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Posts Tagged ‘healthcare’

Boomers Living Longer but Sicker?

Wednesday, February 13th, 2013

“Healthy Boomers” might be a rarer breed than we want to believe, at least according to recently released study.

When researchers compared U.S. National Health and Nutrition Examination Surveys (NHANES) of people ages 46 to 64 in the years 2007 to 2010 (Boomers) to the same information for people in that age range between 1988 and 1994 (the Silent Generation) they found 40% of Boomers to be obese compared to 29% in the prior generation. They also became chronically ill earlier in life, had a greater number of limitations in what they could do at work, and are more likely to need a cane or walker. At the same time, Boomers are living longer than the previous generation.

But is this just a case of Boomers gorging on too many Twinkies and getting sick as a result?

It’s not just Boomers who are more likely to be obese these days. The NHANES website itself states that “Between  1988–1994 and 2007–2008 the prevalence of obesity increased in adults at all  income and education levels.”  That is alarming and we do need to mend our wayward ways, but let’s not single out Boomers for the redirection.

The fact that we are diagnosed with chronic diseases sooner and have to live with them longer is probably not really about accelerating decline either.  In the last 20 years,  there has been an aggressive effort within the healthcare system to diagnose people earlier in the hope that by doing so, chronic conditions can be more easily controlled.

Yes, people are probably being diagnosed earlier than those with the same conditions would have been 20 years ago.  But how many of those in the prior generation would have been similarly diagnosed if the technology to do it had been available and the healthcare mindset had been the same when they were that age?

This spike in obesity and chronic illness is a worry, please don’t get me wrong.  But you can’t tell people “accept this sooner so we can help you manage it” and then be alarmed that the number of diagnoses has increased.

Plus, it is far more fashionable to be chronically ill these days.  In 1988, using a cane or needing concessions at work was a sign of weakness.  People who needed them didn’t ask for them because they didn’t want to be viewed as “handicapped.”  The Americans with Disabilities Act was passed in 1990 and strengthened in 2008.  Now what people ask for–and get–as concessions is mind boggling.

Is this “news” really about Boomers being a bigger mess than they want to admit?  Or is it about how far into “healthcare” we have all marched–to the point of expecting pills instead of finding ways to exercise and asking for “procedures” instead of making healthier lifestyle choices?

This kind of news article makes me angry.  It’s fatalistic and implies helplessness.  “Boomers are going to be fat and old for a long time.”  It smacks of some Millenial enjoying the deterioration of the people who are “in the way” of their own advancement.

What’s really going on here?  Let’s ask more questions instead of just assuming that Boomers have been sitting on their butts too much (which they probably have, but they aren’t alone.)

  •  Boomers are the first generation to have “careers” and face the unrelenting stress of this version of a job market.  How does job stress fit into the situation?
  • Boomers are the first generation to live with the advertising that popularized the notion that you’re not supposed to have pain–and that if you do, you need to pop a pill to make it stop.  Does that thinking result in overuse of the healthcare system?  Does that overuse mean over-diagnosis?  Does the over-diagnosis create health problems in and of itself?  Is that contributing to this observed decline?
  • Boomers are the generation that first tasted diet soda, “lite” entres stuffed with chemicals in lieu of calories, baked goods with more fake ingredients than real ones, and chemicals of all sorts in everything from bottled water to underwear.  What is that doing to our bodies?  And are those of Boomers simply the ones that have had the most time to accumulate all that toxic residue?

Is this just about Boomers being a mess or is this about the way we are all taking care or (or not taking care) of ourselves?

As a nation, we need a heavy, across the board dose of “natural.”

  1. We need to eat food that still looks like what it was when it was alive. (Vegetarians included–What’s with the Gardenburgers??!)
  2. We need get outside and move our bodies doing something positive–whether it’s walking the dog, rock climbing, or joining a cause that gets you hip deep in mud.
  3. We need to slow down enough to notice our own breathing.
  4. And we need to stop saying “tomorrow” to all things things our hearts yearn for–like peace and harmony and some fun now and then.

This is not about Boomers in decline.  This is about all of us in decline.  The thing we need to take away from this article is not “Boomers are losing it.”  The thing we need to understand is that the route we’re all on is not a good one.  But we can change.  All of us.  Boomers included.

 

 

Sit Up Straight

Wednesday, January 30th, 2013

Mom was right. But sometimes it takes a good physical therapist to get you to heed what you were taught when you were six.  Case in point”  SIT UP STRAIGHT.  And for that matter, stand up straight, too.

For the last three weeks, I’ve been working with an amazing physical therapist to get rid of pain I’ve had in my hip for years.  I thought it was arthritis.  I thought it was hip degeneration.  I thought is was a total hip replacement in my not-too-distant future.  All I actually needed was a refresher course in what I got from mom before I went off to first grade: Slouching is not acceptable.

For Mom, it may have been the need to raise a kid who looked half way interested in what was going on.  For my physical therapist, it’s a simple solution to avoid surgery, cortisone shots, and other expensive medical procedures.

I’m living in a 66-year old body.  Things are going to hurt every once in a while.  I’m going to do dumb stuff like clobbering myself with a shovel handle or treating my finger like part of the shish kabob.  You just assume it will get better after you do that kind of thing–and it does.  Except that’s not how it works with my back.  That is not just a “wait and it will be fine” situation.  It happens a little at a time and when it starts to hurt, it’s usually not in my back.  Confusing, right?

Not if you are paying attention to what’s really going on.

The truth of the matter is that most back problems come from poor posture.  I assume that I am standing straight when I’m not, believe I’m sitting up square when I’m twisted into the curve of a too cushy chair, and that I do my work looking straight at it when at least half the time, I’m torqued around so I can do two things–or more–at once.

Believe me, being good to yourself by maintaining good posture sounds simple but is not.  It takes ongoing effort and commitment.  It doesn’t even feel natural for me to stand with my feet equally weighted because I’ve the habit of weighting my left leg more for a long time.  (Thus, the pain in my right hip….)

You might not be blessed with the same luck as I had in terms of ending up with a great physical therapist.  But you might not have to if you remember this one thing:  If you are having pain on a recurring basis, check your posture.

This is one of those “easy fixes” that we don’t hear about often enough.  Back surgery is invasive and not always successful.  It’s a whole lot harder to deal with than re-teaching yourself how to sit on the couch when you watch TV, how to sit at your computer, how to stand correctly.

I am living proof of how much of a difference this can make.  The first time this physical therapist coached me, my life had degenerated into long days of laying on the bed most of the time because my leg hurt so much.  I could not walk a block.  (Yes, this is the hiker who considers anything under five miles “just a walk.”)  I was firmly convinced that it was my leg that was the problem–and I do have a genetic peculiarity that I could blame it on.  It was severe.

But this physcial therapist would have none of that and just went to work seeing how to make the hurt move around.  Once she did that, we knew what exercise I needed to do to get the pain to go away entirely.  And it did–in a matter of a few weeks.

It is way too easy to buy in on the invasive, expensive solutions to common healthcare problems.  Before you do that for leg, back, or hip pain, see what improving your posture will do. (Others have found this also to be true for shoulders and neck.) You might be as pleasantly amazed as I am.

 

Being a Smart Healthcare Consumer

Sunday, October 23rd, 2011

Healthcare has become an astronomically expensive part of life. There are lots of directions to point fingers, but the only place where you have any real control is your own behavior. Taking care of your health without being taken over by the system is a tricky proposition.

What can we do to be good healthcare consumers?

Seeing it as your personal responsibility instead of expecting someone to make you feel better whenever you don’t is a great start. We all need to take responsibility for eating wisely, being active enough to keep our bodies functioning well, and foregoing things that aren’t good for us physically—like tobacco and stress.

That’s a personal quest that will be unique for each of us, but it’s still ours to do. Too often, we agree to take a pill instead of improving our lifestyle choices. That’s simpler for “the machine” than keeping track of how you’re doing on an ongoing basis and it’s simpler for you.

But think about the side effects. Very rarely do prescription drugs come with positive side effects. When you agree to take that pill instead of going the “harder” route, you may well end up with another problem—or more than one–because of what the drug is doing to your body. With lifestyle choices, the opposite is true. When you decide to start walking to reduce your stress, you’ll soon discover that it’s also helping you with your weight, your endurance, and maybe even your mental outlook.

So as a first step, every time you have the option, choose to make the lifestyle choice rather than asking your body to deal with a drug–or a surgical procedure.

The second piece of this is being selective in how you interact with your healthcare providers. An intelligent approach to healthcare is no longer simply a case of knowing when to call the doctor. Many healthcare organizations give you more than one option for getting help. Calling the 24/7 Nurse Hotline may give you enough information to deal with the problem. Going to the urgent care clinic instead of the emergency room will get you in and out faster. (Get your medical drama on TV.)

Forego the temptation of asking the doctor to “fix it” every time you feel uncomfortable. Seeing your family physician for a head cold after three days wastes your time and someone’s (yours or Medicare’s) money. Many things go away on their own if given the chance. Be smart about deciding both when you need to get your healthcare provider involved and how you access them. Learn the difference between “pain” and “discomfort.”

Every time you end up in that doctor’s office you take on two additional risks. First, because sick people go there, you might end up catching something a lot worse than what you went to get help with. Second, once you are “in the system,” your control over what will and won’t be done diminishes considerably.

To stay as far away from “the machine” as you can and still be responsible, you need to make wise decisions about both IF and HOW to get your health care providers involved.

The third leg of this stool is having as much in place as you can so that when you do need significant amounts of medical care, your healthcare providers and loved ones are aware of what you do and don’t want. If you are coherent, ask questions. Find out what the procedure they want to do will accomplish and why it’s important to do it.

It also helps to do all you can to identify what’s happening yourself. Make a strong effort to explain the pain or problem concisely rather than just saying “My side hurts.” We could probably save ten hours of every medical professional’s work week if we were better at this. They are trying to help. If you don’t help them, they will resort to more tests and procedures to figure out things you could have told them.

Be clear—with your family and the medical staff—about what’s wrong, what you need, and what you don’t want.

These three strategies might not keep healthcare totally out of your life, but they will help you minimize your encounters with it. Sounds good to me.

 

Health Care Fantasy

Thursday, February 11th, 2010

Imagine a healthcare system where everyone knows what everyone else is doing on your behalf.  Where they really want you to get well and don’t feel the need to do test after test to cover their butts.  Where the doctors and other healthcare professionals are on salary and all part of the same effort.

Imagine they have the whole thing set up online, so you get the results of lab tests, xrays, etc. as soon as they are available (as opposed to “never’ which is typically the case).  Imagine that you can confer with your doctor via an e-mail instead of a $140 office visit and an hour waiting in the company of sick people.

And imagine that this utopic system is via a health insurance set-up that costs less than the bloated, “silo mentality”  mess you are dealing with now.

It exists–at least in Washington State.  I finally got mad enough to look for something better and it had been there all along.  For the first time in fifteen years, I actually believe my medical resources are something more than a drain on my wallet.

If this country wants to figure out how to fix our horrendous healthcare mess with its astronomical costs and second-rate results, look at Group Health Cooperative and others like it.

Quality health care is never going to come from anything that’s focused on a profit.  That rules out the big pharmaceutical companies, many hospitals, and all the doctors who are part of “professional corporations.”  It rules out anybody who’s “in it for the money.”  It rules in the professionals who care about keeping people well.

We can do this, but the fat cats and the big outfits are not going to like it.  So what?