 You're listening to Barbell Logic brought to you by Barbell Logic Online Coaching where each week we take a systematic walk through strength training and the refining power of voluntary hardship. Barbell Logic listeners, this is Matt and gosh, we have a real treat for the next seven episodes. Dr. Jonathan Sullivan and his cohort, Noah Hayden, have recorded an entire series on the Barbell prescription and the value of barbells in the world of strength and health. And so the story behind this is that Dr. Sullivan along with Andy Baker wrote a book called the Barbell prescription. They talk about that a little bit in this series, but they don't really promote it in its phenomenal book. It's a book about the value of strength training and not only that, but the way that we should be looking at strength training and barbells as medicine for all of us regardless of age or demographic. And so you can go to amazon.com and buy the Barbell prescription. We don't make a dollar off of that. It's a fantastic book. It's the best book ever written on this very source. And so in November of 2019, I had the privilege of traveling up to Gray Steel Barbell where Dr. Sullivan, who we call Sully and Noah Hayden, along with a great group of other practitioners and coaches were leading a Barbell prescription seminar. And I was blown away, blown away by the content, by the professionalism, by the hospitality, by the service of his team there of his staff. And I got to meet a lot of the people that you're going to get to meet in this series. And later as COVID hit in 2020, I started talking to Sully and I said, man, we've got to get this information out there. And he wasn't able to put on those seminars in person in 2020 because of COVID. And so he asked nothing in return. And we talked through, hey, would you be interested in making a series for the Barbell Logic podcast? And he generously and graciously offered to do so. Noah did a tremendous job in really hosting this series and sort of narrating and facilitating the discussion. And so for those of you who are interested in why we do this beyond the aesthetics, beyond taking pictures of yourself for Instagram and for strength and health and quality of life, you're really in for a treat. This is one of the most outstanding series I've ever heard in my life. I got to preview it over the last couple of weeks and I am super excited for what they are about to bring. And so without further ado, here is Dr. Jonathan Sullivan and Noah Hayden along with some of their closest friends and clients and other practitioners. And they are presenting to you the Strength and Rehab series by the author of the Barbell Prescription. Greetings and welcome to the Barbell Logic podcast. I'm Dr. Jonathan Sullivan of Grey Steel Strength and Conditioning in Farmington Hills, Michigan. I am a Barbell Logic online coach and I also have my own practice here where we focus on people in their 40s, 50s, 60s, 70s and beyond. Barbell Logic has asked us to do a series of podcasts, the Barbell Prescription podcasts where we're going to talk about training for people in their 60s, 70s, 80s and so on. I'm joined today by my associate coach and friend Noah Hayden. He works with me here at Grey Steel Strength and Conditioning training people in their 60s and 70s and beyond. And I'm also joined by my friend and client, nurse Ann Buzard, who's going to talk to us about her journey not only as a healthcare professional but as a master's athlete. And it's a great pleasure having both of you here today. Noah is actually helping us produce this podcast. He turns out to be something of a renaissance man and an audio file and he's got us all set up here in the clinic. And he's going to take it away and host this episode of the Barbell Prescription podcast for Barbell Logic. Noah, welcome. Tell us a little bit about yourself. Hi. Like you said, Sully, I'm an online coach with Barbell Logic. I coach people here at Grey Steel. I coach people at my home gym, actually. How are you, Ann? I'm fine. Thank you. I haven't seen you in a really long time. It's good to see you. For this episode, one of the key topics in your book is how Barbell training can best treat the sick-aging phenotype. So that's what we'd like to talk about today. It's a good topic. Yep. So before we get into that, Sully, you're a physician. I am. You've done that for a while. Are you practicing right now? No, I was an emergency physician for about 25 years. And it's been about, what has it been, Ann? Two or three years now. I retired from emergency medicine practice. I worked my last shift, I want to say two and a half, three years ago, and devoted my full time to teaching and our YouTube channel and writing articles and coaching here at Grey Steel. And couldn't be happier. It was one of the best decisions I ever made. But I was a physician for a very, very long time and that sort of formed my ideas about how we age and how we age well and unwell and what to do about it. And it propelled me into kind of doing a new kind of medicine on the other end of the health spectrum and contributed to this development of this idea of the sick-aging phenotype. I wanted to go back a little bit. When did you first decide you're going to pursue a career in medicine? When I was about eight years old. Eight years old. Yeah. I was a biology nerd from the time I was a little boy. I was always interested in biology and living things. I went through a dinosaur phase, which I get just kind of like biology and also de rigueur for little boys. Every little boy has to go through a dinosaur phase. And then I discovered books about microscopy and microbiology. And that stuff was fascinating to me. And I loved to watch the doctor shows when I was a kid. I watched Marcus Welby and what was the one with the neurosurgeon, Ben Casey. I watched him all the time. And it was a kind of thing that resonated with me. And so from the time I was a little kid, I always wanted to be a doctor. I know that you were an emergency physician. Did you always work in emergency medicine? Or did you have any other specialties or areas of focus before that? You have a lot of experience in your training. When you're a third year medical student, you start to do a series of what are called clerkships where you rotate through all the different specialties. So you do an internal medicine clerkship and a surgery clerkship, family practice, pediatrics, all of that. And I actually went to medical school with the idea that I was going to be either a general surgeon or some sort of subspecialty surgeon, like a neurosurgeon. I had given serious thought to neurosurgery. And I was in my surgery clerkship for about 36 hours before I realized that I was not going to be a surgeon. That was not the kind of life that I wanted to live married to the hospital. Why not? I mean, what does that entail? Surgery itself, the actual surgical care of patients and the operating room and all of that is fascinating. But that whole lifestyle and the training, the training has come a long way. But in those days, the training of surgeons was very abusive, in my opinion. And surgical interns and house staff were abused with long hours. And the surgical mentality is very sort of militaristic. Like I never encountered anything in the Marine Corps that was as abusive with the public humiliation. And oh, yeah, it was horrible. And then once you graduate and you become an attending surgeon in your own right, you are literally married to the hospital. And so when I looked at surgery, I saw long hours, I knew a medical career was going to be long hours in a particular surgical career. And I might have swallowed that. But then I saw all these guys with bad marriages, bad backs, and bad dispositions. And I just did not want to pursue that way of life. And at about the same time, I did a rotation in emergency medicine. And that was fascinating to me. It was the best of all possible worlds. You were a generalist, so you had to be able to handle anything that came through the door. And I like that. And you had to be able to perform a certain number of surgical and invasive procedures, which at the time I thought was pretty cool. I actually don't think that's so cool anymore. But you had to be able to do chest tubes and thoracotomies and DPLs. And you had to be able to deliver a baby and you had to be able to manage the airway and so on and so forth. So that was pretty cool. And this was the real kicker. Emergency medicines have a certain amount of control over their time because it's shift work. So when you're in the hospital, you're there and there's nothing else when you're in the emergency department. There's no breaks. There's no time for grab-ass. There's nothing like that. When you're working, you are just, it's solid work from the beginning to the end of the shift. But when the shift is over and you go home, you're home. You don't get paged. You don't get called back to the hospital for a sick patient. When you're not in the emergency department, you're not a doctor. You get to do other things with your time. And that was very appealing to me. So I don't think anyone likes being on call in any career. It was the most horrible thing ever. So Ann, you were a registered nurse. You're retired now. Right. Where did you get your start in nursing? At Henry Ford Hospital. It's now it's called the main hospital, but then it was the hospital. Okay. You know, we didn't have all these sub areas spread up, but I started there, worked there probably till 67, 1967, not 18, 67. And then I had my children and I had agreed with my husband before, and he thought it was very important that I be home with them while they were preschoolers. And I agreed to that. So I stayed out of nursing until my youngest was a kindergartner. And then I went back to work full time for a couple of years. And then I went part-time until they were in high school probably. Okay. And I worked from then until the mid, probably 2010, 2015. Did you go back to Henry Ford? No, from there. It was really funny. I sent a letter to St. Mary's and said I was interested in working there and sent them. I had been in hemodialysis. Just it was a new field when I had quit and I had started the unit at Ford hospital, opened it up and everything. And then I was pregnant. So I had to quit. And then when I went back to work, that was on my resume, although I did not want to go back into hemodialysis as I'm resume. And within 24 hours St. Mary's called me and said, we'd like to interview you for hemodialysis. I thought, oh, great. Why didn't you want to go back to hemodialysis? I don't know. I thought you were going to say because it's kind of horrible. Well, it is kind of horrible. But I ended up working most of my career after that for two years, except for two years when I went to U of M and work, because at that time, it worked better with my personal life to be there. But I like dialysis for the aspect that is what you learn in nursing school, that you know the whole person. You know the family, you know all the dynamics that are going on. So and I had same patients for years. They keep coming back several times a week. Right. And then I got into peritoneal dialysis for the home training. And those people, if they weren't in the clinic, I was usually on the phone with them, making sure they were doing what they should be able to do. And I ended up enjoying it. I quit finally because the company that took over the clinic became very, I suppose I have to, but dollar oriented. Sure. And it was all about that, not about the patient care and the time that was allocated to the patient. So I don't need this. I've never heard that story before. Right. So I quit. What kinds of people would go to the dialysis unit? Like what kinds of patients did you have in general? You mean medically? Yeah. What were some of the conditions that these people would have or the reasons they were there? A few were hereditary situations, you know, genetic disease, polycystics or there was Alport's disease and a couple of the patients that we had. But most of them probably were hypertension or diabetes. We had some that were HIV, but almost all of them, you know, were hypertension. The hypertension and diabetes I imagine were overrepresented. Very much so. Sully, did you ever see the same patients twice? I would imagine that in the ER, you kind of only treat everyone once. Yeah. I still stay in touch with my continuing medical education. I get a number of programs, mostly audio. It's a hard time to go to grand rounds right now because of COVID. But recently, apparently the term super user has come into use in emergency medicine literature that you have this concept of super users. So the short answer to your question is yes, there were certain patients who came to the ER all the time. I mean, all the time. In our time, we just said, look, they're abusing the emergency department. Sure. We try to have a more elevated sort of way of talking about that. Now, the reason that they're quote, abusing the emergency department and being super users is because their internal and external resources for care are just extremely limited by their own nature and by the nature of our society and healthcare in the United States, which is in a fairly parlous state, I think. So yeah, you would see a lot of the same people over and over again. Over time, the phenomenon I observed was that as primary care in the United States became increasingly fragmented and increasingly unavailable to a large segment of the population, people began more and more to use the emergency department for primary care, which is not something that either the department or the providers in the department are really prepared to do. So the emergency department became this literally a poor man's primary care clinic where we delivered poor primary care because that's not what we were set up to do. But yes, we did see populations of, for example, patients within stage renal disease who didn't want to go to the dialysis. So they wouldn't go to dialysis and they wouldn't go to dialysis and they wouldn't go to dialysis and now they needed emergency dialysis. Now they were hypercalemic or they were in volume overload and pulmonary edema and they came in and then we had to set up some sort of emergency dialysis situation for them to shake our finger at them and yell at them and then the process repeats. And then they wouldn't go to dialysis. And then they wouldn't go to dialysis or sicklers who use the emergency department very, very frequently. And there were a few sicklers that I remember they were well known to the emergency department when I first started as an intern and I worked there long enough that 15, 20, 25 years later it would be like, oh, she died or he died because they tend to die young. Lots of HIV patients that we became familiar with and of course there were street people, alcoholics and addicts and stuff who came in frequently all the time. So there was some very, very poor continuity of care. But you did get attached to some patients. There were some patients that you saw often enough to be attached in a strange kind of way. Both of you have a lot of experience treating sick old people. We do. What were the most common problems that patients suffered from? In people over 50, I began to notice and not just me. I mean, it was generally recognized that unhealthy aging was this constellation of processes and syndromes that always seemed to go together when I was an intern or a resident, one of the premier educators in our field, Diane Birnbomber, came and spoke to us at Grand Rounds and she said, di-attention allesity, diabetes, hypertension, high cholesterol and obesity. It's like they always go together, di-attention allesity, di-attention allesity. And that was what I was seeing on the floors and in the emergency department and people started talking about syndrome X, this syndrome X thing, which was obesity, particularly visceral obesity, hypertension, hyperlipidemia, and insulin resistance and diabetes. And these things always went together. So, the resident would come to present a case to me and say, yeah, there's this lady here, she's got hypertension and I'd say, and diabetes, and hypercholesterolemia. And they'd say, yeah, that's right because they just went together. And as time went on, it became pretty clear that this was a syndrome. We call it the metabolic syndrome now and the principal driver of the syndrome is insulin resistance. And that is sort of the core of what I came eventually to call the sick aging phenotype. And I'm sure that Ann observed the exact same thing. I mean, when you saw patients in dialysis with diabetes, how many of those patients with diabetes and renal failure did not have high blood pressure too? Yeah, they all had. I can't remember any of my patients without a hypertension, really. And core diabetes with, if they were on peritoneal dialysis, we used hypertonic dextrose solutions. So, I mean, that just compounded the problem because they'd absorbed the sugar and their insulin requirements would go up and is a vicious cycle. Right. So, that was the next thing that I wanted to ask is how exactly did you treat these people? Like what could you offer them in the hospital to treat these problems? Band-aids. So, a typical presentation would be somebody who came in and their blood pressure was out of control and they were having sort of a non-specific chest pain and you would take a look at them and say, okay, your blood pressure is high, your blood sugar is out of control, your electrolytes are messed up, you're not compliant with your medicine. And so, what we would do is we would address all of those numbers. So, we would look at our test results, sort of a physiological picture of the patient and say, well, your sugar is up, let's give you some insulin and fix that, your blood pressure is up, let's give you some blood pressure medicine and fix that. You're in pain, so here's some pain medicine, we'll fix that. And maybe you're a little bit volume overloaded, so we'll give you a diuretic and we'll fix that. What we never did in the emergency department, and this is an indictment of my profession and my specialty, what we never did in the emergency department in any meaningful way was go to the root cause of this constellation of problems. Regress the syndrome in some way. Yeah, and get to the underlying pathophysiology. So, we have drugs that allow us to manipulate all kinds of physiological variables in any way that we want, but what we're not very good at is getting to the root cause of this sick aging phenotype. So, when did things change? When did you figure out that there was a better way or even a way of addressing these issues that could actually improve the underlying condition? It's a long story and I've recounted it in other places, but to make a long story short, I was also involved in emergency medicine research. I did basic science research in brain injury and repair, the cerebral resuscitation laboratory of the department of emergency medicine at Wayne State University. And I did research on and off for 15 or 20 years on this issue of brain damage and repair after a stroke, cardiac arrest and brain trauma. And a lot of our research was focused on growth factors and my research in particular, a lot of it was focused on insulin. And so, I was completely obsessed with insulin and insulin signaling systems, how insulin signaled to different physiological processes in the cell and so forth. And in the course of my readings and research about insulin, I began to encounter more and more of this data about insulin resistance and the metabolic syndrome. And I also began to, every now and then a paper would pop up what I now call a brobar blood study would pop up in my research where somebody would get a bunch of bros and have them squat and then would look at the level of growth factors. Insulin is a growth factor. They would look at their insulin or their insulin-like growth factor or their growth hormone or one of these other peptide growth factors and see that when people did these exercises that they would have a big spike in the serum release of these growth factors. Also, I was getting to be in my 40s and looking at 50 and I was losing muscle mass. And so, even though I was active and I did lots of martial arts and cardio and had a stupid little bow flex that I would pump on sometimes, I knew I was losing muscle mass and strength and mobility. And so, all of these things sort of came together for me thinking about my own health. And it was pretty clear to me already that our population in the emergency department, these were people who just did not eat right and they did not exercise, they had no physical activity level at all. The burden of obesity and even morbid obesity was really, really high. And obesity is one of the components of the metabolic syndrome. And because I was a scientist and because we worked with such a complex disease process, brain damage and repair in the setting of stroke or cardiac arrest, I had this habit of like making these elaborate pathophysiological models for what was going on like in a brain cell that was subject to ischemia and reperfusion. And I started sort of at first subconsciously and then more explicitly thinking about this, I came to call it the sick aging phenotype. It's like, I keep seeing the same thing over and over and over again. What is going on here? And the metabolic syndrome is part of it, but a sedentary lifestyle plays into it and nutrition plays into it. And I think that this process is self accelerating and complex in a way. It's a lot like what happens to a brain cell when a brain cell gets injured. And what happens to a brain cell when it gets injured is eventually it snuffs itself through a process called apoptosis or program cell death, where it basically undergoes a kind of involution or cell suicide. And I'm thinking, on a human sort of macroscopic level, that's what's happening to my patients in the emergency department is they're basically sending a constant message to the body that like, I don't need you anymore. Right. And the body takes their word for it and starts shutting down and the muscle goes away and the bone goes away and the insulin signaling systems go away and the neurons go away. And, you know, so I'm realized I was looking at human apoptosis and I started sketching out these maps of what the pathophysiology was. And that's where the sick aging phenotype came from. Real quick, because we didn't touch on this, probably because we talk about it so much we forget. What exactly is a phenotype? So a phenotype is a word that is from the Greek and it basically means show type. It's what you see when you look at an organism. So, as opposed to what else? Genotype. So for example, you can have two fruit flies with pretty identical genotypes, but depending on like what you do to them in an experiment or what happens to them in their environment and their life story, they may end up expressing very different phenotypes. So they may have similar genotypes, but they may look very different. And in the Bible prescription, the book I wrote with Andy Baker, we basically start the book out with a description of two identical twins, Will and Phil, who basically have the same DNA, but their life experiences and their habits lead them to the expression of two very different health phenotypes. One of them has a healthy aging phenotype, one of them has a sick aging phenotype. So, because the genetics, we can't really do anything about. Like if I'm born with lousy genetics, I have lousy genetics, I have the wrong parents, there's nothing I can do about that. But I can be born with a very, very good genetic endowment and still screw it up with my lifestyle. Still make poor choices. Still make poor choices. So that's a phenotype. So you started training yourself. I did. How did that go? So when I started training, using linear progression and progressive overload with strength training as my primary focus, as opposed to like, yeah, I'll pump on my Bowflex a couple of times a week. You know, I got a set of barbells and I gave it a try. And as you would expect, I gained strength very, very quickly. And I started putting on muscle again for the first time in years. And I found that it improved my mobility. I used to do all this stretching for martial arts and all this mobility work. And I found that I didn't need to do that anymore. I was much stronger through the range of motion. And I felt really good. And I knew that I was on to something special there. And then I began to look at the literature on strength training, the biomedical literature on strength training, in particular, the biomedical literature on strength training for older adults. And what I discovered was this whole universe of literature, a lot of it, not very good. But some of it was pretty solid and was all pointing in the same direction, good and bad. It was pointing in the same direction, which was, again, a long story short, that this needed to be the focus of exercise medicine for an older adult, not something that they did in addition to their cardio. It needed to be the keystone of an exercise medicine prescription. And I began, because I'm a physician, I began increasingly to think about it in terms of medicine and as a prescription. And it was at about the same time that the American College of Sports Medicine started their exercise is medicine, program or campaign, whatever you want to call it. And it was like this whole world opened up to me. And I remember thinking like, where has this stuff been for my entire career and my entire education? Like, why wasn't I told, you know? And so that that was a real singularity in my life and in my career, this realization. Is that around the time that you decided that you needed to start coaching other people? So the way that happened was I just started lifting on my own and family and friends like, oh, yeah, I would tell them about it. And they would say, well, let me come over and try that. So they come over and try that. And I picked up right away that that was a primary emphasis of that whole model of training. And I had experienced coaching movement as a martial arts instructor. And I was a former Marine Sergeant. So like I tend to be kind of a controlling kind of person. So I would just coach people, right? And they would come over to lift. And so I wouldn't just let them try it out like I would coach them. And in due course, I became a coach myself. And so initially, I was coaching people out of my garage. But as I got more and more into it, and more and more into the literature, and I came to realize more and more what a profound medicine this could be. I decided, you know, I want to do this part time. So we, you know, we found this like little closet space and remembers it. Our first gym, which was like in a tiny little room in a rotten old decrepit warehouse, and started coaching people part time. And then more and more people started showing up and we had to move into a bigger space. And before I knew it, I was like, well, I think I want to do this full time. I met you in that place too. And when I pulled in the driveway, I thought, no, this building's condemned. I got the wrong address. And you know, there's a training camp really soon and like, how am I going to get there? It was the paper, the paper street soap company. Yeah. And I remember going upstairs and thinking this has got to be a haunted house. Like there's no way. It was a haunted house. They like, they did it. They did a haunted house every year. And good. Yeah, eventually eventually the city showed up and was like, yeah, you can't have, this place is like, yeah, someone might fall through the floor. Yeah, somebody might fall through the floor. The place was literally falling apart. I mean, it's impossible to describe. One day we were going up the stairs. It was a couple of days after a heavy rain started and there were mushrooms growing out of the wall. I mean, it was that kind of, you know, it was that kind of place. Horrible. And how did you hear about all of this? Well, it started in probably 2015. There's no cliche, it sneaks up on you like a thief in the night, but I started noticing, I was losing strength in my, especially in my legs, I would kneel down to get something and have difficulty getting back up. And I couldn't open large lids on containers like my laundry detergent, which is rather important. And I was talking to my son about it. And I told him, I said, I don't want to go to a big box gym. I said several of my friends have and they were injured and they just quit. They wouldn't go back and they didn't start doing anything else. I said, I need to do something. He said, you need to go see Sully. He said, he's the best coach in the country for your demographic. And then I started getting all these emails and URLs from my son about this person named Dr. Jonathan Sullivan. And I read them and that had articles that Sully had written. And I had one list that was rules for the gym. And I read through the rules. And one of the rules was that the coach would be yelling at you. And I called my son and I said, I am not going to a gym where someone's going to be yelling at me. And he said, no, no, no, no. He said, that's like the cues for when you're doing the lifts. He will be saying them loudly so that you will do them correctly. And I said, oh, okay. He said, have you made an appointment yet? And I said, no, I said, I have some things coming up in January. I've got to take care of first. And so in towards, I think it was towards the end of January 2016 that I sent Sully an email and said I was interested in coming and talking to him. And we set up an appointment and I came and I had no idea what I was getting into. I didn't, I didn't know what these racks were or anything. My son had been doing it for a couple of years in shed setup that he had at his home in Virginia. But I never went out to see what he was doing. It's just about eight o'clock at night. He'd say, okay, he said his friend, he had a peer that would work out with him so they could coach each other and they'd go out and he'd disappear for a couple hours and come back exhausted. And I didn't know what he was doing out there. And I was never curious enough, I guess, to go look. But Sully had me bend over and pick something up from the floor and stand up from a chair without using my arms. And I thought it was all kind of silly stuff. I didn't know what I was doing until he had me get under a probably a broomstick or something. It was a broomstick. Yeah. And I had to put my arms back and my shoulders about killed me. And he said, how's that feel? And I said, not really very good. I said, it's kind of tight. But I set up an appointment and started coming twice a week and this made all the difference in the world. What differences did you notice? And I guess, how long did it take for you to notice those changes? It did not take long. Probably within weeks, I could notice, you know, differences as far as balance in my strength and things. And it changes your attitude towards life. You think, hey, if I can do this, I can do just about anything, which can prove dangerous. I've not had any injuries in the gym. I have had injuries outside of the gym, just due to my own poor judgment. But Sally works me through them and I get back. You've taken this to a higher level than most people do that come in here. You've actually gone to a weightlifting competition. Well, strengthlifting competition. A strengthlifting competition and competed. I did in Chicago. It was a lot of fun. Actually, my doctor, my daughter, she might be my doctor, persuaded me to take part and she flew in from California and went with me and everything and kind of made sure I was on track for everything I needed to do at the competition. And it was the first time I was able to deadlift 200. And I was delighted. So you deadlifted 200. Did you ever go back and compete again after that? The next year, both my daughter and I went back. And I deadlifted, I believe, as a 205. And just to put it into context, because I don't think we've really addressed this yet, how old were you when you pulled 200 in competition? Probably 76. So you were 79 and a half now, the 80 next May. So 76 years old and you went to competition. You also did the squat and the press. Correct. And then you pulled 200 pounds. And then the other thing that I remember about that was, not only that made us fantastically proud and had an extraordinary performance on the platform, but the other thing that I think I want to put out there was that we actually didn't train you for that competition. Like we kind of kept you on your program. You were on a heavy light medium structure at that time. And then what we did was like, you know, we had do a couple of weeks before the meet, we had her do some singles and then we gave her a quick taper and then took her to the meet. And it was like, so we didn't even actually just do competition training for her. And she just went and killed it. And there was a video of that. Yeah, they got picked up by Good Morning America, I believe. Got picked up by Good Morning America. They should have had you guys on the show. Yeah, broke the internet. Yeah. So pretty awesome. And then she went back the next year and did it again. And then like most of our masters who go to competition, it's like, yeah, that was fun to do that once or twice. And then it's like... Yeah, I'm done. Yeah, a little stressful sometimes. The worst part is the outfit you have to wear. I call it a slinky. Sausage casing. Exactly. Have you ever had any setbacks or issues that you've had to deal with? Oh, last year, April, my brother in Tennessee had to have emergency open heart surgery. And so I drove down there from here. It was about 12-hour drive. And I did not get out periodically and walk around or anything. I just drove straight, stopped for gas, and that was it. And then when I was down there all week, I sat around the hospital, didn't do much of anything, drove back the same way, and it really affected my hips. And I ended up having prolotherapy and cortisone injections and all that stuff. And Sully just let me do whatever I was able to do until we got through it. And I'm still kind of working back from it now because of the lockdown. So that was the next thing I wanted to ask you is how has the pandemic situation affected your training? I know that you did our at-home lockdown workout for several months. I did. Three months, I think? Yeah, just about three months. And Barbell Logic was extraordinarily generous. They allowed us to use their platform at no cost for our Graceland clients. So I was able to coach people through video. And Ann was one of those who just latched onto that COVID lockdown program and did it religiously. And when she came back, as with all the people who did that program religiously and kept moving, it was not ideal. But when they came back, the ones who did it two or three times a week were stronger and had better movement when they came back and got under the bar. Much less ground to recover. Yeah, exactly. And I just had dumbbells, different weight dumbbells that I used at home. How important do you think this physical gym is to your training? I mean, do you think that you could do this by yourself? I might be able to do it by myself. I don't think I would do it by myself. Just because of the accountability of a coach? Accountability and I don't think I'd feel safe. What about training partners that you've had at the gym? Like how much do you think having training partners helps you stick to a training habit like this? I don't know that that has positive effect. I enjoy them. I enjoy the people. Sully's the one that has the effect. If I didn't have him, I wouldn't be training. That's sweet. It's true. Yeah. I mean, what can I say to that? I will say that Ann is like most of our clients, she's a long-term client. She's been with us for a long time. She's part of a crew, that 930 crew that comes in and trains. Ann is a really central part of our community. I think that that's one of the things that people get out of training in a physical gym or clinic like this is that there's a real community that builds up and friendships that build up. I think that that's terribly important and especially in our population where isolation is a problem, that social isolation that a lot of people, especially now with the pandemic, that social isolation that takes over as people get older and family moves away and lose our significant others and so on and so forth. Not only that, but where I live, all of my close friends have either moved north, moved south. One very close friend that was still in the area died last year. Most of my relatives are within 200 miles or so. Really, this is my main community. It's the gym. It's like a family to me. It really is. You've experienced this, Noah. You know what we've got. It's pretty extraordinary actually. It's really hard for it to not feel like a family. It really does. I think that it's critical to have a group of like-minded people that you can share this with because it gets difficult at times. I think a lot of things in life that are good for you aren't easy and don't feel good. They're not pleasurable, but they're still good. The whole voluntary hardship thing, well, that voluntary hardship is easier when you have comrades in arms. For example, when Anne went through the setback with the piriformis and the sciatica and the hips, you had to feel like people were on your side and rooting for you. When you came back to the gym, the fact that you lost so much weight off the bar, it was like, yeah, come on. No, it was like the encouragement was always there from your training partners. I'd like to think from your coach that you felt us behind you and helping you overcome that. And you have overcome it. It's been really extraordinary to watch your grit and determination and your courage in overcoming that because let's face it, a lot of people would encounter a setback like that. Well, that's a reason to stop moving. That's a reason to just give up. But I think that's one of the things that you learn here is that you don't have to do that. Right. It's your choice. And that you have to keep moving. Movement is medicine. It's the sick aging phenotype that we've been talking about. But perhaps if that had happened the first month or so I was here, perhaps I would have given up. But I had two or three years under my belt of seeing that I could work through difficult things. I think that's one of the big lessons of it. So we talk a lot about, again, about sick aging phenotype and the biology of what's going on and how exercise is medicine for unhealthy aging. But we tend to talk about it in biological terms and physical terms. But there's really a cognitive and emotional, and if you want to, spiritual aspect to it all as well. Teaching yourself and reminding yourself, constantly sending a signal to yourself that, hey, I go to this place twice a week or three times a week and I do really, really difficult, uncomfortable things there. And I face my own limitations and those limitations and my progress and those challenges, they're all numbers. Like I can see my progress and numbers on a page. I don't have to guess whether or not I'm making progress. And I think that it's important to me. It's important to me because I'm 60 now. It's important to me that I can still go do really, really hard physical things and impose these challenges on myself and do this voluntary hardship thing even in my seventh decade. And I can still grow and I can still make progress. And if I have a set back, I can come back from it even though I'm, quote, older now, unquote. So there's these intangible or non-biological benefits that obtain as well. It's all part of this medicine. If anyone else is feeling their age, especially for older women, is there anything that you'd like to say to them, Ann, or what would you recommend that they try to do? I'd recommend that they try barbell training. I mean, it's not something as well known in our community, the female community. I mean, I'd never heard of it and look at, I was what, my mid-70s. And I had no idea. I mean, if I had walked in here knowing what that was, perhaps I would have been too intimidated to try. But give it a try. It makes an amazing change. It's transformative. And I've seen it transform you. I mean, I won't say that you're a different person than the one I met because the person that I first met was a beautiful, wonderful person. I think it's made you a better person. It certainly made you a stronger person. And I think it's brought out the best in you over the years. And you're extraordinary. Thank you. Well, I think that's as good of a place to stop as any. I think so too. So thank you all for joining us in this first episode of our Barbell Prescription Barbell Logic podcast. We're happy that you joined us. We're very, very happy to have been joined by nurse Anne Bazaar. She's going to be joining us again for another one of these podcasts a few episodes later. And we hope that you come along for the ride. So I don't know what else to say. Noah, great job. And we'll see you next time.