Anti-Aging Psychologist, Dr. Michael BrickeyJacqueline Marcell









Host: Anti-Aging Psychologist Dr. Michael Brickey

Expert Guest: Jacqueline Marcell

Broadcast: 3-25-08 on where the latest shows are broadcast and posted as podcasts

Jacqueline Marcell has learned a lot about caring for parents. She has a fascinating story with lots of lessons and tips. Her marvelous book, Elder Rage reads like Stuart Smalley on steroids. It explains how just when her life was falling apart, her parents’ problems exploded. Elder Rag–with its drama, wit, and humor is a great read. What especially interests me, however, is that in between the compelling stories, she shows how to solve a lot of problems. What’s more, the experience led her to become a passionate advocate for eldercare services, and reform of the often dysfunctional systems that are supposed to help our parents. In the first part of the show we’ll learn about Jacqueline’s experiences with the system and how her sheer determination got her through it. In the second part of the show we’ll focus on practical advice and how to get the best services. Her website is

TRANSCRIPT ©Michael Brickey–excerpts permitted with attribution

MB: This is Dr. Michael Brickey with Ageless Lifestyles Radio, cutting-edge thinking for being youthful at every age. On each show I interview experts on what it takes to live longer, healthier, and happier. Our program takes a holistic approach in addressing anti-aging psychology, medicine, alternative medicine, fitness, nutrition, and wellness. Our emphasis is on innovative thinking and practices that have solid data and results. Life keeps asking us to learn new skills. We graduate from school and we learn to need resume-hunting and job hunting skills. Many of us become parents and learn everything from Lamaze to diapering to dealing with tantrums. Currently my wife and I are still trying to learn how to tell our seven-year-old identical twins apart and learning how to help our teenagers figure out which college to attend. Then comes the time to deal with aging parents’ problems. I experienced my share in the last several years with my father needing hospice services and my mother losing her short-term memory and eventually getting into a good assisted living facility. You hear about the sandwich generation. I guess, with caregiving for three generations, I’m a double-decker sandwich.After we get through these life lessons, we often say, “Boy, I wish I knew then what I know now.” The trick is learning from other people’s experiences early in the process. Joining me on this show is Jacqueline Marcell, who has learned a lot about caring for parents. She has a fascinating story with lots of lessons and tips. Her marvelous book, Elder Rage, reads like Stuart Smalley on steroids. It explains how, just when her life was falling apart, her parents’ problems exploded. Elder Rage, with its drama, wit, humor is a great read. What especially interests me, however, is that in between the compelling stories, she shows how to solve a lot of problems. What’s more, the experience led her to become a passionate advocate for eldercare services and help reform the often dysfunctional systems that are supposed to help our parents.

In the first part of the show, we’ll learn about Jacqueline’s experiences with the system and how her sheer determination got her through the challenges. In the second part of the show, we’ll focus on practical advice on how to get the best services. Jacqueline, could you paint a picture for us of what was happening in your life before your parents raged?

JM: I was a television executive and I’d had a whole string of bad things go wrong – personally, professionally, and then Mom needed care. She’d had a heart attack 11 years before and Dad had done a great job taking care of her, but he couldn’t do it any more and he wouldn’t give up. So I went to San Francisco to try to help the situation. I had been up there many times, of course, in the 11 years, trying to get him to accept help. I got up there, thought I would maybe be there for a month or so, and I was there for almost a year without a day off, getting him to accept help and getting my parents properly cared for and diagnosed and treated and just everything – the whole eldercare system was just not helping me appropriately. So like you say, if I only knew then what I know now, it wouldn’t have taken me all that time. I would know exactly what to do.

MB: So what was the first thing that didn’t go right?

JM: Well, I didn’t understand that my father – you know, he’d always had a bad temper; this was nothing new to me. It had never been at me before. So growing up, you know, he was 90% great, but boy, was that temper a doozy. And now it was at me, and screaming, yelling, throwing me out the house, calling me nasty names. And I’d cry, and you know, I just couldn’t believe he could possibly be so horrible. I didn’t understand that he was addicted and trapped in his own bad behaviors of a lifetime. But now they were getting distorted. He’d get upset over things that were – you know, just seemed illogical or irrational, at times, and then the next day he’d be normal. So I didn’t understand what dementia was. I didn’t understand it’s intermittent; it comes and goes in the beginning. I didn’t know how to get him to the right doctors who could uncover it early enough. And all that cost me a tremendous amount of time, energy, money, and heartache.

MB: What was your experience with doctors?

JM: Horrible! You know, I’m thinking, well, I have no medical background. You know, I’m relying on the doctors that have taken care of my parents for 20 years. And you know, I would describe all these horrific things that my father had done, and they’d look at me like, you know, “Well, we’ve never seen him be mean. We’ve never seen him rage. We’ve known him 20 years.” He was socially adjusted his whole life. My godfather read my book and he said, “You know, in 57 years, I never once saw this in your father.” And I have a cousin, a distant cousin who said, oh, I just made it all up, never seen my father like that. So my brother said, “Well, have them call me.” Because my brother was the one who got the brunt of it. It was the dirty little family secret, you know, that we didn’t share with anybody. My best friends, growing up, I didn’t share. You know, this was very hidden by the four of us in the family. And what a shame, because had we been growing up in this time right now, we would’ve known how to find help, how to get him in anger management, how to get him medicated properly, how to react to him instead of endorsing and ingraining that behavior, and walking on eggshells, hoping not to upset him. So when you do that, you know, your whole life, you’ve created your own monster in a way, and then you add a dash of dementia on top of it, the chances of you being able to turn that around when somebody’s in their 80s are pretty slim, but I did. And that’s when I finally was so infuriated about what I hadn’t known and what I hadn’t been told by these doctors and healthcare professionals that I was coming in contact with, was when I said, “Okay, I’m chucking my career, my whole 20-year career as a television executive. I’m going to go into eldercare because they need me.”

MB: You describe him as kind of an Archie Bunker and your mother as kind of an Edith Bunker. And he knew how to put on a good show when he went to the doctors’ offices or when he was in front of professionals. Is that common?

JM: I didn’t know how common it was until my book. Elder Rage has been out there now long enough and I get emails every single day – several – that will say, “Oh, my gosh! I thought I was the only person with a father like yours,” or “My mother – you know, we must be related, my mother is just like your father,” or “My husband is just like…” or whatever, and describing that how amazingly sharp they can be when they go to the doctor. Well, if you’re going to a doctor that doesn’t understand how to get to the very early signs of this – I mean, anybody can diagnose it in stage two when a person is wandering or starting to – has a car accident or leaves the stove on and almost burns the house down, or has such drastic behaviors that you get it. You know that it’s what we used to call untreatable senility. Or you know, you know, “Dad, I just told you that four times in the last ten minutes,” and you’re starting to think, “Okay, maybe he’s got some type of dementia.” Alzheimer’s is just one type of dementia – I didn’t even know that, and most people don’t until they get into it. But the mission that I’m on is to get people to understand it earlier, way before that happens, because you don’t go from normal to not knowing that you’ve asked the same question four times in ten minutes, that you’ve got a short-term memory problem like that or that you don’t remember where you live, after 37 years of living on that street. That’s way far into the disease. So we need to catch it very early. And unless you get to professionals who are trained in uncovering that – and it’s more than “What day is it? What time is it? Who’s the governor?” and the mini mental state exam. It’s a complex diagnosis and a complex evaluation. And those professionals are few and far between. So that was my mistake – relying on professionals that didn’t have any training in that. And then I didn’t find out until much later that Dad had told all the professionals he came in contact with, whenever I wasn’t there, not to listen to anything I said because all I wanted was his money – like, I wish he had some! So it just was unbelievable. I just could not believe. And I’m not shy. I have taught at the college level. I’m a pretty educated person. I’m in a major metropolitan area, San Francisco Bay area, and I am begging, screaming, you know, looking, searching for answers, and was not directed properly for a whole year. So that’s when I realized, if that happened to me, this has got to be happening on such a scale around this country with people that may not be as aggressive, may just be taking whatever the doctors say, may not have the education to try to figure things out. And it was tough, tough for me! And maybe in locations that have even fewer and farther between resources to turn to. That’s when I said, “Okay, this needs my help.”

MB: Knowing what you know now, how does a lay person find whether a doctor is knowledgeable, and how do you find the good doctors?

JM: That is really a key factor, isn’t it? And that’s why everything I do, I spread the ten early warning signs of Alzheimer’s disease. They’re in my book. They’re on my website at I want these on billboards, I want them on sides of buses, I want them on public service announcements, so that the general public and healthcare professionals are so aware of these warning signs and that it’s common knowledge of what they are, that when the daughter takes the mother to the doctor and says, “I have kept a little diary here of all the ten warning signs that I’ve been noticing my mother doing, and I have specific examples of this one, and then it was a month later she did this, and a month later that. And so, Dr. Smith, I’m really going to need a referral to the best neurologist in the county or that we can find, that you know of, that is a specialist in dementia.” So that – you know, that’s a very specialized thing. So isn’t it interesting now, I – with no degree in medicine except my DLE, my doctor of life experience – I’m educating doctors all over the country for their CMEs, for their Continuing Medical units.

MB: Wonderful.

JM: And I’ve educated – I can’t even tell you how many doctors I’ve educated. But oh, hundreds and hundreds of nurses, social workers, case managers, for their CEUs. But when I can get a doctor educated for a CME, I am thrilled because then I know – I’m teaching them in a very kind way that they just don’t know enough, and getting them the resources of how to help that family take notes, keep track of the warning signs, and then not just say, “Well, honey, your Mom’s getting old.” You know, that’s what people tell me all the time; that’s what they hear from many of these doctors.

MB: So it’s a two-pronged approach that you’re both educating the professionals but you’re also getting the lay people to really know what to ask for, what to look for, and taking the data into the doctor.

JM: Exactly. They have to. Otherwise, you know, most people put – you know, the doctor should know! You know, what the doctor says. But if you’re attuned enough to say, “Hmm, this is a GP. May not have been trained in dementia.” But I know these warning signs and I’m seeing them in my mother. And she’s still independent – she can still drive and she can still be at home and take care of herself. But gosh, yesterday she couldn’t find her keys – which we all have that happen – but all the sudden I open the freezer and there’s her keys there in the freezer. And I said, “Mom, why did you put your keys in here?” “Well, I didn’t put them there.” “Well, there’s been nobody here but us. We drove here together in your car. You can’t find your keys. I just found them here.” “Well, I didn’t put them there.” So you know, if you know that that was a warning sign, putting things in odd places, you’d have a light bulb go off in your head, instead of just thinking, “Oh boy, did I put these in here?” You’d start to think, “Well, gee, okay, this could be the beginning of some type of dementia, possibly Alzheimer’s, and I need to make a note of this, write it down, and see what else I notice.” Maybe this was fluke. You know, maybe she was putting something else in there. She had the keys in her hand and she was putting the groceries away and they just happened to fall, and she wasn’t specifically doing that. So you have to keep track of these for awhile. It’s that short-term memory, when they ask you the same question in a short period of time, or tell you a story and then ten minutes later start telling you the same story. It’s not when they tell you something one day and then three days later they tell you again, and you’re going, “Mom, you told me that!” and it was three days ago. Well, we tell people this, we tell people that – “Did I tell you this already?” We all do that; that’s normal aging. But it’s more like if you just told me that. That’s the short-term memory isn’t working right. So that’s a key one to watch for. Some of the other ones are the personality gets shifted a bit, you know, where just all the sudden there can be – they just burst into tears over something. Or like Dad – he’d just fly into a rage. Now, he always flew into a rage, but now it was over because he didn’t have strawberry jam instead of his raspberry jam, you know what I mean? I mean, weird things where you’d go, “Jiminys, all right.” And if you chalk it up to old age, you chalk it up to stress – you know, he’d been taking care of Mom for such a long time, couldn’t do it anymore. She almost died from his inability to care for her. And that’s why I had to persevere. This wasn’t something I wanted to do. It was a necessity, because I couldn’t leave Mom alone with him. There was no way. She would’ve died from his inability to care for her any longer. I mean, when I got there she was – oh, it makes me just shudder right now. She was in the hospital, was there for three months from him not taking her to the hospital. She was 82 pounds when I got there from a urinary tract infection, and he didn’t think maybe that was important enough to take her to the hospital. So I couldn’t leave her. I was in this Catch-22. I call it the Caregiver Catch-22. I was trapped there. Couldn’t leave her alone with him. Couldn’t get the doctors to believe me because it was so intermittent, it was so coming and going. It was the very beginning of it. He was darling when he needed to be. I was not taking him to the right doctors who could uncover it early enough. I couldn’t get a caregiver to stay because he’d throw them out of the house within a day or two or call them nasty names. I couldn’t put them in a nursing home – she required full nursing care, he didn’t. He would just take her out. I couldn’t put him in a home; he didn’t qualify yet. I couldn’t – I was like just completely trapped. And that’s when I said, “Okay, well, I’m not my father’s daughter for nothing. You think he’s stubborn. Okay, I am going to figure this out, come hell or high water.” And I persevered until I did. And once I did, that’s when my whole life took a left turn and I made the decision to do something important.

MB: So we have short-term memory. We have behavior changes. We have just not taking care of things. What are some of the other signs?

JM: Oh, let’s see. Disorientation to time and place – you know, like one day driving with Mom and Dad and we’re at the main drag where they lived for decades and I’m in the left turn lane to go see Aunt Dora. And all the sudden he’s screaming at me to turn right. And I’m like, “Dad, what are you talking about. You know she lives over here.” And he goes, “She lives over here! She lives over here!” And I’m thinking, “What? What is wrong with him?” And then all the sudden he just looks blank. And he goes, “Honey, nothing looks familiar.” And I’m like, “That is so weird!” You know, and I cried, and I’d think, “Oh, he’s getting older now.” If I knew that that was a warning sign, we would’ve gone down to Aunt Dora’s and I would’ve made a phone call to the Alzheimer’s Association. I would’ve known to call the area agency on aging or I would’ve known to call the Alzheimer’s Foundation. I would’ve known where to find the resources and I would’ve known how to locate a neurologist specialized in dementia, to get him in there and evaluated early. People say, “Well why do you want to know? Who wants to know if you’ve got Alzheimer’s?” Well, you do. Because if you do, medical science in the last 15 years – we’re blessed to have four band-aids, I call them. You know, they’re medications. They’re band-aids; they’re not a cure, they’re not going to stop the disease, but in most people they can slow down the progression of the disease. Now that’s huge! You get the diagnosis early and you can slow the progression of the disease down, and then you can make sure that your loved one is being treated with an antidepressant, because most people with any type of dementia are greatly helped with that. And the of course, holistically – eating right and exercising and putting all the effort into getting the person to be as healthy as possible in every way, shape, and form that they can be; and socially – getting them involved in senior centers and adult day centers so that they’re active and busy and so they’re not just spending their days in bed or in front of the TV because they get so depressed. But managing it – the depression is one of the warning signs of dementia, so is it depression alone or dementia or a combination? So you’ve got to get the right doctors, so you’ve got to be attuned to this. Then, okay, let’s say you can delay it for a year from progressing to the point where they need 24/7 care – they’re still independent, they’re still able to do a lot of stuff – that’s huge, huge! Because medical science is working so feverishly trying to come up with a cure or trying to come up with a medication that will stop it in its tracks, or maybe even delay it for two or three or five years. Most people don’t. Most people chalk all these symptoms up to old age – “Well, you know, she’s always had a bad memory,” “Oh, she’s always been difficult,” “Oh, she’s always gotten lost” – whatever. It’s the more-so theory of aging – whatever you were as a young person, you get more so that way as you get older. But now these symptoms start to distort that intermittently, where the – it’s so subtle in the beginning that the family doesn’t catch it. So it progresses. Now it progresses to a crisis, and if you haven’t reached out when it was early, now you’re in the crisis where you’ve got to have 24/7 care. You cannot leave them alone, period.

MB: Big-time safety issues, yeah.

JM: Now, even if you get the diagnosis, even if you get the medication, even if you’re doing everything holistically possible health-wise, you can’t go backwards. You can’t go back to the relative independence that you had in the early stage. And see, the early beginnings of this can last – there’s a stage called MCI, mild cognitive impairment, and that can last five or ten years. So it’s really subtle when this thing starts. It takes a long time to get going. Okay, so you’re in MCI for five to ten years. Well, a large percentage of those people will go to Stage 1. Not everybody – they’re still doing tests to see how many people – but nobody goes to the doctor for MCI. You know, it’s like – uh, you know. But they think it’s between 70 and 90% right now, is what the statistics are showing. So a large percentage of those people are going to go to Stage 1. Stage 1 can last two to four years. Everybody ignores that, too, because, well, they’re not that bad. But then you got to that point where there’s been a car accident or they’ve wandered downtown and ended up in the next county over, completely lost – whatever’s happened. Now the family’s screaming for help and they’re saying, “I can’t take it anymore.” You know, it’s been building, building, building, building, and now we’re at the point where, okay, now we’ve got to do something about Dad. Well, now it’s too late. Now you’ve got to take time off work. Now you’ve got to try to find or hire caregivers. Now you’re doing everything you can to elder-proof the house and keep them safe at home and try to get people to care for them 24/7. And this is why Alzheimer’s Disease is costing this country $61 billion dollars a year. 79% of that is the lost productivity from the absenteeism of adult children and spouses having to take time off work to care for their loved ones, because they didn’t wake up in MCI or Stage 1 and do anything about it. So if we could all wake up, if I can get everybody to wake up early, think what we can save families in terms of heartache, but think what we can save our society in terms of all these elders that are progressing into the Stage 2 where they need full-time care sooner than they should have if they’d gotten evaluated earlier. Now let me tell you, Stage 2 lasts two to ten years. Some people move through very quick, other people – ten years of that. Then they go to Stage 3, which is the end, and that is nursing home time. And that’s one to three years of pure hell. I’m trying to just wipe Stage 3 and most of Stage 2 off the map, so if we can catch it early enough, then we delay, we delay, we delay, they die from something else, because one out of eight persons by the age of 65 will get this – one out of eight by 65, and one out of two by 85. So that’s why it’s so imperative for this early, early understanding of this.

MB: What have you learned about how to coordinate the efforts with your siblings?

JM: Well, you know, like I told you, my Dad was really awful to my brother growing up. My brother was eight, nine years older, and I didn’t get that upbringing. You know, my Dad was orphaned when he was ten. He had a fourth-grade education. He lost his mother, his father, his siblings all got battered around, he’s in an orphanage. So there was a lot of rage in that little boy that wasn’t dealt with. Now he marries my mother and boom, there’s a baby right away. So he had tremendous jealousy. He wasn’t evolved enough himself as a man – he was still a little boy and my mother was his anchor. And I think there was just a lot of jealousy of that child. And my brother got the brunt of it, unfortunately. And then eight, nine years later I come along, and I’m a girl – for some reason I don’t get that. I don’t get that same jealousy thing. But I saw my brother deal with it, and it ruined his life, actually. So when my mother had that heart attack – they had an on and off relationship their whole lives. You know, we’re well into adulthood and middle age now and it’s still on, off, on, off. And they never, ever did get along. Well, they had a blowout, Mom had the heart attack, and they never spoke again for eleven years. And I kept trying to get them back together – wouldn’t work. So my brother wiped his hands of all of us, including me. So when I got up there to have to try to solve this and I’m there for a year, there was no help coming from my brother. And it was really hard. You know, this was his mother also. I was sitting in the hospital for three months, feeding her every bite of those meals and, you know, being there until midnight – I’d send Dad home before it got dark – you know, thinking, “Well, he could be here feeding his mother. This is his mother, too.” But I had to walk a mile in his moccasins, you know. I had to realize what my father had put him through and that he did not get the love that I had gotten growing up, and I had to let it go. And so I made amends with him and as soon as my mother was out of the hospital, I got my mother to see her only son. She hadn’t been able to see him – my father wouldn’t allow it – for eleven years. And I mended that fence without any expectations of help from him whatsoever. If I were to do it again, what I would do – and what I tell families, if you’ve got a sibling that doesn’t want to help with the caregiving or they’ve had a much different experience than you had growing up, like I did, you know, people would say to me, “Honey, so sorry about what you’re going through with your Mom and Dad. Is there anything I can do?” And I’d be like – I didn’t know what to say, you know. What I tell people now is make a list of all the things that you need to do, as a caregiver and otherwise, because some people will be happy to come in and sit with you Mom while you go to the market or you do this or that. Other people don’t want to do that part of it. Some people will be happy to bake some cookies for the freezer, though – something that they could do to help. So make a list of all those things. “Gee, you know, my watch needs a battery. I haven’t had a chance to get a battery for my watch. Could you do that for me?” “Sure, I could do that for you.” Now, if I’d asked my brother, “Gee, the car – I haven’t had a chance to get it serviced. It’s way overdue. The tires need rotating.” You know, something where he didn’t have to be involved with Mom and Dad while they were at adult daycare all day and he didn’t have to see them and he didn’t have to be involved in it – I could’ve made a list of things that he might’ve been able to help me with and just said, you know, “Here’s a list of things. If you feel like it, pick one. You know, if you don’t, it’s okay, too. I’m just making up this list and giving it to anybody.” And you know, I’d have at the bottom of the list, “Take me to lunch.”

MB: I love it. It’s such a simple solution, but most people wouldn’t think of it.

JM: Yeah. You know, “That lamp that Dad threw at the caregiver last week is broke. Can you get that fixed?” You know, “He pulled on the curtain rod and that’s all bent and broke.” When you’re a caregiver – you don’t have time for all those things that consume our lives anyway – and then you add caregiving on top of it. Everything else goes by the wayside – until you get your loved on into adult daycare, which I cannot say enough about. I’m a huge advocate for that. And I was a year into it, you know, because I’d have people say, “Well, why don’t you get your parents into that?” I was like, “What is that? A nursing home? I can’t get my father in the shower. How do you recommend I get him to go THERE?” And so, you know, he was a sundowner. He was up all night, she was up all day, meaning I was up the whole time. I couldn’t turn him around. I mean, I am slamming doors, I’m vacuuming next to him – he is out like a light during the day. It’s called sundowning. It’s very common with elderly people, particularly those with dementia. The only way that I was able to finally turn that around was when I got the right doctors, we got the medication to slow down the progression of the disease, we got the antidepressants in both, I was able to optimize nutrition and fluid intake – and then get them into adult daycare all day so that they were busy. You know, they had their crafts and their cooking class and their movies and their field trips and singing. They had all kinds of activities all day – and nutrition and physical exercise. And it was perfect for them and it gave me a little break. And then they’d come home from that and they’d be exhausted and they’d sleep through the night. So it was perfect! And you know, if I’d only known to do that sooner, that it would’ve turned around the sundowning. And I’m for seven-day-a-week daycare because, boy, he’d hit that bed on Friday afternoon after daycare and I could not get him up. Friday night, Saturday, Saturday night, Sunday, Sunday night – Monday morning, he did not want to get out of that bed because he’s been into everything the entire weekend, getting up and just eating. That’s all I could get him to do. So I’m for seven-day-a-week daycare. I’m really an advocate. I’m such an advocate for NADSA, which the National Adult Day Services Association, They gave me their media award because everything I do I mention the value of adult daycare because nobody knows about it. And you know, it’s not a money-making venture. I mean, you know, for $50, to have your loved one go – I mean, how do they make money at that rate. We’ll go into that, and they have hearts of gold, that do that work.

MB: What have you learned about how to recruit and manage caregivers?

JM: Well, I tried everything. I did everything wrong. Everything I did wrong – you can read the things I did wrong, and then how to do it right is in my book, in Elder Rage. But you know, I didn’t know how to hire caregivers. I was calling agencies, you know, and they – “Oh, we’ve dealt with very difficult elders. We know how to manage them.” And, well, good caregivers are in such demand that if you’ve got a very difficult elder like Dad who would call them nasty names and scream and yell if they didn’t do something just perfectly right, and throw things at them – you do not need to be abused, there’s too many other jobs where people would love to have you come and take care of them. So I couldn’t get a professional caregiver. Plus, it was like 20 bucks an hour.

MB: Wow.

JM: You know, it was very expensive. And how am I going to do that? So I started to try to hire – the good thing about going through an agency, though, is that they do – if you check this – background checks. And you’ve got to make sure, okay – “Oh, yes, we did background checks.” “Oh, how far back did you check?” Do they check one year back, three years, ten years, lifetime? Do they check the county, the state, nationally? Criminal – you know, felonies as well as misdemeanors? What do they check? So don’t just be fooled by “Oh, we do background checks.” You want to know what background checks they do. But that’s the good thing about hiring an agency is that they’ll usually do that for you. Plus, the other good thing is, if your caregiver has a problem with their family or their loved one or their car breaks down or whatever, you can call and they’ll have a person there who can fill in and they’re supervised, you know, and they’re bonded – most places will be bonded. Well, all that costs money. That’s why you pay quite a bit of money for that. Well, I had two people needing 24/7 care and the cost was just prohibitive. So I tried to hire caregivers, you know, putting ads in the paper or calling other people, saying, “Do you know anybody?” “Oh, we had one for my Uncle Joe and he’s passed now and she’s great,” and then trying to find her in between, and then of course, trying to find one that lives close enough to where you’re loved one lives. And then I was fingerprinting my own caregivers and taking their picture and being my own little FBI agent. And then, you know, you’ve got to lock up all the valuables. I don’t care how reliable people are, just don’t put temptation in anybody’s path. And even with all of that, I had people steal from us, people on drugs. I had everything go wrong that could go wrong. Until I finally met this gal who came to the interview – the amazing Arianna – and I was at the end of my rope. And you’ll have to read about this gal, with no experience and one year of high school, this gal was the angel I had asked for. And she, with my help, was able to help me turn Mom and Dad’s lives around and get everything accomplished. She and her Mom stayed, taking care of Mom and Dad. I was just so lucky to find her.

MB: If you had to find an Arianna now, how would you go about looking?

JM: Well, I’d know the questions to ask. I’d know to call all the references. And I’d know to go to their home unexpected-

MB: Oh, I like that.

JM: Because that’s the level of neatness and cleanliness I would expect to find in my parents’ home. You know, there’s certain questions you can ask and certain questions you can’t ask, I guess, when you’re hiring people. But you can, you know, kind of go through those. You can get a legal form kind of thing. But I think experience – and I just happened to luck out – she had no experience, but I was just at the end of my rope after about a year of this and I was just, “Fine, whatever, come on in.” But now, I – what a risk I took, you know? But it took me a long time to get her trained. It’s the references. It’s really talking to people – they know this person, they’ve worked – and get five or ten. I mean, really get a lot of references before you allow somebody to be in your home. And realize, you know, these people are not college-educated people, by and large. They’re oftentimes people from other countries, oftentimes people with very limited education, and you care asking them to do a tremendous number of things. You’re asking them to feed, to cook, to prepare – you know, I had them administering pills, because if you have a professional, they’re going to come in and preload a Mediset with a nurse, you know. So here I’m trying to teach her how to do everything – she was like an extension of me, of everything that I was trying to – and I’m, you know, a highly educated person and it was hard for me to do. You’ve got to allow for a learning curve for your caregiver and give them ten attagirls or attaboys for every mistake that they make and try to guide them and teach them how. And reward them – you know, every time – it finally started to hit. First money I got, boy, was big bonuses for amazing Arianna and her Mom. I gave them everything. These people deserve everything.

MB: And I love your idea of going unexpectedly to their home. You just learn so much just by seeing what it’s like.

JM: By observing, yeah. “Oh, I was in the neighborhood and I wanted to stop and give you this.” And you’re going to get an eyeful. You know, you might think twice if you’re a person that likes things neat and organized or clean or – because that’s the level you’re going to expect in the home they’re going to be coming and caring for.

MB: And you could even do that with the pretext, “I have another form I needed you to fill out” or something like that.

JM: Yes.

MB: You’re listening to Ageless Lifestyles Radio on  We’re talking with eldercare advocate and reformer, Jacqueline Marcell. She is the author of Elder Rage, which has been endorsed by an awesome who’s who list of celebrities and healthcare experts and political leaders. Her website is There’s information about her books, her seminars, her blog, and lots of practical advice and resources for helping elders. Anything you want to add to that, Jacqueline?

JM: Oh, I just want to add, take care of you. If you’re a caregiver, make sure you put you first, because, you know, I didn’t. I was so trapped and I got breast cancer. And who do you think called me more than anyone? My brother. So don’t alienate that sibling that’s not able or willing to help with your parents. That’s your family. And you never know. You may need that relationship later. My brother and I have a wonderful relationship now.

MB: Do you think possibly the stress of all the family issues and the job changes and everything contributed to getting breast cancer?

JM: Yes. I think that we are hit with carcinogens all the time, in our air, in our water, in our food. And then you either have an immune system that fights it off or you don’t. And I was under the most incredible stress of my life. And you know, I’ve run some companies so I’ve been under some stress, but this was a stress that was like no other – I cried every day for a year. It was so intense that I was catching every cold, every – you know, I was just – my immune system just went. And that’s when, I believe, the cancer was able to start.

MB: And you’re in full remission and doing well?

JM: I’m in remission, yes. I get tested every three months and so far so good, knock on wood. But what I learned the hard way in both cases is the importance of putting ourselves first. People think it’s selfish or egotistical. But you know, you’re all you have. You know, this is – what you have is you. And in order to be effective and loving partner or for any of your friends or family, you want to put yourself first, because it’s too much for them to – having to try to take care of you also. Everybody’s got their own things, so if we all took better care of ourselves. You also use, you know, the positive imagery – I teach affirmations, I teach gratitude at my seminars, I teach the power of positive thinking and just humor, the power of humor. Boy, the first thing I did when I got diagnosed with breast cancer was I got Netflix and I rented every comedy that I had never seen or the ones that I wanted to see again, because I didn’t want horror movies or anything that would – you know, I wanted to flood my system with endorphins. I wanted to flood it with laughter. And I’ll tell you, they made no money on me – I watched three movies a day, sent them back, got three more. I had a lot of complications. I’ve had six surgeries, six months of chemo, six months of radiation, had a lot of complications – blood transfusion, the whole bit. And I’ll tell you. Positive thinking and keeping going – I didn’t miss one speaking engagement. It wasn’t heroic; it gave me a reason to get out of bed, and gave me something to look forward to, to go do, because I’m so passionate about my work. I couldn’t even imagine if I didn’t have my work to do while I’m going through all of that. But I incorporated a lot of humor into my life wherever I could. And then I made myself little flash cards, my gratitude list that I read over every day – I still read over every day – and just focusing my mind on anything positive and all the positives in my life. Because, you know, when you first start to make that list, you can’t think of one darned thing. And then you put down, “Okay, I’m still breathing. All right, let’s see, what else?” And then, you know, you start to think of more and more and more things, and then if you focus your mind on those, you can’t have a positive and a negative thought at the same time, so who doesn’t want to just have the positive? So I made some flash cards. I put little signs all over the place. I practiced my Stuart Smalley in the mirror – “You’re a wonderful person.” I wake up every morning and kiss my arm [kissing sounds] – “You’re still here, you’re fabulous.” And you know, it helps. It really helps.

MB: One of the things that I really admired in the book was the way that, when things went wrong, you really went in very assertively and got people to make them right. For example, the toilet story in the nursing home.

JM: Oh my gosh, yes. Well, you know, as we know, I take after my father. I told amazing Arianna, “When I get to that age, if I’m like my father, please throw my book at me!” Because, see, by then, we’ll know. We’ll have this wired, so I’m not worried. But the good news is I’m very strong. And when I see an injustice, I’m going to make it right. You know, Mom was in a room when she came out of the hospital – this was my first – you know, after the three months of nursing her back to health and she gets transferred across the street to the sub-acute unit of a nursing home. You know, and every day – Dad’s there during the day, I come late afternoon, I’m there until late at night. And we’re both feeding her every bite. And there’s this lady in the room – they put a lady in the same room with her, you know, with the curtain and the whole thing, and she had this terrible skin condition – I mean, just terrible, all over her body, and she was a very large woman. And nobody ever came to visit her. My Dad said nobody was there all day, and then nobody would be there all night. So I felt bad for her so I was always trying to help her. And you know, I had got a TV for Mom’s room so I made sure that this lady could see it too and every, and I was trying to chat with her a little bit. And then I noticed a little tiny sign outside of our room that said, “Contagious.”

MB: Uh-oh.

JM: And I said, “What!?” And so I pressed the night nurse, when I was there, and I said, “What are – Mom’s not contagious. This person is contagious?” “Yes, she is.” I said, “Well, what the __ is she doing next to my mother? And I have been helping her and nobody told me she was contagious.” So I raised holy heck, as you can imagine. I got in there the next morning. I said, “You’d better tell they’d better have a – I’ll be here the first thing in the morning to meet with the administrators.” And oh, my gosh! You know, “Well, you know.” And I said, “Wait a minute. She’s using the same toilet that my mother’s using. I don’t see it scoured with Clorox every time.” “Well, well, you know, her skin disease is just on her back.” I said, “My mother sits there and leans back all the time with her gown open. What are you telling me?” “Oh, blah-blah-blah.” By the time I got back, the lady had been moved to a private room. We kept a private room. A sign was outside ours that said “Private.” You know, I was like, well, what happens to people that don’t have an assertive daughter like me? What would’ve happened to Mom? Dad couldn’t read that sign with his eyes – he wouldn’t have seen that, he wouldn’t have known what to do. So just think of the horrors that must happen where I raised holy heck about it. What you do in that case is you call the area agency on aging and you talk to the ombudsman. And that’s the person who’s your advocate as a family to tell you what’s going on with nursing homes – how many liens, how complaints, have they had any lawsuits, have they had anybody die suspiciously, what’s the statistics about that place that your loved one’s been put in? You know, she was just transferred there across the street. I had no say of where she was going. It was, “Well, she’s going across the street.” I’m like, you know, I didn’t even know I had an opinion on these things. But now, I’d make sure that that place was fined and cited and everything else. What you don’t know can cost you a lot.

MB: The moral is that even when you have professionals taking care of a parent, you still have to inspect what they’re doing and there often are problems, and when there are-

JM: Yeah, and we only hear about the bad nursing homes. You know, there’s a lot of – God bless anybody that does that work. You know, it has got to be very, very difficult to work in a nursing home. I give – anybody that does, my hat is off to them. And we have so few people going into nursing. We have such a shortage of nurses, you know, all the way around, let alone nurses that want to work in that environment. So, you know, you’ve got to be proactive. And you know, I dropped in at 3:00 in the morning one night. I just had a – I don’t know, I didn’t feel right, and I just got up and got dressed and drove there at 3:00 in the morning. And you know, the guy sitting there was asleep and the buzzers were going off and people were calling for help, and there’s nothing worse than hearing elderly people calling for help and nobody going. Oh! It just makes me cry right now thinking about it. And nobody going to see if they’re okay. And I raised you know what. I got in there, and thank goodness my asleep because if she had been awake and begging for help or had fallen or something, I can’t even imagine what I would’ve done. So – oh, you got me choked up here! They’re overworked, they don’t have enough workers, there’s too many patients. You see, my whole bottom line point of what I said earlier, if everybody knew those ten warning signs, if they woke up early, if the professionals were attuned and the families questioned it, they got the right diagnosis early enough, we delay the disease, people wouldn’t be having to go into nursing homes as much, and a lot of these horrors would be eliminated. I was just shocked a couple of years ago, AARP had an article out about nursing homes – they said that 90% are understaffed. Well, that’s heartbreaking. So you’ve got to be an advocate for your loved one if they’re in a nursing home – or anywhere, you know. Adult daycare – you have to be following up on what’s happening there. If they’re in assisted living, making sure that the activities that you were sold on that were going to be done are happening. You know, what are the meals like? You’ve got to make sure you have a meal yourself at these places. And try a place out first. You know, put your loved one there for rested, you know, instead of signing that they’re going to live there.

MB: Oh, that’s a good strategy.

JM: You know, find out a place that – “We’d just like to try it for the weekend while my husband and I go out of town. We’d just like to have Mom be taken care of for the weekend.” And see how it goes before you commit. That’s a very good thing to always do.

MB: And if something goes wrong, then you said the ombudsman, of course the administrator, and the state licensing agency.

JM: Yeah.

MB: And there’s always wonderful data at

JM: Yes.

MB: You can go right in and specify a mile radius around where you want, and incredible detail about the nursing homes in the area.

JM: Yes! You know, I have all these links on my website at Just scroll down on the left side at the bottom; it’ll say “Eldercare links.” And I have gathered every valuable link that I can find. And you’re just going to find tons and tons of how to find nursing home reports, how to evaluate, how to find – just everything related to eldercare I’ve put on my website. And it’s all free. Just trying to spread good information to people.

MB: Well, I want to be sure to get one more tip from you. How did you handle taking away the driving license?

JM: Oh, my gosh! You got about an hour? Dad was horrible. We couldn’t find the car keys and he had taped them to his leg.

MB: Oh, my goodness.

JM: You know, we’re patting him down, we can’t find the car keys. He had taped them to…! I’m here to tell you, dementia doesn’t mean stupid. Oh! Now, see, with the knowledge I have now, what I would do if I knew that he should not be driving – I mean, Dad, you know, he couldn’t see the big E, number one. His sense of direction, his reflexes were bad, his hearing was bad, he couldn’t wear his – he wouldn’t wear his hearing aid. Just, you know, and the beginning of the dementia had started, which I did not – but he just should not – I knew somebody was going to die if I didn’t take the car away. So he hated me, just hated me – horrible! Well, now, see, what I would do is I would call the Department of Motor Vehicles and I’d ask for the supervisor, I’d make friends with that person, and I’d say, “Somebody’s going to die unless you help me. So what I need you to do is be the bad guy so I don’t have to take the brunt of it. I can just be the good daughter.” And then I would tell Dad, “Oh, the Department of Motor Vehicles called today while you were at daycare or while you were in the shower or wherever, and I’ve got to take you down there tomorrow or this afternoon or whatever,” and he would scream and – I can just hear the swear words, like a sailor, it would be like a blue streak, but it would be at them, not at me. And then I’d have the appointment all set up, I’d take him down there, and they’d do the eye test and they’d do – you know, if he somehow passed that, then they’d give him the written exam, and somehow passed that and cleared the parking lot for a driving test – it wouldn’t even take more than the big E that he couldn’t see – but you know, then THEY would take the license away, and then I could be the devoted daughter that says, “Oh, shoot, I’m so sorry this has happened. You know I don’t want you to feel trapped at home. I want to sign you up for…” – in most areas they have transportation for seniors, you know, shuttles that’ll take people for a very – free if you’re a certain age or a very nominal fee. And I would get one of those big button phones, you know, and I would preprogram it so – maybe even a picture phone, so it would have a picture of a taxi or a picture of the shuttle or the neighbor, a picture of the neighbor, and I’d have it one-touch dialing so that he could always reach somebody if he needed to go somewhere. Now this was of course before we got into where he needed 24/7 care. This was early on when I was there. That’s what I would do now. And get the club and put it on the steering wheel, because I don’t care how many times you tell somebody that they shouldn’t drive. He would agree – the doctors would tell him, and he’d say, “Okay, I won’t drive.” And then he’d forget and he’d think he was just fine, and then he’d go out there and start the car, and boy! So at least get the club on the steering wheel or, you know, I don’t know, you’ve got a kill switch in a locked glove compartment. And “I don’t know. The car won’t start. I guess we’ll have to have it towed.” So you might have it towed somewhere, out of site, out of mind. And, “Oh, they just can’t find that part from Japan.” Do whatever. Put a notch in their keys so the keys don’t work. If you’ve got an older car with a distribution cap, take the distribution cap – you know, there’s a million things you can do. But just make sure they do not drive. And most people don’t, because they don’t want to be the chauffeur, they don’t want to be trapped having to go get every little thing that the person needs. But I can’t tell you the lawsuits that people get themselves into when they don’t take those car keys away soon enough. They wait until there’s a crisis, and the crisis is often somebody getting killed.

MB: Jacqueline, thank you so much for sharing. I simply love your book.

JM: Thank you.

MB: Your website,, has just fabulous information on it. And I’m so happy that you’re doing the advocacy and the reform work that you’re doing. It’s a real blessing for all of us.

JM: I’m doing my darnedest. And I’m still so passionate about it! You know, I said, isn’t it funny how sometimes when life takes you to your knees, it may be the same experiences that take you to your highest purpose, your highest passion, and your highest work.

MB: Well said.

MB: Each show I like to share a baby step to help people live longer, healthier, and happier. When my son was about ten years old, he became very ill. He became so weak he could barely talk, he could barely stand up, and we took him to Children’s Hospital. They poked and probed for about an hour and a half and shrugged their shoulders and say, “We don’t know what’s wrong,” and sent him home. My wife called her mother, who had been an art history major, and described the problem, and she said, “You know, David visited me in Philadelphia about a month ago, and there’s a lot of Lyme Disease in our area. Sounds a lot like Lyme Disease.” So we got on the internet, checked the symptoms – they matched very well. Took him back to Children’s Hospital. We told the doctors, “David has Lyme Disease. Please start the treatment right away.” They did and it cleared up within about 24 hours. Without that persistence, without getting the information, David would probably have very serious disabilities today and for the rest of his life. The baby step is that the information for just about anything that we need or the answer for about anything that we need is out there, if we keep looking, if we’re persistent, if we’re determined to find it. And this fits very well with what Jacqueline described, of how, when things don’t make sense in taking care of parents or any area of life, we need to keep asking, to keep probing, to keep being persistent until we get the information we need, the answers we need.

This is Dr. Michael Brickey with Ageless Lifestyles Radio on  I’d love to get your feedback and comments. Just sent them to Information on anti-aging psychology and the Defy Aging Newsletter, which is free, is at Thank you for listening on our quest to live longer, healthier, happier lives.


Anti-Aging Psychologist, Dr. Michael BrickeySharon Cutler








Host: Anti-Aging Psychologist Dr. Michael Brickey

Expert Guest:  Sharon Cutler

Broadcast: 3-17-08 on where the latest shows are broadcast and posted as podcasts

There is no shortage of information for Boomers and seniors. The problem is wading through the sea of information to find answers and solutions. Often the starting point is figuring out what questions to ask or how to get a good assessment of problems and needs. Wouldn’t it be wonderful to have a go to person? My go to person is Sharon Cutler, who is Editor of and Founder of The Positive Aging Network. On today’s show Sharon shares how she goes about finding information.Her website is  

TRANSCRIPT ©Michael Brickey–excerpts permitted with attribution MB: This is Dr. Michael Brickey with Ageless Lifestyles Radio, cutting-edge thinking for being youthful at every age. On each show I interview experts on what it takes to live longer, healthier, and happier. Our program takes a holistic approach in addressing anti-aging psychology, medicine, alternative medicine, fitness, nutrition, and wellness. Our emphasis is on innovative thinking and practices that have solid data and results.

Well, there’s no shortage of information; the problem is wading through all the information to find the answers and the solutions. Sometimes the internet can give us information in seconds while we’re still in our pajamas, and sometimes it offers us nothing but ads. It often gives us lists and credentials, but little feel for what the services are really like. For example, if you’re trying to find a new family doctor with Marcus Welby qualities, it’s a daunting task. And we know what a family doctor is and we know what we want in a family doctor. When it comes to services for seniors, the tasks is often more daunting. The starting point is often finding out what questions to ask and how to get a good assessment. And it’s even more daunting when the senior is in another city.

Wouldn’t it be wonderful if you had a go-to person? I do. My go-to person is Sharon Cutler. She’s a long-time advocate for Boomers and seniors and she’s editor of, a cornucopia of information on seniors and on Boomers. She’s also founder of The Positive Aging Network, and I have the pleasure of being a columnist for Sharon, I know you’ve been advocating for seniors and Boomers for many years. What inspired you to start

SC: Hi, Dr. Brickey. What happened is that I always was the go-to person for information. People always thought I was smart, quote/unquote, and-

MB: Well, you are!

SC: Yes. But I too have to look for resources. Anyway, when I started my career, it was in childcare, and people would need help, and so I started an agency myself. And in addition to needing like housekeepers and companions for the elderly and things like that, inevitably the family member would say, “I would like to find a good lawyer or a good doctor,” and it set my mind to think that people had difficulty accessing the right resources, and even know the starting point. So I decided to make Mature Resources, which is almost a brand now – we’ve had the name Mature Resources now since about 1987, 1988.

MB: Wow.

SC: Mature Resources really means that anyone over 40 or 50, hopefully through one of the venues that we’ve had – now it’s a website – hopefully we will provide many of the answers, or at least a starting point.

MB: I’m going to really put you to the task. Let’s imagine that – well, first of all, I know you recently moved from Florida to Chicago. Let’s imagine that your parents were in California and you were just starting to get hints that they were having health problems and maybe even some senility. And let’s say that you couldn’t leave home to go to California. How would you go about assessing the problem and getting services for them?

SC: That’s a very good question because many millions of people – I think between seven and ten million estimated people – are children of people who need help, that they need any level of care or they need to have options. So if I was going to have a parent in California, one of the first things would be to use the internet – I certainly encourage people to use the internet – and I would go to the California state government and then the local agencies on aging. You can find them just by putting in “aging agencies” or “senior organizations,” and then picking and choosing the appropriate departments, agencies, community services, and start to make a list and pick what you feel is appropriate to go to the next step, which is finding out what they can do to help you.

MB: Once you have your list of agencies, then what? How do you assess what’s really going on with Mom and Dad?

SC: Well, there’s various things. And I think the world of senior care is quite, quite confusing. Most of the – it truly is. Most of the occupational titles that narrows this did not exist 20-25 years ago, for even some people like senior move managers, daily money managers, who are helping this, but most people in fact have not heard of them. Well, there has to be a starting point. You need somebody there to assess the situation. One of the people that I might call is a community outreach for seniors. Sometimes they send somebody out. I’d see if that was available in that particular town or county. And then there’s also geriatric care managers who are fee for service professionals, usually social workers, who send out a nurse or a social worker. They do an assessment and they help you to determine how Mom or Dad is and what Mom or Dad needs in the future, and then they follow up for as long as your contract with them is.

MB: Before you retain these, what kind of questions would you ask to find out if they were the right people for the job?

SC: I would look up their information online, first of all. I would find out if they were licensed, what their backgrounds are, if they have insurance – you know, especially like a homecare agency, because you want to make sure that theirs is the proper licensure. I would ask them how many years in business. I would probably ask for a few references, and be careful when you call up that they’re not their best friend. Often I think longevity helps. And also if you could find somebody out there who perhaps knows an agency that has worked with them. Sometimes you can even call a library and you’ll find out – or call a doctor’s office. It’s often hit and miss. But when people come to me with a background of many, many years, actually meeting with different kinds of professionals and locating things for my own website and for my own – I just created the 50-Plus Expo in New York. I always wanted to bring people and products and services together. So it’s a – it’s not a treasure hunt, but it is a mission that you have to have tenacity, you have to have patience, and you have to be resilient and know that it’s going to take time.

MB: It sounds like Columbo to me. I picture him going into the library, “Excuse me, ma’am, I’ve got one more question to ask you.” Just nagging a lot of agencies and organizations until you get the answers you need.

SC: Right. You would be very, very lucky if, on the first shot, at the end of the first phone call, you got the answers. I was reading this article that was in Kiplinger’s and it told a story about a couple who wanted to have dream retirement, and they were very logical and knew that they had to both plan for themselves and plan for how long they’ve be caring for her mother. Anyway, when they finished writing their list, it had 4,000 items on it. So I couldn’t fathom what 4,000 things to do would be. A lot of those had to do with their financial situation, stocks and bonds and insurance and stuff, consolidating, picking where they would live and what they would do after retirement, which sometimes in retirement, it’s recreated and goes back to a different kind of career. But 4,000 items – think of that. When most of us, if we have a couple of things to do, it’s overwhelming.

MB: Well, you just knew that was probably 4,000 things right there.

SC: Right.

MB: So you get your care manager lined up – you pick somebody that you trust – and they say, “Well, we need to get some medical exams.” Do you just trust who they refer you to, or do you do more homework then?

SC: There’s always homework to be done, whoever you go to, whether it’s a geriatric care manager, whether you feel that a person needs homecare – whoever you call is going to tell you that “I’m the right solution.” You know, “My company is the right solution. We’ve been in business this long and…” But you might find that someone needs adult daycare, which is a relatively new whole category of care, where people go to a center for the day and they have all kinds of activities, and then they return in the evening, you know, by bus or car, and that might be a solution for someone who needs some care for the person in the daytime. So there’s all kinds of ways that you can approach it. One thing that I tell people is Rome didn’t happen in a day, and you really have to look at all the choices. And you probably still won’t know the choices, all the choices.

MB: Using adult daycare as an example, I’ve seen some that are just marvelous programs and very stimulating, and some that are just kind of adult babysitting. Long-distance, how would you tell the difference?

SC: Well, if you have telltale signs that something is amiss with your parents, I certainly would take a flight there and see. As a matter of fact, this often during the holidays that Mom or Dad says, you know, “Everything is okay, I’m terrific,” and you happen to go there for the holiday, you know, just check in and have some fun, and all of the sudden you realize that Mom has had the stove on all day and that she’s not remembering certain things, and you realize that things have changed and they’re not admitting to it because they’re scared, and that’s happened to many people that I know. So I think that seeing it directly and then, of course, if you’re in that community, it makes it that much easier to look things up. But you know, you can do it on the internet. I just think that you need some kind of personal intervention.

MB: So let’s say you do go to their home. You’re Columbo, again, and you’re gathering this information. Are you writing it all down? And do you have some kind of checklist that you know what to look for?

SC: One of the processes that I have, we have a long checklist. I couldn’t find it for you now because I’ve moved and I everything in boxes right now. But yes, you should be taking notes about the person, about what’s going on mentally, what you see physically, what you get the feeling of emotionally – because many times older people get depressed – and write it down and go from there. And I think that being a questioner, being a sleuth, as you said, enables you to a position of power where you ask the questions, and if you don’t get the right answers from somebody who you think might be able to help, then you go to the next step. For instance, in Florida, there’s 211, which is a crisis and information and resource hotline. Here it’s 311 in Chicago. And 911 we know is for emergency and 411 is for information, so they all end in ones. You have to get to know what’s available in that community. And oftentimes it means bringing Mom or Dad back closer to you at home – they’re at home or in a senior living environment.

MB: The checklist you use, is that something that’s proprietary or that other people might access? Or are there other good checklists?

SC: There are checklists all over. There are articles. If you look up “caregiving” on the internet or “caregivers,” I’m sure you’ll get over a million – as a matter of fact, I’m sitting here and I’m going to look it up right while we speak, because I just saw 16,600,000 Google entries for research and information, how to find research and information, just basically. And then I did it for “elder care” and I got over a million entries. It’s a process. And unfortunately, as we get older, most of us haven’t planned for it and sometimes it’s an emergency, and decisions have to be made very, very quickly – all of the sudden Mom or Dad needs hospitalization or needs some kind of care. So either you have to go out there and start doing the investigating, or you hire someone – and it should be a social worker, geriatric care manager, or call the local government agencies and find out who they would recommend. So when it’s immediate, that’s when it’s the worst.

MB: So let’s say Mom has to go to the hospital. Do you just, again, go with what the doctor recommends, or do you research the hospital?

SC: I don’t know how extreme you can get. If Mom or Dad has to go to the hospital, it’s probably pretty serious. It’s enough to keep them under observation and testing and things like that. And then, of course, with the new rules on Medicaid and Medicare and the insurance issues, Mom or Dad can be in the hospital for one day and their insurance only pays for that one day, and they really need to be there and under supervision for several days. So it’s a tough. I had a situation a couple of years ago. I never thought I would be a caregiver, and my husband was checked for something during an ordinary examination and it was only through a very astute urologist that took a CAT scan of him. He didn’t seem to have any problems that were detectable, but the doctor was more cautious, and he found out that my husband had non-Hodgkin’s Lymphoma. Oh, actually he didn’t, and even the surgeon who took out the tumor didn’t know. He said, “You have some kind of lymphoma and I don’t know the first thing about it.” So the surgeon sent us no place. I mean, he just like stopped dead in his tracks. And if we didn’t have a local organization – in Florida, at the time – that worked with the Sylvester Cancer Center, and they do a lot of clinical trials. My husband probably would’ve been one of those people who all the sudden you hear, you know, “My husband has terminal cancer,” and they just detect it at the end. So I think half of it is luck. But I believe in planning ahead if you can.

MB: Plan your luck.

SC: I believe in putting your ducks in order. And in answer to the question about checklists, we have different forms and different adder-on questions, depending on – we give a free consultation through the Positive Aging Network. We give a ten-minute free conversation so you feel comfortable with us. And then if we want to proceed, we tell you how we work. And then what’s different about what we do is that we will research and we just won’t say, you know, “You need a homecare agency” or “You need assisted living.” We’ll do different options based on what you say or if you send us doctor’s notes and stuff, and we’ll give several choices based on not having relationships with those people, but on research that we do, checking up people through the government, the licensing departments, different ways.

MB: So a number of organizations have favorite providers that maybe even get referral fees or something, and you’re very independent and research-oriented.

SC: Right, right. There are companies – and I’m trying to remember the name of the type of thing they are. Some of them are very, very good. They’re professionals who can get you or someone you love into the best assisted living facility, let’s say, or the best nursing home. And they work on contract with many, many, many of those facilities or types of communities. So while it’s free to you, which is great, they have a vested interested in a placement in one of their contractual places. That’s not to say that they don’t do a good job, because many of them are quite successful and have very good reputations. But they’re not neutral, they’re not unbiased. And the thing that I was always told, even when I had a homecare agency, is that the government always gives out three choices. Let’s say they work with homecare agencies, they have a list and they’ll give you three, perhaps based on – there’s a list, whatever. And that’s what we do. But I think we’re the first people to call ourselves senior information professionals, because we do research – and as a matter of fact, somebody wanted some information and – well, out of it was things that you wouldn’t even think about. This woman wanted to help her mother with things to do during the day, and she wanted to know how she could get to bridge and where were bridge lessons or sessions and stuff like that. So it can be anything from pleasure, you know, things that you want to do, and things that you need to do.

MB: Bridge lessons or a bridge group may sound like a minor thing, but to a senior who that’s the most exciting thing in their social life, that’s real important and can really keep somebody cognitively sharp.

SC: Right. Absolutely, absolutely. Because one of the one worse things to make someone depressed is aloneness, loneliness, and not having anyone to share thoughts with. I recently went to one of a chain of adult daycare centers and I was so impressed with it because they had more activities – it was like a country club. You know, sometimes when I go into an assisted living facility – and a lot of them are really gorgeous – I say, “Wouldn’t this be nice?” But I don’t want to be in it yet, but yet I see all the activity and I see they’re designing the menus and I see how they stimulate you mentally, and the swimming pool and this and that, and it gives you a nice feeling. But oftentimes the assisted living and continuing care communities are quite expensive monthly, so finances will always come into play, as well.

MB: Yeah, I recently had to find assisted living for my mother, and so my brother and sister and I visited quite a few facilities, and we wanted to taste the food – because I think that’s one of the most important things, since it’s the highlight of the day three times a day – and really get a feel for the atmosphere there and how friendly the staff were. And there’s no substitute for actually going there and experiencing it.

SC: Absolutely. And looking over things very, very carefully. I saw the same thing – well, rehabilitation centers are quite different because they’re shorter term and, you know, you’re there to get well. And the whole atmosphere and everything about it – it’s amazing, people don’t have a clue. When I first started in 1985 with my companion and nanny service, they were building the first assisted living facility on Long Island. And we all looked around and we actually went to a meeting at this place – it was locally, one of my friends was admission. And I said, “I don’t know.” And the common thought among those of us who were seeing it as professionals, “I don’t know if these things are going to really work out, assisted living.” And it’s every place. It’s every place, you don’t really have a choice. And there’s all these guidebooks you have.

MB: What do you mean by guidebooks?

SC: For instance, I moved to Chicago so I picked up in one of the drugstore chains, a senior resource guide-

MB: Oh, okay.

SC: Yeah, they can be helpful and they can be very confusing, because there’s all these different areas. There’s help at home, health services, health and wellness, professional services, elder law, life insurance, moving consultants. So it’s a start. I think one of the best things is to have a team, like you did with you mom – to have several people in the family all involved, so that the stress level isn’t just on one person. A lot of people are living long, long lives. And I know you’re very aware of it. I think it’s about 78 years old or something that’s the average lifespan. And people 85 and up are the fastest-growing population. I just heard about someone who is 101 and is a painter, paints pictures and lives by themselves. How great that is.

MB: You’re listening to Ageless Lifestyles Radio on, and we’re talking with the information concierge of aging, Sharon Cutler. She’s the editor of – make sure you type “.org” – a site that’s full of columns and resources for Boomers and seniors. She’s also founder of the Positive Aging Network that she was talking about, a concierge-style services organization for just about everything legal related to seniors. Information on the Positive Aging Network is on the website. Information on anti-aging psychology and my books Defy Aging and 52 Baby Steps to Grow Young, and my free Defy Aging Newsletters are at Sharon, you’re gathering so much information, how do you keep it all organized?

SC: Well, they’re in boxes right now.

MB: How did you get them organized?

SC: Well, I have different topics, because I also write, I write what I preach. As a matter of fact, I’m a columnist also for another website called Infuriates my better half, my husband, because I do have so many files on care giving, on healthcare, on recommended websites – it’s overwhelming the amount of information. And of course, I can just go – I’m pretty well aware of where to go on the internet when I need further information. But I have plenty of files, plenty of paper.

MB: I’m going to take you back to California-

SC: Okay.

MB: And you realize, oh my goodness, I don’t have any power of attorney or do not resuscitate, or any of these documents. Is that something you would do yourself, or would you get an attorney?

SC: I would use an attorney, call the local law association and get a list, or if the community has an elder law attorney association. And I’m just looking here in Chicago. A lot of things to do is the state planning, asset protection, wills and trust, power of attorney, guardianship issues – it goes on and on.

MB: How would a person do their homework before they go to the attorney so they know what to ask for?

SC: Basically, they have to start the research, or call someone like myself, or call a geriatric care manager – except that they would want to come in and see Mom or Dad – which is a great idea, because they can also tell you what is needed. If you know specifically that you need an advance directive or wills and trust, I would certainly care the local bar association, the elder care division, and then go on the individual websites that they will recommend. And I think that if they lost their license or something happened to them as a lawyer, they would be removed from that list.

MB: Say Mom had to go to the hospital. How you handle Medicare can make a big difference in how big the bill is. Any tips on how to make sure that you’re handling Medicare right?

SC: Well, a lot of times there are social workers in the hospital who actually work with the patients and the family. My husband’s going through that now with Medicare – just turned 65 – and he spent quite a few hours trying to figure out Medicare and Medicare supplements, who should I use, what’s missing, especially since he has a prior existing condition now. And you just hope after all your investigations that you did the right thing, but I certainly would go on to or, or just type “Medicare,” type in on your computer “Social Security.” I’m doing the same thing with everything now – you know, it’s not elder care related, but it’s living related – to find out about how I get a new license plate. Everything has to be done. And it’s not easy. I have a lot of books on simplifying your life. And I have to read them, of course. It would be sweet if everything was perfect. I love people when you say, “How are you?” and they say, “Oh, I’m terrific!” And no one knows what really exists. And we all have our good times and we have our times when we need assistance. You know, help is just a phone call, or many phone calls. It’s getting on to the Yellow Pages. It’s calling up professional associations. It really requires a lot of time.

MB: With things like Medicare, there are rules, for example, that if you’re there, I think it’s four days or longer, and you step down to a nursing home, then Medicare covers the nursing home for, I think, 100 days. But if you’re there for three days, too bad – you would have to pay for nursing home completely out of pocket. And if you disagree with the decision the hospital has made, you can appeal it, and that often results in you staying there long enough to qualify for the nursing home step-down.

SC: Right, right. But most people don’t know, you know, initially, especially when you go into the hospital and it’s not planned for. You know a lot – I mean, you’re an expert in this field also and I’m sure you help a lot of people.

MB: Yeah. So let’s say that your mother or your husband was in the hospital and it was one of those situations where the staff just wasn’t doing its job and talking to them didn’t seem to work. How would you go about advocating to get it done right?

SC: I would probably call up the local age *26:29. Yeah, they have *26:32 to check on different places. And if they’re doing the proper thing, then they’re going to want to release them anyway. Yeah, it’s a very sticky situation. I think you have to find professional help or speak to a social worker there, who’s supposed to be nonbiased, and just explain the situation and see what they would suggest. It is a real concern. But hopefully a lot of the people just need minor tune-ups in terms of getting their financial planning done, getting their retirement or their money issues, insurance. I have friends who are consumed with their parents, both on a local and a long-distance basis.

MB: Oh, yes.

SC: One of my best friends, her mother just demands that she come over at least once a week and she writes the – checks her checkbooks and the checks and balances and pays her bills and takes her to the doctor. And fortunately, she has a good employer – that’s not always the case – and she makes up her hours, but certainly she’s away from her office a lot of the time.

MB: Yeah, it can be a difficult balance. For people who need them, there are support groups that can do a lot of good.

SC: Right.

MB: Back in the hospital and nursing home visits, I’m a big believer that you not only want to go there to visit and to hopefully cheer the person up and see what they need, and often since the food is so atrocious, bring them some fresh food-

SC: Back to food.

MB: Some palatable food. But it’s a good time to check everything to check and see if they’re getting the right medications and they’re developing bedsores or pressure points and things like that, because most of the nurses and staff are overworked and often things get by.

SC: Right. And those are the things that you eventually read in the newspaper. I don’t know how you would check for certain things, you know, if the doctor – because there are usually on-call doctors associated with the nursing home. I guess you could call in your own physician to do a second opinion and to just check. But basically, it’s whoever they provide.

MB: Well, a lot of times you have to do that through the nurses, get permission from your parent or whoever it is to ask for a copy of the medication list, and then make sure that you know what each medication is supposed to do and whether it makes to you.

SC: That’s right, because different medications – and even food – you shouldn’t eat certain foods with certain medications and-

MB: Oh, it’s absolutely amazing. I see people in nursing homes who have severe diabetes and I see things on their tray that are just horrible for diabetes. And I ask, “Well, aren’t you on a diabetic diet?” And they say, “Well, I don’t know.” So I ask the nutrition staff and they say, “Our instructions our just to give them smaller portions. We don’t do special diabetic diets anymore.” And then they cited HIPAA privacy regulations, that other patients would know that somebody was diabetic.

SC: Right.

MB: I mean, it’s far more important that people get the right food than whether their roommate figures out they have diabetes, you know?

SC: Oh, gosh. Yeah, again, with your professional expertise, you really see it firsthand all the time. I, on the other hand, have knowledge and resource and research. I try to find out as much information, but that’s when experts like yourself are called in.

MB: The network that you’re developing and I love your website. What other things do you think are going to be happening for services for Boomers and seniors?

SC: I kind of like products that isn’t the ordinary products, and I think that’s where we’re going to go. For instance, on your phone, let’s say you have a cell phone. I couldn’t read one of the phone numbers just now and it really got me frustrated because the numbers are so small. There are phones that have larger numbers. There are doorknobs and stuff that are easier to use. I believe that the wave of the future is going to be making things easier from young to old. Of course, in young children, you have to lock things up. But as we grow, as we age, different things happen at different times. You know, at 40, your eyes suddenly seem to be changing. It happened on my birthday. So I believe in getting as much as *30:54 and making things as simple as possible. And probably a lot of things haven’t been invented yet, and emergency systems that you can have in your home or in the assisted living, you know, which gives you some peace of mind. But again, those are choices. And any age can use it, and I just think that we’re coming up with more and more services that people should be aware of. I just used – when we moved, I must’ve been in la-la land because I thought we were all packed up, and I had someone from – my friend at the senior move management company come over. And she said, “You have about three days’ worth of work, with anywhere from three to five packers, and you’re leaving in four days.” I said, “What?” I had no conception. Your mind is dealing with a lot of different issues, and moving, of course, is extremely stressful, right up there with death, divorce, taxes, those things. But a few years ago, Senior Move Managers, people use their movers. I had things double and triple-wrapped. It’s amazing, the slightest thing had tissue paper and duct tape around it, and it could turn out to be a button. That was a little extreme at times, but nothing was broken. And I couldn’t have done it myself.

MB: It’s kind of analogous to what you do for seniors. It’s a very stressful time in people’s lives. The amount of things to do and information to learn is overwhelming. People can do it themselves, but if they can afford it or if they don’t have the time to learn it all themselves, hiring a professional just makes it so much easier.

SC: Exactly, exactly. You can’t do it all and you don’t now how to do it all. And there are so many choices, and hopefully if one choice doesn’t work out, another one will. But with people who have expertise or good research or value referrals that they have based on working with companies previously – you know, there is a lot of competition in every industry. There’s a lot of homecare agencies to choose from. As a matter of fact, I was speaking a homecare agency owner here in Chicago and found out that they can do things differently than ours did in Florida. In Florida, companion service or a nurse’s registry, they don’t do hands-on care. They’re not allowed to, you know, give you the medication or help you into the bathtub and outside of the bathtub – they’re not supposed to. Here, it’s hands-on. But here, the prices were almost double. I was astounded at some of the prices, but they’re used to it here, I guess. So I think planning, you know, like long-term care and so forth, but I think we have to be responsible for ourselves and then try to avoid having to either have your own issues, something that pops up that just changes your life or changes the lives of those you love. So like the Girl Scouts say, be prepared. I still remember that and that was a long time ago.

MB: That got burned in, along with the cookies, huh?

SC: Right.

MB: Sharon, I want to thank you for sharing your expertise with us. I think in your previous life you were probably a matchmaker and now you’re doing of the seniors and Boomers and the services that they need, and I think you’re just a delight.

SC: Oh, I appreciate that compliment. I will save it.

MB: Okay.

SC: And also, if anyone wants to write to me and to get free tips on caregiving, they can write to and request the free tips on caregiving. And you can write to my email if you have any special issues.

MB: Okay. And the website, again, is And information on anti-aging psychology is at I’d like to share a baby step to help people live longer, healthier, and happier. I adopted a catch phrase a long time ago that you get what you expect and inspect. When it comes to little things like if somebody shortchanged you a dollar or you didn’t get that $5 rebate, it’s not worth my time. But when it comes to healthcare issues, when it comes to safety issues, you do have to not only have expectations of getting good quality services and getting what you need, but you do have to inspect it, because the mistakes are just too costly. And as I was talking about with Sharon, in a nursing home, you need to check the medications and make sure they’re right. You need to check the food and see whether it makes sense. You need to check and see whether Mom is getting turned often enough to prevent bed sores. So if you don’t already have the maxim, recommend adopting the maxim that when it comes to things that are important in life, expect and inspect. And if you’re not feeling well enough to do the inspecting yourself, then you need to find someone to do it for you. That’s what friends are for. And I’d love to get your feedback and comments. Just sent them to Information on anti-aging psychology and the Defy Aging Newsletter, which is free, is at This is Dr. Michael Brickey with

Ageless Lifestyles Radio on We’re talking with Sharon Cutler Editor of Information on anti-aging psychology is at This is Dr. Michael Brickey with Ageless Lifestyles Radio on Thank you for listening on our quest to live longer, healthier, happier lives.


Anti-Aging Psychologist, Dr. Michael BrickeyDr. Christiane Northrup








Host: Anti-Aging Psychologist Dr. Michael Brickey

Expert Guest: Dr. Christiane Northrup

Broadcast: 3-1-08 on where the latest shows are broadcast and posted as podcasts

Dr. Christiane Northrup is one of America’s most trusted medical advisors. She sees menopause as a life affirming –if a woman listens to her body and the wisdom it offers. She is an OBGYN physician who takes a holistic, mind-body-spirit approach to menopause, PMS, and women’s health. Dr. Northrup founded the trailblazing Women to Women health care center. She is author of The Wisdom of Menopause and Women’s Bodies, Women’s Wisdom. She has appeared on Oprah, The View, Good Morning America, Rachel Ray, and hosted six PBS specials. Her website is

TRANSCRIPT ©Michael Brickey–excerpts permitted with attribution

MB: This is Dr. Michael Brickey with Ageless Lifestyles Radio, cutting-edge thinking for being youthful at every age. On each program I interview experts on what it takes to live longer, healthier, and happier. Our program takes a holistic approach in addressing anti-aging psychology, medicine, alternative medicine, fitness, nutrition, and wellness. Our emphasis is on innovative thinking and practices that have solid data and results.

First a caveat: Men, if you think today’s show is only for women, think again. The more you understand about menopause and women’s health, the better your relationships will be with the women in your life. And women, you might want to encourage your husbands or boyfriends to listen to the program, as well, because our guest today, Dr. Christiane Northrup, is one of America’s most trusted medical advisors. She has a very unique take on menopause as life-affirming, that is, if a woman listens to her body and the wisdom it offers. She is an OB/GYN physician who takes a holistic, mind-body-spirit approach to menopause, PMS, and women’s health.

Dr. Northrup founded the trailblazing Women to Women Health Care Center. She is the author of two books, The Wisdom of Menopause and Women’s Bodies, Women’s Wisdom. She’s appeared on Oprah, The View, Good Morning America, Rachael Ray, and hosted six PBS specials. In the first part of the program I want to emphasize Dr. Northrup’s unique holistic approach to menopause, and then in the second we’ll look at more specific things about problems such as PMS symptoms and health problems. Dr. Northrup, when I started reading your book, The Wisdom of Menopause, I was expecting a rather dry tome or manual, and I was delighted and just got sucked into the gripping drama of “What happens to her next?” and “What happens to this patient?” Have you always been so tuned in to listening to your body and intuition, or was this a revelation in your life?

CN: No, I started out that way. My Dad was what we would call today a holistic dentist, and he used to say that the mouth was the center of the personality, and that’s why people didn’t want you messing around in there, and also why dentists had the second highest suicide rate, second to psychiatrists.

MB: Oh my goodness.

CN: So there was a bit of mind-body integration going on in my childhood. And then when I got to medical school, I was completely enthralled with everything that modern medicine could do. And it wasn’t really until I got finished with my residency and met my cousin at a macrobiotic restaurant and she told me she was healing her fibroid tumors with a macrobiotic diet. Now, I had just finished a four-year surgical residency and my approach was surgery, so-

MB: Two different worlds.

CN: I began to meet with Michio Kushi of the macrobiotic community – he brought that to the United States back in the ‘50s – and I sat with him as he went over the diet and also the lifestyle of patients who had been given up on by standard medicine. And sitting there for months, looking at the medical records of people and seeing that they’d already been through everything I was trained to offer was a revelation, as I found many of them get better. And after that, I realized there was also a limitation to diet. And ultimately, when people understood the unity of their mind, their body, their emotions, particularly the influence of the subconscious, what they don’t know that they know, then you’ve got the keys to the ignition, your own ignition, and you can get somewhere. Otherwise, you’re at the whim of the culture which really believes that people are meant to disintegrate at the age of 50, that it’s all downhill from there, that your sex life goes away – all kinds of things that are simply beliefs and not grounded in fact or science at all.

MB: So you see menopause as a wake-up call. Can you tell us what you mean by that?

CN: Yes. It’s as though everything in your life converges to get your attention so that you will do what it takes to get healthy in the second half of your life, or you know, maybe – a friend of mine the other day, Gay Hendricks, said, “Why don’t we call it the second third of your life? Because maybe we can live to 150.” But what happens in a woman’s brain – and I know that this is happening in a man’s brain, as well, to some extent, is that as your ovaries are changing and not producing an egg every single month, you actually get an excess of estrogen relative to progesterone. Now, progesterone is a very calming hormone. It also increases heat and it’s very high during pregnancy, so women feel, usually, very calm during their pregnancies and unflappable. But when you don’t have as much progesterone and you have estrogen, that begins to work on certain areas of your brain, the amygdala and the basal forebrain, which is where old memories from childhood and so on are stored, and unfinished business from the past comes up. It’s as though the hormonal change uncovers things that have always been there. So in my experience, women at perimenopause, which is a six to thirteen year process, remember – menopause just means the final menstrual period – so perimenopause is when all the drama and the action takes place. You haven’t actually stopped your periods; you’ve just started the brain and body changes. So during that time, a woman may remember childhood abuse. She may have no tolerance for the kind of injustice that she’s put up with at her job or perhaps in her family. It may be as simple as saying, “I’m sick of being the one who always starts dinner. I’m surrounded by a houseful of teenagers, all of whom can boil water. I’ve had it!” And what that is, is it’s labor pains of birthing your true self. And the thing that’s so wonderful about midlife is you’ve been out in the workforce usually, you know how to drive a car, you know how to run a bank account, you have enough ego strength, you have enough skills finally to have created a container where your true self can finally thrive. You’re not proving to the world that you can do it. It’s not like being in school – although many women go back to school at this time and enjoy it more than they ever did. So I call it break down to break through. There is no question that the incidence of chronic degenerative diseases increases in the second half of life. This is not inevitable. It has to do with lifestyle choices. And what I believe happens is that, at this turning point, the body will not let you get away with the stuff you’ve been doing for the past 50 years that wasn’t a good idea in the first place.

MB: Before we elaborate on that, it’s only in the last couple of years I’ve heard much about estrogen dominance. How did we end up with this impression that everything was just a lack of estrogen?

CN: No kidding! Yeah, how did we? Well, you know, we could do a brief romp through the history of Premarin. Premarin was the first oral estrogen that was available and made from the urine of pregnant horses, back in 1949, 1950. Before that, estrogen was available only as an injectible. Now, when you have your ovaries removed with a hysterectomy, then you have the rug pulled out from under you in terms of estrogen, progesterone, and testosterone. And so clearly, we have needed a supplement to replace a woman’s missing hormones. And so we thought of the menopause actually, culturally, as a deficiency disease, you see – doctors were thinking about it as you were lacking something. And the truth is that you’re not lacking anything when the body is healthy, when the adrenals are healthy and the ovaries are healthy. But remember, one in three women has a hysterectomy in this country, and so she’s changed the blood supply to her ovaries. And in those women, clearly estrogen, which is considered the most important hormone, but progesterone is left out in the cold and testosterone has gotten short shrift, as well. So it’s all such an interesting thing because science takes place within the context of a culture, and so we look for what we expect to find. If we’re looking at menopause as a deficiency disease and if we have managed to create a pill from the urine of pregnant horses, then if the only tool you have is a hammer, everything looks like a nail.

MB: And we got to pregnant horses so that we could have a patentable medicine that would profitable, as opposed to a generic that wouldn’t earn much money.

CN: Exactly. That’s the whole thing about the term “bioidentical” hormones. Bioidentical simply means hormones that match exactly what your body produces, and those can be made from wild Mexican yams or soybeans, and that gives you the basic hormonal moiety, and then you make changes in the lab, but you end up with a hormone that matches the molecular structure of your own hormones. And if you know the way hormones work in the body, it’s a lock and key, but it’s more than that, because the charges around the molecule of a hormone, the positive and negative charges, cause it to fold in a unique three-dimensional structure that your body recognizes because it has evolved over millions of years to recognize, for instance, 17-beta estradiol. It hasn’t evolved over millions of years to recognize the urine of a pregnant horse. But as you say-

MB: See, as you said, our bodies are smart.

CN: Yeah, and those things are not patentable. The delivery system, however, can be patentable, and that’s why we have some very good choices with the patches, the transdermal patches, Climara, Estraderm. Those are bioidentical hormones that match what is in your body. But it is the delivery system that the pharmaceutical company was able to patent, and therefore they can make money on them.

MB: You see menopause as a gift and a metaphor. What do you mean by that?

CN: The gift of menopause is that you are now your own person and you must source your life from your own spirit, your own higher power, who you really are uniquely. So I often say to women, “Remember what you liked at 11, when you were 11, before your hormones started in.” And the gift is you live from the inside out, instead of the outside in. What happens is women then, because they are operating from who they really are, not from who the world expects them to be, they often find themselves doing the best art they’ve ever done, having the best sex of their lives, being healthier than they’ve ever been, being happier than they’ve ever been. This is the big secret, that life gets better in your 50s and 60s. And this is a secret because our culture believes just the opposite. We are such a youth-focused culture that people who hit 30 suddenly begin to think something is wrong. Can you imagine anything that’s more death-affirming than that, that at 30 it’s all over? This is simply insane. And it creates a great deal of pain and suffering that is needless, because the truth is you’re really at your best starting at about 50. And I think that maybe 65 is when we hit our stride in a big way.

MB: And there’s wonderful research that shows as we get older, a higher and higher proportion of Americans say they’re very happy, and it goes from 28% in your 20s all the way up to 38% in your 70s.

CN: Isn’t that wonderful?

MB: You talk a lot about women being in a subservient role. Do you think there’s something about puberty that brings that on, at a hormonal level?

CN: I do. I absolutely do. I believe that what it is, is that females are the bodies in which new life is formed. And in order to nurture new life successfully, you need support. And therefore you will do whatever it takes to get that support. We are mammals, after all. And so I believe that the women’s movement had to happen, where women said, “Wait a minute. I’m not going to be subservient anymore. I can do this on my own.” So then what we’ve had, what the Baby Boomers have been the pioneers in, is women going out and having sperm donors, or just deciding to have a baby on their own. As you know, in the ‘50s, you would’ve been so ostracized. You couldn’t have done that and stayed healthy, given that we all need community and we need support and social support to stay healthy. So we’ve changed all the rules. The Baby Boom generation has changed all the rules. Now we’re at a point where we can have true partnerships with men, because when you understand your own strengths and you understand yourself as a woman, as the source of life itself, when you see how important that is to the planet and you begin to own your own gifts, you also understand – and this is really new information for me and my daughters in about the past three years, in a way that we live it – you understand that it is this life force that you know how to support, that you actually support men with. Men don’t do well without the support of either their inner feminine or a woman in their life. We know that from psychology studies. The men who are the happiest and healthiest are the ones who have women in their lives. And when you know this as a woman and you don’t see him as more than, you see yourself as equals, but you have specific gifts, and when you can uplift a man and reflect to him his heroic status, when it’s warranted, then you can improve all of life on earth. It has taken me so long to get it that men are much simpler than women. They don’t get complicated like women do. Haven’t you found this? I mean-

MB: Yes.

CN: Yeah.

MB: Very much so.

CN: You have no idea where women go in their minds. I mean, it is like some kind of a maze in there where we make things so complicated. We hold on to old baggage. A man will have forgotten that, whatever you’re bringing up – you know, the fact that he left you standing at the street corner and didn’t know you were going to be there. You’ll be hanging on to that ten years later and you’ll haul it out of your purse and land it on him when something like that happens again, and a guy is kind of defenseless because he doesn’t even remember. Men are in the moment, and when a woman understands that her mind is multi-modal and she can remember forward and backward in time, and she can remember the birthdays and the needs of her whole family, that’s a tremendous gift that we cannot expect men to share that gift with us. They have different gifts and talents. So the anger that comes up at midlife needs to be addressed, but then it needs to be released or you will have a very unhappy second half of your life if you continue with your anger at men in particular.

MB: As my wife says, “Well, it’s all connected!”

CN: Right. And you know, this is why, in medical school, on my boards and all the multiple choice tests, I could figure out a way in which every choice was correct at least once. That’s a woman’s brain. A guys says, “It’s obvious what the answer is.” To a woman, it is not obvious because it’s all connected.

MB: You describe women as wired for intuition. Are they more wired than men are?

CN: I believe that they are wired differently than men are. Men call it a hunch, and the way you see the intuition playing out in men – if I may be stereotypical – would be on the sports field, where they sort of intuitively know where the ball is going to be tossed. Or the great hockey player Wayne Gretzky was able to tell what someone was doing behind his back – and if that isn’t intuition, I don’t know what is, because the definition of intuition is knowing something with insufficient data. I believe that all of us are intuitive, but we are taught to shut that down as children. The energy medicine teacher, Donna Eden, points out that when you say to children – when you acknowledge an energy field around people and places and plants and so on and you acknowledge that it’s there, the child will not lose his or her ability to see energy around things. And in fact, she has many young people that she trained in Ashland, Oregon, who have always been able to see auras, for instance. And that’s part of intuition. Clearly when you walk into a room, your gut knows who’s safe and who isn’t, and we train that out of kids by saying things like, “Don’t talk to strangers.” That’s really a wrong thing to teach anybody, you know; “Just don’t talk to people who seem strange” would be better.

MB: You pointed out that women are more prone to depression until menopause, and then after menopause their rates of depression are equal to rates for men. Does menopause cause women to become more like men?

CN: You know, I think that it does, actually. There’s a role reversal that happens at midlife, sort of kicks in their vocational arousal, as it were. So they want to go out in the world and get it. Many want to start new businesses, and so on. And in fact, the inner part of the ovaries, the stroma, does get bigger, so many women produce more testosterone around the menopausal transition, physically. But metaphorically, there is this huge drive to go out and get something done. Many men have already been out there fighting in the workplace for years, and so many come to the home and want to get more into cooking or gardening. And what works beautifully in a relationship is when they can trade off a bit and start doing what the other has been doing. I believe that women develop their more masculine side and men develop their more feminine side. So for the first half of life, men lead with the low heart and women lead with the high heart – and the low heart, I mean the genitals and so on. But at midlife these things switch around because we really need to come to balance so that it isn’t one or the other. And depression is interesting because it’s often been called anger turned inward. And what happens with many midlife women – it certainly happened with me – is that the anger comes out and gets expressed and you find that it’s simply energy, it’s just jet fuel. Anger means that you have been shortchanged in some way or you feel that you have been, or things haven’t turned out the way you wanted them to. And so it’s your job to address how to change the circumstances of your life. And I’d much rather deal with a woman who is angry than a woman who is depressed, but there isn’t a question – the female brain is more prone to depression, and I think it’s related to the fact that we have the ability to remember every thing bad that ever happened to us.

MB: You talk a lot about accepting responsibility as opposed to being a victim. What do you mean by that?

CN: Yes, this is the most bracing message I have, and that is that you must be responsible for your life, which simply means the ability to respond. It doesn’t mean that you are to blame for what happened. It doesn’t mean that if you were raped as a child or beaten in a marriage or passed over in a job that that is right or just. It simply means you are responsible for your response. So I was recently at the Books For a Better Life Award, and a woman who wrote a book called The 51% Minority – she was a lawyer who was working in a law firm and had been there a long time, was a senior litigator, I believe. And she found that someone who was ten years her junior, who didn’t have half the workload, was earning more money than she was. So she took it to the authorities in the business, and I believe that her boss said, “I will match your salary with his, as long as you don’t tell anyone” – like, don’t let this get out. And she was so outraged by that, that she wrote a book simply to help women stand up for themselves in a way that is reasonable. I believe that there are ways in which you can use your energy that is life-affirming, and then there are ways that you can just run around screaming that, “It ain’t fair and ain’t it awful?” It doesn’t take any time at all to find injustices in the world when it comes to women. I like to say I have footnoted women’s pain; I understand it very, very well from the bone marrow on out. But we’re now at a time when, if anything is going to change, we need to step out of the victim role, because whenever you’re in the victim role – you know that classic triangle, I think it’s called the Rossberg triangle – there’s the victim and then there’s the rescuer and then there’s the persecutor. And usually what happens is the victim becomes the persecutor to someone else, and then someone else has to come in and rescue. And there’s no health in any of those roles, if you’re in those roles chronically. The only health is when you step above all of that and see that you have different choices. You can leave a workplace that is chronically wrong for you. That’s one of the beauties of midlife is you actually get to the point where physiologically you can’t put up with it anymore. You’ve compromised and you’ve compromised and you’ve changed yourself and you’ve done everything in your power to fit in, and it just isn’t working anymore. And finally you say, “Hey, maybe it’s time to do something else.”

MB: So it’s a question of doing something about the anger, doing something about the wrongs in your life. Are there other things involved in listening to your body?

CN: Yes, resting when you’re tired is kind of huge. The average woman is not getting even eight hours of sleep a night, and sleep is the best way to metabolize stress hormones that we know of. It will gobble up excess cortisol and epinephrine. And by the way, excess cortisol and epinephrine are the things that create cellular inflammation, and cellular inflammation is at the root cause of all chronic degenerative diseases – diabetes, high blood pressure, cancer, heart disease. So getting enough sleep is important, resting when you’re tired. The other thing you must do is you must tune in to know what you’re really, really feeling, and that means slowing down. And when I say slowing down, I mean in the moment you pay attention to your body. You make sure you’re breathing fully all the way down to the bottom of your lungs. You have to exercise. And all of these things – you begin to know that your body responds also to choices that are empowering, thoughts that are happy and uplifting, and so little by little you monitor your thoughts. You start your day, let’s say, with a meditation or simply with some breathing, and you see the difference it makes when you change a thought, and you see the difference it makes in your body. But I will say this about the body. If you have a condition that is bothering you, you must understand it did not leap out of the closet to torture you. It’s related to your life. And that’s one of the things I share throughout the book, The Wisdom of Menopause. My own story of a fibroid, a big fibroid in my uterus, creativity that hasn’t been birthed yet, or creative energy being shoved into a dead-end job or relationship. In my case, it was a marriage that wasn’t working. You won’t know what the message was, usually, until after the thing is over. But I would say to everybody, you could so benefit by understanding that everything that happens to your body is a metaphor for something that’s going on in your life. And then you will not feel like a victim of your body. If you want to use standard conventional medicine as an approach, go right ahead. But understand that simply cutting an organ out or taking a pill to squash symptoms is not going to get you to the promised land. Only taking full responsibility for what this might be and working consciously with your body, mind, and spirit – that’s what works.

MB: So we have dealing with the anger, we have taking care of yourself, and really just realigning with “What’s my sense of purpose?” and “What do I need to do with my life?” Let me take a break here. You’re listening to Ageless Lifestyles Radio on We’re talking with Dr. Christiane Northrup, author of two books, The Wisdom of Menopause, and Women’s Bodies, Women’s Wisdom. Her website, has information about women’s health, her books, her newsletter, and speaking engagements, many of which are open to the public. Information on anti-aging psychology and my free Defy Aging Newsletter is at Dr. Northrup, I’d like to shift to some of the practical things that women can do. I hear a lot about eating more soy. Is that helpful or not helpful?

CN: It depends on the woman. Soy has sort of gone – the pendulum has swung, I think, too far with soy, so that women are eating only soy protein. I believe that soy is an important part of the diet, and particularly in those women who are not on hormone replacement or who are having problems with hot flashes, vaginal dryness, anything of that nature, then trying soy is very, very effective in many, and I’ve certainly had – I’ve had women come up to me in airports to say thank you so much, you know, for recommending certain soy products. But there are other women who find that they don’t do well on it. So what I would do is I would try some soy nuts, some soy milk. There’s a product called Revival Soy that is particularly potent for menopausal symptoms, and give it a try. I would also say it’s important to take enough Omega-3 fats. These are what’s found in fish oil. And in an analysis of 70 studies, it was found that fish oil decreases all cause mortality, and is more effective at keeping cholesterol and heart disease at bay than all of the statin drugs. So fish oil is very, very important. If you’re a vegetarian, then you can bet Omega-3 fat in flaxseed or also in algae. So there’s no excuse, is what I’m saying here. You also need to take enough Vitamin D. We find that those women who are most at risk for hip fracture or spinal fracture from osteoporosis are the ones who have the lowest serum levels of Vitamin D. This is the one blood test I believe that every woman should have – not only a lipid profile, you should find out what your total cholesterol is, what the good cholesterol is, the LDL, the so-called bad cholesterol, triglyceride level. Don’t let someone put you on statins simply because your cholesterol is above 200, if it’s in the 200-250, 230 range. If your HDL cholesterol is good and high, like 60 or so, then you do not need statin drugs. Statin drugs decrease coenzyme Q10 in the blood. This is an absolutely essential nutrient for energy production in the cell. And where you need energy production in the cell is in your heart, and the statins are being prescribed far too much. Vitamin D levels should be 50 or above. You can have your healthcare practitioner draw that level. And then you should be taking at least 1000 IUs of Vitamin D every day, or going to a tanning booth – I would recommend the stand-up booths with sunscreen on your face and your hands, and about six minutes will boost up Vitamin D very nicely. It also boosts your mood because it increases serotonin in the brain. Light is a nutrient. So those two things are important. Enough calcium and magnesium. We hear all about calcium; we never hear enough about magnesium. Magnesium and calcium have to balance each other. Women who are depressed often have low magnesium levels. Magnesium is what’s necessary for sparking the nerve – from nerve cell to nerve cell requires magnesium to make that connection, and it’s also very relaxing. A very good way to get magnesium is with an Epsom salt bath. One half to one cup of Epsom salt in the bath, soak in there for 30 minutes, read a good novel – that’s a good prescription for a good night’s sleep.

MB: Are these the same things that would help with hot flashes, or are there additional things that would help?

CN: Actually, those could help. Soy will definitely help with hot flashes in many women, not all. The gold standard for hot flashes is estrogen replacement – although if a woman has estrogen dominance, then progesterone is what will help with hot flashes. And you can use as little as one-quarter teaspoon of transdermal progesterone on your skin – and this is available over the counter at health food stores. One of the good brands is Progest or Emerita. And many women have been helped by that. Also, that can help with premenstrual migraines, because those are triggered by too much estrogen. Now, the other things you can do for hot flashes, you can change your diet and get rid of the white foods. So that would be white flour products, mashed potatoes, white sugar products; also wine and coffee can trigger hot flashes, but not in everybody. So what you do is you say, “Okay, let me give myself a one-week period of time where I stay away from these foods, particularly the wine, and see what happens.” And if you notice that your hot flashes are far less, then you know what triggers them. Then you can decide whether you’re going to have the wine and get a little hot or not. You know, it’s at your fingertips. The other thing that helps hot flashes, believe it or not, is meditation. And Herbert Benson at Harvard did studies showing a 90% reduction in hot flashes with two 20-minute periods of meditation per day, using what he called his relaxation response, which is where you simply sit and repeat a word in your mind like “peace” or “rose.” There are various mantras that you can do. And the reason that this works is that it decreases stress hormones. And stress hormones in the body actually change the way hormones are metabolized. So it all goes back to what we call stress. And my definition of stress is anything in your life that you don’t like the way it’s turning out, and so therefore you’re railing against it. That’s emotional stress. Of course, there’s physical stress of being too cold or too hot or too hungry, that sort of thing. But it goes back to a balanced lifestyle.

MB: One of women’s biggest concerns, and men’s biggest concerns, is about the effect on the sex life. What can a woman do to maintain a good sex life during menopause and after menopause?

CN: Well, this is about my favorite topic. I just written my fourth book on that and it’ll be out in October, called The Secret Pleasures of Menopause. It’s interesting that you can have pleasure or you can have anger, but you can’t have them at the same time. And I’ll tell you why this is so – it’s really key. Stress hormones like norepinephrine, adrenaline shut down not only blood supply, but they also shunt your nervous system in the direction of fight or flight, so you’re preparing for battle. Entirely different from what’s necessary to shunt the blood flow to the clitoris and to the genitals and to the breast and to the erogenous areas of the bodies. For that, you must be very relaxed and receptive to receiving pleasure. So what happens during the midlife transition is all of the stuff in a relationship that’s been shoved under the rug comes up and hits women between the eyes, and the first thing that goes is their sex life. Now, data from the OB/GYN literature shows that the number one predictor of a great sex life during the menopausal transition and beyond is a new partner.

MB: Uh-oh.

CN: Now, the reason I say that is not because I want women to dump their partners, I want them to become that new partner. This is really important. Many times men don’t know what’s going on, and it is the woman’s job to find out, maybe for the first time in her life, what pleases her, what does she really, really want? And I would say for your listeners, write down five to ten things that you really, really want, and then ask for them. Ask your mate to provide them. But you must do it in a way that is very fun and very flirtatious. Now, that’s what you do in a relationship. But many women, for a while there, for a year or two, feel the need to go into a cocoon and reinvent themselves. So I feel as though the sex juice, as it were, the libido, goes underground like the sap in a tree route in the winter. It doesn’t mean it’s gone. It will come back. It will rise again. But a woman sometimes needs a little time alone in a cave as a she reinvents herself. So that’s very important for a woman to know. Then let’s say that she has her time alone or she goes away to a spa or she somehow changes her job or does something. Then it is her job to learn what turns her on. And you actually can learn this and do it with self-pleasuring or what the Daoist masters call self-cultivation. Another word for that, which I don’t like, is masturbation. Women need to learn what their wiring diagram is, and this is work that you do with yourself, for yourself, because you cannot tell another person what you like if you don’t know yourself. And this is the other thing. At midlife, many women develop thyroid problems. Thyroid is in the fifth chakra. It’s about having your say. It’s saying what you need to say. And it’s time that you learned to ask for what you want. This is a huge risk for most women because they’re afraid of being rejected, and many of them are so surprised and delighted to find out that their mate has been waiting for instructions. See, this is what women think. Women are brought up to believe that if a man is a good guy, he will know – he should know what to do to please them. He will know what to get them for Valentine’s Day. He will know what to get them for their birthday. He should do this big romantic thing like you see in the movies. Well, men want to be romantic. They don’t know how to do it. It is a woman’s job to decide what she wants her mate to do for her, and then set the stage to help him meet her expectations. This goes back to women as the bodies that create life. She can help him do that for her. But if she simply clams up and is angry without saying what would please her, then it’s a stalemate. And if you’ve got 25 years of that going on in a relationship, it is little wonder that sex drive goes away.

MB: So the biggest key on sex life is really getting to know your body and your needs and effectively communicating that?

CN: That’s right. And also understanding that menopause per se does not decrease libido, ease of reaching orgasm, or desire for sex. It doesn’t. And I believe that that is a big cultural myth that many women are up against, because they believe this is the end, when in fact it’s just the beginning. You have the ability, through your attention and focus, and to rewire your body for more pleasure. But to do that, you need to work through your resistance to pleasure. And we all have a ceiling on our pleasure that we’ve usually learned in our families of origin. But I’m here to tell you that the way the body was designed, sex gets better. And that is in fact the latest research: The women having the best sex of their lives are in their 60s and 70s.

MB: And also contributing to that is you’re not worrying about the children knocking at the door or interrupting, or so exhausted from childrearing, and you have more time and less worry about pregnancy.

CN: That’s exactly right. Now, for many women, there is the lack of a partner. So I want to cover that for a moment. And for many – let’s say that they’ve gone through a divorce like myself, or are widowed, or simply don’t have a man, of if they’re a lesbian, a woman in their life. Your job, ladies, is to begin to become the person that you yourself would fall in love with. You can use this time to reinvent yourself and become the person that you yourself can fall in love with. I did that for seven years. I’m now with a wonderful man. But I had to go through all of the stuff that all women go through, thinking it’s over, they’re too old. All of that is simply cultural baggage. I also read a book that I would like to recommend to all of you called Mama Gena’s Owner’s and Operator’s Guide to Men. Let me repeat that: Mama Gena’s Owner’s and Operator’s Guide to Men. It’s by Regena Thomashauer. And she runs Mama Gena’s School of Womanly Arts in New York City. I read the book to see if she was crazy or not, and she turned out to be not crazy at all, and in fact helped hundreds of women reinvent themselves and also find far more happiness with themselves and with the men in their lives.

MB: Sounds like a fascinating book. One more question. You talk about how women, or probably men as well, attract the unhealed parts of ourselves, and that brings on a lot of chronic disease. Can you explain that?

CN: Well, I believe that in childhood we make certain decisions about ourselves – I’m too fat, I’m not good enough, I’m whatever. And then the parent that we had the most conflict with, we tend to marry or they become our boss or whatever. And I believe it’s because we’re trying to bring love to an area where we have not experienced love. And then we stay in that relationship until more love needs to be called in than that particular container will hold. And if you fail to leave that relationship or you can’t be in a state of love in that relationship, then you get sick. And-

MB: It’s that simple.

CN: It is that simple. I wish it were more complicated. And I’m not blaming anyone. But let’s look at heart disease. It’s the number one killer of women – and men, for that matter. And it outpaces breast cancer by, you know, about 40 to 1. I mean, it’s the one that – if you’re going to be worried about something, be worried about this, and then do something about it, because heart disease is reversible. But anything that your heart isn’t in will begin to take its toll on your heart. Any time you can’t have your say because whoever you’re with won’t hear it, your thyroid could be adversely affected. Any time you’re not nurturing yourself fully, your breasts will take a hit. It’s that simple.

MB: Dr. Northrup, it’s just so refreshing talking with you and getting this holistic view of menopause and women’s health. I really appreciate you being on the program.

CN: It’s been my pleasure.

MB: I like to wrap up shows with some baby steps to hopefully help you live longer, healthier, and happier. In one of my favorite jokes, a reporter asked a 104-year-old woman, “What’s the best thing about being 104?” And she said, “No peer pressure.” As we get older, this is one of the perks, that we become less and less concerned about peer pressure. And indeed, people in their 80s and 90s says, “I don’t have time for that nonsense!” I think Dr. Northrup was teaching us that if you have problems with peer pressure during menopause, you’ve got one big wakeup call saying it needs to be dealt with now, instead of when you’re 80 or 90. The second baby step principle I’d suggest is what I call the rule of thirds, that unless you’re extremely charismatic or a horrible, horrible curmudgeon, most people have a third of people liking them, a third of the people not liking them or not liking their style, and then a third of people not really caring one way or another. And the moral is to be the person that you really want to be, the person that you really are, so that the third of the people who like you, like you for the real you. You’re listening to Ageless Lifestyles Radio on We’re talking with Dr. Christiane Northrup, author of The Wisdom of Menopause, and Women’s Bodies, Women’s Wisdom. Her website, has information about women’s health, her books, her newsletter and speaking engagements. Information on anti-aging psychology and the Defy Aging Newsletter, which is free, is at This is Dr. Michael Brickey with Ageless Lifestyles Radio on Thank you for listening on our quest to live longer, healthier, happier lives.



Anti-Aging Psychologist, Dr. Michael BrickeyDr. Nicole Flora








Host: Anti-Aging Psychologist Dr. Michael Brickey

Expert Guest: Dr. Nicole Flora, Anti-Aging Physician

Broadcast: 2-24-08 on where the latest shows are broadcast and posted as podcasts

Medicine has focused on treating diseases. What we call healthcare has mostly been disease care. Anti-aging medicine emerged in the last ten years or so to ask what can doctors do to be proactive in preventing aging and diseases. As a new discipline, it has attracted both very dedicated physicians and frankly a few hucksters. Today’s expert is clearly one of the best anti-aging physicians, Dr. Nicole Flora. Dr. Flora was Board Certified in family medicine, obtained a Master’s degree in Public Health, and later specialized in age management and anti-aging medicine. She has been active in research and is on several policy boards. In the first part of the program, we will focus on what anti-aging medicine is and what it has to offer. In the second part of the program, we look at the pros and cons of different anti-aging treatments. Her websites are and

TRANSCRIPT ©Michael Brickey–excerpts permitted with attribution

MB: This is Dr. Michael Brickey with Ageless Lifestyles Radio, cutting-edge thinking for being youthful at every age. On each program I interview experts on what it takes to live longer, healthier, and happier. Our program takes a holistic approach in addressing anti-aging psychology, medicine, alternative medicine, fitness, nutrition, and wellness. Our emphasis is on innovative thinking and practices that have solid data and results.
Medicine has focused on treating diseases. What we call healthcare has been mostly disease care. Anti-aging medicine has emerged in the last ten years or so to ask, what can doctors do to practice preventing aging and preventing diseases? As a new discipline, it’s attracted both dedicated physicians and, frankly, a few hucksters. Today’s expert is clearly one of the best anti-aging physicians, Dr. Nicole Flora. Dr. Flora was board-certified in family medicine, obtained a masters degree in public health, and later specialized in age management and weight management. She’s been active in research and on several policy boards. In the first part of the program, we’ll focus on what anti-aging medicine is and what it has to offer. In the second part of the program, we’ll look at the pros and cons of different anti-aging treatments. Dr. Flora, after years in medical school, what prompted you to get a masters degree in public health?NF: It was part of the career path that I had chosen. After I came out of medical school and residency, I joined a group that was providing indigent care in the southern part of the state, southern Ohio. And we really took care of about 57,000 patients that had no insurance and had no access to good healthcare. And so as part of that path, they pursued the public health arena and then took over a lot of the quality assurance and some of the government programs to help people that couldn’t get good care.MB: So working with indigent patients got you interested in chunking up to a higher level of, “How can we solve some of these problems on a policy level and get a better system?”

NF: Absolutely. We saw some of the epidemics of disease and some of the cultural ills that affected these people, and it really – while I wanted to certainly impact people’s lives on an individual basis, I felt like there needed to be a broader approach.

MB: And then what got you into age management and weight management?

NF: It was kind of an extension of that. You know, after seeing – unfortunately, in the poorer populations, obesity, diabetes, heart disease, poor nutrition and poor lifestyle choices are rampant. And that really was what I wanted to tackle. And in age management, that’s exactly what we approach are all of those things, and how do we prevent those things, and how do we get people to think proactively about their health and about their lives.

MB: So you were working with the other end of the extreme, people who are aging very fast?

NF: That’s right. I would have young people in their 30s – you know, the most extreme examples were the 10 or 11-year-olds that came in and they were already obese and had diabetes. I probably diagnosed 50 preteens with Type 2 diabetes because of poor lifestyle choices. And those kids were not going to live very long.

MB: Was there something specific that got you to go from public health to the age management, weight management?

NF: It had a little bit to do with the system. Unfortunately now, the way healthcare is structured, in order for it to be financially feasible, you have to see a huge number of patients. And I was averaging, on a lot of days, 40 patients a day. And it really became an ethical dilemma to me. I knew I could treat them well. I was treating them at the standard of care, but I knew they needed something better than that, and I wanted to be able to provide more than that. The system as it’s structured now just doesn’t allow for that. So it really kind of became an ethical dilemma – do I give them another pill and I expect to see them in about three months when they come in for the side effects from the pill I gave them last month. I just wanted to have greater contact with my patients and hopefully have a great impact long-term.

MB: So now are you working with kind of a cross-section of social classes and lifestyles?

NF: Well, unfortunately I’m not. Age management medicine, because it is relatively new and because insurances don’t cover it in most cases, right now my experience is relegated to those people that can afford to pay out of pocket, and that’s certainly fine for them but it does leave out a huge portion of the population right now.

MB: Personally, I don’t have any problem with that because it blazes the trail, and what’s the ideal standard of care now becomes the standard of care maybe ten years from now.

NF: Well, that’s absolutely right. And that’s certainly my hope, is that as we get better and better at this and as we hopefully do get rid of, as you said, some of the hucksters in the arena, that it will become standard of care and will be more acceptable to people. And that’s certainly my hope for the long term, and some of the things I do with the physician advisory board and things are to promote those type of things.

MB: And in the long run, it’s going to be cost effective by preventing a lot of health problems, and a lot of medications.

NF: Absolutely, certainly.

MB: If a 50, 60-year-old person comes into your practice, what do you do that’s different than if you were a mainstream family practitioner?

NF: First thing is that I get to know them. Instead of spending 15 minutes, and two or three of that is looking at their chart and seeing what the nurse wrote and having a brief conversation about what’s ailing them today, they’re in my office for their first visit usually between six and seven hours – between meeting with the nutritionist and meeting with any additional people in the office, and they’re usually face-to-face with me for two to three hours. And most people have never had that type of experience with a doctor. And you get to know what’s affecting them, what pressures they’re under, how they eat, how they exercise, what are their support systems, certainly what are their medical issues in the past, what really do we need to fix now and what are going to be hurdles in the future to keep them healthy. So it really is that close connection that is the biggest difference to start with. In the long run, it really is the fact that we work together so closely, maintain a very close relationship. I work with their other physicians, if they have specialists that they work with. It really is that quarterback mentality that I think primary care was originally supposed to tackle, and it ended up just being a paperwork job where you just do referrals for everybody. But it really is keeping the patients educated on everything that’s going on in their lives from a health standpoint.

MB: So right from the start it’s holistic and it’s about a relationship.

NF: Absolutely. And that’s what makes it most rewarding.

MB: I suspect some of your patients are shocked to have so much one-to-one time with the physician.

NF: Oh, that’s the first thing. They’re like, “Really? Are you serious? You need six hours of my time?”

MB: We’ve all spent six hours of our time going from one test to another, but to spend a couple of hours face-to-face with a physician is a real treat.

NF: That’s right. And instead of wasting your time, at least we’re getting educated and getting to know each other.

MB: So we’ve had this first session – then what?

NF: Well, certainly after that it varies, depending on the person and what their individual needs are, what their goals are, what we’re trying to fix and kind of what the short-term issues are, as well as long-term. But certainly, just a general overview is we want to get them eating better, we want to get them moving, we want to – if they need medications, and whatever they need. If they need specialists, if they need therapists, we’ll facilitate it.

MB: I gather that it’s not everybody needs to be at this level of hormones and this level of exercise and, you know, get with the program, but extremely individualized.

NF: Absolutely. And that’s one of the problems we’ve had with mainstream medicine is that we have over-generalized. And a lot of the things that you will see come down the pike as problems are because we took some research point that sounded good and tried to apply it across the entire population, and we abdicated the thought process, I think, in some cases. And so everybody’s very individualized. I do certainly have people on hormones. I certainly have people on blood pressure medicine. I have the whole gamut. But it really is very individualized to each person and their needs and their health and what’s the best combination for them.

MB: How many of your patients come to you and say, “Dr. Flora, can you get me some of that HGH? You know, is it legal? Is it going to make me a he-man?”

NF: Well, I have a small percentage that actually come and say that. I probably have a bigger percentage that think that in the back of their mind. Honestly, about 7 or 8% of my patients are on HGH, but a lot of people, that’s what they hear about and so that’s what they think it’s all about. And certainly HGH is a wonderful medication when used appropriately in appropriate patients with the right expectations. But unfortunately, there is a ton of misinformation regarding it. It is not the cure-all for everything. It won’t make you live forever. It won’t make you beautiful if you’re not beautiful to start with. But it has its place. And it’s a very safe medication and it is certainly appropriate in some people.

MB: So who are the 7% that benefit from it?

NF: The people I specifically prescribe it to are people who have developed a deficiency, so they have stopped producing it naturally – they have no levels. And those people are usually experiencing things like a lot of muscle loss, weakness, tiredness, and a lot of quality of life issues. Growth hormone really affects your ability to kind of appreciate life and mood. And those are the people that really end up benefiting from it the most, are the ones that have that combination. The other thing with human growth hormone is it rarely is a problem by itself. When I see human growth hormone has declined, it’s usually declined in combination with other hormones. And so a lot of times when we balance the other hormones, it will help you produce human growth hormone, and a lot of people will improve their human growth hormone that way, as well.

MB: So you rarely recommend using human growth hormone to enhance; you’re usually using it for people who have deficiencies?

NF: That’s right, yes. I do not.

MB: What about testosterone? I see all these charts about how men’s level of testosterone declines with age dramatically. Is that something that should be enhanced? Or again, are you just concerned about deficiencies relative to a person’s age?

NF: It does decline dramatically. And not only does it decline dramatically, if we look at population studies from as little as about 20 years ago, the average testosterone level of men in our society now is 17% less at any given age, and we’re not quite sure why that has occurred either.

MB: All these metro males, huh?

NF: Yeah, certainly I do recommend we replace it, and I do take men to an optimal level, not for their age.

MB: My understanding, one of the problems with replacing testosterone is that it often gets bound and can actually turn into estrogen and have the reverse effect. How do you control for that?

NF: That’s why if you’re going to deal with hormones, you need somebody that’s very well-educated on how to do it. I’ll see a lot of people come in and they’ve gotten testosterone from one source or another and it’s not being managed well. You have to – before you start that medication – you have to measure all of those things. It’ll give you a pretty good picture of how an individual man or woman will metabolize the hormone. It doesn’t always give you the whole picture, but it’ll give you a good starting point. And then you monitor those as your start therapy and continuously throughout. If men start putting out too much estrogen, then certainly we can sometimes change the route of administration of the testosterone, you can sometimes use prescription medications that block the conversion, and you can sometimes use herbal preparations to stop the conversion, as well.

MB: With women, they practically stop producing testosterone after menopause. Are you doing any testosterone supplements with them?

NF: I do. And honestly, my experience with women is I will see women drop their testosterone usually in their 30s. We always think that the hormone production stops at menopause, but truly, I will generally see women who drop their progesterone, drop their testosterone in the early 30s, up to 10 to 15 years before they actually stop producing enough estrogen to stop having cycles. I will even replace it in some women before menopause if we see that it has declined beyond a normal range.

MB: Top of your head – what percentage of women in our country would probably benefit from hormone replacement after age, say, 40?

NF: After 40? Well, if we say after menopause, I would certainly say a majority, but not – you know, it’s not 100%. There are still other risks to be considered. After 40, though, it really depends on where they’re at in the perimenopausal cycle. But I do see a lot of women in their 40s have a lot of PMS type symptoms, have a lot of weight gain around the middle, develop more fatigue, those type of things. And so – and those are the women that usually seek me out. So of the people coming through my door, it’s a huge percentage. It’s probably 90%. In the general population, I would probably guess at age 40 that it’s probably about half of the women.

MB: So is weight gain a red flag that something’s probably going wrong?

NF: Something is wrong when you start gaining weight. Unless you’re someone that walks through my door and tells me that, “I eat McDonald’s three times a day and I never exercise,” that’s generally not the case. Those people – certainly it’s a lifestyle issue, and everybody has lifestyle issues. But when we start seeing the kind of weight creep, I like to call it, where it’s just every year you’re adding a little bit and you’re adding a little bit, and then all the sudden you’ll see it, about 20 pounds in a year – that tells me that there is a metabolic issue going on. And the fact that we tell women, “You know, just eat less and exercise” – certainly that is good advice, but it is missing a whole component of the picture of what’s going on, and it really is a little patronizing to people that have had weight issues. I’ve dealt with weight issues, and until I personally fixed the metabolic issues, the hormonal issues, it was impossible. I craved food, my appetite was much higher than it is now, and I had no energy to exercise, and it became very mentally daunting when you went to the doctor and they said, “Well, just exercise.” And once all of those thing were fixed, weight for me in the last seven, eight, nine years really hasn’t been an issue.

MB: So for you personally, the weight management became a lot easier?

NF: Oh, absolutely. I wasn’t, you know, five pounds overweight. I lost about 65 pounds when we fixed the hormones. And you know, I still go out to – I ate at an Italian restaurant last night and I enjoy myself. So I’m not depriving myself, but it just became much, much easier.

MB: I keep seeing the term “estrogen dominance” in the press. Is that a useful term, and are you seeing a lot of it?

NF: I do see a lot of it, and I think it’s under-diagnosed, and especially in a 40-year-old that you asked about, estrogen dominance is a big thing. I’ll see it in men, as well, but in the younger women, in the 40-year-old women, what has happened is the ovaries have slowed down so that the progesterone and the testosterone are declining; the estrogen production is still relatively high. And therefore that’s where they end up with some of those more PMS type symptoms. They’re more moody, irritable, the weight creeps up, they tend to retain fluids – all of those type of things. With the men, they gain weight, they put weight on in the middle, they can’t maintain the muscle mass that they had. They get moody and irritable, as well.

MB: For women who are going through menopause, how many of them do you recommend some kind of hormone replacement?

NF: For the people that come to my office, it’s about 90%, because that’s kind of why they’re coming to see me. And they usually – the people that I’m seeing are well-educated, they’ve done their research in this arena, so most of the people that come to see me, I do recommend it. People that I specifically don’t recommend it for – and we can’t lump all of hormonal therapy in one bushel, either – there’s very few people that, given blood work results, that I would say, “You just aren’t somebody that I would give hormonal replacement to.” Certainly if all the blood work is normal, they don’t need hormonal replacement. Most women or men that come to see me will have one abnormality or another. Places that it is a very complicated decision for me are women with a history of breast cancer or endometrial cancer or certain ovarian cancer; women that have a very high risk, so they’ve got two people in their family that have had breast cancer; men with a history of prostate cancer or certain other melanomas and things like that are also big flags for me that, you know, we really need to proceed very, very cautiously. The breast cancer issue is the one that almost invariably comes up in women. They come to me and they say, “I’ve got all these symptoms, my quality of life has declined, but I’m afraid if I take hormones, I’m going to get breast cancer.” The fact of the matter is, at this point – there is a lot of research, and at this point it is not conclusive that hormonal therapy caused breast cancer. It actually is pretty evenly split that it’s very safe, it can lower your risk, versus it increases your risk. And the relative risk increase on the studies that have said that is extremely small. But that is related to estrogen. What women forget is they still have progesterone, they still have thyroid hormones, they still have testosterone, all of these other hormones. So we can’t lump them all in together. So if women are concerned, they’re worried about estrogen, sometimes we’ll use some of the other therapies first, see how we get them feeling – base it on their risk, base it on their blood work, and then maybe add that down the road, once we feel more comfortable and they feel more comfortable about it.

MB: For women who are having that creeping weight gain, how often is thyroid a factor in that?

NF: More often than what we’re led to believe. I’m the perfect example. I was tired, my weight was up. I went to my primary doctor, went to my OB/GYN, went to an endocrinologist – they all said, “Your thyroid is fine.” And that was all based on a screening test. Back in the 1970s, this new screening test came out. It’s called the TSH. The insurance companies pay for it; that’s the only thing that they recommend if you want to look at thyroid. And that’s what all of us doctors that went through medical school since the ‘70s had been trained on, and so that’s all we look at. But thyroid is a very complicated gland. There are multiple hormones involved. There are absorption issues that a lot of doctors just fail to look at. And we like to treat it as a disease, too, like to wait until it’s really bad before we treat it. So I don’t know. So in my case and in patients that I see, probably about 30 to 35% of women will have a thyroid issue that, when corrected, it helps them tremendously. Whereas if you look at the statistics nationally, they say between 2 and 4% of people with weight issues are thyroid-related. And we really have, again, given the whole clinical responsibility – and we like to look at that number on the paper and say, “Oh, the number on the paper is fine,” and we forget about physical examinations, our skin texture and fluid retention and basal body temperatures and examination of the thyroid. All of those things go into the diagnosis, as well.

MB: If a woman’s having weight gain and suspecting thyroid might be a problem, what kind of tests should she ask her physician to do, to make sure that he or she catches it?

NF: It’s a tough thing. Most physicians are going to order the TSH, again because that’s what the insurance companies – and they were told to do. There are multiple other tests that you can do. You can do what’s called a T3 or a T4. The thyroid gland that’s in your throat is controlled by a hormone that comes from your brain and tells it to make thyroid hormone, and that’s called TSH and that’s what the screening test is for. The thyroid gland then puts out a hormone called T4 which floats around in the bloodstream and eventually gets broken down into T3. The T3 is the active form of thyroid hormone and that’s what actually goes into the cells and makes your cells metabolize energy. There’s also, in your bloodstream, there can be antibodies, things that block that T3 or that T4 from working. So you need to look at all of those things. Additionally, you can have issues of absorption of the T3 through the cells, which we don’t really have a good test for. So the biggest thing I tell people, if they’re concerned about thyroid, is to find a doctor that knows what they’re doing with the thyroid. Honestly, most doctors don’t. There’s a couple of very good books on thyroid that I will oftentimes refer patients to, to get educated on it and allow them to help themselves a little better.

MB: And what are those books?

NF: There’s a Dr. David Brownstein who is wonderful – he’s in Michigan. And he has a book called Overcoming Thyroid. And it talks about things from a physical exam standpoint, things that you can do at home to see if thyroid is potentially an issue, see if iodine absorption, which is what makes thyroid hormone active, is an issue. And plus, it gives you symptoms to look at that might tell you if it’s an issue, as well as here’s the test that should be done. So it’s a good quick read that gets you well-educated. And in a lot of cases, my patients will read that and go to their primary doctor and they’ll know a lot more about it than their primary doctor. We can point them in the right direction if they need to.

MB: Other than anti-aging specialists, are there physicians who, because of their specialty, would be knowledgeable about thyroid?

NF: Endocrinologists are the hormonal experts in the medical field. And they are very well-educated and very well-meaning, but unfortunately they treat diseases. Their philosophy right now with thyroid and the way they’re educated and their policies that are put out by the Endocrinologic Society is for thyroid, if the screening test – the TSH test – is elevated to 10 – TSH is an inverse number, so the higher the number, the less thyroid function you have. So with over 10, you treat thyroid. But when you’re going to treat it, you’re going to treat it down to a 2. Where I see a lot of people falling into thyroid issues are between that 2 and that 10, which the Endocrine Society says, “You don’t treat those people. It’s obvious that they have a problem, but we’ll wait until the problem gets worse before we treat it.” And that’s where philosophically I differ from them. I think if you know you have a problem and you have symptoms – you’re gaining weight, you’re tired, all of those things – then we need to treat it more aggressively. If you come in to me and you have abnormal blood tests and it seems elevated but your weight’s perfect, your energy is good, you’re not losing hair, you don’t have any symptoms, then I agree, we should watch it. But our goal in age management is to be more proactive and not wait until you’re in a disease state to fix things.

MB: It sounds like medicine as a whole – and I hope anti-aging medicine takes the leadership in this – needs to define new standards of what’s healthy instead of just what’s unhealthy and disease.

NF: And that’s right. That’s where medicine has been focused for decades now is illness, and nobody knows what it means to be healthy.

MB: Are there boards that are working on that issue?

NF: Oh, absolutely. There are a lot of people that are approaching Congress, approaching like the AMA to try and push things into this direction.

MB: Good.

NF: Certainly there is resistance. Doctors are the slowest people to change their mindset on anything, of any group I’ve ever seen – which is good and bad. But so there is certainly resistance within the system to that. There are also some inherent problems with things like research. Research funding is usually focused on, you know, how do we cure a disease, or it’s coming from pharmaceutical companies which are trying to sell us patentable products. And so there are some problems with getting funding for good research from that standpoint, as well. As well as, you know, there are certain biases, especially in the nutrition field. There are certain – we’ve gone from “Fat will kill you,” to “Carbs will kill you,” and back and forth for decades. And you know, a lot of that is there have been a lot of political shenanigans that have gone into those positions, unfortunately. And it’s probably going to persist for some time, just because – and part of the reason for that is that there’s not one universal answer. We want an answer that says, “Here is what everybody in the world should eat and you will be healthy.” The fact of the matter is not that straightforward. Again, back to where we like to generalize everybody. We are individuals. We are genetically different. We are metabolically different. There is not going to be a right answer for everybody.

MB: Everything you’re talking about is talking about how it’s not easy and it’s very individualized.

NF: That’s right.

MB: Let me take a break here. You’re listening to Ageless Lifestyles Radio on and we’re talking with anti-aging physician, Dr. Nicole Flora. She practices anti-aging medicine and age management, weight management in Cincinnati, Ohio, and she’s associated with Cenegenics Medical Institute in Las Vegas, with affiliated physicians around the country. Her website is, and the Cenegenics Institute site is For information on anti-aging psychology and my books, Defy Aging and 52 Baby Steps to Grow Young and my free Defy Aging Newsletter is at  or you can just to  and it’ll take you to . Dr. Flora, how much does it cost to get a good workup in anti-aging medicine?

NF: Certainly individual doctors charge different amounts. I don’t think there is a set fee. It really depends on what you’re dealing with.

MB: So for a typical person that says, “I’m feeling rundown and want you to work it up and put me on a program of nutrition and exercise and hormone replacement, if that’s needed,” are we talking a few thousand dollars, several thousand dollars?

NF: We’re talking in general, to start with, all-inclusive – between a good blood work panel, which unfortunately is the majority of the cost – probably a couple of thousand dollars. I mean, blood work – we do exercise testing, fitness testing, bone density, body fat, all of those things, plus consultations with a nutritionist – all of those types of things are included.

MB: I’m surprised that it’s not a lot more than that. Sounds like a bargain to me. I mean-

NF: Honestly, if you compare what you would go and pay if went to the hospital and got those things, you’re right. It absolutely is a good bargain.

MB: Considering what we spend on cars and stereos and plasma TVs – well, it’s the cost of a fancy television set – which is more important?

NF: Absolutely. It is an investment. It’s how much do you know about your body, which is – you know, a car is going to last you, on the outside nowadays, 10-12 years. You have to live with this body for a very long time.

MB: You’re engaged in some research. Can you tell us about that?

NF: Through the Cenegenics Foundations, we work with two medical schools, the University of Miami and the University of Nevada, and we do multiple research programs yearly. And the latest one involves weight and particularly hormone replace, specifically growth hormone and testosterone. And that came out through Cenegenics in November. It’s being submitted for publication in March.

MB: Are you allowed to share with us the gist of it, or is it under wraps?

NF: It’s been presented at the national meeting, so I’m assuming I can tell you a little bit. But that we did see, particularly in women, we saw a significant weight loss when hormones were balanced. With men, the weight loss was less significant, but the body fat content came down significantly. So they gained more muscle mass and lost more fat, where women kept their muscle mass consistent and lost fat. So their actual number on the scale, which we women like to focus on a lot unfortunately, changed more so with the women than with the men. But it was statistically significant weight loss.

MB: Well, speaking for men, we’d be happy to have it translated to muscle instead of fat. That’s okay.

NF: Exactly, exactly. So it made people happy on both fronts.

MB: Well, wonderful. I gather your approach to anti-aging medicine is fairly Western as opposed to someone who emphasizes Ayurvedic medicine, colonics and fasting and that kind of thing?

NF: That is true. You know, I am a traditional doctor. I went to traditional medical school and I trained to look at the scientific evidence. So I am more comfortable in that realm. I certainly am open to my patients using other approaches, but I won’t certainly present myself as an expert in those realms. I get, particularly with chiropractic and acupuncture, I get patients that have tremendous response. But certainly I will work with other practitioners if that’s their choice. But again, I just don’t present myself as an expert in those fields because that’s not where my training lies.

MB: It seems to me like there’s three schools: what you’re doing, which is very Western integrative; there’s the more Eastern approach; and there people who are just emphasizing the hormones and the shots and the cosmetics but not asking people to do the exercise, to take a look at their eating, and that kind of thing.

NF: I think you’re correct in that assumption. My personal opinion is that really to have the best outcomes you need a combination of all those things. People like to go to the doctor and be given pills and shots and creams or what have you because that’s what they’ve been taught to kind of expect. But it really – we cannot under-emphasize the other components. You know, the psychological components – and you’re the perfect expert to talk about that. There’s a huge impact on, you know, the diet and the nutrition. If you are going to put – if you want to know what the side effects to this pill that you’re putting into your body are, you certainly ought to think about the side effects of what the food you’re putting in your body are and how we change those. I mean, that – you eat three meals a day. You may take one pill a day. What is going to have the bigger impact on your life long-term? And people like to forget about that component. Eating is unconscious in a lot of cases. Our activity level is unconscious and it takes a lot more work. It’s easier to take a pill or a cream or a shot and not have to do that component. So my opinion is certainly it needs to be a comprehensive program. It has to address all of those things. It is hard as a practitioner to put all of that together, but that’s where the challenge lies.

MB: What do you think is going to happen in anti-aging medicine the next 10, 20, 30 years?

NF: I think we’re going to get better at it, and I think we’re going to get better at doing research at it, I think we’re going to get better politically getting people to support our position that we want to promote health and avoid disease, as opposed to just treating disease. I don’t know in the next ten years where the traditional medical community or the insurance communities are going to be on that front. In 20 years, I think they will be onboard, but it’s going to be a rocky road between now and then, unfortunately.

MB: Do you see huge changes from, say, genetic engineering and tissue engineering that’s going to get integrated into the anti-aging medicine at the practitioner level?

NF: Absolutely. Right now, genetics are – there are a lot of problems with the genetic component, from a decision-making point. But the genetics I think will be the next big mover. However, we have to remember that probably 45 to 50% of what happens to you, you are predisposed to, from your genes. The remainder is lifestyle. So we can’t expect genes to come in and cure everything. We still are responsible for our health and our environment and our psychological wellbeing. So it will never come in – and a lot of people are waiting for it – “Hey, if I get the genes right, I won’t get heart disease and I won’t get this, that, or the other.” But it’s never going to be that simple.

MB: “And I can go to the restaurant and eat everything.”

NF: Right! “And if I’ve got the right genes, my jeans get on fine.” And I actually had a gentleman that called yesterday and said, “Hey, I heard about this genetic testing. Can I get it done to find out, you know, do I need to do this?” And you know, my take to him was that right now, at least, it can sometimes give you a false sense of security. If you have a genetic test that tells you you’re at low risk for heart disease or you’re at low risk for diabetes, does that mean that you don’t need to know what is best to prevent those things? And my position is no, I’m going to treat everyone like they’re at high risk for heart disease and diabetes, because still, the vast majority of heart disease cases and probably 85% of new diabetes cases, Type 2 diabetes, occur in people with no genetic risks. So we can’t rely on a blood test to tell us we’re safe.

MB: One of my pet peeves is statins. I think they have so many nasty side effects; I hate to see so many people taking them. What kind of alternatives do you tend to get into with patients to see if they can get off the statins?

NF: I have a problem with the statins, as well. I feel the same way. Cholesterol – certainly diet is important, but diet – if we’re honest with ourselves and we look back at the medical literature for the last 30 years, diet – and I hate to say this because it will tell people they can go every fried food they see – diet has a very small impact on cholesterol levels, maybe 10% if you’re very good – which is important. Diet has other impacts, though. It affects inflammation, which the statins also decrease. So we can’t just look at the cholesterol number. But diet is important. Exercise is important. Looking at hormonal levels – I never, never treat someone’s cholesterol number unless their thyroid is optimal. Thyroids will impact your cholesterol readings, as will testosterone levels, as will estrogen levels. And so a lot of people, when we get the hormones balanced, we get them eating right, we get them exercising, they don’t need the statins. The statins, I think, are so over-prescribed. If you actually follow the American Heart Association’s recommendations now for cholesterol levels, in my personal practice, my primary care practice – if I followed that, 75% of the patients that I saw on a daily basis would be on a statin. And honestly, that is – in my mind was a big turning point. Common sense has to come into play. There’s either something wrong with our society, with our lifestyle, with how we’re eating – that didn’t come about – you know, that isn’t a genetic issue that all of the sudden 75% of people need a pharmaceutical. It’s either our position as doctors and as researchers is wrong, or there’s something going on culturally with our diet. Something has changed that has made that occur. And that’s why I think, as a doctor, you really, really have to step back and step outside of the box and not just read the recommendations, but go back and look at the individual research that has been done to date.

MB: I’m hearing that public health perspective there.

NF: Absolutely, sure.

MB: How does a person tell whether somebody is a well-qualified, competent anti-aging physician?

NF: It’s tricky. There are a lot of people out there that are dabbling, that are not well-educated on the subject, that have gone to classes that may not have been the best classes, that have gone to seminars or have been pitched products that are not well-supported by research. And so honestly, it is a tough position as a consumer. My biggest thing is that you need to find a physician that you can talk to, that you’re comfortable with on a personal level, that can give you supporting evidence to their opinion, and who is willing to have that conversation, and also who doesn’t treat you – not a cattle call at their office, and they’re not going to treat you – everybody that comes through the door gets this treatment or that treatment. That is, for me, the biggest thing. You want certainly someone who has some experience in the field. You probably need someone who has been doing it – and I hate to, you know, give time cut-offs, but multiple years, five years or more. And you need somebody that, in my opinion, does this as their primary focus. The guys that are doing it one day a week out of their office unfortunately can’t keep up with the amount of medical and other sources of information at this point. You can’t keep up with your regular practice, let alone a whole other field. You wouldn’t go to a gynecologist that did gynecology one day a week and had some other job on the side. You really need somebody that this is their primary focus.

MB: Are there any board certifications yet that would tell you that you had this kind of doctor you’re talking about? Or are we not there yet?

NF: Some doctors will promote a board certification and there is a program out there that they can go take classes and get a board certification. To date, though, that board certification has not been recognized by the AMA. So the AMA has looked at the protocols and they have not given their stamp of approval yet. They may in the future – I’m sure they are continuing to work on that. So right now, board certification is – while it does indicate that they have taken a significant amount of education, at this point we don’t know specifically what that entails.

MB: What’s the patient to do, other than interview the doctor and find out whether they’re full-time in the business?

NF: I wish I could answer that. You know, the other thing that I will tell patients to do that aren’t local to me, is I will tell them to go to a local compounding pharmacist – if they’re women. Men a lot of times will use FDA-approved medications that you get through a regular pharmacy. But honestly, the pharmacists in the area know the good doctors. They really do. If you are an age management doctor and you’re doing hormones, you have to be working closely with a good qualified compounding pharmacist, almost on a daily basis. And I have a lot of patients come to me from a local pharmacist because that’s where they’re asking questions, and I think they’re a good resource.

MB: Oh, I love that strategy. That’s cool. The Cenegenics Medical Institute that you’re associated with, are they certifying people who have comparable credentials to yourself?

NF: Well, we do – at Cenegenics they train physicians and they are actually AMA-accredited to do training. They don’t offer a board certification but they do offer a certification through Cenegenics. They train – they have to be MDs or DOs and they have to go through – they have to see patients with the doctors there and their clinical knowledge is assessed. Certainly they do testing, they do home studies, they do ongoing monthly educational seminars to maintain that certification.

MB: Do they teach the kind of individual time-intensive holistic approach that you do? Or is that more a personal choice?

NF: They do. And that’s where I got my original training. I’ve done training from multiple different sources. But absolutely, they advocate the approach that, you know, you have to spend – to get a good idea of what’s going on with a patient, you have to spend minimally two to three hours with them on the first visit, and then close follow-up is really the key to success.

MB: Is there anything else that you would like us to know about, or some hints or advice that you’d like to share with us?

NF: I think the biggest thing, for people in general, is to not stand by and expect health as a given. You do have to, in our culture today, with the dietary stresses, with the environmental stresses that our body is under, and with the epidemic of disease that is out there, you do have to be proactive and you need to take some responsibility to get well-educated on it. It will make a huge impact in your life and your family’s life and your kids’ life. You’ll be around longer and you will enjoy life more. The biggest thing that my patients want to avoid is living to be 90 and spending the last 20-25 years being sick. And we know, with good medical evidence – this is not new things that we have made up or that there’s some new product – we know, looking at good medical research, that we can prevent probably 65 to 70% of disability that you see in the elderly population, if we start early and if we’re proactive and if each individual takes responsibility for their health, for eating well, for exercising. They don’t need to end up in the nursing home like their parents did. They don’t need to end up living with their kids because they can’t live independently.

MB: My role model is the Energizer Bunny on alkaline batteries. You know, with regular batteries, they just kind of wear out gradually, but the alkalines, you get the steady energy level and then when they die, they just die.

NF: Right, they just fall over.

MB: So it just keeps going and going and going. There’s a gentleman in the news, Mr. Rabinowitz, who recently, at 104, broke his 100-yard dash record at about 30 seconds, which is pretty good for 104!

NF: Oh, my goodness.

MB: And then I noticed he had a stroke a couple of months later. To me, that’s a good role model.

NF: Absolutely. You know, we don’t need to cure a lot of these diseases. We just need to delay them coming on. If I get cancer when I’m 94 and die from it, great, you know. But if I’m healthy until that point – you’ve got to die of something. My thing is that I just don’t want to be sick and tired and accept this unfortunate situation that we see so many seniors in now. And I don’t want us as a population to think that’s how it has to be, because it doesn’t. But you do have to work hard and you can’t wait until you’re 80 to do it. When you’re 80, we can still have good impact, but you’re going to do much, much better if you start when you’re 30 or you’re 20 or you’re working on your kids to get them to eat right and to get them outside and get them moving, and ingrain that as part of their lifestyle. You’re going to have much better outcomes. They’re going to have a better life.

MB: Dr. Flora, I just wish we could clone you.

NF: Well, thank you.

MB: Thank you so much for being on the show. I really appreciate it and appreciate all the information you shared with us.

NF: Well, you are so welcome. It has been a pleasure.

MB: As you’ve probably gathered, I’m a big fan of anti-aging medicine. True, it is having its growing pains and there are people who are emphasizing profits as opposed to the kind of careful planning and individualization and holistic health that Dr. Flora talks about, but I think it is destined to become the family practice medicine of the future. And Dr. Flora is a wonderful example of what an anti-aging physician should be like and what an anti-aging physician can do. I like to wrap up programs with a baby step that hopefully will help you live longer, healthier, and happier. In the business world, we place a lot of emphasis on starting with the end in mind, being very clear about the outcome you want, and then figuring out what it takes to achieve that outcome. In our lives, it’s even more important because it’s our lives! And the outcome we want is to be Energizer Bunnies, at 100, 110, 120, maybe even 150, to still be going strong with a snap in our step and a sparkle in our eye – passion and enthusiasm and a zest for life. The alternative might even be a nursing home. So we need to picture in our mind’s eye vividly ourselves as that Energizer Bunny and just see it so vividly and want it so badly, we’re almost salivating, saying, “I’ve got to have that, whatever it takes. That’s what I want. What do I need to do?” What do you need to do? Well, fortunately I think we got a lot of ideas today from Dr. Flora. You’ve been listening to Ageless Lifestyles Radio on Our expert guest has been Dr. Nicole Flora, an anti-aging physician who practices in the Cincinnati area. Here Cincinnati office website is Her Cenegenics Institute website is Information on anti-aging psychology and my books Defy Aging and 52 Baby Steps to Grow Young, and my free Defy Aging Newsletter is at, or you can just go to  and it’ll take you to This is Dr. Michael Brickey with Ageless Lifestyles Radio, wishing you a very long, healthy, happy life.

How to Prevent Diabetes

March 8, 2008

Anti-Aging Psychologist, Dr. Michael BrickeySteve Freed Pharmacist/Diabetes Educator








Host: Anti-Aging Psychologist Dr. Michael Brickey

Expert Guest: Steve Freed, Pharmacist and Diabetes Educator

Broadcast: 2-17-08 on where the latest shows are broadcast and posted as podcasts

One in three Americans has or will develop diabetes—and in the vast majority of cases, it could have been prevented. Today’s guest expert, Steve Freed is a Registered Pharmacist and Diabetes Educator. His Diabetes in Control newsletter reaches 88,000 medical professionals. His Steps to Health program has been used by a quarter of a million diabetics. He has given thousands of seminars on diabetes, produced numerous training materials, and currently is co-producing a full-length documentary, Conquering Sugar Mountain. The first part of today’s seminar will focus on how you and your loved ones can prevent getting diabetes. Part 2 will focus on new treatment options. His websites are:  and

TRANSCRIPT ©Michael Brickey–excerpts permitted with attribution

MB: This is Dr. Michael Brickey with Ageless Lifestyles Radio, cutting-edge thinking for being youthful at every age. On each program I interview experts on what it takes to live longer, healthier, and happier. Our program takes a holistic approach in addressing anti-aging psychology, medicine, alternative medicine, fitness, nutrition, and wellness. Our emphasis is on innovative thinking and practices that have solid data and results.One in three Americans has or will develop diabetes. This is absolutely tragic because in the vast majority of cases, it could be prevented. Today’s guest expert, Steve Freed, is a registered pharmacist and certified diabetes educator. His Diabetes in Control Newsletter reaches 88,000 medical professionals and 1,000 more laymen. His Steps to Health Program has been used by a quarter of a million diabetics. He has given thousands of seminars, produced numerous training materials, and currently is co-producing a full-length documentary, “Conquering Sugar Mountain.” The first part of today’s seminar will focus on how you and your loved ones can prevent getting diabetes, and then part two will focus on new treatment options and the controversies. Steve, you are so passionate – I think you eat, sleep, and breathe diabetes education. How did you get so passionate about this?SF: I used to own my own pharmacies for over 25 years, so I had four pharmacies in the Chicago area. And I woke up one morning, put the covers over my head and said, “That’s it, I’m out of here.” I wasn’t doing anything that I’d learned in school to become a pharmacist. I was talking to insurance companies, I was selling Beanie Babies – you know, nothing I was doing was related to the knowledge that I had. And I have a lot of diabetes in my family, Type 2 diabetes, and my grandparents on my father’s side, all my uncles, all my cousins, my sister. I’ve seen the worst and I’ve seen the best. So I always was concerned that I was going to get diabetes, so I started to educate myself. And the more I got educated, the more I wanted to share that information with patients. I saw that there was a program to become a certified diabetes educator and I worked towards that, took the exam, and became a certified diabetes educator in 1995 and started working with patients, and realized that there’s about 25 million people with diabetes, that I could probably personally help 24 millions, but I needed help with the last million. So we started a newsletter, myself and my partner, who’s also a pharmacist and a diabetes educator, to educate the medical profession about diabetes, because there it is completely lacking.

MB: What is it that our family doctors are missing with diabetes?

SF: Well, it’s not the doctor’s responsibility, per se, to educate the patient. 95% of the care of the patient has to come from the patient. You know, they have to know what foods they can eat, they have to be able to count carbs, they have to be able to read a food label, they have to understand the numbers when they get their blood sugar results back or when they test their fingers. So 95-98% of the care of a patient with diabetes has to come from the patient, because the doctor is not with them when they’re eating the wrong foods or when they’re not being physically active or not checking their blood sugars. So in order for a patient to control their diabetes, they have to become educated. If they’re not educated, they will fail 100% of the time. The doctors get five to fifteen minutes. It’s not their responsibility. They can’t get reimbursed for it. That’s not their responsibility. Their responsibility is to get the patient educated. That is their responsibility. And that’s where they fall down. They think they can write a prescription, give it to the patient, tell them to come back in 90 days, and it doesn’t work. It fails. And we know for a fact that it fails because the average blood sugar in the United States is close to almost 300, 250 to 300 mg per deciliter, which is completely out of control. And those people will all get the complications of diabetes, but it’s 100% preventable. That’s why I have a passion, because with a little bit of education, when I sit down with a patient for an hour or two, I can change their lives. I will prevent them from losing their eyesight, their kidneys and their limbs, and prevent strokes and heart attacks, Alzheimer’s, cancer, every disease known to man I can prevent, because we all know that diabetes is related to elevated blood sugars. We all know that Alzheimer’s is related to blood sugars. We all know that dementia is related to blood sugars. Our quality of life is directly related to our blood sugars. And they just did a study that they published and they said that if you get diabetes by the time you’re 50, you ‘re going to die 12 years early and you’re going to be miserable for the last 15 years of your life. And that comes from the CDC. So I can prevent all that, just with educating my patients and getting them motivated to make lifestyle changes.

MB: Not everybody can sit down with you. To whom should the doctors be handing off the education piece to?

SF: Well, first of all, there’s a lot of information out there. The problem is there’s a lot of misinformation out there. I see it all the time. People – there’s so much different information out that people get confused. You know, the best thing, though, that people can do is to find out where their education programs are in their area. Usually they’re hospital-based, and you can call the local hospitals and see if they have a diabetes education program. You can certainly get a book and read or you can get CDs and listen. But if you don’t do that, you are doomed for a miserable life.

MB: Where is the bad information?

SF: Well, I hate to say this, but the bad information – and I know that I’ll get in trouble for saying this, but the bad information comes from the American Diabetes Association.

MB: What are they saying that’s off?

SF: Well, what they’re saying is that you should have 60% of your nutrition should come from carbohydrates. All carbohydrates turn to sugar – good, bad, complex, simple – it all turns to sugar. Anybody realizes you don’t give people with diabetes who have sugar problems 60% of their diet being sugar – does that make any sense? Why do you think that the most, 90% of the people out there, or certainly at least 75% of the people out there, are out of control? Because they’re eating too many carbohydrates. They don’t understand it. And if they really understand diabetes, they really understand it, they’re going to know that you can’t eat any many carbs as they would like.

MB: What about people who don’t appear to have diabetes. Is the 60% carb also a bad idea for them?

SF: Well, if you’re not susceptible to diabetes, okay, and you’re eating 60% carbohydrates in your diet, you’re going to get fat – unless you’re running five miles a day, you’re going to get fat. And you know that we have an obesity epidemic in this country. You know, we said, “Don’t eat fat, don’t eat fat. Go on a low fat diet; it’s healthy for you.” Well, we did that for the last fifteen years and now everybody’s fatter, so obviously that didn’t work. You know, it’s the carbs – the carbs turn to sugar, sugar turns to fat, and we get fatter. It’s that simple. And people just don’t see it. And it’s a crime, too. And ADA just two weeks ago came out with a statement that low carb diets are okay. Before that, they were adamantly against it, but the studies are showing that people that are on low carb diets can control their diabetes much more effectively than eating high carb diets. It just makes so much sense.

MB: So if people are on the low carb diets, what do you want them eating instead?

SF: Well, I want them to stay away from some of the carbohydrates – the rices, the pastas, the breads, you know, all of those things that basically turn into sugar. I have a question that I ask my patients, and I say, you know, your grandmother calls you up and she says she wants to invite you over for dinner and she’s making this fantastic dessert. She wants you to stop at the grocery store and pick up some sugar wafers – and they both have diabetes. So you go into the store and you see two packages of sugar wafers. One package says “sugar wafers” and that has 20 grams of sugar per serving. The other one says “sugar free sugar wafers.” That has 0 grams of sugar per serving. You know, it’s not a trick question. Which one would you buy for your grandparents that have diabetes? Would you buy the one with the 20 grams per serving or the one with 0 grams per serving? Which one would you think you might buy?

MB: Well, the sugar free one.

SF: And you’d be wrong. And why would you be wrong? Because you’re only looking at the sugar! If you’d turn the package over and just read the label, you will see that the sugar free has more carbs than the one with sugar. So not only are you killing your grandparents, you’re paying three times as much to kill them. That’s where the education comes in. I get people to read food labels. You go to the store, you pick up two bottles of salad dressing. One is Caesar salad dressing, has 0 grams of carbs per serving, the other one is thousand island. And you look and it says there’s 5 grams of carbs per teaspoon. Well, how many people eat one teaspoon of dressing on their salad? Most people have 3 tablespoons, so you have to multiply it by 15 times 5. So one’s got 75 grams per serving and the other has 0. Well, if you just take the one that has fewer carbs, you’re going to lower your blood sugars – just by doing that, just by reading a food label. You can make a difference in your life just by reading it, because you’re going to make intelligent decisions, if you understand.

MB: Are there other big mistakes people are making?

SF: Well, certainly. You know, there’s one thing – and we developed a whole program around it. We all know that physical activity is good for you. Every person on this planet knows physical activity prevents every disease known to man, and it keeps you healthy, it gives you energy, it improves your memory, it gives you a better sex life, it grows hair, it gets wrinkles out of your skin. Okay, it prevents colds and flus and yeast infections – everything you could thing of, you know, by increasing physical activity – we all know this. Everybody on the planet knows it but nobody does it. Figure that one out. When you go to the hospital, okay, right in front, all the front parking spaces, it says “Reserved for the Chief Surgeon.” You know, your doctors, okay, don’t want to walk, so they park their cars in front. If they were smart, they would put a sign up saying, “All our doctors park in the back of the lot. The front spots are for people that don’t understand.”

MB: Great idea.

SF: So physical activity, along with counting your carbs and understanding of good nutrition, you know, will not only have an impact if you have diabetes, but it’ll have an impact for everybody – not just for people with diabetes. I tell patients, if you want to live healthy, live like a diabetic.

MB: I think you had a statistic that we’ve got millions and millions of Americans who have diabetes and don’t even know it. How do we miss it so often?

SF: Well, 25% of the people that have actual diabetes, okay, are undiagnosed. There’s another 60 million people that have the metabolic syndrome, but now we – you know, diabetes wasn’t bad enough, we had to give it a new name called pre-diabetes. That’s like being a little bit pregnant, okay? There’s no reason for people to have that diagnosis of pre-diabetes. Why not just call it like it is? It’s diabetes. The definition of diabetes used to a fasting blood sugar of 180. Then they reduced it to 140. Then they reduced it to 126. and now, instead of reducing it to 100, we came out with a new disease called pre-diabetes, and the reason we did that was pretty much because if we called it diabetes, those 60 million people, okay, that are self-employed, would lose their insurance all in one day. And if 60 million people lost their insurance in one day, it might cause a little uproar. So we gave it a new terminology called pre-diabetes. But the reason that we miss it is very simple – and I teach this to medical professionals all the time – diabetes starts out as an after-meal elevation of blood sugar. It’s called postprandial. Postprandial is a two-hour blood sugar after you eat. That’s when it’s the highest. So you go to the doctor for a physical, like most people do, and he has you do a fasting so that he can do your triglycerides, because we have to be fasting to get our triglycerides. So you go to the doctor’s office, he does a venous draw, and he sends it out to the laboratory, and it comes back that your fasting blood sugar is 85. Now, if it’s under 100, it’s normal. If it’s 100 to 125, it’s pre-diabetes. Anything over 126, it’s diabetes. It comes back, it’s 85. So you don’t have diabetes. He doesn’t even make a note of it. Okay, that same day, you go out for dinner and you have a big pasta meal with three pieces of garlic bread and a piece of cake and your blood sugars are 350. Well, the definition of diabetes, two hours after you eat, is anything over 200 is diabetes. 140 to 199 is pre-diabetes. So you’ve got a blood sugar of 350 – you have diabetes. Now, who knows that? The doctor didn’t say you have diabetes so you’re not checking your blood sugars. You won’t see that 350. This goes on, time and time again. Next year, you go back to the doctor and your fasting blood sugar is 98. Well, that’s still normal. He’s not going to say that you have diabetes or pre-diabetes. And that same day, you go out for dinner, you have a big pasta meal, and your blood sugar’s 450. Well, you have diabetes but nobody knows it. So we’re not looking at where we should. Now, there is a test called the glucose tolerance test. If you’re overweight, if you have diabetes in your family, they give you 75 grams of glucose in a cola. You drink it in the doctor’s office, you stay there for three hours, and they check your blood sugars every 15 minutes, and you’re putting as much pressure as you can on your pancreas to have it spill over. And that’s how you can tell if you have diabetes, by taking the glucose tolerance test. And then there’s another test called the A1C test-

MB: Okay, but most doctors aren’t going to do that unless you’re at high risk, though, right?

SF: Absolutely. But those people that have diabetes that are not at high risk, because the doctors – you know, they may not be that much overweight, those people are 25% of the 25 million people that are walking around with diabetes and don’t have a clue, because you don’t get the symptoms for years. By the time you go to the doctor and your fasting blood sugar is over the 126, when you’re diagnosed and you have a fasting blood sugar over 126, you’ve already lost 80% of the cells that make insulin in your pancreas. Now you’re running out of time. Now, if we catch it early, we can make small changes in your life and have a huge impact. But when you get it – when you’re diagnosed with a fasting blood sugar over 126, you’re running out of time, and that’s what happens with people with diabetes.

MB: Why aren’t doctors routinely doing the A1C test during annual physicals?

SF: Honestly, it all boils down to dollars and cents. You know, they’re not going to do a test that they don’t feel is going to give them the results they’re looking for. First of all, the A1Cs are not – according to the ADA – are not recommended for diagnosis, and that’ because not all A1Cs are standardized. And what I mean by that is we know that a standardized A1C is 6%, it’s a single digit number which represents your blood sugars every second of the day for the last 90 days. I call it the quality of life test. That test not only determines whether you’re going to live or die, that test actually represents how smart your doctor is. Because if you have an elevated A1C of above 7, certainly for a year or two, then I don’t care who he is, I don’t care what his title is, I don’t care what his education is, okay, you change doctors immediately. Don’t ask questions, just do it. Because in this day and age, with all the knowledge, with all the technology that we have, with all of the medications we have, there is no reason why anyone in the United States today should have an elevated blood sugar of above 6, and certainly I would hope not above 5, 5% A1C.

MB: When a person goes to their family doctor for that annual physical, what should they say to him to have their doctor give them an A1C test and do it correctly?

SF: Well, they should ask the doctor – if they have any diabetes in their family, okay, if they’re a few pounds overweight or their cholesterols are elevated or their blood pressure is elevated, those are all symptoms – okay, tell the doctor you want him to do an A1C test. This is not an expensive test. I mean, I think the labs charge 25 bucks for it or something like that. But pretty much, that will give the doctor a good idea. So if it comes up that it’s somewhere between 5.5 and 6.1, there’s a good chance that you have pre-diabetes. And if it’s over 6.1, there’s a good that you have diabetes. Now he can do a glucose tolerance test to double-check that. But certainly, ask the doctor to do an A1C. They did a study, by the way, called the EPIC-Norfolk Study. It was done about a year and a half ago. And they took, I think it was 15,000 people, and they compared the A1Cs of those people with a 5 and those people with a 6%, so they compared 5% versus 6%, irregardless of whether they had diabetes or not. And what they discovered was those people that had a 6% A1C compared to those that had a 5, had a 28% increase in cardiovascular death. So irregardless of diabetes, it’s a good cardiovascular risk test also, because if you think about it, the higher the percentage of sugar attached to the red blood cell, the stickier it is, and the stickier it is, it increases your risk for stroke and heart attack because it’s clogging your blood vessels. So the A1C is also indicated in cardiovascular risk factors, whether you have diabetes or not. A normal A1C, for someone who does not have diabetes, who is in good health, who is not overweight, is 4.3 to 4.5. According to the ADA, if you have diabetes, your A1C should be below 7. According to the Endocrinology Association, it needs to be below 6.5. But to me, I tell my patients, do you want it at 6.5 or do you want it at normal?

MB: It’s like, how overweight do you have to be to decide it’s too much?

SF: You know, so that’s another misinformation. They never talk about the normal A1Cs. The ADA says it needs to be below 7. Well – and then I ask doctors all the time, and they say, “You know, I can’t even get my patients below 7. You’re talking about 5, 4.5. I mean, that’s crazy. I can’t do that.” Well, of course they can’t, because their patients are not educated.

MB: Did I see where you go into businesses and have the businesses do A1C testing?

SF: We have an A1C test that we help distribute. It’s an instant test. It takes five – one finger sticker in five minutes, and you get the result. So we go into offices and we do A1C testing, and we do diabetes days in pharmacies, where we’ll do A1C testing and let people know. And I did a program for 150 pharmacists, oh, about a year ago. And when I got up there, I said to them, “You know, by the time tonight’s over, I’m going to find two people in this room with diabetes and I’m going to find ten people that have pre-diabetes that don’t know it. And what we did is we checked their blood sugars before they ate, and then I did my program, which was two hours, and we checked their blood sugars two hours afterwards, and then we checked their A1Cs. And lo and behold, we found that none of the pharmacists that were there had diabetes with an A1C, and they said, “Steve, I guess you were wrong. But we did find ten people with pre-diabetes.” And I said, “No, you’re not wrong. I said we were going to check everybody in this room.” There were about ten Hispanic waiters, so we checked the waiters. And we found two waiters that did not know they had diabetes. Because I can pick them out – they’re overweight, you know. So it’s a great test to see what your risk factors are. And 75% of the people out there and the people that are listening to this, 75% of them do not know what an A1C is. And it’s in their doctor’s records. They have to do it if you have pre-diabetes or if you have diabetes – it’s in the records. And you need to ask for, okay, because that is a life and death number. We know our driver’s license, we know our license plates and our Social Security Number, which have nothing to do with our health. But the A1C number, you know, you get the result, you post on the refrigerator door, and then maybe you won’t open the refrigerator as much.

MB: You mentioned Hispanics. Which ethnic groups are particularly prone to diabetes?

SF: Well, what we’ve discovered is Hispanics, Native Indians, Pacific Islanders, Mexican-Americans – all those people, you know, one in two will have diabetes. Any child born that’s any ethnic background – African-American, all those different backgrounds – anybody who has that, one in two will have diabetes. Not one in three, one in two. And that’s because we have a gene called the thrifty gene. And I’ve discovered that most people in those geographical regions where they lived on hot climates in the Mediterranean – we’re going back 1,000, 2,000, 5,000 years ago – where they lived in warm climates. They developed darker skin to protect themselves. Those people that had light skin died out and the genes didn’t pass on. So the people with darker skins were able to protect themselves from the ultraviolet rays, so they survived. But one of the other things that happened to them, they would go through periods of famine and feasting. You know, they’d kill an elephant and they’d have enough for a month, and then they wouldn’t have any food for maybe two weeks at a time or a week at a time. So we developed a gene called the thrifty gene. And what that is, is that when we have food, it turns it into fat. So when we’re eating all this food, it turns it into fat. And then when we go through periods of famine, that fat turns back into sugar, which gives us energy. So we developed that gene to protect ourselves so we could live and become part of the human race. What happened is that we don’t go through any periods of famine anymore. I can walk out my door, walk about two blocks, and walk into a grocery store. I can go into a 7-Eleven. I mean, how far are you away from food? So obviously our bodies are not meant for it, so obviously we get fatter. And because we get fatter, we become more insulin resistant. And then when we’re – insulin is a fat storage enzyme, so insulin takes our food and stores it as fat. So the fatter we get, the more insulin we have to have. So our bodies make more insulin. And the more insulin we have, the fatter we get. And that continues until something breaks. In order to stop that, you’ve got to break the cycle. How do you break the cycle? You don’t eat as many carbohydrates.

MB: Let me take a break here. This is America’s Anti-Aging Psychologist, Dr. Michael Brickey, with Ageless Lifestyles Radio, your source for cutting-edge thinking in being youthful at every age. Today’s expert guest is diabetes educator Steve Freed. His website is It’s packed with information for lay people and medical professionals, including information, educational materials, and the latest news and developments and controversies. And that’s the source for your newsletter. You also have a website, . What is that for?

SF: I work with a number of physicians, very well-known physicians that basically have the same philosophy that I do. And when I find physicians that have the same philosophy, I kind of promote who they are, and if they’ve written any books. And the philosophy that I kind of lean towards is that there’s no reason why anyone should have an elevated blood sugar above normal. And if a doctor can agree with that, then we promote his works. And I work with Dr. Richard Bernstein, who is the father of blood glucose monitoring, the first person to ever use a blood glucose monitor in the United States. And he’s written a couple of bestselling books, The Diabetes Solution. He’s in New York, very unique story. Here is a guy that was an electrical engineer, had Type 1 diabetes and was out of control. This was before blood glucose monitors. And he found one in a magazine because he was an engineer in Germany from the Ames Company. And he wrote away, spent 750 bucks – this was back in the ‘60s, so this machine that – you wore it in a backpack – it was huge. It had two lead acid batteries. And he would check his blood sugars 10-15 times a day. He would measure his food, figure out how many carbs there were, how much insulin he would need, and all his complications went away. And he wrote a letter to the New England Journal of Medicine and the AMA and the ADA, and he said, “You have to let people know about this machine called the blood glucose monitor. It saved my life.” And they sent him back letters – and I have copies of these letters – they said that was “the most ridiculous thing that we’ve ever heard, that people would check their blood sugars two or three times a day and adjust their own medication. On top of that, we’re not going to print your letter because you’re an electrical engineer, and we don’t print letters from engineers, carpenters, and plumbers. We only print letters from doctors.” So in order to get his paper published, he went back to medical school at the age of 47 and become an endocrinologist, and has written two bestselling books. That’s why we promote his philosophy. Anybody who reads his book will drop their A1Cs a full point, and if they read it three times, they’ll drop their A1C two points.

MB: Wonderful. So that’s ?

SF: Right. And we also developed a set of six hours of educational CDs with Dr. Bernstein and we’ve produced and put those out for Type 1s and for Type 2s. And you can listen to the information while you’re in your car. And we guarantee that if you don’t learn something new and improve your life, you’ve got 50 years to return them, no questions asked. I’ve never had anybody return them.

MB: Steve, let me back up a little bit. Could you give us a good metaphor for what diabetes is and how it works?

SF: Yeah, sure. First you have to distinguish – there’s really two kinds – actually three, but we’ll talk about two. There’s Type 1 diabetes, which is completely different than Type 2 diabetes. Type 1 diabetes is an autoimmune disease. We usually get that at an early age where our bodies – our T-cells in our bodies attack the cells in the pancreas that make insulin and destroy them. And before 1920, before the invention of insulin, people would just die of starvation, because all of the food that they ate could not be turned into energy. Therefore, they basically – their muscles deteriorated, their organs deteriorated, and they actually died of starvation. And along comes insulin, and those people now can have normal lives, if they have their blood sugars normalized. So that’s an autoimmune disease and that’s really genetic – we think it is. It’s partially genetic; it could be partially environmental. Type 2 diabetes – now, it used to be called adult onset because you had to be an adult to get it, but we changed the name about eight years ago to Type 2 diabetes, because kids are getting Type 2 diabetes because of obesity. Type 2 diabetes is really a lifestyle-driven disease. You know, we’ll have a cure for Type 1 diabetes in a very short period of time. There’s billions and billions of dollars going into it. I see all the research – we’re so close, really so close. We know exactly what we’re doing, we know what we’ve got to find, we know what we have to do, so it’s just a matter of time.

MB: With the Type 1, then, is that likely to be a genetic engineering or medication, or what do you think the cure will be?

SF: Well, the cure is going to be – we know what we have to do, and what that is, that the beta cells are dying off when you have Type 1 because the T-cells, the killer cells, are killing those beta cells. So if we find a way to turn off those specific T-cells that are killing the beta cells, we now believe that those cells will regenerate themselves if they’re not destroyed. So – and we also found that there’s precursor cells in the liver duct that we can turn into beta cells. So there’s a lot of exciting stuff going on. I mean, really exciting stuff, but that’s for Type 1s, and that’s great, but only 10% of the population has Type 1. 90% are the Type 2s. Now, we already have a cure for Type 2. Nobody knows it, and please don’t repeat this to anyone because we’re going to patent it, and it’s called duct tape.

MB: Okay.

SF: Okay, you put it over your mouth so you don’t eat. Okay, so Type 2 diabetes is really lifestyle-driven, which means that it has to do with your lifestyle, your physical activity, and your eating. That’s pretty much what you – and you have to have it in your genes. A lot of people have it in their genes. And when you overeat and you become fat around the waist, your risk for diabetes keeps going up and up until eventually your body just can’t handle all the carbs that you’re eating and eventually you become diabetic. So we know if you have pre-diabetes or you have diabetes in your family, we can prevent you from ever getting it, by 99%.

MB: I was just reading in Life Extension Magazine that if we come up with a pill that raises everybody’s metabolism so they can eat more without getting as heavy, that actually would be kind of a disserve because we would have these high levels of fat and be converting more and more sugar, and would just aggravate diabetes and cardiovascular problems.

SF: Yeah, there’s no question about that. And let’s be realistic. Any pill that does that is going to have some tremendous side effects. You know, right now we know the best therapy for diabetes is nutrition and physical activity. And insulin – that’s the number one best therapy, because it’s a natural hormone. Our bodies make it, so it’s not something that is foreign to our bodies. But every drug that we – almost every drug that we have in the marketplace are foreign bodies. You know, they’re carbon molecules that our bodies were not meant for. There’s side effects and contraindications and all kinds of problems with every medication because, you know, our bodies don’t produce it. It’s not natural to our bodies. So you know, people have to understand, with Type 2 diabetes, you just can’t go to the doctor and get a prescription and expect that’s going to take care of it, because it won’t. It’s a progressive disease, no matter what you do, as we get older, our bodies slow down and your diabetes will always get worse if you don’t stay on top of it.

MB: So when somebody has a certain level of diabetes, even if they take ideal care of themselves, is there any hope of reversing some of the damage?

SF: Absolutely. If you can get your blood sugars normalized, you can reduce the neuropathy, your eyes improve. If you have protein in your kidneys, which is a sign of kidney failure, that’ll go away. It improves your memory, it improves your skin, it improves your sex life. Yeah, if you control your blood sugars in the normal ranges, what we’re discovering is that the beta cells that make the insulin cannot live in an environment of high glucose. We call that glucose toxicity. And they can’t survive, and they die. When we change the environment in your body to normal levels of glucose, they can come back and regenerate, is what we’re discovering. So you can actually reverse diabetes. You’ll always be at risk for it, but you can actually reverse it, provided, you know – as I tell people, you know, if you lose your eyesight and go blind and they come out with a cure a week later, what good is it to you? You know, so yes, absolutely, by controlling your blood sugars and being educated – because you’re the one that has to do it, not the doctor – you can actually reverse most of the complications from diabetes.

MB: I know it sounds a little silly, but you know, the sticking yourself with a needle several times a day is one of the things that really makes people reluctant to monitor diabetes. Are there tests that people can do on a daily basis other than finger pricks?

SF: You know, there has been billions of dollars spent trying to find a noninvasive way to check your blood sugars, okay? And if you realize that the first blood glucose monitor, the one that Dr. Bernstein was using, used 50 microliters of blood, 50 microliters of blood to check your blood sugars. Today we use 0.3 microliters – 50 microliters to 0.3. There’s no pain, if you know how to do it. You can do it on your arm, you can do it on your palm. There’s absolutely very little, if any, kind of pain. The old monitors that used 50 microliters of blood, you needed a box cutter to get the amount of blood that you needed, instead of a little prick. But here’s a device that can actually tell you if you’ve eaten too much, if you’ve eaten the wrong foods. There’s no way to control your blood sugars on a daily basis without testing. And they’ve had devices, infrared devices that you stick your arm in and they tell you what your blood sugars are. They had a device once called Sugar Track where a thing on your ear, and it shines a light through the skin and it can see the color of the blood. You know, none of these things have come out pretty much. We do now – we have continuous blood glucose monitors. Those are very unique for people that are very proactive, that need to know. They have a monitor that checks your blood sugar just about every three minutes and it’s wireless. You know, so technology changes about every three to six months when it comes to this. So there’s really no pain involved if you know what you’re doing. But you know, monitoring your blood sugars without knowing what to do when you see a reading, what good is it? You know, the average person checks their blood sugars in this country 0.6 times a day. That’s less than once a day, you know – what do you expect to learn from monitoring less than once a day? You’re not going to learn anything. Why even bother? You know, you need to know when you need to check and that’s where the education comes in again. You know, when do I check and what do I do with that information? How can I get my blood sugars down? It all comes from the education, not from your doctor.

MB: For a person who doesn’t appear to have diabetes but wants to make sure they don’t get it, what kind of education do they need? What would you recommend they do, besides the A1C test, to make sure they don’t get it?

SF: Well, I would suggest that they get a book on diabetes, a good book like the one Dr. Bernstein writes, on our website, that tells them about how to control your diabetes. If you read the book and you understand it, you can prevent from ever getting it, because you’re going to live like a diabetic. You’re going to be healthier. Isn’t that the goal as we get older? I have my first grandchild – she’s two years old today. Today I took her to ballet school. I had a ball! That’s what life is all about. And if you have diabetes, that life is not going to be available to you. One of the things I do with my patients, I give them a blindfold, a sleeping blindfold, the kind they give you on the airlines. And I say, “I want to wear this tonight when you go to sleep, and when you get up, I want you to keep it on. Do not take it off. I want you to keep it on for 20 minutes. And I want you to shave, I want you to shower, I want you to cook, I want you to go the bathroom, even if you wet the floor. I want you to wear this thing, okay, and then I want you to take it off and I want you to call me.” And the reason I do that is not to scare people. I want them to realize what they have to lose and what they have to gain by changing their nutrition. When you woke up this morning, did you look out the window and say, “Oh my God, I can see! Look at the sun, the snow, the sky. This is fantastic. I’m going to have a great day!” Or did you get up and put your shirt and pants on and go to work? So we don’t appreciate what we have until we don’t have it. I want people to have that image in their mind so that when they go to the refrigerator or they go out – okay, I want them to tell me that that piece of pie is worth losing that eyesight. Name me one food that you’re willing to give up your eyesight for. Can you do that for me?

MB: No, not even carrot cake.

SF: Right, but that’s what they’re doing! I just want people to realize what they have to gain and what they have to lose, the quality of life as we get older. You know, there’s people walking around in nursing homes, most of them walk around in walkers. Why do they walk around in walkers? Not because they have arthritis. They walk in walkers because they lost their muscle mass and they don’t have the energy. Well, you know, physical activity can prevent that. You don’t have to be in a walker or a wheelchair. These people that get the battery-operated carts they advertise on TV – okay, for sure they’re going to deteriorate, if they won’t even get out of the go-carts to go around the house – they won’t even walk. And Medicare pays for it. You know, we don’t pay for prevention. We would rather treat diseases, give people new hearts and kidneys and limbs. You know, that’s the way our medicine is practiced. We don’t pay for prevention. And eventually we’ll have to because right now diabetes accounts for 33% of the Medicare budget. That’s with about 7% of the population. What happens when that’s 40% of the population? What percent of the Medicare budget will be diabetes? Well, there won’t be any Medicare budget because there’s no way they can pay for all those kidney dialysis machines. If you want to invest in a company, find you a company that makes these home dialysis machines, because dialysis right now is the number one payout for Medicare and it’s going to explode.

MB: With your pharmacy background, are there medications that are contributing to diabetes?

SF: No, there’s not medications – well, I shouldn’t say that, you know. We have a pill-fixing culture. You know, if there’s something wrong, there’s a pill for it and we go to the doctor. When it comes to the quality of life issues and diabetes, you know, that’s really not the issue. The issue is education and understanding your nutrition and physical activity. There are certain medications out there that are very beneficial for people with diabetes. You know, we’ve come a long way, from 1950 to ’95, 50 years, we only had oral drug for diabetes. It was called the sulfonylurea. The first one was called Orinase. Now it’s called Glucotrol or Micronase or Amaryl. And what that drug does is it forces your pancreas to produce more insulin. And that was the drug we had for 50 years. Well, what do you think happens to your pancreas when you keep forcing it to make more and more and more and more?

MB: Goes on strike?

SF: Yeah, it burns out. And you become a Type 1. All Type 2s eventually, if they live long enough and they’re not in control, all Type 2s will turn into Type 1, because they will lose the cells that make the insulin. And it’s 100% preventable. So yes, there’s good medications out there. And the combination with good medications, knowing which medications are the best for you – and I educate my patients, they know about all the medications. They go to the doctor and they tell the doctor what medicine to prescribe. They don’t wait for the doctor to tell them, because the doctors see them for ten, fifteen minutes. These people know which ones, according to their lifestyle, work best. And they tell the doctor pretty much what drug they should be on.

MB: Steve, I’m also fascinated with the documentary you’re doing, “Conquering Sugar Mountain.”

SF: Yeah, I’m working with a director and a filmmaker up in Canada. And basically he’s done all the filming. He’s looking for some support, financial support, and it’s going to be called “Conquering Sugar Mountain.” It should be out some time this spring. And basically, it’s a full-length two-hour feature document – a regular film with a story, but he built in educational components into it. He talks about A1C, he talks about Dr. Bernstein, my partner is on the film talking about diabetes. So he’s put educational components in it, and he hopes basically that it’ll be on public broadcasting TV on a series or something like that. And we helped him – put him in touch with Dr. Bernstein, and we gave him some ideas on getting more information out there, rather than just making it a film. It’s about ten kids with Type 1 diabetes that can climb Mount Kilimanjaro. And they filmed the whole sequence. And it’s a great film. You know, I’ve seen some of the cuts. There’s a lot of good information in it. And like I said, people can watch for it. It should be out some time this spring. It’s called “Conquering Sugar Mountain.”

MB: Sounds great. Is there anything else that you’d like to share with us?

SF: Well, certainly people should be aware. One of the things, when I talk about physical activity, we developed this program called “Know Your Healthy Steps.” It’s been used with 150-300,000 people in four languages, it’s so successful. And what we did is we came up with this idea that because physical activity – you know, every time you move a muscle, you basically burn sugar and you burn excess sugar if you have diabetes. So we really need to come up with a treatment that builds in physical activity. So we came up with this idea of how to teach people how to use a pedometer. A pedometer is a little device – you can buy them in any store – they cost 10, 15, maybe 20 bucks – and it monitors your physical activity because it tells you how many steps you get every day. And we’ve discovered that people monitor their blood pressure, they monitor their cholesterol, but how do we monitor our physical activity so we can document it and see? So I can correlate your steps directly to your blood sugars. So when someone sits down with me, they talk about, “Let’s get a baseline. Let’s find out what your average daily total is.” And then from that, we increase it gradually. And my patients are responsible for reporting back to me their daily steps every single week. And I can directly see that their blood sugars go down the more steps they take, and it goes up the less steps they take. So it’s a way to monitor to see exactly what we’re doing. So I teach people, during a football game, a three-hour football game – we know a football game takes one hour, four quarters, 15 minutes. What if you just got up during those other two hours, walked around in circles in front of the TV, not miss anything except the commercials on how to lose weight. You can walk five miles during a football game rather than sitting on the sofa, eating potato chips. So that’s what we teach people, you know. And when you go to the store, park your car in the back of the lot. That may be 100 steps. Well, both ways it’s 200 steps. Well, if you did that five days a week for ten years, that’s probably over 15,000 miles. Do you think you’re going to burn any calories if you walk 15,000 miles? Well, of course you will. Does it have to be in one day? No. 20 here, 30 here, 10 here, 5 here. You know, take your pajamas and bring them to your neighbor’s house so you’ve got to walk over to your neighbor’s house to get your pajamas – whatever it takes. It’s a way to monitor – it’s been very successful. Have you ever owned a pedometer?

MB: No.

SF: Send me your email address, I’ll send you one. I like to give pedometers away because I will personally add ten years of quality of life on to your life if you read the manual which I send with it, along with the pedometer. And it’s nice to be able to improve somebody’s quality of life for ten years, rather than give them a business card.

MB: Wonderful. When you were talking about physical activity, if we do have a weak moment and have that big pasta dinner, should we get physical right afterwards? Would that help?

SF: Well, it doesn’t really make any difference when you get physical. The point is you need to do something on a daily basis. You know, the Surgeon General says you need to be active 30 minutes a day, five days a week, and that’s baloney. You know what I tell people? If you eat on any particular day, you need to be physically active and get your steps. If you don’t eat, if you starve yourself for the whole day, you can sit on your butt and not do a darned thing. But if you’re going to eat, you’ve got to be physically active. So that’s seven days a week you need to be active – not five, not six, but seven days. It doesn’t mean you have to walk 50 miles. It could mean that you’ll only go out and walk for two miles, maybe ten minutes here, five minutes there, 30 minutes there. That’s why the pedometer is so effective, because people will wear it, they’ll look at it, and they’ll see, “I need to get a few more steps.” So when you go to your dentist and he’s on the 10th floor, take the elevator to the fifth and walk five floors, okay? If you’re on a bus, get off two stops early and walk. There’s ways that we can find things that we don’t have to change our lives to increase our physical activity. Instead of sending somebody an email that’s in the office next to you, you know, print the darned thing and walk over – you’ll surprise the heck out of them. You know, “Why didn’t you email it to me?” “Well, I need to get my steps in.” You know, little things like that. Yes, you can overcome. If you’re going to cheat, if you’re going to eat that piece of chocolate cake that you know you shouldn’t, go ahead for it, eat it, but know that that piece of chocolate cake is going to cause you to have to walk four miles. Now did that piece of chocolate cake taste that good that you’re willing to walk four miles? If it does, go for it. If it doesn’t, don’t eat it.

MB: So it’s like putting a price tag on each of the foods we eat.

SF: Yeah, think about the foods – the bad foods that you want to eat, and say to yourself, “You want to have those french fries? Go for it, but you’re going to have to walk an extra 15 minutes.” Okay, I’m willing to do that, so I eat it – because if not, it’s going to be turned into fat around your waist, which increases your risk for cardiovascular disease and diabetes.

MB: Steve, you’re a wealth of information. Let me wrap things up here. This is America’s Anti-Aging Psychologist Dr. Michael Brickey, with Ageless Lifestyles Radio, your source for cutting-edge thinking on being youthful at every age. We’ve been talking with diabetes educator Steve Freed. His website is  where you can get the free newsletter. And he also has which has lots of information about books and resources. And what’s the website for the test?

SF: And if they’re interested in doing their own A1C test at home, they can do it with a very unique monitor and it’s very inexpensive. It’s about $12 or $13 per test. And that is . And it gives you all the information on how to do your own A1C test at home. So if you have diabetes or your family members are susceptible to it, you know, have everybody in your family do an A1C test. Find out what it is. Make it a contest. Give out a prize to whoever has the highest number. Make it fun.

MB: And the test kit’s only about $10 or something?

SF: Well, it comes in ten tests – you have to get a ten test. And you can do it about every month, because 50% of the result comes from the last 30 days, even though it’s a 90-day average. And the way that works is the blood attaches to the – the glucose attaches to the red blood cell. The red blood cell lives for about 90 days, so we measure the amount of glucose attached to the red blood cell. So that’s how we do that. And a 6% is equal to about 135 mg per deciliter on your blood glucose monitor, and it goes up and down about 35 points per the single digit of the A1C, so you can compare it to your blood glucose monitor. And again, that’s at

MB: Okay. And information on Anti-Aging Psychology and my free Defy Aging Newsletter is at  or you can just go to  and it’ll take you there. I’d love to get your feedback and comments. You can send them to



Anti-Aging Psychologist, Dr. Michael BrickeyDr Richard G. Petty








Host: Anti-Aging Psychologist Dr. Michael Brickey

Expert Guest: Integrative Health Physician Dr. Richard G. Petty

Broadcast: 2-3-08 on where the latest shows are broadcast and posted as podcasts

Are you sometimes baffled by so many schools of thought and contradictory advice about health? Today’s guest expert, Dr. Richard G Petty, has traveled the world meeting with top researchers and gurus to sort out what works and develop an integrated approach to health. Dr. Petty received his medical training in England and since then has obtained three Ph.D.s  He put his knowledge and wisdom together in his book, Healing, Meaning and Purpose. He also is a popular speaker who has lectured in 44 countries. In the first part of today’s show, we’ll look at how Dr. Petty views health and dealing with health challenges. In the second part we’ll look at what he has found to be the most exciting cutting edge developments in health. His website is http//

TRANSCRIPT ©Michael Brickey–excerpts permitted with attribution

MB: This is Dr. Michael Brickey with Ageless Lifestyles Radio, cutting-edge thinking for being youthful at every age. On each program I interview experts on what it takes to live longer, healthier, and happier. Our program takes a holistic approach in addressing anti-aging psychology, medicine, alternative medicine, fitness, nutrition, and wellness. Our emphasis is on innovative thinking and practices that have solid data and results. Are you sometimes baffled by so many schools of thought with contradictory advice about health? Today’s guest expert, Dr. Richard G. Petty, has traveled the world meeting with top researchers and gurus to sort out what works and to develop an integrated approach to health. Dr. Petty received his medical training in England, and since then has obtained three PhDs. He put his knowledge and wisdom together in his book, Healing, Meaning and Purpose. He also is a popular speaker who has lectured in 44 countries. In the first part of today’s show, we’ll look at how Dr. Petty views health and dealing with health challenges. In the second part, we’ll look at what he has found to be the most exciting cutting-edge developments in health. Dr. Petty, is the title of your book, Healing, Meaning, and Purpose, meant to suggest that integrative health starts with purpose?

RP: Absolutely. And you’ve actually just hit the nail on the head. We spent a long time trying to come up with a title, and somebody had just said to me, “Set down, what is the most important thing?” And I said, number one, have a purpose in life. Find your purpose, because everyone has one. Number two is find meaning in your experiences. And number three, from that, health, healing – it all just flows down from there. And so it really is essential. And I’d like to just pick up on something you said there about some integrative approaches. One of the things that we’ve done – and you’re right, I’ve been a globetrotter over the years – is to create integrated medicine, which is very slightly different, and it’s a slightly different idea, but I wonder if I could just share a little bit of that, because I think it’s going to kind of give a context for the rest of what we talk about. So may I say a little bit about that first, perhaps?

MB: Certainly. Go ahead.

RP: Okay. The reason we came up with this term, and I had the privilege of spending several years – eight years, actually – working with Prince Charles on setting up a new system of healthcare, which we call integrated, the idea being not just to cobble together a few different modalities, but the fundamental idea is that health and wellness and, for that matter, longevity, is really a function of integrating all the different parts of you, yourself, your mind, your spirit, your body, your relationships – all of it. And we know full well that if any one of those things is not functioning properly, then you start feeling lousy. And the way that I always look at this is that, for me, symptoms are signals. So if you’re in a dysfunctional relationship, if you have a physical problem, for me those are signals that something somewhere is going wrong and the integration hasn’t worked. So that’s the idea. And whenever we look at people, one of the cardinal ideas is that we look at them from five dimensions: physical, psychological, social, subtle – so for the subtle systems of the body, and spiritual. And not everybody likes all five, and that’s fine. But I approach everything about health and wellness from those five perspectives, and it really does seem to work very well.

MB: If I asked a dozen different gurus, “How do you find your sense of purpose?” I’d probably get a dozen different answers. How do you put that together and integrate it?

RP: Okay, yes, you’re absolutely right. You do always find a ton of different answers to just about everything. And what you also said at the beginning I liked very much – the whole field of health and wellness is so confused and confusing for everybody. So for me, purpose is, number one, it’s very much a personal thing. It’s a matter of what your core constructs are, what really matters to you. And I always, always recommend to anybody, if they’re going to do anything in life, just sit down and find out what really matters to you. And as far as you possibly can, live your life with those, instead of just trying to do what other folks say. The other day I was talking to somebody and he is a very creative individual and he wanted some advice on how to get more organized and time management and all this. And I said, “Steve, wait a minute, wait a minute. You are very creative. Your purpose is actually to generate ideas and you do this fantastically and people pay you a king’s ransom for doing that sort of thing. Why are you trying to teach your cat to quack?” And he said, “What?” And I said, “You’re teaching your cat to quack. Your purpose in life is to be creative and you bring that to everything you do. And so say that you now want to go in a different direction and organize yourself differently doesn’t make much sense.” So I think it’s very individual, it’s very personal, but everybody does have and can find a purpose in life. And some folk even say, you know, you have more than one. You have a higher purpose, you have a spiritual purpose. But I spend a lot of time always getting people to sit down and really look at what are the things that are your hot-button issues, what are the things that matter to you? And if you’re not doing those things, chances are things will not go well for you. I was recently advising somebody who’s a doctor, and he said, “I never really wanted to be a doctor.” And I said, “Why not? Why are you doing it?” He said, “Well, my parents pushed me into it. They’re both doctors. They went to medical school.” And I said, “Well, what do you really want to do?” He said, “I want to play the trombone.” And in fact – I said, “Well, don’t you go and do that?” And in fact, what eventually happened, he put his financial affairs in order and, you know, plays music professionally. He’s found his purpose. And I think it’s always such a mistake, isn’t it, because you and I both know, and everybody listening, there’s so many people who’ve lived their lives through somebody else’s lens – they’ve actually done what other people have said. And it’s very hard to do that and find satisfaction. And eventually what happens, the wheels come off and you start getting sick and something happens. So this is why I think it’s very personal and yes, you’ll get 100 different answers for what is your purpose. It’s individual. Find it for yourself. Don’t rely on anybody else to tell you.

MB: So sometimes the most brilliant things in life are just figuring out how to get it really simple. And for someone who’s trying to find their purpose, it’s just asking themselves, “What really matters to me?” And that makes a purpose very similar to meaning.

RP: Absolutely. And I really do believe that purpose and meaning are very closely interlinked. And if you just sit down briefly and look at the interrelationship of those and what really matters in your life, you will find very quickly that not only will you find your purpose, but everything you do starts to be imbued with more meaning. So I always say to try not to wait until your body, your relationship, something trips you up, telling you it’s time to look for the answers. Because most people go through sort of phases of life when the big questions come up, the “Who am I? What’s the meaning of life? What should I be doing with my life?” We normally get those at crisis time. What I suggest is look right now, today. Start looking at those things and you will find very, very quickly, just asking very simple questions, that you can come up with the answer for yourself very rapidly. So this does not need to be something which takes you half a lifetime. You can find it quickly. And I do a ton of very, very practical things to just find out where people are at, what their center of gravity is, and from that we can work out a purpose, and from that flows meaning.

MB: So, rather analogous to physical health – be proactive when you’re healthy rather than waiting for the symptoms to give you a wake-up call that you have to do something at a time when you’re feeling pretty unresourceful to begin with?

RP Oh, totally. And how many of us, though, don’t start digging our well until we’re thirsty? And it’s such a terrible mistake. You know, there’s a statistic that I think is really very sobering. It was published in the Archives of Internal Medicine a couple of years back, that only 3% of Americans are following the minimum healthy lifestyle, 3%. 97% are not. And that doesn’t even take into consideration things like having meaning, having purpose, looking after your mental health. It’s just the physical stuff – 3% are doing the minimum. Shocking, isn’t it?

MB: So if we’re not even looking at purpose, what is it that the 3% are doing right?

RP: Well, when they look at statistics like that, the 3%, it just means that they’re eating, exercising, and sleeping. And that pretty much is it. And we all know that a healthy life does not need to be complicated. One of the biggest issues that I run into all the time – and it took me, as you said, a lot of qualifications, a lot of experience to get this – that the answers are actually terribly, terribly simple. And you can do things quickly and it doesn’t need to be something that you have to change everything about life. You can do things quickly and easily, and that must be one of the take-home messages: Quick and easy is the answer.

MB: You write about how, if you have your purpose and meaning aligned, you’re going to have far more energy. And again, if I asked our twelve gurus what energy is and what it means, I’d get twelve different answers. How do you translate or integrate all these theories?

RP: Well, I agree with that wholeheartedly, that you will always get a ton of different answers. And interestingly, we’ve just put together a new program on how to boost your energy. And although you can look it in many different ways, they actually – all roads lead to Rome – they all come down to the same kind of thing. There’s obviously physical energy and that’s metabolism, blood flow, and all of those good things. There’s also the relationship with oxygenation and breathing. Then, of course, there is psychological energy – how much you want to apply. And again, if you find your purpose, that’s where you passion comes from, that’s where your energy comes from. And we know successful people are the people invariably who don’t do a lot of extra work, but when they’re working, they focus all of their energy, all of their attention on one problem at a time, get rid of it, on to the next one. So there certainly is a psychological component of energy. I, in recent years, have also become very persuaded that there is another form of energy, these subtle systems of the body, what in China they call Chi and very similar idea in India of Prana. In the West, the Greeks used to call this *12:32 – rather the Romans and the Greeks called it the same thing, Pneuma. And this idea that there is another form of energy in the body, I think there’s more and more evidence for what we now call – I mean, the technical term is the biofield, but there really does seem to be something else. We can manipulate it with acupuncture. We can certainly build it with certain exercises that seem to do something more than just physical jerks, physical exercise breathing – it’s something else. It took me a long time to be persuaded of the existence of these subtle systems; now I’m quite sure that they’re there. And there’s actually some fairly decent evidence beginning to emerge that they’re there. And if those subtle systems aren’t working properly – again, lack of energy, you just get drained extremely quickly. So for me, it’s several separate pieces. But what’s so intriguing, and why I say all roads lead to Rome ultimately, is that if you work on developing, say, we’ll just use the example of doing some physical exercise, breathing exercise, and sleeping better, the Chinese would say, “Well, actually you are building your Chi.” And so in addition to doing the physical stuff and stuff that is easily measurable, you are also doing something else, which is extremely interesting. And I also think that one of the key things about energy is that there are so many very loose ways that people have talked about it. Years ago, we started having a working party in the UK on the whole idea of energy, energy healing, energy medicine, and so on. And one of the people who attended that – it was a small closed meeting – was Brian Josephson, the Nobel laureate, and a good friend and a nice guy. And he remonstrated with everybody and said, “For heaven’s sake, don’t use this term ‘energy’ so loosely.” He said, “These are systems.” And he said, “They’re fields, and you can’t just have energy, you have to have a field as well.” And that’s why we call them subtle systems, so we get over this kind of rather loose talk about energy this and energy that.

MB: So what I infer from what you said, is part of it is just do the things that you know you should do – exercise and breathing and stress reduction – and don’t worry so much about the school. But when it comes to these subtle forms of energy and the systems, are there things that we need to know about that, or should we be studying, since most of us don’t have much of an understanding of it?

RP: Yes. Number one is yes, the common sense things that we all know and love will build all of that. But there’s a whole system of very simple exercises, primarily based in Qi Gong, which is a Chinese system that anybody can learn very easily and guaranteed to boost energy, and very simple stuff that you can do. There are even some points on the body which you can just do a very simple little bit of 30-second massaging of in morning, evening, whenever you need it. And just by doing that and doing a little bit of breathing, it’s remarkable. I can show anybody how quickly you can boost energy. Just the other day I had – let’s think of one of the most skeptical types of people that you could ever have – I had a representative from a pharmaceutical company, drug rep, sales person – very, very nice, but hard-nosed business person and scientist. She told me that she was pretty tired and I said, “Okay, I’ve just done this program, I’ve just dictated all of this. So take your shoes and socks off for a moment and this is what we’re going to do.” I showed her a couple of points – and again, I can share these exactly with the listeners. And she said, “That’s amazing! How did you do that?” And I said, “You did it. You just stimulated these couple of points, did a couple of breaths.” And she said, “I feel like I just woke up and I’m full of energy again.” Very quick, easy things, but things that are very difficult to explain just on a biomechanical model of the body.

MB: Is that something that you could talk us through now how to do? Or…?

RP: Oh, absolutely I could. And we could do this as a little practice for anybody that’s in a good spot right now where they can do this.

MB: In other words, you don’t want somebody to do it while they’re driving.

RP: I’d prefer not, because if you do it while you’re driving, it would not be a good idea, and number two, it would be a little bit difficult because I’m going to make you touch your foot, and I’d really rather you didn’t do that right now because I like people and I don’t want anybody to harm themselves. Very simple, I can show you this, and something that I can do for you, as well, Mike, if it would be helpful, because I’ve just created a little schematic of this. I don’t know if it’s possible for you to do this, but you might actually want to put it up on your website so people could actually have a little look at that after the show, if that would be convenient.

MB: I’d be happy to, yes.

RP: I’ll offer that to you and to your listeners. But it’s very, very simple. One caveat, apart from don’t do it while driving, is *17:57. Just above your ankle bone, the ankle that’s on the inside, if you go about three inches above your ankle, just a little spot there, right in the middle. And it’s very forgiving – it doesn’t matter if you don’t find exactly the right place. And if you just put some gentle massage on there, just gentle pressure for about 30 seconds, that’s number one – you do that for 30 seconds. Then second – and it doesn’t matter if you do it on the left or the right, it’s quite all right – second is right in the very, very middle of the sole of your foot. You just give that a little bit of a massage. And again, it doesn’t need to be exactly the right place. You’ll find it. And again, you do that for about 30 seconds. Then plant your feet on the floor, sit up, back straight, and all I’d like you to do with your feet flat on the floor, is do 30 seconds of abdominal breathing – deep, slow – done, one and a half to two minutes. Try it. I’d like anybody, if they’re in a good spot to do it, just try it. You’ll be amazed and astonished, because just about everybody says, “Wow! How come that happened?” And it’s that simple. That point above your inner ankle, middle of the foot, and breathe – very simple technique. And if anybody can explain to me on using normal, physiological, biochemical models how that works, please tell me. Because one of my doctorates is in biochemistry and I cannot explain this – and I’m also a neurologist – I cannot explain it, but it works every time. So it’s very remarkable. So this is a little free gift for you. And as I say, if it would be helpful to you, Mike, I’ll email you a copy of the little picture that I made.

MB: Great, thank you.

RP: That’ll be a little gift for your listeners and for you, of course.

MB: And thank you for taking us through the exercise. If we wanted to learn more about these systems and other exercises like this, what would be the best source?

RP: In fact, what I’ve done is that my own website, which is – and I should’ve called it something terribly creative like DancingDragons or something, but I’m not very creative so I just used my name – I have, as a real labor of love, created lists of all kinds of places – it’s one of the most comprehensive lists of where you can find out more about Qigong, homeopathy, flower essences – I’ve listed pretty much every integrated medicine program in the States that I know of, and many in Europe, as well as providing access to about 200 medical journals. So it’s all there, and I just did it because I thought people would find it helpful. So my website’s a pretty good place to start, simply because I took the time to check out every single one of my listings. When you and I first started talking, I had a look at your material because you don’t get on my list unless I’ve checked you, and you are going to be on my list – in fact, you’re going to be very high on my list at the end of today – because I always check everything myself. And then I go back and recheck periodically, just to make sure that people haven’t sort of gone wild and wooly. So it’s a good place to start. And it’s lists and has links to most of the major organizations that I’ve been able to check out, so you can find more information. I also have lists of books – I’ve put a load of lists of books and book reviews up on Amazon and then I linked to those through my website, as well. So if you’re interested in boosting your energy and that kind of thing, I provide *21:45 potted summaries of the books, so it gives you a good place to start.

MB: So it’s probably the most carefully thought-out list that’s out there anywhere.

RP: I hope so. As I say, I just did it because so many people kept saying the same thing – where should somebody go to get reliable information? Because I was seeing person after person after person who had oftentimes spent vast sums of money on all kinds of tests and investigations and treatments, some of which made absolutely no sense at all. And I’ve always been somebody who’s looked very, very hard at data. I’ve always been data-driven. One of the things that you may not yet know is that I had the privilege, for many years, of serving on the Research Council for Complementary Medicine in the UK and then actually chaired the whole organization – that’s how I ended up working with Prince Charles. The whole idea was to just find out what’s real and what isn’t, because there’s so much confusion. And once I discovered that there just was – there’s nothing out there. People were being misled all over the place, because most people, with the greatest respect, have never been taught how to read a research paper – I mean, why should they? And so people were just getting into such a mess. And I said, “Okay, I can read research papers. It’s what I do for a living. I’ve trained thousands of healthcare providers around the world on how to do this.” So I said, “Well, okay.” So I rolled up my sleeves and started doing this. And it took a while, but people obviously find it it’s a pretty useful site. I think as far as I’m aware, it is one of the most comprehensive, carefully scrutinized lists available. And I also try to update with new stuff, because, you know, what you said in your introduction is absolutely right. There’s not just confusion about medical things, but even in fact psychology. I talk a lot about the way that we are now in the fourth wave of personal development. You know, we went through all these different phases of what I’d call psychobabble and these different ideas, and now finally the whole personal development area is being data-driven. So your material is all about, “Well, what can you actually do? Show me the stuff.” And that’s so important, isn’t it?

MB: Yes. Let me take a break here.

RP: Sure.

MB: This is America’s Anti-Aging Psychologist, Dr. Michael Brickey, with Ageless Lifestyles Radio, one of those places for you to go to get the kind of information that Dr. Petty’s talking about. Today’s expert guest is integrative health physician, Dr. Richard G. Petty. His website is And his book that puts it all together is Healing, Meaning and Purpose. Information on Anti-Aging Psychology and my free Defy Aging Newsletter is at, or you can just go to and it’ll take you to Dr. Petty, one of the things you have a lot of expertise on is resilience. Can you tell us what you mean by that?

RP: Oh, yes. This is something that is very, very close to my own heart. Resilience is the ability to bounce back, and it is one of the things that we have had the most trouble with, because various things have been happening in society and we as a people have been getting worse and worse and worse, to be honest, at being resilient, being able to bounce back. I think it was General Patton once said that, “I’m not interested in how far somebody falls; I’m interested in how far they bounce after they’ve fallen.” And that really does summarize what resilience is all about, why we’re so interested in it, because there are some very novel ways in which you can build your own resilience and feel much better very quickly. And it’s – I look at everything in the world, if I wished for one thing for everybody, it would be let me teach you how to build resilience. The trouble that has happened in recent years is that because everything has been so very easy – you know, if in doubt, you can just take a pill. That’s the solution to everything, and it’s created real difficulties. People do not any longer have the kind of endurance that our ancestors had. And it’s not a matter of being tough; it’s just a matter of knowing how you can put yourself back together again. There’s some very, very good data recently that even things like how do people handle rejection? People that are very good at handling rejection – and heavens, we’ve all been rejected at some time in our life – are the ones who are resilient. And it’s very important in terms not just of your physical health, but also in terms of your longevity. There is evidence now growing that one of the things that determines how long we live for is our ability to deal with the slings and arrows of outrageous fortune, to be able to bounce back when things hit us – which they inevitably will. It’s part of life’s rich tapestry, isn’t it?

MB: Now, I know you’ve been at the University of Pennsylvania and worked with Dr. Martin Seligman, who is the guru of learned optimism and authentic happiness. How do those relate to resilience?

RP: Oh, very much so. And in fact, the folk there – that was one of the reasons that when Marty started that work, it was driven not just be the ideas of “Let’s all be happy and sing Kumbaya.” It was very much a matter of why is it that some kids and some adults have such problems, and is there something that we can do to build that? And the answer is, absolutely, you can. And when Marty started doing that work, and why it was so desperately important, was that nobody had really been looking at the positive side of life, had they? And it was – at the time, it was just so-

MB: Just like the medical model.

RP: Well, yes. And it’s remarkable that over all of those years, that people really hadn’t looked at it. And so you’re right, it was just all about, “Let’s look at sickness.” And so resilience, to me, is the process of being able to adapt and thrive in the face of any kind of adversity or stress, trauma, tragedy, threat, because when we think about it, our lives never go according to plan. The most important things in our lives are the things that come out of left field unexpected, and they happen all the time. And if you can’t handle those, you’re going to have a real big problem. Now resilience, as I said, the ability to bounce back and being able to adapt and thrive – that doesn’t mean that we all have to just sort of become unemotional creatures like Mr. Spock in Star Trek. It means that you just begin to take control of your life. And I have a few very simple steps that I recommend, and anybody can do these literally in a few minutes a day. And it’s not something that you need to uproot your life, change everything. And there’s some very simple things in terms of – I wonder if we could perhaps talk about one or two-

MB: I was going to ask if you didn’t offer.

RP: Well, number one that I always start with is – and all the evidence on this is self regulation, the ability to be able to monitor your internal states, your moods, your emotions, your reactions, and to be able to watch them and modulate. A very simple way to start with that is I recommend a 60-second exercise. In fact, you can do it in less than 60 seconds. Every morning of just spending 60 seconds before you start your day, just observing your thoughts and emotions. It’s a very, very old Zen technique and it’s very simple. You don’t need to do it for hours. It’s not – if you want to reach Nirvana I guess you would have to. But all I’d like you to do is just spend a minute watching your emotions. The reason why this seems to work so well and has actually now become the basis of an entire new school of therapies, as you know, is that if you get into the habit of basically developing witnessed consciousness, being able to watch yourself, it’s remarkable how quickly you can actually start noticing that you’re not your emotions and you are not your thoughts. And instead of being buffeted by everything that comes through, you are able to quickly take control of the situation. You can de-stress this way. You can watch it happen, and you just begin to detach from the idea that “I am my emotions.” And so I really very strongly recommend to everybody – just try the 60-second thing of watching. You’ll find it’s amazing. Chances are you’ll get hooked and want to do it for more than a minute afterwards. So that’s number one. Number two is to – the key to resilience is coherence, and that’s how we come full circle back to my purpose and meaning. If your world doesn’t feel like it’s manageable and meaningful and comprehensible, it’s extremely difficult to cope. And there’s a ton of very good data on this, that if you feel that your life is unmanageable, things don’t make sense to you, it’s extremely difficult to bounce back. And that was why we started with the purpose and the meaning piece. So coherence, that everything has some sense to it, that you’re not stuck in some dreadful Kafka novel, that you actually are a participant. Because one of the things that is interesting – and I noticed on your website that you’d picked up on this very important data about health, longevity, wellness, that a key to it is to actually be participating, that you not isolate, and that you actually feel empowered and that you can make a difference in your world. Absolutely key – it’s not just about healthcare; it’s empowerment and feeling that you are involved. So this is absolutely a key piece to this. And I don’t know if you saw some very fascinating new data from UCLA about when people are lonely and isolated, the inflammatory mediators surge in the blood, and people that feel better – and in fact, when people start making social connections, the inflammation starts coming down again. Very remarkable, that you can measure it.

MB: And it’s starting to look like inflammation is a real big key to all of our health problems.

RP: Oh, it is, without question. Inflammation is involved in places that most people have absolutely no idea. And I’ll tell you, when I first started looking at this, about 20 years ago when I was writing one of those doctorates, I put in a long section about historical data on inflammation and vascular. And at the time that I was being examined for it, they didn’t know whether they were going to fail me for being too out in left field or give me the gold medal. And it was – now, of course, everybody’s realizing even things like heart failure, arterial sclerosis – they’re all inflammatory. So any kind of social engagement, making friends, it will help you.

MB: So let’s get back to our third step in resilience.

RP: Third is perspective – you must be able to see things from a positive position. And that’s – you see how all these link together. If you have the self-regulation piece, you’ve been watching, you’ve also got this ability to make sense and have purpose. So perspective is absolutely key. Fourth is earned rewards. That’s very interesting, because, you know, for years people used to talk all about self-esteem and all of that. The self-esteem literature is actually a lot weaker than most people realize. And the most important thing about all of that is self-esteem that happens because you’ve succeeded – that’s great. Just telling somebody they’re wonderful, looking the mirror every morning and telling yourself how great you are doesn’t cut it. So it’s having earned rewards. Number five is purposeful physical activity, so actually doing things that are meaningful – I just dug a ditch, it’s great. And the last two that, again, bring us back to where we started are hope – there’s an enormous amount of very good evidence now on the association of hope and recovery from all kinds of illnesses and actually keeping well. And last is faith – and it doesn’t necessarily mean religious faith, if that’s – but having faith in yourself and in something, so to the greater good. And again, that’s that participation thing. So those are my main steps: Self regulation, adherence, perspective, earned rewards, purposeful activity, hope and faith. Together they can change your life in the most fantastic way.

MB: I think one of the most remarkable things that has happened in psychology in the last 20 years is we would look at concepts like resilience or optimism or happiness and everyone would say, “Yeah, we should have that, we want it,” but would be pretty clueless about how to achieve it. And now we have systems that people can use to achieve those.

RP: And I think it’s remarkable, isn’t it, the way in which we had to get other cultures that provided with some of the clues for how to do this. When you think about it, people like the Tibetans – I mean, they were stuck in those high mountain places for a thousand years, they were left alone, and all they did was think about how to control their minds. So probably worth listening to after a thousand years’ experience. And then, of course, the science starting looking – and you mentioned Marty Seligman – and others have done all of this work. And now we realize that there’s a huge amount that you can do for yourself and your family and the people around you very quickly. And it’s amazing how many years. When I was training, and maybe you as well – we didn’t talk about it.

MB: Um-hmm, because there wasn’t any data on it.

RP: No, but now there’s a lot of extremely good stuff. This is not something that’s just cozy or feel-good stuff. It’s absolutely rock solid data. And the other thing – and one of the reasons I became so involved with it, is building resilience, using those very simple steps, is also one of the keys to avoiding burnout. And I once suffered burnout. I missed it completely in myself. I was a meditation teacher and I missed it. So now I’m evangelical about showing people how not to burn out.

MB: How do you see depression fitting into integrated health?

RP: That’s a very big question in this sense. There are multiple contributors to depression. And again, I like to use my little model – physical, psychological, social, subtle, and spiritual. And the reason I do that is because undoubtedly there are some people who have a biochemical – a measurable biochemical disturbance which causes depression. And that may be the predominant feature in that. And those souls oftentimes need pharmacological help. There’s not a whole lot else that works on its own. But pharmacological help is not the only thing. You can also certainly have things in your life which may cause depression because you’re not that resilient or because something really terrible has happened. And there’s also the social component. There’s a very interesting new idea that I’d like to share because it helps people greatly. There’s a fundamental difference in the way that men and women tend to communicate and relate to each other. I’m not taking about something soft – you know, the men are from mars thing; I’m talking about some very interesting empirical data. From early puberty – and this is trans-cultural, not just learned behavior – we know that men tend to be very transactional; women tend to be far more relational. So men – it’s far more about the deal, you know, what’s the answer? Women tend to spend more time on the social aspects, relationships. One of the problems that arises is that during adolescence, girls tend to have much deeper relationships, and when they break, as they do all the time – because there’s so many emotional variance in that – when they break, they get disappointed. And it’s now believed that’s one of the things that may actually set up women to getting depression later in life. And that’s partly the explanation for why depression is more common in women. Useful to know that, because it helps explain lots of very odd data from the 60s and 70s about the causes of depression. And why I use my whole model, I also regularly see people who are depressed because they feel a spiritual hole in their lives. There was a study that recently suggested that 30 million Americans regard themselves as spiritual seekers, people that feel they have a spiritual hole, and that in itself can be a very potent cause of depression. That’s why I’d like to sort of approach it from all of these different angles. And I find that is often a far more satisfactory way of giving people what they need.

MB: I think that makes a lot of sense that it’s different people have different gaps that are causing the problem, and you need to concentrate on what’s causing their problem or what their needs are, rather than one size fits all.

RP: Absolutely correct. And there’s been a great deal of discussion recently because we’re currently in the process of establishing a new diagnostic manual which is due out in 2011, and one of the problems that’s been coming up again and again is the way that people are trying to include normal human variation and make it pathology – which means you have to give it a drug. And you know, it’s okay sometimes to be shy. It doesn’t mean you have social phobia and have to take a drug for it. It’s okay to be depressed because your wife’s died – you know, that’s okay. It really is. And it’s very important to contextualize and just to see exactly, you know, when is it a sickness, when is it a physical thing, when is it psychological, when is it okay – and all of those questions, because we are all different. And the one size fits all does not work, and it ain’t going to help to give everybody in the world Prozac. Somebody tried doing that – there was an entire town where everybody was given Prozac. And believe it or not, some people got very, very, very sick.

MB: Sooner or later we all have friends that develop cancer and maybe we develop it ourselves. What do you say to a person who’s just received a diagnosis of cancer, say colon cancer, and they’re just feeling overwhelmed and don’t know where to start and don’t know whom to turn to?

RP: I’m very happy to reveal that I went through this problem myself several years ago, so I’m a survivor. And I think there’s never one single way to talk to anybody about this, when they’ve had a problem. That’s why I’m always interested to know where is a person’s center of gravity, what’s important to them? Because for one person, talking to a psychologist would be a good thing; for another, a priest; for another, they just really want the kindness and comfort of family members. Because we’re all different. Some people like sympathy; others thing that sympathy is the worst thing in the world and “Go away and don’t bother me with it!” So it’s – we’re all very different in exactly what we like, how we respond, and what will work best for us. So I think the key point is it’s individualized. Know where a person’s center of gravity is. And again, if I had one wish in the world, if I had my magic wand, I would like everybody in America, in childhood, to learn resilience, to learn the art of what’s important for you, how to bounce back. And then it makes it much easier for the people around you to help you as well. So it’s always – I think it has to be individualized, because I know that when I was facing this kind of a problem, my approach was very proactive and I wasn’t about to sit around and feel sorry for myself; I was going to get over this. And five years later, I have. And so how we actually approach that and how we always approach it is, again, from all the different perspectives. And it’s just a slightly different way of thinking and a slightly different way of acting, and it really makes a huge difference.

MB: So your approach is to start with questions about meaning and then also take a look at resilience.

RP: Absolutely, absolutely, because – and I’ll give a very practical example about this and a couple that I’ve dealt with very recently, and somebody else in another part of the world that I used to see, is that whenever anybody has bad news of any sort, anything like this that is happening, is that you really need to find what is important to them. Is it that they’re frightened? Is it that they don’t want to leave their kids? Because when you actually find the area that is important to them as individuals, deep down inside – not the superficial – “Well, I just don’t like being ill” – the real core features, it’s amazing, because then you can very quickly give them advice that fits. So if there’s – in my case, I had work to do. I had a message to bring out and I realized it was time to stop just writing academic papers about it, but actually to take it to the world. And that was – for me, it was very helpful. For somebody else, they would have a different motivator. It would be maybe that they don’t want to leave their kids alone. Whatever it happens to be, individualize it, find where that center of gravity is, find the purpose and meaning, and build that resilience. And if you do those things, you are giving a gift that goes on giving and it’s more valuable than anything else in the world.

MB: That makes perfect sense. What would you say are the most exciting developments in health and integration of health?

RP: Oh, well, there’s so many of them. Mike, you know, this is an amazing statistic – it’s now calculated the sum total of all medical knowledge is doubling every three and a half years. In the area of the brain, it is doubling every two years. I find that just absolutely stunning that if we look at everything that was discovered in the history of the world up until the beginning of 2006, it’s just doubled. And I think that’s just amazing. I think the most interesting things that we have learned recently that are going to impact everybody in a very major way is the brain regenerates throughout life. We know that the richest source of stem cells is actually inside the brain. And the whole stem cell debate that’s been very hard for many of us over the years is probably going to turn out to have been meaningless. The brain is full of the things. And we know that you can continue creating new neurons – not many, but in key areas that are very key throughout life, certainly into your 70s. There are even midwife cells that direct the stem cells. That’s a huge thing. Second is that the brain constantly recruits what it needs. It’s one of the things that is different between us and most other mammalian species. When you’re on a task, what happens – and I always counsel people, “Don’t say this bit of the brain does this and this bit does that.” The brain simply recruits what it requires. That leads us into the other extraordinary thing, the plasticity of the brain. It’s way beyond what most people realize. You’re a psychologist, you know this field very, very, very well. Most people outside our field simply do not know what seismic changes are taking place in psychology and brain right now. And related to all of that is what I love saying, is biology is not destiny. I think one of the most extraordinary things in the field has been the discovery that our genes, certainly the ones in the brain, do not determine our behavior. You know, we were all brought up on things like eye color and sweet peas, and you know, if Mummy and Daddy have blue eyes and little Johnny has brown eyes, Mum has some explaining to do. That simple idea doesn’t work in the brain. There, it turns out, that most of the genes are involved not in determining your behavior, but how you respond to the environment. And this constant interplay is, I think, a very remarkable thing, and it is also informing a lot of this integrated approach, that by doing the right medications, if that’s what’s needed, by doing the psychological material and so on, that all of those things together can have measurable physiological effects in the brain, the spine, in fact probably all over the body. And I think that’s a most incredible discovery. Biology is not destiny. They shape but they do not determine where you’re going.

MB: So if you blink, you just missed more breakthrough research developments, and the developments are becoming more optimistic all the time about our ability to be resilient.

RP: Absolutely. And if we have a real take-home message today – apart from the little thing on how to boost your energy, which is a little gift to everybody – it’s just realize that in the midst of all the bad news that we keep hearing about, there is just this extraordinary maelstrom of new, very positive information. And we’re even reconceptualizing things like how medicines work. I know we’re pretty much out of time today, but it’s a very interesting field. So you mentioned depression a few minutes ago; I’m going to leave you with a parting shot, that it now appears that antidepressants don’t anti-anything. What they do is they help to build resilience. Remarkable new discovery, but that’s something for another day perhaps. But it’s very important for people to know that there’s so much very interesting, new information, rock solid data, that have already had a major impact and is changing all of our lives. It’s wonderful.

MB: I love ending on a positive note, and I love the way you pull so many things together and make it simple and a few steps and common sense, that is not very common. This is America’s Anti-Aging Psychologist Dr. Michael Brickey with Ageless Lifestyle Radio, one of those places for you to go to get the kind of information that Dr. Petty’s talking about. Today’s expert guest is integrative health physician, Dr. Richard G. Petty. His website is And his book that puts it all together is Healing, Meaning, and Purpose. Information on Anti-Aging Psychology and my free Defy Aging Newsletter is at,  or you can just go to and it’ll take you to

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