Weird Medicine: The Podcast - 510 - Mike (Ramsay) Hunt

Episode Date: June 20, 2022

Dr Steve and Dr Scott discuss Justin Bieber's current malady, the rectal cancer cure news, antifungal-refractory jock itch (surprise, it's erythrasma again), scoliosis vs lordosis and more! Please visit: stuff.doctorsteve.com (for all your online shopping needs!) simplyherbals.net  (now with NO !vermect!n!) (JUST KIDDING, Podcast app overlords! Sheesh!) Also don't forget: Cameo.com/weirdmedicine (Book your old pal right now while he’s still cheap! "FLUID!") noom.doctorsteve.com (the link still works! Lose weight now before swimsuit season is over!) CHECK US OUT ON PATREON!  ALL NEW CONTENT! Robert Kelly, Mark Normand, mystery guests! Stuff you will never hear on the main show ;-) Learn more about your ad choices. Visit podcastchoices.com/adchoices

Who hides Easter eggs that you never want to find? The Dust Bunny What do you call a dirty PowerPoint presentation? Mudslides Why did the art collector buy an old septic tank? tank. It's filled with mass-turred pieces. If you just read the bio for Dr. Steve, host of weird medicine on Sirius XM103, and made popular by two really comedy shows, Opie and Anthony and Ron and Fez, you would have thought

that this guy was a bit of, you know, a clown. Why can't you give me the respect? that I'm entitled to! I've got diphtheria crushing my esophagus. I've got Tobolivide stripping from my nose. I've got the leprosy of the heartbells, exacerbating my imbrettable woes. I want to take my brain out

and blast with the wave, an ultrasonic, ecographic, and a pulsating shave. I want a magic pill. All my ailments, the health equivalent of citizen cane. And if I don't get it now in the tablet, I think I'm doomed, then I'll have to go and say, I want to Requiem for my disease. So I'm paging Dr. Steve.

From the world famous Curtis Electric Network Studios. Produced by Adam Goldstein. It's weird medicine, the first and still only uncensored medical show in the history 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 assholes. 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. 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 of 347-7-66-4-3-23. That's 347. Pooh-Hood. Follow us on Twitter at Weird Medicine or at D.R. Scott, W.M. Visit our website at Dr. Steve.com for podcast, medical stuff and news you can buy.

Most importantly, we are not your medical providers. Take everything you hear with a grain of salt. Don't act on anything you hear on this show without talking it over with your doctor. nurse practitioner, practical nurse, physician, assistant, pharmacist, or respiratory therapist, et cetera, et cetera, et cetera, so. All right. Hello, Dr. Scott. Hey, Dr. Steve.

Don't forget to check out stuff. dot, dr.steve.com. Stuff.com. For all your Amazon needs, it really does help keep us on the air whenever you shop that way. So you go to stuff. Dr. Steve.com. You can scroll down and see stuff we talk about on this show, including that crazy weird sex toy thing

that blows air it's bizarre it's down at the bottom in the adults only section and then or you can just click straight through and go to Amazon so it's pretty cool thank you for checking it out

check out Dr. Scott's website at simply herbals.net and please don't forget our Patreon patreon.com slash weird medicine we're doing some fun things over there we haven't done an exam room in a while but I'm getting ready to get some lined up.

The exam room is where we have a celebrity come in and ask us questions where it's like an inverse interview. And if it sounds like my dentures are not tight enough, it's because I'm on the last drags of my enviselines, and it is weird getting used to having my teeth all lined up properly. So does that mean you're going to sing more? No. Oh, but it means I can do cameos.

There you go. Oh, yeah, check out our cameo. Camio.com slash weird medicine, I think. Just search for Dr. Steve, Weird Medicine. I'll say fluid to your mama. It's Father's Day coming up. I'll say secretions to yo daddy. I'll do whatever you want me to do.

If you want Myrtle or Cletus to say hello to him, we'll do that. I'll even put the, I have a myrtle wig. I'll even put it on. I don't care. it's like seven bucks it's the cheapest cameo ever and i just do it for fun but it's fun but what sucked was when i first started doing it said you know i would do it and i'd look at myself it looks like i'm missing a tooth but it was because that one was so far behind the others and i couldn't get it just hold the camera just right so it didn't look like i was some toothless bumpkin from

tennessee uh you know doctor or no so i did um uh get some effing enviselines and the other thing is there is a chance when I retire of doing a little bit of TV work and I didn't want to have to deal with it later so I'm just dealing with it now but it's way better I mean I could tell

with the second Invisaline when I flossed that there was more space and now they're like if we stopped right now I'd be totally satisfied so anyway that's fun that's pretty cool that's cool fucking Invisalines and I will tell you this the way it works

the ones that you buy from, you know, where you send them off and they send them back to you, and it costs half of what the Invisaline is. I don't see how those could possibly work. There is a trick involved with the Invisalines that there's no way that they could do on one of those. And it has to do with putting little post things on your teeth to hold them in to make sure that the movement is correct. And I don't know how the ones were, it's just liners that you put in your mouth could move your teeth around. I just don't see how it works, but anyway. All right.

Cool. Don't forget to check out Dr. Scott's website. It's simplyerbils.net. Simplyherbils.net. And I see we have in this studio audience, well, in the waiting room. That was the wrong draw. That's more appropriate. We have Adam Goldstein, quite the celebrity.

of Adam Goldstein TV, where I got this drop from... Why can't you give me the respect that I'm entitled to? That was... Adam was gracious enough to let us use that drop from his... Not that he owns it. I don't want to get him a DMCA strike, but anyway. And who else we got in there? Well, we got Jimmy Rustler and got Sean Pedrick,

who won the tickets for, or the ticket for the celebrity roast that I'll be participating in in September in Rochester, New York, at the comedy and the car, comath, oh boy, I better do better than that, September 7th, 17th, comedy at the Carlson and is the roast of Carl Hamburger and Vinnie Palino. It'll be fun. Even if you don't know who they are, it'll be. be a fun night and if you're a weird medicine listener and you happen to be there you come say how do you do i'll buy you a beer sounds good assuming that you're not sober and if you are

then hearty handshake all right now how many people other than sean actually entered the contest was there one entrance and he yeah sean entered the contest and he won Well, go, Sean. I like it. Asshole. All right. That'll be cool. So we've got some news to discuss.

And one of them, Dr. Scott, if you have the article on the cancer cure that's gotten all the hype in the news, that would be a good one to start with. Because there was quite a bit of hoopla. about this story, if I may be, you know, use salty language. Yes. So do you have that article? I do, yeah. It's pretty incredible. Of course, the title is every single patient in the small experimental drug trial saw their cancer disappear.

So the headline is every single patient saw their cancer disappear. Insane. Right. Okay. Never heard of it ever. All right. Right. Right. So, so what does the article say?

Well, it's talking about, it's the, it's specifically for rectal cancer. Correct. And I guess last year, 340,000 people died of rectal cancer. Of course. And it's terrible. It's a terrible disease. And before this trial, the treatments were radiation therapy, surgery, chemotherapy. If you catch it early, it's curable.

Yeah, but if you catch it early enough, it's curable. But there's a lot of, of course, trauma associated with the treatments. Yeah, because it's, you know, if it's in the middle of your colon, you just take it out and sew it back together. Again, that's harder to do when it's your rectum, which, by the way, you never think about your rectum until something happens to it. And that's all you can think about. So what else? And they were just saying that out of, I guess, 14 patients, all 14 patients, after two years showed complete resolution without any side effects from the chemo. there or from the medic from this treatment so this sounds awesome for rectal cancer patients

but the problem is it's kind of horseshit okay so and it's kind of this is still a really important um study but it ain't what it was made out to be in the news media so right i went to the original study this is what you have to do and if you if you want to read along with me go to dr steve com and it's it's if you're doing this the week of June what is this June 15th then it'll be the top story and if it's not at the top just go to the search function on our website at dr. steve.com and put in rectal cancer it should come up here's the study is PD1 blockade in mismatch repair deficient locally advanced rectal cancer that That is the title.

It's by Andrea Chercheck and a whole bunch of other people. And that is a pretty nondescript title for an article that got play in every newspaper in the world, basically. So what I thought would be fun, and I did this on the Patreon show, so the Patreon listeners are ahead of everybody on this one because I did that last week. And you can go to patreon.com slash weird medicine, by the way. I thought it would be good to do it here because it's kind of an important study. So here, I'm just going to go through the abstract. We could go through the data in the article if people are really interested in that,

but that should probably be a sidebar. It says neoadjuvant chemotherapy and radiation. Followed by surgical resection of the rectum is standard treatment for locally advanced rectal cancer. So let me just translate that because there's a lot of stuff to unpack in just that. that sentence. So neoadjuvant chemotherapy and radiation, this is where you give someone chemo and radiation in the hope that you can shrink the size of the tumor so that when you take out viable tissue, you're taking out as little as possible.

That's what that means. And when they say locally advanced rectal cancer, that means cancer that's greater than stage one, which is just tiny, you know, you have four stages. Stage one, stage two, stage three, and stage four. That would follow, right? What a genius statement that was. Anyway, but stage one, two, and three are local. And stage three particularly is locally advanced, meaning that it's gotten pretty big, but it hasn't spread to a distant organ or a distant site. So stage four cancer would be cancer where the tumor cells have moved to a distant site like the liver or the brain or bone or somewhere like that and set up residence there and started to

grow. That's stage four cancer and we would also call that metastatic cancer. So these are in people, that's the first thing. This is for people who do not have metastatic cancer in this situation. And that says a subset of rectal cancer is called. caused by a deficiency in this thing called mismatch repair. And this is where you start going, uh-oh, okay. So this is a subset of rectal cancer.

They're not talking about all rectal cancer patients. This study was specific to people that had tumor cells that had this genetic defect in them. So you would ask, well, what's the percentage of rectal cancers that have this particular defect? Do you know the answer to that? No. It's 5%. or 10%. But that's it.

It's between 5 and 10%. So that means 90% of people won't be helped with this. On the other hand, the ones that do have this defect, they're resistant to standard therapy. So, you know, in the past, if you had this mismatch, repair deficient type tumor, it was hard to treat with neoadjuvant chemotherapy and radiation. So they didn't respond well to it. Well, now if you're in the 5% to 10% that have that, now we have this thing.

This is what they're looking at. Now, they thought that people in cancer who spread to distant sight, When they would block this PD1 with other drugs, that there was some effectiveness. So, in other words, in people with metastatic cancer that had this mismatch repair deficient type tumor, they thought, well, maybe these drugs will work for people with locally advanced. They weren't doing that before. So is this a breakthrough then? They already knew that this would work in people with metastatic cancer. Now they're looking at, if we catch them before they're metastatic, can we try it?

And so, you know, it's like, yeah, try everything. If it worked in stage four disease, it probably worked here too. And they did something different in this study, and they used a different agent, and that's what makes it interesting. So that part is interesting. Once you ratchet down your expectations a little bit and see this is in a fraction of people with disease that's hard to treat. and we already kind of knew

that this mechanism worked when they were stage four and so now our expectations are down like does it work in locally advanced disease and do we have a drug that's effective? So what they did was they did a prospective study we know what that means people who listen to the show

know what prospective means as opposed to retrospective. In other words, they do something and they follow people forward in time and this is a phase two study so we remember from the COVID talk there are four phases to studies phase one small

and where you're looking to make sure you don't kill people then phase two would be one where you're looking for effectiveness phase three is where you're looking for less rare I'm sorry less common adverse effects and effectiveness in a larger population and then phase four is post-marketing where you have hopefully millions of people have been on this stuff so you can pick up

the one in a million adverse effects. And they used this stuff called dostarlamab, which is a monoclonal antibody, and it's an antibody that is directed at this PD1 receptor site, programmed death one receptor site. And they gave it every three weeks for six months with this mismatch repair deficient stage two or three rectal adenocercinoma. And adenocarcinoma just means cancer that is derived from glands.

So the way they set this thing up was they were going to do this dostarlamab stuff, and then they were going to follow it with chemotherapy, radiation, and resection. If they had anybody that still had residual tumor. So you got the chemotherapy people sit there tapping their feet. The surgeons are ready to go, and the radiation, And when they completed the study on these people, they had no people that went to surgery, radiation, because they all resolved their tumor. It was gone and 100% of them. So the primary endpoint was sustained clinical complete response 12 months after completion.

And so they had 12 patients, 114, Dr. Scott. 12, that's the problem. This is a very small study. Let's just say this, and I'm not saying that this is true. I'm just saying, let's hypothesize for a second, that dostarlamab kills one people in 100 that take it, but it'll cure 100% of people otherwise. We wouldn't know, we wouldn't be able to see that in 12 people

that's killing one in a hundred you'd have to do a thousand people and then maybe 10 would die right right if you do 12 you're not going to see the one in a hundred if it's one in a thousand you'd have to do you know 10,000

100,000 to see and if it's one in a million then that's going to be post marketing so so that's the first thing is what they saw was effectiveness also what are the odds let's say it was 80%

that this stuff only works in 80 only in 80 I mean, we do things in oncology that will have a 5% to 10% benefit. But if it was 80%, what are the odds that if you had any 12 people that 100% of them would be cured? It's not zero. No. Okay. So this is very interesting.

None of them went to chemotherapy. None of them went to radiation. None went to surgery. And in no cases there was progression or recurrence during follow-up. And that was follow-up over six to 25 months. And they didn't have any adverse offense worse than grade three. So there's four grades of adverse events. And stage four or grade four events require hospitalization and termination of the study.

Stage three is below that. But things like asthma, bronchospasm, stuff like that. So, you know, it's a great study. And for those people that had refractory rectal cancer, before, wouldn't it be nice to not have to go through surgery and all those things? So this is a big step forward. We've said all along that immunotherapy is going to be the thing that's going to eventually be the key to curing cancer because the problem with cancer is immunologic.

It's failure of the immune system to recognize these abnormal tissues in the body as being alien because they're not. They're inside your own body. That's why it's so tough. but so it's a big deal but it isn't as big a deal as unfortunately the medical journalism made it out to be

because they were like well in a couple of months we're going to have a complete cure for rectal cancer and it's yeah we may but it'll be for 5 to 10% of people yeah okay that have rectal cancer but listen it's an outstanding result oh yeah and now let's see what happens

when they do it to 1,200 people And if they still get an outstanding result, what this may do for us is say, okay, this works in mismatch deficient patients. What is it about them that makes this work so well? And can we then translate this into other cancers that are similar? When you get a result like this, it tells you this is the key. We just now have to make it happen in other people, too. So once you learn that, you can narrow it down. So it is a huge step in that regard.

It's not a, you know, like I said, well, I don't want to keep repeating myself, but anyway, okay? Yeah, that's incredible, isn't it? Yeah, it's very interesting. This is how science works, and we will see some stuff over the next few years that will be outstanding based on this type of research. So, okay. I think it's pretty incredible, especially for that 5% to 10%. Oh, yeah, absolutely. Jeez.

Still phase two, so it's not on the market. I used to say this stuff wouldn't help me. It might help my kids and my grandkids. But no, this might actually help me if I can hang on a couple more years before I get my rectal cancer. You know, let's hope not. Pardon me, I was just thinking the... You're okay?

Yeah, I'm sorry. I think I got the same thing. You had a little between the 100,000 degrees outside in allergies. It's a little challenging. It is a little warm today. It's a little warm out here. It is. It seems to be that way across.

United States for the most What were you going to say? Well, hell now, I forgot. No, no, I was, no, I guess what I was going to say is can they take this drug and put it into the data bank, you know, like we talked about a couple of shows ago where if you have a certain cancer, they can biopsy you the tumor

and maybe put it in there and just see if it links up, yeah. Sure, you can always do that. Moving forward, yeah. But this antibody is specific for this anti-PD1. I mean, it's anti-PD1, this program death one receptor. or protein and so antibodies are pretty damn specific now there are other tumors that have this then they might be able to use it for them yeah and don't and isn't it true though if they so

so it's so profound results they can fast track it through to where they can get it on the market more quickly right and we might have got to be careful with that yeah I mean I'm not saying 12 people so they've got to do a phase three trial right I've never seen a phase two trial that only had 12 people in it right so but the monoclonals are different I'm not participated in a monoclonal trial. So I wonder how small their phase one trial was if the phase two trial was only 12 people. But we want to, let's do a few thousand people. There's tons of people out there with, a matter of fact, see how many, what's the incidents?

That's what we want. The incidence of rectal cancer in the United States. Well, maybe we could ask Echo. Let's see if she knows. Echo, what's the incidence of rectal cancer in the United States? States. Here's something I found on the web. According to state university.com, there are about 36,500 cases of rectal cancer diagnosed

per year. Okay, so 40,000 cases. So that'd be 4,000 approximately of these mismatch, deficient cases. And of those, you might get, I don't know, a fourth of them. So over the next year, we might be able to get 1,000 cases, if we can get that many into the study. Right. Okay. So, and maybe if they do 1,000 and they're still showing 100%, they'll fast track the hell out of that,

particularly if they're not showing any adverse effects beyond stage three. It's incredible. Yeah, it's incredible. All right. One thing you might want to look at is look at what tumors have PD1. or PD1 sensitive tumor, something like that while we're doing the next thing. Okay.

All right. Let's do this one. This is pretty interesting. You ready? Yep. Okay, while you're looking that up. This is one about transcranial magnetic stimulation. Hey, Dr. Steve, it's Calvin from California.

Hey, Calvin. So I saw an advertisement on a mobile game for something called the TMS, transcranial magnetic stimulation to treat depression. And I think this sounds like a bunch of phrenology bullshit. I was wondering what you guys were thinking about. So anyways, thank you so much and have a wonderful day. Okay, man.

Yeah, some of this stuff can sound like horse manure, but I'm looking at a study here in a reasonably, this is from Cambridge University Press, really from 2001, so it's not a new thing. And it's called repetitive transcraming. Boy, transcranial magnetic stimulation for depression and other psychiatric disorders. And they looked at seven controlled trials. Five of them were suitable for what we call meta-analysis.

That's where you take the data, mush it all together, and then re-look for statistical significance. And they showed beneficial effect compared to placebo with a number needed to treat of 2.3 with a 95% confidence interval. So what that means is you would get, by, it's significant enough that if you treat two people, you're expected to get a positive benefit. That's not bad. No. Because you've got to treat 30 people with a statin to prevent one heart attack. Right?

At least 30. Yeah. We've talked about number needed to treat before. If someone has a question about that, call in and I'll go through it again. So, yeah, it doesn't sound. ridiculous. They did do a controlled trial in people with schizophrenia, which would have been cool if it had worked, but it didn't. Hey, can I talk about that a little bit, too?

Of course. Yeah, with that transcranial. You're in my, that's in my world now. You're talking where all the freaks hanging out a little bit. No, but you know, a hundred and some odd years ago, they started doing a lot of research on electric frequencies into the body on cells, and it's this thing called rife frequencies, something that I use. who's occasionally we have a little machine that does some of this. Oh, no. I'll just spell that. No, right.

Let me finish there. Oh, no, it's okay. I'm looking at it. It's right. Yeah, the Royal Rife. He was a physicist in Germany. RIF. Yeah, RIFE.

And he was a physicist in Germany in the early 1900s. And so anyway, but, you know, the machine, Dr. Steve, they're doing some of this transcranial electrical stimulation at NIH for glioblastomas. Okay. And also, if you think about this, how much different is it from an E. It's very different. Well, but you're shooting electrodes in the electricity in the head. Yeah, but okay, do you understand that ECT, it's not the electricity?

It's the seizure that it induces. They used to do ECT with insulin, and they would give people a shot of insulin drive their blood sugar so low that they would have a seizure. Okay. And that would work. So it's the seizure, not the electricity. But the electricity causes a seizure. Well, that's right. Okay.

It's just a different way to cause a seizure. because doing it with insulin sucks. Yeah, no insulin. Yeah, doing with insulin is terrible. Yeah, right, but it's not the electricity that's giving the beneficial effect. Well, at least for the most part. It's the seizure. What they found is that people were post-Ictal and other people that had a seizure that their depression seemed to get better.

So they induced seizures back in the day with insulin. And there were other ways that you could do it. But then they found that if they gave someone propofal or something to anesthetize them and then touched them with electricity, it could induce a seizure. And then that tended to make refractory depression better. But we have other stuff now like ketamine that we can talk about. But anyway, go ahead. Go ahead.

I'm looking at Cancer Research, UK, on Rife Machines and Cancer. But go ahead. Well, that was just, that was my main thing. I don't know exactly what he was talking about or that study. But I have seen for years they've used, you know, certain kinds of electrical stimulation to treat all kinds of things. Yeah. Yeah, sure.

We do it for muscles. Uh-oh. What just happened? I don't know. Yeah. I can hear anything. On my, my head set. It's jingling around.

My head said it went to, yep. But the, um, treating, you know, muscles and nerves and things in nature with, with electrical stimulation. So you would think at some point there may be a way to, to, um, treat depression for sure. Okay. I'm looking at Rife Machines as a cancer treatment, and this is considered severely alternative. Oh, yeah. It says it has not been through the usual process of scientific testing.

There are studies that looked at low-energy waves as a treatment for cancer, and they did a study on a small number of people with advanced cancer, and they had a type of liver cancer called hepaticellular carcinoma, and the researchers found that low-frequency waves affected cancer cells and didn't affect normal cells, but they didn't show that it actually did anything to improve the outlook of the patient. So the rife machines are expensive.

They basically are low energy, electrical impulses that are sent through the hands or feet, and they are most likely radio waves, and it's just a different thing altogether. So since they found out that cells respond to electricity back in the day, and I can't remember who it was, whether it was Volt or Hertz or one of those guys that stuck electrical wires into the muscle of a frog and watched it jerk, then we've had all kinds of, you know, quote-unquote electrical therapies come out from lots of different things. And some of them persist to this day, and many of them are quackery. I'm not saying that the Rife machine is. I don't know enough about it.

All I know is that there haven't been enough data generated to show that it does anything. And that is really quantitative and qualitatively different than doing electroconvulsant therapy, which in that case, the convulsant, the C and ECT is really the important thing. Now, for refractory depression, we've got other stuff now. I know they still do ECT, and it is a last resort, and these days we have esketamine. And esketamine is related to ketamine very closely, known on the street as Special K, and it has an onset of about three days. Whereas if you take a selective serotonin reuptake inhibitor, SSRI like Prozac or fluoxetine, or Certraline or one of those, it can take 8 to 12 weeks to kick in.

So this stuff, particularly I'm interested in it because a lot of my patients don't have 8 to 12 weeks for their depression to get better. But the problem with esketamine is it's ridiculously expensive. It's about 400 bucks a dose, and you have to have a special REMs license. That's a sort of risk evaluation management strategy thing, and you've got to have a special pharmacy.

And when you write it, the pharmacy's got to deliver it, Then you've got to give it in the office and keep the patient in the office for two hours. Whereas, you really, if you go to a compounding pharmacy, you can get a ketamine suppository for about five bucks. So it is a bit of a jacked-up situation with the ketamine nasal spray. Yeah. But anyway, but that's pretty interesting. I bet we'll see if we can get some adoption of the ketamine, we'll see another decrease in the number of electroconvulsant therapy. patients but that's sort of a side

people tolerate the cadmine pretty well yeah do they okay yeah they do better than tolerate it they like or at home you know it's a dissociative anesthetic so you sort of feel like you're at another world for a little bit then when you come down your depression's better

it's pretty interesting not to be confused in the street don't go by special K on the street if your depression's bad and none of that. Do this the right way if you need it. But if you know someone that's got refractory depression that's been on all of the stuff, and they've been on deloxetine, aka Simbalta,

they've been on fluoxetine, aka Prozac, and maybe they've thrown some Abilify in there or some other add-on medications. And they're still severely depressed, ask their shrink about esketamine. Yeah, because once you get to that point, there are not a lot of choices in the many. And I think the

branded name is Spravado. Let me see if that's right. Spravato. Yeah, S-P-R-A-V-A-T-O. All right, and if you know anybody that's tried it, have them call in. Sean just said he does have a friend that did exceptionally well. Really? Okay, good to know. All right, thanks, man.

Excellent. All right. You have another story, though, right? Well, yeah, we've got a couple. Do you want to talk a little bit about the Ramsey Hunt? Or do you want to talk a little bit about the... Yeah, so that's interesting. When Justin Bieber's face went numb, I initially thought,

well, why are they making a big deal out of Bell's palsy? But that's not really what he has. That would be the first thing people would think about, Bell's palsy being a paralysis that's often temporary but can be permanent and some people of the nerve that that innervates the muscles of the face and it comes through a tiny little hole in the skull and if there's any swelling of that nerve what happens it cuts off the blood supply to the nerve and it just goes limp and you'll get one-sided facial weakness but that's not what happened to him once you talk about it yeah evidently he's got

a whole lot worse than a bell's palsy it's um ramsay hunt syndrome which um also known as herpes zoster um oticus oticus oticus my god it's a late complication of a varicilla uh oh here we go okay well you got that right give you give yourself a bill but you know it's it does it it presents a little bit like um like bell's policy but it's profoundly worse The outcomes are not as typically positive as Bell's Policy. Typically, if we intervene with Bell's Pause early, we can get it corrected pretty well. But, you know, something I was reading about that,

I didn't know about Ramsey Hunt. The one thing is when the nerves start to grow back, sometimes they will grow back, and the nerves will connect to nerves that they weren't connected to earlier, and they'll actually get different muscles moving in different ways. Like if they close their mouth, it might close their eye. What? Yeah, yeah. This I had not heard. Yeah, I had

never heard that. It's called synchinesia. Oh, yeah, synchinesis. S-Y-N-K-E-N-K. Oh, sin means together. And Kinneasism and its movement. Yeah, Dr. Sieg. And I'd never heard that at all. But what they're saying is that occasionally, what does happen is when, you know, because

what will happen is like with Bell's, and I can speak a little bit more to Bell's palsy than the Ramsey Hunt. When those nerves start to wake up and they start to re-enervate, you know, like you see any kind of, any time with a peripheral nerve damage, which is certainly different from its central nerve. But when they start to, when they start to, when they start. Well, this is a peripheral nerve. It's the facial nerve. Well, that's what I'm saying.

Yeah, it's different from a C&S. But when those nerves start to regrow, people will tend to get tingling, they'll get pain. And it's not always the most comfortable thing. Right. What they're saying with this is that they can actually develop this a degree of synchinesis. which is extremely rare, but has been shown. Well, if you make your living singing, that would suck. Oh, geez, yeah.

You're trying to close your eye and it's closing your mouth or vice versa. Good Lord. Isn't that incredible? Well, so in this Ramsey Hunt syndrome, it's previously inactive varicella zoster virus, gets reactivated and spreads to affect this facial nerve. and they'll have a rash on the ear of the mouth. They may have ringing in their ear. They may lose hearing on that side,

and then they'll get this facial nerve paralysis. So that's a rough one. How do you treat it? Herpes stuff. Yeah. You know, same thing that you would treat shingles with. Right. Valicyclevere, acyclivir, fowl, whatever that other one is.

Phamicyclivir, yeah. And what about steroids? Duclevier, that's it. And steroids, too, I would assume. Yes, with oral steroids to decrease the swelling. And then the, you know, they want to start the antivirals within a couple of days. Yes. And so treating this promptly is the key.

And I'm assuming that he's got good. I mean, he's not one of these that calls me. So I'm assuming he has his own cadre of physicians that work with him. So they caught it early. He should be okay. But it'll be interesting to see. So hopefully, hopefully we don't want anybody to have that. Now, if they have horrible pain, then they may use an anti-seizure medicine called carbamazepine.

And that can be really good for pain of that, you know, in the facial nerves, the trigeminal nerve, which is also is a sensory nerve in the face. And if that gets infected, it can cause severe pain. People, if you've ever heard of Tick De LaRoe, that is also called trigeminal neuralgia, that can be so severe sometimes that people really want to do themselves in. And I've seen some people that had that were just in 10 out of 10 pain. I mean, writhing, screaming in pain. And I watched the ear, nose, and throat guy, take a big giant needle and stick it up under their lip up to where their cheekbone is and infuse it with some. anesthetic and they just all of a sudden they just stop

and they're just sitting there talking to you until it comes back. Yeah, I told them there's all. So some of those folks, that's a tough one, but a few percentage, and it's a decent percentage. I've had maybe 50-50 luck treating that with carbamazapine, but there are other things that you can treat it with. Yeah, it may I say also the

Dackeypunks have been shown to help with Bells Palsy, Ramsey Hunt. Really? Yeah, I sent you that. I sent you that. I sent you a link you did yeah well why don't you give us the data then you have it in front of you no I can't find it okay but I'll look at I will look at it but no I sent you that okay well I'll find it I'll find it but I will say that it's five out of every 100,000 people so people are listening to this if you've never heard of it that's why yeah there's not a it's not very common not a whole lot of people but if you've ever had chicken pox you can get Ramsey hunt syndrome it's

usually in people who are older, and hopefully all of those people have gotten their shingles vaccine, because it's basically shingles of this particular nerve. And so if you don't want to get Ramsey Hunt syndrome and you're old enough to get the shingles vaccine, get it. Because I am here to tell you, I got shingles after taking the Zostricks vaccine. I was one of the few breakthrough cases that people can get, and it was literally, gone within two days. That's how easy it was.

That's unbelievable. Yeah. So I'm a firm believer in the shingles vaccine. All right. What else you got? You got anything from the waiting room? If not, I've got... Well, I've got good news.

Go ahead. Good news for a movie Messiah. He said he's practicing, he and his wife were practicing the, the treatment. I'm sorry, I'm trying to find... That's okay. Well, I'm trying to speak. Anyway, not ejaculating too quickly. Oh, yeah, the delayed ejection thing.

Oh, oh, was that him? Yeah, was the movie Messiah. He said he thought 60 seconds was adequate, which, you know, I'm saying. Of course. I'm like, why are you doing it that long for? Who cares? You wasted a whole half a minute. But he said, it's a movie Messiah is doing pretty well.

Good, yeah. So go back a couple of, well, it was quite a few shows, and we talked about the techniques for delaying ejaculation. if you have premature ejaculation, which, by the way, is judged by... I say, according to the other person. The other person, usually, right. I've never, I never thought I had an issue. Premature ejaculation is anyone that ejaculates sooner than they think they ought to. That's all it is.

There's no definition for that. If you're... Is it movie Messiah? I think so. You think so. You're the one that's reading it. I'm trying to find them. But anyway, if...

if he were with my wife, they'd be fine. Yeah. Because she likes a quickie, and I'm, you know. Yeah, movie Messiah. On going for two hours, and she's like, oh, God, can we get this over? Can we hurry up and get to the end of this so I can get back to my nap? Yeah. So.

She was retired, you know. Yep. Well, apparently she doesn't have any time for that kind of malarkey. She still wants it over with it quickly. Of course, you know, I'm 66. I'll be 67 pretty soon. And if I were having some 67-year-old laying on top of me, you know, grunting. That's right.

With one bad toenail, you know. I don't have any bad toenail. I don't have any of that. Thank you. I used to. I got them removed just because of that. But, yeah, I would probably want it over quickly, too. Get it over with already.

Oh, just let me go, anyway. Go pay for it and then they won't care. Just put another hundred bucks on the table. I love it. All right, you got any other stories? No, not right now. Okay, all right. And let's try this one then.

Oh, wait. Let's try this one. Hi, Dr. Steve, Dr. Scott. How are you guys? Hey, good. How are you, man? Hey, that's great. No shit.

Anyway, since about the summer of 2018, I've had a red itchy rass on the left side of my line. There's days when itching days. disappears, and I can go maybe a whole day without a problem. And then there are days when I can't stop scratching it. It's on the side of his what? That's what I was going to say. Oh, God, I don't know.

I couldn't hear it either. Let's run it back and see. Sorry. I've had a red itchy rash on the left side of my groin. Groin? Wait a minute. Let me mess with the audio a little bit. I was an audio engineer, you know.

Let's see here. What can we do here? Red, itchy rash. Oh, that's something. the left side of something. I've had a red itchy rash from the left side of my mind. I'm going to say groin.

I can go maybe a whole day without a problem. And then there are days when I can't stop scratching it. I try my best not stretching because I know it's probably making it worse. Yeah. I went to a dermatologist about two years ago and he said it wasn't fungal. I tried every over-the-counter anti-fungle cream I can find. Okay.

To no avail. Well, we already know what it is. The dermatologist's diagnosis was, he said, either lichen clannis or lichin sclerosis. Maybe. And he gave me two different topical ointlets to try out. The redness is always there, though. But sometimes the rash appears to be more reddish and raised. Other times, it's lighter in color with, like, flaky, dry-looking skin.

And I'm tired of living with it. I really want to hear this whole thing because we may get a clue. Yeah, me too. It would probably come back after I stopped taking the ailments. And I was back to normal for one to two weeks after the three minutes and ended, and sure enough it came back. Yeah. I've been pretty much just living with it in a sense.

I'm trying to do what I can with it. If the diagnosis is correct, it didn't like in plainest or sclerosis. I don't think so. Is this something that I'm going to have to look with? Should I get a second opinion? Yeah, I would. Okay, so here's the thing. Lichen Planas is an immune disorder where the immune system attacks cells of the skin or the mucus membranes.

They're purple polygonal papules. That's how we remembered it. So they're purplish, itchy, flat-top bumps, right? And then we get them on the mucus membrane. membranes. They're lacy white patches. That's not what he said. No. Okay. So then lichen sclerosis was the other thing. That's patchy white skin that appears thinner than normal. And now that's genital, but also anal areas. Okay. And most people, well, okay, postmenopausal women are at higher risk getting that. But anybody can get it. Neither one of those sound right. This is

what I recommend that he do. And we've talked about this before because no one thinks about this, sometimes not even the dermatologist. Put a black light on it. Go buy one. It costs you $10.00. A little black light. Well, get a good one. Get an actual

black light from like Amazon. And do you remember what I'm looking for? No. Okay. So you're looking for it to that rash, that place that's red to light up a beautiful. beautiful salmon color.

Okay. I had somebody on Twitter. This happened just the other day. Wow. And if it lights up a beautiful salmon color, it's not any of these things. And so they're right. The steroids won't work and the antifungals won't work. It is a thing called erythrasma.

Okay. And erythrasma is called by a carini bacterium. You treat it with antibiotics. Okay. And when you do that, it'll go away and stay away. Okay. Orally, topically? Yeah, orally.

Okay. Yeah. Gotcha. And I'll have to look and see if topical antibiotics will work for it. But I think you've got to work on it from underneath. Oh, wow. Okay. That's a great question, Dr. Scott.

Yeah, yeah. Let's try topical. You look for that up because Carl always hates it when I Google stuff and I'm on the air. So it may be this erythrasma thing because it doesn't sound like either one of those things from what he described. That's why I wanted him to keep going to see if maybe. He would give us another clue. The one clue that he gave us was, hey, you treat it, it just comes right back. And or antifungals don't do anything.

So when I hear it, someone says that I think it's a fungus. I've tried every antifungal and it doesn't do anything. One of the first things I think about is erythrasma because nobody thinks about it. So this person on Twitter the other day said, yeah, I've got this jock itch, it won't go away. And I said, do you have a black light or, you know, put a black light on it? I guess either went and bought one or he had one. He was probably a hippie from the 60s. And he had a black light, and he said, yeah, it glowed bright, you know, salmon pink.

And I said, just go go to your doctor and tell them, I think I have erythrasma. And if they look at you like you're stupid, bring in your black light and give them this article. Wow. Yeah, Dr. Stevens, it looks like some clenomycin topically might work. Yeah. Fair enough. Cool, yeah. Thank you, Dr.

I mean, I guess it would be worth a try topically first. Oh, I would do it topically. Yeah, I would. If you could not take a pill that has to go to the. the tip of your nose to treat a rash in your groin, then that's fine. Yeah, cool. But, yeah. Okay, so I'm concerned that that may be what that is.

You should give yourself a bill. Should I? You should. Give yourself a bill. There you go. Good stuff. You get nothing. You lose.

Okay. All right. Let's move that one to the trash. Let's see. Oh, here's one for Dr. Scott. Oh, no. Okay, and that's a good one. Hey, Dr. Steve.

Bob and PA. Hey, man. Listen to the show forever. and I never thought to call in, but I was wondering, I got, I just noticed right about lower back, my spine does a little curve and then go straight into the lower back. Is that a problem? Should I do something about that, or is it going to be all right? Thank you, sir.

Okay. So the first thing, he doesn't say that there's any symptoms with this. Right. So what do you think? Well, you know, the first thing I'd say is, has the curb been there for a while? Well, he doesn't know. He just noticed it. I would get an x-ray just to look at it.

It might be a little bit of scoliosis, starting to develop as you age, depending on which way it's curvy. It could be completely normal, yeah. Because, you know, normally in your lower back, you've got the lordotic curve, so it kind of curves. Okay, so lordotic means that it's facing toward the front, okay, and then. It should tuck back out where the bottom of your spine goes into sacrament coxics kind of pokes back out. So in that lower part, and nobody knows what saccharacterom or coxics are. So your tailbone and that flat bone and just a, above your ass.

Yep. Yeah, so you can kind of poke, you know, the very end of your spine, which is your tailbone or coxics. But that should have a natural curve. And that curve is there for springiness as a shock absorber, which, you know, so you want that curve there. But if it starts to get too far one way or the other, if it's too straight, or if he's getting a curve from side to side, then we start thinking of it.

I'd actually be more concerned if it were straight. If it's dead straight, that's a big problem. People think it should be, but it shouldn't be. No. If you look at any, Google any, just Google Lumbar. spine x-ray and you should see a sideways view and they'll always have that kind of s curve in it and it looks more pronounced than you would think it would but it's it's actually quite pronounced well you know and dr steve i think a lot of people don't don't appreciate the

fact that there is a vertical load if everything's lined up perfectly but that that that curve is there for a spring because if all those if your spine was completely in a straight line vertical and you got hit on top of the head or you fell straight on your rear end or just walked off a curve. Everything would just, would just explode. It would pop instead of bouncing. Yeah. Yeah, I would.

So I think what happened was he's, you know, he's moving around on his back and goes, whoa, I don't know if this was there. Let's call, let's call Dr. Scott. Yep. And we see this quite often, actually, a lot. People are not, is in tune with their bodies you think they would be. I had a guy come in. Well, let's say, again, I heard about a guy that came in.

And he said, I think I've got a tumor in my spine, in my chest. Okay. And he said, yeah, it's right here, and I can move it around. And if you, this person examined this person's chest, and what they found it was their zyphoid process. Okay. And the zyphoid process has been there since he was an embryo.

Yep. And it's at the very end of your chest bone, the sternum, where all the ribs meet in the front, you have this flat bone, we call the sternum. If you go down to the bottom, there's this kind of pokey thing. It feels like a, you know, it's like, feels like a, you know, it feels like, a mass. It's rounded. And if you poke on it, you can bounce it kind of in and out. Don't do it too hard, but you can bounce it in and out.

And that is your zyphoid process, and it is connected to the sternum with cartilage, and that's why it's kind of springy like that. It kind of wiggles a little bit. And if you never noticed it before, you can be 30 years old, and then you're feeling around, go, oh God, what the hell is that?

And then you come in to see your doctor, and they charge you $150 to tell you that's always been there since you were in amy. There you go. Not a reason not to go if you're worried about something. Of course. Yeah, yeah, yeah. But that person, from what I hear, was extremely relieved and was

worth it. Yeah, worth the visit. And I think this guy, if it's something, he's not sure, has been there for well, you know, go... I don't even know if I do an x-ray, just let somebody look at it. Yeah, because typically, you know, we can look at somebody, Dr. Steve, if they're facing away from us or even towards us, we can see if their hips are out of a line. That's right. One hips higher than the other.

You know, we can have them stand and bend forward away from us, and we can actually kind of see the spine. That's an An interesting one for scoliosis. Yeah, it is, it is. But that just might help you. Yeah. Just to...

If you want to see if you're, somebody you're with has scoliosis, it's a fun test. You stand face to face, step back a little bit, and have them bend over and touch their toes. Now you assess how straight, I mean, could you put something on their back like a ruler and would it be level? And then have them come up slowly with their arms extended toward the ground. And when you do that,

if they have scoliosis you'll see one side will go up before the other and it's really pronounced and that's when I found out I had scoliosis so I'm about two inches shorter than I'm supposed to be because all that stupid shit in my spine

anyway anything else out there oh I see Lovett is out there in the waiting room for people that don't know what we're talking about we do live stream usually on Wednesdays to record this show so you can come hang out with us and just watch my Twitter feed

at Weird Medicine or subscribe to our YouTube channel. We're back on YouTube, not for any good reason, just because I couldn't find another place that had a user interface that I could make work. And now that we've left and come back, I keep getting this keyframe frequency error. I don't know

what the hell's going on. This live streaming sucks. It's a pain, but it's good to see our friends. Yes, it is so much fun to hang out with all these people and stuff. And then, you know, we'll answer questions offline. We play stupid, really, not good songs and things like that. Dr. Scott will play and I will learn a song while you're watching us,

and then we will play it badly, and then we will forget about it and never play it again. It's the dumbest way to do music I've ever heard of them anyway. All right, Dr. Scott, well, before we get out of here, we have some questions from the waiting room. What do you got? Well, continuing in our theme of dermatology. Uh-oh. Yeah, we've got a good one from Sean.

Sean's asking, what is swimmer's it? What causes it and how is it treated? He saw some discussions on Twitter about it. Okay. Well, okay. So swimmer's itch is kind of a different thing. If you look at the CDC website, it's called circarial dermatitis, and it's caused by allergic reaction to microscopic parasites.

It's usually they infect birds and mammals, and so they're released from infected snails, into freshwater and salt water, like lakes and ponds and stuff. So I don't swim in those. I used to swim in fresh water all the time. Now, if you go to Tahoe or something, I'm kind of okay with that. But to just have somebody have a pond in their backyard, I'm not swimming in that shit. No, no, no.

There's bird poop in there. Oh, there's all kinds of stuff. And it doesn't get to the right temperature to kill certain things. And God don't get it in your mouth. No, but it gets the right temperature to grow some little parasites. Well, if it grows amoebas, and you go and you dive down and it gets up in your nose, you get, you know, amoebic encephalitis and stuff like that. So I just, this is just me.

I'm not saying anybody else, but for me, I don't swim in fresh water anymore. Salt water is a lot better, but then, hell, you've got jellyfish and stingrays and shit like that. But, you know, you wonder, well, how in the hell does water become infested with these parasites? they get into ducks and geese and then they the parasites produce these eggs that are passed in the feces because they just shit everywhere

well they don't really shit ducks don't have rectums they have cloaca clakey and what a cloaca is is when you've got your urine outlet and your stool outlet coming out of the same place

so back in the day when you would the joke and it's hilarious ladies when you would do delivery if the kid's head tore the vaginal wall down into the rectum. That happens. It's called a stage four tear. You've got to sew up the intestine,

the rectum, and then the vaginal wall and all that stuff, and it takes some special skill to do that. They would use the joke was, oh, did you make a cloaca? So, you know, it was hilarious. I mean, we can't laugh. about this stuff anymore. I guess it's not

funny. If you get your vagina torn into your rectum, you don't want some asshole redneck doctors making jokes about it. There's other jokes, though, like the Emerson Gooden sign. I'm telling you this, not because I think it's funny. I'm telling

you this as a cautionary tale about how people used to objectify people and make fun of their maladies back in the day. I'm talking in the 70s and stuff. Back when people still smoked in hospitals and things, there was this thing called the Emerson Gooden sign.

Do you remember what that is? No. That's when you're looking at a chest x-ray of someone with large breasts, and then, you know, you're looking at the x-ray, and you point at the shadow of the large breast, you go, Emerson Goodens. There you go. You know, again, not a telling you this,

not because I find it funny, but as a cautionary tale to combat things like that in the workplace. But anyway, so. So, yeah, so they shit out, they cloaca out these parasites into the water, they land into the water, and then, you know, they're just constantly just, you know, what you've seen when grease go overhead, you've got to watch it, because one of them is going to take a dump on your head, and then the eggs hatch in the water, and they get these free swimming microscopic larvae, and they swim in the water looking for a certain species of aquatic snail. This is quite the life cycle. And then if they find one, they infect it, they multiply, and then they undergo this sort of further development, and then they release a different type of microscopic larvae. And these are called circariae, and that's hence the name, circarial dermatitis into the water. And those swim about looking for a suitable host that usually is going to be a bird or a muskrat or something to continue their life cycle.

Now, we are not suitable hosts, but they can burn. into your skin and cause thinking because they're stupid right they're just skin and they just burrow in looking I live here and then your body kills them but then you get an allergic reaction to it

so that's how parasites talk there you go like feel billies yeah like some liverins there you go all right and it's like scabies you get these blisters it's real itchy stuff like that hopefully that answers

your question. And, you know, more, if you get it from a certain pond that you're swimming in, unless you kill the snails in that pond, this will continue. I don't advocate killing the snails. I advocate, go swim in a pool. Find an effing pool. And so they'll, the things will die. You use, you know, they'll use steroids and, you know, baking soda paste and stuff like that to treat it. Salt, bass, etc. Things like that. Yep. All right. Well, last one, our old buddy, Richard Kish, has a question here. Okay, Richard Kish, who knows good music. Yes, he knows good music.

He said, what's your take on, demon scratches? Demon scratches? Okay, I don't know what that is. They usually show up in threes, and no one, like my wife, knows where they come from. She got them again recently. Okay. Hmm. I don't know.

I think you're scratching yourself in your sleep. I'll tell you what we'll do, though. NASA has an article about it. And, no, that's, okay, that's about scratches on the surface of Mars. And that's caused by whirlwinds that dig up circular scratches on Mars because it's got a very thin layer of dust. That's a different thing. So they have dust devils and they leave marks. I'll do some research on this

We've got to look for next time I have no idea But I will tell you this I used to do ham radio From a place in North Carolina Called the Devil's Campground Oh Oh scary kids

And the devil's campground Was this circular place in the woods That no nothing grows And if you sleep in there The next day you'll find all of your camping stuff on the edge of the on the edge of the circle

as if some supernatural force forced you over to the edge of the of the circle because they didn't want you in their circle. We did ham radio there. All we saw were a bunch of rednecks going, this is different from campground.

And, you know, drinking beer and throwing beer beer cans around and stuff. And going, what are y'all doing? You know, what channel are y'all? Is that channel one? So we weren't doing CB. No, we were doing amateur radio, my friend. But anyway.

I love it. Scott, yeah, I can tell you. You love that story. You're otherwise occupied. Anyway, so I find those things to be malargy. My wife likes to watch ghost shows, and I remember her saying that on the third floor. You know, the ghost shows where they put a GoPro on, and then they turn out the lights and they scare themselves, right? And they get all scared.

And, oh, did you see that? And it's like, no, it wasn't. And it's like, I don't know. I didn't see anything either. And they will tell you, I said, Tacey, why are you watching this? She said, well, on the third floor of this hotel, three people died. And now it's being visited by poltergeist. And I said, you know, if that were true, every room in the ICU, the paintings would be flying off the walls and you'd hear, get out.

it's not it doesn't work that way it's not right it's BS all right thank you my friend thank you kush kush why do you call him that you know the first time you put his name on there i read this kush because because you're a hippie because i'm a hippie used to do kush what is kush what is that like vietnamese pot or something what is kush is just a fancy name for fancy weed kush uh cannabis what is that it's no it's something though isn't it a real thing Okay, Cush Cannabis come from, oh, Hindu Cush Mountains, okay. I was thinking it was Vietnamese, but it's from Hindu Cush Mountains. Okay, well, that makes sense.

All right, fair enough. Mystery solved. Anyway, we can't forget, Rob Sprant, Bob Kelly, Greg Hughes, Anthony Coomia, Jim Norton, Travis Teft, Kim Chickens, Richard Kish, Shawnee P, that Gould Girl, Lewis Johnson, Paul O'Charsky, Chowdy, 1008, Howdy, Guplunk. Eric Nagel, the Port Charlotte Horror, the Saratoga Skank, the Florida Flusi, the St. Pete Barkeep Blower, the Dolly Museum Diddler, the ballet Bimbo, the girl with a genetic half-sister, no one knows about. Percy Dunm, Merlin Campo, sister of Chris, Sam Roberts,

she who owns pigs and snake, Pat Duffy, Bill the Cop, Keith DeCobb, Dennis Falcone, Matt Kleinschmidt, Dale Dudley, Holly from the Gulf, Christopher Walkins' voice double, guitarist Steve Tucci, the great Rob Bartlett, Adam Goldstein, Cowgirl Vic,

thank you for your service, ma'am, Cardiff Electric, Casey the Soil Scientist, Carl, of the Tilippes at Quinaveris Carl's, producer chris the subreddit news chick aka that broad crows and the buccaki queen jenny jingles the inimitable vincent paulino everybody eric zane trucker andy tucker and anita dixon the original shot i've got written here she is not a tall woman uh bernie and sid martha from arkansas's daughter ron bennington and of course our dear departed friends g back very the blade and todd hillier whose support of this show

was always gracious and always appreciated. Listen to our SiriusXM show on the Faction Talk Channel, Siris XM Channel 103, Saturdays at 7 p.m. Eastern, Sunday at 6 p.m. Eastern on-demand at 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, get some exercise.

We'll see you in one week for the next edition of Weird Medicine. And thanks, everybody. Thank you, Scott. Thank you, but. Yeah, go for you.