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The Armor Men’s Health Hour: Let Food Be Thy Medicine

Shefaly Ravula, PA-C Explains How Nutrition & Diet Can Help Heal Cancer Patients

The Armor Men’s Health Hour is brought to you by Urology Specialists of Austin.

For questions during the week, call us at 512-238-0762, or visit our website.

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Welcome to the Armor Men’s Health Hour with Dr. Mistry and Donna Lee. Many thanks to KLBJ news radio and all of our wonderful staff here for helping us put on this show. This is a men’s health show. I’m a board-certified urologist. That is a doctor or a surgeon who treats genitourinary conditions of the prostate, kidney, kidney stones, low testosterone, hormones, wellness. We do so much great stuff here.

One of the big reasons that we’ve decided to bring this show to the community is to really highlight a different way of thinking about your health. One of the great things about our practice is how incredibly diverse it is—you would rarely find as intensive of a nutrition program in a medical practice, let alone a surgical practice. We strive to achieve a whole-body approach to different medical conditions.

Shefaly Ravula, PA-C

Today, we are joined by Shefaly Ravula. She is a physician assistant and she is our functional nutrition provider here at our practice. Not only was she a food writer for the Austin American Statesman, she also does cooking shows, and is a trained medical provider. She really understands the connection between nutrition and health and wellness.

It is very easy to talk to people and for them to accept on a superficial level, that what we put in our body can affect our health. That’s easy for people to believe. Somehow, it’s hard for people to believe that if they change what they’re putting in their body, that it can affect their body system.

Triggers for Diet and Nutrition Changes

What are some of the triggers that really inspire somebody to change the way they’re eating or their lifestyle? Often, in the medical world, it’s a new diagnosis. A new diagnosis is like a pain point. It’s a new pain point, especially if it’s a chronic illness. If you don’t have a pain point, then you’re going to have a really hard time being motivated and coached by anybody, including yourself, to make those changes.

Transition points like these are really an opportunity for you to re-examine what you’ve done. You know, smokers often don’t stop smoking until they get a bad illness. People who are overweight often will wait until they have some kind of chronic illness, which is really a shame, because sometimes you’ve waited too long.

Another example is when my fatty liver patients are told they have fatty liver or even cirrhosis, that’s actually when they first hear about alcohol reduction. Or they’ve heard all along, but that’s when they actually do it. It is a real struggle to get people to make lifestyle changes when they’re not having a specific pain point, unless you’re particularly motivated that way. As a medical professional, I have to give out pain points every day. I’ve got to tell people they have low testosterone. I’ve got to tell people that they have interstitial cystitis. And then, of course, cancer diagnoses are a big part of our everyday here.

Drawbacks to Band-Aid Medicine

Band-Aid medicine is, you know, it’s not what I want to call what we do in the medical field. I mean, we need this Western approach, this evidence-based medicine, and we have a role of course, for this kind of medical care. That said, I’d like us to see in this country a better approach to chronic disease and chronic illness, which takes a lot of work. It’s a work on a provider and more work for the patient.

I’m a big believer in philosophy guiding practices. If you were just to kind of generalize the nutritional approach to cancer diagnosis. And nobody here is talking about not doing traditional therapy. You know, if you have prostate cancer, take your doctor’s advice. But every single one of my patients, literally the second I diagnose them, the first question they ask is what should I eat? It’s on the very forefront of their minds.

The Cancer Nutrition Philosophy

How would you explain kind of your philosophy or your approach to cancer nutrition? There’s a lot. There’s a lot there and you can generalize diets for the masses. It would be hard. Everybody knows to eat clean and eat vegetables for the most part. If you look at all the diets out there, Paleo vegetarian, vegan, Keto…I mean, most of them don’t disagree on vegetables. And clean foods, we’re really talking about things that are minimally processed. So whole foods. Not like, a broccoli chip, but just broccoli please. All those kinds of things out there.

The reason your patients are going to ask you first and foremost, “What can I eat?” is because patients need to feel empowered. They’ve been given a diagnosis by somebody else, it’s totally out of their control. This goes for everything, cancer, heart disease, diabetes, whatnot. They are going to ask their doctor because who else can they ask? They don’t, you don’t go to a nutritionist for a well-check. You go to your doctor. So, they’re going to ask you.

Luckily now, you know, incorporate culinary, cooking classes, culinary medicine, into their programs, more and more, but certainly when you and I went, when I went to PA school, or when you went to med school, nutrition was like two hours of your, you know, education…nothing.

Importance of Patient Follow-Through

There’s a lot of reasons for it. How much can we really try to turn the patient’s viewpoint? When somebody comes to me with an enlarged prostate, I know that I can recommend, 10 times out of 10 prostate surgery is going to help you pee better. I’m going to feel very confident that’s going to work. But I’m not as confident that if I send somebody for weight-loss counseling since I don’t know if they’re going to follow through. And I think it’s people being disappointed with our patients follow through that, discourages us to keep going, but that’s never been my philosophy. I’m always a big fan of the one person that decides to go through the therapy.

When it comes to cancer eating, a lot of them are very motivated to lose weight prior to surgery, but it’s the maintenance of some kind of lifestyle. And if it’s too drastic, they, a lot of people can’t stick with it.

Nutrition Principles for a Cancer Diet

What are some guiding nutrition principles that people can easily kind of think about when they approach a cancer diet?

I think the first thing I would say, you can say this the moment you see them in the office is to start eating cruciferous vegetables every single day. They’re a part of the brassica family and, they just all cruciferous vegetables–so this is kale, broccoli, cauliflower, bok choy, arugala, I’m missing a big one here, couple other ones in that class–if you can eat that every day, you know, a good handful or two servings, just put that…We should all be doing this, this is preventative anti-cancer therapy, truly.

Really, I would tell your patients, “You want to do something, you want some empowerment? Do you want to take charge, be in control a little bit? Start eating blueberries and broccoli every single day.”

Reducing Inflammation

The idea is that you’re reducing inflammation, so an anti-inflammatory diet is huge. If I had to really encapsulate what approach is to so many disease processes, it’s this idea that inflammation is a central core component of many things: cancer, heart disease, high cholesterol, weight. And by reducing the inflammatory response in our body, I think that we can reduce rashes, irritable bowel, cancer diagnosis and progression, and so I’m really proud of the approach that we’re taking together when it comes to nutrition.

If you’re out there and you’ve been diagnosed with cancer, whether it be prostate cancer, kidney cancer, or another type of cancer, and you haven’t been given nutrition guidance on what to put in your body, we would highly encourage you to come in and visit with us. What we put in our body has to have some impact in what’s going on with us in terms of our health, even if it’s cancer.

You don’t have to have a urologic condition per se, to be able to visit with Shefaly or our team. And she can see you directly. She’s a physician assistant. She has incredible medical training, worked in oncology, worked in GI medicine, and we are now very happy to have her here in urology.

If you have questions for Dr. Mistry, email him at armormenshealth@gmail.com.

The transcript has been edited for length and clarity. Listen to the original episode on The Armor Men’s Health Hour podcast.

To make an appointment, call us at 512-238-0762, or visit our website.

The Armor Men’s Health Hour: Family Planning

Dr. Mistry and Donna Lee Discuss Vasectomies and Vasectomy Reversals

The Armor Men’s Health Hour is brought to you by Urology Specialists of Austin.

For questions during the week, call us at 512-238-0762, or visit our website.

vasectomy-reversals-armor-mens-health

Hello and welcome back to the Armor Men’s Health Hour. I’m Dr. Mistry, as always, with my host Donna Lee. For those of you that listen to the show, you may recall that Donna Lee is in fact a comedienne, a professional comedienne. And she and I have a running gag that one day I’m going to come up with a whole comedy set.

Are you ready for my first one? What is the difference between a man and a woman?

There’s a “vas deferens.”

Don’t Know What A Vas Deferens Is?

The vas deferens is the tube that connects the testicles to the prostate, and that’s where sperm is transported so that we can make babies.

There are two different surgeries that we do for the vas deferens. This month, I was confronted with a patient who had a very enlarged vas deferens and it was very thickened. It was very tender and painful, it’s calcified vas deferens, and it’s one that resulted, we think, from a trauma that the patient experienced and has now led to infertility and chronic pain. So, we’re going to remove the whole vas deferens.

This process is just called a vasectomy, but that’s going to be a much bigger, much more involved procedure than we would usually associate with a vasectomy.

The Vasectomy Process

For those of you, if you’re at home from work and you’re able to recuperate, you may be interested in having a vasectomy during this time. The vasectomy is a very commonly performed, well-tolerated procedure. It takes about 20 minutes. We do it here in the office.

And we have great music that plays in the background—if you like 80’s new wave alternative because that’s pretty much all that’s going to play. You can tolerate the music because we do offer IV sedation, using intravenous midazolam, which wears off pretty quickly. Most patients are able to walk out of here even though they’re pretty loopy, sleepy, or really funny. They’re always smiling.

That’s another running joke we say about people when they go back to write reviews about the vasectomy, they say, “Well, don’t remember it, but everything went well.”

Single Visit Vasectomy

One of the reasons that we started the IV sedative is because it allows us to do something called a single visit vasectomy, which means that you can come in, get your consultation for the vasectomy, and get your procedure in the same day, which is extremely convenient. It makes it more likely that you’re going to go through with the procedure because you only have to come and wait in the waiting room and wait for me and you know, do all that stuff one time. At other offices, you have to go in 3 times, at least.

Benefits of IV Sedation

It becomes inconvenient when people are already kind of nervous about the procedure. We try to eliminate that one barrier by doing it. Another real benefit of the vasectomy with IV sedation is that you don’t remember it getting done. And early on in my practice, I had this theory that when you’re getting worked on down below, that’s already kind of an anxiety-provoking experience. If you can remember the pulling or the sharpness of any kind of instrument, I bet you kind of makes you like have some anxiety.

That sounds like a one-star Yelp review. And I think a lot of men were having discomfort after their vasectomy just because of that experience of having gone through it. As a result of that, we have much higher rates of actually completing the vasectomy because the anatomy is a lot easier to deal with. And we have fewer people complaining of pain and discomfort afterward. That’s really great. The IV sedation really puts us in a different category. We use a single incision.

Vasectomy Reversals

But we do something else here too, and that’s the vasectomy reversal. We do quite a few vasectomy reversals as part of our male fertility offerings here. The vasectomy reversal is done on some estimates on about 10% of patients that have a vasectomy rethink that decision. You know, you never know. But what’s interesting is second wives are older than they used to be.

If you’re thinking about getting a vasectomy reversal, but your second spouse happens to be 38 or 42, then it may be wiser in terms of the chance of getting a baby to do an extraction. We can do this right from the testicle or epididymis and then go through IVF. We have some wonderful IVF partners that we use. And so that’s one of the important considerations that we ask men to go through before they make a decision on becoming dads again is what would be the most likely way for it to happen?

There are a number of reasons men want to have a vasectomy reversal. There’s remarriage, which is probably number one. There’s just rethinking family size as economic situations change. And then, of course, the most tragic is the loss of a child. It’s an unfortunate tragedy that we deal with probably, you know, 3 to 6 times a year, we have a couple come in with the tragic loss of a child. The vasectomy reversal is a way for that family to find some happiness out of a tragedy.

You can get a vasectomy reversal in the office in some places, you can go down there or someplace that will do it in the office. I think it’s much, much more comfortable to get it done under general anesthesia. It takes, you know, an hour and a half to do it and you’ve got to sit still for an hour and a half and somebody’s working on your stuff. I mean, so we do most of ours in the operating room.

How Much Does a Vasectomy Reversal Cost?

The price for a vasectomy reversal is around $6,000. It is not covered by insurance. And for an additional $500, we will collect sperm that you can cryo-preserve and you’re not going to find that opportunity virtually anywhere. It adds about half an hour to the case since it requires me to examine the sperm under a microscope to make sure there’s moving sperm. It gets sent to a cryo-preservation facility and, just for a little bit of extra money, you have that confidence that even if the vasectomy reversal doesn’t work, then you have sperm that’s in the freezer that you could use for IVF or some other assisted reproductive kind of thing.

Does It Really Work?

A lot of people think of the reversals like just a plumbing job. Like you just took a tube and you’re just, and you are just occluding, and you just have to take that occlusion out and put it back together. But that, you know, the reproductive anatomy is really a living, breathing, evolving system. So, when you occlude the vas deferens with a vasectomy, the sperm backs up into the testicle. Then, there can be damage done to the epididymis and testicle that doesn’t allow the vasectomy reversal to work.

The numbers I usually quote is if you’ve had a vasectomy in the last 2 years or less, the reversal rates about 90%. If it’s less than 7 years, the vasectomy reversal rate is somewhere between 75% and 85%. But if it’s a, you know, 15 years or older, that number can drop to as low as 35%. So, the time since your vasectomy could have a big impact on success as well as any pain or complications you may have had.

The transcript has been edited for length and clarity. Listen to the original episode on The Armor Men’s Health Hour podcast.

To make an appointment, call us at 512-238-0762, or visit our website.

The Armor Men’s Health Hour: ADHD, Memory, and The NEAT Center of Austin with Dr. Jennifer Reynolds

NAU-ADHD-armor-mens-health

The Armor Men’s Health Hour is brought to you by Urology Specialists of Austin.

For questions during the week, call us at 512-238-0762, or visit our website.

Welcome back to the Armor Men’s Health Hour with Dr. Mistry and Donna Lee. I’m Dr. Mistry, your board-certified urologic host, here with my cohost Donna Lee. When I tell people that I’m doing this, this show and podcast and that I have this huge family in this practice, the first thing they ask is how do I, how can I do it? Like how can I get it all done? I jokingly think that I have ADHD, but the truth is I have an amazing wife who takes care of 95% of my life. And an amazing staff here at the office.

Speaking of ADHD…

You know, from the beginning of my desire to do this show, you could only talk about testosterone, erectile dysfunction, and large prostate, prostate cancer, and all the amazing things that we do, without getting to some of the psychological things. Over the course of this show, we do plan on talking about things like alcoholism and depression and anxiety disorder. But I’m seeing so many patients with other neuro-cognitive kinds of conditions. And I started thinking about “What am I worried about myself?” I’m in my 40’s. I went to school for many years and I feel like my success as a professional is dependent on a lot of the motivation. But I worry about my memory, and I worry about ADHD and hyperactivity.

Guest Dr. Jennifer Reynolds

So, we have a wonderful guest today, Dr. Jennifer Reynolds. She’s the CEO of the NEAT Center of Austin. That’s the Neuropsychological Evaluation and Therapeutic Center of Austin.

We use neuropsychology evaluations often in children when we’re trying to diagnose them with behavioral or issues related to how they’re progressing in school. And then we know about neuropsychological evaluations in older patients when I’m trying to diagnose memory, dementia, but there’s this whole big middle. When people think of a neuropsychologist, they think mostly ADHD assessments, or you know, autism spectrum disorders. 

Middle-Aged Men and ADHD

I’ve had an increase of middle-aged—40 to 60-year-old men—coming in worried about cognitive decline and memory issues. A lot of times I see some ADHD issues hand-in-hand with this, meaning inattention, inability to concentrate, impulsivity. All of these things that need to be parsed out from say dementia or you know, early-onset Alzheimer’s. There’s something that happens in the neurotransmission of a man’s brain between 40 and 55 specifically with dopamine and testosterone that can affect memory and cognitive ability, the personality of the man, problem-solving, reasoning, emotions. And all of these things can be examined by a neuropsychologist with a very thorough assessment—valid, reliable assessments.

Diagnosing ADHD

These aren’t things that are self-report where I ask you 10 questions and you say true or false with, you know, or on a scale of 1 to 10. This is 6 hours of testing. But it goes in and out of the brain very specifically to figure out what lobes are functioning best, what lobes maybe need a little more working out so to speak—you use it, or you lose it. And is this an ADHD issue that’s being exacerbated by low testosterone? Or perhaps it is early-onset dementia, or an Alzheimer’s memory problem?

ADHD Signs and Symptoms

From young to old, I get the same blanket diagnosis of ADHD that comes in my office, and they need validation of that because the diagnosis usually comes from a general practitioner who says, “Well, let’s try this cocktail of Adderall or Vyvanse. And if that works, then you have it.”

ADHD is a blanket term that I’m not really fond of. What it really means is a cognitive redistribution of thinking. So, people with attention deficit aren’t always hyper and jumping off walls, and they’re not always inattentive and daydreaming. There’s a lot, there’s a myriad of things that go on, which is the thought emotional process. For example, when you say, give me an example of what it may look like in a day to day life…so somebody with “ADHD” may have a to-do list, right, at their house and they got 10 things to do: change the light bulbs, you know, take out the trash. And before you know it, you’ve got 1/16th of everything done and not a whole thing of anything done.

It can get more frustrating when you have changes in dopamine and testosterone because it’s going to be exacerbated. There’s going to be issues with your relationships because you don’t seem to be paying attention. And by the way, men, it’s not your fault. I mean, it’s dopamine’s fault. You can blame it. So just kind of parsing out and figuring out what is going on in the brain at that age is really important. Our executive functioning cortex, the frontal cortex, is done developing and we’re in mid-life and trying to figure out the brain. Just like any other organ in the body, it needs certain things at certain times in life.

Unfocused, but not ADHD

What kind of behavior might a person exhibit if they don’t really have ADHD but are just maybe not “focused”?

Procrastination is a big one that I see a lot of times in both men and women. The inability to overcome inertia. There’s something important to do. And instead of doing that important thing, you’ll sit there and look on Amazon prime for a new phone cover for 5 hours. Believe it or not, that is a component and attendant of attention deficit. So, what happens is you have an ability psychologically to go to a cognitive fugue state, and you distract from what you need to do because you’re overwhelmed by that which you need to do. You see a lot of procrastination. And then you see guilt coming from the fact that you procrastinated; loss of focus, so even when you do start on that important task, the mind will wander, the mind will drift.

You’ll get tired. I mean, physically, this is something that is converted. You become tired. It’s exhausting just to think about having to think. All of these things start occurring and people start wondering, “Well, am I losing my mind? Am I losing my memory? Am I going to be Grandma Rose in 4 years, who doesn’t know who my kids are?” You know, that sort of thing. And that’s terrifying. It’s terrifying for anybody. So, I think it’s very important on many levels, but certainly on the memory aspect and ADHD aspect to have it thoroughly evaluated for peace of mind.

Treating ADHD

People don’t want to go through extended evaluations. People just want this idea that there’s going to be a pill that fixes it. And then when you put them on the pill, they’re like, well, is there a way to do this without a pill? And there are ways to address ADHD without the use of medications. The problem is that historically, the way that we’ve gone about treating ADHD is through amphetamines. And we build a tolerance to those very quickly within the brain, so they don’t work as well when you’re older.

However, that being said, once you’ve had a thorough assessment—and you know you’ve had a thorough neuro-psych assessment when it’s 5 hours long. But once you’ve had that assessment, then you find learning mnemonics based on the lobes of your brain and what I figure out they’re doing and what they’re not doing. So, if there’s under-compensation, there are mnemonics that you know, I can teach and psycho-educate on that will help compensate, because the brain, you know, is the same as any muscle—use it or lose it.

Stimulating those weaker parts of the brain is more likely to make them more efficient by reconnecting. Neuroplasticity is an amazing thing. But again, you’ve got to figure out where that needs to happen. And in order to do that, you need a thorough assessment.

Ready for your assessment? Contact Dr. Reynolds through neatcenteraustin.com or by calling (512) 540-4767.

The transcript has been edited for length and clarity. Listen to the original episode on The Armor Men’s Health Hour podcast.

To make an appointment, call us at 512-238-0762, or visit our website.

 

The Armor Men’s Health Hour: Nutrition Counseling at Urology Specialists of Austin

Ideal Protein, Food Journals, and the Ketogenic Diet

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The Armor Men’s Health Hour is brought to you by Urology Specialists of Austin.

For questions during the week, call us at 512-238-0762, or visit our website.

The Armor Men’s Health Hour is a show dedicated to providing information on a variety of medical topics, some of which may include sensitive subject material about penises. All cases discussed have been done with the permission of the people involved and their penises.

We’re so excited about being able to bring a variety of men’s health topics to you. Dr. Mistry is a board-certified urologist practitioner who treats men widely for a variety of conditions. And Donna Lee is our practice manager. We also have our very own special guest today: Robert Mendiola, our registered dietitian.

How Does Nutrition Play An Important Role In Urology Conditions?

Throughout the year, we’re going to talk very much in-depth about all the different things that we deal with in our practice. Kidney stones, prostate cancer, kidney cancer, low testosterone, ED and more. One of the central things that we’ll focus on today, however, is the role that nutrition and weight loss plays in all of these conditions. And then we’ll talk about what kinds of tools we give patients to help them lose weight better.

Many Conditions Can Be Improved With Weight Loss—But Not All

Across the board, a lot of conditions do get improvement with weight loss. Things like low testosterone are going to be very responsive to changes in way higher cholesterol prediabetes, which are really common things that come tied in with these different urologic conditions, including erectile dysfunction. When you see urologic conditions, there are sometimes other medical issues going on there as well. We offer that whole program, including diet, which helps connect the dots. It can be really insightful for people and really help kind of get their health back on track. A lot of people are surprised, too.

If you are 350 lb and 5’10”, diagnosed with prostate cancer, however, and you also have diabetes, high blood pressure and obstructive sleep apnea, my decision to operate on you is going to be significantly altered. As opposed to you being 260 lb and 5’8” with only one medical condition. It’s a different animal.

How Does Having A Health Coach Help?

As a health coach, I’m able to provide accountability. We have check-ins and talk about what’s working and what’s not. How are you feeling? And how do we get the ball moving? It’s about an individual practice, an individual program, depending on your disease process. Kidney stones or cancer can be different than something specifically related to low testosterone. Not everybody has to lose weight, but a lot of people do.

What Have You Learned Working With Our Patients?

I’ve learned that people are really curious about nutrition and diet and lifestyle, and there are still so many unknowns. And I think that’s really kind of a fun part of working in nutrition and a science field is, there are so many unknowns still. We can find evidence to support almost anything that we wanted to support. Right now, we could find a study that says, “eating candy for breakfast every day is really good for you.”

But people are very curious, you know, and they are well informed that they come in with really good questions. I’m seeing more and more younger men who are taking charge of their health. Even when nothing is in labs, nothing is out of normal limits, they still want to know if they’re taking care of their health correctly. And I think that’s really cool—I think that’s really changed. I think men in particular and young men. I mean, historically, people only went to the doctor when they were sick, right? So, to see younger people doing that is really impressive.

As physicians, we’ve been so jaded by the fact that our patients don’t listen to us every time that I think a lot of the opportunity to educate patients on just basic nutrition has kind of gone away.

They really are curious, and you don’t fix everyone. But that’s really not the goal. I mean, I guess that’s our goal to fix everybody, but it’s not. It’s not the metric by which we judge ourselves successful. We want to help people change their habits into healthier habits. I love the fact that we have so many patients that are healthier, that are looking to make changes in their health because that’ll keep them healthier.

How Do You Keep People Motivated?

We do a number of things. I just kind of do a check-in. And then we use whatever accountability tool we’ve kind of started or educated or going went over, and maybe our initial visit that might be something like a food journal we get to review together. I know a lot of people are not very big on tracking food.

I usually tell people if you give me 2 to 3 days of eating track, that’s a really great glimpse into your life. And then we can make some changes based off of that. You don’t exactly. Yeah. And some people don’t want to tell you how much alcohol do exactly as I tell people. You know, Don’t be well behaved on this. Be your real actual 100% self. If you eat a pizza and 12 beers, please put that in the app so we could talk about it.

Some people that are maybe not tech-savvy. I try to put them on paper. So, it’s something they can still feel like they are accountable for. And even if they’re not comfortable using their phone like that, um, and then just kind of navigating some of those speed bumps in the road bumps that come up with a busy life and still trying to be healthy. And sometimes the solution is something that that is very medically managed.

The Ideal Protein Program

We are very happy to be able to provide ideal protein here. It’s a medically managed program. It’s strict, but I myself have done ideal protein, and I did achieve the 5 to £7 weight loss. This program is basically a medically managed ketogenic diet. We get our body using fat for fuel. It is lower calorie as well, and it is moderate and protein and pretty low in carbs. One of the great things that it does take the guesswork out of the diet. Which we all have a lot of questions on, and a lot of people don’t have time to answer all those questions before making changes.

It’s a really great way to have some accountability, set up some weekly appointments with the health coach and navigate some of the program. It’s okay. Well, how’s our weight trending and have we had our goal and what’s working. And if you’re a man out there and you’re looking lose about 40 to 50 lb in 12 weeks, I think it’s definitely a very achievable goal.

What Does The Ideal Protein Program Cost?

It would be $300 at the initial visit on that kind of start, you start off with supplements, a week’s worth of food kit, and kind of the whole deal. We go over in the office in the program, and then after that it would be your weeks’ worth of food. So, about $90 a week after that. When you think about how much how much you might spend eating out or things like that, it can balance out really well.

The transcript has been edited for length and clarity. Listen to the original episode on The Armor Men’s Health Hour podcast.

To make an appointment, call us at 512-238-0762, or visit our website.