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Getting Wiser About Medication

RonA

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For some time now, Dorothy has been groggy a lot. At first I thought it was simply part of the post-stroke phase but as time wore on I began to suspect other causes, especially medication. Her rehab doctor has never taken the initiative to reduce or elminate any of her drugs though he has increased the dosage of one. I am not drug-phobic but I do think that drugs need to be reviewed periodically and if possible reduced or eliminated as conditions change. After all, prescription drugs are powerful. This week Dorothy met with our primary care doctor, who is one of those physicians who works hard to avoid medicating his patients unnecessarily. He has been her doctor (and mine) for more than 15 years, so he knows her well. With no prompting he took a look at the drugs her rehab doctor had prescribed. When Dorothy mentioned that she seems to be groggy a lot he asked her if she still has muscle spasms. She said that she doesn't so he suggested that we reduce her Baclofen from the current 30 mg. a day to 20 mg. He said Baclofen is really for muscle spasms and that if the spasms are no longer a problem there is no reason not to back off of that drug. So we did. And now, only four days later, the grogginess has vanished. Dorothy says she feels a lot more alert. I can see the difference too. It's clear to me that she had been in a bit of a drug-induced stupor before we backed off the Baclofen.

I am sharing this by way of reminding others that doctors tend to prescribe drugs without revisiting them from time to time. As a result, many people wind up being medicated long past the time when they need the medication. The other lesson we've learned is how important a patient's primary care doctor is even when other doctors are involved in that patient's treatment.

We had already taken it upon ourselves several months ago to lower Dorothy's Cymbalta dosage with the blessing and guidance of our primary care doctor. There have been no problems since. I'm convinced that she's doing just as well with the lower dosage as she was with the higher dosage. Our primary care doctor says we could reduce the dosage even more if we would like and we may yet do that. We just want to proceed with sensible, measured caution. Our primary care doc is an important guide as we decide how and when to lower the dosage. Better yet, his loyalty is to the patient, not a fellow physician, so he doesn't worry about ruffling feathers by second guessing from time to time. I'm beginning to think we may even eliminate Cymbalta altogether before much longer. Our primary care doctor says that could be worth a try down the road and that because her dosage is so low she wouldn't have to be weaned off gradually.

I firmly believe in the value of the right medication at the right time. But I also believe that no one should take medication without a very good reason to do so, especially for an extended time. Our primary care doctor thankfully subscribes to the same philosophy. I realize my limitations as a layman so I don't attempt to practice medicine without a license. But I also believe that even good doctors too often go on auto-pilot once they establish a treatment protocol for a patient. That's why it is good to have another set of trained eyes on the patient. And that's also why it is critical to always keep watching and thinking when you or your loved one are being treated. So be sure to use your primary care doctor even when under the care of a specialist. He or she is important as an advisor and as an advocate.



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Ron, there is no-one as good as the primary observer, you, who sees the person hour by hour, day by day.  I always told Ray's doctor:  "Ray is doing this, Ray is feeling that.." whenever different behaviour occurred.  We went to the same pharmacy for every script too and once or twice our regular pharmacist questioned a medication, looked it up, told us it clashed with another one, even faxed that information to our doctor.

 

As a caregiver you need to monitor all that is happening to your wife and advocate on her behalf.  Sometimes I thought I was fussing too much, but better to be seen as fussy than to have something hurt or slow down the progress of the one you love.

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Sue, I couldn't agree more. But I do think a good primary care doctor is a wonderful resource for even the most conscientious caregiver. We are lucky to have one.

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I am so happy for Dorothy and for you too because now you have your companion back and she has her mind back!

Yes the price of comfort is often the stupor which is preferable to pain of course but when meds are not needed as much then one wants to emerge from the fog.

 

I have wanted to emerge from the grogfog much earlier than my body wants me to I guess because I am in classes again so I have cut my meds in half but only those for pain which won't hurt a thing because the docs have said take as much as needed when needed. It is nice to have the room to play with dosages on my own because then I can guage the necessity and what works.

 

Thanks for writing about this topic because it can be an issue for some people who continue to take pills just out of habit or regimine and they may not have evaluated their med lists  in a while. And I think that you brought up another important point probably the most important point in my opinion as I read, and that is that stroke stuff changes, improves sometimes, maybe other needs arise as time goes by, but that the meds should change too to meet the current needs.

Another important point is to have a doc that knows you and looks out for your best interest and treats you with dignity. Dorothy is indeed lucky to have one and to have an advocate too.

 

My two cent wish is that now with a new fresh positive and it sounds like more comfortable daily life, that Dorothy can embark on some new adventures with you.

Take care and best wishes and as always thank you for sharing wisdom.

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I've read a lot about statin drugs for lowering cholesterol and all the side effects so with my PCP's go ahead i stopped taking it for a few months. After 27 years of Fibromyalgia i am without fibropain AND my blood sugar levels are down to normal with no change in diet. My cholesterol is within normal limits. Woke me up! I am healthier without.

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I weened myself from baclofen because it made me tired I decided I wanted quality of life not feel half asleep all the time. I have to admit I feel much better without it maybe a bit more tone.not worth taking baclofen.

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