LIVE THE WELLTHY LIFE

The following article was written when I was healthy.  What I didn’t understand then, I now do.  Once you are obese, out of shape and hurting, dragging your butt to the gym is next to impossible.  When you live in the Midwest, walking outside in the heart of winter is dangerous.  

“Yes, I know.  You’re too busy, too tired, too sore, or too sick to exercise.  You have hundreds of excuses for not exercising; and you promise that, when things are better, you’ll exercise.”  I have lots of excuses, all very real.  Even though I’m retired, I’m still to busy.  I’m too busy napping!  Reading this article was a unique experience.  A younger healthier me lecturing the older sick me right out of a Sci Fi movie.  I’ have to be a fool not to listen to myself.  So, I’ll just have to find the motivation and strength to exercise or stop complaining.

I have addressed the fact that many of my patients paid more attention to what they feed their pets than to what they put into their own bodies.  Today, I want to continue to explore the relationship between man and his pet in order to try and figure out why pets get more attention to nutrients, exercise and healthcare than humans.

“Jack, I really need you to start exercising.  Your blood pressure and cholesterol are both quite elevated, and exercise and weight reduction will help.”

“Doc, I walk my dog every day!  Isn’t that enough?”

If you were to watch Jack walking his dog, you would see Jack walk 50 steps and then wait while Fido takes a leak or just sniffs the bushes.  This process of walk, sniff, pee goes on for 30 minutes or more and Jack feels like he has done a day’s work.  In actuality, neither Jack nor his dog has done any exercise.  If Jack wants to exercise with his dog; then he needs to run alongside of his dog as Fido races across his lawn barking at passing cars.

Exercise is the fountain of youth and most of my patients won’t do it!  Why?  Mr. Wonderful and I often pondered that very question and failed to come up with an answer.  It’s as if my patients are sleeping behind the wheel!  They hate the idea of taking medication; yet, they’d rather take a pill than go to the gym 2-3 days a week.

Yes, I know.  You’re too busy, too tired, too sore, or too sick to exercise.  You have hundreds of excuses for not exercising; and you promise that, when things are better, you’ll exercise.  Unfortunately, until you start to exercise, things will only get worse.  You will get more out of shape, take more medications and get much older.

Like the man who falls asleep behind the wheel of his car, you are heading for an accident.  Wake up.  Walk your dog for your dog’s health.  Walk by yourself or with friends for your health.  You don’t have to join a gym, you can start tonight.  When you get home from work, don’t go into your house.  Instead, explore your neighborhood.  The journey starts with just a few steps in the right direction.

BUT I AM

Yesterday, I published “I Don’t Want To Be Right.”  Today, KevinMD published “Artificial Intelligence and Angel of Death.”   I still can’t believe this article showed up the day after I published mine.  It certainly is a spooky coincidence and a scary scenario.

I really didn’t want to be right, but I am.  Soylent Green may not be fiction.

While I wrote this article in 2011, it is still very relevant today.  Last night at my friend’s Christmas Eve celebration, one of his guests and I actually had a conversation about this very topic.  When I got home, I dug this out of my archive.

A lot has changed since 2011. The most important thing is that now I am dealing with a progressive neurological disorder that is slowly stealing my life away.  My own thoughts change on a daily basis, but one thing is for sure; I do not want the government/Medicare to determine how long I live and how I die. Those decisions belong to my family and me.  

The second thing that I know for sure is that life without quality is not really life.  Each of us has to decide what quality of life means and, perhaps, when our lives should end.

July 20, 2011

Sometimes you just don’t want to be right.  Over the past many years, I have seen an alarming pattern arise in my profession.  Many of my patients have heard me talk about “Soylent Green”, an old Charleton Heston movie.  I have even written about it on this blog.  The premise of the movie seems absurd.  Can you imagine the government of the United States providing for all the needs of its people including healthcare, food, clothing, and even death (Food Stamps, Medicaid, Medicare, Social Security)?

David Brooks’ opinion piece in the New York Times on July the 15^{th (http://www.nytimes.com/2011/07/15/opinion/15brooks.html?_r=1)} makes my fear of a “Soylent Green” society frightenly real.  While I recommend you read the entire piece, for the purpose of this blog, I want to highlight the following:  

Mr. Brooks writes, “This fiscal crisis is about many things, but one of them is our inability to face death _ our willingness to spend our nation into bankruptcy to extend life for a few more sickly months.”  He quotes S. Jay Olshansky as saying, “our main achievement today consist of devising ways to marginally extend the lives of the very sick.”    He then closes his piece with “we think the budget mess is a squabble between partisans in Washington.  But in large measure it’s about our inability to face death and our willingness as a nation to spend whatever it takes to push it just slightly over the horizon.”

In “Soylent Green”, the citizens dutifully walked into the death chamber when it was their time.  Mr. Brooks would be proud of how those brave souls faced their demise for the good of society.  Rather than “marginally” live another month or two, costing society a fortune and threatening a budgetary crisis, the citizens of “Soylent Green” did as prescribed, they follow the “protocol” created to save society (prescribed “outcome” equals death).

My question for Mr. Brooks is who defines what “marginally extends the lives of the very sick” is?  Who decides who shall live and who shall die?  I can’t!  Not long ago, I met a “very sick” patient in the emergency room.  He was critically ill having had a catastrophic event.  He was comatose with signs of profound damage.  The neurologist told the family he was “brain dead”.  While Mr. Brooks believes that medical science has made very little progress in extending life, my patient benefited from a remarkable new invention, the “Artic Sun Hypothermic Unit”, and fully recovered.  I spoke to him this a.m.  He was at work! Editor’s Note: He’s still alive today, 15/26/19.

The procedure and hospitalization cost in excess of $300,000.  Saving this one life cost a fortune!  In Mr. Brooks’ world, should we have forgone this patient’s treatment and helped his family “face death”?  Are we “spending our nation into bankruptcy” by working hard to save lives?  Maybe so.  But who are we if we don’t care for our ill?  What do we become when we arbitrarily decide what a life’s value is?  

Mr. Brooks obviously doesn’t practice medicine.  If he did, he would know that an individual life is worth everything to that person and his family.  Mr. Brooks would know that patients survive against all odds and recover to enjoy meaningful lives.  He would know that statistics lie!  A patient with a life ending cancer is told he has three months to live without treatment and 6 months with treatment.  Despite the tremendous expense both financially and physically, he accepts treatment.  Seven years later he is thriving!

Respectfully, Mr. Brooks doesn’t know what he is talking about.  The problem is the policy makers aren’t doctors.  The policy makers are Mr. Brooks’ cronies.  “Soylent Green”, here we come!

Quote Garden

In researching for my articles, I often come across valuable sources of material on the internet. Quote Garden is one of those sources. I found many pages of quotes referencing diets. Some of the best are listed below with my thoughts about their significance.

“Your stomach shouldn’t be a waist basket” – Author unknown! Not long ago, I saw an overweight patient of mine in the drive-in window of a fast (fat) food establishment. He was putting fried junk into his belly.  He puts premium gas in his car. What’s wrong with this picture?

“Don’t dig your grave with your own knife and fork.” – English Proverb. Raucous Ralph, a character in my book and one of hundreds of patients I have seen over the years, did just that. Who do you love more, your spouse, your family, or your food?

“Inside some of us is a thin person fighting to get out, but they can usually be sedated with a few pieces of chocolate cake.” – Author unknown. Many people use food as a drug/medication. Do you? If you are depressed, see your doc, not the local baker. If your marriage is bad, see a marriage counselor. Don’t have a closet affair with Godiva!

“A diet is a penalty we pay for exceeding the feed limit.” – Author unknown. Yes, diets are penalties; and yes, we pay BIG! It’s time to stop dieting and, instead, learn who you are and what you need to do to get healthy. If you’re healthy, stop fretting over your figure and enjoy life. If you are not healthy, work at getting healthy the right way. Diets and Other Unnatural Acts will help you.

“People are so worried about what they eat between Christmas and New Years but they really should be worried about what they eat between New Years and Christmas.” – Author unknown. I’ll end on this note! A healthy lifestyle has room for holiday treats but no room for holiday cheats!

After spending an entire weekday at home, I am sure of one thing; daytime can rot your brain!  Not only can daytime TV destroy brain cells, it highlights the worst traits of the human race.  Dr Phil, Judge Judy, and multiple other TV personalities parade some of the human race’s most embarrassing individuals in front of their viewing audiences.

If you don’t believe me, channel surf like I did!  It was enlightening and frightening.  This article is all about the frightening side of my day at home.  As I was perusing the channels, I was mesmerized by a commercial segment I happened upon.  During that segment, five different law offices were mining for gold.   

“If you have been injured by the use of surgical mesh, call 1-800-We-Just-Won- The-Lottery!”

“If you experienced a bleed on Pradaxa, call 1-800-You-Can-Get-Rich!”

“If your child was born with a birth defect, call 1-800-Make-A-Fast-Buck”

“If your loved one developed a bed sore or fell in a nursing home, call 1-800-Collect-Millions now!”  

“If you developed a blood clot on birth control pills, call 1-800-Screw-Them-And-Get-Rich.”

Yes, we have a healthcare crisis in the US.  Providing healthcare becomes more difficult and expensive every year.  Doctors are criticized for doing unnecessary tests and practicing defensive medicine.  Defensive medicine and the defense of unfounded lawsuits adds to the cost of care.

Is it any wonder that doctors practice defensive medicine?  Frightening is an understatement when describing these commercials.  To make matters worse, each smiling attorney makes one promise:

“We promise that we won’t charge you anything unless we collect on your claim.”  Yes, you can sue a healthcare professional for free!  You can roll the dice without any financial risk!  You can play the odds.  Just call 1-800-Increase-Everyone’s-Healthcare-Costs and hope your doc’s insurance company settles rather than financing a winning defense.

Why would they settle?  It’s simple math.  Pay out $50,000 to settle an unfounded claim or spend $300,000 to win in court.  Luckily for me, my insurer did not settle cases.  Fortunately, they would rather spend $300,000 and win.  Unfortunately, the cost of malpractice insurance is shared by every patient seen in this country.

Frightening?  You bet!  The sharks are circling and all of us are the food they live on!  And no one is doing anything about it.

While it may seem strange, I view Christmas Day as I would any loss.  Yes, I love the Christmas Season with its joyful giving, and its promise of peace on earth and goodwill towards man.  For 3 weeks every year, people whistle Christmas carols, wish each other the best, open doors for strangers and other such niceties.  People perform great acts of charity and appreciate the ones they love and strangers alike.  It’s a truly wonderful time of year.

Then it happens!  Christmas day comes and goes. With its passing, the joy of the season vanishes.  People hurry about returning gifts.  They rush to get that close parking space, burst through the doors of the shopping center and line up with the rest as life returns to normal.  It’s sad indeed!

Wouldn’t it be nice if the one thing you didn’t return this year was your portion of the Christmas spirit?  Imagine a year of peace on earth and goodwill towards all men and women.  This year, try allowing that car in the parking lot that really was there before you to pass. Try holding the door open for a complete stranger while whistling an upbeat tune.  Sound corny?  It’s not!

Why not perform random acts of kindness year round?  I guarantee it will be one of the healthiest things you can do.  Perhaps the true gift of Christmas is the 3 weeks of fellowship leading up to it.  If that is the case, why return such a precious gift?  

I know, I’m Jewish and it’s not my holiday.  Actually, it is!  I believe the true gift of all religious holidays is to bring families and friends together and no holiday does it quite like Christmas.  So, for whatever reason you celebrate, let’s declare the 2020 holiday season a yearlong event!

Be happy, live wellthy and be blessed everyday of your life.

During the next week, many of us will be busy preparing for the holidays, excited to be with family and friends, looking forward to the New Year.  The New Year brings many things, starting with the New Year’s resolutions.  While most of us look forward to a new beginning, hopeful that things will be better, many spend time pondering about the past and saying “what if?” and “if only I had”.

Thirty years in practice has taught me that ruminating on the past and the “what if” question and the “if only I had” reply is detrimental to your health.  After all, you cannot change the past.  While you are busy regretting past errors, you may be missing future opportunity.  Today, a friend told me that one of the most important moments in her life was when I helped her through a moment of self doubt and self recrimination.  She had made a decision many years ago that had long term consequences for her child’s health.  At the time she made that decision, it was the right decision.  Many years later, it was still the right decision, but when viewed through the “retrospectascope”, could be questioned.

All of us are called on to make decisions on a daily basis. As individuals and parents, who do not have a crystal ball with which to look into the future, we make the best decision we can.  All of us, when looking back in time through the “retrospectascope”, realize that some of those decisions turned out to be wrong, some foolish, and some absurd.  What is critical is to remember they were right at the time we made them.  

When you make a decision that affects you or a loved one, take the time to gather as much knowledge as you can.  Follow your heart and your mind!  Give pause, then decide and carry out that decision with great care.  Later, if the decision turns out to be the wrong choice, live with it.  Learn from it.  Do not do the “what ifs”.  “What ifs” serve no purpose.  They lead to self-doubt, anxiety and depression.  They make you less capable and, therefore, more likely to err in the future.  Residing too long in the past steals your future.  Look forward to the future and all of its possibilities.

BLESSING LIST

Do you ever feel overwhelmed? Do you have too much on your plate? Your husband is out of work. You have a full-time job during the day and you are mom at night. Your parents are getting old. Your house needs work. You have too many bills and your children are needy, whiny and unappreciative. Dinner conversations are all about “needs,” that four-letter word. Life needs balance!

Often, we are so focused on our curses and problems that we can’t see our blessings. By adjusting your viewpoint, you can reduce your stresses and better address your problems. Try this exercise:

1. Your husband is out of work; you are blessed to have a husband.
2. You have too much on your plate; you have a table to put your plate on and food to put on that plate.
3. You have a full-time job during the day and are a mom at night; you are lucky to have a job and blessed with children.
4. Your parents are getting old; your parents are alive.
5. Your house needs work; you have a roof over your head.
6. You have too many bills; I can spend less and live with less as long as I have a roof over my head, food on the table to feed the children and a husband I love.
7. My children are too needy; they will learn the difference between wants and needs and learn to be appreciative of what they have.
8. Whiny kids are healthy enough to whine and they will grow up eventually.  

So, make a blessings list. Include everything you are lucky enough to have, everything that makes you smile. Place that list on your bathroom mirror and every morning and night, brush your teeth for two minutes. While you brush your teeth, count your blessings. If you start the day blessed and end the day blessed, whatever happens during the day won’t be too bad. By the way, count the fact that you have teeth to brush as a blessing!

Tomorrow

I grew up in a world where “tomorrow” played a critical role in everything you did.  People saved for tomorrow.  People planned for tomorrow.  “Tomorrow” was the day you were going to enjoy life.  “Tomorrow” also was to be feared.  It might be a rainy day and you had better be prepared for the storm.

My parents worried about me.  “Stewart, you’re spending too much on the kids!  You need to save for the future!”   So life’s cardinal rule was to work hard TODAY so that one day you could relax and enjoy life.  

Flash forward to today.  My mother was right, I should have saved more. Today, the economy is thriving.  I no longer have a medical practice. I didn’t save for the future, but I’ll survive.  Many of those that worked every day and saved their money are finding that the value of their labor has seriously depreciated as their health worsened with age.  Over the years many have lost money in the stock market and other investments.  They find themselves in the same place I am, but they never really enjoyed spending their money.  I did!

There are also those patients who are no longer with us.  They died unexpectedly, seemingly without reason.  Their nest eggs did them no good.  They worked every day, year after year, saving for the future.  Then they died!  Oops, no tomorrow.  So what’s a guy to do?  Plan for tomorrow or live today?

I’ve been thinking a lot about this since I’ve gotten older. witnessed young patients die, and others who lose their health and wealth a little at a time.  I think I’ve discovered a great truth.  “Tomorrow” doesn’t exist.  It is a mythical entity.  Confused?  Think about this.  When you got up today, what day was it?  It’s today, of course!  Every morning, when you get up and out of bed, it’s today, isn’t it?  So, if every day is today, does “tomorrow” really exist?  If “tomorrow” doesn’t really exist, shouldn’t we strive to enjoy today?

I think my parents had it wrong.  I think the old American ideal of working every day, day after day, in order to enjoy a mythical “tomorrow” needs to change.  We need to learn to enjoy the day we have!  When I was in Europe, I learned that Europeans think Americans “live to work” while Europeans “work to live.”  I think they have it right!

So, live your life today and every day!  Laugh, love, and share your life with others.  Hope for lots of “TODAYS;” and, yes, save some of your money, but not at the expense of today’s joys.  Remember, a wasted day is a precious commodity that, once lost, is irretrievable.

One of my readers asked me to write an article on the problem of “excess” and its effect on our health and happiness.  I have alluded to our excess in past articles (refer to November 15 and December 7, 2010, “Four Letter Word” and “Suicide by Food”).  Excesses in food, stressors, nutraceuticals, medications, drugs, electronics, communications and possessions have become the norm in our society.  Those excesses have taken a toll on my patients and their families.

Just prior to Christmas every year, I would treat very successful middle-aged men for depression.  George was successful in every aspect of his life.  He had a beautiful family, four children and a wife.  His family has lived in luxury as my patient was also very successful in the business world.  He even shot in the low 80s on the golf course.  So why was he depressed?  He was affected by the Lexus commercial.  The commercial showed a husband and his son waiting outside in the snow to surprise his wife with a Lexus with a red bow on the roof.  My patient felt that, at his age and station in life, he should be able to give that Lexus to his wife.  He saw himself as a failure despite all of his success because he couldn’t purchase a Lexus for his wife.  

When is enough, enough?  That is an age-old question.  When you have a beautiful family, roof over your head, and food on the table, do you really need a Lexus?  When you are overweight and your weight is harming your health, it’s enough.   In “Suicide by Food,” I reviewed the case of a patient’s excessive food ingestion causing him to go into heart failure and be admitted to the hospital.  When Barrington youth are so desperate as to commit suicide, it’s enough!  In “The Four-Letter Word,” I reviewed how everything has become a “need” and how dangerous being needy is.

My patients stress over everything.  In “Worried Sick,” I reviewed how worry and stress can become a disease and be more harmful than the disease you are worried about.  Yesterday, I wrote about depression.  Work and financial and family stresses are seriously affecting my patients.  Retirement, aging, illness and moving are affecting me.

Throughout this website, I have worked to involve my patients in self-care.  My patients are taking too many medications.  Often, they are on too many medications because of their personal excesses.  I remember working with a patient who had a “healthy” (according to the patient), 1400 calorie breakfast despite the fact that his weight had become a major health issue.

Many of my patients want to be on “all natural” supplements.  Rather than eating healthy, whole foods, they look to the nutraceutical world for health.  They often come in with dozens of supplements (not an exaggeration) none of which are natural.  A few patients do in depth study of their supplements and the companies that manufacture them.  Most do not.

The younger generations live on the internet, Facebook, and twitter.  They text incessantly and are always connected.  They “need” new cell phones, 5G, and Wi-Fi to be happy.  They worry about computer viruses, not the common cold.

So, what can we do?  Maybe I’m not the best person to answer this question.  My children always say that, in the Segal house, the tenant is “Go big or go home.”  I’m currently paying the cost of all of my excesses as I work on downsizing my life. It certainly would have been easier to downsize when I was healthy.  One of my favorite ways of dealing with depression is making a Blessings List. (click on hyperlink) 

Talking about health, wouldn’t it be great to have excess health?  What about replacing Facebook and Twitter with research into appropriate nutrition and exercise.  Try using your smart phone and computer to tract your weight, nutritional intake and output.  What we can do is focus on “Living Wellthy”! 

Also, we can all learn to be thankful for what we have!  Have a great holiday season and a “Wellthy” New Year!