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This is such an inconvenient time to try to do an "end of the year" column. Hollywood launches some of its most potent Oscar bait at the end of the year, and I haven't had a chance to see it yet. Plus, I'm doing some vital writing projects (vital to me; nobody's life depends on it, unless an angry editor shoots me for late delivery) and preparing for my first lectures in my Tolkien-and-Lewis class at Southern Virginia University.

So guess what. I'm not going to try to make sense of the past year. I'll do my movie wrap-up column late in January; and for this issue, I'll talk about some things I've been meaning to write about for months, but always got distracted from by more timely columns.

I mean, if there's any time of year that is, essentially, timeless, it's the week between Christmas and New Year's. Everything's in limbo; very little real work is getting done except by retailers, and they are in another kind of limbo because they're so busy and exhausted they barely connect with the rest of the world at any point other than the cash register. They certainly have no time to read this column!

So while the rest of this issue of the Rhino sums things up, I'm once again proving that I can review anything.

Back in the sixties, when I was in my teens and it became fashionable for people to "self-medicate," I just didn't get it. Why would people take things into their bodies that might have unpredictable and dangerous effects?

I didn't always feel that way. I remember pilfering and eating baby aspirin and vitamin C tablets for their sour-orange taste. But that wasn't self-medication -- in my seven-year-old ignorance, that was candy.

By the time I got old enough to know what medicines actually did, I had learned a few things. For instance, my mother was given diet pills once by a doctor, and stopped taking them almost at once because they kept her from sleeping and made her heart race.

Later, I realized that these had been amphetamines, which soon became known as "speed" and had lethal effects when taken for sport. But those had come from a doctor, given to my mother for her health.

I also learned about thalidomide and saw pictures of the tragically malformed children whose mothers had taken the drug before they knew they were pregnant. Again, this was a prescribed medicine.

I read about early patent medicines (some of which are now sold as "soft drinks") which were originally dosed with cocaine or other potentially lethal and highly addictive drugs. Of course, that was the 1800s, an era when doctors knew very little and it was undeniable that some of these patent medicines made you feel better.

They didn't cure you; they just stopped you from caring how sick you were.

Then I spent a couple of years in Brazil, where (in those days, at least) you didn't have to go to a doctor for a prescription. Pharmacists could give you drugs on their own authority, and you'd pop into the pharmacy to get an injection of ... whatever. The needles weren't always new. It made me grateful for the American Food and Drug Administration, which made it illegal for medicine to be dispensed in such a haphazard and potentially dangerous way.

Slow to Self-Medicate

Gradually I became more and more reluctant to medicate myself, even with "safe" drugs like aspirin and Tylenol. The need would overcome the reluctance, of course -- I used to get through allergy season with Contac, and was delighted to discover that the active drug in Contac was also used as an appetite suppressant.

Of course, later it was found to promote heart disease (or something) and was taken off the market.

I read all about the theory that massive doses of vitamin C could prevent or cure colds. I figured that if it worked at all, it was probably by means of the placebo effect, and since I didn't believe in it, the placebo effect would not apply to me.

Everything has side effects. But to our bodies, of course, there is no such thing as a "side" effect -- there are simply effects. You take the drug into your body and whatever parts of the drug aren't destroyed by the process of digestion get into your bloodstream and go everywhere, entering whatever cells will let them in, and making changes in your body chemistry without checking to see whether you actually wanted this particular change.

So if you dose yourself with huge quantities of vitamin C, how do you know what unpredictable results you might get? What cumulative changes? I had no interest in finding out.

I was (and remain) skeptical about the whole cholesterol thing, too. A causal relationship has still not been proven. For all we know, cholesterol is a symptom, not a cause, of certain kinds of cardiovascular disease. A substance that is made by every cell in our bodies -- how do we know that drastically lowering our serum cholesterol won't have unpredictable and unpleasant effects on other functions and systems in our bodies?

Nothing is good for everybody. Taking aspirin to help prevent heart disease? Fine -- unless you're one of those people whose stomachs are irritated by it. Allergies, sensitivities, insensitivies ... they're different in every body.

When a doctor offered to help me deal with a fungal infection by taking Lamisil internally, I sensed a bit of reluctance on his part and inquired further. The side effects didn't sound good, and even though I probably wouldn't have any of the negatives, I've known people who've died from the use of "safe" drugs. So I didn't take the drug (except as a surface ointment).

Ditto when I was offered Fen Phen as a weight-loss aid. There were no warnings then, except my doctor saying, "Some people are combining these drugs and getting good results, but we don't know what the effects are." That was warning enough for me. I didn't take it.

Lucky for me, eh?

Learn Your Own Responses

But I'm still an American. I experiment on myself despite all my fears.

It isn't a religious thing with me, to avoid self-medication. When I have a headache, I take Tylenol or Advil. I take daily vitamins (Centrum Silver) and yes, I pop baby aspirin, ever since my dad's heart attack. (It was years ago, and after his multiple bypass surgery, he's doing fine.)

And I'm quite aware that doctors don't know everything. Few doctors are trained in diet, and aren't aware of the degree to which the foods we eat can affect every aspect of our physical and mental health.

I know my body better than anybody, and I'm ultimately in charge of what I do to it. Caring for this corpus is a serious responsibility. (And not just for myself -- my family depends on my staying functional for as long as possible ... or at least till people stop buying my books.)

For instance, I didn't need a doctor to tell me that caffeine affects me strangely. I get no stay-awake effect from it; when I used to drink vast quantities of Diet Coke, my sleep patterns were no different, and I could still doze off dangerously if I drove when tired. But then when I stopped drinking it, I'd get massive migraines that would lay me out for a few days. Now even one glass of a caffeinated drink triggers this reaction. Now I avoid caffeine in any form.

MSG makes my face puffy and the inside of my mouth uncomfortably tender, so I avoid it. Too much fat in my diet, and my jaw muscles swell so I can't close my mouth tightly. Too much sugar, and I break out in psoriasis.

No doctor told me these things. I was simply observant -- and I lived long enough to see the patterns.

And, when the benefits seem to outweigh the risk, I do try things. It would be just as bad to refuse medication that might help me function better and overcome the frailties of the human body as it would be to medicate myself harmfully. The trick is figuring out how beneficial the benefits and how harmful the harms are likely to be.

Back in the late 90s, I was seeing what certain drugs could do for chronically depressed people. I had seen for years that I exhibited many of the symptoms. I wasn't ready to go to a shrink, because my depression was mild enough that it wasn't interfering with my life in a serious way.

I read about St. John's wort, which supposedly had anti-depressant effects. I looked for negative side effects and found only that it made you more sensitive to sunlight -- more likely to get a burn. No problem -- that was before I started my serious exercise program, so the sun and I rarely met face to face.

Here's the thing I discovered about St. John's wort: It didn't do a thing for my symptoms of depression. But it did remove or weaken the anger-inhibitor that apparently I've had all my life.

I have never lacked for the ability to be angry; but I don't generally act on it. Or rather, when I am angry, it's as the result of a conscious decision to display the anger I'm feeling in order to awaken the other person to the unacceptability of their behavior. Most of the time, I'm pretty good at bottling things up, which is, of course, the basis of civilization. We absolutely depend on people repressing their anger and quickly forgetting about it. "Letting it all come out" is a recipe for chaos and barbarism, and I've always been a civilized guy.

St. John's wort took the lid off. I found myself, without having chosen to, acting on impulse. I didn't punch anybody, but I engaged in dangerous behavior with my car (far worse than punching a guy!). And I couldn't keep myself from saying cruel things to people, as if I were sixteen again.

When I realized what was happening, I stopped taking the drug, and I went right back to normal. The lid was on again.

Supplements

Wait -- is St. John's wort a drug? No, of course not. A drug would be regulated by the FDA. SJW is a "supplement" ... or an "herb" ... or a "remedy."

This is dangerous territory. Remember that most beneficial medicines are derived from natural substances -- as are most illegal "recreational" drugs. You may need to play chemist to purify heroin or manufacture crack, but they started, once upon a time, as poppies or coca, naturally growing in the wild.

At the same time, it's good to remember that much of "modern" medicine was foreshadowed by the "remedies" and "lore" of people who lived closer to nature and knew many herbs and what they could do.

With our store-bought diets, we can easily find ourselves short of substances our bodies need in order to function properly or to stave off some of the debilitating effects of age.

I'm not going to start eating weeds in order to discover new substances! But I do take seriously the writings of scientists who are investigating the properties of some supplements that seem to have beneficial effects.

And, as with official FDA-regulated medicines, a substance that has long been used for one purpose may turn out to have much-more-important benefits that have only recently been recognized.

Brainkeeping

A couple of years ago, I read in Discover magazine about a scientist who was seriously investigating two over-the-counter supplements that, together, seemed to have powerful effects on the brains of aging rats.

Basically, acetyl L-carnitine and alpha-lipoic acid are housekeeping drugs. Or, in this case, "brainkeeping." They help body cells get rid of chemical garbage that builds up and interferes with the real work of those cells.

In the brain, that rubbish can make our brains work more slowly, our memory function less reliably. Acetyl L-carnitine (ACL) works on the mitochondria, little factories inside every cell in our body; but the work it does there releases free-radical oxygen into the cell. So it is paired with alpha-lipoic acid (AL), an anti-oxidant.

The dosage they're testing with humans right now is 500mg of ALC and 200mg of AL, morning and night. When I first read about this work, I had to take one pill of ALC and two of AL in order to get that dosage. Now, though, several manufacturers have caught on and are putting the doses into a single pill.

I don't know what these remedies might do to you. I do know that for me, they have been effective. I haven't become a mental wizard -- ALC/AL doesn't make you smarter, it just cleans up some of the damage of age. The result is that I am able to access memory more effectively. I am far more likely now to be able to recognize names and faces, to recall where I left things, and to remember facts and sources when I'm writing.

I'm still as absent-minded and distractable as ever -- but I always was, even in my prime. ALC/AC don't make you better than you ever were, they just make old coots like me better than we've been recently.

If you want to read more, try looking at http://www.thefactsaboutfitness.com/news/aging.htm.

Fish Oil

More recently -- the past six months -- I've been taking fish oil. When I first heard about this, I remembered how taking cod-liver oil used to be a torment inflicted on young children by well-meaning, ignorant parents.

Not so ignorant, maybe.

Fish oil consists of the inedible parts of fish, mashed up and turned into an oleaginous mass. You would not put this stuff in your mouth on purpose.

But some manufacturers have packaged it very nicely as huge but flexible and easily-swallowed pills. Don't bite them open -- you will vomit. Just swallow them.

Officially, what they're supposed to do is prevent "heart disease, alleviate auto-immune disorders, plus many other claims" (UC Berkeley Wellness Letter -- http://www.berkeleywellness.com/html/ds/dsFishOil.php). Those weren't my reasons for taking it, though, and I have no idea what effects fish oil might have on such conditions.

And there are potentially dangerous side effects for people already taking anti-coagulants or blood thinners. Read the Berkeley Wellness Letter to find out.

I started taking fish oil because the Omega-3 it contains is supposed to also provide benefits for "mood" -- in other words, to be a natural anti-depressant.

Here's what fish oil did for me:

It let me sleep.

I've had an irritating sleep pattern for most of my adult life. I go to bed, I can't sleep. I can toss and turn for hours, my mind spinning, fretting, worrying. When I started exercising, it helped my sleep -- I could usually drop off after a couple of hours of reading. That was an improvement, believe me!

But with fish oil, I go to bed and rarely can read more than ten or twenty minutes before I start dozing and have to put the book away and turn off the light. Then I sleep for eight hours -- or till the alarm wakes me -- and wake up feeling fine, alert, ready for the day.

That's way better than Simply Sleep (i.e., Benadryl), which leaves me groggy when I wake up; and my days of being unable to get to sleep at all, leaving me staggering around half-awake the whole next day, or not falling asleep till morning and then losing a day by catching up on my zees, are over.

As far as I know, nobody is touting fish oil as a sleep aid. It wasn't what I expected at all. But this was the single worst symptom of my mild chronic depression, and it's cured. I love this stuff.

It's recommended that you take it on a full stomach -- because when you take it alone, you can find yourself with a fishy taste in your mouth a few minutes or hours later. It happens only occasionally for me, and it's not a bother. It might be more irritating to others.

Fish oil can also affect digestion. For me, the results are entirely beneficial, but for others, it can lead to abdominal distress. If it does, stop taking it!

There are people who claim that fish oil -- often in combination with other supplements -- can actually cure or control serious mental illness without the side effects of some anti-psychotic drugs. There are scientists seriously working on investigating these claims; but I urge those who suffer from such conditions to be very, very careful about going off prescribed medications in favor of supplements. Make sure you're supervised and protected in case they don't work and you become trapped in psychotic delusions.

This is all way out of my purview and far beyond my expertise. I am not recommending fish oil as a substitute for anything, and I am warning you to investigate carefully before you start using it. I'm not a doctor and I'm not giving anybody medical advice. I'm describing only what I have observed in my own body and my own behavior.

Nobody Knows Everything

The medical profession is often slow to recognize any value in supplements or remedies. This situation is slowly changing, but you will sometimes find doctors who reject all such non-regulated treatments as quackery. Remember: Doctors are rarely trained in matters of diet. They rely on science, and properly so; but science takes time and commitment, and for a long time the commitment was lacking in this particular area.

But because the science is only just starting to happen, we need to stay skeptical and learn as much as we can about dangers as well as benefits. There are unscrupulous people who sell dangerous substances under the guise of supplements. There are ignorant people who think they're doing good but are simply unaware of harmful effects. And, of course, there are supplements that do nothing at all except drain money from your bank account.

In other words, user beware!

At the same time, I cannot leave my own health entirely in the care of doctors, who are, after all, fallible human beings in a fallible medical community, and they don't know everything. I've been helped countless times by wonderful doctors who knew what they were doing; but I've also been misdiagnosed from time to time -- by the same wonderful doctors. They don't always recognize, from subjective symptoms, what is objectively going on. There are things I know about my own body that they either can't or won't understand.

I'm feeling my way through my own health care, being cautious but also trying things now and then that show promise. There are risks in doing this; there are risks, also, in not doing them. I report my results only. Make of them what you will.

http://www.hatrack.com/osc/reviews/everything/2005-12-25.shtml