Lift Heavy Sh**T In MidlifE!

*Dr. Vonda Wright * (00:00:00) - When we decide that we are worth daily investment in our health. And that you're important enough, which you are. That's when you'll do it. Women in midlife need to lift, to build power and strength so that we can continue to be independent and pick ourselves up off the floor if we slip.

Dr. Sarah Milken (00:00:25) - Hey peeps, welcome to the Flexible Neurotic Podcast. I'm your host, doctor Sarah Millican. Yeah, you heard that right. I'm a real PhD doctor. Long, long ago, like last fucking year, I was sitting in the midlife funk wondering, was this it for me? That day, I realized I needed to get off my ass and start my midlife remix. I dusted off my PhD, wiped the menopause sweat off my forehead, grabbed my golden shit shovel, and started digging deep to all my midlife bitches. It's not just luck, coffee, and hormones that get you through your midlife remix. It's action steps. Let's do this. Hi good peeps, this is the next episode of the Flexible Neurotic Podcast.

Dr. Sarah Milken (00:01:15) - I'm Doctor Sarah Malkin, the flexible neurotic. Today I have a guest who we all need as a midlife bestie. She's a double board certified orthopedic surgeon, an internationally recognized authority on active aging, mobility, and how are lifestyle impacts on brevity? I know you're thinking, Sarah, are you just going to tell us that we have to exercise and lift what you call the dumb weights? Well, yes, but this guest is going to break it down into actual specifics of how, why and what. Just trust me. She's a sought after speaker on empowering women for longevity health practices and is a five time bestselling author. She's on the Today Show and so many other TV programs and so many news outlets because her information is so critical for our lives. Her name is Doctor Vonda Wright. Vonda, how are you? I'm great. You know, I've.

*Dr. Vonda Wright * (00:02:16) - Been stalking you for what seems like a year on the internet. I'm like, this is a cool woman, and she's doing all the midlife stuff that I've been through, so I'm just seeing everything you're doing.

*Dr. Vonda Wright * (00:02:28) - Oh my.

Dr. Sarah Milken (00:02:29) - God. And that's so funny. Because I'm a mutual stalker. I'm like, okay, wait, what waits is she doing? How heavy are those? How many times is she doing them? Oh my God, she went on. Mary Claire's like, menopause cruise. Like, we have so much to cover and I'm so excited for everyone to hear this. The intention of this episode is to dig deep and find out the exact things that will help us. Midlife women want to live longer, be well, be active, be healthy. And what you say is be intentional about the health in our lives. Anyone listening to this podcast is probably on the menopause spectrum between perimenopause, menopause, post menopause, or there happen to be a spouse who is in the car and gets tortured with this as well. Listeners, I promise you, you want to hear this episode and we're going to start with Wanda's mantra is no frailty on my watch. Yes.

*Dr. Vonda Wright * (00:03:29) - So you know what, Sarah? Let's think about our the women we love in our lives, right? Our mothers, our aunts, our our our neighbor.

*Dr. Vonda Wright * (00:03:39) - You know, miss Penny, who you know is all about and everybody's business. Well on one hand. We are so excited to see all the adventures they're doing now that they're through midlife and they're retired and they get to go on traveling and they get to do all kinds of fun stuff. But what we hate to see is them get shorter. We hate it when we see them pull out the ugly silver cane, or even worse, the four legged walker. And all of us.

Dr. Sarah Milken (00:04:10) - Get up from the chair.

*Dr. Vonda Wright * (00:04:12) - They can't get up, and they never intended it. Because when you talk to them about when they were 30 and 40, they are telling you all the stories that are making us blush. But somehow. They have become a fraction of what they were. And because I am a mobility doctor, I am the orthopedic surgeon who is responsible for your bones, or teaching you to be responsible about your bones and your muscles, and about how to get rid of that pesky belly fat and and even how to build a better brain.

*Dr. Vonda Wright * (00:04:48) - That's why I say not on my watch. Because every day in my clinic, I have women like the women I just described. Who either they didn't know or it wasn't a time when women talked about how to master midlife like you and I do. And so age just happens to them. But it doesn't have to be that way. If we're more intentional, if we remain as sassy as we've ever been about getting what we want, when we want, when we want it. And that's what I want when I'm 97 years old. And maybe I die like Queen Elizabeth, who on Tuesday saw the Prime Minister, and on Thursday she just went to sleep. Sassy as ever. That's what I want, Sarah.

Dr. Sarah Milken (00:05:33) - Oh my gosh, me too. I mean, the chronic disease thing, as I've read in your books, it's basically like a lot of people are in their 60s starting to ask these questions and you're saying, wait, you guys, it's not too late, but maybe you should have started this a little bit earlier, because 60s is when all that chronic shit starts stirring up, and then it's like we're behind the eight ball.

*Dr. Vonda Wright * (00:06:01) - So, you know, when I think people should really start thinking about it. Well, I really want my millennial 29 year old daughter and her girlfriends to think about it, but they're not going to think about it, I know that. What I really want people to start thinking about the next phase of mastering. I call midlife like 40 to 60 5 or 70, right? These 30 years. If we don't do it at 35, let's do it on our 40th birthday. Let's finally adult. Let's finally say, okay, I did all the things. I'm 40, I'm out of my parents house. Maybe I have some kids. Maybe I've been working on my career for 10 or 15 years. It's time to think about what comes next. And frankly, about that time is when our hormones start to fluctuate wildly as our bodies decide that, you know, maybe we've got three eggs left and we don't need to be in the fertility hunt we once were. Although I got to tell you, I had my last shot, my child, at 40.

*Dr. Vonda Wright * (00:07:04) - So I kind of was still in the fertility hunt then, but you know what I mean? So I call it the critical decade. Let's start figuring it out between 35 and 45, because if we don't and we hit perimenopause when hormones are, you know, making the wave sign, it's. And it's crazy how it can make us feel. We'll be behind. And I don't want anybody to be behind.

Dr. Sarah Milken (00:07:28) - And what I love about your story is you say you were in great shape. You were a doctor, an orthopedic surgeon, crazy schedule. You had your first biological kid at 40. Then you woke up one day and you were like,, I have an extra £30. I'm a little bit tired. I can hold up this £300 guy doing a shoulder surgery because I have all my patients sit up rather than lay down. You have.

*Dr. Vonda Wright * (00:08:00) - So listen to me. I love that about you.

Dr. Sarah Milken (00:08:03) - I dig deep, so I know. And you were like, what the fuck? I have to practice what I preach.

Dr. Sarah Milken (00:08:10) - It's, you know, because I think for some of us, or not a lot, but many like, you know, some people have quick metabolism. Somebody some of us are skinny fat, you know, where we just look like we're really fit, but we're not. And then you have a baby and then you're £30 heavier and you're like, oh my God, I gotta like, put like the metal to the pedal. Tell us what happened for you. It was sort of like Doctor Mary Claire Havas story. She, like, was like one day she was okay. And then the next day she was in. And she's a menopause expert, a gynecologist, and she didn't even know what was going on.

*Dr. Vonda Wright * (00:08:47) - Well, I've always been an athlete. I was a dancer at 40. I was training for triathlons. And I, you know, I'm not a fast runner, but I was in New York at the time and I was so proud of myself. I got a PR in Central Park, and then you apply all that energy to my career and building an orthopedic practice, which, you know, it's it's competitive.

*Dr. Vonda Wright * (00:09:08) - I was the doctor for a University of Pittsburgh football team. 94% of my colleagues are men. So we're competing to build practices. But I never even as all my years as an athlete felt my body in terms of my body, did what I told it to do. Until I got so sore. Out of nowhere, I could almost not get out of bed. And that's called arthralgia. And I didn't know what it was. And that is a sign of perimenopause. And then I would be up all night thinking about my job, like, why was I so anxious about my job? Or I would be having these heart palpitations at night? And I literally thought, this is why I say I thought I was going to die because my dad had heart disease. I thought, oh my God, am I. So I went and had a stress test. I went to my favorite cardiologist, but you know. I've shared this in podcast before that because I was an athlete my whole life. I would go six months without a period.

*Dr. Vonda Wright * (00:10:13) - I mean, it was just me, just low body fat, blah blah blah. Finally, at 48, I'm having these rivers of periods and I thought, oh my God, I'm finally a woman. I'm having regular periods. It was perimenopause.

Dr. Sarah Milken (00:10:29) - And I'm.

*Dr. Vonda Wright * (00:10:30) - A surgeon. And until I did a deep dive, which I have done now, and I consider myself deep into the menopause expertise I didn't know. And so if people with all the access in the world of health care, like I have didn't know, what do I expect the women in general society, the bankers, the lawyers, the accountants, the doctors and other fields? What do I expect them to know if I didn't know, I.

Dr. Sarah Milken (00:10:56) - Know, so that's.

*Dr. Vonda Wright * (00:10:57) - Why there's such a huge, huge need, right?

Dr. Sarah Milken (00:11:00) - It's absolutely shocking. And I think that that's why I like podcasts like mine and other podcasts. It's like we're saying we're out there saying, you guys, there's all this information out there and some of it we know some of it.

Dr. Sarah Milken (00:11:14) - We're like, oh, that just seems too hard. But I think that like, for me, I want to talk to experts like you to say like, look, Vonda, all of this stuff is doable, but it's sometimes hard to get yourself from knowing information to actually doing it. And what I like about your approach is that you get really specific. You're not just like, okay, girls, go to the gym and lift weights. Like you start getting into very specifics, like how much you should be lifting, how many reps you should be lifting. And we're going to get into that. But first I want to say that you say that a huge part of the population is midlife women, and 80% of us will experience musculoskeletal issues from menopause, and 25% of them or us will be devastated by this. And you don't say it to scare us, but you're laying down the research and the facts like, you guys like this is happening. So if we don't do something about it, it's happening to us.

*Dr. Vonda Wright * (00:12:21) - That's right. If we are not intentional, if we're not exercising our agency and ability to choose like we do in everything else, we make more than 85% of all the consumer choices in this country. We women like us, no matter what our incomes are, control $31.8 trillion. Those are choices we make. Why aren't we making the same choices about our health? Right. So when I talk about I just described arthralgia to you, meaning my entire body hurt. Well, estrogen has a profound effect on all musculoskeletal tissues, whether it has an anti-inflammatory effect, whether it's stabilizes the cartilage, which is the lining of our bones, whether it helps us maintain our bone density or helps us maintain our our lean muscle mass. Estrogen is critical. So when she walks out the door and does not say goodbye and never looks back, the and I'm trying to develop this nomenclature. So everybody uses it and it becomes more known. The musculoskeletal syndrome of menopause are about these six things. It is arthralgia pain all over your body, loss of lean muscle mass as we know.

*Dr. Vonda Wright * (00:13:34) - And I'll tell you more about it. Muscle is critical for health and longevity. It's critical for bone density. Why does Aunt Mabel shrink? It's because her bones are collapsing and getting weaker and weaker., it's it's critical for not accumulating hordes of belly fat. Now, listen, fat is not just obnoxious hanging around in bad locations. It is a noxious metabolic organ that secretes chemicals that can kill us. Right. And so the other thing that women get at a higher rate than men is arthritis. So between these 5 or 6 things, this is why we become frail little old ladies if we don't pay attention. Because here's the deal. The musculoskeletal syndrome of menopause. These six things are silent. We might not even know. Our bones are getting weak. We're becoming frail until we break one. And then it's screaming right there. Silent. Potentially devastating. Why? Because when we are so frail. Because we have low bone density or low, low muscle mass, that we fall from a standing position on our own kitchens, which happens every day.

*Dr. Vonda Wright * (00:14:50) - And we break our hip. 50% of us do not return to pre full function and up to 30% of us die. And we never knew anything was wrong because we never knew our bones were weak. Our muscles were so weak. So. Silent, potentially devastating. But here's the hopeful part. I'm not trying to scare your audience. Nearly entirely preventable. If we get in front of it early enough, we need to start at least by our 40s. So hopefully the women listening were like, oh my God, I need a Dexa scan. What's the status of my lean muscle mass? Am I thin fat? Meaning I may look thin, but my body composition is mostly fat versus muscle, right? So it's it's really a hopeful position I take that we can control this if we control this. Right?

Dr. Sarah Milken (00:15:47) - I love all of that. And I hope that listeners are really listening to this, because you've just laid out the groundwork for, for us in terms of like increasing our longevity and making our lives happier because no one's happy when they wake up feeling like shit and everything's aching, right? I mean, it's impossible and there's no way you want to exercise when you're aching.

Dr. Sarah Milken (00:16:10) - It's not even possible. And you know.

*Dr. Vonda Wright * (00:16:15) - Here's the here's the bonus. What people don't realize because I hear it. I know you hurt too much. You don't want to move or you don't want to lift weights the way I'm going to tell you to. You don't want to. All you want to do is feel amazing again, or amazing consistently, or have the confidence of feeling strong. Well, nothing is going to make you feel stronger than hauling around some weights in the gym and knowing that you're a badass. Nothing builds your mental resilience and your feeling of I got this aging, I got this. So because I can still do hard things.

Dr. Sarah Milken (00:16:50) - So if women are listening to this and they're like, okay, well, who's going to help me with this? Like, what kind of doctor do I go to? Like if I go to my gynecologist, we're doing a pap smear. And I'm hoping she knows about HRT and hormones, but we can't even guarantee that we start feeling like we're fucking crazy.

Dr. Sarah Milken (00:17:12) - We're having all of these symptoms, like, where does the average person go? Like, you're not going to go to an orthopedic surgeon and say, oh, can you give me a health plan? So what would be like a feasible, reasonable plan for the average person until they get to someone like you and they have a broken bone? Or perhaps talk about your precision in longevity programs or, you know, things that exist in the world. Yeah.

*Dr. Vonda Wright * (00:17:43) - The first thing I want women to do is go on a hunt to educate yourself, you know? Think about it the same way. You know, I'm about to my last child at home as a sophomore. We're about to go in the college hunt.

Dr. Sarah Milken (00:17:56) - I know I'm a junior. Yeah, right. You know, I'm a junior in high school now. My daughter, my son's already in college, and we're doing a two week college trip this year. Yes.

*Dr. Vonda Wright * (00:18:07) - I want you.

Dr. Sarah Milken (00:18:08) - To devote the.

*Dr. Vonda Wright * (00:18:09) - Same energy to to learning about this time of life that you are doing.

*Dr. Vonda Wright * (00:18:15) - When your kids are about to go make one of the critical decisions in their life. Right. I want you to read the first thing I want you to read. Just to get in front of the data is to read Estrogen Matters by Avram Blooming and Carol Tavaris. It's a book that changed my life. It summarizes the world's literature on hormone therapy, because I'm not telling every woman that they have to make a decision to do hormone therapy, even though I can regale you with the reasons I do it. But I want you to make a decision based on science, not fear. We are not. We are not children. We do not have to be afraid. We can be surrounded by science. So number one, that book number two, the North American Menopause Society is a great resource. It's called menopause.org. Just do some leisurely reading. They have great position statements so that you have more idea. I hate to suggest social media, but there are some good doctors who are telling the truth. There are a lot of charlatans.

*Dr. Vonda Wright * (00:19:18) - Be careful, buyer beware. But there are some good doctors,, that you see me hanging out with because we're just going to surround you with science and not fill you with fear. So that's number one. Educate yourself. Treat yourself like. Like you're as important as your kid going to college because, you know, women. You know women. We we take care of everybody first before we take care of ourselves. So that's number one. Number two, if you truly want to feel amazing. If you truly want not to shrink like antimony, if you truly want to feel strong and really be able to do whatever you want to do. I just want you to take however long it takes. You get your pad of paper out, and I want you to write down every conceivable excuse you have ever used for not taking care of yourself because you can't out. Excuse me. I've been doing this almost 30 years and I've heard all the excuses. When we decide that we are worth. The daily investment in our health.

*Dr. Vonda Wright * (00:20:21) - And that you're important enough, which you are. That's when you'll do it, because I'm about to give you very specific instructions on the different pillars of what I want you to do, but you won't do them until you decide that you are worth the daily investment in your health. And you are for yourself and for everyone you touch in your lives. If you won't do it for yourself, do it for the people who depend on you. Although I do want you to do it for yourself.

Dr. Sarah Milken (00:20:46) - I love that because you do say that like, look, you're a surgeon. You work 1,000,000 hours a day, you're speaking all over the world, you're writing books. And every day at 5:00 you work out. You tell everyone at your office. You guys, I'm going to work out. And like, sometimes you're not in the mood, and sometimes you just want to go home and take a nap. You want to drink a latte? Whatever. But for you, you've made it a non-negotiable.

*Dr. Vonda Wright * (00:21:16) - Because I know what happens if I go home first.

*Dr. Vonda Wright * (00:21:18) - I do curl up on the couch, write my energy. It's like I turn off a light bulb. So if I'm going to be committed to feeling amazing and do what you described, I literally do have to lift the person up in a. Chair to do surgery on them. I gotta do it. And plus, I gotta be honest with you, I like the way it makes me feel. I like the way it makes me look. I don't feel good about myself when I feel weak. So part of it is, is serving myself right. I want to feel that way. So. What I do. Which if you know, if you if you've seen me at all and I can go into the details of why I do the things, the way I do is I commit to lift heavy. If I don't have time to do anything else, I am going to lift weights because. Lean muscle mass., and the mitochondria, the energy,, little organelles, the little round organelles that make our energy and that live in our muscle are critically affected by that, right? So I'm going to I'm going to lift and I'm going to lift heavy.

*Dr. Vonda Wright * (00:22:23) - And I'll tell you how to do that. I'm I'm not going to gut it out and kill myself by doing high intensity interval training six days a week, which was all the fad a while ago. And I was I love to do that because I get bored on a.

Dr. Sarah Milken (00:22:36) - Treadmill and the spinners.

*Dr. Vonda Wright * (00:22:38) - And the spinners and the rowers and just gutting it out and getting your heart rate into the orange zone a couple days a week. Yes, we do need that kind of stress, but not every day, because you know what's going to happen. You're going to end up in my Monday morning weekend warriors clinic where people have gotten hurt, and then think about how upset they are at that. So we're going to lift heavy. We're going to do low heart rate based training and a couple sprints a week. We are going to live an anti-inflammatory lifestyle. I think people.

Dr. Sarah Milken (00:23:12) - Make sugar, which is basically less or less refined garbage, less carbs, more fiber.

*Dr. Vonda Wright * (00:23:21) - Yes. Lean., green. Leafy.

*Dr. Vonda Wright * (00:23:24) - Lean protein. I like people to have a gram of protein per ideal pound. You gotta count that stuff. You gotta read labels. All packaged food has added sugar. I don't know why, but it does added sugar. And if you're hurting, anti-inflammatory diet will really help with the pain you're feeling. But that's the hardest thing, Sara, for me to get people to do, they won't give up their sugar and God forbid. God forbid I ask people to stop drinking a bottle of wine every night. Because it disturbs your sleep and it's a bunch of sugar, so I don't know how people feel. You can make that choice if you want, but that's really hard for people to give up for some reason.

Dr. Sarah Milken (00:24:07) - Yeah, I'm not a drinker, so that's not my issue. But it is not I my sugar would be real. Sugar, like a brownie is more my issue. But the way I control that is sort of I let myself have something each day because I am the personality where if I say nothing, if I'm like nothing, no sugar, no this like every red light and red flag goes off in my system and I want to eat the entire box of Oreos.

Dr. Sarah Milken (00:24:36) - But everybody works differently with that. Like some people have to be a no sugar. Some people have to be in the moderation zone. It's finding what works for you, because if it doesn't work, you're not doing it.

*Dr. Vonda Wright * (00:24:49) - That is such a great point. It completely doesn't. In the in my first couple books, I would say three bites of dessert. First, because it's desserts. Number two, because you worked hard, and number three because you're about to push it away, but that, you know, three bites instead of the whole quarter of a cake.

Dr. Sarah Milken (00:25:06) - Exactly.

*Dr. Vonda Wright * (00:25:08) - That works for some people. I don't have that much control, Sarah. I either eat it or I don't, because if I take a little, I've already given myself permission. But everybody needs to find the way they do it best.

Dr. Sarah Milken (00:25:18) - Totally. And that's because. Because otherwise you're just not doing it. And then you've already broken down the habit and it doesn't even work.

*Dr. Vonda Wright * (00:25:26) - , you feel bad about yourself?

Dr. Sarah Milken (00:25:28) - Yeah.

Dr. Sarah Milken (00:25:28) - Of course. Now, in terms of the protein, like, I know some people get confused about this when you say ideal body weight, but let's just say you're I want people to understand, like if you're let's say your ideal body weight is £130, you're basically saying that person should be eating 130g of protein per day. And I read that you don't really care that much whether it's plant protein or animal protein, as long as they're getting it.

*Dr. Vonda Wright * (00:25:56) - Right, because I don't want to get into the argument with people who choose not to eat animal protein. I just want you can get a lot of protein from beans and tofu, and it's harder. A pea protein powder. I just primarily want you to have an A protein so that you can heal, so that you can build muscle so that you're not breaking down your own body to nourish it, because your body will take what it wants from.

Dr. Sarah Milken (00:26:22) - It's true that like, if you don't eat protein and you're working out lifting, you're not going to build muscle.

Dr. Sarah Milken (00:26:30) - So is it a pointless exercise then? I mean, maybe not.

*Dr. Vonda Wright * (00:26:36) - But once you got that, you know what? That is a good question. You have to ask yourself what we're striving for. Why are you lifting in the first place? If it's to build lean muscle, why wouldn't you give yourself the building blocks to do that? Otherwise, you're just putting yourself under a lot of stress and you won't recover. You'll probably end up hurt.

Dr. Sarah Milken (00:26:55) - I know because I don't. I think a lot of us women don't eat enough protein. And if we all, for me, like lifting weights is not my favorite thing in the world. It's like commitment. I do it because I have to do it, and that's why I call them the dumb but necessary weights, because I know how beneficial they are. But it is a commitment for me. But at the same time, I don't want to just do it for the sake of doing it so I can check my box. I want it to fucking work.

Dr. Sarah Milken (00:27:23) - So you're saying for it to work, I need to be eating that protein.

*Dr. Vonda Wright * (00:27:28) - You do give your body the building blocks to build the muscle you're working for. Because what is weight lifting do? It actually causes little micro tears. I mean, how do we hypertrophy muscles? We make little injuries. Our body heal it and it heals it with more substantive tissue. But there's a way I want women in midlife to lift. I want us to put down the mammy pamby pink weights that we have been handed our entire lives. I want you to stop doing 4 to 10 sets of ten reps, 12 reps, 15 reps. Because you have to ask yourself, what are you lifting for? Women in midlife need to lift to build power and strength so that we can continue to be independent and pick ourselves up off the floor if we slip. That's I mean, at the end of the day. We are not trying to build endurance. I mean, I'm not trying to lift weights my way to a marathon.

*Dr. Vonda Wright * (00:28:29) - So why am I doing so many manly pamby reps? So the science shows that women in midlife need to lift heavier weights for less reps. So. I'm just trying to make it easy for my people. The range is 3 to 6, but let's make it easy for reps for sets. So that means the example I give is I can I can, biceps curl £15 until tomorrow morning because it's easy for me, but I can only do three reps for reps of 25. And then I'm, you know, trying to use my back. But that will cause enough stress on my system that I recruit more muscle fibers, that it stimulates muscle protein synthesis, that I am starting to stress out the environment enough that I am rejuvenating my stem cells, which is what we want. So you might as well make the work you're doing.

Dr. Sarah Milken (00:29:29) - Work that's so good. And I don't I don't think people get specific enough about that. Like every time you post something like that, I'm like, save forward to this friend, forward to that friend, because we don't really understand.

Dr. Sarah Milken (00:29:42) - And there's so many classes. And I'm not saying they're not good, you know, bars and weights, you know, in a group and all of that stuff is good. But that's not exactly the same thing, is what you're talking about, because you're saying that when you lift to capacity, it doesn't mean you're going to be a weightlifter. Your body, basically your muscles basically start squirting. What's it called? The satellite.

*Dr. Vonda Wright * (00:30:07) - That. So muscles. Muscles make chemicals called myo kinds, which enrich the environment and make you stronger. Right. So that's number one. We need enough stress to do that and recruit muscle fibers to fire together. We also need to create an environment where our stem cells that live in our muscles are called satellite cells, will be regenerative instead of just getting old with us. They need that kind of stress because. So it goes back to the question, what are you doing this for anyway?

Dr. Sarah Milken (00:30:38) - Yeah. No, I love that. And so as soon as I heard the thing about, like, thinking about your muscle squirting, I know that sounds gross and weird, but it's sometimes nice to have, like, just like a basic image.

Dr. Sarah Milken (00:30:50) - So when I'm working out, I'm like, okay, this is so hard. I hate this one is this can be fucking over. But I'm imagining, like, all these amazing juices flowing to my muscles.

*Dr. Vonda Wright * (00:31:01) - Yeah, muscles affect themselves, but they're also endocrine organs. They scored out all the milestones, which affects your whole body. Right? Isn't it interesting? Yeah. I'll tell you two kind of cool things that happen when you,, contract skeletal muscle. It causes the transcription. Transcription is the science word for protein production. Protein synthesis protein. It makes your genes make these proteins transcription of the genes to make a protein. You make one called Clotho. Clotho is the longevity protein. Clotho circulating in your body helps keep all your organs and your brain youthful skeletal muscle contraction and the effect it has by causing transcription of the protein clock. Those. Increases your longevity. But that's not all. The other surprising, amazing thing. And there are probably many more. Same thing. Skeletal construction causes the transcription of a of a protein called Galilean, which then goes and works in your brain and makes you more resilient.

*Dr. Vonda Wright * (00:32:08) - So it's not just about the it's not actually about the little black dress. Although I was going to say to you, Sarah, what's better than putting on a pair of jeans that fit because you've been working out your butt, right? What's better? But what's better is longevity and resilience.

Dr. Sarah Milken (00:32:24) - Yeah, no, I agree with you completely. And as I dig more and more into this, I'm like, okay, the dumb weights, we're doing it, we're doing it. I, I know everyone laughs about that. They're like, I did the dumb whites today. I'm like, good for you. Now you we're so we're sort of putting the pink weights to the side unless you can find higher, higher weight pink weights.

*Dr. Vonda Wright * (00:32:50) - Listen, I would definitely go for it. I would do that. Yep.

Dr. Sarah Milken (00:32:55) - Now how many different types of exercises. So I read that you, you you change your workout every three weeks. Right. So how many like in one workout? How many different things are you doing?

*Dr. Vonda Wright * (00:33:09) - Yeah.

*Dr. Vonda Wright * (00:33:09) - So,, it depends the other. I'll just tell you what I did Sunday with my daughter. We were going to do a total body workout. Normally, I just do legs or arms. So I'll give you two examples. So the four basic compound lifts, the ones that are really I'm focusing on we do a push pull with the upper body. So bench press is the foundation of one of the arm workouts. Pull ups are the foundation of the other arm workout. I don't do them on the same day for the legs., back squats. With a bar you can do a dumbbells, but back squats with a bar is one weight and deadlifts. So those are only four. But they they form the foundation. Like for instance it's a squat day. So that's the first thing I do. Of course that's a four progressive weights right. With that with the leg day I usually put in plyo, meaning I like to jump on boxes. It's good for my bones, it's good for building power to get off the ground.

*Dr. Vonda Wright * (00:34:14) - So I'm jumping up on it. I started on a 20 inch box. I now do a 20 4I0 my God. But that builds, that builds power and I just want to stop any of the people who are thinking that it's going to make you look like a bodybuilder. Look at me. I do not look like a bodybuilder. I just have muscles, right? And no, and I look.

Dr. Sarah Milken (00:34:36) - Fit and toned and.

*Dr. Vonda Wright * (00:34:38) - Right. Yeah. So don't worry. You are not going to turn into a bodybuilder unless you want to. So I'm now back. So those are the four lifts. But then we have to do the things that support those. So if it's a bench press day I'll do biceps I'll do triceps I might do deltoids, I might do lat pull downs with tracks. So on a typical day we do the primary lift. Then we do 3 or 4 of the accessory lifts and for my accessory lifts biceps, triceps, delts. I do eight. So four times four of the of the big lift and then the accessory ones I do eight or I might do eight and six because I'll get heavier on the six less reps more heavy.

*Dr. Vonda Wright * (00:35:29) - So that's two two little compartments, this one, then the accessories. And then I'll do stuff for my core. Like I love Russian twists, I love hamstring extensions. I don't love planks, but I do them I don't love me up. But,, yeah. So we just do a core set. So those three blocks, it takes me about 45 minutes. It doesn't take hours and hours.

Dr. Sarah Milken (00:35:56) - How many days a week do you do that?

*Dr. Vonda Wright * (00:35:58) - I do it, I try to do four, I do three at a minimum.

Dr. Sarah Milken (00:36:02) - Okay. And do you have,, a website, a YouTube, like do you have anywhere where your workouts are posted?

*Dr. Vonda Wright * (00:36:12) - It's interesting you ask that people have been asking a lot. And so I am as soon as I get it done, I'm releasing something called Strong and Courageous. It is just my approach to working out in midlife, and it's a the outline is a free guide, so if people go and sign up for my newsletter, which is not my email, sometimes people want to email me.

*Dr. Vonda Wright * (00:36:34) - It's easier if you just go into my links on Instagram and sign up for a newsletter. My whole email list will get strong and courageous, which is an outline of how I lift. And so, you know, if people want really want to join me or send videos, maybe I'll do a course or something, I don't know.

Dr. Sarah Milken (00:36:52) - Or you should have like a YouTube channel. It's like I should write like.

*Dr. Vonda Wright * (00:36:56) - I don't know, just.

Dr. Sarah Milken (00:36:57) - Have your daughter film it. Just what do you fancy? I think everyone just wants to see, like a midlife woman who's an orthopedic surgeon who knows the research. Like, how is she doing it?

*Dr. Vonda Wright * (00:37:11) - Well, I will, I will text you first and. Okay.

Dr. Sarah Milken (00:37:13) - Perfect. Yeah. Tell me what my workout is next week and then I'll post it., also, I want to talk about cardio for a second. Yeah, that's I mean, we all know that getting steps in is important for a million, zillion reasons, but you definitely have thoughts around cardio and I want you to share them with the audience.

*Dr. Vonda Wright * (00:37:35) - So if you do nothing at all, fidget. Get up from your desk dozens of times. Put your put your computer on on the counter instead of at a desk like I'm sitting right now. Fidget. The more movement during your day is better. That's number one. Number two, the 10,000 steps is kind of random. The research supports about 8000, but just walk around 8000 is about four miles of total steps in a day. Just do it. If we're specifically going to do a workout for cardio again, you have to think about what you're doing it. For most of us who went through the high intensity interval training or getting into the orange zone every day of the week, our heart rates are up when 61, 71, 80, which is near max. And that is not what we need for longevity. That's what we need from running away from a bear. But that's not what we need to live longer. So the interesting thing is I'm a sports doctor. We talked about that. Professional athletes don't gun it every single day.

*Dr. Vonda Wright * (00:38:41) - If endurance athletes, for instance,, work at lower heart rates. As their base training 80% of the time. And so that's what I like my people to do. I like us to work at lower heart rates 80% of the time so that we build our it's called mitochondrial flexibility. The little energy storehouses in our body can flexibly use fat, use carbs, use a protein. And go back and forth. When people are metabolically dysfunctional and have uncontrolled diabetes, they have no metabolic flexibility. So working out your your according to low heart rates is what I'm trying to help people do is be have more control over their metabolism. So what does that mean? Well, if you come to a lab like mine and you're all welcome to come to Orlando, we'll put you through our Precision Longevity program, where we measure all these things for you. Build your own precision longevity.

Dr. Sarah Milken (00:39:45) - I want to come, but I'm like, what if my numbers are embarrassing?

*Dr. Vonda Wright * (00:39:48) - I won't tell because it's a doctor patient relationship.

Dr. Sarah Milken (00:39:51) - Okay.

*Dr. Vonda Wright * (00:39:52) - It's. I can't tell. I'm bound to secrecy.

Dr. Sarah Milken (00:39:58) - Oh my God, no. But even to myself, I'm like, oh my God, what if I whatever I've been doing isn't even like that helpful? But yeah, no, I did. I did have a bone density scan though. Oh good. And I was good and I was actually better than I was last time.

*Dr. Vonda Wright * (00:40:13) - Oh that's perfect I know I love that, I love that. The way to know your heart rate zone without coming and being tested. Getting your lactate threshold tested is and and you know, I get criticized for saying this all the time by exercise physiologist. So just bear with me. This is how we're going to do it. 181 minus your age. If you're a midlife woman, that's going to be about one 2130. That's how I want you to spend your cardio three hours a week, broken up into 45 minute or 1 hour, not two 20 minutes, 45 minutes minimum. And you will find that it'll take you a minute to get your heart rate into the 130 ish, which is about where I work.

*Dr. Vonda Wright * (00:41:00) - Do my heart., but then once you're through it, by 45 minutes, you feel like your metabolism is revving, your broken a little sweat, you can still have a conversation. So that's three hours a week, but then twice a week, remember these stem cells we want to rejuvenate. I want you to sprint. Now don't freak out because,, it's just maximum effort. Sprinting is individual. My sprinting doesn't even look like sprinting, but it's sprinting for me.

Dr. Sarah Milken (00:41:32) - I'm so short. How tall are you?

*Dr. Vonda Wright * (00:41:35) - I'm 54.

Dr. Sarah Milken (00:41:36) - I'm sure I'm 52, but I just feel like it's like my sprint does not look cute.

*Dr. Vonda Wright * (00:41:43) - Oh, Sarah, you could never not look cute. I'm just going to say get over you.

Dr. Sarah Milken (00:41:48) - My sprint is like a turtle jog. Like my daughter walks in and she's like, what? Is that really sprinting?

*Dr. Vonda Wright * (00:41:55) - Yes. You tell her this is maximum heart rate.

Dr. Sarah Milken (00:41:58) - You're 4.5in taller than me. You don't count, you know.

*Dr. Vonda Wright * (00:42:03) - You gave her those legs. You remind her I know that.

*Dr. Vonda Wright * (00:42:06) - I know her access from you somewhere.

Dr. Sarah Milken (00:42:08) - Deep in the gene pool.

*Dr. Vonda Wright * (00:42:13) - Well, I want people. 45 minutes in lower heart rate, two sprints a week. But here's the deal it's not sprinting a long time. It's 30s maximum effort. And then you totally recover so many.

Dr. Sarah Milken (00:42:29) - Times.

*Dr. Vonda Wright * (00:42:31) - For.

Dr. Sarah Milken (00:42:32) - Okay.

*Dr. Vonda Wright * (00:42:33) - When you're done with the zone two, do not do this cold or you're going to pull something. So my example is to get my heart rate into about 125 to 130. The incline is 4 to 5 and the speed is four. And that is that is where my heart rate needs to be. When I go to do maximum effort, I just punch it up to 11. I go as fast as I can, and I try not to fly off the back of the high God.

Dr. Sarah Milken (00:43:03) - I would be in the other room.

*Dr. Vonda Wright * (00:43:05) - Yeah, so it's whatever it is for you. Maybe try nine, but we're and it's only for 30s and then you completely punch down to three. You totally recover.

*Dr. Vonda Wright * (00:43:15) - But that effort gives you metabolic flexibility. And how many.

Dr. Sarah Milken (00:43:19) - Times do you have to do that at the end of your 45 minutes of zone two.

*Dr. Vonda Wright * (00:43:24) - You do four reps of that.

Dr. Sarah Milken (00:43:26) - Okay, so you run for 30. So if you run for 30s, yes, then how long is your recovery.

*Dr. Vonda Wright * (00:43:36) - Until your heart rate goes back down.

Dr. Sarah Milken (00:43:38) - So it could be like a minute, maybe two.

*Dr. Vonda Wright * (00:43:41) - It usually takes me a couple minutes okay.

Dr. Sarah Milken (00:43:43) - Yeah two minutes. Then you do it again.. Okay. Interesting.

*Dr. Vonda Wright * (00:43:49) - So if my if my base training is 45 minutes it usually takes me 15 minutes to get through four reps.

Dr. Sarah Milken (00:43:57) - Got it. Okay. okay. Now I'm sure you've seen me on Instagram with vest bestie. My weighted vest.

*Dr. Vonda Wright * (00:44:05) - That's good for your bones.

Dr. Sarah Milken (00:44:07) - I know, so I did. My husband started that whole craze and then I made fun of him. And then I was like, you know what? Maybe if I, I'll just try it. So I used an £8 weighted vest for like, I don't know, maybe six, eight months.

Dr. Sarah Milken (00:44:21) - And I just moved up to a £10 weighted vest. Oh, good., but I feel like it gets my heart rate up faster. Yeah. More easily.

*Dr. Vonda Wright * (00:44:32) - Well, it's more work, right? Yeah, yeah. More work. And, you know, if there is some some papers, there are some research on how that's great for your bones. So good. Yeah.

Dr. Sarah Milken (00:44:42) - So I feel like that has been like super helpful for me. But I do remind people it's not instead of lifting the dumb weights, you know, sorry too.

*Dr. Vonda Wright * (00:44:52) - It's part of your walking around the house lifestyle.

Dr. Sarah Milken (00:44:56) - Yeah. Totally. Okay, so just to recap that three hours a week at 65% maximum heart rate and then I read that it takes you seven minutes to get to around 130. Right.

*Dr. Vonda Wright * (00:45:12) - Ish. Yeah.

Dr. Sarah Milken (00:45:13) - And then for the next 30 minutes you're on an incline. And then the last 5 to 7 minutes you're breaking a sweat. And then two, two days a week you're going to be adding the sprints part.

*Dr. Vonda Wright * (00:45:26) - I am and I want and I know that that is very specific. Every woman is different. Every man and woman is different. So just because that's what it takes me. It may take you less time to get into your heart rate zone. It may take you more. It may your,. You may recover faster. Slower. So just. Know the principles, but experiment because we're all unique. That's why I come.

Dr. Sarah Milken (00:45:53) - But I think it's sometimes nice to have someone's example and you're like, okay, took her seven. Maybe it takes me three, maybe it takes me ten. But you sort of like have the the order of events now. Like, obviously food is a big deal. Like we can't lie, we can't dance around that. Exercise is key. Weights are key. But like food is important. We talked about protein and how important protein is in your opinion and what the research shows and how we can't we can't synthesize we can't make new muscle without it. Right. But you also talk about healthy fats and fiber.

Dr. Sarah Milken (00:46:34) - So will you give us your like quick and dirty on that.

*Dr. Vonda Wright * (00:46:37) - Yeah. So women need 25 to 30g of fiber. It's. And what is a what is fiber. So it's instead of eating eating white potatoes which is simple starch. Maybe we eat sweet potatoes with the skin because it's all fibrous white, white northern beans have so much fiber in a cup. It's a great way to get it because here's what fiber does. It digests very slowly. It takes a lot of energy to digest green leafy vegetables and fiber. Why do you think cows have four stomachs? Takes a lot of energy and a lot of time to digest that. It's great for your microbiome, it, and the microbiome in our gut. Everybody's heard of that. Now, not only does its job of digesting its food, it's like some scientists think it's like a second brain. It has its own intelligence. So keeping it healthy is is critical for mood and,, and overall health. So but the other thing that fiber does for women in midlife, it, it helps us keep control of our belly fat, which everybody hates.

*Dr. Vonda Wright * (00:47:47) - Right. It's the we may not be we may not weigh more, but we're thicker in the waist. Right. And it's the abdominal fat. And and eating enough fiber helps us with that. Like simple carbs do not. Simple carbs will pile that on. Fiber will help us fight that. So 25 to 30g it's hard to get.

Dr. Sarah Milken (00:48:08) - It is hard. I did hear though that an avocado has like 12g. It does. So I'm like, shit, if I eat one whole avocado a day, at least I'm halfway to the 25 and a.

*Dr. Vonda Wright * (00:48:21) - Cup of beans and you're there. I an avocado, a cup of beans and a couple tablespoons of chia seeds. Done. Oh, I.

Dr. Sarah Milken (00:48:30) - Do the chia seeds. I definitely do that every day., but it's annoying because I used to think that apples had so much fiber, but they really don't. And I'm like, God, that's kind of a waste.

*Dr. Vonda Wright * (00:48:41) - Yeah, I mean, if we're accumulating it 3 to 5g at a time, that's a long haul.

*Dr. Vonda Wright * (00:48:46) - And I think that's what Apple has.

Dr. Sarah Milken (00:48:47) - That's that's why you gotta like, fine. Add a quicker way. Like the avocado. Oh God. Okay, I know we have a few more things to talk about and we're going to wrap up, but I do have to mention frozen shoulder because I feel like Frozen Shoulder could be three episodes unto itself. I've had it. I thought I was going to die. I just want to do like a quick little thing on frozen shoulder, and then I'll have you come back and we'll do a whole episode on it, because there's so many people struggling with it, but kind of tell us what it is, why it happens, and what we can do about it.

*Dr. Vonda Wright * (00:49:22) - So remember our girlfriend estrogen?

Dr. Sarah Milken (00:49:24) - Yeah.

*Dr. Vonda Wright * (00:49:25) - When she walks out the door. She is such an amazing anti-inflammatory. So the way estrogen, one of the things estrogen does is works in our immune system on on a, on a structure called the inflammasome, which helps to take care of all the inflammatory,, byproducts of living.

*Dr. Vonda Wright * (00:49:44) - We we have a lot of chemicals in our body that need to be the fire needs to be put out and estrogen helps do that when you don't have that influence. Our whole body becomes inflamed. So we get one of the places that's most sensitive to that, for whatever reason, we don't know yet is our shoulders. So what happens in our shoulders? And it's not only menopause, but a lot of perimenopausal and menopausal women have that. But people with uncontrolled diabetes with high inflamed inflammation also get frozen shoulder. People with auto inflammatory autoimmune diseases get frozen shoulder. The shoulder is very susceptible to inflammation. So. The layers of the shoulders, skin, muscle. Then we get down to the layer inside called the capsule. It's surrounds our joint. It's like a it's like an orange skin. It protects what's inside. That structure is incredibly susceptible to inflammation. So whether it's menopause, it's high sugar, something minor. Bumping your shoulder on the on the bedroom door, getting up in the middle of the night or nothing at all, it'll start to ache.

*Dr. Vonda Wright * (00:51:02) - And then we do what comes naturally, which is we protect it. You'll hold your shoulder in, you won't use your shoulder, and within one week you will have a shoulder that does this.

Dr. Sarah Milken (00:51:13) - Oh, I or I had it, I thought, I really thought I was going to die.

*Dr. Vonda Wright * (00:51:17) - And it's very painful and I call it you failed to hook your bra test. You can't even reach back there anymore. So. It is due to the inflammation of estrogen walking out or high sugar. So the things that help it are anti-inflammatory living number one low sugar. Number two, if you choose to do it, there is a study that shows that estradiol,, can help decrease the incidence and and severity of frozen shoulder. But when you come into North pads office, here's how we treat it. Number one, we send you to physical therapy. You should keep this thing moving, even though it hurts sometimes. And I do not love steroid injections. I do not give a lot of them. I will put a steroid injection right into the space to cool it down, so that you can actually do the therapy.

Dr. Sarah Milken (00:52:08) - I had to do it.

*Dr. Vonda Wright * (00:52:09) - And then you work and work and work to get your motion back. The other things that we do offer because frozen shoulders can last a couple of years. It's so frustrating. I now offer platelet enriched plasma, which is taking blood out of your arm. We spin off your platelets, which contain all your growth factors, and when we put it into this space, it has a very good anti-inflammatory effect. When people have been suffering a long time, the end treatment is to take you to the operating room, put you to sleep, and I will move your shoulder for you. Oh, and it breaks up the scar tissue. And so what happens is, if you're stuck down here, I can usually, while you're asleep, very easily move your arm to a full range of motion. And then we send you to therapy five days in a row. And people usually recover more than 50% of their motion once I move them. But I don't do that. First, we try to work through it with these non to sleep methods.

Dr. Sarah Milken (00:53:12) - Right now that's interesting. I did not have to do that, but I did have to do the injection. I did the physical therapy and I also it sort of it coincided at a time where I was having one of those what you were talking about, one of those waterfall relentless bleeds. I'd been bleeding for like 2 or 3 weeks, and the doctor was saying that it was probably some kind of, like, crazy hormonal thing that, like, threw my shoulder into this.

*Dr. Vonda Wright * (00:53:41) - Yeah, it was your. It was your perimenopause.

Dr. Sarah Milken (00:53:44) - Yeah. So I took progesterone for whatever. It was like two weeks. And then we stopped the bleeding and then eventually with all the other things it helped. But wow, is that brutal. Okay, I need to talk to you about the concept of healthspan versus lifespan. Yeah, because I think that some women will it will click in their brains when they hear this, that it's not just exercise isn't just about your brain or just about your muscles. It's like a whole mindset.

*Dr. Vonda Wright * (00:54:15) - So at the turn of the century. That 1900 century men live to 40, and we don't know how long women live because they didn't bother keeping data on us. Now the life expectancy of men is about 79, although it's a little lower now, and women is 81. So if you're born. That's the average life expectancy. Now, I personally want to live past 97, but 81. That is years. That is birthday candles that will burn down your kitchen. That is not health. We know that the top chronic illnesses that kill us. Whether we are diagnosed and just managed and we don't think much about them or whether we're not diagnosed at all. Rear their ugly heads at 62, about the time when we're supposed to be retiring and enjoying life. Our chronic diseases. Start to rear their ugly heads. The space and time before you have to deal with lots of chronic disease is your health span. So I don't know about you, but I do not intend to spend the 20 years between 62 and 80 2 in 3 doctors offices a week.

*Dr. Vonda Wright * (00:55:38) - Not me. So when I say not on my watch, we are not going to become frail. We are going to get in front of our chronic diseases. It's because what we would want is to have our health span that time of life when we're healthy, vital, active, joyful, equal our life expectancy. And the way I like to express that is. There's nothing wrong with aging. From the minute of our conception to the minute of our last breath. Aging is normal, but it's how we age, right? And I want to be healthy, vital, active, joyful. And I suddenly in my sleep, not spend 20 years down some slippery slope to frailty where I can't do what I want. Nothing would piss me off more than to be able to do what I want. That's the difference between healthspan and life expectancy. And that's what we're trying to hedge against making these equal.

Dr. Sarah Milken (00:56:37) - Yeah, because we don't want to live forever, but just be sick. Like, what's the point of that?

*Dr. Vonda Wright * (00:56:42) - What is the point?

Dr. Sarah Milken (00:56:43) - I think what's hard though, it's like how we have all this information at our fingertips and so many of us are not doing it.

Dr. Sarah Milken (00:56:53) - Like, why are we not doing the work? Why are habits so fucking hard?

*Dr. Vonda Wright * (00:56:59) - Well, you know what? That's the $94 trillion question. I have been taking care of people a long time, and I have a hypothesis. I have some thoughts.

Dr. Sarah Milken (00:57:07) - I know you do. That's why I.

*Dr. Vonda Wright * (00:57:09) - Asked. I think people know what to do and don't do it. They know what to do and they don't do it. It's because, number one, we're taking care of everybody else but ourselves. We're undervaluing our value, right? Or maybe we're just so insanely busy we can't imagine adding something else so that, you know. Okay, I get that I'm a surgeon. I have a blended family of six children, two dogs and parents. Right, I get that. But I can't take care of them if I don't take care of me. So there's that. Excuse time. There's the excuse of not knowing what to do. But if you don't know what to do, all you got to do is Google something or listen to this podcast.

*Dr. Vonda Wright * (00:57:52) - Because I've now just told you. But here's the here's the other thing I think, Sarah, tell me what you think of this. There are some people who describe how we live as we relive the last six months of our lives over and over and over. So even if you learn what to do, you listened today. You're all enthused. You're going to increase your healthspan to match your lifespan. And you may start. What we find. This is my hypothesis. We go back to the habits where we felt safe. We feel safe eating cookies in our bathrobe, on the couch, or clicking through TV shows. There's no challenge to that. Nobody is going to challenge us. It doesn't feel bad. So I think there's a part of why we don't invest in ourselves. After a certain amount of time, because we're just looking for the feeling of safety again, and we go back to that place. And maybe it was eating cookies, or if we use food as a mechanism, and I don't know if that's too much psychobabble, but I think.

Dr. Sarah Milken (00:59:01) - It's really spot on, especially post-pandemic.. Because I think a lot of us got really comfortable in that Netflix and eat cookies, and there's no judgment because everybody else in the world is doing it. And who knows.

*Dr. Vonda Wright * (00:59:18) - If there's going to be a world. So let's just feel safe.

Dr. Sarah Milken (00:59:20) - Exactly. And there's nothing wrong with safety. We all want it. But what I love about what I read about what you're saying is, you're saying we need to redefine what our safety, what our safety is and what that definition is like. Our natural response is like cozy blanket, rainy day, Netflix and hot chocolate. And you're saying, yeah, that's great. I get that because you do like to crawl up on the sofa, but what our new safety should be is. I can get up the staircase. I can live in the house that I raise my kids in. I can pick up my grandchildren. I can sit on the floor and I can stand up from the floor. That's what our new safety is.

Dr. Sarah Milken (01:00:07) - And that's a new paradigm that a lot of us have to really kind of open ourselves up to and eventually adopt if we want to be in this healthspan mindset versus just kind of shitty lifespan. Like, oh, I lived in 97, but I was in the hospital the whole time.

*Dr. Vonda Wright * (01:00:28) - You know what? Nothing is harder, Sarah, than, you know, I made a joke when when we started describing the old women that live in our street. And nothing is so hard than when I'm on call and. And I and I go to take care of a woman or a man who I know has had a full life. But because their health span did not equal their life span, they are laying in a bed. They can't even get up. They have a clicker. They have to call a nurse. In giving up that control you've always had. That is worth avoiding that because that is a hard place to find yourself at the end of a vibrant life. And so real safety is everything that you just described.

*Dr. Vonda Wright * (01:01:16) - Being able to take care of yourself, carry your groceries in. Get up off the floor. Get on the floor if you want. That's real safety.

Dr. Sarah Milken (01:01:25) - I know it's crazy. And with you and I like at these ages, it's like we do see aging parents and we do see what that looks like. And you think like, okay, okay, her mom can walk six miles a day while chit chatting with her bestie on her cell phone. And her mom plays tennis six times a week, and, you know. But then there's the the same woman at this same age, totally incapacitated. And honestly, everybody's lives are different and different things happen and, you know, different variables. But it's sort of like we have to do right now for what we want in the future. And it's sometimes not that easy to be like, oh yeah, I'm working out now so that when I'm 75, I can carry the groceries out of the car. Because we're so used to instant gratification, especially today in society, we're like, we want this.

Dr. Sarah Milken (01:02:21) - We're getting it right now. Amazon's bringing it tomorrow. But doing something, doing stuff now for 25 years from now. It's not always like at your fingertips.

*Dr. Vonda Wright * (01:02:33) - You're right. And that you know the bankers call that temporal disconnect. Meaning nobody's saving money like we know we should because they want to spend it now. So I get that. I get that because the reason I haul weights around is for my longevity. It is I want to be healthy, vital, active, joyful. But frankly, I'm as vain as the next person. I like that I have one closet of clothes that is still the size I wore in college, now that I lost my 30 menopause. Tragic.

Dr. Sarah Milken (01:03:04) - You know exactly what it is.

*Dr. Vonda Wright * (01:03:07) - Yeah, I did that and I'm done with that. So I lifted a bunch of weights, I recomposed my body and I'm back in the same clothes. That is reward today.

Dr. Sarah Milken (01:03:19) - It's such a great point to is that. You had a blip in the road. Oh, yeah.

Dr. Sarah Milken (01:03:25) - And you didn't. You didn't stay in that hotel forever?

*Dr. Vonda Wright * (01:03:29) - No, I didn't want to be that person I. I was about to have to go and buy a couple sizes bigger clothes and it pissed me off. And I am used to having. I am used to having the strength to do what I want to do. And that day that I, I was trying to lift this £300 guy and it was harder than usual. I thought, oh my God. If I don't do something, this is as strong as I'm ever going to be, and I'm going to slowly give up what I love, and I'm going to have to buy these clothes that I don't even want in a different size that I don't even I know.

Dr. Sarah Milken (01:04:07) - I with my jeans, I have a couple sizes. I'm not going to lie. There's like, I mean, I don't bounce that much, but I definitely have my like, oh, this is like my surprise period week. My, you know, like my pants are a little tight today.

Dr. Sarah Milken (01:04:24) - Oh my God. But you know what I mean. You know, I totally get it. And I love that you're honest about it. And you're not perfect and nobody's perfect. And you're in this field and you're like, hey, guys. Like, I had a moment in time where I felt it. You been there?

*Dr. Vonda Wright * (01:04:41) - Oh, you know what? I even posted it. I mean, there was this if you want to go back, people, it's somewhere on my grid. There was. I make the point that at 40, I was in the best shape of my life. And there's a picture of one of my books. And then the picture of the butt. Is my butt £30 up and then beside it is how I worked to get fit again. So I even put it out there. I don't put many.

Dr. Sarah Milken (01:05:08) - And how long did it take you.

*Dr. Vonda Wright * (01:05:10) - It to me to get from where I hated being until I felt in control again. About six months.

Dr. Sarah Milken (01:05:16) - Yeah, and that's a good point.

Dr. Sarah Milken (01:05:18) - If it's not tomorrow. No. And that's what's hard, is sometimes these little habits, the change is so small that sometimes it's hard to stick to it because you're like, I'm not seeing my size go down. I'm not seeing the scale switch around.

*Dr. Vonda Wright * (01:05:35) - Well. And you know what is something helpful? I don't do it as much as some women suggest doing it, but I took before pictures. That's why I have that picture. Right. And. And every couple of weeks I took another picture because you will not see the change day to day, but over a month you will. Yeah, over three months you definitely will and you'll feel different. And though scale may weigh the same, I don't care about the scale because muscle weighs more than fat. I don't care.

Dr. Sarah Milken (01:06:07) - About that either. But I do care about the muscle. You'll see.

*Dr. Vonda Wright * (01:06:10) - Yeah, you will see the physical changes. So, you know, if you're like that, just set the timer and but you will see it not every day.

*Dr. Vonda Wright * (01:06:20) - You are not going to see it every day, but you will see it.

Dr. Sarah Milken (01:06:23) - And I know some women are probably thinking about this too. What about Pilates, yoga and, let's say like rubber bands or whatever you want? What are your thoughts on that? I mean, Pilates, I'm not. I'm not gonna lie. Plot is the way I do. It is really hard.

*Dr. Vonda Wright * (01:06:43) - Really hard. Yeah. I think. Yeah. I mean, it's a lot of small muscle coordination and neuromuscular pathways and I'm not against that at all., it's going to create a different, leaner body then lifting weights will. So I don't think you should give that up. I just think you should add some heavier weight.

Dr. Sarah Milken (01:07:03) - It doesn't replace weight. Heavier weight training can't.

*Dr. Vonda Wright * (01:07:06) - Replace heavy lifting. Now, what's interesting about bands is there are some really,, high level athletes who. That's all they do. But they're not using the little flimsy bands that we get at target. They're using industrial strength. Really thick.

Dr. Sarah Milken (01:07:23) - So my husband has those. I hate them, they're so hard.

*Dr. Vonda Wright * (01:07:27) - They're hard right there. There are holes.

Dr. Sarah Milken (01:07:29) - Like I have to put like weightlifting gloves on because I feel like they rip my hands open.

*Dr. Vonda Wright * (01:07:34) - Yeah. I mean, for instance, Tom Brady's whole whole book and whole. Not that I'm advertising him, but he uses bands. That's his method. Right? So it can produce athletes like that. But I just prefer metal. I think I know exactly what I'm getting. If it says.

Dr. Sarah Milken (01:07:50) - I don't think if you don't have a full size jam,, that you can get away with having a few sets of dumbbells and getting it done. Yeah, yeah. Which I, which I really like. Okay, so before we wrap up, I know that we've talked briefly about this, but you have said that we all have plans. We have a financial plan, we have a business plan. We have a plan for our kids going to college. But very few of us have like a healthy lifestyle plan.

Dr. Sarah Milken (01:08:22) - And part of your vision and platform is helping women, especially women. But obviously men as well kind of understand that they need a creative vision and help them to create that. So do you want to? Well, I'll just kind of quickly go through each part and you can comment on it. First. You say you have to create the vision. It can't just be brick by brick. What do you mean by that?

*Dr. Vonda Wright * (01:08:46) - I mean that all of us, or many of us have probably experienced the grapefruit diet, the soup diet, the eat Vegetables on Thursday diet. Those are bricks. Unless we know what we want and why we want it. We will always just have a pile of bricks. We will never build a monument to our health. But to do that, it takes a little soul searching. Why? Do what? Not just what you want to feel or do, but why? What are your values? I value being independent until I die. I value being able to take care of my grandchildren, to do anything I want, when I want, when I want it.

*Dr. Vonda Wright * (01:09:33) - I value that, well, if that's truly my value, then I need to create a vision, a plan for how I get there right? It takes knowing myself, knowing my values, weighing every decision I make against what I value. Right. Does skipping three weeks of working out get me? Am I being true to my values right? Who am I and what do I value? Once we examine that, we write it down. I want to do such and such. We have to make it actionable, just like a business plan. In this three months, this is what I want to accomplish. For us for a stepwise vision, but maybe we make a big vision. And then when you do that, write it down and talk to somebody who knows you, because it has to be realistic. You can say you want to climb Everest, you can say you want to do seven marathons and seven continents, but if you don't run, then that may be a 50 year goal, right? Bouncing it off for someone makes it more realistic.

*Dr. Vonda Wright * (01:10:39) - So you've got your vision. Creating a vision. A vision without action is just words on a page. So that's where you take your goal, your vision and your goals, and you break it down into actions like we just talked about. How how am I going to lift? How am I going to do cardio? Maybe I need to hire a trainer to teach me that stuff because I've never done it. But I'm going to do that because it feeds my vision. So those are the actions. The anti-inflammatory diet is an action. I go so far as to teach people how to make calendars. I have this giant racer calendar on my on my kitchen island. And that feeds into reward, which is the last step. But you have to make a plan, create a vision, take action against the plan. Number three is adjust your attitudes. It's the what are the excuses. You know, you're going to say what are the barriers to eliminate the barrier of I don't have any clothes to workout in or scrambling.

*Dr. Vonda Wright * (01:11:42) - I have a work bag. I have a workout bag, I have a hospital chart bag. I'm like the bag lady. But that keeps me. That keeps me organized. And I get it all to where it's going. It's also evaluating why you live the same six months of your life over and over again. Because if you've done this a few times, you know you're good at it for three weeks and then it drops off and you're back to not doing anything, maybe doing the work, the trauma work to say, where did I feel safe and why do I keep going back to that? Creating a vision, taking action. Notice these are all A's., looking at your attitudes that keep you from success. And then finally you assess after three months or so, you assess your progress and then your reward yourself. You deserve a reward. You know, I buy hot shoes., you deserve a reward. And then rinse and repeat.

Dr. Sarah Milken (01:12:41) - I know we give our kids rewards for things.

*Dr. Vonda Wright * (01:12:44) - Yeah.

*Dr. Vonda Wright * (01:12:44) - Give yourself a reward.

Dr. Sarah Milken (01:12:45) - So good. I could talk to you for, like, 15 hours. Because I love how you can combine research, real life, like just the pragmatics of it. And you just talk about the why part. Because sometimes, like we've said a million times today, it's you have the information but you're not doing it. So it's you obviously haven't really thought about what your why is, are you like in some people are probably like, well I don't want to like do that. It's too hard. That's too annoying. It's like impinging on my schedule or whatever. But if you're very clear on your why of I want to lift up my grandchildren, I don't want assistance when I'm older unless I have some kind of disease that requires it or whatever. It's very hard to take action when you don't understand the why part, and the psychology part is an essential piece to all of this.

*Dr. Vonda Wright * (01:13:42) - It is. All of us will like a river, choose the path of easiest resistance.

Dr. Sarah Milken (01:13:46) - Oh my God, I love the path of least resistance. I'm like, can. I'm like, can we just cozy up in that for a minute? As we wrap up, I want to remember in those scary stats of 50% of people who break a bone will not regain their pre-fall status.

*Dr. Vonda Wright * (01:14:07) - If you break your hip, you will not return to the way you live before 50% of the time, and up to 30% of us will die. Not on my watch.

Dr. Sarah Milken (01:14:17) - It's just crazy. And the other stat that you talked about too, was that 70% of all of this, like health banana stuff, can be impacted by lifestyle choices, while only 30% is genetic. So all of us who, like all of us, want to be like, oh, I can't do this happen because it's genetic. Or, you know, I'm diabetic because my mom was diabetic. Well, maybe you're just eating too much sugar. I mean, believe me, I'm guilty of it, too. So we do have agency in this.

*Dr. Vonda Wright * (01:14:53) - We do. And even if we do carry genes that predispose us to diseases, that is not the final chapter. Your lifestyle can influence how your genes express those diseases. You are not destined to die the death that you've seen around you. So it's a hopeful message. It is there that we can control more than we ever thought.

Dr. Sarah Milken (01:15:18) - Scary stats, hopeful message. And I think one other interesting point is having friends or people around you, or spouses who are doing the same shit helps. Believe me, when I want to sit on the sofa all weekend and I see my husband get up, get on the treadmill, sit in the sauna, blah blah blah blah blah. I'm like, okay, Sarah, get your ass up, you know? And then sometimes he'll see me, which is much more rare. Do it first. And he's like, oh shit, I gotta work out. Sarah worked out and it's not a competition. It's just kind of like, okay, everybody's doing this thing in this house, and we're going to kind of all be on the same page.

Dr. Sarah Milken (01:16:02) - Yeah, we're.

*Dr. Vonda Wright * (01:16:02) - We're, you know, we live in families.

Dr. Sarah Milken (01:16:04) - And so. Yeah. And it's like kind of evaluating who your peeps are and what they're doing, you know. So I love that. So one piece of advice for preventing frailty and chronic disease and increasing longevity.

*Dr. Vonda Wright * (01:16:19) - Lift. Heavy. Shit.

Dr. Sarah Milken (01:16:23) - So good. I love it. Okay. Where can people find you?

*Dr. Vonda Wright * (01:16:28) - So I prefer that you find me on Instagram at Dr. Van Der, right? That is where I am every single day. I do have a YouTube channel where I will be posting much more. I have a lot of videos right now, but I actually some workout videos for my previous books if you want to see what. But I'll look at your suggestion. Okay?

Dr. Sarah Milken (01:16:47) - Yeah, no, I want your workout and I'll post it. Okay. Spell Vonda right.

*Dr. Vonda Wright * (01:16:52) - V o n d a w r I g h t. So it's doctor Dr. Vonda. Write all one word.

Dr. Sarah Milken (01:17:05) - Perfect. I want everyone to start thinking about what they can start doing today.

Dr. Sarah Milken (01:17:09) - One small step to getting into lifting heavy weights and exercise in the mid life journey. I want to thank Vonda for saying yes and becoming a new friend of the Flexible Neurotic Podcast. Hey peeps, it's me again. I listen to this episode with double board-certified, orthopedic surgeon and an internationally recognized authority on active aging and longevity, Vonda Wright. Doctor Vonda Wright specializes in longevity, mobility, and all the things we care about in midlife and beyond. She has all the tips and tricks for us to create sustainable strength and endurance in midlife. And yes, it's a lot more than just lifting the dumb weights. Although she affirms that the thing she stands by more than anything else is lifting heavy shit. I know that when I listen to a long episode, I'm like, oh my God, I love that. But then I can't even fucking remember the specifics. This is why I come back and do a golden nugget. Summary. In this episode, we dig deep with our golden shit shovels in a conversation about the things we can control when it comes to midlife health and aging.

Dr. Sarah Milken (01:18:16) - Golden nugget number one being intentional about aging. I say this all the time, but life is not happening to us, and Vonda totally agrees. It may feel like that at times that all these changes are happening and it's all outside of our control. And don't get me wrong, some of them are and they feel really shitty. But we have agency and almost everything. This is something Vonda preaches to her audience, is about aging and being intentional about the role that you play in the process. Fonda said that we need to be active participants when it comes to making choices about our health. Maybe we didn't start thinking about this when we were 29 or 35, but it's not too late to be intentional now. Start today. Fonda says that we have more control in the aging process than we think. She said that there is a difference between healthspan and lifespan, and that we want our years to be healthy and positive versus in and out of the doctor's offices for 20 years, between 62 and 80. The goal is to be strong, active and joyful, not frail and dependent, not on her watch.

Dr. Sarah Milken (01:19:19) - So remember, there's nothing wrong with aging. Just be intentional about it and utilize your control. Golden nugget number two educate yourself. Fonda says that the first step in being more intentional about your role in aging is educating yourself and being the super nerd that I am. I love this as a first step. Of course, health care and advice isn't one size fits all because we're all dealing with different health issues and different stages of menopause, and this is so practical for every single one of us, she says. Start out by going out on a hunt to educate yourself, just like you would when you're preparing for anything. Utilize public research resources. Get really informed about what's going on in your body during this time of your life. Get in front of the data. Learn about women's health and hormones. You guys know that we never leave you hanging on this podcast and this is no different. Fonda gave me some amazing suggestions on where to start with your research, including a book called Estrogen Matters, by which she says, change your life.

Dr. Sarah Milken (01:20:21) - Don't worry about writing these things down. I have them linked in my show notes because we have to make things easy around here for the midlife brains, believe me. Golden nugget number three. What's stopping you? I know sometimes we listen to the podcast, we do the research, and then we're like, wait, now what? Fonda recognizes that sometimes we have emotional or subconscious blocks that prevent us from getting something done or showing up for ourselves in some way. Fonda suggests getting out of pad of paper and writing down every conceivable excuse you've ever had for not taking action to take care of yourself, she says. The key to getting over what's stopping you is realizing that it comes down to accepting and acknowledging the fact that you are worth the daily investment in your health, and you are important enough to make these changes. I love this mental reframe because it's so true, and at the end of the day, like everything else, it comes down to how am I going to make this happen for myself? And being a mom and a wife, it's more than just being about me.

Dr. Sarah Milken (01:21:21) - My family depends on me to show up for myself and to be happy and healthy. I love how inspirational and passionate Vonda is about health and self-responsibility. She said that no matter how long it takes, you do what you need to do. Golden nugget number four the action steps as promised, actionable steps that you can start doing today, starting with the dumb weights or as Vonda says, lifting heavy shit. Yep, you heard me. Wait wait wait wait wait. Let's learn to love them together, Vonda said. If there's one thing that she's going to do to work out that she knows will benefit her, the absolute most is lifting heavy shit. And she made a really good point about this, which is to remember why you are lifting the weights. It's not about being a bodybuilder, although some could be, but for her it's so that she can stay strong enough to pick herself up if she falls one day. It's about maintaining her independence and mobility as she ages. This one really hit home for me and I will absolutely be thinking about this next time I dread.

Dr. Sarah Milken (01:22:23) - The dumb but necessary. Wait. Okay, so what else? Aside from the wait, she stressed that we need an anti-inflammatory lifestyle and cardio. She says sprints specifically are sprints, which okay, I'm on the fence about two, but hey, I'll try it. She said that we should be working out three hours a week at 65% maximum heart rate, sprints two days a week, and lifting heavy weights. Of course. Talk to your doctor. Science shows that for women to build power and strength, they need to be lifting heavier weights for reps of 3 to 6, she said. Try three reps of £25 weights instead of 15 reps with £15 of weight. Experimenting with that is challenging when it comes to a diet and having an anti-inflammatory lifestyle, she says. You need lean protein. Count it one gram per pound of your body and leafy greens for fiber. Oh, I'm so bad at leafy greens. Fonda reiterates the importance of reading labels, knowing what you're putting into your body, giving up some sugar and being lighter on the alcohol.

Dr. Sarah Milken (01:23:28) - Okay, you guys, those are some heavy nuggets. The gold is dripping off these nuggets. Grab it, use it. There are three things you can do. First, subscribe to the podcast. Second, share it with some friends who like midlife shit. And third, write an Apple review. Writing reviews is kind of annoying. It's an extra step, but guess what? It helps the podcast grow. Okay, DM me. You know, I always respond. And of course follow my Instagram at the flexible neurotic duh. Love you talk soon.