Aging in Metro Detroit: You Can’t Fully Avoid Health Concerns in The Trial Years

What you need to know from ages 19-33

trial years

The trial years — ages 19-33 — are the years in which people discover themselves. Usually they’re able to live with little concern about health, but they aren’t totally off the hook.

Everyone knows the costs of addiction — but what about the price of recovery?

When Dr. Julia Aharonov, owner of the Advanced Rapid Detox facility at Pontiac General Hospital, receives calls from parents who are seeking addiction treatment for their children, she makes one request: that they have their child call on their own. It is critical that patients in their 20s to early 30s be invested in completing their own recovery, she says.

“With this program, I find that young people are more successful when they’re very, very determined and very motivated,” Aharonov says. “This isn’t an intervention program. It fixes only the physical part of addiction.”

Most of Aharonov’s patients from ages 19 to 33 come to her for issues with heroin and fentanyl addiction. Patients often turn to these drugs because they are relatively cheap substances often used to self-medicate conditions like PTSD, depression, and anxiety.

“…I find that young people are more successful when they’re very, very determined and very motivated.”

— Dr. Julia Aharonov

Many of Aharonov’s younger patients become addicted to opioids prescribed to treat an athletic injury. Others are exposed to them socially. It’s also not unheard of for some patients to have a genetic predisposition for addiction, she adds. 

In her experience, the older the patients are within this range, the more likely they are to recover, Aharonov says. Patients in the middle of the trial years — between 26 to 28 years old — for example, may have lost their best friend or spouse to a drug overdose. In some cases, they have children that they need to support. These are strong motivators that push patients to do well after treatment.

Patients within this age range may have a hard time affording care. Even if they are on their parents’ insurance plan, Aharonov says they and their loved ones may not have the money to pay tens of thousands of dollars for rehab treatments.   

“What is your child’s life worth?” Aharonov asks. “Parents pay $40,000 a year for a child’s college costs at 18 and 19 and 20 … If they have a college fund, wouldn’t you rather pay to save your child’s life as opposed to for their funeral?”

Talking to your doctor about colorectal health can make a difference in the trial years

By the time many of Dr. Amir Damadi’s patients between the ages of 19 and 33 come into his office, they’re already either experiencing pain or changes in their bowel movements or are concerned about a mass. Generally, these patients are suffering from constipation or diarrhea, says Damadi, a colon and rectal surgeon who practices at locations in Southfield, Novi, Livonia, and Howell.

In this cohort, lifestyle and family history are often the major clues for diagnosing their colon and rectal issues. Patients within this age group may not be able to eat at predictable times due to their work or school schedules. This kind of irregular eating schedule, along with a low-fiber diet, irritable bowel syndrome, hemorrhoids, fissures, or a family history of colon cancer at a young age could be the cause behind bleeding or irregular bowel movements, Damadi says. He adds that a colon cancer diagnosis is rare but not impossible within that age range.

Patients in their 20s and early 30s typically are eating out at restaurants and are not getting a balanced diet, which can affect their bowel movements, Damadi says. He also has to advise his patients not to over clean. He recommends avoiding the use of over-the-counter hemorrhoid cream for too long and washing with soap, which removes the body’s protective layer.

Among his patients in their 20s or early 30s, one common barrier to recieving care is a high insurance deductible, which often discourages patients from coming in for an appointment unless the problems persist, Damadi says. But once the symptoms are severe enough to warrant a doctor’s visit, they’re no joke.

“Pain, obviously, it affects them significantly. It’s hard for them to sit. It’s hard for them to get comfortable … It’s not a thing you can just shut down,” Damadi says. “If they’re bleeding, a lot of times they’re embarrassed. Sometimes they bleed through their clothing … That affects their daily routines.”

Even among those fresh from pep rallies and homecoming games, cancer is a source of anxiety

Chances are, patients who are visiting Dr. Ramachandra Kolachalam aren’t experiencing terrible pain, but they hope to find out whether they are at risk of having cancer.

“Most of them are coming in — they’ve had a biopsy, and there’s a concern of cancer,” Kolachalam says. “Even though their quality of life is not affected in terms of being able to eat and drink and live a normal life, their concern is the possibility of cancer.”

Admittedly, Kolachalam typically sees patients in their 40s to 80s. However, among his younger patients in the trial years, he has seen individuals who have questions about their thyroid gland, concerning biopsy findings, worrisome genetic testing results, or parathyroid disorders.

“Even though their quality of life is not affected in terms of being able to eat and drink and live a normal life, their concern is the possiblility of cancer.” 

—Dr. Ramachandra Kolachalam

Though genetic testing isn’t the only metric by which Kolachalam assess patients’ malignancy risk, it is an emerging tool for understanding the patients’ odds of cancer. He has seen patients who — despite biopsy and genetic tests pointing a high cancer risk — may not have thyroid cancer after all.

Kolachalam says he typically looks for exposure to radiation and a family history of thyroid illnesses, but family history of endocrine disorders are less common than radiation exposure. He occasionally treats patients who live in close proximity to a nuclear power plant near the Monroe and Toledo areas, but cancer treatment is the most common reason for radiation exposure for most patients.

“If I am not convinced it’s serious enough that I should suggest the possibility of a surgical cure, a surgical procedure, I encourage them to get a second opinion,” he says.