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Scot: What are you doing over there with that laptop open and your hands on the keyboard?

Troy: He's taking notes.

Scot: Yeah.

Troy: He's watching the master.

Scot: I let this guy . . .

Troy: First, warm up the participant with some fake laughter. Put the interviewee at ease.

Scot: That's right. Help them feel very confident in their sense of humor.

Troy: By using your fake laugh.

Scot: Today, we're going to talk about building resilience. What that basically means is being able to manage your stress. You've got to do something about stress, not only for just general health because being stressed out can affect your physical health, but stress can also lead to suicide, which is the second cause of death for men 25 to 35 years old. So it's really important that you know how to deal with it, and if you're not able to deal with it, what you should do at that point.

And we brought in an expert. Nick Galli is a health coach and assistant professor of health, kinesiology, and recreation in the Department of ÑÇÖÞ×ÔοÊÓƵ at ÑÇÖÞ×ÔοÊÓƵ of Utah. He works with really high-level athletes, helping them deal with stress. We're hoping maybe he can help us deal with some stress as well. He also teaches classes on health behavior change.

 

Scot: So, first of all, Troy, Dr. Troy Madsen, how do you manage your stress? I'd imagine your job can be really stressful.

Troy: It can be. There's no doubt about it. Yeah. And it's something that you take home with you, and that's the hard thing about it. So I think I find that there are certain stressors just with life, whether it's work or family or personal issues, and then there are certain stressors that are task-related where you have a certain task you have to complete and that just seems overwhelming.

So I find with tasks just breaking it down into something more manageable, but just with the stress of life, having a period every day that's meditative, whatever that is for you. For me, it's running. I run every day, 30 minutes. That's my time. It's not unusual. I have something that just weighing on my mind beforehand. I get out, I run. I'm able to think through it and say, "Okay. This isn't a big deal. It's not worth worrying about. There's nothing I can do about it." Or I say, "Okay. This is how I'm going to approach it." And that seems to work for me.

I'm certainly no expert with stress. Like you said, Scot, it's something I struggle with that keeps me up at night sometimes, but that seems to work.

Scot: Yeah. Physical activity is a way of dealing with stress.

Troy: It is.

Scot: That is interesting. Yeah. Actually, they say that it's one of the better ways. Nick, how about you? How do you deal with stress? You have a new ÑÇÖÞ×ÔοÊÓƵ, you have a couple of kids, you've got a family, you've got a full plate at work.

Nick: Lots of new stressors. Good stress, though.

Scot: Yeah.

Nick: So I think I try to have a mix of what I would call structured set-aside stress management activities. But I also think . . . and this is something that when I work with clients, sometimes, just like with exercise and eating, it's a lot to think about doing something new or separate. Even if it's for stress management, that can be stressful. So it's a mix of maybe one or two structured things that you do, but also something that you can be doing as you walk through life. As you're doing the stressful things, just a different way of approaching them.

So, for me, it's, it's exercise. If I don't get the exercise that I need in a week, I'm definitely grumpier. I don't have as many good ideas. I'm just a worse person if I don't exercise. And then I'm a reader and I do . . . there are some Netflix shows that I'm drawn to. So even though I've got the kids and sometimes bedtime is late, I always make sure I have an hour at the end of the day to either veg out and watch a show or do some reading, or both.

So those are my structure, but then I've really taken to this idea of self-compassion. And that was put forth by a psychologist named Kristin Neff, who wrote a really good book about it.

And this is what's helped me more in my day-to-day, is that when I'm feeling stressed or overwhelmed, first being mindful of that. And maybe we'll talk about mindfulness and just being aware of it, being with it.

Second, recognizing that there are millions of more people like me dealing with similar things or worse and it's just life and I'm not alone. I know that at least with what I go through.

And then third, just making sure that, and this is something that I try to practice what I preach with my clients, having good conversations with yourself. And what I mean by that is being productive in how you talk to yourself, thinking about how you would want other people to talk to you during those times. So that's how I've tried to integrate stress management into my life.

Scot: I took a class with Nick. Well, he was my instructor. I didn't take it with him. There was an exercise. I love this exercise about this talk. I just want to just pull this out a little bit.

He asked us to think about a time we screwed up, like really, really bad, and then think about what we said to ourselves in our brain. "So stupid. How could you let . . ." And then we had to turn to our partner and say that out loud to them at scale that we said it to ourselves. I couldn't do it, which really highlighted how terrible we can be to ourselves in a way that we're not to other people. So that was very paradigm changing for me.

Troy: And that's a great point you made too. Like you said, recognizing that you're doing all right. There are a lot of people that are a whole lot worse off than you. You're doing okay. And having those positive conversations with yourself. Yeah, I think we all tend to beat ourselves up and we all are very hard on ourselves and that's an interesting thought to say that out loud what we actually say to ourselves.

Scot: Yeah. I'm kind of lame the way I deal with stress. I really don't talk to anybody, which I've heard is one way to deal with stress. But I grew up on a ranch in South Dakota. We didn't talk to each other about our feelings. Come on.

Troy: Come on now. No, he would never do that.

Scot: We didn't have them. I don't know. I think some mindfulness later in my life has come into play, just trying to go, "All right. I'm feeling stressed. What's causing this emotion right now? What's going on?" And then realizing, "Well, it's this presentation I have coming up." And then maybe just walking myself through it. "Well, I've done it before. What's the worst thing that's going to happen if I . . ." And then I eventually get to the point where, "Well, if I prepare for it, I'll be fine." So then I can work through what's stressing me out.

So I'm glad that you brought the mindfulness up because I guess I forgot that I did that. And exercise, too, for me. But I'm lucky in respect that I think that there's . . . again, it's very individual. Some people, they're going to be people that experience a lot more stress. My wife and I don't have kids. I don't really have any close family to speak of, so I don't have a grandparent that has Alzheimer's stressing me out. There are a lot of times that just because of who you are, you've got a lot of things coming at you. So it's really easy for me to say, "I don't get stressed out." Well, I don't really have a lot of stressors in my life.

So, for somebody who might have a lot of stressors in their life or they're having a hard time dealing with something, what advice do you give them? What are some tools?

Nick: Yeah. Putting it in perspective, in many cases, the things that stress us out . . . I mean, you just listed several that I could argue these are some of the most wonderful things that . . . maybe not having a parent with Alzheimer's, but having kids and being around . . . Family is a source of stress, but it can also be a very positive source of stress. Work is a source of stress, which can also be a positive source of stress. And it might not always be, but talking it through and helping the individual reframe it in a way where they at least see things in a balanced way.

I think we're a victim of our own assumptions and interpretations and we're our own worst critics. So I try to help clients make sure that they have a rational view of their stressors. But we do at times deal with really difficult things and we can't deny that those things are difficult.

You brought up just talking to someone about it, not with the expectation that they're going to solve the problem, but just somebody who's a good listener and talking it out. Some people like to journal. Journaling can be really useful.

Scot: Yeah. I do morning pages. I forgot about that. I spend a half-hour and just do this brain dump of whatever I'm thinking and whatever I'm feeling, and a lot of times . . .

Nick: It's incredibly helpful.

Scot: Yeah. Really, at the end of it, a lot of times I feel much better.

Troy: And do you save that or do you just brain dump and then delete it like, "I want this gone"?

Scot: No. I don't delete it.

Troy: Do you save it for later?

Scot: No. I don't delete it, but where I learned this from said that you should not go back and reread. Although, I used to journal as a kid, and I've read some of those as an adult and I'm like, "This stuff you were concerned about was not a big deal."

And as an adult, I do go back to my daily pages. I might go back to the last year and see what's going on and be like, "I was really worried about that?" And it does help me have perspective going ahead. Yeah.

Nick: Yeah. And one other thing related to the journaling that I will recommend clients do, especially those that have a lot of thinking anxiety where they just can't get these thoughts, these ruminations, out of their head but they need to be able to, to focus on a task, say, "Okay. That's fine. You want to worry about that? Designate five minutes or 10 minutes a day as your worrying time."

And if you want to just sit there and worry, set the timer, or if you want to be journaling and getting the worry out in that way, that's fine. But when the timer is off, it's off and you leave it and you close the book on it. You've now honored that worry and you're moving onto the next thing.

Troy: And do you find people say they're able to do that, or does that thought just then stay with them throughout the day?

Nick: It's 50/50. It works well for some people. Other people, not as much.

Scot: Yeah, in some situations.

Nick: It's a tool.

Scot: I also find too that my daily journaling will get me to the point where I'm like, "I'm sick of complaining about this. I've either got to do something or let it go because I can't handle myself whining about this anymore." Maybe that's a terrible way to put it. See, I'm being mean to myself right now. I'm calling myself a whiner, right? You should call me on that.

Troy: Well, you mentioned mindfulness, and Scot talked about that a little bit as well. And we're hearing the term more and more, I think, mindfulness. Sometimes, I wonder if we really understand what mindfulness is. Sometimes, we hear it in the context of being very mindful toward others, which sounds more just thoughtful toward others. What is mindfulness exactly and how does that really play into stress management?

Nick: Yeah, good question. I think of mindfulness as having two characteristics. One, it's about being present, not just physically. I tell my students, "I don't want you here just here physically. I want you here mentally and emotionally and spiritually." Maybe not spiritually, but "I want your whole being here." So part of it is being present.

And the harder part I think is being present in a non-judgmental way. Meaning, we're very good at judging ourselves often in the negative. Learning how to view our thoughts and our behaviors in a more neutral way. They just are what they are.

So being present and being present in a way that's more neutral and removing judgment from what we're doing.

Scot: And being present meaning like, "Oh, I'm feeling stressed. I'm feeling sad. I'm feeling . . ." and not judging it and just going, "Why?"

Nick: "This is how I feel right now. Interesting." Honestly. We talk about being researchers or . . . we're human beings. We're all researchers to some degree. We're interested in things. We wonder. So view your own emotions in that way. Think about them in that way.

I find for me that when I'm feeling overwhelmed, one really simple thing that I have taken to doing is, if I'm by myself especially, narrating. Literally, being my own narrator out loud. "I am getting my keys. I'm walking through the door. I'm opening the garage. I'm opening the car door. I'm sitting down. I am putting the key in the ignition. I'm turning the key." Sometimes, you've got to talk yourself into being present.

When you're doing something you don't particularly want to be doing, just talk your way through it. Pretend you're Morgan Freeman or something and just like . . . I don't even know where I learned that, but I just started doing it and it was helpful.

Troy: It's great too. Sometimes I wish we would use that term more, "just be present," because I think sometimes people hear mindful and they're like, "Well, what does that mean exactly?" But like you said, it really does seem . . . and I'm certainly no expert about . . . Being present, like you said, talking yourself through what you're doing, being aware of the sights, the sounds, the smells, everything in that moment, my mind is not thinking, "Okay. This is what I'm doing this evening," or, "These are all the tasks or all the things I'm worried about." Just, "What's happening right now?"

Nick: So much of our stress comes from being future-oriented about bad things that might happen or things that we're worried about in the future. So many people spend so much time in that state that you've got to wonder if you never do anything about that, you're never really living. You're always thinking about, "What's next? What's next? What's next?" Even when you accomplish something really positive, you never enjoy it because you're always thinking about the next thing or worrying about the next thing.

Scot: All right. We covered a lot of ground, I think. I think you gave us some great tips for just dealing with some of those day-to-day stressors, some of those happy stresses, maybe some of those not-so-happy stresses. And if it starts to get overwhelming, there's no shame in finding somebody that can help give you some tools, help you work through it, so you can break through that and go on to great things.

Could Your Smart Speaker Save You During A Heart Attack?

I think most of us that have Amazon Alexa at one time or another are convinced that it's listening to us all the time. And in this case, it could be listening to you and tell you if you are going to have cardiac arrest or not.

This was an article that we found in statnews.com. Alexa has an experimental tool on it that is being tested that's going to warn of cardiac arrest by monitoring breathing. And there's actually a proof of concept study that the ÑÇÖÞ×ÔοÊÓƵ of Washington did around this.

And, Dr. Madsen, I wanted to get your take if this looks legit or not, because a lot of times when I read through this research I can't tell how good is the research, how good were their methods and their techniques. What was your take on this?

Troy: This is kind of tough because they're making it sound like this tool really worked well. So, they're detecting agonal breathing, which is very irregular breathing, long pauses in breathing, which someone would experience if their heart just stops beating. They said it detected 97% of agonal breathing events. And when they looked at over 200,000 clips, they said their false positive rate was only 0.2%.

The biggest thing for me is this whole false positive rate. Yeah, it sounds great if you can have someone where you detect a heart attack, you get 911 there. But on the other hand, how often are you going to be having Salt Lake Fire pounding on your door and breaking it down to get in to you because you have sleep apnea? And in sleep apnea, it's not unusual for people to have long pauses in their breathing.

And the more that firefighters have to do this and try and get in to help someone out, the less likely they are going to respond to these sorts of calls or these alerts. So that's probably the biggest thing that stands out to me.

We see this same issue with technology with some of the devices that people have that are detecting abnormal heart rhythms. And studies have shown that a very large percentage of those are false positive results.

So I'm not sure what to make of it. It would be interesting to see . . . they did a real-world experiment with this to see in these 35 households and a sleep lab to see what sort of false positive rates they got versus true positive rates. But I don't see this happening any time soon, and I don't see this being something that's going to be routed into a 911 dispatch center where you're suddenly having people knocking on people's doors to come in and pull them out of bed for agonal breathing that was detected on their Alexa.

So they reported this false positive rate of 0.2% out of 200,000 clips. So they had, as I mentioned, 35 different households they recorded in, plus a sleep lab. They had 200,000 clips that they analyzed or that the Alexa in this algorithm analyzed, and it means they had 400 cases of false positives. So, the 0.2% makes it sound really small, but when you figure there were 400 cases of potentially a 911 dispatcher being alerted, and then . . . I don't . . .

Scot: For 35 people?

Troy: Yeah, for 35 households.

Scot: Yeah.

Troy: So 400 cases across 35 households, so that means each of these households would have had at least 10 times where the fire department and EMTs are pounding on their door to wake them up and make sure they're still alive. So 10 different times.

It makes the numbers sound really good when you have that 200,000 clip, but you've got to figure this thing probably has multiple clips that it's recording a night or multiple events it's potentially recording.

Again, it's the false positive rate that I think would prevent this from going real-time just because the response would have to be pretty vigorous. You'd have to have people pulling people out of their beds and pounding on their door to make sure they're alive. And after that happens a few times, people are just going to turn their Alexa off or the fire department is going to stop responding.

Scot: Stop showing up, yeah. But like with much of this technology though that is starting to detect these sorts of things, I would imagine algorithms are going to be built around them that will hopefully get that number even smaller. We're at a very interesting crossroads of technology, what it can do and . . .

Troy: It is.

Scot: . . . what it can't do.

Troy: But it's a really interesting dynamic we have here, because on the one hand you have I think a lot of people who work in tech who are used to precision and very precise measurements. Then you have people in healthcare where, on the other hand, I'm saying, "If I'm getting people dragged in the ER 10 times a night for agonal breathing that's nothing, this is ridiculous."

So I think they want to be very precise. They want to capture every possible event where you can reduce that rate of capture and maybe capture half of significant events but have a much lower false positive rate. And that's better than nothing. So it's an interesting balance.

Like you said, I think a lot of these things are in their early stages. We'll see them refined over time. Maybe there's some potential with this.

Scot: It is pretty amazing though that . . .

Troy: It is.

Scot: . . . this thing could actually hear breathing well enough to . . .

Troy: That's the creepy part of it.

Scot: . . . even do as well as it did.

Troy: Yeah, it's going to hear your breathing, what you're saying in your sleep as you're talking in your sleep, your snoring.

Scot: All right. We will put a link to that article in our show notes if you want to read the research study and the article a little bit more closely for yourself.

ER or Not: Bit By a Rattlesnake

All right. Another edition of "ER or Not?" That's where I will throw out a scenario to emergency room physician Dr. Troy Madsen and he will tell us if this is a reason to go to the ER or not or if it's something you can handle on your own.

So this one I have a feeling I know the answer to, but you've surprised me before. I'm out hiking and I get bit by a rattlesnake. ER or not?

Troy: ER. We'll keep it simple because you know the answer.

Scot: Yeah. Is that the answer?

Troy: That is the answer.

Scot: All right.

Troy: You want to go to the ER. The tough thing with rattlesnake bites is a large number of them are dry bites where the snake bites you and it doesn't inject any venom.

Scot: That's possible?

Troy: It is absolutely possible, and it's a surprisingly large number. I think even possibly most rattlesnake bites are dry bites. But the problem is once you start to have symptoms, you really need to be seen and you need to get the antivenin. So this is the medication you get that essentially protects you from having severe reactions to this bite. You can have reactions as small as maybe some swelling around the bite to as serious as your blood pressure dropping, really facing a life-threatening situation.

So the simple answer is go to the ER, get checked out. Often, in these situations, you're far from help and that's the big challenge too. And we've talked before about what you do with these bites, but the bottom line is don't cut the bite, don't try and suck venom out, don't put a tourniquet on.

Scot: So don't do the things that I have been told my whole life to do.

Troy: Yeah.

Scot: Try to stay calm and get help. How much time do I have? If I am out in the middle of nowhere, should I just calmly start walking back?

Troy: Oh, really good question. It's going to vary. You could have a reaction very significant within, say, 30 minutes, or it might be hours.

Scot: Just depends on the person, I suppose.

Troy: It really depends probably on the person, on the nature of the bite . . .

Scot: Yeah. Sure.

Troy: . . . the amount of venom that was injected. So all of those things are going to affect you. If you have other medical problems, that's going to affect your response as well.

Bottom line is get help as promptly and as efficiently as possible. Try and stay calm. That's easy to say when you haven't been bitten by a rattlesnake, but a do whatever you can to get help.

Just Going to Leave This Here

Scot: "Just Going to Leave This Here." It might have something to do with health, might not. Just our chance to get out some random thoughts. Troy, why don't you go ahead and kick this off? "Just Going to Leave This Here."

Troy: Well, I'm just going to leave this here. It's house-hunting season and maybe you're looking at buying your first home, maybe you're looking at upgrading, maybe you're just browsing on the web, on Zillow, or whatever other sites you like to use and fantasizing about this new house and how it's going to change your life. Well, it's interesting. I found something that said that bigger houses don't make us happier.

And it stands to reason, but they actually looked at overall satisfaction with people's home, and compared it to 1973. Our space per person in a home has doubled since 1973. It was at 500 square feet then. Forty years later, 40-plus years later, it's at 1,000 square feet per person. That's our average space per person in a home. People are no more happier with their homes now than they were then.

So don't look at a house as you're shopping around to necessarily find you happiness. I'm sure there a lot of other factors that go into that in terms of neighborhood or access or those sorts of things.

Scot: Yeah, location. Definitely, those make a difference.

Troy: That's a big piece. I think that definitely makes a difference. But house size, a simple thing stands to reason, but I found that interesting.

Scot: Bigger house actually depresses me more because that means more to clean.

Troy: I know. More to clean, more to maintain.

Scot: Right? It's just easier to have the house that you need.

Troy: Keep it . . . yeah.

Scot: But I still get . . . I see those bigger houses sometimes . . .

Troy: You do.

Scot: I'm like, "Oh, it'll be so great to live there."

Troy: I know. It's addictive. Browsing on Zillow and being like, "Wow, look at this 10,000-square-foot home at mid-mountain at Park City Resort. And it's only $20 million. Wouldn't it be amazing?"

Scot: Just going to leave this here. I know that you're a big fan of animals and I wanted to show you video of our new pet that we have.

Troy: Oh, wow.

Scot: Are you ready for this?

Troy: I'm ready for this.

Scot: All right. Here's video.

Troy: Let's see your pet.

Scot: This is from my Ring security camera of my new pet.

Troy: So I'm guessing this is a pet that found you.

Scot: Watch very closely.

Troy: What is it? What is it? What is that? Is it a mouse in the corner there sticking its head out of the wall? What is going on over there? Something in the night vision mode of the ring security camera.

Scot: And you can see its beady little eyes reflecting in the light.

Troy: It's a little mouse sticking its head out . . .

Scot: It's not a mouse, my friend.

Troy: Is it a rat?

Scot: It's not a mouse. There it is.

Troy: Is it a weasel? Is it a . . .

Scot: It's a rat.

Troy: A rat. Okay.

Scot: There it is. See it?

Troy: Well, have you made friends with the rat?

Scot: Yes. His name is Reginald Rat Pants, incidentally.

Troy: So that's actually what you call him? And you call him by that name and feed him from your hand and let him cuddle with you at night.

Scot: No, we don't do any of those things. We came home after vacation and I had a jug of protein powder, those big jugs with a screw-off top, that it looked like somebody took a knife underneath where the lid would screw off and literally just sliced it off. We're like, "That's weird."

And then that night, while we're in bed, we hear this [cracking sound] downstairs. And the next morning when I go down, my rice cooker, where the little steam vent is, something had just gouged into that with its claws or its teeth.

Troy: Oh, wow.

Scot: Up until that point, I was still in denial. I was like, "Well, maybe the protein powder thing got hot and it exploded."

Troy: Because protein powder does that. That's a common occurrence.

Scot: No, it doesn't.

Troy: Oh, it doesn't?

Scot: But I was denial, you see.

Troy: Yeah.

Scot: And then went into the other cabinet and saw we had beans and rice and bags and there were little piles of beans and rice and bags. So I don't know . . .

Troy: It's a regular buffet.

Scot: Don't know how it got into our house. I set up my Ring security camera . . .

Troy: And you saw it in action.

Scot: . . . to track it down and there it is.

Troy: There it is.

Scot: So we've called the proper authorities to come and take care of it.

Troy: See, now I'm sad. You showed me your pet and . . .

Scot: I know.

Troy: The "proper authorities" is code for exterminator. That's sad.

Scot: I've got to say I agree with you on that. We're a little torn in our household too, because he is kind of cute . . .

Troy: I know.

Scot: . . . in the way he pokes his head out to look around very carefully.

Troy: I know. I'm kind of attached to this little guy already.

Scot: If it wasn't for the fact that they're . . .

Troy: Especially since you named him.

Scot: . . . disease-ridden critters.

Troy: Well, speaking of animal encounters, my most interesting animal encounter in my home was a weasel. It was this little thing and it was poking its head out at me and it made the cutest little noise. And I was trying to coax it out. And then as I read online, I thought, "That's not the best idea," that weasels can really be quite vicious. And so it's probably best that I did not try to catch the weasel with my hands. But it was the cutest, friendliest little thing and just poked his head out and made this little noise and it would pop back in.

Scot: In your house?

Troy: Yeah.

Scot: And how did you get rid of it then?

Troy: We got our trusty Beagle Pointer dog to try and get her to chase it out. Of course, she was useless. It was down in the basement and I think we ended up just leaving the door to the garage open and hoped it left. I have not seen the weasel . . .

Scot: And didn't invite more weasel friends over.

Troy: Bring weasel friends into the home, yeah.

Scot: All right. Well, have you ever had an animal in your house or is there something else that you would like to comment on? You can do so at hello@thescoperadio.com. For the "Who Cares About Men's ÑÇÖÞ×ÔοÊÓƵ" podcast, I'm Scot Singpiel.

Troy: I'm Troy Madsen.

Scot: Thanks for listening.