Decrepit No More

Decrepit in the Rain

It was late 2020 when I got a call from a woman responding to an advertisement I had placed in the Cleveland Jewish News for my personal training business. She told me that primarily she was calling about her husband; he was in his mid-70s and in her words “decrepit.” Could I help?

I met with them, and after making all the proper arrangements began training with him 3 times per week for 30 minutes at their home. This was before vaccinations were happening so we were all masked up and training outside on the back deck when possible. I do not know if I would have used the word “decrepit,” but there were a lot of issues: balance, stamina, strength, and flexibility. I created a program specific to his needs and abilities and stuck with the plan.

It was tough going at first, but it was clear that progress was being made. It was proof to him and his wife–and to me–that we are capable of making positive changes in our levels of fitness at any age. It also demonstrated that the definition of “too far gone” needs to be rethought. Things for my client were looking great!

Unfortunately, he had a serious stroke a few months ago. I was worried that all of the progress would go down the tubes. On the contrary, the work we had been doing together helped prepare him to be successful at the inpatient rehab facility where he was for several weeks. He was their star student! Imagine my surprise when I started working with him again and he looked even better than before the stroke; of course, there was (and still is) a lot of work to be done to maintain and increase strength and mobility, but without a doubt between rehab and our workouts he was making a comeback.

Yesterday at his first workout of the week we commented on how he no longer looks or feels decrepit. It took about 8 months–and a stroke intervened–but this guy is proof that a supervised fitness program for older adults can be the difference between independence and decrepitude.

I know this is only one example, but I see progress with all of my clients. Word needs to get out so that older adults can begin to think differently about themselves and their fitness. As we age, we need be decrepit no more.

Testosterone Therapy or Exercise for Older Men?

Testosterone

The most recent issue of Idea Fitness Journal presented a summary of recent research results regarding the efficacy of testosterone therapy in promoting health benefits–especially cardiovascular–in older men. The article reports on studies from the University of Western Australia in Perth.

Many of us know that there has been a boom in sales of testosterone products for older men; they make all kinds of promises. Some are over-the-counter creams, while others are prescriptions available only through a physician.

The study at UWA looked at whether circuit training (a workout technique using different exercises in rotation with minimal rest, often with different pieces of equipment) had the same, less, or greater effect on men’s health than these products. The test followed 78 men aged 50-70 who had no history of CV disease, larger-than-normal waist circumference, and low-to-normal T-levels. Four groups were compared: T-therapy with exercise and without; placebo with exercise and without. Results showed that exercise increased testosterone levels, and that creams added even more. Most importantly, cardiovascular health improved more in those who exercised regardless of whether they had T-therapy. One of the investigators, Daniel J. Green, PhD., noted that while T-therapy seemed to increase muscle mass in legs, there seemed to be no benefit in arterial health and function.

A couple of take-aways for older men: 1. There is not magic pill (or cream) for better health; exercise, proper diet, and rest are still key. 2. The focus in older adults should be less on building muscle mass (although it is certainly desirable to maintain what is there), and more on maintaining and improving CV health if one wishes to avoid the maladies such as heart attacks and stroke.

Self-Care is not Self-ish

Self-Care

It is not unusual to hear about individuals who over the years never took care of their own spiritual/emotional/physical needs because they were busy taking care of others. We can sometimes get so wrapped up in serving others that we forget to focus on ourselves. Others see the focus on self as somehow being vain, egotistical, or simply selfish.

If you have ever flown on a plane you know that one of the safety announcements made before take-off is about what to do in the unlikely event of a cabin de-pressurization. “Masks will fall from the compartment above your head; place the mask over you nose and mouth and breathe normally. The bag may not inflate even though oxygen is flowing. If you are traveling with someone who needs assistance, place your mask on first before helping others.” This goes against the idea of helping others first, but it makes perfect sense; if you lose consciousness due to lack of oxygen, you are of no help to anyone else. We must take care of ourselves first before we can help others.

Self-care is not a luxury. It is a necessity. Self-care means different things to different people. For some, it means a luxurious day at a spa. For others it is a hot cup of tea in the afternoon. Some think of self-care as taking adult education classes, going to the gym, reading a good book, or listening to their favorite music. Whatever works is fine, but it cannot be an “optional.”

My wife and I recently returned from a week-long trip; it was our first vacation since the start of the pandemic. We drove and even took the dog with us. We went to the next state over and had a great time. It was certainly a form of self-care; we both needed to get away and recharge. Not everyone has the opportunity for a week off or has the means to spend lavishly on themselves. Even so, there are ways that we can care for ourselves that still make a difference: eating right, exercising, and getting proper rest. (Do I sound like a broken record?)

It is not selfish to engage in self-care. Self-care is necessary first in order to be able to care for others later.

Freedom From, Freedom To…

The Declaration of Independence

As we conclude our celebration of Independence Day, it is worth reflecting on the meaning of the day. So often we refer to Independence Day simply as “July 4th,” without really thinking about the history behind it. Independence Day is first and foremost about the United States of America’s (although it was not yet called that) separation from the sovereignty of Great Britain. The colonists organized a rebellion (or revolution) against the monarchy that had imposed onerous demands on the settlers. They sought to establish their independence in order to ensure “certain inalienable rights;” among these were life, liberty, and the pursuit of happiness. We must, of course, recognize that not everyone was included in that statement; most notably those of African descent were not figured into the equation. In the eyes of the founders, independence from Great Britain was not just so that the colonists could do whatever they wanted. There was a bigger picture: a grand experiment in democracy and self-determination. Although the ideal is not fully achieved for everyone, the strides are worth celebrating.

Many of the founders of our nation were inspired by the biblical story of the Israelites’ liberation from Egyptian slavery (as were generations of enslaved Africans). In the Book of Exodus, the Children of Israel were not set free from Egypt so that they could do whatever they wanted. According to Jewish tradition, exactly seven weeks after leaving slavery the people stood at Mt. Sinai and received the Law from God. The Israelites were freed from the rule of Pharaoh in order to accept the rule of God and Divine Law. This parallels the founders of this country; they were freed from the rule of Great Britain in order to undertake the rule of law as established by a representative democracy and set down in the Constitution.

Freedom should not be just for the sake of doing whatever we want, but rather in order to serve a higher calling.

This idea has applications in the world of fitness and health as well. So many of us are enslaved to bad habits: unhealthy eating, sedentary lifestyles, poor work/life balance, and not getting enough quality rest. What is the purpose of breaking those behaviors? Of course, we all want to be healthier or look better, but perhaps there needs to be a deeper reason. In working with older adults, I have discovered that many clients seek freedom from bad habits in order to be able to enjoy their lives; for some that means travel, for others it is keeping up with grandkids, for others it is just being able to live as independently as possible for as long as possible.

Freedom from bad habits, gives us freedom to do so much more. At first, it may seem restricting to not just do whatever we want when it comes to diet and exercise; ultimately, however, a healthy lifestyle has the potential to give us the real freedom we seek.

Wishing everyone a great summer. May we remember our freedom “from” in order to achieve our freedom “to.”

Meeting the Recipient

Wednesday was a big day. The Cleveland Clinic arranged for all three donors and all three recipients in our “daisy chain” to meet each other in person.

I had already met Papa Phil; he was the person for whom I donated even though we were not a match; because of my donation, he got a kidney from another donor. Where the kidney that I donated had gone was a mystery to me…until yesterday.

I got to meet Norman. And he got to meet me.

It was an emotional moment for both of us. Almost overwhelming. An amazing embrace of two strangers who now share something very special.

And it was all caught on tape! The Cleveland Clinic had brought us all together to film a kind of “promo” for the transplant program. Not only was it amazing to meet the guy who got the kidney that had been with me for 58 years, I got to meet the other two donors and the third recipient as well.

The time was brief because I had to run to teach a fitness class. On the way home, my wife read a letter from Norman and a card that his mother had written to me. Although I did not really get a chance to talk with either of them, I could tell that I was going to like them both.

Later in the day, we met at a local restaurant for dinner–all the donors, recipients, relatives, and Dr. Wee, the surgeon who made it all possible!

It was an unbelievable gathering as we all got to know each other. Not everyone was from Cleveland. We are a diverse group as well. We all come from different walks of life. And now, for as long as we live, we will be connected to each other by whatever forces brought us together and by a little organ that weighs less than half a pound.

I will never forget June 30, 2021. For Norman and me, it is the beginning of a relationship. We are now KBs (Kidney brothers). To paraphrase Jewish liturgy: I am grateful to God who brought me into life, sustained me, and allowed me to experience this sacred moment.

A Month After Donating a Kidney

Framed Embroidery Kidney Anatomy Art. Hand Embroidered.

On the one hand, it seems like the surgery just happened. On the other hand, it seems like it was ages ago. I will blame my confusion on the residual anesthesia still coursing through my body.

When I posted last about my kidney donation, I was still in what I refer to as “the rough period.” This recovery has been more difficult than I expected. I was told that the first few days would be tough; the day of surgery and the day after were a piece of cake since I was on a lot of pain medicine. The following day when I went home was a lot harder; the car ride home was torture!

I got a list of what I should expect after discharge from the hospital, but somehow I was still caught somewhat by surprise. There was a fair amount of discomfort. I lost a lot of weight (which I did not need to do). I began to feel like I had turned a corner until 10 days after surgery. After 2 weeks, I was back to training clients virtually–albeit with naps in between! After 3 weeks, I was training my in-home clients, and then a few days later I went back to teaching my fitness classes. The main thing now is that I still tire quite easily; as I indicated in my last post, I have really had to listen to my body and figure out what I can and cannot do. I do finally feel like myself again, though, and look forward to building up my strength and endurance.

Would I do this again? Absolutely not–I intend to keep the one kidney I have left! Did I think this was worthwhile? Absolutely yes! A couple of weeks ago, my wife and I had dinner with Phil and his wife; he is the guy for whom I donated, but was not the one to actually receive the kidney since we were not a match. It was great to see how well he is doing; unlike the donor, the recipient feels better almost immediately. Sometimes in life we wonder if we really make a difference. This time, I know that I did. It was also just amazing to have this connection with a stranger.

Next week, the Cleveland Clinic will be hosting a reunion for the 3 donors and 3 recipients in our “daisy chain.” This will be when I meet the guy who got the kidney I donated (I try not to call it “my kidney,” because now it is his). I am kind of nervous about it. I had gotten to know Phil through social media, but the recipient is really a total stranger. I hope it will be just as amazing to have a connection with him; we will see how it goes.

In the meantime, I have heard about three people I know who need kidneys. One is in the thick of finding a donor. It is refreshing to see the outpouring of concern, support and prayers on Facebook. Hopefully, it will translate into something more. Hopefully, someone will see it–just like I saw a post last year–and decide not to keep scrolling, or to just “like” the post, but actually take the first step to find out about donating.

Despite all the discomfort, I feel so grateful that I was able to do this. I am thankful that I did not wait until it was too late. I am proud that I have made my health and fitness a priority.

Thank you to my wife, my family, and my friends for all their support. Thanks to everyone at the Cleveland Clinic: my doctors, the kidney donor coordinators, the nurses, aides, phlebotomists, environmental services, and administrative staff. In my book, you are all heroes too!

Listening to Your Body

It sounds trite, but there is definitely truth to the advice, “listen to your body.”

As you may know from previous blog posts, I had surgery just about four weeks ago. Before the surgery, I was told to plan on 10-14 days of doing nothing, that I would probably begin to feel like myself after 3 weeks…but wait to work out until 4 weeks. I have seen others who have had the same surgery talk about a timeline that extends out to 6 months and beyond.

I saw my surgeon on Wednesday who cleared me to do whatever activities I felt I was able to do. In other words, I have not restrictions, but I should listen to my body…which, by the way, has been saying “take a nap,” a LOT lately. I have been slowly ramping up the activity and exercise, and even started teaching my fitness classes for older adults again last week. I am paying careful attention to what feels right and what does not. At first, I felt lots of twinges from the main incision site, but those have dissipated almost completely. My digestive system is almost back to normal, but I am still mindful (as always) of what I eat and when I eat it. I am particularly cognizant of my energy levels and my sense of balance.

There is, of course, a flip side to this. There are a lot of times when we feel like our bodies are telling us to have that slice of cheesecake or to just stay in bed rather than exercise. There is a fuzzy line between “pushing yourself” and “overdoing it.” We know that what does not challenge us will not change us, and at the same time there is a risk of overtraining. That fuzzy line will be in a different place for everyone.

I am pleased with my progress post-surgery. I am feeling better and stronger nearly every day. The key moving forward will be to really listen to my body; right now it is still complaining a little bit, but if I follow a path of moderation I am certain it will be humming–and even singing–soon enough!

Review: The Game Changers

The Game Changers Poster

I recently had the opportunity to watch The Game Changers, a documentary on Netflix about the benefits of a plant-based diet. The film follows UFC fighter, James Wilks, journey of discovery about nutrition as he is recovering from a sports injury. He is introduced to a slew of new information about the benefits of a vegan diet, but must first overcome the doubts and years of “indoctrination” about the benefits of eating animal-based proteins as part of an elite athlete’s diet. The film makes extensive use of the stories of other elite athletes (including Arnold Schwarzenegger–one of the producers) who have followed a plant-based diet for a while. There are also segments featuring doctors, clinicians, and experts shedding light not only on the scientific data, but also the political and social aspects of the issue. A global switch to a plant-based diet would have huge implications for the environment and the economy.

The film was eye-opening in many ways, but also confirmed what I have read in other places. I myself am a pescatarian–meaning I do not eat poultry or red meat; I do eat fish (although not any crustaceans), as well as dairy products and eggs. I did not make the change for health reasons, but I did find that my switch to a more plant-based diet coincided with my first successes at competitive athletic events such as triathlons and 5k runs. I have competed in obstacle course races and half-marathons as well–mostly over the age of 50–without fueling up on meat and poultry beforehand. The film had me wondering about ways that I can cut even more animal-based products from my diet.

The film is definitely worth a view, but go into it with an open mind. The documentary definitely has its point of view but presents it in a non-judgmental way. One criticism of the film is that much of the story line focuses on anecdotal evidence, albeit rather convincing. It is often backed up with scientific studies, but there may be a need for more of them to really confirm the film’s thesis. Another criticism is that there should have been more information and guidance about what a healthy plant-based diet should look (and taste) like; peanut-butter and jelly sandwiches on white bread are plant-based, but I would not recommend it as a staple day in and day out.

Overall, I found this film to be thought-provoking…and even action-provoking.

No Need to Accept Defeat as We Age

Phil Mickelson 18th Fairway T-shoot TPC 07

Something pretty exciting happened in sports just a couple of weeks ago. Golfer Phil Mickelson, who will be 51 in less than 2 weeks, became the oldest player to win the PGA Championship. This goes against the conventional wisdom that as we age, we are less able to compete and win in sports. This is no fluke, though. In fact a recent article shows the strategy that Mickelson undertook to be successful.

The story is not anything earth-shattering, but rather just a confirmation of what fitness professionals–especially those of us who work with older adults–have been saying for a while. Our bodies undergo changes as we age, but that does not mean we are powerless to counteract them. The article points to three main areas that Mickelson addressed and they are instructive for all of us.

First, among the changes we experience is often a change in metabolism. Some of us when we were younger were able to eat whatever we wanted and not put on weight; as we age, however, we must be more conscious of our nutrition. Mickelson was aware of this and if you look at pictures of him, you will see how much more fit he looks these days.

Second, mobility and strength need to be maintained and even improved. This is a big part of what I do with my clients. It is not enough to simply be flexible; one must also have the muscle power to go behind the movements. For years, older adults were told that it was dangerous to work out with weights; research now shows that as long as it is done in a responsible way, it is key to maintaining independence. Additionally, studies indicates that power training (combining resistance and speed/repetitive motion) is an effective way to boost fitness and even life expectancy.

Third, be certain to assess and re-assess the plan so that workouts and diet are appropriate. Doing the same thing every single workout without progression rarely leads to progress. On the other hand, overtraining can do more harm than good. In this regard, it is good to have a professional like a certified personal trainer to shape a program that will be safe and effective.

Phil Mickelson should be an example to all of us of what we can accomplish if we follow these guidelines. He is just one example, though; we all know that there are many older athletes out there who are pushing the limit and showing us just what is possible. No need to accept defeat!

I Donated My Kidney, Part 2

Giant Bean aka Cloud Gate at Millennium Park - front view

During the months leading up to my kidney donor surgery, one of the questions that I was asked over and over again (in many different forms) was:  “Why are you doing this?”

The simple answer was that if I had the opportunity to save someone’s life, I wanted to try to do it.  But, of course, there are no simple answers…and the question still honestly puzzles me.

Most of the time the answer I gave centered around an incident that happened more than five years ago.  I was serving as a rabbi at a large congregation in Columbus and had a member of my congregation who was in need of a kidney.  He had placed a sign on the back of his car that said “Got Kidney?  I Need One,” along with his phone number.  Someone eventually called the number and was a match.  I had gone to the OSU Medical Center to sit with the family during the surgery; I went into the immense surgical waiting area and made my way to the check-in desk.  I asked for the family of so-and-so, and a moment later a woman (who must have overheard my question) jumped up and asked if I knew that family.  HIPAA-be-damned, I told her I was the rabbi from the family’s congregation.  She informed me that her daughter was in surgery at that moment donating her kidney to him.  I was there when the two families met and it was one of the most incredible moments of my 20+ as a congregational rabbi.  I remember saying to myself that if one day I was able to do something like this woman’s daughter had, I should not let the opportunity pass.

The truth was that I had already let it pass a bunch of times.  Over the years, the congregation had done text study about organ donation (spoiler:  Judaism supports it).  I am sure that I had preached about it over the years.  Undoubtedly there were Organ Donation Sabbaths too.  It had just never occurred to me that this was something I could do (because of my medical history, or because I was raising a family, or because I was too busy, or because this was something that only “heroes” and “angels” do, or because….)  And those of you who read my last blog post know, I am still surprised that it actually happened.

So, back to the original question:  why did I respond to that FB post for someone I did not know at all?  

Growing up, I was always taught how important it was to save a life; in Judaism, one can violate almost any law in order to preserve it.  We were also taught that whoever saves one life, it is as if s/he had saved an entire world.  I knew this was an important thing but there was still a disconnect for nearly 58 years. 

Maybe my response this time was due to a nagging guilt on my part for having talked-the-talk about saving lives without ever really having walked-the-walk.  Maybe part of it was that I was fairly certain there was no way I would get approved so I was not really risking anything.  (Would I get “brownie points” just for trying?)

Like so much of what we study in our lives, we can learn about it, but when do we really get a chance to put it into action?  In this regard, unless we are medical professionals (doctors, nurses, therapists, technicians, etc.), how often are we able to save a life?  The opportunities are out there, but sometimes it is not so easy.  How many of us donate blood to the Red Cross?  (BTW, under doctor’s orders I am not allowed to do that; kidney=yes, blood=no!)  How many of us have been swabbed for a possible match for a bone-marrow donation?  Are we willing to take time out of our days to be inconvenienced to help others who need our help, whose lives we may not be physically saving but whose quality of life we may be enhancing?  Do we stick out our necks when we see someone being harassed?  Are we willing to stand up for what is right through more than just a social media post? 

We cannot do it all.  Pirkei Avot teaches us:  Lo alecha ham’lacha ligmor, v’lo atah ben chorin l’hibatel mimena, “It is not your duty to finish the work, but neither are you free to not do your part.”  The needs in this world are overwhelming–even paralyzing.  We must, however, find what speaks to us and do it because we know the price of doing nothing.  In the last century, so few people took risks to save victims of the Holocaust while the vast majority simply sat by and did nothing–which is all that was need for evil to triumph.

In the final analysis, I am still not exactly sure why I stepped up this time.  It could be that something in the photograph on the FB page reminded me of my own family; if I were in their position, would I not want someone to step forward?  It could be that I wanted to prove something to myself:  that this almost 58-year-old guy who was sick as a child and got picked last for sports teams, who had decided to get healthy and fit, was now capable of using his body to save someone else.  It could be that as I am aging I want to convince myself that I am young enough to do something like this.  Perhaps I am trying to assuage feelings that I have not really accomplished anything of significance or made a big enough difference in the world (I know it is not true, but many feel that way at times).  I certainly was not doing it for any health or financial benefit.  (To be completely transparent, I did get a cool Kidney Donor T-Shirt, pillow, water bottle and tote bag!)

There is an expression in Judaism:  Ma sheh-lo lishmah, ba lishmah.  Roughly translated, it means that something that you do for the wrong reason, in the end you will come to do for the right reason.  Often this refers to people who give money so that they will get their name on a plaque or get some other recognition; charitable giving should be done modestly, but better for the person to give for the plaque than not at all…because eventually they will do it even without the plaque.  

Whatever my motivations might have been to get into this whole kidney donation thing, I am not sure that it really matters.  In the final analysis, because of my actions Papa Phil got a new kidney, and so did two other people.  Does it really matter why I did this?  What matters is that I did…when it would have been much easier not to.  

I know this has been kind of preachy, but what do you expect from a rabbi?  I have learned a lot from this experience, and know that I will continue to do so.  My biggest takeaway:  we should never assume that we cannot make a difference.  I never would have believed that I would be qualified to donate a kidney, but here we are.  Of course, making a difference rarely calls for something this drastic.  Even the smallest of actions can have a tremendous impact, and it is never too late.

I know that I cannot complete the work; I cannot solve every problem out there in our world.  I am grateful to have had the opportunity this time to do my part.