Wednesday, December 9, 2009

Senescence sucks: The final chapter (part 6)

(An elderly Eskimo on an ice floe in the final days of his life.  I would do this now, but I hate the cold.)

Yesterday, I had my follow-up visit with the doc who did the upper GI endoscopy procedure a few weeks ago.  With his scope he looked around in there and took some biopsies.  Turns out I have eosinophilic esophagitis, a disease only discovered in 1978 at the Mayo Clinic.  Not as bad as it sounds.  It is an accumulation of white blood cells in the esophagus, where they should not be, caused by allergens of some type.  It results in food sticking in that pipe for a few minutes on occasion, which is not pleasant.  Treatment is to shoot a steroid inhalant into the mouth twice a day, and then swallow it.  Do this for six months and then see the doc again.

Then, this afternoon, I finally had the follow-up visit to get the results of the sleep experiment I did a month ago.  Remember those 1,000 pages of data?  As expected, I suffer from sleep apnea.  Treatment is to wear this mask that injects air into your mouth while you sleep, a thingie called a CPAP, which reduces the apnea.  We'll find out soon if it makes me feel young again.

So let's summarize.  I have arthritis between two vertebrae in my lower back, I suffer from peripheral neuropathy (which I have not discussed), I have eosinophilic eosphagitis and a hiatal hernia, I exhibit sleep apnea, and I have high cholesterol.  All of this simply proves my point that as you get older, all sorts of systems and parts of your body deteriorate (= senescence).  (J.F. Fries' classic study in The New England Journal of Medicine in 1980 lays all of this out beautifully.  Over the past century, average longevity has increased dramatically, primarily due to reduction of juvenile mortality due to infectious disease.  But maximum longevity has not increased and is not likely to do so, even if we eliminated all diseases.  Maximum longevity is about 85, with only 1 in 10,000 persons making it to 100.  Organ dysfunction simply takes over with advancing age, regardless of any disease process.  The goal, therefore, would seem to be as vigorous as possible until the predicted, and inevitable, "terminal drop".)  My list of medical afflictions is probably pretty standard and, fortunately, doesn't include anything really serious.  For example, when I was diagnosed with neuropathy, my neurologist said to me, "Tom, this is not what is going to kill you".  Oh great!  I love surprises.  Cancer, heart attack, Mack truck, step bare-footed on a rusty garden rake, or stray bullet from a deer hunter?  The possibilities are endless.

It is said that the Eskimos put their elderly on an ice floe when they are near death and send it out into the frigid waters.  This could be a rural, snowy myth--not sure.  But I hate the cold.  In the U.S., we spend tens or hundreds of thousands of dollars in the last 1-3 months of life, and then die anyway.  So I have been pondering what would work for me.  When it is obvious that I am on death's door, here is what Management can do to hasten the end inexpensively:

1.  put me in front of a tv and make me watch NFL football for 24 hours straight while eating Lay's plain potato chips; to cut the time in half, turn on Fox News

2.  wheel me into a room full of cell phones, which are all ringing, bonging, and vibrating; to speed up the process, make sure that some of the ringtones include the William Tell Overture or rapping by Eminem

3.  have a dozen students who I haven't heard from in 10 years contact me to write them a letter of recommendation for law school

4.  take me to Cornell, and have me sit-in on faculty meetings in five different departments in the Ag College in one day when they are discussing budget issues

All of those suggestions will bring the end more quickly and save someone a lot of money.  But for the finale to be more peaceful, and more pleasant, please do the following for me.  Place one of my blue canvas folding chairs in my forest under a large red maple, and then leave me alone with a bottle of scotch and a lap full of cigars, and a dog.  Latin music playing in the background would be a nice touch, but that depends on the cost.  Don't be too extravagant.  The music doesn't have to be live.  Dominican cigars, not Cuban.  A cocker spaniel, not a French poodle.  And 12-year old scotch, not 18.  Then I can drift off wondering why I had been such a gall-darned cheapskate all my life.