Medicine for People!

June 2005

Contents

• Health and Living
• Practical Steps to Health

Health and Aging

When people ask me about "health and aging," I like to remind them that the real issue is "health and living."

When we take care of "living," we accept "aging" as part of the program. Think back to your childhood. If you were like many children, you had the wisdom to see much about life that your parents didn't give you credit for. You wondered why adults seemed blind to many parts of the world that fascinated you. The adults whom you most enjoyed still viewed the world with curiosity. They certainly didn't see themselves as "old people."

Balancing Self and Service

In last month's newsletter I wrote about a group of religious nuns who lived and died while actively engaged in a purposeful community. Religious or not, we all face a paradox in life. We need to engage in our community and give to our families and to our work. At the same time, we need to take care of ourselves.

I see people err both ways on this. If they attend too much to their responsibilities, they neglect their own needs and suffer from lack of recreational time or proper diet or exercise. Other people attend too much to their own needs and wonder why life seems somehow empty. Sometimes these issues bring them to my office with a medical problem. My advice is, "one hand for yourself, one for the ship."

Knowing What Our Lives Are About

Occasionally a patient will report that they've given up the doughnuts they used to love and their cigarettes and alcohol, and they ask me wistfully, "Is coffee bad for me?" I respond by telling them what local writer, poet, and friend Everett Whealdon told me. "Doc," he said, "you tell me to give up my pleasures so that I can live forever, but let me tell you, it's just going to seem like forever."

This conflict between "living" and "reducing aging" will become ever more stark in the future. In the May 2005 issue of Atlantic Monthly, Charles C. Mann pointed out that advances in technology promise to extend life considerably beyond the "three-score and ten." He predicted intergenerational warfare over ever-scarcer resources as a result. This led me to wonder. If I had to choose between giving back to the world what I owe it for the wonderful life I've enjoyed or spending all my resources on medications or genetic modifications to extend my life, which would I choose?

We need, we desperately need, to know what our lives are for and to have the energy and courage to use our time on this earth to further our life goals. When our only concern is to preserve life, we are like the miser who can only save, but cannot spend.

We need to reframe our picture of life. Age is not something to fear. In my daily work, I hope to bring life, more healthful life, to my patients, and yes, that means "age" as well. Do you want to "age" from day to day, or "live" from day to day? Tough choice, huh?

Practical Steps to Health

And now to the "one hand for yourself." What can you do?

1. Be skeptical. Don't trust numbers. Statisticians can lie; laboratory numbers can be wrong; I even saw a CT scan miss a significant cancer once.
2. Don't despair. Accept some uncertainly. Do your homework, research what you can, and make decisions based on the best information you can get.
3. Be skeptical of physicians. Even when we are conscientious, we make mistakes. Be sure we understand what your situation is. Question us if something doesn't seem right. Call us if something doesn't turn out the way we said it would. If we don't answer, call again, and if we still don't answer, find another doctor. There are over 800,000 of us - you are bound to find one with whom you have good chemistry.
4. Remember that you are a "custom job." No one else is exactly like you. You are the person who will discover which life habits make you feel best. When you see news reports about vitamin E or cholesterol, you need to decide, perhaps with the help of your doctor, how that may or may not apply to you. Fads come and go. Don't waste your life on them.
5. You know what your biggest health handicap or health risk is. Deal with it. Get help if you need to.
6. There is no substitute for fresh food, freshly prepared. If you pay attention to the nutritional news, you'll learn that cinnamon can help diabetes, that broccoli prevents cancer, and that flax seed oil promotes heart health. Whether or not you pay attention to the news, eat a variety of foods -- all colors, all tastes, and preferably from the periphery of the supermarket.
7. You have clocks inside of you that govern innumerable metabolic processes. They tell you when to go to bed and when to get up. You have clocks that govern your emotions and intuitions. Keep an eye on these clocks.
8. Your health, your strength and your abilities last longer when used. There was a time when we told our patients with arthritis, back pain, or heart failure to take it easy. Experience now shows that we were wrong. All these people do better with increased activity. Ideally you can live like a bird, which is active until the very end, then dies. Ideally you can escape decades of decline. Activity is the major key.
9. Always remember, death has a hard time with a moving target.

This article was Originally Published in the "Olympic Business Journal."

CJK February 1, 2006

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Medicine for People! is published by Douwe Rienstra, MD at Port Townsend, Washington. Edited by Carolyn Latteier.

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