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Special thanks to John Little and our webmaster for fixing the “depreacate” message and updating the WordPress program.  My inability to post has actually been a blessing in disguise as I could blame it all on the malfunction rather than the fact that I have actually been too busy and preoccupied to post.   My hectic schedule has also required me to revert back to a 3 way split where each section gets trained once every 21 days.  Due to scheduling, this workout was preceded by 10 days of recovery.  Wendy was due for her workout and had 17 days since her last workout.  This was purely related to scheduling issues and not due to debates on frequency on the previous post.

My WOW (chest/back):  Chins, MedX Chest Press, Nautilus Pullover with SS retrofits, MedX Compound Row with SS cam.

Wendy’s WOW:  MedX Chest Press, SS Systems Pulldown, MedX Overhead Press, EZ bar Biceps Curl, Pushup, Leg Press, Manual Neck Flex/Ext

With all the changes going on in the medical side of my life, studying for my Emergency Medicine Board recertification (has to be done every 10 years), preparing for podcasts, and doing consults, I have not had time to research a topic for this week’s WOW, but you all seem to have no problems keeping yourselves entertained.  I recently did an hour and a half podcast with Dr. Mercola (www.mercola.com) which should be coming out soon.  On July 22 I will be be doing a podcast with Ben Greenfield (bengreenfieldfitness.com) and I will do a live broadcast with Diana Hseih on July 31st at 9pm EST (philosophyinaction.com) and it will also be recorded.

I have enjoyed the discussions and tone of the blog (for the most part) and always learn a lot from your discussions.  I have referred some of my phone consult clients and Dr. Mercola’s listeners to specific comments and some of your recorded workouts, so….

Post your WOW’s and your thoughts

I would like to launch this week’s WOW by announcing my participation in Anthony Johnson’s 21 Convention coming up October 24-26th in Tampa, Florida.  I originally spoke at this conference in 2010 and did so with some trepidation, as my understanding of this conference was limited.  To my great pleasure, the young men at this conference were after much more than trying to learn how to pick up women.  Instead, I encountered a group of young people who were intensely focused on self-actualization.  The people that attended this conference were there to learn from the experience (and mistakes) made by others so that they could get a major leg-up in their journey through their one precious life on earth.  I recall that because of my intense work schedule at the time, I felt very poorly prepared for my talk.  I had planned a talk over several weeks and had spent most of my spare time rehearsing what I would say.  For whatever reason, I was very anxious about what I would say to my audience and I generally felt that my talk was going to fall flat.  The evening I was supposed to fly out of Asheville, NC my flight was cancelled.  I was put up in a really crappy hotel to spend the night so that I could get the first flight out at 5am the next morning. It was the only way I could make it in to Orlando by noon and give my speech right after lunch.  That night in the hotel room, I scrapped my entire speech.  I jotted some notes on index cards and rehearsed the talk in my head.  When I arrived in Orlando I took a cab to the conference hotel.  I watched the end of one speech just to get a feel for the room and then met up with Patrick Diver who took me to his studio for a workout.  I had planned to wear a suit, but at the last minute decided to stay in my jeans.  When I arrived back at the hotel, I was up to speak.  As they announced my name, I again scrapped my entire talk and decided to go off the cuff.  I thought it was the worst talk I had ever given, but it turned out to be the most well-recieved lecture I had ever given.  The youtube video of this lecture has registered close to half a million views for a lecture that lasted 1 hour and 38 minutes.

This is not at all what I expected.  I also did not expect to encounter so many exceptional people with an intense interest in self-actualization and the rarest of qualities these days…the willingness to work relentlessly to achieve it.  I again spoke in Austin in 2012.  This time I spoke on the current state of American medical care and how we got where we are today.  I really didn’t expect a bunch of men in their 20′s to even remotely care about this topic, but once again I was wrong in a big way.  I was flabbergasted about the rapt attention from this very young audience (especially since every other time I have tried to explain this situation, eyes begin to glaze over in the first 30 seconds).  Once again, the Youtube video took off and ultimate resulted in a book deal that may bring this perspective to a much broader audience.

This year I am not certain what I will talk about, but it will likely be a series of lessons that a life in the ER has taught me about acting in the face of uncertainty, intermingled with connections to fitness and health.  More important is the list of speakers, each of whom will speak for a full 60 minutes on their topic of choice.  Here is the current list of speakers:

1. Anthony Dream Johnson (unannounced) 2. Socrates – keynote speaker (relationships) 3. Brent Smith (dating/lifestyle) 4. Greg Swann (philosophy) 5. James Marshall (dating/lifestyle) 6. Steve Mayeda (dating/lifestyle) 7. Bill DeSimone (exercise) 8. Skyler Tanner (fatherhood) 9. Sasha Daygame (dating/lifestyle) 10. James Maclane (dating/lifestyle) 11. Nick Sparks (dating/lifestyle) 12. Dr. Doug McGuff M.D. (health/philosophy) 13. Drew Baye (exercise) 14. Don Watkins (philosophy) 15. James Steele II Ph.D. (exercise) 16. Dr. Eric Daniels Ph.D. (philosophy) 17. Ed Aiken (self defense) 18. Dr. Ellington Darden Ph.D. (exercise) 19. Edward Druce (career/entrepreneurship) 20. Dr. Paul Jaminet Ph.D. (health/nutrition) 21. Damien Diecke (dating/lifestyle) 22. Robbie Kramer (dating/lifestyle)

My major benefit in participating will be getting to hear many of these speakers and to interact with them personally.  I originally thought that as an old married guy, the dating/lifestyle lectures would not apply to me.  What I came to realize is that if you are not dating and courting your wife, then you are not doing all you can to have a great marriage.  You really must win your wife anew every day.  No one (including your spouse) cares what you did…they care what you do.  The names related to exercise and diet will be recognized by all and represent (IMO) some of the best minds in the field.  The speakers on philosophy represent some my personal heroes that I probably could never hope to meet under normal circumstances.  I am really looking forward to this event, and would encourage any who are able to go as well.

Here is a video trailer for the conference:  : http://www.youtube.com/watch?v=ZmVjI172B08&feature=youtu.be

Speaking of unexpected:  My WOW this week was conducted in my garage.  I could not get to UE on Sunday due to a very tough shift that kept me a couple of hours late, and no open appointments at UE on a busy Monday.  Using free weights: Military Press, DB rear fly (jrep halves), EZ bar biceps curls, EZ bar lying triceps extension into close grip floor press, EZ bar reverse curl, SuperSlow close grip pushup, Barbell Squat.

Post your WOW’s and your thoughts.

For Father’s Day my wife and kids treated me to a great WOW down at UE.  Wendy did her WOW afterwards.  Images are up on Instagram/Twitter.

Doug: Lumbar Extension on SS Systems Pulldown, MedX Leg Press (seat reclined), Med X Chest Press (horizontal handles), Nautilus Pullover with SS retrofits, MedX Chest Press (vertical handles top half of movement), SS Systems Neck Flexion, MedX Compound Row with SS cam, SS Systems Neck Extension.

Wendy:  MedX Chest Press, SS Systems Pulldown, Lateral Raise (jrep halves), EZ barbell curls, bench dips, MedX Leg Press, Freehand SS Squat, manual neck flex/ext.

Discussion on last week’s WOW brought up discussion of a topic that I am embarrassed to say, I have little to no knowledge about…the topic of heart rate variability (HRV).  Skyler Tanner and Simon Shawcross have both been using HRV monitors to guide them as to their recovery status.  I have always been somewhat against the notion of “body hacking” as I think it commonly implies a hubris that overlooks the true complexity of the human body.  In regards to recovery, I have always used a simple temporal measure of recovery and have tried to verify the temporal measure retroactively by using my progress chart.  Over time I have found that this is an incredibly blunt instrument for measuring what exists (many times) on a razor’s edge.  Also, in my career as an emergency physician, I have found that the stress of the job and/or the circadian disruption seem to have much more of an impact on my recovery status than the actual workout or my proximity to it.  Many times I have also felt that my angst about my workouts themselves (issues of cognitive dissonance regarding protocol), or concern about my recovery interval (workout today or 2 days later) played a more negative role in my ability to handle the workout than any issue related to intensity/volume/frequency.

So I decided to hit up PubMed and all I can say is Holy Cow!  This has been a huge area of study with implications not only for exercise, but for my medical career.  Thinking back, I can strongly correlate patients with bad outcomes from multiple conditions that seemed to show some element of autonomic instability.  Indeed, much of what I have been reading suggests that poor HRV is predictive of bad outcomes for multiple diseases.  Dave Asprey really bent my ear at the last 21 Convention talking about HeartMath and the trainability of HRV.  Turns out there is a ton of research verifying that HRV is trainable, and when acquired through training, appears to confer the health benefits that correlate with spontaneously high HRV.  In BBS one of our definitions of health was “an appropriate balance between anabolic and catabolic states”.  It turns out that it is also an appropriate balance between the sympathetic and parasympathetic state….AND, this state is trainable.  I selected the article below as just an example of many.  I selected it for the following reasons:  1)It appeared in a MAJOR journal 2) It is a good overview and 3) I found the “billion heartbeats/lifetime across all mammals” fascinating.

So in the comments section, please feel free to recommend what monitors and apps to use, as I want to give this a try.  I also wonder if it could give me some feedback regarding a question that has nagged me for the past 10 years: Is good better than perfect?  In workouts where I was meticulous in every detail and gave my best Zen-like performances, they were always followed by some degree of ROBAT, but significant degrees of irritability, depressed mood and lack of psychic flexibility.  Workouts that were good, but not perfect, leave me with a sense of well-being in all realms.  Perhaps HRV could lend some objective data to this observation.  Perhaps HRV along with measurement of critical myokines could provide some answers as well.  Maybe a dissertation idea Skyler?

http://circ.ahajournals.org/content/129/21/2085.long

Post your WOW’s and your thoughts. (photo from last week’s WOW).

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I did the following WOW at UE after working a busy day shift in the ER.  It was a great workout.

MedX Overhead Press, Rear Deltoid Fly (jrep halves), EZ Bar Biceps Curl, Nautilus Triceps Extension, EZ Bar Reverse Curl, Formulator Flexion, Calf Press on MedX Leg Press.

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The image above has been hanging in UE for months now.  One of my clients owns an integrative medicine practice that includes thermal imaging (used as an adjunct or replacement for mammography).  These images are of one of our female clients.  The images on the left are done the day before a workout, and the images on the right are done the day after a workout.  The colors from hottest to coldest are: red, orange, yellow, green then blue.  The hot areas represent increased thermogenesis through brown fat upregulation.  Recently there has been a lot of attention focused on cold thermogenesis as a means of increasing brown fat activity.  Tim Ferriss included it in the Four Hour Body, Jack Kruse, MD includes it as a major component of his interventions and most recently Dr. Ellington Darden has used it as part of the protocol in his new book Body Fat Breakthrough. Although I have not read Dr. Darden’s book yet, I believe he has taken this concept to the next level by exploiting the relationship between high intensity exercise and cold thermogenesis.  Check out the link to the article below.  If you can manage to slog through the technicalities what you will find is that the activation of uncoupling protein (the molecule that uncouples oxidative phosphorylation so that heat is expended in lew or energy production and storage) is improved by the presence of Interleukin-6 (IL-6).  If you will recall, IL-6 is a myokine released by skeletal muscle during intense exercise.  This study used IL-6 knockout mice (animals that are genetically modified to be unable to generate IL-6) to further delineate the action of this myokine as it relates to brown fat thermogenesis.  What the study found was that IL-6 not only amplifies the effects of cold thermogenesis, but that cold thermogenesis is heavily dependent on the presence of IL-6.  With this understanding in mind, the thermal imaging photos taken above take on a whole new meaning.  This subject did not partake of any cold therapy, only her workouts at UE. I can only imagine the synergistic effects if the two were combined.  Perhaps we can repeat this with the inclusion of cold thermogenesis and report back.

http://www.ncbi.nlm.nih.gov/pubmed/24416310

Post your WOW’s and your thoughts.

Last week’s WOW was put in the comment thread of the previous post.  I worked out yesterday at UE with Wendy while the kids carried out their paid janitorial gig.

Wendy’s WOW:  MedX Compound Row (with SS cam), MedX Chest Press, SS Systems Pulldown, MedX Overhead Press, MedX Leg Press, Calf Press on MedX Leg Press, TSC Neck Flex/Ext

My WOW:  SS Systems Pulldown, MedX Chest Press, SS Systems Neck Flexion, Nautilus Pullover with SS retrofits, MedX Compound Row, SS Systems Neck Extension, MedX Leg Press.  Workout T-Shirt is the Ideal Exercise Vision Test taken from the Ren and Stimpy cartoon where they joined the army.  Pictures are available on Instagram ultimate_exercise_.

Sticking to my theme of being hooked on myokines, I am attaching the following full text article on the relationship of myokines and exercise to decreasing cancer risk and for treating the cachexia of cancer.  We have had several cancer patients at UE who have had great results training through their diagnosis, much of their chemo and after their chemo is complete.  In the future I believe high intensity strength exercise will be a very big part of both oncology care and cancer prevention.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3905596/

Post your WOW’s and your thoughts.

Wendy and I did out WOW’s (14 days for Wendy) at UE on Sunday.  There are some photos and videos up on our Instagram and Twitter accounts.  The links can be found now at the bottom of drmcguff.com.

My WOW:  Lumbar Extension on SS Pulldown, MedX Leg Press, Nautilus Pullover with SS retrofits, MedX Chest Press, SS Systems Neck Flexion, MedX Compound Row with SS cam, SS Systems Neck Extension (coupling the chest press with neck flexion and row with neck extension really amplifies the effect on the neck).

Wendy’s WOW: MedX Chest Press, SS Systems Pulldown, MedX Overhead Press, MedX Leg Press, TSC hip adduction/abduction, Freehand squat, TSC neck flexion/extension.

This week’s workout T-shirt was from Doug Holland’s Intelligent Exercise in Shreveport, LA.  Each week will feature a new T-shirt, watch for it on Instagram.  Nothing new to post on the scientific front for now.  Just trying to have some fun with BBS/UE and life in general.

Post your WOW’s and your thoughts.

I have gone back to some workouts emphasizing the full body.  While there is still some split emphasis, the whole body was covered in these workouts.  Both were done at UE.

5/05/14:  Calf on MedX Leg Press, Lumbar Extension on SS Systems Pulldown, MedX Leg Press, MedX Chest Press, Weighted Plank

5/12/14:  Supervised (and video’d) by Instructor Joe Byers:  Nautilus Plate Load Biceps, SS Systems Pulldown, Nautilus Plate Load Triceps, MedX Chest Press, MedX Row with SS cam, MedX Leg Press (reclined “squat” position.

The first workout produced some mild ROBAT on day 2 post-workout that was handled by simply taking a nap.  Today’s workout….we’ll see.  The RenEx pre-exhaust arm routine is a Dura Mater (tough mother-in honor of mother’s day).  For the first couple of hours I felt great and very pumped.  Now the fatigue is setting in.  I will report back tomorrow.  This is definitely one of the most demanding routines I have come across.

In this posting I wanted to make everyone aware that I am opening an additional website: www.drmcguff.com.  I will still be posting my WOW’s and commentary here, and the blog posts will also be available at my new website under the heading “Learn”.  The focus of the new website will be to showcase the products and services that I offer.   Consultations can be scheduled through an online calendar.  Speaking engagements, weekend seminars, and consultations for corporate fitness center, hospital wellness programs can also be accessed there.  The Body by Science Youtube channel can be accessed under the “Watch” heading and I plan on adding content on a much more regular basis.  Finally, my web gurus have insisted that I engage in social media as a means of drawing in more traffic.  I should be participating on Facebook, twitter and Instagram.  Please be patient as I have ZERO experience with social media.  I have gotten my pinky toe a little wet by posting some images and video to Instagram from my workout today.  My Instagram account is listed under ultimate_exercise_.  Go give a look and do what you can to get me started.  Any pointers from those more experienced is appreciated.

My intent is to get much more video and instructional content out there for folks to watch.  I know it can get boring just posting and discussing.  Hopefully this will result in more and better content for everyone to follow.

Post your WOW’s and your thoughts.

I woke up late Saturday after getting home around 2am from working a very busy evening shift.  I did the following workout for shoulders and arms.

MedX Overhead Press

Infimetric Rear Deltoid Fly

Infimetric Lateral Raise

Thick Bar Biceps Curl

Nautilus Plate Load Triceps (with SS retrofits)

Reverse EZ Bar Curl

Thick Bar Wrist Flexion

This was a very effective workout.  The infimetric shoulder work was incredible.  I am always amazed at how quickly and deeply I can inroad with infimetrics.  The same goes for timed static contraction.  With both of these methods I can achieve such a deep level of inroad that I cannot even move my infimetric device or keep in contact with my yoga blocks.  Infimetrics and TSC both seem to illustrate how much we might be able to “hide” during standard, dynamic load-based training.  With infimetrics and TSC I can only last about 45-60 seconds with a graded intent of 50%, 75% and then 100% effort.  With TSC this means each period at a given effort level lasts only 15-20 seconds.

With standard dynamic repetitions I have been using the graded rep intent method (25% on the 1st rep, 50% on 2nd, 75% on 3rd and 100% on all subsequent reps).  I have found that if I am vigilant against any sandbagging that I rarely make it beyond the fourth repetition. This results in a TUL of around 1:20-1:30, which is a fairly short TUL but still not 45-60 seconds.  I am not certain if this is a result of the opportunity to “hide” or sandbag, or if it is simply a difference in modality.  One thing is for certain, using my infimetric device that I constructed out of plumbing pipe from Lowe’s for about $7.00 has resulted in an almost infinite return on investment.  I will attach some photos below of my first 3 exercises in this week’s WOW.

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That little device can be used for lateral raise, rear delt fly, chest fly, biceps and triceps and can inroad the targeted musculature to china in about a minute.

Post your WOW’s and your thoughts.

My most recent workout was done on a mini-vacation to Myrtle Beach.  I was due for Chest/Back so I did the Following:

Dumbbell Row, Dumbbell Flat Bech Press, Pulldown (technogym with motion similar to old Nautilus Rotary Latissimus machine), Dumbbell Incline Press, Dumbbell Deadlift.  This was a great workout.  Left me quite sore, but not systemically drained.

Today Wendy did her workout at UE:  MedX Chest Press, SS Systems Pulldown, MedX Overhead Press, MedX Leg Press, TSC hip adduction/abduction, TSC neck flexion/extension.

BBS follower Ricardo sent the following NY Times article on myokines and how they keep your skin looking young.  While not specific to strength training, the article is specific to IL-15 which has been shown to be released with strength exercise.  The link to the article is below for your perusal.

http://well.blogs.nytimes.com/2014/04/16/younger-skin-through-exercise/?_php=true&_type=blogs&_r=0

Post your WOW’s and your thoughts.

I did the following workouts over the past week.  I did legs/abs at Fike Gym and Back/Chest/Neck at UE.

3/31 at Fike:  Calf Press, Leg Extension (full extension from 3rd rep on), Leg Curl, Hammer Leg Press, Hammer Clam Shell Abdominal

4/06 at UE:  SS Systems Pulldown, MedX Chest Press (horizontal handles), SS Systems Neck Flexion, Nautilus Pullover with SS retrofits, MedX Chest Press (vertical handles), MedX Row with SS cam, SS Systems Neck Extension.

Both workouts were great.  I recovered well despite a very hectic week in the ER.

There has been much debate in the past about whether resistance training significantly affects hormonal profiles as it pertains to muscle growth.  There is little evidence to show that increases in sex steroids or growth hormone are contributing factors to the growth mechanism.  However, recent research does indicate that resistance training does improve overall hormonal profiles as the relate to general health and sexual function.  This recent study shows that resistance training can restore the activity of enzymes involved in sex steroid synthesis, and ultimately testosterone levels in older male subjects.  Activity levels were restored to youthful levels in this study.

The problem with T supplementation or drugs for erectile dysfunction is that the thought process is like pushing with a rope.  Rather than trying to create the right conditions for the end product, you just supply the end product.  The problem is that the end product is part of a feedback loop; when you supply it exogenously, you further inhibit production.  With resistance exercise you are create the proper stimulus to require the desired end-product, thus keeping both sides of the feedback loop stimulated and balanced.  You get the end product as a result of stimulated production rather than as a supplied entity that shuts down production.

FASEB J. 2014 Apr;28(4):1891-7. doi: 10.1096/fj.13-245480. Epub 2014 Jan 17.

Resistance training restores muscle sex steroid hormone steroidogenesis in older men.

Abstract

Skeletal muscle can synthesize testosterone and 5α-dihydrotestosterone (DHT) from dehydroepiandrosterone (DHEA) via steroidogenic enzymes in vitro, but hormone levels and steroidogenic enzyme expression decline with aging. Resistance exercise has been shown to increase in plasma sex steroid hormone levels. However, it remains unclear whether resistance training can restore impaired steroidogenic enzyme expressions in older individuals. Six young and 13 older men were recruited, and muscle biopsies were taken from the vastus lateralis at basal state. The same group of older subjects underwent resistance training involving knee extension and flexion exercises for 12 wk, and post-training biopsies were performed 4-5 d after the last exercise session. Muscular sex steroid hormone levels and sex steroidgenesis-related enzyme expressions were significantly lower in older subjects than younger ones at baseline, but 12 wk of resistance training significantly restored hormone levels (DHEA: 432±26 at baseline, 682±31 pg/μg protein, DHT: 6.2±0.9 at baseline, 9.8±1.4 pg/μg protein). Furthermore, the steroidogenesis-related enzymes such as 3β-hydroxysteroid dehydrogenase (HSD), 17β-HSD, and 5α-reductase expressions were significantly restored by resistance training. We conclude progressive resistance training restores age-related declines in sex steroidogenic enzyme and muscle sex steroid hormone levels in older men.-Sato, K., Iemitsu, M., Matsutani, K., Kurihara, T., Hamaoka, T., Fujita, S. Resistance training restores muscle sex steroid hormone steroidogenesis in older men.

Ask your doctor if diet and exercise are right for you!

Post your WOW’s and your thoughts

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