- "How does the heart keep beating and beating for years
and never stop?"
Don't stop, won't stop, heartbeats for life.
It just does.
You have an SA node, an AV node, the Purkinje fibers,
they go throughout your heart and they help your conduction.
If the electrical system is there,
the musculoskeletal system will listen.
As long as everything else is in place
you know, oxygen, electrolytes, all the good stuff.
"Okay, so pathologists study a tumor once it's removed,
but then what?
Does it get incinerated?
Sent to the dump? Shot into space?"
Well, it doesn't get shot into space,
'cause that'd be quite expensive.
It gets thrown out in the biohazard disposal.
What happens with it then?
I have no idea.
But you've seen those biohazard red bins,
that's where the tumor goes.
And there's no need to incinerate it,
you don't need to burn it.
Actually, I guess if there's like
infectious things in there,
maybe you do need to burn it,
and it ends up being incinerated.
Like let's Google what happens.
"What happens to biohazard waste?"
Oh, 90% of biohazard waste is incinerated.
The more you know.
"An onlooker has the choice to save five people
being in danger of being hit by a trolley,
by diverting the trolley to just kill one person.
We know Dr. Mike would pull that lever,
because he has no problem murdering someone for charity."
#creatorclash, what is that?
I don't get it.
Oh, because I murdered iDubbbz for charity?
I didn't murder him, he's doing great.
Would you divert the trolley to just kill one person?
Oh man.
There's too many other factors
that I don't have the information to.
And as a doctor who thrives in the sea of nuance,
I refuse to swim in this ocean.
- [Observer] Ooh, good answer.
That's professional.
(Dr. Mike laughs) Well done.
- "Is it bad to draw on my hand with a pen?
My mom tells me it will give me pen cancer."
Never heard of pen cancer.
Heard of pen15 cancer if you know what I mean.
"Do nipples grow back?"
Do they grow back after what?
Is my question.
If you had a traumatic thing where you lost a nipple,
no, just skin would form there.
123Music, "If I scratch my mosquito bite,
will it get itchier?"
Absolutely.
The reason this happens is because of histamine production,
the more you scratch, the more inflammation,
the more histamine, the bigger the hive,
the more itchy it becomes.
And if you cause excoriations,
which means openings in the skin,
you could actually create an infection on top of it,
which is a problem,
'cause now you're gonna have to put steroidal cream
to decrease the itching,
and then an antibiotic cream to fight the infection.
"Is it true that if you chew gum while studying,
then chew the same flavor gum while taking the test,
you'll recall the information you studied better?"
It's possible.
They say that you should try and replicate
your study environment as much as you can
during your testing environment.
I think that probably goes a step too far.
You're probably spending more effort
in trying to do this kind of hacking thing,
than actually the effort
that you could be spending on studying.
If you love chewing gum and you love the minty flavors,
stick with the minty flavor, don't change.
And know that if you cram and you stay up all night,
it won't enter your long term memory,
the information you studied.
"Is it weird to go to a doctor for multiple things
at the same time?
What should I do if I have several things to go over
and only few minutes?"
Great question.
Can we cover multiple issues in one visit?
Sometimes yes, sometimes no.
If your symptoms are connected,
and can be pointing to one universal problem
that's causing all of these symptoms.
If you have diarrhea, are sweating profusely,
are having palpitations,
perhaps you're having a thyroid issue.
And had you only presented one of those concerns to me,
I might miss the thyroid issue,
'cause I think, "Oh, diarrhea,
maybe just an upset stomach related to something you ate."
Why sometimes no?
Well, if you come in and you say your foot hurts
because you sprained your ankle,
but then you also get headaches sometimes,
and then you're also due for your pap smear.
You could see how we can't get all that done in one visit,
but a good doctor will say what's the most important to you,
and what they think the most important
is to address in a given moment,
meaning what's the most timely,
and then we can reschedule you for a follow up visit.
"Does it matter when during the day
humans get eight hours of sleep?
I have friends who are bartenders at night
and then sleep during the day."
If you're getting seven to nine hours of sleep,
that's important,
but then consistency is also important,
and then also the time of day of sleep is also important.
Humans are not nocturnal creatures,
so we need to be out in the sun,
and that's how our circadian rhythms work.
People who work during the night and sleep during the day
have more health problems on average.
And we don't have the exact reason as to why that happens,
but we know that it's definitely present.
We actually even have a disorder called shift work disorder
from individuals who have that problem.
"When I have aches and pains,
I treat it with a cocktail approach,
some acetaminophen, some ibuprofen, some aspirin,
all at once.
Should I continue this approach,
or is one better than the other?
Is one better than the other is actually a question
I get a lot from patients.
They're like, "I have this ache or I have a fever."
All three of these medications are pain and fever reducers.
There's certain instances
where I would recommend one over the other,
one is not the best.
For example, if you have kidney problems,
you may not wanna be taking an ibuprofen medication
which gets excreted through the kidneys
and can potentially damage the kidneys.
If on the other hand, you have really bad liver disease,
maybe you wanna not be taking acetaminophen,
'cause that gets metabolized within your liver.
There's different instances where you wanna be smart,
for example, if you're prone to bleeding
and have a bleeding disorder,
aspirin can actually inactivate your platelets
and cause you to bleed more.
I try and minimize the use of these medications,
because reducing fevers is not always a good thing.
A fever is beneficial,
it's helping you overcome whatever infection you may have,
so unless there's a reason,
we shouldn't be lowering a fever in many cases.
"Has a patient ever come in with a disease or a condition
you've never heard of before?"
Absolutely.
Remember I'm a family medicine doctor,
anything can walk through my door at any time.
And I have to not only figure that out,
but also maybe even learn about that condition
right there on the spot.
And the more open you can be with a patient
about what you know and what you don't know,
the better that line of communication's gonna be,
because not everyone can know all the answers right away.
"Why does taking a long, deep breath help calm you down?"
Because it actually activates your vagus nerve.
That is the primary nerve in your body
responsible for parasympathetic tone,
meaning your ability to begin rest, repair and digestion.
If you're very riled up,
you could have decreased activation of this vagus nerve,
and as a result, be very on edge.
So when you take that deep breath,
it actually helps normalize the parasympathetic tone,
helps calm you down, and you chill out.
"Why do I sometimes like the smell of my own farts?"
Okay Krissy, didn't expect that you'd go there.
But there's actually a psychological phenomenon
that's occurring here.
The longer your body is exposed to a specific stimuli
from outside the body,
so for example, when you try and go to sleep,
white noise works well,
because your body starts to tune out the white noise,
'cause it's the same level of noise.
That's why noise that's quiet and then really loud
will wake you up at night,
'cause it triggers your brain to react to it.
But if you constantly over time smell your farts
and smell your own body, you become accustomed to it.
So it doesn't trigger that same level
of response from your brain.
So when others smell other farts, poop or what have you,
it triggers in them that there's a foreign substance,
potentially poisonous substance,
that they should stay away from.
But when it's your own,
your body's not having that threat,
because it's been smelling it for so long,
you have a decreased stimulus response.
"When people train to hold more air in the lungs,
what exactly is getting stronger?
Do the lungs inflate more?"
Well yeah, the lungs can inflate more,
hormonally, things change,
cellularly, things change,
like you're able to produce more red blood cells,
you have a higher hematocrit,
you're able to withstand periods of anaerobic stress
for longer periods of time,
so you have better lactic acid removal from your body.
So it's not just like hold more air in your lungs,
it's the processing of being in an anaerobic state
that is equally important in this situation.
"Hey Dr. Mike, my family tells me that eating too much salt
will melt my bones.
Is this true?
And if so, how much salt is too much?
Melt your bones?
Melt? Melt?
I don't know.
Is it ideal to eat too much salt?
No.
There's recommended dietary intake
for every age group and it's different,
it's also based on health conditions,
so I can't give you an exact number
but just don't over salt your foods.
Moderation.
"Why are some people able to live well into the 90s
if they are heavy smokers?"
Well, this is important,
and it kind of brings up the notion
of what happens when you have unhealthy habits.
Too often I tell patients, "Hey, you shouldn't smoke."
And they say, "Well, my loved one lived a long life
and didn't even have lung cancer."
But the important thing to remember
is not all smokers end up getting lung cancer.
In fact, most smokers don't get lung cancer.
A lot of smokers get diseases like COPD, emphysema,
these are quality of life reducers
and quantity of life reducers.
So you may live into your 90s,
but you have to live with an oxygen tank,
and have such bad dyspnea or shortness of breath
that you can't walk to the bathroom
without feeling a tremendous amount of air hunger.
It's not just do you die, it's how well you live,
and with what conditions you live.
I misdraw my life videos, so I made one.
Animated story of how I came to America.
Such a good,
"well, I bet you don't know a lot about me."
As always, stay happy and healthy.
(upbeat music)