Dr. Mistry: Hello and welcome back to the Armor Men’s Health Hour. I’m Dr. Mistry, your host, here with my professional comedienne, Donna Lee, although you couldn’t believe it sometimes.
Donna Lee: No, I have a joke though. I’ll tell you later.
Dr. Mistry: Go for it.
Donna Lee: I got the rectum joke figured out from my husband. If you’re a listener of ours to the podcast. I asked my husband about his favorite rectum joke and the joke is: Little Timothy was in class and he’s very inappropriate and he told, he raised his hand very eagerly and told the teacher, ‘Ms. Smith, Ms. Smith, my uncle was hurt in the war and he was shot in the butthole,’ and the teacher said, ‘Timothy, it’s rectum. And he said, rectum damn near killed him!’ There’s the joke.
Dr. Mistry: Pretty good.
Donna Lee: I did not write that joke. I think it’s from the sixties.
Dr. Mistry: That was pretty good. One of my favorite jokes is the 90 year old that goes to the doctor for Viagara. The doctor goes, ‘Why? Why do you want Viagra? There’s no way…’ you know. He goes, ‘Yes, I just don’t want to pee on my shoes anymore.’ Ironically, we can fix both those problems here in case you’re wondering, and we won’t judge you if you’re a 90 year old man trying to have an erection. You know, I’m still amazed that our own patients don’t know that I’m the one on the radio when we’re doing the show.
Donna Lee: Who do they thinks on the radio?
Dr. Mistry: I have no idea.
Donna Lee: So they meet you in the room and then they’re like, you sound familiar.
Dr. Mistry: Just this week, a patient that’s been my patient for 10 years says, “I just saw the ad for your radio show. That’s you?” I said, “What kind of impression am I making on new people?”
Donna Lee: That’s so funny. But you have your radio voice on. So maybe in the room we don’t have your radio voice on.
Dr. Mistry: That’s right. When I was younger, I was a lot squeakier, and now I get to be a little bit nicer.
Donna Lee: I love that you said squeakier with such a low voice.
Dr. Mistry: That’s right.
Donna Lee: Squeakier.
Dr. Mistry: Anyway, I’m a board certified urologist. I’m sorry that you have to listen to this show. But we absolutely love bringing you issues related to men’s health and men’s health topics. We love your questions. As a urologist, I treat the entire buffet of urologic conditions.
Donna Lee: What was the other word?
Dr. Mistry: No.
Donna Lee: Panoply? Panoply.
Dr. Mistry: I’m not using big words. I’m not using big words around you anymore, Donna Lee.
Donna Lee: Come on.
Dr. Mistry: That’s all right.
Donna Lee: Panoply!
Dr. Mistry: Just, just, just sit there and be funny. That’s why you’ve been hired. You understand? Hi. Funny. We’re still okay. So in any case, we would love to have your questions. They really drive the show and really appreciate all the engagement. Donna Lee, you wanna remind people how they get ahold of us or make an appointment or tell them about our office?
Donna Lee: Right. You can call us during the week at (512) 238-0762 and much like you want to get to the call and they’re like, “Is this the guy on the radio?” And I want to go, “Well, yeah, there’s only one.” I imagine your voice is kind of unique. But you can email us at email@example.com. You can go to our website, which is armormenshealth.com and you can also send an email that way as well. I’ll get all of those. They come directly to me and then I share them directly with Dr. Mistry.
Dr. Mistry: So you know what’s interesting about my background is that I am a graduate of the Baylor College of Medicine. I’m also a graduate of the University of Texas, but I’m on the medical education staff for Texas A and M University.
Donna Lee: That is confusing.
Dr. Mistry: This week, I am teaching the medical students how to do a male genital exam…
Donna Lee: I saw the prop, the prototype.
Dr. Mistry: ..over the internet. It really takes a lie out of it, don’t you think?
Donna Lee: Yeah.
Dr. Mistry: You really can’t get your hands on it.
Donna Lee: You’re going to have your hands on it. I saw that big ole’ prototype.
Dr. Mistry: Well, it’s a big prototype. It costs $6,000 to get an artificial rectum to do a prostate exam.
Donna Lee: For the fake booty that’s sitting in the office?
Dr. Mistry: That’s right.
Donna Lee: $6,000?
Dr. Mistry: $6,000.
Donna Lee: You could have gotten a sex toy for like $35.
Dr. Mistry: I’m just saying that there’s probably cheaper alternatives. Maybe medical education doesn’t have to be so expensive.
Donna Lee: Oh, I saw the prototype and it looks a lot like the, we were watching a TV show called “Dave” and he had a bottom sex toy and it looks just like the thing in our office.
Dr. Mistry: “Dave” is about a political candidate that looks like the president. It’s a wonderful show from the 1990s…
Donna Lee: Oh, that’s different.
Dr. Mistry: …and you will never bismirch my idea of what that name should be.
Donna Lee: That’s totall different.
Dr. Mistry: And you should really change the kind of app that you have on your television. I’m not judging though. If you have a sexual fetish, we’re happy to take care of it and whatever problems that may arise from it.
Donna Lee: That’s right. We do not judge.
Dr. Mistry: But we do love your questions, and why don’t you give us one?
Donna Lee: Well, we have one. Yes. And you know, we talk a lot about your holistic approach to the patient care and supplements and therapy and physical therapy, and so I thought this was a really good question because I kind of had to Google it. “Dr. Mystery, what is your opinion on saw Palmetto? I’ve been taking it for many years. My GP–general practitioner–has said that it will affect the PSA test so I assume it does have have some effect on the PSA. Does it raise or lower the PSA?”
Dr. Mistry: That’s a great question. Within our practice and certainly within just kind of what people do in their daily lives, people develop this kind of notion of what will and won’t help their health, and a lot of these things are based in science, some are not. I’m really, you know still psychologically in that mode of learning about what is and is not going to be beneficial to our patients. That’s why we have a nutritionist. That’s why we have a supplement counselor. That’s why we try to help patients that want to deal with issues non-pharmaceutically but with supplements and diet and lifestyle changes and make those things work. I had an 80 year old guy that came in this week, 80 years old, looks amazing. He has a prostate 10 times normal size, a 330 gram prostate, and he said, “Listen, what can I do so I can go back and play tennis three times a week?” And we gave him a wonderful option: prostate artery embolization, no catheter, no hospital stay, very little risk to him and he’s going to do great with it. We’re going to try to find a solution for you that matches kind of your outlook and your needs. Saw Palmetto is a supplement that we certainly support and provide in the office. It is from the saw Palmetto plant. It’s an extract. I mean these things don’t become, you know, widely used because they’ve never worked. And so this really gets at kind of our approach to urology. When you do big studies, it shows that for most men, saw Palmetto has no effect on urinary or BPH symptoms, so it doesn’t help your urinary flow. But undeniably there are some men in whom saw Palmetto does work. It’s a low risk medication or supplement. It has, it’s available over the counter. You want to look for a high quality saw Palmetto. We have one that is made by a company called Metagenics.
Donna Lee: Physician grade, right?
Dr. Mistry: I guess. I don’t…I don’t think that’s a thing.
Donna Lee: It is a thing when you sell supplements in doctors’ offices.
Dr. Mistry: Medical food grade is a thing.
Donna Lee: Physician grade supplements is a thing.
Dr. Mistry: Physician grade thing is not a thing.
Donna Lee: Okay, well I’ve been saying it for three years.
Dr. Mistry: Well we ain’t making up words around here. You’re fired. So it’s the saw Palmetto is a extract that, you know, my own anecdotal experiences that men do have improvement with their BPH or urinary symptoms. Now the reasoning for why it does it differs. I believe and the research that I believe that has kind of supported my use of this supplement is that it really, it helps defeat some of the effects that testosterone has on the prostate. So you know, we’re big proponents of normalizing testosterone. We have, you know, over 5,000 patients in our database that we use testosterone on. We try to do it in a holistic and natural form. But the one negative potential side effect of increasing your testosterone is a potential effect on worsening urinary symptoms by its effect on your prostate. And saw Palmetto does have an antiandrogenic or antitestosterone effect on the prostate. And so because of that, getting to the second part of that question of whether it can affect your PSA, the answer is that it can, but it will usually drive your PSA down, not up. So it does it in an incremental way and one that doesn’t really appreciably change how we evaluate your PSA in terms of your prostate cancer risk. So, if you’re on the saw Palmetto, I would not be concerned that it’s abnormally affecting your PSA. If you’re not on a saw Palmetto and [inaudible] it’s working for you, it may not be the right treatment for you may need something stronger than saw Palmetto. And if you are having urinary complaints, but you’re looking for a more natural way of dealing with it, then we have an art in our arsenal of things to do, some dietary recommendations. We use a lot of anti-inflammatories, and there are things that you can do if you’re trying to avoid medications. And of course, surgical interventions can be done quickly, efficiently, easily, safely, all these things, all these words that we like to hear, because taking a medicine can have negative consequences on you in the longterm, especially medicines for overactive bladder and for enlarged prostate that can cause fatigue, dry mouth, constipation, all sorts of other problems that you don’t want to necessarily experience. And so I’m a big fan of avoiding meds when appropriate and if you’ve been managing nothing but beds for your urinary complaints, then you know, come to us so we can talk to you about it.
Donna Lee: That’s right. I just Googled saw Palmetto while you were talking.
Dr. Mistry: You and your Googling.
Donna Lee: It’s just so interesting and it proves urinary tract function, it prevents hair loss.
Dr. Mistry: Why would you go to the Google?
Donna Lee: Because I wanted to see if you were going to say what they said on the Google and you did.
Dr. Mistry: Oh my lord.
Donna Lee: It says “may support prostate health and may help regulate testosterone levels…”
Dr. Mistry: Are you nuts?
Donna Lee: I am Dr. Donna.
Dr. Mistry: Oh my Lord.
Donna Lee: Google back you up.
Dr. Mistry: All right, well, very good. We’ll tell people how to Google us.
Donna Lee: That’s right. You can Google armormenshealth.com, which is our website, and you can see…
Dr. Mistry: You don’t Google websites.
Donna Lee: You can, it’ll take you right there. Armormenshealth@gmail.com is our email address and our locations are Round Rock, North Austin, South Austin, and Dripping Springs. Please send us some more questions. They’re amazing and we love to answer them on air anonymously.
: 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.