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Learning to Dad with Tyler Ross 007 - Dr. Brian DeCastro

Speaker 2: Hi, [00:00:30] this is learning to dad and I'm Tyler Ross. And my guest today is Dr. Brian DeCastro. Brian's a urologist with FOC your health in Warrenton, Virginia, and a graduate from state university of New York upstate medical university. He's performed over 2000 vasectomies. He's a CrossFitter and practices TaeKwonDo in his free time and is also a father to four girls. Thank you very much for being here. Thanks for having me. So, as we were talking about leading into this, or [00:01:00] the first time we met, you know, as a parent, there's not really any way to measure how effective you are as a parent, whereas in business or as a doctor, you know, perform this many successful surgeries, or you've got this on your balance sheet. So the effort of that we're putting in here is to try to help people along the way in the intangible ways that we can to make better decisions as parents. And just in the first few minutes of talking [00:01:30] to you, I got that calm, great bedside manner, which I can only imagine you have with your kids. So I'm excited to have that conversation with you. So thank you again, start with a little bit of background. I really don't know each other at all. I'm curious to know where you're from and what kind of brought you into medical school. Take me on that quick journey.

Speaker 3: Yeah, so I was, um, born, basically worn out in a Tacoma Washington. My dad was in the military. He graduated from west point and was flying helicopters out there. And, uh, you know, basically grew up as an army [00:02:00] brat, kind of moved around a lot when I was younger, but settled in upstate New York for most of my life. And, um, you know, really, uh, I don't know, I always kind of gravitated towards science and medicine and loved that stuff, you know, fascinated by the human body. And, uh, kind of always knew from a young age, I wanted to be a doctor and, uh, you know, basically, um, joined the army, went through medical school and, uh, was stationed out in Fort Lewis and down at Fort Stewart, Georgia and did 11 years. And when I got out, I decided, uh, you [00:02:30] know, we just were looking for a random place to live and kind of ended up here in Warrenton, Virginia.

Speaker 2: That's a lot going on in a really short couple sentences. Um, at what point in time did you meet your,

Speaker 3: Uh, so actually she was also in the army as well. And, uh, we were both stationed out at Fort Lewis. I mean, she was going through the, or nursing, the operating room nurse course, uh, when I was in residency. And, uh, so we actually, uh, met in an Orr room doing a procedure. So it was kind of interesting and then just kind of kept passing each other in [00:03:00] the hospital until finally, uh, one day we actually went out on a date. Yeah.

Speaker 2: Yeah. When, so how long did you date before you got married?

Speaker 3: So I actually, about two months after we started dating, she was deployed to Iraq. And so she was in Mozel for a year. She was there with the combat support hospital. And, uh, so we just kept in touch. I mean, there were some, some months we talked on the phone for, I think it was like 4,000 minutes and, uh, you know, we would work our schedules around the time difference and, you know, talk [00:03:30] for, you know, at least an hour, it seemed like an hour a day. And, uh, wrote letters, emails, letters, those kinds of things, you know,

Speaker 2: About when is this? Uh, this was,

Speaker 3: She was deployed in October, 2005 and got back in October of 2006. So it was a full year. Um, it was interesting way to kind of date because, you know, it was all basically communicating and talking. And, and so you kinda had that part of the relationship, uh, established, you know, which I think a lot of times nowadays people [00:04:00] don't take the time to really get to know each other. And I think that was kind of in some ways a benefit, you know, it was hard, you know, but, uh, also working on,

Speaker 2: Yeah, that's amazing to think that you were dating for two months and then sustained that relationship without basically seeing each other for a year.

Speaker 3: Yeah. I mean, she came, I think she had like a two week, uh, they call it RNR where she came back to the United States, but other than that, it was, yeah, basically just emails and they were just starting to get some of the video, you know, stuff. She was like the choppy one word at a time kind of thing. [00:04:30] Um, but yeah, it was a, it was an interesting start to the relationship.

Speaker 2: So did she come back different than when she left?

Speaker 3: You know, I think definitely in some ways, not, not a major change, but I think just, uh, a definite respect for the quality of life that we have here in the United States and how we're protected and almost in a way she was almost kind of angry when she got back, because she felt like the average person didn't understand that, you know, they took everything for granted. They would get mad at the littlest things and, you know, not appreciate [00:05:00] what they had. And I think that was one of the changes that I noticed in her once she got back. But, uh, other than that, she's pretty much the same person. Were you

Speaker 2: Deployed at all?

Speaker 3: I wasn't actually, I was in for 11 years and just the timing of everything. I never ended up getting deployed urologists. They only sent about one every six months and they were good about protecting us until we finished our boards. Um, and then by the time the boards are done, we were kind of pulling out of Iraq and we hadn't started sending army urologists to Afghanistan at that point. So I kind of almost [00:05:30] felt like it cheated a little bit, but felt guilty, not having deployed in that time, but it just didn't work out.

Speaker 2: I think that's a common feeling among people who are in a branch of the military, who ultimately don't get deployed that some guilt as you have peers that might've been deployed multiple times. There's not really anything you can control. Definitely. So your wife or your girlfriend at the time comes back from Iraq and then where's w at what point do you

Speaker 3: Get married? So it was about [00:06:00] another year. Was it? I think we were engaged in July of 2017, and then we were married in June of I'm sorry, 2007. And we were married in 2008, June of 2008.

Speaker 2: Okay. And then your first daughter?

Speaker 3: Oh, well, we found out that October that we were pregnant. So it was about right after we had basically right after we had gotten married and yeah, I mean, pretty much our entire first 10 years of marriage have been, she's either been pregnant or breastfeeding with the four kids. And

Speaker 2: The first question I want to [00:06:30] ask is in October of 2008, that would mean your first daughter's, you know, summer 2009 birthday. So where were you in your professional life at that time?

Speaker 3: So I had in 2008, I graduated from residency. So I was literally, I graduated from residency, we got married and then two weeks later we drove across country to Georgia to, um, to start as a practicing urologist. And it was kind of a unique situation that was basically sent as a solo [00:07:00] urologist to the Fort Stewart, Georgia. So I had nobody else there. It was just me as the only urologist for about three years. And so it was kind of like being thrown right into the deep end, right out of training. But I felt like the program that I was in, they really trained me well. And I was able to, you know, I just had to be able to think on my own and react on my own and, you know, relied on consultation, you know, with some of the, for some of the difficult cases, but for the most part was kind of forced to jump right into it.

Speaker 2: So that sounds like a lot of transitioning at one time, [00:07:30] you're, you're moving where you live, you're married, you're in a new place and you're just graduating and you've got a baby. So how's, how's the baby impact all of those other things. Like how do suddenly you have to manage your time differently and, or, you know, manage your lifestyle different.

Speaker 3: Yeah. I mean, I think as all dads know, I mean, you're that the day that child comes home from the hospital, your whole life is completely turned around. I mean, the priorities, everything [00:08:00] is totally different. And, you know, from that day on, you're basically focused on your kids and, and making that a priority as well. And trying to balance work, balance your personal sanity and also, um, raise children at the same time and maintain a marriage, you know, which is sometimes the thing that suffers the most when you're, when you're dealing with all that stuff.

Speaker 2: Did your wife tell me your wife's name? Janet. Janet was Janet and O R nurse in Georgia as well.

Speaker 3: She was a, or [00:08:30] nurse up until about the week before our daughter was born. And then since that time she's been at home. Oh, no kidding. She, uh, I mean, it's just such rapid fire, you know, kids after that. And so at this point with four kids nine and under, you know, there's, or her job is probably more difficult than most average jobs, you know, anybody would realize that that's a, that's a pretty tough job.

Speaker 2: I couldn't agree with you more. My wife went back to work after I wanna say it was three years of staying at [00:09:00] home. And I think both of us have noticed how much that she was doing when she was at home, because things start falling

Speaker 3: Apart slowly when they're not that person taking care of your house. And, you know, a lot of just general affairs of life that are easy to miss when everybody's at work. So, and w at what time did you have your second daughter? So we found out that we were pregnant on our one year anniversary, right. Would that be right? [00:09:30] Yeah. Yeah. We found out we were on our one year anniversary right around that week. It was our daughter's birthday's June 28th. Our anniversary is June 21st in, somewhere around that time was when we found out we were pregnant with the second child.

Speaker 2: Okay. And at that point we've had the discussion already, but for the sake of people listening, you know, just to kind of jump into the idea of, you know, not having any more kids, if you don't mind sharing your thought process on after having to do I want to have any more.

Speaker 3: Yes. I think, [00:10:00] you know, that's, that's a time when you're kind of, um, really more susceptible to thinking, man, this is a lot, you know, I have two kids, you know, my, at that point when the one was born, the oldest was not quite two, it was 21 months difference. And so you have a newborn, you have a 21 month old and, you know, it just seems very overwhelming. And I think there's a temptation at that point to say, this is enough, I'm, you know, I'm done having kids. And I think that was the longest gap was between the second and third for that reason, because we kind of thought about, you know, do we really [00:10:30] want to have more kids? And, you know, if we do how many more, and when's the, when is the timing, right. And I think it's, uh, my wife has said that she always wanted to have four kids.

Speaker 3: So I don't know how much of a decision that was for her, but, you know, for me, the idea of having four kids seem like a lot. And, uh, it took us about probably another two years before we decided to have that third. And, um, I, I'm glad that I made couldn't imagine not having four kids now. Um, she always says, if we were younger, she'd go for six, but [00:11:00] you know, I'm 40, almost 42 and she's almost 38. So we kind of figure it's, uh, it's time to watch the family grow up. And some of the things that we've been putting off for a while,

Speaker 2: Well, tell, tell me a little bit about the transition of two kids to three kids. I mean, the overused phrase is, you know, going from man to man to drop it in his zone. So like, how did, I've heard that having a third kid is just like folding another one in the mix, and I've also heard that it's like a [00:11:30] whole new strategy.

Speaker 3: Yeah. See, I kind of, uh, people I've always heard that same thing too. And I, and I thought actually for me, I thought going from two to three was the hardest. My wife thought definitely thought one to two, but I thought for me, I thought two to three was the hardest. And I think it's that idea that, you know, worst case scenario, you each had one kid and you were dealing with the issues that, that one kid was having. But now there's like all of a sudden this baby, you know, that's there and you're like, well, who's going to get the baby. Now I'm doing this. And so you have to kind of, uh, [00:12:00] delegate a little bit better. And I thought for me, that was the most challenging time. Now from three to four, I would agree that felt like nothing. You know, at that point it just felt like, you know, second hand, second nature. Um, but I thought that transition from man Amanda zone was a lot tougher.

Speaker 2: Did you make any like super deliberate changes? Like I'm suddenly doing a block schedule now, or I'm suddenly shifting the way that I approach my work or you've taken on a new mental practice to say sane while these changes are [00:12:30] happening at home?

Speaker 3: I would say no. And that was probably to my detriment, you know, trying to live my life exactly the same as we had more kids until, you know, once we, once we had the fourth and, you know, the stressors of work, the stresses of relationship, all that stuff starts to get to weigh you down. You have to find something, some sort of outlet to kind of help you to deal with the stress of things. And, um, you know, I think for me starting TaeKwonDo and doing CrossFit [00:13:00] have been those kinds of outlets, you know, to give me a little bit of my own time where I can just be by myself and, and trying to relax. Um, because I think, you know, no matter what kind of person you are, I mean, being a father, having a job, being in a marriage, it's all stressful, stressful, stressful stuff that kind of wears on you day to day.

Speaker 2: Yeah. W requires work and maintenance and in conscious effort is you can't just click into cruise control and then just lay out [00:13:30] in my opinion. Exactly. Yeah. Does your wife have things like the, you know, to, to your TaeKwonDo or do your CrossFit? She have,

Speaker 3: Um, she's she loves, um, you know, spin and those kinds of things she likes working out and going to the gym. So that's kind of for a release as well. Yeah. Um, but, uh, she, I mean, she's really her, her patience level and her ability to handle the day-to-day stuff is amazing. I mean, I just, I I'm constantly impressed with how well she does with that. And rarely do you ever see her raise her voice or get angry [00:14:00] with the kids? And, you know, I mean, I, uh, I may appear calm, but I mean, I can be very, you know, when the kids get going, it kind of like, you know, sometimes my reaction is not always the best and, you know, finding ways to be a better dad, as far as dealing with those frustrating moments when your tendency is to yell or to get angry, you know, what is another way that I can deal with this and how can I approach this in a different manner? And I think being in a mix of Irish and, you know, mostly Sicilian, you know, that kind of, uh, [00:14:30] temper tends to be there. And it's, for me, the biggest thing has been learning to deal with that side of things. And just trying to be that dad that's calm and, you know, here's why we're going to do it this way. And you know, this is why we're not going to do that.

Speaker 2: Do you have anything that like snaps you into that calmness? Like, I can kind of take three deep breaths and count to three so that I don't freak out on my kids.

Speaker 3: Yeah. I would say the deep breathing is definitely very helpful. Um, and you know, I've, I, uh, my wife she's, you know, she's constantly trying to help me to [00:15:00] find ways to be a better dad, a better husband, and probably I should be doing more of that on my own, but, you know, she, um, she actually got me a book recently. Uh, it was called when, uh, when good men get angry, I think was interested in the name of the book. And, um, you know, it was really interesting. It was a bunch of different men that this CA he was a pastor or a counselor, and he would basically interview kind of like what you're doing, but with different couples, you know, going through times in their relationship where, [00:15:30] you know, they were dealing with different stressors and it was the different types of guys and how they get angry and helping them to deal with those triggers that kind of set them off and helping them to see what personality flaws led them down that road.

Speaker 3: And I think the big takeaway point from that was, you know, it's natural for, for men, especially to get frustrated and to get angry. Um, but what's unnatural is being able to process those emotions and finding ways to deal with it and to make you a better person. And I think for me, that [00:16:00] book has been very helpful. I'm kind of in the middle of reading that right now. Cool. Uh, so it's interesting read, I, I wish I could tell you the author's name off the top of my head, but, um, it definitely is something, I believe it's when good men get angry is the name of the book. And I'm sure nowadays Google, you can find that pretty easy.

Speaker 2: I'm trying to go through the same thing, you know, as part of this exercise of doing these interviews and reading and listening to other podcasts is trying to be better and that requires being different than you are now. And if you're [00:16:30] pretty happy with the way you are now that requires getting over some fear of change and being vulnerable to trying something and failing at it. Do you notice anything in particular that you've changed or tried to change?

Speaker 3: Well, I think, you know, like you said, if you're not part of a lot of people's problem is that they don't perceive that there is a problem. So you're like you said, you're happy with the way you are. You don't think that you need to do anything different. You know, if only these kids would just listen to what I say, then I wouldn't get angry. [00:17:00] You know, I wouldn't yell. And, uh, unfortunately they're kids and they're not gonna always do what you say, and it's really up to you to be able to make that change. And the way that you respond to them is more important in the long run. Um, because you know, like my wife said, do you want your kids to remember you as a angry yelling dad all the time? Or do you want them to remember you as a, you know, a loving dad who took the time to listen to them and talk to them?

Speaker 3: And, you know, I think that was one of those comments that kinda got to me, you know, I said, yeah, I do need to do something different. You know, I can't just be getting angry all the time. We're [00:17:30] getting frustrated. And, um, I think you have to have that one ability to look at yourself and say, okay, what I'm doing is not really the right way. And there is a better way to do this, and I do need to make those extra steps to make the change. And I think that's the hardest part, you know, especially if you're a type, a kind of very, you know, opinionated, you know, person, it's hard for you to one you always want to be right. You never want to be wrong about anything. And so admitting that you're not doing things perfectly can be [00:18:00] a hard step. Um, and so I think that's the biggest challenge is getting past that and saying, I need to do something different. And I think it just makes you a better person in general, not only good dad, but just in dealing with people on a daily basis. Yeah.

Speaker 2: Yeah. It is very freeing to fall on your face and realize it's not a big deal in efforts of changing. You know, I was, Jesse's straight said something about asking his kids for forgiveness and I'd never considered that. And I did something to them that upset [00:18:30] one of my kids the other day. And I sat them down. I, I said, will you please forgive me? And it was, I had this rush of nerves. Like, what happens if my kid doesn't forgive me, but she's a four year old kid. She just smiled, gave me a hug and walked away. Right. Like that wasn't as bad as I felt more vulnerable than I needed to feel. Right. And do you think having four daughters is, I mean, that's challenge,

Speaker 3: I think,

Speaker 2: Especially to a man [00:19:00] who you're about to tell me you got siblings or men in your life

Speaker 3: Growing up. So it was just three boys in the house. And so our way of growing up with so much different, you know, and I feel bad for my mom in retrospect, you know, just having to deal with men all the time, boys and men. Um, but I think for me, just the emotional side of things and that idea of like, you know, I feel like w with a boy, at least growing up, it seemed like people would yell at you and be like, you know, don't do that, but it didn't seem to affect me as much as it seems to affect [00:19:30] the girls, you know, yell at a girl and they just break down into these tears and daddy is so mean, and you know, that kind of side of things, it was hard for me to understand. And, um, so I think, you know, for daughters, especially, I mean, that's, that's another thing that my wife would always say to me, you know, your daughters are going to pick the kind of guy that you are, you know?

Speaker 3: And so if you're, you know, constantly yelling at you, you don't want them to settle for somebody who's going to treat them that way. So you need to show them what it's like to be treated by a man appropriately. [00:20:00] And so that's another one of those things that, you know, those comments that stick in your mind when you're like, do I really need to make a change? Yes. I mean, for that reason, I need to make a change because I want my daughters to expect to be treated with respect and not to have somebody yelling at them and, you know, to be able to stand up for themselves. And so, I mean, to me, that's one of the most important things, you know, just, uh, that they understand that their value and that, you know, they can't let another man dictate who they are and who they can be. And I think that's a really important thing for young daughters.

Speaker 2: [00:20:30] Yeah. One of the ones that resonates with me heavily, because I've heard a lot of people use the expression, she married her father and it's like, well, now I've got an obligation to be good enough for my daughter. Right. And that, that hits really hard, you know, every single, how would I want someone else to treat her? I gotta treat her that way. So if your wife, how different are your parenting styles?

Speaker 3: Oh, I mean, I just, I think she just, like I said before, she has this calmness [00:21:00] that I just, I can't understand, you know, I never see her get, she'll get a little bit flustered if, you know, when it's the, Hey mama, Hey mama, you know, all four of them at once trying to, you know, gets a little bit overwhelmed, but she never really loses her. Cool. She, she almost never yells, you know, she'll get right down on their level and explain to them, you know, this is why we're going to do it this way. And, you know, just watching her has really given me a lot of tools to be a better dad, you know, because, you know, I grew up in more of an, uh, you know, just kind of more of an old school household. You do [00:21:30] it that way because I said, you know, I wouldn't get a lot of explanation from my mom.

Speaker 3: And so, you know, is that kind of like, you're, you're the child, you just listen to the parent and that's just the way it is. But, you know, kids are, every personality is different. And, and I tend to be that more, that question asks her, but why are we doing it that way? Like, I understand there's a rule, but why is that the rule, you know, that kind of more inquisitive type or, you know, if they'd say there's no more popsicles in the freezer, my mom would have to lift me up and show me the freezer to prove to me that it wasn't there. You know? [00:22:00] And I see that now in my second child, I mean, she is my, like almost identical the way that we look at life and question and do things. And so having that perspective and being able to say, explain to her in those situations, even when I might be getting frustrated with her questions, just to remember, that's, that's how I learned.

Speaker 3: And that's how I wanted, you know, to be explained to me. So another great book that is out there, I'm going to totally draw a blank on this. It's a, it's a book about personalities and I, for the life of me cannot think [00:22:30] of the name, but it basically talks about the four core personalities that are out there. You know, basically how parents and the kids have different personalities or the same personalities interact. And that's given me a lot of insight into dealing with the different personality types of my children. Oh, I wish I could think of the name of that book right now. Um, but basically what it is is, you know, my personality tends to be, they call it the powerful cleric. So always want to be right. Type a type personality. Whereas my first [00:23:00] daughter tends to be this, what they call peaceful phlegmatic.

Speaker 3: She doesn't get excited about the good, she doesn't get too worked up about the bad even keel. You know, sometimes you even wonder if she has emotions, you know, because she's so even, and just, you know, my being able to deal with that, not understanding how she could go through life, so passive, you know, and not have those opinions. Whereas I want her to have that fire, you know, where she doesn't necessarily have that in learning to deal with that and how to manage that personality type versus [00:23:30] my second daughter who was more like my personality and how do we not butt heads having the exact same personality type where, um, and so it's, it's a, it's a great book. If it comes to me, I'll I'll, I'll it?

Speaker 2: Yeah, man, please. Well, something I'm taking away already is just the you're you have put a lot of thought into being a parent that you're not just kind of shooting from the hip that you're actually reading and studying and actively trying to make change. Like I believe, I don't know. Maybe you can [00:24:00] differ, but probably agree that to be a better parent, you have to constantly be exploring yourself and trying to improve yourself. Feel like it's an obligation as a parent to do that for the benefit of your kids. So yeah, you seem to be actively pursuing information to be more conscious.

Speaker 3: And I think really just in life in general, we all tend to go on autopilot and we'll just get into the rut and routine of every day. And we forget that, you know, there is a bigger [00:24:30] PR there's a bigger journey out there that we're on. And if we're not careful, we're going to miss that part of life. And in order to experience it, we need to be more, well, my wife always tells me is you have to be present. You know, you can't just be here at home. You can't just be here on the kids, but you have to be present in the moment with the family. Otherwise it's like, you're not there. And so trying to separate work from home and, you know, not being on the phone, searching for the latest [00:25:00] news article or whatever that's out there and just putting the phone away and just being there for the girls. And I think that's part of the challenge and just continuing to grow, um, I think in life and I think the day that you stop trying to learn and stop trying to improve, I mean, that, that would be a terrible day because we can all till the day we die, continue to learn and grow

Speaker 2: Completely agree.

Speaker 3: So it's really, I mean, it's great that you're doing this podcast because I think like you said, you get so many different unique perspectives from different fields,

Speaker 2: Learned a ton. [00:25:30] So tell me, uh, since having your first child and I was, I guess, nine, 10 years ago, how have you changed or improved as a dad?

Speaker 3: I would like to think I've become a more patient person, you know, and just being able to deal with things a lot more calmly. I don't know if that's true. I don't know if he asked my wife if she would agree with that, but I think she's seen some improvement, you know, in the way, and really just in trying to be a better husband from that standpoint as well. You know, Nate, by my nature in general is [00:26:00] to be very defensive, you know? And so, so she approached me with something and I automatically explained to her why that's not true or, you know, and just learn and stopping and being able to listen now. And, and before I start trying to formulate my rebuttal or my counter to that, and just, you know, trying to listen and understand where she's coming from. And I think, you know, that translates to the kids as well, trying to listen and find out where they're coming from, you know, and I think so being, maybe being a slightly better listener, a little bit more patient, and I think those things take time, you know, it's not, [00:26:30] it's not overnight that you're going to make those changes and there'll be many relapses where you fall back into your old habits, but as long as there's more victories than losses, you know, in the end, you're, you're making an improvement.

Speaker 2: I can completely agree. And along that same line, it might be, might be too easy now. But if you could have done something differently earlier in your journey as a dad, like, what might you have done differently?

Speaker 3: I would say, you know, the, these books just re probably reading more about these different types [00:27:00] of things and not necessarily specifically about being a dad, but in general, just being a better person. Because I think that translates into being a better dad, you know, being able to deal with the temp temper issues and, and the defensiveness and those kinds of things will in the end translate into being a better dad, which you don't automatically think of. You know, you think of those more of a, like dealing with yourself as a person, but if you're not able to do that, then you're not going to be a good dad. You're not going to be a good husband. And so taking those steps to [00:27:30] make yourself a better person translate into the, you know, victories on the other side as well,

Speaker 2: The thousand percent with you. I couldn't agree with you more change gears a little bit with four girls, four kids in general, the metaphor that I use, or similarly I use as a punishment, like a, like a bowling lane. Like I want my kid to, I want to be the bumpers in the gutter, so they don't end up in the gutter. But if, you know, they hit one pen or 10 pounds, they need to learn on their own. [00:28:00] So I perceive the bumpers in the gutters being, you know, for lack of a better word punishment, like how, like, how do you keep your kids in their lane? Like, how do you have some things that, you know, do or don't do when it comes to punishment, good experiences, bad experiences managing their behavior?

Speaker 3: Well, I think one thing we feel pretty strongly about as no physical punishment, so no spanking or anything like that, especially with girls in particular and not that that should really matter, but so that, that's one thing we've kind of taken off the table. I think more [00:28:30] of kind of the idea of taking away things that are important to them. You know, they love their Kindles or, you know, they love their treats, you know, ice cream after dinner or whatever. So we'll kind of use those, those are bargaining tools. And, um, you know, I think the other big thing is really, I mean, kids are little people and I think we tend to, and the older generations tended to kind of discard kids' feelings and opinions and you know, so trying to explain to them, Hey, this is why, what you did was wrong. And this is why we got upset, and this is [00:29:00] what you can do better next time so that we don't get into the same situation.

Speaker 3: And, and on the same token, you have to be willing to do that for yourself. So you say, you know, daddy yelled at you and that was a mistake. I shouldn't have got angry when I shouldn't have yelled. And so I think by showing them that you can admit that you've done something wrong and you can apologize for that. It teaches them that it's okay for them to do that as well. And so I think really just, um, being consistent. I think if you say something, you have to mean [00:29:30] it. Yeah. And I think kids are smart. If you say, like, if you do that, we're not going to go here and then you go there anyway, they're going to learn, Hey, they don't mean it and we can manipulate them. Um, but as long as you're consistent, you're on the same page. I think they know it.

Speaker 3: Doesn't take them long to figure out that if I do something bad, I'm going to have a consequence for this. Yeah. And I think if you can provide that kind of, uh, um, structure, I think that in general, the kids are pretty good, you know, because they know you mean business. I think the mistake that many parents make [00:30:00] too many times is just, you know, giving too many chances, not following through on what they said they were going to do. And sometimes it's hard. I mean, you don't want to take away from a kid, you know, and then watch the three other girls eat ice cream and they're sitting there, you know, visibly upset about it. But they'll remember that next time when they go to do whatever it is, you know, they did. And I think that's really, it feels painful in that moment. But the lesson that they learned for the lifetime is, is far worth it, you know, because [00:30:30] you can't just go through life, getting your way all the time. And I think, you know, the tendency nowadays, as parents is to try to give our kids as much as we can and make their life as easy as they can. It can be. And I think we lose a lot of the, you know, um, you don't learn a lot of the values of life that you need to succeed.

Speaker 2: Why do you suppose that's a tendency? Do you feel like it's a response to the way, you know, the parenting generation was brought up or just the nature [00:31:00] of a parent is to want to give their kid everything, or

Speaker 3: I don't know what caused the shift, but I mean, just even from our parents' age till now, I mean, it seems like a huge difference. And I don't know, I don't know what it is if each generation has gotten more, so they've become a little softer. So they've kind of become softer in the, you know, it has been passed down, but I mean, if you look what our, with what our parents probably had to put up with his kids, I mean, it was probably dramatically different than what we even had to put up with his kids into now what our kids [00:31:30] go through. I mean, I don't even know if kids play outside anymore. It just seems like everything's electronic and everything's handed to them. And, you know, I feel like those are the kinds of things we have to be careful not to fall into that trap of, you know, Hey, so-and-so's parents got them a phone, so I must need, I have to give my kid a phone now or, you know, trying to resist the, some of the tendencies of the culture. Um, and that that's difficult because I mean, my nine-year-old is already asking me for a cell phone. And I, you know, I don't know when I, I'm not wise enough at this point to know when the right [00:32:00] time to give a kid a cell phone is, but you rely on the parents who have teenagers and, you know, what did you do? How did you do it? And, um, so I'm, I'm more of a younger kind of parent mentality at this point in time. But yeah, it's tough. I mean, all those things,

Speaker 2: Let's talk about the devices a little bit like Kindles and iPads and such. I mean, do you, do you restrict the amount of time that they get for one reason or another, whether it be blue light or just going outside and getting some sun or

Speaker 3: [00:32:30] Definitely, I mean, obviously the homework has to be done. They have to, we try to limit the amount of time that they're on it. And also, you know, a lot of it depends on how they've been acting, you know? So that's another one of those kind of bargaining tools. Hey, you know, you haven't been as respectful to mom or you haven't been helping out or you've been kinda mean to your sister, so maybe you don't get to use the Kindle today. Yeah. And I think, um, that's important because, you know, it's easy when we're all stressed and all four of them are running around the house or there, you know, keep coming up to you. I'm trying to get notes done to say, Hey, go, go sit there [00:33:00] and play on your Kindle. And that that's the easy thing to do, but usually not the right thing to do. Um, and so we had to fight that tendency and, and I think try to try to get out there outside with them and, and do more of those kinds of, uh, engaging activities.

Speaker 2: So there's some, this may or may not be applicable to your practice as a urologist, but do you have an opinion about your kids keeping a cell phone in their pocket?

Speaker 3: Oh, as far as from a safety standpoint, I mean, I know that in my, for my, [00:33:30] for myself and I, I'm always reluctant to do that. And even I find myself like at night, sometimes fall asleep with a cell phone by your head or in the morning when you're hitting the snooze, the cell phone, it always gives me a little pause. I don't know how much data there is out there to actually say one way or the other that's harmful. But, uh, I mean, I guess I've had a cell phone in my pocket for a long time and I have four daughters. So, um, it, uh, didn't seem to have much of an effect from that standpoint, I guess, but who knows me nowadays, kids are getting, I mean, I didn't get one until I graduated college and [00:34:00] your kids are getting them at a very young age.

Speaker 2: I remember having a, the first thing I had was a, B a pager beeper. I got too far from home on my bicycle. I had a pocket full of quarters and a pager. I wasn't really thinking about, uh,

Speaker 3: You had to find a payphone transmission or anything. I mean, in some ways I was at advantage because you always be like, you know what, dad, I just couldn't find a paper or I didn't have a quarter nowadays. You have no excuse. You can be GPS tracked on your cell phone. And so,

Speaker 2: Well, it's a as a, as a, as an army brat, has, did that [00:34:30] change kind of your perspective on stability or being in one place or making friends when it comes to being a parent and settling down? Yeah.

Speaker 3: And I think, um, it definitely affected me the way I was always kind of, I was the oldest child and I was always a little bit shy and reserved. And so for me that like constant moving and having to meet new people, it was very difficult. And I think that, you know, that was a big reason. I got out of the army when I did, was my daughter, my oldest daughter [00:35:00] was let's see, I got out in 2013. So she would have been four at the, around four, the time I got it, probably three, technically around the time I got out of the army. And my main reason for doing so is to provide her that stability where she wasn't jumping from elementary school, elementary school, just because I was never a huge fan of that knife. He asked my wife, she feels differently about it. She grew up as a Navy brat and they moved around a lot and she loved kind of like going to different places and meeting new people. And, [00:35:30] you know, she's always says I'm always open to moving and doing things when, if you ever want to,

Speaker 2: Um, does that, uh, is that you think just like a spirit and, you know, she was just born with that. I want to ride a horseback with the wind in my hair type of thing.

Speaker 3: Yeah. I mean, I tend to be a, I don't like change kind of person. So I'm in a minute, maybe why I don't like change as much, but it doesn't seem to bother. She, she always says, if you said, let's move to Seattle today, we moved to Seattle, you know, so yeah. She's tends to be more of a free spirit when it comes to that kind of stuff.

Speaker 2: Um, I'd be [00:36:00] interested to know, uh, this is a kind of a hard tangent, but your perspective on educating your kids, you're highly educated going through medical school. Like, do you feel like your kids are going to have a similar trajectory, you know, elementary, middle school, high school, college, maybe something else.

Speaker 3: I think most parents would like to see their kids graduate from college, you know, at a minimum. I think sometimes I, I don't know if that's realistic for every kid in every family. And so I think you have to be prepared that one of your kids may not feel that way. And you [00:36:30] know, it just depends. I think for me, the most important thing is that I raise a child who is self-sufficient, who can, you know, go out into society and have an impact. And what they choose to do with that is really up to them. You know, I don't feel I have a, we have a family friend who, you know, my kids are going to Harvard and they're going to be their lawyer or doctor. And that's it like, that's the only thing that's acceptable to her. Wow. I'm not one of those parents who feels like, you know, you need to be a doctor because I'm a doctor.

Speaker 3: Um, you know, I think they [00:37:00] can really be whatever they want to be. You know, some things are a little bit harder than others. You know, my oldest says she wants to be an artist and I think, well, that's great. You know, it's just a lot harder to make it, you know, to be successful as an artist. And, um, whereas my second child wants to be an engineer and I think, you know, we need more engineers and that, that seems like a more stable kind of trajectory. So I think, you know, you have to support them in whatever they want to do as long as it's not harmful to them in some way. Yeah.

Speaker 2: Um, I figured would you [00:37:30] rather, your kid be rich or happy? Right. And my answer, I know exactly what I want, what I want. Right.

Speaker 3: You know, as long as I feel like, as long as they're contributing to society in some productive way. Yeah. And that's really the most important thing. Um, you know, the schooling itself, I mean, not, I mean, like he said, I would love it. If they'd all graduate, I would feel successful if I got all four of my daughters through college, you know, and that would be a great day, but obviously not a hundred percent necessary to being a successful parent.

Speaker 2: So, so tell me what a successful parent [00:38:00] looks like. Like as a, as a father, what do you feel like your role is for your kids now? And then, you know, if you want to expand on what you think it is after they've

Speaker 3: Left. I mean, I think now it's, it's giving them an example of what it is to be a good person. And I think in, and how to be a good member in society. And it's not just about having a good job and making a lot of money, but how are you impacting your community? How are you treating other people, you know, w what is most [00:38:30] important in life and trying to find that balance of hard work and, you know, being a good person. And I think that's the most important thing we can teach our kids, and if they can come out at the end, like I said, just basically successful members of society that contribute in some positive way. I mean, that's, that's successful parents.

Speaker 2: I think that's a wonderful answer. I think that's really great. What is something that you want to continue to work on as a parent?

Speaker 3: I think just those same, same things [00:39:00] for me, you know, the, the patient's level listening, uh, being a more compassionate father is as far as my daughters go. I think that is really my main focus right now. And really, I mean, I, I don't think that, I mean, that really ties in with being a good husband as well. And I think, you know, I mean, I think in some ways that's the hardest job, you know, as being a good husband, you know, a lot of times we get focused on the kids, you focused on work and you take your wife for granted. And I think that's probably one of the biggest mistakes that we all [00:39:30] make as men, you know, and maybe there are, um, certainly there are a lot of guys out there that are much better than I am probably at it. Uh, but my tendency is to take my wife for granted and to not do those special things, to make her feel special as well. And I think, you know, that's another big thing that, you know, as a, as a husband, as a father that requires a lot of work in that I need to work on.

Speaker 2: Yeah. I know I need to work on that same exact thing. And it, it's, what's an action item that you can take to do that.

Speaker 3: I, you know, I really [00:40:00] think it's, you know, for me and my wife has told me it's simple, you know, just more you, the idea of just acknowledging her and saying, you know, some sort of compliment every day, if I could just make myself remember to give her one compliment every day, I w I swear that would probably be the easiest thing in the world and, and probably make a huge difference. Yeah.

Speaker 2: Why don't we do that? My, my, my wife deserves exactly that, and I just don't do it despite being aware of that. Like, why don't we do that?

Speaker 3: I have no idea. I have been trying to, I've [00:40:30] asked myself that question a thousand times, and to the point where I'm like, should I just set something on my phone is like an alarm triggered or remind myself to, Hey, give her a call and do this. And I just, I think he just gets so tied up with the daily things in life, or you're just running from one task to the next, you know, picking the kids up from a sports event, getting home, you know, doing dinner, getting them in bed, doing the dishes. It's nine o'clock. And there you are like passed out on the couch and, you know, it's like, w what happened to this day? And you get up and you repeat the whole [00:41:00] cycle again the next day. And I think, you know, too often word is kind of spun up and we're just not thinking about what's really important out there.

Speaker 3: And I wish I had a good answer for you on that one, because I think that's probably one of my biggest problems right now is how, how do you remember to do that? How do you, and, and it's not that you don't remember because they don't deserve those compliments, or they're not doing those things, or you don't think your wife's beautiful. I don't know why you just don't think to verbalize that to them. And I think that's a male problem more than, you know, men just don't [00:41:30] think sometimes like that, you know, that I need to verbalize how I feel. My wife should just know how I feel and you assume they know how you feel, but they're very, they need affirmation. And they need that, those words to remind them because they get tired. You know,

Speaker 2: It's a product of our ego that we don't verbalize it like,

Speaker 3: Hmm. I, you know, I don't know. I really, I had to me, it's it's mind blowing because my wife has probably told me a thousand times the things that I could do to make our relationship [00:42:00] better. And it does take something that simple, you think that I would, that would be so easy for me to do. Um, and then, you know, weeks ago by, and I'll find myself, you know, that I haven't said anything like that, and in a week or two, and you think, how does how's that even possible? And I, and I don't think that they could ever understand. They just see it as, you know, obviously they don't deserve those compliments or they don't deserve that praise. Um, when there couldn't really be anything farther from the truth, it's just that we're just bad at verbalizing.

Speaker 2: I looked at my wife and [00:42:30] thought, wow, she looks beautiful. And just didn't say it. I don't know why it didn't come out of me. I've even thought I should say it out loud. But for some reason I don't.

Speaker 3: Yeah. I would agree. I've had those same, those same thoughts, the same moments. And I wished I had, I don't know what it is. I don't know. What's, it's gotta be a male thing in some way, you know, that we just don't feel comfortable sharing those kinds of things

Speaker 2: Afraid of the way it would land. Maybe like maybe it's not the right time to say it, or is it, there's probably never a wrong time to say that

Speaker 3: I was going to say, I think one thing I've gotten [00:43:00] from my wife is there's never a wrong time. And there, you can never say those kinds of things enough

Speaker 2: Never feeling disingenuous or

Speaker 3: Anything. Right. So, I mean, I think, um, yeah, I just think that's one of those things that we all need to do better. I'm I'm sure there are men out there who do a good job of that, but I would say they're the exception for sure.

Speaker 2: They're just more in touch with themselves are more vulnerable to sharing feelings. Is that a practice that,

Speaker 3: You know, the, you know, one example that comes to mind is my brother-in-law. I mean, he's fantastic at doing that [00:43:30] and that's my wife's brother. So, you know, she sees him doing it all the time to his wife. And so obviously that makes me look bad, but, um, you know, it's, uh, he just, he grew up with two sisters. I don't know if that's the difference.

Speaker 2: I have three sisters. I didn't matter three. I have four sisters. Yeah. Didn't yeah. Yeah. I know I'm actively trying to be better yet. There's one obstacle after another, in my own mind that prevents me from just saying it out.

Speaker 3: Wow. [00:44:00] And you know, the other thing too is, I mean, that's really important with daughters. I mean, you have to constantly give your daughters that same kind of affirmation as well.

Speaker 2: I even have trouble sometimes doing that. It's easier because I don't feel as concerned about the way she reacts. Cause she's four. Right. But yeah, I totally,

Speaker 3: And so, you know what I mean? You, you want them, you want to build their self-confidence because I think if you don't, they're going to look for that information from other guys, you know, and probably at a younger age. And so really the, I mean, [00:44:30] that's, that's been a main focus as well.

Speaker 2: Yeah. Yeah. And having four daughters, I mean, that's a, that would require a lot of, probably as emotional fortitude, the word I want to use for somebody who grew up with a bunch of boys and then have a wife and four girls in the house that require what you're not accustomed to giving has gotta be exhausting.

Speaker 3: Yeah. I mean, it definitely takes a lot of work and, uh, but I, you know, realized the importance of it. And so that's, I think been the biggest motivating factor [00:45:00] and trying to be better at those things is that, you know, the stakes are high and failure is not really an option. It's well said, you know, it, uh, you just got to keep plugging away at it and keep working at it.

Speaker 2: I think you only, I think, I think habits are the result of a period of discipline. So if you can discipline yourself to give those words of encouragement and affirmations, that eventually it becomes a habit and that it becomes easy. Um, and just part of your [00:45:30] life, but transitioning from what you're used to, to where you need to be requires, discipline discipline is hard

Speaker 3: For sure. You know, the two books. So one of the books that really helpful in that regard is called the five love languages. And

Speaker 2: I don't know if you read them and read it, but I'm familiar with the concept. And

Speaker 3: So is the idea that, that there are basically five different ways that people feel loved. And for my wife, clearly, it's one of the things that words of affirmation and that is, you know, [00:46:00] clearly her love language. Whereas mine would probably be more something like either there's physical touch. So I would think a lot of men there there's would be that kind of like holding hands, you know, more physical stuff in nature, kissing those kinds of things. But I think for women, a lot of them tend to fall in that words of affirmation category. And, um, there's also acts of service. And, and I always think like, you know, my wife should see my acts of service as you know, my kind of, um, you know, going to work, supporting the family, um, [00:46:30] doing the dishes, doing the chores. Like that's my way of showing her that I love her, but she doesn't speak that love language.

Speaker 3: So those things kind of almost like falling on deaf ears, almost like, well, you should do those kinds of things like that. Doesn't show me anything. And so I think learning what it is that your spouse, you know, um, values as the love language is important. So that's a, that's an interesting book. And then that personality book did come to mind. It's called personality plus. And, uh, that, that's a really interesting one, uh, in just dealing with people [00:47:00] in general, the different personality types and just how their mind works compared to how your mind works.

Speaker 2: That's awesome. Well, I want to jump into a couple of kind of short answer questions or kind of rapid fire type stuff. Sure. I always have fun with this. And then after that, for anybody listening, I want to start getting a little bit more personal about vasectomies and the decisions associated with, um, you know, ma making that change in your life. But first, if you could provide something, a gift to every father [00:47:30] on the planet, what gifts might you give them?

Speaker 3: Are you talking to like a physical gift or like a, a trait or

Speaker 2: I think whatever resonates with you, it'd be

Speaker 3: A good for me would be patience, patience. If I could give myself that, that would be fantastic.

Speaker 2: So how about a physical gift?

Speaker 3: I don't know. I think at this point in time, I think it would probably be that book about the personalities. I think that was really helpful for me.

Speaker 2: Uh, what is something that you learned about being a dad [00:48:00] from your dad?

Speaker 3: Um, I would say, you know, my dad, he went to the west point military academy. He was in the army growing up, uh, when I was growing up and, you know, flew helicopters, went to dental, school, became a dentist. And so I think for me, just that, uh, that hardworking nature is probably the biggest thing that I picked up from him example. I mean, just watching him. Yeah. And the type of person they was always involved in the community and, and, uh, the way he treated people, [00:48:30] you know, everybody always respected the way he treated them. And I think for me, that was the, probably the most important thing that I learned.

Speaker 2: What was unexpected, what was least expected about being a dad?

Speaker 3: Um, the emotional nature of girls 100% and having to deal with those emotions. Oh, we are sitting at the dinner table and we just last night, some comment to my daughter, my oldest daughter, and she, she just lost it. You know, why would you [00:49:00] say that? I didn't do that. Jumped up from the table and ran into the living room, started crying in the couch. And I thought, man, what, what just happened? I was like, is this a preview of what the teenage years are going to be like, cause I don't think I'm going to make it, but it was just like, we were all just kind of like what just happened there, everybody, everybody was like, yeah. Oh yeah, the whole, all, even the other girls were kind of like what just happened. And so I think that kind of thing is different in women than, than in, in boys. And I think, um, to me that's been the hardest thing to understand. We haven't even gotten to like, [00:49:30] you know, the, when they turn, go through puberty and those kinds of things, I'm going to be the last goodness. We'll be taking extra call during those years.

Speaker 2: All right. Is there a TV dad that you like? No.

Speaker 3: T V dead. Oh man. I'm trying to think of some TV dads now. Oh, it's probably not. I probably can't say this anymore, but back in the day, the huckster, I mean, I grew up with the Huxtables and yeah, yeah. I always admired [00:50:00] cliff Huxtable. Um, I mean the character, not of course in real

Speaker 2: Life, but of course

Speaker 3: You can't talk about bill Cosby anymore, but not anymore. Um, but yeah, like the dad that he went me, he was a, uh, he was a doctor right on the show. Yeah. He was an OB GYN. Yeah. So the way he kind of balanced it in, you know, he was always that kind of calm, you know, dad and you injected the humor into it a lot. I think if I had to pick one off the top of my head, it would be him. I

Speaker 2: Like it. I like it. So [00:50:30] there's a question that, uh, Tim Ferriss asks, I don't know if you're familiar with him, he's a podcaster among a lot of other things that the question is, what message would you put on a billboard if you had a billboard on 95, all the dads on the planet are driving at 75 miles an hour past this billboard. What piece of advice might you put on that billboard?

Speaker 3: Like parenting advice. Yeah. Remember to give your children love and respect? I would think that would probably be it

Speaker 2: Love [00:51:00] and respect. I think that's really great. The love part, I think is if you're paying attention, like not that hard to love your kids, uh, whether you, but the respect part, I think is a challenge to look at a five-year old and respect that they're feeling a particular way or their desire or want is justifiable to them. Right. And okay. I think, [00:51:30] I think that's a really great answer.

Speaker 3: I think so many times you just want to dismiss their feelings and they just want to be heard, you know, they just want to be acknowledged and you know, something as simple as saying, I understand that you want to do this and the reasons you want to do this, but these are the reasons you can't do it. And, you know, and I think just a simple explanation like that can sometimes make all the difference in the world.

Speaker 2: So what, what are some milestones that you think of his dad that your kids, or you have gone through?

Speaker 3: I think [00:52:00] a huge milestone is when they get out of naps and diapers. I mean, that's just like a day that is, you know, we're celebrating for sure. And we're, we're almost on the edge. Our youngest is three. So she's kind of right on the edge of that. Um, and I can imagine that's going to be a wonderful milestone to be able to go places without having to bring a diaper bag or thinking about when we're going to, where we're going to find a place for her to do her nap, those, those kinds of things. And I think those are the, uh, the biggest milestones, you know, going to school, starting elementary school and kindergarten, those kinds of [00:52:30] things are always fun. Yeah. We're, they're all pretty young. So we haven't hit any of the major milestones yet.

Speaker 2: So what is your greatest hope for your children?

Speaker 3: I would say that they're happy and they find, you know, somebody, somebody that they can be happy with. And I, you know, that they have a good, a good life, you know, and that they, they take time to experience the other side of it. I think too many times, even to this point in my life, I've been just so focused on what I was doing to not take time, to look at the stuff [00:53:00] around me and, uh, being present, being present. That's it, that's probably one of my biggest problems. Uh, and so, yeah, I think, you know, the things that my wife has taught me have just been incredible for our, just our 10 years of marriage. Well longer relationship, but so it's, um, yeah, just being able to do those things and it's hard cause you just get sucked into life.

Speaker 2: Yeah. I have being a father to four girls. I think it'd be silly if I went any, without at least asking the question. Once you have a daughter, all your friends start talking [00:53:30] about, oh my gosh, wait till they start dating. When they're 14, 15, 16, or whatever, are you going to be the dad with the shotgun at the door? Are you going to be like, in my observation, I think that children condition daughter's condition you to be ready for that. By like my, my four year old liking a boy at four or, you know, complimenting a boy, like I feel like they condition you for, do you find that you think you'll be ready for [00:54:00] it?

Speaker 3: Sure. That any dad is ever ready for that day? I think that's probably my biggest fear right now as a father is the day that they start dating and, you know, we watch a lot of Dateline, you know, and we just happened to watch it a horrible Dateline last night about, you know, a guy who was abusing like his girlfriend. And, you know, I think those are my biggest fears, but the one thing that I have, I think a little bit of an advantage over most dads, I mean, everybody uses the gun thing, but I'm just, I'm just gonna remind these young gentlemen, you know, do you know what have you, we're all it just is. I remove, I can remove [00:54:30] testicles for a living. So, um, I want you to think about that when you're out, out on your date and just remember that the anesthesia part is optional. So yeah, I think that'll get in their heads even a little bit more than the, uh, some of the other kind of threats out there. Um,

Speaker 2: It would be in my head Mo no doubt. Okay. So let's see. I feel like I had one more than I wanted to ask you. If this recording was to last for generations and generations and your kids, kids, [00:55:00] kids could hear it. What kind of message might you like to deliver from this generation or your experience or life advice for them?

Speaker 3: Oh man, that's a tough one. I would say so generations from now, I hope people are still talking to each other. First of all, um, you know, actually having interactions are, uh, and not all electronic by then, but I would say, um, take time to enjoy the important things in life, love each other, and really treat each other with [00:55:30] respect. I think if you, if you can follow those simple things, you know, you will have a good life or

Speaker 2: Awesome. All right, well, let's jump into some medical talk here for a bit. So for those who are still listening, the way that we met is we went to I'm, my wife scheduled a consultation for me for two, for a vasectomy. And so right away, we felt a great rapport with you and great confidence in you, which is why I wanted to do this interview. But I'd like to kind of rehash that consultation and ask a couple questions for [00:56:00] the benefit of anybody who might thinking about yeah, definitely signing up for one. So, you know, what's the average person that's coming in to get a consultation.

Speaker 3: I would say probably average, um, is going to be somebody in their kind of late thirties, early forties. Who've have two kids, probably on average. It's two kids. Um, most commonly when it's two it's a and a girl, it seems like, but you know, there are a lot of, you know, two boys or two girls that give disectomy as well. But I would say that's probably the average.

Speaker 2: [00:56:30] So let's tell me what is a vasectomy.

Speaker 3: Okay. So basically there are tubes that carry the sperm from the testicles to the urethra tube. Um, and basically we have a sect me as a removing a segment or clipping that tube so that the sperm can not get out anymore. So that's, that's basically the idea of, of a semi it, you know, the procedure varies in length depending on the person doing it on average takes me about 15 to 20 minutes to do the procedure it's done right in the clinic. [00:57:00] The majority, probably 95% of them are done awake under local anesthesia. But you do get some guys who are just very anxious people and right off the bat, usually you can tell who those guys are going to be. And I might recommend that they do that under anesthesia. And certainly anybody can have it done anytime under anesthesia. I mean, that's always an option. You always add the risks of anesthesia and also the cost associated with the anesthesia to the procedure. But in general, majority of people do it right in the clinic.

Speaker 2: I mean, you've, you've had a vasectomy, like what does that feel [00:57:30] like when that,

Speaker 3: Uh, so the best way to describe it. And I, and I've described this to people and they agree as well. It's kind of like somebody, you know, when you were in high school and Gaza go around flicking each other in the testicles, it's that flick feeling when the numbing medicine goes in. And so it's about, you know, 10 to 30 seconds where that medicine's kind of taken effect may kind of feel like somebody flicked you down there. And I think that's probably the best way to describe it. But once that medicine kicks in, pretty much, at that point, you are numb from that point on, it's like going to the dentist, you feel that needle sticking the gums, you feel the medicine [00:58:00] going in, but then once it sets in, um, you know, something's going on up there, but you don't really feel a lot of pain.

Speaker 2: What's the procedure itself? Like, like what are you using? What are you, where are you going in?

Speaker 3: So you basically make, you can make a single or two incisions. Uh, most urologists tend to do two incisions just because of the risk of grabbing the same tube through a single incision. You know? So it kind of, by putting those decisions out to either side, you're ensuring you're getting each side done and it, the inside of the incision is, [00:58:30] you know, it's probably like maybe a centimeter, probably not even as probably like six millimeters. I mean, it's a tiny, tiny incision can be done either with a scalpel blade or there are some people who advertise the no scalpel technique. It's basically just a appointing instrument that kind of creates the whole either way. You're ending up with the same size hole. And the tubes brought up through that hole. I was probably more information than most guys want, but the two was brought up to the horse segment is removed. And then, uh, some people put clips on the end. Some people [00:59:00] tie them off. I tend to burn in either end to kind of steal them and then pull some tissue up over one end to bury it. So that those tubes really can't find each other. Again, they say there's a less than 1% chance of them somehow growing back together. And that's what we do. Check a sample at three months to make sure that everything's good.

Speaker 2: Okay. And so how, how long, you know, after you have a procedure like that, until you are kind of back to your daily life,

Speaker 3: I would say about two weeks more, you want to avoid any heavy lifting, [00:59:30] strenuous activity, intercourse, those kinds of things for about a two week period. You know, I find the guys that push it too soon are the ones that tend to get the problems. You know, I, I've done so many and seen so many patients have issues after who did things too soon that I took a full week off and I stayed away from my activities for about a month. I mean, I do TaeKwonDo and CrossFit, so they're a little bit more physically involved anyway. So I wanted to give myself a full month to recover. And I think really the expectation. And I think a [01:00:00] lot of guys, Trent, you know, there's some guys who minimize it, some guys who make it sound horrible, but a lot of guys will say, yeah, I was up golfing the next day and you know, or going back to work. And I think, you know, it's, it's lucky that you were able to do it that soon, but it should not be the expectation. The expectation should be about a two week recovery,

Speaker 2: The two-week recovery. And I'm, I've heard people say, yeah, the pain on the reason that people push it is because they feel like they can, like the pain is gone. Like how long has the pain,

Speaker 3: You know, I think, um, for me, I didn't really take any pain [01:00:30] medication afterwards. I mean, it was sore kind of like you'd been kicked with a ball kind of sore a couple of days later, but, uh, as long as you weren't doing anything too strenuous, you know, it was manageable ice, you know, putting some ice on there, resting on the couch, but I think you're right. I think people get deceived into thinking, Hey, this isn't so bad, so I'm going to go and do, you know, mow the lawn or do something that they shouldn't have done. And I think guys in particular bad about that kind of stuff, you know, just sitting there and taking it easy. And so I think that's fighting that temptation is [01:01:00] the biggest thing. So

Speaker 2: Tell me why a guy would get a vasectomy rather than a woman having the expression. I've heard his tubes tied. I don't know if that's

Speaker 3: Sure. So in order to have a tubal ligation, you do need to go to sleep. So you do add anesthesia to that mix. And also, you know, they have to do the surgery as kind of intra abdominal. So there's a lot more things that could be injured in the process. So if you're going to compare the two procedures side by side, it's much, much safer for a guy to have a vasectomy than it is for a girl to [01:01:30] have a tubal ligation.

Speaker 2: So if a guy has a vasectomy and what does that, do you end up getting stitches from those incisions?

Speaker 3: So there are two suits. It depends on who you go to. You know, I don't put any sutures in the skin edge themselves. Those incisions just kind of seal up on their own, but there are people who do put sutures in the skin. I actually initially had the sutures in, but I found them quite unpleasant and actually remove them the day, I think the day after surgery, just because I knew I could do that. And I, I, that was just [01:02:00] kind of confirmation as to how I'd been doing it the way I've been doing it without putting them in. And these incisions are so small. I mean sometimes hard to even see them the day or two after surgery. Um, most face of that thing. Isn't the prettiest looking thing in it to begin with. You're not going to notice two tiny incisions in there in the long-term for sure.

Speaker 2: Okay. You it's really, you know, if you went looking for it, you may or may not even find it the scar or something. So

Speaker 3: After, after resect me, what happens to, you know, if you [01:02:30] do your sperms, not going through the urethra anymore, where's it going? So basically, you know, your body is still tends to produce it, but what happens is, you know, because you're not releasing that sperm, the production goes way down, your body tends to resorb some of the sperm and break down the, the old sperm. But you, you know, there are some guys who get a little bit of a swelling of the epididymis, which is the structure that store sperm, you know, uh, and, uh, sometimes you can develop pain from that. You know, some of the chronic pain issues can be from, [01:03:00] um, the backup of sperm fluid in two times in my career. I've actually reversed vasectomies for that reason. Yeah. But, uh, it's very, very uncommon to have something like

Speaker 2: That happened. Well, that's, that's a good segue into why one, you can reverse a vasectomy and two, why would someone do that?

Speaker 3: You know, I think, um, for me, I have a little bit different perspective because I was in the army for awhile and, you know, the, in the army that people tend to do things at an accelerated rate. So a lot of these [01:03:30] guys go off to basic training at 18, they meet some girl, you know, when they're out there on their own for the first time they get married at 20, by 24, they have three kids, you know, in their, like living on a private or a specialist salary trying to raise three kids. And they're like, this is it. I can't do it anymore. I need a vasectomy. And unfortunately, a lot of those marriages don't last, you know, in the long-term. And so you end up seeing them back in their thirties or forties, new spouse looking to have kids again. And so I, I mean, I had at times a list of 30 or 40 [01:04:00] people wanting a vasectomy reversal when I was in the army. Wow. In the five years I've been here in Warrenton, I've had maybe one person asked me for a reversal in comparison, you know, so I think it was just a little bit different situation, but that was the most common reason. You know, there are alternatives even to having it reversed IVF the in vitro fertilization that can actually be done by harvesting sperm directly from the, you know, the testicle or the epididymis, and then using that for the in vitro fertilization. So that's an option as well after the safety

Speaker 2: [01:04:30] Of spurn change after you've had a vasectomy. Uh,

Speaker 3: Definitely. So, um, in a sense that if you do the vasectomy reversal, there are a lot of your body actually develops antibodies against your own sperm in a weird way. The body protects the sperm from the immune system, but once you've had the vasectomy and those two cysts, they can mix. And to the point where your body actually sees your sperm as an, as a, like a virus or bacteria, like in that regard and they form antibodies to it. So a lot of times the reason of a sectary reversal [01:05:00] is not successful is because of the quality of the sperm afterward. Interesting. And the numbers tend to be a lot lower. Um, and also you're, you're trying to basically keep a pinhole tube open when you reverse it. And any little bit of scar tissues enough to kind of close that tube off. So while it is reversible, if you're thinking about the second week, it should not be thought of as a reversible procedure for that reason. Fair enough.

Speaker 2: So after vasectomy, I, does it impact your sex drive? Yes [01:05:30] or no. And what's coming out when you evacuated sperms, not com.

Speaker 3: So 90% of that fluid that comes out in general, maybe even a little bit more is coming from the prostate. And these two things called the seminal vesicles, and that's just strictly a fluid that is in general, a carrier for the sperm. You know, it kind of keeps the sperm alive as it travels. And so that fluid is still there and present. Um, so in theory, you won't notice a huge difference in the volume or even the, you know, anything in dif uh, [01:06:00] you shouldn't notice any changes in January and you shouldn't notice any pain with a Dracula nation. Um, and certainly it should not affect erections in any way, which is an or testosterone level, which are two of the biggest questions that I get, you know, how's it gonna affect my sex drive and how's it gonna affect my, um, erections. And it shouldn't in any way.

Speaker 3: Um, you know, just one thing that pops into my mind, you know, under the company, what are the risks of having the procedure done? I don't think you've really kind of talked about that, but I would say, you know, with any surgery, there's three main risks, bleeding infection [01:06:30] and chronic pain, and so bleeding, uh, because that area is the, you know, kind of a stretchy area. It takes a lot of bleeding to generate enough pressure to stop the bleeding. And that's why you can get a hematoma or a collection of blood that swells up the size of a grape for a soft ball after the procedure. Fortunately, that's exceedingly rare. You know, I've been doing this for 15 years. Like, like you had mentioned, I've done over 2000 vasectomies. I've only had that happen two times and both guys are doing things they shouldn't have been doing after the procedure.

Speaker 3: [01:07:00] Um, so in general, it's exceedingly rare infection is the same, very, very rare. It just so happened that both of those hematomas collections, the blood got infected and the same patients are the only two infections I've ever had. Yeah. So kind of when it rains, it pours type of thing, but it's very rare for both of those things to happen. Uh, chronic pain is something that I would say is a little bit more common. Um, and, um, you know, I, I would say had intermittent pain for up to three to four months afterward, which was a little bit surprising [01:07:30] to me. Um, and it would be random, not that I was doing anything, it would just suddenly come on. It would be maybe on one side and it would just kind of go away on its own, no testicular pain. Yeah. Just kinda like an ache, like what just happened there, you know, you got kicked or hit the wrong way. Um, and I think that was a big surprise to me that it lasted that long. And then just one day it stopped and it's been, you know, eight months since that point. And I haven't had any more issues, but there are some guys where that becomes a more permanent problem. Uh, it's rare. Uh, [01:08:00] but that is something that has to be taken into consideration. When deciding,

Speaker 2: Did you have any nerves going into your procedure?

Speaker 3: You know, I think anytime you have anything done, you always have a little bit of apprehension. I think probably the nerves are more of, am I doing it, making the right decision? Yeah. You know, then, then, you know, I I've seen it so many times that I knew it was kind of an easy procedure and the guy who did mine was one of the guys who trained me in residency. So I trusted him immensely. So I think from that standpoint, but you know, when you're in the medical field, you realize that you can do [01:08:30] everything perfectly and things can still go wrong. And I think sometimes for people who aren't in the medical field, it's hard to understand that that side of it. I mean, why someone has a spontaneous bleed inside there or something who knows, um, you know, and you can do 2000 disectomy is not having an infection. And then one day you have an infection, you do everything exactly the same all the time. And so, um, there are other factors that we can't control. And I think those kinds of things make you a little bit nervous, you know, the unexpected,

Speaker 2: Talking about mindset coming into a vasectomy. Like I told you that [01:09:00] right now, I'm sure, but I don't feel like I'm mature enough to make that decision for 40 year old man. Like I just don't know, but right now I know I don't want to have any more kids put in two years. My mind might change. I give you seen a percentage of your clients afterwards, that kind of wished they hadn't done it.

Speaker 3: You know, I, I, since I've been in Warrenton, I've only had, I think of one guy who came back wanting a reversal. So, you know, I would say it's, it's very rare now. I don't see [01:09:30] a lot of people follow up from that. You know, if, if people aren't doing well, they don't come back from that standpoint. Um, that being said, you should do a semen sample at three months to make sure there's zero sperm. Um, and typical guy fashion only about 25% of guys actually get that done. So it, uh, but the, um, I think I'm kinda lost my train of thought there. Where are we going with that?

Speaker 2: Um, I just, the number of people that kind of regretting.

Speaker 3: Yeah. And I think, um, I think it's tough because I think if you like being [01:10:00] a parent and you like kids, and you're never, you're never going to be fully sure that you made the right decision, you know, I think you can look as your kids get older and now we have a three-year-old and think, man, could we have done this one more time? Probably. Um, should we have done it one more time? Maybe, you know, um, I know my wife feels that way, you know, and, and she definitely is. Um, I, uh, what I would consider a bit of a baby addiction, you know, so I think, uh, I'm not sure she'd ever be satisfied. And, um, [01:10:30] but it, I mean, she, I mean, she's to the point where she even like, should we consider IVF type of thing. So, I mean, I think even when you're sure you're not sure, um, you know, I mean, for me, for girls, that's pretty much my limit. I can, I would be fine, you know, moving onto the next phase of life, but I think if she had her way, we'd have two more. Yeah,

Speaker 2: Sure. How about, um, the, the percentage of people, like the, what would you say the level of certainty is of the people that you see? Like there's some people that go into it, a little indecisive and just kind of go through it anyway.

Speaker 3: [01:11:00] I think, um, everybody kind of goes back and forth is my opinion. You know, I see a lot of people kind of going there are certainly those people who are like, I've always wanted to have two, two, is it, I can't afford more than two. And you know, they're very that this is what they want to have done. They want it, they want it done the next day, if they can have it done the next day. But I think the majority of, of guys, you know, they really have to, you know, couples have to think about it and sometimes one partner is more sure than the other, and that makes it tough to, you know, because, um, you [01:11:30] know, it's, it's, especially when you have the situation where you have four daughters and you're thinking, man, what if we try one more time and we can have that son, you know? And, and I think those are the kinds of things that make it tempting. Um, but I think, you know, you and people always told us, you'll you'll know when you're ready. That's what other advice you got, you would get from other couples? And I don't know that I, I don't know that I ever felt that way or that I don't know that I ever would feel that way necessarily. Um, I think you're always going to have some reservations

Speaker 2: Has made a difference between [01:12:00] being sure and being right. Right.

Speaker 3: And I think, you know, the other thing too, is there's so many, you see so many couples out there who had two kids and then they never had anything permanent done and they have that, you know, kind of third whoops, kind of baby. And they always say the same thing. You know, I can't imagine my life without that child. I'm so happy we had that child. And so even someone who was at that time had two older kids was so sure they didn't have another kid consider that one of the best things that ever happened to them. So, um, I think, you know, it's, [01:12:30] it's really just a, it's a tough decision. But I think for me, the, the things that made the decision easier and we had four healthy kids and my wife made it through pregnancy four times without any major issues. And, you know, every time you have a pregnancy, you're tempting fate a bit, you know, from that side of things, I mean, it's not guaranteed to go.

Speaker 3: Perfect. Um, the older, you know, your wife gets, I mean, the more likelihood that there are complications with the delivery that the babies themselves, and, you know, after 35, the incidence of, [01:13:00] um, down syndrome and some of the other things tend to go up as well. And so those things factor in and just, you know, how old are you going to be when those kids are going through high school and college? And, you know, do you want to be eight years old when they're walking down the stage at college? Or will you even be here at 80 years old? And I think those things tend to make the decision easier when you start to look at it from that standpoint, that can help you take out the emotional illness of it's wonderful having another kid and another baby, but [01:13:30] we can barely make it to the sports for two kids.

Speaker 3: And we have four. So what are we going to do when all four in sports or in choir, whatever it decided to do, um, you know, especially when you don't have that local support, um, you know, some people have their parents in town and, you know, grandparents are great to help you in those situations, but when you're kinda on your own with four kids, you don't have a lot of options to help you out. Yeah. And so for me, those were the, the idea that we, we had to, and you have to give them attention to, I mean, at some point I felt like [01:14:00] four daughters requires a lot of emotional attention, including a wife on top of that. It's, you know, at some point you're emotionally exhausted,

Speaker 2: Right? Yeah. Jesse, you having seven kids said it at some point that the oldest five are entertaining the other two and they don't even want us or right.

Speaker 3: That's true. Yeah. That's true. I mean, you could get a more advanced more help the more you have, I suppose, but

Speaker 2: Yeah. Well, um, you said something about even being around at 80, which, uh, made [01:14:30] me want to ask the question as a urologist to do other things outside of performing vasectomies is any of that, like people coming in to do screenings for their overall, you know, health in that, you know, do you have breath, this is an opportunity for a PSA for anybody that

Speaker 3: Fortunately not only is it a PSA, but my PSA would be about PSA. Um, you know, I think that for guys, that's the number one thing you have to consider? I mean, I think colonoscopy is also equally [01:15:00] important. Um, you know, the incidents of colon cancer and prostate cancer, you know, second only to lung cancer in American men. And I think, um, you know, obviously with the lung cancer thing, if you're a, non-smoker, it's not as much of an issue, but when it comes to colon and prostate cancer, they don't tend to discriminate. And I think, you know, getting your colonoscopy at age 50, um, younger, if you have, um, a family history of colon cancer, I mean really should probably start around 40. Um, and I think the same really applies for PSA [01:15:30] in prostate cancer. You know, if you're, if you have a family history of prostate cancer, you're a much higher risk of having it yourself and you need to start getting your PSA checked, um, you know, 40 for family history and 50 for everybody

Speaker 2: Else. What does PSA? That's a, that's a level

Speaker 3: It's simply just a blood test have. And it's a level of, um, that, uh, PSA in your bloodstream. And, you know, there are certain conditions that cause that to be elevated, prostate cancer, being one, um, you know, the, the test itself has got a lot of bad press, but it's, uh, it's our only way at [01:16:00] this point and reliable way of detecting prostate cancer. And, um, you know, it saves lives. You know, we do see these guys who come in, you know, with, um, really aggressive cancers and we're able to, to stop and kind of nip them before they get out of control. And I think the majority of prostate cancers are slow growing and not aggressive. And we can nowadays observe those kinds of prostate cancers, but, you know, it's still the number two cancer death in American men. And most people don't know that about prostate cancer.

Speaker 3: Um, and really 300,000 guys a year will die [01:16:30] from prostate cancer. Wow. Um, you know, so, or I'm sorry, 30 300,000 a year, we'll have it 30,000 will die from it. Sorry. So about 10% of that, of the total number. Um, so it's, it's still, you know, second only to lung cancer, uh, as far as cancer and American men and it it's one of those things you just want to, it's a harmless blood test, prostate exam, um, get it done once a year. Um, and it can save your life. And, and same with co-ops is even less it's it's like usually every 10 years, unless you have a family history

Speaker 2: Of 40 or [01:17:00] 50. And yeah,

Speaker 3: I mean the, you know, the more I see the more I do the more I think, Hey, you know, even at 42, should I be getting my first colonoscopy? I mean, cause you some crazy stuff out there and when you're a dad, you know, it's not only about you and your health, it, you need to take care of yourself for your family because you need to be around for them. And, and so you kind of have to get over some of those fears that you have about maybe going to see the doctor or getting a blood test drawn or whatever, because, um, again, it's not, it's not really just about you. It's about, you know, the [01:17:30] health and wellbeing of your family for the longterm.

Speaker 2: Do you, do you give anybody advice on how to change their lifestyle to be healthier?

Speaker 3: Oh, certainly. I mean, anybody comes in, who's smoking, I'm going to tell them it's the single best thing you can do for your health and for those around you as well. Um, and I think, you know, that's the hardest, it's really hard for me to, to understand why people still smoke with all the evidence that's out there and all of the stuff that we know about young people and it's just getting addicted at a young age and not being able to shake it. And I think, um, [01:18:00] it's certainly a heavy addiction. So I understand from that standpoint, but, um, it's the single best thing you can do for your health in so many levels. Yeah. And a lot of guys don't know, I mean, it's one of the biggest causes of erectile dysfunction as well, which is not commonly known, but this, that damage to the small blood vessels that supply the blood flow down there. And so I think it's another it's sometimes you can talk about cancer all you want, but as soon as you say that, they're like, wait, wait, smoking causes what, you know, so they're, they're a little bit listening a little bit more after that, but, um, yeah, [01:18:30] there were,

Speaker 2: The incentives are right, right.

Speaker 3: Um, so yeah, that, I would say from a general health, those would be my two pieces of advice and exercise, you know? Yeah,

Speaker 2: Yeah. Don't smoke exercise and you know okay.

Speaker 3: Yeah. Yeah. Which is hard. They eating parts the hardest for, I think for all of us. Yeah. Everything is who doesn't love a good burger steak.

Speaker 2: It's also readily available. I'll tell you, try to go eat a healthy meal on $10 when you go to the natural marketplace. That's my mom's store, but oh, nice. Everywhere else. He's, it's hard to find you [01:19:00] really got to work hard. Well, any, any parting words of wisdom, fatherhood doctor,

Speaker 3: I would say just to keep it working at it, I mean, it's hard, you know, keep working at yourself, being a better person and being a better father, better husband, and it all kind of falls into place and it's all we can do.

Speaker 2: Well, thank you very much for taking the time, man. Thanks for having me. He learned a ton. Thank you. Yeah, definitely. So we're, we're picking the recording back up kind of abruptly because after talking, we realized [01:19:30] that there was a great topic to bring up. So please go ahead.

Speaker 3: Yeah. So I think a lot of patients and I myself struggle with the idea that, you know, some religions believe that having a vasectomy or using birth control is, is wrong. And I think that is a major factor in a lot of guys decision on whether or not to proceed in the idea that is particularly in the Catholic faith, that that all forms of birth control are considered to be a sin. And I think that becomes a really tough topic and I've, I've seen some guys really struggle [01:20:00] with that. I also really struggled with that and the fact that I am doing this ectomies, you know, am I doing something wrong in doing the vasectomies in general? And I, I wish that I had a good answer, you know, for that, the thing that I always kind of think about is, you know, what, what are the teachings, you know, in the Bible itself?

Speaker 3: Is there any guidance on that? And unfortunately, I mean, they probably the concept of a vasectomy back then was not even relevant and you know, what can be extrapolated that, and I, I was never, I've never been able to really find anything to give me a peace of mind one way or the other, you know, I've [01:20:30] always been concerned about the religion and the religious aspect and where men try to make rules and try to dictate the way, you know, over kind of regulate the way people live their lives. And I think, you know, for those who out there, who, who believe in Jesus and who are religious from that side of things, I think the whole reason he came was to say, Hey, you guys are making this too complicated. You know, all these human rules that have been added over the years are making, being a religious person too cumbersome. And, and does this fall in that category? I don't know. Um, but that's probably the only [01:21:00] thing that gives me any kind of constellation and the fact that I've had one and done one, but I thought it was important to address that from those guys who are out there thinking about that, you know, should I do this from a moral religious standpoint? And that's a big factor in a lot of guys decisions to proceed with a me. So

Speaker 2: Do you suggest that they go speak to somebody in their church about it? Or does that answer already?

Speaker 3: No. See, I think, you know, the problem with, you know, especially someone who's, you know, who is Catholic. I mean, clearly when you go to the priest, they're going to give you that answer, that this is wrong. And I think [01:21:30] all I can tell you is, is probably just to do as much research as you can on the topic yourself, you know, find out why it is that the, you know, that rule was ever created to begin with. What is the kind of reasoning behind it? Do you feel strongly that that is something that you should adhere to, or do you feel like, um, it's responsible from some standpoint to not just keep having kids without the resources to, to help raise them. And, and I think it's a tough, it's a tough decision and I may be making the wrong decision or, [01:22:00] you know, doing a, a terrible thing by doing these vasectomies. But, you know, I think at some point, you know, it, it becomes difficult to just keep having children, you know, and it's stressful in life in a marriage and times can be in some ways unfair to the other kids, you know, the more you have, but I see plenty of big families at St. John's who are doing really great and they make it look easy. Yeah. So, I mean, maybe they have the correct answer.

Speaker 2: I think that was a great reason to have a bonus question bonus answer. Very good. Yeah. Thank you for sharing that.

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