Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Can You Lick the Capsaicin Patch?

Episode Date: March 19, 2024

Dr. Sydnee and Justin are welcoming in the spring and allergy season with listeners' strangest medical questions! Why do some people get goosebumps when they do alcohol shots? Does baking soda work for bug bites? Do people with facial hair get more sick? And for real, how long can you REALLY actually look at an eclipse before it's unsafe? Music: "Medicines" by The Taxpayers https://taxpayers.bandcamp.com/ MaxFunDrive ends on March 29, 2024! Support our show now by becoming a member at maximumfun.org/join.

Sawbones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. Alright, this one is about some books. One, two, one, two, three, four.

Two, three, we came across a farm. We came across a farm. We came across a farm. We came across a farm. We came across a farm. We came across a farm. We came across a farm. We came across a farm.

We came across a farm. We came across a farm. We came across a farm. We came across a farm. We came across a farm. We came across a farm. We came across a farm. We came across a farm.

We came across a farm. We came across a farm. We came across a farm. We came across a farm. We came across a farm. We came across a farm. We came across a farm. Hello everybody and welcome to Sawbones, a marital tour of misguided medicine. for the mouth. Oh, he's been sleeping. Hello everybody, and welcome to Sawbones, a marital tour of misguided medicine. I'm your co-host Justin McElroy. And I'm Sydney McElroy. And what a thrill it is to be with you

on this most special day, because this week on Sawbones, we are kicking off the Max Fun Drive, our annual time that we come to you and say, hey, if you like this show, it would really be a big help to us if you'd help us make it. That's right, we're bringing you on as a co-producer.

Basically. Yeah, basically. In a sense, right? Is that something we offer? Do we offer a co-producer credit? No, not at these donation levels. Maybe there's some sort of upper tier I don't know about. I'd be willing to negotiate that.

Here's the deal, here's the short version, and here's what we're asking. If you will go right now to MaximumFun.org forward slash join, you can pledge five bucks a month, 10 bucks a month, whatever feels comfortable to you and feels fair, I think for the shows that you like, then you're gonna pledge that, and you are going to make that donation monthly,

and by doing that, you're gonna get some fantastic gifts. Like, for example, if you pledge five bucks a month, you're gonna get over 600 hours of bonus content. That's from all the shows. That's from all the shows. Not just our show. That's great. But you get all the shows. What'd you all the shows. Not just our show. That's great, but you get all the shows. What'd you do for the bonus episode this year, Sid?

We took medical questions from children who either listened to our show or the children of listeners to our show. And our daughter Charlie read them, and I attempted to answer them, although I'll be honest, Charlie did most of the answering. Wow.

So you can have that, and I mean, over at least 10 other bonus episodes of Sawbones are waiting for you there. At 10 bucks a month, you get all that stuff plus a Sawbones pen, a Sawbones enamel pen. Or any pen you like. Any pen you like, but you're listening to us, let's hope you choose Sawbones, but regardless,

doesn't matter to me. Just go to MaximumFun.org forward slash join right now. Maybe you're listening to us, let's hope you choose Sawbones, but regardless, it doesn't matter to me. Just go to MaximumFun.org forward slash join right now. It won't surprise you to hear that this is a has been tough on the advertising market lately. All shows I think are suffering. You've probably noticed some gaps in Sawbones advertising and that is why this is so important. So please, we need your support.

And if you can just do it right now and don't wait because it's a lot less scary for us, just as a personal aside, go to maximumfund.org Or if you're like me, you'll forget. Go to maximumfund.org forward slash join. So we'll come back to that in a moment, but right now, Sydney, what are we doing this week? I'm so excited.

It's one of my favorite kinds of episodes. Well, I think our listeners like these episodes too. We're doing some of your weird medical questions and we get so many that I think people must enjoy this. And I mean, we get emails that say, so like, yeah, this is a fun one. It's a fun one to do. It's light.

Sometimes we do some heavy stuff on here. This is, I think it's all, yeah, I'm pretty sure. I'm going through the questions in my head. They're light. And I always appreciate when you send us these listeners. We get them all the time, so don't feel like you have to wait. We used to, I used to ask,

hey, we're gonna do one of these questions, or one of these episodes on questions, please send them. Now people just send them and it's great, because then I can just like search my email. So always use the subject weird these questions, or one of these episodes on questions, please send them. Now people just send them and it's great because then I can just like search my email. So always use the subject weird medical questions because that is what I search. That's what she searches. In my email.

So if it's got that in the subject. But we got them. You can read them Justin and I will attempt to answer them. All right, here we go Sid. As always, this isn't advice. I'm just helping contribute to general knowledge about medicine. Right, none of it's specifically directed.

No, if you need healthcare, please go seek a healthcare professional of your very own, not a podcaster. Why do I get goosebumps sometimes when I shoot liquor? Thank you, Ace. Okay, so I thought this was interesting. Have you ever, when you've taken a shot of liquor, have you ever gotten goosebumps?

No, no. I'm not like a tough, I'm not saying like, I have many other reactions, that's just not one of them. No, yeah, I'm not saying I'm tough either, but this specific reaction I haven't gotten. Now, I am familiar with goosebumps as a possible- Series of classic children's- Children's horror film, horror books classic children's horror films.

Horror books, children's horror books, is that? Thrill books, scary books? Thrill books, you said, sorry, stop the show. You said thrill books? Yes, honey, that is, can I be honest? It's a better name for the kids' horror genre because it's not really horror. It is supposed to be a little bit.

Yeah, well horror is intense. You know what, it's what they used to call like, tales to amaze, you know, back in like the pulp days. Okay, anyway, pulp thrill novel. Okay, goosebumps are a common symptom while someone is maybe going through a withdrawal process. Oh, okay. Yes, so from alcohol or other substances,

sometimes we will see goosebumps as part of that. Now this is not me accusing you, don't worry, I'm not saying that you are doing that. So I looked this up and this is a common thing, or at least common enough that other people are asking about it on the internet, so you're not alone. There are other people who experience this. I also found something called the shot shiver

that you have after you do a shot you get a shiver Shot shiver so some of the theories because I was trying to figure out since this isn't something I didn't find a lot of medical literature about it. It was more on Like drinking websites. Why does this happen? Well, we know that alcohol causes your blood vessels to dilate which changes the temperature in your skin It's why sometimes when you're drinking you feel warm, but you're actually losing heat. So drinking outside when it's cold can be dangerous because if you drink enough, your judgment's impaired, you will feel warm, but actually you're becoming colder.

You're becoming hypothermic. That's why that happens. So maybe these changes in temperature can lead to, well, one, the shot shiver that people experience, this sudden shiver right after you take a shot. Goosebumps are interesting though. So they could be related to this change in temperature. I think that would be my best guess as to why that might happen.

But I was looking into like, why do we get goosebumps? I thought this was an interesting sidebar. I thought it was to retain heat, like it's your skin constricting to keep the heat inside your body. It's making the hair follicle, a little muscle at the base of your hair follicle stand up straight.

So your hairs are standing up straight. Is it? But if you don't have a hair there, it just looks like a bump, right? So my guess would be, okay, let me try again. Okay, my best guess would be a vestigial response to like a fight or flight mechanism where we would have the hair, when we are hairier

and had a lot more body hair, if all those stood up, we would be much more aware of subtle changes in the environment. Well, it's more just to keep you warm, but yes, it is, because other mammals experience this. Other creatures with hair do this in response to cold temperatures. And it makes you warmer. But here's what I'm saying. Imagine this.

This has to do with, which, okay, now you will say... I'm saying, evolutionarily, if I get scared, because I think there's a predator, all my hair is standing on end, I'm much more aware of changes in air pressure and wind and people moving around, sound. I'm just like a bunch of little antics. Remember, I'm so hairy.

I'm like Cro-Magnite at this point, right? I'm saying that all your hair is sticking out like that makes you, is like heightening your senses. This is what I'm saying. I don't is sticking out like that makes you, is like, heightening your senses. This is what I'm saying. I don't know that that necessarily holds up. It is something that, in theory, should make you warmer, but we don't have enough hair anymore, humans, to make us warmer from goosebumps. Yes.

Typically. I mean, not to cause an appreciable change. It does, though, in other animals, make them warmer. So, there's that. It is the make them warmer. So there's that. It is the sympathetic nervous system. So that's your fight or flight nervous system. So there's some connection there. Okay, that's fair. But I will say they did some studies in rats

and they found that it also sends signals to stimulate the hair follicles to grow. So isn't that interesting that goosebumps, even if we don't have enough hair necessarily for it to warm us, it's trying to make you grow more hair in the future to warm you more. Next time. Next time.

Next time you better be ready. Anyway, that would be my best guess based on the physiology of it, but I couldn't find a definitive answer for why someone might get goosebumps and respond to ethanol. However, you're not alone. My parents are really into alternative medicine and so recommend me a lot of random cure-alls

for any little problem I have. One of these, I think, includes spreading baking soda mixed with water on a bug bite to stop the itch. I looked it up and found it's actually a pretty common home remedy for bug bites, but not found any hard science or explanation behind it. Hasn't worked for me, but if so many people swear by it, I'd like to know what it exactly is about baking soda

supposed to relieve itchiness. So basically, how does baking soda supposedly take away the itch of bug bites? That's from Micah. Okay, this was interesting to me, because I've also heard this. I have seen this done. I have heard this recommended by my colleagues.

I have never personally recommended it, but. But should you have? Well, so I started looking into it, and you are right in that this is not just advice like old wives tales folk advice or something like that. If you look at major medical websites, they will recommend this. Like from esteemed medical institutions If you look at major medical websites, they will recommend this.

From esteemed medical institutions that publish this sort of information online, from government medical organizations, there are a lot of doctors out there, healthcare professionals recommending baking soda for bug bites. So what's the evidence? Okay, so I started, where are the studies, right? So I'm digging, where are the studies? I'm not finding the studies. I cannot find a place where this is absolutely

evidence-based that we are recommending this. What I did find is one study that looked at baking soda paste applied to psoriasis to see if it helped with psoriasis, and it did not. It was a small study, it was focused on psoriasis to see if it helped with psoriasis. And it did not. It was a small study. It was focused on psoriasis only, so not bug bites or eczema or any of the other many causes or many things that I saw baking soda recommended for.

But it didn't work for psoriasis. And I did find several dermatologists urging people not to use baking soda because it is alkaline and it can actually dry the skin and cause more itchiness and more dryness long term. So it can actually cause more irritation in the long run. I did find a number of places where anecdotally it does relieve the itching sensation.

So I think if we did a study looking subjectively at the like itch relief after baking soda. I do think it would come back that most people experience some relief of itchiness. But is it actually doing something to fix the situation in the long run? I do not believe it is. The theory as to why might it like relieve the itchiness

in the short term? Placebuffet. No, it has some anti-inflammatory effects and it has some antimicrobial effects. And the placebo effect. Placebo effect. No, it has some anti-inflammatory effects and it has some anti-microbial effects. And the placebo effect. Maybe. Maybe. Maybe. Maybe. I don't mean that in a derogatory way.

I mean, if it's a lot of times with the- If you're turning it into a paste. Yeah, if you're turning, I mean like a lot of times with these like passed out alternative treatments, home remedies and stuff like that, I think that there's, part of it is like, this is what was done for me when I was younger. This is what works for me now.

Ooh, is it the touch? Is it the therapeutic touch? Could be. Think about it, you're a kid who gets a bug bite. Your parent, your guardian takes you inside, worries over your bug bite, makes a little paste of baking soda, lovingly applies it to your arm,

kisses you on the forehead, tells you you're gonna feel better, it's gonna be okay. Maybe it's everything around the baking soda, lovingly applies it to your arm, kisses you on the forehead, tells you you're gonna feel better, it's gonna be okay. Maybe it's everything around the baking soda. It could be. Either way, I do think it probably subjectively, and if you're using it one time, I don't know that anyone would say that is harmful,

but in the long run, constant application of baking soda to your skin is not a great idea. And it was wild, because you're right, every major medical website I found recommended it. So, fascinating. Okay, I am a receptionist at a doctor's office, and one of the treatments we offer is Quitenza. Is that right?

From what I understand, it's just capsaicin on a patch. So my question is, what would happen if you licked it? Pfft. Ah! I love people. I've been wondering this for weeks, but I think if I asked the doctor I work for, he would think I was insane. Love this show, by the way. I listened to it on my lunch break. Okay. I love this question. I love when, I mean, I have looked at medications and things like this and had similar thoughts.

So I love this. First of all, capsaicin patches. These are just capsaicin patches. It is 8% capsaicin in a topical on a patch as opposed to putting it in a cream. You rub on you, they just put it in a patch. There are other medications we've done that with, which is a cool way to, I think, administer a medication. And then you just absorb it through your skin. Capsaicin has been found to be helpful for pain, specifically nerve pain, what we call neuropathic pain.

We have some evidence that it can help alleviate that burning, numbness, pins and needles, tingling, however you want to describe that specific kind of pain. It is the capsaicin that is in chili peppers. So if you've eaten something spicy, the spicy, that's the capsaicin. But how many, how spicy is that's the capsaicin. But how many, how spicy is it?

Or how many Scoville units are we talking? You know what? I actually tried to look up how many Scoville units would. Really? Yes, I can't give you that answer. My understanding is that the Scoville unit system is fairly threadbare in terms of the way it ranks things, but I don't know, maybe Man Vs. Food

or wherever I picked that up from wasn't on the money. I don't know. I'm not sure, see, I don't know that that's an episode of ours, but it'd be interesting. So the way that capsaicin works, in case you're interested, we're not entirely sure. We know that it causes the depletion of something called substance P, which is involved in the pain response.

And so we think that by making that go away faster and there be less of it, that's how that's part of how it causes pain relief. But that's not totally all that's happening. So I know this is really interesting. Yes, if you licked it, you'd have a response to it like you would eating something spicy. It would be similar to that. I don't know, because I don't know how many scoville units, I don't know how to tell you like, comparatively.

It's also weird, because it wouldn't be like a, like even the spiciest stuff, it's paired with like flavor. Capsaicin, I wouldn't think has a flavor no but you're still gonna react to it. I think what you'd experience is just like a stinging or a pain right I don't think it would taste like peppery or it would not taste like you would think a hot spicy pepper would probably just be exactly discomfort exactly yeah I assume because I, it's made to be absorbed. So you would absorb it and you would have a reaction to it

like it was a spicy thing. It would not taste spicy, like you said. I know like this is a real danger though, because I have, there's a patch that has lidocaine on it. Same idea, you can put it on an area of skin and numb that area. It's used a lot for things like chronic back pain and stuff like that I have applied one of those patches to a patient before and in didn't wear gloves while doing so and numbed the tips of

My fingers accidentally so that is that is a real Danger in doing that I would never recommend licking these just don't do it It would be similar though. You know, it's funny Just don't do it. It would be similar though. You know, it's funny. You say you wouldn't taste it. Let us know. Don't do it.

But if... Well, I don't know how concentrated it can make you sick. If you have a ton of capsaicin, it can make you feel sick, right? So don't make yourself sick. It would be similar when I had COVID and I lost my sense of taste. Right. Do you remember the girls thought that was really funny? And so they were giving me things to drink and I couldn't tell what they were.

Yeah. And then they put mouthwash. We should worry about our kids. In my soda, and they were like, do you taste that? And I couldn't taste anything, but my throat burned because I drank mouthwash. Oh, God. Yes.

I mean, just a sip. Like, I didn't drink a whole bottle, but like, anyway. And then we educated our children that you can't, please don't do that to mommy ever again. I recently had my Nexplanon birth control implant replaced. My previous one had been placed towards the tricep as my last doctor said the location was safer and less likely to travel to the heart.

However, when getting it replaced, my new doctor said it was in the wrong location and placed the new implant pretty high up on my bicep. Is there any data showing that one location is safer than the other? Also, how would the implant even travel to the heart in either location? Thank you, Sydney, different Sydney.

Different Sydney, so Sydney to Sydney. First of all, do you know how it would travel? Because they have traveled. They found one in a pulmonary thing. Yeah, yeah, yeah. It would just squinch through. Just squinch through? Just squinch through.

Just kind of squinch between the muscle layers and then just squinch through. You got a whole circulatory system running all through your body. I know, just the odds of that seemed wild to me. I didn't know how small they were. Are they really small? It gets into your vascular system, gets into a vein.

Is it that small? They're fairly small. I mean, veins are also, like some of them are large enough. Yeah, they're certainly large enough for this to get into. I think if I should- Some veins and arteries are larger. Capillaries are teeny tiny.

I think if I should, okay, sorry. I was thinking, sorry, ignore me. Ignore me. Okay. I was thinking about an IUD in my head is what I was imagining, and that going through a vein would be unlikely, yes? They're still fairly small,

but yeah, the way they're shaped, I think that would be. We're talking about something that gradually dispenses medicine into your system. Exactly, and it's like a little thin tube thing. I mean, it's not a tube, but like it's a thin cylindrical rod type thing. Do you know what I'm saying? And so it's not like an IUD has that Y shape. This does not. It's just one straight line.

They do completely different things. No, they both do the same thing. They prevent, well, they are intended to prevent pregnancy. Mechanisms are completely different. Well, they secrete, most IUDs also secrete progesterone. There are copper ones that don't, but they're similar. The point of all this is that they're very small. They're very similar, yes, they're very small. They're very small, these are small,

and the way they get other places is they get into your vascular system, so they get into a vein and go somewhere else. They're not supposed to do that, but it has happened. Not a ton of cases, I mean I found like eight in do that, but it has happened, not a ton of cases. I mean, I found like eight in the literature. So like, and there's a lot of these. I think the odds were, I mean, it was like one in a million. I mean, it was incredibly rare that this happens,

but it was happening frequently enough that they evaluated the placement from when they originally came out with it and got approval in the, this was in the US, the UK and the EU. So there's multiple places where they had approved this in one location, they looked at these cases and thought, you know, if we move it slightly so that it's kind of

over your tricep, so it's in a slightly different place on your arm, there's fewer, there's no like neurovascular bundles there, there's not a lot of veins there. And so it's less likely to get into the vascular system in this location. And that is why they did indeed move placement. So if you've had one for a while and you've had it replaced at some point,

you may have noticed that, that they took it out and popped it back in somewhere else. And that is because this area should be safer to prevent that very rare, but still big deal complication. So they have moved the location. Will it be better? We think so. I think with some of these things, time and people doing it is how we know. But this should hopefully prevent that very rare complication.

All right. Good to know. Hey folks, I wanted to remind you to head on over to maximumfund.org forward slash join right now So you can help us to continue to make this show. That's that's the model that we run on here. Um, like I said Advertising dollars have been a lot harder to come by and we are relying on your support now more than ever Um, if you are able to give 20 a month if you can pledge that, you're going to get these gifts. You can either get the bucket hat, it's a Max Fund bucket hat, it's adorable,

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Okay. I have a mustache and a beard. When I blow my nose, obviously there's some mucus that gets caught in there. Are people with facial hair more prone to getting sick? It seems like that would be the case. I thought this would be especially relevant for you, Justin. Yes, it's gross and awful.

And it's the worst part about having a beard. You know, the food getting in there is rough, but sometimes that could be nice. Have something in the flavor saver. That's good stuff. Is this scary? The snot is repellent. What?

Yeah, is this scary that I'm about to answer this question? Are you worried about what the answer might be? I this scary that I'm about to answer this question? Are you worried about what the answer might be? I mean, I hope it's, at this point, getting sick when you have two kids is like, it's like a sweet blessing. It's a sweet treat where you get to just lay down. Maybe for you.

Yeah, well, you should let yourself be sick. You never let yourself be sick. We were discussing this earlier today, because Sydney has been insisting that she does not have a cold. It's allergies. And I realized, you don't go into being a doctor because you love sick people.

Sydney hates sick people. And that's why she wants to get rid of them by curing them. That is her whole thing. You don't get into the biz because you love sick people. It's because you like healthy people and you wanna make more of them. It's not that.

See, you make me sound terrible. It's not that. It's that I don't like being sick. I very much dislike being sick. And what is wrong with being sick? And I think that there's nothing, I don't, this is me personally. I'm allowed to feel the way I feel.

Yes, you absolutely are. And I am someone who likes to be able to go at full speed at all times and do 10 things at once. And it makes me happy and staves off depression. I love a little break. When I have to slow down, it's really hard for me psychologically. And so I, for people who seek me out

and want my assistance in getting healthy, I wanna help them. That's it, that's it. I just figured it out, it's because your job is important. Cause we were allowing you to do it. That is the thing, that's it feels bad. I wanna improve people's quality of life. That is my goal. Whatever that looks like for them,

I want to help them get there. I know, see that. Because that matters. That's all it is. I'm just teasing you. You make me sound biased against sickness. I'm not. I mean, aren't you?

Well, I just want people to feel well and be happy. That's it. So no, Sid, I'm not, I am not worried. Your mustache and beard, as far, I could not find any evidence that they put you at higher risk for upper respiratory infections or other illnesses. My gut says that our hands and stuff are up there so much, like in this area, right?

It's just not going to be that much of an additional cross-contamination. There was a study a few years back, I think it was like 2019, where they measured the number of bacterial cultures. Like they swabbed beards and they swabbed dog's fur and compared them. For science. For science, and beards were dirtier. Than dog fur. Than dog fur. Yeah, we're always dirtier.

This was all a big deal. And then a lot of people pointed out like, did you just swab some chins though, just some beardless chins and compare that too? Cause our skin's really germy, we're germy. We're probably just as germy whether we have beards and mustaches or not. We're just germy. I did not find any evidence that people with a beard or a mustache

are more likely to get a cold than someone without one. So I would not worry about it. And in that study, I think comparing people with beards to dogs fur, I think that's a little... I don't know. It feels kind of like, let's get a headline on on it feels like somebody was mad at somebody who had a beard Yeah, and I did a study it but that was what it would take We'd have to we'd have to actually compare the rates of upper respiratory infections and people with and without facial hair

I was on a work trip and I got a head cold with some very plugged up sinuses I got some intense ear pain when flying home and ended up with an ear infection requiring antibiotics. Is this normal? I figured the pressure change was the cause the pressure change was the cause of the ear pain Okay That's that is a common problem for people who do if you have some sort of sinus infection Sinus condition and then you go up in the air and you go up in an airplane The some ear pain is the pressure differential across your eardrum changes is that does happen. That's real.

It typically doesn't lead to an infection. That's all I wanted to address with this is that yes, you're right. It was the pressure that caused the pain. The pressure is not going to lead to an ear infection. Sometimes if you've got a sinus condition and it goes on long enough, you can have pain in your ear and your sinuses to your middle ear, it's not that far away, you can end up with a bacterial infection.

A lot of these things are viral and will go away on their own, but if they persist long enough, we do think they're bacterial and treat with antibiotics. But the pressure will not cause an infection. Okay, got it. Let's see here. Here is another question.

Hello, Sydney. Years ago, my coworker told me a story I still wonder about to this day. They said that one time while taking medicine, a pill got stuck in their throat. They told me it was stuck there for so long, I wanna say days, but perhaps I'm remembering it correctly, that they had to have surgery to remove it.

Maybe this is a silly question, but is that even possible? Aren't pills designed to dissolve? Thank you so much for making such a wonderful show all these years. Do you know why a pill might not necessarily dissolve in your esophagus, but does in your stomach? Because of acid. I felt like this was a good time to reminisce about the gut hole bromance.

Oh, yes. We have a different, and the gut hole bromance was an episode of our show that if you haven't listened to, is about a guy with a chronic gastric fistula. He had a hole in his tummy and a doctor scientist did experiments on it and wrote a book about human digestion. There it is. There it is. It's a great story. But anyway, it is a different chemical environment in your stomach and small intestine

that allows us to dissolve and absorb that does not necessarily exist in your esophagus. So yes, I'm sure over time the pill would slowly wear down. It's from erosion. Yes, from erosion, but complete dissolution may not happen. And we do sometimes have to go in and get things out. Now, stuff generally doesn't get stuck in a, like, typical, healthy functioning esophagus.

You wouldn't expect that. So that usually leads us to investigate the esophagus to see, are there problems? Is it too, is there like a stricture? Is it too tight? Are there little webs or rings that are causing things to get stuck? Is there a problem with the way that it squeezes stuff down? Is there like a stricture? Is it too tight? Are there little webs or rings that are causing things to get stuck? Is there a problem with the way that it squeezes stuff down? Is there an issue? Not to say that there necessarily was in this case, but we usually would want to dig a little bit and see if there was a reason.

Why did something get stuck in there? Because typically they don't. But it wouldn't necessarily dissolve. And we have had to pull pills and food boluses, we call them. Pleasant. A food bolus out of call them. Pleasant. A food bolus out of esophagus. I have admitted more than one patient for that procedure.

So stuff can get stuck in there and not necessarily dissolve. Yucky. Do anti-nausea bracelets actually work? And if so, how? That's from Dylan. Do you know how an anti-nausea, have you seen an anti-nausea bracelet, Justin? Do you know how they're supposed to work?

Like what is the proposed mechanism of action? I believe if I'm thinking about the right thing, it holds magnets at pulse points. Is that? It's an acupressure. So it's similar to acupuncture where you poke somebody with needles in certain places, only this is pressure.

So you're not actually piercing the skin. Magnets aren't part of it? No, it's acupressure. I mean, some of them might have magnets, but they're based on the principle of acupressure. It may also include a magnet in there. There's a lot of them out there. There's a lot of these that you can buy.

I really went down a rabbit hole with these things because a lot of people were saying they're evidence-based. And I think it's like a lot of things that are, so acupressure, acupuncture, these are very old, come from traditional Chinese medicine. These are extremely old therapeutic techniques used. And so when you have- And there is some evidence, am I remembering correctly?

There are studies on acupuncture. There are studies that support acupuncture, right? Yes, so it is a gray area because there are some studies to suggest these things work, and it's similar with acupressure. They've done studies on these bracelets specifically to look at this point on the wrist that is supposed to relieve nausea when it's pressed.

And they're very, first of all, in a lot of this kind of alternative medicine, the studies are not what we would consider the highest quality. The number is low, they don't always have a control group. Sometimes the investigator or the participants might be biased in a certain way because of how they were selected.

And remember, the main reason for that is that there aren't millions of dollars at stake waiting to be made if this is proved to be, if the efficacy is proved. That's why the research isn't there. Right, so that doesn't mean it does or doesn't work. It just means there's a lot of question mark. There's a lot of unknowability

based on the way you're doing the study. You can't remove coincidence from it very easily. So there were some studies that suggested that it helped specifically with post-c-section nausea for pregnant people who have had a c-section and now are post-delivery for those people specifically. And then there were some studies that said, no, no, no, it wasn't that,

they just didn't puke as much, but they were still nauseous. I didn't find, they've tested it specifically for people on chemotherapy and there was no evidence that it worked for that. How on earth? I haven't found a lot of studies that suggest it helps with motion sickness.

How on earth would you create a control in this study? It would, I mean, a lot of these things, it's really hard because, well, what they do with acupuncture, and I assume they would have to do the same with acupressure, is you put it in a different spot. Because the whole theory is that these places on your body where either you put a needle or you apply pressure

are very specific. And if you're pushing an inch to the left or right, it doesn't work. And so you would do sham acupressure is what they call it, or sham acupuncture. Where yes, they're putting needles in you or pushing on you, but they're in the wrong spots. And that's where things kind of break down sometimes

is that they'll find that people get relief either way. And so then is it really the spots or is it something else that we don't understand? So I could not find high quality evidence that these things work. I found some studies that suggested it's possible. I think that in the realm of alternative therapies, I cannot fathom that putting a bracelet on would harm you.

No. Assuming it's not too tight. Right. I mean, I guess. If as long as you still got blood flow to your hand and you're not paying hundreds of dollars for this, I feel like it would be an okay thing to attempt, but I don't really have a lot of evidence

to think it would help. Okay. Fair enough, Sid. That's fair. Let's see here, here's another question. With the solar eclipse fast approaching in April, we hear the same danger warnings as always. Don't look at it with your naked eye or you'll go blind.

But how long on average does someone have to look at that to happen? Are we talking one second, one minute? Yeah, everybody, let's push the envelope. For now more than ever, I just wanna repeat, nothing we say on this show should be taken as medical advice or opinion. Listen, I'm just gonna tell you,

please don't look directly at the eclipse. Let's just do this one easy. Don't look at the sun. Don't look at the sun. Don't do it, don't do it. Okay, I could not find a case of documented complete vision loss from looking at the sun. There have been more than 100 cases of serious and permanent eye damage from staring too

long at a solar eclipse. So you can damage your eyes. It's not usually, well, the kind of damage that it causes is not complete vision loss. So the idea that you will go blind is not completely accurate. The damage that it causes is more like you lose fine detailed vision, that kind of damage. So you have not completely lost your vision, but it does impact your vision. So please do not stare at the eclipse. The time that it takes, I mean, I would say it is probably longer than one second and less than one minute. So let's just not chance it.

Don't look directly at the eclipse. Don't. We were talking about the eclipse and Cooper started looking at the sun and I explained to Cooper that she should not look at the sun because it will damage her eyes. And then she said, I want to. And then I thought, I remember just how powerless I am

in the world of parenting, because do you know how hard it is to not let a kid look at the sun if they're really, really intent on looking at the sun? You can't watch them all the time. I just looked at her. I just, I wished, I wished on a star, the sun, actually, cause it was out, that she would change her mind. None of it worked.

So, but eventually she lost interest in me. Yeah, I am certain that there isn't a specific number of seconds, I just wouldn't, you don't wanna be the one to do that study on yourself. It's just like there's a specific number of cigarettes that's gonna give you cancer. Don't do any of them. Well, and that varies, and that's a good point too, because a specific number of cigarettes that's gonna give you cancer. Don't do any of them. Well, and that varies, and that's a good point too,

because the specific number of cigarettes that could give you cancer varies from person to person. Right. And so... Maybe you got cool eyes, maybe you have weak eyes. You don't know. Let's not test it. Don't look at the eclipse. Don't look at the eclipse.

Do the thing with the... Don't only do the bucket. Do the thing with the bucket. The bucket of water. Give us special glasses. This is not our kind of science. There are so many, yeah, there are so many of the other kinds of science nerds,

which is not derogatory, because I'm a science nerd, but the other science nerds out there on every social media platform and all over the internet who can tell you the safe way to look at the eclipse. Yeah. How come when I wipe after I poop, it's yellow? Sorry, I should move on to our next question. No, that is our next question. How come when I wipe after I poop, it's yellow? Sorry, I should move on to our next question. No, that is our next question.

How come when I wipe after I poop, it's yellow? Like straight up Daniel, I'm crayon yellow. And that's from, no way in heck I'm putting my name on this. I was part of why I like this question is that that's how you addressed it. So let me tell you this to start with. Generally, poop can come in a lot of different colors and not necessarily be anything to worry about.

But if your poop is persistently yellow or if you are having other symptoms that concern you, please go seek medical attention. Please go talk to a healthcare professional about this because there are things, pancreatic problems, liver problems, digestion issues, that could cause your poop to be persistently yellow. Infections like Giardia, for instance.

And especially if you're having other symptoms like weight loss or abdominal pain or nausea or vomiting or if their stools have changed in caliber in some way. So anyway, my point is, don't just disregard it if your poop has changed color permanently and you don't know why that being said There are things that can make it change color that are totally harmless Things like carrots sweet potatoes and turmeric and I'll turn your poop yellow. All right. And that's okay.

If you're a diet high in fat or gluten can cause your poops to be more yellow. Okay. So there are reasons that your poop can be more yellow and it's totally fine. If you have like a gastroenteritis, like you got the GI bug that's going around, your poop might be yellow during that.

And then it should go back to brown. Your poop should be brown. If they do not return to brown, please go tell your doctor that your poop isn't brown. All right, but don't worry. You're probably fine. I think you're fine. Well, I hope so.

Well, I always wanna give that disclaimer because it can't, it's, man, there's so many things that can happen in the human body. Like you get nosebleeds. Most of the time, I mean, man, there's so many things that can happen in the human body. Like, you get nosebleeds. Most of the time, I mean, I know your nosebleeds I'm not worried about. Sydney's looking at me, by the way. She's raising, I know it's like that.

I'm sorry, I say, I'm talking to you, Justin. Yes. You get nosebleeds. Yes. I know that these are not something to worry about. Yes. But that doesn't mean that every nosebleed ever is not something to worry, but you know what I'm saying?

So I don't wanna just- Yeah, you just want me to keep an underlying, low-level anxiety all the time. Because most of the time it's normal, but there's the one time it's not, and you don't know when it is, and have a good day. Is that what you're saying? What I'm saying is that medicine is an art, not a science.

Yeah, this is, yes, an art, yes. Gothic art. I hear you talk about cold medications not being effective. I swear I trusted Alka-Seltzer Oh, I swear my trusted Alka-Seltzer plus helps me tremendously. Is this in my head? Is it actually harming me? Not necessarily harming you there are a number of Over-the-counter cold medications that contain substances that might not be great, depending on what your personal health history is, right? So like a lot of pharmacies now will have a section for, here are cold medicines that are safe for people

with high blood pressure. And that is because some of the ingredients in over-the-counter cold medications can make your blood pressure go up. And so if you have high blood pressure, that's not a great idea. Similarly, those are usually in the same area for people with diabetes.

So I don't want to say that no over-the-counter cold medicine could ever hurt you because some of those substances can do things that are not great. Most recently, phenylephrine was the cold medicine we called out for not actually doing anything. A lot of studies say that if it's in your cold medicine, it's not really helpful. There are other substances in there that can alleviate some symptoms. A lot of studies say that if it's in your cold medicine, it's not really helpful. There are other substances in there that can alleviate some symptoms. So like if you take a cold medicine

with a bunch of stuff in it and you experience some relief of your symptoms, that's not a placebo effect necessarily. Especially, I think, alka-sulcer plus, I think is one of those like combos where there's like several different active ingredients. Most of them are, and a lot of them have either acetaminophen or ibuprofen in them which are both effective at like relieving pain So if you had sore throat or pressure in your head and sinuses

You probably did notice some relief some of them have dextromethorphan Which also can make you feel kind of loopy and good and dry things up or like a pseudephedrine Which again is gonna open up and dry things up. So like there are ingredients in there that might be making you feel better. Guifinacin sometimes is in there, which can thin out mucus and help you. It is also extremely, I would think, again to bring up the placebo effect

with the bad flavor and the effervescence, it really feels like it's doing something. I have never been able to choke down an entire dose of Alka-Seltzer, but boy, it feels, that makes it feel really powerful. I think the key thing to remember with a lot of these over-the-counter cold medicines is that they're not actually treating the cold. The cold is going to, if we're talking about your run of the mill... Are you saying we don't have a cure for the common cold? We do not have a cure for the common cold.

We don't even really have an effective treatment in the sense that it's not going to shorten the amount of time that you're sick. You're not going to get better faster. It's not killing a virus. It is alleviating some of the symptoms that you're experiencing. And it might do that, but you can go fine without it. And so if you do have other health conditions and you're not sure, you're better off talking to your doctor and not taking it right away because you don't need those things.

Is that fair to say? You don't need them. Fair. One more question about alcohol because we are recording this as St. Patrick's Day is coming up. And so I feel like it's fair to have a couple alcohol-based questions. Second, and most importantly,

why do I get stuffed up when I drink alcohol? I'm not a heavy drinker by any means, but wish I could enjoy a cocktail or two once in a while without feeling like I have a nasty cold. What is up with this? Is there anything I can do to help prevent it? That's from Sam from Wisconsin. That's wild, I've never heard of that.

You've never heard of that? No. Okay. There is an enzyme in your liver that's called alcohol dehydrogenase. Okay. Okay? Oh, ADH.

Mm-hmm. You're checking my notes. I wrote down the names of these so I didn't get it backwards. Okay. It converts ethanol, the alcohol, the stuff you're drinking, into acetaldehyde, okay? Okay. There's another enzyme, aldehyde dehydrogenase II,

which breaks that down into acetate, okay? And this is supposed to happen pretty rapidly in your liver. All of this should be happening like right in succession. If not, acetaldehyde will build up in your bloodstream, in your body. And that can make you feel pretty rotten. What are some of the things that acetaldehyde can cause? Skin flushing, nausea, elevated heart rate, lower blood pressure, headache, worsening asthma symptoms, and stuffy or runny nose.

Mm. This is, if you've ever heard of some people who every time they drink get flushed, there is a term for this that some people use called the Asian flush. Mm. And this is not a, I know that sounds like, oh my gosh, is that a very racist terminology. It is because this is genetic. And some areas of the world have more of this enzyme genetically

and so are less likely to experience this problem. And in some areas of the world, they have less of this enzyme genetically. And these are generalizations. Obviously there's variations in every part of the world. And so they are more likely to build up acetaldehyde quickly and experience all of these symptoms that I just mentioned. That stuffy runny nose may mean that genetically you just got less of that second enzyme

and so you build up that acetaldehyde a little faster than someone else who drinks. So is it permanent though? Yeah, it's genetic. It's just you can't, there's no like supplement or treatment to give you more of that enzyme. There are some people who every time they drink, they have this reaction. And it can be as little as one or two drinks. I mean, it really, it could be the first drink

brings it upon you. There are some parts of the world where genetically they have a lot more of that enzyme. And so they can drink a lot more before they would ever have any of these symptoms. And so that's what, when we talk about people who just like, some people can really hold their liquor and some people can't.

Part of what I think people are getting at is how much of this enzyme do you just genetically have in your body? So they just stick to beer and seltzers, they'll be fine. No, no, no, no. No, no. Wait, why? Why would you assume?

It's alcohol. Alcohol is in beer and seltzer. Yeah, I know. It's just, it's so sad. I'm just trying to help. No, don't say that. It's not sad. It in beer and seltzer. Yeah, I know. It's just so sad. I'm just trying to help. No, don't say that. It's not sad. It is not sad not to drink.

It is a choice that everybody can make for themselves and decide what is best for them and their lifestyle. I know, but they wanna drink, and I'm just sad for them. They'd love to drink a lot. Well, and I will say like- They would love to drink a lot. I get the impression- No, I would never endorse like- This person would love to become a lot. Well, and I will say like... They would love to drink a lot. I get the impression that this person would love to become a super heavy drinker. No, I don't think that's what they're saying.

I don't think that's what this person is saying at all. I mean, I would never endorse becoming a super heavy drinker. Obviously, Sydney. Why would anyone even think that? But what I'm saying is that genetically, it may be that every time you drink any alcohol, beer, seltzer, or otherwise, you have this reaction. Stick to weed. Yes.

So, now you agree with that though, that you're fine with. With what? I said stick to weed. Oh, I didn't hear what you said. I thought you were speaking another language for a second. Okay. No, I'm not, listen. Men are truly from Mars and women are truly from Venus.

Like, speak it a different language. I don't agree with that either. That men are from Mars and women are from Venus, yes. It is demonstrably untrue. That's a very outdated gender norms. We are all from Earth. We don't believe in that here. No, we're all from Earth, except for Kal-El,

of course, the last son of Krypton, and any of his other relatives that happen to be wandering around. Anyway, drink responsibly this St. Patrick's Day, please. If you do drink, drink responsibly. And if you don't drink, that's fine too. You don't have to drink. You don't have to drink.

You don't smoke weed. I was kidding, Sidney, this is just a joke. And I'm never gonna endorse smoking things either. Okay, I understand. Hey, one last time before we let you go, we've all had so much fun today, but there is an important thing you gotta do if you haven't already. Just give it a shot.

See how it feels to support great art at maximumfund.org forward slash join. Our important work, our great art, you can make sure it keeps on happening. It makes it possible for us to do these shows. It makes it possible for you to hear these shows. So if you like that situation, the way it's going right now, it'd be a shame if something happened to it.

No, that's threatening. I'm not threatening. No, don't say it like that. That's not the energy. Please, please support this show and all the other great Max Fund programs, if you can, at MaximumFund.org forward slash join. If you've never become a donor before, try the $5 a month level. Just check out the bonus content.

There's a bajillion things to listen to. Great, great stuff. We had some really fun over at My Brother, My Brother, Me and Taz this year. We did a My Brother, My Brother, Me and Taz this year. We did a My Brother, My Brother, Me. We created a role playing game based on an episode we did called Plato's Rave. And then for the Adventure Zone, me, Travis and Griffin ran that game as the dungeon masters for my dad, who had no awareness of Plato's Rave at all. It's incredible. It's our rumors. I mean, it's our, it's true art.

It's our rumors. There is a lot more great stuff there. Many years, there's a great episode of Sawbones where Sydney and I go to the Walmart and just talk about the medicines that don't work. Remember that one? Just walk around with the audio recorder. Does that where we talked about the pink laxatives?

I think so. They're still selling pink laxatives. They work the same as the green laxatives, guys. Anyway, maximumfund.org forward slash join is the address, please don't wait. Please go right now. It is the only thing that makes these shows possible. It's how we, and again, thank you. It's how we feed our family and dress our kids

and everything, and it means the world to us. So thank you. It's how we feed our family and dress our kids and everything. And it means the world to us. So thank you. And thanks to the taxpayers for the use of their song, Medicines, as the intro and outro of our program. Thank you again for listening. That is going to do it for us. Until next time, my name is Justin McElroy.

I'm Sydney McElroy. And as always, don't drill a hole in your hand. ["Making Love with a Girl"] All right! Yeah! Maximum Fun. A workaround network of artist-owned shows. Supported directly by you.