Santa Claus stepped out of the warm shower, dried off, and wrapped the thick red-and-green towel around his waist.  As excited as he was (after all, it was Christmas Eve), the jolly old elf still followed his daily morning post-shower routine by stepping onto the bathroom scale.  Santa had been first diagnosed with heart failure about a hundred years earlier.  But he had more recently learned from his cardiologist that he himself could play a major role in preventing an unwanted visit to the North Pole Emergency Room or, worse, from landing in the Polar General Hospital ICU.  And avoiding the misery, danger, and fear of a bad heart failure episode was so easy!  All Santa did was weigh himself daily.

Kris Kringle had learned that the heart was just a basic pump, and when his heart began struggling to pump his blood forward through his body, that blood backed up (just like when he stepped on the hose that filled the reindeer’s water trough).  That would cause the pressure inside his veins to increase, which would then cause watery fluid to leak out of his blood vessels.  That leaking fluid would collect in all the wrong places, making his feet, ankles, and legs swell (it was tough enough getting down all those chimneys even without swollen legs).  And in response to this loss of bloodstream fluid, Santa’s two ornament-shaped kidneys would hold on to more water (rather than release it in his urine).  In the end, holding on to more fluid would lead Santa Claus to slowly gain weight.  Thus, even a little daily weight gain might well be an early sign that Santa’s heart was headed for big-time trouble.  Fortunately, such early weight gain often preceded severe heart failure by as much as a full week.  Thus, by owning his health and weighing himself daily, Santa Claus could help his heart and himself out of real trouble.  Any weight gain, and Santa would immediately call his cardiologist, who could modify St. Nick’s medications and help out his overworked heart.  And of course, Santa knew to immediately call his doctor if he experienced other symptoms of early heart failure, like a new dry, hacking cough, any new shortness of breath (even just a little), or that swelling in his feet or ankles. 

“Ho, ho, ho!” the jolly old elf cried out merrily as he stepped off the scale.  No weight gain today.  Still a solid 302 pounds.  He slapped his belly, which rippled like a bowl full of jelly.  Just before Thanksgiving, Santa had gone online to calculate his Body Mass Index (BMI).  Santa knew that BMI better correlated with his overall health risks than did his weight alone, because BMI took his height into account as well.  But being an elf, the old man wasn’t so tall, so not surprisingly, his BMI categorized him as “obese.”  This made the old bearded one pout and cry, because it meant that Santa was at increased risk of high blood pressure, stroke, diabetes, sleep apnea, some cancers, and even dying!  More than placing him on the naughty list, Santa’s massive weight gain this year had really put his health and life at risk.

“Think of the children!” he scolded himself as he looked up to the heavens with a frown.  But what he saw above returned a smile to his ruby red lips.  Mistletoe.  His mind immediately shifted to Mrs. Claus.  She had promised to help him lower his weight (after all, it was so much easier to get healthy and stay healthy if you shared your goals with your loved ones).  Now, Santa knew the difference between real and make-believe.  He knew that he would never have a “normal” BMI (well, maybe someday after he retired, if he could ever find a competent replacement).  But Kris Kringle also appreciated that with a little effort, after Christmas he could lose enough weight to lower his BMI into the “overweight” range, and that by doing so, he’d reduce all those miserable (and frightening) risks to his health and his life.   Mrs. Claus was committed to helping her husband reach his goal by serving smaller portions, cutting back on her cookie baking, and replacing some of the processed carbohydrates in his meals with fresh vegetables and fruits.  And Dasher and Dancer had promised to start walking with Santa for thirty minutes every day (that is, after they had rested for a week or so).

With a twinkle in his eye, Santa pulled on his warm, red long johns, slipped into his soft, white shirt, and stepped into his bright, red pants.  Then he snapped his black suspenders over his broad shoulders with a chuckle.  Last but not least, he clipped his Fitbit® onto his wide, black leather belt.  “Bet I get a lot of steps in tonight!”

His Apple Watch alarm went off.  “Time to check my blood glucose,” he said with a chuckle.  Like the one in every four seniors and the greater than 29 million Americans whose chimneys he would soon slide down, Santa suffered from obesity-related Type II diabetes.  Unfortunately, his blood sugar could not be held in check without giving himself insulin shots several times a day.  But his primary care physician had encouraged him that if he could reduce indeed his weight some following the holidays, Santa might no longer need the shots, as his blood sugar could be controlled with oral medications and a better diet.  Boy, would that be a break!  He really didn’t like giving himself the insulin shots, and he hated relying on Frosty to keep his insulin cold.  Santa much preferred presents and sleigh bells to needles and vials.

After a breakfast of oatmeal and oranges, Santa was reminded by Rudolph to take his blood pressure medication.  It simply confounded the old elf that as many as half of all people with high blood pressure (like him) or other chronic conditions failed to take their medications as prescribed by their doctors.  “That’s crazy,” he said, stroking his long, white beard.  “Where’s the Christmas spirit in not caring of yourself?  Everyone should give themselves and their loved ones the powerful gift of following the care plan they create with their physician.”

“You didn’t take your blood pressure medicine at first,” Mrs. Claus reminded him with a shake of her finger.  She pulled a batch of delicious, healthy kale chips from the oven.  “You said the pills made you feel tired, so you just didn’t take them.”

“You’re right, Sweetheart,” Santa replied.  “But then you told me to talk openly and honestly with my doctor about it.  To tell him what I didn’t like about the medication.  After all, my doctor is my partner.  And sure enough, he said there were other types of pills for my blood pressure that might not make me feel tired.  And he was right.”

“That’s a good Christmas message,” Mrs. Claus said with a smile.  “That if your medicine has side effects that you don’t like, or if it costs too much, or if there’s some other reason you’re not taking it as you should, talk to your doctor.  Chances are, there’s an alternative that will work for you.”

“As I always say,” Santa said, pulling on his furry mittens, “before you see your doctor, make a list of all your questions or concerns, so you won’t forget to ask.”

“Absolutely,” Mrs. Claus agreed with a nod.  “Make a list and check it twice.  And don’t’ be afraid to ask.”

“Right.  Your physician partner wants you to be more involved in your own health and health care,” the jolly old elf said, kissing his wife on her rosy red cheek.  “Well, I’m off to the barn.  Donner has his colonoscopy next week, so I’m going to see if he needs a sleigh ride to the outpatient center.”

“It’s really already been ten years since his last colonoscopy?” she said, surprised.  “My, how time flies.  Still, we can’t let any of our reindeer get colon cancer, not when it’s so easily preventable.”

“That’s right, my dear,” Santa said as he headed out into the light falling snow.  “That reminds me,” he added, stopping and turning his head back to his wife of many decades.  “Isn’t it time for your mammogram?”

“Yes, My Love,” she said with a smile as sweet as peppermint.  “And not to drag you down, but given the inherent danger of flying high above the earth, I just want to make sure…you did sign your Advance Directive, didn’t you?”

Happy Holidays To All Who Own Their Health, and To All A Good Night!

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