If I were a family member or a friend, I'd do my best to try to get him to quit. He reminds of some of the long time cyclists I know, who still ride without helmets. Problems is, their reflexes aren't what they once were. It's one thing to engage in an activity that you know could cost you your life at any moment; quite another to continue doing so when your best days are behind you.
Hope the surgery goes well, he's pain free and he stays that way by moving on to another stage of his life.
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