Grosse Pointe Blank was one of my favorite movies of the 90s. The movie introduced Americans to the Buddhist concept of Shakubuku. What is this and why do many of my patients who have blissfully accepted blood pressure medications as a rite of passage of growing old need it?
The concept is introduced in this exchange between the two main characters:
Debi: You know what you need?
Marty: You wanna tell me what that means?
Debi: It’s a swift, spiritual kick to the head that alters your reality forever.
Marty: Oh, that’d be good. I think.
The most common serious disease in America is metabolic syndrome and it’s usually ignored by Americans. Metabolic syndrome is the constellation of weight gain due to excess sugar and carb intake juxtaposed against too little activity which causes too much insulin to be released, high triglycerides, and high blood pressure. As I tell my patients, it essentially means that you’re a diabetic in training. More than half of Americans over 40 have this problem and many get placed on blood pressure medications and believe that their problem is fixed. Nothing could be farther from the truth. In fact, needing blood pressure medications means that they’re well on their way to halving their “activity span” and that they are in desperate need of Shakubuku.
Why is this an issue? To get to the place that your body has out of control blood pressure, years and years of serious damage has been done to blood vessels, cells, and the musculoskeletal system. You’re basically half way to becoming physically disabled or having a reduced amount of activity as you age. I’ve had patients tell me that they feel healthy, but looking at what they can do as they start these medications, they’re far from healthy. The severe blood sugar instability has wrecked their knees and other joints and the extra weight means they can no longer do many of the things they used to take for granted. So why hasn’t some doctor initiated Shakubuku? Because our insurance system doesn’t pay docs to spend the time to confront patients about difficult things to hear. It does pay them to quickly get to a diagnosis and write scripts for blood pressure medications.
The upshot? If you’ve recently been placed on blood pressure medication because of metabolic syndrome, consider this post your Shakubuku! You are not healthy, but half way to wrecking your health and having miserable elder years. It’s time to take a serious look at your health and begin increasing your activity while taking off the pounds and eating better!