The Saturday Scalpel: Issue 18

From the Desk of Dr. Kevin, MD

“WebMD said death. I say chill.”

Beautiful Scalpheads, gather round,

This is The Saturday Scalpel, and I’m your sexy host, Dr. Kevin Cutthebull, MD, bringing the healthy vibes even when your eyes are as red as a lobster at a sunbathing contest.

Here’s what we got for you today:

• 👁️ Eye-saving protocol backed

• 📉 HRT debunked and updated

• ✅ Rants, revelations, and hormone redemption

Let’s get one thing straight: your eyeballs aren’t innocent… and neither are your hormones.

They’ve both been quietly betraying you while you’re too busy blaming your screen time and oat milk.

Let’s talk about the two most gaslight-y systems in your body: your vision and your estrogen.

Grab your bougie matcha (watch your iron levels!), adjust your readers, and let’s operate.

#1 Your Eyes Are Technically Brain 🧐

No one tells you this, but your retina is actual brain tissue.

That’s right. (*in Frank Sinatra’s tone*)

Your eyeballs are technically part of your central nervous system.

So when you’re staring at Facebook all day, you’re not just frying your eyes… you’re frying your brain.

In fact, the latest eye-imaging tech can now spot early Alzheimer’s, Parkinson’s, and MS… through your retina. (Not gonna lie, it turned me on a bit 🙄…)

So yes, when you protect your vision, you’re protecting your brain.

Which is wild because most people treat their eyes like a windshield… only notice them when they’re dirty or cracked.

Want to avoid the top 5 eye catastrophes?

We’re talking about glaucoma, macular degeneration, diabetic retinopathy, refractive error, and the ever-glamorous dry eye syndrome.

Most of them are preventable, if you stop ignoring them.

Ok…give me protocol, wtf should I do?

Here’s your 5-step prevention protocol, with zero BS:

• Step 1: Go outside.

  Your eyeballs evolved under the sun, not under ceiling LEDs.
  Aim for 1–2 hours of outdoor light daily. This isn’t hippie advice… it prevents nearsightedness and keeps your sleep-wake cycle in check.

• Step 2: Get annual eye exams.
  Even if you “see fine,” you’re not safe.
  Glaucoma is the silent killer of optic nerves, and by the time you feel it, it’s over. Have a professional check your eye pressure yearly after 40. (very important)

• Step 3: Wear sunglasses like I did on my profile picture. 😎
  UV damage accumulates, just like your skincare regrets. Grab UV-blocking shades and a hat. Blue light isn’t your enemy… but use warm lighting at night to avoid circadian shi*tshow.

• Step 4: Fix your dry eyes. 
  Use preservative-free drops, clean your lids with baby shampoo, and blink like you mean it. Seriously, you forget to blink while doomscrolling. Your meibomian glands are begging for mercy.

• Step 5: Supplements that don’t suck.
  If you’re high-risk for macular degeneration, go for the AREDS2 formula.
  For glaucoma? Vitamin B3 (nicotinamide) is emerging as a neuroprotective superhero.

Oh, and here’s your weird vision fact of the week: your peripheral vision is legally blind…around 20/200.

But your brain lies to you and fills in the gaps like a shady Photoshop intern. You’re hallucinating constantly, and your brain calls it “seeing.”

You’re welcome.

#2 The Hormone Plot Twist You Weren’t Expecting

Look, hormones don’t just “drop” after 40… they free-fall off a cliff while flipping you off on the way down.

Let’s break this down without the medicalese:

Your Monthly Hormone Rollercoaster 🌀

There are two phases in the female cycle:

• Follicular phase (days 0–14) — Estrogen ramps up, prepping your ovaries for ovulation like a hormonal project manager.

• Luteal phase (days 15–28) — Progesterone steps in, prepping the uterus for a potential guest (aka pregnancy).

If you're tracking hormones, Day 5 labs are your best bet (FSH, LH, estrogen, progesterone).

Most doctors don’t mention this… now you know more than them.

And that rage-eating during PMS?

Usually caused by a steep progesterone crash, not because you’re "too emotional."

Low-dose progesterone during the luteal phase can actually help smooth things out - no crystals or moon chants required.

Now onto menopause… or as I call it, “The Great Hormonal Ghosting.”

Symptoms include:

• Hot flashes that feel like spontaneous combustion

• Night sweats (aka 3 a.m. swamp mode)

• Vaginal dryness (no jokes here, it sucks)

• Brain fog so thick you forget your own birthday

• Bone thinning that could turn you into a Jenga tower

Now, your estrogen isn’t the problem. It reduces those symptoms, and protects your bones, brain, and heart while it’s at it.

But the way it’s been misunderstood, villainized, and misprescribed is a huge problem...

Story Time…

Back in the early 2000s, the now-infamous Women’s Health Initiative (WHI) study convinced the world that hormone therapy - especially estrogen - caused cancer. (*gasp*)

Spoiler: the study was a flaming hot mess. 

They tested HRT on women 10 years past menopause, used horse-pee estrogen, and a synthetic progesterone (MPA) that no one sane prescribes anymore.

They reported a 27% relative increase in breast cancer risk... but that translated to just 1 extra case per 1,000 women per year.

Oh, and they conveniently left out that estrogen alone actually reduced breast cancer risk by 24% in women without a uterus.

You know what that is?

Medical gaslighting. With a side of bad math.

But don’t worry, I got you, per usual!

Here’s what actually works now… and safely:

• Start HRT at the onset of menopause, not a decade later when the ship has already hit the iceberg.

• Use bioidentical estradiol patches (Vivelle-style), not horse hormones.

• Pair it with micronized progesterone (oral or IUD) if you have a uterus.

• Still feeling meh? In rare cases, topical testosterone helps restore libido and energy… safely, without turning you into Hulk Hogan. (RIP)

• Yearly endometrial ultrasounds to monitor uterine lining.

Scalpel’s Picks

• Your free Gut Health Evaluation and get a quick reality check.

• Dr. Max’s book on “How to fix constipation even when nothing else has worked for you.”

• This hydrogen water flask is my go-to tool for reducing inflammation

That’s it for today’s operation.

Reply to this mail, tell us your story…

I love hearing your success stories, they boost my ego even more…

Catch you next Saturday, same time, same sarcasm.

Tell your hormones to stay sexy,

Dr. Kevin Cutthebull, MD (Unfairly handsome)

P.S. What did you think of today’s edition?