Weird Medicine: The Podcast - 397 - The Situation is FLUID

Episode Date: March 12, 2020

This episode was recorded 1 hour before COVID-19, the disease caused by the SARS-CoV-2 virus was designated pandemic. News on remdesivir trials and other corona virus items. In addition, esophageal strictures and med school prerequisites. PLEASE VISIT: stuff.doctorsteve.com (for all your online shopping needs!) withings.com/steve (for the best fitness wearables on Earth!) Feals.com/fluid (lab grade CBD products!) TRIPP.COM offer code DRSTEVE (relax and get 20% off!) simplyherbals.net (While it lasts!) noom.doctorsteve.com (lose weight, gain you-know-what) tweakedaudio.com offer code “FLUID” (best CS anywhere) premium.doctorsteve.com (all this can be yours!)   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. In the carri-de-old. I've got diphtheria crushing my esophagus. I've got Tobolivir from my nose. I've got the leprosy of the heart bow, exacerbating my impetable woes. I want to take my brain out and blasts 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 a requiem for my disease. So I'm aging Dr. Steve. It's weird medicine, the first and only unscored. Wow.

That was close. It was close. It's weird medicine, the first and still only uncensored medical. show in the history broadcast radio now a podcast. I'm Dr. Steve with my little pal, Dr. Scott. Traditional Chinese medical practitioner keeps the alternative medicine wackos abeg. Welcome back, Dr. Scott. Hey, Dr. Steve. Glad to be here. This is a show for people who would never listen to a medical show on the radio or the internet. If you've got a question, you're embarrassed to take to your regular medical provider. If you can't find an answer anywhere else, give us a call. 347-7-66-4-323. That's 347. Poo-Head. And visit our website at Dr. Steve.

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And so, yeah, so you haven't been here for a while. This has become coronavirus podcast or radio show. But I did want to give some updates on some things. A couple of shows ago, we were talking about, this drug called Remdesivir. Have you heard about it? No, I haven't. Okay, well, let me see if I can get this to come up.

So Remdesivir is a broad spectrum antiviral. And this company called Gilead Sciences is working on it. And they're working closely with global health authorities to respond to the novel coronavirus COVID-19 outbreak. So remember, the virus is called SARS-C-O-V-2, but the disease. disease that it causes is called COVID-19. So it's coronavirus disease 2019. They're doing experimental use of an investigational compound called remdesivir. It's actually not a compound. It's a molecule, but anyway, together with the U.S. Food and Drug Administration and the CDC and the Department of Health and Human Services and Nashville Institute of Allergies and infectious diseases, oh, and the

Department of Defense, oh, and the China CDC and the national, geez, well, they're working with everybody. They're focused on working with this drug called Remdesivir. So it's an investigational nucleotide with broad spectrum antiviral activity. It's not approved anywhere globally for any use, but it has demonstrated in vitro and in vivo activity in animal models against viral pathogens of MERS. That's the Middle East Respiratory Syndrome, which is much more deadly. But, well, what a coincidence.

Tacey, you're on weird medicine. And then she hangs on. Whatever. Oh, my God. How many years? She'd think we do up here. So MERS is Middle East Respiratory syndrome. it is much more or has a much higher mortality rate per case,

but it is much less transmissible. Apparently, MERS gets deep down in your lungs and it's hard for you to transmit it unless you have a big old lung, you know, lung hockey that you cough up and then somebody somehow, you know, touches that and puts that in their mouth. Okay. And then SARS, which also was less,

of a crisis because it really didn't spread far outside of Asia. But they're also coronaviruses, and they're structurally similar to this COVID-19. And limited pre-clinical data on remdesivir and MERS and SARS indicate that remdesivir may have potential activity against COVID-19. So it's an experimental medicine that's only been used in small number of patients with COVID-19 to date. So how do we This is where I wish Cliff was here Because he would

Give me more of the lay person's answer But how would you determine whether this stuff works? What do you think, Dr. Scott, how would you do it? Well, outside of a double-blind placebo study Which I would not do in this case No It would be unethical. So yeah, so we might want to do a blinded study

But not placebo control, but anyway. Yeah, I think, well, I think certainly i think in a lot of cases things like this they're starting to fast track them through the through the fda so but how would you know if this stuff does anything the the medicine itself yeah by giving it to someone who's who's got all the signs and symptoms okay so they get better so what 96% of people get better anyway you've got it you've got to measure that with people who don't take the medicine and give the timeline of if they stop having a fever in two days instead of four days that's an improvement or

There you go. How many people do not have to go on to a ventilator? That's right. Which is really, what freaks make it really, really poor? What you're pointing out, I hope this is the point you're trying to make in eloquently as you are. Yes. Is that, you know, you've got to test a shitload of people because if 96% of people get better, that's assuming a 4% mortality rate. And we're going to talk about that in a minute because it just depends.

It depends on who you are, what your mortality rate is. But overall, let's say it's 3%. So then you've got 97% of people get better anyway. So you give this to 100 people, and 97 of them get better. Anyway. You know, you're like, well, it looks like it works. Well, no, the 3% are still dying. So I'm sorry.

I don't have COVID-19. I've got bad allergies, though. You enable. By the way, this is allergy season. Then you get on a plane, and you're, you're. You know, hacking the stuff, everybody's going to look at you sideways. That kind of sucks. I've been telling people that for this whole week, I'm allergic to the Bradford pear trees.

And when they turn white, I start sneezing. Is that right? And I am just miserable, and I'll be miserable for two more weeks. So how do you tell if somebody is a candidate to be afraid of it's if they have a fever? The fever, correct. Yeah. And typically, I don't think they're seeing as much of the congestion and the nasal running noses with the COVID-19's, my understanding?

It's cough and fever is the big thing. It's not the running nose. And no diarrhea. Cha, cha, cha, cha. Which is good. Although the virus is being excreted in stool. So he's still, I mean, it's going to be clean. Right.

But, yeah. So how would you tell? Well, you give this stuff to thousands of people. And then you see if you can reduce that, the rate of, like Dr. Scott said, can you reduce the duration? of the illness, can you reduce the number of people that end up on a ventilator, and then ultimately are you reducing the number of people who die? Yeah, the severity of it.

So, but you have to, because most people have a mild self-limited illness, you've got to give it to a shitload of people for this to make any sense of all. And I was just reading, too, Dr. Stephen, I know you know this, but about the 1918 flu, the H1N1, I was just looking at the numbers on this thing. It stags. It was insane. It's staggering. You're talking about 500 million estimated worldwide that got the flu.

That was. And they're saying somewhere in the neighborhood of 675,000 United States citizens died. Yeah, worldwide, it was 50 million worldwide. So you had 50 million die. 500 million got it. That was 10% of the world's population. So 10% of 10% is 1%. So this killed 1% of the world's population.

say, well, you had a 99% chance of not dying, but it was still 50 million people. That's how big a billion is. It's massive. You know, there were 5 billion people on the earth at that time. Yep. So, yeah, so 1% of 5 billion. What is you say 1% today? What is that?

You know, what's the population? Well, let's find out. Echo, what's 1% of 7.5 billion? 1% of 7.5 billion is 75 million. Yep. That kind of followed from 1% of 5 billion. But, yeah, so, yeah, it's a big damn number. And even though the vast majority of the people, overwhelming majority, we're totally fine.

It's crazy. One thing that we did learn from that, and I'm going to get back to this Remdesibir. On September 28th, 1918, Liberty Loan Parade in Philadelphia. So they decided, you know, in the middle of this pandemic, we're going to have the parade anyway. It prompted a huge outbreak of flu in that city. There was a huge spike. You look at other cities that had, you know, started to quarantine. And I said do self-isolation even in 1918.

You see no spike. You see just a sort of a smoldering amount. cases. So self-isolation really does work. And quarantining people works as well if we have to get that far. Let me talk a little bit about these remdesivir trials. Gilead initiated these trials. They initiated two phase three clinical studies. So phase three clinical studies where you're giving this to thousands of people. So phase one. So you have this sort of preclinical phase. You have the discovery phase where we think we've discovered something. You have a pre-clinical phase where you start thinking, well, how would we give this to people?

And do we, you know, if we give it to rats, does it just automatically kill them? And then phase one, you give it to a few people, just see if as long as people aren't dropping dead, and maybe you've got some benefit course with this, a phase one trial of 100 people, I'm going to tell you anything. You know, they're just not dropping dead from taking, the medicine. And then you have your phase two trials where you'll do even more people. And now they're up to phase three on this remdesivir. So that's when you blast it out to thousands of people and you're looking at efficacy. In other words, does it benefit people? And if so, how? And then

you're looking at safety. Does it harm people if so how? And then phase four would be post-marketing. So that's after you bring it out to market, then you just follow people. Now you've got million of people taking it, is there a small effect that you could have missed? If you have an adverse effect of, let's say, cardiac events, it's one in 10,000 people, you won't see that till post-marketing when you got millions of people on it. Right. Thanks sense. All right.

So, Gilead has initiated two phase three clinical studies to evaluate the safety and efficacy of repnesevere and adults diagnosed with COVID-19, following the U.S. Food and Drug administration's rapid review and acceptance of Gilead's investigational new drug filing. Good. Yeah, this is one. They've had this drug for a while. They were using it on some other things. And they said, hey, we've got this drug works.

We've got some data. Although that's going to be limited data because there weren't that many MERS cases in general. And they randomized open label. Multi-center studies will enroll approximately 1,000 patients at medical centers, primarily across Asian countries as well as other countries globally with high numbers of diagnosed cases so I would assume Italy would be in their

beginning March 2020, so that's they're doing it now. The first of two studies will evaluate the safety and efficacy of both a five-day and a 10-day dosing regimen of remdesivir in addition to a standard of care. Okay. So you treat them like you normally

would, but you add this stuff. For patients with severe manifestations of COVID-19, so they're going to hit the most severe patients. Because, you know, maybe down the line we'll find out, well, you need to start this stuff before they get severe. You know, Tammy flu is that way. You need to institute Tamiflu in the first 48 hours. Well, you don't know how severe your syndrome is going to be at that point.

Second study will evaluate the safety and efficacy of the same dosing regimen of remdesivir in addition to standard care of patients with moderate manifestations. So they're going to hit the people who are ending up in the hospitals first and then they'll do this second arm where it's people that are just starting to feel like crap. I don't know how they're going to tease out moderate manifestations versus mild.

And they're going to do it compared with standard of care alone. So they'll have all these controls out there. It's just people that they didn't give the drug to, you know, and then they can compare that because they're really, every patient is being monitored at this point. statistically. Now, there are other trials. Health authorities in China have initiated two clinical trials in patients who have been infected with COVID-19 to determine the safety and efficacy of Remdesivir as a potential treatment for the coronavirus. Two studies are being coordinated by

the China-Japan Friendship Hospital and are being conducted at multiple sites in Hubei province. Gilead is providing study drug at no charge and provided input on study design and contact. So, We don't have any good results yet. There is a phase two adaptive, randomized double-blind placebo-controlled trial to remdesivir done by the N-I-A-I-D. And they're looking at people with COVID-19, and they're providing study drug there, too. All right, so we'll just see. There is some compassionate use. Let's see what they're saying here.

It's important to note that it results in individual compassionate use cases are not sufficient to determine the safety and efficacy. So you can apply for compassionate use if you've got somebody that's really in dire straits and you're at your last legs. They'll provide you with the drug, but it doesn't get included in the study data. That's really what they're saying there.

So who's at risk of dying from this? So that's what we all care about, right? I kind of almost don't care if I end up in the hospital as long as I don't die. Knock on wood. Our buddy Richard David Smith ended up in the hospital with flu ended up on the ventilator, but he's okay now. Oh, good.

So I think he would be a proponent of aggressive treatment. In a case like that, he's one of our biggest proponents of influenza vaccine because of that. But if you are less than 10 years old, so far, and we're recording this on Wednesday, March 11th, there have been zero cases of kids dying from this disease. Now, that is interesting. Because usually it's bimodal. You get a bunch of little kids and a bunch of old people who die from these things, you know, like influenza and stuff. Zero fatalities, zero to nine years old.

Now, when you get 10 to 19, it's 0.2%. So my kids are, you know, 15 and 16. They have a 99.8% chance if they get it of not dying from. That's a good thing. That is a good thing. Their dad, hey, not so much. Not so rosy. So it's 0.2 and 0.2 all the way from, so it's 0,000 up to 10 years old.

And then from 10 to 40, it's 0.2. From 40 to 50, it's 0.4. So it doubles, but still low. Mm-hmm. Right. And then you get up to 50 to 59. How old are you? 51.

Okay, so your odds of dying are 1.3% if you get it. Well, she hit. Yeah, it's still. Yeah, it's three times. That's what I was going to say. That's a hell of more. Three times more than a 40-year-old. But you can say, what's 300% more?

Well, this just shows the difference between relative risk and absolute risk. Right on. So relative risk, it's 300% more. If I told you that, you'd be shitting yourself. I'm fucked. I'd be going to the bank and pulling out all my money. That's right. That's right.

Spinning on hookers and cocaine. Dude, I'm so with you on that. Because mine is 300% more than yours. Oh, geez. Which means it's 900% more than a 40-year-old, but still low. So yours is 1.3. So if you get it, you have a 98.7% chance of survival. I mean, seriously, if I gave you those odds, you'd go to Vegas and spend every penny.

Sure, sure. You'd bet it all on black. Yep. Double up, double up again. It'd be a while before you'd probably lose. Yep. Okay, so 60 to 69, 3.6%. So that's me.

I'm 64. So I still have a, what is that, 96.4% chance of not dying. Still pretty good. 70 to 79, 8%. Still, not bad, 92% chance of not croaking. Then if you're 80 or more, then, well, you don't want to know the number for that one. So, no, it's 14.8%. And they'll give you this other number of 22%.

That's in confirmed cases. But remember, there's a ton of presumed cases in China that were not confirmed because the test wasn't ready yet. Right on. So that's why you can get those two numbers. Now, if you're male overall in 2.8% mortality. rate, and this is all cases, that includes unconfirmed cases. If you're female, 1.7%. So you're twice, you know, well, no, that'd be 3.4 or so.

A little less than twice is likely to die from it if you have an X chromosome. Sure. Yeah. Now, this is the one that bugs me. Pre-existing conditions. If you have no pre-existing condition, your death rate for all cases, 0.9%. But who has no pre-existing condition? conditions. The top five preexisting conditions were cancer, hypertension, chronic respiratory

disease, that would be emphysema, diabetes, or cardiovascular disease. Now, I have hypertension. At least I've been diagnosed with it. I'm on medication. Since I lost all this weight, I don't know if I still have hypertension, but does that count as treated hypertension? You know, do you have to have an elevated blood pressure or just have the propensity toward hypertension. I looked everywhere, have no idea. So it doesn't say diagnosis of, so I'm assuming it means when they came in, their blood pressure was elevated. Right. That's what I'm hoping anyway, because mine's always low. But in that case, it's 6%. And cancer is less than that, 5.6%. What the hell?

Wow. That's kind of interesting, isn't it? I don't know. Yeah, but you know, it sounds like the trends, though, to get the more devastating the disease is it just kind of makes you think that, hopefully, if you are in pretty good shape, that you've got a pretty good fighting chance to... Well, the penetrance of this is the other question. So that influenza virus in 1918 penetrated the population to the tune of 10%. Okay.

So if this penetrates to the tune of 10% and continues to have a 3% mortality rate, it'll be less than the influenza pandemic. That will still be the worst human pandemic on record. Sure. Right? Yep. So because then they had 1%. So this would be a third of that.

You know, if it's at 3% and that was 10% mortality. So that would be good. Yeah. Now, if it's twice that, if 20% of people get it, then it's still less than that pandemic. Right? Mm-hmm. But if it's, you know, if we come up any further than that, then it's sort of getting close to that.

And if it's like 50, 60 percent, then this will be worse than as far as absolute numbers of people who die will be worse than the pandemic. Still, most people won't get it. You know, if it's under, you know, under 50 percent of penetrants, most people won't get it. And of those that do, the vast majority of those will not die. So your odds are good. Anyone that's listening to this, your odds are good. Yeah. It just practiced good hygiene.

But you know, Dr. Steve, too, you think about, too, if, let's say the Spanish flu is it called 1918. Yep. And the coronavirus is, let's just say if these viruses are exactly the same as far as penetrants and things of that nature. Yep. At least we have now a little bit better technology. This is true. You know, health, thank goodness, Western medicine has continued to advance. You know, back then, there was not a lot of great ventilators.

Ventilators, right? And not communication. In other words, you know, the ability for us to know the China has got this disease today. Yes. In real time is beneficial to, I think, to the reducing the spread. Absolutely. And, you know, people are politicizing this. And I don't care.

You know, I'm a libertarian. Oh, hell, they've polarized. little the size of a fucking chicken sandwich if it could you know what I'm saying I'll give yourself a beer people come on people are politicizing you know well

Trump is in do you know it's like what do you want him to do this is coming now the one thing that he did do is ban travel immediately and that slowed this this thing down right to the point that you know we're first thing

you try to do is is contain it and then you got to mitigate it that's the that we really don't have any other strategies for this until we have treatment. Until we have treatment. Right. And so slowing it down to buy us some time to try to get

some information in the hands of health care providers, to get the word out. This is coming to, you know, my academy meeting, the American Academy of Hospice Palli Medicine, just canceled their academy meeting. I think that's smart. South by Southwest

canceled. That sucks, but you don't want another Philadelphia common what the hell was that was you don't want another Philadelphia episode yeah where is that coming from

is that coming from Alexa that's her yeah she's off line it looks like okay is she no that's a notification that's okay I wish she wouldn't do that the we don't want another example of what happened to Philadelphia

in 1918 where all those people out together and just, we're just spreading the virus to everybody, you know. Yeah. So I heard South by Southwest isn't giving people their money back, though. That's my understanding. And I think that, I won't say it's maybe it's Kayocho in Miami, I think, is doing the same thing. They're canceling a music festival in Miami and offering refunds. Cayocho.

I think Kaye Ocho. Oh, Kaye Ocho. It means like 8th Street. Yeah, 8th Street. Yeah. Yeah, South by Southwest. refusing to issue refunds after being canceled due to coronavirus. This is from page six, so this will be pretty sensational reporting here.

Let's see what they have to say. This year's music festival season is headed south. Fast. After Austin canceled its long-running annual South by Southwest Festival due to concerns over the spread of coronavirus, the company behind the festival is now refusing to refund thousands of ticket buyers. Their purchases. South by Southwest's original terms and condition of participation states, okay, here we go. Oh, go.

And in all payments made to S-X-S-W are not refundable for any reason. Whoa! Including without limitation failure to use credentials due to illness, acts of God, travel-related problems, acts of terrorism, loss of employment, and or duplicate purchases. According to a spokesperson, however, they will be honoring tickets for future. This is a pretty good deal for this. Because if they don't have to give that money back and they don't have to pay the talent, they just made themselves quite the, quite the, oh, goodness, gracious. Now, Moogfest got canceled this year. They gave everybody their money back immediately, you know, and it was canceled for other reasons.

But I bet this same wording was in theirs, and they just said, well, we're just giving it back. Yeah, I think that makes the most sense. And I think I told you, we're going the big festival over North Carolina. It's an Americana Bluegrass Festival, the Merle Festival, and I'm really concerned about that in mid-April. I think all of these festivals are going to be canceled for a while. It says, we're allowing registrants to defer for up to three years through the 2023 event. We're also working on other ways to add value to their deferred registration.

So not only will they be able to take advantage of a future South by Southwest, but there will be extra benefits included as well. Okay, all right. Well, you know, I get it. If they'll honor them in the future, then that's fine. Sure. Although they ought to give people the option to refund. You know, what if this was on your bucket list and you're on your last legs?

I just want to go to southwest one time. You know, this damn coronavirus. They're not going to be there three years from now. Yeah, you have already spent your vacation for the years. It's like, you know, you can't come back in August when they're going to have it. It's like, well, fuck. No vacation. Well, that happened to us once.

When the Iraq war broke out, they canceled our trip to Rome. I took a damn Italian class. I'm a pol Italiano. O studiato per three months, so tant. You studied for three months Italian. Yeah, very good. Yeah. So, but I was ready to go, and then they canceled.

And then when they rescheduled it, it was like a week before Tacey's due date. And she was still trying to figure out how to make it work, but it just didn't happen. Oh, man. So, anyway, yeah. So what else? That's about it. Don't we have any questions on, like, penis as a pope or something? We do.

We do. I was going to see if there was something else that I wanted to talk about about this. But I can't remember what it was. but it's okay. Oh, yeah, one guy called in about, he's got ankylosing spondylitis. Okay, sure. And ankylosing spondylitis

is an inflammatory, you know, bone and joint disease. And those folks, like others with, like rheumatoid arthritis or psoriasis, Crohn's disease, take these things called biologicals. And he was wondering if that was going to be a problem. So I went to arthritis.org and this was an update from March 6th.

And so they take these biologicals. What it does is suppresses their immune system. Well, one part of their immune system, not the whole thing, but just one part of it. It says, we don't know whether taking immunosuppressant drugs further increases the risk of catching COVID-19. But Michael George, a rheumatologist and assistant professor of medicine and epidemiology at the University of Pennsylvania in Philadelphia. by the way, the site of the Philadelphia parade in 1918 that exploded the influenza epidemic, but they've learned a lot since then. Says that in relation to viruses in general, limited data suggests some of the drugs used to treat autoimmune

and inflammatory types of arthritis, particularly biologicals and corticosteroids, may contribute to higher risk or severity of viral infection. Recent large study of people with cardiovascular, disease found that hydroxychloroquine, that's plaquinell, does not increase the risk of infection, and methotrexate, which is another immunosuppressant we used to use as a chemotherapy drug, increases the risk of infection only slightly. The concern with immune suppression is that the virus could replicate more freely, sure, and cause more severe or extensive disease. For this reason, it's important if you're taking these medications to contact your doctor right

away if you think you've been exposed or experiencing flu-like symptoms. So they don't know. We just don't know. The better part of valor is to be really careful if you're on a biologic, and a lot of people have got to be on them. I was able to wean myself off my prednisone, which I was taking for my polymyalgia rheumatica. And actually, I feel okay. So I've been off, I've been on a milligram for about a week, and tonight I'm not taking any. We'll see what I happen. Because it's all about me. Right on.

All right. Okay, doke. Well, let's, yeah, let's take a regular question. Are you ready to do that? Let's do it. Number one thing. Don't take advice from some asshole on the radio. All right.

Oh, and by the way, assholes literally and figuratively, don't go buy all the toilet paper. No. How much shitting do you need to? do you know people are making masks because they're out of masks okay let's talk about masks for a second yeah that's what they're doing stop with the masks unless you have it right so you don't cough on other people so when you do cough you're not spreading droplets the stuff is spread by droplets which means when I cough I'm you know if I'm standing in the middle of a room

and let's say there's it's the walls are 100 yards away so I'm in the middle of this giant room and I cough, there will be a spray of droplets in front of me, and they will hit the floor. They don't stay in the air. This is not an airborne disease. Gravity. So gravity will pull them to the floor. Now, if there's a table there and I cough on the table, those particles can stay there and may be active for some time until somebody washes it.

So it could be up to nine days they don't know. Oh, wow. But soap and water kills the shit out of this thing. This virus is very fragile in the presence of soap. and water. Because it has an outer membrane that has to remain intact or it can't function, and that membrane is just wiped away by soap and water. So now, I couldn't find anti-microbial wipes at the store, which was idiotic also.

But you can use things like if you're going to fly and you want to wipe off the seat or the armrest, you can use electronic wipes. Those have alcohol and benzalconium chloride and all kinds of crap in them, whatever's in that. And that'll work just about as well, to be honest with you. But people were like, oh, you know, I took a picture of the empty aisle of the Clorox wipes, completely wiped out in my grocery store. People are like, just go to Amazon Boomer.

And it's like, okay, millennial, go to Amazon and try to buy it. Because you're saying that tells me you haven't even bothered, you know, to, and if you go there, yeah, they have it. It's on their website. And the shit's all like will be delivered April 16th or whatever, you know, so. So stop buying. Not two-day delivery. Stop buying this stuff. You know, take some natural precautions.

If you think that you may be at risk for being quarantined for a while, then you need some stuff. You know, I bought a couple cases of ramen just so my kids can eat just in case, you know, we get stuck in the house. But the thing is, I'm a health care provider. Unless I get the virus, I have to go to work. Right on. You know.

So. We did buy a couple extra bottles of liquor just in case. Yes. I think that's perfect. Vodka. Because, you know, vodka is, you can use it anyway. You could use it as cleaner or you can drink it. That's right.

It's dual purpose. Now, you're supposed to have 60% alcohol for your hand, you know, your hand gel to work. So vodka being, what, 40%? It's 80 proof, right? Yeah. Won't do the trick. No. The T-dose people are saying, please don't use vodka as a hand sanitized.

Just drink it. Drink it. That's what's for. Enjoy. All right. Yeah, so stop with all this hoarding shit. I saw people fighting. Now, look, if I was.

bought up all the toilet paper, like this woman, wherever she was, I think it was in another country, there's a viral video, no pun intended. And she bought a bunch of toilet paper, and it was all gone. She bought the last of it. And this woman behind her said, could I just have one of them? And she's like, no, it's mine. And then they start fighting, and they're fist fighting, and they had to break them up and all this stuff. It's like, if I seriously had bought all the toilet paper and somebody behind me, why? toilet paper, I would let them have one.

I mean, how much ass wiping must you do? And what do you think is going to happen? This isn't a zombie apocalypse. And honestly, if there is a zombie apocalypse, the last thing you're going to be worried about is wiping your ass with tissue paper. Yep. Cut it out.

Yeah. And, you know, I was there the other day, and what was it? There was, oh, I needed Ziplocs, and I was going to get two boxes of them, and there was only two, and I figured, oh, shit, people are hoarding ziplocks. So I only bought one of them. Let somebody else be the asshole to take the last one. That karma's on them.

All right. So we do the Ronnie B? We did. Number one thing. Don't take advice from some asshole on the radio. All right. I'm wondering if there's any type of underlying condition that I'm dealing with. Okay.

I called in a while back, mentioning if you eat like steak fries too fast or notice even with bread, you'll feel like a weird choking sensation, and it's very, very bad. But I've noticed that I had that just recently. I was really hungry. I don't know if I just ate too fast, but it was just like bread, chicken breast, you know, with some barbecue sauce. and I ended up kind of having the same thing, but I've never really had that with eating too fast or being too hungry, but you had said it was the starch from something like a chunky potatoes, french fries, something like that, but I'm having that with even chicken.

It's the first time it happened with the chicken. Okay, we don't need the full menu. There'd be some kind of underlying thing. Yes. What if it's grilled? I think I'd have gotten rid of that. But is there anything that'd be concerned about, or is it... Well, what if it's...

What if it's chicken of the sea, I wonder. That's right. Chicken of the cave, which is where COVID-19 came from. Right on. Yeah, was the chicken sousvied or was it done in the pressure? Okay, dude, sorry. I never want to make anybody feel sorry that they called. No.

He could have an annoying issue, for sure. He has an esophageal stricter of some sort. Maybe a heidel hernia. Yeah, right. Yeah, right, which would cause a stricter of the esophagus. I mean, a functional stricter. It doesn't have to be, you know, from scar tissue or anything. Sure.

So something is causing food. You should be able to pretty much eat as fast as you want to. As long as you're not aspirating it into your lungs, you should be able to eat pretty fast. You should be able to stand on your head and eat upside down. And peristolsis should bring that food into your stomach. We used to have to do that experiment when I was in like sixth grade or something. They'd stand us on our head and make us. eat an apple and you can see how the, how, you know, you can still swallow it and still

ends up in your stomach. It's crazy. So, yeah, if you're eating and food is getting stuck, that warrants evaluation because the question is what's doing it. Do you have scar tissue because you've had chronic reflux? Is there something pushing in on the esophagus? Do you have a diverticulum in your esophagus? In other words, a pouch in the esophagus, so it's not a smooth tube going all the way down?

that needs to get checked out. So who would do that? Well, if it's way upper, well, you know what? It should be a GI no matter what because he's swallowing. He's not aspirating. So I was thinking, you know, if you have way upper symptoms, then sometimes an ear, nose, and throat guy can look down there with a fiber optic. But no, you need to go to a gastroenterologist. Tell them you have a sensation of food sticking, started with bread, and now it's things like meat.

and what they'll do is they will have you not eat anything after midnight, come in in a morning, stick a needle in your arm, give you some goofy juice, and they'll go, yeah, and, well, you won't even be aware of it, because they'll go, okay, count backward from 10 or whatever, and you go 10, 9, and then you go, I don't know, should I finish counting? And then, you know, and then you open your eyes, what are they doing, and they're done? I mean, it's literally like that. The last one of those I had, that's how it happened with me, is they said, we're going to give you some medicine. And I laid there and laid there and laid there.

And I said, when are they going to start? Right on. And they were already done. Yeah, and it's like, wait a minute. Yeah. What just happened? They were just giving me a second to wake up. It was really cool.

It's a neat feeling. And then they could look down there and see what it is. Is it something to worry about? Is it something we can easily fix? If you've just got a little scarring down there because you've had reflux your whole life and acid has gone in there and sort of scarred down part of your esophagus, they'll just go down with a dilator, open it up, and they may have to do that every once in a while

until that part of your esophagus learns that it doesn't need to keep scarring down anymore because they're going to treat that reflux. Right. All right. So, yeah, but get that checked. You said you called earlier and asked the same question, and I'm sure we told you the same damn thing then.

This time, you've got to go get it checked. Quit fucking around. Okay. I'm dropping the F-bomb a lot. I'm not in a good mood today. I've got to tell you that. Stuff with my job is not making me happy. A little bit.

So I'm sorry for the French. How the heck are you? Good man. Good, good. Yeah, I'm good. Oh, okay. I get it. I get it.

What he's doing is responding to the person that called saying, I hate it when Dr. Steve pretends like they're live called. They're not live. calls these are voicemails, and somebody got pissed because, you know, someone goes, hey, Dr. Stey, I go, hey, man. Hey, man. I'm not trying to fool anybody, but now I'm going to try to fool somebody. If someone tunes in right now, they may be fooled.

Hey, Dr. Steve. How the heck are you? I'm good, man. How are you doing? Good, good. I'm good. Yeah, what you got? Thanks for asking.

Anyway, I had a question, if I may. Okay, absolutely, of course. Hang on. Yep. Well, I'm getting to it. Okay, well, get to it. I was listening to your podcast the other day, becoming a doctor in the past that you set out upon

after meeting a guy who was a doctor, and you're like, jeez, I'm smarter than this. Yes, right, for people that don't know, you just go back and listen to last, it was either last show or the show before I told the story. But how I became, how I realized I could go to medical school because this guy who I was mentoring who was just dumb as a box of rocks

was a turned out to be a physician. So anyway, I've had some college. I'm relatively smart, much that I like to say. I'd start to go into a specialty, earmills and throat. I find that interesting. It's awesome. Always been dealing with finest issues and my ears and my eyes and my nose and also my throat.

So, you know, what would you suggest? What would you think would be a good jumping off point? Get the toe in the water, you know? I can totally help. Is there a school where they teach people to be doctors and stuff? Yes, it's called medical school, my friend. So, yes, so you want to be an ear, nose, and throat. You're putting the cart a little bit before the horse, but that's okay.

It's good to have goals and reasons to do things. So you're interested in, and that's a great field. It's so cool. You get to pull stuff out of people's noses, and you get to do cool procedures, and it's a really good one. If I had a thousand-year lifetime, I would definitely go back and do an E&T residency, because it is fascinating. And Dr. Pillsbury at the University of North Carolina Chapel Hill. and Newton Fisher, those two were my role models, and they were amazing ear, nose, and throat physicians, along with their partner, Dr. Biggers, who also was great, and one of the people

that taught me a lot about medicine. But anyway, so the first thing you've got to do is get in. You've got to get into medical school. You can't be an E&T without an MD, and you can't get an MD or a DO without going to either medical school or osteopathic school. So how do you get in? Well, you have to decide, do I want to go to an MD school? Do I want to go to a DO school?

Or do I want to do both? Get catalogs from both. And what you want to find is their prerequisites. What classes do you have to have to get in? Now, if you took those, let's say one of them is, you know, you've got to have a semester of biology. And let's say you made a D on it. You need to go back and take it again.

Do what I did. I was what called a post-bacalliate student taking baccalaureate studies. So you go back and you say, look, I want to go to medical school, but I don't have the prerequisites. I farted around, and now I'm really motivated. And so you go to a summer session, take Chemistry 101, get Shams College Chemistry, get a chemistry study group, and do nothing but that for that semester. really fast because it's a summer session it's going to go fast but you're just taking one class and painful live it breathe it i didn't find it to be painful i found it to be stimulating because you're now learning some stuff that's really going to apply to you later and there's a reason to

learn this dumb chemistry now oh i know and you didn't know that doesn't mean you have to like it when you were well you should like it make yourself like it make yourself love it love it and get you know, do what I did and get like 115 average in that. And then when you go to the post-backal, you know, to go get your past post-bacalaureate classes, you show that to them because they'll let anybody take a summer session. But for you to go for a semester and take a bunch of, you know, prerequisites for medical school, you've got to demonstrate to them that you're going to be somewhat successful. So you've aced your chemistry 101.

and Chemistry 102 in summer session. Now you're going to take biology, organic chemistry, physics, and calculus all at once. You don't have to take it all at once. But if you want to do this quickly, if you're a little older, you want to do it as fast as you can, you can do it all in one year. Some of these things you may already have, if you took calculus before and you made an A in it, you don't have to retake it. But you've got to get those prerequisites. And the medical school catalog, or you can just go online and get it. What a catalog.

I'm 100 years old. They'll tell you what the prerequisites are. So you've got to get all that under your belt. That's a minimum you have to do those. And you need to show them that you can make A's in that. Because what the admissions committee is going to see is, well, there's this older person coming through. We need to see that they're able to succeed and that they're truly motivated. So for me, you know, they saw B, B, B, plus, B minus, A in my major.

I made A's in my major, but everything else was B, B, B, minus, maybe a C here and there. And then all of a sudden, I go back to take my prerequisites. It's A, A, A, A, I'm on the dean's list for the first time. I got a 4-0, you know, if I had done that before, I would have graduated Magna Cum Laude, you know, but I didn't. But it looked good, you know, when they're looking at your transcript. now you will then this is excellent preparation for the mcat the medical college admission test but don't just rest on that you want to also take like stanley kaplan or sylvan or whatever to you know mcat preparation course because you need to nail that too so take an mcat preparation

course you will all this stuff will be fresh to you for me when they had physics questions on the mcat Well, hell, I just took it. For everybody else, they took it their freshman year to get it out of the way, you know. And then you have to nail the interview because you'll get an interview if you do all the things that I told you. And you have to nail the interview. You need to be interesting and you need to point out stuff that you've done, that your life experience has shown you that a kid just getting straight out, you know, going high school, college, medical school won't have. For me, it was championship wrestling. Believe it or not.

my second interview with a faculty member was 100%. She went, oh, I see you did championship wrestling. It's like, yeah, sure. She said, what was that like? We talked about that the rest of the time. I told championship wrestling stories. She was fascinated. And I know when the admissions committee brought my chart up, they said,

is that that guy that did championship wrestling? And they're like, yeah, that's that guy. Boom, you're in, okay? Because everything else fit. You want to stand out a little bit. Oh, also volunteer. You need to volunteer it. in places.

Volunteer at a nursing home. Any damn thing. You know, any damn thing. But a nursing home is a good one because it shows that you have compassion for the most vulnerable or, you know, in a daycare or whatever, but it needs to be in a medical capacity. And you're right, they do love having people that are athletes. They're part of teams.

Yes. That have done things like that. Some accomplishments. What have you accomplished in the time that you weren't thinking about going to medical school? Stuck to it. Made a difference. How did that make you want to? Now, going in there.

and say, well, I want to be an E&T because I have sinus problems. Because I love Dr. Steve. That might be the beginning of the conversation, but you need to, you know, I've done some research and I found out that, you know, you can really help people with this, but I just really want to help people. And, you know, I'm just called to do it. That kind of language will get you a long way in there. So good luck with it.

Let us know if you really do decide to pursue it. It's a long slog, but I will tell you, I was 27 when I went to medical school. and now I'm 64 and it was the greatest thing that I did other than having kids you know and that year of prerequisites I was like an effing sponge dude

I learned so much stuff it was unbelievable there's Tacey but we're almost out of time we're working on a new song Band of Horses song called The Funeral which has got nothing to do with anything I just says a cool song

so we're not trying to be you know whatever too dark for the room man or anything like that but it'll uh yeah we'll have that for you next time maybe not be the time after next

yeah because I think we're running a special next week and then we'll be back to regular stuff and maybe we'll do a music episode we'll probably need to at that point yes all right well we can't forget

Rob Sprantz Bob Kelly Greg Hughes Anthony Coomia Jim Norton Travis Teff Lewis Johnson Paul Off Charsky Eric Nagel, Roland Campo, Sam Roberts, Pat Duffy, Dennis Falcone, Ron Bennington, and Fez Watley, who's early support of this show, has never gone on, appreciate it. By the way, I've always used traded plugs for your time on this show.

Now that you're taking simply herbals off the table, am I going to have to start paying you for doing this? Yes, cash. Well, it's been nice knowing you, dude. Listen to our Series XM show on the Faction Talk channel, Sirius XM Channel 103, Saturday at 8 p.m. Eastern, Sunday at 5 p.m. Eastern on demand and other times at Jim McClure's pleasure. Many thanks to our listeners whose voicemail and topic ideas make this job very easy. Go to our website at Dr. Steve.com for schedules and podcasts and other crap. Until next time, check your stupid nuts for lumps. Quit smoking, get off your asses and get some exercise. We'll see you in one week for the next edition of Weird Medicine. Thanks, Scott. You know,