June 20, 2025 • 43 mins
Ever wondered what really happens during a vasectomy? Or why that morning coffee might be setting you up for kidney stones? Dr. David Ludlow pulls back the curtain on men's health topics most guys are too uncomfortable to discuss.
"That wasn't as bad as I thought it would be" – the phrase Dr. Ludlow hears so often from vasectomy patients that he jokes about putting it on t-shirts. In this eye-opening conversation, he dispels common myths about men's health procedures that keep many from seeking necessary care. From explaining how robotic surgery works (no, the robot isn't performing surgery while the doctor takes a coffee break) to clarifying that vasectomies won't affect your ability to perform or enjoy sex, Dr. Ludlow addresses the concerns men rarely voice but frequently worry about.
The discussion ventures into surprising territory, revealing how our modern lifestyle impacts urological health in unexpected ways. Those energy drinks you're chugging for hydration? They're actually dehydrating you. That Western diet with processed foods? It might explain why African-Americans have higher prostate cancer rates than native Africans. Even excessive pornography consumption gets examined for its potential physical (not just psychological) impacts on sexual function – a topic rarely addressed in medical discussions but increasingly relevant as Dr. Ludlow sees young patients with dysfunction issues that shouldn't typically affect their age group.
Whether you're approaching the age for prostate screening, considering a vasectomy, or simply want to understand how to maintain optimal urological health, this conversation delivers practical insights without the embarrassment of the exam room. Listen now to hear from the doctor who's seen it all and isn't afraid to talk about it – your body will thank you.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome to Vegas Circle Podcast with your hosts,
paki and Chris.
We are people who arepassionate about business,
success and culture, and this isour platform to showcase to
people in our city who make ithappen.
On today's podcast, we'll bediscussing all things men's
health, from prostate checks tokidney stones.
We're going to talk the wholenine man about men's health, man
.
So I'm kind of nervous aboutthis interview.
I feel like I'm talking to myprimary care doctor, so, but
(00:22):
let's welcome to the circle,urologist Dr David Ludlow.
Welcome to the circle, my man.
Thank you, yeah, thanks, forhaving me.
So let's jump right in.
Man.
So what made you jump into theworld of urology?
Speaker 2 (00:37):
Great question.
I don't think most kids grow updreaming of becoming a
urologist.
Most kids don't even know whatit is Initially.
Obviously you decide to be adoctor and I think a lot of
people kind of make theirdecision when they get exposed
to different things at medicalschool.
I actually went to medicalschool thinking I wanted to be a
pediatrician.
So if you look at my waitingroom now, I went with a very
different demographic eventuallyyeah, 1,000%.
Yeah, for me, I decided prettyearly on.
(00:58):
I was kind of an athlete inhigh school and whatnot and so I
just liked kind of thatintensity and using my hands and
so I decided pretty early on Iliked surgery.
So then it was kind of a matterof you know, urology a lot of
people don't understand isactually kind of under the
umbrella of surgery, and so youkind of just get exposed to
(01:18):
different things and talk to abunch of different mentors.
And one thing I wanted is Istill like the idea of
practicing medicine and kind ofdiagnosing and having you know
long time patients, but I alsolike to do the procedures and
the surgeries and have areasonable lifestyle.
You know I have a family andhobbies and so a lot of people
said you should try urology, orENT was another one that I heard
(01:42):
that kind of had you know,check those boxes.
So I actually just did you knowrotations and both of them and
I had no idea Urologist did allthe cool stuff they did.
I mean robotic surgery, just alot of gadgets and toys, scopes,
lasers and and I don't knownothing against the ENTs.
I got some good ENT friends butthere's a lot of picking, a lot
of, just like you know, littlemicroscopes and using your
(02:05):
fingers and I don't know.
I just liked, I just liked thesurgeries and and also like the
urologist, I mean they're yourkind of cohorts and you know
they're smart, they're hardworkers, but they're also not
(02:26):
too high on their you know highhorse, you know know, got to be
a little self-deprecating whenyou, you know, dedicate your
life to the urinary tract.
So they're just kind of cooldown to earth, guys.
Speaker 1 (02:31):
Yeah so you do a wide variety of surgeries right?
Can you kind of give like thewhole menu of services or the
primary?
Yeah, so it's a good mix, Imean because we do a lot of
clinic stuff.
Speaker 2 (02:41):
You know, obviously people that have you know all
sorts what you think of urologyproblems or men's health, you
know would come see us and someof the stuff we can manage with
medications and stuff that we doin clinic and then a lot needs
surgery.
So we kind of my, my time issplit kind of half and half
between the operating room andclinic.
So essentially we do all thesurgeries for the urinary tract.
(03:01):
That's male and female, so wehave a lot of female patients.
You know females.
Speaker 1 (03:04):
I didn't know that when we were talking on the
phone I didn't realize females,yeah, so females get kidney
stones females.
Speaker 2 (03:09):
I do a lot of cancer cause I do a lot of robotic
surgery, so do a lot of kidneycancer and you know we do
bladder cancer, obviously underthe umbrella of urology.
Is is the male kind of sexualorgans, you know.
Test is the male kind of sexualorgans, you know testicles and
(03:32):
prostates and things like that,whereas females have
gynecologists.
Speaker 1 (03:34):
So overall, you know there's more males than females,
but definitely see a lot offemales too.
Sure, I'm 45, right?
So when should men startgetting their prostate exam?
Because I hear a wide range of.
I hear you know 40, 45, I'veheard you know later in age now,
but what, from from yourexpertise, what would you say?
Speaker 2 (03:46):
that, yeah, you actually look at different
guidelines and you'll see.
But what you said is kind of inthe in the ballpark.
Okay, I tell most people 50years old there there are maybe
a couple exceptions.
There is a higher risk inAfrican American males and so
you know, if you are gettingroutine labs, what I tell.
(04:07):
And another risk factor isfamily history.
So if you have some of thoserisk factors I don't think it
hurts.
If you're getting labs anywaywith a doctor sometime in your
mid to late forties to just say,hey, throw a PSA on there.
You know that's the.
It's called a PSA which standsfor prostate specific antigen.
It's a screening lab.
And I tell them, hey, if youget a check to 45 and it's
(04:30):
really low, then don't worryabout it and then just start
getting kind of annual screeningwhen you're 50.
But if you don't have any realrisk factors, I think 50 is a
good time to start.
This is probably a stupidquestion.
Why are so many prostate cancercases?
It's essentially the mostcommon cancer in men.
That's a good question.
I mean there's a lot ofresearch going on.
(04:53):
Obviously, with age it's agingmen.
Studies on men in like their80s, like 50% would have some
prostate cancer cells.
Now, obviously the goodmajority of them aren't dying of
prostate cancer.
So that's one of the balancingaxes.
You know we're not just lookingto diagnose prostate cancer.
(05:17):
We're looking to diagnoseclinically significant prostate
cancer that would maybe actuallycause that person problems.
That's why, if you looked atthe screening guidelines, you
also don't see them talkingabout screening people in their
80s, because it's kind of aweird way to look at it.
They got competing factors, theygot other issues going on at
that point.
But yeah, I mean, as far ascauses, I mean I mentioned the
(05:39):
risk factors withAfrican-Americans.
One thing that's interestingabout that is if you look at
Africans, like in Africa, theyactually have a relatively low
risk of prostate cancer.
Speaker 1 (05:49):
Is that the diet?
Speaker 2 (05:51):
But African-Americans ?
We don't know.
But that's what I think.
I think it's the Western dietall the processed food.
I mean, look at the food and allthe ingredients.
I mean it's so hard to study.
You know, like all thesedifferent words, that you can't
even pronounce when you look atthe ingredients.
But you know you got to assumethat over time some of them
might take its toll.
(06:11):
So it's definitely a hot areaof research.
Every once in a while they'llfind something that they think
has a link and then, as they domore data, they're like yeah,
maybe not, so it's still to bedetermined.
Speaker 1 (06:22):
Let's talk about vasectomies, right?
So I've got two kids up laterin age.
I'm scared.
Is it that crazy?
Speaker 2 (06:30):
Well, I sometimes tell patients this I should
create a T-shirt that says thatwasn't as bad as I thought it
was going to be, and give it topeople after the vasectomies.
Speaker 1 (06:37):
Okay, okay.
Speaker 2 (06:39):
You know, that's usually what they say.
Now you know how guys are.
They like to milk things andthey're going to scare their
friends.
And then you get it done andthey're like yeah, I said I told
you it wasn't that bad, youknow.
But, um, now, why you shouldget it?
I mean, really, at the end ofthe day, it's it's probably, you
know, assuming you're marriedor in a relationship, it's if,
(07:05):
if obviously both of you havemade the decision you don't have
any more kids.
I mean it's, it's kind of anice thing to do for your wife.
I mean it's, you know, it's somuch less invasive than to get
your, you know, for the femalesto get their tubes tied.
That's like a legit surgeryanesthesia um, and you know plus
possible side effects from IUDsand and birth control pills.
Uh, you know, on the flip sideit's a 10 to 15 minute clinic
(07:28):
procedure.
Speaker 1 (07:29):
Is it that fast?
Yeah, so are you knocked outfor this surgery?
Not in general?
Speaker 2 (07:34):
Yeah, I mean you can be, you know, per request.
You know, in my clinic we havesomething called Pronox, which
is this kind of happy gas.
Did you say Pronuts?
Speaker 1 (07:44):
No, I was like.
I know he didn't say that Ishould market that.
Yeah, Jesus Christ, we couldmarket it together.
Pronox, pronox, okay.
Speaker 2 (07:51):
It just takes the edge off.
It doesn't put you to sleep,but it kind of relaxes you a
little bit.
And then we use lidocaine.
I kind of compare it to gettinga cavity filled of cavity
filled obviously very differentpart of your body, but I don't
know if you've had a cavityfilled but there's kind of that
like sting from the lidocaine.
You know that gets yourattention, but then after that
it's like, oh man, I don't evenreally feel anything.
(08:13):
That's, that's crazy.
It's the same idea.
You got to inject somelidocaine down there and that
can sting a little bit, but mostof the time after that I got, I
got some Pandora music in thebackground.
Give it a go, we're shooting thebreeze, and usually they're
like well, that's it, we're done.
And then you just got to takeit easy for a couple days
afterwards.
Speaker 1 (08:31):
Is there a lot of side effects from going?
Because, I'm going to be honest, You're scared in that area,
right where you think that, justbeing blunt, I mean you can't
get it up anymore period.
Does that happen?
Do get it up anymore.
Period has that happened?
Do you see a lot of thosepercentages of people once they
get the vasectomy?
Speaker 2 (08:46):
that.
Hey, they're gonna haveproblems down the road.
That's what I'm scared.
Side effects long term yeah,there is like really no chance
of getting erectile dysfunctionthat's what you're working at is
is so far away from the nervesthat deal with that.
Speaker 1 (09:02):
Okay, yeah, you know there's that's the horror
stories you hear all the time.
Speaker 2 (09:06):
And even though the testicle is responsible for
producing testosterone, it's notgoing to have any effect on
your testosterone.
Okay, to be honest, you know, Idon't know what kind of words
we can use on this podcast.
Speaker 1 (09:19):
You can use whatever you want.
You're ejaculate.
Yeah, there you go.
Speaker 2 (09:22):
That's probably not a word, that's brought up a lot
on your podcast Not at all.
You won't even really notice adrop-off in your ejaculation.
I mean a lot of people theyjust don't understand.
They think that nothing's goingto come out after you have a
vasectomy and really you won'teven notice a difference in the
sensation and the erections,except you just won't have any
sperm in it.
Speaker 1 (09:41):
That's clear.
Okay, as far as kidney stones,do you have to perform a lot of
surgeries on kidney stones, oris that something that just has
to pass?
Speaker 2 (09:48):
You can ask your wife .
She works with you, she's in theoperating room and I'd say,
from a volume standpoint, that'sthe most common surgery.
I mean, there's different typesof surgeries depending on the
size and location of the stone,but as as far as like percentage
of my my surgery cases, I'd sayI got, I, I got to assume it's
easily kidney stones.
Um, so, luckily, the mostpeople, the majority of people,
(10:12):
can pass their kidney stones.
But there's a lot of peoplethat can't.
You know, they don't want to,you know, so we preemptively
treat them.
So yeah, that's a a very commonsurgery.
We do.
Speaker 1 (10:23):
Is there anything we can do to make it better for
ourselves to not have theseproblems as far as kidney stones
?
Speaker 2 (10:28):
Absolutely.
I mean obviously it can bemultifactorial.
I mean there's some people thatcould do everything right and
there's some kind ofpredispositions they have, but
absolutely the diet has a hugeinfluence.
That's why I'm always going tobe in business.
Speaker 1 (10:43):
Absolutely the diet has a huge influence.
Speaker 2 (10:45):
That's why I'm always going to be in business.
I mean, it's, uh, it's energydrinks, it's processed foods,
it's, you know, if you do thingsthat increase your uric acid,
like a lot of, a lot of meat,especially red meat, you know
just essentially what, whatpeople are eating every day.
You know, and especially inVegas, uh, people, you know it's
a desert and so people getdehydrated, and what a lot of
(11:06):
people don't understand is a lotof the fluids that they're just
in the habit of consuming donot actually hydrate you.
In fact, a lot of themdehydrate you.
As far as what?
Specifically caffeine you knowcaffeinated fluids is a big one.
And then you know a lot of thesesodas and other types of drinks
.
Even if they don't havecaffeine, they're kind of a wash
(11:26):
.
They don't necessarily hydrateyou, even if they don't
necessarily dehydrate you, butcaffeine definitely acts like a
diuretic.
You know people think like,well, I'm peeing more, that
means I must be really wellhydrated.
But really it's, it's fluidsnot going into your body the way
it should.
It's just coming on out.
Um, you know, so you get peoplethat drink coffee in the morning
and then they have a diet Cokewith lunch and then they have a,
(11:48):
you know a Red Bull to get themthrough the afternoon, and then
they think they're drinking alot of water, but then they look
back and they're like, huh, youknow, I, I really, you know I
still have that same Stanleythat's.
They've been there all day andyou know it's only been.
You know, one third of it'sgone.
So so that's that, you know.
Number one my patients alwaysask if it's their first time.
(12:08):
Stone, you know, I, I harp on.
You know, cut back on stuffthat dehydrates you, or if you
really really want that dietcoke, you got to just realize,
okay, I got to drink even morewater to kind of counteract the
effects of it.
Um, and then you know it's.
You know other just generalhealth things, trying to eat
relatively clean and avoidthings that are high in sodium.
(12:29):
A lot of people hear stones aremade of calcium so they think
they got to cut back on milk andcheese, but that's actually
hasn't really been proven tohave that it's more sodium.
So that's more processed food,packaged food.
Speaker 1 (12:42):
Salt and crap.
Yeah, it adds up.
Speaker 2 (12:43):
Sometimes I feel hypocritical, you know, because
I could do better.
Speaker 1 (12:47):
Yeah, so I feel like I'm beating a dead horse with
this prostate, right, but pornis big right.
Do you have to deal with a lotof that where you know you're
seeing that porn specifically ishaving an impact on men in
general as far as with theirprostate and things along those
lines?
Speaker 2 (13:02):
That was an interesting transition.
Speaker 1 (13:03):
Yeah, I know, set you up the prostate to the porn.
Set you up Just the classicprostate porn transition.
Speaker 2 (13:10):
Well, that's interesting.
You say that I think it canhave.
Well, I mean, listen, I'm areligious guy.
I think it can have a lot ofeffects emotionally and with
relationships and stuff likethat.
But it can have some physicaleffects as well, you know, as
far as performance, as far aserectile dysfunction.
(13:31):
You know it's, it's interesting.
So I had this patient that camein not too long ago and I don't
know it's, it's, I don't knowif it's said from the note from
the primary care doctor or if itwas just on the chief complaint
, but it was, you know,something to the effect of like
(13:52):
difficulty ejaculating or nothaving much ejaculation come out
.
And I was with my partner,craig Hunter, who's another
urologist, good friend of mine,that we share a clinic together,
and you know I'm like man, whatdo you do with these guys?
Because it's not like I cangive them like a medication.
Speaker 1 (14:12):
Sure yeah.
Speaker 2 (14:13):
There's not a procedure and so he's like well,
I ask him, you knowate, andthat's maybe more correlated
with porn than the prostate.
So I'm making that connection.
Speaker 1 (14:28):
And that's what I was getting at too, for sure.
Speaker 2 (14:35):
Maybe not even masturbating.
If they ejaculate or masturbatemultiple times a month,
multiple times a week ormultiple times a day, it's a big
difference.
Yeah, and he's like I canguarantee it's multiple times a
day.
And so I asked.
I worded it the exact same waythat he did and sure enough, the
(14:56):
guy's like multiple times a day.
Speaker 1 (14:59):
And he had prostate cancer.
No or no, no, no, okay, thiswas this was, was was just the
ejaculator yeah, yeah, like painwith the ejaculation.
Speaker 2 (15:06):
He's a young guy, sometimes he's having difficulty
with erections or difficultwith ejaculations, and so, um, I
don't know if this is the rightway to say, but maybe, but
maybe there is too much of a youknow, a good thing sometimes
you know, so you know.
And then another thing withpornography is I think it can
(15:28):
have an effect on erectiledysfunction.
I'm not a sexual therapist butsometimes, you know, the
patients treat us like we are.
So they, you know, sometimesopen up to us even more than
we're trying to get them to.
But, but you know a lot ofpatients, especially if they're
younger.
So so I think this, this isright in line with what you're
(15:48):
saying.
I mean, I'm not having a lot of70, 80 year olds, I think, that
are dealing with this, but whenI have a, a 30 year old, even a
40 year old, that's talkingabout erectile dysfunction.
That's ridiculous.
Or you know, some of these likeejaculatory stuff, I I, if I
can get them to be honest withme, you know, one thing I ask
(16:09):
them like is, if you were notwith your partner, you know, so
say they're married.
You know a lot of these peopleare married Are you able to get
an erection?
And then, if you are with yourpartner, you're having
difficulty.
And a lot of times they'll say,yeah, I mean it's, it's
difficulty with their partnersand I think it's because their
mind is so stimulated with thispornography and you know kind of
(16:34):
what their expectations are orwhatever it is that all of a
sudden, when they're, you know,with a partner, you know,
especially if they're in arelationship, they have a hard
time and that can be verydebilitating.
So they just want, like Viagraand stuff like that but that's
just definitely throwing abandaid at it.
So I think it is definitely a anepidemic.
Speaker 1 (16:54):
I guess you could say yeah, cause everything's at our
fingertips.
That's the thing that's socrazy, man, it's way too easy.
Yeah, it's crazy.
Like I know you have girls also, like I mean, my wife and I we
have two boys and we block themfrom their phones during the
week and they are able to startjust to get a break.
But I feel like, as adults, weprobably need to get blocked
from our phones you know, duringthe week it's magazines or the
(17:20):
slow dial up internet.
Speaker 2 (17:21):
Yeah, it's everything , anything you want.
It's way too easy.
Yeah, I'm.
I'm glad I'm not a kid rightnow.
That's some of the temptationsand stuff that they have to deal
with.
It's it's tough, but yeah, Imean I think uh, definitely a
lot of these habits, whateveryou want to call them addictions
, they can definitely start at ayoung age.
So I think you know, having manwe're, we're kind of going deep
here, but having thatrelationship with your kids,
(17:44):
that you can talk to them andlet them know that you love them
and that's why you're notletting them have access to some
of these things, because youknow you start those habits
young and you know you see it alot.
And relationships.
You know newlyweds and you knowthey have problems, you know,
and so yeah, it's.
I think, along with the urologyissues involved, it can.
(18:08):
It can definitely have a lot ofrepercussions for sure.
Speaker 1 (18:11):
Do you find any diet that can help you with any of
these things that you knowrectal dysfunction, prostate,
things like that?
Anything that you've seenthat's been helpful for me.
Speaker 2 (18:20):
Yeah, yeah, I mean there's there is some data on
that and again kind of similarto the kidney stones.
You know eating clean can canhelp.
You know there are certain kindof supplements or foods that
can help with maybe helping withyour natural testosterone and
kind of blood flow and stufflike that.
(18:41):
I mean diet and exercise ishuge.
I mean, just like you hearabout people who you know oh man
, I lost 40 pounds and I got offmy diabetes medications or I
got off my blood pressuremedications.
You know, people don't realizeit can have an effect on your GI
system.
You know how regular are therecan definitely have an effect on
your urinary system.
You know people don't realizeit can have an effect on your gi
system.
You know how regular are therecan definitely have an effect on
(19:02):
your urinary system.
You know urinary symptoms,erections, all that stuff, um,
you know, just having a good,healthy diet, exercising, you
know, avoiding obesity, avoidingdiabetes uh, diabetes can, can
wreak a lot of havoc with men'shealth.
Erectile dysfunction, kind ofjust urinary complaints, it can
(19:28):
definitely have an effect, it'scrazy how it's all connected.
Yeah.
Speaker 1 (19:30):
Especially stress.
I mean you overweight stressand everything kick you behind.
Speaker 2 (19:35):
Yeah, that's another thing that's crazy.
Emotional stress can have aneffect on stress.
Yeah, that's another thingthat's crazy.
Emotional stress can have aneffect on.
I mean, a lot of people, Ithink have have had that
sensation when um they're reallyanxious about something and you
kind of get that like somethingin the stomach, but you just,
you know you lose your appetiteand stuff like that.
I mean that's kind of crazy.
If you think about it like whatyou know, what does the what
(19:57):
does your gut have to do withyou being, you know, anxious to
go on a podcast or whatever?
you know, my gut felt fine, youmay just go set me up but uh,
but it can also have an effecton on urinary stuff as well, you
know.
I mean, there's actually acouple actual uh urinary
syndromes where people can havereally painful, you know,
(20:19):
bladder or pelvis area kind ofsymptoms, and it's crazy it can
have a direct correlation withactual distress.
Speaker 1 (20:27):
That's wild.
The human body is the mostamazing thing in the world.
Speaker 2 (20:31):
It's all intertwined, you know.
Speaker 1 (20:33):
That's amazing, andrew Schultz.
I don't know if you know aboutAndrew Schultz.
He just had a Netflix specialand he was talking about
infertility, which I thought wasreally interesting that he was
open about.
And you you would think youknow, men, we always blame it on
the women, but a lot of thetimes it's it could be the men,
right?
Do you have that?
That you have to treat a lot ofmen with infertility challenges
(20:53):
?
Yeah, I think, I think I didn'trealize how you know it's, it's
common I didn't realize.
Speaker 2 (20:58):
It definitely is underdiagnosed.
Okay, I agree with you.
Speaker 1 (21:01):
A lot of people just always assume it's it's the
female, and I think and just tocut you off in one second, the
reason why brit brought upandrew schultz was because he's
popular, right.
So he's, he, he's.
He's bringing attention onsomething that I don't think is
discussed enough and it caughtmy attention.
I'm like, wow, okay, I didn'teven, I didn't't even think that
infertility for men was a bigthing.
So that's the reason why I wasasking you about it.
Speaker 2 (21:22):
Yeah, for sure.
I mean, I don't remember theexact data, but I think about
one third of the time you knowif a couple's having infertility
problems.
It's a male issue, which I mean.
That's significant you know,because I think a lot of people
assume it's probably much lessthan that.
Yes, yeah.
So I mean I think it'simportant if you're dealing with
(21:45):
infertility.
I mean these quote unquoteinfertility specialists that do
IVF.
In general, they are under theumbrella of like OBGYN.
Like they do an OBGYN residency.
So, backtracking, this isprobably a review for most
people.
But you know, you get yourundergraduate degree and then
you decide to go to medicalschool, you know, and then it's
(22:05):
during your medical school thatyou decide on what specialty to
do, and then you have to do aresidency in that specialty, um,
so urology is a specialty thatyou do a residency, and OBGYN is
a different one, um, and thenyou can even go beyond your
regular residency training, dofellowship training and you know
specific fields within thatspecialty.
(22:27):
So most of these infertilitydoctors went through an OBGYN
residency and then did afellowship in infertility, and
so they spent their whole careerdealing with females, and so
even when you go see them, a lotof times their focus is on the
females and and and so, um, youknow they're doing all these
tests and some of them are kindof like somewhat invasive tests
(22:51):
when, um, I think sometimes the,the men, are just kind of
waiting and blaming it on theirwives.
Yeah, they should get testedtoo, and and I don't mean to say
that there are actually somereally good infertility doctors
in town that do actually testthe men, or at least encourage
them to get tested as well.
But yeah, they probably shouldbe tested more For sure.
Speaker 1 (23:13):
Yeah, technology is getting amazing.
I can't even imagine wherewe're going to be 10 or even
five years from now, man.
So I heard you talk about likerobotics right, like you're
using a robot when you're doingyour surgeries, correct?
Speaker 2 (23:26):
Yeah, I mean, it depends on the surgery.
Speaker 1 (23:28):
So how does that work ?
Is it you're doing?
Does the robot doing everything?
And you're typing it like how,what does that look like?
Speaker 2 (23:34):
And I'm probably asking a dumb question I wish
and you know it's great.
It's a great question because Iwe throw this term robotic
surgery around a lot of timesand I sometimes have to like I
think it's like an AI.
I got to tell the patients likelisten, sometimes I don't love
that name because you thinkrobotic surgery, you think it's
doing the surgery and you knowI'm taking a coffee break.
But yeah, just on the subjectof technology, by the way, shout
(24:00):
out to urology.
I feel like urology in the last20, 30 years.
The advancements it's made iscrazy the stuff that we can do
minimally invasive.
What's crazy is imagine, like100 years ago, if you had a
kidney stone that was obstructedin your ureter, severe pain,
(24:21):
like they don't have ways to doa CT scan to diagnose it, you
know they you know if someoneneeded to get their stone
treated.
I mean you have to, like I do anopen surgery.
You'd have to, like make anincision in their abdomen, go in
there, figure out what's goingon, like make a hole in your
ureter.
You know, pull out the stone,Like it's.
I mean that's a crazy bigsurgery.
(24:42):
And you know, as Daryl or yourwife can say, I mean usually
these ureteral stones, theyprobably take me what?
20 minutes.
Speaker 1 (24:48):
Oh wow, In and out I go in with a scope.
Speaker 2 (24:50):
I use a laser, break it up, remove it.
You know outpatient surgery.
And they're done the same day.
After a couple days they're backto doing whatever they want to
do.
So you know we call itminimally invasive surgery, the
things that we can do asurologists and a lot of other
fields.
It's amazing as well, but yeah,so to get back to your question
, robotic surgery is a type oflaparoscopic surgery.
(25:13):
So you know a lot of peoplehave heard that term and you
know they always either they'vehad or know someone that's had
their appendix or theirgallbladder removed out and they
know it's through a few smallincisions and so traditional, we
call it laparoscopy,laparoscopic surgery.
(25:33):
You have these few littlekeyhole ports and you can put
instruments in it.
One of them is going to be thecamera and traditionally it's
usually an assistant that'sholding the camera and then you
have two arms and all you can do.
They're like, you know, eitherscissors or graspers or
something at the end, and allyou can do is open and close
them and kind of move them upand down like this, um, and that
still works, uh, if you'reworking in a space that doesn't
(25:55):
require a lot of intricatesuturing or it's not some weird
tight space.
But robotic surgery really tookoff with urology because some of
the cancers we deal with it'sright up that wheelhouse, for
instance, prostate cancer, soalmost the standard of care.
Now you might find anoccasional old school urologist,
(26:18):
like my partner, joe Candela,that does it open, but in
general you do it robotic andit's.
It's really nice in theprostate cause.
That's deep in the pelvis.
You know your pelvis is this.
We're seeing anatomy charts,this big bony structure and it's
deep in it.
If you do traditionallaparoscopic surgery you're
actually just clinging on thosebones.
You can't.
You can't do it, you don't havemuch movement.
(26:40):
But it allows you work in atight space and it has joints,
and so I'm actually in a console.
It's almost like playing avideo game.
I tell people sometimes likeI'm in scrubs.
Speaker 1 (26:50):
You talk to crystals.
There's crystals here, yeah.
Speaker 2 (26:52):
Well, I mean this new generation of kids.
You know they're used tolooking at a screen and doing
stuff.
It's hard actually for peoplethat didn't grow up with video
games and TVs and stuff as muchto pick up on it, cause they're
not used to looking at a screenand being able to to like
conceptualize that they'reworking on it.
But I have this console thatallows me to see what's in the
(27:13):
body with the camera, like 3d,and then I actually have, you
know, the ability to have a fewdifferent arms so I can retract
with one and I and I'm doing itthe same motion like I'm using
my hands.
So if I'm in the pelvis and I'msewing something, I'm doing
like this, but I'm using thejoints on this instrument and
you know I can retract with onearm and then I can.
(27:34):
I have gear like clutches so Ican move my camera around, I can
clutch to this arm and then ifI need to adjust my retraction I
can clutch back to this arm.
And then I do a lot of kidneysurgeries, for kidney cancer as
well.
One of them is a partialnephrectomy.
Nephrectomy means removal of akidney.
Partial means you're notremoving the whole kidney,
you're just removing the tumorand there's a lot of sewing.
(27:56):
As you can imagine.
If you're putting a hole in thekidney you got to do a lot of
sewing to sew it back up and sewit well.
And if you were to dotraditional laparoscopic surgery
, like kudos to the guys thatcould sew well with it but it
was cumbersome as heck Like tojust be able to, like you know,
do this and and, but here, likeI'm able to do all this sewing
(28:18):
and it's, it's, it's, it's cooltechnology.
And now you see it, like youknow, urology really is the
first field that really took offwith it.
And then gynecologists becausethey're the same thing with the
pelvis, doing likehysterectomies, but now I mean,
they're doing brain surgery.
Orthopedics are using it Likeit's just because of how
(28:38):
delicate and fine the movementsare.
It's really taken off.
Speaker 1 (28:41):
That's amazing as far as you know.
Just advice, right in general,just business advice and even
education advice.
Maybe they want to do aninternship is one way to be able
to do it.
That's something I did at TuftsMedical in Boston is took a
three-year internship to reallysee if I wanted to get in
medical.
But what would you recommendfor somebody that maybe they
want to get into the field,because's a side of of being in
medicine where it's a businesstoo right If you have a small
(29:04):
practice and things along thoselines.
But what would you recommend tothem as far as business or
school?
Speaker 2 (29:09):
I definitely think exposure is good.
Speaker 1 (29:10):
I mean, it sounds like you were interested in it
and maybe the exposure kind ofshowed you that, yeah, you know,
maybe this isn't for me, youknow, and that's good that you
figured that out early.
Speaker 2 (29:20):
So I think exposure and you know, so we use the term
shadowing, or you know for me,uh, so I, I did not come from a
medical family.
I was not exposed to it much.
It wasn't until I met and fellin love with my beautiful wife.
Shout out, casey, um, that she,she, has a medical family, okay
(29:40):
, um, and she was a nurse, soshe was actually my sugar mama
for many years.
Speaker 1 (29:44):
There you go.
It's not like me.
Speaker 2 (29:47):
Undergrad and medical school and stuff.
She's, you know, an RN and herdad was a family practice doctor
.
You know her sister's an RN,Another one is occupational
therapist.
Her brothers at that time.
One was like a surgical salesrep, One was a pharmacy rep, so
(30:08):
they're all doing somethingmedical, where my family is like
just a bunch of teachers.
But I was interested by it andkind of started down that
pathway and her dad was a goodmentor because you know he's a
doctor and I had a lot offriends whose dads were doctors
so I kind of talked to them.
(30:28):
But I think what you said ishuge, getting some exposure with
it.
So when I first startedthinking about it, I actually
got a job and this is while Iwas an undergrad at BYU as a
pediatric CNA, a home healthaide, oh wow.
So I went around and worked withthese kids that had like
muscular dystrophy and cerebralpalsy, and I wasn't even doing
(30:53):
like hardcore medical stuff.
I was like getting them readyfor school and like putting them
in their wheelchair, but justbeing around patients, being
around families, learning aboutthe diseases, getting the
satisfaction of helping them.
And, as I told you before I, Iwent to medical school thinking
I wanted to be a pediatricianbecause of that, you know, and
obviously I changed my mindalong the way, but at least I'd
(31:14):
kind of been around health care.
I even worked in like a nursinghome for a while my wife was
like my boss.
She was the nurse and I was thelowly you know CNA.
She was tough, she ordered mearound but just to have that
exposure, but yeah, it's a toughroad, it is Very much so
(31:38):
realized how big of a road itwas.
Like if I had to go back andstart over, I'm like I don't
know if I could do this again.
You know, luckily I was kind ofnaive, you know, um, but uh, I
uh, you know, I served a churchmission in Taiwan so I learned
Mandarin Chinese.
So I came back from my missionthinking like maybe I'll do
something with business, took,you know, business classes
(32:02):
economy many I guess you couldsay I'm fluent.
I mean that was also 20, 25years ago so it's, it's choppy.
Now I kind of have to be leadingthe conversation, but you know
that's amazing.
Um, but uh, um, and, and youknow what, actually those
classes came relatively easy.
I was doing well and I wasgetting a's, and then um, but I,
(32:22):
just for me, whatever, whatever, I wasn't feeling stimulated or
satisfied by it and I I waskind of guided into to try and
medicine.
So then I started taking thepre-med classes.
I was humbling.
Those were not easy, you know,and and some of them they make
them tough.
I mean, they're trying to toweed you out, you know.
And uh, um, all of a sudden youknow it's cutthroat and, like
(32:46):
you know, the, the average inthe class is a B minus.
No one wants to like.
Speaker 1 (32:49):
Oh wow.
So you know, like it was justtough and you know, but
persevered.
Speaker 2 (32:55):
But every step of it's tough I mean it's
competitive to get into medschool so you got to really want
it, you know, be dedicated and,um, I was really blessed to be
able to get in probably my firstchoice, which was university of
Utah, which, even though I'mnot a Ute fan, you know it was
in state and it was close by andit was a great program, um and
uh and you know, but that wasstressful.
(33:18):
You know, I had a lot of thatgut discomfort that we're
talking about as I was goingthrough that process.
Yeah, um, you know.
And then, uh, yeah, medicalschool is a grind.
But, man, once you get into medschool it's a little different.
You're kind of you're, you knowyou're going to be a doctor
there.
It's kind of like you put a lotof time down competitive and a
(33:43):
lot of people won't know this,but urology is actually a really
competitive field.
You know, it's a surgery field.
It's got a better lifestyle,things like that, and so I had
to like do well on my tests andI had to go.
You just got to put yourselfout there yeah, I mean, you,
just I mean it's kind of likethat.
I mean, if you want to be a, anathlete, you got to be putting
in more time than the personnext to you.
And that's kind of how I felt.
I'm like, you know, I wasn'tthe smartest person in my class,
(34:05):
you know.
So I'm like I'm going to go dosome away rotations.
I went to these programs inTexas and Illinois and I'm like
I'm going to get there beforeeverybody else.
I'm going to, you know,whatever, and I'm just going to
like, treat everything like it'sa job interview and you know,
get letters from thesedepartment chairs.
And you know, I wasn't sure Iwas going to get into BYU, but I
(34:26):
grinded, I did.
I wasn't sure I was going toget into medical school, but I
grinded, I did.
I definitely was, you know,never comfortable that I was
going to, for sure, get aurology residency, but yeah, it
worked out for me.
But you definitely you got tobe committed.
But yeah, get that exposure andyou know, but it helps if
you're smart and a good testtaker, but you know, you can.
(34:48):
You know, just kind of like yousee these athletes that you
know they might not be asnatural but they can grind.
I feel like I was a grinder andgot into ohio state, the ohio
state university, and that'swhere I did my residency and it
happened to be kind of a roboticsurgery mecca.
So we did a lot of Ohio.
State, yeah, okay and so, yeah,some of the most high volume big
(35:09):
names, uh, you know, werefaculty there at a in robotic
surgery there, awesome, um andso things.
Yeah, things worked out for me,but yeah, that was kind of a
long answer yeah, but I get itthough.
Speaker 1 (35:20):
Yeah, but if you want it you know I'd encourage.
Speaker 2 (35:22):
I mean, it's great to have a career that is
stimulating.
It's tough, you know, I was oncall, you know, this last
weekend and, um, I had to go doa couple surgeries at UMC in the
middle of the night, uh, sundaynight, and so I didn't wait.
I was awake at 1am and then Ihad to go straight to clinic and
(35:44):
I was all day in clinic andyeah.
So I mean, you know, and this isone of the easier surgery
fields as far as, uh, you know,call and lifestyle schedule.
So you know it's definitely noteasy but it's nice to to have a
career where you feel likeyou're hopefully helping people
and, you know, still gettingcompensated, okay, and you know
and um, but yeah, that's awesome, man, you just got to like.
Speaker 1 (36:05):
You Keep it going.
Speaker 2 (36:06):
I can tell you're a grinder, you know.
Speaker 1 (36:08):
You have to be man.
You're one of the mostsuccessful podcasts in Las Vegas
.
Speaker 2 (36:11):
Thank you, and I'm sure it's, because a lot of
times you outwork the otherpeople.
It's consistent.
Speaker 1 (36:16):
It doesn't help that you have that silky smooth voice
.
Oh, I appreciate it.
No, that's good man.
You brought up a lot of greatpoints, man.
As far as like, maybe if yourethought about it and
restructured your life, maybeyou wouldn't do it.
But the thing is, youpersevered and that's what I got
out of, that is, outworkingeverybody.
Speaker 2 (36:32):
I'm happy I did it.
Speaker 1 (36:33):
I'm just saying it's a long road, we are kind of
imagined.
Speaker 2 (36:37):
I mean, look at it this way Four years of undergrad
, four years of medical school,five years.
The residencies they change,they're usually anywhere from
three to five.
Some are even six years if youdo some research and stuff.
Speaker 1 (36:52):
Plus, I did a two-year church mission, so you
added on to that, so you're like15, 16 years.
Speaker 2 (36:57):
I was almost into my mid-30s before I was making
money.
That's why it's lucky I had asugar mama.
Like me and the nurse and youguys have four kids right, it's
a long road I had friends thatwere buying houses and doing all
these stuff and had theirbusinesses and I'm still racking
up debt.
That's amazing.
Speaker 1 (37:13):
We got four daughters .
I did want to ask you aboutjust a little bit of just one
question about family what is itlike being a girl dad, man,
because you have four girls,right.
What's your household likedealing with basically five,
including your wife?
Speaker 2 (37:25):
It's man.
I don't always understand thedrama.
I'll tell you that.
Speaker 1 (37:30):
Chris, if he was here , he'd be able to speak.
Speaker 2 (37:32):
He has three girls, so you know sometimes they'll
cry on the first day of school,They'll cry on the last day of
school.
Like I'm like I don't get it.
Yeah, you know sometimes what'stheir ages, they're all about
three years apart Right now.
I got one in elementary school,roxy, who's nine.
I got one in middle school, whojust got the principal award of
(37:53):
the year.
Congratulations.
Shout out Kate, and then she's13.
I got one that just turned 16.
Oh wow, nora.
She's at Palo Verde High SchoolMiss Extracurricular.
Everything just broke up withher boyfriend and realizing that
single life sometimes has moredrama than being in a
(38:13):
relationship.
And then my oldest, lucy.
She's 18 and she's actually incosmetology school up in Utah.
Speaker 1 (38:21):
We got them in all levels.
So you're busy life here.
You got a busy life for sure.
Speaker 2 (38:25):
Yeah, cute girls.
Though it's fun, I finally hadto go buy two male dogs just so
I had some Just to keep theenergy right.
So my wife went and got themcastrated, so I guess they're
kind of males, but yeah, that'shilarious.
Speaker 1 (38:38):
I got Snoop and Biggie.
That's hilarious.
Speaker 2 (38:40):
That's really their name Snoop and Biggie.
Speaker 1 (38:42):
Oh, that's hilarious.
Just changing the subject for alittle bit, man.
We always ask guests about food, man, so I'm a big foodie.
But what's your favoriterestaurant in Vegas?
Speaker 2 (38:52):
Ooh, my favorite restaurant in Vegas.
Maybe some recency buys, but Ireally like Lotus of Siam.
Speaker 1 (38:59):
Oh, we've had Penny on, so we know that we live
right close to Red Rock andthere's a lot of good
restaurants in there.
Speaker 2 (39:03):
We're spoiled.
We are Shout out to Lou, we toRed Rock, and you know there's a
lot of good restaurants inthere.
Speaker 1 (39:06):
Man, we're spoiled we are shout out to Lou.
We know Lou and we know Penny.
Speaker 2 (39:10):
That's crazy, yeah but um, uh, the Aria does a good
.
I like probably two.
Two of my top five is Javier'sthe.
Speaker 1 (39:20):
Mexican restaurant.
We were just there.
Yeah, actually us and Chris andhis wife.
Speaker 2 (39:23):
We always go to Newport every year, so we always
go to the, the one there too.
And then uh, din Taiung, whichis actually from Taiwanese food.
So it's a Taiwanese—if youhaven't been to.
Speaker 1 (39:33):
Din Tai Fung— I don't think we've been there before.
Speaker 2 (39:35):
Oh Okay, I was going to say I haven't been there
before.
Oh, it's actually, I think,originally based in Taipei,
taiwan.
Okay, and it does—it's probablyof Taiwanese tasting places,
but it's kind of weird.
You wouldn't think like arestaurant that just specializes
in dumplings would be that good, but it's good stuff.
It's great for like familystyle dining they just bring out
all these different types ofdumplings and stuff.
(39:56):
We always like trying differentrestaurants.
Speaker 1 (39:58):
So if you haven't been there, I strongly recommend
it.
So you mentioned Lotus of SiamJavier's and Dim Tai Fung Yep
Javier's and Dim Ty Fung Yep.
Okay, Excellent man.
What would you want to leave usout on?
Any question I forgot to askyou that you want to leave us
out on?
I know we went on a wild goosechase with different rabbit
holes.
Speaker 2 (40:13):
Yeah, I'm just trying to think of men's health.
I mean, a lot of people areinterested in low testosterone.
You know, we didn't really jumpinto that Touch on that.
Yeah, I, I will say this.
This is, this will be my.
My one piece of advice withtestosterone is I think a lot of
people like the idea of beingon testosterone and wanting to
(40:36):
have more testosterone, but myadvice is you know, do whatever
you can, naturally, you know,eat right, exercise, um, you
know, and you know you know,there's natural ways, you know,
to boost your testosterone.
I've seen a lot of people thatfor, however, they're able to
(40:56):
get their hands on actualprescriptions for testosterone
and the thing they don't realizeis, after a while, if you're
taking testosterone, your ownfactory is shut down.
They're saying, well, I don'tneed to make it, I'm getting it
so kind of like a lot of musclesor whatever, if you're not
using it, they're going toatrophy your factories that
(41:16):
produce testosterone.
they're not going to work aswell.
So you get these guys in their20s and 30s that just want to
bulk up for the ladies a littlebit.
I don't know if they'reconvincing some new male medical
clinic or something, or Tijuana, I don't know but they're
getting their testosterone andit can have lasting
repercussions.
For one thing, you'reessentially committing to it.
(41:40):
If you're on it for long enoughbecause you try to get off of
it, your numbers are going toget really low and you're really
going to have symptoms when atthe end of the day, they
probably never.
Well, I shouldn't say probably.
They didn't need it to beginwith, but it can cause problems
with infertility and otherthings.
So I guess it's just a warninglike, hey, some people need it,
Some people benefit it, but ifyou're getting it, make sure
(42:01):
you're getting it appropriately,Make sure you're trying
everything natural first.
Uh, you know, before you kindof commit down that pathway, you
only got one body man yeah forsure.
Speaker 1 (42:13):
Well, it's a pleasure to sit down with you, man, and
learn just some of theperspectives and how your mind
works.
Man Urology I didn't realizehow many pieces to urology.
It's massive.
Speaker 2 (42:23):
It's a good field.
Yeah, I'm happy.
Speaker 1 (42:28):
I'm going to have to talk my older son into that
because he's big video game andprobably be able to be an
excellent urologist with robotsand everything.
So, um, what's, what's yoursocial handles if people can
reach out to you on there or beable to check you out?
Speaker 2 (42:36):
I think it's dr dave loves golf okay, is it really
okay?
You're a golfer, okay, wellactually I think that's tiktok
my daughter, my, my 13 year oldmanages my, manages my TikTok
account.
I love golf, oh good stuff shegoes with me on a golf trip
doing something Awesome.
But yeah, I think it's EzioLudlow.
So my last name L-U-D-L-O-W.
My high school nickname wasEzio Ludlow.
(42:58):
So, Ezio Ludlow is, I think,instagram Okay and yeah, happy
to have people reach out.
I've had patients somehow reachout to me, sometimes through
social media.
Speaker 1 (43:08):
They probably see you more.
You'd be surprised how manypeople can connect with you on
social media.
It's amazing.
Speaker 2 (43:15):
Yeah, but we're Las Vegas Urology and, yeah, we have
a clinic, just me and my goodfriend Craig Hunter, and we have
nurse practitioner JonathanHigginson and we're just over
there by Mountain View Hospital.
Speaker 1 (43:26):
Awesome.
Yeah Well, absolute pleasure tosit down with you, dr Lolo.
It's a pleasure, learned a lotand check us out at
thevegasurgerycom.
Speaker 2 (43:34):
So appreciate your time, man.
That was great.
Yeah, no thanks for having me.
Welcome to Vegas Circle Podcast with your hosts,
paki and Chris.
We are people who arepassionate about business,
success and culture, and this isour platform to showcase to
people in our city who make ithappen.
On today's podcast, we'll bediscussing all things men's
health, from prostate checks tokidney stones.
We're going to talk the wholenine man about men's health, man
.
So I'm kind of nervous aboutthis interview.
I feel like I'm talking to myprimary care doctor, so, but
(00:22):
let's welcome to the circle,urologist Dr David Ludlow.
Welcome to the circle, my man.
Thank you, yeah, thanks, forhaving me.
So let's jump right in.
Man.
So what made you jump into theworld of urology?
Speaker 2 (00:37):
Great question.
I don't think most kids grow updreaming of becoming a
urologist.
Most kids don't even know whatit is Initially.
Obviously you decide to be adoctor and I think a lot of
people kind of make theirdecision when they get exposed
to different things at medicalschool.
I actually went to medicalschool thinking I wanted to be a
pediatrician.
So if you look at my waitingroom now, I went with a very
different demographic eventuallyyeah, 1,000%.
Yeah, for me, I decided prettyearly on.
(00:58):
I was kind of an athlete inhigh school and whatnot and so I
just liked kind of thatintensity and using my hands and
so I decided pretty early on Iliked surgery.
So then it was kind of a matterof you know, urology a lot of
people don't understand isactually kind of under the
umbrella of surgery, and so youkind of just get exposed to
(01:18):
different things and talk to abunch of different mentors.
And one thing I wanted is Istill like the idea of
practicing medicine and kind ofdiagnosing and having you know
long time patients, but I alsolike to do the procedures and
the surgeries and have areasonable lifestyle.
You know I have a family andhobbies and so a lot of people
said you should try urology, orENT was another one that I heard
(01:42):
that kind of had you know,check those boxes.
So I actually just did you knowrotations and both of them and
I had no idea Urologist did allthe cool stuff they did.
I mean robotic surgery, just alot of gadgets and toys, scopes,
lasers and and I don't knownothing against the ENTs.
I got some good ENT friends butthere's a lot of picking, a lot
of, just like you know, littlemicroscopes and using your
(02:05):
fingers and I don't know.
I just liked, I just liked thesurgeries and and also like the
urologist, I mean they're yourkind of cohorts and you know
they're smart, they're hardworkers, but they're also not
(02:26):
too high on their you know highhorse, you know know, got to be
a little self-deprecating whenyou, you know, dedicate your
life to the urinary tract.
So they're just kind of cooldown to earth, guys.
Speaker 1 (02:31):
Yeah so you do a wide variety of surgeries right?
Can you kind of give like thewhole menu of services or the
primary?
Yeah, so it's a good mix, Imean because we do a lot of
clinic stuff.
Speaker 2 (02:41):
You know, obviously people that have you know all
sorts what you think of urologyproblems or men's health, you
know would come see us and someof the stuff we can manage with
medications and stuff that we doin clinic and then a lot needs
surgery.
So we kind of my, my time issplit kind of half and half
between the operating room andclinic.
So essentially we do all thesurgeries for the urinary tract.
(03:01):
That's male and female, so wehave a lot of female patients.
You know females.
Speaker 1 (03:04):
I didn't know that when we were talking on the
phone I didn't realize females,yeah, so females get kidney
stones females.
Speaker 2 (03:09):
I do a lot of cancer cause I do a lot of robotic
surgery, so do a lot of kidneycancer and you know we do
bladder cancer, obviously underthe umbrella of urology.
Is is the male kind of sexualorgans, you know.
Test is the male kind of sexualorgans, you know testicles and
(03:32):
prostates and things like that,whereas females have
gynecologists.
Speaker 1 (03:34):
So overall, you know there's more males than females,
but definitely see a lot offemales too.
Sure, I'm 45, right?
So when should men startgetting their prostate exam?
Because I hear a wide range of.
I hear you know 40, 45, I'veheard you know later in age now,
but what, from from yourexpertise, what would you say?
Speaker 2 (03:46):
that, yeah, you actually look at different
guidelines and you'll see.
But what you said is kind of inthe in the ballpark.
Okay, I tell most people 50years old there there are maybe
a couple exceptions.
There is a higher risk inAfrican American males and so
you know, if you are gettingroutine labs, what I tell.
(04:07):
And another risk factor isfamily history.
So if you have some of thoserisk factors I don't think it
hurts.
If you're getting labs anywaywith a doctor sometime in your
mid to late forties to just say,hey, throw a PSA on there.
You know that's the.
It's called a PSA which standsfor prostate specific antigen.
It's a screening lab.
And I tell them, hey, if youget a check to 45 and it's
(04:30):
really low, then don't worryabout it and then just start
getting kind of annual screeningwhen you're 50.
But if you don't have any realrisk factors, I think 50 is a
good time to start.
This is probably a stupidquestion.
Why are so many prostate cancercases?
It's essentially the mostcommon cancer in men.
That's a good question.
I mean there's a lot ofresearch going on.
(04:53):
Obviously, with age it's agingmen.
Studies on men in like their80s, like 50% would have some
prostate cancer cells.
Now, obviously the goodmajority of them aren't dying of
prostate cancer.
So that's one of the balancingaxes.
You know we're not just lookingto diagnose prostate cancer.
(05:17):
We're looking to diagnoseclinically significant prostate
cancer that would maybe actuallycause that person problems.
That's why, if you looked atthe screening guidelines, you
also don't see them talkingabout screening people in their
80s, because it's kind of aweird way to look at it.
They got competing factors, theygot other issues going on at
that point.
But yeah, I mean, as far ascauses, I mean I mentioned the
(05:39):
risk factors withAfrican-Americans.
One thing that's interestingabout that is if you look at
Africans, like in Africa, theyactually have a relatively low
risk of prostate cancer.
Speaker 1 (05:49):
Is that the diet?
Speaker 2 (05:51):
But African-Americans ?
We don't know.
But that's what I think.
I think it's the Western dietall the processed food.
I mean, look at the food and allthe ingredients.
I mean it's so hard to study.
You know, like all thesedifferent words, that you can't
even pronounce when you look atthe ingredients.
But you know you got to assumethat over time some of them
might take its toll.
(06:11):
So it's definitely a hot areaof research.
Every once in a while they'llfind something that they think
has a link and then, as they domore data, they're like yeah,
maybe not, so it's still to bedetermined.
Speaker 1 (06:22):
Let's talk about vasectomies, right?
So I've got two kids up laterin age.
I'm scared.
Is it that crazy?
Speaker 2 (06:30):
Well, I sometimes tell patients this I should
create a T-shirt that says thatwasn't as bad as I thought it
was going to be, and give it topeople after the vasectomies.
Speaker 1 (06:37):
Okay, okay.
Speaker 2 (06:39):
You know, that's usually what they say.
Now you know how guys are.
They like to milk things andthey're going to scare their
friends.
And then you get it done andthey're like yeah, I said I told
you it wasn't that bad, youknow.
But, um, now, why you shouldget it?
I mean, really, at the end ofthe day, it's it's probably, you
know, assuming you're marriedor in a relationship, it's if,
(07:05):
if obviously both of you havemade the decision you don't have
any more kids.
I mean it's, it's kind of anice thing to do for your wife.
I mean it's, you know, it's somuch less invasive than to get
your, you know, for the femalesto get their tubes tied.
That's like a legit surgeryanesthesia um, and you know plus
possible side effects from IUDsand and birth control pills.
Uh, you know, on the flip sideit's a 10 to 15 minute clinic
(07:28):
procedure.
Speaker 1 (07:29):
Is it that fast?
Yeah, so are you knocked outfor this surgery?
Not in general?
Speaker 2 (07:34):
Yeah, I mean you can be, you know, per request.
You know, in my clinic we havesomething called Pronox, which
is this kind of happy gas.
Did you say Pronuts?
Speaker 1 (07:44):
No, I was like.
I know he didn't say that Ishould market that.
Yeah, Jesus Christ, we couldmarket it together.
Pronox, pronox, okay.
Speaker 2 (07:51):
It just takes the edge off.
It doesn't put you to sleep,but it kind of relaxes you a
little bit.
And then we use lidocaine.
I kind of compare it to gettinga cavity filled of cavity
filled obviously very differentpart of your body, but I don't
know if you've had a cavityfilled but there's kind of that
like sting from the lidocaine.
You know that gets yourattention, but then after that
it's like, oh man, I don't evenreally feel anything.
(08:13):
That's, that's crazy.
It's the same idea.
You got to inject somelidocaine down there and that
can sting a little bit, but mostof the time after that I got, I
got some Pandora music in thebackground.
Give it a go, we're shooting thebreeze, and usually they're
like well, that's it, we're done.
And then you just got to takeit easy for a couple days
afterwards.
Speaker 1 (08:31):
Is there a lot of side effects from going?
Because, I'm going to be honest, You're scared in that area,
right where you think that, justbeing blunt, I mean you can't
get it up anymore period.
Does that happen?
Do get it up anymore.
Period has that happened?
Do you see a lot of thosepercentages of people once they
get the vasectomy?
Speaker 2 (08:46):
that.
Hey, they're gonna haveproblems down the road.
That's what I'm scared.
Side effects long term yeah,there is like really no chance
of getting erectile dysfunctionthat's what you're working at is
is so far away from the nervesthat deal with that.
Speaker 1 (09:02):
Okay, yeah, you know there's that's the horror
stories you hear all the time.
Speaker 2 (09:06):
And even though the testicle is responsible for
producing testosterone, it's notgoing to have any effect on
your testosterone.
Okay, to be honest, you know, Idon't know what kind of words
we can use on this podcast.
Speaker 1 (09:19):
You can use whatever you want.
You're ejaculate.
Yeah, there you go.
Speaker 2 (09:22):
That's probably not a word, that's brought up a lot
on your podcast Not at all.
You won't even really notice adrop-off in your ejaculation.
I mean a lot of people theyjust don't understand.
They think that nothing's goingto come out after you have a
vasectomy and really you won'teven notice a difference in the
sensation and the erections,except you just won't have any
sperm in it.
Speaker 1 (09:41):
That's clear.
Okay, as far as kidney stones,do you have to perform a lot of
surgeries on kidney stones, oris that something that just has
to pass?
Speaker 2 (09:48):
You can ask your wife .
She works with you, she's in theoperating room and I'd say,
from a volume standpoint, that'sthe most common surgery.
I mean, there's different typesof surgeries depending on the
size and location of the stone,but as as far as like percentage
of my my surgery cases, I'd sayI got, I, I got to assume it's
easily kidney stones.
Um, so, luckily, the mostpeople, the majority of people,
(10:12):
can pass their kidney stones.
But there's a lot of peoplethat can't.
You know, they don't want to,you know, so we preemptively
treat them.
So yeah, that's a a very commonsurgery.
We do.
Speaker 1 (10:23):
Is there anything we can do to make it better for
ourselves to not have theseproblems as far as kidney stones
?
Speaker 2 (10:28):
Absolutely.
I mean obviously it can bemultifactorial.
I mean there's some people thatcould do everything right and
there's some kind ofpredispositions they have, but
absolutely the diet has a hugeinfluence.
That's why I'm always going tobe in business.
Speaker 1 (10:43):
Absolutely the diet has a huge influence.
Speaker 2 (10:45):
That's why I'm always going to be in business.
I mean, it's, uh, it's energydrinks, it's processed foods,
it's, you know, if you do thingsthat increase your uric acid,
like a lot of, a lot of meat,especially red meat, you know
just essentially what, whatpeople are eating every day.
You know, and especially inVegas, uh, people, you know it's
a desert and so people getdehydrated, and what a lot of
(11:06):
people don't understand is a lotof the fluids that they're just
in the habit of consuming donot actually hydrate you.
In fact, a lot of themdehydrate you.
As far as what?
Specifically caffeine you knowcaffeinated fluids is a big one.
And then you know a lot of thesesodas and other types of drinks
.
Even if they don't havecaffeine, they're kind of a wash
(11:26):
.
They don't necessarily hydrateyou, even if they don't
necessarily dehydrate you, butcaffeine definitely acts like a
diuretic.
You know people think like,well, I'm peeing more, that
means I must be really wellhydrated.
But really it's, it's fluidsnot going into your body the way
it should.
It's just coming on out.
Um, you know, so you get peoplethat drink coffee in the morning
and then they have a diet Cokewith lunch and then they have a,
(11:48):
you know a Red Bull to get themthrough the afternoon, and then
they think they're drinking alot of water, but then they look
back and they're like, huh, youknow, I, I really, you know I
still have that same Stanleythat's.
They've been there all day andyou know it's only been.
You know, one third of it'sgone.
So so that's that, you know.
Number one my patients alwaysask if it's their first time.
(12:08):
Stone, you know, I, I harp on.
You know, cut back on stuffthat dehydrates you, or if you
really really want that dietcoke, you got to just realize,
okay, I got to drink even morewater to kind of counteract the
effects of it.
Um, and then you know it's.
You know other just generalhealth things, trying to eat
relatively clean and avoidthings that are high in sodium.
(12:29):
A lot of people hear stones aremade of calcium so they think
they got to cut back on milk andcheese, but that's actually
hasn't really been proven tohave that it's more sodium.
So that's more processed food,packaged food.
Speaker 1 (12:42):
Salt and crap.
Yeah, it adds up.
Speaker 2 (12:43):
Sometimes I feel hypocritical, you know, because
I could do better.
Speaker 1 (12:47):
Yeah, so I feel like I'm beating a dead horse with
this prostate, right, but pornis big right.
Do you have to deal with a lotof that where you know you're
seeing that porn specifically ishaving an impact on men in
general as far as with theirprostate and things along those
lines?
Speaker 2 (13:02):
That was an interesting transition.
Speaker 1 (13:03):
Yeah, I know, set you up the prostate to the porn.
Set you up Just the classicprostate porn transition.
Speaker 2 (13:10):
Well, that's interesting.
You say that I think it canhave.
Well, I mean, listen, I'm areligious guy.
I think it can have a lot ofeffects emotionally and with
relationships and stuff likethat.
But it can have some physicaleffects as well, you know, as
far as performance, as far aserectile dysfunction.
(13:31):
You know it's, it's interesting.
So I had this patient that camein not too long ago and I don't
know it's, it's, I don't knowif it's said from the note from
the primary care doctor or if itwas just on the chief complaint
, but it was, you know,something to the effect of like
(13:52):
difficulty ejaculating or nothaving much ejaculation come out
.
And I was with my partner,craig Hunter, who's another
urologist, good friend of mine,that we share a clinic together,
and you know I'm like man, whatdo you do with these guys?
Because it's not like I cangive them like a medication.
Speaker 1 (14:12):
Sure yeah.
Speaker 2 (14:13):
There's not a procedure and so he's like well,
I ask him, you knowate, andthat's maybe more correlated
with porn than the prostate.
So I'm making that connection.
Speaker 1 (14:28):
And that's what I was getting at too, for sure.
Speaker 2 (14:35):
Maybe not even masturbating.
If they ejaculate or masturbatemultiple times a month,
multiple times a week ormultiple times a day, it's a big
difference.
Yeah, and he's like I canguarantee it's multiple times a
day.
And so I asked.
I worded it the exact same waythat he did and sure enough, the
(14:56):
guy's like multiple times a day.
Speaker 1 (14:59):
And he had prostate cancer.
No or no, no, no, okay, thiswas this was, was was just the
ejaculator yeah, yeah, like painwith the ejaculation.
Speaker 2 (15:06):
He's a young guy, sometimes he's having difficulty
with erections or difficultwith ejaculations, and so, um, I
don't know if this is the rightway to say, but maybe, but
maybe there is too much of a youknow, a good thing sometimes
you know, so you know.
And then another thing withpornography is I think it can
(15:28):
have an effect on erectiledysfunction.
I'm not a sexual therapist butsometimes, you know, the
patients treat us like we are.
So they, you know, sometimesopen up to us even more than
we're trying to get them to.
But, but you know a lot ofpatients, especially if they're
younger.
So so I think this, this isright in line with what you're
(15:48):
saying.
I mean, I'm not having a lot of70, 80 year olds, I think, that
are dealing with this, but whenI have a, a 30 year old, even a
40 year old, that's talkingabout erectile dysfunction.
That's ridiculous.
Or you know, some of these likeejaculatory stuff, I I, if I
can get them to be honest withme, you know, one thing I ask
(16:09):
them like is, if you were notwith your partner, you know, so
say they're married.
You know a lot of these peopleare married Are you able to get
an erection?
And then, if you are with yourpartner, you're having
difficulty.
And a lot of times they'll say,yeah, I mean it's, it's
difficulty with their partnersand I think it's because their
mind is so stimulated with thispornography and you know kind of
(16:34):
what their expectations are orwhatever it is that all of a
sudden, when they're, you know,with a partner, you know,
especially if they're in arelationship, they have a hard
time and that can be verydebilitating.
So they just want, like Viagraand stuff like that but that's
just definitely throwing abandaid at it.
So I think it is definitely a anepidemic.
Speaker 1 (16:54):
I guess you could say yeah, cause everything's at our
fingertips.
That's the thing that's socrazy, man, it's way too easy.
Yeah, it's crazy.
Like I know you have girls also, like I mean, my wife and I we
have two boys and we block themfrom their phones during the
week and they are able to startjust to get a break.
But I feel like, as adults, weprobably need to get blocked
from our phones you know, duringthe week it's magazines or the
(17:20):
slow dial up internet.
Speaker 2 (17:21):
Yeah, it's everything , anything you want.
It's way too easy.
Yeah, I'm.
I'm glad I'm not a kid rightnow.
That's some of the temptationsand stuff that they have to deal
with.
It's it's tough, but yeah, Imean I think uh, definitely a
lot of these habits, whateveryou want to call them addictions
, they can definitely start at ayoung age.
So I think you know, having manwe're, we're kind of going deep
here, but having thatrelationship with your kids,
(17:44):
that you can talk to them andlet them know that you love them
and that's why you're notletting them have access to some
of these things, because youknow you start those habits
young and you know you see it alot.
And relationships.
You know newlyweds and you knowthey have problems, you know,
and so yeah, it's.
I think, along with the urologyissues involved, it can.
(18:08):
It can definitely have a lot ofrepercussions for sure.
Speaker 1 (18:11):
Do you find any diet that can help you with any of
these things that you knowrectal dysfunction, prostate,
things like that?
Anything that you've seenthat's been helpful for me.
Speaker 2 (18:20):
Yeah, yeah, I mean there's there is some data on
that and again kind of similarto the kidney stones.
You know eating clean can canhelp.
You know there are certain kindof supplements or foods that
can help with maybe helping withyour natural testosterone and
kind of blood flow and stufflike that.
(18:41):
I mean diet and exercise ishuge.
I mean, just like you hearabout people who you know oh man
, I lost 40 pounds and I got offmy diabetes medications or I
got off my blood pressuremedications.
You know, people don't realizeit can have an effect on your GI
system.
You know how regular are therecan definitely have an effect on
your urinary system.
You know people don't realizeit can have an effect on your gi
system.
You know how regular are therecan definitely have an effect on
(19:02):
your urinary system.
You know urinary symptoms,erections, all that stuff, um,
you know, just having a good,healthy diet, exercising, you
know, avoiding obesity, avoidingdiabetes uh, diabetes can, can
wreak a lot of havoc with men'shealth.
Erectile dysfunction, kind ofjust urinary complaints, it can
(19:28):
definitely have an effect, it'scrazy how it's all connected.
Yeah.
Speaker 1 (19:30):
Especially stress.
I mean you overweight stressand everything kick you behind.
Speaker 2 (19:35):
Yeah, that's another thing that's crazy.
Emotional stress can have aneffect on stress.
Yeah, that's another thingthat's crazy.
Emotional stress can have aneffect on.
I mean, a lot of people, Ithink have have had that
sensation when um they're reallyanxious about something and you
kind of get that like somethingin the stomach, but you just,
you know you lose your appetiteand stuff like that.
I mean that's kind of crazy.
If you think about it like whatyou know, what does the what
(19:57):
does your gut have to do withyou being, you know, anxious to
go on a podcast or whatever?
you know, my gut felt fine, youmay just go set me up but uh,
but it can also have an effecton on urinary stuff as well, you
know.
I mean, there's actually acouple actual uh urinary
syndromes where people can havereally painful, you know,
(20:19):
bladder or pelvis area kind ofsymptoms, and it's crazy it can
have a direct correlation withactual distress.
Speaker 1 (20:27):
That's wild.
The human body is the mostamazing thing in the world.
Speaker 2 (20:31):
It's all intertwined, you know.
Speaker 1 (20:33):
That's amazing, andrew Schultz.
I don't know if you know aboutAndrew Schultz.
He just had a Netflix specialand he was talking about
infertility, which I thought wasreally interesting that he was
open about.
And you you would think youknow, men, we always blame it on
the women, but a lot of thetimes it's it could be the men,
right?
Do you have that?
That you have to treat a lot ofmen with infertility challenges
(20:53):
?
Yeah, I think, I think I didn'trealize how you know it's, it's
common I didn't realize.
Speaker 2 (20:58):
It definitely is underdiagnosed.
Okay, I agree with you.
Speaker 1 (21:01):
A lot of people just always assume it's it's the
female, and I think and just tocut you off in one second, the
reason why brit brought upandrew schultz was because he's
popular, right.
So he's, he, he's.
He's bringing attention onsomething that I don't think is
discussed enough and it caughtmy attention.
I'm like, wow, okay, I didn'teven, I didn't't even think that
infertility for men was a bigthing.
So that's the reason why I wasasking you about it.
Speaker 2 (21:22):
Yeah, for sure.
I mean, I don't remember theexact data, but I think about
one third of the time you knowif a couple's having infertility
problems.
It's a male issue, which I mean.
That's significant you know,because I think a lot of people
assume it's probably much lessthan that.
Yes, yeah.
So I mean I think it'simportant if you're dealing with
(21:45):
infertility.
I mean these quote unquoteinfertility specialists that do
IVF.
In general, they are under theumbrella of like OBGYN.
Like they do an OBGYN residency.
So, backtracking, this isprobably a review for most
people.
But you know, you get yourundergraduate degree and then
you decide to go to medicalschool, you know, and then it's
(22:05):
during your medical school thatyou decide on what specialty to
do, and then you have to do aresidency in that specialty, um,
so urology is a specialty thatyou do a residency, and OBGYN is
a different one, um, and thenyou can even go beyond your
regular residency training, dofellowship training and you know
specific fields within thatspecialty.
(22:27):
So most of these infertilitydoctors went through an OBGYN
residency and then did afellowship in infertility, and
so they spent their whole careerdealing with females, and so
even when you go see them, a lotof times their focus is on the
females and and and so, um, youknow they're doing all these
tests and some of them are kindof like somewhat invasive tests
(22:51):
when, um, I think sometimes the,the men, are just kind of
waiting and blaming it on theirwives.
Yeah, they should get testedtoo, and and I don't mean to say
that there are actually somereally good infertility doctors
in town that do actually testthe men, or at least encourage
them to get tested as well.
But yeah, they probably shouldbe tested more For sure.
Speaker 1 (23:13):
Yeah, technology is getting amazing.
I can't even imagine wherewe're going to be 10 or even
five years from now, man.
So I heard you talk about likerobotics right, like you're
using a robot when you're doingyour surgeries, correct?
Speaker 2 (23:26):
Yeah, I mean, it depends on the surgery.
Speaker 1 (23:28):
So how does that work ?
Is it you're doing?
Does the robot doing everything?
And you're typing it like how,what does that look like?
Speaker 2 (23:34):
And I'm probably asking a dumb question I wish
and you know it's great.
It's a great question because Iwe throw this term robotic
surgery around a lot of timesand I sometimes have to like I
think it's like an AI.
I got to tell the patients likelisten, sometimes I don't love
that name because you thinkrobotic surgery, you think it's
doing the surgery and you knowI'm taking a coffee break.
But yeah, just on the subjectof technology, by the way, shout
(24:00):
out to urology.
I feel like urology in the last20, 30 years.
The advancements it's made iscrazy the stuff that we can do
minimally invasive.
What's crazy is imagine, like100 years ago, if you had a
kidney stone that was obstructedin your ureter, severe pain,
(24:21):
like they don't have ways to doa CT scan to diagnose it, you
know they you know if someoneneeded to get their stone
treated.
I mean you have to, like I do anopen surgery.
You'd have to, like make anincision in their abdomen, go in
there, figure out what's goingon, like make a hole in your
ureter.
You know, pull out the stone,Like it's.
I mean that's a crazy bigsurgery.
(24:42):
And you know, as Daryl or yourwife can say, I mean usually
these ureteral stones, theyprobably take me what?
20 minutes.
Speaker 1 (24:48):
Oh wow, In and out I go in with a scope.
Speaker 2 (24:50):
I use a laser, break it up, remove it.
You know outpatient surgery.
And they're done the same day.
After a couple days they're backto doing whatever they want to
do.
So you know we call itminimally invasive surgery, the
things that we can do asurologists and a lot of other
fields.
It's amazing as well, but yeah,so to get back to your question
, robotic surgery is a type oflaparoscopic surgery.
(25:13):
So you know a lot of peoplehave heard that term and you
know they always either they'vehad or know someone that's had
their appendix or theirgallbladder removed out and they
know it's through a few smallincisions and so traditional, we
call it laparoscopy,laparoscopic surgery.
(25:33):
You have these few littlekeyhole ports and you can put
instruments in it.
One of them is going to be thecamera and traditionally it's
usually an assistant that'sholding the camera and then you
have two arms and all you can do.
They're like, you know, eitherscissors or graspers or
something at the end, and allyou can do is open and close
them and kind of move them upand down like this, um, and that
still works, uh, if you'reworking in a space that doesn't
(25:55):
require a lot of intricatesuturing or it's not some weird
tight space.
But robotic surgery really tookoff with urology because some of
the cancers we deal with it'sright up that wheelhouse, for
instance, prostate cancer, soalmost the standard of care.
Now you might find anoccasional old school urologist,
(26:18):
like my partner, joe Candela,that does it open, but in
general you do it robotic andit's.
It's really nice in theprostate cause.
That's deep in the pelvis.
You know your pelvis is this.
We're seeing anatomy charts,this big bony structure and it's
deep in it.
If you do traditionallaparoscopic surgery you're
actually just clinging on thosebones.
You can't.
You can't do it, you don't havemuch movement.
(26:40):
But it allows you work in atight space and it has joints,
and so I'm actually in a console.
It's almost like playing avideo game.
I tell people sometimes likeI'm in scrubs.
Speaker 1 (26:50):
You talk to crystals.
There's crystals here, yeah.
Speaker 2 (26:52):
Well, I mean this new generation of kids.
You know they're used tolooking at a screen and doing
stuff.
It's hard actually for peoplethat didn't grow up with video
games and TVs and stuff as muchto pick up on it, cause they're
not used to looking at a screenand being able to to like
conceptualize that they'reworking on it.
But I have this console thatallows me to see what's in the
(27:13):
body with the camera, like 3d,and then I actually have, you
know, the ability to have a fewdifferent arms so I can retract
with one and I and I'm doing itthe same motion like I'm using
my hands.
So if I'm in the pelvis and I'msewing something, I'm doing
like this, but I'm using thejoints on this instrument and
you know I can retract with onearm and then I can.
(27:34):
I have gear like clutches so Ican move my camera around, I can
clutch to this arm and then ifI need to adjust my retraction I
can clutch back to this arm.
And then I do a lot of kidneysurgeries, for kidney cancer as
well.
One of them is a partialnephrectomy.
Nephrectomy means removal of akidney.
Partial means you're notremoving the whole kidney,
you're just removing the tumorand there's a lot of sewing.
(27:56):
As you can imagine.
If you're putting a hole in thekidney you got to do a lot of
sewing to sew it back up and sewit well.
And if you were to dotraditional laparoscopic surgery
, like kudos to the guys thatcould sew well with it but it
was cumbersome as heck Like tojust be able to, like you know,
do this and and, but here, likeI'm able to do all this sewing
(28:18):
and it's, it's, it's, it's cooltechnology.
And now you see it, like youknow, urology really is the
first field that really took offwith it.
And then gynecologists becausethey're the same thing with the
pelvis, doing likehysterectomies, but now I mean,
they're doing brain surgery.
Orthopedics are using it Likeit's just because of how
(28:38):
delicate and fine the movementsare.
It's really taken off.
Speaker 1 (28:41):
That's amazing as far as you know.
Just advice, right in general,just business advice and even
education advice.
Maybe they want to do aninternship is one way to be able
to do it.
That's something I did at TuftsMedical in Boston is took a
three-year internship to reallysee if I wanted to get in
medical.
But what would you recommendfor somebody that maybe they
want to get into the field,because's a side of of being in
medicine where it's a businesstoo right If you have a small
(29:04):
practice and things along thoselines.
But what would you recommend tothem as far as business or
school?
Speaker 2 (29:09):
I definitely think exposure is good.
Speaker 1 (29:10):
I mean, it sounds like you were interested in it
and maybe the exposure kind ofshowed you that, yeah, you know,
maybe this isn't for me, youknow, and that's good that you
figured that out early.
Speaker 2 (29:20):
So I think exposure and you know, so we use the term
shadowing, or you know for me,uh, so I, I did not come from a
medical family.
I was not exposed to it much.
It wasn't until I met and fellin love with my beautiful wife.
Shout out, casey, um, that she,she, has a medical family, okay
(29:40):
, um, and she was a nurse, soshe was actually my sugar mama
for many years.
Speaker 1 (29:44):
There you go.
It's not like me.
Speaker 2 (29:47):
Undergrad and medical school and stuff.
She's, you know, an RN and herdad was a family practice doctor
.
You know her sister's an RN,Another one is occupational
therapist.
Her brothers at that time.
One was like a surgical salesrep, One was a pharmacy rep, so
(30:08):
they're all doing somethingmedical, where my family is like
just a bunch of teachers.
But I was interested by it andkind of started down that
pathway and her dad was a goodmentor because you know he's a
doctor and I had a lot offriends whose dads were doctors
so I kind of talked to them.
(30:28):
But I think what you said ishuge, getting some exposure with
it.
So when I first startedthinking about it, I actually
got a job and this is while Iwas an undergrad at BYU as a
pediatric CNA, a home healthaide, oh wow.
So I went around and worked withthese kids that had like
muscular dystrophy and cerebralpalsy, and I wasn't even doing
(30:53):
like hardcore medical stuff.
I was like getting them readyfor school and like putting them
in their wheelchair, but justbeing around patients, being
around families, learning aboutthe diseases, getting the
satisfaction of helping them.
And, as I told you before I, Iwent to medical school thinking
I wanted to be a pediatricianbecause of that, you know, and
obviously I changed my mindalong the way, but at least I'd
(31:14):
kind of been around health care.
I even worked in like a nursinghome for a while my wife was
like my boss.
She was the nurse and I was thelowly you know CNA.
She was tough, she ordered mearound but just to have that
exposure, but yeah, it's a toughroad, it is Very much so
(31:38):
realized how big of a road itwas.
Like if I had to go back andstart over, I'm like I don't
know if I could do this again.
You know, luckily I was kind ofnaive, you know, um, but uh, I
uh, you know, I served a churchmission in Taiwan so I learned
Mandarin Chinese.
So I came back from my missionthinking like maybe I'll do
something with business, took,you know, business classes
(32:02):
economy many I guess you couldsay I'm fluent.
I mean that was also 20, 25years ago so it's, it's choppy.
Now I kind of have to be leadingthe conversation, but you know
that's amazing.
Um, but uh, um, and, and youknow what, actually those
classes came relatively easy.
I was doing well and I wasgetting a's, and then um, but I,
(32:22):
just for me, whatever, whatever, I wasn't feeling stimulated or
satisfied by it and I I waskind of guided into to try and
medicine.
So then I started taking thepre-med classes.
I was humbling.
Those were not easy, you know,and and some of them they make
them tough.
I mean, they're trying to toweed you out, you know.
And uh, um, all of a sudden youknow it's cutthroat and, like
(32:46):
you know, the, the average inthe class is a B minus.
No one wants to like.
Speaker 1 (32:49):
Oh wow.
So you know, like it was justtough and you know, but
persevered.
Speaker 2 (32:55):
But every step of it's tough I mean it's
competitive to get into medschool so you got to really want
it, you know, be dedicated and,um, I was really blessed to be
able to get in probably my firstchoice, which was university of
Utah, which, even though I'mnot a Ute fan, you know it was
in state and it was close by andit was a great program, um and
uh and you know, but that wasstressful.
(33:18):
You know, I had a lot of thatgut discomfort that we're
talking about as I was goingthrough that process.
Yeah, um, you know.
And then, uh, yeah, medicalschool is a grind.
But, man, once you get into medschool it's a little different.
You're kind of you're, you knowyou're going to be a doctor
there.
It's kind of like you put a lotof time down competitive and a
(33:43):
lot of people won't know this,but urology is actually a really
competitive field.
You know, it's a surgery field.
It's got a better lifestyle,things like that, and so I had
to like do well on my tests andI had to go.
You just got to put yourselfout there yeah, I mean, you,
just I mean it's kind of likethat.
I mean, if you want to be a, anathlete, you got to be putting
in more time than the personnext to you.
And that's kind of how I felt.
I'm like, you know, I wasn'tthe smartest person in my class,
(34:05):
you know.
So I'm like I'm going to go dosome away rotations.
I went to these programs inTexas and Illinois and I'm like
I'm going to get there beforeeverybody else.
I'm going to, you know,whatever, and I'm just going to
like, treat everything like it'sa job interview and you know,
get letters from thesedepartment chairs.
And you know, I wasn't sure Iwas going to get into BYU, but I
(34:26):
grinded, I did.
I wasn't sure I was going toget into medical school, but I
grinded, I did.
I definitely was, you know,never comfortable that I was
going to, for sure, get aurology residency, but yeah, it
worked out for me.
But you definitely you got tobe committed.
But yeah, get that exposure andyou know, but it helps if
you're smart and a good testtaker, but you know, you can.
(34:48):
You know, just kind of like yousee these athletes that you
know they might not be asnatural but they can grind.
I feel like I was a grinder andgot into ohio state, the ohio
state university, and that'swhere I did my residency and it
happened to be kind of a roboticsurgery mecca.
So we did a lot of Ohio.
State, yeah, okay and so, yeah,some of the most high volume big
(35:09):
names, uh, you know, werefaculty there at a in robotic
surgery there, awesome, um andso things.
Yeah, things worked out for me,but yeah, that was kind of a
long answer yeah, but I get itthough.
Speaker 1 (35:20):
Yeah, but if you want it you know I'd encourage.
Speaker 2 (35:22):
I mean, it's great to have a career that is
stimulating.
It's tough, you know, I was oncall, you know, this last
weekend and, um, I had to go doa couple surgeries at UMC in the
middle of the night, uh, sundaynight, and so I didn't wait.
I was awake at 1am and then Ihad to go straight to clinic and
(35:44):
I was all day in clinic andyeah.
So I mean, you know, and this isone of the easier surgery
fields as far as, uh, you know,call and lifestyle schedule.
So you know it's definitely noteasy but it's nice to to have a
career where you feel likeyou're hopefully helping people
and, you know, still gettingcompensated, okay, and you know
and um, but yeah, that's awesome, man, you just got to like.
Speaker 1 (36:05):
You Keep it going.
Speaker 2 (36:06):
I can tell you're a grinder, you know.
Speaker 1 (36:08):
You have to be man.
You're one of the mostsuccessful podcasts in Las Vegas
.
Speaker 2 (36:11):
Thank you, and I'm sure it's, because a lot of
times you outwork the otherpeople.
It's consistent.
Speaker 1 (36:16):
It doesn't help that you have that silky smooth voice
.
Oh, I appreciate it.
No, that's good man.
You brought up a lot of greatpoints, man.
As far as like, maybe if yourethought about it and
restructured your life, maybeyou wouldn't do it.
But the thing is, youpersevered and that's what I got
out of, that is, outworkingeverybody.
Speaker 2 (36:32):
I'm happy I did it.
Speaker 1 (36:33):
I'm just saying it's a long road, we are kind of
imagined.
Speaker 2 (36:37):
I mean, look at it this way Four years of undergrad
, four years of medical school,five years.
The residencies they change,they're usually anywhere from
three to five.
Some are even six years if youdo some research and stuff.
Speaker 1 (36:52):
Plus, I did a two-year church mission, so you
added on to that, so you're like15, 16 years.
Speaker 2 (36:57):
I was almost into my mid-30s before I was making
money.
That's why it's lucky I had asugar mama.
Like me and the nurse and youguys have four kids right, it's
a long road I had friends thatwere buying houses and doing all
these stuff and had theirbusinesses and I'm still racking
up debt.
That's amazing.
Speaker 1 (37:13):
We got four daughters .
I did want to ask you aboutjust a little bit of just one
question about family what is itlike being a girl dad, man,
because you have four girls,right.
What's your household likedealing with basically five,
including your wife?
Speaker 2 (37:25):
It's man.
I don't always understand thedrama.
I'll tell you that.
Speaker 1 (37:30):
Chris, if he was here , he'd be able to speak.
Speaker 2 (37:32):
He has three girls, so you know sometimes they'll
cry on the first day of school,They'll cry on the last day of
school.
Like I'm like I don't get it.
Yeah, you know sometimes what'stheir ages, they're all about
three years apart Right now.
I got one in elementary school,roxy, who's nine.
I got one in middle school, whojust got the principal award of
(37:53):
the year.
Congratulations.
Shout out Kate, and then she's13.
I got one that just turned 16.
Oh wow, nora.
She's at Palo Verde High SchoolMiss Extracurricular.
Everything just broke up withher boyfriend and realizing that
single life sometimes has moredrama than being in a
(38:13):
relationship.
And then my oldest, lucy.
She's 18 and she's actually incosmetology school up in Utah.
Speaker 1 (38:21):
We got them in all levels.
So you're busy life here.
You got a busy life for sure.
Speaker 2 (38:25):
Yeah, cute girls.
Though it's fun, I finally hadto go buy two male dogs just so
I had some Just to keep theenergy right.
So my wife went and got themcastrated, so I guess they're
kind of males, but yeah, that'shilarious.
Speaker 1 (38:38):
I got Snoop and Biggie.
That's hilarious.
Speaker 2 (38:40):
That's really their name Snoop and Biggie.
Speaker 1 (38:42):
Oh, that's hilarious.
Just changing the subject for alittle bit, man.
We always ask guests about food, man, so I'm a big foodie.
But what's your favoriterestaurant in Vegas?
Speaker 2 (38:52):
Ooh, my favorite restaurant in Vegas.
Maybe some recency buys, but Ireally like Lotus of Siam.
Speaker 1 (38:59):
Oh, we've had Penny on, so we know that we live
right close to Red Rock andthere's a lot of good
restaurants in there.
Speaker 2 (39:03):
We're spoiled.
We are Shout out to Lou, we toRed Rock, and you know there's a
lot of good restaurants inthere.
Speaker 1 (39:06):
Man, we're spoiled we are shout out to Lou.
We know Lou and we know Penny.
Speaker 2 (39:10):
That's crazy, yeah but um, uh, the Aria does a good
.
I like probably two.
Two of my top five is Javier'sthe.
Speaker 1 (39:20):
Mexican restaurant.
We were just there.
Yeah, actually us and Chris andhis wife.
Speaker 2 (39:23):
We always go to Newport every year, so we always
go to the, the one there too.
And then uh, din Taiung, whichis actually from Taiwanese food.
So it's a Taiwanese—if youhaven't been to.
Speaker 1 (39:33):
Din Tai Fung— I don't think we've been there before.
Speaker 2 (39:35):
Oh Okay, I was going to say I haven't been there
before.
Oh, it's actually, I think,originally based in Taipei,
taiwan.
Okay, and it does—it's probablyof Taiwanese tasting places,
but it's kind of weird.
You wouldn't think like arestaurant that just specializes
in dumplings would be that good, but it's good stuff.
It's great for like familystyle dining they just bring out
all these different types ofdumplings and stuff.
(39:56):
We always like trying differentrestaurants.
Speaker 1 (39:58):
So if you haven't been there, I strongly recommend
it.
So you mentioned Lotus of SiamJavier's and Dim Tai Fung Yep
Javier's and Dim Ty Fung Yep.
Okay, Excellent man.
What would you want to leave usout on?
Any question I forgot to askyou that you want to leave us
out on?
I know we went on a wild goosechase with different rabbit
holes.
Speaker 2 (40:13):
Yeah, I'm just trying to think of men's health.
I mean, a lot of people areinterested in low testosterone.
You know, we didn't really jumpinto that Touch on that.
Yeah, I, I will say this.
This is, this will be my.
My one piece of advice withtestosterone is I think a lot of
people like the idea of beingon testosterone and wanting to
(40:36):
have more testosterone, but myadvice is you know, do whatever
you can, naturally, you know,eat right, exercise, um, you
know, and you know you know,there's natural ways, you know,
to boost your testosterone.
I've seen a lot of people thatfor, however, they're able to
(40:56):
get their hands on actualprescriptions for testosterone
and the thing they don't realizeis, after a while, if you're
taking testosterone, your ownfactory is shut down.
They're saying, well, I don'tneed to make it, I'm getting it
so kind of like a lot of musclesor whatever, if you're not
using it, they're going toatrophy your factories that
(41:16):
produce testosterone.
they're not going to work aswell.
So you get these guys in their20s and 30s that just want to
bulk up for the ladies a littlebit.
I don't know if they'reconvincing some new male medical
clinic or something, or Tijuana, I don't know but they're
getting their testosterone andit can have lasting
repercussions.
For one thing, you'reessentially committing to it.
(41:40):
If you're on it for long enoughbecause you try to get off of
it, your numbers are going toget really low and you're really
going to have symptoms when atthe end of the day, they
probably never.
Well, I shouldn't say probably.
They didn't need it to beginwith, but it can cause problems
with infertility and otherthings.
So I guess it's just a warninglike, hey, some people need it,
Some people benefit it, but ifyou're getting it, make sure
(42:01):
you're getting it appropriately,Make sure you're trying
everything natural first.
Uh, you know, before you kindof commit down that pathway, you
only got one body man yeah forsure.
Speaker 1 (42:13):
Well, it's a pleasure to sit down with you, man, and
learn just some of theperspectives and how your mind
works.
Man Urology I didn't realizehow many pieces to urology.
It's massive.
Speaker 2 (42:23):
It's a good field.
Yeah, I'm happy.
Speaker 1 (42:28):
I'm going to have to talk my older son into that
because he's big video game andprobably be able to be an
excellent urologist with robotsand everything.
So, um, what's, what's yoursocial handles if people can
reach out to you on there or beable to check you out?
Speaker 2 (42:36):
I think it's dr dave loves golf okay, is it really
okay?
You're a golfer, okay, wellactually I think that's tiktok
my daughter, my, my 13 year oldmanages my, manages my TikTok
account.
I love golf, oh good stuff shegoes with me on a golf trip
doing something Awesome.
But yeah, I think it's EzioLudlow.
So my last name L-U-D-L-O-W.
My high school nickname wasEzio Ludlow.
(42:58):
So, Ezio Ludlow is, I think,instagram Okay and yeah, happy
to have people reach out.
I've had patients somehow reachout to me, sometimes through
social media.
Speaker 1 (43:08):
They probably see you more.
You'd be surprised how manypeople can connect with you on
social media.
It's amazing.
Speaker 2 (43:15):
Yeah, but we're Las Vegas Urology and, yeah, we have
a clinic, just me and my goodfriend Craig Hunter, and we have
nurse practitioner JonathanHigginson and we're just over
there by Mountain View Hospital.
Speaker 1 (43:26):
Awesome.
Yeah Well, absolute pleasure tosit down with you, dr Lolo.
It's a pleasure, learned a lotand check us out at
thevegasurgerycom.
Speaker 2 (43:34):
So appreciate your time, man.
That was great.
Yeah, no thanks for having me.
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