Weird Medicine: The Podcast - 605 - Turning a Trich

Episode Date: September 23, 2024

Dr Steve, Dr Scott, and Tacie discuss: Trichomoniasis Shigella Donovanosis Mycoplasma Genitalium Adult babies Diaper fetish Formicophilia Cuckholdism Abasiophilia Omorashi Frottage Bug chasing symphorophilia Vorarephilia Have we ever cured a disease? Insomnia An "annular" rash Fentanyl BiPAP v. CPAP Please visit: simplyherbals.net/cbd-sinus-rinse (the best he's ever made. Seriously.) instagram.com/weirdmedicine (instagram by ahynesmedia.com!) x.com/weirdmedicine stuff.doctorsteve.com (it's back!) 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!") GoFundMe for Brianna Shannon (Please help Producer Chris' daughter fight breast cancer!) 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

Blah, blah, blah, blah, blah. See, that's the things that are coming out of your mouth, child. Well, that's because you're an idiot. Man, you are one pathetic loser. I am too smart. I am too smart. I am too smart. If you just read the bio to Dr. Steve, a 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 Tobolivir stripping from my nose. I've got the leprosy of the heartbound, exacerbating my impetable woes.

I want to take my brain out and blasted with the wave, an ultrasonic, agographic, and a pulsating shave, I want a magic pill all my ailments, the health equivalent of citizen gain. 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. From the world famous Cardiff Electric Network Studios, yes, the Cardiff Electric Network Studios in solidarity with our friend, Cardiff Electric.

in beautiful downtown bedabler city. It's weird medicine, the first and still only. Uncensored medical show in the history broadcast radio, now a podcast. I'm Dr. Steve, with my little pal, Dr. Scott, the traditional Chinese medicine provider, gives me street cred with the wackle alternative medicine assholes. Hello, Dr. Scott. Hey, there's Steve. And my partner in all things, Tacey.

Hello, Tacey. Hello. This is a show for people who would never listen to a medical show on the radio or the Internet. If you have a question, you're embarrassed to take your regular medical provider. If you can't find an answer anywhere else, give us a call. 347-766-4-3-3-2-3. That's 347. Pooh-Hid. Follow us on Twitter at Weird Medicine or at D.R. Scott W.M.

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And if we do any live streaming, I'm going to do a gambling channel even. I think, you know, that stuff will go on our Patreon as well. And then cameo.com slash weird medicine. I'll say a shout out to your mama. And hang on a second. That was Myrtle's cousin calling. Let me see if I can get her back on the phone here real quick. Everybody loves to hear from Ermulane Spratt, ladies and gentlemen.

Let me see if I can get her here. Let's see Well, I didn't know what you used to do in the heart Well, I was gonna wish you a 69 happy birthday Well, sickerty-nine Yeah, they'll watch him all Watch all a Verdi now she'll want to do that 69 for him Oh no

I don't know what that is I'm doing my show I'll call you back I know you were Oh you did Okay I'll see you by Idiot All right Don't forget Dr. Scott's website

It's simplyerbils.net That's simplyerbils.net Everything going okay over there, Dr. Scott? Oh, yes Yeah, it's getting to be fall allergy season So Tis the season I've got my

Order in for my Dr. Scott's CBD nasal spray Which I got from Simply Herbalstotnats. It's got buffered saline and peppermint oil and a little CBD in there just to kind of even things out and I have used it every day. So thank you. Not an ad. Just letting you know, Dr. Scott is on this earth. And check us out on Normal World. I'm a little behind. I said last week that the next one's going to be about squirting, aka female ejaculation, and I still haven't finished it. So this one, I got to get it right. Now, if you want to

read about it, go to Dr. Steve.com and just search female ejaculation, and I have the actual answer to the scientifically, what's really going on? Is it just piss? Is it something else? So give that

a read. All right, very good. Thanks for everybody in the waiting room. We call them the fluid family. Yuck. It's a terrible name, but but if you want to

join us, while we're recording our show, you can go to YouTube.com slash at Weird Medicine and click subscribe and then hit the notification button and then follow us on Twitter to at Weird Medicine and we usually record Saturdays somewhere between 11 to 12 Eastern in the morning and but at other times at my pleasure. So just keep tabs on that and join. We have a small but delightful group of people that watch us record this live. I don't know why they want to do that.

It's an audio show, not a video show, but it's fun to have them here. Yes. Dr. Scott and I started doing that while back just because it felt different to have to be speaking to an audience no matter how small. So it's fun to do. Anyway, and yeah, our audio show gets thousands and thousands. of times more views than the video part of it, but that's okay. That's because we do a radio show and a podcast, not a video show. Anyway, Tacey, how are you?

Yes, sir. I'm fine. Do you have some Tacey's Times of Topics today? Well, I sure do. 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.

Well, hello, everyone. Hello. So the first topic is about sexually transmitted infections that you've never heard of. Oh, really? Yes. Oh, that's a good one. Who sent you this? I sent it to my damn cell.

Wow, you actually did. Okay, I'm going to give you a preemptive bell. For actually doing some show press. You know what? I do show prep every week, so suck it. Trichomoniasis. Yeah, I've never heard of that one. It's trichomoniasis.

Trichomoniasis is the most common non-viral STI with more than 270 million cases in 2008. More than the combined total of chlamydia and gonorrhea, it's still pretty rare in the UK, but it's most common in under 25s, and it's ten times more common in the black ethnic. minority populations than in the general population. There are only around 6,000 cases each year compared to over 200,000 cases of chlamydia. It infects the genital area causing a greeny, yellow, frothy vaginal discharge. It's unbelievable and it's unmistakable when you see it. It just looks like nan or pudding coming out of the old meat wallet.

Discharge from the penis, pain when passing urine, itching of the genital area, and discomfort in the abdomen. However, as with many STIs, most of the time, there are no symptoms that can be fully cured with antibiotic treatment. Yeah, well, there you go. You use metronidazole. When you diagnose this,

you have to, you know, get some of the exudate. Good stuff, yeah. And put it under the microscope with some saline. It's so thick, you have to dilute it. And you just see these things in there. It's not like seeing bacteria or clue cells or something, they're just like little swimmering organisms.

They're like, it's horrendous. And you look at it and it's like... Yikes. Yeah. Looks like the aliens from storm ship troopers. The movie, remember the vugs? But the little tiny microscopic versions of those.

Oh. Yeah. Yuck. Yep, not good. Pass. Shigella. Did I say that correctly? Yes, you did.

It's transmitted sexually, but it can also be transmitted by poor hand hygiene. It's the name for a group of bacteria which causes gastroenteritis, a common condition, which causes diarrhea and vomiting and dysentery. It sure does. And the thing is, is if you get salmonella, you have to have a huge load of bacteria with chigella. You only need a very few to trigger this thing. I've never actually seen a case of chagella, but I've learned by, yeah. Someone with Shigella can pass it on through infected poo, including if it contaminates food or water. Men who have sex with men are particularly at risk as it can be passed on sexually through contact with the anus or contact with sex toys, fingers, or genitalia, which may have been infected fecal matter on them.

Yeah, well, it's not just men who have sex with men, but yeah. It only takes a tiny amount of bacteria to get into your mouth to be infected. If you're worried, you're, if you're worried, you may have contracted it, as there aren't always symptoms, tell the health care professional that you may have picked up a stomach infection from sex. Okay. Yeah. And most doctors still won't know what the hell you're talking about. That's the problem, because it's unusual. Donovanosis.

No, I do not know what this is. When the UK saw one of its first recorded cases of Donovanosis in August. Oh, we did a story on this. Go ahead. Headlines reported a flesh-eating and skin-riding STI. We hardly ever see Donovanosis in the U.K. Except in those who have had partners in parts of Africa. Whilst painless and treatable,

the most common type of ulcers caused by this STI are fleshy and red, bleeding when touched, other types of ulcers can appear raised in a regular, a foul-smelling ulcer which causes tissue destruction or scar tissue. It has been shown to be Would you stop? It's Donovan. It has been shown to be a risk factor in HIV transmission

due to the bleeding from ulcers. It is mostly found in tropical and subtropical areas with men affected twice as often as women. Yucky boo. I asked on that one too. No, thank you. You didn't like the soundtrack? No, I didn't.

Why? Because it was awful. It's Donovan. It was terrible. It was distracting and it was terrible. Mycoplasma genitalium Oh, wait, say it again? Mycoplasma genitalium.

Yeah, that's a bad one. MGen. Ureaplasma also in that same group, and that sucks too. The British Association of Sexual Health and HIV release new nice accredited guidelines to prevent the emerging pathogen from becoming the next superbug as it becomes more antibiotic resistance. It's the smallest known bacterium which can self-replicate. It's a super bug.

Super bug! Sorry. Oh, my goodness. Are you got it all out? Not even close. Nope. Infection occurs through genital to genital contact or genital to rectum contact affecting 1 to 2% of the population. More commonly in non-white ethnic groups, smokers, and those with multiple sexual partners.

Most people have no symptoms and unaware of the condition can develop complications such as pelvic inflammatory disease, sexually associated reactive arthritis, premature birth, miscarriage, stillbirth, and pain and swelling of the testicles. If Imgen becomes completely antibiotic resistant, up to 3,000 women who have imaging caused pelvic inflammatory disease would be at risk of infertility. This is a real problem. There are people that have chronic infection. with this stuff, they can't get rid of it. Yeah. And what you end up doing is getting on things like doxycycline or azithromycin for months, and maybe you can get it eventually eradicate it.

Okay, here's, oh, here we go. Lympho granuloma venerium. No, that's correct. LGV. Give thyself a bell. Most people have heard of chlamydia, but have you heard of LGBT? It's a type of chlamydia which attacks the lymph nodes. It can be picked up by any ordinary chlamydia test, but requires longer treatment than chlamydia.

It's been rare in the U.K. since the early 2000, there has been a series of outbreaks, mostly affecting HIV-positive men who have sex with men. LGV often has no symptoms, especially in women, or can cause symptoms such as blistering, pain in the lymph nodes, in the groin fever and tiredness as well as inflammation in the lining of rectum of men. Get your hand off my penis! If left untreated, the symptoms become more severe, causing lasting damage to infected tissue and overall health, and reactive arthritis, scarring, swelling, and deformity in some cases.

Patients may experience swelling of the lymph nodes and the genitals ulcer and damage inside the rectum or vagina. Most people recover, but they develop complications. We always worry about the big three, you know, chlamydia, gonorrhea, herpes, syphilis, not so much, but people hear about it. There's all these other things out there that are out to catch you. A little real. This is where monogamy came from. The idea that if you marry someone as a virgin and you only ever have intercourse with them, you'll never have a sexually transmitted disease.

It's where it came from. It's the idea of not eating pork came from. from, you know, cysticercosis. Okay. And, you know, a lot of these things, these social norms were originally sort of the health department. The religious community was the health department of the ancient world, you know. Anyway, go ahead and taste.

A top ten list of unusual sexual behaviors. Mm-oh. Uh-oh. Uh-oh. Number 10. Paraphyphilic infatilism. Infantilism. Yeah, this is like a hebo-phrenic, you know, adult babies, right?

Yes, it's derived from dressing up like a baby or being treated like one. Yeah. It may or may not overlap with dopper fetishism, which is when a person received sexual pleasure from wearing or using doppers. Yeah. Formocphilia. Sexual arousal is derived from having insects crawl all over your body or genitals and usually buy or sting you as they do so. Oh, what is the name of that one?

Formicophilia. Formicilia. Okay, so formicilia, it relates to ants, you know, and when you have itchy skin, it's very often referred to as formication, not fornication, but formication. And it's, they think that that whole thing is a, is a, is, an evolutionary response to being covered with insects and stuff. So, but anyway, yeah, go ahead. That's disgusting.

Cuckoldism. Why would anybody want to do that? You can't get rid of the damn things. Bizarre, yeah. Sexual pleasure is just derived from seeing one's partner engage in sexual activity with another person. What's that cuckoldism? Yes. Is that what you read?

Or from knowing that one partner is having an affair. A surprisingly high number of men and women appear to have such as fantasies. Abaciophilia Spell it A B-A-S-I-O-P-H-I-L-A I have no idea what that is That sexual arousal derived from either viewing or sexually interacting with a person who has limited mobility

Oh, oh, okay, yes I do know what this is These are people who have fetish about amputees and stuff like that Yeah, yeah, yeah, yeah It says such as an individual wearing a cast or using crutches Yeah, I think that's a control thing, sort of. You know, they can't run away from you or something. I don't know.

But there's, that's, that's, this is not that uncommon, actually. Go ahead. Omar Rashi, sexual pleasure is derived from either having a full bladder or watching someone else have a full bladder with themselves. We just watched a TV show about that. Yeah, we're watching. Industry. Industry.

and they like to watch show people pee and pee on each other. I think one of the showrunners has Omarashi. Yeah. I mean, they're always peeing in that show, at least once an episode. Now they got the hottest woman on the show peeing on John Snow from Game of Thrones.

Wow, how the mighty have fallen. But anyway. It's a very good show, though. Yeah. I would have been happy if they just talked about it rather than showing it to be on that. But it's a great job, other than the omarashi. Froturism.

Say it again. Fraudorism. Oh, fraught. It's frotage, frotage, right? That's where you touch people inappropriately, like in a crowd or something. Yeah, non-considding person in a public place. Yeah. Jimmy Norton used to talk about frittage or frotage.

Bug chasing. Sexual arousers derived from having sex. with or fantasizing about having sex with someone who is HIV positive. Yeah, that was a big deal in a big deal, but I mean, it was something we heard about in the 90s particularly. Symphoraphilia,

sexual pressure is derived from watching a disaster occur, such as a car accident or fire. Oh, wasn't there a movie about that? Was that what crash was about? I don't know. Okay. What's the name? How do you spell it? S-Y-M-H-O-R-O- P-H-I-L-I-A Okay

Yeah, let me look and see if that's what that was Sometimes they'll stage disasters too So this is people who like Will light fires There's a subset Oh like an arsonous Yeah

But then they're getting off Sexually from it From watching a barn burned Yeah Wow Yeah Sacco-fricosis That is sexual

Arousal Dorad From cutting a hole in the pocket Of one's pants in order to masturbate in public without anybody realizing that it's happening. Yeah. And the last one, Vorarophilia, V-O-R-A-R-A-R-E-H-I-L-I-A. Okay, yeah. Sexual arousals devolved from the thought of literally either eating another person or being eaten by someone else.

What? Well, there you. Most of these people just fantasize about the act, but some of them actually go through with it. What do you mean? Like cannibalism kind of stuff? It says, click here to read about the case of a man in Germany who was arrested for murder after carrying out this activity. Oh, okay. You mean like human cannibals.

Yeah. That's what I was guessing. And those are the topics of the day. Wow. Amazing. There was, yeah, so there was this movie called Crash. And I'm trying to remember who made it. I don't know if it was David Kronenberg or somebody like that, but it was.

The crash film, it's a 1990-6 film about people who were simpheraphyliacs. They don't mention the name in the movie, but that's basically what it was. So, anyway, all right. Very good. Thank you, Tate. Scott, you got anything? Nope. All right.

Well, let's answer some questions. Number one thing. Don't take advice from some asshole on the radio. Thank you, Ronnie B. It's good advice. I was just listening to old opi and Anthony, like I do. And Patrice was in there talking to you about how we had not had any cures for diseases. You didn't really get a chance to talk the whole time.

Yeah, there's no shit. There's a fucking four people in there, and they were all talking over you. But if you could go on about some maybe cures, have we cured? I know we've eradicated smallpox and... different things, polio, whatnot. But cures, have we cured any diseases? Well, I remember Jim Brewer called you snuffle-upagus. He did?

I don't remember. Okay. By birds. Okay, buddy. So what was he talking about? He's asking, have we ever cured any disease? Okay, three-minute timer starts down. No, we've got another call about the three-minute timer.

It says we should throw it away. Mainly because people there were, getting cut short on things that people want to know about. So let me... Well, that sucks. I know. Well, it was a good idea. We ran the bit. I liked it.

I think there are certain shows where we can say we're going to be on a three-minute timer, and those will be the ones where we want to get through a bunch of phone calls. Let me tell you what the problem is. We didn't get that many phone calls this week. I'm going back to Facebook then. That's all I'm going to do. So things we have cured. So we, yeah, we cure some diseases, all this.

time. Now, if he's talking about, you know, groups of diseases, smallpox has been eradicated. So if you're saying that that's not a cure, there are other diseases that we have eradicated. And one of those was a thing called render pest in ruminants. That's in, you know, goats and cows and stuff. And their ongoing eradication of, of polio, yaws, the guinea worm, and malaria. Malaria would be a big one if we could eradicate the shit out of that. Now, curing something just means that, you know, the patient is no longer suffering from that. And that's really applies to individuals.

So we cure urinary tract infections every day. We cure cancer every day, certain cancers, obviously, and other things like that. So yeah. But the one that I really want to talk about, it's not a cure, but it's kind of interesting, is bubonic plague. Now, Tacey, are you aware that bubonic plague is still seen in, you know, the United States today? No, I'm not. Yeah, it's caused by a bacteria called Yersinia pestis, and it's spread by fleas.

And back in the day, in England and other parts of Europe, people were living with animals and they had rats everywhere, and they were getting bit by fleas. when they were sleeping that were carried by these rats and then they would get plague and this whole cities would be affected by it Shakespeare had to flee London because flee no pun intended but he had to leave London in a hurry because there was

a wave of plague coming through Google the plague of Justinian again that was a plague of European populations that just devastated them to the point that we still hear about it. And that was an ancient Roman kind of thing. And this plague

plagued humans, you know, the human population for generations. And now we hardly ever hear about it. Why? Because we don't live with fleas that much. We're not living with rats. We try to get rid of mice and rats. And we also have antibiotics.

So if someone gets a plague, we just throw an antibiotic at them and they're cured. So, you know, it gets its name, a bubonic. It gets the name from these swollen lymph nodes that they call bubos that are caused by the disease. They're in the armpit, groin and neck, and they can become as big as eggs, and then they ooze pus. They break open and ooze pus. And, you know, it is the same plague that killed so many people during medieval times. 25 million people during the 14th century, which was, by the way, two-thirds of the European population at the time. Can you imagine?

I mean, we were worried about COVID. And here they had two-thirds of people. So 67% of people died from the bubonic plague. And these rats would travel on ships, and they'd bring the fleas and the plague with them. And most people who got the plague died, and then they had blackened tissue due to gas. and so it was called the black death. And at that time, there was no cure. So there have been other episodes of bubonic plague in world history.

And we still have it in the United States. We'll have, you know, a few cases every year. Let's ask, Echo, how many cases of plague there were last year. Echo, how many cases of bubonic plague were in the United States last year? From health.com. And there have been 16 reports. cases of plague with four deaths in the United States this past year. Yeah, so 16, with four deaths, so still 25% of the people died.

Why, it was probably, I'm guessing, elderly folk who had messed up immune systems, and they probably delayed their diagnosis. If you've got an enlarged lymph gland, particularly if it starts oozing pus, don't eff around with that. Don't just assume it's cat scratch fever or something. Get it checked and get it treated. Okay? We test it.

It's very easy to test it. There's just blood or tissue sample tests for ursinia pestis. And then they treat it with Cypro or even doxycycline. Just very easy to treat. Okay. But it can be fatal if it's not treated. So there's any chance that that's what you have. You've got to get treated, okay?

You prevent it by making your place in hospitable to rodents, and you use flea control products for your pets, et cetera, et cetera. Okay? Good idea. All right. How many minutes was that, Tase? I don't know. You told me to stop.

Oh, God. Do you want me to start timing you? No, nope. I don't want you to do anything. I want you just look at Facebook. Okay. Hey, Dr. Steve, Dr. Scott. Tacey, if you're there,

whoever, other alumni. and I are present. This is Randall and I was just talking about a question that came up. I was listening to your folks talking about lack of sleep and I had a couple of things I just wanted to try to cover. One of them is I get like chronic sinus infections. I haven't gotten AT&T work up yet to see if I have a nasal polyp but my wife had a prescription of Montelia cast and she's found an indication for it. She's a nurse as well. Monty Luke and she said she thought it improved. I'm dreading having to go.

It's also called Singular. It's Monty Lucas, yeah. I do a sleep study, but now I'm seeing. I think about it. It might be Montella cast, but I still think it's Montylucast. This new epilepsy drug that is coming out in a double-blind placebo controlled study. And not to take up too much of your time, it's a psilocy. me. And this

is in a European study, and so I didn't know if you felt like that might be something interesting to talk about, and I appreciate everything you do, and you guys are great. Thank you so much. Bye. Hey, thanks, man. Yeah, so the Monte Lucast is this leukotriene inhibitor thing. It doesn't matter really what it is,

but Singular is a great drug for some people that have chronic allergies, and sometimes you just throw it at people. I had had patients who were on three inhalers and started, when the Singular first came out, I, you know, tried it on them, and then they just stopped taking their inhalers, and they were fine. We've also had a close friend whose kid was put on this stuff, and they thought that the kid was autistic until they took them off the Monte Lucast, and then they were fine.

So some kids can have a really bad reaction to it. some adults can have a bad reaction to it. For me, it just does, it decreases my allergy symptoms. I don't seem to have any side effects from it. Yeah, I take it too. Yeah, yeah. It's a good drug. Now, when it comes to insomnia, I was watching Jimmy Dora the other day,

and he was talking about gamma hydroxybutyric acid with GHB, which is the, you know, Roofy, the date rape drug. drug. But I hate that it's called that because actually, although it's been misused, it's significantly misused. It has some really good properties. And there's a branded version of it called sodium oxibate, which is sold under the brand name Zyram. And it really is kind of a cure not only for insomnia, but for certain forms of narcolepsy. So I have narcolepsy. see, and I'm driving down the street, and all of a sudden my brain says, okay, now it's time to go to sleep. And it's like, why are you trying to kill us? And it's like, then who am I talking to in there? But he has been getting more sleep, just so you know.

Well, that's the key, isn't it, is getting, if your sleep architecture is effed up, then you may end up having to make up for that sleep during the day. Like while you're driving. So the hypothesis, so one of the things they do, Right, is they'll give you stimulants. Right. And so the stimulant is sort of keeping you awake, but then it doesn't do anything about the disordered sleep architecture. So what if you had a drug that would make your sleep architecture more functional so that you just didn't have that sleep debt that you had to make up during the day?

And so to me, that makes more sense to treat narcolepsy that way, to have a drug that fixes your sleep architecture. Well, sodium oxibate does that for a significant fraction of people. They don't have to be on stimulants anymore. So now here's the thing. I wanted to try it because I think taking a stimulant for having a problem with sleep is just kind of your – it's not the right approach. fixing the underlying problem, be the right approach. But I can't get it because I have to have not only another sleep test, but a thing called a multi-sleep latency test.

And so you've got to jump through all these hoops. So I've got to go, and I can't get it done until January. So January, I go spend the night with my CPAP, and they do the thing. And then at 6 in the morning, I get up, I go eat breakfast or whatever, go home, take a shower and come back at 8 in the morning and then I have to, they turn the lights out and see if I fall asleep and they do that from 8 to 10

and then they'll do it again from 11 till 1 and then from 2 to 4. I've got to do it. Yeah, I have to be there until 4 o'clock. And if you fall asleep, you know, two times out of the 4 and you have REM sleep, which I know I will because I always dream. Yeah, sure, sure.

then that's a positive test, then you can get this stupid drug. But, you know, I don't know why they're withholding it from everybody because it is, you know, I get it. It can be abused. So can percocet. So can transdermal fentanyl. You know, all these things can be abused. But we're still able to prescribe them and for people who need them. And, you know, you just get a prior authorization if it's not first line.

on your insurance. But this drug, for some reason, you have to jump through all these hoops to get it. Interesting. Yeah. I was going to say, I'm sitting here hearing you describe that. I know for a fact, the 8 o'clock in the morning I would go right back to sleep. Yeah, of course.

And I know for absolute fact, at 3 o'clock, I'd be right back to sleep, too. Well, you may have it, too. I mean, I know narcolepsy is underdiagnosed. And, you know, I have sleep apnea. It used to be worse. I used to, like every Wednesday I would take my laundry to the laundromat, right, or to the cleaners. And I would pull up and I would immediately fall asleep. And I would sleep there for like 20 minutes and then I'd wake up and take my stuff in.

And one time they said that some guy came in and said, I think there's a guy dead out in your parking lot. And they said, oh, no, that's just Dr. Stevie does that every time. So they knew that I was doing that. That's how bad it was. And if I didn't have to go to the laundromat, I'd pull in at work and I'd fall asleep. So once I got diagnosed with the complex sleep apnea and got my Bipap mask on that, stopped happening, but the other stuff still happens. But, yeah, Tacey's 100% right.

When I go to bed at 11, get up at 7, if I can pull that off during the week. then I'm fine. I don't fall asleep while we're watching TV or any of that stuff. So really, I just have to be more disciplined by getting more sleep. But my sleep architecture is still screwed up. If I, you know, I've got this watch that monitors that stuff. I get deep sleep right when I fall asleep. And then it's REM light sleep, REM light sleep the rest of the time.

So I get very little deep sleep. And deep sleep is supposed to be where you get all that true, you know, reparative stuff. That's cool. All right. And about that seizure drug, don't know what he's talking about. So I'm going to skip over that. I was not able to understand the name for it. So sorry about that.

All right. Yeah, if you want to call back, I would be happy to. Yep. Hey, I love your show, by the way. Thanks, buddy. I've got an inch and a half, maybe an inch and a quarter ring on my name. neck that almost looks like ringworm, but it goes away for a week or so. But now it's about four inches, maybe five inches on my neck.

Okay. And it still comes and goes. Okay. What is that? Okay. What do I do? Well, what I've said over the years is it's very difficult to, um, diagnose a rash by photographs.

Absolutely. So people send me pictures of rashes and I don't know. I can tell you kind of generally what it is, but it's very difficult to do. Now, some dermatologists can do it because they're used to looking at these things on slides and, you know, they give presentations and, you know, that's part of the way that they learn

is they just look at one slide after another. And so they can do it better than I can. But it's, therefore, if it's hard doing it, it when I can see it, it's really hard to do it when I'm just hearing about it. But actually, that's a little bit easier because you can say, you know, you can describe it. You know, it's

popular erythematous or, you know, peridic rash with, you know, in a ring shape or whatever. And that, then you're kind of talking about what it really is. So this guy has a ring-shaped lesion. Those are called annular lesion. So this is annular. It's

not a macular lesion, which would be a plaque. or something that's completely filled in. So this has redness and with a clear in the middle. So these are pretty distinctive. And so one of the sort of ring-like lesions is erythema migrans. Arithema migrans is a rash of Lyme disease. But the problem is it doesn't come and go.

What it does is it comes and then it gets larger and larger and then it fades out. So sometimes people miss it. So, you know, in that one, if you have that, they just start antibiotics. If you can catch it during that phase, you don't have to worry about it anymore. Then there's plaque psoriasis, and that will be demarcated, but they're plaques. They're not annular lesions for the most part. There is a thing called eryema multiformy. That's a hypersensitivity reaction, and those are anular ring-like raised lesions with central clearing,

so that makes sense. But they tend to come and stay. They don't just come and go and come and go. And there's a thing called lichen plonis, but that, again, is a purple polygonal papule, so those are not really annual. So the one I'm thinking this may be is a thing because ringworm is a fungus

and it comes and it stays. It doesn't just come and go. It doesn't go away. I'm thinking of a thing that might be numular eczema. A numular means coindexamine. shaped okay so that's a rash it's coin shaped sort of red lesions and they they can come and go yes because it's a form of eczema now there are also you know rash is like urticaria but those usually won't be all in the same place every time urticaria is hives and you could get ring

shaped hives but it wouldn't just come and go and you would know it'd be finally issue unless he was, you know, scratching it, not knowing he was scratching it, or unless he was wearing a shirt or a jacket or with a collar that was irritating or something. Yeah. I'm going with the exma. Yeah, yeah. I think numular eczema might be this thing. Because it can, but it, because it'll kind of come and go a little bit and fade.

And sometimes a little worse, sometimes better. Right, right. And you treat it or you put some cortisone on it, goes away, and then it comes back. So he, he said, what do I do about it? Go see a dermatologist, because we're just guess. These are just educated guesses. I have no idea what it is. But if you go to a dermatologist or a smart primary care provider, let us know what they tell you.

And if they get rid of it, there is this thing. You ever heard of Tinia Versa color? That's an interesting one. It's a rash. And it can kind of come and go, but it's a fungus. And the reason they call it Tinia Versa color is because it can be different colors, you know. and it's usually geographically bordered and it can spread and all that kind of stuff.

I'm going to see if I can find a picture of it for you guys to look at. The radio people can't. And it will be often hypopigmented. In other words, it'll look like Fidiligo almost in some people. And when they tan, it'll be uneven. It'll look weird. And this is not the easiest thing to get rid of.

Now, we used to use selson for this, selenium sulfide, and it makes you stink. But now they are using, you know, ketoconazole and, you know, creams, gels, or shampoes. But you can also take itraconazole, which is sporinox, which is an oral tablet to kill it. And one of the ways that they would do this was pretty cool. they would give somebody the pill and then have them get on a treadmill and sweat. And the drug would be excreted onto the skin or secreted onto the skin through the sweat. And then when they would dry, the medicine would be right where the problem is and it would kill it. And it would not only kill it just on the surface, but because the sweat glands are relatively deep,

it would, you know, kill it all through the dermal and epidermal layers. Pretty cool. You could do that with die flucan as well, or a.k-a-fleconezol. All right. Let's do this one. This is one that everyone should know about. If I can get it to play. Okay.

Oh, boy. There we go. Dr. Steve, this is Jesse. Hey, Jesse. Hey, Jesse. I called a whole bunch of times. I actually listening to your show right now. Saturday night.

Thanks, man. Anyway, I'm in the process of buying a new home right now. Yep. And they told me that it's up to me to get that, I believe it's called radon. Yep. Or it starts with an R. Yeah, radon. That shit that comes up through the soil.

They say it's second leady cause in lung cancer. And I looked into it, and they say it is, but I don't fucking understand it. And why the fuck does it come from the soil? Yeah, yeah, yeah, absolutely. And why does it cause cancer? I don't understand. Because look at all the fucking farm fields. And that's where I live by, enough but farm field.

That's different, though. I guess I just don't understand it. And I figured a man, with your expertise, yeah, I'm being able to answer that question. Okay, man. Thanks a lot, man. Flattery, we'll get you everywhere. Radon is this, it's a radioactive gas.

And the problem with it is, okay, if you're out in the fields, it's not that big of a deal because the wind is just blowing it around. The problem is if it's under your house and then it's wafting up into the house, the still air of a home will concentrate. The levels will continue to build up. It's one of the leading causes of cancer because it causes ionizing radiation. ionizing radiation causes cancer where you're changing the neutrons that are shooting out of this stuff

kill or deranged DNA and they only have to do it in one or two cells and then all of a sudden you've got cells that are growing out of control it's 3 to 14% of all lung cancers and if you smoke and have radon in your home

then you're at even higher risk that's always true if you've had asbestos exposure don't smoke If you work in a mine and you've got coal miners pneumoconiosis, don't smoke. If you've got radon in your house, well, get rid of it, but don't smoke. But, yeah, lung cancer risk much higher in smokers with radon. Now, you can detect it by getting a radon detector. You just put it in your home.

We probably should do that. I think we did it once, but I can't remember if it was in this house. So we probably need to do that again. I thought we had one. I thought we did, too. But there's this little detector that detects it. It's like a smoke detector. Yes, right.

And then, you know, when the electrons, or I don't know if radon is an alpha, beta, or neutron, what it, what kind of particles are released. We'll find out in a second. But they could be detected by having these little films. They got polonium in them. And then, you know, it causes a voltage change when they get hit by. particle that's, you know, radioactive particle. But anyway, again, outdoors, it dilutes to these low concentration because the wind just blows it around. So what do you do?

So let's say you test your home and it has it. Are you doomed? Absolutely not. What you do is, number one, don't smoke. But number two, you put ventilation in your crawl space under your house so that you have airflow under your house at all time so that the radon doesn't waft up into the house, it's just blown away from one end of the crawl space to the other. So anyway, all right? Look and see if you can see what kind of radiation radon emits.

Are you doing that, Scott? Yeah, sure. Yeah, that's, and then we'll start on this one, and then you can come back to it, okay? All right. Well, I hate this new mouse. It can kiss my ass. Okay. Hey, Dr. Steve.

A long time, third time. Hi, Dr. Scott, Casey. Can you elaborate on when it would be okay to prescribe someone sentinel? I know you do palliative care. You probably have people at end stages that it wouldn't harm them. But I was just wondering, just on a regular basis, some moment of the pain, maybe they're on Vicodon. It's not working or something, but is it – I mean, I thought fentanyl was only using surgeries and relative care.

Well, no, okay. So I love this question because this is – I'm going to get on my soapbox, which I'm glad we don't have the three-minute timer right now, Tase. All around our community and all over the country, there are billboards that say fentanyl kills. Fentanyl kills. Well, what they're talking about is street fentanyl because it is dosed in microgram amounts and a 2.2 pound, 1 kilo brick of fentanyl, has 20 million fatal fucking doses in it.

And when you have dealers that, you know, aren't necessarily, I don't know, road scholars, going, well, maybe I need a little bit more kick to this batch, you know, let's just put a couple spoonfuls of fentanyl in here. And now you've got these baggies. going out where people are dying. So fentanyl in that situation does kill. All fentanyl is is an opioid.

Just like morphine, oxycodone, hydromorphone, i.k.a. delauded, that kind of stuff. But it is the molecule itself is slightly different. It's a very small, fat, soluble molecule. So you can do some things with it that you can't do with, say, morphine. Like you could put it on a patch. and it is absorbed through the skin. You can put it in the mucosa of the mouth, and it will be absorbed directly there.

There are people out there that think that morphine can be absorbed from the mouth, from the buccal mucosa, you know, the mucous membrane of the mouth. It cannot. Maybe 7% of it will be. It has to hit the stomach. But fentanyl can be 100% absorbed

in the mucous membrane of the mouth. So there are some cool delivery systems you can do. We do use it in the ICU for sedation, but remember, it's fat soluble. So when you use that, when you turn it off, it's not gone. It's still being leached out into the patient's bloodstream from the fat supply where it's been absorbed over time. Now, we will use fentanyl in the clinical situation when you have someone, either they're in the ICU. but forget about that on the outpatient. If they have chronic severe pain that requires round-the-clock dosing of short-acting medication

and that can't be treated with some other means. So that's the indication for transdermal fentanyl in the outpatient setting. And so if you have someone that's taking, you know, 15 milligrams of morphine, say six times a day, that would be 90 milligrams of morphine. They would qualify for transdermal fentanyl if they needed it around the clock. So they put the patch on 25 microgram patch of fentanyl per hour, and you change it every three days. And that's if they can't take long-acting morphine for some reason. Maybe they can't swallow well or something, and they're using the liquid.

That's the main reason. Now, the insurance companies have started requiring that we use transdermal fentanyl on people because it's dirt cheap. It's about 40 bucks a month instead of 300 bucks a month for the extended release oxycodone. So they've sort of forgotten about what the indication for it is

and just said, well, it's cheap, so you guys have to write it first. This is the way of the insurance company. Now, so when I go to put somebody on this, I'll say, hey, you know, you're taking this much morphine, and your pain still isn't under control. We need to start you on long-acting pain medication.

And your insurance wants us to use, you know, transdermal fentanyl. And people go, fentanyl, what are you trying to kill me? I see them signs out there. And it's like, oh, my God, just can you change the billboards? So if they say street fentanyl kills or the abuse of fentanyl kills, because then I have to go through this whole song and dance, and people are still enter into this with some trepidation until they get on and realize I'm not trying to kill them.

you know so anyway so but that's when that's what that's what it's indication is for now there are some people who have severe cancer pain and this is the only time that this one is um is allowed is you can use trans buckle fentanyl like a fentanyl lollipop or something like that where it's absorbed from the mouth but guess what those things the doctors they sent out this survey to doctors asking do they understand how to prescribe these things and these were people who had already taken the test and signed up for you have to sign up to be able to prescribe them and so many people failed the test that the FDA said fuck this we're taking it off the market

because you people are stupid so those things are no longer on the market so you can only get in the outpatient setting transdermal fentanyl in other words a fentanyl patch and if it's prescribed properly totally safe. Where it's improperly prescribed

is when people use it for acute pain or if they use it on the opioid naive elderly. In other words, you've got someone's never taken a narcotic before and they broke their hip and you try to slap a transdermal fentanyl patch on them. Take six days for it to reach steady state

is the first thing. And most of the time you're going to overdose them. And then they're in the nursing home and these things look like cellophane. If they don't send the medication administration record with them, nobody knows that they're on it. They can't figure out why they're completely gorked out.

It's bad. So using it improperly can be dangerous, but used properly by a provider that knows how to prescribe. It's totally fine. It's just another opioid. It's just one that's a little bit trickier. Cool. Okay.

So let's do this one before we get out of here. And then we're going to check in with the fluid fan. family. See how they're doing. If you want to join the fluid family, again, go to YouTube.com slash at Weird Medicine and click join, but you don't have to join. Just click join and then click the button that says accept gifted memberships because Myrtle gives out memberships every week to random people and other people give gifted memberships as well. And also click the notification button and subscribe to the channel. And then that way you'll get notifications when we go live.

And then you can hang out with us and we'll shoot the shit. Hey, Dr. Steve, it's Randall. Hey, Randall. Hey, Dr. Scott, Casey, or all the other alumni that might be present. The sunburned dick with a sundial, what? Get a piece of yarn. Dude, around once, measure it. Or you can do another nefarious podcaster said as a center of the anus to just pass

the tip. Oh, so, well, he's talking about measuring. I don't know what he's talking about measuring the circumference and the length of your junk. And yes, you do not go from the center of the anus because if they did, I'd have a 14-inch member. So, yeah, you go from the base of the penis when it's erect. Thank you.

All right. Let's see what we got here. Myrtle Manus gifted 20 weird medicine with Dr. Steve memberships. Thank you, Myrtle. I see a lot of people got those. And let me see here. Okay, Dr. Scott, you got any questions? I've got two questions.

Okay, very good. Oh, Don Phillips wants to know. Anytime I lay down, I get congested. If I don't take a Zyrtec D before bed, I wake up full of snot and can't breathe through the night. Okay. What's up? Well, he's got perennial rhinitis. I'm not a big fan of taking the Zyrtec D just because the pseudophedrine that's in there, you know, has some adverse effects.

and taking it before bed may distort your sleep architecture as well. I just wonder, I'll tell you what I like are the breathe-right nasal strips. Breathe-right nasal strips rule because they open up your nasal passages without using medication. And then the other thing I would do is just try this. If you're waking up with snot, try a navage at nighttime before you go to bed. I think he said he tried a navage. Oh, he did? Yeah, I think he did.

All right. Well, I would do it. before you go to bed. So clear out all of the, and then if you need to take a regular Zyrtec or something, that's fine. Then the non-drowsy antihistamines are reasonable. And the other thing possibly is to get one of those highfalutin air filters. Yes, I have a lot.

Yeah, especially in your bed. Yeah, we got one for one of our kids. They're not that expensive. And they're relatively quiet. You just put it one corner of the room and keep that door closed. And what it'll do is it'll take a lot of the pollen and, you know, mold particles and dust and stuff out of the air for him. So wash your sheets, wash your head, wash your dogs.

Yeah, yeah, yeah. Wash your air. Yeah, very good. Now, at least try those. One more question. Yeah. This is from Homer. He wants to know what the difference is between a CPAP and a bi-PAP.

Oh, that's a good one. Yeah, that's a great question. Tacey, you want to take part of that? Oh, I don't know. Okay, all right. Well, Tacey uses CPAP. I use bi-Pap. So CPAP is continuous positive airway pressure.

And so what that does, all that does is apply counterpressure when you're breathing and that keeps your airway open. But when they did that to me, I stopped breathing because I have a thing called central sleep apnea. And for whatever reason, that thing triggered my brain to just think it didn't have to breathe anymore. Okay. So the BIPAP is biphasic positive airway pressure. In other words, it has a pressure coming in and a pressure coming out. So it's also called non-invasive ventilation. So if you heard of mechanical ventilators, they stick the tube down your throat.

You can do this by just strapping a mask on somebody. It pushes air in and that gives them a little back pressure on the way back out. And that keeps the airways open. and it stimulates you to breathe and it'll even breathe for you if you have no drive. And that's the difference. So CPAP is just back pressure.

BIPP is in pressure, you know, pressure forcing air in and then back pressure as it comes back out just to keep the airways open and keep the alveoli going and make sure that you're actually breathing. Okay? That's a good one.

So people who have complex or central sleep apnea they don't have an obstruction in their airway. They just don't breathe. And so they need Bipap to make sure that they're breathing during the night. Whereas what Tacey has is obstructive sleep at me. She just needs back pressure just to hold the airway open. Does that help? Yeah, I think it's great.

Okay. Anything else? No sir to believe it's all. All right. Well, thanks always go to Dr. Scott. Thanks to the fluid family in the waiting room. We appreciate you guys. Thanks to everyone who's made this show happen over the years.

Listen to our SiriusXM show on the Faction Talk channel, SiriusXM, 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 for 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. Go to Dr. Scott's website at simplyherbils.net for CBD nasal spray, remove of fatigue, reprieve, and stress lasts. And I'm going to be on just a plug on the All Apologies podcast this week. We're going to be talking about why they should be apologizing for the new Star Wars. No one's actually apologized for it yet, but they should. 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 additional weird medicine. Thanks, everybody. Goodbye, everyone. You know what I'm going to do.