Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Yes Virginia, There Are More Medical Questions

Episode Date: December 1, 2019

We're marking our 300th episode (OK, it's our 301st) by answering all of your pressing medical questions. Can you really poke your brain through your nose? Where do boob crumbs come from? Listen for t...hat and so much more! Music: "Medicines" by The Taxpayers

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Starting point is 00:00:00 Saubones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, time is about to books. One, two, one, Saw Bones, a metal tour of Miss Guy to Medicine. For the mouth. Wow. Hello everybody and welcome to Saw Bones, a metal tour of Miss Guy to Medicine.
Starting point is 00:01:09 I'm your co-host Justin McAroy. And I'm Sydney McAroy. We just recently passed a milestone sin and this was intended to mark that milestone this particular episode. That's true. Celebration of sawbounds. Yes, it's a week late. It's a week late.
Starting point is 00:01:24 But it's a celebration nonetheless. 300 episodes. That's right. That's a long time, Sid. I know. I make this show for a grip. It's scary because we've done this many episodes and there's, you know, about the failings of medical science throughout history. And there's, I have no shortage of wants to still not fix. No, fix the whole thing. No, I thought in 200 episodes We could fix the whole thing certainly 300 as an outlier But like we really have done a lot of mess ups and we just keep Doing them
Starting point is 00:01:55 So what we're gonna do this week is a question and answer episode I'm going to ask your questions to Sydney and She will answer them as best she can. And maybe I'll be able to help too with my own sort of insights. Yeah, sure. Here's her first question is this. So I have no idea if this is weird or why it happens. I'm a mother of two children. I breastfed both of them, but they're old enough now that happened several years ago. Sometimes in the shower, I notice yellowish deposits of build-up in my nipples. I call them boob crumbs, and sometimes try to get them out. Well, that's, um,
Starting point is 00:02:37 does every person with breast deal with this, am I, is it only after breastfeeding? Am I just super, super gross? And that's from Ronnie. Ronnie, I wanted, I'm so glad you asked this question, and I wanted to address it because it occurred to me that this is one of those things that I have found, and I mean, this can be true of all bodies, that there's stuff that they don't tell you about that will happen to you throughout your life. Some of it is state dependent. It might be because you're in
Starting point is 00:03:07 limbo. Ohio and bad happens. And I don't. I listen. Don't get me started on Ohio right now. But it's just the driving folks. Come on. Come on.
Starting point is 00:03:19 Come out of West Virginia and drive like that. Come on. Well, and their, their laws, the way they legislate. Yeah, but like the bodies of people with uteruses. And the drugs that. And the drugs that. Anyway, this is one of those things that they don't warn you about, but that is definitely true and common,
Starting point is 00:03:37 and you are not alone, you're not gross in any way. So there are something that can form, there are these things that form around the aereola of the breasts, we call them Montgomery tubercles. And there are just these, usually these little like brownish or kind of reddish bumps around the aereola. And they're actually one of the first changes that occur in a body when you become pregnant.
Starting point is 00:04:03 So you can look for those and go, hey, I didn't always pregnant. Well, and they can pop up. There are other associations for the most part. These are something that happen when you're pregnant. And they usually go away, but of course, breastfeeding, it has to do with hormonal changes so breastfeeding can continue them They can still be there and these little tubercles can become clogged They're really just sort of like oil glands like like they they secrete like oily substances and they can they're helping to like Keep everything soft and keep everything from getting cracked during breastfeeding and all that and That you know, they're just they're supposed to be there.
Starting point is 00:04:45 They're normal. It's totally normal. But they can become clogged with some of that waxy oily substance. And then you can, if you try, you can squeeze out of them a little, looks like a little plug of something yellow or white. And it's just like, it's not infection. I mean, I'm not going to say it's not impossible that I mean, I'm not gonna say it's not impossible that somebody is, I mean, these can get infected,
Starting point is 00:05:08 but like this can happen without an infection. And it, I guess it does kind of look like a little crumb. Huh, okay, well. I have, I share this with you as someone who is still breastfeeding. Yes, this is normal, totally happens. Best advice though is actually don't try to squeeze them or pick at them or get anything out of them. They're fine, they're
Starting point is 00:05:29 normal, there's nothing wrong with them. And if you pick at them, you do run the risk of then introducing a infection. Exactly. But you're not gross. This is normal. Is there really a nerve that runs straight from your feet to your throat so that if you walk on cold tile, you'll get sick. And if you drink cold or icy beverages, you will get sick. And that's from America. From America, yes. I thought this was an interesting question because there were actually several that were along these same lines.
Starting point is 00:05:56 This is a folklore thing I've not heard this before. Yeah, well. We're like, we're a hat to keep your body, your entire body warm because you lose heat through your head. This is, I think this is more rooted, my guess would be, because this was not the only question along these lines that I received,
Starting point is 00:06:10 kind of about nerves connecting from your feet to different places in your body. And I- It's the whole basis of reflexology. Well, that's what I wonder, if that's not where some of this stuff comes from, is from the belief that everything in your body connects to a point on your foot,
Starting point is 00:06:24 and that by doing things to your foot, you can fix various everything in your body connects to a point on your foot and that by doing things to your foot, you can fix various illnesses throughout your body. This is not so. It'd be nice, it'd be very convenient, but it's not true. But there is, that's not, I think it's interesting because it kind of reflects, it's cool to talk about how nerves work and how and the things they can do. There are nerves that move things. There are nerves that help you feel things. There are nerves that control your heartbeat. So nerves do all different sorts of things.
Starting point is 00:06:52 They send messages, all different directions in your body to help control everything we do. But illness does not travel along them in this way. It's not like you could, first of all, being cold doesn't make you sick. That's a common myth. Go outside with wet hair, get cold, whatever, that you'll get sick.
Starting point is 00:07:09 No, being cold does not make you sick. And you can't have like an illness, travel along a nerve path that way. Like you step in a puddle. They just send signals, right? Mm-hmm. They send signals. So it is neat.
Starting point is 00:07:23 There are cool nerves that can do a lot of different things. Like I like to mention the Vegas nerve, which is a big nerve that runs from your Madula Oblongata, part of your brain stem. And it goes all the way down to innovate everything from your speech to your heartbeat, to sweating.
Starting point is 00:07:40 It has nerve endings that even reach your colon. So like it is a big nerve that does a bunch different cool stuff. Not your feet, but still nerves are cool and interesting, but they do not do that. My mom was a nurse wound ostomy, hospice. What's ostomy? So, if you have like, have you heard of a colostomy? This is not the question. That would be wild if the question was,
Starting point is 00:08:05 what is my mom do? Have you heard of like a colostomy bag that someone might have? So an ostomy would be like an opening, especially unintentionally made opening somewhere in the abdominal wall to allow, you know, stool contents to exit that way as opposed to the rectum. So like the care of those sorts of openings.
Starting point is 00:08:25 An ostomy is an opening like that. It's not always in the colon. That's why it's a colonostomy. There are ealy ostomies. But the care for those kinds of openings, ostomy care. Anyway, Julie, who asked this question, Julie's mom was a nurse,
Starting point is 00:08:39 and she used to tell me in my sister, nose bacteria is super potent. And if you pick your nose and then touch, say, your eyes or an open cut, you might get a really bad infection. I think this is- Now there's not a question here from Julie, so I assume it's like, call my mom on her bullcrap. Yeah, there was more to the email.
Starting point is 00:08:59 I was kind of, I cut it down, but that was basically that is this true, or was my mom just trying to get us not to pick our nose? Narcana, my mom basically. I assume that your mom is probably referencing MRSA MRSA, which is short for methamethicillin resistance, staphlococcus aureus, which is a strain of staff bacteria that is very resistant to a lot of antibiotics.
Starting point is 00:09:22 And so it is more dangerous in the sense that it's harder to treat, not necessarily in any other. We always call it like a super bug. It doesn't have like super powers. It's just super. Well, it's not even about a ball, that's a sort of power. No, it's vulnerable. There are things we can still use.
Starting point is 00:09:39 I said, nine. But Marissa tends to colonize your nose. MRSA tends, if you carry it, you carry it around inside your nostrils. So while that doesn't necessarily make that act like picking your nose and rubbing it in your eye necessarily more dangerous than like, I don't know, putting your finger in your butt
Starting point is 00:10:01 and rubbing it in your eye, which also... Would be wild. Well, would also introduce bacteria that you don't want in your eye, which also. Would be wild. Well, it would also introduce bacteria that you don't want in your eye. I wonder, I mean, it is, I guess it would be considered an especially potent bacteria. So like your moms are right. If you have a mercer in your nose,
Starting point is 00:10:15 you don't want that getting into cuts or any kind of holes or openings anywhere else in your body. But I would say generally speaking, like try to wash your hands, and especially after you stuck them in any orifice, it's a general with mouth to mouth, our mouths are filthy. This is going to be an ironic intro in this next question, considering what you just said. Hello, my comforting podcasting parental figures. I have a somewhat medical question. I'm 23, and I've been scared of doctors for a long time.
Starting point is 00:10:46 I've been in the urgent care a few times in college, but outside of that, I haven't got to check up since I was 17. I recently made appointment with my new primary care doctor and I have about a month till my appointment. My question is, what do I even do during this appointment? Share every health concern I've had for six years? Teller, I just want to check up. I've never had to navigate being in a doctor's office
Starting point is 00:11:04 without a parent and I'm nervous that I won't say the right things. Do you have any guidance? That's from Maria. I think that's an excellent question because you are so not alone with this fear. I see this very commonly. I try to, when I see patients who are in there like adolescent or teenage years,
Starting point is 00:11:20 always have the opportunity, if everybody is okay with it, to have the parent or guardian step out of the room. In part, we always say that that's so that if there's something private that you want to discuss, we can do it. But it's also to start practicing that interaction of you and your doctor without anybody else present. I think it's just useful for that. Oftentimes, we won't have anything private, so to speak, to discuss.
Starting point is 00:11:46 It's really just... You just stand in silence for three minutes. No, I just ask, you know, is there anything else you want to talk about? You know, I'm always here. And then if they don't have any questions, I usually will take this opportunity to kind of address this exact issue. Eventually, you go to the doctor alone, or you can. I don't.
Starting point is 00:12:05 I said, no, it always comes with me. So I have no experience in this category. But when you do, it can be very intimidating to know, like, what are the rules? Here is the main point to take home is that your doctor is there to help you. And there is no rule as to what you are supposed to say or ask or do. I have
Starting point is 00:12:25 patients who come in who have millions of questions and concerns and lists of things that they want to talk about from the last six years maybe. And then I have other patients who come in and are really more like, I don't know, I'm supposed to go to a doctor. So I came, you tell me. And that's fine too. We are trained to handle all these situations we should be and we should be good at helping you have the doctor's appointment you need no matter what you come in prepared to do or say. I would say for an initial check up with a primary care doctor as a primary care doctor, my goal is to get a handle on one. If you do have an urgent issue right now that you need a dress, well, that's not really the point of a checkup.
Starting point is 00:13:10 Of course, I want to address that. I mean, it's urgent. You need to take care of it. So if you do have something that needs a dress right now, I would say that right at the top. If you don't, they're going to ask you a bajillion questions. They're going to want to know all about your history. They're going to want to know all about your family history, all about your behaviors,
Starting point is 00:13:26 and your habits, your worries, where you are in life, what you're doing, what your goals are. And then they're probably going to want to do at least a bit of a physical exam, like a general checkup kind of thing, just the major stuff that we check. And then they're also going to want to address some like preventive health things. You're this age because of this in your family history or your, you know, your gender. There are different things we might want to suggest tests you might want or vaccines you might need or whatever. So I would say bringing in a list of like six years of concerns, you probably can't address
Starting point is 00:14:00 all that in one visit. Nor would you want to. Nobody wants to be at the doctor's office for several hours. That doesn't sound fun. So I would prioritize the stuff that's most pressing. I would make sure your doctor's gonna wanna talk about preventive health stuff and that's so important.
Starting point is 00:14:15 So you wanna make sure there's time for that. And then for you, these other concerns, I would say, I have some other things I would like to talk about. If your doctor has more time, if the visit's not over great, if not, they may say, hey, can we schedule a follow-up appointment to discuss some more of these things in more depth? And so we can follow up on some of the things we've addressed this time. I think I've always had a suspicion in the back of my head, or at least I did when I was
Starting point is 00:14:37 younger, I don't think as much anymore, but this idea that, and probably this is too much house and medical TV in general, but this idea that I would say one weird thing, like one weird symptom in the doctor would like turn on their heels and be like, what did you say? Say it again, I just cracked this whole thing wide open. That is, I'm not gonna say that is absolutely never true that there isn't something in a case that could be like the one piece of information
Starting point is 00:15:04 that could be helpful, but the vast, vast majority of the time, it's about putting the picture of you as an individual human altogether and trying to help you attain the best quality of life you possibly can. And that is not a one piece of information puzzle. That's a whole human that we're working together to help you be your best you. And you know, it's going to take more than one visit to get there. So I'd prioritize the really important to you right now stuff. And then let your doctor take care of the
Starting point is 00:15:35 stuff they're going to want to tell you is important, which is like your vaccines. I want to have kids in the future, but I'm worried about fertility. I only get my period three to four times a year. This has been the case since I got my period first. First got my period. I definitely don't want kids right now, but I'm wondering, should I see a doctor sooner rather than later? Should I be concerned about this? I'm 21 if that helps Sarah. They then. So this is a good question, and I wanted to address it briefly because we've talked about this somewhat on the show before and I got a lot of tweets Following it up because there was some concern that I'd left out some of the information and I think that's fair I would say Sarah you should
Starting point is 00:16:15 Go and discuss this with a physician and I don't say that to scare you. I'm not saying that there may be an absolutely nothing abnormal, but I'm not saying there may be absolutely nothing abnormal. But most people who have periods have them more than three or four times a year. That is a very low frequency outside the range of what we think is the normal range. And so usually when we hear that, we say, hey, yeah, why don't you make an appointment with your doctor discuss it?
Starting point is 00:16:41 They can ask you some more questions to find out if there's anything else going on. If there's any other, you know, is it related to some other thing that you don't know about? Some other diagnosis that hasn't been found yet. And then at the same time, 21 is also the age that we recommend you go if you do a PAPA cervix that you go and have your first exam PAPSmear done.
Starting point is 00:17:04 So if you've never had that done before, this would be a good time to do it. But yes, it may be, I don't say this to scare you, it may be that everything is absolutely fine, but yes, you should go if you are not having periods anymore frequently than that, you should go see a doctor and talk to him about it. Also, we're a podcast.
Starting point is 00:17:21 So our advice is almost always going to be, yes, you should go see a doctor. Yes, go're a podcast. So our advice is almost always going to be, yes, you should go see your doctor. So I recently had a severe allergic reaction to a medication I was on and I had difficulty breathing. I waited through multiple classes in school before going to the emergency room where they had to administer epinephrine
Starting point is 00:17:38 to help the reaction. How bad an idea was it to wait till the end of the school day before I went to the hospital. I didn't have epipans, so it wasn't like there was anything I could do before I got there Best clueless in Cambridge Can I try? I thought you might be able to answer this? Yes, it was bad You should definitely listen. I don't know a lot about the human body folks
Starting point is 00:18:00 But I know of the important things that it does. Breathing is way up there. I thought you might be able to feel this one, but I just wanted to re-emphasize. And I bet you know this. I bet you know this deep in your heart already, Casey. You should have gone straight to the hospital. Yes. An anaphylactic reaction can absolutely and often is life threatening. You should immediately seek medical attention.
Starting point is 00:18:24 No, you're right. You didn't have an empty pen, so you couldn't have fixed it, but that was even more reason why you should immediately seek medical attention. No, you're right. You didn't have an Epipen, so you couldn't have fixed it, but that was even more reason why you should have left class. Right. You got an Epipen, then you just chill on it. I don't know. No, still go to the doctor, use the Epipen, and then go afterwards, because that's not always the end all
Starting point is 00:18:39 of that whole problem. Anyway, yes, if you're having difficulty breathing, please go see a doctor. You do need immediate medical attention because things can go very bad, very fast. You can go into shock, and then you can die. Yeah, so. And that's one less listener for us.
Starting point is 00:18:58 So please, think about that. Please, next time you have trouble breathing, please immediately go to a hospital. I'm a textile designer and recently, vendors have been bringing me textiles treated with shellfish, kighton or kaitazan. The claim around it is that shellfish kighton is a natural anti odor and antibacterial material. A brief search shows it sometimes uses in bandages or directly applied a wound to encourage healing. Is this a real thing?
Starting point is 00:19:23 If yes, how does it work? Alex. This was a cool question, because I'd never heard of this stuff. This was news to me. Still me in. So yes, kaitasan is a material that is made from some sort of crustacean shell, the kaitan that is in there.
Starting point is 00:19:39 And it is treated with something alkaline, so something like sodium hydroxide. And basically the material that results, there have been, it is used in multiple industries. So a lot of this goes well outside my medical expertise to use in other things that I have nothing to do with. But the thought is that it can be used to, in the lab, it showed some antifungal properties
Starting point is 00:20:06 to inhibit the growth of certain other kinds of bacteria and stuff. And that also, it helps stimulate, like, like an agriculture, it can help plants defend themselves against fungal and other kinds of invaders. So it's been used in agriculture. It's used in wine making in some places. Again, it can help prevent spoilage and things.
Starting point is 00:20:32 And because of all this, there was some interest in it helping with medical applications. And you can find this supplement, by the way, as I was googling about it, I ran into like completely unspricing. Yes, you can buy the kightened capsules and things like that. It has been investigated for wound healing and to stop bleeding, which is why it would be used in a bandage, that makes sense, right?
Starting point is 00:20:54 If you could like impregnate the bandage with it. Sure. And then it would help. Unfortunately, the studies on that so far have not really shown a lot. It hasn't necessarily helped a whole bunch with wound healing or preventing scar formation or stopping bleeding. There was some thought that it somehow attracted more of like your own clotting factors and
Starting point is 00:21:18 platelets and things to the wound, and that's how it did that. But again, it's not, the research hasn't really borne out any of these things. It has been widely applied as sort of a cure all for things like, for everything from weight loss to high cholesterol, to high blood pressure, to crones, kidney disease, gum disease. I guess there are some people who like put it on their gums to like prevent cavities or to prevent gum disease, all kinds of different things. None of these things have ever been shown to be true from research. There are small studies, but so far I think as a medical, it's medical applications are
Starting point is 00:22:04 right now extremely limited. And perhaps someday we will find our non-existent, but there's just no studies to say. I would not, if you find this in your pharmacy, which you can, to take, it will be advertised to you as a weight loss aid. And there are definitely studies that have shown it doesn't do that, because there's always a lot of money to be made in that realm. And so you'll find studies there, and it doesn't do that because there's always a lot of money to be made in that realm. And so you'll find studies there and it doesn't help with that at all. But I would not recommend this as something you need to add to your daily regimen.
Starting point is 00:22:34 You're ready for your next question, sister. I will be ready in just a moment, Justin. But first, let's go to the building department. Let's go. department. Let's go. Okay, next question. Are you ready? I'm ready. Hit me. When I was younger, I would get a fever and my mom would tell me that I could not have anything with dairy. Does the body rack badly to dairy when it has a fever? Or was this just my mom not wanting me to take me myself chocolate milk? Why was I sick? That's from Travis. This is a common myth I have found. Some research led me to believe that your mom is not the only mom or dad or parent or anybody out there who's saying,
Starting point is 00:23:16 hey, you can't have dairy when you have a fever. The thought was that it would curdle in your stomach and make you sick. Okay. I never heard that one, but I don't know if you ever heard this. My mom used to tell me not to have dairy when I had a cold because it would make more mucus. Yes, that feels right.
Starting point is 00:23:34 It feels true in your body. Neither of those things are true. Oh, man. I mean, if you want to drink milk, when you have a fever, when you have a cold, milk is something you typically enjoy. Hey, as a non-medical person, can I just say, the dough is great. If you're vomiting a lot.
Starting point is 00:23:50 I make some, that worsen. Well, I would just focus on things like water or some electrolyte containing substance. But no, there is no danger to dare. I always wonder if these things don't have their roots. And when we talk about the four humors and humoral systems of medicine, where you used to eat and drink certain things or avoid certain things in order to balance your humors,
Starting point is 00:24:11 you got to wonder if stuff like this isn't our last remnants of those kinds of ideas. But no, you can drink that milk when you got a fever. I got a paper cut last night while I was filling out a D&D character sheet. Nerd. Got him. And it hurt like heck. My question is, why do paper cuts hurt so dang much? I've had bigger deeper cuts from kitchen implements and a couple of accidents over the years, but nothing is quite so squizzily agonizing as a tiny sliver of a paper cut.
Starting point is 00:24:40 Hope this email finds you well. Love the show. That's from Gives and Scotland. I thought I wanted to answer this question for two reasons. One, it is a good question. And two, I like the use of exquisitely agonite because you made fun of me when I said that a pain was exquisite. I know. Like your aliou card from Symphony the Night. But it is used. It is not just me, me and Gives. We both use it. I would, you know, I don't, I was thinking about this because I would say this is true.
Starting point is 00:25:09 I have, I have cut myself with knives and I've gotten paper cuts and I do feel like paper cuts are a special kind of pain. Why? Part of it I would say is location. I would say that's a big, that's a big thing. Most paper cuts we tend to get on our fingers, right? And your fingertips have, or especially sensitive. I would say that's a big thing. Most paper cuts, we tend to get on our fingers, right?
Starting point is 00:25:25 And your fingertips have, are especially sensitive. You know, we have different densities of sensory nerves and different parts of our body. And our fingertips in particular need to have a lot of good sensory function, because they do all of our stuff for us. You don't need to have as fine sensory perception in like your elbow as you do in your fingertips.
Starting point is 00:25:48 So I would say a big part of his just location, we tend to get paper cuts on our fingertips and that is a very sensitive spot. So of course it's gonna hurt a lot more. You're actually using him a lot. You're like, cut your own. It's a very active part of your body that's touching a lot of different stuff
Starting point is 00:26:02 and interact with a lot of different stuff. So I imagine it's like very front of mind as a result. I thought this was an interesting way to also bring up the little tip that I always tell people if you have to ever do stick your fingers with like if you have to do glucose checks for diabetes or anything like that or any it came up just and when you did the blood test for ever really well. I always recommend to try to use kind of the edge, the sideier fingertip as opposed to the very tip tip of your finger.
Starting point is 00:26:29 Yeah, if you're going to get a paper cut, that's supposed to get it. I'm so troubled that the answer to this question is not just a no. I can't make his retails of what you've written here, but you didn't write no. If I stick my finger too far up my nose, could I actually touch my brain, or is that just a myth, Ryan? First of all, Ryan, please do not attempt this,
Starting point is 00:26:51 or anyone else, not just Ryan, this is for all listeners, please don't try this. You can't, okay, you can't just stick your finger if you're nose and touch your brain. No, I want to add some color, okay, thank you. No, but I did want to add some color because whenever I hear something like this, I try to think, well, where did that idea come from?
Starting point is 00:27:08 Okay. And above your nasal passages, the part of your skull that's at the top there that like above that gets to the brain part, you know, like inside the skull part, there's the brain part that you don't want to touch. There is- You can't be clear enough about that, is, there is a bone, the ethmoid bone, and within the ethmoid bone, there is this area called the crib reform plate. And it is like, if you look at it, you can
Starting point is 00:27:35 Google this. It's a piece of bone that has a bunch of little like perforations in it. Teeny, teeny, like you can't stick a finger through them perforations. Teeny, teeny, because they allow for the passage of nerves. Okay. Okay. But there is that, there is a pathway. Your finger could not fit through it. But there is a connection between the top of the inside of your nose and your brain, teeny, teeny little perforations in that crib reform plate through which nerves has, but that is why if you get a certain kind of skull fracture and like you damage that area, you can have cerebral spinal fluid leak from your nose, which is bad. And like if that happens, you immediately need to go seek medical attention. Yeah.
Starting point is 00:28:18 Don't finish your classes first. So that is probably where that comes from. But no, you could not just jam your finger up there and touch brain. The recommendation for length of time between pregnancies is at least one year. I've also seen 18 months for pregnancies that end in a C section. What's the medical reasoning behind these weight times? And that's from Annie. From Annie.
Starting point is 00:28:38 The reason this is a good question, the reason is they've just done some more studies on this actually last year. Some new reports came out because we always used to say 18 months or greater. More recently, we've said 12 months is probably sufficient. What we find is that if you wait less than 12 months between pregnancies, we see a higher rate of things like premature labor, higher rate of things like problems with the pregnant person as well as the baby. How much higher incidence of having two babies at once is a huge issue, I think.
Starting point is 00:29:14 That would be mildly mean. That was not in the study, but yes. Yes, if Dr. Justin is in the study. Mortality goes up for both the pregnant person and the baby if you wait less than 12 months between pregnancy. Why is this the case? It's interesting. We're still not 100% certain of all the reasons why.
Starting point is 00:29:33 Part of it kind of feels like it makes sense. Pregnancy is an incredibly taxing state on the human body and you need a lot of time to recover from it. Having recovered from two, I can tell you, I do, I did not feel physically ready. After less than a year, certainly, after more than a year. But you, you need time for your body to recover and heal from everything that it's been through. And then there's also some thoughts that maybe it has something to do with stores of things like iron and folate are very depleted by pregnancy and it takes your body quite a while to rebuild
Starting point is 00:30:08 those kinds of stores. But the current recommendation is that at least 12 months between pregnancy and that's why it's really for safety. There's always that, is it doctors overreaching? No, it's for safety of the pregnant person and safety of the baby. Huh. I have a bump on my head and my family thought it might be skin cancer.
Starting point is 00:30:29 So when I went for my yearly checkup, I had my physician, I asked my physician about it. He looked over for a couple of seconds and without doing any tests, he said, it was fine. How could a doctor tell if a little module on my forehead his cancers are not just by looking at it? There are two questions here, by the way.
Starting point is 00:30:42 Okay, this is a double. Yeah. Let me take the first one first. way. Okay, this is a double? Yeah. Let me take the first one for you. Okay, this is from Joe. And then we'll get to Joe's second. Joe's second, right up a funny thing that I'm talking about. Okay, I'm sorry. I thought this was important to address
Starting point is 00:30:55 because we are guilty in the medical profession of not always showing our work. If it's, especially if it's something that we know immediately, oh, it's this, it's fine, whatever. And we want to move on to what we think is the more important or pressing issue, which isn't necessarily what was the more important or pressing issue to you, which is always part of that,
Starting point is 00:31:19 that's that art of medicine, where you should be able to make sure you're both on the same page as to your priorities. There are a lot of different features. We learn all of this in school of things that are benign and things that maybe aren't benign and things that definitely are dangerous or not benign. And very often, it's a clinical exam. If we biopsy'd every bump, we would all be getting biopsies constantly, right? Because we're all going to get little weird bumps on our skin from time to time. So there are a number of features that we look at, and I could get it.
Starting point is 00:31:55 It would depend on exactly what it looked like for me to tell you why. But a lot of the time, there are just little growths of like fibers tissue or fatty tissue or things that we can tell just from looking and touching. It's not dangerous. What exactly is it? Well, it's probably this. I wouldn't know unless I biopsied it, but it would be unnecessary because I can tell you it's not. We'll keep an eye on it.
Starting point is 00:32:16 If you see any of these changes and feel free to always ask that. Okay. Well, why didn't you think it was a problem and what would tell you it was a problem? Because then you can, I don't think you're the doctor. Well, no, then you can look at it too. It's always good change over time is always one of the features that we look at so That's probably it's always a good idea for us to explain our rationale It helps give people better autonomy better agency over their own bodies But never be afraid to ask that question I can't hear just just that the question I occasionally see a little funny and wake up with one of my arms totally dead because I presume I slept on a nerve wrong. I shake it off after a few minutes,
Starting point is 00:32:54 it's fine again, but I'm apparently sleeping on a punch nerve for upwards of eight, pinch nerve, sorry, for upwards of eight hours. Would this cause permanent harm, or is it just something that happens sometimes? So I like this question because it brought up one of the things I remember from medical school learning and and thinking was very funny, which is Saturday night palsy. It's also been referred to as honeymoon palsy. So we all know that you can accidentally compress a nerve when you're sitting in a certain position or lying in a certain position and Something will fall asleep, right? We've all had the feeling of our arm falling asleep or our hand falling asleep
Starting point is 00:33:29 our foot or whatever and that's all it is you were just you were compressing a nerve Something in your positioning and when you relieve pressure on that nerve It will the feeling will come back and you get all that pins and needles and nobody likes that but it but it resolves pretty quickly If you are to hold that position for many, many, many hours, it doesn't resolve right away. It will go away. You will get your sensation back and your function back in that arm or leg or whatever, but it can take a lot longer. And the thing we were taught in medical school is a radio neuropathy.
Starting point is 00:34:05 So compressing the radio nerve, which is a nerve in your arm. And all these nerves pass through your armpit in this big bundle called the brachial plexus, a bunch of nerves go through there. So what they taught us is like the classic is somebody goes out and drinks a whole bunch of alcohol. And then passes out over the back of a chair, like with their arm hanging over the chair, with their armpit right on the back. And it compresses the radio nerve.
Starting point is 00:34:30 And then the next morning you wake up and you can't move your arm. And it's really, it's the prolonged compression. So that's why they use the example of somebody who maybe has been drinking too much is that perhaps they then pass out and sleep a lot longer than they would have otherwise. But these do go away, but it is interesting because you know, I have seen cases where it
Starting point is 00:34:49 took several weeks for it to resolve. Holy crap. So, is it? But not serious damage. No, no. All the damage went away and the arm was perfectly functional, but it sucks while it's resolving. Here's one from Mike, our last question of the episode.
Starting point is 00:35:07 Being a new parent, as far as I am right now, can be crazy stressful and scary. One of my biggest fears so far has been around vaccines. Everyone's favorite topic. The first big set of corn and CDC occurs at two months. Why is it that long of a weight? Are vaccines unquestionably the most life saving you mentioned ever created
Starting point is 00:35:24 on this virus and bacteria filled planet? Why do we not long of a weight? Are vaccines unquestionably the most life saving you mentioned ever created on this virus bacteria filled planet? Why do we not vaccinate at birth? And that's from Mike. Okay, do I have my theory? And you can tell me how right or wrong I am. Okay. My theory is that at a very young age,
Starting point is 00:35:40 enough of the mother's blood and antibodies is still in the baby that it's okay. That's my theory. That's, that is partially right. That is part, you are partially right. I'm partially proud. That is good. Yes.
Starting point is 00:35:54 Part, so this is a great question. I love to talk about vaccines anytime we get the opportunity. The reason that we have our vaccine scheduled the way we do, the reason that we have certain vaccines at certain ages, is because of one, that is when we are likely to encounter, or before I should say we are likely to encounter those diseases, right, because we want to get vaccinated before the age when most people would get it. So it doesn't, it doesn't do any good to vaccinate you for diptheria when you're 20 because diptheria was historically a problem, much more common in children. So we want to get the diptheria vaccination in there early.
Starting point is 00:36:32 But the other thing is we have to make sure that your body is going to generate an immune response. And so a lot of vaccines are the reason we get them at that age is because we know that's the earliest our body is going to generate the appropriate immune response to the vaccine. Otherwise, it's useless, right? If you gave somebody a vaccine and their body wasn't able to create the antibodies that they need to, then it didn't do anything. This is also why boosters exist, because we found that you can create some of an antibody response, but you need those extra shots to continue
Starting point is 00:37:06 your antibody creation and formation so that you are fully protected against the disease. So that's that's part of why we wait till two months is because we want to make sure that that's the earliest We know that your body's going to generate an immune response. We do feel that there is some protection We know there is some protection that has passed along From the pregnant person to the newborn. So there are antibodies that exist. And that's good. And also that's part of why the vaccines may be aren't as effective, because if you did get antibodies and those antibodies start attacking something like a measles vaccine, for instance, if we gave you a measles vaccine at birth, then it wouldn't work.
Starting point is 00:37:44 You wouldn't get the immune response. And those antibodies that you get from the person who carried you, they go away. They're just short lived. They're not there forever. So you need those vaccines. We know that this is the time where they are that combination of most effective and earliest we can get it to you
Starting point is 00:38:02 before you will be exposed likely be exposed. And that's why we can't give them all at birth. It'd be great if we could. It'd be great if they would all work right at birth. We would do that. But they're all scheduled to be the earliest possible time that they're going to work and protect you. And that is also why it is so important that you stick to that vaccine schedule. I always see questions about alternate vaccine schedules. And the thing is, if you space out vaccines, if you get them later, if you try to get fewer at a time, where there's no evidence that any of that matters
Starting point is 00:38:34 or is important or should be done. I mean, you don't need to do any of that. But if you do, you really run the risk of not getting the immune response in time for you to be exposed to that. And we have measles outbreaks. So I applaud you for wanting to get the vaccines earlier. I'd be right there with you.
Starting point is 00:38:55 If we could have gotten them all at birth, I would have taken both our kids in and gotten them all back. We got the whole bunch of them in the delivery room. But no, no, trust, just stick with the vaccine schedule from the CDC and you you cannot go wrong and get your flu shots. Yeah. There is no too late to get a flu shot. That's right. Folks, thank you so much for listening to our episode. Thank you for sticking by us for 300 discrete episodes. We are so happy that you are here. If you, I'll tell you another thing that you can do
Starting point is 00:39:30 if you want to support our show, head on over to Maccallroy. I mispronounced my own name. That's where I'm at. Head on over to Maccallroy. Looks like it should be Maccallroy. Thank you. Maccallroymerch.com. We've got some beautiful.
Starting point is 00:39:45 There's a solbona's ornament. You can order. We've got a solbona's t-shirt, our vaccines t-shirt that supports the immunization action coalition. Thank you, Sydney. You say it much better than I do. And a pin that does the same thing, a pro-vax pin. We've also got a shirt that I can't believe we haven't talked about. The
Starting point is 00:40:07 Curels Cure Nothing shirt. It's new. It's blue. And it's just right for you. So thank you. I just care about that. I think it's so cool. Anyway, good, good, check that out. And thank you for listening to our podcast. Oh, thank you, the taxpayers, for the use of their song medicines as the Intranount Trauma Program. And thanks to you for listening. That's gonna do it for this week. So until next time, my name is Justin McRoy. I'm Sydney McRoy.
Starting point is 00:40:32 And as always, don't drill a hole in your head. Alright! Maximumfun.org Comedy and Culture Artist Oat? Audience Supported

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