By Dr. Femi Ogunyemi

In this part of the world tradition holds the patient at the mercy of their doctors decisions and instructions. I have seen even the most educated and informed patient hold back when opportunities arise for discussion with their physician. This is more cultural than geographical because these same people do exactly the same thing at doctor visits overseas.

When you are finally seated in front of your Doctor, especially men and women above the age of 45 years, this not the best time to talk current political issues or the next Premier League match.

There are health related topics relevant to your age-group on matters well within your control. However there are some questions you (men) should ask us that will affirm your determination to stay healthy.

Screening for prostate cancer. I’m confused.

The American Urological Association recommends yearly screening with a prostate-specific antigen (PSA) blood test and a digital rectal exam for men ages 50 to 75. Men who have a family history of prostate cancer and NIGERIAN men should begin annual screenings at age 40. PSA is a protein produced by the prostate; a blood test can show whether protein levels are at a normal or an elevated range.

Prostate cancer is a very slow-growing cancer. Even if you have it, it’s not likely to kill you. And an elevated PSA may just be a sign of normal aging. A raised PSA may lead to a needle biopsy. Even if the biopsy reveals cancer, we may “wait and watch” and repeat the PSA test every six months. Prostatectomy or radiation therapy can have unwelcome side effects, such as erectile problems and loss of bladder control. Talking about erections……

“I’m not sexually strong.”

A morning testosterone level is useful to know. Nigerian men must be wary of additional testosterone, especially if there’s a family history of prostate cancer. Obesity, smoking and diabetes can all interfere with sexual function. Taking off a few pounds, giving up smoking, managing diabetes adequately and giving up smoking can all help with improving erectile dysfunction. Some medications, like sildenafil and some vacuum devices are also useful.

Some drugs, both prescription and OTC, such as antidepressants, statins and blood pressure drugs, also can cause erectile dysfunction.

I want to start exercising. Do I need a stress test first?

A stress test involves walking on a treadmill while your heart is monitored to see how it responds to exertion. If you have a high risk for heart disease your doctor may recommend a stress test before you start exercising to make sure your heart is strong enough. Best of all speak to a Cardiologist.

When doctors recommend a stress test, they will always explain why it’s necessary and what they hope to learn from the test. A stress test can lead to false positives that may lead to unnecessary treatments.

Why am I urinating so much?

The number one culprit is caffeine. Alcohol also affects water reabsorption. Cut back on both, and your peeing problem may cease. Your sleep may also improve if you cut out those 2 items (as well as nicotine, heavy meals and exercise) before 6 pm daily.

 “I’ve been having this strange pain. I feel a bit silly asking, but should I be worried?”

Naturally. I cannot complete these 5 questions without mentioning PAIN. There are no stupid questions when you are in front of your doctor. Sometimes men may be squeamish about discussing issues like rectal pain, low back pain, arm pain and testicular pain or swelling. Pain may be minor but may signal bigger issues. Don’t let your doctor dismiss your concerns.



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