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Scot: All right, guys. I've got a question for you. So you're out hiking, or in Troy's case, you're trail running a marathon on a Saturday because for whatever reason that's what you do, or you're camping or anything like that, and all of a sudden you realize you just surprised a bear, and this bear is 10 feet away from you. Are you in danger? Is this a reason for concern?

I'll go ahead and start with Mitch on this one.

Mitch: Oh, for how . . .

Scot: Is your life threatened?

Mitch: Yeah, I'm in danger. I would assume, right?

Scot: You hesitated.

Mitch: It's not, "I'm going to try to be as big as possible."

Scot: Sure. Troy, is that a danger?

Troy: Absolutely. Speaking from experience. Just last summer, I got chased by a bear on the trail. He was not quite 10 feet, but probably 20 feet from me. And I was scared to death. Absolutely. It was incredibly scary.

Scot: Yeah. But you lived to tell the tale.

Troy: I lived through it. I lived to tell the tale. I recognized the danger. I yelled at the bear, and somehow the bear stopped. It was charging me. And I said, "Whoa, whoa," and I put my arms up, tried to make myself look big, and it stopped. So I recognized the danger, confronted it, and then backed slowly away, and then ran as soon as I was out of sight of the bear.

Scot: All right. Well, I think all of us as guys could recognize the fact that if we were face to face with a moose or a mountain lion or a rattlesnake or a bear, this is a dangerous situation. This is a reason for concern. This is something that could potentially kill you. But did you know that statistics suggest that there have only been 180 fatal bear attacks in North America since 1784?

Troy: Oh, wow.

Scot: So it seems like a major danger, right? But there have only been 180 of them since 1784.

Troy: Since 1784?

Mitch: Time out. Every single national park that I go to, you're in the visitor center, they're like, "Bears. Warning signs of bears." You go out on a camping trip. It's like, "Be sure to carry your bear spray." One hundred and eighty, and there's that much . . .

Troy: Wow. I thought it was much more common after watching "Legends of the Fall" and seeing Brad Pitt die . . .

Mitch: Revenant?

Troy: . . . I thought it happened frequently, but I guess not.

Scot: Gosh, it probably could have happened to any of us. That's funny that you bring it up, Mitch. So the fact that there's all this talk about how dangerous bears are any time you go to the parks, but you don't really see warning signs for the things we're going to talk about that are bigger dangers to men's health. Today, we're going to talk about five killers that men ignore. Five things that can kill you that men ignore that kill a lot more men than bears.

That's what we're going to talk about on "Who Cares About Men's Health," with information, inspiration, and a different interpretation of men's health. I bring the BS. My name is Scot. The MD to my BS, Dr. Troy Madsen.

Troy: Hey, Scot. I'm here and ready to talk about bears and beets and "Battlestar Galactica" and whatever else.

Scot: And he's a "Who Cares About Men's Health" convert, Producer Mitch.

Mitch: What's more dangerous, a bear or a Cylon?

Troy: Bears.

Mitch: Obviously.

Scot: All right. So Troy has put together for us a list of things to discuss. These are killers men ignore. Unlike the bear, where we get bear spray, and we wear bear bells, and we take all these precautions when we go hiking, a lot of times we ignore these things, and sometimes they can just sneak up on men.

So, Troy, let's go ahead and start with this list. What are the things we really should be concerned about?

Troy: It's great, Scot, because, like you said, a lot of these things do sneak up on us, and when they do sneak up on us, sometimes it's too late. And these are the things we're talking about today, things that we may not be aware of lurking in the bushes as we're running on the trail, just eating some berries, and then jumping out of the woods right at us and they're on us.

So I'll let you guys guess. What do you think number one on this list is? It's typically been the number one killer of men. It's actually gone down the list a little bit now.

Mitch: Oh, really?

Troy: Yeah. When you think of someone just dropping dead out of the blue, what do you think of?

Mitch: Heart attack.

Troy: Heart attack. Exactly. It's traditionally been the number-one killer of men. I think it's kind of dropped down the list a little bit. I think cancer has moved up to number one.

Mitch: Oh, wow.

Troy: But traditionally, when you think of people, just something sneaking up on them out of the blue, in my mind, I think of a heart attack. And it's one of those things where I've just seen some crazy things in the ER.

One of the cases that just sticks in my mind was a guy who was skiing in his 50s and just came down the slope, dropped down, and had a heart attack. Fortunately, ski patrol was right there, started CPR immediately. He had CPR going for over an hour by the time he got to us in the ER, and he walked out of the hospital three days later. Absolutely remarkable.

Mitch: Wow.

Troy: But it was one of those cases . . . Yeah, it was incredible. When I think back of one of the most incredible things I've seen, it was that.

But when you think about stuff that just sneaks up on people out of the blue, no history of knowing anything about heart disease, I think about heart attacks. And that is certainly one of the sneaky, silent killers of men that you may not know anything about. You may not know it's lurking there until it's too late, and you have a heart attack.

Scot: So, in 2021, guys, about 695,000 people died from heart disease. That's one in every five deaths.

Mitch: Wow.

Troy: Yeah, one out of every five deaths. And again, I think probably 50 years ago, that number was much higher where it was much more than 1 in every 5 deaths. We have done a lot better job of preventing heart disease by recognizing the risk factors and trying to modify those, and doing screening tests when people are having some chest pain or other potential symptoms of a mild heart attack before it's a big one. So we have dropped that number down, but still, it happens with some frequency.

And again, it's one of those things where it can just come out of the blue and no one has an idea that they have heart disease. And the next thing they know, they're potentially in the back of an ambulance with chest compressions going.

Scot: And why do we, as guys, ignore that? Why is that number as high as it is? I would think that we'd be at a point in our world where that shouldn't be that high.

Troy: I think there's a certain piece of denial. We may recognize, "I'm overweight," or, "My cholesterol is high," or, "Maybe I've had some chest pain too. I'm out shoveling snow and I get a little chest pain, but I just ignore it." So I think denial is potentially part of it.

There's also that idea that you just kind of push through the pain, and sometimes pushing through the pain that can be an early warning sign of heart disease, and we just don't go get screened or we don't go to the ER. Then potentially that becomes a much bigger issue, and then you have a major heart attack.

Mitch: So when you're shoveling snow and stuff and you got a pain in your chest, does it typically go away? I'm trying to think of myself, and if I was out and I'd be like, "My chest is kind of . . . Oh, what is that? That's a little weird. Maybe I have an air bubble. Maybe something is going on." And then I go inside, sit down, and if it goes away in a couple minutes, I'm not going to go anywhere to get it checked.

Troy: I know. It's so tough too because if you came in the ER, we'd probably get an EKG on you just to look at your heart. We might do a blood test. If you had those same symptoms and you were 65 years old and had a history of high blood pressure and high cholesterol, we'd do a lot more testing. So it's really tough.

I would say I've just seen so many heart attacks where people describe something exactly like that, and they're just like, "Oh, it's a little air bubble in my chest," or, "It's pressure. It's not pain." Just these weird descriptions that don't fit a textbook, and you do blood work, and the blood work comes back positive, showing they're having a heart attack. It's really kind of a crazy thing.

So it's going to depend a lot on your risk factors for heart disease. Someone who's young and otherwise healthy, hard to know what to make of that kind of symptom. But someone who has other issues, you really have to take it seriously.

Scot: Some of what I've heard too is that kind of media notion, that popular culture notion of a heart attack is this, "Ugh, ugh, ugh." It's this major thing, right? I've talked to a couple of individuals who have had heart attacks, and their main symptom was nausea. It wasn't really even chest pain. It was more nausea, shortness of breath, super tired, couldn't really get around, and they had had some small heart attacks. So it was kind of those symptoms.

Troy: It's really crazy. I know the longer you practice medicine and see patients come in with heart attacks, the more you realize just how many people have symptoms that are what we call atypical symptoms.

I had a guy once who was sent in because he had several fingers that had been amputated and needed to have them reattached. And I said, "Well, are you having pain anywhere else?" He's like, "Well, my shoulder kind of hurts." I thought, "Well, let's get an EKG." And he was having a major heart attack.

He's just sitting there waiting to go to the operating room to have his fingers reattached, and we look and he's having a major heart attack. I'm like, "You've got to be kidding me." It's that kind of stuff. He's not clutching his chest. He's not sweating profusely. He's like, "Oh, yeah, my shoulder is a little sore."

So it's tough. It is really tough because a lot of people have just unusual symptoms, and it can sneak up on people.

And I don't say that to scare people and say at every symptom you have to go to the ER, but also recognize if you're having symptoms that just don't seem quite right, especially if you have other risk factors for a heart attack . . . Like I said, family history, smoking history, high blood pressure, high cholesterol. Those are some of the big things we think about. It's probably worth getting checked out.

Scot: Okay. Cool. So those are some of the ways that you can prevent that from happening. Just being aware of those factors in your life. And then, obviously, we always like to come back to the Core Four, right? Are you overweight? How's your diet, your nutrition, those sorts of things?

How about number two? What is another killer of men that oftentimes goes ignored for whatever reason?

Troy: Well, another one that sometimes goes ignored is prostate cancer. And this kind of gets on the cancer list. Like I said, I think at this point cancer is higher than heart disease in terms of killers of men. We could look that up, but I'm pretty sure it's up there now.

Prostate cancer is certainly on that list. Prostate cancer is kind of tough because one of the things about prostate cancer they often say is men often die with prostate cancer rather than of prostate cancer. So a lot of times people will have prostate cancer, but it's just kind of one of those things where it's there and it just kind of lasts a long time, and it doesn't really have major effects.

But at the same time, it can also be one of those things where it doesn't get diagnosed until it's advanced and it has metastasized, spread throughout the body, often to the bones.

I have seen patients who have come to the ER with back pain. We've gotten an X-ray or a CT scan and have seen metastases in the spine, where it's actually potentially just causing pain or led to a fracture, and the source of that has been prostate cancer.

So it's one of those things again that can sneak up on people, and they don't realize it until it's fairly advanced. Screening is a challenging area to discuss, and it's probably one of those things where we need to get John Smith on here to really talk about screening for prostate cancer.

It has become kind of controversial where some statistics have said that screening results in a lot of false positives, and maybe the risks outweigh the benefits. Others will say, "No. Get screening done. Get a PSA check." It's kind of a nuanced thing, I think, at this point.

But that being said, when I talked to my primary care provider a couple of years ago, I said, "Should I get a PSA?" and he said, "Yeah. Get a PSA." I got it done. I've had it checked for a couple years in a row. It's been normal, fortunately.

So I think there's value in getting screened, but I think that's really something you have to talk to your primary care doctor about. And it is kind of a personal decision based on risk and benefit with that screening test.

Scot: And when we talk about risk versus benefit, are we talking about the notion of, "I get screened. Now I'm getting an unnecessary treatment when maybe I didn't need to get those treatments"? Like you said, I could have prostate cancer right now, but it just never really gets to a point where it's life-threatening until 20, 30 years from now.

Troy: Exactly. And that's the hard part, because you could potentially have prostate cancer or you could have a false positive blood test leading to an invasive biopsy, which can be very uncomfortable. It can have its own risks. It has infection risk with it. That has its own issues.

And then potentially, like you said, you diagnose prostate cancer that could just be there. It may not ever cause an issue. Again, a lot of men will live with prostate cancer and die with prostate cancer rather than dying of prostate cancer. So that's where the controversy of it really, I think, enters the discussion.

But it's worth talking to your primary care provider about, especially if you have a family history of prostate cancer. That's a big consideration, I know, in terms of screening.

So, again, it is one of those things that does sneak up on men. I've seen it in the ER, people coming in with advanced prostate cancer. Hopefully, you can catch it early before it gets to that point.

Mitch: Troy, I just looked up the stats. Cancer is rising. Cardiovascular disease is dropping, but heart disease is still number one. So we haven't quite crossed yet, but we're talking . . .

Troy: So we haven't crossed yet.

Mitch: We're talking 350,000 versus 325,000.

Troy: Okay. Good to know. So heart disease is still the number one killer, but cancer is catching up. Yeah, I wasn't quite sure where we were on that.

Scot: All right. Well, with the prostate cancer thing, my takeaway, Troy, is it's controversial and too complicated, so I'm just not going to worry about it. So we can move on.

Mitch: That's right. It's like, "Well, if I hear that, I'm just not going to get checked."

Troy: Bury your head in the sand. Exactly. I would say the simple answer . . . and this is what I did. I just asked my primary care provider. I said, "These are my concerns. This is my family history. What do you recommend?" He said, "Let's get a PSA." I said, "Good. Okay. Easy enough." So that's what I would recommend.

Scot: Yeah. And then also ask for some second opinions and whatnot in there. It sounds like it's an area where there's a little debate right now, and you need to get all the information to make the best decision for you.

Troy: Exactly. That's right.

Scot: All right. Number three. The killers of men that are scarier than a bear attack, but yet they're just not as sexy, I guess. But still, they're much more dangerous.

Troy: Definitely not. So number three on the list is high blood pressure. Who wants to say they got attacked by high blood pressure? Nobody wants to sell that story.

Scot: Nobody wants that.

Troy: My bear story is the coolest story. I love telling that story. But if I was like, "Oh, yeah. I checked my blood pressure, and it was 160/100" . . .

Mitch: "Whoa."

Troy: Everyone is like, "Oh, really? That's really cool. Tell us more about the bear."

But number three is high blood pressure. We kind of talked about it a little bit already with heart disease, but high blood pressure has a lot more to do with a whole lot of other things than just heart disease. You're talking about stroke risk, risk of kidney disease, a thoracic aortic aneurysm where you can get an aortic dissection where you get a tear in the large vessel leading from the heart. So these are all things that can be related to high blood pressure.

Again, it's one of those things where I've had people come in the ER and I ask them, "Do you have any medical issues at all?" and they say, "No, I don't have any issues." "Have you ever seen a doctor?" "No. Never been to a primary care doctor. I didn't have a need to." And they've got a blood pressure of 200/120.

They've probably had a blood pressure of 200/120 for the past several years, and then everything that comes with that. Like I said, it increases your stroke risk, increases your risk of kidney disease. And then I may do some screening testing, and we find that there's something else going on.

So it can sneak up on people because there aren't a lot of symptoms of high blood pressure. Some people will get headaches. They can kind of tell when their blood pressure is really high, but for the average person, if you've never known your blood pressure is high, you may just be like, "Oh, it's that headache I get every now and then," where potentially that's a symptom of high blood pressure.

So it truly is a silent killer because there's really no way to detect it without a blood pressure cuff on your arm.

Mitch: And even when you say that, when I hear the term "high blood pressure," I don't think of it as dangerous initially, right? You gave me some numbers. I'm like, "Yep. Those are numbers that seem high-ish." I'm not necessarily thinking, "Hey, if I do have high blood pressure, that's a really significant risk to me." It's just numbers, just stats, just something they have to do at the doctor's. But yeah, it sounds like there are a lot of things that it can lead to.

Troy: Exactly. And that's why we get concerned about it. The blood pressure itself, it's probably not a huge deal. I guess if you have some conditions, like you have an aneurysm in your brain, a dilated blood vessel, if that blood pressure gets too high, I guess potentially that could cause issues there where that could burst.

But quite honestly, the blood pressure itself . . . it's more just everything that it can lead to, what we call the end organ damage with the other systems, the brain, the heart, the kidneys. That's where you really run into the issues with it.

Scot: My takeaway from that is as a doctor, I bet as soon as you hear somebody say, "Oh, I feel great." "Oh, do you ever go to the doctor?" "No." That's the person you get the most worried about, right? The person that's like, "Oh, I'm the epitome of health. There's no problem here. I don't even need to go to the doctor. That's how good of health I am."

Troy: Exactly. Those are the ones I'm like, "Okay. How many tests do we need to check here? Let's . . ."

Mitch: Put you down for all of them.

Troy: Just keep checking the boxes because you're probably going to find something.

On the flip side, though, you have to be careful because sometimes you may go to the doctor, or even in the ER, and you may have a high blood pressure there and it doesn't necessarily mean you have hypertension. So that's kind of the tough thing too.

Some people get really concerned. They get a high blood pressure reading. They say, "Oh, wow. I have hypertension. I need to be on medication." It really is more of a trend over time where it's helpful to have a blood pressure cuff at home, just kind of see what it is in the morning and the afternoon. You can keep a log of that. And usually, that's what your primary care provider is going to use to decide if you need to be on medication, not a single reading.

So don't feel like if you go in the ER or go see your doctor and your blood pressure's 150/90 or something that you need to start on a medication right then. It is more of a longer measure that you want to get rather than just a single measurement.

Scot: We're talking about the things that are kind of the silent killers of men, if you will. These are the things maybe we don't pay attention to. They're not quite as sexy as some of the other ways that we could die, like a bear attack or a cougar. What's number four on your list, Troy?

Troy: So number four on the list is diabetes. I will say if there's one disease . . . I mean, there are a lot of diseases. I don't want any diseases. But if I had to say just one disease I don't want to get, it's diabetes. It just has so many complications. And again, it's one of those things that can really sneak up on people.

Scot: If you're trail running and diabetes was hiding behind a tree, you would turn around and run as quickly as possible.

Troy: Well, I would do the back away slowly thing, because usually if you run quickly, it chases you and takes you down. So I would do the slow back away and hopefully stop it in its tracks, and then take off as soon as I could.

I'll say diabetes scares me, I think, because I just see so much of it, and then I just see so many things that go wrong. It's one of those things. Again, it'll sneak up on you sometimes.

I've seen it in the ER where people come in and they are having kind of those classic symptoms of they're very thirsty, they're urinating frequently. Maybe they're even in diabetic ketoacidosis, where they're just really nauseated, super dehydrated, throwing up, feeling miserable, where their blood sugar is just crazy high. It's 500, 600. They're acidotic. You check their blood levels. It's just not in good shape. We have to admit them to the hospital, and that may be their first diagnosis of diabetes.

And so that's a very serious immediate complication of it, but then you've got all the long-term complications. Again, heart disease, kidney disease, strokes. It can cause vision issues. It causes issues with peripheral neuropathy where they lose sensation in their feet. You lose that sensation in your feet, and that leads to wounds and infections and amputations.

It can be one of those things where it's just a slow killer. It takes its toll and just keeps going at a person one thing after another. If you can manage it well and keep your blood glucose under control, you can avoid a lot of those things. In some cases, it is tough to avoid those.

It's challenging. Trying to manage that blood sugar, that's a lot of work for people to do and takes a lot of follow-up with a primary care provider. Really a lot of effort.

And again, it's one of those things I just see so many complications of it. If you can avoid diabetes . . . Again, it's going to be coming back to the Core Four. It's a lot of diet, weight loss, trying to keep weight down. But also, I think regularly seeing your primary care provider and getting that testing done to screen for that, especially if you do have a family history.

Mitch: So we did an episode about prediabetes where I found out I was prediabetic on the episode. It reminds me of a family member. Without being too specific or whatever, they used to talk about the idea that, "Oh, I just have never been able to feel my feet since I got over the age of 30." And we were talking. Would step on a nail and not even realize it until the end of the day, etc. Go figure, diabetes.

Troy: Wow. That's crazy.

Mitch: And that's just kind of it. It's like, "You were ignoring the fact you couldn't feel your feet?" As a man to man, if I couldn't feel my feet, I think I'd go in and get that checked. But I wouldn't think that it was diabetes, initially. But yeah, it's one of the major things.

Troy: Yeah, it is. That is one of the major things, that loss of sensation, and it usually is in the feet first. That has all kinds of complications with it. Like I said, if you can't feel your feet, you're going to form wounds on your feet because you can't feel when it hurts. Then you're talking about infection. Once it gets infected, then you have the risk of amputation and everything with that. And once you have an amputation, then your life expectancy drops quite a bit after that.

So it's such a tough disease. And again, it's one of those things that just seems to . . . It can have that big moment, that really scary moment, like I said, when you're in diabetic ketoacidosis, but so much of it is just that slow process where it seems to beat people down. So it's a rough disease, for sure.

Scot: And the impact of it can't be ignored. Over 13% of men aged 20 and older, with a substantial portion undiagnosed. It could lead to all the complications that Dr. Madsen talked about.

And Mitch had mentioned prediabetes, which if you have a fasting glucose of 100 or higher, between 100 to 130, they consider that prediabetes. I've been kind of around the 100 mark, 97, 98, 99, for a while. But that's 97.6 million people 18 and older have prediabetes. That's 38% of the adult U.S. population.

Mitch: Wow. Crazy.

Scot: So a lot more likely to see diabetes hiding around the corner of that tree than a bear, and something to take super seriously because not only can it lead to death, but, like Troy said, just a tremendous decrease in quality of life, doctor appointments. You've got to start monitoring what you eat and what you do. You have to start paying attention to all those things you take for granted. So better to just try to avoid finding yourself in that situation to begin with.

Troy: Exactly. I mean, quite honestly, there are some days I'm like, "Why do I run?" And then I think about diabetes. That's what I'm running from. If I had to pinpoint one thing, that's what I'm running from. It's diabetes. And I hope it reduces my cancer risk too, because that's out there.

Scot: Yeah. And just to refresh if in case somebody is new, the reason you started running, and then had a lot of great success with marathons and whatnot just as a result of that, was health reason driven. You got some numbers back, and you're like, "I have got to start exercising," and you chose running.

Troy: Yeah. Exactly. I don't know why I chose that, but yeah. A poor decision. In my case, it was cholesterol. A very strong family history, unfortunately, of high cholesterol, as I've talked to my siblings and my dad. But yeah, for me, it was cholesterol. It was the numbers that really pushed me in that direction and said, "I need to do something different."

Scot: Number five, as far as those threats to men's health that maybe we don't recognize as threats. What's number five?

Troy: So number five, we're going a completely different direction here, away from the classic kind of medical things we think about. Certainly, this is a medical issue, but we're talking more about mental health here, and it's suicide. It is something that, unfortunately, I think sometimes kind of does sneak up on men where they don't acknowledge it until it's a really big issue.

Men have a much higher risk of completed suicide than women. Women are more likely to attempt suicide. Men are much more likely to be successful with suicide.

It's kind of this thing where a lot of times in the ER, I would see people come in after a suicide attempt. And in a lot of ways, you could tell it was more of a cry for help. It was an attempt, but it wasn't quite honestly something that was going to kill the person. It was an overdose maybe on some medications or something like that, but not something that was necessarily life threatening.

Not fortunately it happened, but in a sense, fortunately they were able to get medical help and get the attention they needed and get admitted to the hospital and get the care they needed, where sometimes with men, they're like, "If I'm doing this, I'm doing it." And it's often with firearms, maybe overdoses, things like that.

But I unfortunately did see cases of men in the ER after suicide attempts with firearms that potentially weren't actually successful, but just really horrible outcomes.

I think in that sense, it does kind of sneak up on men where that inner tension builds. They don't reach out for help. They may not acknowledge it until it's too much and it's overwhelming. And maybe it's on an impulse that they have access to a firearm, and they may attempt suicide and may be successful with that.

Mitch: I think for men especially, you look at the stats, a 2020 study in the CDC, it's kind of shocking to see the graph of just men being four times more likely than women to actually attempt suicide in certain age groups, etc.

I don't know. I think a big part of it really is some of that idea of the stigma that comes around mental health. I mean, we're doing a lot in the media and pop culture, etc., to start changing how we think about mental health.

Even when I first started to try to get some help with my anxiety, to try to get my mental health under control, there was a lot of stigma, and there was a loss of, "I'm no longer the strong man I was before." I wonder if that's what makes it easy to kind of ignore and put off, is because mental health is something men don't really like to think about or talk about.

Troy: Unfortunately, it's so true. And it is the stigma, quite honestly. I think it really comes down to that where men don't want that kind of stigma. They don't want the mental health label. Unfortunately, with that in mind, as men, we just don't potentially get the help we need until it really is too late, or it's really culminated in some sort of crisis where we're contemplating suicide or we're attempting it.

So, yeah, in a sense, it is a silent killer in that way where for so many people in those men's lives, they may have no idea that something was going on. Or they may have had maybe some clues, but just figured, "Eh, he's kind of going through a tough time, but he's doing all right." We just don't really show a lot of the symptoms of that, and we hide it, and we keep it inside until it's too much.

Scot: And in addition, just looking at this graph and seeing how in any given women demographic, suicide rates by age group, 7.2%, 7.9%, compared to 28%, 27% for men. I mean, it's a drastic difference.

Troy, one of the most interesting things is not only just kind of the discrepancy between how many men attempt and are successful with suicide versus women, it's that the 75-plus men is the highest group of suicide rates by age group. That really kind of shocked me. I would have thought that would have been much lower.

Troy: Yeah. In a way, it's surprising. That being said, single men in particular are at much higher risk. I think maybe a lot of those could be men who are recent widowers who have lost their spouse, and that's a big risk. That's something we certainly are aware of in the emergency department when evaluating these patients.

But it's something to be aware of as a family member, to know that someone who has recently lost a spouse who's in their 70s, there is absolute risk there. And often, there are firearms in the home. That's definitely a risk as well. If you have access to firearms, that's a big thing.

So, yeah, it is surprising. I actually didn't know it was that high in that age group, but I knew that was definitely a risk.

Scot: Well, gentlemen, we're pretty good at, I think, recognizing dangers when we're out on the trail or camping. Not so great when it comes to our health. Hopefully, this sheds some light on some of the things that we should be paying attention to, that maybe should be redefined in our mind as, "Yeah, this is a significant danger, and I should do what I can do to prevent that."

Whether it's buckling down on the Core Four, whether it's getting mental health help, whether it's whatever, going in to get a checkup to make sure your numbers look good, these things shouldn't be ignored. These are serious.

Mitch, do you have any takeaways from today's episode? How is the Mitch after this episode different than the Mitch before this episode?

Mitch: Well, it has made me think . . . not differently, but I'm definitely redoubling down the idea of, "Go to that annual checkup." I don't want to be one of the people that Troy was talking about where it's like, "I'm the healthiest person you've ever seen," and you've never been to a doctor to get any of those things checked.

And I think the second thing is just conceptualizing some of these things in comparison to a bear attack, as goofy as it seems . . . I have men in my life that have bear spray in every truck they own, right? But it's like, "Hey, just so you know, the same sort of approach you take protecting yourself from bears, there are some other things that maybe we can take a step or two and not ignore, and it's a lot more threatening to our health."

Scot: Yeah. Maybe you should have a blood pressure cuff in your pickup too.

Troy: Please do. The blood pressure cuff and a little finger stick thing to check your blood sugar too. Before you grab the bear spray, grab those things first and check those.

Scot: Troy, any thoughts before we wrap this up?

Troy: My takeaway from this, again, is these really are things that sneak up on us. And like Mitch said, the best thing you can do is go to a primary care provider. Just regular exams. They're going to do blood work. They will talk to you about risk factors for these things, potentially pick up on high blood pressure, potentially screen for diabetes, check your cholesterol, all things that can help in preventing these things from sneaking up on you.

But in a lot of ways, we have a lot of insight into our health. And in so many ways, we just really have no idea what's going on, because these things often have no symptoms until they're really on us and an issue. So that's where we need a little extra help through a primary care provider and some of these screening tests.

Scot: Well, thank you very much for checking out this episode. If you have any thoughts, comments, feedback for the show, we would love to hear from you at hello@thescoperadio.com.

Thanks for listening, and thanks for caring about men's health.