PREVENTATIVE MAINTENANCE

El and Bill

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Joined
Nov 8, 2003
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C Dory Year
2000
C Dory Model
22 Cruiser
Hull Identification Number
Sold in 2012
Vessel Name
Halcyon
We all commonly consider preventative maintenance for our boats and are usually familiar with diagnostic testing to prevent damage to our boat’s systems. This is generally considered common sense for all us boaters.

But, what about preventative maintenance and diagnostic testing for the skipper and crew? During our liveaboard years on Halcyon, El and I were careful about the boat and engines but much less so about ourselves (since we were healthy) – and we have paid the price. We would like to share some of what we have learned with our friends here in the pub.

First, healthy individuals need to prevent (not just react when ‘bad’ events occur). What simple tests might we all do (but often procrastinate) to ward off (or detect) problems in our ‘engines’ or plumbing? These are excerpted from UC Berkeley:

1. Detect hypertension:
a) For all adults: Once every two years, if readings are normal. More often if higher than 120/80. (We discovered that blood pressure varies almost from minute to minute, so an accurate reading requires three tests during the day to average out ‘local’ effects).
b) Over 60? More often.

2. Detect plaque in ‘plumbing’:
a) Cholesterol testing once every 5 years; more often if high reading or other risk factors.
b) Heart scan – a simple, quick, non-invasive test (probably not covered by insurance since it is ‘preventative)’ – cost us $200. Tells if there is plaque in or around your heart.

3. Cancer screening
a) For men:
1) Prostate Cancer: Annual DRE test after 50; possible PSA discuss w/ doctor)

b) For women:
1) Cervical Cancer: Pap test, Annual until 30; then every 2-3 years, unless other risk factors.
2) Breast Cancer: Mammography, Annual unless other risk factors; consult with doctor about clinical exam also.

c) Both: Colorectal Cancer, 50 and over, occult test annually; colonoscopy every five years, unless abnormal.

4. Detect Diabetes:
a) Fasting blood glucose test. Over 45, every 2-3 years unless high risk factors.

5. Osteoporosis:
a) Bone density scanning. Over 65 for women; younger for men and women if doc thinks you have risk factors.

6. Eyes:
a) Over 40, every 3-5 yrs. Or doc recommendation

7. Dental Checkup:
a) Every 6 months or dentist advice.
 
Bill,
I would add skin cancer checks at least once a year. As boaters we get a lot of UV out on the water.
 
Ken --
Excellent suggestion -- thanks! E&B
 
El and Bill":2hx9amxb said:
3. Cancer screening
a) For men:
1) Prostate Cancer: Annual DRE test after 50; possible PSA discuss w/ doctor)

Absolutely agree with you El and Bill. Because I had annual physicals, Prostate Cancer was detected for me before it had progressed beyond the prostate. (I was about 58 Yrs. old at the time). We took care of that problem.

Last year during the first annual mandatory physical at my department, the Dr. told me I had "severe hearing loss".....I said "huh, what did you say?" :disgust . He went on to say that I had one year from the day of his notifying me of that information to claim L & I for it. (Result of 31 years in siren equipped vehicles plus 3 yrs. Army gunfire).

Soon, I'll be able to hear EVERYTHING my wife tells me.... :cry

(unless of course, the hearing aid batteries are dead... :wink )
 
Good advice. In fact, I just about covered all of the things listed in a physical last week.

However, did you have to start this post right above the Team Geezer thread?

Nick
"Valkyrie"
 
El and Bill,

You are right, we do need to pay attention to preventitive medicine. I thank you for opening this door, and I hope the Brats will forgive me if I seem opinionated here but Sleep is my other passion.

We have 24 hours every day, and basically, one third of that time should be spent in healthy sleep. There is a not really well known disorder called Obstructive Sleep Apnea (OSA), that is becoming more prevalent in the maturing boomers and is very closely related to, and in some cases a causitive agent in several other debilitating diseases. OSA is a comorbid disease of obesity, congestive heart failure, atrial fibrillation, hypertension, diabetes, stroke and GERD, (gastroesophogeal reflux disease). Anyone with a diagnosis of those should be tested for Sleep Apnea. Depending on which diagnosis, between 25 - 50% of these will be positive for OSA. Theraputic treatment for OSA will often help with treatment for GERD, hypertinsion, obesity and diabetes. OSA untreated can lead on to congestive heart failure, pulmonary hypertension, obesity diabetes, and possible stroke. Another very serious complication of untreated OSA involves daytime sleepiness, and drowsy driving can result in a fall asleep crash, often resulting in fatality.

Testing for sleep apnea should be done under the supervision of a Sleep Specialist, (D.ABSM) a physician who has passed a board examination in Sleep Medicine. Medicare and many insurances do not require a primary care referal to see a specialist. The testing is non-invasive, involves a night in a sleep center, and can be a life changing experience.

The primary signs and symptoms include:
1. Neck size of greater than 17" for men and 16" for women.
2. Snoring, especially loud, or irregular, or snorting while asleep.
3. Daytime sleepiness, (inability to go through the day without napping.)
4. Morning headaches, (resulting from decreased oxygenation to the brain during apnic episodes through the night.
5. Frequent night time urination.
6. Obesity, Body Mass Index over 30
7. Depression, inability to concentrate,

OSA is rarely a curable disorder, but it is 100% treatable. There are several treatments for OSA. The most common, most effective is CPAP, or Continuous Positive Airway Pressure. There are various oral applieances available. Depending on the specific varity of OSA, there are body position devices, (pillows and tee shirts mostly), and there are several surgical treatments available. Treatment would be entered into in cooperation with the Sleep Specialist, and the outcome depends largely on a persons willingness to comply.

OSA is only a small part of the 100+ sleep disorders, but is the most comon seen in the sleep lab. The most common sleep disorder is insomnia which is often confused with sleep apnea.

For more on Sleep check the National Sleep Foundation web site at NSF.org. (Sorry I didn't get the link before I started this.)

OnEdit: The correct link is: http://www.sleepfoundation.org

Guess Where the boat name comes from.

Harvey Hochstetter, RPSGT
Deena Hochstetter, LPN, RPSGT
(Registered Polysomnographic Sleep Technologist)
SleepyC :moon
 
Great addition, you two. Thanks for that info -- not generally known or understood by most of us, and you did a great job explaining it.

As the ol' adage goes, an ounce of prevention is worth a pound of cure. We sure enjoy all you folks in the 'pub' and hope we all don't put off (as we did) the ounce that can keep us in the bounce.
 
If you could live another quality 20 years, by cutting your boating time in half would you do it? The newly freed time would be spent focusing on diet , exercise, and healthy living.
 
While excess weight is not a problem for Bill and El, it is for many of the rest of us (look around at the next CBGT). So, at the risk of stating the obvious, the best "preventative maintenance" that many of us could do is to eat less and exercise more.

Towards the end of December, I got a "bee in my bonnet" (or perhaps someplace else :wink:) to lose some weight. My goal this year is to be the "C-Brats' biggest loser". I know that many of you may think I've achieved that goal many times over but I'm talking about weight loss not general "loser-ness". So around Dec. 28th my morning weight was about 205. I started running - about 3 miles almost every day (about 9 days out of 10 since Dec. 28th). I switched over to drinking a lot more water and I removed most snacks from my diet. The snacks I didn't remove were replaced with healthier choices like fruit. I buy a big bowl of fruit each week and leave it on my desk at work. I still drink as much wine as before and enjoy a good dinner but I do watch my portions and don't eat as much as before.

After about 3 weeks, the running got a bit easier and I now get 3 miles finished in about 40 mins (including a .5-1.0 mile warm up at a slow pace. About 2 weeks ago, I started to add some weight training - all focused on the stomach area. Well, in the last 5 weeks I've lost about 14lbs and I'm still headed down. My goal is to get to about 175 by mid year and I think that's achievable. Anyone else want to enter my unofficial biggest loser competition? We could do weigh ins at CBGT's throughout the year. In addition to the health benefits, think of all the fuel we'd save by lightening up the passenger weight!
 
Roger,
You sure picked a bad time to suggest reducing consumption of snacks-three hours before the Super Bowl! I think you have a great idea-just a few hours off on the timing.
 
Roger,

Congatulations on you're loss. In 2000-2002, i went from hardly running to completing 2 marathons. I had lots of professional help in getting to th at level. The one takeaway i had from that experience is to build in rest days.
 
If you could live another quality 20 years, by cutting your boating time in half would you do it? The newly freed time would be spent focusing on diet , exercise, and healthy living.

Fortunately, that situation doesn't exist. If fact, we believe it is the opposite. Maybe the question should read "If you could double your boating time, would that afford another quality 20 years in a lifetime?"

Our boating time allows us the opportunity for interesting exercise (walking to the market, the post office, the trail on the island, etc. is, by definition, off a boat, uphill and exercise of a delightful sort) and healthy living (long, gently rocking, undisturbed sleep), plenty of fresh air, new (and learning) experiences, no t.v., etc. and our diet (what we choose to eat) is the same aboard or at home (except not quite as easy on the boat without the oven, but that's a minor challenge).

In fact, the past twenty years, homeless and nomadic, has been a wonderful quality shared life. If we had 'cut' our boating or traveling time in half to focus on something extraneous (since we eat, exercise, and live more healthy than if we were in the city on a 'treadmill' for exercise) our quality of life would have been cut exactly in half.

With this discussion, we only suggest that all of us -- living on a boat, going to a job every day, hanging out in a Tibetan monastery -- all of us need to pay attention to the need to checkup on our body's status periodically. Feeling good and healthy is wonderful, and indicative of a 'good' lifestyle (for us), but 'things' can be going on unnoticed within us that require a periodic scan. (Maybe the result of our individual DNA, eh Roger?) This is easy to put off when living an active and healthy lifestyle -- and put off to our peril. We have (as we all have) observed serious health problems in friends and family that might have been avoided or mitigated with earlier detection - hence the reason for this discussion in the 'pub.'

Now, there could be another whole discussion on what constitutes a 'healthy' lifestyle. Here, as in the choice of what boat, personal opinion and experience will be quite different and we would have different answers. However, we would suggest most would agree that:

1. Proper weight (congrats, Roger).

2. Exercise (lots of ways and opinions about this, but no question that exercise is very important)(marathons are one way, demonstrated by Chromer -- good on ya).

3. Proper sleep (re post by Sleepy C).

4. Proper nutrition (again, various opinions and requirements).

5. Mental challenge (phew, how many different ways).

6. Relief from stress (again, many definitions and techniques).

7. Preventative, periodic and diagnostic tests to be sure all's well.

8. Proper boat and ample time to use it.(Ooops, here we go again)

9. And many other ideas ....
 
El and Bill-

bullseye.gif


More proof:

Yesterday, I lost a wonderful 45 year old friend to a massive coronary heart attack! Most all of the above life extending factors were missing. Sad.

Joe.
 
Hey Joe-
"With the rising of the sun and with it's setting, we will remember" Hebrew prayer
Hang in there Joe. Each day is a gift.
 
Well, Roger (on the SeaDNA), we are in with you. We took that look around and we are both looking to be loosers. WE have cut down the snacks :cry (to only chocolate :wink ) and increased the activity level. It sure feels better already but we have most of 11 months to go. See you on the Loosers List.

Harvey
SleepyC :moon
 
First an update:

We have finished our preventative maintenance testing. Whew! We used to think a simple physical with the doc was all that was necessary, but have since had plenty of evidence that most docs (and insurance companies) are not screening (or paying for the screening tests) that detect problems either in their early phase or that are not detected by a simple physical exam (an earlier doc, long-time friend, used to spend most of the 'exam' time sharing travel experiences).

We have discovered several conditions that require 'repairs' - bone loss for El, teeth problems (infections in the gums or tooth roots) are jaw problems that apparently have serious ramifications with overall health -- an untreated infection anywhere can affect other parts of the body where results can be far more serious. We find the tooth/bone loss/jaw connections for El are a complex problem not thoroughly understood by the medical world. And also the arterio plaque problems. We are working through that stuff now.

Enough about us -- now what have we learned to pass on to our friends in the 'pub' --

1. Don't put off those preventative tests we (and others) have suggested at the beginning of this post!

2. Get off the duff and do that exercise stuff -- it is critical for overall health. Each does it in our own way -- running, walking, biking, swimming, working out on the machines or health club, etc. (By the way, sitting watching t.v. doesn't qualify, although it might give a rise to blood pressure this political season). Studies have shown clearly that it doesn't matter what kind of exercise -- just do some!! Of course, some have 'side' effects -- like knees if pounding pavement, etc. -- but pick what's enjoyable (and without side effects) for you. We love brisk walking -- good for the body, great time to chat, beautiful country and fresh air to enjoy. RogerBum (SeaDNA) has a great idea going on the Biggest Loser.

3. Watch what, and how much, you eat. My doc gave me a clear choice -- "the knife or a strict diet! Now!!" And my diet isn't to lose weight, since that's not my problem -- it's what I eat (and don't eat) that matters as it does for all of us, but most (including me in the past) ignore the basic fact that so much 'food' is unhealthy.

4. Harvey (Sleepy C) has given some great ideas about the importance of sleep and the health effects of sleep problems.
 
I just got the first set of results of my LifeScreen ultrasound scans - I think it was a suite of four or five specific screenings, there is one more result that will come in a couple of weeks. It was about $150, not covered by insurance of couse - they'd prefer to pay me after the stoke or heart attack I guess...all results good! I know Bill is an advocate of a test called a heart scan - I have not had that, will have to consider.
 
Sure glad to hear that the scans are good, Pat!! Sorta like cruising with a good chart -- great to know that the waterway ahead is clear of any identifiable shoals or rocks. That peace of mind is so reassuring. (And sure, there can always be a log in the water, but you keep a constant watch for that -- it's the submerged rock, that you can't see, that the tests (or charts) show and that you can detect with a little prudence. Good on ya!
 
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