Aging: this ride is not an E ticket

The Thinker by Rodin

Another birthday rolled in today. Curiously, what also came in my mailbox on my birthday was my new drivers license. Before I shredded my old license I looked at its picture, taken ten years earlier. Comparing the two photos was rather shocking. I was ten years older and I looked ten years older. Maybe I looked older.

Drivers’ license pictures have this knack for making you look old and/or ugly. The DMV gloriously succeeded with me, making me scrunch down to get into the camera’s frame. The new photo is in black and white, which by itself is guaranteed to make you look older. It also gives prominence to my receding hairline, something I had not noticed before. I seem to be developing a sag under my chin. Perhaps its worst feature is the dark looking circles under my eyes, something I never see when I look in the mirror, but which a black and white picture adds. I look grandfather-like, sort of like Grandpa from The Munsters. The horror!

It’s a brave new world that I inhabit as I cross a boundary in time between my lower fifties and my upper fifties. In the novel Brave New World, it seemed everyone was on an antidepressant known as soma, which made life feel blissful. Thankfully, I am not on an antidepressant but slowly over the last ten years my medicine cabinet expanded with a host of prescription medications. In order to keep my aorta from getting too big I am on two heart medicines: Flecainide and Simvastin. (The men in my family have enlarged aortas, an effect of Marfans-like symptoms.) To control cholesterol, I am on a statin, specifically Simvastin. To reduce high triglycerides, I was put on a pricey drug that is encapsulated in fish oil called Lovaza. Then there is the nasal spray (Nasonex), which seems to help with the chronic stuffiness and nasal discharge. Plus there is one optional medicine: Terbafine, which is supposed to kill toenail fungi.

So I take six prescription medicines in all, plus a couple of supplemental ones if I need them, including a muscle relaxant for the sciatica. And speaking of supplements, I take a daily Vitamin D supplement because we middle aged people just don’t absorb much of it naturally, no matter how much time we spend in the sun. There is also a silver multivitamin, because I’m over fifty. There are also fiber capsules to make certain things move more predictably. I also take a baby aspirin to reduce the likelihood of blood clots as well as a daily Zyrtec, which I may give up.

Here is a list of the medicines I took at age twenty: nothing. I didn’t need any but that’s because my body mostly worked like clockwork back then and, of course, I had no health insurance. Now, it gets crankier and I feel creakier, resulting in really annoying conditions like sciatica and numerous trips to my chiropractor. All this plus you try to exercise as much as you can with a sedentary job and mind your doctors’ insistent urgings (only partially successfully) to refrain from all the foods you enjoy and eat all the stuff that vegans love but leave you taste deprived.

However, nothing says “old” better than using a BiPAP machine. A BiPAP machine is a close cousin to a CPAP machine, and is used by the millions of Americans like me with sleep apnea. After two sleep studies, the doctor of sleepology sort of knows what’s going on with me, and she is insistent that every night when I sleep I must wear an ungainly facemask and attach it to my BiPAP. What it does is make my breathing regular while sleeping. Thanks to the power of durable medical equipment it pushes air into my lungs while I sleep, preventing snoring and (hopefully) sleep apnea. If you have sleep apnea, you have lungs that like to sleep along with you. They can’t be bothered to provide all the oxygen you need and will even shut down, until your unconscious brain realizes something is wrong, shoots some adrenaline into your blood and you abruptly start breathing again.  This should wakes you up, although most of the time you are too sleepy to notice. Instead you usually arise in the morning feeling tired and tend to want to nap during the afternoon.

If I had been prescribed a CPAP machine, a steady stream of air would go down my windpipe all night, but that’s not the best fit for an old coot like me. Instead, I get the BiPAP machine, which works with my natural breathing. It knows when I am inhaling and pushes extra air into my lungs in a scientifically controlled and measured manner. To accomplish this I wear a large tightly sealed mask over my face and nose all night. The air is delivered through a sealed plastic hose attached to the BiPAP machine. The mask does not seal perfectly because a couple of years back I broke my nose, making wearing the mask somewhat uncomfortable and with some loss of pressure due to mask leaks. But hopefully while I am tethered to this machine the sleep apnea is gone but at least so far my sleep is not comfortable. I hope that I will get used to it in time. It seems I have no choice. Yet, something must be working, as I run to the bathroom in the middle of the night much less than I used to. I have yet to wake up feeling refreshed like a baby after a night on my BiPAP machine, something I hear happens, but perhaps that is coming.

In any event, all these medicines, minor ailments and durable medical equipment simply reinforce the obvious fact revealed in my drivers license: that I am aging, I know it, people who know me know it, and that the black and white camera at the DMV has documented it in its database and on my license. A much different future than my youth awaits. I’d best settle in for the ride. It sure won’t be an E ticket.