Podcasts Health Lunch and Learn with Dr. Berry LLP112: What should men expect during their annual physical exam

LLP112: What should men expect during their annual physical exam

Published: June 12, 2019, 10 a.m.

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Let\'s Talk about Annual Physical Exam...

On this week\'s episode of the Lunch and Learn with Dr. Berry I am here to start off men\'s health month with an episode on just what to expect during your annual wellness exams. Last week on the empower yourself for better health series, I talked about the biggest reasons why men are dying earlier is that we are just unaware of our health statuses.

Our lack of going to the doctor, being educated on what are our biggest killers has attributed to the majority (8/10) top 10 leading causes of death worldwide to all disproportinately affect men greater. In fact it would likely be 9/10 if not for the fact that Alzheimers usually increases with age but we are dying to soon to experience it.

The annual physical exam is the most appointment you can make when you see a doctor because it allows the doctors to essentially check you from head to toe on what is going on. It is also where we can discover the most problems so it is extremely important to make sure your friends and family members are listening to this episode so they know what to expect.

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Download Episode 112 Transcript

Episode 112 Transcript...

Introduction

Dr. Berry:
And welcome to another episode of the Lunch and Learn with Dr. Berry I\\u2019m your host, Dr. Berry Pierre, your favorite Board Certified Internist. Founder of drberrypierre.com, who start the Lunch and Learn with Dr. Berry as well as the CEO of Pierre Medical Consulting, helping you empower yourself for better health with the number one podcast for patient advocacy. This week we bring you episode 112, the focuses on men and their wellness exams. And of course if you listen to this on the month of June, it is men\'s health month. And if you happen to catch my recent live series on Empower Yourself for Better Health where I essentially kind of lay out the fact that men are dying out here because they\'re not aware of their health and you know, I hope to put a charge in someone\'s battery or you know, someone\'s relative, spouse, somebody to like really push the mill, friends and family members that we have to go get their routine checkups.

And a few I want to check out drberrypierre.com/youtube where you can check out that most recent episode where I go through the top 10 causes for death in men and I really kind of lay out the law that says like, Hey, we really don\'t have any excuses to deal with the issues that we\'re dealing with now. So check if you have the chance. So again, today we\'re going to be talking about the wellness exam. The annual physical exam. Most people call it and a lot of times is probably the only way you can actually get your significant other, your brother, your father, your cousin. It\'s usually the only time you can get them to come into the doctor\'s office, right? Because again, a lot of times I don\'t see them very often but if I can almost see him one time, it\'s usually for their wellness exam.

So I want you to just take a little step back and take some tips on what to expect for the physical exam and you know, understand why we might like crunch a lot of things in there because sometimes, especially with our male patients, we understand that that the likelihood that they\'re going to come back at sometimes kind of low. So we want to take advantage of it when we got a chance. Before I want to go I do want to give a shout out to Dr. Coreos who is a friend in the social media space. She actually runs the hashtag somedocs. And reason why I love her is the fact that she is champion physicians to want to get on social media and really take advantage of all of this stuff that it offers.

You guys know for a long time I\'ve really been championed that bill that says like, no, we have to get on social media. Our patients are on social media. And if you want to be respected, if you want to be accredited in your patient\\u2019s eye. Again, not talking about accredited in the physician\\u2019s eye where you know, you have a couple of journal articles and do some poster presentations and you may speak at a medical conference and two. Because for the most part, most of your patients don\'t care about that, right? One because they don\'t go to those conferences. They don\'t read those magazines so they don\'t even know.

But would they do knows that they check their Twitter, they checked their Instagram and they check their Facebook, they checked their YouTube and you\'re not there. So she\'s a big part of this promotion and you know, making it okay for your physicians to one get on social media. And another thing I love about her is that with her hashtags somedocs. If you have a blog posts and video posts, whatever, and you feed tag or she will actually retweet it and kind of share it out. So again, thank you Dr. Coreos for that. I\'m definitely much appreciated it. Just wanted to make sure I gave her a nice one shout out because she\'s definitely helped the show grow for the Lunch and Learn community. So it definitely appreciative all our efforts. So getting back, we\'re talking about episode 112. We\\u2019re gonna talk about men. We\\u2019re talking about the annual wellness exam. And sit back for great episode and I\'ll see you guys later.

Episode

Dr. Berry:
Alright guys. So this is episode 112. This is gonna be a solo episode. And it\'s funny because obviously if you\'ve been rocking with the show for quite some time, you know and that we started out as a solo episode. This is something that we do and I think we do well. And when we made the change over this past season, season three, we really wanted to make a concerted effort to get the best of the best when it comes to topics of discussion, especially for Lunch and Learn community. And I was very fortunate enough to do that. We\'ve got like two months, almost two months in a row of just amazing guests and like I said, definitely happy for all of their expertise and their support and you know, does the knowledge that they kicked over these past couple months. But I am back with a solo episode and it\'s funny because actually this episode was going to be a group episode as well, but I was unable to connect with this week\'s guest.

His schedule was busy. My schedules is busy so we were unable to connect. But we\'ll definitely make sure, you know, we get them onto the shows at some time. Right. We\'ll, it\'ll happen for sure. But of course this is June. We\'re talking about men\'s health and this episode we\'re talking about the wellness exam, the quote unquote the physical exam that a lot of times it\'s the only time I can see some of my male patients and it\'s something that a lot of times as a physician we kind of cherish and we really take advantage of. Because we understand that if I don\'t order these tests and I don\'t ask these questions, there\'s a chance I may not see this patient in front of me for another year. And for most of my patient specialized outpatient medicine, most of my patients, that\'s exactly was the case.

They were like, doc, I love you but I\'m not coming to see you more than once a year. So get whatever you need to get, do whatever tests you to do, ask whatever question you need to ask while I\'m here cause it ain\'t happen. And once I leave and I respected it and I love that. And that definitely took advantage. So what I want to do is first, you know, do you listened to the episode 65, right? Empower Yourself for Better Health Series where I talked about how the lack of awareness and our health has been killing us. And like us, I mean men, right? It\'s been absolutely killing us. And I talked about top 10 causes of death in that episode. So go ahead, check that out on the YouTube page. But when we stress all of these different factors here, a lot of these things can sometimes, and I hate to say it, but a lot of them could be avoided if they would just comfort a checkup and they would just come and see regularly.

And that\'s why we take so much advantage when we do have you in our office. Right? Because we don\'t know what\'s the next time you get to come see us. So if you listen, right? If you\'re able to get that at your male, father, your cousin, your relative, your friend, spouse, whatever. If you were able to get them to the office, right? Like what should they expect when they get there? Right? I think that\'s always a question at hand, right? It\'s like this unknown cloud of secrecy, right? Again, they don\'t go to the doctor often and a lot of times it\'s out of fear. Right? And a lot of times it\'s out of this superhuman attitude that men tend to have. Like, I\'m not sick, I don\'t get sick. I\'m okay. Like nothing\'s bothering me.
I think one of the most important questions that we\'d like to ask, especially in a hospital setting is do you have any medical history? Right? As usually our questions, right? And for my men, I\'m usually keen on asking, okay, if you say you have no medical history, what is the last time he saw a doctor? Because it\'s very easy to have no medical history if you\'ve been avoiding us for five to 10 years. Right? Like if you haven\'t seen a doctor, and again that five to 10 years, may sound crazy to some of my Lunch and Learn community members. But I know some people who have not seen a doctor in five to 10 years, like that\'s just the way they\'re rocking and you know, God bless them, right? God bless them that something\'s not clicking up on the inside that we don\'t know about. But let\'s say you know, it\'s been five, it\'s been 10 years, right? And they haven\'t seen the doctor.

And of course when you ask them to have any medical history, they say no cause they really don\'t because no one\'s ever told them. Right? But you are able to get this person into your office and you\'re able to get the quote unquote physical exam, right. Because first of all, let me tell you something. The physical exam, the actual physical part is, you know, the easiest part that probably takes like three to five minutes at most. But what\'s most important is all of the ancillary questions you\'re gonna ask your patient in front of you why you got in there, right? So why you got them there, right? And I always like to start head to toe, right? So first and foremost, for people who may not be familiar with the annual exams, right? The annual exam is the doctor\'s appointment that you go to, it\'s usually your longest doctor\'s appointment and not only is it a long the doctor\'s appointment, It usually has a whole bunch of labs are kind of associated with it, right?

So that\'s usually when your doctor orders lasts for just about everything. And we\'re going to talk about those labs later. But it\'s one of those ones where your doctors has to take advantage and get you, you know, while you\'re there. And they really liked it, you know, strike while it\'s hot. So they order every test as every question because they aren\'t sure if they\'re not going to see you again. Right? And for some people was honest, right? I used to take care of patients who are in their 19, 20, 21-year-old. Like I don\'t want to see you in my office more than once a year. Right? Cause there\'s really no reason, especially if you have no medical history, that you should be seeing me that often.

Not say that you can come to me if you, you know, you have a cold or you know, get sick or I\'m not saying that. But they were just coming just for like a regular checkup and you have no medical history. You\'re not taking medications. Right. I don\'t expect you to be seen more often then, you know, once or twice a year. Right. Maybe you might see him every six months just to kind of keep them in the loop, but you\'re not seeing them any more than that. So you have your male, right? Let\'s just, we\'ll call the male Berry. Right? So Berry, you know, finally mustered up the courage and he makes the doctor\'s appointment, right? And I talked about this before. A lot of times what pushes Berry to making a doctor\'s appointment is they have a person like Maria screaming in their ear saying, hey, you need to go see the doctor and they finally do it.

Or there\'s something, some sexual dysfunction issues going on. And Berry\'s frustrated and he\'s like, no, I gotta go see a doctor. I got to take care of this. Right? I\'ve seen a commercial, I can take a blue pill and I\'m good. I need someone to prescribe a blue pill. So those are usually the top two reasons why, you know, men tend to go to the doctor\'s office, at least in my experience. So you know, you\'re able to get buried to come to the doctor\'s office and you know, he\'s in a waiting room and you know, he finally get stay room and now he\'s ready. So usually what tends to occur, especially in your annual wellness exam is. Your doctor usually does a head to toe approach, right? In terms of how am I going to assess this person, how am I going to see what\'s going on?

So usually, obviously from head, we start. I always like to check for vision issues, right? As men, because we\'re so machismo with it, right? Like wearing glasses is like this taboo thing that a lot of us don\'t like to do unless we absolutely have to do it. And for the most part there\'s a lot of diseases that are kind of manifesting with vision issues. So a lot of times when you\'re thinking, we\'re just asking about your vision and vision history is because we want to make sure that it may not be contributing and contributed to from another disease like high blood pressure or diabetes, which is very common. So we tend to ask for a vision issues. We want to make sure your eyes are checked. If you wear glasses, you want to make sure he got that done.

And we want to make sure you\'re eating well. And again, the eating well is goes along with the bowel habits because we know the older you get, the more likely you are to have these issues with bowel and bowel dysfunction. And if you\'re one of my 50 year old gentlemen, right, or 45, depending on your race, right? Uh, and really just kind of varies but just kinda in general, you know, its colonoscopy time, right? And again, it\'s one of those times where we want to make sure the plumbing is working all the way through and through. Because one of the top 10 leading causes of death for men is cancer, right? So colon cancer is something in screen, when you hit that age because it is something that we should be preventing as long as you get a regular checkup. So a colon cancer is a big one, right?

So again, I know I skipped down, but like, so we\'re checked the vision, now we\'re checking the heart, right? And the heart exam. Not only goals or just you know, just for listening, but you know, we\'re checking the blood pressure, we\'re checking your heart rate. Usually when you came in, right? We want to make sure that you don\'t have this underlying problem that could lead to disastrous effects that rock. Like I tell people all the time, blood pressure is one of those things that your body can deal with and deal with it a lot until it can\'t. And once it can\'t, now we\'re talking about stroke. Now we\'re talking about heart attack. Now we\\u2019re talking about disease in the feet, right? Like you can\'t feel and you\'re foot, right? That\\u2019s what happens when your blood pressure becomes such a problem that your body says all right, yeah I\'m done. And so making sure that your blood pressure\'s fine, right? Because again, blood pressure is one of those things that you don\'t really feel symptoms from low blood pressure, especially when it\'s high, until it\'s a problem, right? If you\'re at the point when you\'re starting to feel symptoms because of blood pressures on the high side, you need to go see your doctor immediately, right? If you\'re listening to this and you know when your blood pressure is high, like you can feel it. That means I need to go to the doctor because you should not be feeling it. And if you\'re at the point where you\'re feeling when your blood pressure\'s high, that is a problem. So for heart, we\'re talking about blood pressure, we\'re talking about a heart rate.

I kind of move actually for men, right? And not important for women. Is that the prostate exam? And this is something that I think personally scares men a lot, not only from doing regular checkups, but because of the prostate exam and the digital administration of the endoscopic scope. I think a lot of men dish, you know, shy away from that whatsoever. And it\'s funny because I\'ve had men who meet the criteria who meet the age. And I said, okay, all right, let me, uh, let me check your prostate, see how that\'s doing. And they get stage fright, right? Hey, it\'s so, it\'s such a terrifying thing for them, right? It\'s very weird. I in that instance, right. Especially when you know cancer\'s a leading cause of death, right? All we have to do is this, there\'s physical exam tests that we do in our office.

And of course it was sometimes was hanging out with blood work, right? But in our office, and you still refuse, you know? Yeah. I\'m kind of weary of your decision making. So that\'s definitely something to think about, especially when we\'re doing about the abdominal pelvic exam is in the men at certain ages need to be checked for prostate, right. In large prostates. Now I\'ve always said this a lot, that a patient will always tell you what\'s going on before you have to do any tests, right? So most of your patients, if they\'re going to talk about, you know, in large prostate, they\'re going to tell you urinary symptoms, complaints, they\'re gonna punch in that direction. That still doesn\'t mean you\'re not supposed to check but they will kind of point you in that direction to make sure you\'re going in the right way.

So talked about the eyes, we talked about the mouth, we talked about the heart, talk about the abdomen, the lungs as well. Lungs is a big one. I know a lot of you may have seen these COPD commercials. Again, COPD top 10 leading causes of death for men. And you may have seen COPD commercials where this random person is sitting by a lake and because of the COPD medication, now they can breathe again and they can go outside again. And that\'s all great and dandy, but they don\'t tell you that usually the patient has COPD because they were a smoker and they were smoking for five years, 10 years, 20 years or they always kind of skip that part, right? That\'s always tell my patients like you can\'t skip the fact that this person was smoking for 20 years. Right? So it\'s not surprising that they\'re going to have some lung issues. So making sure that your lungs are working well, make sure you\'re not getting shorter breath easy. That is something you want to be very forthcoming with your physician.

And for men, I could tell you what tends to happen with men is that we\'re so secretive, right, that we\'re so secretive to our family members, to our friends. So that\'s why we don\'t go to the doctor in the first place. But you would think once they get to the doctor\'s office, this, the veil of secrecy would leave? Nope. A lot of them are secret to the end. Like this to the point where you almost have to call them out like, hey, you know what? Maria sent me over here and said you were having issues with your bowels, but yours ain\'t they\'re not. Which is true, right? More often than not. If a person, if a male is sent over to the doctor\'s office by a female relative, a spouse, someone who says like you need to go to the doctor\'s office, a lot of times they\'ll, they\'ll be in the room with you and not because you know, they don\'t trust you. It\'s because they don\'t trust that their partner is actually going to tell them all of the problems. And that happens with men a lot.

We tried to internalize everything and you know, try not to seek help and you know, that\'s where problems definitely will arise because of it. So I think, so we\'ve talked about heart, we talked about lung, I talked about abdominal pelvis. We talked about the eyes making sure eyes are check as well too. And we had Dr. Candrice who talked about skin cancer, a couple of shows back. So again, the importance of, making sure there\'s no weird moles or rash or anything that your, your family members kind of played off. We don\'t want that. So making sure, and again, your skin exams, your regular physician can definitely take care of that while they got you here and kind of move. And if you need something else then see to the dermatologist. So skin exams, definitely an important one as well.

And I think last but not the least, is it comes some of the blood testing. So what actually gets tested when we go to get our physical exam? So I could tell you this from a slew of tests, right? We don\'t have to mention the names because the names that are really important is what they\'re looking for. Some of our testing, right? We\'ll look for signs of inflammation, we\'ll look signs for infection. Some of our tests within that will check to see how stable is the person\'s blood count is? And blood count is a very important a number to think about because if you have this patient who\'s coming in and they\'re giving you symptoms concerning that, they may be bleeding somewhere. You want to make sure that blood count is good. And stable. So blood count is definitely something that thinks about.
And then we check for your electrolytes. We check for potassium and we check for sodium, we check calcium, chloride. We check for all of these different things here because we want to make sure your electrolyte nutritional status is adequate because if not we have to take care of it.

And we\'d take a look at the kidneys. Kidneys are important. You\'ll notice when I stop and mentioned the disease is because it probably hits the top 10 diseases that killed men every year. And kidney disease is definitely in that ball park, right? So kidney disease, and again, this is a routine test. Again, I know my patient Berry\'s not going to come for another year, so I got to make sure I get all of these tests done while I got him here.
So again, we\'re checking for kidney function, we\'re checking for electrolytes, we\'re checking to make sure your blood counts stable, we\'re checking to make sure you know the signs of inflammation or infection. And then, moving all, we check for the big gun right? We talk about cholesterol. Cholesterol is a big one for us, right? So we want to check your cholesterol, make sure your cholesterol was doing well. And we had previous episodes where we talked about the thoughts of cholesterol and good and bad, and what medications to take. We\'re not going to do this here.

Moving forward, we checking for your diabetes? Diabetes is one of those things. It\'s one of those, and I wrote a blog post about this. It\'s a disease I probably not wish would not wish on my enemy, right? Because there\'s not a system that\'s not affected by diabetes. And I think what\'s happening, it\'s probably our fault, is that when we talk about diabetes, especially in the General Public Forum, a lot of people focus on the sugar aspect. Like, oh yes, my sugar is high, but they don\'t realize for us, right? When we hear your sugar\'s high, I hear, wow, you have concerns that you\'re going to have some vascular damage, right? Because diabetes is an extremely fast schuller disease, right? It affects the heart. It affects the legs, it affects obviously our kidneys, brain too. So every system that can be fed through the blood system, right, which is everything diabetes can effect, especially when it\'s uncontrolled. So we\'re checking for that. So again remember and the test that we run lets me know how well you did in the past three months. So not one of these things where I have to be concerned that this like oh maybe a little bit false or you just had some cheeseburger the next day. Like that\'s not going to necessarily change this testing here and may adjust your cholesterol testing but it\'s not going to change that you\'re testing for your diabetes or how severe your diabetes is.

I will sometimes check for thyroid as well cause I want to make sure, and again I\'m, I\'m kind of foreshadowing get right cause I want to make sure all of your hormones are regulated correctly cause we\'ve already seen that when your hormones are not regulated correctly. Because thyroid is out of whack, it doesn\'t matter if your hormones get back into that normal rhythm. Your thyroid has to be a normal rhythm as well. So thyroid hormones, a big one as well that we checked quite often. We\'ve checked the urinalysis. Your urinalysis is a big one. And it\'s big one because it\'s cheap, but it tells us so much information, right? Urinalysis can tell me if you had blood in your urine, right? You\'re now tell me if you have an infection. Urinalysis can tell me if you have a stone in your kidney. So all of these different things that your urinalysis does a great job and educating us on, and it\'s a cheap test as a quick test. Definitely, something that I always like to glean information from.

Last but not least, and this is the big one, right? Testosterone levels. Because I know, especially for my men, someone\'s gonna want to know about testosterone, right? They\'re gonna want to know about, you know, artificial mutation of testosterone when needed. So a testosterone levels. And usually, it\'s not, it doesn\'t come with the annual wellness exam. But if you\'re giving me complaints and concerns that sexual health may be affected. I\'m going to do something about it, right? So I will check a testosterone level just to make sure all your hormones are kind of in line.

So that\'s really the big crux of the annual exam for my men and I really try to kinda hit home all of the big take-home parts to really to let you know that it\'s not a difficult thing to do. It\'s not a test you need to be scared of. And I think knowing the answer, right? Because I think a lot of times when we talk about disease processes, some people just don\'t want to know the answer. But when it comes to, you know, taking care of your health and taking care of your wellness, you have to know what the answer is, right? Because we have no choice because it\'s killing us, right? And I hate to be doom and gloom, but I really want to stress the point, especially when you have this month of June and you know, everyone\'s hype about men\'s health month, but I know what\'s next month comes around, people ain\'t going to be at hype anymore. So I want to like make sure I\'m shouting it from the rooftops, the importance of getting our stuff together men.

So again, I want to thank everyone for listening with me - Dr. Berry. We\\u2019re back with a solo episode like I missed you guys. But again, I want to thank you guys for all your support, has been absolutely phenomenal in this past season, this season, right? Season three that we\'re in as far as the support and effort and people downloading and people leaving five-star reviews. You now had a chance leave that five-star review for me and you guys have a great and blessed day. I\'m going to see you guys next week and next week we do have a special guest, right? So you don\'t have to worry about hearing my voice again solo. Next week we do have a special guest. Because like I said, we like special guests. You guys have a great and blessed day.

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