Phone: 512-238-0762

Fax: 512-341-7370

September 26, 2020

Dr. Mistry and Donna Lee Answer a Listener’s Question: When Should I Start Seeing a Urologist?

Speaker 1: Welcome back to the Armor Men’s Health Hour with Dr. Mistry and Donna Lee .

Dr. Mistry: Hello and welcome to the Armor Men’s Health Hour. I’m Dr. Mistry, your host, here as always with my cohost and partner in crime, Donna Lee.

Donna Lee: That’s right. Hello everybody. I am a partner in crime. I am a criminal.

Dr. Mistry: You know, it kind of hurts my feelings whenever the listeners say that they like, that they need more Donna Lee.

Donna Lee: It doesn’t hurt my feelings. I’m just trying to get a word in edgewise. I can’t.

Dr. Mistry: [ Inaudible] was like, “You guys are really great on the radio. She’s better.”

Donna Lee: That’s right.

Dr. Mistry: I don’t think it’s fair. I don’t have any professional, like entertainment experience.

Donna Lee: Well, I do in my years past , but I’m now switching over to the Dr. Donna Lee Show.

Dr. Mistry: No. You cannot call yourself a doctor. We’re going to get so much trouble.

Donna Lee: Why? I am doing it in air quotes.

Dr. Mistry: This is a men’s health show: Armor Men’s Health. I am a board certified urologist.

Donna Lee: I’m going to turn this into a women’s health. Women’s health show with Dr. Donna Lee.

Dr. Mistry: We started this practice in 2007. This show is brought to you by our urology practice, NAU Urology Specialists. We are a full service, fully contact–no…

Donna Lee: Fully functional?

Dr. Mistry: COVID.

Donna Lee: Yeah, damn Covid.

Dr. Mistry: COVID protective. We are open for business. We are seeing patients. We have telemedicine visits. We have in person visits, and we are here to take care of your urologic needs, hopefully in a holistic manner in a way that you are going to be very pleased with the kinds of treatment options that we have. And this show has really been developed and designed to help delve into some of the topics that we deal with in our own practice, health effects on men, in a deeper way. Your participation as a listener and your participation in our practice as a patient are what keeps us going. Donna Lee, gow do people become patients of ours?

Donna Lee: You can ask any question of Dr. Donna Lee that you’d like: armormenshealth@gmail.com. I’m just kidding. You’re actually going to ask Dr. Mistry a question. And our phone number during the week is (512) 238-0762. Our website is armormenshealth.com. We are blessed to have so many amazing providers. We added on a new provider, Heather Lins . She’s joined our team. So welcome, Heather. We have four incredible MDs, five incredible mid-levels, Dr. Mistry?

Dr. Mistry: That’s right.

Donna Lee: Wow. We have physical therapy, pelvic floor physical therapy we have two physical therapists. We have a sex therapist. We have a sleep coordinator. We are just fully packed around here.

Dr. Mistry: That’s right. Really to help you achieve your maximum health goals.

Donna Lee: Right. I thought you were gonna say something sexual.

Dr. Mistry: No, it’s too early.

Donna Lee: Okay, well, there’s that. We’re in Round Rock, North Austin, South Austin, and Dripping Springs, Texas. And again, you can reach out to us. We will answer your questions on air anonymously, but I will respond to every one of them and you get a free podcast! Forget the free t-shirt. I can’t get anybody to ask for a t-shirt, but I’ll send you a podcast. You can listen to our podcasts wherever…

Dr. Mistry: You’re no longer in charge of ordering t-shirts. You get too many.

Donna Lee: I have a couple.

Dr. Mistry: You know, your questions really do drive the show. Donna Lee, give us a question.

Donna Lee: Right ? This is a really good one. I was really impressed with this. “Dr. Mistry,” M-I-S-T-R-Y, “at what age should men start seeing a urologist to be proactive with their health?”

Dr. Mistry: That’s a great question .

Donna Lee: Isn’t that a good question? I’m impressed.

Dr. Mistry: In our clinic this week, we saw patients that range from 8 to 98.

Donna Lee: Really?

Dr. Mistry: Right. The answer is that seeing a urologist as a routine medical practitioner may not be required if your general practitioner is someone that’s doing a great job. We have been so impressed and so pleased with so many of the general practitioners in this, in this town. If you are looking for a really good internal medicine or general practitioner, please email us. We would love to share those people that we think go above and beyond for patients. We have functional medicine people, we have people who really adhere to the guidelines, people that listen to you and really care about your health because not all doctors are going to spend the time or have the commitment, and not all health systems are designed to kind of provide care that is individualized for you. The next part of that really is when, at what age do most men start experiencing some degree of urologic complaint? And that’s how I’m going to answer that. Erectile dysfunction starts effecting men as early as their early forties.

Donna Lee: Unless there’s like a trauma.

Dr. Mistry: That’s right, unless there’s a trauma, whether it’s a psychological trauma or true trauma or the etiology is purely psychological or hormonal. But what we call vasculogenic erectile dysfunction really starts becoming more evident in the early forties, and it kind of tracks as a percentage of your age. So about 50% of 50 year olds , 60% of six year olds start having some type of rectal dysfunction. The earlier you get that addressed, whether it be through hormonal interventions, or managing your cholesterol to improve blood flow, or getting put on like a daily Cialis to help improve girth and flow–these things are really important. And if you think that your doctor is kind of brushing off your complaints or not treating them well, then a urologist would be a great place to go to.

Donna Lee: We have a patient too, sorry to interrupt–a gentlemen wanted his 25 year old son to see one of us, one of the doctors, because he wanted to be proactive because of what was the actor’s name who died? The Black Panther guy, that guy that , you know, I don’t know his name either now. I feel terrible. But the gentleman who called is African American, as is his son, and he wanted to make sure to be ahead of this, and I thought, “What a great idea?”

Dr. Mistry: And I think that’s right. I mean, if you are predisposed to prostate cancer, for example…

Donna Lee: And there was a history of that in the family.

Dr. Mistry: …that’s another great topic here. When you are predisposed to prostate cancer, let’s say that you were diagnosed or your father was diagnosed with prostate cancer in his 50’s, or if your father died of prostate cancer at any age, then being very, very proactive in terms of getting PSA checked by a urologist starting at age 45 is something that I’d recommend. Now, that’s not even the earliest that we’ve taken prostates out. I’ve taken process out in men in their thirties, and they den generally do have a strong family history of prostate cancer going on. And so prostate cancer, as an example of something to have a very close relationship with a urologist. And the main reason is this: the kinds of criterion that puts you at risk for having cancer are different in a urologist’s eyes than they would be in your primary care’s eyes . We use the PSA as a standard test, but if you’re 45 years old and your PSA is 2.5, I would consider that abnormal. On the piece of paper where the results are printed out, it looks normal. You really need a more keen eye if you’re at risk particularly for a disease process like prostate cancer. The next thing that kind of is more age related would be low testosterone. And testosterone people treat that all over the map from a primary care standpoint. Some people are pro-testosterone in everybody for everything, and some people won’t give you testosterone unless they get a letter from the government, I guess. But you need to know that there’s nuances in how testosterone is prescribed, whether or not you need it, and my feeling is really to judge it based upon symptomology rather than numerology. You know, I don’t really care exactly what your number is. I use that more to guide how much we’re giving you, if what we’re doing is working, and less to determine absolutely whether or not you’re in need of testosterone or a testosterone patient. Erectile dysfunction, low testosterone predisposition to prostate cancer–these are areas in which I think having a close relationship with the urologist really is going to be a benefit. Kidney stones–you don’t need to come see us prophylactically unless you have a kidney stone. When it comes to kidney cancer or other types of cancer that we deal with, they’re usually found incidentally, and then the relationship with the urologist begins. Where a men’s health specialist, where we fit in on that on that really comes down to whether or not you’re feeling at your top best. And that a lot of that is derived from complaints, from sexuality or testosterone and things of that nature. And what we want to do is we want to help make sure that your sleep apnea issues are addressed, we want to make sure that you’re hormonally balanced, we want to make sure that from a nutrition and weight loss standpoint, you’re being optimized. But I hate to tell you, you’re not getting that at another urology practice. I mean, you’re getting that here, you know ? And that’s because , you know, we wanted to build right, Donna Lee, we want to build an amazing place that patients are really well taken care of. I can’t make the other urologists in town or anywhere in the country, you know, really wake up to the need for sleep apnea and nutrition integrated into their practice.

Donna Lee: Right. Well, we had, we’ve had a few patients that complained that their urologists who were a little older and probably heading maybe into retirement, they’re not asking the questions that we’re even discussing on the radio, like talk about your diet, let’s talk about sleep.

Dr. Mistry: Well, I mean, if you think, if you think that a pill is going to fix everything, you’re sorely mistaken. And so , it’s such a great question about physician relationships. I probably have, I would say probably about 15% of the patients that I see on a daily basis are really here just to make sure that they’re optimizing their urologic health. And although they don’t admit it, I think it’s because of probably something in their family or some close relative or friend that had a urologic condition that went undiagnosed. And that’s something we hate to see. A failure to diagnose as one of the most common reasons that people’s health degrades quickly and unexpectedly , you know , and unexpectedly, but presumably some way that could have been avoided if somebody had kind of paid attention a little earlier. An enlarged prostate is another area that we think that I feel once you start having urinary complaints , like from an enlarged prostate, you should probably have a relationship with a urologist earlier rather than later, because that’s how we identify problems earlier, rather than later, and keep you out of trouble. And what a great question. Donna Lee, if people want to learn more about our practice or become our patient, how do they do that?

Donna Lee: They can call us during the week, but I want to point out the actor’s name is Chadwick Boseman. Sadly, he died–he was only 43, I think.

Dr. Mistry: Of colon cancer, can you believe that?

Donna Lee: Of colon cancer. Yeah, Super sad. But yeah. Find a doctor, you guys out there. (512) 238-0762 is our phone number. Our website is armormenshealth.com where you can see Dr. Mistry’s smiling, happy face. We’re in Round Rock, North Austin, South Austin, and Dripping Springs, Texas. Call us during the week, like I said, or you can email us anonymously armormenshealth@gmail.com and listen to our podcast . Thanks so much.

Speaker 1: Dr . Mistry wants to hear from you! Email questions to armormenshealth@gmail.com. We’ll be right back with the Armor men’s health hour.

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