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Post by concertinagirl on Jul 10, 2020 12:15:56 GMT -5
"There's more old drunks than there are old doctors so I guess I better have another round...." I just heard Willie Nelson sing that line in his song a few minutes ago on XM radio. There might be a lesson there for all of us. LOL!
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Post by aquaduct on Jul 10, 2020 12:47:41 GMT -5
What I am about to write are simply observations based on my experience. No scientific study involved. Just some very basic thoughts on quality vs. quantity of life and how much control do we really have. I’ve worked in Skilled Nursing Facilities for 30+ years. I have treated hundreds (maybe even more) of patients well into their 90’s. I have even done therapy with a patient who turned 108 during her time in rehab, walked out (with the use of a walker) and went home to live independently. I’ve always wondered why do some people make to their 90’s and others don’t. Many of those 90 somethings I treated SMOKED for much of their lives. Never once met a 90 something who was a vegetarian. Some claimed to have never exercised, although I believe life in general was far more physically rigorous in their day. The only common denominator that I could see was that they were all rail thin. Never met an obese 90 something. Not to say they aren’t out there, I just never saw them in rehab. My own father is a good example of what I’ve witnessed through the years. He smoked a pack per day until he was diagnosed with lung cancer. He walked daily up to the day of his surgery. He enjoyed a shot of “Schnapps” each evening. He was six foot tall and weighed 150 lbs. (rail thin by my standards). He died two months later after having surgery. He was 89. Still a pretty good run, I’d say. I am certainly not condoning smoking or not exercising as I neither smoke and work-out daily. With that being said, I think genetics has to be a big factor determining longevity. Some of those folks I treated, probably should have died 30 years before I met them based on their lifestyle. We all know people no where near 90 who have died of cancer, heart disease etc. One of my best friends never smoked, ran marathons and WAS a vegetarian. She died of breast cancer at 58. She was rail thin - so perhaps that shoots my theory. Something else that was an eye-opener for me. When I was fresh out of college, I met a patient who was turning 100. I went into her room and with my “Merry Sunshine” bubbly demeanor said, “Good Morning Mrs. Jones and HAPPY BIRTHDAY!” She looked at me with sad eyes and said, “What’s happy about today?” “I’ve lived without the love of my life (husband) for over 20 years.” “All of my friends are dead.” She looked at my left hand and saw my ring. She said, “Young woman, what if you woke up and your husband was gone and so were all of your friends.” “Would you feel like celebrating?” I hugged her and didn’t have a clue as to what to say. I didn’t get it then. But I sure do get it now. Modern society seems to have lost all comprehension of mortality. When I was younger I worked, like you, in a hospital. Did respiratory therapy. Pretty sobering (and highly recommended for any young folks out there). You couldn't help but come face to face with the simple fact that you're going to die. Period. Full stop. One kid (20-ish) got in a fight with his girlfriend and tore down the road in his car. Clipped an elderly couple's car that were coming out of a gas station, lost control and drove through the side of an Earl Scheib body shop. They brought him into our ER where a friend and I had to keep him alive until the doctors could determine that we wouldn't be sued for giving up early- about half an hour. He had a hole about the size of a half dollar coin in his forehead right between his eyes and damn near every bone in his body was cocked at an unnatural angle. Another girl left work at a Burger King at 11 pm and walked across Telegraph road where she was hit by a car. Had to have her chest cracked open so her heart could be hand pumped while they tried pointlessly to save her. She was a week short of graduating high school. Another lady (about 35) spent 2 years in a hospital room on a ventilator. She suddenly got better so they released her from the hospital. She died a week and a half later. And I can go on (but I won't). The point is we're all going to die and there is very definitely a point where prolonging life is not worth the cost. But in this day and age we've been talked into the idea that extending your days no matter what is desirable. No thanks. Beyond a certain point (which for me given my current state and family history is probably sooner than later) just let me die. I fully intend on rejecting heroic measures. Continuing to breath really isn't living. I think recognizing fully that you're going to die is what gives life meaning. Along that lines I've come to appreciate the Catholic concept of Last Rites. The sacrament is all about the church coming together to send you face meeting God in all his glory alone and naked to account for your life. Of course the popular imagination is that this should scare you into being a better person. And the Catholic understanding of salvation isn't guaranteed by merely believing. But it's becoming clear to me at least that the best answer when facing your maker is, "I tried."
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Post by sidheguitarmichael on Jul 10, 2020 13:16:20 GMT -5
But it's becoming clear to me at least that the best answer when facing your maker is, "I tried." Peter, you might appreciate this one: The boxing gym I mentioned upthread is run by one of three brothers—all second-generation retired prize fighters. This guy’s younger brother was the best of the bunch; USA amateur champion, great record, was a staff sparring partner for guys like De La Hoya and Mayweather back in the day. A great trainer, and still in amazing shape in his 40s. (The guy hits like a freight train, despite being my size and weight—which is not big—but I digress). It’s no secret that a good number of former pro athletes tend to let themselves go a little after retirement—without the intense daily training and paycheck, it’s easy to let a few extra craft beer pounds sneak up. One night, over fish and chips at the brewpub after amateur fight night, I noticed that he and his girlfriend were splitting their order of fish and chips. I made mention of it, and of how much I respected his dedication to staying in fighting trim. His response was: “Man, Michael, I don’t want to meet my maker and have him look at me and then try to explain what I did to the body he gave me, all trashed and out of shape. i want to meet my maker and say ‘hey God, look at how well I took care of your gift.” Catholic family, btw. For what it’s worth. Made sense to me.
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Post by concertinagirl on Jul 10, 2020 13:22:08 GMT -5
But it's becoming clear to me at least that the best answer when facing your maker is, "I tried." “Man, Michael, I don’t want to meet my maker and have him look at me and then try to explain what I did to the body he gave me, all trashed and out of shape. i want to meet my maker and say ‘hey God, look at how well I took care of your gift.” Catholic family, btw. LOVE THIS!!!
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Post by TKennedy on Jul 10, 2020 13:32:26 GMT -5
#2, I tore the shit out of the meniscus in my left knee 4 years ago—twisted it on the mat in jiu-jitsu fundamentals class. Due to a combination of extensive wait times to see a doc, general lack of money, and a combatives course (taught by a friend) that I’d been signed up a year in advance for, as well as several high-profile summer gigs and contracted camps in a row, it was a couple of months before I could seriously consider getting in for surgery. By that time, I had talked to a LOT of people who’d had torn meniscus repairs, and they all recommended avoiding it if possible—it’s important to note that these were all (relatively) young, unusually active people. One athletic guy in his 40s was looking at replacements due to bone on bone issues arising from work done in his early 30s. Sobering. So I limped around for 3 years, and did physical therapy exercises. I got to know the security guys on campus, because they were always pulling over and asking me if I needed a lift to class. At one of the same summer camps the second year, the organizer’s first words were “Dude, you’re still limping?” Point being, while recovery was forever-long, at this juncture, I have no limp, I can ruck 65 lbs up deeply wooded hills and walk for miles, and I *was* squatting 1.5x my body weight, until the gyms closed for COVID. Right now, I’m sure the ortho guys on the forum are looking at me in their mind’s eye like I have a boner growing out of my forehead, but that’s the way it was, and is. Time will tell how things hold up long term but, the 3-year mark was a magical turning point. Said knee has held up just fine under some pressure that most people don’t put their joints under, though; so far, so good. Interesting. When I started practice in the pre arthroscopy, pre MRI days the only way to diagnose a meniscus tear was by physical exam and a fairly inaccurate dye Injection into the knee followed by xrays called an arthrogram. A combination of a degenerative meniscus tear and early arthritis in the inside half of the knee is pretty common in middle aged guys. Back then the surgery had to be done open and because of difficulty accessing the actual area of the tear usually involved removing the whole meniscus. That was a pretty big deal with an often prolonged recovery so I would usually procrastinate quite a bit and over a period of three-six months a lot would get better with time and strengthening/stretching exercises and activity modification. The meniscus ground itself smooth and quit catching. With the advent of arthroscopic surgery it became possible to remove only the torn portion and in a lot of situations, especially if there was not much arthritis on the bearing surfaces and tear was a certain type it was a great operation and had a quick recovery and good longer term outcomes. The bad press came from cleaning up a degenerative meniscus when there was also pretty well established arthritis in the joint or the tear pattern was a certain type. Those cases were usually just a temporary patch job and a knee replacement was usually ultimately needed although with certain injection treatments, strengthening, weight loss, and activity modification you could often get a lot more miles out of the knee before replacement. The big problem was patient compliance. I’d say that offered the opportunity the majority didn’t lose weight, didn’t do their exercises, and just wanted it fixed. It was always interesting to me how I would see a new patient that was a skinny, wiry active guy with a positive personality walk in with two knees that were bone on bone and say something like “they’ve been aching a bit recently doc” Then you’d have the obese couch potato with the gloom and doom personality that had mild changes and it was the end of the world.
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Post by aquaduct on Jul 10, 2020 13:38:01 GMT -5
But it's becoming clear to me at least that the best answer when facing your maker is, "I tried." Peter, you might appreciate this one: The boxing gym I mentioned upthread is run by one of three brothers—all second-generation retired prize fighters. This guy’s younger brother was the best of the bunch; USA amateur champion, great record, was a staff sparring partner for guys like De La Hoya and Mayweather back in the day. A great trainer, and still in amazing shape in his 40s. (The guy hits like a freight train, despite being my size and weight—which is not big—but I digress). It’s no secret that a good number of former pro athletes tend to let themselves go a little after retirement—without the intense daily training and paycheck, it’s easy to let a few extra craft beer pounds sneak up. One night, over fish and chips at the brewpub after amateur fight night, I noticed that he and his girlfriend were splitting their order of fish and chips. I made mention of it, and of how much I respected his dedication to staying in fighting trim. His response was: “Man, Michael, I don’t want to meet my maker and have him look at me and then try to explain what I did to the body he gave me, all trashed and out of shape. i want to meet my maker and say ‘hey God, look at how well I took care of your gift.” Catholic family, btw. For what it’s worth. Made sense to me. For me it's more about the car being driven- not staying showroom new.
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Post by concertinagirl on Jul 10, 2020 13:42:34 GMT -5
What I am about to write are simply observations based on my experience. No scientific study involved. Just some very basic thoughts on quality vs. quantity of life and how much control do we really have. I’ve worked in Skilled Nursing Facilities for 30+ years. I have treated hundreds (maybe even more) of patients well into their 90’s. I have even done therapy with a patient who turned 108 during her time in rehab, walked out (with the use of a walker) and went home to live independently. I’ve always wondered why do some people make to their 90’s and others don’t. Many of those 90 somethings I treated SMOKED for much of their lives. Never once met a 90 something who was a vegetarian. Some claimed to have never exercised, although I believe life in general was far more physically rigorous in their day. The only common denominator that I could see was that they were all rail thin. Never met an obese 90 something. Not to say they aren’t out there, I just never saw them in rehab. My own father is a good example of what I’ve witnessed through the years. He smoked a pack per day until he was diagnosed with lung cancer. He walked daily up to the day of his surgery. He enjoyed a shot of “Schnapps” each evening. He was six foot tall and weighed 150 lbs. (rail thin by my standards). He died two months later after having surgery. He was 89. Still a pretty good run, I’d say. I am certainly not condoning smoking or not exercising as I neither smoke and work-out daily. With that being said, I think genetics has to be a big factor determining longevity. Some of those folks I treated, probably should have died 30 years before I met them based on their lifestyle. We all know people no where near 90 who have died of cancer, heart disease etc. One of my best friends never smoked, ran marathons and WAS a vegetarian. She died of breast cancer at 58. She was rail thin - so perhaps that shoots my theory. Something else that was an eye-opener for me. When I was fresh out of college, I met a patient who was turning 100. I went into her room and with my “Merry Sunshine” bubbly demeanor said, “Good Morning Mrs. Jones and HAPPY BIRTHDAY!” She looked at me with sad eyes and said, “What’s happy about today?” “I’ve lived without the love of my life (husband) for over 20 years.” “All of my friends are dead.” She looked at my left hand and saw my ring. She said, “Young woman, what if you woke up and your husband was gone and so were all of your friends.” “Would you feel like celebrating?” I hugged her and didn’t have a clue as to what to say. I didn’t get it then. But I sure do get it now. Modern society seems to have lost all comprehension of mortality. When I was younger I worked, like you, in a hospital. Did respiratory therapy. Pretty sobering (and highly recommended for any young folks out there). You couldn't help but come face to face with the simple fact that you're going to die. Period. Full stop. One kid (20-ish) got in a fight with his girlfriend and tore down the road in his car. Clipped an elderly couple's car that were coming out of a gas station, lost control and drove through the side of an Earl Scheib body shop. They brought him into our ER where a friend and I had to keep him alive until the doctors could determine that we wouldn't be sued for giving up early- about half an hour. He had a hole about the size of a half dollar coin in his forehead right between his eyes and damn near every bone in his body was cocked at an unnatural angle. Another girl left work at a Burger King at 11 pm and walked across Telegraph road where she was hit by a car. Had to have her chest cracked open so her heart could be hand pumped while they tried pointlessly to save her. She was a week short of graduating high school. Another lady (about 35) spent 2 years in a hospital room on a ventilator. She suddenly got better so they released her from the hospital. She died a week and a half later. And I can go on (but I won't). The point is we're all going to die and there is very definitely a point where prolonging life is not worth the cost. But in this day and age we've been talked into the idea that extending your days no matter what is desirable. No thanks. Beyond a certain point (which for me given my current state and family history is probably sooner than later) just let me die. I fully intend on rejecting heroic measures. Continuing to breath really isn't living. I think recognizing fully that you're going to die is what gives life meaning. Along that lines I've come to appreciate the Catholic concept of Last Rites. The sacrament is all about the church coming together to send you face meeting God in all his glory alone and naked to account for your life. Of course the popular imagination is that this should scare you into being a better person. And the Catholic understanding of salvation isn't guaranteed by merely believing. But it's becoming clear to me at least that the best answer when facing your maker is, "I tried." Peter, based on much of what you’ve written in only the past few weeks, I gather that you are a person who lives life to the fullest. That was my point in bringing up my accident. It was that event that made me realize that no matter how much control we think we have, when the Lord calls, you go. Do I still try to take care of myself? Of course, I do. That goes back to the “quality” rather than the “quantity” of life. Many years ago, an elderly patient who had been instructed by his doctor to make of number of lifestyle changes said to me, “I am not so afraid of dying that I am willing to give up living.” His perceptions of what “living” meant may be very different from how his doctor saw it or how you and I see it, but he continued engaging in the behaviors that made him HAPPY knowing fully well that they may ultimately shorten his life a bit. I think “happy” is a wonderful thing. I agree with you wholeheartedly regarding Last Rites. Lar asked for Last Rites three times. He asked each time before a surgical procedure and then again three days before he died. He wasn’t Catholic but he understood the concept and he also knew what it would mean to me. I think it brought him a great deal of comfort and meant a lot to him too. Regarding my elderly patient’s words...you have in idea how often that man’s words go through my head.
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Post by Chesapeake on Jul 10, 2020 14:15:35 GMT -5
On day one in Osteopathic school we were taught that given the opportunity, the body will heal itself. Our job is to remove obstacles to healing. That philosophy gets lost along the way, but is has more than a grain of truth in it. Just as I suspected.
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Post by TKennedy on Jul 10, 2020 14:31:03 GMT -5
Quite a while back we did a multiple school presentation through United Way on lifestyle and nutrition. Our slogan was
“Building A Body To Last A Lifetime”
I always liked that vibe.
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Post by RickW on Jul 10, 2020 19:59:31 GMT -5
No thanks. Beyond a certain point (which for me given my current state and family history is probably sooner than later) just let me die. I fully intend on rejecting heroic measures. Continuing to breath really isn't living. Absolutely. I’m reminded of a story about assisted suicide, where a father had ALS. He was barely able to move, and could only whisper. His son related that his father said, “If you did this to your dog, they’d put you in jail.” What is the point of living like that?
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Post by Cornflake on Jul 10, 2020 20:07:01 GMT -5
Yeah. My brother had rejected heroic measures and they were still performed. My aunt was correct in stating at the time that he wouldn't have wanted this. My death documents say don't do that stuff and I hope to hell people comply. But the living don't want you to leave, no matter how much you're at peace with the prospect.
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Post by jdd2 on Jul 10, 2020 20:17:29 GMT -5
Wasn't there some fellow (a florida doc?) who'd had DNR tattooed on his chest, and they still wondered if he meant it? edit: not a doc
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Post by sidheguitarmichael on Jul 10, 2020 21:28:27 GMT -5
. I’m reminded of a story about assisted suicide, where a father had ALS. He was barely able to move, and could only whisper. His son related that his father said, “If you did this to your dog, they’d put you in jail. Damn, that’s harsh. I absolutely get it, myself, but what a brutal thing to hear. As an aside, K’s mom died from ALS, shortly after we got married. That is no way to go, believe me.
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Post by coachdoc on Jul 11, 2020 8:56:21 GMT -5
"There's more old drunks than there are old doctors so I guess I better have another round...." I just heard Willie Nelson sing that line in his song a few minutes ago on XM radio. There might be a lesson there for all of us. LOL! An old fave of mine, but my partner is a goody 2 shoes so I don't get to sing it much anymore. Used to sing it every gig in the Colorado ski bars. Sort of an anthem.
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