My Most Recent Wellness Visits (Intense Exercise Prevents Deteriorating Health)

My Most Recent Wellness Visits

(Intense Exercise Prevents Deteriorating Health)

In this article, I will overview my two most recent “wellness visits” (aka. physicals) with my personal care physician (PCP). My hope is that discussing my visits and what they revealed about my health will help the reader in understanding and dealing your own health issues.

Background

As I began writing this article, it was the morning of my 63^rd birthday, near the end of March 2024. It also marked three years since I completed in a powerlifting contest, having last completed on my 60^th birthday. The reason it has been three years is I have dealt with six injuries over the past three years, the first having begun two weeks before that last contest. All but the most recent of those injuries are now fully healed. That last one I will discuss later. For details on the earlier ones, see Rotator Cuff Tears and Squat Injury.

In addition, I have been going to the same medical center for over twenty years. But in those years, my PCP has changed six times, and the center has changed its location and name. It is the doctors leaving and being replaced by new doctors that can be most frustrating. It means I have to continually explain my health issues to a new doctor. But at least it is the same center, so they have all of my health records. And some of the support staff have been there for many years, such as the receptionist, so at least she recognizes me when I go to the desk to register for an appointment.

Two visits ago, I got a new PCP. But I talked to him before I even met him. He is the doctor I talked to on the phone when I sustained the injury discussed in the “Squat Injury” article. I finally met him for an appointment a month later, on September 1, 2023. Then I had another appointment with him on March 8, 2024. Both of those visits qualified as my “Wellness Visits.”

This background will be important as we proceed.

Blood Lipids, Intense Exercise, and Chocolate

For many years, my LDL (“bad”) cholesterol levels had been just fine. “Normal” is below 130 mg/dL for someone with my risk factors, which is to say, male, over 45, but no heart related health issues. But then, in 2018, my LDL began trending upward, peaking at 147 in September 2022.

My total cholesterol was always a bit high, just over 200, with normal being <200 mg/dL. But that was due to my rather high HDL (“good”) cholesterol levels. Ideal is above >39 mg/dL, while mine was always over 50, even as high as 74. That was due to my intense exercises, as exercise raises HDL levels.

When my LDL began to rise, I didn’t think too much of it due to that high HDL. It is the ratio of total and HDL cholesterol that is most important. “An optimal ratio is less than 3.5-to-1” (WebMD. Cholesterol). In 2020, for instance, with my total cholesterol at 216 and my HDL at 65, the ratio was 3.3. However, then my HDL began to drop. However, my total cholesterol remained about the same. That was due to the rising LDL. That meant, the ratio was getting worse.

Meanwhile, my triglycerides were also getting worse. They remain just fine as far as the standard goes. Ideal is <150 mg/dL. Mine was always in the low 60s to low 70s. But they also began to rise.

At the worst, in September 2022, my total cholesterol was 217, my LDL 147, and my HDL56. That gave me a total/ HDL ratio of 3.8. None of that was good. My triglycerides were at 89. That was still well below the ideal, but it still showed a trend upward.

What was causing these trends? One obvious answer was the lack of intense exercise. Due to the aforementioned injuries, I was unable to work out at an intense level since March of 2021. And there is a direct connection between both HDL and triglycerides and exercise.

Besides helping you lose weight, increased physical activity can lower your triglycerides, the most common type of fat in your body, while increasing your HDL levels. Benefits can be seen with as little as 60 minutes of moderate intensity aerobic exercise a week (WebMD. HDL).

As I was recovering from the aforementioned injuries, I was getting back into harder workouts. My most recent blood test was in early March 2024. And it showed my HDL at 58 and triglycerides at 59. Those were improvements from my worst, most likely due to now working out at a high intensity. The triglycerides were a significant drop, but the HDL only rose slightly. But I expect it to rise more as I continue with intense training. As such, despite what the above quote says, for me, it seems to take more intense exercise to make a difference.

However, LDL is unaffected by exercise. It is mostly affected by diet, along with some medications. I was not taking any medications that would affect it, so I began wracking my brain trying to figure out what had changed in my diet that could have led to it going up. The only thing I could think of was chocolate.

I had written an article back in 2006 titled Chocolate: Junk Food or Health Food? In it, I documented that small amounts of daily chocolate could be heart healthy. I was never much of a chocolate eater, so I didn’t do much with that information at that time. However, in the years since then, more research had come out showing the supposed benefits of chocolate, especially dark chocolate. As a result, I began to eat some dark chocolate every day. That seemed to increase my desire for chocolate, so I began to eat chocolate otherwise, such as in cookies and in protein bars and powders.

When my LDL first began to rise, I was wondering if it could be the chocolate. But I did some research, and it showed that chocolate did not cause LDL to rise. In fact, some studies show it can lower it. Therefore, I kept eating the chocolate, and my LDL kept rising.

Meanwhile, I began to have an increased problem with constipation. I again did some research and found that chocolate can indeed be constipating for sensitive individuals. Consequently, I began to cut back on the chocolate, and my constipation improved. Then I had a blood test, and my LDL had improved.

That is when I figured my initial research was wrong and maybe it was the chocolate that was causing my LDL to increase, so I almost completely eliminated it. And sure enough, at my most recent blood test with eating virtually no chocolate, my LDL was down to a very good 118. My total cholesterol was also at below normal at 189. With my 58 HDL, that gave me a very good ratio of 3.2.

All of this is to say, not being able to work out at an intense level and eating chocolate caused all of my blood lipids to worsen, while getting back into intense exercise and stopping to eat chocolate caused all of my lipids to improve, so much so that my PCP now says he has no concerns about my blood lipids profile.

However, he did ask if I still ate any chocolate. I told him I eat an occasional chocolate chip cookie. I figure with chocolate chip cookies you get the chocolate taste while only eating a small amount of actual chocolate. He said that was good, as he believed in “moderation.”

Blood Pressure, Intense Exercise, and Sodium Levels

Along with my LDL cholesterol, my blood pressure also began rising as I was dealing with my injuries and unable to work out with any degree of intensity.

It had always been around 120/ 80, but it went as high as 142/ 92 in September of 2022. But at my most recent appointment, it was down to a below normal of 116/ 72. That rise and drop again reflects the lack of then beneficial effect of intense exercise.

That improvement came about despite the fact that I had begun to consume more sodium. The reason for that is I have had chronically low sodium levels. A previous PCP had recommended I try reducing water intake. I found that very difficult, and it didn’t help anyway. But worse, it might have caused my kidney enzymes to become elevated. Specifically, my blood urea nitrogen (BUN) levels had been slightly above normal for the past several years. That can be caused by being dehydrated.

Therefore, I increased my water intake and went the other way and began to consume a bit more sodium. That worked, in that my sodium level was now in the normal range.

My new PCP said it can be a balancing act to consume enough sodium to keep sodium levels normal but not so much so as to increase blood pressure, and to drink enough water to keep the kidneys healthy, but not so much so as to dilute blood sodium levels.

I think I got the correct ratio now. But I will see with my next blood test.

Resting Heart Rate

My resting heart rate was 62 bpm at the most recent appointment. That is at the lower end of the normal range of 60-100 bpm. But it has been lower, as low as 45 at medical appointments. I’ve even had nurses ask me if I had heart issues with it being so low. But I explained it was so low due to working out.

However, at this appointment, it was probably higher due to just getting back into harder training. I suspect it will lower again if I keep training intensely.

Elevated Liver Enzymes

Along with chronically elevated kidney enzymes, I have also had chronically elevated liver enzymes. Specifically, I have had elevated blood bilirubin. In both cases, my levels were only slightly above the normal range. But due to the elevated bilirubin, my PCP had me undergo a liver ultrasound. Along with the liver, it also tested my gallbladder, bile ducts, and pancreas.

I was a bit worried before the test, as a lot can go wrong with all of those organs. A student nurse did the ultrasound. She seemed to be having problems finding all of those organs. That had me asking her, “Are my insides all messed up?” She just laughed. But I think it was just that she was nervous, as there was an older nurse overseeing what she was doing.

In any case, the results were, it was an “Unremarkable study,” meaning everything was normal. That was good to know and a relief.

Elbow Pain

As I was recovering from my various injuries and began to work out harder, I began to notice some pain in my left elbow. It began in the autumn of 2023. However, it was not at all intense, just a bit bothersome, so I didn’t think much of it. But then in February of 2024, it began to worsen.

I had pain in this elbow many years ago, so I knew what to do. I began to take ibuprofen before my workouts, to wear an elbow band during my workouts, and to ice the elbow after my workouts.

The elbow band is not worn over the elbow. It is worn just below it. It may sound strange, but compressing the forearm muscles just below the elbow alleviates stress on the elbow. I still had a couple such bands from my previous elbow pain, but they were a bit hard to use, so I got a new one from CVS. You can also get them at Amazon.

I also did a bit of research and found some rehab exercises to do for it. In that research, I also discovered that I have “golfer’s elbow” rather than “tennis elbow.” The difference is, golfer’s elbow is pain on the inner elbow, while tennis elbow is pain on the outer elbow. My pain is located at the little bone that sticks out from the inner elbow. It hurts if I press on it.

At my PCP appointment in early March, I discussed the elbow pain with my PCP. He didn’t seem too concerned about it. He told me to keep doing what I had been doing. He also said to ice it a second time, in addition to post-workout, which I had been doing, in the morning, then after my workouts in the late-afternoons. But he said, if it gets worse to contact him.

Now, late March, it is still bothersome but feeling somewhat better. As long as I keep doing the preceding, I think it will be okay, and hopefully, it will not impend my workouts.

Medical Information Sheets

Since the September appointment was the first time seeing this new PCP, I gave him what I call my “Medical Information Sheets.” It is three pages that list and describe all of my health problems. It is basically the same as what you will see under “Health Problems” and “ Explanations” near the end of My Life Story on my personal website. See that for more information in this regard.

But here, I’ve given these sheets to the medical office previously. But I updated them before this visit and wanted to hand it directly to the new PCP to be sure he saw it and I could discuss it with him. I just believe it is good to have one doctor who is familiar with all of my problems.

I explained to him that with all of my injuries over the previous three years, many of my health issues had gotten worse. But as I have been able to get back into harder training, I am doing somewhat better. That is why I was concerned about the elbow pain, as I didn’t need yet another injury causing another setback.

I made sure he knew about my Multiple Chemical Sensitivity, as it is the most serious of my problems. It is at the root of many of the others, makes them worse when it flares up, and it keeps me from having much of a life. I mentioned to him that I had a wedding to go to in a couple of weeks that I was concerned about, as I knew I would feel awful afterwards.

He gave me a prescription to take after the wedding or anytime I am in a situation that I know is going to cause me problems. He said it might help calm things down some. It did help me to sleep that night, but I still felt awful for two days after the wedding. But being able to sleep is something, as usually I am unable to do so whenever I go out anywhere.

Vaccinations

Finally, at the last appointment, I made sure my PCP knew I got a series of vaccinations in the previous autumn after my previous appointment. They were the flu shot, Covid booster, pneumonia shot, and RSV shot. I got them over a period of several weeks, getting each a couple of weeks apart.

He had a record of the first three, but for some reason, not the last. I need to contact the pharmacy where I got it to find out why not, but I haven’t gotten to it yet. But I should, as the RSV shot is a one-time thing, so my PCP should have a record that I already got it.

With my own health issues and with living with my 87-year-old dad, I try to avoid any such infections, as I know they could cause me a major health setback. But more importantly, I don’t want to risk infecting my dad, as I know any such infection could cause him even more serious problems.

As for the vaccinations themselves, I had no problems with them other than soreness at the injection site. I did feel awful the next day, but that is “normal” for me whenever I go out anywhere. And on each of those days, the pharmacy for the vaccination was just one of multiple stops. That is my usual practice, to combine trips as much as possible. I figure since I am out and will feel terrible the next day anyway, I might as get as much done as I can.

For those Covid antivaxxers out there, please see my new Covid website before emailing me about the Covid booster shot. But I will say here, my dad also got all of these vaccinations. And it worked. Six months later, neither of us has contracted any of the preceding illnesses. And neither of us had any significant side effects from any of the vaccines. In fact, both of us have been getting the annual flu shot for many years and the initial then annual Covid shot since they have been available, and neither of us were ever infected with the flu nor Covid over the past three years.

Body Age

This final point was not a part of the PCP appointments, but I found it interesting. I came across a website to estimate your “body age” (or physical age). I plugged in my numbers from the most recent wellness visit and how often and intensely I exercise. The results were, my “body age” is 34-years-old! That was probably mainly due to indicating I work out “full gas.” A year ago, when I was barely working up a sweat, my body age probably would have been much higher. But it could get even lower if I get my heart rate back down.

Conclusion

Intense exercise is preventing my health from deteriorating. That applies to basic health parameters like blood lipids and blood pressure and to my more unique health issues. That is why I had been struggling over the past three years, as I wasn’t able to work out with any degree of intensity. But I am doing better now that I can work out at a high intensity again.

Diet is also a factor. My foray into consuming chocolate was really the only “junk food” I have consumed in any significant amounts in many years. I still follow the eating plans outlined in my books God-given Foods Eating Plan and Creationist Diet: Second Edition. And that is doing me well.

References:

Body Age Calculator

Cleveland Clinic. Liver Ultrasound.

Hand Center of Louisiana. Tennis Elbow vs. Golfer’s Elbow.

Healthline. 5 Exercises for Tennis Elbow Rehab.

Healthline. Chocolate and Constipation: Understanding the Link.

Healthline. What Causes High Bilirubin?

Very Well Health. Normal Resting Heart Rates by Age.

Very Well Health. Can Dark Chocolate Lower Your Cholesterol?

WebMD. Cholesterol Ratio: Is It Important?

WebMD. HDL cholesterol: How to boost your ’good’ cholesterol.

WebMD. What Is a Blood Urea Nitrogen Test?