Man Up!
Most men are reluctant to talk about their health, but what’s not being said can have a direct effect on their well-being now and years down the road. So we decided to start the conversation….
It’s sad but true: Most men don’t go to the doctor unless they’re nagged to the brink by a spouse or they’re in extreme pain. Whether this stems from a cultural idea that men should never demonstrate vulnerability or weakness in any way, or whether it’s because most men shy away from the notion of having to discuss their bodies, emotions, or sexuality with another man (not to mention the fear of invasive, uncomfortable tests), it’s no surprise that many guys refuse to go.
“Most men just say to themselves, ‘I feel fine,’ ” says Joseph Tribuna, MD, director of the Family Medicine Residency Program at Overlook Hospital and medical director of the Overlook and Chatham Family Practice, “but the goal of visiting your primary care doctor regularly is to maintain your health and identify potential problems before they arise.” It makes perfect sense and it’s good advice. And yet, getting a regular checkup is still a tough sell to most males. Here, we offer up the lowdown on what typically goes into a routine medical visit for men. And it’s not as bad as they probably think.
The Early Years
“When a man in his twenties, thirties, or early forties comes into the office, I spend time talking with him about his job, relationships, and family, and the stress that often results from these major responsibilities,” says Tribuna. “I remind him to take care of himself while he’s busy taking care of everyone else.” In addition to discussing healthy ways to cope with stress, Tribuna also prescribes routine blood work, checks cholesterol levels, and discusses weight management if necessary. He takes a careful family history, paying close attention to issues like heart disease, hypertension, and diabetes, since these tend to become areas of concern as men age. “I also take a good look at a patient’s skin, since a lot of hidden issues can be seen subtly on the face,” says Tribuna, “and I pay close attention to their back since it’s one area that a patient can’t examine himself, for abnormalities like problematic moles or signs of skin cancer.”
If the patient smokes or abuses drugs or alcohol, Tribuna opens a discussion on the benefits of quitting all nicotine habits or recovering from addiction. Many young men don’t realize what a moderate amount of alcohol consumption really means, and unknowingly drink in excess. Experts advise men to have no more than two standard drinks a day (one standard drink is equivalent to one 12-ounce bottle of beer, one 5-ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits). “The main focus of these early exams is to minimize problems in the future,” explains Tribuna.
Fifty: The Magic Number
Once a man turns 50, screenings for a variety of issues start to become necessary (coincidentally, this is also the time when most men really start hiding from the doctor). “At 50 we begin screening for colon cancer, unless there’s a family history, in which case we’ll start screening earlier,” explains Tribuna. He also does a prostate screening, although this has become controversial in recent years, with some experts arguing that the risks of false positives and unnecessary biopsies associated with regular screenings outweigh the benefits. Tribuna also does many of the same tests he orders for younger men, such as screening for high cholesterol, heart disease, hypertension, and diabetes. Aspirin therapy also becomes a consideration for the prevention of heart disease. “Some doctors feel every man over 45 should take a daily low-dose aspirin,” says Tribuna, “but that is a controversial stance. I tend to look at a patient’s history before prescribing aspirin therapy.”
If this seems like a lot of tests, take heart: “It’s not necessary to do every screening annually,” says Tribuna, “as long as the patient’s risk for a particular disease is low and there is no family history.”
Sixties, Seventies & Beyond
“As men get into their sixties, we continue with all the same screenings we did in their fifties and add treatment for other issues that start to arise,” explains Tribuna. “For example, men who have been active and athletic their whole lives may start feeling the results of the beating their body has taken over the years. And while I encourage them to remain active, we try to find ways they can exercise without injuring themselves.” Tribuna suggests forms of moderate exercise, like brisk walks, ballroom dancing, and swimming. Arthritis also becomes an issue for many men as they age, as does osteoporosis—“although we don’t hear as much about it in men as we do in women,” he says.
So Why Go?
“Many men don’t realize that they don’t have to have a checkup every year if they’re healthy, the way the women in their lives do,” says Tribuna. “But it’s a good idea to establish a relationship with a primary care doctor, so you have a resource for health questions or issues that might arise.” He also points outs that many life-threatening conditions like hypertension and diabetes are silent in their early stages. “So if you’re not at least having your blood pressure and cholesterol checked and having blood work done regularly, you’re putting yourself at greater risk,” says Tribuna. “Prevention is key.”
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