Let’s Talk About Men’s Health
As June comes to a close, we want to give a nod to National Men’s Health month with a discussion with Dr. Daniel Breland about prevention, good health practices, and overall awareness. The topic of men’s health and wellness is often brushed aside and Dr. Breland explains why men are sometimes more hesitant to take care of their own health problems and what they can do to change that perspective going forward.
Speaker 1:
Thanks for joining us for this episode of Centra Scripts, where we talk health and wellness and practical tips for your everyday life. And now here's your host, Kate Kolb.
Kate Kolb:
All right. Thanks for joining us for our next episode of Centra Scripts. I'm here today with Dr. Daniel Breland, and we wanted to take a few minutes today to highlight something that I didn't even know was an official thing until a couple of years ago when I started working at Centra. But Men's Health Month has been classically something that is spotlighted and highlighted during the month of June. So we wanted to sit down with you today, Dr. Breland, as a primary care provider at one of our facilities here, CMG Bedford Centra Medical Group.
Kate Kolb:
And before we get started, though, I just want to let the listeners know a little bit about you. So can you tell us a little bit about your background and what you chose to practice in, and then what brought you to Centra?
Dr. Daniel Breland:
Yeah, absolutely. So a lot has contributed to my decision to come into medicine. That was somewhat of a complex answer, but essentially a lot of that began when I was diagnosed as a type one diabetic in seventh grade. And I knew that I wanted to be in medicine in some aspect.
Dr. Daniel Breland:
After college I actually was a youth pastor for a while, and I had to do a lot of hospital rounds as part of my ministerial duties. So I connected with a lot of patients in that way in the health field. I did eventually go to med school and then, it's somewhat of a non-traditional route because I had already started a family at that point and had had a career as a youth pastor, and went to med school.
Dr. Daniel Breland:
And inevitably after finishing residency, part of our route was trying to find where we could be close to family. And Lynchburg was a great place as it provided a wonderful training facility as well as being close to family. And so we found Centra and joined the residency back in 2012, and from there joined Centra in 2015. I've been doing primary care here in Bedford since that time, and really loved the facility and the folks that I've worked with here.
Kate Kolb:
Yeah. Well, I will say this. We were just chatting a little bit before the podcast started that you and I started at Centra at the exact same time. We were in the same orientation class that year.
Dr. Daniel Breland:
Right. That's right.
Kate Kolb:
And so it's always fun just to kind of see faces that have been around here for the same amount of time that I've been here, and to really hear how your story has gone since then. And so that's just very exciting. And also if you as a listener don't know Dr. Breland's name, it's surprising, because everybody talks about how much they love your practice and what a great addition you've been to the Centra team for these years. So just thank you for the way that you serve your patients in the community around here.
Dr. Daniel Breland:
Yeah. I'm honored to do so. I really appreciate you saying that. That's great.
Kate Kolb:
Absolutely. All right. So let's go ahead and dive in here to the topic at hand. And, again, coming back to this Men's Health Month, just want to spotlight this for the month of June, but obviously not only for June. This is for just the health in general, of good health for the men in our area. But let's start with this first point. Why is it important to make this an emphasis? Why do we want to make awareness for this?
Dr. Daniel Breland:
That's a great question. Much of this has to do with the lack of care that men take for themselves, really. A physician in the men's health network said, "There's a silent health crisis in America. It's in the fact that on average American men live sicker and die younger than American women." And this was kind of a push throughout the nation to try to promote men's health and awareness for prevention purposes. Sometimes men are not great at prevention. A lot of times we wait until we are very sick or when we have symptoms too late, as opposed to taking care of our own bodies in that route.
Dr. Daniel Breland:
So this push for men's health is to try to bring us more aware, men more aware rather, of their own health and awareness. So we do a lot of different things within primary care to try to highlight some of the preventative things that we can go over. So a few more data points to point towards that are that men die at higher rates than women from 9 of the top 10 causes of death, and are victims of over 92% of workplace deaths, interestingly. And women are actually twice as likely to go see a physician as men are.
Kate Kolb:
Yeah. That doesn't surprise me even just with the men in my own life. I just think of like, they've got to be at death's door before they're even going to think about picking up the phone to call somebody.
Dr. Daniel Breland:
Right. Right. So this kind of national push towards this is to try to highlight that discrepancy and really bring men more aware that they should be having a primary care physician and seeing them regularly at some basis. Of course we individualize care, but we do have standards for various ages as well.
Kate Kolb:
Yeah, I love that. And let's just take a pause here for just a minute, because I do want to address this idea of primary care, what primary care is. This is not on our outline, but I just wanted to talk about it for a second, because I think we use that term a lot in some of these podcasts. And it got me thinking while you were saying that, people might not know maybe what all that encapsulates. So talk a little bit about what you do as a primary care physician and what-
Dr. Daniel Breland:
That's a great point. I think some men come in not knowing exactly what my role is in this relationship. So when we say primary care, a lot of times the word gatekeeper is used to kind of direct traffic of one's health, to be the first line responder for preventative things, for really any health care need. And I use the word preventative a lot. We have various tests, various screening measures, vaccine schedules, et cetera, that help highlight various aspects of men's health. So when I say primary care physician, you can come to me for anything, essentially, for any healthcare need. And I mentioned that a lot of men don't come until they are sick. Well, a primary care physician is also here for when you're not sick at all and have zero symptoms. And from an annual perspective, we typically do an annual physical to really highlight and try to delve into one's health and see what exactly, what direction we need to go with that person.
Kate Kolb:
That's great. And you said something while you were talking about screening and different things like that. So I just kind of want to move that direction in our conversation here. Are there conditions in men's health awareness and in their bodies that are more prevalent for men than they are for women? And why should we screen for those? Or is that even a thing?
Dr. Daniel Breland:
Yeah, absolutely. Men are more likely to experience heart disease than women are. That is certainly a leading cause of death in women, of course, but men are more likely than women to have ischemic heart disease, especially. A lack of blood flow. And men are more likely to have certain cancers. Obviously prostate would be an anatomical reason. So that is one thing that we look into, but other cancers even more likely than that: lung cancer, colon cancer. COPD is actually more common in men, certain infectious diseases, diabetes, Alzheimer's, all sorts of things that men are more likely to have than women. And there are various reasons for that. One theory is testosterone and certain hormonal things. But I think one thing with this push in men's health is certainly that don't necessarily take care of themselves as well.
Kate Kolb:
Right, yeah. I was going to ask you that as a subjective question here about that. Do you think that the numbers on some of those might change if men got more consistent with the way that they were going in for exams and things like that?
Dr. Daniel Breland:
I certainly think so. I don't know data on that, if there is a longitudinal studies to reveal that. But we know that women are twice as likely, as I mentioned earlier, to see a provider than men are. So that certainly lends itself to that conclusion, yes.
Kate Kolb:
Yeah. Well, and on that same note, let's talk a little bit about here about why consistent healthcare is important to maintain a healthy lifestyle. So we've already sort of set this bar that there are just sort of the generalities in the male populace that, "Well, I'm fine. I don't want to go there until I absolutely need it." Or I joke all the time. My dad's line a lot when he was growing up, and my dad's a physician so this is even funnier. He was always like, "Just buck up. It's life." And so there's that kind of question that lingers out there of like, well why do I need to go see somebody if I'm doing just fine, or if I'm pulling up the bootstraps and everything's good? So explain maybe to any of our listeners why the consistency in healthcare is important.
Dr. Daniel Breland:
Yeah. So I would speak first to the relationship that I have with a patient. I certainly try to connect with a patient. It is a professional relationship, but I certainly try to connect at a personal level as well. That enables me to really get to know their habits a bit. When someone comes in, we ask not only medical history, family history, social history, surgical, all sorts of things. And I get to know the whole person. So I try to establish that relationship. When we do so, I get to know them well, what their habits are, what their faults are, things that they may struggle with from a health perspective, et cetera. With that consistency, though, I'm able to trend things, trend weights, we get labs periodically. So data trends are important.
Dr. Daniel Breland:
That also holds one accountable. So if I'm seeing someone regularly and hadn't seen them in five years, how am I checking up with them? How am I asking them the tougher questions? You know, are you exercising regularly? How is your diet doing, et cetera, just some of the common sense things of a healthy lifestyle. So if we are consistently seeing one another, there can be improvement. That's natural with anything, naturally. So if I'm in an exercise routine with someone, I have found that if I have an accountability partner, I am going to show up for them and I'm not going to stand them up. So they're there to push me, I'm there to push them. And I see that similarly in this respect too, with my relationship with my patients.
Kate Kolb:
I think that that's fantastic, because I think some of the men that I have talked to in my lifetime, they say very often, "Well, I don't want to go talk to somebody because they don't know me. They don't know my life." And there's not really an impetus to build a relationship like that with a healthcare individual. And I think there's a baseline of fear in it for some men, for sure. "Well, I don't want to go cause they're going to tell me something's wrong with me." So what would you say to somebody who does have a more fearful baseline about their health, or maybe they've seen bad things happen to family members before them and they just think, "Well, if I don't think about it, then it's not going to happen."
Dr. Daniel Breland:
Out of sight, out of mind.
Kate Kolb:
Right, right.
Dr. Daniel Breland:
Yeah. We certainly deal with that quite a bit. Whether that be, "Hey, it's time for your colonoscopy." "Well, I'd rather not know." We'll have that conversation of, "If we can know soon enough we can..." So I certainly encounter that quite a bit with with folks, men and women alike. But like I said, trying to establish rapport with a patient is very important for me, and I think important for the patient as well. So I try not to present judgment to that patient or beat them down in respects to any bad decisions that they've made, but try to help them through that. So I think a lot of impetus falls on the provider in that respect to try to calm that fear a bit. So I certainly play that on an individual basis though, because our fears come from various places regarding different things. So if I can establish rapport with that patient, explain through anything that they may have fear about, we can log through it together.
Kate Kolb:
Yeah, that's amazing. And I think we've been talking here on the last several podcasts and in the last, probably six months around Centra, just this idea of partnering with you to live your best life. And that's been something that we're really trying to take as an organization and move forward into our communities and with our patients. And so, what would you say to that tagline? How would you say you're implementing that in your practice with your patients?
Dr. Daniel Breland:
To live their best life? I certainly come from a very holistic view of the person, meaning not only physical health, but mental, which we've seen a lot of over COVID. Spiritual, there's all sorts of things that really tie into our health. So I really want to treat the whole person. And so I really try to engage with my patients. Like I said, I want to establish that relationship with them, but then treat them medically as appropriate. We have evidence-based reasons for the screening measures that we do. But for most men, we want to really drive in and improve men's health overall.
Dr. Daniel Breland:
I know you've talked about this before on the podcast, but obesity is quite the epidemic. And I think that's a big hurdle for us to try to overcome with living a healthy lifestyle. And so the various tenants and aspects of this that we could delve into. But yeah, treating your whole person I think is very important.
Kate Kolb:
Awesome. Well, let's pivot just a little bit here then and talk about some of those things that would treat the whole person, not just from a, somebody's come in with something that's wrong and we're doing that treatment there, but this preventative nature of medicine that you were talking about a little bit before. And so let's just start with one that I think is something that not just men, but all of us struggle with. But specifically in this context, what would some tips about diet be in terms of living that preventative, healthy lifestyle?
Dr. Daniel Breland:
As you have probably heard, there are many, many available. So I do certainly individualize that for patients. There's some general recommendations for a healthy man, I guess. We often recommend the Mediterranean diet. I think the Men's Health Networks has basically one veggie per meal, one fruit per meal, whole grain foods, less fatty foods, less red meat. Those sorts of things are kind of a general thing.
Kate Kolb:
I just heard every man groan when you said that.
Dr. Daniel Breland:
Yeah, of course. I know, right. That's certainly love it to myself.
Kate Kolb:
Right.
Dr. Daniel Breland:
But certainly in moderation is key. We don't do that well in America.
Kate Kolb:
No, not at all.
Dr. Daniel Breland:
Limiting alcohol intake. Everyone knows these things. It's a matter of putting it into practice, essentially. So there are certainly new diets that are trendy, but everyone needs to get within something that is consistent that they can stick to that is reasonable. And I would also go back to accountability that I mentioned earlier with even exercise. Diet is the same way. If I asked one person in a family to adhere to something, and everyone else is not, it is not going to happen for that one person. Too many temptations available. I remember vividly one person who blamed their spouse every time on their poor A1C, which is an average blood sugar level that we check for diabetics. So I said, "Look, you can't blame them every time. This has got to be a family affair, essentially." So yeah, there's various things online that one can check out to follow one, but it needs to doable and it needs to be something that can be achievable in a long term fashion.
Kate Kolb:
Are there any points of nutrition that men need to make sure that they are absolutely zoned in on that would help with different hormone levels, or just overall more protein to build muscle, or what does that look like for maybe a man's health base than just general populace?
Dr. Daniel Breland:
That's a good question. Again, I think I would go to an individualistic approach because it certainly depends on one's activity level, medical conditions. We have diabetic diets, we have kidney diets, heart failure diets, various things like that. So it definitely is individualistic to some extent, but again, I would kind of backtrack to those first recommendations, I would say, from a general perspective at least.
Kate Kolb:
Yeah. And I think it hearkens back to what you were saying just a few minutes ago, too, about building that relationship with your patient so that you know exactly what that body needs to reach on its normal on its normal basis.
Kate Kolb:
All right. So we talked a little bit about nutrition and diet here for men. Let's move into something that is also very trendy with certain things, is exercise. I feel like all over we see all kinds of "Well do this, and do this, and here's the equipment that you need, and this is how you build the most muscle the fastest," and that sort of thing. So what would you say to the guy that's listening that's just frustrated with what exercise looks like to stay healthy?
Dr. Daniel Breland:
Sure, sure. Again, individualistic approach, but again, I would harken back to the accountability aspect is key. And a lot of this I speak from personal experience.
Kate Kolb:
Right.
Dr. Daniel Breland:
It was tough for me to get into an exercise regimen and have a busy job. I have demanding hours, and a lot of men do. So finding the time is key, but you can. There's so many things that are available from a time perspective. So if someone gives me that reasoning, "Look, doc, I don't have any time to exercise." There are 10 minute videos that you can do at your lunch break prior to work. If you're too tired when you get home, either you have to make yourself do it, or there's some time that you can put this into this. I would certainly say if you're going from couch potato, don't expect to be a marathon runner in a couple of weeks. It does take time to develop habits, and healthy habits, but they do form. So once you become disciplined at some exercise regimen, it will become natural, and to some point, miss it.
Dr. Daniel Breland:
But from a general perspective at every annual physical or something like that, I recommend for men to at least get a hundred... What the recommendation is, 150 minutes per week, whether that be 10 minutes, three times a day, five times a week, 30 minutes a day, five times a week, or whatever it is. Another recommendation though is to do some strength training as well, a couple of times a week at minimum. So doing the aerobic exercise with the strength training is key for overall health too. It is easy to be frustrated with it. So I usually recommend trying to find someone that you can do it with. Many times finding a trainer, YMCA or something like that to kind of help you get started with some kind of plan is very helpful. But after that you can establish your own routine. And I think with time, that becomes habit.
Kate Kolb:
Yeah, for sure. I love the accountability aspect that you keep bringing out and everything. And I think it's important too, to note that it's okay if you're not the best.
Dr. Daniel Breland:
Absolutely.
Kate Kolb:
When you first start to try something. And that that's how you get better at something. And so I think there's sort of this almost embarrassment factor. Or again, it might go back to some of that fear of I'm not going to be as good as the next guy benching whatever next to me. And so I love what you're saying about accountability and kind of taking it slow. And again, that relationship that you have with, with your patient patients and the encouragement that that can be there. So, pretty cool.
Kate Kolb:
So when you're talking nutrition, and exercise, and healthy living, I think it's very trendy, it's very on trend right now in life to talk about, "Well, I'm setting goals for myself. And I've got this list and I've got my bucket list of things that I want to do." But what does that boil down to realistically? How do you encourage your patients when they're starting to set goals for healthier living in a way that's not going to immediately overwhelm them?
Dr. Daniel Breland:
Yes, certainly has to be realistic and reasonable. If someone is wanting to lose weight, I'm not going to say, "Please lose 50 pounds in a month and come back and see me." So they're going to be discouraged if that's not met. I typically allow the patient to set that goal. It means more coming from them, I think. And it also, I can hold them to their word. So a lot of times if someone wants to establish some sort of goal I'll ask them, say, "Well, all right, I want to see you back in six months. What do you think a reasonable goal is for you, and how are we going to achieve it? And walk through kind of a plan." And, and I'll say, "All right, look, I'm going to hold you to this. And I'm going to see you back next time." Maybe a shorter interval, various animals for depending on what their goals are.
Dr. Daniel Breland:
And really with COVID-19 an aspect of that that has kind of helped us is allowing more virtual and tele-health visits. So in that instance I don't necessarily have to have them back in the office to say, "All right, look, how's it going?" We can have a phone visit at some interval. So that's kind of a different aspect of primary care that I've experienced. But back to the question though, is setting those reasonable goals. I think when one is actually successful, it does kind of help give them a boost of confidence. So I would start lower. In medicine we always say, start low, go slow. And I think with, back to my childhood story of The Tortoise and the Hare, slow, whatever the phrase is.
Kate Kolb:
Slow and steady wins the race.
Dr. Daniel Breland:
There we go. Slow and steady wins the race, exactly. So that's somewhat of a mentality that we can adhere too.
Kate Kolb:
Yeah, I had a really good trainer friend of mine that used to say, "Start small, win big." And it was giving yourself little achievable, bite size things, whether it was nutrition or exercise, or just a new skill that you wanted to learn and that sort of thing. And the smaller chunk that you can finish and then build on is a great kind of stair-step to that.
Kate Kolb:
So is there anything else that you would just want to share with our listeners or encourage the men who are listening? "Hey, these are my final words, of encouragement and motivation to you today."
Dr. Daniel Breland:
You can do it. All of these things that we've mentioned are kind of overwhelming and men, a lot of times, don't want to listen to. But I would certainly encourage you to start somewhere, because the decisions that you make earlier in life certainly impact the ones later. We see the complications of an unhealthy lifestyle every day. So if it's a matter of fear, or discouragement, or time management, I am always willing to help someone walk through those and try to overcome those hurdles. And we have primary care all throughout the region, of multiple caring providers who can help you through the same kind of plan. But the earlier that you get these healthy habits instilled in your life, far the better for your ultimate health later on in life.
Kate Kolb:
Yeah. And then, too, the other side of that coin. So let's say there's a listener who has maybe not made the best decisions in their life up until this point. What would you say to them as an encouragement for starting now?
Dr. Daniel Breland:
That's a great question. So I could use the example of COPD. For instance, we know that the the lung function doesn't taper off as quickly when you quit smoking. So there are aspects of those things that are correctable, and that will not deteriorate as quickly, or will stabilize, or even improve depending on what we're talking about. So these things are correctable, and we can help with most things, at least.
Kate Kolb:
Yeah. That's great. And Dr. Breland, I just want to say thank you again so much for taking time out of your day. I know you're incredibly busy. And so it's just been really nice to be able to sit down and talk to you about not only just the aspects of men's health, but about the way that you practice medicine and how that fits into Centra's overall mission that we're accomplishing right now, too. So just thank you again.
Dr. Daniel Breland:
Yeah, absolutely. It's been a pleasure. God bless.
Kate Kolb:
Awesome.
Dr. Daniel Breland:
Thanks.
Kate Kolb:
Well, thanks again for listening. And as always, you can check out more information and other podcasts on this and other topics at centratoday.com.