The Armor Men's Health Show
The Armor Men’s Health Show is what happens when a board-certified urologist and a stand-up comedian walk into a studio… and actually help people.
Hosted by Dr. Sandeep Mistry, founder of Urology Specialists of Austin, and professional, touring standup comedian, Donna Lee, this weekly podcast tackles the medical topics men care about… but don’t always want to Google in public.
We talk about all things men's wellness including the big stuff:
Erectile dysfunction.
Prostate cancer.
Low testosterone.
Enlarged prostate.
Fertility.
Kidney stones.
Vasectomies.
Yes. We go there. Boldly.
Dr. Mistry brings the medical expertise. Donna Lee brings the questions you’re slightly embarrassed to ask. Together, they make men’s health informative, approachable and occasionally hilarious. But it’s not just about anatomy — The Armor Men’s Health Show takes a holistic approach to wellness, covering nutrition, weight loss, sleep, sex therapy, pelvic floor physical therapy, and how all of it connects to living better (and longer). Also featured are top physicians and specialists from around Austin — from cardiology to endocrinology to orthopedics — because men’s health isn’t one-size-fits-all. If you like your medical advice credible, practical, and sprinkled with comedy, this is your show. Because taking care of yourself shouldn’t feel awkward. Unless we’re talking about a crooked body part. Then it’s a little awkward...but they can fix that.
The Armor Men's Health Show
Make Your Prescriptions Work For You: Why Dr. Mistry Loves Compounding Pharmacies like Nucara Pharmacy
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Thanks for tuning in to the Armor Men’s Health Hour Podcast today, where we bring you the latest and greatest in urology care and the best urology humor out there.
In this segment, Dr. Mistry and Donna Lee are joined by Pharmacists David Faulkner and Aleem Khan of Nucara Pharmacy in Austin, Texas. One of the main services offered at Nucara is prescription compounding, a process that customizes prescription medication to patients' needs. This may involve altering the amounts of different medications present within a mixture, or removing certain additive elements like dyes or oils to which the patient might be allergic. Commercial pharmacies aren't able to offer adjustments like these to the prescriptions they fill, so patients might not be aware that customization is an option. If you or someone you love is interested in learning more about making their prescriptions work better for them, please give us a call today or visit www.nucara.com/austin.
This episode originally aired on 9.18.21. Don’t forget to like, subscribe, and share us with a friend! As always, be well!
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Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.
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Welcome back to the Armor Men's Health Hour with Dr. Mistry and Donna Lee .
Dr. Mistry: Hello and welcome to the Armor Men's Health Hour. I'm Dr. Mistry, your host, here as always with my incredibly helpful, very wildly popular...what's your name again? Donna Lee , my co-host.
Donna Lee: That's right. It's Donna Lee and I am more popular than you are, especially when it comes to things about the radio show .
Dr. Mistry: It's my jealousy...
Donna Lee: It should be.
Dr. Mistry: ...when they call for Dr. Donna. You know, a few weeks ago, we had a patient who called herself Dr. Donna Lee.
Donna Lee: And she was a doctor.
Dr. Mistry: And her name was Donna Lee.
Donna Lee: Yeah. I felt kind of slighted, but I'm still Dr. Donna Lee in the world of radio.
Dr. Mistry: Welcome to our show. This is brought to you by the urology practice that I started in 2007, NAU Urology Specialists. We specialize in kind of a holistic brand of urologic care. What that means is we look at the whole body, not just your body from the nipples to the knees.
Donna Lee: That's right. Head to toe.
Dr. Mistry: You have a face? Holy cow!
Donna Lee: What is that?
Dr. Mistry: My god.
Donna Lee: You've got a pretty mouth.
Dr. Mistry: That's, that's right. If your urologist doesn't recognize you with your pants on, you should come and see us for a second opinion.
Donna Lee: Good point.
Dr. Mistry: Donna, how do people get ahold of us and how do people become patients of ours?
Donna Lee: That's right, you can call us at (512) 238-0762. Our email address is armormenshealth@gmail.com and our website where you can see our shiny pretty faces is armormenshealth.com. Check out our podcasts wherever you listen to free podcasts , because we are amazing and award winning.
Dr. Mistry: So one of the interesting things about medicine is that we prescribe medicine.
Donna Lee: What? Fun medicine, sometimes. Party on a Friday.
Dr. Mistry: And so early in the practice, when we were learning about how to treat advanced sexual problems, especially in women, we learned that there were no medicines that you could get for a woman that were like widely available. You couldn't get creams, you couldn't get testosterone creams, you couldn't get, we did a lot of re-formulized drug called Yohimbine to help with orgasmic response. And you don't just pick that up at Walgreens . And so we had to develop partnerships with local compounding pharmacies, and one of the earliest compounding pharmacies that we developed a relationship was Nucara. So we thought we'd have him on the show and talk about compounding. So we've got two wonderful guests today. We've got David Faulkner, he's the director of the pharmacy and , Aleem Khan . He's the pharmacist in charge.
Donna Lee: That's right. They're called pics--pharmacists in charge. Welcome guys.
David Faulkner: Thank you so much for having us.
Dr. Mistry: So David , give us a little background on Nucara.
David Faulkner: Yeah. So new Cora is based out in Iowa. It's only satellite location in Texas is here in Austin. It's been here since 1999. It used to be over right by MoPac. Now it stands at 6111 Burnet Road, basically 2222 and Burnet. And we do a sterile, non-sterile compounding as well as some infusion and have just a few doors down our own infusion center as well, so.
Dr. Mistry: That's really neat. A lot of people might not know what compounding is about, so Aleem, why don't you tell me what does a compounding pharmacy do differently than say your local CVS or Eckerd's? Eckerd's? You're old. Hi 1984.
Aleem Khan: We're going old school. Yeah , no great question. You know, what is compounding? It's this classic science. You know, you think apothecaries and chemists and, you know, black and white pages in a book back when, where you see these formulations and, you know, they kind of read like recipes and such. Well , it's advanced a lot since those days now where essentially it's one where you're customizing a therapy. It might be something that is a manufactured product and now you're trying to customize it to meet the needs of either the prescriber or the patient. So that can essentially change the format of something, change certain concentrations. It's an art and science, but now there's a certain standard and quality that we need to kind of guarantee because at the end of the day you want that safety and efficacy. You're not just kind of experimenting.
Donna Lee: And not everybody needs 5, 10 or 15 milligrams of something. Righy?
Aleem Khan: Yeah. Exactly.
Dr. Mistry: And something interesting is I think for most of our listeners, if you learned what a pharmacist does, like in a big box pharmacy, a lot of it is like regulatory and making sure people counted, right. And then counseling patients. But really the science of like formulating therapeutic options is really in the compounding arena. One of my favorite drugs to compound is the "Mistry party pill."
David Faulkner: Tell us more.
Donna Lee: Tell him more.
Dr. Mistry: It's got, it's got a little bit of Paxil and a little bit of Sildenafil. It keeps the party going longer because the Paxil helps you with premature ejaculation, and the Sildenafil helps you with the erection. Can
Donna Lee: Can we add some Xanax to that?
Dr. Mistry: It would be like the anti Donna pill .
Donna Lee: Yes, please. Keep that away from my husband.
Dr. Mistry: Donna wants it, Donna wants it done quicker.
David Faulkner: We might know a pharmacy that can make such a thing.
Dr. Mistry: Well there you go. So for you guys, when it comes to urology, what would you say some of the most common urologic compounding things that you guys offer ?
David Faulkner: Certainly. Trimix for sure. Trimix being an erectile dysfunction med that's...
Dr. Mistry: And we've talked about Trimix on the show before. Trimix that liquid that you will inject into your penis if you have erectile dysfunction. It gives you an amazing erection.
David Faulkner: It does.
Dr. Mistry: It's not for everyone.
David Faulkner: I hear.
Dr. Mistry: Allegedly, allegedly. It's not for everyone, but in our, in our treatment paradigm, when somebody fails shockwave therapy, when somebody fails oral agent therapy, or if they can't tolerate oral agent therapy, like because of flushing or things of that nature, then Trimix becomes one of the next stages. We do Trimix trials and everything here. And when you need to get the medicine that, that medicine is offered here locally. And, and it's not just one formulation, right? I mean, Trimix is something different.
David Faulkner: Yeah, as the name suggests the Trimix, there's three active ingredients in it. And those three active ingredients can be moved up or down, you know , to the provider's and ultimately the patient's, you know, benefit and where they find what you know is the wheelhouse so to speak.
Dr. Mistry: And we call it Trimix, but sometimes people don't tolerate one of the ingredients or they need a fourth ingredient. And what's important about that is that if you've tried these medicines out there and you didn't like it, it hurt, or you didn't like the way the needle looked or you didn't like something about it, don't assume that everybody does it the same. There are your , your pharmacist, if you pick the right one, can be a partner with you to pick the right formulation, because it may take you six weeks to see a urologist, but it only takes you six minutes to see your pharmacist.
David Faulkner: No doubt. And in addition to moving around those three active ingredients that are most commonly in Trimix, or the bio mixed with quad mix, if there's two or four. You can also mess with the volume that's injected as well to kind of get more of a response if you have, if need be.
Dr. Mistry: Aleem, have you come across any other sexual aids either for men or women that you guys have started using more, more regularly?
Aleem Khan: Aside from the Trimix , there's another compound , Oxytocin that actually helps with the ejaculation, if I'm not mistaken, the process of it. That's one in which you can administer as a buccal troche. Think of it almost like a lozenge type where you kind of suck on that...
Dr. Mistry: What are you sucking on? It's my oxytocin troches.
Aleem Khan: It is minty fresh. Yes.
Donna Lee: Minty fresh. Well that's a nice change.
Dr. Mistry: Eucalyptus.
Aleem Khan: Yeah, yeah. They flavor it all sorts of different ways, but , uh , yeah. Mint tends to work well drops as well. So , so, so that's one that's works now that can both go to the male and female persuasion, not mistaken there . So female and, you know, I like to kind of, you know, give a little bit of...
Dr. Mistry: An extra boost there, huh?
Aleem Khan: You know, like you want to like talk about the better half , so to speak and , you know, like how certain hormones can be used in cream, and...
Dr. Mistry: For sure. We use vaginally applied creams, oftentimes in women with something called vulvodynia, which is pain in the vagina area. And we use a combination of , of creams that have estrogen testosterone, and where compounding has come into an amazing hand or helpfulness is that the listeners may not realize that when it comes to pills, if you're allergic to the pill or the cream, you may be allergic not to the ingredients in it, but what's it, what it's mixed with the binders, the capsule. And so you can actually change that. So I, we had a patient last week who was allergic to red dye. So couldn't take a particular Tylenol with gel cap, right? And so you could, you could just change the way that it was administered and now this allergy became something therapeutic for them.
David Faulkner: Yeah, no doubt. And we also see that a lot , uh , not just in the topical realm of the different medications that we make, but also in the injectable side. You know, if someone doesn't tolerate something that they're getting a testosterone injectable, for instance, but they don't like tolerate cotton seed oil, which is usually what it's manufactured in, we can do it in a whole bevy of different oleaginous type bases, so...
Dr. Mistry: Including grapeseed oil, which is what you get here at North Austin Urology.
David Faulkner: There you go.
Donna Lee: Love some grapeseed oil.
Dr. Mistry: The, the biggest current use for us and compounding pharmacies has to do in the cream arena. So oftentimes we'll get patients that have both a fungal and inflammatory response and maybe need a numbing response. We have the need for like a lidocaine with steroids that sometimes we have people inject into their urethra for a variety of reasons. And so being able to go to the compounding arena, because these things are not available commercially. There's no like, you know, Walgreens option.
David Faulkner: Yeah, no doubt.
Aleem Khan: Yeah. Most certainly. I'd say that some of the more popular items that started in a compounding type of arena , I think manufacturers, big pharma out there have kind of identified some of that and kind of scaled it out a little bit. So I like to refer to us David is a little bit of think tanks and, you know, workshops.
Dr. Mistry: This is where the ideas come from. So when people think about compounding pharmacies and costs , do you guys take insurance for a lot of your stuff? Are most of your things cash? And how do patients find out how much things are gonna cost?
Aleem Khan: Yep. Yep. Good question. Well, you know, it's always a mixed bag when it comes to insurance and in such. We try to maximize the value ultimately at the end of the day to a patient. So think of it in the sense of , how long will this last, or how long will this be effective, or how much of a supply am I receiving? So in that kind of an end, we can kind of make up for any , let's say, denials on an insurance end when it comes to the patient's program. So, so that's one strategy. Another is always kind of trying to work with a patient on what their financial needs are and all of this. So there's a couple of different ways we go about that.
Dr. Mistry: The savvy patient is going to save money.
David Faulkner: No doubt.
Dr. Mistry: Well, thank you guys so much, Aleem and David for joining us from Nucara pharmacy, is a great partner of ours. And we thank you guys for joining us today.
Aleem Khan: Thank you so much.
David Faulkner: No problem. Thank you. Appreciate it.
The Armor Men's Health Hour will be right back. If you have questions for Dr. Mistry, email him at armormenshealth@gmail.com.