EPISODE 2: The Silent Challenges: Understanding Black Men's Health with Dr. John Vassall, MD

The discussion focuses on understanding and improving Black men's health through a community-driven approach to wellness. We explored health challenges specific to Black men alongside the importance of holistic living. Dr. John Vassell provided insights into the medical landscape while fostering awareness of the social determinants affecting health.

• Need for community support in navigating health 
• Focus on holistic health rather than just ailments 
• Understanding how social determinants impact health outcomes 
• Importance of proper diet and exercise 
• Effective communication with healthcare providers 
• Proactive measures for managing common health issues 
• Encouragement of cultural identity in dietary choices 
• Building a framework for better health management 

To support this podcast, go to buymeacoffee.com/realhealthblackmen.

Chapters

• 0:00 Introduction: Taking Control of Health
• 1:04 Building a Community for Black Men's Health
• 1:48 Welcoming Dr. John Vassell
• 5:55 Understanding the Importance of Focused Discussions on Black Men’s Health
• 9:50 The Reality of Social Determinants Affecting Health
• 15:00 Common Health Issues Impacting Black Men
• 22:10 The Role of Diet and Exercise in Health Management
• 30:15 Communicating Effectively with Your Doctor
• 37:30 Key Takeaways and Actionable Steps for Better Health

Transcript

Grantley Martelly: 0:11

This is the Real Health Black Men podcast, where we empower men to take control of their health. We provide vital information and build community support. Join us as we discuss everything from major health challenges to mental wellness to physical fitness. So if you're ready to level up your health and your life, you're in the right place. Let's get started. Welcome to Real Health Black Men. This is a space where we talk about things that matter to us. We're building a community dedicated to empowering black men to take control of our health. We're bringing you vital information, cutting through the noise and giving you the real deal on everything from major health issues to mental wellness, physical fitness and everything in between, because we know that real change happens with support, and that's exactly what we're here to provide. So this is our first full episode, and I'm so glad that you're joining us. My first guest is Dr John Vassell, a doctor of internal medicine, and he's going to give us an overview of health, healthcare, healthy living as it pertains to us, and you don't want to miss a minute of it. I promise you that you will enjoy this episode and that you will learn a great deal from him. So thank you for listening and share this with a friend or a family member and help us get the word out and help us build our listenership so that we can be a great support to each other and we can make sure that we have the information we need to take control of our health and to live our life to the fullest.

Grantley Martelly: 1:55

Today we have the distinct honor of welcoming my friend, dr John Vassell, an esteemed physician with an incredible career spanning many decades. An esteemed physician with an incredible career spanning many decades. Dr Vassil is an internal medicine physician in Seattle, washington and a clinical associate professor and associate dean at the Washington State University Elson S Floyd College of Medicine. His resume is truly impressive. He has held leadership positions at some of the largest healthcare systems in Washington State, including Providence, seattle Medical Center, swedish Health Services and president of the Minor and James Medical Group.

Grantley Martelly: 2:34

Beyond his clinical experience, dr John has been a tireless advocate for improving health access and quality for all. You'll have to look him up to learn of all the awards and accolades he has received. I know Dr John Vassil as the medical voice for the Tacoma Pierce County Black Collective, where his weekly medical talks has been transformative in helping our community members learn to live healthier lives in clear and simple terms. So today I'm excited that he's joining us and we'll be delving into Dr Vassell's insights on a range of topics, from navigating the healthcare system to improving health outcomes for Black men. So let's get right to it and welcome Dr John to Real Health, black Men.

Dr. John Vassall: 3:22

Okay, thank you. Thanks for having me. I'm a graduate of the University of Washington School of Medicine. I did my internal medicine training in Atlanta, georgia, at Emory, at Great Memorial Hospital. I initially started in private practice in Decatur, georgia, came back to work at Group Health and then started in private practice with my best friend and roommate, my medical school roommate Rayburn Lewis, and we practiced together for a number of years, so I have some experience both here and in the South, which I think is important because I've dealt with all kinds of populations in terms of my medical training. However, I'm rooted here in the Pacific Northwest and I've been here for a very long time, so I think that's a good background for people to have in their mind.

Grantley Martelly: 4:19

Well, thank you, Dr John, for that. Yeah, I'm sure the context is going to really help us as we get into our discussion. Now I know that you have some specific information that you want to share with us and we have some questions we want to get through. This is a big topic. We're hoping today that we can touch on some aspects of it, but we may have to do a follow-up podcast or maybe a couple as we go along, because the topic of black men's health, to me, is a significant topic. So I want to begin to do it Go ahead.

Dr. John Vassall: 4:50

Yes, in that regard, I think sort of in terms of setting the stage. What I'd like to people to think about is health and black men's health, and make a little bit of a distinction between health and medicine and medical care. So when I'm talking about health and when we explore health, we're talking about how to live your life in a healthy way, in a fulfilling and satisfying way, and not really think about it in terms of diseases and pills and supplements and those kinds of things. Think of it in terms of how do you live your life to its fullest. So that's what we're going to be talking about when we talk about health, talking about the ability to live your life at its fullest, not impaired by disease or illness or injury. And even if you do have those things disease, illness, injury how do you manage those things in such a way that you can be healthy, health again, being living your life to its satisfying fullness.

Grantley Martelly: 5:59

Living to its fullest? Yes, and that's what we want to do on this podcast is help men to learn to live to their fullest and take charge of their health. So let's begin by this topic of. We know men's health is important. We want all men to be healthy and live their life to their fullest. But why do you think it's important that we talk about Black men's health as a separate category of overall men's health?

Dr. John Vassall: 6:27

I think it's important for people to focus on themselves and where they are Now. That's not to say that we should be necessarily looking at men in silos, women in silos, because health is really a communal thing. It's hard to be healthy in isolation. You know health is really a communal thing. It's hard to be healthy in isolation. You know health is part of health is how do you communicate with other people. But you know you have to focus on yourself first so that you can be healthy and you can be in a position to help other people, including the women in your community.

Dr. John Vassall: 7:04

Very often, when we talk about women's health, people think of reproductive health, they think breast cancer, they think of those kinds of things. When they think of men's health, they think of prostate cancer, heart disease, those kinds of things, diabetes, and I think those things are important and we can't address them unless we focus on them. However, we need to think holistically about how all those things interact and how being a male in this society interacts with your health. Now, what I mean by that? If you're a man in this society, there are certain expectations and even certain stereotypes. If you're a black man, there's certain expectations and certain stereotypes, and so one of the reasons for focusing on black men's health is to be aware of how those expectations and stereotypes may affect your health.

Grantley Martelly: 8:06

So let's unpack that a little bit. We know that, and science has shown that there is certain diseases or certain things that affect people in the Black population more than in the general population. We know for Black men also, there are things that affect Black men more in the Black population than in the general population at large. So let's begin to talk about some of those things. In terms of health and you frame them as a doctor is where should we be focusing and what are the things that we should be giving attention to when we talk about health?

Dr. John Vassall: 8:44

for men.

Dr. John Vassall: 8:45

Yeah, thanks for that question. Here's what I want to make clear that many of the problems and diseases and illnesses and traumas that affect black men do not affect them because they are genetically different. You know, race is not genetic, it's not biological Race and that doesn't mean it's not real, it's not genetic or biological. It's a social and economic construct and races are different if you go from country to country. But in this society they've decided that Black people are a separate race. But that does not mean that we are separate genetically. It does not mean that we're more genetically prone to some of these illnesses or diseases. I'll give you an example.

Dr. John Vassall: 9:41

Now let's start with COVID-19. It was well known that the impact of COVID-19 was greater and the death rate was greater in the Black community and in other communities Hispanic community, native American community than in the communities at large. Does that mean that we are genetically different? No, and in fact there were some people who were trying to make the case that that there were different receptors in the nose that make the virus stick more in black people, which actually is utter nonsense. They're getting COVID and getting more ill from COVID.

Dr. John Vassall: 10:24

That has to do with the social aspect of being Black. Many Black folks and Black men are in jobs that expose them to strangers and strangers. If you're in your family in a controlled environment, you're relatively safer than if you're in an environment where you're coming into contact with a lot of strangers. For instance, if you're a bus driver, if you're a manual laborer, with other people coming and going, if you're in a service job, those are the kinds of jobs where you're often in contact with a lot of strangers, many of whom can carry this disease. So it's not a genetic thing. It's your circumstances, your work environment or perhaps your community environment that makes you more at risk. And then if the society has been such that you've been unable to preserve your health, so you have heart disease, diabetes, then if you become infected you're more likely to die and become very sick. So those are the kinds of things that are social, that put Black men at risk and Black women at risk for diseases. That is not genetic.

Grantley Martelly: 11:42

Yeah, we call those the social determinants of healthcare, Right? One of the things that has also come out in this has also been access. People are talking about access to healthcare. Can you talk about that a little bit, about how that may be showing up also in where we see these things about? Certainly certain environments or certain areas have better access to health care than others.

Dr. John Vassall: 12:12

Yes, I want to talk first about why we need access, and that's about health in the larger picture. Let's talk about some of the disorders and diseases that we see commonly in black community and in other communities, for instance, okay, hypertension is very common among all people of all races. It's particularly common in black community. More so, it's more common in black men, probably caught the cause of dietary issues such as salt intake, general health issues in terms of exercise and physical movement, but also this is where access is important in terms of being able to be diagnosed, because it used to be called the silent killer.

Dr. John Vassall: 13:03

Hypertension is something that you don't know that you have unless you're evaluated and somebody checks your blood pressure. So people can go through years and years and years of having hypertension, suffering its consequences, but because they have not had access to diagnosis, they're not aware of it and therefore they don't get it treated. So that's one example Diabetes. Diabetes is a situation where people have high blood sugar and the reason their sugar is high is because their insulin is either lacking or is ineffective, and insulin is a hormone that allows the body to process sugar. Similarly, people can have diabetes and not be aware of it until a certain point where it becomes symptomatic. There are people when you first. When a person first develops diabetes, they have no symptoms, but then over time they may start feeling themselves thirsty all the time, drinking a lot of water, urinating frequently, and by the time they're diagnosed they may already be suffering organ damage so again, access to medical care is important.

Dr. John Vassall: 14:24

information, and good information about your health is important, because you wouldn't know what to ask or what to look for if you're not aware of what's important to keep yourself healthy.

Grantley Martelly: 14:32

That's a good transition to my next question, which was you know, some people have the idea that hey, if it ain't fixed, don't break it right. Yeah, why do I need to go to the doctor if I'm feeling fine? Nothing is bothering me, I'm not in pain. You, yeah, why do I need to go to the doctor if I'm feeling fine, nothing is bothering me, I'm not in pain? Why should I go to the doctor or the dentist? Okay, I hope.

Dr. John Vassall: 14:51

I've already partially answered that question, and it is that you say if it ain't broke, don't fix it, but you don't know if it's broke unless you look. Okay, and so there can be some things that are going on with your health that you're not aware of unless you actually go in and get evaluated. Now, going in and getting evaluated is easy to say and not often as easy to do as it is to say, particularly to Black men. There are many reasons why and legitimate reasons why Black men are concerned about getting involved with the healthcare system. There certainly has been some sordid history about what has happened to Black folks in medical environments in the United States, but we have to evaluate that in the context of the present and in the context of where we are. So, yes, people are concerned about getting into a medical environment, which is one reason why people should do some research before they become involved in the medical environment.

Dr. John Vassall: 16:00

Who's a good doctor? Sometimes you have to go by what your friends and relatives have experienced, because very often it is, it's your experience. So you may be told that Dr X has a great resume, has been to the finest medical schools, et cetera, but that doesn't tell you how he may treat. He or she may treat you, but that doesn't tell you how he or she may treat you. So while those things are important, it's also important to know how your friends, your relatives, your family, your community has been treated in that system or by that physician. And once you feel comfortable enough, then you can engage in that, in that with that person, with that system.

Grantley Martelly: 16:47

Yeah, I mean that that that's been some of the discussion that has come up. I've talked to people about health. Black men's health is about, you know, feeling comfortable with a physician or with a clinic that they're going to, and some men has expressed that they have not felt that way and in fact, some of my friends have told me I've changed doctors because the one I was going to wasn't treating me and that made me feel comfortable and wasn't answering my questions. So, instead of quitting, I asked around, like you said, and I found another doctor who relates to me. So, as a physician, you're saying that relationship is just as important as a technical knowledge.

Dr. John Vassall: 17:31

Yes, yes, yes, did I say. Did I say yes, it's very important because if a person is scholarly and knows everything, but they don't share that information with you, or they can't share it with you in a way that is useful to you or understandable to you, then that knowledge does you no good. Does you no good? Ultimately, it's the patient who has to make the decisions day-to-day that impact their health.

Dr. John Vassall: 18:06

The physician can give them information and ideas and a pathway but ultimately it's the patient who has to make those decisions, and if the patient is not getting the information and the pathway from that physician, then that physician is not doing them any good.

Grantley Martelly: 18:24

Thanks for answering that question. So my follow-up question to that doctor is so we go to the doctor, we find a good relation, we do the tests, we do our annual physical and we get this report back that has a whole bunch of stuff on it and some of them, you know, has the red, green and yellow lines and stuff like that that tells you if you're good or not. But what's the best way for a layperson to interpret those results that comes back from those blood tests or those physical and blood work that we get when we go to the doctor?

Dr. John Vassall: 19:01

You know that's a great question because it actually highlights something that has really changed over the last few years. When I started in medicine many years ago, physicians tended to hold on to the information. So we'd get the test, we'd look at them and we'd interpret, and some doctors would share them with the patients, some wouldn't, some would share what they thought the patient could handle and would withhold what they thought they couldn't handle, and some doctors would interpret the tests for the patients. And the physicians kept the notes in their chart and very often didn't necessarily share that with the patient either. Over the last several years, those two things have changed. Now very often you can get your medical records online through a secure portal where you sign in and you can look at the notes in your chart. The most physicians in large systems will give you an after visit summary, which is a piece of paper that tells you what they did in that particular visit, what your vital signs were, et cetera. And now, particularly if you're on some of these electronic health records where you have access to your records, you may get the test before the physician sees them. It automatically gets posted to your chart and sometimes the doctor hasn't even seen the results before you have, which can be problematic, because sometimes it's really scary, particularly when you see things that say they're abnormal or they're in a red zone and you don't really know what that means. Sometimes something's in a red zone and it doesn't mean anything except for that the test is off, and sometimes it's in a red zone and it's something pretty serious. So unfortunately well, fortunately and unfortunately, because it cuts both ways, uh, it's it requires you to take control of your understanding of your health in a way that you haven't had to in the past. So how do you do that? To your question, because some of this stuff is really pretty technical and it would take a lot of explaining just to explain a single test, whereas some of it is fairly straightforward and it's not that hard to figure out. For instance, if your blood sugar is 200, it's not that hard to figure out that that's high, it's too high and you probably have diabetes.

Dr. John Vassall: 21:56

Whereas some things are much more subtle, and I'll give you a personal example, and that is your cell counts. You have white cells and red cells and platelets and others. My white cell count is low, quote, unquote. Now it's always been low because it's low white cell counts run in my family and there's nothing wrong with that. Then there's nothing wrong with me. But I've had to convince some of my doctors to stop looking for a disease. I tell them look, my white cell count has been the same since I was in college. So now you're going to be looking for something? Uh, but I? But I'm at a level where I can understand that. That's hard to explain to a lay person and and even to some physicians, because that white cell count is based on the average of quote-unquote normal people, usually normal white men. So that's part of the problem. So I don't want to make this too complicated in terms of your audience.

Dr. John Vassall: 22:46

And how do you deal with those tests? The first thing is you have to have a general understanding of what these tests mean. And again, this is one of those times where you really have to have a physician who can explain this to you and who is willing to explain it to you, and unfortunately, sometimes your visit is so short that they may not have time to do that. But you really need to have a general understanding of what is a high blood sugar, what is high blood pressure, what is a low blood count, and that means a red blood cell count, which would be anemia, and some of the chemistries. What's a normal kidney function test look like? Now, you don't have to know everything, you don't have to know all of this, but I think it's really good to know some of these general things Blood sugar for diabetes, blood count, particularly for women with regard to anemia, kidney tests, liver tests, just those broad areas and get a good sense of what those things mean.

Grantley Martelly: 23:51

So you said something there in interpreting the results that really came back to me. In my own experience I had two times that I got my results back from the lab before my doctor saw them. One of those times was when I was diagnosed with prostate cancer. I received my biopsy scores two days before my doctor called me. Yeah, and I looked at them and I I didn't know everything about it, but it says 50% were positive, 50% were negative. And then I started doing some research and I said, well, if 50% is positive and 50% is negative, that means I have something. And then I started looking up Gleason scores on my own and Gleason scores are four, four and three and three and four.

Grantley Martelly: 24:47

The point about it is that I had that information for 48 hours before my doctor even called me. Yeah, there's a lot of emotion attached to that, but so, even with technology, sometimes, sometimes I think the technology gets ahead of you in the medical professions. You know when we get it so quickly that and then the person is there struggling with what does this mean? Until they can have that conversation, like you said. You know, in my case I was right. I did have it and I told my doctor that and at the time she said yeah, that happens sometimes you get the results and we don't even get them until after you. So I couldn't even call you two days ago and say, hey, grant Lee here's what was going on.

Dr. John Vassall: 25:36

Yeah, it's a byproduct of our sort of our technological error and also some of the issues around patients' rights and their rights to the information. Patients own the information in the chart. You own the information. The facility, the doctor, the hospital, whoever they own the chart and the technology around the chart, the electronic health record, but you own the information. In other words, you're entitled to all of the information in your medical record. Now, when you get it, it can be problematic, because I think it's actually cruel to give somebody information with no context and no training and no information to understand it, particularly when it comes to cancer, which, you know, the word itself is scary. Yes, it is patient's right to have that information, to know that information, and yet the humanity of giving it in a way that preserves the patient's ability to make decisions and to understand the information.

Grantley Martelly: 26:51

In my case, my two older brothers had had prostate cancer before me, so I was able to call them and have a conversation with them about you know what does this mean for me? But I can think about some person who didn't have that or who didn't have that. You get this information and they're staring you in the face and it's like wow, yeah.

Dr. John Vassall: 27:11

Yeah, let's talk about that, that community thing again and having that community of support, because you had that. Uh, that's really important. And let's talk a little bit about family history too, because that's also you bring up that point, which I think is very important. Family history is what has happened before and what has happened to people in your life. That is not necessarily destiny. So the fact that somebody in your family has had this doesn't necessarily mean that you will get it. In your case that was the case, but that's not always the case. So people need not be afraid of their family history or reluctant to find out about it, because it's not your destiny. But it can be useful in terms of helping you to think about what you might expect.

Dr. John Vassall: 28:05

Sometimes it is destiny if it's a genetic problem. For instance, with some breast cancers there's a gene actually that's passed down from woman to woman which can lead to breast cancer. So that is destiny, but in some cases it's not. And prostate cancer it's not necessarily destiny, although it does raise your chances. So it's important to know that because that helps you think about what you should do in the future. So for your sons and your brothers and your nephews and nieces, your nephews, sorry cousins, male cousins they need to think about screening for prostate cancer in a different way than somebody who doesn't have that family history. And again, that doesn't mean it's destiny, but it's something that it puts a different level of urgency for somebody who has that in their family. And on the positive side, you have that support. You have that support People who have gone before who can tell you what their experience has been, and that's a lot different from reading something in a textbook.

Dr. John Vassall: 29:17

Yes, it is, you know has been, and that's a lot different from reading something in a textbook. Yes, it is, you know. And so having that, having those people, especially family members, but it doesn't have to be family, friends, close associates who can tell you what you might expect, I think that's very important that's very important.

Grantley Martelly: 29:43

Let's talk about some of the diseases or illnesses that seem to be appearing very commonly in people of color and things that people should be concerned about. You've mentioned some of them as we've been going through here. We mentioned diabetes, we mentioned prostate cancer, we mentioned hypertension. I was talking to an ophthalmologist the other day and she was telling me you know, there's also some evidence about glaucoma. So what are some of the things that we, as people of color, need to pay specific attention to when we go to the doctor or when we cannot our health.

Dr. John Vassall: 30:17

Yeah, great question, because there's so much to look at and you can go in a thousand different directions and not necessarily get anywhere. So what I like people to think about again is health as being able to live your life in a most satisfying way, being able to accomplish the things you want to accomplish in your life, and part of that is being able to make sure you're in physical and mental condition to take advantage of the opportunities life offers you. I think people should first look at those kinds of things that might be common and preventable, because there's no point in worrying about something that's uncommon and you can't do anything about. But there are certain things that are common and can be either prevented or managed in such a way that they don't impact your life. So let's start with hypertension, that's, elevated blood pressure Extremely common One in three at least adults. If you stop any three people on the street, one of them has hypertension. So that's how common it is. Attention, so that's how common it is. And part of it has to do with life processed foods, lack of exercise, obesity, et cetera, et cetera. So you may not be able to prevent yourself from getting it, but you certainly can manage it by managing those things. Now, if you so, one, it's very common. Number two it's very manageable. You know it's manageable with lifestyle changes, watching your weight, reducing salt intake, exercise and, if necessary, medication. Number three if you don't manage it, you can be in big trouble Heart attacks, strokes, ischemic disease, which means that you have poor circulation, which can lead to amputations, those kinds of things. So it's common, it can be serious, it can be managed. So those are the things I want you to look at.

Dr. John Vassall: 32:41

Diabetes common, serious, can be managed. The incidence of diabetes is really escalating, in part because of the incidence of obesity, because type 2 diabetes's highly linked Type 2 diabetes is highly linked to obesity. It's inability to manage blood sugar. If it's not diagnosed and managed properly, it can lead to heart disease, heart attacks, strokes, blindness because of the blood vessels and the eyes being involved, amputations because of lack of circulation, kidney disease, kidney failure and dialysis. So those are some of the things that can happen if it's not managed. So, once again, you need to get checked, have your blood sugar checked and if you're heading for diabetes, you need to be aware of that so that you can manage it. It's common, it's manageable, it's serious if it's not managed. Heart disease Common right. It can be serious and it can be managed.

Dr. John Vassall: 33:58

Often a heart disease kind of a cardiovascular disease we're talking about. There are various kinds there's valve disease, there's congenital disease that people are born with, but we're mostly talking about atherosclerosis hardening of the arteries and leading to heart attacks, often caused in part by elevated blood cholesterol and other fats in the blood. So calm it. I can't say easily managed, but it can be managed. How do you manage it? With cholesterol-reducing medications if necessary, but first a plant-based diet, maybe with a little bit of animal protein if you need to. But you know there's certainly vegans, like my sister, who don't eat any protein whatsoever and she's perfectly healthy and she's a weightlifter, by the way. So you can be very healthy without animal protein, but that doesn't mean you can't have any. But your diet should be primarily plant-based and exercise, because that burns off that excess fat, that excess cholesterol, and keeps your blood vessels clear and keeps your heart pumping properly. So again, with regard to heart disease common, manageable, serious if you don't manage. Okay.

Grantley Martelly: 35:18

Yeah, that's a good overview, Thank you, and I like. I like your, your as far as in common you know, manageable and we can do something about it. You and you got into the importance of diet and exercise there as well as part of managing some of these diseases. So let's talk about diet and exercise, particularly because you do a really good explanation on what exercise is. When you say that it's not necessarily becoming an Olympic athlete or becoming a CrossFit competitor, what do you mean by exercise for the common person and what they can do to benefit their health with good exercise?

Dr. John Vassall: 36:03

Yeah, that's a great question. Thanks. First of all, I think of exercise as movement. So just think about it as movement. If you're a slug staying in one spot, not moving, that's not exercise. That's the thing. And sometimes we had a question on the Black Collective, if you remember, regarding some machine that moves for you. Right, that's not exercise. So if you're getting some kind of vibrating or torquing machine that moves you around, that's not, in my opinion, exercise.

Dr. John Vassall: 36:41

Exercise is movement, self-movement. If you're not moving, you're not exercising. And think of getting enough movement to keep your joints in shape, your muscles in shape and your heart in shape. So there's what they call aerobic exercise, which is like running and swimming and those kinds of things. It gets your heart and your lungs working together toward their capacity. So those kinds of exercises, that kind of movement walking, running, doing stairs, swimming, those kinds of things are very useful.

Dr. John Vassall: 37:23

We talk about walking a lot, because walking is probably the best kind of exercise, in the sense that most everybody has learned how to walk, they know how to walk, unless they're impaired, but they can walk. You don't need any training, you don't need any special equipment, except for maybe some good shoes if you're walking outside. So walking, if it's a safe environment, has got to be sort of the rock bed of exercise, you know, and the faster you walk, the more you approach running. But you don't have to run. Walking briskly and running are sort of rock bed of movement and exercise. So for people who can walk, that's great. And if you can walk briskly and when I say briskly that means you get your respiratory rate up higher than it is at rest and you get your heart rate up then that's an excellent exercise In terms of muscular exercise.

Dr. John Vassall: 38:28

I like people to think about why are you doing this? You know. Why are you lifting weights? You know. Why are you doing push-ups? Why are you doing sit-ups? It's not so that you can do more push-ups and more sit-ups and lift more weights. It's so that your muscles are in shape to move you when you need to be moved and to move you in a way that is useful for you to maximize your enjoyment of life. I like people to think about that. If you're going to do push-ups, that's great. It'll get your arms stronger.

Dr. John Vassall: 39:02

But while you're down there on the floor, roll over on your back and try to get up off the floor without using your hands. You know that's another form of exercise. It's not what they teach you in the gym form of exercise. It's not what they teach you in the gym. But sometimes you may need to get up off the floor and your hands may be impaired, your arms may be impaired, you may have injured yourself.

Dr. John Vassall: 39:25

So think about how can I use this exercise in the real world. You know, going up and down stairs. Forget that elevator. How about walking up one flight and cashing the elevator from there? Because there's going to be a time when that elevator is not working and you're going to need to use the stairs. So if you haven't been on a staircase in a year, you may have a problem. So you need to think about how does this exercise help me? You're using the stair stepper in the gym, but think about the real stairs and walking up and down real stairs so that when you need to do it, you can do it. So when I think about exercise, I think about movement and I think about how can I use this in the real world, in my real life, to make my life better.

Grantley Martelly: 40:12

And there has been some research and doctors' advices that sometimes exercise can help reduce the likelihood of some of these diseases we talked about before developing, like if you're getting into pre-diabetes you may exercise things like that.

Dr. John Vassall: 40:31

The importance of exercise in our life.

Grantley Martelly: 40:33

Our sedentary world. As we get more technologically advanced, everything seems to be going towards keeping us from moving.

Dr. John Vassall: 40:41

Right, right, Let me say two things about that, because that raises two points. One is, yes, aerobic exercise exercise where you get your heart going and your lungs going also helps. This is not technically correct, but for the visual it helps flush out the stuff in your blood vessels and that excess fat that's collecting. So that's one of the reasons why I'm simplifying and oversimplifying, just so people understand that that kind of exercise, aerobic exercise, helps keep your heart, lungs and your blood vessels clear and functioning and that's why it helps with metabolic diseases like diabetes and that's why it helps with heart disease.

Dr. John Vassall: 41:25

Now, with regard to the muscular exercises that I talked about, sometimes you need to use your muscles in a way that you were not aware of. People know that I'm a big cyclist. I like to bicycle a lot. I ride sometimes hundreds of miles. I've been to Portland and back and on a weekly basis. When I get on the bike I usually ride 10 or 15, 20 miles a day, especially when the weather is nice.

Dr. John Vassall: 41:59

But sometimes stuff happens. I crashed about six years ago and fractured my femur. Now the thing about that is and I got a surgically repaired on by now but there was a time when I had to use muscles in a different way. I had to be able to move around with a broken leg and if you are not in good physical shape, that becomes very difficult. So one of the reasons to be in good physical shape is when you find yourself in a situation where you have to use your muscles in a different way. You may have to use crutches, which means you need more arm strength than you usually use. So, again, that's one of the reasons for doing those push-ups, so that if you need to use your arms for crutches, you have that tricep strength to help you. So again, think about how you can use this in the real world and stay in shape for those times when you may not, where you may need to call on that capacity that you haven't had to call on for physically yeah, I mean that.

Grantley Martelly: 43:03

That resonates with me because when I had my first back surgery and, uh, I was having really bad problems with my leg I mean my my leg actually actually stopped moving at one point, literally stopped moving at one point, and I learned in my recovery the importance of having a good core. I found out I had muscles in that recovery that I didn't know that I had. Yep, it was amazing, I would tell my wife. I said I didn't even know I had muscles in these places, you know, just to get up out of a bed or cheer, right, I was feeling things that I hadn't felt.

Grantley Martelly: 43:45

But my doctor said to me if you had not been going to the gym and relatively good physical shape, your recovery would have been much slower and much more severe. Right, your recovery would have been much slower and much more severe. He says you're learning to use muscles that you have been developing. You're not trying for the first time and it was really important to me because even when I was recovering he said I'm going to get you back into the gym as soon as possible where you can start not lifting stuff but walking on a treadmill and getting some resistance so that you can keep your core built up, because for your back to work properly, your core has to be good. That's right. I learned so much from that. It was amazing.

Dr. John Vassall: 44:28

Yeah, and one of the things that we've been doing in medicine more recently is what we call prehab. If somebody's, for instance, going to have knee surgery or they're going to have hip surgery, it's elective, we know we can schedule it out. We actually start teaching people, for instance, how to use the crutches before they need them, their joints. We have them start learning how to walk with just one leg and crutches before they actually are required to do that because of the surgery. So that's another way of thinking about exercise is preparing you for the unpreparable. That's right you learn hardware.

Grantley Martelly: 45:12

Yeah, you said something before in one of our meetings too that I thought was so important and I didn't think about it until you said it. But this thing about our socialization and our family and where we are from, about sometimes our health is affected by our family, our brain, our socialization, and the example that came to me is like, you know, I love to eat ribs. I love to eat ribs, but it's not always the best thing for me to eat, right? Or my family has certain traditions of you know, macaroni pie, which is macaroni and cheese, or things like that that we love to eat around the holidays. But sometimes those socializations, if we don't pay attention to them, can affect our health. So talk a little bit about that.

Dr. John Vassall: 46:09

Yeah, that's a very important point. Our relationship to food is an important one point. Our relationship to food is an important one and food is not a whole bunch of proteins and vitamins and carbs and all that. Otherwise you could just line up a bunch of pill bottles and take a bunch of pills and call it good, and I don't think anybody's going to do that. You know food is cultural. You know food is almost religious. You know food is a shared experience, is experiential.

Dr. John Vassall: 46:44

Uh, food is identity. You know I mean I'm from, my folks are from Jamaica, and you know saltfish and ackee. You know green banana and plantain in the morning and bammy. I mean that's part of my identity. So you can say that for many cultures they were talking about sake, wine, rice wine that the Japanese drink on the news this morning. You know sushi tacos. You know, you just say it and you know an image comes to your mind when you say sushi tacos. You know you just say it and you know and an image comes to your mind when you say sushi, you think of a certain thing. When I say saltfish and ackee and bammy, a certain image comes to my mind. Yeah, when you say grits and gravy, that certain image comes to your mind.

Dr. John Vassall: 47:31

So, uh, your food is part of who you are and you can't tell people just eat a Mediterranean diet when they're not Mediterranean people. You know, you hear that the Mediterranean diet is the best heart diet. Well, it is the best heart diet for people who live in the Mediterranean. So how do you take those cultural underpinnings and inform them with what can keep you healthy? So, again, it's not a matter of saying, well, I'm never going to eat pork, I'm never going to have ribs. That's not going to answer the question of how do I incorporate health into my identity and live the kind of life, the satisfying kind of life, that I want to live? So be aware that too much meat protein is going to be problematic. Too much salt is going to be problematic. So that means you are going to have to reduce, maybe, the amount that you're eating and you may have to season it a little bit differently so you're aware of your blood pressure, those kinds of things. But that's the kinds of thing that people need to do Not give up your identity and your culture, but be aware and be informed about how to modify those things.

Dr. John Vassall: 48:50

I'll give you an example. Like I said, I trained in Atlanta. For example, when I was in, like I said, I trained in Atlanta and there was a small black hospital where I practiced and we used to, back in the good old days when we had our medical staff meetings, the people in the kitchen actually cooked us dinner and we had dinner around those meetings. Well, the dietician one day didn't tell us that she was going to go to a low-salt, two-gram sodium diet. She changed the way she prepared the food for our dinner Because we're black doctors right, we're black men for the most part, and we're eating grits and gravy and ribs and everything. She didn't tell us until after we had finished everything and we're looking at the plates and then she said guess what? I modified this so that it's low salt, low fat. Nobody noticed. They'd noticed how good it was, but they didn't actually notice that she was able to keep, preserve that culture and preserve that food and that unity and that brotherhood that we felt, without negatively impacting our health. So it certainly can be done.

Grantley Martelly: 50:06

Yes, it can and we need to pay attention to it. I'm from Barbados, my wife is from Bangladesh and all for those cultures cultures food like Jamaica is, I mean, is amazing. Right when I go to my mother-in-law's house, I mean she had food from the time you walk in the door and the time you tell you can smell it like out in the parking lot and it joins us together. But I think what we're trying to say, we've got to moderate it and make sure that we're taking care of our health, not just abandon who we are just because we're afraid of getting sick or something like that when you think about men's health, you still have to think about it in the context of community, and you have to think in context of the women in your life too.

Dr. John Vassall: 51:12

So don't isolate yourself in a bubble of men's health, thinking that you can do that without help from the women in your life.

Grantley Martelly: 51:16

Ok, I'll leave it at that. Yeah, I mean that's important, right, because I keep getting back to this. But I'm in a support group black men around the country and so many times it comes up about the importance of wife and caregivers. Some of the men talk about how important it is to have their wives with them when they go to see their physician and they go to get report. They talk about the support they have when they come home and they have to deal with the issues. So, yeah, I mean, even in our support group that is all men the importance of spouses and women and caregivers keep coming up as a significant part of maintaining our health. As we turn the corner here, I wanted to go back to one question and then I want to ask you to wrap it up. One of the questions that came up to me that somebody told me to ask was how do you communicate with your physician? What's the best way to communicate with your physician when you feel as though you're not being heard or your questions are not being answered?

Dr. John Vassall: 52:24

You know that's a great question and I have to give it just a moment of thought, because what comes to mind first of all is what we said toward the beginning, and that is first finding that person that you can communicate with, and not all doctors are good communicators. I think people know that. So that's where you have to start no-transcript, although you may have to do that from time to time. But again, you don't want it to be a confrontational, uh relationship. The sooner you make that clear that you two are on the same page, the better it is.

Dr. John Vassall: 53:37

You know, sometimes I have this idea in my head and sometimes I actually tell the patient that when I'm dealing with an issue with the patient, with a disease, an illness, an abnormal lab study, and the patients might be getting a little excited and agitated, emotional, I said you know what? There's three people in the room, three entities in the room there's me, there's you and there's the problem. So let's you and me deal with the problem together. It's not you dealing with me, it's not you dealing with me, it's not me dealing with you. You and me together are going to deal with this problem. So if you physician can do that, can separate themselves, and if you can separate yourself in that dynamic and say, here, we've got a problem here and both of us are here for the same purpose and that is to deal with this problem. So now let's address that.

Grantley Martelly: 54:47

Thank you. It's good to hear those words coming from a physician. Right, you deal with it, and some people are intimidated by their doctors. So thanks for the advice. So, as we look to wrap this up today's session, what takeaways or action points do you want our listeners to take with them as we close this session out?

Dr. John Vassall: 55:09

Yeah, I think it's. People are, I think, kind of used to hearing health discussions and so it's easy to just kind of listen and turn off podcasts and keep going about your business. But what I'd like people to do is think very specifically about what you can do yourself, something you've specifically you've heard and a specific action that you can take to make your health better, or a specific idea or understanding that you've come away with. Because if you don't get specific, you're really not going to actually do anything. It's like they say, the journey of a thousand miles starts with a single step, and a step is a physical action. You actually have to do something.

Dr. John Vassall: 56:01

So, rather than thinking broad terms oh yeah, I want to run a marathon Well, you know, if you think in broad terms like that, you may never actually get to doing it. But you think about well, I want to be able to move, I want to be able to run, even if it's just a block, blah, let me start out there and go from there. So I'd like people to think about this whole conversation. What is it that you've heard? That may be different, maybe surprised you, maybe it's changed your approach to your thought, the way you think about something. Think about that and maybe write it down. Then think about what can you specifically do that's going to improve your health, and write that down and then come back to it and check it off when you've got it done.

Dr. John Vassall: 56:51

One of the reasons why people fail with their New Year's resolutions is they're too broad and they're too vague and they're too ambitious. So I want people to be specific about what they've learned from this and what step they can do. It doesn't have to be something big. It doesn't have to be a big step, a little step, because enough little steps add up to something big.

Grantley Martelly: 57:17

Yeah, I mean that's great because that's so important. You know, we quit when we have too big. There's some person I was talking to who was talking about this, about walking, you know, and they were trying to think about I got to go and walk all this stuff and I said, no, just go 15 minutes from your house, walk 15 minutes. And then you got to come back home, turn around, come back home. Yeah, you do that. You walk for 30 minutes. You don't have to find a track and you don't have to do all this stuff. You don't have to walk five miles because your neighbor is walking five miles. If for you it's 15 minutes, it's 15 minutes. You know, and I had to do that for me, right, what, what works for me?

Grantley Martelly: 57:58

Because I was trying to get too complicated and one day I was in the gym and one of the coaches said to me she said you know, grant Lee, the goal is not to wear yourself out and try to do too much. The goal is to modify things and do things so that you get stronger, you get better, you accomplish your goals. You're not in competition with anybody, it's just you. So what is the two things you want to get accomplished, rather than trying to deadlift 400 pounds. If you can only deadlift 95 pounds, that's good enough. That's your goal.

Grantley Martelly: 58:36

I guess I'm saying this because sometimes we get to that point where we're also comparing ourselves to other people. This person is doing this and this person is doing that. I can't do that, so I'm not going to do anything, agree. So, dr John, thank you very much for your time today. I really appreciate it, and thank you for your great advice. I think it's going to be very beneficial to our listeners here on Real Health Black Men and helping us begin to get our hands around these things. I look forward to our continued discussions. I hope that we can come back together again at some point and maybe talk about maybe one or two specific issues that people may bring up. I will let you know. We can go from there, but I really want to thank you for taking the time out of your busy day to do this. I really appreciate it.

Dr. John Vassall: 59:21

Thanks again. Okay, well, thank you for having me on. I've enjoyed this.

Grantley Martelly: 59:28

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