This comprehensive guide will speak directly to fifty-something men about every major and many minor health issues that they are facing, with information on illness, treatments, prevention, drugs, exercise, mental health, hormones, and more, so they understand these changes and know what preventative maintenance they can do to insure a long, healthy life.

Facing Your Fifties
Every Man's Reference Guide To Mid-Life Health
By Gordon Ehlers, M.D., and Jeff Miller

M. Evans and Company, Inc.

Copyright © 2002 Gordon Ehlers, M.D., and Jeff Miller.
All rights reserved.
ISBN: 0-87131-954-3

Chapter One

WHERE DO
YOU STAND
NOW?

A Comprehensive
Status Report

Background Basics

    Who are you?

· A corporate executive who practically lives on the road.

· A regular guy who's trying to be health conscious but isn't getting very far.

· An avid jogger who's in better shape now than when he was thirty.

· A guy whose job keeps him on his feet all day, so he doesn't see the need for "extra" exercise.

· A former jock who hasn't worked out in twenty years.

· An ex-husband who's not very good about meal planning and taking care of himself.

· A nutrition-conscious guy who's always munching on a granola bar.

    As long as you're a male and you're in your fifties (or nearly there), it doesn't matter. What does matter is that you picked up this book. And that you've read this far. That's the first sign that you want to know more about your health and how to maintain and/or improve it.

    But where do you start?

    The first step is to determine where on the general health ladder you stand right now?what rung you're on compared to the "average" or "ideal" fifties Joe. That will be a critical point of reference from which you can put the rest of this book into personal context. And we know that's important, because if you can't apply this book to your own situation, then it's not worth very much. Besides, it's always an interesting exercise to see where you stand against everyone else?even if the results might not be what you expect.

    Don't worry, though, you don't have to jump through any hoops, do any push-ups, or answer any questions that involve speeding trains and velocity vectors (although one does involve math, so get out your pocket calculator). The following are the critical benchmarks by which doctors determine where you are when it comes to overall health. They'll tell you everything from your artery health to your body fat ratio.

    So, with no further ado, pencils ready? Begin. And good luck!

Weight To Height

Level of Importance: High, because those who are overweight risk everything from heart disease to prematurely deteriorated joints.

Ideal weight ranges for men:

5'1" 5'2" 5'3" 5'4" 5'5" 5'6" 5'7" 5'8"

123-145 125-148 127-151 129-155 131-159 133-163 135-167 137-171

5' 9" 5'10" 5'11" 6' 0" 6' 1" 6' 2" 6' 3" 6' 4"

139-175 141-179 144-183 147-187 158-190 165-195 167-200 171-207

Additional Information: Your weight really should not change with age, although lack of exercise, change in eating habits, and reduction in muscle mass will all conspire to put on pounds as you put on years. Keep in mind that muscle weighs more than fat. So if you weigh the same at 55 as you did at 25, you should be proud?who wouldn't??but you should also be aware that muscle mass generally decreases with age. All of which means that your total weight should actually decrease as you get older (unless you're pumping iron). If your weight hasn't decreased over the years, if it's stayed the same, then you're probably putting on fat. (See chapter 8 for diet and exercise details.)

Body Mass Index

Level of Importance: High. It is a good general indicator of fat to body weight ratio. Too much fat can be the underlying cause of numerous health risks and serious ailments.

How to calculate BMI: Divide your weight in pounds by your height in inches squared, then multiple the result by 705. An example?a man who's 5'10" (70 inches) and weighs 175 pounds would calculate: 175 divided by 4,900 (70 x 70) = .0357142 times 705 = 25.18. That BMI means the man is slightly overweight.

Ideal BMI Considered Overweight Obese

24 or less 25 or more 30 or more

Additional Information: Be honest about your true height and weight?the result means nothing if those figures are inaccurate. In body mass indexing, no allowance is given for age. Calculate various weights above and below your own to see how the BMI changes, then set a goal BMI and start working toward it. (See chapter 8 for diet and exercise details.) If you have a good BMI, don't get too cocky?this index is only an indicator of fat to body weight ratio; it's not a yardstick for overall physical conditioning. For very muscular individuals, the BMI may read falsely high.

Blood Pressure

Level of Importance: Highest. This is the primary indicator of how healthy your blood vessels are. In many ways, you're only as healthy as your arteries are.

Ideal Good Range

120 over 80 (or less on both) 120-129 over 80-84

Additional Information: In theory, for those who stay fit and healthy, blood pressure should not change significantly (more than a few points) during a lifetime. However, it has been shown that numerous factors do affect blood pressure, everything from age to stress levels. It's critical to good health for those who do have high blood pressure to bring it down. This can be accomplished through the use of excellent drugs and, to a lesser degree, by exercise, proper diet, and learning how to handle stress and tension. (See chapter 3 for blood pressure and blood vessel details, chapter 6 for stress relief ideas, and chapter 8 for diet and exercise details.)

Cholesterol Levels

Level of Importance: Highest. Research has established that those with a high level of cholesterol in their blood have a greater risk of heart disease (the number one killer of adults in the world) than those with a low cholesterol level.

Additional Information: These latest figures represent new?and tougher?official government guidelines. The only way to get an accurate count of HDL and LDL is to fast for twelve hours before the test. Even the milk in a cup of coffee can affect the results. It is critical to good health that high cholesterol levels be brought down. Exercise can play an important role in this (it can actually increase your HDL), as can diet and the use of any number of excellent drugs that have been developed to lower cholesterol. (See chapter 3 for cholesterol details and chapter 8 for diet and exercise details.)

Blood Sugar (Glucose) Level

Level of Importance: High. Any blood sugar levels out of the normal range could signify diabetes, which can lead to permanent, severe organ and/or body system damage and, ultimately, if not controlled, death.

Additional Information: If a person registers a fasting blood sugar level of 110 to 125, this means he's borderline and will be monitored. If a person has two separate blood tests in which both times the fasting level is over 126, he's a diabetic. Because there are rarely any symptoms from diabetes until it has become seriously advanced, monitoring blood sugar and sugar in the urine are the only ways of detecting this potentially fatal disease. Make sure to truly fast overnight before the test. Diet and exercise can have a tremendous impact on how your body processes sugar. (See chapter 4 for diabetes details and chapter 8 for diet and exercise details.)

Getting the Most Out
of Seeing Your Doctor

We've all heard the horror story: A doctor makes a diagnosis in less than thirty seconds.

    But that's like saying a singer with his first hit song is an "instant star," even though he's worked in the business for twenty years. Inside that thirty-second diagnosis are years of medical school, years of on-the-job training, and years of seeing patients.

    We can all agree, though, that a visit to a doctor is usually too short?a product of many unchangeable variables. So how can you maximize the time you get with your physician? For ailments beyond the everyday colds, here are two suggestions for what you can do prior to seeing your doctor:

1. Get the basics down. When did the problem start? What are all the symptoms? If there's pain, exactly where is it, and what kind is it (dull, sharp, throbbing)?

2. Do some detective work. Every doctor is a little like Sherlock Holmes. Why not be a Doctor Watson and do some background work? Does the ailment come and go at certain times? With certain foods? Try to objectively analyze possible causes.

    Suggestions while you are seeing your doctor:

· Tell the truth?This is no time to try to fool yourself or your doctor. Physicians know most men will lie about three topics: smoking, drinking, and sex. Be honest.

· Mention all medications you take?Even vitamins and herbal remedies.

· Be concise and complete?Respecting a doctor's limited time, you should keep the explanation brief, while including everything you think might be relevant.

    The best advice? Build a long-term relationship with one doctor. The rewards are huge.

Prostate Specific Antigen (PSA) Test

Level of Importance: High, especially for men in our age group. This is a time when an aggressive form of prostate cancer can take its greatest toll (Frank Zappa, the rock musician who died of prostate cancer in his fifties, is a prime example). A PSA test registers a protein that is produced by the prostate. Prostate cell damage (produced by cancer or inflammation) increases the amount of protein detected in the blood.

Additional Information: Testing should start at fifty (earlier in African-American males and those with a family history), and be done on a yearly basis so that any spikes in the readings (even though still in the normal range) can be caught. Increased age (especially beyond sixty) generally means higher average readings, even without cancer being present. The PSA test is controversial, because it can have both false positives (a high reading when you don't have cancer) and false negatives (a low reading when you do have cancer), but we believe the benefits of testing outweigh these relatively slight inconveniences, especially when stacked up against the aggressive, fast-moving form of prostate cancer. (See chapter 4 for prostate details.)

Exercise Status

Level of Importance: High if your lifestyle or job does not include twenty to thirty minutes of physical activity (walking at the very least) several days a week, you are not doing what you should be doing.

Additional Information: No exercise is ever useless, but if you're not breaking even a little sweat or feeling your heart pound just a bit, it's not enough. To establish fitness, you need to sustain some form of exercise (preferably aerobic to start with) that puts at least a slight strain on you and your heart, or you're not getting full value for your exercise. (See chapter 8 for exercise details.)

Excerpted from Facing Your Fifties by Gordon Ehlers, M.D., and Jeff Miller. Copyright © 2002 by Gordon Ehlers, M.D., and Jeff Miller. Excerpted by permission. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.