DePrescribing Site Woes: I'm really... - British Lung Foun...

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DePrescribing Site Woes

Dmactds
Dmactds

I'm really, really sorry that so many are having trouble accessing the site I posted earlier on medicines to be wary of because of age, I am not a member of that site and have never had to "sign in" so I don't know what the difference is but in this post I'll try to send along some more accessible information.

First, there's this : americangeriatrics.org/site...

which is in PDF form and may be of more help though it's much 'wordier' but very informative; secondly, I've had a recent experience with a diuretic, Furosemide that really shouldn't be taken by anyone much less those of us over the age of 55 or 60. I would post a link but I don't have it handy right now so it's really up to the curious to root around for the particulars. I can tell you though that it aggravated my emphysema in the form of increased breathlessness, weakness, tiredness and general 'crappiness'. I told my doctor's nurse I'd taken myself off of it and the fact the National Institutes of Health and every other site I found referencing it thought it was most certainly the work of the Devil and should be never prescribed to anyone over 60..., I'm 76 and my doctor knows my age which is just another instance of the patient being justified in the skepticism of the medical field in the same way they might be skeptical of a shade tree mechanic.

Anyway, that's all for now folks; lemme know if there are any problems...

Regards,

Duncan

19 Replies
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Oh dear. Well at least you got in to see a doctor which is something. I had my usual battle with them and had to trawl up there and the only appointment they had was at 8.10 am next Thursday! Now I am in my mid 60's and have various problems including chronic back pain so I will have to get up very early as it takes me forever to get myself moving in the morning

Good old NHS :( . x

Thank you for your post. I have just trawled through the document and it really is quite scary. Yesterday I had a check up with gp, who is one of the partners in tha practice, to discuss my COOD and silent reflux.

I went armed with the U.K. NICE guidelines but still it did me no good. I wanted to come off the PPIs I have been on for 3 years as there is clear evidence for opesteoporis in long term use, and anything over 8 weeks in fact, and I was diagnosed as osteopaenic 10 years ago. Plus other vary nasty side effects.

My gp refused to listen to my arguments and told me I would stay on them for ever.

Like you I too have had adverse reactions to drugs in the past.

I try to take responsibility for my health but if my gp feels differently about a drug then I don’t get a say in the matter. I am the same age as you, still have all my marbles, am active, eat as healthily as I can, never touch junk food and keep myself as informed as I can. What else is a patient supposed to do? I find it a real dilemma. Though I doubt there is actually a solution.

You'll have to excuse my ignorance but I have absolutely no idea what PPI might stand for so I can't really discuss anything with you; I've included a partial list of what those initials are used for:

acronyms.thefreedictionary....

Acronym Definition

PPI Producer Price Index

PPI Payment Protection Insurance (UK)

PPI Pixels Per Inch

PPI Pages Per Inch

PPI Potash & Phosphate Institute

PPI Plan Position Indicator (radar)

PPI Plastics Pipe Institute

PPI Plan Particulier d'Intervention (French: Individual Plan of Intervention)

PPI Planetary Plasma Interactions

PPI Partito Popolare Italiano (Italian Popular Party)

PPI Pay Per Install

PPI Parallel Port Interface

PPI Patient Package Insert (pharmacies)

PPI Pensions Policy Institute

PPI Past Performance Information

PPI Practical Process Improvement

PPI Physician Preference Item (medical devices)

PPI Pollution Prevention Institute

PPI Projet Pédagogique Individualisé (French: Individual Educational Project)

PPI Personal Property Inventory

PPI Polyphthalamide (Amodel, Allegheny Plastics, Inc.)

PPI Primarily Primates Inc (San Antonio, Texas)

PPI Planning Perspectives, Inc.

PPI People to People International

PPI Preplanned Product Improvement

PPI Policy, Planning, and Innovation (US Department of Education)

PPI Paper and Pencil Test

PPI Portion Pac, Inc.

PPI Planned Position Indicator

PPI Policy Proof of Interest (insurance)

PPI Proposal Preparation Instructions

PPI Preprimary Impaired

PPI Pyrograf Products Inc. (Cedarville, OH)

PPI Programmable Parallel Interface

PPI Printed Postage Impressions

PPI Personal Protection Index (hazard identification)

PPI Peak Program Indicator

PPI Parts Per Inch

PPI Personal Priesthood Interview (used in Church of Jesus Christ of Latter-Day Saints)

PPI Post Partum Interval

PPI Pickle Packers International, Inc

PPI POM Preparation Instructions

PPI Precision Parts International, LLC

PPI Personnel Process Improvement (US Army)

PPI Potato Products of Idaho

PPI Primary Program Institution

PPI Process Prove-In

PPI Power Paragon, Inc.

PPI PCS-to-PCS Interference

PPI Prakken Publications, Inc

PPI Pastoralpsychologische Institut in Schleswig-Holstein und Hamburg eV

PPI Procurement Package Input

PPI Personnel Point of Impact (military paradrop)

PPI Predicted Point of Impact (airdrop mission computer)

PPI Processor to Processor Interface

PPI Permanent Prostate Implantation (cancer)

PPI Payroll Personnel Information

PPI Premier Property Inspections

PPI Petropars Iran

PPI Preservation & Packing Instructions

Sorry I did not mean to put you to all that trouble.

I didn’t mean to blab on and put it down to my state of annoyance when my gp doesn’t agree with me!!!

PPIs are proton pump inhibitors prescribed for stomach acid related probs. I only mentioned my issue with them as there is a link between reflux problems and “ lung” problems to put it loosely and the other effects of long term use of them.

That said I found the article you posted very interesting

So sorry and thanks.

A quick search online yielded this result you're welcome to 'thumb' through and see if anything strikes your fancy:

search.yahoo.com/search?ei=...

Thank you, I have decided to take things into my own hands and follow the de prescribing procedure recommended and then go from there. Wish me good judgement!

Keep posting.

Good wishes

If you dont know this term, tell your GP that you've decided to 'titrate' your ppi meds - that's the medical term for going as low with medication as your condition will tolerate and still be effective. That will make you sound knowledgeable.

Ive been on 3 Lansaprozole in the past and am now on 1 which works fine. I took a long time to go down and started by using one less one day then the usual amount the next then two days with one less etc. You need to fool your body into not knowing you are depriving it of something its got used to. Then if it was me I would stay on the new lower one for at least a month or longer if you have kickback symptoms. The stomach is very sensitive and quickly susses you are changing it's acidity.

Having said all the above, I dont know your situation and why you are on 3 a day but the main thing is to keep protecting your oesophagus and trachea since you have silent reflux. So watch carefully what is happening. And remember that if/when you have to take pred or ABs for infection/inflammation, they both make your stomach more acid. You might temporarily have to go back up by one - Ive had to when Ive had pneumonia.

I always find chewing gum and constant small sips of water helpful as they help wash down the stomach liquids. And sleep raised on your left hand side but Im sure you know that :)

Thank you so much.

That info is very helpful.

I have been on 1x20 mg Pantaprozole for 3 years and wanted to see if another med would work as well but he would not hear of it.

My annoyance was to be told I had oesophagitis and gastritis, and would be on the PPI for ever, when the only endoscopy I had states gastritis and a sliding hernia.

Thanks for the tip about increased acid when on ABs etc as I was not aware of that.

My biggest concern is I’m guessing I am a candidate for Osteoporosis but again he seemed totally unconcerned.

I am going to “ titrate” them, so thank you for that wonderful medical term. It’s good to be educated.

Thanks again for all the excellent advice.

Very good wishes to you.

Out of interest does it make a difference if one has high or low stomach acid iro treatment? I found a link where one can test the level of acid using bicarbonate of soda. So have bought some and am going to try it this week.

Thanks again.

Oh Id really like to know about the bi-carb testing you're going to do.

I have barretts oesophagus but hope this wont progress since my digestion and reflux seems to be sufficiently managed with the 15mg Lansoprozole.

I have osteoporosis in my hip but Im not over-worried. It's not necessarily a downward slide - my last dexa scan showed and slightly improved spinal result though hip had gone over from osteopenia to osteoporosis. As I say, Im not that worried. Ive had some high impact accidents (falling heavily at table tennis, off a ladder painting my kitchen) and no fractures so far. A lot depends on risk - family history, your diet, exercise etc. I have no intention of taking osteo drugs, they are pretty toxic and my osteo clinic nurse agreed it was ok not to unless I have to start taking permanent oral prednisolone.

I'll post a couple of excellent U.S. bone sites in a mo.

Re your question - alternative practitioners would say that too low acid is more problematic as it's strength reduces as you age, making digestion and absorption of food harder. And ppis make absorption of important nutrients more difficult so I take a magnesium and Vit D3 supplement to compensate for this. Both are essential if you have a lung condition (ignore if you already know this :) )

Right, here are the sites:

womenshealthnetwork.com/ost...

saveourbones.com/

Both have e-newsletters you can sign up for and both sell stuff. Living in the UK I never order stuff from the US as there are customs fees, but I learnt a lot from their information. (Some stuff you can get on Amazon though.)

Take care :)

Thanks for your reply O2Trees and the links. I shall look at them later this evening.

This is the link I used but there are several out there.

avogel.co.uk/health/digesti...

They stress that without some good “ burping “ one might have low acid.

I tried this morning and I may as well have drunk water as there was no reaction at all. I m going to repeat it for another 2 days and see what happens and let you know.

My concern as I said is Osteoporosis and also malabsorption of vitamins with these dreaded PPIs, so I take a calcium and vit D daily and will add magnesium as well as you advise.

I too have had a few heavy falls but several years ago,

mostly self inflicted, but nothing recent thankfully.

Thanks again for the advice and links.

Good wishes

Thanks again. I have just read them and they are very interesting and I have signed up for their newsletters.

More great info.

I love this site. I learn something new everyday from someone.

many good wishes.

Ooh I might try that too, let us know how you get on. Excellent advice from O2Trees. I love knowledgeable-sounding words too ;) My consultant is adamant that stomach acid must be suppressed at all costs but it's so easy to over-medicate & store up problems without realising it. Have you had a 24hr ph test? Shows just how much acid you're producing.

I certainly will.

I have not had the test though have read about it.

I have not yet been referred to a consultant. Another of my ongoing woes with my current gp., soon to be ex gp!

You are absolutely right about overmedicating. Plus I’ve stopped reading the side effects now as they are so off putting.

Thanks for your reply and good wishes.

O2Trees
O2Trees
in reply to Hanne62

It's so good to see you posting again Hanne62 xx :)

Isn't furosemide a water tablet ?

Dmactds
Dmactds
in reply to Susan1200

Yes..., as I said in my initial post, it's a diuretic of varying strengths; my script was for 40mg once a day which seems to be industrial strength for older people and its effect on our bodies. It's used by cardiologists for removing salt from around the heart among other things. It's a booger. Have you used it and if so what was its effect on you??

Here's a link to a more official explanation:

ncbi.nlm.nih.gov/pubmed/286...

and here:

peoplespharmacy.com/2012/09...

Susan1200
Susan1200
in reply to Dmactds

Thank you for your quick reply,I have been taking this tablet now for 10 years ,one a day 40 mg I must say I haven't noticed any different I once stopped them for a while,I had got an infection,my Oxygen levels had dropped down to 74 ,so I called the Paramedic , they asked if I took furosemide ,I replied yes but not for a week or two and the paramedic said I should never stop taking them , because of becoming fluid on the lungs.

Dmactds
Dmactds
in reply to Susan1200

Yes..., if you've been taking Furosemide for quite awhile you should not stop suddenly without a physician's okay; I'd only been taking 40mg for a couple of weeks, so the doctor's nurse said just stop which I was going to do anyway before it got more involved in my system.

Here's another recall that just popped up:

wate.com/news/national-worl...

I just read your reply to Susan1200. I have not taken it myself but have a neighbour who is 90 who was prescribed it.

The first day of taking it she was so breathless that I had to call the emergency services as she could not even talk and the poor dear ended up in hospital.

I realise she is much older than you but take into account that fact that she does not have a lung condition, only an old ticker, one has to ask “ why?”

I know she did!

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