Having flown into my tenth decade with some speed, and finding I enjoy the altitude (1), I’ve begun ruminating about getting old. Why, I’ve wondered, have I beaten the odds? Today I’m going to retrace my tracks.  Next time I’ll look at the amazing process of aging itself.

            What was it that allowed me to survive longer than the average male born in 1932? The glib answer, of course, is luck. Dame Fortune has indeed smiled on me, at least in my later years. But what was it that actually kept my blood flowing, and my lungs going, for nine decades? Genetics and lifestyle likely entered in, but so did modern medicine, a big factor as I shall describe.

            In 2001, I noticed something new, a mild sensation beneath my collar bone as I walked up my favorite long hill. It wasn’t pain, just something odd. My medical training led me to suspect it was angina pectoris. A quick visit to a well-organized cardiac catheterization laboratory confirmed my suspicion. (One of my dye-filled coronary arteries was significantly narrowed.) I returned to the same laboratory on the next day, and stents were inserted and expanded in that narrowed segment (2). Presto! Normal blood flow to my heart was restored. No more odd feelings when I tramped up hills.

            Since then, for over two decades, my cardiac pump has been a model of efficiency. It chugs merrily along without a hint of discomfort. Good timing on my part! Stents had been available for only about a decade (3) when I needed mine, those being much improved from earlier versions. Thankfully, those tiny gadgets have kept my important coronary artery nicely open. Without their silent and persistent help, I might well have suffered a heart attack years ago.

            Here’s more about my circulation. During my forties, fifties, and sixties, the electrical components of my heart were cranky. At times they fired off extra beats like a wild drummer. The wild beats by themselves weren’t especially worrisome, but occasionally the electrical noise turned completely rowdy and pitched my atria into brief bursts of fibrillation.

            You probably know this, but I’ll mention it anyway. The heart still can pump blood quite effectively when its two upper chambers are fibrillating, but with the atria just quivering during fibrillation, rather than contracting normally, blood sometimes clots in their appendages. Those clots may break loose and thumb a ride in arterial blood (as an embolus) to the brain, or other organs, thus plugging up a small artery and causing a stroke, or other damage.

            I had a couple of minor versions of a stroke, those called transient ischemic attacks, in which I lost partial sight in one eye for just a couple of minutes. Again, thanks to my earlier training, I was pretty sure what was going on, and the spots showing up in my brain in more recent CAT scans and MRI screens seem to bear that out.

            Even with my relatively small risk of going into atrial fibrillation, I now take an oral anticoagulant, a blood thinner if you prefer, to minimize clot formation should I happen to slip into fibrillation again. The drug I take is effective and has relatively few side effects. It was approved for use only a couple of years ago, another example of lucky timing on my part.

            I’ve also had a few skin cancers, basal cell types that almost never metastasize, and a squamous cell type that usually metastasize late, every one skillfully excised surgically, or frozen off, and all thus cured. I also developed a deeper cancer four years ago, a tumor treated with high-intensity radiation. From all indications that therapy, also quite new and even revolutionary, routed my cancer completely.

            Quick summary. Without the above medical care, my way to 90 would have been bumpier, or knocked entirely off track by one problem or another, reason enough for me to honor the many men and women who made those marvelous advances possible. Thanks to all of this progress, I seem to be ticking along just fine, and feeling great!

            Finally, I must give myself a bit of credit too. Keeping active surely was a plus. I’ve always enjoyed keeping my bones in motion. I played tennis until I had a knee replaced (another great intervention that has lifted my life tremendously, and one not available when I was younger). I still walk extra miles and mess with weights. It’s well established that physical exercise turns on good genes, so I’m confident my gene pool benefits from my activity.  A good reason for me to keep at it! And for you too!

            Next time I’ll nose into the science of aging. You’ll be amazed by all that’s going on.