A Synopsis of Preventive Medicine
It has been almost two decades now since I taught courses relative to the topic above. Those courses included: Human Physiology, Physiological Control Mechanisms, portions of Pathophysiology, Exercise Physiology, Central Nervous System Physiology, Physiological Aspects of Drugs and Drug Abuse, and Physiology of Aging. The ensuing many years of retirement precludes any possibility of claiming I am current on many topics relating to physiology. I am not and frankly, most physiology of modern significance is at the cellular level---indeed to be more correct, it is at the molecular level. So anyone who claims to understand body function today really needs to be a molecular biologist. Most areas that I once may have claimed to be an 'expert' on, I have not kept up to date with in any serious manner. Perhaps the one exception has been preventive medicine---after all, like most people I wish to live a long and healthy life.
More precisely, the object for me is to to live a healthy life as long as possible, not to live as long as I can. We are edging closer to this being a practical reality. A few states now allow assisted death. I believe every person has the right to live as long as they want to live and not be forced to endure living longer because the government or someone's religion demands otherwise. For me it is also an economic matter. To spend tens or hundreds of thousands of dollars of my money or other people's money to keep me alive a few more months goes against my ethical grain. There are many young people dying needlessly of curable diseases or in need of medical care and I prefer such money be spent on those who have a lot of life ahead of them. I don't fear death but I do fear being trapped in a difficult dying process.
The next general point to be mentioned here is that some people will live a long healthy life with no concerted effort on their part to do that. My mother is a good example. She ate anything she wanted, as much and as often as she wanted, she never exercised to speak of, and lived a healthy life until she died at age 98. My father did pretty much the same and lived to be 89, albeit with some health problems in his later years. I guess they had the right genes.
On the other hand, most people can extend their years of good health by attention to some simple guidelines, which I elucidate on below with every effort to be concise. Too much detail and we miss the forest for the sake of the trees.
Weight control, exercise, proper diet, attitude, and mental activities to reduce stress are all general areas to address.
Weight control is one of the most crucial to ensure continued good health. Being overweight is often a contributing factor to a host of medical conditions. Keep in mind the following. There are two kinds of fat cells---white fat cells and brown fat cells. You are basically born with X number of white fat cells and they operate by storing fat---but only a certain percentage of a white fat cell is filled with stored fat. When you gain weight at some point the thermostat for storing fat gets reset and each fat cell now stores more fat. The object is not to let the thermostat get reset for any length of time. If we do, then losing weight can become a huge problem. Thus, if you gain 3 lbs, lose it, then and there, in the next week or two weeks. Brown fat cells actually burn fat and exercise stimulates the formation of brown fat cells. These brown fat cells also produce the hormone irisin which helps prevent or overcome insulin resistance and this guards against some forms of diabetes. Keep in mind that nothing is equal amongst us in terms of preventing weight gain. It has long been known that some people become overweight on less calories than others who, on the same caloric intake, do not become overweight. There are people who, when paid to become overweight, cannot become overweight, or do so only with great difficulty. Once stopped being paid to be overweight they have no trouble losing the extra weight. The idea that weight control is all a matter of will power does a great deal of disservice to those whose genetic makeup is geared in a different direction. There are a lot of potential reasons for weight gain.
Exercise, we all know, is a great activity for maintaing good health. With all the gadgets and use of cars to go anywhere, young people today have serious weight problems. More young people are overweight today than at any point in our history. At the same time, more young adults and middle aged adults are engaged in serious organized exercise activities than ever before. Most forms of exercise are good, and younger people should just do the exercise they like. Muscle mass is a mixed bag. It doesn't hurt but then do we want to really try to maintain this muscle mass in older years? We might feel we need it for whatever reasons when young, but we don't need it when older. After about 55 years of age, walking or swimming are probably the best forms of exercise. Unless we are in a rush for hip or knee replacements, we need avoid stressing joints when older. Walk, don't run, moderate paced swimming is probably even better. Exercise, at least statistically, improves the feeling of well being (for most people), helps guard against a lot of medical conditions, and keeps weight down. Attitude helps. Don't park as close to the store door as you can, the walk to the store is good for you, and in general, never miss a chance to walk instead of being deposited at your destination. Never avoid a short set of stairs to take an elevator---climb the stairs. Try to walk a decent distance everyday or a longer distance every other day.
Proper Diet.
There are more people eating a proper diet today than in the past. The situation here is tricky. The basic principles for good diet are relatively simple. Don't eat too many calories. Avoid saturated fats, trans fat, cholesterol, too little fiber, or eat red meat too frequently---or in too great a quantity at one sitting. Olive oil is the best cooking oil, skim milk or soy milk better that whole/1% fat milk, egg beater better than real eggs in cooking, and therein is a good start. The only vitamin we probably really need take is Vit D, although some people with stomach situations may need Vit B12, B1, and folic acid. After that there are hardly any studies which support going overboard with vitamins. The problem with scientific studies on food habits---these studies sometimes change conclusions over the years. First this or that is bad and then later it's not etc. The problem is there are so many other variables in these studies that interpretation is difficult. I can do a study which might conclude that strict vegetarians live longer or are less likely to have heart attacks, etc. and the question about vegetables would still be open ended. People who tend to become vegetarians also tend to be more health conscious than those who are not vegetarians. So perhaps all the study proved is that those who are health conscious tend to live longer and have fewer heart attacks. It may have little to do with the vegetables (there is sufficient evidence however that vegetables are good for us). When it comes to eating, moderation is a good guide. What about certain herbs, and other specialty products pushed by a huge 'anecdotal' alternative medicine industry? Look, most of these people with a shingle out in this industry couldn't give an intelligent lecture on the physiology of any system in the body. They rarely have had any courses worth anything or from anyone remotely qualified to lecture on body physiology. In many cases these are people who badly want to be doctors but could never gain entrance to medical schools due to non competitive academic grades.
Are the anecdotal alternative medicine industries a bad thing? No, they are not. Most people who use their services are very health conscious and regardless of how much of their money they waste on these services, they tend to eat healthy, exercise, watch their weight, etc. Almost all of these anecdotal alternative health doctors are quite careful not to push any product which is toxic to the body or do anything medically which will harm a person. Outside of the military industry and the regular medical field we desperately need some other industries in this country. Let the anecdotalites be. They rarely hurt anyone and it has long been known that people who feel something is good for their health, even if it is a harmless placebo, tend to be in better health. The relationship between state of mind and body is very important to just how optimally body systems function. For many people, religious beliefs have been replaced by anecdotal alternative health beliefs. There is some truth that most all of us need to believe in something.
Attitude
All the body systems are controlled by the Central Nervous System. This system is essentially a chemical computer. Nerves produce neurotransmitters and these neuro transmitters stimulate, inhibit, or block other nerves from being activated. All kinds of problems can happen, minor or major, when not enough of a neurotransmitter is being produced, or too much produced, or there is a problem with reuptake, destruction, or their actions are being potentiated by the presence of another chemical. Most all drugs taken to impact on the central nervous system act by interfering with any of the above neurotransmitter properties. As with drugs which act directly on other body systems, drugs acting on the central nervous system invariably have negative side effects. Medically, the gain has to offset any side effects to be useful. With millions of neurons in the CNS and all of them producing neurotransmitters, it is no wonder we all individually have unique mental states. The one mental state sought by all is contentment. Achieving contentment is no easy road. It is never an all or none proposition. Suffice it to say here, a contented person is more likely to be healthy and remain healthy, all other factors being equal. So it is best to reduce the stress in our lives. Easier said than done, and I certainly will make no attempt to tackle this topic in this synopsis.
There are a lot of programs which purport to reduce stress in our lives. Some work, some don't, and for the most part, some work for some and others work for others. Some people meditate or do yoga or pray a lot or have therapy sessions of various ilk, or respond enthusiastically to motivational seminars, etc. I tend to take long walks, mostly in nature settings. Whatever reduces stress in our lives is a good thing.
The above areas are the primary ones to get a good start on healthy living. There are, of course, a multitude of of lesser areas we can give attention to, but the object here is to emphasize those areas which can have the greatest impact on our health. Some people manage to make their lives endlessly complicated with imagined or real preventive health issues. Most people I suspect are not trying to live to be 100, just want to live a healthy life to a decent age.
I have seriously tried to make this a real synopsis, a task not natural to my writing style. Interestingly, I enjoy writing on topics which are new to me, which require a lot of thought and some research. Writing on areas of my professional training is a lot less challenging, almost boring. Decades of lecturing on the same topics is quite enough. Following is a plan of sorts to follow regarding the best preventive medicine.
Finding the right doctor is a good place to start. It surprises most people to learn that until relatively recently medical students where given little or no training in preventive medicine. That has changed, am not sure to what degree. I prefer a doctor who is part of a Medical School faculty. These are teaching institutions, to gain an appointment on the staff is very competitive, and because these are teaching institutions these doctors are under the microscope in their practice. Most everything they do is being observed by a small army of interns, medical students, medical associates, and medical school evaluation boards of numerous sorts. Whatever our medical problem, these doctors have ready access to get us attended to by the right specialist with the right credentials. They are really one huge team. "Leave the driving to us' comes to mind.
No matter how good the general physician, many people will have medical problems, usually of a minor nature, for which modern medicine has no quick answer. No good doctor has the time to spend a lot of time mulling over some vague medical problem a particular patient is having. When this happens we need tackle some solutions on our own. Google is a God-send here. The trick to using Google for medical solutions is that we need to limit our input to established dependable medical sources. That is always where we should start. We need constantly remind ourselves that articles on the internet can often be garbage in terms of any scientific validity. There are isolated M.D.'s out there who make a small fortune preying on people's desperate search for solutions to vague medical problems. They are no different than the anecdotal practitioners but at least those people don't claim to be M.D.'s. The main news page of sites like Yahoo and others of similar ilk often carry so called preventive medicine articles. Be careful here. Always check the credentials of the author. For example, there was a headline article which claimed to list the 10 best foods to remove toxins from the body. It was such an absurd title that curiosity got the best of me. The foods listed were of no special significance, certainly harmless enough. But clearly I sensed the author knew little or nothing about digestion, metabolism, or excretion for them to make such a silly claim. I looked up the authors on Google and they were three housewives with a blog.
The other most common internet authors to avoid for medical advice are journalists. Again, you check the source out on google. If they list all the publications they have written for as proof of their expertise, you should be wary. A good journalist who makes medical claims in their writing will list the sources of their information at the end of the article. If they don't do this, just take it all with a grain of salt. After all, they are journalists, not trained medical scientists. They are often motivated to write what people will read and claiming there are foods you can eat which remove toxins from the body is a sure way to attract readers. It is a safe enough scam, can anyone prove they are wrong?
Our time, of course, is precious. Maybe not so much with retired folk like me. There are reputable Medical Institutions which publish monthly medical news bulletins on health related matters, including modern approaches to treating varied medical conditions. These 'letters' cost about $25/year. It is really useful for most people to get 3 or 4 of these. The cost is well worth the sound medical advice given. The ones I subscribe to are: Harvard Health Letter, Mayo Clinic Health Letter, University of California at Berkeley Wellness Letter, Harvard Men's Health Watch (am sure they have a Women's Watch too), John Hopkins Health after 50, Duke Medicine Health News, and UCLA Division of Geriatrics Healthy/Years. For any major health issue we may have, these publications will keep us right up to date on our particular problem. Any information obtained from these sources is a result of legitimate research studies using controlled experiments. A doctor rarely has the time to give us any polished in depth presentation on our problem. Articles from these reputable institutions can fill this void.
Finally, many of us have medical problems which are vague enough or unique enough that the best of doctors cannot see any quick solution. They don't have the time to research or cogitate endlessly about our particular such problem either. We then have to do the research ourselves. Google makes this possible. Anecdotal alternative medicine may be worth the try. Endless munching on some herb may help. Herbs rarely get run through any scientific testing simply because a drug company cannot patent a herb. The Government should run tests but they don't. The Government is busy making smart bombs. The cost of one fancy assed fighter plane would probably cover the costs of scientifically testing most of these herbs. Some of these herbs might really help some medical conditions. Just be sure to google the herb and see if there is any cautionary warnings from a reputable medical institution. When all else fails I think rational people are willing to take risks on the chance something might help. Science does not have all the answers yet.
A lot of the vague symptoms some of us suffer from are due to Central Nervous System malfunction. This is hard for a lot of people to accept. It kind of means the problem is mental. Of course you and I don't have mental problems. Well, sometimes I wonder about you. Almost all of the well known mental problems have degrees including depression, paranoia, anxiety, hyper this or hypo that---and every physiological system is regulated and affected by the Central Nervous System----which means that the digestive problem we have may really be Central Nervous System in origin. At any rate, a visit to a neurologist or stress physician may be in order. I have always felt that these guys have the toughest area. It really takes amazing analytical skill to decipher what kind of treatment might be helpful. Fortunately, a lot of progress has been made in recent years in these areas. Tension and anxiety is a consequence of modern day living. When I was younger there was plenty of time to be bored. The nice thing about boredom now and then is it forces some relaxation. Today a lot of people cannot stand being alone with their own thoughts for even a short time. An assortment of gadgets is always right at hand. I sometimes wonder if very many people have any time at all anymore for deep thought about anything. Be all this as it may, some of our problems are due to excessive tension, excessive insecurity about matters, stiff competition at work, social stresses, family stresses, etc. Relief from these sort of states often takes time and may require trying this or that endlessly until the right relief is obtained. But if we refuse to start dealing with CNS derangements, the problem we have will not likely ever go away.
Too many people let their own feelings and notions drive their medical care. Knowing little about how the body functions, they imagine this or that as the cause and then proceed to find some kind of doctor (using the term loosely) who will agree to treat them for the imagined cause of their problem. Not surprisingly their problem never really goes away, continues unabated or comes back again and again and they spend years diagnosing themselves and seeking those who will happily take their money and go along with such self diagnosis.
Any more paragraphs here and the word synopsis will no longer fit. Hopefully somewhere in here might be something of use to someone reading it. I now am eager to return to topics that are more philosophical.
