A blog about nothing.

Monday, August 29, 2016

YOUR GENES ARE NOT YOUR DESTINY


Recently a friend called me to extend condolences after the loss of a loved one. A remark he made stuck with me. "In light of the incidence of cancer in your family," he said, "have you gotten yourself checked out?" 

Yes, both my brother and my mother had cancer, my brother's tumor affecting the cartilage in his hip, and my mother's affecting her breast. But there is no genetic test that can evaluate your general risk of getting cancer. Yes, with a family history of prostate cancer - my grandfather had prostate cancer and my dad's PSA level is above normal, PSA being the marker for enlargement or neoplasia of the male accessory organ of reproduction - I could conceivably worry about prostate problems. But so should the general population. In fact, half of men over 60 years of age have prostate cancer. But most such tumors are slow growing, do not reduce life expectancy and never invade surrounding tissues. And so these individuals often don't know they have cancer and die of something unrelated. Like heart disease. My PSA is normal and I don't eat any dairy. Since consumption of dairy is strongly associated with prostate cancer, there's nothing for me to stress out about, at least as far as cancer is concerned. And being stress-free is good for the heart. Because really, with heart disease on both sides of my family (I had a grandfather who died of a heart attack, his 4th, at the age of 52) I would be justified in worrying about my ticker. 

But I'm hardly alone. I know women who practically pull out their hair worrying about breast cancer. And while it is true that 12 percent of women develop breast cancer sometime during their lives, cardiovascular diseases and stroke cause 1 in 3 women's deaths each year, killing almost one gal a minute. Over 40 million women in the U.S. are affected by cardiovascular diseases. That's 25% of female Americans, twice as many as will get breast cancer. And 90% of women have one or more risk factors for heart disease or stroke. Risk factors include high blood pressure and high cholesterol in addition to high blood sugar, overweight, and inactivity. 

I on the other hand work out every day, eat a diet of almost exclusively unprocessed foods, don't smoke. And like I said, try not to stress. But there are a few genetic tests that can evaluate your risk of getting certain types of cancers. The BRCA mutation is one of these. You probably learned about the BRCA mutation when Angelina Jolie underwent a preventative double mastectomy back in 2013. Jolie had the mutation and lost her mother to reproductive cancer. Recently the Kardashians were featured getting themselves tested for the gene. They did not have the mutation, and so they got to keep their junk. But if you do have the BRCA mutation, should you cut off your woman parts? Here's a statistic that should give you pause. According to the most recent estimates, 55 to 65 percent of women who inherit a harmful BRCA1 mutation and around 45 percent of women who inherit a harmful BRCA2 mutation will develop breast cancer by age 70 years. This may seem like a lot, especially in the case of BRCA1. The question is, what about the majority (55 percent) of women with the BRCA2 mutation that don’t get cancer? I'd argue that the cancerless population owes their freedom from disease to a healthier lifestyle. Because lifestyle matters. Enter epigenes. 

Epigenetics is the study of heritable changes in gene expression that do not involve changes to the underlying DNA sequence. Unlike your genetic code, which except in rare cases cannot be altered, and when altered usually gives rise to cancer, epigenetic alterations happen all the time. These changes are influenced by several factors including age, the environment, your lifestyle. For example, people whose dietary indiscretions cause them to gain a lot of fat in their life can then pass a predisposition to overweight onto their children, even in absence of the mysterious obesity gene.

Conversely, it would seem to follow that if you lead a healthy lifestyle rife with vigorous activity in nature and nutrient-dense foods, lots of love and affection and a good measure of service to your fellow humans, you not only fortify yourself but increase the fitness of the sperm and egg that will one day take over the planet. Call it your personal contribution to posterity. 

So forget about genes and genetic testing and focus on adopting lifestyle changes that are wholesome for you and healthy for the planet. Because your genes are not your destiny. And remember not to stress! That's good advice for just about everything.

Thursday, August 25, 2016

SUMMER DIETSTYLE


My good friend Gerry requested a dose of my dietary acumen so I sent him the following meal plan, which I abide by and advise others to do the same.

1. 12 ounces of water on awakening first thing in morning

2. 2 cups of melon (watermelon, honey dew, etc.); 1 cup hot water with 2 scoops cocoa powder with dash of stevia (optional substitution for caffeine)

3. morning workout (combination of cardio and resistance)

4. post-workout smoothie
- 1 cup water
- 2 frozen bananas
- 1 cup frozen berries
- 1/4 cup chia seeds
- 1 serving protein powder (on weight-training days)

5. midmorning snack (as much fresh fruit as you like)

6. lunch: 12 ounces water; 3 eggs (hardboiled) and/or 6-8 ounces of fish (sardines, salmon, halibut, sea bass are all low in mercury.); sliced raw vegetable fruits (bell peppers, cucumbers, tomatoes) or leafy green vegetable (lettuce, spinach) dressed with lemon and salt/pepper; 1 large avocado

7. midday snack: 1/4 cup raw nuts or 2 tbsp nut butter; 1 banana

8. dinner: 12 ounces water; 6-8 ounces of fish or 1.5 cups of beans (garbanzo, pinto, black, kidney) with 2 cups water-cooked green vegetables (broccoli, green beans, Brussels sprouts, collard greens, chard, asparagus); 1 cup steamed potato/sweet potato or 1/2 cup quinoa

9. dessert (if desired): banana or other fruit

Eliminate: dairy, grains, other processed/packaged foods, refined sugars, alcohol, caffeine, all oils, fowl/pork/beef

Aim for: 64 ounces water per day.

This is the perfect diet, or at least perfect for right now. Let me explain. After 7 years as a vegan I found that my strength gains and endurance performance had plateaued and quite frankly I was tired of so much bland food and spending my life eating like a fatty on a permanent budget. 

So when I substituted out some fruits and vegetables and legumes and added a little animal protein in the form of fish and eggs, coupled with a serving of vegan protein added to my morning shake (rice and pea protein, by Orgain) I found I was able to inject a little flavor and variety into my culinary regimen and enhanced fitness followed. 

Practically overnight I gained 10-15 pounds of muscle, going from 147 to around 160 lbs. And those 50 lb dumbbells I could only squat and press for 4 reps? I now can do three sets of 10 repetitions with relative ease. I supplemented the weight set that had not seen a new addition for 8 years with pairs of 65 and 80 lb dumbbells. Hello heavy dumbbell presses, rows and deadlifts. Body weight pull-ups morphed into sets with 50 lbs clenched between my thighs, effectively increasing the poundage by 30%. And despite the added musculature I still run 35 to 40 miles each week, in addition to daily mile-long swims and twice or thrice weekly bike rides, so my energy is as high if not higher than it was on a vegan diet. And I'm off the coffee, which only made me irritable and anxious and my back super tight.

Of course there are drawbacks to eating animal protein. The oceans are polluted, even the cleanest waters tainted with environmental run-off and heavy metals, which is why I stay away from white tuna and other high mercury fish. And yes, there is a lot of cholesterol in 3 whole eggs, but my cholesterol was above normal as a vegan, so maybe including some in food will send the message to my liver to curtail production of this important nutrient. Because studies have shown that eating this many eggs does not generally increase levels of LDL in the blood. It consoles me that the fruit I am not eating should certainly lower my blood sugar, which as a vegan was also slightly high. And with their ability to nourish the developing chick, egg yolks are the seed of the animal kingdom. Choline and B12 and other nutrients are hard to come by elsewhere in the diet. Besides eggs taste sooooo good! For a comfort food look no further. And yes, as a plant eater my, lets say, bathroom habits were without smell. Now I smell like the rest of humanity. Probably less, since I sweat so much. Oh well. Thank goodness for Febreze. 

I plan to run a half marathon in the next few months to see how competing in a longish-distance race feels with the added mass. I can tell you I am more explosive than ever. Today I ran 11 miles in relative warmth and finished with 3 sets of 3 minutes in the very steep hill leading to my house. I used to think that a big upper body in a runner would translate into sluggish times, until at the OC marathon back in 2013 I glimpsed Ryan Neely speeding ahead of me. He ran a 2:29 marathon to my 2:51. Damn that's fast. Sure at 23 he was practically half my age (I was 40 at the time). But then there is the marathon junkie Chuck Engle. This guy routinely runs a marathon a week, most of them under 3 hours. He has been doing this for over a decade, in which time he has compiled hundreds upon hundreds of marathon finishes. Chuck, who is older than me by two years, has slabs of mass. And when I saw what he eats, one description came to mind: "protein feast." I gazed slack-jawed at huge amounts of white food stacked high atop his plate as he gorged his spent muscles post-race. So out went the dates I used to consume after exercise. Instead I enjoy sardines. It's an acquired taste. I still do eat about 6 bananas a day.

Does including a judicious portion of animal protein shorten one's life by exposing the eater to added residues and inflammatory mediators? Perhaps. But this life is so much fun! The better question is, which do you prefer, a protracted existence experienced in a perpetual state of irritation and self-deprivation with a heady dose of languor, or a shorter brighter time jumping (and running) for joy in the full bloom of vim and vigor. 

The choice is up to you. I choose stinky farts - and the fast times and strength gains that come with. For now. Try doing the same and see how you feel.


Ryan Neely
Chuck Engle
Yours Truly

Wednesday, August 24, 2016

THE OLYMPICS OF LOVE


I really enjoyed the Olympics this summer. That is, what I was able to catch of them. The powers that be chose to air the opening ceremony precisely when I was in the thick of a family crisis that could not be ignored. Good thing my priorities were straight. But the crisis ended August 10th, and by then the competition had been underway for less than a week. And so I tuned in and watched Brazil beat Germany in soccer. I watched such powerlifts as the snatch and clean and jerk with their funny names and even funnier-looking (pot-bellied) participants. Volleyball and swimming. Women's gymnastics. Track and field of course. I even learned of new events. Synchronized gymnastics involving hoops and batons, and some strange target shooting affair with laser guns. 

And from the comfort of my couch I considered all the dedication, perseverance and practice that goes into becoming the best athletes that these amateurs and professionals could be. And I thought: so many of them hardly scrape by on sponsorship deals. (Not everyone is Phelps or Bolt.) It must be all for the glory. And I thought, what if such commitment and attention to detail were applied to everyday life? What if you lived every moment as if you were that British diver trying for a 10? Wouldn't that be a life perfectly lived, even if there were no audience to cheer you and judge to score you on your form? 

So I put my theory to the test. I woke up early and meditated for 30 minutes. If you were watching you would have caught me snoozing. Oh well, I guess I needed the extra rest. I washed my dog making sure to give extra attention to the paws, and taking care not to be so vigorous as to make Max's customary snarl turn into a snap. Mission accomplished. Vacuuming is no easy chore. There are so many chairs precisely in the rooms that are never used, and doing one's best requires moving each chair (they are heavy) to dust bust the territory underneath without muttering profanities under one's breath. Then came mopping. It's hot and mopping makes me sweat and fills me with malaise. I always consider the futility of life as I scrub the terrazzo clean. I abhor filling the steam machine with water more than once, but always have to because it gets so dirty. But I maintained composure, and managed to make the floor streak-free.

Later I met a man at Whole Foods who liked my book on nutrition and wanted to get together to discuss a business opportunity. But we never hit on the subject, because as we were exchanging intros a stranger interrupted our conversation and proceeded to discourse at length about his view of proper eating. I'll never get that hour of my life back. I could have interrupted the 65-year-old from Algeria, cut him off, said mind your own business. But the love all serve all philosophy I try to abide by, the very philosophy that led me to the Whole Foods meeting in the first place, required me to nod and smile as the man spoke of his love of chocolate and cheese. Get 'em next time. 

Now, grocery shopping is something I truly love, have ever since my mother used to take me and my bros to Westward Ho after school when we were kids. And earning my equivalent of Olympic gold requires choosing the freshest produce, and making sure not to bruise the avocados or bananas. No easy task. It means bringing my own bags (to save trees and pennies). It also means selecting a fresh cut of fish, and being especially friendly to the butcher, who literally holds my health in his hands. I just hope he washed them before leaving the restroom. I also chat up the cashier and help the bagger. Norm was friendly and after I had paid he even shook my hand. He must have liked our witty repartee, because he even ran after me to deliver an empty bag I had left behind. The fact that I was at Ralphs and the bag was from Pavilions didn't seem to bother Norm. Chalk it up to bonhomie. That or he isn't a shareholder at his place of employ. 

Watering plants requires the skill of a shot putter. But here distance is not what counts. It is delicacy so as not to overfill or splash the counter. The orchids that grace the house are beautiful, and jade needs love too. Lifting weights is easy with memories of 500-plus lb deadlifts still fresh in my memory. So I made like a Russian (or a Chinese) and heaved 65 lbs over my head in a dumbbell version of the celebrated snatch. I'm out of breath just remembering this.

And I'm no Michael Phelps, but I like to swim a mile each day, although the race is against myself. When it's you against you, there are no losers, is my motto. Maybe I'll make it into a bumper sticker. Do people still wear them?

So as not to snarl overmuch, Max needs a couple walks a day and at least 10 minutes of cuddling in the morning. That should be the new Olympic event. Not ax throwing, as I just read. But cuddling. I'd win first prize. Because I'm a world-class cuddler. But this takes two, and Max can only take so much love, so I'm still looking for my teammate in this most underappreciated endeavor. Ooops did I just write that?

I make a gold medal-worthy collard green dish, which is my upcoming Olympic event, my next hurdle, pardon the pun. That will be this evening, when I am entertaining my high school best friend Jason Goldberg. Jason is coming over with his young son Cooper, who when he heard of the visit insisted to bring his baseball equipment along, to show me his six-yearl old stroke. Jason told me how much this means to "the Coop," my appreciation (or any adult's, for that matter). And so we'll play a little catch like his daddy and I used to back in the day. Now if I can get Coop to eat my collard green dish I will really deserve my prize!

Tuesday, August 16, 2016

THE ART OF DYING


My mom was re-diagnosed with breast cancer in 2010 at the age of 65. She had been in remission since her initial diagnosis in 1994 when she was 49. At that time she underwent a lumpectomy, chemotherapy and radiation. They also removed her lymph nodes, where they found cancer. The hope was that the chemotherapy would eradicate any renegade tumor cells that had escaped into her circulation. A few years later we had practically forgotten about her condition, such was her good health.

When she started having trouble breathing shortly after becoming a senior citizen, I gave her lungs a listen and it didn't sound like she was moving any air. Her doctor ordered an X-ray which revealed fluid filling the left side of her chest and collapsing her lung. The cancer was back, and had spread to her chest. Weekly drains followed, sometimes twice a week, and when the pleural effusions spontaneously resolved after 6 months we were surprised and relieved. By then her oncologist had put her on oral chemotherapy as well as an anti-estrogen to starve the spread of her specific breed of cancer, known as estrogen receptor positive. Additional scans revealed that the cancer had also metastasized to her bone. We returned home from the doctor's and I looked up metastatic breast cancer with pleural effusion in my pathology textbook. She would likely pass within 5-10 years.

For the next 5 years my mom lived with a semblance of normalcy. Working as a fine jeweler in Beverly Hills, running errands. Cleaning house. Going to dinner. I put her on a vegan diet and cut out alcohol and processed foods as well as meat and dairy, the major source of estrogen in the diet. Estrogen is also secreted by the ovaries and by fat cells, but as a post-menopausal vegan her production of the female hormone was minimal. I made her fresh vegetable juices every day consisting of carrot and apple and ginger with beet and cabbage and lemon. And we cherished every moment.

But in the summer of 2015 she started having pain and fullness in her belly, along with constipation. At her doctor's insistence I took her to the emergency department where we waited all night to be evaluated. The cancer had spread to her large intestine and was obstructing the passage of stool. Before long surgeons would remove her descending colon and attached a colostomy bag just to the left of her belly button. After a month-long hospital stay she made it back home and over the course of a couple months regained the weight she had lost and accustomed herself to daily colostomy changes. She found it inconvenient to work out and could no longer wear a bikini. But it was winter, so this didn't matter. 

This past May the chemotherapy was no longer working. Her tumor markers were slowly going up, and the fullness returned to her abdomen. So she asked to stop her anti-estrogen shots, which were very painful. The doctor decided to stop all oral medication as well and offered IV chemotherapy, but after undergoing this experience in 1994, and losing her hair, and feeling nauseated and grumpy all the time, she said it was not for her. 

So at my dad's suggestion I put her on alternative treatments, everything that we could find that might halt cancer's spread, from melatonin to high dose vitamin D to baking soda and turmeric. Nothing worked, except for the weekly drains of the fluid in her abdomen, which provided symptomatic relief, but made her vomit. And we watched her slowly descend into more and more pain. June and July were rough. She went from 135 lbs to 100 lbs. She could keep nothing down. And the discomfort was terrible. Her primary care doctor ordered pain medication, morphine and Valium, but advised that once she started taking them her body would shut down and the end would quickly arrive. Things were happening so fast. My mom started feeling desperate. She didn't want to die. Should she start IV chemotherapy, despite its being effective in only 25% of patients? 

I remembered reading the lives of the saints. There was a man who died for his faith and was buried alive. But when they dug up his body they saw dirt and blood beneath his fingertips. He had desperately tried to claw his way out of the grave, proving he hadn't come to terms with his end, he lacked faith. I told my mom this. I wanted her to be dignified to the end. She had been my hero for so long, I wanted her to die my hero too. I showed her a picture of the holy man Ramana Maharshi 10 days before he died of metastatic cancer. He was dressed in white and lying in bed. Such a look of serenity on his face. This is you, mom! I reminded her of Justin, my brother. He was diagnosed with cancer at 22 and refused surgery. As he slowly deteriorated over the course of 6 months he never had second thoughts. He taught us how to die, mom. He was a true hero! How could you accept the death of your own son and fear your own? This got through to her. She decided to remain firm and steady till the end. She thanked me for the pep talk.

What she did want was to party. So we decided to throw her a bash. Celebration slash graduation. She always liked Prince, sang his lyrics, "Life is just a party and parties aren't meant to last." Eighty people attended. Friends, loved ones. The estranged. Friends of mine from high school I had lost contact with. I now know why we die. It is so that our loved ones may come together again. She got to talk to everyone. We did her nails and eyelashes and dressed her in the finest garment, and in bed she watched the festivities. It was like a family reunion! As the guests left she started taking pain medication. Over the course of 6 hours she took the daily maximum of morphine and Valium. Such a meager dose would merely put to sleep a healthy person, but in a malnourished 71-year-old with end stage illness, it was enough to push her over the edge. 

On Monday she flitted in and out of consciousness, saying "wow" and "we did it" and "I love you." I carried her outside so she could spend her last moments of lucidity in her beautiful garden. She used to tell me how when I was born and they put me on her tummy in the delivery room, I looked right into her eyes as if to say, "There you are!" And here we were, mother and son, some 44 years later, staring into each other's eyes, not at the beginning of my life, but at my mother's end. The feelings that poured out of me reduced me to a torrent of tears. And yet I smiled through them, for my heart was filled with joy at the beauty of the cycle of life.

Before we brought her back into her bedroom, she looked around with bright, clear eyes. Her final words were, "Who am I?" The question of all questions. She had become undifferentiated consciousness, discarding all individual identity. Like a newborn before it is given a name and with it a personality. Like me, when I first looked into her eyes. 

Her breathing became slower and more intermittent, and she didn't regain consciousness again before leaving her body at 2:30 pm on Wednesday, August 10th. She was surrounded by loved ones, and died completely at peace. 

I got to tell my mom how much she meant to me, thank her, love her, hold her. Sob in her arms. No regrets. This is how people should die, not in a sterile hospital surrounded by strangers, but in the comfort and familiarity of the home, in the presence of the near and dear. Cancer really is a wretched disease, but it provides this opportunity: to know when is the end. How many of us get to wake up to what we know will be the last party we'll ever experience on Earth? I got to enjoy this adventure with my mom, and gratitude fills my heart. May her memory live on, and her example inspire others.

RIP Laraine Pieri Dave (4/24/45-8/10/16). How I love you.