Aging Optimistically: An Engaging Dialogue with Dr. William Choctaw

Welcome to the Healthy, wealthy and Wise podcast with Dr William T Choctaw, mdjd, where the doctor helps you unlock your full potential by equipping you with tools and knowledge in the areas of health, wealth and wisdom anchored in his experience as a business executive, a physician surveyor for the Joint Commission, a former mayor and over 50 years of experience as a general surgeon. You've got questions, he's got answers, so let's get started. Here's Dr William T Choctaw, mdjd.

Good morning, I'm Dr William T Choctaw. Welcome to our Healthy, wealthy and Wise podcast. As always, we're delighted to have you with us, and each month, we strive to provide you, our listeners, with mental, physical and spiritual strength by giving you actionable advice, tips, guidance and information to help you achieve your own personal, professional and spiritual goals. We consider the health of your mind, body and spirit paramount, as a single unit that provides accumulative strength greater than the individual parts to strengthen the whole person. This part of our leadership, this is part of our leadership masterclass series, and it is based on my fifth years of practice as a physician, as a general surgeon, and my 75 years of experience in life, and so please come with us and enjoy it. Today we're going to talk about a very fascinating topic honest aging in the second half of life. What you need to know? Who is this important? Well, think about it. If you are, I'm going to say, 60 and older, you're beginning a probably accelerated or noticeable aging process, and maybe you're less than 60, but maybe your parents are over 60, your grandparents, your aunts and uncles, individuals you work with in your own, your job or socialized with. Aging is all around us, and I believe it's important that we understand what it is and be able to help those individuals who are going through it at their own individual stage. As always, I'd like to start off with my beliefs. Now, the purpose of my beliefs is really to give you the why of every podcast. This is our why W-H-Y of every podcast. I believe that life is about being of service to others, so we do these podcasts because we want to help somebody else. We want to help others. I believe knowledge is power. If you are sick and tired of being sick and tired and you want to change things, increase your knowledge or your skill set in some area. And thirdly, I believe leaders can change the world. Once you become more knowledgeable, once you become focused on helping others, that's when our world begins to change. As always, we like to put up an outline, and the purpose of the outline is to let you know what we're going to talk about and, as importantly, when we're just about done so. We're going to talk about aging and we want to define aging and go from baby bonus all the way back to Gen Z. We're going to look at the eight different types of aging, normal types of aging. We're going to review adjustments one can make to improve that aging process that we're all going through. We're just going through the different stages and as a part of that, I always like to give you a reference that you can do additional research and additional reading on a particular topic, and we'll give you specific information about the extraordinary work one of the positions at the Mount Sinai School of Medicine. This podcast also is a part of what I call master class medicine. Master class medicine. There are two parts to this. One is the podcast that we're doing now, and also we do a separate monthly live podcast, live lecture on various health related issues, and this is a part of that process. As always, I'd like to mention that the only requirement, other than you participating and being involved, is that we want you to use your smartphone. I figured the problem. At least 90% of you have one or certainly have access to one, and the purpose of that is that we can sort of smartphones to be academic hand computers. So it's really a computer that you carry around with you and that's a telephone, but it has so many other different properties. It doesn't matter which brand you have, they're pretty much all the same, but we want you to be able to use this product to look up things, to expand your knowledge and expand your skill set, as it were. So let's look at the definition of aging. What exactly is aging? And when we talk about people getting older and not, what are we really talking about? Well, this is both an opportunity and a challenge, because it really depends on where you are in your process of growing older in life. But, for our purposes of the day, when I talk about aging or older, I'm talking about 60 years of age and older. Now, I know I know there are a lot of you, very, very young, 60 years out there are saying I am not old. Do not put me in that category. I do understand that and please understand, this is only for the point of reference. So I had to pick a number, and so the number that I'm looking at is 60 years of age and older, and indeed some of the symptoms that we're going to talk about today are most noticeable and individuals who are 75 to 85 years of age and older, but in general, for our purposes of the day, we're talking about 60 years of age and older. Some extraordinary work has been done, as I mentioned earlier, by a physician in Mount Sinai, and this is Dr Rosanne Leipzig. She's an MD, phd, and she is Vice Chair of the Department of Geriatrics at the Mount Sinai School of Medicine in New York. Now, many times, one of the things I always like to say is we want you to think alike, doctors, with these podcasts and as physicians are in life. Most of us are very, very familiar with the basic subspecialties, such as surgery and internal medicine and cardiology and pulmonology, primary care, OBGYN, pediatrics, but, quite honestly, most of us probably are not as familiar with geriatrics. Yes, geriatrics is a specialty, and it is a specialty that is specifically designed to deal with the mental, physical and health problems of older patients. Geriatrics Now, how is that important? That's important is that, as many social scientists know, the population now, or the largest single population of individuals over 60 or 65, are called baby boomers. These are individuals who were born in the late 40s and early 50s, and so we have more elderly patients, potentially, than ever in the history of our country, and so it's important, then, for us to learn and be able to treat these patients appropriately. And again, when I say older or elderly, forgive me but I'm talking about 60 years of age and older. So geriatrics is a very, very important topic and it's a very, very important specialty and, like with all other areas of healthcare, our knowledge and our ability and our expertise grows over time. The surgery that one is able to do today, say, general surgeon I'm a general surgeon with the robotics and did not exist 30 years ago. So, like in other areas, be it pediatrics, be it geriatrics, we continue to grow and we continue to get better as clinicians in how we care for these patients. And indeed, much of what we're going to talk about today is in the area of geriatrics. And Dr Leipzig, I might add, has written a book called Honest Aging. So just Google that or put that in your search engine or however you look up stuff and you can get additional information about aging and what's involved with that. But some of the information that we're going to talk about today comes from that and other sources. So if we look at what we call Honest Asian this is what Dr Leipzig calls it it's sort of looking at aging honestly and thoroughly as compared to more superficially. And the first part of Honest Aging is to be able to understand and overcome negatives about growing older negatives about growing older and what's a big negative about growing older. One is that we all tend to oversimplify All old people are this Old people can't use computers, old people can't do this and can't do that. Now, there may be some truth to some of that, but it is variable, is my point, and sometimes a 65-year-old can use a computer as well as a 15-year-old. A lot of it depends on exposure, it depends on experience, it depends on access, et cetera, et cetera, et cetera. But in general, we just want to avoid oversimplification overall, in general, for anything but specifically for the elderly. So when you say, well, all old people can't do this, all elderly can't do this, stop yourself and analyze exactly what you're saying. Another part of Honest Aging is to help others to adapt to the new normal of aging. I always like to say the only constant in life is change, and change occurs every single day. It does not matter whether you like it or not. Change will occur, whether it was changed from the pandemic, or it was changed from artificial intelligence, or it was changed from whatever. Change occurs every single day. If you have children and over the years you've watched them change as they've grown up. So it's one of those things that we need to become comfortable with and we need to be able to adapt to so that we can grow along with change. But there is a new normal with aging and part of that new normal is understanding what happens to the body, mind and spirit as we get older and how we can mitigate problems and make sure that we age healthy. And when I'm talking about aging, I'm talking about the second half of life, we'd like to say, and the third part of Honest Aging is how to have an engaged, enjoyable and meaningful life. Well, let's talk about some things about aging that we need to recognize. Agent alters people over time and that makes sense. Right, as we get older, we change. If you doubt that, you look in the mirror and remember when you looked in the mirror 10 years ago or 20 years ago or 30 years ago. Right or again, we can look at our children and our grandchildren over the years and we can see those changes. Aging also is a long period shaped by individuals, economic, social circumstances, behaviors and neighborhoods. We are products of our past experiences, both physical and psychological. What does that mean? If you grew up a certain way or in a certain neighborhood, whatever your haves and head knots were, those things were part of your personality and your belief systems, et cetera, et cetera. Most, hopefully, will positive, or some might be negative. So an important part of aging is to make sure that our beliefs are positive beliefs that help us to stay healthy. But we're all products of our environment. We're all products of our past experiences and that's why we're different. That's why all 60 years are not created equal, all 70 years are not created equal. All 80 years are not created equal. So we do not engage we do not want to engage in needless oversimplification, but treat each individual uniquely as he or she is. And thirdly, our older psychological issues late in life don't follow a well-charted, predetermined path. In spite of all of our knowledge in medicine, we still don't understand a lot that's involved with aging, and individuals who tell you they have all the answers are not being honest with you, ignore them. So my process, my point, is that this is a continuous process and we continue to learn and we continue to grow. So think about that as you deal with older individuals around you. If you're not in that group, I suspect that you are surrounded by individuals who are, and you may very well be able to be more supportive, more therapeutic, more engaging more helpful to these individuals as they go down this path that you have not yet approached. So there are some predictable changes that occur with aging and, again, some of the things that affect obviously aging and what happens to us, say, at 20 as compared to at 60, can be medical conditions, if we've had any injuries, if we've had any diseases, if we have any major medical issues, if we're born with certain medical issues. These things all affect us differently when we're 20 years compared to when we're 40 years old, as compared to when we're 60 or 70 years old, and many times things don't occur in a very predictable sequence. Also, you may be in a car accident at 50, which may affect how you then are able to grow and develop and operate within a certain environment as compared to what happened before. So my point very simply is there are changes that occur. Those changes implement or affect how we change subsequently. The previous changes affect the later changes and actions of how we age. One of the areas that everyone deals with or thinks about, certainly when you get to 60 years of age and older, is forgetfulness or memory loss, and frequently the question comes up is oh, my goodness, I lost my keys again. And is this dementia? What does this mean? Is this a major problem? Well, let's take a look at that. So what is memory loss? Let's start with the basic and the most fundamental and the most simple Normal forgetfulness. Normal forgetfulness. We all forget. And I'll just say adults, we all forget. Yes, as we get older, that forgetfulness may very well increase. The 40 year old may not have as much forgetfulness as the 60 year old, and likewise, the 60 year old may not have as much forgetfulness as the 75 or the 80 year old. But my point is hence the term forgetfulness is normal. It is not dementia, it is not Alzheimer's. So how do you know the difference? Well, losing things often is not a problem. Forgetting to go to important events or appointments again is normal forgetfulness. Having trouble coming up with desired words with other people the same age is normal forgetfulness. It is not a disease, it is not an illness, it is not dementia. So what is dementia? D-e-m-e-n-t-i-a dementia? Dementia is a group of symptoms that affect memory, thinking and sociabilities to the extent that they interfere with our daily life. Right, a dementia which is in the brain. The brain is the area of the body that is responsible for memory and things associated with memory, but it is a but. Dementia is a group of symptoms within the brain that affect memory, thinking and sociability. Memory, again, is the ability to recall right. Thinking is what we call cognition. I have to drive to the store, so I need to think in terms of which way do I go to drive to the store? That's what thinking is in cognition. And then social abilities, how we interact with others. It is not uncommon sometimes, as individuals begin to age, is that personality may change. They may be more abrupt, more less able to interact with others in a social and a relaxed manner. This may be a sign of dementia. It's not uncommon. So what are some ways to look at this from a different perspective? What are some ways that older or aging individuals are different from younger individuals? Okay, so, let's look at eight particular different areas. First, older people present with different symptoms than young people when they become ill. This is very important. Certainly this was highlighted by the whole COVID situation over the last few years, whereas the mortality rate or the hospitalization rate was much greater when COVID affects someone older as compared to someone who's younger, and that makes sense Theoretically, the younger person is healthier, the body is more effective in fighting injuries I mean fighting disease but as you get older, those processes begin to slow and begin to be more effective, to be less effective. So what I understand is that as we get older and we get ill, those symptoms which makes sense affect us more than individuals who are younger. And for that reason is then, if you are in share a home or you around elderly individuals, a lot, or older people a lot in your family or friends or associates, be aware of illness in them. And all codes are not created equal, all fluids are not created equal and, understandably, individuals who are older, those things would affect them more seriously. Older people tend to react. Number two react differently to medication than younger people. Very, very important. If you are caregiver with members of your family or just you just know individuals and you're in situations where you can go with them to the doctor's office or whatever, be very involved with their medication and how they take the medication. Remember, many times, as individuals get older, they forget to take their medication, and I'm going to suggest that probably most of them are made of five or more medicines and they get them mixed up and, understandably, that itself can be a medical problem. So this is one of the one of the areas that you can be very supported and very helpful of individuals who are of a certain age, particularly if they take medication. Number three older people have reduced energy reserves. A lot of times they just don't feel like doing stuff, you know, and that that's a part of that aging process. Now, certainly you can encourage them, if they're willing to, to participate, but just understand that this is a part of that process of aging and it is normal. Number four cognition slows. This is thinking or processing information, and one of the ways this shows up is with directions. You want them to do X or they want to do X, but then they have to think about it. Okay, I turn left and then I turn right and then I turn left again, even though they may have gone to this place many times, but it may very well be that they may have to think about it more now than they used to think about it. Number five the musculoskeletal system, understandably, and those of us who are older is less flexible. What does that mean? It means that we are able to protect ourselves less. If we fall, we may not be as strong, and so injuries occur more frequently. Hip fractions are extremely common in the very elderly. Number six eyesight and hearing and hearing changes. Now, eyesight is pretty obvious you wear glasses, you don't wear glasses. You wear contacts, you don't wear contacts. But one of the areas that may be more subtle in aging is hearing. What happens is that the inner ear cells they're actually called hair cells within the inner ear have a very, very nuanced and important relationship with the brain in terms of vibration. It affects the balance, and so many times individuals, as they age, their hearing begins to diminish, and again, some faster than others, right, so it's one of the areas that you want to make sure that they have checked out. If they need a hearing aid, then they should get a hearing aid. This is also important in terms of their communication skills or their socialization skills, and so that's very important and it's a very, very common issue in individuals who are aging. And number eight, in family. Sleep becomes more fragmented, and we've talked before on these podcasts the importance of sleep in terms of mental, physical and spiritual health. We want to get good sleep because when we're sleeping it's where our subconscious takes over and sort of cleans up a lot of the things that have happened mentally when we were awake, when we were conscious. So it's an important process to keep us at our strongest and most effective status. So how do you adapt to some of this? So what do you do? We talked about some of the things that make the aging more challenged or having more challenges than those who are not as old. So what are some of the adaptive things that we can do or help them do for these things? Number one who are individuals who are older? Again, I'm talking about basically 60 years or older, but it could be younger, it could be someone 50-year-old. Make sure, or, if you're one of those people, make sure that you know which medications you're taking let's say you're on chronic medications for some condition and that you know the appropriate dosage and that you know when those medications should be stopped. Much injury and difficulty health-wise occurs with, ironically, with medications that we physicians give patients to make them better, but either they are taken improperly or they're not taken at all, or patients continue to take them to medications because they've changed doctors but the new doctor doesn't know about the medication, et cetera, et cetera, et cetera. Yes, health care is doing better now in terms of tracking medications, but you may not always be that fortunate to be in a system where they ask you about your medications, et cetera, et cetera. So it's important for you to be in charge of that and make sure you ask them. Take your medications with you if you need to, or there may be a list. I said, dr Dost, I still need to take medication A, b, c, d and go over the dosage and know especially when those medications should be stopped. Number two be physically active. Of course, and that's always a plus Walking is good, and so don't hesitate to walk. Don't necessarily feel that you need to join a general membership. Just walk and walk regularly and walk at your own pace. Make sure, number three, you eat enough protein. Usually that means meat, because one of the things that happens sometimes as we age is our appetite may change and we tend to eat less and less and less. It's just part of the process. Sometimes, and again, it varies with different people and it varies with different individuals who may be the same age. Number three, number four make sure you drink enough liquids. Now, we always talk about this, but a point I want to make is drink water or liquids even when you're not thirsty. Let me say that again Drink water or liquids even when you're not thirsty, because sometimes we say, well, I'm not thirsty, so I don't really need to drink. No, just get in the habit of doing it. Just get in the habit of doing it. The body needs that hydration to be able to function properly, and so it's just something that we can consciously do and we should do on a regular basis. I do exercises, but particularly exercises that have to do with balance and resistive types of exercise Pushing against things, push-ups, sit-ups, those types of things. Do them at your own pace, but that helps a lot of times. Have your eyes checked, and that's a given. If you need to get a hearing aid, get a hearing aid. And again, so you may want to have your hearing checked, particularly with people around you saying you know, or suggesting that maybe you're not hearing them or you're not responding appropriately. And importantly and this is the last adaptation tip for the aging is do not exercise, drink alcohol or eat heavy meals within about two to three hours of bedtime. Why? Because many times that may make it more difficult for you to have a good sleep and, as we've mentioned before, it's very important for you to have a good sleep. We are all living longer. That's a good thing, but along with that longevity, we have to be aware of how to better take care of ourselves and better take care of those around us. Information from the CDC has shown that the life expectancy in the United States is approximately 79 years. That's longer than it used to be a number of years ago. But, what's interesting, in some countries, particularly in the US, our life expectancy is less than other developed, comparable developed countries. Our suggestion is that we may be more stressed and may not take as many vacations or relax as much, and some studies are suggesting that. So my point, very simple, is to continue to live long and thrive, make sure that we manage our stress levels and don't sweat the small stuff. It is not uncommon that when we get to that 60-year-old level and I'm telling you, I can remember when I first became 60 years of age, I used to say that 60 was the new 40. So some of you may have said that I don't know, but some of the questions that we begin to ask ourselves when we get to be about 60 years of age is what do I do about this pot belly? Why do I have this big stomach? What can I do to get rid of that? How can I improve my sleep? Another one is I'm having trouble remembering names. Is this dementia? And, as we mentioned earlier, no. Another one is do I really need that colonoscopy or mammogram? The answer is yes. Another question at 60 years of age individuals' answers what should I do to get back in shape? Diet and exercise? And finally, do I really need to stop driving? And that answer is if you are comfortable driving and you pass your DMV test and you're legally allowed to drive them, ideally it's okay to drive. If, on the other hand, you feel that there are problems with your driving, it is probably a good idea to seek medical advice in terms of why it's a problem for you and then go from there. Happy aging is a blessing. Whatever, and I can tell you, many years I've had patients tell me, particularly 20, 30, 40 years ago. They'd say something like oh, doctor, don't get old. Getting old is terrible. You have to run around all these doctor appointments, you have to take all these medications and everything hurts and blah, blah, blah, blah, blah, blah. And I don't doubt that. I don't doubt that. But my point is it is a blessing to age, or to be able to age, and so what we want to do here at Healthy, wealth and Lies with our podcast is to help you do that and be happy at the same time. To help you enjoy your blessing and be happy at the same time. Remember that knowledge is power. So take up a habit read more, listen to more podcasts, do something that allows yourself to grow and that you take charge of. It is very important. I believe, particularly in health of the body, mind and spirit, that we frequently visit our belief systems, because a lot of times, many of us have flawed belief systems that end up making us more unhealthy than they should. And remember, as we've said on previous podcasts, that we believe affects how we think. How we think affects how we feel, and how we feel affects how we end. So that's something that we want to do regularly as we age is go back to those belief systems, particularly when we believe something that's negative or makes us feel bad. I go back to that because many times those belief systems are flawed and can certainly be changed. And again, as I said before, knowledge is power, and so, the more you learn, many times that itself is is empowering. Start a podcast or do something similar to that, but, whatever you do, keep moving mentally and physically. I do believe that, as is and keeping with the philosophy of our podcast, that we all become caregivers for those who are aging, that we're aging ourselves, but there's some who are aging faster than we are, and we can see it, and so what I mean by being a caregiver, among other things, is be respectful, be kind, be patient to those who are older than us. Do not oversimplify or treat them as if they are not is not important, and there have been some suggestions that in other countries, particularly in parts of Asia and other places, that the elderly may tend to be more respected and more revered than maybe in the United States. I'm not sure whether that's true or not, but again, that doesn't change the fact that we should all be caregivers for those who are aging, including ourselves, and I believe that that will help to make the world a better place. I think there is something called happy aging, and I think happy aging is something that we can all do. Like everything else, it is something, is a process that we have to intentionally make happen. In summary, aging is very important and honest. Aging is something that we should practice and happy aging is something that we should achieve. Normal forgetfulness is not dementia, it is not a disease. It is something that's normal and it's something that we experience through different periods of life. Aging individuals are different as they get older, meaning 60, 70 and 80 years of age, and so we have to be more circumspect with our health care and the things that physically and mentally happen to them. However, we need to be more patient, we need to be more respectful and we need to be more grateful for those who are older than we are, because they have taught us and, if we are blessed, we will follow in their footsteps. As always, I'd like to end with my basic principles, and my first basic principle is that God is in charge. I am a position of faith, and I believe that God's help in my life has allowed me to be where I am today and to be as happy and as productive and joyful as I am today. Second, I don't have any bad days. I learned that about 30 years ago that days were good or bad when I said they were, so I decided that I would not have any more. I have good days and great days. Number three principle number three don't sweat the small stuff. Most stuff is small. I have learned that whenever something bothered me or I perceived something to be negative, that most of the times I was wrong, but most of the times it didn't matter anyway, so I have learned to let all that go. Number four forgiveness is therapy. Whenever someone does or says something to us that, again, we perceived as being negative, immediately forgive them. It does not matter who's right or wrong, it does not matter what the facts are. Forgive them and you will find that as therapeutic. And number four and finally, everything is a relationship. Relationships are based on three things mutual respect, mutual trust, good communication. If you have those three things, you have a good relationship. If you do not, you have work to do. If you would like to hear more of these podcasts, or some of the podcasts that you may have missed, you're welcome to subscribe to our podcast, you go to wwwbusfraudcom forward slash 21001003. That's wwwbusfraudcom forward slash 21001003. And finally, be the change that you want to see in the world. Thank you and have a wonderful day.

And don't forget to leave a review, subscribe, share and support the podcast. That's at wwwcom. You've been listening to the Healthy, Wealthy and Wise podcast with Dr William T Choctaw, MDJD.