Weird Medicine: The Podcast - 337 - CBD and Depression

Episode Date: November 14, 2018

Is there any evidence for CBD oil in depression? How is it legal, anyway? Also: shingles, gut flora, esophageal strictures, pilonidal cysts, & more! PREMIUM.DOCTORSTEVE.COM is not going away after all. Explanation next week! PLEASE VISIT: stuff.doctorsteve.com for all your holiday shopping! simplyherbals.net premium.doctorsteve.com for unlimited content! 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 some touch yet. Yo-ho-ho-ho-ho-ho. Yeah, me garretail. I've got diphtheria crushing my esophagus. I've got Tobolabovir stripping from my nose. I've got the leprosy of the heart valve, exacerbating my infertable woes. I want to take my brain now, blasted with the wave, and all.

ultrasonic, agographic, and a pulsating shape. I want a magic pill. All my ailments, the health equivalent of 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 a requiem for my disease. So I'm aging 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. With my little pal, Dr. Scott, the traditional Chinese medical practice, who helps keep the alternative medicine wackos at bay. 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. 3477664323.

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puncturist, yoga, master, physical therapist, or whatever. So, very good. Don't forget, please, with the holidays coming up, use stuff. dot, doctor, steve.com for all of your holiday shopping needs, that's stuff. dot, dr.steve.com. Don't forget, tweakeda.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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I know. I'm crazy. All right. Just, I try not to let you guys see my insanity, but I'm a little. crazy. But for a buck 99 a month, you get all the archives and you can support weird medicine. It's pretty easy to do. A lot cooler than Patreon, in my opinion, mainly because you can go get the app at the app store or at Google Play, and you have access to everything right there.

So premium. Dottersteve.com will get you set up. All right. Very good. Tell your story. First, your doggy was sick. Yeah, my little pup, Chewy was sick. She had a, she woke up about.

about two weeks ago, and couldn't swallow. She had no appetite, and I started poking around. She had a big fluid-filled cyst under her chin, right on her throat, poking around. Submandibular cyst. The sub-mandibular cyst, right? So first thing I thought it was maybe a tooth abscess, maybe a salivary stem. Yeah. And I was hoping for not a lymphoma, quite honestly.

That was my biggest concern. Yeah. But a couple, you know, trips to the vet and $1,000 later, she ate today for the first time. So it wasn't lymphoma. We don't think so. And we did another fine needle biopsy yesterday. And still the pathology has been nonspecific, which normally we think is going to be an infection. And she is responding, thankfully, to some little amoxicillin shots because she's just a little thing.

And I put her on some dexmethosone to get some of the swelling out and to increase her energy. And she's doing a little bit better. So she's, she's peeing by herself. And she's, today she ate for the first time in two weeks. So we're pleased. Well, the list of things that a submandibular cyst could be includes, as you said, Cialo letheasis, which is stone in the salivary gland. So sialo pertaining to saliva, or salivary, and lithesis pertaining to stella, and lithesis pertaining

to stone. Mucous retention cysts like mucoseils, and then epidermal inclusion cysts, which are like sebaceous cysts. Right. But then there are these things like a thyroglossal duct cyst, brachial cleft cysts. These are all congenital things that could have been there all along and only just now recently filled up with fluid. Which would be my guess, because she's as little as she is, she's always had a little bit of

trouble breathing. Yeah, yeah, really. makes sense. Okay. Yeah. And you wouldn't, you know, you might not notice it because you're not feeling around your dog's submandibular region until there's a problem. I, you know, I've had people come in to see me that say, hey, doc, you know, I've got this

mass in my chest and you feel, and it's at the bottom of their sternum. I recommend everybody do this right now, man or woman. You can feel it. You feel right on your breastbone in the middle of the front of your chest and work your way all the way down to the bottom. You'll feel this knob down there. and that is called the zyphoid process and you can push it in

it's stuck with cartilage and so it's just a wiggle a little bit yeah it wiggles and I've had people come in going doc I've got a I got a tumor in my abdomen and they're all freaked out they've been worried about it for weeks

they finally got up enough guts to come in and see me and I get to set their mind at ease immediately that's your zyphoid process you know what you've had it your whole life you just never noticed it before that shit happened all the time

you know so yeah and i think my gut feeling is that that's exactly what happened i think she's probably had this for a while and for whatever reason it may be a little infection that fluid just ballooned up overnight so heck yeah we're we're um we're much much much much happier good mommy's and buddies today very good very good so thank you all right well um i had talked last week about stopping the premium service on our podcast. And I think I'm changing my mind about that. I'll explain to everybody. I've been kind of intimating about the end of weird medicine.

And it may still happen, but I'm hoping that we can work something out because what was really happening was I was going to change jobs. and my new job didn't appreciate my extracurricular activities. I mean, you can go, if you really do a deep search, it doesn't take that much, you can find a picture of me leaning on that prostate exam simulator, which really just looks like a big rubber rectum and with testicles and a penis hanging off of it. And I use that to teach not only Jim Norton, but Eliza Schlesinger, how to do a prostate exam. And it's a real piece of medical equipment.

Right. But when you've got, you're sort of leaning with your right elbow on the back of this thing, and the picture just shows this buttocks with rectum and testicles and penis hanging down. and then you've got this goofy look with a thumbs up. You know, it doesn't look, it looks bad. Yeah, right. Awkward. So, but I've decided I'm not going to be embarrassed of what we do here. I look back.

The topics that we cover, sure, we treat them in a lighthearted way, but, you know, we're doing serious stuff. Even the vodka tampon, which would be the thing, well, yikes. first we didn't do it without consent and it was in the interest of science in the interest of getting people not to do that not to do stupid things but everything else that we talk about is serious medical stuff influenza

and often it has to do with the rectum or the bowels or something like that but that's part of the human body people are interested in that too Yep. Oh, gosh, yeah. I mean, you think about how many times we hear questions about erectile dysfunction. Sure. And constipation. Who else is going to answer these questions? I mean, we do it every day and it helps people a bunch. It tells them which direction they go instead of, you know, not doing anything. Yep. And letting it get to a terrible place or running to the emergency department, the emergency department saying, gosh, you don't need to be here.

Right. Don't go to the ER. That's why you have a family medicine doctor, etc. We now we're just sort of patting ourselves on the back, but we have saved lives on this show. We have had every time we do the October, oh, we missed October, usually in October, we tell everyone how to check their stupid nuts for lumps because we say that at the end of every show. And we need to do that today. So please don't let me forget as soon as we're done patting ourselves on the back. But every time we do that, we'll have two or three people email us, hey, I found something. And yeah, I went to the doctor, and that's what it was. And thank you for making me do that.

and so but anyway and i have been a little depressed about this show in the sense that i've been a little just bummed about it ever since gvac died it's not been the same and um i i listened to the shows that he was on when you know it was all of us together and they just seemed a little more lively but um that's okay you you know we're getting old and sad and we're going to die soon so why why do a fun uplifting show so so i think i'm okay with that too but it is i mean every time we do this show i'm looking at him over your right shoulder uh because we've got a big poster of him up on the wall i know so i miss that son of a bitch well i do too terrible but anyway all right so there we are you want to answer some medical questions let's do it let's do

number one thing don't take advice from some asshole on the radio all right well i won't see what we got here when i was younger you eat steak fries what you try not to you know hello is there any related or underlying conditions where possibly old age or Girt regarding when you eat steak fries. This never happened years ago when I was younger. You eat steak fries. You try not to eat them too fast. You're probably not eating them more rapidly than normal and you're hydrated, but you feel

like the starch builds up. You feel like almost like there's something in your throat, but it's chewed up. It's not there. Is there any supplements that can help that? Or is there any underlying medical thing like Gird or something else or an older age? I'm assuming he's talking about what happens to me. If I go to a certain very popular chicken place and I eat their fries, their big waffle fry things, and then if I try to eat something after that, I'll feel like they're stuck in my esophagus.

And they are. They're actually, because we, first off, these things are too damn big. Steak fries are gigantic. And then you've got all this starch. It's just starch. It's just a polymerized sugar. And it's mushy. And we eat too fast.

And so we swallow it. And then it piles up in the esophagus just before it gets into the stomach. Some of it doesn't get all the way in there. And it'll just kind of sit there. And the only supplement that's going to get rid of that is to drink water or something after, you know, something warm afterward to just wash it down into the stomach. Right. Now, a million years ago, I heard the story of a lady that broke her hip because she had what we would term an esophage heel stricter. So this wasn't normal narrowing of the esophagus as it goes into the stomach.

she had scarring from reflux esophagitis. Barrett's esophagus. Yeah, well, she may have had a barrette's, but she had scarring. Right. And the scarring caused a narrowing of the esophagus. Right. And so when she would eat, food wouldn't go all the way in. Well, in the beginning, it would pile up in her esophagus.

She could jump up and down and get it to go down. Wow. Then she had to get up on one stair. You know, she had steps going up to the second floor. She'd get on one step and jump off of that. And then it got to where she needed to go up to flights of stairs. Oh, gosh. And by the time she got up to four and was jumping, she fell and broke her hip.

Oh, bless you. So an esophageal stricter resulted in a woman breaking her hip. If you have that, you should get scoped. Sure. It's a real simple procedure. They give you some goofy juice. They tell you, don't eat after midnight. Don't eat or drink after midnight.

You go in with an empty stomach. They give you some goofy juice. They say, count back from 10, you go 10, and that's it. And the next thing, you go 10, and then, wow, I'm waking up. They didn't do anything. When are they going to do this? And when are they going to do it? And you'll feel fine, but you're not, so you need to get somebody to drive you.

But it's really as simple as that. They can look down there and make sure that this narrowing is normal for you, and it's not something more serious. Well, and while they're in there, they can do the little stretching. they can do stretching if they find a narrowing they can stretch it out

you can swallow normally again yeah and typically they'll have to do that if you keep that up they'll have to do it regularly but still yeah that beats the heck of having to jump up and down to get your food to go out of it's horrible yeah it's tough

so but it is really common particularly with steak fries or big giant waffle fries from a fast food chain that I won't mention their name but they know who they are I'm right on. They're good, though.

They're good, they're good stuff. But, you know, I think a lot of people will get that from other things. It's a little bit harder to chew up. Sometimes red meats can give it the same kind of swallowing issue. So just the. Well, you tend to eat smaller bites of that. Right. And then if it gets stuck, you drink something that goes down.

But when you're eating fries, you're just going one after another. And it swells up. Yeah, and it just piling up in there. And it becomes this big bolus of French fry. Glob. Just stuff some ketchup in it. There you'll be fine. That reminds me.

I had a friend, and she did a rotation in the Philippines. And one of the – she was in some village in the Philippines, and when she left, they threw a party for her. And what they did was they roasted a pig. And one of the delicacies was something called blood sausage. It's a little different than like Irish blood sausage. So what they did was they fed the pig corn. I don't know if they force fed it like they do for foie gras, you know. Sure.

But they fed it corn. And then when they, you know, killed it, they took out its small intestine and it was full of corn. And they tied that off and threw it in the fire. Then that was blood sausage. Oh, my gosh. So it was pig intestine cooked. It was cooked. With sweet corn.

With corn. which actually sounds like it might not be so bad. If it was crispy on the outside and corny on the inside, it might be pretty good. Oh, my word. I have other Filipino friends that wanted me to try something called Ballute. Have you ever heard of that? No, I don't think so. Ballute is a duck egg that's been fertilized, so it's embryo as opposed to an egg.

You know, the yolk really isn't the embryo. People say, oh, you're eating baby chickens. Baby chickens, you're not. The actual embryo might be one, or, you know, egg is one cell in the middle of that yoke or on the surface or somewhere. But the yolk is just there to feed it, to give it energy so it can grow. Because they don't have a placenta, obviously, because the egg is outside the chicken's body. So they've got to have something that will make it grow. Right, exactly right.

But this thing is partially formed duck embryo, and you eat them all. whole, and supposedly it's a delicacy. I've never tried it. But anyway. Oh. Yep. Balut. Balut.

Komusta ka to all my Tagalog speaking friends. Mabajo on kili-kili-mo. That means you have bad B.O. That makes sense. And then Malaki Susu-Moh. That means you have an advantageous TTGR. Oh, wow. Yeah.

I mean, I need to remember that, then. Yeah. All right. Putanginamo. That means you son of a bitch. In Tagalog. So that's your lesson for the day. I got it. Let me teach you another word that's very useful in Hindi. And this is the same in Urdu as well, Bacquas. Bacquas.

Can you imagine what Bacquas might mean? Just think of the sound of it what it might be. Oh, bachwas. It's bullshit. Oh, bullshit. Yeah. it's the greatest word I find myself saying

buccas instead of bullshit well first off because you don't get in trouble saying that in the middle of the hall right around the and it's just such a great word because it's like an Anamonopoeia in the sense that it sounds like what it means

right you know ah bequas buccas I love it all right here we go well

What in the hell is going on with this thing today? Barometric pressure changes still enough. Hey, Dr. Steve. This is John. Hey, John. I'm from Rhode Island. I've got an issue with sweating, hands and armpits. It appears to be seasonal.

It appears to be in the fall, the worst, to the point where I will soak through, you know, three shirts. the armpits of three shirts and I'm wondering if this could be caused by caffeine intake before I attempt that and go through the withdrawals. I do drink a few cups of coffee a day so I'm hoping you can help me out.

Thanks. Wow, that's an interesting question. He kind of took a left turn there. Yeah, I wasn't expecting that. You can get coffee sweating. It's caused from drinking excess caffeine, but he's not. And he's probably drinking the same amount.

He says it only happens in the fall. Seasonal, right. That was a big clue right there. And, but I bet he's drinking the same amount of coffee the rest of the year. So that doesn't make sense. So I don't think that's it. He just has garden variety hyperhydrosis. Right.

But it's seasonal, though. That's the interesting part, you know. Well, I do notice for whatever reason that I seem to sweat more when it turns cold in my armpits and stuff. And I think it's just because I'm wearing heavier. More clothes. That's what I was going to say to. I don't know about the hand thing, but the treatment is pretty easy. You can go to stuff.

Dr. Steve.com and scroll down, and there is an iontopheresis machine that you can actually, that actually works. We've vetted everything that's on there, and it, for whatever reason, passing a very mild current through the hands will stop them from sweating. Now, it's harder to do that in the armpits. You can do it. They make pads to do that with, but it's less convenient. A little stinging. And so I would just use Maxim. You can buy Maxim deodorant, also through stuff.

Dotterant. Maxim deodorant is, and by the way, before anybody at Sirius XM freaks out, it's just a page that's got a link to it to get this stuff. we're not selling anything. You can get this maximum, it's prescription strength, deodorant, but now it's over the counter. And you can use that on your armpits and then use the iontophoresis for the hands. Now, they do make medications for this. There's one called glycopyrolate.

Glypyrillate is a peripherally acting anticholinergic medication. Bingo. Oh, that's half a little. Yeah. So let's talk about that. What it means is it doesn't get into the central nervous system, which is good. And it's anticholinergic, like Benadryl. Benadryl causes dry mouth and other, you know, sleepiness and stuff.

But that's the central effects. This glycopyrolate causes all the peripheral effects, the ones that don't get into the central nervous system. I'm going to make you sleepy, but it will dry up your sweat and maybe give you some dry mouth. Okay? So you can get that from your primary care physician or a dermatologist. They also sell other things like, oh, what is the stuff? Is it tamselosin? Is that right?

It's hydrant, whatever the generic for hytron is. And Tarasin. Terazin. Yeah, Tamsalosin's prostate. Yeah, that's right, right, right. Tarasasin. And it also will reduce this to a certain extent. It works for some people.

The really severe cases of hyperhydro where people are just dripping, sweat off their hands, sometimes they'll do a sympathectomy on them. And what that is where they go in and cut the sympathetic nerves to the hand. But I'd tell you, do that as a last resort only if nothing else works. Because a lot of times when you do that, for whatever, reason you start sweating somewhere else it's almost like the body needs needs it right finds another exit yeah yeah so you got anything from the traditional chinese we do you know standpoint for this there are a couple old chinese herbal formulas and we we would say it's an excess of of heat okay so we

would give you and that's what it is we'd give you something to cool everything off to try to turn down the the um the thermostat a little bit if you will and the other thing is too you know we we would look at it as if it is, in fact, seasonal, if it is related to maybe changes in work environment, you know, maybe it's in a much drier environment because they've turned the heat on or something or whatever. Right, right. Who knows? But, yeah, there certainly are. If some of the Western medications don't work, certainly there are some old Chinese herbal formulas that can be beneficial.

What about sticking needles in? Does it do anything for sweating? Not a whole lot. No, we'll use. But when you put that current through it, though, you know, I was going to say, but we're just thinking it's sort of like ionophoresis. But we will do that with the stem, you know, with the tens unit. and actually put it under the axilla, you know, the armpits and we'll put it in the palms. You know, it's funny.

That makes sense that that would work. And you put the current through it. Yeah, we run it. It's called the five heart-ean deficiency, and that's what it is. It's the hyperhydrosis. It's just translated into that. Hmm. Yeah, so I would put, and instead of using traditional needs, I'd use probably one of my pads,

but you still use a frequency unit or 10 unit or something. Yeah. That makes sense. So we treat it, yeah. Now, I think the hyperhydrosis is a single, like, direct current. but I'm not sure how I actually not sure how that works I think it is too because it drives you know the hyper the um goes in one direction so it should be direct correct direct penetrating in and you know a lot of times they will they will especially in physical therapy offices they'll put a little bit of steroid on it and drive the steroid in there too yeah I know they do that for injuries I don't know if they do that for sweating but not all the time no no no if you do it home you don't yeah okay cool lots of options check that out yeah all right Hey, there's a syndrome where someone can have the testosterone could be too low to where natural supplements do not work? Yeah, natural supplements don't work, period.

So, yes, every syndrome where you have low testosterone, natural supplements don't work. For ED or to raise the supplement, I know you talked about some good supplements. Now, when I say natural supplements, I'm talking about quote-unquote natural supplements, meaning things that are sold in, say, you know, a health food store or something to boost testosterone. I have yet to see a single one of those that's got any data that's worth anything to bring your testosterone back to normal. The only thing I've seen, you know, double-blind placebo-controlled study quality data on for low testosterone is testosterone. Yes, the actual medicine. You know, and what you're trying to do is bring a low hormone back up to normal. And you can argue about what the best way to do that is.

You know, we had a doctor on our podcast that said you need to have that swing. So they advocated shots. I don't understand that because you don't really get a swing in, you know, physiologically. It's pretty constant level. I mean, it varies up and down, but there's no huge swings. It's a diurnal swing, but it's not massive. It's a small. Yeah, and you get a diurnal, meaning daily, swing through putting the gel on every morning because you get a peak in the morning and then you get a trough in the evening.

So, but, you know, people of good intent can argue that particular point, but that really is the best treatment. Okay, if you think she is. Oh, what a surprise. Hold on. Tacey, you're on weird medicine. Steve? Yes. I'm picking me up.

Okay, thank you. You're good. Did you get my message? No. I thought we could do Taquazine because Jill's coming. Ooh, now that sounds good. That sounds good.

We can just order Grubhub. Yeah, let's do it. And have it at the house when she gets there because she's only going to be able to be there from like $6.45 to 8. You got it. Let's do it. so okay okay well i'll be home after i pick him up okay okay sounds good okay bye hey i was i was gonna make it so we're doing in grocery how many years 10 years 10 years

and she still has not it's amazing we're even recording at a weird time and she calls in that what that really says is not so much that that she knows when we're recording because she doesn't no she just calls me that many times a day yeah and when i'm not complaining No, oh, no, no, no complies. It's just hilarious. And then when we try to tell us something, it goes in one end and out the other. Oh, yeah, yeah. Hey, but real quickly, though, and going back to the low testosterone thing, different, different, different things work for different people.

Certainly, you know, I tried the gels and did not work at all. Yeah. I try the shots, and the shots work extremely well. Really? The other thing, you know, pellets, sometimes people will go to certain doctors, then they'll actually do little pellets if you don't like the shots and you don't like the cream. Yeah, that's called testapel. and they have to calculate a dose and they insert these under the skin and then they last many months. Yeah, three to four months, sure.

Is it only three to four? Three to four months, yeah. I mean, that's some of the pelts, but I'm sure there's some last longer. But, you know, I think there's a lot of great options. And I'm with you, Dr. Steve. I've never seen a great pure testosterone booster that is completely natural. There may be one out there, and we just haven't heard of it. You were right.

Three to four months, sometimes up to six months. Okay, yeah. But I'd have to see. I'd have to see some significant data, you know. Yeah, I mean, DHEA has been has been posited as something because it's a precursor of testosterone. You have plenty of that floating around, though. And the issue with DHEA is it's also a precursor to estrogen. Right.

So you can take this stuff and it could be converted to estrogen and make you less manly. that can happen if you overdose on testosterone as well that excess testosterone can be converted to estrogen and you can get man boobs and stuff like that which you do so on them please do this under yes physician care i've seen bodybuilders that came in to their health care provider i'm with a testosterone of zero yep because they just killed the the system for making testosterone. So please do this under a physician's auspices and do it based on a medical problem. I'm not a fan of juicing.

And I will tell you this. Now I'll get bodybuilders who cuss me for that, but I'm just, I'm not a fan. What can I say? You know, it's. But done well, it's a life changer. Absolutely. It's a life changer. Absolutely.

I'm on it. You're on it. Yeah, I'm on. Who else was on it? I didn't hear. Was GVAC on it? No. Maybe P.A. John?

I think maybe John was. I know at one time there was, oh, and double vasectomy feces. Right. And I want to say, I want to say the Scheister. Oh, yeah. There was one time when almost all of us were on testosterone supplement. Yeah, I think the Scheister was that. And it wasn't because of me. No.

Nope. No. No. Hey, Dr. Steve. This is Robert in Birmingham. I was just listening to the one where you were talking about starvation. said on average it took five to seven days, meaning half it took

more, half it took less. Well, technically that would be median, right? Not me? Just a dance checker. Yes, very good. Thank you. Which actually was. Thanks.

Give yourself a bill. Give yourself a bill. Uh-oh. Uh-oh. Okay. So he's right. But in the special case where it's a perfect bell curve, the mean and the median will be exactly the same.

So let's talk about that. So let's say we have a set of numbers 11, 23, 30, 47, 56, getting this from vocabulary.com because I don't want to have to do the math in my head. The mean would be the arithmetic mean. Now, what that is is you add up all the numbers and then you divide them by the number, by the, by the, total number of numbers so we've got five numbers so you add them all up it's 167 divided by five is 33 now the median would be the middle point of the number set where half of the numbers are above the median and half are below so in this case the median would be 30 because that's the midpoint of 1123 30 4756 okay so now

Now, if you had a set that was one to 98, 99, 100, 98 would be the median, right? Mm-hmm. Okay. So, because it's in half the numbers are below and half or above. Yeah. The mean would be something different. Well, let's see. Hey, Alexa, what is one plus two?

plus 98, plus 99, plus 100. No clue if she knows how to do that. Oh. Uh-oh. Alexa, say that again. The answer to your calculation is 300. Okay. So 300 divided by 5 would be 60, right?

Right. Right. Yeah. So the mean and the median in that case would be vastly different. So now, if you have a perfect bell curve, you could have the median and the mean be exactly the same number. But that's a special case. So he's right to point that out.

I use that as shorthand. I'm always in my head seeing a bell curve. And so when I say the mean or when I say the mean, that means roughly half of people will live long. Like if the mean survival is 14 weeks for something, you'd think half of people live longer than 14. weeks, half live less than 14 weeks. That's just shorthand. That is assuming a perfect bell curve, which, of course, they usually aren't. Right.

Okay. All right. Hey, Dr. Steve. My name's Alex calling from Pittsburgh. Hey, Alex. And I have a question more or less, I'm asking on behalf of my girlfriend. We're both in our late 20s. And I have a question about Nsades.

so I recently saw that the FDA strengthened their warnings for things like Advil that there is a greater increased risk of heart attack and stroke but I'm not sure how this affects her being that we're younger and we're not already at we're not already at risk so during her period she will take the max dosage for the first two days. So day one, she'll take four in the morning and then two that evening. And day two, she'll take another four in the morning and then two that evening. And then day three and she's tapered off, maybe one, that third day. But I'm not sure what risk she's putting herself under being that we are young and healthy people. Does this morning only apply to the folks

that are already at a risk for... That's a God, that's such a great question. Give yourself a meal. Every month can accumulate over the years and impact her down the road. Beautiful question. Well, said. We could answer, we could do one,

we could do an entire show answering the levels of this question. But I love how he, he asked the question, is it just for people who are already at risk? And the answer to that is not really. Not really, no, it's not. Um, these non-sroyal anti-inflammatory drugs are very important medications that are widely used.

They treat things like arthritis, um, and other painful conditions. And it's not a, yeah, fever and stuff like that. Cardiovascular events are, it's not a new phenomenon. We know about that. We've known about it since 2006, particularly with the Cox 2 inhibitors, which were things like cellicoxy or celibrex. But since then, they've done some important studies that look at the risk of thrombotic cardiovascular events like heart attack in association with non-steroidal anti-inflammatory drugs. And these drugs would include things like ibuprofen, Naperson, aspirin, although we use aspirin is a special case because we use it to prevent heart attack and stroke.

It really isn't included in this. But it's very hard on the stomach. so we don't advocate using a whole lot of aspirin for stuff. So these two studies, these big studies, looked at the risk of non-steroidals with cardiovascular events, and this is what they found, very small increase, very small increase in the risk of cardiovascular events that apply to all users of non-steroidal anti-inflammatory drugs,

not only those with baseline cardiovascular risk factors. So that answers that one question. you don't have to have a previous risk factor now I would love to see them drill down to see if those people had a larger risk than people that had no because that makes sense sure they found that there was a very small increase in the risk of cardiovascular events after relatively short term insed use and that increases with the increasing duration of use and it was associated with very specific non-steroidal anti-inflammatory drugs I got to get this

Oh No I don't Um Where was I In association with the following Specific non-steroidal anti-inflammatory drugs Number one Cellicoxib or Celibrexit

any dose number two high dose dichlofenac who's on that you know anybody on that yes i know a few people yes i do and it would be greater than 150 milligrams per day or high dose ibuprofen at greater than 1,200 milligrams per day so that'd be right on the cusp is what she's taking her first period day yeah yeah that's right because she was she's taking 1200 that first the first day she's having her menstrual grams right so they identified it as being greater than 1,200 right So, and that's, so when you take ibuprofen over the counter, they recommend that you take two tablets. They're usually 200 milligrams apiece. They're 200 milligrams apiece.

They'll be 400, so you could do that for three times. Right. And then you're in that area. Right. No detectable effect on cardiovascular risk was demonstrated for neproxin at any dose. Wow. So I'm switching over to. naproxin. I'll tell you that. I've always

take an ibuprofen and it works well for me. You know, if I feel achy from a fever or something like that, I'll take some ibuprofen, but I'm going to switch over to naproxen. Yep. And I will say this, the sustained usage of those

when you're not under proper health care can really be a dangerous thing. Yeah. One of my friends, she wasn't under good care and she had a heart attack when she was 35 years old. from taking too much of the of these inseds she had a history of rheumatoid arthritis was diagnosed in her early 20s and because of the particular health care system she was under

she was stuck self-medicating and um after years of taking greater than 1,200 of ibuprofen every single day or whatever it was she was thinking I don't want to throw ibuprofen on the bus but she did she in fact had a heart attack and then three years later had a second one So now she has a pacemaker. Wow. And she's in her mid-40s. She's doing okay now, but it's certainly wonderful medications when used appropriately. And, you know, just because she is younger does not necessarily mean your wife is, you know, doesn't have any,

because the risk factors don't really have a whole lot to do with that. Yeah. I calculated the number needed to harm from their data. It was 333. Okay. So that means she'd have to, 333 people would have to take a non-sterole. anti-inflammatory medicine to show one one event extra adverse effect yeah so all right yeah so she's probably pretty good and you ever buy her a hey buy her a water bottle put on her time

that might help all right just be aware of the risk it's all about mitigating risk and that's what everything is about in this world people who don't smoke still sometimes get lung cancer right people who smoke three packs a day sometimes don't get lung cancer but the people who don't smoke have reduced risk of getting it overall and the people who do smoke have vastly increased risk so and you never know which one which group you're going to be in until it happens right so it's just like you know if you're on the roulette table which is the really other than the wheel of fortune that's the worst bet in the house i used to teach casino gambling so uh the vig is around you know, it's somewhat north of 5% against you.

But you'll have people saying, oh, I'm on a streak. I'm on a streak. You cannot ever say that and be correct. You were on a streak. That's true. There are streaks. But you can't ever say that you're on one because then that implies that you can predict what's going to happen next and you can't.

It's just a chance. But every once in a while you get that probability wave, you could win 10 times in a row. And you'll say, oh, I'm on a. streak well you're wrong and that you will make dumb mistakes if you think you are on a streak and it's the same thing with people who are smoking cigarettes and going well I hadn't gotten sick yet you know it's the same as somebody jumping out of a window and then you know for the first 99 floors they're going so far so good so far so good I think I'm flying yeah all right all right

Hey, Dr. Steve, I need you to text me or call me back as soon as you can't, please, if you can get this message. I'm on my way home from work to the hospital. I got a call from my wife, our 12-month-old son, I guess, took the fall off the bed, and he started bleeding from the nose and throwing up, and they're at the hospital now. They haven't been there long enough to figure out what's going on. Okay. This voicemail is like four months old. I'm just going to say, this is why you don't leave a voicemail if you got an emergency.

Because we won't get it for the longest time. If you have an emergency, call your doctor, call 911. Don't call weird medicine. But this is possibly a sign of a concussion. He may have hit his head. Got some vomiting afterward. Always a good idea if you've got any kind of neurologic event with, a sequelae like that, like double vision, gnauzian vomiting, lethargy, anything like that,

just go get seen. There's no harm in doing that and may be a real benefit. The blood coming out of the nose may mean that he took a pretty good whack. Now, he could be bleeding so profusely that he's vomiting because the blood causes... Running down into his stomach. Yeah, it causes irritation in the stomach. And those people will sometimes vomit, too. Or he could have hyperventilated because he was crying so much, and now he's vomiting.

We don't know. Get him checked out. You did the right thing. Sounds like they're on the right back. You did the right thing, and he called us on the way. He didn't delay anything. All right. Hope he's doing better.

Yeah, me too. All right. Hey. I'm a 47-year-old diabetic truck driver, and I'm getting my ass back in the shape. Excellent. So, you know, cardio, throwing some weights around, bicycle riding. My question to you is, will that help boost, like, the testosterone? Second, being diabetic, is it anything I can do, like, exercise-wise,

to stop this whole, what you call the retro ejaculation? And three, doing sit-ups or crunches. every time I put any kind of pressure you know into my you know abdomen I have this lump that pops up like a bump that comes up right in the middle of my stomach

and my question is one what is it why has questions with some questions we got layers have been working out a muscle way too often and

you have the abdomen muscle and two plenty of possibly, you know, while doing trenches, can I possibly, you know, hold that down with my hand and get it to stop popping up to where I can work around it? Yeah, okay, so let's go backward to four. You wrote those down, right? Because I've already forgotten what the first two questions were.

The first one was the diabetes. Well, but I mean, you wrote them down, right? Testoster me. Okay, okay. So the last thing is he's got ventral diastasis. And what a ventral diastasis is is a separation of, the muscles of the abdomen, you know, they come together and knit together, but it's just knitted together with a piece of connective tissue. And as you, if you get really fat, sometimes

that, um, that tissue will separate and you'll get sort of blooping up of, um, of abdominal contents into that. It's usually, these things are really broad based. So people will go, I've got a hernia. That's not necessarily, it's, it's not really different. It, it is, by the broadest definition of hernia in that something is passing through, something that it's not supposed to pass through, but it really is something a little different than that, and it's a lot harder to deal with. And most of the time the surgeons, I believe, say, leave those alone. You might Google ventral diastasis and see if they've got any surgical stuff for that.

Yeah, I will. And the other question was the retrograde ejaculation caused by, his diabetes, and sadly, once that has set in, it's hard for it to return to normal again. What's going on there is he's had diabetes for so long and so severe that it's affected the nerves going to the sphincter that is supposed to reroute semen out of, you know, increase the pressure so that semen will pass out of the end of the penis instead of, of passing into the bladder. And there's sort of an area where these things can mix. And if you don't shut that back valve down, the semen will follow the path of least resistance into the bladder.

We diagnose this by having someone ejaculate, and then we have them pee into a cup. And if nothing comes out of their penis when they ejaculate, but there's tons of sperm cells in the urinalysis, then that makes this. diagnosis of retrograde ejaculation. Now, he certainly getting better glucose control and keeping it that way, maybe over time, there could be some healing of this, but a lot of times that's a done deal. But it's still worth doing because getting excellent blood sugar control will prolong your life. And I suspect that if you're having retrograde ejaculation, you may have erectile dysfunction

as well, and standard medications for that should work like Cialis or Viagra or Lovitra. Especially after he gets his testosterone back up. Yeah, okay, and diabetes down. And then what was his first question was about testosterone? It was, and it was his diabetes and a testosterone. Okay, if he works out. It was losing weight. Yes, that should improve, but he needs to have it tested after that just to make sure that he's

at the normal level. And if he's not at a normal level, he'll need to. some testosterone replacement therapy, and that certainly would be beneficial to him on all of those grounds, including the working out and losing weight part. Did you find anything on ventral diastasis? Yeah, bottom line is in one of the PubMedic articles was comparing a surgical intervention versus physical therapy type stuff, and they're about the same. The side effects from the surgery can be pretty severe, and because it's not, it's a pretty big

surgery and what they're suggesting is try physical therapy someone that has some experience on how to help you work your the rectus muscle and without making the bulge horse and certainly if it were to um oh you're looking at the article that's the general surgeon's perspective of rectus diastasis is that the one no the one because it's the says the same thing yeah no but this is it was similar but this is okay this one let's put mad general general general general general general surgeon's perspective. It's the same article. Yeah, yeah.

Okay, so I'm looking at that as well. Okay. So the bottom line is, yeah, if you can deal with it, that's a good thing. Yeah, they can do surgery on it. Absolutely. And if you're interested in pursuing that, certainly see your primary care, let them get you evaluated. There are, you know, we haven't seen it. I don't know how big it is, how extensive it is.

If it's narrow-based and you've got bowel contents coming out, then that's a true hernia, that's a big, that's a big difference. Right. So that's got to be fixed. Yep. So, all right. What else? Let's see.

What can we do in one minute? Dance? No, I probably not. Hi, Dr. Steve. So I have a question about the dreams. So I've been studying like really, really, really hard for, like, the past 10, 12 months for some really important examinations. And during this period of time, I've been just having these really hyper-crazy, vivid dreams. Okay.

We're out of time. That happens when your mind is occupied and you've been hyper-focused. And then you start having, you don't, you have weird disruptions of your sleep architecture and you'll have these weird dreams. A lot of times they're related to what you're dealing with. and when your exams are over and you start to relax, take a vacation, all that stuff should go away. All right. All right.

Thanks always go to Dr. Scott. And 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, and Fizz Watley, who's support of this show has never gone unappreciated. Listen to our SiriusXM show on the Faction Talk channel. Serious XM, Channel 103 Saturdays at 8 or 9 p.m. Eastern, I'm not sure which. 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.

And 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. Thank you.