Lectures on geriatric disease prevention and health care

You don’t have to be superstitious about sky-high-priced health products or look for folk prescriptions. You just need to make layered interventions based on your own constitution, and prioritize small daily habits before taking medicines and supplements. 80% of common geriatric diseases (hypertension, diabetes, osteoporosis, sequelae of cerebral infarction, etc.) can be delayed for 10-15 years. Even those who have already suffered from it can avoid suffering less and not affect normal life.

Last week I was attending a consultation at our community health service center and met 68-year-old Aunt Zhang, who has been suffering from high blood pressure for three years. She heard a short video saying that eating celery soaked in vinegar can stop antihypertensive medicine. She stopped secretly for half a year. Recently, she felt dizzy and couldn't stand. She came to check and found that there were 30% plaque in the carotid artery. After asking, I found out that she had also saved half a box of health products that claimed to be able to "dissolve thrombosis." She spent almost 20,000 yuan, and she couldn't use any of them.

When it comes to calcium supplementation, many uncles and aunties ask me if I must take calcium tablets every day? In fact, there is no unified statement in the industry: Western orthopedics generally recommends that women over 55 years old and men over 60 years old take regular calcium supplements plus vitamin D to prevent osteoporosis. ； However, many of our old colleagues in the Department of Traditional Chinese Medicine and Internal Medicine believe that if you can drink enough 300ml of pure milk every day and bask in the sun for 20 minutes on a sunny day, the absorption rate of calcium from food supplements will be higher. However, random calcium supplementation may increase the risk of kidney stones. My general advice to patients is to check their bone density first. If the T-score is lower than -2.5, then take supplements if necessary. If the index is normal, just drink milk and bask in the sun. There is no need to spend that wasted money.

Uncle Li, a 72-year-old patient I have cared for for almost 6 years, had a mild cerebral infarction. After he was discharged from the hospital, he did not buy any health care products. He just insisted on three small habits: walk briskly for 20 minutes after dinner every day, chew each mouthful of rice 20 times, and add half less cooking salt than before. Now for 5 years, his blood lipids and blood pressure are normal after reexamination. Even the constipation he often suffered before is gone. He is in much better condition than when he spent 20,000 yuan a year on health care products.

Oh, by the way, there is another thing I always mention in every lecture. Don’t just focus on what you eat and how much you move. Emotions have a much greater impact on geriatric diseases than many people think. Two months ago, a 70-year-old Aunt Wang, whose blood pressure was usually under very stable control, got so angry that she had a cerebral infarction after having a fight with her daughter-in-law. Fortunately, she was sent to the hospital in time without any sequelae. Many uncles and aunts usually live frugally, but when they see someone selling health care products and shouts "uncle and aunty", they feel soft and pay for them. The products are useless and feel distressed. Their moods are up and down, which makes them more likely to have problems.

There are also many people who ask me, do I need to infuse "blood vessel opening" fluid when the seasons change? This is currently quite controversial: Neurology departments in large hospitals generally do not recommend routine transfusion of blood-activating and blood-stasis-removing medicines for the elderly without underlying diseases, as they feel that these drugs are inappropriate and may increase the risk of bleeding. ； However, many old doctors who have been practicing grassroots medicine for 20 to 30 years will feel that for the elderly with a history of cerebral infarction and coronary heart disease, a week of infusion during the change of seasons can indeed reduce the probability of illness. My own experience is that there is no need for blind transfusions for those who do not have underlying diseases. For those who have a medical history, please discuss with your attending doctor and do not secretly go to a small clinic for transfusions on your own.

Last time a 76-year-old man asked me if walking 10,000 steps a day is good for his health? I told him, walk as long as it feels comfortable and your knees don’t hurt. If your knees are so sore after walking that you can’t lift them up, you can walk 5,000 steps. Don’t compete with your old friends for step count. I’ve seen several people wear out their menisci and need surgery in order to compete for the top spot in the step count list. The gain outweighs the gain.

What I’m talking about today is all based on my honest experience gained from working in the community for almost 10 years and dealing with thousands of elderly patients. There are no fancy words. You don’t need to remember too much. Do one thing first when you go home today: add half a spoonful less salt when cooking. It will be more effective than any health supplement you buy. If there's anything you're not sure about, just stick around after the show is over and I'll show it to everyone one by one, okay?