Tuesday, June 13, 2023

Health and Aging

My father's father died when his heart gave out.  For years, he'd been nominally on a low-salt diet, which mostly existed in the minds of his doctors.  He'd grown up a farmer in upstate New York, and you ate what was in front of you and what tasted good.  He was a fierce, sharply intelligent little man with a prodigious appetite, the sort of man who...having grown up hungry and hardscrabble...would eat not just everything in front of him, but food off of your plate if you were slow or distracted.   Heck, he would eat food off of the plates left behind at nearby tables in a restaurant.  Food must not be wasted. 

Low salt?  Diet?  Those things meant nothing to him.  He smoked in moderation, as did so many men of his era.  He was fond of bourbon, which as a pastor of a large congregation in New York City was the lubricating oil of many a social gathering.  He indulged that fondness until it became something both physically and spiritually toxic.  He was tough as nails, but his heart was not, though it carried him into his early nineties before it finally stopped.

My father's younger sister was a vivacious, free-spirited woman, an ample redhead with a brassy lower East Side accent and a genuine easy laugh.  She worked, when she worked, as a legal assistant, but her dream...as is dream of so many in that wild rumpus of a city...was the theater.  She loved to eat and drink and be merry, and loved the pleasures of life, and eventually there was a whole bunch more of her than her heart could manage.  She smoked for a while, because, well, people still did.  With weight and a disinterest in exercise came one huge heart attack, one that she barely survived.  Her heart and circulatory system struggled for the rest of her life, which she continued to enjoy as much as she could, and a little more than was good for her.  Her death came too soon.

My own father's heart is in the process of giving out.  He had always exercised vigorously, playing tennis and going to the gym.  Despite a lifetime of exercise, he's had multiple open heart surgeries over the last decade.  Bypasses.  Valve replacements.  He'd been encouraged to lose weight, which he did, for a while.  And to take a growing list of medications, which he did, diligently.  He never smoked.  But he paid no meaningful attention to his diet, and shared his father's dark romance with alcohol.

Midway through the COVID pandemic, he started complaining that he was getting short of breath.  I tested him, and it came back negative.  Then he was struggling to breathe, every exhalation asthmatic wheezing rales.  I did a little research, then got him to the hospital.  It was, as I had feared, congestive heart failure.  To the hospital we went, right in the thick of COVID, which was just super fun.  Since then, hospitalization has followed hospitalization, as that progressive disease has slowly closed in around him.

We've fought that for more than a year.  We'll fight that to the end.

It's a battle best begun before the enemy is at the gates.

Entire industries have risen up around exercise and diet, as we've simultaneously grown more sedentary and collectively overweight.  Farming in the 1920s required just a little more effort than working on the couch from home does today.  Heck, it required more physicality than farming today, as mechanized Big Ag rural America has become less and less healthy.

We Americans are trained to live in the moment, as good little consumers must.   Food is fast and abundant, fatty and salty, sweetened with corn syrup, perfectly designed to appeal to us on a primal level, a quick hit of empty calories and lizard brain flavor.  Our world is oriented towards our convenience, towards ease, towards inactivity. 

When we think of caring for our bodies, we are trained to think in terms of a return to youth, or of right now.  We want to look good in our swimsuits this summer.  We want to be attractive and instagrammable, which I'm assuming is an adjective these days.  And sure, if one wants to get theological about it, Jesus did talk about setting aside our fear about the future, about lilies of the field and sparrows and the like.  Being anxious about our mortality ain't the Gospel.  We are not called to obsess about tomorrow.

But we are also repeatedly reminded to live in a state of preparedness for every moment.  Our lives in the right now must be lived with intention, as we acknowledge the likely outcome of any given act, or 

How we choose to live our lives impacts how we will age.  We know this.  Not always, of course.  Cancers and aneurysms, car accidents and incoming city-sized asteroids can bring an end to things no matter how well we have lived, or how relentlessly we've focused on caring for our bodies.

"Eat, drink, for tomorrow we die" neglects to consider that, well, no, actually, tomorrow we might live.  If we live into hope, then it is our assumption that a probable future will arrive at our doorstep.  How we've lived shapes our encounter with that future.

Given my family history of heart disease, this is a daunting truth.  It may well prove to be the thing that sets up my first face-to-face with Jesus.  Or perhaps it'll be the aforementioned asteroid.  I'm not the one who ultimately determines that, but as a sentient being, I do have some input.  From the intention of my choosing, I can choose for or against the likelihood of a more vibrant closing chapter to my life.

I've been vegetarian for most of my adult life.  There are a range of reasons for this, which I've described in detail in my other writings.  It's about a minimization of suffering, particularly the horror of factory farmed meat.  It's about treading more lightly on this world.  There's also a strong component of enlightened self interest.  From all evidence at hand, eliminating meat from one's diet is better for one's heart.  

I'm taking my weight and my need for both load-bearing exercise and cardio seriously.  Sure, I might be vegetarian, but beer and pizza and Ben and Jerry's New York Super Fudge Chunk Chip are all technically vegetarian.  Pastoring and writing are both sedentary vocations.  Gaming and reading are favorite hobbies, and neither of those...outside of Dance Dance Revolution or Beat Saber...require much effort.  My preference, like my aunt's, would be to just not think about it.  But that's a recipe for either a swift death or ...just as likely...a long, difficult, and early old age.  

As I carry the familial Scots-Irish taste for whiskey and fermented hoppy beverages, I've forced myself to cut that back.  The last thing I need are thirty five hundred empty carbs a week, laced with a substance that actively depresses and suppresses heart function.  

These choices are nominally the teensiest bit selfish, all about me and my physical well being.  While I am older and able, that will be true.

They are also about my loved ones, who are...assuming I'm not just set out in the woods on a cold night...those who ultimately will care for me.  Caregiving is hard work, and tending to myself right now diminishes both the intensity and duration of that care.

Living well does not guarantee that we will age well.  Nothing does.  But we can increase the probability that we will age well, and it's always the right choice.