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A Good Day

After months of mucking about with doctors, I sat down with “The Pill Book” and then went on-line to verify what I had found at multiple sources. A long-term debilitating problem was resolved by telling the individual to stop taking a particular medication which was for an extremely minor condition. The individual was having a full-blown reaction to the medication.

Today, the individual was back to their normal self. After New Year’s they can contact the doctor who prescribed the medication and work out a different solution. This was the result of too many specialists, none of whom can take the time to really look at the overall patient. The medication is normally the best, most targeted solution to the problem it addressed, and it solved that problem, but as people age the effects of medication change, and when you throw other chronic conditions into the mix, good solutions turn bad.

The damn inserts with the medication are too general and don’t help you find out what I discovered. They are written in tiny type and de-stress the possible problems. It took me hours to find what I needed to know using multiple searches for possible interactions.

I also discovered a weakness in the usually excellent system for spotting interactions used by the pharmacy involved – if you are controlling a problem with diet and/or exercise, the system doesn’t know to look for interactions. It is dependent on the drugs you take.

Now, if I could just figure out how to bill the insurance companies at my systems analyst rate…


1 hipparchia { 12.27.09 at 10:30 pm }

send them a bill anyway. or offer to rewrite the pharmacies’ medication interaction software for them, for a hefty fee.
.-= last blog ..I [heart] Taco Bell =-.

2 Bryan { 12.27.09 at 10:58 pm }

The key I needed was on a forum for people with the particular problem that the medication addresses. There were a couple of people who had had the same reaction, which takes one to six months to happen. They are starting to prescribe the medication at extremely low doses to be taken daily, to prevent the problem from recurring, and the therapy is very effective.

I wish I had the time and energy to do it, because it is an obvious tool, that should be available to every doctor and pharmacist. The insurance companies have certainly paid out a lot of unnecessary money for the doctor’s visits and the medication.

3 Steve Bates { 12.27.09 at 11:07 pm }

One all too common problem in our medical care system is that patients often are sent to specialists far too early in the process. Possibly 95 percent of my interaction with physicians is with my family practitioner, who is my PCP. He is one of only two doctors who regularly prescribe medicine for me (the other is my dentist). He keeps an eye on my entire health status; those are the terms he thinks in.

Without such a person, an individual patient is vulnerable to all sorts of problems that are largely invisible to a specialist focused closely on only one aspect of health status and care. When medicine became an array of specialists for every patient, something was gained, but something vital was lost at the same time. If I have to have only one element of what is available, give me the “family medicine [wo]man” any day over the array of noncommunicating specialists. I believe the incident you describe may well be a good example of the kind of problem I am talking about.

(Aside regarding those damned inserts in prescription bottles: Step 1 for me is “find my large magnifying glass…)
.-= last blog ..Peace On Earth =-.

4 Bryan { 12.28.09 at 12:28 am }

[I have a hobby-type magnifying glass mounted on a stand with a 12-inch circular florescent bulb, that I got from my Dad.]

The real problem is that doctors don’t have the time to look into these problems. I assume that the Physician’s Desk Reference had the same general information that The Pill Book had, which gave an indication that the drug might be the problem, but it took research to finally understand what was going on.

This medication at the prescribed dosage should be flushed through the system every day, but if you have certain other conditions, it can accumulate. The reason the reaction is delayed is because it may take one to six months for the critical level to be reached, setting off the reaction. Fortunately the level drops quickly after you stop. That is not something that is explained in the standard warnings, and the main reason that the medication wasn’t suspected of being the problem, i.e. most reactions occur quickly, not after months.

You’re right, the PCP should be the person in charge, but many specialists ignore the PCP and don’t communicate what they are doing. The hard reality is that the work of GP isn’t valued by the insurance companies, and they are paid at a lower rate than specialists, despite having greater responsibility for the health of the patient.