Pumping Irony

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

Granted Immunity

Ibuprofen: A cure for the aging immune system?
Ibuprofen: A cure for the aging immune system?

I’m happy to report that my mother-in-law, Shirley, continues to improve and will move from a hospice facility into a nursing home today to begin physical therapy. At 85, her body is still resilient enough to fight off the effects of the stroke that sent her to the emergency room two weeks ago. There are many lessons to be learned from this, but the one I think I’ll carry with me is maybe the most obvious: Keep your immune system in good working order as you age and you can survive almost anything.

Even conventional doctors are beginning to figure this out. As Pamela Weintraub noted in a recent issue of EL, so-called integrative oncologists are focusing on their patients’ “terrain” in a more holistic approach to cancer treatment. Boosting the immune system is key to both fighting the cancer and preventing the disease in the first place.

“For almost any chronic disease, inflammation is at the root,” says University of Texas cancer researcher and biochemist Bharat Aggarwal, PhD. “Most cancer starts by the age of 20.” As the body ages, he explains, toxic exposures mount and genetic damage accrues. Depending on inflammation and the overall condition of a person’s terrain, that deterioration may eventually result in a life-threatening cancer, perhaps many years or decades later.”

This is all about healthy eating, exercise, stress management — the basics of good health — but as is often the case with industrial medicine, researchers are always looking for shortcuts. So I was not surprised to learn recently that Ohio State University scientists were hyping the anti-inflammatory benefits of ibuprofen as a way to strengthen the immune systems of geezers like me.

The study, published in the Journal of Leukocyte Biology, showed that ibuprofen boosted the ability of older mice to fight off an infection. In fact, it ramped up their immune systems to the point where it was just as effective as that of the youngsters. “This may give new meaning to the phrase ‘take two aspirins and call me in the morning,'” John Wherry, Ph.D., the journal’s deputy editor, told Science Daily. “The report may not be about aspirin, but it does show that over-the-counter remedies may have broader value than usually appreciated, including by affecting immune functions that change with age.”

Theoretically, at least, this is good news for Geezerville. All I’ve got to do to keep the old immune system in fighting shape is pop a few Tylenol, or any of the other popular NSAIDs (nonsteroidal anti-inflammatory drugs) available at my local drug store, and I should be good to go.

Probably not a good idea, though. Overuse of NSAIDs sends as many as 100,000 Americans to the hospital every year with gastrointestinal disorders. It can actually impair healing, increase inflammation, and even lead to autoimmune diseases. (Read more about the dangers of NSAIDs here.)

There are no shortcuts to good health or longevity. And no guarantees that all the good things you believe you’re doing to prolong your time on this mortal plane are going to pan out the way you’ve hoped. What Shirley’s taught me in these last couple of weeks is to simply do the best you can, stay positive, and trust your body to roll with the punches.

Oh Death, Where Is Thy Road Map?

My Lovely Wife and I have been spending the past week or so wandering along the borders of that familiar, yet foreign, country called Death and rediscovering its unique topography.

These trips are seldom planned, so when we heard that MLW’s 85-year-old mother had fallen and had been taken to a nearby emergency room, we set out with the idea that we’d pick her up, dust her off, bring her back home, and get on with our weekend. It’s not like she hadn’t fallen before. We soon learned, however, that she’d suffered a stroke and had extensive bleeding on the brain. The prognosis was not good; her doctor told us, quite candidly, that she would not recover.

Shirley had put together a healthcare directive years earlier, so there was no question about heroic measures and no wrenching family debates about feeding tubes and respirators for an independent and loquacious matriarch who quite suddenly could not speak. That was the good news. The bad news was that she wasn’t going to be with us for much longer. And that takes some processing.

Everyone does that in their own way, of course. The great-grandchildren who trooped into her room over the next four days sang, laughed, cried, and generally delivered enough cheerful chaos to keep us all slightly distracted. Shirley’s first-born telephoned from her home in Brussels to tell her what a great mom she’d been. It’s the kind of thing you’d say at a memorial service, she explained, but she wanted to make sure she heard it before it was too late. Through it all, it was the certainty of the prognosis that pushed us along: The terrain ahead was clear and unobstructed by false hopes or wishful thinking. Everyone knew what was coming around the next bend. The doctor told us she’d get there pretty soon.

On Tuesday, Shirley was transferred to a residential hospice facility.  She’d finally been able to eat a little soup that afternoon and swallow a few teaspoons of tepid coffee. And later that evening she ate a bowl of ice cream with such serene delight that I told her I was going to tell the folks at Kemps to get a camera crew in here to film it for a commercial. “You look like you’re in love,” I said. She did not disagree.

When we arrived the following day, she was sitting up in a recliner, holding court. She still wasn’t able to put many words together, but her voice was getting stronger, her face more animated. She was not declining, as expected; and a week after the stroke, hospice staffers began talking about nursing homes and physical therapy — completely new terrain.

The palliative care doctor at the hospital had warned us that Shirley may appear to “rally” a few days before dying, so we don’t quite know what to make of this latest development. We’re all glad to see her showing signs of recovery, of course, but it brings some uncertainty into the trip, the likelihood of peaks and valleys in the road ahead.

But that’s probably the wrong way to look at this. It’s not about us, after all. Shirley’s the one who’s really finding her way. We’re just along for the ride — and all that journey can teach us.

A Birthday Lesson

When all plans had gone awry, a coffeeshop moment produced a delightful surprise.
When all plans had gone awry, a coffeeshop moment produced a delightful surprise.

I got a nice note via Facebook on Saturday from a fellow traveler in Geezerville. She wished me a happy 63rd birthday and noted, quite logically, that “Birthdays are good for you. People who have the most live the longest.”

That’s mathematically indisputable, of course, but it also somehow misses the point. It’s not how long you live that counts. It’s how you live. The years do pile up as we age, and there’s no reason not to celebrate each annual milestone, but if you’re really paying attention, each moment is where real living happens.

I know it sounds dorky, even a bit cliched, but as I get older, I’ve really grown to appreciate those occasions when I’ve been able to be completely present — neither worrying about what I’m supposed to be doing or regretting what I’ve been unable to do. Just being fully in the now.

On Saturday, my plan was for MLW and  me to get out on our bicycles after breakfast, hit Peace Coffee for a mid-morning espresso, then pedal across the freeway to the Minneapolis Institute of Arts to wander among an exhibition of drawings by Matisse and other masters, but we didn’t get out the door until noon, which made coffee a bit irrelevant, and by the time we made it into the vicinity of the MIA, it was really time for lunch, after which it seemed more appropriate to launch ourselves further uptown to the Walker Art Center, where an artist-designed mini-golf course beckoned. Unfortunately, lots of other mini-golfers had arrived by the time we did, and we were informed that if we wanted to play, we’d have to cool our jets for the next 2½ hours.

So, off we went to a coffee shop up the street and were rewarded by an out-of-the-blue encounter with a couple from our distant past, now settled in Austin, Texas, who happened to be in town for a wedding. We had a delightful, completely unexpected reunion. Funny how things turn out.

Through all the shifted priorities and serendipities, the idea is to just smile and move on. No expectations. Just let the day unfold. Just let life present you with what it will.

I’ve been reading the late Peter Matthiessen’s masterpiece, The Snow Leopard, which has reminded me of how challenging this all can be. Matthiessen’s book chronicles a three-month journey through the mountains of Nepal, in which the author, a devoted Buddhist practitioner, finds himself mostly unable to rise above the misery and pain he encounters. Hoping to find a lesson from the lama at a remote monastery, Matthiessen instead learns by journey’s end that it was not the holy man, but Tukten, one of his ragged porters, who carried the wisdom he sought.

 “In his life in the moment, in his freedom from attachments, in the simplicity of his everyday example, Tukten has taught me over and over, he is the teacher that I hoped to find.”

I’m not a seeker in the way folks like Matthiessen are, but I do understand the value of simply being as I enter my 64th year. Every moment is as precious as it is ordinary. And to live it completely is to grow old with no regrets — no matter how many years you may have left.

Coffee or Cicadas?

Cicadas singing in your ears? Have another cup of coffee.
Cicadas singing in your ears? Have another cup of coffee.

I started drinking coffee when I was 16, around the same time I discovered the forbidden joys of tobacco. My friends and I would wander into some all-night diner after a movie or following some random mischief and order up a round of joe — black — while lighting up like we knew what we were doing. The coffee would land amidst a cloud of smoke, and we’d lunge in unison for the sugar. The resulting syrup would keep us going for hours.

Cigarettes gradually lost their allure; I scrunched out my last Marlboro the day before my 22nd birthday, 41 years ago. But caffeine was a tougher habit to kick. I needed a couple cups in the morning or I’d head out the door with a nasty headache. No big deal, really; it’s not like I was going to run out of coffee.

Then, about 20 years ago, my afternoons began to be routinely interrupted by sudden heart palpitations. Out of nowhere, my heart would begin racing and my mind would attach itself to calculating the odds that I might be having a heart attack. It really suppressed my productivity.

My Lovely Wife sent me off to our local homeopath, who listened to my story and summed things up quite succinctly: My fairly modest caffeine intake was messing with my ticker. The solution, he said, was very simple: Stop drinking coffee.

The headache thing made this a little more complicated than he realized, but he sent me home with a small tube of coffea crudea — homeopathic caffeine — which somehow painlessly weaned me from caffeine within the week. Today, I still avoid brewed coffee (even decaf), but an occasional whole-milk latte is a sublime reminder of the comfort dispensed by the beloved bean.

This is not a problem, really. A guy can get used to most anything if he puts his mind to it. Like these cicadas in my ears, which whine at a pitch in the vicinity of High C pretty much all the time. No big deal. But, now I hear that there may be cure for this condition, better known as tinnitus: Drink more coffee.

Researchers at Brigham and Women’s Hospital in Boston dug through data on the 65,000 women who participated in the legendary Nurse’s Health Study II and found that those who drank more coffee were less likely to develop tinnitus. “In our study, individuals who had higher caffeine intake, usually in the form of coffee, had a lower risk of subsequently developing tinnitus than those with the lowest intake of caffeine,” lead study author Gary Curhan, MD, told Reuters.

This might be good news for Starbucks, but it doesn’t seem like much of a choice to me: Get back on friendly terms with Joe and risk cardiac arrest or stay the no-caffeine course and retain my free ticket to the cicada concert for the foreseeable future.

Like I say, a guy can get used to most anything.

Two Cheers for Yoga


As I do most Thursday afternoons, I pedaled last week with My Lovely Wife a mile and a half or so over to the eastern shore of Lake Nokomis to spend 90 minutes in the embrace of something resembling yoga. It’s a ritual I’ve been practicing for a few years now, one that seems to have marginally increased my limited geezer flexibility while teaching me the value of patience. Those hamstrings of mine are not going to loosen up anytime soon.

Our weekly yoga adventure is grounded in compassion and forbearance. Our teacher, the ever-indulgent Jinjer Stanton, asks no more of us than she knows we can muster. “You start from where you are” is one of her favorite expressions (and mine). And, except for the poses that test the limits of my poor hammies, it’s generally a pleasant way to pass the time. But’s it’s not what I would call a workout.

So I was slightly vexed today when I read in my local newspaper a piece breathlessly declaring that yoga is no substitute for exercise. “Yoga appears to be too gentle physically to be anyone’s lone exercise,” the writer asserted. “In one of the most interesting studies of the activity to date, experienced yoga enthusiasts performed their favorite type of yoga for an hour in a metabolic chamber that tracked their caloric usage and heart rate. The volunteers then sat quietly in the chamber and also walked on a treadmill at a leisurely 2 mph and a brisker 3 mph pace. Yoga was equivalent to strolling at 2 mph.”

This level of activity, according to the authors of the study, would “not meet recommendations for levels of physical activity for improving or maintaining health or cardiovascular fitness.”

Well, duh.

I don’t know anyone who does yoga who believes it’s a substitute for a broader fitness regimen. That said, I know plenty of really healthy and fit people who only do yoga. None of them, to my knowledge, have ever entered a metabolic chamber, and I’m pretty sure that most of them avoid the dreadmill entirely.

In fact, yoga is a great way to improve your circulation, balance, flexibility, and strength — all things us geezers need to keep in mind as we get older. Plus, I’m told there are cleansing and restorative properties that result from various poses, though these effects may be more ephemeral, especially if, like me, your hammies tend to attract most of your attention while you’re on the mat.

For most of us geezers, the most direct route to a long and healthy life involves a variety of physical activities — cardio stuff, strength training, stress management, and such. It’s not a one-size-fits-all proposition. Find out what works for you and go for it. And if that includes yoga, just make sure you warn your hamstrings.

The Joy of Manopause

Newlyweds Hugh Hefner, 88, and Chrystal Harris, 28. Poster couple for the geezer virility industry.
Newlyweds Hugh Hefner, 88, and Crystal Harris, 28. Poster couple for the geezer virility industry.

Time magazine this week featured a cover story on “manopause,” highlighting the latest trend in the geezer virility industry — testosterone therapy. It seems guys my age are flocking to these clinics in an effort to stiffen their resolve in the boudior. I think it’s more about trying to realign their reality to match their fantasies.

Lots of interesting things happen to a guy’s body as it slides into advanced middle age, but none is more vexing than when it stops doing what it used to do while in the throes of passion. You go through adolescence and early adulthood with a certain part of your anatomy always on alert (often embarrassingly so), and then one day you discover it just seems to have lost all interest (often embarrassingly so). And then, at some point slightly further down the line, you find (much to your surprise) that you don’t really much care.

This, frankly, can take some getting used to. I mean, most guys spend the greater portion of their adult lives thinking about sex, and to suddenly find that topic plummeting toward the nether regions of your to-do list is quite strange at first. Even a bit frightening, I suppose, if you feel like you’re less of a man if you’re not obsessing about your next roll in the hay.

The geezer virility industry relies upon this sort of thinking for its survival. As long as guys my age harbor adolescent fantasies about conjugal bliss, the makers of Viagra and Cialis, and the clinics offering eternal sexual vigor via testosterone therapy are going to do a brisk business.

Hugh Hefner is the poster boy for this industry. Now 88 years old, the original playboy is married to a 28-year-old model, Crystal Harris. I saw them interviewed on some TV show a couple of years ago, when they were newlyweds, and old Hef waxed poetic about the wonders of the little blue pill.

Now, to be fair, I suppose it’s possible that young Ms. Harris carries with her some expectations for intimacy from her legendary husband, and I suppose any certified geezer who by some odd twist of fate finds himself courting the affections of a much younger partner might have occasion to rely on these products and therapies to meet the demands of the moment.

But, let’s face it, guys: You ain’t Hugh Hefner and neither am I. Most of us are wandering through manopause with wives or partners similarly occupied with the vexations of menopause, a phase that, conveniently enough, features a libido idling mostly in neutral. And if you’ve been together for a couple of decades or more, you both probably understand that this is just another chapter in a long and fascinating journey.

It’s all about companionship now, and while there will always be times when the stars align and you’ll revisit that passion that once seemed so necessary, more often it will be the small gestures of affection that will keep you going. You won’t need any pharmaceuticals to make that happen, no jolt of testosterone to appreciate how much you mean to one another.

Once you get to this place, it’s a lot easier to put this geezer virility thing in its proper perspective. I’m sure old Hef is a happy octogenarian with his young bombshell and a cabinet full of Viagra, but I gotta say, I wouldn’t change places with him for anything.

In Recovery

I hit the gym after work on Friday, but instead of ambling over to the resistance machinery, as I’ve doing in the weeks since I began mixing up my exercise routine, I grabbed a kettle bell and a couple of dumbbells and cranked out my old morning routine: squats, lunges, girevoy. Two days later, I’m having some difficulty accessing objects located below my knees.

It’s my own fault, of course. The machines at the club do not really replicate the lower-body workout you can get with free weights. And it’s a lesson, really, that I should’ve learned a long time ago: Once you stop working certain muscles, the next time you do, you’re going to pay. It’s called delayed onset muscle soreness, a common result of doing physical things your body is not accustomed to doing.

The other takeaway, though, is actually more important. And slightly depressing. The older I get, the longer it takes for my body to recover from my mistakes. It doesn’t express itself when bicycling, as MLW and I did on Saturday (a modest 7 miles), but this morning when I reached for my mat and bench for a little morning zazen, my hip flexors and glutes protested vigorously.

But, rather than push through the stiffness and pain, as I would’ve done in my younger days, I listened carefully and left my kettle bell alone. As the folks at My Generation explain:

Veteran athletes tend to have a sixth sense about their bodies, knowing how long they need to recover from common ailments like ankle sprains, knee pain, back pain and shin splints. Despite the body’s remarkable ability for recovery, it’s not immune to aging, and that recovery time will increase as the body ages. Whereas a sprained ankle might once have been as good as new after a few days or rest, aging athletes must recognize that the same ankle sprain now might require more recovery time. Returning too quickly from an injury can only make things worse for aging athletes, so don’t push yourself.

It is, of course, really easy to find a reason not to work out on a Sunday morning, and the line between injury and indolence can often seem a bit blurry. But, for geezers like me, at least, it always seems prudent to err on the conservative side.

That’s part of the general protocol for aging athletes, which includes taking the time to warm up properly before your workout (does 20 minutes on the Elliptical Death Machine count?), focus on increasing your flexibility (yoga? check), and keep lifting weights (yup). All these things will help you stay fit throughout your time in Geezerville. It’s just that sometimes, like me, you might need a reminder.

Some Aging Experts Who Actually Get It

Luigi Fontana: One aging expert who has figured it out — more or less.
Luigi Fontana: One aging expert who has figured it out — more or less.

It’s always heartening to stumble upon so-called “aging experts” who actually know what they’re talking about. And it’s even more exciting when they’re willing to call out other members of the profession for their cluelessness when dealing with the chronic diseases that beset most of the geezer population.

I’m talking about Luigi Fontana, MD, PhD, and his colleagues, who recently published a commentary in the journal Nature taking the healthcare industry to task for its piecemeal approach to treating those maladies that most commonly affect folks my age — heart failure, diabetes, arthritis, cancer, and Alzheimer’s. “Biomedicine takes on conditions one at a time — Alzheimer’s disease, say, or heart failure. Rather, it should learn to stall incremental cellular damage and changes that eventually yield several infirmities,” writes Fontana, professor of medicine and nutrition at Washington University and Brescia University in Italy.

Fontana and his crew, including researchers from the University of Southern California, suggest that the current Big Pharma treatment approach, which tends to go after the symptoms of disease rather than its sources, has only become the dominant paradigm because it’s the most profitable. Research dollars simply don’t go looking for approaches that promote good health when there’s so much dough to be made selling drugs. With 70 percentage of Americans over 65 suffering from at least two chronic diseases, that’s a big market.

“Economic incentives in both biomedical research and health care reward treating diseases more than promoting health,” he writes. “The launch of a few anti-aging biotech companies such as Calico, created last year by Google, is promising. But public money must be invested in extending healthy lifespan by slowing ageing. Otherwise we will founder in a demographic crisis of increased disability and escalating health-care costs.”

Fontana’s research suggests that those numbers could be dramatically reduced — along with healthcare costs — by focusing more on prevention through behavioral changes, such as diet and exercise. “Heart failure doesn’t happen all at once,” he said in a statement released by Washington University. “It takes 30 or 40 years of an unhealthy lifestyle and activation of aging-related pathways from metabolic abnormalities such as high blood pressure, high cholesterol, and type 2 diabetes to give a person heart failure in his 60s, so we propose using lifestyle interventions — such as a personalized diet and exercise program — to down-regulate aging pathways so the patient avoids heart failure in the first place.”

It’s an approach that has worked in the laboratory, Fontana says, and one that “functional medicine” activists like Mark Hyman, MD, have been practicing with notable success for several years. It’s just not often that “conventional” researchers come to that conclusion. That said, Fontana hasn’t completely abandoned Big Pharma, as he suggests that a couple of drugs (rapamycin, an anti-cancer and organ-rejection drug, and metformin, used to treat type 2 diabetes) have been shown to be useful in lab tests to increase longevity in mice.

Still, the big takeaway for me is that some folks out there in academia, at least, are beginning to figure out what a lot of us figured out a long time ago: The simple path to a long, healthy life is all about diet and exercise. Here’s hoping that the healthcare industry catches on at some point.

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.