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Are you healthier than Santa Claus?

December 24, 2017

Santa recently underwent his annual check-up.

His medical report follows:15622518_689548174549764_5949852411560346_n

Since 23 December 2008, Santa Clause has enjoyed Canadian citizenship status, and his official address is: Santa Claus, North Pole, Canada, H0H 0H0.

Santa is aware that a Sleigh Driver’s Medical is an uninsured service.

Santa is his jovial self and has no complaints. He looks remarkably well for his age (1,747 years old).

Although he wears reading glasses for presbyopia, he impressed on his eye exam when renewing his Class 1 (Sleigh) Driver’s Licence. He comfortably read the bottom line on my Snellen Chart (visual acuity measured 20/10; OD=OS=OU). He attributes his extraordinary eyesight to regular outdoor activity and minimal interaction with screens. It is unclear whether Santa owns a cellphone as he did not check his phone once during the entire consultation.

Santa managed to get a flu shot earlier in the year, anticipating close contact with many sniffling, sneezing, crying and coughing kids during the winter. We discussed hand hygiene to reduce his risk of infection. Santa will carry alcohol-based hand rub with him from now on.

On close inspection, Santa’s rosy cheeks are characteristic of papular rosacea. He received a pamphlet on skin care and should use sun protection when travelling in warmer climes. He has a prescription for topical metronidazole cream.

Santa weighs in at 260 pounds (117.93 kg) and measures 5 feet 7 inches (1.702 m), giving him a body mass index of 40.7 kg/m2.

We discussed the need for weight loss and a complete overhaul of his cookies and milk diet. I have referred him to a dietician to assist with a dietary plan. He will attempt to consume 500-1,000 fewer kcal per day but will not be downloading the myFitnessPal app because he does not interact with cell phones much. He has an exercise prescription which recommends at least 150 minutes per week of moderate-intensity exercise and resistance training three times per week. We discussed the available prescription treatments for obesity (liraglutide and orlistat), but Santa wishes to avoid these for the time being and acknowledges that he doesn’t have drug coverage anyway.

Santa’s Automated Office Blood Pressure reading was 132/84 mmHg. He says he has a BP machine at home, but he has been kept busy with the world’s population growth, and hasn’t used it “for a while”. He will start recording his BP and present the data at his next appointment.

Although Santa had his cholesterol checked, we were unable to calculate his predicted 10-year risk of cardiovascular disease because his age falls outside the usual range studied in clinical trials. He will focus on lifestyle, diet and exercise to manage his risk.

Santa has fatty liver disease based on raised liver enzymes and an abdominal ultrasound. His HBA1C level indicates prediabetes. Santa has a prescription for metformin to reduce his risk of future diabetes by 25 to 30%.

Santa continues to suffer from work-related lower back pain. He sees a physiotherapist regularly and there are no red flag signs or symptoms.

Santa has learnt to live with insomnia. His sleeping habits are erratic. He suffers from shift work disorder and frequently endures jet lag. Mrs Claus complains of his snoring. Santa completed a STOP-BANG survey in the waiting room, and I referred him for a sleep study. It is likely that Santa suffers from obstructive sleep apnoea. This diagnosis will not, however, affect his Sleigh Driver’s Licence because Santa flies outside of controlled airspace. Santa reassures me that the reindeer basically “fly the thing themselves.”

Mr Claus says his travel and tetanus vaccines are up to date. He has also received the shingles and pneumococcal vaccine.

I refilled Santa’s prescription for supplemental oxygen during air travel and collected my lump of coal.

Although we discussed the need for regular follow-up, I will probably only see him again next year.

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