Aging and Chronic Disease

Aging and the Development and Progression of Chronic Disease by J. Davis Here is a rundown of my various chronic issues as they have changed over time: Starting at the bottom, my feet have become wider and wider over the years, changing from 2E to 7E and requiring me to search out companies that have wide enough shoes, a wide toe box, and high arch. Presently the only ones that fill the bill are from Mt. Emey. However my best solution has been to buy sandals which I wear most of the time except when actually in the gym or at some function. Secondly, I stretched out the ligaments on the outside of my right foot with improper lifting technique. I would typically press 40 pounds or so over my body weight doing the decline press with pulleys. However, I was stabilizing myself with my right foot turned outwards, not realizing the strain I was putting on the outside of the foot. The next day, the ankle would hurt but it took me a while to figure out what was happening. By then, it was too late. I had stretched the ligaments and there is no simple way to get them back to normal. So be sure to press weight on the pulleys with the foot turned forwards, and a spotter to stabilize the position would also be helpful. Next, the right knee has deteriorated to the point where I have a slight limp. I had the lateral meniscus removed in 1982, but didn’t really hold back in training. Visiting the doctor a couple of years ago, I was advised it was bone-to-bone. Because it turns inwards, there isn’t much I can do to stabilize it. So I have the option of strengthening the muscle to protect the knee, which entails wear-and-tear on the joint, or not working the quads with subsequent weakening of the knee and greater vulnerability to injury. I choose the former course, but neither is ideal. And I am now unable to run at all, except for the slowest jog, i.e. slightly faster than a walk. Moving upwards, I have some pain in the right hip if I am not careful, the result of years of running long distances with an asymmetrical pair of legs on streets that slope towards the middle to act as arroyos during rains. My right foot is shorter than the left, and my right leg is longer than the left, which matters not at all when one is young and the repair processes are optimal, but catches up with you as one ages. Along these lines, I highly recommend no excessive mileage as one gets older and changing the type of exercise from day to day. So, treadmill one day, elliptical the next (the elliptical machine is harder on the hip), stationary bike or rowing, swimming, etc. And never do more than one type of machine the same day. You are defeating the purpose of avoiding repetitive motion syndrome. I ruined my lower back in the postal service, as there is no safe way to work parcels with the equipment they use. Discussing this issue with my orthopedist, he recommended I continue to do abdominal work but stop all back work. I have, and it does seem to make a big difference, as the lower back is not an issue presently. However, be aware that the treadmill (with its up-anddown pounding) is hard on the back. Obviously outside of the gym, running on asphalt, cement, or any hard surface will be hard on the feet, ankles, knees, and back over time, so should be minimized. The only reason I do any repetitive motion exercise nowadays is for cardio purposes, i.e. 20 minutes in my target zone. In the early 90’s, I was diagnosed with sciatica on the left side. I “resolved” the problem with stretching and NSAID’s, but, of course, the disc still bulges and occasionally presses on the sciatic nerve. After lots of creative stretching, I learned that a hard stretch to the right would pop the disc back into place, resolving the problem completely…at least temporarily. I realized that, because of the limited motion of the right knee, I was constantly picking things up and leaning to my left, which caused the disc to shift and press on the nerve. So now I am careful to bend forwards with my right hand as much as possible, although I still have to pop the disc back into place multiple times every day. The right knee is a big issue, of course, because one generally has weight over the knees most of the day every day when active. But for lifting and work in the gym, the TOS (thoracic outlet syndrome) surgery I had is also very difficult to get around. I broke my left shoulder in a motorcycle accident when I was 16 and never went to the doctor, so it subsequently healed poorly, i.e. the left should is higher than the right shoulder. I think this eventually led to an aneurysm of the right subclavian artery because of the imbalance. I had an excellent doctor, as he predicted I had a 50% chance of dying from the surgery and a 100% chance of losing the right arm, neither of which came to pass. However, as the artery was shooting blood clots into my right arm, I still suffer from impaired circulation in the arm and presently take Plavix (Clopidigrel). Moreover, the surgery required the removal of the entire top right rib, the clipping of the 2 scalene muscles attached to the top rib, a stent in the brachial artery, and resection of the subclavian artery (which however seems to contribute to impaired circulation as well). But, beyond the obvious physical impairment, my entire right shoulder seems to have been structurally weakened. I discussed with both the peripheral vascular specialist and the orthopedist, and they both agree. Structural weakness contributes more to the weakness of the right upper body than impaired circulation. Oddly, for many years after the surgery (which was performed at about the age of 50), both sides were relatively equal and I didn’t have any issues although, because of the difference in angle of the right and left shoulder, I was stronger or weaker on one side or the other for different lifts. But in the past year, I have noticed a substantial difference between the strength of the left and right side which I don’t think I can get back, resulting in a large difference in strength of the left (stronger) from the right (weaker). I also can’t discount the stick work I do virtually every day, often for a couple of hours, which is more concentrated on the right side than left. Endurance work is not conducive to strength. In any case, in the last few years I’ve have had to abandon any heavy lifting on the flat bench press due to my shoulder suffering undue pain. Another curious problem is I apparently tore the long head of the biceps of my right arm at some point in the last 7 years, which I noticed 1) because I was losing muscular size on my right arm and 2) both arms were the same in a picture 7 years previously. Asking my orthopedist, he confirmed that I had torn the long head of the biceps at some point, which was odd to me since I would have thought I would have had some pain or other symptoms. Maybe I did, but it wasn’t enough to flag at the time. I’ve subsequently learned that ballistic martial movements (like a sharp jab), as well as lifting, can cause this problem. In any case, it had been a while and he didn’t recommend reattaching it, stating the right biceps would still have 95% of the strength compared to the left. But what I’ve noticed is the right biceps doesn’t have much endurance and quickly shifts the work in hard lifts to the brachioradialis. In any case, I’m just managing the problem. When I was a kid, I had a commercially available “spring” with handles on the end that was squeezed downwards so the handles touched, which works the pectorals. Before long, it got quite easy to do, so I put it on a shelf, rediscovering it only about a year ago. To my surprise, even after years of lifting for the chest, it was very difficult to get the handles together. I decided to replicate this motion in the gym with the pulleys, pulling them straight down with my arms out to either side. Within a week, I started to notice tingling, numbness, and an electric sensation from my shoulder to my wrist on the right arm. Didn’t take long to figure out I was stretching the brachial neuroplex, now unsupported by the rib, with this particular motion. Of course, I stopped doing this exercise immediately, but it took months to return to mostly normal. Supporting my right elbow on any surface, like a table or car divider would provoke it. Drinking at this age is also very problematic. With declining energy, good sleep becomes more important than when younger. Drinking disturbs one’s life in many ways. Most obviously, drinking a lot of fluids, like beer, in the evening requires one to wake up and urinate multiple times at night and frequently getting back to sleep is not easy. Moreover the extra water changes the fluid composition of the body. In the morning, the eyes, chest, and nasal passages are more watery, not to mention the greater grogginess which reduces one’s urge to get engaged, including rushing to the gym. Drinking stronger beverages with less fluid reduces the problem but, as much as alcohol does wonders for a tired, sore body in the evening, overall it seems to hold one’s progress in the gym back and I personally believe it can contribute to high blood pressure, although I don’t remember the mechanism. It is a known carcinogen, as well. Back to the subject of medication, my father was a person who never took anything but over-thecounter treatments for whatever ailed him, including Tums, NSAID’s, etc. (The exception being he went to the dentist quite often, a consequence of growing up in a small town of Wyoming with little emphasis on oral hygiene.) Moreover, he ate pretty well and drank every day, usually from rather early in the morning, until he died at the relatively young age of 72. My mother by contrast visited the doctor on a regular basis and worked out every issue she had with medical treatment, diet, and exercise. Her issues included kidney stones, hyperglycemia, and hypothyroidism. Although she smoked every day, even the night she died of COPD (chronic obstructive pulmonary disease), she managed to reach the age of 78 and never suffered from cancer of any kind related to smoking, although she did have a couple of melanomas on her face removed. So along these lines, I was attracted to my father’s non-reliance on drugs but also my mother’s adherence to a cleaner lifestyle. My parent’s generation really didn’t exercise for the sake of health, but most work in their generation entailed an active lifestyle which required exertion, but was also financially rewarding. I aspired therefore to go medication free, work out, and try to watch my diet as I got older and subsequently retired, something I hadn’t really done very well in my younger days. Aside from the TOS (thoracic outlet syndrome) surgery I had about 2002, I had not been to a regular doctor since 1988, shortly before joining the postal service. I decided the first thing after retirement with time on my hands and a different future, it was now time to visit the doctor. Well, my dreams of a med-free life were immediately dashed. Seems I also suffered from hypothyroidism, as my GP (general practitioner) discovered with a simple blood test. I subsequently learned, aside from my mother, many of my close family members had the same problem, probably a genetic predisposition. This disease causes a variety of symptoms which are different in every person, but primarily low energy, which I had assumed was normal for an older person and hadn’t much worried about. So I now take a small pill (levothyroxine) with 8 ounces of water every morning when I get up at least an hour before I eat. Another thing I discovered at the first visit was my astonishingly high blood pressure. Multiple readings came back in the 190’s/90’s. At the time I immediately went on a diet and quit drinking, which quickly brought it down, but not to normal, or so it seems. Turns out I also have “white coat syndrome”, which mean a person’s blood pressure is higher in the doctor’s office. In fact, I always have my highest readings when I see a doctor. My son subsequently got me a nice battery-operated blood pressure cuff and I started recording BP on a regular basis. Eventually with diet and exercise (and less drinking) I have been able to maintain it in a normal range, but only when I am resting. During normal daily activities, it is always a bit high (130’s/80’s). I’ve had reduced blood flow in the right arm since the TOS (thoracic outlet syndrome) surgery, but at one point noticed I suddenly had further reduction after doing some pulley exercises with the arms straight over the head and pulling down to the side, similar to what stretched the brachial neuroplex later. Of course, I stopped this exercise immediately, but the problem didn’t subside and the blood flow was distinctly lower. Along these lines, I strongly recommend anyone who has had TOS surgery avoid pulling weight down to the side. Duh! No references exist for this sort of thing, i.e. what one should or shouldn’t do, and everyone who has this operation suffers from different issues. I’ve actually been very lucky to be able to live a nearly normal active lifestyle after the fact. What is particularly interesting is I am able to pull down with straight arms in front, or pull up with straight arms in front or the the side, as well as pull down with arms at my side as long as my elbow is bent without a problem. Anyway, I thought it might be good to see a vascular specialist and get checked out going forwards. He had a number of extensive tests done with some surprising results. For one thing, the resected part of the thoracic artery seems to be partially blocked. Secondly he discovered some calcification of the mitral valve in the heart with some regurgitation (leaking), so apparently the running I was doing for years was wearing my heart out, rather than helpful. I’ve discussed before the possible consequences of extreme actions. Interestingly, I have equal perfusion (blood oxygen saturation) in both hands at rest. Only under duress does the right arm tire more quickly than the left arm. I also asked him about my “cold hand syndrome”, i.e. when I would exercise, the right arm and hand are markedly cooler than the left side. So, for the blocked artery, he advised me they could run a wire up through my femoral artery and try to open it up, but (obviously) there were risks and he wanted a vascular surgeon standing by during the procedure. I am now opposed to any type of surgery except to save my life, so we agreed that we would just monitor the situation. As for the mitral valve, I have no serious heart issues, such as atrial fibrillation, irregular heart beat, enlarged heart, swollen feet, etc., so we agreed to monitor this situation as well. I also discussed the blood pressure situation, monitoring myself every morning and evening for a month. But the doctor said it looked fine and eventually he told me he’d see in 6 - 9 months. As for the “cold hand syndrome”, it was helped somewhat by the addition of the blood thinner, Plavix. Another aging-related issue on the horizon, but not really related to lifting per se, is the cataracts I have in both eyes which, however, do not yet require correction. However, I could have helped myself if I had worn a hat or other eye protection in the many years I spend out under the El Paso (and other areas) bright sun, where the UV value is often 11 during the middle of the day. Similarly, and also not a lifting issue, I’ve had 4 skin cancers, all on my face, diagnosed so far: 3 basal cell and 1 squamous cell. One resolved by itself and the other 3 were removed. Again, I could probably have helped myself by wearing skin protection, i.e. a hat, during my years of time in the sun. Both of theses problems could potentially be issues for lifters if they are entering bodybuilding competitions, since tanning is generally a given in order to be competitive. As one can see, all of these medical conditions are not likely to improve and will probably become more pressing as time goes by. And of course there is always the possibility of other conditions which haven’t yet presented. But at present, I’m am feeling surprisingly good in spite of turning 70 years old in February. So one can only meet problems head on and try to mitigate them as much as possible. No need to give up until things are really hopeless, and things are never really hopeless until one gives up.