Oct 20, 2020

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Dr. Smith: We should not be in the business of determining if our pain is legitimate enough to go get some help for. The question we ought to be asking ourselves is not, "Is this bad enough to get some help for?" The question is, "Do I like this and do I like the way that my life is going? Do I like the way that I feel?" And if the answers to any of those questions are, "I don't like them. I don't like this," then there's something to be done about that.

Scot: The podcast is called "Who Cares about Men's Health," providing information, inspiration, and motivation to understand and engage in your health so you can feel better today and in the future. 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 am an emergency physician at the University of Utah, and I care about men's health.

Dr. Smith: I'm Dr. Andrew Smith. I'm a psychologist and researcher over in the Department of Psychiatry at the University of Utah, and I care about men's health.

Loren: I'm Loren Jepson. I'm a firefighter-paramedic with Unified Fire, and I care about men's health.

Scot: Thank you very much both Dr. Smith and Loren for being on the show today. This is an important episode. I'm a little intimidated on how to handle it and how to handle it well. I'm going to just admit that right up front, so I hope that we do a good job.

We're going to talk about understanding if perhaps you have an alcohol consumption problem. Loren is here to tell us his story about how he came to that realization and the path that he has taken in hopes that perhaps his story will help other men recognize if they have a problem. A lot of times, us as men, we don't recognize we have a problem. So that's what we're going to talk about today.

But before we get into this, Loren, I want to say I dropped the microphone off at the fire station. You weren't there. I dropped it off with a coworker. That place is cool. Do you go in there and go, "Wow, those are some shiny trucks and that's some shiny chrome"? Every day, you're walking into my 12-year-old childhood dream.

Loren: Every day, I'm walking into my dream too. Yeah, it's a pretty awesome station. I can't complain at all. We have nice facilities and nice equipment, and it's a pleasure to work there.

Scot: Troy, you ever dream of being a firefighter?

Troy: You know, I haven't dreamt of being a firefighter, but it's one reason I chose emergency medicine, because I get every day to work with firefighters. They're EMTs. They're firefighters. I talk to them. We're talking. When they transport patients, I see them in the ER. That's one thing I love about the ER, is that I get to work with these individuals, and I'm fortunate to be able to do so.

Scot: Loren, you're an EMT with the fire department. So explain a little bit what that means.

Loren: Yeah, paramedic, actually. There's a bit of a difference, but . . . So we have EMTs and paramedics. We're all firefighters. At my station, in particular, there are six of us, one engineer that drives, a captain, two EMT firefighters, and two paramedic firefighters. We have a fire engine at my station and an ambulance, and we respond to anything that comes in 911-wise, whether it's ducks caught in the storm drain to house fires, car accidents, heart attacks, strokes, you name it, drug overdoses. When the tones go off, somebody calls, we all go.

Scot: By the way, I think I saw the new truck and your coworker showed me where you sat. I was trying to dig for some dirt, like, "How does Loren manage his gear?" I'd imagine that's . . . How do you guys bust each other's chops at the fire station? What are some things you would make fun of each other for?

Loren: Oh, man. You name it. I mean, if there's a flaw in you, it's going to be found out and exploited.

Scot: What's your flaw? You want to share that? How do they bust you?

Loren: Yeah, I'm not going to put that out there.

Scot: All right. Fair enough.

Troy: I've got to say I spend . . . in my training, I spent a lot of time with firefighters and paramedics and EMTs. You guys will do these long shifts, like 48 to 72 hours just hanging out at the station, going out on calls, but it does have a little bit of a fraternity feel there. So it seems like there's a lot of good-natured ribbing and name-calling, a little bit of that there, so . . .

Loren: Yeah.

Troy: Yeah, it was fun to hang out with everyone.

Loren: Yeah. I mean, it's our home for a third of our lives, so we know each other very, very well in pretty much every way at home and at work.

Scot: Dr. Smith, Andrew, talk about a little bit what you do, because I think your area of expertise is pretty interesting. You work with guys like Loren.

Dr. Smith: I really got interested in working in men's issues in particular, as I was getting out of the military and kind of loving that environment. You're talking about joking with each other and ribbing each other, and that's one of the things that I think most guys, most men end up missing that is enviable about the organizations that firefighters and law enforcement officers get to work in. Those environments tend to draw people who are interested in running into the fire and running towards the fight. And I find that to be a really interesting kind of person and a really commendable kind of person, and the kind of folks who I want to help keep doing that kind of thing.

Scot: Dr. Smith is the Founder and Director of the Occupational Trauma Program. Tell us a little bit about what that does.

Dr. Smith: We started a couple of years ago, stood up a therapy, an evidence-based treatment model that is tailored to firefighters, frontline responders, where folks can come in and get in particular the kinds of therapies that we use to help people who are dealing with the kinds of things that chronic trauma does to people.

So a certain kind of person selects into being an emergency responder, but that does something to that person to be exposed to those kinds of traumas and emergencies all the time. So we intend to help people learn how to manage and live with those things so that they don't bleed out into other parts of life, like marriages and parenting and alcohol use and all kinds of other ways that trauma tends to bleed out.

So we treat trauma and mostly with men because that's the large majority of folks who enter those agencies, firefighters, law enforcement.

Scot: However, what we're going to talk about today applies not only to those individuals but also just regular guys, too, that are struggling with maybe drinking too much. We call it a lot of different things: blowing off some steam, tossing a few back with the guys. You hear the mantras of "work hard, play hard." And we as men have a lot of ways to justify drinking more than we should at times, and it's hard to admit that we have a problem.

But recognizing that problem can have great benefits to your health, because drinking too much has a profound impact not only on your body, but your mental health. And it also can cause behaviors such as increased suicide rates, driving cars under the influence, sexual assaults, that sort of thing, that I would think the silver versions of us would not want to do.

So, Dr. Smith, what is that line between tossing a few back and drinking too much?

Dr. Smith: Yeah, that's a good question and at different . . . there's the epidemiologist's answer to that question, which is no more than X amount of alcohol in a given day, during a given week, during a given month.

For example, one of the COVID stress-related studies we're doing right now, we're using a measure that determines that if a male drinks four or more drinks on a given occasion and that happens once a week or twice a month, you end up in different risk categories.

So the answer to that question is a little bit complicated. But based on the literature, it would suggest that going over two or three drinks more than once a week is probably too much.

Troy: And by "it's too much," Andrew, you mean you're more at risk of withdrawal or more at risk of future addiction? What do you see there exactly?

Dr. Smith: Well, you see all kinds of . . . alcohol is one of those things that has a diffuse relationship with lots of factors that end up affecting health. So, for the majority of people, that's not going to turn over into a full-blown addiction per se, but what it does is sort of insidiously starts to work its way into, for example, sleep.

Alcohol and sleep have a really famous relationship where the continuity of your sleep starts to decline, meaning alcohol might help you fall asleep, but it's got a famous relationship with waking you up a few times a night and our ability to go into deep sleep and do things like process stress hormones.

So alcohol does a lot of diffuse things to folks. It can increase lethargy and reduce the likelihood that you're going to go for a run the next day. And it can increase problems with self-regulation, self-control around food, which . . . and when you start adding sleep problems and self-control around food problems and a little bit less energy, then you start moving towards metabolic disease. So, I mean, the domino effect that alcohol can have when we . . .

And how I talk about it with my patients is, "You can drink as much as you feel like you can tolerate given your goals and what you want to do with your life. But here's how you can think about it." You could think about it as if you expose yourself to the same toxin, let's call it a toxin, repeatedly every single day or four times a week, or whatever your rate is, it's going to start to create systemic changes no matter what that thing is. And alcohol is what we're talking about today.

Troy: Andrew, you're saying just a few drinks a week. So three or four, that's where you're seeing these effects?

Dr. Smith: So that's that sort of risk threshold that our instruments tell us about to maybe start to warn people that if they're having sleep . . . Let's say that somebody is having sleep problems, or mood problems, or relationship problems, that's a piece of low-hanging fruit that can be picked.

So I wouldn't raise the alarm at going over three drinks in a single setting in a week if it's not affecting other problems. But when it starts to play out in other ways, that's when we start to think, "Okay, is there something in this system that we can change?" Alcohol is usually one of the easy ones.

Scot: Loren, when did you realize that you had an issue you had to address when it came to your drinking? Was there a moment?

Loren: Was there a moment? There was probably multiple . . . not probably, there were plenty of moments that made me realize that there were some things that needed to be fixed. But in a lot more ways than just the alcohol. I had a lot of stuff going on.

And there was actually an issue at work that made me really kind of have to check myself, and that's when I realized Andrew was an option. I didn't know that he was an option at our work at the time. But I started seeing him and realized through seeing Andrew that there was multiple things that I needed to fix. To be clear, alcohol was a symptom of everything else that I had going on, if that makes sense. Not necessarily the problem, but the symptom of the problem.

Dr. Smith: A tool to manage the problem.

Loren: Right.

Scot: Yeah. Not a very good choice of tools though, right? I guess we all have tools to distract ourselves.

Dr. Smith: Hold on for a second there, Scot. It's an amazingly effective tool . . .

Scot: Yeah. That's why we use it, sure.

Dr. Smith: . . . very, very quickly, that provides immediate feedback. You're kind of being offered a warm hug. So it's one of the most immediate forms of short-term coping that we can access, and it happens to be, in many cultures, socially acceptable and easy to access. So it's a really sensible strategy to managing problems.

Troy: Yeah. Certainly, I think, Loren, you and I can certainly relate in terms of a lot of what we see. And I don't know if you were responding a lot to what you were experiencing at work or if there were a lot of different factors, but you see so many awful things or you just have experiences that stick with you and you just want to forget. Andrew, like you said, it's one of those ways. You can forget things pretty quickly and you can leave work, the whole "work hard, play hard" kind of thing, and leave it behind, compartmentalize. So it's certainly an easily accessible coping tool.

Dr. Smith: What we're doing here is not . . . we're not providing a . . . or at least the way that I like to talk about alcohol is not provide sort of a judgment of the substance itself. It simply exists and it's easy to access. We're talking about its function first, which is really how we discuss it in the clinic as well. "Of course you would. Of course that's something that you would lean into." So we start in the place of agreeing that it has a function, it does something, and that's kind of what we're doing here in this conversation too.

Troy: Yeah, and that makes sense because it's not like . . . Alcohol is not the problem. There are deeper problems. I mean, it sounds like that's your philosophy that you're trying to address and it's one tool you're using to try and address those things.

Dr. Smith: And it's something that, ultimately, if we can agree . . . because everybody is going to make their own choice on this who walks into my clinic. But if we can agree that it's something we can remove to test the idea that it's covering up other problems that really need to be dealt with and it's preventing us from dealing with them, then we can get a little bit of traction on going from that caustic four drinks a night to two drinks a night. What did that do for your sleep, and how did you have a little bit more self-control with your family, or did you feel some emotion that was uncomfortable to you.

So we can start to experiment with that once we start on that same page that this is something that has been useful to you for one thing, but it's got consequences for others.

Troy: I was going to say, Loren, we often talk about often the most difficult first step is just reaching out for help. Was there something in particular? Were you encouraged by family members, colleagues, or was it just something where you said, "Hey, I need to get some help," and you heard about Andrew, and then reached out to him? I guess I'm kind of curious what went into that first step.

Loren: So I was on the phone with one of our union guys, and I was just kind of talking about some things that were going on. I can't remember exactly what it was that I said, but whatever I said caught his ear and he would not let me get off the phone until we talked about this. I kind of talked through it and I ended up in tears on the phone talking to him.

And he started explaining that there are ways to fix these problems, and he's been through it, and he's had to deal with some of these same issues himself, and put me in touch with another guy in our department who handles this stuff. And that's how I learned about Andrew.

So, yeah, that was kind of the moment right there. This guy recognized it from his own experience, and reached out and grabbed me and said, "Hey, man. Let's fix this." Thank goodness I listened to him and took his advice and took that step.

Troy: That's impressive. Number one, it sounds like you weren't necessarily reaching out to him for help. He just recognized it and acted on it. I mean, that's great you got some . . .

Loren: Yeah, I didn't really know how to reach out. I've been in the business of fixing everyone's problems. That's what I do. That's what I get paid for, just like Troy does. So, in my mind, which is a stupid way to think about it, but in my mind, I'm like, "I can't afford to have a problem. I'm the one that's out fixing people's problems. I don't have a problem. I can't afford that. I can't afford to take a month off of work and do all this kind stuff. There are too many things and people depending on me."

And that's the wrong way to look at it, right? You need to focus on you or the rest of the people aren't going to matter pretty soon. But I didn't know how to make that transition into focusing on me.

Scot: Andrew, that's a great point I would like your insights on. So reaching out, it sounds like it could be incredibly difficult for a man or anybody to do this. What are your recommendations there?

Dr. Smith: For men in particular, that's a complicated subject, the idea of asking for help. I think we've been handed, in some ways, a pretty miserable history from the men who raised us and the men who raised them just as a culture for expressing need and vulnerability in particular. And that's a buzzword these days, but it's a really important word.

And in macho environments, hyper-masculine environments like the one that Loren is immersed in . . . and there's a reason that it's like that, by the way, that we could talk about if you wanted to. It's necessary, in some ways, to be that way. And people get a lot of support through that process of shared experience and telling morbid jokes. Dead baby jokes are a way of dealing with seeing dead babies, and paramedics see this kind of stuff all the time and it's really traumatic.

There's also a problem with being vulnerable with the ways that those things creep into your biology and into your psychological health. And so I think the conversation for men is changing now, but we are not very good at hearing each other and allowing each other to be vulnerable. And even saying it, I feel soft using that language, and I'm a psychologist for crying out loud.

Scot: So Loren had another individual reached out to him. Had that not had happened and he wanted to seek help on his own, how would a guy go about doing that then? What's that first step? Is it to talk to your primary care physician?

Dr. Smith: I think that's a good first step, although I think, oftentimes, medications are prescribed in those kinds of environments to deal with problems. And it's really a problem of emotional processing that isn't something that's really comfortable for a lot of guys. So, it's something that needs to be talked about, and through the process of expression and talking about it, something really important happens.

So primary care provider is a good place. Some of the departments, like Loren's department has someone trained and educated to go to with these kinds of issues. Peer support programs exist in these kinds of places, but that doesn't deal with the individual men who might be listening to this who work from home, for example, who aren't immersed in a community like that.

So I don't know what the answer there is outside of talking to a physician, or bringing it up to a spouse, or starting the conversation about, "Things aren't quite right here." For example, "I feel lonely." That's something that a lot of men are experiencing right now. We know it. We know it based on the suicide rates that we see, for example.

Troy: Loren, I'm curious, since meeting with Andrew and taking those initial steps, what's the process been like since then? Have things gone pretty smoothly? Have there been setbacks? What have you had to deal with since then?

Loren: I mean, I might be an extreme case with the things that I had to fix as far as PTSD issues and stuff like that. I'm sure there are tons of guys out there with that stuff, but there might not be some that relate.

But I had to fully commit, and I wasn't super committed right off the bat. I was just going to go talk to Andrew and maybe go through some sessions and see if we could work some things out, which is what I was doing.

But I realized after a while . . . we were trying to figure out maybe I need to go through intensive outpatient three times a week and stay working, stuff like that, and I finally came to the conclusion myself that if I'm going to do this, I'm just going to check out for a while. I had too much going on, work and being a single dad and trying to keep up all those responsibilities, and trying to work on myself just wasn't a super good option for me. A lot of people don't have that option, but for me, I decided, "I just need to go check out somewhere and go work on me and me alone."

So I talked to Andrew about it and I picked a place, and that's where I went. I just dove in headfirst. I was all in. I wanted to fix the deeper-seated issues than alcohol. And they didn't even talk about alcohol there. That's a symptom to them and their goal is to fix all of the underlying stuff that you have going on, whether it's PTSD stuff, or childhood issues, or abuse, or rape. I mean, there was a whole gamut of people out there. In fact, there were plenty of people there that just made me feel like a weenie for even being there listening to their stories because they were so horrific. So I sat there kind of thinking, "Geez, I'm a wuss." But anyway, I dove in and did it 100% the best I could.

I met with Andrew after that. Let me back up. I think he even noticed there was a big change after a couple of months of doing that 100%. There have been some ups and downs since then. I'm not going to sit here and say that I haven't drank at all since then. That would be a lie. But every time I have, it's more of a reminder to me about why I don't want to be having that be a part of my life very much. I got so used to feeling good all the time and being happy, and positive, and having energy, and just being able to do whatever, whenever. And so that comes in and you feel like crap, and you're like, "Geez, that's a good reminder of why I don't want to do that."

Dr. Smith: Loren, can I . . . the process you went through, you said that you might be an extreme case, and I don't view it that way. It just depends how far down the rabbit hole your body has gone in trying to cope with the trauma that you've been through or the anxiety that you're experiencing. The program that you needed was to drop out and to really focus on treating some of that underlying stuff.

But I think the work that we did, if I recall, leading up to you choosing to go do that was really focused on sort of you realizing that if you go down, if you don't take care of yourself, a whole bunch of people will suffer, how important you were to sort of the center of a network of people, starting with your daughter, and moving to your parents, and a whole bunch of people depending on you both emotionally and financially. You had a hard time accepting that at first, but that's where you came to, I think.

Loren: Yeah, absolutely. I think I briefly touched on that earlier, just the whole "I don't have time to go do all that stuff for myself." But you have to go do that stuff for yourself so you can do it for everybody else, and that was the most important issue, for sure. And we did a lot of work on that to get my head in the right place to take that next step that I did, for sure.

Scot: So, as I'm listening to this conversation, now I'm feeling like the weenie. You go do some amazing things. You're saving people's lives. You're seeing these traumatic things that I've never laid eyes on before. And let's just say I'm in a situation where I'm a podcast guy, but yet maybe, let's say, I'm drinking too much, which I recognize as a symptom to some underlying problems and maybe it's just stress at work. It's not like these traumatic things that happened in my childhood.

If I was an individual like that, I'm trying to reconcile what I'm hearing here with whether or not I should feel strange about getting help or feel like I'm even weaker, which I would think would cause another rabbit hole.

Loren: What I kind of learned about myself and everybody in general is everybody's got stuff. I don't care who you are. You've got baggage from somewhere. And nobody, unless you're going through school for it, as far as I know, ever goes through any sort of training program on how to cope with things in a healthy way. And so the majority of people out there aren't coping with things in a healthy way and maybe white-knuckling it or just getting by in whatever way they choose to do that, whether it be working out five hours a day, or drinking too much, or gambling, or whatever. But everybody's got issues that they need to work on.

And going through some sort of thing like I went through, by the time I was done, I was like, "Man, everybody should do this kind of stuff because no one has any idea how to handle all this stuff in a healthy way."

Scot: It's like a set of tools we were never given.

Loren: Yeah, absolutely.

Scot: It's like asking you to go fight a fire without water and a fire truck and all the things you need.

Loren: Exactly.

Dr. Smith: I think it's a rare situation from the generation of men that raised the current working class, working force men, everybody in this conversation right now. I think it's a bit of a rare thing to be handed a set of tools as a male that isn't based on performing at your highest level all the time or else. And what it takes to do that sometimes is ignoring your aches and pain, whether those are emotional or physical.

And there's no question that it takes a tough person to provide for a family, for example, and go to work every day. It takes a lot of ignoring hard things that are happening and that stuff can build up over time if we don't have a place to put it, an outlet for it.

We haven't been given a very good . . . unless your father was particularly insightful and actualized. And it didn't happen for you because you come from the same generation that I did. So we have to learn to teach each other how to do this a little bit better and to get a handle on how to ask for help in this culture that doesn't really have much interest at the current moment in the kind of topics that we're . . . There aren't a lot of cultural forces in play right now that are male-focused, and that's a problem.

Scot: This is an important conversation we should probably continue, but we're a little short on time at this point. So I wanted to get final thoughts from Loren. Pretend that you are speaking directly to somebody who is listening to this podcast because they were intrigued by the topic, maybe recognized that their alcohol use is a symptom to a bigger problem. What would you say to them?

Loren: There's a lot I would say. I guess most importantly is, number one, you're not alone. Number two, everybody's got problems that need to be dealt with in a healthy way. I guess those are the same thing.

But if you're just trying to cut back on drinking or stopping drinking and you think you can just do that by yourself, it's not likely. And unless you go and fix those issues that you have, underneath it all, whatever it is, relationships, your past childhood, whatever it is, you've got to fix that or you're never going to fix the symptom.

Scot: Managing the stress that you're under at that particular moment or any of those things. Dr. Smith, your last thoughts?

Dr. Smith: I would say that we should not be in the business of determining if our pain is legitimate enough to go get some help for. The question we ought to be asking ourselves is not, "Is this bad enough to get some help for?" The question is, "Do I like this and do I like the way that my life is going? Do I like the way that I feel?" And if the answers to any of those questions are, "I don't like them. I don't like this," then there's something to be done about that.

Scot: Dr. Madsen?

Troy: Well, I think the interesting thing for me is we started this episode talking about alcohol use and, really, it's been more about "What are we doing? What are our deeper issues?" And I think that's probably the larger point that Andrew and Loren have really brought out here. It's not about the alcohol. That's just their coping strategy for the deeper issues that need to be addressed.

I so often see people in the emergency department who just want to quit. They want to get off it. They want to stop drinking. And I recognize I don't really have the tools in that setting to address the deeper issues. There's so much more to this. And I think Loren's experience is a great example of taking the appropriate steps to really address that to where it's . . . It's fascinating to me that they weren't talking about alcohol. They were talking about the other issues, and that's what led to the success that he's had.

Dr. Smith: Yeah, and the pathway into alcohol, in my mind, is not through talking about it as the core problem. The pathway into it is talking about how it's messing things up, how you don't like the way it's making you feel or stealing your motivation or whatever. So you could have a Part 2 of this episode and we could talk about alcohol and its relationship with how it sort of tricks our reward system.

Scot: Loren, did you notice any of those things that Dr. Smith mentioned as far as what alcohol is doing to you, how it made you feel?

Loren: Yeah. It's basically a thief, right? It just kind of steals your joy and your motivation, and you think you're . . . For instance, my mind will still trick me from time to time. It's easy to do. It's easy to fall back into that, "Oh, yeah. Remember all that fun you had? Let's have some fun." But then you start having fun and then you're like, "My God. That was stupid."

Scot: Six hours of fun and two days of not fun.

Loren: Yeah. It steals all kinds of things away from you that when you're not drinking you realize. You don't really realize it when you're in that game, right? When you're in that addiction, you don't realize all the stuff that you're missing out on.

Dr. Smith: It kind of grays out the rest of the world so that you think that the only thing that makes you feel whole and like you're living your best life now is a culture that's surrounded by alcohol, like, "I can only ski if I'm allowed to drink beer afterwards. And if I can't drink beer afterwards, then was skiing even fun?" It really takes things that could be naturally rewarding and kind of turns them into something else, and that's a problem of motivation and reward.

Scot: Well, gentlemen, thank you very much, first of all, Loren, for sharing your story, and, Dr. Andrew Smith, thank you very much for being on the podcast. Thank you for caring about men's health.

Loren: Thanks for having me.

Scot: Time for "Odds and Ends." We just have one item today. Nick Galli has been on our podcast a few times, and he sent me an email and wanted me to share this service that he's a part of. If you're dealing with some mental health issues or some emotional issues . . . Now, we talk about the core four plus one more, which is to be healthy now and in the future, you really just need to concern yourself with four things. We try to make it easy, right? Your physical activity, your nutrition, your sleep, your mental health, and also your genetics. So this is the mental health aspect, and this is a clinic that he told me about which offers low-cost counseling sessions via telemedicine for $20 or less.

Troy: That's a steal, Scot. I've often thought about our episode we had with him and I've thought through a lot of things we talked through with him as I've been working and facing some of those scenarios. We talked about our performance and a lot of the pressure we face. I imagine, for a lot of people, just having a couple sessions talking with Nick and his colleagues would be something that would definitely make a difference. I can say just the time we had with him made the difference for me.

Scot: That's right. So, if it's stress, or anxiety, or depression, or just anything like that, if you lost a loved one or job, or have family problems, those can impact your mental health and they can impact your overall physical health. So it's great to be able to talk to somebody and get some tools and a unique perspective, and that's what this particular service will do at that reduced-rate fee, because sometimes that can be a barrier of cost, of $20 or less.

Troy: Just one thing worth pointing out: If you're having more serious issues, severe depression, any thoughts of suicide, anything like that, I'm sure Nick would say, "Hey, be sure and talk to your doctor, talk to a psychiatrist, psychologist." But definitely, those serious things, be sure and talk to your doctor.

Scot: That's right. And we'll put a link, of course, to that if that's something you're experiencing, as well as the link to get these reduced-rate counseling fees for $20 or less. It might just be one telehealth consultation that you need. It could be a couple. So whatever your situation is, cost shouldn't be a barrier. Make that consultation appointment. That is absolutely free. And you can find the link in the show notes.

Time for "Just Going to Leave This Here." It could be something to do with health. It could be just something we want to share.

And I'm going to go ahead and start off "Just Going to Leave This Here." Troy, I have a question for you. You own a lot of dogs.

Troy: Yes.

Scot: What are your dogs' names?

Troy: All of our dogs? Do I have to actually name them all?

Scot: We've got time.

Troy: Okay. [Itty Bit 00:38:24]. That is one dog. Those are not two dogs. Itty Bit is her name. We adopted her. Her owner passed away. Her name was Itty Bit. We kept the name. Charlotte, Sally, Abby, and Shady.

Scot: All right. We just got a brand new dog. His name is Murphy.

Troy: Murphy. I know. Murphy is a beautiful dog.

Scot: Murphy came with that name. We, my wife and I, wanted to name our next dog Kevin . . .

Troy: Kevin?

Scot: . . . because . . .

Troy: So you like normal human names.

Scot: I mean, yeah. So that brings up the question, why are some dog . . . Sally, that's totally cool for a dog name, right? That doesn't sound weird at all. But Kevin . . .

Troy: Kevin is not a dog name. Love it, but it's not a dog name.

Scot: What is it that makes a dog name a dog name then? Why are some names okay, and just totally make sense, and some names are like, "No, that's a human name. That's not a dog name"?

Troy: Y on the end. If it ends with a Y sound, it's often a dog name. Like Murphy. It's sounds like a good dog name. Sally, Itty, Shady, Abby. All those names [inaudible 00:39:24] . . .

Scot: I have the exception to that rule. Troy.

Troy: Troy? Well, it has to have an E sound. It can't just have a Y on the end of it. It has to have that E kind of sound on the end, like Abby. It's kind of like that going up at the end. That's my takeaway because I've had this exact same thought. I'm like, "What is it that makes it a dog's name?" Kevin? But you could him Kevy. That'd be his nickname, Kevy.

Scot: All right.

Troy: And that would sound more like a dog name. That's my rule of dog names. What makes a human name a dog name? It's the E sound on the end.

Well, Scot, I'm just going to leave this here. Since we're talking about animals, you probably saw the video of the mountain lion. Did you see the video of the mountain lion?

Scot: That was insane, where that mountain lion charged that jogger?

Troy: Yeah. Oh, you fell right into this, Scot.

Scot: Oh, what?

Troy: One of my deepest fears is that I will get attacked by a mountain lion. So, since I saw this video . . . I spend a lot of time with Charlotte, who I joke is my mountain lion bait on a leash, in the backcountry. And since seeing this video, it's funny how this plays into your subconscious. She'll like dart towards something. I'll look, like, "Is that a mountain lion? Is that a mountain lion?" It's one of these things. The statistical likelihood of getting attacked by a mountain lion is extremely low. I've never seen a mountain lion attack in the ER. But since watching this video, it's kind of gotten to me.

But this is what I was going to ask you, Scot. I'm so glad you called that guy a jogger because my only request of you, Scot, is if I ever die in a mountain lion attack, please make sure the media reports do not refer to me as a jogger.

Scot: You're a runner.

Troy: I am a runner. Please just give me that last shred of dignity. That's all I ask. Please call me a runner, not a jogger.

Scot: Time to say the things that you say at the end of podcasts because we are at the end of ours. First of all, thank you for listening. That's a big one. And be sure to subscribe if you liked what you heard. We're on all the major podcast platforms.

Troy: We'd love to hear from you. You can reach out to us on Facebook, facebook.com/WhoCaresMensHealth. You can drop us an email at hello@thescoperadio.com. Check out our website, whocaresmenshealth.com, and you can also call our listener line. Scot, what's that number?

Scot: I don't know, Troy. What is it?

Troy: 601-55SCOPE.

Scot: Oh, he has it today.

Troy: I got it. I just heard Mitch say it, so that's why I remembered it.

Scot: 601-55SCOPE and leave a message there. You're going to get a recorded message. Leave a message for us. If you've got a question, a comment, anything we talked about on the show, that would be awesome. We'd love to hear from you. We might play it on the show, too.

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

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