- The Washington Times - Monday, August 8, 2005

District pharmacist Edward Watkins Jr., 62, doesn’t take the prescription medicines he dispenses to others daily.

Brian Ross, 41, a trained chef who is head instructor at L’Academie de Cuisine in Gaithersburg, doesn’t need supplementary drugs to keep his heart and weight in balance although he is surrounded at work by rich food in great quantities.

A 57-year-old Capitol Hill writer relies on aspirin and vitamins rather than expensive doses of Lipitor, a cholesterol-lowering drug given to her by her physician following an operation to insert stents into her arteries.

Though their stories necessarily are anecdotal, the three are representative of a segment of the adult American population often overlooked in medical reports: people who, through personal choice (rather than because of religious belief) are living well without relying on prescription medications.

These aren’t people who routinely disobey doctors’ orders. Nor are they regular practitioners of so-called alternative or complementary medicine such as acupuncture. Mr. Ross, in fact consulted a physician for help losing weight. They also don’t routinely criticize pharmaceutical companies.

Mr. Watkins enjoys good health without understanding exactly why. He is reluctant to give any snappy or sappy explanations.

“Everyone else in my family has high blood pressure,” he says. His doctor, he says, “is somewhat amazed” each time he gets his annual physical exam. He doesn’t work at being well, although he eats at least one good meal a day. He doesn’t do any regular exercise, and he enjoys a bag of chips and a bottle of soda daily. (His personal physician has prescribed antidepressants for him on occasion, when he has felt low or has experienced mood swings for good reason.)

“The job is enough to keep me going,” he says. “I’m optimistic, and I just keep moving on. My greatest satisfaction is communicating with people.”

Mr. Ross, who never had used any prescriptive medicines, sought outside help when he realized that the ballooning weight on his 6-foot frame posed a danger.

“Luckily, we have good genes, so my cholesterol level was low, but still, the blood pressure suffers,” he says. He worried that, in the future, he wouldn’t have enough energy to play with his two children “and because you might be dead.”

It was through working with Dr. Pamela Peeke, a Bethesda-based nutrition and fitness expert who is University of Maryland assistant professor of medicine and medical correspondent for Discovery Health Channel, that he was able to lose 19 pounds in eight weeks earlier this year. His cholesterol dropped even further — from 185 to 153. In addition to gym workouts, he ate six small meals a day, combining “lean protein and carbohydrates and at least five servings of fruit and vegetables” — with very little if any so-called prepared food — on a regimen of no more than 2,000 calories a day.

“What Dr. Peeke told me is true — that you have to be responsible for everything that passes through your mouth,” he says.

Dr. Peeke, author of “Body for Life for Women,” says, “People who blow things off — often men, for sure,” and many care providers such as nurses, are most likely to avoid prescriptive medicines. She describes herself as an athlete who never has taken a prescription anti-inflammatory.

A second group that avoids the medications she calls “attentive people, ones not disassociated from their body. They watch themselves carefully. If they start to feel sick, they kick back, push fluids and get more sleep. The last thing they do is call a doctor out of the blue.”

Men, she says, “wait for a crisis and when it occurs, say, ‘I’ll take a pill and it will take care of the problem.’” Women, especially menopausal women, she has found are learning not to reach for medicines to tackle any depressive tendencies, but instead try changing their lifestyles and go in for complementary medicine as well as over-the-counter remedies.

The writer, who calls herself “the hermit of Capitol Hill,” asks that her name not be used for privacy reasons but talks freely about her experience following the stent procedure.

“I was told I had to take a lot of drugs that became rather problematic,” she says. She was disturbed by side effects she attributed to taking 80 milligrams of Lipitor a day. “I started losing brain power,” she says.

“The doctor said the side effects were the same as for 10 [milligrams] so ‘I might as well give you the maximum.’ I also was on several other drugs connected to the stents.” She gave up the Lipitor — “within two days I felt way smarter” — and gradually other prescriptions as well.

After doing research on the Web and in books, she decided to try taking just aspirin and vitamins. She says she feels much better and has lots more energy.

“I’m pretty convinced there is no way on earth to maintain proper weight and get all the vitamins you need [simply] by eating — not if you are predisposed to get these [diseases] genetically,” she adds.

In 2002, the last year for which data are available, 64.4 percent of Americans took prescription medicines, and Lipitor was by far the leading brand, according to the Medical Expenditure Panel Survey compiled by the Agency for Healthcare Research and Quality, part of the U.S. Department of Health and Human Services. (See www.meps.ahcpr.gov for a breakdown of figures by age, sex, ethnicity, health insurance status and other categories.)

“I think people are beginning to get the feeling [prescriptive drugs] are being pushed onto everyone for even minor situations,” says Larry Sasich, a professor in the School of Pharmacy at Pennsylvania’s Lake Erie College of Osteopathic Medicine. “People are rebelling against what might be inappropriate prescribing. … Somehow there seems to be a belief in the medical community — this is anecdotal — that if you are old, you are depressed and so take this drug to be sure you aren’t depressed. And that can potentially present problems.”

“The public is getting more sophisticated,” says Dr. Edward Langston, an Indiana physician and pharmacist who is on the board of the American Medical Association.

“We have gone through the first 10 to 15 years of direct consumer advertising and [now] a lot of people look around and say ‘nothing is that good.’… The message about overusing antibiotics [and the dangers of possible immunity to the drugs] is getting more widely distributed. Between adults and children, I’ll bet at least one-third say, ‘I don’t want to use anything except a minor decongestant.’”

It’s not the idea of taking prescription drugs that patients should resist, but of combining them needlessly and not inquiring about possible side effects, says Dr. W. Grant Thompson of Ottawa, author of “The Placebo Effect and Health: Combining Science & Compassionate Care.” One good source, he points out, is the information sheet the pharmacy supplies along with the prescription.

“Read it and underline items and if you have questions, talk to a pharmacist or physician,” he says.

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