September 27, 2023 • 21 mins
In this episode, Dr. Mistry and Donna Lee are joined by Dr. Rhett Long, an endocrine surgeon with UT Health Austin’s Surgical Oncology Clinic. Dr. Long is one of the only Austin-area surgeons to specialize in the treatment of cancers and other diseases of the endocrine system, which regulates our bodies through hormones. This vital set of structures plays a major role in our overall health and wellbeing. While most surgical conditions of the endocrine system are non-cancerous and discovered by accident, they can still cause problems by compressing the vocal cords, esophagus, or other nearby structures. Compressive symptoms of thyroid disease may include a visible bulge in the neck, difficulty swallowing, and/or shortness of breath when lying down. Patients with such symptoms, or who struggle with unexplained fatigue, depression, or weight fluctuations should first consult an endocrinologist who can determine the cause and the course of treatment. Should you or someone you love need endocrine surgery, call Dr. Long at (512) 495-5717 or visit the Dell Medical School at UT Austin online today!
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Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Speaker 2 (00:07):
Welcome to the Armor Men's Health Show with Dr.
Mystery and Donna Lee.
Speaker 1 (00:15):
Hello
Speaker 3 (00:16):
And welcome to the Armor Men's Health Show. This
is Dr. Mystery , your host,board certified urologist all
around . Great guy. Hey. Hey .
With my co-host an all aroundgreat girl, Donnel Lee . I love
Speaker 4 (00:27):
It when you call yourself all around great guy.
'cause it makes me laugh outloud. , but
Speaker 3 (00:31):
Not . Yeah , well, I can say whatever I want. That's
Speaker 4 (00:33):
Right. It's your show. This
Speaker 3 (00:34):
Is our show. So , uh, uh, you are a comedian.
That's right. You're also ourbusiness development guru in
our practice. That's right.
This practice is called N a uUrology Specialist. We are
growing and blowing, showingand showing. That's right.
That's , we're more growersthan show, I think. And so we
are an excellent urologypractice. We are growing bigger
(00:54):
and bigger every day . We arehere and ready to see you as a
patient, whether primarily totake care of your urologic
needs or as a second opinion.
We love second opinion. Mm-hmm. Dr .
Speaker 4 (01:04):
Sunny , second opinion mystery right
Speaker 3 (01:06):
Here. How , how do people get ahold of us?
Speaker 4 (01:08):
That's right. If you want that second opinion, or to
learn more about our holisticurology group, call us at (512)
238-0762 or visit our website,armor men's health.com. We are
in Round Rock, north Austin,south Austin , and Dripping
Springs, Texas.
Speaker 3 (01:21):
For those of you that are regular listeners,
you'll clearly and easilyunderstand what my favorite
part of our guest is.
Speaker 4 (01:27):
His penis,
Speaker 3 (01:28):
His name. Oh , Dr .
Long. Hey ,
Speaker 4 (01:32):
Dr . I don't know why I missed that. I'm sorry.
You
Speaker 3 (01:34):
Know, there was a guy in town who used to
practice medicine, Dr . DickChop, and I used to say, don't
go to Dr . Dick Chop or Dr. LesWing . Go to Dr. Moore
Longfellow.
Speaker 4 (01:42):
Hey. Oh, I'm glad Whitney's here today to
to bring that out . ,
Speaker 3 (01:47):
You don't want it shorter. She wants longer .
Speaker 4 (01:51):
Wow. In
Speaker 3 (01:52):
Dr . Dr . Rhett Long is an endocrine surgeon , uh,
in the surgical oncology clinicat Dell Medical School. And is
somebody that I met justhanging around in the surgeon's
lounge one day. I was wondering
Speaker 4 (02:04):
How y'all met. Okay.
Speaker 3 (02:05):
Yeah. We were hanging around the surgeon .
And you know what I love morethan anything, you're pick
Speaker 4 (02:08):
Up only another
Speaker 3 (02:09):
Surgeon. I
Speaker 4 (02:10):
Know . I think you have a pickup line though that
says, Hey, I have a radio show.
Speaker 3 (02:14):
Hey , I have a radio show. Would
Speaker 4 (02:14):
You like to join me, ?
Speaker 3 (02:16):
And you know , uh, what's funny is that I thought
he went to Stanford, but hedidn't. He went to Sanford
University. Yeah , SanfordUniversity. Okay. Yeah .
Speaker 4 (02:25):
We like to consider ourselves the Stanford of
Alabama. So
Speaker 3 (02:30):
Sits different .
Yeah . But , uh, you know , um,something about him though he
did his general surgeryresidency mm-hmm.
at this little unknown place.
Oh , you know what it's called?
Speaker 4 (02:42):
Tell me.
Speaker 3 (02:42):
Baylor College of Medicine, and he fight his
institution on the face thatplanet. Okay . He went at a
time when it was really goodtoo. Really?
Speaker 4 (02:50):
Not the time you went .
Speaker 3 (02:51):
Well , you know , , I probably lowered
their standards out a littlebit. Maybe a little bit. So,
Dr. Long , uh, welcome. Thankyou for joining us today. Well
,
Speaker 5 (02:58):
Thank you. Hey, it's good to be here. And, and , and
I hate to disappoint you, but Iwas actually only a surgical
intern at Baylor College ofMedicine. I actually did the
vast majority of my residencyhere at the University of
Texas, so,
Speaker 3 (03:10):
Well, that's okay.
You
Speaker 5 (03:11):
Got so , I , I at least have some Baylor ties, if
that works for you. It , it ,
Speaker 3 (03:14):
It , it does in fact work. And so you're not
the first surgical oncologist.
We've had, we get Dr. DeclanFleming that has been on our
show before. He's an a amazingmentor and an amazing surgeon.
And , uh, he's a partner ofyours. And , uh, so it really
says something quite greatabout the burgeoning program
that Dell Medical School isputting together. Why don't you
tell us what is a surgicaloncologist and how is that
(03:35):
different from a regularsurgeon?
Speaker 5 (03:37):
Yeah. So , uh, Dr.
Fleming, one of my partners ,uh, he, he's also a general
surgeon by training. So inorder to become a surgical
oncologist, you have to gothrough five years of , uh,
general surgery residency, andthen you'll pursue an
additional, usually two tothree year fellowship focusing
on, you know, surgical oncologyconditions. Now I am an
endocrine surgeon, so Iactually did a fellowship and
(03:59):
endocrine surgery up at theUniversity of Michigan. So
Speaker 3 (04:02):
Endocrine , uh, it means glands Right. And
hormones. And so tell us, whatare all the, the components or
what are the major componentsof the endocrine system that
you specialize in? Sure.
Speaker 5 (04:12):
So, you know , my practice primarily focuses on ,
uh, patients who haveconditions of the thyroid,
parathyroid and adrenal glands.
So , uh, there are endocrinesurgeons and major academic
programs all across thecountry. And it's been exciting
because , uh, you know, I'm thefirst one , uh, here in Austin
who's really focusingexclusively on endocrine
(04:34):
surgery within an academicenvironment. And so it's a new
program, a relatively new atDell Medical School. And, you
know, I'm happy to be the oneblazing the trail.
Speaker 3 (04:43):
Nice. Now, when it comes to endocrine surgery, it
, it's not all cancer, right? Imean, the vast majority of what
you're taking care of is gonnabe benign disease.
Speaker 5 (04:51):
That's absolutely correct. You know, nationally ,
um, most major academicprograms that have endocrine
surgery , uh, a lot of us fallwithin the Department of
Surgical Oncology because we dosee conditions that are
cancerous. So, for example,thyroid cancer, even the more
rare types of adrenal cancer ormetastases or that sort of
(05:11):
thing. But you're right, thevast majority of the stuff that
I see is actually benigndisease. And so, you know, when
it comes to patient referralsand, and , and if you get into
a clinic that, that looks likesurgical oncology, it can be a
little bit , uh, daunting. Itcan be a little daunting. Of
course, I'm not here forcancer,
Speaker 3 (05:29):
This place some
Speaker 5 (05:29):
Scary, but , but that's a , that's a good point.
Yeah . The vast majority of mypatients that I see do not have
cancer.
Speaker 3 (05:35):
So when it comes to thyroid disease, what are some
of the more common conditionsor presentations of thyroid
disease that lead a patient tocome see you?
Speaker 5 (05:43):
So I would say that, you know, the vast majority of
patients , uh, who havesurgical conditions of the
thyroid are typically foundincidentally. So folks who have
an imaging scan done foranother purpose, an example
would be, you know, a carotidultrasound to, to look for
vascular disease. They mighthave a CT scan or a PET scan
(06:05):
that identifies a noduleincidentally. Um, and then I'll
see 'em in , or if they're
Speaker 3 (06:09):
Really lucky, they have a doctor that actually
touches them. They do aphysical exam
Speaker 5 (06:13):
Quite , you know, that's, that's rare these days.
Uh , usually if anyone, if anypatients need to be touched,
they're referred to a surgeon.
Right.. Um , but, butyes. You know , if if it's
something that's that's pickedup on exam, then, then
certainly , uh, you know, anastute clinician would, would ,
uh, order an ultrasound or getsome imaging, and then they'd
ultimately end up in my clinic.
What's
Speaker 3 (06:33):
The purpose of the thyroid gland? Why do we even
have one? Hmm .
Speaker 5 (06:35):
Yeah. So the, the thyroid is actually the first
embryologic gland to develop.
So it's by about four weeks of, of age in , in utero , uh,
the thyroid starts forming.
Wow. And, and so it , it'sextremely important , uh, early
on for development of yournervous system. Basically every
major organ system is, isimpacted by thyroid hormone.
(06:57):
And so, you know, as we age,it's, it's an important
regulator of our metabolismjust overall the way we feel.
Um, so if your thyroid is off,either over-functioning or
under-functioning, can havedrastic impacts on just your
overall wellbeing.
Speaker 3 (07:11):
Wow . And so , uh, as we get older, there are
people that have hyperfunctioning and hypofunctioning
thyroids, and they will see anendocrinologist. But when they
have a mass or a concern forcancer, they'll see an
endocrine surgeon. And as luckhas it, this organ is in a
pretty important place. Right?
Oh , is
Speaker 5 (07:28):
It ? Yeah, absolutely. So the , the
thyroid is located in the neck,and I always tell everybody
who, who ask why, got intothis, and, and no offense to
Dr. Misery here, but , uh, the, the neck is the best anatomy
in the body. It's, it's , it'sso , oh , I hear a fight
coming. Yeah. It's so clean.
Mm-hmm . . It'spretty . Um , it , it ,
it , it's just absolutely , uh,the , the best s stuff you can
Speaker 3 (07:50):
See. I'm , I'm , I'm speechless. Yeah. I'm gonna
invite you to my next roboticprostatectomy, and you're gonna
see pretty Okay . Oh , geez .
All right . And I'll come intoone of your next surgeries.
Okay. And we'll, and we'll seehow pretty that
Speaker 5 (08:00):
Is. C come on, by this week, we'll see you .
Speaker 3 (08:02):
But for how pretty it is, there's a lot of really
important structures rightthere. Right. I mean, people
can, can have complications ofthyroid surgery, which is why
you don't want to go to any,you know, Tom, Dick and Harry.
Speaker 5 (08:13):
Yeah. Hmm . Yeah, yeah. You know, Harry Dick, you
certainly don't want to haveyour thyroid surgery surgery by
somebody who, who does a lot ofrobotic prostatectomy,
. Um ,
Speaker 4 (08:24):
Good point. And welcome to the show.
Speaker 5 (08:26):
Yeah. .
Yeah.
Speaker 3 (08:28):
So , uh, what are some important complications
that , uh, patients need to beaware of that can occur after a
thyroid surgery?
Speaker 5 (08:34):
Yeah. So, you know, and you mentioned that, you
know, I, I do see a lot offolks who have thyroid nodules
or masses that ultimatelyresult in compressive symptoms
of the adjacent structures inthe neck. I also see folks
with, you know, chronichyperthyroidism, that, that is
either refractory to medicalmanagement or is ultimately so
chronic that, that the onlykind of long-term management is
(08:55):
to remove the thyroid. And so ,uh, that's another common
condition that I see. But onceyou're in the operating room,
you know, if all you had to dowas remove the thyroid, it , it
wouldn't take more than about20, 30 minutes. But the reason
that, that the operation is sotechnical is 'cause you do have
to protect those criticalstructures. For one, the
parathyroid glands sit rightnext to , you know, right
(09:17):
behind the thyroid gland, andthey can be devascularized
during a thyroidectomy. The,the nerves that control the
vocal cords are within about amillimeter of the thyroid. So,
you know, if those things areinjured, it makes it really
hard to host a radio showbecause you'll have a, you'll
have a horse voice and, youknow, problem swallowing. And,
you know, last but not least,it's just such a vascular place
(09:38):
that, that you want to be veryvigilant about controlling all
the blood vessels and stuff.
'cause it , it could be a verydisastrous complication if you
were to have something thatbled after surgery. Head
Speaker 3 (09:48):
And neck surgery is probably one of the most
fascinating fields that wasforeign to me when I was going
through training at Baylor. Uh,we separated anatomy and head
and neck anatomy was hiss ownsubtle segment and course. And
we'd have to carry around askull in a box just to keep
track of all the different ,uh, nooks and crannies. Wow .
So , uh, the type of expertisethat a head and neck surgeon ,
(10:09):
uh, and an endocrine surgeonneeds to have is, is quite
tremendous. So , uh, so ourhat's off to you. Yeah. If
somebody needs to come see youas a patient, what's, what's a
good phone number to come andsee you for your endocrine
surgery?
Speaker 5 (10:20):
Yeah, so my office is located at the Health
Transformation Building, sothat's, you know, adjacent to
Dell Seton Medical Center. Uh,and our phone number there is
(512) 495-5717 .
Speaker 3 (10:32):
Dr. Long, thank you so much for joining us, and
we'll be right back. Hello andwelcome to the Armor Men's
Health Show. I'm Dr . Mystery ,your host joined by my co-host
Donna Lee.
Speaker 4 (10:41):
Hey, everybody.
Happy day.
Speaker 3 (10:42):
This show is brought to you by N A U Urology
Specialist. We are a fullservice head to toe, well
nipples to knees, nipples toknee urology practice. We would
love to take care of you foryour prostate and hormone
needs. And Donna, how do peopleget ahold of us?
Speaker 4 (10:56):
Call us at (512) 238-0762. You can visit our
website at armor men'shealth.com. And don't forget to
check out our podcast whereveryou listen to free podcasts. We
have like 140,000 downloads,you know,
Speaker 3 (11:08):
That's nice. And I , and I , I'm only responsible
for 120 of them . Yeah .
Speaker 4 (11:12):
. And your
dad's got the other 20 .
Speaker 3 (11:14):
My dad's got the other 20. . Excellent.
Hi, dad. Uh , today we arejoined , uh, by an excellent
surgeon , uh, a good friend ofours , uh, Dr . Rhet Long with
the University of Texas Health,Dell Seton Medical School right
here in Austin, Texas. Dr. Longthank you so much for joining
us.
Speaker 5 (11:31):
Happy to be here.
Thanks for the invitation. You
Speaker 3 (11:33):
Are an endocrine surgeon. An endocrine gland, as
we explained in the lastsegment, is the system in our
body that regulates our bodythrough hormones. Correct. And
so, you know, in, in my memory,the biggest endocrine glands
that require a surgeon aregoing to be the thyroid gland,
parathyroid gland that kind ofhelps contribute to calcium and
(11:53):
bone and skeletal regulation.
And then the adrenal gland ,uh, am I missing anyone
Speaker 5 (11:59):
As far as my PR practice is concerned, those
are the predominant endocrineorgans that I see now. You
know, neurosurgeons are gonnatreat conditions of the
pituitary. Um , there'sobviously endocrine systems in
, in your field , uh, withinthe testicles, within the , uh,
testicles of course. But thosewould be the predominant
conditions that I would see.
Speaker 4 (12:16):
How big are these glands? How big are the , in
your field?
Speaker 5 (12:20):
Yeah, so, you know, a a normal thyroid weighs about
20 grams. Mm-hmm .
. And , and thenwhen it gets enlarged or
becomes abnormal and, and cangrow down into your chest or
grow out laterally or juststart protruding from your
neck, it can , it can get up toa hundred or 120 grams. And so
the larger it gets , uh, themore potential there are for
developing , uh, what we callcompressive symptoms, where it
(12:43):
, uh, starts pressing on eitherthe trachea your esophagus and
can result in problemswallowing, shortness of breath
when you lie flat, or , orreally just anything that
that's located in that region.
Now
Speaker 4 (12:56):
I was watching TikTok , um, 'cause you know, I
never do that. Yeah. And thislady was on TikTok and she said
that her life was safe 'causeshe was doing one of her usual
toss. And one of the viewerssent her a message and said,
you might wanna go get yourthyroid checked out because it
was, I guess, bulging in herneck. Is that what would
happen? Yeah, I've, you can seeit.
Speaker 5 (13:14):
Yeah. I've certainly, it is not the first
time I've heard that story ofthere's been people on air ,
uh, newscasters, various folkswho you can start to notice a
little protrusion in theirneck, either in the front , uh,
central portion or outlaterally. And , and
Speaker 4 (13:28):
They don't see it themselves because it's pretty
gradual. But the person all ,all of a sudden seeing them for
the first time is like, Hey,what's that bulge in your
Speaker 5 (13:34):
Neck? Exactly. And and
Speaker 4 (13:36):
Unlike your pants . Yeah.
Speaker 5 (13:37):
Yeah.
Speaker 4 (13:38):
Alright . Yeah.
Speaker 5 (13:39):
Well, gotcha.
Speaker 4 (13:40):
Yeah.
Speaker 5 (13:40):
For perhaps some might be more noticeable than
others, but , but yes,
Speaker 3 (13:44):
Nobody's ever stopped me to tell me that. I
may want to check that out.
Speaker 4 (13:47):
You're bulging your pants, but you're bulging your
neck. That's ,
Speaker 5 (13:50):
Yeah. Yeah.
Speaker 3 (13:52):
Now, when people are contemplating or thinking about
who they should see, if they'reconcerned about a thyroid or a
parathyroid problem, who'stheir first stop? Who should
they see first?
Speaker 5 (14:02):
Yeah. So we work really closely with
endocrinologists and , uh,because hormones have such a
important physiologic impact onour body, there's many
endocrine , uh, issues thatdon't necessarily need a
surgeon. They, they need anendocrinologist, but
occasionally, you know, somepatients have conditions that
can only be managed withsurgery. And so if the
(14:23):
endocrinologist or primary carephysician picks up a a
condition that that is, needsto be managed by a surgeon,
then uh, it's nice to havethose relationships because you
certainly wanna see somebodywho does these, you know, high
volume, a high volume thyroidparathyroid surgeon is somebody
who does more than 30 of thesea year. So if you do four or
five, then that's where youmight get into a higher risk.
(14:44):
It's
Speaker 3 (14:45):
Very delicate and intricate . So really having
some experience is really
Speaker 5 (14:48):
Important.
Absolutely.
Speaker 3 (14:49):
An area that we do overlap, you and I is gonna be
adrenal surgery. Sure. What isthe purpose of the adrenal
glands? Because I think a lotof times, you know, our
listeners don't really knowwhat that gland is for.
Speaker 5 (14:58):
Yeah. So the adrenals , uh, obviously sit
right on top of your kidneys.
And they also make hormones,hormones that, that control our
blood pressure hormones thatare involved in sort of the,
you know , sex hormones system.
And then of course, you know,cortisol, which is a very
important hormone, and it , andit's involved with our stress
response. So patients who haveadrenal problems can either
(15:20):
have nodules that arefunctional or nodules that are
not functional. And so , sofunctional
Speaker 3 (15:25):
Nodules will make hormones correct. And if you
have too much of it, it may notbe good. Correct. Well , one of
those hormones is adrenaline,right? Yeah,
Speaker 5 (15:32):
That's right. Yeah.
Speaker 3 (15:33):
And that can really ramp you up and make your blood
pressure go real high. And, and, uh, how are most adrenal
nodules or adrenal thingsdiscovered
Speaker 5 (15:42):
On accident? So , uh, wow. You know, one of the
more common things that we seeare folks that have an adrenal
nodule that gets picked up on aCAT scan, say after a trauma,
you might have these littlegrowths on top of the adrenal
gland. And because conditionslike, you know, stress and high
blood pressure are so common ,uh, it's, it's very easy to
(16:04):
overlook that these nodulesactually might be contributing
to the problem that, that yourchronic medical issues. And so
most of the time, you know, wefind these on accident because
very rarely do sym do peoplepresent with symptoms of, you
know, an enlarged adrenal mass,because usually it's not
something that people are gonnafeel , uh, unless subjectively,
because
Speaker 3 (16:24):
The adrenal gland is really small. And indeed , if
it gets big enough that youneed to feel it, then you're
gonna have a tough, tough goalof it . Yes. Yeah . And as luck
has it, the adrenal gland isreally in a really unique
place, tucked right next tosome other really important
structures. Oh, yeah. Boy,describe that anatomy to us.
Speaker 5 (16:40):
Sure. So the adrenal's, a retroperitoneal ,
uh, structure. So there, thereare obviously a , a number of
different organs and thingswithin the abdomen. And , uh,
you know, as a surgeon, we haveto identify ones that, that are
in specific planes . So eitherin the front part of the
abdomen or in the back part ofthe abdomen. And the adrenal is
one that is, is located in amore posterior portion.
Speaker 3 (17:02):
So we have to move all the intestines and guts out
of the way and go right next tothe major blood vessels, the,
the aorta and the vena cava.
And these little glands arejust tucked right next to these
major blood vessels . Right .
Speaker 5 (17:14):
Yeah. Yeah. It's sounds difficult.
Speaker 3 (17:16):
Yeah.
Speaker 5 (17:16):
It makes for a fun operation though, right?
Speaker 3 (17:18):
Oh, yes . It's a lot of fun. Yeah. Y'all get off to
the weirdest things. Yeah , wedo get off to, yeah . Weirdest
Speaker 5 (17:23):
Things . I
know. Yeah.
Speaker 3 (17:25):
I mean, that's really , uh, you know , I say
it all the time, surgeons are adifferent breed of doctor
because we , um, you know,sometimes the messier it is the
more intrigued and more excitedthat we are going to be to take
care of it. So , uh, ifsomebody is found to have an
adrenal nodule , uh, we don'toperate on most of them, right?
Speaker 5 (17:43):
The vast majority you don't. But really, everyone
who has an adrenal noduleshould undergo a biochemical
evaluation. So essentiallythere's a standard algorithm
for labs that, that your , uh,primary care doctor or
endocrinologist can order. Andbasically the, the purpose of
that is to assess for anyhormonal excess. If all of the
(18:05):
hormones are normal and mostadrenal nodules are gonna be
non-functional, then, then thevast majority can just be
monitored to see if there's anygrowth. Now, some adrenal
nodules might have a suspicionfor cancer, and that's
typically something that yousee either on imaging , uh,
that has some indeterminatecharacteristics or in nodules
(18:25):
that, that, you know, have amore rapid growth over time.
And that's thus why, you know,they need patients need to be
followed for this.
Speaker 3 (18:32):
And , uh, it's, it , it really leads to a common
theme that I try to put on thisis that when you're a patient,
you really have to take controlover your care. So if you've
had a CT scan or you've had anM r I of the abdomen, you need
to get that report and read ityourself because it happens all
too commonly that something ona report gets brushed off by
somebody who just didn't readit properly or doesn't
(18:54):
understand it. You should, youshould know what your imaging
has had because so many renaltumors, adrenal tumors,
abdominal tumors are foundincidentally, and as Dr. Long
said, if you have an adrenalnodule, you should have lab
tests. I have had many patientswith three and four drug high
blood pressure with an adrenalnodule that nobody decided to
(19:15):
check, and it was a functionaladrenal nodule, and we were
able to get them off medicinesand really improve their life
Wow . By just doing the properfunctional assessment .
Speaker 5 (19:23):
Yeah. And I think, you know, if you expand that e
exact same concept to otherconditions that we both see, so
for example, you know, 90% ofpatients who have hypercalcemia
or elevated calcium in anoutpatient setting have a
problem with their parathyroidglands.
Speaker 3 (19:41):
That's right. And if you have chronic stones, you
need to have the properevaluation Correct. So that we
can rule these things out.
Speaker 5 (19:47):
Exactly.
Speaker 3 (19:47):
Dr. Long, if somebody's going to have a
surgery like this and bereferred to , uh, a surgeon,
are they still allowed to comesee you as a second opinion?
Well,
Speaker 5 (19:55):
As you had stated so aptly in the last , uh,
segment, you know, we lovesecond opinions and, and I
believe that that oftentimes ,you know, we will see folks who
either were offered surgery orwere not offered surgery, who
we might have differingopinions on. So if you're being
told that you either have acondition that's , uh, related
to the endocrine system that'seither non-surgical or surgical
(20:18):
it , it never hurts to get asecond opinion.
Speaker 3 (20:20):
And if somebody wants to do that, how do they
call your office?
Speaker 5 (20:23):
Yeah. So , uh, my office phone number is (512)
495-5717 and we're located on1601 Trinity Street in building
a
Speaker 3 (20:33):
Well , I can't thank you enough for giving us this
amazingly high level discussionabout something that a lot of
our listeners may encounter butnot know too much about. Donna.
How do people get ahold of usand send questions to us?
That's
Speaker 4 (20:44):
Right. You can reach us at 5 1 2 2 3 8 0 7 6 2 or
our website, armor men'shealth.com.
Speaker 2 (20:50):
The Armor Men's Health Show is brought to you
by N A U Urology Specialist.
For questions or to schedule anappointment, please call 5 1 2
2 3 8 0 7 6 2 or online atarmor men's health.com.
Speaker 2 (00:07):
Welcome to the Armor Men's Health Show with Dr.
Mystery and Donna Lee.
Speaker 1 (00:15):
Hello
Speaker 3 (00:16):
And welcome to the Armor Men's Health Show. This
is Dr. Mystery , your host,board certified urologist all
around . Great guy. Hey. Hey .
With my co-host an all aroundgreat girl, Donnel Lee . I love
Speaker 4 (00:27):
It when you call yourself all around great guy.
'cause it makes me laugh outloud.
Speaker 3 (00:31):
Not . Yeah , well, I can say whatever I want. That's
Speaker 4 (00:33):
Right. It's your show. This
Speaker 3 (00:34):
Is our show. So , uh, uh, you are a comedian.
That's right. You're also ourbusiness development guru in
our practice. That's right.
This practice is called N a uUrology Specialist. We are
growing and blowing, showingand showing. That's right.
That's , we're more growersthan show, I think. And so we
are an excellent urologypractice. We are growing bigger
(00:54):
and bigger every day . We arehere and ready to see you as a
patient, whether primarily totake care of your urologic
needs or as a second opinion.
We love second opinion. Mm-hmm. Dr .
Speaker 4 (01:04):
Sunny , second opinion mystery
Speaker 3 (01:06):
Here. How , how do people get ahold of us?
Speaker 4 (01:08):
That's right. If you want that second opinion, or to
learn more about our holisticurology group, call us at (512)
238-0762 or visit our website,armor men's health.com. We are
in Round Rock, north Austin,south Austin , and Dripping
Springs, Texas.
Speaker 3 (01:21):
For those of you that are regular listeners,
you'll clearly and easilyunderstand what my favorite
part of our guest is.
Speaker 4 (01:27):
His penis,
Speaker 3 (01:28):
His name. Oh , Dr .
Long. Hey ,
Speaker 4 (01:32):
Dr . I don't know why I missed that. I'm sorry.
You
Speaker 3 (01:34):
Know, there was a guy in town who used to
practice medicine, Dr . DickChop, and I used to say, don't
go to Dr . Dick Chop or Dr. LesWing . Go to Dr. Moore
Longfellow.
Speaker 4 (01:42):
Hey. Oh, I'm glad Whitney's here today to
to bring that out .
Speaker 3 (01:47):
You don't want it shorter. She wants longer .
Speaker 4 (01:51):
Wow. In
Speaker 3 (01:52):
Dr . Dr . Rhett Long is an endocrine surgeon , uh,
in the surgical oncology clinicat Dell Medical School. And is
somebody that I met justhanging around in the surgeon's
lounge one day. I was wondering
Speaker 4 (02:04):
How y'all met. Okay.
Speaker 3 (02:05):
Yeah. We were hanging around the surgeon .
And you know what I love morethan anything, you're pick
Speaker 4 (02:08):
Up only another
Speaker 3 (02:09):
Surgeon. I
Speaker 4 (02:10):
Know . I think you have a pickup line though that
says, Hey, I have a radio show.
Speaker 3 (02:14):
Hey , I have a radio show. Would
Speaker 4 (02:14):
You like to join me,
Speaker 3 (02:16):
And you know , uh, what's funny is that I thought
he went to Stanford, but hedidn't. He went to Sanford
University. Yeah , SanfordUniversity. Okay. Yeah .
Speaker 4 (02:25):
We like to consider ourselves the Stanford of
Alabama. So
Speaker 3 (02:30):
Sits different .
Yeah . But , uh, you know , um,something about him though he
did his general surgeryresidency mm-hmm.
at this little unknown place.
Oh , you know what it's called?
Speaker 4 (02:42):
Tell me.
Speaker 3 (02:42):
Baylor College of Medicine, and he fight his
institution on the face thatplanet. Okay . He went at a
time when it was really goodtoo. Really?
Speaker 4 (02:50):
Not the time you went
Speaker 3 (02:51):
Well , you know ,
their standards out a littlebit. Maybe a little bit. So,
Dr. Long , uh, welcome. Thankyou for joining us today. Well
,
Speaker 5 (02:58):
Thank you. Hey, it's good to be here. And, and , and
I hate to disappoint you, but Iwas actually only a surgical
intern at Baylor College ofMedicine. I actually did the
vast majority of my residencyhere at the University of
Texas, so,
Speaker 3 (03:10):
Well, that's okay.
You
Speaker 5 (03:11):
Got so , I , I at least have some Baylor ties, if
that works for you. It , it ,
Speaker 3 (03:14):
It , it does in fact work
the first surgical oncologist.
We've had, we get Dr. DeclanFleming that has been on our
show before. He's an a amazingmentor and an amazing surgeon.
And , uh, he's a partner ofyours. And , uh, so it really
says something quite greatabout the burgeoning program
that Dell Medical School isputting together. Why don't you
tell us what is a surgicaloncologist and how is that
(03:35):
different from a regularsurgeon?
Speaker 5 (03:37):
Yeah. So , uh, Dr.
Fleming, one of my partners ,uh, he, he's also a general
surgeon by training. So inorder to become a surgical
oncologist, you have to gothrough five years of , uh,
general surgery residency, andthen you'll pursue an
additional, usually two tothree year fellowship focusing
on, you know, surgical oncologyconditions. Now I am an
endocrine surgeon, so Iactually did a fellowship and
(03:59):
endocrine surgery up at theUniversity of Michigan. So
Speaker 3 (04:02):
Endocrine , uh, it means glands Right. And
hormones. And so tell us, whatare all the, the components or
what are the major componentsof the endocrine system that
you specialize in? Sure.
Speaker 5 (04:12):
So, you know , my practice primarily focuses on ,
uh, patients who haveconditions of the thyroid,
parathyroid and adrenal glands.
So , uh, there are endocrinesurgeons and major academic
programs all across thecountry. And it's been exciting
because , uh, you know, I'm thefirst one , uh, here in Austin
who's really focusingexclusively on endocrine
(04:34):
surgery within an academicenvironment. And so it's a new
program, a relatively new atDell Medical School. And, you
know, I'm happy to be the oneblazing the trail.
Speaker 3 (04:43):
Nice. Now, when it comes to endocrine surgery, it
, it's not all cancer, right? Imean, the vast majority of what
you're taking care of is gonnabe benign disease.
Speaker 5 (04:51):
That's absolutely correct. You know, nationally ,
um, most major academicprograms that have endocrine
surgery , uh, a lot of us fallwithin the Department of
Surgical Oncology because we dosee conditions that are
cancerous. So, for example,thyroid cancer, even the more
rare types of adrenal cancer ormetastases or that sort of
(05:11):
thing. But you're right, thevast majority of the stuff that
I see is actually benigndisease. And so, you know, when
it comes to patient referralsand, and , and if you get into
a clinic that, that looks likesurgical oncology, it can be a
little bit , uh, daunting. Itcan be a little daunting. Of
course, I'm not here forcancer,
Speaker 3 (05:29):
This place some
Speaker 5 (05:29):
Scary, but , but that's a , that's a good point.
Yeah . The vast majority of mypatients that I see do not have
cancer.
Speaker 3 (05:35):
So when it comes to thyroid disease, what are some
of the more common conditionsor presentations of thyroid
disease that lead a patient tocome see you?
Speaker 5 (05:43):
So I would say that, you know, the vast majority of
patients , uh, who havesurgical conditions of the
thyroid are typically foundincidentally. So folks who have
an imaging scan done foranother purpose, an example
would be, you know, a carotidultrasound to, to look for
vascular disease. They mighthave a CT scan or a PET scan
(06:05):
that identifies a noduleincidentally. Um, and then I'll
see 'em in , or if they're
Speaker 3 (06:09):
Really lucky, they have a doctor that actually
touches them. They do aphysical exam
Speaker 5 (06:13):
Quite , you know, that's, that's rare these days.
Uh , usually if anyone, if anypatients need to be touched,
they're referred to a surgeon.
Right.
something that's that's pickedup on exam, then, then
certainly , uh, you know, anastute clinician would, would ,
uh, order an ultrasound or getsome imaging, and then they'd
ultimately end up in my clinic.
What's
Speaker 3 (06:33):
The purpose of the thyroid gland? Why do we even
have one? Hmm .
Speaker 5 (06:35):
Yeah. So the, the thyroid is actually the first
embryologic gland to develop.
So it's by about four weeks of, of age in , in utero , uh,
the thyroid starts forming.
Wow. And, and so it , it'sextremely important , uh, early
on for development of yournervous system. Basically every
major organ system is, isimpacted by thyroid hormone.
(06:57):
And so, you know, as we age,it's, it's an important
regulator of our metabolismjust overall the way we feel.
Um, so if your thyroid is off,either over-functioning or
under-functioning, can havedrastic impacts on just your
overall wellbeing.
Speaker 3 (07:11):
Wow . And so , uh, as we get older, there are
people that have hyperfunctioning and hypofunctioning
thyroids, and they will see anendocrinologist. But when they
have a mass or a concern forcancer, they'll see an
endocrine surgeon. And as luckhas it, this organ is in a
pretty important place. Right?
Oh , is
Speaker 5 (07:28):
It ? Yeah, absolutely. So the , the
thyroid is located in the neck,and I always tell everybody
who, who ask why, got intothis, and, and no offense to
Dr. Misery here, but , uh, the, the neck is the best anatomy
in the body. It's, it's , it'sso , oh , I hear a fight
coming. Yeah. It's so clean.
Mm-hmm .
it , it's just absolutely , uh,the , the best s stuff you can
Speaker 3 (07:50):
See. I'm , I'm , I'm speechless. Yeah. I'm gonna
invite you to my next roboticprostatectomy, and you're gonna
see pretty Okay . Oh , geez .
All right . And I'll come intoone of your next surgeries.
Okay. And we'll, and we'll seehow pretty that
Speaker 5 (08:00):
Is. C come on, by this week, we'll see you .
Speaker 3 (08:02):
But for how pretty it is, there's a lot of really
important structures rightthere. Right. I mean, people
can, can have complications ofthyroid surgery, which is why
you don't want to go to any,you know, Tom, Dick and Harry.
Speaker 5 (08:13):
Yeah. Hmm . Yeah, yeah. You know, Harry Dick, you
certainly don't want to haveyour thyroid surgery surgery by
somebody who, who does a lot ofrobotic prostatectomy,
Speaker 4 (08:24):
Good point. And welcome to the show.
Speaker 5 (08:26):
Yeah.
Yeah.
Speaker 3 (08:28):
So , uh, what are some important complications
that , uh, patients need to beaware of that can occur after a
thyroid surgery?
Speaker 5 (08:34):
Yeah. So, you know, and you mentioned that, you
know, I, I do see a lot offolks who have thyroid nodules
or masses that ultimatelyresult in compressive symptoms
of the adjacent structures inthe neck. I also see folks
with, you know, chronichyperthyroidism, that, that is
either refractory to medicalmanagement or is ultimately so
chronic that, that the onlykind of long-term management is
(08:55):
to remove the thyroid. And so ,uh, that's another common
condition that I see. But onceyou're in the operating room,
you know, if all you had to dowas remove the thyroid, it , it
wouldn't take more than about20, 30 minutes. But the reason
that, that the operation is sotechnical is 'cause you do have
to protect those criticalstructures. For one, the
parathyroid glands sit rightnext to , you know, right
(09:17):
behind the thyroid gland, andthey can be devascularized
during a thyroidectomy. The,the nerves that control the
vocal cords are within about amillimeter of the thyroid. So,
you know, if those things areinjured, it makes it really
hard to host a radio showbecause you'll have a, you'll
have a horse voice and, youknow, problem swallowing. And,
you know, last but not least,it's just such a vascular place
(09:38):
that, that you want to be veryvigilant about controlling all
the blood vessels and stuff.
'cause it , it could be a verydisastrous complication if you
were to have something thatbled after surgery. Head
Speaker 3 (09:48):
And neck surgery is probably one of the most
fascinating fields that wasforeign to me when I was going
through training at Baylor. Uh,we separated anatomy and head
and neck anatomy was hiss ownsubtle segment and course. And
we'd have to carry around askull in a box just to keep
track of all the different ,uh, nooks and crannies. Wow .
So , uh, the type of expertisethat a head and neck surgeon ,
(10:09):
uh, and an endocrine surgeonneeds to have is, is quite
tremendous. So , uh, so ourhat's off to you. Yeah. If
somebody needs to come see youas a patient, what's, what's a
good phone number to come andsee you for your endocrine
surgery?
Speaker 5 (10:20):
Yeah, so my office is located at the Health
Transformation Building, sothat's, you know, adjacent to
Dell Seton Medical Center. Uh,and our phone number there is
(512) 495-5717 .
Speaker 3 (10:32):
Dr. Long, thank you so much for joining us, and
we'll be right back. Hello andwelcome to the Armor Men's
Health Show. I'm Dr . Mystery ,your host joined by my co-host
Donna Lee.
Speaker 4 (10:41):
Hey, everybody.
Happy day.
Speaker 3 (10:42):
This show is brought to you by N A U Urology
Specialist. We are a fullservice head to toe, well
nipples to knees, nipples toknee urology practice. We would
love to take care of you foryour prostate and hormone
needs. And Donna, how do peopleget ahold of us?
Speaker 4 (10:56):
Call us at (512) 238-0762. You can visit our
website at armor men'shealth.com. And don't forget to
check out our podcast whereveryou listen to free podcasts. We
have like 140,000 downloads,you know,
Speaker 3 (11:08):
That's nice. And I , and I , I'm only responsible
for 120 of them . Yeah .
Speaker 4 (11:12):
Speaker 3 (11:14):
My dad's got the other 20.
Hi, dad. Uh , today we arejoined , uh, by an excellent
surgeon , uh, a good friend ofours , uh, Dr . Rhet Long with
the University of Texas Health,Dell Seton Medical School right
here in Austin, Texas. Dr. Longthank you so much for joining
us.
Speaker 5 (11:31):
Happy to be here.
Thanks for the invitation. You
Speaker 3 (11:33):
Are an endocrine surgeon. An endocrine gland, as
we explained in the lastsegment, is the system in our
body that regulates our bodythrough hormones. Correct. And
so, you know, in, in my memory,the biggest endocrine glands
that require a surgeon aregoing to be the thyroid gland,
parathyroid gland that kind ofhelps contribute to calcium and
(11:53):
bone and skeletal regulation.
And then the adrenal gland ,uh, am I missing anyone
Speaker 5 (11:59):
As far as my PR practice is concerned, those
are the predominant endocrineorgans that I see now. You
know, neurosurgeons are gonnatreat conditions of the
pituitary. Um , there'sobviously endocrine systems in
, in your field , uh, withinthe testicles, within the , uh,
testicles of course. But thosewould be the predominant
conditions that I would see.
Speaker 4 (12:16):
How big are these glands? How big are the , in
your field?
Speaker 5 (12:20):
Yeah, so, you know, a a normal thyroid weighs about
20 grams. Mm-hmm .
becomes abnormal and, and cangrow down into your chest or
grow out laterally or juststart protruding from your
neck, it can , it can get up toa hundred or 120 grams. And so
the larger it gets , uh, themore potential there are for
developing , uh, what we callcompressive symptoms, where it
(12:43):
, uh, starts pressing on eitherthe trachea your esophagus and
can result in problemswallowing, shortness of breath
when you lie flat, or , orreally just anything that
that's located in that region.
Now
Speaker 4 (12:56):
I was watching TikTok , um, 'cause you know, I
never do that. Yeah. And thislady was on TikTok and she said
that her life was safe 'causeshe was doing one of her usual
toss. And one of the viewerssent her a message and said,
you might wanna go get yourthyroid checked out because it
was, I guess, bulging in herneck. Is that what would
happen? Yeah, I've, you can seeit.
Speaker 5 (13:14):
Yeah. I've certainly, it is not the first
time I've heard that story ofthere's been people on air ,
uh, newscasters, various folkswho you can start to notice a
little protrusion in theirneck, either in the front , uh,
central portion or outlaterally. And , and
Speaker 4 (13:28):
They don't see it themselves because it's pretty
gradual. But the person all ,all of a sudden seeing them for
the first time is like, Hey,what's that bulge in your
Speaker 5 (13:34):
Neck? Exactly. And and
Speaker 4 (13:36):
Unlike your pants
Speaker 5 (13:37):
Yeah.
Speaker 4 (13:38):
Alright . Yeah.
Speaker 5 (13:39):
Well, gotcha.
Speaker 4 (13:40):
Yeah.
Speaker 5 (13:40):
For perhaps some might be more noticeable than
others, but , but yes,
Speaker 3 (13:44):
Nobody's ever stopped me to tell me that. I
may want to check that out.
Speaker 4 (13:47):
You're bulging your pants, but you're bulging your
neck. That's ,
Speaker 5 (13:50):
Yeah. Yeah.
Speaker 3 (13:52):
Now, when people are contemplating or thinking about
who they should see, if they'reconcerned about a thyroid or a
parathyroid problem, who'stheir first stop? Who should
they see first?
Speaker 5 (14:02):
Yeah. So we work really closely with
endocrinologists and , uh,because hormones have such a
important physiologic impact onour body, there's many
endocrine , uh, issues thatdon't necessarily need a
surgeon. They, they need anendocrinologist, but
occasionally, you know, somepatients have conditions that
can only be managed withsurgery. And so if the
(14:23):
endocrinologist or primary carephysician picks up a a
condition that that is, needsto be managed by a surgeon,
then uh, it's nice to havethose relationships because you
certainly wanna see somebodywho does these, you know, high
volume, a high volume thyroidparathyroid surgeon is somebody
who does more than 30 of thesea year. So if you do four or
five, then that's where youmight get into a higher risk.
(14:44):
It's
Speaker 3 (14:45):
Very delicate and intricate . So really having
some experience is really
Speaker 5 (14:48):
Important.
Absolutely.
Speaker 3 (14:49):
An area that we do overlap, you and I is gonna be
adrenal surgery. Sure. What isthe purpose of the adrenal
glands? Because I think a lotof times, you know, our
listeners don't really knowwhat that gland is for.
Speaker 5 (14:58):
Yeah. So the adrenals , uh, obviously sit
right on top of your kidneys.
And they also make hormones,hormones that, that control our
blood pressure hormones thatare involved in sort of the,
you know , sex hormones system.
And then of course, you know,cortisol, which is a very
important hormone, and it , andit's involved with our stress
response. So patients who haveadrenal problems can either
(15:20):
have nodules that arefunctional or nodules that are
not functional. And so , sofunctional
Speaker 3 (15:25):
Nodules will make hormones correct. And if you
have too much of it, it may notbe good. Correct. Well , one of
those hormones is adrenaline,right? Yeah,
Speaker 5 (15:32):
That's right. Yeah.
Speaker 3 (15:33):
And that can really ramp you up and make your blood
pressure go real high. And, and, uh, how are most adrenal
nodules or adrenal thingsdiscovered
Speaker 5 (15:42):
On accident? So , uh, wow. You know, one of the
more common things that we seeare folks that have an adrenal
nodule that gets picked up on aCAT scan, say after a trauma,
you might have these littlegrowths on top of the adrenal
gland. And because conditionslike, you know, stress and high
blood pressure are so common ,uh, it's, it's very easy to
(16:04):
overlook that these nodulesactually might be contributing
to the problem that, that yourchronic medical issues. And so
most of the time, you know, wefind these on accident because
very rarely do sym do peoplepresent with symptoms of, you
know, an enlarged adrenal mass,because usually it's not
something that people are gonnafeel , uh, unless subjectively,
because
Speaker 3 (16:24):
The adrenal gland is really small. And indeed , if
it gets big enough that youneed to feel it, then you're
gonna have a tough, tough goalof it . Yes. Yeah . And as luck
has it, the adrenal gland isreally in a really unique
place, tucked right next tosome other really important
structures. Oh, yeah. Boy,describe that anatomy to us.
Speaker 5 (16:40):
Sure. So the adrenal's, a retroperitoneal ,
uh, structure. So there, thereare obviously a , a number of
different organs and thingswithin the abdomen. And , uh,
you know, as a surgeon, we haveto identify ones that, that are
in specific planes . So eitherin the front part of the
abdomen or in the back part ofthe abdomen. And the adrenal is
one that is, is located in amore posterior portion.
Speaker 3 (17:02):
So we have to move all the intestines and guts out
of the way and go right next tothe major blood vessels, the,
the aorta and the vena cava.
And these little glands arejust tucked right next to these
major blood vessels . Right .
Speaker 5 (17:14):
Yeah. Yeah. It's sounds difficult.
Speaker 3 (17:16):
Yeah.
Speaker 5 (17:16):
It makes for a fun operation though, right?
Speaker 3 (17:18):
Oh, yes . It's a lot of fun. Yeah. Y'all get off to
the weirdest things. Yeah , wedo get off to, yeah . Weirdest
Speaker 5 (17:23):
Things
Speaker 3 (17:25):
I mean, that's really , uh, you know , I say
it all the time, surgeons are adifferent breed of doctor
because we , um, you know,sometimes the messier it is the
more intrigued and more excitedthat we are going to be to take
care of it. So , uh, ifsomebody is found to have an
adrenal nodule , uh, we don'toperate on most of them, right?
Speaker 5 (17:43):
The vast majority you don't. But really, everyone
who has an adrenal noduleshould undergo a biochemical
evaluation. So essentiallythere's a standard algorithm
for labs that, that your , uh,primary care doctor or
endocrinologist can order. Andbasically the, the purpose of
that is to assess for anyhormonal excess. If all of the
(18:05):
hormones are normal and mostadrenal nodules are gonna be
non-functional, then, then thevast majority can just be
monitored to see if there's anygrowth. Now, some adrenal
nodules might have a suspicionfor cancer, and that's
typically something that yousee either on imaging , uh,
that has some indeterminatecharacteristics or in nodules
(18:25):
that, that, you know, have amore rapid growth over time.
And that's thus why, you know,they need patients need to be
followed for this.
Speaker 3 (18:32):
And , uh, it's, it , it really leads to a common
theme that I try to put on thisis that when you're a patient,
you really have to take controlover your care. So if you've
had a CT scan or you've had anM r I of the abdomen, you need
to get that report and read ityourself because it happens all
too commonly that something ona report gets brushed off by
somebody who just didn't readit properly or doesn't
(18:54):
understand it. You should, youshould know what your imaging
has had because so many renaltumors, adrenal tumors,
abdominal tumors are foundincidentally, and as Dr. Long
said, if you have an adrenalnodule, you should have lab
tests. I have had many patientswith three and four drug high
blood pressure with an adrenalnodule that nobody decided to
(19:15):
check, and it was a functionaladrenal nodule, and we were
able to get them off medicinesand really improve their life
Wow . By just doing the properfunctional assessment .
Speaker 5 (19:23):
Yeah. And I think, you know, if you expand that e
exact same concept to otherconditions that we both see, so
for example, you know, 90% ofpatients who have hypercalcemia
or elevated calcium in anoutpatient setting have a
problem with their parathyroidglands.
Speaker 3 (19:41):
That's right. And if you have chronic stones, you
need to have the properevaluation Correct. So that we
can rule these things out.
Speaker 5 (19:47):
Exactly.
Speaker 3 (19:47):
Dr. Long, if somebody's going to have a
surgery like this and bereferred to , uh, a surgeon,
are they still allowed to comesee you as a second opinion?
Well,
Speaker 5 (19:55):
As you had stated so aptly in the last , uh,
segment, you know, we lovesecond opinions and, and I
believe that that oftentimes ,you know, we will see folks who
either were offered surgery orwere not offered surgery, who
we might have differingopinions on. So if you're being
told that you either have acondition that's , uh, related
to the endocrine system that'seither non-surgical or surgical
(20:18):
it , it never hurts to get asecond opinion.
Speaker 3 (20:20):
And if somebody wants to do that, how do they
call your office?
Speaker 5 (20:23):
Yeah. So , uh, my office phone number is (512)
495-5717 and we're located on1601 Trinity Street in building
a
Speaker 3 (20:33):
Well , I can't thank you enough for giving us this
amazingly high level discussionabout something that a lot of
our listeners may encounter butnot know too much about. Donna.
How do people get ahold of usand send questions to us?
That's
Speaker 4 (20:44):
Right. You can reach us at 5 1 2 2 3 8 0 7 6 2 or
our website, armor men'shealth.com.
Speaker 2 (20:50):
The Armor Men's Health Show is brought to you
by N A U Urology Specialist.
For questions or to schedule anappointment, please call 5 1 2
2 3 8 0 7 6 2 or online atarmor men's health.com.
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Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Special Summer Offer: Exclusively on Apple Podcasts, try our Dateline Premium subscription completely free for one month! With Dateline Premium, you get every episode ad-free plus exclusive bonus content.
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!