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Delusions. Man, you are one pathetic loser. Well, that's because you're an idiot. 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. I don't do...
I've got diphtheria crushing my esophagus. I've got Ebola vibes dripping from my nose. I've got the leprosy of the heart. Exacerbating my medical work.
I can't find an answer anywhere else.
Give us a call. It's 3-4-7-7-6-6-4-3-2-3. It's Weird Medicine, the first and still only uncensored medical show in the history of broadcast medicine. Medicine! Broadcast radio. Now a podcast. I'm Dr. Steve with my... This is like the fifth take. I'm not going back to the first show. I'm Dr. Steve with my little pal, Dr. Scott, the traditional Chinese medicine provider. It gives me street cred...
The whack alternative medicine assholes. Hello, Dr. Scott. Hey, Dr. Steve. This is a show for people who never listen to a medical show on the radio or the internet. If you've got a question, you're embarrassed to take your regular medical provider. If you can't find an answer anywhere else, give us a call at 347-766-4323. That's 347-3223.
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're not your medical providers. Take everything you're worth, a grain of salt, an actin, anything you hear on this show, without talking over with your health care provider. Very good. Don't forget stuff.drsteve.com, stuff.drsteve.com.
Most importantly, roadie.drsteve.com. It's R-O-A-D-I-E.drsteve.com, or you can go to stuff.com. Yeah, for real, because it looks like it just doesn't exist. For the roadie robotic tuner, the greatest gift you can give yourself or a friend who has a stringed instrument. Dr. Scott's website is simplyherbals.net. It's simplyherbals.net.
And patreon.com. They get to see everything first. Plus, there are shows on there that cannot be heard elsewhere. There are classic shows featuring Jefferson the Shyster, Double Basectomy, Turd, a.k.a. Adedictomy Todd, a.k.a. Fecalicious.
GVAC, all kinds of stuff. You ever say a word a bunch of times until all of a sudden it loses its meaning? You can check those out at patreon.com slash weirdmedicine. And I'm still doing Cameo, cameo.com slash weirdmedicine. If it weren't for Donna Oliver, I wouldn't have any cameos to do. But I appreciate it, Donna. Thank you very much. So if you want me to say fluid to your mama, feel free to check out cameo.com.
It's a good day, and it's a bad day. So I'm in a double bind. I'm going to feel like shit no matter what decision I make. But so when Patrick Melton invited...
invited me to come to Las Vegas to do our final show. He didn't know at the time when he invited me, but I decided that would be our final SiriusXM show. We're going to do a live show, go out with a bang and all this stuff. Okay.
And I knew it was on Mother's Day, and I talked to Tacey about it, and I said, you know, it's on Mother's Day. And she's like, well, just make sure that the boys spend the day with me because it's Mother's Day. You don't have to be here. And that was cool. I appreciated that. That's fair. So I scheduled it. I've been spending hours there.
making videos for this thing and i bought a new um stream deck nano so i can fire my events and the videos and the pictures and i've got a big full screen picture of uh chad zumach that says you know please clap and uh uh you know that i could use if things were lagging and i and i was also very excited i was going to take a bunch of money and we were going to um
do some gambling and enter a poker tournament. Oh, cool. And doing dinner with Patrick Melton and the rest of the group Thursday night. Going to get to hang out with friends that I haven't seen in quite some time who I really cherish their friendship. And so everything was cool. Well, Liam gets a letter from the dean saying,
And saying that he's graduating summa cum laude. He's got the highest grade point average in his class, in his college class. And graduation is May 10th.
And he wasn't going to walk. He said, you know, screw it. I'm not one for ceremony. He didn't say it in so many words. It was probably more like, uh, uh. Yes. Knowing him, yes. But, I mean, the kid is brilliant, but articulate not so much. And he's a wonderful child. Yeah, no, he is. He's got a great heart. If he catches a fish and it dies, he cries. Yeah.
God, I can't talk. I mean, he gets that from me. I cried watching Willie Nelson and Sinead O'Connor doing Peter Gabriel's Don't Give Up. Have you ever seen that version?
It was right after she got booed off the stage the night after she tore up the picture of the Pope. And nobody knew why she did that. They just thought she was being a turd. But she had a real good reason in her mind for doing what she did. And, you
you know, she got pilloried for it. And so Willie, she got booed off the stage. So Willie said, look, let's just record it in the studio and we'll do a video. And it is heart-wrenching. Now, when Peter Gabriel did the song, and I went down this whole rabbit hole starting with
If you want to see something weird, go to YouTube and search for Midnight Special, which was a TV show when I was in high school that would have Glen Campbell on and then they would have King Crimson. Oh, wow.
And Genesis, the early 70s Genesis, was a prog rock band. It wasn't the band that a lot of people know today. And Peter Gabriel was...
Fucking a lunatic. Was he really? Yes. You have to watch this. Just search Midnight Special Genesis. It was like 1974. It's one of the craziest things I've ever seen. Well, I watched that live and it stimulated me to go down this whole rabbit hole.
Mostly centering on Peter Gabriel, but other people. It's interesting who he turned out to be. But anyway, you watch his version of Don't Give Up.
And it's almost hopeful. And you watch the Willie Nelson version and you're not sure how this is all going to turn out. And it's just fucking brilliant. But anyway, where was I? What was I talking about? Why did I get off on that? Liam's walking. Oh, Liam walking. May 10th. What did that have to do with...
peter gabriel going to uh oh crying crying over stuff yeah that's right here i am in tears fish dying 6 30 in the morning and and i've got tears running down my face watching this video but anyway um so he gets the letter you're graduating summa cum laude you're number one in your class and uh he says you know what i worked my ass off and i was right there with him
From the first week of school when he called me crying because he got a 68 on a syllabus exam, which is not even worth one point. And he was worried he was going to lose his scholarship. Oh, bless him. Oh, no. Poor little guy. He's a perfectionist and he didn't want to lose that 4.0. And so his head was exploding this last semester. And all of a sudden, yesterday, he announces, I'm going to walk.
Oh, goodness. Because of, you know, he gets this letter from the dean and all this stuff. So I'm not like some people. I don't have to.
Some people will get this reference. Take video from the nosebleed section of my kid graduating because I wasn't invited to his graduation. I'm going to feel like shit either way because Stacey said, well, are you still going to Las Vegas? And I'm like, yeah, I can't get out of it. And then the more I thought about it, it's like if I'm in Las Vegas, excuse me, having a big old time, I'm going to feel like shit.
Knowing that he's walking and I'm not there. Likewise, if I cancel at this late date on Hackmania, I'm going to feel like shit.
because, you know, Patrick Melton went out of his way to invite me. He paid for my room. He was going to pay for my flight, but I already had bought it. I wasn't going to let him do that. And, you know, I have all these production pieces that I did. I've got 50 decks of...
The wet brain card game that I was going to sell there to use for my buy-in for the poker tournament, which I'm going to have to figure out a way to unload these now because it would have been easy there.
This is a great, great party card game, by the way. People are going to really love it. And maybe I'll just put it up on eBay or something. But anyway, I've got 50 of them and can make more. But I found a place. It doesn't matter. Too much detail. Anyway, so I'm going to my son's graduation and I'm canceling Hackamania. And if I had decided to go, I would feel like shit. And if I'm not going, I feel like shit.
And, you know, this is the second live event I've bailed on. I bailed on Dabble to Con 2 as well, although I did send in my roast set by video. So you don't get a third mulligan on this. So, you know, in this universe, I'm done. Yeah.
You're out. Well, I am, and I don't blame them. But, you know, I love my friends, and I'm hoping that we can just get together and, you know, do a no-pressure, just get together for a weekend or spend some time in Cape Coral with Carl and his lovely wife and a bunch of us go, you know, have a meet-up down there where we're not doing a show and we can just hang out.
And, you know, when we were done with the show and we were in Clearwater, that was my favorite time because we could just hang and just be together as friends. And we had such a lovely time. And despite, you know, their jobs shitting on people, you know, which is, you know, that's their job. They are lovely people. I don't care what anybody fucking says. Right on. So, yeah.
And so I'm really sad that I'm not going to be able to go. But you got to – family's got to come first. Well, your kids do. Your spouse, not so much. Not so much. Yeah, but you sleep with her. No, I don't. Yeah, if she's pissed, there's no way you can – Well, no. If she hears that, she'll be very angry at me. That's true. Yes, you're correct. But you don't want to be in them. Right. We live together. Yes, yes. You share the same –
Well, we share everything. Yes, yes, yes. But anyway. Yeah. No, I'm just, I'm being an asshole. She doesn't get my humor like that. I have friends who get my gallows humor and Tacey doesn't get it. And so she just gets mad at that stuff. So I have to, I'm going to take all that back. But
But you know as well, though. I'm not editing it out. Liam would be fine. The boss, she'd whip your ass. Well, I don't even care about that. You're right. He told me, just go. It'll be fine. But I can't do that. No, no, no. I agree. I think you made a right choice. My kid's down there with the purple sash or whatever, and he's actually decided he's going to walk and recognize the four years of fucking hell. Hard work.
Hard work. It wasn't all hell, but there were hellish moments. It was hard work. And to pull off a 4.0 and get a full ride and all that, I owe it to him to go. I think it's great. I think it's great. Yes. He's a good one. We could see his future back when he did that.
What was it, the bit that he did with the... Ashley Madison. We could see his potential. Oh, my God. I wonder if I can find that. No, that is still my favorite. We have played it a couple times. Let me see. Here, talk, Dr. Scott. So years ago when Liam was just little, Dr. Steve made up the most...
I think a little, little bit with, um, um, Liam talking like, and, and then he bleeped in some words or bleeped out some words. I mean, it sounded like Liam was this foul mouthed 10 year old. When my mommy's a b****, my daddy goes to SLEmedicine.com. There he can b**** lots of other women. When I grow up, I'm going to be an SLEmedicine man.
Because my daddy's raising me without any moral compass whatsoever. Ashley Madison, find your lovers here. Why exactly are we singing this? Daddy, what's a rotisserie? So there you go. There you go. We knew he was going to be good. Oh, my God, that's hilarious. He's a good little fella. He's good. What really pisses me off about all of this. Oh, I love it.
is I bought the Cletus puppet and I was going to blow up my last spot. You know, I was going to blow up my spot instead of doing something dramatic at the end. I got this stupid ass puppet and
To do Cletus, because Cletus used to call into Cardiff's show all the time. Oh, no. And for the people who are watching this, if you want to watch this stupid stuff, you go to YouTube.com slash at weird medicine. And let's see if I can get his corncob pipe in his mouth here.
Well, how are you all doing there? So he was going to do, well, howdy do, Miss Tight Box. You surely are a sight for sore eyes, Lordy. You are finer than a frog hair split four ways. Let me see. Now, Miss Lucy, I'm addicted to brake fluid, don't you know? But that's okay. I can stop any time.
Well, because, you know, a break, you know, they stop. Coleslaw, what did one eye say to the other? Between you and me, something smells. Well, you know, because that's because, you know, there's a nose in there and you smell with your nose, don't you know? Coleslaw, what do you say to a llama that loves going to a picnic?
Alpaca lunch. Because, you know, an alpaca is one of them kind of animals, you know. I can't stand them Russian dolls, you know. They're so full of themselves. You know, them Russian dolls. Dr. Scott, you open one, there's another one inside there. Cold slaw. Well, hey, Dr. Scott, why couldn't the pony sing in the church choir?
Oh, gosh, I have no idea. Well, he was a little hoarse. There you go. Well, you get that. Coleslaw. I had one where Miss Lucy was going to say that. Here, you be Miss Lucy, all right, Dr. Scott? Okay, I'll be Miss Lucy. All right. Tell me, oh, you know what? The mailman made a pass at me. Go ahead. You can improvise. Well, you know, the mailman made a pass at me.
Oh, how dare he? He did. He surely did. Well, how dare he? Do you get it? Because there is the milkman. Don't you know? I was thinking it's the mailman, but it's the milkman. I'm so confused. The milkman, you damn dumbass. Miss Lucy, I'm going to give you some advice. Don't never believe what an atom says.
They make up everything. Oh, you get it. Because, you know, Adams. Anyway, that's what you're missing. They miss it. Oh, my God. That's what you're going to miss at DabbleCon. That was going to be my finale. I love it. I have 10 minutes of that.
And I was going to keep – I was going to do the Opie Hughes rule of comedy, which is it might be funny. It starts out funny. Then it becomes not funny. You keep doing it until it becomes funny again. Okay. Got it. Got it. But anyway, so that's not going to happen now either.
Anyway, all right. Oh, man. Why do teenage girls always travel in odd-numbered groups, Dr. Scott? Because they just can't even. You get it? Because they say that. Oh, they can't even. There you go. All right. God. All right.
God, I didn't just knock us off the air, did I? Oh, there we're there. Okay. All right. You want to answer some questions? Let's do it. All right. One thing. Don't take advice from some asshole on the radio. So what I'm doing here is there are just voicemails that I have not downloaded, and we're just going to do them off the phone.
a cuff. Okay. These are people who called 347-766-4323, left a voicemail. Normally I download them and I will respond by sending a text. And, but I didn't do that on any of these. So we're just basically going to be doing them, as I said, off the cuff. And the first one is from our buddy, Stacey Deloach. What a surprise. Let's see here.
Hey, folks. Hey, buddy. Hope you all are doing good and everything. Oh, yeah. Not so good. Got a little question for you. You hear about the different levels of cancer.
Yes. Stages one, two, three, and four. So since four is the highest, and that's generally, as far as I would know, would be terminal and everything. Well. What's the characteristics of stages one, two, and three? Okay. When would you elevate from one to the next? Yeah. And it. See y'all. Bye, Tay-Tay. Bye. Well, we'll see you later. We'll see you.
So stages of cancer, why do we stage them? We stage them not because we just like classifying things, but because it may speak to prognosis or treatment. So treatment of stage one cancer may be, well, will be different usually than treatment for stage four cancer. So mostly the stages one through three have to do with size,
In a tumor that is still in the place where it started. Okay. So if you have, let's say, a breast cancer...
Stage one may be a certain, we could look it up, but it's different for different cancers. But let's just say some cancer, stage one is one to two centimeters in size. And then stage two would be 2.1 centimeters to four centimeters. Stage three would be greater than four centimeters, but still in that location. And I'm just making up these numbers. Stage four would generally be
that is spread to a distant site. Could be skin, could be liver, brain, whatever. Now, when Stacey says stage four is generally considered terminal, maybe. You know, we're getting a lot better at this. Some stage four cancers we can control, but
We're not to the point yet where we're curing a lot of those, but that's coming. That CAR T-cell therapy that we've talked about, the chimeric antigen receptor T-cell therapy, where they take white blood cells out, train them, and inject them back in to kill cancer cells.
has in some, particularly in the experimental models, cured people with stage four disease. And there are some viral oncolytic treatments for say multiple myeloma that have affected cures too. So we're getting there.
But, yeah, stage four, definitely worse than stage one, two, or three. Which stage four? Is that something that most people have heard? Metastases? Correct. That would be metastatic cancer generally. Metastases spread to other locations. There are exceptions to this. And the staging, again, the reason they stage it is because of differences in prognosis or treatment.
So, for example, small cell lung cancer really only has two stages. It has limited stage, meaning it's confined to the lung, or extensive stage, meaning it is now metastasized. And the reason for that is there's just really two ways of dealing with it. And the prognosis is different between those two, but everything in between, there's not that much change. You would treat it the same, prognosis is the same. Gotcha.
So that's the cutoff for that one. But that's basically what that is. And every tumor type is different. And, I mean, some of them are very similar and may even have the same criteria for staging them, but they're different diseases. And it's still all a...
a disorder of the immune system and very soon we're going to have nothing but immune modalities for treating cancer and I really feel like we're going to look back at the era of chemotherapy as being barbaric just
A little bit more scientific than the era where we were bleeding people to get rid of their malodorous humors, you know, but not much more. So anyway. All right. Okay. Let's try this one. Oh, yeah. Here's a good one.
Dr. Steve. Yes. I'm trying to get a hold of Sam Roberts. Okay. Don't forget that Val Kilmer played John Holmes in Wonderland. Yeah, that's non sequitur for me. I'm not sure what that was about. But yeah, I can pass the message along to Sam. And if you want to reach out to him, he is at not Sam on X, formerly known as Twitter. All right. Let's see here.
Hey, Dr. Steve. It's your old pal Joe in Virginia Beach. Hey, Joe. Hey, I wanted to talk to you about my heart. Okay. I have high levels of lipoprotein little a. My doctor ran a test and my level is 152, which is high by any standard. Yep. And as you know,
they do not typically run this test in a standard lipid panel. Correct. So being on my Crestor as I am and my Trilipix and Vaseba, my numbers have all been in the normal range except for this lipoprotein little a. Yeah. So I'm a little concerned about my heart health because of that. I am curious about,
If there is a cardiologist out there, if it's standard practice at all to get an angiogram at the ripe old age of 54 just to see if you have any blockages, any silent blockages going on. Yeah, I like the way he thinks.
We have an answer for him, I think. I've had the calcium score twice. My last one was five, and that was about two years ago. But I'm just a little concerned at my... Yeah. So lipoproteins, let's just talk about that. Lipoprotein A is a type of LDL. That's a low-density lipoprotein.
And it's got an extra protein attached to it called apolipoprotein A. And high levels of that are a known risk factor for heart disease and stroke. Now, knowing that you have high risk factors means you're less likely to die from it because you're going to do something about it. The problem is that...
Despite the fact that we know high lipoprotein A levels are associated with increased risk of heart attack, strokes, and other cardiovascular problems, there's no medication currently approved to directly lower lipoprotein A levels. That's the problem. There's a lot of research going on. We don't even know whether this is a marker or a cause.
may simply be a marker because lipoprotein A levels are largely determined by your genes and lifestyle changes have much less of an impact than they do with LDL cholesterol. The fact that his
calcium score is extremely low, is encouraging. Now, the calcium score will not show soft plaques, but most people don't have those. So you could talk to a cardiologist. I'm going to bet that they're going to be very unlikely to be convinced to do an angiogram on you because in your case... So there's this thing called Bayesian logic and
When you do a test, there is a pre-test probability and a post-test probability. So, for example, if you have no sore throat, right, and no symptoms, your pre-test probability of having strep throat is close to zero. If I do a test that has, say, a 10% false positive rate, right,
and your rate and your test is positive for strep, I'm still not going to believe it because the post-test probability is still going to be exceedingly low. Okay? Even though you have a positive test. That make sense? So, you have to take these things into account. Now, the angiogram is the gold standard, no question about that. But I think they're going to go, your pre-test probability is so low that the risk outweighs the benefit. Now,
That's just what I am guessing they're going to say. If you have a strong family history, you didn't tell us any of this stuff. If you have diabetes, if you're a smoker, you have high blood pressure, that kind of stuff, then they might be convinced to at least do a stress test on you. And the stress test would then, if it's...
stone cold normal that I think they would be very unlikely to proceed with an angiogram. But that I think would be okay. And it certainly would be okay to ask them about it, particularly if you have multiple risk factors. When are they going to come up with a pill form of an angiogram? That's what I want to know. Like a pill form for the GI tract. Oh, yeah, yeah. Wouldn't it be cool?
Yeah, something that would just go to the blood vessels and then you could just take a regular X-ray. Yeah, just kind of trace it through. Wouldn't that be cool? Yeah, it would be cool. I mean, it'd have to be obviously teeny. Oh, you mean something that would actually work its way through the blood? Shit, I don't want that in there. No, no, I mean, I'm talking like super teeny. Well, it'd have to be a nanoparticle. And then how would it be able to see anything? That's the problem. If it's small enough, the wavelength of light will be greater than the size of the thing.
Yeah, but wouldn't you think maybe it could show off light and you could take pictures of it as it goes through? Oh, now that might be something. And all of a sudden you look at the light and it all of a sudden does this. Yeah, yeah. It's pinched. You're like, uh-oh. And it's right in the corner of your artery. Yeah, maybe. That's our next million dollar idea. That's a good idea. All right. Let's see here. That's Joe in Virginia Beach. Oh, Joe. Hilton brings you new ways to stay with experiences that let you capture the glory days.
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All right. I don't know what this is. Hey, Dr. Seed. It's D.R. Perkins. You asked me to give a call in with my suggestion for your next podcast. Okay. It's D.R. Perkins. I always thought it was Dr. Perkins. It's like we have this place and it's M.R. Cleaners.
And if you go in there or you call them and say, is this Mr. Cleaners? They get all huffy. And they go, no, it's MR Cleaners. No, it says Mr. Cleaners. Yes, I know what you're talking about. Make it M period, R period. Maybe people will get it. Yeah, I agree. You know, if you don't want people calling it, don't get huffy about calling it Mr. Cleaners when it's literally Mr. Cleaners on your side. So D.R. Perkins. Okay. Now I know.
Okay. Yeah, because I'm going to be in a hospice. Oh.
We got lied to. They said they'd had nurses nearby. They had nurses on call 24-7, but they weren't nearby. And, you know, some of the—well, we'll talk about all of this. We'll get to all of it. Maybe now that you're retiring, like I said, you can be candid. Maybe. Yeah, no, I would absolutely—I'm going to be candid anyway. This doesn't have anything to do with me retiring. No. And I'm not retiring retiring. I'm still going to be working for the next six and a half years. Right.
Well, six now, now that Beck has retired. I will retire the day Beck graduates from veterinary school. That's six years from now now. So because he's completed his sophomore year of college. But I have no problem speaking candidly about this. There are shitty hospices out there. There are shitty hospitals. There are shitty doctors. There are shitty post people, shitty doctors.
People who own cleaning, you know, cleaners, you know, there's all kinds of stuff. So you will run again some really crummy ones. I ran into one that, well, God, I can't even talk about it, but they were really bad. And, you know, some of them have rules that are outside the rules.
Medicare rules, and I'm just getting mad thinking about some of these cases that I've dealt with. So there are crummy ones out there, and how do you weed them out? Well, word of mouth is one. I mean, they told him that there was going to be somebody nearby, and that was incorrect. Now,
And lots of reasons could have been that they could have had a nurse that was in their area that that quit. And now they had to cover or maybe that person was on vacation. The person covering was two hours away. Some of these hospices have huge catchment areas. So you have to ask them that.
I think, but word of mouth, who did you have a good experience with? They all have to be Medicare certified, so they have to meet certain minimum requirements. But what I've found is Medicare doesn't pay a whole lot of attention
unless they get a complaint to, say, a hospice agency that does their interdisciplinary team meeting without a physician present or that dismisses people because they cost them too much money. That's actually not legal for them to do. So hospice basically for a Medicare patient kind of is a federally funded program. In other words, it pays the...
Medicare will pay 100% for hospice services for people who have a prognosis of six months or less who have decided not to pursue curative or life-prolonging treatment. Those are the only criteria. Now, I'm going to give you all one. If you're playing poker, you need to know the rules. If you know the rules and the other person doesn't know the rules, you're going to win, right? So here's the one rule of hospice.
This patient or my mother or my father or my brother, sister or my, you know, whatever, would be more comfortable if only they had X. Whatever X is, they pretty much have to give them. So you'll hear, well, hospice doesn't do blood transfusions. Well...
My father has myelodysplastic syndrome. They have symptomatic anemia, and they would be more comfortable if only they had a couple units of blood. Then they have to do it. There are people who say, well, you can't get IV fluids. Well, my uncle, who is in hospice, is...
having agitated delirium from severe dehydration, he would be more comfortable if only he had a bolus of IV fluids. Then they have to do it. So as long as you couch things in terms of comfort, it is true if you have bone marrow failure, they will not
Check your, you know, come out once a week, check your blood and transfuse you if the number is under eight. But they will transfuse you, or they're supposed to, if you have symptoms from your anemia. Hmm.
So anyway, when they come out to the house, you need to ask them these questions. If I have an emergency, what's going to happen? How far away are people? If that person, do you have somebody in my area? Oh, yeah, we have a whole office full. What are the odds that I'm going to call you at 2 in the morning and somebody's going to be two hours away? Well, if they say, well, you know, we rotate call and, yeah, probably two-thirds of the time it's going to be somebody like that, you might...
Think of getting somebody else. Here's another thing. Where do you admit your inpatient hospice patients to? In other words, if my symptoms get so bad that they cannot be managed at home, every hospice agency is supposed to have
a contract with some facility where they can put you in and do symptom management. If they tell you, well, we can put you at this nursing home and it doesn't have a good reputation, then that might not be satisfactory for you. You want a place that either has a hospice house or access to a hospital where they can have people on call 24 hours a day, seven days a week doing symptom management.
You know, where do you do your respite care? So if you are a caregiver and you're taking care of a hospice patient and you become exhausted, where are they going to put them? There's a five-day benefit for putting somebody in a hospice house, a hospital, or a nursing facility for what they call respite care. Where do you do that? How does that, you know, what's the mechanism?
You know, if I need, if I fall and break my ankle, do I need to call you first? Which, by the way, you always should. And are you guys going to pick up the phone when I call? That kind of stuff. So and you'll know just by the admission process, if it's cumbersome and disorganized and chaotic, then their care may be as well. But, you know.
A lot of times a liaison will come out to the house that won't be the nurse that you're going to be seeing. But hospice is a great program. You just want to have a really good one. And you get nursing care, specialty trained. You get any medical equipment paid for 100%. It could be oxygen concentrator, hospital bed, trapeze for your bed, that kind of stuff. Right.
And it'll pay for any medication required to keep you comfortable. So they're not going to pay for your blood pressure medications. You can still take them. Mm-hmm.
But they're not going to pay for it. They're going to pay for anything that's required to keep you comfortable. Gotcha. And, yeah, you just have to talk. And the other thing is if you get one and they're unsatisfactory, call another one, get them to come out there, and then once you've got them set up, then fire the other one. You can do that. You can vote with your pocketbook anytime. Only you can revoke your Medicare or hospice benefit. Okay? Gotcha. All right. That's good news. All right. Good info. Good info. I hope that helps.
All right. Let's see. Hey, Steve. Quick. Well, it's not really a quick question, but it's OK. I'm not concerned, but my knowing that I'm OKing a vaccine for my daughter, specifically HPV. I don't know why this one's freaking me out because she's older. Yeah.
Is, I'm assuming that it's a standard vaccine. Right. And long-term studies, all that, like as opposed to some other vaccines. Yes. Correct. I know. Maybe more. Thank you. I know what you're talking about. And thank you for not making me go into that again. I don't want to get any more dunning letters from people. Thank you. What is the best way about going to research these things? Yeah. And.
Yeah, I know. Instead of just doing a Google search and getting, you know. Google search isn't the worst thing as long as you're using quality sources. From mainstream, so. Yeah. So let's talk about the HPV vaccine.
It is our first, although I had a doctor, you know, fuss at me for saying that it's the only cancer vaccine that we have right now. He reminded me that the hepatitis B vaccine technically works.
will prevent cancer in people who get chronic hepatitis B and end up getting hepatocellular cancer. So he was right about that. But the HPV vaccine was designed to stop the scourge of a common cancer, a.k.a. cervical cancer. And HPV strain 16 and a couple other ones,
are known to increase the risk and to be the precipitating factors for cervical cancer, which is a really, really shitty cancer. It's considered very safe. It's had extensive monitoring. It came out, I think, while we were doing the show and we didn't have long-term data, but we were in favor of it because the studies were so good in preventing infection
infection with the really pathogenic human papillomavirus strains, which cause, by the way, not only cervical cancer, penile cancer, rectal cancer, and head and neck cancer. So we're talking about a lot of different cancers that this stupid shit-ass virus causes. And
There can be some mild side effects. They're usually temporary. You know, the serious adverse events, I can't say that they don't ever happen, but they are extremely rare. When they do happen, it's, you know, a problem. And, you know, it's usually anaphylaxis, and it's usually three cases per one million doses. That is very treatable. According to my research,
High quality sources, there's no evidence of long-term side effects associated with HPV vaccination. And the benefit far outweighs the risk because we are seeing already a decline, a statistically significant decline in HPV.
abnormal pap smears, and a decrease in the incidence of new cases of cervical cancer. So it's working. We're not quite a generation in. When did the HPV vaccine come out? Can you look at that? And I will – I know Carl loves it when –
But he's when I Google stuff on the air. But H206. OK, so 2006. So we're looking at nine years. So we've got, you know, 10 years considered long term data. So we're coming up on that. Yeah. And can you also Google decline in cervical cancer since since 2006?
and see what we can attribute to the vaccine, because I know that there has been. I can put my fingers on the data.
the decline in abnormal pap smears. Looks like the introduction of the HPV vaccine has been linked to a significant decline in cervical cancer rates, particularly among young women. Studies have shown substantial reductions in mortality, with some reporting 62% drop. Jesus. And cancer deaths in young women under 25, which is, I'd say that's pretty significant. Okay, now that's a relative increase.
risk number. The total numbers of young women dying from cervical cancer are pretty low. Trevor Burrus: Right. But that makes it really low. Dr. Peter Van Doren: But that, right. Correct. Trevor Burrus: Really, really, really low. Dr. Peter Van Doren: Correct. 62%. We do things in medicine for a 5% improvement. Trevor Burrus: Yeah.
And I bet that's aggregate, including women that have not had the vaccine. I'm going to bet because I'll bet if you look at just women that had the vaccine, the number is even lower than that. So anyway. All right. So I got a little more. Yes.
I understand what's going on, and I'm hoping my daughter is not one of those. Yeah. Yeah. I can tell you this. I had my kids get the vaccine, if that tells you anything. Real quickly, they also showed that there's been less head and neck cancers in men and boys. Yeah. Yes. Head and neck cancer can kiss my ass. Oh, it's terrible. Yeah.
Terrible. So, yeah, rectal cancer is no walk in the park either. No. Okay, can I throw in penile cancer into that mix? No, no, no. Don't do that. Don't do that. Because. There you go. I love to masturbate. So that would be a bad cancer to have. So, yes. So that one I'm feeling pretty good about recommending.
You know, read the package insert. There are risks to everything. There are risks to walking across the street as well. So walk across. It'll always look both ways. And when you're going to get a vaccine, look both ways. If you want to email me, I'll send you some of the research that's out there. You can go to PubMed.gov and look at HPV vaccine safety. And there's tons of articles about that too, Phase 3 and Phase 4. All right. All right.
Okay, this one I answered last time. Let's see. Here we go. Hey, Dr. Steve. This is Bill from Texas. Good to talk to you again. I hate to see you go, but I understand. But again, I hate to see you go. Thanks, man. And Dr. Scott, Cincinnati Reds suck still. My question is, I have a bowel movement. Majority of the time, it sinks to the bottom of the bowl. Oh, we did this one last time. Yeah, we did this one. And the Reds do still suck. Yeah, yeah, yeah. Okay. Okay.
Okay, I think we've exhausted those new voicemails. Let me delete all these here. All right, well, let's go to some of the other ones that we've got. We've got like thousands in the back. Hey, Dr. Steve, why the fuck do I sweat for a half hour straight like a pig after a workout? It's really embarrassing. Thanks. Bye. You want to take that one, Dr. Scott?
Well, he's... Everybody's different, for one thing. Yeah, everybody's different, and...
For one thing, it's good that you're sweating and sweating out the heat so you don't overheat. Correct. Older people like me who exercise who don't sweat are at risk for a heat stroke. And I've seen it where people's core temperature jumps up to 104. You think sweating doesn't do that much? The evaporative process does carry off a lot of heat. Yeah. And sometimes your nervous system just isn't balancing itself out properly between the autonomic and...
Yeah. So my thing is if he's working out and he's sweating, could he just jump in the shower and cool off that way and then stop sweating? Yeah. Or do something less intense towards the end of his workouts. Yeah. Do the higher intensity. I am going to throw this out here. If you're having abnormal amounts of shortness of breath with palpitations or nausea while you're sweating because you're exerting yourself, I want you to talk to your primary care about that.
Because one of the symptoms of angina, or some people call it angina, is a thing called diaphoresis, which is profuse sweating. And it's usually associated with exertion. So my dad had it.
But he had atypical angina in that it was his left shoulder would hurt, and he just thought he had bursitis or something when he would work out, and he would sweat, and he would have this bursitis in his left shoulder. And when they put him up on the treadmill, he started sweating, and then he had the classic changes on the EKG, and he started having the left shoulder pain. And he said, oh, I just thought that was my shoulder. And it turned out that was his presentation of angina. So...
If there are any other concomitant symptoms or if you are at risk for heart attack, i.e. family history, diabetes, high blood pressure, high cholesterol, or you smoke, please talk to your primary care about this just to make sure we're not missing something. Yeah, I mean, unless he sweats profusely all the time, he might have like a hyperhidrosis. Right, if it's all the time. But if it's just with exertion, I always...
You know, you always want to rule out the really bad things first, and then you can attend to the sort of lifestyle. Yeah. And if it's just after exercise, I would say, look, try to turn off that autonomic nervous system. You know, cool everything down right at the end of the exercise. Yeah. You know, that way maybe you won't sweat as long.
Get in front of a fan. Yeah. All right. Yes, hi. My name is Jed, and I'm calling from Jackson Hole, Wyoming. Hey, Jed. I have a little issue which only happens in the mornings. When I wake up, I feel a little sick to my stomach, and then I get a little bit of the dry heaves, and then it goes away.
for the rest of the day and then it repeats itself again in the morning. I have spoken to my primary about this and really the only thing that we can find is that I have higher than normal blood pressure which we are currently controlling with diet and exercise and so on and so forth but that hasn't helped with my little morning sickness.
Do you know what he has? I think I have an idea. Well, I've got two ideas. Okay, let's go. He can have post-nasal drip draining into his sinuses at bedtime, and that can make you nauseated in the morning. Sure could. Because your stomach's full of mucus. Yep, and number two thing is he could have some gastroparesis, and a slow gastric emptying can give him GERD. Give myself a bell. I think it's reflux. Yeah, I think it's probably reflux, too, but it could be a little bit of both. So, yeah, when you lay down...
Your gravity isn't pulling stomach contents into the bottom of your stomach. It's layering it out, and it can fill up your esophagus even. And people who have silent reflux in the middle of the night will wake up with nausea as their primary symptom, and the gagging goes along with it. So I would recommend a couple of things.
First, make sure you tell your primary about this. Second, well, he did. He did. I would take maybe some famotidine before bedtime. That's known as also Pepsod. A floating antacid like Gaviscon. And then put a brick under the head of your bed.
Just enough, just a couple inches. - Doesn't need much. - If you bend, if you use one of those pillows that bends you, it's gonna be worse, particularly if you're even a little bit overweight because then that bend will push in on your stomach and it will force more contents into your esophagus.
But you want to raise the whole bed and see if that doesn't help. If it does, that pretty much makes the diagnosis. But at some point, you're going to want to maybe even get scoped so they can see where your hiatal hernia actually is and how bad it is. The other thing, real quickly, is just making sure your stomach isn't cold at nighttime. Oh, yeah. This is Dr. Scott's. Maybe a little warm tea before bed. Yep.
Will help increase motility of your stomach. And no carbohydrates within six hours before you go to bed, and maybe even longer. And sometimes if you can poop. And no alcohol, too. If you can poop before you go to bed. Oh, yeah. If you can have a bowel movement before bedtime, then when you go, then things will start to move through your stomach, and you'll have that feeling. There you go. I'm pretty regular, Dr. Scott.
I can't rightly go to the outhouse in the middle of the night like that old black weirdo. Bite me on my behind. Or black bar. Or the black bar. Oh, no, no. All right. Shut up. There you go. Myrtle. All right, Dr. Scott, before we go, let's hit the fluid family. If you want to join the fluid family, it's youtube.com slash at weirdmedicine.
And click join, and you don't have to pay anything. You just click accept gifted memberships, and sometimes Myrtle goes in and gifts memberships. And I want to thank Corn Diff for being a member for 14 months. He is a talking ear of corn. Quite delightful. And when Opie asked him why corn, he said, well, we're not that good.
You know, we're not that unusual. Corn's pretty plentiful. That's pretty funny.
All right. Yep. Yeah. Outlaw Josie Wales says Dr. Steve puts the spice in hospice. That's hilarious because I used to have a screen or a login that was doc hospice because hospice doc was already taken. Tacey came down. She said, who's do docho spice? Oh, my God. Yeah. Docho spice.
Oh, my God. So anyway, let me see. Can you explain why Cardiff is a potato? I missed something. Are you serious, McRibs? Yes, absolutely. I can explain why Mr. Cardiff is a potato. There used to be a show called Mom's Swipe Left. They were delightful from Maine. I was on their show once and guest. They played a 20 questions guest game that was what's in what.
Oh, somebody's vagina. Oh, God, I'm so sorry, ladies. I've forgotten her name. But what's in so-and-so's vagina? And I took like three guesses and guessed it was a stapler. It looked like a genius. It was just a lucky guess. But anyway, so there was a guy who was a simp for them, and he was called Pom Deterre. And he had a potato filter, and he would do a breakdown of their show.
And Cardiff started goofing on Pomme de Terre by having a potato filter that was exactly the same filter. And he would do mom swipes left after swiping left or something like that. He did a show making fun of Pomme de Terre. And then he kind of couldn't get rid of it. Now he's the floating potato. Oh, my. So he actually stole it from somebody else. Oh, my. Let's see here.
Oh, yeah. King of all dips. I'm sorry, dude. I know. I know. I know. I know. He said you were 90% of the reason I was going 10% potato, orange and broccoli. Oh, the broccoli would be too key. No, they're awesome. They're way more fun than I am. And I am really, really frigging bummed about this. And it was one of those situations where I was going to be bummed either way. But, you know, I've got to do what's right for my kids. Yeah.
And, yeah, Outlaw Josie Wales says, thanks for all the shows over the years. Weird medicine fan since day one. These shows have been cool. And then he tries to trick me into saying something that I will say on the very last show, but I'm not going to fall for it. It has to do about someone's mother's nether regions.
And let me see. Okay. Crispy Biscuit. I've been a hospice RN for 5.5 years. I worked for small hospices for four years. Now the biggest one in the country for 1.5. I'm honest with families on the pros and cons of big, good, good. Well, Crispy Biscuit, we should have you on the show sometime. We love our hospice nurses and I work with them every single day. So, and you know, I want to make sure everybody understands the vast, vast majority of
hospices and the overwhelming majority of people working in hospice except for the few that are burned out are wonderful wonderful people and if they're shitty they don't last very long so crispy biscuit here's to you yeah well wait a minute I don't have a bell here she is
I say she absolutely could be a he. There's lots more bros in nursing now, which I think is really cool. When I walk through the internal, the ICU in our biggest hospital, I'd say 60% of the nurses in there are guys now. Which is good. Yeah, it's good. That does a couple of things. A woman...
who is a physician doesn't automatically get assumed to be a nurse anymore because of the, I mean, there've been women doctors forever. And actually in my class, which was 1982 to 86, there was a majority were women, but I still have women partners who are physicians who walk into the room and they still think that they're, they're nurse. So that is changing with more bros being in nursing. And, um,
The stigma of the male nurse is no longer in the 80s. It was there was a certain stigma about it. And that does not exist anymore. So all of that stuff is good. It's all very positive. So crispy biscuit. If I misgendered you, I apologize. McRibs says Dr. Steve went to my doctor last week, asked about that bump above my ribs below my incision.
but was trying to cover his ass so much he never wrote in my chart other than I'm Benzo dependent. Oh no. So what did he tell you? He or she tell you? Oh, he said he. So, um, goodness gracious. Saxon Savage says he's going to miss Myrtle. No, you don't have to. I'm,
I am bummed right now. And honestly, this morning, I'm like, I'm packing all this stuff up and I'm selling it. That's not going to happen. We're still going to do shows. They're just not going to be serious XM shows. And I'm really afraid I burned my bridge with the dabble verse. And I'm very bummed about that because this is kind of last minute. I mean, it is May or May 10th. And that is what? Two weeks, two weeks from now.
So it's kind of shitty to bail this soon. But Liam told me last night. Yeah. You know? It's his fault. No, I'm proud of him. I'm proud of him. D-Cabinet. No, it's not the end, just the end of SiriusXM. And, okay, McRib said, Mr. Doctor asked if I'm still taking my 80 milligrams of Lipitor. I told him I'm done. Too many side effects. And he came out with Lipitor.
I read it causes diabetes. What? What? Yeah, there's a lot of studies showing statins cause type 2 diabetes. Well, he was on a megadose statin. Hey, diabetes is diabetes. Yeah. Okay. McRib says, OMG, I thought the potato was to hide because of something he did. Well, no, it's not because of something he did. He started hiding his face.
And now he can't stop. And it's become a bit, you know, that we're and look, if you've ever gone to one of the live events, you've seen him. You've talked to him. Lots of people have seen him and talked to him. And lots of people know who he is. But he's done. I have a picture of him dabbing in front of a clock that's stuck at 420. And it's one of the greatest. I can't post it, you know.
So I did post a group picture once that could have doxxed some people without thinking about it, but you know. Oh, Crispy Biscuit says, no worries, I'm a male. So I'm glad I at least acknowledge that I've probably misgendered you. I get mistaken for the doctor all the time, right? There you go. See, it works the other way. I quickly correct that. Sure you do. No, I believe it. Don Phillips showed up. There's old Don. What's up, Dandy Don Phillips? Dandy Don Phillips.
Saw the announcement on Reddit. Is this real? No, this is not the final episode. What that announcement on Reddit was is that I'm not going to Hackamania. But the Hackamania was supposed to be the final episode. I sent an email to Jim McClure today just saying, you know, when do you want me to do the final episode? I would like to say the...
the YMB thing live on the air. So we'll see. Hopefully doing that, they're not just gonna go, "Okay, well you're done. We're just gonna play replays until we find something else." Saxon Savage, "You're doing the right thing. Thank you. You're a good dad." Actually, it's one thing I'm proud of. I think I am a pretty good dad.
And good dads have to make hard decisions sometimes. Thank you. You know, actually, Saxon, of all the things anybody said to me about this since it started, that makes me feel better than anything anybody said to me. So thank you. I appreciate that. And we don't even know each other. If any of your kids, they know that's the truth. They turn out great. Despite their age.
Yeah, Don, we still have a few episodes to go. So anyway. All right. I didn't see any other questions in there. Nope. All right. Well, listen, my friends, thank you all very much for hanging with us. Thanks always goes to Dr. Scott and everyone who's made this show happen over the years. Listen to our Sirius XM show on the Faction Talk channel. Sirius XM channel 103, Saturdays at 7 p.m. Eastern, Sunday at 6 p.m. Eastern. On demand at other times at Jim McClure's Pleasure. And
And many thanks to our listeners, particularly the Fluid family. Those voicemail and topic ideas make this job very easy. 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 Weird Medicine. Thanks, everybody. Thank you. Bye.