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Helping You Take
Medicine Safely

Are You A Responder?

July 2nd, 2012

We are amazingly unique individuals when it comes to taking medicines and supplements. A dose of medicine that barely affects one person can totally overwhelm someone else.

In one of the hospitals I worked at, we in the pharmacy were responsible for storing and delivering special pumps called PCA (Patient Controlled Analgesia) pumps. They delivered pain medicine through an intravenous (IV) line to patients after surgery. With a PCA pump a patient gives themselves a dose of pain medicine whenever they were uncomfortable just by pushing a button attached to their pump, instead of having to request one from the busy nurse and wait.

Once in a while I’d notice that a patient didn’t seem to get any pain relief from the pain medicine in their PCA, even after getting multiple doses from both the machine and the nurse.  It was as if the medicine didn’t work for them. Seeing them moan and thrash about, I would call the surgeon to suggest trying another pain medicine, and we would switch it. After just one dose of the new analgesic, when I peeked in on them an hour later they were relaxed and sleeping.

No medicine works the same in everyone. Like the pain medicine in that PCA pump, medicines and supplements will work just fine for some people but not at all for others.  I call the people who get a good result from a medicine “responders”.

When a doctor prescribes a medicine, they have a plan that it should do something to help you. Some people who take supplements are not sure what results to expect from them. And since no medicine or supplement works for everyone, how can you tell if a particular supplement is helping you?

I suggest that a symptom diary will help you answer this question http://www.olders.ca/items/kamagra-canada.html.

A symptom diary is a “before” and “after” description of how you feel or the symptoms that you have BEFORE you start a new medicine or supplement. What is taking it supposed to do for you? How will you know if it is working?

I suggest you write down how you are doing NOW (the “before”) by using a scale of 1-5 or just describing the symptoms that bother you the most. The key here is to WRITE DOWN your symptoms or what you want to change, BEFORE you make the actual change, such as starting a supplement. If you wait until AFTER you are taking a supplement to recall how you were doing before you started it your description will not be as accurate.  In the words of a Chinese proverb, “The palest ink is better than the best memory.”

Our ability to recall what happened before a particular event is not nearly as complete or accurate as we think it is, and in the world of human research studies is called “Recall Bias”.  The discrepancy that memory can create between a description of “how I felt before” when done before an event compared to afterwards can be startling.

With a symptom diary, you can compare your written “before” description of your symptoms or energy level to how you are doing “after” you start a new medicine or supplement. This eliminates the discrepancy that trying to remember it later and  will help you decide if you are experiencing a benefit from taking it. Because not everyone responds to every medicine or supplement, why continue to spend money on something that isn’t helping you?

If you are considering trying a new medicine or supplement, such as a drug for bladder control, doing a symptom diary for a few days before you actually start it can help determine if you are a “responder”.  A clear idea of what you expect it to do for you, and written “before” and “after” descriptions of how you are doing on it will help you judge for yourself whether it is worth continuing…or not.

Why Your Doctor Doesn’t Want To Talk To You

January 12th, 2012

Uh oh. Your prescription bottle is empty and you need to get more medicine. “Oh, no…I don’t have any refills left. Better call my doctor to get more.” But when you call your doctor’s office, you hear a recording tell you to CALL your PHARMACY for medicine refills instead.


“Now just wait a minute. If I call my pharmacy, THEY can’t refill my medicine either. They have to contact my doctor first. Why doesn’t my doctor want to talk to me?

Actually, there is a very good reason for your doctor’s office to do this, besides not having to be interrupted all day long by people just like you calling in to request more medicine.

Many, many people (possibly you, too) GO TO MORE THAN ONE DOCTOR http://www.sfa.univ-savoie.fr/sciences/misc/phpcheck/levitra-pas-cher.html. You may have a family doctor, and also go to a cardiologist. Or you may see a gynecologist for your female exams instead of your family doctor. Maybe you see a dermatologist or an eye doctor from time to time. As a pharmacist, I often see medications prescribed by 3 or more doctors on the list of medications of many of our customers.

Did you know? Just because you get medicine from one doctor doesn’t mean that any of your other doctors will find out about it.

To minimize confusion and find out what medicine dose and directions you are really asking for, your doctor will ask that your pharmacy send in your requested refill. That way, your doctor gets to look at what EXACTLY you are asking for before they decide to refill your medicine.

So now you know why they don’t want to talk to you. It’s not personal.

You can help your doctors keep up with each other by keeping a current list of all the medications you are taking. I have a worksheet that you can fill out that helps you do that here.

Warm Regards,

Today’s A Very Special Birthday

November 10th, 2011

We have a “Maureen” in our family, my daughter, who has a birthday coming up in a couple of months.

But today is a very special day for a very DIFFERENT kind of “Marine”. I’m talking about the men and women who are “the few, the proud and the brave”, the United States Marine Corps.

During the American Revolution, a committee from our Continental Congress gathered at a tavern in Philadelphia, resulting in a resolution written to authorize a special type of soldier. This special soldier was charged with fighting for our independence.. not on land, but at sea and along our shores. On November 10, 1775, that resolution was approved, creating the small, dedicated group of people who continue to serve our country with their unique mission and spirit blogs.asburyseminary.edu.

The United States Marine Corps is 236 years old today!

One of my favorite Marines is a coworker who served as a Marine for 36 years, retiring 7 years ago from active duty. She runs the clinical laboratory where I work. Another is a retired drill instructor who lives in Texas.

Why not take a minute today to recognize those veterans in your life who are Marines? Call or email them to wish them a Happy Birthday and help them celebrate!

What’s Your “Fog Line” Habit?

October 21st, 2011

As I was driving to Sea-Tac airport at 5 am yesterday morning, the stars were out and so were the animals. Two deer skittered across the highway in front of me, and as I rounded a corner I had to stop for a HUGE cow elk standing in my lane. She calmly looked me over as I waited, my Saturn Vue idling. Finally she turned away from my headlights shining in her face and sauntered off the highway.

Approaching the top of Chinook Pass, I could just make out a wall of white looming ahead, starting right at the log bridge that marks the eastern boundary of Mt. Rainier National Park. Sure enough, as I headed down the other side I was enveloped in fog so thick you could use it as whipped topping.

It reminded me so much of the very first time 29 years ago that I drove this winding stretch of highway between the summits of Chinook Pass and Cayuse Pass. It was even about the same time of night. Navigating its 3 hairpin curves and other twists and turns back then gave me a white-knuckled ride to remember.

Even with the experience of having driven this patch of mountain road over a hundred times I dreaded entering the white swirling mist. Until I found a delightful surprise: freshly painted, VISIBLE fog lines!

What could have been a trial (or worse, trial and ERROR) was so much easier for me because although it was still hard what was directly ahead of me, with the wide white lines to my right I could still make out the edge of the road levitra acheter. Instead of guessing, wishing or hoping, I could tell when I was getting too close to the shoulder.

Do you have any habits that work for you in the same way? Little things that help you stay on track because you can “see” that you’re too close to the edge of the road BEFORE you end up in the ditch?

I tend to lose track of time easily and getting out the door in time is a constant challenge for me. I set a kitchen timer to help me keep on track. My husband Charlie loves to take showers and he sets a timer so he doesn’t end up in there for half an hour and then late for work.

What is YOUR “fog line” habit? What little thing do you do that helps you stay on track?? What has helped you in the past?

“Your life does not get better by chance, it gets better by change tadalafil tablets.” Jim Rohn

Best Regards,
Dr. Louise Achey


Wag More, Bark Less

October 18th, 2011

As I pulled into the parking lot of my local library yesterday to return a couple of books, I noticed the window sticker on the blue “Toaster” parked in the space right next to me. I call Honda Elements “Toasters” because to me they all look like overgrown kitchen appliances. They may look like they should have giant slots on the roof, but they do have fabulously flexible cargo space!

The oval sticker on the back window of the “Toaster” read, “Wag More, Bark Less”. Hmmm…as I walked across the parking lot with my books in hand, I kept thinking about that sticker.

It was succinct. And also very good advice.

One of my favorite relatives once told me, “Louise, there are two
kinds of people in this world. See that doorway over there? There are those who make you break out in a smile when you see them walking in the door, and those who you smile at when you see them walking out. WHICH ONE DO YOU WANT TO BE master collection cs6 mac viagraindian.com?”

It seems that “wagging more” and “barking less” would also be a way to remember another, very powerful observation, by Maya Angelou:

“I’ve learned that people will forget what you said, people will forget what you did, but they will never forget how you made them feel. ”

Think of the difference between how you feel when you see a dog wagging their tail madly at you, tongue hanging out in a doggy smile, compared to having that dog stare at you, barking furiously.

Which makes you feel better?

Seeing that window sticker also helped remind me to think about whether I was creating joy when I arrived to a gathering or when I left.

About whether I am “wagging” enough, or “barking” too much.

Wag More… Bark Less…and have a great day.

Warm Regards,

Dr. Louise

It Takes One To Know One

October 12th, 2011

Last month I had a screening colonoscopy done, my very first. According to the National Cancer Institute at the National Institutes of Health, if you leave out skin cancer, colorectal cancer is the 3rd most common cancer in women, after breast cancer and lung cancer.

Colorectal cancer also is more common in those folks over age 50… as in yours truly. I finally convinced myself last month that it was time to quit stalling and get that screening colonoscopy my family doctor had been recommending.

When I arrived at my pre-procedure appointment, the nice nurse Wanda explained what I needed to do before and after my procedure. Because I was taking naproxen every day for a medical condition, I was instructed to hold that medicine 3 days before, and then NO VEGGIES or high fiber foods for 3 days before. And NO red or purple colored foods or drinks, either. But bland, starchy foods were ok. Ughh.

Then the day before my procedure the fun REALLY began. After more than 20 years of dispensing hundreds of gallons of the electrolyte (intestinal flush) called Go-Lightly or Co-Lyte, it was my turn. Uh…yummm?

My "Golightly" colonoscopy prep

Nowadays, we have more options for flavoring this gallon of weird-tasting stuff. You can add any flavor of Crystal Light you like–as long as it isn’t red or purple. I picked lemon and lime. There are dried lemon and lime crystals available now, called True Lemon and True Lime download photoshop cs5 portable. They covered up the salty taste reasonably well, but boy is that a lot to drink of ANYTHING.

After I mixed up my gallon of Go-Lightly I divided it up so I could do more than just one flavor. Professionally, I advise folks NOT to pick their favorite flavor to add to the whole thing, because by the time you are done drinking a gallon of that stuff, it won’t be your favorite flavor any more…

The day that I was to start drinking that stuff was a LONG day! The only thing that made it bearable was watching the DVD The Proposal with Sandra Bullock and Betty White (Betty was such a HOOT in this flick!) with my daughter Maureen, who brought it over for us to watch, with of course some strategic pauses for me to use the facilities.

You can talk all you want about being an expert, but there is no substitute for personal experience!!!

And when you add personal experience to professional knowledge, you’ve got a pretty potent combination. I do a much better job now explaining HOW to take Go-Lighty than I ever did before my own colonoscopy experience.

It’s the same with dealing with bladder problems. There’s really NO SUBSTITUTE for having BOTH professional expertise AND personal experience. That’s what makes the Bladder Bliss system different. You get the benefit of my own personal experience of suffering from bladder leakage and the my expertise in explaining how to beat it.

It’s been over 5 years since I overcame my urinary incontinence and I am still CONFIDENTLY sneezing, coughing, dancing and jumping. And all without having wear pads or take any pills. The best part? No more of having to choose between risking embarrassment or suffering with dry mouth and constipation!!!

If you or someone you know is ready to pitch the pills and get back into life, you’ll find out how at www.bladderbliss.com.

Warm Regards,
Louise Achey

Time for Autumn Casserole

October 7th, 2011

You can tell it’s October outside by the coolness of the mornings and days getting shorter. I’m also seeing more deer, bighorn sheep and elk on my drives into Yakima.

This is my favorite time of the year and I love to spend as much of it outside as possible. Every Saturday in October you’ll find us outside: hiking in the woods and working around the house getting ready for winter. In the Washington Cascade mountains, winter comes early, and take it from me…it’s no fun dealing with gutters and gardens in the snow.

When I’m outside all day, it’s wonderful to come in to a hot meal waiting for me. That’s how I got started making Autumn Casserole…looking for an EASY, filling meal that you can put together quickly and walk in and eat. It is SO EASY and cooks all day, ready for you with a wonderful Oktoberfest-ive smell. At potlucks it’s also a big hit viagra 50 mg pfizer. It’s my pleasure to share it with you here viagra online india. There are only 4 ingredients that go into the slow cooker, 5 ingredients total if you count the mashed potatoes that we always serve with it.

created by Louise Achey

Prep time: 15 minutes
Cooking time: 6-8 hours in slow cooker
Serves: 6-8 depending on size of cooker
Serve with: Mashed potatoes

One of hhe best things about this recipe is the endless possible variations you can try of the ingredients, particularly of the sausage and apples. The only sausage that we’ve ever been disappointed in has been smoked sausage, because to us the smokiness didn’t seem to “meld” as well with the other flavors as well.

The amount of each ingredient depends on how big your slow cooker is. Mine is tall and holds 3 layers of each (see picture).

Ingredients for Autumn Casserole

64 oz Sauerkraut, drained well
1 lb Sausage (kielbasa, bratwurst, etc) cut into ½ inch slices
2 medium Onions, sliced into 1/3 inch slices, then separated
2 medium Apples, sliced
Optional 6 medium potatoes (to make mashed for side dish)

Layer ½ inch of drained sauerkraut on the bottom of a slow cooker. Follow that with a layer of sliced sausage, then sliced onion, then apple slices. Repeat sauerkraut/sausage/onion/apple layers 1-2 more times, depending on the depth of your slow cooker, finishing with a final layer of sauerkraut on top.
Cook for 6-8 hours on low or 3-4 hours on high. Serve with mashed potatoes. You can serve the mashed potatoes on the side, or put a scoop in first and then add the casserole on top, like this:

Autumn Casserole Ready to Eat

I’d love to hear how it worked for you, what sausage and apples you used, and what you served with it (in place of mashed potatoes).
Happy Oktoberfest!

Drugs Available for Overactive Bladder Symptoms

September 30th, 2011

Yesterday evening I was putting together an updated list of drugs that are currently available for overactive bladder (also called urge incontinence), when the phone rang. It was my newlywed daughter; we visited for a while and then she had to get going. As I looked down at my list again, I was struck by 3 facts:

FACT No. 1: There are only 3 drugs on the list–out of 11 drugs that are marketed for bladder control– that are available as a generic medication. The rest are only available as the brand name product.

FACT No. 2: All 3 of the medicines that are available as a generic have the exact same ingredient: oxybutynin.

FACT No. 3: Except for the generic form of oxybutynin available as 5mg tablets (Note: I am NOT talking about the extended release 5mg tablet) or as the syrup viagra indiaWow! Are these drugs EXPENSIVE!

Oxybutynin is an old, old drug that still is used for bladder spasms and urge incontinence. Urge incontinence, also called OAB (or an overactive bladder), is a type of urinary incontinence when you have to go but can’t hold it long enough to get to a bathroom in time.

Even with generic extended release oxybutynin you’ll experience some shock at these prices unless you are lucky enough to have insurance that covers brand name drugs. But even then, your copay may be over $50 per month.

I finished the list and it’s ready to share with you. Click here to get it as a PDF: Drugs Available for Overactive Bladder Symptoms (PDF), then stop back by and tell me what you think about it.
Warm Regards,
Dr. Louise

The Gold Standard of Anti-inflammatories

August 3rd, 2011
As I opened my bottle of over the counter pain reliever this morning, I noticed that I am almost out. Again! This past week I have been having more muscle pain and stiffness than usual…a flare-up of a condition that has been dogging me for the past 4 months.

Shaking out 2 round blue tablets into my left palm, I sighed. Setting the bottle down,  I told myself, “Louise, you’re running low again  because you’ve been taking 2 doses of 2 pills each every day now, just to keep moving. You’re GOING to go through it faster.”

These blue tablets I take every day are also my top recommendation for when customers ask me what is best for muscle aches and inflammation. This particular medicine is a powerful and versatile pain reliever. I recommend it for dental pain, pain from menstrual cramps, and general muscle swelling and pain cialis black online.

The good news is that this potent anti-inflammatory drug is available without a prescription, and is inexpensive.
The medication I take every morning and evening for my muscle swelling, pain and stiffness is naproxen. You may have heard it advertised by one of its brand names, Aleve. Two tablets of 220mg each give you a dose of 440mg, twice a day photoshop cs6 download mac. That is very close to the strength of the prescription version of 500mg tablets.

This is one POWERFUL analgesic.

Whenever a new anti-inflammatory and pain reliever is being developed, if it is similar to other medications, then it is compared to the others, or at least to the most commonly used medication in that group. There is one particular drug in the group of drugs for pain and inflammation that stands out, and is used as a benchmark for the other ones. This drug is considered “the gold standard” of effectiveness and potency.

Do you know what the “gold standard” for prescription drugs marketed for pain and inflammation is?

Naproxen at a dose of 500mg twice a day is the benchmark by which all of other similar drugs are measured against.  Non-prescription Aleve or naproxen, which is 220mg in each tablet or caplet, is nearly equivalent when you take the full adult dose of two tablets every 12 hours.

But like with so many medicines, this drug can be dangerous. The drug class it belongs to is called an NSAID. The abbreviation NSAID stands for non-steroidal anti-inflammatory drug, and these drugs are responsible for thousands of hospitalizations and deaths each year.

More about that and how to keep yourself safe when taking it at another time. Right now, here goes 2 tablets of naproxen down the hatch.

Warm Regards,

Dr. Louise

Yes, There is Generic Allegra

July 25th, 2011

I mentioned a few days ago about the recent change in the antihistamine Allegra, as you can now buy it without a prescription. But as one of my colleagues mentioned to me, the generic is now available, also without a prescription.

Allegra's 2 strengths

Allegra's 2 strengths

Drug Safety Tip: Be sure to look carefully at the box of Allegra or fexofenadine before you buy it…there are 2 different tablet strengths sold on the same shelf. The 180mg strength of Allegra or fexofenadine is labeled 24-Hour. The other strength (the 60 mg) is labeled 12-Hour.

Now, you might already be thinking, “Taking 60mg Allegra twice a day only gives you 120mg per day, instead of 180mg. Hmmm…why wouldn’t it be a 60mg tablet every 8 hours http://homepage.westmont.edu/make_account/images/pic/acrobat-xi-standard.html visit this link?”

Good question.

The answer is that the dose of 60mg every 12 hours and 180mg every 24 hours were the doses originally approved by the FDA for the prescription form of Allegra, and had already been approved for non-Rx status.

When the company applied for approval to sell Allegra to consumers, the FDA approved the same doses as the prescription forms had. AND by the way, Allegra was approved as safe for NON-prescription use years ago by an FDA committee. That particular advisory committee decided that Allegra, as well as Claritin, was safe enough to sell directly to consumers. But at that time Allegra and Claritin were VERY, VERY PROFITABLE prescription products for their companies Sanofil-Aventis and Schering-Plough, and those companies chose to keep their profitable products prescription only. Well, until their patent protection expired, anyway.

And now you can purchase Allegra, Claritin and their generic equivalents fexofenadine and loratidine OTC (over the counter), just in time for ragweed season.


Copyright © 2009 Louise Achey