Tag: Risk

Health, Motivation

All-Cause Mortality Rates

“Milk is for babies. When you grow up you have to drink beer.”

― Arnold Schwarzenegger

Have I mentioned that I hate the gym? I’ve never liked it. It’s always been something that I half-heartedly do because I know I should. Some years I’m better at it than others, but it’s never been a real habit. I’ve been more diligent the last six months because I started seeing changes in my balance and coordination. But lately I’ve been slacking off due to my reoccurring stomach issues. It’s hard to be motivated to go lift heavy stuff when your stomach is all queasy. But yesterday I watched something that (hopefully) changed my mindset forever.

I stumbled on several podcasts by Dr Peter Attia and Layne Norton. They discuss many topics, but one of them was all-cause mortality and hazard ratios – the likelihood of you dying of something. A study was done of 122,000 people with an average age of 53. The study did a Vo2 max test on the subjects and ranked them into five categories – Low, Below Average, Above Average, High, Elite. The study then correlated mortality rates to the Vo2 rankings. The results shocked me.

Just improving from the Low category to Below Average was a 50% reduction in mortality over a decade. Improve to one more category, Above Average, resulted in a nearly 70% reduction in mortality! Being in the lowest category of Vo2 max carries a higher risk of mortality than coronary artery disease, high blood pressure, and diabetes. Wow.

I’m sure I always kinda knew that having a great cardiovascular system would be a good thing as you got older. But then they followed up with a very similar look at the correlation of lean muscle mass and mortality. Past age 70, the hazard ratio of having very little lean muscle mass is greater than smoking! It turns out falls are the greatest cause of accidental death in the last decades of life. As a nurse, I can attest to this. A fall resulting in a broken hip is a near certain death sentence within 6 months to a year amongst the elderly.

So, in a nutshell being weak, fat, and having low Vo2 max is a near guarantee of an early death.

Seeing this was enough for me. I dragged my queasy-ass stomach to the gym and picked up a bunch of heavy shit for an hour. And I’m going to do it again today. And I’m going to start maximizing my Zone 2 training. One of the things that was said in the podcast is that past age 60-65 you’re realistically not going to gain muscle. The best you can hope for is to maintain what you have. So in the decade before that your goal should be to pack on as much lean muscle mass as possible.

I’ve missed out on much of that window to build muscle and strength due to general sloth and love of nachos. But it’s not too late. Every single percentage gain in lean muscle mass I can make in the next few years is an additional hedge against that hazard ratio. It finally sunk in.

Every single day of doing nothing, sitting, not moving, watching TV, gaining weight – is subtracting a day from the other end.

Think about that. Is skipping being active today because you don’t feel like it, worth dying one day earlier? I calculated out, based upon living to age 85, how many weeks I have left. About 1,600. That’s not very much when you think about it that way. It’s time to maximize those weeks to ensure I have as many as possible.

Let’s roll.

Government, Health

Crossing The Minefield

Because I have some time on my hands, and I’ve got my tinfoil hat shaped just right, I’m going to add an update to my previous (poorly worded) post on leaky vaccines. This one is about risk assessment. I think we’d all agree that each individual should be able to make an informed decision about the risks of getting or not getting the vaccine or booster. In a perfect world we’d see all the pros/cons and decide what’s right for your particular scenario. But what if you weren’t told all the info?

(adjusts hat) Ok, here we go. It’s starting to look like after your first dose of the mRNA vaccine you go through a roughly two week window of a highly immune suppressed state. The reasons why are not clear yet. The most likely cause seems to be that the mRNA vaccine has to turn off the toll-like receptors so the vaccine can enter the cells without being attacked by the immune system. Other options are a fall in lymphocytes and neutrophils that are seen three days post vaccine. Regardless of cause, it appears likely that you are in a highly immune compromised state for several weeks after your first dose. This does not happen after the second dose.

The impact of this is a significantly increased death rate post first dose. This was seen clearly in the Israel data and now in the Palestinian data since they are just now getting their first doses. Going back to Israel, we see the same corresponding rise in death rate following the booster.

Just to be clear, people are NOT dying from the vaccine. They appear to be briefly in a highly immune compromised state and then get covid or a cancer spreads, etc…

So to steal a brilliant analogy – we have some percentage risk by not taking the vaccine, based upon our age, comorbidities, fitness, etc… We can mitigate some of that risk by taking the vaccine, but in order to do that we have to first cross a minefield. You’d probably want to know what are the odds of stepping on a mine, right? Well, the first study on this shows a 46% increase in suspected covid during that two week period. Even the Pfizer data itself shows a 40% increase.

Don’t you think it would have been good to know that you’d briefly have a nearly 50% increased chance of getting covid and massively increased odds of being hospitalized for several weeks after getting your vaccine? The tradeoff for running across the minefield is a vaccine that is eventually 56% effective (not the 95% we were sold).

Again, I’m not arguing that you shouldn’t get the vax. I think most folks 50 and older, or folks with comorbidities should. BUT, don’t you think folks should have been advised that for 2-3 weeks post first dose you need to self isolate as much as possible to reduce the risk of getting covid? I blissfully went back to work after my first dose, including working the covid floor! And why in gods name would we be pushing the vaccines during peaking cases? From a big picture, public health standpoint, you’d want to be vaccinating during lulls in case rates.

Which brings me back to the previous post. What if we’ve created a bunch of vaccinated asymptomatic superspreaders who are inadvertently causing a spike in case rates? And then in response we push/mandate vaccinations and start boosters. We just potentially put millions of people into that two week risk window with covid on the increase and superspreaders walking around… The hospitalization and death rates will be interesting follow this winter.

Come to think of it, my tinfoil hat is feeling a little snug. Time to take it off and go do something productive outside.

Daily Life, Motivation, Travel

What’s Your Risk Tolerance?
  • I just got back from a four day road trip on the ginormous motorcycle. It was a fantastic trip with a couple of “bucket list” rides. I mentioned in my last post that I almost cancelled due to a threat of inclement weather. Sure enough, day one I got caught in a pretty severe rain and hailstorm. Let’s just say that large hail at 60 mph on a motorcycle hurts! The important part is that I survived and it wasn’t nearly as scary as I’d built it up to be in my head. I rode a few other sections that were high speed highway (70 and 80 mph speed limits) with plenty of large semi’s and some high winds. Serious white knuckle time in the beginning, but I wasn’t thinking about it much towards the end of the day. The point is that the unknown is scary and it’s easy to let that fear get the better of you when try to visualize what it’s going to be like. I guarantee that most of the time reality will prove to be nothing like the horrible scenarios you let run away in your imagination.
  • Which leads me to my question on risk tolerance. Pushing through fear is all well and good, but you still need to do a reasonable risk assessment of the situation. A brand new motorcycle rider attempting a busy freeway on his first day is stupid. The lack of skill makes the risk factor way too high. So how do you evaluate risk? When it comes to hiking, backpacking, mountain biking, I have a reasonable amount of life experience. I’m an RN, was a member of a search and rescue team for years, comfortable with navigation, and feel pretty comfortable with knowing my physical limits. My risk tolerance for hiking in the backcountry is pretty high. Barring serious injury, I’m not terribly worried about surviving a few days if something went wrong. I’m reasonably confident I could put myself in a position to be found or self-rescue. More importantly, I feel like I’m less likely to put myself in a bad position in the first place. Most of our rescues on the SAR team were for people who had no idea they were even putting themselves at risk until it was too late.
  • Which brings me back to the ginormous motorcycle. I have many years of riding experience. Unfortunately most of it was simply commuting back and forth to work. The long road trips are new to me, but I feel like I still have enough overall street experience in those scenarios to make good risk assessments. But what I really want to do is spend more time riding in the backcountry. I have no dirt experience. At what point, when riding by myself, am I being stupid? Most of my fears revolve around being stranded. A crash or other mechanical issue that disables the bike. Dropping the bike and not being able to pick it up. A navigation error and running out of fuel or getting into a scenario I’m not capable of riding. Now what? With the motorcycle it’s easy to go distances beyond a simple hike out.
  • So, do I not go out by myself? Do I simply start slowly and go a little further each time? Do I spend days beforehand making a battle plan with every possible scenario for each ride? At some point that’s no longer fun. On one hand, what’s the worst that could happen? Again, assuming no serious injury, the bike breaks down and I’m stuck. A few days of hiking or until someone finds me. While it would suck, very survivable. It’s extremely rare that someone goes missing and perishes before being found. But that’s not a fair burden to put on loved ones waiting at home, thinking the worst.
  • At what point are you being so cautious you’re limiting activities due to fear of the unknown? At what point are you placing yourself needlessly at risk because you failed to adequately prepare and didn’t recognize that you were in over your head? For me I think the answer will be to go slow and over-prepare initially. Of course I’ll seek out more experienced riding partners… but I don’t want to sit at home waiting for that to happen. The other option is to sign up for one of the various riding schools and learn/improve my dirt skills. I suppose I should do that regardless. How do you evaluate risk? Pro’s/con’s on a spreadsheet? Avoid it at all costs? Just do it and whatever happens, happens? I’m honestly curious how others evaluate risk?

Song of the day: Lily Allen | The Fear

Daily Life, Motivation, Travel

I Feel Kinda Guilty
  • Our hospital is in the midst of a horrible staffing shortage. Every day I receive texts from unit supervisors pleading for folks to come in because the floor is short staffed. They offer overtime, premium pay, Covid pay, any combination of hours you want. I delete the texts immediately. Yesterday, while at work, the floor unit coordinator came to me and asked if there was any way I could work tomorrow? I actually would have said yes, but I’m leaving on a trip today on the ginormous motorcycle. I felt a little bad telling her no, but I did have a legitimate reason. Later that night I got an SOS text message from the hospital. They were so short staffed, patients were being treated in ambulances parked in the emergency room bays because there were no beds or staff available to bring them into the hospital. Supervisors were pleading for anyone available to come into work. I felt pretty guilty after reading that. My coworkers are going to have a horrible shitshow of a day today and I’ll be off playing. I don’t feel bad for the hospital, but I don’t like feeling as if I’ve let my coworkers down.
  • In my previous life as an engineer for mega-corp software company, I fully embraced the do or die for the company attitude. I never took time off. There was always some project that, if we just worked really hard for another few months, we’d deliver to the customer and then everyone can relax and take time off. And then we’d miss that deadline. And another. I had hundreds of hours of accumulated vacation time, never used. It was so bad Mrs Troutdog and I actually bought a time-share in Mexico thinking that at least that will force us to take a vacation once a year. We went quite a few years with that warped sense of priorities. Slowly it began to dawn on me that the corporation doesn’t care about you. Oh sure, they pay lip service to “our employees are our strongest link” and other such happy horseshit. Eventually you realize that you’re just a cog in the wheel. I don’t care how important you think you are to the company, if you leave you’ll be forgotten within the week and someone else will take your place. Work hard, do a good job, but realize that any company exists to make a profit and it’s their job to extract every last ounce of work and time from the employees. You can be replaced at any moment. Take all of your vacation time. Stay at a company only as long as it’s benefiting you. If another opportunity comes up, take it. Life is too short to waste it thinking the corporation actually cares about you. I know that sounds terribly negative. Yes, there are companies out there that treat their employees fantastically. Just don’t lose sight of that fact that you are still just an employee and your life is not work.
  • Today I leave for another multi-day trip on the ginormous motorcycle. And sure enough, all of a sudden the forecast is now calling for strong winds and a chance of thunderstorms this afternoon. My brain immediately thought, oh I should probably cancel and go another time. I have to continually remind myself not to be that guy anymore. Don’t let fears get in the way of experiences. If it rains, then I’ll get a little wet. So what? Am I really going to postpone a trip because conditions may not be perfect? I always thought I was a semi-adventurous person. Looking back, my “adventures” were only well within my comfort zone and with activities and places I knew well. On my own I’d rarely try something new or go someplace completely unknown. The “new” things and adventures I’d do were with friends who were experienced and able to lead and plan the activity. It’s amazing how ingrained worry about the unknown can be if you you’ve spent a lifetime being cautious. So, I’m going to hop on the bike and go. Maybe I’ll get wet and the ride might be miserable. Maybe I won’t find much sightseeing and this will end up being days spent being bored in crappy motels. Maybe the bike will break down and I’ll get stuck on the side of the road with no cell service. All of that may happen. But I’ll never know if I don’t try.
  • The interesting balance that I need to learn to strike is at what point is a “just do it” mentality crossing the line into a stupid risk scenario? This weeks adventure is just a road trip to a handful of smaller towns. Probably a few areas with limited cell coverage. Very little risk, other than being on a motorcycle. The other type of riding I really enjoy is dirt and getting into the backcountry. I did a ride a few days ago where I ventured a ways into the forest. Nothing dramatic, but far enough away from civilization that a breakdown or a crash starts having more potential for bad outcomes. On this ride I still saw a few vehicles and if I had to I could have hiked out pretty easily. But the trips I really want to do are much further in the backcountry. At what point is doing a ride like that by myself becoming too risky? At the moment, those fears of the unknown are overcoming the “just do it” attitude. I suppose time and more experience on the bike will dictate how far I’ll push my risk scenarios.
  • My last trip (which was also my first one) on the ginormous motorcycle went mostly undocumented. Just a few pics from my phone. I didn’t want to deal with cameras, video, or more electronics than necessary. I wanted to concentrate on riding and just absorbing the experience. This time I think I’ll try to make a video. I’m not entirely sure how to go about it. I’m no Ken Burns. Most of my video footage ends up being two hours of nothing but a view of the gas tank because I didn’t realize the camera moved. We’ll see how this goes.

Song of the day: The Big Push – These boots are made for walking’ / Satisfaction / Everybody