It’s not like I expected any better from a Men’s Health article reprinted on the Health section of MSN’s website, but I was still annoyed after reading about the 8 Drugs Doctors Wouldn’t Take. I skimmed most of the article because most of the drugs doctors wouldn’t take are also drugs for which I have no need. Except for number five, Prilosec and Nexium.
Now, I don’t take prescription Prilosec or Nexium because my health insurance decided long ago when Prilosec became available OTC that it would be much better for them if I would use my own dollars to pay for this medicine, thanks. These days, I technically don’t take Prilosec at all, since Walgreens, bless ‘em, now sells a generic version. But I do take a proton-pump inhibitor, omeprazole, nearly every day. Sometimes, on bad days (like, for example, today), I take three or four of these fuckers.
I am certainly alarmed to discover that doing so might result in a heart attack as well as increase my risk of pneumonia and bone loss, but for right now, the possibility of developing those ailments feels distant and unlikely, whereas the incredible, breath-stealing, throat burning, wretch-inducing, gut-clenching, audible-moan-inciting pain that I experience when I don’t take the pills is quite immediate.* For the moment, I’m willing to gamble that “no likely connection” between proton pump inhibitors and heart attacks actually means “no likely connection” between proton pump inhibitors and heart attacks. And pneumonia and bone loss, because nothing ramps up the capacity for denial like chronic stomach pain, eh?
Still, given that the older I get, the greater the risks posed by omeprazole become, I would certainly like to discuss other options with my doctor. Despite my generally high regard for my personal doctor, I’m suspicious of the conversation given that one doctor quoted in the article recommends taking Zantac (at which my personal stomach issues LAUGH RIOTOUSLY because seriously Zantac, Tagamet, and those other histamine blockers are about as effective as eating this bowl of paperclips on my desk) and the other doctor suggests, of course, being thin:
“To really cure the problem, lose weight,” says Michael Roizen, M.D., chief wellness officer at the Cleveland Clinic and co-author of “YOU: The Owner’s Manual.” That’s because when you’re overweight, excess belly fat puts pressure on and changes the angle of your esophagus, pulling open the valve that’s supposed to prevent stomach-acid leaks. This in turn makes it easier for that burning sensation to travel up into your chest.
I developed acid reflux when I was in my early 20s and weighed 130 pounds, and I have had it ever since–as a skinny person, chubby person, and a downright fat person. Since developing reflux, I’ve been skinny and then fat and then skinny and then fat again, and while my weight fluctuates like the tides, one thing that never goes away for any great duration is my searing stomach pain. (I have also suffered from acid reflux as a regular exerciser, as a slothful couch potato, as a pack-a-day smoker, as a only-smoke-when-I-drink-smoker, as a non-smoker, as a vegetarian, as an Atkins dieter, as a heavy drinker, as a tea-totaller (or, as close to a tea totaller as I ever get), as a coffee drinker, as a tea drinker, as a water drinker, as a stress-case, as a zen-like relaxed person, as a single woman, as a married person, as a red-head and as a brunette, as a resident of six different states, and as I pursued three different careers.) I know fat people with acid reflux. I know skinny people with acid reflux. I mean, hell, have you ever tried to eat with stomach acid roiling up into your esophagus? It’s a wonder that fat and acid reflux are linked at all.
Perhaps this is what the great Dr. Roizen is actually suggesting! Leaving your acid reflux untreated so that you are unable to eat, until you lose enough weight that the reflux magically corrects itself. Or you die. Whichever. I guess we’ll have to buy his book and find out.
*You know, I’m also sort of fascinated by this side effect (lol get it) of the over-the-counterization of pharmaceuticals. Before my doctor would write me a prescription for Nexium, back when it was prescription only, he subjected me to a few blood tests to make sure I didn’t have an ulcer. Satisfied that I did not have an ulcer, the doctor assumed I had acid reflux (there might have been some fat prejudice there, since I was fat the first time I actually sought treatment for chronic heartburn, although I’d experienced it for about eight years by then) and away I went. Shortly thereafter, my insurance company dropped proton pump inhibitors from their list of covered drugs and I have been self medicating ever since. When the pain gets worse, I take more pills. Every once in awhile, I skip a couple of days to see if whatever ails me has miraculously resolved itself and then spend the next three days in severe pain, doubling up on the pills, and eating nothing with a pH under 7. At this point, there could be a giant acid-producing alien parasite in my stomach and I would never know, because I don’t need to go to a doctor for this medicine, so why should I seek medical care for a condition that is, as far as I’m concerned, treatable. If inconvenient.

10 comments
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June 23, 2008 at 5:33 pm
Becky
Yeah, my fiance has had acid reflux his whole life, and he’s been skinny his whole life. Gaining a little belly fat doesn’t seem to have made the problem any worse either.
Speaking of magic benefits of weight loss… I was in a meeting today and our safety topic is learning how to better handle emergencies/disasters. Someone passed out a Time Magazine article calle “How to Survive a disaster” and there was a little sidebar on “5 ways to improve your ‘disaster personality’”. Guess what #4 was?
4. Body weight. Get in shape! The cruel reality of physics is that overweight people move more slowly and need more space, so they have trouble fleeing. On 9/11, people with low physical abilities were three times as likely to be hurt while evacuating the towers
June 23, 2008 at 6:14 pm
Kimu
Sounds like you need to check in with the doctor regardless of whether the pills are over the counter.
I do know people who’ve had GERD resolve due to weight loss, due to changing their eating patterns (meal size, timing, whatever), due to sinus surgery…you name it. It seems to be a normal but unpleasant physiological response to a variety of situations. This doesn’t seem to be what’s going on with you, though.
June 23, 2008 at 6:48 pm
OTM
Good grief, Becky! la;ksdjf;alkjdf;alkdjf I just what I don’t guh.
Kimu, I think you’re probably right. Howeverrrrrrrrrr I did just make an appointment to see an orthopedist to address a knee issue that I have ignored for five years that now seems to have turned into a knee and hip issue (knees and stomach are my chronic health crosses to bear in this lifetime. All in all, I probably got off pretty easy) so… I will probably keep ignoring the reflux for awhile. I’d hate to garner the attention of my insurance company, plus, ignoring health problems that are uncomfortable but not really debilitating until they begin to get debillitating is kind of how I roll. I blame my nurse mother and my repressively stoic WASPy upbringing.
June 24, 2008 at 12:42 am
Bekbek
I have had to painfully wean myself off of soda to get rid of the worst of the acid. Whenever I fall off the soda wagon I start chowing Tums and Rolaids like tasty candy. So frustrating.
June 24, 2008 at 9:28 am
Tari
ignoring health problems that are uncomfortable but not really debilitating until they begin to get debillitating is kind of how I roll.
I am so there.
Incidentally, my recent health issues have led me to believe that these days, any stomach-related problem that isn’t appendicitis or gall stones is generally diagnosed as acid reflux, until someone starts puking up blood or something. I wonder how much that has to do with the OTC reflux drug action….
June 24, 2008 at 9:35 am
OTM
Totally. I mean, part of it is that people (ha “people” meaning “me”) don’t feel like they need to seek advice from a doctor because the OTC meds treat the problem and it doesn’t occur to them that there’s possibly something else going on. For me, there is also the convenience/frustration factor. I’m really not interested in undergoing a battery of tests that I might have to go to war with my insurance company about only to find out that the doctors don’t know what the hell is wrong with me. Or that I have GERD and should take OTC meds. Even if the impending insurance company battle was out of the equation, I might consider subjecting myself to a full physical work up but god. Just the thought of having to call the insurance company and sit on hold for an hour before I can talk to somebody who couldn’t find his own asshole with a map and a flashlight… I totally can’t cope.
I will seek immediate medical attention if I start puking up blood though. But I might call you first, Tari.
June 24, 2008 at 12:51 pm
Pungo
I didn’t realize Nexium was OTC now. I’m lucky enough to have work cover it.
My problem is that, as a fat person, my doctors assumed that I needed Nexium because I was fat. I was diagnosed with GERD, but I only had one symptom: I would wake up gasping three hours after falling asleep, having breathed in stomach acid. No heartburn symptoms whatsoever, just that one.
I diagnosed myself with sleep apnea and now I don’t have that problem anymore, as long as I use my trusty CPAP machine. I’m trying to wean myself off the Nexium, but now I do get heartburn… I suppose my stomach is going to take a while to figure out how to produce normal amounts of acid.
Being fat actually increases your chances of survival in a lot of disasters. Fat protects your internal organs from damage. If you are trapped somewhere, you have more resources and can wait longer for rescue.
June 24, 2008 at 12:53 pm
OTM
I also understand that being fat makes one harder to kidnap.
June 24, 2008 at 1:10 pm
Tari
Well, the GI specialist I saw told me point blank that even if what I had was an ulcer, he would put me on omeprazole for six weeks either way. You know, just to see if it fixed the problem.
Why do people think doctors know everything again?
I can’t blame you for dreading not only the actual ordeal of going through insane tests (’cause GI tests so often involve barium somewhere or other – blech!), but then having to wrestle with insurance jack-offs whose job is to tell you everything you need is not covered…it’s the reason I have awesome insurance and only ever use it once every five or six years, for catastrophic situations.
And if you call me, I’ll actually listen to what you say, which would be unlike calling a doctor…
June 30, 2008 at 10:10 pm
spacedcowgirl
I was told I had acid reflux (no “typical” heartburn symptoms, but I was having trouble swallowing and an upper GI scope revealed a couple areas of “irritation” according to the GE) and put on omeprazole for it; I am lucky enough that our prescription insurance covers some newly OTC meds at a low price, but if they didn’t I noticed Costco had a generic version that was pretty inexpensive. (BTW if anyone needs cheap Zyrtec, Costco Aller-tec is $15.99 for 300 pills in my area. THREE HUNDRED! I don’t know how they do it. It’s the place to go IMO.)
Anyway, I was stressing over the anti-reflux diet I was given, and doing some web searches that I’m sure you have done many times over since you’ve had this problem much longer than I have, and the main review paper I found indicated that only proton pump inhibitors and elevating the head of the bed (which I’d like to try but it doesn’t seem like it would be good for our newish wooden bed) made any difference to reflux symptoms. All of the dietary recommendations seemed to have inconclusive results. And I’m not sure it said so, but I’m positive “lose weight” falls into the same category in all but a tiny minority of cases. I’ve said before, though, the “lose weight” directive is a beautiful thing if you’re a doctor because it’s almost impossible for the patient to comply, so in most cases you can just send them away repeatedly without ever actually having to treat them; and if they do manage to lose weight and it doesn’t help, you can just tell them that all those years of being fat did irreparable damage. It’s ingenious, really.
So anyway, although in my case I was nervous about taking the Prilosec because I didn’t feel I “needed” it (no actual heartburn) and don’t want to put my stomach acids out of whack for the long term, the info I found indicated that it is at least effective. And my doctor said it was necessary to take it for the spots of irritation he found, so I’m on it temporarily.