This is the last episode featuring Lisa Rieffel as Carrie's sister. After this episode, she is never seen again and her disappearance is never explained.
The title of this episode is a word play on "oral sex" when Carrie is so appreciative of Doug spending time with Arthur that she gives him oral sex and Doug is spending the rest of the episode trying to do more with Arthur so Carrie can "appreciate" him often.
Arthur refers to an army buddy of his, O'Shannon, who got his nose shot off and choked to death on his own blood. Dan O'Shannon is a creative consultant on the show.