The Doping of Our Nation

You cannot turn on the TV, flip through a magazine, listen to the radio or surf the internet without running across ads for the latest medications. We thrive on illness or symptomatology, I should say. These ads turn the simplest symptoms into major diseases. And because most of us fear our own mortality, we listen to these ads.

One of my biggest complaints are against the antidepressants. True, many of them have done good for many patients. And I cannot solely blame them for homicidal or suicidal tendencies of some patients who use them. I believe many of them already had those tendencies and the drug only gave them the energy to fulfill those tendencies.

However, I believe these drugs are overused, overprescribed and overrated. I cannot possibly believe that more than fifty percent of this country is suffering from true anxiety and depression. Life is stressful. No one will deny that. It’s stressful even for those who sit around doing nothing. But does that mean we all need a drug to help us cope. What happened to learning nonmedicinal coping skills? What are we teaching the next generation? That there’s a drug to help with everything? Maybe that’s why they also turn to street drugs. How about those dealing with grief? Do we really need to dope them up, numb their feelings? Is that why, as a people, we can no longer sympathize and empathize with others?

I say it’s time we take a step towards regaining our life, our true self. Say ‘no’ to taking prescription medications as an easy way out. We cannot learn to handle all the problems of daily living if we continue to rely on medications to blur reality.

Disclaimer: I do not advocate stopping medications without first consulting your doctor. Nor do I advocate that those needing medications for serious problems, such as heart disease and diabetes, discontinue using them.

Medical Progress or Profit?

Although the word is not in yet for Avandia, does anyone else out there feel like “Here we go again”?  Another drug possibly being pulled due to severe adverse reactions.  Avandia has been used successfully for many people with diabetes, and although prior studies had shown protective effects for the heart, the latest shows opposite findings.  Which do we believe?  Vioxx helped many people with arthritis but others developed heart problems.  What about estrogen?  That was not pulled but there are warnings for its use.  Rezulin was pulled and if Avandia gets pulled, can Actos be far behind? 

Did the pharmaceutical companies do enough studies?  I cannot say but I’m sure many people have opinions about this.  There is always the debate about whether the pharmaceutical companies are out to make an exorbitant amount of money and bribe their way into getting drugs marketed before all the studies are in.  Its a shame to think that humans are being used as guinea pigs, but on the other hand, how can we ever get the answers?  Before drugs are on the market, research is done on humans.  Unfortunately, it is always a small population that are in the study.  When medicines are prescribed, whether it is a new medicine or an old one, we have to accept that we are still in a study, a live study that is ongoing.  When a significant number of adverse reactions occur, the drug companies have to reevaluate the potential dangers of the drugs.  No drug is perfect, no drug is without its risk.  We may hold pharmaceutical companies liable for a lot but without their contributions would we be better off?  Unfortunately, these companies do have a large profit margin; but are they not useful as well?

Mercy Killing or Cruel Living?

It is unfortunate that since we have so much technology, we as a whole population expect more of medicine and expect everybody to expect more.  What do I mean?  Well, it seems that we all expect to live longer and if someone decides to allow nature to take its course, we ostracize them.  We think they are giving up, we want them to do everything possible, we take them to court if necessary.

Let’s take for example the case of a child born with a severe birth defect.  A hundred years ago, they did not have ultrasounds to detect birth defects.  If a child was born with any problems, it was not expected to live long.  People did what they could but they knew nature would take its course.  Today, many couples take advantage of ultrasounds and other tests to determine if there will be any birth defects.  This does not always prevent problems because they can occur at birth.  But what happens if something does go wrong at delivery or the birth defect is worse than was expected and the child becomes severely disabled?  First, the doctor would probably be sued for malpractice.  This is quite unfair in many cases because unexpected things do happen and all this creates is a rise in liability insurance and overall costs to health care.  But because of technology, everyone expects perfect outcomes.  Secondly, the severely disabled child would probably have feeding tubes and tracheostomies to keep it alive.  Why?  Because advances in technology demand it be so.  If the parents decide not to do this and allow the child to die naturally, how would the public react?  Not that it’s really any of their business, but everyone jumps in to protect a child’s interest.  The parents would probably be dragged into court, declared to be unfit parents and the child would become a ward of the state.  Is this fair?  Just because of the technology, do we have to use it?  Would we rather keep a child alive whatever the cost?  No matter that this child will have no useful life?  No matter that this child cannot interact with another person, cannot breathe on its own, cannot eat?  If we saw an animal in the same shape, do we not shoot it and put it out of its misery?  Yes, this is a human but in this condition, is it not a suffering animal as any other?  I would rather call it an animal than a vegetable.  If we force this child to live, who bears the cost of health care?  This being will require extensive medical care for maintenance as well as when infections arise, which is very frequent.   Is this really living?  Yet how do we give it a dignified death?  And as we delay the issue, the debate becomes even harder.  Technology has created an enormous burden even as it has saved many lives.

Polypharmacy

I heard a story once about a woman who went to her doctor for knee pain.  She was given an NSAID.  Later, she developed high blood pressure and was given another pill.  After that, she became depressed and was given yet another pill.  Consequently, she became fatigued and was given another pill.  Finally, she went for a second opinion and he took her off everything.  She felt better.  Moral of the story: one drug caused side effects for which another drug was prescribed.

How many of us know of people who are taking 7-15 pills a day?  There is always the possibility that one or more of the drugs will interact.  It is also possible that the person is taking one pill to counteract the effects of another drug.  Unfortunately, it is too difficult to say whether the person really has a primary condition for which (s)he is being treated or whether (s)he developed the condition due to one of the drugs.  In other cases, the drug may be absolutely necessary; therefore, if (s)he develops side effects, (s)he needs to be treated for the side effect.  But how does that affect the person?  What are the consequences of taking too many pills?

Should we be like the second doctor and take ourselves off all drugs to see what happens?  Or should we just put up with the side effects and take the required pills?  Are we keeping doctors and drug companies in business by having side effects?  Are we unwilling participants in a mind game by drug companies who put out advertisements for their drugs?  How many of us have answered “yes” to questions posed in those advertisements when they ask “Do you have so-and-so symptom?”  How many of us have asked our doctors about these drugs simply because we heard of them on the TV?

I hope that if I live to be 90, I will only need an apple a day.

Diagnostic Overkill

My husband went to the doctor for a physical mostly because he was tired of dealing with symptoms of dyspepsia.  He was young, physically active, had no other known health problems, no family history of heart disease and did not have any bad habits.  He had an EKG which showed some minor abnormality.  The doctor was unsure so he was set up for a stress test.  It came out completely normal as expected.  It should have been a relief to us but we thought the doctor went overboard, probably out of concerns about liability.  When we later changed insurance, this issue came up and we had a little difficulty getting him insured.

OK, my husband is young and it should be worth it to undergo all the tests to make sure he is healthy and will enjoy a long life.  But is it really necessary to undergo a test like an ECHO, which is expensive, just because the doctor is a little unsure?  What happened to doctors being trained to recognize signs of heart disease?  Are medical schools turning out diagnosticians or medical practitioners?

Now take the example of my 90-year-old demented great-aunt who is bedbound.  Essentially, she has reached the end of her life.  So why would the doctor want to check an ECHO to follow-up on her Congestive Heart Failure?  What difference will it make now?  So what if the test will be covered by Medicare?  The cost will eventually come back to taxpayers, who are already complaining about Medicare cutting back on reimbursements.

Another aunt, in her 80s, has had several strokes attributed to carotid artery stenosis.  She has had a couple surgeries for it and does not want any more.  She knows that she is at high risk for another stroke and the last ultrasound shows the blockage is at 80%.  Must she still have frequent ultrasounds?  Granted it is noninvasive, but is it necessary when she will not have anything done for it?

Is the concern about malpractice leading doctors to order more diagnostic tests than necessary?  If your physical exams suggest a diagnosis for which the patient does not want treatment, must you order tests to confirm your diagnosis?  Are you hoping to scare them into undergoing a treatment they do not want?