Are 14 pills a day too many to take?

DEAR DR. GOTT: I have been taking numerous pills for the last five years – in some cases, as many as 14 different ones in a day while recuperating in a hospital or undergoing therapy at a nursing home and rehabilitation center.

How does a pill know where it’s supposed to go to satisfy a problem? I feel some of these pills may be counteractive. Are they? Or could they be? And who or what guides them to the alleged proper problem area?

DEAR READER: Specific medications are designed to target specific areas of the body to control blood pressure, reduce pain, allow the heart to work easier, control migraine headaches, and perform a host of other functions. Some work on the central nervous system, some neutralize stomach acid, others work in other areas of the body. Let’s take pain, for example. You have injured your knee, and it hurts. After seeing your physician who prescribes pain medication, you take a pill. The pill doesn’t go directly to your knee. Instead, it works with the brain, nerve endings and cells to block the pain. When cells are injured or damaged in an accident, they release prostaglandin. Nerve endings that sense pain are sensitive to this chemical and respond by picking up and transmitting signals through the nervous system to the brain. The brain is informed where the pain is and how much it hurts. The pill does its job and reduces or eliminates the pain signals.

The $64,000 question is how the 14 pills you took knew where to go to provide the service required. Each acted on a specific portion of the body to do its job. The only complication I can see is that some medications could have adverse effects when taken with others. In fact, I cannot comprehend how any one individual can be placed on so much medicine at once. You don’t indicate what you are/were on, so I am unable to comment on duplications or possible interactions. Therefore, I recommend you make a list of your current medications and return to your doctor for an explanation as to whether all are truly necessary. Ask if any can be eliminated, even if only for a trial period.

To provide related information, I am sending you a copy of my Health Report “Consumer Tips on Medicine.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a check or money order for $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

DEAR DR. GOTT: It’s nearing time for my annual Pap smear. I’m 78 years old and stressed about it. I had a hysterectomy at age 36 and have been off hormone therapy for 10 years. Should I continue this practice every year?

DEAR READER: You left one bit of information from your note. Have past tests been normal? If yes, I suggest you speak with your physician about the possibility of discontinuing the annual testing. Most experts agree that women at low risk can discontinue yearly Pap tests after the age 70. If your physician feels strongly that you should continue, perhaps you can do it every other year. If he or she is suspicious of the possibility of cancer or other abnormalities, you should continue annual testing. Speak with your primary-care physician or gynecologist so you know what category you fall into. Then an appropriate decision can be made.

To provide related information, I am sending you a copy of my Health Report “Vaginal Infections and Disorders.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a check or money order for $2 per report to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.