Aging in Metro Detroit: Tackling Health in The Transitional Years

There’s plenty to look forward to from ages 49-64
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transitional years

There are many things worth celebrating in the transitional years, which includes ages 49-64 and is considered the period between adulthood and old age. The top of that list includes the fact that 50 year olds are the best at arithmetic.

COPD is often mistaken for another chronic condition, but the reality is far more deadly

Chronic obstructive pulmonary disease is on the rise thanks to the baby boomer population bulge. The disease is now affecting Dr. Steven Stryk’s allergy and immunology practice. That’s because the symptoms of the condition, which is treated by lung specialists, resemble those of asthma, which is treated by allergists. Those symptoms are coughing and shortness of breath.

COPD, which is an umbrella term for chronic bronchitis and emphysema, is the third leading cause of death by disease globally, up from the fifth leading cause of death about 15 years ago, according to the World Health Organization. In the U.S., it accounts for more than 100,000 deaths yearly. That’s roughly the population of Dearborn.

The nexus of COPD and asthma symptoms is among the top three reasons patients ages 49-64 make an appointment to see Stryk in his Canton and Novi offices. The other two reasons are allergies and frequent respiratory system infections, including sinus and ear infections and pneumonia.

“A couple weeks ago, I diagnosed a 62-year-old woman with stage 3 or 4 COPD. She had no idea she even had it,” Stryk says. There are four stages of the disease, and the fourth stage is the most severe.

Because of the overlap in symptoms, Stryk is well familiar with pulmonologists in his area, which means making a referral wasn’t difficult.

“A couple weeks ago, I diagnosed a 62-year-old woman with stage 3 or 4 CopD. She had no idea she even had it.”

—Dr. Steven Stryk

It used to be that COPD affected men more often than it affected women, but that changed, and the disease became an equal opportunity malady after more women took up cigarette smoking in the late 20th century. Cigarette smoke, whether from actually lighting up or from second-hand, is the leading cause of the disease in the U.S. In poorer countries, the main culprits are biomass fuels used for cooking and home heating.

Health care providers have many ways to treat COPD, such as medications, pulmonary rehab, oxygen therapy, and surgery, but primary prevention by not smoking is the best step, by far, Stryk says.

“Nobody in the U.S. should start smoking, which includes electronic cigarettes and vaping, and if you can avoid significant air pollution you should do so,” he says. “This very simple step could prevent the majority of all COPD in this country.”

A report by the U.S. Preventive Services Task Force may have had a negative impact on men’s health

Dr. Jeffrey Schock sprinkles words like compassion, kindness, and make the patient comfortable into a conversation about being a urologist. That may be because the biggest complaints Schock hears in his Livonia, Novi, and Warren offices from male patients ages 49-64 are about intimate issues: prostate problems and erectile dysfunction.

But bring up the subject of discouraging universal screening of prostate-specific antigens (PSAs) for middle-aged men to detect prostate cancer, as the U.S. Task Force did in 2012 due to over-diagnosis and over-treatment, and another word comes to mind — anger. The task force softened its recommendation last year. It now says men ages 55-69 should consult with their doctor about whether to have a PSA test. But that news doesn’t seem to have traveled very far, Schock says.

Now men are being tested less frequently and often come in with higher PSAs, which can signal cancer or other conditions, when they seek treatment. At this point, their disease is more advanced and no longer curable, Schock says. “Many patients come in and it’s spread to their bones, and they look at you and say, ‘Could I have caught this early?’ ” he says. “What do you say to that?” His solution is to have his patients get a PSA every year, but only after he talks with them first.

He also has another issue with the Task Force: There wasn’t a single urologist on the 18-member panel. Credentials reveal there were epidemiologists, pediatricians, family medicine, internal medicine and geriatric medicine specialists, and even two gynecologists, but no urologist.

The fact that PSAs are so cheap also riles up Schock. “To bury your head in the sand and not evaluate this for a $3 blood test I think is inappropriate.”

Sports medicine doctors are finding more effective ways to ensure you’re not getting slower in the transitional years

You don’t have to be a Tom Brady or a Megan Rapinoe to visit Dr. Asheesh Bedi, sports medicine specialist. “Often times, sports medicine elicits the connotation that we’re just caring for the elite Division-1 or professional athlete,” says Bedi, chief of sports medicine and shoulder surgery at Michigan Medicine based in Ann Arbor. “But the reality is that sports medicine is a specialty dedicated to preserving function for lifestyle activities, including sports and allows people to enjoy those activities across their lifespans.”

That includes people ages 49-64 who are starting to feel the effects of aging or new injuries. At those ages, tendons become more vulnerable; there’s an increased incidence of rotator cuff and other tears; and cartilage degrades to the early stage of arthritis. However, Bedi says we’re in an exciting era for sports medicine because it offers new surgeries and cutting-edge treatments that can help people in all age groups as never before.

“Sports medicine … allows people to enjoy activities across their lifespans.”

—Dr. Asheesh Bedi

“We’ve had a rapid advancement [not only] in our ability to treat these injuries in a minimally invasive way, but now even to augment the healing of these injuries with new biologic treatments,” he says. “Minimally invasive surgery and biologics let people pursue activities into increasingly later stages of life and even, to a degree, put off treatments for arthritis, including joint replacement, for years. “At times we can change the natural progression of those problems.”

The biologics — so called because many are made from living organisms — include platelet-rich plasma, growth factors, and stem cells. Some of these therapies are cleared by the U.S. Food & Drug Administration, while some are still under study.  “There’s certainly optimism with them, but there are more unknowns than knowns,” Bedi says.

On the surgical side, Bedi has seen growth in minimally invasive arthroscopy for repairing and reconstructing various soft tissues, like muscles and tendons. “When it comes to the surgical treatment, the core of sports medicine remains repair of soft tissue, reconstruction of joints, and injuries that occur in joints,” Bedi says. “Our goals are really ultimately set by what the patient’s desires are.”

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