Movember / Men's Health: Week One

11 days

Summary of Movember posts:

11/4/13 November is Movember, when you may notice some of the men in your life sprouting mustaches to draw awareness to men's health issues. While the growing of facial hair may seem silly as an awareness movement, men's health issues remain quite serious. Despite that medical science has long had a bias towards how problems affect men, men still have a lower life expectancy than women. Simply put, we need to start taking better care of ourselves. While the official Movember charity focuses on prostate and testicular cancer, I plan to highlight issues that are relevant to my own practice.

11/5/13 Hand-washing! 'Tis the season for common colds, stomach bugs, and the flu. The best preventive measure a guy can take is regular hand-washing Studies have shown that proper hand-washing (with regular soap) reduced respiratory illnesses by 21% and GI illnesses by 31%. Unfortunately, other studies show that guys are much worse than the ladies when it comes to hand-washing Grab the soap, men, and wash those hands!

11/6/13 Zinc. There is often a lot of talk about zinc around this time of year, as it is often used as a treatment to shorten the common cold. Zinc is often touted in supplements as a prostate panacea. While there is some evidence that zinc can support prostate health, too much zinc has been associated with prostate cancer. Most men get adequate amounts of zinc from their diet and should only supplement it if they are known to be deficient.

11/7/13 Ankylosing Spondylitis. Everyone should take care of their back. However, proper specific diagnosis of back pain is critical to order to guide specific treatments and obtain good results. This is particularly true for young men. Ankylosing spondylitis is a form of arthritis which predominantly affects the low back. Men are 2-3 times more likely than women to have this disease, which commonly manifests from the late teens to early 30's. Stiffness is a major symptom, often even more so than pain. While it is important to address the pain, it is critical to recognize and treat ankylosing spondylitis early in its course to prevent deformity and other complications.

11/8/13 Osteoporosis. Age related osteoporosis tends to occur later in men than women; with increasing life expectancy, we are seeing more and more osteoporosis in men. Osteoporosis can occur in younger men as well, often due to medical problems or medications. Men are more likely to die in year following an osteoporotic hip fracture than women. The best "treatment" is prevention: adequate amounts of calcium and vitamin D and regular exercise.

Running State of Mind

I started running in 2001. At first I didn't really enjoy it, but the trainer I was using was also a tri-coach and he insisted that I run. After a few months, I started getting into it and even did a few races here and there.

The Chicago Marathon in 2005 was both the peak of running career and the downfall. Prior to doing that race, I had always assumed that the race was the hard part. Not so. The preparation was grueling. I always felt like I was preparing for my long runs, doing my long runs, or recovering from my long runs. If I was on call on the weekend, I would have to get up at 3am to do my long run so that I wouldn't have to run in the afternoon heat in August. The race went well. I decided to take a few week break, and that stretched into six years. I did try a few times to resume running, but it just never took.

In 2011, I finally resumed. I had lost some weight, so the running wasn't as physically uncomfortable. I made a pledge to myself to run at least three times per week for 4-6 weeks. It was so tough at first. I remembered how running had previously been almost effortless and meditative. When I was starting up again, it was painful and exhausting. The message "I'm going to die" kept cycling through my brain. However, after a few weeks, that message started to subside.

Now, I'm not running quite the marathon prep distances I used to, but I am running however long and far I want. It is not unusual for me to find that I ran far longer than I planned. My mind just drifts.  sometimes I solve the problems of the world; other times my mind is blank. I used to always run with music; now I vary it up. Most importantly, I am feeling much better, both physically and mentally.

Running in Winter

A while back, I discovered the joys of running through the winter. It kept me focused on my identity as a runner....in fact, it strengthened it. There are always runners on the Lakefront Trail in Chicago, regardless of season or time of day. However, in the coldest months, it is a dedicated crew that is out there, always sharing a nod or wave for the other members of the fraternity. There are other benefits to running through the winter. My tolerance for cold increases dramatically. Also, when spring comes, I find that my endurance and speed pick up noticeably.

The key to running through the cold is having the right gear. If you are miserable, there is no way to remain consistent. At the request of a few friends, I have compiled my list:

1. General - It is critical to layer. Air gets trapped between the layers, and that is what will keep you warm without getting too bulky. You need to have technical wicking layers close to the skin to keep the moisture moving away from your body. The innermost wicking layer must fit close to the skin. It doesn't need to be binding, but it should not be baggy. It is also critical to care for you wicking gear properly. Don't wash with bleach or fabric softeners. Absolutely NEVER use dryer sheets....your clothes will lose their wicking properties.
2. Tops - Depending on the temperature, I will wear 1-3 layers. The innermost layer will be my wicking layer. I have two different weights for this inner layer, one super light and one medium. Sometimes, all I need is that one layer. If needed, I can put on a second layer which is a fleece. I prefer a wicking fleece, but I know some people use a sweatshirt. Finally, if it is windy, I will put on a windbreaker. I typically use a windbreaker vest, but I have one with sleeves for the bitter cold. The windbreaker holds in all the heat and moisture, so it can make it feel like a sauna! I prefer that my fleece and windbreaker have zippers in front so that I can vent it I start to overheat.
3. Bottoms - Usually, I have fewer layers on the bottoms. I have some great sweats that are wicking (not tights), and if I can get away with it, I prefer just to throw on the sweats over my running shorts. However, sometimes it is too cold for that. I have wicking running tights that are pretty warm; I will throw a pair of gym shorts over them so that I don't gross anyone out. If it is super cold, I will put my sweats on over the tights. One two occasions, I have even had to throw on a pair of windbreaker pants over the other two layers. I probably shouldn't have been running those days.
4. Feet - Most of the time, I use my usual wicking running socks. I do have a few pair of heavier socks, also with wicking properties. You can get them at running or hiking stores. I base my choice of shoe on the precipitation. If it is dry and there isn't snow or water on the ground, I wear my usual running shoes. If there is snow, I wear my trail running shoes. Remember to get yourself evaluated for your trail shoe just like your running shoe. I do not recommend running if there is ice. No shoe will give you adequate traction for running on ice.
5. Hands - It is hard to keep your hands warm, as your body is going to shift your circulation to your core. I wear two layers of gloves. My inner layer has wicking properties. The outer layer is usually fleecy or wool. It is ideal if one of the layers has some windbreaking properties (North Face has some good gloves).
6. Head - I have a few different headbands which wrap around to cover the ears. They are all wicking, though of different weights. I don't like hats because they make me overheat. If you do prefer hats, make sure they wick. Often fall races give out wicking hats as swag.

I couple of general reminders:

1. If the weather forecast is for extreme cold or windchill, such that they warn against having any skin exposed, it probably is a good reason not to run outside. Even if you bundle up, it can be damaging to the eyes and lungs.
2. Asthmatics should be careful, as cold and exercise are both fairly common triggers...even more so when combined.
3. There are fewer people running in the cold, so help may not be as available if you get injured. Make sure someone knows where you are. Make sure you have ID on you with emergency contact information. Don't run too far away from populated areas.

Happy running!

7 Lessons From the Death of a Friend

My friend Omar Ahmad passed away Tuesday. We were roommates at the Florida Foundation for Future Scientists program at the University of Florida back when we were in high school. We became fast friends and he kept me motivated as we competed in various science fairs the following year. We won spots as the delegates from Florida to the National Youth Science Fair. After college, our contact was regrettably spotty, but we started getting back in touch in the last few years via Facebook. We had a chance to sit down last year when he was in Chicago. I so looked forward to the continuing renewal of our friendship. Who could have imagined that we wouldn't have time?


In his 46 years, Omar lived more than most people do in twice that time. His accomplishments and impact are beautifully summarized in this piece in the Huffington Post.


I am still trying to process this loss. I cried myself dry by the end of Wednesday. I have been numb most of the week, but I can now smile when I remember him. Even in death he brings people together. I have been in contact this week with people I haven't seen for decades. His memory truly is a blessing.


Omar's passing has been very challenging to me. Aside from the incomprehensible loss, it also forces me to look inward. I strongly believe that every sad thing, every loss, every tragedy comes with a lesson. Sometimes you have to look hard to find the lessons. However, as always, Omar is a great teacher....sadly, what I need to learn is right there in front of me.

1. When was the last time you saw a health provider for routine health maintenance? Omar passed away at 46 from a heart attack. I have no idea how well he looked after his health. For a physician, I take reasonable care of myself. I actually have a primary care physician, and I allow him to direct my care. I routinely see my dentist. However, given my family history of colon cancer, I am overdue for my repeat colonoscopy. I also need a routine skin survey from my dermatologist. I probably should stop ignoring the pain in my neck and back.
2. What do you do on a routine basis to care for yourself? I probably do best in the physical realm. I eat a well-balanced diet. I exercise 4-6 times per week, though I really need to do more cardio. My brain is well stimulated by school. I do miss reading for pleasure, but I hope that will return when I am done with school. I need to nurture myself more spiritually. I grew apart from organized religion years ago. I still consider myself Jewish and spiritual, but I don't really dedicate any effort to developing that dimension of my life.
3. How often do you say "I love you" to the people you love? I am very diligent about this. If any interaction with someone I love could potentially be my last (which clearly is true), I'd like to know that the last thing they heard from me is "I love you."
4. How much do you live for today as opposed to tomorrow? Years of striving to get into medicine taught me all about delayed gratification. Years of practicing Rehabilitation Medicine has taught me that life can change in an instant. I struggle with this. When I try to live well now, I feel guilty about not saving for the future. When I deny myself to prepare for retirement, I worry about not living in the present. I constantly work on this balance.
5. How are you impacting the world and the life of others? As a physician, I have always had the satisfaction of impacting the lives of others. However, at the end of the day, I feel that all I have to give has been drained from me. I marvel about how some of my colleagues are able to go one step further with volunteer work. I am conscious about how that is going to change as I transition into my next career. I actually look forward to the opportunity to explore the different ways I can contribute to this world.
6. What will be your legacy? I don't have kids, and I don't see kids in my future. So what will be my gift to the future? I see some of that in all of the students I have taught as a physician. I love teaching and I hope that I will be able to return to teaching once I have established myself in design. What else can I leave? I think about this. I worry about this. One possibility Rob and I have discussed is helping out gay youth. There are agencies which place gay teens that have been thrown out by their families with stable gay couples. Is that right for us?
7. Are you sure that your regrets cannot be done/redone/undone? This is probably the question that stings most sharply. I will never have the opportunity to rebuild my friendship with Omar. Another friend, Bridget Phillips, was murdered when she was in grad school. Clearly, tragedies such as these can make a regret permanent. How many more, ones that seem so fixed, really could be addressed. There are a few friendships that I have thought permanently damaged that I am considering revisiting. I have also always wanted to live abroad, but figured that the opportunity may have passed, being locked into my current career. While it might create a massive disruption to our lives, might it actually be a real possibility. I know that so many obstacles in our lives are placed there by our own minds. I need to start challenging those barriers.

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What a difference a GREAT massage makes!

Last week I suffered through a thoroughly craptastic massage experience.  While I was not thrilled about paying for another massage quite so soon, I clearly need it.  My muscles were no longer quite so rock-hard and burning, but the brain was still frazzled.  Fortunately, Chicago has many options for massage.....which is great because I'm certainly NOT going back to Kiva.


I decided to return back to Sir Spa.  It had been years since I had been there, but two different people had brought it up in the last week.  Even though I called this morning, they were able to fit me in at the time I wanted.  Unlike Kiva, the place still looks brand new.  They are putting forth the effort and money to keep it maintained.  I wish I had gotten there about fifteen minutes earlier to get a proper steam in prior to the massage....oh well!  My therapist, Bill, was outstanding.  He was not chatty, and when he did talk he used a very soothing tone of voice.  He was very accommodating regarding positioning.  I had suggested minimizing the amount of time face-down, even if it meant less work on the back.  He recommended that I rotate a few times during the massage so that we could give everything its proper due while keeping me comfortable.  I took his suggestion and it worked brilliantly.


I left with loose muscles but barely able to string a sentence together.  I can't remember the last time I felt so relaxed....both mind and spirit.


Thank you Sir Spa for confirming that massage can be such a wonderful experience.

Acknowledging Limits

Yesterday my body gave up. I felt run down and my head wanted to explode. I felt a little better this morning but I thought my voice was going to give out. Also I was afraid I would have to be up late to finish all my homework. I decided to call in sick. Initially I felt really guilty...I probably could have bullied my way through the next few days. However it is time I acknowledge my limits and take care of myself. I don't have to prove that I can do it all.

Pretending

Tried to keep up with friends...going out and drinking this weekend. Getting too old for this. Recovery time too long.