A Healthier Husband

goodhousekeeping.com

WebMD Feature from "Good Housekeeping" Magazine

By Sari Harrar

How to get him to shape up - without nagging or driving yourself crazy

Last winter, Eric Lagergren caught a stubborn cold. "I was exhausted for a week and a half and just not getting any better," he says. He also was drinking water constantly and getting up eight or nine times a night to go to the bathroom. "Then I got clumsy," says Lagergren, 33, who's an editor at the University of Michigan English Language Institute. "One weekend, I broke two or three things around the house — dishes and a vase."

On his own, Lagergren would have waited until things got even worse before seeing a doctor. But his wife, Kathryn Taylor, stepped in. Taylor wasn't worried about her tableware; she was worried about her husband. An endocrinologist delivered the diagnosis: type 1 diabetes. Lagergren's doctors suspect that his respiratory virus caused his immune system to go into overdrive, attacking the insulin-producing cells in his pancreas. His body's ability to make insulin, the hormone that tells cells to absorb glucose (blood sugar), was shutting down. "I give Kathryn all the credit for my quick diagnosis," says Lagergren, who now uses an insulin pump to control his illness. "Catching diabetes early reduced my risk for long-term complications like heart disease. Thanks to my wife, I'm healthier now than I was before I had diabetes!"

Like Lagergren, many guys need a big — or little — nudge from a caring spouse at crucial turning points in their health. In a recent American Academy of Family Physicians survey of some 1,100 men, 92 percent admitted they wait at least a few days before getting care when they feel sick or have pain — and almost 30 percent will hold out "as long as possible." They skip routine care, too. More than half hadn't had a complete physical in the past year, even though 42 percent had a chronic health condition, including high blood pressure, heart disease, arthritis, diabetes, or cancer. Many are also lax about recommended screenings, such as cholesterol tests, prostate checks, and colon exams. "One of the biggest obstacles to improving the health of men is men themselves," says AAFP board chair Rick Kellerman, M.D. "They'll wait to see a doctor until their symptoms are really severe. And if they're feeling fine, they won't go at all."

But there's hope: You have the power to motivate your guy to do the right thing for himself. "Nearly 80 percent of men in our survey reported that their spouse or significant other influences their decision to go to the doctor," Dr. Kellerman says.

Best of all, you can make a difference without badgering him or making yourself nuts. In fact, your actions may do your talking for you. When health economists Tracy A. Falba, Ph.D., from Duke University, and Jody L. Sindelar, Ph.D., from Yale, analyzed the lifestyle habits of some 6,000 couples, they found that a woman's own healthy changes often prompted her husband to follow suit. Men whose wives quit smoking were eight times more likely to kick the habit, too, compared to those whose spouses continued to light up. If women started having yearly flu shots, their husbands were six times more likely to get vaccinated themselves.

There are other motivators as well. Here's what top men's health experts and regular guys say works.

Health Hurdle #1: Checkups and Screening Tests

Smart nudge: Get yours done at the same time.

Men see their doctors for preventive care about half as often as women do, reports the national Men's Health Network. While they may not need as many checkups as we seem to (all those gyno visits!), they do need more than they're getting. This gap is one reason the average life expectancy for men is only 75.2 years, compared to 80.4 years for us. "Women are more accustomed to going to doctors regularly for gynecological exams and pregnancy visits. Also, seeing a doctor isn't viewed as a weakness," says Mark A. Moyad, M.D., M.P.H., a preventive-medicine expert at the University of Michigan Medical Center. "The challenge is helping guys get the regular care that prevents major health problems — or catches them early."

Your best strategy? Make it a joint project: Go for your routine checkups together. "Women and men have many identical health issues," Dr. Moyad notes. "Both sexes need to protect their hearts; lower their risks for diabetes, stroke, and cancer; and be alert for signs of osteoporosis and depression." Dr. Moyad and his wife go for their annual cholesterol and other screening tests together. "It even fosters a little healthy competition," he says. "We each try to have the best numbers."

Say it like this: I'll get my blood pressure and cholesterol checked with you. "Most men will agree to go," says Dr. Moyad. "Now it's a partnership."

Health Hurdle #2: Prompt Attention to Scary Symptoms

Smart nudge: Express concern; don't blame or shame.

If your husband isn't taking care of a health problem, you're probably feeling very frustrated, says psychologist William Pollack, Ph.D., director of the Harvard-affiliated Center for Men and Young Men at McLean Hospital. "But accusing him of dragging his feet will only backfire. It can make a guy feel like a bad boy, and he may become even more resistant."

Nor should you schedule a doctor's appointment for him unless he asks you to. "In my experience, most guys won't go if something's forced on them," Pollack says. "Instead, gather information about the best doctor in your area for the condition, then ask your husband to make the appointment." Offer to go with him, Pollack suggests. "He'll feel supported."

That's what helped get Ira Morrow, 54, a retired forklift operator from Vermilion, OH, to the doctor when he began having breathing difficulties. He was then referred to a specialist, who diagnosed silicosis, a lung disorder triggered by one of Morrow's earliest jobs as a sandblaster. Ultimately, he had to decide whether to have a lung transplant. "My wife, Linda, listened, but she never nagged, never insisted," says Morrow, who had the transplant and reports, "It turned my life around."

What medical issues might prompt your gentle urging? Inattention to already diagnosed health problems like high cholesterol, high blood pressure, or diabetes, as well as difficulty sleeping or pain that doesn't get better in a few days. But you also shouldn't overlook these less obvious signs of trouble.

• A growing belly. This can be a warning sign for metabolic syndrome, a condition that raises his risk for diabetes, heart disease, stroke, and possibly even some cancers. About 25 percent of men have the syndrome.
• Discouragement or irritability. These may signal depression, but the disease can also masquerade as anger, fatigue, or sleep problems. An estimated six million American men have depression.
• Less interest in sex and/or erectile problems. He may have low testosterone, which can also manifest itself as fatigue, depression, or trouble concentrating. A low level of the male hormone is a problem for an estimated four to five million men.

Say it like this: I'm concerned about what I've been noticing, and I'll feel better if you see a doctor. Then follow up with facts about what you see, Pollack suggests. "Avoid criticism." If your spouse continues to ignore the problem or if it's serious, it's time for something stronger: I'm worried about you. I love you, I want to have you around a long time. It's important to me that you see the doctor. And if you think he's really in danger, says Pollack, try: If you keep going on like this, I'm afraid I'm going to lose you.

Health Hurdle #3: Exercise and Diet

Smart nudge: Adopt a healthy lifestyle with him — or without him.

Blame it on "hungry man" portions and an NFL season that never seems to end: Sixty-seven percent of men are overweight, reports the American Obesity Association.

How to get your husband to shape up? Tailor your tactics to his personality, Dr. Moyad suggests. One guy — like a patient of his who lost 50 pounds — might be inspired by a motivational speaker. Another could do well with a group program. Whatever he tries, keep supporting him, says Siegfried J. Kra, M.D., a cardiologist at the Yale School of Medicine and author of How to Keep Your Husband Alive. "By himself, he may do fine for a while. Then, unless he gets reinforcement, he may give up."

Tampa disc jockey "Marvelous" Marvin Boone, 52, credits his wife for helping him stay slim. Shortly after losing 120 pounds, Boone, who hosts a greatest-hits radio program, married Pamela in a Las Vegas ceremony that featured an Elvis impersonator escorting the bride down the aisle. Since then, Boone says his wife has "loved him tender" by revamping their menu. "Although Pamela was always very slender, she did eat a lot of fast food," says Boone. "Now we're into fruits and vegetables, whole grains, and fish. We're doing it together."

And if your guy can't give up double cheeseburgers or get into an exercise routine, adopt healthy habits for yourself, sans lectures. (Remember what the Duke and Yale researchers found: Simply changing your behavior can have a profound influence on what your spouse does.) "As you get results," says Pollack, "he may be inspired to join in."

Say it like this: . Hear that silence? Lectures won't work here. Nonverbal action will, say our experts. And if your husband does start to change, don't become a lifestyle cop. "Men worry that they'll slip up, and everyone will come down on them," says Pollack. "They need a sense of trust."

CHECKING UP: HEALTH TESTS MEN NEED

If your guy's been avoiding the doctor, talk with him about scheduling an exam so that he's up-to-date on these lifesaving checks:

Blood pressure. By 45, more than one in three men have high blood pressure. Hypertension may take five years off a man's life — good reason to have an annual check. A healthy reading is 120/80 or lower.

Body mass index and waist size. BMI measures whether a person's weight is healthy for his height. A BMI of 25 and over raises risk for diabetes, cardiovascular disease, cancer, and arthritis. A waist circumference over 40 inches increases chances of metabolic syndrome.

Cholesterol. Look beyond total cholesterol (healthy is under 200) and bad LDL cholesterol (generally, 100 to 130 is OK). Low levels of good HDL cholesterol (under 40) and high levels of triglycerides (over 150) put men at higher risk of heart attacks and stroke. Guys should have all of these blood fats checked every three years in their 30s, every two years in their 40s, and annually starting at 50.

Blood sugar. One in 10 men have type 2 diabetes, but many don't know it — and are at risk for complications. A healthy guy needs fasting–blood sugar checks starting at 45, earlier (ask his doctor when) if he has a family history of diabetes, high blood pressure, low HDLs, or is overweight.

Colon cancer screenings. This is the third most common cancer and the third deadliest as well. Start screening (colonoscopy is considered the gold standard) at 50, sooner if there's a family history.

Prostate cancer tests. Every man should have an annual digital rectal exam starting at 50; make that 45 for African-American men and those who have a family history of the disease. Many physicians advise PSA screens, too, beginning at 50 (45 for African-American men).

Skin exams. More men than women die from malignant melanoma. A monthly self-check and an annual exam by a doctor can help find suspicious growths early. One danger spot for men: the upper back.

Mary J. Blige Resolves to Be Healthy

http://www.webmd.com/

The R&B and hip-hop soul sensation reveals the inspiring fitness, food, and anger-management lessons that are driving her on a powerful journey of personal and professional transformation.

By Kathleen Doheny
WebMD the Magazine - Feature

Reviewed by Michael W. Smith, MD

Mary J. Blige, the six-time Grammy Award-winning superstar, glides down the massive stone staircase of her Hollywood Hills home to the lower-level gym, where her trainer awaits. Looking toned in black track pants, white tank top, and black sweatshirt, Blige has wrapped a bandana around her head and is makeup-free -- a departure for this diva known for her glamour-girl styling and stilettos.

The Queen of Hip-Hop Soul is ready to sweat. Truth be told, she’s more than ready -- she’s driven. She is preparing to hit the road to promote her eighth album, Growing Pains, and the schedule ahead is grueling: three concert stops in South Africa, five in Japan, one in her adopted hometown of Los Angeles, plus an appearance on The Ellen DeGeneres Show.

Blige invited WebMD to join her for a vigorous one-hour body tune-up in the home gym of her modern manse perched high on Mulholland Drive. The house is airy and uncluttered and offers breathtaking views at every turn. But on this day, she is focused on only her music and her workout.

During and after the session, Blige, 37, confides the backstory of her new CD -- how decades of pain and disappointment have given way to a stepped-up self-image, improved lifestyle habits, better relationships, and more joy in every part of her life. She’s still struggling in some areas, she admits, and she elaborates with an endearing openness and honesty.

Mary J. Makes Fitness a Priority

One of the secret weapons in her ongoing "overhaul" campaign is Gregg Miele, an A-list New York City personal trainer flown in to whip Blige into concert shape. He's upbeat and optimistic, offering a steady dose of goals and encouragement during the workout. He’s given Blige, along with all his other high-profile clients, his trademark black wristband with “self-discipline” printed in simple white type. Looking at it can provide motivation for healthy living, he says. “It’s a reminder for the other 23 hours I’m not with them to make healthy, conscious decisions throughout their day -- a constant reminder that food does not just jump into your mouth!”

Miele makes such axioms a signature of his program. They are designed to goad his clients into the best shape of their lives, including one on his web site declaring: “The difference between who you are and who you want to be is what you do.”

Today, a one-hour workout is on the schedule. Miele kicks things off by asking Blige to take a brief walk on the treadmill. “A gentle warm-up peps you up mentally and physically,” he reminds her. His workout philosophy is goal-oriented and practical. The home gym is tightly edited: the treadmill, free weights and benches, resistance bands, mats for floor exercises, and a stair-stepper machine.

About 10 treadmill minutes later, Miele leads Blige through flexibility exercises on the floor and some resistance exercises for the arms. So far, everyone’s all smiles. But then the trainer hands her the jump rope, and Blige’s face hardens. She frowns. “I hate this rope,” she says.

Miele doesn’t seem surprised; clearly, it’s a protest he has heard before. And the look on his face makes it clear: The jump rope is not optional. So, Blige follows his instructions to skip for 45 seconds -- a time that seems brief only if you are not the one skipping.

Blige’s renewed dedication to her fitness regime -- along with a resolve to clean up her diet and tone down the rage that she says used to be her “default” mode -- reflects her new attitude and new lifestyle plan. She’s kicked the bad habits, excess alcohol and drugs among them, and is embracing healthier ones, despite a grade-A sweet tooth.

Mary J. Blige is learning to love living with a whole lot less drama.

The 411 on the New Mary J.

Her resolve to be healthy -- physically, mentally, spiritually -- didn’t occur overnight, acknowledges Blige after her workout. She is relaxing on a wheat-colored chaise in a grassy corner of her backyard.

Nor did the problems that led to the need for the overhaul pop up suddenly. Blige grew up in the Bronx, overcoming a childhood filled with poverty and witnessing violence to become a top-billed singer, songwriter, producer, and actress. Her albums have sold more than 35 million copies worldwide since her career debut in 1992 with her smash hit, “What’s the 411?”

As Blige’s rags-to-riches success story unfolded, so did the news that she could be difficult and temperamental, and suddenly fly into a rage. She admits to past struggles, including drinking too much, abusing cocaine, and being depressed. The out-of-control anger, Blige says, was programmed into her as a child -- the way nearly everyone around her responded to life’s disappointments.

“That’s all I ever saw, people reacting to things that way,” she tells WebMD. “When someone disappoints you -- bang! You automatically default back to that stuff.”

Over the years, the shame that followed her temper tantrums convinced her that she needed to change. Finally she said to herself: “You can’t keep doing this all the time -- screaming, throwing stuff, breaking things, kicking windows.”

She credits her husband, music industry exec Kendu Isaacs, 40, whom she married three years ago, with much of her resolve to improve herself. He has encouraged her to turn off the “old stuff” and begin anew. “He’s committed to me, his job, his children [her three stepchildren], himself,” she says. “He tries very hard. In some areas he is stronger than in others, and that’s where I come in to help. We balance each other well.”

Lessons learned from the past few years of self-improvement are packed into Growing Pains. Listeners hear the story of Mary, her work in progress, and perhaps, she hopes, their own unfolding tales.

One other new rule, Blige reveals: She surrounds herself only with positive people -- besides her husband, she says, people like her trainer. And Miele’s steady nature and constant support are evident. If she lags even a tiny bit during the hour-long sweat session, he’s right there: “Four more,” he says in an encouraging tone. “One more.”

Mary J. Steps Up Her Workouts

Exercise has been part of Blige’s life for years, but she’s pumped up her routine recently, motivated by appearance and health. “A couple months ago, I was walking up those stairs right there,” Blige says, pointing to the long, spiral staircase that connects her home’s upper and lower floors, “and I was out of breath.” Blige, who turns 38 on Jan. 11, knew she was way too young to be that out of shape. “Then I saw all this cellulite forming on my leg, and I started to cry. Then I thought, ‘OK, this [exercise] is for health reasons. OK, the cellulite might be a touch of vanity, but the fact that I can’t breathe when I am walking up stairs -- it’s like, I have to do this for myself.’”

Part of doing it for herself is sticking to the workouts, no matter her tour or rehearsal schedule. At home, Blige tries to do the one-hour routine five days a week. On the road, she admits, it’s not always easy, but she does what she can. That’s why Miele has designed a program that works for Blige’s jet-set life. He tells her to think of herself as a professional athlete. “For her, there is off-season, preseason, and in-season,” he says, with in-season being her concert tour. During in-season, he tells her, she can’t expect to work out as much or as intensely as at other times. But whatever the length of the workout, Miele designs routines that include cardiovascular conditioning, strength training, and flexibility and that can be done in any gym -- or even a hotel room.

His strategy works just as well for the rest of us time-strapped noncelebrities. For instance? If you have 30 minutes instead of an hour at the gym, get more mileage out of the workout by stretching rather than resting between exercises, Miele says.

Mary J. Cleans Up the Menu

Blige soldiers on, doing crunches on a floor mat. Miele holds the elastic resistance bands as she does arm work, and her limbs look strong and defined. But her newly buff body is not all due to hard time in the gym, she says. Blige has overhauled what she eats these days.

"Three months ago, I was 146 pounds," says Blige, who is 5 feet 5 inches tall. Since then, she’s dropped 11 pounds, weighing in at 135. She’s a size 8 now. “I want to get to 125 pounds with muscles,” she says.

The self-confessed sweets lover focuses on cutting down on refined carbs (including her favorite cookies) and limiting calories to about 1,500 per day.

Blige’s calorie goal is very realistic, says Bonnie Taub-Dix, RD, a New York dietitian. “If you eat below 1,200, it’s hard to meet your needs nutritionally,” she says.

Likewise, Blige’s goal of 125 pounds is excellent, as is her focus on “quality” carbs, Taub-Dix says. And in moderation, “cheat” foods are OK, Taub-Dix adds. Blige is far from perfect, of course. She can’t name just one “cheat food,” for example. She has several, and they’re all sugary: cheesecake, oatmeal cookies, and chocolate-chip cookies.

To help Mary J. cope with her sugar cravings, her trainer has penned in a signature Miele-ism on the bulletin board in front of her treadmill: “What you eat in private shows up in public.”

Mary J. Reins in Her Rage

Consistent workouts, a newfound respect for what she puts into her body: What accounts for this new attitude? “Sometimes anger is positive,” she says. “It pushes you."

Blige reports that a few years ago she learned to redirect her rage with help from a Christian television show and the Bible. “I watched this pastor by the name of Joyce Meyer,” she says. “I’d TiVo her and watch her every morning. She was talking about anger one day. I started looking up these Scriptures [she referred to], and in one it said anger and vexation lodges -- meaning hangs out -- in the bosom of fools. And every Scripture I read ended with fool. And I thought, ‘Oh, no, I don’t want to be a fool.’”

Blige had just taken her first step toward reining in her rage problem.

About one in 100 adults is angry enough to benefit from anger management, estimates George Anderson, whose firm Anderson & Anderson in Los Angeles provides anger-management programs for businesses and individuals.

For many people, anger is the “default” mode, as Blige calls it, learned growing up, says Robert Allan, PhD, a clinical assistant professor of psychology in psychiatry at New York-Presbyterian Hospital/Weill Cornell Medical Center.

“There are vast numbers of people who have grown up learning that the way to deal with a problem is to get angry whenever you don’t get your way,” he says. People who yell or scream nearly always believe those who hear them will see the light and fix the problem, he says. But it doesn’t work. “The other person reacts to the anger and doesn’t hear the message.”

Blige continues to take heart from Scripture passages that advise trying to be slow to anger. She says she reads them every day.

On the new album, she opens up about her progress. In a song, “Work That,” the first verse says:

You can look in my palm and see the

storm cometh

Read the book of my life and see I’ve

overcome it.

While religion and a supportive spouse have provided the way for Blige, Allan cautions that many people need to go further and seek out professional help or a 12-step program for anger management. Whatever the path, “all require a lifelong commitment and a day at a time.”

Mary J. Skips Ahead

Miele guides Blige toward the workout’s conclusion: push-ups on a balance ball, more resistance training exercises for her upper arms, ab work to trim her torso, and 5-pound hand weights to tone her biceps. Blige reaches for the padded cylindrical weight bar Miele hands her, sits on the mat once again, and does ab crunches as she raises the bar, a movement to help strengthen abs and arms at once. There’s some sweat on her brow but she’s not breathing hard. Her pumped-up workouts are paying off.

Almost done. It’s clear Mary J. is ready to rest. But it’s not over yet. “One more time, Mary J.,” says Miele.

Wordlessly, she accepts the hated jump-rope handles. On this grand-finale skip, she stumbles but repositions the rope, finishing her 45 seconds. She puts down the rope, looking tired; but more than that, she looks satisfied.

Mary J. is in peak form -- physically, spiritually, emotionally. She’s taking it one jump-rope skip, one Scripture reading, one day at a time.

Growing Pains celebrates where she’s been and where she’s going. It reflects “everything that I am becoming and have to become,” Blige says.

“No anger, no self-hatred, no self-resentment. All that takes work,” she says. “It’s going to take a long time. And all these songs reflect that.”

As Blige announces for all the world, and herself, to hear on her new album: “It’s OK, show yourself some love.”

She certainly is.

Anger Management 101

Like Blige, Robert Allan, PhD, a clinical assistant professor of psychology in psychiatry at the New York-Presbyterian Hospital/Weill Cornell Medical Center, grew up in an environment where anger was the “default” mode. In his book Getting Control of Your Anger, Allan offers a three-step process for taming rage:

Identify the “hook” that feeds your anger. Knowing that a trigger sets you off is the first step toward changing your reaction and not allowing yourself to express the anger directly by screaming or getting physical.

Step back or disengage from the situation, and figure out the need behind the hook . Disengage by deep breathing, for instance. Or develop an “observing” self, a mini-version of yourself whom you visualize sitting on your shoulder viewing the big picture and warning you not to take the anger trigger, Allan says. When we get angry, the feeling is usually fueled by the need for respect or the need not to have our territory breached, or both, he adds.

Fill the need without expressing anger directly. Instead, ask for what you need.