Weird Medicine: The Podcast - 315 - Vitamins and Heart Disease

Episode Date: June 6, 2018

Dr Steve and crew discuss a new study on vitamin supplementation, why adrenalin is a vasoconstrictor, breast micro calcifications on mammogram, compounding medication, and doctor shopping. STUFF.DOCTORSTEVE.COM simplyherbals.net Learn more about your ad choices. Visit podcastchoices.com/adchoices

Why did the baby chick cross the road? To meet up with her peeps. When do lazy horses refuse to run? Whenever they can, tear. What do you call two ponies on a pudding green? A horse and a horse on a golf course, of course. You're listening to Rured Medicine with Dr. Steve on the Riotcast Network, Riotcast.com. We're missing contains mature contents that may be offended to some listeners.

Let me wrong. What did they wrong in? You know, your house is like another. It won't go down. It won't go down. My boner, my boner, my boner, my boner, my boner, my boner, it won't go down. It won't go down. It won't go down.

country boner who won't go down. Hey, this is Trash. Lead singer of Vertical Small with this week's PSA. Even though Dr. Steve and his friends are smart motherfuckers, they are not your personal doctor. Do not take anything that you hear on this radio show serious. If you're having help issues, go see your own family practitioners. And always remember, fuck P.A. John.

I've got diphtheriae, crushing my esophagus. I've got subalibovies stripping from my nose. I've got the leprosy of the heart valve, exacerbating my incredible woes. I want to take my brain out. I'm clasped with the wave, an ultrasonic, ecographic, and a pulsating shave. I want a magic pill. All my ailments, the health equivalent of citizens. cane. And if I don't get

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your medical providers. Take everything here with a grain of salt. Don't act on anything you hear on this show without talking it over with your doctor, nurse practitioner, physician assistant, pharmacist, chiropractor, acupuncturist, yoga master, physical therapist or whatever. Okay, very good. All right. So, Cliff, welcome. It's been a while since you've been on the podcast.

Yes, it's been a long time. But regular listeners who have good memories will remember Cliff as one of the finalists in the funniest person in the Tri-Cities competition. And he's one of those discoveries we've made that if he went to New York and started doing shit gigs for the next five years, which is really what it takes, at least, he could probably be actually a successful comedian. Instead, he decided to go to school and get his degree, which is a stupid move for a comedian. Talk to Dave Landau. But anyway, but it's great to have you here. You're going to be doing an internship until, what, mid-July, something like that. Something like that.

Yeah, okay, cool. Cliff is going to be doing a couple of best-ofs for air on Sirius XM, and we may get them to do one for, you know, just, sort of a retrospective for the podcast as well. And if you're interested in doing your own retrospective, you can go to premium. dot,doctrsteve.com. That's

premium.com for a buck 99. A month, you can get access to all of the archives, including some premium content that regular podcast listeners haven't heard. And part of that is the funniest person in the Tri-Cities competition, the whole thing from start to finish

with Shulie Agar's stand-up and the competition itself. I can't remember if I included the musical guest as well, but that's all in there at premium.com. You could go there, just download everything and then cancel your subscription cost you two bucks. We're not really doing that to make money. We're doing that to keep my employers

from being able to dig too deep into my archives. Unless they want to pay. If they want to pay, then they can, but that it's behind a paywall. If you've heard of a product mentioned on our show, or if you just need to go shop at Amazon, go to stuff. Dottersteve.com. That's stuff. Dot, Dr. Steve.com.

We're part of their affiliate program, and there's just a click through right at the top. If you want to just use it as your intermediate to get to Amazon, it really makes a huge difference. And it allows, ultimately, allows me to pay some of the folks up pittance. The interns. You know, we pay a pittance. It's a, no shit, it's a pittance, but it's better than what you're going to get if you're on Big Kev's geek stuff. I'm guessing he doesn't pay his people. I'm guessing.

I don't know. Big Kev's a good guy. Maybe he is. But anyway, and go to tweakeda.com. Use offer code fluid and get one third, aka 33% off your order of the best earbuds on the internet for the price and the best customer service anywhere. and they are a Tennessee business. We should do a road trip and go see them and maybe do a podcast from there

because they're in Franklin, Tennessee, which I guess is just outside Nashville. It's awesome. No, I've got family and friends live there. Let's go. It's a great town. We should do that sometime. It's a great town.

And check out ETNComedy.com. Cliff, you'll be happy to know. As a matter of fact, you know what? I may be able to put you on that show. August 2nd. We're having Vic Henley of the Blue Collar Comedy Tour is going to do a thing at Allendale Mansion. They have a 1,200-seat amphitheater. We've got to fill it up.

And last time we had Tim Dillon. They had twice as many people as they've ever had for that, but it still looked empty because the amphitheater is so huge. So if you have less than about 600 people come, it's going to look like nobody showed up, even though, you know, it's a browsing success as far as they're concerned. If you want more information, go to et ncom.com. It's free. They'll have craft beer. That's not free.

And they'll have food trucks, also not free. But we'll have one or two local comedians do, you know, five minutes or something. And then Vic will do an hour. Cool. And it'll really be fun. So, yeah, definitely come to that. Go to E.T.N., like, East Tennessee Comedy.com. and don't forget Dr. Scott's website at simplyerbils.net.

Simplyerbils.net sounds like simplyherballs.net, but spelled slightly differently. And, you know, if you ever tried to go to simplyherballs.net, see if anybody owns that? No. Because what would be hilarious is, you know, it used to be when Dick's sporting goods came out, if you went to dicks.com, it was not Dick's Sporting Goods. And I think probably they, I think now they actually own that domain, but for a while there, it was just exactly what you would think, dicks.com would be. So it's a wild marketing strategy. Yeah, absolutely.

So before we take phone calls, we've got some people waiting and I don't want to make them wait too long. There was an article that came out recently, and we've talked about this multiple times on the show. but this is a pretty important science. It was a study done in the Journal of the American College of Cardiology. And the title of this, this is an article from Science Daily, which is a decent website for science news. Most popular vitamin mineral supplements provide no health benefit study finds. So we've had discussions on this show.

People call me up, vitamin D, vitamin D, vitamin D, vitamin D. I have always said vitamin D, there's no downside to it unless you can get hypervitaminosis D if you take too much, but it's hard to do. But taking a normal daily supplement of vitamin D because so many people are vitamin D deficient. But, and vitamin D deficiency is associated with cardiovascular disease. It's associated with cancer, stroke, other disease states. So the question was, so if. Having low vitamin D is associated with these disease states, is that a cause or a marker of disease, right? So if it's a cause of disease, then correcting that should make it better, okay, or should decrease that risk.

And if it's a marker of disease, you know, for example, your vitamin D goes low because you have total body inflammation, which is the ultimate cause of your cardiovascular disease. You know, I'm just hypothesizing, throwing out some crazy hypothesis, then supplementing that vitamin D won't do anything because it's not the cause. It's just a red, it's a flag that says we've got a problem, but it's not the ultimate cause. That makes sense? Yes. Okay. So, and that's the question.

And I've always been on the side of, if you want to take it, take it. Because we are vitamin D deficient for the most part because we're not getting outside and getting enough sunlight. but don't assume that that's going to prevent heart attack or stroke. But there's no downside to it. So what the hell? And it's cheap. You know, a bottle of vitamin D, you know, five, ten bucks. So anyway, let me just read some excerpts from this article.

The most commonly consumed vitamin, mineral supplements provide no consistent health benefit or harm, suggests a new study led by researchers at St. Michael's Hospital at the University of Toronto. Okay, so it's a Canadian study, so we've got to, you know, take it with a grain of ramp salt. No, I'm just kidding. It's a very prestigious organization. And the Journal of the American College of Cardiology is no shit journal. Okay. So they did a systematic review.

So what is that? A systematic review is where you take a bunch of smaller studies and try to match them for quality, and then you mush the data together. This isn't the perfect way to do a study by any means, because, you know, each one of those studies could have a little bit of bias. If they're all got a little bit of bias in the same direction, you're going to get a lot of bias at the end of this. But it is a way to take a bunch of smaller prospective data

and make a bigger prospective study out of it. And you have to read the article to determine whether they did a good job of that. Okay? You know, if they're taking a bunch of anecdotal evidence and mushing it together, that just makes a bunch of shitty data. Okay. So anyway, they did a systematic review of existing data and single randomized control trials published in English from 2012 to October 2017, found that multivitamins, vitamin D, calcium and vitamin C, the most common supplements, showed no advantage or added risk in the prevention of cardiovascular disease. So it didn't do any good, but it also didn't do any harm.

did not prevent heart attack, stroke, or premature death. And generally, vitamin and mineral supplements were taken to add nutrients that are found in food. And the guy said, we were surprised to find so few positive effects of the most common supplements. So they were actually biased toward seeing an effect. You know, if you're surprised that you didn't see an effect, that means you were expecting to see one. So they were actually biased toward it. These aren't a bunch of naysayers, you know. So our review found that if you want to use multivitamins, vitamin D, calcium, or vitamin C, it does no harm, but there's no apparent advantage either.

Now, that's apparent advantage for things that they looked for because every study that we do has to have some sort of end point. What are we looking for? So if you are doing a study of Viagra, for example, as a high blood pressure medicine, not so great. You know, they had, you know, moderate benefit as a blood pressure medicine and a lot of adverse effects like stuffy nose and lightheadedness. If you didn't have an endpoint of big, meaty, you know, succulent erections, then you would totally miss the point. You know, and that can be going on here. There may be benefits to these things that they didn't, you know, examine that particular endpoint. And it may be unexpected, too.

Like, it could be that these things prevent malaria to a significant degree, but the study wasn't done in a malaria endemic area, so they would never see that endpoint. Okay, does that make sense? Yes. Okay. Now, his team reviewed supplement data that included A, B1, B2, B3. That's like Ernie's egg market.

He's got A1, large, B1, B2 large, and they can't be too large. Oh, there you go. There you go. All right. So anyway. Okay, now they did find that folic acid had a potential reduction in the risk of stroke and heart attack. But it was a very, very small effect. So there you go.

And I'm trying to see if it was statistically significant, and I can't find that in here. So folic acid maybe, you know, most multivitamins have a little folate in it. And we know folic acid is essential for pregnant women to take to prevent neural tube defects. So folic acid, pretty important vitamin. But anyway, so there you go. I was disappointed because I take my vitamin D every day. I take my vitamin E every day to help my peripheral neuropathy. And it seems to, you know, anecdotally seems to be really helping quite a bit.

But now, does that mean that vitamin D is worthless? of course not if the one disease that we know vitamin D prevents is rickets if you're vitamin D deficient you will have rickets you'll be bow-legged your bones will be weak all kinds of absolutely we know that vitamin D will prevent that what about vitamin C totally prevents scurvy I've seen one case of scurvy in my career but it sucked and you know this day and age we're not on ships eating you know beef jerky three meals a day

you know we get enough vitamin C but every once while you'll get one of these guys up there in the mountains that's eating nothing but beans every day and it doesn't have enough vitamin C in it and you know it's usually hermits living up in the mountains and they eat beans because you can just eat them out of the

can and they will often show up you know and get a couple a year with scurvy so really yep that's crazy yep yeah just by eating beans out of can yep yeah because or just eating vitamin C deficient foods and living on those okay you know yeah so but anyway there you go so yes vitamin C will prevent scurvy vitamin C helps strengthen collagen and keep your blood vessels nice and supple and keeps them from breaking and and so there are benefits

to these things. There's no question about it, but not to the extent that we previously hoped. All right. Well, let's take some phone calls. You guys ready? Let's do it. Number one thing. Don't take advice from some asshole on the radio. Yeah. And speaking of assholes on the radio, it's Calvin, everybody. Hey, hey, hey. Area code 408. What's up, man? Hey, Steve, Scott, diagnosis, Cliff, Evie, and all the tens and tens of listeners back home. how's everybody doing he's not exaggerating awesome awesome awesome yeah I had one silly thing and one serious thing okay I had a question about okay so the serious one was um I confirm this through the internet you said that adrenaline was a vaso constrictor and I found that to be kind of odd because every time I've ever had adrenaline it's always made my legs all wobbly and so I thought it was a vasodiliter and also I've had my wisdom

teeth all pulled out while I was awake, all four at the same time. And I believe the Novocaine also had adrenaline in it to spread through the nerve. Yeah. Well, they use the epinephrine or adrenaline in the numbing medication to keep you from bleeding. And you have to be really careful. You don't want to use adrenaline when you're numbing up a finger, for example, because it will constrict the arterial supply, and the finger could get eschemic or decreased blood flow and have damage to it. I have heard, never seen a case of this where they accidentally injected somebody's penis with, so any of these sort of terminal appendages where you've got blood vessels going out and then coming back in, in other words, capillaries hitting them

and then venous capillaries draining them. So I've heard of people injecting a penis with lydicane with epinephrine in it and just have it slough off. So you don't, you know, You know, sluff is a great word because it's, is it, what is it, anamonopoeia where the word sounds like, what it really, like, boom. So sluff, that's what it sounds like when your penis falls off because you injected it with epinephrine, because it's a vaso-constructor, yeah. Sluff. Do you know of like a scientific reason as to why it's a constructor? because to me, logically, the adrenaline would want to flow, and so it'd be a vasodilator to, I mean, I know it's a constrictor. If you, yes, so if you're running from a saber-tooth tiger and your adrenaline hits you, what you want to do is you want to shunt blood away from the GI track because you don't need to be shitting and digesting food right then because you may not make it.

Right. So you need to shunt all your. Maybe not you. Yeah. You want to shunt all your blood. to the central supply so that you're getting blood to your brain and you're getting the heart is able to beat plenty of blood to the periphery, you know, to the muscles and stuff where the vasoconstrictive effect is much less. Okay. So, and that's why that, you know, you're shunning

blood to the places where it's absolutely essential in an emergency. And so the skin can do without it. your nasal turbinates can do without it the the kidneys and brain and lungs and all that stuff need all that blood at that time so that's why all right cool okay what was that you had another question

yeah sure silly thing's fine yeah now when tacy's here you're allowed to chip I'm just telling you that if Tacey's here you can not chip you can always chip TIPO got deported oh did he El Chippo. Yeah, El Chippo got deported.

Yeah, he's never coming back. He's been banned. And actually, I have the guy that deported him. Oh, you do? Oh, okay. Well, let's hear that story. Hello, weird medicine. Super great.

Number one, it's I, your Trump, right here. President, I love this show. I love weird medicine. It's very great. Amazing. Lady diagnosis, she's an 11 out of 10. Totally not like Megan Kelly. Megan Kelly's a 4 out of 10, but maybe diagnosis.

She's the best. Believe me, folks. Weird medicine, super number one, amazing, believe me. God, damn, this is about as boring as sex with my wife. Oh, my God. That's beautiful. That wasn't a bad trial. It's not bad.

It's better than mine. Not bad at all. I'll try again another week. Can I plug a gig? What's that? Yeah, of course. Can I plug a gig? You can plug anything.

Oh, okay. Sure. June 6th, I'm, um, uh, playing rooster tea feathers to wednesday night but rooster tea feathers sunnyvale california june 6th 8 p.m. show so anyways what is that wait whoa whoa whoa no no no now you can't get away that easy what is it that's a comedy venue yeah yeah it's comedy i do stand up okay i had no idea because your chip shit is so fucking unfunny but i you send us a send us a tape hell we'll play it dude we'll plug the fuck out okay yeah

I'll email you a couple things. Okay. So plug it again, and then I want everybody to go and then do Edgar from the crowd. All right. Because he calls our show and does Edgar and he does Chip. And Calvin's one of my Twitter friends. So he's allowed, but I'm also allowed to hang up on him. But anyway, no, I had no idea you were really a stand-up, dude.

That's awesome. When's he going to be there? Yeah. Plug it again. I'm sorry. June 6th, Wednesday, June 6, 8 p.m. Rooster T. Feathers, Sunnyville. Oh, the prized Wednesday night 8 a.m. slot.

Yeah. Yeah, 8 p.m. How long have you been doing comedy? A couple years. It's hard to say exactly because, I mean, I never really had a start date because I used to do public speaking. Like when I'd go do my college classes, I would do presentations instead of writing papers.

And so they give me the option to do presentation. So I just throw in a couple jokes and then talk about the Kyoto Protocol or something. Yeah, I'm so unfunny that when I do a presentation, I usually, if I have to do something with the crowd, I'll do a magic trick instead. And I've got a couple of, I have a couple of real killer magic tricks that I can do for them, you know, to get everybody. I have one where somebody picks a word out of the newspaper and then I have the crowd, have me really. rip up the paper and they tell me which side to keep and I rip it again, which side do I keep and I keep dropping it and the piece gets smaller and smaller and somebody else comes up from the audience who doesn't know this person and points to a word and it'll be that person's word

and we make a big deal. I say, you know, see how we can, what the magic that we can create when we all work together. Oh, that is some good shit. It works for a team building, but I'm not funny you know i just i've you know and you toss a silk for lard over your shoulder yeah absolutely linger longer my friend cliff doesn't know that reference but he'll learn it soon enough well i'll just tell actually i do have one it is embarrassing i do have one magic trick okay yeah i do have one magic trick i mean it's really simple it's so stupid the the mechanics behind it but i went to the dollar store and i got a bunch of packs of playing cards and i made one deck that's all three of hearts there you know no matter what the person chooses

is it's always going to be a three of hearts. So I just say, pick a card, any card. So they think they're choosing something, and then I get to predict it, and everybody goes, yay, yay. Well, that's actually, no, you can make that into a real mystery. Okay, so forcing a card, that's just called a forcing deck, and forcing a card can be part of a true mystery. Now, if you just have somebody pull it and you go,

what is it the three hearts? There's no mystery in that. But then if you turn around and make a dramatic reveal of their card, you know, and you can do comedy with it, too, you know, that can be some cool stuff. I used to have a video of this redneck guy, right? And he would go, go, go, come on in. And then he was like a diviner. He would divine things using fish guts. And so he would fillet the fish and throw the guts on the table.

And then he would mush around in it. And then he would go, well, what the hell is this? And he'd pull up this thing. And it was a rolled up card. And he would open it up and go, is that your card? And it'd always be their cards, you know? So it wasn't a brilliant trick, but it was a little bit more complicated reveal than just saying what the card is. So now that you've just revealed a classic card secret, I'll be hearing from all the magicians.

It's better watch your back now, dude. That's right. Those magicians get pissed off. All right, dude. Yeah, they'll stick the rabbits on me. Okay. Okay, I'll see you, ma'am. All right, thank you.

See you. See you. Calvin in California, actually, a stand-up. He called in one time and got other people doing chip and stuff, and I had to start the show over. I was so flustered by it. So, yeah, the Silkfulard thing, Cliff, just so that you know, you've got to get caught up on all of this. And I don't think, no, if Evie knows this either. But the way I learned how to masturbate was with a, this cloth called a fulard, which is a, use it in a trick called the zombie ball.

You ever seen a zombie ball? They have the silver ball. And I still have it. It's sitting over there. You have a silver ball and you put this silk cloth over it and then it starts to rise. Have you ever seen anybody do that? Yeah. Okay.

Anyway, it's called zombie ball. Well, the silk fulard was just great for. beating off into I need to know where I can purchase a couple of those well that does mean no good so no you've got to use your imagination yeah I can't rip one out with that you know the first

the first couple of times that you that you masturbate as a 12 year old you don't nothing comes out you know you haven't sort of stimulated the seminal vesicles yet and your prostate's underformed but then so the silk full art had

to go when I started you know making crusty messes all over it and trying to do my magic trick with these stains

what the hell wrong with this cloth yeah that sounded just like my mother I love a master

all let's take another call let's see here Karen Area Code 504 you're on weird medicine

hello so my husband actually emailed you about this I think earlier in the week. Okay. I recently had a mammogram done.

Okay. And they found calcifications in my breast tissue. Okay. And, yes. So they did a biopsy. They did two biopsies because the first one, they biopsy the wrong area. Okay. And the second time around, they did the biopsy, and it was more in my lymph node.

Yeah. And they pulled it out and they commented that it was. purple and come to find out that it is tattooing from that has migrated to my lymph nodes from a tattoo that I have on my back sure so that's kind of crazy yeah yeah um that that's amazing well let's talk about microcalcifications first there are little calcium deposits that develop in breast tissue and they're very common and they're usually benign and uh they look like little white specs on the mammogram now if they're clustered then you then you're a little bit more concerned and uh usually microcalcifications if that's how they they named it on your um on your mammogram or not a result of

cancer they'll often you know biopsy to be safe because you don't ever want to miss anything and breast biopsy a lot less risky than say a prostate biopsy is if you think about it and how did they do your breast biopsy did they just stick a needle in without numbing you up because that usually is pretty stunning uh uh experience for a lot of women then they realize that the breast tissue deep inside really doesn't have pain fibers in it uh no they numb they numbed the area uh they numb the area around it and then they have i i guess it was like a little gun with a needle on it i don't know i didn't see okay but um yeah the first time around they actually biopsy my breast tissue and then when they did a follow-up mammogram of me

immediately asked her to find the marker that they placed in there. They were like, oops, we biopsyed the wrong area. Oh, my God. Okay. So, but what fascinated me is that I, I searched for this afterwards because the doctor who did my second biopsy is like, do you have any tattoos? And I was like, yeah. And he said it's most likely tattoo ink.

And when the pathology came back, that's exactly what it was. And I started doing research on it. And apparently this is more common and people don't know about it. Yeah, it's very well known in derminologic circles. I need to qualify that. And I'm just looking at a thing from PubMed Health. Particles from tattooing can spread into lymph nodes. No association with cancer or anything like that.

This one researcher used samples of skin and adjacent lymph nodes taken from six donors after autopsy. And four of the donors had tattoos and were more likely to have substances like titanium in the lymph nodes. The lymph nodes obviously are part of the lymphatic system, which in turn is part of the immune system. So there are these lymphatic channels

that are made to drain things from parts of the body to lymph nodes where these immune cells in this framework can kind of trap it and deal with it. You know, so you're talking bacterial bodies, antigen, stuff like that. If you have a big acne, cystic acne on your face, it may drain depending on the area to the neck, and you'll get an enlarged lymph node there, stuff like that. So, yeah, that's fascinating. So you're living proof of that.

Did you get the slides by any chance? Oh, no, I should have asked for that. Yeah, you can still ask for the pictures of the slides. My husband would have been like, oh, that's cool. But the really weird thing is, this is my, I'm 41, so this is my second annual mammogram. My first one that I had when I was 40, I got this tattoo when I was like maybe 35, 36, and nothing. Nothing. The mammogram was completely clear.

And then all of a sudden this year, it popped up. And apparently these studies say that this can show up in women years later. sure it's so strange yeah yeah that's something in that and oh so they think the microcalcification was actually associated with the tattoo ink that's it wasn't really calcium it was more like titanium probably or iron and yeah you wouldn't be able to tell the difference yeah yeah you wouldn't be able to tell the difference on an x-ray whether it was calcium it's just radio opaque you know x-rays are absorbed by it and so you see a big white speck on there so that's even more interesting.

I have seven, so I'll keep that in mind. Yeah. Yeah, we should probably do a breast exam on you, Evie, just to make sure you're okay. Just for, just to be, you know, safe. I feel safe already. Shut up, Harvey. Yeah, so. So there you go.

Now everybody knows about my boobs. And I'm glad you're getting your mammograms. Hopefully you're getting your pap smears and other health screening stuff that you're supposed to have. Oh, yeah. every year. Okay. Awesome. Excellent. Well, good. Well, hey, thanks for calling in. That's fascinating. I had... Thanks a lot.

Never talked to anyone that actually had proven tattoo ink in their lymph nodes. And it's pretty cool. It's not dangerous? I mean, tattoo ink is like metals and stuff. You know, there's iron, there's titanium, there's other minerals that they use, and there just doesn't seem to be any toxic effect from it. Interesting. So they have not associated it with any kind of illness yet. So that means I can finish up both my sleeves. Yeah, there you go.

There you go. Full body tattoo. Yeah. All right. Hey, thanks, Karen. Hell yeah. Nice, Karen. Thanks a lot.

Take care. Okay, see you. That's pretty interesting. That's cool. Yeah. All right. Let's do one more here and then let's get out of here for today. Let's see here.

Hello, I was wondering in the past you said always seek medical treatment. If you go to one place that sucks. go to another place uh do you get a weird reputation if you if your medication's not working or something and you call you know you're polite but you call several times just to see what's going on in a place or if you're going to a place that has their own where the doctor sells his own medication and uh you know wants you to buy it there and it's compounded and you can't get in any place can they like fuck up your medication or uh make it to where it's not working if they don't if they think that you've called them out on

some shady practices or something like that or how do you know what's going on to not complain too much or yeah it's a tough balance isn't it so first off um unless they're sociopaths they're not going to poison your compounded medication but my my question would be if you think that they're engaged in something shady why are you still going there just go vote with your feet and you won't get a weird reputation that when you get a weird reputation is when you go every doctor you go to those last that was last bunch of doctors everyone was an asshole everyone was an asshole but you're the greatest that's usually a sign of a borderline personality disorder where because those people will have difficulty forming attachments they'll blacklist you

too and then they'll just shit on you and then you'll be the next one so that that sets off a red flag When a doctor, the first time, they're seeing somebody, the patient says that all other doctors are assholes. The other thing is, is if you're doctor shopping, you know, for narcotics or something like that. And these days, particularly with these controlled substance monitoring databases, there's only two to three states that don't have those. They, you know, if you come in complaining of pain and need narcotics or opioids, we don't like to use that word narcotic anymore, but that's sort of a street. layman's term they will always check it and see well you just got

180 of these from Dr. Smith well why aren't you going to him well he's an asshole well that means Dr. Smith fired that person for cause and so those are the kinds of things that's when you can get a weird reputation but otherwise no you have

every right to go to a different doctor if you want to and if your insurance will is locking you into one doctor you can just call them and say, I'd like to switch to another physician or a nurse practitioner or PA or whatever. So feel free to do that. Anytime. All right?

And it's perfectly okay to ask them about adverse effects that you're having or why your medication isn't working. You just say, hey, you know, this doesn't seem to be working. Can we try something else? And most of the time, that sort of approach will work with any health care provider. Anyway, thanks always go to Dr. Scott, Nightner's Evie, intern Cliff, a.k.k.a. 49 set. Go to our website at Dr. Steve.com for schedules

and podcasts and other crap. Until next time, check your stupid nuts for lumps, quit smoking, get off your asses and get some exercise. We'll see you in one week for the next edition of Weird Medicine. And because

comfortably none.