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Speaker 1: Welcome to Stuff Mom Never Told You from how Stop

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Speaker 1: Works dot Com. Hello, and welcome to the podcast. I'm

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Speaker 1: Kristin and I'm Caroline and Caroline. Today, let's tackle a

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Speaker 1: question that has crossed the mind's probably every menstruating woman.

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Speaker 1: What is that tampon's tampons and whether or not tampons

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Speaker 1: caused toxic shock syndrome? And what is toxic shock syndrome? Anyway,

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Speaker 1: this is a basic question that we really have not

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Speaker 1: addressed in the eight thousand episodes of Stuff Mom Never

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Speaker 1: Told You. We have done, even though we've talked about

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Speaker 1: tampons and plenty of times, we've talked about menstruation plenty

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Speaker 1: of times, but toxic shock syndrome, as a listener kindly

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Speaker 1: pointed out, is something that we have not directly addressed.

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Speaker 1: And I remember when I was a young lass and

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Speaker 1: I found a box of my sister's tampons, and you

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Speaker 1: know that that sheet that they have inside, Yes, the

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Speaker 1: answer to the insert with the diagram of the female

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Speaker 1: pelvis and how you put a tampon in, and then

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Speaker 1: in bold letters you see toxic shock syndrome. And in

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Speaker 1: my mind, I thought these are very dangerous. Why would

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Speaker 1: women do this to themselves. I was scared. Well, I

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Speaker 1: remember reading the insert because my you know, I've said

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Speaker 1: before in the podcast that my mother never had a

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Speaker 1: sex talk with me and that I was just kind

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Speaker 1: of left to my own devices slash romance novels to

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Speaker 1: figure things out. And it was the same thing with tampons,

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Speaker 1: like she handed me a box and or she bought

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Speaker 1: me a box, and I think left it strategically on

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Speaker 1: my bathroom counter. And so I followed the diagram to

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Speaker 1: a T down to like Chris, and I laid down

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Speaker 1: on the floor to insert my first tampon. I was like,

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Speaker 1: so scared. I was like, how do I It's it's

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Speaker 1: pointing strange. I'm pretty sure I did that as well.

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Speaker 1: But yeah, I I read the insert and I read

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Speaker 1: the thing about toxic shock syndrome, and I was like, Holly, Molly,

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Speaker 1: what is this. I'm gonna die if I put in

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Speaker 1: too many tampons. But I mean I think because of that,

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Speaker 1: I changed my tampon like way more than necessary every

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Speaker 1: thirty minute. Yeah, yeah, I don't. The thing about the

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Speaker 1: the insert is that you come away knowing that something

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Speaker 1: terrifying called toxic shock syndrome exists. And that you could

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Speaker 1: potentially die from it, but it doesn't really tell you

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Speaker 1: what your chances are and what it is. So before

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Speaker 1: we get into toxic shock syndrome, let's go over very

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Speaker 1: briefly when we started using tampons to begin with, because

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Speaker 1: obviously administruation is not a new thing, and we've been

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Speaker 1: improvising up until the nineteen thirties when tampons became mass marketed.

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Speaker 1: But before tampons, Caroline, what kind of stuff were women

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Speaker 1: using during men's struation? Just any old thing like what

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Speaker 1: like what Egyptians Kristen in the fifteenth century BC. Well,

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Speaker 1: they used softened papyrus, so you'd write a note to

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Speaker 1: your friend and then after after she read it, you

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Speaker 1: just you just slug up that keep it there um.

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Speaker 1: In Rome they used wool. Japan they had paper held

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Speaker 1: in place by a bandage, which the name for that

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Speaker 1: bandage was the Japanese word for pony id. Just like

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Speaker 1: to point out, I like that and you would change

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Speaker 1: it ten to twelve times a day. I mean, how

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Speaker 1: do you have time for anything else? But anyway, Indonesia

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Speaker 1: they use vegetable fibers. In Equatorial Africa, rolls of grass,

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Speaker 1: Hawaii people would use a furry part of a native

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Speaker 1: fern called the hapoo, and other grasses, mosses and plants

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Speaker 1: all throughout Asia and Africa. Yeah, and in the US,

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Speaker 1: as more revealing clothing styles came into vogue, Uh, it

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Speaker 1: spurred the need for internal period absorbers. When I'm talking

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Speaker 1: about tampons, because when you were wearing bustles and lots

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Speaker 1: of quinoline and such, uh, you could get away with

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Speaker 1: wearing a pat all the time. But then once the

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Speaker 1: silhouette became more close cut to the female body than you, uh,

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Speaker 1: the need for the for tampons increased. And fun tadbit

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Speaker 1: that I did not know about was that after World

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Speaker 1: War One there was greater interest put in developing tampons

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Speaker 1: because there was this highly absorbent surgical dressing called sell

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Speaker 1: you Cotton that needed a new market after the war ended,

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Speaker 1: and what can you make with absorbent surgical dressing? T

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Speaker 1: And there's been a lot of technolog technological development around tampons.

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Speaker 1: Dr Earl Hass was the first to develop an applicator,

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Speaker 1: a little cardboard applicator, because his wife was having so

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Speaker 1: many problems with the bulky pads and adult diaper type things. Yeah,

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Speaker 1: and the idea came to hass after he talked to

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Speaker 1: a friend of his in California who used a vaginal

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Speaker 1: sponge for her periods. Um. Yeah, has actually sold the

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Speaker 1: patent to Gertrude Tendrick, a German immigrant who became tam

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Speaker 1: PACs is first president. She made the tam PACs on

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Speaker 1: her sewing machine at home. Yeah, has said a little

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Speaker 1: bit of a sad story because he had his patent,

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Speaker 1: he couldn't really do anything with it. And then savvy

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Speaker 1: Gertrude comes along, buys it up forty two dollars and

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Speaker 1: builds the tamp PACs empire. And it was really in

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Speaker 1: the mid to late n Thanks to Tampacs with that applicator,

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Speaker 1: the tampons started to become more readily available and more

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Speaker 1: widely used, and everything was all fine, well and good

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Speaker 1: tampons were just chugging along. Tampacs and other companies are

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Speaker 1: figuring out how to make more absorbent tampons and so

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Speaker 1: you don't have to change the tampons all the time.

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Speaker 1: And then all of a sudden, in the nineteen eighties,

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Speaker 1: a lot of stuff goes awry. Yeah, all of these

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Speaker 1: lawsuits started cropping up because toxic shock syndrome emerge. Yeah.

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Speaker 1: Toxic shock syndrome was first officially identified in nineteen seventy

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Speaker 1: eight in a study, but it wasn't the kind that

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Speaker 1: we would think of as related to to tampons. It

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Speaker 1: appeared in seven kids between eight and seventeen years old.

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Speaker 1: The study was published in the Lancet Journal, and in

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Speaker 1: nineteen eighty the Centers for Disease Control and Prevention began

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Speaker 1: investigating some follow up reports of fifty five toxic shock

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Speaker 1: syndrome cases and they noticed a pattern among the women

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Speaker 1: because of that group was female, and of those of

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Speaker 1: women who came in with t s s, we're on

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Speaker 1: their period. Yeah. A CDC and u C. Berkeley report

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Speaker 1: from n talks about this time and says that toxic

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Speaker 1: shock syndrome emerged as a result of changes in industry

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Speaker 1: and personal behavior, but responded to rapid public health action,

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Speaker 1: including active surveillance. So all of a sudden, these people, men, women, children,

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Speaker 1: menstruating women, non menstruating women, women who used tampons, women

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Speaker 1: who didn't use tampons. People were all of a sudden

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Speaker 1: having this disease, this problem, and so people, researchers doctors

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Speaker 1: responded pretty pretty quickly to the outbreak. Yeah, and the

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Speaker 1: CDC investigation in some additional case studies implicated rely p

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Speaker 1: are brand of super absorbent tampons, and in September of

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Speaker 1: nine eight, rely pr Is pulled off the market voluntarily

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Speaker 1: because of this t s S problem. And the thing

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Speaker 1: in the tampons that the CDC suspected was causing the

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Speaker 1: problems was a polyester foam that was cross linked with

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Speaker 1: another synthetic fiber, and it's a combination that's no longer

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Speaker 1: used in tampons and in polyakrelate containing tampons were also

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Speaker 1: withdrawn from the market because of concerns over toxic shock syndrome.

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Speaker 1: And we should highlight yet again that those rely pair

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Speaker 1: tampons were the super absorbent kind uh and women may

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Speaker 1: have been leaving them in longer and and as a

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Speaker 1: result of this tampon tampon gate n eight, there was

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Speaker 1: a flurry of media reports about the dangers of tampons

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Speaker 1: because doctors still weren't entirely sure and really still aren't

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Speaker 1: today what the connection between tampons and toxic shock syndrome was.

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Speaker 1: They knew it had something to do with a super absorbancy,

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Speaker 1: perhaps women leaving them in their vaginal canals longer, and

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Speaker 1: also those synthetic fibers. But for instance, the New York

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Speaker 1: Times called it a baffling disease that was thought to

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Speaker 1: be linked to the reversal of blood flow, and in

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Speaker 1: November of nineteen eighty, the Times also reported toxic shock

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Speaker 1: amongst six hundred and fifty two people with sixty three fatalities.

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Speaker 1: But we should point out around this time that after

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Speaker 1: the Rely brand tampons were pulled, TSS cases continued to

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Speaker 1: be reported, so it wasn't like it was just Rely

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Speaker 1: or just super absorbent tampons. Up to sixteen percent of

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Speaker 1: the reported cases after the fact after Rely pulled its tampons,

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Speaker 1: up to sixteen percent of these cases we're in children, men,

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Speaker 1: and non menstruating women, and usually were associated the localized

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Speaker 1: staff infection, so it's not just like you know, leaving

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Speaker 1: a tampon in too long. There are also links to surgery,

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Speaker 1: especially like transplant type surgeries, but the legacy, the public

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Speaker 1: legacy of toxic shock syndrome isn't something about what happens

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Speaker 1: perhaps on the operating table, but more so continually linked

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Speaker 1: to tampon's kind of the same way that intra uterine

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Speaker 1: devices still battle a negative reputation that they got in

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Speaker 1: the seventies and eighties when one particular brand had a

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Speaker 1: negative impact on I forget what the specific uh side

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Speaker 1: effect was for women um. And in two for instance,

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Speaker 1: the first federal jury award of nineteen thousand dollars was

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Speaker 1: doled out to a woman who contracted TSSUM after using

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Speaker 1: plate Tex brand tampons. And there were more than four

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Speaker 1: d other victims of toxic shock who filed suit against

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Speaker 1: Procter and Gamble, which were the makers of the rely

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Speaker 1: pr campons. And I mean around this time, it was

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Speaker 1: sort of a cycle because all right, so people, men, women,

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Speaker 1: children start contracting this disease somehow, this this crazy disease

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Speaker 1: that has all of these scary symptoms, uh, and that

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Speaker 1: was fatal some of the time. So the media starts

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Speaker 1: reporting on it. Tampons are an interesting angle. The more

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Speaker 1: the media reports on it, the more cases are reported.

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Speaker 1: So it's the cycle of like, oh my goodness, so

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Speaker 1: you you do have to ask, and researchers did ask, like, uh,

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Speaker 1: is this a case of their being more or is

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Speaker 1: this a case of the reporting just kind of crystallizing

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Speaker 1: and coming together and realizing, Okay, what we may be

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Speaker 1: thought was something else is actually toxic toxic shock syndrome.

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Speaker 1: So they looked at the death rate, the fatality rate

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Speaker 1: of this disease, and it does, it does ramp up.

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Speaker 1: Eighty eight deaths were known who have occurred in nineteen

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Speaker 1: eighty two, which was the time of the Institute of

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Speaker 1: Medicine report being written about this. It was the first

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Speaker 1: major report about toxic shock syndrome. They found that before

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Speaker 1: nineteen seventy nine, fifteen people were reported to have died

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Speaker 1: from TSS, thirteen in nineteen seventy nine, forty four in

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Speaker 1: nineteen eighty and fifteen in n one. So there's definitely

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Speaker 1: like a bell curve, but a lot of that has

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Speaker 1: to do with increased awareness. So the increased awareness is

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Speaker 1: a double edged sword. More more cases are being reported,

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Speaker 1: but also more women are aware of how to safely

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Speaker 1: use tampons so and maybe go to their doctor when

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Speaker 1: they noticed symptoms. And it does improve the industry in

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Speaker 1: terms of getting products off the market that turn out

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Speaker 1: to not be so good hanging out inside of your vagina.

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Speaker 1: But one thing we have not addressed yet, Caroline is

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Speaker 1: what is toxic shock syndrome anyway? Yeah, so you know,

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Speaker 1: as much as there was a giant scare in the eighties, uh,

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Speaker 1: and a lot of people were talking about it. TSS

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Speaker 1: is actually a rare bacterial infection that is historically associated

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Speaker 1: with the use of super absorbent tampons and occasionally with

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Speaker 1: the use of contraceptive sponges um. Often it results from

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Speaker 1: toxins produced by wait for it, I'll pronounce it staphylo

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Speaker 1: caucus aureus staff bacteria, but the condition may also be

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Speaker 1: caused by toxins produced by group A strepped a caucus

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Speaker 1: bacteria or strep. So basically, if you have had doctors

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Speaker 1: say that if you have had a previous staph infection

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Speaker 1: or really severe strep infection, you just should not use tampons,

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Speaker 1: like as a general rule, like if you have had

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Speaker 1: a very severe previous infection of this type. And I mean,

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Speaker 1: you know, kids, we've all had strap before, but they're

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Speaker 1: talking about like, if you've had something really severe as

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Speaker 1: an adult, you should probably avoid tampons because of that bacteria.

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Speaker 1: And it's characterized by having a fever, the shock and

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Speaker 1: problems with the functions of several bodily organs, which is

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Speaker 1: why it is so fatal. It can be fatal enough

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Speaker 1: to of cases. And do I need to even go

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Speaker 1: through the symptoms because they're wide ranging and similarly upsetting, well,

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Speaker 1: one of them, one of them. Okay, yeah, this is like,

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Speaker 1: this reads like the worst webin D entry ever. You know,

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Speaker 1: webin D. It's always cancer. But so well, I guess

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Speaker 1: we don't need to go into everything. But one particular

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Speaker 1: sign of TSS is a widespread red rash that looks

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Speaker 1: like a sunburn with skin peeling that occurs one to

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Speaker 1: two weeks after the rash, particularly on the palms of

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Speaker 1: the hands and the bottoms of the feet. And this

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Speaker 1: occurs also you know, there's there's hypotension with a high fever, headaches,

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Speaker 1: So it does affect a large portion of the body. Yeah,

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Speaker 1: and that's why you know it can be challenging to

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Speaker 1: diagnose UM and why you know looking for rash is

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Speaker 1: important because otherwise, you know, you might have symptoms like headache, fever, diarrhea,

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Speaker 1: low blood, sugar, muscle eggs, which could be any number

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Speaker 1: of things. And like you said, if you get to

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Speaker 1: women D, probably cancer of your entire body. Um. But

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Speaker 1: one thing to emphasize is that yes, men can develop

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Speaker 1: it too. We've said it before in about of toxic

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Speaker 1: shock cases. It affects non menstreating women, which includes men, kids,

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Speaker 1: and post menopausal women. Now, as far as prevention, uh,

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Speaker 1: it's some common sense stuff that you should keep in mind.

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Speaker 1: If you use tampons and you know you're a menstuating

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Speaker 1: woman in general, Uh, you need to change your tampons frequently,

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Speaker 1: at least every four to eight hours, and consider using

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Speaker 1: the lowest absorbency tampons. You can't. I always use just regular,

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Speaker 1: non scented because you know, we all, we've all we've

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Speaker 1: talked about scented things in the podcast. To try to

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Speaker 1: alternate pads and tampons and avoid using tampons at all

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Speaker 1: when your flow is very light. And the thing is

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Speaker 1: and I'll rely re emphasize this toxic shock syndrome can recur,

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Speaker 1: so if you've had it before or a prior serious

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Speaker 1: strep or staff infection, just try not to use tampons.

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Speaker 1: And the reason why doctors will urge you to change

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Speaker 1: your tampons regularly is that left in place, they become

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Speaker 1: a breeding ground for bacteria. And with those super absorbent

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Speaker 1: fibers to the tampons might be able to scratch the

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Speaker 1: surface of the vagina, making it possible for bacteria or

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Speaker 1: their toxins to enter the bloodstream. So it can set

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Speaker 1: you up for some some bad stuff going on. But

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Speaker 1: if you're now saying, well, oh, I'm just gonna stop

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Speaker 1: using tampons, no, it's not a thing that you have

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Speaker 1: to stop using tampons. TSS is extremely rare. This shouldn't

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Speaker 1: be some kind of scare tactic, you know, away from

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Speaker 1: tampons um. But one other way, though, if you are

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Speaker 1: worried about toxic shock, menstrual ups might be a good alternative.

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Speaker 1: Go ask Alice that we've started many times over at

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Speaker 1: Columbia University and other sources will confirm that menstrual cups

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Speaker 1: might be one way to lower your risk of that.

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Speaker 1: But again, though, because of the fact that these cases

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Speaker 1: can happen outside of the realm of menstrual products, you know,

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Speaker 1: it's it's not just that that we need to pay

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Speaker 1: attention to. Even though when we think of toxic shock

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Speaker 1: a lot of times, the next thing we think of

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Speaker 1: is tampons and periods. Right, there's also reusable cloth paths,

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Speaker 1: but those don't really necessarily prevent toxic shock syndrome either.

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Speaker 1: It's just that the risk is probably slightly lower than

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Speaker 1: with tampons. Um glad Rags, who are the makers of

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Speaker 1: one type of reasonable cloth pad, say that their product

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Speaker 1: is a safer option because blood is not staying in

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Speaker 1: the vaginal canal where the development of TSS is most

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Speaker 1: likely to occur, while the risk is still minimal. Tampons

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Speaker 1: create more ideal opportunity for the growth of these bacteria

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Speaker 1: and dry out the vaginal canal by observing the vagina's

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Speaker 1: natural moisture, which can lead to minute tears and increase

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Speaker 1: the chance of t SS. Nowadays, though we don't hear

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Speaker 1: as much about toxic shock syndrome, it seems like when

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Speaker 1: we hear about it, it's things like you and I

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Speaker 1: were talking about, like, oh my gosh, you've hit peobody,

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Speaker 1: you started your period, you've started to use tampons, and

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Speaker 1: you just read about it as some weird, abstract, scary,

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Speaker 1: nightmarish thing in an insert and in reality it is

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Speaker 1: a bit of an abstract thing because it has such

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Speaker 1: a low incidence rate. For instance, in two thousand one,

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Speaker 1: according to stats from the CDC, the annual incidents rated

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Speaker 1: TSS was one to two cases per one thousand women

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Speaker 1: from fifteen to forty four years old, but that staff

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Speaker 1: doesn't say whether or not it was tampon related during

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Speaker 1: this time. A less common form, the non menstrual TSS,

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Speaker 1: did stay fairly constant from ninety nine to and like

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Speaker 1: we said, that's often associated with hospitalization and surgical procedures.

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Speaker 1: But what's up with the decline after the eighties? You know,

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Speaker 1: we talked about how you know, there's increased awareness you know,

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Speaker 1: women women uh no to maybe take better care when

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Speaker 1: they're using tampons um The c d C. You see

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Speaker 1: Berkeley report that we sat it earlier from cites the

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Speaker 1: decrease in tampon absorbancy, the standardized labeling required by the

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Speaker 1: US Food and Drug Administration, greater awareness like we said

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Speaker 1: about the disease, and the proliferation of educational materials for women,

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Speaker 1: including those scary tampon package inserts. However, of the minstrual

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Speaker 1: cases of TSS continue to affect women thirteen to nineteen,

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Speaker 1: and age group that maybe needs more education, maybe because

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Speaker 1: TSS has been out of the mainstream news for so long.

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Speaker 1: This younger group of women is more prone to get

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Speaker 1: it because they just haven't been hearing about it. Yeah,

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Speaker 1: and then we need to know about how to what

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Speaker 1: it is and how to prevent it. And not to

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Speaker 1: say that the only way you can prevent it is

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Speaker 1: to would never ever ever wear a tampon, But it's

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Speaker 1: just knowing how to take care of your body, you know.

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Speaker 1: It's it's simply not good for you to leave a

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Speaker 1: tampon in for a really long time. Right. You would

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Speaker 1: change a bandage on your arm frequently, wouldn't you. Yeah,

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Speaker 1: And that's actually one other tip that the Mayo Clinic

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Speaker 1: offers for t SS prevention because any place that you

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Speaker 1: have an open wound like that, you have the opportunity

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Speaker 1: for bacteria to get in there for some kind of

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Speaker 1: staff infection to develop into t s S. So it's

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Speaker 1: more than just tampons, hooray, but it's also tampons. It's

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Speaker 1: also tampons. So to to cal many fears, we can

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Speaker 1: say that t S S, while it does have a

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Speaker 1: scary range of symptoms and candy fatal, is extremely rare,

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Speaker 1: and that tampon technology has certainly improved and if you

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Speaker 1: are not comfortable with tampons. There are plenty of other

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Speaker 1: options out there, such as pads, uh, menstrual cups, reusable pads. Yeah. Maybe.

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Speaker 1: I mean, if if this is something that really worries you,

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Speaker 1: the next time you go talk to your doctor, just

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Speaker 1: ask him or her about it, maybe find out some

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Speaker 1: stats or some opinions or just some suggestions. Absolutely. So

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Speaker 1: I hope that answers and you know, all questions about

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Speaker 1: toxic shock. And remember men, you are not immune as well. Yeah,

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Speaker 1: so there you go, toxic shock, not just tampons. Uh.

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Speaker 1: So I would like to hear from other women, especially um,

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Speaker 1: whether or not they had similar experiences as Caroline and

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Speaker 1: I did with kind of being freaked out about what

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Speaker 1: is this t S S thing? Are these tampons gonna

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Speaker 1: kill me? Yeah? But I mean, hey, I'm I'm twenty nine.

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Speaker 1: I haven't had any problems with tampons. Knock on wood,

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Speaker 1: knocking on wood. Well, then, as your letters, mom, stuff

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Speaker 1: at Discovery dot com is the email address, so you

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Speaker 1: can also hit us up on Facebook and now here's

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Speaker 1: some letters. Well, I wanted to share a heartwarming letter

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Speaker 1: that we got from a vy in response to our

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Speaker 1: podcast from October about peggeria. A V writes the quote

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Speaker 1: you read from I think her name was Hayley was

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Speaker 1: a little girl in England with peggeria. It really rang

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Speaker 1: true with me. She said that if she had three wishes,

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Speaker 1: she would in fact not wish away her progeria. Personally,

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Speaker 1: I have something called Marfan syndrome, which is a genetic mutation,

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Speaker 1: and it affects the physical appearance and can be life

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Speaker 1: threatening in certain cases. I too have been asked would

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Speaker 1: I rather not have this mutation? If I had the choice, yes,

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Speaker 1: I would be better off physically, I'd be healthier, and

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Speaker 1: I would have fewer restrictions. But I would not be

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Speaker 1: the same person. I would not be as sensitive and

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Speaker 1: caring and kind as I am now, and I wouldn't

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Speaker 1: empathize with others in hard situations. So I wouldn't trade

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Speaker 1: my experiences for anything. My disease slash syndrome shaped me

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Speaker 1: into who I am today. I know it sounds a

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Speaker 1: little cliche. Lastly, I firmly believe that any hardship that

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Speaker 1: has put onto you can help you get where you

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Speaker 1: need to be and forces you to grow where otherwise

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Speaker 1: you wouldn't have. It's a little inspiration from Maybe Thank you,

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Speaker 1: and I have an email here from Robert about our

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Speaker 1: Black women at the Oscars episode. He says, near the

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Speaker 1: end of the podcast, I heard you guys mentioned Carrie

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Speaker 1: Washington as the star of the show Scandal. I thought

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Speaker 1: it might have been worth mentioning that one of the

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Speaker 1: show's producers is Shawna Rhymes, who is also the creator

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Speaker 1: of Grey's Anatomy and Private Practice, and Irene Kara, who

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Speaker 1: was the first black woman to win a Non Acting

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Speaker 1: Academy Award in for the Best Song Flash Dance. What

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Speaker 1: a fee then, and he says, keep doing what you're doing. Thanks, Robert,

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Speaker 1: You keep doing what you're doing with with feeling. I

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Speaker 1: wish you'd keep builting out that too, nice lebrato. Yeah,

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Speaker 1: I mean I do sing that song every night before bed. Well,

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Speaker 1: thanks to everyone who's written in to mom Stuff at

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Speaker 1: Discovery dot com. Keep your letters coming. You can also

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Speaker 1: find us on Facebook. I had only urge you to

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00:24:11,200 --> 00:24:13,760
Speaker 1: go over to Facebook if you haven't been there already,

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Speaker 1: and check out all the fun and wacky things that

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00:24:16,440 --> 00:24:19,640
Speaker 1: we were up to, especially our photo projects. That's right,

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00:24:20,040 --> 00:24:22,480
Speaker 1: if you are curious at all as to what Caroline

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00:24:22,520 --> 00:24:27,040
Speaker 1: and I look like in fifties housewife costumes. Well, you

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00:24:27,080 --> 00:24:29,240
Speaker 1: can go to our Facebook, please like us all you're

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Speaker 1: at it, and follow us on Twitter at moms Stuff Podcast.

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Speaker 1: You can also find us on Tumbler. It's stuff Mom

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Speaker 1: Never told You dot tumbler dot com. And if you

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Speaker 1: would like to learn more about how to stay healthy,

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00:24:42,920 --> 00:24:45,480
Speaker 1: you can find it at our website, it's how stuff

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00:24:45,480 --> 00:24:52,639
Speaker 1: works dot com. For more on this and thousands of

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Speaker 1: other topics, does it how stuff works dot com