Friday, June 23, 2006

 

Gary Small, M.D.: "The Eight Essentials"

    In this post I'm going determine, cold and quickly, which of the above linked Eight Essentials seem to apply to my mother. In order to avoid, as much as possible, violating a copyright, I'll refer to them by number and title, only. To read the short text for each essential, click into either the title link or the link immediately above.
1. Sharpen Your Mind:
    I'm positive, from what I observe of my mother's experience, that at least the last sentence of this one is true: I believe my mother's brain was naturally set, almost from birth, for longevity. Longevity is one of her personal family legends:
  • People are expected to live into their 90's and further.
  • People are not considered "lucky" unless they live past 100.
  • Dying in one's 70's or before is tragic: Death in this decade or younger is considered to be wholly the fault of the deceased unless resulting from an act of god or something like, which the deceased could neither foresee nor avoid.
  • Death in one's 80's is debatable: Maybe Aunt Matilda could have lived into her 90's if she hadn't insisted on cooking with lard instead of vegetable oil or if she'd taken her medicine like she was supposed to. This despite the fact that what is now considered "healthy eating" is eschewed, in my mother's family, in favor of rich, creamy eating; and doctors generally aren't trusted, not even at the last minute when their services have been engaged; and anything sounding vaguely medicinal is considered to be half (if not more) fabrication.
    It is hard for me to say whether my mother consciously exercised her brain. I assume she crosswords, for instance, for fun. However, maybe she also has mental exercise in mind. She is, after all, a retired Special Ed school teacher who, along with my father, well, they "didn't raise no dummies".

2. Maintain a Positive Outlook:
    My mother is the champion of the positive outlook. She is not a pollyanna; better, she is a realistic, ironic optimist.
    For a long time after I came to live with her, her energy level was quite high. I can't say it is now, but she surprises me with spurts of energy springing from long term habit: If she remembers she could and thinks she can, she can do it. Still. Even with the energy drain of chronic illness. She can be counted on to overestimate her energy reserves, but she's blase about this. Her philosophy is, "Any time is a good time for a nap."
    I can attest to the fact that either she has an incredibly high pain tolerance level or she dismisses pain so easily that she cannot be said to be plagued with pain. I'm sure a lot of this has to do with her positive outlook.

3. Cultivate Healthy and Intimate Relationships:
    I'm thinking, now, one could postulate that when Mom asked me to be her companion she was doing just this. Our relationship is so intimate I have considered that I Am My Mother's Lover. Although she is not socially vivacious, never has been, she enjoys sociability from the fringes with those other than family and long time friends. Otherwise, she definitely seeks to keep avenues open with family members, through thought if not through outright action. She also has a credible history of society and intimate family life.
    I do not know enough about her life long sex life to know if her ostensible lack of one, now, would be considered excusable. I have speculated in places within these journals about my mother's sexuality and sexual history, but she is difficult to talk to on this subject.
    I do know, from personal experience, that once the hormones settle down past menopause, sexuality is a take it or leave it proposition. From this new perch, I wonder, sometimes, if the definition of an Ancient sex life is overrated or, at least mis-defined. I'm not sure my mother could have improved her life, now, by having pursued a sexual relationship in these past years.
    Sensuality, though, is extremely important, from an intimacy standpoint and from a stimulation standpoint. Touch your Ancient One. Get to know them by feel. Be so eye familiar with your Ancient One that you are on early alert for problems. Being the recipient of this kind of attention, I think, is important to longevity, and social receptivity.

4. Promote Stress Free Living:
    I'm not sure what are the "stress busters" referred to in the article. Whatever they are, though, I can testify that my mother has internalized them and uses them frequently. It is almost impossible to stress this woman out. About anything. She can be seen to adjust to surprises, sometimes very volatile ones, but stress, for her, is easily dealt with.

5. Master Your Environment:
    Hmmm...well, I don't think my mother has ever done this. She adapts, but rarely masters, her environments. She is, however, very flexible, even on her own. She singlehandedly, with occasional reminders and suggestions, took herself off her Hershey's Almond Kiss Pills, once she had a chance to digest what her diabetes was and means. She has weathered acts of god well throughout her entire life, the most recent of which was the flood up here in 2000. Overall, although she's slower, now, if "something", anything, a forest fire threat, anything, I have no doubt that my mother, with a substantial second right arm, would make it through fine.

6. Shape up to Stay Young:
    Hmmm, well, she may be beyond this now, mostly, although, as you know if you're a regular reader, I can still, astoundingly, coax her into movement if conditions are right, including temperature, wind speed, amount of sun and her own physical reactions. She over estimates her abilities constantly but pulls back immediately when she realizes this. She has lived a life of physical vigor and spontaneous exercise of a variety of types, right up to her early 80's.
    I wonder if, at her age, assumption of the ability to move trumps actual exercise, although both she and I notice immediate benefits when she is more active.

7. The Longevity Diet:
    Mom has accomplished this one in her Ancient years, mostly with my gently insistent oversight. To her credit, as well, although mostly canned and lacking in the abundance of fresh vegetables (although fresh fruits, including wild fruits, were plentiful and we ate a lot of fruit as kids; so did my mother); our family diet was very healthy. She indulged in a lot of sugar back then, but, I'm sure, not nearly as much as she would have if she hadn't had four kids around to raise. We were barely allowed sugar and/or salty treats. See Sweet Satisfaction.
    And, yes, she does get her treats. She is also not apt to overindulge.

8. Modern Medicine to Look and Feel Younger:
    Well, we're doing the best we can within constraints:
  • Her ailing digestive system;
  • Her desire to be poked and prodded as little as possible and to take as few medications as possible. She enjoys spurts, still, of making herself aware of what I'm feeding her in the name of medication, questioning each pill, sometimes demanding to know why she needs to continue taking her pills.
  • She was put on a cholesterol lowering medication between 1990 and 1994, under her own cognizance. I remember discussing it with her over the phone. She would have been between 73 and 77. Within less than a year a study came out which I read independently in Seattle that indicated that if the patient had a history of high cholesterol (my mother does) but is past the age of 70 and has no heart trouble, the benefit of medically lowering cholesterol is highly questionable, thus, better to preserve liver function by keeping the "elderly" from overmedication. I told her about the article when she spontaneously, in one of our weekly long distance phone calls [1700 every Saturday, generated from her home in Mesa, AZ], announced to me that her doctor had taken her off her cholesterol medication.
        It's debatable whether paying more attention to her cholesterol would have delayed or prevented her mini-stroking, which may have headed off most of her present dementia, although not all, I think.
  • Earlier in our journey my mother did consider, on and off, plastic surgery. Her early and prodigious wrinkling around her face has always concerned her. We talked about it the other night, in fact. I have encouraged it, but she has never been able to take it down to the wire. She has become less concerned with changing her "look" as she ages.
  • I certainly don't think we're overmedicating her. I sometimes wonder if we are under medicating or testing her. But, quality of life to my mother means the fewer doctors and the less obvious preventative and medical attention, the better. Up to the point of crisis I believe this should be respected. I further believe that, in crisis, questioning procedure is legitimate.
  • She has a Living Will to which I intend to judiciously adhere, considering my mother's fascinated hold on life.
  • My mother continues to perceive herself as being much younger than she is, except on days when she is able to, as she says, "Count the years in [her] joints." She is astonished when she rediscovers, sometimes on a daily basis, her age-related infirmities. This, I guess, qualifies as "optimism" and "positive outlook".
    So, I guess my mother would "score" (if such a thing can be said), pretty high and, no doubt, would be considered justification (although not the ultimate justification) of these Eight Essentials. Interesting exercise. I'm thinking of some possible amendments:
  1. Feeling lucky has a lot to do with "it", I think. Or blessed.
  2. Maintain a humorous outlook. Humor is sometimes more valuable than outright positive thinking.
  3. Come to know and be true to your spirit. Surround yourself, as well, with people who enjoy and look to your spirit.
9/22/08 Addendum:  Since I originally wrote this post, both of the links I originally used, which listed the Eight Essentials, are no longer available online. They have been published as a book. Thus, I've linked to Dr. Small's website in the title of this post and to the book that enlarges on these Eight Essentials.

Comments:
originally posted by Deb Peterson: Sat Jun 24, 12:03:00 PM 2006

Gail--Your post started me thinking of what I would list as my "essentials." I wouldn't claim that my essentials apply to everyone--I think it's hard, if not impossible, to prescribe steps that everyone would benefit from, especially in the name of longevity. And I guess my follow-up comment might be: why longevity? Why should I do TOO much in the present for a distant goal? Well, if you're enjoying what you do, and it happens to extend your life, that's good. But I think (and this is a comment on Dr. Small's conclusions, not yours) that "longevity" as a value is something like saying that blue is your favorite color: I have blue shutters on my house and I love it there, someone once served me a blue margarita and I could barely choke it down, I love blue delphiniums and lobelia but a blue rose would be jarring, I rarely wear blue clothing (except denim) because I don't like the way it makes me feel, sky blue is one of the pleasures of life.


So having said all that, I found your three added essentials resonated with me more than the earlier eight. I guess the first of Dr. Small's suggestions--sharpen your mind--is a decided mixed bag for me now. It's always been something I've loved and wanted to do, at the expense of my body!, but I would have to qualify this suggestion. My mother always had a sharp mind--like your Mom, she spent a lifetime instructing formative minds in very creative ways. But my mother--with her above-average IQ and good grades all through school--was not much of an enquiring mind. She had a good, logical gift--probably more "left-brained" than right--but wasn't much of a questioner. I think that--whether one lives long or not--writing your own truth, or as you say, being true to your own spirit, is the most important essential. I don't mean a subjective truth, or a "make it up as you go along" truth, but a brave inclination to calibrate the objective and the subjective, and put it into your own words. Oddly enough, I think my Mom is doing this very thing rather late in life. There's nothing like a little adversity to challenge the complacency.

And Master your environment--okay, I've been reading too much of Waldo lately. I know what Dr. Small means, but maybe I would have worded it differently. I just went back and reread your comments on this and I like the way you interpret it. I might be wrong but it sounds like you see it as moderating one's appetite and learning to "read" the world, "go with the flow"? Am I misinterpreting you, Gail? (Wow, we could have a good discussion of this...) When I first read Dr. Small's words I interpreted them as an attempt at controlling the externals--which needs to be done at times, but I'm uneasy with it as a maxim.

Now that I've blathered on, I think I'll step back a bit--you might want to "riposte"! Food for thought.
 
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