Getting sicker, getting older: You need a coping code

It is ridiculous how many chronically ill people utterly neglect proper nutrition, either in favor of sullen semi-fasting or “Now I can eat whatever I want” gorge fests.

OCTOBER 8, 2017 16:35

Updated: OCTOBER 8, 2017 16:34

Nutrition is important for a healthy life. (photo credit: TNS) — Nutrition is important for a healthy life.

(photo credit: TNS)

Part 1: The physical

I’ve never been much for holidays, especially those that presume to tell you what to feel and how to feel it. Still, there’s something about the Days of Awe that elicits thought. Over the last few years, I’ve taken to some quiet free association and usually come up with several book or column ideas before getting down to what’s on my mind.

The room this year was dark and quiet. I lay on the bed and it occurred to me that if Donald Trump had a serious heart attack or stroke, he would be bragging about the unprecedented numbers of people dancing in the streets.

True, but not particularly apt. Do better.

I did. First, there came gratitude that, even after eight years of diagnosed chronic leukemia and a stroke, my wife still permits me to do the housework. Then popped into me an epiphany that, as a man who has spent his 60s as a semi-invalid, I learned the hard way – several things.

One is that your brain may no longer provide adequate guidance for daily living. Medical conditions, side effects of other drugs, the inevitable decay of aging, and when you can no longer trust your brain, can you trust your mind, with its overload of good, bad and ugly churning about inside?

If so, and if you’re not sick enough for inpatient care, then you need a Coping Code of daily behavior. Then I realized, not entirely by accident, I had created such a code for myself. Perhaps it’s worth sharing. There’s nothing original or profound here, just a set of rules for living a decent, maybe even productive life, when such seems no longer possible.

Herewith Dr. Phil(ip)’s Part I (Physical) of the Coping Code. (We’ll do Mental next month.)

1) Shut up: Living daily with a serious medical condition does not require you to emote about it daily. “How are you?” is a greeting, not a question. As for your nearies and dearies, the only time you should speak of it is when they need to know something: a change in condition or status, upcoming appointments, etc. And of course, “I’m feeling OK, let’s go get some coffee” is usually appreciated.

However, if you must talk (and maybe even listen), there are multitudinous support and therapy groups available, as well as the newish field of geriatric psychiatry.

Just remember: Nobody likes a kvetch.

2) Sleep first: Prolonged sleep deprivation can be disastrous, physically and mentally. It also makes you a not very fun person. Yet it’s astonishing how many older people accept it as part of aging, or of sickness.

There are dozens of ways to deal with sleep problems. (Always see your doctor about it, as often as it takes). Pills may work, at least for a while, but the sleep they provide is chemical, not natural. Still, better than nothing. Warm milk, herbal tea, meditation, counting unicorn feathers – whatever works for you is right, except alcohol as a sleep aid (which never works in the long term).

But first you have to know what your current needs really are. Decades ago, I despaired of ever getting my regular Z’s again. (The doctors thought I had sleep apnea, but I refused to accept any diagnosis that sounded like a teachers’ union.) Finally, recently, I realized that I could get by on one- to two-hour snippets, one mid-morning, one late-afternoon, a couple after midnight.

Now I’m a joy to all around me. Especially when I’m sleeping.

3) Move it: The human body is made to move. Chronic illness deprives you of much of the ordinary daily movement that keeps our metabolisms in tune. So anything you can do around the house – have at it.

I even now appreciate doing dishes (especially after I bought six dozen disposable pans and 10 boxes of American soap pads). Get a stationary bike and/or treadmill, perhaps some light weights. Start easy, improve slowly, and within a few weeks you may hear, “Can I feel your muscle, Grandma?”

4) Feed: It is ridiculous how many chronically ill people utterly neglect proper nutrition, either in favor of sullen semi-fasting or “Now I can eat whatever I want” gorge fests. Nonsense. Sick bodies do not react to food like healthy bodies. There have been substantial advances in the science of nutrition. Avail yourself of the serious info on the Internet and, as always, see your doctors and other providers. Be keenly aware of how your needs and reactions might change, often very quickly. Again, whatever works for you is right.

So there you have the physical half of the Coping Code. Shut up. Don’t fall into any sleeplessness traps. Take as much exercise as you safely can. Eat right for you.

Glory in what you’ve accomplished and what it might empower.

Next: Dr. Phil(ip)’s four moral aspects of the Coping Code.