The Columbus Dispatch
Many doctors foresaw it as the perfect storm facing patients — a combination of the stress and anxiety during a pandemic blended with poor diet, lack of exercise and weight gain.
And they worried that men would face the brunt of it, due to their natural reluctance to have regular screenings and doctor visits.
For those with chronic conditions such as diabetes or heart disease, missing a health screening or regular checkup could be catastrophic.
“At the beginning of the pandemic, we saw a big drop off of patients coming in. We were starting to get worried about those with chronic health conditions,” said Dr. Bryan Ghiloni, medical director for Mount Carmel Health System whose family practice is in New Albany.
Men have often been described as stoic and self-reliant, dismissing aches and pains as natural, he said. Anecdotal evidence suggested that men were skipping out more than women.
“I really think, at the risk of sounding sexist, that we’re wired to take care of ourselves, to minimize problems,” Ghiloni said. And his male patients’ hesitancy worsened last year, with the coronavirus pandemic providing an excuse to avoid going to see doctors.
“Those who were active stopped, they worried more, they ate more. The weight comes on and stress and anxiety lead to high cortisol levels,” Ghiloni said. The stress hormone contributes to high blood pressure, muscle weakness, mood swings or irritability and a host of other maladies.
Male-specific screenings include self-examination for testicular cancer beginning at age 20; antigen blood tests for prostate cancer for those 40 and older, especially those with African heritage, according to Philadelphia-based Penn Health.
For Joe Balistreri, 75, of Powell, regular checkups weren’t always a priority.
“I think the older you get, you start to realize your vulnerabilities and want to do things to protect yourself,” he said. “The younger guys seem to be more concerned with their physical health and condition of their bodies than I was.”
Balistreri’s was required to get an annual physical by his long-time employer, AT&T. The habit stuck, even after he retired, in 1998.
But as a younger man, and an athlete in several sports, he recalled feeling invincible.
Now in his senior years, health issues have cropped up. He’s 50 pounds overweight, has had two knee replacements and is being treated for heart rhythm issues.
Still, he’s managed either telemedicine appointments or in-person screenings with his cardiologist, Dr. Thura Harfi, at Ohio State University’s Wexner Medical Center, who praised his patient’s persistence throughout the pandemic.
But Harfi and his colleagues worried about their less diligent male patients who ignored symptoms such as sharp chest pain or shortness of breath.
“We said ‘What happened to all those heart attacks and strokes?’ People were scared and they wanted to wait it out,’ ” he said.
“It is almost universal that the amount of stress is higher, emotional and physical,” said Harfi, an assistant professor of clinical medicine who directs OSU’s cardiovascular CT and imaging core laboratories.
“We are now one year away, and the fear factor has changed,” Harfi said.
Loss of gym memberships, poor diet and weight gain has been “hugely detrimental to even healthy patients, let alone those who have heart disease,” said Harfi, 40, who came to the U.S. from Baghdad, Iraq, in 2006.
“My perception is that men tend to minimize their symptoms and seek medical attention later.”
But when arteries are blocked, and mild symptoms arise, getting help quickly is critical, he said.
“Time is brain. Time is heart tissue,” he said. “If they come later, the heart tissue is dead.”
“We are now one year away, and the fear factor has changed,” said Harfi, who has seen a more regular appointment schedule recently.
Dr. Michael Jolly, an interventional cardiologist and director of OhioHealth Riverside Methodist Hospital’s cardiac intensive care unit, said that treating men, about half of his practice, requires a different approach to seek out what’s really wrong,
“When you’re taking care of a man, the first thing you ask is ‘where is your wife?’ Jolly said. “We have learned to read the body language of their significant other.”
Ed Werner, 74, a lifelong central Oho resident, began seeing Dr. Joseph Winchell, of Mount Carmel Medical Group in Pickerington, 20 years ago and hasn’t missed an appointment since.
“If I feel something’s not right with me, I’ll tell him about it.,” he said.
Werner often brings along his ex-wife Carlotta, with whom he’s still friends and who helps him answer questions from Winchell that he might not recall.
“She knows more about me than I do myself,” Werner said.
Jolly said the absence of patients early in the pandemic at Riverside and other OhioHealth hospitals was profound and troubling.
“A year ago, when all this was breaking, we didn’t know what to do. There was lockdown and people didn’t know what to do.
“People were not coming in, and dying from home where they never would have before,” he said.
In early to mid-summer, serious complications arose, such as ruptured heart valves. When that happens, Jolly said. “The damage is done.”
The serious cases improved at Riverside in the fall, he said, but worsened again over the holidays.
Health professionals will continue to urge patients to be screened and they want to provide hope.
While not typically covered by insurance, calcium level tests, which cost about $100, are quick, noninvasive and help to spot problems early, said Harfi, who recommends that all his patients regardless of age or gender, exercise, even if they just walk; control their control and see their doctor regularly.
Werner was hospitalized for COVID-19 for a week in March not long after his first coronavirus vaccine shot and said you can’t be too careful.
“Get screened and tested. See your doctor … if you want to live to be a good old age,” he said.
The good news, said Ghiloni, is that catching up on missed visits is possible.
“I’d say if you’ve not been in yet, call your family doctor and get your well check,” he said. “The vast majority of the time, you can get caught up and you can reverse things.”
This article originally appeared on The Columbus Dispatch: Men who skipped health screenings during COVID-19 pandemic can still catch up
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