Sunday, February 28, 2010

How to "Die Healthy"

     Let's face it! Numerous advances in health technology cannot change one fact. Sooner or later we will die. We read about Mr. Rich-And-Famous being admitted to Best Hospital and then succumbing to a life-ending illness - The Great Equalizer. All the resources at our disposal will not change that fact. At first blush this premise may sound too fatalistic; especially coming from a doctor. On the contrary, life and death situations we face allow us to be more pragmatic. Let me tell you about a lesion I learned as a young doc.

     Mr. Jones was in his 90's, living at home independently, driving and managing his own business affairs. Most of his contemporaries take more than ten medications. Mr. Jones took one multivitamin a day. His weight and blood pressure were normal. And except for occasional arthritis pain, he was rarely ill. "I know when it's gonna rain", he proudly proclaimed. I asked him about exercise. He answered, I work on my lawn every day. and when I finish mine, I start on my neighbor's." I marveled at every statement he made. One day he told me what he wants out of life. The words stuck with me. "I want to die healthy."

     This contradiction in terms made more sense as I grew older and wiser. One day I received a call from the police to tell me his housekeeper found him in his bed. He died in his sleep. His story exemplifies the concept of living a healthy lifestyle and being passionate about the things you care about. Mr. Jones lived his life to its greatest potential. He did not smoke. He ate his vegetables every day. And except for an occasional glass of wine, he did not drink in excess. Never afraid of physical labor, he was proud of his muscle strength. Best of all, his attitude was always positive. These are characteristics I see in many patients that live long healthy lives.

     In contrast, there's the story of Mrs. Smith. Initially, she was overweight and smoked 2 packs a day. She had hypertension and high cholesterol which did not stop her from her self-destructive lifestyle. At first she felt well except for occasional shortness of breath and a "smokers" cough. Within a few years she was sick all the time and was on multiple medications and inhalers. Over the years, she developed diabetes, eye problems, and arthritis which caused her to gain more weight. There was always an excuse for her behavior...problems at work and a husband who was not happy being home etc. Her children where having problems of their own and unfortunately, they were following in her footsteps. Eventually she became partially blind and had multiple procedures for her circulatory problems. She was admitted to the hospital frequently and the staff knew her as "Miss Personality". One day at age 70, she came into the emergency room and was placed on a respirator. A DNR (do not rescusitate) was never signed so she remained on life support for 3 weeks until she died. While in the hospital, she developed gangrene of her foot and pressure ulcers that reached the bone. This was not a "heathy death". Many would argue that Mrs. Smith received the best care science had to offer. Technology at its finest! After all, she had everything from MRI's to angioplasties and has a hospital bill to prove it. Among other things , this case illustrates the failure of our reactive health care system. Not only did she have an "unhealthy death"; most days in her life she struggled to live with each breath.

     The choices we make on a daily basis have the highest impact on our health. The industrial complex would have you believe that fast food equals happiness. "Don't worry be happy!" "Have it you way!" The next new drug will solve all your problems. And if that doesn't happen, there's a pill that will make you think it did. We are an ailing society misguided into making the wrong choices. Our decisions are shaped by someone trying to sell something and by a health care system that discourages prevention. When Mrs Smith was younger, she was convinced that "she's come a long way baby". Bad habits are learned by our children with their first Saturday morning TV session. The result: our next generation will have a shorter life expectancy than the previous one.

     So how do you die healthy? You must go against the tendency to rely on technology to solve all your problems. Make the right choices based on old fashion common sense. Value concepts of prevention, healthy lifestyle and ideals that strengthen the human bond. And every once in a while, do your neighbors lawn.

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