Friday, November 24, 2017

A Pathology of Doctor’s Visits …. Of the Elderly

 When medical authorities break the news that your eyesight is compromised, then it is time to be hip and cool and get reacquainted with your dark sunglasses, every time you are in the sun.

Recalling a past time when only blind mendicants being towed around the city by their guides wore those dark glasses, all day.
Now it’s considered hip, cool, and even rad, when you see those celebrities wear those outsized dark glasses even when the sun has gone down.  Even our local hipsters have followed the trend, their little faces almost completely hidden by those faddish glasses.

Now it is my turn.  An old clip-on, recommissioned for new service.

As the centenarian lady runner opined, her performances in her races are not getting any better, but only worse because of her advanced years.

The same could be said of doctor’s visits for one who has reached hard to count years.  Like I am?

Thus, those visits may not be welcomed, but rather dreaded a bit and to be avoided if possible.

Anyway, in my case the choices are next to nothing, especially if I want to continue to live.  So doctor’s visits have to be scheduled and observed.  And because we now live over 7500 miles away from our health provider, the visits take on the nature of one-stop shops.  Examinations covering from head to toe, especially for a case like mine whose medical rap sheet runs in pages, are called in covering various appearances on different occasions.

Expectations on these visits are rather modest and the bars are set very low.  Just hoping that the conditions discovered during the last visits had not worsened, or that no new alarming conditions have in the meantime cropped up.

But like the centenarian lady runner, we foreknow the results to be expected.

And these last visits are no different.  Existing conditions have dipped even lower, and new ones are discovered, expected from an aging body that is on the inevitable road to its own junkyard.

So now know that your buddy pacemaker has to work harder to maintain that normal heartbeat, like 96% of the time.  By the way, your thyroids are not in synched so will now have to lower the daily doses you have been taking.   Also, with the new guidelines, your elevated BP will have to be attended to even more.

And the new findings?  A double whammy.  A slew of quick vision care exams show invasive cataracts on both eyes, and presto, you are now considered a “glaucoma suspect”.  And thus a battery of exams will have to be scheduled.  If you have the time.  And please keep your eyes protected from the blistering sun in the tropics.  So advised to wear sunglasses. As usual, your total cholesterol level is at best borderline.  So….  Etc.…. 

A little glimmer of hope.  Your eyeglass prescription has not changed since the last examination which was years ago.  A significant enough good tidings to celebrate?

While the overall prognosis may not be exhilarating, one continues to be of the thought that life is still bearable and livable.  Continued physical exercise is still allowed and continues to be a  tolerable routine that produces some uplift not only in physical fitness, but more importantly in mental alertness and acuity, part and parcel of what is called the “runner’s high”, or the “second wind”.  This does the late Jim Fixx proud, the father of running who died doing the best thing he liked to do, running.






Monday, November 06, 2017

Life Reduced to Arithmetic Calculations, from Start to Finish.


Exactly 9 months after being conceived, a man is ushered into the world, a world of consuming uncertainties and unknowns.

Where the only certainty is that life is finite, but as to how and when exactly that is the riddle.

Still, man plods through life making arithmetic calculations and planning, based on dog-eared standards refined through the ages

From the age of reason, that man learns to use Arithmetic to plan and live his life.  He plans for the years of elementary, secondary, etc. schooling, the monotonous cadence interspersed briefly with some levity and idleness known as vacations, holidays, etc.

Then he plans for his productive working life, including the idea and feasibility of creating a family of his own.  All this, amidst the uncertainty of the length of his life, but guided essentially by the life expectancy table again honed over the ages, taking into account all other elements which may make that life shorter like accidents, sickness, disease, etc.

Past the peak of his mature life, typically human parts start needing attention.  Some start becoming bothersome and maybe life-threatening, and thus requiring professional help.

As he approaches closer to his expected life span, tweaked by the many enhancements and modifications that blazing science and technology can offer, his arithmetic calculations take on more certainty, and shorter duration.

In my instance, the most hardy and robust of human organs, the heart has required special and customized attention. It has the close assistance of a pacemaker, or more technically an ICD, implanted cardioverter defibrillator, and for my particular case, a dual-chamber unit, with two leads, one attached to the upper right atrial chamber, and the other to the lower ventricular chamber.  Each lead provided with an electrode that will provide the spark when necessary to keep the heart beating normal.

The upper lead will provide the electrical spark that is typically provided naturally by the sinus node in the heart.  Absent the spark, the heart may not beat at all and life will be no more. 

In my case, my beating heart now uses the pacer for the spark needed 98% of the time, while the lower lead is being used only 6% of time.  Per last examination/reading the implanted pacemaker I have still has an expected usefulness of 13 years, taking into account its current usage.

All these details put into context, the more or less exact length of my life.  Until and unless a new pacer is installed to replace the depleted one.

This therefore as one can clearly see, puts an arithmetic certainty to the end of one’s life.