Saturday, June 20, 2009

Shrinking and expanding

If you ever watched a time lapse cartoon of the ageing process you would know what I am going to say! I have weighed and taken the height of hundreds of patients over the years. They always think they are taller than they are, and weigh less than they do. It's not a cheerful job. We have considerably more than a baker's dozen intervertebral disks in our back contributing to spinal length and a bunch of vertebral bodies as well. Over time, these plump and resilient disks dehydrate and narrow. This loss of height is a result of a natural degenerative process. The vertebrae flatten as well, as we age, and so we lose several millimeters of height from each disk and from each vertebral body. In addition, because they flatten more in the front of the vertebrae than the back, the spine bends a bit forward, contributing to the loss of height from the shoulders to the pelvis. That's why my mother's head eventually sank below the top of the car seat when she was driving, and my mother-in-law ended up eating at the table with her chin near her place mat. They lived much longer than their males. The limbs, on the other hand, do not vertically shrink, so that the shortening, when sitting ,is the more dramatic and the foreshortened can reach their knees without bending forward. Since for me, I'm now in that group, the loss of several centimeters in shoulder- pelvic length decreases the vertical volume available in the abdomen for our guts, so we expand sideways. Egad! Ergo, I've become more potbellied. Couple that partly facile excuse, with the substitution of muscle bulk by fibrous tissue and fat, and one's legs become skinnier and skinnier. Man becomes globular stick man. A nurse friend watching me walk down the hall in a hospital gown one day said " You know ,my father would have said you look like a fat man being carried by a chicken." Pretty smart, blaming her father for her tart observation. If there is anything more revealing, less concealing, than a hospital gown I don't know what it is. This is a fertile source for an intelligent couture, to make a bundle, recreating cloth for the new, old shapely!

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