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Using Lifestyle Primary Care Medicine to Avoid The Marginal Decade

Shameless G-ma

As a doctor, I have had the privilege of talking with thousands of folks from all walks of life, in all stages of their lives. During all those conversations I have noticed recurring themes that highlight shared values and concerns.

For example, “I just don’t want to be a burden on my family!” I have heard those words uttered more times than I can count. The person speaking is frequently between the age of 60 and 100, and they are talking to me from a hospital bed. They seem to have the sense they have reached a level of frailty where they know they can’t have the autonomy they have enjoyed in the past. They simultaneously fear having to be dependent upon their loved ones. Of course, they may also dread having to live with their children or taking up other family resources. It’s a very difficult position to find oneself in. There frequently aren’t a lot of “perfect” solutions to be found.

The Marginal Decade

This period of frailty is coming to be known as “the marginal decade”. This describes the last years of our life where our vitality has waned to low for us to live the

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lives we want to. I think the marginal decade is in part a consequence of modern medicine or “medicine 2.0” as some refer to it. When we added scientific principles to the practice of medicine, the era of medicine 2.0 began. It gave us tremendous improvements in life span and many tools to deal with the symptoms of diseases. Honestly, the biggest gift we received from medicine 2.0 was the ability to combat infections with immunizations and antibiotics. These two interventions provide most of the credit for increasing human lifespan. But modern medicine has its limitations.

Have you ever noticed many medications people take for chronic health problems don’t cure the problem? How many diabetics are cured by taking insulin? How many people with high blood pressure are cured of their hypertension. None. This highlights a serious problem with medicine 2.0. Most of the treatments help control the symptoms or consequences of the disease, but they don’t cure the problem. They slow down how fast we die. But they don’t provide a return of our vitality or health.

I think this helps explain the marginal decade: medicine 2.0 helps us live longer--but with a quality of life that isn’t sufficient to live the way we want to.

How to Prevent the Marginal Decade

As we go through life we are continuously and simultaneously in the process of falling apart and putting ourselves back together. When we are young, we are so good at this we grow and thrive. In our middle years we start to slow down in repairing ourselves and little things begin to degrade. This is where lifestyle interventions are so important. By avoiding things that promote faster break down and deliberately engage in behaviors that build our vitality, we stretch our health span out to last to the end of our life span.

If we want to have a long life and great health we need to do more than medicine 2.0 is prepared to offer. We need to take our efforts to the next level. Lets call that medicine 3.0 or lifestyle primary care.

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WFPB of Lifestyle Primary Care

Medicine 3.0 is all about combining a healthy lifestyle approach with the benefits of medications and technology to get the best of both. Your health habits help develop your resilience and vitality. If you want to be fully functional you have to give your body what it needs to do the maintenance. We’ve talked about many of those things previously: activity, healthy nutrition, adequate sleep, stress management, strong social connections and avoiding toxins (drugs, tobacco, excess alcohol). These are the fundamentals of keeping frailty at bay.

ROI of Lifestyle Primary Care: Climbing Mountains

Make sure your health plan includes enough lifestyle interventions to keep your vitality and function high into your last decades. That’s the surest way to avoid the marginal decade.

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