Speaker 1: Welcome to Bill and Juliana the podcast.
Speaker 2: Hey everyone, welcome to the Bill and Juliana Podcast.
Speaker 1: We are very lucky to have doctor Ruckham, who actually
Speaker 1: is our doctor. You're doctor my doctor. He gave us
Speaker 1: both our colonoscopies. He has over forty years of experience.
Speaker 1: He's done over forty thousand colonoscopies, if you can believe
Speaker 1: that at Northwestern well between Northwestern University of Chicago. That's huge.
Speaker 1: It's currently the head of the department at Northwestern Medical
Speaker 1: Center here in downtown Chicago. Yes, and he's a lovely man,
Speaker 1: great Chicago, and he's a big deal. Yeah, he's a
Speaker 1: big deal here.
Speaker 2: So literally, you guys, everyone in Chicago's like, oh, doctor Ruckham,
Speaker 2: Doctor Ruckham, Like he's like such a big deal. This
Speaker 2: is an important episode because doctor Ruckham did my colonoscopy
Speaker 2: as well as bills and that is actually the reason
Speaker 2: we are doing this podcast. We came up to his
Speaker 2: podcast ideas because I was googling all this stuff in
Speaker 2: the middle of the night about the colon off speaker
Speaker 2: is I could not finish the prep the liquid that
Speaker 2: gross liquid for the life of me. And let's get dirty.
Speaker 1: Let's get our hands, get our hands dirty. Welcome to
Speaker 1: the show, Doctor Ruckham, thank you for having me. I mean,
Speaker 1: as people know, you are just a pillar at Northwestern,
Speaker 1: which is one of the great institutions in Chicago. You've
Speaker 1: done Julianna's kolonoscopy, my colonoscopy, coming right out of the gate.
Speaker 1: Who's got a better colon?
Speaker 2: I knew you were going to ask that.
Speaker 1: I knew he was going to be a very competitive company.
Speaker 2: We are who does be honest?
Speaker 1: Always the woman? Yeah? Okay, smart answer. Speaking of bowels.
Speaker 1: As long as we're on the subject, we were talking
Speaker 1: about this. You know, how often should you make a
Speaker 1: ball movement? Is it twice a day, once a day,
Speaker 1: three times a day?
Speaker 3: Size?
Speaker 1: You know? Shape? Like we're with the internet now, you
Speaker 1: get so much information at your fingertips. You don't know
Speaker 1: what to believe.
Speaker 2: What do you really wander? How often?
Speaker 4: Believe it or not? The definition of normal is three
Speaker 4: times a day to three times a week. That's where
Speaker 4: ninety five percent of people will.
Speaker 1: Be with that.
Speaker 2: That's a huge range.
Speaker 1: That's a huge range.
Speaker 4: But it's important because you don't want to needlessly say, hey,
Speaker 4: I need to go every day. If you go every
Speaker 4: two or even every three days, and you're very comfortable
Speaker 4: and it's regular for you.
Speaker 1: That's your norm. That's fine.
Speaker 4: Interestingly enough, too, the consistency is irrelevant. So if someone
Speaker 4: said I have one watery bowel movement a day or
Speaker 4: I have lumpy stool every other day, and that's their normal.
Speaker 4: If they fit within three a day to three a week,
Speaker 4: it's normal.
Speaker 1: I had a fermented plumb once. I'm sorry what I
Speaker 1: was at a health food store and this guy Khalil
Speaker 1: on SUNLIGHTE so you got to try this fermented plumb
Speaker 1: and it was like a gusher. I mean, I no offense,
Speaker 1: but I was in the bathroom all day. I woke
Speaker 1: up in the middle of the night with abdominal pain
Speaker 1: like it was bad.
Speaker 4: The whole thing with fermentation. There's a lot of very good,
Speaker 4: healthy foods that when we eat them, they are not
Speaker 4: fully digested, and they as we get older and older,
Speaker 4: could be thirty five or forty, but you're older than
Speaker 4: you were when you were twenty. Things that you used
Speaker 4: to digest you may not digest as well. So let
Speaker 4: me give you a few examples. Beans, onions, mushrooms, broccoli, calliflower, spinach, kale, garlic,
Speaker 4: A lot of those foods. You eat them, they go
Speaker 4: in your stomach, they go through twenty feet a small intestine,
Speaker 4: much fee twenty feet where food is digested and absorbed.
Speaker 4: And then if it's not fully digested and it gets
Speaker 4: into your colon, the bacteria in the colon see this
Speaker 4: food and they can literally ferment it. And ferment it
Speaker 4: means they chew it up and they make gases.
Speaker 2: I have a question. It is a question that is
Speaker 2: a mystery to many. It is an incredibly embarrassing question
Speaker 2: for some. I'm going to ask you. I don't know
Speaker 2: if you have the answer to this. You might have
Speaker 2: to get back to us because you've probably never been
Speaker 2: asked this in your entire career. Are you ready?
Speaker 1: I'm ready?
Speaker 2: But I think there are millions of people like myself
Speaker 2: affected by this, Okay, since I was younger. I'll walk
Speaker 2: into like a Barnes and Noble, okay, and all of
Speaker 2: a sudden, within five minutes, I don't know if it's
Speaker 2: the smell of the books, I don't know what I'm like,
Speaker 2: where's the bathroom? I have to like immediately make a
Speaker 2: bee line. And then I found I thought I was
Speaker 2: the only person in the world who had this weird
Speaker 2: thing happened. And then I've seen other people on social
Speaker 2: media talk about this phenomenon and some people it's a target.
Speaker 2: Some people it's like a TJ Max. You know, isn't
Speaker 2: that weird? And what do you think it is?
Speaker 4: So I don't think I can give you an answer.
Speaker 4: That's a vedical that's definitive, but if one was to
Speaker 4: speculate it.
Speaker 1: You know how your mind.
Speaker 4: Holds back impulses and when you feel relaxed, if you're busy,
Speaker 4: you're working, your your mind is doing other things. There
Speaker 4: may be just the natural suppression of needing to go
Speaker 4: to the bathroom.
Speaker 1: Kids try.
Speaker 4: Not that you're even holding it in school, but a
Speaker 4: lot of times kids won't go to the bathroom in school.
Speaker 4: And it's not that they're I mean, some are holding it.
Speaker 4: They have accidents and that's an issue, but many of
Speaker 4: them just don't. Many people, you'll hear this all the time.
Speaker 4: During the work week, they don't go to the bathroom
Speaker 4: as much. Saturday and Sunday, when they're home, they go.
Speaker 4: So it probably has to do with just the relaxation
Speaker 4: that you're feeling and you're not in hip that you're
Speaker 4: in the store and you weren't running and doing errands
Speaker 4: and catching a cab ort and relax, and you're letting
Speaker 4: mother nature take over, which is what it should have done.
Speaker 4: Maybe a little while. That's just my guess. That's great,
Speaker 4: But I don't have a medical for sure. Either that,
Speaker 4: or I would tell some of my constipated people that
Speaker 4: go to by the.
Speaker 2: Way doctor feel free to take them mile. Yeah, if
Speaker 2: I haven't got to the bathroom in a while, I'm like,
Speaker 2: I should just go to the bookstore. I should probably
Speaker 2: just go grab something at home goods. So Doctor Ruckham,
Speaker 2: the literally the impetus for this podcast was my experience
Speaker 2: getting my colonoscopy. You don't know this yet, okay, but
Speaker 2: when I was doing the prep for my colonoscopy, I
Speaker 2: heard all these stories about the liquid. The liquid is
Speaker 2: the worst, The prep is the worst. The colonoscopy itself
Speaker 2: isn't bad, that's what everyone says. It's the prep that
Speaker 2: people get nervous about, as you probably know. And so
Speaker 2: when I was doing the prep, I got all my stuff,
Speaker 2: I went to the pharmacy, picked it up, and the
Speaker 2: first couple of SIPs, I was like this isn't bad?
Speaker 2: Why does everyone complain about this? As the day went on,
Speaker 2: it was still fine, fine, fine, and then kind of
Speaker 2: by the end of the day, I started getting a
Speaker 2: little like exhausted from drinking. It wasn't loving it anymore.
Speaker 2: And then I had to set my alarm in the
Speaker 2: middle of the I to wake up to finish the prep.
Speaker 2: And so in the middle of the night when I
Speaker 2: woke up, I kid you not, I literally I had
Speaker 2: like this much left, and I was like, I physically
Speaker 2: cannot take one more sip of this stuff. Okay, so
Speaker 2: much so, and you don't know this, but so much
Speaker 2: so that I thought I have to cancel my appointment,
Speaker 2: Like I'm gonna have to email his office or call
Speaker 2: the emergency line and be like, hey, I'm not coming
Speaker 2: in because I had an early morning appointment and I
Speaker 2: literally could not finish the prep. So I went online
Speaker 2: and I searched do I have to finish the prep
Speaker 2: before a colonoscopy? And there were a million different reports.
Speaker 2: Couldn't get a straight answer. And then finally it was
Speaker 2: actually on Reddit that I saw a line that said
Speaker 2: I am a colonoscopy nurse of twenty years and dot
Speaker 2: dot dot. So I clicked it, and she said, if
Speaker 2: you're healthy, it's your first colonoscopy, there's no nothing scary
Speaker 2: going on that you know of. Then yes, you could
Speaker 2: leave some of the liquid behind. You don't have to
Speaker 2: take it all. And so that gave me reassurance I
Speaker 2: could go back to bed. I came in the next day,
Speaker 2: and I don't know if you remember, but when I
Speaker 2: came out of the colonoscopy and you guys woke me up.
Speaker 2: You were there, Bill, Yeah, I think I asked you.
Speaker 2: I said, how was I in there? You know, I
Speaker 2: wanted to know, like, was.
Speaker 1: I yeah, well slensed down? Yeah?
Speaker 2: Did I do my job? Because I was curious by
Speaker 2: not having that final bit? Was it still okay?
Speaker 4: That's a common question and people think about it.
Speaker 3: You know.
Speaker 4: Part of the issue is not everyone scheduling a colonoscopy
Speaker 4: has a doctor's appointment where you'd have a chance to
Speaker 4: discuss things.
Speaker 1: Most of them.
Speaker 4: Yes, I turned forty five, I'm getting a procedure. Do
Speaker 4: I need to waste the time to go to the
Speaker 4: office and GI doctors don't require.
Speaker 1: That it's scheduled, you can do it.
Speaker 4: So you really never had the chance simplest answer is
Speaker 4: if when you're going to the bathroom it's coming out
Speaker 4: like clear water or like almost like urine, like just
Speaker 4: a yellow tinge pure water, then you're done. You're clean,
Speaker 4: so you don't have to drink anymore because you're as
Speaker 4: clean as you need to be the other part to
Speaker 4: it is there's different types of bowel preps. So some
Speaker 4: people get the whole jug, the four lid, which is
Speaker 4: more to drink, more potent because it'll flush you out.
Speaker 4: Some people get the shorter, the smaller two bottles, and
Speaker 4: when you do the shorter one, it's ideally you'd rather
Speaker 4: not take a short cut from the short cut got
Speaker 4: you know, So those people I would try to encourage
Speaker 4: to drink at all. But again, if they're clear or
Speaker 4: yellow and watery, you're done. God, so you don't have
Speaker 4: to finish.
Speaker 1: I had the four liter or whatever it was it was,
Speaker 1: who's quite powerful.
Speaker 2: And you finishers.
Speaker 1: I finished mine. And the good news is when I
Speaker 1: went in, you said, i'll see in ten years, So
Speaker 1: I had I had a clean bill.
Speaker 4: It's a clean bill, and what that means no poll ups,
Speaker 4: because that's what we're looking for when.
Speaker 1: We do this.
Speaker 4: Most pulps will never become cancer. Looking the other way,
Speaker 4: most cancers started as a poll up, So by removing them,
Speaker 4: you'll eliminate the chance. I mean, what's the odds of
Speaker 4: a healthy fifty year old having a poll up? It's
Speaker 4: probably in the thirty five to forty percent range, So
Speaker 4: that's not uncommon. At age forty five or fifty they
Speaker 4: have a polyp.
Speaker 2: I did have a poll up.
Speaker 4: Yeah, but how many people? How many people will get
Speaker 4: colon cancer? It's about four percent. No test is one
Speaker 4: hundred percent. There's things that could be missed. There may
Speaker 4: be cancers that don't start as a pollup. Yeah, but
Speaker 4: in general we're reducing the risk of colon cancer by
Speaker 4: about eighty percent.
Speaker 1: That's incredible.
Speaker 4: You might find some say ninety percent, some say seven
Speaker 4: by doing ascopy, doing a plenoscopy.
Speaker 2: Now I have to ask you, so when you go
Speaker 2: do a colonospay, you go under correct like you're you're out,
Speaker 2: I mean, or twilight what is it called twilight? Twilight?
Speaker 4: So it's not general anesthesia. You're breathing on your own.
Speaker 4: You're in a sedated to be comfortable. That's the focus
Speaker 4: is comfort.
Speaker 2: Okay, And obviously that's what you know. Like I was
Speaker 2: like excited about that because of course, like the last
Speaker 2: thing I want to do is be awake during a kolonoscopy.
Speaker 2: Yet the person in my right, my husband opposite psycho,
Speaker 2: he what was your reaction when my husband said, I
Speaker 2: don't want to go under. I want to be awake
Speaker 2: for my colonos.
Speaker 1: I've never been under in my life. And I even
Speaker 1: did a shoulder surgery. Yeah, and I didn't go under,
Speaker 1: So you know, I will.
Speaker 4: Look, I've done this sounds like a crazy number, but
Speaker 4: I've done over forty thousand. Wow, okay, and I will
Speaker 4: probably do maybe ten twelve a year. Where people request
Speaker 4: no sedation, I try to discourage it. Why not just
Speaker 4: be relaxed and comfortable. You just don't know how you're
Speaker 4: gonna feel. Everyone's got their own nerves sensitivity. The part
Speaker 4: that makes a colonoscopy potentially uncomfortable is when you're pushing
Speaker 4: it in the stretch. That can occur and if there's
Speaker 4: a loop, If there's a loop and you wouldn't know it,
Speaker 4: your colon could have a loop, and we go in
Speaker 4: and we just twist with our wrists, unravel and straighten it.
Speaker 4: When we're coming out. There's no discomfort, it's just it's straight.
Speaker 4: But you just don't know how people react, and some
Speaker 4: do amazing. And you know, I say this objectively, no
Speaker 4: sexism and vowel. As a general rule of thumb, general
Speaker 4: men's colons tend to be a little straighter than women's.
Speaker 4: Women's tend to have a little more twists. As they
Speaker 4: get older and they've had some children, their pelvic floor
Speaker 4: may drop a little and there may be that twist.
Speaker 2: Is that why men go number two more often?
Speaker 4: And I hear that all the time from the wives?
Speaker 4: Why am I constipated in my husband goals every day?
Speaker 1: And as a rule.
Speaker 4: Of thumb, men tend to go a little more regularly
Speaker 4: than women. Still, there's no way that it can be
Speaker 4: not uncomfortable.
Speaker 1: I won't do it. I will never. When I come
Speaker 1: back to you when I'm sixty out, I am going under. Yeah,
Speaker 1: so I've never been under my life. Still to this day,
Speaker 1: I've never been under. But I can't. I'm not what
Speaker 1: you fear.
Speaker 2: Bill hold on, let me ask you, because my fear
Speaker 2: when I go under, I've been under a lot. I'm
Speaker 2: not even scoliosis, breast cancer, IVF I've been under a lot, right,
Speaker 2: I've had a lot of propofol, a lot of all
Speaker 2: this stuff. My fear is like God forbid something happens,
Speaker 2: and like I don't wake up, right. I mean, that's
Speaker 2: I think most people's fear. What is that your fear?
Speaker 1: What is your fear? I spend a lot of time
Speaker 1: googling medical treatments and things like that, and in Europe,
Speaker 1: believe it or not, they don't go under for poscopies
Speaker 1: in many parts of Europe, right from what I was googling,
Speaker 1: And I'm like, because it's unnecessary, and I just I've
Speaker 1: never been under. I think it's also a lack of control.
Speaker 1: You know, I don't know what I'm going to say.
Speaker 4: That's the comment that I The two things that I
Speaker 4: hear the most when someone says they don't want to
Speaker 4: is they say, I have this fear of losing control,
Speaker 4: and I go like, like, what control are you looking
Speaker 4: for in the next thirty minutes? You know? And occasionally
Speaker 4: some people want to. They literally say I have a
Speaker 4: meeting to get to. I don't want to be sedated.
Speaker 4: I want to just get up and leave. And you know,
Speaker 4: we'll work with them. We'll always give them an ivy
Speaker 4: okay in case, in case their blood pressure got a
Speaker 4: little lower, we can give them fluids in case they
Speaker 4: throw in the white towel and say, you know that
Speaker 4: way we can put But you know if you hate
Speaker 4: when you do that, when someone mid stream says give
Speaker 4: me the medicine, because you say, why did I have
Speaker 4: to put you through this comfort before you said it?
Speaker 2: So if people ask for they don't want the propofol,
Speaker 2: they do the milder one. Do you do people still
Speaker 2: say crazy stuff.
Speaker 4: They people are always worried that they're going to say
Speaker 4: something to most people, they never they never do they
Speaker 4: never do.
Speaker 2: You know, people they just.
Speaker 4: Go to sleep and they're just relaxing, and you know,
Speaker 4: as the procedures going on, I'm constantly with the nurse
Speaker 4: in the room. We're going like Bill, you know, open
Speaker 4: your eyes and if you started like opening them, give
Speaker 4: them another milligram because we're trying to be two to
Speaker 4: three minutes ahead of when you may actually wake up
Speaker 4: a little more. Because it's tye traded to the person's need.
Speaker 4: There's no fixed dose that's going to work for everybody.
Speaker 4: We go a little at a time, another dose, another
Speaker 4: and then you're ready.
Speaker 1: I'm excited.
Speaker 3: I'm looking forward to But I always but I will
Speaker 3: tell you when when people ask me that and there's
Speaker 3: spouses in the room, I always go, you said, I
Speaker 3: love my husband.
Speaker 2: Oh that's interesting. Just a lot of people have so
Speaker 2: many questions.
Speaker 1: I have some questions written down from viewers.
Speaker 2: We literally have people who were so excited that you
Speaker 2: were coming on. Our best friends were very excited. We
Speaker 2: have a good friend in Chicago named David Wells, and
Speaker 2: we told him you were coming on and he said,
Speaker 2: do you know what I want to know? Because we
Speaker 2: asked our friends like what do you want to know?
Speaker 2: And he said, I would love to know if they
Speaker 2: all look the same.
Speaker 1: Like, what do you mean that's whole? He said, Like,
Speaker 1: are some he's looking a knucklehead? Yeah, there's a prettier
Speaker 1: colon than the other one. Any attractive? Like, no, it's not.
Speaker 2: Do they all look the same? I think is actually
Speaker 2: a very good question.
Speaker 4: Well, they look the same if they're healthy, but there
Speaker 4: might be subtle turns and twists and the diverticulum that
Speaker 4: you know, if some colons have so many it almost
Speaker 4: looks like Swiss cheese. And you got to be really
Speaker 4: careful you, meaning you've got to say which one's the
Speaker 4: real opening and which one's the diver if they're bigger.
Speaker 1: If they're bigger. A lot of people are are now
Speaker 1: taking GLP ones. It's causing a lot of problems with
Speaker 1: their ball movements, irregular ball movements, freezing right of the colon.
Speaker 1: What are you seeing now in the industry with so
Speaker 1: many people taking GLP ones.
Speaker 4: Okay, So, so glp ones in general work in two
Speaker 4: different ways. One in the brain they decrease your appetite.
Speaker 4: Two they slow your gut motility, so your stomach doesn't empty.
Speaker 4: So imagine how hungry you would be if you said
Speaker 4: you want a meal after you've had a meal, you'd say, no,
Speaker 4: I'm full. Their stomachs don't empty as well, and that's
Speaker 4: the other reason they don't want to eat as much.
Speaker 4: But it can also affect the colon. People do get
Speaker 4: sometimes diarrhea from it, but a little more commonly is
Speaker 4: constipation that your bowel doesn't move as well because it
Speaker 4: slows gut motility. So when someone's on a GLP one,
Speaker 4: we tell them to not take it for at least
Speaker 4: seven days, got it. The last dose should be seven
Speaker 4: days before the prep so that it's wearing off by
Speaker 4: the time you're taking the bowel prop and you clean out.
Speaker 2: Okay, what's the story with hemorrhoids, Like, at what point
Speaker 2: should you worry go to a doctor about a hemorrhoid?
Speaker 2: You know, sometimes like you get a hemorrhoid once in
Speaker 2: a while and it kind of goes back in and
Speaker 2: then you know, like bye bye, you know it's gone.
Speaker 2: But then sometimes like it can be a little feisty,
Speaker 2: keeps coming, you know, keeps popping out and stuff like that.
Speaker 1: Like, what could tell me about your issues right now?
Speaker 2: I mean, I can admit, I mean.
Speaker 4: We hamorrhids are a very it's a very common question.
Speaker 4: Yeah's a common thing that people come in to see
Speaker 4: a doctor about. Hemorrhids are just blood vessels. So the
Speaker 4: good news is that they don't turn into anything bad.
Speaker 4: You know, people often wonder, well, if I don't do anything,
Speaker 4: we'll turn It's just a blood vessel.
Speaker 2: Okay.
Speaker 4: So now there's two types, and it's important to know
Speaker 4: the distinction. You know, how people use the term rectum
Speaker 4: and anus sometimes interchangeably, but medically, the rectum is the
Speaker 4: end of the colon. That's the end and the after
Speaker 4: the rectum is the anus, which is the muscle that
Speaker 4: you know, if you want to hold it, you can
Speaker 4: tighten it. So the anus has nerves to it. That's
Speaker 4: where external hemorrhoids are in the anus. So external hemorrhids
Speaker 4: can bleed and they can hurt. Internal hemorrhoids are in
Speaker 4: the rectum. They can bleed, but they don't hurt. Warm
Speaker 4: water though, you know, like when you go on a
Speaker 4: hot bath, you know, not no salts, you don't need
Speaker 4: any of that absence. That's old folklore. Just warm water.
Speaker 4: You know how your fingers can shrivel up like brooms.
Speaker 4: When you've been in the bathroom long enough that your
Speaker 4: fingers are shriveling, the hemorrhoids can shrink and that's what
Speaker 4: helps them. Hemorrhos can be caused by a lot of things.
Speaker 4: It could be just bad luck. It could be you
Speaker 4: have diarrhea and you're going frequently. It could be a
Speaker 4: long plate, I'm a runner, a biker on those narrow bikes,
Speaker 4: pregnancy when you're pushing. So a lot of things cause them,
Speaker 4: but most get treated easily.
Speaker 1: I had a hemorrhid once, this is a funny story,
Speaker 1: and I went into one of those float tanks. It's
Speaker 1: like filled with epsom salts right like, and you float
Speaker 1: in these deprivation tanks. It was so paint. I had
Speaker 1: to get out because I don't know if the hemorrhoy
Speaker 1: had popped. But that's salt in the wound. Oh my god.
Speaker 4: Yeah, don't do That's why we don't even do salt anyway,
Speaker 4: It just warm water.
Speaker 1: It was awful.
Speaker 4: But occasionally someone is in acute misery, like they're writhing
Speaker 4: in pain, and that can sometimes be what we call
Speaker 4: a thrombost hemorrhoid, where they feel it and it feels
Speaker 4: like there's a walnut in there.
Speaker 1: It's hard and.
Speaker 4: You touch it, and if it's really usually they'll still
Speaker 4: get better. You'll get better if you if you can
Speaker 4: bear with it a few days. But if it's really miserable,
Speaker 4: that's where a surgeon will literally lance it and like
Speaker 4: pull out, just take it out, yeah, and it'll be
Speaker 4: instant relief.
Speaker 2: Got it. People are very proud of themselves when it's
Speaker 2: like a like a foot snake, right big long yeah,
Speaker 2: And then but is that better and healthier or the
Speaker 2: little like single ones and if they're floating versus sinking, like,
Speaker 2: what do we what should we be proud of when
Speaker 2: we look down in the I would really, I'm very
Speaker 2: proud of it.
Speaker 4: I would refocus that and say that that's an irrelevant goal.
Speaker 2: Oh really, so you can they can all be good.
Speaker 4: If you're evacuating, you're getting riddle waste, you're comfortable, it's
Speaker 4: your it's your norm.
Speaker 1: Okay, you don't have to got it be you know, like.
Speaker 2: So don't be so obsessed with it.
Speaker 1: Yeah, like don't.
Speaker 2: It doesn't matter. So whether they're individual, whether it's whatever,
Speaker 2: as long as it's solid.
Speaker 4: I would assume we'll show people charts even and we'll say,
Speaker 4: you know, is it watery, mushy like sauce or of
Speaker 4: ice cream? Yes, I mean we're talking what will we
Speaker 4: stay in an office? Is it a banana? Is it
Speaker 4: little nuggets?
Speaker 1: You know? Are you straining?
Speaker 4: And they all can be fine if you're comfortable. If
Speaker 4: you're saying I'm having hard stool and it's giving me
Speaker 4: cramps or when it goes through it hurts, yeah, some
Speaker 4: people a big bulky stool and cause not only a hemorrhy,
Speaker 4: but another thing called a fissure. Yes, which a fisher
Speaker 4: is a tear in the anus. So the anal muscle stretch, stretch, stretch,
Speaker 4: and if it's bulky and it keeps stretching, it tears.
Speaker 4: It's like a cut and it hurts and it can bleed.
Speaker 4: So the history can sound very much like a hemorrhide.
Speaker 4: It's just that when the doctor talks the person, you'll say,
Speaker 4: did you have a big, hard, bulky stool when it
Speaker 4: came through? Did you know it was big? Did you
Speaker 4: know it hurts was coming through? And they go yeah,
Speaker 4: and then I hurt and I saw blood. That's a
Speaker 4: classic fisher. The treatment is identical to hemorrhights. Warm bass,
Speaker 4: the creams most heal occasionally, they don't occasionally, And then
Speaker 4: there's other things we do for fishers. I mean, if
Speaker 4: they're really not getting better. You know how people get
Speaker 4: botox for wrinkles, Well, we can inject botox in a fissure.
Speaker 4: If some of the medical treatments don't work.
Speaker 2: Do you think some people just genetically are just genetically
Speaker 2: more able to have like great movements? Because I kid
Speaker 2: you not built tell them the truth I have. I'm
Speaker 2: very regular wonder like I really I cannot say a
Speaker 2: bad thing about my movements. I know that sounds weird,
Speaker 2: but I'm not kidding. No, Bill, don't we always talk
Speaker 2: about this.
Speaker 1: No, not always, thank you though. No.
Speaker 2: No Bill even says he's like, it's unbelievable.
Speaker 1: Well, you you what's unbelievable is how quickly you're in
Speaker 1: and out of the basket.
Speaker 2: Like five seconds.
Speaker 1: I'm like, wait, you you just like in and out?
Speaker 2: That's what I mean. So okay, No, I would say.
Speaker 1: Better if you can do it.
Speaker 4: By the way, people that sit on a toilet and
Speaker 4: read a magazine or a paper that can predispose.
Speaker 1: To ham rights.
Speaker 2: There we go. See, I don't do anything.
Speaker 1: I gotta stop.
Speaker 2: Yeah, you got to stop scrolling on the toil.
Speaker 4: I read the consistency, you know, I mean I I
Speaker 4: mean I have people that you know, they joke, they'll go,
Speaker 4: you know, it was like secretariat.
Speaker 2: But I'm telling you, I think it's hereditary, genetic because
Speaker 2: I have I am the most regular person two three
Speaker 2: times a day, solid in and out of there, not stressed,
Speaker 2: not not pushing nothing yet Yet my diet's not great,
Speaker 2: like I eat like like a twelve year old boy
Speaker 2: who just discovered candy and junk. I don't drink water,
Speaker 2: except for how much water d I drink a day?
Speaker 2: Half a cup?
Speaker 1: Nothing, so you would think so I wonder.
Speaker 2: No, this is a serious question. I didn't have this
Speaker 2: one prepared. Is it like maybe is it a family like?
Speaker 2: Is it my ancestors? Like? Is it something like we
Speaker 2: were from Italy? I don't know, Like I'm just trying
Speaker 2: to figure out.
Speaker 4: I'm not aware of anything that we could talk about
Speaker 4: genetically or heritage.
Speaker 2: Is that interesting though?
Speaker 4: Probably you have just good colonic motility that you know,
Speaker 4: how the you know, the colon in the stools in
Speaker 4: the middle, and then there's the lining and underneath it
Speaker 4: there are muscles that you know, push to propel the stool.
Speaker 1: With someone like you.
Speaker 4: From what you said, we just got good motility because
Speaker 4: stuff get it pushes and it gets out.
Speaker 1: Thank you for carving out the time to come in
Speaker 1: and see us here in Chicago.
Speaker 2: Thank you, doctor Rockham.
Speaker 1: This was so wonderful, What a pleasure. It's really been
Speaker 1: a joy,