right away what it was. Yeah.

Well, that's. Yeah. No, I didn't. I didn't think of that. That was my thing. Yeah. And then you add in the meds and everything else that drive the pressure down further. Yeah.

And the weakness and stuff. That was scary. Again, it's the passing out, then falling down, unconscious, then fall. That's a very different thing than fall, then unconscious. Is that heart-related or is it just blood pressure? It's sort of like the Pott syndrome I was talking about. Dr. Drew? Hold on a second.

Some people, after they urinate, they'll notice a little tingling on their spine. Is that ever you, Caleb? Is that ever you notice anything like that? No, I didn't see. I didn't even notice any of it. No, no i don't mean at that time i mean generally in your life do you get any kind of no you know shivering or anything like that no yeah so people get that and that is that is their autonomic nervous system reacting to the post-micturation josh you had something there yeah um i'm not i don't want to talk about Bob Saget

in this. I just want to separate Heather McDonald's and what I saw. And what it looked like to me was before she passed out, before she lost consciousness, before she fainted, she was telling a joke about Jesus. and she was saying something about how much she thought in the joke. Yeah, that's a joke she opens every night with. That's her joke. Right. So, my point is this. She was saying how much Jesus loved her in the joke. And from my point of view, just seeing a little bit that I saw, I would think that that's more a spiritual experience that led to the fainting. Zero probability. Zero probability. And a dangerous, dangerous thing to speculate about. If you're not a medical person and you see somebody unconscious and you begin to

come up with theoretical frames for diagnosing a condition, that's dangerous. I think Jesus kept her alive, though. Maybe so. She was lucky. Maybe so. She did that joke every night. Maybe it works. She discussed it now every day or throughout the day talking about what happened. And no, there is that is.

Well, she she fainted at the right time. She was in front of an audience so that they were able to save her. Yeah. I mean, fortunately, I mean, it could have gone bad. But if somebody had said, oh, my God, you were struck by the spirit, how lucky you are, as opposed to took her to the hospital. And she and she was taken right to the intensive care unit. There is no spiritual awakening that ends you in the ICU. So no,

but I mean, come on. I, I think that, I think that her spirituality is, is a good thing. I'm not saying it's a good thing or a bad thing. I'm saying she had a medical problem. She was making a joke about it.

So I don't know. I guess Jesus loves comedians too. Yeah. Osman. Hi, Dr. Drew. So it's kind of a three-part thing. It has to do with Crohn's and weight loss. Back in 2019, I decided to drop weight.

I was at 290 and I ended up dropping a lot of weight in only four months by doing keto and very badly only eating around a thousand or so calories. And by doing that, I think I may have kickstarted my system because my mom has Crohn's. And ever since that, I cannot eat vegetables. Every time I eat vegetables afterwards, I have very bad acidic diarrhea, and it feels like I have cramps. Okay. And the entire time, it's just squeezing. It's painful.

And I get that in bursts, and it's usually every 20 minutes to a half hour for an entire day. If I eat more than, let's say, like a cup half of vegetables, I get that for the entire day if i eat more than let's say like a cup half of like vegetables i get that for the entire day and it's horrible and that has kind of scared me from trying to lose weight because i've since then gained it all back like people usually do when you do it unhealthily yeah yeah um i have gained pretty much all that back and more. And now I try to eat healthy with eating, start to eat clean with vegetables. And it does that again, no matter how much I try to do,

substitute with a little bit more of like greens. How is your Crohn's being treated? It is not. That's the bad thing. I've been jumping around from job to job and I just now got insurance. So I'm going to start going to the doctor do some blood blood screening and have them check it out to see what's going on how was it diagnosed it wasn't i'm just worried that i may have it and

i may have kick-started it by doing that i don't know that i have it i just know my mom was diagnosed with it do you have any blood in the stool um No, it is just very, it's very acidic, very liquidy. Do you have pain? Yes, very bad pain. It's pain around the actual butthole and then cramps the entire time. Like my insides are basically squeezing and contracting while I'm trying to pass the stool. That's the diarrhea. Caleb,

how old are you? How old are you? I'm 23. I'm 23. This happened back when I was 21. Yeah, that's around whenever I was first, my Crohn's was first diagnosed is around whenever I believe I was 21 and I thought that I had gotten food

poisoning and so I just just I went into the doctor and I actually turned out to be my first big Crohn's flare uh I don't know if this is the best medical advice but what I've actually had to do is I literally have not eaten any fruits or any vegetables in about 10 years I just I mean no raw fruits or vegetables at all I have to get my all of my raw fruits and vegetables other ways yeah they are yeah they are hard for us to digest people don't appreciate how how difficult roughage can be and if your bowels are inflamed from crones or other bowel diseases it it can trigger things i i you know they're it seems like you should be working with a diitian, right?

And that's the other thing is with losing weight, that's the biggest thing is trying to find a diet that I can actually do that doesn't kind of give me pal fatigue because it's just constant meats and I can't eat vegetables. And so it's trying to like find something that I can actually work around. And plus I do have a really bad habit of, um, like a lot of my friends, when they get anxious, they don't eat. I'm the complete opposite. I'll pretty much eat my feelings away.

So I need to work with that too. Um, I can eat tuna. I've never tried Sam. Uh, cod is, I don't like cod and then other processed fish. Salmon is,

try salmon. I, I, I've been other processed fish. Salmon is... Try salmon. I've been told salmon is amazing. But most importantly, you need to get to a gastroenterologist. You need to get fully diagnosed. You don't want to end up in the hospital like I did. No. You want to get on top of it. And there's a lot of good treatments for Crohn's right now.

And you can maybe get under control and liberalize your diet. And then the gastroenterologist will know a good dietician. You just got to do this. Who wants to hassle with this? Nobody. You got to do it. It's really important. And I want you to think positively.

I mean, these things, you're looking at your lucky time when people, inflammatory bowel disease are highly manageable. And when you have these resources available, such as great dietitians, registered dietitians are so great, understand the complexities of what you're dealing with. And I would just take full advantage of what's available out there. The first medication that they tried on me, it actually worked for 10 years where I didn't, I was completely at no issues at all for a full 10 years. And that was whenever I had to get surgeries was after that medication, I kind of built up, I don't know, like antibodies or whatever happened with it where I had to switch over to something else. And then I just kind of let it go for too long. So don't let this go too long, sir. You got to go get this looked at. Yeah. Yeah. Don't you can get abscess. The sooner you get it, the lower chance you have of having to get a surgery. And I lived, you know, I'd practice on days when the Crohn's patients used to have to take steroids.

And even then they would get fistulas up all over the place. It just was terrible, terrible, terrible sometimes. And yeah, you want to definitely get proper counseling. The registered dietitian will determine whether you need just the supportive counseling of a dietitian or actually need to see a therapist to help with some of that binge eating and that sort of thing. Ryan, go ahead here. Hey, Dr. Kutcher. Hi, Ryan. So I was just curious, uh, I had a antibody, uh, COVID antibody blood test taken and, uh, it showed like the only values it shows is like, if you were negative and it was like

0.08, uh, and that's obviously your negative. Um, what's like a, I guess not like a good number, but just like a higher number of like antibodies. That's cause I was just trying to like weigh my pros and cons like uh risk reward for like getting the booster because i have uh both my moderna shots and i haven't got my booster yet yeah and my my uh antibodies are actually pretty good still um so that's kind of why i was just kind of like weighing like pros and cons but i'm not sure the tests that are commercially available are not good ways of assessing your immunity they're just not okay uh and we got to remember that you know 60 or so wane over six to ten months so the probability is you could be benefited um for sure uh but you know there's

there's a thing i used to represent and i'm still following myself for myself called an editech score i know they just applied for an emergency use authorization to really start to standardize how to really create some sort of documentation of immunity. Are you immune? Are you not? And the tests that are commercially available are just, have you been vaccinated? Have you been exposed? Yes or no? That's about all you answer with those.

And then as far as like being exposed um so my wife had covid uh and i got my antibodies done prior to her having covid and she's like good now everything's good i didn't catch covid uh do you think my antibodies would be higher just from being uh like close contact with her or would i have to actually get the virus there there is such a thing as people having exposure and generating an immune response it's not as not as robust as if you actually got an infection but there is there is such a thing there is such a thing do you have a doctor you can talk to about all this stuff uh yeah yeah make the decision together with somebody i you're you're how old yeah uh 30 and

i am overweight so that's why i was kind of like trying to balance pros and cons. Like I said, I'm overweight at 30 years old. How did you do with the Moderna vaccines? First vaccine, I didn't feel anything, just sore arms. Second vaccine, I did get a fever for about a day, like a pretty aggressive fever. But then those were like my only symptoms. Yeah, these are, I mean, it's reasonable to think this all through carefully and not just jump right into it at your age.

Um, but I think I, I, if I were you, I would probably do it. That's me. I'm not saying as a physician, I'm recommending you do it. I'm saying, nah, if I were you, I'd probably do it. I'm wanting to move about. I have, you know, weight issues that could put me at real risk. I, you know, I might, I might probably do it. All right, weight issues that could put me at real risk. I'd probably do it.

All right, my friend. Thanks for the call. Cool. Thank you. Yeah, thank you. Appreciate you guys coming in today. Thank you, Dr. Art Kaplan, for spending time with us, although we didn't have as long as we would like. We at least got some exposure to him. I'm seeing you guys on Restream here.

I'm not quite sure. As always, I see sort of random sort of negativity. I'm not quite sure what to make of it because I'm not following the stream in real time, so I don't see where it all started. Let's see. I'm going to go open up my mermaid dress from Chris. Here. Why can't I get drunk while I'm taking injectable sublocate? If you're doing all that, if you're using

other substances and alcohol, you're missing the point. And really, you ought to be really thinking about something more comprehensive in your care. You're going to go try the mermaid dress? Very good. Excellent. I'll take a picture for you, Chris. And we'll be back again. I'm going to have my colonoscopy

tomorrow. Hopefully that will go on eventfully. And eat Chinese food while you drink liquids. Tonight. Congratulations. It's downstairs. Bethany Shondark back on Tuesday. Chad goes deep on Wednesday. And we've got a lot of other interesting people set up.

So that will be on Tuesday. Thank you, Caleb, for setting us up. Thank you, Michelle, for booking everything. And Susan, thank you. Thank me for what? Whatever you have to put up with tomorrow with my colonoscopy. I know you like taking care of sick people as your favorite thing. No, it's fine. It's going to drive you there.

And we will see you all on Tuesday. Ask Dr. Drew is produced by Caleb Nation and Susan Pinsky. As a reminder, the discussions here are not a substitute for medical care, diagnosis, or treatment. This show is intended for educational and informational purposes only. I am a licensed physician, but I am not a replacement for your personal doctor, and I am not practicing medicine here. Always remember that our understanding of medicine and science is constantly evolving. Though my opinion is based on the information that is available to me today, some of the contents of this show could be outdated in the future. Be sure to check with trusted resources in case any of the information has been updated since this was published. If you

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