Reflections I: Aging and Medicine

My family doctor was retiring, so I thought I should make an appointment to say goodbye. There was no need for this – there was nothing wrong with me. My high blood pressure is under good control, albeit with enough medication to stun a bull elephant and no more soy sauce. With my low sodium sardine and Original NoSalt popcorn diet and no cheeseburgers ever, my cholesterol count is excellent and triglyceride numbers are good enough to rock the house. Okay: the statin helps. And the Parkinson-like essential tremor in my left hand is not getting any worse, except when I turn the heat down in the house to save money, or when I try to text and accidentally send gobbledygook or profanities. Apparently the kidney cyst is not any bigger, and I’m only aware that the dry macular degeneration is getting worse when I’m told so by the optometrist, which perhaps tells me that I should go see her less often. And the tinnitus is no bother, really; that is, I am used to it. It is like living – not next door – but a few houses away from the construction site of a high-rise condominium. My knees ache and my fingers are growing crooked, but hey! I can still walk three or four miles (in Canadian, that’s 5 or 6.4 kilometres) on these country roads. Of course, I walk with my orange safety vest on so that the camo-wearing deer hunters don’t shoot me in their ebullience at being in the woods carrying alarmingly big weapons. And while I am at it, walking, I can bend over and pick up the Twisted Tea and Bud Lite cans that the drinking-and-driving dingbats toss out their big-ass Dodge Ram windows. Excellent health, I’d say.

     So in I went, chuffed. I passed the weigh-in with the nurse – well, at least there was no comment. I aced the blood pressure test, 120/71, first take, no white coat-itis. I reported that I had stopped taking Benadryl for sleep after twenty years, so that I could avoid dementia (or “the bug” as one of K’s older cousins called it) related to anticholinergic medications. I hope I am not too late. A combination of magnesium and melatonin seemed to be doing the trick, except when “Mr. Big,” aka Dudley the Maine coon cat, walks on my head with his huge six-toed paws, in order to get me up to make his breakfast. The nurse remarked that she had been taking Benadryl too, and might try my formula instead. She didn’t want to get the bug either.

     Then Doctor Edwards* came in. Of all the doctors I’ve ever had in my long life-time, he is my favourite. He is almost as old as I am, and he knows we are both lucky to be alive. I think he has bad habits too, like drinking a whiskey in the evening. My least favourite doctor was a young woman who, when I complained that my knees and feet often ached at night in bed, just shrugged her shoulders, as if to say: you old. I was fifty. I believe she was about 18, having just been hired directly out of high school. Anyway, Dr. Edwards. He endeared himself to me when I first met him, and I confessed to the occasional cigar outdoors only, in the back yard, with no inhaling. He said: “Well, that shouldn’t hurt you too much.” I guess like all good health practitioners, he should have lectured me on the evils of my nasty habit. But no, he did not, he could no doubt tell such a lecture would be pointless, and we instantly became pals.

     But unfortunately Dr. Edwards is an expert diagnostician. Even though I boasted that I shouldn’t even be there, and I just came in to say goodbye, did he not then proceed to give me an unnecessary and thorough examination? While listening to my heart he said something to the effect of: “mmm, I don’t like the sound of that.” This is not what you want to hear coming from your doctor’s lips, especially when he is using a stethoscope. He immediately ordered an in-office ECG, despite my protesting that I was pretty busy that day. “I thought so,” he said after the test: atrial fibrillation. Damn! My life was over! No more cigars on a sweet summer afternoon in the Adirondack chair in the yard, contemplating the state of the universe and things. No more a green bottle of Moosehead Canadian Lager before dinner. Quality of life gone! I confess that I’d been wondering about the occasional shortness of breath, but of course was practising my usual defence mechanism against these things: denial.

     Dr. Edwards ordered a prescription for Eliquis that I was to fill that day, warning me that it could cost me a few hundred dollars, but it was the best and that he didn’t want me to die of a stroke. I appreciated that. He also referred me to a cardiology practise, for which the first available appointment was two months away. Rural America (that is, if you have insurance at all) and Canada have something in common: long wait times. But the American special scrunch-up: with my Medicare “Advantage” insurance, my co-pay for the Eliquis was $397 for that one month. My Advantage insurance company, by the way, assures me – in writing – that it cares about my needs, which certainly warms the cockles. Now, I’m not rich, but thank God I am not an actual poor person. I suppose the very poor on Medicaid might be covered, hard to say. But the millions of working poor? In that case, I guess the option then would be to go right ahead and expire from the stroke.

     What do I think of all this? If I look at just me, selfishly, I am one lucky bastard. I’m not in Palestine or Ukraine or Sudan. I live in a rural paradise with a wonderful woman who loves me more than is reasonable. I am not a migrant farm worker whose house is surrounded by masked ICE agents intending to pick me up and send me to a prison in El Salvador. I am alive, lucky to be so and I have had a good, long run replete with terrible mistakes and happy successes. By the time my father was my age, he was already a few years dead.

     Despite all my palaver and nonsense, I am actually pretty careful about eating and exercise and all. And yet, I think, given genetics and the general wear and tear of a life fully lived, were it not for the good Dr. Edwards and the like, and all their miracle medications, I might well be six feet under. And thus I am grateful. So I say it here: thank you. I am glad to be standing and compos mentis and be able to celebrate my smart granddaughter’s twentieth birthday.

     Sometimes we codgers say we are on “borrowed” time. I have thought this way myself. But I think that is the wrong way to think about it. I like better the term my sometimes crusty cousin uses; he calls it “bonus” time. We have lived full lives, and now have stepped back from the hubbub, but we are still here, and it is a bonus.

     And so it is. Every day is a bonus. Every morning with the sun streaming into the living room, with the mountains of Vermont in the distance, is a bonus. The warm wood stove on a frosty day is a bonus. Mozart playing on the radio while we read is a bonus. Dudley the cat ordering me to open the door is a bonus. The oatmeal in the bowl with blueberries and the black coffee in the white mug are bonuses. My mate’s and my quiet chatting and little jokes and smiles over the meal are bonuses. Later in the day, lunch with old, old friends is a bonus.

     K calls this time a “gift,” That is another good way to think about it. We are lucky to be upright and able to do just that.

* Name changed to protect the innocent.