Men often delay in seeking medical help in the belief that they should just grin and bear illnesses, but delays can make the condition more complicated, writes MICHAEL KELLY.
NEXT WEEK is Men’s Health Week. There has been a Men’s Health Week since 2005 and it’s fair to say that the need for such promotional activity is more acute than ever since the burden of ill-health experienced by Irish men continues to be both considerable and disproportionate.
According to the recently published National Men’s Health Policy, male life expectancy is almost five years lower than that of women, and men in Ireland have higher death rates for most of the leading causes of death and at all ages.
Young men aged 18-35 years are a particularly high risk group – they are almost four times more likely to die earlier than their female counterparts and have the second highest rate of suicide among the 30 OECD (Organisation for Economic Co-operation and Development) members.
Nearly 3,000 Irish men die each year from heart disease while 4,000 men die every year from cancer. An increasing number of us are prone to depression and suicide and over 50 per cent of men aged over 40 suffer from erectile dysfunction.
Men’s Health Week aims to heighten awareness of preventable male health problems, and to encourage early detection and treatment of health difficulties for men and boys. Part of the problem, as readers of these pages are aware, is that men are terrible at accessing health services – we go to our doctors less than women do across all age, ethnic and socio-economic groups; and crucially we also present later which means we tend to have more complications and a poorer prognosis.
This explains why the focus of this year’s Men’s Health Week is on getting men to go to health professionals earlier.
“One of the key issues which underpins the difference in mortality between men and women is the fact that men access services far less frequently than women,” according to Dr Noel Richardson, chairman of the Men’s Health Forum in Ireland (MHFI), which co-ordinates activity on the island of Ireland (Men’s Health Week is a global initiative).
“The key message for men from Men’s Health Week this year is that if you are worried about any aspect of your health, do not delay in seeking medical health. The reason that men have poorer outcomes, poorer prognosis and more complications is that we delay getting help, often until it’s too late.”
The Men’s Health Forum in Ireland also advocates the idea that all men over 50 should get an annual health check-up.
“From a preventative perspective that makes perfect sense,” says Richardson, “though we don’t see a need for healthy young men to be thronging GP offices around the country.”
A number of initiatives are planned to mark Men’s Health Week this year. A promotional campaign will see posters bearing the message “Don’t Wait Till It’s Too Late” in GP surgeries, bookies and golf clubs.
The campaign has also produced a guide for GPs to help them adopt more “male-friendly” practises – these include offering evening clinics so that men don’t need to take time off work, and even simple things such as providing a waiting area where men can feel at ease (a common perception among men is that waiting rooms are designed with female patients in mind).
To mark Men’s Health Week, An Post has produced a booklet on men’s health for its male employees which focuses on the occupational demands of working in the postal service. This initiative, says Richardson, is a great example of an employer taking a proactive approach to the issue of health awareness among male employees.
A key challenge for Men’s Health Week is finding a way to promote health issues in a way that both challenges and supports traditional notions of masculinity.
Many men delay seeking help quickly because they believe that “being sick” or “going to the doctor” somehow represents a failure or personal weakness.
This is something that 46-year-old Victor Tierney can empathise with. The Wexford native worked in the textile industry for more than 20 years and had recurring bouts of breathlessness which he never did anything about.
“I would have to be hospitalised before I would go to a GP,” he says. “I think this is how men are conditioned. Our role in society is that we have to be strong all the time and it is as if you are showing weakness if you go to get help. When I was growing up, the school of thought was always ‘don’t be whinging, get over it’.”
As a result, Tierney ignored the breathlessness. “It started as a mild dose of asthma but I wasn’t taking care of it and it turned into something more serious. I had a very severe attack on one night shift which was a real wake-up call. It takes a scare like that to get most men to get help. That was a number of years ago and I still have relapses now as a result.”
Tierney got involved in a local Men’s Development Network which helped him to think in a new way about his health – primarily that seeking help when you are sick is not a sign of weakness, but rather a way to take control of your health.
He now gets a check-up once a year and is getting treatment for gastric reflux disease which had been causing him severe heartburn and abdominal discomfort for years. “It’s about having the courage to go to your GP and seek help. Ask questions about your health. Take control of it because no one can look after your health except you. It’s not a sign of weakness.”
John Dillon (75) ran a pub in Arklow for 40 years and was never sick a day in his life. In 2003 he started to experience discomfort when going to the toilet but like most men would, he ignored it. “I was straining going to the toilet and passing blood for about five months,” he says. “But I didn’t do anything about it. I just didn’t bother, which is typical of men. It would have had to have been really bad for me to even consider going to a doctor.”
When his wife Maisie noticed that he was rapidly losing weight she urged him to visit his GP who immediately referred him to a consultant. Dillon was quickly diagnosed with bowel cancer and the consultant informed him that it was developing rapidly.
“I was shaking when he told me,” he says. “I just couldn’t get my head around the idea of cancer. When I got home I went in to my bedroom and didn’t come out for two or three days. I didn’t know how to deal with it.
“But my local GP was very helpful and assured me that it is a type of cancer that can be dealt with and that the best people in the country would be looking after me.”
Though the cancer was treated successfully following an operation and chemotherapy, Dillon endured a hellish number of years and further operations to deal with subsequent complications. He also contracted MRSA while in hospital. “It was a life- threatening situation on several occasions. At one point I was down to six stone. There weren’t too many people who would have bet money on me coming out alive.”
But come out alive he did. He is looking after his health and walking daily for exercise – his wife Maisie says he runs the risk of wearing out his walking stick, such is the ferocity with which he pounds the pavements in Arklow. He visits the consultant every six months or so for check-ups. “I wouldn’t be here today but for the exceptional skill and attention of the consultant and the aftercare team.”
Dillon believes there is a salutary lesson for all men in his story, particularly the crucial five- month delay from when he first had symptoms. “We think that if I had gone to the GP earlier I would have avoided the complications that I had. I couldn’t advise men strongly enough – if there’s something that’s not quite right, something that’s not quite fitting in, then go and get it checked out straight away.
“The way that medical science has come on, if you give these consultants a reasonable chance, they can deploy the advances that have been made to help you. But if you delay visiting them, you are effectively tying their hands behind their back.”