Reversing the aging process with neuroplasticity [PODCAST]

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Join orthopedic surgeon Michael Day as he shares his insights on how to reverse the acceleration of aging through lifestyle, habits, and even thoughts. Michael explains the role of neuroplasticity in enhancing the performance of our bodies and how embracing novelty and learning can form new neurologic connections. He also shares tips on how to ward off accelerated aging through exercise, healthy eating, and good sleep habits. Discover how to tap into your untapped potential and redefine what’s possible for you at any age.

Michael Day is an orthopedic surgeon.

He shares his story and discusses his KevinMD article, “The key to reversing the aging process.”

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Get CME for this episode by clicking on the CME link in show notes. Today we welcome back Michael Day. He’s an orthopedic surgeon. His KevinMD article is titled “The key to reversing the aging process.” Michael, welcome back to the show.

Michael Day: Thanks for having me.

Kevin Pho: So we’ll get to the article in a little bit, but for those who didn’t listen to our first episode together, just briefly share your story and journey to where you are today.

Michael Day: So I’m an orthopedic surgeon, and my subspecialty is sports medicine. Last time we were talking about opioid-free surgery, which is a journey that I’ve been on in my practice over the last couple of years. By way of update, I can tell you that with ACL reconstruction for patients under 25, we have not prescribed an opioid in two years, including no rescue prescriptions for any patient. That’s among the young patients who have undergone ACL surgery.

Kevin Pho: Excellent. And just a follow-up to that update: Any complications? Was it what you expected? Were you surprised at the result?

Michael Day: I was a little bit surprised. I thought that there would be some rescue prescriptions. I thought, with the variety, that at least there would be some breakthrough need for opioids, but there really wasn’t, which really led me to question the need for them in that context at all.

In terms of adverse things, we had a couple of patients that didn’t tolerate gabapentin. We had one allergic reaction to gabapentin, and some pain control that I would describe as moderate, where a patient was maybe having 6 out of 10 pain, maybe having a little more pain than we would want. We wanted it to be topping out around 4 out of 10, maybe, but that patient really wanted to kind of tough it out without the opioids.

The one other surprise was how enthusiastic parents were about avoiding opioids. I thought naturally they would want to avoid pain for their kids, and so I thought they would want just the most potent painkillers, but they were really enthusiastic about avoiding it. So I didn’t really have to sell it to parents.

Kevin Pho: So what’s the next step in your studies in this area?

Michael Day: I think the next step is to see if it affects functional outcome and re-rupture rate. If a patient is having poor pain control, that can certainly impact their ability to do high-quality rehabilitation. So if they’re not doing high-quality rehab, for whatever reason, it could affect their ability to protect their ACL graft. So I think if we can get longer-term follow-up on some of these patients, we may see differences in re-rupture rates. That said, re-rupture rates are low, so it might require a lot to detect any difference, if there is one.

Kevin Pho: All right, so let’s talk about your most recent KevinMD article, “The key to reversing the aging process.” So tell us, how did the article come together?

Michael Day: Well, I’ve recently entered my 40s, and traditionally we think about that as being over the hill, an age of decline, and that’s not exciting for anyone that enters that period of life. So again, questioning norms and what’s kind of accepted or received wisdom led me to think about performance at an older age. Each day that we perform, we’re at an older chronologic age than our previous age. But just thinking about performance, whether it’s athletics, in the operating room, or as a parent, which I’ve been for less than 40 years, I was thinking about how we can improve that, and how the chronologic number doesn’t have to be a steady indicator of decline, and that we can always improve.

And that mostly comes down to what’s inside the brain and mind, and not thinking of those two as separate things, but as a unified entity that can change over time. And that’s how we can, not defeat age-related decline, but kind of slow down the acceleration, if you will.

Kevin Pho: So I just turned 50, so I’m certainly interested in hearing what kind of techniques I can use to help reverse that aging process. You introduced the concept of neuroplasticity, which is what you were alluding to earlier. So tell us more about that.

Michael Day: Yeah, I remember going off to college when I was 18, and one of my Latin teachers in high school telling me to really take advantage of the college process, and telling me, “This is the smartest that you are going to be, and your ability to hold information and process and critically think is never going to be higher than when you’re in college.” And for me, that was 18 to 22.

And that was, I think, the accepted neurology at the time, from my outside understanding of that field: We thought that intelligence was static, and after a certain point, that learning or intellectual capacity was highest when the brain was sharpest, in this period of youth, and that it declined until death.

And my understanding of the neurophysiology field now is that that’s been completely refuted, and that we can change the neurochemistry of our brains. We can form new synaptic connections between the neurons, and those new connections can be formed even into late senescence. So that is the basis for continuing to grow even after we stop physically growing our bodies. We can physically change our mind, because a new experience, a new thought, a new learning creates a physically new connection between cells.

Kevin Pho: So what are some examples of things that we can do to establish what you just talked about?

Michael Day: Well, in medicine we always talk about lifelong learning, and so it’s easy for us to buy into that. But we often get into the tunnel vision of our field, or medicine in general, and we think about limited opportunities for learning, like, I’m doing my continuing medical education, or I’m trying to keep up with the journals. But there are so many more opportunities for learning outside of our own field.

Probably the easiest example to think of would be learning a language, an instrument, or some sort of psychomotor skill, because that really challenges the brain to form those new synaptic connections. Or using your non-dominant hand for something that you would otherwise use your dominant hand for, like eating or brushing your teeth. Another one would be just exploring a new area, so walking somewhere you haven’t walked before, or taking a different route to a place that you normally go. Those are some kind of everyday things that you can do. If it’s something like just taking a different route home from work, that requires no investment. If it’s something like learning a foreign language, that may require a lot of investment, change in routine and habits, and significant time, but it can be worthwhile over and above just learning the language.

As someone who studied Latin and Greek in my undergraduate and graduate education, I’ve always been a proponent of the benefits that are not just in the narrow lane of the field of study. People in medicine are always asking me, “What was the point of learning Latin, other than for learning the anatomy names?” I think that learning a skill gives you so many other benefits, from critical thinking and analysis to just the ability to learn. Learning something enables you to practice at learning. So in our constantly changing, evolving field and times, learning is a superpower.

Kevin Pho: So you make that connection between learning a new skill, a new language, or just something new, and building these new synapses, and having that lead to physical improvement in our bodies. What would be an example of that?

Michael Day: Well, there are some pretty remarkable examples of studies where people have looked at people that, for example, visualize athletic training. Visualization is something that, in sports and in surgery as well, has been used by athletes and surgeons to create a success in their mind before creating a physical success on the field or in surgery.

And from a scientific validation standpoint, you look at studies where they’ll have people visualize training a muscle, for example by lifting up a weight, and just visualizing will result in some muscle cell hypertrophy, as confirmed by biopsy. Now, it’s not as much as if you visualize it and then go pick the weight up and train the muscle physically, but it’s that added mental dimension that gives an added edge to the performance. Or if you’re unable to train or injured, there are stories of Olympic athletes that get hurt in the run-up to the Olympics, and they couldn’t train, so they just visualized the training and then healed from their injury. And so they missed all this training, but they were still able to perform on the day. Things like that.

Kevin Pho: So tell us, what are some specific things that you are doing to help build your own neuroplasticity?

Michael Day: Well, I try at the beginning of each day to do some study of foreign language. As a classics major, I spent a lot of time studying the Romans, the ancient Romans, and studied Italian when I was in undergraduate and graduate school. So I have resumed my Italian training, and I do a little bit each morning. But I’ve tried to increase my accountability to myself, and my commitment to it, by hiring an Italian tutor, so once a week I meet with an Italian tutor for an Italian conversation lesson.

And on the athletic side, it’s been not just learning. I’ve been learning about deliberate cold exposure, and then also working on my neurology by exposing myself to cold. So I’ve got an ice barrel on my back patio now, and I’ve been plunging myself in there for as long as I can tolerate. That’s really working on the autonomic nervous system too, but also the mental experience of just doing something that’s uncomfortable.

Kevin Pho: How about nutrition? We always hear about things that we could change in our diet, nutrition-wise, to help reverse that aging process. Any tips from a nutrition standpoint?

Michael Day: I think so. There’s obviously a lot of discussion on dietary frameworks, different ideologies around diet, and I think if any of those works for anyone, and they get results with it, that’s great, and so I wouldn’t want to necessarily debate that. But I think that a whole-food diet is something I would advocate for in general: eating things that are as close to nature as possible, things that you can make in your own home, things that are not processed, so avoidance of processed foods in general.

And then, as much as we don’t want to hear it, the avoidance of sugar, because I think that is just more harmful than we give it credit for. We all, at least in medicine, know the connection with type 2 diabetes, but it’s really the amounts of sugar that can be safely consumed that I think we should begin to question, even for people that are normoglycemic, and the stress that we’re putting on our system by ingesting the amount of sugar that the average American does. Even for a non-diabetic, it may be harmful.

And when I think about neuroplasticity, to go back to that, what we’re making those new neurons of, and what we’re making any cell in our body of, is ultimately something that we breathed in, ate, or drank. And so that’s helpful to keep in mind when we’re making our dietary choices.

Kevin Pho: We’re talking to Michael Day. He’s an orthopedic surgeon. His KevinMD article is titled “The key to reversing the aging process.” Michael, for those listening to you and being introduced to that concept of neuroplasticity, what would you say is the one thing that you can recommend right off the bat that most people can do?

Michael Day: One thing that most people can do right off the bat would be to identify something that they are learning about that is not directly related to their job or obligations. You can even keep a to-learn list and have more than one thing, but just have one thing that you’re focusing on and that you’re learning about. And so that doesn’t take much.

I try to keep one thing that’s top of mind that I’m learning about. So when I’m planning out my week, I’ll write at the top what I’m learning about this week, what I’m focusing on. And then that can kind of keep your mind focused a little bit when you have free time and you might be wandering or straying. Then you think back to what you’re learning about, and it gives you something to move forward. And that can be a way to keep our learning focused, for those of us that are not students, that are not specifically in a learning mode of our life.

Kevin Pho: And my final question, Michael: Tell us some of your take-home messages to the KevinMD audience.

Michael Day: Take-home message: I would say never think that you’re done learning. Always be open to new ideas. Anytime you meet somebody, be open to what you can learn from them, and don’t be enticed into thinking that because of your role or their role, or their background or status, you can’t learn something from someone that you’re interacting with. And lastly would be to question what you already know. Where did it come from? How do you know it? And is it something that holds up and stands true, or something that you need to question the validity of?

Kevin Pho: Michael, thank you so much for coming back on the show, sharing your time and insight.

Michael Day: Thanks for having me.

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