Risky Business

    An estimated 25 million Americans suffer from acid reflux. We're a high-stress society and these are stressful times. Equally important, too many of us are not managing our stress or our weight effectively. (And, no, all exercise is not equal in terms of stress management.)

     I feel compelled to write about "hyperacidity"from the standpoint of a patient, not as a medical professional. I began my journey as a formerly anorexic, teenager, by suddenly developing a gastric ulcer. Back in the day, before ulcers became linked to a bacterium, h. pylori, ulcers meant extreme lifestyle changes, trips to a psychiatrist, surgery, or all of the above. My stomach condition changed my life immediately and irrevocably. A university student, I was assigned stress management classes by the campus health clinic, instructed to see a psychiatrist once a week. Liquor, caffeinated beverages and smokes became out of the question. The bland diet I'd been given was ghastly. Nonetheless fear drove me to do what I was told, and the combination worked.

     Fade to adulthood and 30 or 40 years of a very stressful career. My life and career resulted in GERD.  What is worse than GERD, other than complications, such as Barrett's Esophagus or esophageal cancer? In my estimation, it is treatment. I'd urge anyone considering a proton pump inhibitor (PPI,) to have a very long think. Lifestyle changes take longer than semi loads of antacids or months of purple pills. Eventually facing symptoms is not facing the disorder. (Treatment for h. pylori infection is another matter, one I won't attempt to address here, except to say, it does require treatment.) 

     Whether or not you are obese and suffer an inflammatory condition, just know this. Everyone will have nutritional advice, from the sane to, literally, eating as the Neanderthals ate. A very low carbohydrate diet can help to keep down the overgrowth of bacteria and viruses in the digestive tract, but there are risks. By all means people should consult their physicians, before embarking on dietary or exercise regimens. Even Yoga, which I consider a boon for stress addicts (you know who you are) become competitive and stressful with the wrong approach.

Following the Romanian tradition, garlic is used in excess to keep the vampires away. Following the Jewish tradition, a dispenser of schmaltz (liquid chicken fat) is kept on the table to give the vampires heartburn if they get through the garlic defense. -Calvin Trillin
    
  Truckloads of antacid cannot be a good thing, but I promise a PPI can have profound effects on the body. My first reaction to Prilosec was something to the effect of, "I'm bullet proof. I can have a glass of wine with dinner or some morning coffee! Whopeee!" Over time the GERD had ceased to be life-altering, but joint pain and stiffness were no longer restricted to my arthritic knees. I was unable to take in sufficient Magnesium for calcium absorption. Tests at an arthritis clinic revealed osteopenia and a Vitamin D deficiency. The doctor prescribed pain killers. Nobody, at any juncture, said a word about the proton pump inhibitor. Here is a link to a Harvard Medical School (Harvard Health) publication concerning the treatment of GERD with proton pump inhibitors: http://www.health.harvard.edu/newsletters/Harvard_Health_Letter/2011/April/proton-pump-inhibitors. I found the following New York Times article equally interesting, and a bit less conservative in its assessment of the dangers in using these drugs: http://well.blogs.nytimes.com/2012/06/25/combating-acid-reflux-may-bring-host-of-ills/?_php=true&_type=blogs&_r=0
     Driven to understand the causes of my compound misery, here is what I have found regarding the causes of GERD: http://chriskresser.com/the-hidden-causes-of-heartburn-and-gerd. Here's the thing. Any way I look at them PPIs, like pain killers, are short term "fixes" for chronic conditions. There is more at stake, however, than side effects. It is risky business failing to address the causes of heartburn; by doing so, we also fail to address the causes of inflammatory conditions. It is a double whammy. I've tried many so-called symptomatic approaches, from apple cider vinegar to meditation. They have all worked to one extent or another, but, none was a cure.
     Having abandoned PPIs, I am embracing lifestyle changes. One other thing I can say without equivocation: We live in a climate of stress, and the price we pay for our national addiction to telecommunications is enormous. Humans need to take frequent rests from all the noise. I take regular news breaks, some for weeks or months at a time. Try leaving it all (including the SmartPhone) behind. The freedom may prove addictive!

  

The Quality of Life

Pete Seeger

     We speak about the quality of life, but how do we define it, and how can we measure it objectively? We know, for example, money is not the defining factor in the quality of our lives. Physical, intellectual, social and emotional engagement are key in supporting independence among aging adults. We acknowledge, however, people must meet basic needs, shelter, nutrition, clothing, hygiene and health care, ideally, with their own financial resources. It is a diminishing ideal, as the physical, emotional and financial challenges of aging, literally, hit us where we live. Families cannot always take up the slack, so many elders look to government. Population aging influences so many aspects of society, and is an incontrovertible fact of life everywhere. We know the number of people 50 and over has increased tenfold, since the middle of the last Century. This rate of aging is unprecedented in human history, and the rate at which we are aging continues its rapid advance.

• Although countries experience differences in the rate of aging and are at various stages in the process, population aging is a global phenomenon and will continue. The balance between younger and older people will not reverse at some future time.
• This means many countries will come to the table poorly prepared, particularly, those whose populations age less rapidly.

     So, who's keeping track of how nations are doing in meeting the needs of older citizens? In October 2013 the United Nations (U.N. Population Fund) and HelpAge International advocates published their findings in the Global AgeWatch Index. The study sought to look at conditions facing elderly the around the globe in the face of demographic change.  Here is a link to the rankings:

 http://www.helpage.org/global-agewatch/data/global-rankings-table/

Some countries are not included in the rankings, as well as the criteria used to produce them. It is worthwhile having a look, however, because there were some surprises.

We want a world where life is preserved, and the quality of life is enriched for everybody, not only for the privileged. ~Isabel Allende

     How did the United States come out in the rankings? It ranked eighth. One response to the ratings, however, stood out. It had to do with the estimated 23% of older people living in poverty in the United States. I agree with the responder; this should disqualify the U. S. from inclusion in the top ten. It turns out the study merely considered access to education and employment in developing its rankings.

Added to the dirty secret of poverty among ethnic minorities and women in the United States is another. Americans over 50 face age discrimination in the workplace and in seeking employment. Age adds to other discriminatory criteria, but it is more pervasive and less discussed.  The newer dirty secret is the incremental increase in older Americans who are remaining at work, or returning to work. These are people who cannot retire fully or partially, and meet basic needs.

     This country is a powerhouse, and lead the world in human rights. We can do better by our vulnerable citizens. The hopeful thing, it seems to me, is, as America ages, older people represent a greater proportion of votes. As an American I hold myself accountable to be informed and engaged in the process of furthering a just democracy.

An Unflattering Light

     The world lost a great talent, with the passing of Philip Seymour Hoffman, who was a superb director and actor. He raised the level of his craft to art, never backing away from transcendent truths, beautiful or ugly, in the characters he acted. Precise imitation, mimicry, was not Hoffman's only genius. His genius was his refusal to prejudge a character or an audience. In performance, Hoffman simply did not possess a truth filter, so his performances resonated with stage and film audiences alike.
     Hoffman's 2005 portrayal of Truman Capote, the author of "In Cold Blood", revealed more than the brilliance of the writer, or his descent into the desolation of murder and retribution. Hoffman laid bare Capote's vanity and superficiality in a cocktail party landscape. Add more than a touch of the effeminate, and Capote surfaced as an intellectual elitist, as well as an old-fashioned flamer. Layer by layer Hoffman revealed the the intelligent, sensitive, writer we recognized. Truman Capote shared Philip Seymour Hoffman's capacity to grasp the humanity in broken characters; taking us from annoyance, to squeamish discomfort, to hot tears. It may not have been a defining role for Hoffman (no such role existed,) but he was awarded multiple acting awards for "Capote", one, the 2005 Oscar for Best Actor.  
     He was nominated for three other, supporting, roles in film. However his film acting, as magical as it was, never equaled his greatness onstage. He was theater in New York, during his stage career. Three Tony nominations, one for the role of Willy Loman in Miller's Death of a Salesman, barely cover the awards Hoffman won. Wikipedia provides a more complete list: http://en.wikipedia.org/wiki/List_of_awards_and_nominations_received_by_Philip_Seymour_Hoffman

The only true currency in this bankrupt world is what you share with someone else when you’re uncool. -Philip Seymour Hoffman

     In person, Hoffman was the coolest and most uncool individual anyone could conjure. Unlike many ambitious celebrities, he maintained a private persona. By all accounts he was a great heart. The man, himself, was as candid about his flaws in interviews as he was about the demands of his art. The tragedy was not his second descent into addiction, although it is terrible to contemplate his struggle to stay free of alcohol and drugs. The tragedy is to characterize him as a victim of disease; it would be unjust to portray the man as other than a creative genius with a prolific career. Here is a link to a list of ten films, featuring performances by Philip Seymour Hoffman. You know what to do:
http://www.smh.com.au/entertainment/movies/philip-seymour-hoffmans-top-10-film-roles-20140203-31wlu.html
     Someday we will all die. With any luck nobody will point to our most glaring flaws, let alone, to whatever proved fatal. Personally I'd prefer to skip the obit, funeral, or memorial service. Neither religious, nor particularly sentimental, I know my friends and family will avoid the so-called celebration of life. Somebody will just, raise a glass, L'chai-im!

Upping Your Game

What is your take on advances in telecommunications? Are you an absolutist, someone who feels no interest or need to use a computer or smart phone? Are you a savvy Linux user, capable of operating across all platforms, a wide range of software applications? I have acquaintances in both categories, some of whom are my elders. Increasingly, I believe the people who are least telecommunications savvy are at a tremendous disadvantage in the day-to-day business of life. 
     Ironically, for so many, a computer is not so much a vital tool as it is a sophisticated toy or occasional helper. For others a computer and the Internet are access to resources, education, employment and community. It is the same with social media; Facebook, for example, can be a time drain, or can be used to connect, inform, and contribute to the greater good. I prefer to see computers and the Internet as the gateways to a universe of possibility.
     The good news is that books and courses in computer literacy, the use of the Internet and software applications abound. Many are free of charge or cost little. The better news for elders, however, is free online education. No-one is too old, accomplished or successful for continuing education. Whether you would like a refresher course or two, a certificate program, or a degree, this is a good time to start something new.
      I include here a few links to interesting online programs, beginning with MIT's OpenCourseWare and the BBC Language Courses. I particularly like these two sites, because they provide opportunities to support online education and because they are communities. 
http://ocw.mit.edu/index.htm
http://ocw.mit.edu/index.htm

Education is not the filling of a pail, but the lighting of a fire. -William Butler Yeats

     A number of prestigious institutions have open education programs, but the true revolution is in what are described as "elite" MBA programs, accessible in the form of MOOCs (Massive Open Online Courses.) Here is a link to a list of these courses of study and providers who offer them. Although there is already controversy regarding the trend, whether and how MOOCs should (or should not) be limited, the trend is here now.
http://www.mooc-list.com  
     Personally, I have begun a degree program on Alison, which, I believe, will serve a number of purposes. It is a review of materials I have learned through experience and self-teaching, rather than in my formal education. I hope to utilize what I learn, to serve disadvantaged women, who would become entrepreneurs or enter management careers. I also hope to restart a small business of my own in legal document processing. If all I manage to do is use study against the doldrums of a long, cold Winter, I'll have achieved a critical goal. Have a look at the courses and programs available on Alison, or read about Alison at http://alison.com
     What will you do in 2014 to up your game? Will you join a book club, learn a foreign language, attend a lecture series, travel, help plan a co-community? These are the stuff of dreams, and everyone of every age should dream!