2: When Do You Need a Urologist?

When Should a Man Start Involving a Urologist in His Care?

Scot: All right. It's "Who Cares About Men's Health?" with Dr. Troy Madsen and me, Scot Singpiel. And it is time to welcome Dr. Alex Pastuszak to the "Who Cares About Men's Health?" podcast. Dr. Madsen, have you guys ever met each other before?

Troy: We have not met before. We were just talking that I've certainly communicated with him through his residents. He's fortunate he has residents who will often be people we talked to when he's on call, and we sort of communicated through his residents this weekend. But we have not met in person yet.

Scot: All right. Well, so there you go.

Dr. Pastuszak: It's so much better to put a face to a name.

Troy: It is, it is good. Yeah. For sure.

Scot: I thought for this first time, Dr. Pastuszak, that we should talk about when should you bring a urologist in on your health care team. Like, at what point should you bring a urologist in? You know, part of this podcast is to help people better understand, you know, your health care team and what they can do for you. So let's just start out with what do urologists do for men 25 to 35 generally?

Dr. Pastuszak: Okay. Yeah. No. I suppose that's a good question for me since I'm the urologist on the team.

Scot: Yes, you take that one.

Dr. Pastuszak: Great question. Yeah, yeah. So for a young man, a urologist is a doctor that takes care of what most people consider to be the genitalia. So one of the funny names for us is a pecker checker.

Scot: Okay. Really they call you that.

Dr. Pastuszak: But I like it, I like it. Pecker checker, stream team member. That sort of thing.

Scot: And who calls you this exactly?

Dr. Pastuszak: I mean, I can't say that our patients have ever called me this to my face.

Scot: Okay. All right.

Dr. Pastuszak: But this is sort of the lingo in the field.

Troy: It sounds like something we would say in the ER, but I'm glad that, you know, we tend to be known as a little bit crass in the ER. But, you know, I'm glad it extends beyond that.

Dr. Pastuszak: But in reality, you know, we take care of the penis, the testicles, and also the kidneys, and bladder, and everything in between. So anytime you have a problem with any of those organs that usually brings in the urologist. And for young men more specifically in terms of men's health, we take care of the fertility. We take care of the hormone management. You know, those are two big areas where we're very influential and anything having to do with all those other things I mentioned.

Troy: And I think one question that comes up too is are you doing surgical procedures as well?

Dr. Pastuszak: Yeah. That's right. So we are surgeons, and so we manage the medical and the surgical.

Scot: Okay. And what about vasectomy? You do vasectomy as well, but usually not that young, 25 to 35 is not really looking at vasectomy.

Dr. Pastuszak: No, that's starting to get to the age, and I'm glad you brought that up.

Scot: Oh, really?

Dr. Pastuszak: Yup. That's right. I mean, I think the youngest guy I've ever done a vasectomy on was 18 actually.

Scot: Well, that guy was sure.

Dr. Pastuszak: He was sure and made some very quick decisions. And we made sure he was really sure.

Troy: I imagine so. Yeah. I think one thing that comes up too, you know, for me working in the ER a lot of times, I'll have people come to me with urologic issues. But when is it a good idea just to go to a urologist directly rather than, say, going to a primary care doctor about a question or going to the ER? When it's best just to call you and just get in the clinic?

Scot: Because I would imagine that a lot of times a primary care physician could do a lot of that preliminary troubleshooting.

Dr. Pastuszak: That's right. And so that's a little bit of a loaded question, because, you know, urologists are coming to be known as the general doctors for men's health for lack of a better term. And so, you know, so while I would certainly encourage all our listeners out there to go and see their primary care doctor, if they have a men's health specific problem, so any of the things that I just mentioned, it's not unreasonable for them to come see us first if they can get in.

Scot: Okay. Why is that? Why are the urologists kind of the men's health doctor?

Dr. Pastuszak: Yes. So . . .

Scot: I mean, all the reasons you mentioned earlier, I suppose, and the nicknames included in that.

Dr. Pastuszak: Well, think about when guys start seeing doctors. I mean, you know, Troy, I don't know you see . . . you have patients come in to see you for emergent problems, but guys really don't like to come and see doctors. And so they come to see them once they have problems, and these are some of the problems that first start to happen.

Question for the Urologist: Why Do I Pee a Lot?

Scot: Gotcha. Dr. Madsen, you actually had a question that you . . . for Dr. Pastuszak.

Troy: You know, that's a great point. I was actually reading an article over the weekend about . . . And it was an interesting article. It's said, "I pee a lot. Why do I pee a lot?" And that may be something that starts to come up for a lot of men as they reach maybe their late 20s into their 30s. And would that be something you'd want to see someone for and have some answers for them?

Scot: Because that seems kind of like an old man thing to me. Like, isn't that kind of the stereotype, once you gets old, then you're getting up in the middle of the night going to the bathroom, you got to go to the bathroom all the time?

Troy: Yeah. I mean, and I'm going to make a confession here, because we're all about being open here about ourselves and our personal issues. I get up a lot at night, you know, and this isn't a new thing. You know, this has been going on for a while, and, you know, it's kind of one of the things I think a lot of guys are out there, like, that I've talked to guys in their early 30s who are saying, "Wow, I'm urinating frequently."

Dr. Pastuszak: I think the bottom line answer to your first question, which is, you know, would you want to get evaluated for that and see one of us? Yes. I mean, that's the simple answer. The more complex answer is, you know, this stuff kind of starts to happen as you start to develop problems or, you know, if you drink a lot or if you live at high altitude. I mean, those are all reasons to pee more, but, you know, we have this epidemic of obesity and diabetes, and these sort of, you know, this . . . What's the syndrome called? Troy, you probably know better than I.

Troy: Metabolic syndrome.

Dr. Pastuszak: Yes. Metabolic syndrome. Thank you. You know, and you see these guys who start to have these issues, which aren't diagnosed because like we just talked about, guys don't go to the doctor and they come in with presenting symptoms like yours. Now, Troy, I doubt that you have metabolic syndrome. I'm just looking at you.

Troy: I don't know. I don't know. I'm nervous.

Scot: Well, could he just be drinking too much before bedtime?

Troy: Yeah. I like high altitude explanation. That makes me feel better. I live at about 7,000 feet. So I'm just going to blame it on the altitude.

Dr. Pastuszak: Well, I will tell you, every time I go up to 10 plus thousand feet, I'm probably peeing every hour regardless of how much I pee.

Scot: Are you guys kidding me? Really?

Dr. Pastuszak: Yeah. No. It's something that your body does to adjust to that altitude. It will actually make you pee more.

Scot: I didn't know that.

Troy: Good to know.

Scot: So if you're living at that altitude, then it might happen a lot more often.

Dr. Pastuszak: Maybe that . . . Yeah, yeah.

Scot: All right. So, and what would be some of the preliminary troubleshooting that you would do for that? I'd imagine first of all, you'd ask, "Well, what do you classify as I pee a lot?" Like, what's the average amount of peeing that somebody would do?

Dr. Pastuszak: Right. Well, it depends on if you're in the Army or if you're in the regular population, because in the Army, they want you peeing once an hour and it's supposed to be no darker than like a light yellow sticky pad.

Scot: Oh, wow.

Troy: Yeah. So they stick to the eight glasses a day plus rule for drinking water.

Dr. Pastuszak: Absolutely. But, you know, but honestly it's really when people notice a change and they start to say, "Well, you know, I'm really not comfortable with peeing as often as I do." To answer your question, Scot, we're really looking at every, you know, two to three hours at most people go pee, give or take. And so more frequently than that is sometimes a problem for those folks.

Scot: So I would imagine, first, look at your water consumption. If you're drinking a ton of water, a ton of water before bed, maybe that's a problem. That happened to me. I think I was drinking too much before bed. I was getting up at 2:00 a.m. every morning, and now I don't anymore because I don't drink water before bed.

Troy: Yeah. So rule of thumb is you should be able to make it through a long movie, and if you're not, maybe you need to see a urologist.

Dr. Pastuszak: Couched by how much did you drink before the movie, or did you do the 64 ounce Big Gulp during the movie.

Troy: Yeah. Did you get a large, the gigantic soda in the movie too.

Scot: And as an emergency room physician, like, urinating a lot on its own might not necessarily be anything bad. But if it's accompanying other symptoms, then that's when it could be an emergent issue.

Troy: Oh, exactly. I mean, those are all things I think about. But the cases I see are people who just out of the blue just start urinating frequently, they're really thirsty, then I'm thinking about new-onset diabetes. And then those patients working them up for that. And that's the number one thing in my mind. You know, maybe they have a urinary tract infection, maybe that's causing frequent urination. So those are I think some of the big things I think about, but obviously, you're thinking much more broadly than that. And probably seeing people where this has been going on for quite a while and they finally decide, "Hey, I'm getting up every hour at night. I should probably get things checked out."

Dr. Pastuszak: Yeah. And for us, you know, we can get very specific, you know. And just speaking to the ER portion of this, I mean, your job really is to figure out is there something bigger and worse going on. Our job is, okay, let's figure out bladder problem or prostate problem and that's kind of it.

Scot: Yeah. And then figure out how you can maybe help that person sleep through the night.

Dr. Pastuszak: Absolutely.

Scot: Which is nice or make it through "Avengers."

Troy: And get through a movie. Exactly.

Scot: That's a bummer when you have to get up halfway through.

Troy: Oh, it's the worst. It's the worst. Like I said, in terms of confessions, yeah, you'll hate it, 15 minutes left and I'm sitting next to my wife like, "I'm sorry. I can't do this. I can't make it 15 minutes." You know, but I'm going to blame it again on the large soda I got before I went in.

Scot: All right. Well, thank you very much. It's been, I think, a very informative session. So if you have men's health issues, think about your urologist perhaps as somebody to talk to and then we talked about some of the specific issues that you might need to go to urologist for. And we covered the peeing frequently. So this has been a productive conversation.

Dr. Pastuszak: Yeah. It's been very productive. I'm happy. This is good.

ER or Not: Really Bad Toothache

Scot: Time to play along. It's called "ER or Not." Going to give Dr. Troy Madsen here a scenario and then you get to play along and figure out, would you go to the ER or not for that. And then we'll find the answer from Dr. Madsen today. ER or not, toothache? You have a bad toothache and these always seem to happen like on a Friday at about 6:00 when you know you're never going to get into a dentist.

Troy: That's right and then that's the challenge, you know. The biggest thing I find with dental pain, it's a surprisingly common thing we see in the emergency department, but it's because people can't get into a dentist or they don't have insurance. They don't have a way to pay for a dentist, and so they'll come to the ER. But the biggest challenge is there's not a lot I can offer. I'm not trained to pull teeth. If someone needs a tooth pulled, I'm not trained to, you know, diagnose and drill and fill a cavity.

So if you go to the ER, typically what's going to happen is you'll get a prescription. Often you'll get a prescription for an antibiotic, which will kind of cool things down maybe with some dental pain or infection you've got. And you may get some pain medication, or you may be told just take some ibuprofen and get into see a dentist.

So I would say do not go to the ER. The exception to this would be if you have massive swelling on your face. So sometimes you can get dental pain and then it gets an abscess, a big pocket of infection with it. You're going to know if you have that. It's a lot of swelling, and that's where it becomes a more emergent thing, particularly if it's affecting your ability to breathe or your ability to swallow, and that becomes a much bigger issue where sometimes we need to call a specialist in, someone needs to come in, pull that tooth. Some ERs do have dentist on call for that sort of thing. So that's where I would say go to the ER.

But 99% of the time, cases we see are people who probably just need to try and get into see a dentist. Sometimes there are some free dental clinics if you don't have insurance and you have no way of paying. But try and get into one of those places or go to an urgent care, cheaper than an ER. They're going to do the same thing we'll do in the ER unless you have that large amount of swelling that needs a more emergent, you know, more emergent attention.

Scot: Aside from the large amount of swelling causing breathing problems, could the actual infection itself cause health issues?

Troy: It could. You know, technically it could develop into sepsis, where you actually get that infection in the bloodstream. In those cases, typically you're going to have a fever, you're going to feel weak, your heart is going fast, you know, those are all again and that's more advanced even beyond that swelling. Typically you've had that swelling first, and then it would progress to that point. So it's a lot more than just the common toothache. It's when you're saying, "Wow, there's something really wrong here. It's not just my tooth hurting."

Scot: So most of the people come to you for toothache because it hurts.

Troy: Exactly. It hurts.

Scot: So, all right.

Troy: Yeah. They've got a cavity.

Scot: Gotcha.

Troy: And it's usually, you know, a fairly advanced cavity. And again there's usually not a lot we can offer. They are often frustrated. We're frustrated, but we at least try and get them a referral to see a dentist or give them some resources.

6 Tips to Prevent Injuries During Exercise

Scot: Six tips to prevent injuries during exercise. This is an article from Scripps who's a health care provider in San Diego, a little article we found we thought would be fun to talk about. They go through a few things here that you should do in order to prevent injury during exercise. And if you are somebody who has exercised for a while, these are good things to do. And especially, if you're somebody who is just getting back in activity, these are some solid tips. So I'm just going to summarize quickly, and then we're going to tease out kind of the interesting parts here.

1. Start your exercise routine slowly
2. Warm up your lower extremities
3. Stretch and strengthen your muscles
4. Stay loose
5. Keep your hips, shoulders, and neck in check
6. Listen to your body.

Dr. Madsen, was there anything on this list that particularly spoke to you?

Troy: Well, you know, looking over this list, a lot of it to me just seemed like common sense. It's like, yeah, you don't want to just jump in and go for it just 0 to 100 immediately. But some of these things, you know, I think we probably don't think about a whole lot, particularly the stretching piece of this. You know, I've personally found this that so often I've just wanted to just get out there and run and, you know, then you get the aches and pains. And you just don't put that emphasis you need on stretching and on flexibility. And it's amazing the difference that makes in injury prevention and I think just overall performance.

Scot: What's your stretching routine before you start out on your run look like?

Troy: So my stretching routine before I'm on a run, you know, I'll stretch my calves out, stretch my quads. I do a hip stretch from lying on the ground kind of twisting my hip over, then pulling my leg up toward my chest. I like to, you know, roll my head, stretch my neck out, do some kind of upper body stretch with that. Not a ton because obviously, I'm really working my legs when I'm running. And, you know, it's really, it's a routine of about five minutes before I run, and I try and do it every time. And then on top of that, at least a few times a week, I'm using a hard foam roller and I have found this is essential. It's amazing. I don't know. You've talked to me about you've had IT band issues.

Scot: And I use foam rollers as well.

Troy: Yeah. And it's . . .

Scot: I don't know if I describe them as amazing. It's painful.

Troy: It's incredibly painful.

Scot: But it does help.

Troy: But I call it the sneaky IT band, because if your knee hurts, it's probably your IT band. If your hip hurts, it's probably your IT band, and of course, if your IT band hurts, it's your IT band. So that's the band. That's the connective tissue that runs out along the outer part of your thigh. And as I really started to get into running, you know, I was having knee pain. And as I looked into it more, I was like, "Well, it's as runner's knee." And, you know, and then it's like, "Well, it's probably related to the IT band."

And I started to roll my IT band, and it hurt like crazy. It was just unbelievably painful, but it's amazing the difference it'll make if you're doing a lot of work with your legs just to roll that IT band, push through the pain, do it consistently. And then if you're doing it a few times a week, it really loosens up and it makes a huge difference in knee pain, hip pain, and then just that achiness you'll get in your thighs.

Scot: All right. I'm going to jump in on I think the warming up thing too, because I think it's easy for all of us just to want to start going, because like warming up, just as far as I'm concerned, it's not much fun. It's like, and we're all pressed for time, we don't want to spend the extra time doing it. But I came across this thing on the internet, the Army ranger athlete warrior exercises, and it's a PDF that they give to rangers in the Army. And it's like this pre-movement routine. They call it an active warm-up routine.

Because I used to stretch beforehand and then I don't know if this is true or not, we should bring somebody in to tell us. But I've heard stretching before you exercise isn't necessarily the greatest idea. You should do it after you exercise. I don't know. But I found this active warm-up routine helps me warm up. It helps me kind of stretch the muscles out. It helps me kind of sense if I have any weaknesses that day or any problem areas just by going through these movements.

I figure the Army, I mean, their business is their personnel. So they've probably done a lot of research into these exercises and, you know, do they benefit their warriors because they're not going to have them do something or not. It's completely accessible for a guy like me who's not necessarily in great shape. So for me that actually worked.

Troy: And I've seen you do this. You do your lunges, you do your stuff, and you're giving me a hard time for stretching before I run. But I don't know the answer. Like I said, that's what's worked for me is just doing actual stretching. Like you said, maybe that's better after some sort of exercise routine, but . . .

Scot: We should try to figure that out and maybe it's highly personal, maybe it's just . . . that's what it amounts to.

Troy: Exactly.

Scot: There is no research that says one thing or the other. I don't know.

Troy: Yeah. I think as long as you're doing something to get things loosened up before you just go out there, I think that's essential and again, like you said, it's something we don't want to do. We want to jump in. We want to do our workout. Take the time to stretch before and after. You know, again I think that's . . .

Scot: Or an active warm-up routine. Something that works for you.

Troy: Or an active warm-up, whatever works for you to get going. And I think that kind of fits in, like you said, also with the whole thing to start your exercise routine slowly, you know, not just jumping out there. And it's funny kind of speaking of exercise, but like bigger picture it's obviously a very dramatic example.

But something I'll often see in the ER is the person who comes in on the first huge snowstorm, who's out there just shoveling snow, comes in with a heart attack. And I guess the same thing might apply to exercise. If you're just off the couch and you haven't exercised, and you're just jumping right into it, you know, it's going to cause some issues potentially. Again that's a very dramatic example, but I think it makes sense to see where you are right now not to say, "Okay. I'm going to go out and run 40 miles a week." Start out with, you know, 5 miles or whatever.

Scot: Sure.

Troy: Just start walking if you're not walking.

Scot: I'm going to go ahead and that was the second thing that I liked about this article to start slowly. I've been off and on a weightlifter for a long time. Not that you could look at me and tell it, but anyway, I enjoy doing strength training exercises.

Troy: You hide it well.

Scot: Thank you. But I recently got back into it again, and it's really hard to take it as slow as you probably should, at least from my experience. I jumped back in doing too many sets, doing too heavy of weight, and then I was compromising my form. And I started getting tendon pain and ligament pain, along with muscle pain, and these little supporting muscles that kind of get out of shape quicker than your bigger muscles would start hurting. And then I'd stop again, you know, because I just . . . I wasn't enjoying it.

So I backed all the way back off to just a few exercise, just one set light weights, really concentrating on the contraction, then working those muscles that are supposed to be worked. It was really hard. I did that for three or four months, and I'm actually noticing more gains doing that than I was kind of the traditional, what I believed thinking that I used to have that you have to do multiple sets of heavy weight and that sort of thing.

Troy: Right. You know, and again speaking of dramatic examples because that's often what I see in the ER, I've seen people who have come in after, you know, weight training, CrossFit, who have had severe, severe muscle damage and muscle breakdown to the point where they're in danger of kidney failure because of this. It's called rhabdomyolysis, and you'll occasionally see it in people who have just done tons and tons of intense workout particularly with one muscle group and it causes muscle breakdown that releases protein in the blood. When they urinate, it looks like blood. It's not blood. It's that protein that's released from the muscle.

Scot: That's insane.

Troy: It's crazy and I have seen it certainly on more than one occasion. So again it's a dramatic example just to not just, you know, jump in and just go for it and kill yourself. But to take it slow and build up, and make sure you're doing things right there.

Scot: And I think that dramatic example from what I can take out of that because, I mean, I don't know. You tell me, odds are that's probably not going to happen to somebody.

Troy: Oh, it's not.

Scot: But it's a good reminder that your body needs time to adjust to these things. You can't hit it full steam. You've got to give your body rest and those sorts of things.

Troy: Exactly. It's a dramatic example obviously, but, you know, it's one of those things where, like you said, it's just an example of maybe taking it too quick. But there are certainly variation in there going just too hard and potentially causing some issues with your body.

Scot: And to wrap up, I think it all comes back to number six, listen to your body, you know, when you're tired. When I was doing those multiple sets heavy weights, I had a hard time, you know, squatting to pick something off the ground. That should have told me, like, I was almost too weak to do that. That should have told me, maybe you're pushing a little too hard, like, right? Exercise should help you feel better, not make you feel worse, or not able to do things. So listen to your body and follow, you know, follow what it's telling you.

Troy: And it's tough. I mean, they talk about don't push through the pain, although when you distance run, that's kind of what you do. I don't know. It's a balance. I mean, you're going to have aches and pains. I mean, I've accepted that in, you know, in a lot of things, but then there are those pains that are . . . I think as you build up, you get used to like, "Okay, I have these aches and pains." And that's something that I expect at this point in my workout. But then there are those different pains where clearly something is wrong or that sharp pain, that, you know, more than that common aches you'll get on a long run. So it's a balance. It's tough.

Scot: Yeah. Get out and just do some activity, and listen to your body. And if you have any questions, you know, you could ask us and we could bring an expert in, hello@thescoperadio.com or you can go talk to your own healthcare provider.

Just Going to Leave This Here: Scot's Phone Calls 911

Just going to leave this here, kind of wrap up the show with just a random thought. It gives us an opportunity to talk about something that maybe we want to talk about, but doesn't fit anywhere else. Just going to leave this here. Did you know, Dr. Madsen, that there's a combination of button pushes on your iPhone the will automatically dial 911 for you?

Troy: Is it the buttons 911?

Scot: No, it's not.

Troy: That would have been my go-to.

Scot: I discovered this at the gym the other day. I had my iPhone. I was getting on the exercise bike. It had a cup holder. It was a little too small to put my iPhone in, but I tried and I put it in there. And then all the sudden, I hear this beep, beep, beep, like this alarm noise.

Troy: Wow.

Scot: I'm like, "What's that?" Now, keep in mind, I'm in a fitness facility where lots of people are exercising, right? I've got my earbuds in, and the next thing I hear is, "911, what's your emergency?"

Troy: Oh, wow.

Scot: I don't know. Like, "I'm sorry. I didn't know that I called you."

Troy: So what did you push? I got to figure this out because I can really see myself doing this and having no idea what I'm doing.

Scot: That's what I told the person too. I said, "I'm really sorry. There is no emergency. I don't know what I've done. My phone just called 911." Which, you know, I know that it didn't just do that. I must have done something. They took my name. I was, like, scared that they're going to send cops to talk to me or something.

Troy: Pull you off the treadmill.

Scot: Yeah. So I did a little research and it depends on what kind of iPhone you have. But the iPhone I have, if you push and hold the power button and one of the volume buttons. So again I was putting it to this cup holder. I was probably squeezing it like this. If you do that, watch, I'll show you. Because the first stage is it brings up a screen with some sliders.

Troy: Oh, wow.

Scot: And then you can slide the slider emergency SOS or medical ID. So it's fine. It's just going to sit on this screen until I slide one of those sliders and I can cancel out of it. No problem. That's not what happened to me. What happened to me is if you push and hold, I'm going to try to do this just long enough before it calls 911.

Troy: Great.

Scot: If you push and hold this long enough, it will automatically dial 911 for you. So I'm holding onto it.

Troy: Okay. There you go.

Scot: There's a countdown.

Troy: Whoa. Okay. So that happens.

Scot: I want to do that one more time. See the little countdown?

Troy: Oh, wow, wow. Okay.

Scot: And when the countdown reaches zero, it will dial 911 for you.

Troy: That's kind of cool. It's kind of funny that it does that and apparently at least, we didn't know about this. I don't know if anyone else does. So it seems a convenient way if you're in a, you know, in a bad situation to just grab your phone and hold those down.

Scot: And just hold those buttons.

Troy: Yeah. This is news to me.

Scot: It's very inconvenient if you're at the gym and you put your phone in the cup holder, and there is no emergency.

Troy: That's incredibly inconvenient. I love it, but, yeah, that is super useful. And, you know, in terms of calling 911, it's funny. I've always been amazed at the things that people come to the ER for, and we've had people call 911 from our waiting room wanting to get an ambulance ride. So it's . . .

Scot: Don't do this in the waiting room either.

Troy: Don't do this. Yeah. You know, they deal with enough there at the 911 dispatch, but again I'm sure it's not an uncommon thing for them to get these sorts of calls since apparently we don't even know about it.

Scot: Yeah. Exactly.

Troy: Well, I'm just going to leave this here, but, you know, for me, I guess, the thought I've had right now is just the healing power of nature. And I know that sounds kind of cheesy. But I had a friend come out from Chicago this week and came out to run a race in Southern Utah down in Zion. At the same time I went and ran through Zion National Park, and that's all he could say the whole time is, "Wow, this is so incredible."

We obviously take it for granted here, but as the weather gets warmer, I think it's just so wonderful to get outside and appreciate that. And it really put into perspective for me having him come out here and just talk about the incredible place that we live in here and the opportunities we get, have to get out in nature and the healing, you know, really healing for the soul of being out whether you're hiking, running, biking, whatever you're doing. It's a great place we live and so many incredible opportunities with so many health benefits.

Scot: It is and you think of activity in terms of, you know, something that not everybody has access to. Like in extreme cases, in some dangerous inner cities, you know, kids aren't able to go out and be active in neighborhoods because they're too dangerous for them.

Troy: And that's what he talked about being from Chicago. He said, "There are so many people who live where I live who will never see this and never have access to anything comparable to this."

Scot: Yeah. So something good not to take advantage or something good to take advantage of it, and not take for granted.

Troy: It is.

Scot: "Who Cares About Men's Health?" Thank you very much for listening to episode 2. Hey, coming up on the next episode, episode number 3, you know you need to make some health changes in your life, but you're having a hard time finding the motivation to actually make it happen. Nothing to be ashamed of. It's just sometimes that's the way it is. Like, even if you're like, "I know I need to," sometimes it's hard to translate that into actual action.

Well, we're going to have an expert, Nick Galli. He's going to talk about how you can help find your motivation to make those changes you want. Plus Dr. Madsen will talk about the Apple watch AFib sensor. Is it legit or just a party trick? That's coming up on the next episode of "Who Cares About Men's Health?" You can reach out to us by sending us an email at hello@thescoperadio.com.