Medication Hesitancy - Responsibility

Discussion in 'Viruses' started by Ken Anderson, Mar 11, 2022.

  1. Ken Anderson

    Ken Anderson Senior Staff
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    While I am not particularly interested in a flurry of posts by someone who believes that all medications are from Satan or that there are no therapeutic purposes for any pharmaceutical, I do believe that it is prudent to be concerned over which, and the number of medications, that we are taking, particularly as seniors.

    Of course, you're allowed to believe that the pharmaceutical industry is pure evil or that the government is intent on killing us all through pharmaceuticals, and, to a point, some of that makes sense, but please don't feel the need to refute every post that suggests an actual purpose for a medication.

    I do believe that we should be careful of the medications we are taking. If you don't believe that you should read medication labels unless you're credentialed, discussing your medication regimen with a pharmacist is a good idea. They generally know more about it than the doctors who prescribe the medications and, in that respect, they are grossly underused.

    With a little bit of research, reasonably intelligent people can make reasonably intelligent choices about the medications they take, in my opinion.

    I have had a doctor prescribe Quaaludes to me when I was in my 20s because I was having trouble sleeping when, in reality, I was simply stressed over balancing my job as a well-paid employee and my responsibilities as a union representative. Also, while in my 20s, a doctor prescribed Clinoril, diagnosing me with arthritis in my neck, when this was actually due to the same stress. I took Clinoril for a few years before I decided that it was crazy to think that I had arthritis in my neck while I was in my mid-20s.

    A few years ago, another doctor prescribed statin drugs for high cholesterol when, as I learned, my cholesterol levels were in the normal range, albeit in the upper levels of the normal range. It turned out that he believed that everyone 40 and older should be taking statin drugs. At any rate, prescribing statin drugs for something that a better diet could take care of is irresponsible, just as it would have been irresponsible of me to follow his direction in that.

    During an annual stress test, I was told that they "saw something" in the ECG during the test. Although they were unable or unwilling to describe what it was that they "saw," despite the fact that I'm not a complete moron when it comes to reading an ECG, I received a prescription for a cardiac medication. I forget which one at the moment, but I mentioned it in another forum post a few years ago. Despite two other tests that found nothing, my doctor wanted me to keep taking the medication, despite the fact that it was causing chest tightness and some other problems associated with a heart problem that I didn't have. I changed doctors and the new one took me off of that immediately. Later... it was Propranolol.

    I do not believe that medications are evil or that doctors are trying to kill us with them, but I do believe that they are prescribed too easily and before other measures are tried, and that, once prescribed, doctors are reluctant to tell you that you can stop taking them.

    Twenty years as a paramedic has revealed that a whole lot of medical emergencies come about because of drug interactions, either because the patient doesn't know what he should or should not take the medication with, or because one doctor prescribes something for one thing, while another doctor prescribes another drug for another problem, and the two drugs are not compatible. While I have a book that lists some of these potential problems, this is an area where a discussion with a pharmacist might be reasonable.

    Did you know that the potency of some medications is increased considerably when they are taken with citrus juice? Doctors don't tell you that either, and they may not even be aware of it.

    For these reasons and others that I may add later, I strongly believe that it makes sense to question the medications that you are taking. Don't be afraid to read the labels and the inserts. Certainly, you are not likely to experience every possible side effect that might appear on an insert, but if a new problem crops up after you start taking a medication, it's good to know that the new medication could be a reason for it. Also, some of these side effects might not appear until you've been taking the medication for a while, so it's not necessarily a new medication that's causing the problem. The inserts are there for you to read. You don't have to be an expert to read them.

    My wife was taking a slew of medications, and she told her doctor that she would like to cut them down to two or three, and asked which ones she truly needed to continue with. Her doctor was fine with that.

    If I were still taking every medication that was prescribed for me, I'd be taking probably about a dozen of them. Instead, the only prescription medication I am taking is Levothyroxine, given that someone stole my thyroid.

    I think that the responsible thing is to take some control over your own health, and that includes the medications you are taking. Discuss it with your doctor but if your doctor can't give you a reasonable reason why you need to be taking all of the medications you are taking, there's nothing wrong with getting a second opinion.
     
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    Last edited: Mar 11, 2022
  2. Don Alaska

    Don Alaska Supreme Member
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    Amen to all of that, @Ken Anderson. If you look at the drug info (and it has been brought up here by someone), people over 60 shouldn't take NSAIDs. Almost everyone I know takes some NSAID for something, if only occasionally for mild symptoms. If you take more than 6 prescription meds, you should talk to a pharmacist certified in geriatric medicine, especially if you are seeing more than one provider. Many doctors, and even more NPs and PAs are unfamiliar with a lot of the drugs they prescribe, the side effects and interactions. You may have difficulty finding one, as they usually don't work at retail pharmacies. Any pharmacist will be better than a doctor or mid-level for drug interactions.
    as you said, question anything you are taking or any procedure you are taking or are to undergo unless there is a life-threatening event happening. In that case, do as you are told initially, and question things later unless you REALLY don't trust the person directing your care.
     
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  3. Trevalius Guyus

    Trevalius Guyus Veteran Member
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    Pharmacists should not be trusted, either. I was prescribed Doxycycline, even though I had listed on my medical forms, that I filled out, that I was allergic to Vibramycin. At the pharmacy, I asked the head pharmacist if the two were the same drug. Rather than take a few minutes to look that up in her prescription reference guide, she told me they weren't. I paid my money, went home and looked it up. Yeah, she was wrong! I went back and got a refund. I also called the idiot who prescribed it, and she assured me that there was no indication on my medical records that I was allergic to it. Sure, she didn't know, either, that the two were the same! Now, I always list the generic name, for the dummies.

    I know there are lots of brand names out there. Thing is, it's a duty for those in the medical profession to know them, or, at least, to check them out before prescribing them.

    I have also had doctors prescribe meds that, when I've researched them, I wouldn't give to anyone. In other cases, I've had pharmacists ask me if I really wanted the prescription filled.

    The above makes it sound like I'm on a bunch of meds. I'm on none. The incidents, as described, were based on about five prescription incidents over seventy years. The drugs were prescribed for five acute onset medical episodes. In general, I avoid most prescription drugs, and will continue to do so. I've lived long enough to not want to stretch things out with products from Big Pharma, for the most part.
     
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  4. Hedi Mitchell

    Hedi Mitchell Supreme Member
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    Amen again! Thank you Ken for that needed post.
     
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  5. Don Alaska

    Don Alaska Supreme Member
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    There are duds in all professions, but generally pharmacists are more knowledgeable than providers are, but the better pharmacists often don't work in retail places, but there are exceptions there, too.
     
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  6. Cody Fousnaugh

    Cody Fousnaugh Supreme Member
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    I totally understand Ken's thread, but, and yes, I have a "but".........

    There are those that are Diabetic II, take a medication for it, because they don't want to change their diet and they are nearly as "exercise" prone as others. Shoot, there are folks that are Diabetic II, know it, and don't care. We knew one such guy and he passed away. He was on no medication and loved to buy and eat cookies in his truck before going into his home. His wife had stopped making cookies, pies and cakes when she found out and he got pretty pissed at that. He was prescribed a medication, but refused to take it.

    I'm on two different meds for my blood pressure. One in the AM and one in the PM. My bp was simply too high to go without taking either. With taking both, my blood pressure is where it should be. I have a bp monitor/checker at home.

    I trust my VA doctor, but there have been times that I've wondered. That is, until I check my bp and it's normal compared to what it use to be.
     
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  7. Ed Wilson

    Ed Wilson Veteran Member
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    I think it depends on the person's health condition. High blood pressure is measurable and can be a cause of stroke. Thyroid function is measurable so there are meds for that. Blocked arteries progress with age so statins are a preventative measure. Those are what I take meds for and I trust it's the correct thing to do. I can't speak to other conditions.
     
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  8. Ken Anderson

    Ken Anderson Senior Staff
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    I was reminded of this thread by things that were said in another thread here so, rather than taking that one off-topic, I'll reboot this one. What I wanted to say was that in the years that I worked as a paramedic, if I was having trouble figuring out what was going on with a patient complaining of a medical problem, the chances were very good that it was a medication problem.

    I worked in the Rio Grande Valley of Texas, which was a retirement area for a lot of white people from northern states (Winter Texans, we called them), so this problem was, at least in part, exacerbated by the likelihood that they came to Texas with medication prescribed by their regular physician., and then might see another doctor for whatever might ail them while in Texas. Some of these were Mexican doctors, but that was a minority in my experience.

    Unlike large-city services, I worked much of my career in areas where our transport times ranged from thirty to forty minutes or more, depending on which hospital the patient wanted to go to, so, beyond the necessities, I would try very hard to figure out just what the underlying problem was before arriving at the hospital. Knowing what the problem was went a long way toward impressing the emergency room doctors, who would never take any of it seriously until their own tests came back.

    When I worked in McAllen, most of our transport times were under five minutes, so I might be lucky to have the IV started before we arrived.

    Anyhow, rather than simply running the ECG, starting an IV, administering oxygen, and taking vital signs repeatedly while en route, I would try to figure out what was going on. Trauma was easy and while it was busy work, figuring out what was wrong and what to be done about it was pretty straightforward most of the time. Cardiovascular problems were usually easy, except that most heart patients have other things going on with them, as well. When they presented as they usually do, strokes were easy to figure out.

    Other medical problems were not so easy. Why is my uninjured patient unconscious? Why is my patient confused? For that matter, why does my patient seem to be having a heart attack when he has no cardiovascular history? And so on.

    Medical calls were challenging, and while I could always do what needed to be done to treat the signs and symptoms that I could see and leave the rest of it to the hospital staff, there were advantages to gaining their respect, if only because they might be more likely to cover for me when I did screw up. Besides, while we were not allowed to refer to it as a diagnosis, given that paramedics do not diagnose patients, sitting there on the crew bench looking at a patient for forty minutes can be boring.

    Getting more to the point, one of the most common medical calls that we got turned out to be medication errors. Sometimes, when a patient saw a doctor in the Valley for a new problem they were experiencing, that doctor would prescribe something that didn't play well with other medications they were taking. You'd think that this would be one of the first things a doctor would check before prescribing something, but it happened often. Maybe they relied on the patient's memory for a history of which medications they were already taking. Sometimes, the same doctor might prescribe two medications that don't play well with one another.

    Other times, the patient would decide to take an over-the-counter medication or supplement that didn't play well with one of his prescribed medications, or they would decide to take their medications with grapefruit juice, inadvertently overdosing, as many medications are considerably more potent when taken with citrus juices, particularly grapefruit juice.

    We don't always read the instructions on the medications we take. As an example, I was taking Levothyroxine for over a year before I noticed that I was supposed to be taking it on an empty stomach. Maybe that's why they bumped it up to 200 mcg.

    Some people might believe that if they forget to take their medication in the morning, they can take it at night instead. Sometimes that works, but sometimes it doesn't. They might believe that they can make up for forgetting to take it yesterday by doubling up today. That can be a problem.

    Commonly, older patients, in particular, get caught up in a pharmaceutical whirlpool where a perhaps well-meaning doctor prescribes something they don't need for a problem they don't have (see the OP). While the medication doesn't correct the problem that they didn't have, it might cause some side effects. Instead of recognizing this new sign or symptom as a side effect of the medication, the doctor might decide to treat the sign or the symptom instead, prescribing a second medication to treat the side effect. That can spiral to the point where a patient who had begun with a fairly minor symptom, one that could probably be simply ignored, is now taking a half dozen medications, at least a few of which are causing problems that he wouldn't otherwise have.

    Rather than simply trusting a doctor who spent a few minutes in the room with you, mostly engrossed with his computer, it's a good idea to take some responsibility for your own health, especially when things seem to be going wrong.

    No, I am not discouraging you from seeing doctors or taking medications. Doctors know more about being doctors than I do, and pharmacologists know a whole lot more about medications than I do, so they should be consulted and taken seriously. However, you should be a participant in your own treatment rather than simply a recipient of it.
     
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    Last edited: Sep 13, 2023
  9. Hedi Mitchell

    Hedi Mitchell Supreme Member
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    #9
  10. John Brunner

    John Brunner Senior Staff
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    ^^^THIS (Ken's Post #8) is why I do not take CBD oil or herbals, and I am scrupulous on making sure that my records with all my doctors are accurate. (I also research my meds and my supplements to avoid interactions.) Should I become incapacitated, I want the information to be readily available and accurate.

    This can be difficult when my Gastroenterologist is an independent practice, my Urologist is an independent practice, and my GP and all other specialists are on a common Univ. of VA Health system. Trying to get data sent from one to the others is very difficult. And it's tough impossible getting records updated unless you are verifying the list while at an appointment. My urologist put me on permanent maintenance antibiotic, and I called my UVA doctor to get it added to the list in my records and was told I would have to wait until my next appointment. (Trying to document an extensive supplement list is impossible. And "Multi-Vitamin" is hardly an exacting word, since some contain mega-doses.)

    That being said, there is no excuse to not tell the doctor you are sitting in front of exactly what meds you are taking, especially if they are prescribing you another one.
     
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  11. Ken Anderson

    Ken Anderson Senior Staff
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    Yes, and don't forget any OTC meds or supplements that you are taking.
     
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  12. John Brunner

    John Brunner Senior Staff
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    That makes it difficult if you have a "robust" program. I've learned to pare down my list by just putting "multi-vitamin" and then listing the non One-A-Day stuff like Boron, Quercitin, etc. (although regular stuff like iron, zinc, magnesium, etc can interfere with antibiotics.)
     
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  13. Don Alaska

    Don Alaska Supreme Member
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    The parent of a friend told me they were taking 12 different medications prescribed by 4 different doctors. I was a bit horrified, and I did not know if all had been communicated to all prescribers. I told him to please have his meds reviewed by a geriatric-certified pharmacist, or if one is not available, any pharmacist would be better than none. I don't know if he did but it would have been a nightmare for any ER/ED or paramedic/EMT to deal with.

    Yep, hormones and amino acids are best taken on an empty stomach and try to keep it empty for at least 30 minutes after ingestion. I read a study that said thyroid--either synthetic or natural--are better taken at night. Most people I know take them in the morning upon arising. I think taking them on an empty stomach before bed is better because the stomach is empty for a longer time.
     
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  14. Don Alaska

    Don Alaska Supreme Member
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    I think you may find your medical records are surprisingly open since HIPAA was passed, although they are not always accurate. At a recent appointment, I was told it was in my record that I was a smoker and had also used smokeless tobacco for over 10 years. I informed them I had never used smokeless tobacco, and, while I once smoked the occasional cigar or pipe, I had not done so for 35 years. I don't know where it came from. My insurance company sends me bulletins that my online health record has been update, but I have no idea how to access that record or what it contains.
     
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  15. Ken Anderson

    Ken Anderson Senior Staff
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    My endocrinologist told me to take my Levothyroxine first thing in the morning, and yes, he probably told me to wait at least a half hour before eating. He said that if I forget to take it one morning, I should skip it rather than take it in the late afternoon or evening, but to not let that happen often.
     
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