7 more overused drugs – a book review

Learn what meds you should avoid and why #MindOverMeds#DrWeil#IntegrativeMedicine#bookreview

When I wrote the post 7 overused drugs, I knew other doctors would agree with me, but I didn’t know that a well known doctor was publishing a book that agrees with it.

MIND OVER MEDS- book cover

Published this year by Little, Brown and Company, MIND OVER MEDS teaches you to know

“When Drugs Are Necessary,

When Alternatives Are Better-and When to

Let Your Body Heal on Its Own.”

Andrew Weil, M.D. wote MIND OVER MEDS as well as  Spontaneous Happiness, Spontaneous Healing and other books on physical and emotional health and healing, nutrition, and integrative healthcare. He is the director of the University of Arizona Center for Integrative Medicine.

After the introduction, each chapter stands alone if you want to explore a particular class of medication. The book can also be useful as a reference manual. For each chapter Dr. Weil also collaborated with colleagues with expertise in those areas.

Besides 4 of the 7 drugs that I discussed in my post, Dr. Weil discusses 7 other broad categories that I will briefly review.

 general principles about drug use

  • Don’t stop taking a prescription medication suddenly, unless instructed to by a physician.
  • Wean off medications gradually, supervised by a physician.
  • Don’t attempt to stop medication without first initiating other measures to manage the condition the medication was prescribed for. (paraphrased from the introduction)

Dr. Weil reviewed four medication groups that I discussed in this post- 7 overused drugs

  • Antibiotics
  • Sleep aids
  • Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
  • Opioids and the Treatment of Chronic Pain

six-facts-graphic

Neither of us reject these drugs completely; rather we urge caution,

  • don’t rush to use them without trying non-drug treatments first or concurrently,
  • use only when absolutely necessary, and
  • be aware of potential side effects and harms.

 7 other classes of overused medication

1.Statins- medication used to lower blood cholesterol and prevent heart disease

“Current emphasis on statin therapy should be

balanced by equal emphasis on lifestyle changes.”

diagram of the human heart
Heart diseases affect any and sometimes multiple parts of the heart- the atria, ventricles, the valves, the aorta, the pulmonary artery and veins, the walls and the coronary arteries (not shown in this diagram. )

2. Medication for GERD- gastroesophageal reflux disease, commonly referred to as reflux or heartburn

“Heartburn is a warning sign of disturbed GI function that should prompt us to identify and change the habits responsible for it.”

3. Antihistamines (allergy meds) and Medications for the Common Cold and Flu

These are in two separate chapters but I group them together since the same meds can be used to treat all three conditions.

“People with allergic rhinitis and others…would be wise not to rely on antihistamines, but to try natural remedies and lifestyle change …to control symptoms.”

“Most healthy people recover from both colds and flu on their own with no need for drugs, prescription or OTC (over the counter). “

I included antihistamines on my list of drugs that are underused. I was referring to people with severe uncontrolled allergy. Dr. Weil seems to concur with their use in this case.

4. Steroids- the steroids in the cortisone family, not the anabolic steroids

“Save these powerful drugs for serious conditions and try to slowly wean off them once improvement occurs.”

5. Psychiatric Medications for Adults, Children and Adolescents and for Attention Deficit Hyperactivity Disorder (ADHD)

Dr. Weil’s discussion of these medications takes up three chapters but I’m grouping them together.

These drugs are on my list of underused drugs. I said that because severe mental illness symptoms usually needs  medication for adequate control and those people should stay on medication indefinitely, until a physician recommends stopping. Otherwise, I agree with Dr. Weil that milder illness may not need medication.

“Antidepressant drugs are indicated for major depression, not for routine management of mild to moderate depression, for which more effective and safer treatment options exist.”

“Medication treatment should always be integrated with psychotherapy and other non-pharmacological approaches and should be discontinued as soon as possible” (the chapter on children)

“ADHD is highly overdiagnosed. Children with learning or behavioral difficulties should be carefully evaluated before being labeled with the disorder.”

6. Antihypertensive (hypertension or high blood pressure) Drugs and Medications for Diabetes

I’m grouping these together because these

two conditions frequently occur together, what we in medicine call comorbidity.        complications of high blood pressure

“In treating high blood pressure, it is extremely important to take individual uniqueness into account.”

“Our health care system and our society should encourage better lifestyle choices by making these…more accessible and more affordable…by changing diet, increasing physical activity ..many will be able to keep their use of medications to a minimum..”

7. Medications for Osteopenia (thin bones) and Other Preconditions

“Most people with osteopenia have …low fracture risk. They do not need drug therapy, since the risk outweighs the benefit.”

If you need to check if any of your medications fall into any of these categories, you can check at this link, or ask a question in the comments or here.

MedLine Plus- Drugs, Herbs, and Supplements 

Last words about medication overuse

Dr. Weil offers these last words(among several others) about using meds wisely.

To consumers-

Be informed. Do not take medications (of any kind) unless you know the reason, how they work, and the potential benefits versus the potential risks.

To pharmacists-

Be knowledgeable about the dietary supplements, herbal remedies, and other natural products that consumers are taking.

To physicians, nurses, and allied health care providers-

Be informed about alternatives to medications therapy for the health conditions you see.

To all readers of his book

Contact your elected representatives to end direct-to-consumer advertising of prescription medications.

 

So what are the alternatives to using drugs for these and other conditions? I’ll tell you what Dr. Weil says, as well as other experts, in my next post. Or, you can get Dr. Weil’s book and find out now.

For your review:

7 overused medications

7 underused medications


Driving Miss Norma- a book review

Driving Miss Norma- adventures facing life and death, a book review #DrivingMiss Norma#endoflife

Driving Miss Norma

One Family’s Journey Saying “Yes” to Living- a memoir

By Tim Bauerschmidt and Ramie Liddle

Harper Collins, 2017

(This post contains affiliate links.)

I first learned about Norma Bauerschmidt on Facebook when a friend shared a video about her. She was a 90 year old woman who decided to spend the last months of her life “on the road” travelling with her son in a motorhome. She was diagnosed with cancer but decided to forgo treatment so she could enjoy her remaining time.

I didn’t learn more about her until I saw this book.  I decided to read it, expecting a feel good entertaining read. The story turned out to be far more complex than the little I knew.

Driving Miss Norma - a book cover

Driving Miss Norma tells the story of Norma Bauerschmidt, a WWII WAVE veteran, wife, and mother. She was still in good health at 90 years of age, until she was diagnosed with cancer.

Her doctor recommended surgery to be followed by chemotherapy, and warned her the treatment and recovery would be long and difficult. She told him no, she would rather “hit the road” with her son and daughter-in-law and enjoy her life, seeing and doing things she had not had a chance to do before. And her doctor agreed, saying that is just what he would do.

Tim, her son, and Ramie, his wife, had already been living a nomadic life, travelling the country with their standard poodle Ringo in an Airstream travel  trailer they parked in campgrounds and  Walmart parking lots. They enjoyed travelling, seeing new places, meeting new people. They wondered how adding a 90 year old woman to their wandering lifestyle would work.

By the time they completed arrangements for Norma to join them, she was already frail, and as her illness progressed she needed even more attention and care. Tim and Ramie soon realized that this might be more difficult and complex than they imagined.

In the book, co-written by Tim and Ramie, they tell their stories also; the mid-life challenge of caring for aging parents, making end of life decisions and plans, and coping with parents’ death and  their subsequent grief. Having chosen not to have children, the role of caregivers was foreign to them, and one they had to painstakingly embrace and navigate.

By coincidence, Ramie had recently read the book Being Mortal  “a critical examination of end-of-life medical care.” Until then she had not thought much about the subject. But when she finished the book

Atul Gawande- Being Mortal-book cover
This book caused Norma’s daughter-in-law Ramie to being thinking about end of life issues in a new way

“I knew my life had changed. The way I looked at the end of life had been flipped upside down and backward. I knew now it was time to have those tough conversations.”

(I reviewed this book at this link)

As they travelled, Ramie began writing about their adventures and posting on Facebook to close friends and family. She thought that other people might also be interested so she started a Page, Driving Miss Norma. They attracted a handful of followers initially, as she expected.

up close look at a hot air balloon
Norma went on her first and only hot air balloon ride (complimentary stock photo from Pixabay)

But after Norma’s story was reported on the Good News Network, followed by a CBS Evening News Story , the Page began adding  followers by the thousands.

The were alarmed, even fearful, of what they perceived as an intrusion on their privacy. Until now, they had deliberately avoided media in their isolated lifestyle. Then they began noticing how Norma’s story was resonating with people in a way they had not expected.

“We had suddenly and dramatically found ourselves in the middle of an international conversation about the meaning of life, illness, dying and love. We were learning on the fly how to open ourselves to holding so much raw emotion.”

Her story opened their lives to new people and situations they never imagined would happen. Rather than being a burden, Norma’s growing fame became the vehicle for them to grow closer to her, each other, and a whole new set of friends all over the country and the world.

“We had the support of people all over the world and that was breathing new energy into our days. Here were so many people pouring out their deepest fears, losses, and desires to us. They told us of their caregiving struggles. They shared with us their innermost desires- to make peace with their recently deceased father, to tell someone “I love you.”

Throughout the story Tim and Ramie share about the places Norma visited (see map), people she met, from the common to famous, the foods she tried, sometimes for the first time, and activities she tried, also many for the first time, like riding a horse. They and the new friends they made shared food, fun, love, and laughter.

map of the United States
Norma visited all the sites marked on this map

But they also touch on the serious issues we all deal with sooner or later- aging, frailty, complex illness, terminal illness, end of life decisions, palliative care, death, and grief. They learned some important lessons about human relationships which they illustrate beautifully in their transparent writing.

“We learned how to greet people with open minds and open hearts…the lines that separate people into different boxes-religion and politics and race and age-blurred and faded and eventually disappeared. We got to see the truth in people, including in Norma: her glow, her tenacity, her joy, and her confidence.”

Tim and Ramie wrote the book after Norma’s death. They each took turns writing different chapters, and Ramie took all the photographs that illustrate it. But in a way Norma herself wrote the book, since it was the way she faced the final months of her life that produced the lessons her family learned and share with us in this book.

Norma kept a journal during their travels and after she died Tim and Ramie, with close friends, read it, and were somewhat surprised at what she wrote. Or rather, what she didn’t write.

“She did not write about cancer or fame- the two big themes of the trip for us. She did not write about the fear of dying or illness at all. Instead, she talked about life, living, and the things that brought her happiness:a sturdy wheelchair, mama and baby goats, a good hair perm, and her trusty sidekick Ringo.”

I feel sad that Norma’s trip did not bring her though my town so I could have met her. But there will be “Normas” in my life that I will meet, and perhaps someday I will be a Norma myself. When that happens I hope I remember the lessons this book teaches.

“Joy begets joy, love begets love, peace begets peace.”

You can continue to follow Tim and Ramie on Facebook where they are still

Driving Miss Norma

The Power of Meaning: Crafting a Life That Matters

 by Emily Esfahani Smith

“In a culture obsessed with happiness, this wise, stirring book points the way toward a richer, more satisfying life.”
To explore how we can craft lives of meaning, Emily Esfahani Smith considers an array of sources–from psychologists, sociologists, philosophers, and neuroscientists to figures in literature and history.
Drawing on this research, Smith shows us how cultivating connections to others, identifying and working toward a purpose, telling stories about our place in the world, and seeking out mystery can immeasurably deepen our lives.
She explores how we might begin to build a culture that leaves space for introspection and awe, cultivates a sense of community, and imbues our lives with meaning.Inspiring and story-driven, The Power of Meaning will strike a profound chord in anyone seeking a life that matters.

About the Author

Emily Esfahani Smith’s  writing has appeared in the Wall Street Journal, New York Times, The Atlantic, TIME, and other publications. She is also an instructor in positive psychology at the University of Pennsylvania, as well as an editor at the Stanford University Hoover Institution, where she manages the Ben Franklin Circles project.
Born in Zurich, Switzerland, Emily grew up in Montreal, Canada. She graduated from Dartmouth College and earned a masters in applied positive psychology from the University of Pennsylvania. She lives with her husband in Washington, DC.

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Drs. Paul and Lucy Kalanithi reflected on their experience facing terminal illness in this review-

When Breath Becomes Air- reflections from Dr. Lucy Kalanithi

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When Breath Becomes Air by Paul Kalanithi