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Health care reform starts with a healthy community

Mention People's Pharmacy, and chances are you'll think of Joe and Terry Graedon, the tag team who offer health information on home remedies, prescription drugs and saving money.

Their health advice column runs Tuesdays, Wednesdays and Thursdays in the Life & Arts section of The Buffalo News, and their radio show is aired nationally on public radio.

"People think of us as the 'Pill People,' said Joe Graedon during a recent phone interview. "We are either talking about prescription or over-the-counter drugs, dietary supplements, herbs, home remedies. We're talking about stuff -- that for the most part -- you swallow or smear."

It may come as a surprise, then, to hear the Graedons speak off-topic Friday, when they present the keynote address during the P2 Collaborative Conference at the Buffalo Niagara Convention Center.

"The real question here is: 'How do you motivate yourself to make those lifestyle changes?' " said Joe.

With more than 200 member and partner organizations, the P2 Collaborative brings together health care providers, patients and insurers. The initiative -- dedicated to improving the health of people in Western New York -- is funded by sources including the John R. Oishei Foundation, the New York State Department of Health and the Robert Wood Johnson Foundation.

"Health care reform is at a critical juncture in our community," said Shelley B. Hirshberg, executive director of the collaborative, who distinguished three core topics: health equity, regional quality improvement and healthy lifestyles.

"Exercise is the most important tool we have," said Terry Graedon, "It's much more powerful than most people realize."

"And for the most part, it's free," added Joe. "You don't have to have some $3,000 piece of equipment under your bed that you never use. You don't need to go to a gym or buy expensive bike shorts. Basically you can walk. A fairly decent pair of shoes and a rigorous pace and you're going to get a tremendous amount of benefit."

Talking to the Graedons is much like listening to them on their podcasts. He's the unpredictable, quick-to-comment pharmacologist who likes to play devil's advocate. She's the contemplative, clever and careful medical sociologist.

Borrowing a plank from author Dan Ariely, and his book "Predictively Irrational: The Hidden Forces that Shape our Decision Making" (Harper, $27.99), the Graedons believe that despite the best of intentions, some people are bound to muck things up.

"You go into a restaurant," Joe began, "with every intention of having a healthy meal, and for the most part you do. Then it comes time for dessert. There's no calories in looking at the menu, right? But then you see the chocolate cheesecake."

"Looking is a mistake," Terry interjected.

"The waiter has a really strong motivation. Even if only two desserts are shared by four people, he has just boosted the bill, making his tip higher and the kitchen happier.

"Once you've looked, you're done," he concluded.

"Yes and no," Terry shot back. "It depends on who you're eating with."

Here's the trick.

"If you tell the waiter when he first comes by that you'll give him a little bigger tip if he doesn't bring the dessert menu, you've got the waiter motivated," Joe said."

Or take this anecdote, relayed by the Graedons after they interviewed Dr. Howard Dean, the Vermont physician and governor who unsuccessfully ran for the 2004 Democratic presidential nomination.

Dean is perhaps most popularly known for the "Dean Scream" during a January 2004 rally in West Des Moines. He recalled stopping in a Manhattan Starbucks, where he was about to order a cranberry-orange muffin and hot chocolate.

"It happened to be New York City, where the calories are posted," Terry pointed out. "He changed the order to espresso."

The swing vote was in the form of calories: 400 for the muffin and 210 for a short hot chocolate made with 2 percent milk. The solo espresso rang up a scant 5 calories.

"That information -- available right then and there -- helped him to make a healthier choice," Joe said.

The Graedons rarely hesitate to weigh in on matters of health. Here are their views on:

Swine Flu Vaccination

Joe: "Forgotten amid the furor is that this flu, for most people, is probably no worse than a bad cold, and maybe not even that bad. Certainly, it is less problematic for most people than the typical flu. The high risk people -- pregnant women, health care providers, people who care for young children and people with chronic health conditions -- should be the first in line."

Safety of Over-the-Counter Sleep Meds

T: "Let me just pick on acetaminophen for a moment because it is perceived as extremely safe, and yet every year people get into trouble."

J: "It is so easy to take too much because it is in so many drugs, for example, Tylenol P.M. There's not a lot of logic in these pain reliever/sleep products, so if you're trying to go to sleep at night -- unless you're in a lot of pain -- you just need the antihistamine, which is diphenhydramine. There's no point in taking a pain reliever and an antihistamine. You're getting acetaminophen in your daily arthritis and your allergy pills. Pretty soon, you've overdosed and your liver is in trouble."

Too Much Diphenhydramine

J: "If you're over a certain age, the anticholinergic action is not good for the brain. Taken for long periods of time, they may effect memory and cognitive function, so an older person having trouble sleeping who is taking a sleep medication may begin having thinking problems. It could be something as simple as that nighttime sleep aid, yet it could appear to the family that this person is on the brink of Alzheimer's disease."

e-mail: jkwiatkowski@buffnews.com

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>Seminar at a glance

When: 7:30 a.m. to 6 p.m. Thursday and 7:30 a.m. to 2 p.m. Friday

Where: Buffalo Niagara Convention Center

What: Spend two days with national health experts learning how to improve health care in Western New York.

Keynote Luncheon Address: "Taking Charge of Your Health" with Joe and Terry Graedon from "People's Pharmacy" at noon Friday. Cost $50. To register, visit: http://tinyurl.com/p209lunch.

Event Schedule: For information and fees, visit www.p2wny.org.

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