The Best of Everything After 50

I have an early childhood memory of counting backward from 100—and then waking up much later to the sing-song voice of my mother asking, "Would you like some ice cream?" While I was happy about the ice cream, I still don't know why my tonsils had to be removed. The little buggers had never given me any problems, and yet . . . out they came. To this day, even my mother isn't sure why. During the fifties and sixties, countless American children had their tonsils removed—it was practically a rite of passage. This is no longer the case. We know much more now than we did then, are more informed, and most of us have access to better health care. Questioning a doctor's opinion and seeking out a second one is more the norm. It can still be confusing, though, especially as we get older.

I entered my adult years with the same high expectations of good health that I had as a kid. Why not? I had taken my Flintstones vitamins every morning for years. I felt invincible and indestructible in my twenties and thirties—even my forties.

After I crossed the threshold of fifty, I started to look around a little more. Some people my age were having strokes, contracting cancer, struggling with depression, gaining weight, and developing diabetes. It's not that people who were younger didn't have some of these health concerns. After fifty, it suddenly seemed all too common. I started asking myself the "what if" questions: What if I really get sick, or have a heart attack? Can I get Alzheimer's? What if I get cancer? Do I already have cancer and don't even know it?

I was determined to find out how we could age gracefully, with dignity and relatively good health. Like many other women, I had gone for a long time without doing simple things that could positively affect my health and well-being. Life had kept me busy taking care of others, but kept me from doing the right things for myself. Sleeping enough and exercising daily had seemed like an indulgence, even as I made sure my family was well-fed and well-rested. Was I too late to make a difference in my own health?

Yes, we are going to get older. Let's control how we do it, so we can be productive, fit, and strong women, no matter what our age. There are measures we can take now that will help us to enjoy our later years, not just endure them. Starting today, starting now, make this our goal: everything we do, we will do in a way that will benefit us and our current—and future—selves. We will prioritize our quality of life, not compromise it. It's not exactly starting over, but starting on a new path. It's a thoughtful, mindful approach to healthy living. We can do it.

After giving myself weeks of night-mares by exhaustively researching each and every possible disease and illness and bodily malfunction that could hit a woman over fifty, I woke up one morning and thought: "Enough already." I was making myself crazy, nervous, and a hypochondriac. Not a good way to start on my new life plan. Instead of obsessing over unlikely scenarios and struggling with medical jargon, I needed to get real information about the most probable problems and, more importantly, the best defenses. I needed to call in the experts.

Dr. Greg Pitaro has been my Primary Care Physician (PCP) for over ten years. He's checked my blood pressure and cholesterol levels, taken my temperature and made me say "aaaaah" when I've caught strep throat from my daughters, and has always made me feel empowered with information. When I saw Dr. Pitaro to talk about my concerns about being fifty he was patient, informative, clear, and right to the point.

Certain deaths are preventable. Every year an estimated 900,000 Americans die from preventable illnesses, and millions more are disabled by them. It doesn't have to be this way. Take care of your body and it will take care of you. Do the right things (eat well, exercise, don't smoke, keep a good weight, listen to your body) and you will be doing everything that is in your control to keep preventable illnesses and disease out of your life. Here's what he told me.

You don't need to get crazy imagining exotic illnesses. The biggest dangers are exactly what you'd guess. The leading causes of death for American women over fifty are, in order: heart disease, cancer, stroke, lung disease, and Alzheimer's disease. Heart disease is responsible for about 30 percent of those deaths and cancer for another 20 percent. The good news is that heart disease and some cancers can be prevented, especially if you keep your blood pressure in check and don't smoke.

Since heart disease and stroke are responsible for killing one-third of older women, the entire next chapter is devoted to heart health. But here are the basics.

Most heart disease is related to the build-up of fatty substances—plaque and cholesterol—on the walls of the arteries that carry blood. Most heart disease can be prevented by eating healthy foods, not smoking, getting regular exercise to keep your heart strong and your arteries free from build-up, and minimizing stress and anxiety, which can put strain on your heart.

Are you thinking "Good grief, why is she doing this? I thought this was going to be a fun book about great hairstyles and good sex! She's starting to freak me out!" No, no, no. You just have to face a few facts and make yourself more aware, informed, and tuned into your body, and then we'll get to the fun stuff.

About one in three women will be diagnosed with some form of cancer in her lifetime, so we can't ignore it. The majority of us will survive. The overall five-year relative survival rate is as high as 97 percent for the most common forms of cancer, when it is caught and treated early. The best way to catch cancer in the act is to know what you're looking for.

All cancers begin in cells in the body. Cells make up tissues, which make up the organs of the body. In a healthy body, cells grow and divide to form new cells as needed. When cells grow old and die, new cells take their place, but sometimes things go wrong. New cells form when the body does not need them, and old cells do not die when they are supposed to. The extra cells in the body form a mass of tissue—a tumor, which can be either benign (not cancerous) or malignant (cancerous). Sometimes tumors stay put, but they can spread out and run amok in our bodies (metastatic cancer). If cancer spreads and cannot be controlled, the cancerous cells interfere with the ability of healthy cells to function properly, and that's when the real trouble begins.

About 5 percent of cancers are due to inherited gene mutations. Many of the other 95 percent can be avoided. Here are some recent facts from the American Cancer Society:

The best preventatives for most cancers are the same as for most of our other health concerns:

There are many kinds of cancers, but most cases occur in the same few places in the body: breasts, lungs, colon, uterus, lymph nodes, thyroid, and skin. Some cancers—like pancreatic cancer—develop with little warning and few well-known risks. There are regular screening tests that can help find a few cancers early which are covered later in this chapter and in Chapter 3: Changes Down Under. The sooner cancer is diagnosed, and the sooner treatment begins, the better the odds of survival. To give yourself the best chance of beating cancer, you need to rely on your own good sense and watch for signs, such as:

If you develop any of those symptoms—and especially if you develop two or more at the same time—report them to your doctor immediately. Keep in mind, many of these could be caused by problems other than cancer, so your doctor will conduct various tests (usually non-invasive ones, although biopsies may be necessary in some cases) to determine the cause and to help you decide on treatment.

Lung cancer is the #1 leading cause of cancer death for women. Although almost twice as many women are diagnosed with breast cancer compared to lung cancer, lung cancer deserves a special mention here because it kills many more of us. But it is avoidable.

Smoking. We are considered the smarter sex, and yet more women smoke than men. Lung cancer can also be caused by secondhand smoke or by toxins in the environment, but smoking is the biggest culprit. Once you quit, your lungs start to heal, stopping your risk from increasing.

During my discussion with Dr. Pitaro, I blurted out "I used to smoke!" Since I've been seeing him for over a decade, he already knew that. I suddenly needed to know if I should get a chest X-ray, a CT scan, anything and everything right then and there. He waited until I stopped hyperventilating (How could I have done that to myself? What about how my hair used to smell, and my breath, and my clothes? I started having terrible flashbacks of the little bits of tobacco that would be at the bottom of all my handbags . . .), and calmly explained how this would likely impact me. I started smoking when I was a teenager, and smoked on and off until my mid-thirties, never more than eight or so cigarettes a day. He said I was still considered low risk, because I hadn't smoked a pack or more a day, and I stopped almost twenty years ago. Relief. The statistical cancer risk didn't go down when I quit, but it isn't increasing either, because I no longer smoke. It just stopped where it was. What's more, our risk of developing cardiac disease lowers significantly after quitting (by over 50 percent starting the first year after you quit). Each year you don't smoke the risk gets lower. I'm breathing easier now.

If you do, try your best to quit. You don't need to be told how dangerous it is to your health. Talk to your doctor about the best approach for you. Get a patch, get gum, get help, but you must quit—for your lungs, your heart, your skin, the people around you, your life.

There is no early test for lung cancer. There have been studies on the usefulness of chest X-rays, sputum cytologies, or CT Scans to screen for lung cancer in people who do not have symptoms, but so far the tests that doctors have now are only effective in confirming a diagnosis.

Lung disease is the fourth biggest cause of death in women in the U.S. While several chronic lower respiratory diseases, including asthma, are grouped together under the heading of lung disease, the most serious for people over fifty is emphysema. Emphysema used to be more common among men than women, but that is changing now that more women than men are smoking. It is usually caused by smoking or secondhand smoke, which makes emphysema, like lung cancer, a preventable disease.

Emphysema is a chronic, progressive lung disease in which the air sacs in the lungs are damaged severely enough to impair your ability to breathe and absorb oxygen. Because it develops gradually, it often goes undetected until it is quite advanced and is usually diagnosed in people between fifty and sixty years of age. Symptoms include:

Since many of the symptoms of emphysema are similar to other lung diseases—including lung cancer—your doctor will perform a full physical exam and will also take a chest X-ray and conduct certain tests to measure your lung capacity and function and the amount of oxygen in your blood.

I admit it. I forget things. Is this a sign that I'm getting Alzheimer's disease, or is it just normal, age-related memory loss? Our brains do slow down a bit as we age, but severe memory loss and seriously impaired reasoning skills are not "just part of aging" and should be addressed. Some Alzheimer's-like symptoms can be caused by treatable conditions like vitamin deficiencies, depression, thyroid problems, or excessive alcohol consumption.

Alzheimer's disease is an irreversible and progressive brain disease that destroys brain cells, causing severe problems with memory, thinking, and behavior, and is the most common form of dementia. It ultimately leads to death. It can occur at almost any age, but is more likely once you're over sixty-five. Alzheimer's currently has no cure—but some symptoms can be treated and managed, especially in the early stages. Here are a few basic facts we should know:

Because of the nature of Alzheimer's disease, the person may not know she has it. Diagnosis can be difficult, so a specialist is often required if family members or a PCP suspects Alzheimer's. There are a few tests (MRI, blood tests) that can be done to see if what's happening could be the onset of Alzheimer's—the earlier it is diagnosed, the better it can be managed.

There is so much we don't know about Alzheimer's—including what causes it—but it seems to share some risks with more routine types of memory loss. Recommendations to both improve mental function and guard against Alzheimer's include:

We've covered the major causes of death, but what about diseases that affect quality of life? Heart disease, stroke, cancer (specifically lung, breast, and certain gynecological cancers), emphysema, and Alzheimer's disease are statistically the most deadly for women over fifty—and the threat from all of them can be reduced by the choices that we make—but there are a few diseases that put a big damper on our quality of life.

My hair is naturally wavy. I usually scrunch it up a bit and leave it to air dry (see Chapter 9: No More Bad Hair Days). Recently, I scrunched it so hard that my middle finger began to hurt. The pain lasted over a week. Convinced I had broken my finger in the name of beauty, I made an appointment with a hand surgeon who had once treated me for carpal tunnel syndrome. The X-ray showed a little bursitis that the doctor said would go away eventually. Then he casually said, "Oh, by the way, you have some arthritis in your thumb." What? Only a few things have made me feel old since I turned fifty. This was one of them. Arthritis? Me? I couldn't believe it. My grandmother had arthritis, and I remember how she suffered with it. But hadn't she been way older than fifty? "Look at the X-ray again," I told him. "You must be mistaken." It turns out you can get osteoarthritis (the most common form of arthritis) at any age, but once you are over fifty, the chances of getting it somewhere in your body increase dramatically. It's also more common for women than men. And, yes, when the doctor checked the X-ray again, there it was.