Expatitis, Part 3: Baby Steps with Mr Indy Spensible

The following is part of the transcript of my first clinic encounter with uber-expat businessman Mr Indy Spensible, diagnosed with expatitis:

Doc: …So, Mr Spensible…
Indy: Just call me Indy.

Doc: OK, Indy. Is that short for Indiana?
Indy: No, for the racetrack. My mother thinks I was conceived there.

Doc: Interesting. I’ll file that under “TMI”. So, Indy, your lab tests are back and —
Indy: Am I gonna die, doc?

Doc: Welllll, yes — you are going to die. But not from the labs.
Indy: That’s a relief, I think. Your jokes are pretty bad, doc. Don’t quit your day job.

Doc: Thanks. Speaking of “not funny”, your labs —
Indy: Uh oh.

Doc. Yeah. Your cholesterol was really high. I mean really up there. Like peel-the-fat-off-with-a-spoon up there.
Indy: I know. My docs chewed me out a few years ago, told me to lose weight and exercise. You know, the usual lecture.

Doc: Well, here’s the lecture again. I figured out your cardiovascular score, and —
Indy: My what?

Doc: Your cardiovascular score. It’s a formula that tells you your risks of getting a heart attack or stroke over the next 10 years. You have a 19% chance of either of those happening. A healthy person your age would have a 5% risk.
Indy: Doc, you’re giving me chest pains.

Doc: Wait, it gets worse. I also figured out that you have the heart of someone four years older than you. It’s called your cardiovascular age.
Indy: So, is this a good news/bad news moment?

Doc: Yes, here’s the good news: you can lower your risk down close to normal, all without medicines. Possibly.
Indy: Great! Possibly. So, all I have to do is…?

Doc: …is to lose 12 kilograms, stop smoking, and get your cholesterol down 25%.
Indy: Oh, is that all? Can’t I just sacrifice my first-born son?

Doc: If only it were that easy.
Indy: You know how hard it is to stop smoking, doc. Besides, I’ve cut way back.

Doc: That’s great! When did you start cutting back?
Indy: Yesterday.

Doc: Well, there’s no better time than the present.
Indy: Actually, I think I peaked in high school. Literally. It’s becoming a lot, uh, harder, you know, to get a good, you know doc —

Doc: I think I do know, yes. That problem is almost definitely because of your heavy smoking all these years. Plus your high cholesterol; it also clogs the blood vessels down there as well.
Indy: Wow. That hits home, doc. A lot more than your cardiovascular age stuff.

Doc: So, what do you think you can do to improve your risk of a heart attack?
Indy: Come on, doc, I’m a very busy man. My company would fall apart if I pulled back, and I have no time to go the the gym. And all those banquets! You can’t just turn down a baijiu toast or a cigar at the KTV. It’s bad guanxi.

Doc: OK, then, let’s put it another way. What do you think is a practical goal for you?
Indy: Well…I suppose I could cut down on my breakfast. Lots of sausage and eggs

Doc: That’s a great idea. Do you think it’s a reasonable goal to lose 2 kilos a month?
Indy: Yeah, probably.

Doc: And for exercise, 150 minutes a week is ideal, but let’s start smaller with you. Maybe you can do a 10-minute routine in the morning, just 100 jumping jacks and some pushups and stretching?
Indy: I could probably try that, sure.

Doc: Great. So, that’s your game plan for the next 3 months. Then you come back here, and hopefully you’ve lost 6 kilos and have a nice morning exercise routine.
Indy: Sounds good. Baby steps.

Doc: Exactly! “Baby steps”, from that Bill Murray movie, What About Bob.
Indy: I liked Groundhog Day a lot better.

Doc: Me, too…


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