Thursday, December 22, 2005

Preventative Medicine

Today I went out for breakfast. I had just fasted for 14 hours before my cholesterol test, so I thought little reward was in order. And besides which I was fading fast between a whippet like metabolism and no reserves I need an infusion of protein, lipids, and carbohydrates stat. Anyway as I was waiting to be seated I heard some older gentlemen complain about work, that they could be fired next year if they didn't quit smoking, that they no longer had junk food and candy bars in the snack machines, no more fried food in the cafeteria, and how similar things were happening at their kids' school. Actually complain was too nice a word, whining was more like it. According to them this was an insurance incentive for their companies and that was the reason that they had to be be healthy whether they liked it or not.
It is true that insurance companies and hence the companies purchasing the insurance are trying to save money, healthier employees is one way of doing this. However the truth is much grimmer than this, the healthcare system in this country is broken, it's like a battered bomber with the last engine failing, limping along but gradually losing altitude over a great big ocean. Manpower and financially healthcare is strapped, yes doctors make great salaries but the conditions they work in are demeaning, demanding, and difficult. People don't go into medicine for the money, emotionally wrestling with life and death is never adequately reimbursed. The load needs to be lightened and it isn't, there is an increasingly less healthy younger population and a rapidly growing elderly population with fewer health care dollars and doctors going around.
Thus we try to solve the problem before it happens. The only universally effective medicine is preventative medicine, once you have the problem we treat the symptoms rarely is there a cure. We can decrease heart attacks, diabetes, strokes, cancer, and many other killer diseases by controlling high blood pressure, obesity, and high cholesterol by prophylactically dealing with problems years before they manifest by exercise, diet, not smoking, not drinking, and other lifestyle modifications. Once you have any of these diseases we treat the symptoms, we can control your blood pressure, blood sugar, cholesterol, and whatever other damage by giving medication that have to be taken daily. It treats the symptoms, it doesn't solve the problem. The damage is done, we will need to keep regulating medications, keep admitting to the hospital because people don't take their medications, and continually balance side effects against benefits. You are not your car, there is no warranty, replacement parts, or trade in value. Long term physiological damage that is high blood pressure, obesity, high blood sugar, and high cholesterol will not kill you quickly, but destroy you slowly.
By no means do I wish to blame the patient. Go see your doctor for your check up, this too is preventative medicine. If lifestyle alterations fail, take the medication, thats OK. If you want to try alternative therapies, that's cool, but take your medication and see your regular doctor, too. I just want us all to take responsibility on the front end. If everyone exercised (and kept exercising) a half hour per day we would see dramatic decrease in heart attacks and strokes, if that increased to 90 minutes per day with a good diet ("The South Beach Diet : The Delicious, Doctor-Designed, Foolproof Plan for Fast and Healthy Weight Loss" (Arthur Agatston)) doctors would be largely out of business. The new year is upon us:
  1. Take a 30 min walk everyday (if you can't go see your doctor) the easy way. No more elevators always take the stairs, park you car in the furthest lot and walk (less scratches on the car, too).
  2. Change your diet ("The South Beach Diet : The Delicious, Doctor-Designed, Foolproof Plan for Fast and Healthy Weight Loss" (Arthur Agatston) is an excellent reference).
  3. Increase your fiber intake.
  4. Reduce or even stop drinking pop/soda.
  5. Reduce your caffeine intake, 1 cup of coffer per day.
  6. Reduce your alcohol intake, 1-2 per day (if you can't, you're an alcoholic, seek out help).
  7. Stop smoking (between the patches and welbutrin this is the best time to quit, see your doctor).
  8. Brush your teeth twice daily and floss.

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