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May 30, 2020

A Urology Buffet: Dr. Mistry and Donna Lee Answer Listener Questions About Healthy Aging and Testosterone Therapy

Speaker 1: 

Welcome back to the Armor Men’s Health Hour with Dr. Mistry and Donna Lee.

Dr. Mistry: 

Hello and welcome back to the Armor Men’s Health Hour. I’m Dr. Mistry, your host. We really appreciate you sticking with the show. And for those of you that don’t listen to the show regularly, we welcome you. I am a urologist, a men’s health specialist and this is a men’s health show.

Donna Lee: 

And mystery is your real name. M. I. S. T. R. Y.

Dr. Mistry: 

That’s right.

Donna Lee: 

Somebody kept calling you “Dr. Misery” the other day on the phone and I was like, “It’s Mistry.” And he’s like, “Oh, I’m saying it wrong. I’m so sorry.”

Dr. Mistry: 

Only my kids can call me “Misery.” That buttery voice is Donna Lee, our office manager and my cohost here.

Donna Lee: 

Hot butter biscuit.

Dr. Mistry: 

I think you just liked the word “hot” on that one. If any of you would like to make a young lady’s day, please give her some kind of comment on how nice her voice sounds on the radio. It probably is the thing I have to hear about most nowadays.

Donna Lee: 

Clearly, my boss and my husband don’t compliment me enough, so I gotta get it where I can.

Dr. Mistry: 

Whenever I hear that, I love the Chris Rock line from one of his standup comedy acts. He goes, “Women love compliments.” So for those of you men out there, unhappy with your day, just give your woman a compliment.

Donna Lee: 

My favorite Chris Rock joke is when he says he’s talking about women on their cycles and he said, “I don’t trust anything that bleeds for a week and doesn’t die.”

Dr. Mistry: 

I don’t think that’s his joke. I think that he stole that joke.

Donna Lee: 

It is his joke. He would not steal a joke. No, no, no, no, no. Anyway, I’m a board certified co-host.

Dr. Mistry: 

This show is brought to you by NAU Urology Specialists. We treat the entire buffet of neurologic conditions, whether they be…

Donna Lee: 

“Buffet!” What was that other word you used that I didn’t know?

Dr. Mistry: 

I’m not using words like that anymore. One of the big topics that we treat quite a bit of is erectile dysfunction. That probably makes up most of the questions, whether the erection’s not straight, it’s not firm, it doesn’t last long enough…all sorts of things over and over and over again that we’ll hear about sexual performance. And it’s absolutely our pleasure to be able to give you that advice. If you feel embarrassed to talk about it, please don’t go to some online place and just get a medicine over the phone. Or if you have a concern, let’s make sure that we’re treating that concern. There may be pills that can easily take care of a problem, but maybe taking a pill all the time isn’t the right solution for you. Many men that go online or try to privately get treatment for erectile dysfunction, most of those men do not stick with that treatment for more than three months. And that’s because kind of inherently you understand you’re kind of missing something, some important component of the diagnostic ritual to understand what’s really wrong with you. Recently, a paper was published in our urology journals having to do with low intensity shock wave therapy: L.I.S.W.T. And you’re going to hear this technology under many different names: linear compression therapy…

Donna Lee: 

Penile pulsing….

Dr. Mistry: 

…magic wave therapy, Gainswave therapy.

Donna Lee: 

They use the word “guaranteed.”

Dr. Mistry: 

That’s right, guaranteed.

Donna Lee: 

Guaranteed.

Dr. Mistry: 

Guaranteed. If your doctor’s guaranteeing something to you except for you know, at least their best effort, that’s, I guarantee you my best effort, if they’re guaranteeing your treatment outcome, I would be highly, highly, highly suspicious of anything that anybody can guarantee when it comes to medical medical issues. This low intensity shock wave therapy really showed a dramatic improvement in erectile function after six weeks of therapy. So if it’s something that you’ve heard a commercial about or want to know more about, we offer this therapy probably cheaper than anyone. It’s $2,000 for six weeks of therapy. You’re also gonna get about a 6 to 12 week course of medication therapy, supplements included within it, as well as an evaluation of your testosterone. Because all of these things can make your erections not up to your level of confidence. If you have a question for us, we love hearing your question, and if you’re over the age of 80, you’re one of our favorite people, especially when it comes to your erections.

Donna Lee: 

Oh, you’d love the patients that are just super engaged in their 80’s. Are you ready for this one?

Dr. Mistry: 

That’s right.

Donna Lee: 

This one just caught me in my heart and my pulled on my heartstrings. “Dr. Mistry, I’m an 80 year old man with comparatively good health. Since the quarantine I have slowed down, I can’t seem to speed back up. My walking is limited due to arthritis and foot and ankle. My stature has dropped to about 5′ 8″, I weigh about 210 pounds. I’m not ready to hang it up because life is wonderful when you have a family like mine. My wife passed away a few months ago…” Oh my goodness. “and I live alone, but I can handle that. It was a great loss. Too much information. I know. Thanks for the help. He said my battery may be running down,” meaning I think his physical battery. So how do you help an 80 year old man who’s still got all this life left and wants to increase his stamina and…

Dr. Mistry: 

…and has to stay home!

Donna Lee: 

…and has to stay home, and alone, bless his heart.

Dr. Mistry: 

And I think that it’s a great, it’s a great point. And there’s so much packed into this and I don’t know if I’ll be able to hit all of this. We’ll start with the fact that when you lose a spouse, you hear so often a couples that die like you know around the same time, and this, there’s a physiologic, there’s a psychological component and there’s just this idea of self care that can really take a hit when you lose a spouse, especially now when we are kind of all alone, especially if you’re over the age of 65 and you’re worried now that even your neighbors and friends and family can make you sick. You can see how all those things would be compounded with just such a recent loss. Improving some aspect of physical activity will probably be one of the most important things that can help maintain bone muscle density, muscle mass, energy levels, testosterone levels. When you’re physically impaired with arthritis or unable to walk because that’s kind of the easiest thing you can tell people to do right then. Then doing something from a resistance standpoint is probably going to be your easiest way of doing it. Seated exercises with bands and things like that that can increase resistance even if you’re not up and walking around. I think that that would be an amazing thing, and we’re going to send you kind of information that we have on really good videos to watch or things of that nature. You were able to email us, so I assume that clicking on a link, maybe something that we can accomplish. And I think that that’s going to be important. Number two is going to be how you eat. If you’re exercising less, you may feel like you need to eat differently and that’s absolutely the case. You know, if you’re not burning as many calories, you certainly don’t want to do a lot of things that are going to weigh you down with lots of carbohydrates and things of that nature. It’s hard when they ice cream comes in these one quart, single service, one quart?

Donna Lee: 

One quart, pint?

Dr. Mistry: 

I don’t know. They’re big. However they sell ice cream, probably…

Donna Lee: 

What are you eating?

Dr. Mistry: 

It reminds me of my very good orthopedic friend who once sat down with that entire big gallon of Blue Bell, and he said, “Well, if they didn’t mean for you to eat it in one sitting, they would have given you a better cover for it.”

Donna Lee: 

Oh, true.

Dr. Mistry: 

You know what I’m saying? It doesn’t look resealable. I think that it’s also important to note that if you already have a preexisting hormonal condition, a thyroid condition, testosterone issues, and now you’re a lot less mobile, a lot of those symptoms may become more obvious. It’s not the case that we think that testosterone therapy is the panacea for every everything that ails you…

Donna Lee: 

Not for 80 years old, maybe.

Dr. Mistry: 

…but I would be surprised if this 80 year old man had, you know, who is now somewhat immobile, losing height. Now I’m worried about osteoporosis. I mean, he’s losing something that’s causing his height to shrink. And oftentimes it’s just kind of the strength or the size of those of those bones that make up your spine. And so that could be a way to kind of recharge the battery. Believe it or not, we give a lot of dating advice to men who are having erectile dysfunction or especially those that are either out of a divorce or loss of spouse, try to give them advice on how to get back into the scene, how to make sure that you function well, how you can feel some confidence that you’re going to be able to kind of knock it out of the park depending on what you think you’re going to need to do from a both energy and sexual standpoint. And so those are some, I guess some important things to do, especially if you’re older and quarantining alone, you’re really gonna have to find some way to give those muscles some resistance. I mean, being weightless in space, same thing. They have to tie them down and give them weight bearing exercises or else you’re gonna you’re gonna lose a lot of that strength, muscle mass, testosterone levels go down and things like that. So we may need to give some advice to this young man on how to create his own astronaut training program.

Donna Lee: 

RIght. Because he might have another 20 years and he needs a plan. Right? We’re seeing so many people in their hundreds now. So, I have a quick other question for you.

Dr. Mistry: 

Go for it.

Donna Lee: 

“I am 63 years old, Dr. Mistry,” his testosterone, he said, “I checked it in October and it was 337. My doctor said that’s normal. What do you think?”

Dr. Mistry: 

“Normal” may not be normal for you. So along the bell curve of the distribution of population, it may be, it may or may not be within what we call the two standard deviations of the mean. But whether it’s normal for you is completely up to you and us in helping to treat you. We usually consider normal between 350 and 1000, is what I usually tell patients. Low normal levels can be associated with symptoms in a good number of patients. Usually if you’re otherwise healthy and we can safely do so, we will usually try testosterone therapy if we think your symptoms are compatible: low energy, libido loss, erectile dysfunction, muscle mass loss, difficulty losing central weight–these are things that we’re going to check for and a 12-week course of testosterone normalizing that will certainly tell us the answer on whether low testosterone is the cause of your symptoms.

Donna Lee: 

That’s exactly what I did. I started getting my testosterone checked and boom.

Dr. Mistry: 

Well, that’s a great little segment and thank you so much for joining us. Donna Lee, how do people get ahold of us?

Donna Lee: 

Call us at (512) 238-0762. Send us your questions. We’ll answer them anonymously. I’ll send you the podcast if you missed the answer on the radio from Dr. Mistry. Armormenshealth.com is our website. And again, the email address is armormenshealth@gmail.com. You can also send the question through the website. Thank you so much for an amazing segment, Dr. Mistry: M. I. S. T. R. Y.

Dr. Mistry: 

Thank you for joining us.

Donna Lee: 

Have a great rest of your day, y’all.

: 

The Armor Men’s Health Hour is brought to you by Urology Specialists of Austin. For questions or to schedule an appointment, please call (512) 238-0762 or online at armormenshealth.com.

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