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Sports are more fun than weight training & here is a nifty bike carrier system on a van spotted in one of our Idaho RV parks.

FALL LAYOVER AT HOME September 2018

Take The Challenge?
Resistance Training
I was quite pleased with myself when, after we'd wrapped up our last hiking day for the summer in the Italian Dolomites at the end of August, I launched into my indoor core workout routine the next day. Lunges are considered the single best exercise with which to evaluate one’s core strength and mine were in good form. And I was surprisingly capable when doing other favorite moves that focused on strengthening the mid-section. 

We had hiked or biked almost every day this summer, so I skipped my core routine. I never want to deplete muscles that I’m going to use the next day on the trail or the bike, so I always suspend core training during intervals when we are so active.

But I did notice that I was failing one of my decade’s old, strength assessment tools, which is “Have doors become heavier or can I fling weighty ones open with ease?” I had been leaning into them with my shoulder instead of opening them by extending my arm. Oops! I hadn’t quite decided what to do to restore my ‘door push strength', but was inspired by a 13” resistance training strategy in
The New York Times that a friend had forwarded. 

https://www.nytimes.com/2018/09/12/well/move/in-a-hurry-try-express-weight-training.html

This regime was newsworthy because it was an all-out approach to weight lifting to make us strong quickly. The article didn’t specify which lifts to do but presumes you’ll be going to a gym. I’d be doing my workout in our trailer with what we had, so it would take some improvising to exhaust myself in the recommended 8-12 reps. My first thought was to toss a weight on my back while doing push-ups to deplete my muscles faster.

If you don’t like the way their recommendation sounds, then here’s another one from the
Washington Post the same week: 

https://www.washingtonpost.com/lifestyle/wellness/youve-been-told-how-many-minutes-of-aerobic-exercise-to-do-weekly-what-about-strength-training/2018/09/13/c242ac7e-b6c5-11e8-a2c5-3187f427e253_story.html?utm_term=.f18642f1e41f&wpisrc=nl_lean&wpmm=1. 

Their emphasis is also on swiftly working to exhaustion, perhaps only doing a single lift of each of several forms. Twenty minutes, twice a week can be enough according to their model.

I hope that blending these 2 strategies will help me transition from being a “yo-yo lifter”, as in starting and restarting, and restarting, to becoming a committed, regular lifter. Care to join me in again reviving your resistance training routine?

Still Not Motivated?
Perhaps you’ve noticed like I have that ‘sarcopenia’ is in the news. It’s the loss of skeletal muscle mass (as opposed to muscles like the heart) that occurs with aging. It’s so important to maintain your muscle mass and strength as you age to prevent catastrophic falls and to maintain your vitality. 
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The big views of Central Oregon on our way to LaGrande.

An MD in his 80’s recently wrote a short piece in which he was lamenting his sarcopenia. He considered it the most discouraging aspect of aging to date for himself and he was painfully clear about the looming consequences. His story underscored the importance of the condition but I was shocked, especially since he was a doctor, to read that he hadn’t responded to the physical and psychological loss by changing what he was doing. 

This man was dutifully working out for an hour 3 times a week. “Really?” was my reaction. "How silly to stick with minimum guidelines when you aren’t getting the results you want. What about an hour every day of mixed routines? or adding 2 hours some days?” Few of us need to fear that we’ll do to much. Even as active as we are, we are nowhere near hitting the tipping point of diminishing our health by exerting too much. 

Keep an eye on your goals and do whatever you need to do to meet your personal objectives, like opening doors with a sense of power. Being strong and healthy takes work. Invest the effort in yourself to be your best and don’t settle for less, regardless of what others believe is enough.

It’s controversial, but you might also evaluate your protein intake. Ours about doubled to 100grams/day 4 years ago when we went on a ketogenic diet. Uneasy at first with the big change, we now have no regrets about running a little high instead of low as we had done for decades on our variant of a Mediterranean diet. Many authorities chant that most Americans eat too much protein, which is likely true, but some are starting to put a little asterisk on that comment. An undercurrent of research is now showing that the elderly (like us) need more, sometimes saying a lot more, protein than previously believed.

With this controversy in mind, we think about our new Swiss and Dutch mountaineering friends that we met on San Jacinto Mountain in Palm Springs. They vigorously climb up the mountains in the Dolomites that we walk around and he runs up to the almost 11,000’ San Jacinto Peak while we walk it. Sadly, they both are now suffering from sarcopenia and bone loss. Is it coincidence that these superior athletes who have been told by their doctor to increase their protein intake are having more ‘loss’ issues than us because of the differences in our protein consumption or is it cause and effect? Of course we’ll never know the answer, but it is an intriguing observation. And I’ve recently learned that higher protein intakes help preserve bone mass as well as muscle.  They are enviably lean and fit but we are now crossing our fingers for ourselves and embracing our bulkier profiles.

Kick’em When They Are Down
Medication Reactions
I was sick all summer after starting high blood pressure medications in April. I was so sick that I went off them entirely a week before we arrived home from Europe in early September so I could drive but was still reeling from side effects. 

And then, and then, I had the good fortune to receive one of the 20 coveted Shingrex vaccine vials that Costco received after being out of stock for months. That was the good news; the bad news was that it literally flattened me the next morning. The severe headache and muscle cramps were likely directly due to the vaccine, but we suspect that the anti-hypertensive drugs I still had on board blocked the mechanisms my body would normally use to save me when my blood pressure plummeted in reaction to the vaccine. I laid on the floor for about 4 hours in misery—there was no where to fall to while on the floor.
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Our Hatch, Utah RV park with 10,000’ high Cedar Breaks National Monument in the distance.

We kept an Epipen by my side and Bill constantly checked my blood pressure, struggling to decide at what point he should haul me in to an ER. We agreed that that trip should be avoided if at all possible because the staff would likely over treat me. My lingering reaction to the antihypertensives was abnormal, like my reaction to the vaccine. The last thing we wanted anyone to do was treat me according to the standard guidelines. Fortunately, our watchful waiting paid off: by noon I was able to sit up and I was functional the next day.

New Internist

My new internist was better than the previous one but she quickly laid into me with a hysterical rant about what a bad patient I was. Scolding she said “How did your previous doctor treat you when you were just popping in now and then between your trips?” I responded with “I haven’t had any treatable conditions until now so it didn’t matter." Blame, bullying, humiliation, and criticism; I’d heard all of that the last time I was in the clinic in May. 

And then she attacked me for my reckless attitude towards my health because of taking what are for me, essential hormone replacement therapy (HRT) drugs: How could I possibly stay on those drugs that she didn’t approve of and that were surely causing my high blood pressure? Neither the medical literature or my timeline of blood pressure increases supported her view. 

And what a naughty girl: she had blood levels analyzed to prove that I was being over treated with hormones, numbers with which she planned to bludgeon the prescribing doctor. Amusingly, when she called me with more important lab results, she didn’t respond when I specifically asked about my hormone levels. No bludgeon there: through the patient portal I later learned that my levels were analyzed twice, coming back as “undetectable” both times! She was running a bit short on integrity in my mind, just like my previous internist.

BUT, unlike the other internist who wrote me off as being a nut case, she ordered 4 studies in search of causes for my hypertension and to further evaluate a recently diagnosed heart defect, presumably an unimportant and likely congenital, malformation. At least I had left the battle ground still standing, so I’ll go back to her in the spring. 

I’d hoped to do better with this new internist and switch if I didn’t, but we were again learning how difficult it has become to receive satisfying medical care. Instead of getting cheery referrals from friends back home, we were getting blank expressions and hearing other horror stories. Our massage guy said his first annual visit with his new doc lasted 8 minutes and she didn’t even touch him.
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A welcome sun break on a rainy-day hike near Flagstaff.

Launching
Wrapping Up
Our brief, 2 week touch-and-go at home was all the more compressed by my ongoing illness from my anti-hypertensives but we accomplished what was needed. We’d still be looking for items hurriedly stowed in our trailer, while experiencing a tinge of jet lag, a month later. The list of missing items eventually shortened to 1 jacket with the other curiously placed items gradually being discovered.

I’d hope to shift my focus off of medical issues and on to playing hard once on the road but they doggedly pursued me. My first-ever basal cell carcinoma was incompletely removed while at home, which would require 2 additional appointments with a dermatologist once in Palm Springs. My ax-swinging internist settled down when I reassured her that I’d see a cardiologist in Palm Springs to be evaluated for a possible surgical repair of my heart defect. And then there was the matter of starting anti-hypertensive #4, which I was very reluctant to do.

I seemed to be putting a lid on my high blood pressure with alternative approaches, including continuing to  take the supplement CoQ10 and Naturopath #3’s recommended strongly brewed hibiscus tea and a pile of celery each day. The last 2 are mild diuretics, so my sleep was being disrupted by the new need to pee at night, but that was a minor inconvenience compared with all of the others when on medication. I’d have to very carefully time the start of the mini-dose of the new anti-hypertensive to avoid suddenly being taken down with dizziness or nausea while driving or on a long hike.

Itinerary
Our first stop once on the road would be in LaGrande, Oregon for a repair on a repair to our trailer, then we’d drive longer days than we prefer until we reached Flagstaff, AZ. We’d stay there, which is 80 miles (130 km) short of the Grand Canyon, for 8 days. At 7,000’ (2100 m), it was the same elevation as the S Rim of the Grand Canyon. It’s actually more expensive to stay in the Flagstaff KOA RV park than in the Grand Canyon’s Trailer Village but we don’t like to burn-up our restricted Grand Canyon time altitude acclimating. This way, we’d have 2 weeks to acclimate before doing our round trip hike between the South and North Rims of the Park. We know from experience that is enough time to feel the difference.

We’d spend about 6 weeks bouncing between Flagstaff and the Grand Canyon to enjoy 2 two-week stays in the Park. We’ll be in Palm Springs on December 1 for 3 months, with all of November being spent wherever the best combo of weather and hiking trails can be found. If the snows hold off, we hope to again hike San Gorgonio and San Bernardino peaks near Palm Springs. Like always, we will be in search of 70 degrees.