Podcast transcript

INTRO
Welcome to Docs in a Pod presented by WellMed. Over the next half hour, Docs in a Pod will educate you about the health and wellness of adults everywhere. Co-hosts Dr. Rajay Seudath and award winning veteran broadcaster Ron Aaron will share information to improve your health and well-being. And now here are Ron Aaron and Dr. Rajay Seudath.


RON AARON
Thank you all so much for joining us today on the award winning Docs in a Pod. I'm Ron Aaron, and we're delighted to come to you every week with a look at a variety of health and related issues as they affect folks, many 65 and older, but all kinds of folks in our society. We are really pleased to have with us our co-host Dr. Rajay Seudath. Dr. Seudath is a board certified family medicine physician and native of Tampa, Florida. He’s the current lead physician for Optum at the university location in Tampa. Dr. Seudath received his medical degree from the University of South Florida Morsani College of Medicine. We are so pleased to have you with us as our co-host, Dr. Seudath. We're going to take up the topic of breaking the stigma in men's health beyond the gym. You qualify as a male.


DR. RAJAY SEUDATH
That's correct.


RON AARON
I noted that you kind of bobble around. We see each other on Zoom. You told me you sit on an exercise ball. What does that do for you and why do you do that?


DR. RAJAY SEUDATH
Sitting on an exercise ball is good for your core strength. For people who kind of like to fidget who have a little more anxiety than others, it allows you to stay moving. So, you can actually stay focused with your mind. That's one of those things. But it's also one of the things that I used to do quick exercises between patients and things like that because I don't have time for a whole 45 minute session of exercise. So, I break it up throughout the day. So, it's helpful.


RON AARON
Now confession time. I have tried an exercise ball, and having done several face plants, it occurred to me that I'm not really an exercise ball kind of guy.


DR. RAJAY SEUDATH
Again, you can't really see so well, but I will describe to you that I have an L-shaped desk. So, there's one in front of me. Part of the desk behind me and then behind me. Directly behind me is my chair. So, I can't really go that far back before I'm in a nice, safe stopping spot. There's only one side for me to fall to the right. But, I'm left-handed, so most of my dominance is over here on the left side.


RON AARON
Let's welcome our guests, Stefan Arias. He is a board certified family nurse practitioner, with a strong background in both animal and human sciences. He earned his Bachelor of Science in Animal Science from Texas A&M University, followed by a Bachelor of Science in Nursing from the University of Texas Health Science Center in San Antonio. He went on to complete his Master's of Science in nursing at the University of Texas in Tyler. When he's not at his clinic, he's a devoted husband to Becca, and proud dad to four-year-old Landon. You can often find him breaking a sweat at CrossFit 313. Stefan, it's great to have you on again.


STEFAN ARIAS, NP
Absolutely. Good to see you again, Ron. Nice to see you, doc.


DR. RAJAY SEUDATH
Hello.


RON AARON
Lots of folks when they drive around town, we'll see CrossFit Studios, but have no idea what they are. It's not your run of the mill gym.


STEFAN ARIAS, NP
I've spent my whole life in some type of endeavor of fitness. Whether it was growing up playing team sports, soccer, T-ball, everything else. I played football in high school. Texas is a big high school football area. I did powerlifting in high school as well. So, I constantly found myself in types of athletic endeavors. CrossFit really is more of a methodology than a training gym or specificity or anything like that. The thing I love about CrossFit, there's usually one workout throughout the day and it's infinitely scalable. So, even though you may not be able to do a push up, maybe we can get you on your knees doing a push up, or maybe we can get you leaned up against a plyometric box standing up, but pushing up that way. So there's kind of a short little free ad for CrossFit gyms everywhere. It's infinitely scalable. The door is the heaviest weight when you walk in. You just have to open the door, come in, and the coaches and everything else will figure it out for you.


RON AARON
That is a really good point. Dr. Seudath. We were talking a week or so ago about Physical Health Month and getting folks to get off and into the gym. What Stefan just said, the door's the heaviest thing you have to do before you go in the gym. That's a really good point.


DR. RAJAY SEUDATH
That's a great point. That's such a great point. We talked about obstacles previously, right? What are the obstacles to try and get out of the way? What are the barriers that we can break down to get a person to be more interested in their health and to be able to do that exercise? It's absolutely right. It's getting to that door and finally pulling it open and stepping inside.


RON AARON
All right, Stefan, give me ten burpees. For those who don't know, what is a burpee?


STEFAN ARIAS, NP
I call them fall downs and get ups because that’s really what it is. You just kind of fall down into a push-up position. Everyone at my gym seems to hate them. I tell them, like, you only do 50% of the work. You just let gravity take you down into the push-up position, and after that you push up, stand up, give a little jump and a little clap over your head. And there you go. There's your burpee.


RON AARON
Well, when we talk about the stigma of men's health beyond the gym, I think it's a given that women are more inclined to see their doctor, more inclined to follow the doctor's recommendations than men. If it isn't bleeding and it hasn't fallen off, why go to the doctor?


STEFAN ARIAS, NP
I definitely would agree with you that that's probably an unfortunate stigma that exists in our society. One thing that I always tell my friends who maybe have some of that stigma going on in their life or whatever is everybody gets sick. Everybody has stuff. Just because you are male or anything else, it doesn't exclude you from having problems or anything else like that. Having a primary care office and having a relationship with a physician is important so that whenever those things come up, we can get it checked out for you. We make sure that we know what's going on, or you can just do your regular screenings, and make sure that everything is going on.


RON AARON
Well, let me take a moment and let folks know who may have just joined us, you're listening to the award winning Docs in a Pod. Our podcast is available wherever you get your podcasts. We're also on the radio in several markets in Texas and Florida as well. I'm Ron Aaron along with our co-host, Dr. Rajay Seudath, and we're talking with Stephanie Arias, a nurse practitioner at WellMed at Fort Worth Southwest. We're talking about the kinds of challenges that men, I guess psychologically, have to overcome to check themselves out and to deal with their health. Stefan, for the folks who are listening, very often, if they have a significant other, they're the ones who will motivate that guy to go to the doctor.


STEFAN ARIAS, NP
Very much so, Ron. I cannot tell you how many appointments that I've sat in and the husband leans over and goes, sorry I brought her with me, or the wife leans over and goes, he wouldn't have said anything if I wasn't here. Doctor, you're laughing, too. I'm sure that you've been to those appointments.


RON AARON
I can give you a personal example. My wife for weeks was telling me you're deaf. You don't hear what I'm saying. And finally she said, go get yourself checked out. So, I visited an audiologist who, when I told him the story, laughed and said, that's the reason almost every guy comes in to see me. As it turns out, hearing aids have made a huge difference in my life.


STEFAN ARIAS, NP
Yeah, I threw my hand up in agreeance with you, but also flashed my way. Yeah, I get it. Becca, if you're listening,I am listening. Always listening to you.


RON AARON
For the man who says, I'm in great health. I don't have any problems. I'll go to the doctor when I have a problem. Why should they go sooner? You hear that all the time, right? Both of you?


DR. RAJAY SEUDATH
All the time.


STEFAN ARIAS, NP
Just like we talked about earlier is screenings. I mean, screenings are just incredibly important. I can't even count how many times in my very young medical career that you run into the person that we wish we would have caught it sooner. Or, if they had been getting this screening device, if they had gotten a regular colonoscopy, or if they had had their PSA or their mammogram, or if they had had this blood draw earlier, maybe we would have found it. We would have figured it out, and now we wouldn't be dealing with some of the bigger things that we got going on. That's usually my message to folks when we're talking about doing those uncomfortable screening devices like colonoscopies and other things like that. I understand it's uncomfortable. I understand it's not fun. But the alternatives are a lot worse. So, just the not-knowing piece.


DR. RAJAY SEUDATH
I wanted to build on that. Sometimes, for the guys that are like, doc, I’m fine. I feel good. You took my blood pressure. My blood pressure is good. Everything's fine. Sometimes you have to kind of figure out what it is that they're interested in? What's the parallel you can draw? For most of the guys over 65, it's usually cars. If I say, hey, come on in, I got to see you every four months, we gotta we got to check the oil. We gotta do that blood draw. I need to check your kidneys. You've got a touch of kidney disease. We got to rotate those tires. We got to do this. We got to do that. I gotta make sure you get those stool cards in because you don't want to get the colonoscopy. All those kinds of things. If you can tie it to something they can understand, sometimes that works really well. One guy was really fighting, look, doc, I'm not a car, okay? But I tell you, if I did have a timing belt, I would want it changed. I said, well, let's think of this colonoscopy like this timing belt. If something goes wrong and you have cancer, you'd want us to do that earlier as opposed to that timing belt going off when you're on the freeway. And then all of a sudden you break down, you can’t accelerate this thing and you get into a crash. So, sometimes you have to present the information in a way where, okay, I guess it's manly to go and get this thing checked. I guess I could still be a guy and be healthy. You've got to kind of give him that offramp. You give him the option. I find that sometimes that's just what they need. You have to be given the option to do healthy things and still be who you are.


RON AARON
I had a good friend who never went for a colonoscopy until it was too late. They discovered cancer had already penetrated to his colon walls, and he died of colon cancer. Had he gotten a colonoscopy earlier, he might be alive today. And hat's one of those tragic stories. We're going to continue the conversation in a moment. For those of you who just joined us, you're listening to the award winning Docs in a Pod. I'm Ron Aaron, along with our special guest today, Stefan Arias, who is a nurse practitioner at WellMed at Fort Worth Southwest and from Tampa, Florida, our co-host, and we're delighted to have him, Dr. Seudath, you're listening to Docs in a Pod.


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RON AARON
Thank you so much for being with us today on the award winning Docs in a Pod. If you are enjoying this program, don't forget to rate us and leave a review for Docs in a Pod on the podcast service and elsewhere because the award winning podcast, we bring you insightful conversations on health and wellness with leading experts. Your feedback helps us grow and we hope, reach more listeners like you. So remember, tell folks about the award winning Docs in a Pod. When I say award winning, we're delighted to share with you that for the fourth year in a row, we have won the prestigious 2025 Communicator Award. The award winning Docs in a Pod delivers trusted insights on health, aging, caregiving and more. You can join the thousands who tune in to the radio or podcast Docs in a Pod. By the way, it wouldn't happen without the behind-the-scenes folks like Mark Carion, who is our editor, and Catherine Clanch is our technical director and makes sure we actually get these recordings done and get on the air and on podcasts. So, we thank you for that. We're talking with nurse practitioner Stefan Areas along with her co-host, Dr. Seudath. Stefan, you've mentioned it a couple of times screening tests. Let's focus on men for a moment. Not that we don't spend a whole lot of time focusing on men, but what would be the kinds of screening tests you'd recommend, especially for a male who's 65, 70 and older?


STEFAN ARIAS, NP
Hopefully we started before that. But, definitely looking at PSAs. Prostate health is so important for men. I've got a local urology PA who is a patient of ours. I know he wouldn't mind me telling the story. I always tell him, hey, I don't want to see you in the office. I don't want to come see you. And he said, oh, don't worry, you'll come and see me. It's just a matter of time. Whether it's a vasectomy, whether it's a prostate, whether it's whatever, you'll be here. So, prostate health is so important for us as males. You can run into so many different kinds of issues.


RON AARON
Now, a patient gives false positives sometimes. So, how do you know whether it's accurate or not? That’s the PSA blood test to screen for the possibility of prostate cancer.


STEFAN ARIAS, NP
Correct. I'll try to be as non vulgar as possible, but I always talk to patients and they say, well, when do we get the finger test? When does that happen? And I say, well, we can do these PSAs, and that can kind of save us both from doing the finger test until maybe we need to. This can be kind of a clinical indicator as to do we need to do this or not? Does this need to go see Urology specialty? Where are we as far as where are we sitting at over years on time? And what do our symptoms look like?


RON AARON
Dr. Seudath, I don't mean to play doctor here, but I've done enough shows on this topic. Most prostate cancers are very slow growing, are they not? So, what's the recommendation now? Asking for a friend for males who are 80 and over about getting a rectal exam.


DR. RAJAY SEUDATH
It kind of depends. You don't have to do it every single year on a regular basis. We want to couple our screenings with symptoms. I'm trying not to get too technical, but there's something called pretest and posttest probability. If I have a suspicion that you have something, I should test for it. If you're having difficulty urinating, you're having blood when you have a climax, you're having uncontrollable constipation, and you don't have another reason for it. You’re having pain in your pelvic area. We need to do some sort of rectal exam to find out. Is your prostate enlarged? Is it nodular? Is there something out of the ordinary? Is one side higher than the other? That's one of the things that we would need to check. And then if it was, that coupled with the PSA becomes more suspicious, so then we might definitely send you to a specialist.


RON AARON
How do you train your index finger to be so accurate when examining a prostate? How does it know?


DR. RAJAY SEUDATH
Part of that is through training. There's a wonderful, it's called Golgi, he was a guy who was a physiological researcher, and he had this thing. But in med school, everybody listens to his lectures. In one of his lectures, he says, that thing is like a vice. I had about a finger and I wouldn't let go. The thing is, you really just have to practice. You have to learn what is normal through your training. They do trainings where you're doing it on normal people. I was lucky because one of the people who was guiding us, he could tell us, move your finger to the right. That's the right lobe. Move your finger to the left. That's the left lobe of my prostate. And he was actually guiding us for it. That was very, very helpful. So, I feel very confident when I'm doing that. What am I looking for? Part of what we're doing is we're looking for is what's normal? If you know normal, then you can definitely understand what is happening.


RON AARON
That makes a lot of sense.


DR. RAJAY SEUDATH
Yes.


RON AARON
If you know normal, you'll know what is not normal.


DR. RAJAY SEUDATH
Absolutely.


RON AARON
Stefan, what are some of the other screening tests? We talked about prostate and PSA and digital rectal exams. What else should men do if not periodically annually?


STEFAN ARIAS, NP
I think there's definitely some other things that maybe don't technically count. Some that do technically count as regular screening devices that maybe everybody should be doing> Things like looking at cholesterol levels, A1Cs, all these types of lab draws that we're looking at just to make sure that your general health is in order. Then, of course, if as a male, you start to feel like you're having a little bit more fatigue, a little bit less get up and go. Some of these things that can kind of happen. Well, what's going on with our testosterone levels? What's normal? What's not normal as we age? How is your sleep? Sleep apnea can come in all genders, but that probably leans more a little bit towards the male side of things. When we start getting into those types of questions, now we're really talking about things leading towards cardiac dysrhythmia. What's our weight gain situation look like? How easy is it for us to lose weight? All those can be kind of linked to those sleep apnea questions and answers and things like that.


RON AARON
You mentioned testosterone. You see all kinds of TV ads. Boy, once Joe started taking my product, he felt great, and his wife felt good too. How do you know if you need to supplement testosterone?


STEFAN ARIAS, NP
Lab test. We need to know where you're sitting.


RON AARON
So, don't self- prescribe.


STEFAN ARIAS, NP
No. Right now it's not ideal to do it. I know that there are are places that you can go. I think patients think that sometimes clinicians are blind when they drive down the freeway and I don't see the billboards and the ads that they see in the buildings that are there. We're very aware of what goes on and where you can where you can do those types of things. It's in my opinion better to get a good hard look and have a more unbiased opinion on what's your symptomology? What's going on? How old are you? What's expected? What's not expected? I have a lot of patients tell me, doc, I'm not dead. What can we do there, too? And there's things that we can do. There's treatments. There's things that we can look at. There's things that we can help with.


DR. RAJAY SEUDATH
To segway into that, as you said, Ron, oh, he's feeling good and his wife's feeling good, too. That's what we're talking about. Getting past the stigma. Some men can be embarrassed when they're talking about erectile dysfunction. Not being able to climax, not being able to have intimacy. So, what part of that is where does a person lie on that? Are you having morning erections? Are you able to have an erection but you can't maintain it? Are you able to have an erection but you can't climax? You can't make enough of a climax. So there's a level of these sorts of things, and sometimes it's just talking to them about it, and they might not even think about it. Well, I don't know where I am out of that. I was just experiencing these symptoms and I just didn't want to talk about it because I'm getting old, and that's what it's supposed to be like. So, sometimes you have to give them that option to be able to talk about it and normalize it. It happens very often. There are options that we can do. Let's talk about what you are experiencing, and then we can kind of come up with a plan. Whether that plan is pills, whether that plan is increasing your exercise, getting your blood pressure under control, testosterone placement, or do we need to send you to the urologist for injections? Again, that's one of those things that getting past that stigma will allow people to get treatment. Even if none of that is available, if you're coming back from Iraq and you had your genitals blown off in an IED, then we have to talk about what is intimacy to you and how do you experience it? So, doctors, nurse practitioners, and your provider can help you along that entire spectrum.


STEFAN ARIAS, NP
I think also, doc, when you mentioned the coming back from Iraq perspective and just the mental aspects, maybe it's not war or anything else, but maybe just the mental aspects that are kind of tied into erectile dysfunction. That's also something that needs to get brought up and talked about and can sometimes affect things.


DR. RAJAY SEUDATH
Absolutely.


RON AARON
Perfect. Thank you so much, Stefan Arias, nurse practitioner. You find him and WellMed at Fort Worth Southwest. And for our co-host Dr. Rajay Seudath, I'm Ron Aaron. We'll talk with you again soon right here on the award winning Docs in a Pod.


OUTRO
Executive producer for Docs in a Pod is Dan Calderon. The producer is Cherese Pendleton. Thank you for listening to Docs in a Pod presented by WellMed. Be sure and listen next week to Docs in a Pod presented by WellMed.


DISCLAIMER
This transcript is generated using a podcast editing tool; there may be small differences between this transcript and the recorded audio content.

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