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FitTips for One and All - Vol. XV, No. 6

FitTips for One and All
Volume XV, Number 6
2017

Presented by Fitness for One and All
Director: Gary F. Zeolla

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Health-Related Stuff on Friday the 13^th

Part One: Annual Physical and Blood Test

By Gary F. Zeolla

      I spent Friday, October 13, 2017 dealing with a series of things related to health that most people should consider dealing with. In this two-part article, I will describe that day. It is my hope my busy Friday the 13^th will be instructive to the reader in dealing with these issues.

Annual Physical

      The first health-related thing I did on Friday the 13^th was to go for my annual physical at my doctor’s office. For background, for a long time, the Bible verse of Mark 5:26 about a woman with a flow of blood seemed to be my life motto, “and having suffered many [things] under many physicians and having spent all the [things] with her [fig., everything that she had] and not having been benefited at all, but rather having come to [be] much worse” (ALT3).

      But then a few years ago, I gave up on doctors altogether to help with my many health problems. I now instead have accepted my health problems, while paying close attention to my diet and exercise to enable me to function, along with much trust in the LORD. I discuss this attitude change and my diet and exercise plan at length, respectively, in my books The LORD Has It Under Control and Creationist Diet: Second Edition. But here, I will say, now my life motto is, “But the Lord stood by me and gave me strength” (2Timothy 4:17; ALT3).

      But despite that, I do still believe it is wise to get an annual physical, just to be sure nothing new has cropped up that needs to be addressed. I will explain other reasons I go for an annual physical as I describe what happened at my appointment.

Bodyweight/ BMI:

      After a wait of just a couple of minutes, a nurse called my name and led me down a long hallway to the exam room. She first weighted me. At home, I always weigh myself first thing in the morning in just my underwear, and I usually weigh 120-123 pounds (I’m 5’1”). But at the doctor’s office, she weighed me fully clothed, including with my shoes on. I think that is quite dumb, as clothes, especially shoes, can weigh quite a bit. And that was borne out in that I weighed 126 pounds. She told me that gave me a body mass index (BMI) of 23.8, but I checked it based on 122 pounds, and it was only 23.1.

      For those who don’t know, BMI:

      … is calculated from your height and weight. BMI is an estimate of body fat and a good gauge of your risk for diseases that can occur with more body fat.

Underweight: Below 18.5

Normal: 18.5–24.9

Overweight: 25.0–29.9

Obesity: 30.0 and Above.

Although BMI can be used for most men and women, it does have some limits:

• It may overestimate body fat in athletes and others who have a muscular build.

• It may underestimate body fat in older persons and others who have lost muscle (NIH).

      Thus, whether with or without clothes, my BMI is just fine. But being weighed in clothes, could push some people up from one category to the next. Moreover, BMI is absolutely worthless for those who are heavily muscled, as indicated in the quote. Despite being a powerlifter, I am not that muscular. That is due to trying to keep from gaining weight so as to be able to remain in the 114-pound weight class. But many powerlifters and other strength athletes gain muscular bodyweight over the years, and that could put them in the “overweight” category, despite having little bodyfat. Unfortunately, doctors and insurance companies rarely make allowances for such, causing them to be classified as being overweight, which makes no sense.

Body Temperature:

      Next the nurse took my temperature. It was 97.5 degrees Fahrenheit. That is a bit below what is considered to be normal, “The average body temperature is 98.6 degrees Fahrenheit, but normal temperature for a healthy person can range between 97.8 to 99.1 degrees Fahrenheit or slightly higher” (Cleveland). But 97.5 degrees is normal for me, as my temperature always has tended to run a bit low. In fact, using old-style mercury thermometers, if I wasn’t running a fever, the mercury wouldn’t even move when I took my temperature. I told the nurse that, so she moved on to the next item.

Blood Pressure:

      Next, the nurse took my blood pressure (BP). “Healthy blood pressure for an adult, relaxed at rest, is considered to be a reading less than 120/80 mm Hg” (Cleveland). Mine was 118/ 80. That is actually a bit high for me, as the last time I took it at home with a home BP monitor, it was 108/ 74. I’m not sure if that difference is due to “white coat syndrome” (the tendency for people’s BP to be higher due to the nervousness of being at a doctor’s office), or it is due to differences between the doctor’s and my home BP monitor.

      In my case, it is probably the latter, as I don’t get nervous at doctor’s office, thought I might get upset if I have to wait a long time. But one reason I like this particular doctor’s office is I generally do not have to wait long at all, and this time, I had gone in almost as soon as I got there. But still, if you are concerned about your blood pressure, you should get a blood pressure monitor so that you can check it at home without nervousness or aggravation affecting it. You can get one at Amazon.

Resting Heart Rate:

      Next the nurse took my resting heart rate (RHR) or pulse:

      Your pulse is the number of times your heart beats per minute [bpm]…. normal pulse rate for a healthy adult at rest ranges from 60 to 80 beats per minute…. A lower heart rate is also common for people who get a lot of exercise or are athletic (Cleveland).

      When the nurse first took my RHR, it was 52 bpm. It surprised her it was so low, but I told her that reading was actually a bit high, as it is usually in the mid-40s when I take it at home. She then retook it, and sure enough, it was now only 44 bpm, and that is what she wrote on my chart. The difference was probably because my heart rate had risen a bit due to that long walk down the hallway, but with another minute of rest, it had now returned to my normal mid-40s.

      The reason my RHR is so low is due to exercise. But it must be noted, I do not do any cardio and have not done so in months. As I said, I am a powerlifter, so I of course lift weights. That’s it. I was doing cardio in the mornings for quite some time, but then back in the summer of this year (2017), I gave up on it. Instead, starting on 8/7/17, I moved my speed work to the mornings and do it instead of cardio. I then do my normal powerlifting workouts in the late afternoons.

      Speed work involves doing weightlifting movements like the powerlifts (squats, bench presses, and deadlifts) with a light weight, in a rapid fashion, and with little rest between sets, so speed work is basically interval training. Given that, I figured it would function as my cardio. I do four work sets of 9, 7, 5, 3 reps, increasing the weight each set. I rest just 30 seconds between sets, do not pause between reps, and do the reps in a rapid fashion. That gives it the cardiovascular (CV) effect. I do speed rows in the morning when I will be doing a Bench Assistance workout in the late afternoon, speed squats before a Squats workout, speed benches before a Benches workout, and speed deadlifts before a Deadlifts workout. For further details on speed work, see the chapter on this subject in my book Starting and Progressing in Powerlifting.

      I follow that speed work with a couple of isolation exercises. The isolation exercises are done for much higher reps than I use for my powerlifting workouts (7-20 vs. 1-7), and they are done with a shorter rest between sets (30-90 seconds vs. 3-5 minutes). As such, the isolation exercises fit well for conditioning with the speed work.

      But I was wondering if this would all work as a substitute for regular cardio, so I have been keeping track of my RHR at home, and sure enough, it did not change in the two months between when I stopped it and this doctor’s appointment. As I write this article, it is now the beginning of December, or 3-1/2 months since I stopped the cardio, and it still has not changed. As such, I know what I am doing works as substitute for cardio, which is good, since, as a powerlifter, I find cardio to be quite boring.

Respiration:

      Next the nurse took my respiration rate. “A person's respiratory rate is the number of breaths you take per minute. The normal respiration rate for an adult at rest is 12 to 20 breaths per minute” (Cleveland). This is something a nurse normally does without telling the patient, as it is of course possible to consciously change your respiration rate. She will generally tell you she needs to take your pulse again, but she is really counting your breaths.

      In any case, my respiration rate was 12, which is at the bottom end of the normal rate. That is again due to being in good CV shape despite not doing any actual cardio. Thus, my BP, RHR, and respiration are all well below normal, showing my eating and exercise plans are working very well for general health purposes. I knew that before going to the doctor’s office, due to checking these things at home. But it is nice to have it confirmed by a professional. In fact, that is another reason I go for an annual physical, as the affirmation is a good incentive to keep up with it.

Flu Shot:

      Next the nurse gave me a flu shot. Now I know this might be a bit controversial given the “anti-vax” movement, i.e. those who are opposed to all kind of vaccinations. A discussion of such is outside the scope of this article. I will just say, I think anti-vaxers are about as wrong as wrong can be, so I get an annual flu shot, as having the flu is not very pleasant. Moreover, it was after a particularly bad case of the flu many years ago that one of my many health problems began, namely my fibromyalgia. That is actually rather common, as most fibro-sufferers report having developed the condition after having had the flu or undergone some other health trauma.

      It is also important to get a flu shot before the flu season starts, as it takes a few weeks for it to be fully effective. That is why I always schedule my annual physical in October, so I can get both done at the same time.

      In any case, it only takes a few seconds for the flu shot, but I still look away, as I cannot stand needles. But as a word of warning, do not let the nurse give you your flu shot before taking the preceding vitals. She did that last year, and it caused my RHR to spike up to 88 bpm. She didn’t think much of it, but as soon as she told me the number, I told her that was not right and that it was usually about half of that.

      She retook it, and sure enough, it had dropped to 60 bpm and that is what she wrote on my chart. But then after she left the exam room just a couple of minutes later, I took it myself, and it was down to 46. But it bummed me out that she had written down 60, as again, having my better than average numbers recorded at the doctor’s office is an affirmation that my eating and exercise plans are working, and it bugged me I didn’t get “credit” for my lower than normal RHR that time.

Doctor Tests:

      The nurse now left, and after a few minutes, the doctor came in. My normal male doctor was not available, so I saw a female doctor at the same office. She was an Asian-Indian woman with a bit of an accent, but not so much that she was hard to understand.

      She checked my eyes, nose, throat, and breathing, all of which were fine. She then asked me a few questions about my health, and I told her about my fibromyalgia, stiff person syndrome, and multiple chemical sensitivities (MCS). As always, she had no suggestions as to what to do about any of them. I didn’t expect her to, since, as I said, I gave up hope of getting any help from doctors a long time ago.

      She then gave me a script to get a blood test done. This is one aspect of my doctor’s office that I do not like—they do not draw blood at the office, so I have to go elsewhere for it. The script was for the basic blood work of blood lipids levels, plus a couple of special items I will address in a moment.

      But first, that was the end of my annual physical. It took all of about 15 minutes. But it is always reassuring to know everything is fine, as least as far as what they can test in the office. I now had to go for my blood test and wait for those results for the rest of the physical.

Blood Test

       For the blood test, I had to be in a fasting state. I knew that would be the case, so l had not eaten breakfast. That will be important later. But here, my doctor’s appointment was at 10:30 am. The blood testing place is across a large parking lot in a shopping plaza from my doctor’s office. It closes at noon, so I always schedule my doctor’s appointment in the morning, so I can have my blood drawn on the same day. But unlike at my doctor’s office, I always have to wait a considerable amount of time just to get a couple of vials of blood drawn.

      When you enter the testing place, you take a number. After I take my number, as I sit down in the waiting area, I always ask around to see who has the lowest number, so I will have an idea of long I will have to wait. I have learned that it takes them about ten minutes for each patient. One time, there was half a dozen people ahead of me, so I knew I would be waiting about an hour. Rather than waiting in the waiting room, I drove down the street to go to the bank, took care of my business there, and still got back well before they called my number.

Getting Upset:

      I’ve also learned that no matter how long I have to wait, to try not to get upset. I say that, as being upset when you get you blood drawn can throw off the results, just like it can throw off a BP test. I found that out a few years back when after I had my blood drawn, I had gone home and taken a shower. When I got out of the shower, I had a message that they had not taken enough blood and needed me to come back to give a bit more, so I had to get dressed and drive back up to the lab. I got very upset over the situation as I had a lot to do that day, and this would really mess up my plans. But I went back, and they drew two more vials, and I figured that was that.

      With Thanksgiving that week, it took a week to get the tests results back. To my great surprise, my fasting blood glucose was elevated. Normal is 70-100 mg/dl, but mine was 189. That made no sense. I never had a problem with my blood glucose being elevated before. At my previous blood test the year before, it was only 89. Also not making sense was that my blood triglycerides were very elevated. Normal is <150 mg/dl. At my previous blood test, they were a very low 46. But this time they were 369.

      As a result of that elevated blood glucose result, my doctor ordered a glucose tolerance test, which I was able to get done the next day at the local hospital. It turned out that the original fasting blood glucose result was an anomaly. This time, it was only 96, within the normal range. However, the “tolerance” part of the test was abnormal, not abnormally high, but abnormally low. Normal blood glucose after eating is 70-120 mg/dl, but mine was a low 56. It was then that I was diagnosed with reactive hypoglycemia. Follow the link for details in that regard.

      But here, what caused the high fasting blood glucose reading and even the extraordinarily high triglyceride levels was stress. Doing some research, I found out that the body releases glucose and triglycerides into the bloodstream in response to stress. This is part of the “fight or flight” reaction. Basically, the body is making sure you have the energy to fight off that wild animal or to run from it. At least, that is how your body interprets stress, as some kind of physical danger. But, of course, today most stressors are emotional or physiological not physical, so that pent-up extra energy is not dispersed. That is why stress is so dangerous health-wise.

      In this case, it was being stressed out about having to go back up to the blood testing lab that caused the anomalous readings. My home glucose monitor confirms this. If I am stressed out about something, no matter what I have eaten, my blood glucose levels are elevated, and I would suspect my triglycerides would be as well. The moral of the story is, when you get a blood test done, be sure you are not stressed out or you could end up with anomalous readings as well.

Blood Lipids:
      When I got my blood test results, my blood lipids were as follows. My readings are given first, then the normal reading is given in parentheses. The asterisks indicate that my numbers are out of the normal range.

Total Cholesterol: 203 (<200)*

HDL: 66 (>39)

LDL: 125 (<100)*

TC/ HDL Ratio: 3.07 (<5.0)

Triglycerides: 62 (>150)

When the nurse called to tell me about my blood test, she told me my total cholesterol and LDL (bad cholesterol) levels were elevated. She was correct, if you only look at those numbers. But note my HDL (good cholesterol). It is a very high 66, which gives me a very good total cholesterol/ HDL ratio, and that is what is most important.

Moreover, the referenced normal of <100 for LDL is rather low. According to the National Institutes of Health, a reading of 100–129 mg/dL is “Near optimal/above optimal.” Meanwhile, an HDL level of 60 mg/dL and above is said to be, “Considered protective against heart disease.” Moreover, my triglycerides are very low. As such, overall, my blood lipid levels are just fine, but I had to ignore the nurse and do some research on my own to know that.

The reason for that good lipid state is of course diet and exercise. Exercise raises HDL levels and lowers triglyceride levels. Also, a diet high in monounsaturated fats elevate HDL levels, while a diet moderate in carbs keeps triglycerides low. I discuss such issue in the above mentioned Creationist Diet: Second Edition book, along with in my book God-given Foods Eating Plan. It should be noted, there is very little redundant material between these two books, though both advocate similar eating plans. And this blood test shows those eating plans work very well for producing healthy blood lipids levels.

Iron Levels:

     After discussing the lipids and trying to convince the nurse that my levels were just fine (the patient teaching the health professional!), the nurse now told me I was anemic. What she was referring to was the following:

WBC: 4.12 (4.40-11.30)*

RBC: 4.45 (4.50-5.90)*

Hemoglobin: 13.5 (14.0-17.4)*

Hematocrit: 39.5 (41.5-50.4)*

      WBC stands for white blood cell and RBC for red blood cell, and all four of these are related to iron only in the sense that iron is need for proper RBC formation. But none of these measure iron directly.

      I had this problem once before. For some reason, these numbers were low, so I was sent to a hematologist. He redid the blood test, checking not just these items but other more iron-specific numbers. I had to go for that appointment then a follow-up to get the results. All of the readings were perfectly normal, and that was the end of that, so it was wasted two trips to a doctor.

      This time, thank God, they still had blood left from the initial test, so my doctor ordered more tests to be done on that remaining sample. She had them test for the more iron-specific items. The results were as follows:

Iron: 136 (60-150)

Transferrin: 258 (200-360)

Transferrin Saturation: 37 (11-60%)

TIBC: 361 (303-515)

It can be seen that my levels are just fine. I knew that should the case, as I get plenty of iron in my diet. I keep track of my diet using my Diet Power software, and I average about 20 mg of iron a day. That is way above the needed 8 mg for an adult male (see Diet Evaluation Logs 2017). Why the other readings are off, I am not sure. But I’d bet if I have the test redone, just like last time, they would be just fine as well.

The moral of this story is, do not trust just one test. Be sure to get everything related to the issue tested and to repeat the test before taking any further steps.

PSA:

      My normal male doctor always asks me for permission to check my PSA (prostate-specific antigen). I guess there is some law that he needs to do that, though it makes no sense to me. But even more strangely, this female doctor told me I was not old enough for a PSA test!

      “I’m 56” I replied, but she just shook her head and said insurance would not cover it without a specific reason for the test. Even though my PSA has always been just fine, I really wanted the test done this time, as it did rise the last time I had it done as compared to the time before that, and if it continued to rise, that could be problematic. Therefore, I told her I had relatives who have had prostate problems, but that didn’t seem to matter. She then asked if I ever get up at night to go to the bathroom, and I said I did occasionally, so on that basis, she was able to order the test.

      Normal PSA is less than 4.0. In 2015, mine was 1.5, but then in 2016, it rose to 2.26. That was still below the upper limit, but the rise concerned me, as if it were to continue, it could eventually be a problem. But this time, it was back down to 1.55. I have no idea why it went up then back down. It might due to now taking Doctor’s Best Saw Palmetto, though such normally only affects the size of the prostate, not the PSA reading. But whatever the case there, this again shows why you should have tests redone before basing too much on them.

Kidney Related Tests:

      Also just fine were my creatinine (0.8 on a scale of 0.5-1.2) and protein levels (6.7 on a scale of 6.2-8.0). That is of note as I supplement with creatine, of which creatinine is a by-product, and I follow a high protein diet. But neither causes my numbers to be out of whack. Also okay was my blood urea nitrogen (BUN) level, though it is near the high end of the range, 19 on a scale of 6-20.

      A blood urea nitrogen (BUN) test measures the amount of nitrogen in your blood that comes from the waste product urea. Urea is made when protein is broken down in your body. Urea is made in the liver and passed out of your body in the urine.

      A BUN test is done to see how well your kidneys are working. If your kidneys are not able to remove urea from the blood normally, your BUN level rises. Heart failure, dehydration, or a diet high in protein can also make your BUN level higher. Liver disease or damage can lower your BUN level. A low BUN level can occur normally in the second or third trimester of pregnancy

      A BUN test may be done with a blood creatinine test. The level of creatinine in your blood also tells how well your kidneys are working—a high creatinine level may mean your kidneys are not working properly (emedicine).

      What these tests together show is my kidneys are just fine, despite the high protein diet. That is important as some people, especially vegetarians, like to claim that a high protein diet causes kidney problems. But it does not, as I document in my Creationist Diet book.

Electrolytes:

      Electrolytes are “Salts and minerals that can conduct electrical impulses in the body” (Free). The main electrolytes are sodium (Na), chloride (Cl), and potassium (K). My levels were as follows:

Na: 134 (136-149)*
Cl: 96 (98-107)*

K: 4.3 (3.5-5.2)
 

    Thus, my Na and Cl are a bit low, but that has been the case for many years now. I have no idea why they are low. I have tried reducing water intake and raising salt (sodium chloride, NaCl) intake. I am now averaging almost 3,000 mg a day of sodium, but my sodium levels have not risen.

    But it should be noted, my BP did rise slightly when I increased my salt intake. Previously, my BP had been as low as 100/60. But that was too low. With increasing my salt intake and thus my BP, I noticed an improvement in my health. These benefits included no more occasional lightheadedness like I used to experience, along with a reduction in my fibromyalgia fatigue and improved sleep. The latter makes sense given that a recent study found, “Very short sleepers showed less dietary variation, and they had the lowest total calorie intake, consumed less protein and carbohydrates, and were more likely to be on a low-sodium diet” (Huff Post, italics added).

      My potassium (K) levels are just fine. That is no surprise given that I consume close to 5,000 mg a day of potassium, well above the recommended level of 3,500 mg. That is due to eating lots of fruits and veggies every day, as I recommend in my books.

      That concludes Part One of this two-part article and everything related to my annual physical and blood test. “Part Two: Dentist Appointment, Cemetery Visit, and Pizza Hut” will be posted on this site after it appear in the next issue of FitTips for One and All.

References:

      Diet Power 4.4.

      Cleveland Clinic. Vital Signs.

      Emedicine Health. Blood Urea Nitrogen.

      Free Medical Dictionary. Electrolytes.

      NIH. National Institutes of Health. Assessing Your Weight and Health Risk.

      NIH. National Institutes of Health. What Do Blood Tests Show?

      Huff Post. Don't Snooze on Nutrition: See How Foods Affect Sleep.

All material in this newsletter is copyrighted © 2017 by Gary F. Zeolla or as indicated otherwise.

12/3/17