Are you taking prescription medications?

What was the reason for, or the episode you experienced that caused your doctor to write the prescriptions?

How long ago was that?

Have you ever asked your doctor if you still need to be on them? 

Why do I ask? Because in many instances:

People are put on prescription medications and are never taken off!

Physicians are extremely busy. I have a great respect for them. And it’s not that physicians are irresponsible or uncaring, but if you don’t ask, “why am I still on this?”, most physicians will continue to refill those prescriptions forever, altering your body chemistry and draining your wallet from now into eternity.

SAFETY POINT:

• Never stop taking medications on your own. Only after a conversation with your doctor and only when your doctor feels it is appropriate should you wean off medications.

 

When medical and health problems pop up unexpectedly many times we do need medications to recover.

But often times medical and health issues are due to a situation or circumstance and once that situation or circumstance ends, health returns to normal and medication is no longer necessary.

But you would never know that if you never got off the medication.

Many medications can be weaned safely. If symptoms return then you may need to go back on them — but what if your symptoms were due to a situation or event that has passed? Wouldn’t you rather return to natural health and not be ‘modified’ by a substance?

Hmm… What About Those Drug Side Effects?

Drug induced side effects are very important reasons to wean off drugs that are no longer necessary. Many prescription drugs have life altering and very serious side effects:

• nausea, vomiting, diarrhea
• skin rashes
• headaches
• • drowsiness
  • difficulty concentrating
  • difficulty sleeping
  • depression
  • anxiety
  • dementia

See anything on this list that might need another prescription or over-the-counter drug to alleviate?

All of them!

 

As new meds are added to counter the side effects of existing meds, you become locked into a never ending circle of medication dosing. And as specialists are consulted they order even more meds.

Your PCP or Primary Care Doctor is supposed to be overseeing all of your medications but unfortunately many of them are just cataloging the information — not providing any analysis of what they have received. It’s more like  — “I see you saw the gastroenterologist and he ordered xxx. OK.”

And that’s about it.

Contributing Factors

The following scenarios are all too common, and result in the continuing use of medications that are no longer warranted:

• situational anxiety (an unexpected death, school or work stress, bullying)
• occasional dietary overindulgences
• acute medical complications during a hospital stay that don’t result in permanent injury or long term illness
• (healthy) weight loss resulting in naturally lowered blood pressure and/or blood sugar
• misdiagnosed medical conditions (p.s. if you have any doubts, get a second opinion!)

I’ll give you an example from my own experience. Years ago I reported to a miserable boss who caused so much stress that two of his direct reports went on anti-anxiety meds. Me? I had an episode of acute recurrent ‘heartburn’.

The keyword here is acute. It was a situational response that was acute, not chronic, even though it was recurrent (I had it every day over several weeks).

This distinction makes a difference in whether staying on a med makes sense.

So my acute, recurrent, esophageal pain and ‘lump’ when swallowing was due to:

• situational stress
• overeating at mealtime
• and probably that brandy before going to bed

My stomach and esophagus were protesting with a vengeance!

Short term it’s called heartburn or gastric reflux. Long term it’s called GERD — gastro-esophageal reflux disease which includes changes in the esophageal lining as gastric acids leak out of the stomach and eat away at the lining of the esophagus. If untreated it can lead to more serious diseases like ulcers and cancer. No one wants that.

(Some people are genetically pre-disposed to GERD and may indeed need long term medication treatment. Other people are like me and have the occasional stress-related event and only need some help short term until the event is over.)

Think back to vacations when you indulged just a little too much and suffered for the few days you were vacationing. That’s how I felt every day for a few weeks! My doctor prescribed Nexium and would see me in a month.

By the end of the month I felt better, had returned my diet to something much less gigantic, had cut out the brandy before bedtime, had upped my exercise, and had returned to my daily meditation routine to alleviate stress.

When I returned for my follow-up visit, I told my doc that I felt better — but she felt I should continue the Nexium anyway.

Only when I was persistent about my problem not being chronic recurrent reflux, or GERD, but rather acute due to a situational response to stress, did she agree it was reasonable to stop the Nexium.

If I wasn’t a nurse I would not have known to be that persistent!

And BTW, I loved that doc. She knew her stuff, but prescribing medication is what she was taught — a main problem with western medicine — excessive use of prescriptions.

In a report titled: “Health, United States, 2013” , one in 10 Americans said he or she had taken five or more prescription drugs in the previous month. According to a CBS news article 70% of Americans take prescription drugs and more than half of them are on two.

These statistics are heavenly if you are a drug manufacturer!

Historically doctors managed patients. Now, prescription drug companies are managing diseases — and guess who else? Us. How do they do this and what does it mean to you?

Today, prescriptions are ‘pulled’ through the system.

How?

By you of course.

Nearly every drug commercial and visual ad today includes the phrase, “Ask your doctor if XXX is right for you”.

In addition, drug companies send out their reps in vast numbers hitting up as many prescribing physicians and nurse practitioners as possible with marketing brochures and literature touting the benefits of the various drugs they manufacture.

Unfortunately what they are also pushing is the off-label use (secondary benefits for which there is no clinical trials or FDA approval) of many of their drugs.

So you or your family may be on something that was FDA approved for something else.

Everyone, especially physicians, should read Generation Rx: How Prescription Drugs Are Altering American Lives, Minds, And Bodies by Greg Critser. This is a fascinating look into how the prescription drug industry has become so powerful, and how we have become the most medicated Americans ever, particularly our children.

We are talking about a multi-billion dollar industry. According to Pharmacy Times, Top 200 Drugs of 2012, the top-earning drugs in order of usage were:

• Nexium (esomeprazole) ($6 billion)
• Abilify (aripiprazole) ($5.9 billion)
• Crestor (rosuvastatin calcium) ($5.1 billion)
• Advair Diskus (fluticasone propionate and salmeterol) ($4.9 billion)
• Cymbalta (duloxetine delayed-release capsules) ($4.7 billion)

Have you seen any of these drug ads asking you to, “Ask your doctor if XXX is right for you.” Heck yes! Every one of them.

How have drugs infiltrated our lives so profoundly? There are several contributing factors as to why this is.

• Health care has become a lucrative business for providers, insurance companies, and drug manufacturers with very costly overhead for many of the providers.
• Physicians are caught in the middle, now shaving off the time they can spend with patients — either to make more money or to cut costs.
• There is too much information for any one physician to know so the world of specialists has exploded.
• The prescription drug industry uses sophisticated marketing techniques, statistics, and human psychology to drive sales.

We get drawn in to the drama of the commercial and see ourselves. It’s basic psychology, inherent to humans, and well played by the drug industry.

What Can You Do?

STEP 1 — Understand your medications — and those of your children or elderly relatives:

• Know what they are for
• Know when you started them
• Evaluate if anything has changed since then — stress, weight, exercise, diet

STEP 2 — If you don’t know the answer to any of the above questions in STEP 1:

• Write down all of your medications.
• Include the answers you do know for each of them.
• Bring the list to your pharmacist and ask for help in filling in the blanks. Pharmacists are a great resource for answering medication questions and typically love the human interaction.
• Ask the pharmacists if he/she thinks there are any you could do without.
• But remember, this is fact-finding. Do not stop any medications on your own, or even if you think the pharmacist appears to think you can.
• Ask the pharmacist which drugs may interact with others on your list (as well as any over-the-counter medications you take) and note that on your list.

STEP 3 — Bring the list to your doctor:

• At your next appointment, tell him/her that you need help in understanding why you are still on these medications.
• Request that they be re-evaluated with you — one by one.
• Be persistent in your need for understanding — physician offices are very busy and oftentimes try to rush you through an appointment. Don’t let them.
• Ask which ones you can safely discontinue. If he or she is hesitant to make changes, ask why? 
• If your physician thinks that getting information on the internet is not the best idea, have a copy of this blog with you — written by an RN with years of acute care experience — so you can show it to him or her.

As a nurse I understand the value in taking medications as prescribed. But remember, situational problems that resolve with time or with a change in your environment, are compelling reasons to:

Ask Ask Ask — Why am I still on this or these meds?

And finally, when your health improves, request that your medical record be updated to reflect the change — otherwise incorrect medical information will remain in your health record, and at your next visit you may end up with another prescription!

Good luck! And thanks for visiting. Feedback welcome!

Tune in next week for: Belief Systems — Are they really our own?

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