Scot: All right, let's see how we can screw this up. Who cares about men's health? That is a question that we hope to answer on this podcast. We think a lot of men care about their health even though a lot of people will tell you differently. Who are we? You might ask. Well, sitting across from me is Dr. Troy Madsen.
Troy: So yeah, I'm Dr. Troy Madsen. I'm an emergency physician at the University of Utah Emergency Department, and I'm on the faculty of the School of Medicine. So I teach medical school students, residents. I do research as well, and I'm just a person who is generally interested in health. And I agree, as Scot said, that we often think that men don't care about their health, but I disagree with that very much as a man and as someone who really cares about my health and knows so many men who are very interested in their health as well.
Scot: And my name is Scot Singpiel. I am the Senior Producer of thescoperadio.com, and I own the microphones. That's why I'm here.
Troy: That's right.
Scot: Yes. You're the expert. I brought the microphones.
Troy: You have the toys that make this happen. But, yeah.
Do Your Health Habits Need to Change?
Scot: So on today's show we're going to talk about coming to the realization that maybe your health habits have to change, which was something both Dr. Madsen and I came to at one point. And it can be a little shocking, but it's one of the best things I think we would both agree that's happened to both of us.
Troy: Exactly.
Scot: And also we're going to do a segment called "ER or Not," and that's where I'm going to come up with a scenario. And then Dr. Madsen, being an emergency room physician, is going to tell us whether or not we need to go to the ER or urgent care or if we can just take care of it ourselves.
Troy: That's right. And that's something that I love doing because it's like talking to my family member. I get these calls all the time, and I know the answer they always want is, "You don't need to go to the ER."
Scot: Well, nobody does.
Troy: No one wants to go to the ER. I don't want to go to the ER.
Scot: So, all right, so that's what's coming up on the show. We're going to kick things off first of all with the question, do your health habits need to change? Because for men, 25 to 35 for the most part, and please confirm or deny this from what you've seen Dr. Madsen, it's not going to be some major health issue that just comes out of nowhere and gets you. That kind of stuff tends to happen later in life.
Troy: Oh, exactly. Yeah.
Scot: So the types of things that you are dealing with now tend to be, from what I've read, lifestyle things. So it's the decisions you're making now.
- Are you getting activity?
- Are you taking care of your mental health?
- Are you eating properly?
That if you aren't doing those things, that can cause these big health issues down the road. So it's kind of like saving for retirement, which nobody wants to do. You're investing in your future. It's hard for any of us to wrap our mind around that because we really want to live in the moment, right?
Troy: Yeah.
Scot's Turning Point - "Skinny Fat" and Prediabetic
Scot: So do your health habits need to change? So, for me, I came to the realization probably a couple of years ago, and it was something that took me three or four years to come to. It wasn't something that I went like that. Like you do hear stories about people who've had a heart attack and they're like all of a sudden, "Oh things have got to change." But for me, I have good genes. I'm relatively healthy. But what happened was I went to the doctor for a checkup about four years ago, and I found out my fasting glucose was close to 100, which they start classifying as prediabetes, which is kind of a new thing. Diabetes is officially at 130 I think.
Troy: Yes.
Scot: So it's kind of like the ghost of Scot's health future. It's talking to me saying, you know, your lifestyle choices, the things you're eating and your lack of activity is causing your fasting glucose to go up to a point where you could develop diabetes. And we know that diabetes is the cause of a lot of major health issues down the road, so it's really something you want to avoid.
So I also went out at that point and I got a body fat test, and that was the shocking thing because I've always been a lean, thin guy. I call myself actually now a skinny fat guy, because most people look at me and they go, "You're not fat." Right? But my body fat was at 28.4%. Fifty percent almost 50 . . . I'm sorry, about 54 pounds of me was fat that I was carrying around.
So I made some changes. I started eating a little differently. I started getting some activity in, and a year went by and I went back in for another glucose test and it was only one point better. My body fat, it only dropped 0.5%. So you know, after that year I was a little disappointed. I thought I've made all these grand changes and the same deal happened again the year after that.
So that's when I really had to sit down and it came to me that when I was younger, I was an active person, but over about the past 10 years, I had really become sedentary even when I thought I was being active. I also realized I was probably drinking too much beer. I started brewing my own beer many, many years ago. I like beer, probably drinking too much, and I was causing these health issues for myself. So that was kind of the point.
And then there were other things that happened too. I had a brother-in-law that had some sort of a hip problem that he couldn't even really play with his kids the way he wanted to anymore. And here I am, I'm relatively healthy, but I'm doing all these bad things to myself. So that was my turning point when I decided I need to start focusing on activity and my diet.
Troy: Yeah. And what have you seen recently?
Scot: So I've been doing this. It's been an ongoing process. It's been two or three years now that I've been doing it. I'm a little, I don't know if manic's the right word. I measure out my food. I use MyFitnessPal to log all my calories now. I try to get out every day and I do some sort of an activity. I weight train and I do some cardio stuff. I do some running. So those are the things I'm doing. I have seen my body fat drop down. I'm under 20% now barely.
Troy: That's amazing. From 28% originally.
Scot: So I lost 20 pounds of body fat.
Troy: That's impressive.
Scot: I still want to lose a little bit more. I'd like to get it to about 15% I think. Yes so, you know, it's still a work in progress, and that's not to say that I'm always perfect on my diet. It's not to say I'm always perfect on my exercise, but you know, it's something that I'm working towards. But the biggest point for me is coming to that realization I was not the person that I thought I was. I was not that active person that was eating well.
Troy: Yeah, that's interesting.
Scot: What was your story?
Troy's Turning Point - Mini Sausages May Not Be Best for Your Cholesterol
Troy: Yeah, so mine's similar to yours in that what came up for me was it was just part of a routine screening and the University offers to employees, you know, you can just go and get your cholesterol checked. I had never had my cholesterol checked. I was in my 20s. I thought I am perfectly healthy, you know, I have no issues. I've never had any health issues prior. I just assumed my cholesterol was perfectly fine.
And when I got the numbers back, I was really surprised. My LDL, the bad cholesterol was surprisingly high. The HDL, the good cholesterol was surprisingly low, and I thought, I'm an active guy. You know, I wasn't exercising vigorously on a regular basis, but I like to hike, ski, mountain bike, all those things. I was not overweight by any stretch of the imagination, and here I got these numbers back and just thought, wow, this is really surprising. I looked at my diet and I thought, I sure do eat a lot of meat.
Scot: I'm the son of a South Dakota rancher so . . .
Troy: So you understand that.
Scot: So that was one of the things I had to come to terms with as well.
Troy: Yeah. I mean in med school, you know, I would just go to the store and buy like this package of these frozen mini sausages and then heat these things up in the microwave. That was one of my diet staples as well as like kind of these breaded fried chicken strips. So I thought, "This is not . . . maybe this is contributory." And then as I talked to my family members as well, some of them had had their cholesterol checked and it was high as well. So I'm sure there was a genetic component there as well.
Scot: With a lot of things there are. I mean you can kind of see that in your family.
Troy: Yes, exactly. But for me it was something I thought, well, and I'm not recommending a vegetarian diet for everyone, but for me it was something I'd thought about for years, I think for health reasons, you know, and then ethical reasons as well. I'm just kind of someone I love animals. We foster a lot of dogs and, you know, that kind of thing too. And so it was something that sort of pushed me to say, "Well, why don't I try a vegetarian diet?" And as I did that and I stuck to it years, you know, a couple of years later, got my cholesterol checked again and the numbers were significantly improved. But it's funny even with that, over a few years I was still high on the LDL and I was still low on the HDL. It was a lot better, but it wasn't great.
Scot: And that can be really frustrating.
Troy: It's incredibly frustrating.
Scot: It can be just like, well, just give up now and go back to sausages and breaded chicken strips.
Troy: I know. It was really frustrating, because at the same time I'm seeing cholesterol tests come back on patients I'm seeing, and you look at these guys and you're like, these guys are not the picture of health, and the numbers were still much better than mine. But I think that's what you realize too. A lot of times you're struggling against genetics, and that's just a challenge that, you know, you individually face just based on that.
So I started running a lot more at that point, running on a regular basis, and when I got those numbers checked a year ago, they were great. And so it was sort of this incremental thing I think kind of like you experienced of saying, "Okay, I'm trying something and I'm seeing improvements, but maybe it's not the big change I want to see." But you keep working on it and maybe you make additional changes and you start to see some results.
But as you mentioned too, I think it's one of those things if I hadn't had that cholesterol checked, I would just go along thinking everything's fine. But now and then that happens and it kind of opens your mind to say, okay, I'm not seeing any immediate effects from this. I'm not having a heart attack next week or even in a year or 5 years or 10 years. But you thinking long term and then you make those changes. Then I think, you know, there are immediate effects with how you're feeling in the moment, but I think certainly it's impacting your health 20, 30 years down the road as well.
Listener Challenge: Evaluate Your Lifestyle and Health. Today.
Scot: So I think what we'd like to encourage our listeners to do is if you've already had your turning point, then that's fantastic. Maybe reevaluate again and see if, you know, kind of like Dr. Madsen did, you know, are there some other things that I can do? Am I really eating as well as I think I can? Am I getting the kind of activity that I think I can?
I struggled losing some of the body fat at first, and I thought I was being super active. And that I learned, you know, I upped my activity again . . . now losing fat as a whole different deal than maintaining, right? But I upped it another 15 minutes a day, and that's when I really started seeing changes. It was just that small little change that finally started giving me some results.
So all right. So our challenge to you is to really evaluate your lifestyle and yourself. If you've already hit that turning point, that's great. This is still a good exercise to go through. But if you haven't hit that turning point, I think, you know, just like we were both thinking we were active and healthy and we kind of learned maybe we weren't as much as we thought we were. Here are some things that you should look at from Dr. Madsen to kind of, you know, see where you're at.
Troy: The biggest point I want to make with this is just starts somewhere. Don't expect perfection. As we both talked about, we just started and we just said, "I'm going to try something and then reevaluate." But give it a chance. Give it a few months. See where things are.
Scot: Yes, it can get overwhelming thinking, oh, it's this big lifestyle change. I'm all of a sudden going to have to start eating salads all the time and exercising two hours a day. Don't do that because that's not sustainable.
Troy: It's not sustainable. It's frustrating. And if it's not something you can keep doing, you're just going to feel like, I can't do this. What's the point? It's just too much.
Scot: So start small and then these are the categories you should look at.
1. Look At What You're Eating
Troy: The big one, you know we talked about eating, looking at what you're eating, the types of food you're eating. I would say anything you can do to emphasize fruits, vegetables, nuts, legumes, these are the things that study after study shows they make a big difference in long-term health.
Scot: Yup. And eating a lot of meat makes a difference in long-term health the other way.
Troy: It does.
Scot: As tasty as it is.
Troy: As tasty as it is.
Scot: I'm sorry dad. My rancher.
2. Assess Your Activity Level
Troy: Sorry, exactly. Like I said, I've eaten so much meat in my lifetime. So cut back on the red meats. That makes a huge difference. Look at your activity and we talk about activity, not just exercise, but activity in the sense of are you sitting at work? Should you be standing up more? Getting up every 30 minutes, walking around using a sit-stand desk. Thirty minutes, three times a week can make a huge difference. If you're not at that point right now, just getting out and walking or running or biking or anything like that, try and do that. Start from there.
3. Consider Cutting Down or Quitting Alcohol and Smoking
Are you drinking? You're drinking alcohol or you're smoking? Those are things that you can cut back on or try to eliminate. That's going to make a big difference in your health as well.
4. Gauge Your Mental Health
And mental health. It's one of these things I think it's becoming more accepted hopefully to talk about mental health and the struggles we face, some of the issues we face. Mental health affects everything else. It affects our exercise, it affects our diet, and, you know, it affects just our approach to work and everything we're doing.
If we can approach our mental health, talk to people about it, if we're having issues, address it. But it's not just if we're having serious issues, how can we maximize our mental health to really, you know, be in a good place? Whether it's meditation, whether it's spiritual practices, whether it's having exercise contribute to those things, whether it's friendships, relationships, ask yourself where you are with your mental health. Focus on that and really try and, you know, address things there if they need to be addressed.
Scot: As I was researching the types of things we would talk about for somebody that's 25 to 35, a man, like what are the major health issues facing them, I kind of went down the road that I think a lot of medical people do, and I was shocked to find out it's actually smoking, drinking, suicide. It's a lot of mental health related stuff and you see that in the ER a lot.
Troy: That's what's the saddest thing is that, yeah, that's what kills young healthy people. Suicide and substance abuse. And they're all related in that mental health category.
Scot: Yeah. So there's, you know, I don't know that I'm necessarily an expert on that. I don't know if you are. So we will bring in experts. We're going to try and make that a very important part of this podcast.
5. Address Nagging Health Concerns
Troy: Exactly. And then certainly if there are nagging health concerns, things that have been hurting that are just not getting better, especially if you're looking at periods of like a month or more, it's worth getting those addressed. Get a primary care doctor. I know that in your 20s and your 30s you don't have a primary care doctor.
Scot: Or even want to go.
Troy: I didn't. You don't want to see a doctor.
Scot: Oh, I'll get better. It'll work itself out.
Troy: And usually you do. But then there are those things that just don't get better. It's nice to have a primary care doctor, at least someone who you've established a relationship with. You see him once a year, and then if stuff comes up, you can call them, you can get in more quickly. They know who you are. These nagging health issues, if you've got them right now, get them addressed, and as they come up in the future, you can get in and get those addressed and just make sure things are okay and if they're not, get it fixed.
Scot: All right. And what do you think about getting some tests done? Like that test was your turning point.
Troy: It was.
Scot: The cholesterol. For me, it was the fasting glucose which was the turning point. I mean, there were a lot of other things leading up to that, but that was definitely the thing that made me go, "I need to take this seriously." So like that annual physical, there's a lot of debate whether or not it's still valuable or not, but I think getting those tests would be good.
Troy: I think there's value in that. Like I said, I think there's value just in having a primary care doctor when issues do come up and they can make recommendations on testing if it's worth getting your cholesterol test done. I think it's valuable. And for me it made a big difference.
Scot: All right, sounds good. So work on those things and we'll check in with you next week to see where you're at.
Troy: Exactly. To see how it's going.
Scot: And the concern level on that, that's something you should do right now?
Troy: I think so.
Scot: And the action level critical.
Troy: It's critical.
Scot: That you review this, your lifestyle thing and hopefully you find out that everything's good.
Troy: Exactly. Hopefully everything's good. Just keep doing what you're doing. But I think for probably most of us, you find that there are at least some slight adjustments you can make. You can always do better in all of these areas.
Scot: All right. If you have any questions or comments or thoughts on what we just talked about right there, if you'd like to share your turning point event, if you have any questions about any of the core things that we're going to talk about, your diet, your activity level, smoking, drinking, stress and nagging issues, you can email the show at hello@thescoperadio.com, that's H-E-L-L-O, hello@thescoperadio.com.
ER or Not: Broken Toe
All right. Time for the segment called "ER or Not" with Dr. Troy Madsen. That's where I come up with a scenario and you decide first whether you think you should go to the ER or not, and then Dr. Troy Madsen will give us his opinion.
So today you stubbed your toe really, really badly and you think you might have broken it. I did this many years ago. I was visiting some friends. I was staying on a cot in their basement. I got up in the middle of the night and I stubbed my toe on something because I was in an unfamiliar house. It hurt for days. I didn't go to the doctor. I didn't go to the ER. Should I have maybe done that? ER or not, stubbed toe hurts really badly. Think I may have broken it.
Troy: Well, this is something we're all familiar with, and I am no stranger to stubbed toes myself either. But my approach was I hit my toe on the corner, you know, just at night. Same kind of deal, getting out of bed, trying to go into the bathroom. It hurt like crazy. It was swollen, but I looked at it, everything was moving okay. It hurt to move it. It wasn't displaced where it was turned off to one side or twisted weird or something crazy like that.
Scot: 90-degree angle.
Troy: Exactly. So it looked okay, but I thought it was a good chance this is broken. But I taped it to the other toe. I continued to tape it to the other toe for a couple of weeks after that. It healed up fine and there were no issues. So my answer to that is you don't need to go to the ER. And the reason is if you come to the ER and if I see you at the ER, we'll get an X-ray, and then we'll tell you, "Yes, it's broken," or "No, it's not." But either way I'm going to say tape it to the other toe.
Scot: Is that just you, or is that pretty much what would happen at most ERs?
Troy: That is standard.
Scot: Is it, standard of care?
Troy: Yeah. Typical standard of care for broken toes is you buddy tape it. It's called buddy taping it. You tape it to the other toe. You hold it in place there. You let it heal up and it's fine. I mean the exceptions to that are if it's just twisted weird, where it would need to be moved back in place, or if it is not bending right or you've got tendon injuries where it just won't move, something crazy like that. Those are rare, but that's where you'd probably need to see an orthopedic surgeon.
Scot: Yeah, but you wouldn't need to go to the ER then. You could go see somebody else.
Troy: You wouldn't. You could go to an urgent care. You could set up an appointment in a clinic. So it's not something where you're going to rush in and we're going to do something dramatic with it. Tape it to the other toe, give it a couple of days, see how it feels.
Scot: All right. Sounds good. Just saved you a trip to the ER next time you stub your toe.
Just Going to Leave This Here: Run to the Beat with Weav Run
All right, time for parting shots. We're wrapping up the show. The parting shots segment here is just an opportunity for us and in the future we will have guests as well to just talk about whatever happens to be on our mind. It might be related to health. It might not be. It might be something in the episode. It might be a little tip that we want to share. It's just kind of the odds and ends that we weren't able to fit into the show. So Dr. Madsen, I'm going to put the pressure on you to go first with your parting shot.
Troy: My parting shot is sleep. I think about sleep so much. I think it's because I work night shifts and I have a crazy schedule. Sleep hygiene is one thing we didn't talk a whole lot about, and it's one of those things that I think it's an issue in your 20s and your 30s. I think so many people struggle with sleep.
Scot: Yes, you're right. You're right. We trade in our sleep for other things.
Troy: We do.
Scot: Sleep when I'm dead.
Troy: Sleep when I'm dead.
Scot: That's the rock and roll mantra.
Troy: Or don't sleep and it'll kill you. I think we really undervalue sleep, and sleep hygiene is one of those things that you kind of hear that term and like, well, what does that mean? It sounds kind of silly, but it's just simple things like creating an environment before you go to bed that allows you to wind down. Some apps can help with that. Not having a TV in your room, having a dark, cold, cool room, things like that that help you sleep better.
Scot: My parting shot is about an app. So this app for a long time was free and now I have to pay for it, but I'm gladly paying for it because it makes running a lot more fun for me. When you're running, the optimum rate to turn your feet over is allegedly, from what I've read, 180 times a minute. So that means when you're running, it's . . .
Troy: Three times a second.
Scot: Yes. Okay. So at first I was using a metronome. So there's this app called Weav Run, W-E-A-V run. And what they do is they have music and somehow they figured out an algorithm that I can set my running tempo and it will change the tempo of the music that they've preselected to match my running tempo.
Troy: So essentially all the groups you listen to sound like the chipmunks now because you are going at 180 beats a minute.
Scot: It's amazing how they do it. It doesn't. They're able to make it sound relatively normal.
Troy: Wow. And at 180 beats a minute. That's fast.
Scot: It's pretty well, I mean here, I guess I could play it. So I go in and fix tempo. So it can either work where when you're running, it will detect your tempo and then tell you what it is. Or you could do a fixed tempo. So I usually do a fixed tempo. Let's go. So this is 180 beats a minute.
I got this feeling on the summer day when you were gone
I crashed my car into the bridge, I watched, I let it burn
I threw your shit into a bag and pushed it down the stairs
I crashed my car into the bridge
I don't care, I love it, I don't care
Troy: So now I get a sense of the musical taste too. I like it.
Scot: So that's slower. That's 119.
Troy: That's 119 beats a minute.
Scot: Which from all the running people I've talked to you would never want to do.
Troy: That's really slow.
Scot: It is.
Troy: I'm thinking about running at that pace right there.
Scot: So we'll speed this up.
Troy: 180. Let's hear 180 again.
I got this feeling on the summer day when you were gone
I crashed my car into the bridge, I watched, I let it burn
I threw your shit into a bag and pushed it down the stairs
I crashed my car into the bridge
I don't care, I love it, I don't care
Scot: That's 180.
You're on a different road, I'm in the Milky Way
You want me down on earth, but I am up in space
Troy: Okay. It makes sense. It sounded really fast as you described it, but as I'm thinking about that cadence, that's yeah, that's pretty reasonable. So that's cool.
Scot: I'm going to tell you that's not my favorite music . . .
Troy: That's all right.
Scot: But I've grown to like it. It's better than listening to a metronome.
Troy: It's sure does. And I mean when I run, I listen to music. So it seems like if you're someone who likes to listen to music, that's actually a pretty good strategy to just kind of maintain that sort of cadence when you're running.
Scot: Yes, it's good for the cadence, and I actually do kind of enjoy it, like you hear . . . I worked in radio for a long time, and if you play a song enough times, eventually people will start to like it, right?
Troy: Right. Exactly.
Scot: It kind of the same thing, because they have a limited playlist. So then I start to kind of hear the same songs again and I kind of enjoy it. There's ones that I don't like.
Troy: So you have to use their playlist.
Scot: Yeah, you do. Now that you're paying though, they say that they're going to update it more often. Like for a whole year it was pretty much the same thing and now I'm noticing some new songs. And I'm actually kind of sad, because I'm like, "I don't know this song. I don't like this song." Anyway, Weav Run, you might want to check that out if you need some motivation running.
Troy: Nice.
Scot: All right. That does it for the inaugural episode of "Who Cares About Men's Health?" I'm Scot. That's Dr. Troy Madsen. If you want to reach out to us, you can get ahold of us at hello@thescoperadio.com. That's hello@thescoperadio. All right, more episodes on the way. Thank you very much for being part of the first one, and we look forward to this healthy journey and learning more about our health as men on "Who Cares About Men's Health?"
