The Middle-Aged Genius’s Guide to Almost Everything 37 – “Age, I do abhor thee; youth, I do adore thee”
June 28, 2019
[Beginning of recorded material]
Scott Douglas Jacobsen: When you were younger, how did you look at middle-age? Now, that you’re older; how do you look at it?
Rick Rosner: My objective has been – once I got the not trying to get laid squared away by getting married – to live long enough to live a lot longer with vitamins and exercise. Although, as a younger person, my goal was to exercise to look good enough to get laid. That changed. I thought I had been doing okay for quite awhile. I turned 59 last month. I don’t feel seriously debilitated. I feel like a lot of people by age 59 are not in the best shape.
I feel like in previous generations, for a lot of people, 59 was, at least, the beginning of old age if not being into well into it, but then in March; I got diagnosed with a kidney tumour. That thing was taken out three weeks ago. I had to wait a long time because the surgeon likes the robot surgery setup in UCLA. There’s a long waiting list. He said with a tumor like this. You don’t have to get it out immediately. I would have liked it sooner, but there’s not an increased risk in waiting the couple of months I had to wait to get it out.
I got the pathology report. Its characteristics mean that I am at low risk for recurrence at stage 1A, Fuhrman grade 2 out of 4, which most tumours of this type are. The overall risk for recurrence within 10 years is less than 10%. Nevertheless, I feel like the mortality clock is ticking for me, which it didn’t feel like to any great extent before this happened.
Then earlier this week, when one of my teeth disintegrated when I was eating an old piece of pizza, they had to pull it. They are going to build a bridge by installing a piece of porcelain going over the two adjacent teeth with a fake tooth floating in the middle, which feels like old people stuff. I am down to 30 teeth. It is probably more teeth than most people. Most people do not keep their wisdom teeth. I have 3 of mine.
Still, it feels like I am falling apart. Although, I didn’t miss a day at the gym. I am back up to almost to the weight I was lifting before the surgery. But still, it feels like there is more of a ticking clock. My stepdad was first diagnosed with cancer when he was around 56. They took it out. He got another 12 years. It came back. He took it out again until another 7 or 8 years until it killed him.
I don’t know if I am looking at the same kind of deal. Although, he died in 2006. If I get 12 years or 20 years before recurrence, we’re looking at the 2030s. By then, there should be a lot more tools to go after cancer. I feel like most cancers will be solved by the 2040s. Although, I’ve read a lot of kidney cancer, all cancers, since being diagnosed. What makes medicines effective against a lot of cancers is that there are proteins that the medicine can latch onto, but I read only 2% of proteins – most stuff is made out of protein, protein is what medicine latches onto. Only 2% of proteins are latch onto-able.
They have a handle medicine can grab. Maybe, thinking most of medicine can be solved by 2040s is optimistic, however, by 2030, there will be more to fight cancer at that time than what my dad had in the 2000s. The tips based on this are continuing to maximize odds of being well by engaging in healthy practices, including getting checkups that maybe people don’t even get.
I wouldn’t have caught the tumour. Unless, I asked for some blood tests to make sure everything was okay. Some of my blood numbers were a little off because I lift weights too much and have muscle waste in my urine. It led to an ultrasound because it seemed suspicious. Ask your doctors for tests because some of the nastiest shit that you can get doesn’t cause symptoms, until it is pretty much too late: pancreatic cancer, kidney cancer.
Get all your scheduled checkups and then see about getting some more on top of that because diagnostic technology continues to improve, with kidney cancer, 60% of tumours are now caught at an early stage before they cause any symptoms. Those 60% are largely survivable. Also, if you get diagnosed with something, read as many papers as you can, as you can find online, about what you’re diagnosed with, and its various treatments and propose treatments.
I have a young doctor who works at a major medical center. He has read everything I have read. But I have had other doctors at other times who struck me as not being super up on things even if it wasn’t their specialty, especially when it wasn’t. You won’t understand everything that you read, but you will understand the landscape for your health issue.
You’ll get statistics on what you’re facing and on treatment options. There’s a lot of stuff out there. It is scary. But you ought to research and advocate for yourself, particularly in a country like America where medical treatment is expensive and hospitals and medical practices try to bill as much as possible knowing that in not all cases will they recover what they have billed, because insurance companies are resistant to pay the full bill price.
Individuals may be uninsured or underinsured. It is a terrible system in the U.S. My surgery, everything included was billed at roughly $60,000. It included an overnight stay in the hospital. That $60,000 probably double the actual cost of the procedures, but the hospital has to bill it because they are not going to get that $60,000 from everybody.
Basically, everybody in America has to overbill in America because they don’t recover the full billed price in America. Things are probably more rational in Canada, where everybody’s stuff is paid for under a different system.
However, even in places like Canada, good medicine is expensive. Let’s say it was billed at half of its cost, it would be $30,000, or even $25,000 or $20,000. That’s still a lot of money. Good medicine is expensive, which means that there’s a potential shortage of medicine for people. For instance, if I had been in a higher risk group for the kidney cancer, there were chemos and biologicals (what they call them), which are sophisticated drugs to try to knock down any remaining, recurring cancer.
These things can cost $10,000 a month for a year. So, that’s as much as a house in a lot of places. You have to read up, so you can advocate foe yourself and argue for more expensive treatment options if you feel that they are justified. The most commonly prescribed chemo drug runs many of thousands of bucks a month.
I read and found out it goes semi-generic in February, 2021. So, if I were in a higher risk group, then it would be handy to know. If the doctor said, “No, I cannot recommend it. We cannot justify five you this drug. It is expensive. You’ll be physically debilitated. It’ll cost you out the butt. Your risk profile isn’t such that it is justified.”
At least, I would know to ask, ‘Would it be justified in February, 2021, maybe when the price drops by 90%?” They said, “No, no, it’s not for you, not in your current situation.” All that stuff is good to know. In other episodes of this thing, we talked about how getting into college in America is a mess because not everyone has access to a concierge-level guidance counsellor who knows everything about getting into elite colleges and who has connections at those colleges.
If you don’t have access to somebody who provides that level of service, then you have to assemble all of the information from a bunch of different sources. It is a mess. It is similar with medicine. In the US, given the number of different forces, e.g., economic forces, pulling medicine in different directions, the rate of change in medicine, the new stuff that comes online, the new clinical trials that become available. Drugs that might be approved for use in other parts of the world and not in America, and vice versa.
You need to become your own scholar and own advocate. Even if you are not diagnosed with anything, in your 50s as a guy, and late 50s as a woman, you should really become an expert on what is available in terms of diagnosis, in terms of things to do to make yourself healthier. For instance, I think Silver Sneakers is a nationwide program in America, where once you’re available for Medicare; a lot of policies include a health club membership.
There are thousands of programs across the country, I think. Silver Sneakers is a terrible title. It reminds you of old people walking across malls in America for exercise. A free gym membership or being able to use thousands of gyms across America; that’s a great deal.
[End of recorded material]
American Television Writer
Scott Douglas Jacobsen
Editor-in-Chief, In-Sight Publishing
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