Let’s Get Physical
With the move to San Diego there are many tasks and transitions needed to make everything flow smoothly. Kim and I have the good fortune to be in good health. I am in surprisingly good health given my size and my ongoing lifestyle choices. My family and I joke about how 23&Me designates me as being predisposed to be a performance athlete. I care little about that, but I certainly do prefer to feel good and not be burdened with bad health. Who wouldn’t? Every day that goes by, someone I know has to grapple with some malady or another. The one small bit of common wisdom is that early awareness and vigilance is the key to making the best of bad health situation. Actually, that’s besides the more effective, but clearly more elusive case for prevention. The cost of prevention has always struck me as very dear. Your life is not yours to live, but rather some researcher’s latest sense of what degree of temperance is necessary to achieve prudence for the sake of good health. The irony is clear. You do what is needed to enable a longer life, but the quality of life goes down with each abstinence level achieved. Luckily, everyone has different and probably adjustable priorities, so quality of life becomes a proverbial moveable feast.
Thirteen years ago I had a lap band installed in my gut. It has done what no nutritional education, behavioral residence programs (from one to four weeks in duration), or pure discipline has ever been able to do for me. I am not talking about the 100+ pounds I lost and have successfully kept off all that time. I am talking about the fact that it has effectively doused my interest with and pleasure derived from food. I still eat and I still have things I enjoy eating, but I can skip meals without a thought and I can for the most part eat because I feel I should as opposed to because I passionately want to eat. Most meals find me staring at my food wondering how, after a bite or two, I can motivate myself to eat it. That is still a very unusual place for me to be after a lifetime of prioritizing the consumption of food. The best news is that it reinforces my health status at little or no cost to my new standards of life quality.
I had a very dogmatic doctor (GP) for fifteen years. Both Kim and I used him. He was Irish. I frustrated him for all those years because he was sure my lifestyle would result in irreversible health problems. He was not the first doctor to take that view. A company doctor who treated me between ages 22 – 46 was the first to take up the cause. He was a great guy, so I’m sorry to say I’ve outlived him now by twenty-five years. I met a very trim and driven doctor at Duke who made me her personal project. I am very thankful to her because whatever doubt may have existed about the extent of my fundamental good baseline health was eliminated during my month at Duke in 1998,0 thanks to her putting me through every test known to modern medicine. I’ve had Thallium stress tests, echocardiograms, angiograms, etc., etc. I’ve gone through hepatabiliary scans (also nuclear like Thallium), full-body CAT scans and MRI’s and have had two sigmoidoscopies. Nothing.
Two years ago my Irish GP left to move west and did an exit physical with me. He said, “look, we know you don’t have cardiac issues, there’s no cancer in your family, your PSA is low, your pulmonary function is strong, your blood sugar is well under any level that would cause you to be wary about diabetes, your arterial system (carotid, etc) is devoid of blockages, your lipid profile is good….so let’s talk about your joints!”
That was prescient. I’ve not had any joint surgery even though I’ve had some knee trauma twice. My back and it’s discs are not distended or displaced. No rotator cuff problems. My toes and little fingers have some neuralgia, but I can live with that. I do have all the normal morning or evening aches and pains anyone my age has, but none of it does more than slow me down a little. None of it comes close to knocking me out.
My new replacement GP and I met for my last annual physical with him due to my move. While I have yet to get my blood and urine work back yet, the EKG, prostate exam, blood pressure and general exam all made him shrug. Our biggest topic was that I should stop taking enteric aspirin since the risk of bleeding out from a motorcycle accident or something was far greater than those baby aspirins helping a non-cardiac patient like me. He is equally negative on my continuing on lasik diuretic, but he was ultimately comfortable that I knew when to use it and when to avoid it rather than just popping them daily from my pill box. I told him I was taking a B-12 supplement at his urging last year and he shrugged his indifference. He joked that he had to earn his annual fees with me by making some kind of suggested improvements in my regime.
When you move from serious medical concern through medical frustration and end up in the zone of medical humor and resignation, it feels like a victory for the common man against the mushrooming healthcare juggernaut that holds so many of us hostage. I’m the guy who’s insurance premiums pay for everyone else’s expensive and dramatic medical needs.
Don’t get me wrong, I am sure I will die one day. I may yet develop some nasty disease I don’t see coming. I may even step off a curb in front of a bus and die before my time. I just went looking for an old picture of my father in his youth. What I also found were pictures of my mother in her prime and one picture of her at 100 years and four months as she lay in her hospice bed. I have a sanguine view of my health and since I believe attitude and confidence are half of every battle, I’m glad for that. I have left little on the table (other than some good lately) in my life, which is just as my mother and my father and my maternal grandfather would have had it. What that means in my worldview is that when the grim reaper comes my way, I will salute and exit stage left. The good news is that my latest GP told me today that I should just keep doing what I’m doing. I hope I find as simpatico a doctor in San Diego, because I prefer to get my physical with that kind of dose of optimism.