Gettysburg Medical News
 The Clinical View
 by P.E. Hoffsten, MD
 22 JUNE 2005

STANDARD SOUTH DAKOTA MALE BEHAVIOR:  THE WAY A MAN THINKS?

            Several years ago, I wrote a column entitled “Too Many Widows”.  I had been at a local restaurant for a Sunday noon meal and noticed several tables with as many as eight women eating together.  They were all widows.  It is an observation that men in South Dakota die younger than the woman.  On Saturday mornings when I am in Gettysburg, I host meetings of those interested in discussing various health matters including heart disease or diabetes or cancer or high blood pressure.  Many times it is an exclusively female audience.  Over the years, I have contemplated what men might be thinking in regard to their health.  I have asked the question of both men and women and below are the Top 10 reasons I have found regarding what men think of health considerations.  A man may be a very good cowboy, a very astute business person, a very fine lawyer, a great father, an excellent athlete or able to drink the other guy under the table.  But men just don’t think good when it comes to their health.  Following David Letterman’s example below are the Top 10 beliefs that men seem to have regarding their health:

            #1:  Health is natural  There is nothing wrong with me.  It if ain’t broke don’t fix it. 

            Fallacy: Health is a gift.  With time, everything wears out.  Preventive maintenance is directed at everything in a man’s world except himself.  A man would never treat his tractor or his car or his gun, the way he treats himself.

            #2:  “I’ll just lose a little weight and everything will be fine”. 

            Fallacy:  Weight loss has no impact on preventing colon cancer or lung cancer.  It will definitely help lower a person’s blood pressure, their cholesterol and a tendency to be diabetic but numerous studies over years of time have demonstrated that less than 2% of people who ever take on a weight loss program achieve anything near their ideal body weight and maintain it over years of time.  Voluntary weight loss programs do not work.

            #3:  “I sure don’t need medications.  They aren’t natural.”

            Fallacy:  Just as degenerative disease is a natural property of the aging process, there are medications that reverse and prevent many kinds of progressive degenerative diseases.  Among these are medications that slow or stop the progression of diabetes, the progression of high blood pressure, the progression of heart disease, and the total prevention of problems such as colon cancer.  Nature provides no “natural remedies”.  All medications whether prescription, from the herb garden, or over-the-counter are directed to prevent or reverse some disease process.  Today’s pharmaceutical industry is highly regulated and directed to have evidence based information before a medication can be offered for the general public.  Agreed that medications are not “natural”, disease processes are.

            #4.  I don’t trust medications, they have side effects and they are too expensive.

            Fallacy:  Driving your car has side effects and it is very expensive.  Clearly some of the foods that you eat have the side effect of promoting diabetes and high blood pressure.  Our recreational activities such as bowling (backache), baseball (all kinds of injuries), cigarettes (heart disease and cancer) or sky diving (parachute doesn’t open), all have side effects.  But men still do these things.  Smoking carries a 50% likelihood that it will be the cause of death of the smoker.  Sky diving is no where near that bad.  Granting that medications have side effects and may be expensive, they  still have a very favorable benefit to risk ratio.

              #5.  “I don’t want to take a pill the rest of my life”. 

              Fallacy:  Unfortunately, once a person becomes hypertensive or has diabetes, or has heart failure, it doesn’t “just go away”.  When these things happen, the man has these conditions for the rest of his life.  Unfortunately, God has not given us a pill that you take one time and these conditions go away.  Instead we have medications that reverse the disease process while the pill is taken.  Unfortunately, the pills have to be taken as long as the person doesn’t want the disease process to go on.

              #6.  “None of these diseases are in my family”. 

              Fallacy:  Heredity plays a major part in many disease processes but the environment that the person lives in and their lifestyle also plays a part.  For most disease processes, heredity is permissive for the disease process to occur but the environment and lifestyle are what actually unmask the disease process.  As a vivid example, the American Indian had no incidence of alcoholism and very little incidence of diabetes 300 years ago.  But our modern society has provided an environment in which both of these conditions have been permitted to occur by a very adverse environment for their genetic makeup.  The same principle applies to both sexes and all races even if not as obviously as the example above.

              #7.  “What I don’t know, won’t hurt me”. 

              Fallacy  I shouldn’t even dignify this with a discussion.  There are few greater mistakes to make than to underestimate what you don’t know and how that might affect you.

              #8.  “I am very busy and don’t have time now, I will do it later”.

              Fallacy:  Later never comes.  The highest benefit for preventive maintenance is in our young population. High blood pressure and heart disease begin in the men age 20 years old.  Addressing the problem at a young age is going to have very substantial rewards as the person gets older.  If a man doesn’t have time for a doctor visit now, imagine how disappointed he is going to be when the heart attack or the stroke comes and he is disabled for weeks or months.

              #9.  “Why be alive if you can’t eat what you want and do what you want?”

              Fallacy:  Once upon a time, there was a child who loved cookies.  Mom would take them out of oven and he would have them in his mouth before they had cooled.  He burned his tongue several times and then he learned not to eat such hot cookies.  Similar stories can be told about other children who ate too many green apples or teenagers who drank way too much alcohol and got sick.  Somehow or other most people learned that the pleasure up front may not be worth the discomfort that comes later.  The same thing can be said for any adult even though the lesson often takes much longer.  Fortunately, a burned tongue or a belly ache or an intoxication clear quickly but the ravages of diabetes, heart disease and high blood pressure have a much slower onset and are very unforgiving.  Learning healthy lifestyles at an early time, has huge dividends later in life.

            #10.  “We are all going to die someday, when my time comes, it comes.”

            Fallacy:  There are things that are worse than death.  Avoiding these through simple healthcare measures is well worth the effort.

            Proper preventive healthcare maintenance has huge dividends in the long run.  It is a tragedy that so many men in South Dakota die young because they take less good care of themselves than they do of their tractors.