Search for tag: "smith"

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Scot: It is the "Who Cares About Men's Health?" sideshow. Today's episode, "How Will Smith is going to get you back into the gym." Also, lessons we can learn from a very unfit at this particular moment in time, Will Smith. My name is Scot Singpiel. With me Dr. Troy Madsen, he brings the MD, I bring the BS.

Troy: I like that.

Scot: You like that?

Troy: I do like it. That's good.

Scot: So on Instagram and Facebook, I just happen to stumble across a post that Will Smith put up. And he posted a picture of him . . . the first one that I saw was a picture of him and he's in kind of these tight black shorts, and he's got this kind of zipper up sweatshirt unzipped. And he doesn't look like the Will Smith that we've seen "I Am Legend" or the other movies, right? And he goes, "I'm going to be real with y'all. I'm in the worst shape of my life."

So then I stumbled across another post from Will Smith where again, he's standing there and he's kind of pushing his belly out this time. And again, not the Will Smith we're used to seeing, right? And he said, "This is the body that carried me through an entire pandemic and countless days of grazing through the pantry. I love this body. But I want to FEEL better. No more midnight muffins. This is dead. Imma get in the best shape of my life. Teaming up with YouTube to get my health and wellness back on track. Hope it works."

So I saw that and I thought that that was pretty cool because there's got to be a lot of ego involved when your Will Smith, right? So to post these pictures of you not in the best shape of your life, I think it was really inspiring. And it made me think wow, that's kind of like me minus the movie star career, the perfect family life, and all that.

Troy: Did you actually tell what kind of shape he was in though? Or is he just like in a baggy sweatshirt? What did he have going on there?

Scot: I emailed the pictures to you so you could look and see for yourself. Yeah, check that out. And then we'll wait.

Troy: Is there an attachment? Oh, here's the attachment. What is going on with this email here? Yeah, he's definitely showing off his bod there. Yeah, he's put on a little weight, you know? Yeah. And this is a guy . . . I've always thought about Will Smith being in an incredible shape. So this is good. This is good. I mean, this is good for all of us. Like, yeah, this happens so.

Scot: And I could totally relate to that because, unlike you Troy who upped your physical activity and your output during the pandemic, I kind of went the way of Will Smith, like I just really went south.

Troy: So we've all been in this position though, Scot. This is how I felt a few years ago. Like, I feel good right now. But we've all been in this position, or we're in this position right now, where maybe you felt like you were in good shape and things just went downhill.

Mitch: For a 52-year-old, I mean, it's not a pooch. It's a ponch he's got going on.

Troy: Yeah. And he's 52.

Scot: And what's the difference between a pooch and a ponch? I didn't realize there were . . .

Mitch: I think I have a pooch. It's small. It's like a little fanny pack. Right. And then he's got like a full backpack.

Scot: Wow. The other picture that was really inspiring that I kind of came across at the same time. And this is how I was inspired back into the gym was a picture of him sitting on a shoulder press bench with what looks to be maybe 10-pound weights, dumbbells that he's pushing above head. And it says, "Crazy that this photo was taken right before I picked up the big ones, dang."

So he's joking around. But we've got a great lesson to learn from him here because if you do go back into the gym, and this is kind of what I want to talk about that. He kind of offers us some good lessons about getting back into a fitness routine. So I will say I've been back to the gym, and I've gone . . . I had to go out of town. But while I've been in town, I've gone every other day. And I've done some exercises and it feels great. So thank you Will Smith for inspiring me. If you want to come on the show, I'd love to thank you in person. So see if that happens.

Troy: Yeah, you're welcome to join us on the show, Will Smith, too. If you can . . .

Scot: And then, he also joked about weights here in another Instagram video.

Will: This guy says let's just get the movements. Let's just get your body back into making the movements, so we avoid injury, right? But what that means is he'll just give me the bar with no weights on it to do a bench press. And I'm like, we're not shooting that. Nobody's going to have a video of me bench pressing with just the bar with no weights on it.

Scot: All right, just so you know, afterwards, then they cut to a clip of him squatting a bar with no weights on it. So once again, totally willing to just let it all be out there that Will Smith, who we think of is in great shape is starting slow, starting light. He's easing his way back into it. And I think that was another inspirational thing.

And we've talked about that before on the podcast that you don't want to rush right back into it, because if you do, you can hurt yourself first of all, but it could also kill your momentum after a couple weeks. It just might be too exhausting, so you just might quit. It makes it non-sustainable. And then there's a danger you might not continue.

So I really appreciate Will Smith not only posting that picture, admitting that the pandemic has impacted him, put him in some pretty bad shape. And that you know what you don't go back in and lift weights like you were Will Smith in "I Am Legend" when you're Will Smith after the pandemic. So those are some good lessons for me about getting back into a fitness routine from Will Smith. Any thoughts either one of you guys?

Mitch: One of the things I was thinking is that I really appreciate this, this idea of I love this body, him posting it, non-edited, etc. because the other photo that has been circulating on the internet right now about getting, "back into shape" was Chris Hemsworth getting in shape for "Thor" and he just has the biggest, giantess bicep you've ever seen. And it's just, that doesn't inspire me, right? That kind of gets me in this "I'm not Chris Hemsworth," you know?

Scot: Yeah, or I'll never attain because, I mean, when we talk to Rashago, excuse me, who is our bodybuilder that we talked to, we learned that that takes a lot of work that's not sustainable for the average guy.

Mitch: Right. So seeing this, it's cool. I really, really appreciate this because I've been trying to get back into fitness. And just this idea of I love this body, right? This idea that it's not like a shame. It's not like, no, this is bad. He wants to feel better. It's not all about looking your best. It's about feeling your best.

Troy: Yeah, I mean, just seeing him looking like that. And it's not like it's airbrushed or anything like that, like some of the celebrities they want to present an image. And he's just very real about and says, yeah, I was in great shape. I'm not in great shape now. But I'm working to get back into good shape again. And again, I think we've all gone through cycles similar to that. So it is inspiring to see someone basically saying, yeah, this is not where I want to be, but it is who I am. And I'll keep working to get back to where I was before or somewhere at least kind of close to where I was.

Scot: The other thing that I love about this Will Smith thing is just being humble enough to post, Will Smith doing 10-pound dumbbells. Because for me, I did go back to the gym, and I did go back to doing weights because that's something I've done off and on my whole life. And I just needed something easy. It was something that felt comfortable to me.

But what doesn't feel comfortable when you go back in there, especially here at University of Utah, where you've got all those young students in there is they're moving massive amounts of weights. And then I go and I have to put it on the light stack, right? But reframing why I'm doing it and just going, "You know what, it doesn't matter. I'm doing this for me, I'm doing it for this reason," really helps. And you just kind of got to go, "You know what, nobody's going to see it, nobody's going to care."

And one of the things that I really try to concentrate too on is form, because over my years, I've noticed muscle imbalances start to develop. So instead of just making it about how can I move this weight in any way, shape, or form possible, just to say I've moved a lot of weight. How can I move this weight in a way that is achieving my goals of giving me better mobility and flexibility and balanced strength? So I really watch my posture when I do my back pull downs because, as we've talked about, in a previous episode, I've got this dowagers hump. So I'm trying to get those muscles strengthened and stretching so that will kind of start to straighten out. So those are my priorities now. So that's what's helped me.

Let's move on to the next segment of the sideshow. I guess I should also say a couple other episodes to check out. So we've got the one with Ernie Rimer about the basics of strength training. That's Episode 24. That'd be a good one if you're interested in just starting out. It's good for beginner. Episode 54 getting active again, we talked to Caleb Meyer, he's a strength and conditioning coach who went through kind of a similar thing. So he talked about getting back into it. And then we also talked to Caleb in Episode 58 about kettlebells, which is some exercises that you could do at home learning how to exercise with kettlebells so.

All right, Troy, get out that stack of articles what might we hear about today? Troy's going to go ahead and give us some titles of some articles and we're going to pick which one we want to hear.

Troy: Yeah, Scot, you know, I always love searching through the medical literature, see what's out there. Some of these are articles that have appeared also just in general science magazines, things like that. But I will give you some ideas here, some topics. You pick what you like. So to start us off, we have a randomized trial of oxycodone and acetaminophen versus acetaminophen for musculoskeletal pain. So opioids versus just plain old Tylenol, is there a difference?

Scot: Oh, that's a good one, okay.

Troy: Could there be a dramatic hidden impact of not having a regular bedtime? We've talked about that before. Characterization of scooter injuries over 27 months. It is scooter season now if you've been downtown. We've been almost hit by scooters many times. Extreme exercises carries metabolic consequences. All right . . .

Scot: So I think that's enough choices. I think . . .

Troy: Scot, I can keep going. The flimsy evidence for flossing. How could you pass that one up?

Scot: Next time let's just limit it to three. And then we'll choose from that because I don't even remember what the first three were at this point. Mitch, did you hear one that intrigued you?

Mitch: I'm always interested in scooter injuries because Jonathan broke both his arms.

Scot: Oh, really?

Mitch: Yes.

Scot: Over sleep, over sleep? I would think the sleep one would be better.

Mitch: Yes.

Troy: Jonathan broke both of his arms on a scooter?

Mitch: Yeah, at the same time. He like fell off the scooter with a heavy backpack and he broke both of his arms. And so he was like a mummy all wrapped up for two months.

Troy: People don't talk about it a lot. But yeah, the logistics of breaking both your arms with scooters are awful. We don't get into the specifics. But it really limits you. And when I see people will come will break both their arms, I'm just I'm so sorry about this, like, "Yeah, this is a bad situation to be in. And you're going to be in this for six weeks." So scooters. You want that one, scooters?

Scot: All right. We'll hold on to the sleep ones later. I know that some of the sleep interviews are our most popular ones. So I do want to do those sleep ones for sure. But scooters hits home, so to speak, for Mitch.

Troy: It hits home. Yeah, it does hit home for Mitch, and it is scooter season. And I'll tell you scooters kind of . . . The reason I kind of include this article is I hoped you would pick it because I've done a lot of work with the scooter research and published on that. And it's one of these things that really hit the news where we had articles in "The Washington Post" and "The New York Times" about some of the stuff we did at the University of Utah. And we were one of the . . . not one, I think we were the first site to really look at this and say what happened here. What kind of injuries did we see after people started using rental scooters in Salt Lake? They rolled out. Everyone's using them. What kind of injuries are we seeing? And it wasn't just that we saw people with bumps and bruises, we were seeing people come to the ER who were major traumas, who had very serious injuries, major head injuries.

So this article actually appeared in the "American Journal of Emergency Medicine." It is slated to be published in July of 2021. So it will be published very shortly, but it's appeared online. And this article, they looked at patients at a level one trauma center over it's about a three-year period since November 2017. And had 442 patients who came in there who were injured on electronic scooters. And basically they said, "Okay, how serious were these injuries?" They said that hospital admission for those who came there was 40%. So these aren't patients coming in who were just saying, oh, I bumped and I got a laceration or even just a broken bone. These are 40% of their patients were admitted to the hospital, and 3% of these patients went to the intensive care unit. So these were serious head injuries, very, very serious injuries. They found that people who are more likely to admit it were those who were older than 40, who had alcohol use or other substances, who lost consciousness, or who came in by an ambulance. So kind of some obvious stuff.

But one of the most surprising things for me, both in this article and in the research we did, is the fact that no one uses a helmet. I mean, it's not surprising when you're out there seeing people. But when scooters are going 15 miles an hour, it's a pretty fast rate of speed you're moving on that. We found that in our study that no one reported helmet use. In their study, it was 2.5% of people. The other surprising thing is just that we found a lot of people were intoxicated. I think a lot of people are using scooters to bar hop, things like that. It's dark out, you're riding a scooter, you're . . . at least had a couple drinks. And that's going to increase your likelihood of getting injured. They found that people who had used alcohol or were intoxicated in some way were much more likely to have a serious injury.

So takeaway from this for me is it's a lot of stuff we already know. But it was interesting to see this now in a larger study. Bottom line is electronic scooters I think they're a great way to get around and quick way to get around. But if you're using it while you're intoxicated, that's an issue. It would be great if you had a helmet. I know no one does. But we see a lot of serious head injuries from this, so just be aware. It's summertime. Great time to get out. Great way to get around short distances on scooters. But be aware of the potential for injury, as you're well aware, Mitch.

Mitch: Yeah, and that's what's interesting is hearing that study because when we were in . . . we went to the hospital like 6:00, 7:00 at night. Jonathan had both of his arms broken. And the nurse there was saying, "Oh, well, you're the least severe e-scooter injury I've had today." And that was the most telling thing, where like I'm sitting there and I'm like, "What do you mean?" And she's like, "Well, I can't go into specifics or whatever. But that's all I can say." And it was just he has two broken arms, like how is it . . . And the idea of today. Just how many people are getting hurt with these e-scooters? So it's just really interesting to hear that.

Troy: Yes, and we've looked at that too. Yeah, I mean, the numbers have increased over time that we're seeing which makes sense as more people are using e-scooters, you're going to have more injuries, but yeah, we are seeing more and more.

Scot: Usually within the first two or three times you use it that you're going to get injured. Isn't it? Isn't that kind of the average.

Troy: It's correct. I wouldn't say usually within those times, but your likelihood of getting injured within the first two or three times is much higher. So it doesn't mean that all the injuries or most of them happen then. It just means that people who use it, like, it's their first or second time on the scooter, they're more likely to get injured than someone who's used 10 times so . . .

Scot: Which makes sense because I think it's a whole new way for some people to travel, right? And you've mentioned before they go a lot faster than you might think.

Troy: You go fast. Yeah.

Scot: And you hit something in the sidewalk. And if you got to bail on that, I mean, running 15 miles an hour recover, you're probably going to go down.

Troy: Your legs can't keep up. You're going to fall.

Scot: So I think one of the takeaways for me on the scooter thing too, was if it's your first couple of times, play it conservative till you kind of get used to how that thing works.

Troy: Yeah, take it slow.

Scot: How it's going to react on the sidewalk, how the brakes work, that sort of thing. Don't just get on it and start scooting.

Mitch: And the big thing for Utah, especially with Jonathan yeah, don't drink and ride these scooters. But these-scooters were developed in warm, sunny places. Jonathan fell because there was a little bit of ice on the ground, like the smallest amount of ice and the scooter just . . . whoop. So it's be careful when it gets colder out there because these scooters are still out there. They don't bring them all home so . . .

Troy: Yeah, and it's not just the ice. It's just slick sidewalks after a little bit of rain, something like that. These wheels are so small, and they don't even . . . they're nothing even like a mountain bike. They are not studded at all. They're not going to hold you on any sort of uneven ground or any slick surface. So yeah, I think that's the takeaway. You see people on them all the time. You think, "Oh, so easy to jump on. Great way to get around." But again, it's surprising to me not that we're seeing injuries. That doesn't surprise me. The surprising thing to me is how serious these injuries are. We have seen people who have died because of scooter injuries because of massive head injuries. This is something we have seen, other sites have seen too, so . . .

Scot: And then, any of the-scooter injuries that have come in, have you gleaned anything from any of those patients? They say anything to you that stuck with you?

Troy: The biggest things for me if I had three takeaways it would be if it's your first time on a scooter, like you said, Scot, take your time, make sure you know what you're doing. A lot of people were like, "It was my first time on it. I was going way too fast. I didn't know what to expect." Second thing, carry a helmet. I mean, if I could tell you one thing, like if you're going out just carry a helmet, maybe people will think you look stupid with a helmet on on a scooter, but cite this study if people give you a hard time. I've got some research. Come on, guys. Third thing, don't ride while intoxicated. Those would be the three simple things. And that's what the research drives home too. Again, it doesn't eliminate all potential for getting injured. But I think those are the big things where we see people getting serious injuries where they hit their head. And that's what puts you in the intensive care unit. So not nearly as fun as the green urine article. I was hoping you were going to pick that one. But probably more informative.

Scot: There's always next time.

Troy: I'll save it. It'll continue to reappear so . . .

Scot: All right, thanks for listening to "Who Cares About Men's Health?" the sideshow. We have numerous different shows. So if you're interested in nutrition, activity, sleep emotional health, that's called the core four, be sure to check out our core four episodes. If you're interested in men's health essentials. These are conditions that affect men, be sure to check out our men's health essentials section. And of course, this was the sideshow where it's a little looser, but we still do try to talk about health and tie it back in.

If you did like this podcast and you found it entertaining, informational, useful, inspirational, any of that kind of stuff, do us a favor and just tell one other person, share it with one other person that you think might dig it. That would really help us a lot try to find more listeners and more men who care about their health. Of course, you can also check us out on Facebook facebook.com/whocaresmenshealth. And you can reach out by calling us at 501 . . . And you can reach out by calling us at 601-55-SCOPE and leave a voicemail message or send us an email at hello@thescoperadio.com. Thanks for listening. And thanks for caring about men's health.

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Scot: Here we go. Did I maintain? Troy, are you still there?

Troy: I'm here.

Scot: Dr. John Smith, you there?

Dr. Smith: I am here.

Scot: Did you hear John, Troy?

Troy: What?

Scot: Did you hear John, Troy?

Troy: Yes.

Scot: Troy, did you hear John? John, did you hear Troy?

Dr. Smith: I hear everything.

Troy: I think we're good, Scot.

Scot: Okay. Here we go. The podcast is called "Who Cares About Men's Health," providing information, inspiration, and motivation to understand and engage in your health so you 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'm an emergency physician at the University of Utah, and I care about men's health.

Dr. Smith: And I'm Dr. John Smith, a non-surgical urologist at the University of Utah, and I care about men's health.

Scot: Second time we've had Dr. Smith on the show. The first time, Troy, it took a little warming up to Dr. Smith, but finally at the end of the episode, gave him some applause. So we've become fast friends. It's great to have you back on the show, Dr. Smith. Sure do appreciate you coming on and talking about some urology, urological sort of issues.

Dr. Smith: Thanks for having me back.

Scot: Quick question before we get to the topic, and today we're going to talk about erectile dysfunction because Dr. Smith was telling me that that's a reason, one of the reasons, one of the big things that he sees on a daily basis is guys coming in with some sort of an issue. So we're going to talk about that. We're going to give you the real information. So it's not like you're getting it from the friends on the playground. That's the internet, by the way, in case you're not catching my reference there. You're going to get it actually from the doctor's mouth. So that's going to be awesome.

Troy, I have a question for you. So at one point, you talked about how in the ER, you call urologists sometimes to do some procedures.

Troy: We do.

Scot: What are some of the reasons that you have urologists come to the ER? One time you said that if you're having difficulty inserting a catheter, you might have to have a urologist come and then do that for you. What other reasons?

Troy: Sometimes we call them for kidney stones. That's probably one of the more common reasons. If it's a very large stone that's just likely not going to pass on its own or an infected stone where the patient has a big kidney stone, or even a smaller kidney stone and a bladder infection, kidney infection, along with it. We do call them for trauma-related injuries, whether that's a tear of the urethra or sometimes even a penile fracture. Scot, you may hear that and say, "Wait, is there a bone in the penis that gets fractured?"

Scot: There's not.

Troy: Was that your thought?

Scot: I mean, I know there's not though. I mean, sixth grade Scot would have thought that.

Troy: Sixth grade Scot.

Dr. Smith: Seventh grade Scot knew better.

Troy: He wised up quickly.

Scot: He did.

Troy: It's referred to as a penile fracture. It's a tear in . . . John can describe it in more detail, but a tear in the . . .

Scot: Or not.

Troy: It's an incredibly painful thing. I will say that. Having seen men with penile fractures, it looks incredibly painful. So we will call them for that as well.

I will say along the lines of erectile dysfunction, I was working a night shift once and a man came in at 6 a.m. and he said, "My woman said, 'You leave the house and you go to the ER and you don't come back until you get that fixed.'" We did not call urology for that. We didn't do that to them. But I have seen "erectile dysfunction" emergencies, at least in the mind of the individual in the ER, as well. So again, I did not call urology and push that on them, but it would have been funny.

Scot: Dr. Smith, you would actually handle some of that stuff though, even though you don't necessarily go into the ER. But don't they use . . . for kidney stones, don't they use sound waves now for a lot of that sort of thing?

Dr. Smith: So they can. There are multiple different ways to treat kidney stones. We could probably do a show on that, but . . .

Scot: Well, let's do that.

Dr. Smith: Fair enough. I'll come back.

Scot: Not right now, but yeah, someday. We've got more pressing topics to get to.

Dr. Smith: That's fair. But yeah, there is something called a lithotripsy. and they use a machine where they put a little bag of . . . it feels like a bag of water, like a gel bag, against your back and they find the stone with an X-ray and then they send shockwaves in to break it up.

Scot: Wow. That's pretty cool. Technology is awesome. So let's talk about erectile dysfunction, one of the main reasons guys come and see you. Just want to break it on down. So help us kind of understand what's going on, what you as a urologist do to help men solve their problem, and I think, in general, makes men that are struggling with this feel that it's okay because it is okay.

Dr. Smith: It is okay.

Scot: Yeah, so where should we even start this conversation? I'm not good with sensitive conversations.

Dr. Smith: You just start by digging in. There's no way to just waltz around this thing and hope that it comes to you. I would say a lot of men come in with erectile dysfunction. It can be a . . . well, there are multiple different reasons, but overall erectile dysfunction, the definition of it is the inability to achieve or maintain an erection that's adequate for sexual function.

And so it's estimated that about 18 million men in the United States have erectile dysfunction. So guys, you're not alone. That's a pretty sizable number. Some of them seek treatment, some don't. This condition can affect people in a lot of different ways in their relationships. So it's one of those things where you might as well come in and have a conversation.

Scot: So it's not just about erectile dysfunction. It can cause psychological issues. Are there other health issues that men should be aware of?

Dr. Smith: Sure. So it can be a harbinger of cardiovascular problems, other things like that. Folks with longstanding diabetes often have erectile issues. There are multiple health problems that can cause or precipitate erectile dysfunction. And so those are good reasons to come in as well.

Scot: So my ability to not get or maintain an erection is not because I've become less of a man. It could actually be a medical symptom to a bigger problem, or it could just be mental. What are some of the other causes?

Dr. Smith: Absolutely. So it could be psychogenic, which means that . . . guys like to think if it doesn't work once, it's never going to work again. And so that brings in some gentlemen. Again, diabetes can be a problem, people with known vascular problems, people who've had prostate cancer and had surgery or radiation oftentimes have a decreased quality of erections.

And then sometimes we don't know. We call it idiopathic. There's not a reason for you to have erectile dysfunction but you do. It's not necessarily an age thing, but as men age, generally, the quality of their erection declines some.

But those are kind of the things that we kind of overview with folks when they come in to have a chitchat.

Troy: John, it sounds like there are a lot of different things that maybe could cause it. But how do you really determine if someone has erectile dysfunction? What do you use just to say, "Yeah, it sounds like this is definitely an erectile dysfunction," versus, "Maybe you don't have a problem"?

Dr. Smith: So, generally, I ask a few questions. "Do you have a decreased ability to attain or maintain an erection?" Oftentimes, it's not one or the other. It's both for folks. I ask them how rigid their erection is compared to an erection that they had when they were having quality erections. And one of the big ones for most people is, "Is it adequate for sexual function?" And so if it's not, that's a good indication that it's erectile dysfunction. That's true erectile dysfunction.

Scot: And when a guy comes in and you ask him the questions, how often is the next word out of his mouth or the first word actually when he even walks into your office, "Yeah, I have a problem and I need some pills"? I mean, is that kind of the first thing that you get asked?

Dr. Smith: Not always. Some men come in and that's kind of what they want, and in a way, that's not a bad way to look at it because the pills generally work for all comers of erectile dysfunction. It doesn't matter why you have it. Seventy percent to 80% of patients with erectile dysfunction are treated adequately with medication. So again, that's not a bad way to go, but it does warrant a little bit of investigation at times.

Scot: So there are two different types, it sounds like, getting and maintaining, and then maybe even a third, having the quality of an erection that is adequate enough for sex. You give the man the pills, and then you send him on his way. Is that that, or are there other potential treatments that you might have to look at?

Dr. Smith: If you're going to come to me, I'll generally do a workup for you. The American Urologic Association has guidelines that they put out for everything, and I tend to try to follow those guidelines. One of them is to make sure that there's not a hormonal issue. I'll check a hypogonadism panel, make sure that everything's working as far as testosterone, hormones, things like that.

If I feel like after getting a history from you that there's maybe a cardiac issue, or you're a diabetic that may struggle with controlling your diabetes, I may refer you back to other folks before we get you started on medications, things like that.

But generally, looking at all those reasons, it's not just as simple as saying, "Here are some pills. Go and let me know how it works out." But in certain cases where we do the workup and we don't really find a reason and they do well with pills, it's not a bad way to treat them as long as we work it up and look at it the right way.

Troy: Speaking of pills, John, and the workup you mentioned, I'm sure we've all seen the ads on TV. You're seeing them more and more now, especially if you watch sports, for some of these online things where you basically, it sounds like, probably chat online with someone and then get medication for erectile dysfunction. What's your thought on that? Is that a reasonable route to go for someone who's maybe embarrassed to go into see a physician or any insight into that?

Dr. Smith: I think those companies have a place. One of the companies, I think one of the guys that started it actually had a cardiac issue and that's why he had erectile dysfunction. So they kind of mention that in some of their advertising where it makes sense to maybe talk to your primary doctor as well.

The big thing for me is making sure that people are taken care of the right way. If you were my dad or my brother, how would I want you treated? And I think that sometimes those guys may miss some steps. I've never used them to know a 100%, but I think looking at everything as a whole and making sure that there's not some underlying problem is important.

However, if it's impacting your relationship or there are different reasons, I could see a reason why you would utilize those services. No question.

Scot: You said the pills take care of a majority of men's problems. In the instance that pills don't work, what do you start looking at, at that point?

Dr. Smith: So in general, the algorithm that I use is if oral medication isn't effective, I'll generally refer you to have an ultrasound done, a penile Doppler ultrasound where I'll look for a possible cause of your erectile dysfunction at that point.

And the reason that I don't do that first is it requires us . . . we usually do it with a medication called Trimix, which is three medications that will produce an artificial erection. And most men aren't jumping to get a needle put into their penis. Granted it's a small needle, it's like a diabetic needle that you would use, but most men aren't interested in trying that first.

So I'll generally look at that next and see if I can come up with the actual reason that they may have an issue, and see if there's a blood flow problem and different things like that. And then after that, the options that we have for treatment are, again, if that medication works well to give an artificial erection, you can continue to use that. And then there are other surgical options that are out there as well.

Troy: John, I guess getting back at treatment, obviously medication, injections, surgical options, what if someone comes to you and just says, "Hey, I just don't like taking medications. Is there anything else I can do?" Is there anything you recommend in that situation, or do you just say, "Probably want to try some pills first"?

Dr. Smith: So there are always things you can do. Diet and exercise has been shown to be effective in helping mild erectile dysfunction, to improve the quality of an erection. It's not as effective as medication, as the Viagra/Cialis/Levitra medications, but it has been shown to provide some benefit to improving the quality of erection.

And I think the whole purpose of this podcast is "Who Cares About Men's Health" and you guys often speak about taking care of yourself. And I think if we're all smart about that and we take care of ourselves and take care of our diet, different things like that, make sure that we're healthy, it does improve the quality of your sexual function.

Scot: Does the pill also help in the instances of maintaining or can that be other things?

Dr. Smith: Absolutely. So for some folks who have difficulty maintaining, sometimes a constriction band . . . the layman's term that everyone uses is a cock ring. You can utilize that to help maintain an erection if you have a venous leak where more outflow of blood is coming out of the penis than the inflow can support. And that can be very effective for men with that issue. I would say that's a lower percentage of the patients that you see with erectile dysfunction, but when it works, it works really well for folks.

Troy: Too many stories from the ER with the cock ring, too many. We won't go there. Like things gone wrong, but we won't go there.

Dr. Smith: I'll give you a two-second story that you can edit out.

Troy: Or not.

Dr. Smith: We took a family vacation when I was in residency, out to Hersheypark. I was in New York, so it was a close drive. And we stayed in a hotel, went to Hersheypark the next day. We were going for two days, which if you ever go, don't go for two days. You only need one.

Troy: Been there.

Dr. Smith: But I wake up in the morning, we're getting ready to go to the park, and my kid comes over and she goes, "Dad, look at this ring I found in the drawer." And it's this silicone, spiky little ring. And my wife's jaw just drops. I look over and I go, "Drop it and go wash your hands immediately, child."

Troy: Our department chair in residency was doing teaching rounds. And they had a patient whose complaint was he had a cock ring on, he couldn't get it off, and the department chair did not know what a cock ring was. All the residents there were just totally silent, did not say a word to try and tell him, "This is what it is." He says, "So we'll just look this up," and goes over to the computer and types in and all these images just start coming up. And it's like, "Oh, okay. Let's shut this down." Anyway, yeah, we've seen some crazy things.

Scot: I feel a little left out. I'm the only one without a story.

Troy: Scot, you can make one up. You could just tell one.

Scot: I haven't lived apparently because I don't have a story to share. Both of you sound like you've got even more of them and I have none.

Troy: Unfortunately, yes. But we won't go there.

Scot: Troy, actually I do want to ask you, do you have any advice if somebody is using one, based on what you've seen in the ER, that you want to avoid?

Troy: My advice . . .

Scot: Are we going to get into some argument here with Dr. Smith about you don't think they're safe and he says they are?

Troy: I don't think Dr. Smith will argue with this. My one piece of advice is if you use a cock ring, don't leave it on for three days. It's a bad idea.

Dr. Smith: That's a fact.

Troy: It's a bad idea. I think we're all on the same page there.

Dr. Smith: A hundred percent. Follow the directions.

Scot: Oh, they come with directions?

Troy: Read the directions.

Dr. Smith: Well, they should come with directions. If they don't, you should probably get one that does.

Scot: Have we covered the topic well enough? I mean, I don't know for sure. It seems like we've covered the important points that somebody might have. Did we leave anything out, Dr. Smith?

Dr. Smith: I talk about this all day, every day, so there's always plenty more to talk about, but I think that gets the ball rolling. If you haven't seen a urologist by that point, you probably should.

Scot: Sounds good. And if you have further specific questions, of course, you can reach out to us here at the "Who Cares About Men's Health" podcast. A lot of different ways to do it, which we will put in the links to the show notes, including hello@thescoperadio.com. You can call our scope line 601-55SCOPE. You can do Facebook direct messages, and you can use the name John Smith and just asking for a friend if you feel a little shy about the whole thing.

You know what? I'm proud of us. We really more or less got through this without making a lot of jokes. We've kept the jokes to a minimum, so that's good. Or is that bad? It could be bad.

Dr. Smith: I mean, it depends on the viewership, what they think. If they wanted more jokes, they should probably ask for them.

Scot: Do you find when a man comes in to talk to you about erectile dysfunction that they tend to have a little bit of a different personality? Do they tend to deal with it by joking a lot more than you think they might normally in real life? I mean, what's the demeanor of your average patient?

Dr. Smith: Average patient I would say comes in a little bit gun-shy. Most of them don't want to come in and talk about it, especially the older generation of men that I see in the office. The ones that are just "throw caution to the wind" don't care are generally the guys who've had prostate cancer, where they were told before they had their treatment that this is likely going to cause erectile dysfunction. So they come in and they're like, "Hey, I just had surgery. I have erectile dysfunction. What are you going to do?"

Scot: And it makes sense, because they've got a medical reason now. Getting back to this whole stigma about "Are you less of a man if you can't get it up?" and those sorts of things, there's not a stigma there anymore, right?

Dr. Smith: Right.

Scot: There was a medical procedure that was done beyond their control that caused this to happen.

Dr. Smith: Right. They've already been through a wild roller coaster of being diagnosed with cancer and the unknown there. And so a lot of times they're coming in and they're just like, "Hey, is there anything we can do? I hope so." But they're very happy to kind of be through that mental roller coaster.

Troy: John, along those lines, you mentioned our listenership. A large number of our listeners are women. How often do you have where people are coming in with their significant other, or they say they've been encouraged to come in? Is that something you see often?

Dr. Smith: Prior to the pandemic, yes. A lot of couples would come in together. And oftentimes, the spouse/partner is very supportive of the individual coming in because that intimacy is an important part of their relationship that they've kind of lost and they want it back. And so I did see quite a bit of that.

Now, with the visitor policies and things being different after the pandemic, I've even had a couple of patients say, "Hey, can we FaceTime or can we WhatsApp or whatever with my partner so that we can have this conversation together?" so they're all on the same page, which is great.

Scot: Dr. Smith, as we wrap this up, just kind of give us your final thought. I think you've given the men that listen to this show that might be suffering from this problem hopefully some good information to go seek help and know what to expect. But any kind of final thoughts on this for a guy that's on the fence?

Dr. Smith: There's just no reason to feel bad in any way about it. This is a normal thing. Like I said earlier, 18 million men in the United States have this issue, so you're one of a big group. And there's no reason to wait to feel better and improve your relationships and your confidence in that area.

Scot: Fine work. Thank you so much for being on the podcast, Dr. Smith, and thank you for caring about men's health.

Time for "Odds and Ends" on "Who Cares About Men's Health." We just have one item, and that is in reference to last week's episode about kettlebells. Possibly something you might want to do. A lot of people, their gyms are closed, or you don't want to go to the gym. That was certainly the situation I found myself in. I also used to do just traditional weight training, and I wanted to see if I can get more of a full body, natural movement sort of exercise routine going. So I wanted to do kettlebells, and Caleb helped get me started.

Troy, I'm happy to report that those kettlebells that I bought in that parking lot at the Walgreens in Bountiful, Utah, looked like some sort of a drug deal going down, but no, it was for kettlebells. I have started sniffing around them kind of like a dog sniffs around stuff. So I have started using them. I've started implementing some of the swings and the squats and the deadlifts that Caleb recommended.

And I'll tell you, I really like them. Now, I'm moving really slowly because it's a different type of exercise than I've done before. So I'm watching how heavy of a weight I'm using. I'm also just really not trying to do too many reps.

I've got a really light one up in my office. So I take little breaks while I'm working. I stand up, because you can sit for so long, and I'll do some exercises with that little light, 10-pound one. I've got an 18-pound one in the office. And then the big boys, those are out in the garage and I go outside and I do the swings and the cleans . . .

Troy: Your 35-pounders?

Scot: Yeah, and my full pood as they call it in Kettlebells. The 35 pounds is called a pood.

Troy: That's when you swing the pood in the garage.

Scot: Well, I do it out in the backyard. But I am really enjoying it, and I just wanted to update you that I'm really digging kettlebells. So if you haven't been doing some sort of strength training routine, and they say you should do 30 minutes at least three times a week of strength training, go back and listen to the last episode about kettlebells. Get some do's and don'ts, get a basic little routine, and check out that episode.

Troy: Well, I have not bought my kettlebells yet, but it was very convincing. I'm thinking about it. Like you said, supply and demand right now. Supply is not in our favor. Demand is definitely high. So it's a challenge getting kettlebells right now, but I would like to try them out.

Scot: I highly recommend it.

Troy: I would sing it, but I . . .

Scot: Na-na-na-na-na-na-na-na.

Troy: Thunder!

Scot: Troy, do the honors of singing, "You've been Thunder debunked!"

Troy: I can't do that, Scot. Come on.

Scot: Thunder debunked!

Troy: I kind of have to maintain some sense of dignity.

Scot: Thunder debunked!

Troy: I'm sorry. I can't. I think you already did it.

Scot: Eat this. Don't eat that. It can be really confusing out there when it comes to nutrition, and there's a lot of stuff on the internet. Is it true or is it false? Well, we're going to try to find out again with Thunder Jalili. He's our nutrition expert here on the "Who Cares About Men's Health" podcast. And this is a segment we call "Truth or Thunder Debunked?" So I'm going to give Thunder a statement here and I want him to tell us if it's truth or if he is going to Thunder Debunk it.

Frozen fruits and vegetables are less nutritious than fresh ones. Truth or Thunder Debunked?

Dr. Jalili: I'm going to have to go with Thunder Debunked on that one.

Troy: That surprises me.

Dr. Jalili: Depending on the context, it could be somewhat similar. Let me just give you a really quick background. So if we think about fresh fruits and vegetables that you buy in your grocery store, you've got to remember that product is not as fresh as you think. It was probably picked days or weeks before it found its way to the grocery store, and it was probably picked before it was ripe and it ripened during transit and delivery. So that means you're probably not getting the optimal nutrients in that in the first place.

Now, frozen fruits and vegetables, they're picked when they're actually ripe and then they're subjected to the freezing process. And so they may have a little better nutrient content. But of course, the process of freezing them and blanching them, that may degrade some of the nutrients.

So at the end of the day, when you look at both, they're about the same.

Now, the one exception for fresh is if you have a farmer's market close to you and you go there to buy fruits and vegetables, chances are you're buying something that was just picked in the last couple of days. In that case, that is the most nutritious version of the fruit or vegetable you can get because a ripe fruit has the peak nutrient content. And those were picked when they were ripe before they came to the farmer's market.

Scot: So the statement as it stands, frozen fruits and vegetables are less nutritious than fresh ones, again, Thunder Modified.

Troy: Thunder Modified. It sounds like if you've got the fruit tree in your backyard and you're picking it off the fruit tree and eating it, that's the best you can get. But otherwise . . .

Dr. Jalili: That's the best you can get. Or farmer's market. You've got to make a pitch for farmer's markets, especially when stuff is in season. That's really the highest quality produce you're going to find anywhere.

Scot: Fascinating, though, that frozen fruits and vegetables and fresh ones that you perhaps might get at the grocery store because they were picked and ripened on transit are essentially equal though.

Thunder, as always, thank you very much. We appreciate your participation on the "Who Cares About Men's Health" podcast with "Truth or Thunder Debunked?"

Time for "Just Going To Leave This Here" on "Who Cares About Men's Health." Could be something to do with health, might be something random. I'm going to start.

Just going to leave this here. I am going to encourage you, Troy and our listeners, to unleash your inner puppy. I want you to unleash your inner puppy.

So we have a brand-new puppy. His name is Murphy. I say puppy. He's in the body of an adult dog at this point. He's six months old. You look at him and it's hard to remember this is still a puppy. He behaves like an adult dog, but every once in a while you see the puppy in him. And the moment you see the puppy in him is like when we're outside and he will find a leaf and pick it up and throw it around and chase it and bite it and try to keep it away from you.

There are other little moments where he does puppy things, and that made me think back to times that we've talked about that for your own sanity and mental health, you should play.

And whether that's a hobby that you get into that flow state because you enjoy it so much, whether that's a sport that you like to play either by yourself or with other individuals, I think we forget to play. And we forget the benefits of playing on our mental health and our emotional health.

I've talked to psychiatrists who say that this can actually recharge you. We always talk about taking days off or vacations to recharge you, but it's also about what you do. So I'm encouraging you to release that inner puppy because it can help you unwind and be ready to take on what's going to happen the next day or the next week.

I can speak from personal experience that I find myself recharged after doing that. And maybe if you have kids, maybe that just means when you play with them, just get totally lost in it. Just get totally lost as a kid in it. And it can be hard because our adult brains kick in and we go, "Oh, I'm being silly. I'm being stupid." But just try it. Unleash your inner puppy.

Troy: Great advice. Well, since you have a new puppy, Scot, I'm going to share my puppy advice with you. We have Charlotte who you know. She's a pretty young dog. We guess she was probably maybe eight or nine months old when we got her. She had puppies herself, but we joked that she was like a teenage mom. She wanted nothing to do with her puppies. She'd feed them and then she would come up and play. She was a very young dog.

And Charlotte had a habit, and still has a habit, of eating our remote control for our TV. So what I do now is I keep a spare remote. The original remote I was trying to buy . . . I bought this stupid magic remote a couple of times that cost $50 after she ate it. And then I just said, "Forget it," and found some cheap $8 remote on Amazon.

So each time she eats the remote, I buy a new remote, and I then have a spare remote for when she eats the next remote. So then it takes us a week to get the next remote.

The good news is, I just looked, we've gone through three months now without her eating a remote. So I hope your puppy does not eat your remotes, but if you do, I can share my advice on stocking on remotes and making sure you have a steady supply so you can continue to watch your TV with your puppy.

Scot: Our dog does have a little bit of a chewing thing, but we've kept just chew toys around, and so far that has satiated his need to chew. So we'll see.

Troy: Good. That's great.

Scot: We'll see. But good advice on the remote.

Time to say the things that you say at the end of podcasts, because we are at the end of our podcast. Troy, kick it off with the how you can hear us. Of course, that's kind of redundant because somebody is hearing us right now. They already know.

Troy: Well, you can subscribe. Please subscribe anywhere you get your podcasts, whether it's Google Play, iTunes, Spotify, Stitcher, Pocket Casts. I'm going to mention Pocket Casts, Scot, because you don't like them but my sister uses Pocket Casts.

Scot: So does Producer Mitch.

Troy: So does Producer Mitch.

Scot: They're like the four people that . . . or two people. They're two of the four.

Troy: Two of the four who are still using . . . they probably still have Hotmail accounts as well. Actually, Hotmail doesn't even exist anymore I found out.

Scot: AOL accounts, they probably have.

Troy: Yeah, they have AOL accounts.

Scot: All right. And also then if you want to get in contact with us, there's a couple of ways to do that. And that entails if you have a question you want to ask about a health topic, a suggestion, anything of that nature, hello@thescoperadio.com. That's the email. The Facebook page is facebook.com/WhoCaresMensHealth. And there's also a phone number you can leave a recorded message, and that's 601-55SCOPE. That's 601-55SCOPE. Whatever you're comfortable with, we would love it if you'd reach out and say hi.

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

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Scot: Nobody's got any questions? Good.

Dr. Smith: I thought you brought the questions.

Scot: I do. I've got the questions.

Troy: That's Scot's job.

Scot: That's right. I have two jobs. One is to provide everybody with microphones, although you bought your own, so I feel pretty . . .

Dr. Smith: I did. I brought the heat today.

Scot: Yeah, Troy, Dr. Smith bought his own mic.

Troy: Exactly. Why buy it when you're getting it for free? You gave me mine, so I'm like, "I'm not spending money on this thing."

Dr. Smith: Well played.

Scot: It's "Who Cares About Men's Health." That's the name of the podcast. What do we do here? We provide 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'm an emergency physician at the University of Utah, and I care about men's health.

Dr. Smith: And I'm John Smith. I'm a non-surgical urologist at the University of Utah and I care about men's health.

Scot: All right. Dr. Smith, Dr. John . . . can I call you John, Dr. Smith? Is that okay?

Dr. Smith: You can surely call me John.

Scot: It's John's first time on the show. Welcome. This is exciting.

Dr. Smith: Thank you.

Troy: Welcome, John. Thanks for joining us.

Scot: I noticed Troy is not clapping. He's not nearly as excited as I am, but that's okay.

Troy: I'm very excited.

Scot: He's tough to win over sometimes, so . . .

Troy: Thanks, Scot.

Scot: We'll see how you do.

Troy: We'll see how you do. I'm still warming up to you, so . . .

Dr. Smith: We'll see if I can get him to clap by the end of the show.

Troy: We'll try.

Scot: Dr. Smith, thank you for being on the show. We're going to do some listener questions today. We're going to get to those in just a couple of seconds. But first, Troy, I'm curious, as an emergency room physician, what is the general take in the medical field on urologists? Like, when I said, "We're going to have a urologist on," what goes through your mind?

Troy: What goes through my mind? Well, we very regularly talk to our urologist. We see all sorts of urologic emergencies in the emergency department, whether it's trauma related or other issues we're seeing. They're people we talk to frequently. So, it's someone we rely on in the emergency department and we're very grateful always to have their assistance.

Scot: All right. So, it's great to have their assistance. But, I mean, what do you really think about urologists in general?

Troy: Scot, what are you getting at here?

Scot: I mean, in all fields of medicine, isn't there a little friendly competition between you all and there's some . . .

Troy: I'm jealous of urologists. It's a great field. It's a really great field. It's a very competitive specialty. It's a great field. It's one of those things where the people I knew who went into urology in med school were great people, like good friends of mine. I think it's a very well-respected specialty.

Scot: Dr. Smith, are there some urology stereotypes out there?

Dr. Smith: Oh, of course.

Scot: Yeah? What are some of these urologist stereotypes? Because I think I've noticed some patterns when I've met a few urologists.

Dr. Smith: I guess, on the other side, I . . .

Troy: Are you just trying to get him to cracks and dirty jokes? Is that where we're going, Scot?

Scot: Anything for ratings.

Dr. Smith: There are a few urologist jokes out there that are semi-family-friendly.

Scot: Well, hold on that because, actually, at the end of the show, I'm going to ask you to end with a urologist joke. So, hold on to that, okay?

Dr. Smith: Well, I'll save my favorite for then.

Scot: All right. But are there kind of some stereotypes in the medical field when it comes to urologists? It seems like urologists tend to have a better sense of humor than some of the other specialties. They're cracking jokes a lot. Is that fair or . . .

Dr. Smith: I would agree with that, I think. Most of them are good-natured, fun-loving guys and gals that they like to have a good time, but they also are very intelligent, like to work hard, and take care of folks.

Scot: All right. Sounds good. I can't wait for the joke at the end though. I'm really looking forward to that. That's going to be great, a good urologist joke.

Troy: Yeah. Stick around for the joke. For no other reason. We've got a good joke on the way.

Scot: These questions for our urologist, Dr. John Smith, came from a few different sources. First of all, we have a listener line. You can call and leave a message, and that is 601-557-2673, or easy way to remember it, 601-55SCOPE. You could also email hello@thescoperadio.com, and we also got a few Facebook direct messages. So, if you have a question for a urologist, those are the channels that you can get those to us.

Troy: Sure, it's our bodies, but it's something that's obviously very personal and people crack jokes about their genitalia, and so I think it's one of those things where, yeah, it's something that . . . And it really gets at the essence of our manhood. If you're talking about erectile dysfunction, sure, it's a medical issue, but it really gets at the essence of your virility and your manliness. So, I think it's tough to bring up and it's tough to really be willing to address it, for sure.

Dr. Smith: I think that's true. And then you also have the society stereotypes. It does get to the heart of manliness. A lot of people feel like, "Well, if I can't perform, I'm not a certain one way or another." I mean, I've heard it all from different guys who have different perceptions of things.

Scot: If you want to ask a question and you are a little embarrassed or hesitant, we're going to make this as simple as possible. So, you can say that you're asking for a friend if that makes you feel better. We'll totally believe that. You don't have to use your real name. You can make up a name. You can even use a fake name that's obviously fake, like John Smith, for example. We're just trying to make it super safe. And as a matter of fact, we're making it so safe that we have a urologist who's obviously also using a fake name. So, this is about as anonymous as it gets.

Dr. Smith: Witness protection has been good to me through the years.

Troy: There you go. Nice.

Scot: All right. Here we go. Question number one.

John: Hi. My name is John Smith and I'm calling in the urology line to ask the question "Can guys really get urinary tract infections?" I thought that was more of a woman thing. Anyway, just asking for a friend. Thank you.

Scot: Okay. So, yeah, great question. I guess I am in the same camp. I guess I figured that urinary tract infections, mainly women get them. Can men get them?

Dr. Smith: So, a couple of different reasons why a man would get a urinary tract infection. As men age, their prostates continue to grow. Your nose, your ears, and your prostate continue to grow, but they only told you the first two in school growing up. But when your prostate gets larger, it can obstruct your urinary flow and predispose you to urinary tract infections. That's one of the most common things that we'll see. A gentleman has urinary tract infection and he's older, prostate is generally the cause.

Scot: What if you have to pee and oftentimes find yourself in a situation where you have to pee but you don't have the ability to do so? Can that cause urinary tract infections? If you're a long-haul truck driver or something like that and you're not going to the bathroom as often as you should . . .

Dr. Smith: You can predispose yourself to that. It's less likely. If there's not an obstruction . . . so I tell my patients, "You're either a pond or you're a river." And what that means is if you've ever been around a pond of stagnant water, you know what happens to it. A river generally doesn't look like that.

Scot: All right. And what does that urinary tract infection feel like? I mean, I've heard about it a lot from men and women in my life, but . . .

Dr. Smith: So, it depends on . . .

Scot: And rightly so, it's painful.

Dr. Smith: It sounds awful, yeah. It's miserable.

Scot: I can get myself in trouble here.

Troy: You are going to get yourself in trouble, Scot.

Dr. Smith: Asking for a friend, right, Scot?

Scot: Yes. Friends have told me they've heard this.

Troy: Yeah. Women in your life have said things . . .

Dr. Smith: "I've heard . . ." So, generally, folks will end up with dysuria or burning with urination. Some people go to the bathroom more frequently. Some guys will get kind of groin pain, flank pain. Testicular pain can also occur. Those are signs that you could have that. Fever and chills can also be a sign.

Scot: Yeah. The good news about all those symptoms you mentioned, if any of that stuff start happening on a regular basis, I think I'm going to go visit a doctor.

Troy: Yeah.

Dr. Smith: You probably should.

Troy: Those aren't subtle things. Once you start seeing blood in your urine and burning, you're going to get checked out.

Scot: Question number two, this one is one that came in through Facebook Messenger. No shock here. It's from John Smith and asking for a friend. "Is there any legitimacy to exercises that promise more size, girth, stamina, those sorts of things?" You know those emails you get that say, "Do these exercises and all these good things will happen."

Troy: Now, you're referring to bicep girth, or what's the gist here, Scot?

Scot: These emails are generally in your junk folder and they're promising . . .

Troy: And referring to your junk. Okay, right. Got it.

Scot: Yes, exactly

Dr. Smith: That's why it's a junk mailbox.

Troy: That's right. Got it.

Scot: Yes, because that's all that's in there. Dr. Smith, is there any legitimacy to any of those exercises?

Dr. Smith: I can't confirm that there's any legitimacy there to any of that stuff. The one thing we do know is that diet and exercise can help the quality of your erection for men with kind of mild erectile dysfunction. But there are no exercises or stretches or anything that has been shown to be super effective in that category.

Scot: All right. And even those ones that are for medical use, I'd imagine, if you were experiencing something like that, probably best to visit a physician first and use those under the guidance of a physician, not just kind of a do-it-yourself thing. Or is that okay?

Dr. Smith: Absolutely. You want to be evaluated to make sure that you're a candidate for a lot of those devices. It's always smart to go see a doctor. When in doubt, you should probably go and see a physician about things. It just makes sense and it's safer that way to kind of be under the guidance of someone who's done this before.

Troy: Any downside to using those devices? Have you ever seen things go wrong with those sorts of things?

Dr. Smith: So, I've seen some folks come in with certain cultural injections that they've had put into the penis and things that have promised to give increased size or girth, where they've had an infection from that, and had to have some things taken care of that way. I've also seen people who have tried to inject caulk or silicone.

Scot: What?

Dr. Smith: Oh, yeah.

Scot: What? How? Where?

Troy: Just like something from Home Depot, like some silicone caulk or something?

Dr. Smith: Exactly.

Scot: The way I'm imagining that they would inject it, I mean, there's like one way that I'm thinking that gets in there.

Dr. Smith: And you're probably thinking of it the right way.

Scot: Okay. Wow.

Dr. Smith: I've also had people who've come in with urinary retention who've placed things like that inside their urethra to try to help with rigidity of their erection, so . . .

Troy: Wow.

Scot: Wow. There's a do-it-yourselfer right there.

Troy: So, when you say inject, you're not talking . . . they don't have a needle. They're just going in the urethra, right in the hole there, with the silicone.

Dr. Smith: Oh, no, both ways.

Troy: Both ways? Wow.

Dr. Smith: Oh, yeah. A lot of them will get an infection under the skin because they've injected some of those things at times.

Troy: So, they've injected with a needle under the skin and then just shot it directly in the urethra? Wow. That sounds like a recipe for disaster.

Scot: You haven't had any of those come through the emergency room ever, huh, Troy?

Troy: I have never seen that. After 15 years of doing this, you think you've seen just about everything, but that is one thing . . . I mean, I've seen some crazy things and some crazy things people have put in their urethra, but I've never seen silicone shot in the urethra. That sounds awful.

Dr. Smith: You must not work nights, Troy.

Troy: I worked plenty of nights, yeah. That's just one thing I haven't seen. It's crazy. I haven't seen it, so . . .

Scot: Wow. All right.

Troy: Interesting.

Scot: So, question number two, is there any legitimacy to exercise to promote more size, girth, or stamina? According to what Dr. Smith says, there's no real good research that says that there is. So, don't spend your money on that stuff, I suppose, and don't be injecting either.

Troy: But he did say, though, and it's worth noting, it sounds like . . . John, you did mention that exercise and diet can improve the quality of erections. Maybe not necessarily just the size of a man's penis, but it sounds like there is potentially benefit from diet and exercise.

Scot: And it comes back to that core four that we talk about here. To stay healthy now and feel good now and in the future, you want to work on your nutrition, your activity, your sleep, your stress management, and, of course, know your genetics as well and manage those addictive behaviors and those nagging health issues. So, diet and exercise, it seems like it always comes back to that.

John: Hi. This is John Smith here and I'm calling about the "Who Cares About Men's Health" podcast. I was just wondering if I found a lump on my testicle, is it cancer? Just curious.

Troy: So, Scot, were these guys all planted? Did you tell them just to make up the name and call themselves John Smith?

Scot: On the Facebook page . . .

Troy: What are the odds?

Scot: Here's the thing. On the Facebook page, I said, "If you don't want to use your real name, use an alias like John Smith. You could also say you're asking for a friend." I'm trying to . . .

Dr. Smith: So, you set all these guys up then. Okay.

Scot: Dr. Smith, lump on testicle, does that mean cancer?

Dr. Smith: It does not mean cancer. It can mean cancer, but it quite often does not mean cancer. The other thing is a lot of men like to say, "I have a lump on my testicle," and then I'll do an examination and it's not even on the testicle. There's something that's very common called an epididymal head cyst or an epididymal cyst. Sometimes people will call it a spermatocele. It's kind of a cystic little area of the epididymis, which they can continue to grow, get larger. And a lot of times, men will notice those and they think that there's something going on. I see quite a bit of those, especially younger and middle-aged men.

Troy: So, John, I guess that raises the question as well, as a young man going through sex education in fifth grade, I was taught I should be examining myself every month in the shower to feel for lumps and bumps, get it checked out, and then from my understanding, it's kind of gone out of vogue. Is that something we should be continuing to do, that men should do?

Dr. Smith: So, I think self-examination is important. The biggest thing is just knowing your body, knowing yourself. I don't know that marking the calendar for the 24th of every month to check your scrotum is the way to go. But, you know . . .

Troy: So, you're saying I've been doing it wrong?

Dr. Smith: No, I'm saying you're probably doing it just fine.

Scot: That's so weird. I was over at Troy's house and saw the calendar on his kitchen refrigerator. I'm like, "Well, that's weird, but okay." But now I understand.

Troy: Scot's like, "What's TSE?" "Scot . . ."

Dr. Smith: But yeah, I think to know yourself . . . I mean, most guys, if you have the opportunity to just check things every once in a while and make sure that things are normal. And if anything feels abnormal, it's worth coming in and having someone take a peek at it.

Scot: Yeah, and . . .

Troy: It sounds like . . . oh, sorry, Scot.

Scot: Go ahead.

Troy: It sounds like from what you're saying, though, you don't have to feel like you've got cancer. It's worth checking out. What percentage of these cases that you see actually end up being cancer, people that come in for lumps and bumps they're concerned about?

Dr. Smith: So, for me, it's a lower percentage that I would see that are cancer. Most of them are these very small little lumps that end up being epididymal head cysts or things like that. Testicle cancer, or testis cancer, you tend to have your testicle . . . it feels like a rock. It changes its consistency more so than just a teeny little lump or bump. Those teeny little lumps and bumps are often benign. However, you will find some of those that are cancer, and so it's good to just get it checked out.

Scot: You know what? This is a podcast about understanding your health, and here I am, not going to be as educated as I'd like to be, I discovered a lump about 10 years ago, went in, and it was . . . help me out here. It was benign. They did an ultrasound on it and it was on the spermicidal cord. That's not right, because spermicidal is some . . .

Dr. Smith: Yeah, the spermatic cord.

Scot: Spermatic cord, yeah. It was just something on the spermatic cord and they just said, "Watch it." And if it ever starts hurting, that's when I need to come back. Otherwise, don't worry about it too much. Did I get good information?

Dr. Smith: You did. That's in a similar family to those epididymal cysts. It's in a different location. But those cystic structures, they just end up . . . it just turns into a little sac of fluid, a little sac of water.

Troy: John, getting to your point here, this is kind of what I see too in the ER. We do occasionally see people who come in for this and they find a lump. They're concerned. They don't want to wait to try and get in to see a urologist. But it's a small percentage of the time it's cancer. But like you said, it's worth getting checked out, get an ultrasound just to make sure everything's okay.

Dr. Smith: And ultrasounds are relatively inexpensive, too. There's no reason not to get one, really.

Scot: And probably not go to the ER for it.

Troy: Yeah, not necessarily.

Scot: Unless Troy's on at night.

Troy: Yeah, unless it's 3:00 a.m. on a Friday night, because I have nothing better to do then. Please come in.

Dr. Smith: Well, a lot of times, a good primary care doctor will order an ultrasound for you and get you a referral to the urologist's office where you can get some peace of mind. Because specialists can be difficult to get into at times, but . . .

Scot: All right. Well, that was a good session. How are we feeling about that? Dr. Smith, how do you feel about your first experience on the "Who Cares about Men's Health" podcast?

Dr. Smith: I like it. It's a lot of fun. I think I feel a little ill-prepared at times because there's always more. I mean, in medicine, it's never just as simple as the wham-bam, as Troy will tell you. But I think this is great. I appreciate you guys having me on. It's a lot of fun.

Scot: It's been a lot of fun having you on. And now, the moment you've all been waiting for. Oh, boy. I tell you what. I'm sure that everybody woke up this morning thinking . . .

Troy: I thought it was this, Scot. I thought it was me clapping.

Dr. Smith: Is that Troy clapping?

Troy: I'm clapping.

Dr. Smith: Wow.

Troy: I'm clapping for John. He did a great job. I've warmed up to him now. I'm going to give him some applause. So, it's great having you on here, John.

Dr. Smith: Hey, I appreciate you guys having me. This has been a lot of fun.

Scot: All right. Time to end with a good urologist joke. Dr. Smith, go ahead.

Dr. Smith: All right. What does the urologist say before he starts the procedure?

Scot: What does a urologist say before he starts the procedure? Troy?

Troy: I don't know.

Scot: I know what a urologist says if he or she has a breakthrough. They say, "Urethra!" But I don't know what the urologist says when they start the procedure.

Dr. Smith: "It won't be long now." That's my dad joke/urologist joke. It works for both.

Troy: Yeah. That's good.

Scot: Fine work. Thank you so much for being on the podcast, Dr. Smith, and thank you for caring about men's health.

Troy: So, Scot, I'm just going to leave this here. The silver lining in the pandemic, I think, for a lot of us . . . I know you've talked about some different things you've done. But one thing for us is I've gained a greater appreciation of getting takeout. We have now done where we're regularly getting takeout at least once a week from a local place. We like to try different places out. We really had some pleasant surprises in trying out new places where we'd never eaten before.

Scot: So the takeout always goes home.

Troy: The takeout always goes home because, otherwise, the dogs are leaning over the takeout and drooling in it. That never goes well.

Scot: Maybe you could take the takeout to a park sometime, though.

Troy: We could.

Scot: They could watch squirrels and . . .

Troy: They could watch squirrels and then try and jump up on the picnic table and eat our takeout.

Scot: Just going to leave this here. So, last week, we had "windmaggedon." I don't know what people are calling it. They called it the inland hurricane here in Utah, in the Salt Lake area, in the valley where we had these category two hurricane winds. Now, the difference being that we didn't have water, and the other difference being that category two hurricane winds are constant and these were just the gusts would be up to category two.

Troy: But talk about that feeling of the haves and the have-nots. It was 7:00, 8:00 at night. The sun is going down. I look across the street, and all the houses on the other side of the street, their lights are on.

Scot: That was us, too.

Troy: Like, "Wait a second. This is not fair. I'm over here . . ."

Scot: I know.

Troy: Yeah. "I have nothing here." I am here in my 50-degree house with no heat and my neighbors all are just enjoying it and their heat is on, and their lights are . . . I'm like, "Wait, this isn't right."

Scot: That's when you find an outdoor outlet at your neighbor's and run an extension cord across the street.

Troy: Exactly. That's a good thought. I did not do that. I should have.

Scot: All right. Time to say the things that you say at the end of podcasts because we are at the end of ours. As always, thanks for listening. Please subscribe if you like the podcast so we can be sure to be in your podcast player of choice every single week, and we're on all of them. And if you want to reach out, Troy's got the details on that.

Troy: Yeah. You can reach out to us. Drop us an email at hello@thescoperadio.com. We're on Facebook, facebook.com/WhoCaresMensHealth. Website is whocaresmenshealth.com. We actually have a listener line as well. You can call in and ask questions, and I'm hoping Scot has the number for that line.

Scot: 601-55SCOPE. Go ahead and write that down, Troy, and write that down, everybody else. 601-55SCOPE. If you have any questions, comments, you just leave your message right there. Thanks for listening and thanks for caring about men's health.