Lecture on prevention and treatment of geriatric diseases

More than 70% of common geriatric diseases can be delayed or even avoided through daily intervention. Even if a diagnosis is made, there is no need to be overly anxious. Personalized diagnosis and treatment + life adjustment are far more useful than "standard answer" health care and medication.

I have been in clinical geriatrics for 12 years. Today, I won’t talk about too mysterious theories. I will talk to you about the real things I encounter in outpatient clinics and community free clinics. A while ago, Aunt Zhang from our community came to see me for medical treatment. She was diagnosed with high blood pressure last year. She believed in the "magic prescription for lowering blood pressure" on the Internet and drank three large glasses of celery juice every day. She even stopped the antihypertensive medicine prescribed by the doctor without permission. As a result, she felt dizzy and fell while shopping for groceries last month, and her blood pressure soared to 180mmHg. Speaking of which, I would like to mention that there are indeed different trends in the academic circles regarding the blood pressure control goals for elderly hypertension: mainstream Western medicine guidelines recommend that elderly people over 65 years old without diabetes, kidney disease and other comorbidities should meet the standard if their blood pressure drops to 140/90mmHg. There is no need to insist on the 120/80 standard for young people. ； However, many clinical colleagues of traditional Chinese medicine hold a different view. They believe that if the elderly maintain blood pressure around 150 all year round and do not experience dizziness, headaches and other discomforts, there is no need to forcibly lower blood pressure. Otherwise, insufficient blood supply to the brain will easily occur, which will increase the risk of fainting and fatigue. Both statements are supported by clinical data. There is no absolute right or wrong. The core thing is to match your own physical feelings.

Speaking of which, I would like to answer the most frequently asked question "Do I need fluid to open blood vessels every year?" There is indeed no unified conclusion on this matter. From the perspective of Western medicine and evidence-based medicine, regular infusion of blood-activating and blood-stasis-removing injections for healthy elderly people with no history of myocardial infarction or cerebral infarction has no preventive effect at all. Instead, it may cause allergies and induce phlebitis. We generally do not recommend this. However, some Chinese medicine studies have shown that if you have clear manifestations of blood stasis, such as frequent numbness in your hands and feet, dark purple tongue with ecchymosis, and are particularly afraid of the cold in winter, then using blood-activating traditional Chinese medicine preparations or oral prescriptions for 1-2 weeks every spring and autumn can indeed reduce the incidence of cardiovascular and cerebrovascular events. So don’t just follow the trend and queue up after people say it’s better to lose, and don’t reject it completely when people say it’s useless. It’s safest to find a doctor who is familiar with your physical condition to evaluate it.

Last month, an old patient, Uncle Li, came to me for a review. He has been diabetic for 8 years. I had always heard people say that people with diabetes should strictly control their staple food. He would only eat less than half a bowl of rice every day. He would feel dizzy due to hunger and often suffer from hypoglycemia. Later, I adjusted his plan so that he did not have to stick to a fixed amount of staple food every day: If If I take my grandson to the park for two hours that day, I will eat half a piece of corn or half a sweet potato. If I will watch TV at home and not go out that day, I will eat two less bites. In just over half a year, his glycosylated hemoglobin has dropped from 7.8 to 6.9, and his overall energy level has improved a lot. You see, there is no universal "diabetes recipe", you have to follow your own pace of life.

Last week at a community free clinic, an aunt asked me and said that the live broadcast said that taking lutein can cure cataracts, and she had already bought more than 3,000 yuan. I told her that lutein does have a protective effect on the macula and can delay the progression of age-related macular degeneration. But for cataracts that have already formed, to put it bluntly, the lens has become cloudy and cannot be eliminated by any medicine. The only effective way is to wait until maturity for surgery, so as not to waste money. There are also many elderly people who panic when they are diagnosed with some geriatric disease and say, "It's over now, and I can't live without medicine for the rest of my life." In fact, this is not the case. For example, in the early stage of type 2 diabetes, many newly diagnosed elderly people can even stop taking medication completely through 3-6 months of dietary adjustments and regular exercise such as slow walking and Tai Chi as long as no complications occur, as long as their blood sugar can be stabilized within the target range. There are also mild osteoarthritis, and many people take painkillers when they feel pain. In fact, if you practice squatting against a wall first, avoid climbing stairs or mountains, and avoid squatting for work, most people can relieve their pain symptoms without taking medicine at all.

I usually deal with the elderly a lot, and the most common thing I say is, don’t always use other people’s health prescriptions for yourself. There is a 5-year age difference between you and the old comrade downstairs. One likes to walk and the other likes to write calligraphy at home. The underlying diseases are also different, so how can the rules for eating, drinking and taking medicine be exactly the same? What I’m talking about today are also for reference. If you have any questions, you can come and talk to me alone later. If you have brought the recent physical examination report, I can also take a look at it for you. Elderly diseases are not that scary. Don’t be anxious or take it seriously. What is best for you is the best.