179: 5 'Check Engine Lights' for Men's Health

Scot: In last week's episode, we talked about the men's check engine light. A car has a check engine light, and when that comes on, it means you probably better do something about whatever the problem is.

It was part of an episode about maintenance that guys should do. However, we thought, "Wow, that's a great topic as well." So that's what we're diving into today. So guys don't have a check engine light, but if we did, what things should set it off according to a doctor?

That's what we're going to talk about today on "Who Cares About Men's Health," with information, inspiration, and a different interpretation of men's health. My name is Scot. I bring the BS. The MD to my BS is Dr. John Smith.

Dr. Smith: Good afternoon.

Scot: And I understand he has a health check engine light story for us, so I look forward to that. Producer Mitch.

Mitch: Hey there.

Scot: All right. So the check engine light, it comes on. You probably should do something about what's going on. Sometimes a check engine light, though, comes on and there are no noticeable symptoms. But a lot of times it comes on and there are other things going on. So if men had a check engine light, what would be the things that, if that check engine light came on, we should do something about?

Dr. John Smith mentioned erectile dysfunction last week. Is that going to be one in your top five check engine lights for men that they should get checked out?

Dr. Smith: It is now.

Scot: Well, when I asked you last week, you said that would definitely be one of them. So I would expect that that would be on there.

I don't know what the other four are. This is going to be a lot of fun to see what those things are that, if they happen to us, you probably should get checked out because it could be a sign of a bigger issue.

Mitch, what is your check engine light story?

Mitch: So after years and years of being underinsured or etc., I got really good . . . Like, if you drive a jalopy for years, it's like, "Eh, that light comes on all the time. You just jiggle a cable." But once I started getting some real insurance and stuff, I started to pay more attention where I could.

But the emergency light that came on a couple of years for me was being chronically fatigued. Not just, "Hey, I was out too late, had a couple too many drinks," or something like that, and wasn't feeling great the next day. But I just was constantly not feeling well, and I was tired and run down and sore when I hadn't done anything.

And it took a while for me to finally pay attention to that and go get some second opinions about one diagnosis or another, and find out that I had extremely low T at the time and kind of get that all fixed.

That was something that had I not paid attention to the chronic fatigue, had I just been, "Eh, I'm just tired. I'm just whatever. I'll be fine tomorrow," had I just ignored that sign, who knows how . . . I don't know how I would have started to get better.

Scot: Yeah, that's a good one. Plus, also, didn't some of that fatigue . . . So you did that, and then you still kind of had some fatigue. The old check engine light came on again, and you're like, "I just took this in. What's going on?" Then you got diagnosed with sleep apnea, right?

Mitch: Yeah. Because that was kind of it, too. I was doing better for a while, and it wasn't apnea, it was the restless leg syndrome, which now I have medications for. But that was the same thing. I now didn't feel fatigued through the day, but still, I would wake up.

And it didn't matter when I went to bed, how long I was sleeping, what stats my smartwatch was telling me, etc., I was still tired and just dragging butt all day, every day. That was another one that I'm like, "I've got to go figure this out."

Scot: Got it. And we all know how important sleep is. It's one of our Core Four, right? Nutrition, activity, mental health, sleep. Sleep impacts our health in so many ways. Not just being tired, but it's been shown that if you don't get enough sleep, you can have other health issues. So that's a good check engine light to get checked out.

Dr. Smith, is sleep on your list?

Dr. Smith: Sleep is always on my list.

Scot: I have a feeling you just said that. I don't know if that was on your original . . . All right. I can't wait to dive into this list. The top five check engine lights for men. If one of these things happens, you probably should get it checked out. Any particular order, or are we just going to dive in?

Dr. Smith: So I've got a couple of these things that are probably no-brainers that I think, in reality, they're in the top five just because if you're going to ignore these, you're probably not looking to keep that car running at all.

And so I've got a few extras that I think a couple of them you'll agree that are just kind of like, "Hey, you should probably do something about that if it's happening." And so I've got a few more than five, but it should make sense as we go through.

Scot: All right. You're just an overachiever. Let's go ahead and kick off this list. What's your first one you're going to give to us?

Dr. Smith: Well, I don't know about overachieving, but you think about something like chest pain. If you're having chest pain with exercise, things like that, that's not something I should be telling you, "Hey, you should probably go see somebody about." That's a serious thing. And that can represent cardiac disease. It can represent things like that. I mean, that's a number one thing on my list.

When I'm at my office and I'm seeing people, I'm like, "Okay, what's the worst thing that can happen from the symptoms this person has?" What would be the bad thing? Or in the case of chest pain, this could be a heart attack and kill you. And so that's not something that I hope many of these men are really just sitting on, right?

I'm putting it at the top because it's one of those things that's a no-brainer, so I didn't want to add it in my five. But if we don't talk about it, I think we're also doing ourselves a disservice in that regard.

And so chest pain is one where if you're having chest pain, even with exercise on a regular basis, you're like, "Yeah, man, I'm pretty healthy. I go to the gym, I do my thing, but I get chest pain that hurts pretty bad after exercise or when I exert myself really bad," just go get checked out.

I mean, the worst thing that happens is there's nothing wrong with you, and at least you know. But you don't want to end up being the person who has an issue. And so that was one that I wanted to make sure we touched on because some guys may kind of push it off. I mean, the guys who probably push it off are the ones who have it regularly, consistent with exercise. They're like, "Oh, I just worked out too hard or whatever." Don't sit on that. Go see somebody and talk about it.

Mitch: I mean, for some folks, they might be like, "Oh, I'm pretty sure I'd know if I was having a heart attack." We had my buddy Rob on who had a heart attack to explain his experience, and he was debating whether or not to go to the hospital while he was actively having a heart attack, where he's like, "Oh, it's probably nothing. Do I need to go up there?" That seems like it would be a big flashing emergency light, but sometimes it's not for everyone.

Dr. Smith: Really, I think it sounds like a no-brainer, but sometimes in that moment, you might be like, "Do I really need to go to the hospital?" And it sounds like, Mitch, your buddy was in that same boat of, "Is this really something to worry about?" And so it's worth it. Just make that appointment, go in, and see somebody.

Something that's akin to that would be shortness of breath. You get out, you start exercising, and you're like, "Man, I am gassed way earlier than I used to be. I just can't keep up." Now, if you haven't been off the couch and used to be a marathon runner, and then you stopped, and it's been 15 years, don't think you're going to be back to that status when you get off the couch again. I don't mean that. But what I mean is if you're used to exercising some and you just realize, "Man, I am really feeling out of breath a lot sooner than I would before," or just the simplest things start to cause you to have shortness of breath, that's another one that's akin to chest pain.

Don't goof around with that, because, again, that can represent similar cardiac disease and things like that, where your body is just not able to do the things it needs to, and you may need to get in and have something overhauled.

Scot: And a pulmonary embolism, is that considered cardiac disease?

Dr. Smith: No. Pulmonary embolism is a blood clot that's traveled to the lungs.

Scot: What I'm going to say here is I knew a guy that was in pretty good shape, and all of a sudden, just going upstairs, he'd be completely winded. And he went to doctors, and they were like, "Oh, we think it's asthma. Oh, we think it's this. Oh, we think it's that." And it ended up being a pulmonary embolism.

Dr. Smith: Yeah, I think there are those things where . . . Also, I'll put a plug in for this. If you go and see your doctor and they do something and it's not working, really go back and be like, "Hey, dude, this isn't working. I'm still having these symptoms despite this."

As much as I like to say doctors are really good at their job, sometimes we're not perfect. And we feel really bad when we're not, but we want to do our best for you. If you tell us, "Hey, man, this hasn't helped at all," we should circle back around and say, "Okay. What can we do to kind of make this better? What else can we look at to make sure we're not missing something?"

Scot: All right. Those are a couple of pretty big ones that you think they'd be pretty obvious, but as Mitch pointed out, our guest in the past was debating while he was having a heart attack whether this was important enough. I could find myself in that same situation.

So take shortness of breath, take chest pain seriously, and best-case scenario, you go in and they're like, "Well, we don't see anything emergent, but we'll keep investigating it."

What other check engine lights are there for us guys?

Dr. Smith: So I think Mitch alluded to that huge fatigue. I think that's a big one too. And there are tons of different things that you can have that will kind of exacerbate fatigue. One, sleep apnea. You could have low testosterone. You could have a low thyroid. I mean, there are a bunch of different things that can make you just absolutely fatigued. And so that's one where you don't sit on it because you can feel better. I mean, ask Mitch. Mitch, how much better do you feel?

Mitch: Oh, so much so. I now have the energy to do things. I'm sleeping well enough that I feel recuperated the next day. It didn't matter what I was doing with my diet, my exercise, etc. There was something else going on.

Dr. Smith: Yeah. And there are those things where I'll have people come to my office and be like, "Man, I had a buddy who got on testosterone, and he felt great. And I want to just check my T." We get testosterone labs, and their testosterone is 800. I'm like, "Dude, there's nothing wrong with your testosterone. That's not why you're tired."

It turns out that they have sleep apnea, or I send them to their primary doctor to get some lab work done, and they have a thyroid issue or something that they then work out and they get treated for. They're like, "Man, I feel like myself again." And so there are those things that you really want to watch out for that way.

Fatigue is one of those top ones because there are so many different things that can cause fatigue. And so that would be there as one of those ones to just not sit on.

Most guys want to feel good, get out, do their thing, and that would allow you to have an opportunity to get out and do your thing and find out why you're not feeling the way you should.

Scot: And not necessarily indicating a life-threatening issue, but definitely a quality-of-life issue that could play into it. I'd imagine, Mitch, that that impacted your mental health when you were so exhausted, you couldn't do anything. You couldn't get out and socialize and hang out with people or just even do the things you wanted to do.

Mitch: And I guess that's one of my questions for Dr. Smith. John, what is the difference between just, "I'm kind of tired all the time because I'm working too much or I'm kind of tired all the time because I'm not sleeping as well as I should," and chronic fatigue? Is there something people should be looking for as far as that emergency light is considered?

Dr. Smith: To me, I think a lot of people either have someone mention it to them, like, "Hey, Mitch, you don't seem as active or you seem tired or whatever," or you're just unable to do the things you used to do. You start to go, and you're like, "Man, I am gassed. I really just . . ." Those are the reasons to kind of get up and say, "All right. Let me check this out. Let's just not sit on this for a little while," when you're not able to kind of get up and feel the same way you did.

Scot: All right. What are some other of those check engine lights that us guys really should be paying attention to?

Dr. Smith: So erectile dysfunction is one for me where it can represent a problem. It can be the canary in the coal mine, so to speak. It can represent some early-onset cardiovascular disease for some people. And so having that checked out, going and having a cardiac evaluation or talking to your primary doctor is one where it can pay dividends and really mean a difference, because most people in those younger demographics without other health problems shouldn't be having those issues.

Another one from my field is urinary issues. A lot of men put that off, and they come and see me when things have progressed, and now they're trickling.

Sometimes I'll ask men how well they're urinating by if they hit the back of the bowl, the middle, the front, or they pee on their shoes, and that kind of tells me how bad their urination is. And some of these guys wait until they're literally dribbling on their shoes before they come and see me.

That can cause problems with the kidneys, problems with the bladder, and really make urination a chore for the rest of your life, which you could avoid by just coming in and being seen earlier when those fluids didn't seem to be flowing like they should.

Scot: All right. So, from the urology world, erectile dysfunction, who would have guessed that that is actually indicative of possibly of other problems? So that's good to know. It's not just the one problem. And the urination thing, that's good, too.

So what else is on your list, those check engine light items that us guys should not ignore or that we should go get the code scanned, if you will?

Dr. Smith: I think giving a plug for . . . Mitch has talked a lot about some mental health and things like that over the years. I think that's another one that men . . . the engine light might come on, and they might not want to deal with it. They might want to put the duct tape over the light and not worry about it.

I think we've had a lot of these conversations where life changes happen. You lose a job, you retire, things happen in your life that become difficult, relationships end, things like that where you can really become apathetic to things and lose interest in things, I think that's one where I would invite men to just say, "Hey, let me just go and have a conversation with someone," because it can really make a huge difference.

If you look at a lot of the statistics with the depression and anxiety and a lot of those things that are happening, it's much more prevalent now since COVID, and I think more people are willing to kind of go out and have those conversations. I think those are really important things not to put off because they can really be detrimental long term.

Mitch: I think that I was one of the people that had taped over the light with my mental health. It makes me think of my old Trooper that I had rebuilt the engine on, and it blew a head gasket, and there's steam coming up out of the engine and everything. I pull off the side of the road, and I'm just trying to get it to cool down, reload the stuff. And this woman walks all the way across the parking lot, and she's like, "Sir, I think there's something wrong with your car." I'm just like, "You don't say."

Scot: Or the better man response would be, "No, it's fine."

Mitch: Yeah. And that was kind of it. Similarly, I had people in my life that were saying, "Hey, you seem kind of off," "Hey, it doesn't seem like you have as much energy. You're getting into more fights than you used to," etc. And it was really easy for me to be like, "I'm just fine. I'm just whatever." But it took enough people telling me that to be my warning light to finally go in and talk to someone and start to work on that.

Scot: Yeah. One of the kinds of barriers that I faced is you think, "All right. This is a good idea." You get talked into it. You listen to our podcast, you listen to other people that you should get help, help is a good thing, they can give you tools to deal with these issues and help you work through them.

But then when you make the appointment or after you've made the appointment, you're like, "What are we going to even talk about anyway? This is dumb." And you end up not showing up or canceling, right?

But trust, if you show up, you will find things to talk about. That's what these professionals are able to do. They're able to help you figure these things out. It's not all on you to do all the talking. That's why you're there. So, yeah, don't fall into that trap.

Dr. Smith: Agreed.

Scot: Dr. Smith, what else do you have on your list here? Where are we even at? I know you gave us two bonus ones up front. I think we've hit sleep. I think we've hit a couple from the urology world. We just hit this one here, your mental health. What else is out there?

Dr. Smith: There are a few more that I kind of just want to lump them together because, again, these are just things that if you see . . . If you saw oil leaking on the driveway or you saw those different things of the higher incident things that we're seeing nowadays. Any time you're having difficulty with swallowing or changes in your bowel habits, those are definite things to seek help and look into.

There can be a lot of different things going on along with the difficulty swallowing, persistent hoarseness, or losing your voice, things like that, where you're like, "Oh, that's a weird thing. It just seems to happen." Sometimes there are other things going on that can cause a problem.

And so those would be the things that I would say, "Hey, don't fool around with those things," because we've noticed that colon cancer has been on the rise. It's happening in earlier and earlier age groups, and so not sweeping those to the side.

Those, again, are hard things to talk about. Nobody wants to come in and talk about erectile dysfunction, and then nobody wants to come in and talk about bowel and bladder stuff. But those are things that can really have a big impact down the line.

The difficulty swallowing and the bowel habits, they can kind of go hand in hand where you may have some other issues going on in the gastrointestinal tract. So I wanted to make sure that I kind of touched on that, because I think those are important things not to overlook with the increased rise of colorectal cancers.

Scot: And also, the losing of the voice, we did a podcast on thescoperadio.com network about GERD, given that's one of the symptoms of that, which I started noticing. My dad, towards the end of his life, started losing his voice, and that could have been old age, but I suspect it was . . . I know he was on Prilosec, which is a medication you use for GERD. I suspect that that's what it was. That's my moneymaker, so I take it seriously.

Dr. Smith: Yeah, as you should. And there are a few other things that you can have from that. I mean, long-term GERD can cause changes in your esophagus and put you at a higher risk for cancer in that region of the body. So those are reasons to get that treated and not mess around with it.

Scot: Yeah. And that's another tricky thing, right? The way that tricks us is we might start noticing it, and then we just kind of think, "Well, this is no big deal," and then we kind of forget how long it's been plaguing us.

Obviously, all of us are going to have some heartburn because of something we did that might be for a couple of days. But if you look back and you're like, "Honestly, this has been going on for a couple of months," that's probably a good idea to get things looked at.

Dr. Smith: Those are definitely things you want to take a peek at. The last one that I kind of had on my list was unexplained weight loss. If you're noticing that you're losing a lot of weight, that can be a sign of malignancy. And on the flip side, having an inability to lose weight can be a thyroid issue.

And so those are two things where I think men might get into the mode of, "Well, it's just my dad bod," or you started working out, and you're really dropping a lot more weight than you really should, and you're not thinking about it. Those can be signs of problems. And so just keep that in mind.

I had a close friend of mine who had colon cancer in his 50s, but he just started losing weight like mad. I was like, "Man, you're looking good. Are you losing weight?" He's like, "Yeah. I'm not really trying, though." And in the back of my mind, I was like, "Oh, that's . . ."

I mean, it's one of those things where I know, and it's just like that's great that you're losing weight, but at the same time, don't let that stuff kind of fool you.

And so those would be the other two things that I would say to just kind of keep in mind. And those are the things that are going to help you stay healthy anyway, keeping a healthy weight, watching a lot of these things. They tie back to the Core Four in a lot of ways.

Mitch: How much weight are we looking at before we're concerned, how much loss?

Scot: Gaining or losing?

Mitch: Loss.

Dr. Smith: So about 10 to 15 pounds of unintentional weight loss in a 6- to 9-month, and some people say 12-month, period.

Scot: So if you haven't changed your diet, if you're not exercising more, if something didn't happen, don't just go, "Well, I guess I'm blessed."

Mitch: That's what I was curious about. When I first got on testosterone and some things started working out and I got active again, I lost a lot of weight. And not once did my brain say, "This could be a problem." And I'm fine now.

Scot: Well, there was a reason for it, right?

Mitch: Right. There is a reason, but yeah, don't immediately think that you're just blessed, right?

Dr. Smith: Yeah, testosterone does have a body composition change over time when you start it, which is a nice thing to have. But if you're talking about somebody who's not doing anything, hasn't changed anything, and then all of a sudden, they're like, "Man, it's like my metabolism is back to when I was 15," that's not normal.

And so, yeah, I think those are the things that you want to keep your mind on and just keep in the back of your mind.

Scot: All right. Well, that's a pretty good list there. I know us guys can sometimes just ignore the check engine light, but don't. Don't do it on your car. Actually, maybe this would be a good way to wrap it up. Why do guys ignore the check engine light? I think maybe we're not paying attention. Mitch, maybe you can speak to this. It's because you're like, "Oh, this is going to cost me. I don't have the money to go in and deal with this."

Mitch: I know. As someone who has driven junkers for most of my life and always has a gigantic toolbox in the back of my car, I've learned a lot of ways to keep the car running even at suboptimal levels, because the idea of the cost of a mechanic for the longest time in my life was just something I could not afford.

And so I think a lot of times with health, it's kind of similar where rather than going and getting it looked at, you just are like, "Okay. We'll just make it work."

Scot: Yeah. Just hope for the best.

Dr. Smith: Just put a quart of oil in and run it down the road another 100,000 miles.

Scot: What are some other reasons guys, in your experience, Dr. Smith, just ignore that light?

Dr. Smith: I think a lot of times it's just the uncomfortableness of wanting to talk about it. Sometimes people are busy. Guys blame that a lot. "Well, I'm working. I'm supporting myself and my family," or whatever, and they just don't make time to do it. It's not a priority to them.

In reality, if your car broke down and you couldn't get to work, that'd be a pretty big priority. You come out to a flat tire, and you're like, "Well, now I can't get to work." That's the priority for the day, is to get the tire fixed so you can get to work or put the spare on so you can get to work.

And I think that we don't look at it like that. We just say, "Oh, yeah, my chest hurt a little bit after I worked out the other day. I'm doing well. I'm just working hard. I'm working harder than I ever have, and that's probably why it is." And so we make excuses for ourselves when, in reality, we need to just go in and make sure we're doing those things when we do see those lights come on.

Scot: Or there's some sort of manliness to be like, "Oh, I've got this thing going on, but it's fine. I can deal with it, because I'm tough." I think sometimes masculinity gets in the way as well.

Dr. Smith: Of course. And we've talked about that on other episodes, too.

Scot: And if you're a broken-down jalopy along the side of the road, you ain't no good to anybody. So keep that in mind, I guess.

All right. Dr. Smith, thank you very much. Those are some great things for us guys to look at. If you were listening and any of these resonated with you, our challenge to you is actually to go in and do something about it. Get that thing checked out. It might not be a big deal, it probably isn't, but it could be. And that's why you go in and get it checked out, because it can impact your life, the ones that you love, and your health.

If you have any stories about your check engine light, either that you paid attention to or ignored, and you'd like to share those because you think those would be useful to other guys, by all means, let us know. You can email us at hello@thescoperadio.com.

Thanks for listening. Thanks for caring about men's health.