OK, You Hit 60 – Are You Now “Elderly?” Or “Middle-aged?” Does it Matter?

Image by Stefano Ferrario from Pixabay

I remember 60 well.

It’s when I proactively stumbled out of corporate life after 35 years and into my own business, wrongly assuming that I was equipped with even a modicum of what it takes to succeed in the entrepreneurial world.

I certainly didn’t consider myself “elderly” at that point. Still don’t today, 6 months short of entering my ninth decade.

We seem to struggle with where to put ourselves these days since many of us have been granted a “longevity bonus” of 20, 30, 40 years.

I’ll opt for “modern elder”

I’ve written before about the “modern elder” moniker conceived by entrepreneur Chip Conley, author of “Wisdom at Work : The Making of a Modern Elder”. It fits well and I can carry it to my ridiculous goal of reaching 112 1/2.

It’s really just about the mindset and ignoring the pejorative monikers our youth culture and government prefer to slap on us.

Yeah, my cohort thinks I’m nuts and in denial. It seems, if one is beholden to stats and data, I’m both.

I can roll with it.

On the age scale determined by the average life span in America, my last rites were performed several months ago (no, this isn’t being ghost-written) since the average life span of the American male is around 78.5 years – and going backward, by the way. (Put down that Carl’s Junior cheeseburger and fries and walk away, PLEASE!)

On the other hand, based on how long we know the human body can last (122 years, 164 days, the record set by Mme. Jeanne Calment of Paris when she gave it up in 1997) I’m closer to middle-age.

I can roll with that, too.

You’ve been “portaled.”

We’ve had a need to put ourselves in categories, especially relative to age, for, like, forever. We can thank the American Psychological Association (APA) and corporate marketers for much of that. For instance, until G. Stanley Hall, President of the APA, came up with the concept of adolescence in 1904, we fundamentally just had two age categories – child and adult.

Look where we’ve come today with this drive to drop people into age groupings (each category feeding a market for psychologists and marketers).

Dr. Mario Martinez, neuropsychologist, identified seven age-based “portals: newborn, infancy, childhood, adolescence, young adult, middle age, and old age.

Peter Laslett, the eminent British demographic historian, came up with a much simpler and appropriate four-portal alignment:

  1. First age – childhood/age of dependence.
  2. Second age – adulthood and mid-career jobs.
  3. Third age – the new territory between the end of mid-career jobs and parenting duties and the beginning of dependent old age.
  4. Fourth age – age of dependency and ill health, the doorstep of demise.

I like Laslett’s formula.

I’m in the third age. My projected date for the beginning of my fourth age is 112 and change with my ill health and dependency period being two weeks or less. Actually, my plan is to wrap it all up in much less than two weeks by going face down in a Colorado trout stream still trying to prove that I am smarter than an animal with a brain the size of a pea.

Frankly, it doesn’t matter to me whether someone considers me old or elderly. The only measurement that matters is my own. I’ve grown immune to the rampant ageist comments that persist realizing they come from a chronological perspective and one that is naive to the demographic and attitudinal changes that are taking place.

I know, and you know, sixty-year-olds that are truly old – physically, mentally, attitudinally – well past any semblance of a mid-point on all fronts. Conversely, you can easily find 80-year-olds that will hold their own with 50-year olds in the same categories.

I have grown accustomed to the reactions that come from people when I reveal my true age. It nearly always has a touch of amazement that I look and act the way I do.

I don’t say that with any arrogance because I quickly remind people that what they are observing is no accident. I work at it – and have for decades. I learned long ago that my biology will pay me back with more youthful looks and higher energy if I simply listen to it, understand what it needs at the cellular level, and practice the quite-simple things that it takes to honor my good health birthright and let it reward me in kind.

I say all that knowing that it all starts with attitude and that if I choose to begin to adopt a shitty attitude and drop the disciplines that support my biology, I can easily earn a pejorative age-based tag.

Tags are in!

If I have to have an age-based moniker, then call me a modern elder in my third age. They fit nicely together and don’t have to have a number on them.

I picked a crazy endpoint at 112 1/2 because at age 75 I decided I wanted to have a third of my life left to get some things done that I didn’t get done in the first two-thirds. It’s really a desire to roll all my screw-ups, zig-zags, life traumas, successes, victories into this thing called “wisdom” and spread it around a bit.

Look, I know I’m falling short – but I’m working on it!

The mission.

It has become my “third-age mission”, to change people’s attitudes toward aging, to be a longevity guide, to raise awareness that getting old is inevitable but how we get old isn’t. And, above all, to do as Gandhi said: “Be the change you want to see in the world.”

Haven’t we all learned that people will listen more to what you are than to what you say?

So I feel and think of myself as sort of middle-age, in this now extended period we are calling the “third age” that so many others are also in. I, along with millions of other “boomers”, “pre-boomers” and “early GenXers” can decide to turn this period of post-career period of a 20–40-year longevity bonus into the most impactful, purposeful, productive period of life and make an unimaginable difference.

But we first have to dump the age categories and the self-inflicted ageism that comes with it, adopt an attitude that says “I ain’t done yet” and, no, I don’t have a “use-by stamp” anywhere on me, and move forward intending to continue to kick-ass in a culture in dire need of the collective wisdom we third-ager modern elders represent.

Let’s recalibrate!

We have to continue to redefine or eliminate some old, bad ideas, the most obvious one being traditional self-indulgent leisure-based retirement. Retirement, as we’ve defined it and have had it drilled into us for 5–6 decades, is a trojan horse that moves us away from the way our biology functions optimally and away from one of the key components of longevity – meaningful work.

Every study of centenarians has shown that work and purpose remained a key part of their lifestyles very late into their lives.

Other old, bad ideas are the belief that senescence is automatic and unalterable, that our brains will shrink and move inexorably toward slowness and/or dementia. Or that our longevity is driven by our genetics. Or that a period of extended frailty is a given late in life.

None are true unless we allow them to happen. We have the knowledge to know that our lifestyle choices determine much more of this than we knew just 20 years ago.

We have an obligation to honor what Dr. Mario Martinez termed our “birthright of good health.” We are born with it and have become very good at dishonoring it with our lifestyles and clinging to old, archaic myths and messages.

So, I’m borrowing Chip Conley’s “modern elder” tag for myself since I know I will need to continue to address the naive and ageist questions that will be thrown at me as I continue my iconoclastic journey.

It’s a tall order being a “modern elder” as defined by Conley:

  1. Good judgment
  2. Unvarnished insight
  3. Emotional intelligence
  4. Holistic thinking
  5. Stewardship

I’ve got a LONG way to go to earn that moniker. But it’s a great target that has a healthier, longer, more meaningful life written all over it.

I’m working on it!

Does it matter?

Nope – it’s a number. You aren’t defined by it, regardless of how our youth-obsessed culture and government view it.

You are your attitude.

Do attitudes age?

Yep – if allowed.

Once past 60, I suggest a daily attitude check. Remind yourself that you’re not done yet but, in fact, just starting the most gratifying period of your life.

Think about adopting the modern elder tag and criteria.

You’ve got it. We need it.

Remind yourself that you have kick-ass potential rooted in natural talents, acquired skills and experiences, and decades of accumulated wisdom that would be a terrible thing to waste at the beach, on the golf course, in the La-Z-boy.

Let’s be the change we want to see – need to see!

Two Stories That May Save Your Life – Part Two of A Two-part Series

In last week’s post, our first story in this short series related the story of Paul, a retired airline pilot and aspiring 70.3 triathloner, who averted a possible heart attack through proactive testing that revealed a significant blockage in his “widowmaker” artery.

His is a fascinating story of a journey from daily half-triathlon training to quadruple bypass surgery back to training for another half-triathlon, all the space of a month. Had he not pursued proactive testing, his story likely would have had a much different, and ominous, ending.

This week, the story is different but no less revealing of the importance of being proactive about heart health in our later decades.

In story two, we meet Scott Fulton, entrepreneur, longevity advocate and teacher, and health and fitness advocate who “walks his talk” with personal fitness that positions him in the upper 10% for his age.

I’ve been fortunate to have a few conversations with Scott and find his depth of knowledge on the impact of our lifestyle choices on our longevity to be off the charts. His mission aligns with mine: raise the awareness of our longevity potential and the role of our habits and choices – especially in our third age –  in achieving that potential.

I encourage you to visit his website and, in particular, spend 11-minutes with this video which really encapsulates Scott’s mission and message.

It was with this perspective of Scott, his fitness, and his commitment to healthy lifestyle habits that I was shocked to read, on a LinkedIn post, of Scott’s encounter with a cardiovascular issue.

Here are Scott’s own words from that post. I’ve taken the liberty to bold a few sentences for emphasis.

“I have maintained an active, healthy lifestyle for years. It wasn’t always like that. I burned the candle at both ends in my 20s and 30s, and only in my 60s did the damage caused during those “young and invincible” years habits reveal themselves.

A year ago, I proactively requested a CT Coronary Artery Calcium scan (CAC) and discovered that I had an abnormally high calcium score (calcified plaque deposited permanently in heart arteries).

No symptoms. Never had high #cholesterol.

Two weeks ago, I set a cycling PR (personal record) on a local hill climb, placing me in the top 10 for all ages. Not bad for a once mildly overweight 40-year-old, with no elite cycling background.

One week ago, I had a 1-year follow-up Cardiopulmonary Exercise Test (CPET) and scored in the highest fitness class – excellent. My sports cardiologist however noted a drop in O2 rate at maximal effort and ordered a Cardiac Catheter scan with blood contrast.

Yesterday, scan revealing a 90% block in my Right Coronary Artery. BAM!
Subsequently treated immediately on the table with a stent.

Today I am back, able to resume normal active life without limitations or fear of a heart event.

Despite being vigilant about my health and proactive with biomarker and fitness testing, I barely dodged a fatal bullet.

In a world filled with technology, most of us avoid health data at our fingertips, as though it were a threat to our health. Yet, we quickly ascribe to the popular marketing message that we’re all living longer. It speaks to our view of health as fantasy vs reality.

Living longer in poor health is the ultimate curse. We may tell ourselves we’re eating better and exercising more, OR that we’re young and invincible, OR that it’s too late to make changes, OR that we’re too busy caring for others, OR… but regardless, without data, we’re operating on blind hope. Next time you plug an address into your phone, expecting the data to guide you to your destination, ask yourself, “Why aren’t I doing this for my own healthy longevity?”

Healthspan is a long life, supported by optimal health in our later years. It’s a journey we all hope for, yet struggle to take measurable actions, allowing fear to overrule our daily decisions.

Doctors are amazing at saving lives, but saving health is on each of us. Most chronic diseases sneak up undetected and can hit like a freight train. Usually, however, they are very slow-moving bullets and can almost always be avoided with advanced notice. Break the cycle and pause long enough to check for bullets. One just might be headed your way.”

CAC vs CPET

Some of you know my story – first-ever heart scan (CAC) at 73 revealing a calcium score of 600+ (anything above 400 is considered high-risk for cardiovascular disease) followed by echo and nuclear stress tests to determine if blood flow is affected. Fortunately, things appear to be normal with no major occlusions and, thankfully, my left anterior descending artery (LAD/widowmaker) is apparently clear.

Scott shared with me, in a call I initiated after reading his LinkedIn post, that his first CAC (in his 50s) revealed a calcium score of 1700 and that he has a family history of heart issues.

Because of his teaching, he is very aware of the nuances and insidious nature of heart disease and has connected with lots of prominent cardiologists. With that, he was familiar with the “next level” of cardio-testing called the Cardiopulmonary Exercise Test (CPET) which is also referred to as a VO2 (oxygen consumption) test, a specialized type of stress test or exercise test that measures your exercise ability. Normally reserved for testing of athletes, CPET testing is available from a limited number of facilities.

Scott pushed the envelope and leveraged his cardiologist connections to take testing to the next level. He did two CPETs with nothing showing up on the first test but with the second test at a higher rate revealing the fall off of O2 uptake which led to the cardiac cath test that revealed the right coronary artery blockage.

It’s interesting to note that Scott doesn’t feel the stent is the permanent solution. With the improvements in stent technology, he feels it provides a ten-year bridge to what may eventually be bypass surgery as the next life-extender.

This is a mindset that obviously comes from in-depth learning and attention to data.

Takeaways from these two stories

I see two key takeaways from these two stories:

  1. Take charge. Be proactive. Push. Scott’s opinion is that CAC tests should happen at 40 to find out what track you are on to give you more time to address any issues that are revealed. I would add to that test a carotid and abdominal artery scan. Assume that your doc isn’t going to bring them up unless there are symptoms that would indicate that a problem already exists. Let’s be honest, if we aren’t tuned in to our own health, we fall victim to a health  medical system that only cares about the “cure” and not about “prevention.” There is a reason your doc wants you in and out of his exam room in 15 minutes. It’s the business model to which he, in turn, is a captive.
  2. Understand and use the data. A physician once told me that our biggest healthcare problem isn’t disease, it’s healthcare illiteracy. We take our biological naivete into a broken disease-care system when things go awry and accept the drug- or surgery-based  “cure” message and fail to consider that we have technology that can tell us more much about where we are and what we should be doing proactively and preventively to preserve and extend our health. Do you know where you stand on all of your key biomarkers? Do you understand them? Have you had a serious conversation with your PCP about your biomarkers? Have you pushed for these types of baseline tests?

Paul was astounded by the amount of health data he received when he switched out of large health system to an independent concierge preventive medicine physician. The discussion of his initial wellness physical test data was a two-hour conversation with the physician with baselines established that had never been part of discussion with a system-based PCP.

Don’t be a statistic

Over 600,000 people have a first heart attack in the U.S. each year. Only about half survive the attack.

Avoid being a statistic. Push the envelope.

Two Stories That May Save Your Life – Part One of A Two-part Series

I was stunned.

Three weeks ago, I received this email on a Monday morning from a new friend, a retired airline pilot that I had an extended phone conversation with a year ago following his response to one of my health and wellness-related blogs.

Good evening Gary,

Last April I did a sprint triathlon and started training for an Iron Man 70.3. I am retired and 67 years old and I thought in excellent shape with a change to a whole plant-based diet. In my excitement for my newfound energy, I decided to get my FAA pilot (license renewed). Well. I failed my EKG. Fast forward, testing etc. I am at this time sitting in my room at the Cleveland Clinic in Weston Florida, just had quadruple open heart bypass performed on Thursday. There is too much to share on an email – feel free if you’re still up give me a call till 2 AM another 55 minutes from now on my cell phone and I can discuss these matters.

Fly safe

Paul

I picked up the phone and called. I had to know more.

My conversation with Paul a year ago had centered on his adjustments to a healthier lifestyle following retirement. He was adapting to a new retired life, coming down from decades of being glued to a cockpit chair, sleep deprivation, free but unhealthy airline food, and strenuous schedules that come with being in the first seat for a major international airline – a career that spanned 46 years.

He told me it took him 4-5 months to emerge from a constant fog and be able to sleep 7 hours after years of averaging far less than that. He was proudly attacking the accumulated weight issues related to limited physical activity and marginal diet that accompanied a work schedule that, on occasion, covered 24 time zones in one international round trip.

He took both exercise and diet seriously just before retirement, moving to a whole-food-plant-based diet and elevating his exercise to the point of completing a sprint triathlon soon after retiring, which his wife filmed and turned into this YouTube video:

https://www.youtube.com/watch?v=O8mqpvEHlQs

With his newfound confidence in his health status, he decided to get his FAA license renewed, really for no other reason than to just prove that he could.

That decision saved his life.

He flunked.

An abnormal EKG  came with the suggestion that he arrange for further testing.

He met with cardiologists at a local hospital and didn’t feel comfortable with the way they were handling his situation.

He did more research and connected with the local branch of the renowned Cleveland Clinic where tests suggested an angiogram to isolate the anomaly. His cardiologist felt that the worst-case scenario from the angiogram would be placing a stent in the affected area during the procedure.

He was – thankfully – wrong.

The angiogram revealed 90% blockage in the left anterior descending artery (LAD), commonly known as the widowmaker.  It’s called the widowmaker because the blockage, usually a blood clot, stops all the blood flow to the left side of the heart, causing the heart to stop beating normally – or at all, which is usually the case. 

The intended stent placement gave way to immediate CABG (coronary artery bypass grafting) or, as we know it, quadruple bypass surgery.

What’s the big deal? We do 340,000 of them a year!

I suspect most all of us have heard somewhat similar stories, or at least know someone who has had their chest cracked open for this procedure.

How is Paul’s different? Why should I care?

One of the key differences in Paul’s story – and the point I want to convey to anyone who cares to read or listen – is the proactive nature of his actions. In his words:

“Because my issue was discovered through volunteering (to do) testing, I was then allowed to be part of every decision i.e. what hospital, what doctor, what rehab, etc. If I would have had an event, then all decisions would be made by someone else! Being proactive in health produces a much more preferred outcome.”

I suspect that the vast majority of those 340,000 procedures occur after “reactive testing” in response to some sort of event, be it chest pain, shortness of breath, dizziness, upper back or neck pain, indigestion, extreme fatigue, of God forbid, an actual heart attack.

Heart disease remains the #1 killer in the U.S. with 805,000 occurring annually. Someone dies of a heart attack every 36 seconds in the U.S.

And 1 in 5 heart attacks is silent – the damage is done but the person is unaware of it. 

That may have been Paul’s fate had he not been proactive.

70.3 Ironman triathlon in March

Paul is undeterred. As I write this, it’s been 25 days since his surgery. He has worked up to walking 5 kilometers daily and is nearly free of needing help with any of his daily activities. The March triathlon is still his target. (Note: 70.3 is half of a regular ironman – they don’t like the “half” part in the name). I believe he will get there.

His diet remains fully vegan.

He has engaged a concierge “lifestyle practitioner” as a partner in his self-care going forward. The practitioner is a full-on medical doctor who practiced for years at one of the large local hospitals but could no longer tolerate the way he was expected to care for his patients by the system he belonged to.

As a concierge, he limits the number of patients and is providing individualized preventive care for a $250 enrollment fee and $150/month for unlimited access to his services.

Paul reported that his first visit was two hours long discussing the most extensive battery of tests that he ever experienced.

Raise your hand if you’ve come anywhere close to a 2-hour conversation with your doc.

And the physician actually talked diet and knew what he was talking about.

My own “heart disease” story

I’ve written of this before. Six years ago, at 73, I had a heart scan that revealed I am in the high-risk category for cardiovascular disease (CVD).

In a way, my heart scan was proactive. Not because I pushed for it, but because my PCP encouraged it.

Despite being a septuagenarian, I’d never had a scan. My doc didn’t recommend it because he saw something that concerned him but rather he felt it is a good thing to do as a precaution at my age.

The results scared the s*** out of me – and my wife.

Although my total calcium score was high, the scan showed the LAD (see above) was clear and a subsequent echo and nuclear stress test didn’t reveal any blood flow issues. So, it was life as usual, including my aggressive exercise regimen.

So far, so good.

How proactive are you about this silent disease?

Paul’s experience, and the one you will read about next week, illustrate the merit of being in charge of our health by being proactive.

If you are over 40 and haven’t had a conversation with your PCP (please tell me you know his/her name) about a CT Coronary Artery Calcium scan (CAC), then initiate the conversation.

A multi-state study of more than 28,000 people hospitalized for heart attacks from 1995 to 2014 showed 30 percent of those patients were young, age 35 to 54. The unfortunate truth is that heart attacks are happening to younger adults more and more often. This is partly because the conditions that lead to heart disease are happening at younger ages.

My calcium collection didn’t just pop up – it likely has been with me for a few decades, silently, insidiously doing what it does – collect.

I’m lucky that it apparently hasn’t clumped, which it can have a tendency to do and turn people’s lights out.

If you have reached your 5th decade, you’ve collected it too.

Maybe now would be a good time to find out how much you’ve collected. And to get to know a cardiologist that can help you achieve good heart health.

Don’t wait for an event. Be proactive. Seventy-five percent of heart attacks are first-time events and 40-50% are fatal.

I’ll end by requoting Dr.David Katz, specialist in Preventive Medicine and Lifestyle Medicine, who reminds us:

“We know all we need to know to reduce the major killers in our culture by 80%. We don’t need more fancy drugs, or machines, or more Nobel prizes. We know all we need to know right now.”

Part of that knowing is proactively taking advantage of available testing technology.

What’s your proactive health plan? If you have a story like Paul’s, let us know. We’d like to talk with you about it. Email us at gary@makeagingwork.com or leave a comment below.

What do you call a person aged between 70 and 79? (Please don’t call them OLD!)

Technically, we are called septuagenarians. That’s too big a word for most to memorize and use, so most people (under 70) just call us “old” or “over the hill” or “irrelevant” or “geezers” or yada, yada, yada.

We seem to have a need to put ourselves in categories. A century-and-a-half ago, we had two age categories – child and adult. When you started working the farm, you transitioned to adult and stayed there.

Then creative social scientists/engineers and clever marketers came up with age categories with the first one being “adolescence” which was the brainchild, in 1904, of psychologist and educator G. Stanley Hall.

From there we’ve progressed to as many as seven “age portals”: newborn, infancy, childhood, adolescence, young adult, middle age, and old age, each bringing with it a cadre of exploitive marketers and continued employment for an oversupply of psychologists.

This portal list has received even further refinement and deeper categorization, including the old age category. My favorite, as a late-stage septuagenarian, comes from the late, great author and executive career coach, Ms. Helen Harkness, Ph.D., who died in March this year as a nonagenarian just shy of her 93rd birthday.

Here it is:

  • Young adulthood: 20-40
  • First midlife: 40-60
  • Second midlife: 60-80
  • Young old: 80-90
  • Elderly: 90 and above
  • Old-old: 2-3 years to live

It feels good and right to still be in the “second midlife” category. Come March, I step into the Young Old category.

But that still feels good. It fits for where I feel I am mentally, physically.

It’s really all about mindset.

We’ve created one mental category (old) and a pivot point to irrelevancy by clinging to the irrelevant, illogical artificial finish line of 65 established by the government and the traditional retirement community.

That’s unfortunate because it’s a mindset that takes us to the wrong side of the mental and biological ledger.

Think old = act old.

No, brain deterioration and senescence are not automatic. We can add neurons and build lots of new synaptic connections for as long as we choose.

No, extended morbidity and early frailty are not our destinies. We can “die young, as late as possible” if we understand our biology and neurology and do the simple things they require to hang in and support us.

No, this is not new information. We’ve known these things like forever – and ignored them just as long.

D-A-R-E

I can’t avoid coming back to Dr. Walter Bortz’s simple formula for longevity from his book “Dare to Be 100”:

D=Diet

A=Attitude

R=Rejuvenation/renewal/learning

E=Exercise

While it’s a pretty simple equation, don’t be fooled into believing it’s easy, especially the “A” part. It’s the toughest because the other three don’t get enacted unless the “A” is in place and working.

As Dr. Bortz says:

“D-R-E are biological compass points for aiming for 100, but A – attitude – is most important. Within attitude lie all the planning and decision-making that facilitate the biological steps. It is possible to reach 100 by chance, but it’s not likely.”

With rare exceptions, we were given a vehicle that should carry us to yet another category – centenarian. As Dr. Bortz points out, there is no biological reason that we all should not live to 100 or beyond.

Alas, we’ve gotten really good at disproving Dr. Bortz’s claim with our self-care naivete and resulting lifestyle choices despite having the antidotes to frailty and early death staring us in the face.

Kickass Centenarian

Yeah, it’s a personal goal. It’s a repulsive thought to most and has squashed a few dinner conversations.

Why shoot for 100+?

Because I can.

Because I might just get there. I have self-care awareness and the awareness that the human body can last 122+ years.

So what if I fall a few years short, like Dr. Harkness. Better than just hitting the current average U.S.male lifespan of 78.5 years.

The criminal part of accepting “old” early is that an ailing culture is deprived of the wisdom, talents and accumulated skills and experiences that a septuagenarian can bring to the table to make a difference.

There’s lots of life to live in Ms. Harkness’s last four categories. She proved it, as are more and more septo’s, octo’s, and nona’s.

Feel free to call me a septo or an octo – please, just don’t call me old.