Better Living Through Chemistry

Nearly every healthcare worker we've run into over the last six months has expressed surprise and even amazement that we're not on some sort of maintenance drugs.   Sometimes they congratulate us, sometimes they ask two or three times to be sure that we're understanding the question.  This is unnerving.  I didn't realize things had gotten this bad.

By coincidence, Lynn and I went in for physicals on the same day last November (we were both overdue).  In this world of medical specializations, that meant that even though all of the initial findings were very positive (uncannily so, by the way -- Lynn's and my numbers for all of the various things they check the blood for are almost identical), there were some follow-up visits and tests that were advised.  As concern over adverse drug interactions has risen, the clinics have become more obsessive about trying to make sure that they have a complete list of all of the medications that are being taken.  I've seen the same form numerous times now.  I keep writing "none" and signing my name.  The nurses keep looking at me suspiciously.

My final visit was to the gastroenterology/endoscopy clinic yesterday for "a double".  I'd been there a decade ago to have my esophagus scoped.  For a year or so I'd been having increasing problems with heartburn (or "GERD" as it's been christened).  My father died from cancer of the esophagus, and I knew that he'd had frequent heartburn, so although there isn't any conclusive link between the two, when I'd gone to my regular doctor for a physical back then, we'd agreed that I should have the GI guy take a look, just to check it out.

And indeed, he found some scarring at the lower end of the esophagus.  When we were done, he recommended a two-week course of prilosec followed by twice a day pepcid -- forever.  I was a little surprised and said, "Do I need to make any lifestyle changes?"  I'd been sure that at the very least he was going to recommend that I stay away from certain foods.  "Nope," he said.  "The pepcid will take care of it."  And he wrote me a prescription (these were the days before pepcid had an over-the-counter version).

He was right.  I dutifully took my two tablets a day and the heartburn disappeared.  I signed up for refills by mail so I didn't have to bother stopping at the pharmacy every couple of months.  The healthcare system did everything possible to make it easy and efficient.

Two years later, for completely unrelated reasons, I started exercising regularly and paying more attention to portion control in what I was eating & drinking.  Over several months I lost twenty pounds.  I started experimenting with skipping the pepcid, just to see what would happen, and after a few weeks, I quit using it altogether.  Since then, I have occasional heartburn (half a dozen times a year) when I overdo, and I take an alka-seltzer and go back to sleep.

Same doctor yesterday.  He asked me how I was doing and I explained that I wasn't having any more trouble with the heartburn and hadn't been for eight years, and that this was just a cautionary check to see how the esophagus looked.  When the test was over he said everything looked fine.  "But you should probably still take a pepcid or a zantac every night before bed."  He smiled at me and left the room before I could gather my wits enough (I was still groggy from the anesthesia) to ask why.  I think I will respectfully ignore his advice.

As it happens, I'd just read an excellent review of Melody Peterson's new book, Our Daily Meds which has the engaging surtitle, How the Pharmaceutical Companies Transformed Themselves into Slick Marketing Machines and Hooked the Nation on Prescription Drugs.   For anyone who follows what's been happening with big Pharma over the past decade or two, there aren't any huge surprises here, but it is a story that needs to be told repeatedly, because the general public is not getting it at all. 

In some ways, the conflicted attitudes that our society holds toward drugs mirrors that of our incoherent attitudes toward sex.  We express tremendous outrage at athletes who use "performance-enhancing drugs", have hundreds of thousands of otherwise law-abiding citizens in prison for relatively minor illegal drug offenses, and allow the pharmaceutical companies to talk us into spending billions of dollars on maintenance drugs that may be of dubious benefit.  In what fashion does it make sense that's it's fine for me to take two pepcid a day for the rest of my life rather than exercise and lose twenty pounds, while putting professional athletes in the stocks for taking substances that are designed to help them build muscle mass?  It must make sense to somebody, but I confess that it makes little sense to me.

At any rate, having now spent thousands of dollars on our various tests & procedures over the past six months, Lynn and I can now be declared to be in excellent health.  What a disappointment for big pharma.