There are now six pills in the morning and four pills at night. There are pills to help me sleep and pills for high blood pressure, pills for anxiety, pills for heart failure, pills for coronary artery disease and pills to lower cholesterol. On the weekend, I set out my pill case and carefully place each of the ten pills in their allotted slots.

It takes me about ten or 12 minutes and I hate every minute of it.

I had always prided myself on how few pills I took, given my age. I’d see other people, people my age more or less, sit down to meals and go through the ritual and I felt, foolishly, morally superior.  

Before eating, they’d reach into the pocket or purse and take out the pill case. Make sure they have some water. Line up the pills and take them one by one, each finished with a quick sip.

Ha! I exercise and eat right and don’t smoke and don’t have to take a lot of pills to get me through the day.

A doctor friend had once told me that a good rule of thumb is that on average you take one pill for every decade you’ve lived. I thought I was way ahead of the game. And I secretly thought how awful it must be to be losing the game and dependent on a series of pills for your health.

Then slowly at first, as I nevertheless quickly got older, the pills started to creep up.

There was, first, that vitamin D supplement, for my bones, although research recently had shown that vitamin D supplements had no effect on the rate of broken bones. Still, my doctor said it wouldn’t hurt, so why not?

Then, like many people getting older, I started to develop problems sleeping. I didn’t like taking pills to help me sleep, but not sleeping, I figured, was worse than taking a pill.

When that first pill no longer seemed to work sufficiently, I took a second pill, then a third.

And then I had a heart attack, and before I left the hospital, they loaded me down with all these new pills designed to make sure I wouldn’t be back at the hospital with a second heart attack.

All of this, of course, is not uncommon, as prescription drug use increases with age.

According to the National Health and Nutrition Examination Survey, nearly 90 percent of adults aged 60 or older regularly take at least one prescription drug. Almost 80 percent regularly take at least two prescription drugs and more than a third regularly take at least five different prescription drugs.

When over-the-counter and dietary supplements are included, the rates are even higher. There’s even a term for it: polypharmacy, one patient taking multiple medications.

Mainly this is because as we age, we develop multiple health problems. We are more likely to have chronic conditions like high blood pressure, diabetes or arthritis. And most of the drugs we take for these chronic conditions are taken for years, generally for the rest of our lives.

It may not be uncommon, but taking all these pills still worries me. Older people, I know, metabolize drugs more slowly and we become more sensitive to the medicines we take. Starting in late middle age, the risk of side effects related to the drugs increases, with older people more than twice as susceptible to the side effects as younger people. And the side effects are also likely to be more severe, affecting quality of life and causing more visits to the doctor and more hospitalizations.

I worry, too, about the risks of interactions among all the meds I’m taking and I’m concerned about becoming dependent on my pills—in other words, addicted—and I’m a bit paranoid that one or another of these drugs might lead to the loss of some marbles—that is, cognitive impairment.

But of course, I continue to take them. They are now part of my morning ritual and my bedtime routine.

Take out the pill case. Make sure I have some water. Line up the pills and take them one by one, each finished with a quick sip.

Exercising and eating carefully no longer are enough. Now I need to rely on a bunch of pharmaceutical companies for maintaining my health and keeping me alive. I hate it, but as most of us have concluded, that transfer of responsibility is better than being dead.