Sean O'Connor (Host): Well, welcome back to the Well Within Reach podcast. I'm your host, Sean O'Connor. And today I'm going to be joined by Dr. Badwan, Family Medicine Provider at Riverside's Watseka campus. And we're going to chat a little bit about men's health, but before we get started, Dr. Badwan, I'll let you pronounce your first name because I am terrible at names even.

Hamzeh Badwan, MD: It's ah pronounced Hamza. Okay, and I want to thank you guys for having me here. You guys always do such a great job, and it's my pleasure to be here.

Host: Okay. Well, thank you so much. Tell us a little bit about your background what got you into medicine and what it is you provide with family medicine?

Hamzeh Badwan, MD: Well, I'm from Lockport, Illinois. Not too far from here. And I went into medicine because essentially I wanted to have this mission when I was younger that I wanted to help people. And as you become an adult, there's a million different ways to help. But with my biology and chemistry background, I went into medicine.

I went to SIU and then went to Arkansas to do my residency and everything. And now I'm back in Illinois and ready to help.

Host: That's fantastic. And once you get down into Carbondale, are you really even in Illinois anymore?

Hamzeh Badwan, MD: Great question. I love it there. We often think of it as a different place in the whole world. I love Carbondale, absolutely.

Host: I've been down to Carbondale a number of times and it's a fantastic area, but is like you said, another world. And so, it's really unique for Illinois. So if you haven't been down to Southern Illinois or up to Southern Illinois it's really a unique area. So, today we're talking about men's health. And so it's important, I think, for us as men to really understand how our health affects us as individuals and how it also affects our families The fallout that comes from not being able to get things addressed as soon as we normally do.

Hamzeh Badwan, MD: Well, I just want to address one thing that really concerns me as a provider is the stigma that is associated with men. And the stigma I'm referring to is men don't reach out when they want help. We have this philosophy of being very stoic. Oh, real men, don't complain. They don't seek help. And this is really 1950s ideology.

And, you know, we're in 2023. And, we shine the light on awareness on all these other issues. And men's health is taking a backseat, unfortunately, and I'm here to provide you guys with the resources to take advantage and optimize your health. This isn't about getting treatments when you don't need it. It's about preventing and treating diseases early.

Host: Yeah, I think that's something that to me kind of resonates is that it takes a stronger man to acknowledge that they need help, that they do need to have somebody step in, especially when it comes to mental health, because so many men looking back to their fathers or their older role models look at these stoic men that may be struggling with things. And I think it's,

Hamzeh Badwan, MD: I'm glad you said that. It really takes a very confident and very passionate person to come in and say, yes, I have a problem. And that's, and I, treat this every day and you're not going to feel better unless you try to get help. And it takes a very brave person to say, hey, I need help. And I'm going to go seek some help from my doctor to see if I could optimize my health and just get you to a spot where you're able to go through the day without as many obstacles. And that's what we're looking for. And life's hard as it is. Yeah, let's not make it any more difficult.

Host: Yeah, exactly. Um, the CDC has said percentage of men aged 18 and over in fair or poor health is at 13. 2%. And that number, I think you see steadily rising?

Hamzeh Badwan, MD: We see it a lot and it's because men will wait until their health condition is so severe that they cannot neglect it anymore. And at that point, it's much harder to treat something. So what we're trying to do, with the new generation of docs in healthcare is to really shine light on men's health in terms of mental health, their prostate cancer screening, which we can, we'll get into and of course testosterone and some other things there, but mental health is really the main one there that I think will elevate the quality of life of American men who have a lot of difficulties right now.

Host: Yeah. How does that topic best get broached or approached with your primary care provider?

Hamzeh Badwan, MD: So we try to screen everyone for anxiety and depression, and a lot of guys will never admit to this. They're never going to come into your office and say, hey doc my mood is not where it needs to be. They'll have other symptoms that go along with it, mainly fatigue. Usually it's, doc, I'm just, you know, I get up for work and I'm just not having the energy. And that's a psychosomatic symptom that is part of depression and anxiety. But you really have to force it out of them. But once you start getting it out of them and tell them, like, you're brave for even bringing this up because of the ideology of, you know, real men are stoic. And we need to get past that. We're human, just like everyone else. And we have our issues that need to be addressed. So that's what I try to get them and open the dialogue really get that's all I'm trying to do is open some dialogue. We don't need to start therapy. We don't need to start medicine, but let's just talk about it.

Host: Yeah. Yeah. I think that's the big thing for a lot of men is being able to identify what it is. For my own self, it was, things were off and there was no joy in life anymore. And it was just kinda, I always use like a pendulum of emotion, and the pendulum had stopped swinging back and forth. There wasn't a high or a low, there was just a, eh, kind of thing. And so that's when my wife said, you should talk to your provider about it. And so it does take, somebody to help identify that.

Hamzeh Badwan, MD: Exactly. And you brought in a good point, you're privileged. I'm privileged enough to have a wife that care about us. A lot of guys don't have that and they might not have that support. So it's going to fall on them, but you're right. Absolutely. We're here for him and that's why we're doing this to get the light out, shine it on and hopefully someone is listening here that may it's just one person. I work in a field where I can't save everyone. But, just one's enough.

Host: Yeah. Oh, definitely. And, being able to be frank about it too, even opening up with my friend group of guys and being able to identify, you know, hey that doesn't sound like how you normally have been living. Have you talked to your doc or, you may want to talk to your doc. And, showing, there's no shame in it. So.

Hamzeh Badwan, MD: And absolutely. And, a lot of mental health could be tied into some physiology. And let me elaborate on that. If your mood is depressed or if you're fatigued, this could be testosterone issue. It could be thyroid issue. It could be vitamin D issue.

So we don't always have to go and say, okay, well, you need to be on this medication. Sometimes it's as simple as, you have vitamin D deficiency and need to take a prescribed amount of vitamin D and then all of a sudden, Hey, I feel great. Thank you doc. And my job's easy. The hard part is my patient's ability to be honest with me. That's where the difficulty lies. And that's why I give my patients all the credit. You know what I'm doing, there's nothing special. But what they're doing is and that's having a relationship with their primary care physician. And in order to open up like that, that's really where it comes down to.

Sean O'Connor (Host): Yeah. And that's I think kind of broaches and, or goes into the other topic you mentioned it may not be depression as a whole, but it could be low T. And, so how do you tell someone who's struggling with like low testosterone or erectile dysfunction?

Hamzeh Badwan, MD: I have a lot of patients, between as little as 40 and as high as 60. And 1 of the main symptoms of low T is fatigue, is depression. So I screen people out that way. And if their testosterone is under a certain amount, insurance is going to cover it. They'll pay for it and they will feel immediately better in terms of energy, strength broached erectile dysfunction. No one wants to talk about it. Guys are very embarrassed and ashamed about it. They live with this shame and I have to take it out of people, you know, I screen everyone over 45 and people have told me, you've completely changed my life with just that little improvement in their sexual drive and their ability to maintain an erection because if you guys don't know any guys, a lot of us can be defined by our sexual drive. And as we get older the embarrassment and shame, eats at some guys. So we have to shine a light on it and say, hey, look, this is normal.

Erectile dysfunction happens with guys as they get older. There's no shame in it. No embarrassment. And the good thing is there's medicine for it. It's really cheap. It's not a lot of side effects. And a healthy sexual life is important for every human being.

Host: Yeah. Yeah. And I think the other thing for a lot of guys out there, or people in general is that your provider is bound to keep confidence with it.

Hamzeh Badwan, MD: Absolutely. There's confidentiality here. No one is going to run around and say what's going on. I'm legally binded to keep what we talk about in that room between us. And honestly, when we treat it and we come back and there's a big smile on the guy's faces, they're having fun now. They are a lot more confident in their life and they're doing what we should do as humans and try to optimize our health.

And I'm glad that you guys are here to help me shine the light on it. And I think we could get to more people and more guys and we could do it together.

Host: Yeah. And that brings up honesty is really important too. And so question always gets raised when you go to your provider, um, how many drinks do you have in a normal week? And, or how would you describe your alcohol consumption and the CDC has said that men age 18 and over have had five or more drinks in one day, at least over the past year is right around 30% of men.

Hamzeh Badwan, MD: Yeah. And that is an alarming, very alarming statistic. And what that signifies is when men are struggling, they will drink and this is not good. Obviously, it's not a coping mechanism, but there usually is an underlying issue there that is causing them to drink, whether it's a mood, whether it's fatigue. Whether it's a confidence issue, but it's something that needs to be addressed because a lot of men are coping with their mental illness with drugs and alcohol, which then eventually reduces their life expectancy.

Host: And along with that, we're looking at about 40% of men now have obesity as well.

Hamzeh Badwan, MD: Yeah, and I'm glad you said that. You know, obesity and low T do go hand in hand. And obesity is a pandemic everywhere now. It's worldwide. We're doing a lot of weight management here, whether it's diet, exercise. If you have diabetes, there's some really good medications now. The GLP-1 agonist that really help you out there. So all men, if you're obese, please go visit your doctor. See if there's something they can do to get you on some medications to help your overall health.

Host: Yeah, I think that also dovetails into being active as an individual. And so what can we do as men just overall without dispensing medical advice?

Hamzeh Badwan, MD: Yeah, so that's a great question. I look at health as a multi pronged approach. There's no one part of it. So like you said, it's lifestyle. I'm trying to stay active, stay hydrated, eat three to four small meals a day. Now, none of us have time to go work out two hours a day. No one's saying to go work out two hours a day. Just get out, walk, anything's better than nothing, and you have to build on it every day, and it has to be a conscious effort.

Host: Yeah, and it does help improve your mood, too. You get out, if you've got a pet, take the dog for a walk. You could try to take your cat for a walk. It doesn't always go well. Goes better than taking your fish for a walk, but it's, important to get out and get

Hamzeh Badwan, MD: Absolutely. If you have kids, take them out and show them that, hey, dad's active. Dad goes out. Let's go walk around. Let's go play in the mud. My wife might not like that last one, but. I just wash the kids off with a hose. They'll be fine.

Host: Exactly. They clean up nicely. Well, we've got to take a quick break. We'll talk more primary care provider. Riverside knows that health is your greatest asset and that your primary care provider is your partner in health. If you're looking for a primary care provider that fits your needs, you can find one at riversidehealthcare.org/primary care and Dr. Badwan is on there as well as a number of other great providers. You're specifically in the Watseka area, correct?

Hamzeh Badwan, MD: This is correct. I'm here in Watseka. I've been here for about two years and I'm loving it. If you need anything, I'm more than happy to assist in any way. I just want to broach one, one concept and that's finding the right primary care physician for you. That is the most important part. Primary care is all about honesty and transparency. So if you're not going to be honest and don't feel comfortable, then that's probably not a doctor or a nurse practitioner that you want to be with. You want someone that you can go and speak with and be honest with. And that's really going to be the way to optimize your health because if you keep secrets from your provider or don't feel comfortable, what are we doing?

Host: Exactly. On both sides. What your provider doesn't know, they can't help address it for you. Another really important topic I think is prostate cancer. How often should men get screenings for prostate cancer?

Hamzeh Badwan, MD: So prostate cancer is a preventative cancer that we deal with and it's gotten better in the recent years. We usually start screening around 50. However, if you have a family history of prostate cancer, we will start earlier.

The good thing with prostate cancer screening is it's a blood test. It's called a PSA. We get it. If it's elevated, we usually do imaging. A lot of men struggle with doing prostate exams and digital rectal. We don't really do that as much anymore. So I don't want to scare any of the men there. We get lab works. And if the PSA is high, we get an MRI or some imaging to evaluate the prostate and send you to urologist. So it's painless now. It saves a lot of lives. And if we catch it early, we can really benefit your health overall.

Host: Yeah. And what are some different symptoms that you might see?

Hamzeh Badwan, MD: Great question. So, the number one symptom would be urinary hesitancy. Let me kind of elaborate on that. As men, we get up to go to the bathroom at night. So under three is really the cut off. So if you're going more than three times at night, you may want to get checked out for your prostate. But also, if you're straining while you're urinating, if you feel like your flow is just not as heavy as it used to be, you definitely want to get checked out by a doctor.

And it might be something that's completely benign, but we need to screen you for cancer. And that way, if we find it, we can treat it right away. The technology for prostate cancer has revolutionized the whole system and we should really not see any of that anymore. Very similar to cervical cancer screening in women, we've almost eliminated that when women are actually, and guys that actually follow up.

Host: That's good, good to hear. Being in, certain areas, um, what are some things that you see affecting men in the Midwest or even central Illinois area?

Hamzeh Badwan, MD: Well, we see a lot of men that are ashamed to bring up issues because they make it feel like they're emasculated. However, I want to just highlight the fact that that outdated thinking needs to go. There's no such thing as emasculating. We're all human beings. We all suffer from similar issues. But for the most part, a lot of fatigue, a lot of mental health issues. And then I see a lot of ED too.

Host: Yeah. Yeah. And I think that's important to remember as a provider, really, if you're on the fence about anything, there is nothing you're going to tell you as a provider that is going to shock you. You've seen the gambit.

Hamzeh Badwan, MD: Yeah, this is my job. It's to help you. And, I can only help you so much as what you tell me, and, I just thank you guys for having me here today so I could spread the word and shine the light. And I'm here and you guys can do it at a local level or anywhere. Just find a primary care doctor that you understand that you guys get along with, and there's a transparency and honesty there. And that way you guys can both optimize that relationship.

Host: And do you have anything additional for someone who might be still not following up consistently with their provider on their health or still need to find a provider?

Hamzeh Badwan, MD: I just think of it, I'll give you like an analogy of basketball. Why can't we do a full court press all game, right? We should optimize your health. If you do nothing, you're not going to get better. You're not going to wake up one day and just feel better. Okay, let's get some lab work. Let's see what's going on. And let's see if we could take control of your life, optimize your health and make you as happy as you can be. Because at the end of the day, we're only here for a short amount of time. And as you get older, the more you realize that. And let's prevent anything that's preventable.

Host: Yeah, you only get one go around on this. So, let's make it as good as we can.

Hamzeh Badwan, MD: Absolutely. And I'm just going to touch on one more thing. And that's heart disease. It's one of the leading killers of men. If you have chest pain or shortness of breath, please tell your doctor so we can get a stress test. It's one of the things guys don't do because they just keep all of their symptoms locked up. Oh, it's probably heartburn. Oh, I'm just tired. If you're having any symptoms, please get checked. We do a stress test. If you need a stent in your coronary artery, it's better to do it under a controlled condition rather than wait until you have a heart attack.

Host: Yeah. And that brings up an interesting point of 51% of men now have some form of hypertension. And so what are some things that we can do as men to lower that risk?

Hamzeh Badwan, MD: You touched on it earlier. . Lifestyle, being active is number one. And number two trying to lose weight. And if you could do that naturally, you're not going to have hypertension, which is high blood pressure. And then you won't have to be on these medicines because a lot of guys don't like taking pills. And I say, that's fine. I don't either, but we have to do something to try to help it. And blood pressure is something easy that we could all screen with when we go to Walmart, or go to Jewel, or whatnot, and just check your blood pressure. We should also come to the doctor and get it checked out.

Host: When they go to Jewel, what's a target blood pressure before it's a concern?

Hamzeh Badwan, MD: So ideally, the ideal gold standard is 120 over 80, but in the 130s is okay, and that's why you always want to follow up with your doctor. But anything over 140 needs to be treated, and that's that top number, systolic number.

Host: Okay. And that kind of goes hand in hand with everything, good blood pressure, healthy heart.

Hamzeh Badwan, MD: These are modifiable risk factors, especially cholesterol too. A lot of people are hesitant to take cholesterol medications, but they work great and they prolong life. I take one every day cause I have a family history of that of heart disease.

Host: Sure.

Hamzeh Badwan, MD: And that's what I tell my patients. I've taking it I'm fine. There's no shame in taking a pill.

Host: Yeah. Yeah, there is no shame in taking a pill. And so, anything else we'd like to add today?

Hamzeh Badwan, MD: No. I want to thank you guys once again. You guys do such a great job here and thanks for giving me some time to put some shining light on men's health.

Host: Excellent. Well, we'll have you on again. Hopefully, we can cover some more topics.

Hamzeh Badwan, MD: Thank you very much. I appreciate it. Maybe during the Bears season?

Host: Yeah, well, hopefully, let's go Bears. We know baseball's not going well. As a Sox fan, we know baseball's not going as well and then. But yeah, let's go Bears. Well, thank you so much, doctor.