634 - Achenbach Syndrome - Waylon and Willie and the Boys
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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 clown. Number one thing, don't take advice from some asshole on the radio. I've got diphtheria crushing my esophagus. I've got Ebola vibes dripping from my nose.

Requiem for my disease. So I'm paging.

From the world-famous Cardiff Electric Network studios in beautiful downtown OJ City, it's Weird Medicine, the first and still only uncensored medical show in the history of broadcast radio, and it's now exclusively a podcast. I'm Dr. Steve with my little pal, Dr. Scott, the traditional Chinese medicine provider. Gives me street cred, the whack alternative medicine assholes. Hello, Dr. Scott.

Oh, oh, your mic's not on. What's going on? Let's try that again. Hey, Dr. Steve. Hey, Dr. Steve. Oh, there's the reverb. I like it. Oh, goodness. Hey, Dr. Steve. Oh, this is so much better than the other show. Yes. And ladies and gentlemen, Lady Diagnosis back from sabbatical. Hello, Lady Diagnosis. Hello, 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. Follow us on Twitter at Weird Medicine. I was thinking for a second, God, did I need to change that too? No, we're good. Follow us on Twitter at Weird Medicine or at drscottwm and at Lady Diagnosis, right? Yes. You still on there? Do you ever check it? Never. I will.

Visit our website at drsteve.com for podcasts, medical news, and stuff you can buy. And most importantly, we're not your medical providers. Take everything you hear with a grain of salt. Don't act on anything you hear on this show without talking it over with your health care provider. One thing I want you all to do is go to stuff.drsteve.com and scroll down and you can find our card game.

called Wet Brain. It's a Dabbleverse-related card game. It's based on the game Presidents and Assholes. It's a party game. It's fun. It cost me a lot to make it, so unfortunately it's on there for $30, but I'll autograph the back in gold and all that stuff. If you want it, go to stuff.drsteve.com.

And we use Shopify, so it'll let me know if I start running low on stock, and I'll get it out there ASAP. It's usually a less than 24-hour turnaround, but stuff.drsteve.com. And also you can scroll down and see the Rody robotic tuner, which we use in the studio to tune our instruments. Sometimes you wouldn't notice that we tune them, but it is a robotic tuner, and they also have...

a thing called the Rody Coach that'll teach you how to play an instrument. Lady Diagnosis, do you know how to play an instrument? The piano. Okay, so I've had three different people in here. One was DNP Carissa, who moved away, and then NPMel B., who has Raynaud's and couldn't really play, you know, it was difficult for her to play the instrument.

Of course, you have a condition that might prevent you from playing, but if I give you a roadie coach and a guitar, will you...

put the time in to let it teach you how to play and then come back so we can demonstrate that the stupid thing actually works. I would be willing. I don't make promises on if it's going to work or not. Well, no, no, no. You don't have to promise you'll succeed. Just will you give it a shot? Okay. And we'll talk in a minute why this may not work for you either, because everybody in here apparently has got some

goddamn, you know, malady that prevents him from playing an instrument. Some of us, it's just called lack of talent. Right, right, right. Which is different, of course. Correct. That's yours and my problem, but...

And then Patreon. Check us out on Patreon. Patreon.com slash Weird Medicine. I've got some exclusive content in there. There's classic shows you cannot get anywhere else because we did things when we first started that we really would just as soon not be out there. And all the video things that we are doing will now be there first. So...

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Check out Cameo.com slash weird medicine. I did several of them for Ahmed, our – remember our medical student from Saudi Arabia who got turned on to medicine by listening to our show. I still can't believe this. In Saudi Arabia now is living in – he's graduating here in – let me see.

22 days from residency and he's going to be faculty at a prestigious academic institution in the United States. So it's pretty cool. That is so exciting. Yeah, yeah, yeah. Very proud of him. Mumtaz Siddiqui

And I can't remember how to say congratulations, but I say barakah al-hufiq. It just means God bless you in Arabic. Anyway, Ahmed is an awesome dude. He had me come up to do grand rounds up there, and I got to meet some of his friends and

One of his friends is a ham radio operator, and I sent him a little what we call QRP transceiver. It's a digital transceiver that you can just throw up an antenna. Who cares? Anyway, but he's a cool guy, too. So hello, Dr. Adkins. I don't want to dox anybody. But anyway, they had me do a couple of things.

cameos for him for his graduation that was fun to do so anyway cameo.com slash weird medicine and most importantly simplyherbals.net that is simplyherbals.net and that's Dr. Scott's website people are complaining that they can't get the nasal spray it's back up okay so if you were having trouble getting Dr. Scott's nasal spray it is back up

All right. Lady Diagnosis, let's talk about welcome back to the studio. Thank you. Let's talk about your malady. So what's been going on?

Well, it's just out of the blue. Every once in a while, I get a pain in my knuckles, in one knuckle. It doesn't matter. It's been fingers and toes. All of a sudden, it'll start kind of burning a little. And I'll look at my knuckle, and it's blue. And it just spreads, and the pain gets sharper and hot. Yeah. And then whatever vessel vein explodes, and my whole finger or toe turns purple. Yeah. And then...

And then what happens? It just hurts. Yeah, and then what happens? It goes away on its own? Well, you know, it's blood in your finger, so it just wears away after like a week. Yeah, and then, okay. It doesn't really hurt after it explodes, though. It's the weirdest thing. Yeah, and then how, I mean, it sounds like scurvy, but how often does this happen, and then how much refractory time is there between the two episodes? Well, there's no rhyme or reason to when it happens. I mean, it can happen sometimes like,

Every week or sometimes it goes months and months. Yeah. So there's no associated with trauma at all. No. See, the thing that pisses me off about this is apparently you told me about this and I just blew it off and I apologize for that.

Because you came in with the correct diagnosis. So how did you, before we get to what the diagnosis is, how did you find this? Because this is correct. Wendy, my sister, I told her about it. God damn it, that pisses me off. I'm supposed to be the hero in this story. She's like looking it up and told me what I had. Thank God. Well, good for Wendy. She's correct. Thank you.

But this is a thing called Achenbach syndrome, and it's also known as paroxysmal finger hematoma. It's benign, self-limiting condition characterized by sudden, painful bruising and swelling of one or more fingers.

It's believed to be related to minor vascular fragility, which means you need to be on vitamin C. You need to be taking vitamin C supplementation if you're not already. Oh, okay. Because that... So the reason I said scurvy is that's a vitamin C deficiency, right? And I've seen one case of this in the United States where, well, there are, you know...

These sort of hermit guys that live up in the hollers and they will live on stuff that doesn't have vitamin C in it. And they'll get scurvy. And we've seen one case and they'll have palpable purpura, which is basically, you know, broken blood vessels under the skin. You can feel it. No, it's all over the place. Oh, OK. And it's because vitamin C is.

contributes to vascular integrity. Right? So getting on vitamin C, you might be able to reduce these episodes. So it's not hereditary? Because I believe I asked my uncle if he had ever had that happen, and he said yes.

Okay, well, and the other thing is, you know, the first thing when you first told me about fingers, you always think of Raynaud's, and so it is on the differential. Let's look that up real quick. Let's see. I think I have Raynaud's, too, because it turns, you know, just kind of bluish in the winter. Yeah. Okay, well, Raynaud's is a specific pattern. Okay.

So I've diagnosed several of those in friends of mine. I can't remember if I diagnosed male bees or not, but I have another friend that I diagnosed. And what you do is you put your hand in ice water and you leave it in there as long as you can stand it. And what happens is the blood vessels constrict. So when you take it out of the water, your hands will be white because now they're deficient in blood supply.

Then as they continue to be deficient in blood supply, it will turn blue, indicating cyanosis, right? And then as the blood vessels re-expand, then the hand will turn red as the blood flows back in again. So it's white blood.

and red, so it's very patriotic. Way to go, lady. That's right. There are other countries in this world that have, I think France's flag is also blue, white, and red, so...

But that is distinct from this. This is different. So let's look at the genetics. Okay. With the exact causes unknown, research suggests genes related to acute phase reactive proteins. Well, don't worry about that. And the coagulation slash complement cascade. Interesting. The complement cascade has to do with immunology. Okay.

might be linked to the condition, specifically the F3 gene. We can do genetic testing on you if you really wanted to. We have a geneticist at our cancer center that could do this. That would be intriguing. The observation of Achenbach syndrome in multiple family members supports the idea of genetic predisposition. Now, you have a unique reason why you wouldn't necessarily know that, and we've talked about it on the show, right? What's that?

why you wouldn't know about your family genetics. Oh, well, I did find them. And I did start talking to my uncle and I asked him about that. Well, it was as you were adopted and you found your family through 23andMe or one of those. Yes. Okay. Yeah. And so you talked to him and he said that didn't happen to him? Yeah. Wow. Isn't that interesting? And no one else in the whole world that I've ever talked to has had that happen. So it's not. Have you all ever heard of that? Yeah. Yeah.

Wow. Aukenbox? Yeah, I don't think so. Well, there is... If I have, it's been a long time. Yeah, there is a song about it, though. Oh, yeah, I remember that one. Let's hear about it. Yeah, I remember that song. Are you ready? Yeah, I believe so. All right, let me get you some... Test, test, test, test, test. There you go, test, test, test. The only two things in life that make worth living...

♪ The guitar's a tune good and firm, feelin' women ♪ ♪ I don't need my name in the marquee line ♪ ♪ I've got swollen purple fingers and they're hurting me all night ♪ ♪ Maybe it's time we got back to the Dr. Steve Show tonight ♪

Let's go to Hockenbach, Texas. No! Hockenbach Syndrome. And the boys... Let's turn up. Dumbass. These purple fingers and toes, I've got a feeling like I can't control my pain. ♪

Between Dr. Steve's pain songs and Dr. Scott's tray songs and G-Bach's blue eyes crying in the rain.

Out in Achenbach, Dix. No, Achenbach Syndrome. I know, you're looking at the words and it's hard to not say the words. He's obedient. That was my dead level best. Achenbach Syndrome.

Anyway. I love it. No, I wasn't mad. We just made it up on the fly. Stupid. All right. You can tell this show has gotten much better over the last 18 years. So, yeah. So, a lady diagnosis and her Achenbach syndrome. So, try the vitamin C and see if it makes any difference. Okay. All right. Let's talk about Angie. Anyone who owns a home...

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Good deal. All right. What about like magnesium topically too? Sure. Why not? Topical? Okay. Topically, yeah. Yeah. Topical magnesium? Or even nitro, topical nitro.

If it's bad enough, it's bad enough. See, her problem, though, nitroglycerin would dilate the vessels. Her problem isn't vasoconstriction. It's just they're spontaneously erupting. But you don't know it's coming until it's coming. And then it's like you have maybe an hour. How long does it last, though, did you say? The pain lasts maybe an hour. Oh, wow. So it starts, and then it stops. And then you feel it, and you look, and it starts turning. I could get you some analgesic crud.

cream for when it happens, for that hour when it's bad. It's bad, yeah. But let's see if we can't prevent it. What would be fun is if you kept a diary and you start taking some vitamin C and see if it spreads out those episodes or eliminates them altogether. Okay, I'll do it. And then if it does, we may want to

put a note out to other people, maybe we'll do a study on it. Yeah. Cool. All right. Very good. Well, let's do some questions. We've got some very nice questions. 347-766-4323. And let's, uh-oh. Hey, Steve. I am driving home from my night shift and I'm very tired. Okay. But I'm also hard. Excellent. Why is it when I'm sleepy do I become a boner guy?

Very curious. Yeah, Dr. Steve. I don't know. Because he's not 50 years old or 60 or 70. Yeah, I guess. I mean, he's off work. He's got less stimulus. Less stress. Less stress.

Yeah, I don't have a medical reason. Well, because this is not a known phenomenon. Well, if he works overnight, then he's coming home and first thing in the morning, your testosterone goes up in the morning. Oh, ding, ding, ding, ding, ding. Myself a bell. Yeah, that could be it. And cortisone increases in the morning as well. But usually it's after sleep. I just I'll have to look into that.

So he's working a night shift and coming home in the morning. That's what it sounds like, yeah. Wood. Yes, he's got morning wood even though he's not waking up. Maybe he's not asleep yet. I wonder if he's swing shifting because then his body could be attuned to having morning wood in the morning except the fact that he's awake. Yes.

And it also depends on who he's going home to, too. The number one pun says, let's hope he's not carjacking. He's living up to his name, that's for sure. Or he is carjacking.

Hey, one fun. Don't ever listen to what Adam says because they make up everything. There you go. Oh, my. All right. Oh, my. Next. All right. Yeah, I don't have a good answer for that, but I will see if I can find something interesting to make out of that. But I'm glad. Good for you. He's just bragging that he can still get an erection.

Yes. Of course.

If he says astragalus, I'm going to lose money. Okay. Say astragalus. Okay. That goes into one of the best calls of all time. Yes. Just for the astragalus reference. So that's a long-time listener. Let me take mine and then you do yours. Yep. Good. So back in the day, we used to write prescriptions for quinine. Right.

And quinine, I'd have these little old ladies and little old man like me now who would have these leg cramps that wake them up in the middle of the night. And it's horrible. You cannot ignore that pain. You go, I'll just lay here. You can't. The pain becomes unbearable.

And excruciating. And the only thing you can do is get up and walk around. And if you get up and walk around, it will go away. And there are ways that you can counter...

strain the muscles that are, but when the whole leg is cramping, you can't counter strain just one muscle. You're always going to be cramping another muscle when I say counter strain. So if it was just your calf, you could stand on a stair on your tiptoes and stretch your calf, or you could lean forward against the wall and stretch your calf that way. But when it's the whole leg, I've had cramps so bad that it went up into my quadriceps. Ugh.

So, and really, you just have to walk around, and then it goes away, and then it kind of stays away most of the time. But it is unbearable. So people will go, well, it's potassium, so eat bananas. All that does is constipate you and give you reflux. So...

I highly recommend quinine, but the FDA took it off the market. Would you look, Dr. Scott, and see why they took it off the market? I've always said it was rat cataracts, but I think there was something else to it.

But quinine was used way back in the day as a malaria treatment. So, I mean, it's been medication for a long time. Well, they took it off the market. But what they didn't take off the market is tonic water. Tonic water is quinine water. That's what I was going to ask you. And so when they did that, I started telling my patients to drink four to eight ounces of quinine water at night. And it actually works. And it's very beneficial for...

Magnesium is the other thing. So I combine it with a magnesium oxide. You need to buy a magnesium supplement and quinine water at night. And that will take care of it. Did you find anything? I did. Yeah, what did you find? In...

Looks like a span of about 50 years, the FDA found 93 deaths associated with quinine. What? In the world? Yep. And it was based on possible cardiac events, thrombocytopenia. Oh. But that's a pretty small number. And I'd be... That was why? That's what it says. Wow. Okay. Adverse event reports. Okay.

Interesting. Well, I mean, quinine, is it related to quinidine? But one would think it would be a pretty massive dose it would have taken. Yeah. Because in tonic water, it's a very small dose. Correct. Yeah, it's unbelievably small, and it still works. It's kind of like a... So, okay, so quinidine is a cardiac medication, and it is a stereoisomer of quinine.

Meaning that it is, they are not only related, but they're very closely related. One's left-handed molecule, one's a right-handed molecule.

So that makes sense that maybe it caused some arrhythmias in some people that were at risk. So if you have a history of arrhythmias, don't drink tonic water. But you can buy tonic everywhere. Every bar in this world, you can order a gin and tonic or a vodka tonic. So that's just for leg cramps, not like restless leg. Correct. Nocturnal leg cramps.

And I'll get them because the dog will lay on my leg sometimes and they'll cause me to dorsiflex my feet. In other words, point them away from my body. And I'll lay there for hours like that. And then all of a sudden my legs will start to cramp up. But Tacey started having leg cramps and I gave her tonic water and she just drinks it. She doesn't like lime. She doesn't like...

vodka tonics or any of that stuff. She just drinks it straight. It's pretty nasty straight. But you put a little, even if you're not going to drink it with alcohol, I'm not advocating that you drink alcohol, but if you put a little lime in it and ice in it, it's not bad. As long as you can tolerate bitter stuff. It's pretty bitter. Yeah.

But that's what I like about it. See, I've always liked bitter things. So I drink tea without sugar and stuff like that. Yeah. Tea should taste like tea, not sugar. Coffee should taste like coffee, not sugar. I agree. Me too. Real quick, just a couple other quick little things. Yes, of course. If you're speaking just in like... This is what the traditional Chinese medicine... We're talking leg cramps specifically. Yeah. A couple things. I like to increase electrolytes. So I like to maybe have someone add a little bit of...

Celtic sea salt to their water maybe before bedtime. Like a quarter of a teaspoon in about six ounces of water. Now what the fuck is Celtic sea salt? It's got a lot of trace minerals. I like to have them buy like a trace mineral bottle with all the minerals in it. A couple sprinkles of that. That makes sense. I would buy that. And certainly magnesium

Hydration is a big thing. Hydration. And that's the biggest thing, if it's leg cramps specifically. And, you know, other things, you know, massage certainly can help. You know, a little bath, warm bath sometimes will help too. When it's happening. Yeah. We're talking about prevention. I would try the electrolytes in my water before bed and even maybe during the daytime too. I'll buy that. Because it might be just a little bit dehydrated. And that's not always going to show up in your labs. And surely not on any MRIs or CT scans. No, there's never any labs that show up. You get someone coming in with...

Nocturnal leg cramps. There's never any laboratory abnormalities that are meaningful to that. Now, I will throw out that there are some people with –

And this is not the case for people who have just nocturnal leg cramps, but people who have leg cramps and cramps in other parts of their body that start coming more and more regularly. That is sometimes a nascent sign of ALS.

So we see people with amyotrophic lateral sclerosis, Lou Gehrig's disease, who have these horrible, horrible leg cramps. Now, just imagine if you're laying there and you can't, you know, your motion...

and now you have these leg cramps. You can't get up and move around. It's horrible. Without freaking everybody out, 98% of these fasciculations, these cramps are really benign. Oh, no, no, no. I would say 99.99%. I'm just throwing out there that it is a...

It is a part of the syndrome of ALS as well. So it just hurts. It's not going to hurt you having them. Right, right, right. Yeah, it's really annoying. And I can't imagine what they did in, you know, Henry VIII's time when something like this happened. Now, him, he would just have somebody come in and massage him and jack him off. And he probably felt better after that. So jacking off makes your legs go away. No, it just makes you not think about it.

That's all. All right. Oh, my. Let's see. All right. Let's try this one.

Dr. Scott, how are you? Awesome. Oh, I'm good. Thanks for asking. Let's do that one again. There we go again. Hey, Dr. Steve. Hey, man. Dr. Scott, how are you? Good. How are you? Oh, I'm good. Thanks for asking. As a 50-year-old male, of course, I have a question about menopause. Of course. I was wondering if there's a direct connection between

that a woman has a limited number of eggs and when she has menopause. So in theory, if a woman has four kids, she didn't have her period for 36 months. So does that mean her menopause onset is delayed by three years? Normally, if she didn't have kids or if a woman is on birth control and doesn't have a period for 10 years, does that mean her menopause would have been because she's not deleting

Right. No, I totally understand that. I'm serious. Congratulations on everything. Talk to you later. Hey, thanks, man. Everybody else, check out Dr. Steve on TMAO. He's awesome. Thanks, man. There's no way. I mean, birth control pills...

If this were true, there'd be women having menopause at age 70. Yes, yes. So birth control pills don't delay the onset of menopause. They can make it harder to know when menopause has occurred if you keep taking them. You shouldn't be taking them that late. It increases the risk of naughty things.

So but, you know, birth control pills use, you know, they use hormones to prevent ovulation. You know what else does breastfeeding? Women who breastfeed on demand will not ovulate and at the same rate as someone who is pregnant.

either not breastfeeding or just breastfeeding on a schedule. If you breastfeed on demand, that oxytocin release and other hormones that are generated during that will prevent ovulation. So women who live in countries where they just have a sling and the baby just breastfeeds on demand, they may only have, you'd think they'd have 20 kids because they're not on birth control, but they don't.

They'll only start ovulating again and be fertile or have potential to conceive after they've quit breastfeeding that kid. So they may breastfeed until the kids are two, three, four years old because it's cheap and easy to do and it helps prevent pregnancy. But they still go through menopause at the same time.

Because that's hereditary, isn't it, mostly? For the most part. I mean, it's genetic in the sense that women have sort of a time clock that's ticking that will, you know, at some point, the alarm clock will go off and they'll go through menopause. What about you, Lady Diagnosis? I'm in menopause right now. Are you really? Love it. Love it. Yeah. So...

It is interesting that if you still have a bunch of eggs in there, why are you still... But if you think about it, ovaries...

gradually just stop releasing the eggs and producing estrogen and progesterone so you may have some but you know you can run out of eggs I guess I mean there is a limited number of eggs men produce infinite amount of sperm as long as they're alive they're still producing sperm but women only have the number of eggs that they have but for the most part my understanding and OBGYN who's listening could call in and give us a more nuanced answer to this but um

You can still just stop releasing eggs even though you have them because it's just time. And you get these decline in ovarian hormones that you get the hormonal imbalances cause a variety of symptoms, including, you know, hot flashes and.

bone loss and that kind of stuff. So, but anyway, it's just... All things astragalus are good for. I love astragalus. Biological stage of a woman's life characterized by decline of ovarian function. It's not always just because they run out of eggs. All right? My ovaries are exhausted. They are exhausted. They're probably tired. Curling up and dying. They were probably tired from all the...

Little raisins. Stuff that you did. All that. I got raisins, yeah. Raisins. All my bad stuff. Well, all right. Very good. So what we're going to do is we're going to record multiple episodes of the podcast about once a month. And then when we release them, probably once every 10 days, we'll have three new podcasts every month. If you want to just hear them all, just come watch.

Listen to us on YouTube, youtube.com slash at Weird Medicine. And if you don't want spoilers, whatever, then you can listen to it on the podcast. And we'll be releasing...

What are you doing? Oh, yes. Oh, I see. Well, if you hear the music... That's your secret signal. If you hear the music, I kind of got it. But yes, I like the secret signal. There you go. It's a picture of me from a magazine saying Renaissance Man. You're the cover man. And if you open up the thing, the reason I'm a Renaissance Man is because I've got all these...

action figures and the Magic the Gathering and Ham Radio. What a nerd. Look at this. Let me see that. Look at this dude. He is beautiful. Here, hand it over to me. Well, give it to Scott. He can hand it to me. There you go. Thank you. Your arms aren't that long. Foods were on the table. Let me see here. Yeah, this is really embarrassing. It's pretty hot. Yeah, here's a picture of me, okay, with

Hot sauce that I made, magic tricks, ham radio stuff, and then a big thing of Galactus. God, that's a turn-on. A Galactus resin figure. What an idiot. Good Lord. You'll never be alone. Nice. Now with that broad skill set, it would...

Who would even? Anyway, all right. Well, listen, thanks always go to Dr. Scott. Thanks, Lady Diagnosis. Welcome back. Thanks to everyone who's made this show happen over the years. And now I can erase this paragraph that says, listen to our SiriusXM show. Many thanks to our listeners whose voicemail and topic ideas make this job very easy, particularly those like King of All Diffs, who is one of our mods.

And Gravy Legs, the one pun, McRibs, Woody Haney, and oh, KB. Oh, she's delightful. I got to meet her at Hackamania. Oh, we need to talk about Hackamania. All right, we'll talk about that next episode. All right, did we just go off the air? Are we still on? We're on. We're good? Okay, all of a sudden I've lost the thread.

Okay. I'm threading. Okay, no. Are you sure? Okay, good deal. All right, we got a little, some technical kinks. Shoot, that was close. All right. Check out 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, and we'll see you in one week for the next edition of Weird Medicine. Thanks, everybody.