Weird Medicine: The Podcast - 577 - Antidepressants and Sexual Dysfunction

Episode Date: February 8, 2024

Where do "baby bones" go? Developmental milestones "Other" meds for anxiety Bloody urine Hyperhidrosis from antidepressants Erectile dysfuction "" "" "" "" Complex Regional Pain Syndrome Growth Hormone and Anti-aging What is a Doctor of Osteopathic Medicine? Cough/choke CBD smell Please visit: stuff.doctorsteve.com (for all your online shopping needs!) simplyherbals.net/cbd-sinus-rinse (the best he's ever made. Seriously.) tweakedaudio.com (use offer code "FLUID" for 33% off!) 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, Jim Norton, Gregg Hughes, Anthony Cumia, Joe DeRosa, Pete Davidson, Geno Bisconte, Cassie Black ("Safe Slut"). Stuff you will never hear on the main show ;-) Learn more about your ad choices. Visit podcastchoices.com/adchoices

Harken to thine inner voice and give thyself a bell. No task shall be denied if thy will be strong and true. For when a bell is rung, it carries with it the sound of courage, that giveth strength to even the meekest of hearts. So ring thine own bell, and be mindful of its power and might, for twill be thy guide in whatever task thou sets thy sight. Lord and lady do's your bag. You see, your stupid minds.

Stupid, stupid. 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 Tobolov. I'm stripping from my nerve. I've got the leprosy of the heartbound, exacerbating my incredible 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 in beautiful downtown, the Dabler City.

It's weird medicine, the first and still only uncensored medical show. In the history of broadcast radio, now a podcast. I'm Dr. Steve with my little pal. Dr. Scott, the traditional Chinese medicine provider, gives me streetcred with the wack-all alternative medicine assholes. Hello, Dr. Scott. Hey, Doc Steve. This is a show for people who never listen to a medical show on the radio or the internet.

If you've got a question, you're embarrassed to take to a regular medical provider. or if you can't find an answer anywhere else, give us a call at 347-7-66-4-3-3-23. That's 347. Pooh-Hood. Follow us on Twitter at Weird Medicine or at D.R. Scott, W.M. Visit our website at Dr.steve.com

for podcast, Medical News. And it's tough to go by. Most importantly, we are not your medical providers. Take everything here with a grain of salt. Don't act on anything you hear on this show without talking over with your health care provider. All right, very good. So don't forget.

stuff dot dr steve.com that's stuff dot dr steve.com for all of your amazon needs it really helps a lot and you can go there and scroll down and see the rowdy tuner and you can get it for your person what's a date on this one going to be going to be 16 of uh december of december yeah yeah and uh so no it won't now No, it won't be for the podcast, though, yeah. This is going to be after the holidays. So, hey, it's after the holidays. You didn't get what you wanted.

Go to rody.do.com and get yourself a rody tuner. If you've got a guitar or a mandolin or a bass for the holidays. Or if you got an instrument, a stringed instrument, you don't know how to play it. Go to rody. Dottersteve.com, and they have the rody coach there. It'll teach you out to play the damn thing. It's amazing. And then tweakedaadio.com.

I actually checked the link. It actually works still, 33% off. I've never seen a discount like that anywhere. That's great. So you buy three things, you pay for two of them. And go to Dr. Scott's website at simplyerbils.net. That's simplyerbils.net. And patreon.com slash weird medicine.

I've been doing live streams there, just kind of getting the kinks out. And those are going to get cranked up and will be much more excellent as I've got a new live stream studio. that is working now, but it needs to be optimized and I'm working on that. And then if you want me to say fluid to you, Mama, say thanks for all the wonderful holiday gifts that you got. Go to cameo.com slash at Weird Medicine. No, sorry, that's not correct. Cameo.com slash weird medicine.

That's cameo.com slash weird medicine. It's cheap. And I'll take them on a tour of the studio if you want, whatever you want. All right. Sounds good. Okay, thanks. So check out Dr. Scott's website at Simplyerbils.net. That's simplyerbils.net.

And he'll send you some dopey, weird medicine chotch. Yes. Somebody posted on Twitter all the crap that you've sent him over the years. Oh, I'm good. I'm good. I'm all about sharing. One of them he had for so long that the ink had faded on the... It was funny.

So anyway, yeah, check that out. It's simplyerbils. dot net. All right. Well, Tacey is not here. She's on sabbatical. P.A. Lydia is on sabbatical. DJ Mel B. is on sabbatical.

DNP Carissa, I think, is probably, I don't know if she's ever coming back. She's got a, you know. We've moved to the bottom of her list of importance. She has a new relationship, and so we don't care. We don't hear from her much anymore. But if she wants to come back, she's always welcome. She's always fun to have in here. Well, you know, it's kind of like what John Pryan says about songwriting.

He goes, you know, you only write songs when you're miserable. You know, who wants to write a song when you're happy? That's right. Yeah. So she's obviously happy and she's got something to do with it. Yeah, good. Be miserable with you and I. Right.

Good for both of them. I've been there before. We're formerly happy, aren't we? I was happy once. So I get it. Formerly. Anyway, yeah, you get all involved in your own thing. You just don't think about anybody else.

That's fine. So anyway, the thing I liked about her on here is I'd say, okay, you got anything to comment about that? And she's not a radio person or an improv person, you know, where you're supposed to yes and everything. And she just goes, no. And just leave me hanging. It was funny. She was the queen of one word answers. It was either no or.

Rude. Yeah, rude. Rude. Anyway, maybe she'll come back before she moves away. There you go. All right. Well, we do not have Tacey's time of topics today, so we're going to have to improvise here, Dr. Scott. We're going to wing it.

I like it. So we have a couple of questions, so let's get this going first. Number one thing. Don't take advice from some asshole on the radio. And we've got a couple of recent ones, and then I thought we would go back to 2015. Oh, cool. And answer some questions we never answered. Another time travel episode.

Yep. All right, here we go. Let's see here. Dr. Steve. Dr. Scott. Hello. Howdy? And fluid family.

Hello. Hey, I'm going to show my ignorance here. I've been playing these trivia games. This time you're going to do that? On Instagram, about six questions. questions in a block. And it said that a newborn baby is born with approximately 300 bones. And I Google that got the same answer, but adults have 206.

Right. Where did the other 94 bones go? All right. So this is actually a very good question. I'm going to give myself a bell. Great question. We'll give the listener a bell on that one. Yes, indeed, babies are born with approximately 300 bones.

And if you consider the skull bone to be a single bone, well, then you know the answer because babies with an intact skull cannot, you know, force themselves through the vaginal canal. When they have bones in their skull that are already fused, it's called craniosynostosis. And those babies very often, if they are able to be born vaginally at all, tear their mother all to, you know. all to pieces, and there's a lot of reconstruction has to be done. So those are separate bones. You know, babies have the soft spot. You've heard of the fontanelle. The fontanelle.

And so, but you don't have one of those. You have a soft spot in your heart. I have a soft D as a general rule. But you don't have a soft head. I've got a heart inevitably. Right. And you have a flaccidant. You know, other parts your body.

Wrong parts, hard, wrong parts, soft. Right, right, right. Yeah, I got a hard head in a soft, something in the jungle region. But anyway, so those things all fuse. And so when you look at all the bones that are separate, you know, they, that are allowing for growth, you know. Right. And then the cartilage that binds them together becomes bone eventually. because otherwise, bone would not lengthen.

You need growth plates to do that, and the skull has to be, like I said, malleable to get through the birth canal. So once all of those things fuse together, those 300 bones become 206. And that's the answer. Great question. Very good question.

Right out of the box. Yep. Here you go. Steve, it's Dave. Hey, Dave. Hey, Dave. Quick question. I know you're a parent.

You know my parents? He knows that we are parents. I thought he was doxing me. How many months into my first kid? What resources or where did you look to keep up with developmental milestones? Oh, okay. Well, I had textbooks, but I can tell you where to look. But I always trust your opinion.

and it would kind of like to know all the lists you're comfortable with, things like that. Yeah, yeah, yeah. So what he's asking about is how do you know your kid is developing normally? And I have textbooks. I had training on that. You know what you would see at three months and six months and all those kinds of things. And that's actually on my board exam. But I'm going to give you two resources.

Go to Dr. Steve.com. click on the upper right hand, the three dots in the upper right hand corner, and then click on one page Baby Manual. It has care for the baby, but also talks a little bit about developmental milestones. But what you're really interested in is what's normal for your infant. Okay.

So I like Mayo Clinic. That's a good one. There's, if you just click, or Google Mayo Clinic, newborn milestones, you'll find a page that says Healthy Lifestyle, Infant, and Toddler Health. And then you've got infant development, birth to three months. And what to expect, you know, newborn's movements are jerky at first. There's a couple of weird reflexes where if you take the kid

and you lay them down real quickly, their arms and legs will jerk almost like they're having a, little seizure, but that's a normal, a normal reflex, you know, and then they'll, over time, I remember when Liam was five months, that was the first time that he pushed up and could look at us over a bumper on the bed. Before that, he was completely immobile. Wow. You know, they just kind of, and they're just laying there. And we took him to Eric. Arizona on a trip, and we got a crib that had a, you know, the bumpers in it. They're about six, eight inches high.

And we were just laying in bed and we woke up and there was Liam looking at us over the bumper. And that was like, whoa, he had never done that before. Funny. Yeah, it's funny. That's cool. So anyway, yeah, Mayo Clinic is a good one. Cleveland Clinic, any of those sort of, you know, the American Academy of Pediatrics, American Academy of Family Physicians, they all have these sort of milestone charts in them and they're fine.

Don't just get some rando website other than mine because you don't know what they're saying. And a lot of those, and a lot of those reputable websites are going to have a very similar, very similar. Well, yeah, it'll be all the same stuff. So any of those are okay. I would like to do a, like, a goof website where you say, yeah, your kid should be speaking in, you know, sentences by six months and all the, everybody that looks at, I don't think their kid is dumb. So, anyway. All right. Oh, okay.

So that's, those are the recent ones. Let's go back to June of 2015 and see what this is about. I listened to a show just to, you know, I listened to them to make sure the audio is okay and all that stuff. And there was one where we said, let's listen to this person from 2015. And they were talking about going to the emergency room. Should I go to the emergency room? Right. I'm having shit.

I hope you're okay, buddy. Eight years later. Yeah. All right. There we go. Yes, I'm on VinlaFaxon for anxiety. And I heard you mention an anxiety medicine. today, and I was just curious what the name of that was.

I really do not like Venlifaxin. If I forget to take it, I get busy, and then I don't recover for the rest of the day. Yeah, so Venlofaxine is an S-N-R-I-type drug, a selective serotoninophenapherin re-uptake inhibitor. And it's used for depression, but also for anxiety. and you may remember that when I had chronic abdominal pain for some reason, I never did quite figure out what was going on. My doctor put me on Simbalta, and after about six weeks I said this stuff didn't do anything, and I just quit it.

Don't do that. Yeah, don't do that. That was stupid. I didn't know at the time that, I mean, this was long enough ago with a relatively new drug, that there's a withdrawal syndrome. and I had brain zaps and I had Terminator eyes talked about that

where you know if you see the Terminator when it's in its robot form and you hear the servos moving which why wouldn't you hear that when it's covered in fake skin but anyway and when its eyes would move you'd hear jute juk juk juk with these servos moving right

and I would that's what I would hear when my eyes would move I would hear the servos behind my eyes making noise. It was crazy. It lasted about two weeks. So don't stop that stuff on its own. On your own.

Now, there are lots of things for anxiety. The reason they put you on venlo-faxine is because it is not habit-forming. I mean, there is a withdrawal syndrome if you stop it, but it doesn't cause craving of the drug and all that. And there are other ones like that that are not habit-forming. There's one called hydroxazine, which is basically an anticholinergic drug like Benadryl. I'm not a big fan of taking those every day, you know, three times a day, four times a day for the rest of your life because they increase your risk of dementia down the road. So then there is Buespirone or Buespar. Some people get really good results for their anxiety from that.

I tried taking it because I had bad anxiety, and it just caused a serotonin rush or something. I would be sitting at my desk at work, and I would get this rush. Like I was getting high, but I never actually got high. And I was not a fan of that one. Right. So, and there's non-pharmacologic stuff, too. So you want to talk a little bit about some of the non-pharmacologic stuff. Yeah, I was going to say a couple things, you know, on the more Western side or allopathic side.

And we've talked about it before on a show, but. Some doctors will actually do a stellate ganglion block. So they'll actually take a little needle and put a little diabetic kind of side. We've got to learn how to do that. Yeah, and it's not a simple procedure, but it's a quick procedure. And somebody that's skilled hands and has done a bunch of them can do it, you know, within about a minute. That's about how long it takes. And all they do is they just squirt a little numbing agent over this ganglion.

And it helps to calm me down a little bit. And it works. And they use a lot for the military. A bundle of nerves. Yeah, yeah. And they use it for a lot in military. but they're also using it, you know, a lot outside the military now. You know, now other things would be things like, you know, meditation, breathing apps.

You know, we've talked a lot about the, what's the Oculus, you know, they've got the meditation apps that you actually, you know. I love the Oculus trip app, TRIP. Right, yeah. If you have an Oculus, you can do a free trial and just check it out. They only give you access to the Focus Month. but you can still get an idea of what it's like. And that's notorious for decreasing anxiety, partially because they do breathing exercises. Right, right.

So I had the worst anxiety I've ever seen in anybody I had. You know, everybody thinks it's the worst. But I was almost agoraphobic in the sense that every time I would go out of my house, my anxiety would ramp up. And I've told this story before, so I won't go into it. But I cured my anxiety through challenge. Yes. You know, I continued to challenge it.

And the very last challenge was something that would have normally terrified me, which was being trapped in a crowd of about 10,000 people, shoulder to shoulder. And it couldn't get out. And it was either get better or die. and my brain decided to get better. But the problem with that gorophobia is people get anxious. They get a panic attack.

Let's say when they're driving on the interstate. So they don't drive on the interstate anymore. And then they get a panic attack going to the grocery store, so they don't go to the grocery store anymore. And then the post office. And then it gets to where they're confined to the locale around their house. And then now that causes anxiety. If they get anxiety going out to get the mail, then they don't go out of the house anymore.

And now you are classified as agoraphobic at that point when they just are too anxious to leave the house. And the thing is, is that the anxiety, all it does is make you uncomfortable. It doesn't actually do anything to you. And when you realize that and you challenge it, your body eventually learns that it's not going to kill you and it will go away. I no longer have panic syndrome. I had it so bad I thought about checking myself into a loony bin. Yes. And I don't think that's the proper term, but you know, you know what I mean.

But that's how bad it was. It's hard for people to believe. I had it so bad that if I had a good day, I knew a really, really bad day was coming. And every time I would walk down the street, I would see all these people laughing and talking and stuff. I was like, you guys are fools. You don't realize there are murderers amongst us. There are criminals. You know, that illusion of safety that you have is nothing but an illusion.

Now, am I cured of my anxiety? Yes, I don't have that physical adrenaline, you know, hypervigilant fear reaction anymore. But I was doing EMDR with my shrink. And I only tell this story because other people may relate to. it. And EMDR is this eye movement thing where they, what they learned was is when you're in REM sleep, you are processing information, right? And your eyes are moving back and forth and back and forth.

Well, you can wag the dog by moving your eyes back and forth, and then it will force your brain into an information processing mode. Okay. So, when you do that, one of the things that my shrink does is she does this type of EMDR. And you have to come up with these young Ian, from Carl Young archetypes. Okay. And you had to come up with one for wisdom. And mine for wisdom was Alan Watts.

Okay. And then you have to have a safe space to go to. And that's my, you know, my dad's lake. You know, I felt safe there. and it was peaceful. And then you had to come up with an archetype for compassion, and only a few people get this, but it was Andrew Wiggin from Speaker for the Dead.

It was a book by Orson Scott Card. It was a sequel to Ender's Game. And so, but she said, come up with an archetype for protection. I couldn't come up with one. And I never, it was weird. It was like when I went to my doctor with my neuropathy, he said, walk a straight line and I couldn't do it. I had no idea. I couldn't do that.

And I had no concept of an image of somebody that would protect me. You know, I learned to play the piano at the end of a high-heeled shoe. And, you know, my sister would push my niece down, apparently. This is what I'm learning now. And then blame it on me. And so, you know, she was another adult in my life. My brother tried to protect me from some hoodlums because I was mouth on the mouth and off to him. And he came out and they went away.

But then that night, they grabbed me outside my house and kidnapped me. Oh, gosh. Yeah. And, you know, they, fortunately, they just wanted to just scare the shit out of me. They didn't, you know, want to kill me. But it was terrifying. Sure. For months after that, I laid in bed, I couldn't, you know, I couldn't sleep.

And I just, I made up sermons thinking that somehow that would help. And, you know, at least it took my mind off of things. So, you know, I have no images of protection in my head whatsoever. So, yeah, I'm going to have to work on that. But anyway, where were we going with this? Oh, the anxiety. Yeah. So it lingers.

There's still, I didn't realize I had that problem until she brought it up. And we talked about that. So that was part of my anxiety is I someone was breaking into my house. I caught them and there was no, like they weren't startled and ran away. They just sat there with this cold look and looked at me and just went, yeah, man, like that and just would very slowly turn around and walked out. And that just freaked me the f-out, you know. I think we're learning a lot more about what's going on inside that brain. Oh, well, no shit.

Yeah, no, I'm fucked up. But I don't have anxiety anymore. I'm not agoraphobic. I almost became that, but there was something within me that said, no, you got to go to work every day. Okay. And you got to go to the lab, and you're still going to medical school, and, you know, you can't stop doing things. And by challenging it in that way, you know, I eventually overcame it. So there are, you know, cognitive behavioral therapy is a, you know,

as a way if you take it seriously, a non-pharmacologic way to ameliorate your anxiety, that's where we were going. This guy was talking about the venal vaccine. And then the very last resort are the addictive drugs, and they are habit-forming, like the benzodiazepines. Go ahead. Well, I was to say, before you get to those, there are a number of other things that are real quick. Oh, yeah, of course.

Things like sensory deprivation tanks, you know, acupuncture actually helps with anxiety because it stimulates the serotonin in your body. Well, and you also deprive them of sensation when you're doing it. Other acupunctrists do it that way, too. I know you do it. Not all. You turn the lights down and you have the spa music and the aromatherap. Mine's a very zen space.

Yeah. Yeah, I like to just keep it calm because I'm so wild. It keeps me calm. It was a very calming experience when I did it at your place. Yeah. And I try to keep it like that all the time, especially when people don't feel so well. So, yeah, but they're, you know, exercise, exercise. Yes, is another great thing.

Stimilates endorphins. Great way to work on anxiety. And you know, you know I both have had this live with it, dealt with it, and work through it every single day to a certain degree. But yeah, then you get, but then like you said, the last resorts and you think about. That's what I'm saying. I'm just saying that as a last resort. They work. They work too well.

Yeah. And people end up on them and they can't get off of them. Right. And then when they don't take it, the drug. the lack of the drug stimulates their anxiety response, so they need it again. Yeah. So I really, I think those are great if you've had a severe loss

or if you've had a traumatic event to get you through a little bit. Yes, I agree. You know, I'm fine writing somebody Al-Praise Lam, which is Xanaxed to get on the plane if they have issues. And or, you know, like Tasey took 20 milligrams of Valium before our wedding. She was stoned out of her gourd. But I do, look, there's some people

that need them chronically, and they can't live without it, but I would absolutely go there as a last resort. Yes. You reminded me of a quick story. They were telling about Jerry Garcia one day, was getting ready to go out and play, and I guess was having some anxiety and got handy of some, was

going to give a valium, and he just grabbed all of them, put him in his mouth, and choked him down. And And Steve Parrish, who has the show on Sirius X-Im, was saying that, you know, he was getting, eyes are getting heavy. And he's about to go to sleep. And they're like, hurry, go get all the truck drivers and get all the cocaine they've got. Oh, Jesus. So, poor thing, they, they coked him up to the opposite to Benz of.

And went out and, I guess, during the second, the second said, I guess he kind of came back to, you know. Sounds like. Good old, good old Grateful Dad. Eric Garcia. Have you ever heard the, I don't know if I can find this quickly because I wasn't planning on the Elvis when he was drunk or stoned or something. I don't think so. It's quite humorous.

And I love me of Elvis. Sure. I mean, who doesn't for God's sake. Now, did you know that Elvis in Viva Las Vegas did lists, Liebenstrom? No. I did not. Yeah, one of the songs in there was completely lifted from Frant's list.

Huh. And Eric Carman's All by Myself, which was on my list of wimpiest songs. Oh, God, yes. Is actually Rachmaninoff's second piano concerto. Really? The theme from the second movement.

Oh, my gosh. Yeah. Funny. So, you know, he got, they came after him. Because it's public domain in this country, but not public domain in Russia. And his family is still in Russia, even though Rachmaninov immigrated to the United States after the Bolshevik Revolution. And his family came after Eric Carmen, and he had to give him 12% of the royalties. And if you go look at it, Sergei Rachmaninov has a writing credit on that song. Oh, okay.

Because it's just taken straight from it. All right, here's Elvis, drunk on stage, supposedly, allegedly. I wonder if you're lost in the night. You know, someone said, the world's a stage. It's an each of us play a part. Oh, goodness. Plus tags. Oh, ha, ha.

Ridgelands, select. Fleverly. They never missed the Q. They came back to They forgot the words They'd be changed, you fool You acted strange And why I've never done

Oh gosh Honey, who am I talking to do? You lied And you love me Who am I talking? Oh my gosh I have no cause to doubt you Why they want to remember

Where they go on hearing your life Oh And you go on living without you There you go. Oh, my goodness. So it's still, he was still the king. I would have killed to see that. Oh, my word.

Yeah, so I wonder if there's any video of Jerry Garcia out there on Valium and cocaine. Oh, it's every video. Yeah. A Grateful Dead video, I forgot. I think it's a significant portion of it. I just kidding. I don't know. No.

All right. Well, very good. Okay. I hope his anxiety is better. Eight years later. Yep. All right. Let's see here.

Hey, Dr. Steve. Good morning. My name is Steve. I'm calling from Wayne, New Jersey. Hey, man. I'm calling regarding blood in my urine or speckles of blood. It's little crystallized in my urine. Okay.

Seamen. Okay. I get lower, lower right abdominal pain. I've been to the ER. I've been to my primary. Nobody knows what's going on. Sometimes it seems worse after another thing. After what?

Do you get that? No. Then he crapped out. Yeah, so blood in the urine and the semen would have to be a common pathway. Because urine comes from the bladder, semen comes from the seminal vesicles, and the prostate, and the, Vaz deference. But all of these come through the urethra. So you're almost going to assume that he's got some sort of urethritis and infection in the common pathway.

Maybe some prostititis. But, you know, go see. When you have problems like that, you can go to your primary care. That's great. But if they don't dope it out immediately, you've got to see a urologist. He said they had pain is lower right? Yeah, and it could be a kidney stone lodged in there, too. That's possible.

Yeah. But anyway, yeah, so urology, urology, urology. Yes. Penis equals urology. Yes. Okay. Yes. Go there.

Good look. Yeah. Hopefully you got that taken care of. Hey, Dr. Steve, hey, I had a back injury, and subsequently, I'm on a couple medicine, Lyrica, abuse morphines, and both of them.

Anyway, my question is, is when I start working, I sweat. And when I say sweat, I mean, I will trench four or five T-shirts

within five, six of hours. I mean, you can ring these things out. What do you think is wrong? Thank you. Okay. Well,

it's, I mean, it sounds like he's implying that it's due to the medication. Yeah, that's kind of what I was thinking to.

So, what did he say? He was on Symbolta? Yes, he was on a couple. Symbolta. Was he on morphine as well? Or buprenorphine. I thought, yeah, I don't think he's in morphine.

Of course, I would explain it too. I think the deloxetine is the culprit. Increased sweating is an effect of the SNRI-type drugs, and it's not dangerous, but it can be bothersome. You can use an antidepressant, but maybe just get off that drug and onto something else. You know, they're using it for the neuropathic pain from your back, and there are other things that they can give you, including gabapentin, you know, and some, or you could see a physiatrist. People think, they hear the term physical medicine and rehab. They think they're going to, like, a program.

That's a medical subspecialty. They have the same problem that palliative medicine does. That's why we don't call it palliative care, because palliative care is what they deliver. It's not what they are. Gotcha. And palliative medicine still doesn't sound like, you know, there's still confusion about that. Pain management, that kind of says what they are, but palliative medicine doesn't say what they are. And so eleology has been proposed because if you go to a cardiologist, there's no question what you're doing.

You're going to someone that studies the heart. If you go to a pulmonologist, you're going to someone that studies the lungs, a dermatologist, someone who studies the skin. And then you go to a physical medicine and rehab, and it's like, okay, is this like, am I going to a nursing home? right no that's a subspecialty and they can do some really cool stuff yes they can do facet joint injections the reason i can walk today and i can even run and i can hike and all that stuff is because of a physiatrist or a physical medicine rehab they're those synonymous and they put me on this table they got a sea arm which is a you know an x-ray machine that can swivel around an axis, and they will swivel that thing around until all the holes

line up that they're looking for, and then they know exactly where to put the needle, and they inject you with steroids or some other medication, and you can see it go in, and within a day or two, I'm walking again. I'm not crawling up the stairs in abject pain, and, you know, it's amazing. So I highly recommend anyone with chronic low back pain go see a physical medicine and rehab person, particularly one that wants to treat pain. And you will have a much better chance of getting a non-pharmacologic, non-chronic opioid type therapy out of it. I've never taken the first opioid. And if I showed people my back, they would say, how are they?

hell are you even walking? Well, yeah, and that's what I was going to add to that story, is that you would have been like probably a surgical case. I was going to be. You know, you know what I mean? I mean, had you not tried the physical medicine, so that was a wonderful thing. And surgery is wonderful if that's what you have to have. Right.

But certainly we want to try to keep people from surgery. But good Lord, if you have a failed back surgery, and that's the percentage is pretty high, having the second surgery is even lower. So if it's like 50% of people have a failed back, then another 50 on top of that. So 75, I don't know, the exact numbers, we'll have a failback the third, the second time. And then it's like 80 and then 95. And the more back surgeries you have, the less likely it is that you're going to have a good outcome. Exactly the same numbers as divorce.

Divorce in America. Oh, shit. You know, 50% getting divorced the second time. Fuck off. off. All right. Oh, well, yeah, we've... But I think that's what that is.

I think that's what that is. Yeah, I think so, too. All right. Let's see. Let's try this one. Oh, shit, I'm calling them. No, wait. No, don't do that.

No. They'll be like, who? Oops, wait a minute. Okay, there we go. Hi, Dr. Steve. I'm 50 years old, and I'm taking... He's now 58 years old. Trollafram.

Selexa for anxiety. And it gives me raging erections all day long, but I'm having problems ejaculating. Yes. It takes forever. And I was wondering if there's anything I could take to kind of counteract that because the stralopram keeps me level and I like it. Okay. Well, now this is one that likes the satalopram, but now he's having another problem, which

is delayed ejaculation. So people have a delayed ejaculation with. with the SSRIs, that's a common sexual side effect. There are a couple of things that you can do. One is you could try taking a non-drowsy antihistamine 30 minutes before you have intercourse. That would be like Liradidine, which is clareton, or Famododidine, which is, no, wait, not Famododidine. Is it Fomodidine? Oh, Fomodidine is Allegra.

Yeah, Ligra. Okay. Why am I thinking? I think that's right. Wait a minute. No, it's Fexophonidine. Phamodidine is Pepsid. So, fecsofenidine.

The reason they have similar suffixes is because Fomotidine is an H2 histamine blocker, whereas fexophenidine is an H1 blocker. Well, anyway, so so fexophenidine is Allegra and Laredidine, Claritin. You could try one of those 30 minutes before those very often.

will reverse the sexual side effects of these drugs. If that doesn't work, your prescriber could prescribe, co-prescribe, bupropion. Bupropion works by a different method, and it's supposed to also sort of cancel out the sexual side effects of satelopram. And if nothing else works, you could switch to an SNRI, which have fewer adverse effects like that. Gotcha. Again, deloxetine would be the normal one or venlo-faxine.

Gotcha. Got you. All right. I've got the hiccups. That's just great on a radio show. Hello. Hello, Mr. Weird Medicine. My name is John.

I'm calling from Poughkeepsie, New York. All right. I heard an episode of your show many moons ago, and it was considered RSD, which I've been diagnosed with, and it's very painful, and it's soft. And I was wondering if science has gotten a little better and how they can pinpoint where nerves are being crushed or damaged to the point where it's causing this. And it's something that I would be really interested in getting some more information on if you have it. I appreciate it. Thank you.

Bye. Okay. Well, I wish. He's talking about reflex sympathetic dystrophy. They don't really call it that anymore. It's now called complex regional pain syndrome. And you've got type one and type two. You got anything for him on that?

because there's really nothing new. I have it. They took a toenail of mine off, and I got complex regional pain syndrome from that. Yeah. A cup, well, you know, it's topical, and mine is localized so I can put anesthetic compounded cream on there. You can get lydicane.

You can get gabapentin. You can get ketoprofen in these creams from a compounding pharmacy. They can even add ketamine to it if they need to, to just get a little bit of boost, and it does help with the pain. But go ahead. Well, yeah, and again, if it's a nerve root being pinched in a spine, sometimes you have to have a surgical procedure to reduce that. But that's not typically.

Correct. That's not really what CRPS. Yeah, that's not typically what we see is that we usually it's a sequela of an injury to the nerves. So what we do in pain medicine and acupuncture, both, especially interventional pain medicine anyway, sometimes we'll actually put, and it sounds crazy, but putting the needles in the area where the RSD is, an electrical stimulation will actually stimulate the nerve pathways and shuts everything down. It's called the fatigued, gated channel.

That makes sense. And it gives the body a chance to reset. And it's, you know, the hardest discussion I have with anyone is when they have CRPS RSD. because they want to know if I'm going to make them worse by putting a needle in them close. And that's the most challenging. And I have to tell them, no guarantees, but as a general rule...

I wouldn't think I would make it worse. It shouldn't, no. And believe it or not, you can actually get a little teeny acupuncture needles and people with RSD way easier than you can, you know, and a lot of other folks. Yeah.

It's a very, it's very... Because it's different than a numbness along with mine. Yeah, but it's different than a hyperalgease. You know, like somebody's got a systemic nerve pain from a, you know, from taking... chronic opiates or something or something like that but yeah but the um yeah so we actually do you can actually get a lot of relief from doing other things hyper stimulating it a lot of times you'll send you to physical therapy and let's just say you've got in your hand

like put a vibrate around it or put a hand they'll have they'll do a vibrate or they'll make you like punch rice and punch and punch and punch until you can't punch it anymore wow and that over stimulating sometimes we'll correct that RSD or something yeah so you actually have to over stimulate and one of the worst things give myself a bell Hey, cool. Yeah. Thank you. Well, you tell me something.

You know, and one of the more challenging things and the worst things that someone can do is use opiates long term for CRPS. Yeah, it just doesn't really help. Yeah, so the symptoms, continuous burning or throbbing pain, usually arm, leg, hand, or foot, sensitivity to touch or cold, swelling, changes in skin temperature, alternating between sweaty and colds, Changes in skin color, from white and blotchy to red or blue. Skin texture may become tender, thin, or shiny. Changes in hair and nail growth. So all of this sounds like circulation stuff, which is all related to the sympathetic nerves going nuts. Joint stiffness, swelling, muscle spasms, and tremors.

I have all of that in my foot. Now, the type one is reflex sympathetic dystrophy. This occurs after an illness or injury that didn't directly damage the nerves in the effective limb. About 90% of people have that. And I have type 2. It's also called causalgia, which makes sense. It's causing it. Their symptoms are the same, but it occurs after a distinctive nerve injury.

So most cases occur after a forceful trauma or a leg. And you can get muscle wasting and atrophy. and contractor and all that stuff, if you have a wrist fracture, taking vitamin C might prevent CRPS from occurring. And if you have a stroke, early mobilization will fix it as well.

And sometimes casts that are too tight or improperly put on. Oh, yeah. Can lead to it. Sure. And, you know, Dr. Steve, too, that would be causality because they'd be actually damaging them.

Yeah. We'll actually see it sometimes. It appears there may be a bit of a genetic predisposition. You sometimes see it run in families. Yeah. Yeah, which is tough. Well, remember Maya, the case. No, Maya Rudolph, she's awesome.

Yes. No, the case about the kid with CRPS. Oh, yeah, I'm sorry. Yeah. They had CRPS. I'm looking at Mayo Clinic, and they recommend intravenous ketamine. Studies show low doses, low doses of intravenous ketamine. may substantially alleviate pain.

So there are other medications that you can use. Praisesin, which is known as mini-press, clonidine, corticosteroids might help. Bone loss, medications, antidepressants, and you know, there's a lot of stuff you can do. You've got to go to somebody who knows what the hell they're doing, and they're not blowing you off as a chronic chronic pain patient. You know, and Dr. Steve, a lot of... You need to listen to you and treat you appropriately. And a lot of docs have never seen.

It's why it's important. Many are called, but few actually have it. Same thing with fibromyalgia. Many people are called fibromyalgia, but, you know, are really probably something else. Yeah. All right. Low testosterone. Yeah, maybe.

Maybe. Here we go. Hey, Dr. Steve. I'm Matt from Canada. I was trying to ask you what you think about San Francisco Sloan's documented GH use and what you think about growth hormone use. for anti-aging. Okay, so growth hormone has been demonstrated

to improve healing and trauma in older folks. Other than that, if you don't watch out, you're going to end up like the butler on the Jeffersons. He had a tumor that was causing excess bone growth.

Jaws from the Bond movies had this as well. Oh. It's called Acrimegli. Acromaglia. And it can cause pain in the joints, swelling of the joints, swelling of the jaw. Because what you're doing is if you overdose on this stuff, you're actually telling the bones to grow, but they can't grow anymore. So they do the best they can because you don't have growth plates anymore.

And so, you know, this should be done under a physician or a licensed provider's, you know, direction. and only for specific indications till we know more. Listen, I'm all about anti-aging. I take phosphatidyl syrin, and I take true niogen, which is the nicotinamide riboside, and I take some other things like that, citrus bioflavinoids. And, you know, I'm not quite as bad as Ray Kurzweil. He takes like 200 supplements a day because he wants to live long enough to get. to see the singularity happen where we merge, you know, human minds with machine minds.

And it must be driving him crazy right now because we're tantalizingly close with these AI models, but still very far away. And the new quantum computers? Yes, that too. Goodness sakes. That's what that show Debs was about that had Ron Swanson in it, which actually was very good, was about quantum computing and trying to. recreate reality within a quantum computer.

But anyway, so there's that. So I'm not against in any way anti-aging stuff. I just want good data on it. Or knowing that there's not going to be harm. And that's the problem with, you know, citrus bioflavinoids or phosphatilcerine. They're known to be, you know, safe. Whereas I'm not 100% sure that the HGH is, is perfectly safe when taken for anti-aging.

So I'm waiting for the data on that one. I have an open mind. All right. Let's see. Hi, good afternoon. Hey, good. I was wondering if you could explain the difference between doctors, the child, between an MD and a DO.

Thank you. Sure. Question is, can we tell the difference? between an MD and a DO. They're the same thing. They have the same curriculum. They can do all the same things. There's no restrictions on DOs.

Matter of fact, when I was in Michigan, all of my doctors there were DOs. They were very common. They were called Doctors of Osteopathic Medicine. They do go to separate medical schools, and they have another curriculum where they learn osteopathic manipulation. Now, most of the DOs that I know

learn all that stuff and then they never manipulate again. They do it, they learn it and they sock it away and so that they know the anatomy and all that stuff but then they go do a fellowship

and they do OBGYN or whatever but I had the first DO in Upper East Tennessee where we are was one of my professors and at first You know, they were, back then, Dio's weren't as accepted as they are now.

Yes. And, you know, they just were alien. But this guy was amazing. He was really good. And he did manipulation. So if a woman had horrible back pain because of the amount of the hormone relax and that opens up the pelvis so that they can pass this baby through, you know, before the baby's born, this hormone is secreted and they start to loosen. up their pelvic bones, and that can cause pain. He had a really good manipulation that he would do, you know?

And so he was still doing osteopathic manipulation. I encourage our osteopath friends to do that stuff. To do it, yes. Because they've got some really cool techniques. Yeah, yeah. They just have to have time to do it. That's the problem. That's right.

In a clinic. In a clinic. Age of EMR and 15-minute visits that really should be 30-minute visits, et cetera, et cetera. It's very difficult to do. Yeah. All right. Okay. We've got just a, well, we have a little bit of time.

So we're okay. Yeah, I was calling in. I was a pulmonary specialist. Okay. Yeah. Basically I have a choke in my throat and I have a cough and I'm on the phone all day at work. Yeah, I can relate. They put a nebulizer, an inhaler.

And then Tustinex, and my... Tussianx is a hydrocodone in a resin that lasts 12 hours. Okay. Cough syrup. Okay, got you. Primary care. Hydricodone being an opioid. Our physician won't fill the prescription for Tustan X.

Right. Trying to figure out how I can go about it without a. having to go to the specialist. No, I get it. Some of them just, some of my colleagues won't write anything that has an opioid in it, period. And there are alternatives. Right now, it used to be that if you wanted to get Musinex DM, you had to have a prescription for it. And that is Gwifenison extended release with an extended release dextramothorphan.

And dextramothorphan is an opioid. analog. It is D. Mithorfan, whereas the L. Mothorfan is the one that gets, you know, that actually has pain relieving properties. So dextromothorfan is

the right-handed molecule of Livo-Mothorfan. But it really, unless you chug a whole bottle of it, you're not going to get high from it. But it also, apparently the cough center that is suppressed by opioids,

doesn't care if it's D or L. So the D-Mothorfan will stop you from coughing almost as well as the hydrocodone well with fewer adverse effects and no habit-forming effects. So just go buy that, you know, eight years later. So we are up to June of 2015. We're going to...

We're going to get them done. Get them all done. I promise you that. Before we go, Dr. Scott, you got anything from the fluid family? I do. just got one in from Terry. He's got a question about...

The booed master. He is the booed master, yes. I wonder if he's the master in the boudoir. The boudoir. That's pretty lame. That's a negative. That's a negative bell for you.

You get nothing. All right. Here we go. I've got an edible that has just... Got your hand off my penis. Whatever. I've got an edible. that has just five milligrams of THC.

Good. And it has 80 milligrams of caffeine and a bunch of other stuff. What? Brain goodies. And my wife said she can smell marijuana. So actually, it's five milligrams of THC and CBD combined. So if, let's just say there's two. Is it five of each?

Well, no, it looks like they're combined. So it's just two and a half milligrams of marijuana and two and a half. Maybe. Maybe one and four. It could be four and one. Right. So anyway, the max of five milligrams of marijuana, the, you know, Colorado, or TAC, yeah, but in, you know, Colorado, California, they say 10 milligrams is the normal adult does. That's kind of how they established it.

Yeah. Virginia, the most you can buy in a single vehicle is 10 milligrams. Gotcha. Yeah. So, so he's saying, is it odd that my wife says she can. smell the marijuana on me. Okay, so I'll tell you what this is. This is a gummy that was made from extracted, you know, marijuana plants, cannabis plants.

So, no, it's not that odd. No, it's not. And, you know, yes, you can smell it, you can taste it. When it's synthesized in the lab, it's a little bit different because you don't get all the other aromatics that go along with it if you just get pure THC or pure CBD, but you can tell the ones that are synthesized in the lab versus, which is like maranol, drinab and all, they sell it as, but it's THC, versus stuff that's extracted from a plant. Right.

And that's what makes maranol legal because they can sell it in a known milligram quantity with a known purity, and that's the only way that FDA can approve things. They can't approve things extracted from plants, so they'll never, the FDA will never be able to approve marijuana as medication. Now, the federal government could just legalize it. It just seems to me that when, you know, you have the White House and both houses in Congress, there's all kinds of stuff you could do that you're not doing. And, of course, that's not the case right now, you know, but that has been the case in the

past. And a lot of lip service given about legalizing marijuana and legalizing other medical procedures that don't get done when you have, when you're in power. So it makes you start to wonder if maybe they just want to run on that. the other sides against it. Hmm, wow. We shouldn't have sides on this stuff. No, we shouldn't.

It's enough with the sides. Getting a W for your side. How about the side be the people of this country? How about we do things on that side? Yeah. For, you know, because they have a side, but nobody's listening. We. Yeah.

Us. Yep. We, the people. Yep. Yeah, I hear a lot of lip service, but helping the workers of this country, but I don't see a lot of it being done. But anyway, this isn't a political show. But it does piss me off about the marijuana legalization. It can be legalized already. It makes no sense. The dispensaries that operate in this country are operating with the hope that the federal government will not crack down on them at some point. decide, well, we're just going to do it because they can. Federal government doesn't recognize the state's rights to take a Schedule 1 drug, which is Schedule 1 drugs are

quote-unquote illegal drugs, and make it legal. Now, you can make a non-scheduled drug, a scheduled drug. They did that in Tennessee when they took Gabba Penton, which was not scheduled and made it a Schedule 5, so now it has to be reported. Or you can make a Schedule 5, a Schedule 5, a Schedule four or a scheduled two or whatever you want to do. They're fine with you working your way up the ladder.

You can't work your way down the ladder. And the federal government's just not enforcing it, but they could at any time do it. But also, if you are in a party that proclaims, you know, that you're in favor of legalizing marijuana, particularly, and you have all three parts of of, you know, of the legislative and the executive branch, and you don't do it. You've got to ask why. So is there a reason why, and the reason is going to always be politics? Yep. And when you don't make a decision based on what's best for the people, what you're doing is making a decision that is political.

Right. And that's true for patients, too. if you do something that's not in the best interest of the patients, then that is a political decision, always. Always. All right. Into my soapbox. Sorry. Well, that's because you're an idiot. I know I am.

All right. Well, thanks. Always go to Dr. Scott. Oh, anything else from the fluid family? Nope. They're probably terrified now that I'm going to go on some tirade. Check out the fluid family. YouTube.com slash at Weird Medicine.

Subscribe to notifications. I put out a notice on Twitter at Weird Medicine at the Weird Medicine Facebook page. And on the Weird Medicine Reddit, it's Reddit.com slash R slash DR Steve, Dr. Steve. Or you can get the notifications from YouTube and you can just hang out, people just hang out. You can do super chat.

We don't demand them. And we have memberships. That might be kind of fun. We could do a members-only thing if we get the memberships up. To do that, people would have to gift, you know, the 99-cent membership. So for $10, I could gift $10 memberships to people.

Hell, there's probably not 10 people in the fluid family right now. Only one person would have to do it. Right, that's right. I'm not saying, I'm not begging for it. I'm just saying you could do that. And if we get enough, we'll do something for the members only. Anyway, I hope that everyone has a great week. Thanks to everyone who's made the show happen over the years.

Thanks, Dr. Scott. Listen to our SiriusXM show on the Faction Talk channel, Siris XM Channel 103, Saturdays at 7 p.m. Eastern, Sunday at 6 p.m. Eastern, on demand, and other times at Jim McClure's pleasure. Many thanks to our listeners whose voicemail and topic ideas make this job very easy. Go to our website at Dr.steve.com for schedules, podcasts, and other crap. Until next time, check your stupid nuts for lumps. Quit smoking, get off your asses, get some exercise.

We'll see you in one week for the next edition of Weird Nuts. Thanks, everybody. Thank you. Thank you.