I saw a nice 60+ woman Sharon in the office this week for a six-month follow-up and the visit went like every medical visit should go. 
We worked our way down her problem list. With her, as with most people I see, the process is a collaboration. She knows herself. She does the research. Beautiful.
One of our goals was to get her off the acid blocker Prilosec. We had discussed ways to do it at a prior visit. She reported that she no longer needed the acid medication and the most important change, potentially, was not drinking a lot of water during meals. We had reviewed that water can dilute stomach acid and this can interfere with breaking down the food we eat. If the food is not processed, it does not leave the stomach efficiently and this can contribute to back-up and heartburn. I checked in on her chronic gout. Well controlled with a teaspoon of celery seed powder daily plus some regular black cherry juice.
I asked her about her chronic bowel problems. She had been diagnosed at one point with the pseudodiagnosis irritable bowel syndrome. Still cured with flaxseed every morning and a diet of mostly local, fresh fruits and vegetables.
I was curious about her chronic pain. She had been diagnosed with the pseuodiagnosis fibromyalgia many years prior to seeing me.
She told me her pain was essentially gone. She was off muscle relaxers and the prescription drug Savella. She reminded me she was part of a study at Mass General using medical marijuana. She had found a group in California called Women Grow and they had prepared a tincture that she was taking twice a day. It was working great and her pain was relieved. We had been working on sorting out underlying causes of her chronic pain, but she was comfortable now.
Her blood pressure was perfectly controlled with the prescription medication losartan at 124/78. She was hoping to get off all medication so we discussed what it would probably take. She was already down almost 10 pounds. With her lifestyle changes and some targeted supplements, we had a chance going forward to get her off losartan, but the blood pressure control was too important to be dogmatic.
She had thyroid dysfunction and this was well controlled with Armour thyroid. Armour combines T4 hormone with the more active T3 hormone. We had used that option instead of the more typical synthetic levothyroxine that is all T4, because people do not convert T4 to T3 well as they age. She had good energy and was losing weight.
Each person needs a unique approach. Sometimes pharmaceuticals are necessary, but should be used only when other options are unsuccessful. Each person needs to be involved in their health and work in a collaborative relationship. With Sharon, her variety of chronic health issues were well managed because of a balanced approach that worked up from the basics of nutrition and lifestyle.