Pains Men Should Not Try to Macho Through

When the going get tough, guys should go to the doctor.
By Scott McCredie for MSN Health & Fitness

You’re a guy’s guy, tough as nails and hard as rock, right? Able to soldier on despite hardships or injuries? Because everyone knows that hardship builds character, and pain is all in your mind. And, oh, don’t forget: no pain, no gain.

Well, that’s the traditional view, anyway. Modern males are supposed to dance to a different tune. We’re advised that a healthier philosophy is to listen to our bodies and heed the language of pain, the body’s way of telling us that something is wrong and needs our attention. Men who fail to heed the message often meet disaster.

“Men tend to ignore pain more than women, but they also tend to seek medical attention less than their women counterparts for any ailment or symptom,” says Dr. Camelia Davtyan, associate professor of general internal medicine and health services research at the David Geffen School of Medicine at UCLA.

My brother, Tim, is a good example.

A 25-year-old law intern living in Portland, Ore., Tim woke up one morning with severe stomach pain. He thought the culprits were the guacamole, chips and beer he’d had the night before. “It was the stomachache from hell,” he remembers. “I thought I could endure the pain and hoped it would go away.”

A few days went by and the pain continued. He went to a doctor who examined him but could find nothing amiss. A couple more days passed and he broke out into a feverish sweat that scared him into a hospital, where a doctor immediately sent him to the surgical ward. Tim’s appendix had burst, a life-threatening situation. Fortunately, he was young enough to withstand the bacterial onslaught this caused, and after the emergency appendectomy he recovered fully.

Here’s a list of potent pains that you ignore at your peril:

1. Severe headache

“If you were to say, ‘that’s the worst headache of my life,’ it could be related to a brain aneurysm rupture, which can be quickly fatal,” says Davtyan.

A brain aneurysm is a swelling of an artery due to a weakness in its wall. Anyone, at any age, can have them, but they’re most common in adults between the ages of 30 and 60. If an aneurysm should burst and bleed into the brain, it can cause “hemorrhagic stroke, permanent nerve damage and death,” according to the National Institutes of Health (NIH).

In the U.S., some 27,000 people a year report ruptured aneurysms. In addition to the headache, other symptoms may include nausea, vomiting, a drooping eyelid, light sensitivity and a change in mental awareness.

If you experience the “worst headache of your life,” especially combined with any of the other symptoms, you should go immediately to the ER.

2. Chest pain

Davtyan explains that if you ever have the sense of “having an elephant on your chest"—intense chest pressure, pain or squeezing sensation—you could be having a heart attack, which can also be quickly fatal.

The NIH describes the feeling as “uncomfortable pressure, squeezing, fullness, or pain” in the center of the chest that lasts for more than a few minutes, or goes away and comes back. Other parts of your body can be affected too, including pain in one or both arms, the back, neck, jaw or stomach. You may also feel short of breath, lightheaded, nauseous or break out in a cold sweat.

3. Other chest pains

“Sharp, stabbing chest pain of sudden onset, with or without shortness of breath, could be pneumothorax [a collection of air or gas in the space surrounding the lungs] or a blood clot in the lung,” Davtyan asserts.

The latter condition is called a pulmonary embolism, a sudden blockage in a lung artery, usually from a blood clot that traveled to the lung from the leg. The National Heart Lung and Blood Institute says more than 600,000 Americans experience a pulmonary embolism each year, and about 10 percent of them die from it. Fatalities usually occur within an hour after the symptoms begin, so time is of the essence.

Pulmonary embolism, according to the institute, is one of the leading causes of death among people who must remain in hospital beds for long periods of time—and it also can crop up in people who must sit (say in an airplane or office) for many hours without interruption. (Say, don’t you feel the sudden urge to get up now and walk around a bit?)

4. Severe back pain

It seems that nearly everyone, at one time or another, experiences back pain. It’s the cost of being a biped equipped with a spine designed for four-legged travel. But if you should ever suffer from low back pain combined with either weakness in the legs, pain radiating down one leg, trouble controlling your bladder or bowels, or pain when coughing, it could mean something sinister is going on with your spinal cord. This might be caused by a bulging (herniated) disc, the cartilage that cushions each vertebra, which could be pinching nerves.

In this case you should contact a doctor immediately to prevent permanent damage.

5. Abdominal pain

Pain emanating from the lower right side of the abdomen, with or without fever or nausea/vomiting, could be appendicitis, says Davtyan. As Tim discovered, you shouldn’t delay if you experience prolonged pain in this area. Some of the other classic symptoms of appendicitis are nausea, vomiting, constipation or diarrhea, an inability to pass gas, loss of appetite, a low-grade fever, and abdominal swelling, according to the NIH. But not everyone experiences all the symptoms.

The most serious complication of appendicitis is rupture. Infants, young children and older adults are at highest risk. When bacteria-laden fecal matter from the intestines enters the body cavity, bad things can happen—including death.

6. Joint and muscle pain

The burden of the weekend warrior and aging jock is the duo of sprains and strains. But when should you pay them any mind?

“A lot of people think they can play through the injury and it will be OK,” says Dr. Ed Laskowski, co-director of the Mayo Clinic Sports Medicine Center in Rochester, Minn. “But it’s not OK.” If you don’t get certain injuries treated early by a physician, you could be looking at the prospect of causing further damage or longer recovery times.

Signs to watch for, he says, are pains associated with joint swelling, which usually are the result of inflammation or tearing. If an injury leads to limping or causes your stride length to change, you should get it checked out. Also, instability of a joint could indicate a ligament tear, and should be looked at immediately to prevent further damage.

If pain is combined with a restricted range of motion, that’s another cause for seeking medical attention. “Persistent or worsening pain—and I mean pain beyond normal soreness—is something to watch out for,” Laskowski says. “The earlier you come in, the better you will respond to treatment. I’d say any pain that lasts beyond a few days is something to be concerned about.”

Denial? Not me

So why do many men postpone getting treatment when they feel unusual pain? That turns out to be a complicated question. For his part, my brother had a long list of reasons. “I was in denial about the pain,” Tim says. “I didn’t want to believe that I had to have surgery and take time off work, and it was all going to cost a lot of money.”

“People use a variety of excuses for not promptly addressing a serious pain,” Davtyan says. ”They’re too busy, there’s nobody else to take care of the kids, or ‘I'll take some Tylenol and it will go away.’ ” A lack of medical insurance is another popular reason, she adds.

But whatever the cause, none of them is wise. You may ignore your boss, your wife, your kids, your job and maybe even the dog, but certain kinds of pain should always get your full and thoughtful attention. Or else.

Damage Control for Six Unhealthy Habits

If you’ve ever ignored the conventional wisdom of health experts on the dangers of smoking, tanning, junk foods, or other indulgences, you’ve likely suffered damage to your health and body. Keep reading and learn how to reverse or minimize the effects of those bad habits.

By Bethany Lye for MSN Health & Fitness

The mistake: Smoking
You drained carton after carton of cigarettes—for 15 years.

The expert
Dr. Norman H. Edelman, chief medical officer for the American Lung Association

The damage
Someone who has smoked this long likely has “bad breath, smelly clothes and hair, beginning wrinkles, discolored teeth and perhaps nails,” says Dr. Edelman. “In addition, their exercise tolerance is likely to be limited to some degree and they are likely to have chronic smoker’s cough.”

Smoking: Damage control
After quitting cigarettes, long-time smokers should check for lung damage. To do this, Dr. Edelman recommends asking your health care provider for a simple breathing test called a spirometry, which can be performed in your doctor’s office to evaluate lung health.

In our scenario, which involves a smoker of 15 years, most of the symptoms listed on the previous slide are reversible after quitting cigarettes, says Dr. Edelman. Kick the habit and the bad breath, coughing, and strong body odor will likely fade away. What sticks around, according to our expert, are the wrinkles and discoloration. Still, it’s worth noting that upon quitting, the physical ramifications of smoking won’t progress. Need more incentive? Swearing off nicotine is “the most effective preventive action anyone can take to insure better health,” according to Edelman. “On the average, it will add six to eight years to one’s life.”

The mistake: Sun without sunscreen
Every summer, you’ve splashed in the pool, picnicked in full sun, and played one too many match of beach volleyball—without sunscreen. You may have even paid some visits to the tanning salon for a head start on your summer glow.

The expert
Dr. Arielle Kauvar, associate professor of dermatology at NYU’s School of Medicine

The damage
“Aside from causing skin cancer, sun exposure and indoor tanning are the major causes of skin aging,” says Dr. Kauvar. “Severely sun damaged skin will have a dry, dull appearance, uneven skin pigmentation and freckling, visible capillaries, and wrinkles.”

Sun without sunscreen: Damage control
“Start by having a full-body skin examination by a dermatologist,” says Dr. Kauvar, who points out that this recommended yearly exam is especially important for people who have had a lot of sun exposure. Next, invest in a good broad-spectrum sunscreen. Select one with UVB and UVA coverage and SPF of 30 or higher, then pair this with a topical anti-oxidant. “Antioxidants neutralize the damage from the sun’s rays that pass through the sunscreen,” says Dr. Kauvar. Finally, “Avoid direct exposure between the peak hours of 10 a.m. to 4 p.m.,” says our expert. If you must head outdoors during these hours, wear protective clothing and break out the sunscreen.

The mistake: Poor dental hygiene
Your toothbrush and floss are buried in the bathroom drawer, and you can’t remember the last time you visited the dentist.

The expert
Matthew Messina, dentist with a private practice in Fairview Park, Ohio, and consumer adviser for the American Dental Association

The damage
“Just because someone ignores the bacteria present in their mouth doesn’t mean the bacteria will return the favor and ignore them,” says Messina. “Failure to address the damage from bacteria will lead to cavities, gum inflammation, gum recession, and periodontal disease [also known as gum disease]. Eventually, this will lead to infection and tooth loss.” Though your mouth may seem like a lost cause, there's no need to throw in the towel, says our expert. “While there will likely be damage that we have to address with some dental work to 'make up' for the routine maintenance that hasn't been done for some time, usually things aren't as bad as people fear.”

Poor dental hygiene: Damage control
To start, says Messina, “It’s time to get a new toothbrush and begin to put it to use. Try brushing after breakfast and before bed and work up from there.” Next, bring your floss out of retirement. “While flossing daily is best, three times a week is better than none,” says our expert. Finally, make an appointment with your dentist for a thorough exam. Beyond any special treatment that may be in order, “a professional cleaning will be needed to remove the hard tartar buildup that brushing and flossing won’t get off,” says Messina.

The mistake: Junk-food junkie
The building blocks of your personal food pyramid include items from the office vending machine and the local fast food chain.

The expert
Lona Sandon, registered dietician and spokesperson for the American Dietetic Association

The damage
“It took years to get to this point, and it will take years to reverse it,” says Sandon. “Start assessing the consequences of the past by stepping on the scale.” Our expert recommends calculating your body mass index (BMI) to determine if you are at a healthy weight. “Next, visit your doctor to find out your blood pressure and cholesterol levels,” says Sandon.

Damage control
Cleaning up your diet for the long run requires both a strategy and advance preparation—but the good news is that your game plan is relatively simple, says Sandon.

Step 1: Make a list of fruits and vegetables you like and will eat. Buy these items and keep them within reach in case hunger strikes.

Step 2: Draw a line down the middle of a piece of paper. On one side, list snacks you typically choose and when you usually eat them. On the other side, write down a healthier snack option for that snack and time. Plan to eat the healthier alternatives whether at home or work.

Step 3: Think small. Start with small goals that you know you can reach, like eating two servings of fruits per day instead of going for the full four. After you meet these modest goals, shoot for a slightly bigger goal. It’s all about sustainable, lifelong changes—nothing too dramatic.

Step 4: Add more physical activity in your day. One option is to walk the stairs at work during your break. Just be sure to wear comfortable shoes or keep a pair of sneakers at your desk. Setting up your environment with all the right tools encourages healthy behaviors.

The mistake: Unprotected sex
You’ve had more than a few sexual partners—and you often skipped the condom.

The expert
Dr. Jeanne Marrazzo, medical director of the Seattle STD/HIV Prevention Training Center

The damage
Having unprotected sex puts you at risk for HIV and other sexually transmitted diseases—and the more partners involved, the greater the risk.

Unprotected sex: Damage control
“While the incidence of HIV remains low in the U.S. in many populations, the Centers for Disease Control and Prevention recently recommended that all adults be tested for HIV at least once. This is an excellent opportunity to get that done,” says Dr. Marrazzo. Free tests are available at many clinics and community organizations.

Beyond HIV, our expert recommends a blood test for anyone who hasn’t been vaccinated for Hepatitis B or anyone with recurring genital rashes or sores (often the result of a very common sexually transmitted infection called genital herpes). “If a person is in his or her 30s and has no genital symptoms, I would not recommend routine testing for other sexually transmitted infections, like chlamydia or gonorrhea,” says Dr. Marrazzo.

As for guaranteeing your future sexual health, our expert recommends finding a good health care provider with whom you can comfortably and openly discuss any of your concerns.

The mistake: Heavy drinking
In college you majored in drinking and your bar-hopping habits didn’t stop on graduation day.

The expert
Mark L. Willenbring, M.D., director for the division of treatment and recovery research at the National Institute on Alcohol Abuse and Alcoholism

The damage
“Risky drinking is defined as more than four drinks a day for men or three for women on any given day, and more than 14 drinks for men or 7 for women in a typical week,” according to Dr. Willenbring. “Exceeding this daily limit even 12 times a year places the drinker at increased risk for alcohol use disorders, alcohol abuse, and alcohol dependence. Of course, the impact of drinking to excess differs according to an individual’s mental health history, family history, and personal experiences: “If a parent or sibling is dependent on alcohol, a person’s risk of developing dependence increases by a factor of two to four times,” says Dr. Willenbring. The good news is that “many people who drink excessively in their 20s incur no lasting damage.”

Damage control
Former heavy drinkers and binge drinkers (defined as males who consume upward of five drinks and women who consume upward of four drinks in a two-hour period) should “initiate a personal health promotion program focused on diet, exercise, sleep, and social support,” says Dr. Willenbring. This should include learning new behaviors to fulfill the same purpose that drinking once served. Reformed social drinkers, for instance, might satisfy their desire to interact with others by enrolling in a community class or a recreational sport. Those individuals who used alcohol to self-medicate during times of stress might search for a relaxing new hobby like yoga. The goal is to promote well-being and self-confidence. Dr. Willenbring concludes, “Remain vigilant. Know how much and how often you drink and why.”

Bethany Lye is a freelance writer for MSN Health & Fitness, and she has also written for People and Health magazines.

10 Foods Tough to Digest

Sugar-free gum

Sorbitol, the ingredient found in many sugar-free gums, candies, and diet bars and shakes, can cause an uncomfortable buildup of gas in your gut. Check the labels before you buy to see if you can find sugar-free products that use less troublesome sugar substitutes. The amount also is an issue, warns Gidus. Most people can handle two or three grams without any problems, but a product that packs 10 or more grams will undoubtedly be tough on the digestion.

Sally Wadyka is a Boulder, Colo.-based freelance writer who writes regularly for Shape, Runner’s World, Real Simple and The New York Times.

Beans

Beans have such a notorious reputation for causing gastric distress that they even spawned their own rhyme (come on, you all know it! "Beans, beans …"). And there is some truth to it. The enzyme needed to break down beans is found only in our stomach bacteria. And if you don't routinely eat beans, you might not have enough of this enzyme to comfortably digest them. The result, of course, is gas and bloating. Cooking beans in soup can help—the extra fluid will help digest the large amounts of fiber beans contain, and the extra cooking time will start breaking the beans down even before you eat them. By adding beans to your diet gradually, you will help build up the enzyme necessary to digest them without issue.

Broccoli and raw cabbage

These fiber- and nutrient-rich vegetables are incredibly healthy, but they are also well-known for causing gas buildup in the gut. Fortunately, the solution is simple. "Cooking them—or even just blanching them slightly—will deactivate the sulfur compounds that cause gas," explains Ryan.

Ice cream

There's no quicker way to determine if you're lactose intolerant than to sit down with a big bowl of ice cream. The bloating, cramping and gas are clear messages: Your system is trying to tell you to stay away from such rich dairy products. If that's the case, the only solution is switching to lactose-free frozen treats (such as those made from soy or rice milk). But even if you're not lactose intolerant, scarfing down a pint of Ben & Jerry's in one sitting still will give you some stomach trouble. That's because it's essentially all fat, and fat lingers in the stomach longer than other foods before getting digested.

Raw onion

Onions and their cousins like garlic, leeks and shallots are filled with a variety of phytonutrient compounds—some of which seem to offer healthy, heart-protective benefits, and some of which cause stomach distress (or it could be the same compounds that do both). Cooking them seems to deactivate some of the problem-causing compounds. But on the chance that you're also deactivating some of the good stuff, dietician Mary Ryan, suggests using mix of cooked and raw so that you can reap the benefits without suffering the consequences.

Spicy food

Hot peppers—such as cayenne or jalapeno—give food a wonderful spicy kick, but they can also irritate the lining of the esophagus on the way down. The result: an unpleasant heartburn-like feeling after you eat. "Even if you try to cool down the heat by adding sour cream, you're still getting all the spice and the same amount of irritation," warns Gidus. So rather than trying to mask spice with high-fat cream, opt for milder versions if you routinely suffer side effects.

Fried chicken nuggets

Anytime you take a food, dip it in batter and then deep fry it, you turn it into something that can be a bit hard on the gut. Fried foods inevitably are greasy and high in fat, both of which spell trouble for the stomach. If you already suffer from inflammatory bowel disease, greasy foods are especially problematic and can cause symptoms like nausea and diarrhea, says Tara Gidus, a dietitian in Orlando, Fla. To make a healthier version, take frozen chicken nuggets (or use your own breadcrumb batter on chicken breasts) and bake them, rather than fry.
The advice to forgo fried for flavorful alternatives is also helpful for other traditionally greasy snacks, like potato chips. To get the crunchy, salty sensation of chips without the unfortunate side effects, look for baked versions of potato chips or switch to low- or no-fat snacks like pretzels, air-popped popcorn or soy crisps.

By Sally Wadyka for MSN Health & Fitness

Mashed potatoes

Nothing seems more benign than a bowl of creamy mashed potatoes. After all, that's why they rank near the top of the list when it comes to so-called "comfort foods." But if you happen to be one of approximately 30 to 50 million Americans who are lactose intolerant, you'll find no comfort in those spuds, since most are loaded with milk or even heavy cream. Make them at home using lactose-free whole milk for the same creaminess minus the after-effects.

Citrus juices

These acidic drinks can irritate the esophagus, stimulating the sensory nerves to feel more inflamed. This might feel like acid reflux, but in reality is just irritation. In the stomach, however, the extra acid of the drink can cause other problems. If you haven't eaten (say, you down a big glass of OJ first thing in the morning), your gut is already full of acid, so adding the extra can give you a stomach ache. And if you're drinking lemonade that's sweetened with high fructose corn syrup, watch out: That huge influx of sugar is often a cause of diarrhea.

Chocolate

Most of the unfortunate consequences surrounding this rich delicacy come not from simply eating chocolate, but from overeating it. One small brownie as an occasional treat probably is fine; a triple brownie à la mode probably is not. But anyone who suffers from gastro-esophageal reflux disease (GERD) can experience problems from even a small portion of chocolate. That's because chocolate causes the lower esophageal sphincter to relax, allowing stomach acid to come back up.

The Biggest Health Danger To Men

Thirty minutes of exercise a day can signficantly lower your risk of major disease.
by Stace Colino, PARADE Magazine

Nearly 75 million Americans have a potentially life-threatening disease—and 28 percent don't even know it. According to a new study from the National Heart, Lung, and Blood Institute (NHLBI), more adults than ever in the U.S. have high blood pressure. In fact, it is now the leading risk factor for heart disease and stroke worldwide. And here's the scariest part: Because it doesn’t usually cause symptoms, by the time some people realize they have high blood pressure (a.k.a. hypertension), it already may have caused significant damage in the form of heart disease, stroke, vision or kidney problems, or, in men, erectile dysfunction.

Men are most at risk to go untreated, according to a recent study by the University of Texas Southwestern Medical Center in Dallas. Young to middle-aged men are the most likely to be unaware of the problem, since many don't go to a doctor unless they feel sick. "Because it's not associated with any specific symptoms early in its course, high blood pressure is not something that typically takes someone to a physician’s office," says Dr. Daniel W. Jones, a former president of the American Heart Association and dean of the School of Medicine at the University of Mississippi. "It just doesn’t get your attention." But it should. There's a reason high blood pressure is called "the silent killer."

LOWER YOUR RISK

As people live longer, their risk of developing hypertension (defined as blood pressure of 140/90 or higher) increases, particularly after age 45. "Overweight and obesity are a big part of the increasing prevalence," says Dr. Jeffrey Cutler, a consultant to the NHLBI and National Institutes of Health (NIH). "The increasing consumption of salt in our diets may be a factor too, because obesity raises a person’s sensitivity to the blood-pressure-raising effects of salt." There are steps you can take to reduce your risk, though, no matter what your age or current health. "In the vast majority of people, a very healthy lifestyle can prevent hypertension," Dr. Jones says.

Lose weight

A study at the University of Padua in Italy found that overweight people who lost between 9 percent and 13 percent of their body weight experienced on average a 6.2-point drop in their systolic blood pressure (the top number) and a 3.6-point drop in their diastolic pressure (the bottom number)—improvements that were sustained six years later.

Change how you eat

Some people appear to be more sensitive to salt than others, putting them at higher risk for developing hypertension. Nevertheless, doctors recommend that most people lower their salt intake and increase their potassium. An easy way to do this is to follow the DASH (Dietary Approaches to Stop Hypertension) plan, which the NIH developed to lower blood pressure without medication. It has less salt, fat, and sugar than the typical American diet and includes fruits, vegetables, low-fat dairy foods, whole-grain products, fish, poultry, nuts, and seeds. The DASH plan is usually the first-line treatment, along with exercise, for people with pre-hypertension—unless they have a chronic disease such as diabetes or kidney problems, in which case they may be prescribed medication, too, Dr. Jones says. It also is recommended for those who have full-blown hypertension and are taking drugs to treat it.

Exercise regularly

Regular exercise can improve your aerobic conditioning, which will result in a healthy drop in blood pressure, explains Dom­enic A. Sica, M.D., a professor of medicine and chairman of clinical pharmacology and hypertension at Virginia Commonwealth University. It doesn't have to be vigorous: In a recent review of 26 studies, researchers at the Beth Israel Deaconess Medical Center and Harvard Medical School's Osher Institute concluded that low-impact exercises such as tai chi can reduce blood pressure. Meanwhile, a study at Syracuse University found that resistance training can lower blood pressure in those who have pre- or stage-1 hypertension.

Get enough sleep

"When you go to sleep at night, blood pressure typically drops 15 percent to 30 percent, and your heart rate can drop as much as 30 percent," says Dr. Sica. The overnight reduction can positively affect your blood pressure the next day. On the other hand, a short or fragmented night’s sleep can produce the opposite effect, increasing blood pressure the next day.

TREATMENT OPTIONS

Manage your medications

Several classes of drugs can be used to control hypertension, including diuretics, ACE inhibitors, angiotensin receptor antagonists, beta-blockers, calcium channel blockers, and a drug (approved in 2007) that inhibits renin, a kidney enzyme. In many cases, people will require two or more drugs to bring their blood pressure into the normal range. Because various drugs work in different ways, they can have a complementary, often synergistic effect in reducing blood pressure. Plus, if you use more than one, you usually can take a lower dose of each, which can help you avoid some of the potentially unpleasant side effects (such as swelling, flushing, and headaches), says Dr. Sica.

It is important that you stick with the medication regimen outlined by your doctor. If your blood-pressure readings still aren’t getting into the optimal zone, expect to have your prescriptions or dosages adjusted. "Sometimes you need to try different combinations of drugs until you find the one that works for you," Dr. Sica advises.

Monitor yourself

Doctors recommend that people with hyper­tension regularly monitor their blood pressure at home. Blood pressure can vary considerably, fluctuating as much as 30 percent over a relatively short period of time, depending on environmental conditions or what you’re doing, says Dr. Jones. Home monitoring can help you see how your blood pressure shifts throughout the day and is affected by various activities. Knowing what makes a difference can help you get your blood pressure into the target range.

WHAT THE NUMBERS MEAN

The only way to tell if you have high blood pressure before it takes a toll is to have regular checkups. Because pressure can vary throughout the day and be affected by whether you are standing or sitting, doctors will often take more than one reading during a single visit.

• Top number: Called "systolic pressure," it measures the pressure within blood vessels as your heart beats.
• Bottom number: This records "diastolic pressure," which happens between beats while your heart is at rest.
• Normal: Under 120/80
• Pre-hypertension: 120/80 to 139/89
• High blood pressure: Over 140/90