Transcript
Speaker: Everything on the podcast is for entertainment purposes only.
Speaker: Nothing I say is meant to treat or diagnose, or it's not even advice for you to follow.
Speaker: So remember when you're listening to the podcast, I am a doctor.
Speaker: I'm just not your doctor.
Speaker: Welcome to On Talk with Dr. Dave.
Speaker: Today we're talking to Dr. Steve.
Speaker: Dr. Steve is a family medicine doctor, and I appreciate you coming on and spending the evening with us.
Speaker: Oh, thanks so much for having me.
Speaker: Just really honored to be here with y'all.
Speaker: Tell us a little bit about yourself and what type of medicine you practice.
Speaker: Yeah, I'm Dr. Steve.
Speaker: I practice family medicine in what you'd call a community-based type of practice where I practice in a certain community.
Speaker: I don't work in a hospital, so it's outside of a hospital facility.
Speaker: So it's a typical general practice that you would think about a community doc that has a office somewhere in a smaller community.
Speaker: And then I take care of the people that typically live geographically by me.
Speaker: And part of family medicine is you treat a little bit of everything.
Speaker: You don't get to pick and choose what you're going to see.
Speaker: And people have all kinds of problems when they come in.
Speaker: And that's really what you are.
Speaker: You're there to take care of some of it and you're there to refer some of it.
Speaker: And since you're in a smaller community, do you take care of friends and family, people that you know?
Speaker: Yeah, that can be sometimes a challenge, but yeah, absolutely taking care of people that I know it's not a isolated community, like some rural docs, they would be taking care of family because they have no other options, but just geographically when you live, where you practice, then you are going to run into people that you take care of.
Speaker: Now, when we were talking a little bit before doing the podcast, you'd come up with a list of interesting stories that you collected through your career.
Speaker: in family medicine and we love stories.
Speaker: That's basically what the podcast is about.
Speaker: So let's just jump in.
Speaker: Let's just hit your top story.
Speaker: What came to mind first?
Speaker: Yeah, the first one was actually when I was in residency and we had a guy come into the emergency department and he was coming in for a complaint and we needed to get imaging of his head, an MRI of his head.
Speaker: So we went ahead, I think he was having headaches and they'd been going on for a while.
Speaker: So we get the MRI back and we see something weird on it.
Speaker: There's like a BB by his eye, but it's behind his eye.
Speaker: We asked the radiologist, well, what is that?
Speaker: He looks like there's a BB back there.
Speaker: And it was right by the optic nerve.
Speaker: It was touching the optic nerve in the back of his eye.
Speaker: So we went and talked to the guy and he said, well, the MRI looks good.
Speaker: It doesn't look like you have any tumors or you haven't had a, you know, a stroke or something.
Speaker: But we have a question.
Speaker: Did you ever get shot in the eye with a BB gun?
Speaker: He's kind of start shaking his head and thinking he's, yeah, when I was a kid, like 15, 20 years ago, my friend and I were shooting each other with BB guns in my backyard.
Speaker: And I swear he shot me in the eye, but nothing ever happened.
Speaker: It was really weird.
Speaker: If they were like that BB went in through the corner of your eye, rode the road around the orbit and then stopped right at the optic nerve.
Speaker: And that's one of my craziest stories that we've ever had just to find that 15 years later by chance on an MRI.
Speaker: And the MRI makes me a little nervous too because you never know what those old BBs were made out of.
Speaker: So thank goodness it wasn't magnetic and didn't get pulled around.
Speaker: Yeah, I'm taking out some BBs from people just because we don't know what they're made out of and so nobody wants to do an MRI.
Speaker: So I've removed BBs that have been in people for years.
Speaker: just because they need an MRI.
Speaker: So yeah, and just to think it stopped that short of the optic nerve.
Speaker: And if it just kept going just a little bit further, he would have known he got shot in the eye.
Speaker: We've talked about it on the podcast before, but while we were growing up, it was anarchy.
Speaker: This happened all the time.
Speaker: Shooting beach guns for each other, fireworks, you name it.
Speaker: The parents would know where we were.
Speaker: That's incredible.
Speaker: I think maybe I got shot in the eye.
Speaker: I don't know.
Speaker: I forgot about it.
Speaker: Showed up how many years later?
Speaker: That is wild.
Speaker: Yeah, it's a really interesting story.
Speaker: And the MRI, we were really nervous after that because we're like, this could have been catastrophic with the, with the MRI.
Speaker: You're not even supposed to wear metal buttons when you go into an MRI machine or anything metallic.
Speaker: I know some of the newer BBs are made out of things that aren't magnetic.
Speaker: We always think back to a Christmas story.
Speaker: You'll shoot your eye out.
Speaker: And it's amazing how many BB injuries I've seen just in my career, let alone all of a sudden other people walking around with BBs in their orbits.
Speaker: Yeah, totally wild.
Speaker: Yeah.
Speaker: Now, you were also talking to us about having your wife sleepwalking or your wife as a patient that was sleepwalking.
Speaker: I didn't quite understand who was sleepwalking and who was the patient.
Speaker: So let's dive into that a little bit.
Speaker: During residency in family medicine, you learn a little bit of everything.
Speaker: You're trained in deliveries and things like that.
Speaker: And I was on my OB rotation.
Speaker: And one morning, my wife, when I woke up, she said, Hey, how'd you sleep last night?
Speaker: And I said, Oh, fine.
Speaker: Yeah, totally fine.
Speaker: She goes, Oh, cause you were delivering babies last night.
Speaker: And I like laughed.
Speaker: I like, yeah, I'm on the OB service.
Speaker: We're delivering babies.
Speaker: And she goes, no, I was the patient.
Speaker: I said, what are you talking about?
Speaker: She said that when we had both fallen asleep, all of a sudden I woke her up and I grabbed her legs and I jerked her towards me.
Speaker: And then I started saying things like, we're at 10 centimeters.
Speaker: Here comes the head.
Speaker: All right, the baby's coming down.
Speaker: I deliver this baby and she was going to wake me up, but then she realized what was going on.
Speaker: And she's always just like having, I was like sleepwalking to be sleep delivering here.
Speaker: So she just, whatever, got done with the delivery.
Speaker: She went back to sleep and then I did it again.
Speaker: And then I did it again and I guess I delivered like six babies that night and she just was like laughing and cracking up about how it had happened.
Speaker: And yeah, I think there's just much stress on the OB rotation.
Speaker: What point in the career was this?
Speaker: Was this early on?
Speaker: This was in residency.
Speaker: So it was in the first year of residency.
Speaker: Okay.
Speaker: A lot more stress during the first year of residency, a lot more sleep deprived.
Speaker: Have you delivered any babies since in your sleep?
Speaker: No, thankfully, I'm not on call for deliveries anymore.
Speaker: Oh my gosh.
Speaker: Like delivering, I wake up with work dreams and I'm always mad because it's, we work so hard anyway.
Speaker: And then you wake up and you're,
Speaker: at work in your dreams but I don't think I've ever done anything like that you're aware of no not that I can remember but I will be the first to admit that I learned to tune out the phone the pager the any noises like in the middle of the night noises just because probably got to pray into the hospital it's something that doesn't concern me I have no way of any of this I'm maybe I'm not as reliable about I have not been jerked away
Speaker: to deliver a phantom baby.
Speaker: No.
Speaker: That's not happening.
Speaker: Oh my God.
Speaker: No night surgeries.
Speaker: No night surgeries.
Speaker: No, no, no.
Speaker: No, I'm not doing surgery in the middle of the night while I'm asleep.
Speaker: I do a lot of middle of the night surgeries, just not at home and not with you in the bed.
Speaker: You had mentioned that at one point a patient had a central line stilt in and showed up in your clinic.
Speaker: So explain to the audience what a central life is and why most people aren't just walking around with one.
Speaker: So a central line, when you need to access to put in like a medication or you need to draw blood and you need to draw a large volume of blood, if you use the little veins that are out in your arms and your hands, they're just not big enough to put some of these drugs in that could be, they could damage those veins and cause scarring in them.
Speaker: So you put in these bigger catheters that go centrally.
Speaker: And so meaning that they're not in your arms, they're more central in your chest.
Speaker: And so these central lines are typically for critically ill patients, patients that are getting recurrent drug therapies.
Speaker: You may have some central line in that case.
Speaker: And in my instance, it was a port-a-cap, which is a type of central line that we use when you're getting chemotherapy.
Speaker: My story on that one is I had a lady come in establishing as a new patient, and she was there because she was having a hard time breathing.
Speaker: And she seemed like she had like really bad COPs.
Speaker: And she was a smoker, but it seemed like she was like smoking like three packs a day for how young she was and how bad her breathing was.
Speaker: Anyways, the reason that I needed to take care of her that day was to treat her hard time breathing.
Speaker: And she'd done really well when she got antibiotics and steroids in the past.
Speaker: So I said, okay, let's get those started, but we need to get an x-ray as well.
Speaker: So I sent her to go get an x-ray.
Speaker: And I got a call from the radiologist and the radiologist said, I just wanted to talk to you, which is weird, right?
Speaker: When you order an x-ray, usually just get a report.
Speaker: The radiologist does not call your office to track you down.
Speaker: So he said, it looks like she actually has a broken port-a-calf and it's lodged, you know, in the central venous system still, but that needs to be taken care of.
Speaker: And of course I'm a family doc.
Speaker: I know what a central line is.
Speaker: I know what a port-a-calf is, but I don't know how to manage a broken one.
Speaker: and I hung up with him and I called the patient and I said, hey,
Speaker: do you have a catheter in your chest?
Speaker: And she's, oh yeah, I was undergoing chemotherapy for this cancer that I had.
Speaker: And I said, did you know that it was broken or that like it wasn't connected anymore?
Speaker: She goes, no, I don't know what you're talking about.
Speaker: So at some point she'd had some kind of like an upper extremity movement or an injury or something.
Speaker: We sent her to the ER, they did a CT.
Speaker: And ultimately they like, they got back to me and said, hey, yeah, she has this thing going on.
Speaker: It's not causing a breathing problem.
Speaker: She doesn't have any.
Speaker: embolisms from it and so then it was up to me to try to get a hold of ir and make sure that she got her broken port of cash see that's what i love about family medicine you don't know what's coming on top of being a family medicine doctor you've also started a side business so tell me a little bit about what you're doing i would say spare time but i know it's not your spare time it's not spare time it's on top of everything else you're doing so
Speaker: What have you added into your life here?
Speaker: Yeah, I think as doctors, we're really good at seeing problems and trying to find solutions for them.
Speaker: And I think that's where you get things like Hockenbach syndrome and things named after doctors is because they're trying to find solutions to things.
Speaker: There's plenty of medical devices that are done that way.
Speaker: And when I was first into practicing, there's always certain things that people dread when they come into your office.
Speaker: And one of those for me was IBS because there just wasn't great education on what to do for it.
Speaker: And then an article came out and it was talking about something called the low FODMAP diet.
Speaker: And I thought, this sounds promising.
Speaker: It was like reducing people's symptoms.
Speaker: It was treating IBS symptoms and making their quality of life better.
Speaker: So I was like, great, these guys probably should have, tell me more about the diet.
Speaker: So I was researching and I thought, wouldn't it be great if they have a shake or something that they could take?
Speaker: And there was none, there was none on the market.
Speaker: It was like 2015.
Speaker: And so it always sat in the back of my mind, if there's a market for a shake, this could be a thing to really help people out to make the elimination diet within the FODMAP diet work to make the FODMAP diet easier.
Speaker: And so that's eventually what I got into was saying it's time that there's a meal replacement shake to make it easier for people that have IBS to have some kind of a safe meal that they can take where it doesn't give them the symptoms and pain and gas and bleeding.
Speaker: So that's the little side gig that we're pushing on.
Speaker: How is that for people that have, I know there's a couple different types of IBS.
Speaker: There's like the constipation type and then there's the diarrheal type.
Speaker: Does this help with both constipation or diarrheal or is it more for the kind of the, it sounds like most people that I'm familiar with have more of the diarrheal type.
Speaker: I'm not as familiar with the different types.
Speaker: Obviously I work from the neck up.
Speaker: So this is not my area.
Speaker: Yeah, it probably works better for the diarrhea predominant rather than the constipation predominant really helps.
Speaker: seems like a lot of fiber is the thing that will help them and safe types of fiber and this product we just didn't put a ton of fiber in it so it could help either one of them but it's probably more for people that are for diarrhea type and especially if you're getting the gas and bloating that's really what it's going to help out with because
Speaker: these low FODMAPs or sugars that digest really easy, they don't ferment when they get into the intestines.
Speaker: So if they don't ferment, they don't make the gas, they don't make the bloating, they don't make the cramping and stretching.
Speaker: It causes pain.
Speaker: So is this a product that's on the market now?
Speaker: Yeah, we just launched the product in August.
Speaker: And so it's a online e-commerce store and yeah, it's available to the public.
Speaker: So we're getting great feedback from them.
Speaker: We've had several people with IBS that have said it's really just changed my life.
Speaker: And those are the stories that I absolutely love because it's not necessarily about making, building a fortune in things, but with medicine, we're always trying to help people to get a better quality of life.
Speaker: And that's really, I hope the niche that this one
Speaker: can fit into is that people can have a safe meal that they can go to so that their IBS doesn't have to control every aspect of their life.
Speaker: That's an important thing that's often overlooked.
Speaker: So that's why I said I love people in family medicine.
Speaker: You guys see it all.
Speaker: You do it all.
Speaker: You're doing psychiatric help.
Speaker: You're getting old ladies on treadmills.
Speaker: You're diagnosing heart catheters that are like central lines that are broken, caring about IBS.
Speaker: So the breadth of what you can do is pretty amazing.
Speaker: So I appreciate what you do and the patients that you care for and that you're always looking for ways to help more people.
Speaker: That's so kind of you.
Speaker: Yeah.
Speaker: But we can't make it without specialists.
Speaker: You guys are irreplaceable.
Speaker: So don't go anywhere.
Speaker: We'll try to shorten our lead times to less than three months.
Speaker: That's when I hear about the specialists is, do you know how long it takes to get into them?
Speaker: I'm like, what are you going to do?
Speaker: You're just going to have to wait.
Speaker: Yeah.
Speaker: Third meeting.
Speaker: You need them.
Speaker: There's only so many of us.
Speaker: There's only so many of you.
Speaker: It's why we don't need to be walking on our treadmill.
Speaker: Yeah.
Speaker: We appreciate you coming on.
Speaker: Thank you so much for your time.
Speaker: I really do appreciate it.
Speaker: Thank you guys so much.
Speaker: Thank you.
Speaker: Have a good night.
Speaker: See ya.
Speaker: Bye.
Speaker: Hi, this is Dr. Dave.
Speaker: Thank you so much for listening to this week's episode.
Speaker: Please rate, review, and share this episode so that we can continue to get you more stories in the future.
