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Archive for the ‘Health’ Category

Are You A Responder?

Monday, 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

Thursday, 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.

Say WHAT?

“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,
Louise

It Takes One To Know One

Wednesday, 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

Drugs Available for Overactive Bladder Symptoms

Friday, 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

Wednesday, 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

Be A Squeaky Wheel

Tuesday, July 5th, 2011

I was working at a community pharmacy last Thursday, heading into the July 4th holiday weekend, when one of the customers that came in to pick up his prescription asked if “one of the pharmacists that gives shots” could please help him out with his injection of blood thinner.

He was picking up a refill of enoxaparin, also called Lovenox, for blood clots in his legs and his lungs. As I prepped his stomach for the shot, he told me that this was the second time that he had to buy this expensive prescription. A week ago, he’d noticed a cramp in his right leg that wouldn’t let up and when he went to the doctor, they did an ultrasound and found several clots in his right leg. Then they did a chest CT which also found clots in his lungs.

His doctor gave him 3 prescriptions: one for injections (enoxaparin, also called Lovenox) one for tablets of a blood thinner called warfarin, and the other for lab work: blood tests every day until his blood test was high enough so he could stop taking the shots. He then explained how he faithfully went to his doctor’s office to get his blood tested every day, from Wednesday to Saturday morning.

The call he got on Saturday wasn’t from his regular doctor. She was out of town over the weekend so another doctor, one he didn’t know, called him back on Saturday afternoon and told him that his level was now too high and he was to stop both the enoxaparin shots and the warfarin pills, and come back to the office for another blood test in 4 days.

As I gave him his shot, put a band-aid on it and dropped the syringe in the plastic container we kept for “sharps”, he added, “At the time I knew it didn’t seem quite right, but I didn’t feel like I could ask the doctor about it. Then when I went back in on Tuesday, my test was way too low and I had to start all over again. Not speaking up cost me over $400 in extra tests and more of these expensive shots.”

I agree with him.
If you don’t understand WHY you are being asked to take –or to NOT take-a particular medicine, please, please, please…SPEAK UP!
Being willing to be a “squeaky wheel”…to ASK if something doesn’t seem right or make sense to you will go a long way to help you take medicine safely.



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