Phone: 512-238-0762

Fax: 512-341-7370

August 15, 2020

Dr. Lucas Jacomides on Lasting Longer and Going Harder Than Before

Speaker 1: 

Welcome back to the Armour men’s health hour with dr. Mystery and Donna Lee

Speaker 2: 

To the on women’s health hour with dr. Mystery and Donna Lee, just like the little guy said before the show and I’m Don Lee, dr. Mystery is not with us for this particular segment, but we have our fabulous and amazing dr. Lucas, Jack immediately.

Speaker 3: 

Thank you. It’s hard to follow in the shadows of greatness. So, and I mean, you, of course, Donna, Sonny’s not that girl

Speaker 2: 

Is a control of this show and it is, I, um, he does joke a lot about how I can do the show without him, but he can’t do it without me. And I set that up. Right.

Speaker 3: 

Very, very, very true.

Speaker 2: 

It’s called job security, dr. Jackie meetings.

Speaker 3: 

Yes. We’re not just a bunch of tick talkers. It’s a professional outfit and tick dog may be on by somebody else by the time this airs.

Speaker 2: 

Right. And I do love me some tick tock. I’m obsessed with any cat dog video, for sure. Uh, if you want to call us during the week and talk about your favorite tick tock of shows and channels (512) 238-0762 is our phone number. Our website is changed. It is North Austin urology.com. We have a podcast section on the website now, so you’re not going to Armour men’s health.com. You can, it’ll just redirect you to North Austin urology.com. You can see our smiling faces somewhere on the website, and then you can also email us as always to Armour men’s health@gmail.com. That’s Armour men’s health@gmail.com. We’re in round rock, North Austin, South Boston.

Speaker 3: 

So there are actual tick talk video channels like YouTube, I guess. Yeah.

Speaker 2: 

Yeah. If you click on it and then you like it, you can follow these people. And then I can watch the same cat videos over and over and over. It’s wonderful for my weekends and my marriage.

Speaker 3: 

Yes.

Speaker 2: 

Tic TAC. Uh, what’s your favorite tick tock?

Speaker 3: 

You know, I got ask my kids. I don’t know. I thought that was a clock thing. I don’t know

Speaker 2: 

It is in a different realm, but yeah, it’s taken off.

Speaker 3: 

We had thought about doing something when all this coven stuff hit, you know, like some people did some incredible videos about, you know, like journey, separate ways and all this, you know, I have come from a background and a little bit of video editing and so forth, but that’s why I’m amazed. The whole world is doing it and it doesn’t have to go to school for it. You know, it’s fantastic.

Speaker 2: 

I’m going to expect big things from you, dr. Jack and ladies, we’re going to do some tick talks around the office and we’re going to put them,

Speaker 3: 

Your Dick doc has ticked talking. There you go. That’s ours. And that’s our new mantra.

Speaker 2: 

Oh boy. He, LBJ is going to kick us off immediately.

Speaker 3: 

Uh, Dick doc is appropriate. Right. And leave, leave that out. I’m sorry,

Speaker 2: 

Richard. Um, we do have a quick question that I thought you might find interesting. We love your questions. We answered them anonymously and we thrive on them. So send them to Armour men’s health@gmail.com. But dr. J I thought this one would be a good one to run past you. This gentleman who sent in an inquiry, he wants to make love to his wife longer. He said he ejaculates in less than a minute, every time. And it’s very frustrating for both him and his, which I totally understand, except I’m always a proponent for not having sex. But anyway, he said he does not like using the delay spray. So that’s the lidacain based spray. Right. How does that make a man feel? Is it, does it make, is it numb?

Speaker 3: 

Well, in a sense, yeah. And that’s always the risk is they’re concerned that it might numb her as well and all that. That’s kind of the principle of it, right? Um, yeah. I can see why he might not like it because then it’s like, you’re making love to your, you know, gloved hand or something like that. You don’t really feel anything. Apple pie. Yeah, no, I get that. I think a minute. I’d love, I love premature ejaculators because it never,

Speaker 2: 

Is it like a puzzle piece for you where you, you,

Speaker 3: 

It just amazes me that usually the story is I need to last longer and I asked them, how long is it? And I don’t know, I can’t last 45 minutes. And I’m like, what? 45 minutes by then you, you gals are like, I need to watch kind of kitchen. I don’t, I need to do something else about enough of this. Think of something else. Yeah. The definition is really one minute or two minutes tops. So if you, if your climax and listen to a minute that that is a problem for most folks. Um, and it’s and you say, what can I do about it? I think the, the question is, is there a climax, first of all, is it just a lack of rigidity that just everything just falls down and that’s it correct. And everything just to D to messes that’s true. V D erectile dysfunction.

Speaker 3: 

So that case, yeah, probably something like sildenafil or tadalafil or Cialis or Levitra would work better. It’s difficult because a lot of times, you know, we recommend barriers in some capacity. So if condoms are too offensive into not part of the mood, and maybe you’re still trying to have children with them, then you know, your options can be limited anecdotally and, you know, prescription SSRS, serotonin, reuptake inhibitors, like antidepressant, Paxil, Zoloft, and, uh, but usually it’s all off sertraline, the generic sertraline or Paxil, I’ve had good results with those in the past. I, I often wonder the mechanism and say, maybe it’s not really working at all, but, you know, you’re just not depressed about it, not thinking about it, but, uh, but generally speaking, I think that I’ve seen good results with that. If you can get people, you know, even three or four minutes, frankly, I just sell them. Just there’s a lot of things behaviorly you can do as far as either foreplay so that it’s not all about you, sir. Find an unattractive girlfriend. And then yeah, if I think about mother Teresa, Nicole de you know, perhaps the rest of the time while you’re, while you’re in, in, in, in Flagrante delicto

Speaker 2: 

All right. I forgot you have to speak.

Speaker 3: 

I took Italian so I can hit on Italian girls. Yeah. Gotcha.

Speaker 2: 

Well, that’s good to know. So your, your recommendation is maybe antidepressants the SSRS.

Speaker 3: 

Well, it, and again, we have to be careful about that. I think a lot of times, if there’s other meds that you’re on and we have to know that, but I think anecdotally I’ve, I’ve seen good results with Zoloft and Paxil, and we can write this. So super low dose probably. Oh yeah. Entry level dose. Yeah. 50 of the Zoloft users when I start. Gotcha.

Speaker 2: 

It is the actual side effect is the sexual component. So that makes sense. Yeah. Um, I was going to ask a question about that gentleman bless his heart. I feel bad for him, but kind of jealous of his wife, because he’s trying to get out. Um, my husband’s listening. I’m sure we can leave that part out. Right.

Speaker 3: 

That whole conversation lasted longer than a minute. So I hope that was equally gratifying.

Speaker 2: 

And we do sell that delay spray. Most urologists probably do. It’s a lighter cane base, but I get it. It’s probably not the best, most fun feeling thing. Right.

Speaker 3: 

Well, I think it, it’s certainly safe, you know, it’s know if it gives you off, it wears off. Yeah. Yeah.

Speaker 2: 

I wanted to ask you about your week, the previous week, what was a favorite, um, case or patient you had? Let’s talk about something fun.

Speaker 3: 

Oh, fun stuff. I, again, I don’t want to go into details where they think that I’m listening to them, but I think every erectile dysfunction patient has some great story to tell, you know, you just have to wonder sometimes, but I’ve, I’ve said this on the show before. I think it takes a very unique individual to do what we do. And, and that is that you are going to be within 15 minutes. You’re going to tell me everything about you, including some very sensitive things that you don’t want to tell people, especially your friends and maybe not even your spouse sometimes. And then you have to show us things that we really need to see, but you don’t want to show and you have to establish that level of trust to say, yeah, go ahead. Feel free to show us your parts. Yeah.

Speaker 2: 

Not good at being vulnerable for some reason. Oh,

Speaker 3: 

Oh yes. Especially when in that case. That’s right. So let it all, hang out, tell me some things about you. And then you’re going to get out of my office and you’re going to pay me what crazy. Right. You know, and, and it’s going to be just, and you’re going to feel like, you know what, I got something out of that visit, you know, and I, and this person has a differential diagnosis and he cares about, or she cares about it, you know, for the females go into urology, God bless them. But generally speaking, you know, I think that is always an interesting story to be had. I love the stories.

Speaker 2: 

Right. And we need to, of course keep them confidential, but don’t be embarrassed. You have to go to the doctor at some point.

Speaker 3: 

I know people dance around some things. And occasionally, I mean, I’ve, I’ve busted people’s infidelities when they’re wondering what this new bump is there. And I said, you know what? I know what that bump is. And I also know your wife. So let me tell you what that bump is. And we don’t have to tell anyone else about it.

Speaker 2: 

Oh, but you want to call them a bad name because you probably are friends with the wife. No, no judgment here,

Speaker 3: 

But because you’re my patient and I can’t really that, but yeah, you have to be careful with sometimes.

Speaker 2: 

Oh my goodness. I didn’t think about that. Um, and females, I think it’s not well known that we have a lot of females in our room.

Speaker 3: 

Of course, you know, this is a men’s health hour we’re advertising on. But, um, you know, I take care of a lot of incontinent ladies and that’s again, very socially embarrassing thing to say. I had a patient today is a guy I wanted to see a lady doctor, but I guess you’ll do this. And she refers. So, so I quickly identified as a female and it was fine cause I’m gender, a gender fluid is what the kids call it these days. Um, but I, um, I, I think honestly, yeah, I can see where there is some embarrassment. Certainly men seem to be less embarrassed by showing the ladies their stuff and with us. So maybe, maybe not, maybe it’s the opposite. Maybe women are used to going to Mallaby Jens, and they’re just a little bit more, you know, say whatever needs to be done. That’s true. I didn’t think about that. But incontinence is something that, that I like to take care of. And I think, you know, certainly I had a lady who I thought for sure, needed something surgical and she, and we did some workup on her, including urine dynamics. And we said, no, it’s a medication. That’s what you need. And she got better and she’s very happy.

Speaker 2: 

Wow. Tell us what your dynamics is. We’ve talked about it in the clinic all the time, but we don’t talk about it

Speaker 3: 

Really. Um, well, a lot of times we do it for women, but there’s a place for men to get it done. Um, and it’s basically, we’re putting weird things in your front side backside. And, uh, that sounds really horrible, but that’s a late question in the hour, but, um, but it is, there is some definite value to be understood. So when we don’t know why you’re having this problem, urinating, there are some additional tests that we can do. And that’s probably a good thing we need to talk about. We’re talking like a BPH segment or something like that for benign prostate enlargement or for mixed incontinence, because there is a lot of value to begin with your dynamic, especially with spinal cord injured patients. And you don’t know if it’s more of an obstruction versus a bladder problem.

Speaker 2: 

Wow. There’s so much to talk about. Well, awesome. We’ll discover more about urodynamics in another segment with dr. Committees. You can catch these podcasts for free wherever you listen to podcasts, you can type in whatever word you want to that has to do with urology. And you’ll probably find them an amazing podcast. Email us at Armour men’s health@gmail.com. And you can actually ask for dr. Jekyll meetings. Thank you so much. All right, bye. Now the armor men’s health hour, we’ll be right back. If you have questions for dr. Mystery, email him at at farmer men’s health@gmail.com.

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