Write what you know. Here’s what I know – I am getting old and stuff is changing. I mean changing. So here’s a chronicle which will help the younger reader make an informed decision regarding, oh, say, suicide.

Issues of general deterioration

Heart: Atrial fibrillation is deemed by those who profess to know to be a condition of an aging heart. The substrate of the heart muscle gets bollixed up in its ability to precisely conduct the complex electrical messages which control the 1-2-3-4 sequence of the heart chambers while they pump blood. More commonly affected are the atria, two small chambers atop the heart which are the entry and exit chambers in the pumping process. Atrial fibrillation results in these two chambers not beating at, perhaps, 60 times per minute and starts them vibrating at a rate of, maybe, 1,000 times per minute. In this state they do not contribute much to the overall pumping function. Even more interesting is the fact that blood, nice as it is, is a picky and contrary substance which comes to believe that standing still is an indication of injury and that it should, in such a circumstance, start clotting immediately. In a heart with fibrillating atria, the blood in, primarily, the left atrial appendix is sometimes undisturbed long enough to go into clot mode. In that circumstance the clot, about the size of the tip of a ballpoint pen usually, finally gets flushed out into the bloodstream, up to the brain and, if it finds a sufficiently constrictive spot, clogs the works up, kills part of the brain and gives its owner a stroke.

The prophylaxis of choice in such circumstances is altering the clotting mechanism so that blood is more resistant to clotting and thereby some of the clots and some of the attendant strokes will be avoided. The risk of stroke in atrial fibrillation is 5% per year. With appropriate anticoagulation the risk falls to about 2.5% per year. The risk of stroke in a person lacking this version of a bum heart is, at age 70, about 13% over ten years or, simplistically, 1.3% per year. Said frighteningly, there is a 400% increase in risk of stroke in un-anticoagulated men and a 200% increase in risk for anticoagulated men. Said realistically, out of a thousand guys with afib and on coumadin, 25 will get to have a stroke in any given year. Normals will have 13 guys with strokes in the same time period. In other words, I, being on coumadin, will have a 12 in 1,000 chance of having a stroke I did not otherwise have coming each year. Such odds, in Las Vegas, would get no play at all under any circumstances, being treated as nothing more than background noise. In life, mine in any event, they prompt me to take rat poison (coumadin is warfarin sulfate, a rat poison which makes rats bleed to death) and run an increased risk of a brain bleed (indistinguishable from the much dreaded thrombotic stroke in clinical effect) or just plain bleeding to death from trauma incurred in a car crash or bicycle crash or motorcycle crash, all activities in which I often participate. I also get to display the purple blotches which come from the ease with which I bruise from the slightest bump. I stick my finger every week and wait in fear and loathing for the meter to announce how I am doing. My diet is very important because some foods make me thinner of blood and some thicker. At age 30 I didn’t care dick about whether I lived or died and age 30 is really something to live for. Now look.

Sex Drive: You DO NOT want to know. Google vacuum devices, injections, herbal remedies, unlicensed Indian Pharmaceutical Companies. Or don’t.

Otoliths (otoconia): The “doddering old man” is a trite reference to the peculiar gait and apparently precarious balance of the aging. Here’s why. The primary mechanism of balance is in the inner ear in structures called the semi circular canals. Those are thin tubes (semi circular of course) arranged in two axes at right angles to sense motion in three dimensions. Inside them is a fluid and about a jillion tiny hairs which sense the movement of the fluid as the position of the owner’s head changes. This input, along with visual clues and musculoskeletal feedback, provides position sense which, taking into account our lifelong experience with gravity, leads us to conclusions about whether or not we are about to fall over. If it appears to our internal computer that we are leaning to an extent that our center of gravity is going to get outside our support (usually the position of our feet), we are prompted to move back and get things in balance. For reasons which remain unclear to me, microscopic calcified chunks (“oto” for “ear” and “lith” for “stone”) get in the canals and bump the little hair-like structures, which bumps the brain interprets as tipping over. The corrective action, unnecessary as it is, creates a true imbalance and recovery from that situation causes the staggering, stumbling situation termed “doddering”. It is mightily embarrassing and frustrating and is a significant contributor to the next topic,

Foul Temper: Here are some of the reasons:

Irrelevance:  Old people know how we are perceived. We are generally non- productive and annoying. We require special handling and attention. Our very presence compels nearby young people to form contingent plans for dealing with a sudden health emergency. Our absence from any gathering never decreases the enjoyment of the group.

Expensive:  We need special stuff. Ramps, conveyances, bathroom stops, end of life healthcare sufficiently expensive to make an Evangelical Republican favor euthanasia, nursing homes to tuck us out of sight, liability insurance to guard against the plethora of our torts and a host of other costs.

Repulsive:  A theory which I am unable to verify is that after our biblically allotted three score and ten years our bodies become convinced we are dead and decide to instigate the decay process. Our sweat glands produce a foul substance redolent of onions and shit, our gastrointestinal tracts lose efficiency causing excess creation of eye watering hydrogen sulfide gas, our arthritic wrists are no longer up to the task of adequately cleaning up after the bathroom and our decreasing energy causes us to delay laundering until well past the time when the ripeness of our clothing would, in earlier times, have prompted us to toss the outfit in the washer with a quart of Clorox. In “Bubba Hotep”, a movie, a character’s line is, “everything old people do is seen by the young as either sadly amusing or disgusting.” Insightful indeed.

Intrusive:  Many of us in sad and hopeless pursuit of continued relevance remain in our employments well past our use-by date, taking up scarce spots in mercantilia and insisting on worn out practices and ideas which, it seems to us, worked once and no doubt will continue to do so. We insist, with an air of sanctimony, that things be “faxed” to us, that the only way to efficient operation is for all employees to be in a big room together, that true progress is best aided by taking a meeting with someone. Our contribution to inefficiency includes lamenting the loss of past practices which were invariably more moral, effective and wholesome than current methods. It isn’t really our fault that the past seems so attractive to us – we were raised up on the Garden of Eden myth, the more diminutive version of which is our recollection (also quite mythical) of the salad days of our careers.

In addition to our own dissatisfaction with our condition, people just piss us off. Young people talk much too fast and use slang far too new to have imbedded itself in our brains. Drivers make quick and startling moves, cut us off and occasionally shriek imprecations at us for nothing more than driving five miles per hour below the speed limit in the left lane with our right turn signal on (for miles). Extremely unflattering notes are left under our windshield wipers for offenses no more serious than parking with the parking-space stripe beneath the middle of our car. How can the young world expect equanimity, an upbeat attitude and a sense of humor when we spend our time staring into the bony eye sockets of foul Death?

Okay, that’s it for now. Get the fuck out of my yard.