Weird Medicine: The Podcast - 354 - Ketamine Goes Mainstream

Episode Date: March 28, 2019

Dr Steve's new disease, ketamine approved by FDA for depression, histamines, what are dreams (we don't know), sleep stages, prostates, a rare esophageal malady, and more! PLEASE VISIT: stuff.doctorsteve.com simplyherbals.net noom.doctorsteve.com freshly.doctorsteve.com 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. Me and the garretid. I've got diphtheria crushing my esophagus. I've got Ebola spripping from my nose. I've got the leprosy of the heartbound, exacerbating my impetable woes. I want to take my brain now.

Blast with the wave, an ultrasonic, agographic, and a pulsating shave. I want a magic pill. All my ailments, the health equivalent of citizen gain. 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 aging Dr. Steve. It's weird medicine, the first and still only uncensored medical show in the history of broadcast radio and the longest running show on this channel.

Why am I doing the Sirius XM? opening just to keep people on their toes. I'm Dr. Steve with my little pal. Dr. Scott, the traditional Chinese medical doctor, gives me street cred. With the wacko alternative medicine assholes, hello, Dr. Scott. Hey, Dr. Steve. This is a show for people who would never listen to a medical show on the radio. If you've got a question, you're embarrassed to take your regular medical provider.

If you can't find an answer anywhere else, give us a call. 347-76-4-4-3-23. That's 347. Poohead. Visit our website at Dr. Steve.com for podcast. Podcast, medical news, and stuff you go by. I can't mention contractually. Most importantly, we are not your medical providers.

Take everything here with a grain of salt. Don't act on anything you hear on the show without talking over with your doctor, nurse practitioner, physician, assistant, pharmacist, caropactor, acupuncturist, yoga master, physical therapist or whatever. All right. Don't forget, please, don't forget, to check out Dr. Scott's website at simplyherbals.net. Simplyherbal's. That's right. For the greatest, and I say this without. hyperbole

the greatest nasal spray ever made. Tis the season for it too, by the way. We are selling it like we can't keep it on the shelves. By the way, I've got something to give you. I've got some, you see that

Bobby Kelly tag that we used for backstage passes. They're very nicely laminated with a little lanyard, and it's kind of a cool rare comedy comedy

momento yes souvenir and I'll give you 20 of them so the next 20 people that order something from your simply herbal site

can get one of those oh cool that would be great yeah it would be cool yeah people love they're not autographed or anything I could scribble some

an R and a K on there make it look like it but they are cool he won't care okay so remind me when you go out I give you 20 of those. Sounds good. And, yeah, don't forget that. Check out, if you're interested in losing

weight with me, go to Noom.com. I'm down 25 pounds now, feel like a million bucks, except for my polymyelogramatica, which has nothing to do with anything. We'll get to that later. Hey, I was going to say real quick, too, make sure that if you're a weird medicine friend to put in the comments that that's who you are, so I can send you those out. As if not, it's hard for me to know. Right, right, right. Yeah, so that's very good. And, Also, one thing that we're doing, you know, we've done Blue Apron on the show, and we've done some other food-related things. I got a new one for you. It's called Freshly.

So I got lazier and lazier. So, blue apron, so first, okay, so you cook and you buy stuff, and you end up throwing a lot of stuff away. You only need two radishes. You've got to buy a whole bunch. So the benefit of Blue Apron, of course, was that they have everything perfectly measured if you need one, ounce of soy sauce that gives you one ounce. Yep, that's right. They don't send you a 12 ounce bonnie to throw the rest of the shit away.

Exactly right. It's wonderful. Exactly right. Love blue apron. So we love that. And then I went to Tara's Kitchen. Tara's Kitchen, they do all the prep for you. You don't even have to cut anything up.

It's already pre-chopped and everything. You just dump it all together. Okay. And then, so I did that for a while, and then I got even lazier, and now I'm doing one where they just make the food for you. It's called Freshly. It's all gluten-free. All prepared.

We have really cool. You can do vegetarian, you can do pescatarian, no pork, whatever you want, and it's a really cool thing. And we have a deal for $40 off. Freshly, they deliver fresh prepared meals that make eating right super easy. And it is really tasty. I've only had one thing that I didn't like that much, and it was just one thing I didn't like as much as the others. I still liked it. You can use my link to get six dinners for $39 for two weeks.

That's $20 off each week. Give it a try and let me know what you think. Go to freshly. com. It's f-r-e-h-l-Y dot-doctr-steeve.com. And let me know if you try it, if you like it. I love it. My wife and I love it.

We do three meals a week. And that way, you know, if we got homework to do with the kids or something, we just throw one of those in. And don't worry about it. Well, you know, and Dr. Steve, you're like me with this Freshly thing is wonderful because we don't do a lot of glutons or any, you know, breads at all. So that's, this, this would be wonderful. We'll try it.

Yeah, we'll try it. It's good. Cool. And don't forget, if you want archives of the show, check out premium.com. That's premium.com. That's premium.com. And for a buck 99 a month, you can get access to all of our archives. And if you use the offer code fluid, you get even a better deal than that for the first three

months. All right. So, how are you, Dr. Scott? I'm doing well. I'm battling the Bradford pear tree bloom. Well, what's that? I am allergic, as can be to those dang pear trees. Oh. When they bloom, they turn white. I start sneezing. And I stop sneezing when they turn green. So I've been battling it pretty hard. You're not taking any of your herbal bullshit? I am. And that's about the only thing keeping me semi-sumptuously. fine you know man yeah just a sneeze sneeze sneeze sneeze but i'm right that's almost over yeah spring is here yeah that's i usually have trouble in the spring and the fall so you know there's always something in the air i um uh okay so if you had a patient who had sudden onset of muscle

pain in the shoulders and the hips, moving around, but muscle pain, not so much joint pain, but muscle pain, and mildly elevated inflammatory markers, and really no other symptoms, what would you, what would your diagnosis be? Do you guys have a diagnosis for that? Sure. Well, in Chinese, we call it Wondering B syndrome, which is a wandering inflammation, syndrome of inflammation. Yeah, that sounds right, because we call it pretty much the same thing.

It's polymyalgia rheumatica, and that's what I have. It's usually a disease of 80-year-old women, and all of a sudden, you know, I had just said, because of this, you know, Nume program I've been doing, and I lost 25 pounds, I would just say, and I feel better than I felt in 20 years. And I did, and then this hit. It's got, you know, nothing to do with anything. What's up? Your said rates up? Just very hardly. But in polymyalgia rheumatica, so let's talk about what that is.

It's a syndrome generally found in people over 50. A lot of times you'll see it in little old ladies that are over 80 where they have proximal muscle pain. So I have muscle pain in my hips. And it doesn't, it's not like I worked out. It's a different kind of pain and it keeps me up at night. And I feel like shit. So I got put on some steroids, and that made it better. So that kind of confirms the diagnosis.

There's no blood test or biopsy or anything like that that you can do to prove that you have it. So it's clinical. But polymyelogramatica, I hope nobody in the audience ever gets it. It sucks. So what's the underlying? Because I'm assuming it's autoimmune. We guess. I already had one autoimmune disorder where I had that inflammation in my eye.

Oh, it's right. God, I remember that. How many years ago was that? That was a bunch of years ago. But I had what's called posterior uveitis, and that's an inflammation of the back of the eye. And my vision went from 2020 to 220 one day. And I had to get steroid inject. in my in the back of my eye and one time actually in the eyeball itself so if you want to see

me getting needles stuck in my eye go to youtube.com slash lobster johnson or just google uh dr steve gets an injection in his eye i think it is but anyway have you you know have you changed anything else diet wise eating warm because i know you don't eat great it's not diet it's not diet um but don't you think that but diets can certainly well yeah but the thing that I've changed recently was I got put on blood pressure medication because my blood pressure

has been running up a little bit you know I've always had 120 over so you know I hit 63 I'm falling apart you're an old fucker now and so I did look it up and it rarely it can cause this so I'm off of it my blood pressure is not high enough to being off of it

for a couple of weeks it can make any difference we've got some old Chinese for blood pressure we can put you on well there you go for sure yeah see if it well i'm probably going to come see you for this muscle pain and when i first started on the steroids it kind of just went away but like today i've been sitting a lot and that's the problem with polymyelogramatica too is they uh well there's this thing called gel phenomenon and you know when you're up moving around and you're kind of fluid you feel okay and then when you sit down and like you're watching a movie or something you'll stiffen up like stagnation well it's yeah exactly what it's

It's, um, the jail sets in. Right. Yeah. In Western medicine, they call it jelling, but it's, yeah, where you're, you know, you mix up a bunch of gel it and let it sit. And then all of a sudden it kind of stiffens. That's really what's kind of going on with me. You know, it reminds me the old, of course, we're all huge John Prine fans here. I don't know if everybody else is, but he talks about in one of his songs, if you've ever seen blood, you know, laying on the pavement, it looks like a shadow, you know, because it does.

it becomes gelatinous and loses its color becomes gray, you know. And that's kind of what, and in Chinese medicine, we call it stagnation. So what you're getting is a stagnation of that blood

and the energy through those joints and it gets lodged up in those muscles and you get pain. Yep. Yep. It's a stagnation situation.

I'm just looking to see how you can find it. So I don't know. I'll have to do one of those bitly links, but it just go to YouTube. dot com slash lobster johnson it's l-o-b-s-a-johnson all one word and then you can see me getting a needle it's stuck in my eye we're going to put you on some some curcuma you know some of the tumor because it's

been shown in side head head had studies with steroids in cases like this yeah yeah equally as effective okay I'll try it yep so I'll get you some of that I'll try it absolutely I'll try it All right. We had a news story. The FDA approved ketamine. We've been talking about this actually for some time on this show, actually for years. Ketamine is a street drug, special K, it's called. It's a dissociative drug that causes, you know, a real crazy euphoria.

It was approved for years for anesthesia. And people started abusing it when they'd come out of anesthesia, and they'd kind of be hallucin. and stuff like that. So I guess some people like that. But what they found was used off-label, and we'll use it, like if I've got someone with rectal cancer and they've got a tumor or an ulceration or an inflammation of the rectum will make ketamine suppositories, and very little of it gets absorbed, but it really is an excellent analgesic for, you know, topical mucus membranes and stuff.

You can make, you can compound it into a little top of, oh, cool, topical cream. Yeah, well, we compound it into suppositories and you just shove it up your ass. Yeah, yes, you can compound it into topical creams as well for people who have really bad symptoms. And so they found that this stuff was really effective for depression, but it was so off-label. You couldn't really give it to anybody. And the problem with depression is the medications we have. particularly the selective serotonin reuptake inhibitors, or SSRIs like Prozac, Paxel, and Zoloft, take weeks for them to reach peak effect. And, you know, we used to say two weeks.

Really, it's more like eight or 16 weeks. Oh, wow. Same for the S. You're depressed. That's a long damn time. Same for the SNRIs. Yep. And they have withdrawal syndromes.

and, you know, they've got other adverse effects that come with any medication. You know, there's always going to be some adverse effects, but sexual side effects are a big issue with those medications. Arectile dysfunctional loss of libido, delayed ejaculation, that kind of stuff. Or anorgasmia in the case of women. So we've always been hoping for yet another type of drug that we can use in depression to see if we can, you know, get people feeling better using a different mechanism. So anyway, the U.S. Food and Drug Administration today approved spravato.

It's esketamine nasal spray in conjunction with an oral antidepressant for the treatment of depression and adults who have tried other antidepressant medications but have not benefited from them, a.k.a. treatment resistant depression. Now, in the past, if you had true treatment-related or treatment-resistant depression, about all we had left was shock therapy. Right, E-C-T. And electroshock therapy or electroconvulsant therapy is pretty damn effective, and it's not like what you saw in one flew over the cuckoo-year-old. Yeah, it's not like that. No.

It really never was. I've seen it, and I saw the person's toe twitch. You know, that was all, and maybe their eyes flutter. I have a couple folks going through ECT right now. Really? Yeah. And they're doing well. Yeah. Well, because of the risk of adverse outcomes resulting from sedation, because this stuff is a sedative and dissociation.

Remember, we talked about this being a dissociative drug, so people feel like they're outside their body and stuff like that. The potential for abuse and misuse of the drug, I can just imagine if we had a bunch of people out there with kids. ketamine nasal sprays, tooting up people at raves or whatever these kids call their parties these days. It's only available through a restricted distribution system under a risk evaluation and mitigation strategy. So it's a so-called REM's drug, which means you have to take a course and you have to become certified. You have to register yourself with the federal government, and you have to register the patients, too. And the pharmacies have to be registered. So right now, another REM's drug, it would be the transbuckle fentanyl.

These are for people with chronic cancer pain who have severe breakthrough pain. And they have these fentanyl lozenges and fentanyl lollipops. They don't like them called lollipops, but that's what they are. It's, you know, sugar matrix on a stick. And it looks a lot like a lollipop. Yes, and it tastes like one, too. And those are issued under a REM's strategy as well. So when I prescribe those, I have to fill out a bunch of paperwork, register the patient with the federal government.

They need to check and make sure I am. And then they've got to go to a pharmacy that is also registered and all this stuff. And that's why you don't see people showing up in the emergency room with transbuckle fentanyl. overdoses because they can't get their hands on it. Very difficult. Yeah, at one time, they talked about putting all of the long-acting opioids on a REM strategy, which would just add to the difficulty in getting people medication. So, anyway, so it's going to be on this REM system, and the way it'll work, it says patients with major depressive disorder,

who, despite trying at least two antidepressant treatments, give an adequate, doses for adequate duration, the current episode, who have not responded to treatment are considered to have treatment-resistant depression. The spravado labeling contains box warning. The cautions of patients are at risk for sedation or difficulty with attention, judgment, and thinking. And it looks like you're going to have to come to the office to get your dose, and then you can't be the one driving.

Okay. When you go home. It says the patient self-administer spravado nasal spray under the supervision of a health care provider and a certified doctor's office or clinic. The spray can not be taken home. The health care provider will instruct the patient on how to operate the nasal spray device, and they'll check the patient to make sure that they're okay before they let them leave. The efficacy of spravato was evaluated in three short-term clinical trials,

one longer-term maintenance trial. In the three short-term studies, patients were randomized to receive spravato or a placebo nasal spray. So this one is easy. You have these bottles like Dr. Scott's nasal spray, which you can get from simply herbals.net. But, you know, in one, you put the drug in, and the other one, you just put saline in, and the patient doesn't know, and the doctor doesn't know. And then you see, you know, you measure some endpoint and said, let me see here, the primary efficacy measure was the change from baseline on a scale used to assess the severity of depressive symptoms.

So there are a bunch of those. I don't know which one they used. We use a thing called the PHQ9, and it's just a survey that you give to the patients. And depending on their answers, you add it all up, and it gives you a level of how badly depressed they are. Interestingly, the lowest score you can get is a zero, but one to three is considered minimally depressed. So almost everyone is considered minimally depressed. Wow. It is 2019 after all, don't you know.

Okay, spravato nasal spray demonstrated statistically significant effect compared to placebo on the severity of depression and some effect was seen within two days. And this is unprecedented. The two other short-term trials did not meet the pre-specified statistical tests. The longer-term maintenance of effect trial, patients in the stable remission or with stable response who continued treatment with spravato plus an antidepressant experienced statistically significant longer. time to relapse. In other words, they were better for longer than patients on placebo. So it's not perfect, but it's something else we can throw in our armamentarium, and it kicks in two days.

Right. That's huge. Wonderful. So if I have a hospice patient who only has, you know, 30 days to live, they don't have eight weeks to wait for their antidepressant to kick in, we can bring them in and give them the spravado, and hopefully in two days they start feeling better. Got to be wonderful. Yeah.

That's great news. So anyway, so FDA approves ketamine. That's cool. All right. Well, you want to answer some questions? Number one thing. Don't take advice from some asshole on the radio. All right, very good.

Let's see what we got here. Uh-oh. Okay. New studio. Technical difficulties. That's okay. Dangerous. or is it dangerous, can it cars like heart, problems, heart?

Okay, what? Hey, I was wondering, is the drug Bucerone dangerous, or is it dangerous, can it cars like heart, problems, heart, arrhyth, things like that? What was the drug he was asking about? Buesperon. Oh, Buespiron. Yeah, okay. Yeah, okay.

I took that stuff. Busepiron is an anti-anxiety medication. It's sold under the trade name of Busebar, and they use it to treat anxiety or the symptoms of anxiety. And they don't really know how it works. That's part of the issue with it, but it does seem to work. It's pregnancy category B, so there's no animal studies that have shown harm to fetus, but there are no adequate studies in pregnant women. And it does have a lot of drug interactions.

I mean, I'm looking at the list. It is as long as your arm. Right. So you've got to be aware of what you're on and what you're taking. Your pharmacist should be running a drug interaction or your primary care provider, whoever is going to use this stuff. So you don't want to take Buespirone if you're also taking a drug with monoamine oxidase inhibitor activity. Of course, you all know what that.

is, goodness gracious. Okay, so M-A-O inhibitors are old-school antidepressants. Most people are not on them anymore, but there are some medications like L-Dapril, which people may be on and they may not be aware that those have M-A-O inhibitor activity. So I'm not too worried about that one. It also adds to the effect of alcohol, et cetera. So let me look at the adverse effects, see if there's a lot. anything cardiac can cause chest pain rarely.

Now, here's the thing when you're doing one of these studies, if you have just a weird statistical anomaly and the people in the treatment group get run over by buses statistically more significantly than the one group on placebos, you've got to report that. I'm being a little silly, but it's almost like that. So on these rare ones, you've got to be careful because it could have just. been a statistical anomaly. But chest pain is a rare complication of this medication. Faster pounding heartbeat, I had that with it.

I would take it first thing in the morning, and I was married to somebody that made me extremely anxious, and that's why I thought I needed it. I didn't want to take something addictive because the great thing about this stuff is it's an anxiety medication that's not habit forming. It doesn't seem to be a significant trigger. for abuse and stuff like that but right around 10 in the morning I'd get this what I've I attributed as a serotonin rush I would just get this rush and it go all tingling all the way through my body and you know the first time it happened

I thought maybe I was hyperventilating something you know when you hyperventilate you kind of feel that way sure and so the next day I had it and it was the timed exactly the same and then I skipped a couple doses of the abuse bar and it went away and then I started back up again and then it happened again so there's your proof but anyway in coordination

mental depression sore throat I mean how is that stiffness of the arms or legs I can relate to that less common blurred vision sweating claminess decreased concentration muscle pain spasm cramps or stiffness But, you know, that's my problem right now, but I'm not taking BUSBarr.

But anyway, so I don't see any major cardiac effects with that. So if that's your question. But BUSBarr is an interesting drug. I think it's underutilized. It's pretty good for anxiety. And, as I said, relatively inexpensive and non-habit forming. Now, what do you guys use for anxiety? Well, believe it or not, we have a couple of formulas, one of which is what I base my

stress less formula off of what's called Chihua Lungubuli Wan, which is a... Get the hell out of here. It is. I swear it is. But it's for liver-chi stagnation, and it actually works extremely well. I don't know. I know it's crazy, but it does. It works extremely well.

Really? Yeah, for... So what is it really? Mild depression. Do you know the Western... the Western mechanism of its action by any chance? No. Never even bothered looking it up as all Chinese.

We didn't, that was the whole thing. No, I know, but, you know, some of this stuff. Some of it, there's a lot of carryover. It works the exact same way. Termaric. Tumaric, yep. Has, you know, Cox 2 or Cox 1 activity. I think it's Cox 2 inhibitor, isn't it?

Yeah, I think so. I don't know. Basically the same mechanism as ibuprofen. stuff like that. Yep. So that makes sense. Red yeast rice. Yep.

Has this, has actually the same medication as Mevacore, which is a statin drug. It actually has statin in it. So if you're taking red yeast rice thinking, oh, I'm not taking one of those statins. You're still taking a statin. When you eat on that herb we like for scientists, is Xanthium. It's got a little bit of a mast, you know, inhibitor in it. Mass cell. Mass cell, yeah.

Stabilization. So we should probably explain what mass cells are. They're inflammatory cells. If you look at them under a microscope, they've got all these little globules in them. And when they're in the presence of certain antigens, they will degranulate, which means they basically give their life for the greater good. And they'll explode and send out these globules, and these little globules have histamine in them. And that will, the histamine increases the fluid production in the nose to wash out this antigen, whatever, stuff like that. And that's why we take antihistamines because that effect is pretty blown out of proportion when you're trying to be in polite company and not have your nose draining.

Draining and fluid from your head, yes. So, yeah, so the xanthium has some mass cell membrane stabilization so they don't degranulate as easy. Yeah, interesting. Well, pepperment oil, you know, works on inflammation, so there's a lot of good stuff. All right. Hey, Dr. Steve, got a question for the neurological brain activity when we sleep. Is it, I guess when you go into REM sleep and you have dreams, you know, your body sticks and itself in sleep. But let's say you don't have dreams.

now having said that between dreams and not having dreams is do you think that your body's working itself for fixing it more because sometimes a lot of times to me i have a lot of dreams during the night so it's kind of like your brain's supposed to be shut well i'm not shut down but your body shut down to help it and it's fixing itself because it's coming from the brain or whatever necessary whatever but but if you're having a lot of dreams is it like going fuck the body i got dreams to do my question of that is does it is there something there because i was yeah i don't know here's the thing nobody really knows and we don't know how the brain works so when the brain doesn't work right it's hard for us to fix it we don't know what consciousness is after all this time we still have no clue how this sort of recursive loops of neurons can create a thing that goes, hey, I'm here. It's the, and that's kind of the cool thing about the brain is it does so many interesting things,

not only all day long with sleeping and, you know, keeping us balanced and how many tasks do we manage every single day. But at nighttime, which is one of the things that I talk to people about all the time, is helping people with anxiety and specifically anxiety disorders is how to use that sleeping brain when you're having anxiety. Being able to differentiate between something that needs your attention versus something that doesn't need your attention. For instance, at nighttime, you're laying there at night, you hear the air conditioner kick on. Your body, your brain doesn't move. Maybe you hear your husband or wife storing. Brain doesn't kick on but if you hear

a fire truck going down the street your brain or a knock on your door or a knock on your door and your brain says wait a minute that's important let's let's bypass it there's something that's let's bypass this thing that says hey this isn't important put this down here in the okay level and to me that's the most incredible thing and I don't think anybody has any idea exactly what that mechanism is

yeah there has to be some subroutine that is monitoring what's going on outside because you can be woken up. You know, if your kid comes in your room and say in your name, you'll wake right up. Right. And as your wife saying your name, he doesn't bother you at all. That's right. I'll completely ignore that.

Yeah, so there are some things we do know. We can describe what we see, but we don't know how it works. So, or why we sleep. We think that there's some repairing going on. Healing, sure, healing of the body. I guess. Yeah, almost has to be. almost has to be but maybe not because god you know will you feel like fucking shit when you

don't sleep right and that's a true but is that a function that you need to um uh go through this process and if you don't you feel like shit or is it truly that um if you didn't sleep you would still feel that tired and somehow you'd have to i you know i just don't know it's a you know Is it a, are our brains only good for consciousness, you know, a certain number of hours during the day? And then they've got to, because things build up in it and have to be cleared out. And the only way they can do that is for you to be unconscious during that. I don't know. Nobody really knows.

I don't care what they say. They think they know, but they don't know. I wonder, and you may know the answer to this question, but I wonder what the, just the night time, let's just say, Your body kind of goes into a slow down, pause, cruise control, whatever you call it, uses a whole lot less energy. I'm just wondering how much energy the brain uses versus the heart or the liver or, you know, other organs. You know what I mean? I don't know if anybody's ever.

I don't know, but I do know that the body will basically shunt blood to the brain at the exclusion of all other organs. Well, especially, you know, you think about it when it's endangered. Well, especially somebody falls into, you know, falls. through ice into a frozen, you know, lake. Yeah. The body can somehow shunt the blood away from extremities. That is an interesting one. That's called the diving reflex.

And if you have a kid, particularly with a very small body surface area, and they can chill their whole body really quickly and they fall into a lake, there have been kids that have been successfully resuscitated 45 minutes later. Jeez. So it's almost like a suspended animation situation. And you don't give up doing the code blue until they're completely back to their normal body temperature. Wow. And you're not going to be in too big of a hurry trying to get them back into their normal body temperature. Gradual rewarming is better. Pretty interesting.

Yeah, there's a whole lot of shit we still don't know. And neurology and immunology are the two big final frontiers. some medicine. So let's talk about what we do know about sleep. So you've got these four stages, right? Stage one is the lightest stage. You have slow eye movements and you're drowsy. You can be easily disrupted.

This is where, you know, if the cat knocks something off the table, you know, you'll wake right up. Your muscle tone relaxes, but you're not paralyzed. Now, this is where you can get those things called hypnot jerks where some, what I'll be doing is I'll be falling into sleep. And then boom, it'll be like someone, it's almost like I'm having a dream that somebody kicked a soccer ball and they kicked it right at my face and I have to duck. And you jerk. And those are hypnagogic episodes because you're, they're hypnagogic because you're going into sleep. Okay.

Now, the episodes where you wake up, and we'll talk about this in a little bit, and you're paralyzed. Have you ever had one of those? No. I've had sleep paralysis. No, and I've had the hypnagogic thing. But mine's always a baseball coming up my head. Yeah, well, you were a baseball player. I was a soccer player.

So, there you know. Yeah. So bizarre. But if you ever have sleep paralysis, that's where you wake up and you're paralyzed and then you're hallucinating. You're good because the brain is still dreaming. But you're conscious. It is a form of lucid dreaming, and if you can control it, it's kind of fun. In literature, people who have had sleep paralysis have claimed that they were abducted by aliens,

and they'll almost always say they wake up and they can't move their body, and that I've had it, so I know what it is, and the first time it happened to me, there was a giant eye floating next to my bed. Right? And then when it blinked, I woke up. Oh, my God. So if I didn't know better, I would say, well, maybe that was an alien, and then they abducted me, and I just don't remember it. But, in fact, it was a hypnopompic episode.

Hypnopompic meaning that you're emerging from sleep. So hypnagogic, you're descending into sleep. Hypnopic, you're descending out of sleep. So anyway, so stage one is when you have those hypnogogogic episodes. And then stage two is the... The first actual stage of non-REM sleep, and it's harder to wake you up, and you still have slow-moving eye movements, and your brain waves start to slow, and it's very difficult to wake you up during this time, and your body temperature decreases, and your heart rate slows.

And then stage three is deep sleep, or deep non-REM sleep. is they call this the most restorative stage of sleep. It consists of a certain variety of brainwaves on a EEG, and awakenings are rare, and it's difficult to wake somebody in stage three sleep. They're the ones where you're going, hey, hey, wake up, wake up, wake up. And this is when sleep terrors, sleep talking, or sleep. sleepwalking occurs. So do you know the medical term for sleepwalking?

Somnambulism. Somnambulism. And then do you know what sleep talking is? Some rambling. That's close. Somniloquy. Oh, there we go. Somniloquy.

Like a soliloquy. Sure, of course, yeah. And then night terrors. And night terrors are where people sit up and they just scream. Oh, yeah. And then you usually can get them to calm the fuck down. and then they go back to sleep and they don't have any remembering of it.

Right. So anyway, so that's stage three. And then there's good old REM sleep, also known as rapid eye movement sleep. It's, this is the stage when you're dreaming and you have these rapid eye movements moving from side to side. Your brain waves are more active.

You can be awakened or aroused easily. And if you are awakened during REM sleep, most often will remember the dream. that you're having. So people say, well, I don't ever dream. No, they do dream. They just don't remember it. Right.

But if I put a polysomnia on you, that's the device that, you know, monitors you while you're sleeping, monitors you're breathing, your eye movements and all that stuff. And I woke you, you know, I set off a siren. Every time you went into REM sleep, you would remember those dreams. Right. So. But anyway, and if you wake them up during a REM, They're going to probably feel groggy because you're supposed to go light sleep and then deep sleep.

Let me see. It's LDR. So that's the nemonic I remember it. Light sleep and then deep sleep and then REM. That's the common cycle. And then you'll go back to light and then deep and then REM, light, deep REM. Now, I've got a Fitbit and it. it monitors my sleeping.

I never do that. I'll do a couple of bouts of deep sleep early in the night that I'm in light all night and then a couple of arousals and a couple of REM episodes and then I wake up. So. I have had sleep issues my whole life, kind of like that. I feel like I sleep with one eye open. Really? I'm always in light sleep, but.

You sort of nod. Oh, well, yeah. You tried the, the, um, THC. gummies, right? How did that work for your sleep? I will tell you this. Thanks to you, those gummy bear melatonins were profoundly helpful. And then, of course, when we were in the state of Colorado, we did, I tried the gummy bear THC. And a little teeny piece of that with my 5 milligram melatonin, gummy bear melatonin, man, I slept like I think normal people's sleep. It was wonderful. Really? Yeah, she's. So you would combine the THC?

with the Militone. Now, we're not recommending this. No, no, no, no, no. This is strictly for me. You know, you can get to this. That's right. And it's in, um, but you know, those gummy bears, they are like 10 milligrams and I broke them into quarters.

So there's really a small dose of the T. The THC gummingware. Yeah. Yeah. The, um, that indica, in the couch version. Yeah, indica. Right. Indica.

Right. Yeah. That's the mnemonic I use as well. Did you see, did you see they're putting a THC and a beer now? No, but check this out. And believe it or not, the guy that's inventing this is the same gentleman that invented Blue Moon. Okay. Which is one of my favorite beers.

But he took his beer, took the alcohol out, and is infusing with a little bit of TAC in it. Really? Yep. Yep. They're taking the alcohol out. Yep. Yep. Pretty cool.

Can't be consumed other than at your home. So you have to buy it at a dispensary and take it home. You can't drink it at a bar. Yeah, yeah. So I thought that was kind of interesting. Anything other than smoking. I wish they wouldn't legalize it around here so we could just try all these different things. It's not fair.

No, it's not. But, you know, I'm a huge fan of anything other than smoking. Smoking, to me, is not a great idea. I just don't like polluting the lungs at all. No, me neither, with burned things. No, no. But the lungs are a great way to get drugs into your system. Right.

There are techniques. There's a thing called an AREX, which I don't think ever hit the market, but it was a drug delivery system that they were going to use for things like insulin, but also for morphine so that you didn't have an IV. And the problem with inhaled morphine is if you put it in, let's say, you've seen one of those machines where people have like what they have emphysema and it's a nebulizer. And if you put morphine in that, you get about 10% bioavailability. In other words, if you put 10 milligrams in the pot, you'll get one milligram into the bloodstream. Okay, so it's a 10% bioavailability because most of the medicine you're blowing out into the atmosphere. Because everywhere, sure. So this Aerex thing, it was neat.

It had like little plastic domes, just like caps. Remember caps? Sure. Like you got a cap gun when you're a cat. kid had that strip and the little domes of gunpowder in it and it would advance. Well, this is the same thing except it's plastic and inside the domes instead of gunpowder would be the medication. So every time you would take a breath, it would advance the tape and puncture one of those

domes and inject that, you know, the mist into the stream that you were inhaling. So you would only get medication in that stream when you were actually actively inhaling. And when you do that, the surface area of the inside of the lung is so huge that you get rapid absorption of drugs faster even than maybe even IV. Right. Which you think, well, IV is the fast. Say, well, okay, yes, but you inject it. It's got to go up the arm and it's got to work its way into the circulation, got to hit the heart, and then it's still not mixed up. You know, it's not gone everywhere yet.

But it has to break down and be dissolved kind of throughout the system. Yeah, or dispersed. It's already dissolved, but yeah, it's got to be dispersed through the system, whereas with the inhaled stuff, you're hitting so many capillaries at once that it gets into the system a lot faster. So you figure, you know, nothing can be faster than an IV, but this actually is. And so they can use it for a lot of different kind of drugs. And that's why people enjoy smoking pot because it gets into their system so quickly. But I don't know anyone that's smoking. it anymore. I mean, I'm sure there are some people that do, but everything I'm seeing now

is all geared toward vaping and edible. Yes. So. And there's this wonderful vaping technology with this Evod pen and stuff. You know, it's quite advanced and quite wonderful. So we are advocates of legalization, of sensible legalization for marijuana. And I certainly, for medical uses, why would I deprive a hospice patient of a drug that obviously would do them some good? And statistically shown to do good in excellent clinical trials.

And yet it's political football. We can't have it. There's a bunch of benefits out there, especially some of the other side effects that we don't see in that controlled, you know, versus some of the prescription narcotics. Yeah, it can be a lot, a lot more dangerous. Yep. But anyway. All right.

Hey there. I was calling, this is T. James from Columbus, Indiana, and was calling to see if you could tell me about a little information on an enlarged prostate and fertility. I have a question on going to the doctor not that long ago and them telling me that I was infertile and the doctor had told me it ended up being a internal specialist for the urinary track I guess said that my prostate was enlarged and actually was maybe controlling that sometimes I go to the restroom and it looks like I have jizz in the bottom of the toilet And I was just curious if that's something that you've heard of before and if you could possibly, potentially, if at all, help with that.

Yeah. He has prostateic congestion. And when he's moving his bowels, he's got the, okay, so the back part of the prostate is the front part of the rectum. Right against it. And so when we want to examine someone's prostate, go back and watch the Tippy Tom video. You know, we're sticking a finger in the rectum and pushing down toward the front of the body, and you can feel this sort of rubbery walnut organ in there, and that's the prostate. When you have a real large one that's congested and has an overabundance of fluid in it,

if you pass a hard stool past that, you will extrude. It's not an orgasm. It's just purely fluid dynamics. You're putting pressure, and fluid will follow the path of least resistance. you're extruding fluid out of that prostate through the end of your penis into the toilet. And you may not even notice it because you're not ejaculating. It's just. You're not enjoying it as much.

Yeah, you're not enjoying it. And we will exploit that if we think someone's got a prostate infection. You know, you stick your finger in their rear end, press down on the prostate. And if you have a decent technique of massaging it, you can extrude fluid or express fluid. fluid out the end of the penis. And it's always best if you warn the patient ahead of time that you're going to do this because it's not cool when you do it and they're not ready for it. And you also want to capture it.

So you have them hold a glass slide under their urethral meatus, aka cockhole, and to catch some of it so that you can look at under the microscope. Right. And if you see white blood cells confirms the diagnosis of prostate infection. so yeah so he's got an enlarged prostate he may I don't if he if I had him on the phone I'd ask him how often does he actually ejaculate because ejaculating will decrease prostate congestion it will not decrease prostateic enlargement right and when I say prostate enlargement I'm talking about the actual gland itself is enlarged But if it's just congested, it will appear enlarged until you bust a nut.

That's right. Get some that meanness out there. Yeah, get the poison out. Those tired. Oh. I love a masturbate. Well, who doesn't? But I would tell him, you know, number one, make sure that if he is taking anything,

sometimes in I have seen this a lot, people taking, especially men taking antihistamines can, lead to prostate inflammation. so he could have a little sluggish prostate from that. Or if he has an enlarged prostate, taking an antihistamine will make it difficult for him to urinate. But this will not make him infertile, though. We need to get back to the original question. None of this should cause infertility. So now your...

Unless he's having trouble ejaculate. Yes. Thank you. I'm going to give you one of these. Give yourself a bill. If his prostate is so enlarged that he can no longer ejaculate, then that's it's time to go. get that prostate fixed, but that's a possibility. That's the only link I could think of.

Yeah. Yeah, because if it's swollen heat and he does have a little latent infection in there, that could certainly influence all of, you know, and, you know, it's just simple plumbing. Everything gets backed up in there, and if you can get it cleaned out, typically. And the other thing is, Dr. Steve, making sure that if we, of course, we don't have him on the phone, but if we could talk to him about his bowel movements, make sure everything's nice and soft and those big, giant American turd. giant American turds exactly

right got to soften it up we do have the biggest turds in the world yes some of them bigger than others all right yeah true all right oh so

go get that checked right home that's our that's our advice on that one hey Dr. Steve 27 year old male here hey I've got eocinophilic esophagitis

and I also have strictures in my esophagus that I get that have to be stretched out and fixed and also I'm essentially allergic to all fresh fruits of vegetables and go into anaphylactic shock if there anything I can do to fix any of this cure this or help treat it thanks wow okay so eosinophilic esophagitis it's it's a chronic actually allergic inflammatory disease of the esophagus and there's this type of white blood cell called the eocinophil so we have basophils and eosinophils and eosinophils have red granules in them the basophils have blue granules and it just has to and they're not really red and blue in real life

has to do with the dye we use right the stain that we use and um so this stuff, these cells can be real bastards, and they mediate sort of allergic reactions. And so these eosinophils will accumulate the esophagus, and even though you're using acid-blocking treatments, you'll still have problems with your esophagus, and you can get esophageal stricture, which is what he has. So an esophageal stricture is a narrowing of the esophagus, and you can get food that'll get stuck. Sometimes it'll get so narrow. you'll even get, you know, liquid will get stuck and have to, you know, it'll pile up and then have to drain down. It's a real pain. And, you know, the treatment is often steroids and stuff.

I would see a GI specialist who specializes in inflammatory GI issues, or you could even see a rheumatologist for this. I wish we could talk to him too and just ask him about his diet grains I would take him off all grains just in case you know gluten's milk products etc if he's allergic to that many things

maybe just changing his diet I'm just looking at Mayo Clinic here recommends dairy and wheat products so yeah they're agreeing with you on that one yeah I'd take him off of that first warm foods warm drinks you know little Chinese

way keep things moving through the stomach and staying away from foods that cause the inflammation right and an immunologist can test you for those and see if there are ones that maybe you didn't catch that are causing those if it start there and then you can get tested and look at or you know at least try something but they'll have them swallow a solution of thickened liquid that has steroids in it and just to coat the esophagus and try to calm these damn cells down so all right Who? Well, thanks always go to Dr. Scott. Can't forget Rob Sprantz, Bob Kelly, Greg Hughes, Anthony Coomia, Jim Norton, Travis Teth, Lewis Johnson, Paul Afcharski, Eric Nagel, Roland Campo, Sam Roberts, Pat Duffy, Dennis Falcone, Rand Bennington and Fez Watley, whose early support of the show never was gone unappreciated. Listen to our SiriusXM show on the Faction Talk channel, SiriusXM, Channel 103, Saturdays at 8 p.m. Eastern, Sunday at 5 p.m. Eastern, on demand, and other times at Jim McClure. pleasure. Many thanks. Go 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.