612 - Meat Honey
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This episode is brought to you by Amazon Prime. There's nothing sweeter than bacon cookies during the holidays. With Prime, I get all my ingredients delivered right to my door, fast and free. No last minute store trips needed. And of course, I blast my favorite holiday playlist on Amazon Music. It's the ultimate soundtrack for creating unforgettable memories. From streaming to shopping, it's on Prime. Visit Amazon.com slash Prime to get more out of whatever you're into.

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And anything that might not misbecome the mighty sender, doth he prize you, aunt? I don't remember asking you a goddamn thing. If you just read the bio for Dr. Steve, host of Weird Medicine on Sirius XM 103 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 a, you know, a clown. Why, you give me the respect.

Don't get it now in the tablet.

I want to requiem for my disease, so I'm paging.

From the world-famous Cardiff Electric Network Studios in beautiful downtown OJ 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 wacko alternative medicine assholes. Hello, Dr. Scott. Hey, Dr. Steve. And back from sabbatical, Lady Diagnosis. Hello, Lady Diagnosis. Hello, Dr. Steve. This is a show for people who have never listened to a medical show on the radio or the internet.

If you have a question that you're embarrassed to take to your regular medical provider, if you can't find an answer anywhere else, give us a call. 347-766-4323. That's 347-POO.

poo head. Follow us on Twitter at Weird Medicine or at drscottwm. Visit our website at drsteve.com for podcasts, medical news, and stuff you can buy. Most importantly, we are not your medical providers. Take everything in with a grain of salt. Don't act on anything you hear on this show without talking it over with your doctor, healthcare provider, or whatever.

So very good. All right. Don't forget stuff.drsteve.com. That's stuff.drsteve.com. You can scroll down and see the Rody Robotic Guitar Tuner. It's gift time. So check that out. Or you can go to roadie.drsteve.com.

pick up a roadie robotic tuner for someone in your family or your life that has a guitar or bass mandolin. There's some other instruments that will work well as well. Brian May from Queen said that he was pissed that they only developed this at the end of his career. So it is an amazing thing for under 200 bucks. And then they also have the roadie coach. You can get one and it will teach someone how to play their instrument.

So if you have somebody that wants to learn, an adult particularly that wants to learn how to play the guitar, and they have a guitar but it's just been sitting there because they don't know how to start, get them a Rhody coach. So go to rhody.drsteve.com. Check out Dr. Scott's website at simplyherbals.net. Check out our Patreon at patreon.com slash weirdmedicine. I just uploaded the newest serial killer therapy video for Normal World. Thank you.

It's every Halloween they do serial killer therapy, and this time it was Carrie Pinhead, Saw, and a surprise guest. And we did serial killer telehealth this time, so I was on a TV screen and interviewing these people, these lunatics. So check that out, patreon.com slash weirdmedicine. Also check out Normal World, youtube.com slash at normalworld, or you can always...

Go to Blaze TV. And if you do, I mean, look, whatever your politics are, Blaze TV's got a lot of different stuff on there. They tend to skew to the right. So if you're not into that, that's fine. Just watch them on YouTube. But if you do, tell them old Dr. Steve sent you. I don't get anything from it, but it'd be nice for them to know. And then cameo.com slash weird medicine. I'll say fluid to your mama for a very small amount of money.

More than nothing but less than probably a lot of people do. But I was going to... I don't know. It's just... I would do it for free. They won't let me. That's all I'm saying. So there's a minimum amount and that's what I charge. So I'd just do it for fun. All right. So check that out. Cameo.com slash weirdmedicine. And Dr. Scott has things going at simplyherbals.net. Very good. Been busy. Busy. Yeah, thank you. Got some of the...

Weird medicine people and dabblers sending you orders for Simply Herbal's nasal spray. I don't know about the dabblers, but for sure lots of weird medicine people. Okay, cool, cool, cool. Very good. Well, we had AI make you a new theme song, and it's on my YouTube channel at youtube.com slash at weird medicine. Pretty fabulous. Now we're going to add...

video and images to it and make it a real ad for you. Cool. We'll get that done. AI. This Donna AI, I'm telling you, it sucks if you tell it, well, just make up a song about so-and-so. You know, the words are just cloyingly awful. But if you write the lyrics for it... Mm-hmm.

and let it make the music. It's unbelievable, the stuff that it can do. I was playing some before while we were sitting here waiting. I'm trying to see if I got one that I can actually play. Well, let me just play... Let me see. Yeah, let me play the one about Cardiff Electric, just so that you get an idea of what the AI can do. Now, Cardiff Electric is the floating potato over at the Dabbleverse. He's been a

He's been trolling Howard Stern and Opium Anthony and Eric Nagel. He used to get on Eric Nagel's show and talk about the pie guy who was 3.1415, and he kept calling him that name.

you know, kept confusing it with maybe he was a baker or something like that. It was really stupid, but it followed the Opie, the Opie humor paradigm, which is you keep doing it until it becomes funny. And that's kind of what he did. But anyway, but they say a tater, not a hater. He's a masturbator. He got prestige. He ain't never going to need Mr. Carter, Mr.

He stopped messing with Stunner and John He stopped messing with Stunner and John It all over, the devil verse is done! Caught his electric and his sock hit okay They ain't too bad

I mean. So it created that song. It created that. Wow. I gave it the words and it created the song. And whose voice is it? I don't know. A computer generated? How cool. It has to be a computer voice, doesn't it? Yeah. I mean, the whole thing. It would, yeah. The whole thing is. That's the crazy thing. That's amazing. Is there's no instruments. There's no voice. You can hear the guy breathing, you know, taking a breath. Right. It's weird. It is weird. Yeah. Yeah.

And they say now, I mean, they know how they constructed these things, but they don't know how they actually work. That's kind of freaky. It's just a neural network. That's like females. Watch it. Watch it. Sorry, Diane. Except for Diane, of course. Of course.

Oh, my goodness, Diane. Perfect. Oh, all right. Okey-doke. Anyway, very good. Pretty amazing, that stupid, crazy AI stuff. I've got to research that and see what it does. I don't know what I would do with it. Yeah, it's crazy. Yeah, nothing. Just screw around with it. I actually did want to make a Simply Herbals ad, and so I just wrote some words. I mean, it literally took me 30 seconds to write the words. Mm-hmm.

And then it... I mean, I don't want to play an ad on this show, but let me just give you just a taste of it. And I said, do jazz with a male voice. That's it. Okay? Unbelievable. Wow. Okay, first off... That's unbelievable. How does it...

How does it know to do, you know, the trading fours, the sax, and then the break, and then the drum stop, and then the piano goes in right before the guy starts singing? I mean, that's perfect, you know, jazz sort of trope, right? Yep. Now, I guess you can just teach it jazz tropes, but, you know... But still put them all together. Teaching a human being is hard to do this, but, you know, some machine, and this is actually very clever. This song is so clever that it gets stuck in my head. Let me...

I like it. Yeah. Oh, yeah. Prolonged...

Dr. Scott's Simply Herbal CBD nasal spray is the best on the market. Isn't that crazy? So we're all going to be replaced. I mean, DJs for sure. Musicians possibly. Well, for some stuff. Yeah, for some stuff. Commercials anyways, you know. Right, right. That's so true, yeah. Things that were quality and super important.

Things that appeal to the broadest audience with the lowest common denominator, absolutely. Right now, it can't, in my mind, create actual art. But it creates a simulacrum of art, though. You know, something that if you didn't know a machine made it, you would think a human did it. When I first discovered this, I was watching a YouTube channel called Cryptic Web Chronicle. It doesn't matter what it was, but it was a...

It's a channel dedicated to making fun of this one science fiction writer. And it's a long story. It doesn't matter. But there was a whole group of it's called Platinum Hits Dan. And it was about this podcaster named Dan Mullen. And there are all these songs about him and they're all saying horrible things, but they're all very clever songs.

And I, you know, it's like, how did somebody just sit down and go in the studio and record this? And then I realized it was AI. And you can tell sometimes by the way that it pronounces things like I know human would pronounce it that way. And I was like, how in the hell are they doing this? And so I went and investigated. And there you go. AI. It's incredible. It is. It's pretty bizarre. Anyway. Anyway.

All right. I have a story that I wanted to do. Welcome, Lady Diagnosis. Thank you, Mitch. Glad that you're here. It's been a long time. Great to be back. Yay. Well, so one of our listeners sent me a story about these things called vulture bees. Have you heard of them?

I don't think so. And it's nothing new. It's not like, you remember when they had the killer bees and they were coming north and they were going to kill everybody or kill lots of people and stuff like that. And those things are, those bees are extremely aggressive. But fortunately, they bred with our bees and sort of calmed down and it never became a problem. Vulture bees are...

have been around for billions of years. They're carrion bees. They are a South American stingless bee, and they feed on rotting meat. And some of these produce a substance that's similar to royal jelly, and it's not derived by nectar, but rather from this sort of protein-rich secretions that the bees secrete.

And they're likely derived from the bees diet. What else would they come from? And what people value these secretions. What are you doing? Why are you doing that?

So I can see you. Oh, okay. Oh, thank you. Wow. No, I'm just asking. I didn't know if something was going on that I didn't know about. No. Okay. Lady Diagnosis moving microphones around. That's fine. That's fine. I just was wondering if I needed to know something. But anyway, they call it meat honey. It's protein rich. Now, listen to this shit. Okay. So...

they mix sugary plant products with this sort of proteinaceous paste from their regurgitated meat and they bring it into the hive and they've got these two different pots. And this is the crazy, how did they know how to do this stuff? But they, they take it and they let it mature to form a sweet substance that was used as food and,

But the two resources were kept in separate pots in the colony. Neither are true honey, meaning they're not derived from network. But then they mix them together. So the vulture bees go out and go – by the way, they like to go through the eye socket. I don't know why. Dead things. They go through the eye socket and start eating from there.

And then they take it back to the nest and they regurgitate it into these pots. And then the worker bees start making, you know, they're like, it's like you're taking it to the restaurant, you know, to the chef. And then the worker bees are the chefs and they make this stuff. Oh, yeah.

They gather nectar, produce honey. Oh, okay. There's different studies. Some of the bees do gather nectar and produce honey, but also produce this glandular secretion derived from carrion as this protein source, and they keep it completely separate from the honey. But anyway, but in neither case do the bees ever mix meat-based substances with the substances that they get from flowers. So if they actually make honey, they keep that separate from the meat. Okay.

So it's like having your cereal over here and then your hot dogs in the refrigerator. Isn't that crazy? I'd like to try that. Proteinaceous. I know, proteinaceous. Meat honey. I need some meat honey. Oh, wow. So their species name is Trigona and then the... Wait, would that be the species or the...

whatever, but there's trigona necrophagia, which means that they eat dead things. And the masticated meat is regurgitated into a storage pot, and then the material is consumed by a worker bee and processed by its highly acidic gut,

which breaks down the meat, and then they produce this special substance. Special sauce. Resecreting the proteins as a decay-resistant edible glucose product. Yeah. Wow. And that's what keeps the hive alive. So the carrion bees...

They consume this, but they don't metabolize it. In other words, they're not consuming it for food. They're just carrying it. They're carrying it, and then they take it to the chef that then produces, you know, fixes it and then puts it out there, you know, on plates, I guess, for the hive to eat. Right.

Order up. Yeah, family style dining. Yeah, right. Exactly. Oh, my God. How bizarre. It's a smorgasbord of meat honey. Meat honey. I think that would be a new good band name. I love it. That's going on the list for band names. That's a good name. That's a great name. Yep. Yes, that's a good one.

Yep. Eat my meat, honey. Anyway, so that's vulture bees. And proteinaceous. I love that word. Part of God's great creation is vulture bees. That's wild. All right. You got anything for us this week, Dr. Scott? Let's see. I was reading just a little earlier an interesting thing about the gout.

The gouch. Yep. In North Kakalaki, they call it the gouch. So there's a study that was done in Europe. And it was – they did – they went back and did a huge, huge collection of data, 13 different cohorts. Yep.

120,000 people with prevalent gout. Okay. What do you mean with prevalent gout? Probably like me, it's pretty consistent. Well, prevalent means it's common. Well, I can click on it. Okay, that's okay. Go ahead. They all have gout. Yeah, they all have gout. And they studied genetic data from 2.6 million people. Yeah. And they found that

There's DNA regions where people with, you know, that are born in certain regions of the world are much more

have a greater tendency to have gout. Okay. So it's much more based on genetic. So they're finding the genetic. Well, of course. I mean, I can eat all the shrimp and shit that I'm, and drink beer all I want. You can't do that. Oh, hell, I can't even look at it. So it has to be genetic. There's something in your genetic code that makes you metabolize purines differently. Yep. And so you end up with uric acid crystals crystallizing in some of the joints of your body.

So did that start at birth or you didn't have it when you were young, did you? Well, no, you know, that's just it kind of had to have started to a certain degree at birth. And you wonder going back in time. Yep. If I didn't have some of it in my knees as a young man, I always had knee problems and thought I had arthritis of the knees. OK. And had it for, I mean, since I was 18.

10 years old, you know. When you can start recognizing it. Yeah, yeah. It's like, damn, my knee hurts. You know, you're trying to play football or baseball. It's like, man, it's killing me. So, but, you know, my very first flair was after, you know, of course, a robust night of poker playing and drinking heavy, heavy, heavy, and they were high-gravity alcohol beers. And my ex and I were getting ready to go to Key West, California,

Sunday for a conference that started on Monday. So I got out of bed, you know, Sunday morning. Couldn't walk. Well, in this typical me, I got out of bed and I looked at my toe and it was red and hurt like a MF. I was like, damn, I must have hit my toe on something. Sure, you would think that. That's what you think. What else would you think? She looks at me and she goes, you dumbass. That's gout. And then I looked at it again and I went, oh God, it is gout. Well,

Well, that's the... Okay, when someone's in 10 out of 10 pain, that's what you want to do is call them a name. A dump, yeah. That was classic for her. Yeah, I know, I know. You know how she was. Yeah, that's like when I had Montezuma's Revenge in Mexico. Mm-hmm.

on our honeymoon. And she told me it was psychosomatic. Because I didn't want to go there for the honeymoon. Oh, that's hilarious. You didn't want to go. So you got sick and you did that on purpose. Exactly. So I had a psychosomatic attack of Montezuma's Revenge, which she actually did get two days later. Good. Did you tell her it was psychosomatic? I said, man, I guess that's what you get. That's psychosomatic. Yeah.

Bacteria in your gut really is something. Yeah, it's something else, isn't it? So it's really interesting. So I cannot get anywhere near a piece of shrimp. And if I do drink beer, I have to do a lot of...

Hydration, a lot of exercise, because the more sedentary I am, the worse it is. So shrimp beer is out. Yeah. Well, shrimp, you know, we've got a favorite Italian restaurant here where we live. Yeah. And one of the greatest pizzas they make is a shrimp and capers pizza. It's just divine. And man. Divine. So do they have a medicine? Let's just feel like this uses that word. I haven't had it in 15 years. I know. I know.

So I haven't had that in about 15 years. But, yeah, so that's just what's going on right now is that – and one of the reasons I was reading this article is because I am not tolerating just the pro-benicid, which is for under-X creepers. Can you please stop bullshitting? Yeah.

Because there are two classes of medicine, right? Well, right. For the most part. Let's talk a little bit about gout. So we're talking about a buildup of uric acid in the bloodstream. There's a lot to be with it. Results in kidney stones and precipitation of uric acid into the joints. So there's two ways that you can get elevated gout.

Uric acid levels. Either you produce too much. In other words, your body's making too much and you can't get rid of it fast enough. Or you're excreting too little. In other words, you have normal amounts, but you're not pissing it out like you're supposed to. Right on.

The vast majority of people are under-excretors. Yes. So which one are you? Have they ever tested you? No, never tested me. But I responded really well to the probenicid. The probenicid worked. As an under-excretor, it worked for a long time because alpurnol did not work at all initially. Right. At all. Right. Okay. So if you're an under-excretor, you want to excrete more. And there is a drug called probenicid, as Dr. Scott said, that prevents...

I mean, that enhances your ability to piss out uric acid, right? It binds to the uric acid. It also prevents you from pissing out uric acid.

So they used to use it when they would like if they treated somebody back in the day when penicillin still worked for that. You would give somebody a shot of penicillin per gonorrhea and then give them probenicid and it would keep the penicillin in their system longer. Wow. So it's interesting. It blocks the excretion of penicillin, but it enhances the excretion of uric acid.

Of course, when you enhance the excretion of uric acid into the kidney, what's going to happen is you're going to get more uric acid stones. So in the beginning, you have to give people this stuff called potassium citrate to change the pH of their urine so that they can't precipitate uric acid anymore. Right.

And anybody that has gout stones or uric acid stones, if they take potassium citrate, that will take care of it. But then what you do is you give the people prebenicid and potassium citrate, prebenicid

Prevent them from making stones. And then as the uric acid level drops, when it gets back to normal, you can stop the potassium citrate because now you're not pissing out more. But you've got to stay on the probenicid. So you are chronically on probenicid? Yes. You take it every day? Yeah, and then it stopped working. Well, when you say it stopped working, what do you mean? You start getting gout attacks? Yeah, more common flares. So did you check your uric acid level? No, hell no. For fuck's sake. Yeah.

Well, no wonder. You have to go. You have to ride the levels. Dude, I'm in an office just below you. I can do this. So you have to ride the levels. So if your level is creeping back up, then you've got to change the dose of your probenicin. And then you can take...

Colchicine. Yep. Which I'm doing now. I had one guy that had, I mean, well, I've seen people that had such horrible to facious gout. In other words, the gout was building up in their fingers and you could see it, you know, big giant. And every once in a while, one would break open and you would see like white crystals coming out of their joints. That's not cool. No, I'm sure it hurt. But it's interesting. Well, you know, it's gout at that point, but, um,

And that person I had on allopurinol and colchicine and probenicin. Yes. Still happen. That's how bad their genetics were. So you're taking colchicine every day or you only take it to abort an attack? Colchicine every day. Okay. So when you have an attack, then what do you do? Well...

Usually double the probenicid. Increase the colchicine. But I've done it before, and the colchicine didn't knock it down enough. It will if you do it right. You've got to take enough until you either shit or puke. And then, I mean, it sucks, but, you know, so does a gout attack. Oh, gosh.

And, you know, we can give you IV colchicine, too. Well, you know, and the thing is, and the other reason I was looking at it is there have not been a whole lot of new medications. Right. Because it's never been. There's Eulorac now, though, but it's basically just highfalutin, allopurinol. Right. Well, they're finally coming up with some IV once a week injections. Yeah. And which I'm a little. For prevention? Yeah. And so I'm a little skeptical of that for now, but.

But I think in the future we'll probably have to pay attention to that, I would assume. But, you know, complex, yeah. I don't see anything on that. We have to do alpuranol. Well, there is IV alpuranol. Okay. Yes. Okay. I don't know if I'd bother with that. It just seems a little...

a little over the top, you know what I mean? Yeah. Well, well, but you know, for me, not for people that you can't walk down my stairs without taking baby steps, you know? So it's given that you were once a professional athlete, I think that would suck. Yeah. But you don't make it, but go back to the question is it kind of makes you think is, did we, did I have a much younger age and could have done a little bit better job of, of, um,

Yeah. You know, choices. Yeah. And if that would have made a difference. No, I don't think what you eat can change your genetic ability to clear uric acid. Yeah, yeah. Right. It's not like that. No. It's just you have...

You know, an inability to clear uric acid that's cumulative as you get older. You get worse at it. And then the next thing you know, you got gout. Now, have you ever tried steroids when you have a gouty attack? I have when it gets bad, yes. Yeah. I mean, it's triamcinolone. You can do an injection or you can just do a Medrol dose pack. Yep, yep, yep. Yeah. Oral prednisone works. Toradol. Toradol is the greatest thing, really. You ever tried it? No, never, never. So, cotorolac is a...

potent non-steroidal anti-inflammatory drug. But if you take it every day, it will kill your kidneys. But if you do it in the short term, it's totally fine, totally safe. We do it all the time. Well, you know, as safe as any other. I just kind of get a shot. You can get a shot. They also make it in a pill form. But

Yeah, you can come down to my office. I'll give you a dang shot of Toradol. You'll shoot your ass full. Toradol's great, and it's not an opioid, and it's not colchicine, so it's not going to make you puke. It was a great NSAID. Yep. And different from, what was the old NSAID they used to use for? Indomethacin. Indomethacin, yeah. Yeah, this is a little bit less toxic than that. Yeah, because that was tough on your gut, buddy. Yeah. It would give you an ulcer in a minute.

Yep. But it works. Well, for those who have it out there, just keep working on getting and managing and working with hopefully your providers who know a little bit about gout. Well, and listen, a lot of providers don't know about gout. They don't. If you go in and you say, Doc, am I an under-excreter or an over-producer? And they look at you like, what the hell are you talking about? Run. Yeah.

Don't walk wrong. And find a rheumatologist or somebody in your area that knows something about gout. Right now, all they do is they treat everybody with allopurinol. And it kind of works. But to me, if you have a problem and you can identify the root cause, why don't you treat the root cause? Yeah.

Let's just say I had a—I know of a— You've never had a 24-hour urine? Yeah, we did. We did. You did. So they proved you were an under-excriter. Yeah, it's been like about 15 years ago. I peed a jug for 24 hours. Yeah, yeah. But, you know, let's just say I may have heard of a case where somebody went to their primary with an obvious gout flare. Yeah. And was diagnosed with gout in the office, and you want the medication they gave them? What? Alpirinol.

Yeah, well, of course. Oh, they were having an acute gout case? For the first— No, no, no, no. Thank you very much. Exactly. Exactly.

I was about to vomit. I was about to vomit. Okay, so let's talk about this real quick. Because this is really important. If you have an acute gout attack, and medical students that are listening to this, and there are some... And people who suffer from gout, too. And people who are going to be prescribing. But yes, do not...

allopurinol when you have an acute gout attack because it will make it worse. Acute means really, really bad, right? No, acute means it's ongoing. It's happening right now. Oh, okay. Especially if it's your first one ever. I mean, this individual had never had it before. Some of my colleagues are just idiots. And was told if it doesn't go away in a couple days to double the allopurinol. Shut the fuck up. I swear. I swear.

You're a stupid mind. I swear. Stupid. Stupid. And this person's a doctor? He's a fucking idiot. He's a fucking idiot. And I, well, let's just say I was very kind and I said, I suggest you do this. Go back tomorrow. Right. And give them these suggestions. And I was like,

So we got things fixed. You want to take colchicine until you hear this. Exactly. And how about some incense, too, baby? Anything but allopurinol. Allopurinol. Now,

You want to get it calmed down and then start the allopurinol so it doesn't happen again. But you've got to work it up. You have to do a uric acid level. What if it's normal? Well, maybe it's pseudogout. How do you know that? Well, you can look at it under the microscope and use a polarimeter, which is just basically a disk of polarized lens stuff, and you spin it.

And uric acid crystals will be yellow when they're parallel to the axis of the polarimeter. And then pseudogout will be blue when it's parallel to the axis of the polarimeter. So the mnemonic was YUPA, yellow urate parallel to the axis. And that's – I remember the day I learned that in second year medical school.

And I've used it. I used it in my real practice when I was doing primary care. You'd aspirate a big joint. You'd find these crystals, put it under the microscope with a polarimeter, and you'd spin the thing. And then when it turned yellow, you would see where the axis was pointing. If it was pointing parallel, then those were uric acid crystals. You could make the diagnosis that way. There's lots of different ways to make diagnoses. That's one of them. So anyway, yeah, that's it. The...

The amount of lack of cognition about things like this, I've talked about this on this show before, particularly when it comes to gout, because there's a very scientific, well-

approach to diagnosing and treating gout and seems like nobody fucks with it. It's a little flow chart. You can look it up and go, well, if this is it and it's not, give everybody a pure hell. Idiots. So work at it, people. The sounds of the season can often sound like this. So when are we getting some grandkids? But with Hilton's season to stay sale, they could sound a bit more like this.

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This holiday, Lululemon makes it easy to give a gift that goes beyond. Open the moment. Shop now at lululemon.com. So when do you know when to listen to your doctor and when to be like, are you sure? Isn't that something? And, you know, everybody got made fun of during COVID for doing their own research. But I still think that it's good for you to advocate for yourself. Yes. And not to go, well, doc, you're an idiot. But to say, hey, I was reading this. What do you think? Let them let it be them.

Right. And then if you have somebody that's just obviously not using their head, then find a different primary care. But how would we know? I mean, I'm a lay person. I go in the doctor. I tell them this hurts and this hurts. And they say it's this. Right. Why shouldn't I believe them? Well, OK. What do you research it on? That's a tough one, isn't it? Can I start? Can I start, though? Yes, please. I think the first I have an idea how to approach this. But go ahead. My first approach would be, do you truly feel like they're listening? Right.

If they can recreate what you just said, well, okay, so does it hurt when you do this? Yes, it does. Okay. And you told me that it hurts when you do this. Right. Then they're actually getting it. Okay. Then at least they're processing and they might come up with something crazy. That is part of the protocol. But you have to be able to recreate. If you're truly listening, you have to be able to recreate what they just said. Yep. And they should be doing that anyway. So in summary, what you're saying is bleep, bleep, bleep, you know, A, B, C, and D. Right, right, right, right, right. Then you know they're listening. Yep. Yep.

And especially, I think, being your own advocate, especially if you've got something that's a little odd, it's helpful to me if somebody comes and says, hey, man, listen, I've been to three other people, but nobody's ever heard of this. And here's the research that I've got. I'm like, hey, thank you for – because it's impossible for us –

Anybody would know everything. So when somebody comes in with something really helpful, you go, hey, thank you. That's really beneficial. People do sometimes come in with lists. That's a little different. That's a little different, yeah. Those people are advocating for themselves. I appreciate that. They don't want to forget anything. But sometimes I just go, give me that.

And they go, okay, nope, nope, nope. Yes, yes. Okay, let's talk about this one. Or what's even better when they come in with a notebook full of blood pressures that they've taken three times a day and their blood sugars that they take. Actually, I appreciate that. No, I'm not saying it's bad, but I mean, then you have to go through this whole thing. I'll be there for another 15 minutes. Right. I'm okay with the diary. The diary I'm okay with. Yes.

And actually, I'm okay with all of it. But, you know, I have a relationship with my patients. I kind of know when I can just go, just give me that list. That's so true. That is so true. And they appreciate the fact that I'm actually reading the list and then picking out the things that are actually important, at least to me. But –

Yeah. But they don't like being told also what you think is wrong with you. Because I had a provider I took a list to for a patient and a recommendation on what should be done and what we thought it was. Yeah. And she got mad at me.

Now, mad. Okay. Without violating anything. It's the one I discussed with you. Well, give us an example. What do you mean that you told them what to do? Well, I gave them a printout of, okay, if it's this diagnosis or these symptoms, double check this, double check that. Right. It could be this. Sure. And she was mad that I even gave it. Oh, I wouldn't be mad about that. Why would you? I might ignore it, but I wouldn't be mad about it. Mm-hmm.

Ego. Yeah, so sometimes you can't really feel like you can talk to your provider, right? No, you should be able to talk to them. Now, I had a drug rep come in one time trying to school me on how to calculate breakthrough medication. And it's like, dude, get the fuck out of my office. And then you married her? No.

No, different person altogether. Oh, yeah, sorry. No, it's like, get out of my office. You're going to school me on this? I've got half a dozen articles in the medical literature about this exact topic, and you're going to tell me that, you know...

So I was a little arrogant with that one. First off, I didn't like the guy that much anyway. But second off, it just pissed me off that, you know, don't school me on something so trivial. Like, I don't know what the hell, you know. Anyway, so I can get my hackles up, but it just depends on how you approach somebody. So if you don't want your doctor's hackles to get up...

What you want to do is, well, you should just be able to talk to them, but rather than coming at them like they're stupid or they don't know something...

To say, to always make them think that it's their idea. Right. You know, hey, I found this. What do you think about it? Exactly. And that's what I would do. And then if they blow you off, then that's when you can go, well, wait a minute. This person isn't really paying attention to me or something. But if they blow you off because, oh, this doesn't apply in this situation because X, Y, and Z, and that makes sense. Right. That's fine. But if they just go, ah.

Yeah. You got to reply. Yeah. People just simply want to be recognized and not like, oh, hi, Diane. You know, I met you a year ago. I don't mean that kind of recognized. They want to be seen, seen as human beings, and they want their problems to be processed. Mm-hmm.

So we've talked on this show before about the video that they showed us when I was a medical student about this sort of shaman local, local, witch doctor is not the right term, but a local shaman. And he functioned as the primary care provider for this village. And people would come to him and he would take palm fronds and, you know, wave them over him and stuff like that. And people would feel better.

And what Scott and I will attest to you is that 90% of our patients will get better if they just didn't come to us at all. So 90% of his patients feel better, too. It's the 10% where we can make a difference that maybe he can't. You know, if somebody comes to him with a burst appendix and he's waving palm fronds, they're probably going to die. Whereas they might still die if they come to see me, but they're less likely to because I'm going to.

At least you got some different tools. We have different tools. And knowledge. But the societal role that he plays exactly the same, and we have to realize that. That's what patients want. They want you to – and that guy is really paying attention to those people. He's not blowing them off. They're laying there and he's doing all this stuff. He's doing things.

And that's our patients want that, too. Now, Dr. Scott, nobody goes to him. He doesn't do something. So they're more inclined to feel better just because he touched them, laid hands on them and did something. You know, we just sit there and we don't even listen to their heart anymore and listen to their lungs or do it. You just sit there and pontificate. That's or type or enter on the computer. Right. You don't have to do the note after you do.

After work, you're going to do the notes right then. Well, I do my notes right then, but I'll tell you what, the way I do it is a little different. I've got my computer on wheels.

And so I can wheel it around so that I'm always looking. If I've got, you know, a patient and their spouse, I can put the computer between the two of them. I can keep eye contact with both of them while I'm, you know, doing their note. Because if I don't do that, I'm going to forget stuff. Sure, of course, of course. Or more importantly, you want me to order things that they need. Right. Like tests or medications. I order them right then. They don't leave until I'm done ordering everything and reviewing everything. It's so important. Yeah.

So there you go. But, yeah, eye contact, physical touch used to be a big thing. Then COVID happened and then we kind of got away from it. But still, just even laying your hands on somebody's shoulder when you say, hey, I'll see you in a month or something like that makes a huge difference. Studies have shown people feel better if the provider just touches them in even the most cursory way. That's something.

People like to be touched. That's a great question, Lady Diagnosis. And unfortunately, a lot of people don't figure it out until it's too late that their doctor is completely full of shit or going down the wrong path. That's why second opinions are always okay. Always okay to get a second opinion. If anybody gets mad about that...

then, you know, that says more about them than it does about you. That's another sign that, yeah, don't go. Okie doke. Got it. All right. Got anything else? Number one thing, don't take advice from some asshole on the radio. All right. Here we go. Thank you, Ronnie B. Hi, Dr. Steve. I tweeted this question to you the other day. It's...

Why do men can piss out both holes out of their penis at certain times? What? Excuse me? Okay. You have two holes in yours? No. He's like, why do I piss out of the third hole in my penis all the time? It's like, dude, we got more to talk about. Quite often through my life, but just last week.

Wow, okay. So there are people that have...

the urethral meatus not in the right place. That's called hypospadias. That's where the, instead of the, you know, the urethral meatus, aka the cock hole lady diagnosis. I just like hearing him say that. You just like when he's saying cock hole. That's right.

But the cock hole can be underneath the penis, and that's called hypospadias. And actually, famously, Bobo Curlin from Opium Anthony had hypospadias and had multiple surgeries on his penis, which is, I'm not speaking out of school, has all been talked about on the air. But I think what this guy's talking about is, because he says it's not all the time, I'm trying to decipher and just imagine. I think in his sort of,

Less than articulate way, he's saying that sometimes his stream is split into two. I agree.

And that happens when you have an exudate in your penis. A what? Exudate, like a protein, a proteinaceous fluid that hardens. Oh, okay. And that could be caused by gonorrhea is one. You know, the old saw was if you had gonorrhea, you know, you'd sit in front of the urinal and you'd spray the people on either side of you. Okay.

And basically what it is is there's just this, you know, exudate. It's like pus is, you know, clogging it up, and then it just goes in a bunch of different directions. It could be old semen. It just could be old mucus, too. Sometimes when you wake up in the morning, some people have mucus. And dehydrated, too. From the mucus membrane, right? And it's just kind of dried at the very head. And when they start their stream, it'll be in two streams, and then eventually that plug will...

you know, is pissed out and then it goes back to one stream. So that's what that is. So should you dig it out? No. No, no, no, no, no. Just piss it out. It'll go away. Don't dig anything. No, no, don't dig nothing. We did a whole thing on urethral sounding and my thing on that is if you're going to do it, they make things for it.

You know, you can buy urethral sounds that you can't lose because they've got a bulb or a ball on one end. But to me, listen, my urologist sounded my urethra with a fiber optic scope and Dr. Scott had the same thing. And I felt like I was pissing razor blades.

So he listened to it? No, he sounded it. We've talked about this on the thing. Sounding means testing the depth of something. So like if you're sounding in a boat, you're dropping an anchor with knots in the rope and then however many knots it is. And so when you do...

bladder sounding, you're taking a rod and you're shoving it down the urethra until it hits the back of the bladder. And then you can see how deep that is. Right. And so we're just saying it's just sort of a joke. You know, when they took that fiber optic scope and shoved it in our urethras and looked around the bladder, they're basically, you know, sounding our urethra. But

When they pull it out, it's really, you feel like you're pissing razor blades for about a day. Yeah, it sucked. And the other thing is they take numbing gel and they put it on the end of the thing, of the scope. Boy, do I have dementia? I've got anomia. The thingamajig, that thing, that thing over there. They put it on the end of the

the fiber optic scope and they just jam it in. Well, that doesn't do anything. It makes them feel better. It doesn't make us feel any better. What you have to do is take a syringe and instill it into the urethra full of, you know, lidocaine jelly and let it sit there for 10 minutes. And then you can shove that thing in if you want to. And it doesn't, the patient won't feel anything. But just putting...

numbing gel on the end of the tube and then just shoving it in their bladder. It sucks. I still say propofol was a much better option. Yeah, Michael Jackson's magic milk. Worked wonders, I guess. That's my vote.

That was one of my favorite jokes from the DabbleCon roast was Anthony was there from Opium Anthony. And I said, you know, being a doctor to a celebrity is difficult.

You know, they hated George Nicopolis when Elvis died, and they hated Conrad Murray when Michael Jackson died. And they hate me even more because Anthony's still alive. So there you go. Bravo, Dr. Steve. There you go. There you go. You're a funny boy. That's me. Hi, Dr. Steve and friends.

Hello. Paul from Reno, Nevada. Hey, Paul. How are you? Good. How are you, man? Good.

Good. Good. My question is, can you harvest sperm from the testes 20 years after having a vasectomy? Excellent question. Love the show. And Dr. Scott, please stop saying real quick before every comment. Thank you. I didn't notice that until he said it. That is funny. Real quick, real quick. Real quick. Well, I say so anyway before everything. So anyway. Hey, um...

This is an excellent question because the myth is that when you do a vasectomy, that because there's no more sperm in the semen, that the testicles stop making sperm and they don't. They continue to make sperm. Remember...

Sperm is less than 2% of the seminal volume. So when you ejaculate, it's prostatic fluid, seminal fluid, and just a tiny little bit of sperm cells and fluid from the testicles. So the testicles continue to make sperm. They're just resorbed. After they die, they just get resorbed. The body reuses those proteins, makes more sperm, and just on and on and on. It never stops.

Now, unless there's a problem. If someone has no testosterone, then they will stop. Like if you're taking exogenous testosterone, in other words, testosterone replacement therapy, the testicles shrink and they stop making sperm.

And that person becomes infertile. But outside of that, then they will continue to make sperm. And yes, you could take a wedge resection of a testicle if just someone...

had this genetic makeup that you just had to have their sperm, you could actually open up their scrotum, take a wedge resection from their testicle, and you could harvest sperm from there. So those are things that you can do. That's just one way to do it, but that's the most horrific way I could think of that you could do it. So anyway, yeah, yeah, absolutely. As long as they're still producing sperm, you can harvest it.

Cool. All right. Very good. Good to know. Good question. I need to harvest. Dr. Steve, avid listener. Hey, thanks, man. I listen on SiriusXM On Demand. Oh, excellent. By the way, that is the way to do it. Listen On Demand. That's what helps us the most because they have no other way to figure out

how many people are actually listening. On Demand, the show usually is on there every Sunday. Right. We haven't had a new show in three weeks on the On Demand. And the one that was posted on this week was actually a rerun. So now that's going on a month that we haven't had a new show. Agreed. Just thought I'd let you know. No, thanks, man. It is On Demand.

You haven't had any new shows since October 5th was the last one I listened to. Okay. And the one that they had just recently posted was actually a rerun. Yes. All right. My name's Jimmy. I don't know if he wanted to say it again. He's right. Thank you, Jimmy, by the way. Thank you for letting us know. And he wasn't the only one. And for listening. Thank you for paying attention. That's the big thing, for paying attention. That's awesome.

But I got several people telling me the same thing. So I sent a message to Lewis Johnson. And in fact, Lewis was out on, you know, was away from the office for a while. And the person that was filling in for him did not upload our shows. So they are now all uploaded. So you've got a bounty of like four shows that you can listen to.

Serious XM on demand. That's the way to listen to them. Weird medicine for days. There you go. All right. Well, for four hours. Seems like days. All right. Wish it was days. Hey, Dr. Steve. Marcus from North Carolina. Hey, Marcus. Hey, so my wife's got that gene where they say that she's going to get the breast cancer. Is it best for her to go ahead and get those titties cut off and get the big fake ones? Yeah.

I just want to get your sound medical advice and, you know, fuck PA, John. That's right. This was from like 2015, so it's already been dealt with. And Marcus, I'm sorry I didn't know about that. You could have just called me directly. And so I'm answering this, what, 10 years later.

So what he's talking about is a BRCA gene, and there's BRCA1, BRCA1, and BRCA2. These are genes that help to prevent cancer by repairing DNA, and they keep cells from growing out of control. But then when you get a mutation in the gene, that can increase the risk of developing breast, ovarian, and other cancers.

So, you know, that's rare, affects about one in every 400 people. So not insanely rare, but it is, you know, relatively rare. And you can get tested. You just do a blood test for that.

And if it's positive, it means you've got a higher risk of developing cancer. It doesn't mean you're going to get it, but the risk is very high at that point compared to the regular populace. And I can't say whether bilateral mastectomies with reconstruction would be the thing to do. You just talk to your doctor.

and your primary care provider, your OBGYN, whoever, and talk to them about what your options are. Men can also have the BRCA gene mutation and should be tested regularly.

If they've got a family history, so if there's a family history first degree relative that had breast cancer, ovarian cancer particularly, then it may be smart for the male to get the test too. One out of every hundred cases of breast cancer is a male.

I had no idea. Yeah. So if you have 1,000 women, you'll have 10 of them. The 1,000 cases of breast cancer, 10 of them will be men. And then all the rest, obviously, the overwhelming majority are female, but there are male breast cancer. There have been some famous men with breast cancer too, right? I wish they could come up with something to just not have to cut them off. Right. Are they working on it? They are, yeah. Well, you would assume there would be some kind of

Immunotherapy, I would assume. What I'm hoping is, you know, we talked last time about that triple negative breast cancer vaccine. So let's just prevent it altogether. Right. Yeah. Right? Then you can do whatever the hell you want to do. So would you give that to everybody or just the ones with that? Well, right now they're just giving it to people who have it. Gotcha.

who have cancer, you know, triple negative, meaning they don't have estrogen receptors, they don't have progesterone receptors, and they're not HER2 positive. They're not positive, so they're negative. And so those are called triple negative breast cancer. It's the hardest to treat, to be honest with you. You know, if you've got estrogen receptors, estrogen-sensitive breast cancer, and then you just block the patient's estrogen, they do much better.

So they have this vaccine that's coming for that. So I would love to see...

you know, just a breast cancer vaccine for all the different types of breast cancer. I have seen I Am Legend, though. If you remember, that was at the very beginning. Emma Thompson was promoting a cancer vaccine. And then two years later, everybody's a zombie. So, you know, I want to make sure we're doing the right thing here. But Richard Roundtree, Peter Criss.

Rod Roddy, all those men all had breast cancer, male breast cancer. So don't think that you can't get that. In the meantime, Dr. Scott, what have we got from the fluid family? I'll tell you what. Let me I'll go through the super chats and stuff first. Myrtle Manus gifted 20 weird medicine with Dr. Steve memberships. If you want to get a free membership,

Or if you want to buy one, just go to YouTube.com slash at Weird Medicine, click Join, and then just click the button that says Accept Gifted Memberships, and you may get a gifted membership. It's sort of a random lottery thing. Myrtle usually gives 10 or 20. This week she gifted 20. Aw, nice. Thank you, Myrtle. She's a good one. I like her. She is a good one. And let's see, anything else here? Oh, yeah.

Volkerstein became a member of the fluid family. Thank you, Volkerstein. All right, what else you got? I see a question about why do feet and hands get more sensitive. Yeah, believe it or not, that's from an old lady trucker.

Oh, is that right? It sure is, yeah. Well... She's back. I had a good drop from Lady Trucker. Let me see if I can find this damn thing. You may read the question while you're looking. Yes, yes, yes. So, yeah, so frostbite is a new VA disability claim, thank goodness, because...

So now the VA is actually accepting claims for heat and cold exposure to extremities. And the question is, why do feet and hands get more sensitive to cold? Hold the wheel for a minute, Todd. I've got to take a shit. Okay. That was the trucker duty thing. Double vasectomy Todd was going to ride with Lady Trucker.

And I had her record that, you know, hold the wheel, Todd. I got to take a shit. That's funny. Anyway, go ahead. So why do feet and hands get more sensitive to cold with cold exposure? Do you want to talk about that? Sure. Do you have something? Because I know why. Sure. I mean, the further away from the core, the blood vessels get smaller and smaller as well. So when you get to the tips of the fingers and the toes, you get a lot more.

smaller blood vessels. But the other thing you get, Dr. Steve, is an increase in cutaneous nerves and sensitivity nerves. And what I mean by that is there's a lot more per inch, per square inch sensitivity nerves or cutaneous nerves, sensory nerves,

And your fingertips and your toes and your lips and your genitalia then are like in the middle of your lower back. Correct. So not only are you getting less blood flow down there, but you've also got much more sensitivity there. And the question that she's asking, though, is why do you get this sort of anti-accommodation? In other words, when you have cold exposure, why does it make you more sensitive to cold down the road? Right.

And the thing that makes me think of is when I was in Vermont, we used to see a lot of this. And I'm sure it's a French word.

pronounced, Chilbla or something like that, but it's Chilblains. C-H-I-L-B-L-A-I-N-S. I never knew how to pronounce it. But Chilblains, and this is a skin condition that occurs when the blood vessels in the skin are damaged by exposure to cold. And so frostbite. And it'll become itchy, swollen, and you'll get these discolored patches on the skin, and it can be on the fingers, toes, and ears.

ears and nose and just like Dr. Scott said because you know that's so distant from the core that they can cool down faster and they can get damaged by cold faster and you end up with poor circulation cold weather and then the next time you get exposed to cold you

It's excruciating. And so it rarely causes permanent damage, but it can be really, really uncomfortable. So you've got to rewarm the skin slowly and gently. And just to keep those affected areas dry and warm, you just can't let them get cold again. And so people with chill blains who, you know, got it from Everest, their Everest days are mostly over if it's in their feet. And there are some medications that you can take.

For that, they're basically vasodilators at that point. But anyway, all right. So that's what that is. And that's just, you've got damage of the blood vessels and nerves. And so the next time you get exposed, it just makes it feel worse. I think that's what she's talking about. All right. You got anything else in there? All right. Well, I have another question. Oh, you have one? Okay. I have a question that, no, it's okay, that I did want to get to, and it's a good one.

And here we go. In honor of lady diagnosis. I have a question that is probably your most favorite subject of all time, Dr. Steve. Yeah. Women's areolas. Yeah. Are they shaded like they are...

Ding, ding, ding, ding, ding. No, why would it? Yes, why would evolution care if, you know, if you get bruising? You know, it's not like...

I mean, that's why things change over time, right? Because there's an evolutionary advantage. So there's no upside to hiding bruising. So that's not it.

And, yeah, they look good, but there's no evolutionary advantage to men sucking on them, except that, you know, they may be more likely to stick their penis in until stuff comes out to impregnate a female, you know, in the caveman days. So maybe. But really what the thought is, is that there are several four ways to enhance breastfeeding in men.

human infants because we are not born with a full set of instincts like cats and dogs and other animals are. You know, but so and one of them is the areola. So the contrast, so Stacy's right, the contrast between

May darken further as birth nears and stays dark. And then that contrast allows the really terrible eyesight of the child to sort of zero in on that, gives it a bullseye.

But the other thing is the philtrum, the vertical groove in the middle area of the upper lip makes it easier for a human child to suckle and get milk out. And then the scent of breast milk will also attract the kid's head to that area. And then, of course, the projecting nipple is more pronounced when they're providing breast milk and makes it easier to latch on. So this sort of united package, the newborn baby, their sense of smell is acute.

And it homes in on the breast in general and then the nipple in particular. And once in the general area, if the face is not directly on the nipple, it will move its foreface around until the philtrum, the place in the, you know, the groove in the middle of your upper lip, encounters the nipple, at which point it reflexively opens the mouth and seizes the nipple. And they'll make sort of a, the mouth makes a, a, a,

cat's bum shape, they call it, to aid in suction on the nipple. And then as time goes on, the color difference between the nipple and the surrounding skin will become the homing beacon for the child. So isn't that something? Now, some women have areolas that you can't see. So that's not 100%. I mean, it wasn't required for evolution. It's still just enhanced. It just helps. Yeah, just helpful.

All right. Now, why do men have them? It's just because it's simpler evolutionarily to just have as few differences between male and female as you can. And when I'm talking about male and female, I'm talking about breeding pairs. You want as few differences as you can because it takes too much energy and input to have completely different

things for male and female. I mean, basically, if you shaved all of our heads and then just only showed from the shoulder up, there's a lot of people you wouldn't be able to tell. That's true. If they had XY genes or XX genes.

And so, you know, some of it is societal, but, you know, you got tits. Well, some guys have tits, too. And but the main difference is the genitalia and the genetics. Right. So but even then, everything is the same except for the sex genes, you know, the XX or the XY. That's it. That's the change.

And so the men, when I'm talking about procreation here, I'm not talking about gender identity or any of that stuff. When you're, you know, the male inserts their genitalia into the female's genitalia when we're trying to procreate. And then the, well, I don't have to tell you guys the birds and the bees, but the thing is, is that that's the only difference, right?

And so that's why men have nipples, because it's easier to have them than to not have them.

You know, women, you know, you could have a species where the male just impregnates like a square thing that has a hole in it that they put their genitalia in. And somehow this thing, you know, spits a baby out the other end. You could do that, but it doesn't make – you think it's absurd. It makes no sense. In alien worlds, there may be something like that. But in –

Particularly on Earth, the vast majority of reproduction happens between...

two different sexes so that they can mix their genetics and not have just one set of genes that are just going forward. Because when you only have one set of genes going forward all the time, and if everyone was an identical clone, then one virus could wipe us all out. Mm-hmm.

You know, you notice when COVID came through, it wiped out a certain number of people, but the vast majority of people survived. There's not one virus that can kill all of us, at least not in our experience.

And that's one of the reasons why, because you want to induce natural variation into the species. And so you have this mixing of these haplotypes, you know, that half the genes on the sperm and half the genes in the egg. And they were randomly associated. And when they merge, you get a randomly, you know, a person with genes.

mostly, but randomly assembled genes that go back, you know, thousands of generations. So it's kind of interesting. That's why you can walk through

It's like you're in Europe and you're not going, oh, wait, that's my brother, that's my friend, and they're not. You don't ever, it's very rare that you're going to run into somebody that literally looks exactly like somebody else on Earth. We all say, oh, well, we all have a doppelganger somewhere. That's bullshit. That's not necessarily true. We have enough genetic variation that we can make

Trillions and trillions of different people and their appearance is different and their personality is different. Voice is different. Skin color, everything. So we it is it. Just think about it. Go to Times Square and see thousands of people and you'll not see a single person that you recognize unless they're actually somebody that, you know, you know, that's true. It's amazing. That's true. The the variation. We just take that for granted. Mm hmm.

But it's not. Unless you're in Kentucky. It's non-trivial. The center of tranquility and consanguinity. In other words, you know, inbreeding. Lady Diagnosis is making an inbreeding joke, everybody. Yes.

Yes. All right, my friends. Let's do it. Thank you. Thanks always to Dr. Scott. Thanks to Lady Diagnosis. 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.

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