What men need to know

Dr Bernie Crimmins, author of Blokes’ Health, points men in the right direction towards a longer and healthier later life.

What do men need to know and do in order to live a longer and, more importantly, better quality of later life? The answer to this question is quite simple. Primarily, men need to schedule an annual check-up with their GP. It is that simple. Men aged 15 to 55 go to their GP about 50 per cent less than females. This infrequency of visits results in diseases being diagnosed later rather than sooner.

Men, compared with women, have worse health outcomes of lifestyle-dependent diseases, therefore have an extremely poor health report. Statistically, men are fatter, smoke more and exercise less than their female counterparts. They also suffer more from:
• high blood pressure
• high cholesterol
• diabetes
• alcohol abuse
• cancer
• heart disease
• depression…… no wonder!

Women are incessantly reminded by authorities to get health check-ups, such as pap smears and mammograms. Alas, no regular recalls exist for men, which means they have to do it off their own bat.

Having said that men must get a yearly check-up, just what should they have checked? There are basically four major diseases which account for about 55 per cent of the premature death and morbidity in men. These are:
• heart disease and stroke, which also includes the vascular complications of diabetes
• lung disease (primarily smoking related)
• prostate cancer
• bowel cancer.

If men can take cigarette smoking out of the equation, then they have three major areas which need regular checking – the heart (and associated blood vessels), prostate and bowel. Of course the prostate check puts the fear of God into most men but it is only one part of the overall assessment and is not as bad as they think.

From a preventative health perspective, I cannot stress enough the importance of family history, as it is this aspect of the patient’s record which determines how early the testing should commence. From age 40 all men need to know their weight, body mass index (BMI) and waist circumference and must ask to have the following levels tested:
• blood pressure
• blood glucose (perhaps fasting insulin if overweight)
• cholesterol (good and bad)
• prostatic specific antigen (PSA)
• uric acid
• iron
• vitamin B12
• folate
• testosterone (if over 70).

and functions, including:
• respiratory (include a chest x-ray for those with smoking history)
• liver
• kidney.

• colonoscopy or faecal occult blood test (FOBT – blood in the pooh test)
• heart stress-test of some kind
• electrocardiograph (ECG).

Once a potential problem is found, it can be monitored closely and lifestyle changes implemented to prevent progression to frank disease. The two most important lifestyle changes that men can make to help themselves are to stop smoking and to lose weight. To do the latter, men basically need to eat smaller serving sizes, reduce their grog intake and start exercising on a daily basis. Simple. This exercise must form part their daily routine, such as going to work. There must be no excuses. Every healthy meal eaten, junk food temptation rejected, exercise session done and alcohol-free day completed is the equivalent to what I call ‘lifestyle superannuation’ – benefits may not be seen immediately but will later on in life. The hope is that monetary superannuation will be available at a time in man’s life that he is fit and healthy enough to enjoy it, all due to his previous hard work.

A typical example of lifestyle changes is that of a 54-year-old professional man who, with a poor family history of heart disease, presented with an episode of palpitations which turned out to be atrial fibrillation (a fluttering heart). Prior to this episode he had been fit, well and exercising daily. Upon extensive investigation, a couple of blockages were found in the arteries of his heart, which did not need stenting but would require close monitoring. Unfortunately he was unable to tolerate the prescribed medication so would need to adhere to a stricter dietary regime and lifelong exercise. His prostate was checked and was fine, but a colonoscopy, performed wholly and solely due to his age, revealed three polyps in his bowel which were removed. These little bits of flesh which protrude into the bowel may become cancerous at some time. He will require a surveillance colonoscopy every three years. It won’t be hard to remind him though, as that patient is me!

Get a regular check-up and stay happy and healthy.

Blokes’ Health by Dr Bernie Crimmins, Wilkins Publishing Pty Ltd 2010, RRP $9.95
Reliable and up-to-date information on men’s health can be obtained from Andrology Australia
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