The Life Plan (3 page)

We are all going to age, but we don’t have to get old. Getting old means the deterioration of health, declining energy levels, loss of sexual function, and loss of your zest for life. I don’t want any part of that, and I’ll bet you don’t, either.

When I discovered my own hormone levels were deficient, traditional medical professionals, said that andropause, or declining testosterone, is not a disease, so it shouldn’t be treated. They were wrong then, and they’re even more wrong now. When I was losing muscle tissue and strength, conventional doctors once again said to just accept that I was getting older, and basically, just get over it. Well, hundreds of my patients, including myself, are proving them wrong every day.

Aging is not the enemy. It’s not a disease. In fact, by definition, aging is a gradual change in your body that doesn’t result from disease. Disease is the deviation or interruption of the normal function of any part or system of your body. This without doubt includes your endocrine system and the hormones associated with it. Declining hormone levels are the result of a disease process, not aging, and should be treated. In my opinion it’s malpractice for doctors to ignore declining hormone levels and write them off as simply an acceptable part of aging. It’s just like ignoring high cholesterol levels, high blood pressure, or lung disease caused by cigarette smoking.

Each of us has a unique set of inherited predispositions for certain health issues: That’s your DNA code. On top of that, your lifestyle choices contribute to whether these tendencies will materialize. Lifestyle can definitely trump genetics. So instead of accepting a waning sex life or waiting for disease to appear, you can learn how to use my health strategies based on age management medicine to keep your body metabolically and physiologically in balance so you do not get old.

First, let’s figure out why you’re not in optimal health. The answer for many of us has nothing to do with what you are currently doing. Instead, the problem is the machine we call the American Health Care System.

You might not realize that for most Americans, the quality of the medical care they receive is determined by men and women they will never meet: those who run the insurance companies. These people decide how often your physician sees you, what medications are prescribed, if diagnostic testing that may signal the onset of a silent disease can be ordered, whether you see a specialist, and when you should be admitted into a hospital. Virtually every medical decision a traditional physician makes today is affected by the insurance industry.

Because of this corporate structure, decision making in the practice of medicine has shifted radically from physicians dedicated to your best interest to organizations bound to financial interests. Most doctors aren’t happy with this and find themselves forced into using their medical knowledge and experience for the plan’s benefit and economic goals—rather than doing what’s best for the patient. Medical services have shifted from the hands of the treating physician to administrators, who in many cases aren’t medically trained. Worse, managed care has created an environment in which doctors feel rushed when they see their patients, because more patients per day means more minimum payments from insurers. Their stress becomes your bad service: The patient is left with a ten-minute-or-less office visit with a harried doctor who is focused on managing isolated health problems and dispensing prescriptions. Then, doctors are left to second-guess their findings, which leads you to seek multiple opinions.

Today’s physicians are being placed in an uncomfortable position by insurers, which can jeopardize the care they provide to their own patients. Aside from managing your health, your doctor has to control his own costs: This affects his or her decisions about choosing specific medications, determining necessary lab work, doling out a limited number of referrals to specialists, and more. These decisions can directly affect your provider’s salary. Economic rationales have now replaced clinical judgment.

According to a study published in the
Commonwealth Fund Quarterly, A Digest of Current Work in Health Policy and Practice,
56 percent of primary care doctors and 60 percent of specialists in the United States believe their ability to provide quality healthcare has deteriorated over the past ten years. Medicare continues to institute cutbacks for medical services. If all of this isn’t bad enough, the number of primary care providers, understandably, has continued to decline year after year. The doctor shortage has reached a catastrophic crisis. Underserved areas in this country currently need almost 17,000 new primary care physicians even before Healthcare Reform is implemented. Our new Healthcare Reform will attempt to reach 30 million new patients needing care.

Worst of all, your healthcare is not keeping up with science. We have just ended a century of unprecedented advances in medical knowledge and technology. Serious medical conditions that were once considered disabling or a death sentence are now curable. Most devastating disease conditions in existence today are now manageable. Yet in spite of all the amazing medical advances in recent years, there exists a great paradox in healthcare today—
we simply cannot afford them!
The economics of today’s healthcare has made all of the advances in medical science less and less available—even to those who are willing to pay for them out of pocket. As medical costs continue to soar, patients are increasingly being denied coverage for crucial services by their insurance companies. We have the 37th-worst quality of healthcare in the developed world. Conservative estimates show that over 120,000 Americans die each year from treatable, preventable illnesses that citizens of other countries survive. It doesn’t matter whether you are rich, middle class, or poor; insured or uninsured; male or female; young or old. Your health is suffering from the system that is supposed to be managing it.

So what can we do in order to receive the best healthcare possible? The answer is really very simple—don’t get sick! We must do everything possible to avoid disease, maintain excellent health, and not get old. Prevention is the answer to America’s healthcare crisis. We have the right to know our current health status each and every year, which can be done completely only by proactively screening for silent diseases. Today, these tests are discouraged by insurance carriers who state that these medical tests are “unnecessary.” This must change.

Nothing the insurance industry can throw at medicine today is worse than the reactionary way doctors are trained to respond to disease. Your physician has to wait for disease to appear and then treat it: a fix-it-when-it’s-broken mentality. You literally have to get sick first and hope protocols exist to make you better. But what you may not realize is that an illness begins a cascade of sickness: Once disease sets in it plays havoc on the rest of your body, creating more and more health issues.

It’s no wonder the National Center for Health Statistics reports that even while Americans are living longer, they are not necessarily healthier. Population studies by Billy S. Guyton, at the University of Mississippi Medical Center, show we have “increased the length of life, but made no progress in decreasing the length of disability at the end of life.” An article in a February 2004 issue of the
American Journal of Medicine
said it’s time we abandon a disease-focused medical care approach, which “at best, is out of date and, at worst, harmful.”

A great example of the problem of treating disease instead of preventing it is my patient Richard, a 53-year-old type 2 diabetic who came to my office about a year and a half ago. Richard had a big job, overseeing a large corporation. He was overworked, which left him completely focused on his job and somewhat neglecting his family and his own health. At 5 feet 10 inches and 220 pounds, he already walked and looked like he was in his 60s. He moved slowly and was extremely tired most of the time, and had lost his desire for sex. “I really need help, “he said when he came in. “My doctors aren’t really helping me. They only seem concerned about my diabetes. But the rest of my life is falling apart, and my physicians are only concerned with my insulin and blood sugars.”

His primary care physician and endocrinologist worked on managing his disease—but I took the proactive approach: completely changing his lifestyle with the goal of eliminating his diabetes. First, I had Richard fill out an extensive questionnaire, and then he took a series of blood tests. Then we talked at length about his life and his lifestyle. He told me he was sleeping in the guest room because his wife couldn’t stand his snoring, which would interrupt his sleep and hers, all night long. I quickly realized that beyond the diabetes Richard was also suffering from sleep apnea, which was not diagnosed by his physicians. Before prescribing any medications, I had Richard start my Life Plan, the same one outlined in this book. It consisted of a low-fat/low-glycemic eating plan along with an optimized exercise program that focused on weight training and cardiovascular conditioning. My goal was to get him to shed several pounds and rapidly build muscle mass he had lost over the past 10 to 15 years. Increasing his muscle mass would help improve his metabolism and his ability to control his diabetes. I also wanted to get Richard back into his bedroom, and sleeping with his wife.

Once the blood work came back, I realized I also needed to address his deficient hormone levels and elevated markers of arterial inflammation. I started Richard on a customized nutrition/supplementation and exercise program combined with correction of his hormone deficiencies. The blood test also showed that his diabetes was totally out of control. Hemoglobin A1C is a direct measurement of the amount of sugar that is attached to the hemoglobin molecule and reflects the average blood sugar over a three-month period. Hemoglobin A1Cs in the 6s or above are indicative of diabetes, and his was coming in at 7.3.

Six weeks into the program, Richard came back to my office beaming. He had already lost eight pounds and was on the road to better health. Three months later, his hemoglobin A1C levels dropped to 6. As I continued to fine-tune his hormone levels, improve his nutrition, and increase his exercise regimen, Richard’s hemoglobin A1C levels came down to 5.5, clearly in the safe, nondiabetic range. He was 20 pounds lighter, completely off all medication, and had no evidence of any damage to his kidneys, blood vessels, nervous system, and eyes as a result of his diabetes. Everything had been reversed—including his sex life—and his blood vessels were even healthier, proven by carotid ultrasound and endothelial function studies, and a reduction in his markers of vascular inflammation. In his words, “I feel better than I did in my 30s!”

Had Richard not taken a proactive approach and continued with his insurance-based/disease-focused medical care, his story would have had a totally different ending: poorly controlled blood sugar levels, increased body fat, high probability for shortened life span with the full impact of diabetes over the next 5 to 10 years, including impotence, potential blindness, vascular complications, potential amputations, kidney failure, or a heart attack or stroke.

I can’t fault his primary care physicians, because they were following the standard “treat the disease after it appears” approach. Doctors are paid to treat—not prevent—disease. The insurance industry does not reward your physician for being proactive about preventing disease. As a matter of fact, your physician is penalized if he or she orders tests not backed up with a disease diagnosis.

While uninformed doctors and overall healthcare policies can take some of the rap, we are individuals who operate in the real world of free will. If your health is not perfect, you are not completely without fault or blame. We must all learn how to take responsibility for our own health now, so we can maintain a high quality of life as we age.

Every day the lifestyle choices you make—including the types of foods you eat, the time you put aside to exercise, and the types of exercise you choose—are affecting your health right now, and will affect the way you live in the future. If you’re like many Americans, you’ve shifted from being a couch potato to being a mouse potato, immersed in your computer or favorite electronic gadget. The bottom line is you’re still not moving.

Plus, your diet may be filled with processed foods, unhealthy proteins, and simple carbohydrates that accelerate aging and make you old. All of these bad food choices are quickly stored as body fat and arterial plaque, not to mention that they suck the energy right out of you, add weight, and create stroke, diabetes, heart disease, and Alzheimer’s disease. Men need to change their ways right now if they want to prevent the accumulation of body fat (or get rid of it if they already have it).

And you must learn how to prevent or reverse the loss of bone and muscle tissue. This becomes critically important as we age if we are to avoid nursing home care, chronic pain, immobilization, mental deterioration, and prescription drug dependency. By adopting health-promoting policies, you can become part of a more “active” aging population who will have: