Ask Dr. Irreverent
Got a Medical Question? He’s got an Answer.
Q: I turned 53 last month, and recently I’ve had to get up a few times in the middle of the night to pee. What’s the deal with that?
“Sleepless in South Bend”
Nighttime trips to the bathroom can become increasingly common for men as we age. The good news is that it usually doesn’t indicate any serious problems. Most commonly, it is a symptom of an enlarging prostate. In almost all men, the prostate tends to slowly get bigger in the middle-age years (along with rapidly receding hairlines!). What happens is this – when you go to the bathroom, urine from your bladder travels through a tube called the urethra. Along its path, the urethra travels through the prostate gland. As the prostate enlarges, it can squeeze the urethra and make it more difficult for urine to pass through freely. This can result in trouble starting the stream, a weaker stream and more frequent trips to the bathroom.
There are some medications available to reduce the symptoms, but sometimes surgery may be required to open things up a bit. The tendency over time is for this to slowly get worse. Talk to your doctor if you’re having these symptoms to make sure there isn’t something else going on with your urinary tract.
Q: My wife and I have been trying to have a kid for a while now, but still nothing. I’m starting to wonder if it has something to do with my swimmers, but I dread the idea of going to the doctor’s office to get tested. Is it a big deal to do? What’s the likelihood that it’s me and not her?
Not a big deal at all.
It can take some couples up to six to 12 months to get pregnant. But if you’ve been giving it an honest, good “old college try” for longer than that, it probably is worth talking to your doctor. There could be a variety of issues with either one of you – one of which has to do with your “swimmers.”
It’s understandable to feel some apprehension about getting your “manhood” checked out, but that’s what docs are for, right? Even though this stuff is commonplace for docs to deal with, it’s probably the first time for you. But don’t worry, your doc and his or her staff will remain professional and keep your privacy a priority. The test itself is not a big deal at all – the trick is collecting the sample and getting it to the lab while it’s still warm (usually within 30 minutes). There are a few other instructions regarding collecting the sample, so talk with your doctor so you don’t have to repeat the process.
Q: I’ve been smoking for years, want to quit, but every time I try, I end up caving a few weeks or even months later. What are the best treatments to kick the habit for good?
“The Human Chimney”
Over the years I’ve been practicing medicine, I’ve developed a deep respect for the strength of the nicotine addiction. However, I’m happy to report, I’ve seen lots of men and women beat this nasty habit for good. Anyone can conquer nicotine. The most important thing has nothing to do with medications but has everything to do with your level of motivation. There are a variety of medications on the market to help you quit, but all the medicine in the world won’t help if you’re not ready mentally.
A few quick tips that may help you in your quest for fresher breath:
- Set a quit date. Choose a date wisely, one that will set you up for success (don’t choose a day or week that you already know will be stressful).
- Plan to quit cold-turkey – on your quit date. Studies show there is better success with this method than with weaning down your smoking. You can wean until your quit date, but that is the day you are no longer a smoker – period!
- If you think you’ll have trouble on your own, make an appointment with your doctor to talk about medication options. This can really help make the process a bit more tolerable, for you and your family! Good luck!
Q: I’m confused about vitamins. I heard recently that vitamins aren’t good for you? How on earth could this be right?
This is a really common question, so I’m glad you asked. For most people, taking extra vitamins is completely unnecessary and hasn’t been shown convincingly to lead to any health benefits. And it’s true – there are actually some research studies that have shown that too much of certain vitamins can be bad for you. While there is likely no harm in taking a once daily multivitamin, there are some differences between the various vitamins on the market. It’s always a good idea to talk to the pharmacist or your doctor before choosing which one to buy (a 50-year-old man shouldn’t take a vitamin that’s designed for a menstruating 20-year-old female).
The best option, however, is to eat a healthy diet with plenty of fruits and veggies. If Mother Nature wanted us to take pills for vitamins, they’d grow on trees. The produce section of your local supermarket is probably the best source of vitamins around!
Sometimes your doctor will prescribe vitamins for medical conditions, and it’s important to take them as prescribed. It’s also key that you’re monitored by your doctor if taking prescription-dose vitamins.
Q: My wife and I have three kids, and we both agree that this is a good number. She wants to get off the pill and mentioned that I could get a vasectomy. How exactly does a vasectomy work? Will I notice a difference once it’s done?
Speaking from experience, a vasectomy is an excellent method of long-term birth control. But it’s important to be really sure you don’t ever want to have any more kids – no matter what. It’s considered a permanent procedure. Some people try to have it reversed years later, but it’s expensive and doesn’t always work.
The procedure usually only takes about 30 minutes, but then plan on renting some movies and laying low for a few days. After your initial recovery period, you can ease back into business as usual, including sexual activity.
The vasectomy should have absolutely no effect on your sexual desire or function, except some men may notice a slight decrease in the volume of ejaculate. It’s also very important to remember – you are not sterile immediately after the procedure. You still need to “clean the pipes,” which usually takes 15 to 20 ejaculations over a few months. And it’s important to give a couple of samples to get checked to make sure you are “shooting blanks” before formally stopping birth control (i.e. “pulling the goalie”). You certainly don’t want any little surprises!