Weird Medicine: The Podcast - 328 - Rectum? I Hardly Knew 'em

Episode Date: September 17, 2018

Sphincter gas fun, euthanasia, acoustic wave therapy for erectile dysfunction all make for a weird medical show (hence the name). PLEASE VISIT: stuff.doctorsteve.com simplyherbals.net untuckit.com offer code MEDICINE blueapron.com/medicine Learn more about your ad choices. Visit podcastchoices.com/adchoices

You're listening to Weird Medicine with Dr. Steve on the Riotcast Network, riotcast.com. I need to touch it. You know, ho, ho, hey-ho. I'm in the garretem. I've got diphtheria crushing my esophagus. I've got Tobolabovir stripping from my nose. I've got the leprosy of the heart bow, exacerbating my infectable woes. I want to take my brain now, glassed with the wave, and Ultrasonic, Geographic, and a pulsating chain. I want to magic pills. All my ailments to help the equivalent of Citizen Kane. And if I don't get it now in the tablet,

I think I'm doomed, then I'll have to go insane. I want to Requiem for my disease. So I'm paging Dr. Steve. Dr. Steve. It's weird medicine, the first and still only uncensored medical show in the history of broadcast radio, now a podcast. I'm Dr. Steve. My little pal, Lady Diagnosis,

aka she who will do most anything for a glass of expensive wine. Hello, Lady Diagnosis. Hello, Dr. Steve. And it's her boyfriend, Dr. X. Hello, sir. Howdy. Thanks for being here. Thank you.

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barista, yoga master, physical therapist, anesthesiologist, or whatever. Brewmaster. Or brewmaster. It is true. Poor old brewmaster, John. He caught... He didn't ever come visit anymore. Well, we only started saying FPA, John, because he, you know, when he started up the new business, he quit coming.

Oh, is that why? Yeah. I was wondering why they'd say that. Poor Jill. Right. Where's John and I'd just say FPA, John? And then it started a little thing. And it reminiscent of F. Jackie on Howard Stern from the old days.

So, anyway. Don't forget stuff. dot dr steve.com for all your Amazon needs stuff.com and next show I will have a review of the womanizer sex toy that's at the bottom of the

scrolling or the bottom of the page at stuff dot doctor steve.com and I'll let you guys know if it's really everything that Dr. Perkins set it up to be so we'll see I can't wait to hear that and tweakeda audio.com why don't you guys just buy one and then we'll trade

notes? I was looking for my complimentary issue of that. Well, I can't even get a free one. I'll just use yours, Dr. Steve. Okay. Well, you know, the thing is, you don't touch it to the body. So actually, it is a sex toy that people could pass it around. You wouldn't want to use somebody else's dildo.

That would be gross. Even a glass one, you know it's perfectly clean, but it's still gross. Glass, a glass dildo. Oh, yeah. Glass breaks. Well, those big thick glass dildos, I think they're safety glass. and they're not going to break. I mean, you could hit somebody over the head with it, and I'm sure that's happened.

You don't know lady diagnosis. Oh, she could just break. Oh, I see. Ooh. Oh. Very nice lady diagnosis. She's been doing her cagel maneuvers. Yes.

I'm doing them right now. I am, too. So I have a very tight vagina. Don't forget Dr. Scott's website. It's Simply Earp. herbals.net, simply herbals.net. And tweakeda audio.com, offer code fluid for 33% off the best earbuds on the market for the price and the best customer service anywhere.

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And that's the best way to do it if you're going to be a premium listener. We do sometimes have premium content that we put up there. All the ETN comedy stuff is there. And it's a buck 99. And it helps keep us on the air, and we appreciate it. Do I get any of that money? Well, do you get a check every time you come here? Yes.

Okay, then yes. Then you're getting some of that money. That's how I pay you. And we are one of the few podcasts, by the way, that actually pays people for being on the show. So, you know, Dr. X is a guest, but I'll give you his money. Oh, okay. I'm looking for my complimentary. I know.

Your toy. I get yours. Oh, we do have a compliment. toy for him. It's right behind you above your left shoulder. There you go. Yes, we have a sex toy for you. It's called... The flatus

flute. It's a good thing I don't have gas. You know... Well, next time you do. You know what really kind of ticked me off is that they're... When they do colonoscopies now, what are they using nitrogen or something instead

of what they used to use CO2? CO2 still. Well, okay. My guy, I guess, was using nitrogen or something else that you don't get the delightful thunderous fletus afterward. And I had taken one of those with me to do my colonoscopy, and I do mine without anesthesia. And so I was... Why? Because I don't like the anesthesia. Propofal makes me goofy for like two days.

He just like something large and black up his butt. Well, well, Dr. X. So he's fitting in very nicely on the show. So I had, but I did it without anesthesia. And one of the reasons was I could just pull up my drawers and go to work afterward. I didn't have to take a day off. And I wanted to shove a fletus flute up my ass and get video of it really demonstrating what it can do. Because you'll notice that's a picture of me on there.

So can't you just use it when next time you have. Mexican or something? Yes, but then it's just, you know, the nice thing about doing it post-colonoscopy is you're not going to be shooting out any liquid stool or anything, you know, on the back wall. True. You know, the sphincter is an amazing thing that it can distinguish between gases, liquids, and solids. Absolutely. Selectively let them release. It is amazing.

Well, most of the time you're successful with that. But people ask, well, how is it that the sphincter or, you know, that the rectum can make a, distinction, you know, between those things. And it's like, okay, put water in your mouth. Right, it's a smart ass. Oh, come on now. Okay, we're all about fun here, but puns are

anyway, it's fine. That was very funny. But if you put beer in your mouth, okay, there's a tongue there that has taste buds, but you can tell the between the gas where the, where the liquid ends and the air. And I can't tell you how you do that. You just can't.

If you puff up your cheeks full of air, you can tell that it's air and not liquid. And the ass is just able to do the same thing. There's just not a tongue in their thing, you know, not of your own. There might be an exogenous tongue. You said that, not us. And, but there's no tongue in there to detect flavor and things like that. definitely can detect consistency. I was going to say, you can feel.

Yeah, you can feel. You know when it's liquid. Yeah, you know. But every once in a while, you'll think it's gas, but it's not. It's a sharp. You're right. That's right. And so that's what I don't want to do.

I knew my bowel was perfectly clean, and it would have been a perfect example of a fletus fluid in action. But my guy uses, I think it was nitrogen. And it just all got resorbed so quickly that I was nothing to expel. I had no post-operary, you know, post-proceded. your fletus whatsoever you didn't get the bins no no no it didn't get the bends either so it was weird so i was i was very disappointed that was the whole reason of uh being excited to have my colonoscopy i was going to get this viral video and it just didn't work out anyway all right want to take some phone calls let's do it number one thing don't take advice from some asshole on the radio all right

Adam from San Diego. Hey, Adam. Got a question about euthanasia. Just recently put a cat down, and I was talking to the vet, and she was talking about what she was injecting. It was first the propothal, put to his sleeve, and then an overdose of phenobarbital. And I asked her, with the prisons, I guess there's a shortage of, you know, the injection medicine that they use in prisons. Why can't they use the same medicine that they use to put our pets down?

And that's about it. Thanks. Yeah. Do you want to speak on this? Yeah, the drug companies don't really want their medication used for, give yourself a bill. We'll go with euthanasia or executions. Pentothal, which was what they used to use and is no longer a manufacturer.

Phyopentol. Thiopentol, pentothal. I guess it came out before people, lay people knew what medications were, so it was okay. But with propofal, those manufacturers do not want that brand associated. Yeah, it says authorities are struggling to find drugs used in lethal injections amid a shortage spurred in part by drug makers' objections to the death penalty. So, yeah, they just don't want to be associated with it. So now, phenobarbital, generic, you could basically buy that from anywhere. The other part of it is the state has to have legislation saying what they're going to use.

And sometimes now there's legislators that don't want to be involved in the death penalty either, so they're real slow to change those rules to allow other drugs to be used. And so that's the other thing. It's politics all the way around from the drug manufacturers and the drugs. legislators. Some states are very nimble and can change quickly and have, and I can't name any offhand I was reading about this. Lethal injection was kind of a cocktail that was legally prescribed, and now that one of the main medications is no longer used, it's running into that legal conundrum.

Right. Right. You know, what Kavorkian did was he used. I, gosh, I can't remember what his thing was, but he had a two-step process by which he would sedate the machine that the patient would actuate. That was the key, was the patient had to actuate it. The minute Kavorkian pushed the button for one of his patients, that's when he got sent down the road for killing somebody. But as long as he could make the machine and let them do it, and I think what he was doing was a sedative, and I'm not sure what it was. I'm going to look it up here in a second because we're on podcasts. We're not on satellite radio. and we can pause for a second if we need to and then I think he used a lethal injection of

potassium and potassium if if you get enough of that it will just stop your heart so let's see here um kovorkian machine let's see what if we can have anything here oh no there's a wallach Corvorkian rotating biopsy punch. So, by the way, if you guys ever had any questions of whether Kavorkian was a serial killer or not, just Google Jack Kovorkian artwork and then tell me what you think. Have you ever seen his artwork? It's the most disturbing stuff.

Let Lady Diagnosis bring it up on her phone. And, you know, what is serial killers? What do they like? They like to have a trophy. Well, he would videotape all of his. ostensibly to document it, but he had the videotape. And what else do they want? They want notoriety.

Well, he certainly had that. And they need to be a psychopathic, you know, I have a psychopathic disorder. And then if you look at his artwork, it was the creepiest shit. It's very disturbing. So, you know, he's not with us anymore, so it would be hard to, of course, he would deny it. But what a greater thing for a serial killer than to figure out a way to do it and do it in public and not get in trouble for it, you know? And kind of be praised for it. Yeah.

Well, he did bring, look, there were people who are in the Hemlock Society who were totally on his side. And rational, well-thinking people can have a discussion about whether this, you know, physician-assisted suicide is ethical or not. And there are states in this country where you can have physician aid in suicide, where you can write a lethal prescription for somebody. They have to take it. You can't administer it. Oregon. Yeah, Oregon is one of those. That's exactly right.

I didn't realize that was legal. One of two. Let's see what Kavorkian used. Let's see if I can find it. I can't find it. Yeah. Anyway. Okay.

Kovorkin assisted others with a device and employed a gas mask fed by a canister of carbon monoxide, which was called the Mercitron. This became necessary because Kavorkin's medical license had been revoked after the first two deaths and he could no longer have legal access to the substances required for the Thanatron. Okay, so that was his first device. Invented by Jack Kavorkin to use this device, it called it a Thanatron or Death Machine after the Greek demon Thanatos.

It worked by pushing a button to deliver euthanizing drugs mechanically through an IV. It had three canisters mounted on a metal frame and each bottle of had a syringe that connected to a single IV line in the person's arm. One contained saline, another contained a sleep-inducing barbiturate called sodium thiopental. There we are again. And the third,

a lethal mixture of potassium chloride, which immediately stopped the heart. And panchuronium bromide, a paralytic medication to prevent spasms during the dying process. So he would paralyze him. Of course, they couldn't breathe when they're paralyzed either, and then he

would stop their heart. That's the same thing they use for lethal injection for execution. Is that the three step? Is they used, okay, all right. They put them to sleep, paralyze them, and then stop their heart. Okay. Well, there you go. So I guess that's...

So if you're asleep, you don't have pain, correct? Right, right. No, it's humane in the sense... There's no question that it's humane in the sense that you're not inducing suffering. The question is, is it ethical? You know, and that's where we can have a discussion about that. Well, okay, so thank you for. bringing that up. There is this

thing called the principle of double effect. Did you get taught that? Okay, so the principle of double effect is an ethical principle that's pretty old. Thomas Aquinas was the first one that elucidated it. And what it says is basically that you can do a procedure

or some intervention on someone as long, and it could have a negative outcome. As long as you don't intend the negative outcome. And I'm going to bring this to what we're talking about, and that the thing that you're doing is morally good or at least morally neutral, and you're not intending the bad outcome to achieve the good outcome.

So let's use this for a hospice patient that has terminal agitation, okay? And this is where two to three days before they expire, they just start getting wild and they're thrashing around, maybe trying to get out of bed, or they're really in distress. You've tried A, you've tried B, you've tried C, you can't get to be. under control. And so you've decided you're going to sedate this person. And there's lots of things you can use phenobarb, propofal,

Versed, or Medazalam, and to sedate this person. Well, when you sedate them, they can't eat and they can't drink, you can give them IV fluids and stuff, but you're probably going to hasten their demise by doing this. So that's a possibility that you could hasten their demise by making them, you know,

in a basically medically induced coma, right? as long as that's not your intent. Well, okay, so if you did that to an 18-year-old that was expected to get better, that would not be an ethical move because they're expected to get better. And so sedating them to the point where they die would be basically malpractice at best and murder at worst. If you sedate this person who's expected to expire the next two or three days and you reduce their lifespan by 30 minutes or a half a day, but your intent is to relieve their suffering, according to the principle of double effect, that's an ethical move. And remember, the key part of this is that the bad effect cannot be your intent to achieve the good effect.

So relieving suffering is the good effect, the bad effect is that they're going to hasten their demise. Where Kavorkian got crossways with modern medical ethics was he was intending the bad effect. in other words he was intending the person to die to relieve their suffering okay so now ethics in calculus right there's no right answer these are just things that we've agreed on that a bunch of us have agreed yeah we agree with this that this is ethical but you could have an argument with that and say well wait a minute so you just have to say it out loud that you're intending to relieve the pain you write it in the chart yes but basically that's the same thing okay you're in intending to relieve suffering, and you've discussed the risk benefits and alternatives, and one of the consequences may be hastening the patient's demise, the family understands the risk benefits and alternatives and wishes to proceed, that kind of thing, you know, and then you're good with that principle. And that's a defense in court, too, is using the principle of double effect, because it's

generally accepted. Could you be a well-meaning, intelligent person that thinks that, what? What Jack Gavorkian did was okay, heck yeah, you could. You know, there's being done every day in other countries and in Oregon, and I think Washington's the other one. So I have a question. Yeah. So what's the difference between euthanasia and just pulling the plug of patients' unconscious?

Okay, so patients have the right to refuse any medical intervention that they want. Right. They sometimes lose the ability to exercise that right. So when they lose the ability to exercise that right, that falls to other people who care about them to make those decisions for them. It's called substituted judgment. And withdrawing treatment from someone is not the same thing as euthanasia because when you remove a ventilator from someone, it's not that act that causes them to leave this world.

It's the underlying condition that causes them to leave this world. The life support was merely interfering with that process. Okay. Okay. So now with euthanasia, you're actually making steps to cause someone's demise by giving them a medication or whatever, you know, or pillow over the head. Okay. So does that make sense? Yeah.

Okay. All right. Kind of a heavy topic, but something we need to talk about. all right let's do one more um this one's good hey dr steve really like the show i had a question for you wondering what your opinion or what you know about acoustic pressure wave therapy for ed thanks for your answer yeah are you guys doing any of this no okay so it's low intensity shockwave therapy for erectile dysfunction and uh you know we people have erectile dysfunction, for whatever reason, they're not able to pump more blood into their penis than is being pumped back out. That's really it. It's a mechanical thing.

And when you get an erection, you know, you open up the arterial side and you kind of shut down the venous side. So blood gets pumped in. It's a little bit harder to pump back out. And because of physics, you get an enlargement of the penis, hopefully, and a stiffening of the penis. because the sheath around it is somewhat elastic, but it's not completely elastic. It will stretch to a certain level and then it will stop stretching, which is good

because if it was infinitely stretchy when you pumped more blood in than you pumped out, you would just get a big balloon, you know, a big purple balloon penis, which wouldn't be very good for impregnating somebody or having intercourse with them and be hard to get your mouth around. So it is it behooves us to try to increase blood flow to the penis by whatever manner we can.

And one way that we can do that is with medications like sildenafil that increase nitric oxide in the bloodstream. Nitric oxide helps to dilate the vessels pumping blood into the member and you get these nice, big, meaty erections. I like Cialis is my favorite, but, you know, Levitra and Levitra and. Viagra are also, you know, good choices. But there are other things that you can do. And there's this low-intensity shockwave therapy. The other things that we can do now are al-prostadil injections or al-prostadil suppositories that you shove down the urethra.

And it also causes increased blood flow to the penis. You can use a vacuum pump where those have a cock ring on the end of them and you stick it over your member. and then you evacuate the air where that negative pressure draws blood into the penis and then when you get it you know to the size that you want

you just slip that cock ring off and that traps the blood in there and then you've got the sort of big purple you know pulsating thing that's also meaty yes it's very meaty and then so those are the things that we have now

or an implant you can get a urologist to implant a new you know set of tissues that will enlarge. Some of the old school implants would be just permanently erect. I don't know how that would be good. How does shock work, though? Okay, well, okay, so yeah, I just want to give a little background on what we have now.

So this low-intensity shockwave therapy, they did a randomized clinical trial comparing two treatment protocols, and what they found was that patient benefit more in sexual performance from 12 sessions twice a week compared with six sessions once a week. So you've got to do this, you've got to commit to it. And it's basically a little device that gives low-intensity acoustic shockwaves to the tissues in the penis. I'm trying to see here. They recommend it to people.

Okay, this study, they used people that did respond to. to phospho diastriase inhibitors. In other words, these people can achieve an erection. They can't do it on their own, but they could with medication. They wanted to see if they got better with this treatment so they didn't need it. And so they did twice a week for six consecutive weeks. And people who completed a six-month follow-up were offered six additional sessions. So is this something that's supposed to just make you, like, train your penis to get out again?

or is it ongoing? Nope. What they think is that it induces growth factors. It's almost like stem cell treatment in a way. I mean, it's a way to think about it, that it induces growth factors to reconstruct the blood vessels and the little arterials and capillaries that feed the penis. That's what the hypothesis is.

And let me just see here. When the impact of the total number of sessions received was examined, they got an improvement in their rectile function score up to 62%, 74%, and 83% of patients, and that would be 6, 12, and 18 sessions respectively. No treatment-related side effects were reported, so this really seems pretty effective. You know, we'll do cancer treatments because 5% of people get better, you know? Yeah. So he was just wanting to know if it was effective.

That's interesting. Yeah. So is it like something you put on? No, they would do, it would be like an ultrasound probe kind of thing and it will do this sort of vibration. I don't know what the character of the vibration is. It says it's low intensity, so it's not like getting your kidneys busted, you know, which is high intensity or extracorporeal shockway therapy. That's interesting. Yeah, it is.

I want to try it just for fun. You shepherd. I'm like Snoop Dog. I don't have a problem, but you might. Have you heard those commercials he has? That's hilarious. Anyway, thanks to our listeners whose voicemail and topic ideas make this job very easy. Thanks to Dr. X and Lady Diagnosis. 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.