weekly blog--one for the ages
With the Holidays in full bloom, we look to Harvard Medical for answers to questions about aging that you might have always wondered about.
Take feet for example. By your 50th birthday, you have probably used them to travel 75,000 miles or more. And along with that, you many have lost nearly half of the fatty padding on the soles of your feet. You may also be wearing a shoe that's a size bigger because of weight gain that puts greater pressure on your feet, and because your ligaments and tendons have lost some of their elasticity, which also predisposes them to potentially painful ruptures or microtears.
If you've given birth, your increased shoe size can be caused by hormones released during pregnancy which relaxes the ligaments. Menopause can also affect foot health. Unless countered by medications or exercise, the loss of estrogen and other hormonal changes generally lead to lower bone density, resulting in osteoporosis if enough bone mass is lost. This condition can raise the risk of stress fractures (hairline breaks) in any of the bones of the foot. Unless treated appropriately, stress fractures can worsen and cause the bones to shift out of place.
Moving up to your aging face, consider this: foreheads expand as hairlines retreat; Ears often get a bit longer because the cartilage in them grows; Tips of noses may droop because connective tissue supporting nasal cartilage weakens.
There are also structural rearrangements going on behind the scenes. When we're young, fat in the face is evenly distributed, with some pockets here and there that plump up the forehead, temples, cheeks, and areas around the eyes and mouth. With age, that fat loses volume, clumps up, and shifts downward, so features that were formerly round may sink, and skin that was smooth and tight gets loose and sags.
Meanwhile, other parts of the face gain fat, particularly the lower half, so we tend to get baggy around the chin and jowly in the neck. And then there are the wrinkles. The deep ones in the forehead and between the eyebrows are called expression, or animation, lines. They're the result of facial muscles continually tugging on, and eventually creasing, the skin. Other folds may get deeper because of the way fat decreases and moves around. Finer wrinkles are due to sun damage, smoking, and natural degeneration of elements of the skin that keep it thick and supple.
Happy Holidays. This might be the last blog of the year as ConfrontingAging will soon go on hiatus for a few weeks.
I am writing this blog from a computer in the Business Center at the senior housing facility where my mother-in-law lives. She just returned from a week-long-stay at Yale-New Haven Hospital. At issue were breathing problems that led to a heart valve replacement diagnosis.
Given her age and overall health condition, the doctor said there would be about a 10% risk to do a non-invasive TAVR procedure. Without surgery, he speculated that she might only have another 12 to 18 months to live. With it, her life may be extended a few more months or possibly even an extra year or two. Either way, the other life-altering health issues she has would not go away, and would only increase over time.
Enter that gray area where healthspan and lifespan converge where no one can definitively know what is the best course of action to take. In a best case scenario, the patient would be able to determine his or her mode of medical treatment or to reject it. However, my mother-in-law has dementia and might not be capable of making that call, which leaves the decision in the hands of her Health Care Proxy and family members who might not agree on what to do next.
Adding to the confusion are religious doctrines that conclude that "Man does not 'own' his body; it belongs to God. From the Jewish perspective, the Jewish patient is no different than any other Jew: he, too, is governed by halacha (guides proper Jewish behavior in all aspects of life) and must relinquish a degree of autonomy.
So what is the best road to take at the last stage of life? I would prefer the safe one offering comfort and dignity. I would not like to find myself traveling down a pot-hole marked path with an unsettling amount of tortuous twists and turns.