Thursday, January 13, 2011

Block 6: Geriatrics and Neurology

Block 7 is over but I'm only now getting around to this post about Block 6. I have been mighty busy but the real reason is that this is a tough one to write. My two weeks on Neurology were interesting but my time on Geriatrics was downright depressing and I've been struggling to find a way to put a positive spin on those two weeks.

So, I'll procrastinate a bit more by starting w/ Neurology.

The Neurology consults I saw varied b/t fascinating learning experiences and down-right wastes of time. On the interesting front, I saw a patient with partial status epilepticus which I didn't even know could happen! Status epilepticus is when a person has a persistent seizure that lasts 30 minutes or longer. In fact, in rare cases, it can last days. The patient we saw presented with inability to speak. Of course, we were concerned for stroke but all the brain MRI was negative. An EEG (electroencephalogram) indicated a partial, but persistent seizure in area of the brain that forms speech. Fascinating.

It was great to watch the attending physicians do full neurological exams and then hear them think (aloud) through where the brain or spine lesion must be to cause the problems we saw. We actually diagnosed a lady with ALS (Lou Gehrig's) which was incredibly sad but important for me to see the early deficits.

In the wastes of time department, I have to give my Neurology peers credit. They end up seeing a lot of very boring patients with headaches and generalized weakness/deconditioning for every 1 legitimate neurological problem!

I must admit, I learned a lot less on my 2 weeks of Geriatrics. Geriatrics is a somewhat new sub-specialty that focuses on the needs of the elderly such as maintaining functional mobility, diagnosing and managing dementia and other memory problems, with a lot of cross-over into psychiatric disorders like anxiety and depression. This is important work, there is no doubt about it. And god bless the folks who go into this field! But, I found it very, very depressing. We spent a lot of time at a local nursing home as well as at RIC (Rehab Institute of Chicago) in addition to clinic and inpatient consults.

Thus far, I haven't much minded the aging process. While I'm not a fan of wrinkles and spend way too much money on skin preservation products, I otherwise have been fine with watching the 2* turn to 3* and with the 3* becoming 3*+1 each January 19th. While I'm not quite as svelte as I was before my metabolism slowed, I am likely in the best cardiovascular shape ever in my life and I expect to keep improving my performance in running and eventually in biking and swimming year by year. Plus, I have the ability to eat at very nice restaurants, live right on Lake Michigan in downtown Chicago, and travel to fun places with decent frequency, more so than 5 years ago, so if it requires aging to have that kind of financial freedom, so be it.

But, now, I'm starting to be afraid of aging. Not the next 40 years, necessarily, but the 30 years after that. I don't want to lose my ability to exercise, I don't want to lose my memory, and I don't want to lose my independence. Period. I know that doesn't happen to everyone, but it sure seems like it happens to a lot of folks!

In attempts to put a positive spin on this "fear", I've concluded two things. One, I'm going to focus on positive role models of aging. Like the 80 year olds that Runner's World often features who still run marathons or win Master's races. Like my three grandparents, who are still very active and fun. Second, I'm going to keep a mental list of things I enjoy and would be able to do even if I don't age the way I want to. Like, wearing a huge fancy hat to spectate the Kentucky Derby. Like, spa days. Like, becoming a better photographer. Like, reading, wine tasting, eating good food. Like learning about and watching (non-human) animal behavior.

Over the past few years, I've really started to focus on my physical health and fitness. I'm trying to become an athlete. But I need to be sure I don't neglect my other interests that don't involve physical activity. Don't worry- I'll never neglect wine and food:) But I'd like to focus on reading more books and actively trying to learn more about photography. I'll have a good chance to work on this a bit in Hawaii, I suppose!

I hope this post didn't end up a downer. I tried to turn the experience around a bit and learn from it.

I'd love to hear thoughts from others- older and younger- on the aging process. What would you do if you couldn't be active?


  1. I'm not sure what I would do if I couldn't be active when I am older. There is a woman at the gym who is 97 years old and she is lifting weights and walking on the treadmill like she owns the place. I want to be that woman!

  2. Hi Val--Interesting insights! I'm 45 and have been running for 13 years, so I've been able to experience a bit of the body's aging in that regard. Quite simply, I don't recover like I used to; I'm not as flexible (even though I do yoga); and I get injured more easily. Depressing, yes, but I am not stopping anytime soon!

    As your read on my blog, I'm not so hot at diversifying b/c I am so in love with running. I think that one thing that will help me as I age is moving to a warmer climate in a beautiful setting, ie: the southwest.It's where I plan to be upon retirement and getting the kids off on their own. Being outside, taking hikes, just enjoying the scenery of the desert, more often than not really reaches me. Right now I'm in the middle of winter in Maryland, and not being able to run means not much time outside. It gets me down!