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The most recent life expectancy reports do not indicate the main cause of death



Sometime in the night, Roger, a 58-year-old man, died on the sofa. When his wife went to bed, he still watched television; She heard him snoring and did not want to disturb him. She thought he would eventually join. But in the morning the TV was still running and he was still there. She stooped to wake him up. He was stiff and cold.

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Since Roger died unexpectedly and in his apartment, he came to me in the Coroner County morgue. The deceased was clinically obese with a history of sleep apnea and had chronic neck pain ̵

1; which led to his nocturnal habit of taking oxycodone at bedtime. At autopsy, I found significant heart disease, including the narrowing of two large blood vessels. His battered black lung had pulmonary anthracosis due to years of smoking and foam of pulmonary edema, the latter being a common finding in overdoses of both medications and chronic heart disease.

What exactly had killed him?

Cases like these are usually considered to be opioid deaths because they developed a chemical tolerance to the prescribed medications and were known to overstretch them and because the drug levels measured in his postmortem blood were high enough to be deadly. However, it would be too easy to conclude Roger's death as an accident, another victim of the opioid epidemic that blows through the nation without blaming the underlying medical illnesses that have also killed him. Obesity and obstructive sleep apnea made Roger more susceptible to the side effects of his opioid drugs. His heart disease resulted in low blood oxygen levels, which can lead to fatal cardiac arrhythmias.

One cause of death per customer – that's the rule for death certificates. Today, I confirm many, many overdose cases. It is rare that their victims do not have a natural disease. Most people arrive at my autopsy table with a perfect storm of combined pathological conditions.

The CDC has recently issued a report stating that our national life expectancy is falling for the first time in a century. Most media analyzes have attributed this shocking finding to the increased mortality rate from opioid overdose and suicide. Heart disease and cancer mortality rates continue to decline slowly and steadily as a result of successful medical intervention and improved health behavior. However, they are still the two most common causes of death in the United States and still exceed over three to one overdoses and suicide deaths.

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Diet, exercise, and regular visits to your doctor for routine cancer screening are the combination that you can use to increase your personal life expectancy. Do the things you can do to protect your health, and possibly avoid an untimely visit by the forensic pathologist in your neighborhood.


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