The Longevity Prescription of Dr. Robert Butler: Practice Prevention
Wednesday, 20 October 2010
Throughout this book, Dr. Butler does not waste words. Every chapter is packed with helpful information. Even when the admonitions are not new, they are a powerful reminder about how much we can control about our health and how to do it. Most of it is common sense, but we don't always practice that.
As Dr. Butler notes, we each are our physician's partner in prevention of diseases and conditions and it is important to educate ourselves not only about healthy living, but about the medical procedures that can help.
Sophisticated screening tests, many developed during our lifetimes, can detect problems before they are life-threatening. Your doctor should be your guide, but these are the basic tests:
Cholesterol – at least every five years; more frequently if it is elevated
Fasting Blood Glucose – every three years, more frequently if there is a family history of diabetes or if glucose levels are elevated
Blood Pressure – with every visit to your physician. Hypertension is “virtually undetectable” in daily life, say Dr. Butler, but easy to diagnose.
Colorectal – to help detect cancer, at your physician's recommendation
Eye Exam – every year or two to check for glaucoma, cataracts, age-related macular degeneration and vision loss
Dental – at least once a year
For men, there is an additional annual test for prostate-specific antigen that can detect cancer and other conditions.
Women need several more screenings: an annual breast exam by a physician, annual mammogram, pap smear and bone density test at intervals recommended by a physician. (Yes, there is controversy about how often mammograms should be done; consult your physician.)
When I was a kid, my grandfather's wife, for reasons of vanity, refused to wear a hearing aid and it was impossible to carry on a coversation when everything said by anyone in the room was followed by, “What did you say?” or “Speak up” from her.
Butler points out that hearing loss, in addition to being frustrating, reducing employment opportunities, causing isolation, depression and diminished participation in life, is also a safety issue.
“Not being able to hear such warning noises as honking horns, machinery, or other cues puts the person with a hearing deficit at greater risk for everyday accidents.”
Because it was mostly new information to me, I was most interested in Butler's section on immunizations. He recommends annual flu shots, which I do, and pneumonia (PPV) every five years beginning at age 65. But I was unfamiliar with several others.
Shingles, caused by a reactivation of the virus that causes chicken pox, is a painful skin eruption that occurs mostly in adults and can lead to chronic, debilitating pain and, sometimes, vision loss. A single innoculation after age 60 is advised.
Childhood vaccines protect most of us from tetanus, diphtheria and pertussis during adult years. But tetanus and diphtheria should, says Dr. Butler, be given again to people older than 65 and thereafter at ten-year intervals, especially for people who have close contact with children under one year of age.
If you Google HGH (human growth hormone), you'll get more than five million returns mostly selling it as an anti-aging drug – or selling something the seller says is HGH. Listen to Dr. Butler:
“...there is no anti-aging drug...There is no evidence that HGH enhances longevity (there is evidence, in fact, to the contrary in animal studies).
“...the only thing for certain is that its marketers profit from its sale.”
Butler also mentions testosterone supplementation – that for mid-aged men with damaged testes testosterone can strengthen muscles and bones and enhance sexual function, but there is no evidence that is so with elder men. In fact, says Butler, it may put men at greater risk for prostate cancer and perhaps stroke.
Other anti-aging supplements Butler mentions – carnosine, coenzyme Q10 and ginseng need much more study before anything definitive can be said about their effectiveness for the specific qualities their proponents claim.
There are good sections in this chapter on prevention of diabetes, heart disease and cancer and an excellent section on questions to consider if faced with a potentially terminal disease. Among those questions:
What are the chances I can be cured?
What will my quality of life be as a consequence of treatment?
What is my likely life expectancy?
Do I wish a do-not-resuscitate order in place?
With whom do I need to share news of illness?
How will I spend my remaining time?
What has my life meant to me and others?
This is a section I'm marking with a red Post-it to find easily should I ever need it. There is also an example of a Health Care Proxy, something we should all execute while we are healthy so that if we become incapable of making decisions for ourselves, there is someone we trust to do so. Requirements for this document vary by state, so seek consultation where you live.
You may be familiar with Norman Cousins' book, Anatomy of an Illness which recounts his battle with a life-threatening disease using humor – well, belly laughs actually, induced by watching Marx Brothers movies.
In a section titled “Laughter is the Best Medicine,” Dr. Butler recounts a study in which healthy patients watched portions of two movies – one violent and stressful, the other light and funny.
“...the study found that average blood flow increased 22 percent during laughter and decreased 35 percent during mental stress.”
It's good for us to laugh, so maybe today some of you will leave something in the comments that will give the rest of us a chuckle.
Next week, the final chapter of The Longevity Prescription with tips, tricks and strategies for staying with a new healthy living regimen.
At The Elder Storytelling Place today, Steve Kemp: Long Lost News: Cuban Death Ray Threat
Well, OK, I chuckled at this story and perhaps you will too.
An old lady was very deaf and heard nothing. She decided to get an implant and now she could hear everything.
A few months later a friend said to her," I suppose your family is very happy that you can hear now."
The old lady replied, "Oh, I haven't told them I can hear. I sit in the corner and listen to every word they say. I have changed my will three times."
Posted by: Nancy | Wednesday, 20 October 2010 at 06:18 AM
Shingles. Well, I had Shingles when I was 9. Unusual, yes. Frightfully painful, yes. So my husband and I got the innoculation. Our doctor thought I wouldn't need it. Guess what? I got the disease anyway. Because I got to the doctor the day the rash appeared,I was put on meds which shortened the length and reduced the severity of the disease. It is wise to get the shot none the less. There is a 50% chance it will protect you. Worth the gamble. Hey, My husband didn't get it! Who knew he got the winning 50% "ticket!"
Posted by: notdotdot | Wednesday, 20 October 2010 at 06:28 AM
I am up to date on all of my vaccines and most of my screenings with the exception of a mammogram. I have not had one in several years and don't intend to get another. I have had false positives in the past and I am not confident that they are accurate enough to bother with. I self exam.
I do not use food store supplements because they are not tested and can vary from being weak to being too strong. I don't believe in them and Dr. Butler confirmed my beliefs with the exception of ginseng; the jury is still out.
I have had a living will and medical power of attorney for years. I always talk to any new doctor to make sure he won't override my wishes on 'palative care only' when I am terminal. My children are all happy with my wishes and will help make sure they are carried out.
I think I have covered most bases and am doing as much as I can to stay healthy. There isn't much I can do about old joints that are wearing out rapidly, but I do what I can.
Posted by: Darlene | Wednesday, 20 October 2010 at 06:48 AM
Yes, mam, I do it all. I didn't know about the shingles shot tho. I'll call my doc. Hope and laughter will help all the rest. Thanks.
And why not post a current photo of you in your border too. :)
Posted by: Mage Bailey | Wednesday, 20 October 2010 at 07:21 AM
I think I have covered most bases and like Darlene do as much as I can to stay healthy. I am very active, always have annual flu shot, up to date on pneumonia and tetanus. My doctor of 35 years retired and have a new doctor (the age of my youngest daughter :) she told me with my past health record and now being in middle 70's that I did not need a mammogram unless I felt something unusual. Also pap smear she said I know longer needed. Have not had them in 3 years. I hated these tests!
All of my paper work has been taken care of. If I did not have some colitus and the immune disorder that gives me dry mouth and eyes I would be almost normal - except for tiring more easily. That's it from this aging One Woman!
Posted by: ernestine | Wednesday, 20 October 2010 at 07:34 AM
Forgot to add - as I proof read my entry. I do everything to0 fast and I see errors after something has been posted - but think everyone knows what I mean !!
I am trying to slow down.
Posted by: ernestine | Wednesday, 20 October 2010 at 07:37 AM
Hey Mike, Did you read what the post said about HGH?
Ronni, how did this sales promo slip by you?
Posted by: Estelle | Wednesday, 20 October 2010 at 07:37 AM
Estelle...
I remove about a dozen of such comments a day - sales pitches that trolls seem to believe read like a real comments.
You got to this one before I did. It's gone now.
Posted by: Ronni Bennett | Wednesday, 20 October 2010 at 07:53 AM
http://www.youtube.com/watch?v=gLdf8WwkMWw
You can't go wrong with a morning Lucy laugh...this is a long clip, but anytime I start to make a bread from scratch, I remember this episode...
Posted by: Cowtown Pattie | Wednesday, 20 October 2010 at 07:58 AM
Have an annual physical coming up. This post was just in time to ask some questions about shingles immunization and a couple other items. Thanks!
Posted by: Linda Skupien | Wednesday, 20 October 2010 at 08:17 AM
What a good chapter. I had shingles a couple of times in my 50's and I got the vaccine last year. A 50% chance is worth it in my opinion, what a miserable disease. Even after medication it took nearly five years for the tingling and stinging of the second bout to subside.
The Aging Driver section: I took the AARP driver's online course, http://www.aarpdriversafety.org/. It takes 8 hours but you can do it at home and in sections. They give you up to 60 days to complete it. I believe it cost $15.99. I did it for the discount my auto insurance offers for completion but to my surprise I learned quite a bit including how my ABS brakes actually work.
I do have an end of life document but I never given it to our local hospital or my own doctor, duh!? I will try to do that this week.
Posted by: Celia | Wednesday, 20 October 2010 at 09:05 AM
Sorry, I'm going to rant a bit. Back in the days--hearing aids were just plain awful. They amplified everything. Someone closing a door or dropping a book could be startlingly unpleasant. I know I had one thirty years ago and it cost me a full month's salary. Background noise was increased so much that it was still hard to hear voices. Folks with normal hearing will naturally hear voice over background in most situations. Todays digital hearing aids are somewhat better and a lot more expensive. But, having had two different types of the latest and greatest, I can tell you that they are not nearly as good as the folks selling them for thousands and thousands of dollars would like you to think. Try having one in your ear when people around you start clapping. Over my life, I have spent approximately $15,000 trying to hear better. Meanwhile, businesses including universities do not comply with ADA because it would cost them money. I finally decided that I will spend my money on things that I know will improve my life--like the occasional great vacation. It's got nothing to do with vanity. And if someone wants to communicate they can speak up or write me a note.
Posted by: Arlene | Wednesday, 20 October 2010 at 09:08 AM
Boy, do I ever agree with you. Except I've already had the great vacations...many trips to the Southern Hemisphere. Now, I want Italian shoes and French tires.
Thanks for taking the time to write...
Beverly Johnson
Posted by: Beverly Johnson | Wednesday, 20 October 2010 at 11:13 AM
My doctor, too, discontinued giving me pap smears when I was 65 and had 20+ years of "normal" results. Shingles, I had when I was in my mid-40s, and the after-effects lasted for two years. I got the shingles shot the minute I knew they were available, even though my insurance did not cover it.
Posted by: Cop Car | Wednesday, 20 October 2010 at 11:13 AM
That pneumonia shot - I read it in the book as a one time event after the age of 65. Dr. Butler said "at age 65 unless a previous inoculation was administered within last five years." I read the CDC info and that tallies. I'll also check with my doctor.
Posted by: notdotdot | Wednesday, 20 October 2010 at 12:03 PM
Hearing loss causes can be of different types with some peoples hearing amenable to amplification and others not.
I recommend any hearing evaluations best be conducted by an ASHA nationally certified Audiologist with a Certificate of Clinical
Competence (CCC) and State license. They are trained and qualified to recognize any possible medical issues as opposed to only dealers who do not receive comparable training and may primarily be interested in selling hearing aids.
Arlene is ever so correct about the quality lacking in hearing aids years ago when you, Ronni, thought your grandparent should use one -- not as simple as it seems just because someone doesn't hear as well as they used to.
There is a mistaken belief by many users and others that use of a hearing aid will allow the ear(s) to function as it did before the hearing loss. Nothing could be further from the truth.
The biggest frustration is often the "attenuation" factor as Arlene describes. All sounds are amplifed which can make their use in a group most unpleasant, if not intolerable.
Another hearing aid issue I've encountered with many users is control of the actual volume function which can require considerable fine motor skills for the tiny aids that fit in the ear.
There are other considerations and hearing aids can be very beneficial to many people. Often learning to use them is not as simple as putting on a pair of glasses to help with vision, or getting false teeth.
It's not unusual for a number of hearing aid purchasers to become frustrated using them, then relegate them to the dresser drawer. Years ago it was fairly routine in skilled nursing facilities for Speech-Language Pathologists to work with individuals, including even their family members if needed, to help them learn how to use and/or compensate with their aid. I successfully worked with many, including some who had stopped using the ones they had.
If you are purchasing a unit through Medicare Part B, or whatever your funder, learn about how often you can have them replaced if your hearing change, the aids cease to function properly for various reasons, become damaged, or lost -- especially if someone goes to hospital (be sure they're on your possession list, just like your glasses and false teeth) so if they disappear the facility will have to replace them as likely Medicare or your ins. won't. Even if they can be replaced, the problem with that is you might not be in condition to go to your dentist, eye doctor, or audiologist's office to get a re-evaluation.) When we're ill we're not always able to exercise the normal care with our possesions we ordinarily do.
Posted by: joared | Monday, 25 October 2010 at 04:20 AM