Saturday, September 03, 2011

On longevity and lifestyle-associated diseases with aging, it's time for tough love

Having stopped a part-time job (IT jobs blog, Aug. 29), I probably will spend more effort soon on medical matters, including the ruthless colonoscopy and followup on a PSA antigen test.  I can imagine, because of some heart  arrhythmia, being shaved for a Holter Monitor.   (The preps for the stress test, which I probably wouldn’t pass, are bad enough.) No thank you.

And, at 68, I have to be braced for the idea I could get “bad news”.  So, yes, I need to get some other affairs in order.  I do know that if my life were to end violently, because of aggression from others (as in a terrorist attack), I might have different intentions as to what I want.  Sometimes there are lessons to be learned; some  things have permanent consequences.

I also believe that with some seniors, in terms of medical care, “less is more”.  Some people might remain productive and active much longer than medical “experts” predict, with little treatment in the way of chemotherapy or potentially mutilative surgery.   One trouble with today’s Medicare system (whatever all the talk about means testing) is that doctors have every incentive to over-treat, and it can be difficult to get them to stop at exactly what you want and have faith will be acceptable.

I’m finishing up the reading of Albert Brooks’s “2030”, which I will review soon on the Books blog, but his point that our society cannot afford infinite longevity (without generational warfare) is obvious.  Consider the lifestyle we live.  Growing children need proteins and fats, and having enough food has been a valid concern in the past (and still is in most parts of the world). But our high fat diet reasonably allows most people to make it only to their 70s (or maybe early 80s) at best without major medical interventions.  We used to accept that.  (We didn’t even bother people to purge out for colon screenings.)  During the last months, an unmarried family member stayed home with the elderly parent, who usually did not expect to live long.  There was no moral controversy. But now we can try to keep people going for 15 or 20 more years with bypasses and transplants, the last years of which will get bad anyway.  And the diseases, mostly coronary artery disease and Type Ii diabetes and many cancers, have been brought on largely by behavior and excess food consumption.  If people want thirty more years and to live regularly to 100 or more, they will have to switch over to all vegetarian diets in early adulthood.  And exercise more. In moral terms, it’s that simple.  (See TV blog, “The Last Heart Attack”, Aug. 28.)

Wikipedia attribution link for Holter Monitor picture. 

Update: Sept. 13

Check Sandra Boodman's story in the Washington Post, "Seniors get more medical tests than are good for them, experts say", link

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