Dr. Mike debunks birth control, home births, and medical misinformation | Ep. 55

If you are trying to lose weight, exercise is almost pointless, yes it is important, but diet will help you most of the way. Some people say, well, I'm on my period, so I can't get pregnant. False, you could still get pregnant. Pregnant during her period, fever actually has benefits. What is it that my daughter has a fever? She terrifies me that it is her body fighting the infection when she follows the breastfeeding method the chance of her getting pregnant is about the same as if she were on

birth

control

How the hell did we get pregnant four months after giving

birth

?

There are a number that, like couples, should do it per week. Generally this is what I recommend. Social media is rife with health gurus who lack credibility in

medical

misinformation

, so we sat down with Dr. Mike, he is a Board Certified Family Medicine Physician with over 25 million followers, we asked him Tricky questions like whether breastfeeding is birth

control

, does cold immersion really work, and how to fix your sex life after childbirth? We talk about all of this in much more in today's episode. I don't think we're with the world famous Dr. I was kind of listening to your story, so weren't you supposed to be like Ellen degenerous?

Because you went viral for being like the hot doctor and then and then it didn't work out. or something like that, it was a disaster. I mean, being a young doctor, you're thinking about education, education, just because you want to be the best doctor you can be and I had this moment of virality, which is a strange thing to say, it's a doctor going viral. That sounds like something bad, viral with the pmic. I got invited to do all these talk shows and I didn't know what to choose, so I chose Ellen, the generous show, and I said, "Okay, this is my time." and I'm going to show my

medical

knowledge why I'm the youngest doctor on my show why I published research at a young age and then they call me the day before and say, hey, so Hillary Clinton is announcing her candidacy. presidency she's never done a daytime talk show so we're kicking you out because the other guests are like pink and Jimmy Kimmel oh my god I say oh no problem I'm GNA call Steve Harvey and tell him I'll do your show now I call Steve Harvey again, they say no, no, no, you're last week's news, we're not interested anymore, oh, and I got a real quick lesson on what it's like to get 15 minutes of media fame, oh god. mine. and that's why you started your YouTube channel well.

I started doing some TV shows back then and wanted to put out a meaningful message about preventative care, learning about health and the body and how we can take control of our own health. I was passionate about it, but all the television networks were gatekeepers and said, well, you know, you're not the most famous doctor in the world, you're not from a League IV education, why would we use you? and they essentially started kicking me out of shows and I said, well, I'm going to do it on my own and be a disruptor because that's what I felt like social media was the place for now, looking back, what's this like six seven years later, We have three billion long-form views on the channel.

Oh my gosh, we're hitting 12 million subscribers and it's for Education, they're not there anymore for the sexy doctor part that was stupid that started it, yeah, but now people want to learn and I'm excited about that because that's always It was my passion from day one and that's what we hope to do today is learn from you because you are a very smart guy and you have crazy credentials. I'm curious. I wanted to start with how Heck, we got pregnant four months after giving birth, how did that happen? Okay, so this is something that we don't communicate well in healthcare in general, is risk communication and what it means to have the possibility of something happening when you follow the breastfeeding method, the technical name is Amaria's breastfeeding method. , lamb, that's fine and what's supposed to happen is if you breastfeed the exact right amount, which means a set of every 4 hours during the day, every 6 hours at night for all six months exclusively.

Breastfeeding without supplements just the chance of getting pregnant is about the same as if you were taking birth control. Are you kidding me? but that doesn't mean it's 100% effective, it doesn't work very well after 6 months either and most people who I would say follow this method don't follow it to the letter, that's why it's important to talk about the results in the world. real rather than what happens in research, like the results, for example, most people like. Oh, condoms are very effective, over 90% effective. 97% effective in preventing pregnancy, but when we look at the results in the real world, when people misuse condoms, they break due to misuse, people have sex multiple times in one session, it is possible that first some sperm gets on their hands and then ends up on them. the condom and then use it, it falls to a medium working percentage AG and I think it's important that we talk about the real world instead of what happens when we follow the rules exactly, exactly, I like that, that's more applicable, that goes a long way It makes sense, but that's probably what happened, that's Abby who heard that it's crazy that we got pregnant, did you follow the rules like those three?

Well, look, I think what got me is that I think we once spent periods longer than six hours in the night maybe maybe that was it, we didn't supplement, yeah, we weren't using at least four hours during the day and It was less than 6 months. The only thing I can think of is that maybe we spent more than 6 hours a night and it was and still is 98%, so you had a 2% chance that two out of 100 people were crazy, yeah, I mean, Aby's doctor told us, like her, not to rely on breastfeeding as a method and we knew it and we knew it. from people who had gotten pregnant while breastfeeding before, so we knew that, but we also thought it was literally too comfortable to do that twice unprotected and that's what happened, which is crazy in those circumstances, crazy and it's having children of such close ages.

It's a lot of fun and I'm very grateful for it, but the initial shock like, "Oh my gosh, it's probably not good for you to have back to back, yeah, the general guidance of I don't know the FDA or CC that publishes the guidance." In this, it's like 18 months in between is ideal to let things heal and stuff, but you know the body will surprise you 18 months before you get pregnant again or before you have another baby, okay, wow, MH, yeah, that's a but again it's a guide and then there's the real world what really happens so it's important to know that and the reason why it happens like pregnancy while the situation is going on is because you're not supposed to having a period when you're breastfeeding correctly and people say, Okay.

Since I'm not having my period, I can't get pregnant. Well, ovulation occurs a couple of weeks before your period. The timing is so crazy that we were meant to have them back to back. We had our yes, we had our baby early. July and then we found out we were pregnant in early December, which meant Abby technically got pregnant in early November, so yeah, four months, but look, I had it, so I thought it must have been perfect timing. Do you wait? You have not had. a period in how many years is like four years or something yeah that's ridiculous but I've had two babies yeah cool CU Abby also has an IUD on that like she stops having her period which she also had very curious when talking about IUDs and you brought. increasing birth control, yeah, I feel like there's been a lot in the media recently about how all of that can affect your hormones and your mood, and there are all these different effects that can potentially occur when you're on birth control, whether you that's the a pill or an i, so I'm curious if you could talk about that, because a lot of people like what there's a lot of criticism about hormonal contraceptives now.

Well, I feel like the criticism is short-sighted and a lot of it is fear-mongering. and based on

misinformation

, so it's like twisting percentages of what's really happening and not taking into consideration the other side of the equation, basically, when you're thinking about developing a risk for some medical condition you should also think about If no Don't do the intervention, what is the correct risk? For example, if you have unwanted pregnancies, you may need medical procedures. Pregnancy itself is a high-risk medical event. There are things that happen from an unwanted pregnancy that are risky and most people don't think about.

For that matter, they don't think about the unintended consequences of not taking birth control. What I see mostly on social media is the rise of these health gurus who claim to have all the answers when modern science doesn't have the answers either. or you want to bring nuance to the conversation like if you asked me a question today uh, is it something X good or is it a medical procedure X good? I'll never say it's good or bad, it's for who in what scenario, uh, why would you want to do it? Do you agree with the risks?

Do you agree with the potential benefits? Meanwhile, health gurus who make Tik Tok videos and claim to have all the answers are absolutely terrible for you. This is what you have to do. Never take this. Take this magic pill. is going to fix everything and that certainty and overconfidence is actually a form of trust hacking where if you go to see a doctor and your doctor is not sure and that person is so sure that they are more likely to, From the perspective of a lizard's brain, you think in person you are much more confident, but what I'm trying to teach people to think about when they look at and evaluate different experts is that the person who brings all the nuances is actually the which is more precise because in medicine we are trained to Think about maybe like this, for example, if a patient comes in with abdominal pain, I'm not going to be too sure, say the exact diagnosis, I'm going to say one that is most likely, two , three, four, others that are part of my differential, other things. that can be and then also talk about treatments and say this is a treatment that works x% of the time, but it definitely won't work for you, and that kind of nuance is a little unsettling for people because nobody likes to be insecure. but we have to be comfortable with a level of uncertainty because we are doing the best we can with the information we have at hand, that is the right way to practice medicine.

It's also crazy because we've had friends who have had an IUD and I got pregnant with the IUD when, from what I understand, it's the most effective method of birth control besides abstinence, I'm sure because, like, how do you get pregnant? you're not exactly. I was about to make a joke about that. what we were taught in high school, but I feel like not many of my classmates followed that, but anyway, um, but uh, how does that happen? How does someone get pregnant with an IUD? Because that, in theory, shouldn't happen. I mean anything that is 99% doesn't mean it is 100%, so we have to keep in mind that things happen in these scenarios and there is always a risk.

As you said, it's one of the most effective birth control methods, the reason we like those methods is because they are considered long-acting reversible birth control, which means that when you put them in you don't have to think about it, instead of remembering that you have to take the pill at about the same time every day to get the most benefit and they are reversible so you can always remove an IUD or you can remove the implant so we like them because there is less chance of human error in those situations , but that doesn't mean they are 100% perfect like I just took a sex ed test. that's going live on my YouTube channel today with my nephew and I asked them if they think condoms are the most effective way to deliver.

Patrol said yes, which is not true, they are these long-acting reversible agents, we also ask questions like you. know if there is sperm floating in the pool, can it leak and get someone pregnant or in a hot tub? The answer is no, but he said, "Oh my God, maybe I don't know, so there's a lot of misinformation online and in people's minds that we have to really like going out as doctors and doing a little bit of work." better in education Yeah, I'm going to throw a dog at you and I'm really curious what your thoughts are on this, but we just had something on the podcast that was on all this content where this woman claimed that she got pregnant and said. that's even though they didn't actually do it because they did other acts where you know the substance took over her and then she said it somehow got inside her, in some way, like what's the probability that that happens, yes, very little, like if you round down to a whole number, it's probably zero, but it canhappen, just as I spoke. about before, like if you had semen or sperm on your fingers and then put on a condom a second time, so it's very possible, especially if you're not using a lubricant that will actually kill the sperm, also like some people say, "well, we".

I'm on my period, so I can't get pregnant. False, you could still get pregnant during your period because remember that when most people say they are on their period it is because it is the act of bleeding, but only because you can. be having some bleeding that could be spotting, that could be something else and you're not actually having your period, so there's no 100% way to time when you won't get pregnant every time you have sex without protection. and even when you're having protected sex there's a chance you're pregnant, so how do you feel about those meth birth control methods where they like to give you the green light or the red light?

Oh yes, like a natural family. Family planning, there's no way to predict it, yeah, I mean, look, that's right. In an imperfect system, there are better ways, as with long-acting agents. Stacking things like if you have an iub plus a barrier method like a condom is usually the best way because you get really good odds there plus. You're also getting protection from STIs, which is something most people don't think about, they think, well, they took me off the birth control, I got the IUD or I have the implant, but what about sexually transmitted infections? It's also important to think about it because they do. it impacts people's lives and it's pretty easy to put on a condom and be safe that way, and talking about sexually transmitted diseases, obviously the condom is a great way to protect against that, are there other methods besides condoms that people can use?

Because it's not like there is a condom for men. I think I learned it in the health category, well yes there is a female one too, but I'm sure the male condom is probably more effective, it's more popular, it just isn't. something that even most people argue about, but it allows women to be able to bring their own tool to the game if the man is not ready, there are also dental guards, like if you were going to perform oral sex, yeah, just, again I don't are. so popular, but definitely an option again, the barrier is the key.

We put condoms in that category. This episode of the Unplanned Podcast is brought to you by Huggies Little movers. Nothing is worse than when there is a blowout and poop gets all over your child. the clothes then get on your hands and the carpet and then the carpet is a mess, okay and the bottom line is you want to make sure you are using good diapers for your little one. Accidents will happen, it's not a question of If, but when there are a lot of diapers in this house, we have a lot, we have two babies who go through them quite a bit, consider us the official diaper testers for you and we can say that Huggies is level, we have had Auggie at Huggies Little Movers for a while and we have been blowout free and we used to have so many with Griffin, I know this because we were buying the cheap stuff with Griffin that we like, oh we can get away with that. just search, let's look for the cheapest diapers we can find on Amazon.

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Yes, they also have night diapers that they have as well. Oh yeah, I forgot about those Poo Bears they have. The Augies have The Lion. King Griffins has the Poo Bear, you're right, it's so cute, so cute, so put your baby's bottom in the best-fitting Huggies diaper. Huggies Little Movers, we're taking you back to the episode, so if I'm a woman who wants you to know, have some. kind of a birth control method, but I don't mess with my hormones and I'm afraid of hormonal methods, like what should I do, what would you say to that, yeah, well, first of all, I'll do it as a role play.

Almost if I have a patient who comes in and is worried about hormonal issues with birth control, there have to be some questions later on, like what caused this concern, what exactly are you worried about, and I tried to get to the bottom of where. the concern comes from and if it's based on some kind of false premise or false information, sometimes just debunking that information and showing the right statistics can help a person change their mind and say well, I really want this, but there are no hormonal methods , the first one that comes to mind is like the paragard, the copper IUD, which is something we do in our office quite frequently, it's a non-hormonal IUD, which is a long-acting reversible form of contraception with great statistics, Condoms are great in that regard too.

Also consider again and again that you are also getting the added benefit of STI protection, so you don't have any staunch beliefs about hormonal control in birds, not at all, because it's not about having staunch beliefs in medical care, it's about knowing what the problem is. The truth is through good quality evidence and then presenting that good quality evidence to the person sitting in front of you. In fact, like the entire art of medicine, it is taking generalized information and then individualizing it if it were my patient, because things that happen on a general level do not necessarily always happen on an individual level.

I'll give you an example, so you've heard of people who have high blood pressure and it's important to get it down to a healthy range, because if you have high blood pressure. that may like the diagnosis of hypertension that can increase your risk of heart attack and stroke, so we've seen in medical research that if you control someone's blood pressure to a certain number since they have hypertension to a Better number, you reduce your risk of 30% fewer heart attacks or strokes in the general population, let's say that's great, 30% fewer heart attacks and strokes, but do you then know how many patients you would have to treat to prevent one case of heart attack and stroke on blood pressure medication 80, that means 79 people that I'm going to give a medication that isn't working, that doesn't mean it's not a valuable medication, it still is, it just means that not everyone always has a heart attack or stroke that's why I need to give it to them so many times because in the rare case that they do have it, they have a chance of having it, that medicine will prevent it from happening so I did this body scan on the gym a couple of months ago and I got scared.

Tell him he said my age I lived to was 75 okay and I was like shit my grandpa was 75 years old. I'm 25, just 50 years away and he made me think about my heart health and wonder. I guess one of the main causes of death is that everyone dies from a heart attack. The number one cause of death worldwide and in the United States is heart disease and what is the best way to prolong it to have the longest possible life I don't just think about the longest possible life as a doctor, I think about the length of life but also in the quality of life.

I don't want to just extend your life indefinitely because that's not always the healthiest thing either. do and it's not something you want to do so I think about quality of life and length of life and the way we think about heart disease is maintaining a healthy lifestyle because lifestyle modifications are the biggest drivers of heart disease, so if we control our cholesterol numbers if we control our blood pressure numbers when I say control I mean keep it in a healthy range if we sleep the right amount of hours for our age group if we focus on our mental health if we get the recommended 150 minutes of moderate intensity exercise in a week those things will lead to the healthiest results so if we did something imperfect that we do as humans we might have slightly higher cholesterol because to our diet or our lifestyle or maybe our blood pressure is a little high because we live stressful lives or have a genetic condition, then have a healthy relationship with your primary care doctor to see where medications can come in and help mitigate Part of that risk will also give you the best chance of having a heart-healthy lifestyle H, which is more important, diet or exercise.

I'd say it depends on what number one is, but I'd probably lean towards diet, so for example, if you're trying to lose weight, exercise is almost pointless, are you kidding me, yeah. important, but diet will get you most of the way because to burn enough calories to counteract overeating, say a thousand calories, you even need to do a Sprint workout for an hour and no one exercises that much, not as much as when the Most people exercise, they get on the treadmill for 20 to 30 minutes, they burn like 3,400 calories, that's a Snickers bar, how does it work?

Well, that's why I say diet is much more important because it's much easier to eat excess calories than it is to eat excess calories. is burning calories, that makes sense as does keeping everything else excluded. I'm surprised because she's okay so for example 5 months postpartum Aby looks amazing and works out 5 days a week which I like and that motivates me to get my butt to the gym because normally I wouldn't That, but my wife works out so much that I can't be a lazy bum and just sit and do nothing, it's okay Matt, you can get fat, she tells him.

I say I don't want to be fat, I want to look good for you, I want to look good for you, it's great that you guys motivate each other, but she doesn't, so she's very motivating and I've attributed to her that she looks so good because she does a lot of exercise and I, but you're saying it's actually more, more diet, well, it's more, but it's not, or I don't think it's like some kind of fake psychopath. I think you should do both because I've said it before. If I took all the benefits that come with exercise and put on a pill, I would be a billionaire and the richest person in the world right now because there are so many benefits to offer. exercise outside of weight loss outside of strength gain helps your sex life helps your mental state helps maintain social bonds because they work together like all those things if I can take all those benefits and put them into something that you can just Oh Oh my god, it's amazing.

I feel like people do that. I feel like there are always ads on social media like, “Oh, just eat.” Have you seen those that say this cheeseburger or salad is better? It's actually the cheeseburger because it has fewer calories or something and I think that really doesn't make sense, it's a complete fabrication of the Truth and it just shows that someone isn't well versed in the science. In fact, I just had a doctor on my podcast and he was trying to equate a Hershey's bar with eating grapes and he's like, why eat grapes? They are sugar bombs.

You could also eat a Hershey's bar and that couldn't be further from the truth because that type of thinking simply compares the sugar content in the two things, but just because two things have the same sugar content doesn't mean they have the same impact on your health grapes have fiber chocolate grapes do not have vitamins minerals valuable nutrients that are healthy for you that chocolate does not have especially milk chocolate so to compare the two only in one variable is actually like doing a hyper zoom and not thinking about the big picture, it's like focusing and saying um, you know you shouldn't run because sometimes you can pull a muscle, yeah you can pull a muscle, but what happens? all the other benefits you're neglecting so it's not a complete picture of what's going on and a fun fact like Sam behind the camera who works with me has no medical experience but has a lot of medical curiosity and I got on the channel and I said, Mike, why don't we do some things where you can go to fast food places and you can rank things from the healthiest to the least healthy.

And I have difficulty with that concept because it is very difficult to make precise comparisons wheredon't fool people and some people say oh it's no big deal Hershey's and uh and uh grape like it's not that big of a deal. I think it leads people to start having an unhealthy relationship with food and I feel like that's the worst way. of the diet culture out there, you mentioned fast food and it made me think because we eat out a lot and we're always on the road and we're always filming podcasts in other cities, so I'm always trying to figure out what's the healthiest way.

What I can get when I eat fast food because I want to put good things in my body and that's why I like to watch Chipotle. I think Chipotle has to be healthy, since they make everything fresh, they make it the same day and for the majority. Part of it looks pretty good, but then I went online and looked at the sodium content and thought, "Damn, that's like the daily value of sodium in a meal, if not more, so I'm curious where we should go." to eat when we are there". We're on the road and do you think Chipotle is healthy?

Well, I love Chipotle, so I'm biased there, so I'm going to point it out. I think it's delicious, but you have to watch your salt intake. especially those who struggle with heart disease because salt is one of its unwanted consequences, excessive salt consumption can actually increase blood pressure and blood pressure causes your heart to have to work harder to pump against that pressure, which can cause real physical changes in your heart. making it less effective a buildup of fluid again this is in people who have heart disease um for the average person if you're athletic and you're consuming enough water and that's okay taking a little bit more sodium your kidneys will work well and be fine so.

I don't like to worry about it too much and even at Chipotle if you modify your dish you can moderate your salt intake okay it's just when you think about seasoning and they season the meat like you watch chefs like famous chefs on YouTube and you watch their meat preparation, I mean they're just like salt makes everything taste better and I cringe at that because I feel like there's no nutrition label on this so I can't imagine how much salt is in this food so when If you eat out of restaurants you are likely to get salt. bombs because you know it makes things taste a lot better even when they're cooking, maybe it's not spectacular, so if I eat a lot, if I drink a lot of water and I exercise, let's say three days a week, is it okay if you eat Chipotle every day, yeah, I mean, if you have to look at your macel, what else do you eat during the day?

Because if you eat Chipotle during the day, then you eat cold cuts at night, things that are high in salt too maybe not ideal, but I would never say it's terrible, you know what I'm saying because this is where other than the presenters podcasters and online medical gurus get it wrong: they start focusing on one factor and making it seem like that's what it is. They are going to destroy your life or, on the contrary, like ice baths, they will make you function much better, what they do not realize is that life is as multifactorial as your mood and whether someone is mean to you or not in the street or if Not getting into a car accident on your Uber ride

home

has a much bigger impact on your health than whether or not you ate a bowl of Chipotle that day, yeah, so I try to get people out of this situation of excess.

Focus on the worry because that anxiety. circling the Chipotle Bowl is probably less healthy than the Chipotle arch unless you have a pre-existing medical condition, of course you see how annoying the doctors are and how they answer questions. No, I appreciate that perspective because I think it's very easy, especially on social media. like all my stuff recently has been breastfeeding and babies and stuff and it's just like fear mongering in a way like, I don't know, making you feel afraid of medical intervention or like this is the only way to do it or like If I even received criticism about our own experience, tell me what the criticism was.

I don't know. I had a c-section and then people said no, it's like you don't like it. Cesarean section is the absolute worst. You have to avoid it. all the costs and you had the c-section because you were worried about shoulder dystocia from the first pregnancy, yeah, so that's an important topic to talk about. Shoulder dystocia is an emergency in which, even though the head comes out, the shoulders essentially get stuck in the birth canal and that creates a risk of injury to the brachial plexus, which is the nerve that innervates the rest from the arm.

In reality, it can also cause harm to the mother, so many problems can arise, such as stillbirth and problems with the fetus itself. the baby and um, it's an emergency, so we need to act quickly in those scenarios and when we think about what increases the risk of that, the biggest risk factor is the size of the baby, the fact that the baby weighs more than 8 pounds, 133 ounces officially puts you at risk for that the medical definition of that is fetal macrosomia having a large baby what predisposes you to having a large baby is having diabetes gestational diabetes during pregnancy which can create a larger baby um too use of forceps vacuum assisted delivery things that we use to help navigate uh a difficult birth can actually increase the risk of shoulder dystocia um and in some cases we have to do a cesarean section to prevent that from happening.

I'm curious in your case, your first baby's weight was high, right? it was like 84 okay and then our doctor said if it was if our second baby was any bigger she would be a little worried about not doing a c-section and he was 814 at 39 weeks so then fetal. microsome, yes, yes, so she said that I feel comfortable and also having my first a week before, like at 39 weeks, she also received criticism, so it is difficult too, so receiving oxytocin or bacon during pregnancy also increases the risk of shoulder dystocia, oh. so maybe that's why I don't know well again, it's definitely not why I remember a lot of multifactorial things that happen in those situations and for people to criticize you is a little ridiculous because they don't know the exact medical circumstances and medicine is an imperfect science. so when we recommend things, it's not with this is definitely the right move, there are some cases where it's like no, no, no, absolutely contraindicated, absolute, contraindication, it's like you would never do this in this scenario, but in that scenario you are weighing the pros.

By weighing the cons, you are thinking about the risks, the benefits and during a stressful situation you are letting a doctor help you make the best decision. I don't think anyone could judge you for that unless they were there, thanks to Toaya for sponsoring today's episode. Are you okay with this? I was just reassessing myself, okay, typical kids' vitamins are basically candy in disguise, guys, they're full of two teaspoons of sugar, unhealthy chemicals, and other junk gummies. Growing children should never eat honestly, it's been an increasing stressor for me. How much sugar is packaged in products designed for children?

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Go back to the episode, yeah I really trust our doctor so it was like I didn't want to bring her in and make her talk but I really trusted her and her advice was to have them at 39 weeks and then do a c-section and it was great honestly I preferred the cesarean section. and then I thought, "I'll do that again if I have to. It was crazy how different it was because sexual recovery C was obviously so much like watching you go through that I hated it because, like you, you were in so much pain, your scar still hurts." at this point, it's normal for women to still feel like all the scars could cause harm, not harm, long term pain, that's okay, but it depends on each person reacting differently because yes, because Abby liked seeing it, The recovery was very long, from a cesarean section, but then with the birth it was like suddenly very, very intense, so much blood everywhere, it was like a war scene.

I think that's more traumatized than me, well, I think. which I realized also talking about. For other people who have babies like everyone else, everyone's experience is completely different and so our experience, I think just with the nature of the person you are and the shape of your body. and the size of our babies and many other similar factors. It seemed like ours tended to be more intense in labor and then we know women who, like the baby, came out right away and it was like

home

and it was peaceful and the epidural was completely in like completely. going and they didn't really feel much, so it's like you hear about these really peaceful and very traumatic

births

, like the baby pushed daddy out of the way and that's what was ours so that our yes, all that happens. and that's why home

births

as a topic has come up a lot in the healthcare community and people are a little polarized on the topic, what do they do?

What have you heard? I'm curious, Abby, take this one. I feel like you have strong opinions, what I've heard is strong for me, it would be absolutely not. I would be much more scared at home without doctors present than if I were in a doctor's office, if we had shoulder dystocia at home it would have been terrible. I wouldn't want to just be alone with you, well it's not ideal, it's not just you, home birth is not at home with my husband, it's not my husband's birth, I know people who have done that, although I'm like Your husband, that is not recommended.

I don't trust this guy at all. My non-medical husband's birth is not something I would consider a proper home birth by medical standards. We have a friend who told us about one of his friends who had his baby in a hospital room. They didn't even tell the hospital, nor the Hospital Hotel. Sorry, hotel room. They booked a hotel. They booked a hotel room. In this place we lived in Hawaii on the north shore, which is like I think we were a little far from a hospital, all of our friends had to drive into town 45 minutes to go to the hospital, but this girl from her college rented this or He just booked the hotel and I guess he didn't say anything that would bring it up like his pool or any knocks. in the pool and had the baby in the hotel room.

Wow, I mean, to me, Springs in my mind is like people are using Ubers for ambulance transportation because our healthcare system is so messed up that ambulances are so expensive, so people are using Uber. their medical emergencies Uber has to issue a statement and they stop using Uber as a form of medical transportation. As terrible as it is, this Uber driver is simply not prepared to arrive faster than reality. I mean, I don't know, but he's obviously not safe. We wouldn't recommend that because Uber drivers focus on driving and not providing medical care, so how much does an ambulance cost, it could be very expensive as the ranges are between $500 and $1,800 as it could really be and you have to pay so that it is not. like you can oh sorry you have to pay it's like oh okay yeah I mean you have to pay it okay yeah that's a lot of money I mean insurance should cover it but one time when we used to work, we worked in a pizza. restaurant in college and this guy came in and told me to call an ambulance like he wasn't feeling well andI was so scared I called 911 right away but I was wondering if he went into the store because he expected the payment would fall on the pizzeria or would it still fall on him no it would still fall on him okay the only situation the pizzeria gets involved in It is whether there was an injury or illness due to some negligence or yes, your private property. and he just came off the street but it looked like the way he looked, at least I thought he probably had a phone so I wondered why he wants us to call him but maybe he just didn't have his phone on him. or something like that, but that's very interesting.

I didn't realize how many people I want to know his opinion on home birth. My thoughts again are going to have many nuances. I won't give a good or bad answer on this because of good quality research. What we've seen is that in areas where there's already an established system for home births, whether it's midwives or doulas, some kind of advanced practitioners, maybe they're there to help guide the process in a low-risk pregnancy, in In those situations three things happen in terms of risk. One is that you have a lower risk of medical intervention, which means that makes sense, if you're not in a hospital, you're less likely to have forceps, you're less likely to use vacuums because you're in a hospital, uh, second.

First, there are fewer minor injuries to the person giving birth, so mothers are less likely to have third degree tears, etc., and then the last is an equal or slightly higher risk of neonatal mortality, as if the baby died, oh really, an equal or slightly higher risk. higher, so people, but there are a lot of factors here, okay, you have to follow all those categories, like a low risk pregnancy, have a system in place that is not just dad delivering the baby, you have a trained professional there . a plan for what to do if there is a complication because when you look at the research there is a significant double-digit percentage of people who have to go to the hospital either mid-pregnancy or post-pregnancy, so those things happen, I think there is There was another YouTube couple who wanted to have a home birth and then they couldn't and had to have a C-section in the United States.

It's really weird that the percentage is like 1% of home births in the United States. The Netherlands I think is the highest country, a sum of like 14%, oh wow, they are home births, yes, and they only have one midwife. That's what usually happens with home birth, yes, and they have that plan in place for what to do if things get complicated. Someone with experience, there is a state in the United States that has, I can't remember which one has a really good system for home births and they obviously see better results than all the other states because they have the system in place, yes, I can say that it would be very comfortable . being in your own home to have that peace and not being in something you already know, for some people I think hospitals can be scary so just getting to give birth in your home I can see the appeal of that for sure esp.

If you have a low risk pregnancy and your doctor said yes, you are low risk, so yes, I think the most important takeaway for people is that if you are considering it, talk to your doctor and don't just ask To your doctor, what do you recommend? this, if you want to ask that, that's fine, but then ask why or why not, allow them to express their reasons for concern. Well, you're not totally low risk, you have problem X Y and Z or I'm worried about X Y and Z or yes. I agree with this because you follow all the protocols that the guidelines set out and you are low risk and you have this plan in place, so you always ask a question, but then with follow-ups intended for the doctors as well, mhm, are you feeling?

I like a lot of the criticism that comes to doctors on social media. I feel like I hear a lot that it's like doctors are just trying to make money, like they're trying to get you to like them so they don't want you to have a home birth. because they can charge you at the hospital, yes, no, that's a bit of a conspiracy, yes, um, in general, doctors are like before, I guess more, but now there are still people talking about money-hungry pharmaceutical companies, this and that, and I always see the hypocrisy. in those statements because the people who normally say that are selling you something like some miracle supplement where it's also a billion dollar industry, so they say don't trust the pharmaceutical companies because they're making money off of you, it's like, but you' I'm also making millions and billions off of myself, so let's neglect those points and then look at the other one, yeah, exactly, because it's like well, Pharma has to prove it too.

Wait, they had an essential oil? I saw your video. They were like reacting to people using essential oil. oils and it was like this girl rubbed it on her forehead and it's like oh here's some and they're like just covering this girl in essential oils your reaction was hilarious I mean it's so ridiculous because I don't really like it you matter when they make those recommendations because look, I think they're essential oils or I like this kind of I don't even know what to call them like natural methods. Natural isn't even a great word because natural doesn't mean they're safe, but these low-risk tools can be used in healthcare.

I think there are places for them, so a great example of that is let's say a patient comes in with a viral infection and I tell them look, we can't use antibiotics here because you have a virus, uh, you really have to rest, stay well hydrated. and heal yourself by eating fruits, vegetables, all that, if they have a strong belief that smelling orange essential oils will help them, chances are they have that belief that it will help them. because the placebo effect is real, that's crazy, hell would I like that? It's not that Hur hurts them, there's nothing like smell, smell, smell, because then where I come in is where they say, oh, essential oils will help you control your blood sugar if you're diabetic and that person ends up in a diabetic coma due to diabetic ketoacidosis and now that person dies because of this belief in essence, that's where I step in, yes, but if it's low risk, if it's for comfort, it's for symptom control and mental health support. please do it by all means, that's crazy.

I was actually about to ask that about the placebo effect because there has to be research to back it up, like when you believe in something, oh yeah, I'm sure, Abby, I feel like the place effect works. I wonder about you. Not Abby when she was a kid. What's his name again? Where you couldn't sleep. I had insomnia for an entire summer when I was a kid and would literally stay up if I felt like I was probably going to fall asleep all night. obviously at times and my mom was like Abby, I have this perfect sleeping pill and it will make you fall asleep tonight after a couple of months of this, it was a Tic Tac.

I found out that seven years later I fell asleep that night. I couldn't say I took it like a pill. I wouldn't, oh, you swallowed the drink. That's what I was going to say. I was going to do the doctor thing and warn you that you should never put a candy on before you leave. to sleep because if you fall asleep you could drown but you swallowed it, you swallowed it like a pill and then I fell asleep. His insomnia pills the doctor gave him, but that placebo effect works 30% of the time, it's crazy. It has a 30% efficacy rate, that's why when we test drugs and things to see if they really work, we do something called a double-blind randomized study, randomized control, double-blind study, what does that mean?

First of all, you don't want to have a Selection Bias where people volunteer for the treatment because chances are that if they volunteer, they will be excited that it will work better, so you have to randomize the population. so that it works with anyone, not just this specific set of population. First of all, you randomize it and then when you control for it, that means you tested it against Placebo, so I'm not just saying, acetaminophen, which is the active ingredient in Tylenol? Does it work to reduce pain? I say how well it works to reduce pain. compared to giving him a pill that looks like Tylenol but isn't Tylenol, that's nothing, it's a sugar pill, then we see if it really works because when I say that final statement, the double blind researchers don't know what the real pill is. of Tylenol that has the active medication and the participants don't know it, so they are both blinded and in the end we open it and see well which group had pain control and we will compare which one really reduced the pain, so if it is Placebo, then we know that Talal doesn't work for that, well we actually know that, but in this scenario I love CU so much that I feel like bias influences everything in our world, so when there is only hard data behind things like that and no. bias no oh I feel that way so I think it's true I love that this is how our medical system or whatever we do the best we can.

I wouldn't say that we don't have prejudices, as we are very aware of all the prejudices that exist and we take into consideration those that exist. even some really interesting prejudices that I've studied and talked about on the channel, like you've heard of people saying uh oh, the 105 year old man is here today to tell us the one secret that has allowed them to live longer. , you know it's actually a bias, there's a name for this, it's called Y survivorship bias and we think that because this person lived to be 105, he must have the key, while all his friends who did the same thing don't. they raised the 105 and that's the vast majority of them so the odds aren't the secret and there's an interesting study that actually tested this using I think they were the Oscar winners have you heard of this?

No, it's very funny, so basically what they proved was that there was a Theory that Oscar's liver, uh, Oscar winners live longer than those who don't win an Oscar and they tested it and it was true that those who won the Oscar Oscars live longer on average than their peers who didn't win an Oscar, so they said oh my God, it's the Oscar effect, look at that, if you win an award you get it, can you guess why that's complete nonsense because What is survival? um I don't know I don't see that like correlation doesn't oh that's a great one okay well no you were going to say correlation doesn't equal causation that's true so the fact that two events happen at the same time does not mean that they cause the other to happen at the same time so often in the summer that we have a There are many more sales of ice cream, because people eat ice cream in the summer.

There are also more shark attacks because people go into the water. So just because there are more shark attacks doesn't mean there are more ice cream sales, but the two are correlated. They don't cause each other to happen, so it's important that we always think about that in medicine, but that's not the answer. Thanks to Liquid Ivy for sponsoring this part of today's episode. We had a debate the other day about which flavor IV liquid was the best. better and you in the comments were saying no, it's this one, no it's this one, but I'm proud to announce that we actually discovered that it's peach, it's actually peach, which I love, it's the best flavor, plus it's sugar-free .

It's really good but I actually like the sugar free grape honestly all the IV liquid flavors are really good if you don't know what IV liquid is it's basically a packet that you pour into 16 or water or however much you want . I want to put in 40 oz actually because I like that it's still pretty strong, but not only do they taste good, they're very hydrating, it gives you three times more electrolytes than the leading sports drink and it's in a small package, very easy to carry. with throw it in your diaper bag, throw it in your purse, hell, throw it in your little Lulu fanny pack, yeah I have, that's what you do.

I see you make I have a liquid IB literally every day and they have eight vitamins and nutrients. They are non-GMO and gluten, dairy and soy free and artificial sweetener free and yes like I said I love the sugar free option but I also like all the other options, it's nice to have an option that has nothing but peach in it. It's the best flavor, that's a fact, just like green grape, they are very convenient delicious flavors and I honestly think they are amazing, especially if you are breastfeeding. I think it keeps my milk supply up so that's why I always add them and what's the quote it's like it's more hydrating than water alone they are very hydrating yeah let's say that's why it's called IV fluid and they're also great if you've Had a crazy weekend yeah my brother told me he said that he'll have friends who will have a crazy night of partying court and then the next day they'll be on an IV fluid.

I've heard they're great at it and the weekends are for going crazy, have a game plan. For Liquid IV Monday, get your bulk sugar-free Liquid IV Hydration Multiplier nationwide at Costco or get 20% off your first order when you visit liquid i.com and use code noplanned at checkout you get 20% off your first order when you buy superior hydration today using the unplanned promo code at liquid i.com can you buy more? Place your order now. Okay and back to the episode. This is a form of survivorship bias called immortality bias because let's think about this rationally, most people who win Oscars don't.

If they don't win them early in life, they usually win them later, so now you have to take into account on average, if let's say they were 40 when they won the Oscar, what about the 40 years of life that everyone lived without win an Oscar? Oscar, yes, once you control for those 40 years of life that both people lived without Oscars and then won their Oscar, was that life span longer than the people who didn't win an Oscar? The answer is no, it's okay. That makes much more sense, it was like a bias in that nature of immortality without taking into account the life they live until the moment we study you.

You mentioned big pharma earlier and I heard from someone once. who said, yeah, big pharma already has the cure for cancer and they're just holding it back for money and I'm really curious what your opinion is on that because like me, I was like, oh, honestly, that seems like something. logical. I know that a great farmer makes a huge amount of money, so is there any truth? Well, let's talk about it in a non-medical way because I think this is the best way to talk about it. I'm going to ask you this and I feel like you're a better example than him in this scenario, if a lot of your friends are gossiping about your friend Becky, if a lot of them know the secret, how long will that secret stay a secret?

It's never right because the more people know a secret, the less likely it is to be a secret, so the idea that the entire pharmaceutical industry, which is thousands, tens of thousands of employees, clings to this secret because to develop a cure against cancer, tens of thousands of workers are needed. this secret, what are the chances of this still being a secret? First of all, it's already on the surface. I'm very skeptical that that's the case and then what did you just say? pharmas after what money, oh my God, they don't want money. If you create a cure for cancer, do you know how much money you will have?

Trillions, billions. So, they are anti-m to make money, they are the most adapted people in the world to keep secrets, like now that we are getting into science. It's conspiracy territory and just forgetting the medical science of all of this is ridiculous um and then when we think about the medical science of all of this, I think about when we solve one problem in healthcare we create another so for example we help people to live longer. than they ever lived before, if we look back 100 years ago, we have extended lifespan due to some very basic things like sanitation with antibiotics, but also some medical advances, treatments of certain types of cancer, eh, viral infections, etc. , so we have done a good job of prolonging life, but now what is happening is that we are having an increase in degenerative neurological diseases because the brain was not meant to live that long, so the more people live the more they develop. degenerative diseases where, because they live so long, there's a whole new crop of diseases that are starting to increase, so in medicine it's always like you solve one problem, you create another, you fix one, that's why hyper-optimization doesn't It works in health when Someone says: I can give you this and it will make your hormones improve a lot.

It's like your hormones have to be fine, not better. If you go to the other extreme of hormones, you're going to have all these negative effects because when you hit them on one side, something shows up on the other, so ideally it's like you keep it in balance, so the idea that if they cure cancer then they will go bankrupt is ridiculous because we will have a lot of other medical problems. conditions that they will have to fix, so for those three reasons I think the whole conspiracy is nonsense, yes, you mentioned the ice bath before and I have been doing an ice bath recently and in fact I did it for a whole week. a whole week.

I did a whole week where I took an ice bath and then worked out and then a couple of days from the days when the damn gym had the sauna dressed. I was very upset, but I did it. I did gym with ice bath. SAA, okay and I'm pretty sure I have ADHD. I haven't been diagnosed. In fact, I am currently being diagnosed by a doctor. Abby, Pat just put her next to her. I have a theory that all people with ADHD don't even get diagnosed because Abby hadn't. I scheduled the appointment for myself. I don't feel well.

I thought it's not really for me, it's for my husband. I'm not forcing you to do this. She asked me to schedule this appointment. I may have ADHD and I can't do it, but the craziest thing is that week I was cold, Jim SAA. I had the best focus I've had in years and I thought, is there something you're talking about, like hormonal balance, is there something to do with? soaking in charcoal exercising SAA that helps your body, you know, fixing whatever's wrong here or helping my ADHD get under control and help me focus because it was just like I thought it was, I was killing it, I was like man, this week is incredible.

Like I feel on top, well, or is it Placebo? We have to unpack here, so first, this is happening to you, it's not something we see with the general population, okay, I'm not going to say why this happened to you. I'm going to recommend this as a form of treatment for ADHD, so as iable it didn't work for you. It seems to have worked and the harms of continuing with it are really small, so I encourage you to keep doing it. yeah, number one, that would be my first take as a doctor, um, number two, exercise, wonderful things, sauna, wonderful things, ice baths, uh, anything you can take, a cold shower, you'd probably get the same benefit and the benefits are really very small, but now maintain a routine where you are doing the same three things every day you are getting a lot of benefits from exercise you are getting a lot of benefits from the sauna by warming up your body having that cycle of things happening to your body is that which helps you maintain some kind of order that helps you with the balance of your mental health is totally reasonable, but again not generalizable to the general public, which is why I think the whole ice bath trend is nonsense .

I think it's nonsense because it promises excessive things that are not true, according to research. is so weak to the things that potentially does number one, number two, we don't know how long those effects actually last, so, for example, you take people who have never taken an ice bath, you put them in the ice bath. ice and you see certain markers in their blood change and you say look how amazing the ice bath is, but those markers will remain a year later if you're still doing it, no one really knows and what I know about the human body is that it really adapts Well, then the profit you will get from that initially will be very different from the profit you will get a year from now.

Oh, I realized that the first time I did an ice bath I was shivering. I couldn't catch my breath, I thought I was going to pass out because I got into my friend's bathtub, which was in my Budd, and it was 90 degrees and frigid and I did it for three whole minutes for your heart because, oh, wait Oh. It can be bad for you, so I mean you're young and healthy, so it's okay, it's a lower risk for you, but it's a big stress on your heart, especially people who do it who are older, like I couldn't feel my fingers after 3 minutes.

It's funny because my boy loves when we take baths and stuff or when I give him a bath, I'll be like cold water and he likes laughter so I stay cool headed and go courting and He starts laughing because my hands are cold after the ice bath. So I told you it was bad for my heart because we were pushing each other in the pool and I was like I literally couldn't catch my breath. and I already have a very fast heart rate. I thought you'd probably send me over 200 just by pushing me in the pool.

We made this Tik Tok train that we liked, we asked each other questions and we pushed each other in the pool, but that's it. the pool was 50°, it wasn't like it wasn't 32.7 and by the way, all the protocols where it's like you have to spend so many minutes, this temperature exactly is like no, okay, so how about I'm sure I've heard about the Huberman lab and I like these guys who talk like Joe Rogan has been promoting ice baths, so you think where they get all this research from. So I think you understand that they are very excited about the preliminary investigation. and its function in a field that is not the field in which I work.

I see patients who have real world problems, they can't spend $5,000 on an ice bath from 10x Health like these aren't realistic situations and they also have serious problems. they have incredibly high blood pressure they have incredibly high cholesterol they have diabetes numbers incredibly high blood sugar levels um they don't exercise they're sedentary so talking to them about ice baths is frankly a waste of their time that doesn't do them any good. please because actually biolane Lane Norton said this very well on my podcast the other day, if you're trying to lift as much weight as possible in the form of boulders, would you try to pick up a large rock and then drop it to pick up small pebbles, No? take the biggest rock, that's the biggest effect, so think about all those things we discussed earlier, your 150 minutes of exercise, diet, sleep, mental health, that's already a heavy rock to carry, there's a lot things to do and then maybe. you'll throw the little pebble from the ice bath, maybe you'll throw the pebble from the sauna, but at the end of the day they're pebbles, so when people put so much emphasis on pebbles, let's be real about what it is. is happening and what additional benefit are you giving people because they feel disconnected from how well we are promoting it and, frankly, I think the huge popularity of cold immersions came from cryotherapy centers, when people used to do cryo, remember that thing was actually hot for a while and then they realized that it was making people too cold, it was actually creating some damage to people because they were too cold and it was also very expensive to maintain and they said wow! , we can obtain many of the same benefits. putting people in a bathtub and selling them the bathtub, so they started doing that, but just taking a cold shower like that's what the cold shower is not going to do the same with the trips that we've been doing.

I've been taking cold showers like here in New York and then at home in St Louis and the water isn't that cold in Phoenix where we live, but when I'm in New York or at home the water is freezing like it takes my breath away. when it goes up to my head because my head doesn't sink when I soak in cold water but when I'm in the shower it goes up to my head it's unreal I feel like this is like 33 degree water right now I'm about from It feels like it's okay, I didn't expect that.

I thought you were going to say there are so many health benefits that everyone should Cal plug no, that's ridiculous. It's OK? Why Sana? Why is the SAA different? Are there more investigations behind the SAA? Well, let me, before I leave the cold punch, just tell you something interesting, you know, people, if they have a fever, they say, "Oh, go to a cold bath, that'll do something you don't need to go to." Get in a cold bath to lower your temperature, just go to a room temperature bath because what's the room temperature colder than your body temperature?

That's why, once again, people are just cool, like going into ice water. The poor boy goes into shock again and again. He would even recommend going into a bathtub to lower the temperature. That's not really necessary. We also have a lot of fever phobia as a society, which is also a little strange because there are benefits to fever. I'm really scared. fevers actually what my K has a fever I am terrified what is the benefit of having a fever in a very young child that is a different story but as a healthy adult if you are sick with a virus and your temperature rises to 100 10 101 and no you have other medical conditions, it's your body fighting the infection and by lowering the fever you're actually weakening your body's ability to fight the infection where we've actually seen the research that when you allow the fever to be the infection goes away sooner, you have symptoms for a shorter period of time, you are infectious, which means you are contagious to other people for a shorter period of time in the past, before we had antibiotics, we used to discover that you could treat syphilis by giving them to people. malaria because we had a cure for malaria and we raised their fever very high with the malaria that would solve their malaria infection.uh, spending more time with the baby, that's sweet and you know, people are quick to say 2020 Vision Monday Morning Quarterback, oh well, that's so the father is less aggressive and seeks less sex. elsewhere and focus on child care and that's a beautiful theory and it's an early theory, but it's not 100% proven yet, so it's important that we take all of these studies with a grain of salt, but it makes sense, yeah, yeah, that makes sense.

Because I have been much more emotional. I like it. I don't know when I see the little ones. Now I notice little kids, like when I'm in public and I'm like, oh, he's such a cute kid like you've never seen him before. kids before I didn't notice them before, but now I do because I'm very aware of my kids and I love them so much, so it's crazy, because I definitely felt a change in me too, so it's funny that you're saying that oh dad also experienced some kind of change, it's a unique situation for sure and what I think is great because it highlights how our experiences can shape our hormones and our neurotransmitters and why I think that's important because people talk about it, well, depression is a neurotransmitter disease or mental health is a neurotransmitter disease so you need to take medication and while there are definitely reasons why you may need to take medication, simply doing therapy will change your neurotransmitters in the same way as experiencing a The birth of the baby will change your hormones, so when people say "Oh, therapy won't help me, it won't solve my chemical problem, this may be something that happens with our experiences and things outside of just the medications, the medications they are not the only ones". a way to change our biology, that's really cool, are there benefits for you?

Know? I know some people may have a small group or community of friends that they hang out with, um, that might not be therapy, are there benefits to that too? Sure, just like having a strong community, it probably provides similar benefits to therapy. The number one factor for success and recovery from a mental health diagnosis is a good support system, so I make it a habit when I talk to patients who are going through something. social support if there is a crisis situation where you are very worried that you might do something bad who are you going to call what is the phone number how are you going to contact them is a friend is a family member is a health specialist mental health is a hotline and we create that crisis plan in case those feelings arise, so the social support system is incredibly important, not even in mental health, it's really widespread, like going to a doctor's office to bring a partner who can also listen to the information will go a long way toward better health outcomes, like single mothers.

Part of the reason we speculate that they do worse is that there is no one person to advocate for them, we even see this bias. We used to say that a mother and a father are of utmost importance in having a child. For the child to have the best development, well, it's not even just the mother and the father, it's having two people and it's the presence of power. dividing the tasks about being able to work while the other takes care of the child while one has mental difficulties the other can help cope with the defense it is the presence of two that really helps it is not just about mother and father I can't believe how they are single parents Do it So now that I've been a parent, it doesn't make sense and I can see why that is.

I can see where things could go wrong. It's very difficult to even have the two of us and now, fortunately, we have more support. more family when we had our first child, we didn't have any family around, but it's amazing to me that there are people who raise a child by themselves, yeah, well that's why we were talking about survivorship bias, you'll hear it. People in the community like Hustle look I hustle and that's why I'm successful that's the reason and it seems hustle and being prepared is important because luck favors the prepared which means if you're lucky and you are ready, you will go. to get a better benefit, but the fact that you had social support is really a form of luck, the fact that the pregnancy happened the way it did is also a form of luck, the fact that your genetics are As it is, to a large extent you are being healthy and having healthy children is a form of luck, so we have to remember, when we make all these statements from positions of authority, that there is a huge component of luck and then there are things that are under our control and we should focus as much as possible.as much as we can on the things we can control and then be very grateful for the luck we have had.

It's like that statement: if you want to go fast, go alone, if you want to go far, go together. Yeah, that's true too, so yeah. The community is really great and it's also crazy, in my experience it was harder when it was just Abby and I with our first because we didn't have the support, we didn't have family around us, um, we're also thinking. We figured out how to be parents, we had no idea what we were doing and now at two under two years old, we have a family, we have a lot more support and we also knew what to expect, so to some extent I will say that every baby I thought we would be much more prepared in certain ways, like our second baby just doesn't like breastfeeding and I thought we knew how to do this?

I thought everything was fine, but he just likes they have their own individual personalities that make things more difficult, but yeah, thanks to curology for sponsoring this part of today's episode. He used to have severe acne and was very insecure about it. I look back at today's photos and wonder how. Did my acne get that bad? Remember when I had that huge pimple and I like to Photoshop it out of photos with me and you because it was so big. It hurted me? It hurted me? It was in the middle of your eyebrows and it just came out. sick of it on our dating anniversary with one eye, I was so frustrated with the acne I had and I was finally talking to people about it at the acting program freshman year of college and this girl was like, hey Matt , you should try curology and I had never done it.

I had heard of it before but I went ahead and got it anyway because I was so desperate to try to treat my acne and man am I glad I did because I saw results in the first month or two I would say and to boot. Not only is a dermatologist very expensive and especially overwhelming, like when we were in college the likelihood of us contacting a dermatologist was very low, but with curology they connect you with a dermatology provider that you can message and ask questions. about, hey, what kind of facial cleanser should I use, hey, what kind of moisturizer should I use and you can send them the list of skin care products that you are currently using and they can let you know if you can use them on your skin. or not, simply fill out a questionnaire about your skin, share photos, and a provider will prescribe a custom formula based on your skin's unique needs.

Products are shipped directly to your door every two months. Curists' personalized recipes are formulated to treat your individual acne needs. For early signs of aging, they use a combination of three clinically researched ingredients, making them more effective than over-the-counter cleansers and moisturizers alone. Curology products give you everything you need and nothing you don't, fragrance and paraben free, for a limited time. get your first curology skincare box for just $5 when you visit curology.com unplanned go to curology.com unplanned for this free offer which is curology c r o l o gy.com unplanned trial is 30 days and applies only to your first box subject to inquiry only for new subscribers Back to the episode, well, I guess part of it is that we also liked it this time last year, when we found out that we were in for a surprise, I think that really made the things were stressful, so I'm sure that plays a role too. we're like wow, it's like our life is I feel like we're back it feels good to be pregnant we made it out of the dark place woohoo yeah well celebrating those victories together helps a lot to make you guys feel closer because it's so easy and this It happens to couples quite often, after having a baby, whether it's your first or second, sex decreases because many hormones, like oxytocin, the hug hormone you used to get from each other, end up coming between you. . and being the caregiver, oh that's interesting so it's very important that you reset it and sometimes you have to force it to reset it which means maybe you're not in the mood right now but then it starts with a massage on the feet and power.

Contact like that will go a long way toward resetting things because you have to force it, it's almost like faking it until you make it, and that's true for motives too. Many people think that they have to be motivated to do something like, for example. go to the gym and then they will have the action, but actually you have to do the action and then you will get the reward and then the motivation will follow, so again you are pretending, you go to the gym when you don't want to and then you will enjoy it and you will start to love it and then You will stand up for him and get your friends to stand up for him too, but unless you take the first step to do so.

When you don't want to, the motivation usually doesn't come, it's crazy. I mean, I don't know the numbers that come to mind, but it's crazy, like yeah, like libido is affected by childbirth and postpartum, and yeah, not only. for one person it's for both couples and I guess could you talk more about that? I guess how couples can like to try to get their sex life back on track when there are so many major changes, with all that, yes, first it is. uh from my doctor's point of view, I want to make sure there's nothing medical that's causing that to be a problem so you know you want to get checked out and make sure everything's okay in that regard.

The second is when you think about faking it until you make it, you have to be intentional with this and intentional doesn't just mean the touch and the things we discussed before, but also scheduling the time and it's very difficult to schedule the time. I know you've both talked openly about this, but schedule something. As simple as an hour where you have your own time will go a long way in making you feel free and that is why you will often hear this, even from couples without children, that sex on vacation is different from sex at home, because it's new.

It's free, you don't have the responsibility, the phone doesn't exist, so you have to fake that vacation, even if you can go on vacation, give yourself a certain time and when you do, you will increase the chances naturally. It's happening, but you have to be intentional about it, it's funny you say that because I can't, I can't even count the number of times we've gone, you know, have some time alone and immediately. as soon as you take off your clothes you hear on the baby monitor it's like being a movie yeah it doesn't make sense it's like they know it's like they're reading our mind they say why are you taking my oxytocin exactly me I want it exactly no it's Like they know it somehow and I'm like that and I don't believe in it, I don't think my son knows it, but it happened so many times, it's like they have to read my mind like they have to.

You have kind of a sixth sense about this because it literally didn't make any sense and then like, who wants to do it when you hear your baby crying all the time? Then obviously you can't, so you go. to help the child and then yes, that's how I feel about people who sleep with their children. I wonder how that works in the world. I didn't understand that we haven't even talked about sleeping together. So, because we never really did that with our kids. I mean, there were times when I fell asleep with my son on my chest.

I don't like tossing and turning when I sleep at all, but that would just be like early in the morning, if I'm so tired that you just woke me up, I need an extra 30 minute nap, but I think there's been talk about sleeping on the coast. I know I'm kind of throwing that at you right now. but I guess what people should keep in mind when it comes to co-sleeping with their newborn. Yeah, the data when I came out of my medical education really revolved around a condition called SIDS, which is sudden infant death syndrome, and co-sleeping increases the risk of that because what happens when you're going through a pregnancy, whether it's alone or with a partner, you're tired, you're fatigued, you might be sleeping at odd hours, that's when you're most likely to have Twitch.

That's when you're most likely to sleep as deeply because you're so exhausted and you can cut off the baby's ability to breathe and that could be fatal in some cases and getting back to the topic of sex as well. I'm curious. a number that as couples you should do per week, 47 is generally what I recommend. Well I've seen items like the perfect amount and I like to dothis so I don't know because I also read articles like oh it's possible. doing it too much and then I didn't know if there was a set like this is the natural guideline that I want because then medicine would be much easier.

It could be oh well, you're not living up to your seven times this week, what? is happening, that's really funny, yeah, that makes sense, although it's not even just about individuals, couples are different, yeah, and sex for one couple is different than sex for another couple, so there's as much diversity as be a doctor who has cared for and treated tens of thousands of patients, probably 10,000 patients, um, you've seen such a wide variety of humans and what humans enjoy and how humans interact with each other, how they view their health, how they view the healthcare system. health care that you' I want to speak with certainty here it's like the only thing I can be sure of is that there are a lot more things I don't know than I really know, although it seems like I'm answering all your questions, but usually just I am responding. your questions with more questions, I'm actually very impressed because I don't know how you keep all that information in your brain, like me, if you just go to your computer at home and we look up research today and I just read it for fun, well, a lot of times I follow on social networks the main guideline organizations.

For me, I'm a family medicine provider, which means I do obstetrics. I don't practice it now because my schedule doesn't. I don't allow it, but during my training I gave birth to more than 30 babies. Gynecology. I still practice, so I like pap smears and preventive care. Things like that are great, but I also see kids as young as newborns coming in for certain weight checks or things like. So, uh, up to 1 year old, that's the beauty of what I do, but we also have this organization called the American Academy of Family Physicians that puts out statements.

The American College of Obstetrics and Gynecology (ACOG) publishes great guidelines and then the one that I follow the most is called the United States Preventive Services Task Force. They publish guidelines for screening tests about which ones show benefit versus which ones we shouldn't do or there isn't enough evidence to recommend them because screening tests are important if we can get them. anticipating a problem, preventing it, that's great, but we also have to be honest: many times we can't do it perfectly yet, so we shouldn't rush to start testing people for every condition because we may not have a good answer. and clear.

You are very passionate about all this, which made you decide that you wanted to be a doctor. I think it was early exposure to the field so I came to the United States when I was six years old from Russia my father was a doctor in Russia but then he had to redo his medical education here um I was 40 years old in a new language um and you had I had to go through the whole residency process in medical school, so it was very difficult, but I was also of age now that you know, I was 9 or 10 years old.

I'm watching my dad do it, compared to most kids who are very young when their parents are going through the education system, so they don't see it, so I watched it. He was very curious and excited. My dad actually said, “Maybe you should.” I don't do this because there are a lot of problems with the healthcare system plaguing us right now and I think it's going to get worse. He was right, but I fell in love with it and thought it was a perfect combination of something I was passionate about. I was talented in terms of communicating with patients and I wanted to learn about the body's ability to hold information and I think when you combine passion with ability that's when you get the best results for your career.

I'm curious what your vices are because you know, you know everything the research says, you know what's good for you, but I'm curious if you smoke a sixpack here or there. I know I'm wondering: is there something about you? It's like, I know research is, but I'm still doing this. Oh, that's interesting, so first of all I have to say that doctors are the biggest hypocrites on the planet, just because we know that the evidence about something doesn't mean we follow it and also if I tell my patient the evidence. I don't expect him to make changes.

I just want you to be aware of the risks. That's really my goal, so just because I'm aware of the risks doesn't mean I don't do the things I think the worst thing is the fact that I'm a professional boxer now. That's how it is. I saw that you fought with someone. That's really cool. I have two boxing fights. Do you have any more nearby at the moment? I'm trying to schedule one, yes. I fought on the Showtime PPV, that's ridiculous as a professional, don't you do it against the guy with 20+ fights? He's a UFC fighter and unfortunately I lost on the doctor's scorecards, but it's not something I would recommend to patients because head. injuries and all that is terrible, but you know, you did it.

I know what the risks are and I accept them and do not recommend it to the public. What I'm saying is take boxing in class, hit the bag, work with the trainer, that's super healthy, but don't become a professional fighter, yeah, it's probably the head trauma. I mean, I think about Mike Tyson and since he's probably been punched in the face, I can't even. count how many times exactly, so I don't recommend that, have you felt that I do? Some side effects of boxing, getting punched in the face when I was on intense training days, headaches, sure, oh it's a thing and I hate them so I try. and limit full contact sparring, um, but you have to do it if you want to be a professional.

I mean, it seems like we as humans all take calculated risks when we drive, there's a risk when we cross the street, there's a risk, um, people who rock solo. upload I don't know if you saw the movie with uh Alex freeo yes just free I saw the one where the boy died at the end it was so sad oh I didn't see that era there is another one oh I'm about to say Different movie, yes, but I see that everyone accepts the risks as if they are aware that these things can happen, but they want to push the boundaries because you only have one life and you make decisions with it, as long as you are the one making the decision. we have complete autonomy of the body and that is one of the fundamental principles of healthcare: being a doctor, the patient has autonomy and you do no harm first, so I never recommend an intervention unless I am sure that it will not cause more harm than good.

Then, once I recommend it, I allow the patient to have the autonomy to decide what he really wants and what he hopes to achieve with boxing. It's like a childhood dream, that you had to be a professional boxer. I almost always wanted it. being a professional athlete and it's actually a sad story, probably a disappointment for this conversation, but when I was in medical school I lost my mother to cancer and that was a difficult part of my journey, but I think it shaped me to be a better doctor to be more empathetic with my patients because having to tell doctors to stop doing chess compressions on your mother when you're 20 or 21 is not easy and I think I'm a better doctor as a result, but then From that I was in a dark place I went back to live with my dad traveling two hours a day to go to school because I no longer live near the school and I said I had to do something to get out of this bad time and do the action instead to wait.

The motivation was right to fake it, so I faked it and got a group for a boxing class and went to this boxing class. I started boxing as a hobby and then I had my first fight against a YouTuber in front of 10,000 people in the audience, hundreds of thousands won at home. who gave that money to the Ukrainian cut War Conflict they paid me for that fight then I got an offer to fight on Showtime's pay-per-view under Jake Paul Anderson Silva on their undercard. I was paid $125,000 for what he donated to the Harlem Boys and Girls Club, a lot of things have come out of this unique journey and I feel like I'm very lucky to have had this opportunity.

I'm going to take advantage of this luck as much as I can and it's a really cool experience because it also makes me a better doctor, like when they come and talk about a musculoskeletal injury, whereas before I was like, "Oh, it's okay, it's no big deal." ". but if it stops them from doing something they love, I know how much it means to them so I'm a lot more empathetic in that sense, it's cool that you're also very focused on philanthropy because that's how I found you, I think it was a video of Ryan Trean where I think you donated to feed America, yeah, we gave $100,000, yeah, and so I know you also donated to, you said, Harlem Boys and Girls Club, and then also to Ukraine.

It's very, very cool that you are very focused on philanthropy. Have you always been like this? As a child, did you always just want to give back? In 2015, when I had my little viral moment of fame, the first thing I saw. What I did was how can I do something positive with this? I launched My Own Foundation called Limitless tomorrow, as I did all the paperwork myself. I filed it as a 501c3. We have awarded some amazing scholarships to people not only to go to school, but also to We also donated a lot of money that we raised through fundraising efforts towards the creation of a medical tool for those who have ear deformities. and the nose, either due to trauma or because they were born with them, and this tool greatly simplified the surgical process so that this surgery can be performed in other countries where they do not have specialized techniques, um, and that was only possible with the help of social media and even our patreon, like some people have patreons where they collect money from their fans, we have a patreon where if you pay $9.95 or whatever to be a member, that money every month is donated wherever the viewers choose, so that we have a live stream, they nominate three charities, we talk about them and then everyone votes and we see where the money goes each month. and I think with everything we've been doing, we've already donated like seven figures, so it's really exciting to be able to do that, yeah, that's really cool, that's a lot of fun.

I want to continue doing more of that. with our channel, so I'm really inspired by you and other people like Ryan who have found ways to do it. I know, but I love CU. I love being an entertainer. I love creating entertainment but it's great when you can like to entertain and do good at the same time you had a fight entertaining you made all this money for charity I love that it's like a double whammy it's the perfect combination very inspired by you um thank you for doing the trip today to be on the podcast and yeah, I learned a lot today so I really appreciate you coming out.

I'm glad I always like it when people are excited to learn, thank you for being as committed as you are because sometimes you keep going. conversations and people say: what do they do? It's exciting that people are excited. I learned a lot, yes, I learned so much that my brain is about to explode, so you guys haven't seen Dr. Mike, he has his own podcast, the checkup, right? in addition to his main YouTube channel, you guys can find him on YouTube as well as Instagram and many other places um and yeah, thank you for doing what you do and thank you especially for the philanthropy that you love, that of course is amazing and uh , guys, they will give you my number later, can you uh, any medical questions, I'm all yours, thank you very much, call AB, I was saying that she was like he was married because, like whoever marries him, like you, I feel like To stop somebody. someone you're married to might say, oh, the kid has this problem, yeah, like that, I think especially with kids, I'm always tempted to text them or the doctor to really bother them, but if they were at your house hey , you've got good looks, you've got the credentials like, let's clean this guy up, yeah please, but my brother just had a baby and technically he's not my brother, but he had a baby and they're constantly calling.

Me and they ask me what we do in this situation and most of the time it's just me giving them peace of mind and things to keep in mind that would worry me, so a lot of what it is to be a doctor is beneficial in triage . aspect of when it's serious, when we should go or where we should go, should we go to the urgent care primary care emergency room, that kind of guidance really helps and I feel like it's easy enough that I can take some time to my day to help. Yeah, well, Dr.

Mike, thank you very much, we'll let him catch you. I think he has another podcast to record, so thank you very much and as always, we say peace here 3, two, one, peace, friends.