The Changes We All Need to Make in Midlife
Take action now to avoid our parents' overmedicated approach to health
During a routine physical a few years ago, my physician looked at my test results and told me my blood pressure and cholesterol were high and I needed to go on medication immediately.
"For how long?" I asked. "I don't want to be dependent on pills."
"Taking these medications is common at midlife," he said. "You'll be on them for life."
(MORE: The Case Against Statins)
I felt like I had just been sentenced for a crime I didn't commit. My octogenarian parents take multiple pills a day. But not me.
Still, I went with the program and took the meds, including lisonopril to combat borderline high blood pressure and simvastatin to lower cholesterol, for two years until I decided, like many other midlifers, to make some changes.
The first was to replace my doctor. The next was to work with my new physician to create a plan aimed at reducing my prescription dosages, with the shared goal of eliminating them altogether, if possible.
I am not alone in this quest. Adults like me who have watched overprescribed parents fill up pillboxes each week and make endless runs to the pharmacy are searching for ways to avoid that scenario for as long as possible. That means making lifestyle changes now and sticking to them for the rest of our healthy lives.
"We are not willing to settle for the aging pictures our parents painted," says Beth Reardon, director of integrative nutrition at Duke University's Duke Integrative Medicine. "Our genetic blueprint is no longer our destiny. We are aging much differently, both mentally and physically, than our parents. We don't want pills to remind us that our bodies are tired, which we hear as 'failing us.'"
Choose the Right Doctor and Get to Work
If your doctor believes pills are an automatic part of aging, consider making a change. Find one who is willing to create a reasonable plan to help you stay healthy on your own, through changes in lifestyle. It may take some effort, but when you find someone who shares your goals, the benefits can be significant. "People are looking for something different from their relationship with their physicians," Reardon says. "Some don't want 'a pill for an ill.' They want to address the cause, not the condition."
(MORE: 5 Ways to Make Your Doctor Your Partner)
But while the right doctor can help, you also need to be willing to put in the work. "I had a patient who was diabetic and hypertensive," says Dr. Michael Coates, a professor of family medicine at the Wake Forest University School of Medicine. "We got him into a focused weight-management program, with a trainer to help increase his physical conditioning. He'd been on medications for at least a decade — but he's not on diabetic medication anymore, he cut his cholesterol medication in half and it looks like he may be weaning off the blood pressure medication, too."
I know firsthand how empowering it can be to make such changes. In the past year, in collaboration with my doctor, I cut the dosages for both of my prescriptions in half, too.
We can make huge strides toward boosting health and minimizing the need for pills at any age by choosing healthier foods, committing to a consistent exercise program with an appropriate intensity and engaging in stress-reduction techniques like yoga or tai chi.
"Many midlifers are more open-minded and willing to tap into the healing power of their own bodies as compared to generations past," Reardon says, citing increased interest among her patients in organic, whole foods and mind-body practices like acupuncture, Reiki and therapeutic massage. Wearable health monitors and fitness trackers like the Fitbit Force can also help more of us meet our goals, although so far it appears those who'd benefit most from such devices aren't using them.
Know the Real Risks and Rewards of Medication
If we agree that we all want to avoid taking daily statins, insulin, diuretics, ACE inhibitors or beta blockers, we must also acknowledge that for some of us, medication may be the most appropriate treatment.
"You have to pay attention to your family history," Coates says. "While diet and exercise programs are essential, you might need to be on some medications. The goal for most of us is trying to minimize them and find the middle ground."
Working with a doctor you trust, one who doesn't reflexively dispense prescriptions, you can make an informed decision. "Occasionally we see a diabetic or hypertensive person who insists they can manage the condition without meds, even though their sugar or blood pressure is really quite high," says Leslie Kernisan, a geriatrics specialist at the University of California, San Francisco. "In some cases, the chance of benefit is high and there's a downside to avoiding meds. But there are a lot of people taking meds for which the absolute chance of benefit is pretty low, so it's reasonable for them to avoid meds."
This is part of the thinking behind new statin prescription guidelines released last month by the American Heart Association and the American College of Cardiology. Although the groups' initial calculations have been challenged by many experts, the new guidelines could eventually lead millions more people to go on statins to reduce their risk of heart attack or stroke. But the new advice could also help many others get off longtime statin regimens because it rejects the previous goal of reducing cholesterol levels to a specific target. If an adult has somewhat elevated LDL cholesterol but no other apparent risks for heart attack or stroke, they may now be cleared to stop taking statins.
It's a step many experts, long worried over the potential downsides of millions of Americans taking multiple daily medications, would welcome. "Every time you add a new medicine, it may adversely react with one of the others or with over-the-counter medications that doctors aren't even aware [you're taking], and that compounds risk," Coates says. "Overmedicating can negatively impact organs, such as your liver and kidneys. And the more medications you're on, the greater the chance that you'll be confused, too. My focus is, 'What don't you have to be on?'"
That should be the focus for all of us in midlife.