Q: I hear that too much stress can change your cells so you develop serious health problems. How does that work, and how do I avoid it? -- Chris V., Manchester, New Hampshire
A: That’s true, and here’s how it happens: There are two forms of stress -- physical stress (caused by smoking, illness or overexercise, for example) and psychological or emotional stress (when your stress response to worries or personal conflicts taxes you). Both disrupt healthy physiological processes and, in the long run, trigger inflammation.
With physical stress caused by smoking, for example, the irritation and inflammation from toxic chemicals in the smoke can make lung tissue and mucosal cells go rogue. They mutate and begin to function in ways that are harmful to your body (cancer, for example); it’s called metaplasia. Overwhelming physical stress has been shown even to disrupt the development of eye cells in mice, resulting in blindness.
Emotional stress causes health problems, too. A stress response that’s triggered by your worries about problems such as your job or relationships leads to elevated levels of stress hormones (cortisol and epinephrine) that spur the accumulation of abdominal fat. That produces bodywide inflammation that damages your cardiovascular and organ systems, your immune-fighting capability and even contributes to brain dysfunction. There’s a good chance this reaction can cause harmful cellular changes.
Stress is so great in America today that we all need to find a way to deal with it.
Here are two great stress-busters:
▪ Acting generously. Researchers found that the Meals on Wheels program provides benefits not only to the elderly who receive the food and companionship, but to the providers as well, who report lower rates of depression and higher levels of physical wellbeing.
▪ Online stress-reduction programs and apps. Try sharecare.com’s free stress-busting program.
Q: I’m 87 and having a knee replacement. I’m healthy and active, but concerned. How can someone my age make sure to get the best treatment during and after surgery? -- Bev G., Ketchum, Idaho
A: You sound like a wonderful example of the new wave of super-seniors! About 2 million folks in North America are 90 or older, and they’re proving that you can stay healthy and happy even if you need an operation to replace a worn-out knee.
So to protect older surgery patients, the American College of Surgeons and the American Geriatrics Society have issued guidelines to help assure the best possible outcomes. They’re worth knowing, so you can talk to your doctors about them before you head in for your operation.
Before the operation your docs should determine how to manage all your current and future medications and make sure they’re all taken correctly, including an appropriate schedule for preoperative fasting. A couple of hours before the operation, you should be given antibiotics to curb incision-site infection, and steps to prevent blood clots should be taken.
During the operation the anesthesia must suit your respiratory and circulatory health (regional as opposed to general may be a better option). Use of opioid-sparing pain relief should be discussed. Forced air warmers and/or warmed IV fluids should be used whenever an older person is undergoing a procedure longer than 30 minutes.
Post-op your docs will have a plan to prevent and deal with delirium, if it occurs; pulmonary complications (keeping fluid out of your lungs); nutrition; prevention of falls, urinary tract infections and pressure ulcers in the legs. To prevent blood clots they will get you up as soon as possible.
We’d add: Programs like Dr. Mike’s Cleveland Clinic Shared Medical Appointments for future joint recipients also improve outcomes. They can help you get optimal pain therapy, reduce stress and get in good nutritional and physical shape before surgery (insurance is covering this!). See what your local hospitals provide.
Bev, your question implies you’re proactive, and that makes it much more likely you’ll fly through this surgery and enjoy increased mobility. Good luck!
Mehmet Oz, M.D. is host of “The Dr. Oz Show,” and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. Email your health and wellness questions to Dr. Oz and Dr. Roizen at firstname.lastname@example.org.