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September 18, 2000
MEN'S HEALTH
Men Who Put off Healthcare
The Stubborn Syndrome Could Cost Years of your Life
by Bill Todd

Let's face it: men don't go to the doctor as often as women do. There are lots of reasons for this. One is that women have babies (and so require regular care), and men don't. Another, more insidious reason is that men often deny that they are sick. By the time a man finally does succumb to seeing a health-care provider, his symptoms are much more pronounced. We'll take a look at three specific health conditions: prostate disease, plus two largely asymptomatic diseases, diabetes and high blood pressure, that are easy to ignore but dangerous if left untreated.

Prostate Disease

First is the quintessential male concern, prostate disease. Most older men actually have some degree of prostate cancer when they die, yet more times than not, they don't have any symptoms. Most men who discover their prostate cancer early have a much better chance of long-term survival, regardless of how old they are at diagnosis. One of the classic fears men have of physical exams stem from prostate tests they must endure at the doctor's office. Nobody would call them pleasant, but the dreaded rectal exam actually lasts less than 30 seconds in most cases, and the blood test entails removing only a small sample from the arm.

Symptoms of Prostate Disease

  • Frequent urination
  • Difficulty maintaining strong urine stream
  • Blood in urine

Diagnosis

  • Digital rectal exam: should be performed annually after 40
  • PSA (Prostate-Specific Antigen) blood test: should be performed annually after 50
  • Transrectal Ultrasound: necessary only if one of the above appears positive

Treatment

  • Early stages may just require "watchful waiting" and perhaps medication
  • More aggressive treatment includes surgery of the prostate, followed by chemotherapy, radiation therapy, or both. Surgical removal of the testicles may be required in extreme cases.

High Blood Pressure/Hypertension

Largely asymptomatic, high blood pressure, or hypertension, is dangerous if left untreated. It can lead to numerous complications such as, heart disease, stroke, kidney disease, and loss of vision. Primary hypertension has no cure, but treatment can help prevent its complications. The treatment, however, may require more discipline than many men are willing to undertake.

Symptoms

  • Asymptomatic unless complications have developed in target organs

Diagnosis

  • High Blood Pressure exam showing consistent 140/90 or higher readings
  • Blood Tests showing abnormal electrolyte levels or kidney function
  • Electrocardiogram (ECG) to reveal abnormal heart function

Treatment

  • Lifestyle modifications: weight reduction, salt and alcohol restriction, and stress reduction
  • Anti-hypertensive drug therapy: diuretics, beta-blockers, calcium channel blockers, and ACE inhibitors (all link to Multum) could be used. Some of these medicines have side effects that should be considered.

Adult-Onset Diabetes

Symptoms of adult-onset diabetes can begin as early as age 30, and are often associated with obesity and family history. About 15 million people in the U.S. have diabetes, but only half have been diagnosed. Most people are only made aware of their condition when high levels of blood sugar are found during a routine doctor's exam. Left untreated, diabetes may lead to heart disease, stroke, kidney disease, vision loss, and vascular disease. If detected early, diabetes may be controlled with a change in your diet, losing some weight, or oral medication. But daily insulin shots may eventually be necessary if none of the other treatments are successful.

Symptoms

  • excessive thirst
  • excessive and frequent urination
  • chronic fatigue
  • blurred vision
  • nausea

Diagnosis

  • Blood tests revealing high blood sugar levels in the morning before breakfast

Treatment

  • Lifestyle changes such as diet, weight loss, and exercise
  • Oral medications
  • Insulin injections (when all else fails)

There are many conditions where you'll benefit from early detection, not just the ones detailed here. Develop the habit, if you haven't already, of a yearly physical exam. Even if it seems like your health plan is playing musical doctors, GO. Sometimes noting changes in your body that have occurred over time are more important than absolute measures. A normal blood pressure reading is about 120/80, for example, but if yours has always run 100/60 a sudden increase to 120/80 is worth attention.

In addition, listen to your body. That doesn't mean go running for the doctor at every ache and pain, but when you notice a lasting change, it's time for a visit. Common sense will tell you what's normal and what isn't.

Symptoms that require attention

It's perfectly natural to expect changes as you age, but your body was designed to endure for a long time. If you notice a lasting change (more than a month or so) that is making you rearrange your life, GO SEE A DOCTOR. Some common, and often treatable, changes include:

  • Shortness of breath, wheezing or chronic cough
  • Difficulty in elimination-stopping or starting your stream of urine, loss of bladder control, persistent diarrhea or constipation
  • Changes in bodily functions-sleep, libido, appetite
  • Changes in sensations, especially hearing or touch