Weird Medicine: The Podcast - 456 - They Call Him "The Streak"

Episode Date: May 27, 2021

Dr Steve and Dr Scott discuss: 1) Gabapentin and Weed Craving 2) Double Amputee Circulatory Changes 3) Pain Management and Chinese Medicine 4) Dr Steve Unbound 5) Herpes Transmission 6) Dementia and Aortic Valve Replacement 7) Running Naked on Walter Cronkite and more! PLEASE VISIT: 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!) roadie.doctorsteve.com (The ROBOT guitar and bass tuner! And it ain’t expensive!) simplyherbals.net (for all your StressLess and FatigueReprieve needs!) BACKPAIN.DOCTORSTEVE.COM – (Back Pain? Check it out! Talk to your provider about it!) Cameo.com/weirdmedicine (Book your old pal right now while he’s still cheap!) Learn more about your ad choices. Visit podcastchoices.com/adchoices

Did you hear about the dirty Easter egg hunt? It was hosted by the Dust Bunny. If you just read the bio for Dr. Steve, host of Weird Medicine on Sirius XM103, and made popular by two really comedy shows, Opie and Anthony and Ron and Fez, you would have thought that this guy was a bit of, a, you know, a clown.

Your show is better when you had medical questions. Yay! I've got diphtheria crushing my esophagus. I've got Tobolivir stripping from my nose. I've got the leprosy of the heartbound, exacerbating my incredible woes. I want to take my brain out. Plastic with the wave, an ultrasonic,

agographic, and a pulsating shave. I want a magic pill. All my ailments, the health equivalent of citizen gain. And if I don't get it now in the top. I think I'm doomed, then they'll have to go insane. I want a 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. Dr. Scott, the traditional Chinese medical practitioner, gives me street cred with the wacko alternative medicine assholes. This is a show for people who would never listen to a medical show or 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 of 347-7-6643-23.

That's 347 Poohead. Visit our website at Dr.steve.com for podcast, medical news and stuff you can buy. Most importantly, we are not your medical providers. Take everything you're here with a grain of salt. Oh, God. Don't act on anything you hear on this show without talking it over with your doctors. a nurse practitioner, practical nurse, physician, assistant, pharmacist, chiropractor, acupuncturist, yoga master, physical therapist, clinical laboratory, scientist, registered dietician, or whatever. Don't forget stuff.com.com. That's stuff.com for all your Amazon needs.

Check out Noom, n-O-O-M at dottersteve.com. If you want to lose weight with me, I'm basically very close to my ideal body weight and have been for the last three years. Thanks to Noom, it's not a diet. It's a, what did you call it, a psychology program? Helps you change your relationship with food. Get two weeks off, well, two weeks free and 20% off at Noom.

Dottersteve.com. And check out, if you have back pain, and you ever wanted to try an inversion table, check out the one that I found at backpane. Dottersteve.com. On this one, you've got to spell out Dr. Do-C-T-O-R-S-Eve.com. Well, don't forget Dr. Scott's website at simplyherbils.net. That's simplyherbales.net.

And you're still going to wrap it up, or you're going to hang in there? I was going to say, get it down before it gets gone. Really? Yeah, I am. Yeah. Retiring, man. I'm slowing down. So now what are you going to do?

I know we talked about this last week. You know what? Not much. Nobody gives a shit. No, they don't. All right. Let's just, okay, last week we did a lot of bullshitting, and we got a bunch of this. Do you have bullshitting and get to the questions.

God, man. Okay, okay, okay, I got it. Boring as sex with my wife. Gotcha, gotcha. Gotcha. So we're just going to do a million. Questions of voicemails. Cool.

Probably a million. million minus 999,996, but that's all right. We'll get close. All right. So let's, oh, wait. First, we've got to get the most important disclaimer. Number one thing. Don't take advice from some asshole on the radio.

Thank you, Ronnie B. Absolutely true. All right. Hi, Dr. Steve. This is Barry from California. Hey, Brian. I had something interesting happen a few days ago, and I was hoping to get your take on it. Okay.

I live in California, so it's a medical, marijuana, or a recreational state. Legal state, I've been smoking weed for about five or six years. So my normal use is I'll smoke a joint or even do some edibles, like in the evening after work, after dinner. Probably about four or five nights a week or on the weekends. So I'm a regular consumer of wheat and have them for a number of years. So I have had periods of time where I've quit weed for days at a time like if I'm on a business trip and I'm in a foreign country and I don't have access to weed. I never experienced any kind of withdrawal syndrome or anything, not physically. I never got sick, but there would be times when I'd feel like I really wanted it psychologically when I couldn't get it.

So that's the extent of my withdrawal that I've had for that. But that usually happens if I go without weed for a number of days, just a couple days or even one day maybe, I'll feel like I want to smoke some leaves. Sure. So I have had a bad back, some back pain for a few years now. And my doctor, after an MRI, decided that it might be related to nerve pain. I'm going to go see a neurosurgeon pretty soon, I think, just to talk to them about it. She prescribed me gabapentin. This was five days ago.

Oh, I bet I know where this is going. I've never taken gabapentin before. So I took 300 milligrams at night. That's what she said, just that. And after the first time I took it, the next day, I didn't want to smoke weed anymore. I really lost my taste completely. Give yourself a bill. I have some right there.

I can see it. It's sitting right there. I don't want to smoke it. And that was five days ago. And I have not consumed any weed at all in five days. And I've been taking 300 milligrams of gabapentin each night. And that's when it started. It actually, weed actually seems kind of distasteful to me now.

Interesting. And it's kind of hard to explain. How sad. I don't. It is. You want it anymore. Is this because of the gabapentin, it can't just be. a coincidence.

Give yourself a bill. Yeah, so I let that go. It was a pretty long phone call, but it's pretty interesting. So we got a guy that is a regular, habitual user of marijuana. When he doesn't use it, he wants it. Not a real physical withdrawal, but he feels that he wants it.

Craving it. More like a word for it. Yeah, well, whatever. I mean, craving, I mean, it's all, everything's related, right? Sure. Well, that's a damn. And then he took Gab of Penton. Now he didn't give two shits about it. So I did some research on this, and gabapentin is an interesting drug. It's prescribed as an anti-convulsant, or it was, but I have to be honest with you,

if you know anybody that has been prescribed gabapentin for seizures, then you know, if you know one person that's how you know one more than I know. Yeah, no zero. Because we've used it for neuropathic pain for quite some time. And sometimes it works, sometimes it doesn't, but it does act. It resembles this neurotransmitter called gamma amino butyric acid or GABA. And what that does is it regulates the excitability of the neurons in the central nervous system. And cannabis withdrawal, and when I say withdrawal, I mean, not taking it.

I'm not talking about going through like cold turkey like you do with heroin or something. But when you withdraw it, you get an overactivation of these same stress circuits that are, and it's actually similar to alcohol withdrawal, even though the effects are completely different. Sure. So this has been tested, and that's why I gave him the opi bells several times because there was a study in 2008 where they recruited 50 pot users, and these were people who actually wanted to quit smoking, but were having trouble because they wanted it. And they gave them 1,200 milligrams a day of gabapentin, which is a moderate amount. The max dose is around 3,600. So in a normal person with normal kidneys. So this would have been one third of the maximum dose.

And then the other 25 took a placebo. Excellent. I'll give them this. Give yourself a bill. And they monitored them over 12 weeks. Now, this showed that the gabapentin subjects had a much higher success of staying off the pod. So it seemed to block that craving impulse that was in the brain. It reduced sleep disturbance, drug cravings, unhappiness,

and some even showed some evidence of improved cognition, meaning that they really, I mean, the way they test that is to have you remember groups of numbers and then recite them backward and stuff like that. So it was really interesting. There are these self-control-related circuits, and they can be weakened Mine are weakened when it comes to things like peanut butter on rice cakes, which sounds like it shouldn't be a big deal except when you eat like a whole pack of them, then it is a big deal and you can't stop.

So I have weakened self-control circuits when it comes to things like that because I've been on this diet, you know, this lifestyle for so long, every once in a while I crave something else. So I just don't buy that stuff. but if I have it I'll by God go for it and it's the same thing with pot that's why cigarettes are such a difficult

addiction to beat because it's so readily available you know even drugs some drugstores sell them not all you know some of the chains have said we're not going to sell tobacco anymore that's why

well I don't want to talk politics but that's why Al Gore lost the presidency by the way he didn't smoke pot no well yeah the whole Oh, I tried it, but I didn't inhale. That was his boss.

Well, yes, I remember. But, no, Al came here to Tennessee and told, you know, had a rally and told the tobacco farmers, don't worry about, I got your back. And then went to the convention, or not the convention, yeah, the convention. The national convention. It was like, well, tobacco's bad. We've got to get rid of tobacco. And the tobacco farmers in Tennessee went, what the hell?

And they, you know, they mounted a. pretty massive campaign against him, and he didn't win his own home state. Of course, Al really never was from Tennessee. He's from Washington, D.C., but anyway. So, yeah, you know, I told people at the time if Gore had just won his home state, he would have won, because that's how close it was. Hanging Chads. Yeah, we went to Hanging Chads in Florida because he didn't win his home state. That should tell you something.

Yeah, I guess. I don't know. That was a long time ago, so I don't. I don't figure too many people get mad about what I'm saying at this point. No. So they're doing larger studies to confirm Gabapentin in helping people quit who want to quit cannabis quit it. But this guy points out a phenomenon that is known in the medical literature that Gabapentin has some effect on the craving of cannabis. Interesting.

Very interesting. Yeah, because we do see people on Gabapentin every single day all day long for nerve pain. to varying degrees of success. But, you know, just out of curiosity, and I'm going to look it up here in a minute, I wonder if they've ever done any kind of research on it, Gabapentin, and alcohol withdrawal, you know, trying to get someone who's a profound alcoholic, maybe coming up with other solutions to incorporate with alcohol. I don't know.

I'll look it up while you're on. Yeah, no, I'm looking it up right now. Because, you know, alcohol addiction is profoundly difficult to treat. Gabapentin has been, looks like it has been studied. Let me see if I can find this. So this is just some RIA health website that's pushing it. I'm just looking, okay, here we go. One study compared gabapentin to placebo patients who received placebo had an abstinence rate of 4% compared to 17% that took the 1,800 milligrams of gabapentin.

So the efficacy was still pretty low. but there were three to four times, most four times more people quit alcohol taking gabapentin than took the placebo. Now, I don't know how powered this study was and all that. So, okay, here's a 2007 study found that compared to placebo group, those who took gabapentin significantly reduced their heavy drinking and number of drinks per day. They also increased the number of alcohol-free days. Yeah.

It says people who hadn't reduced drinking while taking naltrexone. So naltrexone is an interesting drug. It's a mu-opioid receptor blocker, but it also helps. We have those receptors, okay? Mew opioids are like morphine, dilata, which is, you know, on the street, aka hydromorphone. Those things are mu-opioid receptor agonists. In other words, they stimulate the mu-opioid. receptor. So morphine,

I get hydrocodone, dilaudid, lentinol. Phenolte. Percocet does, but also percissette does, but also percocet's do the caper receptor as well. And then methadone does the mu and delta receptors primarily. And so they have slightly different effects. But anyway, naltrexone is a mu-opioid receptor blocker. You say, well, alcohol doesn't stimulate the mu-opioid receptor. So why would that work?

well because why do we have mu opioid receptors is not in case we take a percassette it's because we make our own endogenous in other words inside our body opioids ourselves right okay and so when we make endogenous opioids they bind those receptors and those receptors are in deep in the brain in the pleasure center and so alcohol likely stimulates some endogenous opioids that stimulate the pleasure centers and when you block that you don't get that pleasurable feeling when you drink and you will have less of a craving for alcohol that's the hypothesis

and it does seem to work so what they're saying is is that people who didn't do very well with naltrexone may respond better to gabapentin. So there you go. Cool. Something to know.

Yep. Okay, so it's not commonly used but a dictionologist may be using it. Right. All right, anything else on that? Okay. Hey, Dr. Steve, how are you doing? Good.

How are you? This is Lisa. Hey, Lisa. Lisa. You're for Georgia. Woo-hoo. Yay. What does Dr. refusing T-A-V-R have to do with an M-M-M-S-E of less than 12?

Okay. Wow, this is a really packed question. Okay. or that does T-A-V-R make cognitive impairment worse? Thanks, Dr. Steve. I hope it's an interesting question you can do on the podcast. Bye. Yeah, so let's talk about T-A-V-R first.

So T-Av-R is a trans-aortic valve replacement, or trans-catheter aortic valve replacement. It's a less invasive way. to replace an aortic valve when people have what we call aortic stenosis. So this would be people who have a valve that's too narrow and they're not able to pump enough blood out of their heart or is being pumped out under high pressure. So now, so what they're saying,

what she was saying is that this person had an MMSE of less than 12, and that's a mini mental status exam. That's a sign of pretty severe dementia because you and I would score a 30 on that. And that's if you can do serial sevens. Can you do serial seven? Dr. Scott, what's 100 minus seven? 93.

What's 93 minus 7? 86. 86 minus 7. 79. There you go. Very good. All right. Give yourself a bill.

Serial sevens are hard. They are set, yeah. And they pick that for a reason. Now, you can do serial threes, but those are much easier. But so the many mental status exam looks at things like, can you draw two intersecting pentagons? Can you read a sentence and follow, do what it says, and it's just basically, it says, close your eyes. Can you write a sentence with the correct punctuation? And can you memorize three objects?

So this is one of the things that they'll do, Dr. Scott. I'm going to tell you three objects. You repeat them back to me. Okay. able no shit let's see i already flicked apple table penny okay say i'm back oh apple table penny okay now spell world w-o-r-l-d now spell it backwards d l-r-o-w good very good all right give you one of those give yourself a bill now what were those three objects i told you to remember apple table there you go see so

So you would pass that part of the mini mental status. That might be the only part. But there are a lot of people that have short-term memory stuff. As soon as you distract them, that's what that spelling world backward really is for. Sure. Is to distract. I mean, you get points for it, too, but it distracts you from that short-term memory register. And if you have bad short-term memory loss, you won't be able to bring those up.

And then I'll ask you, what's this thing on my wrist? Right on. What is that? Wrist watch. Okay. So it's not, if you answered, it is a thing that tells time. That's a sign of a disorder called anomia where you lose the ability to name things. I had a professor in medical school who had a, and I've talked about him on this show before,

who had an IQ of at least 220. I mean, his smartest person I've ever met. Jeez. And when he got some dementia, he would describe a deck of cards. He couldn't come up with the word deck of cards. cards, but he would say a concentric stack of thin laminates. Now, that is a damn genius with stage one dementia, you know? Isn't that crazy?

That is crazy. Oh, my God. That is a concentric stack of thin laminates. Pretty fascinating. That is pretty wild. So anyway, so this person has a MMSE of 12, which means that they got a lot of stuff wrong on that. Right on.

And then they're asking, why would the docs decline to do? do serve this TAVR on that person. So, you know, baseline depression is linked to poorer outcomes. Sure. But when it comes to dementia, let me see, I had an article here. Let me see. Okay. Dementia in TAVR patients raises several risks, but not mortality.

So among patients, among patients, Undergoing Transcatheter, aortic valve replacement, a history of dementia is associated with higher rates of in-hospital delirium, which I can attest to this. There are seven stages of dementia according to the fast scale, and it starts with just having a little bit of trouble organizing things all the way to being curled up in a ball, just going la, la, la, la, la, all day. And with that being stage seven, you can bring some people in with stage one or two dementia, do a procedure on them and stress their body, get those stress hormones going, and it kicks their brain into stage seven. And some of them come back and some of them don't. And Dr. Steve, doesn't it, have some to do with the anesthesia when they...

I've seen it even when they do spinal anesthesia for, like, hip fractures and stuff like that. Okay, not necessarily just a general bit. So, but, you know, they do use some other sedating medications, though, so it could be that. So they have longer hospital stays and greater chance of discharge to a rehab facility. And this was a nationwide cohort study that compared 3,000 pairs of TAVR patients with and without baseline dementia. It was done research at the Cleveland. Researchers at the Cleveland clinics was a pretty good one. There's really a dearth of data on TAVR and dementia.

And if you have severe symptomatic aortic stenosis, in people older than I am, there just isn't a whole lot of data on people with dementia, whether it does them any good or not. But if they have severe symptomatic aortic stenosis, so what would your symptoms be? You'd have congestive heart failure is one. Fainting is another one. Chest pain is another one. That's sort of the triad of severe stenosis of the aorta that says these people have

a one-year mortality that's significant. Yes. And so in this case, if the patient is really not functional at all, the surgeons may have just said, look, they're not functional enough for them to realize an improvement from this surgery. I would want to know how symptomatic they were. Are they symptomatic at rest? Are they able to get up and do stuff on their own?

Because we've got a mental status exam that's that low. They may not be doing much of anything. They might not be doing much of anything, and so the surgeon may have felt there was the risk outweighed any possible benefit they could have had. But there's not a hard and fast rule on that. So these authors of this study said that they encourage incorporation of cognitive function, the standardized workup for patients considering TAVR, and society guidelines recommend factoring in cognitive status, standardized score threshold has not been established and would require more study. So that was just the surgeon themselves just saying, hey, I'm doing a overall risk analysis,

and I don't think this patient's going to benefit from this, which is good. They're not knife-happy. Yeah, yeah. But it's relatively safe in patients with dementia in general. It's just there are some risks. All right. Hey, Dr. Steve, how you doing? Hey, I'm a good man. How are you?

Good. Hey, I have a question about herpes. I found out from my ex-girlfriend of about a year email that she had herpes a whole time we were together. Okay. Yay. Great news, I know. Give yourself a mail. No, that's the wrong one. Oh, wow. Never mind. Of the virus, especially in someone that is not showing symptoms. And I know there's HSV-1 and HSB2. Yes. And they live on different parts of the body. But I ordered an IG test to see, you know, if I have either of those, but it won't tell me where the virus lives. That's right. I'm just kind of curious

what the prevalence of those strains are out in the population. Appreciate the show. Thanks for the answers as always. Thank you. Yeah, thanks, man. Herpes Symplex is common in the United States. So let's just talk about genital herpes. We could talk about the differentiation between herpes one

and two. We haven't done that in a while. The CDC estimated there were 572,000 new genital herpes infections in the United States in a single year. So 12% of people between the age of 14 to 50, 14 to 49,

have HSV2 infection. And the prevalence is higher, it's really higher than that because an increasing number of genital herpes infections are caused by herpes simplex 1. So people usually get HSV-1, that's the oral herpes in childhood,

and then you go blow somebody, and then you impart HSV-1 to their genitals, and then they have sex with somebody else, and they impart genital-to-genital HSV-1 sometimes. Okay. Herpes simplex two infections, weirdly more common among women than among men, and the percentage of those infected during 2015-2016,

We're 16% of women versus 8% of men among 14 to 49-year-olds. Isn't that interesting? And they think it's because genital infection is more easily transmitted from men to women than from women to men during penile vaginal sex. So if you have just sex with random people, then you have between the age of, let's say, 18 to 49, The odds are, you know, 12% that you'll be exposed to herpes. That doesn't mean that you'll get herpes, 12% of the time.

Now, if you're in a couple, there was a study done, just called reducing the transmission of gentle herpes, and they had monogamous HSV-2 discordant couples. In other words, one person had HSV-2 and the other one didn't. 5% over an 8 month period the transmission was very low and now the reason for that low transmission rate again was they recruited women as the infected

partners in 67% of the couples because usually it's the woman that's infected and it is harder for the woman to give it to a guy than for the guy to give it to a woman so yeah now getting your IGG won't tell tell you when you got it, who you got it from, or where it lives. IgG is just an antibody that shows a mature infection that you're producing antibodies,

which means you were exposed to that antigen. You can do herpes simplex one and two serologic test and see if you've ever been exposed to either one of those. If you have antibodies to them, you've been exposed. Doesn't mean you have outbreaks. And, you know, there are lots of ways that, people can reduce the risk of transmitting it from one person to the other. One thing that you can do is using valocyclavir. And valyclytivir is a herpes-specific drug that will reduce the duration of a herpes outbreak if you get it,

but it will also help to prevent outbreaks if you take it every day. Some people recommend lysine. I still haven't seen a double-blind placebo-controlled study that shows that lysine has any, makes any difference. But I hear about it a lot that people who had frequent outbreaks who take lysine every day have fewer outbreaks. Now, the hypothesis on the mechanism of that makes sense, just because it makes sense doesn't make it true. But herpes, when it assembles itself, has to assemble its coat out of arginine. But its coat is polyarginine. Arginine is an amino acid, and it links all these things together to make its coat.

And lysine will compete with arginine at the level of the enzyme that builds the coat. And so if you have a lot of lysine and the balance is more lysine than arginine, the hypothesis is it's hard for the herpes virus to make its coat. So it just gives up and says, oh, fuck it. Yeah. I give it. Yeah, can't do it. Now, let's talk a little bit about HSV-1 and HSV-2.

These things show atrophism, which means they like to live in certain parts of the body. So HSV-2 loves to live in the genitalia. HSV-1 loves to live in the oral cavity. Why? I don't know. They're just different. I mean, why is the tip of your dick different than your ear? They just are.

I mean, they differentiated when you're an embryo. And so they're different. And there are different proteins and different signaling mechanisms and those things. And so the herpes virus loves to live down. It can attach there easier. But it can live in the mouth. Likewise, HSV-1 loves to live in the mouth, but it can live on your genitalia or more specifically, the nerve endings or the nerve ganglia that feed the genitalia. it loves to live.

So, but when you, they live there uncomfortably. So if you have herpes simplex one on your genitals, you're more likely to have a less severe outbreak and less frequent outbreak. And you may even get to the point where you don't have outbreaks at all. Likewise, if you have HSV-2 in the mouth. Okay. But people think, well, HSV-1, that's the oral one. That's the quote-unquote good one. And it's not the good one because when you have herpes encephalitis, which is an herpes infection of the brain that can cause delirium and even death, that's almost always herpes simplex one.

And that's almost always because of its proximity to the brain. Right. You know, so HSV-1 isn't the good one. It's the goofus and the goofus and gallant relationship between HSV-1 and HSV-2. for those of you highlights readers from the past. They even have that anymore? I don't think so. Let's look up Goofus and Gallant.

Because I remember I would always read Goofus and Gallant. That's got to be old. It is old, but I wonder if they still do it, though. Okay, here's 12 times Goofus from Goofus and Gallant was the absolute worst. There you go. So someone has actually done a web page. You think Goofus would have developed some manners by now. And let's see.

So Gallant says, I wish I had a little, no, I'm glad I have a little brother. But Goofus says, I wish I didn't have a brother. Okay. Oh, my gosh. Let me see. That's not that good. Okay. And then, yeah, you can tell from the mother that she's just totally fed up with Goofus.

because he says, let me see it. Oh, how evil. They have a bunch of what looks like just playing cards on a mat. And goofus, because he's an anarchist, just says, let me see it. But mom wants to control these kids. And she's a control freak. She's a totalitarian. And she has a big smile on her face when Gallant says,

may I see it, please? Hmm. So this is a control issue. Gandalous. Yeah. Let me see. Oh, Goofus uses his book with dirty hands. Ooh.

But Gallant has clean hands when using a book. You don't use a book. You read a book. But anyway, his hand, he's holding his hand up, and it's, the light is shining off of it. Okay, let's see. Uh-oh. Um, okay, this one, here's a woman that looks, horrified because Goofus

says, my, you have nice things in your purse. Okay. But Gallant says, here's your purse, Mrs. Green. What a little shit. I always hated Gallant. Now I know why. Okay, let's see.

All right, we better get back to the questions. What was the question? Wait. About herpes. What, am I boring you? No, maybe everybody else. Okay, well, okay. Gallant and goofs. You can, you can, you could, Look those up if you'd like. Squirrels are scared of Goofus.

That's so he's bad because squirrel, have you ever had a squirrel that wasn't scared of you that didn't have rabies? No. Squirrels eat from Gallant's hand and then bite him and give him rabies. Well, there you go. Yeah, this is all about control. Yep. Goofus grew up liking rage against the machine and F you, I won't do what you tell me. That was goofus.

And you know what? That's way cooler. than that guy who told you if you go to San Francisco, you should wear flowers in your hair. Who would you rather hang out with? The flowers in hair, man. Are you serious? Oh, for sure, yeah.

No. You're silly. All right. Back to herpes. Okay, so, yeah, back to herpes. I bet Gallet has herpes. I bet Gallet has herpes. He's got, he has...

Not the good herpes either. No, he has a bad herbies. Yeah, he's got the bad kind. So, but Goofus is making fun of him. That's what it is. He's like, ha, ha, you have herpes, ha, ha. Don't make fun of my ailment, goofus, says Gallant. All right, yeah, so herpes.

I don't even remember what the hell we were talking about. I think we were done with that, actually. Were we not? Yeah, I think so. I think we've answered the, There's between the herpes and... There you go. Hey, Dr. Steve.

It's Matt and Charleston. How are you? Good, man. How are you? That's good. Good. I'm doing great. Cool, man.

Tumia was on Rogan last week, and he mentioned that he is moving to South Carolina. Yep. And I remember that you also mentioned you are moving to South Carolina. Yeah, completely independent thinking. Not great minds thinking alike. No, it is great minds thinking alike. But it is totally, that's when it is.

It's not one of us said, oh, I'm moving to South Carolina. other one said we're moving to South Carolina, not that I would influence Sir Anthony or Professor Anthony in such a way. But, yeah, no, we're both moving to South Kakalaki eventually. Sometime in the future. Yep. Does that mean that you guys will be doing some sort of collabo, more so radio-type thing? Cool.

Not really a medical question, but just curious. Yeah, where he's going to be living will just be not that far from me, because we'll be in the same state. I mean, it's a big state, but I think I know where he's going to end up or in the general vicinity, and where I'm going to be living, it'll be about an hour, hour and a half away, if I'm right. So I, yeah, I mean, we've talked about it. We've talked about it doing it now, but, you know, I'm with the laugh button, all that stuff. But when I do Dr. Steve Unbound, whenever that is, when these freaking gloves come off, because I'm, you know, I'm employed and I actually care what people think about me when I when I no longer care I've got

some shit to say and I will by God say it so yeah I'm looking forward to either weird medicine unbound or Dr. Steve unbound or whatever and doing it wherever I'm doing it if it happens to be with my old buddy Anthony then that would be awesome but I'm still friends with everybody I think I'm the only person left that's still friends with everybody up to there at least i think i am anyway i hope i am and uh yeah it's going to be interesting so yes something to look forward to but for me maybe not you all but for me this is this is one for you dr scott hello dr steve i hope you're well thank you i miss tase yeah we do too scott got a two-part question for you what does modern medical science have downpacks

Absolutely solid, if it happens. Who's bad? Sorry. You know exactly what to do, no sense or buts about it. And what is still a huge mystery to modern medical science that we just, or you all just, still baffles everything. Well, it's interesting that he's asking you this. But actually, I think that's good because you're looking for. from the outside, you see the things that we can't.

I have some answers for this, but you see the stuff that we can't do because that's when they come to you is because we failed. It's just a shot in the dark. Thank you. Bye, Tasey. Thank you, Stacey, Deloge.

I think it's a great question. KK4WZI. I think modern medicine does a lot of things extremely well. For instance, if someone has a bacterial infection and you can identify that and give them a specific antibiotic for it, And I think it's wonderful.

But let's talk about pain just specifically. Pain is something that I think modern medicine does extremely well, but I also think it fails miserably at. You know, same time, similar cases for different people because everybody is so uniquely different. You know, there's a lot of times, Dr. Steve, you know, as well as I do, a pain medicine used appropriately is an incredible thing. And a pain medicine used inappropriately is a horrible thing.

Yeah, yeah. It's worse than doing nothing. It's worse than doing nothing. I agree. It certainly is. Or it can be. Yes, sir. And I think interventional pain medicine works extremely well.

Doing proper shots in the right spot for the right people, but not because you're doing it because you're trying to, you know, upcharge someone. I think he's a wonderful. My buddy, Paul, has done three or four epidural steroid injections on me, and they've worked every single time. Yeah. Yeah, and it's very targeted. It works extremely well. By the way, check out backpane. Dottersteve.com.

You've got to spell it all out. But I can make this real. For my most recent foray into a non-pharmacologic pain thing from my back. But go ahead. Yeah, and you are doing better with that. I have way better. With your inversion table. But I'll make it really simple for you.

Western medicine treats things that can identify specifically extremely well. And, you know, Chinese medicine, what I do, treats things that are not identified well. By Western medicine. Yeah, you always have a diagnosis. Yeah, you always have a diagnosis, even if we can't come up with one. Yeah, so in other words. Even if we would look at it and go, what that F is he talking? The third pulse.

Yeah, but you know, somebody comes in with a bad stomach and you give them something, but you can't identify exactly what it is. You may not, and I'm not saying you, Dr. Steve. No, no, no. It's a colloquial term. It may not treat so well, but you might send them me and say, hey, man, Liz, we don't know exactly what's going on. Sure. You have a shot at it.

So, yeah, I think Western medicine. Well, that's how you and I got together in the first place. Yeah. So I think Western medicine has a lot of terrific advantages, as long as they can identify specifically. And that's one thing I really hate about what you do is your hands are tied by insurance companies and by bosses, employers. And you know a lot of things you could tell somebody to do that sometimes you can't tell them to do because of your restrictions. So Dr. Steve Unhinged may be a whole different. It's true now.

I can still get sued. I would not give medical advice, you know, per se without a disclaimer. Of course, of course. On a thing. But there are things that I can't, like I can't prescribe marijuana in the state that we live in. Right. For a hospice patient even. Right.

And I know that it would make them better. Yes. Now, I can say, I think it would make you better, but don't tell anybody that I said that. Right. But that's bullshit. Right. Yeah. You know, that's rough.

rough to, so there are things. You know, Alan Watts said there's experiences you can never have. I can never touch the tip of my index finger of my right hand with the index finger of my right hand. That's not an experience I can never have. And so there are things that I can't, it's a bad analogy, but it's just a cool thing that he said, that I can't ever do for my patients because either I'm not smart enough or we just don't know enough.

or I'm constrained either by my corporate construct or by the law. Right, right. So, and those may be things that benefit people. Now, when I would, when Dr. Scott and I worked in the same office, do you remember how that happened? Yes, I do. You do. Okay, how did we get together? Real quick, there was a physician recruiter at our hospital that said, hey, there's a great little spot down in this little country town.

and there's a couple of doctors down there I think you would fit right them with and we've got an open Do you remember that person's name? I do Rambo. Oh, okay. Yeah. Yep.

You don't like the Rambo guy like that. Yeah, yeah, yeah. Yeah, this person's name actually was Rambo. I thought that's what I was going to ask you if it was that person. But anyway, yeah, so Scott, I would send him all the people that I would do all the work up

and they still felt like crap. And people want to be recognized and when I say recognized, just like, hey, Bob, not that, but they want to be seen. That's probably a better term. And they want their problems to be recognized. And they would like a name to put it. We like to put names to things. So look at the sky.

We've named every damn thing we can see in the sky. Every star an end. It's something that humans do. It's where we have to do that. We have to name everything. And people want their ailments named. And if I don't have a name for it. or if they if I do have a name but they find out it's just a description of their symptoms

you know episodic abdominal pain you know a syndrome or something you know I can't think of a better example than that but you know where it's just a description of the symptoms it's not a name then we don't have a complete understanding of it it frustrates my patients and with for good reason and I would send them to Scott and he would check their 12 different pulses or whatever and their humors and their chi or whatever but he would have a name for what they had

and we didn't have a name for it we should probably come up with some examples of things like that and they would come back to me and they would feel better I'd already ruled out the stuff that could kill them and that's why I'd send them to you yeah and likewise

if Scott had somebody complaining of chest pain. Which was great. So we were truly complimentary in that regard. And that's my, I'm totally fine with complimentary medicine. It's not really alternative medicine. I don't like that term as much. But we complimented each other

because the things I was good at, and him not so much, like pronouncing things like islet cells and stuff like that. And the things that I was no good at, he excelled in. And he could name these things that people had that we didn't have a name for, but traditional Chinese medicine did have a name for it. And he had treatments that he could do with them. And a lot of them, I believe, had a lot to do with distracting the central nervous system from using smaller pain to distract the central nervous system from larger pain, inducing those endorphins, those endogenous opioids that we mentioned. earlier and also just deep relaxation because when you go to dr scott

course he has that deep soothing voice and it's real quiet and uh you know he turned he does his thing and then turns out the lights and puts on the spa music and then you lay in there for 20 minutes that you attain of kind of an outworldly um uh state of deep relaxation which is good for anybody you know yep so yeah it's pretty cool but anyway but Anyway, so it's not bullshit. He absolutely helps people. I still send people to him to the stage. Oh, yes, you too.

So anyway. Good. Did question our studies. Hey, hey, Dr. Steve. It's Mike from New York. Hey, Mike. I'm doing well. Hope you are.

Yeah, absolutely. So Casey, hi. Okay, we'll do. I was wondering, now if an individual has both their legs amputated, you have all that circulatory system, the veins, arteries, capillaries, going down, what happens with us? Do they dry up and wither away, or

after their wound is cordarized? They're just filled with a liquid forever. What's the deal with that? Also, the heart, now it doesn't have to work so hard because it doesn't have to pump blood all the way down to the feet and everything.

Does it help give you more meaty to mess in erections? Because it has a better smaller system to pump this blood into? Or does the heart just get lazy and say I'm not going to do so much work? Thank you very much.

Hey, thank you. Both great questions. Let me answer the second. Hey, Dr. Steve. What's going on? What the hell? I'm doing well. Hope you are to. Yeah, absolutely, man. Okay, we got it. Let me answer the second one first. When I moved

to North Kakalaki from Michigan, I was a kid. I was used to playing outside all winter long doing my paper route and all that stuff 10 below, no big deal in the middle of winter. Came down to North Kakalaki. It was 32 degrees. People were coming in from the outside.

Oh, it's so cold. It's so cold out here. I was just laughing saying, this is when we put on our light jackets. When it hits 32, this is awesome. But now, when it hits 30, here, I'm like, oh, so I got used to it, right? And the heart will do the same thing.

Yes. In the beginning, maybe there might be some improvement, but after a while, it just goes, wow, I don't have to, you know. And the amount of resistance that you remove by removing legs, now, you're usually removing them because of bad circulation. So it could be significant in that area, but overall really doesn't make that big of a difference. Now, to the first part, what happens to the vessels? Well, people think that the circulatory system, but the arteries go down and then they connect at the toes to the veins, and then the veins come back up.

Okay? So if you cut the leg off, well, what the hell? You've got a blind end to the arteries, and you've got a blind end to the veins. Does the blood just pool in the leg, and you know it doesn't? So you know that your internal model, if that's your model of the circulatory system, it is incorrect. Right. So the correct model is that the vein, the arteries do pump away from the heart,

but they link up with the venous system in multiple places on the way down and these plexus. And it makes these sort of plexus, you know, networks. It's like a New York subway system. Yes, that's right. That's right. And so that when you cut off those ends that were already, under pressure, there was vascular remodeling that was being done so that the body could adjust for that. The circulatory system can remodel itself, and it does it based on stressors, and one of those being distal increased pressure, so the distal meaning closer to the feet. and so already before you cut that leg off there was remodeling being done and then those connections just reinforce themselves so that you have connections in the leg between the arterial side and the venous side that really weren't doing that much but when you cut the leg off above the knee for example now those become crucial and the arterial side will become larger and more muscular as you add more pressure to it because now there's way more pressure going in those cross.

cross-linked arteries than there were before. Right. Because before they were in parallel, you know, there was a little bit of blood going sideways, but a lot of blood going straight down. Now the blood is all going sideways. But that doesn't take very long at all for the body to adjust to that. Because the heart compensates and backs off a little bit. Yep, yeah, and that too.

Okay. Yeah, there's new blood vessels can sprout off from the remaining vessels. And that's called angiogenesis. as well, okay? And angiogenesis is just where, due to pressure and stress and decreased circulation that the body makes new blood vessels. So unlike the central nervous system where you're pretty much stuck with the cells that you were born with, although that's not 100% either, but more so than the, this vascular system.

Yep. Good question, excellent question. Great question. All right. I remember last time we talked about when I did streaking at UNC and we were on TV. My niece spent a bunch of money to get a press pass so that she could get access the archives of CBS News and she found it. She found this news story. I can't show it to you on here.

And we also can't like just put it up on YouTube. But I can't play it. And you can see my stupid self in this. And let's see. It's called streaking. Last night, some 200. It seems to be a new craze on college campuses, making a dash through a public place and the nude. It's called streaking.

Last night, some 208 male students at the University of North Carolina at Chapel Hill claim that they made a world record streak. And not only that, but it was Mangum Dormitory in Upper North Campus. These 2,000 students and four campus policemen gathered to watch the young men streak by. The crowd, of course, is essential for a successful streak. One streaker said, after all, what good is it that nobody sees you? And that's the way it is. Thursday, February 28, 1974. This is a murder crime.

We did that in February? Shrinkage. Oh, my God. Yeah, well, that gave you some excuse. But I told you the story that my group branched. off from the other group, and we ended up all of a sudden in a crowd, and there were like 20 of us, and people were going to go, who the hell are those people? And let me tell you something, when all of a sudden you're in a crowd of people you don't

know, and you're no longer running with 200 people. It's just you and like 10 people, and now you're dispersed in a crowd. All of a sudden, you realize that you're naked. And I remember I took my tie that I was wearing. I had a Groucho Marx mask on, and I'd lost it somewhere. And I had a tie on, and that was it. And so I took it off my neck and wrapped it, tried to wrap it around my waist so that, you know, my junkal area wasn't quite as exposed. And then this girl that I kind of had the hots for that was in my speech class runs up and says, oh, you guys were awesome.

And it was humiliating is basically what it was. It just humiliating. So anyway, well, listen, thanks always. Go to Dr. Scott. Thanks, Dr. Scott. We can't forget Rob Sprantz, Bob Kelly, Greg Hughes, Anthony Coomia, Jim Norton, Travis Tefft, that gould girl, Lewis Johnson, Paul Ophcharsky, Chowdy, 1008, Eric Nagel, the Port Charlotte Hoare, the Saratoga Skank, Roland Campos, Steve Tucci, sister of Chris, Sam Robert, she who owns pigs and snakes, Pat Duffy, Dennis Falcone, Matt Klein, Schmidt, Dale Dudley, Holly, Holly, from the Gulf, the great Rob Bartlett, Casey's wet t-shirt, Carl's deviated septum, Vicks, fluids, Bernie and Sid, Martha from Arkansas's daughter, Ron Bennington, and Fez Wally, who supported this show, has never gone on appreciated, listen to our Sirius XM show on the Faction Talk channel. Sirius XM Channel 103, Saturdays at 7 p.m. Eastern, Sunday at 6 p.m. Eastern, on demand, and other times at Jim McClure's pleasure.

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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. You know,