Heart Attack at 90: The Hospital Dilemma

At 4 a.m. on an early Friday morning a few days ago, my 90 year-old mom woke up with chest pains. As instructed by her doctor, she took a nitroglycerin pill and waited for relief. After 15 minutes, she took a second nitro pill, and thankfully the pain began to subside. Later I asked her, on a scale of 1 to 10, what level did she estimate the pain to be and her answer was between 8 and 9. Knowing my mom as a stoic German, I knew she wasn't exaggerating and that her pain was pretty extreme.

Three years ago, she had a couple stents put in her heart and the doctors explained to her at that time that she had blockage in another artery, but they weren't able to put a stent in it. They showed her a picture of her heart and she could see exactly where the blockage was and still is. They warned her of the likelihood that she could suffer a heart attack from the remaining blockage. She suspects that is what happened, that she experienced a mild heart attack.

Like many people, particularly elderly people, she is determined not to go to the hospital unless she absolutely has to. She says if the pain became bad enough, she would go, but other than pain management, she knows there is nothing that can be done for her any more. She has literally had heart problems all her life. As a child she used to pass out for no reason and as an older adult has been under the watchful eye of a cardiologist for years.

She argues that, if she were to go to the hospital they would put her on morphine and oxygen and slap on a nitro patch. They'd hook her up to some machines, like an i.v and other monitors. They'd probably insert a catheter, just because. And then they would run a bunch of tests and suggest she have an angiogram, which she would refuse. They would wake her up every hour to take blood or check this or monitor that, which would rob her of the rest she needs.

At age 90, she has decided that she doesn't want to have any more tests done and she definitely won't have any more procedures done. She doesn't want any more stents, no angioplasty and says open heart surgery is out of the question. All four of her kids support her decision and agree that, at this point, she can recover better at home than in a hospital.

She slept almost all day that Friday, but she got up on Saturday morning, had a light breakfast and took a shower. She played with her cat, Holly, and watered her plants. She "puttered" around a little while, then laid back down and slept. She spent most of the day resting, but did get up and do a few things as well. She had no pain, but still had a sense of fullness and pressure in her chest and her left shoulder and arm were bothering her. Sunday, she spent a little more time up and about, but took it pretty easy and laid down frequently. Her shoulder and arm felt better, but she said she was still breathless and got winded easily. She sat outside on her deck in the sun and enjoyed some fresh air.

On Monday and Tuesday she said she's feeling pretty good. After you have experienced an 8 to 9 level of pain, it's all relative, I think. She still has some pain, but it is relieved with half of a pain pill. She gets outside and walks up and down her driveway, which is pretty long. She used to do 10 laps, but now admits that just one lap wears her out. She knows something has happened and that her body is not the same as it was, but she realizes she must keep going and I admire her determination.

Today is Wednesday and she has been checking into her long-term care policy to see what it covers and if it's time to consider assisted-living. Ironically she's probably still too healthy. My brother lives next door to her, so help is very close at hand. She has a device she wears like a necklace that has a button she can push any time if she needs help. In addition, if she falls and can't push the button, the device has a sensor that notifies the screening company, who will then call family members.


She has her ducks in a row, so to speak. She is trying to find a necklace to hold her nitro pills so they are always handy. It is so impressive the way she takes charge of the few things that remain in her control. I should start recording some of our conversations because they are filled with pearls of wisdom that I want to remember. Some of the things she says are just priceless. Things like, "I think I'm going to have to stop raking." She has always loved to rake and it has provided her with good exercise, but those days are over. She also said, " I'm not dying! I'm going to be fine. In my mind I can do anything!"


She has encouraged family members to continue with their lives and their plans. She doesn't want to inconvenience anyone or cause too much of a disruption in our lives. Always thinking of others. This incident happened right as Jack and I were planning a vacation. When I told her we were struggling with the thought of leaving her, not knowing for sure if she's okay, she responded in true fashion. "Oh heavens," she said. "Of course you should take your vacation. You and Jack work so hard and you need time away. You can't live your life in fear of what may or may not happen. I want you to take a big sigh of relief and book that trip. Mom's gonna be fine."

But back to the hospital dilemma, my family saw my dad die on July 27, 1988, in the hospital after heart surgery, hooked up to machines with a huge scar running down his chest and his legs. If my mom wants to avoid that scenario, we all can certainly understand why and we will all do our part to support that decision.

Listen to Your Doctor: Is that Good Advice?

Should you listen to your doctor if they advise you not to exercise? Is your physician giving you good advice when they tell you to skip the strength training? I've been wanting to write this article for awhile, but it sounds so controversial for me to suggest that anyone should not listen to their doctor that I have hesitated. I'm afraid I could go off on some kind of Dennis Miller rant, for those of you who remember him from Saturday Night Live. At the very least, I want you to have the facts and decide for yourself.

On more than one occasion, I've heard someone say that their doctor has advised them against exercising, particularly strength training. My first reaction is to wonder if their doctor really said that. How could a doctor be so irresponsible as to actually tell a patient not to exercise. Surely the person had heard incorrectly or perhaps they heard what they wanted to hear. It doesn't take much of an excuse for most people to avoid exercise and if their doctor said anything that slightly resembled skipping exercise, many people would grab a hold of that and not let go. When quizzing them further, however, it has become clear to me that some doctors are, in fact, advising patients not to exercise, for one reason or another.

Many doctors know shockingly little about exercise, muscles and the benefits of strength training. With all due respect to the medical community, because exercise is out of their scope of practice, they tend to downplay its importance. Many times, rather than prescribing exercise, they suggest rest or at most, recommend walking. The body is designed to move, though, so rarely is inactivity the healthier choice and walking is not enough to maintain muscle and strength. Sedentary lifestyles are the cause of numerous health problems. Perhaps one part of your body may need to be rested or perhaps your exercise program needs to be modified to accommodate illness or disease. Unlike doctors, personal trainers are experts at exercise, muscles and strength training and can easily adapt your program to fit your body's needs and help you safely maintain muscle and strength.

Refraining completely from exercise will simply result in muscular atrophy and wasting that can start a vicious downward spiral that includes weakness, lack of energy and weight gain. But I'm just a personal trainer, what do I know?

Online Personal Training: The Future of Fitness, Part 2

Online personal training is becoming popular as a valid choice in our busy, financially-strapped, high-tech society. Taking the personal training relationship from "in-person" to "on-line" has some advantages and benefits. Is online personal training right for you? It may not be the answer in every case, but it is worth considering if you are interested in hiring a personal trainer. Online personal training is affordable, effective and convenient. It can be the answer for people who are desperate to lose weight and get in better shape.


Affordability is the number one advantage of online personal training versus traditional in-person training. The cost of hiring a trainer for in-person sessions can be a luxury that many people legitimately cannot afford. Minimally, one hour, twice a week, with a trainer who charges a $40 an hour, will cost you almost $350 a month, and many trainers and clubs charge much more than that. That is just not in the budget for many people these days. I get that. My online personal training programs average around $49.99 per month.



Online personal training can be just as effective, if not more effective, at helping you lose weight and get in shape. Traditional in-person training usually involves spending just two or three hours a week with a personal trainer. The problem is, there are another 154 hours, or 22/7, left in the week for you to undo all the benefits of the two hours spent with the trainer. With the power of the Internet and mobile technology, as your online personal trainer, I can be in touch with you every day. Communicating is so easy with this program that I can "be with you," so to speak, 24 hours a day.

You can obtain lasting results by using online personal training because it teaches you self-reliance. Sometimes in-person training relationships can result in a client becoming dependent on the trainer. Unless the trainer is physically present, telling the client exactly what to do, the client won't exercise. This can ultimately become counter-productive because in the long-term, you need to be able to rely on you, not your trainer, to make you exercise. My online personal training program taps into and cultivates your independent spirit and therefore promotes lasting results.

For more information, click on www.wellnessengine.com/beckymillerfitness

Online Personal Training: The Future of Fitness

The Internet has transformed our world in unimaginable ways. Anything and everything you want to know is available to you in the click of a mouse. What if health and fitness were also available to you in the click of a mouse? What if you could have virtual access to your personal trainer via texts and emails 24/7? If we put the power of the Internet and the other gadgets in our high-tech world to work for us in our quest for health and fitness, we would have some powerful weapons in our arsenal. That's what my online personal training program offers you.

For a low monthly fee, you will receive weekly workout programs that are custom designed just for you and your unique needs. These workout programs will be prepared by me, personally. Depending on the type of package you purchase, accountability and nutritional guidance are also available. Most people need the accountability feature. Let's face it! We're too easy on ourselves, so we need to be accountable to someone else in order to be successful. After you complete your workouts, you will report back to me, giving me feedback so I can adjust your workout program accordingly.

Workout programs include strength training, cardiovascular conditioning and stretching assignments and are based on the equipment you have available and the amount of time you can devote to the program. In addition to workouts and accountability, you also receive lots of motivation, encouragement, guidance, tips and nagging! I'll be in your ear, so to speak, every day, helping you make healthy decisions and ensuring you reach your fitness goals.

Online personal training is the future of fitness. Wouldn't it be helpful if you were dragging-ass and thinking about skipping your workout, to receive a text message from your trainer with just the right words to motivate you or guilt you into making it your best workout ever? Or if you're about to indulge in some unhealthy food choice and you instead you send me a quick SOS text or email. In the future, you'll also be receiving access to my videos and podcasts. I'm also hoping to start Skyping as well!

So, help me take fitness into the 21st century. Check out my online personal training website by clicking here!

Let me know if you have any questions!

Death is Just an Excuse for Gaining Weight

I watch a lot of "reality" shows about weight loss, including "The Biggest Loser", "Heavy" and "I Used To Be Fat." Many times, the people trying to lose weight have some kind of breakdown which involves crying, yelling, revelations about past trauma and supposedly getting to the bottom of the reasons why that person got fat. Many times, the fat person has had a loved one die, which they claim led them to turn to food for comfort. I'm not sure I can buy that as an excuse for gaining weight. People have been dying since the beginning of man. Only in recent history has death become an excuse for weight gain.

The generation prior to The Baby Boomers, those born from approximately 1925 to 1946, were known as either The Lucky Few or The Silent Generation. Prior to that, the generation with birth dates from approximately 1900 to 1924, were known as either The Good Warriors or The G.I. Generation. Folks from these generations experienced just as much death as The Baby Boomers, Gen X and Gen Y, but obesity was not a consequence or an excuse.

When I think back on my childhood in the sixties, very, VERY few people were fat. So what's up? Why are people getting fat now because of death when death has been around forever? To me, blaming the death of a loved one for becoming obese is just another example of being a victim. Oh, poor me! My mom died. Or my dad died. Or my child died. Yes, it is sad. Of course the feelings of grief can be enormous and overwhelming, but it does not in any way justify eating mass quantities of food and gaining excessive amounts of fat. I've heard people say that food is their only friend. That's crazy-talk! Food is not a friend. It is simply fuel for the body. If food is their friend, why wasn't broccoli their best friend instead of pizza? Your dog or cat can be a friend, but you wouldn't eat them.

I know first hand the immensity of grief that comes with a loved one dying. My dad died in the hospital after undergoing open heart surgery many years ago and my oldest brother died suddenly, in his sleep, from a massive heart attack several years later. Neither was overweight, but both had heart disease. I felt totally lost after they died. For at least a year after their deaths, I could cry at the drop of a hat, so to speak. I'm sure during this time that I enjoyed eating chocolate. I love chocolate. When I am sad, chocolate tastes extra good and there may have been a few times when I would over-indulge. But.... That doesn't mean that I gorged myself on it or anything else. Nothing ever tastes as good as that first bite. It's all downhill after the first bite, but some people keep eating regardless. Besides, after having too much chocolate, I can definitely count on getting a headache and having my moods spiral out of control, so it didn't take many instances for me to realize it just wasn't worth it.

The bottom line is: I get what it means to want to take the sting out of grief. But turning to food will just keep you wallowing in that grief longer and years later, you will still be feeling the sting because of the weight you have gained. It leads to a downward spiral of turning to food, overeating, gaining weight, feeling bad, turning to food, overeating, gaining more weight, feeling worse, turning to food, gorging, becoming morbidly obese and diabetic, losing all self-esteem. All because you were trying to avoid feeling the pain of your loss.

Instead: Feel the grief. Don't try to avoid the feeling any longer. Feel it, sit with it awhile, cry, experience all of it. Only then will it eventually begin to subside When it does subside, you won't need to turn to food for comfort. You will have found true comfort. If you avoid feeling your grief, and stuff it away, your body will hold onto those feelings and crave some relief from it, causing you to make unhealthy choices.

Let me know what you think! I love hearing from you!

Online Personal Training: The Future of Fitness

Do you want to hire a personal trainer, but can't find the right one?

Or can't afford one?

Do you need a fully customized workout program?

And some extra motivation and attention?

Do you want to use technology to get you in shape?

Would you like electronic access to your personal trainer and workout plans 24/7?

And mobile access? 

 Then you've come to the right place. As my client you'll have access to the workouts I design for you in a printed version that you can view from anywhere at anytime. You'll also be able to check your form through the exercise demos and track your weekly exercise routines. Just click a button and the tracking log will be sent directly to me. This is all possible through online training.

There are many benefits to training with me online. For those of you who currently train with me in-person, having access to my website will provide another great way to ensure your success. You'll have access to a huge exercise library so that if you every have any questions about how to do a move, you can just quickly look it up. You'll also be able to read valuable fitness articles and tips. Plus, you can send feedback about all of your workouts with one easy step and stay in daily contact with me, your trainer.

Training with me exclusively online also provides many, many benefits. I'll give you custom workout plans to follow that will show you exactly what you should be doing every week to ensure you are meeting your fitness goals. After your workout, simply complete the detailed workout log and I'll know exactly what you did, how it went and and questions you have. In addition, you can contact me anytime for questions and support. I'll be there for you to ensure your motivation.

Check out my website for pricing and more information!  http://wellnessengine.com/beckymillerfitness

The Other Half of Miller's Fitness - Meet Jack!

Introducing Jack - the other half of Miller's Fitness! I met my husband, Jack, in the gym. Where else? He was on the stair machine and I was in the weight room. Our story has been about fitness ever since. He manages the local gym and is also an ACE-certified personal trainer. To say that he is in great shape is an understatement. Yesterday he ran 4 miles at 6.5 miles per hour. His heart rate peaked at about 140 beats per minute. Thirty seconds after finishing, his heart rate had already dropped back down to 108 beats per minute. Did I mention that he is 57 years old and we live at altitude, about 8,500 feet above sea level? He can run circles around guys half his age and is "strong like bull", as he would say. He is 5' 10" and when we met in 1990, he weighed about 170 pounds. Now he is a svelte 150 and his body fat is in the low-teens.

We live in the mountains of Colorado and our primary source of heat is a woodstove. Every weekend Jack is outside gathering wood on our property. It's free heat, it cleans up our woods and he gets off on playing lumberjack. He'll march up with mountain with his chain saw in hand, find a dead tree that needs to come down and have at it with the chain saw. He cuts the dead tree into 6 -10 foot lengths and carries them back to the house, by hand, thrown over his shoulder. No ATV's here. He carries it all by hand, making 3 - 4 trips up and down, in all kinds of weather.

Last summer, the cedar siding on our house needed to be power-washed and re-stained. You know the rest. Of course, Jack power washed the whole house himself, then hand-brushed on the stain. He tried using a sprayer, but it just didn't do a good enough job for him. So he hand brushed the stain on the entire house. Doing the peak of the house was challenging, but he eventually got it all. I got queasy just watching him on top of the roof. He says the view up there is awesome. I'll take his word for it!

He says that exercise is his therapy. He has saved us thousands of dollars in psycho-therapy costs because he is a disciplined exerciser. He works out his angst and solves his problems while lifting weights and doing cardio. He motivates me and keeps me going when I don't feel like it. I have to stay in shape just to keep up with him! Fitness is the basis of our relationship. When I think of Jack in the years to come, I just have to smile. I envision a strong, yet wiry guy who will still be trying to play with chain saws.