Weird Medicine: The Podcast - 542 - Nosetooth

Episode Date: February 27, 2023

Dr Steve, Dr Scott, and Tacie discuss: RIP Son of Fritz CBD Nasal Spray Nocturia drug prices vertically fractured pen15 swallowing a toothpick (bad) viral behavior modification a bizarre mutation leaving surgical wounds open pharmacy prescribing sinus infections due to allergies Please visit: stuff.doctorsteve.com (for all your online shopping needs!) ed.doctorsteve.com (for your discount on the Phoenix device for erectile dysfunction) simplyherbals.net  (Dr Scott's website) simplyherbals.net/cbd-sinus-rinse (the best he's ever made. Seriously.) roadie.doctorsteve.com (the greatest gift for a guitarist or bassist! The robotic tuner!) Also don't forget: Cameo.com/weirdmedicine (Book your old pal right now while he’s still cheap! "FLUID!" Most importantly! CHECK US OUT ON PATREON!  ALL NEW CONTENT! Robert Kelly, Mark Normand, the O&A Troika, Joe DeRosa, Pete Davidson, Geno Bisconte. Stuff you will never hear on the main show ;-) Learn more about your ad choices. Visit podcastchoices.com/adchoices

Why wasn't the cat invited to the picnic? Because it always left litter. I decided to sell my vacuum cleaner. It was just gathering dust. Why did the cat stop playing basketball? It threw up too many hair balls. 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 to bowl of I'm stripping. from my nose. I've got the leprosy of the heartbound, exacerbating my

infertable woes. I want to take my brain out and blast it 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

a requiem for my disease. So I'm paging Dr. Steve. Dr. Steve. From the world famous Cardiff Electric Network Studios, subsidized by Cordiff Propane. It's weird medicine, the person's still only uncensored medical show in the history broadcast radio. Now a podcast.

I'm Dr. Steve with my little pal. Dr. Scott, traditional Chinese medicine provider, gives me streetcrette, the whack alternative medicine assholes. Hello, Dr. Scott. Hey, Dr. Steve. And we've got my wife, Tacey, my partner in all things. Hello, Tacey. Hello.

This is a show for people. who will never listen to a medical show on the radio or the internet. If you've got a question, you're embarrassed to take to your regular medical provider. Or if you can't find an answer anywhere else, give us a call. 347-7-6-6-4-3-23. 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 podcasts, medical news and stuff you can buy. Most importantly, we are not your medical providers. Take anything you hear with a grain of salt Don't act on anything you hear on this show Without talking it over with your health care provider All right, very good Please check out stuff.doctrsteve.com Stuff.com for all your Amazon shopping needs

And you can just scroll down See all the stuff we talk about on here Remedies for peripheral neuropathy All that ails you And yeah, that's right. I have a thing that ails you. And you can get the robot guitar tuner from rowdy on there, all kinds of stuff.

Or you can just click straight through, go to Amazon, and anything you purchase there really helps us out, and we appreciate it. Check out simplyerbils.net. That's simplyerbils.net. That's Dr. Scott's website. And patreon.com slash weird medicine. Patreon.com slash weird medicine. That's Tacey and me.

And we do, well, no, it is Tacey and me. but Tacey and I do a show on there that is exclusive to Patreon. And we do a thing called the exam room, which has celebrities calling in. And I said last time Tim Dillon has agreed to do it. I hope he remembers that when I finally get around to schedule that with him. And our buddy Tim. We knew him before he was Tim Dillon. And we've got some other people coming as well.

We're going to have to get Kevin Brennan on when everything calms down and see what's going on between Kevin and Anthony and Gino Bisconti and all that bunch. So, lunatics. And if you want me to say fluid to your mama, get on cameo.com slash weird medicine. And I'll say just about anything. I think I've only turned one down. And it was for a good reason. But anyway.

All right. All right. That's good. All right. And don't forget to check out Dr. Scott's website at simplyerbils.net. That's simplyerbils.net. We've got a phone call about you coming up, Dr. Scott. Uh-oh.

I'm going to trouble again? No, I don't think so. I think it's a good one. Hey, cool. I do have some rough news to pass along to everybody. You know, we always talk about the flatus flute and the artwork that's on the box. Yeah. That's, you know, sort of rent and stimpy rendering.

And for those who don't know, the fletus flute is a whistling butt plug. And we have nothing to do with that. But for whatever reason, they wanted to use our visage on there. So it was Danny from Canada and a guy who we knew as son of Fritz. And unfortunately, Son of Fritz has passed away. Son of Fritz, died? Yeah, he did. Oh, Ritz.

Remember his mom and dad, his dad's name is Fritz, and he's elderly, and he was taken care of him at one point. And yeah, he just apparently was living with some friends of his and they just walked in one day and just found it. Oh, that's terrible. So here's what I don't know anything. We had lost track

son of Fritz, but if Tacey remembers him, then he's pretty memorable guy. And the artwork that he did on the Flatus Flute is one of my favorite things that I have, you know, because it's you know, a hairy ass crack farting out

musical notes into my face and I've got this smile like it's the greatest thing that anyone had ever done. And it was brilliant artwork. Yes, it was. And, you know, he was just, he was a good guy, just a good guy, and his friend emailed

Danny and I. And just said that he always kept track you know, with us. He just didn't, you know, correspond with us that much there in the end. So I want to tell everybody. I don't know anything about his medical condition, but who knows if it was another

GVAC situation where he had a massive myocardial infarction, consider if you have risk factors at all, smoking, high blood pressure, high cholesterol, family history, talking to your primary care about just getting a calcium score done. And I just got an email from somebody the other day that had a calcium score of 650, which is an abnormal test, and they're going to, you know, the cardiologists are going to do a cath or something on them. Or a thallium stress test, or who knows,

a denocene stress test, one of those. And they're going to, and he said, you know, I don't know if I'm going to make it. I was like, no, dude, you're way more likely to make it now because this is a silent killer. And you have the problem, you don't know it, and then until it's too late. So, you know, sudden death is a problem.

It's always been a problem in this country. And so it was a problem all over the world. There's a certain fraction of people just die suddenly. And most of the time it's due to either a massive coronary artery issue or a massive stroke. So please talk to your primary care provider and see if you are a candidate for getting a a stress or a calcium score

and if you're having symptoms you're a candidate for stress test. So what are the symptoms of a myocardial infarction or angina which is you know

the feeling that you get when the heart isn't getting enough blood? You know when you run and you get that burn or you're doing your leg presses with big weights

and you start getting that burn in your calves, that's lactic acid building up in the muscles, and you start feeling this lack of oxygen and build up of lactic acid in there, and it comes across as this burning feeling that's very unpleasant, which usually goes away really quickly. Well, if you start running up the stairs and you're having that in your chest, that is your heart having those same sort of issues, because the coronary arteries that feed the heart muscle are being blocked. And so when it's demanding

more blood, aka more oxygen, then and it can't get it, it's going to start to kick back and cause symptoms. So if you have that, you've got to tell somebody

if you have nausea, diaphragesis, and other, sweating, diffuse sweating, palpitations, shortness of breath, chest pain, any of those symptoms. Doesn't have to be all of them. Going upstairs and it's reproducible or walking short distances,

you've got to talk to your primary care. So, you know. All right. Son of Fritz's real name was Carston. I always thought it was Chris somehow. I thought it was Chris too. I don't know why, yeah. Well, I think maybe that's just his Americanized name.

Could be, yeah, okay. But anyway. What was his real name? He will be missed. Carston, C-A-R-S-T-E-M. Oh, man. I know it. Yeah, I was bummed to hear that.

But at my age, it's like, shit. You know, I get messages like this about once a week with my friend. But he was young. All right. What else we got here? Dr. Scott. Oh, yeah. Well, let's do our phone call about Dr. Scott's thing.

And I'll go ahead and get the design. Number one thing. Don't take advice from some asshole on the radio. This is our buddy Clint, who was recently. been having some health problems. Oh, cool. Hey, Dr. Steve, Dr. Scott. Hey, man.

I want to do, uh, calling let you know. I really like the, uh, the CBD nasal spray that Dr. Scott has. It's really good. I use it at night and I can sleep with the windows open and not wake up in the morning with congestion. But I do wake up, um, I'm in my mid-40s now. So I do wake up in the middle of the night's fatigue. And I can't remember the last time that I didn't.

So I know my PSA is low. So I think it's like at 1.2. It's been a while since I checked it. But I know it's not an enlarged prostate, but is this what getting old looks like? I get up maybe once, maybe 2 o'clock in the morning. P and then I can usually make it through the night. But just wondering what you think. Thanks.

Hey, I'll take this one. If he only has to get up once. That's awesome. That's awesome. That's what I think, too. And also. Yeah, especially plus 40. Does your nasal spray help with like post nasal drip?

Oh, yeah. And actually, it's the best thing ever for postage. Why don't I have it? Well, because I gave it to your husband. He was supposed to pass it to you. But, in all seriousness, it can help with post-nasal trip. Can it? Yeah, I mean, I'm on the Allegra's and the...

All the other stuff. Monty Lucas. I would try mine. Yeah, me too. Just for the heck of it. But you never know. It might help, but might not. Yeah.

And that's the truth. You know what would help you taste, besides what Scott's got is, using the navage. And I'll buy you your own if you want to try it. Because the navage being the saline, you know, lavage device, mechanical netty pot, basically. And if you go to our YouTube channel, we've got N.P. Mel B. She hated putting things in her nose. And she did the Navaj live on the show, and she actually liked it.

She took it home with her. She still uses it. And just cleaning all that crap out of your nose before you go to bed, I think would make a huge difference. Now, you'll regenerate some of it. No question about it. The body can make mucus pretty quickly. But just cleaning the allergens and all that stuff that's stimulating the nose to make. And then following it up maybe with, you know, a saline nasal spray or something like that.

It could really make a big difference. And now that's stuff of yours. And this isn't a commercial. We can't do commercials for your stuff. But it has peppermint oil in it as well, right? Which has been demonstrated, yes, in the medical literature, to be an anti-inflammatory. So that might help. Yep.

And Tacey, are you using... And it's got the saline, too, like the Navaj does. That's right. That's right. Well, you do both. I'm advocating using both. Jesus. Do you...

Are you using nasal steroid right now? No. I'm not. That might help as well. I saw where astolin is now over the counter. Is it astelin or an astelin-like version of astelin is over the counter, which is a pretty big deal. Yeah, so astolin being the nasal antihistamine. And you would stop taking the fexophenidine, aka Allegra, if you took that because you would need.

And really, why take a pill that is going to go to the tip of your toe and to the tip of your nose and your ear and the tip of your fingers when you can just spray the medication where you really need it, which is inside your nose? Yeah, it's called astapro allergy. Yes. Which is, that's. And it has azalastine in it. Is that the active ingredient? It's great when drugs go generic and are actually affordable. Yes, agree.

Which doesn't always happen. Right. We should probably talk about that a little bit. Oh, my gosh. Because we have the, you know, everybody has this problem. Yeah, you have it too. But the other thing is, Tase is the thing that you used to take was dynamist, which was as elastine. And I think.

Dymista. That was it. You're right. You're right. And it was, well, I'll give you. Give yourself. Oh, my God sucks. Five minutes.

We're not like five and since. He's already wound up on me. That's terrible. We, you get a steroid and a topical antihistamine. and that's a really powerful combination. Yeah, and the other one of those is generic as well. I just can't remember the name of it. There's a combination?

No. Okay. Oh, of the other. Of the steroid? Half of it. Yeah, yeah, yeah. Yeah, so you can just buy the two things. There's not, you don't have to mix them together.

Yeah. That's just lazy anyway. It would be nice if we could remember what the other name of. What the Flonase? Yes. Yeah, yeah. Okay. There you go.

Yeah, you can get generic. I think the Fluticazone, right? Flucon. to Flictonase or Flick to Cazone. Yeah, let's Scott pronounce it. All right. Anyway, so that would be something. Now, what were you saying?

Oh, we're talking about the prostate, you know, because Clayton was talking about his nighttime trips to the bathroom. Yeah, a couple things for sure. Your prostate does not have to swell up much, and certainly your PSA does not necessarily go up if you have a slightly. flamed prostates. So he may be starting to get just a little bit of a bulge just enough to retain some of that their urine at nighttime. But, you know, honestly, if he's going once a night, I'd take it. Some people have high urine volume only at night.

It has to do with position and the change in light, dark, through our pineal glands. but they feel sometimes really what a lot of researchers think is that it's not really even that. You get fluid retention during the day because you're standing up and fluid is collecting in your feet. Oh. And then you lie down at night and all that fluid re-enters the blood supply. And because the gravity is no longer holding the fluid in your legs and then it ends up in your kidneys. and now you've got to get up all night and pee. Yeah, that makes sense.

Gravity, baby. It could just be swelling of the legs because you've got bad veins. You could have obstructive sleep apnea because those people have their breathing interrupted many times during sleep. I have that. I think I was snoring last night pretty bad. And I still don't get up to pee in the middle of the night, though. I never do.

Oh, I do all the time. There are certain drugs. Yes, I know you do, which, by the way, this isn't an ad for temperedic but when we got that mattress we got one of those that they advertise where they put a glass of wine on there and they got kids jumping up and down

which is always great when you got kids and wine playing together but anyway and the glass would just sit there and I really never know that you're getting out of bed because the bed is shifting it's just all the fucking noise that you're making

But she's not laughing. No, I said, okay. I'm irritated. Next. So what are you irritated about? Just our switching insurances, which is not fun, and especially pharmacy coverage and trying to find out, well, will you cover this? Well, I don't know. Well, where do we get?

You can go to the website. Well, where do I go to? It's like a big mystery that nobody wants you to know about. This is some bullshit. A big scary mystery. So you got a big list of drugs. You got to switch to a new pharmacy or whatever. And that was our situation.

Nobody helps. Nobody. Well, I had one lady call me. She was very helpful. And the only reason she did that is because she is the pharmacy manager and she wants my business. She knows you. Right. Otherwise, yeah, you wouldn't not have had that out.

And I go in all educated and bullshit. and I'm like, I need to know what the co-pay is. Oh, well, we can't really do that. So, you know, we're so busy. And I'm the only one effing stand in the store. And I'm like, well, you're making a great first impression for me. So the only time you can find out is when they run it. That's the problem.

So this is how this works. If you have a drug and it's not covered by your formulary, A lot of times it'll alert the provider, but most time they ignore that because half the time it's wrong. So you write a drug. Let's say we write drug A for Tacey. And it needs a prior approval or prior authorization. You won't know that until you go and take the prescription and try to get it filled. And then they'll hand it back to you and say, this needs prior authorization.

Now you've got to go back to your provider, get them to do it. Instead of just picking up, you know, pharmacists out there, me talk to you for a minute. Pick up the phone, call the provider yourself. And if you're too busy, too scary busy to do it, hire somebody to do that because it's a real service that you can do for your patients. The few pharmacists around here that will pick up the phone or message, send me a message or call me on my cell phone because they can all have my cell phone and say, hey, can we switch this to this other thing? And that will be covered. And I go, well, either yes or no, I'll go ahead and get my nurse to do a prior authorization.

See, that's what I was trying to do to see what was on formulary in the same class that maybe I could take. They can't, their system will not tell them until they actually try to run it. They deal at that pharmacy with one effing formulary. You mean to tell me, they can't tell me what is on their chronic constipation medication list. They can't. And they are they. I don't know. because the computer will not tell them until...

What are they prescribing? What are they filling? Because that's a big effing clue right there. I agree. I totally agree. Hey, can I throw this up to two, please? Can I throw this up to two, please? Of course.

And what I would suggest, too, what I love are independent pharmacists, especially around here. Because those are the guys that seem to dig a little deeper and work a little faster as far as making context to the providers. And those are the guys I've dealt with for years, and I've had a lot of success with that. But sometimes with employers, they get you by the balls. Yeah, there's nothing you can do. And they're like, you can go to this pharmacy and pay 50 bucks. Or look, you can have it here for 30 cents. Well, remember a few years ago, the big, big, big company in our region took away all of the independent pharmacists.

And that was a bunch of bullshit. That was a bunch of bullshit. That's eviscerated. And we had to switch our pharmacy. because they switched it to that pharmacy, and that pharmacy wasn't staffed to handle it. Nope. Nope. So. But the company didn't care because they'd give it to the big bugs.

That's right. Well, no, they got a discount. You know, they were probably saving millions by doing that. And, yeah, so there's just, like, suck it up. We're paying for it, so it's going to cost you a little bit extra grief. Yep. So if there are any pharmacists out there that are getting their hackles up hearing this and you want to talk about this, we'd be happy to talk. Call in.

And I love to talk to you. Listen, we love our brother and sister pharmacists, but these are the kinds of things that get patients riled up. I can't wait to go in there with my list of 12 rebates that I've pulled up and hand it to them and say, here you go, because they're going to hate my guts. Well, you know, and one of our friends who's an independent pharmacist, I know for a fact, if you went in and gave him a list of medicines, he would actually go through and tell you what he could get for each one. which is different from a big pharmacy. I have an independent pharmacy that I call and I say, hey, if this patient comes over there, how much is that, what's their out of pocket going to be? You know, and they'll look it up.

And they answer? Yep. Well, holy hell. But it's an independent pharmacy. And I was there the day the pharmacist was born. Matter of fact, I think I assisted in his deliveries. So that helps. That's hilarious.

Yeah, it's true. We are getting old. We are getting old, aren't we? God, and then he's got a kid, you know. I was in the elevator one day, and this woman, and this was 20 years ago, and this made me feel old, this woman, she was nine months pregnant. They make them walk, you know, to stimulate labor and progression of the head down into the, you know, vaginal canal. And she got on the elevator with me. She was walking around the hospital, obviously pre-COVID, because you don't walk around the hospital anymore.

But she saw my badge and she said, oh, you know, Dr. Steve, you delivered me. I was like, God, dang. Apparently, I don't know, she memorized the doctor's name that delivered her. I don't remember who delivered our kids. Yeah. That goes, well, you were probably a loopy. I was a little loopy. I could give you their face, but I don't remember their name.

Yeah. One was a guy and one was a woman. Yeah. Yeah. I just remember, Liam came out looking like. like a cabbage patched kid. And Beck fell out. And Beck just, yeah, blooped out.

But he was covered in maconium. That means that they took a dump inside the womb is so disgusting. He was just covered in it. Love it. And they had to take him back there and just sort of basically scrub his skin to get him clean. And look how he turned out. He's so sweet and cute. I know it.

Well, then they brought him, it was near Christmas time. No one gives a shit about this. But we're recording this on an off time. for a reason, because I'm going to be away this weekend. But they brought him into us in a stocking. It sounds like he's going to prison for the weekend. I'll be going away for the weekend. Yeah, that's right.

I'm on a weekend. He's a weekend furlough. But they, it's the opposite of that, though, right? I'm on furlough now. Your own furlough. No, you'll be on the furlough this weekend because you'll be out of town doing the fun stuff. Doing fun stuff, yeah. Well, I don't consider staying with Tacey.

prison, so I'm just saying that. Whatever. Thank you. You just said it. You should give yourself a bill, Steve. I was talking about any... You'd give yourself a deal. He said it. I said it.

I was saying, like, if I was one of those guys that got a DUI, I have to go to prison for the weekend. Yeah. That was the... That was the implication. She's just irritated, so she's going to be mad. She's fired up. She's fired up about those drugs, yeah.

So, I fucking, I forgot what I was going to say, but anyway. All right. All right. I love it. Here, let's take this question. I have tasty topic time as well. Okay, well, let's do that next then.

We better just go ahead and fucking do that right now. Mama did the homework. We got to pay up. We did it for next week since I didn't know this was a little prize. If you're getting up once or twice a night, that's usually pretty normal for guys our age, and it has to do with this whole positional thing. So they consider Nocturia to be frequent getting up in the main. middle of the night. That's when nocturium, knocked being night urea, meaning urinating or pertaining

to urine. So night urinating, if it's frequently like once an hour or once every 90 minutes, something like that, then you've got to get checked. Yeah, I say more than three times a night, you're... Fair enough. Okay, well, that to be once every couple hours. And that's fine. I report any kind of symptom like that. This changes, of course, yeah. That's right. All right. Let's see here. It's Tacey's Time of Topics, a time for Tacey to discuss topics of the day. Not to be confused with Topic Time with Harrison Young, which is copyrighted by Harrison Young and Area 58 Public Access. And now, here's Tacey.

Hello, everyone. So happy to be here today. So happy for you to be here. I'm sure. This information came from a journal called Gizmodo. Oh, yeah. We know Gizmodo. Ten strangest medical cases of 2021. Okay.

We'll take that. Okay. Number one, a vertically broken penis, a medical first. Oh, instead of a horizontally broken one? Man had somehow turned the protective layer of his penis vertically torn, sorry, probably drinking, as opposed to the horizontal kind. of tear. It occurred during sex. He did not hear the loud popping sound that's so many here. It may have been less damaging too. It was successfully treated with surgery and by the six

month mark he could have sex again with no issues. Wow, I've never heard of that. Never heard of a vertical penile fracture. So people go, what? Penises can fracture. Yes, when they are fully erect and this happens very often when the woman is on top and the guy doesn't have control of the thrusting mechanism. And perhaps

he's fully engaged but not fully erect. In other words, he might be slightly on the soft side of you know, cat can't scratch it. That's fully erect, fully engorge,

cat can't scratch it. The old whiskey dick syndrome. There you go. So he might have a little whiskey dick. And she thrusts down and either he's slightly malpositioned or there's not as much lubrication as you would hope in a situation like that. And it bends his penis in half instead of thrusting into the vagina or whatever orifice they're messing around with. and you will often hear a cracking noise. You'll have sudden intense pain and swelling.

And it'll cause a splitting of that sheath, the sort of semi-elastic sheath around the outside of the penis right under the skin. And when that happens, very often they try to repair it, and then you get scar tissue there, and then you get bending where the scar tissue is it'll bend in the direction of the scar tissue. And the reason that happens is because scar tissue is inelastic. And the sheath is semi-elastic,

which means it'll expand up to a certain range and then won't go any further, which is good because if it was totally elastic, you would just fill it up with blood and you'd have this big, you know, like water balloon thing hanging off your pelvis instead of an erect penis, you know. And because it's inelastic, the other side will continue to stretch,

but the scar tissue won't, and so it will bend in the direction of the scar tissue. And that's called Peroni's disease. This guy split it lengthwise. In other words, from the Roman War Helmet to the shaft, and that is extremely unusual. I've been doing this 37, 38 years now. God, I've got to figure that out.

I always say 35, but I've been saying 35 for years now. And I've never seen one of them. So that was a good one. That's incredible. Of course it was. Thank you. Give yourself a bill. That's two for you, for me.

None for you. Okay. The second one is a pain in the ass. Scott gets something. Don't eat sharp, pointy things. No. Happened in Japan. It was a 67-year-old had two months of pain along his right buttock and thigh.

They thought it was stenosis. and prepared him for surgery. But a CT scan showed a 7-centimeter rod lodged in his rectum. It was a toothpick. What a row? Okay. So seven centimeters being, well, so one inch is 2.5 centimeters, so two, two and a half inches. Big-ass toothpick, right?

It was a large toothpick. Yeah, don't do it. Okay, so that one was nothing. No, that's a good one. That's a very good one. Yeah, it's hard to believe it went all way through. All the way through. What did they think was to know?

though, when you said they were going to treat him for stenosis. Dude, I don't know. I just, that's just what I wrote. Okay. That'd be a weird stenosis. This other one is a post-COVID psychosis. Uh-oh. Doctors in California detailed two teens who developed severe psychiatric symptoms,

including extreme mood swings, paranoid delusions, and suicidal ideation following a bout of mild COVID-19. It is theorized that the infection triggered a self-destructive, immune response that went after the brain. Wow. The patients were treated with immunotherapy and helped, but one patient continued to have memory problems and trouble concentrating six months later. Important questions are left to be answered, including how often it happens and whether there are multiple ways the infection can have a lasting impact.

Wow. Yeah, I'm looking at medical literature, a case of a patient for. 44 years old, with no past psychiatric history, behavior included psychomotor agitation, and other words, they were just agitated, perception and thinking disorders, disorganized behavior, and attempted suicide by stabbing. And they linked the virus infection with psychosis to the main concern that COVID-19 could induce psychiatric disorders. And we haven't seen a lot of that. I've seen a lot of COVID-19.

I haven't seen any of this. However, there's lots of things that can cause psychosis that you wouldn't even imagine. Especially in teens, right? Isn't that where a lot of these things kind of just pop out and merge? Yeah, their brains are so plastic anyway. Yeah, absolutely. But you know what else can do? This is fluoroquinolone antibiotics.

So I had a friend whose wife was on a fluoroquinoline. I don't know if it was leifiquin or one of those. I just ran, you know, very commonly prescribed. And she went bonkers. I mean, crazy, schizophrenic-like bonkers. And they got her off the fluoroquinolone. It just went away. It never came back.

So it was induced, you know, it had a temporal relationship with her starting it. And it went away when she stopped it. And we looked that up and it's, you know, not unheard of. Right. But not common. If it was really common, it wouldn't be. But just goes to show you, you find, I'll guarantee you that they'd have a single one of those when they were doing phase three

trials. That's why you do phase four trials, which is after market, once it hits the market, and now you've got millions of people, you can tease out those one in a million, one and ten million kind of adverse effects. Makes sense. All right, good one taste. Good one taste.

One more? This homework stuff, hers, she's... Yeah, she's killing it with the homework. What else she got to do? Yeah. Besides... Look up drug... Like a crisis. Exactly. I do. It was coming.

Try to figure out the secret website. Yeah. Yeah, then didn't they give you the wrong website? Yeah, they gave me the wrong website. Here, you can go on our website. And the wrong phone number. But the first phone number helped me with the real phone number. Okay.

Well, I'm going to tell my friend that you have the problem. Well, I mean. They just need a better system. You should be able to, you know what? You should be able to do. Don't go, you shouldn't have to look something up. You put in your. drugs, and then they have an AI that looks it up and goes through all the protocols and

simulates, sending it in, and tells you, hey, you can get a rebate on this one, you can get this one. One of our kids' drugs, this is, now this is almost just as ridiculous, but I'm not going to complain about it. Okay. Seven cents a month. Mm-hmm. Well, that was the alternative.

The one that he's on is 400 a month. Right. But still, why, just give it to us. You're going to charge us seven cents. Is that going to throw your bookkeeping on? Or how about $10 a month and make up, make up, and that way doesn't seem so ridiculous. That's right. Scott gets a damn bill.

Oh, yeah. Cynthroid, 50 bucks a month on this new plan. Really? 50 bucks a month for Cynthroid because there's a generic that just happens to not work. Right. But it's in your opinion In most people's And if you've got Hashimoto's and the generic works for you

Or you think it does and you feel like crap I just don't want to get a letter from somebody's attorney Just saying And I don't have anything to do with it Other than I take it and I've tried both So there you go That's personal experience Yes

I like fired up Tacey on that I love fired up Tacey She's getting too many bills I think That's just personal That's a personal. This one is called nose tooth. And it's from New England Journal of Medicine. It's just a short one.

You know that old feller nose tooth up there in the heart? Well, a patient had a tooth growing inside his nose. He had his stuffed up, right nostril, and they went in and looked, and it was a rare ectopic tooth. So they removed it, and the congestion cleared up. Well, I'd say it did, because he didn't have a tooth in his nose anymore. He And that's all I have for today That was a pretty good one

Ecktopic meaning it's growing somewhere It's not supposed to be It's in the wrong place Wrong place, wrong down Thank you, Tacey It's Tacey's time of topics A time for Tacey to discuss topics All right, thanks Tase

Good job Tase You're good All right Those are fabulous That's awesome You got to say Yeah, you have to, since I'm sitting next to eat. Hang on.

Now I've got Tacey's time of topic still. This is Tom from Michigan. Hey, Dr. Steve and Tacey and Scott. Hey, man. Any other special guest in the studio. None. This is Tom from Michigan. Hello, Tom.

And my question with regard to surgery, I have been told that sometimes after someone is for lack of a better term, cut open. Yeah. The surgeons can sometimes not get them closed back up. That is true. I was wondering what the truth to that is, how common it is, what causes that, and how how do they get the person closed if that's the case.

Thank you. Yeah. Well, you know, sometimes they'll leave you open to let you. heal from inside out, you know, for certain, after some surgeries, you know, after some cysts, they'll actually help inside up, yeah, that is correct. I mean, I'm not talking like an open heart surgery. Well, like, let's just say you've got an abdominal surgery and the patient had some insult to, let's say it was an ischemic bowel. In other words, a bowel that was dying because it has no blood supply. And maybe the bowel died and they have to go in there and open

it up. And of course, and then take out the dead bowel and then put the two things together, you know, the two ends together. And when they do that sometimes, there's been so much inflammation in there from just having a chunk of dead bowel. And now, or if you had an obstruction and you clear the obstruction, now fluid is freely flowing. And all of a sudden, the guts that they're in there, start to balloon up because they're full of fluid. Right. And not inside the gut, but in the tissue. Because if there was just inside the gut, you could maybe drain it or whatever, but it's

really in the tissue, so you can't drain it. It's like sponge just expanding. And now you can't close the damn thing. Right. And so there's two kinds of delayed wound healing. There's healing by secondary intention and healing by tertiary intention or secondary wound healing and tertiary wound healing. So tertiary wound healing is healing by delayed primary closure.

And that's when you need to delay the wound closing process. And if they feel that they're trapping infection in the wound or, you know, they may allow the wound to drain like you were talking about and then wait for the effects of other therapies like antibiotics or something like that to take place. and then they close the wound. And then there's secondary wound healing is when you have a wound that can't be stitched.

So that's what he's talking about because there's so much swelling under there or you had to take out so much skin that now you can't close the damn thing. And they leave the wound to heal naturally in those cases from below. And this is more common for wounds that have rounder edges

or covering uneven surfaces, things like that. Or like I said, when you've got so much swelling, underneath the wound edge that now all of a sudden you can't close. Now, I used to teach a really cool stitch called the Near Far Far Near Stitch

that'll close just about any damn wound. It'll close wounds that are under a lot of tension. And if we have any medical students out there that want to learn that, I could teach it to them. But anyway, it was taught to me by an old pro surgeon, one of these old school. He was an army surgeon and then came and started practicing. And he was really pretty...

He knew some things, huh? Yeah, he knew some stuff. And he was tough on us, but he really liked us because we wanted to learn from him. And we always gave him the respect that he deserved. Whereas the surgical residence kind of, you know, he's an old man, all that kind of stuff. What does he know? He knew all kinds of cool shit. And, yeah.

So anyway, yeah, so that's what that's about. So, yes, there are times when a surgeon opens you up and they can't close you again. And most of the time they're going to know ahead of time, and they'll warn you about it. This might happen. And if that's the case, then that's just the deal. It takes longer before you're playing football again. Yep. And then sometimes they suit you up and then swelling inside, they weren't counting on causes some of the seams to start to bust open.

And you can get compartment syndrome that way where if you close up a, you know, a wood and it's swelling under. total needs and stuff like that, you know, sometimes. And there's swelling under there, and it's got nowhere to go, and it cuts off the circulation because there's so much pressure because of the swelling of the muscles and the tissues around there. So anyway, all right. So that's what, yeah, that is absolutely true. That's a good question. Healing by secondary intention or second intention.

All right. Okay. This one is apropos to what we were talking about before. Hey, Dr. Steve. My name is Don from New York, and I have a question for you that other listeners might be interested in. Today, I had a pharmacist reduce my dosage of El Prisselaam, which is Xanax, because he felt the doctor is over-prescribing me. Is this legal? And can this be done?

Thank you very much. love listening. Have a great night. Yeah, yeah, yeah. Okay, so every state has different rules on prescriptive authority of pharmacists, but I am not aware, and again, pharmacists call in and set us straight on this. I am not aware of a state that allows a pharmacist to change the dose. They can change how they give it to you.

They can decide how they, how they, want to do it and how they want to dispense it. But I'm not aware of a state that allows a pharmacist to actually change the dose of a controlled substance that was legally prescribed. Now, they can refuse to fill it. Okay. Totally fine. Yeah.

You know, I don't think, you know, I don't agree with this or whatever. Sometimes they have a good reason to do it. Sometimes they're ignorant of what's really going on. And a lot of times the prescriber has not explained to the pharmacist. This is why we're doing this, because you can put that on the prescription. Okay. You have to put the ICD-10 code saying, well, they've got metastatic cancer with painful bony tumors, and they've got a pathological fracture and stuff like that. And this is a weaning or we're weaning or whatever.

You can write all this stuff on the prescription. Wouldn't a phone call maybe be in order? That would, thank you, Tacey. There you go. Give yourself a deal. You know what? You can give it up. He's afraid of me to not.

I've lost it. I'm done for it. I'm hanging up. Pick up the phone. It's so funny how you guys, your self-worth is, yeah, here you go. There you go, Scott. Give yourself a bill. Yes.

I don't care if I deserved it. Fake. So fake. It's bullshit. But picking up the phone and having a discussion, although I've had that where that didn't work, where they actually picked up the phone, said, we think that this person doesn't need this. And it's like, okay, well, let me tell you why they do need it. And, you know, and you want to go, are you board certified in this, this, and this? Because I am.

Have you published 112 articles in the medical literature on this particular thing? Well, I have. You don't want to do that because then you just sound like an asshole. And actually, you are an asshole. So, you know, I try to have a collaborative conversation with them. But, yeah, I had one where I was sending them all kinds of documentation. They just still wouldn't do it. And you know what I felt?

And they're like, well, they're on too many pills or on too many pills. Did you ever see the movie Amadeus? I did. Yes, I did. Okay, do you remember when he wrote the magic flute? No. And Sally Arie was whispering in the emperor's ears, Emperor Joseph something. And he goes to Mozart and he says, Mozart, your opera has too many notes, which is, you know,

it's kind of a ridiculous thing. to say, and Mozart just said to him, okay, you know, your grace or your excellency or whatever you say to the emperor of whatever that, you know, in Vienna, which notes should I remove? You know, and that's what I feel like saying to them because it's just tell Mozart it's got too many notes and him just come back and say, that's fine, which ones do you want me to take out? That's what I feel like saying to them. Well, just give less, less, you know, it's just too, well, what are you basing? that on. Everyone has different tolerance. You know, opioids, particularly have no sealing dose.

It's the only drug you can think of that doesn't have a max dose. If you want to give somebody Simbalta, aka. Deloxetine, the max dose, 60 milligrams, unless you're a psychiatrist, you can go a little bit higher. But, you know, if you want to give somebody ibuprofen, the max dose, 2400 milligrams, assuming that their kidneys and their GI tract is okay. You know, there's always these caveats, but there's always a max dose. The max dose of opioids is assigned by the patient. Whether they get relief or they have tolerance, what their tolerance is. So something that might be a normal dose for one of my patients would kill all three of us.

Yeah. You know? Because we're not tolerant to it because none of us take opioids. So for a pharmacist or anyone else to look at that prescription, say that's too much medicine without having – Examine the patient and looked at their history and had an ongoing relationship with them over time is a problem for me. So it sounds like we're just ragging on pharmacists today. I love our pharmacist partners. I don't mean to because I'm just switching from one to another, the one that I loved, loved.

Yeah. To one that I don't know. Yeah. It's the unknown. And they weren't very helpful. No. And I think if you want somebody's business, be a little more helpful. Yeah.

So, but part of it is the system. They can't tell you with their system, I've not seen a single pharmacy that's able to do this, except for that one that I call, but I don't know what they're doing. They're finagling something I think they're doing. I think they're actually sending the prescription in and then canceling it, I think. And you can't get a lot of pharmacists to do that for you. But until they try to run it for real. it won't tell them anything.

I think that all pharmacies should have some sort of simulator. Hey, if you do this, this is how much you'll pay. And if you do this, we could get it down to this. And maybe at some point, incorporate AI to get to the minimum quicker. I mean, it's not rocket science. That should be a given. Yeah, well, unfortunately, it kind of is rocket science, though, because you've got rebates, you've got prior offs, you've got all this stuff.

and having some, you know, machine learning things say, hey, what we've learned is if you use the rebate for this one, but get a prior off on this one, and this is what you've got to say, you have to fail on these drugs, and just giving them a do this, then this, then this, then this. So they were so unhelpful. I have a list of rebates that I don't want to go back in there with my list of rebates and say, here are my rebates.

Right. Right, but you're going to. You're going to take them a list of rebates and hand them to them, right? And then they're going to say, well, we'll have to wait until we fill those. Right, right, right. And then I'll leave. Yes. So that's what's going to happen.

Yeah, yeah. Which is irritating. Yeah, I know. Because it should be helpful to them to have the rebates ahead of time. Of course. You would think. Of course, but they won't. When they're dead like they were when I was in there today.

Yeah. That's a busy to be different. That is irritating. And what we're not seeing, of course, is all of the e-prescriptions that are flying in. Don't know. I don't care. Steve. I don't care.

I don't care. Next question, Steve. Fair enough. Quit talking, Steve. Hi, my name is Alex. I wanted to know if allergies could trigger sinus infections. Absolutely. Are they not controlled by that?

They are. I mean, they're not controlled by that. Scott, you want to take that? Are allergies? Yeah. Yeah, I mean, if you have allergies, was that increased your risk of having a sinus infection? Oh, gosh, yeah, yeah, because the allergies are going to stimulate all of those histamidic responses inside your nasal. Okay, okay, what does that mean?

So, in other words, yes, the allergies can be anything from, you know, dust to, you know, to pollen, to grass. It can be anything. So what's the mechanism by which allergies could lead to a sinus? When those little things go up into your sinus that cause inflammation. Okay. And that inflammation can do a couple things. A, it can create excess mucos that can cause an infection, ultimately. It can also dry you out.

And it can dry out your sinuses, and that can also lead to sinus infections. When your sinuses crack and it leads to infections. Yeah, well, I'll give you a... Give yourself... Stop it. One that half today. Yeah, and I think also you get swelling of tissues. When you have histamine release in the nose in response to an, you know, an antigen that's up in the nose.

And in this case, an allergen, which is an antigen that your body makes an immune response to. Then you get swelling of those tissues because one of the things that histamine does is open up the blood vessels and you get mucus production. But you're getting mucus production by opening up the capillaries. And yeah, and so Dr. Scott's miming. Wash him out. His CBD nasal spray. And I don't disagree with that. But so what happens is you get that swelling and it blocks off drainage of the sinuses themselves.

So the maxillary sinus, which is where you get sinus infections most of the time, not always, but most of the time, has a little hole out to the outside. All airfield cavities in the body have a hole going to the outside world to equalize pressure. And that maxillary sinus, which is below your eyes, you know, you're what do you call this? the cheek bone. Well, it's maxill of it. What a women call this? Zygomatic. Is that your cheekbones?

Yeah. Your cheekbones. Okay. No, Zygomatic arch is on the side. That's right. Yeah, that's on this side. It goes to the back. Yeah.

It goes to the back toward the ear. But yeah, I'm just trying to give people who are listening. Oh, yeah. Under your eye ball beside your nose. Yeah, there you go. Good. There you go. You get another half.

Yeah, that's a full deal. That equals a whole one. So, but the whole. is between two terminates, which are folds of tissue inside the nose itself. And when those terminates are engorged with fluid,

then they will block off the osteum, which is the hole coming out from the sinus. And when it can't drain, it's just going to fill up with fluid. One snort and a bad bacterium and you got an raging infection in there.

So that's why we usually recommend that people wash out their sinuses, you're really washing out your nose and trying to break that log jam of decreased flow in there so that it can flow again and sort of open up and let the body do some of this work. Because really trying to take an antibiotic to kill bacteria in the middle of a fluid collection is very difficult to do. So anyway, but yes, allergies absolutely can cause that. We are doing this ahead of time.

As we speak now, it is about a week past the Rochester trip. So next visit, I will give you a, or next time we're here, I'll give you an update on that. I did want to tell everybody I was on a shitty song of the week last night, and that's a podcast where they take a song and dissect it and say why it's crummy. And we did wimpiest songs. I've been wanting to do this since 1967 since this song came out and I'm not going to spoil what it is because I went second. Well, you like a lot of wimpy songs, though, like the Smiths and stuff like that.

I do like the smiths and stuff like that. Oh, God, that would have been a good one. Yeah. I am human and I want to be loved. I do love that. I do like some wimpy songs. That's another wrong. But this wimpy song really bothered me.

So check out shitty song in the week with Brandon and Red. It was a fun time, and they're very nice boys. Anyway, thanks to everyone who's made this show happen over the years. Listen to our Sirius XM show on the Faction Talk channel. Serious XM. Channel 103, Saturdays at 7 p.m. Eastern, Sunday at 6 p.m. Eastern on demand. And other times, at Jim McClure's pleasure. Many thanks to our listeners whose voicemail and topic ideas make this job very easy.

Go to our website at Dr.steve.com for podcasts and schedules 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. Hi, Holly. And stay here. Thank you.