MY GERIATRIC PHYSICIAN

                                        The old rusty Nail

AN E-JOURNAL FOR OLD PEOPLE

Russell Burton, an Old Person

Now, the title might be a bit misleading for it could mean that my physician is old.  Well, that is not the case for indeed she is much younger than one who could be considered old. So when you read the title correctly you must conclude that I have a physician who specializes in old people.  The University of Texas Health Science Center located in San Antonio, TX has a Geriatric Center consisting of four physicians with appropriate medical specialties. This concept I think is rather unique and they do not pile up appointments months in advance and the physician takes plenty of time to talk to you.  You know not the five-minute visit most of the time with the physician writing out some prescription that you don’t need because he or she has not taken the time to understand your medical problem(s).

Of course those kinds of physicians have graduated from some medical school which at times gives them a god like ability to diagnose your condition by just looking at you.  Okay, I am being a bit factitious still it would be nice for your personal physician to get to know you a bit.  First they might learn something about you or your history that would have some bearing on your problem.  And, I do presume that you’re going to a physician because you have a problem and you think it might have some medical basis.

I have had three visits now with my geriatric physician group.  My first visit was about an hour long – yes an hour long.  She started out my giving me six things to remember then about ten minutes later she asked me to repeat them.  And, I got five of them immediately about 15 seconds later then I remembered the other one.  Not too bad, but then my brain is holding up alright as I write my monthly BLOGS and am I glad for a body without a brain is a most horrible thing.

During our hour chat she got to know me as she reviewed my meds which I was taking for my high blood pressure, GERD, and my blood thinner.  The blood thinner is for an arterial stint that I had inserted a little over a year ago.  She seems to think we can stop the blood thinner and that would be a wonderful thing to happen.  With this med I always have some severe bruising especially of my arms.  And of course when I cut myself, even very small lacerations it is hard to stop the bleeding.

My third visit was also enjoyable but different.  I was first greeted by a resident who took my history, etc.  You know this is a teaching hospital so patients must be patient as you are part of the learning experience.  He was very young, I thought early college age but of course at my age most everybody is younger so it becomes difficult to gauge their age precisely.  In 2013 while I was attending the Chautauqua Institute summer program the young man guarding the parking gate told me that he would probably not be there next year for he had just graduated from college.  I would have bet money that he had just graduated from high school.

I noted to my resident that one blood pressure drug was causing me to had short dry coughing spells that could be annoying.  He suggested that we might try another blood pressure drug.  Thoughtful but in comes the real doctor who suggested that we just reduce in half the drug I was taking. And take it in the evening instead of the morning. I’m sure the resident was prepared to have his instructions changed as it surely has happened before and will happen again until he escapes what he at times thinks is the ‘meddling oversight’.

As the patient I am thankful for the meddling oversight! Of course he is still learning about old people for his primary training in medicine was based on information on ‘normal-aged’ people.  Older people can have different norms.

I explained to the real doctor that I wrote a BLOG on being old and gave here one of my articles.  As I did, I explained that no one knows what it is like to old until you are old.  Now, she countered that my explaining that she had a severe accident that interfered with her mobility for several years and with great pain.  But, that is not being old.  Of course she has listened to many old people with aches and pains thinking that some of those pains would instill some knowledge about being old. 

Well, it is much more than getting hurt.  As I have tried to explain to someone who reads these articles on old age is that being old is another world that can not be explained.  It must be learned and that can only happen by being old!  There is no short cut or substitute!

Old age is a great dictator giving you no choice but to keep physically and mentally fit as possible.  One does not have any logical choice!  Young people have many choices about life but old people have few good choices.  Of course they can neglect what they must do to live a somewhat normal old life but only at their own peril.

It has been shown many times that the human mind does not care about the distant future.  It only is concerned about what is about to happen.  I wrote about that in an earlier article as the basis for not being concerned about the horrors coming at us full steam with climate change.  It is by far the most important problem we have but it is placed down the list of living priorities because the human mind will not grasp its importance because it is probably a century before we see the catastrophic changes which are surely to arrive then if not sooner.

It is clear that immediate problems are very important and in fact for less sophisticated animals it is by far most important.  The vast majority of animals have a short life span and with having to find food and water each day, escape life threatening danger, plus other serious problems, so short-term problem solving is in our DNA.  Long-term problems which now can be dealt with are very recent and primarily a human event, so of course it is not in our DNA. 

So, like growing old and even quitting cigarette smoking the consequences are far into the future but when they arrive it is usually too late.  I know about smoking for I had a three pack a day habit that was nearly impossible to quit, but I did it.  Now, I look at some of my friends who are still alive and still smoking (many of them died early) or quit much too late and am so glad that I could see the grim future in time.

But for old age it is much different than smoking to deal with.  Unlike cigarette smoking you can’t quit old age and be healthy. And, it is difficult to prepare for the future for it is unknown as to which of the major problems of old age will a person develop.  Still, care must be taken to approach old age with some activities which we know will be helpful.  Of course, those are simple physical and mental exercises which can be started in old age, unlike quitting the smoking habit when it is usually too late.

But of course trying to grow old with dignity I believe must be started early on in the aging process.  I started jogging when I was in my fifties and lifting weights at the gym in my late sixties.  The jogging has been reduced to walking for about an hour three times a week.  My weight lifting I do twice a week and lifting much lighter than the ones I use to work with.

Before my weight lifting, I do my stretches on a machine.  After this exercise, I walk upstairs without holding on to the railing and do a five minute balancing exercise on a ‘T-board’.  The day following weight lifting I do my 30 minutes of aerobics on a stationary bike when I get my heart rate over 100 bpm.

So, did I begin working on my physical prowess as I resist my old age on time?  No one knows but I am glad that I did start when I was much younger for I know it has helped me grow old with some kind of dignity!

As for staying young in mind, try writing a BLOG each month.  And, of course read regularly and don’t forget the Sudoku.

On my last visit she told me that I was very healthy so I should see her but twice a year.  Then she went on to explain the poor condition many people are at my age.  I guess to be considered healthy at my age the bar is not too high. And, I am off the blood thinner.

So I end pleased that I have my own Geriatric Physician who understands old people for old people have different physiologies and many different diseases one of which is old age.