Weird Medicine: The Podcast - 335 - Phish Antibiotics

Episode Date: November 2, 2018

Dr Steve answers a bunch of medical questions regarding non-FDA approved antibiotics, home remedies for sleep apnea (don't), bad science, bad doctors, and more. stuff.doctorsteve.com simplyherbals.net 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. Yo-ho-ho-ho-ho-ho-he-ho. I'm in the carri-did. I've got diphtheria crushing my esophagus. I've got Ebola fives dripping from my nose. I've got the leprosy of the heart valve, exacerbating my infectable woes. I want to take my brain now, and blast it with the way.

an ultrasonic, ecographic, and a pulsating shave. I want a magic pill. All my ailments, the health equivalent to citizen cane. 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 Beijing, Dr. Steve. It's weird medicine.

There I am. It's weird medicine, the first and still only uncensored medical show in the history broadcast radio. Now a podcast. I'm Dr. Steve. And this is a show for people who would never listen to a medical show on the radio or the internet. If you have a question, you're embarrassed to take to your regular medical provider. If you can't find an answer anywhere else, give us a call. 347-76-6-4-3-23.

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Please don't forget to go to stuff.doctrsteve.com. That's stuff.com for all your shopping needs. And tweakeda audio.com offer code fluid provides 33% off the best earbuds for the price on the market and the best customer service anywhere. Check out Dr. Scott's website at simplyerbils.net. And I'm just going to throw this. this out there, I'm going to discontinue the premium service. So if you have it, feel free to disengage. You will not lose anything by doing so. But if you have been subscribing, thank you very much for doing that. It really made a big difference. If you want to still give me a buck 99 a month,

you can keep going, but there won't be any content on that anymore. More on that later in a couple of weeks. Coming up, we're going to have the great Dave Cecil, who won a national songwriting contest. It's going to be here in the studio, and it's going to be one of our last Sirius XM shows. So just hang in there, and all will be revealed in the fullness of time. All right. Let's get to it. Number one thing.

Don't take advice from some asshole on the radio. Oh, and that's the case. All right, let's go. Well, Hey, Dr. Steve. It's your pal Jim from Massachusetts. Hey, Jim. Hey, I got a question for you.

You never talk about podcasts, but there's one that I've been listening to, and I'd like to know your opinion. Oh, no. I talk about podcasts. You guys should check out my pals, David and Jason, at DC on screen. Put a little more DC on your screen. They are two delightful. nerds who uh love the dc cinematic universe or the dc e you the extended universe and uh these fucking guys will watch every single episode of dc generated um uh fair on television which means

they watch batman the animated series now they're going to have to watch titans they will watch obviously the Flash because it's awesome. They'll also watch Arrow and Legends of Tomorrow, Supergirl. You know, you may not be aware of this, but that show, Lucifer, which was one of my favorite comic books of all time written by Mike Carey. He was one of the greatest characters in the Neil Gaiman series Sandman. Lucifer was an awesome character The TV show, not... This device received an important update and we'll restart. Oh, thank you.

We'll be ready again shortly. Oh, thank you. Thank you, Alexa. It's good that she let us know that. The TV show, not so much. So anyway, yeah, they'll take the hit and watch that so you don't have to. Anyway, so check out DC on screen. If you're interested in DC stuff, they also have a call-in line, and you can call in and, you know,

serious calls only. If you were a southern guy able to do an old lady voice, you might call them every week saying stupid things. So I'm just saying hypothetically. Well, if you lack him failures. All right. Anyway. It's called Dr. Death.

And it's a tragic story. And that's what Opium Anthony called me. A surgeon who did cause harm. unfortunately. And the question I have for you is at one point, they mentioned that he did work in the state of Tennessee and that the medical association there knew that he was a bad surgeon, but they did not report him. I'm just curious to know what your opinion is of that. I know nothing about this case. So I'm going to just speak in general. The Tennessee Board of medical examiners is actually pretty activist.

And the interactions I've had with them have been very positive in the sense that I feel like they have the well-being of not only the patients, but, you know, of health care in the state. And that's true of boards of medical examiners all across the nation, I think. Well, wait, there was more to his question. Let me see what else he was going. The basis of this whole podcast is whether or not he should have been turned in and why didn't people turn him in. Yes. It seems to be kind of a brotherhood, particularly among surgeons, to not squeal on the other. Okay.

Okay. So maybe, but I haven't seen that. I got to be honest with you. I have been in a situation or let me say I've heard of a situation where one surgeon, surgeon was in a hospital that was having increased adverse effects. Because how can you tell a bad surgeon? Are they just shitheads? No, that's not how.

You care about their outcomes. So if you have a disruptive doctor, that comes into the chief medical officers purvey to try to get them under control so that they're not upsetting staff. and other physicians, stuff like that. But that's not the sign of a bad doctor. A bad doctor is someone who has bad outcomes. You could, for information services, what we used to call medical records, a bad doctor would be somebody that doesn't dictate their notes on time.

If you don't dictate your notes on time, you get suspended. If you have increased bad outcomes, you don't necessarily. get suspended. So it is weird that something as simple as not completing your medical records on time will get you suspended, but having bad outcomes won't. Well, that's, there's reason for that. What if Dr. A, you have Dr. A and Dr. B. And Dr. A is doing a procedure and that's very simple and repetitive and they could do it with their eyes closed. And Dr. B is doing trauma, major trauma surgery and is operating on the sickest patients. Which one of those is going to have the worst outcomes?

In the end, when you look at things like mortality and morbidity, in other words, complications post-surgery where the patient doesn't die. And, of course, it's going to be Dr. B. So you have to be able to match these physicians with regard to their caseload and their patient population and their payer mix and everything. You've got to be able to match them. Sometimes you can't do that. Sometimes you may have one physician or one surgeon, and this could be an MD or a DO, that is. Well, let's also throw podiatrists or DPMs into this as well because they are surgeons that will operate.

What if you just have one? What are you going to compare them to? So now you have to compare them to national averages and you got to what if they only operate on the sickest people. You've got somebody that's really got an interest in, say, diabetic wounds or something like that. They're going to have worse outcomes than somebody that's just taking off toenails and stuff. So there's that. Now, if you have somebody that's clearly having bad outcomes compared to some cohort,

and it could be the national average, it could be locally, you know, if you have three cardiothoracic surgeons and two of them have great outcomes, and one has post-operative, post-operative infections, constantly or at a higher rate, these hospital systems will pick up on that because they monitor these things because it makes them look bad too if you got somebody who's actually practicing substandard medicine. So they will go to that physician, show them the data and say, here's what's going on. Is there something that you're doing that we could be doing better to prevent this and they'll work with them and try to make it better? If they're intransigent, sometimes they'll lose their privileges and then sometimes they'll turn around and sue the hospital for restraint of trade because if you're a surgeon and you're banned from working in a hospital, you can't make any money and you still have that $250,000 student loan to pay off and stuff like that. So unfortunately, money motivates you to try to keep your job.

So most people presented with a fact like that will knuckle under and improve their performance if they're able to. If they're not able to, sometimes they'll end up practicing some other brand of medicine. I've seen that happen before where you've got a surgeon that starts practicing primary care instead because they're able to do that. They're licensed physician in the whatever state. But they're really, as far as some sort of a cabal that prevents people from squealing on other people, we don't have to squeal on other physicians. The statistics speak for themselves. But the other thing I don't want is that we have to be really careful when we start turning each other in for things.

Because I have seen pain management physicians get quote unquote turned in or completely. Plaints filed against them, either by a pharmacist or another physician or whatever, because they didn't understand what they were doing. You know, they may have been dealing with a very injured population or cancer pain or something. They're writing larger than normal doses, which they're able to do. They're board certified to do that. They're the ones that should be doing it. And someone didn't understand it. And so they turned them in.

And then now it's a problem. What's the board of medical examiner supposed to do? Well, now they've got to come investigate. and just depends on who is auditing your charts whether you survive that or not. So it's tough. So, you know, I'm not saying it shouldn't be tough. Physicians, nurse practitioners, PAs, nurses, LPNs, I mean, can I list more health care professionals, should be held to a very exceedingly high standard. No question about that because they hold people.

people's lives in their hands. So we have to balance that versus just being fair to somebody. So that's what I don't, again, I know nothing about this case could have been the most egregious case in the world. I know nothing about it. So I really can't comment on that particular case. But that's just kind of how the system works. And it is mostly self-correcting. And there are mechanisms in place to ensure quality. And, you know, it's to the point where people can't even market themselves on quality anymore. Why? Because quality care is kind of the baseline. You have to be delivering quality care to just even be in the marketplace. So saying, well, somehow your quality is better than somebody else is very difficult to prove and is sort of silly to say that because it should be a given that you're delivering quality care. Anyway, I hope that answers your question. Oh, well. Hey, Dr. Steve, this is Ryan from Indiana.

And I've got a question about antibiotics. So recently I was going through a dental infection, and I did get it taken care of going through the dentist, but looking online, I seem to be getting mixed answers with this about people saying that it's okay to take these fish antibiotics, the fish mocks and fishmocks forte. According to survivalists, they say that this is a good addition to having a bugout bag or an emergency kit. And other people are saying that it's not a good idea, that there's a reason that it's fish antibiotics and not, you know, label for humans.

But under the pill identifier, they seem to have the same markings on the pills. And if you look them up on the pill identifier website, it doesn't say that it's for humans or for animals or fish or whatever. It just says, you know, amoxicillin, 250 milligrams, 500 milligrams, et cetera. So I guess my question is, is taking or having this fish amoxicillin safe for a bugout bag or safe for humans to take? Okay. So he had a dental infection, and someone told him, yeah, you could just take fish antibiotics.

Because it's true. Fish take the same things we do. And you can go right online and, by fish amoxicillin, fish fluconazole, which is antifungal. And, you know, why not? Surely they're fine, right? Well, here's the thing. Things that are not marketed for human consumption that are prescription medications

are not legal for sale in the United States for the purpose of humans taking them. And there's actually a reason for that. Fish antibiotics are apparently completely unregulated. They should fall under the Food and Drug Administration, which is the group that oversees human and animal drugs. But those are for companion animals and food animals. Ornamental fish don't fall under that category. So they're available in pet stores or online. They've not been approved, conditionally approved, or even indexed by the FDA.

and it is completely illegal to market them for humans. There's no assurance of purity, no assurance of safety, no assurance of effectiveness. The FDA doesn't have any information whether these things are even what they say they are. And the veterinarians say the reason the FDA doesn't regulate them is just too small of a problem for them to bother with. But I'll guarantee you if this key, keeps up where, you know, if there's an adverse effect from somebody taking a fish antibiotic, the FDA will get involved. So, you know, here's the thing.

If it, if there was a nuclear war tomorrow, I would probably head to the pet store to get my antibiotics because you know everyone's going to the damn pharmacy. There's going to be a shootout outside the pharmacy, and it's going to be mostly over Oxycontinent. and stuff, but it will be over people who are smart enough to say, we need to get our hands on antibiotics and get them now. So I would probably head to the pet store and pick up my antibiotics from there just because I'm less likely to run into somebody who's going to shoot me. That's the only time that I would consider this.

Otherwise, it's a non-starter. It doesn't make sense. It's probably not, well, it may not be safe. Maybe. Do you want to risk taking an antibiotic on a maybe? not me. So I cannot recommend that. Nuclear war, zombie apocalypse, alien invasion, yes, then I could see it as a last resort if I couldn't get my hands on the real stuff.

But otherwise, hell no. Hell no. All right, there you go. That's my answer. Hello, Dr. Steve. My name is Jim. I'm calling from New Hampshire. Hello, Jim.

I'm a big fan of the podcast and the series show, so I'll hear this on either one. Okay. But you've been talking a lot about flu shots and flu mist lately. So I have a quick question about the flu mist. I have a four-year-old and seven-year-old, and I'd like to do the flu mist if you think it's more beneficial to them. I haven't really been able to get a sense of which one you feel is better to get. But our pediatrician is not doing the flu mist this year. I have no idea why, but I got out of the night.

And they're only doing the shots. You know, I can force my kids to get the shots. It's fine. But I just want to get your opinion on if you think one is better than the other. And if you think the flu mist is better for them, then I don't know how to track down a place that may offer that. You know, if there's a website you can go to or something. Okay. We used to be told that you got somewhat better.

immunity from the flu mist. So let's set this up. Flu mist is a live attenuated virus that you spray up your nose and it's communicable. If I give it to my kids, they may be able to give it to me, but it doesn't cause influenza. It may cause a very mild viral syndrome, but it will stimulate immunity to the influenza proteins that are on its surface. And that's the whole key to this and that is stimulating immunity against the influenza strain that's coming. Now, I'll just summarize this again. I've talked about on other shows. The groups that are making these vaccines will look at what's going on in our summer in the

Southern Hemisphere, which is their winter, and try to guess what strain of influenza we're going to have problems with in our winter based on what they're seeing. in their winter. And sometimes the damn virus mutates like crazy and they get it wrong and sometimes they nail it. I've seen the flu influenza vaccine be as low as 6% effective and as high as, I don't know, more than 6. In general, people who get the influenza vaccine, if they get influenza, will have an easier time with it and be at less risk of hospitalization, less risk of dying. So still worth getting, even if you get it.

Those of you who have listened for a long time now, a couple of years ago, I got influenza. I had a, I was 60 something, I guess I was 60, just turned 60, got a fever, woke up with a fever of 105, had influenza, took the Tammy flu, was forced to stay off work for seven days and burn a bunch of vacation time, but sailed right through it. Basically, that was a seven-day vacation where I got. caught up on Arrow on the CW and that's when I got hooked on all the stupid CW DC shows. Hence, my involvement with the DC on screen podcast, but, well, involvement. I have been on it a couple of times, but hence my fandom of that podcast.

But anyway, but I sailed through it and I had every right to end up. up on a ventilator, given how rough it started and how old I was at the time. Now, we used to be told that the flu mist, because it's live attenuated virus, gave you a more vigorous immune response. Now they're kind of hedging their bed saying they're probably about the same. So the shot is it killed, or it's not even killed. It was never alive. but it's a non-alive, just antigen vaccine that is presents your immune system with key proteins that are on the surface of the influenza virus and primes the pump with regard to antibodies to kill those particular viruses.

So if it's the same, then, all right, then, so what are you going to do? If your kids are afraid of needles and are just pitching a fit, I'd give them the flu mist. If you're under 50 and you don't like needles and the flu mist is readily available, I'd do the flu mist, the nasal spray. Otherwise, just take the shot. Everybody else takes the shot. Now, why is your pediatrician not have it this year? because they got burned last year and the year before because it was offered for sale and then taken, and then that offer was withdrawn. Because last year and the year before, the powers that be determined that the flu mist was worthless.

And so they didn't offer it. So people have gotten out of the habit of ordering it, which is too bad because it is a nice alternative. The year that I got influenza, I also had flu mist and the flu shot because my kids had gotten flu mist. And then, of course, they turned around and gave it, gave me the virus. So I got the, even though I was too old, quote unquote, to get the flu mist vaccine sprayed up my nose. I still got the flu mist vaccine because I guarantee you my kids infected me with a live attenuated virus. And then I got the flu shot as well. And I still attribute all of that to me just sailing through.

I was sick for a day and then I was fine. All right. Listen to last week's show. If you didn't hear it here, I had him also on the podcast. You can go to Dr.Steve.com. Listen to the podcast. It's called Hyperfluzix. And I had Richard David Smith, the owner and CEO, a co-CEO with his wife, Shetai, of hyperphysics,

which is an energy drink for nerds. And he got influenza without having a flu shot, ended up on the ventilator. It was touch and go there for a while. And so he is my greatest ally when it comes to talking to people about getting flu vaccines. And he's a lot younger than me, and he almost didn't make it. And, you know, I did have my vaccines and I sailed through. I can't say 100%. That's what it was.

It was, you know, it's a cohort of one, but it's still, I feel that that helped me to sail through that. Anyway, all right. Hey, Dr. Steve, this is Lee calling from just up the road in central Virginia. Hi, Lee. Long-time listener, first-time caller. I've got a quick question. I'm a lifetime runner and had just quit recently due to problems with my knees and my hips. but I've developed something I think is called Morton's Neuropathy or Neuropi.

It feels like I've got a sock stuck between my toes on my left hand. On my left foot, not my left hand. But I wondered if you could provide any details on that. And you mentioned on one of the shows recently some supplements that you were taken for something similar, it sounded like. And I was wondering if you could give me some advice on that. Yeah, I don't think this is a Morton's neuroma. Morton's neuroma is usually painful. It affects the bottom of your foot, usually the area between your third and fourth toes.

But it could feel like you're standing on a fold in your sock or you've got a sock between your toes. So it could be a Morton's neuroma. What it is is it's a thickening of the tissue around the nerves that lead to the toes themselves. and it can in some people it's a sharp burning pain other people it's dull and has this sort of weird dysesthesia like he has dysesthesia meaning weird feeling people who wear high-heeled shoes can get it runners can get it stuff like that and people that have bunions and hammer toes and real high arches will also get it so most of the time this is treated by a podiatrist if it's going to be treated in an aggressive way,

they'll do x-rays. They might do ultrasound, could do an MRI. And every once in a while, they can inject it, or they can do this decompression surgery, or they can actually go in and remove the nerve. But then you're going to have a dysesthesia then because you're going to have a numb foot, or at least that part of your foot.

At home, what you can do is if there's no contraindication, You can take anti-inflammatory medications. What else is anti-inflammatory? If you've listened for a long time, direct cold, not ice. I got fussed at by somebody. Somebody had said something about ice for a wound, and I didn't correct them on it. But cold, we've never advocated ice. We've always advocated cool or cold compresses.

But anyway, you can freeze. a, like a water bottle and then put a towel over it and then roll it back and forth with the bottom of your foot. Or you can just stop doing what you were doing that caused the problem and sometimes it'll go away. So if home remedies don't take care of it, then seeing a podiatrist is usually the way to go. Now, he asked about the neuropathy. Neuropathy is great. I canceled an E.T.N. Comedy event, which was Rich and Bonnie. We're supposed to come down a couple years ago because I was worried that I was going to be in a wheelchair by then because this demilinating neuropathy I had got so bad that I couldn't even stand up in the shower without propping myself up. I went to a neurologist. I had numbness of my hands and feet, pins and needles. and ataxia.

Ataxia is just a broad-based gait where you're using your visual fields to try to stabilize your gate instead of your body's sensing it. It's also called a loss of proprioception, meaning you have a loss of your body knowing where your joints are or where parts of your body are.

So if you close your eyes and I take your finger, let's say your middle finger and your palm is facing down and I take your middle finger and I point it upward for you passively. Your brain should be able to detect that I'm pointing it upward. And what my body was no longer able to do was to determine where my tibia and fibula, in other words, the long bones of the lower leg, were in respect to my feet. So I was unable to balance. And if I closed my eyes and lost that visual sense of where my body was, I would just start to fall.

So it was pretty bad. I went to a neurologist and they said, yeah, you got demyelinating neuropathy. Nothing we can do about it. Just stop drinking. And it's like, okay, I drink a beer maybe two a day and maybe one more on the weekend. I don't think that's it, but I did it, didn't do any good. Stopped my statin. Couldn't stop my PPI.

A statin drug is a cholesterol drug there also can cause peripheral neuropathy. But now I'm increasing my risk of having heart attack and stroke because of that. I have a family history of early heart disease. My brother had a heart attack at age 59. So, you know, I had to find some solution. And so I went on PubMed.com, which is open to everyone. This is the National Library of Science Medical Database for Medical Literature, and every piece of literature, including the hundred that I've written, are in PubMed.com.

And you have access to them. And knowing how to interpret them is a whole other thing, but once you do a few of them, you kind of learn it. Anyway, so I did an exhaustive literature search, and I found four nutritional supplements, which surprised me, because I'm not a supplement guy. I'm always given Dr. Scott, holy hell, about his sort of non-imperic approach to medication, but, you know, that's what makes it interesting having him on this show when he's on. but these had data. None of them were excellent double-blind placebo-controlled data that was good enough to make it standard of care, but it was pretty good data on some of these.

And so I tried them. One of them was glutamine, which is an amino acid. Another one is alpha lipoic acid. The third one was vitamin E in the gamma complex form. and then the fourth one was myoenocetal. And then there's a fifth one called, oh, I can't remember what it is because I didn't take it. But they're all on my website at Dr. Steve.com. You can click, if you know someone that suffers from peripheral neuropathy, click on the upper right hand corner.

It says, for neuropathy sufferers, I put my whole journey on there. And I have links to all those supplements. So anyway, so I took all four of them, damned if I didn't get better. Within about three months, I was able to stand in the shower and close my eyes without falling over. I was able to heal tow walk, which is good if I ever get pulled over for a sobriety test because there's nothing better than going, walk, I can't do this even at the best at times. They're like, yeah, yeah, yeah, right. I mean, I can get hauled in and have to demand a blood test because I'm going to look drunk if they make me do the healed toe walk. But now I can kind of do it.

I am still not as good as my kids who have no neuropathy, but I'm a whole lot better than I was. And the feeling in my hands and feet has improved dramatically. My hands still, I can tell that they're not quite 100%, but I'd say they're 96%. My feet are 99% back to normal. So I'm pissed at my neurologist for just blowing me off and saying there's nothing we can do. I always hate it when people say that. But I'm doubly pissed that it's like, dude, isn't this? Aren't you supposed to know this stuff?

So anyway, but I am happy that I was able to do that research and find something that actually helped. And again, it's a cohort of one. I can't make any generalized statements about it other than that's what happened to me. But I do have the articles and links to those articles so that you can read them your damn self on my website at Dr.steve.com. Okay. Hope that answers your question. Behooy, Dr. Steve. This is Bobby from Texas.

Hey, Bobby. I've got a five-year-old daughter who, for the past... Well, I have two radio shows. two months plus has had a cruddy sort of cruddy cough and it's been persistent it's been ongoing we went to the children's hospital in the middle of the night one night when nothing was working i was giving her uh some medication I believe it was mucinex for children, and she couldn't keep anything down, coughing all the time, throwing up, vomiting, and then they diagnosed her with bronchial spasms, seasonal allergies, gave her an albuterol inhaler, and then showed us the door. follow-up with her pediatrician said that we should get her on allergy medication,

so we've been given her Liradidine in the form of children's antihistamines. And nothing really seems to be working. And I would really love to figure this out. Should we start doing a nebulizer? If we did a nebulizer, is albuterol sufficient, or is there another form of inhalant, I guess, that she could take more? arms, all kinds of stuff. The problem is, what's actually causing this cough?

He mentioned that the kid coughs until she throws up. That is a sign of pertussis. And pertussis is also called whooping cough. These kids will get a cough, and they'll cough, cough, cough, cough, until they puke. And it will drive the parents crazy because these kids will be up all night coughing. And if you all remember longtime listeners to the old Opian Anthony show, Anthony Coomia got pertussis and it took him off the air for some period of time. And then even after that, if he would laugh, he would cough.

I'm not saying anything out of school. He talked about it on the air. At that time, I wrote a letter to Sirius XM saying, look, you need to require pertussis vaccine for the adults who work in this. building because a pertussis outbreak because it's whooping cough is very contagious could cripple this organization of course what they didn't do anything but um it's so it could be that the problem with it is when you treat people with the proper antibiotic for whipping cough the inflammation persists in the lungs for up to four to six weeks afterward so it can last for a long time, even after the bacterium is dead.

So it could simply be a case of under-treated whooping cough, in which case we would expect it to go away here directly, as we say in Tennessee. Now, if that's not it, then a pediatric pulmonologist or a pediatric immunologist may be the next place to go. There are other allergy medications. I've seen kids with mild intermittent asthma and moderate persistent asthma come off all their medication once they get started on Monty Lukast, aka Singular. It's not a perfect drug. There are downsides to it, but most kids tolerate it really well, and that could be an option.

Yeah, an inhaler, a nebulizer may help, but you want something to prevent the, or to reduce the sort of chronicity of this syndrome that your daughter has. And to do that, she's going to have to be on suppressive medication for some time. If it is an allergy, just treating the underlying allergy, maybe with allergy shots or something like that may help. but she needs to see a specialist for this. And the pediatrician, you know, I don't know how many times. Here's the thing. Look, if you go to the pediatric emergency room, all they're going to do is do something expedient to get her out of the door. And that's not a criticism of emergency rooms.

That's what they're there for. They're there to deal with emergencies, get people stabilized, and get them the hell out of there. And so you're not going to get a good answer there. You're going to get a good answer by following up with your pediatrician multiple times. And if they don't get anywhere, then being referred to either a pediatric pulmonologist or a pediatric immunologist if it looks like it's allergic and go from there. The thing I like about pulmonology is they can do the spirometry, they can measure her lung volumes. they may do x-rays and be able to interpret those.

There are other, you know, even all the way. I've heard of kids before they had a chronic cough. You know what? They inhaled a penny, and they've got a foreign body stuck in their lungs, and nobody ever found it. And the pulmonologist found it. Penny would be pretty easy to see out an x-ray. But what about a fish bone or something like that? You might not see it.

They would find it when they did bronchoscopy. So I would kind of lean toward the pediatric pulmonologist as my first place to go after you've exhausted what the pediatrician is. Okay. And let me know how that turns out, if you would, please. Now I'm going to worry about her. Hey, Dr. Steve. This is Clint. And this is Candice.

We just found 1-822 penis. Yay. We're the kind of question on taping your mouth at night. for, like, mouth breathing. It's called a biohack. I was just wondering if you've heard of it, if you know anybody who does it, or if it even helps.

I'm sure helps maybe post-nasal trip and stuff like that. But I was just wondering if you know anything about it. I've tried it. I've used a Band-Aid, you know, something. I didn't use duct tape the first time. So I was just seeing it. What you know about it.

Thanks, buddy. Thank you. Okay. Thank you. I think that's the first time we've ever had that. We're a couple is called together. And then she didn't add anything to that, but except a very cute voice. But anyway, there are people that do this that tape their mouths shut at night.

There is a thing called Somni Fix. And you can get this at Amazon or stuff. Dot, Dr. Steve.com. And it's a gentle mouth tape for better nose breathing and improved nighttime sleeping. I'm not endorsing it. I'm just saying it exists. There's actually a product out there for taping your mouth shut. And it is an option, I guess, but I got to be honest with you, why are you mouth breathing?

If you have a deviated septum, fix that. If you're just a goofy mouth breather, there are other things that you can do. There are straps that you can use to keep your mouth shut. There are appliances you can wear in your mouth. You can talk to your dentist about. But here's the thing. I don't want you just taping your mouth shut if you're snoring, particularly if you're a bad snorer. If you're thinking of doing something like this, you must be a really bad snorer.

And if you are, there's a possibility that you have untreated sleep apnea syndrome. So I would go. Look, you guys like to do stuff together. Go to the doctor together. talk to them about your snoring, if that's what it is, and see if you meet the criteria for a sleep study. Now, usually what they'll do, if anybody comes into my office, and particularly if they're complaining of fatigue, they're not sleeping well, and they snore, I won't send them right

for a sleep study because a lot of times it's expensive, it's inconvenient, you got to stay overnight, and they kick you out about five in the morning, it sucks. But what I will do is send them home with a sleep study screening test. So remember, screening tests have to be sensitive, meaning that they'll pick up all the cases that you need to pick up. They need to be cheap. And the syndrome you're screening for needs to be prevalent, in other words, it's relatively common. And it has to be treatable. So you've got to meet those criteria before a screening test makes sense.

Well, sending somebody home with a pulse oxymeter, in other words, the thing that they wear on, their finger that all overnight will read minute to minute second to second their oxygen saturation and if they dip show multiple dips below normal on that sleep um i'm sorry on the oxygen saturation that is a good screening test for someone with sleep apnea and is a good test that will justify a sleep study and uh that way now they know you have it so So they'll slap the mask on, let you sleep for an hour, demonstrate, oh, well, not, wait a minute, sorry. They'll let you sleep for an hour with these straps wrapped around your chest and the pulse oxymeter. Watch you sleep apnea, document it, then put the mask on, and you can walk out of there with a prescription for a mask right away, whereas it used to be, you had to go for the sleep study just to make the diagnosis.

Then you would come back for the mask and then do a titration study where they kind of run the thing up and down. Mine, I did it all in one. So I'm a weirdo. You know, I was falling asleep. I would get to work every morning and fall asleep for 10, 15 minutes out in the parking lot. And it was so bad that I pulled in at the laundromat where I drop off my dry cleaning every Thursday. and they knew me and some guy came in and he said, I think there's a guy dead in his car.

It was me. And they were like, oh, no, that's just Dr. Steve. He'd been taking a nap out there. So I would pull in and then immediately go to sleep. And I got to where I couldn't watch TV without falling asleep. My kids were yelling at me and my wife was mad because we'd have to watch things twice. And it was messing up our TV time. And so I went and I had the screening test.

It's very simple. Wear a thing on your finger. And they put a, you wear a band around your chest and it will read your breathing and oxygen saturation. And if the breathing stops and the oxygen saturation drops, that's a positive screening test. I went in and had my CPAP titration study. and what sucked about it was is the CPAP stopped me from having the obstructive sleep apnea. In other words, the kind of that kind of breathing, totally stopped that.

But then I just stopped breathing. It was like my body said, well, we don't have to breathe at all. So I have what's called complex sleep apnea. So I have a mixture of obstructive sleep apnea and central sleep apnea. Central sleep apnea is just that where the brain doesn't tell my body to breathe. and you'll never die well, okay, you won't die directly from that. In other words, you'll never totally forget to breathe

to the point where you just don't breathe and then you don't wake up. That's not what happens. What happens is when you don't breathe, there's a part of your brain that senses that and goes, hey, asshole, wake up. And then you wake up just enough to start breathing again and then you fall right back asleep.

And when you're constantly doing that, You never get into that dream state called REM breathing where you're able to dream and actually get restful sleep. So you're always sort of hovering above that. And that's why you could sleep 8, 10, 12 hours and you still feel exhausted and tired. So get that checked and talk to them first before you start taping your mouth. I just think that's weird. but there's if you go to stuff dot dr steve.com click on the amazon link you'll see somnifix you'll see sleep strips by azazar that sounds like some weird cult uh re zeal snorpper

mouthpieces there's all kinds of there's so many anti-snoring um uh devices out there because it's a real problem. I stopped going camping with my dad when I got old enough because he just snored like, you know, like an MFer. And I grew up camping with my dad and my uncles and all of these guys laid on their backs and just snored all night long. And I still have vivid memories of the dreams I had

of being chased by gorillas all summer long because we would camp for a month at a time. and yeah anyway all right quick question for you what are floaters that you see in your eyes every once in a while i've started to experience this every once in a while especially in bright sunshine what causes those and what can you need to tell you clear that up

okay um so floters in the eye in case you couldn't hear him the eye is um composed of It's a fascinating dang thing. If you ever want to learn something really cool, look at the embryology of the eye. Just Google it on YouTube, it. Embryology of the eye or the evolution of the eye. Because apparently the eye is a perfect device in the sense that octopuses, octopi, evolved at an eye completely separate.

from us we're not in the same i mean our common ancestor goes so far back and yet their eye is very similar to ours and uh so it's it's maybe the best way at least on this planet to uh create a sensing organ that can actually see things so you got your lens and you've got fluid in there and then the back part of the eye the biggest part of it is um filled with this sort of liquefied jelly stuff called vitreous humor. And if you get any debris in there, like little cells from the retina that are floating around,

they will obstruct the rays of light that are entering your eye and cast a shadow on the retina, and you will see these as floaters. And if you're seeing them at the top of your vision, you know, if they're floating around up near the sky, they're actually in the bottom of your eye and vice versa.

So if you, and the only reason I'm going to go into detail on this. I've only got a minute 35 left, is to warn you that if you ever are just walking along one day and all of a sudden you get a shower of these floters, all of a sudden your vision is filled with them. This is a sign of a vitreous detachment and requires urgent ophthalmologic evaluation. So a vitreous detachment, remember I said this stuff is sort of this liquefied jelly. It's half liquid, half jelly. I mean, it's just a very liquidy jelly, put it that way. But it does have some solidity to it. And as you get older, this jelly can start to shrink. It dehydrates a little bit. It gets old, and it pulls away from the retina.

When it does that, a fluid that's in the eye will have to take up its place, right? And when it does that, it'll wash across a lot of cells from the retina. and debris from the back of the vitreous and you'll get the shower of floaters. So if you get that, ever get that, you're looking up at the sky, all of a sudden it's like, damn, I have more floaters than not. Get to an ophthalmologist and get them to look at your vitreous detachment. You can walk in and say, I think I have a vitreous attachment. If you get flashing lights with it, you may have a retinal detachment with it,

and that is actually an ophthalmologic emergency, so get that checked out. All right, thanks always. Go to Dr. Scott, although he's not here today. We can't forget Rob Sprantz, Bob Kelly, Greg Hughes, Anthony Coomia, Jim Norton, Travis, Teft, Eric Nagel, Roland Campo, Sam Roberts, Pat Duffy, Dennis Falcone, Ron Bennington, Fez-Wantley, Lewis Johnson, Paul Offcharsky, whose early support of this show has never gone on. Appreciate it. Listen to our Sirius XM show on the Faction Talk Channel, Sirius XM, Channel 103, Saturdays at 8 p.m. Sunday at 5 p.m. Eastern on demand and other times at Jim McClure's pleasure. Many thanks to our listeners whose voicemail and topic ideas make this job very easy. 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.