November 18, 2025 • 32 mins
In the debut episode of The Male Room, Jordan the Producer makes a confession that stops Dr. Mills in his tracks: he hasn’t had a full physical in nearly a decade. What starts as a sheepish admission quickly turns into a bigger conversation about modern men and medical avoidance — why so many guys skip routine checkups and how often you really need to see a doctor. Dr. Mills breaks down the guidelines with his trademark mix of clarity and humor, debunking a few myths along the way and explaining why “I feel fine” isn’t a health plan. It’s a funny, relatable, occasionally humbling kickoff to the series — and the answer to “How often should men go to the doctor?” might genuinely surprise you.
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Episode Transcript
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Speaker 1 (00:00):
Let's talk about it. Let's talk about a man hero.
Let's talk about it. Let's talk about the man Hero.
Speaker 2 (00:17):
Welcome to the Man, Hey, everybody, Doctor Jesse Mills here,
Welcome to the Mail, the podcast where we are going
to discuss all things about guys and the people that
love those guys, and how to make those guys even
better than they already. Are so excited that you're part
of this podcast. I want you to feel the enthusiasm
that I feel every time I come to work in
(00:37):
the morning and treat an exam room full of guys.
Try to get them educated about their own healthcare literacy,
Try to separate the hype, try to separate the science.
The world of men's health is this crazy, mixed up
place where all kinds of therapies have been put out
there that may make sense, may not make sense. Some
(00:58):
things that you think are completely wacky actually have scientific evidence.
And so over the course of these episodes, what I
want to do is I want to get to know you,
and I want you to get to know me and
how I look at things. And I'm a very practical guy.
I went to medical school the University of Iowa, which
is one of the phenomenal top research institutions, but it
still is a good rooted Midwestern experience where we try
(01:22):
to teach common sense. After finishing medical school at Iowa,
I trained in general surgery and urology at the University
of Colorado, doing everything from taking out appendices to major
prostate cancer surgeries. And that's when I developed the niche
in men's health and male reproductive surgery. And so for
that training, I went down to Baylor College of Medicine
(01:43):
and studied with a legend in the field, Larry Lipschutz,
who's still very active today. He taught me the nuances
of microsurgery as well as hormone therapy and management. And
after doing that, I established one of the first comprehensive
men's clinics in the state of Colorado. And then a
big bucket of what I've developed is treating sexual dysfunction,
especially problems with erections, how it pertains back to cardiovascular
(02:06):
health and overall men's health. And then a condition called
Peyrone's disease. It's a very nuanced condition that affects millions
of guys in that they developed scar tissue in the
penis that causes them to not be able to have
normal penetrative intercourse anymore. And after doing that in Denver
for about eight years, I was thrilled to have the
(02:26):
opportunity to be recruited back to UCLA where I did
my undergraduate research, then start the Men's Clinic at UCLA Health,
which is now celebrating its tenth year of open treatment
to men coming from all different backgrounds with all different
issues that affect their reproductive health, their hormonal health, and
their sexual health. And now I would say, on an
(02:49):
annual basis, we're seeing somewhere north of twenty thousand men
to help guys live their best lives and optimize their
care and we're going to learn and simulate what it
is going to be like if you were in my
office and I was taking care of you, as if
you were one of the thousands of guys I'm able
to help. So that's it. The ground rules are none.
We're just going to let this organically develop. We're going
(03:11):
to bring in a bunch of guests that are going
to have different perspectives than I do, and we're going
to hash out how to make you the best possible
guy you can be. It's going to be a day
in the mailroom. And I'm super excited to be joined
by my producer, Jordan Runta, who's going to be my
on air presence to keep me focused, to ask questions
(03:32):
as if he were a patient himself, as if he
were the guy in my waiting room I was going
to see next. And Jordan is so great that you
bring a wealth of recording experience here, but more important,
you're going to be an active participant in this entire venture.
I'm going to bounce ideas off you. I'm going to
ask you what you think, and you're going to ask
me what I think. And then we're going to do
(03:54):
this as a as a comprehensive look at men's health.
So that's what we're here for. But thanks again and
be a blast.
Speaker 3 (04:00):
Oh I'm so excited for this. It's going to be great.
Thanks for having me.
Speaker 2 (04:03):
But you know, as we kind of we're talking about
all the logistics about how to set this up and
what it entails, I realized I don't really know that
much about who you are, what are you doing, and
what are you looking for out of this podcast other
than just a couple of guys talking and bringing on
some really smart guests.
Speaker 4 (04:20):
I mean, I kind of view myself as the voice
of the audience here as I just turned thirty seven,
and I've just started to hit the age where I think,
oh geez, I really got to start taking an active
interest in my own health.
Speaker 3 (04:29):
Just selfishly.
Speaker 4 (04:30):
I'm so happy that I can be here and learn
from you and maybe sort of post some questions to
you that I imagine a lot of listeners might have
too that aren't as steeped in the knowledge and all
the training that you have.
Speaker 2 (04:40):
Yeah. Man, I don't want to harsh your mellow, but
you're thirty seven. Do you know when did we start aging?
Just come up with a number? Do you? How do
when is it? Like? When is the start? Is is it?
Thirty seven? Is it? There's an actual scientific answer to this.
So what what do you think? When do you think
we stopped being young and we start to grow old
from a molecular cellular mechanism.
Speaker 4 (05:00):
Well, doesn't the brain stop the neuroplasticity begainst the heart?
Speaker 3 (05:04):
And I want to say, at age twenty.
Speaker 2 (05:05):
Six, damn, bro, Yeah you got some skills. Yeah, so
that's about right. The first signs of senescence, which is
kind of the scientific term for aging, the neurons start
to sort of die off somewhere around twenty five twenty six,
which is I'm sure, I'm sure that's what the rental
car companies had in mind, because you know, you can
go to war at eighteen, you can bribe when you're sixteen,
(05:27):
you can drink when you're twenty one, but you can't
rent a car to you're twenty five. They're waiting for
that last stupid frontal impulsive neuron to die off before
you could actually rent a car. But you're right, that's it.
Twenty five. And then in my world, in the world
of urology, which encompasses everything from kidney stones to prostates
to sexual dysfunction and both men and women, we look
(05:48):
at something called the endothelial cell, which lines everything from
your coronary arteries, so the heart arteries, to the back
of your eye, the retina too, in my world, the
lining of the penis. And they're this amazing molecule called
nitric oxide, and nitric oxide it's the simplest, tiniest little
molecule that won the Nobel Prize in around nineteen ninety two,
(06:11):
and we found that nitric oxide levels start to drop
right around age twenty five to twenty eight, and that
is the first sign of atherosclerosis, which is the hardening
of the arteries. And so when we stop producing high
levels of nitric oxide, that's when the wheels start to
come off. The great thing is that so much of
(06:32):
this arterial sclerosis and so much of this endothelial cell dysfunction,
you can start to reverse that, and you actually can
start to see levels of nitric oxide increase, either through
improved exercise, improved nutrition, or sometimes medications will get into that,
but yeah, we're going to figure out how to take
a thirty seven year old, how to take a forty seven,
(06:52):
how to take an eighty seven year old, and figure
out what that eighty seven year old can do to
reverse some of this degradation there's a loss of nitric oxide.
I mean, that's what it's all about, is this very
simple breakdown of what you can do in the kitchen,
what you can do in the gym or outside, and
then what you can do in the bedroom. And you
can interpret that however you want, but mostly mostly at
(07:14):
this point we'll talk about how you can sleep better,
But then there are the things you can do in
the bedroom that I'm sure our listeners will be interested
in figuring out how to optimize as well, so it's
gonna be totally cool.
Speaker 4 (07:55):
Very recently, earlier this year, I started going to the gym,
seeing a trainer, started to talk to him more about nutrition,
and went to get my first check up in a decade,
which I am not.
Speaker 3 (08:05):
Very proud of. But also I know an embarrassingly common
thing among men.
Speaker 2 (08:10):
Yeah, as guys, the traditional narrative is that we don't
go to the doctor unless, you know, we broke a
bone and we've got some piece of our ear hanging
off our face after a mountain lion attack or something,
and then we know, whitchbone, that's right, and that's it.
You know, really, when you look at the literature traditionally
in medicine about how guys engage the physician, over forty
(08:34):
percent of primary care visits for guys between the age
of eighteen and sixty is for something youury logic, which
means basically, you know, they can't pee, they can't have sex,
or they have a kidney stone or something like that,
and so so actually that's one of the reasons that
drove me into urology as part of my creation story
when I got there, I realized how much I loved
(08:54):
taking care of patients and having the dialogue, but also
how much I loved the idea of being able to
go into and operating room and fix a problem, put
a couple of stitches in the skin, and send the
guy home and make them better than they were before
they started the operation. Was what drove me into this.
And then when I learned also from all of my
internal medicine and primary care rotations and working even in
(09:15):
borough farming communities, how many men don't really have those
touch points in how they engage the medical community and
why it's not their fault, it's not our fault. I mean,
maybe a little bit of is we have a pathologic
level of stoicism where we're constantly playing through pain and
we're constantly thinking, you know what I mean, if it
(09:35):
doesn't kill me, it makes me stronger. And that's kind
of true, because the human body is amazing at regenerating itself.
So if we do break that bone and we kind
of get the ends a little bit close together, it'll
probably heal up okay, and you can get back on
your tractor and make a living for your family, and
you certainly don't want to take you any time off
work during the harvest or during planting season, and so
(09:57):
all of those things together, you know, unless really are
in extremists, as we say in the medicine community, or dying,
then you don't go in. And so, yeah, you can
go decades without a check. And maybe the other thing
that drives men's health into existence is that we realized
early on that women do have a built in touch
point on an annual basis with their primary care or
(10:19):
their guy in tocologist, and that they have to do
cancer screening and particularly the papsmerror and often in this society,
most of the birth controlled decisions are made by women,
since it seems to be they're the ones that carried
the burden whether they went to or not, you know,
going in for their oral contraceptive pill renewals, and guys
we don't have that, although we do have an oral
contraceptive coming on the market for guys at sometimes in
(10:41):
the not too distant futures. That's a cliffhanger we'll come
back to at some point. But yeah, I mean, that's
it is that if you don't have to go in
on an annual basis, then you just chug along. You
get your last high school physical when you're eighteen, and
then you know, you don't go back into see a
doctor and tell your appendix ruptures, and you know, sometimes
that's it thirty seven. Sometimes it's at twenty seven. Sometimes
(11:03):
it's at seventy. And so it's amazing. Even in my
practice in urban Los Angeles, the number of guys that
I see in their sixties that don't have a regular
doctor is about thirty percent. So, in other words, they've
jumped through I every single hoop to just get to
a super sub specialist. And I start with the same
conversation that we just started with you, which is, well,
(11:24):
what got you here today? You know? So I'll ask
you with that preamble, is what was it that got
you into your first checkup where you just chugging along
and thinking, you know what, I'm starting to read a
lot about things in the health sphere and I should
probably be a little bit more informed. Or was it
something said, wow, man, you know I've got this pain
in my knee. No, for me, it was a little.
Speaker 3 (11:46):
Bit more Okay.
Speaker 4 (11:48):
I think for a lot of people, the pandemic kind
of threw off a lot of our routine. I you know,
instead of going into the office every day and moving
around and being out in the world, set of working
from home, just a much more sedentary lifestyle than I
really wanted.
Speaker 3 (11:59):
And I just finally was like, you know.
Speaker 4 (12:01):
What, it was New years earlier in this year, just
you know, New Year's resolution kind of thing, going to
get back out there, going to go to the gym
and really take this seriously. And then from there, you know,
as anyone who starts to dig into the health sphere knows,
it's such a rabbit hole. I mean, there's just so
many different sections you go into. It becomes a full
time job if you let it. And yeah, I just thought, okay,
(12:22):
well a real baseline thing I should probably do is
go to see a physician and see if there's anything
that I should know about that I should keep an
eye on or deal with, you know, God forbid.
Speaker 3 (12:31):
And yeah, luckily I'm pretty much okay.
Speaker 4 (12:33):
But yeah, it was really trying to get back in
the swing of things after a weird couple of years,
which I think is something a lot of people can
relate to.
Speaker 2 (12:40):
Yeah, no, I think you reminded me of a patientis
maybe towards a tail end of I mean, I don't
even know where we are in this pandemic. It's still
going around, I guess, but but we'll call it, you know,
the shutdown, the lockdown. And I saw him and he
looked even with his mask on, I could tell he
just looked amazing. And I said, yeah, what's the deal?
You know? I said, well, I realized early on in
(13:02):
this deal, and we have all this time, and I
could have either become a chunk, a drunk, or a hunk,
and I decided to become a hunk. And it always
resonated with me because unfortunately, I saw a lot of
drunks during that time period too, and a lot of chunks.
And it's easy. Oh well, you know, gym shut down.
You know, I remember going to my gym in the
(13:22):
early days with night trial gloves on my hand and
a mask and I was spraying hands, attis and everything
and thinking somehow that was going to keep back the
tide of you know, it was a single handedly take
on the pandemic and keep this gym open, and with
it a couple more days, that was it. You know,
we lost it all. They started refunding gym memberships and
then trying to get weights online. That was that was hilarious.
(13:46):
I can get anything. So so no, I think that's
that's an interesting wake up call, and it's one that
a lot of people we went two ways on. We
either went way in and said, no, this is great.
I'm you know, I'm not driving two hours a day
and a commute, and especially in a city like Los
Angeles where the average commute I'll make up a number,
but it's probably somewhere about forty five minutes to an
(14:07):
hour for most people that work anywhere within the Los
Angeles area. So that's an hour to two hours a
day that people had on their hands that they could
be much more efficient. So I love that, I mean,
terrible thing to go through as a world to get
us a wake up call. But I also think one
other thing that is critical to our mission here with
(14:28):
this podcast is you're saying that there's just massive information
overload and so much of healthcare is being delivered by
clickbait these days. And what I'm looking for, you know,
is Led Zeppelin said a long time ago, a voice
above the din. Right, the din is every time you
open your browser, if you click on anything health related
(14:49):
instead of getting you know, another supplement or another apple
cider vinegar cure. You know, let's get into this, right,
Let's get into what works, what's worthless, and really make
some and out of our time together. So that's that's
kind of the creation story for what we're doing here.
Speaker 4 (15:05):
I mean, as you mentioned, in the same way that
the pandemic in a roundabout way brought me into the
realm of health, it also delivered a whole lot of misinformation,
probably more than I've ever seen in my lifetime in
terms of different health things. So yeah, I think this
is a very necessary mission now more than.
Speaker 2 (15:21):
Ever, sure, right, And I think it divided us. We
all became armchair physicians, and we all tried to consume
the literature and make something out of it. And I
think that's the other thing that we have an obligation
as a healthcare community, is to teach people a little
bit about how to read a paper, you know, And
I think that'll be fun. And not every paper is
(15:42):
the same, not every journal is the same. There's kind
of this minefield in the medical literature that's been going
on for the last oh ten years, at least of
what we call pay to play journals, where let's say
that I decided today, even though you know the whole
point of our time together on the show is that
I'm not going to sell you anything. But let's say
I decided to. Let's say that I was feeling a
(16:02):
little light in my wallet and I wanted to come
up with a supplement. And this supplement is going to
be amazing, Jordan, You're going to want this right every
day you take a Mills extract and I'm going to
figure out exactly what do you want out of this drug. Well,
I want to drop twenty pounds and I want to
get the best directions I've had since I was seventeen.
(16:22):
I want to be able to last as long as
I can, to please as many partners one or many
that I can. I want to get chiseled abs, and
I want to always be happy. I want to wake
up every day and I want to be happy. Is
there a pill for that? Well, yeah, because I invented it.
And it might look exactly like a green M and M,
(16:44):
it might taste exactly like a green M and M.
But I'm going to give you one of these a day.
It'll come in thirty if you buy six months at
a time, I'm going to give you a deal. What
It'll be ten dollars off a month. So we're going
to come up with I don't say, ninety bucks for
the first introductory six months on my pill. Well, how
do I know this works? I mean, where as a literature,
is it scientifically proven? Well, of course, because I wrote
(17:06):
a paper in the Journal of supplement Research. It's incredibly
well vetted, it's on pub med, and I did a trial.
Don't worry, you know, I know it looks kind of
strange that I paid three thousand dollars to this Journal
of Supplemental Research in order to get it published, But
it is published in its indexed Unpubbmed, So that actually happens,
(17:27):
you know. So a lot of the science that you
think is science is coming from journals that are barely
peer reviewed that I'm paying cash to get published. So
there's a lot of conflict of interest. We're going to
have a lot of shaggy dog stories. By the way.
That's just the kind of the way that my brain works.
But somehow, maybe with editing it'll make sense, or maybe not.
You just let her rip, But you go back to
what you said about the misinformation. I get why there's
(17:51):
a frustration because as a physician, I'm really specialized. I'm
really good in the world of men's health. That's where
I lecture, that's where I teach, that's where I published.
But you know, if I have a rash on my knee,
I don't know what to do about that. And if
I google rash on knee, and you know, even with
my level of education, I can still get sucked into
(18:12):
that because dang, this thing is itches and it's driving
me crazy and I can't wear pants because of this thing.
And it's just amazing how quickly you can go into
this clickbait sphere of just well, you know, for forty bucks,
I could buy this topical cream and make this go away.
So that's the crux of what we got to do here,
is we've got to arm people with enough knowledge of
(18:34):
how to consume the knowledge that they're getting flooded with.
And what I hope that we're going to get out
of this is that you're probably going to be okay.
That whatever we're talking about, you're probably going to be okay.
Because the human body is so amazing and we've had
people that have lived to one hundred, you know, well
before we even had antibiotics, and so some of this
(18:55):
is going to be genes. Some of this is going
to be common sense. Some of this is knowing what
we already know but we don't want to hear, which
is that you probably shouldn't eat yourself into a Thanksgiving
daycoma seven days a week, five days a week. It'll
be the opposite of cheat days. It'll be like you know,
it'll be days I'm going to have a cheat week
and then like a strict day.
Speaker 3 (19:16):
It's intermittent, fast thing, but we're playing with the ratio.
Speaker 2 (19:19):
Yeah, it's drinking and gambling and carousing on Saturday, but
still in your pew on Sunday morning. That's the that's
going to be the new healthcare. Heck, yeah, all right,
you're onto something. We're going to table that and we're
going to circle back to that figure out how to
make it work. But the common sense I think we
get lost on is that we know what we have
to do. We know that we have to eat less,
we know that we have to move more, we know
(19:40):
that we have to sleep better, and we just don't
know how to make it into a cool package like, Okay,
well you got ten thousand steps a day. Does that
make sense? Yeah, maybe ten thousand steps a day is
better than three thousand steps a day, but we really
don't have great level one day to show that that's
the key to health. And then we have to worry
about honest lead, the guilt of shaming ourselves into thinking, oh, man,
(20:02):
I just ruined my day. I got nine eight hundred
steps a day, and I just I didn't get those
last two hundred, so I'm probably going to die when
I'm forty eight. Let's try to figure out how to
make guys feel like, yeah, they're probably going to be okay.
You know if you realize that, you know, living your
nutritional life out of a drive through is really a
terrible idea. That's a pretty easy habit to just stop.
(20:48):
I think one of the big problems that men face
is they want to jump in on this stream without
actually sticking with their fundamentals. And that's what I really
want is I want us to say, Okay, before you
move on to the next great supplement that somebody's trying
to sell you, how are you sleeping, what's your nutrition like,
(21:09):
how are you exercising? And where are we going to meet?
A guy along the way is going to determine his
overall health and his overall projection of where things are
going to go. So that's what's going to be.
Speaker 3 (21:22):
About mainstream fringe. I love that.
Speaker 2 (21:24):
Is there yeah, or evidence based? Well, I'll give you
an example. I mean, it's in apropos of nothing. But
there is this treatment modality for erectile dysfunction, and we'll
talk about this as things progress, called shockwave or low
intensity shockwave therapy. And for the longest time, we really
didn't have any great level one data that it did anything.
(21:46):
And now because it's a pretty safe device, anybody even
without a medical license, can administer. In fact, there's even
home versions of shockwave. And I was very reluctant to
adopt it because I didn't see good level one data.
Now we've had randomized controlled trials. Now there's even a
code for it, so that insurance is starting to cover
(22:07):
it more and more, and so that's evidence based. It's medicine.
It's still not practiced by most urologists or most people
that treat direct out as function in the mainstream. So
it's fringe, but there's evidence. Is it perfect evidence? Is
it good evidence? As say sil DENTIFHIL or Nope, not
there yet. We don't have that massive, blinded trial, but
(22:28):
it may be something that people would be interested in.
Those are the kind of things we're going to look for.
Whereas every day somebody comes into my office and says, hey,
I found this new herb supplement that's supposed to be
better than viagra, I would say, show me the data,
let's see where it is. If you can give me
some good level one evidence, then we'll put that in
the evidence based fringe category. Otherwise throw it out, stick
(22:50):
with what we know now.
Speaker 4 (22:51):
The theme of this episode, it's felt like an appropriate
starting point is sort of humorously, we call it, how
often should we go to the doctor right now? What
do you have to say about that? I mean, it
seems like a very loaded question for me to ask you.
Speaker 2 (23:05):
Yes, no, I mean, it's it's perfectly appropriate because one
of the things about men's health is that we don't
have that perfect screening eighteen year old, get your pelvic exam,
get your paps mirror, and get your birth control pill,
and so we don't really know. I mean, the answer
is probably once a guy hits his mid twenties, he
(23:26):
should be checking in once a year. What do we
do in the mid twenties, Well, this is when we
developed the habits that can either make or break us
as we get to my age, which is mid fifties.
So even for me, who was in medical school in
his mid to late twenties, I probably had only gone
to the doctor a handful of times in my entire life.
I joked that maybe I went to medical school because
(23:48):
we were so not part of the traditional medical community
growing up. That you know, we were all healthy Midwestern
farmstock that you know, we didn't really go to the
doctor unless and we had a bone sticking out of us.
And so so that's maybe part of my interest is
that I didn't have that much of a medical background
growing up, and so by the mid twenties, you can
start to develop atherosclerosis, you can develop plaques in your
(24:11):
coronary arteries, You can be putting on way too much weight,
You can start getting hypertension or high blood pressure problems,
your testosterol levels could be going down, you could be
having fertility issues, and so a general screening exam before
we get too fancy of just getting your blood pressure checked,
getting your weight monitored, or at least your waste circumference,
getting some basic blood tests, your cholesterol levels, your hemoglobin
(24:36):
A one C, which is as an indication of long
term blood sugar control, so it's kind of a screening
test for diabetes as well as metabolic syndrome. All of
that should start in your mid twenties, and then I
think once a year after that, if you come in
with anything other than just a wellness check, that's when
your doctor can be really the most ugul So if
(24:57):
you do come in with something as simple as maybe
in a lower abdominal pain or discomfort, or constipation or
irritable bowel syndrome or any of those things, then that's
when we can start to specialize and probably need a
little bit closer call up than every once a year.
But our first real major screening event is guys should
(25:18):
be colon cancer screening in our mid forties. And that's
what we have changed. Used to be early fifties. We
moved back a few years because we are seeing a
trend in younger men and women developing colon cancer. Not
sure why, all kinds of theories, but bottom line is
then once you hit forty five, you have to get
(25:39):
that colon oscaby and start being a little bit more
hands on and proactive about your screening. But yeah, when
do you go to the doctor if something hurts or
just because you haven't been in five years?
Speaker 3 (25:49):
We're ten in my kids or ten in your case.
Speaker 2 (25:52):
Yeah, I mean you're not alone. Again. A third of
the guys that I see as a super specialist, board certified,
fellowship trained micros and thirty percent of those guys don't
ad primary ducks. So that's what we're trying to do
is change change the way that men interact with their
heathcare system. But you know, Jordan, there has to be
a value add as well. I mean, there has to
(26:12):
be a reason. And that's where I think this new
field is coming in, which is okay, well, great, so
I'm doing everything right, my blood pressure's fine, I'm exercising,
my nutrition's good. But what else is there? And I
think that's where we start to look at how do
you take a twenty five or thirty year old guy
and start to talk with him about aging? Because we
(26:34):
know that we start to get older when we hit
our late twenties, and I think that's a defining moment
when we think, well, what can I do so that
even as a thirty year old guy. I want to
make my best one hundred year old self.
Speaker 4 (26:49):
Do you find and I didn't prep this question at advance,
and I want to choose my words very carefully here,
but do you find in your practice and in your
field of work as a whole, there's got to be
a lot of really unhealthy thoughts that men have about
taking care of themselves, in the sense of like, oh, yeah,
real men, don't go to the doctor, real man, I'll
just just walk it off, walk it off like that
(27:10):
kind of mentality. Do you find that that's something that
you come up against a lot in your practice?
Speaker 2 (27:14):
Yeah, well, you know, this is a good example of
statistical bias, Jordan. So that's exactly why we're doing what
we're doing, because maybe when we're talking to the nine
out of ten guys that I'm not seeing, they're hearing
this and thinking, oh wow, okay, so wow, I didn't
realize that. You know, and I'm twenty eight years old.
I probably shouldn't be drinking a six pack a day.
I probably should be exercising, I shouldn't probably be in
(27:37):
the drive through for most of my nutritional requirements. And
those are the guys that we're trying to change. That
is the value proposition of what we're doing here is
making it simple, making it fun, and figuring out how
to make that first step. It's going to be a
good twenty minute visit with primary doc, just to get
your metrics, get your blood pressure, get vital signs are
(27:59):
vital because they're vital, and so knowing what your heart
rate is, knowing what your blood pressure is, knowing what
your weight is, knowing if you're having any pain, these
are all things that can impact your health, your wellness,
and your longevity.
Speaker 3 (28:13):
Well, I think it's a great mission statement for our
first episode.
Speaker 2 (28:17):
Right, Yeah, it beats balls to the wall, but that
works too. But yeah, we'll go with it, Jordan, that
sounds more friendly anyhow.
Speaker 4 (28:25):
I know it looks like the next episode we're going
to be talking about you mentioned it earlier, treatment for
low testosterone.
Speaker 2 (28:32):
Yes, yeah, So the world of testosman therapy is super
exciting because it is so much more mainstream now. But
it's almost mainstream to the point where there are a
lot of guys taking it that probably don't need it
and don't know why they're taking it. That's still a
fraction and there's still a lot of guys walking around
that are untreated. And there's everything from pills to gels,
(28:56):
to injections to long term pellets. I mean, there's so
many different ways to treat this condition that is so
common and can not only just have what I would
call lifestyle issues. People worry about, oh, you know, my
lipidos down, or I'm grumpy, or you know, I'm not
getting morning erections, which are all actually not lifestyle at all.
(29:17):
These are all serious health issues. But then also just
making sure guys are having optimal muscle health, optimal bone health,
and optimal cardiovascular health. Those are the big big things
that normalizing testosterone can do from a longevity angle as well.
So you bet, I think it's going to be fun.
This was a great way to get to know each other,
good way to get to know our audience. And might
(29:38):
hope above all hopes is that you leave this with
a little bit better stewardship of what you read, because
the misinformation and health has gone all the way back
to you know, ancient Egypt asient Greece. I mean, we've
all had people that have claimed to offer fountains of
youth and better healthcare do this and do that. Think
(30:00):
of even in the seventeen hundreds in our country and
thinking that by bleeding guys down to almost death that
was a good cure. We're not that far removed. That
sounds ridiculous today to think, oh, blood letting is a
way to go. But there's a lot of fringy stuff
out there that people are doing that can also be detrimental.
So we're going to try to give guys the tools
they need to just crush it, crush this thing we
(30:23):
call life.
Speaker 4 (30:23):
That's not a bad podcast title either. Yeah, go back
to the drawing board on that.
Speaker 2 (30:28):
All right, fair enough, bar enough. We'll have to re record.
Speaker 4 (30:31):
The theme song, Doctor Mills, thank you so much for
sharing all this with us.
Speaker 3 (30:34):
I feel like, what are your patients? I feel like
that's gonna be the dynamic that evolves.
Speaker 2 (30:38):
Yeah, I want you to be one of my impatients.
I want people to be really, really proactive about their care.
They don't want to sit around a way for it.
Speaker 3 (30:45):
You're a very patient man, My friends, It's going to
be great.
Speaker 2 (30:48):
You have no idea. I'm seeding inside with pigs up,
bottle up enthusiasm.
Speaker 1 (31:01):
Let's talk about it. Let's talk about the maro. Let's
talk about it. Let's talk about it a maro.
Speaker 2 (31:17):
Let's talk about it.
Speaker 1 (31:20):
Let's talk about the me hero.
Speaker 4 (31:25):
The Mailroom with Doctor Jesse Mills was a production of
iHeart Radio. It was executive produced by Jordan Runtog. It
was edited, mixed, and mastered by Beheid Fraser, and the
theme was provided by long Transit. If you like what
you heard, please subscribe and leave a review. For more
podcasts from iHeart Radio, check out the iHeartRadio app, Apple Podcasts,
(31:46):
or wherever you listen to your favorite shows. This program
is intended for educational and informational purposes only. It is
not a substitute for professional medical advice, diagnosis, or treatment.
You can sort your healthcare provider for any medical or
other related.
Speaker 3 (32:03):
Questions or concerns.
Speaker 4 (32:04):
The views and discussions aired on this podcast are those
of doctor Mills and do not represent the official positions
of UCLA or UCLA Help
Let's talk about it. Let's talk about a man hero.
Let's talk about it. Let's talk about the man Hero.
Speaker 2 (00:17):
Welcome to the Man, Hey, everybody, Doctor Jesse Mills here,
Welcome to the Mail, the podcast where we are going
to discuss all things about guys and the people that
love those guys, and how to make those guys even
better than they already. Are so excited that you're part
of this podcast. I want you to feel the enthusiasm
that I feel every time I come to work in
(00:37):
the morning and treat an exam room full of guys.
Try to get them educated about their own healthcare literacy,
Try to separate the hype, try to separate the science.
The world of men's health is this crazy, mixed up
place where all kinds of therapies have been put out
there that may make sense, may not make sense. Some
(00:58):
things that you think are completely wacky actually have scientific evidence.
And so over the course of these episodes, what I
want to do is I want to get to know you,
and I want you to get to know me and
how I look at things. And I'm a very practical guy.
I went to medical school the University of Iowa, which
is one of the phenomenal top research institutions, but it
still is a good rooted Midwestern experience where we try
(01:22):
to teach common sense. After finishing medical school at Iowa,
I trained in general surgery and urology at the University
of Colorado, doing everything from taking out appendices to major
prostate cancer surgeries. And that's when I developed the niche
in men's health and male reproductive surgery. And so for
that training, I went down to Baylor College of Medicine
(01:43):
and studied with a legend in the field, Larry Lipschutz,
who's still very active today. He taught me the nuances
of microsurgery as well as hormone therapy and management. And
after doing that, I established one of the first comprehensive
men's clinics in the state of Colorado. And then a
big bucket of what I've developed is treating sexual dysfunction,
especially problems with erections, how it pertains back to cardiovascular
(02:06):
health and overall men's health. And then a condition called
Peyrone's disease. It's a very nuanced condition that affects millions
of guys in that they developed scar tissue in the
penis that causes them to not be able to have
normal penetrative intercourse anymore. And after doing that in Denver
for about eight years, I was thrilled to have the
(02:26):
opportunity to be recruited back to UCLA where I did
my undergraduate research, then start the Men's Clinic at UCLA Health,
which is now celebrating its tenth year of open treatment
to men coming from all different backgrounds with all different
issues that affect their reproductive health, their hormonal health, and
their sexual health. And now I would say, on an
(02:49):
annual basis, we're seeing somewhere north of twenty thousand men
to help guys live their best lives and optimize their
care and we're going to learn and simulate what it
is going to be like if you were in my
office and I was taking care of you, as if
you were one of the thousands of guys I'm able
to help. So that's it. The ground rules are none.
We're just going to let this organically develop. We're going
(03:11):
to bring in a bunch of guests that are going
to have different perspectives than I do, and we're going
to hash out how to make you the best possible
guy you can be. It's going to be a day
in the mailroom. And I'm super excited to be joined
by my producer, Jordan Runta, who's going to be my
on air presence to keep me focused, to ask questions
(03:32):
as if he were a patient himself, as if he
were the guy in my waiting room I was going
to see next. And Jordan is so great that you
bring a wealth of recording experience here, but more important,
you're going to be an active participant in this entire venture.
I'm going to bounce ideas off you. I'm going to
ask you what you think, and you're going to ask
me what I think. And then we're going to do
(03:54):
this as a as a comprehensive look at men's health.
So that's what we're here for. But thanks again and
be a blast.
Speaker 3 (04:00):
Oh I'm so excited for this. It's going to be great.
Thanks for having me.
Speaker 2 (04:03):
But you know, as we kind of we're talking about
all the logistics about how to set this up and
what it entails, I realized I don't really know that
much about who you are, what are you doing, and
what are you looking for out of this podcast other
than just a couple of guys talking and bringing on
some really smart guests.
Speaker 4 (04:20):
I mean, I kind of view myself as the voice
of the audience here as I just turned thirty seven,
and I've just started to hit the age where I think,
oh geez, I really got to start taking an active
interest in my own health.
Speaker 3 (04:29):
Just selfishly.
Speaker 4 (04:30):
I'm so happy that I can be here and learn
from you and maybe sort of post some questions to
you that I imagine a lot of listeners might have
too that aren't as steeped in the knowledge and all
the training that you have.
Speaker 2 (04:40):
Yeah. Man, I don't want to harsh your mellow, but
you're thirty seven. Do you know when did we start aging?
Just come up with a number? Do you? How do
when is it? Like? When is the start? Is is it?
Thirty seven? Is it? There's an actual scientific answer to this.
So what what do you think? When do you think
we stopped being young and we start to grow old
from a molecular cellular mechanism.
Speaker 4 (05:00):
Well, doesn't the brain stop the neuroplasticity begainst the heart?
Speaker 3 (05:04):
And I want to say, at age twenty.
Speaker 2 (05:05):
Six, damn, bro, Yeah you got some skills. Yeah, so
that's about right. The first signs of senescence, which is
kind of the scientific term for aging, the neurons start
to sort of die off somewhere around twenty five twenty six,
which is I'm sure, I'm sure that's what the rental
car companies had in mind, because you know, you can
go to war at eighteen, you can bribe when you're sixteen,
(05:27):
you can drink when you're twenty one, but you can't
rent a car to you're twenty five. They're waiting for
that last stupid frontal impulsive neuron to die off before
you could actually rent a car. But you're right, that's it.
Twenty five. And then in my world, in the world
of urology, which encompasses everything from kidney stones to prostates
to sexual dysfunction and both men and women, we look
(05:48):
at something called the endothelial cell, which lines everything from
your coronary arteries, so the heart arteries, to the back
of your eye, the retina too, in my world, the
lining of the penis. And they're this amazing molecule called
nitric oxide, and nitric oxide it's the simplest, tiniest little
molecule that won the Nobel Prize in around nineteen ninety two,
(06:11):
and we found that nitric oxide levels start to drop
right around age twenty five to twenty eight, and that
is the first sign of atherosclerosis, which is the hardening
of the arteries. And so when we stop producing high
levels of nitric oxide, that's when the wheels start to
come off. The great thing is that so much of
(06:32):
this arterial sclerosis and so much of this endothelial cell dysfunction,
you can start to reverse that, and you actually can
start to see levels of nitric oxide increase, either through
improved exercise, improved nutrition, or sometimes medications will get into that,
but yeah, we're going to figure out how to take
a thirty seven year old, how to take a forty seven,
(06:52):
how to take an eighty seven year old, and figure
out what that eighty seven year old can do to
reverse some of this degradation there's a loss of nitric oxide.
I mean, that's what it's all about, is this very
simple breakdown of what you can do in the kitchen,
what you can do in the gym or outside, and
then what you can do in the bedroom. And you
can interpret that however you want, but mostly mostly at
(07:14):
this point we'll talk about how you can sleep better,
But then there are the things you can do in
the bedroom that I'm sure our listeners will be interested
in figuring out how to optimize as well, so it's
gonna be totally cool.
Speaker 4 (07:55):
Very recently, earlier this year, I started going to the gym,
seeing a trainer, started to talk to him more about nutrition,
and went to get my first check up in a decade,
which I am not.
Speaker 3 (08:05):
Very proud of. But also I know an embarrassingly common
thing among men.
Speaker 2 (08:10):
Yeah, as guys, the traditional narrative is that we don't
go to the doctor unless, you know, we broke a
bone and we've got some piece of our ear hanging
off our face after a mountain lion attack or something,
and then we know, whitchbone, that's right, and that's it.
You know, really, when you look at the literature traditionally
in medicine about how guys engage the physician, over forty
(08:34):
percent of primary care visits for guys between the age
of eighteen and sixty is for something youury logic, which
means basically, you know, they can't pee, they can't have sex,
or they have a kidney stone or something like that,
and so so actually that's one of the reasons that
drove me into urology as part of my creation story
when I got there, I realized how much I loved
(08:54):
taking care of patients and having the dialogue, but also
how much I loved the idea of being able to
go into and operating room and fix a problem, put
a couple of stitches in the skin, and send the
guy home and make them better than they were before
they started the operation. Was what drove me into this.
And then when I learned also from all of my
internal medicine and primary care rotations and working even in
(09:15):
borough farming communities, how many men don't really have those
touch points in how they engage the medical community and
why it's not their fault, it's not our fault. I mean,
maybe a little bit of is we have a pathologic
level of stoicism where we're constantly playing through pain and
we're constantly thinking, you know what I mean, if it
(09:35):
doesn't kill me, it makes me stronger. And that's kind
of true, because the human body is amazing at regenerating itself.
So if we do break that bone and we kind
of get the ends a little bit close together, it'll
probably heal up okay, and you can get back on
your tractor and make a living for your family, and
you certainly don't want to take you any time off
work during the harvest or during planting season, and so
(09:57):
all of those things together, you know, unless really are
in extremists, as we say in the medicine community, or dying,
then you don't go in. And so, yeah, you can
go decades without a check. And maybe the other thing
that drives men's health into existence is that we realized
early on that women do have a built in touch
point on an annual basis with their primary care or
(10:19):
their guy in tocologist, and that they have to do
cancer screening and particularly the papsmerror and often in this society,
most of the birth controlled decisions are made by women,
since it seems to be they're the ones that carried
the burden whether they went to or not, you know,
going in for their oral contraceptive pill renewals, and guys
we don't have that, although we do have an oral
contraceptive coming on the market for guys at sometimes in
(10:41):
the not too distant futures. That's a cliffhanger we'll come
back to at some point. But yeah, I mean, that's
it is that if you don't have to go in
on an annual basis, then you just chug along. You
get your last high school physical when you're eighteen, and
then you know, you don't go back into see a
doctor and tell your appendix ruptures, and you know, sometimes
that's it thirty seven. Sometimes it's at twenty seven. Sometimes
(11:03):
it's at seventy. And so it's amazing. Even in my
practice in urban Los Angeles, the number of guys that
I see in their sixties that don't have a regular
doctor is about thirty percent. So, in other words, they've
jumped through I every single hoop to just get to
a super sub specialist. And I start with the same
conversation that we just started with you, which is, well,
(11:24):
what got you here today? You know? So I'll ask
you with that preamble, is what was it that got
you into your first checkup where you just chugging along
and thinking, you know what, I'm starting to read a
lot about things in the health sphere and I should
probably be a little bit more informed. Or was it
something said, wow, man, you know I've got this pain
in my knee. No, for me, it was a little.
Speaker 3 (11:46):
Bit more Okay.
Speaker 4 (11:48):
I think for a lot of people, the pandemic kind
of threw off a lot of our routine. I you know,
instead of going into the office every day and moving
around and being out in the world, set of working
from home, just a much more sedentary lifestyle than I
really wanted.
Speaker 3 (11:59):
And I just finally was like, you know.
Speaker 4 (12:01):
What, it was New years earlier in this year, just
you know, New Year's resolution kind of thing, going to
get back out there, going to go to the gym
and really take this seriously. And then from there, you know,
as anyone who starts to dig into the health sphere knows,
it's such a rabbit hole. I mean, there's just so
many different sections you go into. It becomes a full
time job if you let it. And yeah, I just thought, okay,
(12:22):
well a real baseline thing I should probably do is
go to see a physician and see if there's anything
that I should know about that I should keep an
eye on or deal with, you know, God forbid.
Speaker 3 (12:31):
And yeah, luckily I'm pretty much okay.
Speaker 4 (12:33):
But yeah, it was really trying to get back in
the swing of things after a weird couple of years,
which I think is something a lot of people can
relate to.
Speaker 2 (12:40):
Yeah, no, I think you reminded me of a patientis
maybe towards a tail end of I mean, I don't
even know where we are in this pandemic. It's still
going around, I guess, but but we'll call it, you know,
the shutdown, the lockdown. And I saw him and he
looked even with his mask on, I could tell he
just looked amazing. And I said, yeah, what's the deal?
You know? I said, well, I realized early on in
(13:02):
this deal, and we have all this time, and I
could have either become a chunk, a drunk, or a hunk,
and I decided to become a hunk. And it always
resonated with me because unfortunately, I saw a lot of
drunks during that time period too, and a lot of chunks.
And it's easy. Oh well, you know, gym shut down.
You know, I remember going to my gym in the
(13:22):
early days with night trial gloves on my hand and
a mask and I was spraying hands, attis and everything
and thinking somehow that was going to keep back the
tide of you know, it was a single handedly take
on the pandemic and keep this gym open, and with
it a couple more days, that was it. You know,
we lost it all. They started refunding gym memberships and
then trying to get weights online. That was that was hilarious.
(13:46):
I can get anything. So so no, I think that's
that's an interesting wake up call, and it's one that
a lot of people we went two ways on. We
either went way in and said, no, this is great.
I'm you know, I'm not driving two hours a day
and a commute, and especially in a city like Los
Angeles where the average commute I'll make up a number,
but it's probably somewhere about forty five minutes to an
(14:07):
hour for most people that work anywhere within the Los
Angeles area. So that's an hour to two hours a
day that people had on their hands that they could
be much more efficient. So I love that, I mean,
terrible thing to go through as a world to get
us a wake up call. But I also think one
other thing that is critical to our mission here with
(14:28):
this podcast is you're saying that there's just massive information
overload and so much of healthcare is being delivered by
clickbait these days. And what I'm looking for, you know,
is Led Zeppelin said a long time ago, a voice
above the din. Right, the din is every time you
open your browser, if you click on anything health related
(14:49):
instead of getting you know, another supplement or another apple
cider vinegar cure. You know, let's get into this, right,
Let's get into what works, what's worthless, and really make
some and out of our time together. So that's that's
kind of the creation story for what we're doing here.
Speaker 4 (15:05):
I mean, as you mentioned, in the same way that
the pandemic in a roundabout way brought me into the
realm of health, it also delivered a whole lot of misinformation,
probably more than I've ever seen in my lifetime in
terms of different health things. So yeah, I think this
is a very necessary mission now more than.
Speaker 2 (15:21):
Ever, sure, right, And I think it divided us. We
all became armchair physicians, and we all tried to consume
the literature and make something out of it. And I
think that's the other thing that we have an obligation
as a healthcare community, is to teach people a little
bit about how to read a paper, you know, And
I think that'll be fun. And not every paper is
(15:42):
the same, not every journal is the same. There's kind
of this minefield in the medical literature that's been going
on for the last oh ten years, at least of
what we call pay to play journals, where let's say
that I decided today, even though you know the whole
point of our time together on the show is that
I'm not going to sell you anything. But let's say
I decided to. Let's say that I was feeling a
(16:02):
little light in my wallet and I wanted to come
up with a supplement. And this supplement is going to
be amazing, Jordan, You're going to want this right every
day you take a Mills extract and I'm going to
figure out exactly what do you want out of this drug. Well,
I want to drop twenty pounds and I want to
get the best directions I've had since I was seventeen.
(16:22):
I want to be able to last as long as
I can, to please as many partners one or many
that I can. I want to get chiseled abs, and
I want to always be happy. I want to wake
up every day and I want to be happy. Is
there a pill for that? Well, yeah, because I invented it.
And it might look exactly like a green M and M,
(16:44):
it might taste exactly like a green M and M.
But I'm going to give you one of these a day.
It'll come in thirty if you buy six months at
a time, I'm going to give you a deal. What
It'll be ten dollars off a month. So we're going
to come up with I don't say, ninety bucks for
the first introductory six months on my pill. Well, how
do I know this works? I mean, where as a literature,
is it scientifically proven? Well, of course, because I wrote
(17:06):
a paper in the Journal of supplement Research. It's incredibly
well vetted, it's on pub med, and I did a trial.
Don't worry, you know, I know it looks kind of
strange that I paid three thousand dollars to this Journal
of Supplemental Research in order to get it published, But
it is published in its indexed Unpubbmed, So that actually happens,
(17:27):
you know. So a lot of the science that you
think is science is coming from journals that are barely
peer reviewed that I'm paying cash to get published. So
there's a lot of conflict of interest. We're going to
have a lot of shaggy dog stories. By the way.
That's just the kind of the way that my brain works.
But somehow, maybe with editing it'll make sense, or maybe not.
You just let her rip, But you go back to
what you said about the misinformation. I get why there's
(17:51):
a frustration because as a physician, I'm really specialized. I'm
really good in the world of men's health. That's where
I lecture, that's where I teach, that's where I published.
But you know, if I have a rash on my knee,
I don't know what to do about that. And if
I google rash on knee, and you know, even with
my level of education, I can still get sucked into
(18:12):
that because dang, this thing is itches and it's driving
me crazy and I can't wear pants because of this thing.
And it's just amazing how quickly you can go into
this clickbait sphere of just well, you know, for forty bucks,
I could buy this topical cream and make this go away.
So that's the crux of what we got to do here,
is we've got to arm people with enough knowledge of
(18:34):
how to consume the knowledge that they're getting flooded with.
And what I hope that we're going to get out
of this is that you're probably going to be okay.
That whatever we're talking about, you're probably going to be okay.
Because the human body is so amazing and we've had
people that have lived to one hundred, you know, well
before we even had antibiotics, and so some of this
(18:55):
is going to be genes. Some of this is going
to be common sense. Some of this is knowing what
we already know but we don't want to hear, which
is that you probably shouldn't eat yourself into a Thanksgiving
daycoma seven days a week, five days a week. It'll
be the opposite of cheat days. It'll be like you know,
it'll be days I'm going to have a cheat week
and then like a strict day.
Speaker 3 (19:16):
It's intermittent, fast thing, but we're playing with the ratio.
Speaker 2 (19:19):
Yeah, it's drinking and gambling and carousing on Saturday, but
still in your pew on Sunday morning. That's the that's
going to be the new healthcare. Heck, yeah, all right,
you're onto something. We're going to table that and we're
going to circle back to that figure out how to
make it work. But the common sense I think we
get lost on is that we know what we have
to do. We know that we have to eat less,
we know that we have to move more, we know
(19:40):
that we have to sleep better, and we just don't
know how to make it into a cool package like, Okay,
well you got ten thousand steps a day. Does that
make sense? Yeah, maybe ten thousand steps a day is
better than three thousand steps a day, but we really
don't have great level one day to show that that's
the key to health. And then we have to worry
about honest lead, the guilt of shaming ourselves into thinking, oh, man,
(20:02):
I just ruined my day. I got nine eight hundred
steps a day, and I just I didn't get those
last two hundred, so I'm probably going to die when
I'm forty eight. Let's try to figure out how to
make guys feel like, yeah, they're probably going to be okay.
You know if you realize that, you know, living your
nutritional life out of a drive through is really a
terrible idea. That's a pretty easy habit to just stop.
(20:48):
I think one of the big problems that men face
is they want to jump in on this stream without
actually sticking with their fundamentals. And that's what I really
want is I want us to say, Okay, before you
move on to the next great supplement that somebody's trying
to sell you, how are you sleeping, what's your nutrition like,
(21:09):
how are you exercising? And where are we going to meet?
A guy along the way is going to determine his
overall health and his overall projection of where things are
going to go. So that's what's going to be.
Speaker 3 (21:22):
About mainstream fringe. I love that.
Speaker 2 (21:24):
Is there yeah, or evidence based? Well, I'll give you
an example. I mean, it's in apropos of nothing. But
there is this treatment modality for erectile dysfunction, and we'll
talk about this as things progress, called shockwave or low
intensity shockwave therapy. And for the longest time, we really
didn't have any great level one data that it did anything.
(21:46):
And now because it's a pretty safe device, anybody even
without a medical license, can administer. In fact, there's even
home versions of shockwave. And I was very reluctant to
adopt it because I didn't see good level one data.
Now we've had randomized controlled trials. Now there's even a
code for it, so that insurance is starting to cover
(22:07):
it more and more, and so that's evidence based. It's medicine.
It's still not practiced by most urologists or most people
that treat direct out as function in the mainstream. So
it's fringe, but there's evidence. Is it perfect evidence? Is
it good evidence? As say sil DENTIFHIL or Nope, not
there yet. We don't have that massive, blinded trial, but
(22:28):
it may be something that people would be interested in.
Those are the kind of things we're going to look for.
Whereas every day somebody comes into my office and says, hey,
I found this new herb supplement that's supposed to be
better than viagra, I would say, show me the data,
let's see where it is. If you can give me
some good level one evidence, then we'll put that in
the evidence based fringe category. Otherwise throw it out, stick
(22:50):
with what we know now.
Speaker 4 (22:51):
The theme of this episode, it's felt like an appropriate
starting point is sort of humorously, we call it, how
often should we go to the doctor right now? What
do you have to say about that? I mean, it
seems like a very loaded question for me to ask you.
Speaker 2 (23:05):
Yes, no, I mean, it's it's perfectly appropriate because one
of the things about men's health is that we don't
have that perfect screening eighteen year old, get your pelvic exam,
get your paps mirror, and get your birth control pill,
and so we don't really know. I mean, the answer
is probably once a guy hits his mid twenties, he
(23:26):
should be checking in once a year. What do we
do in the mid twenties, Well, this is when we
developed the habits that can either make or break us
as we get to my age, which is mid fifties.
So even for me, who was in medical school in
his mid to late twenties, I probably had only gone
to the doctor a handful of times in my entire life.
I joked that maybe I went to medical school because
(23:48):
we were so not part of the traditional medical community
growing up. That you know, we were all healthy Midwestern
farmstock that you know, we didn't really go to the
doctor unless and we had a bone sticking out of us.
And so so that's maybe part of my interest is
that I didn't have that much of a medical background
growing up, and so by the mid twenties, you can
start to develop atherosclerosis, you can develop plaques in your
(24:11):
coronary arteries, You can be putting on way too much weight,
You can start getting hypertension or high blood pressure problems,
your testosterol levels could be going down, you could be
having fertility issues, and so a general screening exam before
we get too fancy of just getting your blood pressure checked,
getting your weight monitored, or at least your waste circumference,
getting some basic blood tests, your cholesterol levels, your hemoglobin
(24:36):
A one C, which is as an indication of long
term blood sugar control, so it's kind of a screening
test for diabetes as well as metabolic syndrome. All of
that should start in your mid twenties, and then I
think once a year after that, if you come in
with anything other than just a wellness check, that's when
your doctor can be really the most ugul So if
(24:57):
you do come in with something as simple as maybe
in a lower abdominal pain or discomfort, or constipation or
irritable bowel syndrome or any of those things, then that's
when we can start to specialize and probably need a
little bit closer call up than every once a year.
But our first real major screening event is guys should
(25:18):
be colon cancer screening in our mid forties. And that's
what we have changed. Used to be early fifties. We
moved back a few years because we are seeing a
trend in younger men and women developing colon cancer. Not
sure why, all kinds of theories, but bottom line is
then once you hit forty five, you have to get
(25:39):
that colon oscaby and start being a little bit more
hands on and proactive about your screening. But yeah, when
do you go to the doctor if something hurts or
just because you haven't been in five years?
Speaker 3 (25:49):
We're ten in my kids or ten in your case.
Speaker 2 (25:52):
Yeah, I mean you're not alone. Again. A third of
the guys that I see as a super specialist, board certified,
fellowship trained micros and thirty percent of those guys don't
ad primary ducks. So that's what we're trying to do
is change change the way that men interact with their
heathcare system. But you know, Jordan, there has to be
a value add as well. I mean, there has to
(26:12):
be a reason. And that's where I think this new
field is coming in, which is okay, well, great, so
I'm doing everything right, my blood pressure's fine, I'm exercising,
my nutrition's good. But what else is there? And I
think that's where we start to look at how do
you take a twenty five or thirty year old guy
and start to talk with him about aging? Because we
(26:34):
know that we start to get older when we hit
our late twenties, and I think that's a defining moment
when we think, well, what can I do so that
even as a thirty year old guy. I want to
make my best one hundred year old self.
Speaker 4 (26:49):
Do you find and I didn't prep this question at advance,
and I want to choose my words very carefully here,
but do you find in your practice and in your
field of work as a whole, there's got to be
a lot of really unhealthy thoughts that men have about
taking care of themselves, in the sense of like, oh, yeah,
real men, don't go to the doctor, real man, I'll
just just walk it off, walk it off like that
(27:10):
kind of mentality. Do you find that that's something that
you come up against a lot in your practice?
Speaker 2 (27:14):
Yeah, well, you know, this is a good example of
statistical bias, Jordan. So that's exactly why we're doing what
we're doing, because maybe when we're talking to the nine
out of ten guys that I'm not seeing, they're hearing
this and thinking, oh wow, okay, so wow, I didn't
realize that. You know, and I'm twenty eight years old.
I probably shouldn't be drinking a six pack a day.
I probably should be exercising, I shouldn't probably be in
(27:37):
the drive through for most of my nutritional requirements. And
those are the guys that we're trying to change. That
is the value proposition of what we're doing here is
making it simple, making it fun, and figuring out how
to make that first step. It's going to be a
good twenty minute visit with primary doc, just to get
your metrics, get your blood pressure, get vital signs are
(27:59):
vital because they're vital, and so knowing what your heart
rate is, knowing what your blood pressure is, knowing what
your weight is, knowing if you're having any pain, these
are all things that can impact your health, your wellness,
and your longevity.
Speaker 3 (28:13):
Well, I think it's a great mission statement for our
first episode.
Speaker 2 (28:17):
Right, Yeah, it beats balls to the wall, but that
works too. But yeah, we'll go with it, Jordan, that
sounds more friendly anyhow.
Speaker 4 (28:25):
I know it looks like the next episode we're going
to be talking about you mentioned it earlier, treatment for
low testosterone.
Speaker 2 (28:32):
Yes, yeah, So the world of testosman therapy is super
exciting because it is so much more mainstream now. But
it's almost mainstream to the point where there are a
lot of guys taking it that probably don't need it
and don't know why they're taking it. That's still a
fraction and there's still a lot of guys walking around
that are untreated. And there's everything from pills to gels,
(28:56):
to injections to long term pellets. I mean, there's so
many different ways to treat this condition that is so
common and can not only just have what I would
call lifestyle issues. People worry about, oh, you know, my
lipidos down, or I'm grumpy, or you know, I'm not
getting morning erections, which are all actually not lifestyle at all.
(29:17):
These are all serious health issues. But then also just
making sure guys are having optimal muscle health, optimal bone health,
and optimal cardiovascular health. Those are the big big things
that normalizing testosterone can do from a longevity angle as well.
So you bet, I think it's going to be fun.
This was a great way to get to know each other,
good way to get to know our audience. And might
(29:38):
hope above all hopes is that you leave this with
a little bit better stewardship of what you read, because
the misinformation and health has gone all the way back
to you know, ancient Egypt asient Greece. I mean, we've
all had people that have claimed to offer fountains of
youth and better healthcare do this and do that. Think
(30:00):
of even in the seventeen hundreds in our country and
thinking that by bleeding guys down to almost death that
was a good cure. We're not that far removed. That
sounds ridiculous today to think, oh, blood letting is a
way to go. But there's a lot of fringy stuff
out there that people are doing that can also be detrimental.
So we're going to try to give guys the tools
they need to just crush it, crush this thing we
(30:23):
call life.
Speaker 4 (30:23):
That's not a bad podcast title either. Yeah, go back
to the drawing board on that.
Speaker 2 (30:28):
All right, fair enough, bar enough. We'll have to re record.
Speaker 4 (30:31):
The theme song, Doctor Mills, thank you so much for
sharing all this with us.
Speaker 3 (30:34):
I feel like, what are your patients? I feel like
that's gonna be the dynamic that evolves.
Speaker 2 (30:38):
Yeah, I want you to be one of my impatients.
I want people to be really, really proactive about their care.
They don't want to sit around a way for it.
Speaker 3 (30:45):
You're a very patient man, My friends, It's going to
be great.
Speaker 2 (30:48):
You have no idea. I'm seeding inside with pigs up,
bottle up enthusiasm.
Speaker 1 (31:01):
Let's talk about it. Let's talk about the maro. Let's
talk about it. Let's talk about it a maro.
Speaker 2 (31:17):
Let's talk about it.
Speaker 1 (31:20):
Let's talk about the me hero.
Speaker 4 (31:25):
The Mailroom with Doctor Jesse Mills was a production of
iHeart Radio. It was executive produced by Jordan Runtog. It
was edited, mixed, and mastered by Beheid Fraser, and the
theme was provided by long Transit. If you like what
you heard, please subscribe and leave a review. For more
podcasts from iHeart Radio, check out the iHeartRadio app, Apple Podcasts,
(31:46):
or wherever you listen to your favorite shows. This program
is intended for educational and informational purposes only. It is
not a substitute for professional medical advice, diagnosis, or treatment.
You can sort your healthcare provider for any medical or
other related.
Speaker 3 (32:03):
Questions or concerns.
Speaker 4 (32:04):
The views and discussions aired on this podcast are those
of doctor Mills and do not represent the official positions
of UCLA or UCLA Help
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