Get Your Colon Cancer Screening!

Stop Cancer Sign Car Bumper Sticker Decal 5'' x 5'' | eBay

Yesterday I had my biennial colonoscopy–a little early, since the last one was in August of 2019. You may recall that I blogged about it back then.

I really do not mind having my colonoscopy. The prep is way better than it used to be; the day before yesterday was Miralax mixed with Powerade Black Cherry and it was impossible to taste the difference from plain Powerade. The drugs during the procedure were, as usual, great and I remember nothing. Best of all, the doctor found initially that there seems to be no disease activity (I am in remission from Crohn’s Disease) nor signs of cancer; several biopsies were taken and those results will be out later this week.

In the meantime, here is another reminder to get your colon screening after age 50. A colonoscopy is not the only screening out there; ask your doctor for his/her recommendation. Colonoscopies are about 94% accurate in their findings, which is pretty good odds! The process is not so much fun, but two days of inconvenience and some discomfort is way better than having to undergo cancer treatment.

In general, as we age, it is recommended to get out in front of all the recommended health screenings. The success stories we hear about people diagnosed with cancer are much more common when the disease is caught early. So get that colonoscopy, prostate screening, mole check, mammogram, etc.

It isn’t necessarily fun, but I’m told it’s more fun than cancer.

That Spare Tire…

Dinky Spare Tire

No. Not that spare tire.

CNN recently reported on a difference you might see the next time you see your doctor. Instead of just getting weighed and perhaps calculating your BMI (Body Mass Index), the nurse may measure your waist circumference. Why?

Weight that is carried around the abdomen is especially dangerous. It is an indicator of VAT (Visceral Adipose Tissue). This is more than just the “jelly” you see around your waist; VAT often wraps itself around internal organs and is associated with higher levels of cardiovascular disease.

This is not news per se; we have long known that this kind of fat is dangerous. What is new is the increase that has been seen over the last year–many assume due to the COVID-19 “nineteen.” Some people may have actually put on 19 pounds during the pandemic (due to sitting at home with a house full of food coupled with less activity); even if we have put on less, it is important to realize that the added weight is not just a matter of changing how our clothes fit or our appearance. It has serious health consequences–which is why doctor’s offices are increasingly measuring waist circumference.

We also have different body types. Some folks carry their weight in their bottoms or legs. In any case, eating properly and maintaining a healthy weight and BMI is always a good idea. For those of us–myself included–who are relatively slim but put on weight right in the belly, though, we should be especially cognizant of the risks of VAT.

The article is definitely worth the read. It is not long and it gives easy instructions on how to measure waist circumference and how to interpret what you find.

Knowledge is power…and, in this case, it is also a tool for reaching better health outcomes. Check that spare tire!

If Not Now, When?

Hourglass

Rabbi Hillel, one of the greatest teachers in Jewish tradition (110 BCE-10 CE), is the author of the well-known saying: “If I am not for myself, who will be for me? If I am only for myself, what am I? If not now, when?”

This pithy expression asks us to examine our role in the world, where we fit in. Although these words are over 2000 years old, they are compelling today as well. We must be willing to put in the effort to advance ourselves; we should not rely on others to look out for us. At the same time, we should not be so self-centered that we forget our obligations to those around us. Finally, there is a time to philosophize over these matters, and a time to act.

It occurs to me that Hillel’s words do not just address our spiritual or emotional status, but our physical well-being as well. As readers of this blog know, the interplay between body and soul in Judaism is a fascinating one. Our tradition recognizes that body and soul need each other; our souls require a body to “house” them during our sojourn on earth, and our bodies would only be dust (according to Genesis 1) were it not for the soul.

When it comes to our health and fitness, it is up to each of us to make sure that we care for the body given to us by God. We must make sure that we eat properly, exercise, and get appropriate rest; we cannot abuse our bodies and expect someone else (a medical professional, a personal trainer, a magician?) to make it all better. We also run the risk of being so concerned with our own physical wellness that we forget about the needs of others. This is a natural human instinct; we are afraid to give up something of our own lest we need it later. It is not a zero sum game, though; for one person to be healthy does not mean that someone else has to be denied access to healthcare, good food, vaccines, etc. There is enough to go around (at least in the United States) if we have the will to make it so. Finally, we should not put off taking better care of ourselves for later when we think we will have more time, or more energy, or feel more motivated.

This last point is perhaps the most important. A journey of a thousand miles begins with just one step. That step may be joining a gym, downloading an app to eat more healthfully, simply going on a walk, or scheduling a mammogram or colon cancer screening. We can come up with hundreds of reasons for why we cannot do this or that when it comes to fitness and health; sadly, we often come to know the danger of putting things off only when it is too late.

If not now, when? Whether I am only for myself or only for others is a moot point if I never act. Hillel asks us to think about ourselves and about others; even more importantly, that thought must move to action. Our health and welfare should always be a priority. Let us treat them as such by not waiting any longer to be the best version of ourselves–emotionally, spiritually, relationally, and physically. If not now, when?

The Health Hazard Posed by Racism

RACISM

Over the last few years–but certainly more intensely since the killing of George Floyd–our nation has begun to recognize the serious damage that has been caused by racism. The brunt of that damage, of course, has been felt by minority groups, but many recognize that racism harms all of us.

Although I consider myself an open-minded and empathetic person (who happens to belong to a minority group too), I do not fully understand the challenges faced by others who do not look like me. I have been shielded from much of the hatred, violence, and injustice. The last couple of years have made me more aware of the insidious ways in which racism has infected every corner of society; it has impacted jobs, public safety, self-esteem, the arts, and politics to name just some areas. I have become more attuned to how widespread the problem is.

As someone who is in an allied health profession, I know that the health challenges faced by minorities are different than those faced by the rest of society. Yes, there are certain diseases that are endemic in various communities (Sickle-Cell Anemia among African-Americans and Tay-Sachs among Jews), but socioeconomic conditions almost always contribute to worse health outcomes as well. For instance, lack of access to fresh fruits and vegetables in some neighborhoods while fast-food is readily available affects poorer Americans more than others. Scarcity of affordable housing and healthcare as well as substandard education can also contribute to the problem.

An article published last week on http://www.nbcnews.com highlights a recent statement by the Centers for Disease Control and Prevention (the CDC) that calls racism a “serious threat” to public health. In particular, the CDC claims that racism has “profound and negative impact on communities of color” and is contributing to disproportionate mortality rates among people of color. The article is worth a read for its explanation of why exactly this is an issue. Racism in our society has contributed to the very challenges listed above. One cannot help but pause to consider why minority groups suffer worse health outcomes across a variety diseases (when comparing apples to apples).

I have not read the report from the CDC yet, but from my experience as a personal trainer I know that people from lower socio-economic status are less likely to be able to afford a gym membership, fitness equipment, or access to a trainer. Many minority groups find themselves in that lower socio-economic segment; racism since the birth of this nation has certainly contributed to that overlap.

As a country, we must continue to confront our sad and on-going legacy of racism. As we do, we will more fully understand the myriad ways in which it affects its victims. Ultimately, it affects all of us; as we have seen with COVID-19, viruses do not understand skin color, national origin, sexual orientation, or political affiliation. How is it then that minority communities were so disproportionately affected by the pandemic? Let us be aware of the role that racism plays in all of this; until we recognize it, we cannot hope to find solutions.

Aching from Too Much Computer/Desk Time

Old man with bad back

A couple of months ago I suddenly found myself with a sore and stiff back. It got so bad some days that I wondered how I was going to get out of bed. Other days I could barely lean over the bathroom sink to wash my face. I saw my primary care physician who recommended a few stretches, and the DO who was working with him even did a few manipulations. After a week with little progress, I asked my doctor about seeing a chiropractor; he thought it might be a good idea.

I was surprised to see that my chiropractor was part of a holistic health center at the Cleveland Clinic; I had always assumed that chiropractors were in practice for themselves and seen as being somewhat out of the mainstream in terms of medical care. Thankfully, after a couple of visits to the chiropractor–with some new stretches and strategies–I was back to my old self.

The problem, he explained, was not an uncommon one–especially as the pandemic drags on and many of us are still working remotely. We are spending too much time just sitting in front of a screen. As a personal trainer, I used to be on my feet all the time; there was even a rule at the gym where I worked that we could not sit down while with a client unless it was to demonstrate an exercise or a machine. Now that I am training remotely–with the exception of my group fitness classes–I am almost exclusively sitting down. Even with a rolling stool (the kind you often see in a doctor’s office that requires good posture since there is no back), I still managed to put a lot of pressure on my spine and hips. Now I make an effort to get up and walk around every now and again, and sometimes to even train while standing.

A recent article on CNN’s webpage by Stephanie Mansour (https://www.cnn.com/2021/03/30/health/exercises-for-computer-users-wellness/index.html), offers five exercises that can also help those who are stuck in front of their monitors or laptops for hours on end. The exercises are: arm circles, wrist circles, hip circles, ankle circles, and leg circles. Nothing too radical here! Rather what we have are simple exercises that can be done quickly and easily without any equipment. They have little cardio or resistance value, but keeping ourselves limber and out of pain contributes to our ability to do those kinds of exercises.

I imagine that virtual training will always be a part of my personal training enterprise, and that therefore sitting in front of my laptop will be part of the formula as well. I do not want a repeat of the back pain from late winter, so I will get up and move around on a regular basis…and try these exercises too!

Stay healthy, and keep moving!

Exercise after COVID-19 Vaccine

Syringe and Vaccine

This coming week I will be receiving my second Pfizer Covid-19 vaccination. Needless to say, I am grateful and relieved to reach this occasion…but I am also a little concerned.

Most people I have spoken with have had some kind of reaction to the second dose. Many of my clients have had to cancel workouts with me–some were knocked out for 5 days. Others, however, felt “off” for a day and then were fine. So what awaits me next week?

Medical experts note that everyone reacts differently; some even indicate that a strong reaction is a good sign of the immune system ramping up its defenses against the virus.

What does this mean for those who are regular exercisers? Should we work out after receiving our shots?

Yahoo News ran an article yesterday on this topic (it originally ran in Business Insider); here is the link: https://news.yahoo.com/know-exercise-covid-19-vaccine-152010050.html?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAALvUGT_dj_yYn8ZDh7dBamMrsbFkrQBQRIzdumYt5cJR0od7djGCIja3IVRyvfhyqxIXXwcjIruvqvuYGo6w9tQgTlVf0CewlGYEokeZFaNd-Nk58o-BOSk-_uRp06YGb-SOZL34zgXn4TZ07-LTBKr6ax_oA8tj2QZeiyPQY8Kq.

The author, Anna Medaris Miller, does not surprise us at all. The advice in a nutshell is that if you feel up to it, go ahead and exercise before and after the shot. If not, take it easy. Listen to your body and act accordingly. In any case, exercising before or after the injection does not seem to alter its efficacy; overtraining, however, may have a negative effect so do not run a marathon right before the vaccination. The doctor interviewed in the article, Dr. Kevin Bernstein, does warn that we should avoid the opposite as well; sitting around for a week afterwards is not recommended. It is up to each individual to judge their own situation, but an effort should me made to keep moving.

Finally, the article notes that arm exercises can help to alleviate the pain at the injections site. Bernstein did pull-ups (which may be a bit much for most people), but other arm exercises can lessen the discomfort; a cool washcloth at the spot and over-the-counter painkillers can also help.

I will let you know how it goes next week. In the meantime, I look forward to reciting the Jewish prayer when I get the shot: “Praised are You, Lord our God, Ruler of the Universe, who brought us into life, sustained us, and allowed us to reach this moment!”

“You had a bad day…” or two…or three…

.bad daY

As you may have noted in my previous posts, a lot of preparation went into the celebration of the Passover holiday (today is day 3 of 8). There is, of course, all the cooking and cleaning, but when you are concerned about your diet and fitness this holiday provides extra challenges.

First, many of the foods we typically eat during the year are off-limits because they have some kind of leavening in them. Most of them do not, but the marketing of foods for Passover often causes us to stock up on less healthy options that we would not think to purchase during the rest of the year. Second, the first two nights of Passover are marked with the Seder feasts; traditionally, there are certain foods we eat as part of the meal and the accompanying story that goes with it. Like Thanksgiving, however, there is an emphasis on large quantities of food.

I had the added complication this year of not being able to track my calorie intake or activity; this is because I do not use electronics on the Sabbath or the Holy Days of the Festival (last 2 and first 2 days). Since the holiday began on Saturday night, I went three days without recording as I usually do (Friday sunset through Monday sunset). Yes, meals were planned in advance, but it was difficult to control the serving sizes. Tracking has been an important tool for me as I work to keep myself at a healthy weight.

The news was not so good when I got on the scale after the Holy Days. So, I had a bad day. One of the lessons from Noom–which I have long shared as a personal trainer–is that a bad day (or two or three) is not a cause for feeling defeated. It sounds corny, but every day is a new day. This morning I got back on the program and started tracking everything again; it was not that hard. I did not lay any guilt on myself; on the contrary, I was kind to myself and reminded myself that I should not begrudge a little extra “celebration” on a festive holiday. A couple of days is okay; a week or a month would be a different story.

Here I am, back on track. This is a healthy approach to setbacks. As they say, “hop back on that horse.” Not bad advice as Passover continues for five more days and as many approach the Easter holiday with all its peeps, chocolate eggs, and family dinners.

Reflections on Reaching My Goals

The new field goal posts at Vaught-Hemingway Stadium

Sunday was a monumental day in terms of a fitness goal I had set for myself. Those who follow my blog know that 7 weeks ago I joined a weight-loss program (Noom) in order to take off the weight I had put on during the pandemic; I had tried unsuccessfully to do that on my own for about 2 months.

Sunday, I met my overall goal–losing 15 pounds in 7 weeks; not only did the pandemic weight come off, but it also brought me to the middle range of the ideal weight for an adult male 5’10” tall. I have wanted to get to this spot for several years and am finally there! I love the way I feel; I am way less exhausted after my workouts and I feel like I have more energy. I love the way I look; my clothes fit better, I can see my obliques and abs, and I had to get a new belt to hold up my pants! Two things I am thrilled about: eliminating the visceral fat around my waist (which is an indicator of better health) and reaching a goal that I worked hard to accomplish.

What was different this time? Two things.

  1. In the past I just tried to watch what I ate and monitor physical activity but not in a “casual” way. Several times, I used My Fitness Pal to track those, but I was never really consistent about it, nor did I have a sense of what my calorie intake should be in order to achieve success. Additionally, although I may have lowered my calorie count, I was not necessarily eating the right kinds of foods–too much processed stuff and not enough greens and whole grains. This time around I used Noom. It is not inexpensive, but I know that if I put my resources into something I am not going to let it go to waste; who wants to spend money on something and then simply let it go down the tubes? The fact that I was invested financially meant that I was invested emotionally and physically. Noom also has coaches, a kind of support group (that I only joined when I was almost at my goal), as well as regular educational tidbits on the app that are informative and motivating. Bottom line: to get results, get invested.
  2. I had a partner supporting me. My wife (who is close to her goal as well) is doing Noom as well. We both support each other and hold each other accountable. We know that one of us slips, the other one will slip as well…and when one shows discipline the other one will too! I honestly think this was a more important factor than the first point above. I do not know how folks lose weight on their own when others around them are eating a less healthy diet with larger portions. The beginning was hard as we both adjusted to a greatly reduced calorie counts, but then we put our heads together and found recipes and foods that would fill us up with as little a dent in the calorie budget as possible. It became like a kind of game and we were a team! This journey has even brought us closer together!

What is next? Obviously, I must now maintain the progress that I have made. Noom has adjusted already now that I am not in the “weight loss mode;” my calorie budget has increased a little. It is now up to me, though, to stick with the program–even with the upcoming Passover holiday–tracking the food I eat and physical activity. I suppose a time will come when I won’t need to do all the tracking, when I am so used to how and how much to eat that it will no longer be necessary. That is still in the future.

For now, I celebrate reaching a goal…and get ready to set my next one!

Making Sacrifices for Better Health

Chumash printed and commented by S.L. Gordon

This week in the Jewish lectionary cycle, synagogues around the world begin reading the Book of Leviticus. The very first Torah portion is called Vayikra after the first word in the first verse in Hebrew; the reading describes five of the sacrifices/offerings that Israelites were to make in the Tabernacle (and later in the Temple) on various occasions.

The Jewish view of sacrifices is different than what we often think about. In modern parlance, sacrifice is thought of as giving up something. Usually the sacrifice is made in order to accomplish something else–to appease a god, to give thanks, to request something from a god. The ultimate goal is to engage in the creation of holiness; this comes from the Latin root of the word sacrifice. In Judaism, the word used is Korban and, linguistically, it has nothing to do with holiness; rather it means to approach or come close. The goal of a sacrifice then is to come closer to God; this may better explain why Abraham was willing to offer up his son. The aim of a sacrifice is not transactional but rather to simply be in relationship with God.

In the world of fitness and health, we also talk about making sacrifices, but in a different way. Those who have ever tried to lose weight know that we have to “sacrifice” eating some of the foods we might like, or at least eat them in different quantities. Working out also requires setting aside time that might be spent watching TV, shopping, or doing other activities; belonging to a gym or hiring a personal trainer involves a financial commitment that may necessitate cutting something else out of the budget. There is only so much time in the day and only so many resources, and we have to make choices…or sacrifices.

A more positive way to look at these sacrifices is not as having to “give something up.” Rather, the Jewish view of sacrifice asks us to think about what our choices can do in order to “bring us closer.” Closer to what? Closer to our health and fitness goals. Closer to living the kind of life that we want. Closer to actions that reflect our values.

Over the last 6 weeks on my weight loss journey I have had to sacrifice a lot–mostly my beloved pastry! In the process, however, I have found that I am closer to who I want to be. I feel the way I want to feel. I look more like how I want to look. I find I have more energy and stamina. I am indeed “closer” to where I want to be…and I did it by making “sacrifices.”

As we reflect on the beginning of the Book of Leviticus, let us consider the sacrifices we are willing to make (and are not willing to make) in order to bring us closer to who we really should be.

Wishing all a great weekend and Shabbat Shalom!

Let My Diet Go? Planning for Passover

Olives, Matzoh, Radishes, Liver Pate, and Sweet Pickled Peppers

The holiday of Passover is about 10 days away and for most Jewish people across the globe, preparation is in full swing. Why is this Passover different than all other Passovers?

You might think the reason is because of the pandemic, but by Passover last year we were already in “lockdown” mode and most Seder meals were done with only a few people and/or virtually with family and friends. The real difference this year has to do with the changes that I have made in my diet over the last five weeks or so. As I have noted in previous posts, I have been tracking all my exercise and all my calorie consumption; as of this morning, not only have I taken off all my COVID weight, but I am also 2 pounds away from my goal weight. It is an amazing feeling; I like the way I feel and the way I look!

This year, my wife and I are approaching Passover in a different way when it comes to food. For those not familiar, during the 8 days (7 in Israel), we eat no leavened foods: no bread, no pasta, no cake, etc. Over the years, however, many substitutes have been produced so that now it is possible to make Passover “bagels,” brownies, noodles, etc. They use ingredients that are permitted on Passover, but from the standpoint of being healthy…well, let us just say, that maybe they should not be permitted. It is still a carb nightmare. We are planning ahead so as not to lose all the progress we have made since we began this journey.

Typically, we make lots of recipes that use Matzoh (unleavened bread); recipes call for using it in “lasagna,” desserts, and even (the ever-popular) Fried Matzoh. This year we mapped out EVERY. SINGLE. MEAL. You read correctly. For the entire 8 days, we have charted out what we will eat, and it involve as little Matzoh as possible (which clocks in at 140 calories/piece). We are going heavy on vegetables and lean proteins (lots of fish since we do not eat meat or poultry). During the Seders, we are supposed to drink 4 cups of wine; we will not use such big cups this time around. Most years, Passover seems like a lost cause when it comes to eating healthy…and when it comes to the Passover Seders, think Thanksgiving-sized feasts two nights is a row. This year will be different from all other years. We have planned for it to be different.

Of course, it will not be easy. We are only shopping, though, for what we will eat (as listed on our menu) so that we do not have the temptation of lots of junk food to snack on. We are also going to drink LOTS of water to combat the famously constipating effects of many foods served on the holiday.

I will keep you posted on how it goes during the holiday, but I am actually looking forward to not feeling bloated and stuffed for much of the week. It will be worth the effort for that reason alone. Continuing to make progress toward my health goals will be icing on the (Kosher-for-Passover) cake!