You can clearly tell Chelsea is not really hacking, because after she takes her hand away from her face coughing, a big huge hack comes out and her mouth isn't moving.
Alan says the title of the episode.
Alan: Where would you meet a nine-year-old girl?
Jake: We're in the same math class.
Alan: Is, uh, she one of those advanced students?
Jake: Sadly, no.
Alan: You told Chelsea you loved her. You gave her an engagement ring. This is what it's all about—being there for her, no matter what: for richer or poorer, better or worse, in sickness and in health.
Charlie: Call me crazy, but I prefer richer, better, and health.
Jake: Maybe she has an STD.
Jake: It means, "Sexually Transmitted Disease".
Charlie: I know what STD's are.
Alan: Your uncle helped to invent them.
The German episode title is "Der Schwellkopf meines Sohnes", and the French title is "L'énorme tête de mon fils", both exact translations. The Italian title is "Sciroppo per la tosse e bourbon", meaning "Cough Syrup and Bourbon".
Latin America: April 21, 2009 on Warner Channel
Australia: May 5, 2009 on Channel 9
Czech Republic: May 5, 2010 on TV Nova
Slovakia: October 8, 2010 on Markiza
This episode's end titles has Chuck Lorre's Vanity Card #246.