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May 9, 2020

Never Give Up: Urologic Health and Wellness at Any Age

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, as always…

Donna Lee: That’s your real name.

Dr. Mistry: That is my real name.

Donna Lee: M. I. S. T. R. Y.

Dr. Mistry: That’s right here with my interrupting cohost, Donna Lee.

Donna Lee: You told me to interrupt you more.

Dr. Mistry: That’s right.

Donna Lee: It’s D. O. N. N. A.

Dr. Mistry: I think our newest…I don’t think people needed help spelling your name.

Donna Lee: They do. Somebody yesterday asked me how to spell my name.

Dr. Mistry: Oh my Lord.

Donna Lee: And then a girl at the dry cleaner…no, actually at the tanning place like months ago when we were allowed to go out, and she’s like 21 years old, she said, “How do you spell your name?” I said, “Donna?” She’s like, “Yeah, I don’t know how to spell that.” And I said, “It’s D-O-N-N-A.” And she said, “What’s your last name?” And I said, “McBride.” And she said, “Could you spell that?” I was floored. She was 21.

Dr. Mistry: Well, it’s very interesting, you know, because today with auto-correct on your texting, you know, you’d never have to spell anything, but everything comes out garbled anyway.

Donna Lee: Right. But you should know how to spell “Donna.”

Dr. Mistry: I am a board certified urologist. Our newest shirts will say “More Donna,” thanks to everybody’s comments about wanting more Donna on the show.

Donna Lee: It’s because I’m funny and you’re super straight. Oh, oh I had a patient call and he asked yesterday, he said, “I love your show. I listen to your show.” He’s one of our patients. “I listen to every weekend. You and Dr. Mistry are so funny. You get kind of rowdy and he has to control you,” like the other guy that you’re keeping me in line. And then I referenced, “Well actually Dr. Mistry is really funny and dirty and person.” And he said, “Oh, it’s perfect that y’all are the way you are on the radio because it wouldn’t be right if he was the dirty one on the radio.”

Dr. Mistry: That’s right.

Donna Lee: And I was like that totally makes sense.

Dr. Mistry: That’s right.

Donna Lee: Because he’s the surgeon.

Dr. Mistry: That’s right. I’m the straight laced…

Donna Lee: You’re board certified…

Dr. Mistry: …straight laced, well-educated, board certified urologist. People often ask me why I became a urologist and you know, I tell them…

Donna Lee: I do know.

Dr. Mistry: …it’s because of the jokes.

Donna Lee: You like the jokes.

Dr. Mistry: I do like the jokes. It’s an irreverent field in which we get to take people through some of their most personal, tragic conditions, but try to do it in a very compassionate way. A lot of people don’t know what a urologist does. We treat things that you would think of like erectile dysfunction. We’d also treat things like you wouldn’t think about like low testosterone. We deal with testicular pain, flank pain due to kidney disease, a number of abnormalities in the way that the kidneys and the urinary system has developed, and then of course, cancer–kidney cancer, bladder cancer, prostate cancer. During these times in which we had a slight delay in doing a lot of these cases, it’s been a really cancer-heavy surgical load as well as a cancer-heavy patient load here in the office. It reminds us that the health effects of our body’s aging system doesn’t take a break, even though we’re all stuck at home. Understanding how to deal with those cancers, really trying to kind of process information and advice can be hard for some people. And so we would encourage you that if you’ve been diagnosed with a urologic cancer and you’re not so sure about the advice you’ve been given or want to get a second opinion is definitely that we do here. We specialize in it, and it’s absolutely something that we really treasure and value in being able to give either confirmatory or alternative advice for a number of different cancers.

Donna Lee: Right. And you have a lot of, we always talk about the tools in the toolbox. You’ve got lots of tools that we have at the clinic, so.

Dr. Mistry: That’s right.

Donna Lee: We’ve got so many different procedures that if you don’t specialize in it, Dr. Yang or Dr. Jacomides or De. Ong will in our group.

Dr. Mistry: That’s right. And I think that gets to the “more Donna” comment. Our practice, NAU Urology Specialists, has four physicians that practice here. 3 wonderful, mid-level providers;2 PA’s; 1 wonderful nurse practitioner that’s been with me for 10 years.

Donna Lee: Yeah she has!

Dr. Mistry: She’s amazing.

Donna Lee: She is amazing.

Dr. Mistry: Leonora is amazing. We also have a nutritionist onsite, we have a pelvic floor physical therapist onsite. We provide sex therapy outside.

Donna Lee: She’s been with you, too, 13 years, Dr. Tredway.

Dr. Mistry: Oh yeah, she’s been with us…Dr. Tredway has been with us forever. But when I was a young man.

Donna Lee: But she’s still a young lady, so I don’t know…she’s pretty hot.

Dr. Mistry: She stopped in time somewhere along the way.

Donna Lee: That’s right.

Dr. Mistry: Trying to provide a more holistic version of care has been our goal here. We welcome people who do their own research. We don’t, I’m not so bothered when somebody comes in…

Donna Lee: And says, “I googled it.”

Dr. Mistry: …with a stack of papers. If I can’t out-educate you more than your own self-education, than I’ve, I’ve fallen. And I learn so much from patients about supplements and holistic care and more natural kind of therapies. And so many of our patients don’t want to take a pill for things.

Donna Lee: No, they want a natural fix first, or at least a discussion about a natural fix.

Dr. Mistry: For sure. And if you’re getting blown off because you don’t want to take a medicine and you would like to see what alternative treatments there are, I mean, your physician should be able to give you some data or some advice or some guidance. There’s not a one size fits all for any medical condition, certainly not any urologic condition.

Donna Lee: You know who’s super holistic is Dr. Tredway. Holy moly. She’s got essential oils and supplements that she can tell you all about. She’s so well versed in that whole world of holistic medication.

Dr. Mistry: That’s right. And Dr. Tredway is a, has a doctorate in physical therapy. She’s especially trained in pelvic floor physical therapy, which we use for a number of conditions you may not even think. Chronic pain of the testicles and groin, chronic flank pain due to psoas muscle issues. We can, she helps with premature ejaculation, also erectile dysfunction due to pelvic spasms, lots of urinary issues, and in fact, when it comes to urinary urgency and frequency, almost 2/3 of patients can go without medicine if they adhere to the proper pelvic for physical therapy and nutrition program.

Donna Lee: That’s a big, big number.

Dr. Mistry: Especially since a lot of those medicines have side effects.

Donna Lee: Right! And who wants a side effect? Especially when you’re stuck at home?

Dr. Mistry: That’s right.

Donna Lee: “This side effect may cause headaches and incontinence,” and you’re stuck at home, so…

Dr. Mistry: And we love your questions. I think we had a, we had a great question…

Donna Lee: We had one that you’ll love.

Dr. Mistry: That’s right.

Donna Lee: You love you an older man.

Dr. Mistry: That’s right.

Donna Lee: So I thought that we’d start with this one, this patient in his eighties. This is his question: “Dr. Mistry, what is a normal PSA for a healthy” brace yourself, “83 year old man?” He said his is at the number 8, his PSA.

Dr. Mistry: That’s a great question.

Donna Lee: It’s kinda high though.

Dr. Mistry: You know, one of the reasons that you made the comment about me liking older men is that I love men who, despite their age, want to remain functional sexually, physically–they’re not going to adhere to any kind of societal norms about what they should be or shouldn’t be expecting at a certain age. And certainly after you get over the age of 70 or 75, people start kind of, you know, saying, “Well this may be a problem but you’re probably too old for it to bother you.” And prostate cancer is a great example. Did we have normative values for PSA as you age? But those aren’t based upon that as you get older, your PSA can be higher and you’re not likely to have cancer. It’s more that we accept a higher PSA in older patients. When I was a resident at Baylor College of Medicine, I did a study…

Donna Lee: What?! First time I’ve heard that!

Dr. Mistry: …a published study that showed that in fact older men at the same PSA level were more likely to be diagnosed with a more aggressive cancer than their younger aged counterparts. So as a rule, I have never really accepted kind of a write off age for PSA levels. If your PSA is over 4, you have a 40% chance of having cancer. And if your PSA is over 4 and if you have cancer, then you have about an 8% to 10% chance of having something that’s a little more aggressive, and that number goes up the higher you get, and over 10, the number goes to 60% likelihood of cancer and a higher likelihood of a more aggressive cancer. Now the type of things that we do to diagnose cancer, like a prostate biopsy or a physical exam, some of these things may be considered very invasive to some people. We really like doing MRIs of the prostate in our office because you know, it kind of balances invasiveness with being thoughtful about whether you might have a disease or not. And especially if you’re healthy…I mean, sometimes you get an 83 year old whose parents lived until 90 or 100, so you don’t just say, “Well, this guy’s 83. Life expectancy’s 76, you know, maybe he’s already 7 years over his warranty.

Donna Lee: Don’t count him out!

Dr. Mistry: Don’t count him out.

Donna Lee: And he sent an email–that’s pretty impressive!

Dr. Mistry: That’s right. He hit us up on Snapchat! I’m going to check out his Tic Tok later.

Donna Lee: He’s on Tinder right now looking for a lady!

Dr. Mistry: And so, you know, if you’re an older man and you feel like your PSA or your prostate symptoms have been written off, if you have bothersome urinary urgency and frequency, but people have kind of refused to give you treatment because of your age and you’re looking for alternative treatments, and especially if you’re 80 years old and you’re now experiencing erectile dysfunction for the first time, please come on in.

Donna Lee: Please call Dr. Mistry.

Dr. Mistry: We’re going to take great care of you. We’re going to certainly kind of address these things in a safe, effective manner that–I mean, you get to decide how the quality of your life is. You know, it’s not for me or society or anybody else to decide. I’m going to try to help make those kind of dreams come true and we have a wonderful team here. I think that you’re going to find that, you know, when we are able, we will try to provide, you know, top level care, get you in quick and make sure you’re given a whole buffet of options for whatever male urologic…

Donna Lee: A buffet of options!

Dr. Mistry: A buffet of options for your condition.

Donna Lee: You know, we had a 70-something year old man call, and I happened to answer the phone, and he was wanting his Sildenafil refill and he said, “It’s just, it’s more for muscle strengthening,” for whatever diagnosis he had. And he said, “It’s not really for what you think it is.” And I guess he was embarrassed. And I said, “Oh, I don’t care. I’m not judging.” And he said, “Cause that dog don’t hunt no more!” I said, “Well, sir, that dog should hunt some more. You’re only 73.”

Dr. Mistry: That dog should hunt. And now that my father is over the age of 70, 70 doesn’t seem so old to me anymore.

Donna Lee: Right. I know, now that I’m approaching…the age that I’m approaching.

Dr. Mistry: Now that you’re approaching 40.

Donna Lee: That’s right. Oh boy, I wish!

Dr. Mistry: Why don’t you tell people how to get ahold of us?

Donna Lee: That’s right. You can call us and talk about your dogs not hunting and we’ll fix you up with a hunting regimen. (512) 238-0762. Our website is armormenshealth.com and easy enough, you can email us questions to armormenshealth@gmail.com. You can also send your questions through the website as well. We’ll get those. (512) 238-0762 is our phone number and we will be right back after these amazing messages.

: 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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