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By Richard P. Holm
How to Live Long By Richard P. Holm, MD A college friend of mine recently had a heart attack and I found myself in an email conversation with my buddies, talking about his condition and reflecting about our own wellness. I recently read that only 20% of our potential lifespan is determined by genetics. This then begs the question: what can each of us do to improve our longevity and protect ourselves from my friend’s fate? Preventive medications and supplements have been widely advertised by the pharmaceutical and supplement industry, but unfortunately are at best minimally helpful in protecting people from vascular disease. Rather than taking pills, making simple life-style changes can be considerably more effective. This starts with realizing the huge benefits that can come from something as simple as a daily walk. Walking 12 blocks (one mile) a day can be the goal, and if this is out of your range, start slowly and build. Even a little is good. A recent study found that people who walked three miles a day (or ran 45 minutes three times per week) lowered their risk of death by over 30%. The greatest benefit to their health, however, came with that first mile. Side effects of daily walking include increased strength and energy, strong bones, improved mood, better balance, and superior sleep. There is a lot of talk about treating obesity, but studies show that the best weight loss programs usually fail after five years. Therefore, I never encourage people to have weight loss as their goal. Solid science shows a lower calorie diet (20-30% less than usual) and emphasizing beans and vegetables, will enhance longevity, even without weight loss. In general, a person who is heavy, but is also strong and physically fit, has a life expectancy like a thin person. Longevity also seems to be improved in those who are well connected to friends and family. The same goes for those who nap daily and in those who have a religious or spiritual center. Physician stress studies have also shown that people with a creative outlet do better. There is also scientific data to show that those who drink one or two glasses of wine daily, and not to excess, live significantly longer. Of course, bad things can happen to people who are doing everything right. However, it’s hard to beat a day that includes taking a brisk walk, making something creative, eating balanced smaller meals, taking an afternoon nap, enjoying a glass of wine with a friend, and then saying a prayer of thanks before bed. The goal shouldn’t necessarily be to live long, but to live well. By Richard P. Holm, MD
There was once an abusive man. He was an only-child, growing up loved but overprotected. He always received praise for being a ‘nice guy’, but lacked the discipline to control sudden bouts of rage and anger. In school, he was protected from repercussion because his parents would pressure his teachers, and he dropped out of sports because he was intolerant of direction. His marriages failed because whenever he felt criticized, he would fly into a rage, and gradually the emotional abuse became physical with divorce to follow. When it was time to care for his elderly and dependent parents, he was again abusive. The parents were reluctant to confront him or call for help because they felt responsible. They were terrified of his rage and physical threat, or worse, feared he would ignore them and leave them helpless. There are many theories for why people abuse others. Psychologists say that every case is different, and every abuser is driven by a different monster. Carrie Askin, a clinical social worker and author who has extensive experience with patients who are abusive, says that people commonly become abusive because they never learn to tolerate criticism and thus retaliate when they hear it. She states that abusers often learn from their youth that she or he is entitled not to hear criticism, has the right to punish anyone who violates that right, and can do so without any expectation of repercussion. It is paradoxical that the most common reason for people to become abusive is because they did not experience fair discipline as a child. If one is to improve as a person, they must learn to take constructive criticism very early in life. Those who haven’t accepted this life lesson and who respond to every disapproval with anger and retribution eventually live an isolated, ignorant, and unfulfilled life as people run from them when they come near. There are other reasons why people become abusive. Sometimes it is people who have never known kindness and were abused themselves that become abusive, almost in self-defense. They were taught, by example, that abuse is ‘normal’ and ‘deserved.’ About one third of the children raised in this kind of environment become abusive adults. This means, however, that two out of three raised in a family with abuse do NOT become abusive. Bottom line: abuse should never be tolerated. Children, spouses, and the elderly should be able to trust the people around them and live in a safe environment. Abused people should call for help from their physician, minister, social services, or even police. By Richard P. Holm, MD
When asking a group of friends how important music is to them, I heard a lot of answers. “Music must live in our brains somewhere close to where emotions reside.” “Think of how the plot of a movie is moved by the music, from The Wizard of Oz and Jaws, to Star Wars and the Sound of Music”. One friend told me, “I have music in my life every day.” My wife Joanie said, “If I am grumpy, put on a waltz and my bad mood goes away.” Another friend said, “Music dips into the deepest aspects of my soul.” Almost everyone enjoys music of some type, whether it be classical, country, hip hop, blues, or jazz. But music can be for so much more than pure enjoyment. It can enhance feelings and memories of suspense, fear, compassion, sadness, and happiness. There is scientific data to show that music therapy significantly helps improve physical, cognitive, emotional, and social well-being. Music therapy is commonly prescribed for treating medical illnesses, physical and developmental disabilities, psychiatric disorders, and neurological impairment. Music therapists are now working in hospitals, psychiatric centers, nursing homes, rehab centers, schools, daycare facilities, substance abuse centers, and hospice programs. I have the privilege to sing with a voice-only choir called the Hopeful Spirit Chorale. Almost every week, we sing for an individual who is either sick at home, in the hospital or nursing home, receiving help from hospice, recovering from an illness, or who simply would appreciate it. We sing well-known hymns and non-religious songs mostly in four-part harmony. One choir member said, “we are caring people lifting the spirits of others with a nice gift of music.” However, music is one of those gifts that gives back as much, if not more, as is given. There is an unexplainable thing that often happens with that choir when the music is just right. A spiritual connection shivers through everyone’s bones; tears may flow, and the individual and family being sang to feels loved. I know this doesn’t work for everyone, but when I try to define what God is to me, the great mystery is at least partially explained when, in song, the harmonic spirit embraces my soul and brings balm to my fears and suffering. By Richard P. Holm, MD
Screening for cancer is sometimes like fishing for walleye. If you have the money, you can buy a good fish-finder to see where the fish might be. The finder may advise that there are fish down below your boat or your ice-house, but you don’t know if they might be carp, northern, or weeds . . . and not walleye. If, then, you decide to drop your hook, sometimes you only catch small ones that aren’t keepers and they all go back. Sometimes you catch nothing. Sometimes, however, you catch the big one. Okay, this is not the perfect metaphor, but screening for cancer often requires advanced and expensive technology that are not always accurate. Once there is an indication that there might be cancer, the next step usually requires the commitment of a significant, sometimes invasive, effort that doesn’t always result in the best good for the patient. Sometimes, however, you catch a dangerous cancer about which you and your doctor can do something to provide a cure or, at least, add significant days of quality time to your life. We are not talking about a patient coming to the doctor with a cancer that is discovered because the prostate cancer stopped the urine flow, the breast cancer lump grew to an easily feel-able size, the lung cancer induced a cough that turned bloody, or the colon cancer caused blood in the stool. We instead are talking about screening for cancer in perfectly healthy individuals who are not experiencing any symptoms. Examples of this preliminary screening would be a yearly prostatic-specific antigen (PSA) blood test for prostate cancer in 50-plus-year-old men, a yearly mammogram in 50-plus-year-old-women, and a CT scan of the lung one time in all 50-70-year-old smokers. Experts measure the value of screening in several ways. First is the cost of the test and any further treatment that follows, measured against the benefit. This would be the financial cost to the patient, the insurance company, or the government, but would also include the pain and emotional suffering cost to the patient. Second is the sensitivity of the test: if it isn’t sensitive enough, then it will miss cancers. If it is too sensitive, then it will indicate cancer even when there is not cancer. The PSA test is not encouraged by many experts because it misses a lot of prostate cancer, and, at the same time, it identifies too many non-dangerous tumors that will never cause harm to the patient but would result in treatment that disables the patient without enough benefit. We call this a test with poor sensitivity and poor specificity. There are screening tests that have good sensitivity and specificity, however, and times when even the PSA is indicated. So, let your doctor be your fishing guide through these difficult and challenging waters. |
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