Caveat: I’m not a doctor, and I don’t even play one on TV. This is all my opinion.

When that phone rang one dreary gray morning back in 2001, and it was my urologist calling with test results, I fully expected to be exonerated once again from a medical malady, as I’d always slipped by before, no matter what the test, usually with passing grades and a smile.

Not this time. The news as cloudy as the weather, the apologetic voice said that the biopsy results were positive for prostate cancer, and we needed to make an appointment to discuss what to do next.

I was in shock. Only 46 that year, my lucky personal experience with disease was limited to increasingly infrequent colds and flus, a broken collarbone at 6, and a nasty bout with Hep A. For me, the gold standard around which all health issues revolved was the yearly HIV test, and as long as I could keep passing that, nothing else would even come close.

As I did my research and discussed the options with the doctors, the more it occurred to me that prostate cancer (PC) was a numbers game. There was a number for the PSA (prostate specific antigen), a blood test you take, which when elevated, can be an indicator of PC. There was your age, also a number, a higher number (say, 75 vs. 46) being indicative of both the kind of treatment that would be recommended and the likelihood of surviving PC and dying of something else. Finally, there was the Gleason score, which was a numbering system indicating the aggressiveness of the cancer cells, a higher number being worse than a lower number.

John Fitzgerald Kennedy said, "Physical fitness is not only one of the most important keys to a healthy body, it is the basis of dynamic and creative intellectual activity."  Though not Jack's most eloquent moment (perhaps he had Marilyn or missiles on the brain), I know exactly what he means.  After I modeled for the new Daddyhunt campaign, they asked me if I would be interested in writing a health and fitness blog.  I accepted with a self-imposed mandate to approach writing about fitness in a JFK-approved fashion:  from a cerebral and not a body-centric perspective, from a scientific and not superficial one.  Thinking such a task might prove painless at worst (I have countless bylines in all of the major fitness publications) I set to reviewing the blog entries and member comments that had come before me, and discovered painless it was not.

Hey Guys

Every year in April, we recognize STD awareness month. In San Francisco we hold community screenings as well as do local presentations on the prevention and treatment of STDs. But as we wrap up the month, I want to remind you guys that STD awareness should be a part of routine sexual health year round. So here are some thoughts and tips on STDs that I find useful.

STDs: The gifts that keep on giving.

Make sure you don’t get a one gift that you can’t casually get rid of as the months change. Sexually Transmitted Diseases (STDs) are on the increase. So, when you are thinking about keeping yourself and your partner safe always remember to include BOTH HIV and STD in your thoughts.

Some common STD’s  include: Chancroid, Chlamydia, Cytomegalovirus (CMV), Genital Warts, Gonorrhea, Hepatitis, Herpes, HIV, Human Papilloma Virus (HPV), Syphilis, Molluscum Contagiosum, Pelvic Inflammatory Disease, Pubic Lice, Scabies, Trichomoniasis, Urinary Tract Infections.

STD WATCH!
Signs to look out for:

Dear Kirk,

Years ago I suffered from a extremely severe hereditary case of acne (almost all my family members have suffered it). Fortunately and after many years I took control of this but still have terrible scars on part of my back and chest and ironically not on my face. In order to boost up my confidence I started to work out, now I'm athletic and in excellent shape but I've grown very conscious of these scars. I'm very clean and always groomed and have an excellent appearance till I have to take my shirt off and show my scars. What I usually do when I hook up is just turn off the lights but there are cases where this is impossible. And sometimes I have to give explanations of why I have these scars. I've been celibate the past few months because I feel embarrassed about this.

I'm sorry you had acne – it can really do a number on your self-image. I had it all over my back as a teenager and felt like a total leper.

There are plenty of guys who think scars are sexy. Acne is one of those experiences that many of us have endured, or at least we had friends in high school who went through it. So I'm sure lots of guys understand. When you have sex with guys with scars from burns or surgeries or self-inflicted wounds, it's difficult sometimes to know what to do. Do you risk making your partner self-conscious by asking him to tell you the story of that part of his body? Do you ignore it? I find myself intrigued, even turned on, by scars.

Aside from my years of involvement with weight training and other fitness activities, I have been practicing meditation in one form or another for over 40 years. Although meditation techniques and the philosophies that underlie them may differ greatly, meditation in general involves quieting the body and mind to achieve a state of peaceful alertness in which one can experience deep insight into the nature of self and the universe. However, the peace, clarity, and sense of meaningfulness of life that come with regular practice of silent meditation can seem to evaporate as soon as you open your eyes and enter the workaday world.

When I started teaching public high school back in 1984, I also started exploring ways to carry the benefits of silent meditation into my work life that often seemed stressful and hostile to serenity.

Two ancient traditions that in general have regarded meditation as an important spiritual practice for millennia are Hinduism and Buddhism. Both traditions offer us various models for bringing greater serenity and centeredness into daily activities. You need not subscribe to any dogma or belief system to benefit from some of these techniques. You need only possess an open mind and the willingness to use your own body and mind as laboratories for experimentation and discovery.

Every so often I think about sexual health and how, as gay men, we have become so focused on STDs that we forget that as we age other things happen to our bodies, and specifically our dicks, unrelated to STDs.

A few that I’ve spent some time looking into recently are Peyronie's disease and Priapism, both of which affect our dicks and can be a rather uncomfortable and perhaps embarrassing conditions. Yet I rarely hear about them, so until I started reading up on it at the request of a pal I was pretty much in the dark as well.

Since I’m not a medically trained professional, I certainly can’t diagnose and these are just my personal thoughts  but I figured I’d share some highlights that I found and a few links to that I thought useful.

Peyronie's disease

Peyronie's is essentially a tissue condition that involves an abnormal curve upwards in the penis. Now, before you all start looking at your dicks, many of us have some slight curve in one direction or the other as a normal condition. What is distinguishing for Peyronie’s is that it can cause pain, and an extreme abnormal curve when erect. In some cases a shortening of the length can occur. During the early stages of Peyronie's, pain is often reported, some erectile dysfunction can occur as well. For most men, the ability to have sex can be maintained with Peyronie's.

Unfortunately, not a lot is known about its causes, but it seems to occur after an injury to the penis, often times during sexual intercourse…ouch!.. and many of us know that rare time when during insertion, we aim wrong or bang-n-bend ourselves when a particularly aggressive man is bouncing on our dick.

As for treatment, some medications have been studied with various results as well as a surgery option for extreme cases.

It doesn't require too much imagination to think of situations where greater flexibility would confer a great advantage. (I'm thinking of myself on my back with my feet next to my ears, for example…) Men often avoid flexibility training either because they hold the ridiculous notion that it is just for women (Remember Jane Fonda in tights?) or that it is just not as sexy as pumping iron or sweating on a treadmill. Stretching does involve a certain degree of sustained discomfort, however slight, and without the sex appeal of cardio and weight training flexibility training is all too easily skipped over.

This is unfortunate because one cannot claim to have a complete fitness program without doing some flexibility training. This kind of training is important for everyone to speed recovery from other forms of exercise, reduce the duration and severity of delayed onset muscle soreness (DOMS), and improve your versatility in a variety of situations. It becomes especially important as our bodies age because greater flexibility means less likelihood of injury in even normal, everyday activities.

We used to think that stretching should be done before weight training as part of a warm-up routine. However, research has shown that deep stretching of muscles actually reduces their ability to contract strongly, and this effect is definitely not desirable when you are trying to build some lean tissue.

Winter holidays invite us to gather with friends and family for unusually sumptuous meals. Even strict dieters can and should take holidays from eating "clean," bodybuilder lingo for maintaining a relatively low-fat, controlled-carbohydrate, nutritious diet. Some foods are good for your body, but some holiday foods are especially good for the soul. A single meal or day of meals alone need not derail a fitness program as long as you don’t let overindulgence become your regular dietary style after the holidays.

Mature men tend to put on more body fat more quickly than younger men, so overindulgence can produce undesired effects more quickly than when we were younger. The main two reasons are lower levels of activity and of testosterone. Assuming you don’t have a physical ailment or disability that prevents you from vigorous exercise, your activity level is largely a choice.

Some people "pay" for their overindulgence by feeling guilty. This can be an insidious, unconscious way to avoid doing anything really effective about getting back in shape. The unconscious dialogue goes like this: "If I feel guilty enough, I don't have to think about a diet or exercise."  Ditch the guilt and just return to healthier habits.

Editor's note:  Frank got such a great response to his post on STDs that we decdided to let him answer one of the key questions people asked in a new post.

A reader asked me about syphilis. It appears he is having a debate with a couple of people about it and is hoping I can settle it for them.

One person thinks that if they catch it early, then only one penicillin shot is what is needed. Another says that it doesn't really matter WHEN you catch it. You should get all three, especially because there is no way of knowing WHEN you actually got it.
This is a great question actually, especially with syphilis rates increasing in many major cities in the United States.

The reader hit on a complicated and confusing area of syphilis.

According to Dr. Jeff Klausner, who heads up the San Francisco DPH - STD section, you are both in the right area, but here is the simple explanation.

If someone finds out they have an early case of syphilis, then the treatment is one dose of medicine given by two injections in the butt (one in each cheek).

If they are unable to tell if it is an early case, then the recommended treatment is 3 doses of medicine given out over three weeks.

This is why it is pretty important that sexually active gay men, have a routine syphilis test every 3 – 6 months. It can help catch the infection early and reduce the treatment discomfort as well as reduce the chances of infecting anyone else.

It is one of the reasons San Francisco launched www.STDtest.org to make it easy for gay and bisexual men get tested in an easy, confidential and accessible process. Check in your city to see if there is a similar program.

Hope this clears things up.

Frank

We used to think it was enough to spend some time on a treadmill or something similar to keep fit. But cardio-vascular exercise alone will not preserve bone density and muscle mass. As time passes without adequate stimulation, aging bodies lose both, and these changes can result in falls, broken bones, back injuries, and decreased resistance to disease in our golden years.

Cardio is important, no doubt, but to achieve total fitness we need to lift some weights one way or another. There is an old mistaken notion that men with well-developed muscles will have all that “turn to fat” if they don’t' keep lifting. Muscles will atrophy if they are not regularly and sufficiently stimulated, and men who eat more calories than they burn will store the excess as fat. But if you have ever built muscle at any time in your life, the foundation will remain, and rebuilding will be easier through a process known as “muscle memory” than for those who never lifted a finger.

Whether you are new to weight training or returning from a break in training, it is wise to start out your weight-training program slowly and carefully, allowing plenty of time for your body to adjust to the new level of exercise. Before you lift anything heavier than your gym bag, however, you should start out with five-to-ten minutes of a warm-up exercise such as a treadmill, elliptical trainer, or stationary bike. The idea here is simply to get blood flowing, warm up stiff muscles, and break a sweat. We used to think that stretching before lifting was a good idea, but we now know that stretching is best done between lifts and after training. Done before lifting, stretching can actually decrease muscle strength.