Men’s Health: Deferred Maintenance (Part 1)

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Kendra:

Whether it’s yourself, your partner, spouse, father, or brother, awareness of men’s health issues affect us all .I’m Kendra. And in today’s episode, I was joined on the phone with Dr. Eli Pendleton to discuss some pressing topics that impact men throughout the lifespan. You’re going to want to listen in and perhaps share this episode with someone you love. Dr. Pendleton unpacks issues that many shy away from. Alcohol use, mental health, and erectile dysfunction to name a few. He’s also offering health tips by decade to give you the information you need to stay on top of your health, no matter how old you are, let’s get started.

Kendra:

Hi Dr. Pendleton, it’s a pleasure to speak to you today. Thank you so much for joining me on the phone for this important conversation.

Dr. Eli Pendleton:

Well, thanks so much for having me. I appreciate the invitation.

Kendra:

Well, let’s just jump right in. Why do men avoid coming to their doctor and right out of the gate before we get into specifics, why do men need to take their health seriously?

Dr. Eli Pendleton:

Well, I think that men need to take their health seriously because it’s the only health they have. I think that it’s kind of like anything that you own or anything that you work with regularly that you want to get checked up and you want to make sure everything’s running properly and you want to try to avoid any bigger problems in the future.

Dr. Eli Pendleton:

As to why men generally avoid the doctor, I don’t honestly know. I think that it’s probably multifactorial. I think that there’s a certain stubbornness sometimes that they don’t perhaps want to hear what they think they’re going to hear or have the ideas that their significant others have been telling them be validated in some way. I also think that there’s some intimidation as to exactly what’s going to happen and feeling like you’re ceding some control. I think that men, the last time they see a doctor often was when they were 18 and getting immunizations prior to going off to college or what have you. There’s no routine maintenance that is recommended that brings guys in. So they get really out of the habit. Whereas women obviously go in for kind evaluations a little bit more frequently. And so they’re just used to going to the physician.

Kendra:

Makes sense. On average, I read that men live sicker and die younger than American women. And that from nine out of the top 10 causes of death, men actually lead. It’s like you said, it all starts with that kind of stigma that men are less likely to go for their routine screenings and exams. So what do men need to know about what they should be looking forward to or what they should be doing?

Dr. Eli Pendleton:

Well, I think that in general, I tell patients all the time, as much as you hate to hear it, good clean living seems to really be the ticket. Watch your weight, watch your diet, watch your alcohol intake, keep up with your exercise, that sort of thing. All of those things really pay off in the long run. I think that we all tend to have that period in our twenties where you feel like you’re bulletproof and you kind of are, but that doesn’t last all that long. And all those decisions can really start to bear fruit as it were the kind that you don’t want later on down the road.

Kendra:

Do you see if there’s any stigma with men taking off time for work or being reluctant to come in during their working years?

Dr. Eli Pendleton:

Yes, in short. I think that we’re slowly moving away from that. I think that there’s just like guys have been stubborn and don’t want to think that you have to go to the doctor regularly if you don’t feel sick. I think that the corporate environment, or even just the work environment has had somewhat of a similar attitude for a long time. And there’s more of a recognition these days that if you ignore acute problems, they become chronic problems and that’s more likely to cut into productivity and all those kinds of things.

Dr. Eli Pendleton:

So you see insurance companies that are partnering with employers to incentivize earlier screenings and that sort of thing. I will say that in the past couple of years, I feel like I’ve seen far more young men who come in to just establish care.

Kendra:

That’s encouraging.

Dr. Eli Pendleton:

Yeah, it’s very different then it was not all that many years ago. And guys coming in and saying, well, I just want to establish a relationship so that then I can make sure that I’m keeping up with my health. And it’s really nice to see. There’s nothing worse than talking to somebody who’s perhaps in their fifties who hasn’t taken good care of themselves and they want you to make them feel 18 again. You say, I’m really sorry.

Kendra:

I’m not a magician.

Dr. Eli Pendleton:

That bus left the bus stop years ago. It’s not coming back.

Kendra:

I think I want to focus on three main categories in this conversation. One, alcohol. Two, weight. And three, aging. But before we get in deep into those, can you tell our listeners just a little bit about you?

Dr. Eli Pendleton:

Sure. Of course. I am a family physician. I went to medical school at University of Kentucky. I grew up out in Oregon more or less. And then at UK, I met and fell in love with a Kentucky woman and we all know how that ends up.

Kendra:

Go Cats.

Dr. Eli Pendleton:

We have lived in Louisville now for about 10 years and just really loved it. And I joined Baptist. I was at the University of Louisville for nine years and joined Baptist back in the fall. And I’ve really enjoyed the community and the focus on overall health and wellness.

Kendra:

Awesome.

Dr. Eli Pendleton:

And I have two kids and two boys. So I’m trying to raise them to be the right kind of Kentucky stubborn.

Kendra:

That’s right.

Dr. Eli Pendleton:

Instead of the one that gets in your own way.

Kendra:

You got to point that stubbornness in the right direction.

Dr. Eli Pendleton:

Right, exactly.

Kendra:

Well, let’s jump straight into a topic that many people avoid: alcohol use. I know it’s linked to the increase of stroke and heart attack, but what else goes on with alcohol? What other diseases does it play a factor in?

Dr. Eli Pendleton:

Yeah, that’s a great question. A lot of our culture is based around alcohol and it’s been interesting to see that there are some newer studies showing that millennials and some of the younger generations seem to not be drinking quite as much as the older generations, but we certainly live in a state that does fairly well for itself on alcohol sales. So many occasions and events focused around alcohol. Alcohol can really have some kind of insidious health effects. It can raise your blood pressure, it can raise your weight, it can impact your sleep. It can affect the way in which you, obviously acutely, it can affect you neurologically and over time can have kind of a cumulative effect as well. And I think that there’s a lot of stigma around admitting that you have had alcohol problems. You might not consider yourself to have an active alcohol problem. Like, well, I don’t feel like I drink too much, but you’ve probably had incidents in your life that you would take back that happened because of alcohol. And it’s important just to recognize that it’s okay to admit that you’re probably overindulging at times and you need to regulate that just like so many other things.

Kendra:

So before a listener tunes us out and thinks this doesn’t apply to me, let’s get into the reasons we are making this a distinction because in addition to being a contributing health factor to a lot of health concerns, would you say that this is under reported by most people?

Dr. Eli Pendleton:

Oh, sure. It’s actually interesting. I had a discussion with my neighbor about this the other day, my neighbor went to the hospital and they quizzed him on how much he drank. And he answered very honestly, he said, well, I typically have two cocktails a day. Well, in medical school, granted, it’s been a little bit since I’ve been out of medical school, but in medical school oftentimes were taught to go ahead and take whatever answer the patients give you in terms of alcohol use and maybe double it because it was so chronically underreported. And so this poor guy just got put through the ringer. Now granted, his two drinks a day is the max. Anything more than that I always tell people, it’s my job to tell you that this is probably doing you more harm than good and is really probably a bad habit at this point.

Kendra:

Yeah.

Dr. Eli Pendleton:

But he was dead honest in his answer. And everybody, I think that the doctors that were treating him just assume that it was probably two times that yeah. When I see people, I try to ask them very nonjudgmentally. And then you just say you know you better than I do, but here’s what we know from research. And the most you should drink in a week is kind of 10 to 14 drinks for guys and no more than three or four at a time, because then you really put yourself at risk for those individual alcohol problems and then potentially the cumulative effects over time.

Kendra:

Yeah. And so I think dependency is a big concern, right? Because even if you’re abiding by those guidelines and not getting drunk per se, a habit that’s forming can still be alarming.

Dr. Eli Pendleton:

Oh, absolutely. And I think that alcohol is generally a bad coping skill. It certainly may feel like it takes the edge off after a long day. But if that’s the crutch that you reach for most frequently, then it’s easy to ignore the other impacts of stress in your life. And it can become a maladaptive coping skill where in some it’s hurting you more than it’s helping you

Kendra:

We’ll be right back.

Speaker 1:

When it comes to your health, no topic is off limits. Even when you’re outwardly healthy and fit, scheduling regular exams helps us catch problems early to help you stay that way. Find a primary care doctor for awareness, prevention, regular screenings and referrals. Visit Baptisthealth.com/provider to get started.

Kendra:

We’re back with Dr. Eli Pendleton to continue the discussion about men’s health.

Kendra:

That’s a good segue into the importance of mental health, stress and depression. It’s easy to make that correlation of alcohol and depression perhaps debate, which came first, but it’s a serious concern.

Dr. Eli Pendleton:

Right. Oh, absolutely. And it is very interesting when you dig into family history, you are talking to a patient who says that his father drank a fair amount and then you start digging into mental health. And most of the time they will say, yeah, I think he probably was anxious or was depressed and was drinking to cover it up. And it’s very easy to then kind of adopt that same sort of tactic in your own life. It’s a depressant typically, it may make you feel great initially, but overall it is going to depress your psyche a little bit and can make the depression worse. And obviously if you make bad decisions when you’re imbibing, then that doesn’t tend to help.

Kendra:

Yeah. So it can exacerbate those existing mental health issues. I read that men are twice as likely as women to suffer from work-related stress. And I think that makes sense. It was alarming to me that work related stress at times can cause people to come home and gosh, I need a drink after this long day. And I think there’s a real concern that work related stress, kind of the rat race cycle that we’re in, can lead to an alcohol dependency. Does that cause you concern?

Dr. Eli Pendleton:

Oh yeah, absolutely. And I think that I work really hard at talking about it in terms of stress, just like you said, I think that it’s far easier to call it stress because it’s a less stigmatized term that depression necessarily.

Kendra:

Yeah, it’s more acceptable to be stressed.

Dr. Eli Pendleton:

Yeah. Right. Because everybody has stress and stress can be a good thing, but too much of it over the longterm could be a bad thing. Whether it makes you feel anxious or whether it makes you feel depressed overall, it’s more or less the same thing. So I think talking about that can be really useful and trying to, so you don’t think you’re depressed, you don’t think you’re anxious. How is your stress impacting your life in ways that you don’t like? And sometimes that can be a more productive conversation. And like you said, I think that it can sometimes if you feel like you don’t have any other coping skills except a cold beer, then that’s what you reach for. It’s a convenient crutch. And it’s one that we all learn in college. It’s just, sometimes you don’t learn other ones.

Kendra:

So if somebody is listening to this right now and they think, you know what, that does kind of sound like me. I do come home and I go straight to the fridge and grab a beer and use it to unwind. And that’s my relaxing time. What do they need to know? What can they reach for instead? Or how can they kick off that conversation with their doctor?

Dr. Eli Pendleton:

Sure. I think that’s a great question. I think that recognizing that you’re experiencing stress that is not healthy is the first step, and you can even bring it up as that. Say, you feel like the stress of my work is really starting to get to me and I’m worried that it’s leading to some bad habits. I think that drinking is one of those things that can feel like a moral failing sometimes. And people don’t recognize that it is a coping skill and sometimes a maladaptive coping skill, but it’s a coping skill, nonetheless. So I think that we’re there to try to help you learn some different coping skills. That’s not the one you rely on. And I think that also just admitting and look, I always tell people you’re perfectly welcome to blame anybody else in your life because I don’t know anybody else.

Dr. Eli Pendleton:

And so if you want to say your wife made me come here and your partner made you come here, whatever. That’s okay. Whatever it takes to kind of break that ice and understand that I have work related stress too. And I deal with a lot of those things too. And there’s been more and more, I’ll use myself as an example a lot because there’s been a lot of focus in medicine about we have been historically stoic about our stress and how the job can affect us longterm. And so we’ve had to become much more focused on that and mindful of it. I will sometimes just tell people when you’re feeling that feeling, try to figure out where that feeling is coming from and why you feel like you need to do what you’re going to do. Because a lot of times we do these things to avoid uncomfortable feelings. Those are some conversations that a lot of guys have just never had before, but I find that overall, they tend to be far less bad than they think they are.

Kendra:

Yeah. It’s like, what are you trying to cope with? And let’s get to the root of that.

Dr. Eli Pendleton:

Right. Exactly. Yeah, absolutely. And is it that your kids are being jerks, which I get. That you feel like life is being unreasonable in some way. I get all that. Let’s talk through it and figure out how we can not let it get in your way.

Kendra:

So there’s a definite stigma we talked about with alcohol and I think we’re seeing our society start to at least break down the stigma in mental health. Do you see that men are still less likely to seek help with their mental health? Is there still that kind of macho attitude?

Dr. Eli Pendleton:

I think that there can be. I think that it really depends on who you’re surrounded by and what kind of conversations you are either a part of or here in your work life, in your home life, et cetera. Like I said, I think that a lot of employers are starting to recognize that this is a really important thing and if we want our workers to be happy and productive, then we need to help them focus on these kinds of things. And so I think that doctors are being prompted to do more mental health screenings with the work physicals and all that sort of thing. So I think that it’s becoming more frequently encountered in life, which then obviously starts to de-stigmatize it. I think that having more people in your life who can talk about these things. Every once in a while, I’ll talk to a patient and they say, Oh I feel like my dad needs to have this conversation. And I say, well, so go have it with them. Sometimes it’s easier for you to reach out to your friends and family than it is for me. Because coming in to see me, as we’ve already discussed, is a little intimidating,

Kendra:

Well, let’s transition now to healthy weight. This is something that people hear all the time, diet, eat healthy, exercise. So that’s ingrained, but what do men need to know about maintaining or getting to a healthy weight that maybe they’re not thinking about?

Dr. Eli Pendleton:

Once again, I think that you can oftentimes feel like you’re kind of bulletproof and you are at a healthy weight when you’re younger without really having to work hard. And then weight can start to climb on. Or for a lot of people, they are raised in environments where there is not a focus on health. And so they are raised overweight and they don’t ever know any different. And I think that there’s a very rough estimate of weight and weight for height that we use called the BMI, the body mass index. It’s a calculation you can do. You can find the calculation online. It’s pretty easy to do. And the healthy BMI is between 18 and a half and 24.9. Below that is underweight, above that is overweight. I think that much like when you live in a state where alcohol use is rampant, it’s very easy to underestimate your own use.

Dr. Eli Pendleton:

When you live in a state that is generally overweight, it’s very easy to underestimate how overweight you potentially are and understand that they’re broad categories. But if your BMI is above 25, then you’re considered overweight. You probably are carrying around a little more weight than you should be. If your BMI is over 30, then you’re technically considered obese. And if it’s over 40, then you’re technically considered morbidly obese. And what that means is that your weight is now likely to start causing health problems. BMI’s below 40, obviously can cause health problems too. Like I said, you can feel bulletproof for a long time. And then all of a sudden you hit 50 and all of a sudden you’re obese, your knees hurt, your body’s telling you your testosterone’s low.

Kendra:

All these problems stacked on top of each other.

Dr. Eli Pendleton:

Right. And again, it’s just one of those things that’s worth paying attention to. And recognizing that, yes, we like sweet tea, but you can’t drink 32 ounces of it a day because that’s going to catch up with you. And there are some things, it’s not your fault in a lot of respects because food has not been good for quite some time and good food is not necessarily healthy food. And there are also some easy changes you can oftentimes make to start to make some headway on it, if you do find yourself being overweight or obese.

Kendra:

Do you think it’s harder for men to discuss weight concerns than women?

Dr. Eli Pendleton:

I think it can be certainly because I think that we are not necessarily, again, it depends on the person, but not necessarily held up to the same standards.

Kendra:

There’s like a romanticization of the dad bod you know, the whole dad bod culture.

Dr. Eli Pendleton:

Yeah. Well, and I think it’s a real balance, right? Because I think that if you find that in the middle of a stressful environment with work and with home and all that, and you feel like you’re letting yourself go, that you don’t need to flog yourself about it, but we also need to recognize that carrying around extra weight can really be unhealthy for you. And especially in a state where there’s a lot of families that have been here for a long time, and there’s a lot of family history of heart disease, et cetera, you can only outrun your family history for so long. So one of the best things you can do to prevent the same health problems that your father might have had, or his father, are really maintain a healthy weight and avoid unhealthy habits.

Kendra:

You brought up something interesting too, that if you’re under 18.5 in your BMI you’re considered underweight, I think we don’t talk about that a lot. We talk a lot about people being overweight, needing to lose weight and get down to a healthy weight. But there’s certainly a sector of the population who need to get up to a healthy weight too.

Dr. Eli Pendleton:

Oh, sure. That can be just as, if not more stressful for that segment of the population as well, just because it can be really hard and there’s some allowance made for body type and such, but there are eating disorders among guys.

Kendra:

Sure, yeah.

Dr. Eli Pendleton:

And people find that hard to believe, but there’s what we call exercise anorexia, where you may be eating quote unquote normally, but you’re exercising-

Kendra:

To the point that it offsets.

Dr. Eli Pendleton:

Would suggest that you need to be eating twice as much. And so you’re restricting calories.

Kendra:

And you don’t just want to gain weight to gain weight. You want to gain healthy weight or build muscle. And so then do you see a lot of guys turning to supplements, and I think the rise of places like GNC and things like that, people are just filling themselves up to just pack on muscle. What’s your stance on that? What would you tell people?

Dr. Eli Pendleton:

I think that a lot of that stuff is somewhat faddish, and so it’ll go away or come and go over time. I think that within a very regimented diet and exercise program, some of those supplements perhaps have a place for athletes or elite athletes. I think that for the average person, most of those supplements, the only predictable result is that it drains your wallet because they tend to be pretty expensive. And all of that said, I am 100% supportive of people taking care of themselves and doing what they believe is helpful. I think though that remember that a lot of those supplements aren’t regulated and so there are a lot of risks that are perhaps not well advertised with some of those. I think that you also have to remember that our egos are relatively easy to prey on. We all want to feel like we’re still 18 and that we are still bulletproof. And so anything that advertises itself as helping us to be that, it’s easy for us to fall prey to that.

Kendra:

A lot of those like pre-workout supplements and things like that, they have a lot of stimulants in them and caffeine and can those have harmful effects on your heart?

Dr. Eli Pendleton:

Yes. Over time they absolutely can. I have certainly had a handful of patients who come in with high blood pressures and you investigate a little bit of what they’re doing and what they’re eating and such. And you find that they’re probably causing their own high blood pressure with some of the supplements that they’re taking. I think that reading those ingredient lists, you get cross-eyed and it’s hard to know exactly what’s in them and it’s just worth being careful.

Kendra:

Well, I think that’s probably an important point to make to listeners that those are also things that you need to be reporting to your doctor when they ask you for a list of what you’re taking. Because that’s something that’s probably easily just honestly overlooked. You don’t think that’s not a medication. You didn’t get it from a pharmacy. I imagine people don’t report. Oh yeah, I take a BCAA or this pre-workout.

Dr. Eli Pendleton:

Right, I think you’re more inclined to ask some patients than others. If you have somebody who is a big time CrossFitter or something like that, and comes in all bulky, then you ask them. But there’s a lot of people who take them who you wouldn’t think to ask and they wouldn’t think to necessarily report it, they can cause all sorts of issues.

Kendra:

I hope you’ve been enjoying this conversation with Dr. Eli Pendleton. Join us again next week to finish the discussion about men’s health. You won’t want to miss the health tips by decade. So be sure you’re subscribed to this podcast so you don’t miss it. And if you like what you’ve heard today, send this episode to a friend. We’ll see you next time on Health Talks Now.

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