How To Stay Strong, Healthy, and Fulfilled Like “Doc Thor” | Ever Onward - Ep. 51

Caleb , thanks for coming on . Man Pleasure Straight from the hospital .

Yeah , club sports are an entity all their own and just I was the same way like I played club hockey growing up and it was club just because it wasn't a school sponsored sport , but you just paid for your ice time and the ref time and your parents carted you around the state and you traveled because you had . Where'd you grow up ? In Wyoming , wyoming .

Where were you born ? I was born in Provo , utah . I never lived there . My dad was doing his training . He works for Williams , which is a big natural gas processing company , so he was doing training there . They had me and then they moved right to Wyoming , essentially , so I was born there what town ?

And it's the middle of winter and he's like there are these great big fish in there and , and I will remember , he had this little aluminum boat with like a 25 horsepower outboard and we'd go fishing , trolling for these lean cod in the middle of the winter . And I just remember sitting in that boat because he is a , you know , we got there .

We I can't remember what time we got there and got there in the dark and all day long and we didn't catch one fish . He showed me all these pictures and I just thought there's a point at which , like , I just would rather die . I'm so cold that it's , definitely , it's a .

A lot of people who have moved into town , who like outdoor activities , you know , mountain biking , skiing , hunting and fishing , those types of things , and I'm a sports medicine physician , so as a sports medicine doctor , you know those are sort of our bread and butter patients . And then the club sports that's exploded and getting bigger and bigger and it's busy .

Yeah , we see a lot of people and a lot of injury care and then a lot of performance enhancement and optimization . It's kind of like my niche and there are a lot of people who are interested in that . So from a physician standpoint , we're really busy .

And I think the biggest complaint that I think everybody has in town is it just takes too long to see a , you know , a doctor . It's a long wait and we're aware of that . We realize that it's definitely a problem , trying to do everything we can to fix it , but it it .

Just there's a lot of people that need to be seen and you know , I think , um , that's a good and a bad problem , right like it's job security , but at the same time , we feel that stress oh , yeah , yeah , how does it ever correct itself ?

One is just do you worry about burnout ? Because even I mean you think of all the specialties that there are in medicine . You are a sports medicine doctor , so in theory , you've picked the thing that you're around healthy people all the time , happy people all the time people to get better .

I mean you're not dredging in the ERs , like some of us schmucks do , but just the pressures of modern . I hear it from all my colleagues that were in medicine with me . They're just like I don't know man . It's just , it's different now . Talk about that .

But you're right , I did pick a profession that I enjoy , so there's passion there . I really like where I'm at . I can't really see myself being a doctor or doing anything else . So , that being said , when I , when I feel like you know , I talk to people about burnout , I don't look at it as burnout .

I look at it as being tired because I enjoy what I'm doing . And I look at the definition of burnout . There's a sense of , there's this lack of purpose , lack of autonomy , lack of drive .

He went so far as to say depression is a luxury . Like you , you know , he's like , and he brought up my dad , who's a hard-working blue-collar guy . He's like when was the last time your dad didn't go to work because he was sad ? And I was like never he goes . When was the last time your dad didn't go to work because he was tired ?

And I was like oh yeah , no , no , he just he always went . Like when was the last time your dad didn't show up ? Because he was , you know , he like brought these things up and he was like you know , burnout is a state of mind and he's like , you decide the state of your mind .

And yeah , of course there's certain levels of you know , the tissue breaks down . We get , you know , I get that , I recognize

that . But I think burnout really comes down to losing the joy in your work . And as long as the joy is there and you're able to manage being tired , I don't . I don't like . For me , I don't feel burned out Now . That being said , I definitely acknowledge the tired you know working .

I work in clinic five days a week and then I work walk in like urgent ortho , orthopedic , urgent care at least one weekend , if not two weekends a month .

And then I work nights , at least two or three nights a week I'm covering some sport and then at least one or two weekends a month I cover a sport and then I try to make it to my kids sports and then I try to do the things that are .

You know , I have other jobs outside of medicine with you know , social media and content creating and you know , sponsorship things that I do that are ancillary income . So I feel like I realistically probably work seven days a week but I don't mind that I . I sort of probably enjoy that in some ways .

But I recognize that the people that I work with and you know , the the majority of people that I work with don't really want to work seven days a week , 365 . They like breaks . They want to have some some change in the the scenery , and I definitely have . You know , we were joking as we were coming in .

I , I'm a blue collar guy with a white coat and I work like a blue collar guy that came from nothing and has something to prove .

And , uh , you know , I've been in practice for six , six , seven years and I still feel that way and I think that as long as I feel like my my work has purpose and that there is some benefit to it outside of just a paycheck , I feel okay with it .

And then all the other things that I do keep me busy and keep me out of trouble , as simple as that sounds . I have got pretty bad ADHD and if I sit still too much I get pretty bad anxiety . Truthfully , a dangerous place for me is on a beach with nothing to do . It causes me to be quite unrested and pretty agitated .

Nothing to do it causes me to be quite unrested and pretty agitated . So the more busy I am , the less there's time for the demons to get in my head and rattle me up . So I recognize that there are a lot of people who get burned out . I recognize that a lot of people feel tired and there's probably some crossover there .

But for me , as long as there's some purpose there , some mastery , some autonomy it's been written about that those things create a feeling of success for me . Seeing patients that are improving helps me to feel like , you know , if I wasn't here and helping this person , then their life's affected in a negative way .

The people that work with me I don't say for me , I say with me , because they're my team and you would know this as well as anyone If you don't have good nurses in the uh , in the ER , you're not going to do well Like you're just not going to do well .

So the team that I work with , I'm I'm definitely very aware of their level of being tired and everybody's is different and I don't want to overdo it for them . But for me I'm , I'm , I'm doing okay still Definitely work hard and definitely tired from time to time , and I'd acknowledge that . And for me to recharge it doesn't take much .

I go to the mountains and go hunting or go fishing , or I have a little ranch , I have some cows , I do a small cattle business . So going out to work with my hands helps me , doing things with my family helps me . So I think there's a way for me to recharge .

It doesn't take a week off , it just takes maybe a couple of hours and then I feel like I'm ready to go again . It's great .

I mean you think about , like , if you strip it down to that , like someone's got a problem and they don't know how to fix it and they need , they need a physician to help them or heal them , um , and it's such , there's nothing like it and I mean it's just such a privilege . I mean .

I think , I truly mean that I think most of the people that I knew , associated with for years , you know decades of my life , they felt the same . They felt the same kind of honor and privilege . It is gratitude for just being able to wake up every morning , go to work and take care of people , and I think that will always be the essence of health care .

I think what happened to health care in my time and is the , the , the bureaucracy and business and interactions just are mind-numbing in today's world .

And and um , thank heavens that you still have the good part of it right , there's still patient care and it still motivates you and you still walk away every day saying , man , I had some , I had wonderful interactions and I got to take care of patients , the sacred privilege , because the rest of it's it's changed Right .

You're a lifelong learner as a doctor . You constantly reading , like that's exciting , you know it's , it's challenging in a good way . But it's those other things you're talking about , like the . You know the fights and the struggles with insurance and the fights and the struggles with an administration .

Or you know gosh , the chart notes , and I mean litigation and surveys and complaints and all the things that , like , you know it's all that other stuff that makes it more difficult . My dad used to joke . My dad's definitely like my dad is one of the coolest like blue-collar guys .

He's got a book full of quotes and he always talks about like when he's he got out of cattle business , cause my grandpa was a it was a cattle hand , my dad was an oil guy , so he's , you know , moving up breaking these chains of bondage from the cowboying days and stuff , and so when I , I was the first one to get a bachelor's degree in my family , and

when I went to school , my dad he was like you know , just remember that with cows you always win . And I didn't , you know .

And I grew up cowboying and working in drilling and I worked on rigs for a lot of years too , and like now that I've got my own kind of life and some hobby cow business on the side , I recognize that the value in that was , even though he got out of the cattle business too , he realized that there were days where the paperwork was killing him .

For him it was working with engineers that like they're telling him that it's supposed to be built like this and he's telling him it doesn't work like that . Like come and put the wrench on the nut and I'll show you .

Like you can't do it because the engineers are like , well , on paper , I don't care what it says on paper , come put it on , you know what I mean . And then for us it's the same thing .

It's like well , we need you to see this many patients , or we need you to do it in this amount of time , or we need you to get these things done before you order that MRI . I say , hey , listen , I hear you , but that's not how it works . Yeah , like come , that saying comes from the cows . You always win . Like you can't argue with that .

Like eventually you're going to get them into the next pasture , eventually they're going to get fed . Eventually you're going to get them in the trailer , eventually you're going to get slaughtered . Eventually you're going to put them in a package . Eventually , like at some point with cows , you it may fight , at some point you're going to win .

I also—I'm really connecting with you right now because I think of my life now and what I enjoy more than almost anything is going out and taking care of the cows , doing those simple things . There's always something to do . It's so good for me , it's so , in fact it's . You know we go up to McCall , to the ranch , and that there's always work to do .

And it's fun work and I enjoy it . I'm outside and I'm with my dogs and I'm not thinking about anything . I don't care where my phone is . I don't even check an email and for me , if I go on vacation , like to Hawaii or somewhere like that , it's like I'm a wreck .

Uh , a lot of advances , a lot of treatment , and you get to be part of the performance side of it too , and that's got to be exciting because you're around healthy people that are trying to improve their physiology and those sort of things , and what advances have you seen .

And it's an exciting time to be , you know , I think we started kind of with the hey , I just got off work , I'm tired , I'm dragging ass coming in here to now like , hey , there's great things going on , right .

We use that term , of course , in medicine , but the vast majority of orthopedic complaints are non-surgical and you know , finding treatment for people that is successful , that doesn't require a surgical intervention , is remarkable .

Getting people back to doing the things that they want to do , or getting them to a higher level of doing the things they like to do , is is very , it's very um enriching , and so I think orthobiologics is a field where we're seeing advances and um improvements in outcomes , which is really exciting .

Um , I think , a lot of to understanding I'm I'm really happy to see that um , strength and conditioning is and and improving body composition is being looked at more as a medical treatment . Now , yeah , it's more common um and it's more accepted , I think , in the in the public's view .

Uh , 20 , I mean , I've been , I've been working as a personal trainer , writing diets for people and exercise programs since like 2002 . So I've done that for a long time and I always used that , incorporated that in my practice along through medical school and residency . I was always the guy in the back that's like , well , hey , what about if they get stronger ?

Like , would their knee pain get better if they got a better quad VMO activation ? Or hey , what about if they get stronger ? Like , would their knee pain get better if they got a better quad vmo activation ? Or hey , what about if their hip , if they're oh hey , what about if they got their glute needs stronger ? Would they get better ?

Like you know , I was always that guy that was the professors where I was like , here's the meathead again talking about lifting weights . But but really now we see that , gosh , that actually is a huge component . Like we can prevent significant orthopedic concerns as well as metabolic and health concerns .

Lifespan improves and healthspan improves with , you know , improving conditioning and um and improving body composition , like reducing body fat , improving skeletal muscle it's , it's the silver bullet and you know , there people have known that a long time but it's becoming accepted that . Oh yeah , it's not just the doctor harping on me to lift weights .

I actually think this is a good idea . It's becoming common knowledge . So , as a sports medicine provider , being able to use exercise and nutrition as medicine is really exciting to me , because that's a .

That's another passion for me , and being able to incorporate that to where you know , even if it's someone who's never exercised before , we're helping them so that they're learning how to exercise and eat differently versus someone who's really good at exercise .

I mean , like a big part of my practice with sports performance is helping professional , semi-professional , collegiate olympic athletes improve . In what ways can they improve ? And it's really exciting to do that as well . Like that's .

I mean that's like if you , if you were going to compare that to like mechanics , that's like someone who works on uh , you know the , the , the jalopies , the . I don't want to like honda civic right versus a ferrari . You know what I mean .

Like that , of course , you need to work on the Honda Civics because that's what keeps America running is all those cars that have great gas mileage and stuff . But once in a while you get to work on a race car and that's really fun and exciting .

warrior . Want to be healthy , want longevity in your life , want to be healthy and and live long and enjoy your things . What are the things you're telling your patients right now ?

I mean ground level fall , the hip fracture leads to all cause mortality , right . So if we can improve your skeletal muscle and your bone density , that's what we need to work on right now .

And if you're 40 or 50 and you have a sport you like you know you like golf , pick a ball , whatever tennis , it doesn't matter what it is like let's , let's get you to the point where you can do those things more frequently with less pain , right .

So , less of the idc type pain , and a big part of it is just making really simple small changes with people and then just keeping them accountable isn't so much of a consistency , totally like , like , go go through like , so we're . Honda Civic . Yeah , sticking on Honda Civic Honda .

Yeah , what does their exercise program look like to really make a change in their life ?

I mean , did you brush your teeth today ? Yeah , why ? Well , it's just part of my routine . I want my teeth to last me a lifetime . Right , like well , you look at it like that , then ? I mean , people used to ask me in the gym like man , how do you stay motivated to work out through residency ? It's like I don't .

I'm usually full of answers not all of them , right , I had no answer . I was like I don don't know . Nothing really motivates me . What inspires me is seeing some 50 year old guy that's overweight , that's come into the gym two or three times a week Cause he wants to be healthy and be around for his grandkids , like that . You know how hard that is that .

You know how difficult that is for that guy to show up here in the morning going to work 12 hour shift driving a FedEx truck , and he's going to come in here in the because he wants to be able to be around for his grandkids . You know how hard that is . This guy never worked out before right With a Honda Civic .

If you put oil in the machine , you fill it up with gas , you put tires on it and if you drive it like a reasonable human , it's going to last you a long time , right . Same thing if we're in our 40s .

I mean , if you just take care of it and maintain it , if you stay ready , you don't have to get ready Right and so with with someone who's like in that timeframe , by the way , that your thirties or thirties and forties were probably the most influential , and most 30 and four year olds don't realize this .

This is a whole nother lecture that I give people but , like in your thirties and forties , you don't realize how pivotal and quintessential that decade of life is to set you up for the next 30 . You really have like people have no idea how important it is , Cause they usually gain 10 or 15 pounds in their twenties .

And then how can we alter that in a way that isn't catastrophic Usually does not need to be a catastrophic change . It can be very simple . Like you know , stop drinking your calories , right , drink water instead of , or drink a calorie free . You know these are the foods you really like . Let's just eat a little bit less of those things Like .

You can still have spaghetti meatballs . Just eat a little bit less . You drive by three gyms on your way to work . Would it ? Would it kill you to get up an hour earlier , or maybe leave work a little bit earlier or maybe sneak in there ? You know what I mean .

Like there's options , right , and so I'll tell people too , like , even if they've got a desk job or something , it's like , well , hey , can you stand up and walk for 90 seconds ?

Usually people , even I mean , I'm busy , like my job is like , but I can spare 90 seconds to walk up and down the hall and if you do that 10 times , like all of a sudden you're adding steps , adding minutes and you're exercising throughout the day .

You can be pretty effective if you stretch like let's talk about stretching , stretch and and get some cardio and some weight training in . It's not a lot of time every day .

Most people see dramatic changes If you go from , like Honda Civic .

If you can do , if humans can change a pattern and maintain that pattern for three months , they start to notice a big change . Maybe not the rest of the world , but if they're able to do that for six months , then you know people that they know really well are going to notice there's been a difference .

If they do it for a year , they're a completely different person . Cellular level , everything changes mitochondria , red blood cells , white bloods all of it changes right within a year and so you can be a completely different person in a year . The hard part for people it's not complicated , it's just difficult to do .

The science is not complicated , it's very simple , right ? The equation is very simple , the biochemistry is very simple , even though metabolism would take up this entire wall Calories in , calories out , and then macronutrients , micronutrients and then output , and lean muscle mass is the metabolic organ that we're really focusing on .

So increasing lean muscle mass , appropriate intake , consistent time frame it really isn't complicated , but it is really hard to do for most people and I think that , having some very simple , achievable goals , you can't set the bar so high that you walk in on day one and you're like , well , I am never going to climb to the top of that mountain , not going to

even try , like that . It just shuts people down . So if you , if you're like , well , how about today , at our 15 minute break , maybe we don't have a cigarette , maybe instead we just have a conversation , don't smoke . And tomorrow , instead of having three Pepsis at lunch , maybe we just have one .

And then , a year from now , you're drinking water and you're not smoking and you're exercising and live a longer half of your life .

Testosterone levels are lower than ever historically , Cortisol levels are higher than ever , Sleep's worse than it's ever been . I mean , you start going down all the trends that we have in america . And then you look at just the obesity rates in america and comorbidities that are happening in america , and and then so there's all that .

And then just go to like , well , why would we be having more anxiety , depression than ever before ? And you're like , well , I don't know ?

I mean because people do , they use , they use food as a way to deal with their stress and anxieties and that's it's not an appropriate method , but it is quite common . Exercise changes your brains , you .

You have a pharmacy floating around in your body and people may not realize this , but as you exercise you release hormones and endorphins that change your brain chemistry the same way that a tylenol would or an aspirin would or an antibiotic .

I mean it changes your chemistry , your neurochemistry , and those , those chemical changes that occur have a dramatic effect upon the way you feel and , as you mentioned , cortisol levels , stress hormones , neurotransmitters , which are responsible for a lot , lot of the function , the functions of your body , and homeostasis and how it all works .

But exercise pretty much plays a role in every human system . I mean everything from your skin . I mean , even if you start exercising and you have difficulties with inflammation in your skin , I mean , I've got a good friend who's a dermatologist .

I've talked about this with him a lot like how exercise improves your skin , and that doesn't seem like something that would come up in Chapter 1 of dermatology , but it probably should , because it's something we have , all of us have access to .

Not all of us have access to the medications that might make your skin clean and healthy , right , but we can all exercise and it does . It has a direct effect upon your cells and your skin and can clear up inflammatory responses that occur in your skin , and I've seen that happen with patients too . It's remarkable .

So if you're looking at one tool , one lever that you can pull to improve mental health , that pretty much we have data that supports its use for everybody . It's exercise . I mean , it works on your neurochemistry , it works on your mood , it works in a plethora of other ways that are .

You know , the science is really incredible and it's exciting , but it's also really simple . You know , just get your heart rate up and keep it up and do some resistance training , release some endorphins , release some chemicals , change , change your hormone levels and feel better . I mean it's , it really does work . That's powerful stuff , okay .

Comparison will rob you of happiness and you know , if you're a civic , don't compare yourself to a ferrari and remind yourself that civics do just fine . Yeah , it's interesting like you'll find things , sometimes big things , that can be improved upon with the Ferraris , the pro and the higher level athletes , and it's often the same component . We're humans .

We have one heart , two lungs , 10 fingers , 10 toes , right Like you've all got . For the most part , we're all built the same , but we're all built different , and I mean that in the most as simple as that sounded , it was incredibly profound that you just have one heart beating in you , just like everybody else . So if it's possible , it's possible .

It doesn't matter where you start from , but the Ferraris . Usually you have to dig a little bit deeper to find the key to making this car faster . How do we make this person more effective ? How can we help them with improving their rest and recovering their sleep ? How do we help them with their mental health ? How do we help them improve muscle .

They're already quite big and quite strong or quite lean and quite fast . Like , how do we improve upon that ? And it's not . It's interesting because you know the the term asymptote right . Like this continual improvement but not a lot of change on the on the x-axis .

They get to this point where , like super trained athletes , will feel like they're they're not really improving anymore . They've just met this plateau . But they really are . It's just it's such a small increment that it's hard for them to notice it . So a lot of times what we're doing is showing them like , hey , you are improving and here's how you're improving .

And like sometimes they're data driven , sometimes you know , sometimes it's not . It's like having them step back and look and say , oh , you're right , I , I do feel like I'm I'm doing okay in these aspects , and then you know it's interesting too , it's it's fun to find ways for them to get you know to build strength .

The human body is a phenomenal machine . Oh my gosh , it's so exciting to to watch it , watch it work at its highest level and and honestly , I'm just enamored by performance . For someone who's a fifth grade kid that just learns how to swing a bat , it's like man . Did you see how that kid swung the bat and hit the ball .

It takes so many motor neurons firing on the same way for him to do that . It's just as exciting as watching someone hit their 50th home run in the season or whatever . It's still just powerful to see . But I love working with those high-level athletes because it causes me to work a little bit harder too . I have to dig a little bit deeper .

I have to find new , unique ways to improve upon where they're at , and that's fun and exciting . That's cool .

The hard part is like if you call in and I work for you know a big hospital system and you're on hold for a long time , I would just say don't give up , stay , stay on the phone don't give up . Don't give up like don't give up , like stay on there till you get what you need , like don't take no for an answer , kind of a thing .

Um , you know , it's funny , people reach out in a lot of ways now that they didn't used to social media , being one of them , and I have a hard time there because I can't legally , like really communicate with people through social media . It's not a safe way for that , you know , for lots of reasons .

But people reach out through social media all the time to get appointments and things like that . But you know , people get on online and they they can request a consultation and we're we try to do our best to get people in . We're probably only really booked out maybe three or four weeks from a , you know , a new patient evaluation .

But , um , the hard part is like the type of evaluation , the time frame . People often will call and be like , well , I want to be seen on a tuesday at three o'clock , and it's like , well , yeah , you know how , about a wednesday morning at 8 am ? No , I can't do mornings . It's like , and that's you know how , about a Wednesday morning at 8 am ?

No , I can't do mornings . And that's sometimes what pushes people out a little further is like their availability .

Talk about how that fits into your life and content and all that .

The same way you would start working at trying to get into college or going to a new job or something like that yeah , dude , look at that . Oh man , a couple of magazines I didn't . You know what's funny ? All those things that I do on social media , too , are it's just learning the process and understanding .

I looked at it like I was trying to learn calculus social media . I thought that , going on the titan games being on tv , I was expecting this mass expansion social media . I might have gained 500 followers after that so you know , dustin portella yeah , I do okay . Yeah , he's done it .

In med school they told us get rid of all social media right . So I canceled , deleted everything , and then in residency they were like , no , it's okay if you have social media . So I started a social media account , got on the Titan Games shortly after , thought it was going to blow up . It didn't .

I was like man , I thought they were going to help us , like that was the trade here , but it didn't . It really got big when I started learning . I started learning the process and using social media like a tool , just like I was learning calculus and once I learned how to improve it . Now now I understand how to continue to make it grow .

But it is a lucrative . It is a lucrative business tool and it is also something that my perception of social media is that it can be so terrible that and everyone has it that I want to create , at least in some ways , some positivity out there .

The the bigger your social media following is , the more there are people who say mean things . And uh , and you know , and I've had people get jobs , like I had a guy in Canada get a job using my name and credentials from a picture off of social media . He made fake ids and stuff and I got called by this company like hey , are you coming to work today ?

I was like , what are you talking about ? And so like there are weird things like that that happen through social media that I had no idea it was even going to be a thing and I used dr pertella as a reference often to be like , hey , man , what do you do in this situation ? You know , and he was like , oh , yeah , anyway , so that's been cool .

But social media is a great way for me to connect with people and and to create . Um , I think I do two things I try to make people laugh , create positivity , and then I slip education in there . If you just did education , it's it . It like I did that for a long time and I would get you know , nobody sees it .

Yeah , you , yeah , you got to do it all . You got to do it all , yeah .

That dodge is remarkable . I started working with boone um . It was really interesting . He was training at the gym just shortly after his incident and I was like , hey , man , like he was trying to do a tricep press down and he couldn't quite get to the rope to change it .

And I was like you know , I knew enough about , uh , adaptive athletes to know that he doesn't want someone to help him . He wants to do this on his own . It's important for him to learn how to do this . But at the same time , I was like , hey , the real goal is for you to make those triceps bigger and tougher , isn't it ?

So , yeah , I'm like so what if I create an opportunity for that to occur by moving this down for you ? And he goes that's fair deal , so I'll take that deal . It's like all right , and that's how it started .

And then , from there , I was like , hey , you need to get , uh , you need to get stronger , and you can't do it here .

And so I had him come work out with me at the mecca gym for a few years , like we worked together , like I would train with him two or three times a week , and then from there it became like he needed help from a physician standpoint with other things , and so I would see him as a patient . But I didn't know it started that way .

I don't want to sound boastful , but I'm pretty stout and there would be days where I'd be training with Boone and I'd be like holy crap , this kid just not only did he stand up out of this wheelchair to do what we're doing , and the weight maybe isn't the same , but he's making me work , and like I'm supposed to be training him .

And like there'd be days where I'd just be like you good , hoping he'd say yes so that we could quit , because that kid , yeah , does not understand quit .

And and that's one of them like that's like uh , that's an inspiration to me is watching someone overcome adversity , make adaptations and modifications in their life to be successful , and do it with a positive attitude . And he'll , he won't lie to you until he never gets sad or gets down to the dumps . He does just like all the rest of us so great .