So I was reading this thread and wondering about personal health and how some people seem to be relatively robust, and others seem to be jinxed by the Sickness Gods. I then got to wondering how much of it is hypochondria, general whininess and attention seeking and how much is actual ailments.
I mean, I know people who just seem to be fucked by life; one person I know has constant allergies, sinus infections, backaches, endocrine problems, girly-part problems and various other minor ailments, but have good vision and teeth.
Another seem to be seriously snakebit- hemochromatosis, high blood pressure, diabetes, GERD / Barrett’s esophagus, stomach issues, COPD, mental health issues, etc…
Both of them are around 40, FYI.
Then there are the people more or less like me… rarely get sick, and when we do, it’s either something common and communicable (cold or flu), and it’s once or twice a year at most. We may have something like high blood pressure, but we take our meds and control it.
Is it a matter of some people just get an unlucky (or lucky) draw with respect to health, all else being equal? Or is there more to it?
Not having any citations (because this is MPSIMS), what I assume is that there are a lot of poorly understood conditions that manifest in all kinds of seemingly-unrelated ways. There probably *is *one treatment that would improve all of the side-effects at once, but medical science doesn’t even understand the problem yet, much less what the solution might be.
My mother and one sister were pretty much born with health problems. My other sister was strong as a bull until she hit 60. I’m past 60, but still reasonably healthy.
Almost all of my siblings and cousins on my father’s side of the family have some degree of thyroid problem, so I’m sure genetics plays a part, as well.
There’s a lot of conditions which are linked to genetics, so depending on which gene-set you have you’ll range from a very high probability of having a bunch of illnesses to being strong as a bull and getting “old age” in your death certificate.
My sister in law was very upset a few years ago because she’d read an article describing some gene which had been found to correlate to a bunch of illnesses and conditions that both her husband and our mother have/had. Some of them are things that I would never have thought might share a common link - pulmonia at age 3 and a bad back, seriously? Well, yes, according to that article, yes seriously.
There are people who get communicable diseases all the time. They’re called parents of toddlers in daycare.
Mental health issues often travel in packs. People with some mental health conditions are also likely to self-medicate, and the drugs they use to do this can cause other health issues. People with mental illnesses are more likely to smoke, for example, and that can lead to all kinds of health problems.
Something like smoking all by itself could make someone sickly. Smoking doesn’t just cause lung cancer. Smokers also have a higher risk of heart disease and of developing conditions like type 2 diabetes or rheumatoid arthritis.
Some health conditions can cause a lot of different complications. Diabetes and high blood pressure are two that come to mind. If you don’t have access to good medical care, you might not know you have diabetes or high blood pressure, or you might not be able to effectively treat them. It’s estimated that more than 1/4 of people with diabetes in the US haven’t been diagnosed.
Some people might have been exposed to some toxin that stays in the body and causes many different problems, or one that can cause problems to crop up years after exposure. Radiation would be an example, as would lead. It’s also possible to get chronic poisoning from things like lead or arsenic.
You’d assume due to evolution we would be healthier. Now that microbes are not a major threat in wealthy nations shouldn’t the sickly have been purged by natural selection? Even if they procreate they still have kids who have a lower survival chance due to being orphans. We had to survive a lot of threats in our history. But we also rarely lived past 40 either.
Anyway, yeah some people are sickly and some are healthy. Heart disease is a good example. Some people have genetic lines where everyone dies in their 40s from it, some live to their 90s with healthy hearts.
Plus one illness can cause others. Physical and psychological stress can make you more vulnerable to other illnesses.
Being sick can make you sicker. If you aren’t exercising because you’re sick, then you become more susceptible to other health conditions. Which then exacerbate the first illness.
It amazes me that we aren’t a lot sicker than we already are, considering how many moving parts we have and how many health threats there are. But in the end, no one escapes poor health. Every morning I wake up without anything hurting or leaking or clogged up, I let out a sigh of relief.
Autoimmune diseases tend to run in packs also. I know lots of people who have combinations of arthritis, lupus, fibrymyalgia, etc. They seem to be triggered or at least stimulated by inflammation somewhere in the body, as are many heart issues, so there is also a strong correlation of heart/blood problems in those same people.
Among somewhat healthy people, some I know just seem to not have any common sense and overdo things. Especially as they age and their bodies become more injury-prone and slower to heal. I hear complaints from them every few months about some new injury they sustained doing something they knew they shouldn’t have been doing. Like someone with a history of back problems lifting heavy things.
Than what? Evolution isn’t an optimizing principle.
If orphans are likely to be cared for by family or group members until they grow up, that might not be as much of a hit to survival chances as you’d think. We have plenty of evidence that humans will do this. We’ll even do it for the young of other species in some circumstances. Google for bottle-fed kittens for a cite, or if you are just having a shitty day and need a pick-me-up.
This also assumes the cause of sickliness wouldn’t have any reproductive advantages associated with it, and would show up equally in all people affected by it. If it’s something like sickle cell disease or cystic fibrosis, caused by two copies of a recessive gene, you could have the full-blown disease show up in only 1 in 4 people from affected families. The carriers of sickle cell disease have added resistance to malaria, which is a net advantage if you live somewhere where malaria is a problem and there is no effective treatment for it.
You could also have a trait that is a problem in some environments and not so much in others. Light-colored skin makes people more susceptible to skin cancer caused by sun exposure. That’s probably less of a problem if you live in Sweden than it is if you live in Australia. Suppose there were a gene that makes you more likely to overeat if there is an abundance of food. That’s a problem in a modern developed country. In an environment where there are periodic famines, it might be an advantage- you build up fat during times when there is food, which helps you survive the famines.
This isn’t actually true. Life expectancies in earlier times were lower, but a lot of that was due to infant mortality. People who did survive infancy often did live into their 60s or 70s, but infant mortality drags down the average.
Even if diseases were randomly distributed, you’d expect that random distribution to favor some and hurt others. Just as an example that trips up most people: if you flip a random coin 100 times, you expect at least one run of 7 heads or tails in a row. Most people “intuitively” think that the word random means you won’t see more than three or four in a row.
Of course, disease is not randomly distributed in every case. If you have a genetically weak immune system, then you’ll get more than your share of diseases, all of which can have side effects and long-term symptoms. If you grew up in an area with high levels of pollution or low levels of nutrition you might also expect to be less healthy.
I’m not talking about that exactly; in that context, everyone would get all the diseases, and most people would shed them in a week or two with no lingering ill effects, but the sickly person would end up with pneumonia.
And FYI, I’m not talking about senior citizens or people where you’d expect some degree of ill health, but rather people in their 20s through 50s.
In one of those people above’s defense, I think their doctor is kind of crazy and always diagnoses anything as the worst possible interpretation of the symptoms and treats them accordingly. I went to that doctor for a while… right up until the point when she told me that I had MRSA and was likely going to need IV vancomycin if the drastic course of Levoquin that she was prescribing didn’t do the job. All that because I had a couple of little pimples on my upper chest and shoulders. (never mind that I’m hairy like some kind of bear or ape).
I quit going to that doctor, and my new one just said “You’re hairy, and you have a few small pimples, which isn’t uncommon. That’s really weird that she wanted to put you in the hospital for MRSA based on that.”
So I wonder how much of a component both the person’s willingness to go to the doctor, and the doctor’s diagnosis and treatment mindset have to do with it?
But some of that variation is going to be due to random chance.
Some people are also more likely to complain about their health than others. I could see the ones who complain more being more likely to go to the doctor and get more diagnoses, even if they’re not actually getting sick any more than the more stoic ones. That might depend more on things like personality, gender roles (we’ve all heard the stereotype about men never wanting to go to the doctor), and cultural attitudes about sickness than actual physical health.
It’s not always a weak immune system that will make you sickly. There are plenty of autoimmune diseases where your immune system is attacking some part of your body. Some people take immunosuppressant drugs to treat those, which of course makes them more likely to catch communicable diseases. Some autoimmune diseases can cause other health problems on their own, like type 1 diabetes. A too-strong immune system can make you sickly, too. Of course, someone who knows they have a chronic autoimmune disease is going to be going to the doctor more often than someone who doesn’t, so it’s possible that a doctor will pick up on some problem they have that might otherwise have been missed.
Are you sure some of the people you talk about being seriously snakebit aren’t also smokers? Smoking is a risk factor for acid reflux disease and other stomach problems, type 2 diabetes, high blood pressure, and COPD. It wouldn’t cause hemochromatosis (that’s genetic), and it wouldn’t cause mental illness, but self-medicating for mental illness might cause some people to smoke.
Allergies can cause sinus infections, so those two might be related.
No but we are evolved to deal with a large number of threats we no longer face. In wealthy countries we do not have to worry about malnutrition, the elements, physical violence, microbes.
Since our bodies are designed to survive with all those threats, now that those threats are gone you’d assume we would be extremely healthy. I guess in many ways we are, most people live the first 40ish years of their life with few (sometimes no real) health problems. Considering the endless moving parts of the human body like **Monstro **says, that is pretty remarkable. But it has been endless generations of weeding out those who couldn’t survive in a hostile environment until breeding age.
True, mild sickness can provide various survival advantages (even many mental illnesses may just be extreme forms of traits that have a survival advantage in moderation). Our autoimmune diseases could be a result of our overly hygenic environment. So who knows what % of disease that wealthy countries deal with are just extreme forms of beneficial adaptations, or negative effects of our current living situation (which is hygenic and socially isolating, which would create illnesses in itself).
However I don’t think people will ever treat someone elses kids with the same level of concern and responsibility that they would give their own children.
I was basing my argument off of charts like this.
In stone age societies, about half of people died before age 10, the other half died before age 40. About 5% lived beyond 40.
In ancient Greece and Rome it wasn’t much better, barely 10% made it to 50.
It isn’t just exercise, being sick is mentally stressful and mental stress can screw up your bodies self repair mechanisms. Plus if your sleep is screwed up due to an illness then sleep deprivation will also screw up your bodies self repair mechanisms.
That assumes there aren’t any new threats. There are. There is exposure to pollutants that didn’t exist in pre-industrial times. There are threats from the novel environment where there is too much food available. There are new diseases- there was no HIV before the nineteenth century, for example.
It’s also that the current medications for autoimmune disorders work by suppressing the immune system, so that lays the person open for problems they might otherwise not have had. I’ve seen this happen with two of my relatives.
I’m not far off from your first example. Allergies, asthma, respiratory infections a few times a year, joint problems, lower back problems, and chronic migraine. I’ve had the first three problems my entire life. The onset of joint and back problems happened in my 40s; many women in my mom’s family have these problems around this age.
I got screwed by the Health Gods. My dad was also heavily exposed to Agent Orange during his two tours of Viet Nam. These things may or may not be connected.
However, I’m also wicked smart and funny, and have truly great hair, so things could’ve been worse.
Anyway, yeah, some people do get screwed by the Health Gods. Some whinge about it all the time for sympathy and stuff. I’ve had to unsubscribe from some support groups because of all the whining and “it’s not fair!”. Well, no, it’s not fair. Suck it up, buttercup, stop moaning, and get on with what you CAN do.
These days, you can have a number of long-term chronic conditions and if you are well-managed, you can still die of “old age” and a series of events unrelated to your chronic condition.
However, “old age” or similar really shouldn’t go on the death certificate. As the CDCsays, “The elderly decedent should have a clear and distinct etiological sequence for cause of death, if possible. Terms such as senescence, infirmity, old age, and advanced age have little value for public health or medical research.”
I go through stages of being a healthy person and stages of being a sickly person. The tend to go in 4-5 year blocks. I knockwood am in a healthy stage. My last sickly stage was a never ending series of neurological and pain issues, capped off with walking pneumonia, strep and for the coup de grace, Appendicitis in a 6 month period. I don’t go to the doctor until I know that some hard core drugs are needed. I keep going to work, walking the dogs and doing the yard work.
I come from a family where you are one of two things: Stronger than an ox or medicated to high heaven. My dad? Even at pushing 80 is stronger than an Ox, or perhaps two. His brothers? 2 are medicated so heavily that I am honestly not sure how they can think straight enough to swallow the water with the pills. The third one is pretty damn healthy given age etc…
My mother - also stronger than an ox. At 72 she started a job in the garden section of Home Depot. She participated in a slinging contest of bags of garden soil - she didn’t win but did hold her own. Her sister and brothers? Their list of ailments might crash SDMB. All dead by the time they were her age.
My brother? Physically sound - mentally not so much
