‘Man up’ and go to the doctor

DR. JENNIFER STULL, a family practice physician at Eastern Woods Family Practice, talks with patient Eric Bibler. This week is Men’s Health Week and Stull and other health care providers want to spread the message that keeping tabs on one’s health is important. Men are more likely to put off seeing to their health than women are, a habit that can put their health at risk. (Photo by Randy Roberts)

DR. JENNIFER STULL, a family practice physician at Eastern Woods Family Practice, talks with patient Eric Bibler. This week is Men’s Health Week and Stull and other health care providers want to spread the message that keeping tabs on one’s health is important. Men are more likely to put off seeing to their health than women are, a habit that can put their health at risk. (Photo by Randy Roberts)

Staff Writer
Men, it’s a good idea to go to the doctor regularly even if you feel healthy.
A campaign to encourage regular checkups as well as greater awareness of prostate cancer, depression and other health issues affecting men is underway. June is Men’s Health Month and this week is Men’s Health Week, a nationwide observance designed to raise awareness.
“A lot of guys don’t really think about their health on a daily basis,” said Brandon Leonard, director of strategic initiatives for Men’s Health Network, a nonprofit organization.
Leonard cited Centers for Disease Control and Prevention statistics that show men are half as likely as women to go to the doctor for preventative care. Even if something is wrong, they may put it off, he said.
The Men’s Health Network is encouraging men to take control of their health. Leonard said they should get at least 30 minutes of exercise each day and should eat healthy, including lots of fruits and vegetables and lean protein, and cutting out saturated fats and trans fats.
Men should also stay “on top of their important numbers,” such as cholesterol, blood pressure and glucose, Leonard said.
Leonard encouraged men to think of taking care of their health as benefiting not only themselves but their loved ones, who want them to live long and healthy lives.
One obstacle is that many men say they have busy lives and it is difficult to take time off work to go to the doctor, Leonard said. There is also a feeling of men perceiving themselves as “too macho to go into the doctor’s office.” Boys are taught from a young age to be stoic if they scrape their knee, and to “be a man,” which can give them a sense that being a man means not seeking help when you need it, Leonard said.
He said this may lead to men in their 40s or 50 who, experiencing chest pain, may assume it will go away and they shouldn’t worry about it.
Leonard said men need to be aware that heart disease is “the number one killer for men and women” and blood pressure and cholesterol are among the factors that may make them more likely to get it. Prostate health, including not only prostate cancer but other conditions such as enlarged prostate, can affect men “particularly as they get a little bit older,” he said.
This year’s Men’s Health Week campaign is particularly highlighting mental health. Men and women both can experience depression, stress and anxiety but men are less likely to seek help. Instead, what happens is “waiting and bottling things up and not getting any kind of help for … maybe it’s depression and they may be holding onto things for a long time,” Leonard said. Over time this can lead to serious problems including suicide, he said.
Leonard said the Men’s Health Network is trying to “shatter this myth that it’s not manly to ask for help.” In fact, it “takes a lot of courage,” he said.
He said women can play a role by encouraging their brothers, fathers, husbands and boyfriends to “go and get that help if they need it.”
Men’s Health Week was first passed by Congress in 1994 and has grown each year since, Leonard said.
Dr. Jennifer Stull, a family practice physician at Eastern Woods Family Practice, said all men should see their primary care provider every year or two “just for a general checkup.” This should include reviewing blood pressure and weight, discussing diet and physical activity, and reviewing preventative medicine like immunization and screening tests. Stull is particularly likely to order blood work to measure things like cholesterol or blood sugar levels if her patients are overweight or obese. She said most of her patients are overweight or obese, and she encourages patients to learn about lifestyle changes such as changing their diet.
Immunizations for otherwise healthy adults she recommends include a flu shot every year for all ages; a human papillomavirus vaccine for adolescents and young men, a tetanus booster every 10 years, a shingles vaccine once after age 60 and a pneumonia vaccine after age 65 (there are two versions of this pneumonia vaccine, and everyone should have a dose of each).
Men who have smoked should be screened once between ages 65 and 75 for an abdominal aortic aneurysm; a bulging of this blood vessel that can create a rupture, Stull said.
Smoking is also the number one risk factor for stroke, heart disease, cancer and lung disease, she said.
Other screenings include a colon cancer screening between ages 50 and 75, and a hepatitis C screening for people born between 1945 and 1965, Stull said.
Stulll encouraged men to tell their doctors their family history. Patients also may want to communicate with their insurance company to find out if a certain test is covered, “so you do not end up with a surprise bill.”
Stull said there is a stigma for men seeking help for depression, but she has found that they are more willing to talk to her, a family doctor, than to a therapist or psychiatrist.
Carol Oehler, a therapist at Century Health, has seen differences in how men and women seek mental health care. She said Century Health has roughly as many men as women among their clients but the men are much more likely to put off seeking help for conditions like depression until symptoms have gotten severe.
“Women tend to come in at an earlier age to deal with traumatic experiences that may have happened in their childhood,” she said.
In addition, men often start substance abuse at a younger age than women, she said.
And once they do seek therapy, it often takes more time with men before the therapist can get to the issues. Oehler said men believe they’re weak if they cry, and that they should “suck it up.”
“‘Man up,’ I hear that a lot,” she said.
She said sometimes when men retire or become disabled, and are no longer as busy as they were in their working lives, emotional issues they haven’t faced for years will suddenly rise up.
Men frequently, though not always, prefer female counselors so they can tell them things they might not be comfortable telling another man, she said.
Oehler said sometimes a man seeks help when his wife tells him he must or his employer refers him. In other cases, the man may recognize anger and irritability in himself that reminds him of his own father, and he comes to seek help because he doesn’t want to be that way with his own children.
Men, more than women, are often “very hesitant” about being on medication, Oehler said. She tells them that not everyone with a mental health diagnosis needs to be on medication, and many people who do go on medication may only need it for a short period of time rather than forever.
Oehler encourages men to seek help for not only their own sake but everyone in their family.
“Because usually he is not really aware how his mental health issues may be affecting his entire family — his wife, his children, what have you,” she said.
Dr. Andre Gilbert, a urologist at Blanchard Valley Urology Associates, said women have the advantage that they go to the gynecologist routinely. So women are regularly getting health education and are aware of the need for checkups.
“And men don’t have that,” he said.
Gilbert said it’s important for men to realize that screening can find some conditions in the early stages, often before symptoms appear, which is preferable to waiting until later.
Testicular cancer is more prevalent among younger men and Gilbert encouraged boys starting in their teens to examine their genitals once a month for any masses.
Often when a man does go to his doctor about a mass, surveys find he has had it for an average of six months before getting it checked out, he said. Gilbert said men shouldn’t become overly fearful, and not all masses turn out to be cancer. But he encouraged men to be aware and to get anything unusual checked out.
Prostate cancer screening is generally recommended starting at age 55, although men who are at higher risk, including African-American men and those with a family history, may need to start earlier. Gilbert said men should check with their physicians as to how frequently they need screening.
Gilbert said men may also want to get a urine test through their primary care physician which can screen for lesions in the kidney or bladder that may create microscopic amounts of blood in the urine.
Sexually transmitted disease are also a concern and sexually active men should take steps to protect themselves against them, he said.
Gilbert said men can also safeguard their health by avoiding well-known carcinogens such as smoking. Smoking increases the chance of bladder cancer up to eightfold, since as nicotine breaks down it irritates the lining of the bladder, he said.
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