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cover of episode 619 - Flatus v. Eructation

619 - Flatus v. Eructation

2025/1/14
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Weird Medicine: The Podcast

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Dr. Steve: 我对人工智能在播客制作中的应用很感兴趣,特别是Notebook LM。它可以根据文章生成听起来像真人对话的播客,这让我感到非常惊讶。我认为这在未来会有很大的应用前景,因为将来没有人会阅读文章了。 我也对其他一些话题感兴趣,例如:治疗肠道而不是大脑来治疗抑郁症和焦虑症,经颅磁刺激疗法,以及一些非药物治疗抑郁症的方法。我还讨论了老人的气味,以及打嗝和放屁的区别。最后,我还谈到了慢性胰腺炎和酒精滥用之间的关系。 Dr. Scott: 我主要讨论了经颅磁刺激疗法,以及刺激迷走神经来治疗抑郁症的方法。我还谈到了慢性胰腺炎和酒精滥用之间的关系,以及如何预防和治疗慢性胰腺炎。 Tacey: 我在节目中主要参与讨论,并分享了一些个人的经验,例如鼻中隔矫正手术。

Deep Dive

Key Insights

What is amlodipine and how does it work?

Amlodipine is a calcium channel blocker used to treat high blood pressure and chest pain. It works by relaxing blood vessels, increasing blood flow to the heart, and lowering blood pressure. It prevents calcium ions from entering heart and blood vessel cells, which helps relax the muscles around the vessels. It has a long half-life of 30 to 50 hours, allowing for once-daily dosing.

Why might targeting the gut be more effective for treating depression and anxiety than targeting the brain?

Research suggests that the gut-brain axis plays a significant role in mood disorders. The gut produces serotonin, a key chemical in depression and anxiety, and the vagus nerve acts as a communication highway between the gut and brain. Targeting the gut with medication could avoid crossing the blood-brain barrier, reducing side effects. This approach may also explain why people with mood disorders often experience gastrointestinal issues.

What is transcranial magnetic stimulation (TMS) and how effective is it for treating depression?

Transcranial magnetic stimulation (TMS) is an FDA-approved treatment for major depressive disorder. It involves placing an electromagnetic coil against the scalp for 20 minutes, five days a week, for several weeks. Studies show that 62% of adults who complete 36 sessions achieve full remission, and 83% experience a positive response. It is a non-invasive alternative to electroconvulsive therapy and is particularly useful for treatment-resistant depression.

What causes 'old people smell' and is it a real phenomenon?

Yes, 'old people smell' is real and is caused by a natural chemical change in the skin. The compound 2-nonenal, an unsaturated aldehyde, is produced as fatty acids in the skin break down with age. This compound has a musty or grassy odor and is more prevalent as skin thins and loses elasticity. It is considered a normal part of aging and is not always noticeable.

What is the difference between a belch and a fart?

A belch (eructation) occurs when gas escapes from the stomach through the esophagus and mouth, while a fart (flatus) happens when gas moves through the intestines and exits through the rectum. The path of least resistance determines whether gas becomes a belch or a fart. Swallowing air can lead to belching, while gas in the intestines will eventually result in flatulence.

What is the risk of pancreatic cancer in people with chronic pancreatitis?

People with chronic pancreatitis have a 5% risk of developing pancreatic cancer over a 20-year period. The risk increases eightfold five years after diagnosis. Chronic pancreatitis, often caused by long-term alcohol abuse, leads to permanent damage and scar tissue in the pancreas. Stopping alcohol consumption is critical to reducing the risk of further complications.

Chapters
Dr. Steve announces the final Weird Medicine show after 20 years and introduces Notebook LM, a Google product that generates podcasts from uploaded articles. The hosts discuss AI-generated content and its implications for the future of podcasting.
  • Final Weird Medicine show announcement
  • Introduction of Notebook LM for AI-generated podcasts
  • Discussion on AI's ability to generate realistic conversations

Shownotes Transcript

Translations:
中文

This is not how sane people scorn and defiance slight regard. My jokes don't go over. I don't care. You see, you see your stupid minds. Stupid, stupid.

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 that I'm entitled to! I've got diphtheria crushing my esophagus. I've got Ebola virus dripping from my nose. I've got the leprosy of the heart valve exacerbating my incredible woes. I want to take my brain out and blast it with the wave, an ultrasonic, echographic, and a pulsitating shave. I want a magic pill for all my ailments, the health equivalent of Citizen Kane. And if I don't get it,

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 of broadcast radio.

Now a podcast. I'm Dr. Steve with my little pal, Dr. Scott, the traditional Chinese medicine provider who gives me street cred, the whack alternative medicine assholes. Hello, Dr. Scott. Hey, Dr. Steve. And my partner, Tacey. Hello, Tacey. Hello. 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, you're embarrassed to take your regular medical provider. If you can't find an answer anywhere else, give us a call at 347-766-4323. That's 347-POOHIT. Follow us on Twitter at Weird Medicine or at drscottwn.

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 health care provider. Okay, very good. Check out stuff.drsteve.com. That's stuff.drsteve.com. You can scroll down, see the Rhody tuner, or you can go to rhody, R-O-A-D-I-E.drsteve.com. Spell out doctor.

and see the Rody Robotic Tuner. We use it here in the studio, and also the Rody Coach. Rody Coach will teach you to play an instrument. So if you've got a guitar for the holidays, and you're sitting there just looking at it like a lump,

If you don't know how to play it, go to roadie.drsteve.com. Buy a roadie coach. It's not that expensive. You clip it on there, and it's got an app. It'll teach you how to play your instrument. Check out Dr. Scott's website. It's simplyherbals.net. That's simplyherbals.net. And check out our Patreon, patreon.com slash weirdmedicine. I'm putting up all kinds of eclectic stuff on there, including...

some AI-generated music, which is, you know, some of it's interesting. But what I really want to do, Dr. Scott, is there is this thing called Notebook LM, and I'm using it right now to generate podcasts for my staff. So I'm taking articles that we want to, that I want them to know something about. And then you upload it to Notebook LM, which is a Google product, and

And it generates a podcast. And these two people talk. And it sounds like two human beings talking about stuff. And they'll even go, yeah, this one's a real tough one. You know, stuff like that. It's crazy. You've never heard anything like it. So what I'm going to do is I'm going to take my roast set and upload it there and see what they do with it. Right.

From when I did the roast of the Hackamania or Dabblecon or the roast of Carl and Vinny. Wow. Let me see if I can find an example of Notebook LM just so that you can hear this. That is really interesting. LM. Yeah, it's notebooklm.google. And let me do, let me log in here real quick. This will just take a second. Sorry. I hadn't actually planned on doing this. So, yeah.

Yeah, let me, here's just an article about methadone conversion. I just want you to hear this. This is the nuttiest damn thing. It's almost unbelievable. And you can hear them breathing and then they pause and they think about things and they have opinions. It's so weird. It's the craziest thing you ever heard. It's taking a minute to load up. Sorry. Of course it is.

You can also, okay, listen to this. Welcome back, everyone. Today, we're taking a deep dive into the BJR method for converting patients from other opioids to methadone. It's a pretty important topic, especially in palliative care. Absolutely. You know, ensuring proper pain management is crucial for patients facing serious illnesses, and methadone can be a real game changer in those situations. Right. It's known for being super effective for pain that just doesn't respond to other treatments.

Plus, it's got that. Can you believe that? How much of that did you write? None of it. Fuck. No, I gave him an article on methadone conversion. Oh, for fuck's sakes. Isn't that something? Dude, yeah.

I didn't write any of that. That's just insane. No, I thought, I just knew you'd written it. No. An upload or something and they were reading it. No, no, no, no. I'm just uploading articles. So I'm going to take all of my articles and I'm going to upload it and put it somewhere so that it'll be there because in the future, nobody's going to read shit. No. And it's going to have AI spoon feeding. Why would you? I mean, hell, it just makes us even lazier. Yeah. Long half-life can be given in a bunch of different ways and it's pretty cost effective too. Wow. Yeah. All big advantages. Yeah.

Wow, wow, wow. But there's always a but, right? Isn't that something? That's really incredible. Really, yeah, that's incredible. I just don't even understand it. I mean, I do understand it. That's the crazy thing. But it still blows my mind. It's baffling. You know, and just the music that you can do. Yeah. You know. Yeah.

You know, that's just AI generated. And some of these AI generated songs are so catchy that they stick in my head. They become earworms. Did you know also there is a study that was done that if you have an earworm, you'll have perfect pitch for that earworm. So like when, what's a good example? The HBO show.

I can home it at exactly the right pitch. And then there's theme songs like Larry David's, you know, I get that, that, that, that, that, that, that, that, that, that.

I'm almost going to bet that if I queued up that song that that would be right. It would be the right pitch. I don't have perfect pitch. I have relative pitch, if that. But when it comes to earworms, people will have perfect pitch for those. Isn't that interesting? Yeah, I can do that with a lot of those Allman Brothers songs and Grateful Dead songs. And they'll be on the right key? Yeah, because I can think of it at nighttime and I'll wake up in the morning and I'll be like, oh, that sounded like it was in a G or something. Let me test it real quick and just see. Oh, my God. Just calm the fuck down.

Jesus. We've got to wrap it up. It's hot in here. Okay, okay. Hang on. I'm going to do... Last year warm. Last year warm. Yeah, yeah, yeah. Let's do Rachmaninoff's third piano concerto. Oh, my God. And I'm going to say that it goes... Okay, let's see how close I am. Here we go. Okay. Okay.

And if it's way off, then it doesn't work. It's a bad earworm. Why? I'm not staking my fucking reputation on it. Why would you laugh? It just shows that the hypothesis isn't exactly right. You know, I was right on the money. Ha ha ha ha!

Isn't that something? Mm-hmm. Sure is. Okay, fuck off. All right. Anyway. That's amazing. Check out cameo.com slash weirdmedicine. That's cameo.com slash weirdmedicine. I'll say fluid to your mama. And, you know, I'm in a mood to say something to your mama right now, so feel free. All right. Okie doke. Don't forget Dr. Scott's website. It's simplyherbals.net. That's simplyherbals.net. Mm-hmm.

And check me out on Normal World, youtube.com slash at normal world. And the Ask Dr. Steve segments have been on hiatus for the holidays, but I've got a new one on Saturday.

on ass play and whether that causes an increase in fecal incontinence, Dr. Scott. Or hemorrhoids. Or hemorrhoids, yeah. So I've got all kinds of nice pictures of sheep and goats and horses, you know, dropping loads all over the place because they just walk around just shitting, you know. They don't care. Yep, yep.

One of the reasons why it's hard to domesticate goats to bring them inside the house because they're cute and they'll run around and they'll shit everywhere. And they just shit everywhere. It's horrible. But the goat pen that I had when I finally got rid of my goats, best place to ever put a garden.

Oh, yeah. I was just loaded with goat shit. And it was the best fertilizer. I had these giant pumpkins. I mean, at least two and a half, three feet in diameter. It was crazy. The leaves were bigger than three people's heads. Like elephant leaves? Yeah, yeah, yeah. It was pretty cool. You could do that with rabbits, too. If you have rabbits in a cage, you elevate the cage and just let them. And then plant your garden that spring.

where the rabbits were living. But anyway, yeah, this is a gardening talk with Dr. Steve. That's my next project. So, and yeah, so check that out. And what else? That's about it, I guess. We got a Patreon too, patreon.com slash weirdmedicine. Putting old shows on there from going way back that are not available anywhere else. So if you're interested in, you know, ancient history,

which some of it's kind of interesting. Check out patreon.com slash weird medicine. Anyway, all right. What we got today? Let me see. Tacey, you have no topics for topic time? Okay, very good. So we'll just, well, what in the hell am I supposed to do? Let's see here. We'll do... It's Tacey's time of...

It doesn't really work. What a way to start the new year. Off to a rousing start. I was excited to be here this morning. I guarantee it. Yeah, me too. I mean, we haven't done this in a while. No, no. We missed our Christmas show. We didn't do any Christmas long this year. No, I know. That's true. I did a couple of shows on my own, and then we did some replays.

And I kind of this last week, the New Year's, I didn't even put out a podcast for this week because I figured that nobody would be listening anyway. So anyway, but happy to be back. I do have an announcement. I am. Check out Hackamania dot com. It's Las Vegas.

uh, May 9th through the 11th. It is Mother's Day weekend. I don't know why. I, I am concerned that it's going to, uh, affect attendance, but, but anyway, we'll have a big old time. Uh, uh, Tukey will be there. Uh,

And I don't know if Cardiff is coming. Patrick Melton from Nobody Loves Onions will be there. And probably Ray DeVito. I don't know if Anthony and Pat Dixon may come. It's just, you know, it's an eclectic group of people.

And I'm going to do the first and final Weird Medicine live show. And for all intents and purposes, and Dr. Scott, I haven't really talked to you about this. Probably should have done it off the air. I think it may be the last Weird Medicine show ever. When is that? May 9th. May 9th. May 9th. And...

It's just after 20 years, it's enough, I think. And I'm interested in doing more documentary-style stuff now that I've learned how to work Da Vinci and I've got my green screen set up. And thanks. I really appreciate Dave Landau and his group, Angela Boggs and Bryce and Steve Farr and Ken Kuykendall and the rest of the group over there. They've really helped me.

bring me along as far as video production is concerned. They forced me into buying...

camera that's broadcast quality and they pay me nothing. But that's okay. The experience has been worth it. The exposure was worth it. And I really want to just do some sort of one-off type projects and then be on other people's shows and stuff. So we'll see. You know, I said I was going to retire the day that Beck graduated from high school and that was two years ago. So

You know, that didn't happen. Of course, Beck dropped the night of his graduation was supposed to be my retirement date. And then he gets, you know, he graduated with honors and he's a smart kid. And he says, yeah, you know what? I think I might want to go to veterinary school. So now that's four years of college and four years of vet school before he's making any money.

And on top of that, I realized that if I retired and went on Medicare, no one in my family would have insurance but me. I mean, I could go back to work. Yeah, you could, but you don't want to. No, I don't want to. And I was looking for an excuse. My point is I was looking for an excuse to not retire. Yes, you are. Speaking of excuses. And so I'm probably going to find an excuse not to retire.

do weird medicine but right now the plan is the very last the final episode of weird medicine will be that week of mother's day go ahead speaking of excuses since you've got a good excuse to miss mother's day i have a lovely item at the gallery that um i would like to have for valentine's day that's all right i i um

It should be ready by Valentine's Day. Let the record state that I volunteered to not do this and to have my last show at Davilcon 3, and somebody said, oh, no, no, no, you should go. Nothing's free, baby. But you should... The quid pro quo was that I had to make sure that the boys were spending the whole weekend with their mother on Mother's Day. Nothing is free. I've...

Believe me, I'm well aware that nothing is free. Can you give us a real? As a matter of fact, everything is extremely expensive. That's right. Not only is it not free, but it's prohibitively expensive. What were you going to say, Scott? Can you give us a like a 30 second version of what Hecumania is? Yeah, yeah, yeah. Sorry. For those of us who are non-believers. It's a it's a it's it's like a.

It's like Gen Con, you know, or Dragon Con. Oh, cool. But for weird-ass fucking comedy. So last year, they had Ray DeVito did stand-up. Earl Skakel did stand-up. They had a bunch of different people doing stand-up. Then they had a comedy competition. Then they had Who Are These Podcasts and Biggest Problem in the Universe and Inferno.

Nobody loves onions doing live podcasts. And then afterward, we all went to—no, shit, that was a different event. But the Largo event, we all went to a karaoke bar and watched Royce Lopez do the greatest karaoke I've ever seen. The whole karaoke bar. It was a bunch of regulars, a bunch of old folks singing—

Hotel California and stuff. And then he comes in doing CeeLo and shit. Just blew the top out of the house. Anyway, yeah, it was amazing. But yeah, and then everybody just kind of hangs out and you're in Las Vegas too. So, you know, there'll be comedy shows and just we might have a poker tournament or whatever. It's just all the people in this sort of hackverse are

who are these podcasts, you know, Tookie Soup and all that stuff. And we're sort of peripheral to that, you know. But anyway, yeah, it's fun. It's fun. It's a nice weekend. Is Vegas going to be big enough to hold all of you guys? That's funny. Go to hackamania.com. Use promo code WEIRD. Don't let Carl and them beat my ass. Right now I think Tookie is number one for selling tickets online.

which is appropriate, but let me sell a few. So come hang out. I used to say I'll buy you a drink, but it's, you know, I'm... No, we're not buying drinks this year. The whole being... Well, it's not even that. We're spending money on February 14th. It's not even that. It's just that...

Drinking is like the core of certain people in this universe, then I don't want to be like that. But I will give you a hearty handshake if you come say howdy-do. And I'll have some...

tchotchkes and swag and stuff like that. So if you buy your ticket using promo code weird, then you'll get a little packet of like weird medicine poker chips and Tacey's 50th birthday poker chips. You can look at and, you know, late at night fantasize to stuff. OK. All right. So there you go. That's that's the news.

And that's the news. So let's see here. Number one thing, don't take advice from some asshole on the radio. Yeah, boy, isn't that true. Now, there was a question in the chat room. So if you want to join the fluid family in the waiting room, it's YouTube.com slash at weird medicine. Click.

the subscribe button and the notification so that when we go live, you'll get a notification. Follow us on Twitter at Weird Medicine, but also click the join button, but you don't have to join.

But just click Accept Gifted Memberships, and Myrtle usually goes in at the beginning of every show and gives away 10 or 20 gifted memberships, and there is some members-only content and stuff like that in there. I found it. You found it? Okay, yeah. So what's the question? So, hey, Dr. Steve, it's Matthew. Yep. Could you please explain how amlodipine works? Yeah. I asked my doc, but she doesn't have the gift of dumbing things down like you do.

Okay, yeah, absolutely. Amlodipine is a calcium channel blocker type antihypertensive blood pressure medication. And it lowers blood pressure and it treats chest pain by relaxing blood vessels. And it increases blood flow to the heart. So think of it this way. And we've used this analogy before. Let's take a water pump.

And we're going to hook a hose in the outlet and a hose on the inlet.

And it's one hose. Okay. So you're taking one stretch of hose and you're hooking one end to one end of the pump, one end to the other end of the pump, and you're completely fully charging this thing full of water. So when you turn it on, water goes out the outlet and circles around the hose and then comes back in the input. Right. So it's a closed loop.

Now, we can play with this. So let's put a pressure gauge on there. Let's, you know, just pop it through the hose. And it's a certain pressure when you turn this thing on. Now, one way that I can decrease the pressure is by increasing the caliber of the hose.

By relaxing it. In other words, making the hose have a bigger diameter. The same amount of fluid in there, but a bigger diameter. And so the pressure will go down, right? That's basically what amlodipine does. It's by a different mechanism. It's what the angiotensin receptor blockers do, ARBs, like Losartan and stuff like that. Yeah.

I could also turn the pump down, just turn the pump so it's not pumping as hard. And that will also drop the blood pressure. And that's kind of what a calcium channel blocker does. Mm-hmm.

Or I could bleed off some of the fluid, leave everything else the same, but have a little spigot on there and bleed off some of the fluid and the pressure will go down. That's what diuretics do. So amlodipine is the one where it increases the caliber of the vessels and drops it that way. And it prevents calcium ions from entering the cells of the heart and that relaxes them. So when you stimulate...

muscle calcium ions will flow in and then it will contract. And so if you prevent the calcium from going in, those muscles around the blood vessels will relax because they can't contract. Gotcha. Okay. And because it increases blood flow to the heart, it can improve chest pain as well.

And it's a long-acting drug. It has a half-life of 30 to 50 hours, which means you can take it just once a day, which is great. It has side effects. Number one, if you have...

Oh, if you have aortic stenosis, in other words, if you have a narrowing of your aorta that's serious enough, you don't want to drop that blood pressure because if you do, now the whole aorta will collapse. You won't be able to pump blood through it.

And to be clear, stenosis is a narrowing of the vesicle into the heart. Right. I thought I said that, but thank you. It's caused by valvular constriction, and so you get, you know...

an increase in velocity of blood coming out of the heart and a decrease of the amount of blood coming and increased back pressure. Which is not good. So the narrower it gets, the worse that is. And actually, you know, one of the signs of a poor outcome with aortic stenosis is if you have syncope, in other words, fainting, or congestive heart failure, because that means that the back pressure is so high that it's

It's backing up into the lungs. And so those are not good. So, yeah, so you would not want to use this in someone that had severe aortic stenosis. But fix the aortic stenosis. Then you can do whatever you want. It can increase the heart rate.

Which could make angina worse sometimes because the body's trying to compensate for what we're doing with these pills. So we're opening up the blood vessels and dropping the blood pressure and the heart's going, oh, what the hell's going on? Because you can't talk to it and say, just calm down, everything's fine. So it's going to be harder to try to compensate for that.

So anyway, and if you already have heart failure, it can make it worse. So, you know, you want to make sure that you only take this under the guise of your doctor.

healthcare provider. The other thing that can do that can drive some people crazy is cause edema in the legs because you're opening up those blood vessels. Fluid can leak out with gravity pulling fluid down and pools in the legs and you get leg edema or swelling in the legs. All right.

And don't take it if you're pregnant because they don't know if it does anything good. Yeah, Matthew. Does that help, Matthew? I hope that helps. Anyway, you got any other questions from the fluid family? I was looking through. I don't see any yet. Okay, that's fine. If you do. I'll keep your heads up. I have an article, medicating the gut and not the brain could help. What do you think? I would say hell yes. Depression and anxiety. Hell yes.

So, you know, researchers experimenting in mice to better map pathways between the brain and the gut, including a nerve that serves as a highway for serotonin, a chemical that plays a key role in depression and anxiety. These experiments indicated that aiming medication for depression and anxiety toward the gut may prove more effective than the current approach of targeting the brain. Wouldn't that be nice if we had serotonin

like medication that would go to the gut and not cross the blood-brain barrier and wouldn't cause some of those weird side effects. You know, these drugs right now are developed to go to the brain, and it was always thought because the brain controls behavior, that's where they act. And so, you know, the gut, like the brain, also produces serotonin. That's why some of the nausea medications we have affect serotonin receptors.

And the experiment showed the potential importance of the vagus nerve. We're going to talk about that in a little bit in treating mood disorders. So vagus nerve stimulation has been shown to improve mood as well. And, you know, you can do that non-pharmacologically. So you can sell that shit over the counter if you want to, and they do. Mm-hmm.

But anyway, it may also explain why people with mood disorders also have GI issues. You can't separate. We say we can't separate mind from body, but you can't separate the mind from the gut for sure. So let's see. Altering how existing medication delivered to different parts of the body is generally faster and cheaper than developing and testing completely new compounds. Yeah.

All right. So that's kind of interesting. So I think we're going to see more research on this brain-gut axis. Now, we were talking about non-pharmacologic research.

treatments for depression. Magnetic stimulation. You know anything about that, Dr. Scott? Sure do. Are you doing some of this stuff in your office? A little bit of it, yeah. Yeah, this, you know, people who've had trauma therapy, behavioral therapy, meditation, medications, and they still have refractory depression, I have advocated at least considering psychedelic therapy for those people or ketamine therapy.

under the care of an experienced provider now. But there's this transcranial magnetic stimulation was approved by the FDA in 2008, treat major depressive disorder. Now, this is not electroconvulsant therapy. Some people may be thinking that.

But you do five days a week for several weeks, and you sit in a chair, and they put this electromagnetic coil against your scalp for 20 minutes, and you just sit there and play on your phone. And it does change your brain chemistry. Now, 62% of adults that complete 36 sessions go into full remission, and 83% have what's called a positive response rate. So that's huge.

Now, 36 sessions, how many weeks would that be? Almost a year. No, it's seven weeks because you're doing it daily. You're never doing it daily. Sorry. Yeah, it's okay. Which would be kind of a pain in the ass, but you're going in daily for 20 minutes. But can you just take this thing home, though? That would be nice. And just sit at home and do it, or do you have to go there?

I'd say they want you to go there. It's probably pretty expensive. Let's look up transcranial magnetic stimulation at home and see if you find anything. But I think that's sort of interesting. Now, because people have chronic depression, I have an article called 10 Habits of People Who Have Mastered the Art of Pretending They're Okay, According to Psychology.

Number one, they're experts at the smile. In the grand masquerade of life, the smile is a powerful tool. Psychologists have found individuals skilled at masking their true feelings will often default to a smile. But it's not just any smile. It's a well-practiced one that appears genuine to the untrained eye.

A fleeting moment of eye contact, a quick flash of the teeth, and voila, they're successfully deflecting any probing questions about their well-being. You may know someone on the Internet who does this smile periodically, try to pretend that everything's fine. Did you find something on the transcranial? I found all kinds of stuff. At home? For at home? Yeah, well, give it to us.

Tase, you want to go first? Well, I don't have – I'm just looking through articles right now. I found something called Pulsetto. It's non-invasive. First ever science-backed vagus nerve stimulator solution. Oh, that's a vagus nerve stimulator. Okay. Yeah, Dr. Scott and I were doing that for a while. Yeah, and, you know, I still do some of it with – depending on –

And I do it in a couple of different ways. But to answer your first question, as far as a transcranial one, it looks like there is one that you can buy for a little over $3,000 and take home and use. Ouchie. Yeah, but, you know. One of insurance will pay for it. Yeah. But, you know, we do a couple of different ways. I'll actually stimulate the stellate gangling with X-function needles and electrical stimulation. Right.

Instead of injecting it. Instead of injecting it, correct. So, yeah, talk about the stellate ganglion for a second, and I want to know if there's...

data on stimulating externally rather than injecting it. Yeah, the answer, so a little bit about the stellate ganglion, it lays right along the top of the first rib in the neck, and it's right next to the carotid artery, so it's kind of a delicate place to get to. And if you're going to inject it, you need someone that's obviously got some training, but they do it with... Like me. Like Dr. Steve, and some of the guys that I work with, they're all military guys, and they were trained to do this in the military, like Walter Reed,

They were trained to do it with an ultrasound, and they would go in with a steroid or a numbing agent and put it right on that stellate. And that's how they treated a lot of the PTSD. Interesting, because it was originally designed for increasing surrogacy.

and blood supply to the arm and, you know, for reflex sympathetic dystrophy. And for like brachial plexus and thoracic allus. But then they found that it worked for PTSD as well. Yeah. And the reason it appears is because it does help to downregulate that vagus nerve. So when... Because the vagus nerve being part of the parasympathetic system, kind of calming your system down. What...

Anytime we see anybody, and you know this like I do, chronic pain syndromes.

chronic elevated stress syndromes are what we call upregulated. Yeah. We like to calm down the entire system. Right, which is one of the reasons we do breathing exercises and all that shit. Your heart, your bowels, your stomach, everything. Just calm everything down with this vagus nerve. Yeah. So that's the one way I do it. And again, to answer the second part of the question, any research? I don't think so because it's not, it's a really new technique and as far as I know, I'm the only one doing it. Okay.

Well, there is data on using TENS unit, you know, transcutaneous electrical nerve stimulation on the stellate ganglion.

But the only data that I can find right now is that it does improve blood flow and improves pulse oximeter signal, you know, the dynamic range of signal on a pulse oximeter, which is what the injection does as well. So you would think that it would follow and that it would have the same effects, but we'll just have to see. And that's kind of what Tacey was describing, too. I think she was describing you wear around your neck.

And it actually stimulates the vagus nerve right along where the stellate ganglion is. And at least that's what it looks like on this video or this image that I'm looking at. Yeah. I'm really interested in whether you can get that transcranial bullshit. I mean, not bullshit. It's not bullshit. No, no, no. But you can taste it. But like I said, it's $3,000. What I found is that people are zapping their brains at home to improve focus and clear brain fog. But is it safe? With what, though? What are they even zapping it with? I don't know.

I don't recommend that. Electric acupuncture. Oh, God. Transcranial direct current stimulation, or TDCS. Okay. That is actually different. Are they buying something to do that, like Amazon or something? I mean, I don't know. Don't do any of this shit without...

Without it being established clinically, make sure it's FDA approved if it's a home device for the indication that you're using it for. Or just talk to your shrink about it. These can cost between $40 and $500. Okay.

Is it FDA approved for the indication or is it one of those things that... No, it's just a bunch of enthusiasts who are doing it. I got to see data. Many of them are marketed as having clearance from the FDA, which entails a less rigorous review process than what's needed for approval. Correct, because they're not selling it as a medical device. I'll guarantee you that they're saying, you know, there has not been approved for these things like they do for...

herbal drugs that are on the market says, you know, the FDA hasn't approved these claims or whatever. Interesting. Well, you know, the transcranial...

magnetic induction thing is just an induction coil and it probably had some specific frequency or set of frequencies that'll be something you'll be able to buy at home at some point because if you have to go every day for seven weeks which would be 35 sessions that's a lot

It's tough. Now, if you have refractory depression that's never responded to anything and now all of a sudden you're in remission, it's worth it. You do it, yeah. But still, it'd be nice if you could do it at home. Mm-hmm. Anyway. Interesting. All right. Very interesting. Well, let's get back to people who pretend that they're okay. I'm okay. Everything's okay. They're masters at diverting conversations.

If someone asks how you're doing, flash that smile and steer the conversation toward something else. I'm fine, but how's your garden coming along?

Or did you catch the latest episode of what, Tase? Landman. Landman. Yeah, that's a good one. That'll get you off on something. That Allie Larder say something, I'm saying she. Anyway, they have a knack for staying busy. Uh-oh. Wait a minute. Did one of you assholes pull this for me? Because every single one of these things is what I do.

I don't know about the smile. I have resting bitchy face, but let me see. They have a knack for staying busy. Oh, they're experts is using. Oh, humor as a defense. Wow. Yeah.

They're master of the art of making others laugh, creating fun, jovial atmosphere that keeps their underlying struggles hidden. You better move on to the next subject. They're keen on helping others. Oh, no. What the fuck? Which one of you assholes sent this to me? Get him to read this and see if he sees himself in it. They put on a brave face even when alone.

They have a tendency to downplay their feelings. Sounds like a therapy session to me. Yeah. They perfected the art of isolation. They're incredibly resilient. Well, I'll take that. Yes, that's true. Eat shit and die, both of you, whoever sent this to me. Lord and lady, douchebag. Come on.

It wasn't me. I'm too lazy to look anything up. I would love to take credit for that. Well, maybe it was a listener. I would love to take credit for it, but I really can't. All right. Okay. Well, fuck all y'all. All right. Let's take some phone calls. Let's see. Hello. Oops. Hello, folks and fluid family. Hey, man. And Tay-Tay. Oh, no. Got a question for you. Is it possible for your skin to get thinner?

And the reason I ask is I can bump something with my hands or my arms, and I'm just going to start bleeding and bruising. And those bruises and everything take weeks to heal up. Doesn't happen on my legs or my calves or anywhere else. It's just on my arms. So I don't know if it's...

Skin's getting thinner or whatever, but I've quit taking my baby aspirin just to see if that helps me. Well, that'll help improve the free bleeding, but it won't improve the thickness of your skin. You just get old. And it is. You do lose some skin.

tone and some fluid and some fat and collagen and elastase or elastin, sorry, in the skin as you age. We weren't designed to live this long. It's amazing that our skin doesn't just fall off after we turn 40 because, you know, we were designed to reproduce at, you know, 15 or 16 and be dead by 30. Yeah.

And, you know, so it's everything after that is just sort of evolution went, oh, well, you know, who cares? Because once you're done reproducing, evolution has nothing to do with you anymore. But, yeah, and skin heals in a bunch of different stages, and it takes a little bit longer as you get older, too. When you have a wound, the first stage is a thing called hemostasis. So the blood vessels constrict.

and then platelets form together to form a clot.

And then you get the inflammatory phase where white blood cells clean the wound of bacteria and other foreign agents. They come in. And this is why it's so hard to heal bone and joints and stuff like that or to get bacteria out of them once it's in there because there's not enough blood supply to get all these things there. You know, the bone has some blood supply, but it's shit. Right.

And then proliferation, you get these healthy cells that migrate to the wound and it builds new tissue from the edges, which is incredible that this works this way. You know, it doesn't matter how small the wound is. The body will go in and notice it and go to fix it. And then the last stage is remodeling. And that's where the wound is strengthened and you get scar tissue, et cetera, et cetera. It can take days, weeks, months, even years sometimes.

And, you know, scabs will form over the wound to protect it while the new tissue heals. So quit picking them off.

And, you know, itching is a real common symptom, and it's just caused by irritated nerve fibers in the affected area. But if you have a wound, keep it clean and dry. There are times we put an occlusive dressing over there, but let wound care do that. If you've got a wound that you're having problem healing, or if you have a wound that will not heal, that's a sign to go see somebody. That needs to be checked because a non-healing wound is not normal. Wounds should heal regularly.

And, you know, if you have deficiencies in proteins, carbohydrates, okay, these are all things that you lose in your skin as you get older. Vitamin A, C, and E, those are minerals that you need or vitamins that you need to promote healing. Magnesium, copper, zinc, iron, all that stuff. So if you have a real monotonous diet and you're having trouble with your wound, you know, with bleeding and stuff, just take a multivitamin. Take an elder multivitamin. Yeah.

And I'm not prenatal vitamin even. Yeah, yeah, yeah. Sure. Something like that, yeah. Okay. All right. Good question. Excellent. Hey, Dr. Steve. This is Spencer in Alabama. Hey, Spencer. I'm calling you back. You read my question last week on the podcast about my...

Nose being stopped up and blowing blood and all that stuff. Yes. And we said that he probably had a deviated septum, if you remember. You thought it was a deviated septum. Well, okay. And certainly it was. I went and saw an ENT, and he put me on some... Wait, so I diagnosed it as a...

Deviated septum, and he went to the ENT, and it was. Give thyself a bell. Give myself a bell. It says give thyself a bell. Well, it says give thyself a bell, and I'm giving myself a bell. Lone A's and something called...

Lord, I can't even pronounce it. Azolastine. Simply Herbal Nasal Spray. Azolastine hydrochloride. There you go, Azolastine. Yes, he should be using Simply Herbal Nasal Spray. Correct. Correct. And here is it.

Oh, no, wait, that's wrong. I had that simply Herbal's theme song. I tell you what, since I had my deviated septum fixed, I feel like I can drive a Mack truck through my nose. I can breathe. Yeah? I couldn't breathe before, and I didn't know that I couldn't breathe. Was it painful?

Well, yeah, I had like a... Packing and stuff? Conbulosa. Conchobulosa. Conchobulosa. Yeah. So my face would... She had the most effed up septal obstruction that you've ever seen. I looked at... Really? The doctor was looking at the computer and I walked in and I thought, oh God, whose face is that? Whose is that? That's a mess. And it was mine. It was mine. Oh, jeez. Bless it.

Yeah. So what happens with a concha bolosa is you get an air-filled cavity in the turbinate itself. Right. So you get these turbinates or these sort of ridges there.

mucous membrane and if you get an air cell in one of those it just pushes out and it's worse than a deviated septum because it's just big giant turbinate that you can never clear it. So she had to have that removed and they did a nose job at the same time. Yeah, for free. Oh, cool. Yeah. It wasn't exactly for free. I said, how much would it cost? And he said, no.

Nothing. Yeah, nothing on top of... We're going to be up in there in a while. Right, right, right. Just line it up. Get the wheels changed. Right. So he should, yeah, he should have had some of this. There you go. I'm talking now.

Okay. There we go. That's what I'm talking about. Yep. Even the AI knows. All right. So, oh, we're going to finish this guy's phone call, right? Yeah. We were congratulating ourselves. Wait a minute. Okay.

And certainly it was. I went and saw ENT, and he put me on some Flonase and something called, Lord, I can't even pronounce it.

Azolastine hydrochloride. Azolastine, yes. Whatever in the world that is. Well, okay, I can tell you what it is. The Flonase is a steroid that decreases the inflammation in your nose, and then the Azolastine is a topical antihistamine. So you're not taking a pill...

that goes to the tip of your toe and your ear just to get into your nose. You're actually taking the medicine and putting it where it belongs, which is in the nose. All right. I'm going to try these for three weeks and see if it clears it up. And he said, you know, if not, he's going to have to do surgery. So I don't know what that entails. Is that something I should let someone know?

operate on or keep trying other things. But you were 100% right. And as always, I appreciate you guys and everything y'all do. Well, yeah, let's talk. Thank you for the kind words. You want to talk about the process of the... The process wasn't great. I mean, I'm not going to say it was, but the healing was...

You can't breathe through your nose, and I don't know if they pack it. They didn't pack mine, so I'm thankful for that. Well, they did, though. You just don't remember. Oh, well, I was kind of stoned. But anyway. Talk about the process from beginning to end, what your experience was, because he's going to be going through this, because that has a lasting angle to do shit. Well, I mean, it's been a long time. I mean—

Sure. I remember we picked the kids up and the kids go, somebody cut mommy's nose off. And just... Okay, so you went there that day. Yes. And then I remember people come... And what did they do? What was your experience? They came in, they gave you a shot, that kind of stuff. Tell us the story. That's all... I don't really remember it. Okay. I got to 98 and went to sleep. So what'll happen is you'll go and they will...

give you some medication, and they'll say, yeah, count to 10, and then when you get to two, you'll go, hey, this shit ain't working, but you're already waking up. But you will have a nose full of packing material. So Tacey came out of there, and she had this...

three, four foot roll of shit in her nose. But they didn't leave it in, they took it out. Right, they took it out and it was just bloody and mucousy and all this kind of stuff. But basically what they're doing is they may break

when they say break your nose, but they're going to readjust it so that the septum is straight. And for most people that have this done that couldn't breathe, they say it's the greatest thing that they ever did. My dad said the greatest thing he ever did was having his cataracts removed. That's pretty great, too. Tacey can speak to that. But, yeah, like Tacey said, now she feels like she can drive a Mack truck up there. She didn't even know how bad her breathing was until it was opened up. Yeah. Wow.

Well, you don't know. No, you don't know. It drives me crazy when the swelling in my nose is so bad that the turbinates are just jammed up against the septum itself, and that feeling of pressure is just horrible. But anyway. I'm with you. All right. So, yeah, that's how it'll go.

And just tell them it was worth it, Tase. It was totally worth it. And I asked my doctor to give me two weeks off instead of one, and he did. And so I got two weeks off. It was lovely. Yay. And then I got a—

straight nose from it. Yeah, and you got a nose job and he gave you extra time off so you just used up all of your unethical, immoral behavior all at one thing. Ripping off the insurance company, ripping off your employer. There you go.

All right. Okay. Oh, goodness. Poor taste. Hey, it's Donna Bell from North Carolina. Hello. Is old people smell a real thing, like a real chemical? And what can people do to ameliorate it? Ooh, a good one. And as always, I'm asking for a friend. Yes, of course. Yeah, old people smell is not a myth. It's real.

And it's described as musty or grassy. And it's caused by a natural chemical change in the skin by a compound called 2-nonenol. N-O-N-E-N-A-L. I'm not 100% sure how to pronounce it. 2-nonenol.

And it's a byproduct of the breakdown of fatty acids in the skin, which is what we were just talking about in old people. So their skin gets thinner and then these compounds break down and you get the smell. It's not always noticeable, but it is considered a normal part of aging. And it's an unsaturated fatty acid that increases in the skin as people age and then it breaks down faster because there's more of it.

And it's like I said, it's not always noticeable and there's a lot of variation. So I looked up the two known and all in on Wikipedia just listed as an unsaturated aldehyde. So aldehydes are smelly and like acid aldehyde is a molecule that.

that is between ethanol, which is alkyol, and its final byproducts. And when you're turning it into vinegar, that which is acetic acid, it goes from alcohol to acetaldehyde to acetic acid. And people who can't metabolize alcohol will get stuck at acetaldehyde, and those are the people who get really sick when they drink alcohol.

Or if they're on antabuse or what's the antibiotic? Anybody remember? Nope. Metronidazole. So metronidazole will stop the metabolism of alcohol. And when you take it, alcohol with it will make you sick. It's that antabuse effect. Well, anyway, so but to nonanol is an unsaturated aldehyde.

And it has, they could describe it here as the component of aged beer or buckwheat. And it's unsoluble in water. Of course we knew that because it's a fatty acid on top of everything else. They also describe the odor as orris, O-R-R-I-S. Can you look that up and see what the hell that is? Fat and cucumber. Spell it again. O-R-R-I-S.

Odor's been associated with human body odor alterations during aging. But this is, you know, these people that smell things for a living...

They have these people, and they have these trained noses, and they hold things under there, and they'll describe it. This is one of the things that they describe. You have taste. This looks like it's like a perfume thing, and it's a rare fragrance ingredient that comes from the root of the iris plant, particularly the iris germanica and iris pallidia. Huh.

Yeah, the most valued component of orris root is oil of orris, a yellow-white mass containing... It's considered the world's rarest perfume ingredient. Really? More than ambergris, which comes from whales? I mean, I don't know. That's crazy. Yeah, they used to mine whales for ambergris, just to, you know, you kill this beautiful giant thing...

and maybe eat some blubber and stuff, but then have the ambergris and then just throw the rest in the ocean for the fish to eat. It was kind of shitty. But yeah, it says here it has myristic acid in it, which is a common unsaturated fatty acid.

And it comes from nutmeg butter. I want to look up ambergris real quick. Now it's going to drive me crazy. Why did they, first off, how did they find out that this shit inside whales made good perfume? And it's a solid, waxy, flammable substance produced in the digestive system of sperm whales, just sperm whales. Those are the coolest whales.

And freshly produced ambergris has a marine fecal odor. Mmm. It acquires a sweet, earthy scent as it ages, commonly liked to the fragrance of isopropyl alcohol without the vaporous chemical astringency. It's been highly valued by perfume makers as a fixative. Okay. That allows the scent to last much longer. It's been mostly replaced, mostly replaced by synthetic ambroxide, sometimes used in cooking. No, stop it.

killing whales for this. Yes, make the fake stuff. It's like in Dune, you know, they finally, when the sandworms all died, spoiler alert. Nerd talk. They came up with a synthetic version of the spice melange. But anyway...

Yeah, ambroxide is a key constituent of the responsible for the odor of ambergris. It's auto oxidation, blah, blah, blah, blah, blah. Okay, it's small amounts are used as a flavoring in food or in perfume as a fixative. Because if you just put scents in alcohol, they will sort of...

disappear. But if you throw a little of this fat in there, apparently it will fix it because, you know, a lot of that stuff is fat soluble and it'll last longer. How did they find that out, though? It's kind of crazy. It is. Yep. Poor sperm whales. Oh, well. All right. Hello, folks and fluid family. Got a question for you. Yep. What is the breaking point or differential point between a belch or a fart? Easy. Okay.

I know. You're making fun of me now. No. But really. No, it's a good question. At what point does it differentiate when it's going to come or go? Yeah. Stacey is famous for asking the same question twice. You know what he calls? He does it every time. You know, what is this? No, seriously. What is this? But thank you, Stacey. It's an excellent question. So a belch is also known as an erectation. Erectation.

E-rock radio is a famous whatever. There's a joke there somewhere, but I couldn't find it. So eructations and, you know, fart is flatulence or flatus. And they are both manifestations of gas escaping from the GI tract. So if the gas is in the stomach,

The path of least resistance is out the esophagus and the mouth, and so you will have a burp. But if it escapes into the small intestine, now you're going to have bloating. And then eventually, as it works its way through, it'll hit the colon, and then it will be –

distributed to the world as flatus or a fart. So when I was a kid, I used to inhale or actually swallow a bunch of air so I could burp the alphabet. I can still do it, but it's unfortunate at my age to do that. But I would blow up my stomach with air and then I could... I could do the whole alphabet.

Well, you never get all of it out. And so the next thing you know, within about an hour, that gas has passed through your small intestine through to your colon and now you're farting. So if you really want to ensure that you can pass flatus for whatever reason, for a practical joke or whatever, you can take inulin fiber, but you can also swallow a bunch of air and then just don't belch it up. And it has to come out the other end.

All right. So that's the answer. I've got a real quick update. This is actually a pretty good update. Okay, good. Roger Smith says a blubber oil, they found that because I guess it smelled good because they rendered it down for oil. Yeah. So they can make fire. Yeah, whale oil like lamps and stuff. Yep. And they also used it for automatic transmission fluid too. That's so crazy. But why the ambergris though?

You know, that's the thing. I guess they just rendered everything down that they could find. But, yeah, whale oil is apparently high-quality oil. But, Jesus, you know, we have other ways of making oil now. We do now, yes. Synthetic. Yeah. But anyway. Poor whales. They're crazy.

All right. Let's see. Hey, Dr. Steve. How's it going? Good, man. How are you? Great. I'm so happy to hear that. All right. This is Rob from Fredericksburg, Virginia. Hey, Rob. A while back, I had called about how much weight a man has to lose

what that ratio would look like for his penis to grow an extra inch. Correct. And I'm curious, how much weight would a woman have to lose in order for a guy to shove his big, meaty erection further into the woman's vagina? Oh, okay. Yeah, who cares?

Next. Because that just helps her. It doesn't help the guy at all who cares. All right. All right, Dr. Scott, what do you got from the fluid family? By the way, if you want to join the fluid family, go to youtube.com slash at weird medicine and click join and then click subscribe.

accept gifted memberships, but also click the subscribe button and the notification so that when we go live, you'll get notification. Follow us on Twitter at Weird Medicine, and I usually put out a notice there when we're getting ready to go live. Go ahead, Scott. Right on. So Lincoln's got a great question. Hey, can you talk about chronic pancreatitis from alcohol abuse and the likelihood of it becoming pancreatic cancer?

cancer. He's had several flare-ups of pancreatitis and is concerned that that might be something to pay attention to. Well, chronic pancreatitis is basically just long-term inflammation of the pancreas

And eventually it causes permanent damage and scar tissue. And the risk of pancreatic cancer is higher when you have chronic pancreatitis. In other words, it's there all the time. Now, if you have intermittent pancreatitis, you know, it's harder to define. Now, if you have hereditary pancreatitis, then it's even worse because it started when you were a kid. Those people have pancreatitis starting when they were five years old. It's horrendous.

In those people, they recommend that the pancreas, at least that they be evaluated to remove the pancreas. Yes, you'll be diabetic afterward. And yes, it's a big surgery. But no, you won't have to deal with severe abdominal pain your whole life.

The risk of pancreatic cancer for people with chronic pancreatitis is about 5% over a 20-year period. So the vast, vast majority of people will not develop pancreatic cancer. So if you have chronic pancreatitis, you have a 95% chance of not developing pancreatic cancer. Okay.

Now, the risk is eight times higher five years after the diagnosis. So it's, you know, it starts to go up. So make sure that you get this dealt with. If it is caused by alcohol, you got to stop. If you have a single pancreatitis episode from alcohol, that is your body telling you cut the fucking shit.

and go to a meeting, get some help. You can do it. Go to SAMHSA, S-A-M-H-S-A, and find meetings or an addictionologist that can treat you if you can't do it on your own. There is medication that can absolutely help, and some people go into the hospital or go inpatient to do this. And there's medication-assisted detox and then medication-assisted medication.

There's things you can take to prevent you from having relapse. And then go into meetings just knowing that you're not alone. If you're not big on the spiritual 12-step stuff, there are— A thousand other— Tons of other 12 steps that are not spiritual in nature. You know, they just talk about the universe, right? You know, there's—

you know, the universe is bigger than we are kind of stuff. And there are a lot of new, those, those, like some of those brain stimulating things we're talking about earlier. Yep. Um, there are a lot of new things coming on board, like, um, the cognitive behavioral therapies. Sure. And those, um, what is it? The MBT, um,

EMDR? EMDR. I'm sorry. EMDR therapies where there are a bunch of things coming on board. Yeah. I did EMDR. It helped me quite a bit. Yeah. It's interesting. It's really... And you don't have to have the machine either. The machine's just LEDs that make your eyes go back and forth. What they found was that...

If you when you're having REM sleep and you're processing information, that's really what's going on during REM sleep. At least they think that's what it is. Your eyes are moving back and forth. And they found that if you make your eyes move back and forth, you'll process information. So you can actually make changes in the circuits in your brain by moving your eyes back and forth under the proper guidance of a shrink device.

And then you can do it on your own at home. And you can do it. They do it just by tapping on both sides of the body, all kinds of stuff. So, yeah. Yeah. You can quit. But this is your body telling you you need to quit. And, you know, if drinking is interfering with your lifestyle or your ability to work or have a relationship, you got to quit anyway. Don't wait for pancreatitis to get off the sauce. All right. And, yeah, if you need...

for getting some help on that, feel free to email us. The contact form on our website is functioning again. I didn't realize for the longest time it's not been there and so it's back up. So feel free to email us if you need anything or you can reach out to me on Twitter at Weird Medicine.com

If you do that, I may or may not see it. Or you can go to our subreddit. Subreddit is reddit.com slash r slash drsteve. And I answer questions there as well. Or you can just call in. We can get you some help that way. All right. Very good. All right. Well, thanks. Go to Dr. Scott and Tacey. Thanks to everyone who's made this show happen over the years. Listen to our SiriusXM show. All right.

On the Faction Talk channels here, Sex M, Channel 103, Saturdays at 7 p.m. Eastern, Sunday at 6 p.m. Eastern, On Demand, and other times at Jim McClure's Pleasure. And many thanks to you, our listeners, whose voicemail and topic ideas make this job very easy. And thanks to our mods in the Fluid family, particularly Amanda Davidson and who's the other one? Oh, King of All Diffs.

and Dr. Scott, of course. And go to our website at drsteve.com for schedules, podcasts, and other crap. Until next time, check your stupid nuts for lumps, quit smoking, get off your asses, get some exercise. We'll see you in one week for the next edition of We're in Medicine. Thanks, everybody. Goodbye. Business taxes. We're stressing about all the time and all the money you spent on your taxes. This is my bill?

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