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Doc, This recent posting (partial copy/paste) on Med Page today should give you some solace...

"At birth, a male child may expect to live to age 76 but at age 75, instead of turning to dust, a man can expect to live to age 86. If he makes it to 86, he can expect to live to 91. If he makes it to 91, he may live to 94. The age where a person has an approximately 50% chance of dying in that year is 108. Why we live longer has a lot to do with the social determinants of health and access to the best medical care. People who die before age 75 are usually the victims of trauma or a variety of illnesses or just bad luck. The population of survivors beyond age 75 are a smaller, but more resilient, group. What we know is that life is a survival of the fittest curve and the longer one lives, the longer one lives."

'Live long and prosper. Jim/Maryland

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I felt as you did about turning 70. So, I hung on to 69 like it was my last breath. When 70 came, I did NOT take it well. This coming from a person who has worked out like a Trojan warrior for over 40 years, high impact, high intensity cardio, strengthening, power walking for hours, biking, hiking. I was crazy into working out and made the time to do it. In my later 60's, I found I could not maintain the highest level cardio and had to put the brakes on a little. I was not happy about that. When I turned 70, I was morbidly depressed. I really hit rock bottom, it just felt like the end of the world. Interestingly, about 8 months into it, I started to change. For some reason, on a particularly peaceful March evening, 2020, my being shifted and I decided I was OK! Still working out, lifting weights, had just joined a wonderful woman's group (something I had never done before), and of utmost importance, I began to *accept*, also to start taking more small risks, not worrying about every.little.thing. Something might give me a bout of gerd, eat it anyway once in awhile, you have meds! I smiled. Within 2-3 days, covid lockdown. That pretty much challenged my new lease on life, but I was still able to work out as I always did, with a step, using my many internet instructors, who had become kind of like friends. Today, I am 73, and I wish I were back turning 70 with my happier outlook and no covid ahead. But, if we're going back, I'll take 40 or 35. No younger for sure.

I still work out but at a lower pace because that is where my body wants to be, but I *push* it. I figure if I die exercising, that's ok. Still lift weights, do a bone builders class which I've done for about 5 years now, have added balance work and find that kind of oddly rewarding as you can actually get better at it, even at an advanced age.

Doc, you will do fine. And keep dancing. I am not a Dead Head but the song that has kept me moving both physically and mentally is Touch of Grey, long version. Seriously. From catchy, upbeat tune to the amazingly fun lyrics, it never gets old for me and always lifts my spirits. I promise, you won't be able to sit still and you *will* smile. It's also a great driving song, but be warned, hard to drive when you want to be movin' and groovin'. Sigh. Best to you at this turn around the bend. You got this.

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So glad you being shifted for the positive after hitting 70! And so many found staying fit challenging during the height of the pandemic and had to improvise workouts as you did.

Love Touch of Grey and it is an infectious toe-tapping tune. The video with the band playing as skeletons and the drummer smoking a cigarette is classic.

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Hahaha. It would be impossible for me to put into words or emphasize enough how vital exercise has been to my life. It has kept me going through the darkest of time. I can't say enough for working out and I do very often on social media, forums, everywhere I can find to share this truth. Groups I joined online during the pandemic have to hear it, whether they like it or not. It is TRUE. It works the body and it works the emotions!!! I've never read or heard a negative thing about exercise. It's truly the magic pill for which everyone is searching!!

I love the skeleton video, however, it doesn't have the instrumental break in the middle, which just makes me forget the world and fly out of myself like a rocket. You've probably heard it, but here's a link just in case. They call folks like me "Touch Heads." Starts around 2:15.

https://www.google.com/search?q=a+touch+of+grey+video+long+version&rlz=1C1CHBF_enUS994US994&sxsrf=AJOqlzV8O4sTiWql1-lfcjTYavRSY_67DQ%3A1678554402418&ei=IrUMZOODGdyh5NoPq_GjKA&ved=0ahUKEwjjnJG3rtT9AhXcEFkFHav4CAUQ4dUDCBA&uact=5&oq=a+touch+of+grey+video+long+version&gs_lcp=Cgxnd3Mtd2l6LXNlcnAQAzoKCAAQRxDWBBCwAzoGCAAQFhAeOgUIIRCgAToFCCEQqwI6CAghEBYQHhAdOgQIIxAnSgQIQRgAUN8FWJkhYKgjaAZwAXgAgAGeAYgB1w2SAQQxMi42mAEAoAEByAEIwAEB&sclient=gws-wiz-serp#fpstate=ive&vld=cid:17ef9a84,vid:VgMeEzkHTqc

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I turned 70 last October.

When I was going to be 69 in 2021, I complained to my husband that I only had one more year to 70, & his reply was, "well you know what the other option is?"...

So he died last June & I tell people 'he took the other option'...

I have to find humor, in most things, even though I miss his terribly.

We used to go to Colorado for a couple weeks, every May and September [for his vacations] and climb to waterfalls and such.

Well, I've had to rethink vacations by myself, so I signed up for a church history tour this October for 15 days/14 nights that goes from Boston to Kansas City.

I'm hoping to live many more active years, although I'm not sure I can do pushups because of hand strength, but I can stand on each of my legs for over 10 seconds...even the one with the knee replacement and I dance around the house everyday.

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Kayleen,

Keep on one leg standing and dancing! I find myself dancing around the room sometimes when a song comes up on my shuffle that particularly inspires me. Most often it is a talking Heads song or a Clash song but if "Here Come The Runts" by AWOL Nation starts playing my feet go especially wild. I noted that the YMCA I joined has dance cardio fitness classes that I might join.

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I had to ask Alexa to play that one ☝️ for me...

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Is that 70 pushups without stopping or broken into sets? Just asking so I know what I have to beat.

Competitively yours,

DF

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One session, done very quickly! Likely <1 per second although I haven't put a stopwatch on it

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I am impressed! Now striving to catch up.

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I ove everything about this post, especially the video. I am a 76 yo female who struggles to do even one push-up even though I’m young for my age. Looks like i need to get to work!

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Happy birthday. I’m celebrating my 69th in exactly a month. Since i semiretired two years ago I joined a hikers club and regularly hike 5-6 miles over hilly terrain. It’s not so much fun going uphill now, but I can keep up with the group and never had to quit.

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Thanks Larry! Hilly Hiking makes a great, invigorating and interesting cardio exercise..And I'm sure the "club" aspect allows for more Connection. For many in the midwest the winter and summer weather limits outings and they have to develop indoor cardio routines.

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I noticed I struggle on the hills. I have trouble catching my breath and some chest discomfort, though no pain. My cholesterol is a little high and and recently started low dose Lipitor. Do you think I need a calcium or stress test? I don’t have any other risk factors except my dad had angina at my age and eventually needed a bypass which has me a little worried.

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Your symptoms do sound like angina. I would definitely see your PCP about further treatment and possible diagnostic testing.

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Happy Birthday!!! I will sleep well tonight after reading your "Does Your Patient Really Have Diastolic Dysfunction?" since I was diagnosed with Grade 1 after my echo today.

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Thank you! So glad my diastolic dysfunction article is helping people.

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Happy birthday to you 🎂🎶🎉.

Just turned the 7-0 on 3/1.

Appreciate your enthusiasm and just what I needed to read today. I used to be able to do 30- from the knees not toes

Have developed pericarditis after a heart procedure. Do you have any articles or past letters letters I can read ? Not progressing/improving like I want 🤷🏼‍♀️

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Thank you!

I haven't written on pericarditis although I've taken care of a fair number of patients with the diagnosis and seen pericardial effusion on hundreds of echocardiograms.

Not sure I have anything to offer as there are so many causes and so many different clinical trajectories that a general article is not much help. I will tell you that pericarditis after open-heart surgery (during which they open the pericardium, the sack around the heart) is very common and typically resolves within a few weeks. Thus, for most , it is a painful situation but not one that makes long term prognosis worse.

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Had wolf miniMaze procedure end of November. Landed in er in December with pericarditis- we know cause. Just can’t resolve it. I appreciate you taking the time to respond. Thoroughly enjoy reading your newsletter. Keep up with the pushups! And enjoy the Ben and Jerry’s. Deb

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Happy Birthday too!

I’m always impressed with Sir David Attenborough, who’s still presenting documentaries in his mid-nineties.

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He is a treasure

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Happy bday 🤞!

I find push ups too hard on my one shoulder that has various tears, but recently I’ve been trying to get back into them by cheating. I keep my knees in the ground, still works the same muscles!

I highly recommend shadow boxing, too. Balance, core, self imaging and ego boosting posturing, cardio, antagonistic muscle groups, coordination, and you can watch that PBS Muhammad Ali documentary in the background!

🥂

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Ryan,

Yes. For women with less upper body strength the knee push-up is the standard as well. During my shoulder troubles I would find chairs with handles and do push-ups or lean against a wall. All good ways of getting the same benefits but without as much stress on joints.

As for shadow boxing, I've never formally studied it but find myself doing something similar while on walks when I want to warm up a bit and don't mind attracting stares.

I recently signed up for the Amazon Prime add-on PBS documentaries, primarily to watch Ken Burns' documentary on Country Music (which is great and was recommended by a musician patient of mine). We've moved on to The West and will add Ali to the queue.

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Congrats on your upcoming 69th birthday. I have enjoyed being 69 for 4 years!

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Don,

Your youthful appearance has always amazed me!

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What is your definition of a proper push up? I have seen Chuck Grassley and Lindsey Graham doing their push ups, but they only go half way to the floor. I was taught to touch your nose or chin to the floor for a valid push up. It makes a huge difference in the number one can do when done this way.

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Excellent question!

I 'll pull up the link from my original push-up article

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For a description of the perfect form for a push up see here.(https://www.health.harvard.edu/blog/rise-push-ups-classic-exercise-can-motivate-get-stronger-2019021810165)

I go down until a portion of my body touches the floor. This article says when your elbow is at a 90 degree angle which is pretty much the same for me. I choose a hand position that is most comfortable.

The push-up engages your body from top to bottom. It works several muscle groups at once: the arms, chest, abdomen (core), hips, and legs. Push-ups also can be modified as needed. “By adjusting the speed you perform a push-up, the angle of your body, and even hand placement, you can add more or less intensity, or focus on specific muscles,” says Dr. Phillips.

"A study published in the February 2016 issue of the Journal of Physical Therapy Science found that the chest muscle activity was greater when push-ups were performed with the hands placed halfway inward from their normal position. Hands placed outward work the triceps more"

I had to experiment with different positions during the year or so that I struggled with shoulder/bicep problems

A lot of papers took about pushups in 60 seconds..

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I had to give up pushups--too hard on my wrist--used handles for a while. Maybe if it heals I'll be able to re-start.

I haven't found 70 to be too tough. 71 coming up in May.

Good luck!

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At times I feel some discomfort in the wrist. Handles changes the stress distribution and can be helpful. A softer or cushioned mat also helps with wrist pain.

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Many years ago had same problem. A hand surgeon looked at it and thought it might be Kienbock's disease "but you're a little old for that". Luckily I apparently was too old for that. Just early arthritic changes.

Getting pain with the handles, so I'm on a layoff.

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I turned 68 a couple of months ago. As I sit here, enjoying a salad (guilty pleasures: croutons and lite Catalina dressing) I was thinking about "don't eat crap". About 15 years ago, I became, for 4 years, a geographic bachelor when I accepted a new position about 6 hours from "home". The youngest was just starting high school and I commuted home almost every weekend, watching him play various sports and trying to be a presence. When he graduated, my wife joined me in Oklahoma. One of the key elements of the house we bought was the kitchen for me. The back yard, with the pond and waterfowl all year long were for her. During my 4 years in an apartment, I relearned how to cook, and supplemented that work with lots of Food Network time. Prior to that, I'd gotten a pretty good reputation for smoking all sorts of meats on a smoker a friend and I constructed... from 5 feet of pipeline pipe, made in 1929 (it, too, has a story). In the apartment, I started buying what I needed for only 2-3 days of cooking. I shunned cans, bought fresh, and learned the French Mother Sauces. I wandered into Italian fare. I learned how to make marinara from scratch. I've experimented with pasta but I'm still not there yet. I've played with several of their seafood delicacies. I revisited my love of Japanese food, and while I'm no where close to proficient, I still play a bit.

Some time around 2016 I started walking. Running is right out after a torn and spontaneously healed Achilles tear, and a failed extra-articular ACL repair, with the orthopods saying they refused to try a second time. That said, my walking pace pre-COVID was on the order of 12 min. miles. I started doing at least one 10K a year in 2017, and did them virtually in 2020 and 2021. My times got notably worse after my first bout of COVID in mid-2020 but a 16-minute walking mile is still reasonably respectable. For a while, I was in a gym membership and lifted 3 or 4 days per week (remember, I was still commuting from Oklahoma to central Texas) but that became moot in March of 2020. Our move to Colorado has complicated my walking, as it's not safe for a pedestrian on the side of the road in front of the house. That said, 3 weeks ago, I managed to log over 65 miles at Disney World over 4.5 days, and only had sore feet to show for it.

I retired in late September, 2021, and by 1 FEB 2022 we were "living" in an AirBNB in Colorado looking for the next house. When we did buy (at the height of the housing madness, the remodel included a small, efficient kitchen with my choice of stove. Professional gas burners, electric convection oven, and a hybrid built-in grill.

So: I'm not eating much crap (Whole Foods soourdough bread is one of my worse choices), and I'm exercising a bit, still. Your article has me looking at the gym again, as Colorado winters at 7000 ft can restrict outdoor time, especially with an unstable knee and ankle. The push-ups will have to wait a bit longer, 'til I'm further down the road on a revision of a rotator cuff repair last fall.

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Gerry,

Nice to hear of your culinary journeys. In the last 5 years as I've cut back on office hours and hospital duties, I have become the cook in our household and I love it. Most recently, my wife after hearing rave reviews, purchased an air fryer. I was philosophically opposed. But I've experimented and found that some vegetables work well with it. In San Diego for some reason this winter gas prices were insanely high which has provided motivation to cook electrically.

I feel like every man in our age group has had rotator cuff problems. Must be the curse of a joint asked to do too much for too long.

BTW, move to San Diego and live at sea level without snow all year round :)

Dr. P

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I may try to tag up with you... our daughter and her SO live in San Diego.

I've little doubt my earlier escapades led to the rotator cuff injury. I'm actually surprised I didn't injure both shoulders. The ACL story involves motorcycles, and subsequent laser-tag stunts, while the Achilles story is one of multi-trauma, ladders on school bus faces and slick floors in a maintenance facility. I never agreed to grow up, and I'm paying for it now.

I've air-fried a few things, with some success. Latest escapades have involved an instant pot for pressure cooking. There again, my "training" via Food Network has helped.

gc

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Sounds good.

Motorcycles seem invariably to be associated with torn/broken/crushed bones and ligaments.

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A friend and mentor, now deceased, was an avid motorcycle rider... and an ER doc/trauma surgeon. Then he got hit by a car. Stopped riding. Settled down and got married. I'll not relate how he referred to motorcycle trauma patients after that in his ER. Your audience might not appreciate what those guys consider humor.

As for my efforts thereon, I was learning how to ride one, within the first 10 hours on the thing, when it got away from me. For some reason, I've had no desire to try it again. Rock climbing? SCUBA diving? EMS? Sure. They're all predictable and safer. Motorcycles are reserved for people who want to eventually be listed as "patient".

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Wishing you a happy birthday and a very large thank you for your dedication to informing us about THE TRUTH, as best you can tell. ☺️ I get occasional messages from Chris Crowley who has moved into his 90’s now and still skis and inspires. Appreciate your posting the 7. 🥳

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69? You’re still a youngun’! I’m feeling pretty darn good at 79…it just keeps getting better, although admittedly, a little creakier! 😂

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that is music to my ears! 79 is the new 59

Dr P

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