Let me begin with my eyes. I first got glasses when I was 8, around the time when JFK was assassinated. I have a distinct memory of the drive back home from the place where we got the glasses. It was nighttime. The streetlights seemed so much brighter; everything appeared much clearer. Alas, that sensation didn't last. And for much of adult life my vision has been somewhat off, even with the correction provided by the glasses. For the past 20 years or so I've had bifocals - the continuous kind. While I was quick to adjust to those, I'm never really sure whether I'm looking at something through the right part of the lens. Since then I've been diagnosed with the triple whammy - macular degeneration, glaucoma, and cataracts. I've got friends my age who have had surgery to remove their cataracts, but they didn't have the other issues. My optometrist, instead, has me on a regime of eye drops, 3 times a day with dorzolomide and once a day with latanoprost. In addition, I take an eye vitamin pill twice a day, currently PreserVision. I then go for checks at the doctor's office on a regular basis, some of which is just to monitor pressure in the eyes while the rest is to check field of vision. My right eye has already declined some in that regard. The left eye is better. But there is no expectation that the deterioration will reverse course and begin to show improvement. The goal now is to slow down the decline.
I've made various accommodations to deal with the situation. One of those is relying on my Kindle Fire when I read books, where the font is large and there is substantial line spacing that I've inserted. I now much prefer that to reading paper books. My main computer is an iMac and I keep the screen resolution quite low, so items look large. That works for me. And then, as to driving, I try to avoid doing it at night, particularly in areas where there aren't streetlights. With this I function reasonably well. If my vision were to deteriorate much beyond where it is now, I'm not sure whether I could find a suitable alternative approach, so I'm hoping I don't have to anytime soon.
Let me move on to my other health concerns. For more than 20 years, there have been three foci of those concerns. One of those is my weight, which was close to normal when I got married in 1990, but after 9/11 it ballooned upwards as my knees gave out so I could no longer go jogging for exercise. And, foolishly, I didn't find an immediate substitute exercise activity. I was extremely busy at work, so I let that absorb this other time. In retrospect, it was a big mistake. I want to note here something I've only come to realize recently. While a singular event that causes me stress can be dealt with in an undo way, I need a healthful response to repeated sources of stress or it will be debilitating for me. In my case it wasn't just the overeating and lack of exercise. It was drinking too much as well. And all of that becomes habitual. Bad habits are hard to break. When the subject matter is not my own person, I can be objective, logical, and sometimes insightful. It makes you wonder how I could be so stupid when it came to my own health. But, no doubt, I was.
Another focus was my blood pressure, which also was quite high. I received medication for that to keep it under control. Initially, that was lisinopril/hydrochlorothiazide, which I took twice daily. After several years of that, I began to show improvement (from lifestyle changes) so the dosage was reduced to once per day. Eventually, even that seemed like too much medication, so I went to straight lisinopril. But that was less than effective so I went back to hydrochorothiazide, as a separate pill. It worked to lower the blood pressure but it has a negative side effect on my feet. So now I take it every other day, while taking the lisinopril every day.
The third focus was physical pain, mainly due to arthritis, to which I'm genetically disposed. The issue is how to contain it or avoid it entirely. Over the years, I've had physical therapy sessions with multiple therapists, to address different loci of pain. And while I'm told to do exercises that are taught in those sessions, the reality is that I stick with those as long as the therapy sessions are ongoing and then for a while longer, after which the pain seemingly goes away, and then I stop doing the exercises. I think the psychology of this is understandable as the exercises are something of a nuisance, but that is not a real excuse for making this mistake.
Now let me make an aside, which is relevant for what follows. In 2018 I was diagnosed with prostate cancer, for which I ultimately received radiation treatment. The cancer is now in remission, tracked by an annual PSA blood test. Here is the real point I want to make. As prostate cancer is eminently treatable, and as I later learned most men will get it eventually if they live long enough, in itself it wasn't that big a concern. But the oncologist made it clear that there was a risk the cancer could spread to nearby bones or other tissue. That thought truly frightened me, as it was the first time that I really contemplated my own mortality. More than one scan was done to see if the cancer had indeed spread. Those scans turned up several false positives. I learned that the scans themselves don't distinguish well between cancer and arthritis spots, one needs additional diagnostics to identify which it is, and that arthritis actually riddles my entire body, even while at many of those sites there is no pain. My fear of dying in the not too distant future disappeared, but fear that I will face a lifelong struggle with pain thereafter intensified.
Later that same year I was experiencing a lot of pain in my right hip and my lower back. I saw an orthopedist, who said I was a candidate for a hip replacement. My mom had many of those and each time the hip would get infected, so the prothesis had to be removed. Armed with this knowledge, I was concerned that I would have a similar experience if I had this procedure. So I opted to delay and in the meantime try to lose a good chunk of weight, thereby increasing the likelihood that the procedure would not create undo complications. I now had incentive to lose weight for other than vanity reasons. (As I sometimes fret about the gray hairs in my eyebrows, I certainly don't want to claim that I'm not vain, yet that has never given me sufficient reason to diet seriously.) And then I learned from experience that the weight loss itself might very well lessen the pain in the hip and the back. Had I understood that ahead of time, I might have done more about weight loss earlier.
Let me fast forward to the present. I still haven't had a hip replacement even though I've lost 100 pounds since 2018. In 2025, the orthopedist said that there are so many other things going on in the area of the hip that I'd still have substantial pain even with a hip replacement and I'd be better off having the pain doctor address my situation. He had me get physical therapy, for itself and partly as a necessary preparation to be eligible for a steroid injection in my back, which I subsequently got. At the time I started physical therapy I couldn't walk 1/4 of a mile. Now I can go for long walks. Earlier this afternoon, I was able to do about 5 miles at an estimated 20 minutes/mile. That's been my recent experience when I walk outside. (Champaign is comparatively flat with the few hills we have quite modest.) On the treadmill I don't walk for as long but I do go faster. I much prefer to be outside, if it is warm enough for that. But when I'm inside I do a bit of other exercise that maybe I should be doing once in a while in any event. I try to do some exercise at least 5 days a week unless I'm really hurting. Playing through pain is for young people, but not for me.
Here is one other episode to round out the picture. In early 2023 I was having abdominal pain and felt very gassy. I was diagnosed with SIBO (Small Intestine Bacterial Overgrowth). Subsequently I had a colonoscopy which found I had a tortuous colon, a partial explanation for the SIBO as well as why I'd likely experience constipation with some frequency. For the SIBO, they also tested for intolerance to certain foods; lactose is the one I remember; I didn't have lactose intolerance. And maybe they did gluten too. An antibiotic was prescribed and I was put on a Low FODMAP Diet. That was a 6 weeks regime. It's the lessons I took from that experience that really matter for now. Berries and other fruits became a staple of my diet, as did green vegetables. Now I restrict my carbohydrate intake quite a bit, almost never having pasta or white potatoes, bread (whole wheat) only in limited quantities, also modest amounts of protein mainly chicken, lean pork, salmon, cod, and tuna from a can. (I gave up beef in 2018 when my urologist said that doing so was a way to keep the prostate cancer from coming back.) And I seem to have stopped eating ice cream, something I would never have predicted in advance. My weakness is the occasional sweet roll at breakfast time. I'm particularly vulnerable to those extra large chocolate chip cookies which seem in vogue now. So as to the diet it isn't an absolute thing, but I don't stray too far from where I want to be. And then, once in a while, I will skip a meal or two, either because I simply don't feel hungry or because I was a bad boy the day before and want to make up for that.
I wish the story would end there, because that's the picture I'd like to paint. But my experience is that aging seems to move the goalposts with regard to health. The first sign of this for me was when my blood tests started to show a high Creatinine number, an indicator of some issue with the kidney. While my Creatinine number is now in the normal range, they started to measure the GFR (Glomerular Filtration Rate) and while mine has bounced around some it has been consistently below 90 (the cutoff for normal) with the most recent reading being 68. Based on that evidence I've been diagnosed with Stage 3A of Chronic Kidney Disease. Apart from the other steps to promote good health that I've mentioned above, I need to stay hydrated (nighttime is a challenge for this because I go to the bathroom frequently and I don't want to increase the frequency by drinking water then) and to avoid salt as much as I can. While I never salt my food, I do wonder how much salt I take in with processed food, such as tunafish or canned chick peas. If it comes down to that, I will need to get somebody else to do my food preparation, a person who can take explicit steps to reduce the salt in the food.
Then, a couple of years ago, I was diagnosed with a fatty liver, based on what the blood tests showed. The AST was a bit high in November 2024, though it has come down since. The ALT has been normal throughout the time that it has been measured. Based on this I had a FibroScan in April 2025. The CAP score was high then while the Liver Stiffness score was normal. I was told to lose weight, which I've done. The FibroScan was repeated just 9 days ago. The CAP score had come down into the normal range. Hurray for that. But the Liver Stiffness score jumped up and now I'm in Stage 2 of a Fibrosis diagnosis. (Stage 4 is consistent with cirrhosis of the liver.) I've been told to give up drinking alcohol. You'll pardon the pun, but that's a tough pill to swallow. However, mainly out of fear I've been on the straight and narrow for the last 8 days. Sticking to this regime is another matter. Writing this post is one way I'm trying to come to grips with that.
I have learned a few facts about Fibrosis. The good news is that it is reversible, provided the liver damage isn't too bad. So I can hope that if I do stick to a regimen of not drinking alcohol that eventually I will go back to Stage 0 and Fibrosis won't be a concern. Then my brother, who is a doc, told me that there is something called a FIB-4 score, which makes a probabilistic Fibrosis forecast based on the results from a blood test. (It would be nice if the FibroScan and the blood test painted a similar picture.) My current FIB-4 score is 2.3, a middling number that I suppose corresponds reasonably well to a Stage 2 diagnosis. The last thing I learned is that it can take months and months of abstinence for the results to show up, though 6 months should be sufficient to detect any changes. Alas, the way health insurance works these days, my next blood test and FibroScan will be a year from now.
This makes the not drinking quite different from the dieting, where I can weigh myself on a daily basis, and the monitoring of my blood pressure, which I can also check at my whim. I won't get feedback on the not drinking for quite a while. I need to take it on faith that progress is being made. There is a well-known paper (to economists) by Koopmans called Measurement without Theory. This is theory without measurement. I find it somewhat unsettling.
But I do know a couple of things from my own casual empiricism in regard to my own drinking. If I have more than one drink, it tends to raise my blood pressure and dehydrate me. Further, my self-control is diminished so with regard to eating those bad things - chips, candy, leftovers that should be saved for tomorrow - I'm much more prone to do so after a couple of drinks. These reasons provide some evident motivation for abstinence.
I've also learned a few ways to cope. Recently I've taken to drink decaf on the rocks, in a tumbler which I haver previously used to have some alcoholic drink on the rocks. The feel in my hand is the same. The taste is obviously different and I'm prone to drink the decaf quickly where I would try to slowly sip the alcohol. It is not a perfect substitute, for sure, but it is something. And I've taken to having non-alcoholic beer on occasion, with my favorite being Coors Edge. This is closer in taste to the Real McCoy, but without the kick. Let me get back to that because it gets to the motivation for drinking alcohol.
And I've taken a page from the book Nudge by Sunstein and Thaler, on how to discourage the drinking up front. Again, my casual empiricism suggests, that my wanting to have an alcoholic drink is dependent on time of day. It is nil in the morning and early afternoon. Then it begins (it must be 5 PM somewhere - the time when Happy Hour starts) and probably continues for several hours thereafter. If I go to sleep early, which is my own personal nudge, I don't need to be disciplined that long and then can go the entire evening without drinking. When the Illinois Basketball game starts late and I feel that fan loyalty means I should watch it live rather than view a recording the next morning, that presents a challenge and I'm more prone to drink then.
Now let me briefly discuss motivation for drinking and then try to bring this post to a close. As a habit, it can be a form of celebration. It can be enjoyed for the taste as it is consumed rather than for the after effects. When I drink alcoholic beer and I'm the one who buys it, how it tastes matters a great deal. Both of these I would term drinking for pleasure. Sometimes, however, when the arthritis pain seems especially intense, and the Tylenol I take doesn't seem to be that effective in reducing the pain, then the drinking is done as a way to feel numb to it all, an alternative to taking a narcotic. The numbing also seems needed when I'm feeling heavily under stress and want some relief from that. It would be healthier if I could reduce or eliminate the source of the stress in advance. This is one real reason why I have greatly reduced reading the news. Absent that source reduction, however, the stress becomes very much like a physical pain and then one drinks to numb that. Taken together, these reasons can make drinking habitual, which it has been for me.
But, I hope what I've written above indicates that I've taken real effort to break that habit. However, I have not gotten anywhere close to complete abstinence. And I'm scratching my head now as to what else I need to do to achieve that. Further, if the reality is abstinence much of the time but still the occasional stumble, how do I limit the damage of those episodes and then get right back on the horse? I don't have an answer to that question as of yet. For now it seems to me that if I do try to answer it I might encourage the initial stumble.
I have an appointment with the nutritionist who ordered the FibroScan. That appointment is 20 days from now, not quite a month after the scan was done. It seems a good time to take a reckoning on these matters. In the meantime, I've thought it through about as much as I can for now and I aim to take it one day at a time till then.
