Michelle Rupp: Hello and welcome into this week’s edition of AFMC TV. We’re glad you’re joining us. Today an important topic. This one is for all the men in our lives. We’re talking about men’s health and many topics surrounding it. Joining me today is Dr. Byron Curtner here with AFMC. And so, you know, we thought it made sense if we’re going to talk about men’s health. Well, let’s bring a man in and talk about men’s health. So, it’s hard for men to go to the doctor. Why do you why do you think that is?
Dr. Byron Curtner: Well, this may be crazy. Uh and I’ll have to admit I don’t have a lot of evidence for this, but I’m going to contend that that’s not true. And that may be wild. And that does fly in the face of the conventional wisdom. But my little bit of flimsy evidence for that is back in 2015 or 2017. I’m not sure the second dates. The CDC did a study addressing that question. You know, it wasn’t the world’s fanciest study. They just went and ask people, have you seen a doctor in the last year? And what they found uh was that the differences weren’t as dramatic as what we might think. About 70% of men in the low 70s said they’d seen a doctor in the last year and about 84, the mid 80s women, you know. So, the differences weren’t as dramatic. And then if you break it down by age group Over 65 there was virtually no difference in men and women after the age of 65. Yeah. And if you look at the younger the differences were mostly from younger folks. Which probably kind of makes sense because 20-year-old men, 30 year old men probably don’t need to be running the doctor all the time. And women you know are pregnant. They got to go see a doctor when they’re pregnant, birth control pills, there’s pap smears. So, I don’t have a lot of evidence of this and it’s kind of a wild theory but I’m going to contend it’s not true.
MR: Well, I like that.
BC: Until proven otherwise.
MR: Okay well let’s go with that. I’m going to, let’s go with that. You know we’ve got Father’s day coming up and so are there conversation starters that maybe grown children, adult children you might want to have with their father to just kind of ascertain how dad’s health is.
BC: Well, speaking as an old man with grown Children I would say no I would say mind your own business now. That’s not entirely true.
MR: That’s what my dad would say too.
BC: Yeah of course that’s not true. You know to me probably the wisest thing is to in general mind your own business and leave your old dad alone. But I don’t think there’s anything wrong, I think it’s a good idea to maybe mention it one time and you know, and say, you know, dad, have you seen the doctor, you know, and explain why, you know, golly would like you to see a doctor, maybe here’s the reasons. And when your cranky old dad won’t do it, I think you kind of got to leave it alone, you just leave it up to him now, given that there’s going to be some exceptions to that. You know, if your dad’s having chest pain, if he’s got a big black mole that looks like a melanoma, if, you know, if he’s got some kind of horrible condition, you just got to fuss at him and just stay after him till he goes. So, you know, there’s some judgment to that, but you know, you can lead a horse to water, you can’t make him drink. And, you know, that’s kind of my thinking on that.
MR: Are there some milestones though for men or ages where you really do need. Your past the age of 40 and so you need that colonoscopy, or you know, you need this or you need that. What are some of those?
BC: Yeah, absolutely. I think that’s very, very important, you know, one of the most important things you can do, and I always said 40, you know, there’s some leeway, some people say younger, some people and there’s not a lot of hard evidence one way or the other. But I think sometime around the age of 40 you really ought to try to make an effort to go to the doctor at least once a year when you’re not sick, you know. Go to the doctor when you’re feeling fine and let him just kind of kick your tires. You know, there’s some things you need to have done and some things that can save your life, even if you’re doing okay. There are immunizations you need, there’s cancer screening of all kinds of the things you ought to do. And if you go when you’re sick, most doctors don’t have the time to address those things while they’re trying to address your sickness. And so, I think my recommendation is probably starting around 40. I’d go see the doctor once every year. I think that’s a really, really good idea.
MR: I think that’s great advice to go when you’re not sick.
BC: Yeah, I think it’s really, really important because doctors are busy and if you’ve got four things wrong with you, he’s not going to have time to talk to you about your cholesterol or your prostate cancer screening your colon cancer screen or you’re shingle shot of your pneumonia shot, all those kind of things that you really ought to have.
MR: Yeah, okay, that’s good. That’s real good. Um, so this time of year we’re all, I shouldn’t say we, but most of us are, we’re outside, we’re in the garden, maybe we’re cycling. Maybe we’re running trails in the woods, uh plenty of opportunity to run into ticks and all those fun creatures.
BC: Oh, they’re nasty critters, but there’s just nothing nastier than a tick.
MR: So, what do we need to do? And I mean just at a, at a baseline, if we’re working in the garden, you know, or cutting grass even some of the men who are bush hogging, what do you, what do you do? What do you recommend? Where do you look?
BC: By and large I think you ought to try to stay out of the woods in the summer in Arkansas. I mean there’s just, it’s too darn hot. Every bug on earth is out there. You know, the copperheads, cottonmouths are out and of course the nastiest of all critters are ticks. You know, if you get, if you’re getting heavy brush, you’re going to get ticks on you. Off will help, but you’re right, you know, Arkansas is a hotbed for tick borne disease. One of the biggest in the nation’s most common and 50% of people that get tick borne disease do not remember are not aware of having a tick come off of them. So, you, you know, even if you go out and get the paper, you can get a tick on you and you can get sick, there’s no doubt about it. There’s no good way. You just, you know, if you’ve been exposed, you need to really carefully check yourself for ticks, because the longer the tick is on you, the more likely you are to get sick. The sooner you can get that devil off of you, the better off you are.
MR: How do you get it off? I’ve heard tweezers. Some people take a match, something with fire.
BC: And so, the people that are supposed to know say don’t burn them, that’s just a bad idea.
MR: I mean, I’d rather not.
BC: What could go wrong with that. You know, hot paperclips? But the experts say, take some fine tweezers, grab him by the end, slow firm pressure without twisting because if you twist him, you’re going to take his head off and that’s a whole other thing and you generally got to go to a doctor and get it dug out, you know. So, you want to, you want to just gently pull and then once you get him off, don’t squish him not with your hands. But put him on scotch tape and hang on to him in case you get sick because it might help down the road to know what kind of tic you got bit with. Particularly if it’s the black legged tick that is really, really uncommon in Arkansas. But if you did, if you were the really lucky guy that got the black legged tick that carries Lyme in Arkansas, which doesn’t happen very much, it’d be nice for the doctor to know that.
MR: Yeah, okay. What kind of ticks do we have if we don’t have a black leg?
BC: We’ve got dog ticks and lone Star ticks; they carry a host of tick borne diseases. You know, the big one that kills people is Rocky Mountain spotted fever. And you know, we’re, we are a hotbed of Rocky Mountain spotted fever. But there are a lot more. I’ve had Ehrlichiosis before. It’s very, very common Arkansas. In fact, the real name is Ehrlichiosis Chaffeensis because it was discovered in Fort Chaffee.
MR: Wow.
BC: Yeah. And then we have this southern tick related fever brash thing. It’s STARI. And they’re all they’re all kind of like they’re associated with high fevers. Most responded Doxycycline. But Arkansas is one of the number one states in the Union for tick born disease and it can be very, very serious. If you have a fever in the spring or summer in Arkansas, you need to go to the doctor because it’s Rocky Mountain spotted fever until proven otherwise.
MR: Okay. And that’s what I was going to ask is how do you know if, if you’ve been bitten, especially if, well, I’m looking and I don’t I don’t see anything, but you know, you can’t look back on the back of your neck or anything like that. So, what would maybe be some symptoms if, and is it just fever, but things to keep in mind that have been outside and maybe one of those jumped on me.
BC: Any kind of rash is concerning a fever in spring, you know, we don’t see a lot of flu, we don’t see a lot of things that cause fever in the spring and summer. Certainly, you can have flew in august, it happens. But fever in spring in summer in Arkansas, you just got to think Rocky Mountain spotted fever because if you miss it, bad things will happen, you know, up to including dying. But other things like ehrlichiosis, tularemia; all those things need to be treated real quick. So, fever, headaches, rash, body aches. And just because you hadn’t pulled a tick off doesn’t mean you don’t have it. Remember 50% of people that get rocky mountain spotted fever or other tick-borne disease do not have a history of finding a tick on them. And I found that in my practice to when I was practicing medicine, you know, lots of, lots of folks didn’t remember pulling the tick off of them. Uh, you know, and there’s, you just, you just got to look for those ticks in the places they hide.
MR: What about treatments. If you can get to a doctor fast enough because it doesn’t have to be fatal.
BC: Right. Most, most tick-borne diseases respond to Doxycycline. It’s antibiotic and there are other antibiotics that can be used, but it’s the one that we use the most. It’s the easiest and has the most history behind it.
MR: Okay we’ll go to something a little less ugly. But none the less. It’s out there and that’s poison ivy.
BC: Oh yeah, it’s plenty ugly on its own. I don’t know if anybody ever dies from poison ivy, but it is unpleasant.
MR: You may want to die.
BC: Oh yeah absolutely. You may think you’re going to die, that’s right.
MR: Again, as we’re gardening as we’re outside you know we just want to keep our eyes open. Was it a four pointedly or three pointed leaves?
BC: No what you’re looking for Is the three-pointed leaf with a terminal leaf. Yeah, that’s what you want to look for. All the Roos family has a three pointed leaf. And the well it’s it’ll be too little leaves and the third leaf will have a little tiny stem on it. So, if you’ve got three leaves that all come together in the same place that’s probably not one of the Roos family. But if the two bottom leaves are kind of together and then the end leaf has a tiny little stem of terminal leaf then you just want to avoid it at all costs. Even if it’s not poison ivy, you can just stay away from it. Yeah, and I can’t recognize the leaves. You know, they all look the same to me, but I can see something with three leaves in the terminal leave and no I’m better off staying away from that.
MR: And if you don’t stay away from it and you get home and you realize is it everything you touch, you’re spreading that oil.
BC: Who knows? Well, we know it can spread because we all, we’ve all, most of us had the experience of not being out in the woods and having the dog come in and get it on you, you know, that kind of thing or not touch anything. So yeah, who knows where the oil comes from or how long it stays. But yes, you’re right.
MR: So if you are unlucky and find yourself in that situation, calamine lotion, Benadryl, just whatever to kind of reduce the inflammation.
BC: Everybody has their own cocktail for it, you know.
MR: Oatmeal?
BC: Yeah, yeah. Your grandmother has a way to treat it. Your doctor has a way to treat it and all of them work okay. Systemic steroids, our kind of classic Prednisone, Decadron, you know. They’re fraught with some side effects. Maybe some side effects that we in the past didn’t realize that maybe, you know, we’ve always kind of thought the occasional steroids that was probably fine for you. Maybe it’s not. There are folks that swear by systemic steroids for poison ivy, and you know that if that’s what works for you, you can start to make an argument for that. My, my cocktail was always the scrubs. There’s a class of medicine that it looks kind of like the grout, the stuff you clean your grout with that little beads in it and you just scrub yourself just really, really hard with it just as long as you can and that will give you like eight or nine hours of relief and so I would always tell people to just, you know, just scrub like the devil when they go to bed and usually they can sleep through the night with that and then you can kind of put up with it and during the day with some steroid cream. And sure, you know, whatever your grandmother gave you, calamine, your oatmeal, whatever it is, it’s probably okay. Poison ivy can get infected and can be serious, you know? So, if it starts looking like it’s infected, if it’s not going away then by all means you want to go see the doctor.
MR: How long does it typically hang around?
BC: Three weeks.
MR: Oh no.
BC: Usually people are always shocked. They say, well this has been three weeks. Yeah, it’s about three weeks.
MR: I had no idea it would hang on that long.
BC: Yeah, it’s terrible.
MR: That is not, is not fun. Alright. Anything else you’d like to add Dr. Curtner about men’s health, about ticks, snakebites, anything? Obviously, I leave those doubles alone. All right, well thank you so much for coming in today.
BC: Well, I’m glad to be here, thank you.
MR: And thank you so much for joining us. We’ll see you back here next week for more AFMC TV.
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