21st Century Medicine: Where Are We Headed?
What is Driving The Anti-Aging Phenomenon?
AntiAging Medicine lies at the conjunction of 2 powerful forces.
Baby boomers born between 1946 and 1964 are divided into two waves -- a leading wave that has always been very socially involved and a trailing wave that always wants everything -- now. The entire population numbers in excess of 76 million in North America.
The first wave is now beginning to turn 50 (hitting the wall) at the phenomenal rate of 1 every 18 seconds and will continue to do so for the next 20 years. Refer to the seminal work by Ken Dychtwald published in 1986 entitled Age Wave, later followed by Age Power..
Baby boomers have and will continue to represent a significant economic force in American society. They do not want to grow old. They will continue to seek out remedies and trends that will keep themselves young, vibrant and potent. Witness the rapid success of Viagra and 24 hour Nautilus Gyms.
At the same time Medicare is predicted to go broke starting sometime between 2007 and 2015 depending on cost assumptions [see table or chart or see entire report]. Nothing out of Congress has changed this equation. This has been well documented by the Medicare and Social Security Board of Trustees [see Medicare statement and National Bipartisan Committee].
Baby Boomers and those that follow do not believe that Social Security will exist in its current form when they begin to retire. It has even been said that X-Generationers believe more in flying saucers than the advent that Social Security will be around to take care of them in the distant future. Recent editorials update these notions of "social insecurity" with breathtaking vision.
Even more, Medicare cannot continue in its present form, exhortations to the contrary.
Thus, we cannot realistically expect Medicare to provide us with the low cost give-it-all-to-me level of care as our parents currently demand and expect.
AntiAging Medicine will be the recipient of a consumer-driven force in medicine like no other phenomenon we have ever seen in the past.
It is the driving force behind what some are calling Alternative Medicine or what is being termed in the Academic community Complimentary Alternative Medicine (CAM). See the establishment of the Office of Alternative Medicine with a meager budget of $6 million at its inception just a few years ago which has now grown to about $50 million. See the growth of Alternative Medicine courses being taught in medical Schools. See also the Mickie Eisenberg study of 1990 [see review] revealing an astounding $13 billion dollars being spent out of pocket on all forms of "alternative care." This figure has mushroomed into a much larger number today.
AntiAging Medicine lies at the conjunction of conventional medicine and this new growth of non-conventional medicine.
Given all of the above it becomes quite obvious that AntiAging medicine is the wave of the future. It is the Medicine of the 21st Century, because of the demand and because our approach to medical care cannot continue to emphasize the increasingly costly and highly technologically oriented form of crisis intervention that is the cornerstone of conventional medicine.
A Sea Change is Now Happening -- a la Alvin Toffler
Most of the dollars in medicine today are spent in the last 6 weeks to 6 months of life in a vain effort to prevent inevitable death. They are not being spent in physician's office for routine visits.
We currently have a disease management system.
The answer to the 21st century is in true health care system which is pro-active, wellness-based and interventional at a much earlier stage.
AntiAging Medicine is based on the notion that Aging is a treatable condition. This is a radically new notion.
The seemingly inevitable degenerative diseases of aging such as heart failure, arthritis, diabetes, and many of the most common forms of cancer are actually preventable and avoidable or at least amenable to mitigation by some simple and then some more complex means.
Our best examples presently are the amazing feats of strength of "old men" such as Jack LaLaine, swimming across the Bay, tugging a 1000 lb barge behind him at the age of 65. Or John Glenn riding into space, for the second and triumphal time, at the age of 76. Or the countless numbers of active 60, 70 and 80 year olds who play vigorous and demanding games of tennis 5 days a week. George Bush parachutes out of an airplane for the second time. Youth becomes (and has always been) a state of mind that can be extended far into the 60's, 70's, 80's and beyond. George Burns had one of his most funny, incisive and wry interviews when he was 92.
what is the General Approach?
AntiAging medicine starts with the metabolic approach to nutrition, diet, exercise and supplementation with vitamins, minerals, anti-oxidants and various other vital co-factors.
But the real expertise of this rapidly emerging specialty lies in the responsible, judicious and knowledgeable application of balanced hormonal replacement therapy -- the cornerstone of a true rejuvenation program.
An even more powerful third step emphasizes "Brain Longevity" using agents such nöotropics or smart drugs. In a competitive environment the use of cognitive enhancement is a key to survival and thriving. These have already been well worked out in Europe. They are now being imported here.
Newer Drugs, Agents and Modalities
Because the specialty is still in its infancy, we would expect that many of the traditional drugs being employed in conventional medicine are either being superceded by or supplemented with a variety of biological agents, herbs and newer forms of "smart drugs." A panoply of agents becomes bewildering to the traditional practitioner, although we have recently seen even the staid publisher Medical Economics recently publish it first volume of the PDR of Herbal Drugs.
Facts and Comparisons, based in St. Louis, publishes the most authoritative loose-leaf tome called Facts and Comparisons for pharmacists. They have, for years, been quietly publishing an equally authoritative monthly newsletter entitled The Lawrence Guide to Natural Products. This has been superceded by The Review of Natural Products. The German government also has published a volume called the German E Commission which is probably the most authoritative approach to the western application of herbs.
To look to traditional and FDA approved drugs may be truly limiting if we are trying to understand the full impact of this emerging specialty.
The Medical and Scientific Process
Medicine and science is always in process. This means that the half-life of all medical knowledge is about 2 to 3 years. What is not known now will be common knowledge in 3 years at which time the cycles continues to repeat itself. Thus, to expect that all studies need to be completed to validate the use of the various agents being employed in the AntiAging community will again limit our full understanding of its power. Vitamin studies are limited by money available (or not available) and long lead times. As one leading AntiAging researcher, William Regelson, age 73, of Medical College of Virginia has said, "I don't have time for these younger scientists to figure this all out. I have a real time imperative." He has been taking DHEA, of which he has studied and published, for about 20 years -- all without ill effect.
25-30 years ago we began to see the first use of Estrogen replacement in women. The endocrinologists, who are not a very imaginative or bold group, demurred. The Gynecologists, who are the front line practitioners for most women took up the challenge and began the process of initiating estrogen replacement.
Nature abhors a vacuum.
Today the use of estrogens, progesterone or progestins and even Testosterone is becoming commonplace, if not well understood, by the average GYN practitioners.
We are beginning to see tiny stirrings in our approach to men suffering an equally debilitating phenomenon called Andropause or improperly called the male menopause. We call it the dwindles.
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