Q&A: addressing despair; elevated liver enzymes; non-surgical tricks for knee arthritis; muscle loss from Ozempic

We're going head to toe this week!

ICYMI 👉

• Myths & Facts about Menopause & HRT

• Ozempic is a Sophisticated Mind/Body Drug 🧠

• Why Taylor Swift is Good for Your Health

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Disclaimer: The views expressed here are entirely my own. They do not reflect those of my employer, nor are they a substitute for advice from your personal physician.

Photo by Florian Klauer on Unsplash

The following subscriber questions have been lightly edited for length and clarity.

QUESTION #1: ADDRESSING DISEASES OF DESPAIR

What is happening to us, collectively? I feel like the story I've been hearing is that people are getting cancer younger, are more depressed and anxious, substance misuse is on the rise, "lifestyle" diseases are on the rise, etc. It’s like we're living longer, but sicker.

I'm glad for all of the pharmaceutical innovations we have that can alleviate suffering. I guess I'm just wishing there wasn't so much suffering to alleviate in the first place. We've figured out how to address many of the communicable diseases - maybe addressing the noncommunicable ones is the next frontier? Here's to less suffering.

-Tamara

Dear Tamara,

I hear you. It does feel like the medical industrial complex is coming up with solutions (such as Ozempic or Prozac) for issues that would be better solved with less despair in the first place. I agree that we need to address the suffering head-on (i.e, what are the key drivers of the obesity, opiate, and mental health epidemics?) However, I think we can problem-solve symptoms and root causes at the same time. 

To my mind, that includes employing modern pharmacology for diseases while considering a number of individual and societal “to do”s. In my humble opinion the path to uncovering and addressing despair must include:

• redefining health as more than a number on the scale or a perfect cholesterol score - and instead as a process of awareness, acceptance and agency,

• educating ourselves on what is truth and what is a convenient lie when it comes to medical information

• finding trustworthy guides to help us separate fact from fiction and false narratives—and to support us in our unique health goals

• facing unpleasant facts about who we are, the choices we make, and the realities of our lives and deciding what we can change and what we cannot

• doing the best we can with self-compassion and compassion for others who are trying to live authentic and healthy lives

• LOBBYING our local, state and federal governments to reform health care such that every American has access to primary care and most importantly where primary care medicine includes behavioral and mental health services (in addition to routine screenings and counseling on preventative health)

• VOTING for anyone who sees health is a fundamental right, not a privilege, and who understands that health includes more than a quick checkup with a doctor who is glued to his/her computer and doesn’t have time to address the whole person

• VOTING for anyone who understands how broken the medical system is in this country and how broken doctors are for participating in a system that treats people as a number on the scale or a set of boxes to check instead of an actual person

• advocating (and praying) for people who are suffering from poverty, disease, discrimination, and ideological capture who may be voting and arguing against their own health and self-interest without knowing it

• remaining humble about what we do not know

• staying curious and open minded

• continuing to learn from each other

Phew!

Thank you, Tamara, for being a thought partner in this conversation. You have helped me. ❤️

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QUESTION #2: ELEVATED LIVER ENZYMES

My liver enzymes ALT and AST are slightly elevated. We checked in Jan and March. My doc dropped my Rosuvastatin statin to 5 mg. Check in July. This is freaking me out. Can I take Tylenol? A glass of wine. She mentioned a liver ultrasound if they are still elevated. I’m freaking out! -Eileen

Dear Eileen,