Bonus Episode: Wounded Weekend Warrior? Dr. Hurt Explains When To Worry About An ACL Tear

In this episode, Dr. Mistry and Donna Lee are joined by Dr. Joel Hurt of Austin Orthopedic Institute. As an orthopedic surgeon specializing in knee and shoulder repair and replacement, Dr. Hurt sees his fair share of "weekend warriors" or patients who push themselves beyond their current ability or fitness level during recreational activities or workouts. The resulting injuries can include everything from mild tendonitis to serious ACL tears. If you have a joint injury, Dr. Hurt can tell you when to worry and what options you have if you do need repair or replacement surgery. Visit him online at austinoi.com or call 512-856-1000 today!

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Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.

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Transcript

Speaker 1: 0:07

Welcome to the Armor Men's Health Show with Dr. Mystery and Donna Lee.

Speaker 2: 0:13

Hello, this is Dr. Mystery host of the Armor Men's Health Show. Welcome to our show. I'm joined today, like I'm joined every week by our cohost Donna Lee.

Speaker 3: 0:21

That's right, everybody. Hello out there listening. Happy Day.

Speaker 2: 0:24

Today we are bringing you this show brought to you by the Urology Practice started in 2007. Naau Urology Specialist. I'm a board certified urologist. Donna's just certifiable. Mm-hmm.

Speaker 3: 0:35

<affirmative> and funny and super cute.

Speaker 2: 0:37

Well, she thinks a lot of herself, which is very nice. I think confidence has a lot to do with being a comedian and a surgeon. What do you

Speaker 3: 0:42

Think? You know what? That's true. I am a standup comedian. Yes.

Speaker 2: 0:45

So she was the devoted, the seventh funniest mom in America by Nick at night

Speaker 3: 0:48

Night, to which my mom always said in her kayak. Said, who? Nick? Who?

Speaker 2: 0:52

Nick.

Speaker 3: 0:52

Is Nick.

Speaker 2: 0:53

Such a big difference at Night<laugh>. We are a men's health show. We love to focus on things between the nipples and the knees. I'm a urologist. I love talking about legal bears and yumm yums, but today we're gonna talk about something different.

Speaker 3: 1:04

Why are we talking about

Speaker 2: 1:05

We have a wonderful opportunity today. We are. We have a guest. We do. We have to be on our best behavior.

Speaker 3: 1:10

This guy over here?

Speaker 2: 1:11

Yes. Dr. Joel Hurt with Austin Orthopedic Institute. Dr. Hurtt, welcome today. Hey,

Speaker 4: 1:16

Thanks for having me. Welcome.

Speaker 2: 1:17

You know, Dr. Hurtt is the inspiration of this show. Did you know that

Speaker 3: 1:21

Uhuh

Speaker 2: 1:21

Really? He is. He is. Wow. We sat one day and he said to me, he goes, you know, Sonny, we don't need to prepare or have like big, like videos that are real fancy and stuff like that. Just the stuff that we know off the top of our head our patients would love to hear. And that really inspired me to do this show because we don't even prepare. Obviously

Speaker 3: 1:38

We don't, obviously, it's very clear that we

Speaker 2: 1:40

Don't, I think that most of our listeners have pretty good idea that

Speaker 3: 1:42

We did, you know, that Dr. Hurt, that you were the inspiration to all this magic.

Speaker 4: 1:45

Is

Speaker 2: 1:46

That really true? It is absolutely true. Wow. So thank you so much for joining us today. I, I feel like I got to be able inspiration to you because I gave you the, the confidence to become your own orthopedic surgeon and, and, and set off on your own and start your own thing For sure.

Speaker 4: 2:00

That was part of it.

Speaker 2: 2:01

No, you were. Yes.

Speaker 4: 2:01

Yes. You were an inspiration for sure.

Speaker 2: 2:03

Aw

Speaker 3: 2:03

Kidding.

Speaker 2: 2:04

<laugh>. No, there's no doubt. I'm telling you. Wow. We love to last time. It's called the Mutual Admiration Society. Right? Right.

Speaker 3: 2:10

Swinging your penises around again.

Speaker 2: 2:12

<laugh>. So Joel. Yeah. That was Saturday's. Continue Joel. So you're an orthopedic surgeon and what is your specialty area?

Speaker 4: 2:18

Uh, I specialize in knee and shoulder, everything from, uh, sports reconstruction to replacements in both those areas.

Speaker 2: 2:25

So, you know, as I get older, approaching 50 soon. Mm. I find that sometimes after doing even like activities that I've been like routinely doing, like sitting on the couch,

Speaker 3: 2:36

<laugh> watching TikTok

Speaker 2: 2:37

Sometime, then my thumbs hurt. No, um, uh, we, we often see in the practice, um, men who are trying to achieve more and more as they're getting older and older. We see so many that are doing testosterone replacement and trying to work out. But, uh, these weekend warriors, there's, there's some injuries that these people kind of can complain of when it comes to their knees and lower extremities. You know, I thought it would be good for you to talk about what are some common complaints that men experience and what causes them.

Speaker 4: 3:03

Sure, absolutely. I'd love to do that. You know, we get, have people come in all the time who, um, are in various phases of their life. So we talk about the, let's talk about the most common where I start seeing these things as in the late thirties, early forties. And, you know, you're used to participating with sports at a certain level and all of a sudden stuff starts happening. Um, you start having swelling or pain or clicking and catching. That used to not happen. And usually it's the day after and it gets to the point where you're even seeing like a little, uh, bubble developed on the side of your knee. And this is an effusion, which is fluid on your knee. That's super common. And so a lot of times you have to sit down and look at the x-rays and, and talk about in many of these cases, not all the cases, many of these cases, these are, these are signs of what I say, it's too many birthdays. It's the accumulated, um, injuries that occur over time, plus it's genetics and you're starting to see somewhere and tear in your knee and it's starting to show up.

Speaker 2: 3:55

Now, men, you know, we don't often listen to our bodies and what, uh, the idea, the idea that we would stop doing an activity just because it causes a little bit of pain, sometimes it will foreign to us. Sure. So when should men, you know, if they're having any kind of pain, you know, what kinds of pain should men like stop doing the activity or start adjusting what they're doing?

Speaker 4: 4:17

Yeah, that's a great question and I think, you know, even to, before I answer that, let me just say the goal is to keep you active. Anybody can put you in a wheelchair. Anybody can say just stop doing things. But the goal is to keep you doing the things you wanna do. So when should you take a pause and say, this is more serious than just a little tendonitis? Um, if you see swelling, and the easiest way to tell that is if you're straighten your knee out and you see a bubble there. Or if you can push'em one side and it's like a watered, you can feel this fluid wave goes through your knee. That's the check engine light of your knee. It doesn't tell you what's wrong, but it says there's something going on inside of your knee that's, that's more significant than just a little tendonitis. And it is probably working that looked at, that's one, um, one sign. Another sign would be if you are starting to have worsening pain at night, at rest on a consistent basis, starting to limp, um, during or certainly after the activity. I think that's a sign that you should get it looked at for sure.

Speaker 2: 5:07

I think a lot of us have seen or experienced people who have an acute injury or some kind of major injury to their knee, uh, during a physical activity. And, you know, uh, being the urologist, all I really know is the acl. So maybe you could tell us what, what are the ligaments that, that and not the music festival? Yeah. Not that one. I can't get tickets to that one. I could probably get tickets to the ACL that breaks my, uh, my leg though.<laugh>. So, so if, if somebody's gonna, uh, experience an acute injury, what, uh, what is likely to be injured and what are the symptoms of that?

Speaker 4: 5:37

Yeah, so I mean, I see almost daily in my practice, somebody coming in, having some event where they are playing a sport. They usually try to cut, make a hard cut, and they feel their knee shift. And I saw a patient yesterday and he said it felt like my knee exploded inside immediately swelling. And almost, almost a hundred percent of the time you're done participating, you can't go back on to the court or the field or you can take a few steps and then you realize

Speaker 2: 6:03

You really are, you're not walking this one off.

Speaker 4: 6:05

No, no, you're not, you're not playing another quarter or you're not finishing the next tennis match. That's not happening. And so that is a, that's a typical history. And before I go in the room, nine, nine times outta 10, I know that patient has an ACL tear.

Speaker 2: 6:17

Oh my gosh. And so, uh, when that happens, is that an immediate surgical repair? What, what happens to that patient? You know, what are you planning on doing? Yeah, so

Speaker 4: 6:27

You don't, your ACL won't heal itself, but you don't have to have an ACL to do many, many things in life. And I've told this to many patients, you can live a happy, healthy life without an acl, which you can't do, is you can't cut and pivot. So you can run as long as you're running straight ahead. You can work out daily activities in most cases are fine. But if you try to go play a sport where you're gonna plant and cut to the side, your knee is most likely not gonna be stable. It's gonna shift again. And every time that happens, it's gonna cause damage

Speaker 2: 6:51

So that my wife can't run away from me<laugh>, she runs straight forward,

Speaker 4: 6:56

Straight,

Speaker 2: 6:56

Straight. Right. Well, well I know what I'm doing today, tearing a acl. So if somebody's gonna fix that, um, what are some of the options that people have to fix it? And, and you know, so many people come to me ironically and say, my knee hurts. Can you order me an mri? Like they immediately want, they think the MRI is like the end all and be all of all imaging tests. What is the appropriate imaging that people should expect? What is the timeline? People should try to get things fixed when they have knee problems.

Speaker 4: 7:23

Sure, I'll talk about that. And they can go to my website. I have a video that's how to know if your ACL's torn and goes through all this in detail. But, uh, if you've got that swelling, if you had that event, then I think you should get it looked at because there're gonna be other things wrong as well. You can have meniscus tears and particular type of meniscus tears that are more urgent that can cause damage if you leave them alone. A locked bucket handle meniscus tear is what's in my mind right now. But it, let's just assume it's just an ACL tear. What are we typically gonna do? We're gonna examine them. Usually I can tell before they leave the room, we get them around to confirm, but I can tell before they, they leave the room that they have a tear just by a physical exam. And generally we're gonna let some time go by, we're gonna get their knee moving, get their swelling down within three to four weeks. Most people are walking without a limp. The vast majority are doing fine

Speaker 2: 8:03

Even if without a

Speaker 4: 8:04

Repair. That's right. And then, and then to your point, what do we do? Well, if we're gonna reconstruct it, we, you know, the patient says, I want to go and participate these sports. This is important to me. And generally that's 99% of people under the age of 40 and even most people in their forties. Um, then the number one way to do this is to reconstruct it. So, uh, acls don't heal themselves in cases. And, um, there are some people experimenting with trying to repair them these days that's been done in the past. There's a one saying, don't be the first person or the last person to do anything and in terms of surgeries. And so, um, I think we need to see that evidence that that is actually successful and really has long term legs before that becomes mainstream. So by far and away most people are reconstructing. That means you're taking a ligament from somewhere else in their body or from a, from somebody else who's recently passed away and you're inserting it in a, um, through surgery to reconstruct, to reproduce that

Speaker 2: 8:56

Ligament. So most of the time when somebody's getting an ACL repair, they're getting like a cave or some, some, some other ligament from, you know, either from that person or from somebody else to replace that, that that segment as opposed to trying to tie together the torn ligament that they already have in

Speaker 4: 9:12

There almost a hundred percent of the time. And so I, that's why I use the word reconstruction versus repair.

Speaker 2: 9:16

So, um, you know, we've talked about all the wonderful resources that you have. Where is your website? How do people get to be, uh, patients of yours and how do they get to learn so much more about orthopedic injuries? Sure.

Speaker 4: 9:27

So we're part of Austin Orthopedic Institute and you can go to austin oi.com. Myself and my partners have lots of resources on there on my webpage. There's um, a ton of videos and I'm adding to those all the time. And those are educational, they're free and they're just to help patients. They get to know me. But if it helps them in any way, even if they don't come in, that's great. You can call us at five one two eight five six 1000 if you want to come in and we'd love to see you.

Speaker 2: 9:48

8 5 6 1000. That's amazing. Why do we get such a stupid phone number? That's your

Speaker 3: 9:51

Fault,<laugh>. You pick that like 15 years ago.

Speaker 2: 9:54

It is like

Speaker 3: 9:55

The worlds, we need 8, 5, 6 nuts or

Speaker 2: 9:57

Something. Okay, look it up. If anybody here works for at and t, it's 8, 5, 6. Nuts. Nuts.

Speaker 3: 10:02

You're welcome.

Speaker 2: 10:03

We will get no female patients, you know what

Speaker 3: 10:05

I'm saying? No, that's okay. We'll get do that<laugh>. Sadly we think I

Speaker 2: 10:11

Oh my god. Our humor. Geez.

Speaker 3: 10:12

Oh boy. Well, Callister during the week at 5 1 2 2 3 8 0 7 6 2. We're in Round Rock, north Austin, south Austin and Dripping Springs, Texas. Our new shiny website is armor men's health.com and we're gonna continue this discussion with Dr.

Speaker 2: 10:24

Joel. We'll be right. Hello and welcome to the Arma Men's Health Show. I am Dr. Mystery, board certified urologist and host of this wonderful show. Join us always by my co-host Donnel Lee. That's

Speaker 3: 10:34

Right, you finally got it right. The Armor Men's Health

Speaker 2: 10:36

Show. You know, Donna, uh, I've been doing a medicine for a long time. That's

Speaker 3: 10:40

Why you have gray

Speaker 2: 10:40

Hairs. And this week though, was the first time I really wanted it as a punch a patient.

Speaker 3: 10:45

Oh, stop it. I'm telling we're doing this on the

Speaker 2: 10:46

Radio. I walked into the room

Speaker 3: 10:48

And he said,

Speaker 2: 10:48

He said, you know, I'm really comforted to see a more mature older doctor<laugh>. I could not believe what he said

Speaker 3: 10:56

To me. And he just walked

Speaker 2: 10:57

Out. I was confused. I looked behind me. I looked behind me wondering who he

Speaker 3: 11:04

Was talking about. Oh, it's you.

Speaker 2: 11:06

But this is our 15th year.

Speaker 3: 11:07

Yeah, that's why you have all the grays. It's very, I'm

Speaker 2: 11:10

An old doctor now. You are. I'm not the young buck on the field anymore doing cutting edge stuff. No, I'm just like the

Speaker 3: 11:16

Old guy. I did have the photographers color in though on the Photoshop your

Speaker 2: 11:19

Headshot. Oh, I know, we know<laugh>. My favorite thing is to get head shots because they put that thing in your hair where it makes you not as bald. Well,

Speaker 3: 11:26

I got,

Speaker 2: 11:27

Anyway, if you wanna look at our head shots, where

Speaker 3: 11:29

Do they go, Donna? They go to armor men's health.com. This show is brought to you by AAU Urology Specialist, which Dr. Mystery founded 15,

Speaker 2: 11:37

Just 15 minutes ago.

Speaker 3: 11:38

<laugh>. That's why

Speaker 2: 11:39

He's so young. I just graduated<laugh>. We are joined again by a wonderful, wonderful guest, a great friend of our practice and an amazing doctor. Dr. Joel Hurt. Welcome back. Joel. Welcome

Speaker 4: 11:49

Back. Thank you so much. So Joel,

Speaker 2: 11:50

Where did you go to medical school?

Speaker 4: 11:51

UT Southwestern in Dallas.

Speaker 2: 11:53

Oh man, that's the second best medical school in Mexico.<laugh>. Well, what's the first, obviously Baylor. Yeah. Okay. And where did you do your training?

Speaker 4: 12:01

I did it at Parkland at right next to UT Southwestern. So I spent nine years

Speaker 2: 12:04

In Dallas. Oh. The second best place to learn for urology<laugh> behind Baylor<laugh>. Oh no, that's weird. Well, that's good. And you can say all your alphabet and stuff like that, so that's nice.<laugh> And what is the name of your practice? Knows his phone number. Austin

Speaker 4: 12:17

Orthopedic Institute.

Speaker 2: 12:18

Right. What's the

Speaker 4: 12:19

Website? Austin oi.com.

Speaker 2: 12:21

That's right. As men age Arthritis is a very commonly stated reason for so many of our aches and pains. So maybe you could tell us kind of where are the most common places that arthritis, why are Southern all of a sudden, what happened? Oh, I'm Lockhart just like you, Amy. No, I'm Lockhart. Okay. Well, okay. You're a Lockhart tie. That's right. Tell us about a arthritis. What is it and like what are the main, uh, joints that are gonna get affected by

Speaker 4: 12:44

This? Sure. So when I talk to patients about arthritis, I just try to keep it simple. And this is a deterioration of your cartilage surfaces in your joints. The major joints that are involved we usually see are hip, knee, and shoulder as the cartilage deteriorates, whether it's genetic, whether it's related to post-traumatic changes. You had an injury years ago and that's led to this deterioration. As that occurs, the surfaces are no longer as smooth as they used to be. And so you start having pain, you start having swelling, you start having locking, catching. And oftentimes people don't anticipate as instability. They say My knee feels unstable, it's not a ligament problem. It's oftentimes just arthritis. It's just another manifestation.

Speaker 2: 13:16

What is the most common, like first line treatment for arthritis that people may

Speaker 4: 13:21

Overlook? Yeah, so we can't turn back the hands of time. Our, our ability to repair or restore cartilage back to normal is limited, especially in the diffuse, more age related or long-term arthritis issues. If you've got a focal cartilage lesion, then we can do transplants and we can do some specialized things for that. But when it's in your entire joint, we can't restore, we can't regrow your cartilage. No stem cells, no hyaluronic acid, no conjoin and glucosamine are gonna regrow the cartilage. What we're trying to do is we're trying to control symptoms. That's first line defense. And so that's physical therapy, that's an anti-inflammatories and Tylenol, that's weight loss. Every pound you lose is six pounds off your knee. And it's not always easy to do, but can make a profound difference. That's

Speaker 2: 13:59

An amazing, and you gain an inch in your penis,<laugh>. That's, that's right. You lose 30 pounds. We're about that. You get an inch on your penis and you lose 180 pounds on your knee.<laugh> Yeah. You go, you know, it's a, it, it's a, it's a win-win. It's a great message because you would think that more orthopedic surgeons would have nutritionist in their clinic because weight loss is such an important component of joint health and knee and, and, you know, joint health in general. So when somebody has, you're talking about symptom control, physical therapy to me seems kind of opposite to what would help like a knee that's overused. So maybe you could tell us why physical therapy is such an important, uh, adjunct to your therapy.

Speaker 4: 14:32

Yeah, absolutely. So, you know, getting range of motion, making sure that your muscles are appropriately toned and balanced makes a big difference. Sometimes you don't understand that there are other joints affecting downstream, so, um, your hip does have an effect on your knee. These things biomechanically interact and there's a lot of proof. There's a lot of, there are a lot of articles out here that show symptomatic improvement when you do the right forms of physical therapy. And so that's gonna be important. You're gonna need to deal with a therapist who understands this and you're gonna avoid ballistic activities. Things where you're pounding and hit. So people say, well, I like to walk or exercise that's easy on my knee. And I say, no, actually it's harder than you think. I push people to swimming, biking, elliptical, and rowing as less impact type activities that, you know, get your heart moving and build. And

Speaker 1: 15:11

It's a smoother motion,

Speaker 2: 15:13

Right. It's a smoother motion. Burn some

Speaker 4: 15:14

Calories.

Speaker 2: 15:14

So when somebody is using anti-inflammatories mm-hmm.<affirmative>, you know, sometimes people come to me and they're like, yeah, I take four Advil every four hours and I've been doing it for the last 20 years. Sure. What is, what is kind of your preferred recommendations to people when they're using anti-inflammatories for arthritis pain?

Speaker 4: 15:29

Sure. So I think les is more, all these things are foreign substances in her body and they can't have side effects. It can affect your, your kidneys clearly it can cause gastritis and if, and lead to bleeds, et cetera. So even I, ibuprofen as common as it is, can have issues. So you wanna be careful with that. I think firstly, you try to use them only when you absolutely need them. You can use them prophylactically before you're gonna go do an activity. So if you're gonna go climb a mountain and you know, you have a little arthritis taking ibuprofen beforehand, just like if you're gonna go drinking, you don't want to hangover. Taking it beforehand can actually be incredibly effective.

Speaker 2: 15:59

That's a really good piece of advice there is that if you, if you kind of prophylactically do things, you know, I love that word. Mm. All day. Because pulling out's a terrible strategy. That's

Speaker 1: 16:06

Right. A vasectomy is better.

Speaker 2: 16:07

<laugh> vasectomy is much better. Well, when it comes to when do you seek care for arthritis, what are the, the kind of hallmarks of when, you know, my knee pain or shoulder pain or elbow pain or whatever, pain mm-hmm.<affirmative> really needs the, the help of an orthopedic surgeon.

Speaker 4: 16:22

Yeah. I think just how it's affecting your life. So when you're starting to miss things that you wanna be able to do. So this, and I'll just use the example when I'm trying to help somebody make a decision if they should get a knee replacement, what I tell'em is you're be you're ready for it when number one, you have confirmed arthritis, but also you've tried other things. And then the last thing is, and conservative options that we've discussed, including injections, et cetera. And the last thing is your, your life is changing. You're not able to go and do the things that you would want to go do, spend time with your grandchildren. Um, go on this hike. Things that are reasonable. We're not talking about running marathons, we're talking about reasonable things. Find yourself sitting more and more or missing out on activities or you're just suffering. You know, at night your knee is aching and keeping you up. It's time to start thinking about that.

Speaker 2: 17:00

So if you put a joint replacement at one end of the spectrum Sure. And anti-inflammatories and just physical therapy at the other end of the spectrum. Sure. What are some of the middle range things that people may not know about that people could take advantage of that an orthopedic surgeon would do to help with that kind of pain?

Speaker 4: 17:14

Yeah, so we talked about some of em. Weight loss in therapy, you can also do injections, corti

Speaker 2: 17:18

Injection.

Speaker 4: 17:18

So you can put cortisone in in your knee. And so what is that? I tell people it's like a heat seeking missile of ibuprofen in your knee. It's a lot more effective than just taking oral meds. It's gonna have a much more profound effect when it quickly within five days, it can last varying amounts. We, I give about a thousand a year. I've looked at that and we just give a lot of these. I've been doing this for a long time. It is a tool, it is not the tool, it doesn't actually cure the arthritis, but it can be incredibly effective. I have patients who get an injection and don't come back for years sometimes, and I don't. And so it, they can be very helpful.

Speaker 2: 17:46

Are there things that a patient would know to look for that makes an injection better or worse or an injector better or worse?

Speaker 4: 17:54

Sure. Inject door define that.

Speaker 2: 17:56

Like you like, like, like, like if I'm looking for a guy to inject my knee, what am I looking for?

Speaker 4: 18:00

Yeah. Well, I mean, you know,

Speaker 2: 18:03

Because there's only so many be graduates in there. Right, right.

Speaker 4: 18:05

<laugh>, I think most doc, most, most orthopedic surgeons can inject an knee well. Uh, that said, when somebody comes to me and they've tried an injection and they have mild arthritis and they didn't respond, oftentimes I'll try it again because I don't know if their PA did it. I don't know if, um, if a patient is a little bit overweight, they had a little bit difficulty getting it into the joint, but if you haven't put the cortisone in the joint, it's not gonna work. And so I wanna make sure, you know, trust, but verified that I, that that actually didn't work. It,

Speaker 2: 18:31

It's such a spectacular piece of advice because oftentimes patients will come to me and they'll be kind of frustrated that I want to go again and do something that a previous urologist did. Mm-hmm.<affirmative>. And I, I always think to myself like that same thing, trust but verify because, you know, having a great ego is a really important like, prerequisite of being a great, of being a great surgeon, you know, and I never think anybody does it as good as I when you do it. So, uh, that's, so after injections, um, have you seen any kind of more holistic or kind of other kinds of approaches that people have taken that have worked?

Speaker 4: 19:01

Sure, sure. I mean, I think, um, so for sure we've talked about waste loss and for sure we've talked about getting other things, um, tuned up, et cetera. And then there are things out there that people have used. Some, um, of the, um, some of the more, um, less, less prescribed type medications that are out there. I'm trying to think what's the, what's the anti-inflammatory that's, um,

Speaker 2: 19:25

Celebrex we use

Speaker 4: 19:26

A lot. Well, that's per no that, but I'm talking about um, like the her or topicals. No topicals or, um, turmeric.

Speaker 3: 19:35

Turmeric. We do

Speaker 2: 19:36

A lot of that. Yeah. We do a lot of turmeric. Now do people ever inject like, like spongy stuff into the, into the joints? Sure.

Speaker 4: 19:43

So, so there, how acid is a, is a lubricant a thick gel that we inject into the knees. Um, meaning orthopedic surgeons, anybody who does musculal care can do that. And that has, there's some evidence that that can help with symptoms. It doesn't regrow cartilage, but it can help with symptoms and it works completely differently than steroids

Speaker 2: 20:03

Do. Well Joel, I can't thank you enough for, uh, giving us such great advice and you got to use lubricant and prophylactic.

Speaker 3: 20:09

I learned two things too today. My ability to not ever exercise is going to pay off soon because I'm not gonna be hurting. That's correct. And we don't use the words miss a heat missile guided.

Speaker 2: 20:19

Can you, can you get arthritis of the butt because I do a lot of sitting

Speaker 4: 20:23

<laugh>

Speaker 3: 20:23

Anyway. Website.

Speaker 2: 20:25

Joel, how do people get ahold of you?

Speaker 4: 20:26

Yeah, so you can, uh, reach us via phone number five one two eight five six 1000. You can find us on our website, austin ooi.com.

Speaker 2: 20:33

Can't thank you enough. And Donna, thank you so much for another great show,

Speaker 3: 20:37

Keith Guided Missile. You're welcome.

Speaker 1: 20:40

Dr. Mystery wants to hear from you. To submit a question, visit armor men's health.com. We'll be right back with the Armor Men's Health Show.