Drug Pushers

Any chance that after all the bad doctor experiences you have have heard about and shared with us.... that maybe, and this is only a maybe, that it wasn't the drug that caused the stroke but the age of your grandfather? Seems that your mother had used the very doctor that you are upset with for years and years, believe you said decades, and it doesn't seem that he has ever caused your mother any harm in all that time, or at least you didn't mention that he had. Your mother must have trusted him to take her own father to him. Sometimes a painful pain in the neck is a warning that there is a blockage, one of the beginning signs of a possible stoke. I'm really sorry about your grandfather. I really believe that doctors for the most part try to do their best ...I would like to think that they aren't out to hurt their patients. I can tell by your message that you really loved your grand dad. I'm really sorry to hear about his stroke.

I don't mean to offend anyone but I'm a bit aggravated right now. Earlier I was plain infuriated.

My 94 year old granddad is the most amazing person I have ever known. At age 94 he shoots trap on the range where he lives 3 to 4 days a week. He loads his own shells and gets at it again. He has led an amazing life. When I last visited him people seemed to regard him as a hero around the range. It was amazing to watch people interact with him on that level.

But a few weeks ago he went to visit my family as he has for years and years. My mother brought him to the doctor she has used for decades, because his neck was hurting. That was a mistake. The doctor, and I use that term loosely, prescribed him a strong narcotic for the pain.

My younger brother, who is also a doctor, went ballistic went he found out what my mother's physician had prescribed. Unfortunately, he found out after my Grandfather suffered a debilitating stroke.

What ever happened to 'Do No Harm'? Shame on that doctor. Will that doctor wipe my granddad after each bathroom visit now? Will he pay for the care he will need until he dies? Will he comfort him as he sits and rots away?

One of the most amazing men who has ever lived has to suffer the indignity he is now going through, because a legal drug pusher gave him something he had no business dolling out. My grandfather's two sons went to Louisiana for a visit and my mother said my granddad cried as they left. It was the first time she had ever seen him cry.

My younger brother said the drug prescribed is about to be changed to an even higher classification of narcotic. Maybe the other doctor doesn't keep up with current events. Shame on him. But why give a strong narcotic to a 94 year old anyway.

In case you don't know, one of the leading causes of death in our society stems from people taking legal drugs, as prescribed. Get your head around that. Not using drugs in an inappropriate or haphazard way, but the way they were prescribed.

My brother-in-law died at age 36 from what a doctor prescribed him. Shame on that doctor, too. I have little tolerance for this.

My son was prescibed an intense medication by a renowned specialst after he had a number of fainting spells. I was dead set against it because I disagreed with the doctors assessment. I did not follow her logic in her diagnosis, but everyone went on and on about the amazing qualifications of the physician. They talked about her being featured in all the latest journals etc. etc. She told us if the fainting continues after a certain amount of time then we would know it was in fact not epilepse he had. I knew he didn't have epilepse and sure enough, the fainting continued.

But do you know what? The highly paid specialist made us feel like bad parents when taking our son off of the meds. She insisted that her original diagnosis was correct. But it turned out my son has a condition where he simply needs to stay hydrated or he will pass out. Fluids. Can you believe it? He just has a lower tolerance for passing out if he is low on fluids. So at school they keep Gatorade in the office for him. But you know what, pharmaceutical companies and doctors don't get rich by selling fluids. It's not a highly profitable business model. Tom Thumb sells a bottle of Gatorade for about 2 bucks.

I have another friend who I went to school with who had a stroke a couple years ago because of medication she was taking. It all just makes me sick.

I know doctors are under an incredible amount of pressure and have to make many tough decsions. I feel for that. But I see no reason why a doctor needed to prescribe what he did to my granddad and basically cause his slow, painful death.

To all my friends here, thanks for letting me vent.

I am just now seeing this thread.

Mike, I am sorry for your tragedy. With that said, I know you are an emotional man and ask that you step back and perhaps rethink the situation before you blast this doctor, and basically all his/her peers, with both barrels. I find it somewhat curious that you have labelled the provider in question a 'pusher' when he/she had seemingly taken care of your mom for years without 'pushing' anything on her. Providing care to the very elderly is tricky, and there may be factors that were in play that even you are unfamiliar with. Sometimes narcotics are the right answer for people with severe pain and are less harmful than ibuprofen. Sometimes there are issues with kidney function or the stomach which make ibuprofen the wrong choice and a narcotic a much safer choice! With that said, anything that leads to altered mental status should generally be avoided or used with caution in the elderly. My point is that I have a feeling there is probably more to the decision than even you might be aware of, and you might be guilty of ignoring the concept of 'first doing no harm' by bashing the hell out of a whole profession.

Are there pushers in the medical community? Yes, without a doubt. There are providers who will dispense inappropriate pain medication for cash. Our local pusher, Dr Webb in Destin, went down last year and will probably live his life out in jail. That is good. Just below the pushers on the sleaze ladder are the quacks who take cash in exchange for performing bizarre tests and offering unproven remedies, often soaking desperate people for substantial sums. We have more than our fair share in this area. I had lunch with one of Florida's Attorney General candidates a few months back, and I asked that he make it a priority to rid Florida of the menace providers, be they quacks or drug pushers.

It might also surprise you that most likely whatever was given to your grandfather was generic and not marketed by any pharmaceutical company bunnies. The drug companies are a whole other topic, and briefly, your comments are on the money.

Exactly Mike. Heaven knows there are wonderful doctors and other health care workers and I send them a HUGE .

But we must be very vigil when it comes to seniors. Case in point. My father in law. At 80 he had elevated cholesterol. Mind you there was NO history of heart disease in his family, he had low blood pressure and his ratios - HDL/LDL were fine - also, he was thin. YET his primary care physician told him he needed to get on Lipitor. Well, that was the beginning of the end. He became weak, his leg muscles were atrophying and he was deteriorating. I did some research and found hundreds of people in the same condition from statins. And the big point here is that statins are NOT tested on the elderly. Their bodies are different and don't stand up to the same dosage that is tested on adults. Statin side effects are not rare yet when we brought up his muscle weakness he got very defensive saying that his doctor wouldn't put him on something that would "do harm." I insisted he get off and finally he listened and he became a lot better. Only next time he went back to the dr., he chastised him and well, he got back on. He got worse again. My dh and I were outraged, printed and faxed a study regarding elderly and statins and pretty much told the dr not to ever push that on him again. Instead, he gave him an osteoporosis drug (at 80) that burned his esophagus to the point where he had trouble swallowing. Therefore, he ended up with a feeding tube and ended up ultimately having such "back up" issues into his lungs that he died from those complications. My point is that this attempt to correct every symptom is ludicrous - especially in the elderly. Neither one of these issues had to even be treated by meds on a man at 80. Some red yeast and a few tweaks on the diet and a program of light weights and walking would have been great for his bones.

I could tell you my father's story - but that's another time....

G

• Polypharmacy is the biggest threat to an elderly patient. It is crucial that geriatric patients maintain a relationship with a primary provider. Often, geriatric patients are managed by a host of specialists. There needs to be one primary provider whose job is to look at the whole picture. Medications react with each other and elderly patients are not able to metabolize meds as well as younger adults. It is often these medication reacting with each other that pose a danger.

• It is imperative that an elderly patient (or any patient, for that matter) keeps a written list of medications to take with them to each medical visit. This list should include the medication name, strength, dosing times, who prescribed the medication and when the medication was started. This will greatly help any medical provider see the big picture. Patients tend to forget a medication or two when asked to verbally present their list of meds in the office.

• It is important that older adults see a primary provider who has some experience with geriatric patients. Doesn't have to be a geriatrician, but one should inquire about geriatric experience.

• Please remember that medicine is complicated, especially when dealing with older adults. There are many over the counter medications that are high risk for older adults, not just prescribed ones. All of us need to become more vigilant as patients. We need to pay attention, ask questions and most importantly, become more active in our own health maintenance.

I would like to discuss one thing you mention above that I encounter frequently. Many people take red yeast rice for cholesterol. I ask them (nonthreateningly, of course) what motivated them to make that choice and whether or not they know the mechanism by which red yeast rice (potentially) lowers cholesterol. Without exception, it has to do with a fear of statins (Lipitor, Crestor, Zocor, etc) and a desire to be 'more natural', and I have YET to have a SINGLE user of the RYR know anything about the product's pharmacology. It is interesting to see their reaction when I explain that red yeast produces lovastatin at some point during the organism's metabolism and this is the ingredient thay are ingesting that lowers cholesterol! Zooiks! It does not sound like the case with your grandfather, but I would say that if someone truly has hyperlipidemia not improved by diet and exercise that requires medication, RYR is a terrible strategy as the amount of active ingredient (the statin) is probably trivial (or potentially high!) and varies from dose to dose. If one is going to go through the trouble of taking something, it makes much more sense to go ahead and use a statin (or Niacin for that matter) where the product taken is a known entity. And no, it does not have to be lipitor-there are currently two excellent statins available at Wal-Mart for $4 a month, which is an incredible value when you compare the efficacy of the product and the price (go try to buy a botlle of red yeast rice for $4!).

Without delving to deep into this controversy, I want to add some tips that will definitely help medical providers care for an elderly patient:

• Polypharmacy is the biggest threat to an elderly patient. It is crucial that geriatric patients maintain a relationship with a primary provider. Often, geriatric patients are managed by a host of specialists. There needs to be one primary provider whose job is to look at the whole picture. Medications react with each other and elderly patients are not able to metabolize meds as well as younger adults. It is often these medication reacting with each other that pose a danger.

• It is imperative that an elderly patient (or any patient, for that matter) keeps a written list of medications to take with them to each medical visit. This list should include the medication name, strength, dosing times, who prescribed the medication and when the medication was started. This will greatly help any medical provider see the big picture. Patients tend to forget a medication or two when asked to verbally present their list of meds in the office.

• It is important that older adults see a primary provider who has some experience with geriatric patients. Doesn't have to be a geriatrician, but one should inquire about geriatric experience.

• Please remember that medicine is complicated, especially when dealing with older adults. There are many over the counter medications that are high risk for older adults, not just prescribed ones. All of us need to become more vigilant as patients. We need to pay attention, ask questions and most importantly, become more active in our own health maintenance.

Without delving to deep into this controversy, I want to add some tips that will definitely help medical providers care for an elderly patient:

• Polypharmacy is the biggest threat to an elderly patient. It is crucial that geriatric patients maintain a relationship with a primary provider. Often, geriatric patients are managed by a host of specialists. There needs to be one primary provider whose job is to look at the whole picture. Medications react with each other and elderly patients are not able to metabolize meds as well as younger adults. It is often these medication reacting with each other that pose a danger.

• It is imperative that an elderly patient (or any patient, for that matter) keeps a written list of medications to take with them to each medical visit. This list should include the medication name, strength, dosing times, who prescribed the medication and when the medication was started. This will greatly help any medical provider see the big picture. Patients tend to forget a medication or two when asked to verbally present their list of meds in the office.

• It is important that older adults see a primary provider who has some experience with geriatric patients. Doesn't have to be a geriatrician, but one should inquire about geriatric experience.

• Please remember that medicine is complicated, especially when dealing with older adults. There are many over the counter medications that are high risk for older adults, not just prescribed ones. All of us need to become more vigilant as patients. We need to pay attention, ask questions and most importantly, become more active in our own health maintenance.

Great points, and I might expand the hi-lighted point above. Forget the list, BRING THE BOTTLES to the visit! The advantage of this is that any ambiguity about what is being taken is eliminated. Even lists get chaotic without meticulous documentation. There is no question as to the prescriber, dosage, timing, etc. if the label is available. Also, seniors tend to amass pill bottles;I don't know if it is frugality or what, but they frequently hold on to medications that have been discontinued. A clinic is a great place to unload these unused medications as they really are hazardous waste if you think about it, and clinics are capable of disposing of such properly. I like to throw the unused medication away right then and there so as to prevent confusion down the road or accidental ingestion by kids. I also find it helps to jot a note on the labels like 'blood pressure' or 'diabetes' to help people understand what the medication's purpose is.

I have YET to have a SINGLE user of the RYR know anything about the product's pharmacology.

Dr S

Excellent points in the posts you and others made. Lots of useful tips. THX.

Ha - I've yet to see a single user of any drug - otc or prescription who knows anything about the product's pharmacology. ;-)

As far as RYR all I can say is that I have a circle of friends online and otherwise who have used it, or Niacin (as you said), or diet (I am one who lowered her cholesterol from 199 to 141 strictly by diet alone - I rarely take supplements) and others who have chosen to go the route of Zetia for example (some seem to tolerate that better than lipitor)

BTW, I can google RYR and muscle pain and come up with this:

muscle pain red yeast cholesterol - Google Search



and I can google Lipitor or statins and muscle pain and come up with this:

muscle pain lipitor cholesterol - Google Search


People clearly are having a lot of trouble with Lipitor and not so much with RYR.

My sister was prescribed Tricor - one day she called me from WalMart. She couldn't walk. She was scared to death. She had to call her dh to come get her (age 56 btw) I told her to ask her doc if it could be the Tricor messing with her muscles. He told her - in no uncertain terms - no. He got on the phone, in front of her, to schedule tests with a neurologist and my sister, thank goodness, butted in and asked the doc to ask the neurologist if it could be the Tricor and he said YES. So my sister got off of it but it took her a while before weakness was resolved.

I surely am not blaming all doctors. I say to the patient (and family members of patients) Know these drugs - prescribed or otc. Go home and look up drug before filling it. Ask questions. Keep a list with you and as was said, bring in bottles to visits. Research alternatives like I did. TELL doctor how you feel when you are on the medication. Perhaps just tweaking it would help. My mother in law dropped weight and was starting to feel drained - I suggested she phone her doctor and tell him she lost weight and might her prescription dosages be changed?

Back to subject - Mike's grandfather. So sorry all that happened. Perhaps, because you shared, someone else won't have to go through the same.

G

I can't get the links to work, but I can pretty much guess what you are getting at. You can get your information where you choose, but I am telling you I have never seen anything other than some mild crampy type stuff from statins that resolved with discontinuation. This class of medication has been widely used for years now and is very safe and highly effective.