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Episode: Sawbones: How's My Lump Doing?

Author: Justin McElroy, Dr. Sydnee McElroy
Duration: 00:36:22

Episode Shownotes

As a gift to the audience, we have another Sawbones Q and A, answering strange questions submitted by listeners! How does a menstrual disk work? How should we ACTUALLY clean our ears? Are cat biscuits bad for pregnancy? And why does Justin have the old man cough?Music: "Medicines" by The

Taxpayers https://taxpayers.bandcamp.com/Harmony House: https://harmonyhousewv.com/

Full Transcript

00:00:00 Speaker_03
Sawbones 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.

00:00:16 Speaker_03
Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it.

00:01:06 Speaker_04
Hello, everybody, and welcome to Sawbones, a marital tour of misguided medicine. I'm your co-host, Justin McElroy.

00:01:11 Speaker_01
And I'm Sydney McElroy.

00:01:13 Speaker_04
And I'm so excited to be doing one of our favorite kinds of episodes. This is a gift. Speaking of the holidays, this is a gift to us.

00:01:23 Speaker_01
This? Like the show?

00:01:24 Speaker_04
Yeah, like recording medical question answer episodes is a gift to me because I like doing them so much.

00:01:29 Speaker_01
I didn't know where you said, I thought you were about to introduce something that is a gift to us. This is a gift to us and here it is.

00:01:35 Speaker_01
And I thought you were going to, I thought it's just the two of us in the house right now, but I thought maybe somebody was going to come through the door with a big present or a giant check.

00:01:44 Speaker_04
No, no such luck.

00:01:45 Speaker_01
Or maybe take me out front blindfolded and there'd be a car with a big red bow on it. I don't want a car, but like maybe. I don't, maybe we did that.

00:01:52 Speaker_04
Before we get into it, I just want to say thanks to everybody that watched Candle Nights this weekend. If you did not check it out, go to bit.ly forward slash Candle Nights tickets 2024.

00:02:03 Speaker_04
It is an amazing special full of lots of really talented people and a lot of friends and a lot of surprises, songs.

00:02:12 Speaker_01
Songs, and a continuation of A Medicine Called Christmas.

00:02:15 Speaker_04
Yeah, there's lots of skits. There's great, it's great, it's great.

00:02:18 Speaker_01
Our kids are in it.

00:02:20 Speaker_04
And it really goes to Support Harmony House, which is a shelter for people experiencing homelessness in our area. It's doing amazing work, and your help is really appreciated.

00:02:29 Speaker_04
It just costs five bucks to watch the show, but you can donate more if you like. That'd be very kind of you. Bit.ly forward slash candlelights tickets 2024. Okay, but Sydney, enough flammatory for me. We're gonna help people do that.

00:02:46 Speaker_04
Today we're gonna fix people.

00:02:47 Speaker_01
That's right. Yeah, so we're gonna do some weird medical questions. Yeah.

00:02:52 Speaker_04
Are you ready for the first one?

00:02:53 Speaker_01
Yes, I'm ready.

00:02:54 Speaker_04
Go for it. Now you had mentioned earlier you wanted me to start doing voices for each of these different question askers. Is that still the case?

00:03:00 Speaker_01
I'm pretty sure I didn't, but go for it.

00:03:03 Speaker_04
No, no, no.

00:03:05 Speaker_01
I heard, heard.

00:03:06 Speaker_04
Gotcha. When I was pregnant with my now almost one year old, several of my moles got puffier. and I developed a few small skin tags under my breasts.

00:03:18 Speaker_04
I assumed my moles would return to normal postpartum, but they're still larger than before and protrude quite a bit, just the right size for my kid to grab onto, of course. What is it about pregnancy that causes these skin changes?

00:03:28 Speaker_04
Will my skin eventually return to my pre-pregnancy state? Thanks for so many years of such a great show." That's from Holy Moly in Missouri.

00:03:38 Speaker_01
This is a common thing that people who are pregnant experience, not just moles, but all kinds of skin changes. And it can be very distressing if you're not prepared for it, right?

00:03:50 Speaker_01
And there are a wide range, so definitely your moles, if you already have some moles, they can change during pregnancy.

00:03:56 Speaker_01
You can see stretch marks, of course, a common thing that people might experience during pregnancy, acne, you can get more skin tags, you could have, like varicose veins or like spider veins, you know, those kinds of things.

00:04:09 Speaker_01
There are certain areas of the skin that like have a darker pigmentation. There's something that's classically called like the mask of pregnancy. Have you ever heard that term? Yeah, I have actually.

00:04:20 Speaker_04
Yeah, I think we discussed it long, long ago during our long run of pregnancy episodes around in 2014, I guess.

00:04:28 Speaker_01
It's called melasma or cloasma. Anyway, all of these changes have to do with just the sort of hormonal, chemical milieu in your body during pregnancy. You're growing a human. There's a lot of growth factors.

00:04:44 Speaker_01
There's a lot of what we call angiogenesis going on, which means making of blood vessels. So there's a lot of things promoting growth of cells, of tissue. inside your body flowing all around at the same time.

00:04:58 Speaker_01
And that can lead to changes and growths on your skin as well. So a lot of things will go back to the way they were prior to pregnancy afterwards.

00:05:10 Speaker_01
But some things like if a skin tag gets larger or a mole or something like that gets larger, it's probably not necessarily gonna shrink afterwards. But that also isn't necessarily something that you have to worry about, if that makes sense.

00:05:24 Speaker_01
And it's variable for everybody. It's like with stretch marks. For some people, the stretch marks go away after pregnancy. For other people, they might stick around. Some of the stretch marks might go away and others might stick around. It's different.

00:05:36 Speaker_01
There's a lot of, I think, kind of like folk medicine sort of lore around what you can do to try to change or prevent or

00:05:44 Speaker_00
Yeah.

00:05:45 Speaker_01
Quote unquote fix. I hate to say fix your body made a person. So whatever, whatever your body looks like now, having made a person, it's a wonderful thing because you made a person with it.

00:05:59 Speaker_01
And this is the, this is how, this is what you have to show for it. Look at my body. It created life.

00:06:07 Speaker_04
Amazing.

00:06:07 Speaker_01
I know, it is, it is. But the one thing I will say is that probably these moles are not necessarily going to get smaller. But any moles, you should always, I never wanna just say, so don't worry about it. Keep an eye on things.

00:06:23 Speaker_01
If something looks different from the other moles on your body, if something is asymmetrical, it's not like round or oval or whatever, if it's asymmetrical,

00:06:31 Speaker_01
if it's changed in color in some way, if it continues to get bigger, if it's bleeding or blue or turned dark or black, anything that changes or is concerning, go get it looked at.

00:06:44 Speaker_01
It never hurts to go get something looked at if you're really worried about it. A lot of these changes in pregnancy are completely benign, meaning no big deal, nothing to worry about.

00:06:52 Speaker_01
But if nothing else, you'll sleep better if you go to your doc and say, hey, is this okay? And they say, no problem.

00:06:58 Speaker_04
Let's get those skin screens, folks. I know it's a little uncomfortable, but it's important. Hey, Justin and Sydney, I keep getting ads for the Flex Disc. and it says it empties itself when you pee. How does that work? Please, I'm so confused by this.

00:07:13 Speaker_04
Now, Sydney, this question asker needed a couple more sentences of context because I have absolutely no idea what any part of this sentence means and I'm kind of losing it. This feels like a yes, yes, no. I don't understand.

00:07:28 Speaker_01
Yes, okay. I wanted to do this question because I also, full disclosure, had no idea what the Flex Disc was. And so my first Google was, what is the Flex Disc?

00:07:42 Speaker_01
And then I found the website for the Flex Disc, and now I understand what it is and what the question is about. Justin, the Flex Disc is a menstrual disc. Now, you've heard about menstrual cups, right?

00:07:56 Speaker_01
Most famously, infamously, famously, the Diva Cup, I think is the one, that's the brand most people,

00:08:05 Speaker_04
All right, just from what you said already, I 100% can tell you what this product is. I've got it. You ready? Okay, what's a menstrual disc? Here's what a menstrual disc is. It's like a change purse, right?

00:08:19 Speaker_04
And you have the menstrual blood goes into the disc and it catches it. But then when you pee, it squeezes it in a change purse fashion that squeezes the sides ever so slightly to allow

00:08:34 Speaker_01
The disc to empty into the toilet Um, you're kind of right I mean not exactly like the mechanics and certainly I don't know about the um change purse kind of Comparison imagine. I just sent you a link.

00:08:52 Speaker_04
Okay, but do you know the kind of change first?

00:08:54 Speaker_01
I'm talking about though.

00:08:56 Speaker_04
Yes Yes, and then you're change first and you squeeze it and it opens like a pac-man

00:09:01 Speaker_01
OK, so kind of. The menstrual disc is similar to a menstrual cup. And what this is, is these are devices that you can use in place of like a tampon or a pad while you're having a period.

00:09:15 Speaker_01
So the cup looks like a little cup, and you insert it into the vaginal canal. The disc looks more like a disc. You'll see it in the picture. You can look this up. It's a little disc.

00:09:25 Speaker_01
And again, you insert it and it actually, if you look at the diagrams, it fits more deeply into the vaginal canal is part of the benefit of it. It's like just sort of up there more snug. It might be more comfortable.

00:09:40 Speaker_01
And then I think the big selling point, as far as I can tell, is hands-free emptying and I think that's what this question is referencing. I saw that there was hands-free emptying and I was Intrigued. So here's how this works.

00:09:58 Speaker_01
So you have to imagine you've got this rounded sort of cupped disc, right? You see it. It is inserted up right underneath the cervix. So all the menstrual blood that's falling out of the cervix is falling into this disc.

00:10:13 Speaker_01
And it's up beyond the pelvic bone. You don't need to just take my word for it.

00:10:18 Speaker_01
If you're having a really heavy flow day or if you just want to empty it, when you go to the bathroom while you're wearing your menstrual disc, you sit down, I mean on the toilet, like you do in the bathroom, and what you're going to do after you've completed what you went there for,

00:10:38 Speaker_01
And this is according to their website. I have not tried this. You give your pelvic floor muscles a little extra downward push. And I like in parentheses, they say, while still sitting on the toilet.

00:10:50 Speaker_04
Whoa, so important.

00:10:51 Speaker_01
Do not get up. Do not. Do not get up. Do not be in church. Don't put your pants on yet. And they say right here, imagine you're trying to poop or alternatively trying to give birth to your disc.

00:11:02 Speaker_01
You should see or feel a little blood dump out into the toilet.

00:11:04 Speaker_04
Joke's on you. I'm always pretending I'm giving birth to my disc.

00:11:09 Speaker_01
So that is the self-emptying, the hands-free emptying feature when you pee. Now it sounds like it won't, unless it's really full, it won't empty every time you pee necessarily.

00:11:20 Speaker_01
So it's not like if you're on your period, every time you sit down, you're gonna see some blood, but you might, especially if it's a heavy flow day, because that action of like, and you know what I'm talking about, it's kind of like,

00:11:32 Speaker_01
Yeah, you're doing it right now with your face. And I don't know how to feel about that. It's like a vagal- I'm just stretching. It's like you're pushing. Yeah. You do that. I can imagine it. And it empties.

00:11:43 Speaker_04
I've squeezed things out of my body before.

00:11:45 Speaker_01
I have not tried this. I think that's a cool, fascinating feature of this menstrual disc.

00:11:50 Speaker_01
And perhaps something that if you are looking for an alternative to tampons, and for some reason you don't, you know, you got the cup, maybe it's just not what you want to do.

00:12:00 Speaker_01
Yeah, after you do this, I think you have to pop it back into place a little bit So they recommend that after you have emptied it you With a clean finger just pop it back up where it was now a second if you gotta get your hands involved What's the point?

00:12:14 Speaker_01
Well, that's easier than removing it dumping it out cleaning it off putting it back in

00:12:18 Speaker_04
I think it's only a convenience if it saves me having to wash my hands. That's the thing. If I could absolutely cut hands out of the product.

00:12:25 Speaker_01
Are you suggesting that you don't wash your hands every time you go to the bathroom?

00:12:28 Speaker_04
Well, if my hands aren't involved in the process at all.

00:12:31 Speaker_01
Why would your hands not be involved in the process?

00:12:33 Speaker_04
What do you mean?

00:12:34 Speaker_01
Did you flush the toilet?

00:12:35 Speaker_04
What? Yeah, with my elbow. What do you mean I flushed the toilet?

00:12:38 Speaker_01
With your elbow.

00:12:39 Speaker_04
Or my foot, not with my hand. What am I, an animal? Look, I flushed the toilet with my hand in a public place.

00:12:45 Speaker_01
You've touched anything in that bathroom. You should be washing your hands every time you go to the bathroom.

00:12:49 Speaker_04
You have the dirtiest elbows. All elbows. Your elbows are a biohazard. It's all elbows. I remember, now listen, I got into the whole hand washing thing during the lockdowns, just like everybody else. I loved it too. It makes me nostalgic from time to time.

00:13:04 Speaker_02
I'm glad it took a pandemic for you to wash your hands.

00:13:06 Speaker_04
Hello, Sydney and Justin. I recently had our first baby, and there have been so many instances between my OB, the discharge nurse in the hospital, and our pediatrician where we talk through information and get care.

00:13:19 Speaker_04
Then they hand me paperwork that I assume reviews everything we talked about. When I get home, I discover the paperwork covers many other topics the doctors didn't even mention.

00:13:27 Speaker_04
We had an entire manual about taking care of babies from the hospital that I didn't even find until three months later. I know you can't cover everything in the 15 minutes that you're supposed to limit each patient.

00:13:37 Speaker_04
It would be nice to be able to ask questions from the paperwork while I'm there in the office rather than having to call later.

00:13:42 Speaker_04
It's frustrating for me and I can only imagine how much more frustrating it would be for parents and patients who struggle with reading, organization, et cetera. What's provider's responsibility in terms of patient education? Can you speak to this?

00:13:53 Speaker_04
That's from Emily.

00:13:56 Speaker_01
Emily, this is a tough question because I think what we're really getting to are the inadequacies that are baked into our health care system in this country.

00:14:04 Speaker_01
So, I mean, ideally, after someone has had a baby, you should be in an environment where you are provided with the support and knowledge, all the information you need, all of your

00:14:16 Speaker_01
answers to all of your questions before you're kind of, you know, left to do it alone, right? And I think what we're up against, a number of things. One, you've given birth in a, let's say you're in a hospital. Most people do in this country.

00:14:33 Speaker_01
So you're in the hospital. Well, we are now pressured to discharge people after they've given birth within 24 hours. Well, at 24 hours, I shouldn't say within. At 24 hours, if it was a vaginal delivery, and then at 48 hours if it was a C-section.

00:14:49 Speaker_01
You can have up to 48 if it was vaginal, up to three days if it was a C-section. So, and I mean, obviously, I'm not, these are generalizations. If there are other complications, it may be longer.

00:14:59 Speaker_01
But the point is, these are the pressures on the physicians in the system and on the nursing staff to get the patients through the absolute necessary stuff and make sure they're ready to be discharged in that time frame.

00:15:15 Speaker_01
And so what you see us focusing on then, I think, are one, the stuff that we need you to do to meet criteria to leave the hospital. So I need to make sure that the person who's giving birth and the baby are stable.

00:15:28 Speaker_01
that the necessary testing that you have to have before you leave the hospital has been done, and that, I mean, that's pretty much it, and that the baby is eating and has peed.

00:15:39 Speaker_01
I mean, there's really very little that keeps you in the hospital technically. And then in terms of what I need to tell you, I start triaging information, and I'm just the universal provider in this situation.

00:15:51 Speaker_01
So what do I need you to know most importantly? I need you to know when to come back, how to feed baby, and that baby pees and poops. And then some vague information about sleeping that usually is not very helpful, right?

00:16:06 Speaker_01
Because whatever we say about sleeping changes every five years and none of us know. And I don't know how babies sleep. I've parented, I've doctored. How do babies sleep? I don't know. I don't know what the right thing is.

00:16:15 Speaker_01
I don't remember how I learned to sleep. No, and most of us block it out, right? Like, if you've had to get a baby to sleep, you've probably blocked out all of it because it was traumatic for you in some way, as it was for all of us. But anyway.

00:16:27 Speaker_01
So we triage that information, we tell you what's absolutely necessary. Wash your hands, don't smoke around the baby, put it on its back to sleep, use a car seat, and then we let you leave. And we feel better if we give you a book or something.

00:16:39 Speaker_00
I don't even know if we give a booklet.

00:16:41 Speaker_01
A video, a video about, I mean, something like really like the fact that we send people the video that's like, here's how you know not to shake a baby. Like that's like in a video.

00:16:52 Speaker_01
That's, I mean, that's, and I think that the problem is that we, our hospital makes more money if they get you out in the time they should. They lose money if they keep you longer.

00:17:04 Speaker_00
Yes.

00:17:05 Speaker_01
It shouldn't work that way. And I do not believe that all the individuals in that system the providers and the nurses and the lactation consultants and all those people, I don't believe they're ill-intentioned or that they want it to be this way.

00:17:16 Speaker_01
Having been one of those people in a hospital, I do not want it to be this way. But it is the system around them. And so they conform to it. And it sucks for you and it sucks for them.

00:17:25 Speaker_01
And you end up home without all the information you need and the support you need.

00:17:30 Speaker_01
We don't have a culture of sending, you know, there are other countries where they send a midwife to your house or a nurse to help support you through those early weeks before and after pregnancy. We don't do any of that here.

00:17:43 Speaker_04
Can I say something that I have not fully thought through, but you helped me to, but this is my gut is I feel like that.

00:17:51 Speaker_04
I feel like the, my personal feeling is that by and large we should be working to reduce the role that hospitals play in the birthing process, period. I think that should be a goal that we have. And personally, after our experiences, I feel like

00:18:11 Speaker_04
after you have birth, I don't wanna hear anything else the hospital has to say about it, I guess, is my opinion. I don't agree, I don't feel like this should be medicalized from the beginning.

00:18:24 Speaker_04
So I don't know, I feel like there was just this pressure to like, keep the kid in the hospital. I mean, like, and keep the, I just don't, I don't have that trust there. Like, you know what I mean?

00:18:35 Speaker_04
Like, I don't have the trust to, I don't really trust them to what I should be doing with the baby. I don't trust the hospital. Sorry.

00:18:45 Speaker_01
We had two very different experiences. One in which the rush was to keep us there because we don't know what's going on and to cover our butts, we'll just keep your kid longer. And the second was, oh, you guys are fine.

00:18:55 Speaker_01
Get out of here as quickly as possible. So we had both ends of the spectrum. And neither serves you well, and both leave you feeling partially traumatized by what should be a really amazing experience. Hard, but good.

00:19:09 Speaker_01
So I think that's what you're seeing. I will say that in that kind of climate and culture, the best thing we can do is advocate for ourselves.

00:19:18 Speaker_01
I think that there are ways to have safe births outside of hospitals, certainly, whether it's in a birthing center or even a home birth.

00:19:28 Speaker_01
But you got to make sure you have one that you've been vetted for that in terms of risk for your particular pregnancy. There are some that are safer to have in a facility where you can have surgical, you know, delivery if you need it.

00:19:41 Speaker_01
And then there are some that are totally appropriate for that. And then make sure you have the infrastructure to support it. Again, there are other places in the world where there's lots of this in place and it's done a lot safely. It's very routine.

00:19:51 Speaker_01
In this country, it's not. And so then that leaves room for kind of the fake medicine people to slip in who are going to try to convince you to do a water birth. And you shouldn't do that.

00:20:03 Speaker_01
But that doesn't mean that you can learn a lot from a trained midwife. We went and took birthing classes from trained professional midwives. And they were hugely helpful. And those are two different things.

00:20:18 Speaker_01
And I think, unfortunately, in this country, you have hospital birth, and then everything else gets tossed into the same bucket. And that's not accurate.

00:20:24 Speaker_04
Here's another question. I keep getting ads on Instagram for different ways to increase lymphatic drainage through rubbing various things on my skin, like a jade ruler, gua sha, dry brushing, et cetera.

00:20:35 Speaker_04
Is lymphatic drainage something I need to do manually? It seems like the lymphatic system is really important, and I find it hard to believe that it needs to be manually manipulated. And that's from Lymphie in Lancaster. Lymphie, you're on.

00:20:47 Speaker_04
Sorry, Lymphie in Lancaster.

00:20:50 Speaker_01
Lancaster.

00:20:51 Speaker_04
Lancaster.

00:20:52 Speaker_01
No, Lancaster.

00:20:53 Speaker_04
No, you're right, because the kiss is- Right, the kiss is in Lancaster.

00:20:56 Speaker_01
Lancaster. I always thought it was Lancaster.

00:21:00 Speaker_04
All right.

00:21:01 Speaker_01
Anyway, uh, it's their time. So your your lymph system works however you want. Your lymph system works without you pushing on it. You are absolutely right. You don't need to.

00:21:10 Speaker_04
It's funny Cindy because it looks like you're pushing on your lymphatic system in your face right now. It looks like you're trying to induce some drainage through your temples.

00:21:17 Speaker_01
I think I think that a lot of us, if you wake up feeling a little puffy, you've got some extra fluid in your interstitium, which is different, by the way, than lymphatic drainage. That's not your lymph system. Your lymph nodes aren't swollen.

00:21:30 Speaker_01
If you've got extra interstitial fluid and you're pressing on your face and trying to manipulate fluid, I think you feel better after you've done that. I think the other thing that happens is you wake up, you feel puffy,

00:21:41 Speaker_01
You rub your face for a while, some hours pass, and then you're less puffy because now you're upright and gravity has an effect on that. I don't, there's not, one, you do not need to manually manipulate your lymphatic system.

00:21:52 Speaker_01
That is not a, you don't have to do that, don't worry. So if you don't do it, that's okay, you don't need to. If you do it and you like it because it feels nice, I have no data to say, especially like using a jade roller, is that dangerous for you?

00:22:05 Speaker_01
I mean, unless you're pressing hard enough to bruise yourself, it's hard for me to see how you would, how it would be bad. I mean, worst case scenario, you paid too much for something.

00:22:13 Speaker_01
I don't know as far as I have seen any data that says any of this does. anything, I am certain you'll find testimonials and I'm certain you'll find subjective reports that it was helpful, but in terms of like actual improved lymphatic drainage.

00:22:28 Speaker_04
Sid, here's the big question. Is it time for a break?

00:22:33 Speaker_01
Actually, Justin, yes. Before the big question, we got to go to the billing department.

00:22:37 Speaker_04
Let's go. Sidney wants the deal with earwax and Q-tips. The box is very clear that under no circumstances should you put a Q-tip in your ear, but we do it anyway.

00:23:02 Speaker_04
Did they get advertised for ears at first and then have to change the packaging after too many horrible incidents? Why do we think Q-tips are for ears if they're not? And then, you know, there's a lot more clarity here.

00:23:13 Speaker_04
Haley wants to know, how bad an idea is it to use Q-tips to clear your ears? Haley, I can tell you right now, Dr. Sidney is not gonna give you secret permission to go use a Q-tip in your ear. I've tried, she's not gonna do it.

00:23:25 Speaker_01
And if not Q-tips, how?

00:23:27 Speaker_04
How do we clean our ears?

00:23:30 Speaker_01
So you shouldn't put Q-tips in your ears. I'm sorry, I'm gonna keep saying that. I have seen- What about ballpoint pen caps? No, don't, oh, that's even worse. I think that's the, you know what?

00:23:40 Speaker_01
If there are doctors out there who are saying like, go ahead and put Q-tips in your ears, it is only in situations like that where you have somebody like Justin who's like, well, what if I straighten out a, you know, a paperclip and stick the end of that in my ear?

00:23:53 Speaker_04
No, I don't straighten it out. I leave it bent in an arc. That's a more effective- Okay.

00:23:58 Speaker_01
So you've made your own little unsterile curette there. That's great. Staff covered curette.

00:24:05 Speaker_04
I'll turn on the stove and I'll put it through the burner sometimes.

00:24:09 Speaker_01
Don't do that. Don't stick things in your ears. Here's the problem. You can't see what you're doing. It's a very narrow canal and it has an end. It's a closed circuit. It ends at the eardrum.

00:24:21 Speaker_01
So you're not going to poke your brain, but you could poke a hole in your eardrum and that does happen.

00:24:27 Speaker_01
More likely, though, because I have not seen a lot of people who have jammed something so deeply in their ear that they actually ruptured their own eardrum. It does happen. It does happen.

00:24:38 Speaker_01
What I see more commonly is that you shoved that wax so deep into your ear canal that now it's kind of like pasted up against your eardrum. and that is so much harder to get out.

00:24:51 Speaker_04
You smooshed it, you've tamped it down basically.

00:24:53 Speaker_01
Yes, you've tamped it down and now it's gotten wax that gets stuck back in there gets dry and crusty and then it's really hard to get out.

00:25:02 Speaker_01
Wax is supposed to be kind of soft so that it just naturally like flakes and runs out of your ear like oily soft like candle wax. If it gets real dried out and crusty from being stuck in your ear canal too long, It's really hard to remove.

00:25:15 Speaker_01
The lining of your ear canals is really sensitive and it can start to irritate that lining. You can get like bleeding and scabbing inside your ears. So this is really why we say don't stick Q-tips in your ears.

00:25:27 Speaker_01
I mean, you could poke a hole in your eardrum, but this is probably what you're going to do. And then you might get some of the cotton stuck in there. I have dug

00:25:33 Speaker_01
the cotton heads, like just the little cotton ball from the head of a Q-tip out of ears multiple times. That happens a lot. So you think you're doing good and then you pull the Q-tip out and the cotton's gone.

00:25:44 Speaker_04
So score one point for ballpoint pen cap.

00:25:48 Speaker_01
Here is, so this is why we say don't do it. It probably won't help. If you want to use, I've told people, if you want to clean the outside of your ear, like the little curves and crevices on the outside part of your ear with a Q-tip, I guess, yeah.

00:26:01 Speaker_01
That's great for washcloth though. Well, you can use a washcloth too. You could do that.

00:26:05 Speaker_01
I would use, and they sell these over the counter, there are ear flushing systems where a lot of the cheapest version, if you want to go really cheap, you can get one that's just like a bulb syringe, like you use in a baby's nose.

00:26:20 Speaker_01
You want to fill that with like room temperature water, not too hot because you don't want to burn yourself and not too cold because you'll make yourself dizzy.

00:26:27 Speaker_01
You want to fill that with just like some room temperature water, tilt your head, angle it so that your canal is pointing down towards the sink, probably do it over the sink or the shower or something like that, and just squirt it in there.

00:26:39 Speaker_01
That's a really safe way and that a lot of people, they sell them over the counter. There's fancier ones. There are ones that are like shaped like little ear things that you shoot in there, like little guns and things and whatever.

00:26:49 Speaker_01
But the point is cleaning them out with sterile fluid is a much better way or I say sterile. It doesn't have to be sterile. It's in your ear. It can just be water from your tap. Cleaning it out with water, room temperature water is a safe way. Okay.

00:27:03 Speaker_04
Uh, Sid, I was wondering, is there a name for the feeling that makes you think that you're about to have diarrhea? Like, how nausea describes feeling like you could potentially throw up. If not, can we make one up?

00:27:13 Speaker_04
Thinking about this for no particular reason, that's from Sam. And bubble guts is normally what I go with, but I guess it's not a technical term.

00:27:20 Speaker_01
Well, I was gonna ask if you wanted to make one up because I don't know of a term- Bubble guts.

00:27:24 Speaker_04
For that. How I normally describe it is bubble guts because it's like, it's like rough, you know what I mean? It's bubble guts. It's like all squinchy and squinchy in there and you just feel like things are about to blow.

00:27:36 Speaker_01
I mean, usually we just say, like, urgency. You can use urgency, that feeling that you need to go to the bathroom either way. Like, you can have urinary urgency or... Poo-poo urgency. Rectal urgency.

00:27:49 Speaker_02
Rectal urgency? Bubble guts is so gross.

00:27:53 Speaker_04
Okay. Well, I mean, so is diarrhea.

00:27:56 Speaker_02
What do you want? If you want to make one up.

00:27:58 Speaker_04
Hibiscus. Hibiscus wave. Is that better?

00:28:01 Speaker_01
Sam, if you want to make one up and popularize it, I'll go with it.

00:28:05 Speaker_04
Hey, sometimes when I'm using the toilet, I'll blow my nose with toilet paper and then use that same toilet paper to wipe. This is the question asker, not me. I would never.

00:28:13 Speaker_04
I always assumed that since any pathogens on the tissue were already in my body, I'm probably fine. Am I good? That's from Sincerely Snotty on the Potty, and I absolutely respect this question. What do you think?

00:28:23 Speaker_04
I really like this question because... It's a real God made dirt so dirt don't hurt kind of philosophy. I'm into it.

00:28:32 Speaker_01
Sometimes someone says, I do this thing, and is this okay? And you think, oh man, I hope it is.

00:28:40 Speaker_04
Yeah. Oh, I never thought about four.

00:28:44 Speaker_01
I will say this, uh, please don't do it the other way around. Yeah, definitely. I prefer if we're going to take a, if we're going to gamble, blow your nose first.

00:28:52 Speaker_04
Yeah. You nasty dog for even like suggesting the hypothetical where you're like, got to get a sniffle.

00:29:02 Speaker_02
I'm assuming you're like blowing your nose and then kind of balling it up so that the used side is now inside. You're like a Garbage Pail Kid card right now.

00:29:11 Speaker_04
You are like a Garbage Pail Kid.

00:29:13 Speaker_02
Revealed for the other use, for the downstairs.

00:29:16 Speaker_04
Too nasty.

00:29:18 Speaker_01
too hot for tv oh it's summer nights you're probably probably you could get away with it probably because i mean if we're talking about like the epithelial surface of your skin which is the like your your skin your skin skin um the the

00:29:38 Speaker_01
bacteria that you've blown out of your nose like a lot of like staph and strep and stuff like that it lives on your skin and so probably you're not like taking bacteria that have never been somewhere and putting them a new place right like you're probably it's same old same kinds of bacteria and the only thing i could see as i was trying to think through could this pose a problem is you do depending on how you're wiping you could touch mucosal surfaces like like if you are someone

00:30:04 Speaker_01
who has a vagina and you're, I don't know, you're really getting in there. I mean, maybe. And then you're kind of taking staph and strep bacteria and putting it somewhere. Again, probably not a big deal, probably would just be part of normal flora.

00:30:17 Speaker_01
I can't, if you have a big cut,

00:30:20 Speaker_01
That was the only thing I could think is like, you shouldn't take a big ball of bacteria, and if for some reason you've got a cut or abrasion or something, a sore spot, an open wound, and you rub bacteria against it, you could cause an infection.

00:30:35 Speaker_01
I feel like I'm really reaching to make this bad, though.

00:30:38 Speaker_04
So there's no problem.

00:30:39 Speaker_01
But then it just sounds like I'm endorsing this behavior, which I guess I am.

00:30:42 Speaker_04
Yeah, it's better for the Earth.

00:30:44 Speaker_01
I think we got time for one or two more.

00:30:47 Speaker_04
Okay, if a cat makes biscuits on a pregnant person's stomach, can that cause any problems for the developing fetus? I can feel this one, yeah. Yes, absolutely, it's a big problem.

00:30:56 Speaker_01
What do you mean?

00:30:57 Speaker_04
Oh, it's just, you should never let a cat do that. It could absolutely squinch the baby's face and pinch their cheeks and it could hit the soft spot and explode the baby.

00:31:08 Speaker_01
You know you're wrong, right?

00:31:09 Speaker_04
Yeah.

00:31:10 Speaker_01
Okay, good, just making sure. This is from, oh no, the cats involved were Mimic and Echo.

00:31:17 Speaker_01
Yeah, thank you Mimic and Echo for this great question Amazingly I cannot I I can't think of any way that a cat making biscuits on your pregnant Belly would you just wanted to talk thing about that? I did. I have my cat did that? Yeah, CJ did that?

00:31:32 Speaker_01
Oh But yeah, no, I don't I mean That cat would, I mean, how big is your cat? It's a house cat, but I mean, it's a house cat, right?

00:31:41 Speaker_04
We're not talking about a jungle cat.

00:31:44 Speaker_01
Don't do this with jungle cats.

00:31:46 Speaker_04
Don't let a jungle cat make biscuits on your belly.

00:31:49 Speaker_01
But this is a little house cat. I can't, I can't.

00:31:53 Speaker_04
Hello, Justin and Sydney. Long time listener, first time caller. When I was three, my family doctor found a benign lump on my stomach and told my mom it didn't need to be removed, but as an adult, I could for cosmetic reasons.

00:32:04 Speaker_04
As he guessed, it would only be visible if I had abs. 20 years later, my mom still brings this up. Can't help but wonder how my lump's doing. It's impossible, I absorbed it. I tried to feel for it many times and can't find it.

00:32:17 Speaker_04
Does it scale with me as my body grows? What's going on in there? I definitely don't have abs, so it's Schrodinger's tumor in there. Not malignant or muscular in Maryland. And it, I mean, who knows? You know?

00:32:28 Speaker_01
It, okay, I don't know.

00:32:29 Speaker_04
Body's weird about this stuff. This is one of the weirdest things about the body is sometimes it gets lumps and they go away and nobody knows.

00:32:36 Speaker_01
That's really the answer to this question. This is what I'm saying.

00:32:38 Speaker_04
I had words on my hand for 15 years of my life, woke up one morning, gone. No explanation.

00:32:44 Speaker_01
The heart wants what the heart wants. I hope this is not frustrating, but this is just a general rule of the show. I can't answer your specific question because I didn't examine you, and I don't know what the nature of your exact lump was.

00:32:56 Speaker_01
So it's impossible for me to give you direct advice, and we don't do that on the show anyway. But generally, Justin, you're right. We form a lot of weird little lumps and bumps and masses and things that often are no big deal.

00:33:09 Speaker_01
Now, sometimes they are, but that's why you did the right thing. You went, you got it checked out, your doctor said it was no big deal. I could wager a guess that maybe it was made of like fatty adipose tissue. A lot of them are. They're called lipomas.

00:33:20 Speaker_01
No big deal. Some of them do get bigger, some of them don't. I have one in my arm that I never felt until I was older and now it's gotten a little bigger, but it's just a lipoma, it's no big deal.

00:33:30 Speaker_01
I have one in my stomach under some scar tissue that I think is a little lump of scar tissue. They're no big deals. But yeah, your body can resorb things or they can get bigger or they get smaller or they just stay there forever. No reason.

00:33:42 Speaker_01
But if you're worried about a lump, as always, go get it checked out. I have a question for you, Justin. Real quick, the last one.

00:33:50 Speaker_01
This one, I'm at my parents' house for the holidays and a question presented itself, why do all men of a certain age cough like that? You know what I'm talking about. I love my dad and older men in my family, but holy smokes, these coughs.

00:34:01 Speaker_01
Is there a medical reason they get so bad or they just no longer care to try and make them less aggressive? Thanks from Lauren. Justin, why do you cough that way? You already cough that way. You have the old man cough already. The cough.

00:34:17 Speaker_04
No. My wife's a doctor. Maybe she could tell me what's wrong with me if I'm so broken. What old man cough? Tell me what cough do you mean?

00:34:24 Speaker_01
It's like a very aggressive, explosive cough.

00:34:29 Speaker_04
Yeah, well, you wanna get it out, right? I mean, what are you coughing for?

00:34:32 Speaker_01
Here is my theory.

00:34:32 Speaker_04
I could either cough all day or once at 9 a.m. and once at 9 p.m. It's up to you.

00:34:38 Speaker_01
Here is my theory. I think that, generally speaking, as a species, as we age, we worry less about other people's... like, perception of us. Like, we're less about appearances. We're more just like, I'm living my life.

00:34:51 Speaker_00
I can't be bothered.

00:34:52 Speaker_01
I think that's part of it. And then I think generally, men, generally speaking, are allowed to be loud and be present in a way.

00:35:02 Speaker_01
Whereas, like, as a woman, I think I tend to, like, hide any sort of noise I'm making, like sneeze, cough, whatever, like, bury it into my elbows so that I'm making no noise and taking up no space because I was taught to do so. This is my theory.

00:35:17 Speaker_01
I don't know, but I know Justin already has it. You've already got the old man cough.

00:35:21 Speaker_04
This is such a good question, but I gotta go get the kids at school.

00:35:23 Speaker_01
Okay, if you figure out why.

00:35:25 Speaker_04
Hey, thanks so much for listening to our podcast about our very good marriage. Aww, we love each other.

00:35:35 Speaker_02
Don't joke like that. It's not a funny joke. We have a great marriage.

00:35:38 Speaker_04
Thanks to the taxpayers, and I really do have to go get the kids.

00:35:41 Speaker_01
I know, we gotta go get the kids right now.

00:35:43 Speaker_04
I'm literally like standing up as a fan. Thanks to the taxpayers for using their song medicines as the intro and outro of our program, and thanks to you for listening. That's gonna do it for us. Until next time, my name is Justin McElroy.

00:35:53 Speaker_01
I'm Sydney McElroy.

00:35:53 Speaker_04
As always, don't drill a hole in your head.

00:36:14 Speaker_00
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