April 20, 2010 • 30 mins
There are less than a hundred documented cases of people who cannot feel pain and suffer from a condition called congenital insensitivity to pain. Josh and Chuck discuss the dangers and symptoms of CIP and related disorders in this episode.
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Episode Transcript
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Speaker 1 (00:00):
Brought to you by the reinvented two thousand twelve Camray.
It's ready. Are you welcome to stuff you should know
from house Stuff Works dot Com. Hey, and welcome to
the podcast. I'm Josh Clark. I can feel pain with
me as always A Charles W. Chuck Bryant and he
(00:23):
hold on, dude, Chuck can feel pain as well. I
just tested him. I wanted to make a hund percent sure.
That's the second take though, and you didn't really have
to do it twice. We could effaked it this time.
I wanted a realistic response. Well that's real, Josh, pinch
me hurt? Yeah, yeah, you could tell um you are right? Yeah,
(00:44):
I'm fine. Okay, how you doing besides the throbbing forearm?
I'm great, sir, and you I'm doing pretty good. Good.
Everything's just peachy, including with my hair. Josh has a
he goofed He shaves his head and he kind of
goofed it so he looks like a a patient from
some word where he had to surgery or something in
his on his brain. I didn't goof my hair, that's right. Yeah,
(01:08):
and I have an eastern black haircut now right. Yeah. Um.
So other than that I'm feeling pretty good. You're right,
So you felt emotional pain with your odd haircut. I did, which,
by the way, Chuck, is different from physical pain. You
knew that because of a yet to be released audiobook.
That's right, it's forthcoming. It's a little teaser for everybody. Um,
(01:32):
But there are actually people out there, Chuck, who cannot
feel pain straight up, don't feel pain. It's amazing. It
is very rare, but it happens. It is rare, Chuck. Actually,
the only hard number that I've seen is UH sixty
sixty reported cases worldwide, sixties since three. Actually, I've got
(01:57):
thirty five in the United States as of now. Yeah,
I've seen I saw that number as well. I've seen
people who just plumb said, we have no idea how
many could be under reported, especially with younger kids. UM
with what we're talking about is called congenital insensitivity to
pain with an hydrosis. Otherwise, we're just gonna call it
(02:20):
SIPA for short, right, because that's much easier. And that
is actually part of a it's a sub type of
a larger disorder called hereditary sensory and autonomic neuropathy UH.
And this is actually the type four SIPPA is type
four s H s A N. Yes, and it's the
most severe. Uh. Well, we'll get into what it all means,
(02:42):
but it's the most severe. We will. Um. There's actually
kind of a recent famous case of it. There's a
British physician named Dr Jeoffrey Woods. You heard of him, chuck, No,
But is he one of the g o F guys. Yeah,
he's British. Yeah, he's spilled programmed with two ms in
an e UM. But Dr Woods uh travels to Pakistan
(03:04):
fairly regularly, and while he was there he heard about
a kid who used to pass like thick needles right
through his arm walking on hot coals. Uh, and showed
no signs of feeling pain whatsoever. And he wasn't in
the gym Rows circus. No, he wasn't, actually, but he
probably could have done a lot better for himself than
(03:25):
just on the streets of Lahore right. Um with Dr
Woods heard about this guy and this little kid and
was kind of interested and finally got around to trying
to go see him. Right before he could see him,
the kid, around his fourteenth birthday died. Actually, Um, he
was he was. I don't know if he was dared
or he was doing it for money or whatever, but
he jumped off a roof and died. But Dr Woods
(03:48):
got ahold of this kid's family and actually found out
that a bunch of them have no sensitivity whatsoever to pain. Yeah,
which is also called analgesia. Oh that's the other word
for it. Didn't know that. Yeah, pain killers are called analgesics.
So this would be like the state of not having
pain or having reduced pain would be analges yet. But
this isn't just reduced pain as a chuck, No, we're
(04:10):
talking about no. Uh. You can feel pressure, but you
can feel no pain. Uh. And you can feel no
heat or cold. You can feel no temperature on your
skin either. Right, that's the one with anhydrosis, Yes, exactly. Okay,
let's talk about the pain part first. Let's talk about
pain in general. Okay, how do how do we feel pain? Well, Josh,
(04:31):
your your nervous system is where all this happens. And
we're talking about your brain here. This is your brain
on pain. Yeah, your cranial nerves, spinal cord, spinal nerves,
and other things like your gangli and receptor sensory receptor
stuff like that, and your nerves carry messages to your
spine through your body to your spine. Spine carries it
(04:52):
to your brain and the receptors. If you burn your
finger or something will send the message up to the
spine to the brain that says you got burnt, It hurts, right,
and it sends a response message that moves your hand
away real quick, touching a hot stove or something like that that.
You can take it from here though, because your Mr
Doctor guy Dr Clark, thank you chuck. Um. Actually, the
(05:16):
sense of pain, the experience of pain is called no susception,
right um. And this is the experience of physical pain
as a response to noxious stimuli. And there's actually four
categories of noxious stimuli. There's mechanical, electrical, thermal, and chemical,
right um. And we have actually specialized uh nerve endings
(05:37):
receptors called no susceptors that are responsible just for sending
pain signals. They use peripheral nerves. Yes. Actually, as as
painful as pain is, we have it for a reason.
Like you said, you know you're touching a hot stove
and your brain says, get your hand off of it,
(05:57):
right um. We also all uh what one one theory
of how we develop fear, which is good in and
of itself as well, UM, is through direct conditioning. That's
one of three ways we we learn fear responses is
through direct conditioning. And part of direct conditioning is experiencing
(06:18):
physical pain because once you've hit the hot stove, once
you know that the stove is always going to burn
you exactly, or if you're a dumb kid, maybe two
or three times, but eventually you're gonna pick it up.
Right now, what happens with sippa, as far as I understand, um,
and actually did you notice as well? There's there's not
a pet explanation of if you have SIPPA, this is
(06:41):
exactly what happens to you. Yeah, well probably because it's
so rare. Right. But when you think that if they
could get this the group of patients together, they would
find like, okay, well yeah, all of you people are
lacking no susceptors. Uh So in some patients the no
susceptors aren't there. In other patients, UM, the peripheral nerves
(07:01):
that the nose acceptors are attached to, or uses the
information highway UM aren't there, or else they're not innervated. UM.
There's a lot of different ways that this this can
come about. But it all results in this cardinal diagnosis
or diagnostic tool of SIPPA, which is you feel no
(07:22):
pain and you aren't responsive to temperature either. But nerve
conduction is there, right, It depends on some of them.
There's innervation and others the nerves aren't conducting, they're not
capable of conducting. And specifically with anhydrosis, I think, um,
there's no there's no innervation of the nerves in the
(07:44):
sweat glands. So when you start to get hot, there's
nothing sending your brain the message, Hey, you're getting hot.
We need to start sweating so we can cool down. Well, yeah,
we should go ahead and say that that's the A
is anhydrosis and after the sip part, and that's the
most sever your case, and that's when you don't sweat,
which you know how I sweat. I know you definitely
(08:07):
don't have anhydrosis. Remember at the aquarium, I sweated underwater
in like forty degree water too. I mean there was
like little chunks of ice floating on the surface of
the water and you had cartoons sweat jumping off your
forehead did so is I could handle the anhydrosis part
or at least a slight version of that. I could
deal with that, right. Uh, and this is our These
(08:29):
are ekron sweat glands or ekron glands that are responsible
for regulation of body temperature. So what they they found
with the anhydrosis, it seems fairly uniform in that respect
that we the a sip of patients don't have um innervation,
meaning the nerves aren't becoming activated in their sweat glands. Yeah,
(08:51):
and that's especially I mean it's bad enough to over
you know, because you can overheat just as an adult,
but it's really scary with babies with SIPPA because a
baby can overheat and die like very easily. Well yeah, actually,
I think of people who have SIPPA die before or
by the age of three, and I think another quarter
(09:15):
of those deaths are um from sepsis from an untreated infection.
One of the things about not being able to feel
pain is you can cut yourself and if you're a kid,
you don't think, well, I'd better treat this cut. And
at the same time you're not crying, so your parents
aren't alerted, and so this cut can go untreated become infected.
(09:37):
When they cut is infected, the bodies immunological response UH
raises your body temperature. It can lead to a fever,
and unchecked, this fever can actually lead to um brain damage.
So a lot of patients with SIPPA who have made
it past you know, three or so have some form
(09:57):
of mental retardation. Yeah, they also saw where um. We'll
get to the tips later, but since you brought it up.
One of the tips for small kids as they will
teach the child to recognize blood and teach them what
that means. So if you see blood, you need to
come find mommy and daddy real quick because you don't
know you're hurt. But that's a bad thing to happen,
So come come find mom and dad. Yeah, and I
(10:18):
thought these tips that, like you said, we'll get to
in a minute, or they were pretty clever, right, or
come fine mom and mom or dad and dad. Chucky guy,
I've been minded around here. Or just mom or just
dad or uncle Charlie, who's uh grandma or grandma or
grandpa and grandpa. There's all kinds of scenarios, A lot
(10:40):
of know somebody the first person um to be legally
pronounced a sexual was legally pronounced a sexual in the
last couple of weeks, I believe. Really, yeah, it's true.
Very interesting that. Yeah, Okay, where are we, Chuck, Let's
talk about sipa. The medical history of sippa Okay, as
(11:02):
far as I could find, it was first described in
eighteen forty seven, uh and described as what is going
on here? Yeah, exactly. And actually in the sixties. I
read an article in nineteen sixty that was based on
UM a hypothesis that people who feel no pain were
actually it was actually a psychological disturbance. There's been such
(11:26):
a massive affront to their ego that as a response,
the response to their ego mounted resulted in a loss
of the sensation of pain. That cat just can't feel pain.
He's so out there, so far out. There is a
doctor who was who was surveying this literature of UM
(11:46):
certain patients, and he was describing like how the diagnosis went,
the diagnosis went. And there's this one poor guy in
the fifties who he was described as a pretty nice, upbeat,
bright guy, and he goes to the doctor and it's like,
I can't feel pain. And the doctors like, oh yeah,
so you can see this half drunk doctor, right, he's
got like a glass of scotch and a right and
(12:09):
uh right, and the little reflective thing on his forehead. Um,
and he ran this guy through a battery of tests,
including squeezing his testicles, running an electrical current across his
lower teeth, and Chuck, it gets worse, taking a skin
and muscle biopsy without anesthetic. What did he do each
(12:32):
of these? And was he like what about that? You know?
I feel that? Can't you imagine like this? Doctors like, oh, yeah,
that didn't yeah. Um, So the psychological idea was discarded
pretty quickly. And now, because we're in the age where
the genome has been cracked, it's all genetics, right, yeah,
(12:54):
And I guess we should go ahead and mentioned too
that they think they have narrowed it down to a
mutation of the t r K A parentheses in t
r K one gene, which appears to control nerve growth,
but again they don't know for sure. They just think
that might be the culprit, right, Chuck, that seems to
be the likeliest UM candidate, because that gene actually is
(13:17):
it's responsible for producing nerve growth factor, which goes and
recruits UM neurons and nerves, isn't I guess it would
be neurons uh to become no susceptors, and so that
wouldn't happen, right, right, But they're kind of speculating still
a little bit, right. Yeah, we still don't have an idea.
(13:38):
I mean, sixty cases reported worldwide, thirty five in the US. Maybe, although, um,
it does seem like it would be genetic, like that
kid in the Little Horror Pakistan when he died and
the doctor went to go see his family and found
out he had siblings that had the same condition. Sure, Um,
that suggests either something environmental close to the home or uh, genetic,
(14:01):
And that's kind of what they're leaning to. That's the
genetic part, right, Josh. They do think or do they
know for sure that it's an autosomal recessive disorder. I
don't know how they do, but that's that's how I
take it, right, Which means that both of your parents
must pass down a copy of this gene. So each
one of your parents has this mutation and it's not
(14:23):
related to gender or anything. But they do know that
both of your parents have to give it to you,
so that that's probably what makes it rare as well. Well, yeah,
both of your parents have to have this really rare thing. Apparently,
also it hasn't It doesn't affect every ethnic group. Oh
really Yeah, but I was reading another study on this
from I think two thousand and it was in I
(14:45):
think Jerusalem or Tel Aviv, one of the two, and
they got together a bunch of kids who had sippa
and um, some of them were related, and they took
a family history and found that I think nine of
the thirt participants parents were first or second cousins. So
I wonder how much that has to do with something
(15:07):
too interesting? Yeah, very interesting? So should we talk about
some of the problems. I mean, they're pretty obvious, but
there are something that I didn't actually well, yeah, let's
talk about raising a baby with sippa. How would you
first start to recognize that your kid has sippa? Well,
that's a problem because the first way you would probably
(15:27):
recognize it is seeing witnessing an accident that should cause
your baby to cry, and your baby doesn't cry. Right,
that's like, did you have you ever heard the discovery
of ether and nitrous ox side is anesthetics right here? Well,
actually it happened in New York City, but a physician
from our fair City name ms Dr Crawford Long. Yeah.
(15:47):
I did a little book report on him when I
was like the fourth grade. He was like our nineteen
sixties Scotch and cigarette doctor, and that he liked the
party and he noticed that people on in the depths
of an ether bender would run into walls and gash
their foreheads and not have any response to it whatsoever,
aside from laughing hysterically. Right exactly, look at all this blood. Yeah,
(16:11):
so there's there's a similarity there. And well for me
to add that tangent, we have Crawford Long Hospital here too,
I know, look at you with the sidebars. So, like
I said, the first thing it will happen is apparent
season accident and the child doesn't cry. Um, so you're
gonna have some problems getting diagnosed. So because it is
so rare. Uh. And in the meantime, the kid could
(16:33):
end up with an infection and die of overheating or
suffer some sort of brain damn. One of the other
big problems with the baby is um when a baby tease,
a baby just naws like crazy, but if they don't
feel pain, they may gnaw like straight through their little
baby finger without even realizing right, or their tongue or
their lips. Those are common injuries as well, yeah, which
(16:55):
is just awful. There's also um ice scratching. Yeah. Well,
they said though on the teeth, they said that some
parents it's elect to have the teeth baby teeth removed
altogether and wait for the adult teeth to come in,
at which they're in age where they can understand like
don't bite through your finger. Yeah, but that's not good either,
because then your child has no teeth and it makes
it harder to eat and right, but it's like eat
(17:15):
baby food for many many years, or she right through
your tongue right right? You know? So what was the
one you just mentioned? I scratching? Yeah, you know you
if you are just rubbing your eye or whatever, you
pretty much know when to stop. If you are a patient,
a sip of patient, you don't know when to stop.
I was reading about this five year old girl who
(17:35):
blinded herself. She can still see shapes, I believe, um.
But she had one eye removed and scratched the other
eye and she was five and could barely see. She'd
done it to herself. Well, another tips, since we're there,
a lot of parents elect to have little baby goggles
for their for their child, so they can't get to
their eyes, which is sad. Yeah, um, hunger pains. This
(17:59):
was interesting. They don't feel hunger pains, so eating isn't
something they realized they should do. So uh they sometimes
sip A patients will set a clock to remind them
to eat or to use the potty. Right, Because one
of the ways that you know that you have to
go number one or go number two is from the
(18:20):
discomfort involved. Your body is alerted like you need to
evacuate your bowels, and so you go evacuate your bowels.
But if you don't have any sense of discomfort whatsoever, Um,
you aren't going to go to the bathroom. You can
suffer constipation all manner of horrible results from that from
(18:41):
holding it too long. Yeah for sure, Um, fractures are
very common. Obviously. You can slam your hand in the door,
won't feel the pain, won't realize you've got a broken
hand and joints to This is something I hadn't thought
of either. But consider this, like, how many times have
either one of us moved in our chairs during this podcast?
And the reason we're moving shifting is because it's become
(19:04):
uncomfortable to lean on that joint, so we move and
put the our weight on another joint. That's your body
telling you to to shift, so you're not putting too
much stress on anything. Right. If you don't shift, then
all of that weight is on that joint, and this
can actually result in charcot joints. These are joints where
basically you can't feel pain. Uh, to develop charcot joints
(19:27):
because when you it's the result of like a prolonged
and repeated destruction of a joint or several joints, And
what happens is like little bone fragments break off and
then you have bone pieces grading in the joint, it
fills with fluid and UH, there's definitely a point of
(19:47):
no return that can lead to amputation, um limb replacement,
that kind of stuff. Gez, Well, one of the since
we're kind of doing the problem tip thing, one of
the tips don't think we have so far. One of
the things that they recommend is occupational therapy, so they
can teach your child different ways to sit and do
(20:08):
physical tasks to like put the least amount of stress
possible on those joints, right or they may say your
kid needs to be in a wheelchair a little more
than than here. She is true and again very sad.
This whole thing is just one of the most depressing
rare disorders I can think of. Uh, if you have
a baby that has um SIPA, you should probably do
(20:30):
a regular check over your child, like you need a
baby proof the heck out of your house. Like it's
baby proof anyway, but you really need to go overboard
with softening corners and things like that, making sure the
stove and anything dangerous isn't accessible the knife drawer, that
kind of thing. But um, you should also check your
check your child for until they're old enough to do
this on their own, check them for injuries, you know,
(20:53):
a couple of three times a day. Also, um, because
of the anhydrosis. Uh that a lot of families opt
to move to cooler climates just you know, to protect
against overheating. Yeah, and um, Katie Lambert wrote this article
of stuff you miss in history class are cohorts And
uh Katie supposed that as far as getting exercise, which
(21:16):
you know everyone needs, that swimming might be a good
good thing for them to do. And that kind of
made sense to me. Yeah, but have you ever like
swam and sweat it underwater? Well you know it? Well, yeah,
but now I I wondered about that because I mean,
if you think about it, if you are sweating underwater,
then your body's saying you need to be cooler than
(21:36):
the ambient water temperature. So it could still lead to trouble.
I guess getting cool water and maybe don't swim so
much that you're gonna be sweating could be my advice.
Dr Chuck's advice. That's good advice, Dr Chuck. Although the
water is a good medium because it's easier on the joints. Yeah, well,
I think that's why she recommended it. Sure, Uh, there
(21:57):
is no cure, no that that has happened yet, and
it's so rare that it's it's one of these things
it's hard to get a cure when you don't have
anyone to test it on. Yeah, although Chuck, don't you
think the advent of stem cells will probably cure everything?
I hope so. Well, I mean think about it, it's
(22:17):
a if it's a genetic flaw measually that means that
an enzyme or protein isn't being produced, so you just
use stem cells to generate that enzyme or protein and
R Clark no more sippa. There are a couple of
websites should we go ahead and plug those. Gift of
Pain is a website set up by a family whose
(22:38):
daughter has SIPPA, and if you want to have your
heart broken and learn a little bit, you can go
visit there and help. Roberto dot com is another one
that details a young boy with SIPPA and Chuck. Also
there is, from what I understand um, a pretty good
documentary called A Life Without Pain by director Melody Guild
(23:00):
and it's about SIPPA. Huh, it's supposed to be pretty cool.
I haven't seen it, but anybody interested, we want to
rent that? And I say look for a pain podcast
in the future. I think we should do one on
pain Josh and Chuck's House of Pain. Do you know
how many times I'm gonna pinch you during that thing?
(23:21):
It's gonna be rough, hopefully no more than once. It
will be more than once, all right. If you want
to learn more about SIPPA, type in c I p
A in the handy search bar at how Stuff works
dot com. That means it's time for listener mayle yes sir, exactly, Chuck,
(23:42):
I want us to give a special shout out the
three sisters triplets. In fact, we have triplets triplet listeners. Yeah, Helen,
Spence and Echo, and they all three are voracious stuff.
You should know listeners A cool name, Yeah, yeah, I
like it. A Spence goes by Zebra apparently just came
(24:03):
in when I was on vacation. Huh yeah, yeah, because
you replied I did, and you promised the shout out
and never gave it. Yeah. They we didn't do a
shout out and we are now though, I mean, come on,
they break me over the coals and I responded, yeah,
And you know, we typically don't do shoutouts because we
get request and there's just too many of them. Yeah,
but how many triplets do we have listening to? Exactly?
(24:23):
So if it's something remarkable, or if you want your
name read so bad, just tell us your quadruplets and
make up three names. So you guys keep the fourth
doubt and thanks for listening. Thank you girls, and we'll
get the listener mail eventually, I think. But we should
probably plug Facebook and Twitter tweet tweet. We are children
(24:44):
of the next generation. I don't know modern why I
think no your x M. Why no, seriously, we're definitely
not millennial. So, yes, we're on Facebook now, for sure.
We're on Facebook. We have can validated are We had
multiple pages. It was kind of a mess, but now
we're all consolidated. We're personally putting stuff on Facebook and
(25:07):
talking to people. It's kind of kind of fun. Actually, yeah,
it is. You're doing a heck of a job, Chuck.
You you can type in stuff you should know on
Facebook's handy search bar and that should bring up our page.
You go ahead and join. I'm very curious to see
how many people join. Yeah, you know, as long as
we have more than all the other podcasts combined, and
I'm fine. Yeah. And the same goes for Twitter too.
(25:29):
Do you have that same that same desire, the same goal. Yeah,
so I've embraced Twitter. I can't believe it. Yeah, I'm tweeting. Yeah,
Chuck's first tweet was hilarious, as I imagine all successive
tweets will be. Our Twitter name is s y s
K podcast. That's our Twitter name at yeah past right,
(25:49):
the little at simbulture for those of you who don't
know how that works. Right, Uh, so you can check
those out join up, follow us, and we will be interacting. Right,
We're gonna come down from our ivory tower, right, yeah,
all right? Uh so, Josh, I'm gonna call this um
earthquake survivor. Did you read this one? Pretty remarkable? You're
(26:10):
You're back. You're not on vacation anymore. Hey, Josh and Chuck.
I just wanted to email and say thanks for unknowingly
doing a lot to keep things normal for me in
the least normal of times. Let me explain. I live
in Santiago, Chile, and in late February I was invited
to the camping trip in a place down south called Mocha.
(26:32):
Do you like my phonetic pronunciations. It was all really
last minute, but before leaving I managed to grab ahold
of your latest podcast, which was How Braille Works, put
it on the old iPod. I thought I might need
it for the long bus ride, and I only grabbed
that one because, being a true fan, I had already
listened to the others, So good for you, Ignacio. On
(26:53):
our second night camping on the island, we had an
eight point eight Richter earthquake, if you remember, and we
were pretty near the epicenter. We had to run from
a tsunami, which only gave us about seven minutes to
get the higher ground. After the earthquake, our tents and
all of our stuff was washed away. We never saw
it again. Turned out we had it easy. Most of
(27:15):
the homes on the island were taken by the wave,
and we camped without tents of course, with the locals
up on a hill for a couple of days before
being able to even take a plane to start our
journey back home, which was difficult, Josh, because the bridges
were down, streets were cracked, and there was no gas
at the gas stations, that kind of thing for like
five days. Um. In the middle of it all, I
(27:36):
was feeling really bad about everything, though grateful for being alive,
and I was not really knowing about my friends or
family since cell phones were down and I was in
the middle of the least normal situation I'd ever been.
Then I remembered I had your podcast, pulled out my
iPod which I had saved in my Fannie pack and
just listen with my eyes closed, really happy because that was,
(27:58):
for the first time the only nection to normal I had.
That is awesome, really cool. Uh. It made the hugest difference.
So I wanted to say thank you so much like
you guys to stop and think what a difference you
can make in the listeners lives. So let's stop and
think for a moment. All right, all right, nice? I
feel good. How often do we just sit and be quiet? Never?
(28:21):
Never what we're supposed to do? Uh? You you have
a loyal listener for years to come. That is from Ignatio. Thanks.
Ignatio was alive and well thank god. Did you hear
about the Day's Army Family or the Day's Arms. They're
a family from Haiti who survived the Porter Prince quake
and they had a son who lived in Saniago who's like,
(28:43):
come live with me. You're kidding. They moved to Saniago
just in time to survive the Chili quake, survived both though. Yeah, yeah,
and since you said that that way, it's the name.
What did you say? The name of the place was Saniago.
The Day's Arms, Yeah, they're the family. That's that's the
plane Illinois. We should say, well we goofed that one.
(29:05):
We didn't know. It's apparently planes death planes. Dutch Boot
sounds very strange because it would seem like it would
be silent, but everyone made fun of me saying you
sounded like tattoo with the plane deplane. I think we're
the same. We're interchangeable. My pain is your pain. You
can you can switch our guts, right bellies. So officially, UH,
(29:29):
I would like to switch bellies. You're a slightly smaller
than mine. Thank you. UM. Officially, we'd like to make
that correction. It is de Planes, Illinois, and it's yo.
Claire yeo. Claire was continent, it's not. And in Canada
they called Canadian bacon bacon. Yes, Canadians. We have corrected
that for two years now, so you can stop with
(29:51):
the emails. It's a joke. If you have a correction
you want to send Chuck or me, or you want
to get into some UH email combat over a topic
and issue something like that, send us an email. Do
not cite Wikipedia UH to support your claims, or else
you've lost right out of the gate. Do better wrap
(30:13):
it up. Send it to stuff podcast at how stuff
works dot com for more on this and thousands of
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more how stuff works, check out our blogs on the
house stuff works dot com home page. Brought to you
(30:36):
by the reinvented two thousand twelve camera. It's ready, are
you
Brought to you by the reinvented two thousand twelve Camray.
It's ready. Are you welcome to stuff you should know
from house Stuff Works dot Com. Hey, and welcome to
the podcast. I'm Josh Clark. I can feel pain with
me as always A Charles W. Chuck Bryant and he
(00:23):
hold on, dude, Chuck can feel pain as well. I
just tested him. I wanted to make a hund percent sure.
That's the second take though, and you didn't really have
to do it twice. We could effaked it this time.
I wanted a realistic response. Well that's real, Josh, pinch
me hurt? Yeah, yeah, you could tell um you are right? Yeah,
(00:44):
I'm fine. Okay, how you doing besides the throbbing forearm?
I'm great, sir, and you I'm doing pretty good. Good.
Everything's just peachy, including with my hair. Josh has a
he goofed He shaves his head and he kind of
goofed it so he looks like a a patient from
some word where he had to surgery or something in
his on his brain. I didn't goof my hair, that's right. Yeah,
(01:08):
and I have an eastern black haircut now right. Yeah. Um.
So other than that I'm feeling pretty good. You're right,
So you felt emotional pain with your odd haircut. I did, which,
by the way, Chuck, is different from physical pain. You
knew that because of a yet to be released audiobook.
That's right, it's forthcoming. It's a little teaser for everybody. Um,
(01:32):
But there are actually people out there, Chuck, who cannot
feel pain straight up, don't feel pain. It's amazing. It
is very rare, but it happens. It is rare, Chuck. Actually,
the only hard number that I've seen is UH sixty
sixty reported cases worldwide, sixties since three. Actually, I've got
(01:57):
thirty five in the United States as of now. Yeah,
I've seen I saw that number as well. I've seen
people who just plumb said, we have no idea how
many could be under reported, especially with younger kids. UM
with what we're talking about is called congenital insensitivity to
pain with an hydrosis. Otherwise, we're just gonna call it
(02:20):
SIPA for short, right, because that's much easier. And that
is actually part of a it's a sub type of
a larger disorder called hereditary sensory and autonomic neuropathy UH.
And this is actually the type four SIPPA is type
four s H s A N. Yes, and it's the
most severe. Uh. Well, we'll get into what it all means,
(02:42):
but it's the most severe. We will. Um. There's actually
kind of a recent famous case of it. There's a
British physician named Dr Jeoffrey Woods. You heard of him, chuck, No,
But is he one of the g o F guys. Yeah,
he's British. Yeah, he's spilled programmed with two ms in
an e UM. But Dr Woods uh travels to Pakistan
(03:04):
fairly regularly, and while he was there he heard about
a kid who used to pass like thick needles right
through his arm walking on hot coals. Uh, and showed
no signs of feeling pain whatsoever. And he wasn't in
the gym Rows circus. No, he wasn't, actually, but he
probably could have done a lot better for himself than
(03:25):
just on the streets of Lahore right. Um with Dr
Woods heard about this guy and this little kid and
was kind of interested and finally got around to trying
to go see him. Right before he could see him,
the kid, around his fourteenth birthday died. Actually, Um, he
was he was. I don't know if he was dared
or he was doing it for money or whatever, but
he jumped off a roof and died. But Dr Woods
(03:48):
got ahold of this kid's family and actually found out
that a bunch of them have no sensitivity whatsoever to pain. Yeah,
which is also called analgesia. Oh that's the other word
for it. Didn't know that. Yeah, pain killers are called analgesics.
So this would be like the state of not having
pain or having reduced pain would be analges yet. But
this isn't just reduced pain as a chuck, No, we're
(04:10):
talking about no. Uh. You can feel pressure, but you
can feel no pain. Uh. And you can feel no
heat or cold. You can feel no temperature on your
skin either. Right, that's the one with anhydrosis, Yes, exactly. Okay,
let's talk about the pain part first. Let's talk about
pain in general. Okay, how do how do we feel pain? Well, Josh,
(04:31):
your your nervous system is where all this happens. And
we're talking about your brain here. This is your brain
on pain. Yeah, your cranial nerves, spinal cord, spinal nerves,
and other things like your gangli and receptor sensory receptor
stuff like that, and your nerves carry messages to your
spine through your body to your spine. Spine carries it
(04:52):
to your brain and the receptors. If you burn your
finger or something will send the message up to the
spine to the brain that says you got burnt, It hurts, right,
and it sends a response message that moves your hand
away real quick, touching a hot stove or something like that that.
You can take it from here though, because your Mr
Doctor guy Dr Clark, thank you chuck. Um. Actually, the
(05:16):
sense of pain, the experience of pain is called no susception,
right um. And this is the experience of physical pain
as a response to noxious stimuli. And there's actually four
categories of noxious stimuli. There's mechanical, electrical, thermal, and chemical,
right um. And we have actually specialized uh nerve endings
(05:37):
receptors called no susceptors that are responsible just for sending
pain signals. They use peripheral nerves. Yes. Actually, as as
painful as pain is, we have it for a reason.
Like you said, you know you're touching a hot stove
and your brain says, get your hand off of it,
(05:57):
right um. We also all uh what one one theory
of how we develop fear, which is good in and
of itself as well, UM, is through direct conditioning. That's
one of three ways we we learn fear responses is
through direct conditioning. And part of direct conditioning is experiencing
(06:18):
physical pain because once you've hit the hot stove, once
you know that the stove is always going to burn
you exactly, or if you're a dumb kid, maybe two
or three times, but eventually you're gonna pick it up.
Right now, what happens with sippa, as far as I understand, um,
and actually did you notice as well? There's there's not
a pet explanation of if you have SIPPA, this is
(06:41):
exactly what happens to you. Yeah, well probably because it's
so rare. Right. But when you think that if they
could get this the group of patients together, they would
find like, okay, well yeah, all of you people are
lacking no susceptors. Uh So in some patients the no
susceptors aren't there. In other patients, UM, the peripheral nerves
(07:01):
that the nose acceptors are attached to, or uses the
information highway UM aren't there, or else they're not innervated. UM.
There's a lot of different ways that this this can
come about. But it all results in this cardinal diagnosis
or diagnostic tool of SIPPA, which is you feel no
(07:22):
pain and you aren't responsive to temperature either. But nerve
conduction is there, right, It depends on some of them.
There's innervation and others the nerves aren't conducting, they're not
capable of conducting. And specifically with anhydrosis, I think, um,
there's no there's no innervation of the nerves in the
(07:44):
sweat glands. So when you start to get hot, there's
nothing sending your brain the message, Hey, you're getting hot.
We need to start sweating so we can cool down. Well, yeah,
we should go ahead and say that that's the A
is anhydrosis and after the sip part, and that's the
most sever your case, and that's when you don't sweat,
which you know how I sweat. I know you definitely
(08:07):
don't have anhydrosis. Remember at the aquarium, I sweated underwater
in like forty degree water too. I mean there was
like little chunks of ice floating on the surface of
the water and you had cartoons sweat jumping off your
forehead did so is I could handle the anhydrosis part
or at least a slight version of that. I could
deal with that, right. Uh, and this is our These
(08:29):
are ekron sweat glands or ekron glands that are responsible
for regulation of body temperature. So what they they found
with the anhydrosis, it seems fairly uniform in that respect
that we the a sip of patients don't have um innervation,
meaning the nerves aren't becoming activated in their sweat glands. Yeah,
(08:51):
and that's especially I mean it's bad enough to over
you know, because you can overheat just as an adult,
but it's really scary with babies with SIPPA because a
baby can overheat and die like very easily. Well yeah, actually,
I think of people who have SIPPA die before or
by the age of three, and I think another quarter
(09:15):
of those deaths are um from sepsis from an untreated infection.
One of the things about not being able to feel
pain is you can cut yourself and if you're a kid,
you don't think, well, I'd better treat this cut. And
at the same time you're not crying, so your parents
aren't alerted, and so this cut can go untreated become infected.
(09:37):
When they cut is infected, the bodies immunological response UH
raises your body temperature. It can lead to a fever,
and unchecked, this fever can actually lead to um brain damage.
So a lot of patients with SIPPA who have made
it past you know, three or so have some form
(09:57):
of mental retardation. Yeah, they also saw where um. We'll
get to the tips later, but since you brought it up.
One of the tips for small kids as they will
teach the child to recognize blood and teach them what
that means. So if you see blood, you need to
come find mommy and daddy real quick because you don't
know you're hurt. But that's a bad thing to happen,
So come come find mom and dad. Yeah, and I
(10:18):
thought these tips that, like you said, we'll get to
in a minute, or they were pretty clever, right, or
come fine mom and mom or dad and dad. Chucky guy,
I've been minded around here. Or just mom or just
dad or uncle Charlie, who's uh grandma or grandma or
grandpa and grandpa. There's all kinds of scenarios, A lot
(10:40):
of know somebody the first person um to be legally
pronounced a sexual was legally pronounced a sexual in the
last couple of weeks, I believe. Really, yeah, it's true.
Very interesting that. Yeah, Okay, where are we, Chuck, Let's
talk about sipa. The medical history of sippa Okay, as
(11:02):
far as I could find, it was first described in
eighteen forty seven, uh and described as what is going
on here? Yeah, exactly. And actually in the sixties. I
read an article in nineteen sixty that was based on
UM a hypothesis that people who feel no pain were
actually it was actually a psychological disturbance. There's been such
(11:26):
a massive affront to their ego that as a response,
the response to their ego mounted resulted in a loss
of the sensation of pain. That cat just can't feel pain.
He's so out there, so far out. There is a
doctor who was who was surveying this literature of UM
(11:46):
certain patients, and he was describing like how the diagnosis went,
the diagnosis went. And there's this one poor guy in
the fifties who he was described as a pretty nice, upbeat,
bright guy, and he goes to the doctor and it's like,
I can't feel pain. And the doctors like, oh yeah,
so you can see this half drunk doctor, right, he's
got like a glass of scotch and a right and
(12:09):
uh right, and the little reflective thing on his forehead. Um,
and he ran this guy through a battery of tests,
including squeezing his testicles, running an electrical current across his
lower teeth, and Chuck, it gets worse, taking a skin
and muscle biopsy without anesthetic. What did he do each
(12:32):
of these? And was he like what about that? You know?
I feel that? Can't you imagine like this? Doctors like, oh, yeah,
that didn't yeah. Um, So the psychological idea was discarded
pretty quickly. And now, because we're in the age where
the genome has been cracked, it's all genetics, right, yeah,
(12:54):
And I guess we should go ahead and mentioned too
that they think they have narrowed it down to a
mutation of the t r K A parentheses in t
r K one gene, which appears to control nerve growth,
but again they don't know for sure. They just think
that might be the culprit, right, Chuck, that seems to
be the likeliest UM candidate, because that gene actually is
(13:17):
it's responsible for producing nerve growth factor, which goes and
recruits UM neurons and nerves, isn't I guess it would
be neurons uh to become no susceptors, and so that
wouldn't happen, right, right, But they're kind of speculating still
a little bit, right. Yeah, we still don't have an idea.
(13:38):
I mean, sixty cases reported worldwide, thirty five in the US. Maybe, although, um,
it does seem like it would be genetic, like that
kid in the Little Horror Pakistan when he died and
the doctor went to go see his family and found
out he had siblings that had the same condition. Sure, Um,
that suggests either something environmental close to the home or uh, genetic,
(14:01):
And that's kind of what they're leaning to. That's the
genetic part, right, Josh. They do think or do they
know for sure that it's an autosomal recessive disorder. I
don't know how they do, but that's that's how I
take it, right, Which means that both of your parents
must pass down a copy of this gene. So each
one of your parents has this mutation and it's not
(14:23):
related to gender or anything. But they do know that
both of your parents have to give it to you,
so that that's probably what makes it rare as well. Well, yeah,
both of your parents have to have this really rare thing. Apparently,
also it hasn't It doesn't affect every ethnic group. Oh
really Yeah, but I was reading another study on this
from I think two thousand and it was in I
(14:45):
think Jerusalem or Tel Aviv, one of the two, and
they got together a bunch of kids who had sippa
and um, some of them were related, and they took
a family history and found that I think nine of
the thirt participants parents were first or second cousins. So
I wonder how much that has to do with something
(15:07):
too interesting? Yeah, very interesting? So should we talk about
some of the problems. I mean, they're pretty obvious, but
there are something that I didn't actually well, yeah, let's
talk about raising a baby with sippa. How would you
first start to recognize that your kid has sippa? Well,
that's a problem because the first way you would probably
(15:27):
recognize it is seeing witnessing an accident that should cause
your baby to cry, and your baby doesn't cry. Right,
that's like, did you have you ever heard the discovery
of ether and nitrous ox side is anesthetics right here? Well,
actually it happened in New York City, but a physician
from our fair City name ms Dr Crawford Long. Yeah.
(15:47):
I did a little book report on him when I
was like the fourth grade. He was like our nineteen
sixties Scotch and cigarette doctor, and that he liked the
party and he noticed that people on in the depths
of an ether bender would run into walls and gash
their foreheads and not have any response to it whatsoever,
aside from laughing hysterically. Right exactly, look at all this blood. Yeah,
(16:11):
so there's there's a similarity there. And well for me
to add that tangent, we have Crawford Long Hospital here too,
I know, look at you with the sidebars. So, like
I said, the first thing it will happen is apparent
season accident and the child doesn't cry. Um, so you're
gonna have some problems getting diagnosed. So because it is
so rare. Uh. And in the meantime, the kid could
(16:33):
end up with an infection and die of overheating or
suffer some sort of brain damn. One of the other
big problems with the baby is um when a baby tease,
a baby just naws like crazy, but if they don't
feel pain, they may gnaw like straight through their little
baby finger without even realizing right, or their tongue or
their lips. Those are common injuries as well, yeah, which
(16:55):
is just awful. There's also um ice scratching. Yeah. Well,
they said though on the teeth, they said that some
parents it's elect to have the teeth baby teeth removed
altogether and wait for the adult teeth to come in,
at which they're in age where they can understand like
don't bite through your finger. Yeah, but that's not good either,
because then your child has no teeth and it makes
it harder to eat and right, but it's like eat
(17:15):
baby food for many many years, or she right through
your tongue right right? You know? So what was the
one you just mentioned? I scratching? Yeah, you know you
if you are just rubbing your eye or whatever, you
pretty much know when to stop. If you are a patient,
a sip of patient, you don't know when to stop.
I was reading about this five year old girl who
(17:35):
blinded herself. She can still see shapes, I believe, um.
But she had one eye removed and scratched the other
eye and she was five and could barely see. She'd
done it to herself. Well, another tips, since we're there,
a lot of parents elect to have little baby goggles
for their for their child, so they can't get to
their eyes, which is sad. Yeah, um, hunger pains. This
(17:59):
was interesting. They don't feel hunger pains, so eating isn't
something they realized they should do. So uh they sometimes
sip A patients will set a clock to remind them
to eat or to use the potty. Right, Because one
of the ways that you know that you have to
go number one or go number two is from the
(18:20):
discomfort involved. Your body is alerted like you need to
evacuate your bowels, and so you go evacuate your bowels.
But if you don't have any sense of discomfort whatsoever, Um,
you aren't going to go to the bathroom. You can
suffer constipation all manner of horrible results from that from
(18:41):
holding it too long. Yeah for sure, Um, fractures are
very common. Obviously. You can slam your hand in the door,
won't feel the pain, won't realize you've got a broken
hand and joints to This is something I hadn't thought
of either. But consider this, like, how many times have
either one of us moved in our chairs during this podcast?
And the reason we're moving shifting is because it's become
(19:04):
uncomfortable to lean on that joint, so we move and
put the our weight on another joint. That's your body
telling you to to shift, so you're not putting too
much stress on anything. Right. If you don't shift, then
all of that weight is on that joint, and this
can actually result in charcot joints. These are joints where
basically you can't feel pain. Uh, to develop charcot joints
(19:27):
because when you it's the result of like a prolonged
and repeated destruction of a joint or several joints, And
what happens is like little bone fragments break off and
then you have bone pieces grading in the joint, it
fills with fluid and UH, there's definitely a point of
(19:47):
no return that can lead to amputation, um limb replacement,
that kind of stuff. Gez, Well, one of the since
we're kind of doing the problem tip thing, one of
the tips don't think we have so far. One of
the things that they recommend is occupational therapy, so they
can teach your child different ways to sit and do
(20:08):
physical tasks to like put the least amount of stress
possible on those joints, right or they may say your
kid needs to be in a wheelchair a little more
than than here. She is true and again very sad.
This whole thing is just one of the most depressing
rare disorders I can think of. Uh, if you have
a baby that has um SIPA, you should probably do
(20:30):
a regular check over your child, like you need a
baby proof the heck out of your house. Like it's
baby proof anyway, but you really need to go overboard
with softening corners and things like that, making sure the
stove and anything dangerous isn't accessible the knife drawer, that
kind of thing. But um, you should also check your
check your child for until they're old enough to do
this on their own, check them for injuries, you know,
(20:53):
a couple of three times a day. Also, um, because
of the anhydrosis. Uh that a lot of families opt
to move to cooler climates just you know, to protect
against overheating. Yeah, and um, Katie Lambert wrote this article
of stuff you miss in history class are cohorts And
uh Katie supposed that as far as getting exercise, which
(21:16):
you know everyone needs, that swimming might be a good
good thing for them to do. And that kind of
made sense to me. Yeah, but have you ever like
swam and sweat it underwater? Well you know it? Well, yeah,
but now I I wondered about that because I mean,
if you think about it, if you are sweating underwater,
then your body's saying you need to be cooler than
(21:36):
the ambient water temperature. So it could still lead to trouble.
I guess getting cool water and maybe don't swim so
much that you're gonna be sweating could be my advice.
Dr Chuck's advice. That's good advice, Dr Chuck. Although the
water is a good medium because it's easier on the joints. Yeah, well,
I think that's why she recommended it. Sure, Uh, there
(21:57):
is no cure, no that that has happened yet, and
it's so rare that it's it's one of these things
it's hard to get a cure when you don't have
anyone to test it on. Yeah, although Chuck, don't you
think the advent of stem cells will probably cure everything?
I hope so. Well, I mean think about it, it's
(22:17):
a if it's a genetic flaw measually that means that
an enzyme or protein isn't being produced, so you just
use stem cells to generate that enzyme or protein and
R Clark no more sippa. There are a couple of
websites should we go ahead and plug those. Gift of
Pain is a website set up by a family whose
(22:38):
daughter has SIPPA, and if you want to have your
heart broken and learn a little bit, you can go
visit there and help. Roberto dot com is another one
that details a young boy with SIPPA and Chuck. Also
there is, from what I understand um, a pretty good
documentary called A Life Without Pain by director Melody Guild
(23:00):
and it's about SIPPA. Huh, it's supposed to be pretty cool.
I haven't seen it, but anybody interested, we want to
rent that? And I say look for a pain podcast
in the future. I think we should do one on
pain Josh and Chuck's House of Pain. Do you know
how many times I'm gonna pinch you during that thing?
(23:21):
It's gonna be rough, hopefully no more than once. It
will be more than once, all right. If you want
to learn more about SIPPA, type in c I p
A in the handy search bar at how Stuff works
dot com. That means it's time for listener mayle yes sir, exactly, Chuck,
(23:42):
I want us to give a special shout out the
three sisters triplets. In fact, we have triplets triplet listeners. Yeah, Helen,
Spence and Echo, and they all three are voracious stuff.
You should know listeners A cool name, Yeah, yeah, I
like it. A Spence goes by Zebra apparently just came
(24:03):
in when I was on vacation. Huh yeah, yeah, because
you replied I did, and you promised the shout out
and never gave it. Yeah. They we didn't do a
shout out and we are now though, I mean, come on,
they break me over the coals and I responded, yeah,
And you know, we typically don't do shoutouts because we
get request and there's just too many of them. Yeah,
but how many triplets do we have listening to? Exactly?
(24:23):
So if it's something remarkable, or if you want your
name read so bad, just tell us your quadruplets and
make up three names. So you guys keep the fourth
doubt and thanks for listening. Thank you girls, and we'll
get the listener mail eventually, I think. But we should
probably plug Facebook and Twitter tweet tweet. We are children
(24:44):
of the next generation. I don't know modern why I
think no your x M. Why no, seriously, we're definitely
not millennial. So, yes, we're on Facebook now, for sure.
We're on Facebook. We have can validated are We had
multiple pages. It was kind of a mess, but now
we're all consolidated. We're personally putting stuff on Facebook and
(25:07):
talking to people. It's kind of kind of fun. Actually, yeah,
it is. You're doing a heck of a job, Chuck.
You you can type in stuff you should know on
Facebook's handy search bar and that should bring up our page.
You go ahead and join. I'm very curious to see
how many people join. Yeah, you know, as long as
we have more than all the other podcasts combined, and
I'm fine. Yeah. And the same goes for Twitter too.
(25:29):
Do you have that same that same desire, the same goal. Yeah,
so I've embraced Twitter. I can't believe it. Yeah, I'm tweeting. Yeah,
Chuck's first tweet was hilarious, as I imagine all successive
tweets will be. Our Twitter name is s y s
K podcast. That's our Twitter name at yeah past right,
(25:49):
the little at simbulture for those of you who don't
know how that works. Right, Uh, so you can check
those out join up, follow us, and we will be interacting. Right,
We're gonna come down from our ivory tower, right, yeah,
all right? Uh so, Josh, I'm gonna call this um
earthquake survivor. Did you read this one? Pretty remarkable? You're
(26:10):
You're back. You're not on vacation anymore. Hey, Josh and Chuck.
I just wanted to email and say thanks for unknowingly
doing a lot to keep things normal for me in
the least normal of times. Let me explain. I live
in Santiago, Chile, and in late February I was invited
to the camping trip in a place down south called Mocha.
(26:32):
Do you like my phonetic pronunciations. It was all really
last minute, but before leaving I managed to grab ahold
of your latest podcast, which was How Braille Works, put
it on the old iPod. I thought I might need
it for the long bus ride, and I only grabbed
that one because, being a true fan, I had already
listened to the others, So good for you, Ignacio. On
(26:53):
our second night camping on the island, we had an
eight point eight Richter earthquake, if you remember, and we
were pretty near the epicenter. We had to run from
a tsunami, which only gave us about seven minutes to
get the higher ground. After the earthquake, our tents and
all of our stuff was washed away. We never saw
it again. Turned out we had it easy. Most of
(27:15):
the homes on the island were taken by the wave,
and we camped without tents of course, with the locals
up on a hill for a couple of days before
being able to even take a plane to start our
journey back home, which was difficult, Josh, because the bridges
were down, streets were cracked, and there was no gas
at the gas stations, that kind of thing for like
five days. Um. In the middle of it all, I
(27:36):
was feeling really bad about everything, though grateful for being alive,
and I was not really knowing about my friends or
family since cell phones were down and I was in
the middle of the least normal situation I'd ever been.
Then I remembered I had your podcast, pulled out my
iPod which I had saved in my Fannie pack and
just listen with my eyes closed, really happy because that was,
(27:58):
for the first time the only nection to normal I had.
That is awesome, really cool. Uh. It made the hugest difference.
So I wanted to say thank you so much like
you guys to stop and think what a difference you
can make in the listeners lives. So let's stop and
think for a moment. All right, all right, nice? I
feel good. How often do we just sit and be quiet? Never?
(28:21):
Never what we're supposed to do? Uh? You you have
a loyal listener for years to come. That is from Ignatio. Thanks.
Ignatio was alive and well thank god. Did you hear
about the Day's Army Family or the Day's Arms. They're
a family from Haiti who survived the Porter Prince quake
and they had a son who lived in Saniago who's like,
(28:43):
come live with me. You're kidding. They moved to Saniago
just in time to survive the Chili quake, survived both though. Yeah, yeah,
and since you said that that way, it's the name.
What did you say? The name of the place was Saniago.
The Day's Arms, Yeah, they're the family. That's that's the
plane Illinois. We should say, well we goofed that one.
(29:05):
We didn't know. It's apparently planes death planes. Dutch Boot
sounds very strange because it would seem like it would
be silent, but everyone made fun of me saying you
sounded like tattoo with the plane deplane. I think we're
the same. We're interchangeable. My pain is your pain. You
can you can switch our guts, right bellies. So officially, UH,
(29:29):
I would like to switch bellies. You're a slightly smaller
than mine. Thank you. UM. Officially, we'd like to make
that correction. It is de Planes, Illinois, and it's yo.
Claire yeo. Claire was continent, it's not. And in Canada
they called Canadian bacon bacon. Yes, Canadians. We have corrected
that for two years now, so you can stop with
(29:51):
the emails. It's a joke. If you have a correction
you want to send Chuck or me, or you want
to get into some UH email combat over a topic
and issue something like that, send us an email. Do
not cite Wikipedia UH to support your claims, or else
you've lost right out of the gate. Do better wrap
(30:13):
it up. Send it to stuff podcast at how stuff
works dot com for more on this and thousands of
other topics. Is that how stuff works dot com. Want
more how stuff works, check out our blogs on the
house stuff works dot com home page. Brought to you
(30:36):
by the reinvented two thousand twelve camera. It's ready, are
you
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Chuck Bryant
Josh Clark
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