Live Right, Live Longer

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Into the Blue: A Father’s Flight and a Daughter’s Return
Susan Edsall
New York: St. Martin’s
June 1, 2004

You: The Owner’s Manual: An Insider’s Guide to the Body That Will Make You Healthier and Younger
Michael F. Roizen, M.D., and Mehmet C. Oz, M.D.
New York: HarperResource
May 1, 2005

Okay, it’s two weeks into the New Year and your resolutions to eat healthier and exercise more are now thoroughly shot to pieces. (In fact, by the first weekend after January 1 they were pretty much on life support anyway.) Sure, you were eager to turn over a new leaf. Then the work week began, you got home late a few times, then opted for some quick junk food. You watched some DVDs, and then it was too close to bedtime again and again, too late to go out and walk or you’d get your heart pumping fast and lie awake all night. You conclude that you’re stuck in an unconquerable rut forever, and will never change.

Well, not so fast. Getting out of a well-worn rut can take some serious work, but once the hard turn is made, you’ll never feel better about yourself and desire to return to the old ways. Right now you’re bummed out and need some inspiration. These two volumes couldn’t be a better place to get it. The first one describes the plight of a man that could eventually be yours if you don’t work to change your bad habits. The second is a practical guide to changing your life and the rewards you will receive for doing so.

Into the Blue

Susan Edsall’s father Wayne Edsall is such a fanatically devout builder and flyer of antique airplanes that if he reached a point in his life where he could no longer pursue his hobby, he would no longer want to live. Saturday March 25, 2000 is the day where both his hobby and life almost ended for good. Four days after undergoing heart-bypass surgery he suffered a debilitating stroke which crippled his ability to speak and move on his right side. Thus began the odyssey of this exceptional father and his tenacious daughter to recover his physical faculties.

The stroke occurred on a Saturday morning, yet Wayne’s doctor showed no interest in returning to the hospital before Monday. This indifference was a shock for Susan: Her father couldn’t talk, could barely move his limbs on his right side, was pouring water from a pitcher into his room telephone, and no one could or would give her or her family a prognosis.

Susan’s sister Sharon, so upset at the sight of her newly discombobulated and drooling father, begins to cry and a doctor sternly lectures her to “get her act together.” On her first visit to the hospital in Bozeman, Montana, the information clerk couldn’t even muster the energy to give Susan clear directions to her father’s room. Wayne’s costly room was appallingly ugly and austere in decor, and wreaked of sweat and urine. How bad was her dad’s stroke, Susan asks the nurses. Answer: it’s too early to tell, ask Dr. Lilly who won’t be in until Monday.

Monday rolls around, and Dr. Lilly doesn’t know anything. His specialty is rehabilitation, not neurology, so ask the neurologist Dr. Moore. What Lilly is able to tell her is incomprehensible gibberish, and he doesn’t have the time to make it intelligible to a layperson. He looks for a brochure but there are none. “But I’m not asking general questions here. I’m trying to find out specifically about my dad,” pleads Susan. Answer: ask Dr. Moore the neurologist he says, before whirling around and walking down the hall.

It’s not until the next day that Susan is able to track down Dr. Moore, and of course he knows nothing about Susan’s dad, and is busy with other things, thank you very much. When asked about specific rehab treatments, Dr. Moore urges Susan to contact Dr. Lilly, the rehab specialist who already said that he didn’t know anything about her father’s rehab. Next stop: the hospital library, where there’s nothing beyond Stroke 101. Dumbfounded, she suspects that the hospital staff couldn’t really be this ignorant and callous. Surely they knew the true, bleak prognosis and were hiding it from patients and families out of a sense of compassion.

The days between Wayne’s stroke and rehab are surreal. Dr. Lilly, the “rehab specialist,” comes by every day to hold a pen in front of Wayne’s face and ask him what it is. Wayne rolls his eyes at the perfunctory exercise. After six days Wayne is finally transferred to a rehab center, but the initial elation quickly disappears. In the catacombs of the hospital, the center reeks of stale basement air and is filled with dirty old appliances, ugly furniture, and old worn-out boxes of Scrabble and Monopoly.

As if the homeless-shelter atmosphere weren’t bad enough, there’s then an insufferable procession of young, hyper-enthusiastic physical-therapy flunkies. First Paul, with spiked blond hair and a snake tattoo circling his waist, whose greatest ambition for Mr. Edsall is to get him to play solitaire and send e-mails. Then “tactful” Cowboy Frank, who told Wayne, “I heard you used to be a pilot! Well, you’ll never be able to do that again.” Then the unforgettable Ann:

She sprang into the room as if propelled by a slingshot. She was tall and athletic, wearing red sport pants with a white racing stripe down the side, white tennies with souls that wedged out at the bottom for a good solid grip, and a T-shirt tucked into her elastic waistband. A thick elastic band held her long dark hair and a high ponytail that bounced and swung when she walked. Her cheeks were naturally rosy, her lips soft. I could just tell she ate a big bowl of cereal for breakfast, plunging her oversized spoon into it with gusto and slurping. I imagined there would be lots of jobs she’d be perfect for — doggie day care, summer camp for overweight children, handing out food samples at Costco…”Patients like us to be peppy and encouraging!” Ann chirped. “It gives them a shot in the arm!” She bounced up and down on her toes, grinning.

It quickly became apparent that the hospital’s real intent for rehab was to get patients to accept their disabilities as fait accompli, then pass them off onto someone else. Mr. Edsall would just have to find happiness making peanut butter sandwiches, and if he really made phenomenal progress, popsicle-stick birdhouses. Susan concludes that this is why the doctors, nurses, and rehab staff didn’t have answers to the simplest questions, e.g., how long on average do patients improve before they level off? There weren’t answers because complete restoration wasn’t a real goal. Susan would have to take matters into her own hands if Wayne was ever going to fly a plane again.

Susan and her sister Sharon planned to alternate two-week periods of supervising their father’s rehabilitation for three months, then assess their progress toward their goal of having Wayne return to the skies in a year. It was a bold objective in uncharted waters, especially for a father who could no longer “read, write, speak, add, subtract, reason, or even reliably remember [their] names.”

Sharon drew up specific goals for her father, e.g., reading aloud at 110 words per minute and naming items in a category at 16—20 per minute. Every morning Wayne would review a series of alphabet flash cards, read newspaper headlines in the local paper, and read one very short story. Writing began with word games: first phrases, then short sentences. Then there was the problem of acknowledging progress. Wayne was improving impressively, but couldn’t see it through his own impatience. Wayne’s first readings, at 25 words per minute, eventually reached a speed of 93. Then there was his long struggle with math; never good with numbers, he nevertheless made steady improvements under his daughters’ relentless drillings.

The most triumphant and damning moment of the book is when Wayne returns to the hospital for a follow-up. By the first of June (two months after his stroke), Wayne’s recovery is phenomenal. He stammers little and reads aloud at 110 words per minute, average for a normal adult. He walked without any noticeable disability on his right side and had been driving his truck for a month. Surely the hospital staff would marvel at such a miraculous transformation.

Cheri, Wayne’s first hospital therapist, last saw him when he couldn’t even complete a sentence. Surely she would flip when she saw Wayne’s stunning progress. When Wayne approached her and spoke flawlessly, and his performance only elicited a slight smile and then an abrupt dismissal from Cheri, the family was stunned.

Thinking this was an anomaly, the family moved on to Wayne’s follow-up with Dr. Lilly. To help other families cope with the sparseness of stroke recovery information, Susan compiled a list of addresses, phone numbers, and Web sites where the family members of stroke victims could find material on stroke recovery. Susan is stunned when Lilly tosses it aside on the counter. After Wayne almost flawlessly reads two paragraphs from a Time magazine article, Lilly assesses his reading skills as only “acceptable” before adding, “But you did substitute a word. I’d like to put you on Ritalin.” Lilly explains that some research suggested that stroke survivors on Ritalin can retrieve words easier. Susan, who had read voraciously about stroke recovery, had never heard of such research.

Susan: Do you know anything about who did the study? My husband is a medical librarian. I could have him do a literature search.

Lilly [without making eye contact]: No. I don’t. It [Ritalin] can’t hurt him, and I think it would be worth a try.

Susan is surprised to be going around in circles yet again:

I had this funny feeling that Dr. Lilly wanted to bless me with his disappeared gun. Maybe it was the funny way that he wouldn’t look me in the eye. It was as if he wanted to give us a refresher on the rules, the first one being “Doctors are right, so you don’t need to ask pesky questions.”

Lilly then asks Wayne if his sex life has resumed. Susan simmers at the question:

Ten minutes later we climbed back into the car without having heard a single “Congratulations” or “Good job” or “How wonderful,” but knowing, straight from the horse’s mouth, that mom and dad were back at it in bed. There was sullen silence.

Stunned by the hospital staff’s hostility, the family didn’t utter a word to each other for almost the entire two-and-a-half-hour drive home. Then:

“They’re just jealous,” Sharon said, as if the bats had finally cleared out of her belfry and she’d had a sudden blinding insight. “Well they sure as hell ought to be,” I agreed, my eyes still closed. “Those pr-cks.”…[Sharon to her father:] “Next time we should wheel you in there in your pajamas with your tongue hanging out of your mouth and baby food smeared on your shirt. Maybe that would make them happy.”…”They are so f—ing parochial that they can’t bear it when somebody else does something better than they do,” I rail. “Those pigs.”

Heart attack, heart-bypass surgery, and stroke require a pilot’s license to be surrendered. Pilots then have to wait six months before reapplying for their license, plus another six months for the application to wind its way through the Federal Aviation Administration (FAA) bureaucracy. The first week of March the following year, it had been nearly a year since Wayne’s stroke. The long-awaited letter from the FAA finally arrived, but Wayne couldn’t find the strength to open it. Susan read him the letter. Miraculously, the FAA bureaucrats allowed him to fly again.

Six weeks after receiving the letter, it was late April. Flying his Fleet Series 9 would be the ultimate test; a Cessna required skill, a Fleet seasoned mastery. If he could fly the Fleet, then Wayne Edsall knew that his old pre-stroke self was back again. One day in late April he gave it a try. Mustering up all the courage he could, Wayne wedged himself into the pilot’s seat, and in minutes was up in the air. It was the greatest gift a daughter, against so many formidable obstacles, could give him.

You: The Owner’s Manual

Of course better than a miraculous recovery like Wayne Edsall’s, is not to be in need of one in the first place. Ariel Sharon, if he ever wakes again, would surely agree. Following Michael F. Roizen and Mehmet C. Oz’s advice should put you in good stead, and they make it clear that when it comes to longevity and health, genes aren’t everything.

In fact, according to Roizen and Oz, just five adjustments can have a dramatic effect on your life expectancy: controlling blood pressure, quitting smoking, exercising a minimum of 30 minutes per day, controlling stress, and following a healthy diet. If you make those five adjustments, then in the next 10 years you have just a 10% chance of dying or having to suffer disability compared to a typical person your age. You control more than 70% of how well and long you live. By age 50, your lifestyle dictates 80% of how you age, the rest is genetics.

I had been told that ideal blood pressure is 120/80. Roizen and Oz (hereafter, R&O) say 115/76. Although an atypically low blood pressure doesn’t add much in years to your life, even slightly higher numbers can be bad news over the long run. R&O point out that over 50% of heart attacks can be attributed to blood pressure readings between 125/80 and 140/90. A third of heart-attack victims die, and 50% of that one third are dead on arrival to the hospital. Half of the people who have heart attacks never feel a single symptom, and it’s not unusual to feel anomalous symptoms. The authors cite the case of CNN’s Larry King, who felt a sharp pain in his right arm — left is more typical — and only reluctantly went to the hospital at the urging of a friend. King was surprised to learn that he had a massive heart attack.

Leg pain when you’re walking can be a sign of arterial disease. The understandable tendency is to avoid pain and stop walking, but that can make the problem worse. Continued walking stimulates the body to make new paths for blood to get to blood-starved tissue. R&O recommend at least 60 minutes per week of cardiovascular activity that elevates your heart rate to 80% or more of your age-adjusted maximum (find this by subtracting your age from 220).

What’s nice about the authors is their recognition of negative returns. Sixty minutes per week of stamina training is good, but more not only adds nothing to longevity, it can even decrease it through additional wear and tear on the body. If exercise is alien to you, start walking and slowly add in some weight lifting. Too many impatient people go from walking to running, but that stretches the joints too much. Instead, go from walking to either cycling, swimming, or an elliptical trainer. R&O report that a balance of stamina and strength training will make the average 55-year-old eight to nine years younger in real age.

In terms of blood cholesterol, losing even 10 pounds of weight, avoiding white bread, sugar, and pasta, and keeping saturated and trans fats to under 20 grams a day will lower bad LDL cholesterol. To increase your good HDL cholesterol, get one tablespoon of olive oil, 4 ounces of fish, or 12 walnuts a day; walk or engage in any physical activity for at least 30 minutes a day; take niacin; and have at least a drink of alcohol every night. (Careful, though, while alcohol reduces inflammation, more than 2.5 drinks per day for men and 1.5 for women speeds up aging of the immune system.)

Part of the reason to keep the heart healthy is to keep the mind healthy. A study of physician IQs beginning in 1950 showed average declines of about 5% each decade. However some increased their IQs as they aged; decreases in brain function aren’t inevitable with age. A study of retirees showed that those who were sedentary got no smarter, while those who walked 45 minutes at least three days a week improved their IQs. Increased activity improves cardiovascular function and this in turn improves brain function. Keeping mentally active also prevents memory loss. Avoid the same routine day after day. Learn a new language, musical instrument, or new skill. Rearrange your daily routine week by week as much as possible, at work and home.

Drinking 24 ounces of coffee per day decreases your risk of Parkinson’s disease by 40% and your risk of Alzheimer’s by about 20%. It appears that caffeine has a beneficial impact on neurotransmitters and can make you three to six months younger in real age, however it is not for everyone. Stress reduction can improve mental health (no surprise there). Daily hassles such as deadlines and getting the kids to school on time do not age the brain. The danger comes from “Nagging Unfinished Tasks” that continually aggravate and major life events such as moving, dealing with financial burdens, and the death of a family member. Laughing can make you up to eight years younger in real age and meditation can not only help maintain brain cells and preserve memory but reduce stress to prevent depression and anxiety.

A chapter on digestive health is interesting. It turns out that good tooth-brushing and flossing habits are good for your heart. Gum disease has links to heart disease; the same plaque that creates tooth decay can add plaque to your arteries leading to anything from heart attacks to erectile dysfunction. (Taking good enough care of your arteries is the best way to stave off any need for Viagra which has been linked to partial blindness.)

Speaking of embarrassing subjects such as erectile dysfunction, R&O point out that the best solution for diarrhea, contrary to urban legend, is not sitting on the can and waiting it out. It’s chicken soup with rice or calcium tablets. The former protect the cell lining of the intestines while the latter control muscular movements that propel the runs. While you’re on the can, be sure to replace your dry toilet paper with wet wipes or wet the paper before you wipe. Dry toilet paper is ineffective, irritating, and increases the likelihood of hemorrhoids. Okay, that’s enough of that subject.

For those concerned with weight control, R&O suggest eating off 9-inch plates instead of traditional 13-inch ones. The smaller plates hold less in calories, but still psychologically bring the same feeling of satiety as larger dishes. Smaller portions reduce arterial and immune aging. The most fascinating suggestion it to eat a little fat before each meal to prevent your stomach from emptying quickly. Tea and unbuttered toast for breakfast leaves a stomach in about 30 minutes, increasing the odds of a midmorning snack binge. However, with peanut or apple butter spread on the toast, the same process takes 3.5 hours.

Finally, in a chapter on the immune system, R&O recommend staying clear of government tap water. You can get low-grade infections from it that lead to bloating, itchy eyes, stomach cramps, and fatigue. Most people have no idea what’s happening to them or what the cause is. Although Evian water is a bit pricey, at least use a filter, the simplest being the charcoal type on water pitchers.

All these are just a few of the abundant number of tips that R&O dispense, in addition to a healthy diet outlined at the end of the book. You is a good harbinger for the future of American medicine as well. While being M.D.s schooled in an allopathic system that sees drugs and surgery as knee-jerk solutions to most problems, R&O write, “we believe that food is the next frontier in medicine — by studying how food can be used for healing.”

Pom Power

The only disappointing aspect of R&O’s book is the inexplicable lack of mention of the super antioxidant of 2005 — maybe Twenty-First Century — pomegranate juice. At first, for some reason, this one scared me. I saw the dark red bottles in the grocery store, had never seen or had a pomegranate in my life, or ever even heard anyone talk about them. Like most health food, I figured no news had to be bad: healthy, but probably nasty to the taste buds. Jeff Tucker urged me on, telling me it was as good as any bottle of fine wine, but good grief, this is a guy who doesn’t seem to mind cod liver oil that much.

I very gingerly tried the POM Wonderful pom-blueberry mix. Delicious! Next, pom-mango, then pom-tangerine, and then pom-cherry. Excellent. Then pure pom itself. Not bad at all.

The POM Wonderful brand has a definite plantlike, tart taste to it but this is a cinch to tweak. One nice combo is filling a large glass or tumbler a third of the way with crushed ice, adding a third bottled water, then topping of with pom juice. Adding a dash of orange juice is nice. If you want a nice little spike beyond that add some vodka or Sutter Home Moscato. Do your own experimenting. Two a day — in addition to a healthy diet and exercise — should keep the cardiologist away.

The benefits of pom juice? Even the usually very skeptical Consumer Reports was impressed. It conceded that it was rich in polyphenols, “antioxidant compounds linked to a variety of disease-fighting benefits.” One study in 2000 found that pom juice had three times more antioxidant activity than red wine or green tea. Another study found that the juice exceeded blueberry, cranberry, and orange juices in antioxidant activity in terms of suppressing damaging free-radical molecules. A Clinical Nutrition study found that drinking a glass a day for one year reduced blood pressure, decreased the oxidation that causes harmful LDL cholesterol to stick to artery walls, and reduced the clogging of neck arteries which can lead to stroke. Consumer Reports also noted that pom juice had less sugar than grape juice and none of the unhealthy fat of dark chocolate.

Pom juice is pricey, the 46-ounce bottle of POM Wonderful running anywhere from $8.99 to $9.99 in my neck of the woods. The Frutzzo organic variety, though not as full bodied, is a bit cheaper and better tasting. I had no problem drinking it straight from the bottle, as it has a more mild, sweet, and fruity taste than POM Wonderful. Unfortunately it’s much harder to get in my area.

Diminishing returns again: pom juice is great but more is not better. It packs some carbs, so more than a large glass per day of just the pure juice is probably not a good idea. Eating pomegranates directly is an interesting experience, but can make a big mess of your kitchen. The juice form seems to be the way to go.

So cheer up, resurrect those resolutions, get back on your feet and exercising, and have a safe and healthy 2006!

Dr. Dale Steinreich [send him mail] teaches economics in Missouri, is a contributor to the investment advisory, and is an adjunct scholar of the Ludwig von Mises Institute.

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