A woman in her late sixties was recently told by her physician that she could not have her total hip replacement until she lost at least 100 pounds. According to her doctor, her morbidly obese condition would make her surgery more risky, make her recovery more hazardous, and likely negate any positive outcomes the surgeon could create with the new knee joint replacement. The problem? In her current condition, she can barely walk with a cane, so calorie-burning exercise of any type is unlikely. She has no conscious control of, or rational guidelines for, her eating habits. At her age and body size and mental attitude, she is not likely to be able to lose the weight. Is it too late for her?
A 55-year old man attended a lifestyle workshop where he learned various strategies for keeping his arteries cleaned out so that he would have better blood flow to his heart, kidneys, and brain. He decided to change from a sedentary life with a high fat, high calorie, high salt diet and no treatment for his high blood pressure to a lifestyle of moderate, regular exercise, a low-salt Mediterranean diet, and regular physician visits. The problem? Two strokes have paralyzed him on his right side – both arm and leg. As a result, he is confined to a wheelchair. Physical therapists are trying to invent pool exercises and exercises that he can do at home, but the basic consequences of his stroke are irreversible. Is it too late for him?
A 48-year old female went through a cardiac lifestyle workshop. She had her lipid profile, blood sugar levels, blood pressure, height, and weight measured. She received excellent counsel on the changes that she needed to make to help her heart and vascular system become more healthy. The problem? She had a heart attack last year which left her heart able to function at about 18% of normal capacity. Even when wearing her oxygen mask and taking her medications, she is only able to walk across her living room before she must stop and catch her breath. She can change her diet as counseled, but the exercise portion of her counseling is not possible. Is it too late for her?
A 43-year old, obese male was diagnosed with Type II diabetes eight years ago. Only in the last three months has his wife been able to convince him to see a diabetes counselor. The counselor helped him create a meal plan that they could maintain on their limited income. The counselor showed him how to check his blood sugar level with a glucometer (which he had refused to use before) and what to do for high or low readings. The counselor suggested several other lifestyle changes that would help him lose weight and help get his diabetes under control. The problem? He has lost 80% of his vision and has renal failure. The doctor will not put him on a waiting list for a kidney transplant until his loses weight and demonstrates that he can get his diabetes under control. Is it too late for him?
It is never too late to make lifestyle changes; the worst of medical conditions can be made better with improved lifestyle habits. BUT – when permanent damage has been done to an organ system, it is too late to prevent that damage. In this case, the best one can hope for is improved recovery, maximizing the use of what is left of that organ system, and preventing further damage.
Health educators often pray for people to make the changes and avoid the catastrophes that are coming. This includes young people before they develop problems, people who have a family history of chronic illnesses, people who know they have the early stages of a chronic, life-threatening, life-altering disease entity, and people who have had an earlier warning that their medical condition is advancing. The important thing is to do it today – before it’s too late.