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What is the absolute worst type of animal bite? Or what’s a bite that seems harmless but that could cause serious damage? I see it all the time in the Emergency room, people come in for all sorts of bites and wild animal injuries. But can one bite actually kill a person? How about a quick chomp paralyzing a patient or causing neurological damage?


It can absolutely happen if not treated right away, that’s why today we are discussing and breaking down 5 different types of animal bites and why you need to treat them or seek help urgently. It could be a matter of life or death.


1. Snake Bite


The temperatures are heating up in certain parts of the world, like here where I live in Southern California and that usually means snakes are more active. You see them when you go hiking, sometimes they find their way in your house, but no matter how you come into contact with one of these slithering serpents, it's best you don't get into a tangle with them because the results could be disastrous. For starters, most average folks are not able to easily identify which snakes are which, out there in the wild. And with that, you may not know if the snake you are locking eyeballs with is venomous or not. So if bitten by any type of snake it's a no-brainer to just use extra precaution and j get to the hospital immediately.


That being said, of course, not all snakes are venomous. Venomous snakes are capable of injecting venom by way of their bite. So let’s pretend for a sec you’re bitten by a venomous snake, which is usually apparent by the two fangs on the snake that deliver two pretty distinct puncture marks to an area of the body. Depending on what type of venomous snake you are bitten by, a person will usually begin to see symptoms immediately that then worsen over time. Realistically you need to get to the hospital as soon as you can but you absolutely want to seek medical attention within 30 minutes. Doctors, if they have it, will administer antivenom. But if a bite is left untreated, your bodily functions could break down and you may experience trouble breathing, severe tissue destruction, paralysis, organ damage, or even death.


Brown snakes for instance in Australia are highly venomous and bites can lead to rapid blood pressure drop, cessation of blood clotting, and cardiac arrest all within just minutes. Here in Southern California, I treat a lot of Rattlesnake bites, which can be fatal for about 1 in 600. Luckily we have an antivenom that can help reduce symptoms but you have to get to the hospital as quickly as you can.


Now one other thing, do not ice a snake bite. This can cause smaller blood vessels to constrict and sometimes produce dramatic tissue damage. If bitten, just focus on getting to the hospital.


2. Ticks


As someone who grew up in the North East, I'm used to having to search for ticks when coming in from wooded areas. But you would be shocked to learn all of the diseases these tiny little pin-sized creatures can carry. Now depending on where you live in the world and which tick species are native to your region, Being bit by a tick could result in a million different ailments. Things like: Anaplasmosis, babesiosis, Colorado tick fever, Lyme disease, encephalitis, Rocky Mountain Spotted Fever, Southern Tick-Associated Rash Illness, Q fever, and more.


Now if you’re like well I have no idea what any of those things are? But they sound scary. They for sure are. These diseases trigger rashes and fever, fatigue, pain, skin ulcers, and neurologic problems, some very severe and some that endure for years. With Lyme disease specifically is more common in the US. I have treated patients who couldn't walk, who had heart problems, and more with later stages of Lyme disease, it’s no joke.


So, If you have a tick bite watch for an expanding red rash or lesion at the site of the tick bite or an unexplained feverish, achy, fatiguing illness within 1 to 4 weeks after the tick bite. If you are concerned, you could even take a picture of the rash and contact your physician. A lot of these have very distinctive patterns, for instance, a bullseye rash pattern could show up.


If you think you are bitten don’t just brush the experience off either, like eh it's just another bite. In areas that are highly endemic to Lyme disease, for instance, a single prophylactic dose of doxycycline may be used to reduce the risk of acquiring Lyme disease.


3. American Alligator


Maybe you’re heading to the South this year to do a little vacationing or heck maybe you even live there. I know I've certainly seen them when I used to live in North Carolina back in college, but an alligator's bite can be extremely serious and life-threatening. I mean talk about a force that could kill something or at least do some serious damage. The bite of an alligator is strong. We’re talking a psi of 2,900 LBS strong or enough to crack a turtle’s shell. So just imagine what it could do to say human skin or an animal’s skin. And not to mention they have 80 sharp teeth to go along with that to easily tear things into pieces.


If you are the unlucky one who gets gnawed on by an alligator we usually treat it as major trauma. I know it may seem obvious with major lacerations and flesh missing, heck possibly even fingers or limbs missing, but even if you didn't lose any of your digits. It’s also important to realize that one could also be at high risk for a soft tissue infection because of the microorganisms that can be transferred from gators.


If you are wondering about the crocodile’s bite, similarly if you find yourself in a run-in with a crocodile and make it out of there, definitely get to the hospital. But the kicker is the force of their bite is said to be even stronger than the gator, so it’s best you just steer clear of these saltwater beasts altogether.


4. The Mosquito


It’s time for the deadliest animal on the list, Their bite alone is responsible for the deaths of more than 400,000 people every year.


I know what you are thinking, a mosquito? Really? But it's true, these little bugs and their bites can mean deadly consequences if not treated accurately. So let’s break this down further shall we?


It’s very rare that you actually feel a mosquito bite you. That’s because the mosquito injects saliva that prevents clotting and numbs the area so you don't usually feel the bite, allowing the mosquito to feed on your blood undisturbed.


And a mosquito’s little pesky bite can transmit a smorgasbord of dangerous diseases to humans. Things like: Malaria, chikungunya, dengue, yellow fever, encephalitis, and Zika Virus. The list goes on. As I said at the beginning of this, more than 400,000 people die every year from malaria alone.


So when to go to the hospital? Anyone bitten by a mosquito who then experiences nausea, fever, swollen lymph nodes, a rash, or a prolonged headache should visit the emergency room. Hospitals will try to figure out which mosquito-borne disease you may be suffering from and offer supportive therapies.


For full disclosure, not every mosquito out there carries some sort of killer disease but you should definitely be on high alert, especially when traveling somewhere new that is known to have these infected mosquitos or high instances of these diseases. For instance, some places in South America, are on higher alerts for Zika Virus and encourage travelers to Practice Enhanced Precautions. Similarly, the highest transmission of malaria is found in Africa, South of the Sahara.


Now if your mosquito bite isn't that serious, just super itchy and annoying, try washing the area with soap and water then ice it a bit. You can even use a mix of baking soda and water on it or any over-the-counter anti-itch cream. People also say honey and aloe vera work. If you want me to do another video on all the most dangerous bug bites in the world of spiders. let me know because I could do a whole video just on bugs and just spider bites alone.


5. Shark


I’ll start with the good news about shark bites. The odds of being killed by a shark are about 1 in 3 or 4 million. In fact, you have a much higher chance of dying from a selfie-related accident than a shark attack but shark bites can be extremely serious and even fatal.

Also, the necessary medical treatment depends on the severity of the shark bite and even what kind of shark the biting will also factor into that. A great white shark for instance has a much more violent bite than say a nurse shark. But regardless of who or what bit you, it's imperative that you get to safety first, so in other words, get out of the water and try to stop the bleeding.


It’s super important to restrict the blood flow, a lot of times that means keeping a wet suit for instance on, it kind of keeps things intact as much as possible and stops a person from bleeding out. And if I didn’t say it already, get to the hospital or seek out medical help as soon as humanly possible.


Now at the hospital obviously the treatment will depend on the severity of the bite but typically we may take a patient quickly to the operating room, remove any dead tissue, course, control bleeding, and clean the wound thoroughly.


Lastly, just some minor shark encounter details to keep in mind. Sharks are attracted to high-contrast colors, and a lot of divers use the phrase “yum yum yellow” for instance talking about sharks’ attraction to certain high-contrast colors. So keep that in mind if you’re out surfing. And if you really have to fend for yourself, gills and eyes are very sensitive. But of course, that's only to be used if you are truly in an emergent situation where you have to go head to head with a shark. Luckily most of us will never have that experience but if you know someone who’s ever had a run-in with a shark let me know in the comments.


What is the absolute worst type of pain? I see it all the time in the Emergency room, on a scale of 1-10 where’s your pain level at? But what truly is the most excruciating type of acute pain one can experience?


Here are 5 of the most off-the-chart painful pains a person can experience.


1. Kidney Stones


Medically known as Nephrolithiasis, having kidney stones is unimaginably painful and to paint a pretty picture for you it’s often compared to the pain of getting stabbed with a knife. And get this It’s estimated that 12% of Americans for instance will develop a kidney stone in their lifetime.


Not fun would be the biggest understatement of the year. You see these small crystalline pebbles form in the kidney or urinary tract. Aka- the body’s drainage system area for removing urine from your body. And boy are they painful. Usually made from either calcium, struvite, uric acid, and cysteine they block the flow of urine, making the kidney swell and causing waves of sharp pain at the mid-back, abdomen, or sides. And for dudes, pain at the end of their penis as well. And that’s all my friends, kidney stones often result in fever, blood, and pus in the urine and vomiting.


Now, once a kidney stone is confirmed, treatment with IV fluid and medication allows the stone and the pain to hopefully pass sooner rather than later. Now when I say pass. I mean yes you basically have to give birth to this hard pellet via your urethra.


Though stubborn small kidney stones can be broken up with shock wave therapy, or lithotripsy. And larger stones may call for more complex treatments like surgery. Usually, kidney stones are fairly small in size, maybe under the size of a pea, but even a grain of rice stuck in your ureter, you don’t want it, believe me, I see it. Oh and according to the Guinness book of world records, the largest kidney stone ever recorded was over 5 inches at its widest point. A golf ball in comparison is just under 2 inches.

Did I mention that nearly half a million people visit the emergency department each year with these painful bladder boulders? You’ll want to avoid it like the plague if you can but possible causes include not drinking enough water, obesity, weight loss surgery, eating food with too much salt or sugar, or too much fructose. Infections and family history might all increase the risk of developing a kidney stone. If you’re one of the poor souls out there who’s ever had a kidney stone, let me know in the comments on a scale of 1-10 how painful it actually was.


2. Trigeminal Neuralgia


Often described as lightning hitting your face, let me say that again, often described as lightning hitting your face, trigeminal neuralgia is sudden attacks of severe, shooting facial or head pains that can be so debilitating a patient is unable to do anything at all while this excruciating nerve pain is happening.


Sounds crazy Scary and painful for sure, but what causes this severe shock therapy to the head? Well, when the trigeminal or 5th cranial nerve, one of the most widely distributed nerves in the head is disrupted in some way. For instance, a blood vessel could be pressing on it as it exits the brainstem, causing the wearing away or damage to the protective coating around the nerve (the myelin sheath).


These, let’s call them “lightning strikes” or severe types of symptoms can happen in people with multiple sclerosis, nerve compression from a tumor, arteriovenous malformation, which is a tangle of arteries and veins. Or even perhaps because of saying a sinus surgery, oral surgery, stroke, or facial trauma.


Did I mention that this extreme, sporadic, sudden burning, or shock-like facial pain that could even be set off by something as light as a gush of air or brushing one's teeth and last anywhere from a few seconds all the way up to an hour or two? Yeah and not to keep piling on to the bad news pile but there is no cure for it either. Although it can be managed with therapy and meds.


An estimated 1 in 20,000 people will experience this type of physically and mentally incapacitating pain. And for some reason, it tends to be more common in women than men.


3. Giving Birth


They say giving birth to a child is supposed to be one of the best days of your life. Well, what if I told you it can also be one of the most extremely painful sensations one can experience in their lifetime. I see it all the time in the Emergency Department. Here let me set the stage real quick, recently reproductive studies came out and compared menstrual cramps to be as painful as a heart attack. Now, what if I told you that labor and delivery for some have been described as the most extreme menstrual cramps. Aka pain scale- Heart attack on steroids. Though not in the chest.


Labor and delivery in a nutshell is the ending portion of pregnancy where a baby leaves the uterus passing through the vagina either “naturally” or via c-section.


During this time one’s uterine muscles start contracting hard, with severe cramping in the abdomen, back, legs, and groin area, tightening up, squeezing, pulling, and feeling like someone or something has just twisted your insides. It’s not pretty. And that's if there are no complications or tearing that could happen. Oh and this whole pain-filled process on average they say the active labor lasts somewhere between 4 to 8 hours but some go longer.


Alright, this is not to scare anyone off from having kids one day but it's just to have an honest discussion about how painful and complex this process can be for expectant mothers out there. Now luckily if a patient decides there are ways to try and relieve some of the pain. Non- medication methods include trying different delivery positions, walking, warm compresses, applying counter pressure, and breathing techniques. Or for those who opt for it there are pain medications and epidurals to help ease some of the pain.


Despite how painful it seems to be, luckily we’re all here thanks to our parents. Let me know if you or someone you know was given birth and what their pain experience was like.

4. Broken Femur


Speaking of babies, our next painful experience may make you cry like one when you find out just how truly agonizing it is. Yes, I’m talking about a Femur Fracture. I think we can all agree that breaking any bone royally sucks but breaking the longest and strongest bone in your body. Not something you would wish on your worst enemy.


You see, your femur is located in your thigh and it runs from the hip bone all the way down to the knee. Plus all the large arteries that run down your leg as well, let’s just call it a perfect storm for a bloody mess if you break your femur. Now, usually caused by some sort of severe accident like a sports injury or car crash, when one fractures this area, you cannot put any weight on the injured leg, let alone walk on it. Any sort of movement in this area will result in immediate screaming.


Also, you got the bone break, which is not fun but also think of all of the muscles that are attached in this area. Sometimes when patients come into the ER, I have to…

(cut the muscle or adlib portion about the muscle here)


So what is the recovery process like? To be honest it's a long one. 4-6 months I'd say at least. And it's broken up in different phases with lots of pain management. You have to first set the bone back into its proper place, with surgery to have some hardware put in. And while the body is regenerating new bone growth and battling the inflammation associated with all of this, we also highly recommend physical therapy to strengthen the muscles around the bone. If you want me to do a full video on the most painful broken bones you can experience let me know that too in the comments below.


5. Corneal Flash Burn


You know when you’ve had a really long day at the beach and your body turns red like a lobster. Maybe you even get so sunburned that blisters start to form. How much that hurts, right?


Now imagine all of that but in your eye. I'd say it's excruciating enough to make a grown person cry, but honestly, crying only makes it worse.


Now the cornea of the eye is the clear, outer part of the eye that helps your eye to focus light so you can see clearly. Now imagine a flash burn to the eye so bad it basically just singes it all. Say goodbye to 3-D glasses and seeing for a bit and hello to Eye-patches because Bloody, pusie and painful are only the beginning.


Usually, when I treat or see corneal flash burns in the ER they are caused by things like welding torches, being exposed to too much bright Ultraviolet light, lasers, tanning bed lights, and snow reflection even when skiing or snowboarding. But even Looking directly at or near the sun, especially at higher elevations can cause your cornea to burn. No your parents weren't lying when they said don’t look directly at the sun for long periods of time. This can in fact fry your cornea.


Now here’s the tough part about treating a corneal flash burn. Just as your eyes sort of start to heal themselves, anytime a patient blinks their eye or opens and closes their eye, it kind of basically sluffs off any sort of healing layer that occurred. Restarting the whole painful healing process. When we treat this obviously first artificial tears, medications, and pain meds to help prevent infection and to try and prevent your eyelid from sticking to your eye. In severe cases, surgery may also be needed to repair the area. So remember especially if you are welding or doing anything with a large amount of UV light, definitely wear eye protection, you do not want to have to come to visit me in the ER with a cooked cornea I can assure you.


How to Manage Pain?


Alright, now it's time to talk about pain management and how to manage the pain. Now obviously pain is subjective and really depends from person to person and of course the severity of the condition you are suffering from but if you or someone you know is experiencing pain, there should be ways hopefully to find some sort of relief. Now, If you are experiencing a medical emergency or sudden onset of severe acute pain obviously go to the hospital immediately, but if this is a chronic pain condition that comes and goes over time may see a pain specialist or a doctor that really knows the ins and outs of the exact ailment or condition should be considered. That way you can get to the root of the problem rather than just masking the pain with say medications. Don’t give up on finding relief and be proactive for your own health.



Caffeine, is it secretly good for your health? Can it stunt your growth or worse yet, kill you? How about Alzheimer's disease and erectile dysfunction? Does it cause that? And what about asthma?


Today we’re breaking down 8 unsuspecting truths about caffeine that you need to know right now!


Myth #1: Caffeine Can Kill You?


Don’t freak out about what I’m about to tell you. But yes technically this is true. It can. In fact, I've even treated a number of people who had some health issues from ingesting way too much caffeine in the Emergency Department. Symptoms like: tachycardia, or sped-up heart rate, tremors, high anxiety, and vomiting among other side effects. It can affect your body if consumed in too high amounts. That’s why it's important you know the difference between a healthy amount and just how much is too much?


The U.S. Food and Drug Administration considers up to 400 milligrams a safe amount of caffeine for healthy adults to consume daily. That’s equivalent to about four cups of coffee, or ten cans of soda, or 2 energy shot types of drinks in a day. But please keep in mind different products out there have different amounts of caffeine and other added ingredients like loads of sugar, so the limit and health impact can really vary from product to product. They say the average person in the U.S. drinks about 135 mg a day or about 1.5 cups of coffee. How does your caffeine intake compare to the average?


Alright back to the question at hand, Could too much caffeine kill someone? In rare instances yes. When caffeine is consumed in very high doses, at say in excess of 5 grams in adults (which is 5000 mg) yes it could be lethal. Remember you’re only supposed to drink up to 400 mg a day. Here’s the caveat: higher levels of caffeine consumption is usually found more with products like powdered caffeine and caffeine pills like with weight loss pills. In a concentrated potent product, the dangers increase a lot. For instance, some concentrated products out there contain around the same amount of caffeine as 20-30 regular coffees. This is not good, so please be safe, and like with anything, don’t go buck wild on it and know what ingredients are in the type of products you are consuming. Alright, I'm going to get off my high horse and move on to the next myth, I think you’re going to like this.


Myth #2: It Stunts Your Growth


We’ve all heard this one, but this is not true. This has long been a myth circling coffee and just about anything caffeinated for that matter. Heck, I know I definitely heard it when I was growing up, if you drink too much soda, it will stunt your growth. But where did this rumor start?


It may have had something to do with the fact that decades ago some research studies found an association between high caffeine intake and reduced calcium absorption in the body. And we all know that calcium is good for bone density and health so the thought was that any lack of calcium in the body could be a contributing factor to osteoporosis.


So if you say you drank coffee or some other caffeinated beverage for instance, you could in theory, be at increased risk of osteoporosis. But here’s the issue with this. The studies also concluded that the reduction in calcium absorption associated with caffeine intake was very small, and the calcium loss could even be offset by adding 1-2 tablespoons of milk to your cup of coffee that you drink. So to flat out say caffeine stunts your growth is a bit of a stretch.


Myth #3: Caffeine Can Make You Live Longer


Errr what? Ummm but Doctor Wagner didn’t you just say that too much caffeine could possibly kill me? And now you’re saying it has health benefits, I’m confused.


Here’s the deal: caffeine by way of coffee can actually be very beneficial for your health. Besides feeling more alert and giving one energy…drinking coffee has been linked to lowering risk for all sorts of health problems. Diseases like: Parkinson’s disease, liver disease, type 2 diabetes, and dementia are just the beginning.


For instance, one scientific study revealed that drinking 3-5 cups per day was associated with a decreased risk of dementia & Alzheimer’s disease by about 65% at late life. Other evidence suggests that normal consumption of caffeine can reduce the risk of colorectal cancer by 26%. For women, drinking at least one cup of coffee a day that’s associated with lowered stroke risk, which is the fourth leading cause of death in women. I could go on and on about all sorts of health benefits from caffeine and caffeine-related products like coffee.


I could go on and on about all sorts of health benefits from caffeine especially when consumed through coffee.


Myth #4: Caffeine Sobers You Up


Uh No, not exactly. Listen, we all know that alcohol can have sedative effects on the body. In other words, in addition to making one impaired, it can also make a person feel sleepy. And it usually hits a person 2 to 6 hours after alcohol consumption.


So here’s where the myth comes into play, one would think that because caffeine does the opposite of alcohol, or generally makes people feel more alert. It could kind of counteract the buzz. But this is just not the case. Although it might make a person feel more alert after a late-night chug fest, it, unfortunately, cannot remove the feelings of or state of drunkenness or the cognitive deficits that alcohol can cause.


For instance in one lab study. Mice were given alcohol followed by the human equivalent of eight cups of coffee. After the caffeine intake, the rodents did appear more alert, but they were still much worse than the sober mice at getting around a maze.


The reason is that we have to metabolize the alcohol we drink in order to diminish its effects. The body processes it in several ways but it’s mostly broken down in the liver by two enzymes, alcohol dehydrogenase, and aldehyde dehydrogenase, and eventually excreted.


Myth #5: Caffeine’s Good for Asthma


This one is in fact true. If you struggle with asthma issues or even shortness of breath, you may want to listen to what I'm about to say. Caffeine does appear to improve airway function for up to four hours in people with asthma after consumption. In fact, it is a weak bronchodilator and it also reduces respiratory muscle fatigue. And Caffeine is also chemically related to the prescription drug theophylline which has been used over the years to treat wheezing, shortness of breath, asthma, chronic bronchitis, and other lung diseases.


Now is this a substitute for your quick-relief inhaler or other asthma action plan prescribed by your doctor? No, because we all know if not treated properly asthma attacks could be life-threatening, but caffeine has been suggested to have protective effects against asthma, and reduce asthma symptoms.

For instance: in a study out of Korea where researchers analyzed the frequency of the participants' beverage intake and their findings showed that caffeinated coffee consumption lowered the frequency of asthma. And yet another study found that the consumption of caffeine prior to exercising may reduce the symptoms of asthma as well.


Speaking of ummm stunting your growth, next myth you’re going to want to know about: Caffeine Cause Erectile dysfunction?


Myths #6: Erectile Dysfunction:


I’m happy to report this one is also false. Caffeine has many effects on the body, it gives you that burst of energy that can be great for um athletic performance but it can also narrow the blood vessels throughout the body, so with less room for blood to flow, it can temporarily raise blood pressure a bit which is why researchers initially suspected that there could be a potential link between caffeine and ED.


But according to one study, caffeine intake is actually linked to reduced odds of having erectile dysfunction (ED) in men who drink the equivalent of two to three cups of coffee per day. Evidently, caffeine triggers a series of internal effects that lead to the relaxation of the penile arteries, and the smooth muscle that lines cavernosal spaces, thus increasing penile blood flow.


Number 7 Caffeine Myth: Caffeine Causes Insomnia


Insomnia? Eh not usually but could it disrupt your sleep yes. But it really all comes down to your body's sensitivity to it. According to the American Academy of Sleep Medicine, it takes about 30 to 60 minutes for caffeine to reach its peak level in the blood. Then the half-life of caffeine, or the time it takes to eliminate one-half of the caffeine people have in their bodies, is about 4 hours.


But keep in mind this also depends on things going on in your body like for instance: one factor could be your metabolism, or say how much fiber you have, or how frequently you consume caffeine, processed mainly through the liver, some caffeine can stick around in the body for several hours. But for most people, a cup of coffee or two in the morning won't interfere with sleep at night.


Your sensitivity may vary, though, people who are more sensitive may not only experience insomnia-like effects but also have caffeine side effects of nervousness and gastrointestinal upset, etc. And women who take birth control pills may keep caffeine in their systems for up to 4 hours longer than compared to those who are not on the pill. And Pregnancy can even extend caffeine's half-life even more. Interestingly though, on the other end of the sensitivity spectrum, it’s said that Caffeine's half-life may be shortened in people who smoke. So moral of the story here: if your body is sensitive or impacted by caffeine's effects try not to consume any caffeine products at least 6 hours before going to bed.


Myth #8: Caffeine Can Provide Relief For a Headache


This is a caffeine truth. During a headache, blood vessels swell or go through other changes causing more blood flow around the brain. Now this increase of blood to the brain area puts pressure on surrounding nerves which sends pain messages to the brain. Aka what you experience as a headache.


Caffeine has vasoconstrictive properties, meaning it could cause your blood vessels to narrow, restricting blood flow, which might relieve a little bit of that pain you're experiencing from your headache. Now caffeine taken with other common headache pain meds could also increase the absorption and strength of the medication to provide even faster relief.


But keep in mind also that consuming too much caffeine can also trigger headaches and caffeine withdrawal can sometimes also have the same blood vessel enlarging type of qualities and trigger a headache as well. Adjusting to the right amount of caffeine in your system is key here.


So just how much caffeine is in some of your favorite beverages?


An 8-ounce cup of coffee: has about 95 to 200 mg of caffeine.


A 12-ounce can of cola on the other hand: 35-45 mg.


And your average 8-ounce energy drink? Typically they have between 70 to 100 mg of caffeine. Obviously, there are some with way more than that, but let’s just say the average.


Now tea, on the other hand, depending on the type of tea, has around 13-60 mg on average for 8 ounces.


So if you and your buddies are trying to stay up all night cramming for school or you gotta drive home and you’re getting tired you may want to just opt for a good ol’ cup of coffee to get the most bang for your buck so to speak.

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