5 Reasons You Don’t See a Doctor, But Should
By: Jenna Bergen
Men in the Crystal family shy away from stethoscopes the way vampires recoil from crosses. Stuart Crystal avoided checkups throughout his 20s. His 30-year-old brother, Jonathan, waved him off when Stuart noticed a strange lump on Jonathan’s neck. “The lump kept growing bigger,” recalls Stuart, now a 46-year-old retired police officer living in Florida.
Months later, Jonathan saw a doctor, who instantly ordered a biopsy. It was lymphoma, and it had spread. A week later, he was dead. “His doctors said that he might have lived had he acted quickly enough,” says Stuart.
Jonathan Crystal should be an exception. Yet a recent survey by the American Academy of Family Physicians reveals that 55 percent of U.S. men haven’t seen their M.D. in the past year. “They’ll ignore blood in their urine and watch testicular tumors grow to the size of grapefruits because they’re afraid to come in,” says urologist Sheldon Marks, M.D., author of Prostate and Cancer: A Family Guide to Diagnosis, Treatment, and Survival.
Even young guys sometimes die horrible deaths because they ignore warning signs. We’re here to bust your excuses and show you how to maximize your visit once you go.
“I’m healthy. Why get a checkup?”
How do you know you’re healthy? One-third of all heart-attack victims never have any warning. “Men often wait until a crisis occurs before they see us,” says Rick Kellerman, M.D., a family physician in Wichita, Kansas, and board chairman of the American Academy of Family Physicians.
Doctor’s orders: To stop dreading exams, find a nearby internist (an M.D. specializing in internal medicine) you like and respect. Take care of the “like” part by meeting with several physicians in your area before an emergency strikes. See who asks the most questions about your medical history.
Double-check your gut instinct at docboard.org/docfinder, a site that lists disciplinary actions and malpractice suits against doctors. All clear? You and your new doctor can decide the frequency of your physicals based on your family history and risk factors, says Dr. Kellerman.
Maximize your visit: The nurse will cuff you as soon as you sit down, but the reading could be misleading. Sitting still for 16 minutes before being tested produces blood-pressure numbers that are more accurate, according to a study in the American Journal of Hypertension. The goal is for your BP to register less than 120/80 millimeters of mercury (mm/hg). If you test out at 115/75 at home but hit 140/90 in an exam, ask for a do-over.
“It all just feels too awkward.”
If you think a prostate exam is the height of humiliation, get over it. “Look, as a doctor it’s not something I look forward to either,” says Dr. Marks. “But I’ll do it so you don’t die a terrible and preventable death.”
An STD is another excuse to shy away from medical scrutiny. “Men almost always know when they have a sexually transmitted disease,” says Dr. Marks. “Usually, there’s a painful, burning, itching discharge from the penis. It won’t get better without treatment.”
Doctor’s orders: Remember, a prostate-specific antigen (PSA) blood test is noninvasive. As for digital rectal exams, don’t worry about jokes concerning your manhood. “Outside the office, doctors don’t talk about guys’ sizes,” says Dr. Marks. “The men we do talk about are those who opted for pain and death over 10 seconds of embarrassment.”
Regarding STDs, does the idea of stomaching a painful urethral swab have you feeling ill? Chill out. If your faucet has a drip, most docs will simply capture a few drops and send it to the lab. Meanwhile, they’ll prescribe a full course of oral antibiotics that covers gonorrhea, chlamydia, and syphilis.
Maximize your visit: Let your doctor know if you take the hair-loss drug Propecia, which can lower your PSA reading by half after a year of use. That doesn’t mean your risk of prostate cancer has plunged. In fact, an artificially lower score could be masking underlying trouble, according to a study published in Lancet Oncology.
“I hope it’ll just go away.”
Even something as innocuous as a mole needs to be checked out. Melanoma is a cancer of the skin’s pigment-producing cells, and it kills almost 8,000 people each year. What’s more, one out of every 58 people will be diagnosed with it in his or her lifetime. “It’s a very aggressive tumor,” says John Romano, M.D., a clinical assistant professor of dermatology at Cornell University’s Weill Medical College.
Still, many men drag their feet. “I’ve had patients say they saw a mole changing but were afraid to come in because of what we might say,” says Dr. Romano. “Bad news becomes a self-fulfilling prophecy.”
Doctor’s orders: Any mole that suddenly darkens or changes shape should be checked out, especially if you have many moles or a family history of melanoma. Other warning signs: a ragged or blurred border, color shifts across the mole’s surface, or a diameter exceeding that of the head of a pencil eraser.
Maximize your visit: Think of your skin as a single organ; cancer can crop up in areas not directly exposed to sun. Point out any suspicious moles, even those normally covered by clothing.
“I don’t want a scope up there.”
“Men aren’t used to being probed and examined like women are,” says Mark Reichelderfer, M.D., the chief of clinical gastroenterology at UW Health in Wisconsin. “But it’s a small price to pay to prevent a totally devastating disease.
“More than 50,000 people die of colon and rectal cancers each year, and early screening could have prevented many of those deaths. “One in three people who wait to come in until they’re experiencing symptoms—blood in the stool, severe abdominal pain, or a narrower stool—will die,” says Dr. Reichelderfer.
Doctor’s orders: Everyone knows to see a doc if they’re flushing blood down the toilet, but anemia and rectal pain can also signal cancer. Regardless, schedule a colonoscopy every 10 years, starting at age 50. If a family member has had colon cancer, begin screening 10 years before the age at which they were diagnosed.
Maximize your visit: While not as accurate as a traditional colonoscopy, less-invasive virtual procedures are better than no exam at all. A tube is inserted into the colon, but instead of a 30-minute expedition into your bowels, a CT scan captures a 3D image of your innards in 10 to 15 minutes. “We can fly through the colon and look for polyps like a video game,” says Dr. Reichelderfer.
“I can’t afford a checkup.”
Even with insurance, co-pays and deductibles can hurt. If you’re having trouble making payments, speak up. “I’ve never known a doctor who wouldn’t try to help, whether it’s by not charging as much or by giving you extra samples of a prescription,” says Dr. Marks. If your doc orders a bunch of tests or medications, it’s okay to inquire about less-expensive alternatives.
Doctor’s orders: Read the bill. “Often, you’ll see errors, which are rarely to your benefit,” says Dr. Marks. “I’ve seen men charged for gynecological procedures.” If you can’t understand the medical jargon, ask your doctor to look over the bill for you.
Maximize your visit: Don’t hesitate to ask your doctor for free samples of any medications he’s prescribing. Yes, it’s playing into Big Pharma’s marketing strategy, but it’s also a quick way to save money.