By allowing ads to appear on this site, you support the local businesses who, in turn, support great journalism.
The annual physical exam
Placeholder Image

 I'm not sure when the term "preventative maintenance" first entered my consciousness. Most likely it was in the early 1960s, when my daddy taught me how important it was to change the oil in the car every 2,500 miles. And not only was it important to change the oil, but to grease the suspension fittings.

Nowadays cars routinely run 6,000 or more miles between oil changes, and since I can't even find a grease gun anymore, I reckon suspension fittings are permanently sealed. Sometimes, too, I find myself wondering what Daddy would think about cars that supposedly can go 100,000 miles without needing a tune up.

At any rate, although I never bought in to keeping the exterior of my vehicles spotless, I have always done what I could in terms of preventative maintenance on the inside. As all but two of the cars I've owned made it at least to six figures on their respective odometers, experience has taught me that there is great merit in preventative maintenance.

I'm not so sure when it was that I made the connection between preventative maintenance on a car, and the same for the human body in terms of trying to stay healthy. When I was younger, I felt, like most young folks, that I was pretty much bullet-proof. I could eat what I wanted, when I wanted, and have a libation or twelve, and it would all be fine because I was young and active and bullet-proof.

But somewhere in the early 1980s, though, a series of strange things began happening that caused me to seek professional medical advice. My doctor sent me to another doctor, who sent me to a specialist. A bunch of tests later the experts decided that I had something called Lupus, which they said came in two forms: Discoid Lupus, and Systemic Lupus Erythematosus, or SLE.

I was fairly naïve and asked what the difference was between the two. The specialist was fairly blunt; he said that Lupus is an auto-immune deficiency disease in which the body's defense mechanisms mistake the body's own organs as diseases and attack them. In Discoid Lupus, the body thinks the skin is the enemy and attacks in areas triggered by exposure to sunlight. Discoid Lupus is not so big a deal as you can basically control exposure to the sun by wearing long sleeves, wide-brimmed floppy hats and trousers. About the worst thing you get is what they call the "butterfly patch" on your cheeks.

But SLE, warned the Doc, can kill you. With SLE, the body's defenses attack every internal organ relentlessly, thinking them to be the enemy.

Over time, I've come to know folks with SLE and learned all too well that the Doc's blunt description was on the money.

At the time of my diagnosis in 1984 we had two young'uns and my wife was very pregnant with our third. If I was to lose a battle with Lupus, I needed to prolong it as long as I could in order not to leave my wife trying to raise three little kids alone.

So I started an aggressive program of preventative maintenance, which included a healthy diet, lots of exercise, regular physical exams and daily doses of a fairly aggressive anti-malarial drug which had serious side effects necessitating, among other things, routine vision fields testing to detect irreversible retina damage which might result from the drug.

This long story had a most unusual ending.

Another weird side effect of the anti-malarial drug was that after a few years of buildup it caused unannounced and uncontrollable diarrhea for an infinitesimally small percentage of patients.

Yep, you guessed it. I was one of those folks in that almost non-existent percentage of patients. One day I was fine, and the next I was in the hospital, totally unable to even guess at when I would next need to visit the porcelain throne, and immediately.

The good news from all of this is that if someone doesn't like what I have to say and accuses me of being full of excrement, I have hospital records which prove otherwise.

But at any rate, I was in the hospital for about four days, and during that run (no pun intended) I had been removed from my anti-malarial protocol. Along about the third day in the hospital the diarrhea ceased, and further tests revealed that the problem was stemming from the side effects of the drug.

My doctor sent me then to a local dermatologist of note. After carefully studying the mountain of test results which had accumulated over three years of treating Lupus, the renowned dermatologist stated that he felt the diagnosis for Lupus had some wiggle room. He suggested that I might actually have a skin disease akin to Psoriasis.

And then, in his Conyers office, the dermatologist offered me a lovely choice: did I want to sally forth believing I had Lupus, or would I rather fight "the heartbreak of Psoriasis?"

I jettisoned Lupus right then and there.

Still though, to this day, I fight with the borderline characteristics of Lupus: joint pain, fatigue, weird skin things like a bruise from a cut incurred six years ago which won't go away. But I've found it a liberating thing to believe that any problems I encounter are not related to a dread disease that's out to get me.

So I avoid the beach. Give me San Francisco Bay, or London, or maybe Alaska in January.

But, seriously, what I clung to was the idea Daddy had taught me decades before: the idea of preventative maintenance. And although I was only in my 30s, I started having regular physical exams. And now that I'm in my 50s those regular exams have turned into annual exams, which is what I want to talk to you about today.

Last week I met with my good doctor for the annual digital rectal prostate exam. Oh, sure, we did the blood pressure and EKG and drew enough blood to stage a Dracula movie. But if you're a male and have hit the half-century mark, and have endured your first exam via proctoscope and your first colonoscopy, then you know that the annual physical exam is really all about the digital rectal prostate exam.

My doctor and I are on the same page with all of this. We get the niceties out of the way, and then he says something to the effect of "let's get it over with" and I assume the position.

But I'm always careful to first remind the good doctor of everything he's told me in the past about my prostate, so that he will spend as little time in there as possible. There is no need for him to rediscover fire, or reinvent the wheel, you know?

After we've gotten that rubber glove thing done, we can talk about all the other stuff that's relevant. And we did again this year, as we've done for more than a decade now. There's a good chance that if I would actually commit - and that's the secret ingredient - to the course of action he recommends that I could be a lot healthier, and maybe even happier.

Although I do a good job of disguising it to most who know me, I really consider myself a closet intellectual. And as such, I realize that the key to becoming whatever any of us wants to become lies within ourselves. You, I, any of us, can do whatever we want if we just commit to it.

One of my resolutions for 2007 was to lose 60 pounds. So far, after eight months, I've gained three. But there are four months left in 2007. The secret to weight loss, or for any worthy cause, is to commit to it.

Frankly, I may not get there. Like most of us, I have battles in my private, personal life that I fight every day. I think of some things as monumentally important, and put them on the front burner. Other things which I consider trivial get relegated to the "I'll get to it" pile.

Right now I'm dealing with the fact that I'm in my late 50s and have not achieved anything close to what I thought I should when first I heard a man named John Fitzgerald Kennedy, in his inaugural address, speak these words: "Ask not what your country can do for you; ask what you can do for your country."

I know it's all relative, as our friend Einstein would say.

So let me leave you with this, friend. Preventative maintenance will keep your car running for a long, long time. And it'll do the same for you, respective of whatever you've inherited genetically from your ancestors. I was a very lucky person to be granted a reprieve from Systemic Lupus Erythematosus a few decades ago. But there are many who were not so fortunate.

If you've lost friends or acquaintances to Lupus, and would like to learn more about the disease and what you can do to help those who deal with it daily, access online and take it from there.

Regardless of your age or desire to learn about rare and odd ailments, please take it to heart that what's good for the goose is good for the gander, and make an appointment with your doctor for an annual physical exam.

For, as with our cars, no matter what the outside looks like, we all need to spend a little time with "preventative maintenance" on the inside to keep on keeping on.

Nat Harwell is a Newton County resident whose column appears Sundays in The Covington News.