Knock Knock, Hi! with the Glaucomfleckens

After reading your very disturbed (and very funny) comments, I briefly explore whether a large “package” might negatively affect figure skating rotational velocity.

Then we pivot to the eyeballs. The Pitt keeps delivering ophthalmology cases, so I break down gonorrhea conjunctivitis (yes, that’s a thing), what really happens when someone super-glues their eye shut, and why trimming eyelashes is sometimes the most heroic act in medicine.

Finally, we get into something far more serious: a routine clinic visit that revealed a pressure of 55 and one of the most devastating diagnoses in glaucoma, neovascular glaucoma. It’s a masterclass in ischemia, abnormal blood vessels, and when the goal of care shifts from saving vision to preserving comfort.

Takeaways:


Why gonorrhea causes “hyperacute” conjunctivitis and how it looks dramatically different from viral pink eye.


The reassuring truth about super glue in the eye (it’s the eyelashes, not the eyeball).


Why adenovirus still scares ophthalmologists more than most bacteria.


How a central retinal vein occlusion can quietly set the stage for neovascular glaucoma years later.


When a pressure of 55 isn’t a surgical emergency and why sometimes the right answer is comfort, not intervention.

To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live 

We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! [email protected]

Can’t get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! –⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ http://www.patreon.com/glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ 

Also, be sure to check out the newsletter: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://glaucomflecken.com/glauc-to-me/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

If you are interested in buying a book from one of our guests, check them all out here: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.amazon.com/shop/dr.glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

If you want more information on models I use:

Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://anatomywarehouse.com/?aff=14⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Plus for 15% off use code: Glaucomflecken15

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A friendly reminder from the G’s and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://www.EyelidCheck.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for more information. 

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This week we sit down with Dr. Claire Brandon, one of only a handful of GI psychiatrists in the country, to talk about something most of us learned in med school and then promptly never thought about again: the gut-brain axis.

Why does stress wreck your stomach?Why do chronic GI conditions come with anxiety and depression attached?Why does “it’s all in your head” miss the point entirely?

We talk about serotonin living in your intestines, inflammation affecting mood, why doctors struggle with gray areas, and how radical acceptance might actually be more powerful than another test.

We also get into what happens when medicine can’t “see” the problem and why that makes everyone uncomfortable.

Then, in true Knock Knock Hi fashion, we pivot from neuroscience to fecal transplants… and somehow land on a heated (but respectful) discussion about whether people should have kids.

Takeaways:


Your Brain and Gut Were Connected From Day One: Literally from embryology. This isn’t a trendy concept. It’s foundational biology we’re finally paying attention to.


Inflammation Doesn’t Stop at the Intestines: Autoimmune conditions, chronic GI disease, and mood disorders are more intertwined than most patients (and doctors) realize.


Invisible Symptoms Create Real Anxiety: When medicine can’t “see” the pathology, everyone feels unsettled, including physicians.


More Testing Isn’t Always the Answer: Sometimes decreasing hyper-focus on symptoms can actually reduce suffering.


The Gut Microbiome Is Just Getting Started: From depression to Parkinson’s research, we’re only beginning to understand how bacteria influence the brain.

—

To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live 

We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! [email protected]

Can’t get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! –⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ http://www.patreon.com/glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ 

Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/

If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken

If you want more information on models I use:

Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link: https://anatomywarehouse.com/?aff=14 Plus for 15% off use code: Glaucomflecken15

--

A friendly reminder from the G’s and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://www.EyelidCheck.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for more information.

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This episode starts with something that makes me very angry and ends with something that makes me genuinely happy. First, we talk about what’s happening in Eugene, Oregon, where a nonprofit hospital system decided not to renew a 35-year contract with its locally rooted emergency physicians and instead hand the ER over to a large corporate staffing group based thousands of miles away. Wait times went up, morale collapsed, doctors spoke up and admin responded by replacing them. If you’ve ever wondered how corporate medicine quietly dismantles community care, this is a textbook example.

Then, to save my sanity (and yours), we pivot to something fun: medical magic. The things ophthalmologists do every day that would absolutely get us burned at the stake a few hundred years ago: instant pain relief, artificial lenses, and the quiet miracle of glasses.

Takeaways:


How a nonprofit hospital replaced its local ER doctors with a corporate staffing group and why it’s happening all over the country.


Why closing one emergency department predictably overwhelmed another and how admin blamed the wrong people.


The hidden cost of replacing community physicians with rotating, nonlocal staff.


The ophthalmology treatment that turns 10/10 pain into 0/10 pain in seconds and still feels like magic.


Why cataract surgery and artificial lenses might be one of the greatest medical miracles of all time

To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live 

We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! [email protected]

Can’t get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! –⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ http://www.patreon.com/glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ 

Also, be sure to check out the newsletter: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://glaucomflecken.com/glauc-to-me/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

If you are interested in buying a book from one of our guests, check them all out here: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.amazon.com/shop/dr.glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

If you want more information on models I use:

Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://anatomywarehouse.com/?aff=14⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Plus for 15% off use code: Glaucomflecken15

--

A friendly reminder from the G’s and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://www.EyelidCheck.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for more information. 

Go to Cozy Earth now for a Buy One Get One Free Pajama Offer from 1/25-2/8! Yes, go to cozyearth.com they are doing a BOGO pajama promo. Just use my Code: KNOCKKNOCKBOGO

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Learn more about your ad choices. Visit megaphone.fm/adchoices

This episode starts with TikTok’s updated Terms of Service, specifically the part where apps want to know where you are at all times, and quickly spirals into a much bigger question: did we accidentally sign up for the surveillance state… or was it always inevitable?

Kristin and I debate privacy, inevitability, pessimism, preparedness, and whether refusing to participate actually protects you, or just makes life harder. Somewhere in there, we revisit COVID lockdown memories, the great toilet paper shortage, and why Kristin still believes in go-bags… everywhere.

Then things get personal. We talk about Milo, our very large, very inbred standard poodle, and his recurring seizures. I do what every human doctor does best: Google outside my scope, panic quietly, and admit I don’t know what I’m talking about when it comes to dogs. We walk through idiopathic epilepsy, toxins, brain issues, genetics, and the complicated question of when a dog actually needs lifelong seizure medication.

Finally, we crack open First Aid and land on Ehlers-Danlos syndrome — collagen, hypermobility, bruising, joint issues, blood vessels, aneurysm anxiety, and what it’s like to live with a genetic condition that medicine still doesn’t fully understand. It’s nerdy, personal, and surprisingly validating.

Takeaways:


Digital Privacy Isn’t Theoretical: Location tracking, data collection, and why opting out isn’t always realistic.


Preparedness vs Panic: Go-bags, pessimism, and how couples balance very different risk tolerances.


Dog Seizures Are Terrifying: Idiopathic epilepsy is common, but deciding when to treat isn’t simple.


Pet Insurance Confusion: Why even doctors don’t know what’s actually worth paying for.


Ehlers-Danlos Reality: Collagen types, hypermobility, bruising, and living with a condition medicine still struggles to define.

—

To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live 

We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! [email protected]

Can’t get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! –⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ http://www.patreon.com/glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ 

Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/

If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken

If you want more information on models I use:

Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link: https://anatomywarehouse.com/?aff=14 Plus for 15% off use code: Glaucomflecken15

--

A friendly reminder from the G’s and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://www.EyelidCheck.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for more information.

Go to Cozy Earth now for a Buy One Get One Free Pajama Offer from 1/25-2/8! Yes, go to ⁠⁠⁠cozyearth.com⁠⁠⁠ they are doing a BOGO pajama promo. Just use my Code: KNOCKKNOCKBOGO

Produced by⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Human Content⁠⁠⁠
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We start this episode exactly where you’d expect: Olympic penis drama. From pole vault mishaps to ski jumpers allegedly injecting hyaluronic acid for aerodynamic advantage, we briefly explore how far humans will go for gold.

Then we pivot to the eyeballs.

First, a patient with sudden, painless loss of half their vision walks into the ER. What sounds like a retinal detachment turns out to be something far scarier: a branch retinal artery occlusion, essentially a stroke of the eye. I walk through the differential, the workup, and the hardest part of the job, telling someone their vision will never be the same.

Then, a second case: weeks of foggy vision, a strange rash on the palms and soles, and a diagnosis that still earns its nickname as the great masquerader. Neurosyphilis shows up in the retina, reminding us why ophthalmologists never stop respecting infectious disease.

Takeaways:


How a branch retinal artery occlusion presents and why it’s essentially a stroke localized to the eye.


Why sudden painless vision loss still deserves a full stroke workup, even when imaging looks clean.


How to talk to patients when vision loss is permanent, but not yet fully defined.


Why syphilis earns its reputation as a medical chameleon and how it can inflame the retina and optic nerve.


The good news: why neurosyphilis caught early can still have excellent visual outcomes with IV penicillin.

To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live 

We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! [email protected]

Can’t get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! –⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ http://www.patreon.com/glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ 

Also, be sure to check out the newsletter: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://glaucomflecken.com/glauc-to-me/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

If you are interested in buying a book from one of our guests, check them all out here: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.amazon.com/shop/dr.glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

If you want more information on models I use:

Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://anatomywarehouse.com/?aff=14⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Plus for 15% off use code: Glaucomflecken15

--

A friendly reminder from the G’s and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://www.EyelidCheck.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for more information. 

Produced by⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Human Content⁠
Learn more about your ad choices. Visit megaphone.fm/adchoices