My mother was in her eighties when she became constipated, so she started eating whole wheat bread and drinking prune juice. It didn’t help. At her next regularly scheduled physician’s appointment (after you develop chronic illness, they tell you when to come in, you don’t tell them), stool softener’s were prescribed. When they didn’t resolve the problem, my mother started using Fleet enemas. When her physician found out that Mother was using enemas two or three times a week, she prescribed some other stuff and said that if the constipation didn’t stop then she’s have to hospitalize Mother.
A couple days later my mother was reading a “women’s magazine,” i.e., Family Circle or Good Housekeeping or some such, and she came to an advertisement for her arthritis pain medication. You’ve seen the type—a two-page, full-color layout that reports virtually everything the drug company has to tell the U.S. Food and Drug Administration (FDA) about the drug. Mom read every word (we are a family of compulsive readers) and in the list of side effects it said that the drug could cause constipation. Mom went back to her physician, who had been prescribing the pain drug, and showed her the advertisement. The physician switched her to a different arthritis drug and the constipation stopped.
There are three important lessons to be learned from this. The first is that physicians do not know the side effects of the drugs they prescribe, and they do not check. The Physician’s Desk Reference (PDR) is a complete encyclopedia of all legally manufactured drugs sold in the United States. It is updated every year. It is available on-line at http://www.pdr.net/drugpages/productlabelinglist.aspx. Every physician has a PDR. In thirty years I’ve probably been seen by a hundred physicians, taken upwards of three hundred thousand doses of drugs, and suffered ruinous side effects. Only once has a physician pulled out the PDR in my presence—and that was not to check for side effects: it was to ascertain whether the pharmacy had correctly filled the physician’s prescription. The last thing a physician will suspect to be the cause of your illness is the drugs he prescribed; the first thing he’ll do is try to blame somebody else.
The second lesson, therefore, is that an informed patient is a healthy patient. If your physician doesn’t know and won’t check for side effects, then you have to. Look at it this way: would you rather give yourself an enema or read drug literature? Choose one.
The third lesson is about what to read. When you leave your prescription at the drugstore, tell the pharmacist that you want the “manufacturer’s insert.” The manufacturer’s insert is the piece of literature that reports all the stuff the drug company has to tell the FDA about the drug. It includes all the side effects. Typically, there are about a hundred for every drug. Did you know that? Did you know that your drugs can mess you up in ways you never imagined?
I took Neurontin and it caused chronic impingement syndrome in my left shoulder. They were doing all kinds of horrible things to treat the shoulder pain but they were all ineffective because they weren’t treating the cause. It wasn’t until I stopped taking the Neurontin and the pain went away that I figured out what had happened. I was hospitalized at the time and therefore had no access to the PDR. Plain and simple, the medical staff doesn’t want you to have knowledge.
There are two reasons for this. The first is that you won’t really understand what you read, therefore the physician will have to spend time explaining it to you, and he doesn’t want to take the time. The second reason is that the physician will lose control of you. As long as you are kept in the dark about what’s going on, then the physician can order you to do this-or-that, and you will be compliant. Physicians’ reward compliance with more drugs, which have more side effects, which will be diagnosed as new illnesses, which will be treated with more drugs, which will have more side effects. Welcome to my world. When I stopped taking drugs, I had two and a half quarts of pills on my nightstand (because there wasn’t room for them all in my medicine cabinet).
The manufacturer’s insert will be printed on teeny tiny letters on an itsy bitsy piece of paper. It will contain a great many words that you do not know. It also will contain a great many words that you do know—words like “mortality,” and “asthma” and “elderly,” which are words currently associated with Symbicort and Abilify, both of which are widely advertised on television. You will recognize words like constipation, diabetes, and blurred vision. You may not know what akathisia is but you do know what a headache is. And you know enough to ask your physician to explain things.
Your pharmacist may be your best friend; get to know him. Pharmacists don’t know disease but they sure as hell do know drugs, and they generally aren’t impressed by physicians. I took a prescription to my friendly local pharmacist who glanced at the drug, then looked at the physician’s name and said, “Yeah, Dr. X. He prescribes this for all his patients.” If your physician has a one-size-fits-all policy and is prescribing the same thing for everybody, then it’s an odds-on bet that you don’t need it. My mother’s cardiologist prescribed a cholesterol lowering drug without checking her cholesterol level; he prescribed it for everybody.
Your drugs may be doing weird things that you’d never associate with them. I took a drug for my kidney disease and it caused uncontrolled menstrual bleeding. If you develop a new problem that you’ve never had before, figure out when it started then ask your pharmacist what drug you started to take at that time. Frequently, that’s the culprit.
An informed patient is a healthy patient. Read the manufacturer’s insert for all your drugs. Be healthy!