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Man Up, Kentucky


Alarming statistics of men’s health don’t have to spell doom

The health of Kentucky men is in need of some serious attention. But there’s good news—if we’re willing to listen.

I say “we” because I’m right there with you. At 45, I’m slower and softer in the middle than I once was. I struggle to strike a balance between doing right by my work, my wife, my three kids, and, oh yeah, my own health.

It’s a struggle everyone faces to some extent, but if staying active, alert, and alive were a ballgame, the scoreboard would show the Kentucky men’s team is falling behind.

According to the World Life Expectancy website, a Kentucky man’s average lifespan is 73.4 years, 44th in the nation. The men of Minnesota and Connecticut, for example, are outliving us by more than five years.

At rates much higher than men in other states, we fall to cancer—worst among the 50 states, according to the America’s Health Rankings website—heart attacks (49th), and stroke (45th); and suffer from diabetes (45th), which is often associated with obesity (39th).

To understand why and what we can do about it, Kentucky Living recently convened a panel of health experts to talk about the state of men in our state. Their conclusion: we face numerous challenges, no question, but the game for each of us is far from over, if we’re willing to do what it takes to win.

Coaching ourselves up
“Not unlike men around the country, the Kentucky man can be a bit proud and a bit stubborn,” says Eli Pendleton, a doctor with University of Louisville Physicians who specializes in family medicine. “In my experience, it’s the women who are more interested in their health. When seeing a man for the first time in my office, it is often because a woman in his life encouraged him to be there. Our reluctance to seek medical care, especially preventive medical care early in our lives, likely contributes to women living longer than us.”

According to the Centers for Disease Control and Prevention, U.S. men die almost five years earlier than women and are more than twice as likely to report they haven’t seen a doctor in at least two years.

Maurice Walker is a 36-year-old husband and father of four in Danville. A former high school athlete, today he works two jobs and rates his health as a 7 on a scale of 1 to 10. He concedes, “I have a little bit of a belly, but that’s from good old home cooking and raising four kids.”

Walker has a family history of diabetes he doesn’t want to repeat. That’s why he makes sure to get his annual physical every year. If some men might avoid the doctor’s office because they’re afraid of what they’ll hear, Walker reminds us that sometimes the news is good: “Last checkup, I was healthy as a horse.”

Doctors say avoiding annual physicals is a dangerous gamble. After all, would any self-respecting man drive his car or truck for 20,000 miles without an oil change? Of course not. Going years without a checkup for your body makes even less sense, particularly when it comes to conditions like high blood pressure, also known as “the silent killer.”

David Hanna, a Nicholasville psychologist, says, “Many men never see a doctor until they have a crisis. I wouldn’t know that I have high blood pressure, which is now controlled with medication, if I wasn’t getting regular screens. I wasn’t symptomatic. I felt fine.”

Our panel made basic recommendations like stop smoking and don’t abuse drugs and alcohol. Beyond that, they said perhaps the most critical step a man can take to improve his health and extend his life is to establish a relationship with a doctor or nurse practitioner and get regular checkups. Those should include, among other things, measurements of:
• Blood pressure
• Height, weight, and waist circumference
• Hemoglobin A1C (blood sugar)
• Lipids (fat cells in your bloodstream)

Hanna understands why some men feel apprehensive; he says they don’t want to be told, “‘You need to stop smoking. You need to lose weight. You need to change your diet.’ You feel like you’re never going to get there, so why start?”

Why indeed, especially when figuring out a game plan for your health can be so confusing.

A voice in the huddle
My parents are Jackson Energy Co-op members in Clay County, and they tell the story of a local fellow known affectionately as Old Man Frost who lived to be 102. Once asked the secret to his long life, he declared, “Don’t worry about nothing, and eat a stick of butter with every meal.”

Okay, thanks.

Our men’s health panel does not endorse Old Man Frost’s approach, but his example brings up another important reason to have your own doctor—and ask him or her questions: in a world filled with voices offering sometimes unreliable health advice, who do you listen to?

We’ve seen conflicting media stories for years about studies of both stress and butter consumption, for example. Coffee, red meat, dairy products, and more have been the subjects of so many contradictory reports that earlier this year, the New York Times published a story with the headline, “We’re So Confused: The Problems with Food and Exercise Studies.” Apparently, health studies tend to rely on people keeping food and activity diaries that may not always be entirely accurate, plus it’s hard to account for every genetic and environmental variable. Not all these studies produce reliable or reproducible results. Adding to the confusion are media outlets eager to publish stories with click-bait headlines like this from Huffington Post UK: “A Glass of Red Wine Is the Equivalent to an Hour at the Gym, Says New Study.”

“Physicians are trained to view data skeptically with a scientific approach,” says Ron Waldridge II, a KentuckyOne Health family physician in Shelbyville. “Patients should lean on their physician as a source of truth when it comes to sorting through conflicting evidence. When I have an electrical problem in my home, I call an electrician—same theory applies.”

According to our panel, for all that still isn’t entirely known about the human body, the basics of being healthy are pretty simple:
• Smoking makes it likelier you’ll get lung cancer
• Obesity puts you at greater risk for diabetes, heart disease, and stroke
• Eating fresh fruits and vegetables has extensive health benefits
• Exercise is good

Of course, we know all of that, don’t we? It isn’t so much lack of knowledge or desire that keeps us from being healthier. What is it, then?

Making your own game plan
David Cole is a 21-year-old English major who grew up in Wayne County, where his parents are members of South Kentucky Rural Electric Co-op. He’s studying at the University of Kentucky and says that for him and many people he knows, “Getting the rent check in on time is way more important than our bodies. It’s probably a side effect of being on the clock or on the go constantly, in work or in classes. When we finally get time to rest and have a little recreation, we don’t tend to care about what we eat or drink. We just take advantage of those moments of reprieve and let ourselves go.”

Who among us hasn’t felt that way? Maybe in the last 24 hours? Maybe right now?

But the decision to become healthier doesn’t have to be all or nothing, certainly not right away.

Pam Kirchem is director of membership services with the Kentucky Hospital Association headquartered in Louisville. She says, “Remember that a small, positive lifestyle choice can make a big difference.”

In fact, small positive (or negative) lifestyle choices are all we ever make. We determine our own health based on what we decide to put into our bodies and how we move one bite, one sip, one step at a time.

And in the most fundamental way, that’s good news: our health is under our control.

Many men have figured this out, adapting their eating and exercise habits and finding they’ve improved and likely lengthened their lives in the process. (See Men on the Move, below.)

That doesn’t mean it’s easy, and some men face greater health challenges than others.

Many of Ellen Knox’s clients struggle with injuries sustained during military service. As medical director of the mental health department at the Robley Rex VA Medical Center in Louisville, she sees how they also struggle with the disparity between how physically sharp they felt in the military and how differently they feel today. “They feel a sense of loss,” she says, “of the view of themselves as strong and fit.” To help her clients transition, Knox encourages them to create a health and fitness plan that fits their personality and preferences. Some guys prefer to work out by themselves. Others do better with a buddy. “A lot of men are competitive. You can use that,” she says, encouraging some to use Fitbits and join group weight-loss or fitness challenges.

To coach a reluctant client, Knox might ask this straightforward question: “Is it more important to you to eat whatever you want and stay in the shape you’re in, or is it more important to make a change?”

It’s a question we all have to answer for ourselves, and goes hand in hand with that preceding one, “…so why start?”

The reasons for us to man up and take charge of our own health are all around us. Look at the people who share your house or your last name. Look at the pictures on your walls or in your phone.

They’re the ones who’ll miss you when you’re gone. Sure, we’ll all be gone one day, but don’t we want to put as many good days between ourselves and our last day as possible?

I have no intention of giving up beer, barbecue, or birthday cake, not today—but I could have those things less. I could trade a few evenings on the couch watching ballgames for evenings on a court or in a field playing ball with my kids, or with some aging would-be athletes like me who might have slowed down, but haven’t given up.

According to the health and longevity stats, I could potentially earn myself a few extra seasons that way.

No guarantees, of course. It’s all about odds, but that’s okay. In sports, Kentucky is the world-renowned home of hoops and horses—why not health, too? After all, we know which bets to take, which races are worth running.

Men on the Move

Ellen Knox, medical director of the mental health department at the Veterans Affairs Hospital in Louisville, recommends this video about a disabled veteran who lost 140 pounds:

The employees of Owen Electric Cooperative have made tremendous changes in their health by working with personal trainer Jordan Nevels. Watch them talk about their experience:

Chuck Combs is a Jackson Energy Cooperative member who lives near the Clay County town of Oneida in a place with no sidewalks. That’s what makes it all the more impressive that he’s lost more than 100 pounds just by walking.

Combs’ weight peaked at 332 pounds and he was diabetic and on cholesterol medication, having to check his blood sugar at mealtimes and give himself daily shots. “I wanted to get off that so bad,” says Combs, who’s retired. He has a heart condition and other issues but, “One thing I could do was walk.” So he walked. And walked. And walked. He walked in the cold and the rain and the dark, sometimes wearing reflectors or flashing lights as he walked up and down State Route 11. He also changed his diet, learning to love broccoli and carrots.

“One morning I got on the scale and I started cheering like I won a ballgame,” he says. These days Combs weighs about 220 and no longer needs diabetic shots. His recommendation: “You can’t look at it like, ‘I’m gonna fail.’ You got to have some kind of faith.”

Heath Eric describes his former lifestyle as “a toxic mix of a high-stress job, pitiful diet, little to no exercise, and I’d been through two painful divorces. I gained a lot of weight and my body ached all over.” Health screenings confirmed that Eric was in bad shape, so he started reading up on healthy eating and took up cycling again. He lost 40 pounds, quit soda, alcohol, and his toxic job. Today, Eric’s a full-time musician, performing with his wife as the duo Heath and Molly. They won’t play venues that allow smoking.

Based in the McLean County community of Rumsey, Eric says the work gives him professional satisfaction and the opportunity to exercise on the job, setting up and playing outdoor summer shows in the Kentucky heat. “Just turned 45,” he says, “and feel better than I did in my late 20s and all of my 30s.”

Mark Kinley of Danville has maintained a disciplined approach to eating and exercise for years. The habits have paid off: after a recent medical exam, the 55-year-old was told he was “in perfect health.” Still, he says, “I’ve fallen off the wagon several times, especially when entertaining co-workers after work and during holidays.” Rather than despair and give up, he just returns to his diet, which is heavy in lean meats and salads, and his five-day-a-week workout regimen.
A systems administrator with Toyota, Kinley says, “You have got to see the end results before you start your workout. No matter what’s going on in life, if you can see it, you can have it. Stay focused and disciplined and you will get there.”

Two letters that send men to the doctor: ED

Our Kentucky Living panel of men’s health experts pointed out that many men who otherwise avoid the doctor’s office will show up when faced with one particular condition: erectile dysfunction (ED).

Stephen Winters, an endocrinologist with University of Louisville Physicians, says a man with ED might need something more than a little blue pill.

“ED is a flag for the doctor to check for diabetes, high blood pressure, or neurological or vascular disease,” he says. “Men who present with ED are much more likely to have a heart attack over the next 10 years. What is ED? It is a problem with blood flow.”

Many men faced with ED just want a prescription for Viagra, Cialis, or similar drugs; others visit men’s clinics to address this specific issue. Our panel expressed concern about some such clinics, saying too many use unreliable testing methods, fail to thoroughly evaluate the patient, overprescribe testosterone supplements, and focus so much on treating a patient’s ED that they neglect other warning signs.

If you experience ED, Winters says, “You should have a history and a physical.”

Tips for finding a doctor

If you want to live a longer, healthier life, establish a relationship with a doctor or nurse practitioner. Get regular checkups and talk to them about your history and your long-term health needs; plan for your future, and find out what you need to know about the sometimes-confusing information we get about health and fitness from the media.

Those were among the strong recommendations from the panel of men’s health experts Kentucky Living recently convened to discuss the state of men’s health in Kentucky.

But how do you find the right doctor if you don’t already have one or if you want a new one?

First, check with your insurance to see what doctors in your area are part of your network. If there are doctors in your area you’re interested in seeing, call their office and ask if they take your insurance, or will see you even if you don’t have insurance. Ask your friends, family, neighbors, etc., who they see or would recommend. There are also extensive resources online:
Consumer Reports lists tips for finding the right doctor.
U.S. News and World Report provides a searchable database of doctors throughout Kentucky, organized by city.
Reader’s Digest describes how doctors evaluate other doctors for their own medical care.
• To research a specific doctor in Kentucky, you can look up his or her physician profile with the Kentucky Board of Medical Licensure.

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