Medication - why do I feel so strongly on this subject?

At the beginning of this blog, I will state that anti-biotics have probably saved my life twice and certainly saved my husband's life.

On Tuesday, January 27th,  the first item on the news was about some medication and dementia.
http://www.bbc.co.uk/news/health-30988643

I also heard on a newscast this week, that GPs will be paid to prescribe statins. What?

I felt as I did when writing this blog last June:
http://alisonrussell275.blogspot.co.uk/2014/06/i-could-weep.html

I need to write from my own experience. I wanted to express my views on the pharmaceutical industry in the book, but the editor thought that my comments would look like a rant and decrease the efficacy of the content. Begrudgingly, I took her advice. I wrote the book to help people and left much out. Hopefully, I can include something in the new book in progress. Something suggesting that they question and research the medication that they and their relatives have been prescribed and it helps just one family, then the job is done. The ripple effect can be powerful. 

When did I start to question medical matters?
Seriously, in 1978. Though in 1968, I had experienced unpleasant side-effects from some medication I was taking for period pain. But then it was a given and you didn't question doctors. I'm only too grateful that Attention Deficit Hyperactivity Disorder (ADHD) was not known in my childhood, as I feel that Ritalin would have been prescribed. Too scary to contemplate.

In 1978, I underwent a small gynae op. On the follow-up appointment, I mentioned that I was still in extreme discomfort on occasions. I told the surgeon that it seemed to be every month and around the time of ovulation. He thought it was nonsense and memorably said, " If you don't buck your ideas up young lady, you will lose your husband." You don't believe me? It's true. 

So I carried on, in extreme discomfort every month, until one day in the library, chance (?) led me to a book on a condition I had never heard of before, called Pre-Menstrual Syndrome, (PMS) or Pre-Menstrual Tension (PMT), as it became known. A book that changed my life for the better. The contents made sense and the recommendation was for taking extra Vitamin B6.  In our small town was a small grocer's shop and he had a comprehensive sideline in vitamins and nutritional supplements. He was helpful and I was soon feeling better, though he mentioned that GPs didn't like what he was selling. I mentioned my Vitamin B6 purchase to  my GP, he laughed and said, "You're flakey." Some years later he offered me large bottles of Vitamin B6 on prescription.

In 1981, I was getting fed-up of diets and thought I would try some slimming-pills. I didn't go to my own GP, knowing he wouldn't give me any medication. But the grapevine worked well and everyone knew of the GP who would give you anything you asked for. He did. I was prescribed slimming pills, though cannot recall what they were, except I went as high as a kite when taking them. Life and soul of the party. Until the day I had a road accident on my way to work. The Ford Transit van hit a bend, mounted the pavement, knocked over a wall and I was fortunate to be alive, when the vehicle stopped, with my head having smashed through the side window. I didn't tell anyone what I was taking, but I knew the pills had made me more reckless than usual. I stopped taking them.

It was around this time that the TV presenter, Esther Ranzen, ran a campaign on her programme, 'That's Life' about the addictiveness of some anti-depressants called Valium and Librium. That made sense of what some of my friends were experiencing. The pharmaceutical industry created another type of medication. One in daily use today. Selective Serotonin Re-uptake Inhibitor (SSRIs), claiming they were not addictive. No? Fifty million prescriptions for anti-depressants alone, last year?! The majority of these drugs are unsuitable, if not damaging for the under 18s. Does that stop them being prescribed? No. It's scandalous. 

At least ten years ago, I heard a radio programme where some British medics were attempting to make the World Health Organisation (WHO), recognise that while Big Pharma was saying that some medication wasn't addictive anymore, the withdrawal effects from SSRIs could be so bad, that people didn't want to come off the medication, thus creating a dependence. Not so different from an addiction?  The WHO didn't listen.

In late 1990s, I thought I would research the menopause, before it occurred. Hormone Replacement Therapy (HRT) was beginning to get wider publicity and I started to read up on the subject. This was also timed with another TV personality, Dr Miriam Stoppard, visiting the local town extolling the virtues of HRT and promoting her new book on the subject. It was a powerful presentation and I doubt there were many women in the room who did not feel motivated to "find the HRT that suits you and stay on it for life."

I heard this presentation before learning about how the brain works, trance states of learning and how emotional hijacks occur. Twenty-four hours later, with my emotional enthusiasm calming down and therefore beginning to think logically, I started to look at the consequenses. One question loomed large in my head. If every woman over 50 took HRT for the rest of their lives, who would really benefit? Only one answer. The Pharmaceutical industry. I researched Dr Miriam Stoppard. She sat on the board of a Pharmaceutical Company and they had sponsored the luncheon we'd all enjoyed. The scales fell from my eyes. 

I have never believed anything I've been told since then. Not without researching and becoming informed. It is no coincidence that when I found the following quote on a drinks coaster, I  adopted it for my readers too.

"Believe nothing, no matter where you read it or who has said it, not even if I have said it, unless it agrees with your own reason and your own common sense. " Attributed to Buddha

So, a couple of years later, when the GP told me that for a variety of reasons, I should take HRT, I told him that I was making an informed decision (and by that time I was very informed) and declined it. He told me that I was foolish and "not to rubbish HRT." This is the same GP, who a few years later, asked me why I needed a bone density scan. When I said it was due to family history and my refusal to take HRT, he told me that I was correct in not taking it. Gobsmacked, I reminded him of what he'd previously said. He slid his hand across the desk, placed it on top of my hand and said, " Things change, my dear." When the scan showed the I had stopped the bone density deterioration with nutrition and exercise, this was excused by, "it must have been a faulty machine." My bone density is still okay.

Around this time I had been working for a number of years on a psychiatric unit. My views haven't changed in nearly twenty years, except the situation is far worse. 

In 2015, I could replace HRT with Statins. 

I was at a post-play conversation with an actor last month. The actor was recovering remarkably well from a severe stroke. Also present was a consultant from the local stroke unit. At one point the subject of statins arose. The consultant said that, "everyone over 60 should be taking them." There was a slight murmur in the room, but no-one said anything. I couldn't keep quiet, so just said strongly, "No". At the same time a woman at the next table, also made a negative comment. The consultant looked daggers at both of us.

Afterwards I went up to the woman. She said, " Statins nearly killed my husband. My daughter is a doctor and wants me to take them, but I have refused." She then turned to her companion and asked her if she was taking them. The companion uttered these words, " I don't know. I just take what he gives me." *knocks head against wall*

That's the attitude of the majority of patients. Doctor knows best. They don't. As one said to me, "we can only guesstimate." But if HRT was originally sold to be taken by all women over 50, what about the profits from everyone over 60 taking statins?

Doctors are also exposed to an onslaught of advertising and sponsorship. Have a look around the surgery next time, let alone the names sponsoring medical training, hospital units etc:

Back in the nineties, we visited Centre Parcs. It was Friday afternoon and walking through a cafe, I bumped into the practice nurse for the GP surgery I attended then. (The HRT one). She looked very happy and told me that she had been attending a course on diabetes. The course had finished, but as Centre Parcs couldn't sell the accommodation for the weekend only, they were being allowed to stay on. I jokingly asked (I guessed the answer), whether she was paying or the Pharmaceutical Company? Her reply was, "Oh, it all free, the Pharmaceutical Company are paying, but it doesn't influence our prescribing." No of course it doesn't, advertising never works does it?

A Surgery Manager attended a seminar on the psychology course I was taking. It was held in a large, draughty, faded ballroom in a faded hotel. "I wish my doctors could hear this, but last week they were guests at Blenheim Palace, why would they come here and pay?" Fortunately, some did and still do.


I was asked to give two workshops to the staff of a day centre for adults with mental health problems. After I had spoken, the consultant asked the staff to stay behind for a talk by someone from a Pharmaceutical Company about a new anti-psychotic medicine. I was furious and naive. That's how my fee was being paid. I refused to take it, though people said I should have taken it and given it to charity. Emotional arousal had shut off logical thought. 

I have stated that my life was saved by anti-biotics. Twice. On two occasions I had pneumonia and ended up in A&E. The first time was on Millennium Eve, so I definitely remember how I celebrated - not! Except I was diagnosed with kidney problems and sent to the urology ward. Atypical symptoms and one mistake. Okay, but two? Eight years later, the same thing happened, but this time after I had told the doctor about the first time and was pretty sure the atypical symptoms were the same. On the second visit to hospital, I was given oral morphine. It should have been bliss, but the pain didn't go away, so I was given another dose. The pain was indescribable and I thought I was going to die. I should have been given a stomach liner beforehand, but wasn't. The same thing happened to my 90 year-old father with a pre-chemotherapy drug he was given. That's my father who was given no more than six months to live at the most, due to the 'off the scale' reading he had on a test. He lived for forty-four months, all them lucid, but frail in the end.

Common-sense takes me back to my chemistry lessons. I wasn't very good at the subject, but I do recall the layout in the workbook. We had to draw a diagram and write, Method, Result, Conclusion.

Medication is full of chemicals. One chemical interacts with another. In turn, they interact with the chemicals in our brains and bodies. A great deal of research has been done about the side-effects from each medication. There is sizable research about taking two medications together. There is little or no research about more than two medications taken together, but how many people do you know who are taking more than two medications every day?

Another question came to me, when working on the psychiatric unit in the 90s. It can still be asked. Anti-depressants are taken to reduce depression and anxiety conditions, that's why they use the word, 'anti'. So, why do so many people say, without thinking it through properly, "I'm depressed and taking anti-depressants."? Having spoken to several paramedics in the UK and Australia, they inform me that most of the people who have committed suicide or attempted suicide are taking anti-depressants. Not working then are they?  Ah, people will say, but they were depressed. 

An acquaintance died by suicide. He was having some bad symptoms, physically and emotionally. He was taking medication. Except that it turned out that he wasn't taking it regularly. He didn't realise that he was going cold turkey on a regular basis, with distressing consequenses. It must have been awful for him. So awful, he hung himself. Not that the Coroner knew that's what he'd been doing, because he didn't ask and wasn't told.

Just withdrawing from caffeine is bad enough, let alone strong medication with harmful withdrawal effects. 
http://alisonrussell275.blogspot.co.uk/2014/02/its-cold-turkey-stupid.html

The information about side-effects is out there, researched and written about by qualified people. But Big Pharma shout louder or rather, have the bigger advertising budgets.

Okay, I'll stop. You have the idea. I could write an entire book on my observations and experience alone. At present I do not take any medication, something that made a hospital doctor recently ask, "How did you manage that?" If I took everything I've been told to take, I would rattle, be severely overweight and exist rather than live. I'm not negligent, but have made informed choices. 

Far more accomplished people have wrriten about the subject. An excellent start is Ben Goldacre http://www.badscience.net/

NB: From Thursday, February 2015
innereye.eu/obhiblog/wp-content/uploads/2015/02/Letter_Wollaston_Feb_2015.pdf 

©AlisonRRussell2015

It's going 'Cold Turkey', stupid!

It was 10.30am on Friday, January 31st, 2014.  Adrian was driving us to a nearby town for a funeral. He wondered whether there would be enough time to have a cup of coffee somewhere, before going to the church.

That would be nice, I thought. Visualising the smell and taste of coffee was tempting. I wanted a coffee, but it was Friday. A weekday. I don't drink coffee on weekdays.

Crash! Bang! Clang! A penny dropped. Surely not? It couldn't be. I haven't been that stupid have I?

Three weeks later and it looks as if I may have been.

My liking for black coffee began back in 1966 at a vending machine. I pressed the wrong button and a black coffee was dispensed, instead of a white one. I didn't have enough time or money to change it. I drank it and have never drunk white coffee since. I also have a life long loathing of brown tea.

Thirty years ago, I realised that drinking coffee in the late afternoon or evening was giving me palpitations at night, so reduced my coffee drinking to morning only or had decaffinated coffee. As the years went by, so my liking for a strong coffee increased and preferably using freshly ground coffee. I never sweetened the drink, which, frustratingly, gave me nothing to give up in my coffee, when on a diet.

The years passed and the coffee got stronger, so much so, that I'd rather go without a coffee, than have a weaker one. I started to generally, only have coffee at breakfast. I enjoyed it so much that two mugs became normal.

In 2013, a mostly benign hiatus hernia started to cause more discomfort. I knew I should lose 20lbs or so, but on reading up on the complaint,  I guessed that two mugs of strong black coffee every morning may not be helping. I decided to reduce the amount to one mug and then keep it to weekends only, as a treat.

As I've said, I loathe brown tea, but purely for health reasons, had trained my palate to tolerate weak green tea, with a flavour.  I drink that on weekdays. What a contrast!

I am fortunate to generally keep in good health, with just a sign of arthritis in one finger joint.  During the summer last year, I became more aware of the aches and pains of ageing. Or was it? My father, had kept himself extremely fit by regular walking and climbing thirty stairs to his flat every day, until he was 89 years old. As the aches and pains increased, I started to hold on the the stair banister at home, when going upstairs. I would often think how appalled my father would be to see me. I rarely took any medication, as I wasn't in any pain, just stiff and achey, like the flu. This included every finger joint too.

I visited the GP and asked for a blood test. I needed to know if it was osteoarthritis.  If it was,  I would know what I was up against and deal with it accordingly. I had various tests done and they all came back negative.

Last Autumn, Adrian's illness and recovery took over in importance and 2014 started. I still felt the same and as I climbed the stairs, on occasion, I allowed myself to wonder how long it might be until a chair lift would be required. I'm not being melodramatic, just stating what seemed to me, to be the future.

As a therapist, one question that could often elicit a helpful response, was '"when doesn't this problem happen?" While there are some conditions, illnesses and problems that are constant 24/7, generally most people can identify a period of time when the problem is less or doesn't exist at all. Therein lie the clues for the therapist, doctor or practitioner.

What had been staring me in the face, but I had been blind to, was that the stiffness and aches were better at the weekends and at the beginning of the week. Sometimes I would have a small, weaker coffee at work on a Monday or Tuesday.

Why does the penny drop when it does, is a question I ask in the book? It fascinates me.

On Friday, January 31st, I had climbed into our old Land Rover awkwardly. The step up had begun to  feel too high and my previous agility was lacking. I was feeling below par.

So, why, when Adrian mentioned having a coffee, did my brain click into gear? Within seconds I was Googling, 'caffeine withdrawal, aches and pains'.

There it was. A connection.  Loads of connections. Of course, I knew about caffeine withdrawal headaches, but not the aches and pains. Could this be the answer? Had I been putting myself into 'cold turkey' every Monday or Tuesday? It would make so much sense.

I decided to take things slowly. The following week I kept to the same routine, so wasn't surprised when I felt increasingly stiff and achey, as the week passed. 

The last two weeks I have enjoyed one strong, black coffee every morning. No stiffness in my lower body and 90% less in my hands.  I can climb the stairs quickly and without holding on. I mentioned it to the GP, when asking about an appointment about the hernia. She looked embarrassed and covered a mug of coffee on the desk. "I know", she said, "I tried to give up coffee, but felt so terrible that I'm back on it."

Was I stupid? I think so. I spent all my years in practice, helping people discover the connection between the mind and body, including the importance of good nutrition and mental health.  Helping people understand the acute problems that withdrawing from any medication too quickly, can cause. I can't believe that I didn't see the blindingly obvious signs myself.

A client I saw a decade ago came to mind. Her nutrition was awful, because she cared more about her horse than eating healthily. She changed her diet immediately and made a dramatic recovery. She was elated and said, "I was feeding my horse and dog, better than me."

Where could it have ended? Like much else in my life, which I will be addressing in another blog.  Being offered medication, instead of sorting out a nutritional or stress related connection. That's why I'm cross with myself. I know the connections. I know about food and mood diaries. But I was blinded by my age and an acceptance that it was to be expected.

I have a choice too. Do I work through the withdrawal and have a caffeine-free life? I'm not ready for that yet, but if I have to, I will.  I'm losing weight again and I hope this will help the hernia. Perhaps I should stop lifting heavy bags of compost in the garden too?

I shall wait and see.

Two of my favourite text books on the subject are:

Optimum Nutrition for the Mind by Patrick Holford

The Antidepressant Solution by Joseph Glemullen, MD

@AlisonRRussell2014