Episode Transcription

Erik Axene 0:01
But I hit a point I think we all sometimes will hit that point where you’ve just got to make a change and and a lot of it was motivated by heart health you’re listening to E M S, with your hosts, Erik Axene and Matt Ball.

It’s been a while Matt since we’ve been

Matt Ball 0:21
it has been a while to do a podcast if you guys don’t recognize this guy. Yeah, I mean, you have lost quite a bit of weight over the last couple months. And working hard.

Erik Axene 0:31
Yeah, you know, it’s been little little bits.

Yeah, you know, consistency. Yeah.

Consistency. I think a friend of mine friend of ours. Yeah. motivated me at a funeral. Yep. We were out at bowls funeral. And tragic case. Yeah. But I remember being out in the, on the field there with him. And our friend Russell and Krantz. Yeah. And he’s a fitness Nazi. A good thing to say, is Guru,

Matt Ball 1:00
the fitness guru. He is he’s intense. He is a freak of nature. That guy, but I’ll say like he works. I mean, I think he definitely has some genetics in his favor. But that dude works in the gym and nobody, you will not outwork crowds in the gym. We’ve had D one athletes that have come into our fire department. 22 years old, and Chris is in his 50s. And he’ll outwork them. That guy has an engine like I’ve seen him work. It’s just the most humble, nice, funny, goofy guy you’d ever want to meet anyway.

Erik Axene 1:34
So when I’m talking to him, and I knew that I wanted to improve my health, because I had gained a lot of weight through COVID. Well, it all started. I mean, ever since medical school. Yeah, I just fitness has been not a priority. Sure. I used to be in great shape as a decathlete football in college and you know, really in great shape as a wrestler. Yeah. But after medical school, it just fitness was not in the cards. Yeah, right.

Matt Ball 2:00
You know, we’re working 22 hours a day, it was hard to find time to workout.

Erik Axene 2:05
But I hit a point, I think we all sometimes will hit that point where you’ve just got to make a change. And and a lot of it was motivated by heart health, because I, you know, we’re talking about these things in our lectures on cardiac issues. And I you know, as a medical director, I’m trying to, and as an ER doc, I mean, I’m, I don’t want to be that patient. Right, you know, and so I wanted to lose weight. And so I also wanted to get back into the gym. Yeah. And so there’s a lot of things I wanted to accomplish. And, and I’ve lost weight before. And I’ve started fitness regimens before. And then they last for a while, and then they fade away. But this time, I really wanted to do something. And Russell gave me great advice. I said, Hey, Russell, just one sentence. Can you just give me some advice on how to just just want to do something and stick with it. And I really want to start getting more healthy. Any advice for me? And I didn’t intend for this word of wisdom to motivate me so much. But he said I got one word for you. Consistency. And so that’s the key. Yeah. And so yeah, I’ve lost somewhere between 30 and 40 pounds.

Matt Ball 3:15
Yeah. Well, we were looking at videos today. We were looking through some stuff from last year, just seven months ago, eight months ago. dramatic difference. I mean, yeah. Which is applicable to what we’re talking about today, which is heart health. Right. It’s very applicable because it’s losing weight, we have a huge problem in our country with processed food, fast food over eating massive portions, sedentary, sedentary lifestyles, not exercising at all. And so we have these people that are way overweight, huge heart problems. And we’re seeing it in our communities in our fire departments, the calls that we run on just it’s all encompassing,

Erik Axene 3:53
and the way we’ve organized the podcast today is The Good, the Bad and the Ugly. So we’ll circle around we’ll come back to plenty to help again Yeah. But let’s you know, the heart is an amazing organ and it’s really the weak point to most people die. They’re going to die. Most people die of cardiovascular disease. So this pump that we have is pretty amazing organ it pumps 2000 gallons of blood every day. 100,000 heartbeats every day. 60 million gallons of blood pumped in a lifetime. Two and a half billion heartbeats? I mean, and without a break? Yeah. This one takes a break. You call somebody’s calling 911 for you there. Yeah,

Matt Ball 4:35
it’s kind of like I mean, when you think about it, you know, the pump theory of the pump. It is a huge part as a firefighter, right? Because on the fire ground, the pump of the engine is the heart of that fire, right? If that pump goes down, pretty much everything else shuts down. Do you got to pull people out and shut things down because of a safety thing and and a lot of firefighters I know that maybe struggle with understanding in how the heart works, but there may be good at driving or hydraulics, when you start relating it back to a pump. That’s all it is. That’s all it It

Erik Axene 5:08
reminds me of that lecture that we did a couple years ago now. But we went out and used an engine to teach cardiovascular. So for shock, right. And I remember talking to some of those firefighters later. And even even after the fact, there’s still wanting to talk a little bit more about in helping me to understand some of the fluid dynamics of work in an engine and the pump, I mean, it all relative that all fit together. Well, that’s part of the amazing thing. That’s like the good, right, these are good things. The heart is an amazing organ. It’s one of my favorite things to learn about and, and study and follow up on current literature with new EKG patterns. Right? These are very,

Matt Ball 5:46
and it’s one of the scariest things and we’ll talk about is, I know with newer paramedics, and even you know, pregnant people who have been paramedics for a long time, I get asked all the time, I need to get better at EKGs. You know, and it’s one of those things, I think if you don’t use it, you lose it, you know, and, and you have to stay current, you know, watching our videos, staying in the books, watching YouTube videos, whatever it is, because there’s always new things that are coming out. But I know that like reading 12 leads and things like that are very intimidating to a lot of parents

Erik Axene 6:14
they are and that’s one of the things I know in our recent newsletter. It’s on the website. On ace, ace now, you could check it out. We talked about some of these EKG pearls, right? And how important it is to recognize the dangers of potential cardiac emergency. Even if there’s a normal EKG, what was like 11% of people with STEM ease now have a normal EKG initially. That’s right. So you can’t hang your hat on that normal EKG? No,

Matt Ball 6:47
I think we’ve said it a lot of times in our lectures that you always treat your patient, not your monitor, right? You have to take everything in context, when you’re treating patients. It’s not just what your monitor is telling you. But I mean, I’ve had patients and I’m sure you have too, that are pale diaphoretic they look sick, and they’re complaining of horrible chest pain or whatever the case and their EKG is perfectly normal. It’s like, well, something’s going on here. Like you can’t fake diaphoresis Right. And, you know, when it’s wintertime in Texas, you know, it’s, it might be a little bit warmer than Chicago, but it’s certainly not warm outside. And yeah, you got to treat your patients. It’s not always the monitor.

Erik Axene 7:25
You know, I was talking to a fire chief in Phoenix last week. And he was telling me his story of when he had a STEMI the EKG was normal. And the the the astute ER doc and the cardiologist ended up taking them to the cath lab and, and he again, he was one of the other 11% his EKG evolved and did eventually show STEMI. But initially, everything was normal. And that ER doc kept him, the cardiologist took him to the cath lab 99.9% blockage of his led the Widowmaker big one. And that’s and that’s really where the good gets bad. You know, we talked about the good of the amazing heart and the good of us being experts in our field to recognize the signs of a heart attack. But now the bad though, unfortunately, is like we said earlier, this is a disease that kills more people than anything else. Yes. And, and I think I think it might be good to talk a little bit about EKGs, some of the basics are approaching an EKG and talking a little bit about maybe STEMI. A little bit. That’s really what we’re looking for. And then and then a little bit of some of the red flags. Yeah, I

Matt Ball 8:31
would say we’re looking for two things. We’re looking for arrhythmias. And then we’re looking for STEMI is on top of that you’re kind of first off looking for is the heart rate regular. And like we talked about in our lectures, that you kind of think of looking at an EKG like you’re jumping out of an airplane, and you kind of get that 10,000 foot view, right? And we ask ourselves the three questions, right? It was fast or slow? Is it Yeah. Is it faster? Is it slow? That’s the first question. And you know, most of my paramedic students are, you know, we get guys out. And you know, they jumped to one thing, it’s like, is it fat, you’re missing the fact that it’s filled with RVR? Like, you’re getting into looking at ST segment elevation, like slow down. So look, is it faster? Or is it slow?

Erik Axene 9:11
And that’s what we tried to depict in our newsletter, Ace 911. Just we went through some weird EKGs. And as weird as an EKG might be, if you stick with the order, the first thing we do, is it fast or slow. And that’ll kind of calm me down. It’s like okay, I can I’ve got

Matt Ball 9:27
I’ve got a plan. Yeah. And then

Erik Axene 9:28
is it regular, irregular? Exactly. Is it wide or narrow? answer those three questions. 95% of EKGs. That’s right will become clear. Yeah.

Matt Ball 9:37
And the EKG is that we can treat in the field or do anything about it’s going to show you those easily and anything else you bring to you in the ER. But I think having that process in place, especially for our newer paramedics is really helpful. It’s kind of like having sampler O P Q R S T, you got a major trauma patient, I don’t know what to do, follow up QRS t, you know, follow your trauma algorithm, and you’ll be fine. You know, and so that’s super helpful. And then you kind of get a little bit closer and then you look at your 12 leads, right? That’s kind of rhythm identification, right? That’s not going to tell you a STEMI. No, asking yourself those three questions is not going to tell you as part

Erik Axene 10:13
of the 5%, I would say exactly that 5%, which we need to be good at tonight. And like we said in the newsletter, we can be good paramedics to be good with those 95% of EKGs. But the excellent paramedics and hopefully we all try to strive to be excellent Yes, is to be good with that 5%. That’s right, actually recognizing, and being an expert with identifying stem ease that may not appear like a posterior STEMI doesn’t, that’s not your machine’s not going to show you that you got to be smarter than the machine.

Matt Ball 10:39
Yeah, and you can’t just read the top of your EKG paper. Because if you do that, you’re probably going to get the you know, it’s going to be wrong, a lot of the times it’s going to tell you it’s a STEMI when it’s not a STEMI. Or it’s not going to alert a STEMI when it is a STEMI. So you really have to be good at I had one of our former EMS chiefs, he used to always tell us, he would just fold the top of that paper down. Now there’s useful information, the QRS, the PR interval, that’s fine. But as far as the Meet stemming criteria, and this and that, he wouldn’t even look at that. And so again, having a systematic way to of looking at your 12 lead is one of the things I teach, it doesn’t matter how you do it, but I always look at one ABL look at my lateral leads first. And then I go through to three and aVF, look at my inferior leads. And then I go v one to V for my interior separately. And I just do that to have a plan. So I’m not just scattered looking at everything.

Erik Axene 11:28
And I think it’s the same way we’re going to talk about it in a minute. But but you know, having a plan for whatever it is three kgs, for example, or traumas or you have an a, an algorithm, you go through a system, it’d be less likely to miss things. Perhaps

Matt Ball 11:43
it’s like trauma guys, you know, in the military. They’re trained and trained and trained on blood sweeps and you do a rapid trauma assessment. You’re looking for life threatening things, throwing tourniquet on addressing bleeding you’re trying to save. So it’s the same thing here. It’s the same thing here. We’re doing the same thing except with the heart. We’re rapidly getting vital signs. We’re doing a 12 lead, we’re looking for life threatening patterns. It’s like, oh, this person’s having a huge STEMI I’ve got to go, you know, yeah, I can give aspirin I can give nitro I can give oxygen, but that is not fixing the blockage in their coronary arteries. We’ve got to get them to a cath

Erik Axene 12:18
activated, transmitted if you have that in your system,

Matt Ball 12:22
which I think most transports Yeah, exactly. Yeah, and for EMT folks, you know, obviously, you can’t do 12 leads, you know, so you’re looking for patterns. You know, if you’ve got a guy that’s complaining of crushing chest pain, he’s pale, he’s diaphoretic, men typically are going to experience that typical center of their chest crushing. I’ve had guys, big, muscular, tough looking dudes writhing around on the floor. Just I mean, I could hardly get them to sit still long enough to do it slowly. And then I’ve had little tiny little 80 year old ladies having massive 12 leads that were just complaining of lethargy, it’s crazy. The difference that

Erik Axene 12:59
actually reminds me of a red flag is this something that we need to be careful of is when we’re treating elderly patients, oftentimes, those nerves aren’t quite working like they did when they were in their 20s 30s and 40s. When they’re in their 80s and 90s. Where they don’t feel chest pain, where they present with, like you said, some atypical sign in women in general, tend to be more

Matt Ball 13:19
they’re tough, a typical, you can just say it there. It will be interesting.

Erik Axene 13:23
They have when they have heart attack, they’re more likely to die.

Matt Ball 13:26
Well, yeah. A wise though. They don’t feel the pain that

Erik Axene 13:31
it’s more a typical. Yes, exactly. And 70% of all stem e’s are from them. Guess. So we count for most of the stem ease. But when a woman has one, that tends to be nice. Yeah. And then I think, based on literature, there’s they think it may actually be because women have them later in life. So they tend to be older. Yeah, sure. Which makes them more at risk for

Matt Ball 13:55
reverse event. Yeah, younger. Yeah, the males are usually younger. We’ve had a couple of guys in our department that have had some issues and they were fairly young

Erik Axene 14:02
when I when I use I’m glad you brought it up. Because you know, to me, the STEMI is that big red flag thing we’re really watching for when we get an EKG but but you do have that sick patient and then you get the EKG to see if there’s an answer there. Sometimes the answer is not a STEMI sometimes it’s an arrhythmia what, what to use that first first rhythm comes to mind when I say dangerous for them. What do you think of

Matt Ball 14:25
that? Oh, I mean, V TAC V tag with a pulse? systole? Well, yes, obviously. Obviously, if they’re dead, you’re thinking it’s gonna be one of only a couple but yeah, for sure. Dead patients. Yeah, asystole. There’s not.

Erik Axene 14:39
No VTEC is one that can be a sphincter tightening moment where you

Matt Ball 14:45
see to me V TAC in an awake patient is probably more of a sphincter tightening moment than asystole like AC sleeves like protocol. I know. Exactly where V Tac is a little bit more like, this is interesting.

Erik Axene 14:56
You know, I like the SBTs. That’s one of my favorite things I would say vagal maneuvers to try to convert it. In fact, that’s one of the cases we have on our newsletter this this month. Yeah, check it out, again, Ace 911, but is the SVT. And we talk a little bit about the vagal maneuvers, but we don’t really get into it. But the vagal maneuvers can be really effective if you do them, right. Yes, the 50% effective if you do it right,

Matt Ball 15:21
do you remember the patient that I brought you that we did the vagal maneuvers on the

Erik Axene 15:25
system that didn’t work at all? So

Matt Ball 15:26
you remember, he worked in some ways? Yes, she was an unknown etiology she had had it happened in the past? About four months, I think before that. And they had to shock her out of it. Yeah. And there was a little bit my partner was ready to pull out the adenosine. And I was like, Wait, a man hangs 30 something year old? And I’m like, wait a minute, this isn’t sounded right. Right. And, and the thing was, she was stable. And you know, sometimes as paramedics, the best thing you can do if you’re not sure what’s going on, if the treatment could be positive, could be negative to your patient. And they’re stable. Sometimes it’s

Erik Axene 16:02
best to not do anything. Yeah, don’t expose them to the risks of a side effect. We

Matt Ball 16:05
preach about being aggressive, and we want our paramedics to be aggressive. And medical directors want us to be aggressive. But you have to be smart about it. And with this,

Erik Axene 16:13
I want you to be aggressive. I think, like you said, I

Matt Ball 16:16
think aggressive. Well, yeah, but I’m thinking if you come up on somebody with a GCS of three, and they’re not protecting their airway, you want them to be aggressive and taking I see what you’re saying. Yeah, I agree with you. I agree. But like this lady, provided the only vital sign that was off was her heart rate was 181 90. Everything else was fine. She was awake, she was alert. She was oriented. She just felt like our heart was racing. And we couldn’t rule out WP W right? And adenosine carnism. You know, it’s like, well, you know, this may or may not be good or bad. And so we just started the IV and even you looked at the EKG, I can’t

Erik Axene 16:52
rule it out either. Because it called the electrophysiologist. Yep. And he

Matt Ball 16:56
said it was WCW you’re gonna have to shocker. I think you ended up giving her Procainamide

Erik Axene 17:01
I think we did here. Yeah, I think we did. I remember actually is interesting. We had him on one of our courses, actually. Yeah. Doctor, you. And we were talking specifically about this. And I think things have changed in the literature. Because remember, he’s thinking, Well, he was recommending No, give Wolff Parkinson white adenosine. That’s okay. Yeah. Where it’s, it’s when there’s a fib there, that it can be deadly. Yeah. The the wolf Parkinson white with a fib. That’s the bad one. Yeah. And, and so there is, I still, you know, I’d still call it. But it does make sense when you explained it. And that was a great lecture that we found that I really enjoyed that

Matt Ball 17:41
it was good to have. And we did her vagal maneuvers, which is where but it didn’t work. What did briefly voted for 510 seconds. And then she went right back into it, which is when you were like, I’m gonna have to shock you. And I think she,

Erik Axene 17:54
if I remember correctly, she’d been there before. That’s about four months

Matt Ball 17:57
earlier. And Dr. Yu was happened to be the one that he remembered her and was like, Yeah, that’s what he said. You’re gonna have to cardioverter so remember, she was begging you Don’t do that? Because it hurt. Yeah. Anyway. Yep.

Erik Axene 18:07
could send a consent issues, too. Right. It gets into some consent for us. Yeah, yeah. But you know, one thing I like about the SVT rhythms and other rhythms too, is like when we talk about it as as crazy as an EKG might look, step back. Is it fast or slow? Is it regular, irregular? Is it wide or

Matt Ball 18:26
narrow? And ask you know, if you’re new, you know, bring that senior person in, you know, if you’re a senior guy, you know, be there to support your new hermetics. You know, this, it’s not super complicated. It really isn’t that complicated. There’s lots of resources out there that you can look at, to identify these rhythms, the treatments, pretty simple, know your protocols, follow your protocols, and you’re going to do good by your patients. And it can be

Erik Axene 18:51
fun to learn it.

Matt Ball 18:52
I find it very interesting. I

Erik Axene 18:54
didn’t do and we make it fun. Yeah. For what did we do? We so we’ve done one of the lectures cycles. Yeah, Lamborghinis. The Lamborghinis. We did for slow heart rhythms. We have a sloth. We Dr. Shim shocked each other with the shock Tayto Well, one lecture you shot and I got you back you got me back with the dog collar. Well, yeah, no

Yeah. Things to know. I

Matt Ball 19:17
think that was it. We had the shock collars. We had the shock Taita we did the motorcycles for tachycardias. And then we did that yeah, we

Erik Axene 19:24
did the wheelie up the road there. And 110 I

Matt Ball 19:28
was on the Harley. I was just cruising. Maybe you were the one flying up and down like a maniac. You

Erik Axene 19:32
look cool with a drone chasing you. That was so cool. Yeah, we do have a lot of fun, though. Yeah. And I think that if you have fun learning that’s part of our philosophy for sure. Making lectures you and I we try to make them fun and engaging. You know, it’s funny, I was talking to some fire chiefs dinner in mentioned in Phoenix. I was talking to a fire chief in Phoenix and, and, you know, when we make lectures, it’s kind of like fishing. I like to fish and You know you could spend all your money getting that right reel you know that the pole and you know all the fancy fancy tackle and boots and gloves and all the all the fishing gear and the boat and everything right. But ultimately when it comes down to grabbing a fish, it’s what you got on the hook.

You know what I mean? Well, yeah, a little bit of skill where to place your hook. That’s true. There’s some other things but but you

know, one thing we do I think that’s unique in the industry, is I think we got the bait. Yes, is getting engagement, getting people interested because see ease are usually pretty boring. And it’s just click, click, click get through it so I can get it done. And I think we have fun making them interesting. And not that we’re trying to bait people. But but when you have something interesting in in get you get engaged, get hooked. And then you realize, man, I’ve been watching for 10 minutes, and I’ve been having fun, right? And then and then we switch gears and then we do something else. Interesting.

Matt Ball 20:59
Oh, man, I’m only 10 minutes in opposite. Yeah,

Erik Axene 21:02
I like that. Yep. But anyway, so I think that those are those are some of the cool things. I think that people find interesting with what well, and this

Matt Ball 21:11
is a super important topic, because like we said, it’s a huge problem in our country, cardiovascular health is a huge problem. It’s a huge call volume that we have, you know, most of our out of hospital cardiac arrests in our environment is going to be cardiac related. You know, it’s not going to be trauma, it’s most of the time it’s going to be in adults, it’s going to be a cardiac issue, right. So we really should be like military medics, they’re really good at trauma, because that’s all they do. Urban or, you know, civilian firefighter paramedics, we should be really good at the cardiovascular system and heart problems, because that’s the majority of what we do. But it’s also very applicable to the fire service. Because it’s such a big problem among firefighters, you wouldn’t you this statistic, you said as far as the first heart attack, and

Erik Axene 21:57
it’s cited in our newsletter, but the average age of a first time cardiac event in the general population is in the mid 60s, right. In the first responder community, the first cardiac event, mid 4120 years.

Matt Ball 22:12
It’s crazy. Yeah, our cancer, cardio rinses, the

Erik Axene 22:15
ugly. We talked about the good. We talked about the bad now this is the ugly in our own community. Being experts of finding these cardiac problems, we really struggled with heart health.

Matt Ball 22:25
This is another reason why I am passionate about our education. As paramedics, I know a lot of firefighters got into the fire service to kick in doors and put fires out and do all the cool stuff. And I love that stuff, too. Right? I love that too. But if we are not good at treating these medical, especially cardiac patients, it’s very likely that in your career, if you spend enough time in this job, that one of your brothers and sisters could go down on a call, or at the station we’ve had, we’ve had a firefighter go into cardiac arrest at our station. I mean, he’s been very, very vocal about his situation. But I mean, we had a firefighter go down, young, healthy guy go down full arrest into our sides. And luckily, we had capable really chiefs, you know, the chief that was there very well, that were still paramedics, and we had two brand new EMTs. But they knew what to do. They immediately delivered care. We had a drunk, they immediately recognized the rhythm and they saved his life. Yeah, I mean, they absolutely want. It’s what it’s all about. And a lot of times, like I say, we get firefighters get a little bit complacent. Because they’re like, I don’t like to see EMS stuff. It’s boring. And it’s like it not only could it be one of your brothers or sisters, it could be you. That goes down in a fire. The statistics say it’s very likely to happen. And we have to know what to do in those situations to treat our own people. Yeah, you know, it’s very important. We know that

Erik Axene 23:58
well, you know, to end our podcast and we’re not done yet. But I think the this this heart health issue, how do we become more healthy? I think we have a very stressful sort of a job. Everybody knows that. We have sleep pattern issues,

Matt Ball 24:13
energy drinks. I think that’s another thing that we could talk about the monsters in the bangs and the Red Bulls in the coffee. I mean, it’s interesting.

Erik Axene 24:21
You know, the first thing I changed in this whole process of trying to become more healthy. I got rid of the diet sodas, and I started Oh, really? I mean, I’ve always liked the topo cheat codes and the seltzer waters. Yeah. But in the ER, I started to get into a habit of having a Diet Dr. Pepper or Diet Coke or diet at 2am. Yeah, and my night shift. Yeah, at the halfway point from nine to seven. the halfway point was 2am. And so at 2am I would go grab a diet soda, go out to the ambulance bay and drink that and just take a couple minutes of getting away from the chaos, right? Get a caffeine high and come back in for the second half of the ship. And then it was early enough that it didn’t affect me going to sleep at night when I got home but or during the day when I got home. But that was where it started that little habit. And then and then it was right around that time actually Devon’s right here behind the camera. Hi, Devon. You know, we got to talking, and we that’s Devon’s really one of the big reasons why I’ve lost

Matt Ball 25:21
the weight. And he’s lost a lot of weight. He looks fantastic. Yeah. And

Erik Axene 25:25
you know, some of the motivation, Devin and Devin wouldn’t mind me telling this is that learning a lot about the heart and hearing us talk about this, Hey, I wanted to be more healthy. So we had a conversation and said, Hey, let’s let’s hold each other accountable and weigh in every week. And we have punishments. And honestly, in a week when I want to cheat and have that food I know I shouldn’t have I think, Devin because if I don’t make weigh in, then he gets punished. Yeah, I don’t know why.

Matt Ball 25:52
You’re doing like a team mentality. It really

Erik Axene 25:54
is. And Devin, I think we’d say the same thing if he was up here. But we’ve we’ve we’ve held each other accountable now for a number of months. Lots of months. I don’t know how many it’s been but we’ve lost weight and been successful. And you know what, it’s been fun and encouraging. And it’s not something that’s going to be a passing fad. For me, it’s built into the lifestyle. You same thing with fitness. I’ve been going to the gym three days a week, consistently now for almost a year. And I’m starting to see the benefits of that. And and I think those are things I can do the rest of my life. But it didn’t start big. Right?

Matt Ball 26:26
It didn’t start small, incremental things. Yeah. And

Erik Axene 26:30
you know, when I made the decision to go to the gym, I didn’t make the decision to go to the gym, I made the decision to set my clothes out early in my closet, and set my alarm. And so when I set my alarm to put my workout clothes on, I went to the gym. Right? That was that was really the small decision I made that helped me to make this other decision has turned into a habit. Now,

Matt Ball 26:52
you know, a lot of guys if you listen to like, Goggins or Jocko Are these like kind of motivational military guys. And they talk a lot about how motivation is crap. And it’s really true. That mode, if you’re waiting for motivation at four in the morning, there’s no motivation, the motivation is boring, My bed is warm, and I want to stay right here. You know, I don’t want to get out of bed and it’s cold and whatever. And it’s about discipline. And doing what you know you need to do is what you need to do. And that’s a big part of and that’s not easy, and that’s creating habits.

Erik Axene 27:25
You know, for me, what was a really good, you know, switch that I flipped was identity. I identified myself as a kind of an overweight guy that was trying to be okay with it, you know, I’m not I’m never going to be in shape, like I was in college. And I started to identify as being overweight, and I even joked about him kind of fat. He’s the big guy, right? And I still was able to mountain biking do the fun things I like to do but I started to identify it’s almost feel okay with it. Now I don’t identify with not accepting identify myself as a guy that makes good health choices. I tried to be strategic with the way I plan my meals, and try to limit the intake of calories. And same with extra, I’m a guy that goes to the gym. Sometimes I go to the gym, and I don’t stay long because I don’t want to be there. But I go to the gym,

Matt Ball 28:11
you check that box. You know, one thing I think we do need to say before we finish up is another huge thing is family history. Because you can be I’ve known guys that don’t smoke, they don’t drink, they eat clean. They exercise every day. Super healthy. We know a guy he’s a chief with your department, who, you know, very healthy used to run the stairs was only a pretty healthy guy overall. And at 39 years old, had a lot of cardiovascular blockage. Family history is huge. I just had a friend unfortunately, at 52 years old, just a couple of weeks ago, I’m going to his memorial service on Saturday, wife woke up and he had passed away and asleep must have had a massive heart attack. It’s what it sounds like. And so family history plays a huge role in your cardiovascular health. So if you don’t know like if mom or dad or grandma or grandpa had a heart attack at the age of 50 and you’re not getting checks, and you’re getting close to 50 you need to start doing that because you can be in the gym all the time and still dropped out of artifact. Absolutely. So you need to pay attention to that kind of stuff.

Erik Axene 29:14
Well I think the close it out what I would say if you’re listening and you’re wanting to be more healthy, is I would encourage you to make small choices. Building small habit and start with that to some small that’s easy to do. And then it’s called habit stacking and you stack another habit on that and you can build and then I think those are the decisions that we carry with us through a lifetime. So anyway, it’s been great. I love this This so good to be back. I can’t wait for the next one. I think the next one will be on rattlesnake so I can’t wait. It’s gonna be fun.

Thank you for listening to EMS, the Erik and Matt show

Transcribed by https://otter.ai