Weird Medicine: The Podcast - 390 - Ma Ma Ma My Corona

Episode Date: January 23, 2020

Dr Steve discusses Novel Coronavirus 2019-nCoV that was first noted in Wuhan, China recently. Also FEALS.COM/FLUID (check it out), and Gilbert Syndrome, which doesn't lead to obsessively collecting hotel shampoo, oddly enough. PLEASE VISIT: feals.com/fluid for 50% off any subscription (cancel anytime!) stuff.doctorsteve.com for all your online shopping needs 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. Yeah, me garreted. I've got diphtheria crushing my esophagus. I've got Ebola fives dripping from my nose. I've got the leprosy of the heart valve, exacerbating my incredible woes. I want to take my brain out and blasts with the wharf.

wave, an ultrasonic, agographic, and a pulsating shave. I want to magic pills for 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 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 broadcast radio, now a podcast. I'm Dr. Steve, and this is a show for people who would never listen to a medical show on the

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But give it a try. Let me know what you think. And if you want archives of the show, go to premium. com and all the instructions are there. And don't forget Dr. Scott's website at simply herbals. All right. Let's get into it. Okay, I'm recording this January 23, 2020. If you're listening to this any time significantly after that, in other words, if they're replaying this show, some of the things I'm about to say might sound stupid to you because things have happened since then that I can't predict. But anyway, right now, we're just in the beginning of a coronavirus, emerging, rapidly evolving situation with the that the CDC is involved in. And look, you can read CNN and Fox News and all these.

Just go to the CDC website because that's where they're getting their stories from. And you'll get it straight from the spigot, so to speak. And I'm just thinking of all these fallacious references that I could make, but this is a serious subject. So anyway, just go there and get it straight from the source. You can search cdc.gov and then just put in coronavirus or just go to the cdc.gov front page. It'll be all over the place. So the CDC is closely monitoring an outbreak of a respiratory illness caused by a novel, which means new coronavirus named 2019 NCOV. It'll eventually be called Wuhan coronavirus or Wuhan coronavirus.

It was first detected in Wuhan City in China. It continues to spread. They feel like they've pinpointed it to a fish market where they had live snakes, I guess, and the snakes have been found to be infected with this. Now, that's the thing with this coronavirus, is it generally lives in animals. animal hosts and then eventually every once in a while one or two of them will evolve to the or mutate to the point where humans can pick them up. When that happens, because it's a novel virus, we don't have antibodies to it in the population so it can spread pretty rapidly, particularly if it's easy to spread. And that's the issue, isn't it?

if I can cough in the air and a hundred people will get it, that's a very easily transmitted disease with a high contagious potential, whereas if I have to have sex with you 20 times and maybe one time out of the 20 or 200, you would actually contract the virus that's very low contagious value. All right. So a number of countries, including the United States, have been actively screening. Incoming travelers from Wuhan and human infections with 2019 NCOV have been confirmed in the following places.

Taiwan, Thailand, Japan, South Korea. And then the United States announced their first hour first infection with the 2019 NCOV, detected in a traveler returning from Wuhan on January 21st, 20. 2020. So that's the thing. So, so you set up this screening. Well, we're just going to screen people from Wuhan. Well, the Chinese government appropriately is quarantined Wuhan. But now, I mean, what are you going to screen people from Taiwan who now have gone to England? Now do you, because they just went there, I mean, you end up having to screen everybody. You can see how quickly this thing can spread, particularly in this world where people can, you know, there's ease of movement. You just hop on a plane, you go somewhere, and you can be patient zero in that area. Chinese health authorities were the first to post the full genome. In GenBank, the National Institutes of Health Genetic Sequenced Database. That's a good thing.

So they got the virus. They pulled it apart. They sequenced it. And now you can look at the DNA, see what's common with other coronaviruses. Do we have something already that my mind? match some of these proteins that would allow us to get closer to getting a vaccine or even a treatment for it. I mean, you can treat some viruses.

Obviously, we've been very successful in treating HIV, which is a retrovirus. We're decent at treating influenza. We've got a new medication called zoe flus, and I can't remember the generic name for it. But it's a one-dose wonder, apparently. You catch it within the first 48 hours, you take one dose, and it really improves your ability to stay out of the hospital and your ability to not die from influenza. So we're getting there. And a universal vaccine for all influenza is on its way. So hopefully that's coming very soon as well.

So coronaviruses are these family of viruses that some cause illness. people, others circulate among animals. Most of them cause in humans the common cold. And rarely they're saying animal coronaviruses can evolve and infect people and then spread between people. And you've seen this already. There's this Middle East respiratory syndrome. And then there is SARS, which is severe acute respiratory syndrome.

All of these things that you've heard about, SARS and Mars. MERS. SARS was first reported in Asia. MERS was reported in the Middle East. And all of these things are coronaviruses. And let's see here. When personal person spread has occurred with SARS and MERS, it's thought to have happened via respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza and other respiratory pathogens spread. A spread of SARS and MERS between people have generally occurred between close contact. So, you know, close repeated contact seems to be required. You can't just go into a movie theater cough once, like in that movie, what was it, outbreak or something.

And, you know, they showed the particle coming out of the guy's mouth was sitting and watching a movie and other people inhaling them and then getting the disease. early on, many of the patients in the outbreak in Wuhan, China reportedly had some link to a large seafood and animal market suggesting animal to person spread. However, growing number of patients reportedly have not had exposure to animal markets suggesting person to person spread is occurring. Yeah. So if you saw this disease and every person was associated with that market, you would think, well, maybe it's not able to be transmitted here. human to human, only animal to human. And that makes you feel a little bit better because you can sort of nail down the source, eradicate that, and then you're done. But now you start seeing people like these people in Taiwan or other countries that have never been to that market.

And it's like, uh-oh, they had to have gotten it by being exposed to a human being that had it not another animal. Both MERS and SARS have been known to cause severe illness in people, the situation with regard to this one is still unclear, while severe illness, including illness, resulting in a number of deaths, has been reported in China. Other patients have had milder illness and been discharged. There are ongoing investigations to learn more. This is a rapidly evolving situation. Information will be updated as it becomes available.

So what you're interested in is what are my risks of catching this and what are my risks of dying from it? So the risk assessment by the CDC says that outbreaks of novel virus infections are always a public health concern. The risk from these outbreaks depends on characteristics of the viruses, we've already alluded to, including whether and how well it spreads between people, the severity of the resulting illness. Well, I see, I'm a genius. I've already said all these things. And the medical or other measures available to control the impact of the virus, for example, vaccine treatment or medications.

investigations are ongoing to learn more, but some degree of person-to-person spread of 2019 NCOV is occurring. It's important to note that person-to-person spread can happen on a continuum. Some viruses are highly contagious like measles while other viruses are less so. Well, again, thank you, CDC. Your old pal, Dr. Steve, already threw these ideas out. Let's see here. Of course, I'm just, I'm patting myself on the back because, you know, there's nobody else here to do it for me. It's not clear yet how easily it spreads from person to person.

It's important to know this in order to better assess the risk pose. So they're just, in other words, it's saying we don't know. The immediate health risk to the general public is considered low at this time. Nevertheless, CDC is taking proactive, preparative precautions. They're saying what to expect. More cases are likely to be identified in the coming days. more cases in the United States, given what has occurred previously with MERS and SARS, it's likely that some person to person spread will continue to occur. So one of the things that you can look at is how many people have been exposed to it and how many people got it.

So if you expose 1,000 people to this virus and 10 of them get it, then it's a 1% transmission rate. Then how many of those people die from that? Well, let's say one of them do. Well, then 10% of the people that get it die, but most people don't get it. So that's one sort of scenario. Another one is a lot of people get it, say of the 1,900 get it, but only, you know, nine of those die. Well, then again, that's still going to be a 1% death rate, but, you know, it's much more transmissible. so you'll see more people dying from that.

So we'll see. Right now, it looks like the vast majority of people who got the virus have survived, but there have been some deaths. We don't know what the circumstances were. Were they elderly? Were they sick? Were they young? Were they bad immune systems?

Where there's some other factors that were involved? We'll know more as time goes on. For right now, I'm not losing a lot of sleep over this. I'm concerned for the people. that have been exposed and to see what the mortality is. It's tragic for the people who have died from this. But keep your fingers crossed that this is something that we can contain very easily. And the less contagious it is, the easier it will be to contain it.

All right. And, oh, the other thing, remember, we've talked about this before, if there is a low asymptomatic carrier rate. So if you have people walking around that don't know they have it, but they're able to transmit it to people, then that's going to be a problem because, you know, one person can infect a whole bunch of people before they realize they're second and then quarantine themselves.

Whereas smallpox is a great example. of a disease that had a very low asymptomatic carrier rate. So if you were shedding virus, you had smallpox lesion so people could stay away from you. And not only that, the way we eradicated smallpox was we caught every person that had a smallpox outbreak and vaccinated everyone around them. The other fortuitous thing was that the vaccine worked very quickly in that disease. So if you had Joe Blow in some village somewhere who came down with smallpox, you'd go to that village, vaccinate everyone around him to kind of make a moat around him, make him not leave and vaccinate all these people. And then the virus can't spread. It just has its way with him.

He either survives or he doesn't. And then that's the end of it. It doesn't spread to a bunch of other places. So smallpox had very low asymptomatic carrier rate and a very rapidly acting vaccine. So that was a perfect scenario for eradicating a virus. Measles kind of the same way. We, I got in, somebody called me a MFing liar on Twitter when I said that we had eradicated measles in this country in the, you know, in the, early 2000s, and then they showed me this graph of how many cases there actually were, and so

they couldn't have been eradicated. No, we eradicated. Every single one of those cases came from somewhere else. So there was not a single case of transmission of measles in this country during those times when it was quote-unquote eradicated that was native to the United States. Let me look this up real quick. Measles, U.S. Let me see when that was.

So in 1978, CDC set a goal to eliminate measles from the United States. By 1982, measles was declared eliminated. What that means, so eliminated is the word that I use, not eradicated. The absence of a continuous disease transmission for greater than 12 months. and that was in, sorry, in 2000, that was declared. So for a while there, we had no continuous disease transmission for greater than 12 months. So all of the cases that came in were from other places, and they weren't transmitted to other people. Now, I get people, and now I'm on my damn soapbox, because you guys got me talking about measles, people who will tweet to me and say,

look at this, there's more people are harmed by the vaccine than are harmed by measles in this country. Therefore, we need to stop vaccinating people. It's like, of course, when you have an effective vaccine and you have a populace that is vaccinated, they're not going to be any disease. So no one's going to be harmed by the disease. And vaccines are not 100% safe. nothing is, and there will be people who will be harmed by the vaccine. No question about that. But if you're talking one in a million, whatever the number is, you're talking one in a thousand people died of measles.

So do the effing math yourself. If we stop vaccinating people, we'd have one and a thousand people that get measles will die. And a lot of those are kids. my friend in kindergarten died from the measles. It was before we had vaccine. I was born early enough that I don't have to worry about measles immunity as an adult because I actually got measles when I was a kid. And the measles vaccine didn't come in.

I think I was probably, well, I was up there in maybe even middle school before the measles vaccine started becoming. widely used. So, yeah, don't give me that BS. I mean, it's just, yeah, it looks crazy. Oh, yeah, the vaccine harms way more people than measles does. We didn't have a single case of death from measles in this country. And I'm not 100% sure we can say that of the vaccine.

And if you vaccinate your kids and they have a catastrophic reaction, it's horrible. It's tragic. I totally agree. But by the same token, if you are in your car and you're wearing your seatbelt and you get in a wreck and you get, because of the seat belt, you get trapped in your car and you die in a flaming ball of fire, that's also tragic. And that's one case where the seatbelt caused injury. but if you didn't wear your seatbelt and gotten that same wreck and there wasn't a fiery ball, but you were thrown from the car, you got a one and two chance of dying, 50% chance. So this is this whole thing about risk mitigation.

I know it sucks. It's terrifying. It's like the lottery. But if I gave you the odds of one in a million and sent you to Vegas, you'd bet everything you had on black at the roulette table. So, you know, that's just how it is. So the unvaccinated population, if you're trying to prevent deaths, we have to vaccinate people for measles and other viruses like that. And yes, there will be tragic consequences, sadly, but the infinite, not infinitely more, but orders of magnitude more.

tragedy if you don't vaccinate. So, you know, and think of rabies. When's the last time you worried about a dog being rabid that was running around your neighborhood? When I was a kid before the rabies virus, that was a thing. And it was terrifying. They ran these effing commercials that gave me nightmares about rabies. I was terrified to go outside because maybe a rabid dog would be out there and would come

after me. And then the whole Kujo thing didn't help anything when it came to rail. Although I think the Kujo, the book and the movie probably helped people to remember to vaccinate their animals. So we just don't see a lot of rabies. It's still out there because foxes and bats will have it and animals will get it. And sometimes when you have an outbreak in an area among the fox population, they'll throw food out that's laced with the rabies vaccine. to try to have settled things down. So kudos to the veterinarians and wildlife folks out there that take care of things like that.

And the one back, people are, oh, you love all vaccines. No, I don't. There's one that I'm not convinced about yet, and that's the chickenpox vaccine. Chickenpox is usually a self-limited disease. People dying from chicklepox from chicken-chicklepox is rare. But the vaccine appears to be very safe. But the issue that I have with this is we're vaccinating people for a disease that is very mild as children and is very serious if you get it as an adult. So if you get it as a kid, the worst thing that can happen to you down the road as far as chickenpox is concerned is you get shingles.

or if you have an immune disorder down the road as an adult, you can get disseminated varicella, which is shingles all over the place, and that's bad. But that's pretty much the worst that can happen to you. If you do not get chicken pox as a kid and you're not immune to it anymore, then if you're a pregnant woman and you get chicken pox, while you're pregnant, it can have catastrophic effects on the fetus. And as an adult, you can get really sick. as shit. So when we vaccinate people to get them to not go through having this meat or chicken pox

when they're a kid, and we don't know 100% whether people are going to be, have lifelong immunity to that chickenpox virus. What we're doing is we're setting people up to get chicken pox when they're 40. And so, and if we find out they've got to get boosters, well, when's the, look at your life. When's the last time you had a tetanus shot? If it's been more than 10 years, then you're the person I'm worried about because you're not keeping up with your health maintenance. You'd get a tetanus shot every 10 years. No one ever thinks about that vaccine, by the way.

And so you're the person I'm worried about because you might be. 30, 40 years old. You didn't get your chicken pox booster if we find out that they need one. And now you're at risk for getting chickenpox as an adult. So I'm not a fan of that vaccine until they can show me that you get lifelong immunity or they can implement a program that makes it easy for everybody that's had the vaccine to get booster shots and to figure out some way to consistently get everybody to get those so that these adults are not

and I just don't hear people talking about this one very much. So that's my concern. Anyway, all right, so I'll keep up on that coronavirus and keep you up on vaccine and virus news as time goes on. Okay.

Let's take a couple of phone calls. First thing. Number one thing. Don't take advice from some asshole on the radio. Thank you, Ronnie Bean. Trueer words cannot be said. All right. And if I sound like an idiot today, it's because I'm recording this at 7.30 in the morning.

I'm not awake yet, so I think this would be a good time for a word from our sponsor. And you will try to always get it right. But the beauty of life lives inside of you. And I hope someday you find it too. Hey, Dave. Yeah, ma'am. You experience stress? Can happen.

Anxiety, chronic pain like I do. Trouble sleeping, at least once a week. Well, you're not alone. A lot of us do. Personally, I think our listeners of this show know that I have an autoimmune thing called polymyelgerumatica. Most of the time it's 80-year-old women that get it. But, you know, your old pal, Dr. Steve, has it. It causes some pretty severe chronic muscle pain.

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Check out feels.com slash fluid. And let's take a few phone calls. What up, retard? You're showing up on the goddamn series X-em fucking goddamn fashion talk. Okay, good. If you don't like that, you can suck my goddamn fuck. Okay. Hey, go fuck yourself.

Oh. Goodbye. I wonder where he was from. Yeah. Okay. Hey, I guess we showed up on Sirius XM Faction Talk 103. That's where we're supposed to be. 8 p.m. on Saturdays, 5 p.m. on Sundays, and other times at Don Wickland's pleasure.

And also on iTunes and the Internet. Hey, Dr. Steve, this is Calvin from California. Amen. So I have two questions. One, epinephrine, norapherin, and narcan, when they're injected into somebody who needs it, are injected into the upper outer thigh unilaterally. But what do you do if somebody has no size? Where do you inject it?

Anywhere. Okay, so what he's asking is, like if you're giving someone an epinephrine shot, an epipen, for example, they have a medical emergency. And they're going to die sometimes, or at least have a very serious illness if they don't get that epinephrine right away. and what we're treating is a thing called anaphylaxis where that's an immediate type hypersensitivity reaction where someone gets stung by a bee or eat shellfish and now all of a sudden they can't breathe and their airways swelling up their lips may be swelling up they're getting bronchospasm in the words the airways are clamping down and the most immediate treatment is to give a shot of epinephrine which is adrenaline and it opens those airways up and allows the person to break. Whenever you do one of those, if you have symptoms, you need to go straight to the emergency room, because it is short-lived. And you may need further treatment or probably will need further treatment.

So what he's asking, I'm guessing, is if someone has, you know, had a hemipelvectomy, which is where they no longer have an upper outer thigh. But, you know, it's rare that someone has both upper outer thighs. gone, but in a medical emergency, you can just basically give it anywhere where the patient has meat. You can even do it in the deltoid. You know, if the answer is, they're going to die if you don't give it. You give it anywhere you can get at them. Same thing is true of Narcan. Narcan is the mu-opioid receptor blocker that's given either intravenously or subcutaneously under the skin or up the nose.

In the case of the Narcan nasal spray, you just spray it up someone's nose, and it knocks off. It competes for the receptor space with the narcotic that's trying to kill them when they're having an overdose and allows them to live. Again, if you give that in the field, you must transport that person immediately to the hospital because it may only last 10, 15 minutes. You've saved their life, but if you just then walk away and ignore them, if they've got a large enough. dose of these opioid analgesics in their system, the Narcan eventually will just lose its grip on those receptors and the opioid will regain control and the next thing you know, the patient's comatose again. So you can give it anywhere you want. All right. And then the other one, except in the eye. Don't give it in the eye. Thank you.

One was dealing with Texas Cedar Fever, it's like this pollen dust stuff that gets everywhere. It's really, really irritating. I was taking some Claritin, and the tats are 24 hours, but they're really small. They're little speck things. How can something so small last for 24 hours? Yeah, okay. It's just when you take a medication that's either excreted by the kidneys at some point, in some form, or it hits the liver and is changed, or both.

And every chemical reaction has a, you know, a duration, and that's what gives these things their half-life, is how long they're in your system. So I'm just going to give you a very simplified answer. So something like Liradidine, which is the generic name for Claritin that last 24 hours, or fexophenidine, which is Allegra, which also lasts for 24 hours when given in a dose of 180 milligrams. Basically, that's the rate of its degradation. It takes about 24 hours for it to get out of your system. So it hits the liver.

Some things are immediately en masse changed to inactive drugs. So they're very rapidly out of your system. And then other things, they pass through the liver and maybe 5% of it gets changed and the rest of it passes through unmolested. But each time it passes through the liver, 5% degrades. And so you can calculate the rate of change from that. And, you know, at some point you'll clear it all from your system unless it's stored in the fat long term, like some medications are. Like fentanyl is fat soluble. Fentil is a very potent opioid that's causing.

a lot of mayhem out in the real world, mainly because it's so potent. It's dealt in microgram amounts instead of milligram amounts. And therefore, if you've got a dealer who is cutting heroin with fentanyl to make it to boost its potency, when they do that, unless they measure that very carefully, they can very easily give the dose in that package. packet, you know, make that dose fatal. And therefore, we don't recommend street drug use because if you can't 100% trust your pharmacist to give you exactly what's supposed to be in the bottle, then things happen. And, you know, the pharmacists don't start calling saying, I'm trashing you.

I'm not. It's, I've been to the pharmacy before and gotten, you know, one less pill than was supposed to be in there. or I've gotten rarely, and this is rare, maybe one or once or twice in my life, gotten something that wasn't supposed to be in there. And if they didn't catch it, I got it home. And then they go, oh, gosh, you know, we made a mistake. Shit can happen.

It's as close to perfect as it can be. But even in a perfect situation when humans are involved, things will happen. So if I can't 100%, I can 99.99% trust my pharmacist, but it's not 100%. I want to always be proactive and look at my pills, make sure I got what I'm supposed to get, et cetera. And that helps them. Why would I trust there for somebody on the street that's just going, well, looks like this stuff needs a little bit more fent. I'll just give it a little teaspoonful. You know, you can pack millions of fatal doses of fentanyl into a kilo of fentanyl, which is 2.2 pounds, which is a really small little brick that's easily smuggled into this country, which is why we're seeing more of it.

And the ER docs that I talked to at these meetings almost universally say everything that they're seeing out there as far as opioid overdoses right now is coming from, you know, illicit fentanyl use. And, you know, a lot of the dealers who are cutting this stuff are not organic chemists, so they may not understand how to even measure out microgram amounts of something. So anyway. So, yeah, so that's how this works. Every chemical reaction has a rate of change, and loradidine, a little Claritin just has a very slow rate of change compared to some other drugs. like Tylenol, for example.

Tylenol is every four to six-hour drug, Claritin's in every 12-hour drug. Transdermal fentanyl is an every three-day drug. But that's because they've manipulated its half-life based on its delivery system. So when you slap a transdermal fentanyl patch on your skin, the medication sinks into the skin and gets into the bloodstream very slow.

So you have to have a lot of drug on the patch to sort of push that through. And then so it takes 18 hours for a transdermal fentanyl patch to peak, about three to six days for it to hit steady state. So, but they formulated it. So you change it every three days, but that's how. So you might ask the same question, how in the world does, you know, a patch last three days? Well, that's how.

The other way that you can manipulate the drug. duration of action and by extension, the half-life of medication is to change the rate of absorption of it. And they'll do that with things like oxycodone. So oxycodone by itself has an unadulterated half-life of two to four hours, say. It takes about 20 to 30 minutes to get in your system, and then it's in and out in about four hours. So I said half-life, denyment, duration of action. Now, you can change that by putting it in a wax matrix. Put it in wax so that when it hits the GI tract, the heat and the fluid and the GI track

sort of leaches the drug out of that wax matrix over, let's say, 12 hours. And now you have a thing called oxycontin, which is just extended release oxycodone. And to you, you can't tell when you take that. whether we've reformulated oxycodone so that it's slowly metabolized by the liver, or have we put it in a wax matrix and made it just leach out slowly over time? To you, there's no, it's completely transparent, which one is which. All right. Hopefully that helps.

All right. I don't know if you're able to email me. Oh, what? Okay, wait a minute. Hey, Dr. Steve. This is Tim in Michigan. I listen to your show on the replay, as I don't get a chance to listen to it live because I work. But I have a question on Kratum or Kratum.

I've been on Norkel for probably about 15 years now for disc damage in my back. And now they basically have turned it into chronic pain issue. or that's how they classify it anyway and of course all the problems now trying to get opioids with for chronic pain and all this kind of crap I'm seeing a lot more I'm members on some groups on Facebook for chronic pain and stuff like that

and they're all talking about cratum being a pretty decent alternative to narco to opioids and that kind of stuff I'd love to find an alternative that I could get off this stuff, but I still, you know, have the underlying issues of my back problems. And now because of what I believe is the opioids causing all this chronic pain, I'm in serious, serious pain. And I've got to do something because this isn't good. Yeah, I get it. I get it.

No, it's a real problem. And when he says opioids causing pain, you may think he's crazy. But actually, there is this thing called opioid hyperalgesia syndrome that actually, when you, as you take the opioids, you're stimulating these pain receptors and you get an increased amount of pain. And as you increase the pain medication, it actually gets worse. And so the counterintuitive thing when you're in the middle of this is to reduce the dose of the opioid. And then magically, this actually gets better and maybe even discontinuing them altogether. But because of this sort of political situation in medicine right now where chronic pain patients, a lot of them feel like they're being looked at as if they're criminals or they're seeking something they shouldn't be seeking, et cetera. And a lot of this came from the 80s when physicians were told that we were under treating pain.

And so we started treating more pain. And then we had more and more people getting, having issues with addiction. And now we're getting ding saying, we caused this, this opioid addiction problem. And so there are some docs out there just won't write anything or they are hacking and slashing at all their patients without regard to whether they need the medication. And so they're put in a bind. And people are getting desperate. So they're saying, okay, I'll get off this stuff, but give me an alternative. But we don't really have a good alternative, or at least we haven't funded one.

We've done a lot about the supply of these medications, in other words, just cut it to the bone. If you look at any graph, if you go to Dr. Steve.com and just search opioid. I've got a graph on there that shows the volume of pills rising at a linear rate until about 2010, and then falling off pretty precipitously at almost the same sloth. from then on, and then from 2015 to 2016, it drops precipitously again, and I mean really, really rapidly. And at the same time, you see opioid overdoses increasing almost geometrically. And it makes total sense as you reduce the supply of the safer alternative. You're increasing the demand for a less safe alternative.

We just talked about fentanyl and how easy it is to overdose on that stuff. And these little packets full of white powder don't have the microgram amounts of fentanyl printed on them. So it's very hard to know by just looking at them how potent they are. Well, anyway, so people are desperate. And then they read about this cratum stuff, and they're like, well, maybe I'll try that. And there have been some people that had successes with it. But I don't like this situation where we put people in this situation where now they have to do sort of armchair, pharmacology at home without any support from a medical professional, they actually

know something about this. And let's talk a little bit about what Kratum is. It's a tree. It grows naturally in Thailand, Malaysia, Indonesia, and Papua, New Guinea. And it's been used as traditional medicine in those areas for ages. It's also now making it out to the real, I don't want to say out to the real world, to the Western Hemisphere where people are starting to use this stuff as well. And it's not illegal in most places, or a lot of places, less and less legal.

But, you know, it's a very interesting molecule that deserves more examination. There's some aspect of the cratum, and it could be one molecule or it could be multiple molecules. that's harder to say because it's a plant, right? And so like pot can have multiple active molecules in it. We always concentrate on THC, but there are others like cannabodial or CBD and lots of other cannabis-related molecules. Well, some parts of the nerve cells like opioid receptors, and then there are other things that act or other either parts of that same molecule or different molecules that act as alkaloids so they can give you a euphoria or even sort of semi-hulucinations and stuff like that.

So very interesting. And there have been some great successes, people saying, look, I got off everything. And then there are other people that I talked to, and we've had on this show, who have said they switched from, say, oxycodone to cratum. And now they're addicted to cratom. They can't get off of it. And then there are other adverse effects that go along with it, muscle tremors, itching, sweating, dizziness, dry mouth, seizures, even hallucinations, and even liver damage. So, you know, the FDA is saying there's no FDA approved uses for creatum. That doesn't mean that it has no use.

It needs to be further studied. And I know that some of you guys got to do something and you're desperate force. some relief. Go see an addictionologist if you're having trouble with street drugs or pills. And there are things that they can do to help you with. And I promise you research is ongoing to try to make this process even easier. And I've seen studies where they try to make people go through withdrawal in one day. And what they'll do is they'll give them a general anesthetic so that they're out of it completely and maybe even on a ventilator and then they saturate their opioid receptors with opioid blockers and let them go through withdrawal in a

day and then when they wake up at the end of 24 to 48 hours they're finished with withdrawal and the only so the physical dependence is over and the habit and psychological dependence are the only two things that you have to deal with that makes it a lot of. easier. Still in easy because the habit and the psychological addiction are very, very powerful. If you talk to someone for an hour on a radio show about addiction and they've been off drugs for ages that can still get triggered by that. So it's very, very powerful. And you have to be vigilant about that all the time. That's why people continue to go to meetings, even though maybe they've been sober for decades.

So that's one source of emerging research. The stuff I've seen so far on that is expensive and it's not been any more effective than other brands of rehab. But I would very much be interested in seeing further research on this topic. and it's being funded. So if we can figure out not only a way to deal with the supply, but deal with the demand, then we may have an answer to this. And then the chronic pain folks who truly have legit pain can be left alone

and let them get their medication without somehow being seen as other, you know, because that's really, really irritating. All right. Hey, Dr. Steve, this is Gary from Oklahoma, and I got a question about some blood work that I got and that's actually come up a past few times that I've done blood work and it's about my Billy Rubin count and doctor came back and gave me call like, hey, you know, we probably need to discuss this, but it's the first doctor that I've been to that actually wanted to discuss it. Yeah. So, anyway, let's... So this guy's had an elevated Billy Rubin. Billy Rubin is produced by the liver.

When you get liver obstruction like cirrhosis, your Billy Rubin will go up. When you have an elevated Billy Rubin, if it's high enough, your skin will turn yellow and the whites of your eyes were turned yellow, and that's called jaundice. If it's in the eyes, it's called scleral icteris, and it's a sign of pretty significant. liver problems. Now, he, this guy has been, apparently had a bunch of lab work done in his life, and it's all showed this elevated Billy Rubin. He's saying, this is the first guy that's ever said they want to do anything about it. So that implies to me that other people have seen it have sort of blown it off. So when you have a sort of chronically elevated, low, very low level of elevated Billy Rubin, you start thinking about things like Gilles-Barre syndrome.

So, Jilbert syndrome is very common and very harmless liver condition, where the liver just doesn't process the Billy Rubin. So we always learn, so there's this process called conjugation, and so you conjugate the Billy Rubin, and then you can test these things. Don't worry about it. It just, it's, that's all sort of doctor speak. But the way I remembered, if you're a medical student, Gilles-Berr, it starts with a G.

So it, the Billy Rubin goes right through. And then there's this other thing called Krigler-Najar syndrome where conjugation never starts. So both of those will result in elevated Billy Rubin's, but you can do a real simple blood test to differentiate the two of them. Anyway. So the. Levery doesn't properly process the Billy Rubin, so you get this mildly elevated Billy Rubin level.

And Billy Rubin is, you know, it's produced by breakdown of red blood cells. And if you have Gilber's syndrome, it's also known as constitutional hepatic defunction. And it's also could be called familial non-hemalithic jaundice. You're just born with a condition. You've got this inherited gene mutation, so you're a mutant. And your superpower is you make slimy. elevated Billy Rubin in your bloodstream. I don't know how useful that's going to be.

You may not even know you've got it until you've discovered it like this person did. So the body normally processes Billy Rubin. It's just a yellowish pigment made when your body breaks down old red blood cells. It travels through your bloodstream to the liver where the enzyme breaks down the pigment and removes it from the bloodstream.

Then the Billy Rubin passes from liver to the intestines with bile. It's then excreted in the stool. It's a lovely process. And, you know, a little bit will remain in the blood. It's detectable in the blood. By the way, if you want to read along with me, this is, you know, one of my favorite websites, particularly for this show,

is Mayo Clinic because they have excellent expositions on this stuff on just about everything you can think of, and it's very well geared toward the lay audience. So anyway, so how do we diagnose it just through blood test? So they'll do a direct and indirect Billy Rubin test, and then when they compare the two, they can tell if you have Gilles-Barre syndrome. And, you know, usually you don't need to do any other testing other than that. And it's very simple to do.

So, yeah, do it. And then you can run around and tell everybody, yeah, I got Gilles-Ber syndrome. You know, feel sorry for me. And you can sort of use that to your advantage at parties. It's like, oh, yeah, dude, I just found out of Yale Bear Center. And then they'll be, oh, God, I'm so sorry. So sorry, because they don't know what the hell are you talking about. All right.

Get that checked out. Hey, Dr. Steve, is it true that when we sneeze that our heart stops beating, like, for a millisecond? And then when people say, God bless you, that's just, that because the devil can't get a hold of you and damn you eternally. Just wondering, I've heard that ever since. I was a kid. Sure. And you probably also heard that you blow your soul out with every sneeze, too. That's why people say, God bless you, or a gazuntite when you sneeze.

But there is actually something to this. Your heart doesn't stop, stop in the sense that you have a cardiac arrest. But there's a thing called sternutation, and that's this reflex that's, you know, it's a brainstem reflex. and when you have something that irritates the upper lining in the nose, these nerves carry the signal to the brain stem, it triggers the eyes to close and the chest to contract. And then your lungs expel a burst of air. But one thing that doesn't happen is there's any signal to the heart to stop. So what does happen is when you have this huge increase in intratheracic pressure, when you, You know, when you get that sort of just right before you sneeze, it's hard for blood to pump into a thorax where the pressure from the outside is so high at that second.

So for that one second, you get an interruption of blood flow. It's not complete. It just decreases it. And when that happens, the blood supply coming out of the heart will decrease. for a second. Then you may have a compensation, but it actually increases soon thereafter. So if you grafted out, you would see a little dip in blood flow going into the thorax, but other than that, your heart does not stop. Okay, listen, we're out of time. Thanks always go to Dr. Scott, Lady Diagnosis, Cliff Andrews, none of whom are here,

but I thank them anyway. That's just how magnanimous I are. I am. I are. As how it Magnanimous I are. Oh, I got to quit recording these at 7.30 in the morning. I'm sorry. We can't forget Rob Sprantz, Bob Kelly, Greg Hughes, Anthony Coombe, Jim Norton, Travis Teft, Lewis Johnson, Paul Offcharski, Eric Nagel, Roland Campo, Sam Roberts, Pat Duffy, Dennis Falcone, Ron Bennington, and Fezz Watley, whose early support of this show has never gone unappreciated. Listen to our SiriusXM show on the Faction Talk channel. Serious XM 103, Saturdays at 8 p.m. Eastern, Sunday at 5 p.m. Eastern and on demand and other times at Jim McClure's pleasure.

Many thanks go to our listeners whose voicemail and topic ideas make this job very easy. Go to our website at Dr. Steve.com for schedules and podcasts and other crap. Until next time, check your stupid nuts for lumps. Quit smoking, get off your asses and get some exercise. We'll see you in one week for the next edition of Weird Medicine. Thank you.