By Carol A. Cates, MSN, MBA, RN
Chief Nursing Officer
Odessa Regional Medical Center
During this time of year, I say so often to people, “Have a Safe, Happy, and Healthy New Year!” The older I get the more I think I should add to that, “To have a healthy year, you need to pay attention to your health, and that means seeing a primary care provider regularly.”
Human beings are wonderfully and magnificently made. We have physiological backup system upon backup system that let us adapt and keep us functioning on levels that few other creatures can duplicate. Paleontologists talk about that in our history as hunter/gatherers. We are “pursuit predators.” We don’t have the fur, teeth, and claws that so many other creatures have in assisting with survival, yet, we have been very able to not just survive but thrive because we just keep going when other creatures cannot. That is largely because of our many backup systems. After many years in health care, I firmly believe that if you give a person enough time, the human body can adapt to almost anything.
So many times in my career, I have seen people in very critical condition while their stunned family keeps saying, “they have never been sick a day in their life.” The reality is with many of those people is not that they are truly healthy, but that they have been functioning on their backup systems and didn’t know it. Unfortunately, when people are running on backups constantly, it just takes one little extra stressor, and it pushes them over the edge into illness. That is because when they have been running purely on the backups, they don’t have enough time to adapt to that extra stressor, and very few extra resources to dedicate to healing. That means they very quickly become very, very ill.
This brings me to the downside of being wonderfully and magnificently made. Unless you see a physician regularly, and get things done like preventative care and routine lab work, you will never know you are functioning on back-up systems until they run out. I cannot stress enough how important it is to have a relationship with a primary health care provider and to see them for routine check-ups, not just when you are sick. Because that is when the doctors can find and treat those underlying conditions like high blood pressure, pre-diabetes, and early organ failure before you start running deep into the back-up systems.
Let me give you an example of what I mean by this. The acid/base balance in our blood has a tiny range for where our systems can operate versus where our blood becomes so acidic or so basic that we cannot survive. There are two main systems that control that acid/base balance. Acid is controlled by the amount of carbon dioxide in or blood. How fast we get rid of the carbon dioxide in our blood depends on our breathing. The faster and deeper we breathe, the more carbon dioxide we can get rid of. Base is controlled by bicarbonate which is made by our kidneys.
Carbon dioxide we can change quickly, but bicarbonate takes time to change. Let’s say you have lung damage from smoking. That is going to affect your ability to get rid of carbon dioxide, which if you don’t adapt, will make your blood more acidic and eventually will become so acidic you cannot survive.
There are two ways you can adapt, you can breathe faster and deeper, but if your lungs are damaged, that doesn’t really help. The other way is that your kidneys go into high production for bicarbonate. That takes time, but so does most lung damage from smoking.
So, you adapt (we call that compensation in health care), and never know there is a problem. But then something happens where the lungs suffer more damage quickly and can’t get rid of the carbon dioxide at their previous levels, like with pneumonia, or there is something that happens to the kidneys where they can’t make bicarbonate at high levels, like with some forms of renal failure. Then you will get very sick, and very quickly.
