Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Yes, More Medical Questions Answered!

Episode Date: July 26, 2019

Does medicated chap stick doing anything? What are doctors hiding? Why can't you keep your bones? This week on Sawbones, Dr. Sydnee and Justin bring you answers to these questions and many more on a new Q&A episode! Music: "Medicines" by The Taxpayers

Saubones 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, time is about to books. One, two, one, Saul Bones, Manlterer, M.E bones man to her misguide medicine. I'm your co-host Justin McRoy And I'm Sydney McRoy. Why did you change the intonation and you added the dear friends?

Because I was eating a bowl for a sort of protein bowl with chicken and rice and beans and It was spicy. And it's doing things to my mouth that as a professional broadcaster, I should be above. But as a human being, I'm not. I'm only a man, flesh and bone. You're gonna have to work on that.

Our podcast listening audience enjoys the comfort of repetition, the familiarity. Indeed, indeed. Of the rhythm of your intro. Right there with them. Should I try it again? Just try one they can. Yeah, just try it again. Hello, everybody and welcome to Saul Bones, my idol to Rubin, Miss Guy to Miss. And I'm your co-host Justin McAroy. I'm Sydney McAroy.

That was just for you, wasn't it? I'm just not realizing. That was just for you. I needed that to get in the right headspace. Justin, our listeners have questions. Yes. So many questions. And we have a vacation coming up. So it's just perfect for us. No, we have answers to your question.

You act like these are so easy for me to put together, but here's a little, I'm going to peek behind the curtain for everyone listening. I still, even if I know the answer to your wacky wild weird medical questions, even if I know deep in my heart, I still look them up because I want to make sure, I want to cross reference and double check. And then sometimes these medical questions are more like general science questions

or about the medical industry system stuff that I don't necessarily have at my fingertips. So I do research these, just my point. Well, I'm happy that you do because there's some of my favorite. I always feel like I get a few new wrinkles in the old cerebellum when we do one of these episodes. Well, our listeners have great questions. They really, really thoughtful, interesting. I hadn't necessarily thought about questions

So well, let's get right into it. There's no need for us to waste any more time our first question comes to us from Rebecca Rebecca says I had an osteocondroma on my shoulder for about half my life and Rebecca's wanting to know why She can't get her she can't keep her bones if you get them removed She had the osteocondroma and she was talking about how she was going to keep it as a knick-knack But they said that they Rebecca couldn't take it with her I kept asking for it and parents got to see it in person, but she was a little couldn't take it with her. Kept asking for it.

Parents got to see it in person, but she was a little asleep. She's only seen pictures. Her mom thinks maybe she had to do some tests to make sure it wasn't cancerous. And Rebecca wants to know why she could not keep her bone. So this is a good question. And I think you could take it and generalize it to other things that we remove from your body. Why can't you keep them? And Rebecca mentioned specifically, I've heard of people keeping kidney stones. Why was I not allowed to keep that? And so I had

to look into this because what we generally, what you might hear if you ask your surgeon or one of the other staff in the operating room or whoever does your intake, if you ask somebody, can I keep this piece of bone, this my appendix, my gallbladder, whatever, they'll probably tell you you're not allowed. Why? Well, that might not be true. So some hospitals do have policies that are probably rolled into, you know, when you sign a permission to treat form at a hospital, you're signing, you're agreeing to a lot of things.

And among them, it might have in there if we remove anything from your body, you're not allowed to keep it. And it's just a hospital policy, probably one for ease of, if you're going to give something to somebody back, one, if you do need to do tests on it, if you need to do pathology, if you need to check and see if something's cancer, as Rebecca mentioned, you do need to take it to the pathology lab first and do those studies. And then you're going to have to try to get through the logistics of making sure that if there were any concerns for infectious disease or whatever, that it's not that, that it's all fine and safe to give back to someone. And there's a lot of logistics time, money, and doing that, and a lot of hospitals just don't want to mess with it. And they don't want to be liable if they don't do it right. It's an organizational pain in the butt.

In some cases, there's a practicality. Sometimes when they remove certain things from your body, they actually have to kind of crush them or destroy them as they remove them for ease of removal so you can do like a smaller surgical site, something like that. Like the brains of the ancient Egyptian pharaohs. Yes, yes, that's actually a good.

Scramble up with a rod and pulled out the nose. So we don't necessarily do that with your brain. Good, which is good. For broadcasting. But for other things that might happen, and so in that case, you can't have it back because it was destroyed in the removal process. Sometimes they do need the entire thing to do testing on.

If it's a very small piece of tissue or something, they might need the whole thing. But there are other times where they just tell you, no, because, and honestly, as a physician, I can back this up. We don't know how that would work. I don't know. I put it in a jar and hand it off to someone else

who takes it to the other person who looks at it under microscope. I'm not really sure what happens after that. You might just be asking the wrong person and you need somebody who's more in an administrative role to answer. The problem is, if you as a layman myself, if you have to ask more than one person for your kneecap,

you start to look like someone with a problem. If you say casually, like, hey, I like my kneecap after you remove it, and they say, I don't know, and you're like, get me the person I need to talk to to take this kneecap home today. If you do that, and it is not, now again, if it's an internal hospital policy,

it is what it is. But if there is a one, which a lot, well, I mean, people have done this. I read a lot of stories of people who have kept, the story I was reading was a young person who kept their foot that had to be removed and carried it around with them. I get that.

And you can do that, because there shouldn't be any reason that a removed piece of a human is any more dangerous from like a biohazard standpoint than any other sort of, I don't know. Gross thing that you'd cut off. That we have in our house or anything like that. It's me. I mean, as long as there wasn't some sort of an incredibly infectious disease process,

if we just removed it. There shouldn't be a problem as what I'm saying. And it can be preserved appropriately. So you may be able to keep it. It's worth asking if your doctor doesn't know, don't give them a hard time. We probably don't know. But you might just need to ask somebody in an administration about it. And if there's not a policy, now there is some legislation because some will tell you

it's illegal. That's not a policy, now there is some legislation, because some will tell you it's illegal. That's not entirely true again. Now there is something called the Native American Graves Protection and Repatriation Act, which makes it illegal to own or trade any remains of someone who's Native American. And so that's actually, that is one legal issue. And then there are a few states, Louisiana, Georgia, Missouri, they have specific bands on owning human body parts. And that includes your own.

So if you're in those states, it may be a little more of an issue, but. Fair enough. This next one is from MP who asks, what's your hot take on asexuality and medical stuff? For example, sometimes a quote low libido has been listed as something that might raise concern. I am asexual, so I straight up have no libido.

Or when I get a pap smear, my body super rejects things going up my down there. It stings and burns, probably more than it should, but I can use tampons just fine. Online asexuality forms tell me this is a common for asexual vagina havers, but a lot of doctors don't seem to register that asexuality is a thing so I don't bring that up. Do you all learn about that and is there any research on the relationship between asexuality and quote unusual symptoms? It's from MP. I think this is a good question because it draws some some important distinctions that I would say at least when I went through medical school, which

is not that long ago still getting longer and longer ago, these weren't we weren't trained in any way about asexuality. But I'm not saying that my medical school curriculum is necessarily indicative of every medical school in the country. But I know that a focus on all types of diversity is a big movement within American medical schools today. Because it has not been any kind of diversity that you can discuss has not been a focus previously. And I know that there are many medical schools who have made very intentional efforts to try to change that. So the curriculum at my very school

may be better than that today. But it is something that physicians you see who maybe even aren't that much older are still not necessarily in the know. So I'd say that you're probably right that sometimes doctors aren't quite certain what you're talking about. They may not be educated on this. And it's hard because I don't want to say that it should not be on the patient to do the emotional labor of explaining that. It should be on RN to do better.

And there are more and more, I have a whole collection of explaining that. It should be on RN to do better. And there are more and more, I have a whole collection of journal articles. There are more and more journal articles being published on these kinds of issues. But all that aside, if you see low libido as something that is like a diagnostic term or a complaint in a medical chart, that is almost certainly coming from the patient themselves. The patient was complaining about a low libido or low sex drive. that is almost certainly coming from the patient themselves. The patient was complaining about a low libido or low sex drive.

Yes, exactly. If a patient comes in and says, I am concerned because I did have a higher libido and now I don't and I am, my life is, I personally have less of a quality of life because of this and I want you to address it, tell me diagnostically what happened and how do I, you know, treat it, how do I fix it?

If they come in and say, I have no sex drive, but that is the way I do it. I'm still crushing it 24-7. That's just who I am. That's just how I roll. That's not going to be a medical complaint. No, no, and I can't see any physician ever pushing past that. I don't, I personally wouldn't, I mean, that's not something I would go digging for unless it was specifically relevant to whatever the medical complaint is, whatever the patient

has brought to me to address that day. And if a patient asks me, I am concerned, I did have a libido, I don't now, can you help me address it? Of course, and I will put that in the chart, you know, I mean, I, there's probably a code for a libido, I don't now. Can you help me address it? Of course, and I will put that in the chart. You know, I mean, there's probably a code for low libido. But if it's not, if it's who you are, if you don't have sex drive and it's you, then that's not a problem.

There's no pathology there, just like with asexuality in general. It's not a pathology. It's just a way a person is, just like heterosexuality or, you know, whatever LGBTQ everybody who's not straight, that's just a way people are. So there would be no pathology. So you shouldn't have a doctor trying to address that or trying to change that or treat that in any way. And I think that it involves a lot of open conversations with doctors and on our end, a lot more focus on that kind of education in medical school definitely needs to be done.

Because in terms of your question about research, not that I'm aware of and we certainly aren't teaching enough about these things in medical school. Here's one from Emily from a very young age. I had problems with my feet. I'd been constant pain and it'd get so bad that I couldn't walk. Finally at 13, I went to an orthopedic surgeon instead of the podiatrist that I had been seeing since I was five. The surgeon told me I had an extra bone in each foot

and the left extra bone was pinching a nerve. It was removed, but I still have the right extra bone. Is having extra bones common? I'm curious as to why the poditris never noticed extra bones in my X-rays, but the surgeon saw it right away. So I had to actually look up how common it is. I know that having an extra bone here and there, having an accessory bone is what we would probably call it.

An accessory, it's an accessory. Sure, casual, fun, cookie bone. It's an extra little, it's like an earring. For all seasons. But a bone. It's not as uncommon as I would have, I know that that happens. I've seen it incidentally on X-rays. And most of the time people wouldn't know because most of the time they don't cause you problems.

Obviously they can. Most of the time they don't. And so you wouldn't know unless you just haven't get an X-ray and say, hey, look, that's there. I'm guessing the podiatrist just didn't notice because it was on both sides and maybe it didn't click right away. I'm not going to slam this podiatrist. Who knows? You know, I would say it is not- Like one of those two spot the differences. Puzzles, you know what I mean? Yeah. They just looked and they both looked the same. It looked the same to me. I look the same.

The fan has four blades. The cat is gray with a bushy tail. It looks the same. I would never suggest that there is anything intrinsic to the training of an orthopedic surgeon versus a podiatrist that would make one better that spotting that than the other. I'm glad your surgeon did, though.

The most common, extra bone that you're gonna to have in your foot, if you have one, is an accessory-nevicular bone, which is what I wonder. It's just one of the bones in your feet. It can occur anywhere from 2 to 20 percent of the general population. Obviously, we have no idea. We don't know. In a lot of people, this can happen. It's not nearly as uncommon as you would think.

There is pain that can be associated with it. Most of the time, it isn't. But if it is pushing on other structures that cause pain, then they call that accessory and a vicular syndrome. We're so creative. I love it. In medicine. Then you can have things, you can need things like perhaps surgery, but sometimes just

things like a cast or a boot or ice or physical therapy or some sort of orthotic device, all those kinds of things. But it is not nearly as uncommon as you would think. I'm glad you're, I'm glad your surgeon found it. I hope you got to keep it. Well, I guess it depends. That's an extra weird thing. It's got, you can name it whatever you want at. Well, I guess it depends. It's an extra weird thing that makes God, you can name it whatever you want at that point,

name it after yourself. You only want one with that bone. It could, maybe it's an actual accessory then, making it into a necklace or. Here's one from Aiden. If two people who develop an immunity to a disease, like chickenpox, have a child, how come the child can still get the disease?

This is a good question. It reminds me of my favorite joke from my brother, my brother and me, because it wasn't my joke, so I wanted to say it. Elizabeth Gilbert told us that if you feed poison ivy to a goat and then drink the milk, the development of immunity to poison ivy, and Travis said that if you feed a goat,

your passport and you drink the milk, you, poison ivy. And Travis said that if you feed a goat, your passport, any drink the milk, you'll get diplomatic immunity. That's a good one. I always like that. That's a good job, Travis. I do mind you. So unfortunately, this is not the case that you will be immune if you are born to two people

who are immune to chickenpox. In terms of the person who has the sperm in the equation, whether or not their immune really doesn't factor into it. So that won't, this just not. You're not going to carry what provides immunity or antibodies, and the sperm's not going to carry those antibodies. So that kind of is irrelevant. Now the person who actually carries the pregnancy,

if they have antibodies to chickenpox, some of those antibodies are going to cross the placenta. There are a lot of different antibodies that cross the placenta and can provide some transient immunity to the newborn baby. Do I have this right that like, I'm probably mischaracterizing this, but is the sperm basically bringing information? DNA. DNA. And the egg is really like the...

In the beginning, it's just DNA, but then all that DNA programs, all kinds of stuff to happen. Okay. In the beginning, it's just a bunch of information. So why can the... I guess, is it because the, it's growing inside. Okay, I got it.

The person who carries the pregnancy has antibodies in their bloodstream that will cross the placenta while the fetus is developing. Okay, I got it. So it's the location. It's not the, it's not the egg or the sperm. It's the location.

It's not the location location location. It's not the house, it's a neighborhood. And the neighborhood in this sense, the pregnant person is the one who can their antibodies to whatever they are immune to can cross the placenta and provide immunity for a while. This is called passive immunity, meaning that the baby's body is not making antibodies. It just got some, right? This somewhere just kind of handed over to it. And those only last so long. And if you're not making new ones, then at some point that immunity wears off.

And it's usually after just a few weeks, those antibodies are gone. And then you are susceptible to whatever diseases again. There's some more passive immunity that occurs from breastfeeding. You can pass antibodies through breast milk to the baby. But again, this is not permanent. The only way that this baby will be protected against chickenpox or whatever infectious disease you're talking about is by making sure that they are immunized according to the CDC childhood immunization schedule on time, other immunizations.

I mainly like this question, Aiden, because you gave me an opportunity to talk about this again. Well, get your vaccines. Now, you use your bully pulpit. We can move on to the real reason that we're all here. The billing department. Making money. Exactly.

Let's go. The medicines, the medicines that ask you make my car before the mouth. Okay, Sidster. Who do we have next here? Grace. Hi, Dr. Sidney and Justin. It didn't say doctors. Well, it's a typo. Hi, Dr. Sidney and Justin.

My friend recommended you to podcast me a few months ago, and I've loved working through the archive ever since. Thanks. Yesterday, my roommate made a comment that's so interesting and lightning that doctors don't actually let their friends and family follow the medical advice they give out to their patients. It's worth noting she's obviously anti-vax,

doesn't believe in mammograms, et cetera. She believes that doctors give different advice to loved ones, but they do it on the download, if they are really to advise their patients what they actually want to say, they'll be fired, lose their medical license, et cetera. I know there was a family practice doctor who was a friend of the family growing up that fed these ideas. She really feels like she can't trust the entire medical field because doctors are in the pocket of being silenced by the government slash big pharma. There's no way to argue with her. in the pocket of being silenced by the government slash big farmer, there's no way to argue with her.

So I, okay, first of all, there is a question here, just like, is there any basis to this, basically. Right. I think it's worth addressing this because, well, first of all, man, as a fellow family practice physician, it makes me so sad to think that someone in my beloved field said these ideas. Bad example. I, there is, there is no basis to the idea that doctors have secret clubs where we get together and like share all the real stuff and then so that we can make sure and tell each other and tell our families

and tell our friends and then tell our patients something different. There is no truth to that, which I think most people would probably expect. And there is no pressure from, I mean, for many, certainly administrative pressures on cost-control and things can occur in different medical institutions. But at the end of the day, if other doctors are like the doctors in my department, we kind of feel like we should get to do what we want because we went to medical school and whatever the costs are for the company, that's not our problem. Our job is to take care of people. That tends to be the struggle most of the time, Justin can attest to me. There was a secret thing that Sydney could tell patients that would be good for them and would irritate her superiors.

She would do it every single day, all day, every day. You would hear it from everybody. And I and not maybe perhaps not all physicians are chaotic good, but but I think a lot of us are. So I think we we took most of us, you can't speak for oppositions. Most of us take very seriously't speak for oppositions, most of us take very seriously the oath that we took, the promise we made, and we wanna be right.

We wanna give people right information. We also can be a little arrogant and we like to get it right. And that means giving you the right answers so that you can feel better and come back and say, I feel so much better. You were right, that was great advice. Thank you.

That is our goal for the majority. But I think it's worth noting that while there is not an actual basis for the idea that doctors intentionally give you bad advice, we have a long history in medicine of all members of the medical community, not just physicians, everybody, physicians included, taking advantage of people who have less power, of minority populations, of anyone who is not able to necessarily have access to the information for themselves, or to speak up for themselves, have the, you know, judicial power, have the systemic power, there are plenty of examples throughout medical history of those people being taken advantage of

and of being experimented on and used in the system. And so if you say is there a historical basis for it, there are lots of examples. We do a whole podcast about it in medical history of times when vulnerable populations were mistreated by the medical establishment. So I can understand why some people approach medicine and the whole system with trepidation. That is, I think that that is something that

we as medical professionals could be better about understanding, having some sympathy and empathy for and trying to work through with our patients, as opposed to just saying, well, that's not true. Right. You know, now, again, it isn't true now. I mean, this is not the way things work, but if people are still nervous and a little concerned, I think that a conversation between them and the people they've trusted with their care, we should all be open to.

The doctor included. There you go. That's what you would say. Thank you, Justin. Thanks for just undermining my entire argument. That was, by the way, that's the internet. We just, that's Twitter right there. Here's my well-reasoned thoughtful response,

and then here's the tweet that undoes it all. I will say also that these doubts are going to persist until medicine is removed from an inherently immoral capitalist system. It's not going to live in. That's true, that's true. If we were in a more single payer system, it would be a lot easier.

It would be a lot more transparent. Mike says, my doctor can not answer this question when asked, and I wanted to reach out to you since you've been such a great communicator on the subject. My sister refuses to vaccinate a child, my children are older, and we kept them away from her family at a great and emotional cost. My wife is about to have our third child, and we're worried about my mother acting as a carrier between Families because the mother often babysits my sister's child and she's our kid shortly after when I asked my mother not to visit This in the hospital or until the new baby is had her its vaccines She wanted to know when it would be safe when I thought most kids have a majority of vaccines by age two But I know there's more to it than that

most kids have a majority of vaccines by age two, but I know there's more to it than that. What age is relatively safe for a vaccine child to be around someone who is frequently near unvaccinated one? Am I being overprotective? Now, I would imagine that if the mom has had her vaccines, like, that's not, I mean, we're not really worried about like skin transference or like closed transference, right? With this stuff? No, I mean, we're not really worried about skin transferants or like closed transferants, right? With this stuff? No, I mean, I'm not saying that that is completely impossible, depending on what infectious illness we're talking about. But I think what the big concern would be is if the mom

got something and then gave it, which if your mom's been vaccinated against all these things or had them, I don't know how old she is, depending on when she was a kid and what vaccines we had. If she either had the diseases or has been vaccinated in theory, that should be protective. It's tough that this is such, I'm sorry that you're in the situation because this is a tough situation. And this question I have seen come up many times in various forums. So your kids are protected against the majority of childhood diseases. I would say, I wouldn't say too, I would say by the age of five probably.

With that last set of, if you think about, if you're a parent, you know, your kids get a lot of vaccines early on and there are several times you go, and they get like five or six at once. The last big chunk of those is between the ages of four and six, and it's what a lot of people think of as the kindergarten shots, the shots you have to get. And it's your last set of boosters, but for a wide variety of childhood diseases.

And once you get those, you should be protected against those. Up until then, you're getting shots and you're getting boosters and you do have immunity to them. But it's hard as a doctor and as a scientist for me to say that at any given point, your child is 100% protected. If they haven't finished out their entire series of boosters, otherwise we wouldn't do the boosters, right? That's why we do them. That being said, even after the childhood vaccines are done after age five, we give another booster for tetanus, diphtherium, pertussis later. We give another booster, form an angitis later. The HPV, not that that's a concern in this case, but there are vaccines that come later

that HPV, not that that's a concern in this case, but there are vaccines that come later that you're not getting yet. So it's hard until everyone's vaccinated, they're not protected completely. I would say that the majority of childhood vaccines are done until five would be, if you want a more concrete answer, that's probably it. I would say if your mom's been vaccinated

and the kids that your sister's kids aren't sick, then you're probably safe most of the time. But if your sister's kids get sick and they're not sure what it is since they are now vulnerable and I feel for those children because they're vulnerable since they're not getting any of their childhood vaccines. If they get sick in any way, one, I hope they see a doctor very soon to be evaluated to make sure it's not one of those diseases and two I would keep everybody away From the new baby and your kids in general until you figure out what they have but I'm sorry my I'm sorry

You're in that situation. That's a rough one me too From Joe I hope you can help me understand what seems like a series oversight the scientific study of medicine and how scientific data is used by insurance companies in America I'm a type one diabetic and I've been using Humilog 100 for about 10 years. This is a type of insulin. Okay. Can you condense this question now for me because there are several paragraphs of it. The important point that I know, the important point that Joe wants to know is they were well controlled on Humilog and then their insurance company this month chose to stop covering

hemolog and has required all patients to switch to novalog under the basis that these are scientifically equivalent. And they are wandering. Why is there such a huge oversight in scientific studies? What can we do collectively to get the government to regulate insurance companies? So they cannot force patients into dangerous medical situations by requiring medication switches without first funding studies on the effect of switches. So specifically, the question is about, why do we make patients switch?

And if we are making them switch, have we done a study on the front end to say that not only are humolog and novalogue equivalent just because these are the two drugs being used in this case, but switching from one to the other won't affect anything. If you're well controlled on one, we can switch it to the other and you'll be just as well controlled on the other, because the active switching is actually part of the problem, right? It's not just, you know, in a lab or the two equivalent, the switching itself is part of the problem.

And part of this has to go to what a formulary is, like why does your insurance company have a formulary? Why do they only pay for certain drugs? Why did they switch from hemologenovac? Cheaper. So generally speaking, when they make a switch, it's a money thing. They have inherently immoral capitalist system. The insurance companies have pharmacy and therapeutics committees, which is a panel of doctors, nurses,

pharmacists, and other clinical experts who sit down and decide what are the drugs we should cover. And they set those tiers, you know, your insurance company probably has like a first tier and a second tier and a third tier and all that stuff. And what your copays are for them, they set all that. Now it's to the exact cost, they don't do that part. But they set what drugs are on the different ones. And if anything is equivalent, then they may replace it with something else, right?

Because a lot of classes have more than one drug in that class that does the same thing. The problem is that if you've got a company that makes humilog and a company that makes no vlog, the two of them are indirect competition because this is capitalism. So one's gonna try to undercut the other one with better pricing to get the deal

with the insurance company to get on their formulary. And they can do that at any time, which can have you switch. Medications halfway through the year, it switches every year, every year, they redo the formulary. And you might say the same, your drugs might say the same, or they might have changed, they'd always do that once a year. But in a lot of states, you can change it in any time. Now, there has been legislation in more recent years

to try to stop this process, to try to at least pin insurance companies down so that they can't switch formulary mid-year. But even if you did that, they could still reevaluate their formularies once a year. And as a physician, I can tell you, January is always a disaster.

It's always with proton pump inhibitors, PPI's medicines like Nexium, Prevacid, all that Dexolent. Every formula changes on everyone, every January. I have no idea why. Money, I know why it's money. Money, money, and here. As money is the problem. But as long as there's all these behind the scene, monetary deals being made, I don't think anybody's's gonna fund any studies on this other stuff because they can they can switch and whenever they want to get the best deal and they'll tell you that they're doing it to get you the consumer the best deal. Because you know how good companies are passing those savings on to you.

But the concern is well in a lab these two drugs were proven to be equivalent, so fine, we'll just switch between them. And you know, studies and things that we observe in vitro and the way something reacts across the whole population doesn't always reflect how it does person to person and what your personal experience might be. So what I would say is, one, on a small level, you can lobby your elected officials to prevent insurance companies from switching

formularies mid-year, but on a larger level, we need to completely redo the entire American healthcare system. So either one, whatever you guys have time for this afternoon, you want to do either one of those things would be great. Chris wants to know, this is going to be a final question I believe. Yes. Is there any benefit to Medicaid to lip balm or does it basically do the same thing as the regular con? This is one of those questions that we sometimes encounter where like just by seeing, just

by asking the question, I already know the answer. Like, because I took a half second to think about it, like I feel like I already know how this is gonna go. So first of all, I had to, Chris, I'm so glad to, well, I both thrilled that you asked this question because I've learned new things and also dismayed because I don't really like the things I've learned.

When you asked about medicated lip balm, first of all, I had to look up that, what do they mean when they say medicated? Because- I said say bitthal. So yes, most of the time, from what I can tell, if a chapstick, I shouldn't say chapstick,

that's a brand, if some sort of lip balm, you're gonna come after us. Chapstick or otherwise, says medicated, they're probably talking about including menthol or camper or something that makes your lips tingly when you use it. That is typically what medicated means. There are other things you can put on your lips that actually have medicine in them, like things for cold sores and stuff like that, but that is not what medicated, that is not the way I'm taking this question to mean, medicated lip balm. I think we just mean like,

Chapstick versus Medicated Chapstick, right? Got it. Yes. Now, that tingly sensation doesn't actually do anything for you. A lot of people enjoy it, but it doesn't. They master it. but it doesn't. They nasty. But it's not helping you in any medical sense. And we've talked about this before with stuff

like anything that's mentholated, right? Stuff you put on your skin or like inhale. Like it can make you feel like you're breathing better. Yeah. But it's not, it's just, it's insane. It's a bit bad. The thing about your lips is that you have a barrier on all your skin, your lips included, called the stratum corneum, and it stops moisture

from leaving your skin and evaporating out into the environment, right? Well, during the summer or during the winter, when the air is dry, you can lose moisture more readily. And so a lot of people like to use something like a lip balm, some sort of protective coat that will prevent, that's all it does. It just coats your lips to try to prevent them from losing moisture so quickly, right? And there are times, like I said,

like in extreme cold conditions, or when it's really dry or whatever, when this could be helpful. Yeah. You know, the problem is that, and people have actually accused these products of being addictive for this reason. It's not addictive. It's not in the sense that like when you talk about an addiction, you don't become physically

dependent on lip balm. Your right isn't working differently because of the introduction of lip balm. No, and you don't go through withdrawal symptoms if you stop using it. It's not that kind of thing. But what can happen is that because of some of these ingredients, specifically the menthol and the camphor and things like that, a lot of people tend to react to that with a little bit of irritation and dermatitis. So what you might interpret as,

oh, my lips are starting to itch and feel irritated, I must need more of this medicated lip balm is actually the effect of the medicated lip balm on your lips. Well, we actually see it similar. If I remember correctly, see all the similar phenomena with, like, anacids. Yes, with things like thoms or role aids or things that can, in over time, trigger more acid production, even though they can reduce your symptoms initially. So, and this is not for everybody, we don't know.

I mean, they've estimated like 10 to 15% of people are gonna have this reaction, it could be more, could be less. But it may be that every time you use your medicated lip balm and then a few hours later, you go, ooh, my lips feel itchy, I need more of it. It's really the lip balm itself that's causing the problem. And if you just go cold turkey, stop using it and wait, your lips will heal, and then you'll find you didn't need it to begin with.

And this is this is blown my mind as somebody who walks around with a tube of some sort of lip balm in my pocket literally 24 seven. I have one by my bed when I sleep at night. Again, I'm not addicted. That's what you say. You're like scratching your arm for a rolling. I want to use some. Talking about it makes me want to put some on my lips, but. You are addicted. I'm not. No, well, I mean, and obviously there's more to addiction than just the physical addiction.

There's psychological dependence as well. But it also smells really good. I have to face it, Joe, addicted to bone. The one I'm using, you got me, it smells like coconut. I love it. I feed your addiction. I don't know. I'm not addicted. I'm not addicted. I'm not addicted. But the point it also had a face at your addicted to the bomb. The one I'm using, you got me, it smells like coconut.

I love it. I feed your addiction. Oh, man, I'm your dealer. Got any champs to this is not me. This is not me railing against, by the way, lip balm. I think if you don't use the medicated ones, then it's probably just like, I mean, go go for it, you know, I mean, I don't think there's any reason to be concerned.

But if you're using medicated lip balms and you find that your lips feel itchy and irritated a lot, you might want to try and experiment. Don't use it for a few days and see if you actually feel better without it. It'll be a tough couple days. You're not withdrawing, but because your lips will feel kind of dry and itchy. But then they might be better. So there's your man, my mind exploded for this information. Folks, that's going to do it for us this week on solbos. We hope you've

enjoyed yourself. Thanks to the taxpayers for the use of some medicines as the intro and outro program. Thanks to Max Fund Network for having us as a part of their extended podcasting family. And thanks to you at home for listening to our podcast. We hope you enjoyed it. And if you have questions like this, I guess you can always send them to�bones at maximumfund.org. Yeah, please just title it something like medical question, weird medical questions, something like that in your email, because I search for these, I save them up. So even if I didn't answer them this time, I save up your questions and

try to get to them whenever we do one of these. So perfect. Folks, that's going to do for us this week. So until next time, my name is Justin McAroy. I'm Sydney McAroy. And it's always don't drill a hole in your head. Alright!