Weird Medicine: The Podcast - 433 - Coming Undone

Episode Date: December 3, 2020

Dr Steve, Tacie, and Dr Scott discuss Dr Steve's shingles, his neurogenic claudication, and his upcoming dental surgery. The man is falling apart. Dr Scott has helpful ideas from an alternate universe. Also hyperthermia, hemochromatosis, covid screening, and more! Please check out: stuff.doctorsteve.com (for all your online shopping needs!) noom.doctorsteve.com (lose weight, gain you-know-what) Get Every Podcast on a Thumb Drive (all this can be yours!) wine.drsteve.com (get the best deal on wine…delivered to your home!) simplyherbals.net (for all your StressLess and FatigueReprieve needs!) hellofresh.com/weird90 (america's #1 meal program!) betterhelp.com/medicine (online counseling NOW) Learn more about your ad choices. Visit podcastchoices.com/adchoices

Number one thing, don't take advice from some asshole on the radio. If you just read the bio for Dr. Steve, host of weird medicine on Sirius XM103, and made popular by two really comedy shows, Opian Anthony and Ron and Fez, you would have thought that this guy was a bit of, you know, a clown. Your show was better when he had medical questions. Hey! I've got diphtheria crushing my esophagus. I've got Tobolovir, dripping from my nose.

I've got the leprosy. of the heartbells, exacerbating my infectable woes. I want to take my brain out and blast it with the wave, an ultrasonic, ecographic, and a pulsating shave. I want a magic pill. All my ailments, the health equivalent of citizen cane. And if I don't get it now in the tablet, I think I'm doomed, then I'll have to go insane.

I want a requiem for my disease. So I'm paging Dr. Steve. Dr. Steve. No, it's weird medicine. The first and still own. uncensored medical show in the history of broadcast radio now a podcast i'm dr steve with my little pal dr scott the traditional chinese medical practitioner who keeps the weird alternative medicine wackos at bay hello dr scott and we also have my wife tacy the professional

webex attendee hello tacey what's up this is a show for people who would never listen to a medical show on the radio or the internet if you have a question you're embarrassed to take to your regular medical provider if you can't find an answer anywhere else give us a call 347-766-4323. That's 347. Pooh-Head. Follow us on Twitter at Weird Medicine at Lady Diagnosis and at D.R. Scott W.M. Visit our website at Dr. Steve.com for podcasts, medical news and stuff you can buy.

Or go to our merchandise store at CafePress.com slash Weird Medicine, where you can get a crystal stool scale mug for that crazy gift exchange at work. or a flatus flute, go to fletis flute.com. I get nothing from that except amusement. Either one of those gifts with a couple lottery tickets. It's a pretty good. It's a pretty good gift. One of those white elephant.

People fight over lottery tickets. Not so much the stool scale mode, but. The fletus flute now, you can just pass it around. Nobody's fought over that. Let everybody make it toot. It's very COVID-friendly. Most importantly, we are not your medical providers. everything you're with a grain of salt. Don't act on anything you hear on this show without talking to over with your doctor, nurse practitioner, practical nurse, physician assistant, pharmacist, chiropractor, acupuncturist, yoga, master, physical therapist, clinical laboratory scientists, registered dietitian or whatever. All right, don't forget to check out Dr. Scott's website at simplyherbals.net, simplyherbals.net.

And please don't forget stuff.doctorsteve.com. Tis the season for Christmas, ha. Monica, Kwanza, whatever, and it's, you can get everything that you want at stuff. Dottersteve.com because it's basically a alias for Amazon. So just click through to Amazon and then that helps us. Or you can scroll down and see all the crazy stuff that we've talked about on this show, including treatment for neuropathy, the Navage, that crazy sex toy that I can't even remember who recommended that to us. All that kind of stuff is that stuff.

Dottersteve.com. Check out our wine club at wine. Dottersteve.com. It's, when I say our, it's the one word members of. Does the radio show really promote sex toys? No, not really, but it's just on there. We had talked about it on the show. Well, I'm so proud.

Well, what about the fletus flute? I am more proud of the fletus flute. I can say it could be a sex toy, I guess. Well, it's just a way for people. people to enhance their pleasure in the bedroom. That's all. It's between consenting adults. No.

Okay, or not. All right. Okay, but you better go look at it quick because I'm going to take it down. Oh, I'm not the one who's the boss here. I'm just saying. Really? Disappointed. That's news to me.

So check out the wine club that Tacey and I are members of that's actually quite delightful is wine. It's Naked Wines. You get intimate. Well, not that intimate. Intimate. Here we go. You get pretty intimate considering compared to, like, you know, the Gallo brothers.

Try interacting with them on their website. But you can interact with the vintners, and it's pretty cool. And you get free stuff. The other day, they just sent you a free bottle of wine for no reason. Oh, did I drink it already? Yeah, well, it's in your thing. So, you know, it's really cool, wine.doctrsteve.com. It's a good gift to give somebody to.

And then tweakeda audio.com, I just bought some wireless earbuds from them. I used the order code fluid. And so I bought, I don't know, two or three of them. They were 100 bucks, and it took off 30 bucks. And if you have children, you know you're always looking for those. Yeah, and these are quality. And they got the best customer service anywhere. And if you want to lose weight before the big holidays, go to Noom.

dot Dr.steve.com. It's N-O-O-M dot Dr.steve.com. Not a diet. It's a weight loss program, but it really is a psychology program that helps you change your relationship with food. It's pizza not. And then, of course, Dr. Scott's website

at simply herbals.net. So let's talk shingle. Shingles can kiss my ass. You know what else can kiss my ass? Shingricks, the vaccine, because... I got it. I suffered for four days, and I got shingles anyway.

Although I'm really being facetious, get your shingles vaccine anyway, because I'm expecting to have a much less severe reaction than Tacey did when she had shingles, for example. I hope so. Me too. So I got it. I get it. And then Tacey's like, oh, no, I like it's cancer. So it's like, please stop doing it.

Don't be supportive of your husband, whatever. I don't know. Don't care. You know what? Just go jump off a bridge. Whatever. Do whatever you want. Well, by God, maybe I will.

Well, I want you to. Well, well, good, man. Then we're fine. Hey, I do have a story. Yeah. Oh, cool. A New Orleans Super Spreader Swingers Convention leads to at least 41 COVID-19 infections. Oh, my goodness.

She's the least. That sounds like a fun party. Okay, and did that it? You're just going to read the headline? I mean, it's fine. Mm-hmm. Yeah, that's it. Yeah, attendees of the 2020 naughty Noghlin Swingers convention swayed in place at their tables

and flirted behind masks from a distance. I still got it. After being tested for coronavirus and agreeing to wear masks, 250 people checked into a New Orleans hotel for the Swingers Convention on November 14. to reconnect a community separated by the pandemic. I'm wondering about that, you know, if swingers were having a hard time. No, really, I mean, you know, because it's a hard time. They like to get together in clubs and stuff.

I mean, I want to overgeneralize, but, you know, it's hard to swing with people you don't know particularly. But even with people you do know, even as friends. Like, we had a nice little dinner last night. Go ahead. And then that night, someone ended up with diarrhea, not me. Right. I don't want that image in anyone's, I mean, although it's not like I haven't had it. But anyway, so no matter what we do with people, there's always a scare, you know?

Always. Yeah. Always a scare. Yep. Well, you look at your microphone and make sure that it's set properly. It should be on flat and zero dB because I'm having trouble with your mic tonight. yes it's it's set properly okay maybe I'm just hearing does she sound weird to you no sounds muffled to me okay all right maybe it's just my ears um yeah it's uh so they went they went

through all these precautions which are the right things to do but um I you have to do more than that so for example we are watching the great British whatever baking show and then we're also watching some other reality shows like, I don't know. The Bachelorette, the best show ever. Right, The Bachelorette. 90-day fiancé. Well, they don't, yeah, they didn't quarantine there. They're all in masks and stuff.

No, but we watch it. But they have gotten, they put them in quarantine for 10 days and then did serial tests on them so they could all get together and put the crew in quarantine, everybody. Anybody that's going to be on the show had to be in quarantine for a period of time and then have serial negative tests. And then they can all make out and hug or, you know, work together and all this stuff. There's plenty of making out. Yeah. Plenty of it.

Yeah, well, on The Bachelor, not so much on the baking show. No, not on the baking show. But so I am, so that's the way to do it. These guys kind of did, you can't have a convention and then isolate everybody for two weeks before. the convention. You just can't do it. Who can do that? So you've got 250 people, and apparently somebody

was infected, and, you know, even though it seems like they did all the right things, they were wearing masks, you know, if you're swingers, you're probably not socially distancing, at least not the whole time. And anyway,

city did not require a permit for the annual swingers convention, which was a little more than a tenth of its usual size. Oh, my God. They usually have 2,500 swingers. Well, honey, I know where we're going next year. We're going to New Orleans. I'll just let you go, sweetie. Oh, yeah. I don't think they are cool with just dudes just showing up. So I need to be in attendance. Yeah, that's, you're my bargaining. You can take Scott. Yes, that's right. I'm sure that would go over great, too. They'd be like, oh, gross. Yeah. So anyway, yeah. Well, anyway, let's get back to me. Sorry. That's okay.

shingles. So let's talk a little bit about what shingles is and why I'm a little pissed because of this vaccine is supposed to be 96% effective. I guess I'm in the 4%. But things have been a little stressful. I had to work all through Thanksgiving and we had a ton of patients where it just slammed constantly. My phone is constantly going off with this emergency and that emergency. I mean, it's not, it hasn't stopped in a while. And the next person who tells me that this COVID shit is a hoax, I'm going to punch them in the nose because, I mean, our hospital is sick of it. I'm just sick of hearing that. Our hospital is full. And we're looking at getting even fuller over the next few weeks. But shingles is a viral reaction that causes a painful rash. So last night, I thought I was laying on something or I'd scraped my back or I felt like I was laying on. like a pistachio shell.

Okay. Okay, that's what it felt like, that sort of sharp pain, but I couldn't move it, and then I rubbed it, you know, I tried rubbing it, and it's like, is there something on there? And then I'm like, oh, my God. So Tacey looked at it this morning, took a picture of it, but there was just one of them. And I said, well, it could be, it could be just a Zit, but it doesn't feel like any kind of Zit I've ever had before. And then it just kept on today.

And, you know, if I'm just sitting, I don't notice it, but if I move a little, around at all. I can tell it's on my on my left flank and Tacey and Scott looked at it tonight and what you said there were five of them now. About five. I mean you would not let me count them.

You can count them. We were just going Oh, you know. Oh for fuck's sake. Well, that makes me feel worse. Everything is just everything is just gone to hill. Everything. Yeah. That's the fucking truth. Everything's going to shit.

Well, yeah, I guess. There's some things that haven't. COVID-19's been good for one thing. It's encouraged the adoption of telemedicine everywhere, which is a good thing. I can't think of too many other good. Oh, yeah, no meetings. Well, the other good thing I think it has done is cut down the onset of the flu season. Yeah, I think we talked about that last week, but I think that's true.

I haven't seen a single case of influenza or of, um, viral gastroenteritis, knock on wood, or any of that stuff. So that's pretty interesting, isn't it? So shingles is caused by the varicella zoster virus, which is the same virus that causes chicken pox. And once you've had chicken pox, the virus retreats, your body gets rid of it, except for in one place where the virus is inactive in this nerve tissue real close to the spinal cord and sometimes close to the brain. so it could be up in the head, and then when the shingles comes out, you get it in your eye, or sometimes it's in the trunk, and then that's why you get it, you know, across your torso, right? So I touched your dirty little shingles.

Right. Does that mean that I'm going to get it again? No, no, absolutely not. Because I feel it on my fingers. Okay. Scott could lick your fingers, and neither one of you would be affected by it. because you've both had chicken pox. You cannot give shingles to another person because they have the, you know, intact immune system

and the virus just sits there and then your body fights says no, hell no. We have our own virus embedded in our spinal cord. Thank you very much. So it doesn't talk. Territorial shingles. Yeah, we can't. We don't need you. Okay.

So it doesn't talk to my shingles. No, not at all. Now, but what you could do, is if you touched a kid who had not been vaccinated or an adult who had never had chicken pox and never been vaccinated, you could give them chicken box. You can't give them shingles. Okay.

It's weird. So shingles comes, because you had chicken pox and it retreats into these little nerve ganglia and then when you have a period of massive stress or for whatever reason your immune system turns its head for a second, then it comes out. It will always be in one nerve root unless you've got a really effed up immune system, in which case you can get disseminated shingles.

That's where it goes everywhere. But normally it will follow one single nerve root, which is how you know it shingles because it's always on one side of the body or the other. It's never on bows. So where will your little nerve root go? My nerve root is I can count it up. I can tell you exactly where it is. So there's the lesion.

So mine is at probably the fifth, thoracic vertebra. So, you know, there's 12 thoracic vertebra, and the spinal cord comes down in between the, like, the fifth and sixth vertebrae. There are these holes that are made by the interlocking nature of the vertebral bodies. You know, the top one interlocks with the bottom one, and they interlock in such a way that there's little holes on either side that the nerve root comes out. It's cool as shit. And so that's the nerve root where mine, was living, and that's where it's coming out, and it will come out right close to the spinal column, and then it will kind of come around and go down as that root, nerve root.

Oh, and to your privates? No, no, no, no. It'll just go down slightly because the nerve roots come out and then rotate down as they come to the front. So you already know where it's going to be. Yep. It'll start at round T5, you know, the fifth vertebrae. and then work its way around my flank

and then end up slightly lower than that right above, like, T7. Around my umbilical cord, that's right. Can I pitch in here? It's funny you say that's where it feels like because when I looked it, it looks a little lower than that. Oh, is that right? It looks T-10ish.

T-10ish, yeah. Yeah, it's close to that floating rib. It's close. Yeah, you might be right. It's a little lower than what. And the only reason I bring that up is because you know is when you have pain in the back there's not as many sensory nerves.

Sometimes you get a feeling. Well, here, let me stand up, and I'm going to point at where at the vertebral body. Yes. Which one is that? Nobody can see that shit. You're not even. Yeah, about 10. Yeah, you're about three or four down from seven.

You can see it, Tacey. I can see it. I can see through. Whatever. About 10-ish. Yeah. It's down below your scapegular about three or four levels. Okay.

Yeah, there you go. Well, anyway, yeah, it is weird. It's hard to figure out for you to tell on your own body. That's right. So, yeah, so anyway, it's not life-threatening. It could be very painful. Mine is not very painful yet. Mine was very uncomfortable, not very painful.

But I really could have gotten a couple of days work off with it. You know, shingles is a good excuse. It is a very good excuse. Especially if you tell them you're contagious. It was too late by the time I figured out what it was before I said anything to anybody. because it was in a very private place. Right. I think I just figured out what was wrong with your arm.

It's not anything I did. I know, I know. Okay. I just wanted to make sure. I guess I'm fired up today because you're just a little bit of a butthole. I am. It's fine. I don't feel good.

You know, the crappy thing is, and we'll get to this. But you know how I am. I can't. Sympathy, I can stand empathy. I can't deal with sympathy. especially then it gets me stressed out thinking that I'm worse than I am. Well, then you had four days of misery after the shingrit's vaccination. When I do get cancer, then what are you going to, how are you going to act then?

So, you know, all that goes to my mind. We have a plan. And you'll feel better. We have a plan, don't we, Tasey? Yeah. We have a plan. Good. Yeah.

You won't suffer. You'll be fine. Anyway. It'll be over quick. It'll be quick. So shingles can kiss my ass. Tacey, oh, there's two bad places you can have it. In the Grines, it's what we call it here in Tennessee,

which would be the private area, or on the face. And where was yours, Tase? In the Grines. Not on the face, right, not on the face. I was for sure that Steve gave me herpes, and we had some talking to do. Or your boyfriend gave you herpes. Or that. Somebody had some talking to do.

Because I was like, We got some talking to do, that's for sure. So they did that test. They did that test because I wanted to know, I mean, you know, hello. Yeah. Yeah, there's another thing that masks as genital herpes called, and it's been a long time since I've seen a B-S-Sy syndrome, B-E-C. Oh, boy, it's that weird French C thing.

Let me see if I can find it. B-H-C-E-H-E-T. Look that one up. Yeah, I remember, but I don't remember what hell it is. And I remember that I saw one of those, and it causes blood vessel inflammation throughout the body. But every once in a while, if you get the lesion in the private area, you'll think that that person has herpes, but it's not. Let me see. Of skin.

I think I've seen this one time. Have you? Yeah, one time. Yeah, mouth sores, eye inflammation, skin rashes, and legion. lesions and genital sores. So, yeah, I got fooled by that one once. Soar all over him. You know, I've seen shingles one time on both sides.

On the guy's back. I've only seen it once. It could happen, particularly if they're really older and their immune system sucks. Yeah, but risk factors that increase your risk is being older than 50, anything that weakens your immune system, anybody undergoing cancer treatments or taking certain medications that really I'm the only category I fit into is being older than 50. And the reason you care about it, besides the fact you could give somebody chicken pox, is that it can cause stimulation of the pain fibers that never goes away.

And it's called post-herpetic neuralgia. And that can last anywhere from months to years to the rest of your life. And so they have found that if you treat it quickly with valicyclevere, you take a gram three times a day. It's valetrex, which you would use for genital herpes or cold sores and stuff like that. It's an antiviral. Yep. And sometimes you can throw in steroids along with that, and that will decrease the risk of ending up with post-herpetic neuralgia. If it's in your face, obviously, you can get vision loss.

shoot, Jim. So how bad is it on a scale of 1 to 10? Mine? Not that I care, yes. I'm just wondering. Two. Quit bitching about it. I'm not bitching any dirt.

Oh, my God. And keep your damn dirty fingers away from her in nuts just in case. Yeah, no, it'll be, it'll totally be fine. Yep. Yeah, it's about a 2. My stupid neurogenic clotication is right about a 1. right now. Well, I don't know what that is.

Well, that's the leg pain that I have from the narrowing of the spinal column at L5S1 that I have due to a thing called spondylolisthesis where the stupid, you know, I'm just falling apart, Tase, and I apologize. You married an old man where my vertebral bodies are no longer laying on top of each other, but that one is slipping off the other one. And as it does that, it's pinching the nerve root. And when I walk, I get pain in my leg that can be pretty severe. And I went through physical therapy, and it's a whole lot better than it was.

My only concern is I could live with it like this. I don't think I'm going to have surgery for it being this bad. But I used to walk the shit out of them at Disney. I mean, Tacey and the boys would be like, we're tired. And I'm like, no, we're still going to see Woody. and stupid crap like that. But I don't feel like I would be the one that was driving that train anymore. So there's, you know, but there are some more invasive things that help with the spondylosis.

Like what? And certainly with the stenosis. The acupuncture does help with the tens unit on it. Why am I surprised? You do need to go. Yeah, I do want to go to you. I mean, it's what I do. No, I know.

I do it every day. Of course. And epidurals. If you're going to go to the, to pay less, you're going to go. get a new pair of shoes. If you're going to go to Scott, you're going to get needles stuck in your own. And it feels so good. It does, yeah. I have been actually for real meaning to do that. So tell me what else you would do. Well, the other thing would be an epidural just prior to you have had three of those. Did it help? Yeah. Absolutely. That's pretty good. So when he says

an epidural, what they did was my buddy, who is a physical medicine rehab guy, put me on a on a sea arm, which is a thing where he can see through my body using x-rays. And he would line up the C-arm exactly where he could see the holes. And when he does that, he knows all he has to do is go straight in line with the projector and the receiver, and the needle will go right in, right? So he did that. Hopefully. Yeah.

If he knows what he's doing. But he can watch it too. And then he injects the dye and he can watch it go in. And he did perfect job. And the first time he did it is like, oh, hell, I'm cured. You know, I'll. But then after about a month, it came back. And then he did two the next time.

Two levels or two? Two levels. Two levels. And it helped for, well, it still feels better than it did. But I didn't get that instant relief that I did the first time. Very consistent with epidurals for that. Yeah. Typically, the first one works super great.

second one not so great and third one it can be good but there are a lot of times at that point in time you have the epidural and you get up and it's no better at all yeah yeah and that's just but that's that's kind of the norm yeah you know they could they get depending on where it is a small surgical procedure like a laminectomy would be something that could provide some yeah well let me tell you what they're telling me they want to do fusion they want to go in from the front sure sure and they want to jack it up to put it back into where it's supposed to be put spacers in there take the disc out completely the disc between the two vertebral bodies put in spacers in there and then flip me over to go in through the front to get to my spine they got to move all my guts aside it's a big deal

it's a big deal and and then they would flip me over open me up again and then put a cage in there, put a bunch of rods and screws and stuff to hold it in place. So that's what I'm trying to avoid. Yes. But I don't want to wait so long that now when I have to have it done, I'm too decrepit to have it done. Oh, God. I'm in so much trouble.

You are in trouble. But here's the thing, too. You're not in trouble. I'll take care of it. If I get that bad, you won't have to worry about it. Oh, that's terrible, too. Yeah. I mean.

There's just no way out. I can't win with her. I mean, obviously, that is a massive, massive surgery. But there's, you know, the big, and you know this as well as a lot of it, but not everybody knows it. The biggest thing we'd be mostly concerned with is motor loss or sensory loss. Which I have. If you have motor loss and sensory loss, then we've got to pay a little closer attention to it, for sure. I have more sensory loss than motor loss.

I don't have a dropped foot. But one of my friends who had this kind of same problem, that person, has foot drop because they waited too long to operate. And so, you know, it's a waiting game, or it's a game kind of. It is, yeah. You know, when is the exact right time to do it? Yep. And if the pain is not intolerable.

It's not intolerable. Typically, we'd say, hang, almost at least try. Yeah. You know, and sometimes extended PT, where there's really great pelvic floor tightening will help. Yeah. Because that'll help. She's got me doing that. Sometimes to push that vertebrae back.

What about it? What about the inversion table? Have you tried by that? Well, I asked about that. But nobody was really thrilled about that. I thought it would be a good idea. My physical therapist, she's been working. She said, look, you can wear a brace or you can just build one out of muscle.

And so that's what we've been working on is building up abdominal core muscle strength. So, anyway. All right. Let's call this show Steve's Medicine. Yeah. Should we talk about my dental implants? We've got to finish treatments for the shingles. Okay, yeah, yeah, go.

Because that's one thing we had. We didn't discuss. You know, in addition to the antivirals, which is you have to do, the lysine, L-lycine, which is an over-the-counter, that help block the receptor sites. Because what happens is the virus will attack the receptor sites on the nerve and start breaking it down, which causes a post-repetic neuralgia, right? Well, right. Well, the virus is made of polyarginine. That's viral code, is polyarginine, and lysine is an analog of arginine. and when you overwhelm your system with a lot of elicine,

it's harder for it to make its coat. Kind of blocks those. It blocks the enzyme in the virus that allows it to build its code. Okay, okay, okay, yeah. But those are hugely important to get it. If you get those on board quickly, you'll do super great. And then, of course, if you continue to have pain, what I do, tell me.

shingles, it's a technique I call surrounding the dragon. The shingles is a dragon. And I'll go from your spine. I'll do a nerve block. It's your spinal column where the root comes out. Oh, yeah. And we'll do a nerve block there. And then what I do is I actually take needles and stick them around the rash and put electrical stimulation to it.

I'm all in on that. 99 times out of 100. It works extremely well. Really? Yeah. Is that data you just made up just now? or did you actually do data? I mean, is there really a study that says it's 99% effective?

Because you know that's an outstanding number. It is an outstanding. But I am outstanding in my field, all right? No, I'll look it up. I don't know the exact numbers. Yeah, yeah, yeah. But the acupuncture with stimulation, electrical stem, is certainly recommended for. Hell, I need everything.

You do. We can put you on a stretch table. We'll make you three or four inches tall. Do you have one of those? No, but I can make one. Well, I've got a truck and a chain. That's all you need. That's right.

We'll fix him. And a thermos. And Hillbillyville, we'll fix him. So this guy called, and I don't know who he is, his name is Rodiano. And he sent us a bunch of questions. Since I heard that episode, maybe number 31, when you were remembering losing your virginity. I don't think you were here for that one, Taze.

Oh. He said, I hate my voice, but I'm sending you spicy questions for the show and funny stories from Croatia when I was a kid. So he sent five questions. I said, we will call you the Croatian Stacey Deloche. And he said, who is she? Poor old Stacey. So I haven't listened to these, and I thought we would just try them and see how they go. Are we freestyling it?

Yeah, we'll freestyle this. Okay, first thing, we've got to get Ronnie B in there. Number one thing. Don't take advice from some asshole on the radio. All right, very good. So let's see here. Uh-oh. Oh, boy.

Here we go. Oh, no. Okay. Hi, Dr. Stephen, everybody in the studio. What? I love the show. And I have a quick story and a few questions. I bet that he did not intend for it to sound like that.

Let's see if his other ones sound like that. because when he recorded this, I bet I know what it was. He recorded it on a 50-cycle European computer, and now we're playing it on a 60-cycle European computer, so it's, you know, one-sixth faster. That's what I'm guessing. Let's see.

Or you just loves helium. Yeah. The second question needs to say. Helium. Radiano. Oh, I planned the whole show around this. Let me see. Here's another one.

Shate, a human shape. Well, let's listen to... We were kids between 10 and 12, and we were playing with a ball in the park. I can't understand. I'm good enough. And sometimes... Dude, you've got to send them again.

Email me, and I'll tell you how you can fix this. Dang it. Well, that was a great show. It's over. Yay. Let's go. Time to go watch a Hallmark movie. Surely Steve's got at least another.

I do. I've got all kinds of stuff. Yeah. Well, we hadn't talked about his teeth yet. Oh, his teeth are nice. Oh, that is true. Hi, Dr. Steve. You know how they say that you're supposed to fast before surgery with anesthesia?

Well, what happens when you eat like endless pasta bowl or fish and chips? And then you get into a car wreck or your appendix burst or you need an amputation. say. Yeah. They say that the anesthesia can cause you to vomit and then you aspirate on that. Well, that's, okay, kind of it. It's not necessarily that the anesthesia causes you to vomit, although it could. It's that if you do, you don't have any protection of your airway unless they've got you intubated.

So when they put the tube down. into your lungs, you can no longer vomit into your lungs, but you can just make a mess of the, of the, of the, of the, of the, of the, of the surgery theater. But when they pull the tube out, if you vomit then, that's when you're really at risk for, for aspiration. In other words, you know, stomach contents going into your lungs. So that's what they're trying to avoid. So that's why, you're right, when you get in a wreck and they don't have any choice, you've got a full stomach that's just risk. And that's why emergency surgery is always inherently more risky than surgery that you've scheduled.

That's basically it. So, yeah, they just do the best they can. And if they have to, they'll just pump your stomach, too, you know. And then before taking you to surgery. Yeah, just in case. And stick a tube down there and just hook it up to suction. Let a rip. Yep.

All right. Do you have anything else on that one? Nope. Okay. Hi, Dr. Steve. My name is Darren. I've been diagnosed with hereditary hemachromatosis. And I go to my blood doctor regularly.

We got that down and under control now. When I go see my hepatologist, I've seen her once. And she really didn't do very much. We've done a lot of blood tests. One of the markers said that I might possibly have starting of cancer. They did the fibroscan, and I do have beginning stages of cirrhosis. Okay. So I'm curious as to why she said, well, we're going to see you again in six months,

and we'll just do palliative care. To me, I heard let's just keep you comfortable. tell you die. If I got this discovered at such an early stage, that why would there be no other type of treatment aside from lose weight because of the non-alcoholic fatty liver disease? And let's cross our fingers and hope. Why is that? Yeah. So there's a lot of miscommunication going on here. I think that the physician used the word palliative incorrectly, which I see that a lot, and the patient interpreted it in a way that they didn't intend. So people who have, say, stage four cancer will get palliative chemotherapy.

The oncologists use that to mean it's not curable, but it's treatable. Okay. Okay. Whereas the hospice care, for example, is a form of palliative. care in the sense that if all flowers, you know, of all chrysanthemums are flowers, but not all flowers or chrysanthemums, in the same way all hospice patients are palliative care patients, but not all palliative care patients are hospice patients. Matter of fact, only about 10% of them are.

So for those that don't know, palliative medicine is a medical subspecialty that deals with pain and symptom management in advanced disease. and also medical decision making. And that is a medical subspecialty. So there's even more confusion. There's about 33% of doctors out there that think that the word palliative is synonymous with hospice and it is not. So there's a, and I believe that what this hepatologist was saying was we're going to palliate your symptoms because we can't cure the hemachromatosis. But they didn't mean, I think you're dying.

Now, if he has early cancer, needs to be set for a biopsy, and that's treatable. You know, hemachromatosis is a disorder in which the body builds up too much iron, and it builds it up in the skin, heart and liver, and other glands and joints. Too much iron is kind of irritating to the body and can be toxic, and these people can end up with cirrhosis, which is damage of the liver. They can be at increased risk for hepatocelular cancer, which is cancer, of the liver. Heart problems, arthritis, diabetes, stuff like that. A lot of people don't know they

have it. Their skin can be sort of tan looking and they almost can look healthy. They may feel tired and weak though, and it's sometimes difficult to diagnose. And some people never have anything at all. And they say about, I guess, 10 out of 100 people who have this will get severe liver disease. So if your skin is a bronze or gray skin color and you have weight loss, joint pain, abdominal pain, loss of sex drive, you think it's your testosterone, but your testosterone's okay, and you're tired and weak, you think it's your testosterone, and that's okay, they may want to test you for haemochromatosis. So what you do, if you find out that you have it,

is you get the liver biopsy. You do a thing called iron chelation therapy. This is the one time that chelation therapy actually does something positive. And you do this if you can't have cereal phlebotomy. In other words, they'll take out pints of blood just to get rid of some of the iron and they'll just toss it. they'll have you avoid multivitamins, and they'll have you avoid vitamin C, which seems weird, but vitamin C helps you absorb iron in your diet.

So they're going to have you avoid vitamin C supplements and stuff like that. So this is something that primary care can sometimes deal with, but you're going to want a gastroenterologist and above. And if there's any sign of hepatocellular cancer, that needs to be worked up. I don't understand. Six months. Follow-up? Early signs of, no, if you see anything, that needs to be worked up.

Yeah, soon as well. So he needs a liver biopsy. Yep. And then be sent to oncology if it turns out to be positive because it's still treatable. Okay. All right. Good question. Yeah, really good question.

Here we go. What's up, Dr. Steve? I have a question. I got a rapid COVID test, and they stuck the. Q-tip not that far up my nose just in my nostril and she said yeah you got to have enough mucus in there for us to like look at it whatever hear all this stuff about false positives false negatives my question ultimately is how do they know if they got enough mucus or if they got enough of your nose slime when they're looking to see if they see the virus I guess they just they just

if they don't see the virus how do they know they got enough right yeah Yeah, because you can't see the virus. You're exactly right. No, it's all about technique. And if you have to follow the instructions to the T in the COVID or any other test kit. And if you don't do that, then you run the risk of having false report. The test that I get every week, the at-home test, that's a rapid kit, isn't it? I don't know.

I don't know what they're doing. Well, they do it pretty rapidly. Okay. Do you stick it way back far in your head? No, I do not. Just three times around in each nostril. Yeah, yeah. So there were some that you had to go all the way to the back of the nose, and those were very uncomfortable. And then they designed some new ones where it's just more sensitive and you don't have to go so far back. And you can just do the front of the nose. And there are some new ones that I hear have not seen them that you can do in the mouth as well.

or just with saliva. So, you know, the samples in the front of the nose are safer, particularly if someone has nasal polyps or something, you're not bumping up against those. So, yeah, if you got a negative, if you had typical symptoms with fever and all this stuff and it was negative and you really feel like, wow, I still think I had COVID-19, just repeat the test. If you get an unexpected result, the first thing to do is repeat the test. So if you expected to be positive and it was negative, it's okay to repeat it. If it's still negative, you're probably really negative.

Now, we had a friend who got a positive screening test, and everybody was freaking out because he runs a business where a lot of people are, you know, in his face all the time. But then his two more specific tests that came after that were negative. So the first test was probably a false positive, and that can happen as well. So when you're using screening tests, you want a test that will be throw a wide blanket over everyone and catch every single case that you can get. And that puts you at risk for having more false positives. And so on those, you always want to check a more specific test to follow it up.

So, for example, urine drug screens, they can be thrown off by all kinds of stuff. If you take certain stomach medications, it'll look like you're taking methamphetamine. And so when you get those, but those are screening tests. Which stomach medication is that? It was rinididine, which isn't on the market anymore. Oh, okay. But there are other examples of things like that. And that's, but that's a screening test.

So it's not very specific, but it's very sensitive. So you'll catch all the people who are using methamphetamine. But in that net, along with the tuna, you're going to get some dolphins, I guess, is the analogy I can come up with. And so in that broad, cast net that you'll get all the methamphetamine users, but you'll get a few rinitine users, too. So you always take those screening tests that you run in your office and then do a more specific test like a GC mass spectroscopy or a thither. thin layer chromatography that will now weed out those rinididines and we'll get it down to just the people that had methamphetamine. Now you say, why don't you just do that in the beginning?

Well, those tests tend to be a lot more expensive. So if you're going to screen everybody, you want to screen them with a cheap test and then only do the expensive tests on the ones that are positive. Okay. Does that make sense? Oh, yeah. Okay. All right.

Let's do this one. Dr. Steve, I have a question, very simple. I think if our body's natural defense is to raise our body temperature in hopes that that would kill whatever off, why isn't there a treatment like in a hospital or whatever where they raise your body temperature? Like why isn't going into a salon or a fucking an hour a treatment for diseases, if you will? Or am I just completely missing the picture? No, not at all. Not at all. I'll even give you one of the other.

Give yourself a bill. Now, Scott may want to talk to this a little bit because he does all that hot yoga and all that crap. The problem is that if fever was a really good defense, we wouldn't need antibiotics and stuff like that. It's just a really marginal, and in some ways, is more of a sign that there's activity going on. with the immune system than it is in any way helping it other than if you're a little bit warmer, those cells work a little bit faster. But hyperthermia, which is elevated temperature, is a type of cancer treatment. And you expose body tissues to high temperatures like about 113 degrees, and it shows that

that can damage and kill cancer cells, usually with minimal injury to the tissues around them. and I'm just looking here on a website from cancer.gov. How is hyperthermia used to treat cancer? It's almost always used with other forms of cancer therapy such as radiation and chemotherapy. It can make some cancer cells more sensitive to radiation or harm other cancer cells that the radiation cannot damage. And when you combine hyperthermia and radiation therapy, they're often given within an hour of each other, and it can also enhance the effects of certain anti-cancer

drugs. So, yeah, you've got it. Increasing temperature can be used to fight disease, just not in the way that you were thinking, I think. But they'll use it in sarcoma, melanoma, cancers of the head and neck, brain, lung, esophagus, etc. So, all right. Now, excuse me, they'll do local hyperthermia where heat is applied to a small area.

using a bunch of different techniques. You can use external approaches. You can use internal approaches. And then there's regional hypothermia where you heat up a body cavity or an organ or a limb. I remember that we used to do a type of chemotherapy where they actually dumped warm chemotherapy liquid into the abdominal cavity. Yeah, chemo wash. Yeah. They still do that in some.

Yeah, and here's a continuous hyperthermic peritoneal perfume. The technique used to treat cancers within the peritoneal cavity. That's the space between the abdomen that contains the intestine, stomach, and liver. And they'll include primary peritoneal mesothelioma and stomach cancer. During surgery, the heated anti-cancer drugs flow from a warming device through that paroteneal cavity. And the cavity reaches about 106 to 108 degrees. So not enough to heat them up. Now, to his point, whole body hyperthermia is used to treat metastatic cancer that's spread throughout the body.

It can be accomplished by several techniques that raise the body temperature to 108 degrees, including the use of thermal chambers, similar to large incubators or hot water blankets, which is what he was asking about. Why can't you just get in a sauna? So pretty interesting. Yeah, that's good stuff. Yeah. So that's an excellent question, and he was more right than he thought. All right. Hey, Dr. Steve, this is Jeff up here in Seattle.

You might remember the one that doesn't want to be your pal. What? What? Just had a quick question about diphtromine. I know it's the active ingredient in Tylenol. No, no. Some other. That is incorrect.

False. Diphon hydramine is, well, I'll give him one of these. I don't ever want anybody to feel bad about it. He was close. He won't be my pale. I have no idea what that's about, but Diphonhydramine is the active ingredient Tylenol P.M, I believe, because

Tylenol is acetaminophen. That's just basically a pain, an analgesic and an antipyretic, meaning it's good for fever and pain. But diphenhydramine is an antich medication, also known as Benadryl. Yeah, okay. So anyway. decongestions or antihistamines.

There you go. But I wonder what the side effects of long-term use might be on something like that. Quite a while ago, I decided that instead of taking Tylenol PM because I didn't want the Tylenol, that I would start taking just the diphyanideamine that I can buy over the counter to get some sleep at night. I take about, oh, 50 to 100 milligrams. depending on whether it's a weekend or not. And it puts me right to sleep, and I get the best sleep I've ever had.

My back feels better. A lot of things feel better, and I can sleep through the night. But just concerned about long-term effects on that, man. I don't blame you. Yeah. Absolutely. I think it's a great question. And that is the problem with this stuff is it works so well for people,

and it's not habit-forming. And so there's no withdrawal syndrome when you stop it. But Benadryl or diphenhydramine is an anticholinergic medication. And because of that, it causes dry mouth and dry eyes and stuff like that. And the thing is that acetylcholine, which is what it sort of antagonizes, is involved in learning and memory. And so they did a study, a team led by Shelley Gray. She was a pharmacist at the University of Washington School of Pharmacy, tracked 3,500 men and women ages 65 and older. And it was a long-term study, and they used pharmacy records to determine all the drugs and prescription over the counter and all this stuff that people took for 10 years.

And they tracked them for an average of seven more years after that. And during that time, 800 of the people developed dementia, you know, memory loss of a pathologic sort. And when they looked at the use of anticholinergic drugs, they found people who used these drugs were more likely to have developed dementia as those who didn't use them. And moreover, the dementia risk increased along with the cumulative dose. So taking an anticholinergic for the equivalent of three years or more was associated with a 54% higher dementia risk than taking the same dose for three months or less. Now, this is not a prospective double-blind placebo-controlled trial. So causation and correlation aren't the same thing. So it could be that people with early dementia, you know, have more sleep problems

and they take more diphineine. Sure. And maybe that's the association. Or it could be just that there's something in, you know, emerging dementia that causes that. And that the other people that take it, you know, for sleep are fine. So, um, um, these, they feel, you know, this is hard from Harvard. Uh, they say that there's mounting evidence that anticholinergics aren't drug to take long term if you want to keep a clear head and keep your head clear into old age.

Now, that was just a 54% of higher risk, but there were thousands of people that didn't develop dementia in this as well. You know, the vast majority of people did not develop dementia. So there were 800 out of 3,500. So what's the percentage? Echo, what percentage is 800 of 3,500? 800 is 22.86% of 3,500. So 22% of people developed it.

And of those, there was 46% didn't take an anticholinergic, too, you know? So I don't know. It's interesting. Well, it's, no, I'm sorry, there was a 54% of higher dementia risk. So we can't exactly work out the exact numbers. But there were a bunch of people that never took it and got dementia anyway. But it did increase the risk. So it's about risk mitigation.

And it would have been interesting if they had another group of people that didn't take it at all, 3,500 match controls. And none of them took any Benadryl at all. Would they have had fewer dementia cases? So anyway, that would be the way to do that. So you got anything to... Well, and the other thing I see occasionally is people who take the diphenhydride means for sleep over a long period of time, they can develop rest of the legs, and they can certainly develop some prostititis.

They can get some B.P.H. So I would be concerned with those two things. One of the first times I realized that Benadryl wasn't the totally benign medication that I thought it was, was when I was a medical student. and my intern was called to see a guy who was unresponsive and he was just sitting there like a zombie, right? He wouldn't move. He was laying there like a zombie. And she did a, she was very, very good, thorough at University of North Carolina.

So she was pretty quality resident. And she palpated or felt a midline mass right above his pelvic, pubic bone. and she correctly surmised that that was his bladder, and he was having bladder outflow obstruction, so she put a fully catheter in his penis and got a couple of liters of urine out, and as soon as his bladder drained, he sat up and went, wow, that really hurt.

And what had happened was somebody had given him a shot of Benadryl, and he was an older gentleman, and his prostate couldn't handle it. So anticholinergic drugs and prostates do not mix because they will cause bladder outflow obstruction. You can't pee, and then that's in a medical emergency. Yep. And he's kind of taking a big dose, 50 to 100 at bed time. Is that what he's had 50 to 100?

Wow, that is a lot. Yeah. 25 is one tablet, typically. Yeah. Typically it's in 25 milligram tablets. But if he's doing 50 to 100, I'd look at some of the things. He needs to talk them. Yeah.

I wonder if he's tried melatonin. Really, you know, long-term effects of melatonin seem to be less severe than long-term use of diphenhydramine. He might want to talk to his health care provider about that. But you hate to not sleep. Oh, gosh, no, no, no. We don't want him to not sleep, but certainly maybe want to look into some other things that may be causing his insomnia. And there are other non-pharmacologic things you can do to promote sleep as well, including meditation. Well, that's pharmacologic.

God damn it. No, it's not as an herb. Oh, okay. That's not a drug. It's an herb. It's natural. It's natural. Yep.

But anyway, as you were going to say, I'm sorry. No, that's fine. I don't necessarily disagree with that. Weed's got some anticholinergic properties, too, though. You know, it makes your heart beat fast and gives you dry mouth and all that stuff. It makes you swimming-headed. So I'd like to see the long-term use. of THC for sleep and see if it has a better safety profile.

That'd be something we could maybe research over the next week, if there is any data like that. But there are other just non-pharmacologic things like the Trip app. Check that out, t-R-I-P.com. The first time I did it, I just fell asleep. We had Bobby Kelly over. He fell asleep. He almost fell out of the chair.

We were wondering if he was asleep or not, and he started to move to the left. It almost just went right up. down onto the floor doing the trip app. So if you've got an Oculus, get T-R-I-P-P-P-that app, or you can go to T-R-I-P-P-com and just read about it. And it's almost a reason to buy a dang Oculus. I'm telling you, it's the most incredible app I've ever seen.

So there are things like that. There are other non-pharmacologic things that you can do to help you sleep. And I would try that. I would be nervous about just taking vina-drill for the rest of my life. But again, it just increases. your risk. Just because you do it doesn't mean you're doomed to get dementia. Well, that is a lot. That's a lot. And I know nothing, but I know that's, that's a lot to take. Well, all right. Well, thanks always go to Dr. Scott. Thanks for Tacey.

But never to Tacey. Never. Always to Tacey every day. I'm thankful for Tacey. Just not her sympathy. You can, I know, I'm sorry. I'm just, I can't deal with people feeling sorry for me. That's what it is. Can't deal. But I want people to feel sorry for me, so that's also the thing. I don't know what to do. I'm a damn nut.

And you knew that when you married me. And she's stretching. And look at, oh, my God, look at that. Well, you're off the hook tonight because I have shingles. Oh, yay. But if I didn't, just watching you do that, you'd be in big trouble. We can't forget Rob Sprance, Bob Kelly, Greg Hughes, Anthony Coomia, Jim Norton, Travis Teft

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ideas make this job very easy. Go to our website at Dr.steve.com for schedules and podcasts, other crap. Until next time, check your stupid nuts for lumps, quit smoking, get off your asses and get some exercise. We'll see you in one week for the next edition of Weird Medicine. Thank you, everybody. Thank you, Tacey. You're delightful.