Pod Insights Tetragrammaton with Rick Rubin Dr. Mary Talley Bowden About this episode Dr. Mary Talley Bowden is an ear, nose, and throat physician and founder of BreatheMD, a direct-care ENT clinic that emphasizes transparent pricing and outpatient airway care. She completed her residency at Stanford University, and she is board-certified in otolaryngology and sleep medicine, focusing her practice on sinus, sleep, and allergy disorders. During the COVID-19 pandemic, Dr. Bowden became a nationally prominent physician for opposing vaccine mandates, advocating for early outpatient treatment, and engaging in high-profile legal and regulatory disputes with hospital systems and medical boards. She is also the author of Dangerous Misinformation: The Virus, the Treatments, and the Lies, a memoir about her COVID-19 work and clashes with medical institutions, set for release in May 2026.
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Transcript 15,572 words · 7 speakers
Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.
0:02 Rick Rubin? Tetragrammaton.
0:23 Speaker 01 I was sort of a nerd growing up. I loved school, loved homework. I was good in science and math, and I wanted a career. So that's where it sort of started. But I remember thinking, I could never be a doctor. Wow, that's like, that's just too hard. But then, just bit by bit, it just happened. I mean, it started with me just wanting to have a career, wanting to be independent. And then curiosity for science and curiosity about the human body.
0:54 Rick Rubin? After residency, did you open your own practice right away?
0:58 Speaker 01 No, I mean, you have, so when you finish residency, you have a lot of options. You can go on and do a fellowship. You can join an academic practice. You can join a big group practice. You can join a small practice, or you can go solo. I was done with the academic culture when I finished residency. I wanted to get out of there. I actually got a job offer at Kaiser in California, Northern California, but I didn't want to be an employee.
1:29 Rick Rubin? Understood.
1:30 Speaker 01 I wanted autonomy. But I was so young, I didn't want to go out solo yet either because no one trained you during residency how to set up a practice. So I joined a small practice, which was wonderful. And it was just two other doctors.
1:46 Rick Rubin? Where was that?
1:47 Speaker 01 Houston. So I moved out of California, back to Houston.
1:50 Rick Rubin? And you're from Houston?
1:51 Speaker 01 Well, I'm from Atlanta and then I matched in Galveston, Texas for the first part, first two years of my residency, which was amazing because we had the largest prison hospital in the state of Texas. And as somebody who's training, it was incredible because the prisoners wanted to be there. They didn't care if you looked like you were 16 years old and you were, you know, practicing medicine on them. And I mean, my very first day of residency, they threw me into the minor operating room by myself, just taking lipomas off prisoners all day long.
2:27 Rick Rubin? Wow.
2:28 Speaker 01 It was just very hands-on. But my future husband wanted to move to California and a spot opened up at Stanford. So I moved, I transferred and finished at Stanford and Stanford was total opposite. It was very hands-off, a lot of very important people as patients, you know, more observing than doing during your training. You know, this was during the dot-com boom when we moved out there. And then we were there when it crashed. And then my future husband didn't like his job, so he decided to move back to Houston. So I joined a small practice in Houston and that was great because I had a lot of autonomy, but I also had somebody dealing with the business side of medicine.
3:13 Speaker 01 I did that for seven or eight years and I started having kids. And I have four boys. The first two, I kept working. Then I got pregnant with a third and decided, okay, I'm gonna take a year off. And during that year, I got pregnant again. So I had four boys in five years and I just couldn't do it anymore. I just, we didn't have family in town. So I just stopped practicing those and I stopped for seven years.
3:43 Rick Rubin? Wow.
3:44 Speaker 01 And I did not go back until six months before the pandemic.
3:48 Rick Rubin? Well, what motivated you to go back?
3:50 Speaker 01 I just, it was an itch that needed to be scratched, you know, I missed it.
3:54 Rick Rubin? And the whole time, did you feel like, I'll go back?
3:56 Speaker 01 No, I wasn't sure. I just, I just kind of put that on the back. I mean, I was.
4:01 Rick Rubin? Your hands were full.
4:03 Speaker 01 It was really hard. And my, my husband at the time was, he traveled like crazy. So I was like, I felt like a single mom. It was great, though, because I really didn't have to take him to the doctor because I could just check their ears all the time and all that. So, but I decided, though, when I went back, I was going to do it differently and call myself third-party free. Because I didn't want the government butting in, or insurance companies, or hospitals. And I opened what's called direct specialty care. So I don't take insurance.
4:37 Rick Rubin? How did you get the idea to do that? Was it in reaction to the experiences you had before?
4:44 Speaker 01 Yeah, I mean, what used to drive me crazy is, as part of an ENT exam, we often do an endoscopic view of the nose. So we numb up your nose with some spray. And they put a little camera in there. It's not a big deal. It's five to 10 minutes. But we would bill for that extra as an extra charge, because it's extra time and you got the equipment and all that. And half the time, the insurance company wouldn't pay for it. And the patient would get some, like a $400 bill. And then they'd come back angry, like, why did I get this huge bill? And I used to find myself debating whether to do this exam based on that, based on the insurance.
5:28 Rick Rubin? But if you weren't thinking about the financial side, you would definitely do the test?
5:32 Speaker 01 Right, that's what I think.
5:33 Rick Rubin? You wanted the results of the test?
5:34 Speaker 01 I would do the test, right. And I shouldn't have to weigh in the insurance.
5:38 Rick Rubin? Right.
5:39 Speaker 01 So now, I just charge a flat fee. And if you need the exam, you get the exam. It's not even an issue. There's no extra fee. It's just part of the visit. But things like that. It's just the surprise element of what is insurance going to do? I just hated that.
5:56 Rick Rubin? So when you moved back to Houston, and you joined the small group, tell me about what that practice was like. Like, what would people come in for?
6:06 Speaker 01 Just, you know, a basic ENT practice revolves around a lot of acute respiratory tract infections, tonsillitis, ear infections, sinus infections.
6:20 Rick Rubin? What would you do for tonsillitis?
6:23 Speaker 01 It depends on, I mean, is it mono-causing tonsillitis? Is it tonsillitis where you're on the verge of having an abscess? So we get, as an ENT, we see peri-tonsillar abscesses, which are, can be a life-threatening condition.
6:38 Rick Rubin? Wow.
6:39 Speaker 01 It's highly gratifying to treat, though, because you basically drain the abscess in the clinic and the patient's like, oh, just instant relief.
6:47 Rick Rubin? Oh, that's great.
6:48 Speaker 01 As a doctor, like, when you can instantly help somebody, that's very gratifying. But allergies is a big, sleep apnea.
6:57 Rick Rubin? When did sleep apnea become a thing?
6:59 Speaker 01 So I finished my training in 2003. I actually was in Texas and I transferred to Stanford. And we were sort of the cutting-edge place. We were the place in the country where people were doing research for sleep apnea. You know, there had been some movement prior to that, but probably the early 2000s was when it really became a thing. So I remember feeling like, oh, this is great. We are going to make a huge impact in everybody's lives. And to some degree, that was true.
7:32 Rick Rubin? Yeah.
7:33 Speaker 01 But there was a flip side to that. I mean, I saw surgical procedures being done that did not work at all. I actually published-
7:41 Rick Rubin? Did you not know that yet?
7:42 Speaker 01 Uh-uh. I was being trained to believe that you can fix sleep apnea with surgery. And actually, I published a study about a procedure called hyoid advancement.
7:55 Rick Rubin? What is that?
7:56 Speaker 01 So your hyoid bone is this little bone in your neck, right under the chin. And there are a bunch of muscles that your tongue attaches to the hyoid bone. And so what we were doing is bringing that hyoid bone forward to try to bring the tongue forward. Most of sleep apnea basically come from the back of the tongue falling into your throat and obstructing the airway. So the goal was to bring the tongue forward so that it doesn't fall back into your airway. That study taught me a lot because it made me realize how flawed a lot of studies are. You know, the surgery really wasn't as standardized as they would have liked you to believe. There were different surgeons performing it differently.
8:38 Speaker 01 Like, some surgeons removed all of the muscles from the hyoid bone and then brought it forward. And some surgeons left all the muscles attached to the hyoid bone and brought it forward. But that really wasn't accounted for in the research. But I'm just a resident, I'm just sort of watching this, but... And we actually did publish a study showing that the hyoid surgery was not effective for treating sleep apnea, so...
9:02 Rick Rubin? Tell me the study you did.
9:04 Speaker 01 We basically looked at how successful we are in lowering the apnea/hypopnea index. So that's the key number that you look at for sleep apnea. Apnea is when you completely stop breathing for at least 10 seconds. Hypopnea is when the airflow diminishes by at least 50% and the oxygen level drops 3% or 4%, depending on how you measure it. You add up all those events during the night and then you get an average per hour. So you get the apnea/hypopnea index. If it's over 5, it's considered sleep apnea, so 5 events per hour. If it's 5 to 15, it's mild. 15 to 30, it's moderate. If it's over 30, it's severe sleep apnea.
9:49 Speaker 01 So we were basically measuring pre and post apnea/hypopnea.
9:53 Rick Rubin? How do you do that test? Sleep study?
9:56 Speaker 01 Yeah, and so that's another thing that's really evolved. But at the time, the gold standard was a sleep study overnight, usually in a hospital. Electrodes all over your body, electrodes on your...
10:10 Rick Rubin? That doesn't seem like the most comfortable night of sleep.
10:12 Speaker 01 No, I don't really know how people do it. I mean, I will say, if you have horrible sleep apnea, you can sleep through anything. But the people with sort of the borderline or mild, the really hard time falling asleep. Because you've got electrodes on your scalp, you know, they're doing EKG and EEG. They have electrodes on your legs. And it's expensive, too. It's about, I don't know how much it was at that time, but right now, it's probably about $1,200 to do a sleep study, if you're going to pay cash. So we were looking at, you know, before surgery and after surgery. And we did not find a statistically significant difference, but... Yeah, I came out of residency very gung ho to do surgery on patients.
10:52 Rick Rubin? Well, you want to help people.
10:53 Speaker 01 Yeah, yeah, and I, you know, I'm an ear and throat doctor and we operate. We're geared to want to operate. And I joined a practice with another doctor who was very much interested in sleep. And he read his own sleep studies, which is not something that I was trained to do. We were trained to cut on people, but not read sleep studies. So I started reading sleep studies and that just gave you a much better sense of what was going on. Started noticing that body position is huge with sleep apnea.
11:24 Rick Rubin? What's worse position?
11:24 Speaker 01 On your back.
11:25 Rick Rubin? On your back.
11:26 Speaker 01 And I'm actually working on a study right now, looking at this. But I would say the vast majority of people I see with sleep apnea significantly worse on their back. And some people, it's only on their back. So I would say to people out there who have been diagnosed with sleep apnea, ask your physician, okay, what was my score when I was on my back versus when I was not on my back? A lot of doctors don't look at that, but that's key. And if it's only on your back, you can buy something off of Amazon called a sleep backpack. And it's like wearing a little pillow on your back and it keeps you from rolling over. And you just sleep on your side and that can be curative.
12:08 Speaker 01 The other thing that we never talked about during residency is weight. I mean, weight is huge. If you lose 10% of your body weight, you can diminish your sleep apnea by 25%.
12:21 Rick Rubin? Wow.
12:21 Speaker 01 Yeah, it's huge. We did not discuss that at all. I mean, we basically said it's a lost cause.
12:26 Rick Rubin? Yeah. And at the time, the only solution, the surgery that didn't work?
12:31 Speaker 01 Well, no, I mean, the CPAP machine. So CPAP machine, and I'm not saying that we just rush, you know, we always encourage people to try the CPAP machine first. I mean, that's very gold standard.
12:44 Rick Rubin? Tell me about CPAP machine.
12:45 Speaker 01 So there's no downside to the CPAP machine. If you can't tolerate it, it's fine. It's not like, you know, surgery. And it's not taking a medication, but you do have to, you have to strap this mask on your face. There's some that just go on the nose. There's some go on the nose and the mouth. And I will say, the people with severe sleep apnea adjust to it pretty well and pretty quickly. And once they adjust to it, they will not sleep without it. They love it because they feel so much better. What happens, people with severe sleep apnea, they don't get the deep sleep that they need because your body is sort of fighting all night. You know, the deeper you sleep, the more likely you are to obstruct. So your body, to compensate for that,
13:30 Speaker 01 keeps you at lighter stages of sleep so that you don't obstruct. And then you end up just feeling like, even though you slept for seven hours, you feel like you got very little sleep. So, those patients with severe sleep apnea, once they get adjusted to CPAP, they feel amazing and they don't want to sleep without it. The harder people are the ones with mild or even moderate sleep apnea, they have a much harder time adjusting to it. And so those are the patients where we try to find an alternative, like surgery.
14:04 Speaker 01 Now I want to talk about sleep testing too, because that has changed since I was in residency significantly. I used to be a real snob about it, like you have to do an overnight study in a sleep lab, and then once you're diagnosed with sleep apnea, you have to go back for a second night and do a CPAP titration study. Well, now, the technology has gotten so good that that is unnecessary for the vast majority of people. Unless there's something strange going on where you're having like possible seizures during your sleep, or it's just something other than routine snoring. You really don't need to do a sleep test in the lab. You can do them at home.
14:45 Speaker 01 The device I use, and I have no financial ties to this company, but it's called Idamar, and it's a watch pat. You put something on your wrist, you put something on your finger, you put something on your chest. You don't have to have anything on your face at all. The equipment's disposable. Information goes to the cloud. I can get a sleep study the next morning on my computer and then go over the results over the phone. And if you do have sleep apnea, you don't need to go in for a CPAP titration study anymore because the machine is now automatically titrate the pressure with each breath. So we call it CPAP, but it's really Autopap. So you basically just give the machine a range, which is standard,
15:30 Speaker 01 four to 20 centimeters of water pressure. You do a ramp where it's like a little 15 minute window where it gives you, eases you into the pressure. And you can do that at home and it's become much easier now. Honestly, it should, I think it should be over the counter. There are loads of apps you can download on your phone that will record you while you sleep to see if you're snoring. So that's an easy starting point if you're not sure. It's just get the app, see what's happening while you're sleeping and if it's questionable, then see a doctor.
16:07 Rick Rubin? Does everyone who snores have sleep apnea?
16:12 Speaker 01 No, definitely not. No.
16:15 Rick Rubin? What else could it be? It could just be snoring.
16:17 Speaker 01 Just snoring, just turbulence of the airflow in your nose or your throat.
16:21 Rick Rubin? And what are the best solutions for snoring?
16:24 Speaker 01 Well, earplugs for the spouse. Seriously, it's not, if it's no, if it's just snoring and not apnea, check the nose. So oftentimes there's an issue, you know, allergies can be part of the problem. Weight, you know, there are a couple of over the counter nasal sprays that could be tried that are easy. I mean.
16:46 Rick Rubin? Like Exclear?
16:47 Speaker 01 Yeah, I love Exclear. It's going to be more subtle than the medicated sprays. Exclear is a, it has xylitol in it and xylitol is a natural sugar which has decongestant effects. It is, that sugar is actually poisonous to bacteria, so it helps with infection. If you want to do something a little bit stronger, you can try Afrin as a test. You know, I know you're grimacing. Afrin is highly addictive, so everybody needs to be forewarned, but Afrin has some wonderful uses. It's very effective for nosebleeds, but it's also a good test for snoring. So if you use Afrin before bed and it significantly improves your snoring.
17:31 Speaker 01 That means that the problem is from your turbinates, which are these things inside your nose that swell. So you know, when you get congestion that comes and goes, that's turbinates inside your nose and they get congested. The Afrin is a strong vasoconstrictor, so it shrinks the turbinates dramatically. So if that fixes your snoring, then you know that turbinates are the problem. And you can address that long term with medicated sprays or surgery. And there are some procedures that can be done in the office that are fairly, you know, non-invasive. But using Afrin as a test can be helpful.
18:10 Rick Rubin? Are there any other natural remedies, like neti pot or anything like that?
18:14 Speaker 01 The neti pot is a little bit harder to do than just a squeeze bottle.
18:19 Rick Rubin? Yeah.
18:20 Speaker 01 But everybody kind of calls it the neti pot. But the squeeze bottle is a little bit easier. There's also the Navage, which is sort of a power wash. You can use more salt to get more of a decongestant effect. You should never forget to put the salt in there because you put straight water in there, it burns like crazy.
18:38 Rick Rubin? I've had that experience. Feels like your head's gonna explode.
18:40 Speaker 01 Yes, it's crazy.
18:42 Rick Rubin? Yeah.
18:42 Speaker 01 And then I personally, I have my patients. I give these little bottles out in my clinic, which is half baby shampoo and half Betadine. If you're allergic to iodine or Betadine or shellfish, you shouldn't do this. But Betadine is a wonderful antiseptic. It's what we used in surgery. Kills viruses and bacteria, fungi. You add a couple of drops of that to your water.
19:07 Rick Rubin? You drink it?
19:08 Speaker 01 No, no, no, in the sinus rinse kit. No, you flush your nose with it.
19:11 Rick Rubin? I see.
19:11 Speaker 01 Yeah, yeah. I mean, you could drink it, but this is for your nose, just to try to like kill if you're, if you're, if you have a cold or something, it can be helpful. And then the baby shampoo breaks up biofilms, which is a sheet of bacteria. It adheres to the lining of your sinuses and can be resistant to antibiotics.
19:34 Rick Rubin? Are there other devices that can hold your nose open?
19:37 Speaker 01 Mm-hmm.
19:38 Rick Rubin? Do those work?
19:39 Speaker 01 Yes. Well, there's Breathe Right Nasal Strips.
19:42 Rick Rubin? Mm-hmm.
19:42 Speaker 01 Most people have probably heard of that. It's like a little plastic adhesive one.
19:46 Rick Rubin? You see football players wearing them sometimes.
19:48 Speaker 01 Yeah, yeah. Well, so what that does is opens up your nasal valve. And that is the most narrow part of your nose. So the Breathe Right Nasal Strip is tried and true. It is, you know, personally, I don't really like having that adhesive on my nose. But there is a magneted one, which I actually haven't tried, that looks great. And then you can also have surgery. You can have surgery to basically strengthen the nasal valve. Because as you get older, the tissue gets weaker, the structure gets weaker. So some people, you can put a little cartilage in there to strengthen that nasal valve area.
20:28 Rick Rubin? Are there any devices to sleep with to put the tongue in the right position physically?
20:34 Speaker 01 Yeah, well, you can have a mandibular repositioning device. It's like a night guard, but it brings your lower jaw forward. Yeah, I do talk to patients about that, but it can irritate the TMJ joint, which, once that gets irritated, can be a big problem for people.
20:51 Rick Rubin? I see.
20:51 Speaker 01 And it's also expensive. It's thousands of dollars usually. I know there's things that hold your tongue, but I'm not aware of anything that's really been super successful. There is a newer surgical technique that, it's called Inspire, where they implant an electrode that connects to the back of your tongue. And when you're asleep, it stimulates the back of your tongue so that the tongue.
21:16 Rick Rubin? Shocks you?
21:18 Speaker 01 Yes, yes, yes.
21:19 Rick Rubin? Wow.
21:21 Speaker 01 I, I usually do not recommend that for people.
21:24 Rick Rubin? Yeah.
21:25 Speaker 01 It's a four-hour operation, and then you have an implant in you for the rest of your life, so.
21:30 Rick Rubin? So there was a surgery to solve the problem that didn't solve the problem? And why did you decide to do something about it instead of the system?
21:40 Speaker 01 Well, you know, during residency, I didn't really do anything about it. I just sort of observed and I'm naturally conservative about surgery to begin with. And during residency, I saw, because I'm ENT, we do sinus surgery. And I just remember seeing these patients come back for their fifth or sixth sinus surgery. I'm like, what more can be done? I mean, I don't understand what more can be carved out of the inside of their nose. So that made me a skeptic and then.
22:12 Rick Rubin? And that's your job. That's what you're trained to do.
22:15 Speaker 01 Right. And then, you know, when you get out in the real world, buck really stops with you. When you're a resident, the buck doesn't stop with you.
22:21 Rick Rubin? Understood.
22:21 Speaker 01 When you get in the real world, you have patients coming to you and you're suggesting they get this surgery that has risks to it, has a pretty brutal recovery. Like when you operate on somebody's throat, it's a brutal recovery. You want to make sure it works.
22:37 Rick Rubin? Absolutely.
22:37 Speaker 01 There's nothing worse than the patient coming back to you after they've gone through all this and said, ah, it didn't work. So I'm very sensitive to that. And I'm very cautious about sending people to the operating room unless I can, you know, see a very definite problem that can be fixed. And I'm fairly certain fixing it's going to improve their life.
22:57 Rick Rubin? You do that personally, but on a systemic level, you weren't trained to do that.
23:03 Speaker 01 No, but it's just something that comes with, you know, when you're in an academic institution, you've got a team of people to diffuse the blame. You know, a patient may come back and see an entirely different doctor for their follow-up. So it's a little bit easier to contend with that as a doctor, I think. But when the buck stops with you and you've got the, you're alone with the patient.
23:29 Rick Rubin? Yeah.
23:30 Speaker 01 Yeah, you give them bad advice, it comes back to you.
23:32 Rick Rubin? That's a really good argument for always finding a doctor who's your specific doctor as opposed to an institution. Because just in terms of accountability, in that relationship.
23:42 Speaker 01 Right.
23:42 Rick Rubin? With you and the doctor, they'll feel some sense of if this doesn't work, they're coming back to see me.
23:50 Speaker 01 Personal accountability, yes, yes.
23:51 Rick Rubin? Seems reasonable.
23:52 Speaker 01 Yeah.
23:55 Speaker 01 It's true for any profession, honestly, right?
23:58 Rick Rubin? What is a nebulizer used for?
24:01 Speaker 01 Nebulizer, breathing treatments. So it is, it's a very simple machine. It's a small little motor and it connects to a tube. It sends pressurized air through that tube. Tube connects to a mask. Connected to that mask is a cup that you put medication in. And the pressure aerosolizes the medication. So it's distributed throughout your nose, throat, and lungs.
24:32 Rick Rubin? And what would you use that for?
24:35 Speaker 01 Asthmatics use it. They're having an asthmatic attack. You know, the two primary medications that are used are albuterol and budesonide. Albuterol is a short-acting bronchodilator. It opens up the airways when you're having a bronchospasm, as asthmatics do. And then budesonide is a steroid. It's anti-inflammatory. It's longer-acting. And I use the budesonide nebulizer treatments very routinely in patients with stubborn, you know, when you have a respiratory tract infection. The first week, you know, you get the fever, the congestion, the sore throat. And then the second week, in some patients, it kind of settles into the, into the lungs.
25:20 Speaker 01 And you're not really suffering from an acute infection anymore. You're suffering from an inflammatory response. And those breathing treatments can be incredibly helpful. Can you get that persistent cough that won't go away?
25:34 Rick Rubin? Yeah.
25:34 Speaker 01 So it's, it, it has applications beyond just asthma. I use it all the time for treating respiratory tract infections.
25:42 Rick Rubin? Would it also be helpful for pneumonia?
25:44 Speaker 01 Yes, I mean, it, so it does have a steroid in it. So you, you need to make sure that the infection is under control because steroids suppress the body's ability to fight infection.
25:55 Rick Rubin? I see.
25:57 Speaker 01 If you give steroids too early in the course of an infection, that can backfire and make the infection worse. But like I said, in that second week, as long as the infection's under control, super helpful.
26:08 Rick Rubin? And can you always tell when infection's under control?
26:11 Speaker 01 If you're experienced, yeah. I mean, not always, but there are patterns that as a doctor you recognize.
26:18 Rick Rubin? Other than the steroidal treatment, are there any other things you can nebulize that would be helpful for something like pneumonia?
26:25 Speaker 01 Well, even just plain saline.
26:27 Rick Rubin? Yeah.
26:27 Speaker 01 It helps just loosen up the phlegm. Yeah, a lot of people are nebulizing colloidal silver, food-grade hydrogen peroxide. I personally don't tell my patients to do that just because I haven't needed to. I have enough tools in my toolbox.
26:44 Rick Rubin? Understood.
26:45 Speaker 01 But I know people are doing those and have told me they've found them helpful.
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29:11 Rick Rubin? Can you remember any cases along the way that were pivotal? Either didn't go the way you thought, or it gave you new insight about what to do going forward?
29:19 Speaker 01 Well, yeah, there was one case where it was a VA. This patient came in with very subtle swelling of the soft palate. And I was suspicious of a tumor. I ordered the MRI. I was very proud of myself because he had a huge tumor in there.
29:38 Rick Rubin? Wow.
29:40 Speaker 01 I left that, so you do a rotation, so you spend several months. Patient ended up getting an operation. It was a benign tumor, but it was big. Ended up getting an operation and ended up hospitalized for six months.
29:55 Rick Rubin? Wow.
29:55 Speaker 01 Died. And I'm like, well, maybe...
29:57 Rick Rubin? For a benign tumor?
29:58 Speaker 01 Yeah. Maybe, maybe I shouldn't have picked, I wish I hadn't, you know, he probably would have been totally fine. It probably was slow growing. But sometimes you can, you know, you can overdo it.
30:08 Rick Rubin? Yeah, yeah, yeah. And then would you say from that time forward, you would be more wary?
30:15 Speaker 01 Yeah, so one good example that we see as ENTs is acoustic neuromas, which is a benign tumor that grows on either the hearing nerve or the balance nerve. And it can present with ringing in one ear, or hearing loss in one ear, or balance problems. And for example, if you see, if you get a hearing test and there's a significant difference in hearing in one ear, it's pretty rare, but about 1% of the time that will be from a neuroma. So standard is you get an MRI. And then if you pick up an aroma, what do you do? Well, in residency, I would have said, go get that thing, you know? Go operate on it, cut that thing out.
31:00 Speaker 01 Now, I'd be like, oh, I would just watch it, you know?
31:03 Rick Rubin? See if it grows.
31:04 Speaker 01 See how fast it's growing and... But that, you know, that's not the mindset when you're in training.
31:10 Rick Rubin? Yeah. So basically, you've come to realize that you just won't rush into surgery. It's not the solution for everything. But you don't rule it out.
31:20 Speaker 01 No.
31:20 Rick Rubin? And you still do surgeries?
31:22 Speaker 01 Yes.
31:22 Rick Rubin? Yeah.
31:23 Speaker 01 Yeah, so one of the most gratifying surgeries I do is just a simple adenoidectomy.
31:28 Rick Rubin? What is that?
31:30 Speaker 01 So you have a ring of tissue in the back of your throat, your tonsils, your adenoid in the back of your tongue, the base of your tongue. It's called Waldihr's ring. All this tissue does is produce white blood cells. So people get very concerned when you take out tonsils, am I, you know, destroying your immune defense in the back of your throat? Well, that would be very hard to do without removing the base of your tongue, which most people don't do that. So when you take out the adenoid, and interestingly enough, your adenoid shrinks and basically disappears by the time you're an adult. But in some kids, it just completely blocks the nose. So the, you know, the stuffy kid with the nose is always draining and it can lead to ear infections.
32:16 Speaker 01 And taking that out is like life-changing. Kids are out of anesthesia and usually that night, they're back to their normal selves and then they're like, all of a sudden, can just breathe.
32:28 Rick Rubin? Wow.
32:29 Speaker 01 Those are very gratifying.
32:31 Rick Rubin? Do you ever consider changing someone's diet for allergy?
32:34 Speaker 01 Well, yeah, but it can be overkill. You know, some people, because there's some diet tests and you have to be careful how you test, because there are some tests out there that overcall it. And then people get very wound up and overly cautious about what they eat. But definitely, there's, you know, some dietary things. And the way I usually tell people is, you know, eliminate things and then maybe test to confirm, rather than test first.
33:03 Rick Rubin? Elimination diet.
33:04 Speaker 01 Right.
33:05 Rick Rubin? What is tongue-tied?
33:07 Speaker 01 So I was trained, and I still, I still go by this. When the tongue is sort of tethered to the floor of your mouth, and it's hard for you to protrude your tongue. So like, if you're trying to lick an ice cream cone, and you find that difficult, you might have tongue tie. And newborn babies sometimes have difficulty breastfeeding because there's a little bit of tethering there. Well, I was trained, you just go and snip it, and we're done with it. But now, it's become a thing where you have to use lasers, and you just have to do physical therapy after. And it's become complicated and expensive. So I'm old school. I just keep it simple. You can do it in the office. You do some topical anesthesia, scissors, and done.
33:53 Rick Rubin? And was there any reason not to do it?
33:55 Speaker 01 I've never seen a complication from it. I'll say that. So I wouldn't say it always, you know, solves the breastfeeding problem. But I've never seen it backfire or have issues because it was done.
34:08 Rick Rubin? What are your thoughts on mouth tape?
34:10 Speaker 01 I'm an advocate.
34:11 Rick Rubin? When would you use it, and how do you use it?
34:13 Speaker 01 Well, what it does, it forces you to breathe through your nose, which also forces the back of your throat open. I actually want to do a study on this because I could only find one study published about this, which is interesting because it seems to be, everybody's talking about it. But it makes sense because if your mouth is, you know, if the air is going through your nose, it's going to have to go through your throat. I personally, I sleep with a chin strap because I don't want that tape on my mouth. But you can buy-
34:43 Rick Rubin? That's the same thing?
34:44 Speaker 01 It's basically, yeah, just keep your mouth shut while you're sleeping.
34:47 Rick Rubin? And has your sleep changed when you started using that?
34:51 Speaker 01 Well, I can tell, if I, if I don't use it, and my mouth, if I wake up, my mouth is super dry, then I know, like, I've probably been snoring, and yeah. So I feel like I sleep better with it.
35:03 Rick Rubin? So you come back, you start your new dream practice that feels more like a spa than a doctor's office, and tell me how it started?
35:12 Speaker 01 Yeah, I mean, it was quiet, slow, manageable. You know, a lot of people word of mouth. It was easy, it was quiet, it was great.
35:23 Rick Rubin? What happened next?
35:23 Speaker 01 Yeah, and then COVID came.
35:25 Rick Rubin? Do you remember the first person who came in with it?
35:27 Speaker 01 Yeah, it was very interesting.
35:28 Rick Rubin? Did you already know it was called COVID at that time?
35:31 Speaker 01 No, it was very interesting because it was friend of the family. And their child had been in China for exchange, like some sort of school trip. And just came back with stubborn bronchitis. And I remember saying to them, have you heard about that virus in China, do you think? And they were like, oh, no, no way. And sure enough, you know, within a couple of weeks, it just exploded in in the US.
36:02 Rick Rubin? What did you recommend for treatment in that first case before you even knew what it was?
36:07 Speaker 01 Yeah, you cover for secondary infection with antibiotics. You give steroids if needed, you do breathing treatments, just sort of basic common sense. What I'd always done for respiratory tract infections.
36:17 Rick Rubin? Were there any cases where you couldn't help the patient?
36:22 Speaker 01 Well, when COVID got really hot and heavy, I had some patients come in. I can only think of two. They just couldn't get better, but they came in like.
36:34 Rick Rubin? Very late.
36:35 Speaker 01 Very late.
36:36 Rick Rubin? I see.
36:36 Speaker 01 But the early patients and even some of the late patients, I had some really severe cases come into my office who normally I would have called 911 because they were so sick, but they refused to go to the hospital. And we just brought them in every day and we threw the kitchen sink at them and saved them. It was amazing.
36:59 Rick Rubin? Why would they not want to go to the hospital?
37:01 Speaker 01 Because people have lost all trust in the system because.
37:05 Rick Rubin? Even early in COVID?
37:07 Speaker 01 Well, this wasn't, I wouldn't say this is super early. It's super early, I didn't see super sick people. It was more. It was the fall of 2021. When things, that was the third surge. And it was also the largest surge. And that's when a lot of people ended up going in the hospital. More so than the earlier parts. And early on, I was using monoclonal antibodies, which worked very well. They were not controversial at all. And initially, I could get as many doses as I wanted. I could just reach out to the manufacturer. They'd be at my office the next day. Unlimited supply. Wonderful. And I never rationed them.
37:50 Speaker 01 So I became known in town as a place to get monoclonal antibodies. Because other places, you had to be a certain age. You had to be a certain ethnicity. Like, they were even doing it by race in some places.
38:03 Rick Rubin? Why would that be if it was something that you could call an order for anybody?
38:07 Speaker 01 Well, they were expensive and the government was paying for them. I'll say that. So I didn't ration them. I didn't give them to, you know, there was an age cutoff. I didn't go do that. But if you were, I think it was, you had to be 12 or older. I can't remember. But as long as you were the right age, I didn't, it was come one, come all. And they worked really well. And people bounced back very quickly. And then what happened? The government took over distribution. So then it became harder and harder to get the monoclonal antibodies.
38:36 Rick Rubin? Why would they do that? If the healthcare system was working, why would the government want to take it over?
38:43 Speaker 01 I have theories on that.
38:45 Rick Rubin? Do we not know for sure?
38:47 Speaker 01 Well, we don't have proof. But I mean, looking at the timeline, it all coincides with the COVID shot. They basically, the government took over distribution of the monoclonal antibodies. It became harder and harder for me to get them. And then they completely shut down the monoclonal antibodies at the exact same time. And this was early September 2021 that they mandated the COVID shots. So to me, the timing is just not a coincidence.
39:19 Rick Rubin? Now, if the monoclonal antibodies were working and the vaccine was new and we didn't know much about it, it seems odd that they would discontinue something that was working.
39:33 Rick Rubin? I can see doing both.
39:34 Speaker 01 Yeah, well, the people were not getting the vaccine because they knew they could get monoclonal antibodies. You actually were not supposed to get the vaccine for three months following treatment with monoclonal antibodies. You're supposed to wait. And the government was getting frustrated because people were not on board with the vaccine as much as they would like.
39:56 Rick Rubin? I remember people desperately trying to find the vaccine.
40:01 Speaker 01 Actually, I looked at this this morning because I was curious. In the first three months, only 30% of the people got the shot, got one shot.
40:10 Rick Rubin? And it was available to everybody?
40:12 Speaker 01 I don't remember when it became available to everybody, but I don't know. I saw in Texas, I saw some people just, because I actually emailed my patients, curious like, okay, what's your stance on this? And there were people on both sides of it, like, hell, no, I will never get that thing. And other people, sign me up ASAP. It was interesting. So it came out in December, end of December. And, you know, ivermectin got chastised for the first time in March.
40:43 Rick Rubin? Had you been using ivermectin before that?
40:45 Speaker 01 I only started using ivermectin when I couldn't get monoclonal antibodies anymore. You know, they took away monoclonals and then...
40:52 Rick Rubin? In your experience, did the ivermectin work as good as the monoclonals?
40:56 Speaker 01 Yes, but I was nervous about that because I was like, monoclonals, like overnight, people would wake up the next morning and feel wonderful. I was like, there's no way ivermectin is going to work like this. And I wouldn't say it doesn't, it's not as quickly impactful as the monoclonals, but...
41:13 Rick Rubin? Monoclonals are intravenous, yes?
41:15 Speaker 01 You could do an inject, you could do four injections or you could do an IV. But it was a very, it was, you know, a quick IV, like 15 minutes. It wasn't a big bag.
41:24 Rick Rubin? So in one day, you would get the full dosage?
41:27 Speaker 01 Yep.
41:27 Rick Rubin? You wouldn't have to take it over time?
41:29 Speaker 01 No.
41:29 Rick Rubin? With ivermectin, it was more like an antibiotic. You would take it over time?
41:33 Speaker 01 Right. Yep. Ivermectin, the earlier you took it, the better.
41:36 Rick Rubin? Yeah.
41:37 Speaker 01 I mean, you could still take it in the late stages, but the earlier you took it, the better.
41:41 Rick Rubin? What were the other things besides ivermectin and the monoclonals that made a difference?
41:46 Speaker 01 Hydroxychloroquine. Personally, I used, I got COVID early on. I mean, it like melted it away. I had that chest tightness and with the COVID and I was shocked. I was like, wow. I mean, instant.
41:59 Rick Rubin? Wow.
42:00 Speaker 01 Hydroxychloroquine, but you know, Trump came out and said how great hydroxychloroquine was. And then it became forbidden. I mean, the Texas State Board of Pharmacy actually told doctors, "You may not prescribe hydroxychloroquine for COVID."
42:15 Rick Rubin? He was president at the time, wasn't he?
42:17 Speaker 01 Yes.
42:17 Rick Rubin? It was just a wild story.
42:19 Speaker 01 It became very political.
42:20 Rick Rubin? Wow. It seems like health shouldn't be political.
42:24 Speaker 01 It should not. I was not political at all prior to COVID. I hated politics. But gosh, it became very political. And yeah, the Texas State Board of Pharmacy took it away from us. So I put it, I put that on the back burner. I just assumed, at that time, I wasn't fighting everything. So, okay. And then I just did my best with breathing treatments and I would use steroids and antibiotics as needed.
42:50 Rick Rubin? I also remember the way they got the vaccine out fast. What was it called?
42:55 Speaker 01 Operation Warp Speed?
42:56 Rick Rubin? Yeah, Operation Warp Speed. I remember the president on TV touting Operation Warp Speed. And many people on television saying, "I will never take that drug because that's the president's drug. We will not take that."
43:09 Speaker 01 Right. Yeah. And then they're, and then they changed their tune.
43:12 Rick Rubin? It's all so strange.
43:14 Speaker 01 It's all, yeah.
43:15 Rick Rubin? Hard to understand.
43:16 Speaker 01 It is. It's very, we need to get the politics out of healthcare.
43:20 Rick Rubin? So then, any other things besides the medicines? Did other things help? Or did you prescribe any other supplements or lifestyle choices?
43:30 Speaker 01 Vitamin D is the most common deficiency I see by far. I mean, we can test for it very easily. And I would say, when I look at that, probably 70% of my patients that I test are low in vitamin D.
43:45 Rick Rubin? And you're in a sunny place.
43:46 Speaker 01 Yeah, yeah, yeah. So that's a very easy thing. We did vitamin D, zinc.
43:52 Rick Rubin? Why do you think vitamin D is low in people who live in places with a lot of sun?
43:56 Speaker 01 Well, we're still, you know, you're inside a lot. Think about how much time we spend inside, at the desk, on the computer. And then, you know, when Houston's hot, people, basically, it's like.
44:08 Rick Rubin? Stay inside with air conditioning.
44:09 Speaker 01 Yeah, yeah, yeah. The vitamin D is huge. We did zinc, vitamin C, vitamin C in high doses. There's great studies showing it prevents sepsis when given early. And there's also a lot of data showing it just, you know, decreases the duration of colds. So vitamin C was big.
44:29 Rick Rubin? If you were sick, what's the mega dose of vitamin C that would be the right one if you're not well?
44:35 Speaker 01 I tell my patients, you know, just at home, taking five grams a day. But you can, you know, we do IVs where you get high dose vitamin C for people that are sick, like 25, 30 grams.
44:48 Rick Rubin? Wow. And there's no toxic reaction to that?
44:51 Speaker 01 Well, you do need to make sure they have an enzyme that can process it. So it can, there's, you know, there's some caveats to it, but. And if they have kidney stones, that can sometimes be an issue. Zinc, that was another one, inhibits the virus from entering the cells. Glutathione, which glutathione, you can't take orally. So the oral form of that is called NAC or NAC. That can be helpful for respiratory and inflammation.
45:23 Speaker 01 Yeah, the nasal irrigations, the saline, also irrigating your throat. But, you know, ibromectin has been sort of the mainstay, I'll say that, of all the things. I was a skeptic about it, actually. Before I started using it, I really dug into the safety. And I did my own research. I didn't just take anybody's word for it. I went to the FDA's website. And I found the study where Merck. That Merck had to submit to the FDA to get it approved. And in that is all sorts of toxicity data. And a key number that we look at is called the LD50, which stands for lethal dose 50. It's a benchmark number about toxicity of drugs.
46:07 Speaker 01 And it's basically the amount of drug that would kill 50% of lab animals. And what I found is the LD50 of ivermectin is, I mean, at least 100 times higher than what we're prescribing. Wow. It's super safe. And then I also did a literature search, trying to find reports of accidental and intentional overdose from ivermectin. I could not find any reports. Whereas if you do that search for Tylenol, you'll find thousands. So I knew it was safe. And then I started using it with sort of trepidation, wondering, is this really going to work? But I ended up treating over 6,000 COVID patients. Wow. And everybody that got early treatment survived. About one-third of those patients were monoclonal antibodies.
46:51 Speaker 01 And about two-thirds, I didn't have the monoclonal antibodies at my disposal.
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48:33 Rick Rubin? But what happened next?
48:36 Speaker 01 So I was also doing testing for COVID. And we became known in town as the place you could go to get a COVID test and get the results back quickly. And we did a saliva test.
48:48 Rick Rubin? Was that not available elsewhere?
48:50 Speaker 01 No, so LabCorp became the first in the country to do testing. And this was March, I think it was like March 10th. And they quickly became inundated and they were taking two weeks to get the results back.
49:05 Rick Rubin? Because they were getting all the tests from all over the country?
49:07 Speaker 01 Right, and they were the only lab doing it.
49:09 Rick Rubin? Wow.
49:09 Speaker 01 And so people were advised to quarantine for 14 days if they got exposed. So the point of testing was so that you didn't have to quarantine, but the results were taking two weeks, so it was completely pointless. So I had already been working with this lab called Microgen DX. And they do a PCR test for bacterial and fungal infections in the sinuses, they do it skin, their specialty is PCR testing. So they came out with a PCR saliva test for COVID. And because I'm in a strip mall, it worked out very well because we could take a cup out to people's cars, they could spit in the cup, they could leave it in a basket outside
49:51 Speaker 01 our office, and they didn't get swabbed at the nose and our staff didn't get exposed and we'd have the results back the next day. So my little clinic, it kind of exploded because of that and the monoclonal antibodies.
50:06 Speaker 01 Because I was doing testing, once the vaccine came out, I was starting to track people, like, he's been vaccinated and he's not. And so what I found was that the vaccinated were outnumbering the unvaccinated, and they were just as sick, if not sicker. I had privileges at Houston Methodist Hospital, which was the first hospital in the country to mandate the shots. So they did this on April 1st, 2021, five months before the government mandated them, sort of paved the way for mandates. And I had privileges, but I had never used them. I was very loosely affiliated with them.
50:45 Rick Rubin? What does it mean, having privileges with a hospital?
50:47 Speaker 01 Meaning that if you have a sick patient, you can admit them to that hospital and treat them at that hospital. Sort of just had it as backup, because I'm ENT, I'm primarily outpatient. And I actually did have a good relationship with them because I was working with them on research. Because I was doing so much testing, we were looking at sort of ENT symptoms with COVID. But when I started seeing this trend, I reached out to them, I said, hey, are you seeing what I'm seeing? Like, I'm seeing all these breakthrough cases. Is that what y'all are seeing? You know, curious.
51:19 Rick Rubin? What's a breakthrough case?
51:21 Speaker 01 People that are vaccinated that get COVID.
51:23 Rick Rubin? I see.
51:24 Speaker 01 And I sort of got the, you know, oh, well, we think it's just gonna lower severity. Well, this is the first hospital in the country to mandate the shots. I would think they'd have a firm response to that. Like, I'm sure they were tracking it. So that didn't sit well with me. And I started speaking out on, at the time, it was Twitter, now X. I started speaking out on Twitter. I did not have a following, I mean, I have, you know, I'd post something and no one would like it, I had no following. But, you know, I was pretty timid compared to things I'll say now. I mean, I said, Ivermectin works, and vaccine mandates are wrong. I had a lot of people very distraught about the mandates,
52:09 Speaker 01 which I, legitimate concerns. I mean, this is, had not been tested long. It was a new technology. And, you know, I just saw firsthand how distressed people were over these mandates.
52:23 Rick Rubin? And you saw firsthand that
52:26 Rick Rubin? It wasn't necessarily helping the people who were getting it.
52:29 Speaker 01 Right, like, I knew early treatment worked.
52:31 Rick Rubin? Yeah.
52:32 Speaker 01 And I was seeing the vaccine wasn't working.
52:34 Rick Rubin? You had that experience before the vaccine ever came.
52:37 Speaker 01 Right.
52:37 Rick Rubin? You were dealing with it and having success.
52:39 Speaker 01 Right. Yeah, I wasn't fearful of the virus because I saw that we could treat it. And I didn't see a need to mandate these shots. So I started speaking out on social media about it. And then things really heated up in the fall of 2021. And that was the third and largest surge of the pandemic. Nine months following the rollout of these shots. So theoretically, we shouldn't be seeing a surge, right? And in October, it was October 22nd. This woman reached out to me wanting help because her husband was in the hospital. And they had determined, they had given up. They were talking hospice.
53:22 Speaker 01 And she wanted him to try ivermectin.
53:25 Rick Rubin? How old was he?
53:26 Speaker 01 He was in his 50s, late 50s. Sergeant's deputy, father of six.
53:34 Speaker 01 Served his community for 30 years.
53:36 Rick Rubin? Yeah. How long had he been in the hospital when you got the call?
53:40 Speaker 01 About a month. And some would say, well, it's too late for ivermectin. But that's not true, actually. Even at that late stage, people found it effective. And it was so safe. It's like, what's the harm in trying?
53:52 Rick Rubin? Yeah.
53:53 Speaker 01 Especially if you're, you're saying that he basically has no chance of living.
53:57 Rick Rubin? Yeah.
53:58 Speaker 01 And he had tried to get ivermectin prior to becoming hospitalized and couldn't. So we knew, she knew he wanted it.
54:05 Rick Rubin? And just to be clear, ivermectin is over the counter in some parts of the world, yes?
54:09 Speaker 01 It is over the counter in five states.
54:12 Rick Rubin? In five states?
54:13 Speaker 01 Yeah, now.
54:14 Rick Rubin? Wow. I've been in other places in the world where you just go into the pharmacy and buy ivermectin, like, next to the clotrimantin, let's say.
54:22 Speaker 01 Mexico.
54:23 Rick Rubin? Yeah.
54:24 Speaker 01 People buy it from India all the time. I mean, it's super safe. So she decided to sue the hospital. Because they tried to find a doctor in the hospital who would prescribe it. They would not. So they had to find a doctor willing to prescribe the ivermectin to submit with the lawsuit. So I became that doctor and I agreed to help. And it turned into a big mess.
54:49 Rick Rubin? Did you know what you were getting into at the time or no?
54:51 Speaker 01 No, no.
54:52 Rick Rubin? No, you just, there was a guy who was sick.
54:54 Speaker 01 Right.
54:55 Rick Rubin? You've seen 6,000 patients get better.
54:59 Speaker 01 Right.
55:00 Rick Rubin? And you feel like you can help somebody who's dying.
55:02 Speaker 01 Right.
55:03 Rick Rubin? Is that correct?
55:03 Speaker 01 Exactly.
55:04 Rick Rubin? Okay, just want to make sure I understand it.
55:06 Speaker 01 Yeah.
55:07 Rick Rubin? Clearly what happened.
55:08 Speaker 01 I had never had this situation before. It was just very unique.
55:12 Rick Rubin? No, your intentions are good and you're doing what you would normally do.
55:15 Speaker 01 Right, right.
55:17 Rick Rubin? There was no criminal intent.
55:18 Speaker 01 No, and I knew that the ability for him to get ivermectin depended on the outcome of the lawsuit. Like, it was never under the delusion that I could just give him ivermectin. I knew it all hinged on the outcome of the lawsuit. And so I testified and a Texas senator also testified during this hearing and we won. And the hospital was ordered to grant me emergency temporary privileges so that I could give the patient the ivermectin. And during the pandemic, that was, that process of getting privileges was expedited. It was usually a same-day process because they were in such need of doctors helping.
56:01 Speaker 01 You know, they didn't make you go through all the rigmarole that you normally have to go through. But not in this situation. They made me get letters of recommendation. I had to submit my surgical caseload. They waited three days and then they decided they were going to deny my privileges. Even though, I mean, I had a clean record, never been sued. At that time, I still had a good reputation.
56:25 Speaker 01 So it became very messy and complicated because they had to go back to the judge because they were, they were defying the court order. And then after a bunch of back and forth, the lawyer for the patient said, "We're good to go." "I talked to the lawyer for the hospital. It's all been worked out. We can send a nurse to the hospital to give him ivermectin."
56:48 Rick Rubin? It's also been days and the guy's dying.
56:50 Speaker 01 Right, right.
56:51 Rick Rubin? You've already wasted days and this guy's life's hanging in the balance.
56:56 Speaker 01 Right. So I send the nurse and the police show up. They call the police on her. And the hospital had appealed and the judge had granted them a stay, meaning that the order, the original order was no longer valid. But the lawyer for the patient never got the stay. She didn't know about the stay. So we were under the impression that the order was still valid. But the nurse left. Like, it wasn't like she tried to shove him to the ICU and she left. So they, the hospital turned me in the medical board. They actually turned me in the medical board before this even happened. They turned me in the medical board as soon as the lawsuit occurred, where I wrote the prescription for the ivermectin as part of the lawsuit.
57:40 Speaker 01 And I am still battling the board to try to clear my name.
57:43 Rick Rubin? Really?
57:44 Speaker 01 Yeah. I could have made it all go away if I paid $5,000, took eight hours of CME and then retook the jurisprudence.
57:53 Rick Rubin? What is that? Eight hours of what?
57:55 Speaker 01 CME, continuing medical education. There's a legal exam that all doctors have to take in Texas. They want me to retake it. I could have made it go away with that, but I just decided to fight, just on principle.
58:09 Rick Rubin? Because the principle of it was, it has nothing to do with that. Is that right?
58:13 Speaker 01 Well, it's become politicized. It's lawfare. You know, it was a messy, complicated situation where my intentions are good. And they're basically, they're basically telling patients that you can't sue a hospital. You can't bring in another doctor for a second opinion outside the hospital. It's really giving the power to the hospital and not the patients. And
58:37 Rick Rubin? Sounds really dangerous.
58:39 Speaker 01 Yeah, yeah. Well, in from this, what I would like is to have some sort of legislation in place where patients can bring in a doctor from a who doesn't have privileges to give a second opinion, as long as their license is in order.
58:55 Rick Rubin? Yeah.
58:56 Speaker 01 You know, any doctor should be able to come in and give a second opinion. If you have a relationship with that patient, as a patient, you have a doctor you really trust, that doctor to have privileges at your hospital, the patient should be able to bring that trusted doctor into the hospital to get a second opinion.
59:12 Rick Rubin? If you have a doctor who's your main doctor and they know you, you know them, an accident happens and you go into the emergency room and you end up in the hospital, the way it currently stands, your doctor can't come in and give their opinion?
59:24 Speaker 01 No, no, no. Mm hmm.
59:26 Rick Rubin? That's amazing.
59:27 Speaker 01 Yeah, we should change that.
59:30 Rick Rubin? Yeah, especially if you have a trusted relationship with with anyone.
59:33 Speaker 01 Exactly.
59:35 Rick Rubin? So that's been going on for how many years now?
59:38 Speaker 01 Four years.
59:38 Rick Rubin? Wow.
59:40 Speaker 01 $250,000 in legal fees.
59:42 Rick Rubin? Wow.
59:43 Speaker 01 It's crazy.
59:43 Rick Rubin? Unbelievable. Is there any light at the end of the tunnel?
59:49 Speaker 01 I mean, I'm appealing, so so far it's been trapped in the executive branch. So it went from a little informal settlement conference, and then it goes to the state office of administrative hearings, which is administrative law judges that are not elected and they're they work for the medical board. Basically, they work for the state. So now it goes outside of that system to the judicial branch. So I'll take it to a state district court, and then from there I'll have to appeal to the Supreme Court of Texas. But and then I'm also suing them just for violating my due process rights. There's been all sorts of shenanigans that are just, you know, they're just trying to make this as difficult as they possibly can.
1:00:33 Rick Rubin? Yeah, it's a wild story. Anything you looking back, could you have done anything differently? Or now, if you had it to do over again, what would be different?
1:00:44 Speaker 01 I wish I had started using ivermectin earlier.
1:00:47 Rick Rubin? Yeah.
1:00:47 Speaker 01 I wish I'd been more outspoken.
1:00:49 Rick Rubin? Yeah.
1:00:49 Speaker 01 I was.
1:00:50 Rick Rubin? Just because you saw it work.
1:00:51 Speaker 01 Yeah, yeah. But I don't have any regrets over the trouble it's caused me.
1:00:56 Rick Rubin? No, because you I assume regardless of what is being put on you, you did what you thought was right.
1:01:02 Speaker 01 Right, right.
1:01:04 Rick Rubin? What do you think happens next?
1:01:06 Speaker 01 Like I said, I'm still in the midst of all this mess. I want to see that legislation we talked about. One thing we didn't talk about is the head of the snake is the Federation of State Medical Boards. So when I got my complaint, I got three complaints from the medical board, all about ivermectin. So not just this one, but I had two other complaints and not from the patient.
1:01:30 Rick Rubin? That's what I was gonna say. Patients didn't complain?
1:01:32 Speaker 01 No, no.
1:01:33 Rick Rubin? Just the system?
1:01:35 Speaker 01 Yeah, I had a pharmacist complain about me. So I prescribed for a 17-year-old boy. And I talked to the dad and the stepmother. I thought it was, I didn't know it was the stepmother. The mom complained about me prescribing it to him. He never even took it. And there was no harm or anything, but it's just basically she had preconceived notions about ivermectin and she thought I was trying to poison her son. But doctors all across the country, it was the fall of 2021. We all got complaints from the medical board over ivermectin. And
1:02:10 Rick Rubin? If you prescribed it the year before, what would have happened?
1:02:14 Speaker 01 So the organization, the F S and B Federation of State Medical Boards, sent a directive to all the medical boards across the country to go after doctors for prescribing ivermectin. So it wasn't just me.
1:02:28 Rick Rubin? Are they doing this because they thought it was dangerous?
1:02:31 Speaker 01 Well, I think, you know, like monoclonal antibodies, ivermectin was demonized because they wanted more people to get the vaccine. You know, if we had treatment, early treatment available, then people are less likely to get the vaccine. And I actually sued the FDA over this because the FDA, they put something on their website in March of 2021 about doctors should not prescribe ivermectin and patients should not take ivermectin for COVID. And then August 23rd, 2021, they put out, I don't know if you saw the infamous horse tweet, but they put a tweet out with attractive woman nuzzling a horse.
1:03:13 Speaker 01 And it said, "Seriously, y'all, you're not a horse. You're not a cow. Stop it," about ivermectin. And that tweet really did some damage. It went viral. Right after that, they went after Joe Rogan for taking ivermectin. Rolling Stone put out that misinformation about, you know, they showed these people lining up for the emergency room, claiming that they were poisoned by ivermectin and that people with gunshot wounds couldn't get in, or something like that. It was insane. And then shortly thereafter, the Surgeon General came out and said, "We have to put an end to misinformation from doctors."
1:03:55 Rick Rubin? From doctors?
1:03:55 Speaker 01 Yeah. And then the Federation of State Medical Boards sent out directives to all the state medical boards to go after doctors. So I'm actually in a lawsuit against them with three other doctors.
1:04:11 Rick Rubin? Are the people on the board all doctors?
1:04:14 Speaker 01 Mm-hmm, no. It depends on the state. In Texas, I think it's like 75% doctors, 25% non-doctors.
1:04:24 Rick Rubin? Wow, it sounds like no wonder people have lost faith in the system.
1:04:29 Speaker 01 Mm-hmm.
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1:06:02 Rick Rubin? Have you documented this whole thing? Have you written a book?
1:06:06 Speaker 01 I've written a book. It comes out in May. It's called Dangerous Misinformation.
1:06:13 Speaker 01 It was actually four years ago, almost to the day, that I got just publicly shamed by Houston Methodist. They sent out a tweet. They suspended my privileges because I was speaking out against mandates. And I found out that my privileges were suspended from a text message from a reporter at the Houston Chronicle. So they went to the media before they went to me. And then they tweeted out that I was spreading dangerous misinformation.
1:06:40 Rick Rubin? Just to be clear, you weren't against the vaccine. You were against the mandate.
1:06:44 Speaker 01 I didn't see any harm. I didn't see the people getting harmed from the vaccine. I just saw it wasn't working.
1:06:50 Rick Rubin? Right.
1:06:51 Speaker 01 And so I was anti-mandate. And I actually, days before they did that, I tweeted out vaccine mandates are wrong with screenshots from patients sending me emails. I tweeted that out 25 times in one day. And that made them mad.
1:07:09 Rick Rubin? Yeah. What were the screenshots of?
1:07:13 Speaker 01 I sent out an email to my patients. And when that hospital, Texas Ugly Hospital, denied my privileges, that same day, I got a notice from a surgery center that I had privileges at that I had to get the COVID shot or I wouldn't be able to operate there. And that same day, I also got a frantic phone call from a patient who had a history of bladder cancer and her urologist at Houston Methodist had called her and said, "You may have to find a new doctor if you don't get the shot because we're talking about not letting patients in." So all those three things happened on the same day. And so I sent an email to my patients explaining that.
1:07:57 Speaker 01 And I said, "Going forward, I'm going to prioritize seeing the unvaccinated." So I'm not taking new patients that are vaccinated unless you have a life-threatening issue. I never upheld that, but I was trying to make a statement.
1:08:10 Rick Rubin? Yeah.
1:08:11 Speaker 01 And-
1:08:11 Rick Rubin? Also, if the medical establishment was saying, "We're not going to treat the unvaccinated," you're like, "You can come to me." It's like, "I'm the alternative."
1:08:20 Speaker 01 Right. And so I got a lot of emails in response to that. So I did screenshots of those responses. And then I put on the heading of tweet, "It was vaccine mandates are wrong." And I literally did 25 of those in one day. And at the time, I really didn't have a big account. I mean, I had like-
1:08:36 Rick Rubin? But the idea is that everyone deserves treatment. That's it. You were going with the idea that all humans deserve compassionate treatment.
1:08:44 Speaker 01 Right, right. And you should be able to choose what you put in your body.
1:08:48 Rick Rubin? Of course. What have you learned since?
1:08:52 Speaker 01 Yeah, so I saw that the shots weren't working initially, but then I started to see people that were harmed by the shots.
1:08:59 Rick Rubin? How would you see that? How would that come up?
1:09:01 Speaker 01 So I would see previously healthy people come in with dramatic changes in their health status in short proximity to the time they got their shots. And I started to see a pattern of symptoms. I would see strange rashes, rashes that would not respond to antihistamines or steroids. I would see strange-
1:09:22 Rick Rubin? Was that different than the people who had contracted COVID prior to there being a vaccine?
1:09:29 Speaker 01 Yes, yes, definitely. I mean, I definitely have seen long, like, COVID with prolonged symptoms. I definitely, and I believe that there is such a thing as long COVID.
1:09:40 Speaker 01 What I've seen with these vaccines is more dramatic. Yeah, like long COVID on steroids. So strange rashes, strange neurological issues like severe pain in one part of the body. And, you know, the imaging studies, there's nothing to explain where this pain is coming from. Seeing a lot of POTS, P-O-T-S. It's when your blood pressure and pulse become erratic and you may stand up and your blood pressure drops and you feel faint. Or you may just be sitting there and all of a sudden your pulse just starts racing for no reason.
1:10:20 Speaker 01 A lot of fatigue and some people have strange, like I had a 39-year-old male. I mean, I'm still seeing this four years later, too. People still coming to my office. Swelling under his, you know, initially under the armpit where the shot was given. And then it migrated to the other armpit and then it migrated to his groin and it's been going on for four years.
1:10:44 Rick Rubin? Wow.
1:10:45 Speaker 01 That kind of thing.
1:10:47 Rick Rubin? Have you seen any patients who've had similar things who were not vaccinated?
1:10:52 Speaker 01 No, I mean, no. And I mean, that and...
1:10:55 Rick Rubin? Even people who've had COVID?
1:10:57 Speaker 01 Well, I would say, I think the mechanism is the spike protein. And the spike protein can be from COVID or it can be from the COVID shot. Problem with the COVID shots is they were designed so that your body creates a spike protein with no off switch. So the concern is, and I don't think it's in everybody got the shot. I think some shots were more potent than others. The shots required very stringent storage requirements.
1:11:27 Rick Rubin? Is that possible that some shots could be more stronger than others? That sounds crazy.
1:11:32 Speaker 01 Well, manufacturing, so manufacturing, you know, these things were... Operation Warp Speed, right?
1:11:38 Rick Rubin? Mm-hmm.
1:11:38 Speaker 01 Super fast. So there could be discrepancies in the quality from manufacturing. But the other factor is the storage requirements were super, like you had to buy specialized freezers and they could not sit out at room temperature for very long. And so my theory is a lot of people really kind of got a dud.
1:11:57 Rick Rubin? I remember you could get it not at a doctor's office, but just at a tent.
1:12:01 Speaker 01 Or a lot of people, you know, I don't know how it was here, but in Texas, you could go down to the NRG stadium in your car. So I'm like, how do they keep those shots, you know, fresh when you're...
1:12:15 Rick Rubin? So just tents in parking lots?
1:12:16 Speaker 01 Yeah, yeah, yeah. So the problem, though, with these vaccine injuries is we don't have a lot of tests. There's not a test for spike protein in the body. The only thing that I have found useful is looking at antibodies. So after you get COVID infection or a vaccine, you produce an antibody response and that's a lasting response. And it does wane with time. But what I'm finding in the people that got the shots is these antibodies are staying super high and for very long periods of time. And in the patients that got the shots, the average level I'm seeing is about 13,000.
1:13:00 Speaker 01 And the people that not get the shots is about 1,300. So it's about 10 times higher. And this is four years later. It shouldn't, they should dissipate. Right? So it's a little bit muddy, but it suggests that there is lingering spike protein in the body.
1:13:17 Rick Rubin? If there was a desire to get to the bottom of this, what would be the tests that would be needed to see the spike protein in the body?
1:13:27 Speaker 01 Right.
1:13:27 Rick Rubin? Could there be one?
1:13:28 Speaker 01 I just got a note about this yesterday. In fact, a lab that says they have a test for spike protein, but it needs to be validated. And there is a lab in Germany that's doing it, but I have had... Mixed reviews on that from other people, so I don't use it.
1:13:46 Rick Rubin? Do you know of other doctors who also were helping people who needed help during this time?
1:13:52 Speaker 01 Oh, yeah, yeah. And a lot of us, you know, I'm not the only one that's been dragged through the mud because of that.
1:13:59 Rick Rubin? Excited to see what happens, and it would be really great to find out more information, like if we could really find out what.
1:14:06 Speaker 01 Well, we have, the current administration is saying, oh, we need more data, we need more data. We do have an abundance of data. We have over thirty-six-hundred peer-reviewed published studies showing adverse reactions from these shots. We have autopsy reports. We have life insurance and disability data that peaked in the third quarter of 2021 when the COVID shots were put on the market. Other countries, like Czechoslovakia, has data showing that the harm, you look at all-cause mortality. Czechoslovakia has very convincing data that all-cause mortality shot up after these COVID shots.
1:14:52 Speaker 01 Yeah, you look at the swine flu vaccine in 1976, it was pushed out hard. A large number of Americans took it, approximately, I think, twenty-five percent of the country took it. They had thirty deaths and they pulled it off the market. So it's kind of a similar situation, right? It was an emergency situation, they pushed out this new vaccine. They quickly identified that the vaccine was potentially harming people and they acted on it. Here, you look at, yeah, the first three months, similar, about thirty percent of Americans took the shots.
1:15:31 Speaker 01 Pfizer, according to their own data, twelve-hundred-thirty-three people died from the Pfizer shot in that first three months. Now compare that to swine flu shot, thirty people died. And what do we do? Not only do we ignore that, we double down and we mandate it.
1:15:51 Speaker 01 There's a website you can look at, openveers.com. And VAERS is the Vaccine Adverse Event Reporting System. It's known to be under-reported. So I will say of all, I see a lot of vaccine-injured patients. I see every day, and it's four years later. And invariably, I'm not the first doctor they've seen, but I am the first doctor that has reported their injury to VAERS. It doesn't have to be, you know, 100% confirmation. It just needs to be suspicion. But these patients aren't getting reported to VAERS because there's been such a, you know, we can't speak the truth about COVID or the vaccine. But if you go to openveers.com and there's just a stunning graph,
1:16:36 Speaker 01 you look at, you know, there's been very few reports to VAERS. And then you get to COVID and it's just, it's a volcanic explosion during COVID of the reports from the injuries. And the medical profession, only 10% of doctors are continuing to get these COVID shots.
1:16:59 Rick Rubin? 10%.
1:17:00 Speaker 01 10%. And this was by the CDC. They announced this during the last ASIP meeting in September. They talked about this. Only 10% of healthcare workers are continuing to get these shots. The gig is up. The doctors know.
1:17:15 Rick Rubin? Yeah, if the doctors are not taking them, that tells you something. Tell me about other parts of the world where maybe they didn't have vaccine or couldn't afford the vaccine. How did they fare during the pandemic?
1:17:27 Speaker 01 Yeah, you know, our country, I think we have 4% of the world population and we had 15% of the COVID deaths.
1:17:35 Rick Rubin? Wow.
1:17:37 Speaker 01 And I don't, I should have looked this up. I know Africa fared much better and much lower uptake. Now, Africa probably, they probably live a cleaner lifestyle than Americans, I would imagine. But we should have led the world, right? We saved the world with the COVID shot, right?
1:17:57 Rick Rubin? What percentage of the people that come to you now, come to you with COVID-related stuff? Is it all back to normal of people coming in with tonsillitis?
1:18:06 Speaker 01 I wish. I miss those days.
1:18:08 Rick Rubin? Still now.
1:18:08 Speaker 01 I miss them terribly. No, I'm telling you, every, almost every day, I am reminded of the carnage from these shots. I see it and it's people whose lives have been utterly destroyed. And they're not getting any help. I mean, they, they go to other doctors and they're just told there's nothing wrong with you, or they're put on psychiatric medication.
1:18:30 Rick Rubin? Wow.
1:18:31 Speaker 01 Oh yeah, I saw a patient that was put on a sleeping pill, Valium and an antidepressant.
1:18:38 Rick Rubin? What are the things you can do for the patients who come in with either long COVID or a vaccine injury?
1:18:44 Speaker 01 Well, the most effective thing I've found is ivermectin.
1:18:48 Rick Rubin? Really?
1:18:48 Speaker 01 Actually, yes. It's not, you know, a lot of it's trial and error.
1:18:51 Rick Rubin? Is that legal now?
1:18:53 Speaker 01 Well, yeah, it's always been legal. It's just, yeah.
1:18:56 Rick Rubin? Is it legal to prescribe though?
1:18:58 Speaker 01 Yeah, yeah. It's never been illegal to prescribe. So there's, it's off-label. So off-label means that the FDA has not said, okay, this medication has been tested for this disease and been shown to be effective. But doctors use drugs off-label all the time. Like prior to the pandemic, it didn't even occur to me if I was using something on-label or off-label because, you know, a drug can be in use for, you know, it initially gets approved for some issue and then doctors kind of figure out, oh, it also works for this.
1:19:30 Rick Rubin? Can you think of any example where that's the case?
1:19:33 Speaker 01 Yeah, gabapentin, which is a horrible drug. I don't like it. But there's something like 18 different uses for it even that go beyond its initial off-label. But that's a widely prescribed drug that no doctor kind of goes in, looks up, oh, is this on-label or off-label? I mean, that's just not the way any doctors practice medicine. I never gave the FDA a second thought prior to the pandemic. I mean, it was just...
1:19:59 Rick Rubin? Helping people.
1:20:00 Speaker 01 Yeah. The FDA is there to approve a medication and, but they normally wouldn't be involved. And I don't think I explained this earlier, but we did see them over that. Because when they, when they put out that tweet and they put out the stuff on their website, they were basically interfering. Between the doctor-patient relationship. They were telling doctors what you can use and they can't do that. And they were telling patients what they can take and they're not allowed to do that. So we actually successfully sued the government, which is really hard to do. And they had to take down their tweet and they had to take off the misinformation on their website. That was a win.
1:20:38 Rick Rubin? Yeah, I can remember Peter Iteya, early in the pandemic, looking at all the studies and seeing that ivermectin was helpful. And he was prescribing ivermectin for his patients. And then one day he called the pharmacy to call in the ivermectin order. And they said, no, we can't do that. And he went berserk. And he's like, no, you're the pharmacy, I'm the doctor.
1:21:00 Speaker 01 Yep.
1:21:00 Rick Rubin? The pharmacy can't tell the doctor what to prescribe.
1:21:03 Speaker 01 Oh, yeah, don't get me started on the pharmacy. I'm, I gotten so many, so unfortunately in Texas, there is a law that gives them the final say.
1:21:12 Rick Rubin? Wow, the pharmacy over the doctor.
1:21:14 Speaker 01 Yeah, I mean, the purpose of that was because of the abortion pill. If a pharmacist felt morally against dispensing an abortion pill. That was the purpose, to give them that freedom if, you know, they're anti-abortion that, you know. But they abused that. There was no, you know, moral thing over ivermectin. So we had like this underground, like the Underground Railroad of pharmacies. Like we had a little secret net, secret list. And I only, I recently publicized it for a long time. That, that list I had to keep secret. I was scared that people would go after these pharmacies.
1:21:51 Rick Rubin? Yeah.
1:21:51 Speaker 01 This is crazy, but now ivermectin will become over the counter in Texas. They just passed the law.
1:21:56 Rick Rubin? Congratulations.
1:21:58 Speaker 01 Yeah.
1:21:59 Rick Rubin? The pandemic is over.
1:22:02 Rick Rubin? How would you like things to be now?
1:22:04 Speaker 01 Yeah. I would like the government to go away.
1:22:08 Rick Rubin? You said before COVID, you weren't aware of the government's involvement in anything.
1:22:13 Speaker 01 No, I never paid any attention to anything.
1:22:15 Rick Rubin? No reason.
1:22:16 Speaker 01 CDC, FDA, they did their own little business and it was, you know. And, you know, thankfully because of my practice, Medicare, Medicaid, all that was just, it was just outside my realm. I was practicing medicine without any interference. And I would like to go back to that. But there is a growing movement called direct primary care.
1:22:42 Speaker 01 And it's basically like affordable concierge care. So you pay a monthly fee, it's comparable to a gym membership. And you get much more time and access to your doctor. You only use your insurance for catastrophic care.
1:22:56 Rick Rubin? Mm hmm.
1:22:56 Speaker 01 Kind of like your cars, right? You don't use your insurance to get the oil changed. And, you know, it's rare to find specialists like myself that are cash only. But that is also growing too. That's the direction I would like to see occur. I know that there is talk, maybe it's already been implemented. But I know that improving access to health savings accounts so that you can use your pre-tax money towards healthcare expenses is a step in the right direction. And you're moving away from these insurance companies just... The only winner is the insurance company and the hospitals.
1:23:38 Speaker 01 They actually do well, but doctors don't win, patients don't win. There's options where you can be outside the system, but you're still covered for, you know, catastrophic care.
1:23:51 Rick Rubin? So if somebody wanted to opt out of the system, what is the best way to find this type of practice?
1:23:58 Speaker 01 There are two websites. Independent Medical Alliance, IMA, and Free Market Medical Association, F M M A. Independent Medical Alliance grew out of the pandemic. It used to be frontline critical care alliance, but then it just sort of rebranded since COVID is over. But it's independent minded doctors that, you know, had the guts to go against the grain during the pandemic. And then Free Market Medical Association. I was actively involved prior to the pandemic. They kind of cast me aside. I was one of the directors for the Houston chapter.
1:24:40 Speaker 01 But when I became infamous, they...
1:24:44 Rick Rubin? Radioactive.
1:24:44 Speaker 01 Yes, yes. Yeah, they kind of distanced themselves from me. But I do believe in their organization. They're not all like minded, but for the most part, I like the way, you know, their independence from the system is good.
1:24:58 Rick Rubin? Tell me about the new practice, right when you started it. Did you imagine it would be just like the last one, but now you're doing it yourself and no insurance?
1:25:07 Speaker 01 Yeah, so it was actually, it's financially risky because like... Doctors aren't gonna refer to you because their patients have insurance. But to me, my goal was just, you know, make enough to cover the overhead and see where that goes and just, you know, be a happy doctor. And I didn't need the money to do the practice. I was just doing this because I wanted to be a doctor again. You know, because it's become so much, so hard to get into a doctor in a timely fashion now. I became sort of the acute care clinic for respiratory tract infections because I can see people that day.
1:25:44 Rick Rubin? I see.
1:25:45 Speaker 01 So that's sort of how I started. The other thing that I had advantage of is people that have high deductible insurance plans, basically cash on my patients, come see me because I knew exactly how much it would cost. It wouldn't be some pie in the sky, have no idea until I get the bill. And even with surgery, like I can do surgeries for so much cheaper than what a doctor that takes insurance. Like, for example, if you needed your tonsils out, my fee, and that's not just me, but anesthesia and the surgery center, about $3,500.
1:26:27 Speaker 01 You go to Houston Methodist Hospital, it'll be $17,000.
1:26:31 Rick Rubin? Wow, big difference.
1:26:33 Speaker 01 Yeah.
1:26:34 Rick Rubin? Would you say that your office functioned more or less like an urgent care? If people could just come in?
1:26:41 Speaker 01 Yeah, I would. And, you know, my goal was to make people psychologically better. Because, you know, I was pregnant for basically five years straight. It would wreck my day going to the doctor. So Houston is home to the largest medical center in the world, the Texas Medical Center. And navigating that monstrosity was, you know, you go up a 10-story parking garage, then you go down and out, it's like being at the airport, basically. The Houston Airport. So I really wanted to make it easy. I actually, I located my clinic in a strip mall so that there was none of that. It was very easy. You park and go in.
1:27:23 Speaker 01 I use spas as inspiration. So I infuse the air with peppermint spray.
1:27:30 Rick Rubin? Nice.
1:27:31 Speaker 01 And I play spa music. And my waiting room is tiny. If you do have to wait, we put you in a zero-gravity massage chair. And you do not fill out any papers. That used to drive me. I'd fill out every time I was at the OB's office, papers.
1:27:45 Rick Rubin? You created the doctor's office you wish you could go to.
1:27:48 Speaker 01 Right, exactly.
1:27:49 Rick Rubin? That's great.
1:27:50 Speaker 01 Yep. And then I provided onsite so you can get your lab drawn in my office. If you need an IV, you can do in my office. If you need a breathing treatment, do it there. If you need a CT scan, we do it in the office. So, you know, it's a hassle. You go to the doctor and then, okay, well, then I gotta schedule this somewhere else and...
1:28:10 Rick Rubin? Goes on forever.
1:28:10 Speaker 01 Yeah, yeah.
1:28:12 Rick Rubin? Do people come to you for insomnia?
1:28:14 Speaker 01 They do, but I'm pretty strict about not prescribing medications to help people sleep. So people book an appointment with me. I'm like, well, you can come see me, but I'm not prescribing Ambien or any of those. But I do think there's sort of this basic fundamental issue with sleep that it boils down to you've got to calm your sympathetic nervous system down and stimulate your parasympathetic nervous system. And there's some very common sense things people can do. You know, you get into this horrible cycle where you can't sleep. You stay up too late.
1:28:58 Speaker 01 Then you end up taking a nap during the day. And then it just kind of perpetuates the problem and it's a vicious cycle. But if you've ever cleaned out your garage or spent the entire day, you know, working on your yard or cleaned out your attic, that is something you can do that will completely exhaust you, will help your mind calm down and kind of reset your focus. The other thing is it's important to reset your circadian clock is to watch the sunrise. That is the most potent thing you can do to reset your clock. So, reset it by watching the sunrise and then just completely exhaust yourself doing something, you know, don't...
1:29:43 Speaker 01 You know, if you tell somebody who's not sleeping to go run three miles, that's a lot harder than, okay, clean out your garage. You will completely exhaust yourself. And then, once you get back into a better pattern, that can be all it takes. Women, I will say, menopausal women, when they start losing their hormones, especially progesterone, that can contribute to problems sleeping. So that is one medication I will use in women. It's progesterone to help them sleep. Men, oftentimes, it's the prostate, and they have to get up to go to the bathroom. So that's not something I treat as an ENT, but I'll, you know, have them recognize that that can be a problem that needs to be addressed.
1:30:28 Speaker 01 But the other tricks I like, so if you have a pillow on your eyes, any kind of weight on your eyes stimulates your parasympathetic nervous system. So a trick we all learn in our training is if somebody comes in the emergency room with a hypertensive crisis, if you rub their eyes, it will bring their blood pressure down. So it's the same concept. You put weight on the eyes. It stimulates your parasympathetic nervous system. The other thing is a weighted blanket. Now, sometimes that makes people too hot, but if you can tolerate the extra heat, that weight on your body also stimulates the parasympathetic nervous system. And then, if you just can't shut your mind off, I listen to an audiobook when all else fails
1:31:13 Speaker 01 just to get my mind sort of focused on somebody else's problems, and then I drift off to sleep. I used to use that with my kids all the time, too. When I couldn't get them to sleep, I would just put an audiobook on, and that would definitely do the trick.
1:31:29 Rick Rubin? And what about ringing in the ears?
1:31:32 Speaker 01 Ringing in the ears is very hard to treat. Often, or typically, it's from damage to the tiny hair cells in the cochlea, and then they start emitting sounds. The only success I ever have in treating ringing, assuming it's just the most common type of ringing, where it's sort of this low hum that doesn't pulsate with your heart, but just is a noise in your ear. If you pop your ears and it changes the tone of the ringing, then fixing the eustachian tubes can help the ringing. So sometimes it's because there's too much pressure in your middle ear because the eustachian tube is clogged
1:32:16 Speaker 01 and that pressure in the middle ear is transmitting to the inner ear. And if you fix the middle ear, then the inner ear will be better. It doesn't often cure it, but it can make it better. And sometimes it's more than just using sprays, like you have to try steroids or something like that. But if the nature of the ringing changes when you pop your ears, there's more hope that you can do something about it. If it doesn't, and typically we recommend you get a hearing test because you want to make sure that you're not seeing an asymmetric hearing loss in one ear because that can be a sign of more serious problems. But assuming that it's just regular old tinnitus, there's not a lot you can do for it.
1:33:00 Speaker 01 There's a newer device called the Lineat, but I don't have a lot of firsthand experience with it. But it's basically biofeedback. And sometimes hearing aids can be programmed to drown out the ringing. A lot of people, once they know that it's nothing serious, they just learn to get used to it. It's kind of like if you moved into a neighborhood right next to the airport. The airplane might drive you crazy when you first move in and then eventually you just forget about it. So people adapt to the noise. But it can be very bothersome for a small percentage of people.
1:33:40 Rick Rubin? Tell me about when you would recommend that someone get hearing aids.
1:33:45 Speaker 01 Yeah, it's funny. People are often pretty resistant to hearing aids compared to glasses. And I would say, you know, if you're not sure, start with something inexpensive like Costco or, you know, and see how you like those. And then if you find them helpful, then maybe upgrade to something fancier where, yeah, they can program them so that when you're in a noisy restaurant, it helps drown out the background noise and amplify the voices close to you. But yeah, I would say just start with something inexpensive if you're not sure. Just test it first.
1:34:22 Rick Rubin? What's the most unusual thing anyone's come in with?
1:34:27 Speaker 01 Well, the most memorable, I think, is when I was in Galveston. So I'd started my residency at UTMB in Galveston, Texas. They had the largest prison hospital in the state of Texas, and they bust people in from all over the place. And I saw a prisoner where the other prisoner had bitten his ear off, and I had to sew it back on. So that was probably the most memorable. And I remember seeing some patients come in with maggots. So people with chronic wounds sometimes get infested with maggots.
1:35:05 Rick Rubin? What do you do for maggots?
1:35:07 Speaker 01 You just clean them all out. You debride it, and it's usually around dead skin. So they're cleaning the dead skin. So it's basically just cleaning off the wound and...
1:35:17 Rick Rubin? You've seen a lot in your life.
1:35:19 Speaker 01 Yeah, it's not that exciting now in the real world. But during residency, you see so much. You see just wild things.
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