Cell 2 Soul: The Humane Health Care Blog

Henriette Thompson: Nonagenarian Pianist and Marathoner

Harriette Thompson, a classical pianist and cancer survivor who started to run marathons when she was 76 and ran the fastest time in a marathon for a woman over 90, died on Monday, October 16 in Charlotte, N.C. She was 94. NY Times Obituary.

[In the past few years, she ran] while wearing white tights to cover the open wounds on her legs from radiation treatments for cutaneous squamous cell carcinoma. Over the last seven years she had also dealt with a recurrence of oral cancer, which first struck her in 1986. The short and instructive New York Times obituary has many teaching points and is inspirational.

1. This 94-year-old musician and athlete died from a fall at the facility she was living in, not from her cancers.
2. Although she had squamous cell carcinoma of her legs and was being treated with radiotherapy the skin cancers were not proximate causes of her demise. This corroborates the work of E. Linos on “Nonmelanoma Skin Cancer in the Elderly.” In my opinion, we pay far too much attention to skin cancers which are billable to Medicaid and Medicare than to having patients use canes or having 94-year-old people being extremely cautious about stairs.
3.  This remarkable woman was a pianist until her death, she was an athlete. She had great meaning of her life.

For me, as a dermatologist, this reinforces the fact that treatment of non-melanoma skin cancer in the elderly, especially people over age 85, is not likely to improve their quality of life. Before recommending therapy, we may need to step back and not scare our elderly patients into having unnecessary surgery but, as experts, we should have honest discussions with them. Lesions in certain areas are best treated (around the eyes, nose, ears); but lesions on the torso and extremities can often be followed by active surveillance.These short You Tube videos will interest some of you.

 

 

Slomo: A San Diego Legend

"The mass of men lead lives of quiet desperation... A stereotyped but unconscious despair is concealed even under what are called the games and amusements of mankind. There is no play in them, for this comes after work."  H. D. Thoreau

Thoreau sequestered himself at Walden.  The erstwhile neurologist, Dr. John Kitchin, fled a medical practice to in-line skate on the boardwalk.  On any given day, "Kitchin [can be seen] meticulously skating up and down San Diego's promenade. Disillusioned with a life that had become increasingly materialistic, he abruptly abandoned his career and moved to a studio by the beach. The locals call him Slomo, knowing little about his past life, but cheering and high-fiving him as he skates by in slow motion. He has become a Pacific Beach institution."

If you missed the provacative and, for some, inspirational NY Times article, click on SLOMO.

Exercise

 

Why We Exercise

“Physical activity is an elixir of life, but we’re not teaching people that. We’re telling them it’s a pill to take or a punishment for bad numbers on the scale. Sustaining physical activity is a motivational and emotional issue, not a medical one.
Studies have shown that what gets people off their duffs and keeps them moving depends on age, gender, life circumstances and even ethnicity. For those of college age, for example, physical attractiveness typically heads the list of reasons to begin exercising, although what keeps them going seems to be the stress relief that a regular exercise program provides.
The elderly, on the other hand, may get started because of health concerns. But often what keeps them exercising are the friendships, sense of community and camaraderie that may otherwise be missing from their lives — easily seen among the gray-haired women who faithfully attend water exercise classes at my local YMCA.

Read full NY Times article: "Changing Aremica's Anthem on Exercise."

Lester Breslow, Who Linked Healthy Habits to Logevity

Dies at 97  NY Times, April 15, 2012.

This post was inspired by, and is dedicated to, Dileep G. Bal, M.D., Kauai District Health Officer, State of Hawaii and previous Chief of the Cancer Control Branch in the Department of Health Services in the State of California.  Mahalo!

Lester Breslow

The work Dr. Breslow will be most remembered for is the Alameda County California study that [is purported to have] rocked the public health world, because it proved with numbers that behavior indisputably affects longevity. Its seven recommendations are: do not smoke; drink in moderation; sleep seven to eight hours; exercise at least moderately; eat regular meals; maintain a moderate weight; eat breakfast.  Full "Lester Breslow Obituary."

 Strangely, this is very similar to what William Osler espoused in the 19th century: "‘the desire to take medicine is perhaps the greatest feature which distinguishes man from animals... Of one thing I [am certain] that that a little more exercise, a little less food, and a little less tobacco and alcohol, may possibly meet the indications of the case."

Of course, our grandmothers told us the same thing.  Yet, it took men of of science many years to corroborate their proscriptions.

For more information see this article about The Alameda 7.

Just Walk

"Exercise guidelines from the American Heart Association and other groups recommend that, for health purposes, people accumulate 10,000 steps or more a day, the equivalent of about five miles of walking. Few people do, however. Repeated studies of American adults have shown that a majority take fewer than 5,000 steps per day.

The condition becomes a serious concern only when inactivity is lingering, when it becomes the body’s default condition. 'We hypothesize that, over time, inactivity creates the physiological conditions that produce chronic disease,' like Type 2 diabetes and heart disease, regardless of a person’s weight or diet."

Full NY Times Article.

This article was based on a study published in February 2012:

Mikus CR, et. al.  Lowering physical activity impairs glycemic control in healthy volunteers. Med Sci Sports Exerc. 2012 Feb;44(2):225-31.
Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65201, USA.

 

What's the single most Important thing you can do for your health?

Dr. Mike Evans is founder of the Health Design Lab at the Li Ka Shing Knowledge Institute, an Associate Professor of Family Medicine and Public Health at the University of Toronto, and a staff physician at St. Michael's Hospital.  He answers the old question "What is the single best thing we can do for our health" in a completely new way.

See: 23 and 1/2 Hours

Dr. Mike Evans

Click here for more about Dr. Mike Evans.  Thanks to Bob Swanell of Vancouver, British Columbia for alerting us to this video.