The Armor Men's Health Show
The Armor Men's Health Show with hosts Dr. Sandeep Mistry and Donna Lee is a weekly show covering a multitude of medical topics important to men...and sometimes women. Dr. Mistry is a Board Certified Urologist and founder of NAU Urology Specialists in Austin, TX. Donna Lee is Director of Business Development and a professional stand-up comedian. The medical and wellness discussions between them (and guests) will be informative, interesting, and funny. Dr. Mistry and Donna Lee discuss topics such as erectile dysfunction, prostate cancer, enlarged prostate, testosterone therapy, fertility, kidney stones, vasectomies and so much more. Their holistic approach to men's health which includes nutrition, weight loss, sleep health, sex therapy, and pelvic floor physical therapy will also be showcased. In addition, they have prominent and respected physicians and specialists throughout the Austin area who will give their views on important men's health topics such as orthopedics, cardiology, endocrinology, internal medicine, general wellness, and much, much more.
The Armor Men's Health Show
Colonoscopies: The Dirty Details and Why You Can't Procrastinate With Dr. Bowden-McKay of Capitol Gastro
Thanks for tuning in to the Armor Men’s Health Hour Podcast today, where we bring you the latest and greatest in medical and urology care and the best urology humor out there.
In this segment, Dr. Mistry and Donna Lee are joined by gastroenterologist Dr. Crystal Bowden-McKay of Capitol Gastro for a discussion about colon cancer risk and colonoscopies. While no one loves completing the bowel prep involved in getting a colonoscopy, it remains the best diagnostic and therapeutic tool for finding and removing colon polyps. This procedure also allows for longer intervals between screenings--so get your colonoscopy done and you might not need another one for several years! While colon cancer is often difficult to detect without screenings, there are some warning signs you should never ignore: blood in the stool, whether dark brown and tar like or bright red, should always be cause for concern. So when should you have your first colonoscopy? For most patients with an average risk, 50 is the age when you should schedule your first colonoscopy. If you're an African American with an average risk, you should start slightly sooner at 45. If you have a family history of colon cancer or advanced adenomas, meaning one first degree relative or two second degree relatives with these conditions, you should consult with your GI doctor who will likely recommend starting at 40. Other risk factors that make earlier screening necessary include having inflammatory bowel disease or a genetic predisposition to developing colon cancer. While not the most pleasant of experiences, colonoscopies are lifesaving health screenings, so call your GI today and make sure you're on schedule!
You can contact Dr. Bowden-McKay at (512) 963-6022 and capitolgastro.com
If you enjoyed today’s episode, don’t forget to like, subscribe, and share us with a friend! As always, be well!
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.
We enjoy hearing from you! Email us at armormenshealth@gmail.com and we’ll answer your question in an upcoming episode!
Phone: (512) 238-0762
Email: Armormenshealth@gmail.com
Website: Armormenshealth.com
Our Locations:
Round Rock Office
970 Hester’s Crossing Road
Suite 101
Round Rock, TX 78681
South Austin Office
6501 South Congress
Suite 1-103
Austin, TX 78745
Lakeline Office
12505 Hymeadow Drive
Suite 2C
Austin, TX 78750
Dripping Springs Office
170 Benney Lane
Suite 202
Dripping Springs, TX 78620
Welcome back to the Armor Men's Health Hour with Dr. Mistry and Donna Lee.
Dr. Mistry:Hello and welcome to the Armor Men's Health Hour. I'm Dr. Mistry, your host, here as always with my cohost, the very funny and talented Donna Lee.
Donna Lee:Thank you. You never say cute or funky. It's always just...
Dr. Mistry:Funky? This is the word you're looking for?
Donna Lee:I thought you'd shoot me down if I said"pretty," so...
Dr. Mistry:You know what I realized? You can never, you can never guess the compliments a woman's looking for.
Donna Lee:No, you can't.
Dr. Mistry:Or I can't at least.
Donna Lee:But if you give her one, if you at least give her one, she's okay.
Dr. Mistry:That was the Chris Rock joke."Women love compliments."
Donna Lee:I thought it was a joke where he said,"I don't trust nothing that bleeds for a week and doesn't die."
Dr. Mistry:Well very good. Nice to meet you everybody. This is a men's health show. I'm a board certified urologist. Donna's a professional comedienne, that she was 12 years ago when she was voted the seventh funniest men, woman, mother, mother in American.
Donna Lee:Seventh funniest mom in America per Nick at Night.
Dr. Mistry:That's right.
Donna Lee:I got street cred.
Dr. Mistry:There you go. One of the things that we get asked a lot, Donna is when people hit certain milestones, like 30, 40, 50, 60, 70, they come in for like a men's health checkup. And I think that we can handle a lot of that. We do labs, we examine their prostate, which is kind of like the urology handshake. And there's so many things that you do. And I, I feel like having a great doctor in your life is important, but...
Donna Lee:Like any specialty, yep.
Dr. Mistry:But the one thing that I see a lot of men not do...
Donna Lee:...is take care of themselves?
Dr. Mistry:...os get a colonoscopy.
Donna Lee:Well, you're probably not gonna want to do that either at that time.
Dr. Mistry:Are you kidding? I'm already signed up.
Donna Lee:You get one every weekend.
Dr. Mistry:Hey, hey! That's enough out of you, grosso!
Donna Lee:Is that where you and my husband go all the time?
Dr. Mistry:Oh my Lord. So, anyway, we have one of our partners in health. We have Dr. Crystal Bowden-McKay with Capitol Gastro. Thank you so much for joining. I'm sorry for the jokes.
Dr. Bowden-McKay:No, it's...Thank you for having me.
Donna Lee:Welcome back.
Dr. Mistry:For those few listeners that are still tuned in, maybe you could just briefly tell me what a gastroenterologist does and what role they play in kind of the screening health of us in, as human beings.
Dr. Bowden-McKay:Yeah. So gastroenterology is pretty much the medicine doctors of the gastrointestinal tract. And when it comes to screening, we are the physicians that would do pretty much screening for colon cancer, because it's our forte. We are the specialist in endoscopy.
Dr. Mistry:It's the 21st century. Do we still need to stick cameras in people's like orifices to look for colon cancer? I mean, haven't, we figured something out better? Because patients ask me all the time, isn't there a better way to find prostate cancer? Nope. We've got to stick something in there... So when they, when they asked you that maybe you could just describe what the colonoscopy experience is like. And then some alternatives to the colonoscopy that people have kind of are using to look at people at risk for colon cancer.
Dr. Bowden-McKay:Right. So definitely there are different modalities available for colon cancer screening. Colonoscopy is just one of those I'm having a colonoscopy is the only screening tool that can also the therapeutic tool, meaning that it's kind of like the one-stop shop, so.
Dr. Mistry:Because you can go in there, find a polyp and take it out.
Dr. Bowden-McKay:Exactly. So that's the whole point is to find them into remove them at the same time. It's also the only modality that allows for pretty much prolonged intervals between needing rescreening.
Dr. Mistry:Meaning that if you got a negative colonoscopy today, you may not need it for another 10 years.
Dr. Bowden-McKay:Exactly. So that's really nice. The other modalities are what we call stool-based testing. So they essentially look for either markers of blood or changes in the colon DNA that are indicative of possible polyp or colon cancer.
Dr. Mistry:So like the poop is really kind of the litmus test of how the rest of the, the gut is doing.
Dr. Bowden-McKay:Yes, exactly. Although we do have to point out that if you have a positive test with those stool tests, you then need a colonoscopy.
Dr. Mistry:That's right. So all roads end in colonoscopy.
Dr. Bowden-McKay:Yes.
Donna Lee:All end roads ends towards poop.
Dr. Mistry:That's right. You know, one time we had a GI doc, we had, we had a general surgeon on and all they could do is complain about how Donna's gut health was so terrible. Do you remember that?
Donna Lee:Oh, that's right. I do. And then he like reached out to me afterwards. He was like,"You should really get help." I'm like,"I'm scared."
Dr. Mistry:It was the funniest thing.
Donna Lee:I said,"Is it not normal to want to throw out up, to run back to the bathroom and throw up a few times a day or something like that?" And he was like,"That is not normal. You need to be checked."
Dr. Mistry:That's right. So people are always like,"Well, I don't need to get screened. I'm not having any symptoms." But I tell them when it comes to prostate cancer, once you have symptoms, like that's a very bad sign because you're probably going to die of prostate cancer. So, but when it comes to colon cancer, are there early symptoms, late symptoms? What, what are some symptoms that people would worry about that may really alert them to something going on?
Dr. Bowden-McKay:Unfortunately, you know, we're not really meant to feel a lot of things in our GI tract. So by the time patients typically present with symptoms that are related to colon cancer, it's already probably pretty far advanced. So the most common symptom that people typically complain of if they have colon cancer or advanced adenomas--so, adenomas is just essentially almost colon cancer--is bleeding. So people are complaining of either black tarry stool that's coming from more of the beginning, part of the colon or bright red blood.
Dr. Mistry:So bright red blood in the stool is probably not something we should ignore.
Dr. Bowden-McKay:No, please do not.
Dr. Mistry:And then a colonoscopy is one screening tool. Now there's some other ones that I see. I see like this really fun little box that dances on television. What's, what's the what's what's cologuard and who should use that?
Dr. Bowden-McKay:Cologuard is a stool-based a screening test for colon cancer. It's a two-part test. It has a test for blood, which is kind of the traditional old school colon cancer screening tool. And then it also has a DNA based test, which looks for changes in the, in the stool that has DNA that's related to either colon polyps or colon cancer.
Dr. Mistry:So to make this work, presumably you have to poop in a cup, right?
Dr. Bowden-McKay:Yes.
Dr. Mistry:And who is an appropriate person to poop in a cup instead of getting a colonoscopy?
Dr. Bowden-McKay:Any stool-based, has the patient needs to be what we call it completely average risk. So this is a person who's never had polyps on a previous colonoscopy. These are patients that are not having any symptoms, meaning no blood in the stool. No, no complaints whatsoever. And also patients who have no family history of colon cancer or advanced polyps.
Dr. Mistry:So if you are very low risk, it's possible that you could potentially consider yourself somewhat safe with something like this. But if you're going to go through a colonoscopy, I don't think anybody cares about getting a little bit of propofol going to sleep and getting something done to them. They really care about the bowel prep.
Dr. Bowden-McKay:Right. And that that's...
Dr. Mistry:Why do you make us go through it? What's what's wrong with you people? Is this some sick joke?
Dr. Bowden-McKay:I know, it's civilized torture. That is definitely the part that patients--so if they don't know what a colonoscopy is, they are scared about being awake for it. That's the first question.
Dr. Mistry:You're not going to be awake for it.
Dr. Bowden-McKay:But you're not going to be awake. Thankfully with our anesthesia colleagues, we have made it a much more pleasant experience.
Dr. Mistry:And can you drive there and drive home or not?
Dr. Bowden-McKay:Not if you're going to get the propofol[ inaudible].
Dr. Mistry:Men, be nice to your wife. Let her drive you.
Dr. Bowden-McKay:Yes. If you're going to get sedation for your colonoscopy, you can not drive yourself home for sure.
Dr. Mistry:Okay. So then they go and about how long does the colonoscopy last?
Dr. Bowden-McKay:The colonoscopy itself only takes about 30 minutes.
Dr. Mistry:Okay. So you go get a little sedative, you get this thing put somewhere. And I don't think people need to really imagine what's happening. Let's just say that you go to sleep and something happens. Then you wake up, you feel great.
Donna Lee:Tickle your butt. You get the date rape drug and they tickle your butt.
Dr. Mistry:This is not what we're saying on the radio. Do you understand? It's not...
Dr. Bowden-McKay:No. Please don't scare people away from their colonoscopies.
Dr. Mistry:If it's anything, it's the it's, it's the Michael Jackson milk.
Dr. Bowden-McKay:Yes. It's the Michael Jackson drug. But I tell them that they're going to be monitored the whole time, unlike him. That's right. You're not going anywhere that you're not supposed to go.
Donna Lee:And you're not sore afterwards right?
Dr. Bowden-McKay:No.
Dr. Mistry:My wife's an anesthetist. So somebody like her is going to take care of you. And she's gonna do a very good job. But again, why the bowel prep?
Dr. Bowden-McKay:I know. So the colon's only job is to turn liquid stool into solid stool. That's what it does. That's only, its only role in our body really. So it's always full of stool all the time. But in order for me to see the lining of the colon, which is where the polyps and colon cancer hang out, we need it cleaned out. I need to be able to see.
Dr. Mistry:Because it's gross for people to think. But that sewer pipe has stuff caked on the sides of it.
Dr. Bowden-McKay:Oh yeah. All the time.
Dr. Mistry:And if you don't, if you don't clear that stuff out, you're not looking. And I have seen the images of colonoscopy when it's full of poop, nobody's seeing nothing. It is just a big brown mess.
Dr. Bowden-McKay:Right, yeah.
Dr. Mistry:Do your, do your bowel prep.
Dr. Bowden-McKay:Please.
Dr. Mistry:And, and is the bowel prep pretty much going to be the same regardless of which gastroenterologist you go to?
Dr. Bowden-McKay:Most of us gastroenterologists, you know, we really talk about how to do high quality endoscopy and having a good bowel prep is probably the most important thing.
Dr. Mistry:Even though it's annoying to do, if you're only going to do something once every 10 years, do it right.
Dr. Bowden-McKay:Do it right. You don't want to come back and let it. You don't want your gastroenterologist to see you after the procedure and be like,"I couldn't see anything. You have to come back in six months."
Dr. Mistry:Yeah. I don't want to do that.
Donna Lee:Good point.
Dr. Mistry:Unless you're going to make it a hobby of it.
Donna Lee:[Inaudible] on the weekends.
Dr. Mistry:No. Do not make a hobby of your colonoscopy team.
Dr. Bowden-McKay:No.
Dr. Mistry:It is probably not worth it....
Dr. Bowden-McKay:You probably have problems if it's a hobby.
Dr. Mistry:And I know we don't have much time, but the PillCam, which sounds awesome, but I don't know if I could swallow something that big. How big is it?
Dr. Bowden-McKay:The PillCam is really used for looking at the small intestine. So the small bowel, because...
Dr. Mistry:You can't skip, you can't put scopes in there. It's too, it's too, too high or low up.
Dr. Bowden-McKay:We get, we do have, we do have, so interventional gastroenterologists or advanced endoscopists, they do do procedures to go into the small bowel, but those are very complicated, very long procedures. I mean, it's, you need to know which side you're going to start out. You're going to go from above? You're going to go from below? And the PillCam kind of helps us delineate that and if we even need to do the procedure. So the PillCam itself is it's pretty large. It's a, it's a little over two centimeters long. So yeah, it's a fairly big horse pill.
Dr. Mistry:As of right now, we don't have a great alternative to doing your colonoscopy. So don't be afraid guys. Get it done at 50, unless you're at risk, then you get it done at 45. Is that right?
Dr. Bowden-McKay:So if you, it's 50 for all average risk patients with exception of African-Americans--they should actually be started at 45. 40 years old if you are high risk, and that means if you have any first degree relative, who's had colon cancer or advanced adenoma or two second degree relatives who have had colon cancer or advanced adenoma. Also there's special indications for patients who have inflammatory bowel disease or patients who have genetic predisposition.
Dr. Mistry:So ask your primary care doctor starting at 40 if you're someone that needs to have it earlu. Thank you so much for joining us today. Dr. Bowden-McKay from Capitol Gastro(512) 593-6022 is their number Capitol Gastro with an O. Two o's really,.com. And Donna, how do people get ahold of us?
Donna Lee:You can reach out to us at armormenshealth.com or call us at(512) 238-0762. Thank you so much.
Dr. Bowden-McKay:Thank you.
:Dr. Mistry wants to hear from you. Email questions to armormenshealth@gmail.com. We'll be right back with the Armor Men's Health Hour.