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From Prostate Checks to Kidney Stones: A Urologist's Guide to Men's Health

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Ever wondered what really happens during a vasectomy? Or why that morning coffee might be setting you up for kidney stones? Dr. David Ludlow pulls back the curtain on men's health topics most guys are too uncomfortable to discuss.

"That wasn't as bad as I thought it would be" – the phrase Dr. Ludlow hears so often from vasectomy patients that he jokes about putting it on t-shirts. In this eye-opening conversation, he dispels common myths about men's health procedures that keep many from seeking necessary care. From explaining how robotic surgery works (no, the robot isn't performing surgery while the doctor takes a coffee break) to clarifying that vasectomies won't affect your ability to perform or enjoy sex, Dr. Ludlow addresses the concerns men rarely voice but frequently worry about.

The discussion ventures into surprising territory, revealing how our modern lifestyle impacts urological health in unexpected ways. Those energy drinks you're chugging for hydration? They're actually dehydrating you. That Western diet with processed foods? It might explain why African-Americans have higher prostate cancer rates than native Africans. Even excessive pornography consumption gets examined for its potential physical (not just psychological) impacts on sexual function – a topic rarely addressed in medical discussions but increasingly relevant as Dr. Ludlow sees young patients with dysfunction issues that shouldn't typically affect their age group.

Whether you're approaching the age for prostate screening, considering a vasectomy, or simply want to understand how to maintain optimal urological health, this conversation delivers practical insights without the embarrassment of the exam room. Listen now to hear from the doctor who's seen it all and isn't afraid to talk about it – your body will thank you.

Speaker 1:

Welcome to Vegas Circle Podcast with your hosts, paki and Chris. We are people who are passionate about business, success and culture, and this is our platform to showcase to people in our city who make it happen. On today's podcast, we'll be discussing all things men's health, from prostate checks to kidney stones. We're going to talk the whole nine man about men's health, man. So I'm kind of nervous about this interview. I feel like I'm talking to my primary care doctor, so, but let's welcome to the circle, urologist Dr David Ludlow. Welcome to the circle, my man. Thank you, yeah, thanks, for having me. So let's jump right in. Man. So what made you jump into the world of urology?

Speaker 2:

Great question. I don't think most kids grow up dreaming of becoming a urologist. Most kids don't even know what it is Initially. Obviously you decide to be a doctor and I think a lot of people kind of make their decision when they get exposed to different things at medical school. I actually went to medical school thinking I wanted to be a pediatrician. So if you look at my waiting room now, I went with a very different demographic eventually yeah, 1,000%.

Speaker 2:

Yeah, for me, I decided pretty early on. I was kind of an athlete in high school and whatnot and so I just liked kind of that intensity and using my hands and so I decided pretty early on I liked surgery. So then it was kind of a matter of you know, urology a lot of people don't understand is actually kind of under the umbrella of surgery, and so you kind of just get exposed to different things and talk to a bunch of different mentors. And one thing I wanted is I still like the idea of practicing medicine and kind of diagnosing and having you know long time patients, but I also like to do the procedures and the surgeries and have a reasonable lifestyle. You know I have a family and hobbies and so a lot of people said you should try urology, or ENT was another one that I heard that kind of had you know, check those boxes. So I actually just did you know rotations and both of them and I had no idea Urologist did all the cool stuff they did.

Speaker 2:

I mean robotic surgery, just a lot of gadgets and toys, scopes, lasers and and I don't know nothing against the ENTs. I got some good ENT friends but there's a lot of picking, a lot of, just like you know, little microscopes and using your fingers and I don't know. I just liked, I just liked the surgeries and and also like the urologist, I mean they're your kind of cohorts and you know they're smart, they're hard workers, but they're also not too high on their you know high horse, you know know, got to be a little self-deprecating when you, you know, dedicate your life to the urinary tract. So they're just kind of cool down to earth, guys.

Speaker 1:

Yeah so you do a wide variety of surgeries right? Can you kind of give like the whole menu of services or the primary? Yeah, so it's a good mix, I mean because we do a lot of clinic stuff.

Speaker 2:

You know, obviously people that have you know all sorts what you think of urology problems or men's health, you know would come see us and some of the stuff we can manage with medications and stuff that we do in clinic and then a lot needs surgery. So we kind of my, my time is split kind of half and half between the operating room and clinic. So essentially we do all the surgeries for the urinary tract. That's male and female, so we have a lot of female patients. You know females.

Speaker 1:

I didn't know that when we were talking on the phone I didn't realize females, yeah, so females get kidney stones females.

Speaker 2:

I do a lot of cancer cause I do a lot of robotic surgery, so do a lot of kidney cancer and you know we do bladder cancer, obviously under the umbrella of urology. Is is the male kind of sexual organs, you know. Test is the male kind of sexual organs, you know testicles and prostates and things like that, whereas females have gynecologists.

Speaker 1:

So overall, you know there's more males than females, but definitely see a lot of females too. Sure, I'm 45, right? So when should men start getting their prostate exam? Because I hear a wide range of. I hear you know 40, 45, I've heard you know later in age now, but what, from from your expertise, what would you say?

Speaker 2:

that, yeah, you actually look at different guidelines and you'll see. But what you said is kind of in the in the ballpark. Okay, I tell most people 50 years old there there are maybe a couple exceptions. There is a higher risk in African American males and so you know, if you are getting routine labs, what I tell. And another risk factor is family history. So if you have some of those risk factors I don't think it hurts. If you're getting labs anyway with a doctor sometime in your mid to late forties to just say, hey, throw a PSA on there. You know that's the. It's called a PSA which stands for prostate specific antigen. It's a screening lab. And I tell them, hey, if you get a check to 45 and it's really low, then don't worry about it and then just start getting kind of annual screening when you're 50. But if you don't have any real risk factors, I think 50 is a good time to start.

Speaker 2:

This is probably a stupid question. Why are so many prostate cancer cases? It's essentially the most common cancer in men. That's a good question. I mean there's a lot of research going on. Obviously, with age it's aging men. Studies on men in like their 80s, like 50% would have some prostate cancer cells. Now, obviously the good majority of them aren't dying of prostate cancer. So that's one of the balancing axes. You know we're not just looking to diagnose prostate cancer. We're looking to diagnose clinically significant prostate cancer that would maybe actually cause that person problems. That's why, if you looked at the screening guidelines, you also don't see them talking about screening people in their 80s, because it's kind of a weird way to look at it.

Speaker 2:

They got competing factors, they got other issues going on at that point. But yeah, I mean, as far as causes, I mean I mentioned the risk factors with African-Americans. One thing that's interesting about that is if you look at Africans, like in Africa, they actually have a relatively low risk of prostate cancer.

Speaker 1:

Is that the diet?

Speaker 2:

But African-Americans? We don't know. But that's what I think. I think it's the Western diet all the processed food.

Speaker 2:

I mean, look at the food and all the ingredients. I mean it's so hard to study. You know, like all these different words, that you can't even pronounce when you look at the ingredients. But you know you got to assume that over time some of them might take its toll. So it's definitely a hot area of research. Every once in a while they'll find something that they think has a link and then, as they do more data, they're like yeah, maybe not, so it's still to be determined.

Speaker 1:

Let's talk about vasectomies, right? So I've got two kids up later in age. I'm scared. Is it that crazy?

Speaker 2:

Well, I sometimes tell patients this I should create a T-shirt that says that wasn't as bad as I thought it was going to be, and give it to people after the vasectomies.

Speaker 1:

Okay, okay.

Speaker 2:

You know, that's usually what they say. Now you know how guys are.

Speaker 2:

They like to milk things and they're going to scare their friends. And then you get it done and they're like yeah, I said I told you it wasn't that bad, you know. But, um, now, why you should get it? I mean, really, at the end of the day, it's it's probably, you know, assuming you're married or in a relationship, it's if, if obviously both of you have made the decision you don't have any more kids. I mean it's, it's kind of a nice thing to do for your wife. I mean it's, you know, it's so much less invasive than to get your, you know, for the females to get their tubes tied.

Speaker 2:

That's like a legit surgery anesthesia um, and you know plus possible side effects from IUDs and and birth control pills. Uh, you know, on the flip side it's a 10 to 15 minute clinic procedure.

Speaker 1:

Is it that fast? Yeah, so are you knocked out for this surgery? Not in general?

Speaker 2:

Yeah, I mean you can be, you know, per request. You know, in my clinic we have something called Pronox, which is this kind of happy gas. Did you say Pronuts?

Speaker 1:

No, I was like. I know he didn't say that I should market that. Yeah, Jesus Christ, we could market it together. Pronox, pronox, okay.

Speaker 2:

It just takes the edge off. It doesn't put you to sleep, but it kind of relaxes you a little bit. And then we use lidocaine. I kind of compare it to getting a cavity filled of cavity filled obviously very different part of your body, but I don't know if you've had a cavity filled but there's kind of that like sting from the lidocaine. You know that gets your attention, but then after that it's like, oh man, I don't even really feel anything. That's, that's crazy. It's the same idea. You got to inject some lidocaine down there and that can sting a little bit, but most of the time after that I got, I got some Pandora music in the background.

Speaker 2:

Give it a go, we're shooting the breeze, and usually they're like well, that's it, we're done. And then you just got to take it easy for a couple days afterwards.

Speaker 1:

Is there a lot of side effects from going? Because, I'm going to be honest, You're scared in that area, right where you think that, just being blunt, I mean you can't get it up anymore period. Does that happen? Do get it up anymore. Period has that happened? Do you see a lot of those percentages of people once they get the vasectomy?

Speaker 2:

that. Hey, they're gonna have problems down the road. That's what I'm scared. Side effects long term yeah, there is like really no chance of getting erectile dysfunction that's what you're working at is is so far away from the nerves that deal with that.

Speaker 1:

Okay, yeah, you know there's that's the horror stories you hear all the time.

Speaker 2:

And even though the testicle is responsible for producing testosterone, it's not going to have any effect on your testosterone. Okay, to be honest, you know, I don't know what kind of words we can use on this podcast.

Speaker 1:

You can use whatever you want. You're ejaculate. Yeah, there you go.

Speaker 2:

That's probably not a word, that's brought up a lot on your podcast Not at all. You won't even really notice a drop-off in your ejaculation. I mean a lot of people they just don't understand. They think that nothing's going to come out after you have a vasectomy and really you won't even notice a difference in the sensation and the erections, except you just won't have any sperm in it.

Speaker 1:

That's clear. Okay, as far as kidney stones, do you have to perform a lot of surgeries on kidney stones, or is that something that just has to pass?

Speaker 2:

You can ask your wife.

Speaker 2:

She works with you, she's in the operating room and I'd say, from a volume standpoint, that's the most common surgery. I mean, there's different types of surgeries depending on the size and location of the stone, but as as far as like percentage of my my surgery cases, I'd say I got, I, I got to assume it's easily kidney stones. Um, so, luckily, the most people, the majority of people, can pass their kidney stones. But there's a lot of people that can't. You know, they don't want to, you know, so we preemptively treat them. So yeah, that's a a very common surgery. We do.

Speaker 1:

Is there anything we can do to make it better for ourselves to not have these problems as far as kidney stones?

Speaker 2:

Absolutely. I mean obviously it can be multifactorial. I mean there's some people that could do everything right and there's some kind of predispositions they have, but absolutely the diet has a huge influence. That's why I'm always going to be in business.

Speaker 1:

Absolutely the diet has a huge influence.

Speaker 2:

That's why I'm always going to be in business. I mean, it's, uh, it's energy drinks, it's processed foods, it's, you know, if you do things that increase your uric acid, like a lot of, a lot of meat, especially red meat, you know just essentially what, what people are eating every day. You know, and especially in Vegas, uh, people, you know it's a desert and so people get dehydrated, and what a lot of people don't understand is a lot of the fluids that they're just in the habit of consuming do not actually hydrate you. In fact, a lot of them dehydrate you. As far as what? Specifically caffeine you know caffeinated fluids is a big one.

Speaker 2:

And then you know a lot of these sodas and other types of drinks. Even if they don't have caffeine, they're kind of a wash. They don't necessarily hydrate you, even if they don't necessarily dehydrate you, but caffeine definitely acts like a diuretic. You know people think like, well, I'm peeing more, that means I must be really well hydrated. But really it's, it's fluids not going into your body the way it should. It's just coming on out.

Speaker 2:

Um, you know, so you get people that drink coffee in the morning and then they have a diet Coke with lunch and then they have a, you know a Red Bull to get them through the afternoon, and then they think they're drinking a lot of water, but then they look back and they're like, huh, you know, I, I really, you know I still have that same Stanley that's. They've been there all day and you know it's only been. You know, one third of it's gone. So so that's that, you know. Number one my patients always ask if it's their first time.

Speaker 2:

Stone, you know, I, I harp on. You know, cut back on stuff that dehydrates you, or if you really really want that diet coke, you got to just realize, okay, I got to drink even more water to kind of counteract the effects of it. Um, and then you know it's. You know other just general health things, trying to eat relatively clean and avoid things that are high in sodium. A lot of people hear stones are made of calcium so they think they got to cut back on milk and cheese, but that's actually hasn't really been proven to have that it's more sodium.

Speaker 2:

So that's more processed food, packaged food.

Speaker 1:

Salt and crap. Yeah, it adds up.

Speaker 2:

Sometimes I feel hypocritical, you know, because I could do better.

Speaker 1:

Yeah, so I feel like I'm beating a dead horse with this prostate, right, but porn is big right. Do you have to deal with a lot of that where you know you're seeing that porn specifically is having an impact on men in general as far as with their prostate and things along those lines?

Speaker 2:

That was an interesting transition.

Speaker 1:

Yeah, I know, set you up the prostate to the porn. Set you up Just the classic prostate porn transition.

Speaker 2:

Well, that's interesting. You say that I think it can have. Well, I mean, listen, I'm a religious guy. I think it can have a lot of effects emotionally and with relationships and stuff like that. But it can have some physical effects as well, you know, as far as performance, as far as erectile dysfunction. You know it's, it's interesting. So I had this patient that came in not too long ago and I don't know it's, it's, I don't know if it's said from the note from the primary care doctor or if it was just on the chief complaint, but it was, you know, something to the effect of like difficulty ejaculating or not having much ejaculation come out. And I was with my partner, craig Hunter, who's another urologist, good friend of mine, that we share a clinic together, and you know I'm like man, what do you do with these guys? Because it's not like I can give them like a medication.

Speaker 1:

Sure yeah.

Speaker 2:

There's not a procedure and so he's like well, I ask him, you knowate, and that's maybe more correlated with porn than the prostate. So I'm making that connection.

Speaker 1:

And that's what I was getting at too, for sure.

Speaker 2:

Maybe not even masturbating. If they ejaculate or masturbate multiple times a month, multiple times a week or multiple times a day, it's a big difference. Yeah, and he's like I can guarantee it's multiple times a day. And so I asked. I worded it the exact same way that he did and sure enough, the guy's like multiple times a day.

Speaker 1:

And he had prostate cancer. No or no, no, no, okay, this was this was, was was just the ejaculator yeah, yeah, like pain with the ejaculation.

Speaker 2:

He's a young guy, sometimes he's having difficulty with erections or difficult with ejaculations, and so, um, I don't know if this is the right way to say, but maybe, but maybe there is too much of a you know, a good thing sometimes you know, so you know. And then another thing with pornography is I think it can have an effect on erectile dysfunction. I'm not a sexual therapist but sometimes, you know, the patients treat us like we are. So they, you know, sometimes open up to us even more than we're trying to get them to.

Speaker 2:

But, but you know a lot of patients, especially if they're younger. So so I think this, this is right in line with what you're saying. I mean, I'm not having a lot of 70, 80 year olds, I think, that are dealing with this, but when I have a, a 30 year old, even a 40 year old, that's talking about erectile dysfunction. That's ridiculous. Or you know, some of these like ejaculatory stuff, I I, if I can get them to be honest with me, you know, one thing I ask them like is, if you were not with your partner, you know, so say they're married.

Speaker 2:

You know a lot of these people are married Are you able to get an erection? And then, if you are with your partner, you're having difficulty. And a lot of times they'll say, yeah, I mean it's, it's difficulty with their partners and I think it's because their mind is so stimulated with this pornography and you know kind of what their expectations are or whatever it is that all of a sudden, when they're, you know, with a partner, you know, especially if they're in a relationship, they have a hard time and that can be very debilitating. So they just want, like Viagra and stuff like that but that's just definitely throwing a bandaid at it.

Speaker 2:

So I think it is definitely a an epidemic.

Speaker 1:

I guess you could say yeah, cause everything's at our fingertips. That's the thing that's so crazy, man, it's way too easy. Yeah, it's crazy. Like I know you have girls also, like I mean, my wife and I we have two boys and we block them from their phones during the week and they are able to start just to get a break. But I feel like, as adults, we probably need to get blocked from our phones you know, during the week it's magazines or the slow dial up internet.

Speaker 2:

Yeah, it's everything, anything you want. It's way too easy. Yeah, I'm. I'm glad I'm not a kid right now. That's some of the temptations and stuff that they have to deal with. It's it's tough, but yeah, I mean I think uh, definitely a lot of these habits, whatever you want to call them addictions, they can definitely start at a young age.

Speaker 2:

So I think you know, having man we're, we're kind of going deep here, but having that relationship with your kids, that you can talk to them and let them know that you love them and that's why you're not letting them have access to some of these things, because you know you start those habits young and you know you see it a lot. And relationships. You know newlyweds and you know they have problems, you know, and so yeah, it's. I think, along with the urology issues involved, it can. It can definitely have a lot of repercussions for sure.

Speaker 1:

Do you find any diet that can help you with any of these things that you know rectal dysfunction, prostate, things like that? Anything that you've seen that's been helpful for me.

Speaker 2:

Yeah, yeah, I mean there's there is some data on that and again kind of similar to the kidney stones. You know eating clean can can help. You know there are certain kind of supplements or foods that can help with maybe helping with your natural testosterone and kind of blood flow and stuff like that. I mean diet and exercise is huge. I mean, just like you hear about people who you know oh man, I lost 40 pounds and I got off my diabetes medications or I got off my blood pressure medications.

Speaker 2:

You know, people don't realize it can have an effect on your GI system. You know how regular are there can definitely have an effect on your urinary system. You know people don't realize it can have an effect on your gi system. You know how regular are there can definitely have an effect on your urinary system. You know urinary symptoms, erections, all that stuff, um, you know, just having a good, healthy diet, exercising, you know, avoiding obesity, avoiding diabetes uh, diabetes can, can wreak a lot of havoc with men's health. Erectile dysfunction, kind of just urinary complaints, it can definitely have an effect, it's crazy how it's all connected.

Speaker 2:

Yeah.

Speaker 1:

Especially stress. I mean you overweight stress and everything kick you behind.

Speaker 2:

Yeah, that's another thing that's crazy. Emotional stress can have an effect on stress. Yeah, that's another thing that's crazy. Emotional stress can have an effect on. I mean, a lot of people, I think have have had that sensation when um they're really anxious about something and you kind of get that like something in the stomach, but you just, you know you lose your appetite and stuff like that.

Speaker 2:

I mean that's kind of crazy. If you think about it like what you know, what does the what does your gut have to do with you being, you know, anxious to go on a podcast or whatever?

Speaker 2:

you know, my gut felt fine, you may just go set me up but uh, but it can also have an effect on on urinary stuff as well, you know. I mean, there's actually a couple actual uh urinary syndromes where people can have really painful, you know, bladder or pelvis area kind of symptoms, and it's crazy it can have a direct correlation with actual distress.

Speaker 1:

That's wild. The human body is the most amazing thing in the world.

Speaker 2:

It's all intertwined, you know.

Speaker 1:

That's amazing, andrew Schultz. I don't know if you know about Andrew Schultz. He just had a Netflix special and he was talking about infertility, which I thought was really interesting that he was open about. And you you would think you know, men, we always blame it on the women, but a lot of the times it's it could be the men, right? Do you have that? That you have to treat a lot of men with infertility challenges? Yeah, I think, I think I didn't realize how you know it's, it's common I didn't realize.

Speaker 2:

It definitely is underdiagnosed. Okay, I agree with you.

Speaker 1:

A lot of people just always assume it's it's the female, and I think and just to cut you off in one second, the reason why brit brought up andrew schultz was because he's popular, right. So he's, he, he's. He's bringing attention on something that I don't think is discussed enough and it caught my attention. I'm like, wow, okay, I didn't even, I didn't't even think that infertility for men was a big thing. So that's the reason why I was asking you about it.

Speaker 2:

Yeah, for sure. I mean, I don't remember the exact data, but I think about one third of the time you know if a couple's having infertility problems. It's a male issue, which I mean. That's significant you know, because I think a lot of people assume it's probably much less than that. Yes, yeah. So I mean I think it's important if you're dealing with infertility. I mean these quote unquote infertility specialists that do IVF. In general, they are under the umbrella of like OBGYN.

Speaker 2:

Like they do an OBGYN residency.

Speaker 2:

So, backtracking, this is probably a review for most people.

Speaker 2:

But you know, you get your undergraduate degree and then you decide to go to medical school, you know, and then it's during your medical school that you decide on what specialty to do, and then you have to do a residency in that specialty, um, so urology is a specialty that you do a residency, and OBGYN is a different one, um, and then you can even go beyond your regular residency training, do fellowship training and you know specific fields within that specialty.

Speaker 2:

So most of these infertility doctors went through an OBGYN residency and then did a fellowship in infertility, and so they spent their whole career dealing with females, and so even when you go see them, a lot of times their focus is on the females and and and so, um, you know they're doing all these tests and some of them are kind of like somewhat invasive tests when, um, I think sometimes the, the men, are just kind of waiting and blaming it on their wives. Yeah, they should get tested too, and and I don't mean to say that there are actually some really good infertility doctors in town that do actually test the men, or at least encourage them to get tested as well. But yeah, they probably should be tested more For sure.

Speaker 1:

Yeah, technology is getting amazing. I can't even imagine where we're going to be 10 or even five years from now, man. So I heard you talk about like robotics right, like you're using a robot when you're doing your surgeries, correct?

Speaker 2:

Yeah, I mean, it depends on the surgery.

Speaker 1:

So how does that work? Is it you're doing? Does the robot doing everything? And you're typing it like how, what does that look like?

Speaker 2:

And I'm probably asking a dumb question I wish and you know it's great. It's a great question because I we throw this term robotic surgery around a lot of times and I sometimes have to like I think it's like an AI.

Speaker 2:

I got to tell the patients like listen, sometimes I don't love that name because you think robotic surgery, you think it's doing the surgery and you know I'm taking a coffee break. But yeah, just on the subject of technology, by the way, shout out to urology. I feel like urology in the last 20, 30 years. The advancements it's made is crazy the stuff that we can do minimally invasive. What's crazy is imagine, like 100 years ago, if you had a kidney stone that was obstructed in your ureter, severe pain, like they don't have ways to do a CT scan to diagnose it, you know they you know if someone needed to get their stone treated.

Speaker 2:

I mean you have to, like I do an open surgery. You'd have to, like make an incision in their abdomen, go in there, figure out what's going on, like make a hole in your ureter. You know, pull out the stone, Like it's. I mean that's a crazy big surgery. And you know, as Daryl or your wife can say, I mean usually these ureteral stones, they probably take me what? 20 minutes.

Speaker 1:

Oh wow, In and out I go in with a scope.

Speaker 2:

I use a laser, break it up, remove it. You know outpatient surgery. And they're done the same day.

Speaker 2:

After a couple days they're back to doing whatever they want to do. So you know we call it minimally invasive surgery, the things that we can do as urologists and a lot of other fields. It's amazing as well, but yeah, so to get back to your question, robotic surgery is a type of laparoscopic surgery. So you know a lot of people have heard that term and you know they always either they've had or know someone that's had their appendix or their gallbladder removed out and they know it's through a few small incisions and so traditional, we call it laparoscopy, laparoscopic surgery. You have these few little keyhole ports and you can put instruments in it. One of them is going to be the camera and traditionally it's usually an assistant that's holding the camera and then you have two arms and all you can do. They're like, you know, either scissors or graspers or something at the end, and all you can do is open and close them and kind of move them up and down like this, um, and that still works, uh, if you're working in a space that doesn't require a lot of intricate suturing or it's not some weird tight space.

Speaker 2:

But robotic surgery really took off with urology because some of the cancers we deal with it's right up that wheelhouse, for instance, prostate cancer, so almost the standard of care. Now you might find an occasional old school urologist, like my partner, joe Candela, that does it open, but in general you do it robotic and it's. It's really nice in the prostate cause. That's deep in the pelvis. You know your pelvis is this. We're seeing anatomy charts, this big bony structure and it's deep in it. If you do traditional laparoscopic surgery you're actually just clinging on those bones.

Speaker 2:

You can't. You can't do it, you don't have much movement. But it allows you work in a tight space and it has joints, and so I'm actually in a console. It's almost like playing a video game. I tell people sometimes like I'm in scrubs.

Speaker 1:

You talk to crystals. There's crystals here, yeah.

Speaker 2:

Well, I mean this new generation of kids. You know they're used to looking at a screen and doing stuff. It's hard actually for people that didn't grow up with video games and TVs and stuff as much to pick up on it, cause they're not used to looking at a screen and being able to to like conceptualize that they're working on it. But I have this console that allows me to see what's in the body with the camera, like 3d, and then I actually have, you know, the ability to have a few different arms so I can retract with one and I and I'm doing it the same motion like I'm using my hands. So if I'm in the pelvis and I'm sewing something, I'm doing like this, but I'm using the joints on this instrument and you know I can retract with one arm and then I can. I have gear like clutches so I can move my camera around, I can clutch to this arm and then if I need to adjust my retraction I can clutch back to this arm.

Speaker 2:

And then I do a lot of kidney surgeries, for kidney cancer as well. One of them is a partial nephrectomy. Nephrectomy means removal of a kidney. Partial means you're not removing the whole kidney, you're just removing the tumor and there's a lot of sewing. As you can imagine. If you're putting a hole in the kidney you got to do a lot of sewing to sew it back up and sew it well. And if you were to do traditional laparoscopic surgery, like kudos to the guys that could sew well with it but it was cumbersome as heck Like to just be able to, like you know, do this and and, but here, like I'm able to do all this sewing and it's, it's, it's, it's cool technology.

Speaker 2:

And now you see it, like you know, urology really is the first field that really took off with it. And then gynecologists because they're the same thing with the pelvis, doing like hysterectomies, but now I mean, they're doing brain surgery. Orthopedics are using it Like it's just because of how delicate and fine the movements are. It's really taken off.

Speaker 1:

That's amazing as far as you know. Just advice, right in general, just business advice and even education advice. Maybe they want to do an internship is one way to be able to do it. That's something I did at Tufts Medical in Boston is took a three-year internship to really see if I wanted to get in medical. But what would you recommend for somebody that maybe they want to get into the field, because's a side of of being in medicine where it's a business too right If you have a small practice and things along those lines. But what would you recommend to them as far as business or school?

Speaker 2:

I definitely think exposure is good.

Speaker 1:

I mean, it sounds like you were interested in it and maybe the exposure kind of showed you that, yeah, you know, maybe this isn't for me, you know, and that's good that you figured that out early.

Speaker 2:

So I think exposure and you know, so we use the term shadowing, or you know for me, uh, so I, I did not come from a medical family. I was not exposed to it much. It wasn't until I met and fell in love with my beautiful wife. Shout out, casey, um, that she, she, has a medical family, okay, um, and she was a nurse, so she was actually my sugar mama for many years.

Speaker 1:

There you go. It's not like me.

Speaker 2:

Undergrad and medical school and stuff. She's, you know, an RN and her dad was a family practice doctor. You know her sister's an RN, Another one is occupational therapist. Her brothers at that time. One was like a surgical sales rep, One was a pharmacy rep, so they're all doing something medical, where my family is like just a bunch of teachers.

Speaker 2:

But I was interested by it and kind of started down that pathway and her dad was a good mentor because you know he's a doctor and I had a lot of friends whose dads were doctors so I kind of talked to them. But I think what you said is huge, getting some exposure with it. So when I first started thinking about it, I actually got a job and this is while I was an undergrad at BYU as a pediatric CNA, a home health aide, oh wow.

Speaker 2:

So I went around and worked with these kids that had like muscular dystrophy and cerebral palsy, and I wasn't even doing like hardcore medical stuff. I was like getting them ready for school and like putting them in their wheelchair, but just being around patients, being around families, learning about the diseases, getting the satisfaction of helping them. And, as I told you before I, I went to medical school thinking I wanted to be a pediatrician because of that, you know, and obviously I changed my mind along the way, but at least I'd kind of been around health care. I even worked in like a nursing home for a while my wife was like my boss.

Speaker 2:

She was the nurse and I was the lowly you know CNA. She was tough, she ordered me around but just to have that exposure, but yeah, it's a tough road, it is Very much so realized how big of a road it was. Like if I had to go back and start over, I'm like I don't know if I could do this again. You know, luckily I was kind of naive, you know, um, but uh, I uh, you know, I served a church mission in Taiwan so I learned Mandarin Chinese. So I came back from my mission thinking like maybe I'll do something with business, took, you know, business classes economy many I guess you could say I'm fluent.

Speaker 2:

I mean that was also 20, 25 years ago so it's, it's choppy.

Speaker 2:

Now I kind of have to be leading the conversation, but you know that's amazing. Um, but uh, um, and, and you know what, actually those classes came relatively easy. I was doing well and I was getting a's, and then um, but I, just for me, whatever, whatever, I wasn't feeling stimulated or satisfied by it and I I was kind of guided into to try and medicine. So then I started taking the pre-med classes. I was humbling. Those were not easy, you know, and and some of them they make them tough. I mean, they're trying to to weed you out, you know. And uh, um, all of a sudden you know it's cutthroat and, like you know, the, the average in the class is a B minus. No one wants to like.

Speaker 1:

Oh wow. So you know, like it was just tough and you know, but persevered.

Speaker 2:

But every step of it's tough I mean it's competitive to get into med school so you got to really want it, you know, be dedicated and, um, I was really blessed to be able to get in probably my first choice, which was university of Utah, which, even though I'm not a Ute fan, you know it was in state and it was close by and it was a great program, um and uh and you know, but that was stressful.

Speaker 2:

You know, I had a lot of that gut discomfort that we're talking about as I was going through that process. Yeah, um, you know. And then, uh, yeah, medical school is a grind. But, man, once you get into med school it's a little different. You're kind of you're, you know you're going to be a doctor there.

Speaker 2:

It's kind of like you put a lot of time down competitive and a lot of people won't know this, but urology is actually a really competitive field. You know, it's a surgery field. It's got a better lifestyle, things like that, and so I had to like do well on my tests and I had to go. You just got to put yourself out there yeah, I mean, you, just I mean it's kind of like that.

Speaker 2:

I mean, if you want to be a, an athlete, you got to be putting in more time than the person next to you. And that's kind of how I felt. I'm like, you know, I wasn't the smartest person in my class, you know. So I'm like I'm going to go do some away rotations. I went to these programs in Texas and Illinois and I'm like I'm going to get there before everybody else. I'm going to, you know, whatever, and I'm just going to like, treat everything like it's a job interview and you know, get letters from these department chairs.

Speaker 2:

And you know, I wasn't sure I was going to get into BYU, but I grinded, I did. I wasn't sure I was going to get into medical school, but I grinded, I did. I definitely was, you know, never comfortable that I was going to, for sure, get a urology residency, but yeah, it worked out for me. But you definitely you got to be committed. But yeah, get that exposure and you know, but it helps if you're smart and a good test taker, but you know, you can. You know, just kind of like you see these athletes that you know they might not be as natural but they can grind. I feel like I was a grinder and got into ohio state, the ohio state university, and that's where I did my residency and it happened to be kind of a robotic surgery mecca. So we did a lot of Ohio.

Speaker 2:

State, yeah, okay and so, yeah, some of the most high volume big names, uh, you know, were faculty there at a in robotic surgery there, awesome, um and so things. Yeah, things worked out for me, but yeah, that was kind of a long answer yeah, but I get it though.

Speaker 1:

Yeah, but if you want it you know I'd encourage.

Speaker 2:

I mean, it's great to have a career that is stimulating. It's tough, you know, I was on call, you know, this last weekend and, um, I had to go do a couple surgeries at UMC in the middle of the night, uh, sunday night, and so I didn't wait. I was awake at 1am and then I had to go straight to clinic and I was all day in clinic and yeah.

Speaker 2:

So I mean, you know, and this is one of the easier surgery fields as far as, uh, you know, call and lifestyle schedule. So you know it's definitely not easy but it's nice to to have a career where you feel like you're hopefully helping people and, you know, still getting compensated, okay, and you know and um, but yeah, that's awesome, man, you just got to like.

Speaker 1:

You Keep it going.

Speaker 2:

I can tell you're a grinder, you know.

Speaker 1:

You have to be man. You're one of the most successful podcasts in Las Vegas.

Speaker 2:

Thank you, and I'm sure it's, because a lot of times you outwork the other people. It's consistent.

Speaker 1:

It doesn't help that you have that silky smooth voice. Oh, I appreciate it. No, that's good man. You brought up a lot of great points, man. As far as like, maybe if you rethought about it and restructured your life, maybe you wouldn't do it. But the thing is, you persevered and that's what I got out of, that is, outworking everybody.

Speaker 2:

I'm happy I did it.

Speaker 1:

I'm just saying it's a long road, we are kind of imagined.

Speaker 2:

I mean, look at it this way Four years of undergrad, four years of medical school, five years. The residencies they change, they're usually anywhere from three to five. Some are even six years if you do some research and stuff.

Speaker 1:

Plus, I did a two-year church mission, so you added on to that, so you're like 15, 16 years.

Speaker 2:

I was almost into my mid-30s before I was making money. That's why it's lucky I had a sugar mama. Like me and the nurse and you guys have four kids right, it's a long road I had friends that were buying houses and doing all these stuff and had their businesses and I'm still racking up debt. That's amazing.

Speaker 1:

We got four daughters. I did want to ask you about just a little bit of just one question about family what is it like being a girl dad, man, because you have four girls, right. What's your household like dealing with basically five, including your wife?

Speaker 2:

It's man. I don't always understand the drama. I'll tell you that.

Speaker 1:

Chris, if he was here, he'd be able to speak.

Speaker 2:

He has three girls, so you know sometimes they'll cry on the first day of school, They'll cry on the last day of school. Like I'm like I don't get it. Yeah, you know sometimes what's their ages, they're all about three years apart Right now. I got one in elementary school, roxy, who's nine. I got one in middle school, who just got the principal award of the year. Congratulations.

Speaker 2:

Shout out Kate, and then she's 13. I got one that just turned 16. Oh wow, nora. She's at Palo Verde High School Miss Extracurricular. Everything just broke up with her boyfriend and realizing that single life sometimes has more drama than being in a relationship. And then my oldest, lucy. She's 18 and she's actually in cosmetology school up in Utah.

Speaker 1:

We got them in all levels. So you're busy life here. You got a busy life for sure.

Speaker 2:

Yeah, cute girls. Though it's fun, I finally had to go buy two male dogs just so I had some Just to keep the energy right. So my wife went and got them castrated, so I guess they're kind of males, but yeah, that's hilarious.

Speaker 1:

I got Snoop and Biggie. That's hilarious.

Speaker 2:

That's really their name Snoop and Biggie.

Speaker 1:

Oh, that's hilarious. Just changing the subject for a little bit, man. We always ask guests about food, man, so I'm a big foodie. But what's your favorite restaurant in Vegas?

Speaker 2:

Ooh, my favorite restaurant in Vegas. Maybe some recency buys, but I really like Lotus of Siam.

Speaker 1:

Oh, we've had Penny on, so we know that we live right close to Red Rock and there's a lot of good restaurants in there.

Speaker 2:

We're spoiled. We are Shout out to Lou, we to Red Rock, and you know there's a lot of good restaurants in there.

Speaker 1:

Man, we're spoiled we are shout out to Lou. We know Lou and we know Penny.

Speaker 2:

That's crazy, yeah but um, uh, the Aria does a good. I like probably two. Two of my top five is Javier's the.

Speaker 1:

Mexican restaurant. We were just there. Yeah, actually us and Chris and his wife.

Speaker 2:

We always go to Newport every year, so we always go to the, the one there too. And then uh, din Taiung, which is actually from Taiwanese food. So it's a Taiwanese—if you haven't been to.

Speaker 1:

Din Tai Fung— I don't think we've been there before.

Speaker 2:

Oh Okay, I was going to say I haven't been there before. Oh, it's actually, I think, originally based in Taipei, taiwan. Okay, and it does—it's probably of Taiwanese tasting places, but it's kind of weird. You wouldn't think like a restaurant that just specializes in dumplings would be that good, but it's good stuff. It's great for like family style dining they just bring out all these different types of dumplings and stuff. We always like trying different restaurants.

Speaker 1:

So if you haven't been there, I strongly recommend it. So you mentioned Lotus of Siam Javier's and Dim Tai Fung Yep Javier's and Dim Ty Fung Yep. Okay, Excellent man. What would you want to leave us out on? Any question I forgot to ask you that you want to leave us out on? I know we went on a wild goose chase with different rabbit holes.

Speaker 2:

Yeah, I'm just trying to think of men's health. I mean, a lot of people are interested in low testosterone. You know, we didn't really jump into that Touch on that.

Speaker 2:

Yeah, I, I will say this. This is, this will be my. My one piece of advice with testosterone is I think a lot of people like the idea of being on testosterone and wanting to have more testosterone, but my advice is you know, do whatever you can, naturally, you know, eat right, exercise, um, you know, and you know you know, there's natural ways, you know, to boost your testosterone. I've seen a lot of people that for, however, they're able to get their hands on actual prescriptions for testosterone and the thing they don't realize is, after a while, if you're taking testosterone, your own factory is shut down. They're saying, well, I don't need to make it, I'm getting it so kind of like a lot of muscles or whatever, if you're not using it, they're going to atrophy your factories that produce testosterone.

Speaker 2:

they're not going to work as well. So you get these guys in their 20s and 30s that just want to bulk up for the ladies a little bit.

Speaker 2:

I don't know if they're convincing some new male medical clinic or something, or Tijuana, I don't know but they're getting their testosterone and it can have lasting repercussions. For one thing, you're essentially committing to it. If you're on it for long enough because you try to get off of it, your numbers are going to get really low and you're really going to have symptoms when at the end of the day, they probably never. Well, I shouldn't say probably. They didn't need it to begin with, but it can cause problems with infertility and other things. So I guess it's just a warning like, hey, some people need it, Some people benefit it, but if you're getting it, make sure you're getting it appropriately, Make sure you're trying everything natural first. Uh, you know, before you kind of commit down that pathway, you only got one body man yeah for sure.

Speaker 1:

Well, it's a pleasure to sit down with you, man, and learn just some of the perspectives and how your mind works. Man Urology I didn't realize how many pieces to urology. It's massive.

Speaker 2:

It's a good field. Yeah, I'm happy.

Speaker 1:

I'm going to have to talk my older son into that because he's big video game and probably be able to be an excellent urologist with robots and everything. So, um, what's, what's your social handles if people can reach out to you on there or be able to check you out?

Speaker 2:

I think it's dr dave loves golf okay, is it really okay? You're a golfer, okay, well actually I think that's tiktok my daughter, my, my 13 year old manages my, manages my TikTok account. I love golf, oh good stuff she goes with me on a golf trip doing something Awesome. But yeah, I think it's Ezio Ludlow. So my last name L-U-D-L-O-W. My high school nickname was Ezio Ludlow. So, Ezio Ludlow is, I think, instagram Okay and yeah, happy to have people reach out. I've had patients somehow reach out to me, sometimes through social media.

Speaker 1:

They probably see you more. You'd be surprised how many people can connect with you on social media. It's amazing.

Speaker 2:

Yeah, but we're Las Vegas Urology and, yeah, we have a clinic, just me and my good friend Craig Hunter, and we have nurse practitioner Jonathan Higginson and we're just over there by Mountain View Hospital.

Speaker 1:

Awesome. Yeah Well, absolute pleasure to sit down with you, dr Lolo. It's a pleasure, learned a lot and check us out at thevegasurgerycom.

Speaker 2:

So appreciate your time, man. That was great. Yeah, no thanks for having me.