I’ve spent the last couple of weeks making house calls to “at risk” seniors in rural South Carolina. At the rate of about 7 house calls per day, I was able to make some observations based on a respectable sample size. I was both surprised and intrigued by the living conditions I encountered, and I’m pleased to report that I have now performed my first physical exam under the careful scrutiny of a cat, rooster, and hen team (photo at left). On another house call I was offered a pygmy goat as a thank-you for my efforts, and countless good-natured folk offered me home made iced-tea and such edible delectables as fish patties and peach honey.
But what struck me the most was that certain seniors were in far better health than others their age, and that the healthier ones all had one thing in common: strict daily exercise regimens. I realize that this is not ground-breaking news (that exercise is good for us), but the stark contrast between those who exercised and those who didn’t could not have been clearer to me.
One particularly charming 85 year old man gave me a tour of his vegetable garden, and explained that he bicycled into town six days a week to give away okra (and other veggies) to church friends and town folk. Growing vegetables and giving them away was his current life’s work, and although he lived in extremely modest circumstances, what he owned was tidy and clean. He was joyful, bright, and had the physique of an athlete.
Contrast this man to another patient in his 80’s who didn’t exercise at all, and stayed inside smoking cigarettes most of the day. He was blind in one eye, nearly deaf, struggled to breathe, had sores on his skin. He was depressed, over-weight, and swollen from heart failure. I was so sad to see his condition, and the relative squalor in which he lived. Urine and smoke odor permeated the house, and I wondered how much longer he would survive.
When I arrived at another octogenarian’s home, I noted that the garage was filled with watermelons of various sizes. Upon further inquiry, the gentleman said that he had hand-picked the watermelons from a plot of land that he owns 2 miles from his house. He brought them back to the house with a wheel barrow… and had made many trips back and forth over the past week. He was taking no medications and had a completely normal physical exam.
And so my days went – back-to-back visits with seniors who either were engaged in an active lifestyle, or who were wasting away, cooped up indoors with advancing dementia and chronic disease. I realized that no medical treatment has the power to overcome the relentless damage that inactivity, smoking, and deconditioning cause. The secret to a healthy old age lies in lifestyle choices, not pill bottles.
As we enjoy the last holiday weekend of the summer, let’s consider how important labor actually is to our mental and physical well being. You’re never too old to haul watermelons down the road, grow okra for your neighbors, or simply commit to smoking cessation and daily walks. If you do this regularly, your health will surely improve – and your quality of life will be enhanced immeasurably. In the end, adding life to years is what medicine is all about.
Active, healthy medical students are more likely to prescribe physical activity to patients, according to research presented at a meeting of the American College of Sports Medicine.
A research team assessed objective markers of cardiometabolic health, including cardiorespiratory fitness and attitudes on physical activity counseling, in 577 freshman medical students in Colombia from 2005 to 2010. Students’ health and fitness were measured by waist circumference, body mass index, fasting glucose levels and lipid profiles, in addition to the 20-meter shuttle run test.
Attitudes toward physical activity counseling were gauged through students’ answers to “How relevant do you think it will be in your future medical practice to counsel your patients on physical activity?” and “I will have the ability to counsel my patients more credibly and effectively if I am physically active.” Read more »
*This blog post was originally published at ACP Internist*
Several studies have shown that women have a higher mortality rate than men if they have a heart attack. A study published in the American Heart Journal helps to explain why. The researchers looked at data from 2,542 women who had a heart attack. Compared to men, the women were older, less likely to be white, and less likely to smoke. They also had more serious health conditions than the men. They had diabetes, high blood pressure (hypertension), congestive heart failure, and chronic obstructive pulmonary disease (COPD).
We’ve known for a long time that women are about 10 years older than men at the time of their first heart attack. The authors believe that the reason women are more likely to die is because of these other conditions that are present. Women in the study were also more likely to receive a blood transfusion and experience gastrointestinal bleeding, strokes, and vascular complications which lead to death.
They didn’t find any gender difference when they controlled for these other conditions. The number of diseased vessels were the same as was the severity of stenosis.
So what does this tell women? The guidelines for longevity and good health haven’t changed: Don’t smoke, control high blood pressure, and make sure your weight is healthy to prevent diabetes and other vascular problems. Stay active. Heart attacks can be prevented by good lifestyle choices.
*This blog post was originally published at EverythingHealth*
“Why should I take my blood pressure medication,” you ask? The more I do this thing called hospitalist medicine, the more I appreciate the power of lifestyle choices we all make.
Every opportunity I get I give my patients my smoking lecture and charge their insurance a CPT 99406. Everybody knows that smoking is bad for you and it causes lung cancer. Nobody knows all the other stuff. They’re always shocked.
Maybe it’s time for me to start a blood pressure lecture. I often have patients who say: “Why should I take my blood pressure medication?” They always answer their own question with the same answer: “I was feeling fine. I didn’t see a reason to take my blood pressure medication.”
You see, these are people with insurance. These are people with the Medicare National Bank. These are people who don’t have to lift a finger or a dime to pay any out-of-pocket expenses for their healthcare. And yet, they still lack the motivation to care for themselves, even with incredible resources out there these days to help them — things like great online blood pressure chart sites for home monitoring.
Whatever the reason — whether it’s ignorance, laziness, lack of motivation, lack of remembering, or selfishness — people just don’t take care of themselves. Read more »
*This blog post was originally published at The Happy Hospitalist*
As an American, I was proud when I heard the news. I grinned to myself. It was on my way to work, through a beautiful city park, with the sun rising over the hillside. The morning radio program reported the news that a California judge overturned their state’s ban on gay marriage.
I know what you’re thinking: A medical blog is running amuck right into a political hornet’s nest. But isn’t it true that a nation’s kindness is a defining characteristic?
America and Americans do much that is good and right. Examples of such goodness are too numerous to list. If you are a victim of a calamity, you can be sure that America will help. Ask Haiti. And it’s not just foreign countries, we help each other. There’s a flood and then there are volunteers. A power outage and there are cords across the streets. It’s not controversial to say we are a kind nation. Read more »
*This blog post was originally published at Dr John M*