Weird Medicine: The Podcast - 470 - OOPS! Spoke Too Soon!

Episode Date: September 10, 2021

Well, crap, I pretty much promised myself we would only do Covid-19 related major news going forward and return to "Dixon Nutz" as before. Great plan, until I contracted the stupid virus myself. Topics: RegenCov is a badass jam for those that qualify The vaccine still works, if your goal is to stay out of the hospital A guy with tingling and dizziness WTF: A pulled pork covid test? Self Penile Amputation 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 ($30 gets them all!) 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!) betterhelp.com/medicine (who doesn’t need a little counseling right now?) wine.doctorsteve.com (Naked Wines is the best wine delivery club in the US. Claim your voucher!) Learn more about your ad choices. Visit podcastchoices.com/adchoices

Echo, ask Dr. Steve for a fun fact. If you're chewing, you are masticating. Ha-ha, right, chip. Peckas. For another fact, please say. Tell me another fact. To quit say, stop. I don't think I can do better than that one. 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 bad. bit of a, you know, a clown. Your show was better when you had medical questions. Hey! 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 infertable woes. I want to take my brain out. I'm clasped with the wave, an ultrasonic, ecographic, and a pulsating shave. I want a magic pill. All my ailments, the health equivalent of citizen cane. And if I don't get it now, in the time. 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. It's weird medicine, the first and still only uncensored medical show in the history broadcast radio, now a podcast. I'm Dr. Steve broadcasting to you from COVID Central. This is a show for people who would never listen to a medical show on the radio or the internet.

If you've got a question, you're embarrassed to take to your regular medical provider. If you can't find an answer anywhere else, Give us a call at 347-76-6-4-3-23. That's 347 Pooh Head. Follow us on Twitter. No, there's no us. Follow me on Twitter at Weird Medicine. Visit my website at Dr. Steve.com for podcast, medical news and stuff you can buy.

Most importantly, I'm not your medical provider. Take everything you're in the grain of salt. Don't act on anything you hear with this show. talking it over with your doctor, nurse practitioner, practical nurse, physician assistant, pharmacist, chiropractor. Good Lord. Acupuncturist, yoga master, physical therapist, clinical laboratory scientist, registered dietitian or whatever.

I could just go back and redo that, but I just do not have the stamina today to do it. I'll explain why in a little bit. Anyway, don't forget, please, stuff. dot dr steve.com stu-u-f-doctrsteve.com you can click straight through to go to Amazon and helps keep us on the air. You can scroll down and see some of the products we've talked about

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one for bass and one for guitar and it is the most incredible thing. It's my favorite thing to pull out when I'm playing music because everyone is like, what in the hell? So, and in a good way. So check that out at stuff.org.com. And then my favorite wine club is wine. Dot, Dr. Steve.com.

It's naked wines. It's, you know, small wineries, and you get some really good wine for really inexpensive price. It's fantastic. And if you want to lose weight with me, check out Noom, N-O-O-M dot Dr.steve.com. And it is a psychology program that helps you change your relationship with food, get 20% off, and two weeks free by going to Noom.com. You can just try it if you don't like it to hell with it. And check out Dr. Scott's website at simplyerbils.net.

All right. Yeah, Dr. Scott's not here because he's afraid of catching COVID. Yeah, your old buddy came down with it on Monday. So I'm recording this on Friday. So Monday at 4 p.m. And I know where I got it from. And shut up, it wasn't the Chicago trip. I know where I got it from.

It happened subsequent to that. I knew the minute it happened. I can't really talk about it because of, you know, HIPAA and stuff. But it was, I was fully PPE'd up, but there is one. Let me just, I'll say, I can say this much. There is a weakness even with fully having personal protective equipment on. So I had an N95 mask, and then over that I had my regular mask just so you don't lose the regular mask, really. Not much, there's no utility in that.

And then I had my gown and my gloves, and I had a face shield. Now, the face shield comes down to just below your chin, and that's great as a barrier to keep people from, you know, coughing in your face. but when someone is coughing or yelling or you have to lean in because there's communication issues or whatever if there's enough velocity to that cough or the yelling or whatever that can work its way underneath and you can feel it underneath the face shield and now you can feel that wind on your face well the one vulnerable place is your eyes and I got a viral conjunctivitis and I know that's the port of entry for this so you know the PPE is good but it's not it's not perfect we're not walking around in hazmat suits hasmat suits are are perfect shields but you don't want to be walking around in the hospital

with those although I've during a code blue I've seen people in hazmat suits The problem with the hazmat suit is how do you get it off without contaminating yourself? Well, you mostly don't, so you just make sure you wash your hands and don't touch your stupid eyes or face before you, everything is clean again. But anyway, so, yeah, that's what happened. And I remember coming home that night and saying, if I don't, if I didn't contract COVID-19 today, I'm never going to. Well, I should have kept my stupid mouse shut because, indeed, I guess it was five days later. Would that be right? Yeah, about five days later, I felt like at 4 p.m. on Monday, I felt like I'd been hit by a Mack truck.

Now, every fall, I have the same feeling. I feel terrible. I have got horrible seasonal allergies in the fall. I'm usually sick for two months with just kind of low-level malays and nasal congestion. Yeah, I should just go get allergy shots. I'm just, I started and I quit going because I'm lazy and stupid. So that's on me. But I thought that's what I had.

And I'm like, yeah, it's just allergies, just allergies. But it just got worse and worse throughout the day. and I felt more and more malays, and then I got a headache, and just felt like crap. I'm like, ah, this is really bad allergies this year. So as I walked out of my office to go home, I asked one of the nurses on the floor if I could borrow her thermometer. I want to take my temperature, because when I reassure myself it's 98.6, then I know I'm fine.

It's just stupid allergies. It was 102, and I said, oh, get the F out of here. That can be right. Let's check that again, and it was now 102.5. So I had a test at, you know, a quick test at home that I'd bought, took it. Shit, it was positive. And I'm like, oh, my effing God. So that was Monday.

So my temp hit 102.9. I did have a pulse oxymeter, checked it. It was around 95, which is low for me, 95% oxygen saturation. You're running 96 to 98, 99 all the time if you're reasonably healthy. But it was 95, but my temp would not come down. And so I isolated myself in my room, and I erected a physical barrier so that I had a room, a bathroom, and then I had the upstairs where my studio is, that nobody comes up here anyway. And then my family could have the rest of the house.

And, of course, now they've been exposed, so they've all been fully, vaccinated so they were allowed to continue on with their thing but they had to get tested in three days to see if they were positive so they isolated or i'm sorry quarantine i isolated they quarantined and they got um their test done and they're all negative so that's that's the good news uh the next day um i had a regular PCR test done that's the polymerase chain reaction test because The one I did at home was just one of those nasal antigen tests, and they won't really accept that in a lot of places. But they told me I was going to have to wait three days. Well, hell, you know, I'm part of that Pfizer trial.

And as part of the Pfizer trial, they're very interested in people who get sick after they've had the vaccine. I had my vaccine a year ago. So because I had my vaccine a year ago, my humoral immunity, in other words, the level of antibodies I had in my bloodstream was probably close to zero, but my cellular immunity is still intact. That never goes away. So I felt pretty confident that as sick as I was, I probably wasn't going to progress to severe illness or go to the hospital or die

because I had been vaccinated. But I wasn't taking any damn chance. either. So the Pfizer people, once I reported on my diary that I was sick, they called me in, and I had to break isolation to go in,

and they have a method for getting you out of your car and into the place safely and all that stuff. Don't worry about that. I wasn't exposing anybody unnecessarily. And, or at all. And they're fully PPE'd up. And they got me in there, did a 20-minute test,

And my temp at that place was 102.9. And when you're 66 and you've got a temp of about 103, that hurts. It hurts pretty damn bad. So they sat me down. They said, listen, we can do the Regencove right now if you want it. And it's like, hell yeah, I want to do that. So let's talk a little bit about Regencove. Regencove is a monoclonal antibody cocktail.

Meaning that monoclonal antibodies, we've talked about this on the show, people have listened for a long time, know what a monoclonal antibody is. It's where you take, I'm not going to go through the whole process, but you get these cells that are basically immortal, and they will continue to produce antibodies. You can make big vats of them, and you can train them to just make the antibody that you want them to make. And then if you're smart like, you know, regeneron is, you can patent those and you can sell them.

And they have a cocktail of two different antibodies that are in this thing that's called Regencove. And although right now in our area, there's a shortage of the little bags that you give IV, there's no shortage of the stuff itself. So what they did was they gave it to me in four shots in my abdomen, which sounds horrible. It didn't hurt at all. I mean, there was no pain whatsoever. And they said, let's go make you worse at first, but then it's going to make you better. And so I got home and all of my PCR tests were positive. Got home back to my isolation room.

Sweated it out that night. It felt like crap, dry cough. malays, muscle aches and pain of a sort that I had not experienced in my life and just, you know, had a hard time sleeping insomnia, night sweats, the whole thing. And then Wednesday morning, because that was on Tuesday, Wednesday morning I wake up and it's like, what the hell? I woke up at 5 in the morning, felt great, checked my temp. it was 98 sex, checked my oxygen saturation, it was 98.

I think I tweeted out a picture of this at some point. I tweeted out two of them, and they were like the same. It was like 98, 98, 97, 97, something like that. And it was like a miracle. If it had been any other virus, where I was not required to isolate for a full 10-day. I would have definitely gone back to work. That's how good I felt. So I'm a huge fan of the regenerant.

Let's talk about its penetrance into the medical community, however. You know, this is free, by the way. It's authorized and it's free. And it's reaching fewer than 30% of eligible patients. And that's up from like 5% a month ago. Now, it is increasing. We're seeing an increasing usage, but still the percentage is relatively low. So who should get this stuff?

Not just anybody. If you're not at risk for progression to severe disease, you shouldn't seek and take a place from somebody else. It's just how it is. If you're not at risk, take ibuprofen or, you know, neproxin. If there's no contraindication, Tylenol, if there's no contraindication, treat yourself symptomatically as you would with any other cold. and keep an eye on your symptoms. But if you're not at risk for progression to severe disease, you're probably going to just be fine.

There are exceptions, of course, so just don't be, you know, don't lose your vigilance. But this is standard of care for people at high risk. So who is at high risk? Number one, people over 65. Number two, obese people. You can define that as greater than 25 BMI, but, Most people are using 35 BMI for this to be truly at high risk for this. Uncontrolled hypertension, diabetes, immunocompromise states, people with cancer, undergoing chemotherapy, autoimmune diseases.

There's a whole list. So if you are on that list, please talk to your primary care provider if you turn out to contract COVID-19 and see if you're a candidate. candidate for this treatment because I'm telling you I'm just sitting here I'm not twiddling my thumbs I've actually been working I haven't taken a single day of PTO because of this because I've been doing telehealth from home it's stupid I figured oh you know if I get COVID I could take 10 days off and it's hell I worked a 10 hour day yesterday so from home of course so anyway now I want to just tell you the other side of this I have a friend and she's said it's okay to tell this story because she wants to get the word out who had COVID-19 and she has

a disorder that would put her at high risk for progression and she didn't get the Regencove and by the time they thought of it and sent her in because she was just getting sicker and sicker her oxygen saturation was 86 percent and she was too sick to get it because if you get that sick, they feel like it's the potential it couldn't possibly make you worse. So she didn't get it. They sent her to the hospital. They didn't admit her, but they sent her home with oxygen. She's now on oxygen.

It can probably be on oxygen for some time, and it's going to be months before she's back to normal. So, you know, early treatment with Regenkov, if, I mean, look, if you've been listening to my show for a long time, you know that since the beginning of this, I've been pushing therapeutics. Vaccine, great, prevention, great. But the thing that will end this is a therapeutic, and this isn't it, by the way, Regenkov isn't it. But the thing that will end this is a therapeutic that you can take at the early onset of illness that will keep you from progressing to severe illness.

Because, again, the issue here, is that, yeah, a lot of people are getting really sick and a lot of people are dying, but the percentages are still astoundingly low. But the problem is we are actually overwhelming our medical profession right now. And the level of burnout and the people who are getting it are now, you know, people in our area are dropping like flies right now. And so you lose that productivity for 10 days of those people. So that's more patients they can't see.

and so we're having problems with staff. And, you know, there's just a lot. We're getting very close to a critical area. If we had a pill that you could take at the onset of your illness that would prevent you from progressing to severe disease, all of these hospitalizations would go away. All of these deaths would go away. It would have to be a really, really good pill.

It would have to work better than Tamiflu does for influenza. but even that helps prevent hospitalization and death. So that's what we're looking for. But this is one of those things. This is a therapeutic that will keep 70% of people who take it out of the hospital. I'm sorry, that's not right. It's more than that. It reduces hospitalization by 70%.

And that is a huge, huge number. And, you know, most of the people who take it wouldn't have ended up in the hospital. So the absolute number of people that won't end up in the hospital after taking this is actually much higher. So, but we're still looking for that panacea, which is going to be a pill that we can take. You get COVID-19. You go to your primary care. They hand you a prescription. You go get it filled.

And then you isolate yourself. Everybody does that. Nobody goes to the hospital. It'll nobody dies or ends up on the ventilator. That's the goal. Whether we'll achieve that, we'll see. But there are some candidates on the horizon. Pfizer has a pill that they're touting that's in phase two slash three trials right now.

Mulnupirivir is sort of the spiritual successor to fat. I have a pyruvier, which I was pushing early on with this, but just didn't turn out to go anywhere. I still not sure what happened there. But that was my one prediction that really just didn't come to fruition. But I have high hopes for molnupyrivere, and they just need to move this along. And I still think challenge trials are the way to go, but, you know, there's ethical issues with that. If you don't know what I'm talking about, that's where you give somebody COVID-19 and then you treat them with whatever you have and see if it works. You could just speed things along because you're not sitting around waiting for people to get it.

But there are enough people getting it now that, you know, I guess a challenge trial for a therapeutic really isn't necessary. You just have to identify those patients and treat them. A little COVID brain going on there. Challenge trial more effective for vaccines. scenes and stuff. I'm being stupid, but ok-doke. So that's my COVID-19 story. Yeah, I had

to give a talk, a statewide talk today, and obviously I did it remotely, so I'm all hepped up on prednisone and Teselon and Mucinex DM to make sure that I didn't break out into coughing fits

while I was giving that talk. I figured, well, this is a perfect time to go ahead and record a show for you all. So anyway, all right. So enough of that. I'm okay. I'm going to be okay. And thank you all for your well wishes. I've gotten a lot through Twitter and email. And I really do appreciate it. And let's see what we've got here. Number one thing. Don't take advice from some asshole on the radio. All right. Let's take a few phone calls here. Let's try this one. Uh-oh. Hey, Dr. Steve. It's Mike in New York. Hey, Mike.

I was listening to the show. You and Dr. Scott were talking about some guy who cut his penis off while he was being chased by the police. Yes. Many years ago, I worked in a supermarket. Which, by the way, was just a nutty response to being chased by the police. I'm not sure if he thought, I'm not sure what he thought he was going to accomplish with that, but obviously he was crazy. And this EMT would come in every day. I guess I'm not supposed to use the word crazy.

anymore. He was, he had, he had an issue with mental illness for lunch and she would do her shopping. And one day she got a call on how to leave her groceries and took off. When she came back the next day, she was telling me there was an old guy who cut his penis off trying to commit suicide. And she had said that it was very common for an older gentleman to attempt suicide in that fashion. I was just wondering, is that true? And if there was some, some kind of a psych evaluation of, you know. Yeah, there is. And it's, you know, self, it's called auto amputation, penile auto amputation.

And what we see this in mostly is people with severe mental illnesses. And I'm looking at a case. This is, oh, boy, there you go, sorry. This is from the annals of medicine. in surgery of December 2020. It's called penile strangulation and amputation in schizophrenic patients. It says strangulation or amputation of the penis is the preserve of psychotic patients in the majority of cases.

The situation can be the cause of major complications, both urinary and sexual. Yeah, that kind of goes without saying. The management is multidisciplinary between urologist and psychiatrist. And so they say self-harm of the penis is an unusual situation requiring urgent, multidisciplinary intervention. And again, it occurs in the majority of cases in psychotic patients. Rarely secondary to alcohol or drug abuse, although I've seen cases of those as well. Rarely it doesn't mean never.

So different figures of self-transgression include castration, amputation, strangulation, and strangulation by metallic or non-metallic objects, good Lord. Treatment varies depending on the time of consultation, severity of the lesion. So let me just give you this patient case. And you don't want to look this up. The picture is just, this is one of those moments when I really miss GVAC being in the studio because this is really cringe-worthy. This is Mr. AM, 22-year-old.

a person with schizophrenia. Two, let me see, two history of attempted suicide four years previously. This person was admitted to the emergency room for amputation of the penis at its root. And then they give us two photographs. Thank you very much. Unnecessary. On admission, clinical examination found an agitated patient in hemorrhagic shock. He received emergency.

resuscitation treatment and psychiatric advice. After stabilization, the patient was referred to the emergency room where he underwent re-amplantation. The course was marked by a good clinical course. Four days later, when he was released, the patient committed suicide with a knife. Good Lord. Oh, this poor bastard.

So they reattached his penis and then he can, God, oh, I hadn't read that whole thing. That's really kind of a downer, isn't it? Oh, no, yeah. We don't need these photographs. Here's the other case. I haven't read this one either. I kind of like to do these cold so I can get the same effect you're getting,

but this is really pretty gruesome. Mr. S.A. H. 42 followed 13 years for schizophrenia, taken by his family to the emergency room for acute urine retention. Clinical examination revealed a calm patient presenting. An elastic object tightening the base of his penis with edema, meaning swelling downstream, and significant maceration testifying to the crinicity of the lesions. Okay, so let me, so in other words, the tissues were waterlogged, which told them that this had been going on for quite some time.

The patient underwent ring removal and emergency psychiatric advice. Follow-up was stopped by the normal resumption of diureasus. In other words, he started peeing again, finally, and the presence of signs of cutaneous suffering, but without sign of notable ischemia, aschemia being, you know, death of tissue due to blood flow. Or, you know, loss of blood flow. So the picture on this one, how can I describe it?

So at the base of his penis, there is a ring and a constriction, and then it just looks like he has this sort of twisty, terny, mottled-looking bratwurst instead of a penis. And at first, I thought that he had covered it up with saran wrap or something, but apparently that's his tissue. I don't know.

That's the craziest thing I've ever seen. If you really want to see it, just Google penile strangulation and amputation and schizophrenic patients in that article will come up. But that would be for educational purposes only, no purient interest, please. So anyway, yeah, it's a thing, but it is not common in the elderly

unless they are psychotic. So thank you for that question. Good God. All right, let's see. Let's try this one. I don't know what this one is. Hey, Dr. Steve. This is Adam from Colorado.

Hey, Adam. And no, I'm not partaking. So I have a question for you. Okay. A 35-year-old male. About a year ago, I had a vasectomy. Good. And after the vasectomy, you know, they tell you to clear the pipes 20 times or whatever, and I did all that.

And then, uh, you didn't have any problems during it. But I don't know, maybe around like time number 15 or 16, I started to get like this incredible pain in my left nut. I'm talking like I had to sit down after, you know, ejaculating and just, I mean, it hurt. And I went to the doctor, told them what was happening, and they scratched their head, thought it was really weird, prescribed me some really strong antibiotics for 10 days and everything was fine. They wanted me to send me off to get my nuts, you know, X-Rot, not X-ray, but, you know, take a look at it, you know, get in there and I just didn't do it because everything was fine, then I haven't had any problems, ejaculating sense. But do I have anything to worry about? I took the, you know, antibiotics, nuts are fine, doesn't hurt when I ejaculate anymore.

Everyone's happy. Yeah. Just curious of your thoughts. Yeah, no, I think you answered your own question. You know, one to two percent of people who have a vasectomy will have some post-vasectomy pain syndrome. But that's usually pain in the testicles that last for around three months. But it can cause painful ejaculations. And that is felt to be a benign syndrome.

What they wanted to send you for was an ultrasound, I'm betting, just to look and see if you're, if the vasectomy looked okay. But the fact that you are now able to bust a nut in a painless fashion and they're satisfied and you're happy, I think that's, hell, that's good enough for me. So just follow up with your urologist, you know, for your routine visits and just keep them up to date on everything. But yeah, it sounds like you had a weird version of post-vasectomy pain syndrome. And you can, I guess you can imagine as, you know, as you contract that the pelvis, that rhythmic contraction that you get when you ejaculate, that's so delightful normally, when you've just had surgery in that area that it's just tugging, tugging the loose ends around.

And, you know, they're trying to heal and the nerves are trying to resettle and go, what the hell happened? There used to be a tube here, and we don't know what we're supposed to be sensing anymore. It makes sense to me that there would be some pain in some folks with that. I had none with my vasectomy. One of the things, if you do have a vasectomy, don't be fooled by the fact that you don't have any pain right after it's over. It's because of the anesthesia. And I thought, well, I'll just go back to work. And then I was like, holy shit, does that hurt when I got home?

But it only lasted for a couple of days. And frozen peas wrapped in a towel really helped. And then you just sit and watch TV, watch Seinfeld, do whatever you want to do. And I wore one of those, you know, baseball catchers hard cups. You know, and it was fun. Because, number one, nothing could touch my nuts, and they were very nicely ensconced in this hard sort of triangle of plastic. So nothing bothered them, and they didn't hurt. I actually could go to work.

It's a little weird walking around with that. But what was really fun was if you ran into something, like one of your friends, you could just take your fist and just pound your crotch, and it would sound like this. And it would just surprise them. The looks on people's faces you get when you're just taking your fist and pounding your crotch. It was quite hilarious, but I have a weird sense of humor, so maybe not do that one. All right. Let's see what else we got here. Hi, Dr. Steve.

Yeah. Oh, that's great. I hope you're well. Okay. Hey, I'm okay. I got going to go over. My pit bull and I have been eating pulled pork and drinking beers all night in an effort to develop what I'm calling my proprietary COVID detection test.

Okay. Now, we've done limited testing and studies here on my stepchildren, but I'm wondering if you have any suggestions and how I can bring that to the medical community, perhaps get some funding, so we can share it with America at large. Well, I give you, yeah, I mean, pulled pork dinner costs, what, 20 bucks? Yeah, I give you 20 bucks for some good pulled pork. Appreciate your thoughts there, Dr. Steve. That's it.

All that's good to talk, you. Okay, okay, man. Pulled pork and beer sounds good to me. No clue what in the hell it has to do with COVID-19, but it can't, you know. Listen, everything in moderation, including everything in moderation, every once in a while you've got to blow it out your ass. And that sounds like a damn good evening to me. I can't, well, used to. I can't eat pork anymore.

That's just getting old. can kiss my ass. There's so many things I can't eat anymore. My stupid stomach doesn't like it, but I'll still do it because it's so good. Now, when I was in college, let's just talk pulled pork for a minute. I went to college University of North Carolina, Chapel Hill. And at that time, I don't know if it's still there, there was a barbecue place called Allen and Sons. And we used to go there a couple of times a week. And in North Carolina, it's a vinegar spicy vinegar sauce, and it was outstanding. I mean, your mouth would be on fire.

Your head would be buzzing because you have a couple of beers. You walk out of there, and it's hot out, you know, a nice August, you know, afternoon or evening, and you're with your friends, and it was one of the greatest experiences. You could imagine a culinary experience. Well, after I left Chapel Hill, I remember I came to Tennessee, and they said, I was interviewing here, and they said, do you want to go to a barbecue place? And I'm like, hell, yeah, I do. I love barbecue.

And I sat down and I was like, what in the hell is this? This is not barbecue. It was all, they put some kind of weird tomato sauce on it and stuff. I've come to appreciate it. But at the time, the only barbecue I knew was North Carolina barbecue, because I'm from North Kakalaki. I never had barbecue anywhere else. Well, then I've learned that there's, you know, Texas barbecue, and then you've got your brisketes and your regular barbecue and all this stuff.

And I've come to appreciate different regional varieties of barbecue. But I was on, I read an article that ranked the top 10 best barbecue places in the universe, which is a pretty big deal. It's a universe a big place. And it turned out Allen and Sons was number one. So that was my problem. I was always trying to recreate. It's just like, I guess, the first time you smoke a cigarette,

you spend the rest of your life trying to recreate the feeling you got the first time you smoked a cigarette. And you can never do it. You are always doomed to fail. So just quit smoking. You'll never get back there again. And that's the way it was with me with barbecue, as I was trying to recreate that other places, and I couldn't do it because what I had grown up on

was the best barbecue in the universe. So if Alan and Sons is still there, go check them out. They used to be on Highway 86 and just outside of Chapel Hill. Anyway, so, yeah, pulled pork good in moderation, of course. All right. Let's see here. Hello, Dr. Steve. My name is Kevin. I'm a 44-year-old male.

Hey, Kevin. I've been having dizzy spells since January of 2020, and they last all day. And in the last month and a half, those dizzy spells have also been, I've had the feeling of being drunk, and I haven't had any alcohol for the last month. and I've also get the body tingles it's like a body stone like edibles

and I haven't had any drugs in over a month okay doctors have tested me doing business tests MRIs I'm a neurologist and doctors can't figure out

what's going on I've seen an earnotes throat specialist they have nothing idea just wondering about your advice thank you very much have a good thing Okay, so you have to differentiate dizziness, types of dizziness. So are you having vertigo?

Vertigo is when the room spins. So you close your eyes and you can imagine that the room is spinning. That's one kind of dizziness. The other kind of dizziness is actually lightheadedness. So if it is, you know, this room spinning kind, vertigo, there's a difference. definitive workup for that. You've had the MRI of the brain. You know, they will work you up for things like, you know, Meniere's disease, any kind of positional changes that cause it may indicate that you've got some stone or some sludge in the semicircular canals of your

ear, and there are ways around that. But you're having more symptoms than that. So you're having some tingling in your arms or your let me see let me let me run that one back i'm going to get this whole litany of symptoms if you all don't mind let's do that all day and then the last month and a half those busy spells have also been i've had the feeling of being drunk and i haven't had any alcohol for the last month i wonder if you mean disequilibrium so disequilibrium or do you just feel stupid like you're drunk? That's a, you know, and this is one of the problems with not having a two-way. If you have disequilibrium and the room is spinning, again, that's vertigo.

That's vertigo. And that can last all day long, and there are treatments for that. There are treatments for that. Let's see. What else? And I've also got the body tingles. It's like a body stone, like edibles. Yeah, I have that right now.

so the body tingles is almost always a but not always but almost always a symptom of hyperventilation and hyperventilation is a symptom of anxiety so you've got these other symptoms going on and you don't have an answer and so you have anxiety and that may be caught in when you drive your carbon dioxide down because you're breathing too fast for your body's needs, you get tingling in your fingers and your hands. I'm getting it right now because I've had to talk for two hours straight without stopping. And I have COVID-19, so, you know, I've, you know, yeah, I had the regenerate. I'm not a thousand percent out of, you know, back to normal yet. So, yeah, I'm having those tingling episodes right now.

So let's try one thing. I don't know that I can solve the rest of the problem, but I do have some ideas. And one thing I would want to do on you is an orthostatic blood pressure test. So if you have your own blood pressure cuff, you can do this at home or have them do it in the office. You lay down for five minutes, you check your blood pressure and your pulse. Then you stand up. immediately check after 10 minutes, stand up and check your blood pressure and your pulse.

If your blood pressure drops and your heart rate rises and stays that way, and particularly if you can reproduce these symptoms doing that, then you have made the diagnosis of orthostatic hypotension. In other words, low blood pressure when you stand up. And when you stand up, your body is supposed to clamp down on your blood vessels so that it forces, it increases the resistance to flow in your body, which forces blood flow into the brain. And if it doesn't do that because the autonomic nervous system is moving slow for whatever reason, if you have diabetes or just you're getting older, then that will be an issue. and then you'll feel lightheaded. And if you walk around, you could be lightheaded all day.

You could even faint. So that's one thing. The other thing I'd like for you to try is for the tingling. Let's isolate the tingling for a second because a lot of times you break these things down into manageable pieces. You can deal with it. So if we can prove that the tingling is caused by hyperventilation, then at least you know what that is. and that it's the anxiety from the other thing. And then they just have to work on figuring out what the other thing is.

So I want you to learn the technique of square breathing, and that's we're going to do this together because it's going to help me too. So in square breathing, the theory is that if you inhale 25% of the time and exhale 25% of the time, that means 75% of the time you're not doing either one of those things, or you're not doing the other thing, and therefore you cannot hyperventilate. So a normal hyperventilation is in, out, in, out, in out, in. Well, what we're going to do is in, pause, out pause, and that will form a square, and we're going to do this in four second increments. So we're going to take, you and I are going to do this together, and anyone else

that's having anxiety out there, learn this technique. It will have. help abort a panic attack. It will stop a lot of these physical symptoms of anxiety. Here we go. So we're going to inhale for four beats. Hold for four beats. Exhale for four beats. Hold for four beats. Of course, Tacey calls right now. Okay, let's try that again.

Inhale for four. Hold for four. Exhale for four. Hold for four. Repeat that for two minutes or until your symptoms abate. My tingling is already feels better, having just done that. at the one time. Sorry, I didn't have a cooler sound effect.

I wasn't planning on doing this today. But the technique of square breathing will help to differentiate whether those total body tingles that you're feeling are being caused by the anxiety and concomitant hyperventilation. Now, for the rest of your syndrome,

if you have orthostatic, Hypotension, what I would do with you is a tilt table test where they can try to recreate some of these symptoms by putting you on this tilt table, and a cardiologist will do that, and if they identify a reproducible problem, they can usually fix it. Also, I'm assuming, and this is a big assumption, that they've given you either a Holter monitor or an event monitor, a Holter monitor is an EKG that you wear for 24 to 48 hours that records every single beat, and then they can analyze it and see if you've got any weird rhythm problems. An event monitor is something you can wear for a month, and it only records when

you push a button when you're having an issue. Right now, this sounds like you're having symptoms every day, all day, and if that's the case, I would do a Holter monitor. If it's still intermittent, and there's a possibility we could miss it by putting a 24-hour monitor on, I would give you an event monitor. Okay? All right. I hope that helps. Let's see here.

All right. Hey, Dr. Steve, Dr. Scott. Okay, so I'm 58. I'm in excellent health, but I went on TRT about five, six months ago, and it's been frigging fantastic. Good. Almost no negative side effects at all. Yeah, yeah, yeah.

Even before the TRT, I was in pretty good shape considering, you know, that deficit. When I went on it, however, I got with my trainer and kicked up my workout, so I'm pretty jacked right now, and I'm loving it. Anyway, here's my concern. When I was going through all the initial testing and checkouts to get on the therapy, they asked me at least three times if I had sleep apnea at all. I've never had it, so my answer was no. fast forward about a month four to month four of the TRT and I must say I had about two or three scary episodes of waking up gasping only when I was on my back which is rare because I'm a side sleeper like 99% of the time so I start Googling and I found a few of the top medical sites don't do that really a very weak evidence according to medical science to correlate TRT with apnea the only thing I can see is if you somehow gain a lot of fat around your neck, that could put pressure on you and cause episodes. I'm not that worried about apnea overall because I do sleep on my side most of the time,

and I really didn't gain any fat that I can tell, only some muscle. So what do you think about this? Thanks a lot. Yeah, man. Okay, so these could be two independent things. You could have sleep apnea and hypogonadism or low testosterone and end up, requiring testosterone treatment and the two things could not be interfering with each other

but you know historically testosterone replacement therapy has been considered quote unquote dangerous for patients who already have severe obstructive sleep apnea because it could exacerbate their symptoms it tends to increase that apnea hypopnea

index in other words a number of episodes that they have and decreased O2 saturation And they felt that it was reduced contraction of the airway dilator muscles rather than just neck fat. I mean, if you think about it, you're getting leaner, you're not getting fatter. But, you know, why is there reduced contraction of the airway dilator muscles? There are some mechanisms for that. They're not 100% sure. But you also have increased metabolic consumption with greater oxygen demand.

And therefore, if you're on the borderline with low oxygen, it's going to knock you over into further territory. And then there may be decreased central response, in other words, brain response to lack of oxygen, which increases the number of apnea episodes that you could have. You could have central apnea. In other words, it's not obstructive anymore. It's now central. So these things are possible. So I'm not going to say yay or nay that what you have is caused by your testosterone or any of that stuff. But the second that you start, gosh, do I have obstructive sleep apnea, boom, that is an indication to go get a sleep study.

So just go get the sleep study and see. And you feel good. You're having a good response to your testosterone. I'm not advocating you stop it at all. But I do think that untreated test, shit, untreated obstructive sleep apnea causes some pretty severe disease. So you've got to get that checked. So call your primary care, tell them you woke up gasping. When you're on your back, you're worried you've got sleep apnea and get a sleep apnea test.

And that will, I'll tell you what, it changed my life when I had mine. Now, you may not feel adverse effects. You're not having fatigue and those kinds of things. I was actually falling asleep. When I'd play into work, I'd fall asleep for 20 minutes before I could even get back into work again. And then if I'm typing or if I'm sitting, and every once in a while, like, I'd play music with Dr. Scott. I mean, I know it's boring, but it's not that boring. I actually fell asleep once.

We were recording, and I fell asleep. and my bass playing, I mean, it was, it became very robotic, which was weird. My sleep persona is not very good bass player, but I, you know, it wasn't, he couldn't tell the difference. So it was funny. But anyway, yeah, that's how bad it was for me, but I know it's not like that for you, but I would still get it tested because it may be very mild. And then what they do, if it's mild and positional, you start wearing a t-shirt to bed.

And in that t-shirt, you sew a pocket and in the middle of your back. And in the middle of that pocket, you put a tennis ball, and that will keep you off your back at night. There are other ways to keep yourself off your back. But that's a real cheap and easy one to do. And that may be all you need. but I would not counsel you to do anything other than get a sleep apnea test right now. All right. Let's see.

How much time have we got left? Have we got time? Let's do, yeah, let's do this one. Hey, Dr. Steve. My name is Rich from Philly. And I had a question for you about something I saw on TV, Penn and Teller's bullshit show from the early 2000. Greatest show ever. in the show I can get in line with, but this one in particular was about secondhand smoking,

and they defended that it was not dangerous, and that studies they were using to push legislation against smoking were misrepresented. I was wondering where we were with that today, and if you have any studies that you go to for secondhand smoking, and it makes you kind of wonder your sources and how... No, I know, I know, I know. I get up on things. I appreciate you. Thank you. I was like, this one will be easy.

And then I went and did a literature search, and what you find is there are a lot of papers written by the surgeon general and stuff like that that reference other studies. But most of what's out there about secondhand smoke that the CDC is referencing are white papers that they themselves did. Now, do I think they're biased in this regard? I don't think so. But, you know, it would be nice to have some hard evidence. I found some systematic reviews. These are where they mush a bunch of studies together. And even these are kind of, you know, I would just like some hard statistics.

This is called the burden of disease attributable to secondhand smoke exposure, a systematic review. Sounds pretty good. It's from a journal called Preventive Medicine in 2019. it's not a rag and it said our aim was to provide a systematic review of studies on the burden of disease due to secondhand smoke exposure reviewing methods exposure assessment diseases causually linked to second hand smoke

health outcomes and estimates available to date so then they go on to say that you know they did this big literature review they looked at 588 studies and 94 were eligible 72 were included in the review and most of them were based on comparative risk assessment approach, you know, where you basically what that is is, you know, you just, are, is this population exposed? Is this one not? Is there a difference? And they assessed secondhand smoke exposure using mainly surveys on exposure at home and

workplaces. Can you see why it's hard to just say? Because what we want to know is, does secondhand smoke? cause cancer? Does it cause heart disease? Does it cause stroke? That's what we want to know. And this is the kind of stuff that we have to deal with. There's, yeah, 588 studies. Even these guys can't make it all, make, you know, cogent sense. So diseases more frequently studied were lung cancer, ischemic heart disease, stroke, chronic obstructive pulmonary disease, asthma, breast cancer, stuff like that. And then they looked at some stuff in kids, too, lower respiratory

tract infection, ear infections, asthma, sudden infant death, and that kind of stuff. So they said the secondhand exposure assessment and the reported population attributable fraction. So that's what they're looking at is what is the fraction of people that you can attribute in a population to secondhand smoke. And it says they were largely heterogeneous. In other words, the data was all over the place. As an example, the population attributable fraction for lung cancer varied from 0.6 to 20.5%.

So how can you make any sense out of this? It looks like there were no beneficial effects. I mean, that would be a negative effect, right? So you'd have a negative number. So they were all positive effects. So there is no safe amount of secondhand smoke. We just don't know how much it affects people. So you can pull up a study that says, well, this one says this.

Well, I can pull up another one that says this. I'm not saying secondhand smoke is good. Matter of fact, quit smoking. Don't inhale secondhand smoke. Okay. But what we can't do is point to a definitive study or a definitive systematic review that says this is how much your risk is increased by being exposed to secondhand smoke for these diseases. Now, there are some things about, you know, children in houses where there's smoking and those kinds of things.

Obviously, kids are going to be more sensitive to this. So at the very least, if you're going to do it to yourself, which I recommend you do not. Listen, I smoke three packs a day. I attribute the fact that I've done so well with COVID to two things, the fact that I am, well, three things. I met my ideal body weight thanks to Noom, which you can again look at at Noom.com, and that I quit smoking 25 years ago and regeneron, or a regenerate. Gen Cove. So, anyway, so yeah, it is an interesting question. I will continue to research it, see if I can find anything that's even any more definitive.

You can go to the CDC and read their excerpts from the literature, and they tend to be a lot more dogmatic about it than I am on this, but even at 0.6%. Let's just say that the population attributable fraction of just lung cancer, forget all the other diseases, from secondhand smoke is only 0.6%. So it's just over a half of 1%. You multiply that times the number of smokers or people who are smoking, I'm sorry, the number of people that are inhaling secondhand smoke in this country, and that is not a, trivial number of people who are, can attribute their lung cancer to secondhand smoke. So it's the magic of large numbers, folks. And there you go. So I want to thank everyone who is listening to this show right now. Thanks for hanging in there with us.

We can't forget Rob Sprantz, Bob Kelly, Greg Hughes, Anthony Coomia, Jim Norton. And by the way, I blame Carl from WATP for my COVID. He doesn't have it. I think he gave it to me anyway. Some kind of magic wizard type person. Super genius. And I think he has magical powers and he gave me COVID. I'm sure he just thought it would be funny.

And Travis Teft, that Gould Girl, Lewis Johnson, Paul Ophcharsky, Chowdy, 1008, Eric Nagel, the Port Charlotte Hoare, the Saratoga Skank, Roland Campos, sister of Chris, Sam Robert, she who owns Pigs and Snakes, Pat Duffy, Dennis Falcone, Matt Kleinschmidt, Dale Dudley, Holly from the Gulf, Steve Tucci, times three. By the way, Steve Tucci, the Tucci band had quite the tragedy. They lost one of their members to COVID. The guy was apparently a really sweet guy, great guitarist, great vocalist, and a great friend to my niece and Steve, sadly, unvaccinated, got COVID-19 and expired. So, you know, if for nothing else, just get your vaccine. We'll talk about that next time. It just, you guys know I'm not a vaccine

mandate type person. But what we're treating right now, the sickest people that we're treating right now, almost 100% of those are unvaccinated. So just take that for what it is and get your vaccine. Please, I don't need to lose any more friends of friends. And I definitely don't want to lose any listeners. So check out the great Rob Bartlett, Vicks, Nether Fluids, Carl's deviated septum, Bernie and Sid,

Martha from Arkansas's daughter, Ron Bennington, and Fez-Watley, whose support of this show has never gone unappreciated. And people will go, oh, well, you had the vaccine, and you got it. Yeah, and I did fine. That's why. So, you're right. I got the vaccine. I got COVID, and I'm here to talk about it just a few days later,

and I'm, you know, 100% okay. Listen to our Sirius XM show on the Faction Talk channel. Channel 103, Saturdays at 7 p.m. Eastern, Sunday at 6 p.m. Eastern on demand and other times at Jim McClure's pleasure. Many thanks to our listeners whose voicemail and topic ideas make this job very easy. Go to our website at Dr. Steve.com for schedules, podcasts, and other crap. Until next time, check your stupid nuts for lumps. Quit smoking, get off your asses and get some exercise. We'll see you in one week for the next edition of Weird Medicine. You know,