But isn't it true that many tests generate return visits to the doctor? I was getting one blood test per year. The result: Everyting is always good. No problems and no need for drugs. But this last time the doctor asked me to get more blood work in 6 months. Quest Diagnostics does the blood work but it's always followed by another office visit to my doctor, even if the results are good.

I have always gotten my test results by mail or email. If there was a problem I was called to come in. I can't speak for what others do.

What we do is ask that a copy of the results be mailed to us, which they must do.

Or if you get a script have that request written in.

No follow up if you wish.

we also ask to have a copy sent to us when they send it to the doctor. It is easy to interpret and then if there are questions one can set an appointment for blood work follow up with the doctor. To go in as as matter of course to have the doctor tell one all is OK is one of the problems with health care....not necessary expenses. They do it because medicare will pay for it. That in itself is not a reason to go to the doctor to get the results.

btk

3-4 meds?

I'll tell you from actual experience as an RN at TVRH that people who are inpatients at the hospital average MUCH more than 3 home meds. It's rare if anyone over the age of 50 has 2 or less. Many, many have 10 or more!

I'm not saying it's wrong or right - just letting you know my experience over the past 8 months at TVRH.

And PS > My personal doc up north (and so far down here) has never, ever left my room to talk to a RX rep. I know for a fact that he made them come on a certain day, at a certain time. And he gave all all of the 'free' samples to those people who could use a break (money wise).

If over 50 taking 2 or less is rare, what is over 60 taking none?

Not sure what you are asking. My point is that people over the age of 50 in TVRH (vast majority of my patients are 70 or so) take many, many meds. And yes the older they are the more pills they seem to take. I don't think I've had one patient yet over the age of 60 with no home meds.

Russ what I'm saying is my wife & I take no meds, so you're saying that's unheard of in your practice, interesting

Can I ask what R the most used drugs treating ie: BP, cholesterol etc.

Also is there a correlation of number of meds and obesity?

I am 70 years of age and take no meds. I get a check up about once a year and all is well, so far..

I have asked several times for your age, Jimbo. That makes a big difference in a lot of things. I am guessing you are in your early fifties. Am I correct? I didn't take any meds when I was in my early fifties.

Your diet isn't the total answer to good health, no matter how much YOU believe it is. There is NO shame in taking medicine to maintain your health. It goes without saying that just about every person I have ever met knows that an optimum weight and a healthy exercise regimen is important to maintaining good health together with a varied low fat diet containing a lot of fruits and vegetables and small portions of meat/protein.

HOW OLD ARE YOU? I am 72.

There is no doubt that the most prescribed drugs are for hypertension and to lower cholesterol. Those drugs are prolonging our lives. I don't see anything wrong with that.

All great points Gracie (and BTW you look marvelous for 72!).

Yes I would say BP is the number 1 med category (ACE inhibitors etc.). Then drugs for AFIB or other heart rate issues (Beta blockers, CCB etc.). Then statins for cholesterol. Then thyroid issues (synthroid etc.). And a surprising number of men with ED meds.

People also take many non-RX meds like Baby aspirin, Vit C,D,E,multi, PPI (think Prilosec generic).

I've had many patients with over 15 meds.

I would say the most meds I see are for blood pressure and/or cardiac related illnesses--most of them also end up on statin drugs for cholesterol, diabetes--lots of people with type II (used to be called adult onset), and smokers end up with several inhalers for copd

Im 63 and take no meds at all. I do take supplements such as fish oil, vitamin D, and low dose aspirin. I eat right and ride my bicycle 2 hours a day five days a week. I'm like most people, I would like to go to Panera or McDonalds every morning. Eat pizza two or three times a week or go to Sonny's BBQ and get daily specials all you can eat $9.99 but I don't because there would be a price to pay (3 -10 meds a day.) Mostly dew to overweight conditions and obesity. A third of people my age are obese. With that causes many medical problems.

As I said I'll tell you when we meet maybe 9/21.

Do you mention (or in fact believe yourself) that BP, cholesterol and ED, can be corrected with diet.

Yes I said ED.


.

There is a lot of truth in the saying
 

"We are what we eat". That being said, each person comes to their understanding of that in their own time. If you have been raised with that understanding, then it is easier to make food choices based more on health than on gustatory preferences.

In many cultures, food is a central focus and preparation and ritual is very important and I am sure that it is harder for many of those raised in that type of environment to make food choices based on health, until there is some personal reason that sends them in that direction.

For many people, as we get older, unless there is some compelling reason to change our practice, it isn't a priority for us and it is often viewed as depravation, particularly if we have been raised with food (especially something sweet) as a reward.

At 70 and 72 my DH and I have not taken any meds for over 30 years and for me that includes aspirin. As a matter of fact the only prescriptive thing I ever remember taking is 1/4 Valium on my doctor's insistence, for a few weeks after my first husband died.

We do use homeopathic remedies and flower essences when we feel the need for some additional support and I suppose that could be construed as medicinal. I am just thankful that we have had the experience and opportunity to walk a different path.

However I recognize that each person comes to his/her own decision about what to eat and what to take and there is no one size fits all path. More important is feeling good about the choices you are making and joyfully eating whatever you are choosing.

Some experts have said that the attitude with which you eat is more important than what you eat and I believe there is truth in that too and goes a long way in living a happy life, which is, after all is said and done, the goal of each of us. I think.

Bon Appetit!

LW888

[QUOTE=jimbo2012;548251]As I said I'll tell you when we meet maybe 9/21.



Do you mention (or in fact believe yourself) that BP, cholesterol and ED, can be corrected with diet.

Yes I said ED.


.[/QUOTE

For sure. I'm living proof of that. I weighed 268 lbs. When I went for a health screening the year I retired my glucose and cholesterol was red lining. The nurse asked if I was taking any BP medicine. When I said no, all she said was you need to.
After retiring instead of going on all the medicines I changed all eating habits, started exercising every day. Now my weight is 182 and all vitals are normal. All just from loosing the fat.

Well, I have to think you are much younger. Your son is in college. Our grandson is in college. Age does make a difference in health and 20 years makes a LOT of difference.

Never said my son was in college???
I'm older than you're thinking. :a20:

Didn't you tell us he was studying law?

several years ago he was, sorry for the confusion, he has his own practice.

He probably is still studying law then:pepper2:

I do think that diet and exercise play a vital role in your health. I wouldn't be much of a nurse if I didn't think that way. And yes sometimes these conditions can be corrected by this alone (especially when they are accompanied by a large weight loss - just watch Biggest Loser). But there are many people who have unexplained high BP or heart arrhythmia that would die (or die younger) without medications.

Well said Gracie...

Well said GG and Russ Boston.

When I first moved to the Villages my neighbors said the same thing to me when I told them I didn't take any medications. They said, "wait 'til you get older." I was only about 60 or 61. That was so frustrating because I knew I was doing the right thing, diet wise. Today I'm 71 and still don't need medication. But can I tell them I was right? No, they have all passed away.

It may not be the total answer for various reasons. Most people won't do it
so how can it be the total answer, or even a partial answer?

If you have to because you reject dietary measures, well, then I guess you have to take medication.

I guess you are speaking for everyone because you have presumably met a lot of people. And if they all knew what was best, most likely everyone else does too. And that's how you know what's best. Right?

Nicely said, I can only add

“We should focus on diet, not drugs.”

Thanks for your insight on this topic. It doesn't match up with the information that was given at the first USF lecture. Perhaps it's because people who get admitted to the hospital have greater health issues than the average person who doesn't need hospitalization.


My opinion: I see a progression that starts with the standard American diet. Poor diet, like smoking, can take several decades to bring about poor health. So, when some health issue developes, people don't see it as a failure on their part because all they did was eat the standard diet like everyone else. So why change anything? Most people continue eating the same diet.

With the same diet, it's only a matter of time before another drug gets added for something else. At age 65, 9 out of 10 people take at least one medication. By around 70 it might be 2. By age 75 the average is 3 to 4 medications, and 5 or more is not uncommon.

It's not unlike smoking, drinking or gambling addiction, in that it starts with one and then progresses (i.e., one cigarette, one drink or one gamble). So when we hear about 10 to 15 medications, it's just further evidence of the future direction for the average drug taking senior.

Let's face it. Some people are just self destructive. Whether its food, alcohol, or cigarettes. Thay know it's all bad, BUT ;;;:loco:

Thanks, you made me laugh with the Loco icon at the end. :wave:

Remember I deal with locals as well as Villagers. And many patients in the hospital are not there for the first time.

Dr. kickback
 

A common problem in illegal drug and device marketing cases is doctors’ willingness to delude themselves into thinking that cash, lucrative trips and other kickbacks do not affect them, said Mr. Morris, the chief counsel.

“Somehow physicians think they’re different from the rest of us,” Mr. Morris said. “But money works on them just like everybody else.”

Mr. Sullivan, the United States attorney, said officials hoped to send a strong message to doctors. “I have been shocked at what appears to be willful blindness by folks in the physician community to the criminal conduct that corrupts the patient-physician relationship,” he said

Source NY Times full article

A rather simple fix was/is employed by the medical group I worked for. Pharmaceutical reps had no access to the providers directly. They met with the chief pharmacists at the medical centers. A pharmacy board consisting of pharmacists and physicians met regionally to discuss each medication. Only after evaluation of the cost/benefit/effectiveness/safety of a med could it be added to our formulary. To be added, a med had to have demonstrated in independent studies or in-house trials that there were significant advantages over one already in use.

The pharmacy department also controlled samples, and distributed them to the appropriate departments as needed.

Our members would often ask for particular meds they saw advertised on TV. If there was a compelling advantage/reason for a non-formulary med for that particular patient, it would be prescribed. But the pharmacy tracked non-formulary requests and they were reviewed for appropriateness.

Our providers were prohibited from accepting gifts from pharmaceutical companies. If they were to speak at meetings about a particular medication or procedure, they were only allowed to accept a small honorarium in addition to actual expenses as they were still receiving their regular salary while away. This also had to be reported to the medical group and was tracked.

When people come back again and again, I assume it's often because of end-of-life situations like advanced lung cancer or emphysema. Is that correct?
And do they come mostly from nursing homes?

I can think of a lot of reasons why the same people would return to the hospital again and again. Diabetic episodes. Brain bleeds. Kidney stones. All of those have caused repeated hospitalizations for friends.
Chronic inflammatory colitis... alcoholism causes bleeding. Addiction to prescription drugs. Falls. Infectious diseases. People over the age of 55 have a high incidence of pneumonia.

http://www.aafp.org/afp/2001/0115/p257.html

That link was 12 years old, here's one a bit more recent.

Not sure why you included kidney stones?

Hospitals don't do much for them and they occur in younger adults as well.

Cardiac is number one.

People who have kidney stones are admitted because of the heavy pain medication that must be administered and observed. Kidney stones can be chronic and can be caused by diet.

Also they can occur as a side affect to certain meds.

When I recommend a certain diet, I'm targeting those who can tolerate all or most foods. Just like the government's food pyramid (It may be called food-steps now). Not that I approve of all of the governments recommendations. But the point is this: They make recommendations whether or not it will suit everyone.

If we were to live in a world where no one could make recommendations unless they suited everyone, where would we be? The field of nutrition would be set back to what date in history?

Or sometimes, calcium supplements.

I never suggested it should be all about lifestyle. I'm simply trying to point out that right now it's mostly one sided in favor of medications and operations. I had hoped this issue would be addressed by the health alliance but it wasn't addressed in any significant way. It seems the health alliance was set up by medical doctors for medical doctors.

This is not the way to make The Villages "Americas healthiest hometown". At least it won't do it in any significant way. The way it is now, it just amounts to tinkering around the edges.