Myself for not catching this sooner. The pharmacy for not cross checking the drugs. Or the doctors.
My hubby is taking a boat load of medication (like who isn’t when you have this disease). We have a spreadsheet of all the medications and we provide copies to all the doctors. Below is the list- dosage changes as needed per the doctor. almost all of the medications are filled through the same pharmacy with the exception of the mental health and pulmonary drugs
INTERNAL MEDICINE: Pravastatin, Fenofibrate, Levothyroxine, Vitamin D, Fish Oil, Multivitamin, and Epi-pen
Recent problems in the last two months include - Occasional hallucinations of people who are not there. Severe edema. And a few Pluvicto SE - no saliva and nausea. The doctor said one of the SE for the morphine might be causing the hallucinations. So I trusted the answer and left it at that for a while. Today I was rereading the SE for morphine and further down in the body of the text two drugs they say is not to be taken with it was Ondansetron and Nortriptyline. I went to the pharmacy to talk with them about it. The pharmacist on duty didn’t even seem to know they were listed as a problem. When I pushed the issue he looked up something on his computer and the said I needed to ask one of the doctors about SEROTONIN SYNDROME. I looked it up… yikes it can cause all kinds of problems not to mention death.
Now I’m wondering and worried what other drugs interactions might be going on with all these drugs and not one doctor or pharmacist told me to watch for them. I guess I’m going to have to check each drug with WEBMD
I suggest others check their own drug list to make sure they don’t have any interactions. The powers that be may not have told you of any particular problem.
UPDATE: The regular pharmacist was in today (had to get my shingles booster to protect myself- hubby got shingles right after finishing chemotherapy). He reviewed the drugs that were on his system and added on the ones that weren’t. He then cross checked them for bad effects. He then gave me a printout of everything. He said that the only ones that he would keep an eye on were the ones I already identified. He asked how long he had been taking them- since it was over a few months he said if there’s going to be a problem it would have shown up by now.
Thank you everyone for your help and input on this matter 💗💗💗💗
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Unfortunately this is a very common problem in my experience. Doctors seem to happily prescribe medications without knowledge of in some cases, serious interactions. You really need to be your own advocate and be sure to read the leaflets carefully and check online for drug interactions then challenge the Doctor for not pointing them out.
I give all of my doctors a list of my meds and supplements, updated when there's a change. I keep a list of all my doctors, meds, and 'afflictions' in my wallet.
Yes, we do that every visit. I even watch to see if they scan it into his records. I know his Internal Medicine doctor goes over the list every visit. However currently she is deferring to the oncologist since his primary issue is the cancer.
I use Medscape. So does my Primary and my Oncologist. When I have a script change, my first request to them is confirm any contraindications and let's go over SE's. I don't know about getting mad. Now you know, move forward.
Here's a link and I just selected Erleada as an example:
We had a similar experience of incompatible medications. I guess I was naive to think the doctors read patient’s medical record/medications before prescribing treatment. Surely, we need to be advocating for ourselves and loved ones as many of us do, but we don’t have the medical degrees the “-oligists” own and so we rely on their expertise.
I've found that a very useful site.. I use it to keep track of everything I'm taking, and check for interactions (there are a lot) and side-effects (there are a lot).. and I use it to print out a list of meds for the MD visits where they ask you what you're taking. Rather than spend 20 minutes remembering what I'm taking, I just hand them a copy of the drugs.com list.
It’s true that there are many of us taking several medications, but that is an unusual amount, truly a ‘boatload’, as you put it. As such you will inevitably encounter health care professionals who are not experienced with patients taking that many drugs concurrently.
It’s not to say they shouldn’t be aware of all the possible interactions. Unfortunately It does mean someone in your husband’s perceived state of overall health can induce apathy among some doctors. It’s one of the dark sides of medicine that isn’t talked about enough. I am sorry.
Now you know to expect this. I had a few doctors simply give up and refuse to continue to see me when no easy answer was found for a condition I had a few years ago. Fortunately it resolved on its own eventually, but the ordeal was revealing.
Find out all you can on your own and act accordingly. You can search for doctors who really care, but they can be hard to find. Be not angry! You are carrying too much weight already.
Yes! We used to have a joke that he has doctors from the knees up but since the cancer it’s from the toes up. I advocate for him as much as possible but we’re limited to which doctors we can use due to our insurance and his health (travel time). Fortunately some of the doctors cared enough to help him get additional medical care from the Veterans Administration.
The good news is anger is not forever unless you cannot forgive.And life is too short not to forgive-WMC
Use caution with Webmd and similar. While they're generally reliable, you can get bad advice and also misinterpret what's there. Trust your doctors and also read Webmd, etc. If you don't trust your doctors get different doctors.
This is the only way to be safe. Giving someone in the doctor's office an up-to-date list of medications accomplishes nothing unless you know someone there who is knowledgeable is looking at it carefully.
First I am sorry to hear about the drug interactions. I am the care giver for my wife who takes on average 16 meds. When I get a new drug I do my best to read all the literature that comes with the drugs initially and save them in a file folder. I am no expert I just do the best I can as a laymen.
However in defense of the doctors and pharmacists just consider how many patients and prescriptions they see and fill in a day. Sure they hopefully are helped with potential common side effect interactions by computer programs but NO program or medical provider is infallible. They are human just like you and me.
You didn't state age, but I think you should look at sciencedaily.com/releases/2.... Oxybutynin should _not_ be taken by seniors. There are several other drugs that will work without the potential dementia side effects.
Even the NIH says: "As far as bladder medications are concerned, immediate release oxybutynin has been shown to adversely affect cognition in the cognitively intact elderly." ncbi.nlm.nih.gov/pmc/articl...
A search of oxybutynin and seniors comes up with many references, here's another from UCLA health: uclahealth.org/sites/defaul...
I had them put it in my chart that I do not want it prescribed for me due to the potential for dementia.
Good luck on getting all the meds under control. It is a shame that there is not a "doctor of medicines" to look over extensive lists like yours and make sure they are all needed and appropriate.
Sheesh! And I thought my husband took a lot. With all the research I've done about prostate cancer and congestive heart failure (since my husband has both) I've discovered that pharmacists know a "boatload" more about drugs, individually and in combinations, than any doctors! We're extremely lucky to have found an excellent one that we've used for several years. She's now quite familiar with all my husband's health issues and why he takes each Rx. His CHF is now getting worse as well as his ejection fraction, leading to a new Rx for edema. As soon as I showed up at the CVS pharmacy to pick it up she came over for a consult and discussed at length a potential problem with potassium levels that need to be monitored closely due to other meds he's taking and reminded me again when I picked up a refill last week. In addition I take the time to read any/all literature that comes with any new Rx. Also, before we parted ways with the MO and she was discussing the options my husband had in light of his 2nd recurrence and worsening SEs, she mentioned that he might want to try bicalutamide. Thank goodness I have a very good memory and told her that the doctor on the cancer center's urology team had prescribed that early in his treatment and it failed... they then sent us to her. It was at the same hospital and she had full access to his records but had missed that. I knew that if you take that drug after it fails it will actually feed the cancer and told her that. Sounds like you're doing your part with the spreadsheet and I keep records up to date in a Word Perfect doc that I constantly update and provide to each doctor/health team including palliative care now! We caregivers have to stay vigilant! I'm not a big fan of Dr. Phil but I remember one show about drugs....he said that there is a lot of info available about drug interactions regarding any 2 drugs and some on 3, but after that amount the drug companies/doctors/etc. rarely know about potential problems and interactions, so always ask questions if you have any.
You have a good pharmacist. My regular pharmacist was off that day. So I’ll recheck with him later. And yeah we joke about wishing for frequent flyer points for how often I visit. Also it’s a different version of CHEERS were everybody knows your name.
Thank goodness we have our memories but this Chinese Proverb: The Palest Ink Is Better Than the Best Memory. Says it all because there are times I have forgotten an important thing. If I hadn’t wrote it down/put it in the iPad I wouldn’t have been able to ask the questions we need answered. Blessings to you and your husband.
What an aweful experience to have to go through. One can feel quite powerless in this type of situation.
It sounds like your husband has many competing health condtions that involve high cholesterol, hypothyroidism, breathing, seizures, neuropathy, bladder urgency, serious bipolar and depression, osteoporosis and obviously prostate cancer. There are also supplements that may be to counteract side effects of some of these drugs.
Since I really don't know all the specfics of your husband's health history and I am not a doctor, I can only offer the following observations:
1. Some drugs cause side effects (i.e. high blood pressure, high cholesterol, etc.) which then trigger being placed on drugs for those side effects.
2. Some of these medications may have been prescribed early on and may be less important at his current stage of disease but no one has rechecked that it is correct now.
3. There may be other medication options that work more effectively with less side effects and perhaps he can be on less medications overall.
4. The specialities sound like they are not acting as a team to coordinate their efforts and that's very important.
5. He is on multiple pain meds and a pain management doctor should be able to streamline these. These may be causing the hallucinations. If he is at a final stage of life, hallucinations also can occur.
6. Dry mouth is a common side effect with many drugs and there are mounthwashes for this.
7. If the source of the nausea is know, perhaps it can be eliminated. If not, have doctors figure it out. Likely thet will wamt to place him on anti-nausea medication which may be okay if it is a light weight version.
8. I have found that certain types of canabis gummies with CBG and THC calm my neuropathy, as an alternative to thoe meds. I do still take a light dose of Lyrica before bed also.
9. All his doctors should be board certified in the areas for which they are prescribing and treating him. If not, they may lack the expertise to manage the medications.
Most importantly, I recommend you find an outside health proffessional, experienced in managing this kind of issue to review his meds and see what seems to be off, unnecessary, contraindictated, etc. and have them contact his doctors to make adjustments. You must stay involved in every decision to be sure it makes sense to you.
It seems to me that he may be over-medicated and some medications may be working at cross purposes with each other. I have seen this in family members and friends. If it comes down to the side effects being worse than the disease they are meant to treat, I would go for quality of life - but that's a personal choice.
Final point is never just blindly follow a doctor's advice. Be as informed as you can, ask questions and be his advocate. Good luck!
We don't have as many drugs to juggle as you do, but drug interactions really are a worry. I cross-check interactions using drugs.com but have also twice sat down for an in-depth review with the pharmacist at our cancer centre. Although our neighbourhood pharmacists are conscientious, they readily admit they are not familiar enough with cancer treatments to provide the best advice. I find the hospital pharmacists in the cancer centre who also have online access to our complete health records and drug lists are exemplary. They also have almost immediate access to our MO via her nurse. All this being said, we still monitor. Interactions and risks always need to be weighed against benefits. Good for you for being on it.
I got a surprise at my last visit with my family doctor. He caught a conflict in my medications. I guess that is one of benefits of general practitioner. Maybe you should talk to your family doctor if you trust him/her. They can go over all of your meds and see if there is a conflict.
Got the wrong meds or interaction between meds lately?
So I was going to mouth off about me being an "old normal" guy and then go into a diatribe about what's happening in the U.S. and the world. When all of a sudden I decided to post using the KISS method.
1. Everyone is busy texting.
2. Everyone is busy getting Inked.
3. Everyone is on the Weed.
4. There's no more "George Bailey" (It's a Great Life) types working in pharmacies.
5. Most people can't pass a math test without their cellphone or computer.
6. Most students can't spell and their grammar sucks.
7. Most young people don't know how to hold a pen or a pencil.
8. No sense of humor or laughter.
9. Social media is the new way of hanging out (in your pajamas from your parent's basement).
10. Finally most doctors and most people "don't give a shit".....
Man oh man...........I'm getting to be like those old people I use to make fun of.....
j-o-h-n wrote -- " ... When all of a sudden I decided to post using the KISS method ... "
MY KISS >>
Born + Live + Die --- the + and + is the crap we go through between the actions, some good and some bad. I've enjoyed the good and am dealing with the bad the best I can without complaint 'cause I know that 'there are many others worse off than me
Wish I could Double Like your post. Thanks for an early afternoon giggle. 😀
BTW, I got very lucky (fortunate) with the woman AND ONLY woman in my life. Didn't work out for Sonny and Cher but so far we're happily working towards year 51 being married with our wedding song >>
Thanks and Congrats. BTW I figure you don't know about this US regulation:
Government regulation 17-2384-0-33K states that If you are still married to the same spouse after 48 1/2 years of non interrupted marriage you can declare either one or both spouses as dead and all life insurance payout monies are forfeited and sent to the US Government.
I almost forgot. Cher dumped Sonny during a ski slope "accident" when she found out he was doing too much Sharing on the side...
Hold on, not so fast........ in that case, The Federal Government repossess your scheduled angel wings.......So get used to walking or peddling those 3 wheeler bikes again (of course with raccoon tails and a warning bell).....
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