Have any of you heard of the term P4 Medicine? The term was coined several years ago by biotech pioneer Leroy Hood. Following a complex recipe of the integration of biomedicine, information technology, wireless and mobile, a new phase of digital medicine is being born. The shorthand for P4 Medicine – Predictive, Preventative, Personalized and Participatory – is already in play. Right here, right now, we are witnessing the transformation of how we will receive and experience health care, and it is amazing. How is that happening, and how will it affect us?
The vision of P4 Medicine is that instead of waiting for clinical symptoms to appear, like a growth spotted on an ultrasound after it has spread, physicians will be able to see early warning signs of malignancies from a tiny bit of blood analyzed by genomic instruments and software. If the genes and proteins are really predictive, then physicians could take early action, or patients can focus on prevention via lifestyle. All of a sudden, the focus of medicine goes from reaction to an investment in wellness.
And then there is the technology portion. There are currently over 20,000 different mobile apps available which merge your phone and diagnostics. For example, you can now measure your blood glucose on your and send it to your physician, which, in turn, can help you better understand your blood sugars as a diabetic. (Already, this has covered Personalized and Participatory.) Once this information is predictive, it can also be preventative as well. And that’s just for starters.
The booming field of mobile-health technology is only one part of an equation that is playing into this transformation. For example, GE Healthcare manufacturers a portable ultrasound device about the same size of a cellphone. It’s called the Vscan, and it allows a physician to look directly into the heart of a patient. Here, both the patient and the physician can see the muscle, the valves, the rhythm, and the blood flow. Already, we are touching on the Participatory and Personalized element of P4 Medicine. When we have the experience of witnessing what is happening inside our own body, we can start approaching medicine differently. No longer is your physician simply informing you about news which you may feel slightly removed from. (The language is medical. You may feel a disconnect.)
For those of you who, like me, have had the overwhelming experience of seeing your developing fetus via ultrasound, you can remember what that experience was like. For the first time, you are drawn that much closer in, witnessing life inside you. Similarly, physicians expect that patients who witness their own health in real time will be propelled to take charge of their own health care. It stands to reason that patients are more willing to make lifestyle changes that keep them healthy when they can monitor the consequences of their actions in real time.
Here at oomphtv, we aim to be a great communicator of new age 21st medicine, so stay tuned. Dr. Hood, in particular, believes that this transformative new idea in healthcare is near the tipping point. Timing is everything – we are blessed to be a witness.
If your curiosity is piqued, check out theP4 Medicine Institute for more information.
I know that I will not live forever, but maybe, just maybe, I can make some lifestyle changes that can influence how long I do live. Most importantly I would like those years to be healthy and as active as possible.
Over the past few years I have been reading some of the work that Thomas Perls, MD has been doing with centenarians at Boston University. He has written many books, papers and articles all about the topic of longevity. He recently developed this quiz based on the latest research on what factors help lengthen a person’s life. (this quiz is recently published in Health Magazine so it’s focused a bit more towards women, but men will learn from this too) Thomas Perls, MD is the real deal and I have the highest respect for the work he has been doing.
So spend a few minutes and take this quiz. Once you figure out your number, examine your numbers to figure out on how some simple changes can potentially add years to your life. This is kind of interesting quiz and do make you think about your own health. Give it a shot. And yes, you can make some small changes in your life that can make a difference.
1. When you’re stressed, how do you handle it?
a) Very well. I thrive on it and find it motivating.
b) Pretty well. I have regular healthy outlets, like yoga, walking, or calling a friend.
c) Not so well. It’s hard for me to let problems and worries go.
2. How often do you do things that keep your brain sharp, like learning a language, playing chess, or solving crosswords?
1) A couple of times a week.
b) Between once a week and once a month.
c) Rarely or never.
3. Do you spend time with friends on a regular basis?
a) Yes, I have lots of friends, and I’m very social
b) Yes, I have a small circle of close friends whom I enjoy spending time with
c) No, I usually either go it alone or spend time just with my partner
4. Have any of your parents, grandparents, aunts, or uncles lived to be 97 or older?
c) Don’t know
5. Do you have a brother, or sister with a history of heart attack or diabetes?
c) Don’t know
6. How much do you exercise?
a) 30 minutes at least five times a week
b) Some, around twice a week, and/or I regularly do something active like gardening or walking
c) Rarely or never
7. Are you at a health weight? (go to health.com/healthy weight calculator if you’re not sure.)
a) Yes, I’m within my ideal weight range.
b) Pretty close. I’m a bit above what the the charts say I should be, but I’m energetic and don’t have any weight related health problems.
c) No. I am well above my ideal weight, and I get sluggish and out of breath quicker than I’d like.
8. Do you smoke?
9. Do you floss?
a) every day
b) Once in a while
10. How often do you eat red meat?
a) 4 times a week or more
b) 2 or 3 times a week
c) Once a week or not at all
11. Did you have a child without fertility assistance after the age of 38, or did you stop getting your period completely after the age of 54?
(If you’re too young for either of these questions or don’t have children, pick “b”
12. Do you have a primary care doctor you trust whom you’ve seen in the last year?
b) No, but I see my gyno each year
13. How would you describe your sleep?
a) Great. I sleep enough so that I wake up feeling clearheaded and rested.
b) Could be better. I don’t get enough sleep, and I’m often tired during the day.
c) Not so great. I try to sleep, but I have insomnia sometimes or often.
KEY: For women start with the number 89 and add or subtract based on your answers. Males would start with 86.
1. a) 0 b)0 c)-5
2. a)+5 b)+2 c) 0
3. a)+5 b)+2 c) 0
4. a)+10 b)0 c) 0
5. a)-3 b)0 c) 0
6. a) 0 b)-2 c) -5
7. a) 0 b) 0 c) -8
8. a) -15 b) 0
9. a) 0 b) -3 c) -3
10. a) -5 b) -5 c) 0
11. a) +5 b) 0
12. a) 0 b) 0 c) -3
13. a) 0 b) -2 c) -2
Your potential age = years old.
Tomorrow marks another birthday. As I age, I recognize that good health is more and more important than anything. It’s everything.
We’ve all heard the “be proactive” call to action. In a sense, this is assessment from a bird’s eye view. We can assess our lifestyle by repeating the mantras we’ve all heard before: Follow a healthful diet. Get plenty of exercise. Channel our stress. Don’t smoke. Moderation is key. Be engaged, be mindful. Okay, okay….let’s say that we do all that. Are we where we should be in the preventative health maze?
When I conduct an on-line search for “How to Assess Your Health”, my computer screen urges me to take a health report card quiz so that I can determine what my risk factors might be and use my overall score to evaluate my health. Been there, done that. I’m healthy, according to my on-line test results. Is there anything else included in proposed self-diagnostic test kit? Yes. One more thing: I need to trace my family history, which will give me clues about what diseases I might be susceptible to. According to my on-line guides, I am now complete. I can feel assured that I can head off problems before they ever come to the surface.
I’m not a medical professional and sincerely don’t profess to be, but through a devastating illness which my husband is currently combating, I’ve learned that assessment is key to everything. The assessment that my husband’s doctors and nurses speak of is that of learning about your own norms by following a road map and listening to your body. So this year, I’m challenging myself to actually learn something about my own norms, to “look under the hood of my engine” so to speak. I’m making my first attempt to understand how I run.
Last week, I had my annual physical. Although I get blood work done every year or so, this was the first time I requested a hard copy of my lab results. I also requested that my physician walk me through the results. He consented, and was happy to empower me to learn about the person whom I think I’ve known all too well for many-a year now. This was a valuable lesson. Having seen the same physician for years, he told me how my norms have been running for everything from blood sugar to iron, from blood pressure to cholesterol, both good and bad. I asked about hemoglobin, thyroid, and Vitamin D. And the list didn’t stop there.
I feel as though for the very first time, I’ve practiced the best prevention method: understanding. Not only did my physician take the time to teach, I became an inquisitive student. I followed up his assessment by utilizing a primer I found on the New York Times which allows the user to look at blood counts and understand what they mean. This served as a great follow up to help me interpret my test results.
As we continue to drown in this information age, it’s easy to get lost between multiple health blogs, hundreds of internet sites, and countless medical apps. The daily bombardment of drug advertisements and the conflicting (but well intentioned) studies about medical tests can be confusing at best. Ironically, the very best person to advise us, our doctor, is now more likely to spend less time with each and every patient. This is especially why we all need to get acquainted with ourselves, know our baselines and understand what they mean. How else will we recognize a change of status if and when a change happens?
Of course, when you’re sick, knowledge is power. But I’ve just learned that knowledge is power when you’re healthy as well.
I just watched “The Green Buddha” video again for the first time in few months, and am still struck with how my 81 year old mother, Jeanne Dowell, still skis, hikes and travels with great agility and flair. My friends still ask how she is able to stay that active. I always say it’s probably do to her genes, but also the fact that she has kept active all her life. There are scientific studies that back this up.
In a newly published book, “Treat Me, Not My Age”(Viking), Dr. Mark Lachs, director of geriatrics at the NewYork Presbyterian Healthcare System, discusses two major influences (among others) on how well older people are able to function.
The first, called physiologic reserve, refers to excess capacity in organs and biological systems. We’re given this reserve at birth, and it tends to decrease over time. In an interview, Dr. Lachs said that as cells deteriorate or die with advancing age, that excess is lost at different rates in different systems.
The effects can sneak up on a person, he said, because even when most of the excess capacity is gone, we may experience little or no decline in function. A secret of successful aging is to slow down the loss of physiologic reserve.
“You can lose up to 90 percent of the kidney function you had as a child and never experience any symptoms whatsoever related to kidney function failure,” Dr. Lachs said. Likewise, we are born with billions of brain cells we’ll never use, and many if not most of them can be lost or diseased before a person experiences undeniable cognitive deficits.
Muscle strength also declines with age, even in the absence of a muscular disease. Most people (bodybuilders excluded) achieve peak muscle strength between 20 and 30, with variations depending on the muscle group. After that, strength slowly declines, eventually resulting in telling symptoms of muscle weakness, like falling, and difficulty with essential daily tasks, like getting up from a chair or in and out of the tub.
Most otherwise healthy people do not become incapacitated by lost muscle strength until they are 80 or 90. But thanks to advances in medicine and overall living conditions, many more people are reaching those ages, Dr. Lachs writes: “Today millions of people have survived long enough to keep a date with immobility.”
The good news is that the age of immobility can be modified. As life expectancy rises and more people live to celebrate their 100th birthday, postponing the time when physical independence can no longer be maintained is a goal worth striving for.
Gerontologists have shown that the rate of decline “can be tweaked to your advantage by a variety of interventions, and it often doesn’t matter whether you’re 50 or 90 when you start tweaking,” Dr. Lachs said. “You just need to get started. The embers of disability begin smoldering long before you’re handed a walker.”
Lifestyle choices made in midlife can have a major impact on your functional ability late in life, he emphasized. If you begin a daily walking program at age 45, he said, you could delay immobility to 90 and beyond. If you become a couch potato at 45 and remain so, immobility can encroach as early as 60.
“It’s not like we’re prescribing chemotherapy, it’s walking,” Dr. Lachs said. “Even the smallest interventions can produce substantial benefits” and “significantly delay your date with disability.”
“It’s never too late for a course correction,” he said.
I certainly agree to Dr. Lachs. I have my own mother to observe as a living example. My mother no longer runs at 81, but she does walk a lot and keeps her active yoga practice. The whole idea here is to keep moving no matter how young or old you are.
By Michael Thomas Masters
At 80 million strong, and with plenty of oomph, the baby boomers generation is the largest in American history.
The forthcoming holidays and New Year are customary times for all people, especially the vast population of baby boomers, to contemplate on our futures. All baby boomers have experienced many winter holiday moons past.
Nevertheless, a particular segment of baby boomers with valid concerns and insights that are often over-looked (or completely ignored) in regards to aging, in both print and visual media, are the millions of American gay baby boomers who are 50 plus. In addition to our being largely over-looked in regards to our aging needs and concerns, we repeatedly also experience increased bias and discrimination, which is of great concern.
One of the few films that deal with the lives of elder gays, “An Empty Bed” (1989), reflects on the grace, struggle and honesty of aging.
In these obstinate and challenging economic times, no baby boomers needs, nor deserves, additional unfair worry and stress reaped upon us, due to our sexual orientation, especially at this festive time of the year. After all, trimming holiday trees, creating fabulous dinners, sharing gatherings with loved-ones, gift giving and spreading good cheer applies to everyone. Above all, I love selecting a gorgeous pine tree to decorate and addressing and mailing holiday cards.
Good, affordable and just healthcare and retirement should be available to all of us, particularly as we grow older. However, it is not.
In fact, California is the only state with a law saying the gay elderly have special needs, like other members of minority groups. A new law encourages training for employees and contractors who work with the elderly and permits state financing of projects like gay senior centers.
“Out and Aging: The MetLife Study of Lesbian and Gay Baby Boomers,” (which can be found at: www.maturemarketinstitute.com under “What’s New”) is the first national survey of its kind that found more than a quarter of gay American polled (twenty-seven per cent) feared discrimination as we age. Less than half-expressed confidence that health care professionals will treat them with “dignity and respect.”
Fears of insensitive and discriminatory treatment are particularly strong among lesbians.
It has been reported that lesbians are more troubled than gay men about their financial stability as they age and report being less financially set for retirement. On the other hand, gay men are more likely (than gay women) to be concerned with being alone (43% versus 36%).
On a positive side for LGBT baby boomers (as well as for all adult gays) in April 2010, President Obama issued an historic memorandum to help ensure equal access to hospital visits and decision-making rights for same-sex couples. It is a significant step forward for the health-care rights of gay couples.
If you are a part of a same-sex couple or marriage, and want to make the most of these protections, you will need visitation forms to make certain your family and friends can visit you, as well as a health care proxy and living will. In doing so, this will ensure that those who know you the best can make medical decisions on your behalf in an emergency.
Furthermore, President Obama ordered hospitals participating in Medicare or Medicaid to ensure that all patients’ advance directives, which include appointing someone to make healthcare decisions if necessary, are respected.
Discover more about this important equal rights process, and to download sample forms, go to, http://www.hrc.org/issues/protect-your-visitation-and-decision-making- rights.htm
Another great resource for Gay Baby Boomers is the Lesbian and Gay Aging Issues Network (LGAIN), which is a constituent group of the American Society on Aging. The organization raises awareness about the concerns of lesbian, gay, bisexual and transgender (LGBT) elders and about the unique barriers they encounter in gaining access to housing, healthcare, long-term care and other needed services.
Let us not give up, or let up, until excellent, fair and affordable healthcare is available for all baby boomers (and all Americans) alike.
Happy and healthy holidays with a fulfilling and successful New Year, filled with immense oomph and joy, for everyone!
Michael Thomas Masters can be reached at firstname.lastname@example.org