5) TIPS ON KEEPING HEALTHY AND ON AGING

Two potentially life threatening afflictions dramatically reminded me of my mortality. While I am generally loath to burden others with any health problems I might have, I do feel that my good readers might benefit from what I have to say about these two “incidents” and perhaps even find what I learned from them to be lifesaving. My wife Joan noted a strange looking skin growth on my torso and promptly sent me to our dermatologist, Dr. Sheldon Gottlieb, who quickly determined that the growth, while unsightly, was harmless. He did show considerable concern about what I had dismissed a harmless liver spot on my chest. However, he took a biopsy sample that soon revealed that I had a Clark 2 (on a scale of 4) melanoma, which he promptly removed. I then had to have a large chunk of my chest surrounding this area surgically removed to ensure none of the melanoma remained and I had to be checked regularly for a long time. I relate this because, had this not been caught in time, I most probably would have died in 1992 or 1993. In short, Joan and Dr. Gottlieb saved my life. When discovered early, melanoma is probably the easiest cancer to cure. When caught too late, it rapidly metastasizes throughout the body and becomes a certain death sentence. Therefore, pay close attention to all skin blemishes and have one’s back and back of legs examined regularly by a spouse or friend. When in the least doubt about some unusual new skin change, make a beeline for your dermatologist. In any case beware of getting too much sunshine without adequate protection. Check with your dermatologist on the best preventive measures.
    When I left the White House in early 1993 and began working at home, I also started exercising one hour a day, six days a week and worked myself into good physical shape. (I hate exercising and only watching the History Channel while exercising made it palatable.) In 2005, even though I had no reason to fear heart trouble, I began taking one 81-milligram (“baby”) aspirin daily as, given my advancing age, a just-in-case protection against a heart attack. I also always kept a full-strength 325-milligram aspirin in my shirt or pajama pocket in case of an attack. In early September 2007, I began noticing that I was getting winded easier than usual. Then, in late October 2007, in the middle of a meal, I suddenly couldn’t eat any more and felt very strange. Although I had none of the normal indications of a heart attack such as pain in arms, chest, or side, shortness of breath, or perspiring, I quickly chewed and swallowed the aspirin in my pocket and had Joan come home and take me to the emergency room of Suburban Hospital in Bethesda MD. There it was quickly determined that I had had a heart attack, and the next day I underwent angioplastic surgery, which revealed that I had one artery completely blocked and another partially blocked. The surgeon inserted stents in both.
    The point I am making here for my readers is that my attendant doctors all said that my being in good physical shape, taking small aspirins daily and one full strength one at the onset of symptoms did a great deal to ensure not only my surviving this heart attack at age eighty-five, but greatly improved my chances of a full recovery from what they said was an inherited, not self-induced, affliction. (For example, I had given up pipe smoking some twenty years before.) After the operation, I joined the hospital’s excellent cardiac rehabilitation center where I continue to vigorously exercise three times a week to keep myself in shape and guard against any relapses. One thing that even normally healthy people should watch to avoid heart problems is sodium intake. It is well known that one should “go easy with the salt shaker.” What is far less well known is the incredibly high sodium content of most prepared and canned food. For example, a small can of soup can have 850 milligrams of sodium. A single frozen dinner could have up to 2,000 milligrams or more of sodium. Check with your doctor as to what your daily limit should be. Generally it’s about 2400 milligrams (the equivalent of one teaspoon of salt), but decreases with age. For example, I’m limited to less that 1,700 milligrams, but this varies to some extent from person to person. Incidentally, when having a heart attack, it is best to arrive at your designated emergency room in an ambulance to ensure you will be seen immediately. Otherwise, you may well have to wait.
    After my heart attack and surgery, I learned of another relatively new noninvasive way to overcome heart disease, EECP (Enhanced External Counterpulsation), which consists of a series of outpatient treatments that are far less expensive than heart surgery, including even angioplasty. All I know about this comes from a book, Heal Your Heart with EECP by Debra Braverman MD, who at the time of writing was a clinical assistant professor at the University of Pennsylvania School of Medicine (Celestial Arts, Berkeley/Toronto, 2005). According to this book, EECP was approved by the FDA in 1995 and by Medicare in 1999. One of eight physician endorsements of the book was from David Holmes, MD, FACC, FACP, professor of medicine in the Cardiovascular Disease Division, Mayo Clinic and Foundation. Dr. Holmes stated, “After medications have been tried, EECP might be considered as an adjunctive to conventional surgery and invasive procedures instead of being used after these procedures are performed or have failed.” Not being a physician, I, of course, am not going to recommend any kind of medical treatment. I simply thought that those suffering from heart problems, after consulting with their cardiologists, might want to look into this.

In conclusion, as an experienced octogenarian, still in fairly good physical and mental shape, I would like to offer some tips on coping with “advanced middle-age.” (This can also be of use to younger generations.) Get at least eight or nine hours of sleep at night and have a one hour nap in the afternoon when possible. Get plenty of exercise. The best exercise is, I believe, walking as much as possible. Swimming is even better when available. Don’t spend a lot on fancy equipment you might well never get around to really using (as do so many adults of all ages). Simple weights, stretch bands, an exercise mat and a simple exercise bike are all you need in addition to a good book on exercising. As I mentioned earlier, I, personally, have always hated to exercise in place and found it only palatable while watching TV programs I liked. If you are in poor health or otherwise not in good physical shape, I very much recommend Tai Chi which is non-impact, low energy exercise, but which, with relatively little exertion, can get one into quite good shape over time. There are good CDs on Thai Chi for senior citizens. I always included some Tai Chi in my regular exercise routine. Don’t embark on any exercise program without first having a physical examination and attendant recommendations from your family practice doctor.

Almost as important as physical fitness, is maintaining mental acuity To that end I strongly recommend to men never to completely retire. Women can usually handle it well, but men seem all too often to rapidly go to pot mentally and physically when they stop leading useful lives. I say to men, keep engaged in some useful activity after you have retired from your last job. Start doing a different line of work that interests you, at least part-time.  This could well include volunteering. People of all ages are often welcome as volunteers in a host of activities, many quite interesting and rewarding.
Keep learning. There is a saying that “one should live as if today would be one’s last day, but learn as if you will live forever.” As I used to tell my students, “When you stop learning, you start dying.” Read a lot and keep up with what’s going on. Also writing is a great way to exercise your mind. If you can’t get it published, you can always post it on your website. If you don’t know how to use a computer, learn. It’s not all that difficult.

When you read this, my next birthday will be my ninetieth. In other words, I am playing in the last half of the fourth quarter. One would think that this thought would be depressing, but I can’t remember when I have been happier. Having a wonderful wife and a great marriage, of course, is primarily responsible for this, in addition to maintaining an active life and an open and receptive mind. Writing this book has also played a key role in making my life full and productive even at this late date, and I intend to keep on writing up to the very end. Strangely, I don’t feel at all old. In fact, as I look back, the oldest I ever felt was when, at 23, I was one of the Navy’s youngest ship captains in a ship that was falling apart in a Navy that was also falling apart. (See Chapter Nine of  my memoirs) Now many are often afflicted with assorted aches and pains with increasing age and can become depressingly aware that time is short. As famous movie star Bette Davis once put it, ”Old age is no place for sissies.” But on the other hand, that great French actor/entertainer Maurice Chevalier once noted, “Old age is not so bad when you consider the alternatives.”