During my training as a physician, and there\u2019s no reason to believe this has appreciably changed for young doctors now, I was taught that if you saw a patient in your office for a medical problem of any sort she\u2019d leave dissatisfied if she didn\u2019t receive a prescription. \u201cReaching for your prescription pad,\u201d the professor explained to a group of us, \u201cis the universal gesture in medicine that the encounter is drawing to a close. Writing up to three prescriptions is fine. More than that will get your patient worried. Handing her the prescriptions means \u2018our visit is over.\u2019 Advise her when she should return and you can move on to your next patient.\u201d<\/p>\n\n\n\n
In those distant days, just a fraction of the prescription drugs on the market now were available. We never dreamed back then so many new drugs would be created by the pharmaceutical industry (there are about 80 brands of birth control pills alone). It seems straight out of the pages of a Philip K. Dick novel that committees of physicians appear to be creating new diseases in order to justify FDA approval for new drugs. (\u201cAs long as we\u2019ve got Nexium, let\u2019s rename heartburn GERD.\u201d)<\/p>\n\n\n\n
Who would have guessed back then that many of today\u2019s professional articles extolling new drugs come from pharmaceutical industry-funded studies that conceal any bad results. Who knew about restless legs syndrome until Mirapex? Fibromyalgia until Lyrica? Social anxiety disorder?<\/p>\n\n\n\n
C. Difficile colitis, a condition caused by antibiotic overuse, is now curable with ten days\u2019 use of yet another antibiotic that will set you back about $500. And then this gem, from the Journal of the American Medical Association<\/em> (JAMA<\/em>): Correctly taken prescription drugs are the third leading cause of death. Oh, and by the way, NSAIDs (ibuprofen, etc.) are the major cause of gastrointestinal bleeding and kidney failure, Tylenol overuse the top reason for needing a liver transplant.<\/p>\n\n\n\n So it\u2019s not at all surprising that new patients arrive at WholeHealth Chicago with something I\u2019ve dubbed the \u201cTwo-Bag Syndrome.\u201d These are patients who already have their own physician–and they\u2019re generally happy with her–but who realize one morning that they\u2019re taking a very large number of pills. If your doctor was taught, like me, that you\u2019d be dissatisfied without a prescription, over time your medicine chest is going to get pretty crowded.<\/p>\n\n\n\n As you may have already guessed: Bag #1 contains prescription drugs. And Bag #2? Nutritional supplements.<\/p>\n\n\n\n Sometimes the Two Baggers bring medical records, which makes things easier for me. I always include a physical examination because, after all, you don\u2019t want to eliminate blood pressure meds from someone who has high blood pressure.<\/p>\n\n\n\n And then to work.<\/p>\n\n\n\n First, the supplements. As a rule, people take more supplements than they actually need, and often they\u2019ve long since forgotten why they started on them initially. Many of us are enticed by an advertisement that includes a photo of a healthy looking person holding up a bottle, but just as often we succumb to the recommendation of a friend or health food store clerk. Then the magical thinking sets in: \u201cI\u2019m still alive and feel okay. Maybe it\u2019s that vitamin. I\u2019d better not quit taking it.\u201d One of my jobs is to reassure patients that trimming the supplement regimen will not cut life short.<\/p>\n\n\n\n Then we move on to prescription drugs. If you remember, most prescription medications basically cover the damage of an unhealthful lifestyle, so common sense says if you take better care of yourself meds often become unnecessary.<\/p>\n\n\n\n To say these words puts the ball back into my patient\u2019s court. Prescription drugs have a tendency to make us lazy about our health, giving us a false sense of confidence, believing we\u2019ve covered the damage we\u2019ve inflicted and we\u2019ll be fine if we just keep renewing our meds. A good friend of mine (not a patient!) pops a statin for cholesterol and a Glucophage for diabetes, the pair a prelude to his cr\u00e8me brulee. \u201cI\u2019m supposed to take these with food,\u201d he adds, without a whiff of irony. Well, if that\u2019s your choice the pharmaceutical industry is more than willing to support it to your (early) grave.<\/p>\n\n\n\n I saw patients who\u2019ve been taking care of their health responsibly–losing weight, exercising, reducing stress, taking their own blood pressures at home, and trying alternative therapies. And it\u2019s paying off.<\/p>\n\n\n\n The easiest of meds to discontinue are the statins. With a few weeks of meticulous eating and weight loss, your cholesterol and triglycerides can plummet, the drug can be stopped, and side effects end. Meds for diabetes and high blood pressure might take longer to quit, but with good choices both can be tapered or discontinued altogether.<\/p>\n\n\n\n If the events that triggered your depression are now fading into the past, maybe it\u2019s time to taper your antidepressant or replace it with St. John\u2019s wort. Consider trading in your anti-anxiety meds for L-Theanine and regular meditation. Leave your GERD drug behind by eating smaller meals earlier (with less alcohol) and elevating your head during sleep. Perhaps even replacing your birth control pill with an IUD or diaphragm. Oh, and since you know that most respiratory infections are caused by viruses, wash your hands regularly and don\u2019t call your doctor for an antibiotic at the first sneeze.<\/p>\n\n\n\n Many diseases are the result of unlucky genetics rather than unhealthful lifestyles. Some people suffer chronic pain. Some svelte and apparently healthy people actually have diabetes, high blood pressure, or deep-seated depression\/anxiety\/panic attacks. Chronic conditions like hypothyroidism, certain cancers, and rheumatoid arthritis and other autoimmune diseases like lupus and multiple sclerosis are held in check for years by medications. Obviously, these drugs remain permanently in Bag #1.<\/p>\n\n\n\nHealth history of the Two Baggers<\/strong><\/h2>\n\n\n\n
This past week in the office was a good one, and the basis for today\u2019s health tip<\/strong><\/h2>\n\n\n\n
Of course some medications are absolutely necessary<\/strong><\/h2>\n\n\n\n