House of Cards
The television show House of Cards has become quite popular. The phrase house of cards is an idiom and refers to an organization or plan that is very weak and built on a shaky foundation. Such organizations can thus be easily be destroyed or fall apart upon their own weight.
The human body as designed is not a house of cards. But, our health habits can turn it into an undesirable house of cards. On its own the human body is remarkably remarkable. And, it remains that way in the face of good health habits.
In fact, the human body is marvelously designed. But, poor health habits play havoc on this marvelous “invention” and eventually weaken the very foundation of the body. The human body is very forgiving – meaning it can accommodate and tolerate a lot of abuse in the wake of poor health habits, but only for so long, and then it yields and finally says it has had enough.
Too many people push to find where that breaking point before they are motivated to make changes to their health. Don’t be one of them. It rarely works. Take this into consideration. Ninety percent of smokers who have coronary bypass surgery resume smoking within 2 years. Change is hard. Best to change before any significant harm as been done.
“It Just Came on Suddenly”
I hear this a lot from patients – how something “just came on suddenly”. Of course, it always does – the symptoms that is. Think about it. One second you had no chest pain, and the very next you do. One second you are walking around fine, and the next you are on the ground with a fractured hip.
One second you are talking, and the next you have a stroke and cannot communicate. So symptoms always come on suddenly. The processes behind those symptoms did not, however. And, that’s the major point of this post.
Here’s another example to illustrate this point. We can get a chest x-ray everyday on someone who has smoked for 40 years and the x-rays will look fine. Then one day, the next day, there’s a lung mass. It wasn’t seen the day before, but there it is today. So even the signs of disease come on suddenly. But, the process that leads to those signs and symptoms began much sooner.
Symptoms are what you feel and are subjective findings of disease. Signs are objective indicators of disease (lab tests, diagnostic studies, physical exam findings, etc). As doctors we talk about signs and symptoms as they typically go hand in hand, but you can have one without the other.
Aging and Functional Reserve
Just because you have no signs or symptoms does not mean you are dodging the bullets being fired by your poor health habits. And, generally speaking once signs and symptoms manifest they become permanent – not always – but usually. In other words, even if you are successful in making the necessary changes you may not be able to undo the harm that has already happened – harm that may, at the least, already affect your quality of life.
As we age we eventually lose cells in all our organ systems – the brain, heart, kidneys, bones, and other organs. We lose what’s known as functional reserve. And, in fact, aging has been defined as the loss of functional reserve of an organ system. Once functional reserve is lost then organ failure ensues leading subsequently to total body failure or death. Poor health habits accelerate the loss of functional reserve.
The Rapid Fall of a House of Cards
A house of cards does not fall down slowly. It falls down rapidly. And, that is perhaps one difference in our analogy between a house of cards and our health. Poor health habits typically kill us slowly, but in an ever accelerating fashion when coupled with the normal aging process.
Diabetes gives way to heart disease, renal disease, neuropathy, and vision problems. Obesity gives way to heart disease, diabetes, arthritis, and more. Heart disease gives way to peripheral vascular disease and stroke. Our health becomes a downward spiral when any of these chronic diseases are present.
Pros and Cons of Medications
It’s not unusual to see patients who want to be on diabetic or cholesterol medications because it’s far easier than changing their dietary habits. But, that’s the wrong mindset to have. You are fooling yourself. But, you won’t be able to fool your body for very long.
We know that modifying a risk factor of a disease with medication doesn’t always modify the risk of disease (for instance raising the good cholesterol or HDL with medications does not lower the risk of heart attacks). It’s better to modify that risk factor through lifestyle changes.
Read that again to make sure you understand it. Just because you can make a blood sugar or cholesterol level look good with medication doesn’t mean you are preventing the entire harm of eating a unhealthy diet. And, that gets lost by patients and physicians alike.
Don’t gamble with your heatlh and approach it like a House of Cards episode. Build your health upon a strong foundation centered on good nutrition and regular physical activity.
