This month's Healthy Actions topic is men's health, but a few of these tips are also good for everyone's health. So women, you can take note, too.
This month's expert is Dr. Troy Bishop, an internal medicine physician with Unity Health Network. He joined the Cuyahoga Falls-based primary care network, which is the largest independent physician group in Northeast Ohio, last year after more than 20 years at Summa Health.
Get to the doc
One of the biggest hurdles for men is just to get to the doctor.
“I think their resistance comes from apprehension,” Bishop said. “I tell them at their physical that I hope they don't need me. We're meeting once a year and kinda hanging out. It is a way to make it easy. We trust each other.”
Then, he said, “if there ever was a crisis, God forbid, they're comfortable reaching out to me.”
Bishop suggests men should visit the doctor at least once between ages 18 to 25 for a cholesterol and other basic checks, immunizations and a risk profile.
“Truthfully, the biggest risk at this age is their car” and safety in it, he said. “The next risk is accidents and depression and suicide.”
After that, Bishop said there is no official guidelines, but it would be good to see the doctor every three to five years, unless there is a family history of something that would require more visits or risks in their lifestyle, such as high-risk sexual behavior or substance abuse.
Once men are in their 50s, that's when “we start to dial in to a little more aggressive screening … and begin to see the doctor yearly.”
The guidelines indicate colonoscopies begin at 50 unless you have an immediate family member who has had colon cancer or an advanced polyps. In that case, you should start with a colonscopy at age 40 or 10 years younger than the age that relative was diagnosed. Colonoscopies should then be repeated every five years.
About those screenings
Colonoscopies are one way to screen for colon cancer, and should be done every 10 years, if there are no issues, Bishop said. Many men can stop at age 75.
Another option is an in-home fecal DNA test called ColoGuard, which requires a prescription from your doctor. Bishop said he recommends this for a majority of his patients with no family history of colon cancer or previous polyps. The mail-in kit analyzes a fecal sample. ColoGuard can be used every three years, if there are no issues. A positive test should be followed up by a colonoscopy, Bishop said.
Another important screening for men 65 to 75 who have smoked at least 100 cigarettes in their life is an abdominal aortic aneurysm screening, Bishop said. It is an ultrasound, which takes pictures of your aorta to identify a problem before it ruptures, which could be fatal.
About that other exam
A digital prostate exam is not something men look forward to. Bishop said it's also unnecessary and recent national guidelines from the U.S. Preventative Services Task Force agree. The task force and the American Urological Association concur that the blood test for a specific antigen for prostate cancer is also not recommended, or is a decision you should discuss with your doctor.
Bishop said some men avoid going to the doctor because they're worried about the exam.
Bishop, however, hasn't regularly performed a digital exam as a screening test on a healthy male in years unless requested.
“You're literally just brushing the surface,” he said. “It is proven to in no way improve survival and we're doing this thing that men hate. Why would I?
“If you're having pain, you can't urinate, there's blood in your urine or when there's a symptom, that's different.”
Tips for everyone
•?Fighting obesity: The rate of growth for diabetes in American men and women is dramatic, Bishop said.
“We're treating the disease with medicines that lower the sugar, but we're really not getting at the heart of the issue, which is our diet, which is high in sugar, high in processed grains” and carbohydrates, he said.
Options include a plant-based diet or discussing the use of fasting or episodic fasting for somebody who might be insulin-resistant or pre-diabetic, he said.
•?Mental and spiritual well-being: People's mental and spiritual well-being is just as important as physical well-being, Bishop said.
“How many people have mental and emotional struggles? I'm finding there's a lot of people. If we're honest, it's all of us at some point, yet why don't we ever talk about it? We're enamored with all of this discussion of health but in our country probably one of the biggest health concerns is we're not emotionally and spiritually well.”
Bishop recommends some practical things, such as prayerful meditation.
“I'm a person who prays. You can be a person who meditates,” he said. “Our mental wellness determines in a huge way our physical wellness.”
Setting aside 10 to 15 minutes a day to clear your mind, or even taking a moment at your desk at work or when you're waiting somewhere, is helpful, he said.
“I ask patients, ‘How often are you sitting quietly in a room, with no one bothering you, just focusing on wellness/being mindful of your life? Do we take 10 minutes to do that? I've almost found no one who does, including myself.”
Studies have shown that regular meditation can improve such things as fertility and blood pressure, he said.
You also don't have to sit still to clear your mind or focus. It can be in yoga, or for Bishop, it's while he's lifting during a workout.
•?Alcohol: It's common in our society to think that you need to drink alcohol in order to relax, which is wrong, Bishop said.
“People are treating their stress with alcohol. Not that it's not good to sit with your spouse or friend and have a drink; it can be good,” he said.
So what's too much? Needing a glass of alcohol every night in order to relax, he said.
“If you're drinking more than two drinks for a male and more than one for a woman every night, it is physically unhealthy,” he said.
“If one beer is all I need on the weekend, I don't think it's wrong,” Bishop said. “If I'm having a talk with a friend who needs me to be there for him and a beer is a reason for me to be there to be there to talk, it's one of the most powerful interactions,” he said.
Beacon Journal consumer columnist and medical reporter Betty Lin-Fisher can be reached at 330-996-3724 or email@example.com. Follow her @blinfisherABJ on Twitter or www.facebook.com/BettyLinFisherABJ and see all her stories at www.ohio.com/betty