Thursday, January 29, 2009
IN MY OPINION (Column)
A Medical Peek Into the Future
By TED RUHIG
The ancient Greeks of poetic mythology had a poem, which is worth noting today:
Astrologers foretold to me
I’d live till I was thirty-six
But I will settle for the three
Decades and then be glad to quit
By golly, our sense of what it means to live a long life has changed from that of long ago. Longevity has increased significantly almost everywhere in the world. Life expectancy worldwide increased from 46 years in 1955 to 66 in 2005, with an increase to 75 projected for 2050.
Since 1950, developing countries have enjoyed a 23-year gain in life expectancy, from 41 to 64, with continued gains to 74 projected for 2050. According to the U.S. Census Bureau, Andorra has the world’s longest life expectancy of 83.5 years. Life expectancy in the United States is ranked 30th in the world, and it is currently 78.6 years.
As we continue to extend our lifespan, we will need lots of patience and forbearance to make sure we age well. Strength and energy don’t have to leave us as we get older and older. And if we have health problems, we can try to solve them well into old age.
A recent newspaper story noted: “80-year-old patients with clogged arteries or leaky heart valves used to be sent home with a pat on the arm from the doctor and pills to take to respond to symptoms. Now, more are getting open heart surgery with remarkable survival rates, rivaling those of much younger people.”
People 75 years and older are the fastest-growing segment of the U.S. population; this group is projected to more than quadruple over the next 50 years. Forty-percent have heart disease. Now, because of the increasing ability of those who treat these individuals and a knowledge that is expanding about the nature of their disease, those with congestive heart failure, the leading cause of death among the elderly in the U.S., are being greatly helped.
Years ago, physicians “were told we were pushing the envelope” to operate on a 70-year-old, observed one cardiologist in a recent article. But today, we have elderly folks who are extremely viable and mentally quite sharp, who want to decide for themselves whether to take the risk. Even 90-year-olds are having open-heart surgery, according to a Yale University cardiologist who has researched older heart patients.
There are other ways besides surgery to tackle congestive heart failure. Researchers are pointing out that patients who exercise regularly can improve their heart health. A 1996 study demonstrated that just 15 minutes of exercise five days a week decreases the risk of a cardiac death by 46 percent.
No longer are patients passively suffering declining health. Heart failure patients are being encouraged to exercise and even begin rather vigorous training programs. Doing all of this not only increases their physical health, but it also allows the patients to feel better about their lives.
Last July, an article in the New York Times described one particular heart patient who decided to take control of her own destiny. When Hazel Homer was 99, more than one doctor advised her that there was little to be done about her failing heart except wait for it to fail one final time. But Mrs. Homer was not interested in waiting to die of what many would call “old age.”
Now, at 104, Mrs. Homer’s heart is still ticking, thanks to a specialized pacemaker and defibrillator that synchronizes her heartbeat and can administer a slight shock to her heart if it falters.
Her operation, done a month before her 100th birthday, reflects what some doctors are hailing as a new frontier in medicine: successful surgery for centenarians.
“She’s just a peek into the future,” said the cardiologist who performed the surgery. Asked what she liked most about her life, Mrs. Homer said simply: “That I’m alive, I guess. That’s the big thing. That I’m alive.”
— Capitol News Service