DRUGS - my bete noir

[sennetta]

telegraph.co.uk/news/2019/0...

Nuff said.

I declined all the extras proffered by my GP and am now off pred - have been for the last 6-8 weeks or so.

[SheffieldJane]

I am with you all the way there sennetta, it takes courage to resist the pressure we are put under to take “ just in case” drugs.

I hope that you are feeling well and painfree.

[sennetta in reply to SheffieldJane]

Thanks Jane - so far, so good! Will post back with more detail in due course when the house has recovered from me catering for our daughter's wedding and being away. Plus we are entertaining at lunchtime tomorrow. Only got back late last night! Glutton for punishment!!!!

[SheffieldJane in reply to sennetta]

Well there is an all round test of your wellness if ever I heard one!

[jinasc]

Yes, two years is the general time quoted,,,,,,,,,,,but please remember that it is remission and not cure and don't go daft........take it slowly. I just wish that everyone was 2 years.

I also declined all 'just in cases' but it still took 5 years for remission with GCA only.

It was not a smooth ride even though I had brilliant Rheumatologists and two GPs.

[sennetta in reply to jinasc]

See my reply to Jane - I had no choice but to "go daft" as you put it!!

[jinasc in reply to sennetta]

Never mind the house recovering after lunchtime to morrow, feet up and let it all go hang for a couple of days. The last thing you want is ''it' to come back.

I speak from experience of a lady who had been an avid golf player...............she did a tournament one month later and then 4 weeks later ' IT' came back.

Take care and enjoy.

[sennetta in reply to jinasc]

Fortunately I don't play golf! B-U-T..... I've been sitting looking at all the damask napkins and tablecoths since 27th July, the day of the wedding. They are all washed but still need wet starching and pressing...there were 70 at the wedding...and they need to be ready by Christmas. There are all the pillow cases too the house was full for the wedding - 14 staying and the same again in December - such is life in this mad house. All HAS to be done before I start teaching again in a couple of weeks. No choice. As it is I've usually done the Christmas cake and got the mince pies in the freezer by now. Instead I've mucking around for weeks making sugar flowers for a wedding cake!!!!!

Whoops - have gone off piste - might be in trouble with those on high. Will keep you posted re health and what transpires re health without pred in due course.

Cheers all. V

[HeronNS]

Good for you. So far I've avoided antidepressants and bisphosphonates and somehow still kicking!

[scats]

Well done getting off pred.

I agree, my father's drugs were delivered in a carrier bag I found it frightening, but he felt quite happy with it. Probably another case of treating the symptoms not the cause.

Last time I saw my GP he wanted to know why I had declined methotrexate when I saw the rheumy. I told him and added " while I'm confessing I'm also not taking......." and said I'd been researching them, statistically it wasn't worth while. He just smiled and said I'll take them off your perscription in that case. I think he knows me now!

[HeronNS]

1 in 4 Canadian seniors prescribed 10 or more drugs.

cihi.ca/en/1-in-4-canadian-...

[scats in reply to HeronNS]

Frightening isn't it.

How did we get to this state? Is it people wanting an easy and quick solution or doctors not having enough time to work out the cause of a problem?

[DorsetLady PMRGCAuk volunteer in reply to scats]

A bit of both!

[scats in reply to DorsetLady]

Not to mention heavy marketing. It could get worse they will need to find a use for all that oil we are no longer using.

[PMRpro Ambassador in reply to scats]

Part is a patient develops adverse effects to something and the doc hands out something for the adverse effect - instead of changing the drug or suggesting other ways of dealing with any of the problems.

And the marketing for some new drugs makes them sound innocuous when they aren't.

One thing that will have contributed to the problem in the last 5 years at least is the increased use of the new generation/direct acting anticoagulants instead of Warfarin. Especially when used with certain other medications the blood level rises to scary levels and the slightest problem can lead to life-thretening bleeding. The marketing insists they don't need to be monitored like Warfarin - they do, especially in the cardiac problem patients.

[scats in reply to PMRpro]

That's very interesting I didn't know that about the new anticoagulants that is worrying.

Your first paragraph sums up my father's situation exactly. He was an inteligent man but would never question his doctor and was grateful for every drug he was given.

[piglette]

They say that anti depressant use has doubled, however I understand the same number of people are taking anti depressants but for longer. They also say that there should be a review of medicines. I thought we all had to have our repeat prescriptions reviewed yearly. I assume that the amount of drugs given out is often the easy way of keeping people happy. If a doctor does not give people something to take they often feel let down, also a lot of people demand drugs and rather than fighting with them the doctor just gives in for a peaceful life. I suppose I don’t really blame the doctors. They could get the pharmacies more involved, they could do the yearly review instead perhaps.

[HeronNS in reply to piglette]

I like the idea of covering costs, presumably no more than meds in the long term, for things like holidays in a natural setting, activities to promote social connection, not to mention providing true health care, not the sickness care we are given.

[piglette in reply to HeronNS]

I think it is habit to a certain extent, also I do wonder about doctors not wanting to let go of their power, being cynical. They say they don’t like all the ideas to help them reduce their workload like getting people more active and using keep fit facilities etc plus using the pharmacy, then complain they are overworked.

[HeronNS in reply to piglette]

Here I think the GPs have some legitimate concerns as for example pharmacists get paid more to give a vaccination even though the doctor will actually spend more time with a patient, checking, at least asking about other health concerns. And a lot of talk about how it's okay to have no family doctor if a nurse practitioner has agreed to see you, which sounds like the NP is independent of a doctor's support and oversight. I don't know about you but that makes me uncomfortable, and a friend of mine in that position is not happy but she's had no family doctor for about 5 years so what is she to do? She's my age. A lot of our doctors' time is taken up by paperwork because, stupidly, they're paid per visit, not on salary, nor on number of patients. They should never have said at the beginning of Medicare that they wanted to basically be running independent businesses, although reimbursed by government.

[piglette in reply to HeronNS]

In U.K. the GP practices are paid a fixed sum per patient per year, not per visit. The GPs are not actually employed by the NHS but are set up as their own little businesses, paying for virtually everything within the surgery including salaries and furniture. In the main they do not pay for prescriptions. Also there is something funny about getting IT paid for externally and also odd items of stock. They also have incentives which go towards QOF points, so basically the more points they get the more money they get. I personally think it is crazy. We have one doctor who is a dab hand on QOF points which seems important if you want to maximise the payments for your surgery. For example you may get x amount per person for prescribing statins, but I think it can actually be more complex than that.

[HeronNS in reply to piglette]

We have some pharmacare, for people on welfare and seniors, the latter can opt out if they have other coverage, and we did. As far as I know no doctor will directly benefit from prescribing certain meds.

[piglette in reply to HeronNS]

Some people pay into private care in U.K., but otherwise we have free care at the point of demand, although things seem to be slipping a bit.

[HeronNS in reply to piglette]

The senior's pharmacare comes with a hefty premium, possibly with a means tested sliding scale, don't really know as we've never needed it. We pay plenty for our "extras", like physio, eye glasses, dental care, etc, so some of that is covered by the retirees insurance plan from hubby's old work, as well as prescription drugs, and for that a significant amount is deducted from hubby's pension. "Free" care we may have, compared to the USA but a lot of it really isn't approaching free.

[piglette in reply to HeronNS]

In U.K. we do have to pay towards dental, opticians and prescription drugs, although they are subsidised by the government. Certain people do get prescriptions for free for example however including old age pensioners. The sad thing about the NHS is how badly it is administered with an even worse computer system (or systems all not talking to each other) and the lack of them. If you are an emergency though, I think the NHS could be counted as probably the best in the world.

[PMRpro Ambassador in reply to HeronNS]

They don't benefit personally as far as I know but the practice gets money to reinvest

[Suffererc]

I refuse them too. Only take pred now and Adcal. That's still too much but hopefully none at all. Do take paracetamol but I buy that.

[Rimmy]

It'd be 'great' if everybody had a 'choice' about which drugs they could or couldn't take - the trick is to be able to separate which ones !! Regarding taking Pred for GCA is a 'no brainer' I reckon and for those with PMR similarly unless they wish to 'risk' the possibility of it morphing into GCA with all the potential consequences. But essentially agree many drugs can do more harm than good and the risks of 'polypharmacy' are quite clear - what we all need is very SMART medicos to adequately help with such decisions - isn't that a big part of what contemporary medicine is meant to be doing ... ?

[sennetta in reply to Rimmy]

We do have a choice - just take them....or not! What we really need is true facts of the advantages and disadvantages without the bias of Big Pharma which influences the doctors.

[HeronNS in reply to sennetta]

In the US drug ads are allowed on tv, and this influences the general public. Although given that they have to list all the side effects you wonder why anyone would ever consider taking them. I see some ads on Canadian tv but their content is, I think, much more tightly controlled, and usually restricted to otc meds like painkillers, antihistamines etc. This can be counterproductive. I was appalled to see an ad for Prolia, but it said nothing about bones, only stuff about staying young! Perhaps it was a bit of damage control after the bad press. I don't think any ads for prescription meds should be allowed.

[PMRpro Ambassador]

I didn't need a study to tell me that!!!! And about time too ...

See my reply to scats