Weird Medicine: The Podcast - 419 - Doctor X

Episode Date: August 23, 2020

Dr X and PA Jill join Dr Steve and Tacie for a roundtable discussion on various topics. In a surprise move, Stacy DeLoach calls in. Topics include, COVID deaths vs cancer deaths, Fire Engine lore, and more! PLEASE VISIT: stuff.doctorsteve.com (for all your online shopping needs!) simplyherbals.net (While it lasts!) noom.doctorsteve.com (lose weight, gain you-know-what) Get Every Podcast on a Thumb Drive (all this can be yours!) hellofresh.com/weird80 (America’s #1 meal kit and get $80 off!) feals.com/fluid (50% off your first order of premium CBD sent to your home!) Learn more about your ad choices. Visit podcastchoices.com/adchoices

Number one thing, don't take advice from some asshole on the radio. I've got diphtheria crushing my esophagus. I've got Tobolabovir, stripping from my nose. I've got the leprosy of the heartbound, exacerbating my incredible woes. I want to take my brain out. I'm clasped with the wave, an ultrasonic, ecographic, and a pulsating shave. I want a magic pill.

All my ailments, the health equivalent, and 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 paging Dr. Steve. It's weird medicine, the first and still only uncensored medical show in the history of broadcast radio, now a podcast.

I'm Dr. Steve with my little pal, Tacey, the most excellent serving wench. Hello, Tacey. Hi, everybody. And the return of P.A. Jill, the also most excellent serving wadge. Hello. Uh-oh. And from the bowels of a medical school that will remain unnamed, Dr. X. Hello, Dr. X.

It's a different Dr. X, everybody. You're not, I think you're like the third person that I said, what do you want your, your radio name to be? And it's like doctor. I'm the original. This is a show for people who never listen to a medical show on the radio or the internet. 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 on 347-7-66-4-3-23. That's 347 Poohhead.

Visit our website at Dr.steve.com for podcast, medical news and stuff you can buy. Or go to our merchandise store at Cafe Press. dot com slash weird medicine where everything you buy we make 25 cents most importantly buy all you can buy a million things and we'll be fine most importantly we are not your medical providers take everything you're with the grain of salt don't act on anything you hear on this show without talking it over with your doctor nurse practitioner physician assistant pharmacist chiropractor acupuncturist yoga master physical therapist clinical laboratory scientist registered dietitian or whatever so dr x every time um i used to

to just say, talking over with your doctor, nurse practitioner, I'd say physician's assistant. I got corrected on that one, not by PA Jill or PA John, who were on this show for almost 10 years, but by some listener who said his wife was offended because I said physician's assistant. Right. So I was wrong. Yeah, drop that apostrophe yes. Yeah. So is it physician hyphen assistant then?

I mean, it doesn't make sense otherwise. Well, there's not a hyphen. It's just physician assistant. So it's a title. Yeah, gotcha. And so then after that, anytime somebody complained, why don't you say clinical laboratory scientists, I would just add it in there.

Naturopathic doctor as well? No, I won't add that. No, thank you. Veterinary. No, I would. I would. On Facebook, those are the best, though. Yeah.

People never find the answer until they go to see one of those. That's partly true. Well, and we could talk about selection bias because that's really interesting. But first, let me get a couple of plugs in, even though now we're just... We don't have to talk about selection. I just want to get this over with. Go to feels.com slash fluid, FLUID, stuff.

dot, Dr. Steve.com for all of your Amazon needs. Stuff.org.com is the driving force behind weird medicine. Tweakedaio.com. Offer code fluid, FLUID, for 33% off the best ear. Buds for the price on the market and the best customer service anywhere. And if you want to lose weight and get to your ideal body weight with me, go to noom. Dottersteve.com. Noom is not a diet.

It's a psychology app. It has completely changed my life. It's amazing. Even when I binge, I binge on rice cakes now. And I love it. You know, it's totally changed my life. I used to binge on bags and bags of Snickers. So I'm down six pounds.

All right. Very good. Wait a minute. Let me give me one of these. Good job, Tase. It's very slow, but it is happening. And it's not too hard. So if I can just keep my mental attitude and do what I've been doing.

And what did you call it, Jill, the other day? You said, fault work. Relentless. Oh, relentless effort. Relentless effort. Just not ever giving up. A bad day does not mean a bad day. It doesn't.

It's relentless effort. So you have a bad effort. David it doesn't matter because you have relentless effort to get to your goal and it doesn't even have to be a bad day you've got your whole life to do this it doesn't have to happen tomorrow they talk about non-scale rewards in other words that it's not just about the scale now I can fit into some better clothes I look better when I look at a picture of myself now I don't immediately just go yuck like I used to I still you know if I look at it it's like look at that head on that noggin on that guy he thinks he has an eggplant head I do I do I got an egg looks like a head that looks like an egg that made it with an egg plant. No, no. Because, well, I got this parotid. Dr. X, that's your next thing is to figure out what's wrong with my, what I can do about my parodid hypertrophy. So I have like mumps.

And my brother noticed it. And it's like, well, that's why my face looks so stupid. And I went to an E&T and he went, yep, you got that. And it's like, well, okay, do about nothing. It's like, we've got to figure out something that we can do. So that's your next job before I see you. Photoshop. That's exactly right.

Photoshop is a hell of a drug. That's right. And if you want archives of this show, which, of course, you do, go to Dr. Steve.com, the middle of the page. You can click on a link. And for $30, you get a 32-g-g thumb drive with every show on it, including P.A. Jill and P.A. John, going back to the beginning. Oh, million years ago. Plus, oh, Dr. X.

I'll give you one of these. It's a weird medicine, COVID face mask. Awesome. Oh, you know what I found the other day, Steve? And you get one of those, too. And then I throw in a little extra something. The Flatis Flute. Oh, you got a Flatis Flute.

Yeah. I never made a penny off of those, but I thought it was hilarious. Yeah. There's one behind you. See, isn't there one behind you there? I want a Dr. X to see it. I don't see it. I don't either, but I found like three.

Remember when I cleaned my closet out of taste and I found all that good stuff? Yeah. So Dr. X, the Flatis Flut was part of that. The Flatis flute is, and don't. think less of me as you're with it. Now that I'm no longer you're attending and now we can be friends. It is a whistling butt plug

and it's just a joke but the artwork was done by a guy named son of Fritz. He's a German immigrant. His parents are German and he's a really cool artist. His artwork sort of looks like Renan Stimpy. And what it is is there's this

hairy ass that is shooting out Flatus in the form of musical notes into my face, and I'm smiling like it's the greatest thing that ever happened. So if you want to check that out, go to fletusflute.com. Anyway, all right, well, let's get this show back. Oh, you must have one. Now, before you went to medical school, you were a paramedic, and you did fire truck stuff.

Fire truck stuff, right? and you actually were going to drive the hook and ladder, is that right? Tell me about that because I didn't even know they, I mean, do they still have the ones where the person sits in the back and has to steer the back of the truck or whatever the hell you call it? So when I was back in the fire department, they mainly call them tillers, no longer hook and ladder, but very few departments have them nowadays. So the apartment that I actually joined didn't have them, unfortunately, but it was my goal in life to hopefully be able to. to drive a tiller, and maybe one day I still can. So tiller is the one that's got the... Tiller is the one that has the two drivers that has the separate base

where you need the driver in front and the back to be able to direct the... And that's so that they can cut corners better? Better in cities, yeah. Yeah, yeah, yeah. That's really cool. It's cool as hell. It is cool. Yeah.

Never thought about it. It's cool. So, yeah, I'm fascinated by the whole thing because I know nothing about it. Firefighting. We had chest pain rob here, by the way, I should tell you why we called him chest pain rob. And this is just so that all the guys out there who don't know this story, listen and heed my words.

So stupid chest pain Rob goes to the emergency room one day. And he, because he had chest pain, right? Well, that wouldn't be enough for us to call him that. So he gets, you know, an EKG and everything. And he goes home that night. And everything was fine. Got some blood work, troponans and all that stuff. He goes home, and he's taking his shirt off when he and his wife are going to bed,

and he's got one of the lead things still there stuck to his skin, right? And his wife goes, wait, what's that? He hadn't told his wife he went to the emergency room. Oh, nice. And so she goes, wait, what's that on your chest? He goes, oh, it's one of those EKG leads. I went to the emergency room today with chest pain, and oh, my goodness, did he catch holy hell? Guys, don't go to the emergency room and try to not tell your wife.

And if you are going to do that, make sure she never finds out about it. Now, I know why she, I mean, I understand that she got pissed and I kind of see it, but what's the deal with that, the wives here? If your husband goes to the ER and has chest pain and then doesn't tell you about it, what is it about that that pisses you all? if anything. Jill doesn't give a shit. She hope John dies, but... No, I mean, are you really asking

that question? That's the dumbest question ever. What do you think, Jill? Well, we got guys listening and they don't, they're not going to believe me. If you went to the ER because you had a laceration that they sutured up, okay, maybe we don't need to know about that. Hey, I cut my finger in it

and I had some stitches. But if you go to the ER with chest pain and there's a possibility you're having a heart attack, in which you might die or have a major surgery, yeah, I think that's a conversation we need to talk about. That certainly falls under how was your day category. I mean, that, that, something you might mention before, I just noticed the EKG lead

stuck to your chest. That's the stupidest thing I've ever heard. So anyway, that's why he's chest pain rob forever. I thought he was chest pain raw because he actually had heart attacks and things. No, no, no, no. No, he never did. I thought he was really in poor health. How is he, anyway? I haven't talked to him in the longest time.

He's actually, the reason I brought him up was because he was, he's an EMT with the fire department. So he's a first responder. Well, hello, if you're out there. Yep. And so anyway, so how did you get into that? That's so crazy. So I got into it. It's not like you're a big hulking woman either.

No, no, but I have older brothers. And I know that's hysteria. You wouldn't necessarily be a big hulking woman to be in the fire department. But that's sort of what you would sort of imagine. Right, right. You know. Now, I got into it because I've always enjoyed kind of physical, more demanding things, sports and all that. And somebody told me that EMS was pretty feasible to do, just like a six-month class.

So I started that way. And then wanted to end up cutting cars because I thought that was really cool. Just seeing the jaws of life. I wanted to be able to use those, cut up cars, help extricate people. Yeah, it's a new mass. or hydraulic vice? We used to be hydraulic. Now they're more so pneumatic.

Okay. Or even battery powered now. They're getting really, they're so much lighter. Like the typical Jaws of Life that we would use when I first started, we weighed about 60 pounds, and now they're starting to weigh around 20 pounds. Are you kidding me? Not even kidding. And you can open up a car door with a 20-pound?

Battery-powered device? I wonder what else you could do with that. So that's how it started. But in order to do vehicle extrication. you had to be a firefighter. So I went through the fire class and really enjoyed that too. So I just kind of stuck with that and did that for a while. Let me ask you this.

Did you go to medical school eventually because you were driven to do or were you just tired of being told what to do by people who were dumber than you? Let's go with the latter. Yeah, yeah. Thank you. All right. Let's give me one of these. A bill?

Oh, no, wait. Give yourself a bill. That's why I went to medical school. I was in television and I was doing championship wrestling and doing all this stuff. And I was moving up the ladder. And I just got so fed up of being told what to do by people who were, to me, infinitely dumber than me.

And I figured if I went to medical school, that wasn't the only reason. But that was one thing that kind of finally got me to go. I always wanted to do it. And I always wanted to help people and all that stuff. But that's what spurred me to finally say, hey, I need to do this. I need to make a change in my life. Right. So good deal.

Well, good. Well, welcome. and feel free to just jump in on all of this stuff that we're going to talk about today. Christine's never listened to the show. Matter of fact, as of... Good for her. Three hours ago, she just thought I was, you know,

some elderly attending of hers. And then I took her out to lunch, and then she ordered a rye. And I'm like, oh, now, wait a minute, now. This is pretty cool, because I ordered Willett's bourbon. We were done with work, by the way. It was a very late lunch. And then I find out that she has a concealed carry permit.

And I'm like, oh, she's a woman after my own heart, and she plays instruments, too. And it's like, hell, just come over. Tacey's at home drinking. And it'll be a big old time. How do you know we were drinking? Well, it's Friday, and you took half the day off. And your name is Tacey. Yes.

And I have met you. All right. So anyway, don't forget to check out Dr. Scott's website. at simplyerbils.net. He is gone but not forgotten, and he will be back someday. And I guess that's it. We got anything to plug? You want to plug? Oh, Jill. You want to plug your thing? What thing? Well, your brewery. Oh, oh. So people who don't remember, P.A. Jill is married to P.A. John, who is no longer P.M. John. He's BM John. Right. Brewmaster John. Or bowel movement, John.

Exactly. Yeah. So if you're in. in our area, you should check out J.R.H. Brewing. And we have our product in cans in local grocery stores and convenience stores. And obviously, you can get anything that you want at the brewery as well and growlers and pints to go. And, you know, obviously with the COVID situation, things are still iffy with going out. But we definitely are taking the appropriate precautions for that. And having our table spaced out, we have a lot of outdoor space. We have a food truck, which is awesome, which is at Alley Cat, which has a great... They're all the time there?

They're there all the time. Yes. And I would argue what... Yummy fries. Yes, right. You've had it, right? Awesome. Okay.

So, and a great Philly cheese steak. And I would have to say that cheese steaks aren't my thing. Like, that's not my go-to, but they have an awesome. A good one is a good one. Oh, man. It's awesome. And they, and I've seen people come from Philly and say, wow, this is like the best Philly cheesecake I've had outside of the city.

It's really a good one, yeah. People from Louisiana say that about my gumbo. There you go. And I say that about your barbecue shrimp. Oh, thank you so much. We should do that again. We should. I'm just hitting these stupid buttons way too many times today.

It's just because Christine is here. No, I like it. Showing off. And so, yeah. I mean, Dr. X. And I picked up on that a moment ago, but, you know. Sorry. So, but yeah, you should totally check out J.H. Brewing.

Yeah. Yay. Yeah, J.R.H. Brewing, your husband, I used to, you know, I love to just crap on him. Of course you. But I can't. I can't. Not for his beer maker. Everything else. I can totally crap on him because, you know, that was part of the dynamic of the show. Right, right.

It was fun just crapping on P.A. John. But, you know, as a brewmaster, this guy is the real deal. Yeah. He's made at least two, maybe three of my favorite beers that I've had in my life, and I have been on this earth for almost 65 years. Yeah. And I've been drinking for 59 of those. Yeah.

Big birthday coming up, everybody. We're getting all kinds of Part D letters in the mail. Oh, yeah. Tacey used to, when I turned 50, I would get AARP letters, and Tacey would get the mail, and she would just write ha. in big red letters and put it in my pile because she's a turd. And then now I'm actually getting Medicare. Now it's just sad.

I'm not getting Medicare, though. I told them no thank you. At all? No, I'm getting Medicare Part A, but I have good insurance, so I'm just going to do that. At all? Are you crazy? You should totally reap your benefits. You've been paying into that for a long time. So, but anyway, all right.

Well, very good. Oh, so I'll just continue to pay for your shit. that's okay let's just do that okay that sounds good oh we've just gone downhill this is a terrible show that's that's your new drop tacy well it's true it's true again today let's do it again here let's hear tacy's new drop okay oh we've just gone downhill this is a terrible show this is terrible and then we have god damn this is about as boring as sex with my while I agree. Can you please stop bullshitting and get to the questions?

You haven't answered a single fucking medical question. The Bob, man. What's a pot, man? Your show is better when you had medical questions. Agreed. Okay, whatever. All right. You just say AIDS like in a cheering way?

Yeah, yeah. Yay. Well, it's like Mark Norman does that. There is a good treatment for now, but I mean. I mean still. Mark Norman just throws out random words. I love that. He did a video for a friend of mine. It was his wife's 45th birthday or something. And Mark was just walking down the street and just throwing out random words like coronavirus and stuff. It was just, I had to be there. Anyway, all right. So here's a good or a bad question. You tell me, Steve, but this is a question that was in our household for a while. If you could choose, would you choose, and this was early on in COVID. Would you choose HIV, which has lots of good proven treatments?

Would you choose COVID? Ooh. Okay, well, okay, one's an acute illness that could be fatal. One's a chronic illness that untreated would be fatal, but it's very treatable. I think I'd take HIV. That's interesting because that's what P.A. John said as well. I said COVID all day long. Well, you're young and mostly healthy.

But you're a two-time cancer survivor, so you could. So you could be, you know, in a risk group. I'm in a risk group for COVID-19, big time, with my age. So, you know, HIV, you can get the retrovirus counts down to zero now. Right. And that was John's argument. Yeah. It's like, I could have like a zero viral load and, you know, and live for, never have AIDS, ever.

And I'm like. It's a lifelong regimen, though. That's true. I don't like that. For some, though. I mean, is Magic Johnson still taking medicine? I mean, he's been, he got HIV when? It was Magic Johnson, right?

I didn't just libel somebody, did I? No, yes, you're correct in your name. Johnson and HIV. Because he was one of the first to get on a retroviral, anti-retroviral cocktail, right? Mm-hmm. So, 1991. Okay. So, you know.

30 years? Yeah. Well, 91. See, you have to do Howard Stern math now. 91, 2001, 2011, 2011, yeah. 29? Yeah, something like that. Is that right? 29?

Is that a year? 29 years? 29 years, right? I don't know. I've been drinking. I'm doing math on a Friday. Oh, I understand what you're saying. Like, it's a total of 29 years.

The way you said it, I was like. We used to have Echo. I don't know what I thought you were saying. And she could answer questions for us. and I have not plugged her back in since I redid the studio. Because she sucks, Steve. 29 years. Yeah, it's crazy.

There you go. So, but he was started on the anti-retrovirals really early on. But I've seen people who have zero counts, and sometimes they take them off their medicine. It doesn't come back. Have they said that about Charlie Sheen? Isn't he undetectable? I don't know. I hope so.

I mean, I don't want anybody to have detectable, you know, HIV. So, anyway. All right. Do you remember? when that was so scary and it scared everybody and it was just... Listen to me. I was in medical school when it happened and we would put the hazmat suits on because we didn't know what it was. Double glove, all that.

The whole thing. And I remember this, I was working in an immunology lab at the time and there was an immunology postdoc in there. And we had just taken a virology course. We're like, it's got to be a virus. And he was like, oh, there's no way that's a virus that causes that. And he was making fun of us that we were so stupid to, you know, dumb medical students that here he was a Ph.D. postdoc that we would even entertain the idea that, you know, that AIDS was caused by a virus. Wow. He was a dumbass.

Obviously. Just shows there's dumb asses everywhere. The guy was a Ph.D. Couldn't be stupid. Well, there were plenty of dumbasses when it comes to HIV in the 80s. Yeah, that's true. In the early 90s. Well, and, you know, when you see something new like that, there would be people who are very set.

in their ways. For example, helicobacter pylori, there was a time, so Dr. X, you want to talk a little bit about helicobacter and why we talk about it? Sure. It's a bacteria that causes people to have ulcers. Yeah, that's right. I guess most typically, not in the U.S., but definitely there's a problem here. Yeah.

More prevalent in other countries. So it's a bacterium that causes stomach ulcers. A lot of the gastroenterologists that I talked to were like, there is no. No way there is a bacterium that can live in the stomach and cause stomach ulcers. And they just thought it was hilarious until it was proven to be the case. You know, these things where they use Koch's principles and you go in and you culture them out of there. And yes, here they are. And then you put them back in an experimental model and it causes ulcers.

Well, you just prove that that's what it was. Right. So now we test for H. Pylori every single time they do an EGD. You know, for those that don't know, an esophagastrodoidoscopy, which is just a, you know, the typical scope from above. Not like the scopes that your mother had where she had a colonoscopy, and she said, Now, Steve, I'm going to have to have one of them up, you scopes. Talk about the treatment for H. Polori, though. It's pretty intense.

I mean, the treatment is not great. Yeah, it's two antibiotics and a protopause. pump inhibitor, right? And are they still doing it that way? And the antibiotic, one of them was chlorithromycin, which can be really tough on the old stomach. And then the other one is a moxicillin, right? It's been so long since I've treated it.

And we used to add pepto to that as well. Oh, yeah. It's like 16 pills a day. Yeah. It's a big deal. Yeah. Two to four week treatment. And unfortunately, sometimes it doesn't even get rid of it.

Right. And they'll still have symptoms. I don't even know if a lot of doctors still treat it anymore. It was like a big thing. Yeah, I remember they used to have those, what did they call those packs that had the prev packs? Prev packs. And now they're just not, it's just not much of a topic. I don't know if it's just old school news, but back in the day it was.

Yeah, we tested a low. We had a breatheria test there in the office, Steve. Remember we worked at, where we did it together? Yeah, we would, on every, any person that had abdominal pain with the reflex, yeah. Everybody got the breath test. Yeah. had it there in the office. I wonder how sensitive that is compared to the EGD, though.

But, you know, if it's positive, it tells you something. It's specific. It just wasn't very sensitive. Correct. Yeah. I mean, the biopsy is definitely more specific and sensitive in the answer. So, Jill, you brought up COVID-19. I did.

So there is a new drug. U.S. Food and Drug Administration is fast-tracked a promising drug to treat COVID-19 patients, and it is in trial at Houston Methodist Hospital. So I don't know what phase they're in. It's called RLF 100. It's also known as a viptidil. Now, vipidil is an interesting drug. It blocks replication of the coronavirus in human lung cells and in human white blood cells, which is pretty cool.

This drug, though, is a synthetic form of human vasoactive intestinal polypeptide, which normally if you take that orally and it hits your gut, you're just going to have voluminous diarrhea. So I'm very interested they're giving this IV so it never touches the gut. So this isn't going to be the drug that's going to end this because you'll have

to be in the hospital to get it. But it's a promising new drug and it looks like I'm trying to look. I'm looking at clinical trials.gov, by the way, any of you all that want to look, see what's out there. If you want to track your hydroxychloricloric trials or your favipyriere trials, or all of this stuff and there's all kinds of new stuff coming out there's a synthetic

cannabinoid so it's like CBD so it's a synthetic version of cannabodial but you know which is CBD which is the non get you high one of the non get you high molecules from him or from the pot plant too and they're targeting a specific receptor that hopefully will prevent or with, or, you know, knock back cytokine storm, which we've talked about a bunch on this show. That's when the immune system sees the virus and just goes ham. And when it goes ham, what happens? Now there's too many inflammatory factors running around the bloodstream,

and now all this inflammation starts to settle in the kidneys and in the lungs and all these. Because I figure how does a respiratory virus cause someone to have renal failure and die? Or their blood pressure to drop or thrombosis in their arteries and stuff like that. It's all because of this total body inflammation. And this stuff will forestall that. So it's pretty cool. And it is, you know, people tout cannabis products as being, you know, panaceas for everything. Well, here's one where it actually looks like it's going to do something.

So it's only in phase one try. right now, it will not be available on the market for at least a year, but they're doing studies on it now. So you can check out all these things at Clinical Trials.gov. And I'm looking at this one for this eviptidil or whatever. What did I say? Yeah, avipididil. Novel coronavirus is known to cause respiratory failure, which is the hallmark of acute COVID-19. Approximately 50% of those who develop critical COVID-19 die despite intensive care and mechanical ventilation. Patients with critical COVID-19 and respiratory failure currently treated with high-flow nasal oxygen, non-invasive ventilation or mechanical ventilation, will be treated with a viptodil, a synthetic form of human vasoactive intestinal peptide plus maximal care versus placebo. So this will be a double-blinded placebo-controlled trial, the at very best kind of data that we can get, where the patients don't know, the provider doesn't know, the only one that can determine who it is.

is, is an independent monitoring agent or agency that's watching the data constantly to make sure that they're not slipping into an unethical situation where, you know, if the Evipta deal really shows it, look, nobody's dying in that group, and still 50% are dying in the other group, you've got to stop the trial, right? And decode it. Otherwise, they won't decode the answers until the very end. And so there you go. So that's very interesting.

It says non-clinical studies demonstrate that vasoactive intestinal peptide is concentrated in the lung and is specifically bound to the AT2 cell where it prevents. Oh, boy. NMDA-induced cap says three activation in the lung. Okay. Thanks for that. That's awesome. It inhibits a bunch of inflammatory markers.

So anyway. Is that AT2? Tonson why they were targeting ascentiters? Yep. Yep, absolutely correct. Oh, well, let me give you one of these. Give yourself a bill. All right.

So it says five phase two trials of Avipto-Dil have been conducted. So this should be under European regulatory authority. So this should be, okay, it's 144 participants, so this will be a phase two trial as well. If you remember, the phase one trials, they'll do 30-40 people. Phase two, 100 to 300. in phase 3, you know, 3,000 to 30,000. And then phase 4 is post-marketing. So very good.

Very interesting. Now, one other COVID-19 related thing is we've been talking about this R-sub-T. Jill, are you familiar with that? No. So R-Sub-T is a number. It's the average number of people who become infected by infectious person. But this is real world. So R-Sub-0 is the theoretical.

You know, if you put one person with COVID-19 in a group of people that have no immunity to it, how many people will they infect? The answer is about 2.4. If you do that with measles, the answer is 12. So I'm going to, so anyway, the R-Sub-T uses real-world data. I'm going to have to drink something here. Sorry, I'm going to hit the button. sorry

all right so the r sub t uses real world data so if you have an r sub t of 0.9 100 people will infect 900 people

which will affect 810 people you know and then 720 so it'll continue to drop right if it's above one let's say it's 1.5 then 100 people infect 150 people which will infect 400 or an

Now, whatever, what is it, three something, and then 450, and it'll start to rise geometrically. When you hit an R sub T of two, you're seeing that doubling, where 100, in fact, 200, 400, 800, 600, you know, and it goes crazy. So we've been talking about this for a while, several weeks ago, maybe four or five weeks ago, four-fifths of the states in the United States had R-sub-Ts above one. So they were seeing cases increase. We are now at a point, and we are recording this, just so that you know, August 21st, 2020, where two-thirds of the states now are below one. That includes Michigan, Delaware, Nevada, Montana, Georgia, excellent, New Jersey, Oregon, etc. Alabama, Arizona, Louisiana are at the bottom of the bottom of the. the list. There are sub-tis are 0.8 and above, so they're doing very well. We should give

them one of these. I should have just hit the applause when I hit the cough button and just, you know, let it apply, just, you know, voluminous applause. Nobody would have known the difference. North Dakota and Hawaii are the two with the highest R-sub-T right now with Texas close behind. North Dakota? Yep. Now, remember, this doesn't, huh? Was that where the motorcycle rally was? Oh, I don't know. Is that right?

They might be. Oh, where was that? Somewhere up the head. We could look that up. Is that like Sturgis or something? Yes. Yes, it was an S word. Now, this doesn't mean necessarily that they're going to have insane numbers of cases.

It just means they're having, you know, they're having a lot of spread right now, community spread. Well, you would just think about North Dakota is not very popular. Right, right, right. People are spread out. Why does that happen? That seems to exchange. Yeah, there's is 1.2. And also, I thought Hawaii

had all these really strict restrictions. They do. That's probably why. This is a pretty populated island, right? I mean, there's only so many places you can go as well. And the other thing is, listen, the highest in this country right now is 1.27. Wow. South Dakota.

That's pretty good for everybody. So let's say. That's what I was thinking. Sturgis is in South Dakota. South Dakota. Okay. Well, South Dakota is number three. Okay. So when you get down to, say, Alaska. And so Alaska is sixth in line.

Your R-sup T is 1.08. All of these states are so close that people say, don't wear, oh, mask, don't do nothing. Well, okay, if you're a mask don't do nothing person, will you grant me that it might prevent 10% of transmission? That means 90% of the time it will do absolutely nothing. If you're wearing the mask, it's just like you're not wearing it. But 10% one time in 10, well, you grant me that. Because if you will, then wearing a mask, we'll get all of these states down below 1.0. I love the people who wear the masks in grocery stores around their neck.

Like they wear them just to get into the building. Yeah, and then they bring it down. Or we were at the bank the other day, and there was a person in there. And when she would talk to us, she would pull her mask down. And it's like, no, that's when it needs to be up, honey. We were laughing so hard and trying not to laugh at her, but even our kids were laughing at her because it was hilarious. Yeah, she'd come right over there and she'd have her mask on. As soon as she'd start talking, she'd pull her mask down.

It's like, stop, please stop doing that. This right here says Sturgis Motorcycle Rally tied to new coronavirus cases, a state away in Nebraska. Oh, is that right? So it was, it was in Nebraska or it was in South Dakota? He was in South Dakota. But it was people went back to Nebraska and brought up with them. Just like our big old fashion Bristol Motor Speedway incident we had. Did anybody?

They said no COVID was related to Bristol Motor Speedway. I'm sure it was. Tacey, what are you speaking of? Was there, though? I mean, what are we? I mean, I don't know of any. That's why I asked Tacey. It was literally like they released a statement that said there was no COVID.

Well, they really tried hard to not to be able to put it on and not have anything happen. So they did some, you know, they did a lot of stuff there to, and if they can demonstrate that you can do something like that and not have a big major outbreak, then, you know, bravo to them. It's just a really bad idea in general. Well, I know. And it's just like schools are getting ready to go back. And we'll see every place that seems like schools are going back to, there's always a big outbreak after, regardless of the protocols and precautions. Well, I mean, I don't know. We're getting ready to see, so we'll let you know in a couple of weeks.

Right. And hopefully that statement is true about the Bristol Motor Street. Yeah, me too. They really are using that as a standard. Like, hey, they've already had a large organization. I mean, you know, NCAA football. That's what they did. They are all team members required to wear a face mask at all times.

Fans are required to wear a face mask when they arrive while entering the gates, which is where there's congestion. and in high traffic areas, fans may feel free to remove their mask when they're in their assigned seat location. Social distancing will be required among groups of fans in the grandstands and individually in concession lines

and restrooms will be required. Well, that's all we ask for, really? If you social distance and you wash your hands and you wear your mask when you can't social distance, what else can we do until we have a vaccine? I mean, that's all that anybody's asking anybody to do. I mean, you have to live,

and we've done things like that. I have seen on Facebook where people complain about having to go into a restaurant with a mask on, but being able to take it off when they sit down and how they don't understand that. And it's like, but that's where the congestion is. The congestion is at the coming in and going, yeah. But they're like, well, that's just stupid. Now, they're doing temperature checks for their employees. And by the way, if you want to reassure the public, if you've got a restaurant and they can't social distance in the kitchen,

you want to reassure the public, just let everybody know that you're screening your employees before they come in. And they're doing, all guests will be required to have a non-invasive temperature check before entering the gates. So you know they picked up a few people that had fevers that they kicked out. Now, not everyone who has COVID-19 has a fever. But, again, if we can knock out 10% of this, when we've got our sub-T of one, that was our dog, by the way. What's he doing? Is he throwing up? No, he's just digging it.

Ralphie, what do you think? Come here, Ralph. What do you think? Can you, can you, nothing? Okay, he's got nothing to say. If you can knock down 10% of it and get that R sub T below 1,

that's all we're trying to do. Get the R sub T below 1 and this will diminish on its own. You know, this whole time I thought that our rise in numbers was due to that Bristol Motor Speedway. So I did not know. that they're saying no. They're saying no.

Yeah. Because I was pretty angry that they were even trying to do that. I'll tell you what, though, Tastes, a lot of people that come to Bristol would have gone somewhere else. You know, they aren't from around here, a lot of them. So, yeah. No, I think ours was just that there were places that really weren't paying attention to some of the rules.

I've been by some bars where people had no masks on, they were all mushed in together. Or do you think beach vacations maybe had some stuff to do with it? Maybe. But, you know, we did a beach vacation. We didn't go anywhere or do anything. Right. The easiest thing to do was to stay away from other people at the beach because it's wide open. Yeah.

And so we did that. And then we went in and cooked. And every morning, the 65-year-old went out and, you know, braved the shopping. Only because he wouldn't let me do it. But then I wouldn't have wanted to do it. So then there's that. So there's that. Who cares if I die, right, Tase?

Oh, I do very much so. So the other thing they did at Bristol Motor Speedway was limited attendance. It was less than 25% of the seating capacity, so good for them on that. How many does that seat? I mean, you can fit. A sheet's over 100,000, yeah. But still, 25% of the seating capacity, plenty of space for people to spread out. They did contactless tickets and concessions, and parking passes had to be reserved prior to the event to make sure that people weren't all mushed up together.

Let me see. They didn't allow coolers. I don't want to get the, well, that's just so they can sell stuff in the thing. That has nothing to do with safety. And then they did cleaning. They had hand sanitizer everywhere. They had employees PPE, and they were monitoring restrooms, all that stuff. Good for them.

Well, good. There's nothing better than watching people watching at a NASCAR race. There really is. My favorite thing to do. I mean, it's like nothing you've ever seen. before tattoos on the side of the road, you know, renting showers, doing tattoos on the side of the road, doing showers, it was like an extravaganza. Pre-COVID, it was pretty cool because, yes, all these people would be mushed together

right near Jill's house. Oh, yes. And, yes, there would be people who were selling showers, and then they would take the towel and hang it out, and then when the next, when they'd have like five towels, then when the next person came, they'd take the most dry out and give it to them. Oh, I've seen it. Yes, I've seen it. Yep. The Speedway didn't do that. These were individuals that were making a couple

of bucks. That was one of the funnest nights we've had. That was... I absolutely agree. We didn't stay for the whole race. It was just getting to it. That was so awesome. That's big fun. Yeah, it was load of time. Tailgating for a race? Yeah. Yeah. All right. Want to take some questions? Yeah. All right. Number one thing, don't take advice from some asshole on the radio.

All right, and that asshole would be me. I can't wait to give some advice. Hi, Dr. Steve. I had a quick question. I was in Vegas, and I was drinking fairly heavily. I coughed up some stomach acid in the back of my throat, and this happened on New Year's, and I've been feeling like this, feeling like burning sensation, like, in the back of my throat, ever since. Needless to say, it's

going on about five weeks. I'm wondering what I should do should you think it'll go away or if you have any suggestions. Thank you so much. Appreciate your help. Okay. Tase, you want to take that one? Nope. No? Okay. Jill? That seemed right up your alley, Tacey. What are you talking about?

I know. I know, right? I mean, I would think, yes, that would go away. So what does he got? Yeah, so he has, he had some reflux and he's just irritated his esophagus with his reflux from his alcohol. He's probably still refluxing. That's the thing. Correct.

And he just was able to be asymptomatic before, but now he's got it riled up in there. You think it was maybe the beginning of something? Yeah. So now when he lays down at night, stomach acid, you know, works its way up into his esophagus and continues to irritate it. Correct. Yes, I agree. So Dr. X, what do you think he should do?

Depending on the amount of alcohol he's drinking, maybe cutting down some. and then also going for... Oh, God. We don't ever advise that. Stop. I know. That's just this horrible advice. Listen to her.

She's just a baby. And it's going to. Okay. We're just kidding. Yes. He needs to cut. Just a penny on the amount. Yeah, he needs to come back.

And then also getting an acid pill, like a pantoprasol, trying that out for a month. Yeah. So a PPI or an H. two blocker or just, you know, chug some Gaviscon or Milana before you go to bed at night and try that first now. If you find a lot of people who are listening may have this problem where they wake up in the middle of the night with just fluid in their esophagus. I used to aspirate it, if you remember.

And if you drink or eat a lot of carbohydrates before you go to bed, you're more at risk of that. That valve called the lower esophageal sphincter which is kind of it's not even a valve it's just sort of a muscle ring that tries to keep stomach fluids in the stomach and esophageal fluids or mucus protected and you lay down at night and then sometimes it'll just open up and your whole stomach will flood up into your esophagus yeah you need to try to eat earlier in the evening also and you're right about the alcohol because i know like friday i don't have heartburn maybe maybe I'll get it on Friday night, maybe Saturday night.

And I know exactly why that it is. You're not binge drinking, are you today? No. Yeah, and carbonated beverages, I think, make a big difference in that too. You know, really, just those bubbles. Chocolate. I have had people that have this, that I have put on a low-carb diet, and they absolutely, they say that their reflux goes away.

So if you are having that mechanical reflux, where it's coming up when you're laying down flat. Well, don't lay down flat, but don't lay on a pillow either. You know, some people put pillows behind their back and sort of lay sitting up. Well, if you're a regular obese American, what you're really doing is the stomach will then push in on your stomach and actually increase the pressure and increase the amount of reflux. So instead, you want to put a couple of bricks or some rise or something that will raise the head of your bed up about two or three inches and therefore you can let gravity be your friend and gaviscon

is a brand name of a liquid an acid that actually floats and so for people have mechanical reflux no carbohydrates within four to six hours before and really shouldn't eat within four to six hours but for sure no bread potatoes potato chips are cereal people eat cereal before they go to bed None of that within four to six hours. Go easy on the alcohol before you go to bed, raise the head of your bed, and then take some floating gaviscon before you go to bed. Some people can manage it just with that. Now, if you have persistent symptoms, then you have to go get checked out. Back in the day, when I trained, you would give people an H2 blocker, which is like renitadine, which is off the market.

Now, Zantak or Pepsid you can buy over the counter for six weeks. and then if they still had symptoms, they had to be scope. They're a little bit more lax about that. Now, what are they teaching you now, Dr. X? That same thing. Also, the acid blockers like the omeprasols, the pantoporazoles for a month. And if symptoms are continuing, then you've got to go get the scope. You took physics, right?

A long time ago. Yeah, yeah. Have you ever thought about it? It always boggles my mind. A proton pump inhibitor. You know what? A proton, a naked proton is, yes, It's a hydrogen nucleus, but a naked proton is a quantum object.

It's three quarks bound together. How in the hill did nature figure out a way to pump quantum objects from one place to the other before, you know, millions of years? You know that the stupid dinosaurs had them. Millions of years before we ever even conceived of quantum physics at all. I mean, quantum physics is only 50, 60, 70 years old. Isn't that crazy? That is crazy. And there's a, you know, just a meat pump is protein that can take naked protons and move them from one place to the other.

That just blows my mind. So anyway, we were talking about why the universe is math-based on a show a long time ago. Tacey and I have these philosophical physics-based Not once. Not ever. But, you know, two dinosaurs going to get water

at a watering hole, there's still two of them even if the two of them are too dumb to know that there's two of them. So anyway, I don't know what that has to do with anything. What on earth? Yeah, you lost me there. Honey, you married somebody else.

I don't know what you're talking about. Hey, man. I've been actually trying to stay away from most of the COVID stuff, but I kind of had a brain fart. If you look at the American Cancer Society. Stacey Deloche, everyone. Can't not

acknowledge Stacy if he's calling in. 606,000 people died last year from cancer. So far, there's like 165,000. I know that sounds horrible, but 165,000 have died from COVID or COVID related.

I mean, if you have a motor vehicle accident, you have tested positive, then I guess they kept that as a COVID death. Okay, we can talk about that. Oh, Steve, I've been hearing that so much. But that's still less than one third. Okay, let's talk about that for a second. I know what point he's going to make. Let's talk a little bit.

Have you had any, without violating HIPAA, have you had any COVID deaths? Do you guys do your death certificates yourselves? No, not. Attendings do them? That's another thing. Okay. Anyway, the United States has had 174,000 deaths that were attributed to COVID. So I do do death certificates.

And the way that we were instructed by the state was not if they died with COVID to say that that was a COVID death. They said, if you have someone that's in a car wreck and they test positive, that's not a COVID. death. Are they testing people who have died? Well, sometimes that might happen, whether they already tested them. Let's say they tested them on Tuesday, and their test is still pending, and then on Wednesday they have a car wreck. Okay. And, no, they're not just testing it at random just because somebody dies. So we were instructed not to call that a COVID death. So I know this, at least the state of Tennessee is not trying to hyperinflate those numbers. Now, some hospitals may. It's all over Facebook, but that's exactly what's happening.

And it's not. There may be some hospitals that are inflating some numbers because they might be able to get some more money that way. My understanding is there are places that if you meet a certain threshold of critical COVID cases, then you can get some more money. But you should be using that for ventilators and P.P.E. So it's not a general standard rule. It's just happening with unscrupulous.

What? unscrupulous people. Yeah, very good. You got it. So, yes, because, let's just say I have someone who dies of, I don't know, secondary pneumonia. They got a bacterial pneumonia. But the bacterial pneumonia was started because of COVID-19. So they had COVID-19.

They got a viral pneumonia. They got better from that. But then they had a subsequent viral or bacterial pneumonia. And that's what they died from respiratory failure. My death certificate that I wrote for that patient would say respiratory failure as a consequence of bacterial pneumonia as a consequence of COVID-19. That would be considered a COVID death because the SARS-COV-2 was the proximate cause of this person's demise. If they hadn't gotten that, they'd still be alive today. And I think that's fair.

So that's how we're taught to do that. and that's how we're mandated to do that from the state. So, okay, so anyway, so what's, what's, what's Stacy saying here? I got to get a new damn mouse. This thing is no longer working properly. Okay, let's go. The number of people that die from cancer, don't you wish people got more proud about being healthy, not getting cancer?

Yes. Okay, thank you. Yes, that's the answer. Yes, I do. I wish people would mitigate their risk for everything. We're really cool about mitigating, most of us, mitigating risk of getting this coronavirus because it's scary. But people still smokes, people still binge drink,

people still do, you know, have unprotected intercourse with people they don't know, stuff like that. So, yeah, I would like for every, people still don't wear their seatbelts. you know so yes i would like for everyone to mitigate all risk in their lives but that's really hard to do and that's all we can do we can only mitigate it not smoking doesn't guarantee it that you won't get lung cancer and smoking doesn't mean you will get it it just increases your risk and not smoking decreases your risk so yes i do it's and yeah we need to put this stuff in perspective we do this with opioids too um you know dr x and i this week have written a ton of opioids

because we deal with cancer patients. And cancer pain is difficult to treat with other medications, so we use a lot of opioids. But, you know, they'll talk about, well, we have all these opioid-related deaths, and that's true. 90-some-x percent of them now are caused by illicit drug use, not prescription drug use, but anyway. But then if you look at things like deaths from Tylenol,

deaths from alcohol, deaths from... you know, uncontrolled diabetes, they are, those things all dwarf the opioid deaths. So it's just the big topic of the new. But it is a big topic. Well, it's something that we should be preventing. No question about that. Oh, I know there's problems with it. Yeah, I know there are.

So that's all, that's all Stacy's saying. And I agree with them. We got it's hard. We got to put this stuff in perspective. All right. So, Steve, what about the people who say, you know, when do we let this end? You know, COVID's a thing. Yep.

It's affecting everything. When do we go back and... Just let it happen. And live our normal life. And when does this end? I've seen this... I know exactly what I'm answering. On again, Facebook, forever.

They ask, is it a vaccine? Is it... And I think your answer to that would probably be yes. Well, that's one of the... Could you get everybody to take it? You know, people give our president all kinds of rations of stuff, and he deserves some of it, or a lot of it. But one thing that he said recently that's really true. is that the first thing we really need to hit

is a therapeutic while we're waiting for a vaccine. He's right. So I'm still hoping Favapyrivere, which is a pill that you can give early on in the course of the illness, will prevent people from going to the hospital, prevent people from dying, and then we can go back to normal

if it works, if it's effective enough. So, okay, thanks to... to my wife, Tacey. You're always a delight. Thanks to P.A. Jill. Great to see you. Thanks, Dr. X. We can't forget Rob Sprantz, Bob Kelly, Greg Hughes, Anthony Coombe, Jim Norton, Travis Teff, Lewis, Johnson, Paul Ophcharsky, Eric Nagel, Roland Campo, Sam Roberts. Pat Duffy, Dennis Falcone, Matt Kleinshmidt, Dale Dudley, the great Rob Bartlett, Ron Bennington, and Fez Watley, whose support of this show has never gone unappreciated. Listen to our Sirius XM show on the Faction Talk channels. Sirius XM Channel 103, Saturdays at 8 p.m. Eastern, Sunday at 5 p.m. Eastern on-demand and other

times at Jim McClure's pleasure. Many thanks to my niece Holly, whose support of the show has always been just, she's a nut. 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. Hey, I just wanted to make a quick announcement. My niece, Chris, is a Ph.D. speech pathologist nationally renowned. And you all may have noticed that my voice has been, I've been having some problems over the last few months.

I left in my choking spells so she could listen to it instead of just. editing it out and sending it to her. I thought I'd make you all suffer, too. And she's made a couple of diagnoses and some recommendations that I'm going to get that looked at. It looks like I've got some laryngeal spasm from floppy vocal cords and floppy laryngeal muscles, probably due to age and the way that I use my voice. So I'm going to be pursuing that in the future, and hopefully, we'll see some improvement.

Anyway, so a big shout out to my niece, Christine, who is quite the genius. And, of course, I can't mention her without mentioning my other niece, Holly, who is, not only listens to the podcast, but listens to the Sirius XM show. She's insane. So thank you both. Love you guys very much. And we'll see you all next week.