Reflections on the Lecture on Prevention and Treatment of Geriatric Diseases

This time I listened to a lecture on the prevention and treatment of geriatric diseases given by the geriatric medicine department of a tertiary hospital in conjunction with the community health service center. The core takeaway can be explained directly - don’t treat geriatric diseases as a “normal phenomenon of getting older”, and don’t blindly copy the “general health prescriptions” on the Internet. Prevention should focus on the three words of “early, fine, and constant”, and treatment must follow the three principles of “individualization, multidisciplinary, and full cycle”, which is more effective than any number of expensive supplements.

Last Saturday’s lecture was filled with the elderly and their families in the community. Aunt Zhang, who was sitting next to me, felt regretful when she heard the orthopedic doctor talk about the classification of osteoarthritis. She had been suffering from knee pain for almost a year. She always said, "There is no pain when we are old." She usually put on some plasters to carry it. The doctor said that she should have received rehabilitation intervention long ago. If she delayed it for another six months, she might have to have a joint replacement. She had suffered for most of the year in vain.

To be honest, I have stepped into many pitfalls before. I always felt that buying expensive supplements for my parents was a sign of filial piety. Deep-sea fish oil, multivitamins, and vitamin C effervescent tablets were moved home in boxes. Last year, my mother drank the vitamin C effervescent tablets I bought every day. During the physical examination, it was found that the kidney stones were 2mm larger than before. I thought she was buying a fake. But this time I found out that if you eat about 300g of fresh fruits and vegetables every day, your vitamin C intake is completely sufficient. Excessive supplementation will increase the risk of kidney stones. When it comes to supplements, the experts at the scene also mentioned the current industry controversy: The view of the Department of Western Medicine and Nutrition is that "what is missing should be supplemented, and if there is no shortage, do not supplement." Blindly supplementing excess nutrients will only increase the metabolic burden on the liver and kidneys. ； However, TCM geriatrics experts present also gave a different idea: Many elderly people have weak spleens and stomachs and cannot eat the recommended amount of meat, eggs, and milk on a daily basis. Their protein intake is chronically insufficient. There is no need to stuff indigestible fatty meats and hard-boiled eggs. Instead, they can use yam, gorgon seeds, lotus seeds and other medicinal and food ingredients that are good for the spleen and stomach, or supplement them with hydrolyzed protein preparations, which will have higher absorption efficiency and will not burden the gastrointestinal tract. Both statements are supported by clinical data. To put it bluntly, the choice should be based on the physical condition of the elderly person at home and cannot be ignored.

Oh, by the way, I was particularly impressed by the case described by the on-site cardiovascular doctor. There was a 72-year-old man who heard on the Internet that nattokinase can dissolve blood clots. He secretly stopped the anticoagulant prescribed by the doctor for three months. As a result, he suffered a cerebral infarction and was sent to the ICU. In the end, he could not move half of his body. My dad has done this kind of stupid thing before. He heard from the neighbor downstairs that celery can lower blood pressure, so he secretly stopped taking antihypertensive medication for half a month. Finally, he was so dizzy that he couldn't stand and went to the emergency room. I had to record the doctor's original words and play them on a loop for him when I got home. Dietary therapy is always an auxiliary and can never replace prescription drugs. This cannot be overemphasized.

Speaking of exercise, it was even more interesting. The two doctors on the scene had really different opinions. Orthopedic doctors say that elderly people with osteoarthritis should not follow the trend of "10,000 steps a day". Walking too much will accelerate the wear and tear of joint cartilage. Five to six thousand steps a day is enough. Try to choose activities such as swimming and elliptical machines that put less pressure on the joints. ； The rehabilitation doctor next to him immediately added that you should not stop moving completely because of joint pain. It is good to practice silent squats at home, with your back against the wall and your knees no more than your toes. Do 10 sets of 1 minute each time every day to build up the strength of the quadriceps, which can actually reduce the load on the joints. It is much more effective than simply walking less. I heard that both doctors were right, so I arranged for my dad to have it when I got home. He used to compete with his old friend in walking competitions, walking more than 10,000 steps a day, and endured the pain in his knees. Now I had an official basis to persuade him.

I used to read on the Internet that playing mahjong can prevent Alzheimer's disease. This lecture also corrected this misunderstanding for me: if the elderly with high blood pressure and glaucoma sit for several hours while playing mahjong, and their emotions fluctuate with the cards, it is easy to induce cerebral infarction, increase intraocular pressure, and even blindness in severe cases. If you want to exercise your cognitive function, you can plant flowers at home, learn a simple harmonica, or even go to the park every day to chat and argue with old friends. The effect is no worse than playing mahjong, and there are no side effects.

When the show was over, I asked the doctor for almost ten minutes. I took out all the physical examination reports of my parents last year and asked them one by one. I wrote down three pages of notes. In the past, I always thought that geriatric diseases were inevitable obstacles as we got older, and that they could not be cured and had to endure. After listening to this, I realized that more than 80% of common chronic diseases in the elderly can be well controlled with early screening and early intervention, and there is no need to suffer unnecessary sins. This week I have made an appointment for this year’s senior physical examination for my parents. I have specially added bone density, cognitive function screening and Helicobacter pylori testing. Early examination will ensure peace of mind. To put it bluntly, no matter how much pension money you save for the elderly, it is better to take daily preventive measures carefully. The whole family will be safe and sound, which is better than anything else.