He's tired. Not sick, exactly — just tired. His sleep is off, his energy is low, and the number on the bathroom scale has been creeping up for two or three years. His wife mentions the doctor. He says he'll call. He doesn't call. It's a story that plays out in Westlake, in Avon, in Rocky River, and in just about every suburb west of Cleveland — and the conditions building quietly in the background don't wait for a convenient opening in the calendar.