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Thread: People don't get this kind of workout stuff

  1. #51
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    • starting strength seminar april 2024
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    Quote Originally Posted by Polishdude20 View Post
    Mind sharing some examples?
    Typical:

    A 58-year old man, smoker, with Type II diabetes mellitus, obesity, and high blood pressure suffers a hemorrhagic stroke. The Sick Aging Phenotype. He is sent to a "Skilled Nursing Facility," where he languishes for two more years, with minimal physical or cognitive rehab. One night he comes to the emergency department with HCAP (Hospital associated community acquired pneumonia), hyperosmolar state, a blood sugar of about 1000, profound dehydration, and sepsis.

    As Billy Mallon has said, the "Skilled Nursing Facility can't even water the plants."

    He has no living will, his family has not executed a DNR order, and the SNF director has decreed him a full code. He has advanced decubitus ulcers, and his sacrum is clearly visible. He has a J-tube for feeding sticking out of his stomach. He has a suprapubic catheter, which is grossly infected, and the tiny bit of urine in his bag is turbid and dark. He is awake and alert and is able to speak somewhat, although he is delirious. He is febrile. He has no peripheral venous access, and requires immediate volume expansion for resuscitation. Because he is a full code, multiple attempts are made at central venous catheterization, but he has scarring in the subclavian space and an ultrasound-guided internal jugular line does not flow well, for reasons that are not clear. He gets two intraosseous lines, one in each lower extremity. In other words, first we jab him a half-dozen times with needles in his arms and hands, then another half-dozen times in his neck and under his collarbone, and then finally we drill holes in his tibias so we can put some goddam fluid in him. He receives 4 L of fluid and a norepi drip before his blood pressure starts to respond. His serum lactate is 8 and his troponin is elevated, suggesting that he has a non-st-segment elevation myocardial infarction (although trop is often nonspecifically elevated in sepsis; cardiology will be consulted anyway). He gets more fluids, big-time IV antibiotics, and an insulin drip. He responds initially, but then his respiratory failure worsens in the ER and repeat CXR shows a "bloom" of his pneumonia and bilateral patchy infiltrates. He is in ARDS. We intubate him and put him on a ventilator. He is admitted to the ICU. Given his recalcitrant lactate, possible MI, and the finding of ARDS, his prognosis is grave, but miraculously, and quite unfortunately, he "survives."

    After 23 hospital days, he is discharged to the same nursing home.

    Designation: Full code.

    Process repeats.

  2. #52
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    Damn...He is/was just a young one. Damn.

  3. #53
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    Dr Sullivan, you could write horror novels. About 5 years ago I sat with a caseworker From our local hospice organization and got their sales pitch. My wife was in the next room resting in her hospital bed. This was in our house. The case worker was giving me her sales pitch about moving my bride to one of their hospitals. To stabilize her. And then she could come home. My wife's oncologist had pursued every possible avenue of treatment. And even Added an additional course when we specifically requested it. Only, when the treatments were tearing her down so much that they became life threatening, did we throw in the towel. So exactly what the fuck does it mean to get a dieing 42 year old woman stabilized? It means they make a shit ton of money for inpatients. They keep them alive as long as possible under the most horrible conditions you can imagine. Because each day of pain bring their bottom line higher. They make money. And the earlier they can get you into their hospital, the more they can make. I did not call the woman a bloodthirsty money grubbing whore. I tried to smile and say that we weren't ready for that. And I took her card and sent her away. A few days later when one of her doctors was teaching me how to drain her lungs he asked about the whole thing and. Told me about a hospice organization run by the catholic hospital who would Provide a daily nurse. They were completely different. Kind. Patient and helpful. And when my wife began to transition the nurse discreetly told me. My wife died at home. The way she wanted to.
    In late 2015 my father was dieing. In the hospital he was visited by many of his buddies whom he had worked with with. Several of them had served with my father in combat around the globe. After one visit. I was walking his old friend out and thanking him. And he looked me in the eye and said " you know the best manner death?" I didn't. " a violent one". I was struck by that. It sounds terrible because we always romanticize the end as slipping away peacefully. I don't know how many people get the peaceful death. But wasting away and suffering ain't peaceful.

    And I want to live another 40 years. But when the end comes I would rather suffer 30 minutes of terror and be eaten by a bear than die in an old folks home.
    Last edited by PizzaDad; 05-16-2017 at 12:31 AM.

  4. #54
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    my dad died in february. a guy who was 6'5" and some 260lbs in his prime was down to oh maybe 140lbs of translucent skin and bones and tubes stick in a multitude of places. fuck that. i'll do whatever i can to avoid that.

  5. #55
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    Quote Originally Posted by Dag View Post
    Quote Originally Posted by Cheesepuff View Post
    Yeah, is this strength program available in "pill form"? (rolls eyes)
    I dont get why anyone would want this. The journey IS the fun. That's the good part - there isn't a finish line. The finish line is when you die.
    You don't get why someone would want the results without doing the work? If there was a (presumably magic) pill that could give me a 500 lb bench, a 600 lb squat, and a 700 lb deadlift, I would take it today. Then I'd find a new hobby with my 15 hours of free time each week. I like lifting, but sometimes I'm lifting because I know the process will get me PRs down the road, not because I'm enjoying the process.

    Quote Originally Posted by Jonathon Sullivan View Post
    I'll die in the saddle, thank you.
    I like how Al Oerter put it - "To die under a squat rack, that's acceptable. To die at a board meeting, that is not."

  6. #56
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    One brother, James, died while running which he loved to do. Witnesses said he was dead before he hit the ground.

    Another brother, Richard, overate and did not exercise. He acquired diabetes and suffered for 20 years before his body finally gave out.

    I definitely prefer the option James took. I haven't run for 20 years but lifting is a pleasure.

  7. #57
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    I helped my wife nurse her great-aunt Dessie as she died in our house. A hospice nurse came every day to help too, and supplied her with the morphine she needed.

    Dessie was thin and hard-working, and lived independently until 3-4 weeks before her death. She was lucid until the last week or so. I miss her.

    I hope to die that well, myself. Lung cancer is agonizingly painful, but at least is relatively quick, not like the very slow death from complications of diabetes.

    Blowing my aorta while deadlifting at age 80 would be even better, of course.

  8. #58
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    Quote Originally Posted by Sean Herbison View Post
    I like how Al Oerter put it - "To die under a squat rack, that's acceptable. To die at a board meeting, that is not."
    Quote Originally Posted by cwd View Post
    Blowing my aorta while deadlifting at age 80 would be even better, of course.
    There was a discussion in Rip's forum about aneurysms last month. Dr Sullivan said,
    This. As far as I'm concerned, aortic aneurysm is an absolute contraindication to barbell training.
    I read this with interest because I had seen that on the list of tests recommended by the US Preventive Services Task Force is screening for abdominal aortic aneurysm for "Men Ages 65 to 75 Years who Have Ever Smoked." They give this test a grade of "B."

    As I smoked off and on until I was 29, I just assumed I would get the screening in four years when I turn 65. But now I know I won't because of the small chance they might find something.

    I would rather collapse under the barbell and die quickly then be told I couldn't train and just have to allow myself to deteriorate.
    Last edited by Culican; 05-16-2017 at 09:19 AM.

  9. #59
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    A story that Heinlein could have written: The Geezer Guerrillas. They take on missions no one else will. Qualifications? Be deadly, tough as nails, and have a terminal disease.

  10. #60
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    starting strength coach development program
    Quote Originally Posted by cwd View Post
    I helped my wife nurse her great-aunt Dessie as she died in our house. A hospice nurse came every day to help too, and supplied her with the morphine she needed.

    Dessie was thin and hard-working, and lived independently until 3-4 weeks before her death. She was lucid until the last week or so. I miss her.

    I hope to die that well, myself. Lung cancer is agonizingly painful, but at least is relatively quick, not like the very slow death from complications of diabetes.

    Blowing my aorta while deadlifting at age 80 would be even better, of course.
    We had the same story with my father-in-law. Moved in with us a little over 2 years ago, at 87. Had been completely independent, and very active, up til then. And that was with heart issues for 25 years (pacemaker, blood thinners, the whole works). He never let any of that slow him down. When he told us he thought he was about done, we contacted a hospice service, who was terrific in helping us care for him. And even then, he was a fighter. He did 15 minutes on his exercise bike just 3 days before he died!

    I set up my home gym in the basement within 2 months of his passing. I'm determined to stay strong and healthy (as much as is in my power to do), for as long as I can. And then? I think I'll go find a bear (h/t to PizzaDad!)

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