Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Do You Know How Italian I Am?

Episode Date: June 4, 2024

Hot time, summer in the city, time for listener Sawbones questions! Questions like: Why is blood sticky? Why does skin itch when it grows back? Might my twin reject my organs? And should I bring my own speculum to an exam? Music: "Medicines" by The Taxpayers https://taxpayers.bandcamp.com/

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 in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert.

We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert.

We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. Hello everybody and welcome to Saw Bones, a marital tour of misguided medicine. I'm your co-host Justin McElroy. And I'm Sydney McElroy. My tone of voice makes it sound like I'm bringing you breaking tragic news, but it's just, it's just me. But isn't that sad?

Does it drive you absolutely batty when your husband in your own house gets sick? That's gotta feel like a huge dereliction of duty. Right in your backyard. Because I allowed it to happen. Because you allowed illness in your home, in your backyard. Okay, do you think that doctors have the ability to prevent all illness and we're just withholding it

from you if we do not do so? No, dear heart, that's what makes it a joke and not a real thing that I say to you. That is the difference there. But you have nailed it though, that is 100%. If I could prevent illness for you, I certainly would. Because, well, why do you love you? And?

And. The whining. You're so whiny. Yeah, the whining. It really stops everything, you know? Like time stops. Yeah, but you know what, Sid? I asked you to look in the otoscope,

with the otoscope in my ear three days ago, and you didn't, and I didn't bring it back up again until this exact moment. No, I did look in your ear. And I told you that there was wax in there, and it was blocking the eardrum, and we were gonna have to flush it out. You never did any of that though, did you?

Squeaky wheel gets the grease it seems. We've been a little busy. Yeah, but it seems like if I had been a bit more of a squeaky wheel, I'd have perfect hearing other than the hearing loss that I have, other than that. Did you put the drops in your ear like I told you to? To soften the wax so I could flush it out? Did you do the podcast?

That's not my job. Your job is doctor. My job is podcast. If podcasting could heal you, I would every day. Listen. I would for you privately podcast to heal you. Lately our job has been community theater. Yeah, our job has been community theater

and barely parents. That's been our job. Parenting. Our kids are out of school. We are directing one show. We are in another show. Our kids are in a school, we are directing one show, we are in another show, our kids are in a third show. And we're building.

We're building the set, we're painting the set, we're helping collect props, we're helping. I don't mean that in the community theater since we're building set, I mean, Sydney and I are literally every day, going for hours a day to build the sets on our own. I receive power tools. Not quite. For Mother's Day.

Yeah. That was my present. Yeah. Yeah. Well, and a medical, a very cool medical kit. Both sides of you. Emergency medical kit. The craftsman, the doctor, both sides.

The craftsman, that's the side of me. Anyway, so I say all that as a way of also saying I'm sorry we've been absent. Yeah, here we are though. Yes, we're back. We're back and you have a- Mostly better. A bucket of questions waiting for us

that I'm going to pose to Sydney. I do, I do. And now before I have a fun story from my dad. This doesn't involve someone dying. Oh good, for a change, yeah. I know, it's exciting. Whenever my dad starts a story, I think this is a lot of dads.

This is a very dadly thing. The dads wanna tell you like, hey, do you remember that person? And then they're gonna tell you about how they died. How they died, 100%. Did you go to school with, they died. Or they went to prison. Yeah, it's one of those things.

One of those two. But this is not about that, but he told me this story and I thought this is a cool story for our show, but I don't think it's a whole episode. I just think it's an interesting story. And I thought this would fit well into a medical questions episode. Well, it's an interesting story and I thought this would fit well into a medical questions episode. Well, it would regale me, I guess.

Justin, did you know that the Beatles are responsible for the CT scanner? No, honey, I didn't know that. This is how my dad started the story. Well, I mean, can I say though, credit to your dad, that's the best way to start the story, I bet. I mean, it's very, it's very hooky. Now, I'm sure he heard this on maybe another podcast

or Reddit. He gets, we frequently will get him like those trivia calendars. That reminds me of when Dot came up to me and she said, did you know that narwhals are not the unicorns of the sea? I had to be like, dang, okay, tell me more. Okay, you got me, kid.

I'm hooked. Okay, so you know, EMI Electrical and Musical Industries, which was the Beatles record label. Yes. Okay. So, back in the 1950s, there's a researcher, Godfrey Hounsfield there, okay? And it used to be an industrial research company back when Godfrey was working there. He did a bunch of work on computers. He helped build the first all transistor computer,

which I don't know anything about computers, but I guess that's a big deal. Has to be. Must be. But all of that was not profitable back in the 50s because we didn't love computers yet, I guess. Mm-hmm, yeah, we weren't into them. We weren't into them.

They were so heavy that they could fall and crush us, and that's less of a problem now. Some of them definitely still could, but back then, all of them could. They took up whole buildings, and now we wear them on our wrists. Like we tolerate fridges, but we don't try to make them part of our lives.

Like we don't, you know what I mean? Like we don't get bunches of fridges for every room or try to make laptop fridges or any of that because they're too big and we don't like things that can fall on us and kill us. I do wish I had a laptop fridge though or one that I carried with me. Right, but you don't feel anything.

That would be convenient for snacking. If you buy your fridge, you never think about it again because it's so big it could fall and kill you. People don't like that kind of thing. Listen, I might disagree with you because I really love fridge water. And so like our fridge is important to me because it supplies me with fridge water,

which is the best water. Love fridge water. Anyway, so- Even though our maniacal kids keep changing it to crushed ice, who enjoys crushed ice? You are gonna bring out all the crushed ice fans with that one.

I'm not talking about the good ice and I'm talking about crushed ice. It's like, boy, this drink's good. I wish it talking about the good ice and I'm not talking about crushed ice. It's like, boy, this drink's good. I wish it could be wetter in five minutes. Perfect. Wetter and colder. That's what this needs. Let me finish this story so you can ask me questions. Okay. So it wasn't profitable. The company sold its computer wing in 1962. And then in 1962, it also did something else. EMI signed to the Beatles. Oh, that's funny.

Because they were also, like I said, a record label. At that time, Godfrey was still so well respected at EMI that they were letting him just do his independent research there, which is kind of like, I always wonder, eventually he would be funded by the Beatles' profits. Right. Like, that's how he would keep going. But initially you gotta wonder if they weren't like, you don't work here anymore. You can work here, but you don't work here, but you can. But you don't, so we're not gonna pay you, but you can.

It's like Milton from Office. Yeah, we corrected the error. I do, I got a respective business that's like, what's your model? Okay. Well, let me tell you We got four British guys that play music. We got from a bunch of Liverpool bars. Okay, what else? We have an old man trying to make an incredible new scanner. So both yes, which one will pan out? We don't know so we just do both of these at once. But turns out. Both. Both. That's a great business.

Good job, guys. Good job. You picked two things unrelated. You picked two things, slammed up. So the Beatles funded his research, obviously. He went on to invent the CT scanner and EMI released it in 1972 and he got the Nobel Prize for Medicine in 1979.

And it was thanks to the Beatles' profits that he was able to continue this research and create the CT scanner. Amazing. So there you go. Amazing. Do you feel good that you didn't have to try to stretch that into a full 30 minute episode?

I can see, there would have been a lot of winding anecdotes. But it's a fun and it fits into Sawbones. And I thought this, you know, spicy anecdotes. Do you think there was ever a time? Exciting, interesting anecdotes. Do you think there was ever a time where they were like interesting anecdotes. This is a good place for it. Do you think there was ever a time where they were like, hello, doctor, what are you working on in here? Isn't that incredible, John?

Yes, it is, Paul. And maybe they contributed, and then maybe he showed up, and he was like, hey, I had some lyrics that I thought. Yeah. Here, guys, I call this LSD. Let me know what you think. I invented it. I made it.

I made this. I don't think he was that kind of scientist. Oh, maybe in the 60s. Every scientist was that kind of scientist. I don't know Godfrey, maybe he was. You weren't there. Read me our first question. Hello from Australia. I have thrombophilia.

Hey, good. And that's good? No, that was a good pronunciation. I'm not saying good. You have thrombophilia. Okay, so you can understand out of context it was a wild thing for you to say, right? No, that was a good pronunciation. It's not, I'm not saying good. You have thrombophilia. You're saying. Okay, so you can understand out of context, it was a wild thing for you to say, right?

Sorry, I mean, well, I could see you trying to pronounce it and you did a good job with it. You're welcome. As your PR agent, I just want to clarify that Dr. Smarrl meant good on my pronunciation. Yes. And for that and other health reasons, I'm not allowed to donate blood, but I've always wondered,

what would happen if I donated blood to someone with hemophilia? Would they cancel each other out, fight strongest blood wins? During COVID, we had a blood shortage, I called to see if I could donate and ask this question. And the answer he gave was, I don't get paid enough for this.

Which is kind of a weird thing for somebody in a position of begging for human blood to get, like it's a bit saucy. Like, okay, I'll keep all nine pints then. Fine, be that way. Thank you for the wonderful show. Best wishes. Ellen. Ellen.

Well, I mean, when one of our listeners includes their name, I assume they want us to. Okay, well, Ellen, there's a question. So specifically, Ellen mentioned Factor V Lydon as the thrombophilia. They're different, so they're, I think we're kind of familiar with the concept of hemophilia.

We've done a whole episode on it, and most people have heard about it, I think, because of the royal families. Right. Historically, all the royals who had hemophilia, and then maybe at some point in a genetics class or a biology class or some sort of science class in your life, they've shown you like a big family tree

of all the royal families of Europe and how hemophilia was passed among them. Have you ever seen that? Oh, I have not. I have been shown that in so many science classes, I couldn't tell you, and med school classes. Anyway. Do you guys ever talk about the fact

that Factor Five of Leiden sounds a lot, lot, lot like the name of a mid-80s Japanese anime? If someone told you, because the L and the R sounded the same in Japanese, right? If I could see the logo of Factor 5 Raiden in my head, it sounds awesome, right? It could be right there with Captain Harlock and all the other classics. It could, but it's not awesome, I think, because what factor five Leiden is, it's a clotting disorder that means the protein

that stops the clotting process. So like your blood is clotting because you're cut, something's bleeding, right? So your blood starts the clotting cascade, is what we call it. That's good, we want it to start clotting so that you don't just keep bleeding. This is all good.

But the protein that stops it, APC, doesn't work right. It doesn't, it's not that it doesn't work at all, but it doesn't work right. And so APC is supposed to stop factor five, so it keeps going when you have this mutation, so you keep clotting, so you can have clots. This is the opposite, if you think of hemophilia as you can't clot Loosely, you just keep bleeding and there are different kinds of hemophilia and there are different kinds of clotting disorders

Would it make you clot? So this is kind of a bunch of factors involved in clotting and stopping clotting It's like the old what would happen if you put a humidifier and a dehumidifier. This is exactly yes So if somebody with hemophilia who can't clot their blood or has difficulty, I shouldn't say can't, has difficulty clotting their blood, receives blood from someone whose blood clots too easily, what happens? So I had to, this was an interesting thought exercise.

And I went through this whole thought exercise before I got to sort of the denouement, but I'm gonna save that because this is how I researched this, because I was sitting there thinking through the different kinds of hemophilia, and I had to remind myself of all the clotting cascade, because I haven't studied that in a while. So hemophilia is different kinds of bleeding disorders.

Some affect factor eight, some nine, some 10, so there's different kinds, okay? You need eight, nine, and 10 in the clotting pathway to do their thing before you ever get to five. And once you get to five, if you have factor five Leiden, you can't stop it. Like five, the thing that's supposed to cut five off and you don't keep clotting isn't there. So you don't stop it. So I don't think it would cancel each other out So I don't think it would cancel each other out because even though with hemophilia, you have less of eight, nine, or 10,

you still have some of them. And so you would still move through the clotting pathway to an extent. And once you get to five, if you now have factor five Leiden, it's not gonna stop, so you're gonna have a clot. Right. So it would be less of the initial factors,

but once you get to that other factor, and once that card has fallen, the dominoes will keep falling. Okay. Does that make sense? Yes. Okay. However, the recipient does not have factor five lydin.

Right. So they would have some of the protein that they need to stop factor five. So maybe they could stop it. Okay. So maybe it would be fine. So it might be fine. So this is what I got to is, I actually think it would be fine. So it might be fine. So this is what I got to is,

I actually think it might be fine. And then I thought, okay, all of this only matters if you're donating plasma, which has the clotting factors in it. Right. Okay. Because otherwise it's stripped from it. If you're just donating what we call packed red blood cells, meaning we've stripped all of that out of there

and they're just- Power red they call it. Power red. So gross. If you're just donating power red and not all the other stuff- Gatorade, it's my blood. I don't think it would matter at all with that. I mean, other than the fact that like donating blood, if you have a bleeding or clotting disorder, there is some, it might be low depending on what the disorder is, but there could be some risk to the act of donating blood right right other than that. I thought well

Red blood cells should be just fine. It seems weird. There's a restriction So then I went to the red cross page and found that people with factor five Leiden can indeed donate Packed red blood cells as long as they're not on an anticoagulation as long as they're not as long as you don't have a clot And you're having to take the blood that are for it, you can't donate plasma, but you can donate packed red blood cells. So this is where I got to, I thought, well, they should be able to,

and then I found out that other smarter people than me already knew that. So maybe it's just a US versus Australia thing, but here in the US, you can indeed donate packed red blood cells if you have factor V blood. So there you go. This was the end of this very long thought exercise

that I went through as I had diagrams of clotting cascades up on my computer and I was working through them. The answer was on the website. The answer was on the Red Cross page. Why is blood sticky, speaking of blood? That's from Julie. Okay, so I had to think about, is blood sticky?

Do you think about blood being sticky? I've had blood on me many times. I would say more viscous. Yeah, which is I think I think we're using I think we are saying viscous in the same. I think we're saying the same thing. Yeah, we're using different words It's probably more sticky obviously is is the coagulation starts right as it starts to turn into a Exactly scab or whatever exactly so initially when, so initially when someone starts bleeding, the blood is not particularly sticky. As the clotting factors that we just discussed start doing their thing, the blood intentionally becomes, it's sticking together so that it stops.

So that's not a flaw, that's the design. And there are things that can make blood stickier. If you have higher red blood cells, there are some that can make blood stickier. If you have a higher red blood cells, there are some conditions you can have that automatically you have more red blood cells. There's some medications that can increase your red blood cells, classically smoking. If you are a smoker, you may have a higher red blood cell count.

That can make your blood more viscous or stickier, more clotting factors, so if the blood is clotting, it's going to get stickier. Higher lipids, if you have really high, I have seen blood that actually looks like you can see the fat in it. You can see like the cholesterol in it, like the white, creamy, that's gonna be more viscous.

I'm surprised they never use that blood and cigarettes thing on a detective show we've watched, or like House or something, like, the blood is pretty sticky, I guess we've got a smoker. That would be amazing, that would be amazing pull. Hey, Sid, I'm a rower, so I get blisters. That's the untruest thing I've ever said. That is the furthest life experience from my own.

Yeah, you are not. I am not. No, you are not. I am a rower, so I get blisters on my hands. That's a normal part of rowing and dealing with it as part of the sport, But I've always wondered why my blisters itch while they're healing. So why does skin itch when it grows back?

That's from Janice. This is, you know, I started thinking about this, Janice. Is this really, because everybody always says like, it's itching, that means it's healing. Have you heard that? I hear that constantly, like, because I do a lot of wound care in my day-to-day job now. And so people will say like, I think it's getting better, it's itching. That feels like a middle-aged, constantly, like, because I do a lot of wound care in my day-to-day job now, and so people will say, like, I think it's getting better, it's itching.

That feels like a middle-aged sort of, like, imagining the little guys going down there to fight it, you know what I mean? Like, well, your humors are flooding down there, so it's itching you. There have been studies looking into, is this a real thing, or is this sort of, like, a folksy medicine kind of belief? It is a real sensation. It is definitely something that people, not all, but it is generally experienced by many, many people, the sensation of itchiness when something is healing. And it probably is because tissues are healing.

So there is evidence that itchiness is a sign something is healing. Now that doesn't always mean that because it's itchy, it's healing. Obviously, there are lots of other reasons that we itch. But there have been, they've looked into this to see. Biologically, that is strange to me, right? Because the opening of blister, it introduces infection, right? And it's weird to me biologically that we have developed the urge a blister, it introduces infection, right?

And it's weird to me biologically that we have developed the urge to scratch at or itch blisters and things like that where it's gonna expose it to more infection. It feels like kind of a bug. It is, from an evolutionary perspective, it is not helpful, it is not advantageous. I mean, I don't think it's a function

as much as a dysfunction. So the thoughts, they've tried to look at like, why would you experience this? Some of it is like histamine release. When things are healing, histamine is still part of that process, and one of the things histamine does is make you itchy. Also collagen formation, just as the tissues are reforming like scar tissue

and all that, it is like the sensation, the stimulation of that, your brain may interpret as itchiness. The other thing is just crossed pathways. Those nerves that are in that superficial skin as the skin is healing are being stimulated. And so you're kind of getting that, nerves can do this where they kind of miss,

it's not misfiring, as they're firing, we are feeling it and we don't know what it is. And that is not uncommon for us to interpret, I don't know what this is as itchy. Sure, yeah. That is a very common. Well, because part of it might be to get something off of you, right?

Like you've got a bug on you, you don't recognize the feeling of that bug, or it could be poisonous or whatever. So you need to build the- That's exactly true. No, and so I think instead of a, think about it this way. So if we feel something crawling on us,

we might experience the sensation of itchiness, or it could be like formication, which is ants crawling in your skin. Tell me more. Formimication. But like you experience the cessation of itchiness so that you scratch at it and get the bug off of you. Obviously you don't wanna do that

when something's healing, you shouldn't. Please don't scratch it, leave it alone. But it's similar to like pain, right? Pain is functional. If something hurts, that's your body's way of saying, stop doing that thing, you could damage yourself. That is, so pain has a function. There's a reason we experience pain.

But then when you look at like chronic pain, it has lost its function. We don't need like, chronic pain is not necessarily telling you something's wrong. So now we've entered into something that is functional, that has become a dysfunction. I think it's the same thing. Itchiness has a function.

And now this is a dysfunction of itchiness. Okay, that makes sense. I have more questions for function, and now this is a dysfunction of itchiness. Okay, that makes sense. I have more questions for you, Justin. Oh. But before we get there, we must go to the billing department. Let's go. The medicines, the medicines, that escalate my cough for the mouth.

I'm Sequoia Holmes, pop-culturist and host of the Black People Love Paramore podcast. Contrary to the title, it is not a podcast about the band Paramore. Each episode, I, along with a special guest co-host, dissect one pop culture topic that mainstream media doesn't associate with Black people, but we know that we like. Tune in every Thursday to the podcast that's dedicated to helping black people feel more seen here on Maximum Fun. I'm Yucky Jessica. I'm Chuck Crudsworth.

And this is... Terrible! A podcast where we talk about things we hate that are awful! Today we're discussing Wonderful, a podcast on the Maximum Fun Network. Hosts Rachel and Griff and McElroy, a real life married couple. Yuck! Discuss a wide range of topics, music, video games, poetry, snacks.

But I hate all that stuff. I know you do yucky Jessica. It comes out every Wednesday, the worst day of the week wherever you download your podcasts for our next topic We're talking Fiona the baby hippo from the Cincinnati Zoo. I hate this little hippo Said how do the doctors know my blood type? Do they also have a document or sample of my DNA? Do they take a little sample when I was a baby? Do they know how Italian I am? That's something I say when I walk into rooms a lot.

Do you all know how Italian I am? Not at all, right? Not very much at all, Justin. I think you're like 0%. I'm probably 0% according to, I don't know, I haven't done one of those, but if I did one. You did do one. Did I?

Yeah, we did one for an episode. Oh, right, right, right, right, right, right. No Italian that I recall. Is my DNA protected by HIPAA? How do we make sure we don't do eugenics? This question's all over the place, Daniel. I gotta be honest with you. How does blood work related to this?

What if I have an affliction that's passed out genetically? Can they test it without reading my DNA? So mostly I wanna know how Italian I am. Love to show you all pumpkins and penguins, Daniel. So I thought this question, Daniel, you do go all over the place here, but I thought this was a good thing to address. I don't necessarily know your blood type.

This is commonly- Okay, can you, this is gonna sound weird, but can you clarify some of the pronouns in that sentence? Like, I don't know exactly if you mean the broad doctors. As a doctor, if you are my patient, and this happens not infrequently, so you're not alone, Daniel, I will have a patient come in

and they'll be talking to me about whatever they're there to see me for, you know, blood pressure or whatever. And in the course of the conversation, they'll say, hey, by the way, can you tell me what my blood type is? And I think there is an assumption that somewhere in our medical records, somewhere in your history, I have your blood type recorded.

I don't, very often I don't. It's not the case. Now, when you were born, it is likely. If you were born. I don't know what that means. It is quite possible or likely, depending on the situation, that your blood type was recorded. That is quite possible.

Quite likely, in fact. However, I don't necessarily have access to those records. And often, if you're an adult, I definitely do not have access to those records. I don't know where they are. We're kind of still in that point in this country where they might be on paper somewhere, they might be scanned into some computer somewhere, but trying to find those records could be almost impossible.

I wanna see if they got it in the Red Cross app. I feel like I've seen it there before. Now, the Red Cross might know your blood type, because they type it when they take it. I can find out your blood type by ordering a blood type. This sounds like a threat. So if you really wanna know, your doctor can give you an order,

you take it to the lab, they draw your blood, they tell you your blood type. But generally speaking, your primary care doctor may well not know your blood type. And if you don't either, it's a good thing to know, it's a good thing to find out, they can test you for it. I don't know, insurance payment and all all that you'd have to work that out because without needing a transfusion It's ridiculous, but I can see insurance companies saying well. Why do you need an able time?

I can't I can't keep mine in my head. I for some reason I try I know your blood type. I don't know my blood type That makes me feel bad because now I now you're gonna say what's mine, and I don't know. Mine is A plus, but that's what I like to get. Yeah, I know, but I have the same blood type, or both A plus. Or both A plus. That's bad, right? Or is that good? No, I mean, we can give each other blood.

Do you want? No, I'm good. I mean, I think I'm good. I haven't had labs done in a while. Anyway, and so we definitely don't have your DNA, necessarily. There's no reason we definitely don't have your DNA necessarily. There's no reason we would have that information. You can do things like the online genetic testing

that you send away for, I'm not gonna plug any of the companies, we've done an episode on this before. You can do things where you will give a company your DNA. And then they will have it. And then you've just gotta trust whatever they're gonna do with it. When we did, now I know our DNA is stored in a lab

in Indiana. That's right. Because you and I were part of the COVID vaccine trial. Oh, right. And part of it is that we signed a form that said we're gonna take your DNA. Do they? They have our DNA in a lab in Indiana

for the next 15 years. So there you go. So you can choose to get your DNA profile checked through these various companies. But generally, that's not something your doctor's just gonna do. Now, if you have to visit a geneticist, if they're working you up for specific genetic disorders,

there are specialized circumstances where they might look for certain genes or do some kind of DNA profile. But generally speaking, your family doctor does not know your blood type or does not know anything about your DNA unless you have pursued those things. Hey, you know, this is like our third question about blood,

so I wanted to take the opportunity to say that, just to remind you, there's always a huge need for blood. If you've never donated before, it's not as scary as it seems. You get free snacks afterwards. A lot of times they have t-shirts. One time I got a Shark Week t-shirt just from giving blood, which seems like I was robbing them at that point, because I'll just make more of the crap, A lot of times they have t-shirts. One time I got a Shark Week t-shirt just from giving blood,

which seems like I was robbing them at that point because I'll just make more of the crap and they're giving away Shark Week t-shirts? Thanks suckers. Takes like an hour, it doesn't hurt too bad. And if you can get in there, the app makes it really cool now because you can watch your blood.

If you're micro goal oriented like myself, I can watch my blood go to Indiana or whatever, wherever it's going and see how they've used it and stuff. So it's very gratifying if you get a chance. Another question, Sydney, you got it. I am an identical twin and I've always wondered if I gave my sister a kidney slash liver slash bone slash marrow, et cetera,

would she still need to take rejection medication? Is the likelihood of rejection different if we were newborns, i.e., before other external factors come into play? Can I guess? That's from the spare twin. I would guess, I don't know. There is a part of me that feels like it would probably be okay,

but there is also a part of me where I feel like it might fall into the uncanny valley where the body's like, okay, that is exactly like Janice, except that's definitely not, Janice is what they call the liver. That's definitely not Janice, but it looks exactly like, you're gonna think I'm crazy, Paul, that's the kidney. Yeah. Don't look at me that way. Okay, so I had to check this out, because in my head, and this is, okay,

this is very important in medicine. Just because something makes sense, logically, doesn't mean it's true. There are lots of things about the human body that don't make sense. I would think at birth it would probably be fine, but I don't know if like genetic mutations over your lifetime would be enough of a, you know?

So likely you would not need anti-rejection medications. There are a number of identical twin transplants that have been done and studied that do not take anti-rejection medications and are just fine. So this is actually kind of a changing area of medicine. I found studies as recent as the last couple years where they've looked at the number of identical twin transplants that are taking anti-rejection meds and ones that aren't.

And what they found is about half of the sample they looked at were taking them, but they didn't necessarily know that they needed them. So I think it's this area where probably they've done a transplant, they automatically put these patients on anti-rejection meds because that's what we do, and then the risk of taking them away is so high,

it's a tough thing to study, right? Because if you take them away and then they reject the organ, that's devastating. I mean, that could be fatal. So how do you know? But definitely we have people who have gotten a transplant from an identical twin who are not on anti-rejection meds. So we know it is possible. So yes, I know.

I mean, because genetically it's the same thing. It is the exact same organ that you have implanted. They're just doubles of the same organ. So, and they used to, by the way, before we could do DNA to look for perfect matches, do you know how they used to test to see if like, because they used to do transplants between identical twins, assuming that they matched,

but the way they would double check it is they would take a piece of skin from the person who was donating and attach it to the person who would receive the organ and see if the skin got rejected. Oh wow. Isn't that wild? It's wild, yeah.

And if the skin wasn't rejected, they would transplant the organ. But now we can check DNA, we don't do that now. Hey Sid. Can I ask you a question? Yeah. And it's a little bit personal. Okay.

What would you do if a patient brought their own speculum to an exam? Why are they selling them? So- That's from Heather, and you need the context. Heather sent me a link to Nella. Scoot down with confidence, they say. No, I'm not gonna give you my email address, Nella.

Anyway, Nella is, they sell the Nella Comfort Kit, which is a speculum kit for those of you who have vaginas and require speculum exams. The Nella Comfort Kit gives you your own speculum to bring along with you, along with what's in there, some socks, a pair of socks, a stress ball, a vaginal wipe, and an instruction sheet for your doctor. That's for 49 bucks. I got to say, I don't know why this exists. I can't, both as a physician and as a patient who receives these exams on a regular basis,

I don't know why you would need to bring your own speculum. They claim that it is a more comfortable speculum. They cite the fact that it's plastic and one-time use. Okay, I have only ever used plastic single use speculums in my practice. Do metal ones still exist? Yeah, they're still there. And some clinicians may use those. They're certainly still out? Yeah, they're still there. And some clinicians

may use those. They're certainly still out there. I don't really like them. They've got a little dial, you've got a wind to open them up. The plastic ones are way easier. They click to let you know that they're opening, which maybe the sound isn't pleasant. But I like the plastic ones. That's all I've ever used. So we're using plastic ones, a lot of us anyway. They cite that it's thinner. Well, so we have different sizes. We actually assess the patient to see what size we are gonna use, depending on your age and your body type and size,

and whether or not maybe you've had children. Like there are a lot of factors that go into what speculum we use, and a narrow speculum is not right for everyone's body shape and size. So it might not work for you. It might be the wrong shape for you. That's not always a plus. It really depends on your specific situation,

and that's why I have a variety in the office that I can choose from, so that I use the right examination tool. I have no idea why you would need this. I would never bring one with me. I asked a lot of people who have vaginas this question, would you want to bring your own speculum in a little box with you to your doctor?

And they all said, absolutely not. And to be fair, I feel, just to say, because I'm a cisgender dude over here who's never experienced this, my suspicion is that if cisgender dudes needed specula, there would probably be a wide assortment of, I mean, just judging from what I've seen in vape pens, there would be a wide assortment of specula in all colors. Like power speculums. Yeah, this one really gets through, I don't know. But I will say, I just want to say, I am certain this is an absolutely uncomfortable experience for a lot of people, maybe like traumatic for some folks

I know, and we can absolutely validate that need for comfort and that like uncomfortableness without validating someone's desire to profit off of that. And that's where like the diff, that's what sucks to me about this. This feels like somebody saying, oh, you're afraid, give us $49. That's exactly what this is.

Because what they reference is that these are for the 90% of, first of all, they say women, which I have a problem with. Great job. Great job, people selling, yeah. Because not everyone who has a vagina and needs an exam is a woman. So for the 90% of women who get anxious about OB-GYN exams, for women who've had pain or bled,

for your daughter who's scared, for the one in four women who've had sexual trauma, for gynecologic cancer survivors, for women in menopause. Okay, so they're saying like, if you're anxious, this is better. No, could we do episode after episode on the inadequacies in care directed at people with vaginas and cervixes and who need this sort of examination?

Absolutely. And are there insensitive providers? Oh yeah, oh yeah, we've all met them, I know them, I hope I've never been them, I don't think I am, I think I'm sensitive. But all of that can be addressed without paying this company $49 for a speculum that may or may not be the right thing for you. And also just, I mean, for fancy socks and a stress ball. And we have vaginal, we have wipes,

we have those in the office, we offer them, or they should. And if you're not getting that experience from your provider, absolutely, you need to advocate for yourself, complain, find a different provider, but it will not be fixed with $49. And please don't hand your clinician an instruction sheet on how to do a pelvic exam. Yeah, it would be great for the doctor-patient relationship. No, you don't need this company in between you and a provider. You and the provider need to be able

to have this conversation. And providers, we need to hear this conversation and be open to it. And you do not need to pay this company $49 to do it. Hi Sydney and Justin, this is the last question. Last question, Sydney. Hi Sydney and Justin. I have a weird medical question for the next time

you do a questions episode. I probably didn't need to read that part as self-evident, huh? Why do I get cold when I stay up too late? Sometimes if I have a really late night, I will get chilled, even if the room I am is fine temperature and didn't change at all. Thanks so much for the show, Jess.

I am so stoked to see this question because this happened to me this week because we are dying trying to make the magical candy guy Willy Wonka go on the stage and do all of his magical tricks and it's taking our blood in our Soul to make it happen. Also, we're in Margaritaville Simultaneously. Yes, which I try to convince the girls yesterday is called Marinara Ville. I couldn't get him on board. Anyway, I Was so exhausted but the cat started crying for her smooth bird

She had to have her smalls So I forgot we forgot forgot to feed her. And I got up and I thought I was getting the flu because I was so tired and I was chilling. My body was shaking because I just wanted to be in bed asleep. So I love when we get questions like this because Justin, I also have experienced this.

Good, not good, but. And I don't think I'd ever, well, I'd never thought about it as something other people were experiencing. Yeah. And I don't think I'd ever, well, I'd never thought about it as like something other people were experiencing. And it is. This is like that, that is the connection that was just made for me that I'm not dying. So it's not about time of day, as you may guess.

It's not like after 2 a.m. you get cold. It's not time, it's the sleep deprivation. So what you're feeling is a lack of needed rest. And sleep helps our brain in thermoregulation. So your body regulates its temperature, right? We are not like lizards where we are just, whatever the temperature around us is our body temperature. Our body internally regulates.

We're supposed to be around. Externally for some of us. What do you mean? You know, with the balls. I meant your brain. Your brain regulates your temperature. Yeah, but the balls shrink up and that helps regulate your temperature.

No, okay. The body's doing it. But you understand the control center of your body is making all that happen. Like your balls aren't doing it on their own. Hey listen, Sid. I gotta accept where the control center is, you know what I mean? But I'm just... You're great.

Waka waka! I can't with this. Your brain regulates your internal temperature. It's around 98 ish degrees. There's a lot of discrepancy about exactly what a normal body temperature is these days. I've been clocking in a lot of 97s this week. It may actually be around 97 degrees and we've been wrong for a long time. But you get the idea.

It's around there and that's where we're supposed to stay. And the only reason it goes up is because we have a fever or an infection or something else or You know, that's a bad situation. You're overheated or it goes way down. That's bad, too Right. Anyway, it needs to stay in that range When you in order to do that your brain has to be well rested It has several there's a lot of things that go into thermoregulation. There are other factors There are other disorders that can change it. But sleep is part of maintaining thermoregulation.

When you stop sleeping for long periods of time, your brain starts to lose the ability to regulate your temperature well. Now that doesn't mean that you're going to like heat up to 108 or something. It doesn't mean that you're going to, your body temperature is gonna drop to the 80s. And I mean, you're not gonna die eventually with enough sleep deprivation, you will die. But in that short period where you're starting to experience sleep deprivation,

one of the things the brain lets go of is that constant- Is it like a system to jettison? Like, okay, we're not doing that anymore. And just a little, again, just a little to make you feel cold. Not enough to make you freeze to death, but a little to make you feel kind of cold. That's what's happening. And so the fix for it is sleep.

But it's that simple. But do you see what the body's doing, though? That's genius. Body's like, hey, you should get under a blanket. You should go get under a blanket. You should get under a blanket. Wouldn't it feel good to lay down under a blanket right now? Go lay down under a blanket.

There are lots of ways. Yes, there are lots of ways, yes, there are lots of triggers in our brain to tell us go to sleep. But that is, well, I mean, that's, you know, that's why we have adapted to circadian rhythms. That's why when it gets dark, our brain releases melatonin and says, go to sleep now.

Good, you see, do you see the sleep? We have, evolutionarily, that is advantageous to us because when we respond to those triggers and we go to sleep, our brain can do everything it needs to do, like regulate our temperature. Hey folks, thank you so much for listening to this podcast that we call Sawbones. Well, everybody calls it that because it's called that.

Things the taxpayers for you. So there's some medicine says the intro now to our program. Sorry again about last week y'all. It's been a real, just like full disclosure. It's been a lot of work. It'll be better, but it's been really tough couple of weeks. And thanks for hanging in there with us.

We appreciate you. And come see our show by the way. There's gonna be some great shows this summer. June 14th through the 16th, June 21st through the 23rd. You can come see Charlie and the Chocolate Factory. That's the 16th, June 21st through the 23rd, you can come see Charlie and the Chocolate Factory. That's the version of, there's so many versions. Dad is playing Grandpa Joe,

and then there's a weekend dark, and then two weekends after that, come see Sidney and I escape to Bar-Garuda-ville. It's gonna be a party. After we've opened up our veins and let our blood spill into the gutters of the theater and making the magic for the audiences, then it will be a party.

Yeah, and our kids are in the pre-show for Lanka. They're adorable. They're adorable, it's great. Come on out, very reasonably priced. Bring a picnic basket. Make an evening of it. It is in Huntington, West Virginia. It is in the one thing about it.

You do need to know it's in Huntington, West Virginia. That's gonna do it for us this week. Until next time, my name is Justin McElroy. I'm Sydney McElroy. And as always, don't drill a hole in your head. ["Makery Man's Theme Song"] All right! Yeah!

Maximum fun. A workaroundaround network of artist-owned shows, supported directly by you.