Lecture experience on prevention and treatment of geriatric diseases

There is never a universal formula for the prevention and control of geriatric diseases, and there is no health regimen template that suits everyone. Prevention is given much higher priority than treatment. Even if chronic diseases such as hypertension and diabetes have been diagnosed, personalized daily management can reduce the risk of fatal and disabling complications such as myocardial infarction and stroke by more than 60%.

Most of the people who came to listen to the lecture this time were old people who were familiar with each other in the community. Aunt Zhang Guilan, who was sitting next to me, came with questions. She has had high blood pressure for 20 years. She used Douyin to see people saying that celery juice can reduce blood pressure. She drank it for half a year, a large cup every morning on an empty stomach, and occasionally skipped antihypertensive medicine. As a result, she felt dizzy and went to the emergency room last month. Her blood pressure soared to 180. She was so scared that she no longer dared to follow the trend.

When we talked about the dietary issue that everyone is most concerned about, we just happened to run into the controversy over whether the elderly should go vegetarian or not, which has been very hot in recent years. The two doctors who came this time had different views. Dr. Li from the Department of Endocrinology spoke first, saying that he had treated several elderly people who had been on a vegetarian diet for three or four years. However, their blood lipids did not drop much. Instead, they were diagnosed with sarcopenia and staggered when walking. Last time, an 82-year-old man fell at home and fractured his hip. He lay down for three months and then left. This was because of insufficient muscle mass, poor balance, and weak recovery ability after a fall. His point of view is very clear: people over 70 years old, even if they have high blood lipids, should eat lean red meat two to three times a week, about one or two each time, and supplementing with high-quality protein is better than anything else.

When Dr. Wang from the nutrition department answered the question, she did not deny the feasibility of going vegetarian. She said that if you are an elderly person who has religious beliefs or cannot eat meat, a vegetarian diet is not impossible, but you must be able to coordinate it. One boiled egg, 300ml warm milk, and one or two soy products every day are the bottom line. Otherwise, if you just eat cabbage and radishes, you will not get enough protein, and your immunity will be so weak that you will not be able to withstand pneumonia in winter. She also gave the example of her mother-in-law. The old lady had been a vegetarian for ten years. She always caught colds before. Later, she was forced to add an egg and drink a cup of milk every day. She didn't even catch the flu last winter.

I hear a particularly strong resonance here. My dad was diagnosed with type 2 diabetes last year. He heard from the community health group that pumpkin is a "magic tool for lowering blood sugar." He steamed half a pound of pumpkin as a staple food at noon every day for a month. When he went to have his fasting blood sugar checked, it was 8.9. At that time, the doctor scolded him for eating blindly. This misunderstanding was also mentioned in this lecture. It was said that the glycemic index of pumpkin is 75, which is a high-glycemic food. The so-called "hyperglycemic" only means that its dietary fiber can delay the absorption of carbohydrates. If you eat half a catty at a meal, your blood sugar will rise faster than eating rice. Where does the hypoglycemic effect come from? To be honest, this kind of misinformation about health care has really deceived too many people.

After talking about the misunderstandings about prevention, the doctor then talked about the medication issue that everyone is most concerned about. A 76-year-old Uncle Wang raised his hand and said that he now takes 6 kinds of medicines for high blood pressure, coronary heart disease, and diabetes. Sometimes he has acid reflux after eating. Can he take two kinds of medicines? The doctor from the cardiology department directly said that you should never stop on your own, but it does not mean that the more you eat, the better. Nowadays, many elderly people have the problem of "polymedication". It is best to go to the geriatric department every three months for medication reform, and screen out duplicate, unnecessary, and conflicting medicines. At that time, I thought of Grandpa Zhao downstairs. He used to take 5 kinds of medicines. Last month, he went through medication reform and only needed to take 2 kinds. Now his blood pressure and blood sugar are very stable, and even the stomach pain he often suffered before is gone. This is because two kinds of medicines were irritating to the gastric mucosa. In fact, they can be replaced with milder ones.

At the end of the lecture, the doctor also gave a very down-to-earth tip: when you are watching TV at home, don’t just sit. Put an empty mineral water bottle under your feet and roll back and forth for 10 minutes. This can not only promote blood circulation in the lower limbs, prevent varicose veins, but also practice balance and reduce the risk of falling. I tried it on the day I got home and rolled it for 15 minutes. My feet were always warm when I slept that night because I had cold feet in winter. Don't tell me, it really worked.

I used to think that as people get older, they cannot escape age-related diseases such as high blood pressure and arthritis, and they can only wait until they get sick before going to the hospital for treatment. After listening to it this time, I realized that our prevention and control of geriatric diseases does not mean that we should not be sick at all, but that we should try our best to prevent the disease from affecting our quality of life. Being able to freely visit the market or go out to play chess with old friends is better than anything else. Before I left, I saw Aunt Zhang holding a notebook full of notes. She said that when she got back, she would drink celery juice every day instead of twice a week, and add a glass of warm milk in the morning. Last week, she sent me a WeChat message saying that her blood pressure has been stable at 130/80 for the past half month and she is no longer dizzy. She also said that next time there is such a lecture, she must invite her wife to come and listen to it.