(Disclaimer: This post appeared originally on June 29, 2011. It contains references that are graphic in nature, and which may be considered offensive; reader discretion is advised. The initial catalyst for posting this information was my 2011 Colonoscopy. I had a second procedure recently, and it seemed like a perfect time to reprise this post).
A couple of days ago I had a Colonoscopy, which is the endoscopic test of the colon and the distal part of the small bowel with a camera. The procedure is recommended for men over age 50, on a periodic basis; every 10 years if no irregularities are found, and more frequently if non-benign polyps or other issues arise during the test. Mine was scheduled as a regular sequential step in my Annual Physical regimen, not from any kind of alert or scare. That is as it should be.
This is not intended to provide a by blow-by-blow of my procedure. I am addressing this topic to provide a public service. I have observed both anecdotally and from numerous data streams, men in general and African American men in particular, are notorious for neglecting our health. There are too many reasons to enumerate, but a few include:
- Distrust of doctors (Some black men still reference the Tuskegee Experiment)
- Fear…of doctors, of medicine, bad news, of pain, of surgery, of anesthesia, the
- Unawareness of early warning signs
- No regular doctor
- Lack of health care benefits (African Americans are more likely to be
Unemployed or Underemployed, and therefore less likely to have insurance)
- Misplaced priorities (some men take better care of their homes and/or cars than
they do their personal health)
- Good intentions; bad execution (Many of us “intend” to” schedule an appointment
to see a doctor, but don’t)
- Procrastination (Delay, delay, delay)
- Superman complex (The perception that one is young, healthy, and totally bullet
- We are on a super secret suicide mission (No, we just act like it)
Those are 10 of my own very unscientific, totally straight off the top of my head reasons. After setting them to paper, I decided to look for an expert opinion…OK; I checked to see what a doctor thought. Not surprisingly (to me anyway), there was a fair amount of overlap.
Dr.Sharon Orrange, Assistant Professor of Clinical General Internal Medicine at the University of Southern California has weighed in with what she believes are “The 10 Real Reasons Men Don’t Go to the Doctor.” Since she actually practices medicine, I will allocate more weight to her opinion than mine…though keep in mind, I do have the inherent advantage of being a man. Dr. Orrange’s 10 most compelling (or real, as she puts it) reasons are:
- You are afraid we will put our finger up your butt. We will, especially if you are over 40 or have any complaints related to your bowel movements. Yes, you get a rectal exam after the age of 40 once a year for a feel of your prostate and so we can check your stool for microscopic blood that you can’t see.
- You are afraid we will examine your balls. We will, if you are 40 or younger. The peak age for testicular cancer is 18-40 so guidelines recommend you get a once a year testicular exam. Don’t worry it won’t hurt at all.
- I feel FINE. I am glad you feel fine, but you can feel FINE with high cholesterol, high blood pressure and elevated blood sugars. Your mother or wife won’t feel fine when they are taking care of you after you have a stroke. Don’t wait until you feel awful to come see us.
- Going to the Doctor is a chick thing. Many of you feel this way but remember we live longer than you do. If doctor visits are a chick thing well, then, nursing homes are a guy thing. You have to get over this. It’s true, the waiting room magazines are not for guys but when you come see us you will see that many of the medical assistants, doctors, phlebotomists and medical records folks are men. Real men go to doctors.
- You are embarrassed to talk about what’s going on with you. The bright red blood on the toilet paper when you wipe, the red itchy rash in your groin and on your feet, the problems you have at times getting a boner, getting up at night a few times to pee, we hear it all the time. You are not alone and our job is to show you how common this is and help fix it for you.
- You don’t find the office hours convenient. I get this and urge you to find a doctor who is accessible and can work around your office hours. Seriously though. The average guy watches 16 hours of TV a week, you can come for a 30 minute visit once a year and maybe a couple of follow-up visits as needed.
- Going to the Doctor is giving in to your nagging wife. I had a patient who gave his wife for her 20th anniversary a copy of his Lipitor prescription, thinking this was a GIFT to his wife that he was taking care of his medical issues. It is true, women rightly so nag their dads, brothers, and husbands to go to the doctor because they are tired of square dancing with women at the assisted living facilities.
- You don’t realize we are here for prevention. You don’t have to be sick to come see us and if you establish a relationship with us you have easy access when you do get sick. Once a year we can touch base with you to discuss age appropriate screening which we KNOW helps keep you well.
- You don’t have a relationship with a physician. If you are not attached to a regular physician by the age of 40 you are more likely to get in trouble. Unlike women who need annual pap smears and contraception, you haven’t had to see someone regularly from the age of 18-30. Find someone your friends use or enlist your partners help to find someone that might be a connection. You want someone accessible and younger physicians are much more likely to e-mail so look until you find the right match.
- You think we will pick on you for your habits. Drinking a 12-pack on the weekends, not exercising and eating bad foods, among other things. These things are not as uncommon as you might expect. We will put you on a long leash and let you pick and choose the habits to get rid of as needed.
If you are a Doctor Dodger, the reality is, it is of little consequence whether your reasons for doing so more closely resemble Dr. Orrange’s list or mine. If your recalcitrance leads to a preventable heart attack, some form of cancer, or a stroke, you will have contributed directly to reducing your quality of life, as well as that of your family members. Such actions could also lead to premature death. It really is pretty simple; fear, embarrassment, death (sooner rather than later)…pick one dude!
Let’s be clear here, human beings are not immortal. Psalms 90:10 advises us: “The days of our years are threescore years and ten; and if by reason of strength they be fourscore years, yet is their strength labor and sorrow; for it is soon cut off, and we fly away.” Proponents of the Bill Maher School of Thought dismiss such biblical advisory as akin to magic, wizardry, or witchcraft. But I am reasonably certain even Mr. Maher would concede that we all will die. Moreover, I wouldn’t bet the farm that he doesn’t have a regular physician, regardless of his rationale.
The point of seeing health professionals on a regular basis is not to live forever; none of us will. Rather, the idea is to leverage the best possible existence out of our all too brief time here on earth.
As most of us know, women live longer than men. Once upon a time, this was largely attributable to the rigors of backbreaking manual labor, and long before that, due to the results of men losing too many battles with the lions or other members of the Wild Kingdom, in the quest to determine who would eat…and who would be dinner.
Neither of those historical tableaus aligns with today’s American reality. No, the underlying contemporary contributory factors for those of us now living in the USA are that poor exercise habits, irresponsible dietary choices, too much smoking and drinking, and eschewing regular checkups and prevention screenings combine to lead to a lower quality of life (health wise), and ultimately, to a shortened lifespan; on average five years less than for women.
According to a 2007 Harris Interactive survey that included over 1,100 men, the American Academyof Family Physicians found that:
- Many men go to the Doctor only when they are very sick
- Before they did, many of these men waited several days to see if they felt better
- Most of these men had a regular doctor
- Most had currently active health insurance
- Most said they felt comfortable talking to their physician
In an even more recent survey, conducted by Esquire magazine in January of 2011, researchers found that:
- Roughly half of American men ages 18-50 had no primary care physician
- One third had not had a check-up in more than a year
- More than 40% had never had their cholesterol checked
- 70% had never had a prostate exam
Do you perchance know the leading causes of death in America? According to the Centers for Disease Controland Prevention (CDC), complete information available in 2007, broke down like this:
Number of deaths for leading causes of death:
- Heart disease: 616,067
- Cancer: 562,875
- Stroke (cerebrovascular diseases): 135,952
- Chronic lower respiratory diseases: 127,924
- Accidents (unintentional injuries): 123,706
- Alzheimer’s disease: 74,632
- Diabetes: 71,382
- Influenza and Pneumonia: 52,717
- Nephritis, nephrotic syndrome, and nephrosis: 46,448
- Septicemia: 34,828
Source: Deaths: Final Data for 2007
Based on CDC research, Heart Disease and Cancer, the top two causes of death in the United States in 2007, led to nearly twice as many deaths as the cumulative totals of causes 3 through 10. In fact, the number of deaths attributable to Heart Disease alone, (616,067), nearly equaled the total for causes 3 through 10 (667,589).
It is important to recognize that the relative death rate for men is higher than that for women for all of the Top 10 causes. While there are hereditary factors that contribute to individual proclivity to develop Heart Disease, a timely and committed change in lifestyle in concert with an appropriate medical remediation, prevention, and/or maintenance strategy can help most men (and women) live a relatively normal life.
In summary, this post is a cry for help on behalf of men. Perhaps, more aptly stated, it is a call for men to step up and help themselves. As a general rule, ours is an interdependent society. That means, someone, somewhere relies upon you. So men, I urge you to unite on behalf of a cause that intuitively selfish, but intellectually selfless. I entreat you to recognize this undeniable truth; “Men’s Health: A Compelling Quality of Life Issue!” Yes, this is a cause that requires you to think of (and act) for yourself first. But in doing so, your wife, or significant other, your children, your siblings, your parents, your friends, your co-workers, your career, your civic association, your fraternity, and yes, your state of mind, will all benefit.
I’m done; holla back!
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