Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Why Do I Always Burp Next to My Wife?

Episode Date: October 3, 2023

It’s time for us to answer some more listener medical questions, if “us” means “Dr. Sydnee McElroy.” Questions like: can you cook dirt enough to make it clean? What is Gaze-Evoked Tinnitus? Why do we rub our eyes when we’re tired? And can I taste . . .with my eyes? Music: "Medicines" by The Taxpayers https://taxpayers.bandcamp.com/

Saw bones 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. that weird growth. You're worth it. Alright, talkies about some books. One, two, one, two, three, four. We came across a pharmacy with a door and that's lost it out. We were shot through the broken glass and had ourselves a look around.

Some medicines, some medicines, the escalant macaque for the mouth. Wow. Hello everybody and welcome to Saul Bones, a marital tour of Miscite at Medicine. I'm your co-host, Justin McIntyre. And I'm sitting back for it. Do you think, I like the eliteration, but do you think saying that it's that we're married in the tagline adds anything to the pitch? I don't know if it adds to the tagline, right?

Are you more inclined to listen to it because it's like marital? I think it draws attention to like, what's fun about our dynamic maybe? That we're married. Some people might read it as a martial tour of misguided medicine. I have had people say that.

It's like a militaristic sort of. I have been introduced at things as the host of a martial tour of Miss Guy. And then I have to be like, ha ha ha, very normal. Very normal. Because I don't want to correct, it's never a cool look to correct someone.

But it has nothing to do with martial anything. So I don't want to get that confused. Hey, listen, it is a, maybe you'd guess by the looseness of our intro here, but we're having fun this week with another one of our medical Q&A's. Always one of my favorite kinds of episodes. Let me do. These are the fun medical questions. I have been answering not fun medical questions on morning.

Is that interesting? Can I give a peek into what I'm doing? Is that I don't know if this is, Justin says it's interesting. Maybe it's not. I think everything you say is interesting, sweetheart. I'm a board certified family physician. Here she goes. Which means,

Okay. Humble, Brad. No, I'm just, I am clarifying, because if you're not in sconce in the world of having to maintain certification. She does this everywhere. I'm a board certified family position, and I would like to,

she cannot get happy with this place. I don't do that. I don't do that, and I'm pretty good about not putting MD after I signed something that isn't an official doctor document. You would never, I would never say my name again that it didn't have a doctor before it.

It would be an effort. Do you know how embarrassing it is to like signers, like get a receipt or something and sign it with an MD, and blue. I know. Do you know how embarrassing it is to like signers, like get a receipt or something and sign it with an empty and then just look like the worst person? Like you look like such a like, oh, am I, am I impressed now that you signed your Apple Bees receipt with an empty? Like, why did you feel the need to tell me that? Like, it's such a, ugh, move.

And it's totally, anyway, I don't usually. You're a board certified physician. The point is, I just thought it would be interesting for people to know. In order to maintain board certification, you have to do a bunch of stuff. And you also have to pay a bunch of money. That's a whole other conversation. You got to do a bunch of stuff to prove that you still can be a board certified, whatever kind of doctor.

And I have to do, you either have the option of taking a big giant test once every 10 years on all of your field Which as a family doctor is kind of intimidating because most of us don't continue to do all the things that family medicine can do for our entire career Some people do but like I don't deliver babies anymore. I used to but I don't know So that part of my medical knowledge is restier than like I'm really good at acute management of wounds I'm really good at substance use disorder management. I'm really good at acute management of wounds, I'm really good at substance use disorder management, I'm really good at, there's a lot of other things I'm great at now because that's what I do all the time.

Anyway, I opted to do this thing where I take 25 questions every three months for four years, which I thought sounded better. The ever going test, the ongoing forever test. It's a forever test and it sounds like not a big deal, but then it's just in your mind all the time that you either have to do the questions or like, I just finished them this morning and I'll be thinking about finishing the next 25 for the next three months. And it's also open book, but timed.

I think that it feels worse to miss an open book question. I think there's something about that that makes you feel like, oh, you could have used any book and you didn't get the right one. You had access to all the world information. I'm doing fine so far. I'm going to, I mean, knock on what? I'm going to maintain my certification. I feel like everything will go. Okay. I'm just sharing that this is what you have to do to maintain board certification and it's a giant pain and very stressful, but it ensures you that your doctors are always studying and learning. I don't know. There's a peak behind the. Yeah, but we're going to be asking you easier questions today. Yes, these then won't be timed, right? Yes, except in the sense of the listener interest

is always a time where that we're working against, they could at any point switched any of the countless other forms of entertainment. So we gotta keep it happy. All right. Keep something snappy. Peppy, something snappy. Okay.

I got something for you. I quit. I quit. Okay, we're gonna have to stop that. I quit, Mr. White. Okay. I got something for you. I quit. I quit. Okay, we're gonna have to stop. I quit, Mr. White. Okay. We're in medical questions. Here we go.

I just need to sit. Why do we, that is a pitfall for city and I. If something is ever close to a quote from that thing you do, so we start talking about a really nice van or anything like that. Anything from the room. Anything from the room. Rent is probably the worst. Oh yeah. Anytime we start talking about a really nice van or anything like that anything from the room anything for the room rent It's probably the worst. Oh, yeah, anytime we start talking in New York City. It's in the universe

I can't say the next line. Why do we want to rub our eyes when we're tired? And why does it feel So good. That's from Zia You know, I didn't know I I also have observed this phenomenon I don't they never taught also have observed this phenomenon. I don't, they never taught us in medical school why people do that. So I actually had to look this up to figure out like, why do we do that? Can I take a guess? Yeah.

Okay. When you're getting tired and you're sleepy, your eyes are wetter because that helps to hold your eyes closed. And so when you rub them, you're helping them get the waterworks going up there and help to keep your eyes closed. That's what I think. That's okay. You're sort of like you're in the right area. Don't patronize me. Just go ahead and tell me if you're interested. No, but like seriously, you're in the right area, but it's kind of backwards actually.

And I didn't know this was true. When you are trying to stay awake, when you're actively fighting that fatigue, you blink less. Your eyes get drier. It is thought that rubbing your eyes like that is an attempt to stimulate those lacrimal glands, your tear to stimulate moisture. So keep aight so you can stay awake longer. Well to not to stay awake longer, but to soothe your eyes, that's why it feels good because your eyes are getting dry and that's uncomfortable.

So when you rub them, you stimulate that moisture, you moisten your eyeballs and they feel better. So that's why it is. Must've been so satisfying to you to find such a concrete answer to this question. It was, I mean, it was a really cool answer. I also, I didn't know that we blink less when we're tired. I didn't know that.

But apparently that's part of your subconscious trying to stay awake. You're like resisting blinking because you might blink so hard you fall asleep. I've gotten so bad at it anymore. Like I used to be able to stay awake pretty well. I'll just be like literally telling my body like, do not fall asleep. Keep watching this movie. I know you started it too late, but stay awake and who is just nothing doing. I'll just realize that I just missed some. And can I tell you a scary movie about aliens

where there is like one line of dialogue in the entire movie that is not the choice when you're trying to stay away? That was rough. Hey, I'm not a bad movie, but still. Long time listeners, first time collars here with some questions, we have a normal one and a weird one. Here's the normal one.

Do mineral salt deodorants work if they do? How is aluminum and deodorant bad for you? So I wanted to focus on, first of all, I didn't, I wasn't, I'm not really familiar with mineral salt, I had to look up these mineral salt deodorants and there's like basically they're what they're saying is these don't have chemicals in them, they're all natural

and so they're supposed to be better for you. Here is the take home. Whether or not you think these work better for you, because I mean, people say that they do the same thing from like in terms of they keep you from sweating and they fight odor. As far as I can tell, they don't work as well. From everything I'm reading, they're like, these don't always work right away. And you may actually sweat and smell more when you first start them, which makes me think, like, well, you just over time you adapt to the fact that you're sweating your instinctive ear. I don't know. Yeah, see you used to the smell, maybe?

I have no idea. I don't use these. I use, I'm not going to plug a deodorant. I use a deodorant that is a standard sort of commercial product. I think the important thing to know is that there has never been any proven danger from these other deodorant formulas that contain aluminum or the other things they tell you that are bad. So I think that my bigger problem is if you like a certain kind of deodorant

because it does have some other sort of natural ingredient and you like the way it smells or you like the way it feels or you think that it works well for you, that's fine. I mean, because it's all about like your comfort, right? We don't wear for the most part. You're not wearing prescription deodorant for a medical reason. If you're... That does happen, but I'm not saying in most cases for like me, I'm wearing it because

I don't like the feeling of sweat under my armpits. So I wear deodorant. So whatever works for that purpose for you is fine. And that there is no danger to all those other deodorants that contain aluminum that anyone has found at the point. And actually, I think that's fine too if you want to. I don't have any problem with it. I just think it's important to know that we don't have scientific evidence for these claims.

Like, the National Cancer Institute says these deodorants with aluminum have never been shown to cause cancer. I mean, we learn new things every day, but as it stands now, I think this is a little bit of fear mongering and whatever, use whatever deodorant works best for you. Do you have a take on the weird question? Well, I just thought it was interesting to bring up because I lost though. Oh, no, this is entrapment. I didn't write this.

Why do I always burp when my wife is next to me? Okay, whenever I come home or even just go to sit next to her in another room with him maybe five minutes, I'll have burped a few times. Is this a known bug? Nobody I know seems to experience this. It's literally every time, please help me.

It's ruining my makeup gain. That's from casting Gabe. So, and I'm not sure, Gabe, are you the burper? I don't know. I don't know. It doesn't matter. It doesn't matter.

Well, I'm gonna tell you, you do know somebody who has experienced this. You now, you said you don't know anybody else who's experienced it. You do. His name is Justin McAroy. And his wife, Sydney McAroy has experienced this. I feel like you save them.

And not just your burp, your grotesque ones, you save for when you're in proximity to me. This is the doctor. So that I can go. Hi. This is, you're okay. I can answer that. You also don't even attempt to like turn your head

or anything. You sometimes you'll lean towards me. I'll answer this question. Okay, I'll answer this question for you. I'll hide. Dr. Justin here. There's two factors going on here. One is you are probably within proximity of your partner

when you're eating food a lot and drinking. And that is because that's usually a communal time. So you're ingesting more and thereby creating more gas and that is part of the effect, right? Because when you swallow, air gets in there and that can come out in the forms of burps or hiccups or farts or whatever. And I don't know your relationship.

My heart's a whole other thing. I don't know your relationship but I know some people in some relationships, maybe when they burp at all around their partner, it's such a gigantic federal case that you're abundantly aware of it. What I'm saying is there is an observation bias going on here. When you let one of those beautiful boys free on your own, wouldn't even pass your notice. Okay.

Why would you even attempt to note that you just let out a grody burp? But when you're around your partner, you become abundantly aware of every little bit of math gas that escapes your lips. I know, okay, okay. I'm just saying, I'm not gonna be labor this. I don't have a problem with burping in public personally. Personally.

All signs to the contrary. What has always amazed me is that if I am burping in public, I kind of do a little like I turn my head or I kind of almost like I'm gonna sneeze or something like I do a little vampire like to, so that I'm not just burping in everyone's face. I in some way try to like, muffle that process.

And you usually like lean your body forward and announce the burp to the room. Sometimes that's to get it out. Why is this, why am I on trial? Let's talk about the next question. High Sydney and Justin in parentheticals, thank you. On terrorism. Between having older relatives who sometimes

do me an exam room with them to help advocate for remember things and my own chronic health issues and gender-framing care, I've seen a lot of doctors. I noticed that completely separate from bedside manner. They vary a lot and how well they explain things and how willing they are to explain them. They run from ones who struggle to explain why they need multiple incisions for gallbladder surgery

to my family care doctor growing up who loved having a carey kid asking her questions, her diagnosis and medicines. Plus one surgeon who positively beamed when I mentioned I'd take an organic chemistry because that meant he got to probably explain why he couldn't drain an abscess under a local anesthetic. I know that med schools are trying harder to teach bedside manner, but is this a skill they're also trying to instill in future doctors? Even with the short appointments we get, it's been really useful to help me

and family members do a better job of advocating for ourselves, point out issues and ultimately do what we need to do to get or stay healthy, thank you, both Tara. I think it's, I thought this was a really interesting question because we are taught as part of like our clinical skills, because I mean, we have a class that is called clinical, well, at my med school, it's called clinical skills, I don't know, something similar. So the idea of not just knowing the medicine, but also taking care of the patient, that

envelops like bedside manner and then communication skills and all that, that is taught in medical school. That is definitely part of it. In terms of specifically explaining things to patients, we're definitely taught things like don't use medical terminology. You know, like speak their language. We kind of learn this whole other language in medical school. And if I use that to a patient who didn't go to medical school, they may not have any idea what I'm saying. Right. So we're taught that kind of stuff to like use layman's terms and ask, do you have any questions and then do your best to like answer them? But in, but like skill sets in communicating scientific information or like complicated

medical information to somebody who doesn't already have that knowledge base, I would not say is a huge focus, generally speaking in, in the medical world. And that's reflected by the fact that there are a lot of people who are brilliant in their field, but can't tell you anything about it in a way that you'll understand. And I think that's a science problem in general, right? Like, not just medicine. It's all of science where we have this issue. So, I would say the other part of it is probably, it depends on where you trained and culturally

what that area is like. In some areas, you'll find a lot more what we call paternalism in medicine, meaning that your physician may be a lot less likely to explain things to you. And more likely to just say, here's what it is, trust me, this is what you need to do. And might tell you some things to look out for, but they don't really get into specifics

because they're being paternalistic. And there are some patients who want that. I've had patients before who are like, don't, I don't need to know all that. Just tell me what to do. Right. Like me at the macaque. I would say that we are, yes,

I would say that we're moving in a direction where we're urged not to do that. And that's certainly I was trained that way. Don't just say, do this because I'm telling you you need to do it. Explain to them why it matters. Explain like form and alliance with your patient so that you are in this together

and working together on this issue. And the only way to do that is with shared knowledge. But I mean, you're gonna find it different from place to place. And I don't know. I think science, communication in general could be more of an area of focus in all the sciences, right?

I absolutely think so. This question is inspired, they're also working in a broken system that doesn't incentivize them to spending an extra second with you when they could be in another patient's room and make more money. I could get, well, I could get into that too.

Like if I spend more than- Making more money for the hospital, not like for a person. Not in the work I do. I don't get paid for the work I do outpatient now, so I don't have this restriction now, but previously, if I spent more than 15 minutes with my patient explaining things,

I'm losing money for the practice, which is not a concern to me personally. But I could end up reprimanded, fired, whatever. I'm not saying this about my old practice, just generally speaking. This question is inspired by the recent episode about the carpet python parasite, specifically when you talked about washing food

before eating it and the perils of kids eating dirt and sand. Hypothetically, would there be a way to wash or cook dirt or sand? Mm-hmm. Mm-hmm. Mm-hmm. Mm-hmm. Mm-hmm.

Mm-hmm. Mm-hmm. Would there be a way to wash or cook dirt or sand that would kill potential parasites and make it more safe if it gested? I suppose this is more of the cooking questions. Whatever you're not asked. This is from Faith.

Faith wants to know if you could start an after I get clean. So, I mean, yeah, like you could, if you, this is really like a food handler's question, Justin, like you could feel this, like if you theorize that chicken or fish or pork or whatever sort of thing that we cook intentionally to kill any other sort of microorganisms that are in there, including parasites, right? Very specifically, there are cooking recommendations for fish because fish are known to have parasites and other things too.

So there's very specific temperature guidelines, both on the high end of the spectrum, like that, you know, you can get them hot enough to kill all the parasites, and you could freeze them that will kill most known parasites. So yeah, you could do that with sand or dirt. I don't know why you couldn't like boil sand or bake. I don't think you could boil sand with it not being a liquid, but I do understand what you're saying. Well, put it in water and then boil it.

Yeah, that's mud though. Yeah, well, then you'd have to dry it. But you have to dry it out. So then you put it in a food dehydrator. And then there's open air. Like they could get, it could get right in. Or you could bake it. You could bake, say, ooh, bake sand.

Yeah, bake sand. No, they're, oh, you get glass. I mean, if you got an autoclave, that would work too. Yeah. Yes, there would be ways to sterilize dirt or sand so that you could eat it. As a party trick, I guess. And not, and not get a parasite. There are other like, and I am not an expert in this.

We're moving outside of my area of expertise into like all the other stuff that might be in dirt or sand that isn't. Almost certainly metals, tracel, like, like, yeah. Exactly. That isn't a microorganism that are good reasons not to eat Dirt or Sand, but in terms of parasites, yeah, you could cook Dirt or Sand. In school, I learned God-

Please don't eat Sand or Dirt. I'm not gonna encourage this. Even if you cook it, even if you boil it, please don't eat Sand or Dirt. I did learn in school that God made Dirt so Dirt don't hurt. That is what I- You're not in school?

I learned that in school from my colleagues, not from my teacher. Oh, I was gonna say, thank you. Hey West Virginia educational system. Hey Sydney and Justin, I know that I occasionally twitch as a little as I fall asleep.

My wife twitches a lot as she's falling asleep. Usually it's just a small finger arm twitches. Why does this happen? Is it some evolutionary relic that's from Brian in Seattle. Hey, Jess, can I tell you something? Yes, do you? You do this.

Oh, yeah, I know. Yeah, you know. You've told me before. You are never shy about drawing out and diagramming all of my many paling. No, you made me nervous for a while because you were doing it so much. Oh, wow, yeah.

That was why I asked you about it. But we figured that out and everything's fine. Yeah. Hypnic jerk. My brain pills, right? My brain pills. I believe it is a side effect. figured that out and everything's fine. Yeah. Hypnic jerk. Not brain pills, right? My brain pills. I believe it is a side effect. Yes.

I believe that is what we are. But it does not seem to disturb your sleep is what I've noticed. Yeah, I grew up a great sleeper. Well, there are nights where you do that. I know you do because I always fall asleep after you and you still wake up feeling well rested. You tell me. And so it happens.

Sometimes you're still in a quality sleep. I'm like, I'm like, trying to stay awake during a movie, like I'll start getting the twitches in. Yeah, and so they're very common. It's the same as if you've ever said, like you had a sleep start or like that dream of falling off a building sensation kind of thing. Like it doesn't always have to be that clear cut.

You had a dream where something happened and then you jerked and you jerked and you're sleep. Like it doesn't always have to be that clear cut. You had a dream where something happened and then you jerked and you jerked and you're sleep. Like it's not always like that. Because it's just this, you know, involuntary contraction or jerk. So something just moves. It can be smaller or larger. You could have one as you're falling asleep

or you could have multiple some people do. There are certain triggers sometimes, like things like caffeine can trigger them. It's thought that maybe alcohol before sleep could general like sleep deprivation and then try and catch up on that. So like there are some specific things and then some people just have them.

I started drinking and I, that actually helped, I think somewhat, it's hard for me to say because I am sleep, but.'s hard for me to say because I am sleep. But you still have them. Yeah. Yeah. Well, because it always takes me a minute. I might still be looking at TikTok and I'll find a funny TikTok and I'll be like, it's

just and so awake and you'll move and I'll think, oh, he is. And I'll be, I don't know, almost fell for it. That's a hip-knit jerk. Now, you'd think that always stops her from showing me the funny TikTok. But sometimes it just decides, I got to see it right now, man, get up, get up, homie. It's time to go. It's some kind of startle reaction. It may be that your brain thinks

as all your muscles kind of relax as you're falling asleep, it may actually think you're falling. And so it's trying to jerk you back awake for a second. We use, we're our ancestors slept in trees, right? Like it's not wild to think that we would have a little bit of that evolutionary. It's also good to remember folks as some of you think about a lot.

Remember that you're not the evolutionary endpoint. You know, when you're talking about even like a game that's been out for 20 years, they're still patching it, so make you fixes. This is that we're not done as a species. This is something we're now in future generations. I'm sure. If these happened during the daytime, you need to go see somebody about that.

These are associated with falling asleep. If they're happening, like, I just jerk in the day, please go talk to somebody about that. That's not what we're talking about here. Generally speaking, if it's concerning to you or disrupting your sleep, or if your partner is really worried about it, whoever noticed it, go get it checked out. But most of the time, a hypnic jerk while you're falling asleep is not, is not an end in of itself dangerous or indicative of dangerous. Sidney, this is my first time checking the timer since it started wearing.

I know. I was about to tell you. Yes, we've got to go to the billion apartment, then we're going to have to lighten around this guy. That's okay, we can. Let's do it. The medicines, the medicines, the escalates my car before the mouth. The human mind can be tricky. Your mental health can be complex.

Your emotional life can be complicated. So it helps to talk about it. I'm John Moe. Join me each week on my show Depresh Mode with John Mo. It's in-depth conversations about mental health, with writers, musicians, comedians, doctors, and experts, folks like Noah Khan, Sashir Zameda, and Surgeon General DeVec Merti. We talk about depression, anxiety, trauma, imposter syndrome, and perfectionism. We have the kind of conversations

that a lot of folks are hesitant to have themselves. Listen, and you won't feel as alone, and you'll have some laughs, too. Depression mode for maximum fun, at maximumfun.org, or wherever you get your podcasts. Hey, this is KT Weapon, Operation Specialist. I'm here with... Christian Dweñas, Producer, and we're both worker owners here at Maximum Fun. October is National Co-op Month, so we're celebrating our brand new co-op and some others,

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We worked with some of our favorite artists to make them really special. For details on merch, all of our upcoming events like Meetup Day and more, visit MaximumFun.org slash Cooptober. That's COOP, T-O-B-E-R. Happy Cooptober. That's CO, OP, T-O-B-E-R. Happy Co-optober. Hey Dr. Sidney, I got one.

Why does my voice get deeper in the morning? What about the same thing when I'm sick? Also, it's got deeper as I've aged? What's the deal? Love, Paul. Do you know? Well. Specifically, morning voice.? Do you know? Well. Specifically morning voice.

I thought was an interesting question. Morning voice, I would guess. I'd guess a lack of hydration. If I had to guess, I know performers when they want to be at their best voice, drink a lot of water, honey tea, whatever. That's the main thought. Your vocal cords, those two pieces of tissue,

have been still, and then air has been passing over them for some number of hours, we'll have long you slept. And so you need to lubricate them and work them out. It's like it's like stretching a muscle before you run or exercise. If you've been sleeping on night and you jump right out of bed and then go do some sort of strenuous activity, you know, your muscles aren't ready. It's the same thing. Your vocal cords, you just need to lubricate them. They've gotten dried out and then you need to start using them.

And then they start flapping and making sound and the sound gets closer to what it typically sounds like. And then it happens all over again the next morning. I have definitely noticed the voice lowering as I've gotten older though. Even through my 30s, my voice has gotten low. Like if you go back and listen early episodes, it's my voice is much higher. It just has to do with the way those vocal chords, if they've changed over time, if they're thicker than they were, you know, if they're a little drier, a little

moisture, that changes in the moment. But then if they have changed slightly in thickness, changes in the moment, but then if they have changed slightly in thickness, could fluctuating weight change that too? Because I know that that can alter the hormones in your body, right? Different amounts of fat tissue in the body. Oh, I mean, it's not fat tissue, but it's an interesting question. We know that, but I mean, yes, I mean hormonal levels definitely affect. We know that because we can see with hormone administrations, we can see voice change in, you know, pitch. And so definitely hormones can affect it as we age. But like weight loss in the sense of, do they get

bigger or smaller? No, you know what I'm saying? Not that, but like yes, yes, hormonal shifts, whether due to weight or age, or you're taking hormones or whatever, definitely affect the vocal cords. Sickness is probably inflammation, right? It's going to take a vocal cords lower sound. Exactly, or if they're like a little bit inflamed, if they're like, you said inflammation,

but like if they're holding onto fluid, would be the other thing. So we talked about dried out, but like if they're a little bit swollen, that would be a good word for it. Then that would change the tone too. After being on the antidepressant, Venn LaFaxing.

Oh, thank you. That's the effects form. For about 20 years, I weaned myself in a medical supervision, off of it. It took over a month to do it, and during the process, I experienced gaze evoked tonightus. It is freaky. What causes it and what is going on? That's from Mark. I never heard of that before. I had never either. Really? Yes. This is a pretty rare form. So have you, you've experienced

tenidus before? Yes. I said tenidus tenidus. Tenidus. Whatever you want to call it. When what, and can you describe what that is? The ringing of the ears. Yeah, and sometimes people experience it as a buzzing or humming, but like. It can be, it doesn't sound as serious. It can be really bad for some people. It can. The former, the former chief of Texas Roadhouse killed himself because his tenetis was so bad.

Oh my gosh. This is a true story about the former head of Texas Roadhouse. I didn't know that. I didn't know that. I didn't know that. So it is. It can be in terms of quality of life, even if it doesn't, once you've had it evaluated, even if it doesn't mean there's anything like, you know, fatal or serious or terminal

associated with the symptom, your quality of life can be greatly impacted by it. Specifically, gaze of vote, Tinnitus, is when you move your eyes in different directions and it changes how loud the sound is. That would be wildly. Yeah, so specifically, you look off to the periphery and the sound gets louder. Yeah. I bet that's pretty wild for like a day before the novelty wears off and it's just the pits. Yeah. Here was what was interesting. As I was looking into this, I couldn't find a lot of reports of it being associated with antidepressant discontinuation syndrome.

The reason I say that specifically is that you don't withdraw from a lot of these medicines in the way that we think about withdrawal, right? Like there aren't, it's not dangerous for the most part. I'm making generalizations. So we don't call it withdrawal syndrome, but we do call it a discontinuation syndrome because we know that when you stop these medicines,

you can definitely experience some physical and emotional mental, psychological sensations that are unpleasant or uncomfortable, but they are transient. They do go away once it's completely out of your system. Tinnitus was listed as both a side effect of a lot of these medications and part of the discontinuation syndrome.

Gaze evoked Tinnitus was not that I could find. So certainly that can happen, but this must be a rare side effect. And generally, this kind of tinnitus is pretty rare. And usually only associated with a patient who has had a specific kind of tumor removed. So it's not with the tumor itself. There's a specific tumor you can get called an acoustic neuroma or a shwanoma. You were, they looked at you for that when you first experienced tinnitus to make sure

you didn't have it. It's a nerve-sheet tumor, so the nerve-sheet around the nerve grows abnormally. It's typically a benign tumor, but as it gets larger, it can cause symptoms, and so we generally remove them. It's around the auditory nerve, so it's in your brain. After you remove it, what we think is happening because some of the a lot not should say a lot, it's still pretty rare, but people who have had this tumor removed can develop gaze of octenitis. And the thought is that it has to do with as those pathways regrow after surgery as your brain is forming these new little tracks and connections.

rain is forming these new little tracks and connections. There is this cross between movement and like, not necessarily movement, but like your visual area and your auditory area, like the nerves get rewired in the wrong way so that they connect the two, so that when you look in a different direction, you hear something. That's why.

So it's like, yes, things that normally don't connect become connected. So that's usually what it's associated with. So that's what it is. This is a question from Austin, and it's basically Austin was trying to find out on the internet how far to space out ibuprofen and acetaminophen and got a very wide range of answers. And basically, a lot of folks rarely have the time resources to call a nurse line or ask a doctor, so what is Dr. Google?

Feel so dodgy for basic health information. Thank you, Austin. And Austin also wanted to know if there's specific websites I trust or how do I search for stuff. OK, this is tough to give general recommendations for, because you're going to get as many bad answers to any medical question as you will good answers on the internet.

Generally speaking, if they're being put out by a medical facility, if you're looking at information about something from Cleveland Clinic or from Mayo, or in a- Mayo clinic has a lot of these, and a lot of these, like, they, they, they, they, they, they pop up a lot. Yes, they do.

If you're looking, or if you're looking at CDC recommendations, you know, National Institute of Health recommendations, the US Preventive Service Task Force is what gives all like screening recommendations. If you're looking at these organizations, you're looking at evidence-based information that someone has vetted who has medical knowledge and is putting out into the world. So that should be valid information. If you are reading from some popular medicine website blog newsletter, I have no idea,

50-50, could be perfect, could be totally wrong. Could be AI generated. That's becoming more and more common, just AI scraping other articles and tossing together something. So I wouldn't, I would never trust any of that. If you're listening to other people's anecdotal experiences, I'd be very wary of that because an anecdote does not equal evidence. And so it may apply to you or it may not.

And the person may be well-meaning. Not all of this is malicious. Yeah, I mean, there's an aspect of this where a lot of the advice is going to be extremely non-specific because there's a legal ramification of giving you a specific thing that turns out to be incorrect. That's why we always have the disclaimer at the beginning of the R episode.

And we have a doctor on the show, you know what I mean? Like, no one wants to be in that position of saying, like you told me, you told me on your website that I could do this and it hurt me and now I'm suing you. So. Well, we follow evidence that is based on generalized, you know, data that we've gathered from many people

and that we applied then to all of our patients in the clinic room, in the exam room. We're individualizing that treatment plan in the way that works best for that patient. And that is not something that you can answer easily on a website. I would check and see our office, for instance, has a 24 hour on call line where you can talk to one of our doctors. If you have a specific question that you're really concerned about and you can't wait until the next day to call, um. Who man's that? You're out of do that?

Our residents. Oh, nice. So I did as a resident, yes. But you might check into that and see if your primary care office has that. And if you don't have a primary care provider, you should. Would you like to do that? It seems like that would be kind of a fun game. You should get one.

Just hanging out in a room, answering questions for people. Uh, I honestly, it's so hard to answer them in a safe way without being able to, and especially if it's a patient you don't know, because you're answering for the whole practice. You probably need nothing like just coming to the office a lot. A lot of the time it's just triage, either go to the ER now or that sounds like something that you can come in and be seen for in the morning. It's really hard to do that effectively. Uh, hey, all this has been a weird one for me.

I recently had lacic done. I've been using it to eye drops. The weird thing is I can often taste them in the back of my mouth after. It kind of tastes like when you have a hard time swallowing and uncoded pill, bitter and chemical. Why can't I taste something I'm putting on my eyes? If this is normal, I feel like more people should mention it. Thanks, Hadley. It is normal. You can taste eye drops.

Why? Because of something called your nasolacromal duct. It is a duct, so a tube, an empty space that runs from the inside corner of your eye. That's also where tears can be generated. And then there's a tube where they can go back in. Moisture and fluids can go back into this tube and down into your nose. They drain down into the back of your nose, which can then drain down the back of your throat. That's why sometimes if you sneeze bad, it blows at your eye.

It's all connected. You ever had that? I have not. Oh man, it's bad. It's all connected up there. So yes, when you put the drops in, if they drain down that duct, and then especially if you lean your head back, they're going to go right down the back of your throat. You're gonna taste them. Okay. Hi, Sydney and Justin. Recently, I was scrolling Facebook and saw an ad

for lithium supplements. As someone who works closely with folks who have mental illness diagnoses, I know lithium is a treatment for bipolar at major depression. Upon further investigation, the capsules are sold are 1 milligram. I tried to do some research,

and I'm not a doctor assigned as I just had a hard time understanding anything I found. I thought, man, I wish to do could just explain this to me. So yeah, my question, is this one that's a homeopathic remedies slash vitamins that you don't really need, or is there a real benefits to lithium? Thank you.

And this is a supplement, so I'm guessing not like a prescription, like this. You can look at a lithium or a tape is the form that most supplements were in or ORO tape TAT. That is. Yeah, this is like, yeah, like, you just buy it like five bucks at Walmart. Yeah, so that is not the same form of lithium that is prescribed, you know, for, usually

for bipolar disorder is what we're talking about. This is not the same like it is a different complex. It's not lithium carbonate, so it's a lithium orotate. Lithium can be combined with different things to make different salts, and those different forms have been tested since we've known about lithium's ability to manage certain things to, specifically, bipolar disorder for a very long time.

We've known about lithium's psychoactive components since the 1800s, at least. We have tried lots of different chemical forms of lithium. The stuff that you're prescribed is not lithium or a tape. Lithium or a tape has been studied since at least since the 70s. There was like a renewed interest where they tried to say, because of the way this lithium molecule is comprised, we think this would be a better, it would penetrate the blood vein barrier better and you'd have higher concentrations in the brain. Meaning, you could use less of this to get the same result of lithium carbonate.

That was the theory behind it. The studies were really inconclusive. They did one that sort of showed that they did another, and this was in rats. They did another one that also killed the rats kidneys. So then they were like, well, maybe it's more dangerous, which is a known, by the way, all of these things you have to measure levels because there are a lot of known problems with lithium toxicity, meaning like your levels get too high. Are you saying Sydney that the dose makes the poison? I am saying that.

That's what you're saying. Especially with lithium is a great example of the dose makes the poison. Lithium orate does not have evidence behind it to show that it would be better, that it would be more effective, that using lower doses definitely would have the same effect as other forms of lithium, but with less toxicity because you're using lower dose, we have no evidence that conclusively supports any of that at this point, which is why it is sold unregulated as a supplement in extremely low doses that are much lower than we would ever think would be active in your body in any way. So here is what I would say about these supplements.

active in your body in any way. So here is what I would say about these supplements. Best case scenario, they're probably doing nothing. The bioavailability is in question. So like how much of that are you actually absorbing is it getting anywhere in your body at all? Are you basically taking something homeopathic? I mean, there's lithium in there, but like, is it enough to do literally anything?

That's the best case scenario. The worst case scenario is you're taking something that is chronically giving you low dose lithium exposure and we don't know what that's going to do. Or as in one case report I read, you take too many and then you do exhibit symptoms of lithium toxicity, which there was someone hospitalized with signs and symptoms of toxic levels of lithium from taking these over the counter lithium supplements. They're being pushed for things like alcohol use disorder and other any other psychiatric diagnosis, but that was the one thing I kept seeing it pushed for. Like, this is a great way to quit drinking. I would, I would, that makes me very upset. I would say far away from anything that claims to be better

than what we know are evidence-based conventional therapies. Because again, best case scenario, they just don't work, worst case scenario. They're harming you and keeping you from accessing treatments that we have evidence. That one of these are shady. I'm looking at some, most of them just say like 1 milligram, 2 milligrams, this one here says 1,000 micrograms, which sounds bigger, doesn't it?

Sounds real loud. That's a lot of fun. Well, see they're playing on like, that's for me. That's for me. Exactly. And for me, because I took a ton of science classes, I immediately see that. But if you, if you're a specialty area of, you know, knowledge or interest or whatever is something else, you're not going to immediately see the micro and milla and understand why

they're tricking you or how they're tricking you. It's not going to be readily apparent. So this is why I, I would stay away from any of these things and I would go talk to someone who is an expert in this area to help you manage whatever your concern is, whether it's bipolar disorder, alcohol use disorder, another substance use disorder, whatever. Please go talk to a healthcare professional.

Don't take these supplements. Best case scenario, you're wasting your money. Best case. Best case. Hey, thanks so much for listening to our podcast. We hope you've enjoyed it. If you wanna see us live October 13th, we're gonna be at New York City.

It's in conjunction with New York Comic Con, but it is not, you do not require a badge to get there. Sobans will be available for my brother, my brother, me a long night for the J-MAM, but for you, my public, anything. I will also be putting myself through a similar Herculean trial in Philadelphia. Two nights prior, if you want to come see us with my brother, my brother, me in Philadelphia, that's October 11th at the Miller Theater, October 13th at the Javits Center. October 12th, there's gonna be a New York City Taz show the adventure zone. You can take us for all of them,

bit.ly-fords-mackelroy-tour.com. Thanks to the taxpayers for the use of their song, Medicines, as the intro announcer of our program. It thanks to you for listening. We hope you answered all your queries satisfactorily. But until next time, my name's Justin McRoy. I'm Sydney McRoy. And as always, don't drill a hole in your head.

So I don't know why I said we answered. I mean, we don't know. Yeah, it was just me. Alright! Maximum Fun A work-road network of artist-owned shows supported directly by you. supported directly by you.