Men Over 60: Don't Quit Now!
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About this ebook
“Dr. Dorsen offers an antidote to time and a commitment to daily respect for your body and mind. With insight and clarity, he encourages us to make health a daily habit.”
- David Feldshuh, M.D., Ph.D., Pulitzer nominee for Miss Ever Boys’ based on the Tuskegee Study, professor of theater at Cornell University, and practicing emergency room physician.
“If we are going to help make a healthy world it is essential that men become kind and soft and step down from the altar of power. These things were not spoken in medical school maybe because most all the teachers were male, and psychiatry did not address the unhealthy features of the male personality. Thank you, Peter, for showing the possibility for a healthier world, making healthier men.”
- Patch Adams, M.D., a physician, comedian, social activist, clown, and founder of the Gesundheit! Institute, “Patch” is the author of the film,” Patch Adams” (1998), “Bringing Good Health to You” (1998), and “House Calls”(1998).
“Men Over 60: Don’t Quit Now! supplies helpful information for men in their senior years who want to stay active and healthy. To share this type of information with senior men is an admired goal of Dr. Dorsen and myself. I recommend Dr. Dorsen’s sequel to Dr. D’s Handbook as a helpful guide to anyone interested in this age group.”
- Barry Mink, M.D. was catcher for the Cincinnati Reds out of high school with 40 years as a practicing internal and sports medicine at the Aspen Clinic. Dr. Mink has been the team physician for the US Biathlon Team and Nordic team physician at both the 1980 and 1994 Winter Olympics.
“I came to this book for the information, but I stayed for the inspiration. There is lots of new information, even for an experienced physician. But more importantly, this book offers the inspiration to implement a healthy lifestyle as we pass from our 60s and beyond.”
- Edward Feinberg, M.D., MPH, chairman emeritus department of ophthalmology; faculty retina-vitreous service.
Peter J. Dorsen, M.D.
Dr. Peter Dorsen was educated at Dartmouth College, Cum Laude in classics, and the Rutgers New Jersey Medical School (Newark). He has practiced general internal and sports medicine for over three decades. As a Fellow in the American College of Sports Medicine, he has served at the US Olympic and Paralympic Training Center in Colorado Springs and worked as a physician with the U.S. Cross Country Ski Team. He has written over 300 human interest juried articles, and contributed to several books relating to men’s issues. He is the author of the Vikings Change the Play Against Alcohol and Other Dangerous Drugs, Dr. D’s Handbook: Health, Fitness, Living, and Loving in the Prime of Life for Men Over 40: A Guide to Health, Fitness, Living and Loving in the Prime of Life, Crazy Doctor: Mixing Drugs and Mental Illness, and Up from the Ashes: One Doc’s Struggle with Drugs and Mental Illness. More recently, Dr. Dorsen has been a licensed alcohol and drug counsellor. He has spoken on many sports medicine, alcohol and mental health topics at US and world cross-country and chemical health forums. He currently cross-country ski races at national and international masters cross-country skiing races and currently takes the podium for age-related wins. He prides himself on his vegetarian cooking, carpentry and gardening. He lives in Eagan, Minnesota with his partner, Nada, and their Standard Phantom poodle, Willow.
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Men Over 60 - Peter J. Dorsen, M.D.
Men Over 60: Don’t Quit Now!
Peter J. Dorsen, M.D.
Austin Macauley Publishers
Men Over 60: Don’t Quit Now!
Dedication
Copyright Information ©
Endorsements
Acknowledgements
Foreword
Prologue
Chapter 1: Fear of Dying
Chapter 2: Physical Changes of Men Over 60
Chapter 3: Cognition and Brain Function
Chapter 4: Balance, Posture and Locomotion
Chapter 5: Speed and Reaction Time
Chapter 6: Retirement—Good News or Bad News
Chapter 7: Spirituality—Where Is God When We Need Him by Reverend Brewster Budge
Gere
Chapter 8: Invincibility Versus Invisibility
Chapter 9: Sex Is Not a Dirty Word Over 60
Chapter 10: Loss and Mood Changes Over 60
Chapter 11: Stretching
Chapter 12: The Strength Training Mantra
Chapter 13: Aerobic Exercise
Chapter 14: An Ounce of Prevention When, Where, How
Chapter 15: Training Options
Chapter 16: Nutrition—You Are What You Eat
Chapter 17: Medical Illnesses of Men Over 60
Epilogue
Appendix 1: Calculating Life Expectancy
Appendix 2: Calculating Life Stress
Appendix 3: Dietary Diversity List
Appendix 4: Depression Indicators
Appendix 5: Ways to Prevent Neck Pain and Cervical Kyphosis of Aging
References
Bibliography
Glossary
About the Author
Dedication
For Kata, Gabi, Bria, Nada, and my beloved parents and grandparents
Copyright Information ©
Peter J. Dorsen, M.D. 2023
The right of Peter J. Dorsen, M.D. to be identified as author of this work has been asserted by the author in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the publishers.
Any person who commits any unauthorised act in relation to this publication may be liable to criminal prosecution and civil claims for damages.
The medical information in this book is not advice and should not be treated as such. Do not substitute this information for the medical advice of physicians. The information is general and intended to better inform readers of their health care. Always consult your doctor for your individual needs. Portions of Men Over 60 have appeared in XC World Digest.
A CIP catalogue record for this title is available from the British Library.
Cover illustration, Resolve by Brant Kingman. Photography for the Stretching and Strength Chapters by Odd Osland. Author cover photograph by Scott Kassenoff.
ISBN 9781398464667 (Paperback)
ISBN 9781398464674 (ePub e-book)
www.austinmacauley.com
First Published 2022
Austin Macauley Publishers Ltd®
1 Canada Square
Canary Wharf
London
E14 5AA
20231003
Endorsements
Dr. Dorsen offers an antidote to time and a commitment to daily respect for your body and mind. With insight and clarity, he encourages us to make health a daily habit.
"Men Over 60: Don’t Quit Now! merges practical advice, inspiration, and humor in a lively read. Dr. Dorsen’s medical knowledge and willingness to report on the ups and downs of his own over-60 body are unique. The book bolsters confidence, shows paths to a fulfilling later life, and provides guidance for sexual resurgence."
The ever-inquisitive Dorsen is the optimal age to write this book based on the program for success in his xc skiing. He’s old enough to have experienced the slow development of xc in the US during the ’50s, ’60s and ’70s and old enough to witness all the advancements in the available information for maintaining what I call a good lifestyle. Plenty of good tips here.
"Men Over 60: Don’t Quit Now! supplies helpful information for men in their senior years who want to stay active and healthy. To share this type of information with senior men is a similar goal of Dr. Dorsen and myself. I recommend Dr. Dorsen’s sequel to Dr. D’s Handbook as a helpful guide to anyone interested in this age group."
"This is the best book I have read on how men can stay healthy and happy well into their 60s, 70s, and 80s. It is healthy and holy, all root words of holistic. Men Over 60: Don’t Quit Now! advises how to stay healthy and happy in each of these domains and THRIVE in our later years of life."
"Members of the USA cross-country master’s association American XC Skiers enjoy the combination of witty prose and interesting science provided by Men Over 60: Don’t Quit Now! Dr. Dorsen offers the right blend of facts and fun, plus a sprinkling of motivation to keep both athletes and non-athletes in the best third of life. Most important of all—not quitting!"
"In his comprehensive new book, Men over 60: Don’t Quit Now! Dr. Peter Dorsen addresses the challenges of aging from two interconnected perspectives – that of a medical doctor, and that of a life-long competitive athlete.
As a physician, Dr. Dorsen has seen in many of his patients the negative impacts of coronary heart disease, smoking, lack of exercise, poor nutrition, and even a lack of self-worth, the latter brought on by retirement. At the same time, Dr. Dorsen has been able to confront and delay these age-related challenges in his own life through his enthusiastic participation in strenuous, outdoor exercise (cross-country skiing, cycling, distance hiking), a nutritious diet and the cultivation of a positive mental outlook."
"Thank you, Peter, for showing the possibility for a healthier world, making healthier men. In Men Over 60: Don’t Quit Now! Dr. Dorsen provides the keys for all of us older Americans to improve the quality of whatever time we have remaining by enjoying physically active, productive, and fulfilling lives."
"I came to this book for the information, but I stayed for the inspiration. Men Over 60: Don’t Quit Now! offers the inspiration to implement a healthy lifestyle as we pass into our 70s and 80s."
Acknowledgements
Those who helped me continue as a writer include my brilliant academic and eclectic cousins, David Dorsen, and half-a-century mentor, professor and civil libertarian, Norman Dorsen, who, despite his incomparable erudition, accepted my New Journalism style. Jody Nolen, bless her self-destructive soul, the brilliant daughter of Dr. Bill Nolen (The Making of a Surgeon) was my first writing teacher who pushed me over the edge.
Minneapolis Star Tribune feature writer, Ralph Thornton, who covered such minority sports as cross-country skiing and horse racing at Canterbury Downs, Minnesota, who took me under his wing but, sadly, went down in a split second with cancer.
Retired University of Minnesota journalism professor, Herman Sittard, was my second writing mentor, who wisely told me, I’d flunk anyone with a grammar or spelling error.
I wish I’d listened. Dave Paulsen was there to welcome me back to cross-country ski racing when I needed it most. John Kelso, Larry Geiger, Johnny Morton, and Patch Adams stood tall and supported our mutual adventure of aging.
I learned how to spell complementary medicine from the wonderfully accepting holistic medicine guru, Dr. Bill Manahan, who always provided honest and supportive analyses that would serve to validate this book.
There were those who read and gave solid endorsements for my exploration of fellow men over 60. They include Peter Cleeves, Johnny Morton, Johnny, Caldwell, ophthalmologist, Professor Dr. Edward Feinberg, Olympic physician and internist, Dr. Barry Mink, Cornell drama professor and ER MD, Dr. David Feldshuh, who wrote Miss Evers’ Boys, Dr. Patch Adams, and fellow medical School co-conspirator, Dr. Daniel Tartaglia, who, with Dr. Karen O’Neill, my New Jersey and Baltimore City Hospital comrades, were joyous participants in the social revolution of American medicine in the early seventies. I am indebted to those who generously supported my book: minyan mate, Ron Metz; Bend Oregon fellow ski racer, Len Sherr; Norwegian ski ace, Arvid Krogsveen; massage therapist to Olympians, Steve Carmazon; my MG Midget go-to guy and friend, Brad Larson; Karen Hoffrogge; and Dr. Stephen Zuckerman, the Roger Dangerfield of internists.
My dearest ski compadre, Odd Osland, systematically and unselfishly took masterly pictures for the stretching and strength chapters that are enhanced by one-time body builder, power lifter, and Colorado champion downhill skier, Doug Hagerty. My dear new son-in-law, cinematographer, Scott Kassenoff, magically created my photo for the book. He brought me Koa Blu Kassenoff, my adorable new grandson. The amazing sculptor and visual artist, Brant Kingman, has again provided Resolve, the book cover image.
Dan Emerson, my long-time editor from early writing days for Minnesota Physician, unselfishly read and reread versions of this book. The late Dr. Art Leon took me under his wing for a mid-career sports medicine fellowship and an opportunity to participate in unique research. I am indebted to his foreword and continual support as the book progressed. It was my honor also to have support in many ways from the eclectic Dr. Henry Blackburn, New Orleans jazz aficionado and world-renowned epidemiologist.
My thoughts are always for my artistic three daughters, Bria Danielle Dorsen, Gabriella Nicole Kassenoff, and Katarina Marica Dorsen, and blessed with grandsons, Indio from Kata
and Joey Medina, Koa Blu Kassenoff, from Gabi,
and my beloved new son-in-law, Scott.
Faruk Abuzzahab, M.D., PhD, world-renowned psychopharmacologist has been my guide as well as introducing me to his lovely daughter, Nada Josephine Abuzzahab, the love of my life. My big thanks to dear friend, Louis Maravelas, of Make America Greek Again
fame, and his bookish love, Mary Jo Pauly. He reluctantly sold me my greatest (other) passion, a ’79 MG Midget, that has helped me escape the pressures from writing Men Over 60.
I can’t forget to thank Dr. Kip Minaert, my Dartmouth soul brother, with whom I underwent dangerous but memorable ill-advised thrills and chills. I have had joy with my Duluth family, Mike Mancini, Amanda, and the now-deceased Paul Maire.
Additional family members have always been in the wings: Annie Nye and her daughter, Judy Nye; ‘Ancha Ancha;’ and Sanyi and Susy Gross, who always provided love and understanding. I salute Dr. Seymour Lifshutz—the best internist I have ever known—and his artist wife, Phylis, who supported my writing over the years. I salute uncles and aunts, Rhoda and Allan Labowitz, Uncle Bob and Rita Dorsen, their daughter, cousin Nan Dorsen, and especially, my beloved Dr. Howard Happy
and Verna Adler.
But how could I ever forget my dear parents, Dr. Lydia, and Buddy
as well as incomparable grandparents, Anuka and Popuka Adler.
Thank you to Austin Macauley for superb rendering of the cover for Men Over 60: Don’t Quit Now!
"We don’t stop playing because we grow old.
We grow old because we stop playing."
– George Bernard Shaw
Foreword
Arthur Leon, M.D., M.S.
Henry L. Taylor Professor in Exercise Science and Health Enhancement School of Kinesiology, the University of Minnesota
And ought to know that from nothing else but thence came joys, delights, laughter, sports, sorrows, griefs, despondency, and lamentations. And by this, in an especial manner, we acquire wisdom and knowledge, and see and hear, and know what are foul and what are fair, what are bad, and what are good, what are sweet, and what unsavory…and by the same organ, we become mad and delirious, and fears and terrors assail us.
Hippocrates (460–370 BC)
Doctor Dorsen’s Men Over 60: Don’t Quit Now! is an apt sequel to Dr. D’s Handbook for Men Over 40: A Guide to Health, Fitness, Living, and Loving in the Prime of Life.
I recommend this well-written book to help middle-aged and older men (and women too!) maintain or, better yet, improve their health, physical fitness and, hence, quality of life during the aging process.
The author, Dr. Peter Dorsen, a clinical practitioner as well as alcohol and drug counsellor, and a well-published medical writer, applies his skills to crafting Men Over 60: Don’t Quit Now! as a follow-up to his earlier work, Dr. D’s Handbook for Men Over 40: A Guide to Health, Fitness, Living, and Loving in the Prime of Life, that targeted men over age forty.
Reinforcing the relevance of this book is of the direction in which our society is maturing. The number of persons older than 60 is expected to double from 2010 to 2050, increasing from 40.2 million to an estimated 88.5 million. One wonders how this senior age explosion will affect the work force, the economy, and the health care system.
This book provides American Heart Association’s Guidelines for a heart healthy eating pattern to the featured chapter, ‘Nutrition: you are what you eat.’
He advises, Let’s get going and provides vital suggestions for staying in shape.
This book provides an extensive description of stretching exercises for maintaining or improving whole-body muscular flexibility. Detailed guidelines are also provided of exercises for promotion of muscular strength and cardiorespiratory fitness (CRF).
For the most efficient methods for both CRF and strength training, the author, himself a competitive athlete, recommends a circuit training program in the gym consisting of rotating between 6 to 10 machine stations for 40 to 60 minutes 3 to 5 times per week at an exercise intensity of 65% to 75% of a person’s maximal heart rate which may be approximated by 220-age.
Physical activity and especially aerobic exercise of sufficient intensity and volume to increase aerobic fitness as assessed by peak V02 uptake assessed by exercise testing, has been referred to by Fiiuzza et al., as the real ‘Polypill’.
This is based on the documented benefits of 150–180 minutes per week of even moderate-intensity aerobic activity in reducing risk of multiple major problems associated with aging, including cardiovascular disease (CVD), type 2 diabetes, colon and breast cancer, as well as all-cause mortality.
Aerobic exercise, as he describes, has well-documented beneficial cardiovascular effect, which can improve cerebral blood flow. This includes reduction of major risk factors for atherosclerosis, obesity, dyslipidemia, hypertension, insulin resistance, metabolic syndrome, and type 2 diabetes. It also has direct anti-atherosclerotic effects, including improving vascular endothelial function. Regular exercise can also preserve and restore the elasticity of major conduit arteries during aging.
Research, mainly observational, has identified modifiable medical conditions and lifestyle factors that can enhance and maintain cognitive capacity and reserve by lifelong learning and intellectual activities. Healthy dietary practices combined with regular physical activity can reduce the risk of CVD and for their positive effect on brain function and its blood supply.
Awareness and management of psychosocial problems as identified by the author in his chapters about retirement, spirituality, lack of identity, modifiable stressors, and personal losses implicit with aging, are relevant for adaptation to the inevitable process of aging. Muscle strengthening, maintaining flexibility, and posture-promoting exercise – as covered in several chapters in Men Over 60—may stabilize deleterious effects on the aging process, and improve awareness and avoidance of balance, gait, muscle spontaneity, and speed. But, of tantamount importance, reduce the risk and consequences of cognitively avoidable falls and traumatic brain injury (TBI).
Doctor Dorsen, from his medical perspective, outlines how important CVD risk factor such as lipid problems, hypertension, diabetes, obesity or smoking not controlled by diet, and regular physical activity can be successfully managed with pharmacologic interventions.
In summary, this easy-to-read, meaty book provides concise healthy guidelines for helping attenuate the detrimental effects of aging on physical fitness and for the prevention of common chronic diseases associated with aging.
Prologue
The secret of health for both mind and body is not to mourn the past, worry about the future or anticipate trouble, but to live in the present moment wisely and earnestly.
– Buddha
I am writing a handbook for men who are of retirement age. Why does society expect us to dry up and blow away? Like me, some of my friends go kicking and struggling accepting the inevitable milestone of 60. It is like it snuck up on us. The years from our forties raced by. As health care has offered longevity, today’s 60s and beyond are the 40s and 50s of twenty years ago.
Four years back, at 70, during my 310-mile solo month-and-a-half hike over the Superior Hiking Trail along Lake Superior—never one to believe in a hereafter—I thought, Wow!
I realized there had to be a higher force alerting me that if I were not more alert to danger, I would die. So, I got right to it and watched where I put my next step. At last, I now understood that I was not God or the center of the Universe but a miniscule dot on its perimeter.
Socialization is essential. There is no more fun for me—loads of other cross- country ski maniacs around me—than when the starting gun goes off. Except if the police are chasing me. As we exercise and just exult in being alive, we are all role models for each other or others.
It is hell to grow old but the alternative sucks. I want to grow older younger. It is crucial to stay vital. Hang out with young people. Do not retire unless you must. I can never comprehend why people count the days until retirement and, when they do so, dry up and blow away. More about that later. Make plans. Rediscover yourself but be mindful of realistic challenges as I lay them out. I am a notoriously lousy driver. I do not like driving and am not particularly good or safe at it. I will not drive a yellow bus at seven in the morning with wild and crazy tired (from texting their friends all night) teenagers. I will not deliver parts for Napa.
Growing older than 60 was always something that happened to someone else. The grey or no hair, the paunch (men spread out like apples, women like pears), was a giveaway. Now, I am 78. I am motivated by the fact that I refuse to act my age and would like to convey this life attitude. If I check out Sunday’s obits, I do not check the ages of those unfortunate to have passed on. We have optimistic expectations for how long we will live. Actuarial tables that are based on my lifestyle and the parents I did not choose, reveal that I am likely to live to 94.
It is realistic to accept that we have limited earth time. Again, I accept that there is a mystical force—not saving me—but reminding me that if I’m not careful, I’m going to die sooner than scheduled. I comfort myself that I have predetermined my body will go to The University of Minnesota School of Medicine. I hope aspiring doctors do not giggle over my body as I did over Ethyl, my designated medical school cadaver. She did not look great after we were done. She did not look great when we started.
Men Over 60 is not necessarily a self-improvement book alone. My wish is that it be entertaining as well as enlightening. I want to explain the feelings we all have about that final Uber ride to the great beyond. How can we accept what we do not know or understand? Rather than obsessing about where we go next, avoid negative thoughts, maximize health, and grow older younger.
As I did in my earlier book, addressing men’s challenges at 40, I spice most chapters about men over 60 who although knowing the importance of acknowledging the grim reaper, must also move on. This book is meant to pick up where Dr. D’s Handbook for Men Over 40 left off but with new concerns. This book is not about denial. It does not advise temperance, quitting or neurosing. Men Over 60: Don’t Quit Now! offers solid advice about what to expect hurdling past 60, all the while accepting the next challenge of our lives, and not quitting despite the inevitable.
JAMA, the esteemed medical journal, reminds us that, The number of persons older than 60 is expected to double from 2010 to 2050, increasing from 40.2 million to an estimated 88.5 million.
Such statistics warn of the negative impact of an increasing elderly population on the work force. What will be the cost to the health care system?
Fellow athlete, Roy Carlsted, whom I profiled in Dr. D’s Handbook, was still out on the ski trail at 90 plus. An electrician, he had been retired for decades. Since last I wrote about Roy, he had lost his wife of many years to cancer and, unlike most men our ilk who are not equipped to cook or clean as their spouses once did for them, Roy thrives as a bachelor. Outwardly, he would say he was comfortable with his life but missed his wife. There are other downsides for a ninety plus despite he has stayed wonderfully active. His daughter confided, Roy can be forgetful, especially finding his way on a several hours drive north to our lake home.
Last time I skied with him, it was a sunny, cold, Minnesota winter day. It was 20 years since we had skied together on a backwoods trail. He had all the life and juice of a man 20 years his junior. Roy remains an example of the benefits of a vigorous life. The guy was an Eveready battery. If he was not skiing, he would have been on his road bike. It is difficult to believe that Roy had had a quadruple bypass 10 years back. Alas, Roy elected not to do ski marathons any longer.
A long-lost friend from my Dartmouth days, the esteemed Reverend Brewster ‘Budge’ Gere, who has written the spirituality chapter for the book, quotes Ecclesiastes to help us enter this later chapter of our lives. His perspective about how important it is to find spiritual meaning over 60, convinced me to journey back for my 50th college reunion. That decision runs counter to why I had not returned since my 25th, arrogantly claiming that I don’t attend reunions because I don’t want to be around old people.
We need not see ourselves as either conquerors or the vanquished. Cooperation, harmony, tranquility, peacefulness, and serenity can become our new companions, filling our hearts with positive thoughts, freeing our minds to focus on important matters, saving our energy for living life fully and appreciating each day as never before.
– Reverend Brewster ‘Budge’ Gere
Chapter 1
Fear of Dying
I have pride that I have the strength that puts me in the top 1% of fitness in the over-70 set. Men Over 60: Don’t Quit Now! can allay fear of dropping dead from a sudden infarct or a killing arrhythmia. This chapter explains why, with consistent exercise, our maximal heart rate drops, and why we should still screen for narrowed coronaries. Progressive decrease in muscle mass and strength starts in our 30s. Aging men still have great endurance but at a slower pace. Marathoners who have done 100s of long races, can develop enlarged hearts, and atrial fibrillation accompanied by congestive heart failure. When the latter happens, cardiac output deteriorates when conduction circuits may become disrupted.
Man cannot possess anything as long as he fears death. But to him who does not fear death, everything belongs. If there is no suffering, man would not know his limits, would not know himself.
– Leo Tolstoy
I suggest we refute ageism. Society wants to believe we should ‘take it easy’, or ‘act your age’. There’s no fool like an old fool.
I encountered family hysteria as I embarked on my 310-mile mid-May through mid-to-late June solo ‘through’ hike on The Superior Hiking Trail from Duluth, Minnesota to Canada. Dad, come back, please come back,
was how my eldest daughter reacted.
Key words for such an experience starting in northern Minnesota mid-May: cold, tough hills, mud, no sign of humanity and horizontal rain. Mid-June brought mosquitos. I did not quit. I did not bail. I thought about quitting my trek constantly, especially when I was soaked through and near hypothermia. I realized before long that there was some mysterious force not about to save me but rather, to send me a message that if I kept being such a dumb shit, I could die. More about that later.
Research shows that those of us over 60 think and fret about death and dying less than men in their 40s. Every day as I look into the mirror, it reminds me I am not going to be the first man to score at the local bar. Even worse, as a Gray Panther, I find myself being called ‘Sir’. Are we invisible or have we just become superfluous? Gone are Greek and Roman times when