Tuesday, June 7, 2022

Navigating medications - broken things in medical care

Image result for images of medication bottles

As many of you know, my beloved had a 98% blockage of his LAD artery in his heart over two years ago.  It is called a "widowmaker" heart attack because so few people survive this particular form of blockage.  He survived, for which I am absolutely thankful for.  Our love for each other fills our home everyday.  I can't begin to say how much his love and adoration for me makes my world so joyful every single minute.

That heart attack also brought a lot of changes into our lives.  We changed our diet dramatically.  I'd say we're now 95% vegan, some yogurt, but no oil, no other dairy, etc.  My sweetie has lost 55 pounds, and I lost 25.  He was also put on a regimen of aggressive drugs in order to promote a healthy recovery, protection of his stented LAD, and to keep his blood pressure down.  

But recently, those drugs that are supposed to be saving his life are acting more like poison.  Some of this may be due to the fact that he's lost so much weight, but some of it is that we've discovered that he is on "contra-indicated" combinations of meds, yet no doctor has agreed to revisit his condition.  

Today his cholesterol is actually too low, and his platelet counts are almost in the toilet.  He's been feeling sicker and sicker, after having months of being healthier than he has felt in over a decade.  So we've had to be the sleuths and the advocates of taking a serious look at how his medications are influencing his health.

Our process has been long, slow, painful, and frightful.  A year ago a key medication was changed.  three months after that he was in the hospital, he was parched, dizzy, nauseated, and disoriented - so he guzzled too much water (yes even water can poison you if you consume too much).  In the months that have followed, he has alternated between feeling fine, better than ever, and being weak, dizzy, unsteady, dry mouthed, and getting spikes in his blood pressure.  I'd estimate that these "weak" times have been occurring every six weeks or so, and the events would generally last 2-3 days then settle out.  

The most recent time, however, is worse than ever, and has been going on for three weeks.  Doctors pulled his statin and his blood thinner. Yet they added another blood pressure medication without clear reason to. None of the changes improved his platelet count, and he still was in this pit of weakness, confusion, dizziness and anxiety.  We did and still do, strongly suspect a drug interaction.  

I took a spreadsheet and listed each of his meds.  Then going to the Mayo Clinic drug listings I marked the "contra indicated" drugs for each of his meds, and listed out all of the possible side effects for each drug.  I then highlighted each symptom he experienced under each drug.  We suddenly had a very clear map where two of his daily meds were covered with yellow highlights (i.e he had symptoms), and much to our surprise we also found that there were contra-indications across the spectrum of his medications.     Additionally several of the medications are KNOWN to cause low platelet counts. 

 

It became insanely clear that the predominance of his issues revolved around the blood pressure medication he had been put on a year ago.  Because he didn't have any reaction for over three months, the association with the medication was never made.  

Now the trick is that the suspected medication is a beta blocker so it can't just be stopped - even if it is making him sick.  So we are in a taper mode, and as we are tapering he appears to be improving.  I'm still saying prayers.  

My take away - yet once again, is that how is it that people can even navigate the medical system, much less the medications?  I have spent years of my life helping family members and friends navigate this world of medicine because of my "superpower" (see that post in my blog).   

But this is wrong.  Doctors can't be taking 8 hrs of 15 minute appointments per day because of our money driven medical insurance companies, and find time properly research things like this.  how do patients who are walking mysteries get help???  Our faulty assumption was that the EPIC computer system used by our medical community would flag possible drug interactions since all his doctors are on the same system, or that the singular pharmacy he gets all his meds from would have flagged this.