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<v Speaker 1>Imagine the place where you can escape for a day,

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<v Speaker 1>get immersed in a world of rooms, inspiration, and expertise,

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<v Speaker 1>where you can lay luxury, accommodation and kids cam fees

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<v Speaker 1>from ninety five sets. Tickets are free to everyone and

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<v Speaker 1>include all the attractions you've just imagined a day out

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<v Speaker 1>at the kia Ikia the Wonderful every Day.

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<v Speaker 2>Oh hello, hey, Hi, it's your little newborn niece who

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<v Speaker 2>looks like an old Greek sailor. Ali Ward here with

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<v Speaker 2>another episode of Ologies. So in this episode we're going

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<v Speaker 2>to talk to a person who is passionate, so passionate

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<v Speaker 2>about those lumpy snoots we've all got sniffing around right

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<v Speaker 2>in the bullseye center of our faces. And this ologist

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<v Speaker 2>really knowses stuff. So much information on allergies and smells

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<v Speaker 2>and history and street drugs. But before we get to it,

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<v Speaker 2>per usual, thanks to everyone making the podcast possible by

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<v Speaker 2>buying into the Patreon membership starts to twenty five cents

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<v Speaker 2>an episode. My heart is cheap, so you guys, let

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<v Speaker 2>me pay an editor and buy Mike cables and memory cards,

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<v Speaker 2>and you ask great questions which I pass on to theologists. Also,

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<v Speaker 2>merch is available at ologiesmirch dot com and on Mondays.

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<v Speaker 2>I post photos on theologies Instagram of you sexy biscuits

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<v Speaker 2>wearing your Ology shirts and hats and pins. You can

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<v Speaker 2>tag it Ologies merch and let me see your faces

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<v Speaker 2>the babies. Also, for no money and very little effort,

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<v Speaker 2>you can be a friend of Ologies just by telling

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<v Speaker 2>your carpet cleaner or aunt in law or account executive

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<v Speaker 2>that you like it and that they might also, And

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<v Speaker 2>as a quiet, thirsty thank you, I read all your

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<v Speaker 2>reviews on iTunes each week, and then to prove it,

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<v Speaker 2>I read you one. This week's review is titled on Creepiness.

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<v Speaker 2>It's from Jjpyo. Hello, Allie. I would like for you

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<v Speaker 2>to stop calling yourself creepy. Although you do often admit

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<v Speaker 2>to some creepy things, Reading all your reviews is not creepy.

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<v Speaker 2>So if you're creepy, that makes me creepy. And I

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<v Speaker 2>think it's rude that you're calling me creepy all the time.

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<v Speaker 2>I digress. The podcast it is very good five stars. Okay,

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<v Speaker 2>Onto Rhinology. Why not a gy? So you likely have

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<v Speaker 2>a firm but soft and a beautiful but gross wedge

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<v Speaker 2>of flesh holding cord on your face. But how well

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<v Speaker 2>do you know it? I mean, it's a mystery in there, man,

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<v Speaker 2>It's a moist catacomb that leads to your brain. Is

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<v Speaker 2>that how it works? We're going to find out. So,

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<v Speaker 2>first off, rhinology comes from the Greek for snout. I

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<v Speaker 2>came to know this rhinologist through a Twitter lead. Someone

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<v Speaker 2>was like, heypes, I got a rhinologist for you, and

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<v Speaker 2>I was like, let me add him. So I happened

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<v Speaker 2>to have been in Detroit last week shooting, and I

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<v Speaker 2>made some time to take a lift over in a

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<v Speaker 2>torrential Michigan summer downpour to find the entrance at the

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<v Speaker 2>Henry Ford Medical Center in the downtown d No relation

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<v Speaker 2>to the museum I also do work with. It's just

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<v Speaker 2>in Detroit. Literally everything is named after Ford. Gcuting a

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<v Speaker 2>restaurant where I Tater Tots the same day. Now, this ologist,

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<v Speaker 2>who by the bye has an entire YouTube channel brimming

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<v Speaker 2>with sinus surgeries, took me to an office and we

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<v Speaker 2>gabbed about noses for oh almost an hour. Over an hour.

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<v Speaker 2>Side note, Okay, I can deal with a lot of

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<v Speaker 2>gross shit. I've held spiders as big as my palm.

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<v Speaker 2>I've eaten scorpions. I've even dated musicians, but I cannot

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<v Speaker 2>deal with the word or the concept of this, and

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<v Speaker 2>I'm gonna whisper one time. Okay, mucus. I did not

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<v Speaker 2>want this episode to be a sonic minefield for my

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<v Speaker 2>gag reflex. From now on, when you hear the that's

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<v Speaker 2>just me bleeping the moist M word, I'm gonna say

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<v Speaker 2>the F word freely, but I'm censoring the word that

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<v Speaker 2>rhymes with fucus because I can and I will. So

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<v Speaker 2>to make it fun, feel free to take a sip

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<v Speaker 2>of your beverage at the ding or do a tiny,

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<v Speaker 2>imperceptible butt dance when you hear that noise in celebration

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<v Speaker 2>of not hearing the word that it's replacing. I will

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<v Speaker 2>do that on my end with my end. Now, if

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<v Speaker 2>you love that word, feel free to lock yourself in

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<v Speaker 2>asana and sing a song about it on a banjo.

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<v Speaker 2>I don't give a fuck. I just can't deal. So

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<v Speaker 2>it's dings from here on out. It's Dad's podcasts. She'll

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<v Speaker 2>do it the way she wants, Okay, all right, oh man.

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<v Speaker 2>In this episode, we talk about hey fever and nose

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<v Speaker 2>jobs and septims and piercings and snoring and snorting and smelling,

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<v Speaker 2>and I had nose idea of the mysteries deep deep

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<v Speaker 2>in my skull holes. So open your ears, throat, and yes,

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<v Speaker 2>your nose for the life altering wisdom of rhinologists, Doctor

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<v Speaker 2>John Craig, so works. Yeah, get up in it. Thank you,

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<v Speaker 2>by the way for doing this.

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<v Speaker 3>Are we on?

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<v Speaker 2>We were on, We're already rolling. But thank you so

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<v Speaker 2>much for letting me come to this hospital on a

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<v Speaker 2>very very rainy sunday in Detroit.

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<v Speaker 3>We are in the depth of the d.

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<v Speaker 2>We'll start with the basics. How long have you been

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<v Speaker 2>a rhinologist? And that is a word, correct.

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<v Speaker 3>It is a word. Yes, So I've been in practice

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<v Speaker 3>for three years now. That's after doing a five year

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<v Speaker 3>residency in E and T surgery and then a one

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<v Speaker 3>year fellowship in dedicated rhinology.

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<v Speaker 2>When you were a kid, did you have a fascination

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<v Speaker 2>with certain body parts or certain types of medicine? Or

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<v Speaker 2>I mean, I want to ask how you picked noses,

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<v Speaker 2>but that's not it. I feel like how you've selected

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<v Speaker 2>noses would be a better way of phrasing that, but it.

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<v Speaker 3>Could call No, there wasn't any particular my father was

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<v Speaker 3>an emergency room position.

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<v Speaker 2>Oh he was, so you grew up around I grew

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<v Speaker 2>up around.

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<v Speaker 3>Yeah, my mother was a X ray tech as well,

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<v Speaker 3>so a lot of medical conversation. I was just always

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<v Speaker 3>fascinated by not so much anatomy because we didn't talk

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<v Speaker 3>about anatomy that much, but just the thought processes behind

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<v Speaker 3>medical decision making. And for some reason that that was

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<v Speaker 3>interesting to me, and like, you know, the high school

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<v Speaker 3>era really yeah. So and then I went to college

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<v Speaker 3>and studied psychology and then it took on like a

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<v Speaker 3>whole other level of understanding the doctor patient interaction, and

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<v Speaker 3>that combined with my kind of interest in science, just

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<v Speaker 3>made sense.

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<v Speaker 2>Do you find that when when rhinologists get together, it's

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<v Speaker 2>just like a chat? Are all cha boxes?

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<v Speaker 3>Big doork session?

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<v Speaker 1>Oh?

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<v Speaker 3>Yeah, it's pretty common. Actually, it's probably one reason I

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<v Speaker 3>liked it too. Everybody's very passionate about the nose and

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<v Speaker 3>the sciences. So I definitely had a lot of sinus

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<v Speaker 3>slash nasal issues growing up. And I don't think it

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<v Speaker 3>drove me to choose to do this, but it is interesting.

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<v Speaker 3>There must be some subconscious process or maybe conscious that

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<v Speaker 3>drove me.

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<v Speaker 2>There's got to be a doctor heel self situation, like

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<v Speaker 2>you know, I'm also a client, Like there's got to

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<v Speaker 2>be something there. Now, I'm sure you get this a lot.

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<v Speaker 2>E and T's why are ears, noses, and throats all

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<v Speaker 2>lumped together? Were you studying and you're like, I'm leondering

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<v Speaker 2>about this throat and these ears, but I really care

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<v Speaker 2>about the noses. Was there any part of you where

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<v Speaker 2>you're like, let's just get to the noses. Do you

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<v Speaker 2>prefer the nose over the ears in the throat is

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<v Speaker 2>what I'm asking?

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<v Speaker 3>Oh, yes, okay, very much so. Yeah, No, I've always

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<v Speaker 3>been since about midway through residency. I was more fascinated

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<v Speaker 3>by the inner workings of the sinuses and the nasal cavity.

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<v Speaker 3>So all those areas for me were just more interesting

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<v Speaker 3>than the throat in the ears.

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<v Speaker 2>Poor throat in ears. The ears seem like a whole

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<v Speaker 2>other situation, to be honest, because I get that the

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<v Speaker 2>nose in the throat are connected. Anyone who's ever gotten

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<v Speaker 2>soda up a nose or out a nose. I threw

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<v Speaker 2>up jello shots on my twenty first birthday out of

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<v Speaker 2>my nose, So we get that they're connected. But the ears,

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<v Speaker 2>that's hearing. Did you have to learn everything about ears

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<v Speaker 2>as well, and then you could say, okay, noses, I'm

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<v Speaker 2>on to you.

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<v Speaker 3>I think that's a very insightful comment you just made.

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<v Speaker 3>A lot of us do feel that the ears are

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<v Speaker 3>their own world. But yes, I think the people treating

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<v Speaker 3>the nose definitely view the ear as a separate entity.

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<v Speaker 3>A lot of times the hearing apparatus is definitely a

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<v Speaker 3>separate entity.

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<v Speaker 2>I do also feel like ears are like, we have

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<v Speaker 2>the smallest bone in the body, and everyone knows that

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<v Speaker 2>fact about us. Yes, that's okay, ears, we get it

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<v Speaker 2>so quick. Aside, this was going to be an insert

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<v Speaker 2>to just talk shit on the smallest bone in the

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<v Speaker 2>body and the ear for being like, yes, I do

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<v Speaker 2>contain this smallest bone in the body. But I looked

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<v Speaker 2>up this little thing. It's called the stapes. It means

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<v Speaker 2>stirrup because it's shaped just like a metal stirrup that

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<v Speaker 2>you slide your boot in while hoofing around on a horse.

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<v Speaker 2>It also looks like a tiny, tiny wishbone glued to

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<v Speaker 2>a plate. And I wanted to be like whatever, ears,

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<v Speaker 2>who cares? But I gotta be straight with you. I

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<v Speaker 2>gotta come clean and say it's a really cute fucking bone. Like,

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<v Speaker 2>it is so tiny, it's smaller than your pinky nail,

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<v Speaker 2>this cute little thing, and it's held aloft in your

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<v Speaker 2>inner ear by tendons, and it makes the femur look

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<v Speaker 2>like Godzilla. And it's so cute that you have two

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<v Speaker 2>of these, probably gently rattling around in your skull like micromachines. Ooh. Anyway,

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<v Speaker 2>Doctor Craig cares about nose medicine in particular because, as

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<v Speaker 2>we mentioned in his upbringing, having shitty nose function can

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<v Speaker 2>be a real buzzkill. Sinus issues suck.

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<v Speaker 3>But they can cause significant quality of life issues for patients.

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<v Speaker 3>If you have trouble breeding through your nose, a lot

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<v Speaker 3>of a lot of pain bleeding. These things affect your

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<v Speaker 3>daily life. It's hard to conduct normal work day if

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<v Speaker 3>you always have blood or fluid pouring from your nose.

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<v Speaker 2>It's true, it is very like a first day with

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<v Speaker 2>a bloody nose. Yeah, not happening.

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<v Speaker 3>Not good.

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<v Speaker 2>Do people ever shove tampons up their nose when they

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<v Speaker 2>have bloody noses? Sorry, I'm still asked some.

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<v Speaker 3>Version of that. Yes, some type of packing material can be.

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<v Speaker 2>Placed perfect for it to be honest.

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<v Speaker 3>I've actually definitely seen a patient show up to my

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<v Speaker 3>office with a tampon on their nose, so it's possible.

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<v Speaker 2>Was it a lady or a man?

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<v Speaker 3>Man?

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<v Speaker 2>Yeah, I have a feeling he borrowed.

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<v Speaker 3>It from somewhere I think he did. Yes, were you

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<v Speaker 3>like well done, sir? I definitely applauded his efforts. He

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<v Speaker 3>got the job done.

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<v Speaker 2>So when you talk about pathologies, run me down some

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<v Speaker 2>of the big eiaes. I mean, what would you say,

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<v Speaker 2>or maybe run me down what your most common issue is.

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<v Speaker 2>Is it like I can't sleep because my nose is

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<v Speaker 2>messed up? Or is it allergies?

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<v Speaker 3>That's a great question. So the full gambit, I would say,

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<v Speaker 3>from inflammation to tumors, So inflammation would be things like

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<v Speaker 3>allergies sinusitis. Sinusitis can actually be either inflammation driven or

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<v Speaker 3>infection driven, so it doesn't always mean an infection heads up.

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<v Speaker 2>Itis just means inflamed or swollen, red, painful, So siny

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<v Speaker 2>sitis just means inflamed nosal area. Now, if you've ever

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<v Speaker 2>had senioritis your last semester of school, you have maybe

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<v Speaker 2>been inflamed and hot and swollen, which honestly sounds a

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<v Speaker 2>lot more like a freshman problem. But I'm not a doctor,

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<v Speaker 2>so I don't know. Okay, onto nose problems.

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<v Speaker 3>The nasal obstruction is a huge one. What do I

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<v Speaker 3>mean they're just trouble breathing through your nose?

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<v Speaker 2>I thought you meant someone shoving something up there.

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<v Speaker 3>No, no, we'll talk about that. But so with nasal obstruction,

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<v Speaker 3>it can be an anatomic cause. People talk about a

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<v Speaker 3>deviated septum. So those would be the more common things,

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<v Speaker 3>but then you have the rare things such as tumors,

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<v Speaker 3>and then this area that I also work on. It

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<v Speaker 3>was called the skull base, which is the bony separation

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<v Speaker 3>between the sinus cavity and the brain cavity.

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<v Speaker 2>Oh, there's a bony separation there.

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<v Speaker 3>Yes, okay, they're very close to each other.

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<v Speaker 2>I didn't realize that we had a bony separation because

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<v Speaker 2>I feel like you always learned about like in Egyptian

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<v Speaker 2>mummies would use a hook to gather the brains through

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<v Speaker 2>the nose. I figured it was a straight shot.

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<v Speaker 3>In it's kind of a straight shot. But yes, you

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<v Speaker 3>would have to go through the skull base to do that.

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<v Speaker 2>Oh, you'd have to poke through. You'd have to preforate it.

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<v Speaker 2>How thin is it?

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<v Speaker 3>It's a good question. Pretty thin overall, some areas or

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<v Speaker 3>a couple of millimeters.

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<v Speaker 2>Some areas are less than a MILLIMETERSO is anyone else

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<v Speaker 2>having an existential meltdown? Thinking about like a millimeters thin

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<v Speaker 2>plate of bone separating your brain from the entire world, including,

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<v Speaker 2>but not limited to the air of a porta potty,

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<v Speaker 2>or the door handle of a mall, Like we have

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<v Speaker 2>thin bone plates in our skeleton heads with the fuck

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<v Speaker 2>So you had to do a lot of dissecting, of

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<v Speaker 2>course in.

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<v Speaker 3>Your life, right, many many, And I also have a

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<v Speaker 3>weird interest in cadaver dissections, so I've actually published a

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<v Speaker 3>number of papers on that.

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<v Speaker 2>So it's wait, okay, you have a weird interest in

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<v Speaker 2>cadaver dissection. Yes, explain to me what a normal interest

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<v Speaker 2>in cadaver times section would because I feel.

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<v Speaker 3>Like that's it might be true.

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<v Speaker 2>What do you mean by that?

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<v Speaker 3>Because that just means that in training you're always expected

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<v Speaker 3>to do some degree of cadaver dissection as part of

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<v Speaker 3>your learning. But I just realized that it's harder to

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<v Speaker 3>read it in books than it is to just get

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<v Speaker 3>in there. And so in both residency and fellowship, and

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<v Speaker 3>even now, whenever we have cadavers available, I stressed to

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<v Speaker 3>the residents that I teach that it's really important to

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<v Speaker 3>get in there and really explore the anatomy, so.

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<v Speaker 2>Everyone, because I have a friend who's a doctor who

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<v Speaker 2>said that once you crack someone open, there's so much

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<v Speaker 2>more variation than you would imagine. Oh yeah, you think

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<v Speaker 2>like this is when the limit goes. But just as

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<v Speaker 2>people's faces look different, like their livers look different, and

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<v Speaker 2>their pancrases look different, like you really got to see

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<v Speaker 2>a lot of them. Yep, was that scary the first

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<v Speaker 2>time you cut open a cadaver? I'm sorry, I gotta ask.

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<v Speaker 3>I wouldn't use the word scary, but different for sure.

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<v Speaker 2>I feel like different is what you would call something

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<v Speaker 2>like like pineapp couscous or jazz fusion. Cutting open a

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<v Speaker 2>husk of a person seems like a bit of an

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<v Speaker 2>understatement for that word. But once again, all Ward here

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<v Speaker 2>is not a doctor. I have never filayed a dead

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<v Speaker 2>volunteer in order to fix living.

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<v Speaker 3>People gives you a different perspective on life.

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<v Speaker 2>Did you do you find that, having been around cadavers

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<v Speaker 2>that you embrace your living life more. You're more aware

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<v Speaker 2>of mortality or no, No.

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<v Speaker 3>It doesn't affect me that way.

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<v Speaker 2>I guess I feel like I would be man, I'd

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<v Speaker 2>be like, that's gonna be amazing. Would you ever donate

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<v Speaker 2>your body to science?

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<v Speaker 1>Uh?

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<v Speaker 3>Yes, I haven't officially done that yet, but.

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<v Speaker 2>Well I know you're alive, but you've considered it.

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<v Speaker 3>Yes.

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<v Speaker 2>The one thing that's weird about the nose is it's

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<v Speaker 2>something that's in our in our face. But you look

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<v Speaker 2>at a skull and you're like, there's just an empty cavity.

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<v Speaker 2>Noses are just cartilage, which is kind of crazy to me.

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<v Speaker 2>So this, but can you give me the breakdown of

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<v Speaker 2>the anatomy of a nose? What is a nose made out?

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<v Speaker 3>All? Right? So, if you think the nose is an

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<v Speaker 3>external component, kind of the floppy part that you actually see,

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<v Speaker 3>there are cartilages that form kind of the external architecture,

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<v Speaker 3>but they're in places that you wouldn't really predict, and

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<v Speaker 3>so it's not like one solid sheet of cartilage. There's

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<v Speaker 3>two sets of cartilage that do some weird curvature things.

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<v Speaker 3>But that's how the tip of your nose is formed.

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<v Speaker 3>And then we call them the side walls kind of

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<v Speaker 3>the floppy nostril parts. They provide support there, and then

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<v Speaker 3>the inner lining of the nose is made up of

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<v Speaker 3>what we call mucosa. Mucosa is like the inside skin.

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<v Speaker 3>Of course, you got the nostrils that lead into each

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<v Speaker 3>respective nasal cavity. And then how deep do we want

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<v Speaker 3>to go inside the nose here? How deep do we

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<v Speaker 3>want to go inside the those here?

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<v Speaker 2>By the way, I had a boyfriend whose Polish grandmother

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<v Speaker 2>called nostrils n assholes. Oh, she didn't realize that wasn't

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<v Speaker 2>the word for them, And I've ever since then, I've

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<v Speaker 2>always loved the term soles.

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<v Speaker 3>That's pretty good. Yeah, well, remember.

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<v Speaker 2>That, what are the sinuses?

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<v Speaker 3>So you've got cheek sinuses we call them the maxillary

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<v Speaker 3>sinuses in each cheek, and then the forehead or frontal

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<v Speaker 3>sinuses up in the forehead, and then you have these

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<v Speaker 3>other weird sinuses that go kind of further back in

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<v Speaker 3>the nose between the eyes, called the ethmoid sinuses. And

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<v Speaker 3>then way back, about seven or eight centimeters back in

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<v Speaker 3>the nasal cavities, you have the sphenoid sinuses.

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<v Speaker 2>So to recap, you are just lousy with sinuses, just

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<v Speaker 2>tiny hidden rooms in your face. And your skull. But wait,

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<v Speaker 2>how many and what exactly are they where? What are

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<v Speaker 2>they doing there?

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<v Speaker 3>In total? We say there are eight sinuses, four on

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<v Speaker 3>each side, and then what are they They're basically just

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<v Speaker 3>air filled spaces within the bones of the face. But

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<v Speaker 3>they're lined by that mucosa that we spoke of. All right,

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<v Speaker 3>So the mucosa that's what gets swollen when we talk

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<v Speaker 3>about allergies and sinusitus. So you can imagine if you

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<v Speaker 3>have these sinus chambers draining into the nasal cavities. They

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<v Speaker 3>drain through small holes.

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<v Speaker 2>Gross, but stay with me.

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<v Speaker 3>So if circumferentially around that opening the tissue that mucosa

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<v Speaker 3>swells up too much, that's when we have problems with straining.

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<v Speaker 3>And if you have that swelling curry inside the nose

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<v Speaker 3>too much, you could have trouble breathing through your nose.

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<v Speaker 2>So a lot of the stuff that comes out of

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<v Speaker 2>your nose originates in these in these caves in your face. Yes,

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<v Speaker 2>what happens when you have let's say, allergies or you

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<v Speaker 2>have an infection. Why does your why does this tissue

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<v Speaker 2>insist on swelling? What does the inflammation help? What's the point?

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<v Speaker 2>Why do why is it like, oh, there's pollen in

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<v Speaker 2>the air well for you, I'm going to swell up

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<v Speaker 2>so you can't breathe.

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<v Speaker 3>Yeah, well, it's definitely not an adaptive measure. It's not

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<v Speaker 3>normal for people to have this swelling, right, the average

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<v Speaker 3>human being. So you get fluids ceping into the tissue

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<v Speaker 3>that causes swelling, and that's when you get a lot

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<v Speaker 3>of the symptoms. Now, patients with allergies and they have

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<v Speaker 3>a significant histamine response, all right, So they have certain

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<v Speaker 3>cells on their tissue that release histamine and that sets

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<v Speaker 3>off a whole cascade of different symptoms.

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<v Speaker 2>Now, histamines, before you float them to the top of

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<v Speaker 2>your shit list, can have your back when things are good.

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<v Speaker 2>They keep you awake and they help flush out bacteria

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<v Speaker 2>that might want to kill you. But with allergies like

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<v Speaker 2>to pollen or dust or pets, the immune system senses

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<v Speaker 2>it freaks the fuck out, like this pollen is trying

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<v Speaker 2>to kill us. All hands on deck and sends a

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<v Speaker 2>group text essentially to your body being like if you

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<v Speaker 2>see this pollen around eighty six, this mofo, we hate it.

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<v Speaker 2>Pollen's like, hey, I'm just airborne plants, ferm. I don't

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<v Speaker 2>even want to be in your nose holes. You inhaled

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<v Speaker 2>me calm down. But histamines tell your blood vessels to

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<v Speaker 2>get leaky, y'all, and your eyes and nose water to

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<v Speaker 2>flush it out of your body. Now, why do some

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<v Speaker 2>people have shitty allergies and others are like, I've got

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<v Speaker 2>nine nine problems, but ragweed season is not one. It's

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<v Speaker 2>mostly genetics, so thanks to your mom and dad. But

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<v Speaker 2>there's also something called the hygiene hypothesis. So if you

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<v Speaker 2>weren't raised around enough like low key grime like animal

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<v Speaker 2>dander and fungus spores, your body freaks out when it

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<v Speaker 2>encounters it. I myself grew up digging for worms in fields.

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<v Speaker 2>I have no allergies. Thank you mom and dad for

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<v Speaker 2>letting me go dig for worms. Speaking of which, you

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<v Speaker 2>can also eat worms to help your allergies. I mean, yes,

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<v Speaker 2>there are anahistamines and steroids which block your body from

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<v Speaker 2>launching that inflammatory attack. But also also you can eat hookworms.

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<v Speaker 2>So these little parasites attached to your gut walls, and

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<v Speaker 2>some studies show that they may release compounds that tell

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<v Speaker 2>your immune system to just take it down and notch sun.

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<v Speaker 2>Not a lot of hookworms in the developed world, but

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<v Speaker 2>it's hookworm Palooza in other parts of the globe where

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<v Speaker 2>they have fewer allergies. You can also try local honey,

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<v Speaker 2>as discussed in the B episode melotology, which may help

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<v Speaker 2>your body warm up to neighborhood planches, or immune therapy

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00:20:07.759 --> 00:20:10.799
<v Speaker 2>where you're slowly introduced to allergens so your immune system

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<v Speaker 2>calms down and stops being let's be honest, kind of

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00:20:13.440 --> 00:20:16.000
<v Speaker 2>a bigot. But if you don't want to get shots

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<v Speaker 2>or take drugs that make you sleepy, or get intestinal

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00:20:19.720 --> 00:20:24.240
<v Speaker 2>parasites on purpose, doctor Craig has some other saltier advice.

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<v Speaker 2>But what do you tell people who have allergies? Is

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<v Speaker 2>there anything they can do on the front end that's

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<v Speaker 2>not just tamping down the histamine response.

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<v Speaker 3>Yeah, so I'm going to throw out a disclaimer first off. Okay, well,

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<v Speaker 3>I am a rhinologist. I lean on my allergy colleagues

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<v Speaker 3>here significantly, so I can tell you what I do,

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<v Speaker 3>and then when things get too complex, I definitely employ analogists.

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<v Speaker 3>But in general, if you have kind of run of

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<v Speaker 3>the mill allergies, I think the simplest, safest thing you

401
00:20:48.599 --> 00:20:51.680
<v Speaker 3>can do actually is topical saline to your nose. It's

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00:20:51.720 --> 00:20:55.279
<v Speaker 3>actually been shown that we don't know why precisely, but

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00:20:55.359 --> 00:20:58.160
<v Speaker 3>if you can flush the allergens that might be in

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00:20:58.200 --> 00:21:01.680
<v Speaker 3>the nose out of the nose, than you in general

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00:21:01.720 --> 00:21:03.359
<v Speaker 3>have a better baseline of symptoms.

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<v Speaker 2>Oh like a netty pot.

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<v Speaker 3>Yeah, much like a netti pot.

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00:21:07.039 --> 00:21:08.319
<v Speaker 2>I've never used a netty pot.

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<v Speaker 3>Oh, you got to try it.

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<v Speaker 2>I imaginely have is it really?

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<v Speaker 3>Oh?

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<v Speaker 2>Yeah, Okay, there's part of me that knows I'm not

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<v Speaker 2>going to flood my brain with saline. But I'm like,

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<v Speaker 2>what if I'm the one person that has just a

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<v Speaker 2>gaping hole in my skull based bone and I just

416
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<v Speaker 2>flood my brain?

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<v Speaker 3>Well, we could put one thing to rest. If you

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<v Speaker 3>don't have clear fluid pouring out of your nose at

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00:21:31.720 --> 00:21:34.039
<v Speaker 3>the baseline, you probably don't have a spinal fluid leak,

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<v Speaker 3>which means you probably don't have a hole in your

421
00:21:35.799 --> 00:21:41.359
<v Speaker 3>skull base. But but no, I mean, the one in

422
00:21:41.400 --> 00:21:45.000
<v Speaker 3>a trillion type situation of that happening, I wouldn't worry

423
00:21:45.039 --> 00:21:45.400
<v Speaker 3>about that.

424
00:21:45.759 --> 00:21:47.319
<v Speaker 2>What does it feel like, I've never done it?

425
00:21:48.200 --> 00:21:50.400
<v Speaker 3>If you do it properly, you know, head over a sink.

426
00:21:51.200 --> 00:21:53.480
<v Speaker 3>I use a squeeze bottle. Personally, but some people do.

427
00:21:53.519 --> 00:21:57.319
<v Speaker 3>The netty pot fluid will go inside one nasal cavity,

428
00:21:57.319 --> 00:21:59.519
<v Speaker 3>it comes out behind your nose back out the other

429
00:21:59.559 --> 00:22:01.240
<v Speaker 3>nasal cab So you score it on the right, it's

430
00:22:01.240 --> 00:22:02.119
<v Speaker 3>going to come out the left.

431
00:22:02.279 --> 00:22:04.160
<v Speaker 2>Where is it going in the meantime.

432
00:22:04.839 --> 00:22:07.119
<v Speaker 3>That's a good question if you have not had sinus

433
00:22:07.119 --> 00:22:09.119
<v Speaker 3>surgery before. Most of it just goes through the nasal

434
00:22:09.160 --> 00:22:12.920
<v Speaker 3>cavities and in some of these nooks and crannies called

435
00:22:12.960 --> 00:22:16.119
<v Speaker 3>the me eight I within nose. But if you haven't

436
00:22:16.160 --> 00:22:19.480
<v Speaker 3>had sinus surgery, they don't usually get into the sinuses themselves, okay,

437
00:22:19.480 --> 00:22:21.519
<v Speaker 3>so they just go in and out. So basically you're

438
00:22:21.559 --> 00:22:25.359
<v Speaker 3>flushing out any crust debris, maybe thinning out the layer

439
00:22:25.400 --> 00:22:26.039
<v Speaker 3>that's in your nose.

440
00:22:26.160 --> 00:22:29.079
<v Speaker 2>But it does seem to help, so squeeze bottle daddy

441
00:22:29.119 --> 00:22:32.759
<v Speaker 2>pot so. Doctor Craig says that well, the salty nose

442
00:22:32.880 --> 00:22:36.599
<v Speaker 2>enema is a great starting measure. Most patients might need

443
00:22:36.680 --> 00:22:40.680
<v Speaker 2>an over the counter topical steroid like a flownaise which

444
00:22:40.720 --> 00:22:44.160
<v Speaker 2>will drop the inflammatory response in the nose, or like

445
00:22:44.200 --> 00:22:48.160
<v Speaker 2>an oral antihistamine. Those are tablets, but remember histamine also

446
00:22:48.240 --> 00:22:51.759
<v Speaker 2>keeps you awake, so don't take antihistamines before like a

447
00:22:51.839 --> 00:22:55.240
<v Speaker 2>four hour annual sale symposium, or when you're about to

448
00:22:55.279 --> 00:22:58.559
<v Speaker 2>walk into a Catholic wedding ceremony, because that's just asking

449
00:22:58.799 --> 00:23:02.039
<v Speaker 2>to drool on yourself, which I have recently done. Now

450
00:23:02.079 --> 00:23:05.839
<v Speaker 2>in Japan, I just looked this up. Nodding off in public.

451
00:23:06.000 --> 00:23:08.799
<v Speaker 2>They have a word for it. It's called in emory,

452
00:23:09.319 --> 00:23:12.799
<v Speaker 2>and it means to sleep well present, and it happens

453
00:23:12.799 --> 00:23:15.559
<v Speaker 2>on trains and in the office all the time. The

454
00:23:15.680 --> 00:23:18.400
<v Speaker 2>Japanese are like, good on you, dude, you must be

455
00:23:18.440 --> 00:23:20.880
<v Speaker 2>working hard. Also, it's nice that you didn't just leave.

456
00:23:20.960 --> 00:23:23.680
<v Speaker 2>You just stayed at this dinner party and napped upright.

457
00:23:24.039 --> 00:23:28.240
<v Speaker 2>So enemory isn't a bad thing. However, it's frowned upon

458
00:23:28.400 --> 00:23:32.240
<v Speaker 2>in like assembly lines and such, so your benajeryl may

459
00:23:32.359 --> 00:23:36.319
<v Speaker 2>have those side effects, including an emuri, which I've got

460
00:23:36.359 --> 00:23:39.319
<v Speaker 2>to be honest, is my new favorite Japanese thing, like

461
00:23:39.400 --> 00:23:41.960
<v Speaker 2>since their game shows. Did you know some of their

462
00:23:41.960 --> 00:23:45.880
<v Speaker 2>game shows involved discovering if everyday objects like tables and

463
00:23:45.960 --> 00:23:49.240
<v Speaker 2>chairs are actually made of candy by biting them and

464
00:23:49.319 --> 00:23:52.200
<v Speaker 2>climbing slippery stairs covered in soap and getting a butt

465
00:23:52.200 --> 00:23:59.319
<v Speaker 2>in your face if you answer trivia wrong, a naked butt.

466
00:24:01.359 --> 00:24:06.720
<v Speaker 2>I love you Japan anyway. Have you ever been super

467
00:24:07.359 --> 00:24:12.000
<v Speaker 2>just flummixed or just stumped by a case both?

468
00:24:12.000 --> 00:24:14.119
<v Speaker 3>The interesting part and the problem in my field is

469
00:24:14.119 --> 00:24:16.640
<v Speaker 3>that there's a lot of rare pathology. Some tough ones

470
00:24:16.640 --> 00:24:21.119
<v Speaker 3>that come to mind would be nasal polyps. So nasal

471
00:24:21.160 --> 00:24:25.200
<v Speaker 3>polyps if you've ever heard of them. They're basically extreme

472
00:24:25.319 --> 00:24:28.519
<v Speaker 3>swelling of tissue inside the sinus and nasal cavities. They

473
00:24:28.559 --> 00:24:31.559
<v Speaker 3>turn into basically like swollen grapes hanging down on your nose,

474
00:24:32.200 --> 00:24:34.680
<v Speaker 3>and so they can cause the whole spectrum of sinucide

475
00:24:34.680 --> 00:24:37.240
<v Speaker 3>of symptoms, trouble breathing through the nose, lack of smell

476
00:24:37.880 --> 00:24:38.960
<v Speaker 3>would be the classic ones.

477
00:24:39.039 --> 00:24:40.079
<v Speaker 2>Ooh, nose grapes.

478
00:24:40.279 --> 00:24:43.880
<v Speaker 3>Yeah, no, no, not a good fruit to have.

479
00:24:45.359 --> 00:24:49.839
<v Speaker 2>Do you this stupid question? But can you spot a

480
00:24:49.880 --> 00:24:53.079
<v Speaker 2>nose job a mile away? Usually yes you can?

481
00:24:53.799 --> 00:24:59.920
<v Speaker 3>How so it takes Actually, rhinoplasty is separate from my feel.

482
00:25:00.200 --> 00:25:03.720
<v Speaker 3>I collaborate with rhinoplasty surgeons when I need the external

483
00:25:03.759 --> 00:25:06.559
<v Speaker 3>portion of the nose addressed. And so do you mean

484
00:25:06.599 --> 00:25:11.119
<v Speaker 3>the classic esthetic rhinoplasty? How you tell? Yeah? Usually there's

485
00:25:11.359 --> 00:25:14.160
<v Speaker 3>a narrower look to the nose, perhaps the nasal tip

486
00:25:14.200 --> 00:25:18.359
<v Speaker 3>is a little more upturned than average and just in

487
00:25:18.400 --> 00:25:19.160
<v Speaker 3>general smaller.

488
00:25:19.720 --> 00:25:23.559
<v Speaker 2>And have you seen any trends with that or you know,

489
00:25:23.599 --> 00:25:26.279
<v Speaker 2>I mean, if you look at hair trends over the

490
00:25:26.359 --> 00:25:28.880
<v Speaker 2>last thirty years, there have been some good ones and

491
00:25:28.920 --> 00:25:33.000
<v Speaker 2>some bad ones. Do you see that happening in and

492
00:25:33.039 --> 00:25:35.640
<v Speaker 2>I know that you don't focus on rhinoplasty, but do

493
00:25:35.680 --> 00:25:38.599
<v Speaker 2>you see that happening in like cosmetic surgeries at all?

494
00:25:38.640 --> 00:25:41.599
<v Speaker 2>Like is this nose very in from these this year

495
00:25:41.680 --> 00:25:42.119
<v Speaker 2>to this year?

496
00:25:42.880 --> 00:25:46.440
<v Speaker 3>Definitely in the eighties nineties there was a characteristic nose

497
00:25:46.480 --> 00:25:50.000
<v Speaker 3>that people were going for. Definitely the narrower look. There

498
00:25:50.000 --> 00:25:50.920
<v Speaker 3>are definitely trends.

499
00:25:51.000 --> 00:25:54.559
<v Speaker 2>Like with fashion, it's probably just look up at Kardashian's

500
00:25:54.559 --> 00:25:55.519
<v Speaker 2>Instagram or something.

501
00:25:55.759 --> 00:25:56.920
<v Speaker 3>No, I won't comment on that.

502
00:25:57.200 --> 00:25:59.440
<v Speaker 2>Yeah, but I wonder if people are like, I want

503
00:25:59.440 --> 00:26:00.599
<v Speaker 2>to Jane nose.

504
00:26:00.720 --> 00:26:01.640
<v Speaker 3>Oh, I'm sure that.

505
00:26:02.759 --> 00:26:05.400
<v Speaker 2>So I look this up and this is indeed the case.

506
00:26:05.519 --> 00:26:08.079
<v Speaker 2>So a bunch of plastic surgeons are saying that the tiny,

507
00:26:08.319 --> 00:26:12.039
<v Speaker 2>eurocentric look is falling out of fashion. People don't want

508
00:26:12.680 --> 00:26:16.680
<v Speaker 2>perfectly straight or symmetrical noses either. They're like, change it

509
00:26:16.759 --> 00:26:18.720
<v Speaker 2>up a little bit. I still want to look like me,

510
00:26:18.920 --> 00:26:21.960
<v Speaker 2>don't make it too boring. Also, now some people are

511
00:26:22.000 --> 00:26:25.559
<v Speaker 2>getting non surgical nose jobs, where instead of shaving down

512
00:26:25.920 --> 00:26:29.720
<v Speaker 2>your cartilage fins, essentially a doctor will pump some filler

513
00:26:29.799 --> 00:26:31.759
<v Speaker 2>into the bridge of the nose just to fill out

514
00:26:31.799 --> 00:26:34.400
<v Speaker 2>a line. And other folks are getting kind of a

515
00:26:34.480 --> 00:26:38.880
<v Speaker 2>reverse nose job with implants added to restore what their

516
00:26:38.960 --> 00:26:41.960
<v Speaker 2>nose look like pre surgery. They're like, you know what,

517
00:26:42.240 --> 00:26:44.640
<v Speaker 2>I just want to look like me speaking of putting

518
00:26:44.680 --> 00:26:48.319
<v Speaker 2>things into noses. Weirdest thing you've seen shoved up on nose?

519
00:26:49.480 --> 00:26:51.799
<v Speaker 3>Uh? An undone paper clip?

520
00:26:52.200 --> 00:26:52.480
<v Speaker 1>Why?

521
00:26:54.759 --> 00:26:56.759
<v Speaker 3>Uh so it was actually a child?

522
00:26:57.160 --> 00:26:59.759
<v Speaker 2>Oh? Man, ouch, poor kid place.

523
00:26:59.599 --> 00:27:02.559
<v Speaker 3>It up their respective grandparents knows while sleeping.

524
00:27:02.640 --> 00:27:06.880
<v Speaker 2>Oh never mind, that child is ruthless. Okay they what

525
00:27:06.920 --> 00:27:07.799
<v Speaker 2>did they do?

526
00:27:08.799 --> 00:27:12.319
<v Speaker 3>Well? We had to go to surgery and it was interesting,

527
00:27:12.359 --> 00:27:13.039
<v Speaker 3>to say the least.

528
00:27:13.079 --> 00:27:18.000
<v Speaker 2>Once again, interesting is good for pineapple couscoose. This is

529
00:27:18.039 --> 00:27:22.319
<v Speaker 2>intense and brutal ps. It wasn't a paper clip.

530
00:27:22.359 --> 00:27:26.640
<v Speaker 3>And actually was multiple paper clips. So yeah. Luckily they're malleable,

531
00:27:26.680 --> 00:27:28.440
<v Speaker 3>so you can kind of bend them with instruments and

532
00:27:28.440 --> 00:27:30.519
<v Speaker 3>get them out of the nooks and crannies of the sinuses.

533
00:27:30.559 --> 00:27:33.920
<v Speaker 2>But multiple when you say multiple, are you saying two

534
00:27:34.160 --> 00:27:37.519
<v Speaker 2>or are you saying there are three? That's too many? Yeah,

535
00:27:37.720 --> 00:27:40.440
<v Speaker 2>once you get over one, it's too many paper clips.

536
00:27:40.839 --> 00:27:43.000
<v Speaker 3>One would argue one is a lot, but I.

537
00:27:43.000 --> 00:27:46.119
<v Speaker 2>Think that's I think that's more than enough. How was

538
00:27:46.200 --> 00:27:48.200
<v Speaker 2>the patient's morale?

539
00:27:49.279 --> 00:27:52.039
<v Speaker 3>So it's funny. So this case that always comes to

540
00:27:52.039 --> 00:27:54.039
<v Speaker 3>mind was when I was in training and I didn't

541
00:27:54.039 --> 00:27:58.240
<v Speaker 3>follow the patient pre impostoperatively, So I don't totally know,

542
00:27:58.319 --> 00:28:01.440
<v Speaker 3>but one would imagine there may be some familial tension

543
00:28:01.480 --> 00:28:01.799
<v Speaker 3>after that.

544
00:28:02.839 --> 00:28:05.319
<v Speaker 2>Yeah, you think, I wonder what the kids next birthday

545
00:28:05.440 --> 00:28:08.640
<v Speaker 2>was like. It's like, uh, Grandpa's on a cruise on

546
00:28:08.720 --> 00:28:12.480
<v Speaker 2>purpose and is never going to make it to your birthday. Man, Yeah,

547
00:28:12.480 --> 00:28:15.279
<v Speaker 2>that's rough. Did you ever see that Simpsons episode where

548
00:28:15.279 --> 00:28:17.400
<v Speaker 2>Homer puts a crayon off his nose? No?

549
00:28:17.480 --> 00:28:20.079
<v Speaker 3>I didn't, mister Simpson.

550
00:28:20.440 --> 00:28:23.079
<v Speaker 2>I'm afraid you have a crayon lodged in your brain.

551
00:28:23.400 --> 00:28:25.000
<v Speaker 2>They find that he has a blue crane up his

552
00:28:25.039 --> 00:28:26.920
<v Speaker 2>nose and that is my Homer's Homer. They take it

553
00:28:26.960 --> 00:28:31.480
<v Speaker 2>out and Homer is very like realizes how dysfunctional society

554
00:28:31.559 --> 00:28:32.119
<v Speaker 2>is and how.

555
00:28:32.480 --> 00:28:34.400
<v Speaker 3>Wow was it in his brain? He was in his

556
00:28:34.440 --> 00:28:35.599
<v Speaker 3>brain interesting.

557
00:28:35.440 --> 00:28:37.200
<v Speaker 2>And I think at the end he puts the crayon

558
00:28:37.279 --> 00:28:39.000
<v Speaker 2>back in because he's just like, you.

559
00:28:38.960 --> 00:28:42.319
<v Speaker 3>Know, all right, tell me when I hit this week,

560
00:28:42.440 --> 00:28:46.680
<v Speaker 3>but deeper, you Pilsner pusher. Maybe he had a spinal

561
00:28:46.680 --> 00:28:47.160
<v Speaker 3>fluid leak.

562
00:28:47.200 --> 00:28:50.400
<v Speaker 2>Afterward, let's debunk some flint flam. What do you think

563
00:28:50.519 --> 00:28:54.279
<v Speaker 2>is the biggest myth about noses and sinuses that you're like,

564
00:28:54.400 --> 00:28:55.759
<v Speaker 2>that is not correct?

565
00:28:55.880 --> 00:28:59.799
<v Speaker 3>I love this question. One thing is that facial pain

566
00:28:59.880 --> 00:29:02.920
<v Speaker 3>is most commonly not from SIGNI sitis. What is it

567
00:29:02.960 --> 00:29:07.240
<v Speaker 3>from most commonly, and this has been studied some form

568
00:29:07.279 --> 00:29:11.720
<v Speaker 3>of neurogenic pain, so whether that's migraine would be a

569
00:29:11.799 --> 00:29:16.200
<v Speaker 3>very common one. Actually migraine. Everybody thinks of the classic migraines,

570
00:29:16.200 --> 00:29:18.079
<v Speaker 3>but there are atypical forms of it where you can

571
00:29:18.200 --> 00:29:20.920
<v Speaker 3>just have isolated facial pain and a running nose and

572
00:29:20.960 --> 00:29:25.240
<v Speaker 3>nasal destruction. Really because it affects nerves, nerves supply the

573
00:29:25.279 --> 00:29:27.400
<v Speaker 3>tissue within the nose as well as the tissue of

574
00:29:27.440 --> 00:29:30.000
<v Speaker 3>the skin, so you can get the running nose factor,

575
00:29:30.279 --> 00:29:32.960
<v Speaker 3>the congestion feeling a lot of times they'll feel like

576
00:29:33.000 --> 00:29:35.559
<v Speaker 3>just things are full, yeah, and then of course the

577
00:29:35.640 --> 00:29:39.880
<v Speaker 3>severe stabbing pain like over their cheeks or forehead, And unfortunately,

578
00:29:40.400 --> 00:29:43.079
<v Speaker 3>this information is not disseminated to all physicians as well.

579
00:29:43.519 --> 00:29:46.119
<v Speaker 3>So it's a tough one because if if you're not

580
00:29:47.000 --> 00:29:50.160
<v Speaker 3>seeing noses all the time and putting scopes inside your

581
00:29:50.160 --> 00:29:52.279
<v Speaker 3>nose to see where the sinuses drain, I think the

582
00:29:52.319 --> 00:29:54.440
<v Speaker 3>tendency is to hear that somebody has a running nose,

583
00:29:54.920 --> 00:29:57.960
<v Speaker 3>trouble breathing, facial pain that matches all the symptoms of

584
00:29:58.000 --> 00:30:01.359
<v Speaker 3>signy SIDIS. But if you do sign a surgery for

585
00:30:01.440 --> 00:30:04.079
<v Speaker 3>all these people, you're gonna find that the pain does

586
00:30:04.119 --> 00:30:05.400
<v Speaker 3>not reliably go away.

587
00:30:05.640 --> 00:30:09.680
<v Speaker 2>Oh no, so and it might just be an unlucky migraine. Yes,

588
00:30:10.160 --> 00:30:11.839
<v Speaker 2>oh god, that's got to be frustrating.

589
00:30:12.000 --> 00:30:14.680
<v Speaker 3>Yeah, it can be very frustrating. And so whenever I

590
00:30:14.720 --> 00:30:17.200
<v Speaker 3>see patients with those conditions, I just get them checked

591
00:30:17.200 --> 00:30:20.400
<v Speaker 3>out by a facial pain person. And it almost every time,

592
00:30:21.119 --> 00:30:23.680
<v Speaker 3>like seriously, almost every time, they find something that they

593
00:30:23.680 --> 00:30:26.000
<v Speaker 3>can treat medically and then we avoid sign a surgery.

594
00:30:26.000 --> 00:30:27.839
<v Speaker 2>How often would you say that it's that case where

595
00:30:27.839 --> 00:30:30.400
<v Speaker 2>it's like it's just an unlucky migraine.

596
00:30:30.599 --> 00:30:33.839
<v Speaker 3>So we're talking isolated facial pain nearly. I mean, it's

597
00:30:34.000 --> 00:30:35.279
<v Speaker 3>over ninety percent of the time.

598
00:30:35.599 --> 00:30:38.359
<v Speaker 2>Really, that's so interesting. I didn't know that it's crazy.

599
00:30:38.400 --> 00:30:40.839
<v Speaker 3>I mean, I probably see out of twenty patients, twenty

600
00:30:40.920 --> 00:30:43.880
<v Speaker 3>thirty patients a day, I see at least three per

601
00:30:44.000 --> 00:30:45.799
<v Speaker 3>day with isolated migraines.

602
00:30:46.160 --> 00:30:49.519
<v Speaker 2>So if you have a face ache instead of a headache,

603
00:30:49.759 --> 00:30:52.079
<v Speaker 2>it might be a migraine. How crazy is that? Now?

604
00:30:52.240 --> 00:30:55.319
<v Speaker 2>Why does our nose run? Why do we get stuffy

605
00:30:55.359 --> 00:30:56.079
<v Speaker 2>when we cry?

606
00:30:56.319 --> 00:30:58.519
<v Speaker 3>So if you cry too much, you could get some

607
00:30:58.599 --> 00:31:01.480
<v Speaker 3>tears literally coming out of your nose, and then there's

608
00:31:01.519 --> 00:31:05.640
<v Speaker 3>probably some emotional nerve response that again signals those same

609
00:31:05.720 --> 00:31:08.599
<v Speaker 3>nerves that somebody's get signaled with migraines and can cause

610
00:31:08.599 --> 00:31:10.680
<v Speaker 3>a runniness and that the congestion though, does that happen

611
00:31:10.759 --> 00:31:12.440
<v Speaker 3>when you cry a lot? I guess I don't cry

612
00:31:12.519 --> 00:31:13.160
<v Speaker 3>very often, so.

613
00:31:13.440 --> 00:31:15.880
<v Speaker 2>I feel like you get congested when you cry. So

614
00:31:15.920 --> 00:31:20.119
<v Speaker 2>evidently when your nose cries, like literally tears come out

615
00:31:20.200 --> 00:31:24.079
<v Speaker 2>of your nose, your tissues get coated with liquid sadness

616
00:31:24.400 --> 00:31:26.759
<v Speaker 2>and things just jam up a bit. In there also,

617
00:31:26.960 --> 00:31:29.720
<v Speaker 2>your tissues swell, causing you to need tissues.

618
00:31:29.920 --> 00:31:31.519
<v Speaker 3>I'm going to blame the same nerve reflex.

619
00:31:31.599 --> 00:31:33.119
<v Speaker 2>I'm sure it is. It's got to be a nerve

620
00:31:33.160 --> 00:31:36.119
<v Speaker 2>reflex your brains is like, are we sad, let's jack

621
00:31:36.200 --> 00:31:37.400
<v Speaker 2>some things up to distract you.

622
00:31:37.559 --> 00:31:37.839
<v Speaker 3>Yeah.

623
00:31:37.880 --> 00:31:41.799
<v Speaker 2>Perhaps, And now, how much of your work involves smell

624
00:31:42.000 --> 00:31:42.759
<v Speaker 2>in disorders with.

625
00:31:42.839 --> 00:31:48.759
<v Speaker 3>Smell percentage wise? Isolated smell loss is not a major

626
00:31:48.839 --> 00:31:52.000
<v Speaker 3>part of my practice. I mean, I definitely see those patients.

627
00:31:52.480 --> 00:31:57.079
<v Speaker 3>It's a very difficult condition. You kind of break it

628
00:31:57.119 --> 00:31:59.200
<v Speaker 3>down into how long it's been there, and you try

629
00:31:59.200 --> 00:32:03.000
<v Speaker 3>to figure out why it occurred. Sometimes you don't come

630
00:32:03.079 --> 00:32:05.880
<v Speaker 3>up with a true reason. People just develop spontaneous smell loss.

631
00:32:05.920 --> 00:32:08.359
<v Speaker 2>Oh, my friend Micah had a fever as a baby.

632
00:32:08.359 --> 00:32:10.920
<v Speaker 2>He has no sense of smell. So you just don't

633
00:32:10.920 --> 00:32:13.640
<v Speaker 2>have to shower when you go out to brunch as

634
00:32:13.680 --> 00:32:14.720
<v Speaker 2>much as you want. It's great.

635
00:32:15.039 --> 00:32:16.599
<v Speaker 3>Not for him though, yeah other people.

636
00:32:16.759 --> 00:32:20.599
<v Speaker 2>Yeah, but what is happening when you're smelling something? It's

637
00:32:20.680 --> 00:32:24.119
<v Speaker 2>going through your tissues? Does the air? Does the air

638
00:32:24.720 --> 00:32:28.079
<v Speaker 2>hit your sinuses and then your sinuses pick it up

639
00:32:28.079 --> 00:32:29.880
<v Speaker 2>and tell your brain what smell it is?

640
00:32:29.920 --> 00:32:32.720
<v Speaker 3>Like, what sort of But it's more about the location

641
00:32:32.799 --> 00:32:37.279
<v Speaker 3>of those smell fibers. So air brings in odor molecules.

642
00:32:37.319 --> 00:32:42.200
<v Speaker 3>Those molecules hit the surface the nasal surf. It's more

643
00:32:42.240 --> 00:32:45.079
<v Speaker 3>than nasal cavity than the sinuses. So airflow normally doesn't

644
00:32:45.119 --> 00:32:47.839
<v Speaker 3>go into the sinuses. It actually just goes through that

645
00:32:47.880 --> 00:32:50.759
<v Speaker 3>central kind of inner chamber that we spoke of. And

646
00:32:50.839 --> 00:32:54.920
<v Speaker 3>so the olfactory receptors on specific nerves are located high

647
00:32:55.000 --> 00:32:57.680
<v Speaker 3>up in the nose, and then there are certain structures

648
00:32:57.720 --> 00:33:00.039
<v Speaker 3>in the nose where there are higher concentrations of the

649
00:33:00.200 --> 00:33:03.359
<v Speaker 3>olfactory cells, and then then that triggers a whole cascade

650
00:33:03.400 --> 00:33:06.119
<v Speaker 3>of chemical and neurogenic reflexes that go to the brain,

651
00:33:07.200 --> 00:33:08.599
<v Speaker 3>and then that's how we interpret smell.

652
00:33:09.079 --> 00:33:12.200
<v Speaker 2>So there are certain areas of the inside of your

653
00:33:12.200 --> 00:33:14.279
<v Speaker 2>nose at smell, and certain areas are like, that's not

654
00:33:14.400 --> 00:33:14.839
<v Speaker 2>my job.

655
00:33:15.039 --> 00:33:18.200
<v Speaker 3>Most of it definitely occurs. Yeah, just to the nasal cavity.

656
00:33:18.960 --> 00:33:21.000
<v Speaker 2>Do people give you a lot of nose gifts like

657
00:33:21.400 --> 00:33:23.160
<v Speaker 2>coffee mugs in the shape of noses?

658
00:33:23.880 --> 00:33:26.240
<v Speaker 3>I wish, but no, there's not a lot of.

659
00:33:26.200 --> 00:33:28.480
<v Speaker 2>Like Etsy items for rhinologists.

660
00:33:28.880 --> 00:33:30.759
<v Speaker 3>There actually are. I mean, I've got like a Picasso

661
00:33:30.799 --> 00:33:34.640
<v Speaker 3>painting that has a big nose. Whenever I do see

662
00:33:34.680 --> 00:33:37.759
<v Speaker 3>weird nose art or anything, I definitely pick it up.

663
00:33:38.000 --> 00:33:41.160
<v Speaker 2>Side note, I popped over to Etsy to see what

664
00:33:41.279 --> 00:33:44.079
<v Speaker 2>kind of nose gifts the craft of Sphere had to offer.

665
00:33:44.200 --> 00:33:47.559
<v Speaker 2>And first off, there are a lot of delicate nose

666
00:33:47.599 --> 00:33:51.839
<v Speaker 2>rings out there, and also crocheted nosewarmers which look kind

667
00:33:51.880 --> 00:33:55.400
<v Speaker 2>of like a macrome bikini top and a surgical mask

668
00:33:55.519 --> 00:33:59.480
<v Speaker 2>bread tiny children. There was also an item advertised as

669
00:33:59.519 --> 00:34:04.920
<v Speaker 2>a bronze's nose refrigerator magnet, which seems like at eighteen bucks,

670
00:34:05.000 --> 00:34:08.960
<v Speaker 2>a steel for solid bronze, but it turns out it's

671
00:34:09.000 --> 00:34:13.199
<v Speaker 2>a painted plaster object according to the seller quote, an

672
00:34:13.239 --> 00:34:16.519
<v Speaker 2>exact replication of my own nose. I popped on over

673
00:34:16.559 --> 00:34:19.480
<v Speaker 2>to Amazon and I found a tank top bearing simply

674
00:34:20.039 --> 00:34:24.599
<v Speaker 2>hashtag rhinologist and a bike bell stating that its user

675
00:34:24.719 --> 00:34:27.760
<v Speaker 2>was the world's best rhinologist. So there's some gifts there.

676
00:34:27.920 --> 00:34:31.920
<v Speaker 2>In the end, I primed doctor Craig a plastic snawse

677
00:34:32.440 --> 00:34:34.599
<v Speaker 2>that was also a pencil sharpener. I'm sure you can

678
00:34:34.639 --> 00:34:37.360
<v Speaker 2>imagine how that worked. It cost five dollars, but I

679
00:34:37.440 --> 00:34:40.159
<v Speaker 2>sprung for the four dollars gift wrap to include a

680
00:34:40.159 --> 00:34:42.840
<v Speaker 2>note of thanks for his appearance on ologies and that

681
00:34:43.159 --> 00:34:47.199
<v Speaker 2>I couldn't have picked a sharper expert who knows his material.

682
00:34:47.960 --> 00:34:49.880
<v Speaker 2>This is why I call myself your dad. Do you

683
00:34:49.920 --> 00:34:50.760
<v Speaker 2>dream about noses?

684
00:34:50.920 --> 00:34:51.840
<v Speaker 3>Oh? Yeah, you do?

685
00:34:51.920 --> 00:34:54.159
<v Speaker 2>Oh yeah, what's your latest nose dream?

686
00:34:54.599 --> 00:34:58.519
<v Speaker 3>It's usually more perioperative stress, you know, like you just

687
00:34:58.519 --> 00:35:00.519
<v Speaker 3>did a case and you think about the end. I

688
00:35:00.519 --> 00:35:02.360
<v Speaker 3>see people sinuses in my mind all the time.

689
00:35:02.639 --> 00:35:03.039
<v Speaker 2>You do.

690
00:35:03.119 --> 00:35:05.719
<v Speaker 3>Oh yeah, I remember people sinuses. It's weird.

691
00:35:06.000 --> 00:35:08.199
<v Speaker 2>But yeah, like how you would remember a dog or

692
00:35:08.199 --> 00:35:08.960
<v Speaker 2>a face.

693
00:35:09.320 --> 00:35:11.280
<v Speaker 3>I'm probably better. I'm probably better with that than I

694
00:35:11.320 --> 00:35:12.800
<v Speaker 3>am with like remembering names.

695
00:35:13.519 --> 00:35:14.440
<v Speaker 2>What do they look like?

696
00:35:15.039 --> 00:35:17.679
<v Speaker 3>Well, you just remember their surgical anatomy and some of

697
00:35:17.719 --> 00:35:21.440
<v Speaker 3>the challenges during the case and specific surgical maneuvers and

698
00:35:21.519 --> 00:35:22.079
<v Speaker 3>things like that.

699
00:35:22.159 --> 00:35:26.119
<v Speaker 2>So what was your first surgery, like on a live

700
00:35:26.320 --> 00:35:30.280
<v Speaker 2>human being, Because you're good at cadavers, Like the first

701
00:35:30.280 --> 00:35:33.320
<v Speaker 2>time you were like, they're like, all right, Doc Europe.

702
00:35:33.400 --> 00:35:36.880
<v Speaker 3>Yeah, it's creepy. Yeah, it's a nerve wracking. Plus you

703
00:35:36.880 --> 00:35:40.840
<v Speaker 3>have people watching you and critiquing you, so it's always

704
00:35:40.679 --> 00:35:42.920
<v Speaker 3>it's a unique experience, to say the least.

705
00:35:43.159 --> 00:35:46.480
<v Speaker 2>Cutting into a person is unique, like a good pineapple

706
00:35:46.519 --> 00:35:47.840
<v Speaker 2>couscous You.

707
00:35:47.760 --> 00:35:50.559
<v Speaker 3>Know, in training, you start like not so much in

708
00:35:50.599 --> 00:35:53.320
<v Speaker 3>the operating room, but maybe in the er and you're

709
00:35:53.360 --> 00:35:56.960
<v Speaker 3>closing up lacerations in the face, and that's always a

710
00:35:57.079 --> 00:35:59.360
<v Speaker 3>unique experience as a young resident training.

711
00:35:59.400 --> 00:36:01.679
<v Speaker 2>So people's bleeding faces.

712
00:36:01.840 --> 00:36:04.599
<v Speaker 3>Yeah, yeah, they can be pretty extensive lacerations or dog

713
00:36:04.639 --> 00:36:05.719
<v Speaker 3>bites or things like that.

714
00:36:05.800 --> 00:36:08.960
<v Speaker 2>So ooh and so surgically, they kind of train you

715
00:36:09.119 --> 00:36:11.119
<v Speaker 2>and you go up and up until you get deeper

716
00:36:11.119 --> 00:36:12.719
<v Speaker 2>into the face perhaps sort of.

717
00:36:12.920 --> 00:36:15.599
<v Speaker 3>Yeah, you definitely start with more run of the mill

718
00:36:15.639 --> 00:36:19.599
<v Speaker 3>surgeries up front, things like tonsils and adenoids, and then

719
00:36:19.920 --> 00:36:22.320
<v Speaker 3>more in the middle of your training. You developed the

720
00:36:22.360 --> 00:36:25.199
<v Speaker 3>endoscopic skills for for sinus surgery.

721
00:36:25.280 --> 00:36:27.559
<v Speaker 2>So you've had to do tons of ectomies. Oh yeah,

722
00:36:27.679 --> 00:36:28.679
<v Speaker 2>I got one of those.

723
00:36:29.159 --> 00:36:30.480
<v Speaker 3>Oh at what age?

724
00:36:30.519 --> 00:36:32.599
<v Speaker 2>Oh twenty six, dude.

725
00:36:32.760 --> 00:36:33.320
<v Speaker 3>Not pleasant.

726
00:36:33.440 --> 00:36:36.880
<v Speaker 2>It was not It was not okay, But I it

727
00:36:36.960 --> 00:36:39.199
<v Speaker 2>was the only time I've ever been put under, and

728
00:36:39.360 --> 00:36:41.159
<v Speaker 2>I remember waking up being like that wasn't so bad.

729
00:36:41.559 --> 00:36:43.960
<v Speaker 2>And then I looked in the mirror and I just

730
00:36:44.000 --> 00:36:47.320
<v Speaker 2>saw a little smear of blood under my chin that

731
00:36:47.360 --> 00:36:50.000
<v Speaker 2>they had not wiped, they had missed, And I was like,

732
00:36:51.000 --> 00:36:53.960
<v Speaker 2>what happened here? Like if this is just a smear

733
00:36:54.000 --> 00:36:57.000
<v Speaker 2>that they missed, Like there's just must have been blood

734
00:36:57.000 --> 00:36:59.639
<v Speaker 2>all over my face, right, Like, is that what happens.

735
00:37:00.280 --> 00:37:04.119
<v Speaker 3>Who knows. I meant the anesthesiologist pulled the tube out, you.

736
00:37:04.039 --> 00:37:07.360
<v Speaker 2>Know, Okay. I was just like, never the surgeon's fault. No, no,

737
00:37:07.400 --> 00:37:08.880
<v Speaker 2>But I was like, what kind of game of throne

738
00:37:08.880 --> 00:37:10.840
<v Speaker 2>shit was going down when I was asleep?

739
00:37:11.199 --> 00:37:13.400
<v Speaker 3>Like, well, that's a whole other world. Yes, it's the

740
00:37:13.480 --> 00:37:16.800
<v Speaker 3>operating room environment, but I mean, you guys.

741
00:37:16.840 --> 00:37:20.360
<v Speaker 2>This always this always surprises me that like as surgeons,

742
00:37:20.440 --> 00:37:25.559
<v Speaker 2>you guys talk and play music and like it's it's

743
00:37:25.639 --> 00:37:29.519
<v Speaker 2>not I've pictured just deally silence and like you could

744
00:37:29.519 --> 00:37:33.079
<v Speaker 2>hear someone breathing. What is the actual environment, Like what's

745
00:37:33.079 --> 00:37:34.840
<v Speaker 2>the what's the mood, what's the atmosphere.

746
00:37:34.920 --> 00:37:38.880
<v Speaker 3>Yeah, I mean it definitely varies by you know, surgeon personality.

747
00:37:38.960 --> 00:37:41.719
<v Speaker 3>So they're definitely some people that prefer very quiet or

748
00:37:43.159 --> 00:37:46.920
<v Speaker 3>I don't prefer it that way. I like music. I

749
00:37:47.039 --> 00:37:48.920
<v Speaker 3>like people talking because I do a lot of teaching,

750
00:37:49.039 --> 00:37:51.519
<v Speaker 3>so I expect people to be asking me questions throughout

751
00:37:51.519 --> 00:37:54.679
<v Speaker 3>the whole case, and I also fire questions back at them.

752
00:37:55.000 --> 00:37:57.119
<v Speaker 3>So it's a very interactive or environment with me.

753
00:37:57.599 --> 00:38:00.880
<v Speaker 2>That's cool though if I'm pretty much half deaf on

754
00:38:00.960 --> 00:38:04.280
<v Speaker 2>the operating table, so there's no reason for everyone else

755
00:38:04.320 --> 00:38:07.480
<v Speaker 2>to have stony silence. Right, what do you listen to?

756
00:38:08.159 --> 00:38:11.920
<v Speaker 3>Oh? So I am a hip hop fan. Okay, so,

757
00:38:12.800 --> 00:38:15.039
<v Speaker 3>and I'm in Detroit and I've almost been an Eminem fan,

758
00:38:15.079 --> 00:38:17.719
<v Speaker 3>so I do listen to Eminem. I also listen to

759
00:38:17.760 --> 00:38:20.280
<v Speaker 3>a lot of nineties hip hop. I'm from the West Coast,

760
00:38:20.360 --> 00:38:24.000
<v Speaker 3>so I'm a big Tupac fan. And then I often

761
00:38:24.039 --> 00:38:28.239
<v Speaker 3>will listen to Hits stations, you know, And I don't

762
00:38:28.239 --> 00:38:30.800
<v Speaker 3>want to offend anybody, So if anybody's offended by rap,

763
00:38:30.840 --> 00:38:33.039
<v Speaker 3>then I definitely will just go to the Hits.

764
00:38:33.199 --> 00:38:35.079
<v Speaker 2>The patient can't object, and that'd be great if they

765
00:38:35.079 --> 00:38:36.960
<v Speaker 2>came out of it and suddenly they were like, you know,

766
00:38:37.320 --> 00:38:39.159
<v Speaker 2>let's put on some Tupac on the way home.

767
00:38:40.119 --> 00:38:43.119
<v Speaker 3>Yeah, a little subconscious recollection would be cool.

768
00:38:43.440 --> 00:38:46.000
<v Speaker 2>So what kind of situation would get you on the

769
00:38:46.079 --> 00:38:51.440
<v Speaker 2>rhinologists table as a professional? As a rhinologist, what should

770
00:38:51.440 --> 00:38:53.559
<v Speaker 2>people be on the lookout for when it comes to

771
00:38:53.599 --> 00:38:55.760
<v Speaker 2>their nose health? Because we don't think about our noses

772
00:38:55.800 --> 00:39:00.000
<v Speaker 2>unless we're contouring them or there's fluid pouring out of them.

773
00:39:00.039 --> 00:39:01.159
<v Speaker 2>What should we be aware of?

774
00:39:01.599 --> 00:39:04.800
<v Speaker 3>Yeah, there are some more red flag symptoms that sometimes

775
00:39:04.800 --> 00:39:07.840
<v Speaker 3>get overlooked and we might as well just highlight them.

776
00:39:07.920 --> 00:39:12.239
<v Speaker 3>So I always think of anytime you have one sided symptoms.

777
00:39:12.639 --> 00:39:15.000
<v Speaker 3>So if for like the last month or two, the

778
00:39:15.079 --> 00:39:17.360
<v Speaker 3>left side of your nose is completely blocked and not

779
00:39:17.440 --> 00:39:20.239
<v Speaker 3>the right, or you only have left sided nosebleeds, it's

780
00:39:20.280 --> 00:39:23.199
<v Speaker 3>probably time to get checked out. You know, it could

781
00:39:23.199 --> 00:39:27.320
<v Speaker 3>be as something as simple as a deviated septum, but

782
00:39:27.760 --> 00:39:29.719
<v Speaker 3>you don't want to miss the bad things. And so

783
00:39:30.119 --> 00:39:32.960
<v Speaker 3>when I see one sided nasal obstruction, the first thing

784
00:39:32.960 --> 00:39:34.199
<v Speaker 3>that goes through my head is I need to make

785
00:39:34.199 --> 00:39:39.000
<v Speaker 3>sure there's no tumor. So tumors tend to grow and

786
00:39:39.039 --> 00:39:43.039
<v Speaker 3>affect one side and by the time, and they usually

787
00:39:43.039 --> 00:39:44.719
<v Speaker 3>sit in the sinuss for a while before they grow

788
00:39:44.760 --> 00:39:46.320
<v Speaker 3>out into that inner chamber.

789
00:39:46.639 --> 00:39:48.840
<v Speaker 2>And now you will put a camera up a n

790
00:39:48.840 --> 00:39:52.760
<v Speaker 2>asshole and poke around. Has that been like revolutionary?

791
00:39:52.960 --> 00:39:55.599
<v Speaker 3>Yes, game changing, I mean totally change the field.

792
00:39:56.119 --> 00:39:58.639
<v Speaker 2>You mean you must have to use less radiology as well, right.

793
00:39:58.480 --> 00:40:01.360
<v Speaker 3>It's that great comment. Yes, I actually am very principled

794
00:40:01.360 --> 00:40:05.000
<v Speaker 3>against unnecessary radio or radiographic imagine because I can see

795
00:40:05.000 --> 00:40:07.360
<v Speaker 3>the important areas where the scinus is drain, and so

796
00:40:07.480 --> 00:40:10.000
<v Speaker 3>we don't need to be getting cat scans and things

797
00:40:10.000 --> 00:40:11.239
<v Speaker 3>to radiate people all.

798
00:40:11.119 --> 00:40:14.599
<v Speaker 2>The time, and so what anything else that anyone should

799
00:40:14.639 --> 00:40:15.039
<v Speaker 2>look for.

800
00:40:15.519 --> 00:40:17.679
<v Speaker 3>Yeah, another one that has been popping up in the

801
00:40:17.920 --> 00:40:20.280
<v Speaker 3>media too, or is the spinal fluid leak?

802
00:40:20.559 --> 00:40:25.760
<v Speaker 2>So god? Uh okay, So yeah, this is brain fluid,

803
00:40:26.039 --> 00:40:31.159
<v Speaker 2>so stuff from the comfy, watery sack surrounding your brain

804
00:40:31.440 --> 00:40:33.079
<v Speaker 2>kind of like when you buy a pickle and a

805
00:40:33.119 --> 00:40:36.199
<v Speaker 2>pouch at seven eleven. But it's brain fluid out of

806
00:40:36.199 --> 00:40:38.519
<v Speaker 2>your face. So doctor Craig says that if you ever

807
00:40:38.559 --> 00:40:42.880
<v Speaker 2>have clear fluid leaking from your nose, especially if it's

808
00:40:42.920 --> 00:40:46.920
<v Speaker 2>one sided, definitely get it checked out because normally clear

809
00:40:47.000 --> 00:40:51.920
<v Speaker 2>nasal drainage should be both sides. So one quick question, fuck,

810
00:40:52.480 --> 00:40:56.559
<v Speaker 2>walk me through. A spinal fluid leak is when the

811
00:40:57.000 --> 00:40:59.480
<v Speaker 2>shit around your brain is dripping out of your nose.

812
00:40:59.559 --> 00:40:59.880
<v Speaker 3>Correct?

813
00:41:00.239 --> 00:41:05.119
<v Speaker 2>That should be like fire alarm emergency, Like that's not

814
00:41:05.320 --> 00:41:06.599
<v Speaker 2>something you want to happen.

815
00:41:06.519 --> 00:41:09.039
<v Speaker 3>No, you don't. But the problem is it's not common

816
00:41:09.159 --> 00:41:12.360
<v Speaker 3>enough to where even a whole lot of physicians are

817
00:41:12.360 --> 00:41:15.119
<v Speaker 3>thinking about it all the time. So if patients present

818
00:41:15.280 --> 00:41:17.960
<v Speaker 3>and they have a runny nose, they might just get

819
00:41:18.039 --> 00:41:20.280
<v Speaker 3>put on some sprays and then follow up in three months.

820
00:41:20.639 --> 00:41:22.719
<v Speaker 2>Oh my god, how mad would you be if your

821
00:41:22.800 --> 00:41:25.800
<v Speaker 2>brain fluid was leaking out your nose and someone's like,

822
00:41:26.679 --> 00:41:27.519
<v Speaker 2>take some clareton.

823
00:41:27.800 --> 00:41:30.599
<v Speaker 3>I know it happens. It's not that uncommon for that

824
00:41:30.639 --> 00:41:31.079
<v Speaker 3>to happen.

825
00:41:31.559 --> 00:41:33.880
<v Speaker 2>I feel like it's too bad that brain fluid isn't

826
00:41:33.920 --> 00:41:37.159
<v Speaker 2>tinted a certain color like a transmission fluid or something.

827
00:41:37.280 --> 00:41:40.719
<v Speaker 2>Oh it's blue. Like this is a real issue, and

828
00:41:40.800 --> 00:41:42.360
<v Speaker 2>what would cause that?

829
00:41:43.360 --> 00:41:46.239
<v Speaker 3>So two main causes. One would be trauma. Okay, So

830
00:41:46.599 --> 00:41:50.199
<v Speaker 3>if you have a high velocity head injury, you can

831
00:41:50.239 --> 00:41:54.280
<v Speaker 3>crack that skull based bone and the leak may occur then,

832
00:41:54.440 --> 00:41:56.840
<v Speaker 3>or it could occur like months later, just from a

833
00:41:56.880 --> 00:42:01.679
<v Speaker 3>delayed wound healing process. Or there's another type called spontaneous

834
00:42:01.679 --> 00:42:08.039
<v Speaker 3>spinal fluid leaks. The thought is you get chronic pressure

835
00:42:08.119 --> 00:42:10.440
<v Speaker 3>changes at that skull base. It's already thin, eventually it

836
00:42:10.440 --> 00:42:13.760
<v Speaker 3>thins to a point where it's gone, and then one

837
00:42:13.760 --> 00:42:15.559
<v Speaker 3>way or another there's a tear in the lining of

838
00:42:15.599 --> 00:42:17.639
<v Speaker 3>the brain that then allows fluid to drip.

839
00:42:17.840 --> 00:42:20.280
<v Speaker 2>Oh so it's like a burst dam kind of yeah.

840
00:42:20.599 --> 00:42:25.400
<v Speaker 2>Oh yeah, man, So watch out for those things. What's

841
00:42:25.400 --> 00:42:28.280
<v Speaker 2>happening when people put cocaine up their nose, when people

842
00:42:28.280 --> 00:42:31.679
<v Speaker 2>are crushing things and snorting them. I'm sure that you

843
00:42:31.719 --> 00:42:33.159
<v Speaker 2>have a cautionary tail or two.

844
00:42:33.559 --> 00:42:36.760
<v Speaker 3>Uh you know what's fun I haven't seen that many

845
00:42:36.800 --> 00:42:39.199
<v Speaker 3>people yet. I mean I've seen a few. So what's

846
00:42:39.239 --> 00:42:43.400
<v Speaker 3>happening is cocaine basically acts to constrict blood vessels, so

847
00:42:43.559 --> 00:42:48.440
<v Speaker 3>it's extreme. We call it vasoconstriction. And so there's obviously

848
00:42:48.559 --> 00:42:53.360
<v Speaker 3>mechanical trauma from the actual shards of cocaine and that

849
00:42:53.639 --> 00:42:55.960
<v Speaker 3>can cut the nose and then it gets deposited in

850
00:42:56.039 --> 00:42:59.440
<v Speaker 3>the tissue that will cause a really extreme construction of

851
00:42:59.440 --> 00:43:03.039
<v Speaker 3>the blood vessel, so that over time can basically cause

852
00:43:03.079 --> 00:43:06.079
<v Speaker 3>death to the tissue. And so the nasal septum is

853
00:43:06.079 --> 00:43:09.760
<v Speaker 3>a very highly susceptible area because it's right there in

854
00:43:09.760 --> 00:43:11.360
<v Speaker 3>the front of the nose, and so if you hit

855
00:43:11.400 --> 00:43:13.360
<v Speaker 3>it with cocaine for a long period of time, the

856
00:43:13.880 --> 00:43:17.280
<v Speaker 3>mucosa on either side of the septum can die and

857
00:43:17.320 --> 00:43:19.920
<v Speaker 3>then the cartilage in between doesn't have a blood supply,

858
00:43:20.039 --> 00:43:21.920
<v Speaker 3>so it's gone. So that's how people get holes in

859
00:43:21.960 --> 00:43:23.199
<v Speaker 3>their septum from cocaine.

860
00:43:23.239 --> 00:43:27.840
<v Speaker 2>Use. God, why do people snort some drugs instead of

861
00:43:27.920 --> 00:43:31.760
<v Speaker 2>just putting them in their body through other mucosal areas.

862
00:43:32.480 --> 00:43:37.119
<v Speaker 3>I couldn't give you perfect answers, but I mean, for one,

863
00:43:37.199 --> 00:43:39.559
<v Speaker 3>it gets absorbed fairly quickly. I think that gives the

864
00:43:39.880 --> 00:43:45.320
<v Speaker 3>like initial high quicker. But I don't know if there's

865
00:43:45.519 --> 00:43:48.360
<v Speaker 3>ingestible form of cocaine. To be honest, it.

866
00:43:48.360 --> 00:43:50.719
<v Speaker 2>Didn't strike me until later. But yes, if you've ever

867
00:43:50.719 --> 00:43:54.639
<v Speaker 2>read up on altitude sickness in Machu Pichu, you may

868
00:43:54.639 --> 00:43:58.239
<v Speaker 2>have heard that a lot of hikers keep a soggy

869
00:43:58.320 --> 00:44:01.800
<v Speaker 2>lump of chewed up cocoa in the cheek, or you

870
00:44:01.840 --> 00:44:07.480
<v Speaker 2>can drink cocoa tea. Also booty bumping. What's booty bumping? Oh,

871
00:44:07.559 --> 00:44:11.599
<v Speaker 2>it's the same as key stirring or plugging or butt chugging,

872
00:44:11.800 --> 00:44:14.480
<v Speaker 2>which is when you mix drugs with water and then

873
00:44:14.679 --> 00:44:18.719
<v Speaker 2>stream them up your dark canals of your posterior, thereby

874
00:44:19.000 --> 00:44:23.840
<v Speaker 2>bypassing the pesky delay that digestion might afford. Now this

875
00:44:24.360 --> 00:44:27.480
<v Speaker 2>all according to a blog post entitled Everything You Need

876
00:44:27.519 --> 00:44:31.079
<v Speaker 2>to Know about butt Chugging, written by a retired police

877
00:44:31.119 --> 00:44:34.079
<v Speaker 2>sergeant named Keith Graves. I wish I went to his

878
00:44:34.119 --> 00:44:37.760
<v Speaker 2>retirement party. I bet that was so fun. But wait,

879
00:44:38.119 --> 00:44:43.239
<v Speaker 2>ingestable cocaine? Hmmm, Hello soft drinks, Lest we forget that

880
00:44:43.360 --> 00:44:47.119
<v Speaker 2>Coca Cola got that coca from somewhere now in the

881
00:44:47.199 --> 00:44:51.679
<v Speaker 2>late eighteen eighties. It was invented by doctor J. Pemberton,

882
00:44:51.920 --> 00:44:55.360
<v Speaker 2>who was a Confederate soldier who was addicted to morphine

883
00:44:55.400 --> 00:44:58.400
<v Speaker 2>and he wanted to make a health tonic. He was like, man,

884
00:44:58.639 --> 00:45:01.800
<v Speaker 2>this cocaine juice. We'll fix your fucking life. And he

885
00:45:01.920 --> 00:45:04.840
<v Speaker 2>began selling it in drug stores and then he died

886
00:45:04.920 --> 00:45:08.960
<v Speaker 2>suddenly two years later. But his family was like, yeah, man, yeah,

887
00:45:08.960 --> 00:45:10.599
<v Speaker 2>you know what, let's make this a business. Like one

888
00:45:10.639 --> 00:45:12.280
<v Speaker 2>day it'll be the biggest business in the world and

889
00:45:12.320 --> 00:45:14.639
<v Speaker 2>people wake up and drink it and we'll sponsor the Olympics.

890
00:45:14.639 --> 00:45:17.920
<v Speaker 2>Holy shit, man, yeah, let's do it. Because they were

891
00:45:17.920 --> 00:45:22.679
<v Speaker 2>on cocaine. Now. Originally Coca Cola had about nine milligrams

892
00:45:22.719 --> 00:45:25.920
<v Speaker 2>of cocaine per glass, which is about a fifth of

893
00:45:25.960 --> 00:45:29.920
<v Speaker 2>what you would see like when a chubby line is

894
00:45:30.000 --> 00:45:35.440
<v Speaker 2>snorted in movies about nineteen eighty Stockbrokers or like on Entourage.

895
00:45:35.480 --> 00:45:38.039
<v Speaker 2>I don't know, by the way, what are those actors

896
00:45:38.079 --> 00:45:41.639
<v Speaker 2>really snorting. Well, it turns out it's usually lactose powder

897
00:45:42.119 --> 00:45:45.360
<v Speaker 2>or the prop master coats the inside of the rolled

898
00:45:45.440 --> 00:45:48.760
<v Speaker 2>up one hundred dollar bill with vasoline so that the

899
00:45:48.840 --> 00:45:52.480
<v Speaker 2>lactose sticks to the inside. But either way, doing pricey

900
00:45:52.519 --> 00:45:55.480
<v Speaker 2>street drugs that wrote your septum and turn you into

901
00:45:55.559 --> 00:45:59.519
<v Speaker 2>a maniac d bag probably not the best life choice

902
00:45:59.559 --> 00:46:02.800
<v Speaker 2>if you could avoid it. Just just picture like an

903
00:46:02.840 --> 00:46:07.119
<v Speaker 2>image of a rainbow star streaking across the cosmos and

904
00:46:07.159 --> 00:46:17.639
<v Speaker 2>a the more you know graphic. But it's a bad idea.

905
00:46:18.119 --> 00:46:19.880
<v Speaker 2>It also seems very expensive.

906
00:46:20.559 --> 00:46:21.840
<v Speaker 3>That probably is also true.

907
00:46:21.960 --> 00:46:26.559
<v Speaker 2>Yes, if anyone really needs an upper I drank yerbamate

908
00:46:26.760 --> 00:46:29.239
<v Speaker 2>for a number of years, and boy, oh boy, that

909
00:46:29.320 --> 00:46:30.440
<v Speaker 2>thing that have you ever had it?

910
00:46:30.760 --> 00:46:31.079
<v Speaker 3>What's that?

911
00:46:31.199 --> 00:46:34.679
<v Speaker 2>It's a type of South American tea. Oh seriously, though,

912
00:46:35.239 --> 00:46:38.920
<v Speaker 2>your bmate, man, I don't know how it's legal, because

913
00:46:39.119 --> 00:46:42.239
<v Speaker 2>like a month's supply is four dollars and I would

914
00:46:42.320 --> 00:46:46.800
<v Speaker 2>scrub my bathroom grout at midnight for fun. I had

915
00:46:46.840 --> 00:46:48.960
<v Speaker 2>to finally quit because I drank too much and I

916
00:46:49.000 --> 00:46:54.199
<v Speaker 2>turned into the human equivalent of a scared chihuahua. Yeah.

917
00:46:54.400 --> 00:46:56.679
<v Speaker 2>I had some friends that are like, are you on drugs?

918
00:46:56.679 --> 00:46:58.440
<v Speaker 2>And I was like, no, I discovered a tea at

919
00:46:58.480 --> 00:47:02.519
<v Speaker 2>Trader Joe's. It's very care oftenative. It was, It's intense

920
00:47:02.719 --> 00:47:05.159
<v Speaker 2>a lot. I'm sure a lot cheaper than street drug.

921
00:47:05.199 --> 00:47:07.760
<v Speaker 2>How do you feel about septum piercings when you see it?

922
00:47:07.760 --> 00:47:10.039
<v Speaker 2>Are you like no? Are you like go for it?

923
00:47:11.480 --> 00:47:14.599
<v Speaker 3>Hmm? There is of course the potential when you take

924
00:47:14.599 --> 00:47:16.280
<v Speaker 3>it out that you would have a hole in your septum.

925
00:47:16.679 --> 00:47:19.679
<v Speaker 3>So to me it would seem like unnecessary risk. But

926
00:47:19.760 --> 00:47:23.840
<v Speaker 3>if it's you know, a strong personal preference, I don't know.

927
00:47:23.880 --> 00:47:26.960
<v Speaker 3>I haven't seen too many problems from them holes in

928
00:47:26.960 --> 00:47:27.440
<v Speaker 3>the septum.

929
00:47:27.840 --> 00:47:29.440
<v Speaker 2>That's good. So you don't see a lot of people

930
00:47:29.480 --> 00:47:32.440
<v Speaker 2>coming in just like dragging themselves into the er with

931
00:47:32.559 --> 00:47:33.960
<v Speaker 2>an infect.

932
00:47:33.519 --> 00:47:36.400
<v Speaker 3>Effectually, I haven't, but I mean, it's of course a

933
00:47:36.440 --> 00:47:37.880
<v Speaker 3>possibility if.

934
00:47:37.719 --> 00:47:40.519
<v Speaker 2>You're let's say you had a child that's like, Dad,

935
00:47:40.760 --> 00:47:42.639
<v Speaker 2>I'd like a septum piercing. Would you be like, okay,

936
00:47:42.679 --> 00:47:43.519
<v Speaker 2>but I'm doing it.

937
00:47:43.920 --> 00:47:45.920
<v Speaker 3>I would probably just be with them at the piercing

938
00:47:45.960 --> 00:47:49.039
<v Speaker 3>studio and hyper analyze exactly what they're doing.

939
00:47:49.159 --> 00:47:51.440
<v Speaker 2>But I feel like it's an easy one to fake though,

940
00:47:51.480 --> 00:47:52.960
<v Speaker 2>you know what I mean. I feel like there's some

941
00:47:53.000 --> 00:47:54.440
<v Speaker 2>good clip on septum rings.

942
00:47:54.639 --> 00:47:56.719
<v Speaker 3>It could be true, right, kind of makes sense. I mean,

943
00:47:56.920 --> 00:47:58.320
<v Speaker 3>it might be a market you should explore.

944
00:48:00.079 --> 00:48:03.119
<v Speaker 2>I try to find out what percentage of septum piercings

945
00:48:03.119 --> 00:48:05.880
<v Speaker 2>you see in the wild are actually piercings and what

946
00:48:06.000 --> 00:48:09.519
<v Speaker 2>percentage are just clip on? But like a bow tie,

947
00:48:09.599 --> 00:48:12.360
<v Speaker 2>you'd have to tug on it or ask or launch

948
00:48:12.400 --> 00:48:16.400
<v Speaker 2>a multifaceted study on it. Now, I did learn that

949
00:48:16.480 --> 00:48:20.159
<v Speaker 2>they don't actually pierce your cartilage. They find what's called

950
00:48:20.480 --> 00:48:24.880
<v Speaker 2>your sweet spot, scientifically known as the columella, which is

951
00:48:24.920 --> 00:48:27.400
<v Speaker 2>a little bit of flesh at the tip of your

952
00:48:27.440 --> 00:48:30.920
<v Speaker 2>nose past your actual septum, which makes the whole shebang

953
00:48:31.320 --> 00:48:35.199
<v Speaker 2>less drilly and really more gentle pokey. But can I

954
00:48:35.320 --> 00:48:38.840
<v Speaker 2>just say that, hot dang, If you're afraid of blood

955
00:48:39.239 --> 00:48:42.320
<v Speaker 2>or commitment and you want to clip on septum piercing,

956
00:48:42.639 --> 00:48:46.079
<v Speaker 2>Etsy is coming through for you. But what about putting

957
00:48:46.119 --> 00:48:49.599
<v Speaker 2>things on the outside of your whiffer? Oh? I did

958
00:48:49.599 --> 00:48:52.599
<v Speaker 2>forget to ask. Do strips that you stick to your

959
00:48:52.599 --> 00:48:55.440
<v Speaker 2>nose that open your nose up to prevent snoring? Do

960
00:48:55.480 --> 00:48:57.599
<v Speaker 2>they work? And how? So?

961
00:48:58.079 --> 00:48:59.880
<v Speaker 3>They work, But it's not so much for the snoring.

962
00:49:00.079 --> 00:49:03.199
<v Speaker 3>What it works on is what we call nasal valve collapse.

963
00:49:03.840 --> 00:49:07.599
<v Speaker 2>Ooh, get in bed with nasal valve collapse.

964
00:49:10.840 --> 00:49:15.039
<v Speaker 3>So the floppy part of the nose, the nostrils, we

965
00:49:15.119 --> 00:49:18.199
<v Speaker 3>call them the nasal valve region. So it's actually pretty

966
00:49:18.199 --> 00:49:21.239
<v Speaker 3>common to have some degree of narrowing or collapse there.

967
00:49:21.559 --> 00:49:23.360
<v Speaker 3>So what the breathe right strip is help or you know,

968
00:49:23.440 --> 00:49:26.280
<v Speaker 3>generic strips whatever are helping with They'll just lift the

969
00:49:26.320 --> 00:49:29.199
<v Speaker 3>floppy nostril outward, kind of like flaring the nose. So

970
00:49:29.360 --> 00:49:33.199
<v Speaker 3>if that is your area of obstruction, which isn't necessarily

971
00:49:33.199 --> 00:49:35.719
<v Speaker 3>the case, but if it is, then it should improve airflow.

972
00:49:36.039 --> 00:49:39.280
<v Speaker 3>And in those situations, if that's your only cause for storing,

973
00:49:39.440 --> 00:49:42.159
<v Speaker 3>it'll help with storm. But it's not. I mean, snoring

974
00:49:42.239 --> 00:49:44.920
<v Speaker 3>is multifactorial. You can have obstruction at any level of

975
00:49:44.920 --> 00:49:47.800
<v Speaker 3>the throat that won't help with a breathe right strip.

976
00:49:47.960 --> 00:49:50.719
<v Speaker 2>Does snoring sound different if it's a nose snore versus

977
00:49:50.719 --> 00:49:53.119
<v Speaker 2>a throat snore? Like, could you if someone played you

978
00:49:53.159 --> 00:49:56.159
<v Speaker 2>an audio clip, could you be like, that's a flopping asshole?

979
00:49:57.400 --> 00:49:59.400
<v Speaker 3>Good question. I don't. I don't. I'm not aware of

980
00:49:59.440 --> 00:50:03.639
<v Speaker 3>any literature on it, and I don't watch enough snores.

981
00:50:03.800 --> 00:50:05.639
<v Speaker 2>So if you try it and you are told that

982
00:50:05.679 --> 00:50:08.400
<v Speaker 2>you're still snoring, you might it might be in the throat,

983
00:50:08.400 --> 00:50:09.280
<v Speaker 2>it might be something else.

984
00:50:09.400 --> 00:50:12.920
<v Speaker 3>Yeah, snoring actually is not a prominent primary complaint.

985
00:50:13.000 --> 00:50:14.880
<v Speaker 2>I would think that would be the first. You just

986
00:50:14.920 --> 00:50:16.800
<v Speaker 2>have a line of snores that are in there with

987
00:50:16.840 --> 00:50:21.360
<v Speaker 2>like maybe a tired cranky spouses being like good at fixed.

988
00:50:21.679 --> 00:50:24.679
<v Speaker 3>Well. In some people's clinics, yes, but in my rhinology clinic,

989
00:50:24.679 --> 00:50:27.440
<v Speaker 3>it's not the primary. But it's definitely I mean a

990
00:50:27.559 --> 00:50:32.599
<v Speaker 3>huge you know area of healthcare right now right obstructive SLEAPABNA.

991
00:50:32.719 --> 00:50:34.000
<v Speaker 3>So yeah, a lot of people see that.

992
00:50:34.559 --> 00:50:39.559
<v Speaker 2>So I looked at one website appropriately called stopth umble

993
00:50:39.840 --> 00:50:43.639
<v Speaker 2>dot com that tried to describe the sounds of snores

994
00:50:43.679 --> 00:50:45.719
<v Speaker 2>based on the cause, but it had a lot of

995
00:50:45.719 --> 00:50:47.840
<v Speaker 2>weird pop up ads. So I don't know if it's

996
00:50:47.880 --> 00:50:51.039
<v Speaker 2>even trustworthy. Now, as soon as I have a some

997
00:50:51.280 --> 00:50:54.239
<v Speaker 2>knowledgist on this is going to be a top order

998
00:50:54.239 --> 00:50:59.280
<v Speaker 2>of business, trust me. Okay, So onward and upward. Nose

999
00:50:59.320 --> 00:51:01.440
<v Speaker 2>hair trimming. Should we do it? Should we not do it?

1000
00:51:01.800 --> 00:51:06.559
<v Speaker 3>Hmmm? Probably overall the recommendation should be you don't do it.

1001
00:51:06.679 --> 00:51:07.000
<v Speaker 2>Okay.

1002
00:51:07.639 --> 00:51:11.239
<v Speaker 3>There is some function to the nose hairs. They catch debris,

1003
00:51:11.519 --> 00:51:14.039
<v Speaker 3>but you can trim it up and it's fine. I mean, listen,

1004
00:51:14.119 --> 00:51:17.400
<v Speaker 3>if you are having nose hair growing out of the

1005
00:51:17.440 --> 00:51:19.760
<v Speaker 3>nostril and it bothers you. It's safe to clip them.

1006
00:51:19.800 --> 00:51:21.199
<v Speaker 3>You're not going to costume me problems. But if you

1007
00:51:21.199 --> 00:51:23.760
<v Speaker 3>do trim the tissue and cause a nose blade, then

1008
00:51:23.880 --> 00:51:25.480
<v Speaker 3>you could have a problem.

1009
00:51:25.679 --> 00:51:27.320
<v Speaker 2>Why does it? Do you know why it hurts so

1010
00:51:27.400 --> 00:51:29.519
<v Speaker 2>much if you pluck a nose hair. We've all done it.

1011
00:51:29.519 --> 00:51:30.039
<v Speaker 2>It's horrible.

1012
00:51:30.119 --> 00:51:33.639
<v Speaker 3>Yeah, it is quite it's the worst. Yeah, just the

1013
00:51:33.679 --> 00:51:36.960
<v Speaker 3>nerve innervation. It's those nerves again, they have to.

1014
00:51:36.920 --> 00:51:38.079
<v Speaker 2>Be very very sensitive.

1015
00:51:38.199 --> 00:51:40.079
<v Speaker 3>Mm hm, oh god, I know.

1016
00:51:40.280 --> 00:51:42.480
<v Speaker 2>Yeah, it's a it's a what a form of torture.

1017
00:51:42.760 --> 00:51:44.639
<v Speaker 2>I mean, as a person who's had a lot of

1018
00:51:44.679 --> 00:51:47.760
<v Speaker 2>things waxed, there's nothing I would rather wax my entire

1019
00:51:47.840 --> 00:51:49.800
<v Speaker 2>body twice than one nose hair.

1020
00:51:49.960 --> 00:51:51.760
<v Speaker 3>It is. Yeah, it's crazy how painful it is.

1021
00:51:53.320 --> 00:51:55.159
<v Speaker 2>Do you want to do a lightning round? Sure? Okay,

1022
00:51:55.199 --> 00:52:00.760
<v Speaker 2>these are questions from listeners. Okay about noses to you. Okay,

1023
00:52:01.400 --> 00:52:04.760
<v Speaker 2>But before we take questions from you, our beloved listeners,

1024
00:52:04.800 --> 00:52:07.119
<v Speaker 2>we're going to take a quick break for sponsors of

1025
00:52:07.119 --> 00:52:09.840
<v Speaker 2>the show. Sponsors. Why sponsors, you know what they do?

1026
00:52:09.960 --> 00:52:12.920
<v Speaker 2>They help us give money to different charities every week.

1027
00:52:13.119 --> 00:52:15.440
<v Speaker 2>So if you want to know where ologies gives our money.

1028
00:52:15.639 --> 00:52:18.159
<v Speaker 2>You can go to aliwar dot com and look for

1029
00:52:18.199 --> 00:52:21.239
<v Speaker 2>the tab Ologies gives back. There's like one hundred and

1030
00:52:21.320 --> 00:52:24.400
<v Speaker 2>fifty different charities that we've given to already, with more

1031
00:52:24.559 --> 00:52:26.679
<v Speaker 2>every single week. So if you need a place to go,

1032
00:52:26.719 --> 00:52:28.239
<v Speaker 2>donate a little bit of money but you're not sure

1033
00:52:28.239 --> 00:52:31.440
<v Speaker 2>where to go. Those are all picked biologists who work

1034
00:52:31.480 --> 00:52:34.840
<v Speaker 2>in those fields, and this ad break allows us to

1035
00:52:35.599 --> 00:52:38.199
<v Speaker 2>give a ton of money to them. So thanks for

1036
00:52:38.280 --> 00:52:39.519
<v Speaker 2>listening and thank sponsors.

1037
00:52:40.159 --> 00:52:43.440
<v Speaker 1>Imagine the place where you can escape for a day,

1038
00:52:44.239 --> 00:52:48.760
<v Speaker 1>get immersed in a world of rooms, inspiration and expertise

1039
00:52:49.360 --> 00:52:54.440
<v Speaker 1>where you can lay in luxury accommodation. Thank kids, cam

1040
00:52:54.519 --> 00:52:59.920
<v Speaker 1>fees from ninety five sets. Take yourself free to every

1041
00:53:00.559 --> 00:53:05.519
<v Speaker 1>and include all the attractions you've just imagined a day

1042
00:53:05.679 --> 00:53:09.639
<v Speaker 1>out at the kia Ikia the wonderful every day.

1043
00:53:10.519 --> 00:53:15.639
<v Speaker 2>Okay, your questions, Krista Avanpado asks, My eye doctor once

1044
00:53:15.679 --> 00:53:18.719
<v Speaker 2>gave me exercises to strengthen my eyes and they worked. Wonders,

1045
00:53:18.800 --> 00:53:20.760
<v Speaker 2>is there anything we can do to strengthen our sense

1046
00:53:20.800 --> 00:53:22.960
<v Speaker 2>of smell?

1047
00:53:23.119 --> 00:53:27.119
<v Speaker 3>Hmmm, So there's some some good evidence when you have

1048
00:53:27.159 --> 00:53:31.119
<v Speaker 3>smell loss that something called olfactory training helps. I'm not aware.

1049
00:53:31.159 --> 00:53:33.079
<v Speaker 3>If you already have good smell, then I don't know

1050
00:53:33.079 --> 00:53:36.119
<v Speaker 3>if it'll strengthen it. But if you've lost your smell,

1051
00:53:36.400 --> 00:53:38.920
<v Speaker 3>then some studies have shown that if you get like

1052
00:53:38.960 --> 00:53:43.440
<v Speaker 3>some of those extract oils like citrus, rose, geranium, things

1053
00:53:43.480 --> 00:53:47.320
<v Speaker 3>like that, if you smell those thirty seconds each four cents, okay,

1054
00:53:47.719 --> 00:53:51.280
<v Speaker 3>around three times a day, that may stimulate more smell function.

1055
00:53:51.679 --> 00:53:55.119
<v Speaker 3>Really yeah, and actually I've seen it work, so it's

1056
00:53:55.119 --> 00:53:56.599
<v Speaker 3>got good evidence behind it at least.

1057
00:53:56.639 --> 00:53:58.719
<v Speaker 2>So oh that's amazing. I had I thought you were

1058
00:53:58.840 --> 00:54:01.760
<v Speaker 2>just just shit out of luck. There, you're just plumb

1059
00:54:01.760 --> 00:54:02.280
<v Speaker 2>out of luck.

1060
00:54:02.559 --> 00:54:05.039
<v Speaker 3>Sometimes sometimes you are, but sometimes you can fix it.

1061
00:54:05.360 --> 00:54:07.960
<v Speaker 2>So so huff some essential oil. See what happens?

1062
00:54:08.000 --> 00:54:08.320
<v Speaker 1>Yeah?

1063
00:54:08.360 --> 00:54:11.559
<v Speaker 2>Great? Late night Pie wants to know. I frequently get allergies.

1064
00:54:11.559 --> 00:54:14.559
<v Speaker 2>What can help me breathe better? Any nose exercises or

1065
00:54:14.559 --> 00:54:17.519
<v Speaker 2>herbal remedies that you suggest? Anything herbal?

1066
00:54:17.719 --> 00:54:21.599
<v Speaker 3>So I'm not aware of any herbal remedies. I'm sure

1067
00:54:21.599 --> 00:54:24.559
<v Speaker 3>there are some that would work, but just from you know,

1068
00:54:24.639 --> 00:54:27.119
<v Speaker 3>evidence based medicine per se, I would say, you know,

1069
00:54:27.159 --> 00:54:30.840
<v Speaker 3>a topical steroid is very safe for long periods of time,

1070
00:54:31.159 --> 00:54:33.440
<v Speaker 3>and the saline rents that I mentioned before are just

1071
00:54:33.599 --> 00:54:36.199
<v Speaker 3>good simple nasal treatments. And then if you have a

1072
00:54:36.239 --> 00:54:38.440
<v Speaker 3>lot of the itchiness it you knows that you eyes

1073
00:54:39.039 --> 00:54:42.000
<v Speaker 3>or some other you know, body hives or you know,

1074
00:54:42.039 --> 00:54:43.400
<v Speaker 3>antihistamines would be great.

1075
00:54:43.599 --> 00:54:47.920
<v Speaker 2>Okay, I got a couple of questions about sneezing. Tyler

1076
00:54:48.000 --> 00:54:50.880
<v Speaker 2>Q wants to know what's the deal with bright lights

1077
00:54:50.880 --> 00:54:54.239
<v Speaker 2>making people sneeze? What's the correlation there? And I have

1078
00:54:54.960 --> 00:54:56.880
<v Speaker 2>that where if I'm gonna sneeze and I'm about to

1079
00:54:56.920 --> 00:54:58.760
<v Speaker 2>lose it, if I look at light, I think your

1080
00:54:58.760 --> 00:55:03.280
<v Speaker 2>pupils constrict, and there's some like photo sneeze reflex.

1081
00:55:03.840 --> 00:55:06.920
<v Speaker 3>I need to read more. Apparently, Yeah, it's interesting. I

1082
00:55:06.960 --> 00:55:09.119
<v Speaker 3>wanted to blame it on migraines, but I guess maybe

1083
00:55:09.119 --> 00:55:10.239
<v Speaker 3>there's actually if.

1084
00:55:10.119 --> 00:55:11.760
<v Speaker 2>I am about to sneeze, you know when you lose

1085
00:55:11.760 --> 00:55:14.239
<v Speaker 2>a sneeze and it's just like devastating. Yeah, you're like

1086
00:55:14.280 --> 00:55:16.639
<v Speaker 2>where did that go? If I look at a bright light,

1087
00:55:16.920 --> 00:55:19.840
<v Speaker 2>then my pupils get small and then that's what triggers

1088
00:55:19.840 --> 00:55:23.079
<v Speaker 2>the sneeze. But my DNA profile said I'm likely to

1089
00:55:23.079 --> 00:55:25.199
<v Speaker 2>have a photo sneeze reflex, and I was like, damn straight,

1090
00:55:25.239 --> 00:55:29.440
<v Speaker 2>I do interesting? So yes, This is called photic sneeze

1091
00:55:29.599 --> 00:55:32.920
<v Speaker 2>reflex and it happens to about twenty to thirty percent

1092
00:55:32.960 --> 00:55:36.039
<v Speaker 2>of people and it is inheritable. So next time you're

1093
00:55:36.079 --> 00:55:40.440
<v Speaker 2>about to disseminate your nose contents away from your body

1094
00:55:40.440 --> 00:55:42.239
<v Speaker 2>in one hundred miles an hour, which is what a

1095
00:55:42.280 --> 00:55:45.559
<v Speaker 2>sneeze is, but it might go away, look at light

1096
00:55:45.760 --> 00:55:48.320
<v Speaker 2>and see if that does the old trick. Also, this

1097
00:55:48.440 --> 00:55:53.639
<v Speaker 2>whole thing is called ready for this autosomal compelling helio

1098
00:55:53.880 --> 00:55:58.519
<v Speaker 2>ophthalmolic outburst, which sounds like a real mouthful, but guess

1099
00:55:58.519 --> 00:56:03.519
<v Speaker 2>what it stands for? A chew? Yes, someone backronymed that

1100
00:56:03.519 --> 00:56:07.199
<v Speaker 2>shit so hardcore, and I have to say that that

1101
00:56:07.480 --> 00:56:17.679
<v Speaker 2>achievement is nothing to sneeze at. Sorry, you love it,

1102
00:56:17.840 --> 00:56:18.880
<v Speaker 2>you love all of it.

1103
00:56:19.360 --> 00:56:20.360
<v Speaker 3>I love these questions.

1104
00:56:20.440 --> 00:56:23.360
<v Speaker 2>I know, here's Carrie or here's carl wants to know?

1105
00:56:23.679 --> 00:56:28.760
<v Speaker 2>Does muco faigi mute coffage boost your immune system? That

1106
00:56:28.800 --> 00:56:32.599
<v Speaker 2>sounds like eating and I'm gonna bar right now onto

1107
00:56:32.599 --> 00:56:35.159
<v Speaker 2>my computer. Does it help your immune system?

1108
00:56:35.440 --> 00:56:37.559
<v Speaker 3>I don't think so, okay, and we all swallow our

1109
00:56:37.559 --> 00:56:40.440
<v Speaker 3>own about one. Did do court today?

1110
00:56:40.480 --> 00:56:41.639
<v Speaker 2>So when did you courts?

1111
00:56:41.760 --> 00:56:43.800
<v Speaker 3>Yeah? Four to eight cups if you want to do

1112
00:56:44.320 --> 00:56:47.679
<v Speaker 3>the measurements. So you're all, we're all swallowing it. Only

1113
00:56:47.679 --> 00:56:49.519
<v Speaker 3>a certain percentage of people actually notice it and get

1114
00:56:49.559 --> 00:56:50.039
<v Speaker 3>bothered by it.

1115
00:56:50.239 --> 00:56:53.599
<v Speaker 2>Oh my god, how do we make that much fluids?

1116
00:56:53.960 --> 00:56:58.440
<v Speaker 3>Well, it's part of the mucosa. It's it's a secreting powerhouse.

1117
00:56:58.559 --> 00:57:01.320
<v Speaker 2>Just keeps going, Oh my god, that's a lot. Julie

1118
00:57:01.400 --> 00:57:04.079
<v Speaker 2>Rose asks that. She says that her nose runs every

1119
00:57:04.079 --> 00:57:07.079
<v Speaker 2>time she eats, even if it's not anything spicy, every

1120
00:57:07.119 --> 00:57:09.079
<v Speaker 2>time she eats. Now, why do spicy things make our

1121
00:57:09.119 --> 00:57:11.280
<v Speaker 2>nose run? And why does her nose run every time

1122
00:57:11.360 --> 00:57:14.119
<v Speaker 2>she eats? She says, it happens. It's been happening as

1123
00:57:14.159 --> 00:57:15.039
<v Speaker 2>long as she can remember.

1124
00:57:15.280 --> 00:57:20.320
<v Speaker 3>Yeah, so definitely read up on vaso motor rhinitis vaso

1125
00:57:20.639 --> 00:57:22.480
<v Speaker 3>m oto r rhinitis.

1126
00:57:22.679 --> 00:57:25.400
<v Speaker 2>Now, if this happens to you, it might be an

1127
00:57:25.480 --> 00:57:30.000
<v Speaker 2>overactive nerve response or something is wonky at the junction

1128
00:57:30.239 --> 00:57:33.559
<v Speaker 2>between a nerve and a gland. But doctor Craig says

1129
00:57:33.559 --> 00:57:37.639
<v Speaker 2>there are other triggers, like temperature change or wine. Now

1130
00:57:37.760 --> 00:57:41.320
<v Speaker 2>with Rose on a patio season upon us, what do

1131
00:57:41.360 --> 00:57:41.760
<v Speaker 2>you do?

1132
00:57:42.159 --> 00:57:44.960
<v Speaker 3>And there's actually a nasal spray that works usually very

1133
00:57:44.960 --> 00:57:47.280
<v Speaker 3>well for it it's called atravant okay, and it basically

1134
00:57:47.320 --> 00:57:49.239
<v Speaker 3>binds a receptor on the gland. It just blocks it

1135
00:57:49.280 --> 00:57:52.760
<v Speaker 3>from secreting. Oh so, and there's actually there's a new

1136
00:57:52.800 --> 00:57:56.760
<v Speaker 3>treatment out that I do offer. I think I'm one

1137
00:57:56.760 --> 00:57:59.960
<v Speaker 3>of the few people in Michigan right now. It's an

1138
00:58:00.199 --> 00:58:05.360
<v Speaker 3>nasal cryotherapy that freezing yeah. Yeah, and it's there's a

1139
00:58:05.360 --> 00:58:09.760
<v Speaker 3>publication from Stanford last year very encouraging. This is a

1140
00:58:09.840 --> 00:58:13.199
<v Speaker 3>very difficult problem to treat, and so when patients either

1141
00:58:13.239 --> 00:58:16.639
<v Speaker 3>aren't responding adequately or just don't love using ACCURVT nasal

1142
00:58:16.679 --> 00:58:18.920
<v Speaker 3>spray whenever they have a running nose, it's an option,

1143
00:58:19.639 --> 00:58:21.320
<v Speaker 3>and it's a non surgical option. You usually do it

1144
00:58:21.360 --> 00:58:22.400
<v Speaker 3>in the office with them awake.

1145
00:58:22.880 --> 00:58:25.920
<v Speaker 2>So so anyway, you just freeze off an area, Yeah.

1146
00:58:25.800 --> 00:58:27.679
<v Speaker 3>Just one area in the back of the nose where

1147
00:58:27.960 --> 00:58:31.960
<v Speaker 3>most of the nerve fibers applying glands are and then

1148
00:58:32.599 --> 00:58:35.440
<v Speaker 3>if that fails, there's a surgical option that most people

1149
00:58:35.519 --> 00:58:37.559
<v Speaker 3>don't need. But every once in a while you'll have

1150
00:58:37.599 --> 00:58:42.039
<v Speaker 3>to consider cutting a nerve further back, a little trickier procedure.

1151
00:58:42.079 --> 00:58:43.639
<v Speaker 2>But but think of the money you're going to save

1152
00:58:43.639 --> 00:58:44.199
<v Speaker 2>on cleenex.

1153
00:58:44.440 --> 00:58:45.599
<v Speaker 3>There you go, see is there a.

1154
00:58:45.599 --> 00:58:48.119
<v Speaker 2>Kleenex types that you're like, don't use a kind of

1155
00:58:48.159 --> 00:58:50.320
<v Speaker 2>lotion in it, use a kind of lotion in it?

1156
00:58:50.440 --> 00:58:52.840
<v Speaker 3>So large for organic, I think I would just go

1157
00:58:52.960 --> 00:58:56.440
<v Speaker 3>with whatever feels smooth and less annoying to the tip

1158
00:58:56.440 --> 00:58:59.159
<v Speaker 3>of the nose. But nothing sticks out as superior.

1159
00:58:59.280 --> 00:59:01.159
<v Speaker 2>It's try the paper, okay to use on your nose.

1160
00:59:01.800 --> 00:59:02.719
<v Speaker 3>Not the rough stuff.

1161
00:59:02.800 --> 00:59:05.920
<v Speaker 2>Okay, just checking, yeah, okay. Charles Anderson wants to know

1162
00:59:06.000 --> 00:59:08.400
<v Speaker 2>what is the best technique for blowing your nose when

1163
00:59:08.440 --> 00:59:11.119
<v Speaker 2>you're super stuffed up? What do you do when it's

1164
00:59:11.159 --> 00:59:12.480
<v Speaker 2>just a traffic jam up there?

1165
00:59:13.000 --> 00:59:16.719
<v Speaker 3>Oh? Yes, So usually the problem is not blowing. The

1166
00:59:16.760 --> 00:59:20.639
<v Speaker 3>problem is too swollen in there, so it feels like

1167
00:59:20.679 --> 00:59:22.960
<v Speaker 3>something's like blocking and you can clear it. But a

1168
00:59:23.000 --> 00:59:25.280
<v Speaker 3>lot of times there's something in your nose called your

1169
00:59:25.519 --> 00:59:30.239
<v Speaker 3>turbinot's turbo t U r b I nat ees. Okay,

1170
00:59:30.840 --> 00:59:34.119
<v Speaker 3>they're tissues that swell up periodically. It's like their job.

1171
00:59:34.159 --> 00:59:37.119
<v Speaker 3>But they're kind of puffy, bulbous structures on the inside

1172
00:59:37.119 --> 00:59:40.079
<v Speaker 3>of the nose on the side walls, and they're made

1173
00:59:40.079 --> 00:59:42.360
<v Speaker 3>of bone on the inside and then puffy tissue on

1174
00:59:42.360 --> 00:59:45.360
<v Speaker 3>the outside. And so those are classically get crazy swollen

1175
00:59:45.440 --> 00:59:49.880
<v Speaker 3>during allergies, and so even a normal person without any

1176
00:59:49.960 --> 00:59:53.159
<v Speaker 3>disease at all may notice sometimes that one side's blocked

1177
00:59:53.519 --> 00:59:55.920
<v Speaker 3>and then a few hours later the other side's blocked,

1178
00:59:55.920 --> 00:59:57.519
<v Speaker 3>and then it switches back and forth. So what can

1179
00:59:57.559 --> 01:00:00.440
<v Speaker 3>happen when you have a cold or bad out allergies?

1180
01:00:00.639 --> 01:00:03.760
<v Speaker 3>Those tissues can both on both sides get crazy swollen,

1181
01:00:04.000 --> 01:00:05.719
<v Speaker 3>and then it's tough to breathe in, but it's also

1182
01:00:05.760 --> 01:00:08.679
<v Speaker 3>hard to blow out. Yeah, So if you're in that situation,

1183
01:00:08.719 --> 01:00:12.119
<v Speaker 3>I would say start by using a topical therapy. Flush

1184
01:00:12.119 --> 01:00:13.880
<v Speaker 3>your nose with salience. See if it's getting through at

1185
01:00:13.920 --> 01:00:17.159
<v Speaker 3>least try the floon aise or some kind of Now,

1186
01:00:17.239 --> 01:00:19.800
<v Speaker 3>you gotta be careful with the decongestins. All right, everybody

1187
01:00:19.880 --> 01:00:22.079
<v Speaker 3>hears the myths about they're not myths, they're real.

1188
01:00:22.280 --> 01:00:25.639
<v Speaker 2>But affron spray, yes, can you get addicted?

1189
01:00:25.920 --> 01:00:29.880
<v Speaker 3>Yes? So it's it causes something called taca phal axis,

1190
01:00:29.920 --> 01:00:34.880
<v Speaker 3>which is just an immediate kind of Your body immediately

1191
01:00:35.559 --> 01:00:38.800
<v Speaker 3>needs more of it pretty much, So then you have

1192
01:00:38.800 --> 01:00:40.320
<v Speaker 3>to keep using it, keep using it, and when it

1193
01:00:40.320 --> 01:00:43.599
<v Speaker 3>wears off, the tissue gets even more swollen. So that's

1194
01:00:44.000 --> 01:00:49.079
<v Speaker 3>a condition that we call rhinitis. Medica mintosa. And it's

1195
01:00:49.320 --> 01:00:51.679
<v Speaker 3>it's not a great scenario because it's hard to get

1196
01:00:51.760 --> 01:00:53.960
<v Speaker 3>rid of because patients don't want to stop using their

1197
01:00:53.960 --> 01:00:58.840
<v Speaker 3>affron chasing the dragon right exactly. So we do have

1198
01:00:58.880 --> 01:01:02.119
<v Speaker 3>ways to try to temper that. But obviously, if it's

1199
01:01:02.159 --> 01:01:05.719
<v Speaker 3>not getting better, if this is not a temporary congestion

1200
01:01:05.800 --> 01:01:09.400
<v Speaker 3>and issue blowing your nose, you really should get checked out. Okay,

1201
01:01:09.559 --> 01:01:11.480
<v Speaker 3>Usually it'll be a fleeting thing. You just have to

1202
01:01:11.480 --> 01:01:13.760
<v Speaker 3>deal with it for you know, hours to a day

1203
01:01:13.840 --> 01:01:14.239
<v Speaker 3>or something.

1204
01:01:14.920 --> 01:01:18.480
<v Speaker 2>But that's really interesting to know that you can get addicted.

1205
01:01:18.639 --> 01:01:18.840
<v Speaker 3>Yeah.

1206
01:01:18.960 --> 01:01:20.920
<v Speaker 2>I had a friend in high school named Jeff who

1207
01:01:20.960 --> 01:01:23.639
<v Speaker 2>was addicted to afron, and we're like, well, if a

1208
01:01:23.679 --> 01:01:25.960
<v Speaker 2>kid's going to get addicted to something, I guess right,

1209
01:01:26.320 --> 01:01:28.199
<v Speaker 2>the affron. But still you.

1210
01:01:28.119 --> 01:01:30.960
<v Speaker 3>Don't have like withdrawal from it. If anybody's wondering, it's

1211
01:01:31.039 --> 01:01:32.719
<v Speaker 3>just annoying to try to get off it.

1212
01:01:32.920 --> 01:01:34.840
<v Speaker 2>How long is the how long would it take to

1213
01:01:35.480 --> 01:01:36.119
<v Speaker 2>kick afron?

1214
01:01:37.000 --> 01:01:39.400
<v Speaker 3>So I actually it's funny. When I was in college,

1215
01:01:39.440 --> 01:01:41.480
<v Speaker 3>I had no idea about this, and I had a

1216
01:01:41.519 --> 01:01:45.119
<v Speaker 3>horribly deviated septum, couldn't breathe through my nose, and so

1217
01:01:45.239 --> 01:01:47.639
<v Speaker 3>I used afron because somebody told me to try affron,

1218
01:01:47.880 --> 01:01:49.320
<v Speaker 3>and I just use it for a few weeks and

1219
01:01:49.320 --> 01:01:50.840
<v Speaker 3>then I tried stopping it and I was like, oh

1220
01:01:50.880 --> 01:01:52.719
<v Speaker 3>my gosh, I can't breathe it all through my nose.

1221
01:01:52.880 --> 01:01:56.039
<v Speaker 3>So it took me, as I recall, two weeks before

1222
01:01:56.079 --> 01:01:58.119
<v Speaker 3>I felt like I don't need it anymore. But I

1223
01:01:58.480 --> 01:02:00.880
<v Speaker 3>kicked it. I just said, just so.

1224
01:02:01.079 --> 01:02:04.599
<v Speaker 2>Doctor Craig says you can kick affron addiction with a

1225
01:02:04.599 --> 01:02:08.760
<v Speaker 2>little topical steroid spray, which affron is not. It's kind

1226
01:02:08.760 --> 01:02:12.559
<v Speaker 2>of like weaning you off and then assess what caused

1227
01:02:12.559 --> 01:02:16.039
<v Speaker 2>you to need the affron So flownase is it's kind

1228
01:02:16.079 --> 01:02:18.599
<v Speaker 2>of like the methodone in this situation. I think I

1229
01:02:18.599 --> 01:02:22.559
<v Speaker 2>don't know. Okay, now this next question is quick and gross,

1230
01:02:22.760 --> 01:02:25.440
<v Speaker 2>but we're going to get through it together. Michael Kris

1231
01:02:25.440 --> 01:02:28.559
<v Speaker 2>has a question about if boogers serve any real purpose

1232
01:02:28.599 --> 01:02:30.199
<v Speaker 2>other than being annoying and embarrassing.

1233
01:02:31.559 --> 01:02:34.519
<v Speaker 3>No, not really, it's just dried up. It's annoying.

1234
01:02:34.639 --> 01:02:36.760
<v Speaker 2>Okay, good to know. I was hoping we weren't have

1235
01:02:36.840 --> 01:02:39.440
<v Speaker 2>to go down a real there's I could. I could

1236
01:02:39.440 --> 01:02:41.880
<v Speaker 2>talk about drain clogs, and I have in this podcast,

1237
01:02:42.280 --> 01:02:44.440
<v Speaker 2>but for some reason, boogers is one of the things

1238
01:02:44.440 --> 01:02:47.119
<v Speaker 2>that I'm like, like, my gag reflex chokes up, and

1239
01:02:47.159 --> 01:02:50.039
<v Speaker 2>that's very rare for me. I've let spiders crawl on

1240
01:02:50.079 --> 01:02:52.280
<v Speaker 2>my body, Like, I'm not grossed out by a lot,

1241
01:02:52.320 --> 01:02:57.480
<v Speaker 2>but that's one thing that I'm like, book, Yeah, you're

1242
01:02:57.559 --> 01:02:59.199
<v Speaker 2>a good man, dude.

1243
01:02:59.239 --> 01:03:00.639
<v Speaker 3>I pick a lot of them every day.

1244
01:03:00.719 --> 01:03:04.800
<v Speaker 2>Oh God, you're that's good karma. Okay. A last question

1245
01:03:05.119 --> 01:03:07.960
<v Speaker 2>for the lightning round. Jamie Gibbs wants to know why

1246
01:03:08.320 --> 01:03:10.679
<v Speaker 2>is smell such a big trigger for memories. But I

1247
01:03:10.719 --> 01:03:12.159
<v Speaker 2>think that's more a neurological thing.

1248
01:03:12.280 --> 01:03:15.079
<v Speaker 3>No, there's a specific section of your brain responsible for

1249
01:03:16.320 --> 01:03:19.679
<v Speaker 3>smell related memory, so it's strong too. I mean, it's

1250
01:03:19.719 --> 01:03:21.679
<v Speaker 3>a very strong neural connection.

1251
01:03:22.039 --> 01:03:26.199
<v Speaker 2>So side note, blame this heavy whiff of nostalgia on

1252
01:03:26.320 --> 01:03:31.199
<v Speaker 2>the old factory bulb having direct connections to the amygdala

1253
01:03:31.320 --> 01:03:34.079
<v Speaker 2>and the hippocampus. These are parts of the brain that

1254
01:03:34.239 --> 01:03:38.519
<v Speaker 2>deal with memory and emotion. So your smell center essentially

1255
01:03:38.559 --> 01:03:40.440
<v Speaker 2>cuts the line and is like, Hi, I'm here for

1256
01:03:40.480 --> 01:03:44.079
<v Speaker 2>the emotions right through the back door. It is nuts.

1257
01:03:44.119 --> 01:03:46.639
<v Speaker 2>You can smell a perfume from you know, high school

1258
01:03:46.679 --> 01:03:48.320
<v Speaker 2>and be like, oh.

1259
01:03:47.920 --> 01:03:49.880
<v Speaker 3>Ah, the memories, So true.

1260
01:03:49.719 --> 01:03:53.519
<v Speaker 2>Prom So what we just talked a little bit about

1261
01:03:54.119 --> 01:03:56.639
<v Speaker 2>having to pick buggers, But what's the worst part about

1262
01:03:56.639 --> 01:04:01.719
<v Speaker 2>your job? The thing that you're like, uh, is it spreadsheets?

1263
01:04:01.760 --> 01:04:03.679
<v Speaker 2>Is it anything disgusting? Is it?

1264
01:04:04.320 --> 01:04:09.199
<v Speaker 3>Well? I suppose as a physician, definitely the there's issues

1265
01:04:09.239 --> 01:04:11.679
<v Speaker 3>with the administrative side separate from the clinical side. So

1266
01:04:12.440 --> 01:04:15.000
<v Speaker 3>I mean the administrative things we just as doctors. It's

1267
01:04:15.039 --> 01:04:16.800
<v Speaker 3>just part of the job. Now you have a lot

1268
01:04:16.880 --> 01:04:21.519
<v Speaker 3>of paperwork, and now it's ework, but you spend you know,

1269
01:04:21.559 --> 01:04:25.000
<v Speaker 3>a good couple hours every day after a long day

1270
01:04:25.039 --> 01:04:29.280
<v Speaker 3>doing documentation, So that's it. It comes with the territory.

1271
01:04:29.320 --> 01:04:33.360
<v Speaker 3>It's just it's probably the less gratifying part of the job.

1272
01:04:34.800 --> 01:04:38.239
<v Speaker 3>I mean as far as clinically, honestly, for what I do,

1273
01:04:38.760 --> 01:04:40.079
<v Speaker 3>there aren't too many downside.

1274
01:04:40.400 --> 01:04:45.960
<v Speaker 2>Once again, this brave hero would rather literally pick strangers'

1275
01:04:45.960 --> 01:04:49.039
<v Speaker 2>noses than fill out forms. And honestly, I get it.

1276
01:04:49.400 --> 01:04:51.320
<v Speaker 2>What do you love about your job the most? What's

1277
01:04:51.320 --> 01:04:54.840
<v Speaker 2>the most gratifying or what moment has been like made

1278
01:04:54.840 --> 01:04:59.760
<v Speaker 2>you want to cry about it in a good way.

1279
01:05:00.320 --> 01:05:03.119
<v Speaker 3>I mean, there's just something gratifying about going to work

1280
01:05:03.159 --> 01:05:09.480
<v Speaker 3>every day, working hard to fix people's problems. You know,

1281
01:05:09.639 --> 01:05:12.159
<v Speaker 3>I don't think there's one thing that makes my job

1282
01:05:12.239 --> 01:05:18.360
<v Speaker 3>most gratifying, but there's definitely something fascinating behind deeply understanding

1283
01:05:18.440 --> 01:05:22.440
<v Speaker 3>an area that is very rare in terms of the

1284
01:05:22.480 --> 01:05:24.519
<v Speaker 3>diseases that affect the nose. The longer you do this,

1285
01:05:24.639 --> 01:05:28.719
<v Speaker 3>the more patent sinuses you see very gratifying because usually

1286
01:05:29.199 --> 01:05:33.480
<v Speaker 3>patent nice, widely open sinuses result in better outcomes. So

1287
01:05:33.840 --> 01:05:36.760
<v Speaker 3>I always joke with patients and say that pretty much,

1288
01:05:37.719 --> 01:05:40.559
<v Speaker 3>if not the probably the second purpose in my life

1289
01:05:40.719 --> 01:05:45.440
<v Speaker 3>is to keep sinuss open. Literally, so my deit deteriorates

1290
01:05:45.480 --> 01:05:47.239
<v Speaker 3>the more sinuses I see in the office that are

1291
01:05:47.280 --> 01:05:49.960
<v Speaker 3>starting to close down, because then I have to find

1292
01:05:50.000 --> 01:05:50.960
<v Speaker 3>ways to keep them open.

1293
01:05:51.079 --> 01:05:53.679
<v Speaker 2>It's like whack the mole with sinuses, just keeping them open,

1294
01:05:53.880 --> 01:05:58.000
<v Speaker 2>keeping them open. Yep, everyone, sinuses, keep them open. May

1295
01:05:58.039 --> 01:06:01.800
<v Speaker 2>your nose tears be joyous and your sinuses be as

1296
01:06:01.880 --> 01:06:05.880
<v Speaker 2>open as your heart. Have you considered getting a satin

1297
01:06:05.960 --> 01:06:10.480
<v Speaker 2>jacket with the words doctor knows best embroidered on the back.

1298
01:06:10.880 --> 01:06:12.760
<v Speaker 3>I would not be against that. I have made a

1299
01:06:12.760 --> 01:06:16.199
<v Speaker 3>sweatshirt already what it just says Henry Ford rhinology with

1300
01:06:16.239 --> 01:06:16.639
<v Speaker 3>my name on.

1301
01:06:16.639 --> 01:06:18.119
<v Speaker 2>It, and you got it made.

1302
01:06:18.199 --> 01:06:20.159
<v Speaker 3>But I make them for the residents toos. But no

1303
01:06:20.400 --> 01:06:22.159
<v Speaker 3>satin is a good spin on that. I might have

1304
01:06:22.199 --> 01:06:23.159
<v Speaker 3>to consider that next time.

1305
01:06:23.440 --> 01:06:27.400
<v Speaker 2>Just saying, just some fancy embroidery, perhaps a couple of

1306
01:06:27.400 --> 01:06:29.280
<v Speaker 2>more nose puns in your life. I think there was

1307
01:06:29.280 --> 01:06:31.480
<v Speaker 2>a room for it, to be honest, very I learned

1308
01:06:31.599 --> 01:06:35.079
<v Speaker 2>so much now I can't stop thinking about my skull

1309
01:06:35.159 --> 01:06:35.880
<v Speaker 2>plate base.

1310
01:06:36.159 --> 01:06:37.920
<v Speaker 3>Ah yes, yes, the skull base.

1311
01:06:38.079 --> 01:06:39.639
<v Speaker 2>No spinal fluid dripping out of it.

1312
01:06:40.480 --> 01:06:41.599
<v Speaker 3>Well, thank you so much for having me.

1313
01:06:41.639 --> 01:06:44.840
<v Speaker 2>Oh my god, I loved it so To hear more

1314
01:06:44.880 --> 01:06:47.599
<v Speaker 2>about doctor Craig's rhinology work, you can head to his

1315
01:06:47.679 --> 01:06:50.840
<v Speaker 2>YouTube channel, which I'll link in the show notes, or

1316
01:06:50.920 --> 01:06:54.360
<v Speaker 2>you can just search Henry Ford Rhinology on YouTube, or

1317
01:06:54.400 --> 01:06:56.719
<v Speaker 2>you can look for the Facebook page for the Henry

1318
01:06:56.760 --> 01:07:00.440
<v Speaker 2>Ford e NT group. Now. I'll also post more links

1319
01:07:00.440 --> 01:07:04.360
<v Speaker 2>on my website at alibard dot com slash ologies. You

1320
01:07:04.360 --> 01:07:09.239
<v Speaker 2>can follow ologies on Instagram at ologies also on Twitter

1321
01:07:09.280 --> 01:07:14.199
<v Speaker 2>at ologies. I'm on both as Ali ward with one l. Now.

1322
01:07:14.320 --> 01:07:17.880
<v Speaker 2>To cover your human body with ologies merch like pins

1323
01:07:17.880 --> 01:07:22.679
<v Speaker 2>and baby onesies and shirts, head to ologies meerch dot com.

1324
01:07:22.760 --> 01:07:25.639
<v Speaker 2>Sales support the production of the show, and thank you

1325
01:07:25.679 --> 01:07:28.639
<v Speaker 2>Bonnie Dutch and Shannon Feltis for that. Also, if you're

1326
01:07:28.679 --> 01:07:31.679
<v Speaker 2>looking for some good karma, maybe you need a boost

1327
01:07:31.719 --> 01:07:33.719
<v Speaker 2>and you want to help one of my favorite kids,

1328
01:07:33.920 --> 01:07:36.920
<v Speaker 2>Shannon Feltus's son Aidan, you can help him make it

1329
01:07:36.920 --> 01:07:39.079
<v Speaker 2>to camp for special needs kids. You can get a

1330
01:07:39.239 --> 01:07:43.400
<v Speaker 2>very cool shirt designed by Bonnie Dutch the proceeds send

1331
01:07:43.519 --> 01:07:46.599
<v Speaker 2>Aiden off to Camp. That's at ink to the people

1332
01:07:47.119 --> 01:07:49.960
<v Speaker 2>dot com slash Aiden Style, and I'm gonna put a

1333
01:07:50.000 --> 01:07:51.800
<v Speaker 2>link in the show notes in case you want to

1334
01:07:51.800 --> 01:07:54.400
<v Speaker 2>buy a shirt and send a very cool kid to camp.

1335
01:07:54.679 --> 01:07:57.360
<v Speaker 2>I'm just throwing that out there because I think it's

1336
01:07:57.360 --> 01:08:00.639
<v Speaker 2>a really great cause. Now to join the Facebook group

1337
01:08:00.719 --> 01:08:04.800
<v Speaker 2>where Ologies listeners share photos of be swarms and pictures

1338
01:08:04.800 --> 01:08:07.679
<v Speaker 2>of dogs and links to cool science news. You can

1339
01:08:07.719 --> 01:08:11.159
<v Speaker 2>find Ologies podcast on Facebook and one of the wonderful

1340
01:08:11.239 --> 01:08:14.480
<v Speaker 2>admins Aaron Talbert or Hannah Liippo will approve you. Thank

1341
01:08:14.480 --> 01:08:17.279
<v Speaker 2>you guys for doing that. And you can join the

1342
01:08:17.439 --> 01:08:21.119
<v Speaker 2>behind the scenes club at patreon dot com slash Ologies

1343
01:08:21.119 --> 01:08:24.079
<v Speaker 2>that gets you access to video messages and you can

1344
01:08:24.119 --> 01:08:27.920
<v Speaker 2>submit questions to Ologists before I record the episodes. And

1345
01:08:28.000 --> 01:08:31.560
<v Speaker 2>those funds help me pay my cherished editor Steven Ray Morris,

1346
01:08:31.640 --> 01:08:35.000
<v Speaker 2>who edited this episode well in a metal tube over

1347
01:08:35.039 --> 01:08:38.520
<v Speaker 2>the Atlantic instead of watching a bunch of quality rom

1348
01:08:38.640 --> 01:08:41.399
<v Speaker 2>coms and action flicks on his flight to and from London.

1349
01:08:41.520 --> 01:08:44.960
<v Speaker 2>Thank you for that. You should be sleeping. The theme

1350
01:08:45.039 --> 01:08:47.680
<v Speaker 2>music was written and performed by Nick Thorburn, who I

1351
01:08:47.760 --> 01:08:50.279
<v Speaker 2>just saw driving around my neighborhood recently. I got very

1352
01:08:50.279 --> 01:08:53.520
<v Speaker 2>excited and I waved. Now, if you stick around until

1353
01:08:53.560 --> 01:08:55.279
<v Speaker 2>the very very end of each episode, you know I

1354
01:08:55.279 --> 01:08:58.039
<v Speaker 2>tell you a secret just for saying thanks for sticking

1355
01:08:58.039 --> 01:08:59.560
<v Speaker 2>it through the credits, and I'm going to give you

1356
01:09:00.079 --> 01:09:03.960
<v Speaker 2>one follow up secret. Rubbing hemorrhoid cream on a blemish

1357
01:09:04.000 --> 01:09:07.760
<v Speaker 2>did not help at all. If anyone needs a tube

1358
01:09:07.800 --> 01:09:11.279
<v Speaker 2>of barely used hemorrhoid cream, please contact me reach out

1359
01:09:11.319 --> 01:09:14.039
<v Speaker 2>on Twitter. I will mail it to you. You can

1360
01:09:14.079 --> 01:09:16.880
<v Speaker 2>put it anywhere you want. That's none of my business.

1361
01:09:17.319 --> 01:09:19.279
<v Speaker 2>And the other secret I'm gonna tell you, let's make

1362
01:09:19.319 --> 01:09:24.239
<v Speaker 2>it nose related and blemish related. Once I had a

1363
01:09:24.279 --> 01:09:28.680
<v Speaker 2>blemish on my nose after my senior year of high school.

1364
01:09:28.680 --> 01:09:32.079
<v Speaker 2>It was there for six weeks. It left a tiny scar,

1365
01:09:32.640 --> 01:09:35.279
<v Speaker 2>and boyfriends had asked me, oh, what's this from? And

1366
01:09:35.359 --> 01:09:37.760
<v Speaker 2>I told a couple of them that it was from

1367
01:09:37.840 --> 01:09:41.359
<v Speaker 2>chicken pox. I'm sorry I lied to you. Now everyone knows.

1368
01:09:42.680 --> 01:09:44.640
<v Speaker 2>If you zoom in, you can see it on pictures.

1369
01:09:44.680 --> 01:09:46.800
<v Speaker 2>It's very small. It looks like a chicken pox scar.

1370
01:09:47.039 --> 01:09:52.399
<v Speaker 2>But really, that was a hard summer, you gots. I

1371
01:09:52.399 --> 01:09:54.359
<v Speaker 2>remember when it finally went away. My mom was like,

1372
01:09:54.760 --> 01:09:59.079
<v Speaker 2>I'm so happy for you. I was like, thanks, mom. Anyway,

1373
01:09:59.079 --> 01:10:05.239
<v Speaker 2>there's my secret herby hacodermatology, hobbiology or doo zoology, lithology,

1374
01:10:05.880 --> 01:10:20.600
<v Speaker 2>new technology, meteorology, people, bettology, ethology, seriology, eldology. You know

1375
01:10:20.640 --> 01:10:22.439
<v Speaker 2>when you lose a knees and it's just like bo