2 Self Care Tips

Two points that I think all of us should keep in mind as we look to take care of our health as we age:

First, if we reach a point where we feel the benefits of taking a prescription medication outweigh the potential negative effects, it's important to monitor liver and kidney health.

Why?

Because virtually everything we put into our circulation, including prescription meds, has to be processed by our liver, and the bulk of any residual waste from said meds has to be filtered out of our system by our kidneys.

Generally, prescription meds are highly concentrated and potent chemical compounds, so despite their small size, any meds that we take daily for decades will put cumulative stress on our liver and kidneys.

Depending on the specific medication(s) in question as well as dosage(s), our liver and kidneys may do just fine in processing and filtering without sustaining irreversible damage. But it's prudent to monitor these organs via routine blood work to ensure that there are no early signs of breakdown.

Liver health is generally monitored via an enzyme called ALT, and kidney health is monitored with blood creatinine and to a lesser extent, simple urine analysis.

The second self care tip is this: remember that the older we get, the greater our risk of experiencing complications with major surgery and harsh treatment protocols like some types of chemotherapy and radiation. Also, our tissues don't heal as well with each passing decade.

Generally, my view is that the risks that accompany major surgery after about the age of 80 outweigh the potential benefits. Clearly, many personal variables need to be taken into account, including the specific health issue at hand, one's health status, and the statistics that are available for the major surgery/treatment being proposed, including best upside scenario and downside risk.

Does it make sense to have bypass surgery when one is 85 years old? How about open abdominal surgery to remove a large section of colon and perform an ileostomy in one's 80s? And what about chemo and radiation for a malignant growth around the kidneys when one is feeling relatively healthy at 83 years of age?

A lot can go wrong with major surgery at any age, but especially so when we reach about 80 and beyond. The sad and perhaps harsh reality is that for some specific medical specialities, the vast majority of income is made from performing major surgery on elderly patients where the patients take on considerable risk and the medical team has little to lose and significant income to gain - in this scenario, it is only natural to expect a surgeon to express confidence in a successful outcome, and to downplay the potential risks and complications.

There are many good-hearted health care providers in our world who are honest and provide the same guidance to their patients that they do for their loved ones. But ultimately, we must remember that it is the patient who is taking on all of the risks, and the health care provider is heavily incentivized to carry out expensive surgeries and treatment protocols.

When presented with the option to have major surgery or undergo any treatment plan that our tissues will pay a heavy price for, some questions to ask are:

1. What is the percent chance that I will die from this?

2. What is the percent chance that I will suffer serious complications that will leave me in a hospital bed for many weeks or months where the care is partly or mostly governed by a defensive mindset of wanting to protect one's own livelihood? Is it really helpful to a severely weakened patient to have multiple vials of blood drawn every day to ensure that all providers involved can say they did all they could?

3. What would the quality of my life look like if I refused treatment and just did the best I could with diet and lifestyle?

4. How and where do I want to spend my remaining days?

My experiences over the past 25+ years tell me that it's essential to carefully think about such things well before we are faced with having to make such choices. Once a patient is diagnosed and told that they can be "cured," the natural tendency is to want to believe in a successful outcome and to be dismissive of the risks.

I hope these thoughts are helpful to some out there.