Birthdays Are Good For Your Health

I've probably talked too much about birthdays lately.  I certainly have had plenty of them.  My 63rd was at the end of May.

But a friend sent me a note that said "birthdays are good for your health--people that have more birthdays  tend to live longer."

Sixty-three.  Sounds old.  I remember one time when I was a teenager and we had a new guy working with the youth at our church.  He was married with a couple of kids and in his thirties.  I very clearly remember thinking that a man in his thirties was really old.

Not so much now.

But here I sit with bifocals (or the modern day equivalent-progressive lens), hearing aids, walking with a limp.

Oh, I still bounce up in the morning excited about what the day brings.  My wife teases me about it.  

My alarm clock makes a subtle click before the music comes on and I'm awake, sitting up, and turning the alarm off before the first three notes.

About those hearing aids...John Berry convinced me to overcome my vanity and go for the behind-the-ear model instead of the in-the-ear and oh my goodness they work so much better. 

And I need a knee replacement.  My right knee is pretty worn out which is why I usually walk with a limp.  But it doesn't hurt and it does the things I want to do quite well so no knee replacement for me.  For now.

So what do we need to do to live long and be healthy as we get older?  Just like saving for retirement, it pays to start young. 

That means to establish good health habits.  Like exercising regularly.  And eating better.  No smoking (ever, ever, ever).  Getting enough sleep (that one's more of "do as I say, not as I do").  Finding something to laugh about every day.

And get your weight under control.  There is no doubt that weight control gets harder as you get older.  Your metabolism starts to fail you. 

I can't tell you how many patients that I've had who have a weight problem because their knees hurt so bad that it restricts their mobility.  And if you can't move, you can't burn the calories.

If you're "middle aged" it's much the same thing.  Life gets busier and time for exercise and taking care of yourself seems hard to find.  I've told lots of folks that you simply have to be selfish and take the time that is necessary to preserve your health. 

Regular medical care (a.k.a. annual physical) is also important.  I can remember my PCP asking me "why are you here?  You're the healthiest person I know."   I was 40.  It was simply part of my attempts to stay that way.

I've said often that it is more important for the 60-something to lift weights than it is for the 20-something.  Beginning in our late 20's, we start losing muscle mass.  Since few of us also lose weight, that means that muscle is being replaced by fat. 

Add in the need for weightbearing activities to help fight off osteoporosis and you can see why I say that it's more important to exercise later in life than it is when you're younger.

If you're late to the game, don't worry.  It's never too late to start getting healthy.

Opiods Kill More Than Car Wrecks

99% of the opiods used in the world are used in America.

Vicodin.  Percocet.  Hydrcodone.  Oxycodone.

Opiods.  Highly addictive.  And Tennessee is one of the worst states for opiod use in the country. 

More statistics:  4.56% of Tennesseans are either addicted to opiods or abuse opiods.  Since 2012, opiods have been a bigger problem than alcohol in Tennessee.  In 2010 (the last year these statistics were available), there were prescriptions written in Tennessee so that every citizen over 12 would have 51 hydocodone pills.

From the latest statistics available, Tennessee is second only to West Virginia in number of prescriptions per person (for all prescription medicines).

But providers are a small part of the problem.  From available statistics, only 17% of the opiods in use in Tennessee come from a physician prescribing medicine for their patients.  Over 50% of opiod users get their pills from a friend or a relative.

The rest from come from a variety of sources including illegal sales from drug dealers.  We have all heard of the pill mills and our own community has not been immune to that abuse of the system.

I know of a lot of physicians that simply refuse to prescribe opiods.  That can be a problem for the medical community, as opiods can be a very useful part of medical care, particularly after surgery.

Other statistics:  People addicted to opioids are "more likely to be married, employed, and have greater than 12 years of education."

We can't ignore the bad news.  In 2011, 1062 Tenneesseans died from opiod overdose.  In 2014, that figure rose to 1263.  That's more people than died from car wrecks.

But we also can't ignore that medicines are an important part of health care.  It always gets my blood boiling when people or pseudo-health care practitioners declare that all medicine is bad.  That just isn't so. 

I can't tell you how many patients that I've had through the years that tell me "I don't take pills." 

High blood pressure?  I have it.  The first line of medical advice for treatment of hypertension (high blood pressure) is to exercise more and eat better.  Been there.  Done that.  It isn't enough.  I still have to take my medicine.

And let me add a few more statistics.  #1, vaccines work.  Only 2% of U.S. deaths were caused by pneumonia and the flu in 2013.

There have been at least an 80% reduction in deaths from HIV since 1996 due to effective antiretrovirals.

What's this got to do with sports?  A significant portion of those with an opiod addiction started on that path while dealing with sports injuries.  I couldn't find a specific figure on that but I know enough specific cases to know that it is a pretty big issue. 

You see, that's part of the problem.  Those addicted to opiods are often our friends and neighbors.  

Their addiction often started with legitimate injuries or medical issues. 

In any case, it is a huge problem in Tennessee and we all need to focus a lot of attention on it.  What can you do?  Understand that it is at the crisis level.  Recognize that it can happen to anybody.  Support those in the throes of addiction.  If it's a family member, learn what you can do.

And if it's you, get help.

College Athletes Should Be Paid

You know, for a while, I've had a column in the works that talks about how college athletes should be paid.  That tuition and books and housing just aren't enough for some who can't afford a burger out with the guys.

I remember seeing it firsthand when my son was in college.  He was by no means on an unlimited budget but if he wanted to go out with friends for dinner, he could afford to do that.  Many of his football buddies could not.

We found pretty early on that if we ever showed up with pizza, we needed several.   We would show up with food and football players would come running.  It's like they could smell the arrival of anything edible.

It really hit home when we were going in a local store and one of my son's buddies was coming out empty handed.

We knew this young man--always polite and respectful and, like most offensive linemen, big as a house--and had made friends with his mom.  Mom was this really great lady that was a single mom and worked hard.

I asked this young man if everything was OK.  Most people don't walk into a big box store and come out empty handed.  He replied that everything was great, that he was just in the store making a payment on the  lay-away plan for his computer. 

I remember lay-away plans, where you paid so much as often as you could and when you had paid in enough, you got the product.  But I thought that system went away a long time ago.

And I just assumed that most college students had computers.  I believe this was the young man's junior year and he still didn't own a computer.  Rare then and unimaginable today.

The argument against an allowance is that these athletes are getting a free education.  OK.  I'm good with that.  My son was the beneficiary of that.  But I also know that he, like most college football players, rarely emerge unscathed physically.  They have injures that will follow them for the rest of their lives. 

And I know that lots of colleges are making millions of dollars off these athletes.  They can't work, can't hold down part time jobs.  It's either against the rules or they don't have time or both.

So yes, college athletes deserve an allowance.  Too many come from households that cannot afford to send their college student any money.  None.

Now, when you hear that some college athlete sold his jersey or whatever, please don't think so harshly of them.

But with the recent rash of misbehavior by college athletes, it doesn't seem quite right to push for more benefits.   It certainly makes one stop and think.

Maybe we are creating a culture of privilege and entitlement where athletes (and others) feel that they can get away with anything. 

Maybe we are only seeing the end result of excuses that we give our young people.  I just don't know.

What I do know is that it really does not matter what opportunities you are given, what advantages you are provided.  We have personal responsibilities for our actions.

It really is as simple as that.

So Your Shoulder Hurts?

My wife always prefers that this column addresses the things that I know best.  Like sports injuries, physical therapy, athletic training, and rehabilitation.  Oh, she will acknowledge that I do have a pretty good understanding about things like dedication, dignity, effort, exercise, and persistence.

My best critic and biggest supporter, I do listen to her (most of the time).

So after reading last week's column (which she really liked) about my Bucket List (or lack thereof), she suggested I write about something more medical. 

Being the always attentive husband (this was, by the way, sitting over coffee after Sunday breakfast), I asked "like what?"

"Well, what do you do most of?"

That one was fairly easy.  Much of every day is spent on helping people deal with their shoulder problems.  It seems like we're in the middle of an epidemic of shoulder problems. 

I put those into two categories.  The first is the most common and I blame it all on the computer.  

Everybody spends too much time on the computer.  For many, it's part of their job.

I know I do.  Medical documentation and the many administrative responsibilities inherent to my job put me in front of a computer for several hours most days.  At times it seems like I spend more time on the computer than I do treating patients. 

I even talked to an employee of a local manufacturing plant and his day was spent in front of a computer.

So what's the problem with computers?  It's the posture that using a keyboard requires you to assume.  Head down.  Shoulders hunched forward.  Our computers are rarely high enough and our arms are never supported enough.

And so we pay the price with shoulder problems.

The other category is the weight lifter.  Typically, it's the younger athlete who has really gotten into weight lifting.  But too often it's the older lifter who has been at it for years.  The common denominator?  The bench press.  The younger lifter spends too much time on the bench press because that's what all his buddies are doing (and yes, it's mostly a male thing).  The older lifter spends too much time on the bench press because...well...it's what he's always done.

It's easy to spot them both.  When you look at them standing in front of you, you see the backs of their hands since their shoulders are rolled so far inward.

And that, friends and readers, is where I come in.  Maybe they've torn their rotator cuff or had other shoulder surgery.  Hopefully we get to them before it has gone so far that surgery is their only option. 

In a nutshell, it's their posture.  They may stand up perfectly straight but their shoulders aren't where they need to be.

The key ingredient is to training those muscles that hold the shoulders back in a neutral position.  Part of that is likely to be adjustments to how they work at a computer.  And for those dedicated to the bench press, it is likely to mean that they need to turn their focus away from the bench press.  Far away sometimes.

Oh, it's sometimes more complicated than that (that's why I have a job) but those are the basics. 

The Non-Bucket List

Are you old yet?  I don't mean in years.  Do you act old regardless of the candles on the birthday cake?

I know people my age that are already old and feeble.  They look old and act old.  I know other people that when they tell you their age, you find it hard to believe they're that old.

I had a birthday this week. I've never hid my age.  Those folks on publish their birth date but not the year (thus not revealing their age) don't get it.  I'm not sure that I've ever been embarrassed about any age that I've been. 

Sixty? I'm OK when somebody says "you look good for a man of your age."  Fifty?  Didn't give it a thought.  Forty?  Hardly registered.    Thirty?  I can't remember it but it sure seems young now.

Remember the movie The Bucket List?  I don't really have one.   Oh sure, there's some things I want to do and see. 

I want to see my grandkids as happy adults.  If you had asked me about my own kids when they were little, I would have said I wanted them to be successful adults.  There's a difference.

But that hardly seems a "bucket list" type goal.

I've never wanted to jump out of a perfectly good airplane and hang gliding (basically attaching yourself to a kite) never interested me. 

I like to scuba dive but I've already been diving with whales and too many sharks.  Don't want to push my luck too much.  I don't need to go deeper and have absolutely no plans to dive in a cave.

I love to ride my bicycle but I have no desire to do one of those cross-country things.  I don't want to be gone that long from home.  And it seems like it would turn biking into a job.  Or a personal quest to prove something that I just simply don't find it necessary to prove. 

Local rides with great friends are as good as it gets  (although if Ken Bell says lets head out west to ride mountain bikes...well...I'm in).

I've always wanted to see Machu Picchu but it seems an awfully long way to go for a day hike.

Visiting the South Pacific would be nice.  Tahiti and Bora Bora sound sufficiently exotic but I suspect that I would enjoy the Caribbean just as much.

I'd like to visit Italy but if I don't ever get there I'll be just fine.  There are so many incredible places in the U.S. that I haven't seen yet.

I want to visit really cool, off-the-grid places like Fort Aransas, Texas and Jerome, Arizona.  (Actually I've seen Jerome--I just want to take my wife there.)

I want to be healthy into my old age and I build a lot of my lifestyle around achieving that one.  

Maybe that's more appropriate for my "kick-the-bucket" list.  Eat right. Exercise daily. 

And anyway, doesn't a Bucket List seem like a "me" list?  As I've gotten older, it seems that life is far less about "me" and more about those that I love.  

Family.  Friends.  Especially those grandkids.  I find myself wanting to spend every minute that I can with my wife.  

Research tells us that good long term relationships and lots of friends help increase our life expectancy.  In a couple of weeks, I will have been married for 40 years and I'm blessed with more friends than any man should ever expect to have. 

So here's my point:  Live life.  Every day.  See the beauty in what surrounds you.  Life the life that makes you happy and that brings joy to every day.  Don't wait on the next grand adventure to sustain your  happiness.

Respect and Dignity

When you were growing up, did you have someone tell you that the sky was the limit?  Did you have someone in your life that supported you no matter what?

Maybe it was your parents.  (Surely it was your parents.)  It could have been a teacher.  For me it was a coach.

Oh my mom used to tell me every morning as I left for school "tell all those girls how handsome you are."  I wasn't.  She knew I was insecure about all that. 

My parents certainly had academic expectations for me.  They expected good grades.  They expected me to go to college.

I have no idea how they so fully manifested those expectations.  It was never an option for me.  And this was from a largely uneducated family.  My dad dropped out of school in the 6th grade to provide for his family when his own dad died.  (And sorry if you've heard that before.)

My mother completed high school but nobody in my family had ever gone to college.

The importance of education was a lesson I learned completely.  I wish I knew how they did that.  I would share it here and scream it to the masses.

Our parents have an indelible influence on who we are, what we do, and what we become.

I often (too often, probably) say that I don't see many bad kids but I see too many bad parents.

Let me tell you a little story.  Last Saturday, while returning to Heritage High School at the end of the Tour de Blount, I was approaching Coulter's Bridge when a young man, maybe 19 or 20, who was also on a bicycle but standing off the road, yelled at me as I passed "you do realize you're blocking traffic, don't you?"

My answer was "yes I do" although seconds later I wished I had said "you do realize that I am traffic, don't you?"

Now this isn't about to turn into another piece on the rights of the bicycle rider (the late, great Jim Dykes would say atta boy to that) but one about respect. 

What kind of upbringing did this kid have that would give him the impression that he could disrespect a complete stranger that way?  An obviously much senior stranger?

What lessons did his parents teach him (or not teach him) that left him with the impression that he could say anything to anybody, to disrespect  that complete stranger?

I mean, you could ask why he was so ignorant of traffic laws.  I had every right to be on that road.  Sure, there was a car behind me but he had only just gotten there and I was approaching an intersection where I would have allowed him to pass.  Do his parents really let him drive a car without knowing the basic rules of the road?

I believe that one of the basic lessons our parents owe us is how to be respectful.  How to represent the family with dignity.  To be polite, courteous, and considerate. 

I also believe those things form the basis for producing successful adults.  And I believe that this young man's parents have failed him.

Not Just Tennis Elbow

How many of you have helped set up a wedding or other event and moved a lot of folding chairs in doing so?  If you've done that, you might know what I'm talking about. 

Here's the scenario:  Most people will pick up two chairs at a time, holding them from the top.  There are usually a lot of chairs to set up for a wedding or some kind of event.  That means a lot of lifting.

OK, if you've done that, do you remember waking up on Sunday or Monday morning with the outside of your elbow really hurting? If this is the scenario (or something like it) and that's where you hurt, what you've developed is lateral epicondylitis, sometimes known as "Tennis Elbow." 

Do this:  with your arm in front of you, bend your wrist backwards.  That is called wrist extension.

Now think about what you're doing when you pick up all those folding chairs--you're extending your wrist against resistance.  Maybe you're not actually moving your wrist backwards but you are resisting wrist extension.

The muscles that extend the wrist are mostly in the forearm and, more specifically, attach to the outside of the elbow.

And that's where the problem ends up.

Lateral epicondylitis is usually due to repeated trauma, putting too much stress on your elbow too many times.  Like carrying those folding chairs.

It got the Tennis Elbow name because a lot of tennis players (particularly beginners) develop it.  Most of the time, if tennis is the culprit, it is usually from hitting a backhand with bad form.

If you think about it, the mechanism is the same as lifting all those folding chairs.

The backhand in tennis is essentially a wrist extension activity.  If the problem in is poor form, the solution can often be a session or two with a good instructor.

In doing so, you fix the cause of the problem.  You remove the trauma.

That happens to be the best solution regardless of how you developed lateral epicondylitis--you've got to fix the cause.  In the case of carrying all those folding chairs, you've probably learned your lesson.

But there are a lot of other things that are similar that can contribute to lateral epidondylitis.  Picking up a suitcase or briefcase.  Lifting anything by a handle.  Once started, anything you grasp can hurt. 

And once you get a raging case of lateral epicondylitis, it can be hard to get rid of.  It seems like everything you do, every time you even clench your fist, you aggravate it.

Sometimes it requires medical intervention.  But even then, if you don't do something about what caused it in the first place and what is keeping it aggravated, you won't stay better.

Most of the time, that part is pretty simple--any time you pick something up, lift with you palm facing upward.  That avoids stress on those wrist extensors and allows everything to heal up.

Decide what you are doing that is contributing to the problem and fix it.  Do that consistently enough and you should be fine.