I always enjoy seeing Mr. G. I've known him for close to 13 years.
He has, what others might term, a cantankerous personality.
He's an 88 y/o male that lives in the country, is a nudist, and smokes, chews and drinks excessively.
He has a history of hypertension, coronary heart disease, congestive heart failure, peripheral vascular disease, and emphysema.
He remains completely independent. He walks without a cane/walker. He's cognitively intact. He's continent.
He's compliant with medications.
He's been married for 54 years but he and his wife have lived in separate homes, on the same piece of property, for the last 20 years or so. They were starting to get on each others nerves.
Me: Are you still using your special recipe every morning?
Patient: You bet, as regular as a goose going barefooted (he has an assortment of quotes-I usually have to have him repeat them at least once so that I won't miss anything).
Me: Can you review it for me again?
Patient: Yep, I drink a V-8, followed by 2 beers, then 3 cups of coffee, one more beer , eat a raw onion like an apple and have 2-3 cigars.
Over the course of a typical day he smokes 5-7 cigars, drinks 6-9 beers and chews tobacco. His favorite food, beside onions, are his "beans and weenies."
Patient: Go ahead Doc, get it over with...
Me: You shouldn't be smoking cigars, chewing tobacco or drinking so much.
We both laugh.
His clinical exam remains incredibly stable. At the end of most visits he always makes sure to remind me of one thing.
"Don't see many folks my age doing as well as I am, do you?"
"Nope, I don't, see you in about 6 months."