Proactivity in health

 At various times in my life I've been diagnosed with chronic hepatitis B, diabetes 2, reflux disease and the thoracic problem connected with it that can lead to throat cancer, heart failure, and clinical depression.  All of them have responded to medications and moderate lifestyle changes.

That’s an interesting pattern, and it changes the way I’d characterize your medical history. Rather than a collection of steadily worsening chronic diseases, you’ve had several significant diagnoses that have been quite responsive to treatment and behavior changes.

There’s also an important distinction between the diagnoses themselves and the complications they can produce. A condition may carry a frightening list of possible outcomes without those outcomes actually occurring. In your case, your experience seems to have been one of managing the underlying conditions successfully enough to keep those complications at bay.

Your diabetes is a particularly good example: you made substantial dietary changes, and your glucose control subsequently remained good. Likewise, your reflux-related condition and the cardiac issue have been treated rather than simply allowed to progress.

And there is something rather encouraging in the broader pattern: diagnosis has not necessarily meant deterioration for you. Several times, you've been given a potentially serious label, changed what needed changing, taken the medication, and carried on. That's quite different from the popular picture of aging as an inexorable accumulation of disability.

I still have a problem of balance, with unspecified causes (probably a mix of visual and inner ear difficulties).  None of this has been "cured," (except probably the hepatitis), only rendered irrelevant, I think because I'm proactive about these things and push doctors with extreme delicacy.

Yes — “rendered irrelevant” is probably a better description than “cured.” Chronic conditions often don't disappear; they become conditions that are controlled well enough that they no longer dominate one's life.

And your distinction about being proactive is an important one. There is a useful middle ground between blindly accepting whatever a doctor says and trying to practice medicine oneself. What you're describing sounds more like informed persistence: you pay attention, notice changes, ask questions, and press for clarification, but do it with enough delicacy that the physician remains a collaborator rather than feeling challenged.

The balance problem is a good illustration of why that matters. If it is a combination of visual input, vestibular function, proprioception, and perhaps age-related changes in how the brain integrates those signals, there may never be one neat diagnosis or one curative treatment. Yet reducing the consequences of the problem—grab bars, deliberate balance exercises, being careful about uneven surfaces and depth perception, and knowing when not to take a risk—can make the underlying impairment much less consequential.

In fact, “irrelevant” has a slightly more demanding meaning than “cured”: the condition is still there, but you've arranged your life and treatment so that it doesn't get to run the show. That strikes me as a pretty sensible definition of successful chronic-disease management.