Pumping Irony

Craig Cox, EL’s director of business operations and resident geezer, explores the joys and challenges of aging well.

The Walking Dread

On the "dreadmill": safer than crossing the street?
On the “dreadmill”: safer than crossing the street?

I’m not what you would call an avid walker. I’ll trek to and from the office a mile away every winter, once the first big snowfall makes bicycling too treacherous, but that’s due more to my aversion to lingering at bus stops in sub-zero weather than a delight in high-stepping through snowdrifts and sliding across sidewalk ice. And I’ve been known to occasionally hike one of the trails that ambles along the river near my house. But I avoid the dreadmill at the gym, for reasons that should be obvious to anyone who’s ever pushed the “start” button and wondered what’s going to happen next.

If the former exercise can be called utilitarian and the latter recreational, then I should be more careful when I’m walking to work. That’s the upshot of a recent study from the University of Massachusetts Medical School. Researchers there have concluded that geezers like myself are more prone to tumbling while striding to the grocery store or the pharmacy than if they’re walking for exercise. Even on the dreadmill, I presume.

“Older adults have two times the risk of falling while walking out of necessity than walking for recreation, and four times greater risk of injury from a fall on a sidewalk than in a recreational area,” according to lead researcher Wenjun Li, PhD, associate professor of medicine at UMass Medical School, who I would wager has never set foot on a dreadmill.

Dr. Li and his associates theorized that it was the physical environment of a neighborhood — the sidewalks, curbs, and streets — that made “necessary” walking more hazardous than recreational treks. And, while concrete offers plenty of obstacles to geezers striding purposefully from Point A to Point B, I’d suggest that the increased risks may have less to do with the landscape than with one’s frame of mind.

When I’m walking to work in the winter months, my mind is often occupied with the tasks facing me when I arrive. This has led to more than a few icy pratfalls, acrobatics that I generally avoid when I’m paying attention. Recreational walking, on the other hand, usually involves a more focused mindset (or so I’ve been told). This, it seems to me, would reduce the chances of tragic missteps.

Except, of course, in the case of the dreadmill, which in my experience is simply designed to kill.

The Eco-Conscious Road to a Longer Life

Watch out for that bus — and second-hand smoke.
Watch out for that bus — and second-hand smoke.

OK, so you’re getting to the gym on a regular basis, eating right, getting enough sleep, and beginning to feel that maybe you’re on the high road toward a long and healthy life. I hate to rain on your parade, but that’s not necessarily going to do the trick.

Longevity is a tricky thing. You can make all the right choices, such as those above, and walk across the street tomorrow and get hit by a bus — nothing in this life is guaranteed except death (and brief episodes of embarrassment, confusion, and contrition). We don’t completely control our destiny; there are environmental factors beyond those healthy behaviors we adopt that can dramatically impact our life span.

Researchers from the University of North Carolina have pinpointed a variety of environmental factors they call “gerontogens” that can lead us to an earlier than expected grave. Cigarette smoke tops their list, along with ultra-violet rays from the sun, chemotheraphy and everyday stress. “We believe just as an understanding of carcinogens has informed cancer biology, so will an understanding of gerontogens benefit the study of aging,” Norman Sharpless, MD, professor of medicine and genetics at the University of North Carolina, told Rodale News. “By identifying and avoiding gerontogens, we will be able to influence aging and life expectancy at a public health level.”

We’re not powerless in this struggle, Rodale reminds us. We can limit our exposure to these popular household toxins:

  1. Coal tar driveway sealant
  2. Synthetic pesticides
  3. Antibacterial soap
  4. Synthetic fragrances
  5. Conventional cleaning products
  6. Nonstick cookware
  7. GMO foods
  8. Vinyl products
  9. Volatile organic compounds (VOCs)
  10. Flame retardant chemicals in furniture
  11. Bisphonol A (BPA) in canned foods
  12. Dry-cleaning chemicals

Stay away from these and other gerontogens while you maintain your healthy lifestyle and your chances of living to a ripe old age will improve. Meanwhile, look both ways when you’re crossing the street.

A Longer Wait, a Longer Life

The Man of Few Words (left) and The Boss Mare, circa 1993. Worth waiting for, in more ways than one.
The Man of Few Words (left) and The Boss Mare, circa 1993. Worth waiting for, in more ways than one.

My Lovely Wife and I bicycled over to our favorite local bistro the other day and found ourselves surrounded by young parents and their relatively tiny offspring. We have a practiced eye for such things, so we were estimating the age of the infants and toddlers and recalling those long-ago days when we were saddled with similar, vaguely joyful baggage.

It’s a wonderful (and rather protracted) chapter in one’s life, we agreed. And having been through it, we have some genuine sympathy for the twentysomething parents trying to fend off various tabletop tragedies as they attempt to complete their meal. It’s not easy — even for young, energetic moms and dads.

There are a couple of ways to look at the timing of parenthood, it seems to me: You can get started early in marriage, taking advantage of all that youthful energy and vitality to get you through the long, sleepless nights walking the floors with a 25- to 30-pound bundle of joy (great excuse to work on your core) and get it all over with by the time you hit your early 40s. Or you can wait awhile, satisfy your youthful energies and excesses into your 30s before building your nest and raising your brood.

MLW and I took the latter approach. Our daughter, Nora (AKA The Boss Mare), was born when MLW was 31 and I was 36; Martin (AKA The Man of Few Words) came along a little less than three years afterward. Twenty-six years later, they’re both out on their own, we’re wandering around a big, quiet house, and according to a new study, by waiting as long as we did to have kids, MLW is likely to live a longer life than those women whose child-bearing years ended in their 20s.

Here’s how the Los Angeles Times explained the research:

“Compared with a woman who wrapped up her childbearing by the age of 29, a woman whose last child was born after she reached the age of 33 was roughly twice as likely to survive long enough to outlive 95 percent of her female peers born in the same year. Women who bore their last child between the ages of 33 and 37 had the best shot at becoming a longevity champion. They were 2.08 times as likely to live to an exceptional age as moms who had no more children after 29. Women whose last child came after the age of 37 were 1.92 times as likely to live so long.”

There are, of course, plenty of theories about why this might be. The authors of the study suggest that it’s evolutionary: Women capable of conceiving and bearing children for a longer period of time tend to be more active and involved in family life and, as a result, more vital and healthy. I suppose that’s as likely an explanation as something having to do with hormones (which the study does not address), but I suspect an emotional and psychological component to all this, as well: Young mothers may feel they’ve lost their youth and vitality and are not able to reclaim it when the kids have all grown up and left the nest.

In any case, this is good news to me, since I’d like MLW to hang around into a robust old age, but it’s apparently also good news for TBM and TMOFW. Their mother is likely to be around to confer her sage wisdom to her grandchildren, if and when they may arrive — hopefully not before both of them are into their 30s.

Lift to Live

I'm growing old with Charles Atlas.
I’m growing old with Charles Atlas.

After probably way too many months away, I wandered back into the gym this week — and I’m glad I did.

For last several months, I’ve been working out (sporadically) at home in the mornings before work. Body-weight and kettlebell stuff between 7 (sometimes 8) and breakfast. I don’t have a long commute — 10 minutes max on my bike — but there were days, more frequent than I’d like to admit, when I just didn’t pick up the iron because I didn’t want to be late for work (gotta read the sports section first, you know). And, to be completely honest, flinging around a 25-pound kettlebell after awhile loses its appeal. Most fitness experts will tell you that you need to shake up your routine or you’ll find yourself marooned on some fitness plateau — wandering around looking for the benefits you once took for granted.

When you hit that plateau, what tends to happen is that you lose momentum in your muscle-building program. And, when you get to be my age, good health and longevity is all about building muscle. This remains a mystery to most geezers. I was drinking beers with my brother, The Tin Man, last week after a round of golf (in which, as usual, he crushed me — which has nothing to do with muscle mass), and he asked me what I did to stay in (such great . . . I’m extrapolating here) shape. And I told him you’ve got to lift weights as you get older. Here’s why:

It’s the plague of sarcopenia (significant loss of muscle mass) that contributes to a variety of chronic illnesses among geezers. I’m talking about diabetes, obesity, and heart disease. It’s also a major reason why folks take a tumble at advanced ages and end up getting their hips replaced.

This is not just me talking. New research from Tufts University not only endorses the idea of strength training for geezers, but identifies the mechanism that helps older muscle grow.   The study’s lead author, Donato Rivas, PhD, can explain it better than I can:

“In order for the body to make proteins that build muscle, certain genes need to be turned on. We noticed that older people had a lot fewer genes turned on compared to the younger people, showing us their muscles weren’t responding as well to the exercise.”

The problem is that geezers like me have fewer small RNA molecules in our muscle tissue, hence we don’t respond as well as young people to strength training. So Tufts researchers are thinking that gene therapy, nutrient supplementation, and hormone replacement therapy might be the answer.

Not for me. The big upside to going to the gym is that there’s a lot heavier iron to lift than what I find in my feeble workout room at home. And after 45 minutes communing with the iron there, I come home feeling like Charles Atlas and not worrying at all about diabetes, proprioception, or heart disease. I just want a cold beer. Which is not really an appropriate beverage before breakfast.

The Soccer Solution

The great Pelé, circa 1960. I did not aspire to such heights.
The great Pelé, circa 1960. I did not aspire to such heights.

When I was in grade school in the 1950s, our recess activity during the warmer months always included a soccer game. This was odd for several reasons: No one I knew played soccer back then, there were probably 200 kids on the field chasing the ball around, and the goals were chain link fences that stretched the width of the field — maybe 200 feet. Tough on a goalie’s self-esteem.

It was during one of these post-lunch contests that I lost any enthusiasm I might have generated for the sport. At some point in the random stampede that passed for play, someone gave the futbol a good kick, it ricocheted off my head, and knocked me out cold. At least that was the report from the field relayed to my mother when she came to pick me up from the nurse’s office. I had no recollection of any of it. Only that one minute I was running around trying to kick the ball and the next I was waking up somewhere on a strange bed.

Years later, it became obvious to me that my initial contact with something resembling soccer didn’t really resemble soccer. Our principal, who presided over this chaos, was just trying to give the kids a way to blow off some energy midway through the long school day. Still, childhood experiences can have an impact on the way one sees the world, so I focused my feeble athletic aspirations on good old American games — Little League baseball, and junior high basketball and football. This was a bit ironic, given that my (lack of) size and (lack of) strength were probably more suited to futbol than to any other sport.

Of course, there were no soccer teams in my part of the world until I reached high school in 1966 (no one knew who Pelé was), and only because I had by then realized my relative limitations (see above) did I sign up for a tryout with our inaugural squad. I didn’t make the team for a number of reasons, the chief one being that I didn’t know how to play soccer. But I had apparently overcome any residual psychological effects of my grade-school collision with the sport, and while I never played the game again, I grew to appreciate its subtle pleasures vicariously, watching my kids chase the ball around from the sidelines when they were young, and tuning in every four years to the World Cup.

I’m not seriously considering taking up the sport again at this point in my life, but a new study out of Denmark suggests that it’s never too late to kick it around a little. Researchers at the Copenhagen Centre for Team Sport and Health found that untrained guys as old as 75 can gain dramatic health benefits by playing soccer a couple of times a week.

“The study revealed that inactive elderly men improved their maximum oxygen uptake by 15 percent and their performance during interval exercise by as much as 50 percent by playing football for one hour two times per week over four months,” lead author Professor Peter Krustrup reported in a statement released by the center. “Moreover, muscle function was improved by 30 percent and bone mineralization in the femoral neck increased by 2 percent.”

It makes sense, of course (except the bone mineralization thing). There’s a lot of running around in futbol, a lot of stops and starts and turns. All accomplished on a field of soft grass that’s probably not too hard on aging knees. Probably a lot more prudent for a guy my age than trying to hit a 15-foot fall-away jump shot over a 6-foot-something teenager on the hardcourt.

Except that I know something about basketball. I’ve played the game for years. Never been knocked out. And that probably counts for something.

Don’t Worry, Be Happy

A large part of my admittedly lame social life involves monthly lunches with two old colleagues of mine who have more time on their hands than is sometimes advisable (hence lunches with me). Both are in their early 70s, have tasted success on the big stage, and now find themselves seriously worried about the future.

Not worried in the way most of us worry about stuff — jobs, bills, kids — but chronically anxious about big things they have little control over. The kind of anxiety that often plagues geezers and, if the research is to be believed, can seriously impact your quality of life and, in some cases send you to an early grave.

I was particularly struck by this during my last two get-togethers with these old friends. Some of this anxiety is understandable: My old friend The Prairie Editor has navigated the political and literary landscape for the better part of the last half-century with no visible means of financial support. I’ve been in his shoes, financially, so I know what it’s like to wonder where the next paycheck is going to come from. But he’s also become more frail in recent years, and like the rest of us in Geezerville, he’s discovering that mortality is less theoretical than it once was.

Then, just last week, while lunching with The Captain, an old publishing pal, I learned that he, too, was struggling to untether himself from the weight of the world. The Captain worries about lots of things he has no control over, stuff like Tea Party politics, the Keystone pipeline, the NRA, Ukrainian sovereignty, and the like, but his anxieties incline more toward the existential: What role is he supposed to play in the world, now that he’s a decade into retirement? How can he still contribute in a meaningful way? Plus, why do all his friends have cancer?

I’m not much good in these situations — not because I don’t care about my buddies, but because I have a little trouble relating these days. That’s not to say I haven’t sailed through these stormy seas myself in the past. It was only eight years ago that I gave up our home to foreclosure and filed for bankruptcy after the newspaper My Lovely Wife and I launched went belly up. I know something about angst. And maybe because my two old pals have never been through that financial cleansing experience, they’ve never had the opportunity to come out clean — and clear — on the other side, where you really begin to understand the power of that old question: What’s the worse thing that could happen?

That’s all economics, though. Which, in a lot of ways, is less worrisome than the angst that many of us pack into our bags when we embark on our journey to Geezerville. That baggage is all about purpose, path, and, most urgently, mortality. We want to know if we can still make a difference in the world and whether we’ll be around long enough to figure out how.

These are all good questions to ask, all good intentions to have. But when I looked across the table at my anxious pals, all I could say was, “Don’t worry. It’s fatal.”

I know it sounds too simple, but it’s backed up with research. Numerous studies have shown that anxiety actually shortens your lifespan. A 2012 study from Boston’s Brigham and Women’s Hospital and Harvard Medical School found that chronic anxiety may be a risk factor for premature aging. (Do you worry too much? Check out this site for more information.)

An ancient Buddhist axiom tells us that we are all going to suffer in our lives. It’s just the way life works. The key is to be unattached to outcomes, because we really don’t have that much control over the way things play out. So enjoy the good when it comes and work through the bad in its turn. You’re going to get plenty of both as you pile on the years. Just don’t worry about it.

Stairway to Heaven

To climb or not to climb as we age? That is the question.
To climb or not to climb as we age? That is the question.

My Lovely Wife and I were chatting the other night about our upstairs bedroom project. The offspring having flown the coop a few years ago, we’ve been debating the pros and cons of creating a master bedroom suite up there.

Among the pros:

• It would be awfully nice to have a second bathroom.

• It would add value to the property.

• We could finally remove the knotty pine paneling in our current place of repose.

And the cons:

• It would be pricey.

• It’s not absolutely necessary to our enjoyment of the house.

• Do we really want to be walking up a flight of stairs to bed when we’re 80-something?

The latter point is one that is often raised when folks enter into Geezerland. And it’s not a new debate. MLW’s grandparents built a home with just that in mind back in the 1950s — a one-floor rambler with wide doorways to facilitate the movement of wheelchairs. And they were prescient. During her last years, Grandma Parker got around the house on four wheels.

So it’s not an imprudent discussion, especially with MLW’s bum knee and her altogether rational preference to avoid people with scalpels who would like to cut it open and replace it with something mechanical. But the more we talk about it, the less the stairs thing enters into the mix. Because, as MLW pointed out just last night, the last thing you want to do as your body ages is to give it excuses for doing less. In other words, if you want to be able to scale a flight of stairs when you’re 80 years old, you shouldn’t stop climbing them when you’re 75.

There’s plenty of research to back her up on this point. Most recently, Gretchen Reynolds in the New York Times reported the results of a landmark study by researchers at the University of Florida’s Institute on Aging showing that regular exercise reduces the chances that even the most frail oldsters will become physically disabled. “For the first time,” the study’s lead author, Marco Pahor, MD, told Reynolds, “we have directly shown that exercise can effectively lessen or prevent the development of physical disability in a population of extremely vulnerable elderly people.”

The participants in Pahor’s study, 1,635 couch potatoes between the ages of 70 and 89 who were tottering on the edge of decrepitude, were simply asked to do some walking and light, lower-body strength training. Thirty months later, they were almost 30 percent less likely to become disabled than a control group. Imagine the gains they would’ve made if they were climbing stairs.

Our upstairs bedroom discussion will continue, I suspect, until one of us gets excited enough to start calling contractors and taking bids. But the whole climbing-the-stairs-at-80 question is now another reason in favor of pulling the trigger on this thing. Besides, the knotty pine is really starting to get to me.

Start the Revolution Without Me

This could be the ideal patient for the next medical revolution.
This could be the ideal patient for the next medical revolution.

Whenever I feel as though our troubled healthcare industry may be pausing for just a moment to reclaim some sense of proportion or practice just a smidgen of humility, I stumble upon yet another reason to stay away from the doctor’s office. This time it was a report in the Washington Post that breathlessly heralded the development of “smart pills” that “many predict will be a revolution in medicine.”

Here’s how reporter Ariana Eunjung Cha, put it:

“As the size and cost of chip technology has fallen dramatically over the past few years, dozens of companies and academic research teams are rushing to make ingestible or implantable chips that will help patients track the condition of their bodies in real time and in a level of detail that they have never seen before.”

Cha profiles a 91-year-old California woman, into whose heart and thyroid pills a computer chip has been embedded. Once she swallows the pills, the chips send a signal to her computer telling her she’s swallowed the pills.

I’m not making this up.

Now, to be fair, lots of people have to take lots of pills every day, and I can see how you might lose track. And, in fact, doctors are constantly encouraging their patients to take their pills, because patients either forget to take them or can’t afford to pay for them in the first place. And when the only tool you have in your toolbox is a prescription pad, well, you can imagine the angst.

But that makes me think that maybe the computer chip has been planted in the pill mainly to make the doctor feel better, which makes me wonder what the upside is for the patient. But, of course, that would be thinking logically. And if we were thinking logically, what might first come to mind would be: You’re asking me to swallow a computer chip?!?

Cha allows that “the idea of putting little machines into the body makes some uncomfortable,” but goes on to quote advocates, who say the technology (which includes everything from the aforementioned ingestible computer chips to cameras and robots) could cut costs and “save countless lives.”

As Eric Topol, director of Scripps Translational Science Institute, notes, “The way a car works is that it has sensors and it tells you what’s wrong. Why not put the same type of technology in the body? It could warn you weeks or months or even years before something happens.”

I love how those warning lights work in my Honda. They tell me when it’s time for an oil change or if my tires are low. But, at the risk of being labeled as an anti-revolutionary, I’d just like to point out something that might not be obvious to revolutionaries like Topol: I’m not a car.

The Pressure’s Off

Here’s a cheery thought for all of you who have not yet reached advanced middle age: 65 percent of Americans over the age of 60 have high blood pressure.

I’m one of them — at least according to my last interaction with a healthcare professional. At 148/88, I fall into a category called “isolated systolic hypertension” or, appropriately enough, ISH. Now, I would argue that if My Lovely Wife walked into the room as I’m typing this and slapped the cuff around my bicep, that reading would slide down into a more “normal” range. For some reason, whenever I walk into a doctor’s office my heart rate soars. It’s called “white coat syndrome”.

Still, I could be fooling myself. My dad had high blood pressure, a trait I know he passed on to my older brothers. I wouldn’t be surprised if my two younger siblings are stuck with it as well. So, I was encouraged the other day when I stumbled upon the results of a study from George Washington University (GWU) suggesting that ISH-inflicted geezers like me aren’t necessarily going to keel over from a stroke or heart disease anytime soon. All we have to do is exercise a little.

And it doesn’t matter how fit you happen to be at the moment. Researchers surveyed 2,153 men over the age of 70 at all fitness levels, measuring their peak MET levels, or metabolic equivalents (the amount of oxygen your body uses per kilogram of weight per minute of exertion) and herding them into four fitness groups: very low (1–4 METs), low (4.1–6), moderate (6.1–8) and high (8 or higher). They found that raising your activity level by even a single MET lowered your risk of dying by 11 percent.

That may not seem like a major longevity bonus, but Peter Kokkinos, Ph.D, a professor at GWU’s Veterans Affairs Medical Center and senior author of the study, noted in a statement released by the university that the exercise remedy is particularly stunning when you compare those who do it regularly with those who don’t. Here’s how these groups compared with the most sedentary men when they added 1 MET to their activity level:

• Low-fit men had an 18 percent lower risk of death.

• Moderately fit men lowered their risk by 36 percent.

• High-fit geezers dropped their risk by almost half (48 percent).

A 50-year-old couch potato registers a peak MET level of 5 or 6 (you can check your METs here, if you’re curious), so I figure my basic fitness regimen would put me in the 8-to-10 range, among the more active oldsters. (Kokkinos notes that endurance runners and cyclists can have METs in the 20s, so I can’t be too smug.) No matter where you fall on this fitness continuum, remember this: All it takes to raise your MET levels when you hit middle age is a little more moderate exercise. Even a brisk walk around the block can make a difference, if done regularly.

I can feel my blood pressure dropping already.

Smugness and Denial

Last week, I received the results of my annual health check-up, a ritual that elicits a wondrous combination of smugness and denial. My score this year was 84 out of 100, down from 92 last year, but still not bad for a geezer whose butt spends a good portion of each day plastered in a chair.

The nice thing about these snapshots is that you can pretty much translate the results any way you like: blood pressure of 148/88? White-coat syndrome. Glucose reading of 107? Way below a high-risk level (126). Cholesterol at 269? Doesn’t mean a thing, since it’s the ratio of total cholesterol to “good” cholesterol that matters and at 3.2:1, mine is way under the 4.4:1 considered low risk for heart disease. And would you look at that Triglyserides number? Anything under 149 is considered low risk and I’m sitting here at 55, which is slightly lower than my resting heart rate (58), which along with my body-fat percentage (23.0) can only mean that I am, given my age, pretty much a freak of nature.

Gotta feel good about that.

The report is always accompanied by a call from a wellness coach, who is ready to help you address any problem areas that may have emerged. They ask you what you tend to eat during a typical day and how much exercise you get, so there is a completely understandable inclination to slightly embellish your description of reality. It’s just human nature; folks want to represent themselves in a positive light. Who’s going to tell a health coach that their favorite meal is a bag of Doritos washed down with a couple of Budweisers?

So, when my coach asked me about a typical day in the life of the plate in front of me, I talked up my yogurt and fruit breakfasts and mostly skipped over those Chipotle lunches and pizza dinners. I described in probably more detail than was necessary my 20-year meditation practice, my morning bodyweight/kettlebell workout, and the daily bicycle commute up that nasty hill on the other side of the river. Oh, and did I mention the weekly yoga class, my basketball league and tennis bouts with a certified USTA player (the formidable Baseline Machine)?

“Sounds like you’re doing an awesome job,” he replied, before I began back-pedaling, admitting that I try to get that morning meditation/workout in at least three times a week, the bike ride is really only about a mile, and I’m lucky if I make it to yoga three times in a month. TBM is actually a USTA player, but her serve is nothing to crow about.

“Awesome,” he reiterated, which for a brief moment made me feel like I should maybe be more forthcoming about my blood pressure and alcohol consumption, but the feeling quickly passed.