Search for tag: "troy"

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Scot: Do you take time just to reflect on things in your life, Troy? Do you have any knowledge about the act of reflection, the art of reflection, if you will?

Troy: All I know is what Dr. Chan told us before. He told us, "We think about the past and it makes us depressed. We think about the future and it makes us anxious." Those were his words, so maybe reflection isn't always a good thing. Sometimes it does, and we can, I think, become a little bit nostalgic and think the past was so much better than maybe it was, which was interesting to hear him say that. But as he said that, I thought, "Oh, that makes sense."

But I think there's value in reflection, certainly, in terms of appreciating what has happened and appreciating the experiences, and taking it in a positive way, while also recognizing that sometimes it can be a little depressing to reflect.

Scot: Mitch, do you take time to reflect?

Mitch: That is a complicated question because . . .

Scot: I love it.

Mitch: It's the opposite of what Troy was just saying, where as someone who has struggled with mental health for a lot of their life, who is just barely starting to learn a lot about myself and about how I can manage and cope with things, my therapist says that I need to not self-reflect, but instead be introspective.

So it's this idea that, for me, I do remember the bad stuff and I do focus on the terrible things that have happened, and I replay them over and over and over again. It's like bizarro nostalgia where things were terrible and things will probably always be terrible, etc.

So instead, introspection, or at least the way that it has been taught in this particular definition when it comes to my mental health work, is taking an intentional look back on things that have happened, and having this kind of approach and mindset of, "What did I feel when that thing happened? What was it that made me feel that way? How can I prevent it in the future?"

Rather than just like, "Oh, man, that was a great time," or, "Oh, man, that really, really sucked," actually going through in a very active process to kind of stop the potential of . . . I don't know another word for it, but just this negative despair-based nostalgia from kicking in.

Troy: Interesting.

Mitch: Yeah. It's an exercise I do.

Scot: Let me tell you, I think maybe you're doing a deeper reflection than I am.

Mitch: Sure.

Scot: Which is part of the reason why I think this is a good show to do, because that word is thrown around a lot, right? Reflection. It's time for a reflection. When we get to this time of year, at the end of the year, we reflect on whatever. But what does that really even mean? And that's why we're doing this episode today, to work on this notion of reflection.

This is "Who Cares About Men's Health," offering information, inspiration, and a different interpretation of men's health. My name is Scot Singpiel. I bring the BS to the podcast. The MD to my BS is Dr. Troy Madsen.

Troy: I'm here, Scot, and I'm ready to reflect.

Scot: Mitch Sears is in the mix.

Mitch: Hey, I'm going to reflect too, I guess.

Scot: And psychiatrist Dr. Benjamin Chan is going to talk about the power of reflection with us as well. How are you doing, Ben?

Dr. Chan: Doing great. Happy to be here.

Scot: Do you take time to reflect, Dr. Chan? Is that something you do?

Dr. Chan: All the time. Incredibly powerful. Incredibly needed.

Scot: So we're really looking forward to hearing about the benefits of this exercise of reflection. I mean, we've talked about other things that have benefits that you might not think have them, like gratitude, for example. So reflection, this is going to be a lot of fun.

Are you guys ready for a quote drop to start this thing? I'm going to drop a quote on you. Are you ready for this?

Troy: Let's do it.

Scot: All right. Here it comes. "We don't learn from experience. We learn from reflecting on our experience." That's John Dewey. He was a philosopher and a psychologist and an educational reformer. And he was the guy . . . his form of learning is "we learn by doing." So he's saying, "You get that experience, you do things, and then it's not truly learning until you pause and actively reflect on what just happened."

So, Dr. Chan, I have a question for you. Reflection seems like kind of a big concept. What is reflection when it comes to your practice of mental health?

Dr. Chan: Great question, Scot, and happy to tackle that one right off the gate. We're going deep right at the beginning. I love it.

So, from a mental health perspective, reflection is essential. And I love that quote by John Dewey. I think the first step is to look back at the situation or experience. We're all creatures of habit. We have built in patterns into our thoughts and behavior, so taking a pause and looking back at a specific situation or experience, I think, is the first step of reflection.

And I don't know, Mitch or Troy, can you think . . . I'm going to turn the tables on one of you. Can you think back to a situation or experience that you really thought about and pondered?

Scot: Generally, it's at a party and generally it's the day after and I'm like, "I was too loud and obnoxious." That's usually my reflection. And I think, "I'm a little over the top. I need to cool my crap a little bit."

Troy: I mean, mine often comes down . . . I certainly reflect on personal events. I have spent a lot of time reflecting on some events that have happened in the ER. Sometimes I think that's been a little detrimental because I've probably dwelt on it and maybe have even beaten myself up over it. But yeah, no doubt I definitely reflect.

Mitch: Yeah. Like I had mentioned a little earlier, for me, especially as I'm going down this long road of mental health and dealing with past trauma and dealing with all this other stuff, I have been practicing and learning strategies to reflect in such a way that it is productive and not mentally exhausting or retriggering or whatever. So, yeah, I reflect on a lot of things, but learning how to do it in a way that doesn't impact me has been a journey.

Dr. Chan: I think that's beautiful. And I think that's the first step, is to look and recognize. And then, Troy, and Mitch, and Scot, as you all mentioned, I think Step 2 is to think about it, reflect upon it. And then Step 3 is to learn. So look, think, and learn.

I think this is where we kind of break past behaviors, past thoughts. And you can do this either talking about it with someone, and that's the role of mental health. A lot of people, that's what we do. We talk about these past experiences or these past situations.

I really like journaling. I'm big into journaling now, and I think this is linked to what we discussed previously about gratitude, but just to actually write about these different experiences and what you learned about it.

Troy: I wonder though, Ben, is there danger in spending too much time in reflection? When we had an episode on anxiety, I remember you said, "We think about the past, it makes us depressed. We think about the future, it makes us anxious." Is there danger in just spending too much time thinking about the past?

And also, does that encourage just . . . Let's say if we already have some neurotic tendencies, does it encourage further neuroticism, where we are just overanalyzing situations and dwelling on them and thinking through them? I'm curious about your thoughts on that balance there.

Dr. Chan: Yeah, you used the word I was going to use, Troy. Balance. Moderation in all things. And the last step I was going to advocate for is to plan. What can you do next? What could you do differently?

Yes, if we're caught up, if we start perseverating, if we start just fixating on past behaviors, past traumas, past experiences, and we don't come up with a plan, we don't come up with a new way to approach it, yes, it would increase neuroticism or anxiety.

It's really difficult. It's extremely hard. And I don't know if anyone would feel comfortable in sharing something that happened in their past, but I think we're all experiencing and navigating life. And again, we're creatures of habits. I think life just gives us the same learning experiences again and again until we actually learn from them.

Mitch: Sure.

Troy: I like, though, what you said about looking at it as more of a looking to, "How can I act? How can I do things differently?" rather than just dwelling on it, which can definitely be a problem, I think.

We just dwell on maybe . . . Like you said, Scot. "Wow, I just talked way too much last night and I just feel stupid." And you think over and over, "What did I say? Okay, these guys must think I'm an idiot," versus just saying, "Hey, I had a good time there. Maybe I did talk a little too much. I'll try and talk less next time." I don't know.

Scot: Or maybe I could come to the conclusion that, "No, I'm fine with that, and I just need to make my peace with that." I think that seems to be the difference, using these remembrances of these experiences or reflecting on these experiences. And I love that you said plan, because that's kind of the thing then that gives it closure to me. You come up with, "All right. Well, what am I going to do about this going forward if I choose to do anything about that going forward?"

And one of the benefits I saw when I did some reading on reflection is it can help improve sleep because of that. A lot of times, the act of reflecting can give closure to things that otherwise we might dwell on. Does that sound accurate, Dr. Chan? Have you heard that?

Dr. Chan: Yeah. Again, Scot, I love your examples. Yes, I think all of us to a certain degree, when we lie down in bed at night, we start replaying a lot of those experiences and situations from our days. And we're our own worst critics. We tend to focus on the negative, not so much the positive, like, "Oh, I should have said that in that meeting," or, "When that person interacted with me, I should have said that," or, "I was quiet in that moment, and I should have spoken up," or, "This happened at the grocery store," or, "This interaction happened with a family member."

That is reflection, but also, like what Troy said earlier, if you perseverate on it, if you can't let it go, that could cause you to have insomnia. That could cause people to have difficulty falling asleep. Totally accurate.

Scot: Some of the other benefits I saw of reflection, in addition to better sleep, is it can reduce stress and anxiety levels. Why would that be, Dr. Chan?

Dr. Chan: Again, we're going to have the same situations presented to us again and again and again. And we can't control how other people think or feel or act. We can only control how we think and feel and act. And if that is sparking a reaction inside of us, that causes anxiety. That causes stress. So that's why I love doing this podcast, because to me, this is essential for high-quality mental health.

Scot: I also saw some of the benefits. Gives clarity to thoughts, which I think we've all experienced that. When we've reflected on something, we get some clarity maybe we didn't before. It creates self-awareness, and it can also create room for growth. So those are some of the benefits I came across.

Has anybody else, when they've reflected, noticed benefits that they'd like to share at this point?

Mitch: So through the work that I've been doing with my mental health specialist, the process of kind of an active reflection has allowed for me just very much that room for growth. It allows me to kind of put all the thoughts and memories and all these things that are kicking around in my head all the time to be able to say, "I don't need to worry about this anymore. I don't need to think about this anymore. I have an understanding about it. I've acknowledged the feelings that I had. I've come up with a plan to prevent any negative thing from the future." Or if it's a positive thing, how I'll get more of that in my life, whatever.

And when you don't have so much mental . . . Or myself at least, when I don't have so much mental processing power being completely devoted to the past, to just thinking about that reflection and re-feeling and reliving those things over and over and over again, it allows me to think about new stuff, and to figure out what I do and don't like in life, and how to make sure I get more of it.

Troy: I don't know if you mentioned, Scot, I didn't hear specifically, but we had our gratitude episode, and I do think that reflection does also help us to reflect on . . . Certainly we reflected on a lot of things we were grateful for, but just on a daily basis, I think it helps us in terms of reflection to experience gratitude for the positive things. And I think there's value in that too, just because it kind of helps you reframe things in your mind rather than reflecting on the negative things.

And then as new things happen, seeing negative in that, I think it then helps to potentially carry that reflective attitude of gratitude forward into the day. Certainly, there's value in that as well.

Dr. Chan: And something that I've seen again and again and again, especially during the pandemic, just to make it real world, is emails. All of us have received emails that seem upsetting or have what we perceive as a negative tone. And to me, this power of reflection is not to immediately fire back an email and reply.

Scot: But it feels so good, Dr. Chan.

Dr. Chan: I know. It feels terrific. Again, reflection. Did that person really mean to say that? Taking a pause, going for a walk, or reflect upon the intent.

I tell everyone I work with that if you get an email that causes this negative reaction inside of you, don't respond right away. Sleep on it. Revisit it the next day. Maybe type up a rough draft. Kind of process your thoughts, going back to the journaling, and then really think about pushing send.

I always feel it's better to pick up the phone and just talk to people. And unfortunately, I think with the pandemic, a lot of our communication has been altered in many ways, and sometimes we over-rely on technology. So that's just a real-world example that I've seen of reflecting about the intent and the tone of people's emails.

Troy: That's so true. I wish you could have told me this 20 years ago, Ben. And I wish there was something you could implement in your email that would just not allow you to respond for 24 hours. I will tell you, 90% of the things I've said in the course of my life that I've regretted, I've said via email. Because you don't say those things in person. You just fire off a response. You misinterpret the tone. It's so impersonal, it's easy to say things you would not say otherwise.

It's so true. Definitely power of reflection. I agree. If you can take time just to reflect on an email and let it sit and sleep on it and continue to reflect on it, there's huge value in that.

Scot: So reflection is this really broad thing, but it seems like it kind of breaks down to this. It just breaks down to if you're experiencing something or if you're thinking about a memory or if you are wondering how to move forward, it's just taking a pause and thinking about it and trying to break it down and analyze it. 

For me, at the end of the year, I tend to reflect on the goals that I set for myself that year, or the things that I wanted to try to accomplish for that year. And reflection in that instance is like a plateau when you're hiking. You can stand at that plateau, and you can look down and see how far you've come, and you can look up and see where you still want to go. You can celebrate the victory of making it to that plateau while still admitting, "I would like to continue on my journey."

So let's bring this back to the Core Four and health for a little bit. Do you guys reflect on your activity, your nutrition, your sleep, your emotional health? And what does that process look like?

Really, our whole show is based on this notion of a turning point, and reflection is required for those turning points. Things happen, we do things, we think about them, then we create this new thought that sometimes puts us in a new direction. And it might make things a lot better or just even a little bit better.

Dr. Chan: I love that, Scot. And I don't know if you're teeing this up for New Year's, but what is our plan? What are our goals for 2023? And this, to me, is where reflection comes in. We're coming out of the pandemic, there have been a lot of changes, and we all have different goals, personal goals, professional goals. Where does that growth occur?

Because if you're not actively reflecting, or as Troy and Mitch have talked about, expressing gratitude for where you've come from, how do you know where you're going?

And to me, this is a perfect segue into what is going to happen next year for us? What is the plan? And you need to reflect upon where you've come from. So I think of 2023. When you talked about that hiking analogy, Scot, that's what came to my mind.

Troy: And I would say, Scot, too, I certainly do that as well. I can't say I have a formal process in terms of that reflection on the Core Four, but what I often find is when things just kind of feel off, like just, "Something is off," it often comes back to thinking, "Okay, how's my sleep? How are things going there? How's my mental health?"

Just kind of checking in on a lot of those things and then finding, "Great, I've made these changes recently. Maybe this I didn't implement as well as I could have." Maybe we can revisit that and potentially refocusing, and then moving forward with that in mind.

Scot: As I was doing some reading, I came to the conclusion that there are some rules for good reflection. We've talked a little bit earlier, that Dr. Chan brought up, which I loved, that you've got to look, think, learn, and plan. And it's that planning part that helps give you closure.

But some of the rules I found for reflection . . . Feel free to add to these or tell me it's a bunch of crap if you want to, Ben. I think the first thing you have to do is you have to stop and make space for reflection. We're so busy and we occupy our brains all the time, even in downtime with our phone or whatever, that you actually kind of have to stop and be . . . What am I looking for here? You have to be . . .

Troy: You have to be still.

Scot: Yeah, you have to be still, but you have to . . .

Troy: Your mind has to be open and still.

Scot: You have to be intentional about stopping and making space for reflection. And I've read some stuff that said even maybe do a little meditation first to kind of get your brain in the place to do that.

Is that something you've heard of, Dr. Chan? When you talk to patients, is there a bunch of steps that you have them go through to prepare themselves to reflect and then to reflect properly?

Dr. Chan: Totally. It's almost like an adult homework assignment. You need to literally carve out time. For a lot of us, we're all working professionals and we have very busy lives, and our Outlook or Google Calendars rule our lives. So you need to go in and set aside a couple of hours a week and block those out so people can't schedule something in there.

I don't know if you use the word reflection, but executive time or personal time. You can do that during the day. A lot of people do that during the lunch hour. This is time for not just sitting at your desk and returning emails, but just go for a walk, or go out to eat by yourself or with friends. I mean, there are ways to carve out time.

So it's like an adult homework assignment, and it works extremely well. There are a lot of demands on our time and you need to prioritize this reflection time. If not, you never reflect. And that's unfortunately the cycle you get into.

Scot: And as the quote earlier said, "You don't learn from that experience. You learn from the act of reflecting." So if you're not scheduling time to do that, then you're not learning. You're not progressing.

Not only just at the end of the year or beginning of the year, I think a lot of times reflection happens during maybe vacation when we do have a little downtime or when our routine is broken up. So you've got to make that space.

And then something else I read said, "Don't beat yourself up." It's an honest evaluation based on what's working and what's not compared to your values and your priorities. And you're just honest and just very straightforward about it. Try not to be emotional about it if at all possible.

And then also be kind, because change can take time as well. So you reflect and you want to make some changes, but that doesn't necessarily always happen overnight.

Troy: Yeah, I like that. And being kind to yourself I think is essential. A lot of it gets back to what Ben said about just using it as a time you can plan, and plan your next steps. I think you can do that, you can reflect, be kind to yourself. Say, "Hey, should I do anything differently?" If not, no. Forget it. Forget about it. Don't reflect on it anymore. And if so, great. Take the lessons you can learn and move forward.

I think that's the biggest risk for me personally. I do have a tendency at times to reflect way too much on things and beat myself up and I think that's problematic. So I think if you can take from it what you can and move forward, that's the best approach.

Dr. Chan: That's beautiful, Troy. I love that.

Scot: I found some questions from a paper from Halloran 2016 called "The Value of Self-reflection." And I wanted to share some of these questions and see what you think.

This notion of reflecting, some of us might have things we want to reflect on or that come to our mind, but maybe this would be some thought starters for you if you want to take time to reflect.

And it doesn't always have to be at the beginning of the year. It could be during the workday. I often will make myself a cup of tea and take 15, 20 minutes. The rule is no social media, no work, no email, and I just sit there and I sip my tea and I just think about things. I give myself that space to reflect.

So here are some of the questions that I found interesting, and see how these resonate with you. Am I using my time wisely? Am I taking anything for granted? Am I employing a healthy perspective and not letting matters that are out of my control stress me out? Am I living true to myself? Am I still passionate about my career? Where am I feeling stuck? What do my finances look like? How have I allowed fear of failure to hold me back? When have I felt the most alive? How can I improve my relationships? Am I taking care of myself physically? What old habits would I like to release? What new habits would I like to cultivate? How can I be kind to myself? And finally, what is it time to let go of?

Mitch: Can I . . .

Troy: Yeah, can I get that list? Those are some great questions to reflect on.

Mitch: So side story here, one of the things that I started doing with my friends in college when we were struggling with anxieties, depressions, whatever, is we started doing an adaptation of a kind of witchy ritual called "Candle in the Wreath."

And with "Candle in the Wreath," everyone gets a single candle that they hold, and you light it up and you have a wreath of dead bows from the winter, and you have a big candle in the middle. And everyone, either aloud or to themselves, stands with their candle lit and lets the wax drip and they're supposed to say what the things are you are letting go of this year.

And everyone will say things and whatever, and then you have this big . . . when everyone blows their candle out, when they're done, when they feel they've given enough time, this wreath is so disgusting and covered in wax and just gnarly and gross. And you throw that on a bonfire and everyone lights their candle one more time and you say, "What am I saying yes to? What am I welcoming in the next year?" And it's supposed to let out bad energies, bring in good energies. And it's funny to see that those same questions are in a research article. That's all.

Troy: I love that you described that as kind of witchy.

Mitch: It is kind of witchy.

Scot: Troy, you want to get together and do that ritual?

Troy: Are you guys free tonight?

Mitch: Yeah. Well, you would be shocked . . .

Troy: I'll bring the branches.

Mitch: . . . how much catharsis . . .

Dr. Chan: Candles. I'll bring the candles. 

Mitch: Year in, year out, you have all these very high-functioning, super intense often, accelerated students for a while and things like that, and they just . . . It's like the only time that some of these people have ever done that kind of reflection or asked those types of questions to themselves, and it's shocking.

Troy: But I think there's incredible value in doing that regardless of how you go about doing it, if it's an actual physical act like that or some other process. But yeah, I think that's something that we need to do more of.

Scot: So, as we wrap up the episode, I was thinking about a couple of things I wanted to reflect on. One came to mind almost immediately, and I need to build in more time to actually think more deeply about this.

But as I was exercising the other day, my right shoulder used to be . . . I don't know what I've done to it over the years that I couldn't lift something over my head, but I've been working really hard to get that strength back in that shoulder.

And the other night as I was lifting, I'm like, "Wow, actually I've got strength back. I can do this again." It's not where I want it to be. It's not the same level as my left arm, but that was that plateau for me. I'm like, "I'm not where I want to be. I'm not where I was. I'm feeling pretty good about this."

And this has been something that I've been working on, or at least thinking about because I work out off and on, for over two or three years. So that comes back to that time thing.

Troy: Yeah. And it's nice because there you have a very physical manifestation of your progress. And for a lot of us maybe, it's just like, "Hey, I didn't react to that email like I might have reacted a year ago." And it's maybe something more like that where it's kind of our analogy being like, "Hey, I got my arm up higher than I did a year ago."

Scot: Well, gentlemen, I encourage you to take some time to reflect. I will get you a copy of those questions. Of course, we'll post that along with this podcast episode on our website. So, if that list of questions was useful for you, you can start asking yourself some of those questions and go through this process of reflection whether it's at the beginning of the year, which is kind of a natural time for a lot of people to do it, or like Dr. Chan recommended, maybe you need to carve out . . . Maybe you can't do two hours, but maybe you can do a half hour. Maybe it's 10 minutes before bed. You can pick something.

I like, Troy, you're just kind of doing a gut check and then going, "Well, how could I make this better? Why is it that I'm concerned about this? Is it something that I really do need to worry about?" and then putting some closure to that.

So, gentlemen, as always, it's always a pleasure talking with you. Thank you for listening, and thank you for caring about men's health.
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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: Mitch mentioned that he was using a product named Huel to Troy, and Troy and I went, "What?" We had no idea what he was talking about.

Troy: No idea.

Scot: Yeah. And he explained it to us a little bit and then had some questions that we couldn't answer about it, so we thought, "Well, let's get our nutritionist Thunder Jalili on the show."

So this is "Who Cares About Men's Health," providing information, inspiration, and a different interpretation about men and men's health. We've got a good crew here. I love this crew. I love this crew right here. I provide the BS. My name is Scot Singpiel. He provides the MD. His name is Dr. Troy Madsen.

Troy: Thanks, Scot. We love you too.

Scot: And then we have Ph.D. Thunder Jalili. He knows so much about nutrition and how the body processes nutrition and does its nutrition thing. And I know I completely just undersold what you've spent your whole career doing, but let me just say Thunder is really smart about this stuff.

Thunder: That was a great introduction. I'll take it.

Scot: Okay. Yeah, you're great. And then we have Mitch.

Mitch: Hey.

Scot: He's a Hueligan, apparently, I've come to find out.

Mitch: Yeah. There's a t-shirt even that they sent me. It's a whole thing.

Scot: Yeah. So you ordered some of these Huel meal replacement products. Are they meal replacement products? What are they, Mitch?

Mitch: So you hear about them sometimes on podcasts, on some of the tech blogs that I read all the time. They were definitely invented by Silicon Valley tech bros for tech bros. All of the branding and everything is very, very much, "It is the world's number one complete food." It's not a meal replacement. It is a food.

And the kind of concept is that, "In this busy world that we're all in, you don't have time to think about your nutrition, your macros, what you're going to eat. So we have created a product that is a 'nutritionally complete meal' with an exact amount of calories, an exact perfect amount of," according to them, "macro distribution." It's vegetarian. There's supposed to be a ton of nutrients in it. It's all super foods. Who knows what's in it?

And it's okay. It's not the most delicious thing in the whole wide world, but it's okay. I don't know. I just was curious, how much of this is all hype to repackage the old SlimFast-style meal replacements of the '90s to today's tech culture? So I'm glad that we have Thunder on to kind of talk me through this.

Troy: Mitch, I'm curious. Do they market it as this is all you eat? Or you're on the go, you need a quick meal, you eat your Huel? Or is it just, "This is your food. This will sustain you and you will eat nothing else"?

Mitch: So there are a couple of brands out there that are not Huel that I have not tried that do market it as, "This is all you eat." You eat three shakes a day and you're perfect. All the nutrition your body needs. I couldn't really get behind that particular brand because the idea of just drinking a kind of earthy-tasting protein powder . . . It was like protein powder plus dirt plus a little bit of chocolate. Eating that three times a day, slurping that down was not my idea of a good time.

So the Huel and the reason I hopped on the Huel train was they have what is called their . . .

Scot: Is this your next t-shirt, the Huel Train?

Mitch: Choo-choo, all aboard.

Scot: He's in deep, guys. He's in deep. Intervention.

Mitch: Yes. But what I liked about the kind of marketing for the Huel is that they market it as, "This is a healthy lunch to have." They talk about how you can have their breakfast shake and their lunch and then have whatever you want for dinner. It's this idea of, "Don't go for fast food. Have this instead." And I appreciated that more than thinking I was joining some group of people who just don't like food anymore. I do like food. I don't know. I don't get it.

Troy: Well, I've got to tell you, Mitch, and I mentioned this to Scot off the air here, that I used to do a lot of cholesterol testing on people as part of a job I had. And this one guy, he was a tech guy, and I checked his numbers and I was blown away. I had never seen cholesterol numbers like he had. Crazy, crazy low LDL, crazy high HDL. I was like, "What do you eat?" He said, "Soylent. All I'll eat is Soylent." He said, "Totally on a Soylent diet." It was crazy.

Mitch: So he was doing the goop? He was doing the goop all day, and it was . . . Oh, my God.

Troy: Yeah. He was doing it all day, every day. That was all he ate. So he was not doing Huel like you're talking about it where it's like, "Hey, this is your healthy lunch and you can eat whatever you want for dinner." He was going all in. It sounds like some of these are marketing where it's just like, "24/7 this is all you eat." But the numbers were impressive. I will say that.

Mitch: That's crazy. Okay.

Thunder: That sounds like such a boring food culture.

Troy: It sounds horrendous, but . . .

Thunder: I know. It's like the Russian Gulag of eating.

Troy: Exactly. It's just like, "Eat your porridge."

Scot: I knew that Thunder was going to . . . Thunder is very pro-real food just because I think he enjoys the experience of eating real food.

Thunder: And it tastes good. You can make it taste good too. Isn't that a bonus?

Troy: I was going to say Thunder has already referred to me as the metronome of eating. These guys take it to a whole new level.

Thunder: That's right. You can set your watch by the way Troy eats.

Troy: That's right. But these guys, this was something else, the Soylent diet. And it sounds like probably some of these people that are doing Huel 24/7. That's a whole other level.

Scot: Thunder, what's your take on this? To me, my initial reaction is this probably is not good. I don't know. But then I hear what Troy just said. So what's your take?

Thunder: Like you guys, I am kind of a novice to the whole world of Huel and I tried to educate myself a little bit about it. I don't think they're doing anything new, as Mitch mentioned.

Over decades, there have always been food substitutes, meal substitutes, and they're always marketed with the same sort of thing. "You're too busy to make food, so eat this," or, "You want something healthy and you don't know how, eat this." etc.

So my take on it, this is probably not a terrible thing if you want to do it sometimes. I think, overall, the danger . . . I don't know if danger is the right word, but the problem with this sort of thing, in my opinion, is that it gets you really used to reaching for a convenience product to get your meal out of the way and move on to the next phase of the rat race.

I don't know. To me, it sounds restrictive. I've never tasted it, so I don't know if it's delicious or if it tastes like crappy camp food. But that's one of the things that I would wonder about. Would it get boring? I mean, you're all excited, you do it for a few weeks or a month, and then you're totally sick of eating all these lunches because you're rotating between the same five options.

I don't know, but maybe we'll find out because Mitchell is doing the experiment for us. So we'll get some information about it.

Troy: Along those lines, Thunder, too, I wonder . . . There probably are some beneficial health effects. I don't doubt that. I just wonder about the psychology of eating that way 24/7 and what the long-term effects of that are. Is it like being in the desert with just a small amount of water and then you get to the oasis and when you finally get a chance to drink water, you just overdo it and kill yourself? Do you just break down at some point and just go crazy and just eat tons of fast food? I don't know.

Thunder: Yeah, that's a great point. The health thing and then do you just totally go off the deep end because you can't take it anymore with the monotony?

I will say, regarding the health aspect of it, I'm split in my mindset of that. Just glancing at some of the ingredients and nutrition labels, it doesn't look like it's bad from a health standpoint at all. It's just that I wonder if you become reliant on it, does that prevent you from going out and seeking whole foods on your own? Do you get so used to the convenience that then the meals you do on your own tend not to be great because you've kind of fallen off the wagon of cooking and finding whole foods and going down the classic nutrition route?

Mitch: That's interesting because that was the big thing that I was wondering about. We talk a lot about whole foods. We talk a lot about they're the best possible version. But we've also said like, "Eh, if it's frozen, it's okay. It's still pretty nutritious." And this flash dried or whatever it is. It's 100% like camp food. It tastes . . .

Thunder: Yeah, freeze-dried

Mitch: . . . like camp food, but maybe a little bit better. I don't know. Maybe I'm just biased. But ultimately, is the processing or anything problematic for the foods that are in it, the ingredients? Is the nutritional value impacted by the way that it's formulated and shipped and packaged?

Thunder: I mean, the general answer is probably some, but it's hard to answer specifically without taking the ingredients in their natural state before they're freeze-dried or whatever and comparing them to the rehydrated version.

So we're going to guess that, yeah, there's going to be some degradation of some of the vitamins. But who knows exactly how much? Hopefully, you make it up with other parts of your diet as well, or maybe by just eating enough Huel that if the levels are lower, you eat enough volume to make up for it.

Scot: Hey, question for you Thunder. One of the things that you talked about one time was the food matrix that the nutrients reside in, and that makes a difference, right?

Thunder: It does make a difference, but this does seem to be like whole food. So I've got to give them credit for that. They're taking whole ingredients, not just powderized this or that. They're incorporating whole foods, which theoretically would address the food matrix issue.

Scot: All right. So, Mitch, I'm confused. I thought these were shakes.

Mitch: They do make shakes. That is an option you can have. I found them to be gross. That is a personal . . . That is not an official stance for this podcast or our organization. That is just a Mitch Sears opinion. Kind of gross.

Thunder: They taste like wallpaper paste.

Mitch: No, more like . . .

Scot: And that is a Thunder Jalili opinion. Not necessarily . . .

Mitch: Not the podcast.

Thunder: A completely uninformed opinion because I've never even tasted it.

Mitch: Sure. No, it's more along the lines of . . . Have you guys ever had the taste of pea-based protein powder? That weird veggie taste? You mix that with the smell of dirt and you mix it up with some almond milk and that's . . .

Thunder: My mouth is watering.

Scot: Again, why are you doing this?

Mitch: But I don't eat that. I eat the fancy hot and savory stuff. It's like a mac and cheese. And it's got quinoa-based noodles and a yeast-based cheese sauce, right? Or a Mexican chili that's full of lentils and beans and whatever. So it's 100% like the camp food you'd get at an REI or something like that, the kind of freeze-dried, rehydrate type stuff.

Scot: And do they amp up other nutritional stuff by adding additional things to it?

Mitch: That's what they say. They say they're able to increase the amount of plant-based protein. There are 27 vitamins and minerals. It's high in fiber because it's all lentil- and veggie-based.

Troy: Mitch, it sounds like you're going to do this.

Mitch: What? What am I doing? I just have it sometimes.

Troy: Are you doing Huel? I thought you were . . .

Mitch: I'm doing it.

Troy: I thought you were going all in on it. You're doing it. You're actively doing it.

Mitch: Oh, no. I am currently eating some Huel for lunches and I have another one that is some fancy oats that I have in the morning, high-protein oats. It's a similar concept. But it's not like I'm doing it every single day every, single meal.

Troy: Okay.

Mitch: I just mix it in there when I know I'm going to have a busy day or something like that. So I just do that rather than go get a gas station taquito.

Troy: Okay. So it's going to . . .

Thunder: The infamous roller food.

Troy: Yeah, it beats the alternative.

Scot: Yeah. I guess in comparison to that, it's pretty good stuff, right?

Troy: No, it really sounds like it is.

Thunder: In the application that Mitch is using, it's probably fine because he is not living off it. It's not the staple of his diet. Yeah, I don't really see any problem with it.

I think in the grand scheme of things, if you look across the spectrum of people that would be interested in this, maybe you'll get some people who want to make this their meal all the time. And that could have some issues.

I mean, for one, it's probably really expensive, and for two, it probably gets them away from exploring what they could get out of real foods and just gets them locked into this particular panel of meals.

And then as Troy was saying earlier, what if you just get to a point where you're like, "I can't take it anymore," and you just fall off the wagon and just will eat anything because you need a different taste?

Troy: And along those lines too, you mentioned cost, Thunder. Mitch, what are you finding in terms of how much you're paying for a meal?

Mitch: So it ends up being about $3 per meal.

Troy: That's pretty cheap.

Mitch: Maybe a touch more than that.

Scot: That's way cheap.

Mitch: So that's kind of more . . .

Troy: That's really cheap.

Mitch: Yes. They give you a bunch of bags. You have to order a certain amount, so there is a bit of an upfront cost. But yeah, for me to have just a couple of bags in the back, just on-hand, emergency replacement food, it's been nice. It's been nice to have that. I do worry that this feels processed. This feels like a trap. This feels like it's all snake oil or something like that. So I wanted to figure out.

Thunder: Technically, Mitch, it is processed because it's dehydrated and you have to reconstitute it.

Mitch: Yes. But is it killing the nutritional value? That kind of stuff.

Thunder: Yeah. And again, that's difficult to say. There's probably a little bit of a hit with the nutrients, with the vitamins and the phytochemicals, but it's impossible to say how much.

I have a couple of technical questions about the Huel. So you add water and you just throw it in the microwave. Is that how you prep these?

Mitch: Yeah. You put two scoops. They have these little special measuring scoops. If you want to get real technical about it, they give you the exact weight measurements, and then you put a couple of scoops of water, throw it in the microwave for two minutes.

Thunder: So how much food does this make? Are you full? Are you satiated from eating that?

Mitch: Yeah. It's a big bowl.

Thunder: Okay.

Troy: I'm just confused, Mitch. Yeah, I'm just trying to figure out what these meals are, because my initial thought when I heard about this, I thought of Soylent. With Soylent, you're just drinking soybeans. I mean, it's just like a soybean paste and that's what you're drinking.

It sounds like, though, here you're talking about different varieties. They are like camp food, but some have a pasta sort of consistency to it. Others are just protein drinks. So it sounds like there at least is some variety both in the texture and the flavor of it.

Mitch: Oh, yeah. And I think that's kind of what drew me to it. They've got chilis, they've got Cajun dishes, they've got curries, they've got a chicken and mushroom. And they always spell it a little different because there's no meat in any of their products. A tomato and herb. A sweet and sour if you're feeling like you need a little bit of takeout Asian-type food. It's a good mix. They're okay. They're all pretty okay.

Troy: Yeah. For me, for someone who's certainly not a nutritionist, the way you're doing it seems to make sense where you're using them to substitute certain meals. It's not like it's overly expensive. It sure beats some of the alternatives for fast food or quick meals.

And it sounds like, from what Thunder is saying, there's definite nutritional value there. It's not like the freeze-drying process is necessarily causing it to lose a lot of that. So it seems like a pretty good approach.

And talking about it and just looking at their website here, I'm actually intrigued and maybe this will make it into my food metronome. We'll see.

Mitch: Oh, sure.

Thunder: Hey, I'm looking at the offerings, the hot and savory offerings. There are nine. They're advertised on the website. And I think it'd be neat just to real quick look at some of these ingredients, because they do emphasize the whole food thing.

I'm looking at yellow coconut curry because I actually like coconut curry. So they have dried grains, which consist of brown rice and quinoa, pea proteins, flaxseed, coconut milk powder, raisins, desiccated coconut, which just means dried up coconut, yellow coconut curry. So these are all pretty much whole ingredients that you would use if you're making coconut curry.

And then at the end, they have all the other things they add to it to bump up the nutritional content. And what I mean by that is ascorbic acid, which is vitamin C, nicotinamide. Is that in cigarettes? Nicotine? No, that's actually a vitamin.

Troy: No, I don't think it's the same thing. Yeah, nicotine is in cigarettes, but I don't think nicotinamide makes it in there.

Thunder: But it's funny. People will look at ingredients and they have no idea what some of these are because we're not used to seeing these added to food. They have alpha-tocopherol, which is vitamin E, lutein, which is a carotenoid, a vitamin A derivative, calcium, zinc, retinol acetate. So you guys get the idea.

Troy: Interesting.

Thunder: They're basically putting a multivitamin in these products. And every one has basically elements of a multivitamin added to it.

Troy: Yeah, that's interesting to hear that because as I was scanning over it, I got the impression it's a lot of, like you said, whole foods and you're getting the nutrition from that. It sounds like it has that certain component, which is the bulk of it, but then they're adding a whole lot to it as well to get those vitamins in there.

Thunder: Yeah. That's good for the label.

Mitch: I was so sure that there was going to be an "Oh, Mitch, you're ruining everything" episode. This is awesome.

Scot: I'm actually a little surprised too. And this feels like it's becoming an ad for this product, which it certainly is not, right? I'm still skeptical. I don't know why. I find that to be interesting. It doesn't sound like it's expensive. I figured it would be. It sounds like it tastes okay. It sounds like Thunder is reading the label and he is like, "Yeah, this seems all right." Troy is all like, "If you're just using it as a once in a while meal replacement, that'd be fine."

Thunder: Yeah, and I think that's the take-home message. Once in a while meal replacement, this is okay. You could do a lot worse.

I think what Troy and I agree on is that you don't want this to be the foundation of your diet all the time because while you could get by strictly from a nutrition standpoint, I think you miss out on other things. You miss out on trying new foods, trying new sources of nutrients, and the element of extra nutrition you get from fresh things, farmer's market products and so forth. But as a once in a while meal supplement, I think go for it, Mitch.

Mitch: Cool.

Thunder: I can't even really ding them for too much sodium. That's the low hanging fruit. You always bash on frozen foods or processed foods. "Oh, it has too much sodium." It doesn't really have a lot of sodium either. Yeah, as far as meal replacements go, it doesn't look like it's bad.

Scot: All right, Mitch.

Thunder: For me, it would really come down to taste, if I can stomach it or not.

Scot: Why don't you invite us over for a Huel dinner and we could do some taste testing?

Troy: Yeah. Speaking of inviting people for meals, why don't you serve us up a Huel buffet? We can try all sorts of different Huels.

Scot: We could all sit down at the table and then you can get up and you could put it in the bowl and we can watch you use the specially designed scoop to put two scoops of water in your food and then put it in the microwave and you can bring it out. That'd be great.

Thunder: It could be like a bonding food preparation experience like we talk about except with powder.

Mitch: It just feels like a joke on some sci-fi show of some sort where it's like, "Oh, yes, let me reconstitute the meal."

Scot: Who knows? That may be the way of the future. So I think this episode was all about Mitch wanting permission that this is okay.

Troy: Yeah.

Mitch: Yeah, basically.

Scot: Am I getting it correct that you guys are giving him permission?

Thunder: Yes. Mitch, you have permission to have occasional Huel.

Scot: All right, Mitch. Permission granted.

Mitch: Yes.

Scot: Can we wrap up the episode?

Mitch: Absolutely.

Scot: Okay. Thank you for listening and thank you 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: Hey, Mitch. Troy's got an announcement that he wants to make, something he wants to tell us.

Mitch: Oh, really?

Scot: Are you excited about it?

Mitch: I'm quite excited. I always love surprise announcements.

Scot: All right, Troy. What's the big announcement?

Troy: Well, Mitch, I'm going to preface this by saying, do you remember that episode we did a while ago about Dr. Turok's male contraceptive gel?

Mitch: Yes.

Troy: It doesn't work.

Mitch: Oh, no.

Troy: I'm just kidding. I was not part of his study. But I'm having a baby. My wife and I are having a baby.

Dr. Jones: Yay. Congratulations.

Troy: This is our first child.

Dr. Jones: Congratulations. Oh, are you in for a ride.

Troy: Oh, I don't think I have any idea what I'm in for. I'm extremely excited. Yeah, honestly couldn't be more excited, but definitely a bit nervous. Baby is due in September. We are just super excited. And I have to tell you the way we announced this baby, and I think, Scot, the way you found out.

Scot: I mean, I'd kind of call it finding out. There were still a lot of questions.

Mitch: Exactly.

Troy: Like, "Really, is this a joke?" Yeah, so we ran . . . Laura had this all planned out. When she told me, I came home from this late shift at 3 in the morning, and she gave me this gift bag that had the positive pregnancy test, said, "Hey, it's an early birthday present." I opened it and was like, "You've got to be kidding me. Wow."

And so, anyway, she had planned this out. We had already planned a marathon. She ran in a shirt that said, "Baby's first marathon," and then sent the picture out to the family and it took them forever to figure it out. I had to then send a close-up of the picture, and still no one responded.

And then I had to say something that says, "I promise this is not a late April Fool's joke," because it was April 2nd. And finally my sister-in-law, not any blood relatives, my sister-in-law figured it out and said, "Wow, you're having a baby." So baby is on the way. We're super excited. Yeah, due in September.

Dr. Jones: Wow. That is going to be wonderful. It's wonderful.

Scot: Today on "Who Cares About Men's Health," we thought maybe you might be able to use a little bit of help. I think as guys . . . I don't know. I can only speak for myself and men that I've observed. It seems like during that nine months we are like, "Well, we don't really have much to do."

Troy: Yeah. "This is easy."

Scot: But maybe we should be looking for something to do. I don't know. So that's what we're going to talk about today. It's the "Soon to be Dad" episode. "Who Cares About Men's Health" is about information, inspiration, and a different interpretation of men's health. Today's crew, as usual, he brings the MD, Dr. Troy Madsen, and dad-to-be.

Troy: That's right. Bringing the MD and bringing the baby soon.

Scot: Bringing the MD and the D-A-D.

Troy: D-A-D.

Scot: I bring the BS. My name is Scot Singpiel. And Mitch Sears just generally makes the podcast better. Mitch, how you doing?

Mitch: I'm doing pretty good. I'm excited for Troy.

Scot: All right.

Troy: Thanks, Mitch.

Scot: And Dr. Kirtly Jones is an OBGYN. She is part of our scoperadio.com family. She does the "7 Domains of Women's Health" podcast. And she is an expert on this sort of thing, not only the technical aspects, but also from maybe what your partner might want. Any dad-to-be support mechanism that you might be offering? I don't know. We're going to find that out.

So, Dr. Jones, do you find that the statement I made about guys during those nine months just kind of think, "Well, I really don't have much to do," true or not? Should we be thinking that? What's your take on that?

Dr. Jones: Well, it can be, but you shouldn't be thinking that. So in the first trimester, and we don't know exactly where Troy and his partner are in their trimesters, it can be pretty rocky because there can be a lot of nausea. And so, when someone is throwing up all the time and they can't eat, there are things . . . First of all, you feel a little guilty because you are half of this creation, but not the part that throws up all the time.

There is something called couvade syndrome where men experience all the symptoms of the pregnancy. They even go into labor. There's a special hut for them. So in some cultures, the men act out all the symptoms of nausea, and vomiting, and back pain, and you name it, and then labor. And then the women just go on about their lives and work in the fields, etc., and raise the kids.

So men can walk away and we know all over the world men walk away from a pregnancy, leaving the pregnant person to deal with all of it. But if you're a pair, and if you're listening to someone throw up all morning, it would be, "What kinds of things can I bring to you? What kinds of things can we have in the house that might make your tummy settle a little bit better?" That's kind of helpful. "I heard that ginger worked for you. I've been reading up about this. Can I bring you some ginger?"

Scot: Troy, would you like to practice that? I'd like to hear you say that.

Troy: I'm just fascinated by this couvade syndrome. So these are men who are actually experiencing all the symptoms of pregnancy? And they're not doing this consciously, it sounds like. They're actually experiencing this.

Dr. Jones: Yeah. It's not a common thing. It's in some cultures and not in others. So clearly there are issues. Some partners want to go over the top and order everything by the time they're 12 weeks, and you've got hundreds of dollars of baby carriers. Guess who gets to pay for it, maybe?

So how much are you going to be in the physical domain? And in the physical domain, your partner is probably going to be experiencing whatever she might be experiencing, but being supportive, like, "Can I help you lift that? I know your back has been really sore. This is getting farther in pregnancy."

If she says, "Gee, I want to go skydiving," you're not going to say, "Is that the best idea?" There are some things that she won't do with you or she won't feel like doing with you.

So by trimester, first trimester is nausea, vomiting, the things that happen physically that you could be helpful with in terms of just saying, "Oh, gosh, that's so awful," and maybe, "Tell me what I can do to help."

Scot: Let me jump in quickly. So we also sent an email around to some women who just recently had babies in the office. And the thing you just said was one of the answers that came back. It said, "I think, for me, it's knowing how . . ." This is what they wish that their husbands knew.

"I think, for me, it's knowing how difficult pregnancy can actually be for women. There were some days I couldn't get out of bed because I was so tired or sick, and my husband didn't really understand at first what was going on. He thought I could just do the same things I did before pregnancy. Eventually, he got it, but pregnancy can do wild things to your body that I think a lot of men don't understand."

Dr. Jones: And it can do wild things to your emotional life as well. So people can feel overwhelmed. They can cry easily. Things about mommy hormones. So just being understanding that things are not going to be the same, and the pregnancy is just the first nine months of the rest of your life that's not going to be the same.

Troy: That's encouraging.

Scot: I was going to say we're like three minutes in. How do you feel now?

Troy: I know. I'm kind of speechless really. But we are in the second trimester now, so things . . .

Dr. Jones: Things are pretty good now.

Troy: Yeah. Laura really had a great first trimester. Definitely the fatigue and nausea. I tried to offer what I could. I'll tell you, just being the very independent person that she is, she did go out and buy all of those things for nausea herself, and I should've done that for her, but . . .

Dr. Jones: No, no, no.

Troy: Yeah, she had her stockpile.

Dr. Jones: You can just say, "Wow, good for you. You're doing an amazing job."

Troy: Right. But yeah, certainly she had plenty of nights where she was just very, very tired, and just fatigued, and didn't have a lot of energy, and just needed a lot of sleep.

It is definitely a process, though, of understanding that and really trying to kind of understand exactly what the other person is feeling, and the emotional impact of this as well. Like you said, definitely a process of trying to figure that out, especially for someone who's going through this for the first time.

Dr. Jones: Women lose their entire sense of their bodies, and some people relish this whole transformation of their body, but some people don't. "Gee, does this baby make me look fat?" So I think it's how do you approach the change in your beloved's body? And mostly you just say, "I think you look strong. I think you look wonderful."

Women often feel quite insecure about the changes in their body, and it's appropriate because they've been invaded, and just being supportive in how they may not feel quite themselves. "What can I do? What can I do to help?"

And then, of course, in the third trimester, when someone is carrying 20 . . . It's like carrying a fanny pack that's got 25 or 30 pounds on your . . . not on your fanny, but in front of you. So you could imagine carrying a 30-pound pack on your waist in front of you. It puts you off balance, and your back can get sore, and you have reflux, and you have heartburn. Some people have problems with carpal tunnel and other things. It's just saying, "What can I do to help? What can make it better?"

Scot: Troy, practice that. Let's hear you.

Mitch: Right now, I want to hear it.

Troy: Yeah. What can I do to help, and what can make it better?

Scot: Yeah. There you go.

Troy: There you go. Yeah. And I think for me, too, a lot of it has been trying to just even identify those things without having to even ask that question. Just looking around and saying . . . As we've talked about before on this podcast, we tend to have a lot of animals at our house. We foster a lot of animals. It's her job. She's the director of an animal rescue group. So just trying to say, "Hey, I'm just going to clean up after these animals and do what I can here to help out."

I find it's a little bit of a tough balance because, like I said, Laura is a very strong, independent woman, and I don't want to come off as patronizing in any way either, like saying, "Well, you're pregnant. You really shouldn't be lifting that," things like that. She's going to lift these animal crates, and she's going to do this stuff. So I do find it is a little bit of a balance there too of . . .

Dr. Jones: Oh, absolutely. And if someone is getting cranky, all you need is someone telling you what you should be doing or shouldn't be doing. By the way, do you foster cats?

Troy: We do.

Dr. Jones: Great. Do I need to give you the toxo talk?

Troy: We're well aware. Yes. I've been cleaning all the litter boxes and . . .

Dr. Jones: There you go.

Troy: Yeah. I am the designated poop scooper in this home. Litter boxes, dog poop, you name it. That's my specialty.

Scot: Troy, we brought Dr. Jones on not just so we could tell you what we think you should do, but so you could also ask questions. I mean, why have a podcast if you're not going to utilize it to your own benefit once in a while? Lord knows we've done it with this one, so . . .

Troy: Oh, I know.

Scot: Did you have anything that you wanted to ask Dr. Jones about? She is really the expert on all of this.

Troy: So many questions. As I've read about pregnancy, I kind of feel like we're in the eye of the storm right now. It sounds like the first trimester obviously can be pretty rocky, and Laura did great and did not really have any significant vomiting, but some nausea, fatigue. And now everything just feels good, and everything is going well. What's coming up next? What's the third trimester going to be like?

Dr. Jones: Oh, it's that 30-pound pack that's hanging off your belt. So, number one, if everything is going well, and her blood pressure stays wonderful, and she doesn't have any leaking of her amniotic fluid, and it's a perfectly healthy pregnancy, it still is . . . people tend to feel a little bit more fatigued. It's hard to find a nice place in bed, because you're kind of rocking and rolling trying to find a nice place.

And of course, she's going to be very pregnant in the hottest months of the summer, and so finding a cool space in your bedroom is going to be important if she wants it.

And then when it gets to lifting the 30 pounds that's on her waist, and then anything else, just say, "How can I help? What can I do?"

So I think probably she's strong. Anybody who just ran a marathon in pregnancy is very strong, and she's probably going to cruise through her third trimester really well. Not all women do that. For some women, they have back pain, headaches, carpal tunnel, swelling feet, things that make them feel enormously uncomfortable, and then there's labor.

Troy: Probably the most intimidating part to me is thinking about that process, labor, and what to expect there, and how do you deal if there are complications. And again, the challenge for me is I just see everything that goes wrong with everybody's lives.

Scot: In the ER, yeah.

Troy: In the ER, yeah. I do, and I see the bad outcomes. I will tell you, I had a very emotional experience recently, and it's just crazy the timing of this, of caring for a baby who just was delivered right outside the door of the ER. With a baby on the way, that's something else. I mean, you try to push your emotions aside.

And fortunately, everything went beautifully, could not have gone better. But 6 a.m. on a night shift to have that happen. So I definitely have felt the impact of this emotionally where before I might not have felt that as much. I was like, "Oh, wow."

Dr. Jones: So you felt different?

Troy: Oh, yeah. No question about it.

Dr. Jones: So you already are emotionally a new guy. You're a new guy because of what's happening.

Troy: Oh, without a doubt.

Dr. Jones: And it wasn't a cognitive choice. It just happened.

Troy: Yeah, without question. So I guess in terms of when labor comes and when that time comes, what do we expect at that point? What do I expect as a father-to-be, and how can I be supportive through that process?

Dr. Jones: Well, I think that's another situation where you're going to need to take your partner's lead on this. For some women, they want to take classes, they want their husband there doing back massage, they want someone helping them do counting with them.

My husband actually, as a neurologist, had some experience in hypnosis. So he and I practiced hypnosis, and he did hypnosis through the first 20 hours of my labor until the 11.5-pound baby was really not going to fit, and we had the baby, had a C-section.

But he was right there for me. And it was hard watching someone who's completely in control all the time and needs to be in control lose it. So it's just being there. But let her ask you. Let her tell you.

The paradigm that you see on TV, which I've seen so many times, is the couple are working together, they're doing great, and then she gets in this magic situation called transition when it's just before she's ready to push, and she's screaming, "Get out of the room. I never want to see you again. Don't you dare touch me." You guys have seen that on TV, haven't you?

Scot: Oh, yeah.

Troy: I've seen it in person, yeah. In emergency medicine, I've had to deliver at least 10 babies. I spent a month on OB, and I've seen it all. So when I say I've been there . . . But it's so different as a healthcare provider, and then when you're there and seeing this person you love and you care about go through this, I think that's the challenging part.

Dr. Jones: It is.

Troy: How am I going approach this? And obviously, there's that part of me that can very easily switch into clinical mode and doctor mode, and I don't want to do that. I don't want to try and be the doctor in the room and trying to be very unemotional or clinical. But at the same time, I'm concerned that I will feel a little overwhelmed by this as well.

Dr. Jones: You will, and you should. It's overwhelming.

Scot: Overwhelming how?

Troy: I'm sure I'm going to experience a lot of anxiety going into this and, "Is everything going to go well? How are things going to turn out?" Certainly a lot of very deep empathy for Laura as she's going through the labor process, and just wanting to do anything I possibly can to ease that process for her, and wanting to be available to her to whatever I can offer.

Yeah, there's going to be that excitement leading up to it, just the anticipation of this new baby. I'm concerned about feeling overwhelmed with this. Like I said, I'm the kind of person who likes to keep my emotions in check, no doubt.

Scot: If you are moved to cry . . . Are you going to be in the room during the delivery?

Troy: Oh, I'm sure I will, yeah. I joked with Laura that I'm going to deliver the baby, but she didn't like that idea. I told her, "I'm an expert. I've done this. Trust me."

Dr. Jones: Ten times.

Scot: Is that because you want to save some money? Is that what you're trying to do?

Troy: Exactly. We're going to save a little cash on this kid, avoid the hospital copay.

Scot: That's right. Some guys do their own plumbing. Troy delivers his own kids.

Troy: "I got this. I got this."

Scot: If you find yourself emotional, like where you might cry because it's such a beautiful moment, are you going to fight that back, or are you going to let that happen? And, Dr. Jones, what do you think about that? Is that what a guy should do or not?

Troy: Scot, I would love to tell you I'm just going to let the tears flow, but I know myself too well, and I'm going to try and hold them back. I'm going to do the same thing I did when we first had our ultrasound at 14 weeks, and I saw that baby and that image of the baby. Laura looked over at me, and I sure tried to hold them back. And afterwards she said, "Were you crying?" I said, "No, I wasn't. Of course not. Why would I do that? Eh, maybe a little bit." So I'm sure I'll try and hold it back.

Dr. Jones: Well, even if you do, you can say, "Well, I'm overwhelmed." You don't have to let the tears fall if they're not right for you. I mean, we've seen it all. And sometimes the experience is totally scary. It is very scary. And of course, I'm a former OB, so I also think of all the things that can go wrong. And a first baby, it just never always goes as you hope. It's just a little different in some way than you hope.

But what you want is you want to be with a team that you completely trust, and that's the biggest thing. Whoever is there with you, wherever you choose to have this baby, you want to be with a team that's going to be there for you. So you don't have to be the doctor in the room.

Scot: Now we're going from Troy being DIY to Troy recruiting like he's the general contractor. He's recruiting his crew. Going around to his friends.

Troy: I've already done that. As soon as Laura told me that night, the next morning I emailed someone I know well who's done lectures for our residents, who has been the OB for several of my friends and colleagues, and I emailed her that first morning and said, "Please, I'm scared." I didn't say, "I'm scared," but I'm sure she could tell I was scared. I was like, "Will you be our OB?" And she was wonderful and got right back to me. Yeah, I'm very happy to be working with her and have her caring for us and for our baby.

Dr. Jones: Good. Well, I think that you are . . . you know what's going to happen. You're going to let her run the agenda as she's pregnant in terms of asking you for what you need, and letting her know that, within the limits of you taking weird hours and call, you're going to be there for her.

And then what happens is after the baby is born, the first couple of months, where there's a baby up all the time, do you help out with that? Does she help out with that? How much breastfeeding are you going to do?

Scot: Yeah, Troy, do you help out with that?

Troy: I'm planning to, trust me. I'm all in on this, and she's made it clear I'm helping out with this too.

Mitch: I mean, he's already a poop scooper.

Troy: I'm already a poop scooper. Diapers are going to be easy. That's going to be a piece of cake. That will be a relief from what I usually have to deal with.

Scot: Dr. Jones, I cut you off a little bit there. You were leading into breastfeeding. Where's Troy's involvement in that, though? He can't help there, can he?

Mitch: Yeah, that's actually one of the questions from our new moms, was how do men help during that process?

Dr. Jones: Well, they can bring the baby. So if they're not co-sleeping, and there are lots of opinions about whether babies should sleep in the bed, but if the baby is in a crib nearby, you go get the baby, you can change the diapers for the baby, the mom can breastfeed and put . . . How you work that out is a rhythm that every couple establishes.

Troy, you're used to sleep deprivation. And maybe your partner is really good at it, maybe she's not. So how you begin to juggle that is something that each couple finds their own way. I'm sure you're going to do great. That's the reality, is when there's love, you guys will do just fine.

Troy: Yeah. Again, for me going into this . . . And we've talked a bit about how this is going to look once the baby is born, and how all that works. That's kind of the approach I'm trying to take. I'm going to be available. I'm very fortunate that working through the university, I do get paternity leave. I'm absolutely taking it, and I want to do everything I can to help Laura, whatever it means in terms of sleep deprivation or getting up in the middle of the night.

And like you said, my hope is just that we can figure out how that works and how that looks exactly over those first couple of weeks. And I guess that'd be my question, too. Do most couples then . . .

Dr. Jones: Couple of months.

Troy: It's a couple of months to find that pattern? Okay.

Dr. Jones: Well, the baby is always changing. So they call the first three months of a baby's life who's born at term the fourth trimester, because they are still on truly autonomic phase. They just sleep, and poop, and eat, and that's about all they do. And then at about 2.5 to 3 months, they come up with a smile and then everything is perfect as soon as they smile at you.

But it's hard because just when you think you've got Plan A, the baby has changed, and then you have to say, "Oh, I guess we're going to work with Plan B." It's just being flexible.

It's being aware that moms don't always feel on top of their game emotionally after a baby is born. They can feel kind of overwhelmed. They can feel like their independence is gone. Some women have postpartum. Everybody gets baby blues. It's a period of a day, or two, or maybe even a week when they say, "Oh, this is really hard." But postpartum depression affects a lot of women, 20%, when Mom's mood isn't really enough, isn't up to the task, and she needs more support.

You just kind of have to be aware and ask her, "How are you feeling? Is there anything I could do for you today?" As long as you're talking, as long as you're emotionally available to each other, you'll do it fine. It's amazing. It's the last refuge of the rank amateur of this parenting thing.

Troy: The last refuge of the rank amateur.

Dr. Jones: Right. So do you know if you're having a boy or a girl?

Troy: This is a girl.

Dr. Jones: Congratulations.

Troy: A baby girl on the way.

Scot: Really?

Troy: Yeah, a baby girl.

Dr. Jones: Wow. Congratulations, It's just magical. It's going to be just magical. Not that boys aren't magical too. They both are.

Scot: Are you sure about that? I was wondering this morning, I was like, "I bet you they're going to have a boy."

Mitch: Yeah, same.

Scot: I mean, might want to double-check that.

Troy: We've got another ultrasound coming up shortly, so we'll have them take another look, make sure they got it right. They seem pretty confident.

Scot: Yeah. So there was one other one. It's "Should new dads go to the appointments during pregnancy and after?"

Dr. Jones: I think that's what the partner wants. My husband was a resident. I was not going to have him . . . This was in the old days when residents never, ever, ever . . . they didn't have an IV, and if they didn't have . . . straight out of the operating room. They did not miss a day. So I was not going to ask him to go to any of my appointments. I think you do what she wants.

Troy: Yeah. And she's asked me to go, and I've been able to go with her. So, again, yeah, you're right. I think it just depends on your situation.

Scot: And what's your role in those appointments then? Is it just to be there? Is it to remember things that have been talked about?

Troy: I mean, I think my role has been more just to be there with her, and I really have tried not to . . . Again, avoiding going into doctor role. I've been trying to just be there as husband and future father and just be there with her. I've tried not to ask a lot of questions or anything like that. Let her ask the questions she wants to ask. Let her OB talk to her, and not feel like she has to be talking to me because I'm the other doctor in the room or anything like that. But yeah, it's really been just being there. And that's what it's been so far, just being there with her and she . . .

Dr. Jones: Well, if you have a question, it's a good thing. I mean, I really liked it when husbands had questions. So if you have something to ask, then it's appropriate to ask.

Troy: Yeah, for sure. And the good news is everything has been so straightforward so far. I really haven't had to ask anything, and Laura has asked the questions I think that needed to be asked.

Scot: Oh, you're grading her now?

Mitch: That's what I was going to say, yeah.

Scot: She's asked the questions that she needed to ask.

Troy: I had my checklist in my mind and she passed.

Mitch: Backseat doctoring.

Troy: Not at all. I mean, I think they were just questions that we talked about beforehand that she had. And that's probably why I'm there too, because she may have had some questions in her mind. But yeah, we really have talked a lot about those things beforehand, and she's asked me questions.

And then in this case, I don't want to be the doctor to my baby or to my wife, so I've just provided my opinion but have tried not to steer the conversation when we're with the OB.

Dr. Jones: Of course. You're a natural already.

Troy: I wish. I feel far from it. Like I said, I feel inadequate. That's how we started this episode. That's probably a good summary.

Dr. Jones: Thank you for using your words.

Troy: Yes. I feel inadequate. That would be the absolute best word to describe how I feel.

Scot: Congratulations, Troy.

Troy: Thank you.

Scot: Yeah. On behalf of Mitch and myself, this is your baby present.

Dr. Jones: Oh, great.

Troy: I could not have asked for a better gift. This is my man shower. You guys just held a man shower for me. I couldn't have asked for a better man shower.

Scot: Yes. Dr. Jones, thank you so much for being on the podcast and talking to our nervous new dad, and thanks for caring about men's health.

Dr. Jones: What a treat. Talk to you soon.

Troy: Thank you.

Dr. Jones: Bye.

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: All right. Before we get to the show, I wanted to say thank you to Troy.

Troy: What did I do?

Scot: You sent me a graduation present.

Troy: Oh, yeah.

Scot: It was very much appreciated. So here's how this went down, Mitch.

Mitch: Okay.

Scot: My wife goes out to the front porch and gets an Amazon package and brings it and hands it to me. And I'm like, "Well, that's weird. I haven't ordered anything recently." So I opened it up, and I look at it and it's some sort of light, but it's weird. This is really weird. I don't know what's going on. This must be somebody else's package.

And that's when it dawned on me to look at the label, right? No. It's addressed to me, my address. If I ordered this, what? Did it accidentally have something in my cart and I clicked order? I mean, I had no idea what it was. So I'm like, "Who's sending me a gift?" And I looked at the thing again, and I still can't tell what this thing is.

So then I finally find the one with the little message. Troy, I'm going to go ahead and let you tell me what the note said.

Troy: Scot, the note said, "Dear Scot, Congratulations on your graduation. May you always serve as a beacon in the dark as this toilet light serves you." And then added "From the MD to your BS." And then, "(MS)," since you're now an MS. "Every time you see this toilet light, I hope you think of us, Scot."

Scot: I'll tell you I haven't laughed out loud like that in a long time when it finally hit me what was going on and what that thing was. And my wife was like, "What?" And I explained it to her. She rolled her eyes hard when she found out what it was.

Troy: That's great.

Scot: She was like, "Can't you just turn the light on?"

Mitch: No.

Troy: No, you can't.

Scot: I was like, "Well, this is so you don't have to." So I don't know what bathroom it's going to go in. Probably not our main bathroom because she doesn't seem to be too supportive of it.

Troy: She's not thrilled with the toilet light. We might have to have a talk with her about the value of a toilet light since both Mitch and I are huge fans now.

Mitch: Life-changing.

Scot: Yeah, I explained that to her and she rolled her eyes hard again twice. Anyway. Troy, thank you very much for the present of the toilet light, which we've talked about before, about how it's life-changing for you two because then you don't have to turn on the main light, and it's easier to go back to sleep if nature calls in the middle of the night.

Troy: Yeah. Well, I'll tell you what, Scot. I think the toilet . . . sometimes I ask myself, "Have I done anything of value in my life?" And I think about this podcast and I say, "Well, has this podcast done anything of value?" And then I think about the toilet light. If nothing else, we've inspired people to buy the toilet light, and it does help.

Mitch: It does.

Troy: It does help with your circadian rhythm. I love it. I love the toilet light.

Scot: Just paying it forward, man. Paying it forward.

Troy: Paying it forward to you, Scot. Join the toilet light club. Congratulations.

Mitch: Yeah, congratulations.

Troy: Congratulations on your graduation. It's a huge accomplishment.

Scot: Hey, guys. You ready to read your letters from your past self on the show?

Mitch: Do we have to?

Scot: Yes. We have to.

Mitch: Okay. All right.

Troy: My letter is going to arrive in January, so I'll just be trying to remember what I wrote.

Scot: All right. Back on January 4th on "Who Cares About Men's Health," instead of doing New Year's resolutions, we tried something a little bit different, because sometimes when you repackage things, it might be a little bit more effective.

At its core, sitting down and reflecting or thinking about where you are and where you want to be, that's not a bad thing. But sometimes, New Year's resolutions, we know they don't work, so we tried a different approach. We wrote a letter to our future selves.

There was a little bit of a miscommunication. Mitch and I already got our letters because one of the things that we decided was maybe you should review these things a little bit more often than every year. Troy, he's getting his at the end of the year, but he says he can remember most of it.

So we're going to read our letters and we're going to find out where we are about . . . what? It is five months, almost six months later, where we are here.

So this is "Who Cares About Men's Health," bringing you inspiration, information, and a different interpretation about health and men. My name is Scot. I bring the BS to the podcast. He brings the MD, Dr. Troy Madsen.

Troy: I'm here, Scot, even if my letter is not here.

Scot: And Mitch brings the microphones. Welcome to the show, Mitch.

Mitch: Hey there.

Scot: All right. So I dug out my letter. I thought it was going to be really cringe reading my . . . I felt weird writing it, so I thought, "I'm going to get this and I'm going to think it's dumb." Actually, I didn't think it was that dumb. So please don't make fun of me, because that will change my whole . . .

Troy: Yes, because we would have if we think it's dumb.

Scot: Well, I guess I would . . .

Troy: We'll just stay quiet. We'll stay quiet.

Scot: No, I would expect no less than you to tell me.

If you did not hear the original episode on January 4th, Episode 92, you might want to go back and listen to that. Even if you don't, you might want to adopt this. I found this to be a good exercise actually, writing this letter to future me, because when I read my letter when it came a few months later . . .

And by the way, you do this through a website called futureme.org. You write it. You tell it when you want it to send that letter to you, and then just you're minding your own business on one day, and this letter comes to you from yourself and you can go, "Oh, yeah, I remember that. I wanted to do that," or, "Oh, yeah, I've actually stuck with that." And I found that I actually kind of stuck with some of this stuff.

So, Mitch, do you want to go first? Troy, do you want to go first? Do you want to say anything before we jump into these letters?

Troy: Maybe I'll go first since I don't have my letter. Like I said, I misunderstood the assignment. And I unfortunately did refer to it as an assignment.

Scot: Yeah, very painful. It wasn't something you were looking forward to doing or it wasn't something you thought, "Oh, this will make my life better." It was an assignment.

Troy: It was an assignment. I didn't truly embrace it. But I had mine set to come in a year, so I'm not going to get it until next January. But it will be kind of funny to read it because a whole lot has happened since then.

So this was early January we wrote these, and I basically just said, "I'm writing this to myself because Scot told me to do it." And I think I said some things in there like . . . It was kind of one of those, "Well, I hope you're still doing this and doing this. I hope you're still running and I hope you're still eating well," and that kind of thing.

So it wasn't particularly profound. But it is funny to think back on it now, because I do hope I'm still doing those things at that point. And I think that doing those things at that point will be a whole lot more challenging than I thought it was going to be.

Scot: Mitch, do you want to do your letter next?

Mitch: Sure. And one of the things I found was really interesting with this exercise is that in my many, many, many self-help books that I've read in the years, they've always been like, "Journal. Put your thoughts down," whatever, but I can never commit to that.

But something that was really surprising, especially upon reading this letter, was it was an exercise in kind of self-compassion and self-understanding. And writing it in your own voice to yourself was something that was very impactful in a way that no journaling I've ever done before has been that way. So I love this. I love this so much.

I'm going to talk around the curse words, but here we go.

Scot: Why are you swearing at yourself, Mitch? Come on.

Mitch: No, it's chill. All right. Here we go.

Scot: All right.

Mitch: Dear Mitch. Well, the last few years have been a trip, huh? A plague, earthquake, a hurricane in a landlocked state, riots with overturned cars, and military presence in downtown Salt Lake City, an insurrection. Just another round of unprecedented times in your lifetime full of them. Kudos to you for surviving the best you can.

I would also like to remind you of all the good things because it can be so easy for you to forget them in the face of such overwhelming circumstances. You have begun to focus on your health in a way that will set you up for success in the next act of your life, making great strides including quitting smoking, something you've never been able to do, beginning physical therapy to finally overcome your limitations you've had since high school, and got over yourself enough to seek the mental health professional to help you unearth and work through the root causes of your now officially clinical anxiety.

It's hard, and it sucks most days, but you're doing it and you should be proud of yourself for that, even when there are slip-ups or setbacks.

In the face of people telling you to give up on your professional aspirations and hustling for over a decade, you finally earned a career doing the work that you love with a great team that supports you. It's time to settle in and get down to the work you've always wanted to do. Don't let the stability be confused for stagnation. You can leave the struggling hustler side of yourself behind.

It's important to remember that you found your own way to this point and you should be proud of that. Many of your setbacks have come from relying on the outdated and blindly general advice of others, including the guidance of those who do not have your best interest in mind, whether it be the firm direction from a mentor who made his fortune in the 1970s, a group of roided-out jerks on social media trying to tell you how to be healthy, or even the advice of a borderline cult leader speaking through a teapot.

I genuinely hope that you start trusting yourself more. You're the one in the driver's seat as you navigate this topsy-turvy world. You're strong, smart, and capable, and deep down you know what is best for you.

Listen to that gut of yours. Seek out the novel, the bizarre, the joyful. It's led you to great places before, right now, and it will in the future. Sincerely, Mitch.

Scot: Wow. That was awesome.

Mitch: I guess.

Troy: That was. I'm so glad I don't have my letter right now. It would've seemed superficial and lame compared to that.

Scot: Yeah, I'm going to be going next, so that's my big fear. But that was really, really insightful. One of the things that I did love is you were very kind to yourself. I really loved that. And you patted yourself on the back for just making it to this point. And you have made some great accomplishments. So, yeah, I agree with Past Mitch. Good job.

Mitch: Thank you.

Troy: And I agree too, yeah.

Mitch: I put off this for so long when you first assigned it. I think I ended up sending it middle of February to be honest because I just didn't know what I was going to write. But there was a moment in time that it was just like, "You know what? Let's just do this and be nice to yourself." I don't know why I have to keep telling myself that, but it's like, "Be nice to yourself," and it was an exercise in that.

Troy: Yeah, and I like it too because it's being nice to yourself, it's recognizing where you've come from, the trajectory you're on. And I think it's great, too, because it just keeps you saying, "Hey, let's just stay on this trajectory, keep doing what we're doing." And you also recognize the potential pitfalls along the way and the distractions and talk about those.

And so I think it's a good reminder as you wrote that to your future self to continue to watch out for those distractions and those things that seem to potentially make you think that maybe you're not doing as good a job as you are doing and things that have gotten you down in the past. So I really liked how you framed it.

Mitch: Yeah, it sounds better than a resolution.

Troy: I was going to say I like too that you made reference to . . . I'm assuming that was to Scot and to me in the letter.

Mitch: Oh, yeah, of course.

Troy: The great team you're working with?

Mitch: Yeah, definitely. For sure.

Troy: Okay. Thank you.

Mitch: No, you guys are great.

Troy: We'll take credit for that.

Scot: I'm a little bummed because he preempted the obvious joke there, like, "I'm a little bummed I wasn't mentioned in your letter, Mitch." But I was. What are you going to do?

All right. Here's my letter. And I love how I tried to . . . Troy framed this as an assignment and I tried to frame it like this was spontaneous.

Dear future me, had a quick moment to write so I thought I'd drop a line.

Troy: Just happened upon this website and thought, "Why not?"

Mitch: Who are you trying to fool? Yourself?

Scot: I don't know.

Troy: Future Scot is like, "Wow, Past Scot was so spontaneous."

Scot: Actually, no. I'll tell you exactly. I remember what was going through my mind. I had the hardest time starting this letter. So I just had to let go and say, "Just write something and then just kind of go with it." So that's exactly what that line was all about.

I started and stopped this assignment, as Troy would put it, numerous times because that first line was so tough for me. So that's what that was.

Mitch: Same.

Scot: I had a quick moment to write, so I thought I'd drop a line. How are things? I just had some time off over Christmas break. It was great to have a little time to reflect without the hecticness of everyday life. Like every year, the holidays provide an opportunity to slow down and consider how things are going.

Of course, after the season of gluttony, eating and exercise are on my mind. Not to say I don't always think about nutrition and activity. They seem to be a constant struggle and at the forefront of my mind all the time, especially this time of year.

I think about how nice it would be not to have to think about them, but that's not the world we live in. A couple of hundred years ago, activity was central to getting food. Today, calories are everywhere and no real energy is needed to acquire them. It's a constant struggle to get my needed daily activity and eat well.

And you know me, I like to overcomplicate things. So this year, I'm going to try to simplify. For nutrition, I have three rules. Number one, always eat my veggie, eggs, and oatmeal breakfast. I do pretty well with that, so I can build on it. Second, always have food prepared for lunch at work. Third, stop eating at 6:00, which will give me a 12-hour fast.

For activity, two rules. First, do your daily physical therapy exercises and stretches for your nerd neck and hamstrings and glutes. Second, sweat 30 minutes a day. The cornerstone is strength exercise. This can be with body weight or weights or kettlebells. I guess for both goals my hope is consistency.

I also realized I have a couple of personality traits I'd like to improve because they introduce stress into my life. First, I overthink things. I'd like to think less and do more. I know I'm a better reviser than creator, so create, don't overthink and talk yourself out of things. Also, when you talk yourself out of things, it's because you're scared or don't want to exert effort. So just do it.

Second, I spend a lot of time in the future thinking about things I have to do or how things are going to be different in the future. I'd like to be more present and deal with future things at the appropriate time. I don't have to think about all the things I have to do at home when I'm walking my dog.

Maybe starting a to-do list, I can completely vacate those thoughts from my head until I have to deal with them. Just open up the to-do list and engage with what needs to be done at that moment.

Anyway, I hope you're doing well and look forward to hearing back from you about how you're doing. Sincerely, Scot.

So that was my letter.

Troy: It was good, Scot. I liked it. Like you said, it's one of those things, and that's kind of what it took for me too, although I didn't put nearly that much effort into it. It was just sitting down and just writing something. For me, it was just writing that line saying, "Well, I'm doing this because Scot made me do it." Yeah, you're kind of led into it like maybe catching up with a friend or something and dropping them an email.

But you got into very specific things there in terms of your goals, and yours definitely seemed more resolution-focused than maybe Mitch's was, where his was kind of more, "Let's keep going the direction we're going," where you had very specifics in there.

Curious, reading it now, how do you feel about your resolutions and the things you talked about there?

Scot: So I had forgotten about a lot of that until I read it again. For one, the living in the moment has . . . it kind of went away. And also, the thought of, "You overcomplicate stuff," was good to read again, because just a couple of days before we did this show, I reread my letter and I read that to myself. So I recognize that's an ongoing problem, and I kind of forgot that I was going to try to do that, so this reminded me. It was a nice, gentle reminder.

I did really well on my morning breakfast, but when I was in my Master's program, sweets and comfort food, I just couldn't keep them out of my mouth. The person who empties my garbage at work knows more about my emotional state from week to week than probably anybody else in my life just based on what's in there. It's like packages of cookies and packages of Juicy Fruit, because I chewed a lot of Juicy Fruit gum.

I started out exercising really, really well, and I put the ego aside and I really worked on doing good form and just building strength up slowly. And then things kind of fell apart.

I discovered during this process how hard it can be if you have something in your life that all of a sudden kind of takes over your life. Really, as stupid as it sounds, because it should be like, "How hard is it to eat well and get some activity?" But all that stuff fell aside for about a month and a half in the middle of this Master's program. But I'm back at it now. The letter kind of reminded me that was something that I wanted to do.

And I'm going to start working on just doing things and living in the moment again.

So it was just a good reminder of things that I kind of wanted to accomplish, and some I've done okay, and some . . . that little nudge to, "Oh, let's reboot that," was helpful in those letters.

Troy: So it served its purpose. I mean, it's one of those things where . . . like you said, it's a good reminder that a lot of things you're doing well and other things, just maybe refocus things you forgot about.

Mitch: Well, I appreciate that you took a moment to emphasize behaviors and mindsets and things, because for me that was the real focus. Like, coming up with a goal to eat breakfast certain ways or "be healthier, be whatever," those are resolutions that happen all the time and they have a try or fail state. But by focusing on mindset, focusing on attitudes, that's powerful stuff to recognize that in yourself and commit to changing it and stuff. That's the kind of stuff that'll cause real change, I think.

Scot: I hope so because I get super frustrated when I'm trying to do stuff at work, and I'll start a project and stop a project and start a project and think, "Oh, this isn't good enough," or, "It should be this or that," and I make it complicated. And then I just don't do anything, right?

I don't know where that's come from in my life. I don't know if I've gotten older and I'm like, "Well, this really needs to be this way to be better." Because I know more, I have higher standards for what I need to do. And maybe what I'm working on isn't something I have a lot of experience with, so maybe I need to put those standards aside for a little bit and just do it and then adjust and improve as I go.

I mean, it's been paralyzing for me, those things. So yeah, it's been a good reminder.

Troy: Yeah, and thanks for sharing that with us too. Obviously, it's very personal and a lot of things that you recognize that you're trying to improve. Like Mitch said, focusing on more mindset and just general approach rather than those specifics, it was great to hear that. And I like, again, that yours had all sorts of different components to it with the specifics and then that broader focus as well.

I was going to say I think this activity, too, is kind of like what we've talked about with so many things. You find things that work for you and things that don't. I'm curious, are both of you going to write another letter to yourselves? Or what did you think about this?

Mitch: Yeah, I'm going to do it again. It was almost a punch to the gut when I read this again. It shot up in my email, and I was having a rough day. And there was something about reading my own kindness back to myself that just got me out of that funk.

Troy: Oh, wow.

Mitch: Yeah. It's like, "Remember, you can feel this way. You can act this way. You can appreciate these things about your life. Remember them in these moments where you're stuck in black-and-white thinking, where you're in a depressive state, where you're struggling to stay motivated and enjoying life." So yeah, when I'm having another day, I'll probably write myself another one.

Scot: Yeah, actually, maybe we should . . . So we're going to do another follow-up at the end of the year. Really, I think every three months would be probably better. Personally, I would do this every three months, because I think that constant reminder is good as opposed to every New Year's.

You get to the day before New Year's Eve and you remember all the resolutions you made. You're 364 days away from them, so it's like, "Oh, I guess I'll start over tomorrow."

But we know Troy is getting his in January. So, Mitch, I'll write one, you write one, and we'll do a third follow-up and see where we're at.

Troy: That sounds great. But I was going to say, though, like so many things we've talked about, a lot of times you find things that work for you and things that don't work. This just didn't really resonate with me. Maybe if I did sit down now and do it again and I got a letter in three months, it would really hit home.

But I think you just find things that work. For me, it's more I jot notes in my phone on different thoughts I'm having about different things that are on my mind. Or even hearing some of the things Scot talked about in terms of general approach and mental health things or things that we want to change just about our approach to work or stress or whatever it might be, that's what kind of what works for me.

And then I'll go back later, scroll through my notes, and read a note I wrote three months ago, and it kind of has that same effect like you mentioned, Mitch, of reminding me where I want to be and just bringing things back into focus.

Yeah, I think writing notes, whether it's a letter to yourself or a journal or notes like that, like I said, like I do in my phone, or whatever works, I think there's a lot of value in that. And then getting a chance to read it later. So I think just find what works for you.

Scot: All right. Well, if you want to participate with us, we're going to check out Troy's letter at the end of the year. Mitch and I are going to write another letter, and we would encourage you to do the same thing.

The website is futureme.org. And you can go on there and you write the letter yourself. You can make it public or private. I chose to make mine private. You could actually read some other people's letters, which was actually kind of interesting as well . . .

Mitch: Oh, yeah.

Scot: . . . to read what other people were saying about themselves. And you might want to do that to get some ideas going.

And then you can set it when it's going to arrive. So you could do it three months, you could do it at the end of the year, or whatever. So check that out.

When are you getting yours, Troy? January 1st? December 31st? What?

Troy: Whenever we wrote these. Was it January 1st? I don't remember.

Scot: It was January 4th.

Troy: It was January 4th. So mine is going to arrive January 4th, and what a different world this will be.

Scot: Yeah, let's check in.

Troy: It'll be interesting to read my very superficial letter. I'm looking forward to it.

Scot: We'll check in with each other with another "Letter to Future Me" follow-up on January 4, 2023.

Thanks for listening. 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: Troy, I've got a question for you.

Troy: Yes.

Scot: Are you emotionally available?

Troy: If I even knew what that meant, I would know how to answer it. Let's start with that first. I don't even know what you're asking me, Scot. Am I available to your emotions? I don't know.

Scot: Mitch, are you emotionally available?

Mitch: I guess it's how . . . I think I'm more emotionally available than I once was, but again it's . . . Yeah, I don't know, man. Maybe.

Scot: Troy, it sounds like Mitch knows what that means.

Troy: I know. Mitch apparently got past Step 1, which I haven't.

Scot: We might have to defer to him. This is "Who Cares About Men's Health," giving you information, inspiration, and a different interpretation of men's health. "Emotional Availability: I Guess It's a Thing." That's the name of this episode.

Today's crew. He brings the MD. It's Dr. Troy Madsen.

Troy: I'm trying to be available to you, Scot. Yes, I am here physically. I don't know that I'm emotionally available, but I am physically available today.

Scot: The BS to his MD, that's what I bring to the show. My name is Scot Singpiel. And he just generally makes the podcast better, it's Mitch Sears.

Mitch: How are you doing today, Scot?

Dr. Jones: Very nice.

Mitch: Look at me. Emotionally available. Boom, boom, boom.

Scot: And that lady voice you hear on this very manly podcast is one of my most favorite people ever. She is the host of one of our sister podcasts or brother podcasts. I don't know if they have a gender really. But "The Seven Domains of Women's Health." You can find that on thescoperadio.com. It's Dr. Kirtly Parker Jones. Welcome, Dr. Jones.

Dr. Jones: It's an honor to be here.

Scot: All right. Troy, I'm going to tell you how we ended up at this place of emotional availability. We were on Dr. Jones' podcast about men and crying, which, conveniently, when we told you about it, you're like, "Oh, I've got something that day."

Troy: I promise I did have something that day.

Scot: Yeah, I'm sure you did have something.

Troy: I did.

Scot: So Dr. Jones brought up . . . she said, "You know what?" We said, "We'd love to have you on the show. What could we talk about?" And she said, "Well, why don't we talk about emotional availability in men for their partners?" And Mitch and I are both like, "Yeah, that sounds great." And then Mitch and I both went to Wikipedia to find out what that meant, and we still don't know.

So, Dr. Jones, let's start right there. What does being emotionally available mean? And how does that tie back into health, men's or otherwise?

Dr. Jones: Great question. It might mean things to different people differently, but I would consider that emotional availability is a state of mind where you are able to recognize the emotions in your own self. Then you might be willing to express them, label them, and help regulate them. And then, with the practice of understanding your own emotions, you are more able to understand, or at least listen, to the emotions of your partner.

So, developmentally, it's been suggested that because girls are raised to be like their mothers -- now these are old-fashioned developmental theories -- they are more tied in with their mother's emotional state. Boys are raised to be more like boys, therefore not like their mother and therefore somewhat distant.

So you can say that the issue of emotional availability is a new one, but it's as old as "men are from Mars and women are from Venus." It's the difference between men and women. And I think that those sexual stereotypes need to be thrown away because there are certainly women who are not emotionally available and there are lots of men who are.

Troy: So why is this referred to as emotional availability? Because it sounds like it's a lot more . . . like you said, really the first step is it's more emotional awareness, like understanding our own emotions, and I guess then it makes us available. But sounds like it's a lot of awareness involved.

Dr. Jones: It is. You have to be emotionally available to yourself first. So there's some work to be done or you need to raise them that way in terms of your children. There's a great Crosby, Stills &Nash song, which none of you have even heard because you're too young. "Teach your children well, their father's hell did slowly go by." So I think we need to teach our children to be emotionally available by our own examples and by verbalizing how we are feeling, and so our children can feel.

Once you are emotionally available to yourself, then you are more willing to be emotionally able to listen to, reflect, work with your partner's emotions.

Now, I consider it kind of a girly whine. "You're not emotionally available to me." But in fact, if you're not emotionally available to yourself, this concept of emotional intelligence, then a lot of anger, fear, anxiety goes unaddressed, and it makes people sick. Their immune system doesn't work so well. Their blood pressure goes up. A lot of chronic diseases in men might be tied to inner frustrations, anger, fear, anxiety that they aren't labeling, expressing, and able to process.

Now, when you live with someone, it's nice to be able to at least empathize when circumstances make them sad and reflect on them. You might ask your partner, "Would you like me to be emotionally available to you?"

Scot: Oh, boy.

Troy: Yeah, that was going to be my next question for you. How effective is this really? And do you recommend it? I totally get being aware of our own emotions and recognizing them and acknowledging them, but it seems like it may not go over super well if we're saying to our partner, "You seem really angry right now." I don't know. "I sense a lot of anger."

Scot: As Dr. Jones was talking, Troy and Mitch, I'm sensing this recurring theme that we've talked about, right? That sometimes as men, we don't recognize what our emotions are. We don't label them. We don't really think, "Well, why am I feeling this?" We don't sit with them. We don't want to deal with them, right? And we know the detriment that has on our health, but I'm starting to see that maybe that could have detriment on relationships, which ties back in to emotional health again.

Before we get to Troy's question, Mitch, you wanted to ask something?

Mitch: Oh, yeah. As you were explaining being emotionally available to yourself, it really kind of rung true with me because I've been starting my own little mental health journey. And one of the things that I kind of ran into is one of my very first meetings with my latest therapist was like, "Hey, I have a tightness in my chest. I don't know what I'm feeling. I can't think straight, whatever." And it took him talking me through the physical sensations to recognize the emotions that I was feeling. He's like, "You sound like you are anxious. You sound like you are worried. You sound like you're whatever." It's like I couldn't even recognize that in myself, right?

And what was interesting about it is that constant anxiety, that constant kind of stress and worry that I was experiencing, but not recognizing, I wasn't aware enough to figure something out to fix it.

And secondly, it was taking a real impact on my health. I was having everything from problems with clenched jaws, to higher blood pressure, to all sorts of issues that immediately started to change as soon as I started to at least recognize the emotions and was able to start problem-solving, which I think is the step I was trying to jump to without even recognizing what the problem was, like a typical man.

Dr. Jones: Wow. Mitch, that's amazing.

Scot: Do you feel a little like a Neanderthal that you're like . . .

Mitch: Yes.

Scot: . . . "What is this strange emotion? Oh, it's anxiety."

Mitch: I do.

Scot: To me, it sounds silly, but you know what? I found myself in that same situation, too. It's kind of crazy, isn't it, that we wouldn't know what these emotions are?

Mitch: Well, I felt dumb and embarrassed almost. Luckily, I love and trust my therapist, but there was this kind of situation where it was like, "Ugh, what do you mean? Of course, it is." I've been dealing with this for a year now, and, "Oh, of course it is. Duh."

Dr. Jones: Well, remember, for men, they may have had it modeled. So the only primary emotion, which is love and happiness, and fear and anxiety, but the only one you may have seen exhibited in your life was your father's anger, or maybe your mom wasn't available either. So that's the only one you've got that you might actually have a label to, because you saw the men around you get angry. And that one you get, but there's a lot more inside.

Primary emotions are ones that immediately cause a physiologic response. And if you have the physiology, but you don't have the word, then you can't really dig down into why this is happening. Is it good or is it bad? I mean, I hope you kind of know when you're happy.

Mitch: Sure.

Dr. Jones: I hope that one comes up and you're like, "Wow. I feel happy," instead of, "Gosh, why does my chest feel a little bigger and why do I feel I can have more air? Oh, maybe I'm happy."

So you may not have had it modeled for you. It may not have been taught to you, or bad things could have happened when you were growing up that made you stuff everything down. So, for men and for women, the difficulty of being emotionally available to yourself is that you either didn't have it modeled or you stuffed it someplace because it hurt.

And those kinds of things in a relationship . . . I think your concept, Troy, if you say, "Gee, you look like you're angry," what I have learned from my husband and a 50-year relationship is that I cannot guess what he's emotionally feeling because sometimes I guess wrong and it does not go well.

So if I say, "How are you feeling?" or, "Are you feeling something hard right now?" then he might tell me. I want someone that when I start to cry or when I get upset about something can come over and at least put his arm around me. He doesn't have to say, "Oh, I see you're so sad because something has happened to our son," or your car isn't working, or whatever. At least I want him to come over and recognize that I am feeling sad or I'm feeling anxious or worried, and he'll put his arm around me, which says, "I know you're not feeling very good right now and I'm here for you."

So that's what being emotionally intelligent . . . I want him to at least recognize when I'm in emotional distress. And likewise, if he's in emotional distress, I'd rather not walk around the house on tenterhooks thinking, "Oh my God, what is wrong? Is it my fault? Is it his fault? Whose fault is it? Did I do something wrong?" It's better for me to kind of know.

You don't get to 50 years together unless you've kind of, sort of worked things out, unless you're just strapped down and you have no choice.

Troy: It sounds like then you're saying in terms of emotional availability, it's one thing for us to identify the emotions in ourselves, but it's maybe not the best idea to try to identify the emotions in others. But at least make ourselves available to them and at least tell them that maybe something seems off and at least open the door if they want to talk about those emotions that they're experiencing.

Dr. Jones: Exactly. Because if you come up to me and say, "Gosh, I think you're angry," that's going to piss me off.

Scot: No, no, no.

Troy: Even if you are angry.

Scot: It's always a question. "How do you feel about that? How are you feeling?"

Troy: Exactly.

Mitch: One of the things that I had trouble with for a long time is I'd be . . . I'm a chronic projector, and I'd be like, "Are you mad at me?"

Dr. Jones: Exactly.

Mitch: "Are you mad that I did something like this?" Then I'm also assuming, right? I'm assuming you're feeling a certain way and I'm also assuming that it's my fault, right? And that's not a good dynamic to have with anyone.

Dr. Jones: No. Don't assume that you know what they're thinking. But being emotionally available means, "I feel like something is hard right now. Can we talk about it?" or, "Is there something I can do to help you with this sense at being unease, lack of ease?" "Well, yeah, the planet is exploding and there's global warming and we're getting shot in streets and . . ." "Wow. Yeah, boy, that is awful. Do you want to talk to me about that some more?"

Scot: So what I'm getting here, emotional availability, first of all, as men, we have to begin to recognize our own emotions and identify things other than anger.

And I loved what you said. A lot of times we talk about when you need to seek a health professional, whether that be a licensed clinical social worker or somebody else. And a lot of times, as men, we talk about to have some tools to deal with things.

But I think another thing that Mitch just pointed out is to maybe start recognizing emotions that we've never been taught about as men before in some instances. A lot of men maybe have, and I think things are getting better. I don't know if you'd agree or not, Dr. Jones.

Dr. Jones: I do.

Scot: Yeah, as we move forward. I can speak from my own experience. I came from very stoic people. So I probably don't know half the things I feel most of the time. So the first thing you've got to do is recognize your own emotions, and then that's when you can start to become emotionally available to somebody else. Show us what that might look like.

Dr. Jones: Well, how it might look like in yourself, it's what I call the RULER project, which we've done a podcast on actually, which is recognize that you're feeling something that's uncomfortable or something. You're feeling something. Understand what it was. What was the trigger that made you feel that way? Can you label it? Can you give it a word? Can you explain it or express it to others?

That's the step that . . . if someone in my family were upset and they said, "I'm just feeling upset. I'm feeling so sad," or, "I'm feeling really angry," those are the kinds of things that really help someone not get in your way. Or, "Can I help you with that?" or, "What can I do to make this better?" which you probably can't, or, "I want to hear about this because you're important to me."

That's what it looks like when someone is able to say, "This is what I'm feeling and it doesn't feel good," or, "This is what I'm feeling and it feels really good," or, "I'm really happy. And it makes me anxious because I'm so happy."

And then the other person is able to then say, "That explains why you've been stomping around the house all day," or whatever. That kind of opens up a little bit of a dialogue so that people can value each other.

And for guys, in particular, for who modeling emotional intelligence has not been really made clear to them, there's been a lot of shame. So if you feel anxious or if you feel sad or if you feel fear, it's not been okay.

When I look at the uber sort of masculine men on movies, those guys are just . . . I think of the new Jack Reacher. I think, "Wow. I would never want a relationship with that guy. I see his anger. Boy, oh, boy. But I don't see anything else in him."

So I think that many people, men and women, are looking for a long-term relationship, which means, "I want someone to be part of my emotional life, not just my physical life. Not just my cooking or the house that we share. It needs to be a little bit more than that."

Now, once again, not all women are terribly emotionally available, and some men are very. And for some women, they may attach themselves. Women say, "Well, why do I pick these guys? Why do I keep picking these guys?" Well, they also may have this kind of distance modeled for them in their father and it's all they know.

Or they think that not showing emotions is strength and they want to attach themselves to strength because they are anxious. They're not self-confident. They want that burden laid on the guy in their relationship or the other person in their relationship. And having one person be the strong one and the other one being the emotional one. That's kind of hard. You ought to share this stuff.

Mitch: I had a question kind of relating back to mine. I love the RULER technique. I think that, for me, I really appreciate acronyms and strategies and whatever. But that L, that label, I have run into feelings that I don't have a name for, and the best I can do . . . And it's probably modeling and I have to work with my specialist to kind of figure out what it is. But you come up with, "I feel oogie. I feel meh. I feel blah."

And so is there . . . I don't know. I just feel like such a novice here where it's just like, "Is there a guide?" Is there something that I can see all the feelings I could be having or emotion should I should be having and I can kind of point to that.

Troy: It's like the pain chart, the little kid pain chart. "That's my pain right there."

Mitch: The sad face.

Troy: The sad crying face. Yeah. We need the equivalent for men's emotions or something.

Dr. Jones: Well, there actually is an emotional wheel.

Mitch: What?

Dr. Jones: So the people who looked at primary emotions say, "These are the ones that have physiologic consequences and they're immediate." So they happen to you even before you can give it a label. It just is an immediate response fear. Maybe love, happiness, anxiety, you know when it happens because it happens so fast. There are secondary emotions which are combinations of primary and secondary emotions.

Now, what they might feel like? Any strong emotion can raise your pulse and raise your heart rate. Although true Agapeic love, I think, actually can make your . . . I mean, the love of a child, the love of a very good friend can bring your blood pressure down. Holding hands with someone that you love, that actually brings your blood pressure and your pulse down. And they've done this in MRIs and they've looked at what parts of the brain are activated.

Getting a good therapist is a really . . . You say, "I don't know what the name is I'm feeling, but this is how I feel. This happened to me, and this is why I felt like that." If you could say how you feel and you understand what made you feel like that, you might be able to come up with words.

Oogie, I need a little help with oogie. I got oogie. I can kind of feel oogie. I feel oogie below my diaphragm. It's not above my diaphragm. I don't feel it in my heart. I feel it below my diaphragm. Well, what were the things that made you feel oogie? If you told me what made you feel that way, I might be able to put a label on it.

But there is a very beautiful wheel, emotional wheel, that gives people a . . . I can send you guys a link for this and you can work on it, if you'd like. You can spin it around, see how you feel.

Scot: How do you start that conversation if you're the partner and you're thinking . . . Well, actually it could go either way, right? So you're the partner and you're thinking, "You know what? I would like to explore this idea of emotional availability in my existing relationship." Or you're the partner that maybe you're thinking, "I wonder if my partner actually would find more satisfaction in the relationship out of this." I mean, it could work either way. How would you start to progress forward? Because even that name carries baggage, right? Emotional availability to some people could sound . . .

Dr. Jones: It does. It means somebody isn't. It means blame, blame, blame already.

Scot: Or it could just be like, "Oh, that's touchy-feely, I'm not into that."

Dr. Jones: Well, you can just say, "I've been thinking about this." Either one, the person who's got more emotions or the person who's got less emotions, "I've been thinking about this and our relationship is important to me. I do or don't want it to be . . ."

"It's uncomfortable when you cry at the table, but I don't want to shut you off or I don't want to be blocked off from you. So I'd like to learn how to talk about this." This is the guy who sees his wife cry about stuff or his girlfriend or his boyfriend or whatever, and he just doesn't get it. But he loves this person. So, "I see you cry and I need some help. I need some words. Are you willing to work with me about that?"

And then if you're the person with more emotions, "I've been thinking about this and I love you and our relationship is really important to me, but I need to feel that you're tied with me to the things that I feel strongly about. Can we talk about it? I cry at the table because I'm sentimental. All we have to do is talk about my family or our son, and I start to cry, and I don't want you thinking it's sad because it's not sad. It's sentimental. Can we talk about what words I use and how it might make me feel and what I want from you when I feel like this?"

So I think it's better than rather than saying "you" words . . . You guys already know this. "You do this, or you don't do this, or you are feeling this." It says, "This is the way I feel. And can we talk about it?"

I think it would be good if we had a long-term relationship based on the support of each other's feelings, not just our physical needs, or our financial needs, or our spiritual needs, or you name it. I'll go through all the 7 Domains without you guys even knowing it.

Troy: See, Dr. Jones, I want to take a moment here just to put this in perspective. Our most recent episode was on poop.

Dr. Jones: Yeah. And you know what? Your emotions can come right through with your poop, because people who are really anxious can get diarrhea.

Troy: I'm just saying this is hard even for me to think about it. So I am empathizing with any man out there right now who is listening to this and hearing you say these things and saying, "These are things we can say to our partners." This is a stretch. This is tough.

And I agree. I have definitely taken the approach of, for whatever reason, you kind of push emotions down. And it's hard to acknowledge those emotions in a partner and ask them to express those emotions. I think maybe we are afraid of what they're going to say, or we're afraid of being responsible for those emotions or triggering those, or whatever it might be. But yeah, this is a lot harder to talk about than poop. I'll say that.

Scot: So, Troy, question.

Troy: Yes.

Scot: Question for you, Troy. All those things that Dr. Jones just said, if that was coming from your spouse, would you, as a man, with your history, cringe a little bit? Would you be like, "Oh, boy, here we go. I don't know about this. This sounds pretty intense"?

Troy: I would cringe a bit. Yeah. I will say, honestly, I feel like . . . and maybe Laura will disagree. She'll listen to this and be like, "No, you haven't." I will feel like I've made progress there.

I think, like you said, Dr. Jones, the key to this is just acknowledging your own emotions. Often, I've really tried to acknowledge more, "Okay. When am I feeling anger? When am I feeling anxiety? And what's the root of that?" And a lot of times it gets down to, "Oh, I'm sad and it's coming across as anger," or, "I'm anxious. I've got a shift coming up in the ER and I'm feeling anxious about it. And that's coming across as, again, maybe as anger." It seems like a lot of these things come out in men as anger, and I've definitely felt that in myself.

Dr. Jones: They do.

Troy: But again, hearing you say those things, I think, for me, emotional availability has been trying to be more aware of my emotions, and often what the root of . . . Even what may seem the emotion, there's a deeper root to that. And then be willing to express that and talk about it. But it's hard.

Dr. Jones: It is, but the work is worthwhile. Maybe Mitch can even speak to this. It gives you a much broader palette with which to paint the tapestry of your life. When you have some words, some colors to explain the things that you've seen . . . You have a powerfully rich life, Troy, in what you've seen and how you deal with that, the words you use or how you color that, what an amazing life you would lead if you had a little bit of contact with those.

Mitch: And from my perspective to "man it up a little bit" is another tool in the toolbox, right? No, if you don't have the right socket, you can't fix a certain thing on your car.

And so, for me, I knew that I was not in a good place and it wasn't until I was able to actually recognize, discuss, and talk about, even to myself just in my head, the emotions I was feeling, there was no way for me to actually start to work to fix it.

And so if that's the very baseline of at least my . . . Yes, I'm living a more full life. Yes, yes, yes. I feel it every day. But for a part of me, not feeling like garbage all the time and being able to know that I'm taking active steps to fix it, and all it took was a bit of acknowledgement and a bit of vocabulary, has been night and day within the last year.

Dr. Jones: Yeah. Amazing.

Scot: Would you say that there are two aspects . . . I'm picking up two aspects of emotional availability. I think Troy has kind of hit on one, right, which is a man's ability to talk about what they're feeling, thinking, etc. But it's also a person's ability, whether a man or a woman, to be receptive to the emotions of another person. And we haven't really hit on that as much. How can somebody start to work on that?

Dr. Jones: Well, I think once you've learned . . . getting back to starting with yourself, if you can forgive yourself . . . When you say, "This emotional response is normal. It's natural. It's real. I'm an intact human person, and I forgive myself because I felt angry or sad or whatever," then when you realize that someone is feeling that way . . .

In fact, it's often not about you. I think you're afraid you're going to get the downstream effect if you recognize, or at least, "Gee, it looks like things are harder. I feel like you're having a hard day. What can I do for you?" And if they break down and cry, then just go put your arm around them. You don't have to do anything bigger than that for a start. And then if they unload all of it, just say, "I'm listening. I hear you." That may be all that it takes.

Scot: So instead of avoiding it and pretending that's not going on in your life, maybe just acknowledging it would be a good first step.

Dr. Jones: Or don't analyze it. "Boy, I got into trouble." "Oh, I see why you're so angry." "Boy, you could be angry because your dad did this and then your boss did that and you're feeling inadequate. Boy." No, that does not go well because that's all those "you" words. "You're feeling this and you're doing that."

Say, "Wow. I'm so sorry. Can I sit with you a little bit? Talk to me about it." Don't try to analyze. Let them use their words. Just let them know that you're seeing and you're hearing and you want to be there with them, whatever they're feeling. You're not going to run away from it.

Scot: Let's wrap this up. Troy, what did you take away from the episode and what's something that you're going to try based on what you learned today?

Troy: You're putting me on the spot, Scot.

Dr. Jones: Never, never, never do it.

Troy: I know there's someone is listening to this episode.

Mitch: Oh, no.

Scot: What does that somebody want to hear?

Troy: This is really putting me on the spot. That someone probably wants to hear that I will say exactly what Dr. Jones said. Number one, I will not say "you." I will not use a lot of "you" words, which I sometimes have a tendency to do, like say, "You seem angry," or, "You seem sad." And rephrasing that as . . . I wish I could remember exactly how you said it.

Scot: That would be helpful.

Troy: Yeah. "Something seems off." I will say it that way. I'll say, "Something seems off. Is there anything you want to talk about?" Maybe rephrasing things that way and being willing to say that, first of all, and then saying it the right way.

Scot: How about you, Mitch?

Mitch: I feel good that I'm kind of on a journey. I keep using that word. It's so overused. I'm just glad to know that the kind of work that I'm doing right now can lead to a more colorful, more interesting life, and recognize that, as an individual, I feel a lot more than just anger, right? And being able to recognize that, talk about that. I'm hoping that my relationships can be a lot stronger.

Dr. Jones: Yeah, and especially your relationship with yourself. The inner voices that you have that aren't always supportive, they're not always nice voices that you hear, and saying, "Wait a minute. That's not me. That's my inner voice that's saying, 'You're not good enough,' or you're this, that, or the other." Being able to forgive yourself for when you feel a certain way so that you can process and move ahead and take a deep breath. Take 10 deep breaths. It's just a lot easier. You will find yourself feeling better. Mitch, you put it better than I possibly could.

Scot: I think the thing I'm going to take away is I tend to ignore other people in my life, meaning when . . . I don't want to ask, "Hey, something doesn't quite seem right. You want to tell me about it?" because I'm afraid of what I'm going to hear, right? I'm not going to be able to deal with "I'm sad" or "I'm angry" or "I'm whatever." But I think I'm going to try to be brave, and I think I'm going to try to start acknowledging that and doing that and seeing how that works out for me.

Dr. Jones: Be brave. I think about that.

Troy: I like that. Yeah.

Dr. Scot: The firefighters who ran toward the burning building of 9/11. Be brave. Being available is being brave.

Scot: We'll do that, right? Men will run towards the danger like that. But if we think that somebody we care about is angry at us? Oh, man, we're not going to bring that up.

Troy: And I'm also going to say I will not tell whoever this individual is, who I happen to be speaking to, that I'm running toward the burning building on 9/11.

Mitch: Oh, no.

Dr. Jones: Don't do that.

Troy: That would not go over well, but it's a good analogy. We do have to be brave.

Scot: Well, Dr. Jones, I think this is a step in the right direction hopefully for any guy that wants to maybe become more in touch with their own emotions or be more supportive of the emotions of those in our lives. And sometimes our best lessons on the men's health podcast come from wise women such as yourself. So thank you for caring about men's health and being on the show with us today.

Dr. Jones: You're so welcome. It's been great.

Scot: Hey, congratulations. You made it this far. You even made it beyond the end. This is Scot from "Who Cares About Men's Health," and it just dawned on us that if the topic we talked about in this podcast is something that's important to you, and you'd like to perhaps get some emotional availability in your relationships, and you don't know how to have that conversation with your partner, use this podcast as a tool.

Tell them you heard it. Let them listen to it. That way you're starting from some sort of a common place. And then let the discussion go from there. So use this podcast as a tool and share with somebody in your life that you think could benefit from it.

All right. That's it. For real, we're gone this time. Thanks for listening. 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.

Troy: You've got to say something like, "Troy puts the stud in studies," or something like that. Something good. I'm just kidding.

Scot: I will never say that.

Troy: I was just trying to think of something better than "Troy's articles" or whatever you called it.

Scot: That's us. It's a "Sideshow" episode. That's what we like to call a soft start. You caught us in the middle of a little prepping trying to decide what we're calling this segment, where Troy scans the medical journals so you don't have to and then shares an article that hopefully is of some interest.

Troy: Hopefully.

Scot: Yeah, this is "Who Cares About Men's Health," a "Sideshow" episode. My name is Scot. With me, as always, the MD to my BS, Dr. Troy Madsen.

Troy: Hey, Scot.

Scot: And Producer Mitch.

Mitch: Hey there.

Scot: All right, Troy. Let's take a look at your articles, hear what you've got. Go ahead and put those articles on display.

Troy: Look at the articles.

Scot: Yeah. Go ahead and put those articles out on display for us. We're going to pick one.

Troy: Oh, we're picking?

Scot: Oh, yeah. I mean, unless you just decided you had one that you . . .

Troy: I decided.

Scot: Oh, okay.

Troy: This title is so good that I knew even if I gave you my list of five, including the one on green urine that I keep trying to get you to pick, I know you'd pick this one.

Scot: All right.

Troy: And I'm just going to read it to you and if you don't like it, if you're just like, "No, we would not have picked that one," let me know and I'll pull up some other ones.

Scot: Okay.

Troy: The title of this article from the "Journal of Emergency Medicine," the title is "Battlefield Acupuncture Versus Standard Pharmacologic Treatment of Low Back Pain in the Emergency Department: A Randomized Controlled Trial."

Mitch: Oh, Troy, I did a bunch of interviews about this. Keep going.

Troy: Yeah. Tell me I have not piqued your interest.

Scot: So when you say battlefield, you mean like a war battlefield?

Troy: That's a good question.

Scot: Oh, okay. Well, I guess, Troy . . .

Troy: I'm hoping I piqued your interest enough that I can . . . I'll explain what battlefield acupuncture is. I didn't know before this article.

Scot: Move forward with this one. Go for it.

Troy: Okay, we got it. So battlefield acupuncture, to your question, is a technique using acupuncture. So you're familiar with acupuncture? You use these little needles in different spots. Ideally, the way this is designed, it's supposed to then relieve pain or lead to different effects.

Acupuncture, of course, is considered an alternative therapy, and it's one of those things where it has gained more mainstream acceptance as these types of studies have come out. But it's been considered a traditional therapy, an alternative therapy. It is not something I have ever done or have ever practiced. I did spend a day shadowing, spending time with an acupuncturist during med school, which was really cool, to kind of see what she did and hear her philosophy and see her approach and see the patient's response.

But battlefield acupuncture is a technique where there are certain little needles that look more like little tiny darts that are placed in specific places in either one or both ears.

The idea behind this is that these spots are said to influence the central nervous system pain response. And by putting these little needles in these different spots in the ear, they then decrease pain that is coming from other sites in the body. I mean, that's the theory. Again, I'm not a traditional practitioner, but I'm just kind of reading what I found on it.

Scot: Time out. In the ear, or in the part around the ear, or the earlobe?

Troy: In various parts. So yeah, let me clarify that. Not in the tympanic membrane. You're not going in the ear hole. These are different spots . . .

Scot: Okay.

Troy: Yeah, these are different spots on the auricle of the ear. You do not want to puncture the eardrum. These are spots . . .

If you just do a Google search for this, you can see photos of where these spots are. They're basically at the very top of the auricle of the ear, so the very top of the ear, and then kind of maybe half an inch down from there. And there's another spot half an inch down from there. There's a spot on the earlobe. There's a spot just on the very front part of the earlobe.

So they're like little tiny darts, and they actually have a tool that you use to place these. They just stay in place until they fall out. So it's usually three or four days. You put these in there, you leave them in, and you just send people home with these in place.

Scot: Wow.

Troy: Yeah, it's fascinating. Again, I have never done this. I've never been trained on this. This is the first article I've seen looking at treatment of low back pain.

And then you might ask, "Why would I even care about this? Because surely I have some great treatment for low back pain." I can tell you that when you see a patient come to the ER, the first thing you'll see is their name and a chief complaint and that's what shows up. And when the chief complaint is low back pain, that to me is one of the most frustrating things to go and see because there is so little that I can offer.

It used to be these patients would come in and everyone would just get opioids, like, "Okay, here's your script for Norco or Lortab." That's a horrible way to approach it and that's what's led to the current opioid epidemic.

So now when people come in, I say, "Well, you can try ibuprofen or Tylenol." "Well, I've already been trying that."

"Well, you could try some lidocaine, some numbing cream on there." "Well, I've tried that."

"Well, you could try physical therapy." And we actually had a physical therapy in our emergency department and did a study on it, and that was great. But that person was only there 30 hours a week and the emergency department is open 24/7, so that's not something I can offer that often.

So if there was something I could actually do and say, "There's evidence behind this and this is going to help you," and people actually did it and said, "Wow, it helped me," that would be really cool.

So this study, essentially what they did is they took patients who came into the emergency department . . . It's a fairly small study, more of a pilot study we would call it, where it's kind of like, "Hey, let's try to see if it works. If it works, let's do a bigger study."

So they only had 52 patients. Twenty-six of these were randomized either to getting this battlefield acupuncture done or to just standard treatment, which would be the stuff I talked about where it's just like, "Hey, do whatever you normally do."

The patients with the battlefield acupuncture had a significant decrease in their pain score when compared to the patients who just had standard treatment.

And they then contacted these patients two to three days after they were there and found that the patients who had the battlefield acupuncture continued to have a significant improvement in their pain scores compared to those who were sent home either with a prescription or with just standard stuff we would do for low back pain.

Of course, there were no difference in any adverse effects. It's not like these patients were getting a lot of infections, they were complaining of a lot of pain or bleeding, or anything like that.

So their conclusion was that this potentially shows some promise. I can tell you please don't come to the ER right now and ask for battlefield acupuncture, because we don't have the tools there. It is not something we're doing. But maybe a study like this and some subsequent studies, if they continue to show this works, maybe it's something we're going to learn to do. I would love to be able to offer something better than what I can realistically offer in the ER.

So kind of a cool study. A pretty simple thing, it looks like, to do. It's just something we're not doing now, but maybe we'll see more of this in the future.

Mitch: I have to chime in because I've done it.

Troy: So when you say you've done it, have you performed this on people?

Mitch: Yes, I have.

Troy: Wow. This is cool.

Mitch: Okay, so 2011, it was my old life as a documentary filmmaker. We were working on a project called "The Painful Truth," and we were traveling all over the country investigating chronic pain patients and how they are treating their different conditions and how it impacts their family. And I got to actually go to this big medical conference. And one of the rooms where they were doing a breakout session was all about battlefield acupuncture.

You go in there and up on front, there's like this cute small woman who's been studying it and she published the paper. And then there are these military guys in full uniform with all their awards and medals and everything, talking about how they were using acupuncture in the ears and the tragus and all these different parts to stop people from going into shock on the battlefield.

Troy: Wow. So that's where it got the name then. I had no idea before this.

Mitch: So I was actually able to get one of them to be interviewed with us. And when we were talking about the interview, he pulls out first an orange and he's like, "Here's the tool. I want to show you how easy it is here. Here, why don't you go ahead and put some of these little brads in." And it's like a little gun and it's just, "Pew, pew, pew." So I bedazzled an orange.

And then he's like, "Do you want to see what it feels like?" And I'm like, "Absolutely, yes, a thousand times." And so he clips my ear. I'm trying to find some photos of it right now. But he clips my ears, and I didn't feel anything because I wasn't going into shock. But I'm like, "Wow."

And then he asked if I would feel comfortable doing it with my cameraman, and I said, "For real?" And the guy was not sure, but I'm like, "Oh, come on. It'll be fun." So yeah, I got to basically bedazzle my cameraman's ear with this tool. And it was just . . .

Troy: Did they draw the spots on there for you to shoot this little gun into, or did you just see it and you're just like, "Okay, there, there, there"?

Mitch: So they had a little printout and they were like, "Here's where you're going to do it." And then when I was doing it, he took his little Sharpie and did little dots on the guy's ear to be like, "Here's where you're going to shoot it."

Troy: Make sure you hit the right spots, yeah.

Mitch: And so the big part of it is that this for them at that time was . . . This was not necessarily something that a battlefield medic would need to have special training for. They can train anyone to do it, right?

Troy: Yeah. It's sounds so simple.

Mitch: So it was really kind of cool to . . . And especially for him, the guy who was giving me the interview and everything, he was like, "These for so long have been treated as 'alternative medicine.'" Big quotation fingers there. But they're starting to find real applications. And so it's kind of exciting to hear that you also found a study about it.

Troy: Yeah, that is fascinating. Again, it's not something I've ever been trained on. And there probably are other emergency-department-based studies that have done this kind of thing, but there are not a lot. And maybe there are some others with low back pain, but this is the first time I've seen this.

I would love to be able to do this. Again, I would love to also maybe see some larger studies just saying, "Yeah, this panned out and we are seeing an improvement and this works."

Again, Mitch, like you said, it sounds super simple to do. As I've looked at pictures of it, it's like, "Okay, just hit these five spots." It's not rocket science, and you just need that tool, the same tool you had, which we don't have. But that's so cool you were doing that.

So if we can do this, I'm going to bring you in to teach us all how to do it, Mitch. Apparently, you're the expert now. You have more experience with this probably than any physician in our emergency department. So you're coming in.

Mitch: Okay. All right.

Troy: I love it.

Scot: Can we get you one of these guns on eBay?

Mitch: I don't know.

Troy: They have them on eBay?

Scot: What do they cost? What does one of these things cost?

Troy: I don't know. I've never looked into it.

Mitch: It was like a handheld staple gun. It was between a hole-punch, like one of those single handheld hold-punches. It was kind of like that plus a staple gun. It didn't feel too technical.

Troy: Yeah. We should probably clarify. Don't do this at home with a staple gun. It would be unwise and unsterile. But yeah, it seems like if you have the proper tools and a sterile device that's designed for this, it doesn't sound difficult.

Scot: Troy is a physician, right? Mitch mentioned something that resonated with me. Alternative medicines, right? There's a lot of stuff out there that people swear by. But as a physician, or at least many physicians I've talked to, until they can see some hard evidence that it actually makes a difference, they don't really accept it as a treatment. But it sounds like you would be in all the way on this because of this study?

Troy: I would like to see at least a couple more studies that replicate the results. At the same time, I don't want to just do something just to do it. It would be nice to see something that helps. I would be open to doing this if a patient . . . if I talk to them about options and I said, "Hey, there's been a small study. It seems to make a difference."

The big thing for me is, "Is there a big downside to this? Am I going to be causing harm?" And if I'm not going to be causing harm, and they did not report significant adverse effects with this, if I'm not going to be causing infections in their ear, or a lot of bleeding or things like that, and there's reasonable evidence to support it, I would offer it to a patient specifically that way. I would say, "This is something . . . there's been a small study." I'd say, "We can try it if you're interested."

Scot: And if this really did work, that sounds like it would change your life. It would make you go from seeing name and back pain to name and I can help this person. Name and back pain, going, "Oh, geez," to name and back pain and, "I have something I could probably do."

Troy: I would love to have that. If anyone asks me, "What is the most frustrating thing you deal with in the emergency department?" it is back pain, because people come there wanting answers and wanting a quick fix and it's a 15-minute discussion often of saying, "Hey, this is what you need to do. It's going to be a long process. You're going to have to do physical therapy. I'm not going to prescribe opioids for this. I do not want to do that. I do not want to create potential for addiction." And then I'll offer them the Lidocaine, things like that, and say, "Well, maybe this will help."

But yeah, to be able to just be like, "Yeah, I can try this. We can do this and there's evidence to support it," would be wonderful.

So we'll see what happens. Again, it's one of those articles where you see it like, "Oh, that's really cool." I can't say it changes my practice right now where I'm going to start doing this. Obviously, I don't have the tools to do it right now or the training. But it's one of those that maybe we're going to see more on this. It takes a while for these things to come into practice, but maybe in five years, this will be a standard approach in the emergency department. Who knows?

Scot: All right. You made it to the end. Good for you. Be sure to check out some of our other "Who Cares About Men's Health" episodes.

What you just heard is what we call a "Sideshow." It's where sometimes we talk about health topics that aren't necessarily directly related to what we normally would talk about, which is the core four plus one more. That is to be healthy now and in the future, you should concentrate on your nutrition, your activity, your sleep, your emotional health, and you've got to know your genetics.

Plus, we also have episodes that are dedicated just to men's health issues. So check out some of those episodes as well.

And if you know somebody that would find any of them useful, please go ahead and let them know about the podcast. It's the best way that you can help us grow the podcast.

If you want to reach out, lots of ways to do that. You can call us at 601-55SCOPE and leave a voicemail, you can email us at hello@thescoperadio.com, or you can check out our Facebook page. That's facebook.com/whocaresmenshealth.

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: Troy was out of town, so I was not able to call Troy with a medical issue that I had.

Troy: Oh, no.

Scot: Yeah. I mean, you were on vacation. I wasn't going to bother you.

Troy: Thanks.

Scot: I mean, I more or less knew the answer, but I thought it might be an interesting topic. And I think maybe we can learn something, especially if you have kids, or if this happens to you. So I swallowed a crown last week.

Troy: So a crown from your tooth? This was not a toy from a Burger King meal.

Scot: No.

Troy: A child's meal. This was a crown that popped off your tooth and you swallowed it?

Scot: Yeah. So I'm just eating a sandwich, and then the next thing I know, I've got this raw nub of a tooth in my mouth. I'm like, "What happened?" And I check around in my mouth and the food, and it's not there.

Mitch: What was in that sandwich to knock a crown off?

Scot: I don't know. This particular crown has been problematic. I don't know if it was made right. I've had to have it glued on a couple of times.

Mitch: Geez.

Scot: So, anyway, I swallowed this crown. Now, the first thing I think . . . Do you guys want to guess what the first thing I think is?

Troy: The first thing I would think is, "Now I'm going to have to sift through my poop for the next four days to find this stupid crown."

Scot: Yes. Right.

Troy: That would be my first thought. I would not be concerned about this crown being in my stomach. I would be concerned about what's going to now have to happen over the next four days, depending how frequently you have bowel movements.

Scot: Yeah, because I wanted to retrieve that. Crowns aren't cheap. They're kind of expensive, right?

Troy: Like a thousand bucks, aren't they?

Scot: What's that? A thousand? I don't know.

Troy: They cost a lot, yeah. To make a crown is not cheap.

Scot: I mean, they take time to make it. That's going to be two trips minimum to the dentist, one to get the mold and then the other to install it. So I'm like, "All right. So I wonder, first of all, when do I need to start worrying? Is today's bowel movement going to be something I need to worry about, or . . ."

Troy: "Is this the one?"

Scot: Yeah. Or do I need to wait a little bit? So I started doing some work on the internet. And we've talked in the past about, is it a concern? When should you be concerned when you swallow things?

Troy: Yeah. So were you concerned about that? Were you concerned about it causing problems in your intestines, or was it more just like, "I've got to sift through my poop"?

Scot: Yeah. I mean, from what I've learned from you, unless it's got some sharp edges, or it's really, really big, if it can make it down your throat and it's got smooth edges, you're probably going to be okay and just pass it if you're an adult.

Troy: Yeah. I love that you took that. Really, if it's wider than three centimeters, or longer than five centimeters, or it's sharp . . .

Scot: Can we talk about this in inches? I mean, what country do you think we're in?

Troy: If it's wider than 2 inches or longer than 3.5 inches . . .

Scot: Better.

Troy: . . . that's when you get concerned.

Scot: That's a pretty big object.

Troy: That's pretty big. Or if it's sharp. If it's big, it's not going to get past your stomach. You've got the pylorus there, which leads out of the stomach into the duodenum, the small intestines, all that. So if it can't get past that, it's going to block it. So that's the problem. But yeah, a crown, that's really small. You're fine.

Scot: So clarify something. I could theoretically swallow something that is too big to pass from my stomach into my small intestine?

Troy: Oh, for sure.

Scot: Okay. So the throat is not the limiting factor here, unfortunately?

Troy: It's not the throat. No. It's the stomach going into the small intestine. And on a regular basis . . . not super regular, but it's not uncommon for me to see people who intentionally swallow items, adults who intentionally swallow items, and then we have to call the GI doctors in because it meets one of those criteria, and they have to go in and fish it out. It's just sitting in their stomach waiting to block things up. But you were fine with your tooth. That's not a big deal.

Scot: So, anyway, during this kind of search, I found out some interesting fun facts, and then we're going to get back to what a recovery effort looks like in a situation like this. When you start thinking about . . .

Troy: I've got to ask you this, Scot. Did you really want to put a crown back in your mouth that has . . .

Mitch: That's what I was going to say.

Troy: . . . gone through your small intestines and large intestines that you pulled out of your poop? I mean, is it worth the money saved? I don't know. I'm curious where this is going.

Scot: Yeah. I've always wanted to have the name "stinky tooth," so maybe, the nickname.

Troy: Rot Mouth?

Scot: All right. So a couple of little fun facts that I found. This was kind of interesting as I'm doing the search. So there have been a lot of studies looking at coins. If you swallow a coin, how long does that take to pass? And the range is anywhere from 3.1 to 5.8 days, average of about 4 days to pass a coin. There was actually a group of pediatricians that did an experiment where six of them swallowed a small LEGO head.

Troy: Oh, boy. This is good.

Scot: Because kids . . . And this was actually published in the "Journal of Pediatrics and Child Health."

Troy: Oh, I love it.

Scot: Yeah. They swallowed these little, small round LEGO heads, and they wanted to find out how long it took to pass through their systems. Obviously, pediatricians would have an interest in that because of kids. So they kept a daily diary of their bowel movements, and they recorded these little details, like the texture that could potentially impact the toy's . . .

Troy: Oh, that's awesome.

Scot: . . . travel time through their systems. By the way, they called that the SHAT scale.

Troy: Love it.

Scot: They had to rate their turd's qualities on the SHAT scale, which stood for Stool Hardness and Transit.

Troy: So good. That might be the best scale acronym I've heard. I've got to start using that.

Mitch: Who are these scientists?

Scot: This was a group of internationally renowned pediatricians, is who this was.

Mitch: They're just choking down some LEGOs, and then . . .

Scot: Yeah, and then sifting through their own. And then the other thing is when they recovered it, they call that their FART, which was the Found and Retrieved Time score, their FART score.

Troy: I love it.

Scot: Anyway, LEGO heads, there was a range of 1.14 to 3.04 days, with the average being of 1.71. The women pediatricians passed it faster than the men. Why? I don't know. And one of the pediatricians never found his LEGO head after a week.

Troy: Oh, wow.

Scot: So it could have been he didn't pass it. It could have been he missed it.

Troy: Probably missed it.

Scot: So, anyway, those LEGO heads went through faster than a penny. Why would you say that is, Dr. Madsen? It took a penny four days. The average was 1.71 on the LEGO heads.

Troy: Well, imagine a penny in a stream and imagine a LEGO in a stream.

Scot: Sure.

Troy: That's my theory.

Scot: A round LEGO head versus a flat penny.

Troy: Yeah. It's like having the wind at your sails with a LEGO. You've got more stuff pushing. You've got more surface area for it to push than a penny, which can maybe just sit there and stuff moves around it. I don't know. That's my theory.

Mitch: Is that the twist? Does Scot have a bunch of LEGOs for us to swallow?

Troy: Is this where we're going now?

Scot: Yes.

Troy: Please, no, Scot. Please, no. I'm still traumatized by the cooking stuff. Don't make me do this.

Scot: I like to think in holistic terms on the show. We dealt with cooking, which is in. We're going to deal with the out now.

Troy: And then we'll evaluate our own transit times.

Scot: So, anyway, back to the crown. So then I started thinking about, strategically, from a practical standpoint, how do you recover it? And this is when I actually wanted to call you, because I'm like, "I could take some laxatives and whatnot." But then it's just under the bottom of a muddy, yucky bowl.

Troy: So let me get this right. You wanted to call me. I wish you had, now that you're telling me this story. I wish I had not been on vacation. But you wanted to call me to ask me how you should sift through your poop to find your crown?

Scot: Yeah. I wanted some ideas.

Troy: As if I, number one, regularly counsel people on this, or, number two, do it myself?

Scot: It's possible. So I did a quick internet search, and it was really kind of surprisingly difficult to find on Google how to do this from a practical standpoint. And then finally I did. And this is another interesting thing. You can see how one person's idea can travel on the internet, because I found the exact same idea on numerous different websites almost verbatim, all these websites almost claiming it as their own.

Troy: Let me tell you what I would have told you, Scot, and I'm curious if this coincides with what you found. If you would have called me, I would have said to poop into a colander, like one of those strainers that you would use for spaghetti or something. Poop into that. Stick it . . .

Scot: "Hey, honey, where's the colander?"

Troy: "Can you get the colander?" Put it in the shower and then take a showerhead, especially if you've got one with a handle on it, with hot water, and just soak that thing, and let that poop break down and run out of it. And then the tooth would stay in there. That would be my advice. It limits the amount of time you spend touching the poop and sifting through it, which sounds absolutely disgusting. So that's what I would have told you.

Mitch: Have you suggested this before? That seemed like a very quick answer. Have you just thought about this hypothetically?

Troy: Neither, Mitch. I can't say I've ever thought about how to do this. If Scot had called me, that's what I would have said. To me, this makes the most sense. I'm not touching it and taking a fork or something and . . . That's what I'm trying to imagine. Would you take a fork or something, and push on it, and see if it hits something? I don't know. It sounds awful.

Scot: So there were a couple of suggestions I saw that talked about that theory. I didn't want to spoil any of our kitchen utensils, so that was out for me.

Troy: The colander theory? You're talking about the one I came up with?

Scot: Yeah.

Troy: Oh, okay.

Mitch: The Madsen Colander Technique.

Scot: You've been wanting to get something named after you. Maybe that's it, the Madsen Colander Technique for recovering stuff you swallowed.

Troy: It's called the MC Poop, the Madsen Colander Poop . . . the MC Poop Technique.

Scot: Yeah. And then you could do some research papers on this, because I think you're right. I think minimizing the actual touching, and the time, and where is that going to go after you're done is key to this process. That was what was in my mind, too.

I like your idea better. But I was thinking a colander is better because it's got fewer holes. I was thinking a strainer, one of those wire mesh strainers, or a screen. "Hey, Honey, why are you taking the screens off the window?" "Don't worry about it."

Troy: "Don't mind me. Just doing a thorough cleaning of the screens."

Scot: The other idea that was out there was you get a solid bucket, like something you can sit on, and for the next few days, you poop in that bucket. And then you take two plastic knives and you just mash it up until you find what you're looking for.

Troy: That sounds horrible.

Scot: Yeah, it does.

Troy: That's bad. That sounds horrible, because that's too much . . . for a knife to hit it, you've got to be cutting every quarter inch through that thing to . . .

Scot: Oh, you're cutting and mashing, is what you're doing. You're not just cutting.

Troy: Yeah, I don't like that.

Scot: And then you've got dirty knives afterwards and a dirty bucket.

Troy: It sounds messy.

Scot: One guy actually in some comments said he didn't do that, but he put newspaper on the bathroom floor.

Troy: No. Definitely colander technique. Definitely go with the MC Poop Technique.

Scot: So how dangerous is that if you start colandering your poop? I mean, it's gross, yes. Could you get sick from that?

Troy: If you are at the same time perhaps eating one of our candy bars or granola bars that we made, if you have one of those on the side and you're reaching for that. I think as long as you're not touching your face or your mouth, you're fine, and you wash your hands after.

Scot: Got you.

Troy: But it just sounds disgusting.

Scot: And then the other thing is, after you get it out, then your point was a lot of comments, is like, "Sure, if it's a gold one, maybe, because I'll get the gold value back. But I don't know that I want that in my mouth." And people were like, "Well, make a bleach mixture of blah-blah-blah. And then when you take it to the dentist, they'll . . ."

Troy: Yeah, sterilize it.

Scot: "They'll sterilize it too." I don't know if I took it to the dentist, if I told the dentist where it came from, if he would even put it back in your mouth.

Troy: Yeah, I would not tell anyone that story.

Scot: So, anyway, I chose not to try to recover.

Troy: So, end of the story, you did not do either one? You were just so turned off, you said, "No way"?

Scot: Yeah. I just decided that wasn't worth it.

Troy: I probably would have done the same thing, honestly. I would have said, "Well, got to get a new crown made." I mean, it's going to cost you . . . I don't know how much the crown itself costs. Maybe it's like $500, but it's . . .

Scot: I guess I'll find out.

Troy: I guess you'll find out, unfortunately.

Scot: Yeah. So is there a chance that something like a crown could stay in your stomach, or is it pretty good chance it's going to pass through?

Troy: It's going to pass. It's small enough. It's not going to have an issue.

Scot: Mitch, would you have tried to recover?

Mitch: Not at all. No. The rabbit hole of internet research you did and everything just would not have even entered my mind. It would have been like, "Call up the dentist and be like, 'Hey, I need a new one immediately.'"

Troy: It's like, "I'm out."

Scot: Troy, would you have considered doing it for a moment?

Troy: I would have considered it for a moment. Absolutely. But then as I thought through the logistics of it, and I thought through using the colander and all that kind of stuff, which would probably be my go-to, I probably would have said, "It's not worth it."

Scot: And how did you propose getting it into the colander?

Troy: Just poop straight into it. Sit on the toilet seat, hold it under you, and poop straight into it. I mean, how else are you going to do it?

Mitch: It's got me thinking of . . . Our colander is one of those that you can pull the sides out, and it fits across the sink.

Troy: Oh, that's awesome.

Mitch: So we'd just do one of those, and then into the . . .

Troy: That would be ideal.

Scot: So you're just pooping straight into the colander, not with it in the toilet or anything?

Troy: So, basically, if you had Mitch's colander, it'd be ideal. But most of these have two handles on them. You could sit down on the toilet seat so it feels natural for you. You could still hold on to those two handles. I mean, you could even drop that colander into the toilet bowl. Who cares if it's all wet?

Mitch: That's true.

Troy: You could just drop it in there.

Scot: Then it's like panning for gold.

Troy: It's like panning for gold. You've got to pull it out because then I think you really need to put it in the shower, and you've got to have hot water because that's going to dissolve stuff most easily. I think then you put in the shower, you just turn that hot water on, you just leave it on, let it run, walk away, come back in 15 minutes, hopefully everything is down the drain, and you've got whatever is going to stay there is going to be there.

So, again, if you did have corn on the cob, or ate peanuts, you might see some relics there. We'll refer to that as fool's gold, but eventually you would probably find what you need, whether it's the tooth or whatever else you're searching for, or some valuable penny you swallowed, or whatever.

Scot: All right. Well, I hope we've learned some lessons from this. Lesson 1, if you swallow something, you know when to be concerned or when not to be concerned. It depends on the size and it depends on the sharpness, when you would want to go to the ER. We have an "ER or Not" at thescoperadio.com where Dr. Madsen talks about that if you want to get more details on that.

This is for adults too. So I don't know kids. I would imagine all that stuff is smaller, and it's probably a little different for kids. I mean, you're not a pediatric ER doc, so you probably don't know either, do you, Dr. Madsen?

Troy: It's all pretty similar for kids. The big thing with kids . . . a lot of things you see with kids is coins. They will swallow coins, and you have to be really careful there because they may breathe it in their lungs. You may see a coin in their mouth and then it's gone. They may breathe it in. It gets stuck in their trachea, or it gets stuck in the esophagus. You can just search on the internet and find these cool X-rays of this coin just sitting stuck in their esophagus. So that's not an uncommon thing in kids.

Scot: Even with this crown, it said, "Make sure that you swallowed it and that you didn't breathe it into your lungs." Can you breathe it into your lungs? Is that a thing?

Troy: Sure. I mean, if it somehow popped off as . . . Let's say you're exercising and taking a deep breath. But you would know it's there. You would want to cough it out. I will tell you your crown is not in your lungs right now. Don't worry about that.

Scot: Okay.

Troy: Yeah, you would feel it. It would irritate it like nothing else. You would want to cough it out. If it's stuck in your esophagus, you're going to feel it too. It's going to be hard to swallow. You're just going to have this feeling in your throat like something is stuck there. You'll know it's there. But those are big things to watch out for.

Scot: Nonfood items that meet the size requirements Dr. Madsen threw out that are smooth and that aren't dangerous, otherwise, like button batteries, if anybody swallows a button battery, ER. Do not pass Go. Go straight to the ER.

Troy: Yeah. And that's a big issue with kids too. Those button batteries can cause erosion through the esophagus and all kinds of issues. And those size measurements I gave you, those are going to be smaller in kids. There, you're going to be a little more cautious. But the sharp thing, that's one of those things. If it's sharp, it's got to come out, if you can get to it.

Scot: So, anyway, there's my crown story. I'm going to the dentist today, actually. I'm going to ask the dentist if they would have put the crown back on if I'd have brought it in. I'm going to ask them if they've ever encountered this before.

Troy: Well, Scot, since you told this story, I have to tell just quickly my favorite story from residency.

Scot: All right.

Troy: We had someone who came in and said they swallowed a pencil. So the resident and the attending physician are asking, "Well, okay, do we really trust him?" Kind of said, "He may have some ulterior motives with this." There were some other circumstances.

So they asked, "Would a pencil show up on an X-ray?" So they had the great idea, "Let's tape a pencil to this guy's back. We're going to shoot an X-ray of the stomach, including the chest. And if the pencil on his back shows up on the X-ray, but we cannot see the pencil in his stomach, we'll know that we could see it if it was there, and we'll know he didn't swallow it."

So they take him over to the X-ray. They tape a pencil to his back. They go to shoot the X-ray. The guy reaches on his back, pulls the pencil off and swallows it. And on the X-ray, they see two pencils.

So they got their answer, but have fun explaining that to the GI doctor when you call him and you say, "Hey, I've got a guy with two pencils in his stomach you need to come and fish out." They say, "Why does he have two pencils?" "Well . . ."

Scot: "One was him. One was us."

Troy: "One was us." Yep.

Scot: All right. Well, thanks for listening to the "Sideshow." Next week, back online with an episode we're really excited about. We're going to talk to a listener, Brett, about a condition he was diagnosed with called fatty liver disease. I think we're going to tentatively call this episode, "Hey, whose liver are you calling fat?" We'll find out what that diagnosis means, which more and more people are getting this diagnosis, and what you can do about it. Is it exercise? Is it diet? Listener Brett on the next "Who Cares About Men's Health."

And in the meantime, if you want to hook up with us, you can do it a lot of different ways: hello@thescoperadio.com, you can go to facebook.com/whocaresmenshealth, and the best thing you can do is just tell one other person about us. Tell one other man about this podcast that you think would find this podcast valuable. And thanks for listening to "Who Cares 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: Hey, this is Scot from "Who Cares About Men's Health?" What we're trying right here is a brand new concept we're calling the "Who Cares About Men's Health Sideshow." So as the podcast is developing, we've come up with some different themes. One is our "Core Four Plus One More," which is activity, nutrition, sleep, emotional health, and then also knowing your genetics have a big impact on your current health and your health in the future and also can help prevent disease in the future as well. So we do episodes that focus around those areas and how to improve in those areas and just education in those areas.

Another concept that we have are "Who Cares About Men's Health Men's Health Essentials." These are diseases and conditions that impact men, stuff you need to know in order to remain healthy. And now, this particular concept, if you see a show called the "Sideshow," we're going to be a little bit more loose. Could talk about some of the Core Four stuff, probably going to involve a few more personal stories, and might be some articles that Troy has, or just some other interesting things we think you might find interesting. But if you're here because you want to focus on your "Core Four Plus One More," check out those episodes. That'd be a good place for you to go. If you're interested in specific men's health conditions, check out our "Men's Health Essentials." If you're interested in a little bit more free form, then that's what you're going to get right here. So pick and choose what you like and enjoy.

I need to talk about nutrition because I was a freak at one point. Like before this podcast started, I was logging and weighing all my food, and I scheduled my times to eat, and I stressed about what I ate, and I didn't want to eat any bread, and I hesitated on fruits because I was trying to keep low carbs. And I didn't want to, you know, eat too much fat and . . . I should talk about that, because I changed a lot with my nutrition. I think I feel pretty much okay.

Troy: Well, that gets to that orthorexia and . . .

Scot: What's orthorexia?

Troy: Well, do you remember . . .

Scot: Oh, that eating disorder.

Troy: Dr. [Pohl], Susan Pohl, she talked about it very briefly, buy it's not anorexia. I mean, it kind of obviously has that same root.

Scot: [inaudible 00:02:02]

Troy: But it's orthorexia where you get like a very strict diet and to the point that it becomes like a compulsion where it's just like, "Oh, I can't do that, I can't do that, I can't do that. I have to do that exactly this way," where it is classified as an eating disorder. It's a newer thing that's come out in the last 5 to 10 years I think. But that might be interesting to talk about your experience and say, "Hey, do I meet the criteria for orthorexia?" And I can dive on mine too. Like, sometimes I wonder, "Am I orthorexic?"

Scot: You know what changed all of that was, first of all, realizing that I didn't need as much protein as I thought, because I was building my life around protein. Second of all . . . Actually, the first thing was when Thunder said, "If you just alter the time that you eat. Like, if you do 8 on, or 16 off, or even 12 on, 12 off, you can eat what you want and you're going to maintain." I'm not going to go crazy with junk, but at least I'm like, "Well, I don't have to weigh my food anymore." So that was kind of good. And I kind of have an idea of how much I'm eating now anyway. That's so freeing and it's freeing to know that I can have bread. I just had some great sourdough bread. It wasn't made by Mitch this time, but . . .

Troy: It's all good.

Scot: . . . Bob and Randy Harmon made it and they did a pretty good job of it.

Troy: Nice.

Scot: Yeah. Troy, what do you got there? Looks like you got some sort of medical journal there. You want to tell us a story from that book of medicine?

Troy: Well, I have several options today, Scot. Would you like to know about the effectiveness of honey for symptomatic relief of upper respiratory infections?

Scot: Okay.

Troy: The efficacy of ginger for the treatment of migraines?

Scot: Okay.

Troy: The effect of vitamin D supplementation, omega-3 fatty acids, or strength training for older adults?

Scot: All right.

Troy: A man with a gnawing sensation under his scalp?

Scot: Eww, that sounds creepy. I bet you Mitch is going to vote for that one.

Troy: Maybe he will.

Scot: Yeah, so which one of those are you going to vote for, Mitch? What do you like?

Mitch: Oh, I don't know.

Troy: Or let me give you the last one. A pilot trial of topical capsaicin treatment for cannabinoid hyperemesis syndrome. Basically, how do you treat retching when you smoke marijuana?

Mitch: They all sound so good. I can't choose.

Troy: I know. Every one of these I could use in some form.

Mitch: All of them, please.

Scot: I don't know. Which one, Mitch?

Mitch: We can we talk about the cannabinoid one? I am interested.

Troy: Yeah, absolutely. And this is something I use in the ER.

Scot: Really?

Troy: Yeah.

Scot: Oh, this technique, if somebody . . .

Troy: Yeah.

Scot: . . . comes in with this problem. All right.

Mitch: I'm in.

Troy: I put it on myself before I go to work. It's how I get through the shift.

Scot: All right. I'm into this. So essentially, it's about people that smoke marijuana, and then they start retching, what to do about that?

Troy: Yeah. How do you treat it, yeah.

Scot: Okay. So what journal is this from?

Troy: This is from the journal "Academic Emergency Medicine."

Scot: All right. Troy reads them and finds a good story so you don't have to. So . . .

Troy: That's right.

Scot: . . . go ahead and go.

Troy: So Scot, so this is an interesting article. I love articles that just show you a fairly simple treatment, and maybe it's not a huge study, maybe it's not the best done study, but it shows it's effective. And then you try it at work and you treat someone with it, or maybe you try it yourself and it works. So as you know, the use of marijuana is becoming more and more prevalent. Maybe they have a prescription for it. You know, there's several states where you can use it recreationally legally. So we are seeing more and more cases in the emergency department of what's called cannabinoid hyperemesis syndrome. And what this means is that people who use marijuana frequently can sometimes just develop just retching vomiting. They just cannot stop vomiting and they feel miserable. Sometimes they treat it by taking a hot shower. For some people, that seems to work. But there was a study that was done, and this appeared in the journal "Academic Emergency Medicine." So not a big study, they had 30 patients, and 17 patients, so about half of them, they treated with capsaicin cream. Are you familiar with capsaicin cream?

Scot: No, what is that? Mitch, do you know what capsaicin cream is?

Mitch: It's like the granola version of IcyHot. What's that brand called?

Troy: Yeah. Well, actually the brand is called Capzasin, C-A-P-Z-A-S-I-N, so you may have heard of it. But yeah, something you can use to treat muscle soreness. I mean, capsaicin is a pepper. So it's actually like this pepper in this cream, and people put it on sore muscles, sore joints, things like that. Kind of like IcyHot, it relieves the pain because it just stimulates these nerves in a certain way that the nerves are then more focused on that or it just, you know, overstimulates them in a sense where then you're not so focused on the pain there. But the bottom line is that's what it's used for. It's over the counter, super easy to find this stuff in any pharmacy, any place you want to shop.

But basically, they treated 17 patients with the capsaicin cream and they treated 13 patients with the placebo, just another cream that was not a capsaicin cream. They found, in just about everything they measured, in the patient's nausea, in just their vomiting, you know, like the 30 minutes, at 60 minutes, they found that the large majority of the patients who had the capsaicin cream did better. And patients who had the capsaicin cream, 29% had complete resolution of the nausea versus none of the patients who had the placebo treatment.

Scot: Wow.

Troy: So, yeah, pretty significant improvement, and that's complete relief. But then just looking at, okay, how much did you improve? Maybe not completely. People who got the cream did a lot better. So it's something I use in the ER, because we see this surprisingly frequently, people who come in who just are having this retching vomiting and feel miserable. And I'll just order up some capsaicin cream. I'll have them apply it to their abdomen and the large majority of the time, with an hour, they feel better. And I say, "Just take this home. If this happens again, use this cream."

Mitch: You take the cream and you rub it on your belly?

Troy: Yeah, you just rub it on your belly.

Mitch: Oh wow.

Troy: It's very simple. You're not rubbing it on joints or anything like that. You're just rubbing it on your belly. Don't drink it, don't eat it, just rub it on your belly. Just use it externally. It's just a cream. You know, I don't know if this will work for any other types of nausea, I've never tried it there. Certainly there are other meds that can help with those sorts of things. But a lot of times with these patients who come in with this type of vomiting, it's like you give them other stuff and nothing seems to help, like a lot of the standard medications we use. You use some capsaicin cream, makes a difference, they feel better, I just tell them, "Use it at home."

Scot: And you have to put it on your abdomen? If you put in your arm, then it doesn't help?

Troy: Yeah, don't put it anywhere else. Just rub it right over your belly. Right over that spot that's cramping up, that's miserable.

Scot: Do we know why it works?

Troy: I don't know why. And I don't know [inaudible 00:08:48]. It's probably the same thing as the hot shower. It's one of those things, I remember seeing case reports about this, you know, a few years ago where people are like, "Hey, we tried this and it worked." And I don't know if it was the same thing as the hot shower, where some dude is just like, "Hey, I've got some of my grandmother's arthritis, while I'm in here I'm going to rub this on my belly," and then he told someone else, and then someone reported it in a medical journal, and then here's this really small study that said, "Hey, it really seemed to help." So I don't know the origin or the rationality behind it.

Scot: It's a bizarre thing to try.

Troy: It is.

Scot: You know, like any time you look at anything, sometimes I look at like foods and I'm like, "Who decided to try that first?" You know? And it's like who decided to try this first?

Troy: Who decided to do this first?

Scot: Like what was the connection that they made that they're like, "That could work."

Troy: Yeah, I don't know. And again . . .

Scot: Why ask why sometimes, right?

Troy: Why ask why? I'm sure there's someone who's come up with some sort of physiologic explanation for why it worked. But I guarantee that's not the reason someone used it in the first place. It's not like someone thought, "Well theoretically, this could make a difference." Again, the only reason this study happened, it's because of some of these case reports that were out there that I saw, you know, appearing in journals several years ago. And so someone tried it at some point, it seemed to work, and now here's a study, very small study, but says, "Yeah, it does seem to work." And my experience is that it does seem to work.

Scot: Hey, thanks for checking out "Who Cares About Men's Health The Sideshow." If you liked what you heard, we'll have more Sideshow episodes coming up. I also ask you to check out our "Men's Health Essentials" and our "Core Four" episodes to help you lead a healthier life today and in the future. Feel better now and later.

By the way, check out our migraines episode that we just recently did. It's really, really good if you know somebody that suffers from migraines. And if you know anybody that might enjoy what you just heard, do us a favor and just share this podcast with that one person. If you share that podcast with this one person, it will help us get to more people that we can help and more men who want to care about their 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: All right. It's time for the check-in, the "Who Cares About Men's Health" Declutter Your Life, Fix Your Mental Health check-in. It's a challenge to get rid of some clutter. The premise is that your clutter can cause mental anguish, whether it's that you look at it and you go, "Oh, that used to be me," or that clutter represents stuff you didn't get done, or if you look at it, and you just can't stand clutter.

We started out with Troy being a little apprehensive, but he really came on strong in week number two. I was pretty gung ho to begin with, and we're going to find out how I did. And Mitch is taking a very systematic approach to what he's getting rid of. So let's check in with Mitch first and find out what was this week . . . this week was clothes, or was that last week?

Mitch: Clothes was last week. So this week I've been getting my partner involved, and he's been hesitant about one thing or another. But we've been talking through it. He's been seeing what I've been doing, and he's participating. And so what I've brought in today is we've been getting rid of those good boxes that seemed to take up all of our shelves, right? I brought these boxes in, in particular because every time it's like, "Oh, well, I'll keep that one special box. It's a really nice box. That's a box we should keep." This is for a little 3D camera attachment, and the box literally only holds that one device, right?

Scot: You can't take that little insert out and turn it into a regular box?

Mitch: No, it's built into the box, so what are . . .

Troy: It's still a nice box, though.

Mitch: Thank you. I understand. But that's the same thing here.

Scot: This is a recent trend. Yeah, this nice box thing is kind of a recent trend, right? When Troy and I were kids, there was no such thing as a nice box and a not nice box. Stuff came in boxes, and you got rid of the boxes and kept the stuff. Now sometimes the boxes can stay on your shelf longer than you own the stuff.

Mitch: Right. And that's just it. Here is a fancy pen that he got two, three years ago. Cannot find the pen. It's got a nice felt . . . look at how nice that is. Wow.

Scot: Oh, it's a little pen bed.

Mitch: We had a whole shelf worth. It was a whole trash bag worth of boxes that we just got rid of and it's just . . .

Scot: How does that make you feel, Mitch, getting rid of those nice boxes?

Mitch: For me, it feels fantastic because it's like, "Here's one for our little Roomba that we have. Why do we have this gigantic Roomba box? Well, what if we move and need to put the Roomba back in the box?" And it's like, "Okay . . ."

Scot: So it makes you feel great. Did you run into any problems getting rid of these boxes? What was the attachment that Jonathan has?

Mitch: So it 100% is that this could have a use. And so we had that conversation that I've been having with myself when I went through all my tech stuff, which is probably what we'll talk about next week. But when was the last time I needed this one specialty cord? I'm holding on to it for technology that doesn't even exist anymore. But there's this idea of potential.

And so by talking about, "Hey, you have all this camping stuff that you use regularly and you have a hard time putting it places and it's sticking out. What if we were to get rid of all these boxes and then you have a place for the stuff you do use today?" And that was really the conversation that happened.

It's night and day. Suddenly, he has a little workout room in the back that now has more space. So it's great. It's absolutely great. There was a bit of picking up each box and being like, "When are you going to use this?" It was good, though. It was good.

Troy: Yeah, at one point, we had a closet beneath our stairs that you couldn't even enter because it had so many empty boxes in it. It was that same idea, like, "Well, we might use these someday. Storage. Gifts." And then it gets to a point it's just like, "We're not using these." I'm sure everyone's got that somewhere in their house, the nice boxes or just even large boxes that could come in handy at some point.

Scot: I'm going to go next. Is that all right, Troy?

Troy: Please.

Scot: All right. So I'm a little disappointed in myself, but I'm going to take advice from what we've talked about on this podcast before. If I could sum up how well I've done at this challenge over the past couple of weeks in a sound, this would be the sound. Yeah, it hasn't been pretty. I haven't done well.

But what I'm going to do is I'm going to take the advice that we give ourselves in making any sort of change that sometimes you have to be kind to yourself, right?

Why am I not doing well? Is it because I'm actually not doing well, or is it because of the expectations I set? Because at the beginning, I was going to follow the pattern of one thing on the first day, two things on the second day, three things on the third day, four things on the fourth day, and so on.

Troy: Let me correct you, Scot. That's not the pattern you were going to follow.

Scot: Well, no.

Troy: You did a huge number of items that first week. You were at like 200. We did straighten that out, but you had like 200 items in the first week.

Scot: Yeah, I did. So I mean, the first week was kind of okay, but I literally, for the past two weeks, have done nothing. Although I did make a promise last check-in that I was going to list this stuff on eBay, some of my tech that I thought I could actually get some money for. This might be $300, $400 here, this laptop. You'll notice they're in boxes now, and they've got the packing material. And I weighed them because selling stuff on eBay is a freaking process and a half. I measured the boxes so I can put that in, and I wrote the descriptions and I took the pictures and they are now listed on eBay. So I have three things that I'm selling on eBay. I guess that's progress.

I'm just going to be kind to myself and say, "Hey, you know what? It wasn't the expectation that you had, but yet you're making progress." This is some pretty big progress, I think. Even though it's not quantity, it's quality. Normally, I don't like to sell stuff because there's definitely a lot more activation energy and a lot more that you have to do to make that happen, but for $100 here and $300 there and maybe $80 there, it's worth it. So I have made a little progress in that respect.

Mitch: Well, something I wanted to say really quick is there is a program nationwide in every state and they take old tech and donate it to in-need schools for their tech programs and their learning things. So if you have old tech, old phones, old whatever, they actually use them in the tech labs of these at-need, at-risk schools.

Scot: Cool.

Mitch: And so I just thought that was . . . for me, I'm not going to list this 10-year-old iMac, but it's a place where I could give it. I don't have to pay that recycling fee, and I know that it's going on to help someone out.

Scot: And by the way, I took a couple of old phones to Best Buy. This is not an endorsement of any particular business, but when I did, they actually take a lot of electronic stuff for free. So yeah, look into them. I was really surprised as much stuff as they took for free.

Troy, how are you doing?

Troy: Doing well. So this week was clothing for me, and I thought I was doing pretty well with clothing because I'd done a big purge like a year ago, but once again, it's those things.

And it's funny. I don't want to sound like a jerk saying this, but I have a lot of what I was referring to as my fat clothes. These were suits and nice clothing items, like really nice clothing items that just do not fit me anymore. And again, I can't say I was fat. We talked about the whole BMI episode, but I did fall into the overweight category and this was about five, six years ago. And I kept thinking, "Well, what if I put the weight back on? I've got to keep this stuff around." But at this point, I'm just like, "Hey, I'm not using this stuff," and so I got rid of it. So I unloaded a couple of really nice suits that I just am like, "They don't fit."

It's funny because with Laura, my wife, they had a family photo like two years ago and I had not worn a particular suit. They wanted everyone to wear a grey color, so I pulled out this grey suit and I put it on and I looked like a child wearing his father's clothes playing dress-up or something. It was embarrassing. I didn't even do it until the day of, so that's what I wore to the photo but.

Anyway, I unloaded this stuff. That was my big project of the week, trying to unload clothing, stuff that just doesn't fit, stuff I haven't worn. And again, it was that same process of saying, "Hey, I haven't used this. I don't expect I'm going to use this anytime soon. There's no reason to hold on to it."

Scot: With those nice suits, it can be tough, though, right?

Troy: It is. I mean, it's one thing to get rid of an old shirt or something, an old T-shirt, but it's quite another thing when it's a really nice suit that at some point you paid several hundred dollars for. It's like, "Well, this is a great suit. I can't get rid of it." But again, if you're not wearing it, if it doesn't fit, no reason to keep it.

Scot: Yeah. I wonder how that will play into your . . . I mean, it's also good to get rid of it because then if you do start putting weight back on, then you have to . . . It's like a good punishment. "You're going to have to go out and buy a fat suit now."

Troy: That's exactly right. And that's kind of the thought I had, like, "Well, do I really want to have this there in case I put 20 pounds back on?" Then I'm like, "Well, I can't put 20 pounds on. It's going to cost me several hundred dollars to go buy more clothing." So you don't want to keep that there, I guess, with that in mind.

Scot: All right. So next week, guys, what are you working on next week? Let's go to Troy first.

Troy: Scot, I have saved the worst for last, and it is the garage. It's the place we all dread. It's like the final resting place for everything before it finally makes it to the trash or to a thrift shop.

So here's the challenge. This is why this is grand finale. It's like the perfect storm of items. It's, number one, items I might use someday, and there's a good chance of that. Number two, there's the sentimental value. My grandfather passed away years ago, and at the time he passed away, my grandmother gave me all his old tools or a lot of his old tools. I have these containers of screws and nuts and bolts he had collected over the years too that he thought he would use someday. So it's the perfect store of sentimental value, things I might use someday. So this is going to be a challenge.

Scot: Mitch, what's next week look like for you?

Mitch: I'm going to get a little out of the box. I'm going to be doing a digital cleanup. In all the years, I have . . .

Scot: Digital decluttering.

Mitch: I'm up to 12 terabytes in my life and I need to get that shrunk down. And so in cleaning everything up, I found all the SD cards, I found all of the little USB drives that I've gotten over the years, and I downloaded a program, I bought a program that's going to find duplicates, etc.

I don't know where all my projects are. I have a lifetime worth of work, and I can't tell you which files and where they are. So I'm going to get a little outside of the box because we have a small apartment, we've done most of that cleaning stuff, and I'm going to focus on my digital life.

Scot: I love digital decluttering. I have Evernote that just is a mess. It stresses me out thinking about all the stuff that's in there just like you said. And digital, it can be so out of sight, out of mind.

Mitch: It's a little black box that has bajillions of things in there, and I have no idea where anything is. So I'm going to find all the duplicates and make an organization system and see if I can't shrink it down a bit.

Scot: I like it. If I was to describe my strategy in audio terms next week, this would be it. I don't know what my strategy is next week.

Troy: That sounded a lot like your description of your success so far. It sounds fairly pessimistic.

Scot: I don't know what my strategy is. Troy, I'm thinking of the garage as well. I did a garage purge two or three years ago when we moved, but I want to get in there and insulate and drywall and then put up some storage.

So even though maybe I'm not going to accomplish as much on this as I want to of getting rid of stuff, I think that our going through this challenge has set my mindset that, "Sure, I could put up shelves on every square foot of my garage and just keep all those things," but I think I'm going to go in with the mindset of, "What is it that I use? How can I make it that that is the most accessible easy stuff to get? What is stuff that I need to continue to keep that I might not use all the time? Where can that go?" And then not cover every square foot of my garage in shelving. So I think it's a mindset that I'm going in that I might not have had a couple of years ago.

All right. Well, it sounds like we're all doing pretty good. Any final observations before we wrap up this check-in for week number three?

Troy: Well, my big observation, Scot, the biggest challenge I've had with this is as I've gotten rid of things, I've thought to myself, "I have space for it. Why do I have to get rid of it?" So it's been sort of a change in mentality where I think it gets back to a lot of what we talked about early on in this, that it's not about "Do I have space?" It's more like "What does this bring to my life? What does this really add to my life?"

And it's also sort of that change in mentality of saying, "Hey, I'm not my stuff. This is not me. I have this stuff. I don't need to hold on to this for some sense of identity. I am who I am." A lot of these items that may have sentimental value. I think there's some value in learning to let go of those things.

So I think that's probably been the bigger thing for me. Every time I've done this before, it's been about either we're moving or we're trying to remodel and I don't want to move all this stuff. I just need to get rid of it because it's taking up space. Where this has been a very different mentality. And getting back to the mental health piece, I think that's been a really positive thing.

Scot: How has it impacted your mental health?

Troy: I think that's the biggest thing. Even now as I'm looking around, I'm obviously still decluttering, but it has become more not so much, again, "Oh, yeah, this closet has got plenty of room. I can just leave this stuff here." It's more like, "Hey, this isn't something I use. It's not something that brings anything to my life. I don't need to hold on to this stuff."

And so, like Dr. Chan talked about early on, he said something that stuck with me. He said, "We think about the past and it makes us sad, and we think about the future and it makes us anxious." And so I think it kind of takes that piece out where you hold on to a lot of things and maybe there is kind of that sentimental piece, but it's also kind of like, "Hey, why do I need to hold on to this? Let's focus on the here and now and where I am now." And I think just from a mental health perspective, that's a more positive thing.

Mitch: With Jonathan going through this same process and kind of exposing him to these ideas, it's kind of cool to see how excited he is, right? He's starting to look at more . . . he's like, "I would like a new chair." And it's being able to say, "Well, this chair that we've had forever, it's perfectly good, it's perfectly whatever," to be like, "Get something that you actually want." Make space for what you're doing right now, not the identity you had three years ago. This piece of furniture does not define you. We can get rid of it and get something new.

So it's been really interesting to kind of get rid of this stuff and see how excited he is about rethinking about how we use our space, what we put in that space, and actually making room for now.

Troy: I like it.

Scot: And how it makes you feel and how you feel in that space and how . . . yeah.

If you'd like to join us with the declutter challenge, we still have one more week left I think. I think we're doing this for 30 or 31 days. You can do so. Just go to facebook.com/whocaresmenshealth, and go ahead and let us know how you want to participate, why you want to participate, maybe post up some photos of some of the stuff you're getting away. Join us and see if it improves your mental health as well with the declutter challenge with "Who Cares 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: Welcome to "Who Cares About Men's Health." It's the first of our month-long series on getting rid of your stuff to improve your emotional health. So the challenge was laid down that we were going to do some minimization. We were going to get rid of some clutter in our lives and see if that improved our mental health.

If you haven't listened to that episode with Dr. Chan, be sure to go back and listen to it, it's the one right before this one, so you get the premise of what we're doing. But essentially, we have made an agreement, all four of us, that we are going to try to get rid of some stuff and see if it improves our mental well-being.

So my name is Scot, and I am the manager of thescoperadio.com, and I care about men's health. And let's go to Troy, Mitch, and Dr. Chan.

Troy: I'm Dr. Troy Madsen. I'm an emergency physician at the University of Utah, and I'm struggling with this challenge, but I do care about men's health.

Mitch: I'm Mitch Sears. I'm a producer at The Scope Radio, and I've been getting rid of tons of stuff already.

Scot: Yeah. I think Mitch is going to be the success story for this episode. I think there are going to be some winners and some losers.

Mitch: It's a process. It's not a competition.

Troy: It's a competition and you already won, Mitch.

Scot: Dr. Chan, how are you doing so far?

Dr. Chan: I'm Dr. Ben Chen. I'm a child and adolescent psychiatrist, and I teach in our medical school, and I too care about men's health. Yeah, I've gotten rid of something big and I'm happy to talk about it and explore it. And I agree. It's a journey, not a destination.

Scot: All right. Well, if it's a journey, then I'm looking at your guys' backsides way ahead of me, because I'll talk about my failures here in a bit.

But let's go to Mitch because I think Mitch's story . . . I already know a little bit about it. It's pretty incredible what he's done in just this one week. So, Mitch, go ahead and tell us your experience so far with decluttering your life.

Mitch: All right. So it started out pretty interesting. I was looking around, because I've gone through this purging process before, and I was just like, "What are the things that are lingering, causing me a little excess stress that is really not necessary, and it would be better just to get rid of?"

And one of the things that actually helped out first was . . . I've had a broken down Mazda since last summer. And I was just like, "I've been putting it on the market. No one wants to buy it. It can't drive out of its parking space." It was about time for the registration to come up and I'm like, "I am not going to pay for this again." So I just sold it to a junkyard. I kept telling myself, "Oh, it'll sell for more. Oh, it'll sell for more. Oh, if I just repair it. Oh, if I do whatever."

I'm in an apartment complex. I'm paying for parking. It's just an extra level of stress. So I just got rid of my 2006 Mazda 6 to start this whole off.

Scot: Nice.

Troy: That's huge. That should count as 500 items right there. I mean, if broken down in all its components . . .

Scot: That's right. There's a radio. There are four doors. There are how many spark plugs?

All right. So tell us how you feel after getting rid of it. So I find it intriguing because I think we all do that. We might have something we think we can get a little bit more money for, so we hold on to it longer than we think. So how are you feeling now having taken less money?

Mitch: So, for me, I just sat down and I did the actual math, like, "How much am I paying for a parking spot every single month for a car that I cannot use? How much am I paying for a second parking spot for the new car, the old beater that I'm driving right this very moment?" And I when I finally really thought about it, looked at how much I was actually spending, and how much I would do for re-registering for something I wasn't even using, it wasn't that big of a deal to sell it for less than I was asking for originally.

But to have it gone, to not have to see it every day I go on my morning run, that was it too. Every day I'd go on my little morning run that I've been doing, I would run past the Mazda and I'd be like, "Ugh, I've got to get rid of that thing. Ugh, what do I have to fix on that thing?" And just to have that gone, load off.

Scot: That's good.

Mitch: It's a load off. It's one less thing to worry about every single day.

Scot: All right. That's not all, gentlemen. That's not all of Mitch's success stories. Mitch, tell us how you turned a guitar into a recording closet.

Mitch: Yeah. So we're still finalizing the deal right now, but my old guitar from my punk rocker days back in high school, my Godin Solidac, I have not played that thing in five, six years. And the original owner who had gotten rid of it for one reason or another would like it back, and so I'm getting rid of something that was . . . That's the most emotional thing that I've gotten rid of the last week, was this guitar.

Scot: Was it an identity thing?

Mitch: Yeah. That guitar was what made me a musician in middle school and high school. I was in a band called "One Way Sidewalk" for a hot minute there, and it was just hanging out with the friends and wearing my black shirts and studded belts and everything. There was so much of my identity wrapped up in this object. And there was a moment when I'm taking pictures of it, when I'm getting all wrapped up for this guy, that it just . . . man. And I had to realize that's not my life anymore.

Scot: Dr. Chan, would you like to help Mitch deal with the fact that he just gave away a big part of his identity? That can't be easy, can it? Do you encounter people that have to go through that?

Dr. Chan: Yeah. Just listening to your story, Mitch, that sounds really hard and sounds like . . . we joked at the beginning it's a process. But it sounds like you're in a better space for it and especially if it's . . . You said you sold it back to the original person?

Mitch: Yeah, and that feels good too.

Dr. Chan: It's like the cycle of life.

Mitch: Yes.

Dr. Chan: That's beautiful. So you know it has a good home.

Mitch: It does.

Dr. Chan: It's being played and used. And I don't mean to anthropomorphize inanimate objects, but we could have a "Toy Story" moment here. It sounds like this guitar is in a happier place.

Mitch: Yeah, rather than under a bed in a box not being played. Absolutely.

Scot: Yeah. Do you have other stories you'd like to share? Because I think the spotlight really is on you this week.

Mitch: Well, in making myself this podcast hole, I got rid of all the duplicate cables that I have, and there were almost 100 of those. More just clutter removal stuff this week. Next week, I'm looking at clothes in closet. So I probably have some stories for that.

And that was it too. I think that . . . and I've done this before, but there's a real joy in suddenly getting rid of the old things, getting rid of an old identity, and using some of the money that I've made to invest in my identity now. I have career aspirations. These podcasts that have been something really enjoyable and a way to touch base with journalism again. And so being able to get rid of a past self, a past identity, and invest in my current identity, as woo-woo as it may sound, it's great. I'm so excited to be in this podcast hole. It's good.

Scot: It's just a cool little space that you have now. That's neat.

Mitch: Yeah, all my own.

Scot: So what was the formula you chose to get rid of your stuff? Did you go with the one thing the first day and then doubling it each day? So 1, 2, 4, 8, 16, 32? Or what did you do?

Mitch: No, because that math gets out of control.

Scot: All right. Fair enough. Who wants to go next? Do you, Troy, or you, Ben?

Troy: Maybe Ben should, because I'm probably the worst example here. So we'll save me for last.

Dr. Chan: Yeah, I'll go next, and then I have to hop off in about 15 minutes. So the item that I targeted was an old mattress, box spring, and headboard. You can't really donate this stuff. If any of you out there have tried to donate a mattress, box springs, and headboards . . . I don't know if it's because of concerns about infectious disease. I don't know. But Goodwill, DI, they won't take it. They don't want it.

And these items are large. And nowadays if you buy these foam mattresses, it comes in these . . . Amazon will ship it to you and you'll open it up and it'll grow with time. That's beautiful, but then we have a full-fledged old mattress that really doesn't fit into cars. And I know this is a men's podcast, but I really don't recommend putting on top of the car and trying to put your arm up there and driving it somewhere.

Troy: Tie it on with a piece of twine.

Dr. Chan: Yeah. So I would venture some of you right now or a lot of you that are listening have an old mattress, box spring, headboard in some corner attic/basement/cellar of your house, and it's just taking up space. And so my goal, and I'm halfway there, I moved all of them out of the basement and I need to find a company or rent a truck to get rid of . . . because they recycle them now. There are a lot of recycling pieces within the mattresses.

I was just looking up that every day . . . and I don't know if this for shock value or if I'm just being a shrill for big mattress companies. But I read that 50,000 mattresses are disposed of a day, which sounds to me like a lot. They're just taking up space in landfills, so they really recommend recycling them, but you have to pay for someone to recycle it, which I'm fine with doing.

So that's what I'm letting go of is an old mattress, box spring, and headboard. It takes up a lot of space. They're old.

Scot: And it's a lot of effort to get rid of it. It's like electronics in a way. You want to get rid of this stuff, except for yours is huge, right? So then you've got to pay money. I had to hire a company to come pick up some stuff, and it was like $75, and I'm like . . . So there's some activation energy that you have to get over there as parting with that cash to get rid of that stuff.

Dr. Chan: Yeah. But it feels good because it's created more space in the house. Why do we hold on to the old pieces of furniture that . . . obviously, it's broken down. It doesn't work as well.

Scot: Why did you? What were you thinking when you decided not to get rid of it? Or was it the hassle of getting rid of it?

Dr. Chan: We have kids, and so we have, "Oh, the kids might want this one day or this could be a good college starter set when they go off to college." Or when you have Aunt Billie, when they visit, it's easier just to get a mattress and throw it down on the ground. There's this utility factor, but all of it is just inconvenience. How do we donate something this large? How do we donate large furniture items?

Scot: So I found if you put that stuff on ksl.com and just very specifically say, "Bring your pickup and bring buddies to load it . . ." If you price it low enough, people will show up. And sometimes that's the value for me. I might make a few bucks on selling it, but it's more about I'm getting somebody to take it out for free, essentially, on that bigger stuff.

Plus also, when you do this, it makes you pause for a second and think next time you buy. It's like, "Do I really need this, and what happens when I have to get rid of it?" Because when you go through this process of "what a pain it is to get rid of some stuff," it slows your roll when you're doing the purchasing in the future. At least that's what I've found.

It sounds like, Dr. Chan, you're doing some strategic targeting. You're not doing the doubling, the 1, 2, 4, 8, 16, 32. Right? Is that your game plan?

Dr. Chan: Yeah, I went for size. I went for big items.

Scot: And then next week you'll have some other big items or . . . I guess we'll have to wait for next week.

Dr. Chan: Oh, yeah. The moment of anticipation transcends the moment itself. So I'll leave you hanging.

Scot: All right. So I tried the double every day. That means that in this first week, I had to get rid of 127 things in the first week alone, and it's only going to keep getting bigger and bigger. So I think I may have bitten off more than I can chew. I've got a grand total of 79 of the 127 things that I said I'd get rid of. And that's counting each individual sock, not socks as a pair. So it's a little bit of a lame strategy there, but I inventoried the things.

Plus, also, we were out of town last week. So I was really scrambling today to do this.

What I learned is it takes a little bit of time if you're going to do it at that kind of scale. I need some time to think about this, but here's my list. Are you ready? And if there's anything on this list you want to learn more about afterwards, let me know. So 10 inflatable novelty microphones.

Troy: I'm already intrigued.

Dr. Chan: Inflatable?

Scot: Yeah.

Mitch: Like regular size or mini size?

Troy: And novelty.

Scot: Yeah. They look like a regular microphone, but you blow them up. They're inflatable. Wait. Hold your questions.

Troy: Where would one purchase these?

Scot: Hold your questions to the end, gentlemen. Hold your questions to the end.

Mitch: Why so many?

Scot: Ten inflatable novelty microphones, two two-terabyte hard drives, one Tamagotchi, eight network cables, four coax cables, one wall patch kit, two magnetic hooks, one timer, two light bulbs, one pair of ice walkers, one XLR cable, three masks, eight tripods, five mic holders, four dress socks, one Super Ball, five tube socks, four greeting cards with five envelopes, which I counted separately, two worn out running shoes, one Eddie Bauer pullover, three white ribbon lapel pins . . . I did keep one, however . . . one "Star Wars" popcorn pail that's been used as a garbage can until we got our dog who takes things out of the garbage can, so I had to get a better solution. One four-gigabyte SD card, one busted screen protector for my iPhone, and two non-working iPhones. Questions?

Dr. Chan: You win.

Troy: Wow. You totally win. I'm impressed.

Dr. Chan: What's a Tamagotchi? What's that?

Scot: I'm reaching for it. Back in the '90s, they were these virtual pet key chains.

Dr. Chan: That's what I thought. Oh, wow.

Scot: Yeah. So it's not one of the original '90s ones. I got rid of those a long time ago, or they broke, but I saw in a store this Tamagotchi. I don't know how many years ago. Ten years ago? And I thought, "That's cool. I liked that at the time." Probably this was 15 years ago. And it's still in the box. It's still in the box. I never opened it, never messed with it. I've kept it on a display case just to show off and I just decided, "You know what? That means nothing to me. There's no sentimental value to that whatsoever, so I'm just going to get rid of it." So that's the Tamagotchi.

The inflatable novelty microphones I got because I was going to use them in my radio broadcast class. So they say when you're doing a class, if you throw something around like a ball . . . like, if you ask a question and then you throw the ball to a student, then the student has to answer the question, and then they throw it to somebody else for the next question, that keeps the energy up. I thought I'd do this with inflatable mics, but it just never really worked. So I bought those on amazon.com. Probably came from China or something.

I'm going to talk about the hardest thing that I'm still debating about. This is a common theme in my life. That's why I'm going to share this. So around birthday and Christmas, I can be hard to buy for. And sometimes I will say, "Oh, that'd be kind of cool to have." And then I get the thing and I realize it isn't as cool. So now it's hard to get rid of because it was a birthday present or a Christmas present from somebody that's close to me.

So I have this pair of blue suede shoes that I have never worn. Around here in Utah, what good is suede? I even actually went out and got a can of suede protector because I read in order to protect them, to keep looking nice, I should do that. I sprayed them down. Still have never worn them. They don't even have shoelaces anymore because I took the shoelaces out for another pair of shoes when my shoelaces in those broke.

I just about put them in the box, but I'm like, "Well, maybe I'll try to wear these," because they're kind of cool. But I've tried to get rid of them three or four times, and here I am again trying to get rid of these shoes that were a gift. Gifts are tough.

I've really watched my mouth now talking about things that would be neat to have because I've learned around here you might end up with those things. So that's my one story.

Troy: So you have gotten rid of the blue suede shoes then?

Scot: No. I pulled them out. They're sitting separately from the big pile that I'm giving away. I'm still vacillating on those.

Troy: You're still deciding.

Scot: I still think I'm going to put shoelaces in them and wear them, but I probably know better.

Dr. Chan: Scot, I'm the psychiatrist, I guess, here on this call. How do you feel? How does it make you feel?

Scot: I think this was low-stake stuff.

Dr. Chan: My non-minimalist side to me when I hear about the Tamagotchi and your "Star Wars" trash can, I start thinking, "Those are collector items. No, Scot, don't do it." But then I'm trying to combat that with the spirit of what we're trying to do.

Scot: Yeah. And to me, they might be collector's items, but if I really think about it, they're not. They don't really mean anything to me. So it's not that big of a deal on these, I think.

I'll let you know how I feel when I'm getting rid of my four ceramic pigs. I'll tell you more about those in another week.

Troy, your turn.

Troy: As you know, this is something I struggle with and I admitted it upfront. I'm definitely a packrat. I'm not a hoarder in the sense that I would be on the "Hoarders" show, but I do hold on to stuff. I'm fortunate to have a spouse, Laura, who does not do that and very often encourages me to declutter. She heard about this challenge and we talked about it, so she has fully embraced it. And she's getting rid of stuff. So I'm counting her stuff in my total.

Mitch: That's cheating.

Troy: That's fair game, Mitch.

Scot: I don't know. I don't think so. I don't think it's cheating.

Troy: Yeah, it's part of the entire household.

Mitch: All right.

Troy: It's like "what's yours is mine," and if you're getting rid of it, I'm definitely counting it. So I'm definitely counting items that she is getting rid of.

She's really made some headway with this, but she has several times now -- I shouldn't say offered -- has stated that she is going to go through my stuff and get rid of stuff, and I said, "Don't do that. Not yet. Let me go through it and decide."

So, as I've started going through stuff, it's been backfiring on me. So I found these old covers I had for my shoes to protect them from rain, and I was like, "Wow, I haven't used these in years. I should try using them." And so I tried using them and they tore, so I got rid of them. But then I bought a pack of 50 disposable rain covers. So I failed on that. I went from one pair of disposable covers for the shoes to now 50 pairs.

I found an old Bluetooth earpiece that I thought, "Oh, this would be great when I'm listening to audiobooks around the house. I could use this." It doesn't work very well, so I got rid of it and bought a new one.

Mitch: Oh my god.

Troy: And then I found an old water bottle that I was going to get rid of, but I was like, "I need another water bottle." So now I've washed it and I'm using it.

I don't know, Scot. This is not going super well for me.

I did count my pairs of running shoes. I have at least 30 pairs of running shoes, 5 of which I actually use. I definitely have some sentimental attachment to a lot of these shoes because I've run a lot of races in them. But I'm starting to come around to saying, "Hey, I'm not going to wear these shoes." They're worn down. I'll probably get plantar fasciitis if I try and run in these shoes at this point. So I think I'm going to succeed in really narrowing down that stock.

But like I said, my success so far has been due to Laura's efforts and definitely not mine.

Mitch: It's funny that you mentioned that because as I've been moving . . . I also live with a partner and I have this box of "maybe probably going away stuff" as I was going through all my tech stuff especially. He's been going through and throwing things out. He'll be like, "Why are you getting rid of this?" I'm like, "Oh, well, I don't use it." "Well, maybe I'll use it." And so there's suddenly a new pile being invented as the things I try to get away keep getting pulled out. So we'll see how that counts toward my total.

Troy: That hits too close to home.

Scot: Troy, I love how he's whispering right now. You can hear him whispering.

Mitch: I am. I'm in my own special soundproof room now, and I'm still going to whisper.

Troy: Yeah. He can't hear. I love that you shared that, Mitch, because this isn't the first time this has happened in my household. There have been boxes in the garage that were scheduled to go to DI, and I will admit I have gone through those boxes and have pulled items out of those boxes. I relate to Jonathan.

Scot: They say that one of the strategies that you should employ if that happens is once you've made that decision, then you need to get that stuff to Goodwill or wherever you're going to take it immediately.

Troy: Oh, yeah.

Scot: You can't leave it out there and then go back through it a couple of weeks later. Once you make the decision, you've just got to live with it.

Anyway, how's everybody feeling? Dr. Chan, looks like he had to check out, so he's bailed on us. We'll check in with him next week. But how's everybody feeling so far? Mitch, I think it sounds like this has been a great week for you.

Mitch: Absolutely. I can go on a run without worrying about what's happening to the car. I have a space that I'm excited about that I'm going to be utilizing. Yes, I bought a thing or two. I now have foam, whatever. But at the same time, it's finding the stuff in my life that stresses me out and turning it into something that can help me succeed moving forward. That's been my strategy.

Scot: Cool. Troy, how are you?

Troy: Scot, this is funny. We've talked about so many things on this podcast, and I have embraced a lot of those things, like sleep. We've talked about diet, all that, and it's been great. I've been a little shaken by this and it's been an interesting experience to realize, "Wow, I really do hold on to a lot of things."

And maybe it's partly their sentimental value. Maybe it's my background as a history major. I like artifacts. I like these things that represent our past, and I think there's some value in it when clearly there's probably not. So I'm working on it. It's definitely a process.

Scot: I've been through this process before, so I think that's why it was particularly challenging. That, and the fact that I put it off last minute. But I found success in this process before. I've enjoyed it. I think what I need to do is go out to the garage. That's going to be where I'm going to really be able to conquer.

My goal is eventually to drywall and insulate the garage and put up some storage stuff, but make it clean storage. Not have every nook and cranny dedicated to storage. And just try to have the storage for the stuff that we use on a regular basis so it's easier to access. And so when you see it, you're like, "Yeah, that brings me happiness. That's useful in my life."

So I think when I get there, I'll be happy. But right now, it's still a little stressful.

All right. Well, we will check in next week and see how everybody's doing with the minimalization challenge. I look forward to hearing how Mitch progresses in the next week because I think he's made a lot of progress this week. I suspect he might slow down, but he might not. Troy, I look forward to finding out how you continue to cope with getting rid of things or if you keep pulling stuff out of boxes.

Troy: Or I just keep buying more stuff.

Scot: Yeah. Exactly.

Troy: And just keeping more stuff. But yeah, not a good trend so far. Definitely, there's a lot of room for improvement for me.

Scot: All right. Well, guys, thanks for partaking in the challenge. And if you would like to partake in the challenge, you can go to facebook.com/whocaresmenshealth. If you want to post any pictures . . . we'll post some of our pictures of our stuff. And if you'd like to join the challenge or communicate with us, go ahead and let us know.

Before we go, Mitch, your dad actually gave us a tool that might help us in the future. Tell us what this tool is. Your dad is part of this now.

Mitch: Yeah, so my dad, and my parents, avid listeners. My father decided to put an Excel sheet because he was focused on the math that you proposed, a doubling of an item every day. I think I sent it to you. How many items is it going to actually be at the end of the month if you double every single day? It's one of those math problems where, "If you keep a penny in a bank for this long."

Scot: This can't be right.

Troy: What's the total number? I need to know this, because I know you talked about this doubling and I know it's an astronomical number. I just need to know what the number is.

Mitch: It's ridiculous.

Scot: No, this can't be true.

Troy: I'm sure it's true. Mitch's dad calculated it.

Mitch: He knows math.

Troy: I know it's a huge number. When you told us, "Double every day," I was like, "That's a gigantic number." That's like an infinitesimal amount of things.

Scot: What am I looking at here?

Troy: You're approaching infinity.

Mitch: So the first column is the day, the second is how many new things you need to throw away, and then the third column is cumulative, how many things you have thrown away by adding each one so far.

Troy: What's the number at Day 30? That's all I need to know. How many items?

Scot: I must have misheard on their on their on their thing because this is . . .

Troy: Again, Scot, when you told me this, I said, "This number is gigantic."

Scot: This is impossible. I can't . . .

Troy: What's the number?

Mitch: On the 30th day, you will need to throw away 536,870,912 items.

Troy: I knew it.

Mitch: By the end of the month, you will have thrown away 1,073,741,823 items.

Troy: I knew that, because when Scot said it's doubling every day, I knew the number was just . . . it approached infinity, which is basically what it does. Scot, I think it probably doesn't double every day. Maybe it's just the number of items of that day, like maybe Day 1 is 1, Day 2 is 2, Day 3 is 3. It's impossible.

Mitch: I don't even think I have a billion things in my life.

Troy: I don't think I do either.

Scot: Okay, so there are some flaws. No wonder it felt overwhelming.

Troy: See, Scot, I didn't want to say anything though. I just wanted you to continue to do this to see if you had anything left at the end of the month, like if you had just stripped your house bare and took every screw out of the wall so you could meet this number.

Scot: Yeah, I'm going to have to look this up. I must have misunderstood something, obviously.

All right. Well, gentlemen, I look forward to next week. I'm going to redo my math and try to figure out something more sustainable.

Troy: Clearly a radio personality and not a math major.

Scot: Yes.

Troy: It's all right.

Scot: That's a good joke, right?

Mitch: Thanks, Dad.

Scot: If I couldn't become a math major, which major would I become?

All right, guys. 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: All right, Troy, this is your show. Go ahead. I'm just kidding.

Troy: Don't put me on the spot like that, man. You know I don't know what to say.

Scot: All right. Here we go. "Who Cares About Men's Health," providing information, inspiration, and motivation to better understand and engage in your health so you feel better today and in the future.

Got some guys here that care about our health. We're proud to say it too. 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.

Thunder: I'm Thunder Jalili. I'm a professor in the Department of Nutrition and Integrative physiology, and I care about men's health.

Scot: All right. Today on the show, what's wrong with a few extra pounds? Is that a bad thing or not? We're going to talk about your diet, your nutrition, that extra weight you may be carrying around, and how that could impact your health today and in the future as well.

So, right after the holidays, and you tune in to your favorite podcast, "Who Cares About Men's Health," and boom, this is the topic we choose. I'm sure you're like, "Thanks, guys. I just got done gluttonizing from Halloween through New Year's and this is when we're going to talk about a few extra pounds?"

So, Thunder, from a nutrition standpoint . . . we talk about proper nutrition and exercise in the core for health now and later. And one of those reasons is to keep your weight within a healthy range. But why does that matter? We've learned that knowing why we do things is important for us to actually follow through on those things, so what's wrong with extra pounds?

Thunder: Well, there are several health risks associated with extra pounds. I think the one that most people know about is the fact that it increases your risk for diabetes. And it's actually the weight gain that happens around the middle, so around the belly. That's kind of the worst kind in terms of increasing diabetes risk.

And that happens to affect men more than women. So as a guy, when you see the belly start to get bigger, which happens after the holidays, that's not always a good thing.

With women, the risk is a little less, they tend to gain weight in different places, more around the extremities and the legs and the rear end. And that's not as bad as far as diabetes risk. So that's the main one.

And then the other one that has been getting more attention lately is actually the fact that obesity is related to cancer risk. So it turns out that that's another risk factor for cancer, is obesity.

And there's now some work that's actually being done in our department trying to also establish a link between metabolic syndrome, which is what happens when people gain weight, and having that be the link to increased cancer risk.

Troy: So, when we talk about a few extra pounds, Thunder, are we talking like, "I just did not do super well eating over the holidays. I put on five pounds"? Are we talking 10 pounds, 20 pounds, or we're talking BMI, looking at that? Anything that you can put there in terms of a cutoff where you really see that risk?

Thunder: Yeah, so if you want to just take the straight clinical approach, BMI, the cutoff where you start to see increased health risks is a BMI of 25. Twenty-five to like 29.9, that is the range that is called overweight. That's where you see these health risks go up. Obviously, the greater the BMI, the more those health risks go up.

To translate that into pounds, what does that mean? Because most people are not quite sure how to make a connection between, say, a BMI of 27 and extra pounds. It's an easy calculation to do. There are lots of online calculators that can help you do that if you want to go in and type in your body weight and your height and it can spit out your BMI. But in general, if somebody is probably 15 to 20 pounds over their ideal body weight, their BMI is going to be in a range that's going to be around that kind of mid-27 or so. And that's where the health risks are going to increase.

But I encourage everyone to go online, find one of those BMI calculators, and try it out. It's good to know where you're at.

Scot: So I'm standing in front of the mirror right now looking . . .

Thunder: Always a bad idea.

Scot: Well . . . I'm looking at my stomach. Is it just the front part of my stomach or the love handles/muffin top? Does that count? What are we talking here?

Thunder: Yeah. It's all there. It's everything.

Scot: Okay. Allow me to put my shirt back on and back away from the mirror slowly now at this point.

Thunder: And mostly the abdominal obesity that is the subject of concern, that is kind of the front, like as your belly protrudes out. Love handles are a bit more subcutaneous, and that's not quite as bad. If you think about like the anatomy of the body, the fat that's packed in around the intestines and the organs, that's the kind that is more associated with diabetes risk.

Scot: So you talked about metabolic . . . what did you call it? Metabolic disease?

Thunder: Metabolic syndrome. Metabolic syndrome is three out of the following five conditions. Either somebody has kind of high blood pressure. Maybe not the blood pressure that we would classify as classic high blood pressure, but that borderline high blood pressure. They may have slightly elevated cholesterol. Again, on its own, maybe it wouldn't be the first thing of concern, but it's elevated more than normal. They may have slightly higher blood glucose levels, which is indicative of pre-diabetes. And they probably have extra weight around the middle, around the belly that we were talking about. And they may have more fat, which we call triglycerides, in their bloodstream.

So, if somebody has three out of those conditions I described, or more, then we would say they have metabolic syndrome.

If somebody has this undiagnosed hypertension, maybe they're running around with a blood pressure that's 5 or 10 points above what we would classify as normal and that would maybe fly under the radar when they would go get a health screening or whatever, but over time, that can increase risk.

Scot: Is the fat the cause of these things starting to happen, or is the fat the indication these things are going to happen? Does that make sense? Because the fat is an indication of a lifestyle that somebody has maybe been doing that is not the healthiest.

Thunder: Yeah. I would say the fat is an indication of the lifestyle that can affect some of those factors, because we know lifestyle is involved with cholesterol or hypertension or, obviously, blood sugar. So, if somebody is gaining weight, for me, and Troy can chime in on this, that's the first kind of warning sign, "Let's take a closer look and see what else happens to be there."

Troy: Yeah, exactly. And I think you're right, Scot, and obviously, Thunder. Yeah, it's one of those things where is it a chicken and egg thing? Is it because these other things are going on? But my understanding is they're all interrelated. Yeah, one may cause the other, but then the other is there, and then it feeds into the other thing.

So I do think that putting on that extra weight, and obesity is going to make you more likely to have that blood sugar that's going to be a little bit too high. And then often, once you get into more of the diabetic issues, then you're going to see more high blood pressure with it and heart disease and all that as well.

So, yeah, it's hard to say if one is definitely the thing that precipitates everything else. But I think definitely the obesity is something that really gets that ball rolling, especially if you've got any sort of genetic tendency toward these things or any sort of just mild underlying issue. It's really going to push that forward to where it gets much more severe.

Scot: It sounds like those video games where you have to string together moves, and you get times two, times three, times four, times five. It sounds kind of like that's what this is, except for not in a good way.

Troy: Yeah. Exactly. If you're already struggling with your genetics, and then you have a tendency toward high cholesterol or toward high blood pressure or diabetes, and then you throw in obesity, you're right. It just makes that snowball and take off.

Scot: What is the turnaround for somebody that has found themselves in a range that's concerning? They've gone online, they did the calculator, they figured out their BMI. How do you start to turn that around? Is it just exercise? Is that what it is?

Thunder: Oh, it's the whole package. It's exercise, and it's what you eat. It's really difficult to use only exercise to control your weight. Unless you're young and you exercise like crazy, then you can probably do it. But if you're a middle-aged guy and you're looking to control your weight or lose weight, you're going to have to bring nutrition into it as well.

Troy: Thunder, what about long-term risk? I've got this BMI calculator up on my computer, and I'm putting in the weight I was five years ago when I was living in California, just living the life of convenience. And every day, there were snacks in the break room, and I was eating snacks, and my BMI was in the 25 to 29 range. How does that compute to longer-term risk? Is my risk dropping immediately as I lose that weight? Or does that time at that range put me at risk of a heart attack in 10 years? Or any idea in terms of what that means longer term?

Thunder: Yeah, I would guess that your risk does drop fairly quickly after you assume a normal body weight or healthy body weight, I should say. So there shouldn't be any reason to say, "Oh, I've already been overweight, so what's the point? The damage is done." I would always try to go towards healthy weight because your risk can always be reduced.

Troy: Again, I was actually a little surprised to put that in. I think at the time, I didn't really realize exactly where I was in terms of BMI, or maybe I justified it or something and I was telling myself it was muscle mass, which it wasn't.

But I'm hoping it's kind of like some of these ads and some of these graphs you see about quitting smoking, about how you may not think that it's making a big difference, but one month after you quit smoking, your risk is dropping. Then you look at that risk drop a year, and then two years out, and it's a pretty dramatic drop in your risk, just with that change. And I imagine the same thing would apply to weight loss as well.

Thunder: Yeah. There have been human studies and animal studies that have found that, where you take an obese animal or human and weight loss occurs, and then you find that their bodily function improved, like their endothelial function in their blood vessels is better, and their insulin sensitivity gets better, and things like that. Yeah, we do have a fair amount of evidence that shows weight loss always results in some sort of improvement.

Scot: I'd like to jump in and say, Troy, at no point have I ever thought that you would have been pushing a BMI that was unhealthy. I need to also confess I had at point . . . maybe now again. Who knows? I had been pushing a BMI that is not healthy, because I would not have considered you overweight. So I think it's good, even if you don't realize, I think your story is really great to maybe check that number out just to make sure, because it can make a big difference.

Troy: It's eye opening. Like I said, I'd never really thought about it until we were just talking now and I thought, "Wow, I wonder . . . well, where am I now? Okay, good." I thought, "Well, where was I five years ago?" And I put it in there and was like, "Wow, I would definitely was in the overweight range."

And it wasn't one of those things where anyone ever necessarily told me, "Hey, you're overweight." People aren't really going to tell you that anyway, hopefully. But I certainly did not think of myself as overweight. So it's a little bit eye opening when you actually plug those numbers in there and see what the results say.

Thunder: Hey, can I add two quick things, as long as we're on the topic of BMI? The thing is, there are so many people in our society who are overweight. Now, I'm making a distinction between overweight and obese. Being overweight is almost normal, really. So the thing is people will say, "Oh, he looks pretty good. Maybe his belly is a little big," but it doesn't register because that's what you see all the time. So that kind of desensitizes us to what overweight actually is.

And then the second point I'll make about BMI is it is just considering your overall body weight. It doesn't discriminate whether that weight is from fat mass or muscle mass. And in the classes I teach, we always do BMI and I come across a fair number of young men who will have kind of a higher . . . like a BMI of 26 or 27, which is in that overweight range, but they're not overweight at all. They're just more muscular than the average person. So you have to keep that in mind, that that can affect BMI, but not in a negative way.

Troy: And like I said, that's how I justified it in my mind, but it was not the case.

Scot: I think you know.

Thunder: Yeah, you know. You can borrow Scot's mirror.

Scot: Yeah, it might be 28 and you can tell yourself it's muscle, but I think if it's muscle, you know.

All right. Hey, Troy, since you've got the BMI thing up, why don't you walk us through what that looks like so we all have a better idea of what we'd be getting into?

Troy: I just Googled "calculate BMI" and it took me to the NHLBI, National Heart, Lung, and Blood Institute, to their BMI calculator. I just put my numbers in here. There's a standard and there's metric. We're going to use standard just because we're using feet, inches, and pounds. My height is five feet, and I'm going to put 9.5 inches. Sometimes I will say 5'10", but it's 5 feet, 9.5.

Thunder: Come on. Go for it.

Scot: COVID has gotten Troy down a half an inch.

Troy: I'll be honest here and type 5 feet, 9.5 inches. My current weight it's about 153 pounds. So that puts my BMI at 22.3. The normal range it gives me on here as a normal weight is 18.5 to 24.9. So I'm within that range.

But then I thought back, "Okay, where was I five years ago?" And I peaked out there at 175 pounds. My height was the same. It hadn't changed. Still, 5 feet, 9.5 inches. That's a 22-pound difference. And at that point, my BMI was 25.5. Overweight is 25 to 20 29.9. Although I did not realize it at that time, I was at that time in that overweight range. Surprising for me to think about that because I certainly didn't think of myself as overweight.

Scot: Thunder, let's go ahead and wrap this up. So we've discussed that this is not a healthy thing, that you should try to get back to more of a healthy weight. Exercise is definitely a part of that equation or activity. You should be getting that 30 minutes every day. But unless you're young and exercising a lot, that's not the only thing. So you're going to have to take control of some of the things you're eating.

I think a lot of us realize we're not probably eating the healthiest, and we can make some adjustments. But what are some of the things that you think could make the biggest impact right off the bat? What are some changes that could be made right away that can make a difference?

Thunder: So what I recommend to people, the first thing they should look at is their sugar intake. The reason why I pick on that is because there's a lot of hidden sugar in foods that we don't really suspect. Between drinks, like iced teas and obviously sodas and juices and snacks and things like that, it's just easy to have a lot of that in there.

Scot: All right. So sugars would be one of the first things, the obvious sugars in the sodas, and then the hidden sugars and stuff like sweetened yogurt. Any sort of flavored yogurt that's not a plain Greek yogurt is going to have hidden sugars. Get rid of those. What would be a good Step 2 then?

Thunder: A good Step 2, I would say, is look at the timing of your eating. When do you eat? When do you snack? Things like that. Sometimes people are grazers. They'll tend to kind of nibble and munch the whole day, and that basically puts them in a position where their insulin levels are always high. Insulin is the hormone that's needed to make fat and to store nutrients. So looking at your food habits, your behavioral habits is another way. Maybe instead of eating 18 hours out of a 24-hour cycle, try to eat 8 or 10 hours. That's a great tool to use.

Scot: If you find yourself overweight and you're trying to lose that weight, is that something that you should go to a health professional and should be done under the supervision of a health professional? Or is this something that a person can do on their own safely? What is both of your guys' take on that? Thunder first.

Thunder: I would say if you're just trying to lose 10, 20 pounds, something like that, then just do it on your own. If someone is very obese, with a BMI of over 40, and they're in a position where they have life-threatening conditions, they need to lose 100 pounds or 200 pounds, at that point I would recommend those people get involved with the physician because they need a more drastic weight loss program.

Troy: And it's also worth thinking . . . Scot, you mentioned working with a healthcare professional. If you have just struggled and you can't get the weight off and you're morbidly obese, consider gastric bypass. Consider bariatric surgery. It's been proven it works. It's successful. Most of the time, people are able to lose weight. They're able to keep the weight off long term. Obviously, we want to talk about diet and exercise and everything there. But if this is about really trying to reduce your long-term risk of heart disease, and diabetes, and everything else, and just nothing has worked for you, talk to your doctor. That's something to consider. And for some people, that's what they need and it does the job.

Thunder: Yeah, and I think it's important to make a distinction between someone that's trying to lose 15, 20 pounds versus someone who is 75, 80, 90 pounds overweight, and they have pre-diabetes and maybe they have high blood pressure. So they have documented medical reasons that they need to lose weight to improve those conditions. What we're talking about in contrast is someone who is slightly somewhat overweight, 20 pounds, and they know if they can stay on that road, in 10 years, you're going to have an increased risk of various ailments.

Troy: Exactly.

Thunder: I think that's important for listeners to keep that in mind.

Troy: Yeah, we're not talking about getting in swimsuit shape and getting gastric bypass for that. This is about taking a surgical step to reduce your long-term, very real risk of heart disease and stroke and everything else and serious medical issues, and someone who's been struggling with long-term morbid obesity.

Yeah, this is not really what we're talking about, but, again, getting back to that question of when do you talk to your doctor, when do you think about medically supervised things, I think that's probably more where you may want to look into that.

Scot: Some good lessons. Fat is an indicator that you might have some other health issues down the road. So even if it's just a little bit more than you'd like, perhaps start turning that thing around sooner than later before it becomes much more difficult, because as we've learned today, that extra fat can impact your health in a lot of different ways, including diabetes, and heart disease, and cancer.

Thanks, Thunder, for that great information today, and thank you for caring about men's health.

Troy, are you ready for a new segment idea we're going just kind of float out there and see how it works?

Troy: Yeah, let's do it. Let's start something new.

Scot: All right. As guys, I think . . . at least I can only speak for myself, but I like this feeling of being prepared to handle situations that come up. So, if a situation comes up and I'm out in the world, I'm like, "I know how to help with that."

This is "Who Cares About Men's Health." You are an emergency room physician. So these are going to be a little bit more serious things, but I think I want to call the segment "How Do You Handle It?"

Troy: "How Do You Handle It?" I like it.

Scot: "How Do You Handle It?" We're going to talk about some things that might happen out in the world, and hopefully, you are going to be able to give us some advice on if this happens, how we could be helpful and useful in that moment so we know how to handle it.

Today, I thought it might be fun to do frostbite. Not fun to get frostbite, fun to do frostbite. You think you've had frostbite at one point in your life.

Troy: Oh, yeah.

Scot: Didn't you tell that story?

Troy: It was awful. Yeah. I was nervous. It was bad. It was one of those things. I was out on a long snowshoe run in the middle of winter, and it's like eight degrees out and my feet are covered in snow the whole time, just in powder. And I get up to the point where I'm turning around to come back down, and I think, "Wow, I can't feel my feet, but my feeling will come back as I get closer to home in lower elevation and as things warm up a little bit."

I get home, and I take my shoes off, and I still can't feel my feet. Right now, as I'm talking about it, I still have that sensation. Just thinking to myself, "From the ankle down, I can't feel my feet. This is the weirdest thing."

I peeled my socks off and my socks were pretty much stuck to my feet because they were frozen on my feet. I looked at my feet and it looked like textbook pictures of frostbite. My feet were just white. And I touched my feet and I could not feel anything. I started to feel very nervous. It was scary.

Yeah, I did experience at least some mild frostbite. Fortunately, I recovered from it. But we can talk a little bit more about that process of what I did to treat that and how you do that. But it was a scary experience.

Scot: When you saw that, was there a little bit of a denial? You're like, "I know I'm a doctor. I know I've studied this. I know what it looks like. I'm seeing it on myself. No, that can't be frostbite."

Troy: I usually go one of the two extremes. I'm usually in complete denial, or I go all in and I'm like, "Wow, I have frostbite, I'm going to die, and I'm going to lose my feet." And that's kind of extreme I went to. It was more like, "Wow, should I call 911?"

Yeah, I was nervous. It was one of those things where it was a combination both of being like, "Okay," and then there was a lot of pain following that time. So it was both that pain and then also definitely a high sense of anxiety associated with that.

Scot: Painful. Your feet are white. Those are some of the things to look for. You said there are different degrees of frostbite. So how do you handle it? Cover some of that for us.

Troy: I think one of the important things about handling frostbite is, first of all, if you're in a situation . . . let's say I were up there at the top of my run, and I'm at 9,000 feet, and my feet are in the snow, and I think to myself, "I think I have frostbite." I should not make a fire there and boil water and try and get water hot and try and rewarm my feet because my feet are going to get cold again. You don't want to thaw it out and then have it freeze again. That's the number one goal.

Scot: That's the worst thing?

Troy: Yeah. Don't thaw it out. Do not treat frostbite unless you're in a situation where your feet can stay thawed out. So, if you're up there in that scenario, and you're like, "Wow, I have frostbite," just deal with it and get to a point where you can then be in a safe place and treat the frostbite and not have it refreeze, because that's when really bad damage can happen. That's probably the number one take-home of it.

Scot: All right.

Troy: But then once you get to a point where you can thaw your feet out, or your hands or whatever it is . . . feet, fingertips, toes, those are the most common sites where we see frostbite. The way you want to do it is get a warm bath, about 100 degrees. Something that feels warm to you. You put your hand in the water, and it's like, "Okay, this is warm. It's not crazy hot where it's burning my hand, but it definitely feels warm." And you want to re-warm your feet in that.

Basically, what I did was I took our bathtub, I filled it up, just started running some warm water in there, and I put my feet in there and it hurt like crazy. So as that blood started coming back into my feet and the tissue started to re-warm, it hurt like crazy and it itched. I just wanted to scratch at my feet. It was very uncomfortable.

And that's the biggest thing with re-warming frostbite, is it does hurt. If we see it in the emergency department, sometimes we have to give pain medications with it to help people tolerate that. But you want to just have warm water where you're circulating that water through there. Maybe get the bath full to a certain point and then just keep running some more water in there and go through that process. For me, I did that for about 15 minutes.

Then I looked at my feet after I had re-warmed it, and I actually sent a picture to Laura, my wife, at that point. I said, "I'm a little bit nervous," because it just had this funky, weird appearance like my feet were all bruised as that tissue was re-warming and blood was trying to work its way back in. It was kind of scary looking.

That's often where the damage happens in frostbite. It's not the freezing piece. Usually, the freezing doesn't cause the tissue damage. It's during that re-warming process that it can get damaged.

But I tried just to do what I would normally do with any sort of patient and just say, "Okay, we're going to go through a re-warming process now." I took some pain medication with it too. I took a Tylenol to help with some of the pain I was experiencing.

And after I'd done that first 15 minutes, I kind of took 10 minutes off and said, "Okay, we're getting there. I'm still nervous about this, but let's do another re-warming trial in the bath and see how things go." And then I went through that, and after that second 15 minutes of re-warming my feet, things weren't back completely to normal, but I was getting some feeling back in my feet. At that point, the tissue was looking a little more normal, not really that crazy, weird bruise look to it. It's the same process I'd recommend someone go through if this happens to them.

Scot: If you're in a situation where you are at the top or wherever of the 9,000-foot peak, or wherever you might happen to be, is there a point where you just make it your priority that I'm going to stay here until somebody can come get me and I'm going to start re-warming stuff right now?

Troy: No, I wouldn't. Because then you've got hypothermia and everything else you've got to deal with.

Scot: Oh, right.

Troy: If I'd stayed up there . . . like I said, the high that day was in the single digits. And if I'd stayed up there and I'd stopped moving altogether, then I'm risking hypothermia. Then you're risking not only loss of limb, but loss of life. You want to just keep moving. This is going to happen probably when you're somewhere in the backcountry on a hike or snowshoeing or . . .

Scot: Snowmobiling.

Troy: Yes, snowmobiling or something like that. Yeah, don't stay put. Just work your way back and work your way back calmly and recognize that, yeah, you've got some frostbite, but you can deal with it and you can work through it and get things back to normal.

Scot: So the protocol that you would follow in the ER is literally what you described that you did at home You don't have any secret weapon?

Troy: No secret weapon. The treatment for frostbite is re-warming. And it really just comes down to trying to get it re-warmed as soon as you can. You just want to keep re-warming until that tissue no longer feels like a block of ice, that crazy feeling that I felt as I touched my feet where it felt like ice. You want to get it re-warmed to where it feels like normal tissue.

Scot: All right. "How Would You Handle It?" Our very first one on frostbite. How are you feeling about that?

Troy: Feeling good. It's something I think that's very relevant right now. We're going to see, I think, a lot more of these things this winter. Frostbite, potentially avalanche injuries, things like this, stuff that happens in the backcountry because my guess is we're going to see a whole lot more people getting out in the backcountry this winter, just with COVID and everything else. So this is one thing to keep in mind. Know what frostbite is, know how to deal with it, be prepared for it, know what to do if it happens.

Scot: Time for "Just Going To Leave This Here." It might have something to do with health or it could be a random thought that we have.

Just going to leave this here. Troy, do you ever run on the treadmill?

Troy: I do.

Scot: You ever get on that thing and think, "Oh, man, this is a form of punishment"?

Troy: Oh, absolutely. That's why I run outside.

Scot: So I found an article in "The New York Times." The treadmill was once a criminal sentence.

Troy: That doesn't surprise me.

Scot: And there's a picture that shows prisoners on a treadmill in London around 1850. Yeah, the treadmill used to be . . .

Troy: Is a form of punishment.

Scot: It was a form of punishment.

Troy: Probably would be considered cruel and unusual punishment. That's why it doesn't exist anymore. You can't do that to prisoners now.

Scot: You're right, and you shouldn't. If you throw golf on the TV while you have them on the treadmill, that's cruel and unusual. That's like the worst.

Troy: That's awful. Well, Scot, I'm just going to leave this here. I ran across an interesting website recently. It opened my eyes to some very fascinating pedestrian laws. I am very attuned to pedestrian laws because I am often a pedestrian. And when you're a pedestrian, you really feel like your kind of putting yourself out there. I've been in some places as a pedestrian on the road where it's downright scary.

But let me ask you about this, Scot. You've got kind of the crosswalks that are just the two lines going across the road. And then you've got the crosswalks that are like those thick things that look like railroad ties going across the road. Do you know what the difference is in the law with those things?

Scot: I didn't know there was a legal difference. No.

Troy: There is a legal difference. If someone is in a crosswalk when there's just the two stripes going across the road, you just have to wait until they're not on your side of the road and then you can go. If you're at a crosswalk with those big railroad tie looking things, and those are usually school zones, you have to wait until the person is completely off the crosswalk before you can go. Interesting.

Scot: I didn't know that difference. At one point in my life, I had heard that here in Salt Lake, if the pedestrian was in the crosswalk, but they were on the other side of traffic, not my area, even then you were supposed to let them completely clear the crosswalk. But there are actually visual indicators. That's interesting. That's good to know.

Troy: Scot, this came up on a website. Actually, the state of Utah put it together. Some of this may be different state to state, but the website is drivermyths.utah.gov. It kind of goes through some of these things. And some of these are a little tricky. It was a little bit surprising to see what laws are specific to pedestrians in crosswalks and what we really need to be aware of.

Scot: All right. Time to say the things that you say at the end of podcasts because we are at the end of ours. First of all, if you want to get in touch with us, you can do it in a lot of different ways. The way that would be kind of cool is if you called 601-55SCOPE. That's 601-55SCOPE, and leave us a voicemail with your message, your question, your feedback, whatever. But there are other methods as well.

Troy: You can contact us, hello@thescoperadio.com. We're on Facebook, facebook.com/WhoCaresMensHealth. Our website is whocaresmenshealth.com. Also, subscribe anywhere you get your podcasts. We're on Apple, Google Play, Spotify, Stitcher, Pocket Casts, whatever works for you.

Scot: Thank you for listening. Thank you 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: "Who Cares About Men's Health?" And we just wanted to kind of give you one final gift of 2020 because that's the kind of giving guys we are. I mean, I know Troy's a lot more giving than I am generally. And Troy, this was his idea really.

Troy: This was my gift to all of our listeners. You know, Scot, we wrapped it up last week, but we said we can't end 2020 like that. We've got to have one final thing we say here. So we're giving you this.

Scot: All right. So before we get to our final thing here, this is going to be just a short "Who Cares About Men's Health?" We wanted to let you know some of the episodes coming up next season that we're pretty excited about. We've got some familiar faces back on. Thunder Jalili is going to talk about obesity and why is that a big deal when it comes to your health, and you might be surprised . . .

Troy: Great way to ring in the new year.

Scot: Yes.

Troy: Because I'll feel guilty on January 3rd or whenever it's going to air.

Scot: We're also going to bring back John Smith, he's our urologist, with another episode of ask a urologist. One of Troy's acquaintances is going to come on, tell us about, [Roshago 00:00:58].

Troy: Yeah, Roshago is someone I've known for over a year now. And he is a bodybuilder, not a professional bodybuilder, but just below a professional level, fascinating guy in terms of what he goes through for these bodybuilding competitions. Like talking to him, I hear him talk about body fat and how low he goes and what that does to him, how he diets for this, his whole process. Really, it's going to be fun to hear from him and his experience and then how that translates to the average guy. You know, like Scot, you know, a completely different world, but how do we incorporate some of what he does to try and, you know, put on a little more muscle mass and take off some of that fat.

Scot: And then also our very first episode back will be on a topic called cognitive load, which is fascinating and how COVID-19 and the pandemic has maybe impacted your ability to concentrate and even solve difficult problems. And there's actually a psychological explanation for that, which we'll talk about and we'll have some tips on how to overcome that as you head into 2021. But here is your Christmas present, if you will, your gift, your final gift, whatever holiday you celebrate, this is our little thing that we are giving to you. Our final, just going to leave this here. I'm just going to leave this here. So I wanted to let you know, Troy, that I have started puzzling. I've started doing a puzzle.

I know I'm a little late to this party. I know that this is so beginning of the pandemic, you do puzzles.

Troy: Yeah.

Scot: But my wife got a puzzle for me of Bryce Canyon for my birthday, 500 piece puzzle. I finally dumped it out on our big table, and I've really enjoyed it. You know, we talk about finding those things that can kind of take our minds off of what's going on or distract us or use a different part of our brain, and puzzling really is kind of filling that for me. So what I've enjoyed about it is getting intimately kind of familiar with an image and just knowing every little, small detail. It forces you to look at these little, small details you may have overlooked before. And then you look at all the pieces on the table, so you're looking at the cover, right, and you get the overall image. And then you look into the pieces on the table and then starting to recognize those patterns, those little intimate details that you might not have noticed before. And just the kind of even searching for the different pieces that go there. I've really started to enjoy that, and I find myself in a Zen state. I was up till midnight last night because I lost track of time.

Troy: Wow.

Scot: Putting together this puzzle. And, you know, so anyway, I just was really excited to share that that is something that I found has really kind of helped distract me. It's kind of like that hobby that we talk about. So it's not all on exercises back to, you know, reduce that stress and that sort of thing. You're laughing, what do you got?

Troy: But I can't help it, Scot. You're talking about puzzling. My only association with puzzling is Christmas Eve at my in-law's house, and every year, my mother-in-law has this gigantic, super-involved Christmas puzzle. And she wants us all to get involved and do it. And I do as much as I can. And usually, the other family members who are there find some excuse to get away from there. And so one year it seemed like it was just me and her doing this puzzle all evening. And I was just like, "Please, please make it stop." Nothing against my mother-in-law, but it was just trying to find these pieces. What you were finding to be a Zen-like experience, I think with my difficulty with concentrating for a long period of time, I really struggled with, so maybe I need to do more puzzling, but I'm glad you found that satisfaction.

Scot: Well, and I think the context . . . Yeah. The context for you isn't that great either because that's not what you're looking to do over your holiday.

Troy: It is really not.

Scot: Like, for me, it's like I go down to have my lunch and instead of taking my electronic device and just scrolling, I'll eat my lunch and I'll just kind of look at the pieces and look at the picture and, you know, I might find two or three pieces that help me with it and that's fine. I'm not breaking any records solving this thing, but, you know, it's something different other than, you know, mindlessly scrolling.

Troy: No, it's good. It sounds more productive than sitting down and watching "The Office" for the 40th time on Netflix, which is usually how I spend my evenings. So, yeah, definitely, a better activity than that.

So, Scot, I'm just going to leave this here. I now have gotten the COVID vaccine and I got it last week. As you probably know, it came to the U.S., rolled out last week. The first person to get it was in New York City. I think it was a MICU nurse in New York on Monday. And then I think you were involved in the news conference at the university on Tuesday where our first person in Utah to get it was also an ICU nurse at the University of Utah, and then I was fortunate enough to get it later that day.

So they told me I was one of the first 50 people. It was just dumb luck. I was leaving my shift in the respiratory unit after taking care of COVID patients all day, very sick patients, and one of our nursing administrators said, "Hey, do you want to get your COVID vaccine right now?" And I said, "Absolutely." I went upstairs up to the medical intensive care unit. We had several other frontline healthcare workers there from the MICU, from the emergency department, some from the trauma service, and I got the vaccine.

And it was a really cool experience. It was like a very bonding experience with everyone there. Like people were all getting pictures of each other and pictures of themselves doing this, probably all sorts of HIPAA violations with that, but we didn't care. You know, it's like, "Hey, this is amazing." And I had a lot of emotions. I think, like, I didn't think a ton about it at the time, but afterwards I got home and went for a run and kind of thought about it and, you know, kind of had a few different emotions. I mean, one was a very deep sense of gratitude that I was able to get this. And, you know, just kind of this feeling like, "Hey, here's the light." This is the light at the end of this very dark tunnel that we've been traveling through, and this is how we get out of it.

And I felt so grateful that I could get that vaccine, and I also felt a little bit of guilt. I mean, I got to be honest. It's almost kind of that survivor guilt. I kind of thought about people I've cared for over the last nine months who haven't made it and how I wish they had that vaccine and they could have prevented this and they could have gotten through this and guilt too that I was getting this when I know so many other people both in my life and then patients I know, and other people who I would rather have this than I have it. You know, I'd rather that they get it before I get it. So a little bit of guilt too.

So kind of an interesting range of emotions there. But my biggest feeling was I am so grateful to have this. You know, I guess it's kind of like feeling like you're on a ship that's wrecked and you're the first one ashore and you want to get everyone else to shore. And my thought was I want everyone else to have this right now. I want it right now for everyone. I know that is not logistically possible, but it was kind of like that opening of the door to say this vaccine is here. We're rolling it out. People are getting it. And I'm so grateful to have this. And I want as many people to have this as soon as possible.

So what I can tell you, in terms of reaction, the shot, the vaccine did not hurt going in. It's sore. You know, it was sore afterward, just an ache for a day or two after in my left deltoid, on my left shoulder where I got the injection. Maybe a little bit more of an ache than a flu shot, kind of like a tetanus shot if you remember how you feel with the tetanus shot. But otherwise, I felt fine. You know, everything's good. I've been running consistently since then. Everything's been great. So I would absolutely encourage you whenever you have the opportunity to get the vaccine, when that opportunity comes to get it.

Scot: I'm excited for you. That makes me feel better. I know that you've got, you know, all the safety precautions in place in the ER, and you're very diligent about that, but this is just that added level of protection and security. Now, does this mean that you can go after your immunity builds in two weeks, you can go visit your parents again because you won't be carrying it or no?

Troy: It's tough. The guidance that we have received and that others have received and given as well is to continue to practice everything you had practiced prior to getting the vaccine, which means I'm going to be wearing the same PPE at work, you know, the same mask, the same PAPR helmet, all that kind of stuff I'm wearing. The reality is still I need a booster in 21 days. From what I understand, two weeks after I got the injection, I should have built up maybe to 50% to 80% in terms of that immune response, and then that booster at 21 days gets you up to the full response. So we're really . . .

Scot: Which is like 95%?

Troy: Yeah. I mean, 95% reduction in risk, 100% in terms of just the response you'll receive from it, but a 95% reduction in terms of risk of catching the virus. But you can still catch it. That's a little of the challenge. You can still catch it, but it reduces that risk significantly. I mean, the efficacy of this vaccine is mind-blowing for me. Like this is better than anything I think any of us ever hoped for. So, hopefully, that plays out in the long term. Again, I don't know what the implications are for family, but I've been visiting my parents, meaning that I'll go down and see them, we'll hang out outside, you know, social distance, that kind of stuff. So when I do them, that's how we do things, and I don't think that's going to change anytime soon.

Scot: Time to say the things that you say at the end of podcast, because we are at the end of our podcast. All right. So if you want to reach out . . . wow, this is the last podcast episode of the year, Troy.

Troy: Wow, this is it. Yeah.

Scot: We're heading into 2021 after this one. All right. So if you want to reach out, you can do that, we've got a lot of ways. You can email us at hello@thescoperadio.com, you can go to facebook.com/WhoCaresMensHealth, or you can go to the website whocaresmenshealth.com.

Troy: We also have our listener line, it is 601-55SCOPE. We'd love to hear from you. Subscribe anywhere you get your podcasts, Apple, Google Play, Spotify. Please rate us five stars if you like us. Thanks for listening. And thanks for caring about men's health.

Scot: Have a good holiday, my friend.

Troy: You too, Scot.