Geriatric Medicine

Let’s start with the most important point: If a senior’s shoulder repeatedly swells with fluid, and you can draw out a large bottle every time, it’s mostly not “simple degeneration,” but another disease. This post is for you if you have an older family member whose shoulder repeatedly fills with fluid, has been aspirated several times, but always swells up again quickly. What is this disease? Inside the shoulder is a group of tendons called the “rotator cuff,” which is responsible for hanging the arm steadily in the shoulder socket. As we age, this tendon group can tear completely. After it tears, the humeral head moves upward, and bone rubs directly against bone. The fine calcium salt crystals ground off fall into the joint cavity, which in turn stimulates the joint lining to inflame and continue the destruction. ...

Recently I was spending time with an older adult, and he said to me: “Life really doesn’t need to be that long. I’m already in my 80s, why would I still go exercise and work out? I already go out and walk several times a day, that’s already very good!” Honestly, the first half—“life doesn’t need to be that long”—stumped me. That’s a question about the meaning of life, not something I can answer in a few sentences in clinic. But the second half—“walking several times is enough”—happens to be my own specialty, and I’m confident about this: walking is great, but for an 80-something older adult, relying just on walking really isn’t quite enough. I’ll start from here in the rest of this post. ...