Comments on: Let's get normative! Octogenarians and heart surgery http://onthepharm.net/2008/10/senior-heart-surgery.html Life on the pharm Mon, 26 Jul 2010 18:29:42 +0000 hourly 1 http://wordpress.org/?v=3.0 By: Earl C Morris http://onthepharm.net/2008/10/senior-heart-surgery.html/comment-page-1#comment-182320 Earl C Morris Sun, 23 Nov 2008 13:15:32 +0000 http://onthepharm.net/?p=447#comment-182320 I take long lunch breaks all day to do whatever i want! I take long lunch breaks all day to do whatever i want!

]]> By: drbganimalpharm.blogspot.com http://onthepharm.net/2008/10/senior-heart-surgery.html/comment-page-1#comment-182306 drbganimalpharm.blogspot.com Sat, 22 Nov 2008 16:48:07 +0000 http://onthepharm.net/?p=447#comment-182306 Heart disease is preventable (and so is afib, and thus coumadin therapy as well). If silent inflammation is controlled, then many chronic disease states can be controlled without medications (or at least much less -- don't worry -- us rph will still have jobs). I think Americans will always expect 'heroic' measures for non-heroic diseases. How do we add quality to our years? And not just numerical meaningless years...??? I certainly don't want to retire from pharmacy and have degraded movement/hearing/vision/sight/etc whilst injecting insulin, popping coumadin and 'limiting' my greens, despite all the fancy pharmacogenetic testing...which will probably be administered by new graduating classes of pharmacists -- betw MTM, counseling, filling and 15-min lunch breaks (I'm being sarcastic *ha*). -G Heart disease is preventable (and so is afib, and thus coumadin therapy as well). If silent inflammation is controlled, then many chronic disease states can be controlled without medications (or at least much less — don't worry — us rph will still have jobs).

I think Americans will always expect 'heroic' measures for non-heroic diseases. How do we add quality to our years? And not just numerical meaningless years…??? I certainly don't want to retire from pharmacy and have degraded movement/hearing/vision/sight/etc whilst injecting insulin, popping coumadin and 'limiting' my greens, despite all the fancy pharmacogenetic testing…which will probably be administered by new graduating classes of pharmacists — betw MTM, counseling, filling and 15-min lunch breaks (I'm being sarcastic *ha*).

-G

]]> By: Cathy Lane RPh http://onthepharm.net/2008/10/senior-heart-surgery.html/comment-page-1#comment-181940 Cathy Lane RPh Thu, 30 Oct 2008 21:43:48 +0000 http://onthepharm.net/?p=447#comment-181940 I would have to say that 'yes', I don't like that question. Defining 'productivity' in our elderly 'living treasures' may not result in increased (economic) GNP, but if the quality of life can be maintained, then the benefits of expending required effort, and way of valuing our elders may have to measured in other ways than in tangible and measurable work output. Gerontologists and healthcare economists may be developing different cost-benefit analysis algorithms in the future. I don't really know. Maybe this is commentary on the dearth of workers in the aging population, due to decreased childbearing and what those one-issue voters would decry as the scourge of an abortion-happy society? I know that there are pockets of societies throughout the world in which average lifespan is quite high compared to others. I can imagine that in order to live that long and so well, that the octagenarians live a rigorous and vigorous lifestyle. Now, in opposite circumstances with elderly in poverty-stricken nursing home 'farms' (deliberately provocative scenario) whether someone can say that there's a quality of life in 'artificially' maintaining lifespan of living tissue may be a different matter. I went to a regional symposium on arrhythmias and HF earlier this month. In an open forum, a panel of cardiothoracic surgeons were asked what the age of the eldest patients they performed open heart surgeries. I recall answers generally were in 90's. It seemed that if the patients were well enough to reach that age and still be able to tell the doc to go ahead and do it, and chance for full and complete recovery was technically good, the docs felt compelled to go for it. I would have to say that 'yes', I don't like that question. Defining 'productivity' in our elderly 'living treasures' may not result in increased (economic) GNP, but if the quality of life can be maintained, then the benefits of expending required effort, and way of valuing our elders may have to measured in other ways than in tangible and measurable work output. Gerontologists and healthcare economists may be developing different cost-benefit analysis algorithms in the future. I don't really know.

Maybe this is commentary on the dearth of workers in the aging population, due to decreased childbearing and what those one-issue voters would decry as the scourge of an abortion-happy society?

I know that there are pockets of societies throughout the world in which average lifespan is quite high compared to others. I can imagine that in order to live that long and so well, that the octagenarians live a rigorous and vigorous lifestyle. Now, in opposite circumstances with elderly in poverty-stricken nursing home 'farms' (deliberately provocative scenario) whether someone can say that there's a quality of life in 'artificially' maintaining lifespan of living tissue may be a different matter.

I went to a regional symposium on arrhythmias and HF earlier this month. In an open forum, a panel of cardiothoracic surgeons were asked what the age of the eldest patients they performed open heart surgeries. I recall answers generally were in 90's. It seemed that if the patients were well enough to reach that age and still be able to tell the doc to go ahead and do it, and chance for full and complete recovery was technically good, the docs felt compelled to go for it.

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