Weird Medicine: The Podcast - 474 - Total Cement of the Heart

Episode Date: October 7, 2021

Dr Steve and Dr Scott discuss: New therapeutics and a crazy trial no one saw coming Kyphoplasty Gone Wild Loss of Penile Length due to Necrotizing Fasciitis This guy's urologist is a good egg How to talk to your doctor when they stink 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!) Learn more about your ad choices. Visit podcastchoices.com/adchoices

Which Jedi always got his brother's hand-me-downs? Obie 2 Canobi And if you just read the bio to Dr. Steve, host of weird medicine on Sirius XM103, and made popular by two really comedy shows, Obi and Anthony and Ron and Fez, you would have thought that this guy was a bit of, you know, a clown. Your show was better when he had medical questions.

Hey! I've got diphtheria crushing my esophagus. I've got Tobolivir, stripping from my nose. I've got the leprosy of the heartbound, exacerbating my impetable woes. I want to take my brain out. I'm clasped with the wave, an ultrasonic, agographic, and a pulsating shave.

I want a magic pill. All my ailments, the health equivalent of citizen cane. And if I don't get it now in the tablet, I think I'm doomed Then I'll have to go insane I want to requiem For my disease So I'm paging Dr. Steve

It's weird medicine The first and still only uncensored medical show In the History of Broadcast Radio Now a podcast I'm Dr. Steve with my little pal Dr. Scott, the traditional Chinese medical practitioner who gives me street cred with the wacko alternative medicine jackoffs

Hello, Dr. Scott Hey, Dr. Steve. This is a show for people who would never listen to a medical show on the radio of the internet. If you've got a question, you're embarrassed to take to your regular medical provider.

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and stuff you can buy. Most importantly, we are not your medical providers. Take everything here with a grain of salt. Don't act on anything you hear on this show without talking over with your doctor, nurse practitioner, practical nurse, physician assistant, pharmacist, chiropractor, acupunctures, yoga master, physical therapist, clinical laboratory, scientist, registered, dietitian, or whatever.

All right, very good. Please don't forget about stuff.doctrsteve.com. It's what makes the world go around around here. Stuff. Dot, dr. steve.com. You can click straight through and go to Amazon. Why wouldn't you want to do that? Or you can scroll down and see all the lovely things that we've talked about.

this show. And the Flatis Flut will be on there as soon as Son of Chris gets me the embed code. So, but until then you can go to Flatisflute.com. I have nothing to do with that. I just think it's hilarious. And then Dr. Scott's website at simplyerbils.net, simplyerbils.net. And then, I guess that's it. Yeah. We have tweaked audio.com. Offer code fluid for 33% off the best earbuds for the price. All right. Very good. All right, sir, are you ever, oh, you did change the camera. So we're trying to do this live stream. And I'm kind of, you know, Matt Kleinschmidt from the laugh button has been saying you need to do it.

And Carl from who are these podcasts been saying you have to do it. Vinny from the creep off. I've been saying, and so all people, certainly I respect in this business, all saying you need to do it. Eric Zane. So we're going to try it. Let's do it. And we'll see. Yeah.

So it's kind of fun. You know, I've got three 4K cameras in here. I have no idea how it looks out there, trying to use a little OBS to broadcast. That was Vinnie Paolino's idea, an excellent comedian, by the way. And there you go. So here we are. You got anything at Simplyherbalst.net these days? I ask you that every time.

It's like, oh, boy. Well, you know, nothing new, nothing new. All right. So you have a couple of stories. I have a couple of stories. Then we're going to take blind phone calls because I do not have any, I did not do any show prep because I am still getting killed at work. So anyway, I've got this article from The Lancet. I don't even remember what it is.

So I'm just going to plug the, that's great. That gives everybody a lot of confidence. I care about you to the point. Okay, so I thought this was very interesting. I've been preaching on this show since day one of this stupid pandemic that therapeutics going to be where it's at. Right. In the end, vaccines, yes, powerful tool, but the thing that will let us go back to normal, particularly if this coronavirus does what all the other coronaviruses have done and become endemic is we need therapeutics. Because that keeps people out of the hospital.

If we could keep people out of the hospital with therapeutics, then they don't, you know, end up on the ventilator and they don't die. We don't overwhelm the system and people don't die. That's the way to go. So vaccines will prevent that, but we've already found they're not perfect. Obviously, they're not perfect. None of the therapeutics are perfect. We need every tool at our disposal.

But having a pill that, that we can take as an outpatient where you get COVID-19 and then you go to your doctor and they diagnose you, you get a prescription, nobody's freaking out because the pill works so well, keeps people out of the hospital. That's awesome. So Molnupiravir, I talked about Fava-Piravir, gosh, I don't know, 18 months ago, and I really thought that it was going to come out not this last June, but the June before. but it didn't.

We were all focused 100% of our energy on vaccines at that time. And when we go back and look at this, I just wonder if therapeutics were kind of pushed to the side. I know there were a lot of clinical trials going on, but it just didn't seem to be that the push for therapeutics that there was for the push for vaccine. But vaccine's very important. Don't get me wrong.

So. Right. So Fabapyrivar didn't come out, but its first cousin, they're kissing cousins, you know, God knows what they do, you know, at family reunions, but it was Mulnupiravir, and Mulnupirivir is probably going to get FDA approval pretty quickly. It's not the panacea we were hoping for, but in the study that they did, it reduced hospitalization by 50%. In other words, in the group that didn't get it, 14% went to the hospital, and the group that did get it, 7% went. And in the group that didn't get it, several people died. And I can't remember the exact number.

I'll pull that article up in a minute if we need to. But in the Molina-Pirovere group, zero people died. Now, it was not a big enough sample size to prove that it 100% prevents mortality. But it is very interesting, and it was statistically significant, if I remember correctly, from the study. Now, the study, yes, it was done by Gill. by, sorry, by Merck, and therefore, there are people who find it suspect. I get that. The thing about it is, is that to apply for FDA approval, you've got to do the damn

study yourself. You have to. You can't rely on someone else's study to do your FDA approval. So there will be more studies and over more time, and we will get some idea of how awesome or, you know, less so than this stuff is. It seems to be very well tolerated right now. Good, good. And, okay, so that's number one.

Number two, because I said on this show, we're not going to talk about COVID-19 anymore unless I've got some real news. Number two is a study, and I just, I wish I had a, you know, oh, drop on this thing. I'll give them this, but, well, that doesn't count. Wait. Give yourself a bill.

But I'm going to give them at this. at the same time, I'll give them one of these. And the reason for that is that they finally did a study on remdesivir on people before they go to the hospital. We've been so focused on the critically ill, which we should. No question about that.

We need to try to make them better and get them to survive once they get to that position. But they finally did a study on people before they went to the hospital and they showed, you know, around a 50 to 60%. If you'll look up that one, it's early Remdesivis.

severe study. And they showed a decrease in hospitalization there as well. So we have now, that hasn't hit FDA approval yet, but that should be easy to get to just change the indication. Instead of for the critically ill hospitalized, they're going to change the indication and also include people who are not yet in the hospital. So when this is done, we will have three that are proven to work, which is Molinopiravir, then the monoclonal antibody, and remdizivir. Now, you'll notice two of those, well, all three of these are new and people, you know, they can sell them for a lot of money. People will say, well, what about Ivermectin, which you can just buy off of the shelf?

the multi-center double-blind placebo-controlled study for that is still pending. And I have not seen the data yet. We've got a lot of small study data. Some of it's good, some of it not so good, but still worthy of investigation. And the last time I checked on clinical trials.org, there were still about 70 studies looking at Ivermectin. So people are looking at it. I don't want anybody to think that they're just pushing that to the side. And if it works better than these things,

hell, yeah, we're right the hell out of it. And I'm going to give you one. Yep, yep, yep. Write the F now, and this is what I'm leading up to, that is something off the shelf that looks pretty damn good. Oh, cool. And this is from e-clinical medicine, and this is an online first thing.

It was published September 9th, and it's the effects of adging, I'm sorry, adging, adding, El-arginine orally to standard therapy in patients with COVID-19, a randomized, double-blind, placebo-controlled, parallel group trial. Give yourself a bill. That's the right kind of trial. Now, this is results of the first interim analysis. So what they did was L-arginine is just an amino acid. You can, hell, you can buy it at GNC.

Oh, yeah, yeah, any pharmacy. And it's, remember, we've talked about trying to prevent herpes recurrences using lysine because the herpes coat is polyurginine. And lysine and arginine kind of look similar to these enzymes. And so when you overwhelm the body with lysine, the hypothesis is that the virus will have a harder time to build itself. If there's more lysine than there is arginine around. Well, anyway, so we may find if people do this that they get herpes out, right? Who cares if you don't die?

Right. I don't think so. I'm not saying that that, but it would, you know, we don't know. You know what you mean. You never know with these things. So it says endothelium, that's, you know, the tissues, the very small tissues on the inside, that line things like blood vessels and stuff like that. Primary target of severe acute respiratory syndrome, coronavirus 2. a.k.a. we call it COVID-19, but the virus is actually called SARS-C-O-V-2 or SARS-CoV-2, whatever you want to call it.

The syndrome that it causes is COVID-19. And L-Urginine has been shown to improve endothelial dysfunction. Okay, oh, that makes sense. However, the effects of L-Arginine have never been evaluated in coronavirus disease. So they did, as I said, a parallel group double-blind randomized placebo-controlled trial people who listen to this show all the time. No, those are the magic words. Conducted on patients hospitalized. Now, this is one for people with severe COVID-19. Again, maybe they'll do a study on people who are not so severe. But the endothelial damage is the thing that really makes people severely ill.

That's part of it anyway. Patients received 1.66 grams of L. Arginine twice a day or placebo administered orally. So these had to be people. that either had a, you know, a nasogastric tube, in other words, a feeding tube, and they were on the vent, or they were not yet on the vent because they could take pills. And then the primary endpoint was reduction in respiratory support assessed at 10 and 20 days after randomizations. Secondary outcomes were length of hospital stay, time to normalization of their white blood count, and time to obtain a negative PCR test.

So remember we've talked about these studies, you have to have a primary endpoint. You can have secondary endpoints, but the primary one is the one that you're looking at. So, for example, when they were studying sildenafil, which is the active ingredient in Viagra, the primary endpoint was reduction in hypertension. Right. But they had this magical secondary endpoint, which was. An incredible side of that. They came up later.

They had to add it to their study. And then they finally had to do a primary study on erectile dysfunction that said, hey, we're not looking at, we're going to consider low blood pressure a side effect now. Good. And the primary effect is the, you know, the meaty, delightful, tasty erections that you get. Perfect. Okay. Perfect. All right.

So let's just look at the results at, okay, so no treatment, emergent, serious events were attributable. to El Arginine, that makes sense because it's just an amino acid. At 10-day evaluation, 71.1% of patients in the L-arginine arm, and 44% in the plesimo arm had the respiratory support reduced. So in other words, and this was statistically significant with a P of less than 0.01, so the odds that this would be random would be one in a thousand. You know, it just happened by random chance. A significant difference was not detected at 20 days, however.

So there may have been a difference. I've got to look at the data, but it wasn't significant at 20 days. So that's for people who stayed in the hospital that long. They were sick enough. You get somebody that's going to be in there 50, 60 days. El Arginine probably going to help them very much. But here we go. Strikingly, patients treated with L. Arginine exhibited a significantly reduced in-hospital stay versus placebo.

with a median of 46 days in the placebo group versus 25 days in the L. Arginine group. These findings were confirmed after adjusting for co-founders, including age. See, I love these guys. They're doing all the right things. If you had more elderly people in one group than the other, that might skew your data. So you've got to normalize those things. You've got to account for that. Duration of symptoms, comorbidities, in other words, other diseases like emphysema, heart disease, that stuff.

D-dimer, it's a blood test we do that is positive when you have a blood clot in your body, but also positive other times as well, as well as antiviral and anticoagulant treatments. The other secondary outcomes were not significantly different between groups. So very freaking interesting. That's pretty cool. So in this interim analysis, so when you're doing a double-blind placebo-controlled study, you have to have someone who's paying attention to the data to make. sure if you're killing someone that you stop the study, but also if it becomes unethical

for you to continue because they're doing so well in the treatment side, they'll stop the study. Okay. Can fast track it kind of. Yep. And that's what happened with the original Remdesivir. It became unethical for them to continue with the double-blind placebo-controlled trial, which which is why they never got enough people to do mortality data in a placebo, in a placebo environment. Okay.

Because, you know, they were showing that people were getting better. Right. It was statistically significant to the point where now it was unethical, but they couldn't continue the trial long enough to get enough people to show that the decrease in mortality was statistically significant. There was one. They just couldn't prove it. Okay. Okay.

That's cool. All right. So, L. Argenine. So, you know, we're always talking about off the. shelf things like hydroxychloroquine, zinc, which zinc does reduce colds. It was on my boards today. I took boards today. And it was a guy who came in with cold symptoms, calm and cold, cold, clear, runny nose, dry cough, no fever, and nasal congestion.

and he wanted to know what would reduce what was the most likely thing he could take to reduce the duration of symptoms because he had to give a big presentation in three days. And the answer was zinc gluconate. Wow. Oral zinc gluconate because it's the only thing that shows there's been some clinical trials that show it can decrease the duration by about a third. So if it would have been, you know, 10 days, it would be seven days instead. Okay. Or if it's going to be six days, it would be four.

So, you know, it could be significant. And that's the only thing that we've ever showed that did anything with common cold. Interestingly, common colds, many of them are caused by coronavirus. So I have predicted a long time ago, it's not just me, but that this coronavirus, once our generation is dead and gone, and this, you know, my kids and people younger than them grow up, They'll get hit with this again. It'll just be a cold for them. Right.

And then their kids, it'll just be a cold for them. And then this will be an endemic virus. This will be the sixth circulating coronavirus until the next shittin, novel one comes out. So death to all viruses. I still advocate a Manhattan project, moonshot style effort to destroy human pathologic viruses. I haven't had a single person give me a reason not to do that. Right. There are some beneficial viruses out there probably, but those aren't the ones I'm talking about.

I'm talking about Ebola, measles, chicken effing pox, which is, you know, more of a lifestyle thing. Coronavirus is big time, those kinds of things, you know, pathologic viruses. We already killed smallpox. No one's mourning the extinction of smallpox in this world. world. Now, why was it so easy to do that one and harder to do these other ones? Because we all know that there are asymptomatic carriers of, you know, SARS-C-O-V-2. There are no asymptomatic carriers of smallpox. That's the great thing about it. So when you have a case, you can see them. You call whoever the, you know, the world smallpox elimination council. And they come and vaccinate everyone.

one around them. So the two things that smallpox had in its favor for marking it for extinction was, number one, it was a shitty disease. It killed a lot of people, so we were paying attention to it. Number two, no asymptomatic carriers. And number three, the vaccine worked really fast. So you could vaccinate people around and just build a wall of immunity around that person. And so, you know, 70% of the time they would survive, nobody else would get it. And then you just stopped it right there. So Ebola and Marburg and those seem to have, as

far as we know, no asymptomatic carriers. Right. And they kill the hell out of people. So we should be paying attention to that. Yeah, really quickly. Now, if we can come up with the vaccine, that's where these MRNA vaccines were first, you know, developed were for things like Ebola.

Didn't work so good in that, but they're still working on it. So if they can get a rapid vaccine that works to prevent it. We can build moats around people. Then the next thing we've got to do is figure out where in the hell Ebola comes from. They still don't know. Is it bats? Is it

somehow from the water? Snakes. Who the shit knows? But once we figure it out, we're going to get them too. You know? And we'll just vaccinate them. You know, we don't see rabid foxes so much anymore

because they'll throw food out that has rabies. vaccine in it and you know I remember back when rabies was you know a stray dog in your neighborhood was considered a monster yeah you know and I have friends from India in places where they don't vaccinate and they feel the same way wow you know and I you know it's not just India there are other countries but countries with large rural populations where they're not vaccinating against rabies then you know a stray dog I mean you always teach all your kids don't ever go near them.

Right. You know, and then if you see the commercials that they had. Foaming at the mouth. Oh, my God. When I was a kid, I still, I had nightmares about this rabies commercial that they had with this guy walking down the stairs and then they go, you know, the flights had flashed and they'd start foaming at the, and it was black and white. It was that, it looked like later on, I realized what it was, is that, you know, that sort

of weird gray black and white that George Romero used in Night of the Living Dead. how creepy it was, particularly at the beginning when they're in the graveyard. That's what it looked like. Or if you want to go back, go back and see Mickey Spillane movie from the 50s called Kiss Me Deadly. It looked like that. It was just terrifying to a four-year-old kid. Oh, gosh, yeah. You know, it was in 1959.

And, again, had a friend of mine in grade school, kindergarten, who died from measles. that was pretty effing creepy. And then the vaccine came out for measles, and we all jumped on it, particularly at my school. Yep. You know, because, yeah, we had a friend who died from it. So, anyway, a fan of those kind of vaccines. Shoot you. For people who say, oh, he's a vaccine.

She chills the vaccine. I am not a fan of the Veracella vaccine. Period. I think it's a dumb idea, and I don't see the value. And I've talked about it on this show before. I guess, you know, I could give it two seconds just to have some credibility. But, you know, unlike measles, chicken pox very rarely has severe side effects. I'm not going to say it never does.

But my concern is they're vaccinating kids when they're young and then they're not giving them boosters. And we don't know if, whoa, what in the shit was that? How is that? Okay. And we still, I could edit that out, but it'll ruin everything. So I'm just leaving it in. So we don't know that that immunity lasts through adulthood. And if you get chicken pox when you're a kid, it's no big deal, sort of like COVID-19.

If you get chicken pox when you're an adult. Well, it sucks when you get it as a kid. Yeah, yeah. Well, it does. But, you know, I don't remember it. Oh, damn, I do. I mean, I remember having it, but it's not like I remember laying around suffering. You know, I just don't remember that.

I had it at Christmas. I remember I couldn't come down and all that kind of stuff, but I did get a Mr. Machine go look that one up. I had it on the bottom of my feet. Oh, yeah. So I had to walk on my knees. Oh, God. It was terrible. Oh, my God.

Well, anyway, that was just from your parents hanging you upside down, slapping you on the... Probably so, on the head. On the souls. Yes. Just to teach you a lesson. And then they told you, oh, it's chicken pox. You have chicken pox. Now, that may be right.

I'll probably have a dream of that tonight. Thank you, Dr. Steve. I love it. But, yeah, so when you get chicken pox as an adult, it sucks. And if you're a pregnant adult, it sucks for you and for the baby. So I am concerned about that. I would like to see some data that shows that we're not seeing adult chicken pox. And that'll be over the next 10 years is when we'll really start seeing it if we're going to see it at all.

So, anyway, all right, very good. You're checking out the chat room? Yeah, we got a bunch of friends today. Yeah, well, just keep an eye out. And if you do, just say something. Sure. We probably should take some. Did you have a new story, didn't you?

Yeah, I actually had a good one, yeah. You had a penis one or something, right? No, no, no, I thought it was a penis one when I first looked at it. No, but this, it's crazy. You're supposed to bring penis stories. I look for penis ones, but there were no good penis ones. Okay. You said that last week about vagina ones, and then I found like 20 of them. So penis in the news. Hey, are you going to let me do my story? Yeah, yeah, go ahead. It's actually a good story.

Okay, okay. A man was having chest pain, then the doctors found a four-inch piece of cement in his heart. What? Exactly. So after two days of chest pain and shortness of breath, a man went to the ER. When he started doing some studies on them, they found a four-inch piece of cement piercing his heart and right lung according to the, it was in the New England Journal of Medicine. How the hell did this happen? Dr. Steve, this thing looks like a damn. I don't need to see it.

I trust you. It looks like when I first looked at it, I thought it was a tape for him. Really? Yeah, it's four inches long, kind of thin and long. Yeah, it looks like Omuamua, the elongated asteroid that came through the solar system. You know what I'm talking about? Nerd alert. Nerd alert.

No, no, you know, it looks like it looks like it looks like it looks like it looks like it was an alien spacecraft. It looks like those bones that people run through their nose kind of. Yeah, okay, sharp on both ends. Yeah, sharp on both ends. So, interestingly, the cement had leaked into this guy's. bloodstream. The cement. Anybody who's not from around here is already he-hawn.

Is that cement paw, Uncle Jed? A cement balling. Okay, so the cement, how did it get there? The cement had leaked into this guy's vascular system. How? Following a kifoplasti. Shocking. What?

And they said this is not the first. Okay, tell them what a kifoplast is because nobody knows what the fuck is. Yeah, so a kifoplasti, a lot of times will be used when people have a compression fracture in their vertebra in their spine. Yeah. So the spine is like a bun. of balsa wood blocks and sometimes one of them will crush just like if you put enough weight on a bunch of balsa wood blocks one of them may crush and it hurts like hell and typically it's in the

middle the middle of the middle of the thoracic spine so right in the middle of your back kind of between your shoulder blades yeah that's typically where it happens and in dr. Steve you know we see it a lot with um an osteoporotic um older females than older males who have tell them what osteoporotic means you got quit using all this jargon they have you know i talk to my all my medical students and residents about not using you know words that are the public don't use i have to guide dr scott in that way too i need a lot of guidance thank you but um but the um but so our osteoporosis is just a deteriorating um bone disease so the bones getting soft right the bones getting soft and and what's probably happened in this gentleman is his bones got a little soft

he probably got a little compression fracture so what the neurosurgeons will do and maybe some spinal orthopedic surgeons will do they'll like likes to go in with a big needle, and they'll go into that actual bone itself, and they'll shoot this cement. I thought it was just resin, though. Isn't it just epoxy? Well, it's like a cement. I don't know exactly what it's a man.

It says a pasty compound called PMMA, a type of bone cement? No, you're right. Okay, I'll give you one of these. Give yourself a bill. You were more right than me. Well, once every 15 years. But it normally works pretty well. The cement is supposed to stay inside the vertebrum.

It solidifies just like you would have a foundation. It's stabilizes it. It's just like if you're going to put a new block under one corner of your home, it's sagging. And that's what they did. But somehow, and evidently, this has happened before. How the, hell, I have to get in his heart. My guess is whoever put it in. That's what we want is the guess of an acupuncturist on how this is.

Hey, I'm just kidding. I know more than your average. Yes, you do. Yes, you do. But anyway. It's hard. It's hard to say, but the guess is probably when, if the bone may have been softer than what they thought, and when he injected it a little bit too much force, maybe it went

through the backside of it. They just couldn't tell. It's inside his heart, though. It was literally pierced his heart and lung. Oh, oh, it pierced it. Okay. So it was outside of it and then working its way into it. Yeah.

Isn't it crazy? Oh, God, I bet that hurt. Yeah, there are no images of that, but they showed them removed. The removed, pierced Pek-O-Kong. So if you go past, okay, so let me describe the procedure and then we can, I think we can figure out a way that this might have happened. Because I know when they taught us how to do lumbar punctures, a lumbar puncture is where you're trying to get fluid from the spinal canal. And you need to go between two vertebrae to do that, right? And so you've got those bony knobs, we call them spinous processes, and they kind of point down.

And so you have to sort of aim up to get into that. And what they always taught us was if you get pulsatile blood back when you do that, you've actually missed the canal and you've gone into the aorta and to, you know, make excuses really quick. Call for help. Yeah. So let's see here. It says spinal compression fractures occur primarily in spinal vertebrae that have been weakened by osteoporosis, just exactly as Dr. Scott said.

they typically occur in the thoracic regions, so that'd be between the neck and the low back, but can occur in the lumbar spine, which is in the low back. So the goals are to reduce pain from the fracture and stabilize the vertebra, just as Dr. Scott said. So what the neurosurgeons tell me is it's the microscopic movement of these fragments in there that actually causes the pain. And so the hypothesis is that when they stabilize all that, the pain will get better. So the patient lies face down on the operating table, and the surgeon makes a small half incision over the affected area. And then using x-ray guidance, the surgeon inserts a narrow tube through one part of the vertebrae into one side of the fractured vertebrae. And then when they do a thing called a balloon kipoplasti, there's this balloon tamp.

is inserted through the tube, and they inflate to create an open cavity inside the bone and restore the height to this collapsed vertebrae. Then the surgeon deflates it, removes the balloon tap, and then they put this compound called PMMA, which is bone cement, and is injected into the cavity until it's full. It hardens quickly. I guess it's kind of like dental cement, creating an internal cast of the fractured vertebrae. And then you can do that on the other side as well, so that's on one side. of the vertebral body.

Now, in other forms of kifoplasti, other surgical approaches for creating the cavity can be used like a net or a ball or something like that. Then they close the incision, and then you stay on the operating table when the cement hardens, and it takes like five minutes,

and you usually can go home the same day. Yeah, it's pretty quick. So that's pretty cool. Now, so if you could stick a needle all the way through into someone's aorta, I could imagine that you could miss the area where you thought you were and inject it into an empty space

and when you do that and you're pulling it back out you're going to make a long thin thing right right so you push it in and then as you're pulling it out you get a long thin sort of tube and now this cement is just in there and where's it going to go it's just going to start moving around

and if it moves forward in that area it's going to hit the heart and the lung so yeah that makes sense how that happened when you first brought it up, I thought it was actually inside the ventricle of the heart and was like, how the hell did that happen? No, it wasn't your fault. It was just the way I imagined it. So,

if you all want to see how this is done, just Google, go to YouTube and Google kifoplasti. K-Y-P-H-O-P-L-A-S-T-Y. That's a good one. Good one, huh? All right. Almost as good as the penis one. Well, I got a penis one. Oh, God. Here we go. Prostate cancer patient who lost their penis to a flesh-eating bug

wins six-figure National Health Service payout this for our friends over the seas, overseas. The surgery left this 63-year-old with just an inch and a half of his penis

and no muscle in his stomach. Oh, my Lord, this poor guy. It was a cancer patient contracted a flesh-eating infection after routine operation and was left with just an inch and a half left of his penis and he got six-figure

some for the National Health Service at Southern University Hospital, NHS Foundation Trust in Essex. By the way, for our British fans or listeners, I do love the Essex accent. It's admitted that a delay in diagnosing potentially deadly necrotizing fasciitis left him with life-changing injuries. So, yeah, necrotizing fasciitis is when bacteria get in some of these layers under the skin and they can just move up and down wherever they want to go. and they just eat away and the skin just slaps off. And if your penis happens to be in the way, you will end up with an inch and a half of penis. So Dr. Scott just told me there are no good penis stories.

That's not a good penis story. It's a horrible penis story. It's a horrible penis story. It's a good one for this show, though. All right. All right, you got anything else? Nope. All right.

So this is what we're going to do is, wait, penis extensions do not work and should almost never be carried out. Okay, wait a minute. Let's see this one. Okay, penis extensions do not work and should almost never be carried out. Who is saying that? It's in quotes. Surgical and non-surgical procedures to increase the size of men's penises do not work and carry high risks.

New research suggests, according to a review published in the journal's Sexual Medicine Reporting, not only are the majority of these treatments ineffective, but they could lead to severe complications, such as permanent numbness, I don't like that, penile deformity, well, it depends on the way it's deformed, shortening, not good, erectile dysfunction, not good. It also says most men are unhappy with the results following treatment. So they did a systematic review. Now, remember, a systematic review is where you take a bunch of studies and then you mush all the data together, but you try to get all of it that's regarding your topic.

So it's slightly different than a meta-analysis where you want to get everything. So they included 17 studies assessing a total of 1,192 men. And studies with fewer than 10 cases were eliminated from the review. So non-surgical treatments included extenders, injectables to increase the girth. We've done that story where people were injecting like lip filler around the circumference of their penis to give themselves that sort of ribbed. feeling. Don't do that. Don't do it. No.

And vacuum devices, which are also used to treat erectile dysfunction. They do work for that. Probably don't work to extend the size of your penis unless you're talking about the difference between your flass and an erect penis, then that's fine. Surgical interventions, oh, included suspensory ligament incision. Okay, this is one of those things where they go above the penis itself, and there is a ligament that when you have a really raging erection, you know how it points kind of up or, you know, out and up, but mostly up, when you, there's a ligament, the suspensary ligament that holds it up. So if you cut that, then it will increase the penile lengths by about an inch because it will just kind of come out of the body. But it will always point down to the ground. You'll have to lift it up. Pointing it all way. Yeah, yeah.

Tissue grafting, and then, oh, listen to this one, penile disassembly. I don't like the sound of that at all. And these treatments count up to cost up to 40,000 pounds, which is, I don't know what that is. And what's 40,000 pounds in, okay, Echo, what's 40,000 pounds in U.S. dollars? She'll tell us. 40,000 pounds is 54,347 U.S. dollars in 83 cents. So it used to be around $2.50 per pound, and now it's about, what, a buck 10, something like that? Yeah, something like that, right?

Yeah. So anyway, so these treatments can cost up to about $54,000. Some are available with the National Health Service, but only for clinical reasons, i.e. to repair bodily trauma rather than cosmetic ones. So let's see. Those seeking penile enlargement are sometimes diagnosed with a psychological condition called penile dysmorphia, i.e., they perceive themselves to have a small penis when, in fact, a normal length. Remember, the normal length is 5.5 inches as measured from the base to the tip of the erect penis. So, you know, it used to say six inches, and people, you know, there were a whole lot of people going, well, wait a minute, I must be below average, but no, you're exactly average if you're 5.5 inches.

anyway so there you go so a lot of not highly recommended doing penile extensions well just because it doesn't seem to work very well and people are not happy with the results all right so one thing that we have is

we've got a bunch of voicemails and I haven't screened any of them oh no here we go yeah here we go with this so I was thinking that we could just play the damn things and see what happens let's give it a shot motion detected at the front door Okay.

I got to do something about that. All right, let's see here. There we go. Let's try this guy. Hey, Dr. Steve. Dustin's in California. Hey, I just got my ball sniffed yesterday. Yeah.

Still sitting on the couch. I'm watching your life feed right now. Oh. Hey, Dustin. The swelling. I don't mind the swelling. It looks pretty good. But they use the laughing gas on me.

And I got all tingly. Okay, I'm going to stop you right there. Your urologist is a thousand times better than mine. Yeah, and mine took a daisy razor, dry, scraped my nuts, stuck a needle in the Vazdephyrins, and said, oh, this is going to feel like I'm shooting it into your testicle, and he wasn't wrong, and then we went on from there. I would have loved to have had some laughing gas,

because I do love me some laughing gas. Anyway, and yes, it makes you feel all tingly, and Chanda, who we've had on this, show did a thing where she took a protein-enrich plasma and injected into my scalp to see if she would make my hair grow more, you know, just make it thicker. And she did laughing gas when she did that. And I felt all tingling know exactly what he was talking about. But every time she stuck the needle in my scalp, I saw fireworks go off.

It was the coolest thing. It was like, oh, fireworks. That's how well. Yeah, I love fireworks. Okay, anyway. I was cracking jokes, and I don't know if the urologist and them or whatnot were They weren't laughing at my jokes. Maybe I just wasn't funny.

Yeah, that's usually what it is. You think you're hilarious. You think you are. But probably not so much. Or they were paying attention to what they were doing, which is probably good. Something. But anyway, it was quite the experience. And you mentioned when you got yours, your sniffed that kind of gave me the confidence to go in there and get it done.

All right, man. I told my wife, this better pay off. So anyways, thanks for the show. and thanks again for helping me get through yesterday and going in there with confidence. Hey, I'm glad. Good, good, good. No, hey, good for you.

It really isn't that, you know, we make fun of it, but of our experience having it done because, you know, we can because it happened to us and we can make fun of it. But I never want to do that to the point, you know, to the point. You know, we're trying to normalize it. Right.

And we want people to realize it's not that big of a deal. because if two wimpy ex-hippies, like, we can do these things, then anybody can do it. And, you know, it's just like that picture of me, if you Google or YouTube search Mando Birch, I think it's on our channel, and Dr. Steve, you can see a picture of me when I was 21. And I will pass that driver's license around when I go to my kid's career day at school. And I'll say, listen, if that idiot can go to medical school. anybody in this room can. I don't care how goofy you are. So, but it's the same kind of thing.

And, you know, we got through it. It wasn't that big of a deal. We got over it. If I can give Dustin one piece of advice, definitely get the hard catcher's jockstrap. That's what it's called, right? I mean, what do you call it? It's a cup.

Cup, yeah. But it's the thing that's the catcher's way. You have to have jockstrap to hold you kept in place. Right, right, right. Okay. Got to have a both. Well, mine was integral to the, to the thongy thing.

But anyway, get a cup, and then you can sort of walk around with impunity, because for the next few days, if anything touches your, that part of your, the junkle region of your body, it will be an experience that heretofore you have yet to experience. And right now, if the numbing hasn't worn off, you think, hey, I'm good, but it's going to, it's coming and uh but it lasts a couple of days there's no big deal i went to work i think i took one day off and went to work wore the cup i was fine uh frozen peas wrapped in many layers of paper towels or you know just a regular towel just you don't want to give yourself frostbite that would be stupid and then you would really then it really hurt yeah yeah so hey congratulations of dust

and that's cool dude all right so yeah we actually got a call straight from the live stream, and it was a good one, so maybe we should do this more often. All right. Okay, doke. This one looks like it's, I don't know who this is. This looks like it could be Tracy from Louisiana, I think. Let's see. What's the best way to pick a new physician by people's personal reference or going through your insurance company to make sure that that doctor gets paid?

Well, that's an important one. You don't want to find the best doctor in the world, then find out you've got to pay cash unless you're rich. If you're a celebrity, you don't care. But you want a person that has the best word of mouth and forget health grades. I go on and goof on my medical school classmates health grades all the time, and they do it to us. I mean, everybody does it to each other. And then a lot of the reviews that are negative are people who didn't get their own. lower tabs that they wanted and they're the ones that'll go on health grades and give somebody

a review so don't pay any attention to that I think those websites are completely worth us talk to people who you know who are around you and say who do you like someone say I hate my doctor well don't go to that person unless they hate them for a reason that would make you like them you know like I go in there well I can't think of a great scenario but you can you can think of a great scenario where somebody would say I hate that doctor because of X and that makes you actually want to go see them. So I hate, you know, anyway, like I said, I could think of 100 inappropriate ones and a couple of decent ones, but you know what I mean.

So, but word of mouth, and then you just check them out. And remember, you can vote with your feet. If you get in there, you don't like them. Go somewhere else. Take your business elsewhere. If the front office is crummy to you, go somewhere else. But, you know, give them a chance to fix it, though. You know, if they're crummy to you, if they're rude, they may be.

be they're having a bad day. You talk to the office manager, say, hey, they kind of treated me kind of rude out there. And most of the time, the office manager will go, oh, gosh, you know, I'll take care of that. Let's get you back in here, and we'll do better next time. And if they do that, then heck, you know, go ahead and go back. Okay, how can I shut her up when she does that? It's people dropping packages off up front. Anyway, all right.

So, let me see. Here is Albert from Albuquerque. Let's see. Okay. Oh, well, the first thing he's going to say is something we have some news about. Cool. Hey, Dr. Steve. It's Albert from Albuquerque.

How are you doing? Good, man. How are you? Great, great. Hey, listen, I miss Tacey. But I heard your episode today, and you're talking about Patreon. And I'm not sure, but I'm thinking you're talking about prostitution. But I can't be certain.

No, no, no, no. No, no. No, we're going to, we're not going to OnlyFans. We're going to Patreon, and it is just to let Tacey be on the show again. And she can only do it on Saturdays, so we figure we'll do the special edition on Saturdays, and we'll throw those up on Patreon. And it'll be real cheap, real cheap, not a dollar. It'll be slightly more than that.

And we'll do like three shows a month, and it will be no ads and nothing but just. Tasey drinking and talking. Tacey drinking, yelling at me about stuff, and then we'll just do phone calls. So we're going to try it and see. But, yeah, that's what that was about. No, it's not prostitution. Thank you. That's for other former radio people to do.

And not prostitution, by the way. But, you know, only fans, a whole other thing. That's not what we're doing. I'm not talking about anybody in particular. Trying to earn some money on her. Anyway, I turn up. Okay, yes, I may be, I may be guilty of that, yes. I go back to an issue I've had ongoing for a while.

I had an extremely elevated testosterone, they thought. So I went to an endocrinologist, did not get a good feel for that person's communication skills, let's put it that way. Okay. So I chose to go to a second endocrinologist and get a second opinion. It took me several months to do it because I went to a teaching hospital and it took a... Let me throw them one. One thing out here on this, you don't have to like your specialists.

They have to know what they're doing. You have to like your primary care and people that you see frequently. But if you're just going for a consultation, you don't have to like them. I counsel people. Listen, you've got to like me. You don't have to like this person I'm sending you to. So if that helps any. But anyway, so he went to a different place.

A little while. Yeah. But I got the great explanation that I wanted from the person that I talked to, the doctor I talked to yesterday, related to free versus total testosterone and the concerns and the correlation and causation of elevated PSA related to free testosterone, not total. In any event, the long and short of this is it doesn't appear like I probably have any kind of an issue. I probably have a naturally high sex hormone, which is binding the testosterone and resulting in a high test. However, it was a little bit disturbing for me to go through this process.

and have to get my first, second opinion from a doctor in 60 years. Yeah, I agree. And I figured maybe you should take a minute or two on how we should feel about talking to our medical community and our doctors. Because I know I felt a little awkward in challenging my doctor when I didn't get a good vibe on the first endocrinologist. I think it's totally fine. Listen, even if the insurance company is paying for it, you're paying for the insurance. This is your body, your life. to pick. You have autonomy. The number one principle in modern Western medical ethics is that patients

have autonomy. In other words, they have the ability to make their own decisions about their health care. To do that, you have to be fully informed about your health care. That's a whole other thing. But you get to make this decision. So if you go in and for whatever reason, you just get a bad vibe, you can just, again, vote with your feet. I usually counsels. to speed things up because of the problem you had was once you went to get the second opinion, it took forever to get one. To try to get that relationship to work if you can.

Yes. And sometimes you can talk to somebody, and it's usually the office managers, the one you want to talk to. And if they just blow you off, if they get all defensive and stuff, fine, then get the hell out of there, you know, and go get a second opinion.

But you deserve to be treated with respect. I went to a consultation many years ago when the computer thing was first starting, and the doctor's computer was set up so that he could not do anything without turning his back completely to me. I was looking at his back the whole time, and then he would sort of shout questions at me and then be putting stuff in the computer. That sucked. And you know what really sucked about it? It was somebody I knew. Oh, wow.

Yeah. I mean, I've known this person. forever. And I think we either trained together or I trained right under him when he was something like that. I can't remember. Or we came at the same time. Not, no, not

the, you know, we came to this town at the same time. Right. But anyway. So, yeah. So, yeah, you deserve all of those things. You're paying a lot of money. Healthcare in this country costs a lot of money. And you deserve to be treated with respect

if you don't like it, how they're treating you, get the hell out of there. But to summarize, give them a chance to fix it if they can, if it's fixable. Yeah. Because you never know when somebody's seen just previous to you as far as clinically. It shouldn't matter, but we are human beings. It shouldn't matter, but you just, sometimes, it's just a bad day. Yep.

Yeah, I'm looking, Sean in the chat room talking about the post-vasectomy pain said frozen peas are the key. Dr. Scott, okay, Richard says I had a test today. My teacher said it was a vast deference from my other taste. Well, that's pretty funny. Hey, hey, that fellers again. Oh, boy. Unbelievable. All right, you got anything?

Well, Jody was asking about if she had mumps on one side, can she get them on the opposing side? No, not really. Shouldn't be able to. So really, mumps is one of those viruses. You get it. You really don't get it again. And when you say you got it on one side, what that means is the parodid gland, which is the salivary gland on that side.

You know, you had parodiditis, which is one of the side effects of mumps, or one of the effects of mumps, one of the symptoms of mumps, is inflammation of the parodid gland. And when that happens, it could be one side, both sides, or no sides. and you still get the same immunity. It's not a, you know, the other parodic gland isn't susceptible to it just because it didn't swell up that last time. That's a good question. That's a damn good question. Give yourself a bill.

All right. I think we're one of those. Got anything else? That looks like. Seriously? I'm scrolling back down through them all. Okay. Because, yeah, it was a lot of chatting.

That's okay. It's a good thing. No, you all have fun over there. It's good thing. All right. Well, we can't forget Rob Sprant's, Bob Kelly, Greg Hughes. I'm going to be on Opie's live stream tonight. That will be fun.

I haven't talked to him in ages. Anthony Coomia also have not talked to in ages and got to get together in South Kakalaki. Very soon. Jim Norton, Travis Teft, that Gould Girl, Lewis Johnson, Paul O'Charsky, Chowdy 1008, Eric Nagel, the Port Charlotte Hore of the Saratoga Skank.

Roland Campo, sister of Chris, Sam Roberts, she who owns pigs and snakes. Let me do that one again. Hang on. She who owns pigs and snakes. Pat Duffy, Dennis Falcone, Matt Klein Schmidt, Dale Dudley, Holly from the Gulf, Steve Tucci, the great Rob Bartlett, Vicks, Nether Fluids, Carl's Deviated Septum, Casey's Wet T-shirt, Carl Hamburger, Vinnie Palino, Bernie and Sid, Martha from Arkansas's daughter, Ron Bennington,

Fez Wattley, who's support of this show, has never gone unappreciated. Listen to our SiriusXM show on the Faction Talk Channel. SiriusXM Channel 103, Saturdays at 7 p.m. Eastern, Sunday, 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. the next edition of your medicine. All right. Thank you, Dr. Scott. Thank you, buddy. You know what I'm going to be.