Posts Tagged ‘Drugs’

Needless to say, I’m on the “almost too old to bother” with this test. But in my defense, the first time I was scheduled, after Katie Couric made it seem so easy, Gma Ada had a heart attack. I cancelled and flew to NJ.

The second time, just last year, I bought the gallon jug of prep medicine along with two gallons of margarita mix, because we were hosting a Cinqo de Mayo party. Honest. Last April Gma Ada broke her hip, so I cancelled and flew to NJ.

This third time for my very first colonoscopy would be the charm we figured. I considered not even telling Gma Ada what was happening but in the end Bob dropped me at the hospital and drove his Mom to the dentist today. In bubble wrap.

Here is what I learned while drinking myself into oblivion last night.

1. Don’t bother buying any Crystal Light. It only changes the color which made me think I’d flunk the test.

2. Don’t try to read Southern Living Magazine. It’s all about FOOD and you won’t be having any for awhile.

3. Ditto for TV. Did I need to know that Red Lobster is having a special on lobster of all things? The PBS special on rice however…

4. Don’t start texting with that friend who writes you long letters. Your attention span cannot possibly keep up with your powder room visits.

5. Don’t leave any jelly beans or nuts lying around the house, your memory starts slipping and you might be tempted to eat one.

6. Don’t accidentally mix the infant simethicone drops in with your dog’s dinner. It’s hard to multi-task while chugging GoLytely – a most ironic choice of names for my liquid diet.

7. Don’t forget to thank your husband. For answering your same question multiple times, “Did you talk to the doctor yet?” and for cooking dinner when it’s all over. The hospital socks are a nice touch!

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Had a short talk with Bob yesterday about Philip Seymour Hoffman. And we both thought it’s a shame, but not for all the general reasons everyone’s been talking about, like his life and character and talent. Because ever since some 19th Century chemist decided he could change morphine into heroin –  thereby making it much more euphoric, easier to administer, lasting longer and with lower dosages – people have been overdosing on this drug. A drug that is still used medicinally in the UK…because for really sick, terminally ill people, there is literally nothing like it. It is the opiate on steroids! For many years people, I mean ordinary brothers and sisters, mothers and fathers, black, white and brown, have been dying for/on heroin for over a century.

What’s different is that now another celebrity has died of addiction. But really, what’s different? A bag of heroin costs about $10 and an oxycodon pill costs $40, so that’s different. PSH had the money to go out and buy a week’s supply of heroin, he didn’t have to perform a sex act on the street to get high, so that’s different.

Doctors are encouraged to “Treat Pain,” nurses have us rank our pain on a scale of 1 to 10, in fact in some states if a doctor or NP doesn’t “treat our pain” he/she can be sued. There are whole buildings being built to deal with pain management in health centers across America. So in the same way we’ve become aware of the dangers over overprescribing antibiotics, doctors need to become more aware of the addictive powers of pain killers. Because for some of us, as Jim Carrey said of PSH: “For the most sensitive among us the noise can be too much.” 

I might say after knee surgery, “That pill makes me feel funny,” so I stop taking it. But the addict, probably 10% of the population, has a part of the brain that recognizes that narcotic in a primal center of their neural cortex, the addict says, “More please.”  Someone I knew well once said, “There are no 50 year old junkies.”

But here is a conversation we need to start in DC. Why not make Naloxone (aka Narcan) available over the counter? This is a miracle drug which can bring a dying, overdosed person back to life, and instead of waiting until an EMT or ER doc is available to administer it, which is often too late, why can’t families and friends of addicts purchase the drug as a nasal spray to keep in their home? Well they can in a program in MA, oh God I love that state! I knew it when they went for McGovern!

The problem has become more urgent: Heroin overdose deaths in the U.S. nearly doubled over the last decade, from 1,725 in 1999 to 3,278 in 2009, according to the Centers for Disease Control and Prevention. During the same period, deadly overdoses from opiate-like drugs, including painkillers, have nearly quadrupled, from 4,030 to 15,597. Naloxone works by blocking certain drug receptors in the brain. It has no effect on alcohol or cocaine overdoses but can be used against such painkillers as OxyContin, Percocet and Vicodin. http://www.huffingtonpost.com/2012/04/26/naloxone-drug-overdose-antidote_n_1456531.html

There was no one with PSH at the time of his overdose, so having Naloxone nearby may not have helped him. But once the rest of the country follows MA’s lead, we may get the chance to save more lives, because I believe recovery is possible. One day at a time. read more: http://healthland.time.com/2012/04/13/naloxone-debate-fda-hears-testimony-about-making-an-overdose-antidote-nonprescription/


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This is an addendum to the last blog post, courtesy of the Bride and TN Poison Control Center. I guess this is not such a new recreational drug. She has seen many teens die in the ER and her husband has seen the results as well in Vandy’s ICU. Molly has also been called “bath salts.”

04-04-11 What is in Molly’s Plant Food? (one of the latest recreational drug rages to affect Tennessee’s teens and young adults)

Question of the Week
April 4, 2011
What is in Molly’s Plant Food?  (one of the latest recreational drug rages to affect Tennessee’s teens and young adults)
Molly’s Plant Food is a synthetic hallucinogenic amphetamine marketed as a “plant food” that contains ingredients that produce highs similar to Ecstasy. Molly’s Plant Food is usually purchased at a convenience store and is packaged in a capsule form with a cost of $8-$12 per capsule. The product label warns “not for human consumption”; however it is packaged in a psychedelic colored wrapper and several Internet web sites and chat rooms refer to the product as “legal ecstasy”. The active ingredient is mephedrone, which is not a scheduled (DEA) drug, therefore making it legal.
Over the past six months, The Tennessee Poison Control Center has received an increasing number of calls from emergency departments regarding symptomatic patients who have ingested or snorted Molly’s Plant Food. Clinical effects include euphoria, anxiety, paranoia, agitation, tachycardia, hypertension, delusions, diaphoresis, and weight loss. The treatment is supportive with intravenous fluids and benzodiazepines. Signs and symptoms have lasted an average of 24-48 hours.
This past week brought good news. Under an emergency court order sought by the Tennessee Agriculture Commissioner and the Attorney General, sheriff narcotic detectives have been removing the products from convenience stores in Rutherford County. Since Molly’s Plant Food is titled a “plant food”, it must be registered with the state as a fertilizer (the purported use of Molly’s Plant Food) and clearly list its ingredients. Molly’s Plant Food has neither been registered nor are the ingredients listed on the package.
This question prepared by Marilyn Weber, CSPI, MSN, RN Tennessee Poison Control Center

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I’ve noticed that news travels slowly in the South. Maybe it’s the history of cool, early evening  breezes on a front porch, where neighbors would catch up with the news of the day, or maybe it’s just the culture. Everything is slower here, and I’ve come to expect it and actually I’ve come to like it. A little banter before a business transaction never hurt anyone, and in fact it helps keep us human.

Well, it’s not often that my husband says he hasn’t heard about a drug. He is a walking encyclopedia of drugs – their generic and brand names and what they say they can do for one of his patients. I used to quiz the Bride on a shoe box full of flash cards filled with a pharmocopia of drug information that she had to commit to memory in order to practice the art of medicine. Brand and generic name on one side, its prescribed use and complications on the other.

But my brilliant hubby never heard of “Molly.” We just figured this illegal drug hadn’t made its way to our sleepy central VA town. Two people died over the past weekend at a concert in NY, and one died in Boston from a new “club/designer/street” drug named Molly. When we heard this news, I said it must be a type of Ecstasy, and I guessed right.

“Molly is classified as a Schedule One drug by the federal government. That means they believe it has “no currently accepted medical use” and “a high potential for abuse.” So now we know it a very pure form of the club drug MDMA , and when taken with other drugs, including alcohol, it can be fatal. http://www.drugabuse.gov/publications/research-reports/mdma-ecstasy-abuse/what-does-mdma-do-to-brain

And yesterday, we found out that one of our own, Shelley Goldsmith a 19 year old second year UVA student, may have died last Saturday after taking Molly at a rave club in DC.

“Shelley Goldsmith had a full scholarship to U.Va., where she was beginning her sophomore year. She was a Jefferson Scholar and a member of the Alpha Phi sorority. Students remembered their friend by painting the Beta Bridge near campus with the message “Shelley our Shooting Star.”

Her autopsy results haven’t been published yet, but statements from her friends, the people who accompanied her by bus to DC, are becoming public. It may take awhile, even in this digital age, for news to travel, but I hope our kids are listening. My condolences and prayers to her family.



Picture from her sorority’s tumblr page

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This is a morality tale. It’s about trust and medicine and more.

This morning I was trying to figure out what’s happening with Morning Joe? Mika looks mad all the time, and Joe is always elsewhere, thankfully in a split screen from time to time with his audio turned off. When I heard this health writer talk about the rule of 7. He heard a drug rep say that it usually takes 7 visits, face to face, with a doctor in his/her office, before said doctor will trust them…in other words they need to be able to talk about their kids’ soccer games so that the rep can pitch his reasons for prescribing their high priced drug over another. At least that was what I inferred from his use of the word “trust.”

This was an aside, they were talking about the low polling numbers for Obamacare at the moment, but of course Joe had to complain about doctors in general on their iPhones while dealing with patients. About not listening to their patients, about young doctors not looking them in the eyes. Fear and loathing in medicine, that’s the GOP war cry. But let’s extrapolate. If you need to see someone 7 times before they can trust you, maybe a patient also needs to see their doctor 7 times before the patient can trust the doctor?

I didn’t want to write about this, but my MIL Ada thinks I should. She is a lively, active octogenarian. She is still working as a marriage counselor, and traveling the world, but she’s been feeling tired lately, getting leg cramps, and hates to complain. Let it be said, when Ada visits us it’s a whirlwind of activity and her home is usually teeming with friends “dropping by.” So her base level for “tired” may mean she only had one big event this weekend so she decided to clean the refrigerator and invite people over for a pool party. But a recent doctor visit had her worried, her liver enzymes looked high.

So Ada gathered all her drugs in a basket, and went to her pharmacist for a look-see. It turns out, she was double-dosing on a cholesterol medicine. Her internist had taken her off the name brand Lipitor, and prescribed a generic, only Lipitor kept getting refilled right alongside the same exact drug in its generic name!

This, her trusty second opinion doctor/son Bob told her, accounts for the liver problem and her tiredness. And, Bob told her, he sees this ALL THE TIME in the ER. Elderly patients on a cornucopia of drugs complaining of symptoms that to a trained acute care specialist look like drug interactions…and so in ERs all across the country, doctors and nurses are sifting through a patient’s drug record right alongside caring for trauma and stroke and heart attack patients.

I’ve learned that doctors rarely “write” prescriptions anymore – they are emailed to a pharmacy. So where did this system fail my Mother-in-Law? Was Lipitor taken off the doctor’s list of drugs, or did the pharmacist, or pharmacy tech who read the new email Rx just add the generic without thinking? How many other patients are suffering?

Technology is supposed to add fail-safe measures to health care, but how do you build “trust” with a machine? Maybe, just maybe talking and listening to a patient is more important. Here is Great Grandmother Ada, with her “little” doctor.


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