In This Episode
A Surgeon's Turning Point
Dr. Rodney Barker lives an active life, getting outdoors and hiking with his wife whenever he can, but it wasn't always that way. This surgeon had his own turning point story that came when he first started practicing medicine.
Dr. Barker had been in practice for about 5 years when he had his wake up call. Like many men as they get further along in their career, he began to get very busy. He wasn't working out or eating quite as well as he used to. He had put on some fat and had lost some muscle. He was feeling not as good as he used to.
As a surgeon, Dr. Barker does a lot of standing in his job. As he stopped working out, he soon found himself having trouble staying on his feet all day. He would come home after a day of surgery and feel worn out and sore. He'd lie on the couch in front of the TV until he fell asleep, just to find himself getting up and doing it all over again. He was in a cycle that was significantly impacting his health.
Dr. Barker woke up one of these mornings, took a hard look at himself in the mirror and decided he needed to make a change.
He gets outside whenever he can and tries to work up a sweat at least once a day for 30 minutes. This new focus on his daily activity level has lead to looking better, feeling better, and is helping him stay able-bodied enough to do what he loves as he ages.
Remember, 30 minutes of activity a day can lead to immense health benefits for anyone. "That's all it takes," Barker agrees. You don't need to spend two hours in the gym every day to be fit.
What Is A Hernia?
A hernia is a defect in the muscle layer of the abdominal wall that causes the muscle lining to be thinner than usual. Eventually, that muscle wall weakness may form into a hole that allows organs and tissue inside the abdominal wall to poke out into places they shouldn't be.
Hernias can form anywhere along the abdominal wall, typically from the belly button down. A majority of cases are inguinal hernias that form at the very bottom of the abdomen, leading to a lump in the groin area.
The media will often portray a hernia being caused by someone lifting something heavy, then feeling a pop. That's not quite true. Hernias are caused by many factors. Remember, the hernia itself is a weak spot caused by your genetics. The contents of your abdomen can move through the hole by many means. The act of lifting something heavy, coughing or sneezing, or just going about your daily activities can cause the hernia to form. Some people have a hernia present at birth and don't even realize it until they're older and their muscle tissues begin to weaken.
You Don't Need to Rush to the ER if You Find a Hernia
Troy will often have patients rushing into the ER when they discover a hernia. Patients will feel bump, get scared, and think it's an emergency.
Hernias do not typically a medical crisis. Unless the hernia is incarcerated - meaning the bowel is stuck in the hernia and kinked - there is no need to go to the ER. Incarceration is not subtle. People with an incarcerated hernia they will suffer extremely painful cramping and vomiting. You will know if you need immediate medical attention.
Hernias Will Not Go Away On Their Own
You may have heard that hernias happen when a person is moving something and they hear a pop. While some patients do experience something along those lines, it's not the most common way people find a hernia.
A majority of people will first find their hernia while in the shower. A patient will be washing themselves when they feel a bump that wasn't there before. THe bump may go away when they lie down, then come back when they stand up.
While a hernia is not a condition that requires immediate medical attention, a hernia will never go away on its own. A hernia will need to be treated with surgery, but not immediately. A lot of hernias are asymptomatic, meaning there is no pain or other complications. It's just an annoying lump. These types of hernias can be monitored for a long time before surgical intervention. Dr. Barker has had patients that lived with hernias for ten years before seeking treatment.
When any hernia becomes symptomatic, it will need surgery.
What to Expect with a Hernia Surgery
Hernia surgery is a very simple procedure with a great success rate. Barker does most hernia surgeries laparoscopically, using small tools through a small incision in the stomach..
The procedure itself starts with three small little incisions under the abdominal muscle layer. Dr. Barker will then separate the muscle layers without making any cuts. He then puts the displaced tissue back through the hernia, into the abdomen where it belongs. Finally he places a patch of surgical mesh over the hole to prevent anything from coming back through.
Most of Dr. Barker's patients will be able to go home the same day as the procedure. The recovery is relatively quick, with most people back to their regular activity within ten days to two weeks. In fact, some of Barker's patient heal up even faster. He has run into some of his patients on the slopes skiing less than a week after he's repaired their hernias.
How Can a Person Prevent a Hernia?
Hernias are congenital. People are born with the likelihood of a weak abdominal wall and the potential for a hole to form. But is there anything a person can do to prevent them?
Dr. Barker says that hernias happen to everyone, but anecdotally, he has found that people that stay physically fit are less likely to form hernias. He emphasizes that there is no hard data to back that up, but with his long career of treating hernias he is confident in shape people are less likely to form them. A majority of hernia patients are getting older and forming hernias as they age.
A common misconception is that weightlifters are likely to form a hernia as they strain to lift heavy in the gym. Dr. Barker says this isn't the case. Lifting heavy objects doesn't cause hernias.
Additionally, a hernia is not a reason to stop exercising. Exercise will not make the hernia any worse. As long as the hernia isn't causing any pain or interfering with your daily activity, you can carry on with your life as normal. However, if you do experience any pain at any time with your hernia, you should seek treatment.
Hernia Trusses, Belts, and Briefs: Do they Actually Work?
A hernia truss is a supportive undergarment that tries to keep the protruding tissue in place and relieve discomfort from a hernia. These devices can also be called hernia belts or briefs. If you have a hernia, should you consider using one of these devices?
Trusses were very common just a few decades ago. They could be bought at any drugstore to help men with hernias. Back then, hernia surgery was not as effective or simple as it is today, so patients would turn to whatever relief they could find.
Trusses do not treat the hernia. Only surgery can actually fix the condition. These devices do little more than hold the hernia in place. While these trusses may help some patients with asymptomatic hernias, the only solution available is surgery.
Is Surgical Mesh Safe?
If you've recently stayed up late watching cable TV, you've probably seen an ad about patients experiencing complications from the surgical mesh used during hernia surgery and class action lawsuits against the mesh manufacturers. These ads can raise some serious concerns and may lead patients worry about the safety of using mesh during their hernia surgery.
Dr. Barker uses surgical mesh in his operations and vouches for the mesh's effectiveness. Surgical mesh significantly reduces the chance of the hernia reforming after surgery. According to Barker, there is no research based evidence that modern surgical mesh used in hernia surgery causes post-surgical complications.
Dr. Barker has been treating hernias since before mesh was regularly. He has found that the very low occurrence of patients suffering from chronic pain after surgery is the same now as it was back when hernias were treated without mesh.
If you find an unusual bump in the shower and believe it's a hernia, go get it looked at by a professional. Your physician should be able to diagnose what that lump is and prescribe what your next steps in treatment should be.
Just Going to Leave This Here...
On this episode's Just Going to Leave This Here, Scot learns that ER doctors will actually call poison control themselves, The first thing you should do is call poison control. And Troy second guesses himself after learning that an Apple Watch saved a man's life after it sensed a total heart block. On a previous episode he was concerned about the frequent false positives from the device.
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Scot: I'm surprised this guy is still here, because we're so loud. I would have . . . If I was him, I would have packed up and left. I'd have gone to another table.
Troy: Maybe he's a fan. He's just like here listening.
Scot: Oh, that's Scot. That's Scot and Troy. They're talking about men's health. They're so cool, they're taking ownership of their health. That's so awesome.
Troy: We have our fan sitting out here.
Scot: Maybe someday, I can take ownership of my health, too. Be cool like they are.
What you're about to hear is men talking about health. Do not be alarmed. It's okay. No one's in danger. No one's here against their will. It's just that we care, and we want others to care too. And that's why we're here. My name is Scot Singpiel. I am the manager of thescoperadio.com. And I care about men's health.
Troy: And I'm Dr. Troy Madsen. I'm an emergency physician at the University of Utah, and I care about men's health.
Dr. Barker: And I'm Rod Barker. I'm a general surgeon at the University of Utah, and I also care about men's health.
Scot: It's another one, Troy.
Troy: Nice.
Scot: They say we don't care about our health. But yet, we have not . . .
Troy: Look at this.
Scot: . . . had a moment when we've not been able to find somebody that cares about their health.
Troy: No one has yet said "I don't care about men's health."
Scot: You're right.
Troy: I just going to say, "one of these days," just to see if you catch it.
Scot: So before we get to the topic today, we're going to talk about hernias. I wanted to ask our guests, Dr. Rodney Barker, or Rod Barker. Did you have a health turning point? Like, a lot of times, Troy and I, we like to ask our guests, there was this moment where you're like, "I'm not quite as healthy as I probably need to be. I need to make some changes." Did that happen to you?
Dr. Barker: It did. I was in practice for five, six years. And I was very busy working, and did not take the time to exercise regularly. Didn't watch my diet like I should, and I put on a few pounds of fat, and lost a few pounds of muscle, and I wasn't capable of doing the things I could when I was younger. And I didn't feel as good.
And one day, I kind of woke up and decided to change that, and started eating healthier, and exercising regularly, and lifting weights, and totally turned that around.
Scot: And it went perfectly from that point on.
Dr. Barker: Oh, heavens, no. Never does. It is a stop and start kind of thing for most people. Yeah, the key is never quit. You know, you might fade and miss a week, but then you got to pick it back up, and start over, and keep going. And you do keep some of the gains as long as you don't take too much time off.
Scot: No. And you discovered it makes you feel better, and you can start doing those things that you were able to do when you're younger again?
Dr. Barker: Absolutely. A long day in surgery when I wasn't in good shape was difficult. And I noticed I would ache, and hurt, and go home and have to lay on the couch, and go to bed. Once I got back into shape, surgery became easier, and longer, my endurance went up. My work hours probably went up, and my wife doesn't like that part. But I'm in the slow-down phase of my career now, so . . .
Scot: That's an awesome story. And one of the things that really resonated with me was I had that kind of same occurrence during my transformation as well, which was a lot of different little things for me. But one of them was I was at a concert, and I was standing, it was an outdoor concert, I'm standing up and about, I don't know, half hour into it, my calves started cramping.
Like, I couldn't just stand at a concert. I'm like, "This is ridiculous." I'm asking my body to do something, I've never had a moment where I've asked my body to do something. I'm not an extreme athlete or anything, and it couldn't do it. And that was a moment where my body was not able to do what I wanted it to do. And I was like, "No, I don't want this anymore."
Troy: And it's a great point you make too, where with work, you felt like, I'm too tired after work to exercise. And now, you're saying, you found that with exercising, it made you feel even better after work to where it made work a little bit easier, and, you know, you didn't feel so many aches and pains there, and then went on to be able to exercise on top of a long day in the operating room.
Dr. Barker: That's correct. A lot of times, I have to get up early to get it out of the way, but it pays off. You don't need to exercise for two hours. Thirty minutes a day is plenty for most people, if they're consistent and regular, and they put some intensity into it.
Scot: Yeah. Get a little sweat going on, whether it's weights or, you know, some sort of sprints, or running, or whatever, so . . .
Troy: I agree 100%. 30 minutes. I think that's the key. So many people think it has to be this heroic effort. But if you can do 30 minutes, like you said, consistency is key, and it makes a huge difference.
Scot: All right, want to talk about hernia. So I'm going to tell you a little story. I had a moving day recently, and I called my buddy, Troy here to ask to ask him to help. And he said, "Oh, I don't know if I can help you, Scot, my hernia is acting up again." And I don't know if he was being straight with me or not.
Troy: I think you're making this story up, but I like it.
Scot: So I thought . . .
Troy: It wouldn't be the first time I found an excuse to not help someone. But, usually, it's my back pain we've talked about before, my mid-thoracic band. I'm going to start pulling out a hernia excuse now.
Scot: So I thought maybe we could bring in an expert here, who does hernia repair surgeries. And, look, go ahead and lift the shirt up. Let's see what you've going out. I'm concerned about you. I want to make sure we get this . . .
Troy: Well, Scot, generally, it doesn't involve lifting this shirt up. Generally, it involves dropping the pants to find hernia, so . . .
Scot: Maybe I don't know what a hernia is, so let's start there.
Troy: We're not going to go there. I'm sure he can inform us much better. But I was going to tell you, we're not going to be doing any hernia checks today.
Scot: What exactly do a . . .
Dr. Barker: I appreciate that.
Scot: What is a hernia?
Dr. Barker: A hernia is a defect in the muscle layer of the abdominal wall that allows contents that belong in the abdomen to come through that hole and poke out.
Scot: So, like, at what level, because Troy is talking about dropping pants. I guess I imagine belly button area, or is it lower?
Dr. Barker: The belly button is a common site. But the majority of hernias we fix are actually inguinal hernias, which are at the very bottom of the abdomen.
Scot: Okay, so below the belt line.
Dr. Barker: Yeah, groin area.
Scot: I see. And then, is it something that the person did to cause this? Is it because they were lifting something that was too heavy, or I mean, what causes them?
Dr. Barker: I kind of get away from that causation. It's irrelevant to have a hernia. It is a congenital weak spot, and it can be caused by coughing, sneezing. Many people are born with hernias. But they don't manifest till they get older, when their tissue start to weaken. So it's not necessarily a single factor that causes a hernia.
Troy: And it's not uncommon for me to see people come into the ER for a hernia. They feel something, maybe they were moving or helping someone out, doing a lot of lifting. They notice something there, they're scared, they come to the emergency department. What's your recommendation in terms of going to the ER versus saying, "See your doctor for a hernia"?
Dr. Barker: Unless the hernia is incarcerated, there's no need to go to the emergency room.
Scot: Regular guy, incarcerated, what does that mean?
Dr. Barker: That means there's bowel actually stuck in, and it kinks the bowel off, and obstructs it. Now, that can be hard for some people to understand. But incarceration is not a subtle thing. People with incarcerated hernias have a bowel obstruction. And within a short time, they're cramping and vomiting, and they feel terrible.
Scot: So that's the extreme danger end of a hernia. So if you get that the bowel starting to push out and incarceration?
Dr. Barker: Yeah, when the bowel gets stuck.
Scot: Is that what you called it?
Dr. Barker: That's what it's call.
Scot: Oh, so just like you've been put in jail.
Troy: It's like put in jail. It's not a good thing.
Dr. Barker: The bowels gets put in hernia jail.
Troy: It's hernia jail, and it can't get out.
Scot: All right. So how did most people that notice if they have a hernia? I've heard the traditional thing is like you're doing whatever, and you hear a pop.
Dr. Barker: That happens. Some people notice they're in the shower, and they're washing off, and they feel a bump on one side or the other. And it wasn't there before, and they may lay down, and it goes away, and they stand up, and it pops back out.
Scot: The old bump. Bumps are never good, are they? If you're feeling a bump.
Dr. Barker: Usually not.
Scot: Yeah.
Troy: The other question I'll often hear from people is "Okay, I noticed this, I've got this hernia. Is it just going to go away? Do I need to have surgery for this?"
Dr. Barker: Never going to go away by itself. People are going to eventually need surgery if it becomes symptomatic. And the majority of people will end up in the OR for this. But a lot of hernias can be watched. We see some pendulum swinging on that back and forth with providers. Lately, it's been a little too lax, where people we'll have symptomatic hernias that are bothering them, but their health care provider tells, "Well, you don't have to worry about that. Just a hernia." That's not necessarily true. If it's bothersome, if it's causing symptoms, it should be fixed.
Troy: And let's say I'm the type where I just, I don't want to have surgery. I mean, maybe I'm in a situation I don't have insurance or there are other barriers, and I'm just, like, "I don't want to go through this." What can I do about this hernia to deal with the symptoms?
Dr. Barker: That's a good question. Not always one size fits all answer. Most people can live with hernias for a long time. We see patients come and leave, come in, and, "Oh, I've had this hernia for 10 years." I don't recommend that because it becomes harder to fix.
Scot: As long as it's asymptomatic, right? If it's just a bump, it's fine. But if it starts kicking out symptoms, that's when you need to start worrying.
Dr. Barker: Even people with low-grade symptoms can live with it for a while. We don't necessarily recommend that. Especially if they're having a hard time pushing it back in and they develop transient obstructions, then they really need to get it fixed. But you can live with a hernia for a while, and if situations where you just can't take time to fix it, but that doesn't mean it's not going to turn around and bite you.
Troy: And, you know, one of the big barriers to having surgery is, you know, maybe some people have never had surgery before or they've had family members who have been had extensive surgeries, been hospitalized for several days or a week after. What's this surgery like for a hernia?
Dr. Barker: Usually pretty good, especially a regular inguinal hernia like we typically do. I do the majority of them laparoscopically. People go home the same day. I see them back in two weeks, and most of them are back to their regular activities doing fine and can't believe how easy that was.
Troy: So within a week or two, some of these people are just exercising, doing at least some lifting, pretty much back to their normal routine?
Dr. Barker: Yeah, three times in my career, I've met people on the ski hill in less than 10 days after fixing their hernias.
Troy: Were they trying to avoid you when they saw you?
Dr. Barker: No, no, no.
Scot: I'm in trouble.
Dr. Barker: One of them walked right up to me in the lodge. And one of them, I met on the slope. And the other guy, he yelled at me from a lift.
Scot: Oh, that's great.
Troy: Because they feeling great, back very active within 10 days, you said?
Dr. Barker: Yep.
Scot: I want to get back to, you said you don't like to assign blame, but I want to try to maybe unpack here a little bit. Are there things that could be happening in somebody's life that would make them more susceptible to a hernia? So, as always, we talked on the show about, you know, our core four, which is nutrition, activity, stress, sleep. And then the plus one more is genetics. You can't outrun your genetics. So to some extent, it could be genetic issue, and that's just hand you're dealt.
What about those other things? Can managing those other things help prevent a hernia from coming on, or don't we know?
Dr. Barker: You know, there's not a lot of hard data, but just from endless amount of anecdotal experience, people that stay in shape and stay fit, and do not become overweight or obese, I think you have a significantly lower chance of developing a hernia. Especially umbilical hernias, we see a lot of those and men, as they get older and they get the beer gut and the big belly, and it stretches out their abdominal wall, and that little tiny hole that's been there their whole life ever since their umbilical cord dried up and fell off gets stretched out, and something pops through it, and now they have a hernia.
Troy: Have you ever found any association with constipation and hernias, or is there just nothing there in terms of any association?
Dr. Barker: Not that I'm aware of, but they're both very common problems. And we do hear of patients or see patients who their hernia first manifest itself after bouts of constipation and really straining. But I don't know that it's a huge risk factor.
Troy: Not necessarily causing it, but maybe that's what leads them to just notice it, like you said, a lot of straining and something pops out.
Dr. Barker: Yep.
Scot: Are weightlifters more prone to get hernias like these guys that are moving massive amounts of weight? Is that a tough question?
Dr. Barker: It is a tough question. I don't know the answer from a scientific standpoint, but I don't see a lot of really fit people with hernias. Not as much as we see people who are just getting older. We do see younger men who, they were born with this defect, they're born with a canal that's open there, but it never got big enough to herniate until they got older. And sometimes, it's lifting a heavy weight that causes that to dilate, sometimes it's getting older and the tissues getting weaker that causes it to open up.
Scot: But don't avoid those behaviors. Don't avoid strength training and that sort of thing because you're afraid you're going to get a hernia.
Dr. Barker: No. I wouldn't.
Scot: The benefits far outweigh.
Dr. Barker: Absolutely. And I tell people with hernias, like, they may have a small asymptomatic hernia and they want to know, "Well, should I stop exercising?" I tell them, "No, if this is interfering with your life, get it fixed." But the benefit of exercise far outweighs the hernia issue.
Scot: What about belts and briefs? I did a quick Google search here, and I found this, you know, that there are belts and then there's brief. I mean, did these work?
Dr. Barker: Yes and no.
Scot: Because they're making promises that are a little scary. They're like, you know, they're saying, "First of all, are you suffering from a painful and irritating hernia?" They're kind of, you know, if somebody needs to get surgery, they might be putting that off, right? Because I don't want to, and they're wearing these briefs. Is that actually help or hurting the situation.
Dr. Barker: So these hernia belts, we used to call trusses, and they were very common decades ago. You could buy them in almost any drugstore. At the time, hernia surgery wasn't as effective as it is now, and people would often wear trusses for years and get away with it. I've seen older men who have had trusses for decades. They work in some patients, if they can apply them correctly, wear them correctly. They work by holding the hernia in, by essentially, like, putting your hand over the defect to push it in, except they are belt form.
They do not always work. Some people have a miserable experience with them. And we just generally don't recommend them. But I've had patients who have lived with them for years and have done well.
Troy: Now, if you've ever spent any time and maybe you have late at night, just watching TV, and, you know, you're going to see some of these ads come on about hernia mesh and these lawsuits, and all this. Maybe, someone's nervous about potentially defective mesh or just having seen too many of these, these late-night ads. What's that all about?
Dr. Barker: Every time I see someone with a hernia and we talked about repair, we have the mesh talk. There's things we don't know. To, you know, full disclosure, we don't know everything about mesh. We do know that it significantly decreases the rate of recurrence after a hernia repair. I'm old enough to remember when we fixed most hernias without mesh. And some of the complaints that people have now that they say mesh is causing, which is usually the chronic pain syndrome, that was going on long before we put mesh in people. So I'm not sure that mesh is have great contributed to that.
When you have a million hernias fixed a year in this country, and just a ballpark estimate of 5% of those people will have pain a year after surgery, it may be higher, but 5% might have it worse enough to go see a doctor. That's a lot of patients. And if you have a thing you can blame, like the mesh, it gives this new industry something to fuel.
So there's a lot of ads. If you Google hernia mesh, you'll get the first 40 things that pop up are lawyers telling you to call them. There's not a good evidence, though, to support that this is a real problem. There have been certain meshes in the past that have been problematic, that have been recalled, that are no longer on the market. But in general, the vast majority of hernias are fixed with mesh and the people do fine.
Troy: And what sort of process, then, in terms of the surgery? What are you doing exactly? Are you just finding the defects, sewing it closed? How does mesh figure into this whole thing as well? Just, you know, more out of curiosity.
Dr. Barker: So the repairs I typically do are laparoscopic. We make three little incisions, starting right at the belly button, and get underneath the muscle layer. Though we're not quite all the way into the abdominal cavity. We separate the layers, and we really don't cut much of anything, we just separate them, pull the stuff, the belongs inside back inside, and expose that muscular and connective tissue floor. And then we put our mesh patch in there as this new layer that just slides in between, we let everything go back on top of it, and it blocks the hole so nothing herniate through.
Troy: So you don't actually have to close the hole. And just placing the mess there to prevent stuff from coming through the hole.
Dr. Barker: Correct. That's on an inguinal hernia. Now, the ventral hernia is a little different. We usually try to close the holes, but the majority we fix are these growing hernias. And the spermatic cord goes through that hole. Depending on the type, so we can't really close it. It would be difficult to close anyway, the tissues are rather firm and fixed in that location.
With open repairs, there is the techniques. You don't have to use mesh. You can close the existing tissue. There are some who claim they work as well. Vast majority of studies in mesh, the vast majority of experience shows that for most surgeons, mesh repairs give a stronger repair. So we do reinforce those open repairs with mesh as well.
Scot: It's amazing, as a non-doctor in the room that you can even do this. Like listening to you guys talk about, kind of, the ins and outs. That's pretty crazy.
Troy: Yeah, it is. And, you know, the fact that you're doing everything laparoscopically like you said, people are back on their feet quickly. It's a same-day surgery, so I'm sure you've seen advances in this procedure in your career, and I imagine seeing faster recoveries and, you know, people back on their feet a lot more quickly.
Dr. Barker: Yeah. I've never been totally 100% happy with hernia repairs. I don't know that we found the perfect way to do it. But the best I have found is what I use now. And that's a laparoscopic approach, like I described with a patch that just is an additional layer slid in there. And it works well, has low recurrence rates, has low risk of chronic pain. And people can get back to their regular activity very quickly.
Troy: If I wake up tomorrow, and I, you know, I'm in the shower, I'm feeling, and I feel a hernia. I'm not going to, you know, Scot, we're not do any . . .
Scot: I thought you had one.
Troy: I don't have a hernia. I never gave you that excuse. Like I said, it's a great excuse, I'll have to start using that for moving.
Scot: Because nobody's going to want to look. Yeah, show me. Prove it.
Troy: No one's going to question it. So if I do find that I have a hernia, what's the next step? Call my primary care doctor, call a surgeon, buy some of these briefs online, what would you recommend?
Dr. Barker: I wouldn't recommend jumping right to the briefs. I'd get it check first. And you can see your primary care doc. You can call a surgeon, most surgeons are more than happy to see you, and talk to you, and give you your options. I don't operate on every hernia patient I see. I see people who have small asymptomatic hernias that someone just found on a CT scan for some other problem, and they didn't even know they had it. And I usually tell them, "Hey, if it doesn't bother you, it doesn't bother me, and, you know, call me when it starts to bug you."
Troy: So you're not destined to have surgery if you go to a surgeon. It sounds like you're telling a lot of these patients, "Hey, you're doing fine, let's recheck you in a while. Come back if you're having issues."
Dr. Barker: A lot meaning the ones who come with no significant symptoms. Most people that come to see me are past that point, and that's why they're at the surgeons. The primary care docs would see more of the asymptomatic ones.
Scot: All right, time for a segment called Seven Questions. today. We've got Dr. Rodney Barker here, he's a surgeon. So we're calling the seven questions for a surgeon. I think the name explained itself. I like to overexplain things, I'm going to try not to.
Question number one, how do you get your head in the game when it's time for a surgery?
Dr. Barker: Anymore, it's kind of there all the time. But, that's a great question, I don't take it lightly. It's something I kind of get psyched up for. It depends on the complexity of the operation and the potential risks. Sometimes, the most outwardly minor procedures can carry a significant risk. So I try to get myself a little bit scared.
Scot: A little bit scared.
Dr. Barker: Little bit scared, just enough to . . .
Scot: Yeah, to respect what's going on.
Dr. Barker: Right.
Scot: I'm that way with the table saw.
Dr. Barker: Exactly. Very good point.
Scot: I like to get a little bit scared before I use that table saw.
Troy: I thought you're going to say you're that way with podcasting. Just like it, you get a little nervous.
Scot: It's actually maybe I'll try that.
Troy: Get a little scared before you do it.
Scot: Question number two. When people find out what you do, what's the most common question they ask?
Dr. Barker: Most people want to know what kind of surgery I do, then I start explaining the different operations.
Scot: Why did you pursue medicine?
Dr. Barker: At first, I was going to be a pilot. That was my goal of all through high school and into college. And then I was serving a mission in southern states, and I would spend a lot of time going into hospitals to see sick people. And I felt that that's where I needed to be.
And at first, I didn't know surgery was my calling. But when I was a kid, I would always build things with my hands and work on things and people would look at. And my mom would actually bring people down to my room and have them watch me build these three-foot long sailing ship models when I was 10 years old. And everybody would walk out of there and say, "You should be a surgeon."
Scot: That's a weird connection to make.
Dr. Barker: Well, and I would think, "No way. That's too much school. That's too much . . . " I never wanted to do it, but then I felt that was where I really needed to be, and I've never turned back on that.
Scot: Knowing what you know and seeing what you've seen, you cringe a little bit when?
Dr. Barker: Hmm, good question. I don't cringe much.
Scot: Okay, fair enough.
Dr. Barker: I'm pretty low key, glum.
Scot: What's one thing you wish men knew when it comes to their health?
Dr. Barker: That they need to take care of themselves when they're young? Because it catches up to you. You know, I'm 60 years old. And I see people all the time who are my age that can't even function anymore. I see others who are in great shape and run marathons or triathlons. But it starts when you're younger. And if you've got bad habits when you're young, you know, you can get away with it. About 30, it will start to catch up with you. By 40, it definitely catches up to you. And you won't have a healthy active life when you're ready to retire if you don't keep in shape.
Scot: Got to get that momentum going early.
Dr. Barker: Yep.
Scot: I like that. Favorite TV or movie surgeon, or scene, or show?
Dr. Barker: Yeah, most TV, movie things that have to do a surgery are so inaccurate, I can hardly watch them. "Scrubs" was one of my favorites because the medicine part of"Scrubs" was actually fairly accurate.
Troy: That's what I tell everyone. I say "Scrubs" is the most accurate medical show on TV.
Dr. Barker: Yeah.
Troy: It is.
Scot: That's funny.
Dr. Barker: And it's a great comedy.
Troy: It is, and the dynamics and everything, the fact that the residents are lower on the hierarchy than the janitor. It's so accurate. I love that show.
Scot: Well, Dr. Rodney Barker, thank you so much for stopping by. And also, thank you for being an advocate for men's health. We sure appreciate everything you do and talking about hernias. And thank you.
Dr. Barker: You're welcome. Thank you for having me.
Scot: Post show. Dr. Rodney Barker talking about hernias. Troy, Dr. Madsen, I liked him. He's a good guy.
Troy: He's a good guy.
Scot: Yeah, good guy, has some good stories, I think some good stories about how things he's seen in his own experiences, important it is to just kind of really take care of your health early on in life, to pay dividends later in life. And the thing that he said was something that really struck me at one point is I want to have an active older life when I get to the point where I want to retire. And if I have a hard time bending down now to pick something up, it ain't going to get any better as I get older. So I got to address these issues now. And had I been kind of consistently addressing the issues throughout the past 10, 15, 20 years, I wouldn't be at this point.
Troy: That's right.
Scot: So, anyway, just another cautionary tale, I guess.
Troy: Yeah. I mean, he's a great example of that. Like, you know, he sounds like he's very active. He talked about his transition period. He's staying super active now. And this is the guy who's a surgeon. And he's got a busy operating schedule. He has long days in the OR. He's finding time for this. I feel like if he can do it, certainly, I can do it, we can do it, and certainly make time to exercise.
Scot: Yep, and then, also just about hernias, I think the takeaway is, if you notice the lump, probably you should go have it looked at. Does not necessarily mean you're going to have to have surgery if you're not getting any symptoms like pain or anything like that.
Troy: That was my takeaway too. There's no rush to fix it. And that's what I tell people in the ER. If it's bothering you, if you're having symptoms with it, then it's a good idea to fix it. And I think that was a big takeaway from him, too. So often, like I personally think about having surgery, and I just think, I don't want to have surgery for anything. I just don't want to go through it. But as he described, this is a very simple surgery. The same day thing, he's doing it laparoscopically, so it's not a big deal if you have to have it done.
Scot: All right, just going to leave this here. It's a question for Troy. I'm not exactly sure how I came across this information. But I just wanted to find out. So you, you know, work in the ER. Do you call poison control when you have a poison control issue?
Troy: I do.
Scot: I'd heard somewhere that if I went to the ER and I had a poison issue that you might just call poison control?
Troy: You're right.
Scot: Okay.
Troy: We would.
Scot: Because I've talked to people from poison control before and they say, if there's been a poison in your house, the first thing you should do is call poison control.
Troy: Yes.
Scot: Because . . . And now, this just really reaffirms that for me, because if that's all you're doing, then I can just save that step. And then now tell me, is there something I can do on my own or do I need to go to the ER?
Troy: That's exactly right.
Scot: Huh? All right.
Troy: Call poison control. They are an incredibly great resource. We often have patients who, not often, but here and there, we have patients who come to the ER who had some sort of poisoning or exposure, who called poison control, they referred them to the ER, and then I will call poison control and just confirm that and say, "What do you recommend?" And a lot of this stuff, I'm calling them as a consultant just to get their input. I may know what I think needs to be done. But it's helpful to have them on board of the patient's admitted, the inpatient team continues to console with them, they may have a toxicologist who sees the patient. So they're a great resource. Absolutely call them before going to the ER.
Scot: All right. Well, that's my . . . just going to leave this here. I won't ask that question.
Troy: Yeah. Well, I'm just going to leave this here. You know, we had a podcast where I talked about all of these false positive with Apple watches. And these people who get sent to the ER saying it's a-fib. Well, there was actually a case report in "The American Journal of Emergency Medicine," where they talked about an Apple Watch picked up a really serious condition, complete heart block. This is something that's life threatening. Patient had his Apple Watch on. It detected this, he went to the ER for it, got the treatment he needed, which in this case, was a pacemaker.
So not all things with technology are false positives. Certainly, you can have things that are significant things that your Apple Watch might pick up. So don't feel like, again, from our previous podcasts that I'm saying that, you know, when it tells you to go to the ER, something's wrong, that you ignore it, because in this case, it was serious, and it picked it up.
Scot: Yeah. To circle back around, this is the heart rate sensor on the Apple Watch that is detecting a-fib.
Troy: Yeah, it detects a-fib or detects various other abnormal heart rhythms. In this case, it detected a case of complete heart block. And the patient, you know, would not have known about this otherwise. He might have had some symptoms. Sometimes, though, the symptom you have with complete heart block is your heart just not working, and you die.
Scot: Wow.
Troy: Yeah, it's a serious thing. So this guy, he was detected with his Apple Watch. He got treatment for it, and he's doing fine.
Scot: Oh, yeah. I'm sorry. Spaced out there for a second.
Troy: Like, what are we doing here?
Scot: I'm supposed to say the things that you say at the end of podcasts.
Troy: Right. We've reached that point.
Scot: We're pros. All right. So do you want to say any of the things that people say at the end of podcasts? You feel comfortable yet?
Troy: Apparently, I probably should, since you're having a stroke or something.
Scot: No, I'm not having a stroke.
Troy: I don't know what happened there, but . . . So thanks for listening. If you like us, be sure and give us five stars.
Scot: Say nice things.
Troy: Say nice things about us. Tell your friends and family. Recruit the people, join our Facebook page. We are on facebook.com/whocaresmenshealth. There's not an about in there. It's just Who Cares Men's Health. Email us at hello@thescope.com.
Scot: thescoperadio.com
Troy: I'm sorry.
Scot: You're almost there, man.
Troy: I was so close. I was going to say help@thescope.com. That's not it.
Together: hello@thescoperadio.com.
Troy: That's it.
Scot: Yeah.
Troy: So thanks for listening.
Scot: And thanks for caring about men's health.