Dr. Mistry and Donna Lee Discuss Some Surprising Aspects of Their Practice, Which Treats Men and Women

Donna Lee: 0:00
The Armor Men’s Health Hour is brought to you by Urology Specialists. For questions during the week, call us at (512) 238-0762 or visit our website at armormenshealth.com. The Armor Men’s Health Hour is a show dedicated to providing information on a variety of medical topics, some of which may include sensitive subject material about penises. All cases discussed have been done with the permission of the people involved, and their penises.

Speaker 2: 0:35
Welcome to the Armor Men’s Health Hour with Dr. Mistry and Donna Lee.

Dr. Mistry: 0:42
Welcome to the Armor Men’s Health Hour. I’m Dr. Mistry, your host here with my cohost Donna Lee.

Donna Lee: 0:48
Hello. Welcome everybody.

Dr. Mistry: 0:49
Welcome on this Sunday. I hope everybody had a great Thanksgiving and got their fill.

Donna Lee: 0:55
I’m still full. Do we need to diet as a group?

Dr. Mistry: 0:55
We’re in the middle of as what Ray Solano calls the “Sugar Superbowl” of the year from Thanksgiving all the way, he included it all the way to the Superbowl. For those of you listening for the first time, I’m Dr. Mistry. I’m a board certified urologist and this show is brought to you by NAU Urology Specialists, the urology practice that I started in 2007.

Donna Lee: 1:23
You’ve been around for 12 solid years very proudly.

Dr. Mistry: 1:26
And we’re, we’re blowing and going, huh?

Donna Lee: 1:28
Goodness gracious. Can this year end already?

Dr. Mistry: 1:31
You know, it used to be the case that we were really busy in November and December. Things got a little quieter in January. And then about five years ago we just never stopped getting quieter.

Donna Lee: 1:40
That’s what I thought when I joined you about two and a half years ago. I thought, “Oh, in January we can breathe again.” That’s not happening. That didn’t happen.

Dr. Mistry: 1:46
Well, you know, it’s an interesting kind of interaction between the fact that insurance rules require so many things done at the end of the year because deductibles are done. And then the beginning of the year, because if you waited to get something done, you want to get it done right away in January. The practice has become incredibly popular. You know, the show has helped, just the incredible care that we have in our wonderful staff. So I have to give you kudos for the staff.

Donna Lee: 2:12
Oh, thanks. And we have it recorded! That’s awesome. I’m going to keep playing that back to myself, that loop of you saying that. Thank you. That was very sweet.

Dr. Mistry: 2:19
Oh boy.

Donna Lee: 2:21
We did have a really low turnover with our providers. I was just thinking about that the other day. We have like we’ve had providers with you for 10 years. One of them was 10 years, 6 years, 5 years.

Dr. Mistry: 2:29
That’s right. You want to tell people about our urology practice?

Donna Lee: 2:32
Yes, we are located in round Rock is our main location, Round Rock. North Austin and we also have a cute little location in dripping Springs by the high school. Our number is (512) 238-0762 during the week. And we look forward to your questions. We have a few questions today. Our email address is armormenshealth@gmail.com. That’s armormenshealth@gmail.com. Armor Men’s Health is a division of NAU Urology Specialists. And our website is armormenshealth.com.

Dr. Mistry: 2:58
Because it seems like we’re such an exclusive practice, a lot of people may not know that we take insurance, and we take all sorts of insurances.

Donna Lee: 3:05
98% of the insurance plans, which is not a problem at all. We love that.

Dr. Mistry: 3:10
So if you’re a Medicare patient, or a Medicare Advantage patient, or you have a commercial insurance, the chances are that we do accept your insurance and if you don’t, then there’s sometimes arrangements that can be made. But absolutely, if you’re interested in making an appointment with our office about any number of urologic or men’s health issues, we’d love to see you.

Donna Lee: 3:26
Yep. We treat men and women. I think a lot of people think we mostly treatment, but our mix is what?

Dr. Mistry: 3:32
60/40, that’s right.

Donna Lee: 3:34
So, with 40% women. So don’t shy away, women–we’ll take care of you too.

Dr. Mistry: 3:37
That’s right. Women get kidney stones, women have problems with blood in their urine or recurrent urinary tract infections. And then of course we have an amazing treatment program to help women with sexual dysfunction, whether it be low libido, problems with dryness, or whether it be any number of things that, especially if they seem complicated to you. These are things that we really thrive on taking care of.

Donna Lee: 3:59
Right. A lot of family practice groups and OB-GYNs will send us female patients for sexual dysfunction because some urologists or some OB-GYNs don’t even focus on that. I didn’t realize that until I joined you.

Dr. Mistry: 4:09
It takes a lot of time with those patients and expertise and specialty work. We have a pelvic floor physical therapist in the office as well as having a sex therapist always in the office, so that really helps kind of treat those patients.

Donna Lee: 4:21
Right. Our sex therapist is amazing, Sylvia. And then we have Robert’s a registered dietician that we have. Who else do we have? We have so much going on.

Dr. Mistry: 4:28
We do, we have a lot of pieces that you wouldn’t necessarily think are part of a traditional urology practice, but that kind of helps us deliver kind of a more holistic care that we think is really valuable for people.

Donna Lee: 4:40
Right. And our sleep study coordinating group, Austin Sleep Solutions, they’re pretty awesome too.

Dr. Mistry: 4:44
That’s right. Again, another thing that you wouldn’t necessarily expect to get at a urology office. When you talk to urologists and you talk about the impact that obstructive sleep apnea has on a number of urologic conditions, like frequent urination at night or fatigue or low testosterone, they’ll tell you for sure it’s a problem. Being able to offer testing in the office I think makes us a more comprehensive place to get your care.

Donna Lee: 5:05
Do you want to touch on that? Because we have a lot of patients who they’re not thrilled about the little 10 second questionnaire when they come to the office. It really does take just a few seconds. I think I’m talking about it mostly with patients with testosterone. When the front desk says “this patient is upset and doesn’t want to fill this form out,” and then we have a chit chat with them or the front desk will explain “your sleep affects everything.” And then they kind of calm down and they’re like, “Oh, okay.”

Dr. Mistry: 5:26
I think we’re just in a transition time period in, you know, in medicine where people go to the doctor with a certain level of expectation. But really that expectation should be that I’m going to get taken care of really, really well. Not necessarily that this doctor should do this and that doctor should do that. The best way, not the only way, the best way to screen those people that are at risk for obstructive sleep apnea is through a little screener. Now, the problem with screeners is that in an effort to be comprehensive, they often seem very generic. So do you feel tired? Do you snore? Do you feel sleepy at the, you kind of in the mid day. These are very generic questions, but if you say that you don’t have any of these symptoms and the likelihood of you having, you know, bad sleep apnea is really low and it just kind of prevents us from having to test people unnecessarily.

Donna Lee: 6:10
And our sleep study group has a teeny tiny little contraption they send you home with so you don’t have to go sleep in some strange bed offsite.

Dr. Mistry: 6:16
That’s right.

Donna Lee: 6:17
And I actually made my husband go through this and he slept very well for 2 nights with the little thing hooked to him. And it turns out he had some sleep apnea.

Dr. Mistry: 6:25
Yeah. I mean just an oxygen sensor and then something to measure breast excursion. It’s really not that intrusive of a device and absolutely can help distinguish those people that are having a lot of trouble with de-oxygenation at night. And I certainly think that if you’ve been recommended to have a sleep apnea test, you should definitely go through it. And if you become a patient of ours and we recommend it, then it’s being done specifically because we think that it’s a good idea for you.

Donna Lee: 6:52
Right. Gotcha.

Dr. Mistry: 6:53
So, we are blessed with a lot of great listeners and just the feedback that we hear from our own patients and from people that emails is great. We have some questions today.

Donna Lee: 7:03
Yeah, we do. We’ve got a few questions. I love that the patients are sending them into armormenshealth@gmail.com. This one says “Dr. Mistry, I have low T and a low libido. My wife and I would like to have a child…” There’s some typos here, so I’m trying to distinguish what he says. “If I, if I try, it kills sperm. I’ve tried Clomid and New Testa…” I’m not sure how to spell that, “with, with lackluster results. What else can I try?”

Dr. Mistry: 7:28
That’s a great question. So the interaction between low testosterone levels low sperm count levels is one that poses a conundrum to us as people who are trying to take care of you. Because if you take testosterone, just straight on testosterone, whether it be in a cream form, pellet form or injection form, there’s a large likelihood that your sperm count will go down. And in some patients, a lot of them, in fact, it goes down to zero. And getting, getting somebody pregnant with zero sperm count is tough.

Donna Lee: 7:58
It’s hard. It’s really, really hard.

Dr. Mistry: 8:01
And speaking of getting hard, so, you know, oftentimes low testosterone will also contribute to erectile dysfunction and low libido makes it so that having sex is more like a chore that time of month. And then if you and your spouse are really, really kind of anxious about getting pregnant, it makes kind of the pressure to get an erection and the pressure on sex and everything, just so much worse. And it’s a cycle that I’ve seen over and over and over again.

Donna Lee: 8:25
So stressful for the couple.

Dr. Mistry: 8:28
That’s right. That’s right. And so we’ve used HCG, we’ve used Anastrazole, we’ve used Clomifene as alternatives to testosterone to kind of improve testosterone. But really what those meds do is that they increase what we call intratesticular testosterone. And that helps with sperm counts and sperm quality. A lot of people will not improve their libido. About half or 70% of people who we think should improve their libido, but just not, just not as universally as those that get on testosterone. And worse, if you’re on testosterone and you switched to one of these alternatives, it may not feel the same. So we attack libido in some different ways. Sometimes we’ll use Buproprion or Wellbutrin in an off label way. Sometimes we’ll use other medicines just designed for libido enhancement. We’ll find ways to reduce your prolactin level. And then, there’s the cycle of, you know, men kind of think it’s their sex drive, but really it’s a little softening of their erections. So we’ll try something like a daily Cialis for them. And I explain it by saying that I’m going to give you a pill that’s going to help you hit home runs and maybe we’ll play more baseball. And I think urologists all struggle with being good like storytellers. But that’s, that’s my story. You know, I don’t play golf because I slice it, but if I had a pill that would help me hit it straight down the fairway every time I might might go play little more golf, you know? And so that’s what I try to explain to people.

Donna Lee: 9:59
So many euphemisms.

Dr. Mistry: 9:59
We’re trying. That’s right. You’re the one that said harder.

Donna Lee: 10:04
Sorry, I’m surprised I didn’t get censored.

Dr. Mistry: 10:08
It just slips out.

Donna Lee: 10:09
That’s what she said.

Dr. Mistry: 10:10
That’s all right. Well thank you so much, Donna. You want to tell people how to email us next time so that we can make fun of their questions?

Donna Lee: 10:17
No, we didn’t make further that question. That was a really good question. You can email us at armormenshealth@gmail.com. That’s armormenshealth@gmail.com. Our website is armormenshealth.com. Our phone number during the week is (512) 238-0762. Give us a call, you can even ask for me. I will be happy to talk with you and it looks like we’ll be right back after these messages.

: 10:38
Dr Mistry wants to hear from you. Email questions to armormenshealth@gmail.com. We’ll be right back with the Armor Men’s Health Hour.