Philip J. Goscienski, M.D.
* You don't see the damage until something collapses.
Back in the Stone Age, whatever caused death usually did so quickly. An infected wound usually finished the job that an enemy or some animal started. Most of us take for granted the miracles of antibiotics and modern surgery but it was only a handful of generations ago that life ended about the same way that it did in the Stone Age. Not only have we replaced acute infectious diseases with chronic non-infectious ones, modern maladies creep up on us stealthily and end a life as suddenly and surprisingly as a well-aimed spear.
High blood pressure is the single most important factor in causing coronary artery disease and stroke but half of its victims are unaware that they have it. About half of fatal heart attacks occur in persons who had no idea that they were susceptible to a sudden, life-ending event. Strokes occur without warning in most victims. The frightening epidemic of type 2 diabetes that is now reaching down to pre-teens and that threatens the fiscal stability of our health care system has a grim feature: 50 percent of diabetics are ignorant of their diagnosis. A hip fracture from a minor fall or back pain from a collapsed vertebra is nearly always the first clue to osteoporosis because weak bones don't hurt.
Americans do, indeed have a termite lifestyle. With almost no exceptions the chronic but silent diseases I have described result from poor lifestyle choices. Modern Stone Agers, from Australia to Kenya to Paraguay enter the sixth or seventh decade of life without any of them. The blood vessels of these hunter-gatherers are free of obstruction into old age; nearly all Americans accumulate fatty deposits in their arteries before they leave adolescence.
Each of the major chronic diseases is preventable with measures that are so simple that the most primitive societies on earth have been able to survive and to thrive for thousands of generations. Hunter-gatherers suffer from a lack of labor saving devices but they benefit from strong hearts and bones. A high level of physical activity lowers blood pressure, keeps blood vessels healthy and makes bones thick and strong.
The typical American heart attack or stroke victim has lived for years with upwardly creeping cholesterol levels and blood pressure that rises with every extra pound of fat. Like the destruction that a colony of termites inflicts on a house, the narrowing of coronary or brain arteries goes unnoticed because the fatigue, the loss of energy and the poor mental function increase slowly. We blame it on aging and adjust our lives accordingly.
We can do more than we are doing to detect these silent diseases. Our system denies $20 for a diabetes screen but spends tens of thousands for months or years of kidney dialysis. Until very recently, Medicare would not pay for routine physical examinations that might identify early hypertension or heart disease but would cover the cost of a coronary bypass. Everyone should have a blood pressure measurement once a year, especially those with a family history of heart disease or stroke.
The termites are winning.
Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at email@example.com.