Tell Giselle: What’s up with wellness

I got an email notification that my upcoming appointment with my primary physician required I complete a questionnaire, either online or at the physician’s office, prior to the start of the exam. I opted to do it online and was surprised to see major changes to the process.

Instead of the annual checkup that included an actual physical exam, this time it was not called annual. Medicare now calls the yearly time spent with my primary physician a “wellness visit.” There would be a charge if I requested a “physical.” That is where the doctor would put their stethoscope to my chest to listen to my heart, then while holding the scope against my back, hear my lungs do their thing.

No putting their hands on my throat to detect if there was any lymph node or thyroid gland enlarged. No palpating my breast or abdomen to feel around for unusual lumps that may indicate a cancerous or benign growth. No skin check for bruising or suspicious moles, no ear probe to look for wax buildup. You get the idea, no touchy touchy, other than the doc’s fingers being on a keyboard and smart phone, to update my medical history, correct mistakes in the record, order tests like lab work and screenings, to renew prescriptions, or to search online for medical AI info.

Wellness? Really? Do you know any senior on Medicare who is actually technically well? Likely most are dealing with at least one chronic or acute issue, having some decline in health, whether it be complications from obesity, high blood pressure, cancer, failing eyesight, hearing loss, bunions, sleep apnea, osteoarthritis, sexual dysfunction, frequent urination, among a slew of other common challenges, like mental health, or drug and alcohol dependency, that destroy wellness.

At a recent music event held at a popular restaurant, I sat at a table with four people who are a few years older than myself. Each of them — to one degree or another — is somewhat less fit than I am, based on a few metrics that anyone with decent vision can see. While they ate delicious-looking meals that were high in saturated fats and sodium, I marveled at how even tiny dietary changes can positively alter the trajectory of one’s wellness, if one embraces leveling up one’s lifestyle.

We had a good laugh over the absurd word change to the Medicare healthcare world we seniors inhabit. One wife told me about her latest experience at her doctor’s appointment. She went on about the ridiculous test that seniors are given, whereby they are required to draw a clock, indicating a time that the physician’s assistant (who does the pre-check) specifies. She told me her clock was to indicate ten minutes after 11. So was mine. Standard, cookie-cutter, one-size-fits-all assessment.

She joked about how younger generations are not going to do well with that part of the testing, as they have grown up with mostly digital clocks. I told her it likely will have to be revised, but that drawing a clock accurately is actually an important screening tool. She and her husband did not realize that the dementia clock test is a simple way for healthcare workers to detect whether or not a person is in mental decline, for example, due to dementia or Alzheimer’s disease. I explained that a number of years ago, I did volunteer hospice work at an Alzheimer’s ward and learned then that not being able to replicate a time on a clock, by drawing a nicely formed circle and placing the numbers and clock hands in the proper position, can reveal brain dysfunction.

If there are wrong sequences of numbers, misplaced numbers, or clock hands, further testing will be recommended to determine the extent of the cognitive impairment. What’s brilliant about this test is anyone concerned about the cognitive capacity of their parents or a partner can have them do this test. It does not require anything other than a piece of paper, and pen or pencil.

As to the rest of the conversation, it was pretty clear that these folks are aware of the toll aging has on one’s quality of life. How life turns on a dime. One month, you are thinking you can see pretty well, and the next, you discover you really are overdue for an eye exam. The headlights of oncoming cars have a halo glow, and you realize you’ve cut back on driving at night. Then you learn not only do you have a cataract, you are given a glaucoma diagnosis.

Wellness is a poor word to describe what happens during the appointment with your primary. There’s an unrealistic expectation by the government that people are going to take to heart the wellness aspect of this approach. Based on what I’ve seen from those in my extended circle, they are happily and unfortunately dismissing any concerns that the lab results show. These are retired people who may or may not be stubborn, but they are not embracing getting more vaccinations, whether it be for shingles or updating their tetanus booster (due every 10 years), or continuing with the COVID booster — that my physician said in a voice that conveyed great aggravation — are being recommended for people my age, every six months. Not happening.

For those who do care about wellness, it’s wise to do an annual. Get the PSA checked and do all the screenings so you can get a grip on why you don’t feel so hot. The snoring is not helping you to live your best life, and it is not helping you seduce your partner. Nor is using words like wellness when you aren’t feeling it.

Giselle M. Massi is the author of “We are Here for a Purpose: HOW TO FIND YOURS” and the novel “Just Dance the Steps.” Her romantacy “WYNTER’S DREAM” is now available. Giselle was a journalist with The Denver Post for 16 years and writes the newspaper advice column TELL GISELLE. Contact her at www.gisellemassi.com.

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