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Book offers great advice for seniors

A pharmacist I have never met has enabled me to manage buttons, snaps, hooks and shoelaces without difficulty each morning.

While I've never talked with Armon Neel Jr., I've read his recently published book that was co-written with journalist Bill Hogan, "Are Your Prescriptions Killing You?"

Straightforward and full of facts and anecdotes, it is a book for senior citizens, caregivers, doctors and even lawmakers looking for ways to cut soaring medical costs. 

Despite the title, it focuses on both prescription and over-the-counter drugs, warning us, for example, to substitute acetaminophen pain relievers for ibuprofen and naproxen. He explains the reasons and, yes, he gives brand names.

Simply put, as we age, our bodies lose the ability to break down some drugs and have less tolerance for others.

I learned we gradually fail to produce an enzyme essential for absorbing vitamin B12. That revelation brought relief for me.

"Older people need to be given vitamin B12 by injections - or, as a second choice, sublingually (under the tongue) - in order to receive any benefits from it," Neel writes.

This spring I started a daily dose of B12 that initially alleviated the early morning hand numbness and pain from carpal tunnel symptoms that date back more than three decades but have worsened this year.

The first B12 supplement I used was an under-the-tongue variety.

The second was a pill version. Soon I was struggling to make my fingers function each morning.

Since I've returned to that tiny under-the-tongue - an inexpensive over-the-counter pill with half the dosage of the pill form - dressing has been almost a breeze.

I'm sure that was hardly the goal for Neel, 73, a consulting pharmacist focusing on geriatric private patients and nursing home residents since 1977.

Rather the book focuses on serious consequences of use and overuse of prescription and over-the-counter medications that are suitable for younger people but not for the over-60 crowd. 

We endure ads for many of those very drugs every time we turn on the nightly news ... those lauded for addressing high cholesterol, high blood pressure, bone loss, indigestion and reflux symptoms and allergies.

Neel is blunt at times, as in the concluding paragraph about statins that are prescribed to lower "bad" cholesterol.

"If you're 60 or older, my recommendation is that you stay away from statins at all cost - the greatest cost, of course, being your good health."

I expected an avalanche of criticism from pharmaceutical companies and even physicians after the book went on the market July 3. I thought insurers would support it.

So far, I've found little of either in Internet searches.

In mid-August, I contacted David Elliott, certified geriatric pharmacist with the West Virginia University Department of Clinical Pharmacy. He hadn't seen the book.

But consulting with an assisted living facility and patients at the WVU geriatric clinic housed at Charleston Area Medical Center's Memorial Campus, he's well aware of the importance of focusing on the potential benefits versus adverse reactions for the elderly.

For example, those statins, touted to cut high cholesterol.       

"Someone 85 with no evidence of clogged arteries or with a heart condition, what's the likelihood it will benefit them?" he asked.

With just 15 Certified Geriatric Pharmacists in West Virginia at present (they are listed at

-a-CGP ) and one a year training with Elliott in the WVU program, it's not likely that many of us already in the upper age bracket will encounter one.

But Elliott has advice for all seniors.

"The most important thing is to have one primary care physician or nurse practitioner or physician's assistant to look at all their medication and advise them."

And he's not talking about taking in a list of drugs to an appointment, but actually hauling the containers of every prescription, over-the-counter medication and all supplements.

"Throw them all in a bag," Elliott said.

At the end of his book, Neel provides a nine-question "self-assessment quiz" and a list of medications seniors generally should avoid.

If you get the book, don't jump to the end. There's too much good information earlier.

The Kanawha County Public Library system currently has copies of the book on order,  and a copy at the Cabell library system can be requested through Putnam libraries. I downloaded it to my Kindle from, where it is also available in hard cover.

Contact writer Evadna Bartlett at


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