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Scot: Hello? One, two, three, four. How are you doing? Let's hear how you're sounding today, Troy.

Troy: One, two, three, four, five testing.

Scot: Oh man, I can't tell where you end and I start.

Dr. Madsen: Isn't that amazing?

Scot: Those microphone levels are perfect.

Troy: Look at those spikes on there. Those green spikes.

Scot: The relative volumes are set. So now we can start our conversation.

Troy: Nice.

Troy Suffers a Bad Trip Alone On a Run

Scot: I'm really kind of amazed that you're here today, Troy. Last time, we didn't talk about it on the mics, but we're going to talk about on the mics today. You were out doing a trail run and I don't know, like broke six bones, your pelvis, got a concussion. I mean what happened to you out there?

Troy: It was bad and it was one of those things where it happens and you're in that moment and you just think to yourself, "Wow, am I okay? Is anything broken? What's going on?"

Scot: Yes, let's back up a little bit. So like all those things didn't happen to you. I was exaggerating a little bit, but you do a lot of trail running and you were out on a run. How far out were you from the car when you had your fall and what exactly happened and what did you hurt?

Troy: So I was out on a trail run down in the San Rafael Swell, which I love. I grew up in Price in Eastern Utah and the swell is just southeast of there. So if you're looking for a great place to visit, the Swell's a great spot. So I was running from the Wedge Overlook. There's a trail that runs along the rim. I was the only one out there. There was nobody else on the trail, so it was beautiful. It was great. Really nice to be out there.

Scot: And about to get scary.

Troy: It can be scary.

Scot: Yes, with nobody out there.

Troy: With nobody out there. So absolutely nobody. It's just me and a few birds flying around in Nevada 1000-foot cliff off to the side. So it's always an interesting place to run. But I was about eight miles from my car. I was about 2 hours and 40 minutes into this run. I was planning to go for four hours and I tripped. And it's not unusual for me to trip on the trails. You know, you catch a toe on a rock, but I can usually catch myself. Catch myself like okay, I'm good. I don't go down. But for whatever reason I really tripped. Like I caught my left toe on something. It actually pulled my shoe off. Yeah. So then I'm coming down and it's, you know, this really kind of rocky surface, really jagged rock. So I reached for it with my right leg to try and stop myself.

Scot: Right leg or right arm.

Troy: The right leg to try and catch myself to not go down.

Scot: I got you.

Troy: And usually I can, but then I just felt this tear in my right hamstring just hurt like crazy. And then my left foot came down without a shoe on it, hit the rock and then I felt it in my foot and sure enough I broke my toe from that. And then came down on my hands, really scratched my hands up. So it was not good. It's one of those where I went down and at that moment you're just thinking, "Wow, okay, did I break anything? Am I going to be able to give back to my car?"

Scot: Hamstring, toe.

Troy: Hamstring, toe.

Scot: Those are the major things. Eight miles away from your car.

Troy: Eight miles away. And my first side is, can I even walk? My hamstring, that was the big thing. I mean I could feel it in my toe but my hamstring just hurts so bad. But my first thing was get up, see if everything's moving okay. I was able to at least kind of move okay. I could not extend my right leg completely just because of that pain in my hamstring, you know, my left toe hurt like crazy. I was like, yeah, I probably broke it. We've talked about this on the podcast before. So immediately my mind went back to the podcast and I said, "Okay, if I were talking with Scot about this, I would say just tape it up." So I said, "I'm going to be okay. I'm just going to put my shoe on. I'll be okay with the toe."

Scot: Did you have tape with you?

Troy: I did not have tape. I wish I had tape. But at least I was thinking, you know, just keep it stable and it should be okay. I should be able to keep going.

Scot: All right. So this is an interesting conversation number one about your story. If this happens to somebody, they're eight miles away doing whatever and they end up hurting themselves and there's some concern that they're not going to be able to get back and there's nobody else around, you get up, you ascertain what's going on. I mean, is there a point where you don't try to get back and you hope somebody shows up if you don't have cell reception or I mean what . . .

Troy: I think you have to try. I mean in that scenario there was no one else out there. I had been out there, like I said, almost three hours. I had not seen another person. So I wasn't going to see anyone. So I think you have to try and get back and you get to get to a safe place and you've got to do whatever you can to get there. I mean, maybe if there are other people out on the trail, you could wait for someone and you've been seeing people and someone could call for help. You could call for help, but if I had called, you know, I thought, well, it was one of those things again where I kind of tested and I thought, I think I can get back.

Scot: So you had cell phone reception?

Troy: I didn't actually test my cell phone. I mean, I tested my legs and I thought, I think they're moving.

Scot: Okay, good. So then you started heading out.

Troy: I did. I headed out and I ran. Which again may not have been the best thing, but I found that running was actually easier than walking because I didn't have to extend my leg completely. Keeping my knees bent didn't seem to put so much strain on my hamstrings, so I ran very slowly. It was more of a limp, more of a hobble.

Scot: Sure. I found the same thing when I ran my marathon that I had knee issues and I would walk the aid stations and it got to a point where that hurt worse and just keep running.

Troy: I know sometimes it's like that.

Scot: So if you're caught out in the middle of nowhere, maybe, you know, try.

Troy: Maybe try running don't walk. I don't know. I'm not necessarily recommending it, but it just, it seemed to work. It hurt less than trying to walk and get through it with that.

Scot: And then you made it back. So you did make it back eventually.

Troy: Yes. I made it back to my car.

Scot: Eventually. And then you went to the doctor right away, right?

Troy: Yes. So you know me so well because you know the first thing I did is . . . because I love going to the doctor, the first thing I did is went to the doctor. No, absolutely not. I did not go to the doctor.

Scot: No. First thing he did when he got back to his car is he decided to finish his run and you ran beyond your car again. How many miles? You're the worst.

Troy: Yes. Like I said, I'm a horrible example. I'm not dispensing medical advice right now and I'm not suggesting anyone do what I do.

Scot: How's it been since the fall then?

Troy: So it's been slow progress.

Scot: You didn't go to the doctor.

Troy: I didn't go to the doctor.

Scot: Icing, do anything like that?

Troy: I didn't. I mean at that point, you know, it was hour from there to get to my parents' house, which is in Price where I was, you know, visiting my family and saw them and at that point it was like, well, it hurts. I don't know that ice is going to do a lot of good. Studies I've seen that have looked at ice after injuries, they show that it probably doesn't make a big difference. This was on studies on ankle sprains. It doesn't really reduce swelling a whole lot. So I always tell people if it makes it feel better, you can use some ice on it, but don't feel like you have to rush to get ice on it.

Scot: Interesting because that's always kind of I think the first thing you're told to do.

Troy: It's the dogma. And it's the first thing we do in the ER. We throw an ice pack on it, but I think it kind of numbs it up and it makes it feel better, but long-term, I don't think it makes a huge difference. So I didn't rush to throw ice on my hamstring. My toe, I got some tape at my parents' house. I taped it to the toe next to it. And that's what I've continued to do since then.

Scot: Which I want to stress that a lot of times when somebody comes into the ER with a broken toe, that's what you do. As long as it's not sticking off 90 degrees from the rest of the toes. It's not something crazy.

Troy: Exactly. Yes. And then I looked at my toe and it looked just really bruised up and hurt like crazy, but I thought, well, it's probably broken, but it looks like it's more or less aligned and I'll just tape it up.

Scot: Got you. And since then, healing?

Troy: Very slowly and it's been frustrating. It's one of those things where I've been running consistently for about four years now where I run every day and I'll tell you I've continued to run since then, but it's been an adjustment. And it's been tough because I think a lot of people, you know, we go through this where you find that you are making a lot of progress. If you're running, maybe you feel like you're getting faster or biking or you know, you're just feeling stronger or whatever the situation is.

Scot: Or even weightlifting. That's something I've been struggling with lately is I'll go to the gym and lift weights and then I'll have some issue with my shoulder and then that kind of is a setback and you're just like, why am I even trying?

Troy: Yes. And it's tough and that's been exactly the thought I've had. Like why exactly am I doing this? I've been doing this and I've been seeing progress and it's been a big change mentally to say I've got to slow down. And I got on the treadmill and I was running 10-minute miles and that was as fast as I could go. And this is where, you know, I ran a race a month and a half ago and was, you know, I was running consistently seven-minute miles in that race and it just like, I can't run that fast at this point and it's probably going to be months and months before I can.

So I think it's tough, you know, I think we all face injuries, whether it's stress injuries from that that repetitive motion of whatever exercises we're doing or falls like this or other things come up. So for me it's definitely been a moment of saying, okay, why do I run? What do I get out of it? What do I enjoy? I want to continue to do that.

Scot: You got to go back. Go back to the original reason which was . . .

Troy: Which was, I enjoy that time of . . . what do I do enjoy it?

Scot: Well, I mean for you it was because you were trying to manage your cholesterol. You decided I need to get some activity in my life. I'm going to choose running. I'm going to do a half hour run every day regardless of how I feel.

Troy: That was exactly it.

Scot: That was the whole reason you started and all this other stuff was just kind a cool side effect that you improved at the rate that you did. And every time you come in and you tell me your marathon times, I just shake my head and go, "I don't know how you're doing that."

Troy: And that's exactly the thought I've had. I said, I got into this because yes, there were the health benefits, but then there's just purely the fact that I just enjoy it. And even though you know, I'm going to run slower and it's more difficult than it's been hurting, but at least it's improving every day. I enjoy just being outside, I enjoy running. I enjoy that time of like meditation and thinking through problems and you know, stuff we've talked about before as well.

Scot: So that activity is good for you. And I think with me and my weight training, I've been doing weight training and I have to come back to that as well because you start making these improvements. I can only speak for myself, right? As a beginner weightlifter. You start making these improvements and all of a sudden you start focusing less on the activity and more on, oh, I wonder if I could get my bench up to such and such pounds. And then you end up maybe hurting yourself because you move too fast or whatever and you forget the original reason why I'm doing it is just to get some activity and keep my muscle tone, you know, intact and that sort of thing.

Troy: No, it's exactly right. And for that reason, I mean, as I've just been dealing with this lately, I've thought, well this is a good thing because I think it does bring you back to why did I start to do this? It's not about the competition or about measuring myself where I was a month ago. Sure, that's great. But it's really just about the enjoyment of the activity. The additional health benefits. So I think it's good for that reason. It's frustrating. It's definitely been a mental adjustment and it's, you know, it hurts. So that's been no fun, but it's been good too.

Scot: Well, good luck. I hope that you start to recover because it breaks my heart a little bit.

Troy: Well, thanks. I appreciate it. Hey, we're going to be running together so this is good.

Scot: Yes, you're right. Now we can actually run together because I could never do a seven-minute mile. Oh maybe I could manage a 10 for a couple of miles

Troy: I'm looking forward to doing some good five-and-a-half-hour marathon.

Scot: I'm the guy when his fast friends hurt themselves, but now they want to run with me.

Troy: I know. Exactly. Thank you. I appreciate it. I really do.

Scot: We all serve a purpose, I guess.

Troy: There you go.

ER or Not: I Have Electrocuted Myself

Scot: It's called ER or not. We're going to give up the scenario and then you determine whether or not you should go to the ER for it. Dr. Madsen will tell us if we're right or not. So ER or not, you shocked yourself. And I'm not talking about like you made a hole in one or you ran a six-minute mile shocking yourself. I'm talking like you electrocuted yourself. You grabbed a hold of an extension cord, you got some electricity pass through your body. I mean it can happen a lot of different ways. ER or not?

Troy: So this one is fairly definitive and you're not going to like the answer but the answer is you need to go to the ER. And this is kind of a pain because really the recommendations are out there is if you get shocked just by a household outlet, that amount of electricity can cause an abnormal heart rhythm. And that's the reason to go to the ER. You get an EKG. You come in, you tell me, you know, I was working on some electrical stuff or like you said you grabbed an extension cord . . .

Scot: Yes. Let's do the electrical stuff. I'm putting in a new light fixture, right? And maybe I didn't turn off the fuse box and I get a little, I get bit, that's the electricians call it. I got bit. See how I am with the lingo there.

Troy: I like it.

Scot: If you get bit, is that enough?

Troy: If you get bit . . .

Scot: Even if it's just . . .

Troy: If you feel that shock on your hand from a household electrical source, you need to go to the ER. And it's kind of a pain to say that, but you really need to get an EKG because the concern is that electrical activity passes through your body, it could potentially cause some sort of abnormal heart rhythm. So anytime anyone comes to the emergency department, if they're telling me, yes, I was working on some household electrical work, this was not a high voltage line. I mean that's a whole other story if you're talking about, you know, maybe trying to get something down and climbing up a ladder around your house and you get shocked by high voltage line, that's a big deal. But even this household voltage, it's potentially something that puts you at risk.

Scot: It's one of the few times you've said this. This is definitive.

Troy: I know. It really is. But it's pretty straightforward when you read about this. It's like, yes, you have to go and you have to get an EKG. If it's a high voltage injury, then we're going to check some labs on you. We're going to observe you for several hours afterward as well. And it's just one of those things you can't really mess around with. I mean, I've seen some horrible injuries from not necessarily the household outlets, but some of these high voltage injuries. That the big thing is they can cause maybe a small burn, but they can just cause severe muscle damage internally, these sorts of things. So electricity can be a big deal. Definitely worth getting checked out.

Poor Diet is Linked to 20% of All Deaths Worldwide

Scot: The headline is poor diets are linked to 20% of all deaths worldwide. That is one out of five people dying because of poor diet. There's an article that we saw in based on research published in "The Lancet." They said poor diets killed 11 million people worldwide in 2017. Now, what it is suggesting I think is interesting and some good stuff to keep in mind as you maybe perhaps struggling with your own nutrition. They said the top risk is overeating sodium and trans fats so that can lead to a like cardiovascular disease. What are some of the other things that high sodium diets can lead to?

Troy: A stroke is one of the big things we see. Like you said, yes, heart disease, heart attacks, high blood pressure. All interrelated with that high sodium intake.

Scot: Okay, so they said that was the top risk, but the second is not eating enough nutritious foods, including:

• Whole grains
• Nuts
• Seeds
• Fruits
• Vegetables

They said that grains are linked to lower rates of cancer, lower rates of type two diabetes and also cardiovascular condition. Nuts have healthy fats and a lot of vitamins and minerals. And they recommend eating more whole grains and nuts and reframe your dietary thinking. So instead of thinking of cutting out junk food and other things, think about adding more nourishing foods to your diet because we as people react better to being told eat more as opposed to restricting what we eat, which is a bit of a paradigm change, which I think was the interesting thing that this article brought to me. What as a doctor did you notice, Troy?

Troy: Yes, that's I think what really stood out to me in this. And it's one of those things where, you know, you think if you've got a kid you're talking to or something, if you just tell them all the time, don't do this, don't do this, don't do this, don't do this, it just, it was like, well, what do I do? But if you emphasize, well, do this, focus on these things. I think we all respond a lot better to positive reinforcement than just saying, don't eat this, don't eat this.

But if really the emphasis is, you know, they say we're still told so much don't eat junk food, but if we really emphasize eating these things, and again and again in studies, this is what we see that makes a difference in your health, eating whole grains, nuts and seeds, fruits, vegetables, polyunsaturated fats and legumes. So we're talking beans, chickpeas, things like that. If you can emphasize those things in your diet, the other things just seem to get pushed out. You're not thinking so much about sweets and sodas in that because you know, over time I think your body sort of adapts and looks at the fruits as sort of providing those sweets. Maybe it's not as sweet as a soda or a candy bar or something. But as you really emphasize those things, I think it makes a huge difference.

And I mean, personally, I can speak to this. I know maybe we've talked about, you know, I'm not recommending a vegetarian diet for people, but I am vegetarian. And I came to a point where I looked at my diet and I said, "Wow, I'm a vegetarian but I don't eat vegetables." That doesn't make any sense. This is ridiculous. You can eat incredibly unhealthy as a vegetarian. You can eat all kinds of pizza and you know, just carbs and all kinds of stuff. But as I've really tried to emphasize these things, and partly based on the science that's out there saying these are what make a difference, all those other things kind of get pushed out of the diet. So that was my takeaway from it. Emphasize the good rather than always just thinking, don't eat junk food.

Scot: And eventually the bad will kind of get pushed out. That's my experience as well. When you start emphasizing the good and eating more nutritious foods, your cravings for all those other things start to go away. Either A, because you're full and you don't want anymore. I mean, that's what I do. I just tell myself, all right, I'm going to eat some of these healthy things and then if I want to have that, I can. Generally, after that point I'm like, I don't really want that right now. So, you know, it gets me by that.

I think the other thing for me is I was at a point in my life and I think a lot of people are like this where people are avoiding whole grains. They're avoiding grains in general. They're trying to be more gluten free. And I was avoiding for a while whole grains and rice and stuff like that. And I'm not exactly sure how I got to that point. It was some sort of a mental thing. I don't know if it was society. I don't know if it was, you know, experience that I would lose weight without them. I don't do that anymore because a lot of fiber and a lot of good vitamins and minerals can come from whole grains.

So I think that was my takeaway. It kind of reinforced that, you know, having some tuna sandwiches and whole bread every once in a while is fine. Eating rice is a staple is fine. Even though a lot of people think it's got high carbohydrates but they're healthy carbohydrates. So that was kind of my big takeaway. I already kind of eat some nuts and that sort of thing.

Troy: And I agree with you. I think whole grains are great. I think balance is good. I think emphasizing one group over another or saying carbs are bad, bad. I don't think that's the case. I think you need balance and you need whole grains and you're going to have carbs and whole grains. They're going to have gluten. Gluten intolerance is something that's become a bigger thing that a lot of people talk about you as you look at the science behind it, actual cases of legitimate glucose intolerant or gluten intolerance or celiac sprue is the, you know, the medical disorder is known, are not that common.

We may attribute certain symptoms that we have to gluten, but again, actual proven medical disorders, it's not that common. And I think the balance is good to have the whole grains. Obviously to have the fruits, vegetables, nuts, legumes, all those things. Really emphasize those things as it talks about here.

Another thing that stood out to me is they said that poor diet is responsible for more deaths than smoking, which is pretty remarkable to think about. You know, obviously we attribute so many health issues to smoking while at the same time saying, well, I don't smoke so I'm good. But you know, when you really look at what you're eating and how you're eating and those habits, you may be worse off than if you were smoking. We're not suggesting you smoke, but . . .

Scot: It really reframes how important diet is.

Troy: It does. It really does. And we convince ourselves where we have healthy habits, but sometimes when we really look at things, particularly diet, it may not be all that healthy.

Scot: All right. So instead of telling yourself you can't have the bad foods, emphasize that you need to eat the good foods. And the article did say one the things that you could do right away to improve your diet is to add more whole grains and nuts because I guess a lot of people not getting enough of those.

Troy: That's right. And this, this really jumped out to me. They said that people eat only 12%, as many nuts as they should and only 23% as many whole grains. Now the emphasis on whole grains is because lack of whole grains has been linked to things like cancer, type two diabetes, heart disease, and then obviously nuts. We always think about that with these heart healthy fats, vitamins, minerals.

So I think if you can just make it easy for yourself, have these around the house, obviously whole grains incorporate into your diet. I think just with the regular foods, incorporating breads, things like that, but have snacks available that are nuts when you. When you take stuff to work, let that be your snack. Snack on almonds, such a great snack, heart healthy.

And I think just in general, just making a healthy diet a convenient diet is really key. Having plenty of fruits and vegetables at home, reaching for these when you're reaching for snacks. Again, trying to use that to push some of the junk foods out of your diet and just making the healthy food your go-to.

Scot: Well, you hang with us this long. That's fantastic.

Troy: Thank you.

Just Going to Leave This Here

Scot: Now it's time for a little bit of a treat. A segment called just going to leave this here. It could be random thoughts. Might be related to health, might not. Just going to leave this here. I am preparing for my upcoming physical and I thought I'd talk through the process because I think sometimes, I think it can be useful. My turning point was related to a physical I had a while back when they took a look at my fasting glucose and they're like, huh, it's getting kind of high. You might want to take a look at this. You might have a condition called pre-diabetes. That was one of many stimulus that kind of was part of my transformation story. It wasn't anything dramatic. It was just these little things.

Troy: So you have found value in the physical, although you said the yearly physical seems a little redundant sometimes.

Scot: I have. Well, for me, the value is in the tests. So as I was thinking about what I'm going to talk about at my physical, I'm going to be sure that I get my fasting or not my fasting glucose, my A1C test to see how I'm tracking because to me that's an important part of staying motivated with what I'm doing, and also it's the reason why I'm doing what I'm doing. So I think I'm going to ask for those tests. I'm not going to ask for my cholesterol because from what I understand, you only need a couple of years and it was in pretty good shape last time. And I guess that's it really. I mean, but I actively went through the process. How would you prepare for a physical?

Troy: I think there's value just in having a primary care physician who knows me, who I have touched base with, who I can get in touch with if things come up, if I have health concerns rather than trying to get established with someone new. I think there's a lot of value in that. But I think like you said, it's worth reviewing your health thing, saying, okay. I've had this nagging concern that's kept me up at night. Maybe it's something I haven't thought about in the last month or two, but it was really bothering me a couple of months ago. Things like that are worth mentioning and making a list.

Scot: Yes, that's a great point because nagging health issue is one of our core six.

Troy: Exactly.

Scot: So I guess the final message I have on my just going to leave this here is, you know, prepare for your physical. And I think you have, we have a couple of good tips here. Plus, also, I think there's value in getting your blood pressure and your pulse and those things looked at.

Troy: Yeah, exactly. Know what you're trying to get out of it. So I'm just going to leave this here, but I was excited to hear this news that the FDA has approved, what is referred to as a new extra genital test for chlamydia and gonorrhea? This is new.

Scot: This excites you.

Troy: This excites me.

Scot: Why is that?

Troy: Because it's something I need to test for in the ER. I test patients for this. The larger point here is that chlamydia and gonorrhea are not just diseases of the genitals. This can happen in the throat. People can get throat infections that may feel like strep throat and it's from chlamydia and gonorrhea. The bigger point here is it's summertime. Maybe you're traveling, maybe you're feeling a little bit more adventurous. Don't feel that safe sex just involves using a condom and that oral sex is safe sex. These sorts of things can happen everywhere. I've seen many cases in the emergency department of people who do have chlamydia and gonorrhea in the throat, in the eye. These sorts of things happen. Stay safe out there and be aware of this.

Scot: And be aware of your partner.

Troy: Be aware of your partner exactly.

Scot: Yes, okay. So you might want to avoid that if it's . . . this is a bigger conversation.

Troy: This is a bigger conversation. But the big point here again is that the FDA just approved this test so we can actually test for it now instead of just saying, well, I think that's what it is. We're going to treat it. Actually, I can do a swab now.

Scot: This didn't exist before?

Troy: Oh no. So technically I could use a swab that we used for the genitals that's using it off label and it was questionable how accurate that was.

Scot: So this is specific.

Troy: This is the new thing that is specific. It's extra genital meaning it does involve the genitals. It involves the throat. Technically, you could do a swab if there's some drainage coming out of the eye. I've seen chlamydia and gonorrhea in all of these locations. So something to be aware of.

Scot: What about in urgent care? Do they have this test?

Troy: Good question. They probably do. The health department might as well. You can get STD testing through the Department of ÑÇÖÞ×ÔοÊÓƵ. They have clinics so they can do things there as well. So I'm assuming they're going to have this test also.

Scot: Well we're at the end of the podcast so that means I do the stuff that people do at the end of podcasts which is tell you our email address. It's hello@thescoperadio.com if you want to reach out. This where I ask you to subscribe. If you like it, be sure to leave a review or give us a rating. It helps other people find us. And then I tell you about what's coming up next time. Physical therapist, Keith Roper is going to come in. And he's a pretty cool dude and he's going to tell you why physical therapists are awesome and can actually help with a lot of problems you might not have considered before. ER or not Dr. Madsen is going to tell if you need to go to the emergency room if you get hit in the head with a soft ball. And we're going to talk about scooters. They are popping up all over again. Your chances of getting hurt on that first ride are pretty high. We'll find out why and that's coming up next on "Who Cares About Men's ÑÇÖÞ×ÔοÊÓƵ?"