- "When I see someone I have a crush on,
does my heart literally skip a beat?"
No, but it can speed up,
and you could even have something known as a PVC. (laughs)
Like, a PVC is a premature ventricular contraction
where your heart, like, beats,
but nothing really happens.
So it's like an incomplete beat, if you will,
but they happen rarely and without symptoms,
usually pretty benign.
So the answer is maybe.
"Help, I fart really hard and it hurts.
How do I fix this?"
Is there a name?
Fart splints or something?
Sam, you know what it is.
- [Sam] I've never heard of this before.
- Painful fart.
- [Sam] Sam, you got painful farts.
You know what this is.
- The answer is, what's going on,
sometimes there's hemorrhoids.
And there's two different types of hemorrhoids,
internal and external.
External is usually the ones you feel
'cause they're past the pectinate line.
There's also anal fissures that can bleed quite,
quite badly.
You can actually end up getting a cream
that's called nifedipine.
It's compounded with usually some lidocaine
or some other numbing agent that allows that sphincter
to relax a bit and heal better.
There are surgeries obviously,
but those are for more advanced cases.
"Someone please tell me if you had no bones,
could you still move?"
- No.
No.
Well,
no!
- No.
Well...(laughs)
- Because your muscles are attached to bones,
and if you have no bones, the muscles aren't attached
to anything so you couldn't move.
"Why do vegetables taste bad?
Why can't they just taste good?"
I disagree.
I think an asparagi in my mouth after a steak is wonderful.
Asparagi, right, when there's multiple?
I'm googling it.
- [Sam] Plural of asparagus.
- It's either asparagus or asparaguses.
I take back my asparagi.
Okay, there are no asparagis in my mouth,
only asparaguses.
That sounds weird.
(Steve Carell laughs)
"I'm 25 years old and I've never had a nosebleed.
I would very much like to experience one.
How would you," no.
What is? Why?
What am I reading?
"How do I know if I have a slow metabolism
and whether I need to speed it up?"
Unless there's an issue,
meaning you're struggling to lose weight
and you've been documented to be overweight
and there's a health condition that's being impacted
by the fact that you're overweight,
I wouldn't worry about your metabolism per se.
And in general, the things that you would do
to live a healthy lifestyle will help you maintain
a healthy metabolism.
I wouldn't think about it as slower or faster
because a too fast metabolism is also problematic
and too slow is problematic.
So ideally, you want a balanced metabolism.
And a balanced metabolism is one that comes
with a healthy lifestyle.
Obviously, there are some factors outside of your control,
but that's when diseases happen,
and that's when a doctor should intervene.
"All of your hiccup cures are just
the top results on Google.
What makes you any better than just googling
what's wrong with me?"
I guess you can.
It's just, Google's gonna give you a lot of info,
and it's gonna be in text and boring
versus here, we're having fun
and enjoying the time together!
Hey, how are you doin'?
- How are you doin'?
- "I've been having a lot of problems
with excessive sweating.
I know you've dealt with this a lot,
so do you have any advice?"
Become okay with sweating is a good piece of advice,
and I've become better with it.
Understanding that it's kind of part of life.
There are prescription-strength deodorants
that you could use.
You could even use them on your palms
if that happens there.
There are injections like Botox
that you could inject directly into sweat glands.
I've never went down this route,
but I've heard people do it,
and I've met doctors that do it with good results.
You just have to do it maybe a couple times
in order to get longer lasting results.
I don't know, I kinda just sweat and live.
"You got so triggered in your last meme review
by people saying they shower at night.
I shower at night because it keeps my bed cleaner
when I go to sleep.
Do you really think showering in the morning is better?"
Yes!
And I take a passionate stance on this,
and I wanna argue with everybody in the comment section
that I prefer to shower in the morning,
and that's the logical way to go.
Let's lay out a list of pros and cons of showering
in the morning versus at night.
Let's say you shave very frequently
and you get some nicks sometimes,
maybe it's better to shower in the morning.
Why?
Because you have more platelets in the morning,
interesting, fun medical fact.
Let's say you're stressed out
when you wake up in the morning
or you need a little creativity bump,
it's a good time to do it right there in the morning.
And you know what you do at night?
You sweat, usually more than you sweat during the day
with the exception of exercise, obviously.
You're gonna have oil in the night,
you're gonna have sweat in the night,
clogged pores in the night.
So waking up in the morning
and showering gets you ready for the day,
cleans off your body, and makes you ready to go on.
The only thing I would say is
if you're gonna shower in the morning,
shower a little bit cooler
because warmer might make you sleepy
and wanna go back to bed.
But now for the people who like to shower at night,
ideally if you are doing this, it can help you fall asleep,
especially if you do it, like, 90 minutes before.
You keep it short, like, five to 15 minutes
because if you're exposed to a lot of heat
for longer than that, it could actually be activating
instead of sedating.
Benefits, obviously throughout the day you get dirty,
oil, all that stuff,
and therefore, you might not wanna bring that
into bed which can be acnegenic,
causing some clogged pores and stuff.
Also, it might be better to shower
at night if you're sun sensitive
because if you exfoliate, for example,
and then you go out in the sun,
that might be a problem 'cause your skin's more sensitive.
But if you exfoliate at night, for the morning,
you're ready to take on the day.
And probably the best reason for most people
that have allergies to shower at night is
because you wash off all the pollen that you got on you,
and then you don't bring it into bed so you sneeze less.
Do with that what you will,
but for me, morning shower.
And, like, post-exercise obviously
because you don't want yeast and all that stuff developing.
"Did you become a doctor because your father forced you?
Because I think you'd be a better stand-up comedian."
Okay, you're probably being sarcastic.
No, my father didn't force me,
and I would not be a better stand-up comedian.
I would like to try my hand at it.
I kinda did on the live tour,
and I had, like, two good jokes,
and in order to see them,
you have to come to the next edition of the live tour
whenever that's happening.
"Is Bear in a Jeep Grand Cherokee commercial?"
There is a Newfoundland dog named Bear
in the Jeep Grand Cherokee commercial,
and I am kind of upset that they didn't use my Bear.
Bear, you know you're in a commercial?
Come here.
Have you been secretly going out
and earning in the night Jeep Grand Cherokee ads?
I should get at least a little cut.
I feed you.
Wow.
I don't care if you're working without my permission,
come here,
but you do need your working papers all right, son?
Just next time if you do a commercial,
can you do it for, like, a Lamborghini
so they give us one for free?
"Do people actually sleepwalk?
How can I make sure it never happens to me?"
You can't make sure,
but if you sleep well, you sleep the same number
of hours consistently, you don't take any substances
that impact your sleep,
the risk of you sleepwalking decreases,
but you can't be 100% protective of it.
"Is it normal to have migraines every single day?"
No, absolutely not.
In fact, while we have medications that are abortive
in nature that stop migraines,
there's also medications that are preventive in nature
and that prevent migraines from coming on,
and you should discuss those with your doctor.
And not all of them are labeled migraine medications.
Some of them are like heart rate medications
like beta blockers that actually help with migraines,
or antidepressants that can be used off label for migraines.
So, worth a discussion.
"When the doctor asks if I'm on any prescription drugs,
should I tell him I'm using prescription toothpaste
or does that not count?"
I have yet to hear about prescription toothpaste,
but absolutely, it counts.
It should be, are you taking anything, period.
Like, prescription or non-prescription,
those things still have side effects.
So I don't even understand the distinction between the two
unless you're asking to refill a prescription
to send something to the pharmacy.
I never just ask my patients,
are you taking any medications?
It's, are you taking any medications?
Are you taking any supplements, any creams, et cetera?
So toothpaste absolutely falls into that category,
prescription toothpaste 'cause that's not just,
like, a regular over-the-counter product.
"Are breads that have a bunch of visible seeds
in them actually healthier than bread that doesn't?
Or is that just a marketing trick to seem healthier?"
Well, first of all, Lizzy, some people enjoy those seeds.
Like for example, I like bread with pumpkin seeds
or sunflower seeds on it.
I think there's a big factor to be had with flavor.
There's also different macros that come
with those breads because depending on the type of seed,
you may increase the protein concentration.
Also, the big hack that comes from having seeds is fiber.
If you don't mind the seeds, I add them on.
"Can I become more tolerant of mental health medication?
30 milligrams used to do the trick,
but it doesn't feel like it has the same effect anymore.
Have I gotten used to it?"
It really depends which medication you're talking about
because some medications absolutely do have
a tolerance-building effect.
Xanax as an example, like, those are benzodiazepines.
The answer is it depends.
"Do you have a workout playlist you can share?"
I don't.
I just use dance workout playlist.
Actually, I could show you a picture of it.
Workout music hits 2023.
It's a really random playlist, but I like it.
"Is it better to hydrate myself with warm or cold water?"
There's probably no perfect answer to that.
Really cold, not ideal.
Really hot above 140, we've seen rates
of esophageal cancer going up.
So, again, stay away from the extremes.
"What is the actual risk of drinking alcohol
if you're on painkillers?
What could actually happen?"
Well, it depends which painkillers you're talking about.
If you're talking about opioids, obviously,
there's the risk of respiratory depression,
and then if you pass out,
you can aspirate your own vomit and die.
When you're drinking alcohol,
you're less likely to make good decisions
so you could take too much of the painkiller and OD.
When it comes to stuff like Tylenol,
it takes a load onto your liver
because your liver actively needs to filtrate it.
And in fact, some of the biggest hospitalizations
for liver failure come from an overuse of acetaminophen,
which is the active ingredient in Tylenol.
And then when it comes to, like, the Advils
and Motrins of the world, these are NSAIDs,
non-steroidal anti-inflammatory drugs,
and those can actually have an impact
on your stomach lining, which then by drinking alcohol
which irritates the stomach lining
kinda has a doubling effect
of irritation causing worsening gastritis,
especially if you have an ulcer.
"Is it true that eating poppy seeds
on a bagel can cause you to fail a drug test?
How long does it take for those seeds to clear your system?"
You know, it's a good question.
I don't know, but anecdotally, I have heard this to be true,
specifically in, like, armed forces
and police officer exams,
they tell you not to use those products.
"Is it healthy and safe to eat insects like crickets?
I'm seeing them become more popular here
in Europe and I'm skeptical."
If they've been prepared by an adequate food agency,
I don't know what the equivalent of FDA is in Europe,
then I don't see why that would be a problem.
Eating them fresh off the ground,
I can imagine that some things could go wrong.
I don't know, not really a wildlife expert.
"Is playing chess an exercise?
Because when I play, my heart rate goes way up."
You know, I used to think it no,
but there's been articles coming out
of individuals losing a significant number
of pounds while playing chess and tournaments.
You know, glucose feeds the brain
so it obviously burns some calories,
your heart rate goes up.
I would say that it's an imperfect exercise
'cause it doesn't make use of your muscles,
your musculoskeletal system.
And as a result, you can develop aches, pains
by being in the same locked-in position.
I would say incomplete exercise,
but a good exercise nonetheless.
Val, "What time of day is best for working out?
Can I make more progress going in the morning for example?
Is there a time of day the body is more primed
for exercise?"
I've seen this go both ways within my patient population,
even for myself.
For example, if I'm gonna do a low-intensity
long exercise session, doing it at night doesn't bother me.
It actually helps me fall asleep real well.
But if I was to do sprints
and doing them close to bedtime at night,
when I dump all of that adrenaline,
it's actually hard to fall asleep
and I need some time to wind down.
Also, some people are not early morning risers
so when they wake up, they don't feel great.
That works also even more both ways,
that some people will start exercising
and feel better.
Therefore, that's kind of their hack to getting started,
and other people just don't get good adequate performance,
and they would prefer to work out later in the day.
But medically speaking, we don't have
a thorough answer for that.
"You said sweating more means you pee less.
Does the same apply to crying?
Can I cry so much I never pee?"
Never pee, no 'cause you're still gonna be using liquids
unless you stop drinking and then you keep crying.
Ultimately, your tears will dry up probably before your pee.
In fact, if I see a child in the emergency room
and their lips are dry and they're crying
and I don't see tears, I'm really worried about dehydration.
"Why do I get hiccups anytime I eat any really spicy foods?"
Oh, that's probably because
you're irritating your diaphragm,
and your diaphragm starts to have, like, a spasm in it.
If you take an inhale
then a little bit more inhale, without exhaling,
and then another one real quick, really fast
and really hard, it actually stops the hiccup.
I don't know how.
It, like, paralyzes your diaphragm or something.
"What advice do you have about whether a patient
should go see a doctor that works in a giant hospital
and healthcare system versus seeing a doctor
with a small local private practice?"
I think most days, doctors that are even
local private practice are affiliated
with bigger institutions.
I'm a fan of having a small local physician
that you have a good rapport with
and longstanding relationship with.
And then if something is outside of their practice
or their abilities to help you,
they have a healthcare system
behind them that they can refer you to.
But a giant hospital could be really good
if you have a rare condition
or obviously, like a Level I trauma
or something like that.
"Why do I keep getting charley horses in my legs
when I'm trying to sleep at night?"
Most commonly for young, healthy, athletic people
this happens as a result of fatigue.
If you over fatigue a muscle,
especially if you start a new exercise regimen,
you go a little too hard,
you could start developing those types of cramps.
Also, there's obviously issues with electrolytes
in some people that are maybe dehydrated
or they're not just taking in enough electrolytes.
"How can I learn to swallow a pill?"
Oh, there's actually really useful diagrams
on Harvard that they show, I'm showing them here,
about using a water bottle where you actually
suck the water bottle,
and it allows you to swallow the pill better.
Obviously, there's certain pills that you can crush
and sprinkle into yogurt or applesauce or something.
Just be careful.
Not all pills are able to do that.
Make sure you read the instructions really carefully.
"Why does a baby become comforted by a pacifier?"
It tricks the baby into thinking they're being fed,
I presume.
It's the suck reflex, so makes sense.
I'm not a huge fan 'cause it changes the development
of the baby's mouth.
I try to minimize pacifier use
or at least encourage my patients to minimize pacifier use.
But that being said,
I understand a crying baby is very difficult.
So I understand the need for a pacifier.
"Is rosacea a bad thing?
I've always had it,
but always thought it was just one of my beauty traits."
Well, it really depends what's causing your red cheeks.
A lot of times doctors will say it's rosacea,
but it could be rosacea plus something else.
I would more so look at the symptoms,
how much they're bothering you,
what else is going on in your body.
Generally speaking, rosacea is just kind of
a blood vessel issue that causes some discoloration
on your skin that usually is localized to the area,
but not in every case.
Sometimes rosacea can be paired
with autoimmune conditions for example,
or rosacea can be diagnosed when there's really
a more correct diagnosis like lupus
and you get the butterfly rash.
So you gotta be really careful when it comes to rashes.
Kris Collins, AKA Kallmekris, actually shared
some really intimate stories on this podcast.
I highly recommend you check out
"The Checkup" podcast with Kris Collins.
As always, stay happy and healthy.
Click here.
(easy-going music)