Weird Medicine: The Podcast - 566 - When Your Provider Is a Dunce

Episode Date: November 15, 2023

Dr Steve, Dr Scott, and Tacie discuss: depression vs thyroid disease some providers don't LISTEN - patients aren't numbers on a piece of paper metformin for long-covid gut benefits from intermittent fasting loganfield dredges up an oldie 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/cbd-sinus-rinse (the best he's ever made. Seriously.) RIGHT NOW GET A NEW DISCOUNT ON THE ROADIE 3 ROBOTIC TUNER! roadie.doctorsteve.com (the greatest gift for a guitarist or bassist! The robotic tuner!) see it here: stuff.doctorsteve.com/#roadie Also don't forget: Cameo.com/weirdmedicine (Book your old pal right now because he's 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 ;-) PLEASE NOTE: as soon as our channel has moved to Studio71 we will be back to weekly shows! Learn more about your ad choices. Visit podcastchoices.com/adchoices

You see, you see, you see, your stupid minds, stupid, stupid. Man, you are one pathetic loser. You get nothing. You lose. Good day, sir. 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, 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 Zabolivis stripping from my nose. I've got the leprosy of the heartbells, exacerbating my incredible woes. I want to take my brain out and blasted 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 insane I want to requiem for my disease So I'm paging Dr. Steve From the world famous Elias from Kentucky

Studios It's a long story It's a weird medicine The first and still only Uncensored Medical Show In the history of broadcast radio now a podcast. I'm Dr. Steve with my little pal, Dr. Scott.

The traditional Chinese medicine provider gives me street cred the wack alternative medicine assholes. Hello, Dr. Scott. Hey, Dr. Steve. And my partner in all things, Tacey. Hello, Tacey. Hello. This is a show for people who never listen to a medical show on the radio or the internet.

You're 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. 3477-68-4-3-2323. That's 347. Poo-Hid. Follow us on Twitter at Weird Medicine or at D.R. Scott W.M. Visit our website at Dr. Steve.com for podcast, medical news and stuff you can buy. Most importantly, we're 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 over first with your health care provider. Don't forget to check out stuff.com. Stuff.doctrsteve.com. I'm going to I'm not going to beg, but I'm going to ask you to go to stuff. Dottersteve.com. Click through to Amazon when you're going to buy something or scroll down and see what we got on there because there's some interesting things there. Plus, it really helps to keep us on the air,

including the roadie robotic guitar tuner, which is amazing. And check out Dr. Scott's website at simplyerbils.net. That's simplyerbils.net. Check out Tacey. and me on patreon.com slash weird medicine, where we do special shows. Dr. Scott and I may be doing a special Patreon show this weekend because Tacey's going to be out of town. Oh, yeah. So it might be a music show, though.

Carl knows that those don't go well, but we're going to do it anyway. And then cameo.com slash weird medicine. I'll say fluid to your mother or whatever else you want me to say within reason. Now, the reason I said for the Elias from Kentucky Broadcast Network is because Elias from Kentucky is listening and he is 13 and started school. Yeah. Why his mom lets us listen or lets him listen to this. Because he's awesome. Horse do do not know, but we do appreciate him listening and we appreciate his mom too.

and that's about it. Well, check out Dr. Scott's website at simplyerbils.net. That's simplyerbils.net where you can find the best CBD nasal spray. Yes. Actually, the only CBD nasal spray

that I've ever seen. Yes. And we've got someone in the YouTube channel, the fluid family, named Diesel Child, and he or she, I'll just say they, apparently bought six bottles of that crap from you. By going to Simply Irbles.com.

And I give Scott a hard time. It's not crap. It's actually awesome. It's, you know, you say some silly things on this show sometimes. Of course. But that stuff is the bomb. So we're not supposed to actually be selling things. But check it out at Simplyerbils.comnet.

That's his website. Anyway, yeah, very good. Okay, man. I'm proud of you on that one. Thank you, sir. delivery system ever now N. P. Mel B. was going to be here

today and she had to think out because she had to have dinner with her mom. And P.A. Lydia was going to be here today but what is it? She got drunk and ate a hot dog in New York City or something. What the hell was that? I don't know. I was not...

You're still hung over. You're still hung over. I'm still hung over, I think. Bullshit. on that text thread. DNP, Carissa, had a headache and took a drug for the first time, then she just smoked up a second ago. Anyway, we're going to put them back on rotation, and hopefully now that N.P. Melb's business is straightened,

and she'll talk about it, and Tacey, you and she have a lot to talk about because she feels the same way about endocrinologist that you do when it comes to thyroid stuff. Yes, exactly. And I'm just going to blow up her spot a little bit. What she's, her point is, is that they look at numbers, and they go, oh, well, your thyroid stimulating hormone is a little bit low, so we need to back off on your thyroid hormone. And she's saying, I feel good for the first time in, you know, 10 years.

Please don't do that. And they did it anyway. No. And Tacey's had the same problem. I got up and walked out when a physician was talking to me about depression when I was trying to tell him I felt like crap because of my thyroid. I know the difference. Right. So I just got up and walked out because I was wasting my time.

Well, tell us the story a little bit. So let's talk about the symptoms of depression. And hedonia, the inability to enjoy things, right? Apathy, the inability. Did you know that Anne Hedonia's was my ex-wife's middle name? T-he, that's a pretty good one. I knew it. Yeah, yep, yep, yep.

Give myself a bell. That was, you deserve that. Give myself a bell. Not too, though. Yeah, that was good. That was good. I'm sorry. She doesn't listen to this show, does.

I hope she does. She probably does. I'm just for the torture. So I'm sorry, Taze. I didn't interrupt you. No, no, no, no, you didn't. That was good. That was funny.

Yes. My middle name's Ann Hedonia. Blank, and Hedonia, blank. Well, her first name was Anne and her middle name Hedonia. Anyway, that's not even good, but it would work. It would make sense, though. It would explain a lot of things. And, you know, the Anne in front of, so hedonism, that's where this comes from.

The word hedonism means to enjoy everything. and to kind of overdo it and then the Greek A in front of it, but you wouldn't say A hedonia, so we'll add the N sound to split up those phonem. So Anhedonia means not enjoying things. Okay, so, but that's the root word. Interesting, yeah. For hedonism and Anhedonia are the same.

So Anhedonia apathy. Right. Let me see. What else? you know, change in eating habits, change in sleeping habits, depressed mood, those kinds of things. That's not what you were having, right, Tase? No. What were you having?

I was exhausted all the time. Fatigue. I mean, and I could not. The one thing that was in common between depression and this. I knew something else was going on and my numbers were, they had told me that I had Hashimoto's. Tell everybody what Hashimoto's is because they've got to get on the same. page. It's just when your thyroid screwed up. I mean, your thyroid

doesn't work anymore. Give myself a bell. At first it works too good and then it won't work at all and then it's back and forth and back and forth and back and forth until it just does. It's an autoimmune disorder where the thyroid is attacked by

your own antibodies which initially causes it to be stimulated and maybe produce too much thyroid hormone and then when it finally kills the thyroid, then this is oversimplified, but when it finally kills the thyroid, then

you're producing too little. Right. Right? So, tell us what you felt like. Just give us the experience that you had with the endocrinologist. Okay, my anxiety was through the roof. I mean, I couldn't hardly function, and I was exhausted

at the same time. Yeah. So I walked in to see him really hoping for some help from this, quote-unquote, specialist. Correct. And my family practice physician knew more than he did, and he treated me by a number. And your evidence being what? What did he do?

My evidence being how I felt. No, I'm saying your family practice provided knew more than this person as far as treating you. What's your evidence when you say that? Well, because she made me feel good. He did not. Okay. and what did he do? He didn't do anything.

Pissed you off. If he didn't do anything, you wouldn't have walked out. What was the conflict? Well, he said, don't let depression get you down. Your numbers are fine. There you go. That's the key. So what he did was he looked at you as if you were a number on a piece of paper

rather than looking at the whole person. It's called a holistic approach to medicine. We're not talking about holistic medicine. That's Dr. Scott's Baileywick. What we're talking about is looking at the whole person. And people are not fucking numbers on a piece of paper. Men have the same thing when they go in and the range of testosterone is 300 to 800 and your testosterone is 301. And they go, well, you're normal what's in the normal range?

So ain't nothing wrong with you. It is such bullshit because what they're doing, Tase, is confining you to one or two standard deviations on a bell curve. But the reason we have fucking bell curves is because there are people that live on the periphery. And that's why you have a bell curve. Not everybody has to be confined to one to two standard deviation. You've got to use your – I'm mad today. You've got to use your head when you're looking at these. And it's just like my, no, it's as if you had an employer that said, we're going to only pay you, you know, if you're unproductivity, for example, we're only going to pay you two standard deviations above the mean.

Anything above that, we're just going to cut it off. It's stupid. You work till September and then you're off October, November. Yes, it's idiotic. And when you look at testosterone, particularly, how do they determine these normals? This is the problem with these quote-unquote professionals, is they've forgotten their math and they've forgotten where these numbers come from. These ranges aren't just set in stone. They are determined empirically.

In other words, you get a thousand people. Let's do testosterone first, then we'll do the thyroid. You get 1,000 people and you test them all for testosterone. And then you take the mean of those numbers and you go two standard deviation, just a simple mathematical thing, and you go, that's the normal range. We're going to agree that two standard deviations from the mean is normal. Well, the problem with that is that a lot of people are walking around with undiagnosed low testosterone, and they are included in that.

And they're miserable. And, but they're included in that calculation. So it's skewing the normal range down. And so you are including people with low testosterone. Whoa. What was that? I don't know. I didn't touch anything else where.

I didn't touch anything. Okay. All right. Maybe it's just my brain getting ready to explode. You're, it's skewing the normal range. downward. And so when you have a provider, and I'm looking at you, nurse practitioners and P.A.'s two when I talk about this, that says, well, 301's normal, but 299 is abnormal, but you've got somebody, let's say they're 350, but they have all the symptoms. Right. They're low testosterone,

we're talking low testosterone here, fatigue, erectile dysfunction. Insomnia. sure insomnia is a big one that's what mine is yeah um and they also have uh physical weakness and loss of libido etc etc but you're telling somebody oh no you're normal so i'm not going to treat you you're an asshole yep yep and it's the same gd thing when you have somebody with thyroid disorder and you're confining them to two standard deviations from the mean whereas you and mLB both are slightly different and you need a slightly different number. It's, oh, and you know the other thing is, when you get a

number that is abnormal, what's the first thing you do? Scott, and you're not a clinician in this sense, what's the first thing you do when you get an abnormal test result? Thank you. Okay. Oops, oh shit. He's giving bells out. Yes.

They're coming out of style. I know what? I can hear a bell in my head. Give thyself a bell. Oh, there's your bell. All right, I got it fixed. Anyway, so what were we talking about? Where were we in that conversation before I went looking for? Something about deviated standard. From the norm, that's a deviated septum.

Yeah, you guys are just different. You need to be treated like people, not numbers on a piece of paper. That's all I'm trying to say. And I like to add to that, too, Dr. Steve, you know, 50 years ago, which is not that long ago, right there weren't computers saying well you know your your thyroid or and you know the the the providers used to go oh gosh you have these things you must have blank right and didn't necessarily need a a lab value that was generated through a computer right it says hey man you yeah you get this stuff so I think the biggest

we've lost our ability to listen yes thank you pay attention I'm not giving you another belt I agree with you 100% but it's 100% right because people like Tacey you know, the benefit Tacey has is, first of all, she's smart, she knows her body, she pays attention, and she can articulate, you know, but think about that's my point, but think about the folks that don't have

her knowledge of medicine. Yeah. I mean, hell, they're just walking out. They're walking out and they're going, well, I guess I ain't got that. Yeah, I guess I'll just feel like shit. I guess I'm supposed to feel terrible. Hey, Tom, like 301. I'm normal. I'm normal. Yeah, it beats all ever, so. Yep.

Clinicians out there look at your patient. Okay, I'm going to tell you a story. The year is 1987. I am an intern in family medicine, rotating on internal medicine. I'm 13 years old. Okay, fuck off. Nope, who's wrong. We're wrong. Can you like, shut up?

So anyway, actually, let's amend that. It was 1986 so you were 12 and which by the way I told her dad at one point thanks for being such an asshole and he was like well okay what do you mean I said well if you had invited me over to your

house when I was an intern like these other people I won't name because it'll docks everybody but like this attending and that attending who had us over for barbecues and stuff like that. Instead, you were an asshole

tried to keep me out of the doctor's lounge, and you didn't want to have anything to do with us, unless it was two in the morning, one of your patients died, which they always did. And I had to go pronounce them. If you'd been a nice person like that, I would have met Tacey when she was 12,

and when she came into my office at age, whatever it was. Now she's older than that. Then she would have been off limits. Because I would have gone, oh, I met you I remember when you were diapers, yeah. Yeah, but instead, he didn't, and here we are.

But anyway. There you go. So, what was I going to talk? Oh, no, so, okay. Just rambling? Yeah, you got a story. 1986. You were a resident.

Yes, I'm just rambling. Internal medicine. So, 1986. Right. Got a lady in the intensive care unit. Her legs are mottled. Her blood pressure is 70 over nothing. and she had what we called then bacteremia,

which we now call sepsis. Okay. And it was pretty obvious, and she had stage four cancer, not obvious not going to make it. But she had a slightly elevated creatin, which is a sign of kidney failure, and her potassium was six.

Now that's what we call a panic value, when your potassium is elevated. Because the body usually is just in its homeostasis. In other words, it's desire to keep everything on a normal level and compensating for changes and stuff like that. It wasn't able to do that anymore. So my chief resident, who will also remain nameless, looks at this and goes, okay, and he starts firing off orders, right?

Ding, ding, ding, ding, ding. give some furosomide IV. Let's do kxolate, which is a potassium retaining resin. Give her a kxlate enema. We'll do this, this, and that. And maybe some calcium, if I remember right, intravenous. And we moved on on rounds. Well, that afternoon, when we did afternoon rounds,

he looked at her labs, and it showed a potassium of 4.2. And he's like, yes, yes. And he's strutting up and down the ICU, you know, punching the air as if, you know, he'd actually accomplished something. And I'm, and back and this went on. Oh, wow. For several minutes. Showing off how smart he was.

Yeah. Or she was. Or yes. Yes. And punching the air. And I'm like, dude, you know, you're not looking at the patient at all. You are literally looking at a number on a piece of paper and congratulating. herself. And, you know, she passed away that night, as everybody kind of knew that she was going

to. And, you know, it really, it was a little bit later, I saw a movie called My Dinner with Andre. Have you seen this movie? No, I've never heard of it. It's Wallace Sean. And can you look it up. I can't remember the director's name. It wasn't Andre Previn. It was a different Andre. And Wallace Sean did this movie. It's my dinner with who? I'm sorry? My dinner with Andre Gotcha Well, how far It's a little short-term

Remember Luffs Literally four seconds ago But anyway My dinner with Andre And it is Two hours almost Of Wallace Sean And Andre

So-and-so Eating dinner And them just having a conversation And at one point During this, Andre, the director is talking to Wallis Sean, the actor, and you know him, right? It's Wally Sean, the guy from, you know,

it's inconceivable from the Princess Bride. And, but Andre's talking about when his mom was in the hospital, and if I remember correctly, she had stage four cancer, similarly dying in the hospital, but she had fallen and broken her wrist. And the orthopedist had splinted her wrist or casted or whatever. and he came out and talked to Andre and said yeah she's doing great she's doing great all he looked and he said all he looked at was her arm right this patient elderly woman dying in the hospital and he comes out and says she's doing great because he had looked at the cast on her arm and he had done his thing and it was a good job did you find out who Andre is no but I will tell you this Hey, but I will tell you, hang on.

Andre Gregory. Yeah, there you go. Well, I was reading, Andre Gregory. Rotten Tomatoes gives it a 92%. Yeah, it's been a really good movie, yeah. It's an awesome, awesome kind of art film. Yeah. You have ADHD, too.

He got caught up in the... I told somebody, though, that I said, the only person I know with worse ADHD is me. And us two together, poor Tacey. Scott's reading the review. Tacey needs medication. Oh, this thing got good reviews. It was sort of a salmon.

art film, existential film where it's just two guys talking for an hour and a half and that's it. And it was really, they're... Is it sad or is it? No, it's really compelling. It's funny. Yeah, it's compelling. It's crazy.

You know, it's Wally Sean. Oh, he's awesome. He doesn't love him. It would be inconceivable. I don't like him. Right, right, right. Yeah. But anyway, so same sort of thing. And back then, when was that movie did it say Dr. Scott

Okay. I'm on it. I'm on it. No, I'm going to beat you. Hold it. It was about the same time. About the same time. Damn it, she's right. I don't think I saw it until after this thing had happened, but it was contemporary. It was in the same decade.

And that was what was going on in medicine right then, as we were just looking at our own little pieces, and we were looking at people as numbers on a piece of paper. And sadly, for Tacey and N.P. Melby, and countless dudes

who have low normal testosterone this shit is still going on. Now, if you have low normal testosterone and you're symptomatic, email me. Go to Dr. Steve.com, click contact, or you can just email me.

I give out my email address. I don't give a damn. It's DR. Steve 202 at gmail.com. And I will send you an article to print out and take it to your primary care provider that says, says you should treat low normal people who are symptomatic. Because when you do that, if they have, quote, unquote, low normal testosterone,

which we now know if you're symptomatic is low testosterone, that it improves their health-related quality of life. And that's all we care about when it comes to testosterone anyway. Yeah. And I think a lot of people don't understand, too, Dr. Steve, that, you know, those numbers on some people, a 300 may be high for some people depending on what their baseline was, you know. And that's why it takes just a little bit of effort from your provider to say, well, let's look at this and see how you're doing.

Because just because if it's 302 and you feel awesome and you're lifting weights and everything's perfect, you don't need it treated. Yeah. It's in the same token. Yeah. That's right. That's right. If you're not symptomatic, I wouldn't treat it. No, heck no.

If the numbers were low, that's correct. As long as you're good. That's what we're trying to do is treat symptomatic hypogonadism. Right. Now, if you want to preserve fertility, you don't want to necessarily get on testosterone. If you're trying to have a kid and your testosterone is low, then you want to get on chlomaphene, which Tacey was on. You want to talk about that experience? Made me evil.

Yeah. Well, you weren't so evil, but when you came off of it, you were crying for two weeks and went every time your pregnancy test was negative. was what they were giving it to her for was to stimulate ovulation because Tacey has PCOS. And it's like piece, it's like pieces of shit, right? PCOS. And so for months and months and months, they gave her a certain dose of chlomaphene,

and we would have to have intercourse at a certain time. and that included whether we had people over to the house or not or a clock could go off and say well we have to do it right now and that was always fun it was sort of like what I imagine medieval marriages were like where the people had to sit outside and almost watched the king and queen consummate their marriage

to make sure it was legal well it had to be done so yeah that's what it was just had to be done it wasn't for any It's a good thing she didn't enjoy it. It was just to be a job. No, it just happened. But when it happens that quickly, there's not a lot to. But then they doubled her dose and then she had, then we got pregnant with Liam immediately.

Oh, wow. Yes, but we were also on vacation. Correct. I think the stresslessness of it. We highly recommend to people who are having trouble getting pregnant is go on vacation. It works almost every time. Yeah. It works for us twice.

The second time we were on vacation and we didn't know it because we came back and said, okay, we're going to have another kid because Liam needs somebody to play with, which he played with him for about five years and then that was the end of that. But, you know, he, you know, anyway, so they don't dislike each other. They just have nothing to do with each other except now they're living literally on top of each other in college. So we're going to see how that goes. But I was looking forward to the attempt at getting pregnant again because what that meant was clomaphene then have intercourse, intercourse,

intercourse, then cry for two weeks, which I could live with if the first part was happening. And then do it again until she got pregnant. and she was just getting ready to start the clomophane and what the fuck she was already pregnant and I'm like rats no more sex for me damn it's over the fun was over at that point yeah she came in and said look at this because they test you before they start giving you the clomede

which is the appropriate thing to do and she was already pregnant and that again happened on vacation so so that's where that's how the streak began yeah and then the first time you were in in labor for what 17 hours and it was rough and she had to have the epidural and all this stuff the second time she barely had

time to get the epidural and when they got the epidural in they said well let's check you and she was 10 centimeters and it was like oh let's get this thing out of here I got stuff to do her dad didn't make it her mom didn't make it you know it was like we're having this baby right now so really

Tacey could she just blooped back out she could have had 20 kids if we'd been you know Frontier Marm and Pop A little younger. Yeah. I pushed harder to pee. Yeah.

You just bloop and there he was. He just fell out. Okay, but let's move on. Okay. What was that bad? Enough Tacey. Enough Tacey. 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. By the way, Logan Field is in the in the fluid family waiting room and that's my friend John that I went to visit in Wilmington and we just got my Moogfest blanket back so John thank you very much my friend

and I had a question from him in the queue and I just realized it was from 2021 so maybe we'll play it anyway in honor for me. I think it's some damn anti-dive vaccine thing, which is fine, but I think that's probably what it is or some vaccine skepticism from 2021, because John was quite the vaccine skeptic. Well, we'll see. Since he's here, we'll play it. And then we can either make fun of him or go, yeah, bro, you know what? You were fucking right. So anyway, what you got, Tase? Okay. So my first article or topic is about ADHD and how There are symptoms beyond a lack of focus.

Uh-oh. Yes. Check. Here we go. I have 13 other ADHD symptoms as well as the criteria you must meet to receive a diagnosis as an adult. Okay. Let's have them. Let's have them.

Okay. Check. Pretty disorganization. What? Disorganization. Check. Relationship concerns such as inattentiveness being easily bored, talking over people in conversation.

To what now? I'm not, I didn't hear a thing she does that. So anyway, what's the next? As a curse, as a result, a person with ADHD may come across as insensitive, irresponsible, or uncaring. And do what?

No, we're doing that. That's inconceivable. Number three, lack of focus, of course. Oh, shit. Being easily distracted. Did you see that fucking thing? We are on a role. Finding it hard to listen to others in a conversation.

Check. It says I usually listen to Sirius every Saturday. It's past Saturday. There wasn't an episode on the feed. What? No. Uh-oh. Not in a baseball game on.

Oh, I bet they're preempting us again. Number four, restlessness and anxiety. Sh, double check. Got to get the fuck out of here. An adult with ADHD may move around frequently, tap their hands or feet, loo-loo-loo. Shift in their seat.

Find it difficult to sit still. See, Jimmy, when I walk like this, yeah. Emotional concerns No, don't have you this Hyperfocus Oops, oops It often easily Distractive but they may also have something called hyperfocus

Where they can get so engrossed in something That they become unaware of anything else around them That's how we knew our kid had Liam Played Star Wars, Lego Star Wars We just wanted to see how long he would go What was he six? Yeah

And we wanted to see how long he would go Oh, and it was hours and hours and hours. We weren't going to stop him. We eventually had to. It was like, well, we can't keep up on top of that. Well, he was hogging the good TV. He's the hogging the TV. Exactly, right.

Okay, go on. Time management concerns. Procrastination on task. Showing up late. Fuck off. Ignore assignments they consider boring. Mm-hmm. What about forgetfulness?

Not a chance. he's a fucking idiot we all know that that can affect careers and relationships impulsivity interrupting others again being socially inappropriate rushing through tasks I got it all right

acting without much consideration for the consequences it sounds like this is a is she talking to her therapist written by I'm just kidding Negative self-images. Yeah, well, I am a fucking idiot. Lack of motivation and fatigue.

Physical health concerns. Okay. Okay, enough. I was 99 out of 100 so far. Yeah. Substance misuse as well. That I don't have a problem with. So testing for it.

Unless Celsius counts. Which I think for you sometimes it might. It might. Okay. And okay, Ms. Perfect. Ms. Wine drinker. Testing for adult ADHD. Okay.

It typically involves at least two detailed interviews with a mental health professional or primary care physician. I barely sit down for one, much less make it two. And then you need to have, according to the DSM-5, which is diagnostic and statistical manual of mental disorders. You need three ADHD presentations. I'll read. Sorry. Three. Three of those symptoms, yeah.

And so treatment, you know. I was just looking at my sound board and wanted to play that one. You may want to consider cognitive behavioral therapy if your symptoms are mild just by getting organized sick with plans and finish activities that you start. I'm so fucked. And, you know, the thing is, I'm 60. Something. However, I'm going to be 68 years old in, what, two weeks. And it's a little bit late to, you know, to fucking, and I can't tolerate the medicine.

No, I've done cognitive behavioral therapy. I'm actually in therapy, individual therapy, right now, and she does a bunch of stuff. But, you know, what am I going to do? Right. We start taking Adderall now. Oh, hell no. You know, I went undiagnosed for literally 60 years. I'm sort of known about it.

And Dr. Steve, what gave it away? Well, dude. It's like I look in the mirror. I'm like, oh, my God, I drive myself. I drive myself crazy. Not to mention everybody around me. I was in elementary school. They didn't have such a thing in 1960.

And so I was just an underachiever. And I was disruptive in class. And I was stupid Steve all that time, you know. and the only reason, well, not the only reason. One of the reasons I succeeded in medical school was, and I did kick its ass, was I finally figured out how to harness it to my benefit, but it didn't change the fact that I had ADHD. I had to harness that hyper-focusing shit.

Right, you can laser focus, yeah. But one of my classmates who was, was he in medical school, He had already graduated as a cardiologist told my best friend that Steve will never make it. And I went, okay, you know what? It's on. The gauntlet. It's on. And, oh, no, I don't think it is on.

No, it's own. It was on. And that carried me through some tough times of medical school thinking about him, saying that shit. behind my back to my best friend who he knew was my best you know when she was reading through those

all those lists it took me like when I was in second grade I remember getting you know sent to the principal's office because I refused to do the homework I did always I said I'm not going to do that same math problem 20 times I do it once

I know how to do it and I don't have to show you how to do it I'm going to tell you something even worse I never learned my math or my multiple tables. I still don't know them. I mean, I kind of do, but what I learned is

that you know, multiplying times six is the same as multiplying times three and then times two. And multiplying times eight was the same as multiplying times four and then times two and shit like that. And then I had to memorize the sevens.

I'm still a little fuzzy on those. Sevens are hard. Seven, well, but then every one of the sevens is a two, three, four, five, or six, and everybody knows seven times seven, 49. And then, you know, eight times seven is going to be four times seven times two, you know, et cetera. And that's how I learned that because I was, by God, not going to memorize all these damn tables. It was way more fun to do it that way.

Yep. And, of course, Tacey, her dad taught her the magic way of doing nines, and that's the way I learned them, too. you know, six times nine, you take six minus one is five, and then five plus what is nine, that's four, 54, which actually is a lot more work than just learning six times nine is 54, you know. Yep. But anyway, so, yeah, I never learned them because fuck that. I'm not learning this.

My mom had a record play. I had a record player in my room. She had records that would play, and she tried to subliminally get me to learn it at night. It would go six times three years, eight. Six times four is 24 And it would sing the song And it would go over and over And I would hear it go

And then Six times one is six Just over and over and over again It's like God give me a break It didn't help How funny Anyway

That's good stuff That was ADHD That's what it was And Tacey I apologize For of being an ADHD asshole. Yeah, me too. And I'm sorry that you had to marry this.

I really do apologize for that. It doesn't change anything. I'm still going to be impulsive and do stupid shit. Topic number two. All right, topic number two. There we go. COVID out trial. This is a breakthrough study on a diabetic drug that helps prevent long COVID.

Oh, wow. Oh, I did read this. This is a good one. Metformin, when taken early during. a COVID infection. Now, this has not been published, but it will be in the Lancet. And this, yeah, this is in a pre-print, has not gone through peer review, I think, right? Is that correct? That is correct. So they have, they've submitted it to Lancet. I don't know. Has Lancet accepted it yet? I don't know in my little. Okay. So let's just take this with a grain of salt. It's on a pre-print server.

That's my understanding. Forty-two percent drop in long COVID with my. mild to moderate infections. And they're defining long COVID as. COVID that lasts a long time. Were there specific symptoms of long COVID that they were looking at? There were three oral meds that were tested, metformin, Ivermectin, and Fuvoxamine. Yeah. It was called the COVID-out trial.

Blinded to randomized treatments, trial was decentralized with no in-person contact with participants. age 30 to 85 obese confirmed COVID fewer than seven days symptoms no known prior infection they join the study within three days of a positive test okay I'm going to back up and everything I said was bullshit this thing has been accepted it's just published online first and has not hit the print journal yet so this is that changes things cool okay so this thing has been peer reviewed it's been accepted for publication in the lancet infectious disease, and it's published online first. Sorry, Tase, go ahead. So the monthly follow-up for 300 days and participants told if they get a long COVID diagnosis

or not. Metformin was doled out over 14 days. They had 1,323 in the study and 1,125 agreed to do long-term follow-up. 564 in the Metformin group. About 55% had received the primary Mary COVID-19 vaccination series. 8.4% reported that they were diagnosed with long COVID. Metformin group 6.3 got long COVID compared to 10.6 with placebo. Risk reduction for metformin was 42% versus placebo. When it was started less than four days after symptoms began, there was a 64% reduction. The others showed no benefit.

More research is needed. Okay. So what they were looking at were any sort of symptoms that were related to a COVID-19 infection that lasted beyond a certain time. And what they were saying is most of the studies stopped looking at people after 35 days and they looked at people much longer than that, up to day 180. So they said 1,100 completed one survey after the survey after the the assessment for long COVID at day 180. Did you, did you, did you, did, did, did, did, did, did, did, did, did, did I didn't hear if you read that because I was reading. I said monthly follow up for 300 days. Okay. All right.

And participants told if they had a long COVID diagnosis. I'm just looking to see how they defined long COVID because they had a specific definition of long COVID and I'm trying to find what their definition was. But it's, I guess it was just any symptoms. Um, anyway, I'll, I'll, I'll try to research that just so. Now, I know a bunch of people that have long COVID in the, yeah, I see, overall, right, 8.3% of the participants reported receipt of a long COVID diagnosis by day 300. So this was pretty long study for this kind of study. And most of the long COVID diagnoses were made by primary care providers.

Did you come across that? And I'm still looking to see how they were defining long. long COVID, but I think it's just any person that had symptoms like loss of smell or taste or brain fog or something like that. They didn't have it prior to.

That were associated with the diagnosis. Yeah, that's interesting, isn't that? Did they roll out other, I mean, other things like thyroid or testosterone or stuff? I mean, they said there's selection bias in that individuals who choose to enroll in clinical trials and complete 10 months of follow-up might not

represent the general population you think there are all the people with hyper-focusing from ADHD. Tacey, do you want to talk a little bit about what metformin is? No, not really. I mean, I did my topic time. That's pretty much on.

Metformin is a diabetes drug. Let's just say that. Brand name, glucophage. Yeah, and it's very commonly used in diabetes. So, they all also said they excluded groups at low risk for severe COVID-19 and adults with a normal BMI and those were younger than 30 years old, whether those findings would be generalizable to those populations remains unknown. So this is an early study, but you know, what the hell?

The problem with just throwing everybody on metformin is, is there are some adverse effects from, or possible adverse effects from that, including low blood sugar. In GIAA adverse effects. Yep, and shitting yourself. and, you know, flagellants and that kind of stuff. But also, they don't know, I don't think they know what the proper dose is. So if they want to look at this, now what they've got to do is do a prospective study on metformin alone saying we're going to do placebo versus 100 milligrams or whatever, you know, 25 milligrams, 100, 300 and try to find the right dose for this. Above this, we had no perceived benefit in long COVID.

but we had more side effects, and then they can kind of narrow down with the dose is. That's pretty cool, though. Cool. Good so. You done with that? Yes, I have one other topic that's really boring. Yeah, no, it's not boring. No, do it, do it, do it.

All right, here we go, then you ask for it. Go potty. Both intermittent fasting and calorie restriction may benefit the gut. Oh, okay. But gut, gut bacteria and the microbiome are important to a range of health-related. processes in the body, and a lack of diversity as tied to more diseases. There are several so-called blue zones in the world, one in the United States, areas with extremely high rates of people who live past the age of 100 years old.

So intermittent fasting, a new study from the University of Colorado's medical school highlights how changes in the gut microbiome brought about through dietary interventions can influence gene regulation and overall health. Really? So participants in this study, all whom have either overweight or obesity were instructed to fast for three non-consecutive days each week for a year. And an earlier analysis found that the diversity of gut bacteria in individual microbes was significantly improved even at only three months into the year-long study. I'm just kidding. No, no, no.

So what they find out. You were right. I'm having trouble coming up with top. I should have trusted you. No. Just, you know what? All you got to Google, dick, dick, nuts, balls. I don't want to always do that, though.

Okay, all right, go ahead. So anyway, if you're going to fast or you're going to do calorie reduction, yes. Apparently it helps your macrobome in your gut. And that would lead to improvement in what? Are they saying cardiovascular disease or just how you feel or what? We don't know. I mean, you know, it's in here.

You were right. I'm sorry. I shouldn't have pushed you to do this way. I was thinking we might just use this one to play us out, but it's okay. Yeah, okay. Okay, yeah. All right. So intermittent fasting might be good for the gut and will, to be determined whether there's any significant benefit to your overall.

I'll try to make the next one about a penis. Well, yeah, you can throw a penis in there every once in a while. Oh, right. Let's see. Let's do John. phone call. Let's do John. See, this is three, two years later is this complete horseship

because this is actually two years and two months later. That's how old this voicemail is. We'll see. Is Loganfield still in there? Hey, Dr. Steve. Long time listener, first time caller. Now, I'm just kidding. I've called you a few times before. This is Loganfield in

Wilmington. I had just a quick question, comment, whatever you want to call it. I know there's a lot of people out there are not getting vaccinated or choosing not to not to not to be vaccinated and a lot of their family members I'm assuming he's talking about for COVID-19 not for measles and rebella and that stuff are not I guess happy with that and possibly a little freaked out about it Oh, yeah, we had all kinds of people like that. We had people that were not vaccinated, that were not allowed to go to family reunions and stuff like that during this. And Stacey Deloche, if you remember, you know, he caught a lot of hell and I caught a lot of hell for his prank that he pulled with, you know, a counterfeit fake or, you know, a vaccine card.

But the point of that was that if you had a concert where you made people bring a vaccine card for $100, that was the premise, the $100 you could get a fake money, that did not protect you. No. That didn't protect you. So anyway. I think that, and, you know, they are faxed. And they think that just because, you know, that person isn't axed, that's going to make it more dangerous for the person who is vaccinated or. Right. And that's another question is, you know, Jimmy Dora always said, listen, if you want to wear a mask and you want to get vaccine, well, you're protected.

So what do you care if I have one or not? If you believe that the vaccine, which, of course, we know the vaccine is perfectly effective and prevents transmission of disease and hospitalization. You know, that's for the YouTube algorithm. If you have done all those things, you're protected. What do you care if somebody else does? Now, I've kind of come around to some of this in the sense that I'm not a fan of mandates. I never have been. People go, well, you're a shield for the vaccine company.

I say, are you aware that I was against mandating vaccines from day one? And they're like, no. And it's like, okay, well, then we're cool. I was in favor of therapeutics from day one. And I'm still wondering what the hell happened if I have a pyruvier. I see we have Molinaperivir on the market with its 30% reduction in hospitalization compared to, say, early IV remdesivir or, you know, Paxloved for people at high risk. And that's for people at high risk. But I'll tell you what Monopirivir is awesome for.

If you're not at high risk and you can get your doctor to prescribe it, it'll make you feel better in about a day. So that stuff is the bomb for symptomatic relief. just don't assume that it's going to be great for keeping you out of the hospital if you're at high risk but if you're at high risk you should be doing early remdesivir or you should be doing uh paxlovit or whatever you know i'm i'm a big fan of that but what the hell happened to fab here of here june of 2021 um it was out there i was talking about it on my covid sit reps and it just kind of faded away. You know, Fuji had this drug that was

anyway, I'm getting into the weeds on this, but Fuji had a drug for influenza that was very promising for SARS Cove 2 and it just kind of never went anywhere and I'm not sure what happened there

because the next thing we knew, we had Paxlovid. Well, it wasn't the next thing we knew. A year later we had Molnapir and Paxlovod and we had these antibodies that worked for a while and then didn't work and now we're just not even bothering with the monoclonal antibodies anymore

but anyway so yeah it was a scary time and I know where John's going with this unfortunately brevity is not his strong suit or even if the person has had coronavirus and at that time we weren't paying attention

to natural immunity either and we thought at that time that the vaccines were perfect we're going to Because we were told that. We were told if you take the vaccine, you can go look at the videos from back then. If you take the vaccine, you won't get it. If you take the vaccine, you won't be able to transmit it to anybody. Now, does that make me an anti-vaccine person?

Hell no. I'm taking the vaccine. When the booster comes out, I'm going to take it, knowing that there's some risk, but there's more risk to me being 67, 68 years old, if I don't take it in my opinion. So it's your choice. Don't try to mandate something that hasn't been approved by the federal government. That's my issue that I have, is that the FDA never approved these things. If they do, then we'll have a discussion.

And when I say never approved them, I mean, you know, they're approved under emergency use authorization. But, you know, let's, I'd like to, you know, the FDA is a very deliberative body, and they're not going to approve, approve something. until they are by God ready to do so, which is why thalidomide never hit our shores, which is why I am still a fan of the FDA, despite all of the criticism that they've gotten, because they are very deliberative and we'll just see, you know. Yeah, there's adverse effects to everything,

but you've got to weigh the risk benefits and alternatives to things. in the end, at the very end of of Delta and beginning of Omicron when things started to calm down, what we were seeing is everybody in the ICU was somebody that was unvaccinated. There's no doubt about that. And they were all people at high, high risk

that had not gotten the vaccine. So I still, and most of the people who are critical of the vaccine still will say, yeah, if you're at high risk, the vaccine is for you, because the benefit outweighs the risk of the vaccine at that point. But they're not in favor of is mandating that

school-age children get it until we can see that there's a clear danger from the virus that's greater than the risk of the vaccine. Anyway, all right? Can't believe it. Thanks a lot, John. Thanks, John. Brought us back to this pain and suffering.

Anyway, yep. Anyway, that's an old, old phone call, but still brings up some old old emotions about that, anyway, okay, well, listen. Well, thanks, everybody for joining us today. I brought up the wrong script.

So let me say, thanks always go to Dr. Scott. Thanks go to Tacey. Thanks to everyone who's made this show happen over the years. Listen to our SiriusXM show on the Faction Talk channel. Serious X-7 Channel 103, Saturdays at 7 p.m., Eastern Sunday at 6 p.m., when we're not preempted for sports, on-demand, and other times at Jim McClure's pleasure.

Did you have another question from the Fluid family before I get on here? No, we can do it Saturday. You do? No, let's do it now. We're not doing one Saturday. Oh, okay, yeah. Yeah, we'll do it now. Okay.

Let's do it live. Hey, Dr. Scott. We'll do it live. Do it. Hey, Dr. Scott, Dr. Dr. Steve. Hey. I had a cataract surgery a week ago.

Hey, congratulations. Yeah, so one eye. Best thing my dad said he ever did was having cataract surgery. Yeah, well, it would be interesting. Well, we'll talk about it. Now I realize the yellow is gone. Didn't realize yellow was there to begin with. But something is...

Yellow in your eyes. Something really weird is going on. Okay. Is it possible that part of the reason we developed cataracts as an evolutionary development to keep our retinas and our optic nerves from being damaged over time kind of similar to sunglasses. When I got my new lenses, everything is so bright, I'm having to turn down the screens, down to dim,

TVs, cell phones, computers, and just normal lights are all a little too bright now. I'm pretty sure my brain will adjust. Just wondering if that's an evolutionary trend. I don't think so. The reason I don't think so is because we never lived that long. Well, that's what I'm wondering is as you live in it

just kind of keeps so much light from coming through to keep your retinas from the light sensitivity is coming from dryness because you've got inflammation in your eye from them ripping out your old lens and putting a new one in what they were talking about but he said they had different lenses

now like high definition lenses $3,000 or regular lenses $2,000 and all this stuff but this is your vision should be clear which it is and it may take weeks for your eye to settle down and start lubricating

again and the iris to work properly. What I recommend is don't fight it. Use sunglasses. Right on. When you're outside, use sunglasses. I'm sure they told you that. And then avoid direct sunlight for the first couple of weeks until it

settles back down and do exactly what you did. Turn the blue sensors down or turn the... But it's I don't think that it's an evolutionary thing to protect the eye. I think after you have surgery, which evolution did not prepare us for, that your eye is just very sensitive because of the inflammation in the eye. Cool.

Yeah, but that's an awesome question. Great question. And my dad had cataracts in both eyes, and he said the greatest thing he ever did was doing that because now I could see clearly. Again, he didn't realize how bad his eye was. You lose resolution for the most part when your eyes. or the lenses get cataracts in them and it is caused a lot of times

by ultraviolet light right right and you know you get these spots on the lenses and the brain can control for that but you will lose resolution and so that's what I'm noticing is that I have decreased resolution when I read things

and I have to you know squint a little bit more and those kinds of things and when you really know you need to do something is well two things will happen you will be driving and the street lights will have halos around them and that's light refracting around these spots on your lenses just like when you see a picture of a star through a telescope

you'll see those refraction lines that are really what you're looking at is light refracting around the struts that are holding the secondary lens you know, in the middle of the mirror. And you'll see those lines. Stars don't really look like that. They don't really have, you know, six or four white lines around them,

but they will when you, there's nothing you can do about that when you're using that kind of telescope. And the other time that you'll know you need to do something is when your ophthalmologist looks in your eye and goes, oh, shit. Wow. Then you need to have your cataracts removed. Right on. But, yeah, that should get better.

Use the eyedrops they gave you to lubricate your eye. I really like the Sistine. Sistine Ultra. That's my favorite, but they may have told you other ones to use, and that really should help quite a bit. Cool. Okay, don't complain. Thank you, Dr. Bates.

All right. Well, thank you. And that's an excellent question. Are you done with questions over there? Yes, sir. They were grabbing it up. Okay. All right.

Well, listen. Again, thanks to our listeners who's 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.

Goodbye, everyone. Bye, guys. Thank you.