Are We Fit Enough To Stay Alive?
Are We Fit Enough To Stay Alive?

Are We Fit Enough To Stay Alive?

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My birthday is December 1, the day this article is scheduled to publish. Whee. This is one of those “throw-away” birthdays, although it is a prime number now that I think about it. You would think ages that are indivisible would get more attention than they do, but they never have before so I don’t see any point in celebrating them now. To do so would feel rather like arriving at a dinner party two hours late when there’s only one extremely thin slice of cake left, and it’s rather mangled but the hostess will make you a sandwich if you like. Actually, that’s exactly how this birthday feels—an ill-timed imposition that could have been better received had it not decided to show up between Black Friday and Cyber Monday. No one wants to stop shopping long enough to have sugar-free cake.

To be honest, I don’t recall this having been a problem before, landing in the middle of shopping season like this. It has, back in 2013, but I was having difficulting walking that year and my attention was more on staying alive. Shopping during and round this weekend has shifted over the past six years, though. According to Statista, digital Black Friday shoppers only spent $1.19 billion in 2013. They spent more than double that last year while shopping at brick-and-mortar stores has fallen to 35% and that’s only if the sales are good at a level where stores are losing money. Busy stores are no longer the thrill they once were and a quarter of would-be shoppers say the discounts, as severe as they are, still aren’t worth fighting the crowds. 

Not that I’m the likely recipient of any of that shopping. One’s birthday is easily overlooked when people are focused on spending money “for the kids,” because, you know, every child needs a new 72” flatscreen. Even people who share the same birthday with me, Bette Midler, Carol Alt, Sarah Silverman, never invite me to their parties. Disturbingly enough, Woody Allen was born on the same date. I’d have to turn down that invitation if it ever arrived. 

There’s also the fact that the “holiday season” keeps expanding further and further back into November. Birthdays falling in December and January have always been subject to the “this is for your birthday and Xmas” cheap-ass syndrome. Now, it’s engulfing birthdays in November as well. Winter birthdays are being slighted and it’s not fair. But that’s okay, we only complain when no one’s listening.

What really matters, though, is that we keep having them. Every year, there are millions of people who celebrate their last birthday and for some, perhaps, maybe those over 90, or who have hit the century mark, that’s okay. Perhaps they’re ready to go. Those who have suffered fatal illness and were in great pain likely don’t mind passing, either. Everyone else, though, would have rather stayed alive had circumstances been different. 

Consider some of the people who left us this year before we were quite ready for them to do so:

  • Laurel Griggs, the 13-year-old Broadway actress who died following a severe asthma attack.
  • Former Pixies bassist Kim Shattuck was 56 when ALS ended her creative life.
  • House Hunter Suzanne Whang was also 56 when she passed in September from breast cancer.
  • Kylie Rae Harris, the singer known for Twenty Years From Now, was 30 when she was killed in a car accident.
  • 46-year-old actor Gabe Khouth suffered a heart attack while riding his motorcycle.
  • Boxer Pernell Whitaker was 55 when he was hit by a car.
  • Actor Cameron Boyce was 20 when a seizure ended his young life.
  • A stroke took 51-year-old director John Singleton.
  • A stroke also took 52-year-old actor Luke Perry.
  • Journalist Soni Methu, the first Kenyan to host CNN’s Inside Africa, was only 34 when she collapsed and died.

If you didn’t recognize some of those names it’s likely because they were still young and just starting to make what would have been an indelible mark on the world. Of course, there were more. Millions more. Every year it’s the same, smart, bright, talented people whose lives who don’t have a chance to make it to an age where death seems reasonable. 

This is why birthdays matter. We have reason to celebrate the fact we’ve survived while the planet has made another trip around the sun. We’ve no idea the number of times during a year where we “almost” didn’t make it, we “almost” became victims had one small detail been different, we “almost” were in the wrong place at the wrong time. 

For all the “almosts” though, there are millions of people who die each year for one basic reason: they didn’t take care of themselves. Maybe that wasn’t the direct cause of death, but they unwittingly hastened their departure from this life, setting themselves up for heart attack or stroke, or some other “natural” cause, because they didn’t to the things necessary to prevent or at least, delay or mitigate those events. 

Now, let me stop right here before someone gets all upset and admit that no, strokes and heart attacks are not always preventable. There are elements at work in our bodies we know nothing about until it is too late. I get that.

However, the numbers don’t lie and the numbers show that a significant number of deaths could have, perhaps should have, been delays or completely prevented had someone simply taken better care of themselves. This leads me to my motivational question for this week: 

Are we fit enough to live?

Be Thankful You’re Not Already Dead

How many of us were sitting around a large table this past week telling each other how thankful we are while simultaneously stuffing our faces with more food than some third world people eat in an entire month? I’ll admit to being one of those. I love roast turkey, especially when I’m not the one cooking it. While turkey is supposed to be one of those “good for you” foods, the 17th helping, you know, the one where you’re picking the slivers of meat off the carcass, is taking it to excess. We all love to celebrate, but as a society we tend to take things too far, not realizing when we’ve had too much of a good thing.

I’m more than a little disturbed by a study released this week by the Journal of the American Medical Association.  “Life Expectancy and Mortality Rates in the United States, 1959-2017,’’ doesn’t bring good news as we head into the season of continual parties and overindulgence. The study especially points out a problem with the Midwest, and particularly the state of Indiana. We’ve got a problem, folks. Here’s the bad news straight from the lion’s mouth:

During 2010-2017, midlife all-cause mortality rates increased from 328.5 deaths/100 000 to 348.2 deaths/100 000. By 2014, midlife mortality was increasing across all racial groups, caused by drug overdoses, alcohol abuse, suicides, and a diverse list of organ system diseases. The largest relative increases in midlife mortality rates occurred in New England (New Hampshire, 23.3%; Maine, 20.7%; Vermont, 19.9%) and the Ohio Valley (West Virginia, 23.0%; Ohio, 21.6%; Indiana, 14.8%; Kentucky, 14.7%). The increase in midlife mortality during 2010-2017 was associated with an estimated 33 307 excess US deaths, 32.8% of which occurred in 4 Ohio Valley states.

Here, please allow me to translate. 1. A higher number of people between the ages of 25-64 are dying. 2. A third of those deaths are in Midwestern (Ohio Valley) states, including Indiana. 3. There are multiple, largely preventable reasons for this problem.

There are a number of reasons this study is alarming. Let’s start with the fact that from 1959 to 2014, life expectancy increased annually. While the rate of increase had already begun to decline, in 2015 it started going backward and that trend has not changed. I know, anecdotally that seems diametrically opposed to the fact that we’re seeing more people live well beyond 100. The good news is that if you make it past the age of 64, yes, you are likely to live longer. The problem, however, is that fewer people are living long enough to meet the standard retirement age of 65. Since life expectancy is calculated as an average, the number of people dying at middle age skews the overall life expectancy downward.

This is explicitly a middle-aged adult problem. During the same study period, infant mortality rates dropped, mortality rates among children ages 1-14 dropped, “retrogression” occurred among those 15-24, and people aged 65-84 did especially well. So, why are we failing at the point in life when we should be the most vital and most successful?

There are a few hot spots. “Between 1999 and 2017, midlife mortality from drug overdoses increased by 386.5% (from 6.7 deaths/100 000 to 32.5 deaths/100 000),” the report says. Read that sentence again. This isn’t the 60s. From 1999-2017, overdose deaths increased by 386.5%. While opioid deaths certainly account for a fair percentage of that, we’re obviously not dealing appropriately with the overall problem.

Alcohol-related disease, particularly cirrhosis, comes in a strong second. “ …during 1999-2017, age-adjusted death rates for alcoholic liver disease increased by 40.6%.” Compared to 396%, 40% doesn’t seem so bad but wait, the news gets worse. If we narrow the range down to look specifically at adults 21-34 that percentage jumps to a whopping 157.6%. Young adults, millennials, are literally drinking themselves to death. Yeah, maybe put down that 14th glass of wine, Karen.

I doubt anyone is surprised that suicide is on this list, having increased 38.3% for the group overall and 55.9% for those 55-64. What’s interesting is those suicide deaths among younger groups, especially celebrities, tend to get more attention because we realize the lost potential in those young lives. That the greater increase comes between those 55-64 is what should alarm us. These are the parents of millennials, the once who have financed their adventures, done their jobs, and should, theoretically, be planning for retirement. Instead, an increasing number are saying, “fuck it, I’m out.” This seems to indicate something larger than just an ongoing undiagnosed mental health problem. Ramifications are here for workplace stress and long-term economic worries as well. 

To some degree, we can look at those three areas of increased mortality and say they all directly involve personal choice. These aren’t things that just “happen,” but are the results of deliberate choices people make. While that opinion is a gross over-simplification of the matter, the point of personal choice is still there.

What may be most disturbing for the majority of middle-aged Americans, and especially those living in the Ohio Valley, is the less glamorous category the report describes as “Organ System Diseases and Injuries.” If that strikes you as a vague umbrella term, it is. Fortunately, the report gives us some definition. To start, “heart disease and lung (notably chronic pulmonary) disease, hypertension, stroke, diabetes, and Alzheimer disease,” get the obvious nod. Those areas had already been increasing since the late 1990s. What broader examination revealed, though, was that hypertensive disease (stress), alcoholic liver disease, infectious disease, mental and behavioral disorders, obesity, pregnancy (didn’t see that one coming), and injuries (such as pedestrian-vehicle collisions).

Again, digging down into the details paints a gruesome picture. “Deaths from mental and nervous system disorders were second only to deaths from drug overdoses in influencing changes in life expectancy and were the leading contributors to decreased life expectancy among white females. Among white females, respiratory disease mortality was a larger contributor to changes in life expectancy than either suicides or alcohol-related causes and accounted for more deaths in rural areas than drug overdoses.” Among men, drug overdose deaths dwarf every other cause of death studied. Mind you, that’s across all age groups. 

If you’re a non-Hispanic indigenous person or black, your community is at significantly greater risk than the parallel white group. The dramatic increase in all-cause mortality started in 2010 and has moved steadily higher since then. Again, drug overdose is the dominant cause factor, but increases in alcoholic liver diseases, suicides, and hypertensive diseases are nothing to be ignored. 

Oh, and let’s not miss this gem hidden down in the details: “The gradient in life expectancy based on income has also widened over time, with outcomes at the lower end of the distribution explaining much of the US disadvantage relative to other countries.” Translation: America’s poor are dying faster and in greater numbers than poor people in other developed countries. Let that sit and stew in your brain as you’re contemplating another sandwich of turkey leftovers. 

We’ve known that there is a health crisis in America for some 30 years. We, collectively as a society, didn’t want to hear it when, as First Lady, Hillary Clinton introduced a comprehensive health plan back in 1993. Even liberals within the Democratic party thought it was excessive. Now, we’re finding out it wasn’t and we’re also discovering that, once again, we’ve ignored a problem so long that we’re dramatically behind the curve in looking for a solution. 

In fact, given the dramatic nature of this report, you should probably be thankful that you’re alive to read this article and haven’t fallen victim to any one of the some 20-plus increased causes of death mentioned in the report. If we’re going to live longer than the generation before us, which is already pushing at that century mark rather frequently, we’re going to have to make some changes. We’re each going to have to take our own mortality more seriously than we have to this point. I would hate to think that this might have been your last Thanksgiving, but statistically, it could be.

Addressing The Most Critical Issues

I grew up thinking that the most likely cause of deaths for individuals in the United States is either cancer or some variation of heart disease. Statistically, that’s still true. However, the study released this week shows that the US has made dramatic improvements in treating both those areas, well above advances made in other countries. A US citizen with a cancer diagnosis is A) more likely to have been diagnosed early, B) more likely to receive aggressive treatment to put cancer into remission than are patients in other economically developed countries. That doesn’t mean everyone lives, we all know too many people who have died too young, but one’s odds are better here than anywhere else.

What this demonstrates is that when we decide to focus on a problem, we are fully capable of finding solutions to those problems. However, as a country, we have terribly short attention spans and only seem able to focus on a handful of things at a time and we do so to the almost complete exclusion of everything else. The opioid crisis isn’t new. Suicide isn’t new. Alcoholism has been with us as long as we’ve been a country. We’ve largely ignored those issues, comparatively speaking, and now they’re biting us in the ass, killing people faster and younger than ever before.

The Opioid Crisis

One of the matters I find interesting is that there has been a huge push among states Attorneys General to hold Purdue Pharma, the maker of OxyCotin and other opioid manufacturers responsible for their role in causing the current crisis. That’s good and there’s no reason to not support that effort. However, not nearly as much energy is being put into actually stopping the crisis now that it’s here.

Don’t get me wrong, there are people who are trying. I’ve looked through at least a dozen governmental and medical reports (it’s a damn good thing I can translate academic obfuscation to English) and there are people who know what to do, people providing the money to do what needs to be done, and programs in place to get resources to the right people. It’s all there and most have been there since at least 2016 if not longer. So, why is this still a problem?

A couple of huge issues continue to be problematic, and I’m concatenating a number of sources so please excuse me for not listing them (Google is your friend if you’re really interested). First, doctors are finding it difficult to treat severe pain without opioids. No, I’m not going to give untested homeopathic “remedies” any oxygen. Let’s stick with what actual scientific study tells us. The CDC’s recommendation for physicians (which is delivered in a hilariously simple slide show presentation) first states that opioids should not be prescribed for routine pain. That’s cool, and necessary unless one happens to have liver disease, or is pregnant, or has renal or certain gastrointestinal disease, in which case many of the NSAIDs recommended can’t be used. Even the CDC recognizes that physician training in identifying appropriate non-opioid pain treatment is lagging, stressful, and time-consuming.

The second issue is getting treatment to more rural areas where the effects of the opioid epidemic are staggeringly high. I find it interesting that, anecdotally, “small-town boredom” gets blamed for rural opioid deaths. That’s bullshit. Opioid dependency is rural areas starts with a doctor’s prescription in over 90 percent of cases. Once addicted, resources in rural areas are few and where they exist they are overwhelmed with the number of people needing help, causing delays and insufficient treatment. Managed recovery from opioid dependency is time-intensive which makes it extremely expensive to provide. Despite millions of dollars in grants having been provided to address this situation, ongoing funding has lagged and many clinics established just two or three years ago are having to close, leaving people in rural areas without options. 

However, the CDC does recommend some non-drug interventions and high among them is exercise therapy. Keep that in mind, we’ll get back to it a little later.

Millennial Alcoholism

Alcoholism is also high on the mortality list and the report specifically calls out millennials, people ages 24-35, as being most likely to die from alcohol-related diseases. This comes despite the frequent public appearance that millennials are doing a better job at sobriety. After all, they initiated Sober September and other peer-oriented campaigns to at least help people drink in moderation. However, the reality is that young adults are drinking more and drinking more often than their predecessors ever considered. 

A number of reasons persist for why this statistic exists. Most point to a litany of stressors unique to the millennial age group at this particular time in history, such as frequent periods of unemployment caused by the gig economy, oppressive college loans, parental pressures and excessive expectations starting when they were children, prolonged effects of childhood trauma (think growing up in an age where school shootings are a real threat), the socially welcoming environment created by the explosion of small/local breweries, and extreme cases of undiagnosed or undertreated anxiety. 

What’s certain is that traditional alcohol abuse programs, especially 12-step programs that require attending meetings on a regular basis, aren’t working. Again, there are at least a dozen reasons (75 percent of AA members are over 40, 62 percent are male, just for starters). While every treatment center I consulted says they have new and modified methods for treating millennial alcoholism, none could say they’re seeing any significant level of success (I won’t embarrass them by calling them out, but if your insurance covers them they were likely contacted). 

Here’s where the medical community is letting millennials down. I’ve looked. There is ZERO medical consensus on how millennial alcohol addiction and abuse should be treated. While almost everyone agrees traditional programs don’t work, opinions on treatment are widely varied and, most importantly, severely undertested. There’s also precious little oversight of so-called treatment centers as to the efficacy and success rates of their programs. For parents concerned about their adult child’s drinking problem, dropping them into the closest rehab center has an extremely low chance of doing anything other than completely alienating your child. 

What has show promise, in some cases, is exercise therapy. Again. Stick that in your pocket, we’ll be back.

Responding to Increased Suicides

Over the number of decades I’ve been alive, we’ve seen the response to suicides move from one of absolute silent denial, to shaming the victim for being selfish or cowardly, to blaming undiagnosed mental illness, to blaming peer pressure and other external stressors, to cautiously and controversially acknowledging a person’s right to die. Watching this spectrum develop across nearly 60 years has been depressing because as our responses have changed the problem itself has grown increasingly worse. There are more suicides per capita in the United States than ANY other developed country. The numbers aren’t even close.

What’s particularly bothersome in this JAMA report is that it shows a significant increase coming from a seemingly unlikely demographic: adults between the ages of 55-64. This hits home because these are my peers and if I’m totally honest I understand perhaps better than I care to admit how attractive suicide can appear in one’s mind. For men of this age, there are too many times when we look at our situation, consider the possible alternatives and the amount of effort needed to address any of them and feel the desire to simply say “fuck it all,” and remove one’s self from the equation—let someone else deal with the bullshit. And while we sometimes may hate to admit that we’ve put ourselves in these difficult situations, where we feel the most desperate is when one feels powerless to affect the outcome in a way that doesn’t bring pain to someone. 

Now, let’s be very clear, the guidelines for helping someone who may be suicidal, regardless of age or gender, haven’t changed. Here they are again because we can’t repeat these too often.

  1. Reach Out. Ask direct, impossible to misunderstand questions. Don’t hint, don’t beat around the bush. “Are you thinking about suicide?” is never inappropriate.
  2. Listen. If you ask a question, don’t dismiss the answer. Give people room to talk even if to you it sounds petty and irrelevant. To them, whatever they’re saying is likely important and meaningful. Ignoring or dismissing someone’s feelings only makes it worse.
  3. Check their safety. Damn, but this is super important. We live in a culture where people say they just want to be left alone. That’s fine up to a point. When someone disappears for periods longer than what is normal for them, check. Even if that disappearance is digital, such as not posting stupid memes on Facebook. Check on them. The person that suddenly stops being part of their normal group? Check on them. Sure, they may have perfectly legitimate reasons for the change in behavior. Still, check on them.
  4. Decide what to do, together. Talk about what needs to be done to keep them safe. Don’t “take over” and tell them what’s going to happen. Involve them in the conversation and, going back to #2, listen. Create a plan that’s good for them or it’s not as likely to work.
  5. Get help. You should already know the Suicide Prevention Hotline number is 1.800.273.8255. Click that number and you will be connected to the service’s chat line. The service is also available in Spanish and for those with hearing issues. If the helpline seems too extreme for the situation, look for a service provider that is appropriate, such as your regular doctor, a school counselor, a therapist, or friends and family who can be supportive (if family is too deep in their own issues or the cause of someone else’s issues, it’s okay to leave them out of the equation). The important point is that there’s a community of solid, understanding help.

I wish I could sit here and tell you how to prevent suicides, especially among men ages 55-64. That statistic is going to haunt me for a while. The problem is that single risk factors don’t predict suicide well at all. For all the research that’s been done toward preventing suicides, psychologists have no reliable tools to work with. They have to rely on their intuition and as a result some people inevitably slip through the cracks. [source]

There is some improvement in intervention tactics (read about them here) but they require a qualified clinician which makes them a budget item many resources can’t afford. They also, based on previous trends, tend to skew toward identifying and helping younger people. Not as much effort has been put toward protecting people on the back side of being middle-aged.

What seems to make as much difference as anything is for people to be there for each other and, increasingly, we’re not terribly good at that. We’re more plugged into reading our phones rather than each other’s faces. We don’t pay enough attention to pick up on the subtle clues that maybe something’s wrong. 

Oh yeah, guess what gets mentioned as one of the ways to address suicidal ideations: exercise. Keep reading.

Fitness, Exercise, Diet, and Staying Alive

When I started writing this article at the beginning of the week, my whole purpose was to talk about fitness and exercise. I’d already done the interviews, had the quotes pulled, and was ready to write. Then, the JAMA study hit my inbox and it was too important to ignore. Further, the deeper I looked into the studies behind the report, the more a continuing thread became obvious: fitness and longevity have an important connection

There are a handful of caveats before getting too deep into this topic. First, and most importantly, consult with your doctor before starting or dramatically changing any fitness or exercise regimen, especially if you have already been diagnosed with high blood pressure, heart disease, arthritis, or at risk for a stroke. Many people have justifiable limitations in what they can do and nothing discussed in this article intends to suggest that doctors’ instructions should be ignored.

Also, anyone just starting a new exercise regimen should keep a close eye on their heart rate and blood pressure for the first six weeks. When one’s body has adjusted to being sedentary it may not always respond in a predictable manner. Keep watch until a routine is developed that is appropriate for you. 

Finally, the material that follows is a mix of science and experience. While I believe everything is accurate at the time of publication, there are always exceptions for which we cannot be held responsible. Again, if you have ANY questions or concerns, please consult your doctor.

Fitness and I have already had a challenging relationship. As a kid, I remember someone coming to school and distributing posters supporting the President’s Physical Fitness program. I convinced my mother to let me hang the poster on the dining room wall and started doing the prescribed exercises every day after school. For additional motivation, I hung a Marine Corps. recruiting poster next to it. Being a Marine was the ultimate goal because they had the coolest dress uniform. For Christmas that year, my parents even splurged and bought me a weight set. We’re talking old school dumbells and barbells. I tried, probably doing things that were potentially dangerous because I had absolutely no supervision in my quest. 

My motivation didn’t last long enough to see any positive results. I was that skinny kid who had trouble breaking the 100-pound weight goal. The only muscles I had were the ones required to keep me ambulatory. Not seeing myself turning into any version of the hulking machine I desired to be, I gave up.

My next serious attempt was in 1986, weeks before my wedding. A new gym had just opened in McAlister, Oklahoma, just down from the Braum’s Ice Cream shop. Fitness was cool at that moment, with everyone including Jane Fonda releasing fitness videos. The cost fit my budget so I joined. My first workout was with a trainer who also happened to own the place. He was a big guy with massive muscle structure. He started me on a very basic workout. I made it 20 minutes before I threw up all over the gym floor. I wish I was kidding. I went back a couple of times after that but was ultimately too embarrassed to keep it up.

I would try a chain gym later, around 1989 I think, again with the trainer, and this one lasted for the better part of the year. Still, when I didn’t see the results I thought I should see, still looking for those massive muscles or anything that looked like it might be a muscle, I decided it wasn’t worth the $50/month I was paying.

For the next several intervening years, I convinced myself that the physical requirements of my job was sufficient enough exercise, and had those tough assignments come every day that might not have been wholly inaccurate. There were trips where we were climbing rocks, repelling into canyons, and doing all those things that require putting your worn clothes in a separate bag for the trip home. Those were the exception, however. Most days were spent in a studio where the craft services table was too laden with donuts and too convenient for perpetual snacking.

When fitness really hit home was after the event that took out my left leg. Faced with a doctor who wanted to push pain killers to help keep me mobile, I opted for something more akin to physical therapy. Appropriate shoes were purchased, a gym membership was obtained, and away I went, this time with a different goal not so much to put on muscles but simply to stay fit enough to keep down the pain. This time, it worked.

Then, three years ago, when I was given the diabetes diagnosis, exercise was again emphasized, this time with a caveat: don’t overdo it. Having a different doctor made a huge difference. He was much more concerned about my total health and wanted to balance staying active, a very necessary component to fighting diabetes, with not having a heart attack or stroke because my blood pressure is a freaking nightmare. 

Most mornings, you’ll find me in the gym right after the kids get on the bus, while it’s still reasonably quiet. I’m joined by several other people my age or older, not because it’s a gym for seniors, but because the staff is accepting and supportive. While, like anyone, there are days it doesn’t fit the schedule, I’m able to stay consistent enough to tell a difference. Regular exercise is good and necessary.

My store is anecdotal at best, though. What I found interesting about the JAMA report released this week is that for every major area of concern, fitness and exercise is listed as one of the major components of an overall plan to combat the things that are killing us, including opioid addiction and suicide. Staying active and having a regular, focused exercise routine, even a simple one of riding a stationary bike for several minutes, brings a truckload of health benefits that not only have positive effects for our body, but for those portions of the brain related to both addiction and suicide. 

Note: exercise alone doesn’t cure any of the critical problems we’ve discussed, but as part of an overall wellness plan, it can make a huge impact.

Understanding Fitness From People Who Do Fitness

I am convinced that when it comes to fitness and exercise, the best people to talk to are the people who do it every day, the folks for whom it is a way of life. Not all of them are fitness coaches, necessarily, but anyone has what it takes to achieve significant results to the degree of competing at high levels probably knows what they’re doing, and most do it well with their overall health in mind. Yes, there are those who use illegal steroids or push powders that produce dubious results I won’t deny that those people exist. However, most of the fitness people I’ve met over the years take a more common-sense approach that doesn’t risk ruining their lives later.

A common-sense approach to exercise has always been the best approach. I remember my mother watching the late Jack Lalanne on television in the morning, way back in the early 60s before there was a fitness craze. His whole purpose was to specifically help women who stayed home find ways to stay fit while maintaining the socially-expected routine of the day. He had them doing jumping jacks, squats, thrusts, pushups, and using cans of food in place of dumbells for curls. His goal wasn’t to turn women into fitness competitors but help them stay healthy.

Obviously, the world has changed a bit since Jack was on television every morning, so I reached out to some local people and convinced a couple of them to sit down, somewhat stationary, and talk with me for a moment. Their advice in relation to overall wellness is insightful and workable for almost anyone. Let me introduce them to you.

Jordan Rachelle is a fitness competitor, coach, and business person on top of being a busy mom. She’s one of those people who bubbles with enthusiasm even after having car trouble on the Interstate on her way to meet with me. She’s walking proof that you’re not too busy to be fit.

Bob Berbeco is not only a fitness competitor, but he’s one of those guys who ride motorcycles competitively, putting his body millimeters from the ground while taking curves as speeds that scare the living crap out of me. Dude, you’ve got to have some major respect for someone who can pull that off and not spend most of their time in a hospital bed.

I talked to both for several minutes and have narrowed down their advice to a few easily consumable points.

Stop Making Excuses

Excuses come easy. Everyone has a busy life. Not everyone can make time for exercise, can they? Well… 


“It doesn’t have to be like this big, huge, ‘I’ve got to go to the gym.’ It can be little things. It can be walking upstairs instead of taking the elevator. It can be parking out further instead of looking for the closest parking spot. It’s all those little incremental things that can actually keep you a little more physically fit than going to the gym. You kind of have to be principled about it.”


“Life comes at you in all these different ways, but you find time to take a shower, you find time to brush your teeth … but when your heart is in something, you make it happen. There are a lot of people who are talkers and they all have an excuse: ‘Well, I work a 14-hour shift,’ or ‘I work night shift,’ or ‘I’m going through a divorce,’ ‘I have four kids,’ ‘I have this, I have this, …’ And it is not that I’m a pro at it but I can say from my lifestyle I don’t believe many people can tell me, I don’t have time. I have four children, I own two companies, I am co-hosting a TV show, and I also do consulting for fitness. So you find time.

Do What Makes Sense For You

I am anti-fad on almost everything and especially when it comes to both diet and nutrition. Just because a certain fitness regimen or a specific diet worked for your best bud doesn’t mean that your body is going to respond in the same way. So much of what is consumed through popular media means well but can actually have a detrimental effect on many people. I asked Jordan and Bob to tell me a little bit about what works for them and they have some good advice.


I love putting meal plans together. Nobody’s meal plan is going to be the same by any means. And then I’ll create workout programs for different individuals based on their body. So many people get a blank slate for a workout and it’s not right. At 6’ 7” you have to work out completely different, the way that you pull muscle, the way that you stretch it. …

With every single [client] I do gym work. So with every single one, I give a workout program. Some of them like to work out with me and then we’ll go that route, we’ll go one-on-one working out so I can watch their form, so I can watch, you know, are they tiring out, are they taking a longer rest break than they should be taking, monitor their heart rate along the way. So, you know I do both where some people I send them workouts and some people come workout with me.”


Listen to your body. That’s kind of difficult, it’s kind of a slippery slope. You can say, ‘Well, my body’s sweating and this hurts so I’m gonna stop doing it.’ If you’re listening to your body, is this injury soft tissue, ligaments that I’m injuring? Is it muscle soreness? That’s a good thing. 

When I go there [the gym], I don’t look at my phone. I don’t talk to people either. I go in, I’m there for a reason, I just want to do my thing, I’m sorry, I don’t have social time. I’m not going to take pictures of myself. I’m going to work out and I’m going to leave. And it’s very intense, focus on intensity don’t worry so much about the weights. Make sure as you’re doing it you have good form. By the time you’re done, you’ll feel like you’ve had a good work out.

You Really Don’t Have To Be A Gym Rat

One of the aspects my doctor emphasizes is not going overboard. For me, there is always the danger of re-injuring my leg or hip which would be immensely counter-productive. Yet, I was always under the impression that the people who are the fittest spend the most time in the gym. That couldn’t be further from the truth. I asked Bob and Jordan about the routines they use. Here’s what they had to say.


My workout regimen, I change it every four weeks. I actually have three workouts that every for weeks I go to the next one. The exercises change fairly dramatically challenged. That was actually Jacqueline’s (Sobotka) suggestion. She’s helped me. I’ve always been pretty active. I went to Jacqueline, a diet and workouts, it changed things. It actually made it more exciting, too. You do the same thing for a year and it gets boring. That’s what I like about that four-week switch. I start feeling like I’m getting bored and now I’m going to the next thing. 


I have people who come to me and say, ‘I’m in the gym for four hours,’ and I’m like, ‘Why? What are you doing for four hours?’ There’s a point in your workout where you start breaking down your own muscle. Most of the time I don’t recommend someone be in the gym more than an hour. There’s some people may take an hour and a half just because of mobility; getting from one station to another. But there’s so many people who go out there and they push, push, push, push, push. And someone will say, ‘Oh my gosh, my first rep I was up 80 pounds and I did thirty more minutes.’ No! You just tore down everything you just built. Yes, I know you’re wanting that pain, you’re wanting that burn, but there’s nothing in that that’s benefiting you. You’re creating acids. Your cortisol levels are increasing. Your body is going into ‘save’ mode, it’s not going into ‘let’s build.’ 

Attitude Makes A Difference

As with almost everything else we do in life, attitude can make or break one’s experience. From the moment we wake up in the morning we determine the course of our day, and through that our health level, with our attitude. Personally, I’m horrible at this aspect. It doesn’t take much to send me grumbling and growling through the day. That not only affects the efficiency of my workout, but my attitude also plays a huge role in where my blood pressure is going to rest for the day. 

Jordan and Bob came at the topic from two different directions with instructions that are both practical and workable.


What I do for the first 21 days with any client that I work with is they check in with me daily. So when they check in with me that means within the next 30 minutes they’re going to the gym. The general emotion in people is they don’t want to not do their job. I mean, most people won’t choose not to do it. Situations come up and excuses and all but it’s not like they start their day saying, ‘I’m not going to do my job.’ So, I encourage everyone who’s going through fitness that they look at this as another job. Because the payout is your health. That’s the best investment you can make.


I tend to be an optimistic person anyway by nature, but I feel happier, I feel more focused, I don’t feel fearful. I feel like I’m able to accomplish what I need to. Whatever comes my way I’ll have the energy and the focus to accomplish what needs to be done. …So, I worked on my diet and since I’ve been working out, I’m 50, going on 51, I can honestly say I feel healthier, more energy than I did when I was in my 20s. I did the Daytona 200 (GP race) and I finished that race, my legs were sore, but I was ready to go out and party. Recovery, energy, strength, that’s where working out and being healthy really benefits.

Your Health Is Everyone’s Problem

One of the challenges in looking for solutions to our nation’s health problem is that we keep running into the healthcare debate about who’s paying for what. Let’s skip that whole part about which plan is or isn’t the best. Let’s look at the fact, and yes I said FACT, that when you are sick, when your children are sick, when your neighbor gets sick, everyone is already paying and the cost is not insignificant.

When you are sick, even if you are depressed or just have a headache, you stop doing things you would otherwise do. You don’t do your job as efficiently, if at all. You don’t do things with your friends and family. You don’t go to movies, buy new clothes, or go out to eat. You are creating a deficit in the overall economy.

Then, if you do go see a doctor, the cost to the economy rises even more. Not only does healthcare have the potential to drain your life savings, someone has to pay for the portion you don’t or can’t. Sure, that’s supposed to be the job of insurance, but as costs skyrocket insurance companies create profit by raising everyone’s rates, so everyone pays. Healthcare costs are absolutely swallowing the US economy [source].

Need that in a dollar amount? The overall cost is difficult to calculate because of reporting issues, but what we do know is that productivity loss due to health-related issues tops $530 billion dollars annually, most of which are initially shouldered by employers and passed on to the consumer through higher prices. [source]

What isn’t a drain on our entire social system? You staying healthy. When you’re healthy, you don’t take as much unscheduled time off work. When you’re healthy, you’re not getting your co-workers and friends sick, causing them to miss work. When we are healthy, we have healthier babies, lowering the infant and mother mortality rates. When we are healthy, we are happier, resulting in fewer suicides. And are you ready for this? When we are healthy and happy, we feel less chronic pain, reducing our dependency on pain killers that may be addictive, such as opioids [source].

Depending on which study one wants to believe, the individual out-of-pocket cost for illness is somewhere between $4,200 and $6,800 annually. That’s assuming one only has basic issues like allergies, generic flues, and other issues that can be treated and released. Once one has to be admitted to the hospital, even with insurance, the costs explode. The money taken from your wallet is only a fraction of what is taken from the economy at large. 

What I’m about to say isn’t going to be especially popular but it needs to be said. If we’re going to talk about any form of national healthcare policy, then we need to also talk about national wellness responsibility. If we’re going to look toward the government to protect the global right to human healthcare, the government has to look toward us to be decent stewards of that right. 

This isn’t a strange concept, really. If we want the freedom of speech, we have a responsibility to not be hateful or induce harm through that speech. If we want the freedom to carry firearms, then everyone has the responsibility to not let them fall into the hands of stupid people who find joy in killing. If we want the right to vote, we have the responsibility to actually vote. If we want the right to drink alcohol, we have the responsibility to not kill someone on our way home from the bar.

We’re accustomed to all those limitations (for the most part). No one questions those. Maybe we need to be equally as diligent in protecting our right to health care. 

How might that look? Probably something like this:

  • Mandatory annual health screenings for everyone.
  • Preventative healthcare, especially for people over 40.
  • Vaccinations for everyone, without exception.
  • Elimination of fresh food deserts.
  • Financial support for neighborhood gardens.
  • Tighter controls on air quality in both public and some private spaces.
  • Mandatory wellness education that goes beyond PE.

Here’s the rub: If we as Americans are dying faster than other developed countries, there’s really only one source to blame: ourselves. We make the choices that put ourselves and other people in risky situations. You and I decide if we’re going to get the flu shot this year or spread our germs to everyone. You and I decide if we’re going to drive recklessly. You and I decide if we’re going to vote for people who support laws allowing people with mental health issues to own guns. Well over 80 percent of the health issues that lead to death have a connection somewhere along the line to our own behavior. 

One way or another, we all pay the bill for healthcare. Doesn’t it make sense that we would take the steps to reduce those costs before they occur?

Birthdays Remind Us To Live

For all the grumbling and griping I might do about how old I am, I’m nowhere close to being done living. I’ve warned my boys since they were little that they are going to have to put up with my cranky old ass until I’m at least 150, which means I’m barely a third of the way through this journey. If I’m going to make it to my goal, I’m going to have to take better care of myself.

And as irritating as some people are, I don’t want to spend the better part of the next 80 or so years alone, either. I need someone around who rolls their eyes when I say or type something stupid. I need someone to walk with at the beach when it finally makes its way to Indiana in about 30 years. I need someone to fill my scotch glass when my own hands get too shaky.

So, I’ll make a deal with you. I’ll pay more attention to my exercise regimen and diet if you’ll pay more attention to yours. I’ll drive a little more sanely if you’ll stay the fuck out of my way and stop blocking the damn roads for sports events. I’ll try to get more sleep if you’ll stop waking me up with interesting stories in the middle of the night. 

And we can both celebrate all the birthdays still to come. Blow out the candles. I’m taking a nap.

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