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Chapter 1: What is the main topic discussed in this episode?
This is a podcast from Rover.
Medical Mondays with Dr. John.
Here he is, Dr. John.
Good job.
How you doing? Welcome back. Hello. Yes, driving in this morning, listening in to all the listeners, the great Rumble listeners, and some of the most excruciating pain they've ever been in. Oh, pain is horrendously painful.
It's a fascinating thing because there's the physical nature of pain and then there's the brain nature of pain and how someone perceives what pain is. Someone might have pain which is 10 out of 10 and someone else might have the same pain that's 2 out of 10. Yeah, yeah, yeah.
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Chapter 2: What are the different types of pain and their perceptions?
So, fascinating stuff.
Yeah. Just looking back in your history of being a doctor, what is there, would you say, in your opinion, that you can get that is the most pain ever? That could affect a human. Is it compound fractures? Is it ruptured organs? Is it childbirth? Is it kidney stones? Kidney stones. I can vouch for those. Someone texted in and said they had 45 in one kidney. Sorry, sorry, Miles.
Dr. John was just doing charades with me. Oh. You had seven kidney stones?
Yeah. Yeah, best one was when I was driving down the motorway in England and I was working in ED in England and suddenly I went whack and so then we changed and my wife drove me back and then she drove me into a traffic jam.
Brilliant. Absolutely brilliant. That's helpful.
Have you ever tried to writhe around the inside of a car trying to climb out the windows and out the doors? Anyway, that's not nice. But anyway, the pain is... Bryce has got a cough.
And that's a 10 out of 10.
Painful as well.
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Chapter 3: What are the most painful conditions according to Dr. John?
No, to be fair, it hasn't been. It's more I felt bad because I feel like I was being annoying in the studio by hacking away and coughing. It's sort of been, I reckon, two weeks. It does feel like it's a lot better. But I'm sure there's many people in this position about this time of the year where this annoying cough seems to last for about 12 hours or so.
You'll get through most of the day fine and then at about 7 or 8 p.m., It'll just start coming away and it can be mucusy and hacky and it sounds guttural. And then most of the day, as I say, you're fine. Is there anything I can do about it or will it just go away?
There's very little you can do to absolutely remove a cough, right? A cough is caused by a couple of things. One is the irritability of the tubes taking air down into your lungs. When you get a respiratory tract infection, you clear out all the nice protective lining layer of the big tubes and they become really twitchy.
And as we're saying, as the temperature drops, that twitchiness will increase, and overnight your natural body steroids decreases, so coughs will always come out at night. Lying down flat, bang, you're going to cough. So what we look for is cough plus.
Cough plus fever, cough plus pain when you breathe, cough plus night sweats, cough plus increased shortness of breath, cough plus sudden weight loss. And a cough that's getting worse. So if you've got those, brilliant. If you've got a cough more than four to six weeks, we'll have a look at it. But underneath that, sorry, mate, concrete pills, Vicks on your feet.
No cough medicines, none of that, nothing. Basically, they're just opiates. That's the best cough medicine in the world, is opium. Okay. Alien's quite good too. My guy.
My guy. Come see me, I'll give you some of that shit. Heaps of texts coming through, Miles. Text and doc 235. Once again, didn't help me at all. And he's actually my GP. Invoices in the mail. I'm a male tradie. I'm 34, nudging 150 kegs, lacking a lot of energy lately, falling asleep about 8, 8.30, waking up multiple times in the night. Mrs. gets mad because can't be bothered doing anything.
Something to worry about. Yeah.
I'd go OSA, obstructive sleep apnea. 150 kegs, what's called Pickwickian, Mr. Pickwick from Dickens. Big guys, big jowls, go to sleep, obstruct their airway, and they never wake up right. They wait through the night because they're basically losing the oxygen out of their bloodstream overnight because they stop breathing.
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Chapter 4: How can I manage a persistent cough effectively?
We don't have a really good idea what's going on with it. Now, basic maintenance is steroid going up and down in potency, some moisturizing cream, some vitamin D cream quite often will help as well. There are some new things around for people who've got whole body psoriasis, which is really a horrible thing. We want to make sure the diagnosis is right.
And there are some other skin conditions which can mimic psoriasis. So if it's not following the pattern, we normally go get someone to do a little biopsy on it just to make sure.
Okay. Hey, Doc, my eight-year-old son has molluscum. Molluscum contigiosum. Yeah, it's on his eye. Yep. He's been to the doc, says it runs its own course. It does. But has developed a red eye over the weekend. Nothing to do with it. What's that, sorry? Nothing to do with it. What is it? The name of it does sound like a Harry Potter spell.
It does.
I tell the kids they've got Harry Potter-itis. I say, yeah, you've got a Harry Potter disease here. What is it exactly? It's a viral skin disease like a wart. It's not a wart virus, but it behaves in exactly the same way. Eventually your immune system finds it and wipes it out. So we try and tell people to chill on it.
I'm 20 years old, Doc. My body's quite hairy. I've always been quite like the Sasquatch, but one thing that really bothers me is the insane length of my bottom hairs to the point that I'm always creating a nugget catcher. Like a dad. I shave it, but it keeps growing back, obviously, longer than every time to the point that the missus is feeling like she could get a French braid out of it.
Why didn't you just let Roger ask his own question? What should Rog do? Yeah, what should Rog do? Do you want to see it? Rog's trying to throw us off the set by saying he's 20.
Not much he can do for that, is there? You could try some depilatory creams, try and knock off the actual hair follicle. In case, you can do electrolysis to actually kill the hair follicle.
Laser, that's what I do. Laser, same thing, yeah.
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Chapter 5: What are the options for managing obstructive sleep apnea?
I was happy to say, believe it, a peanut or a toy or something up there.
Yeah, it could have been up there for years. I'd go up there and have a look at it. So especially unilateral, one-sided nasal discharge and smell, you get that checked out.
All righty, we'll come back after Tool. Last chance with Dr John. He's in for a Monday. Texting Doc, 3520. You stink this, you're on the rock. Doc won't add a few of those. Checking things out. Doc, left knee sore when doing leg curls. Should I be worried? Thanks. I do do leg exercise. I don't skip leg day. Average squat's about 100 kilos, but yeah, left knee is sore.
No, you're doing fine. It depends on your age. If you're 25, you tone down the exercise a little bit. If you're 65, bad luck. Just a report just came in last night, which I was reading. You know how you've got those men. How often are you reading reports? All the time, mate. Every day. You do? Yeah, I read the New England Journal. I read Medscape. I do all these things constantly.
Keep myself up to date. You know how guys get sore knees in their 50s and they get a little meniscal tear and they go and get a meniscectomy. They've now proven categorically that the operation does nothing.
Although, I read that headline.
Doesn't do a thing.
That's obviously been recent. That's 10 years.
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Chapter 6: What should I do if I suspect scabies?
They've done a 10-year follow-up on it now. They took some guys, split them half and half. One got the real surgery. One got sham surgery where they knocked them out, just made little nicks in their leg. So they thought they had the surgery. They knocked them and followed them up. 10 years down the track, no change. So the orthopaedic surgeons just lost a big money spinner.
How important are, I mean, me and Mel's obviously prime examples. No, moles inspired me. With weight training and stuff, I read lots that it's really good as you get older or any age, but building and creating muscle, huge benefits from it.
Yeah, it helps stabilize joints, keeps the mobility going. So there's two parts. One's the aerobic fitness, which keeps heart and lungs going well. And the other one is weight bearing and weight work, which keeps up muscle strength.
And keep your tendons nice and supple as well. So they don't go snap. Down a step.
Yeah, I know how I do it.
Thanks, Mel. Don't take steps. Slow down. Doc, I had folliculitis. Folliculitis on my scalp? Folliculitis. That's how I said it. For a number of years now, I've used antiseptic shampoos, antibiotics, orotane in the past, and orotane works best, but after three to five months, they come back. What's your advice?
Ooh, interesting question. Probably the orotane is an interesting one. It's a vitamin A derivative, which is quite nicely, and it's quite grunty stuff. So it's probably something which is going to keep going on. Intermittent courses of tetracycline antibiotic might also help. There we go, get my name right.
One day I get bronchitis several times a year. Anytime I get a cold, it turns into bronchitis. Is there something I should be worried about?
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Chapter 7: How can I treat psoriasis effectively?
My doctor just waxed me on antibiotics and prednisone every time.
So, no, you can expect two to five respiratory tract infections in a 12-month period. Bronchitis, you can't treat. There's no active treatment for it. Yeah, unlucky. Antibiotics don't work. Unless you're an old crud smoker, in which case they will load you up with everything.
Hey, Dr. John, 34 years old male. My balls are big, like really big. No hard lumps or anything painful, just massive. One is the size of a tennis ball. The other is about the size of a baseball. I enter the pleasure realm a lot, but it doesn't seem to make them any smaller. They can be extremely uncomfortable, as you can imagine.
Would it be a good idea to get one removed and just have one big one? Like a moon hopper.
Like a beanbag. Which one are you going to do? Which one do you love the most? That's like your kids. Which one will I get rid of? No, making sure it is the testicle rather than the bits hanging around the testis. That would be the other thing. So it would be unusual to have testis that size. Believe it or not, your ejaculate doesn't come from your testicles, right?
Your ejaculate comes from the seminal vesicles, which are deep inside the body. Testis just makes sperm and it tracks up the vas deferens and gets stored in your prostate gland. So having a good, doesn't make your balls shrink. Interesting. There you go.
Because I caught a sword.
You felt lighter afterwards?
Hey, Doc, can I just ask, we're wrapping this up now, but one question did come through. Haven't done a number two since Saturday. Am I going to be okay?
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