cybercat wrote:
> "flitterbit" > wrote
>> LOL! One of our previous cats was a little on the temperamental side; his
>> file said, "FRACTIOUS!!!!"
>
> I think that's what mine said until the Unfortunate Incident. Do you have
> any idea how they figure out if you have a broken tailbone without an x-ray?
> I sure didn't.
>
>
I don't know, but I suspect you do now, and that it has something to do
with applying pressure to tender areas until the recipient screams; you
have my sympathy!

jmcquown wrote:
> "Arri London" > wrote in message

>> The pills are probably what killed her; she wasn't really very ill other
>> than that.
>
>
> I concur. I never got those prescriptions filled but there were four
> different doctors seeing her at the hospital before she was sent to the
> PT/rehab unit. When she finally did come home the scripts were all
> issued under one doctor's name (and it certainly wasn't the
> gerontologist who had her down to three prescriptions). I only met this
> doctor one time. It was before my mother broke her hip while under
> hospital care. Well before she wound up on all those medications. He
> looked a little like a young Desi Arnaz and my mother commented on how
> handsome he was. She also pointed out, "Jill, he's not wearing a
> wedding ring." Mom, stop that! LOL
>
> Jill

While four different services may have seen your mother, usually one of
them is running the show. In her case I imagine it was the Hospitalist?
You sent me a scan of 15 scripts, not the 30 you claim she was
prescribed. It was immediately obvious from the scripts that your mother
was being treated for hypertension, hypothyroidism, Atrial fib, some CHF
and pulmonary disease. Also included was Megace, a steroid used to
stimulate appetite, and some electrolyte replacements to compensate for
the loss caused from the Lasix, a diuretic. The only things I see
missing from the scripts you sent me were some pain pills? Did you have
those filled?
Was she being seen by anyone routinely all the years she was taking care
of your father? Some times people put their own health on the back
burner and ignore problems when caring for others.

"Goomba" > wrote in message
...
> jmcquown wrote:
>> "Arri London" > wrote in message
>
>>> The pills are probably what killed her; she wasn't really very ill other
>>> than that.
>>
>>
>> I concur. I never got those prescriptions filled but there were four
>> different doctors seeing her at the hospital before she was sent to the
>> PT/rehab unit. When she finally did come home the scripts were all
>> issued under one doctor's name (and it certainly wasn't the gerontologist
>> who had her down to three prescriptions). I only met this doctor one
>> time. It was before my mother broke her hip while under hospital care.
>> Well before she wound up on all those medications. He looked a little
>> like a young Desi Arnaz and my mother commented on how handsome he was.
>> She also pointed out, "Jill, he's not wearing a wedding ring." Mom, stop
>> that! LOL
>>
>> Jill
>
> While four different services may have seen your mother, usually one of
> them is running the show. In her case I imagine it was the Hospitalist?
> You sent me a scan of 15 scripts, not the 30 you claim she was prescribed.
> It was immediately obvious from the scripts that your mother was being
> treated for hypertension, hypothyroidism, Atrial fib, some CHF and
> pulmonary disease. Also included was Megace, a steroid used to stimulate
> appetite, and some electrolyte replacements to compensate for the loss
> caused from the Lasix, a diuretic. The only things I see missing from the
> scripts you sent me were some pain pills? Did you have those filled?
> Was she being seen by anyone routinely all the years she was taking care
> of your father? Some times people put their own health on the back burner
> and ignore problems when caring for others.



Fifteen wasn't enough for you? As I explained in my email to you, I
probably threw away the other two prescriptions along with the package the
hospice nurse brought home from the hospital for my mother. Forgot about
that, didn't you?

The other prescriptions accompanied her discharge instructions. I was also
told to take her to physical therapy for 4 weeks, although how I was
supposed to do that with a woman who couldn't walk and who was discharged
from the PT/rehab unit as "not improving" I have no idea.

Oh, and I was given information to have her eat only low-fat, low sodium
foods. Drink skim or 1% milk, eat eat egg beaters, eat boneless skinkless
chicken breast, ground turkey, etc. Since she weighed only 80 lbs before
she went in the hospital and we were trying to get her to eat more I found
that ludicrous. Then of course, they put her back on coumadin when spinach
was one of the few things I *could* get her to eat once she came back home.
Her gerontologist immediated took her off coumadin and put her on low dose
aspirin instead.

My mother wasn't on pain medication. She got liquid (children's) tylenol
here at home. And the "routine" physician she saw last year was one I told
them to keep away from her while she was in the hospital. He's the guy who
had her on the original nine prescriptions (three of which were taken three
times a day) before I got a gerontologist to do home visits, do blood tests
and urinalysis. He was very fond of writing prescriptions.

That's the trouble with "medical people". They aren't the be all, end all
simply because they went to medical school. At some point you have to step
up and ask WHY are you giving her all of this?!

Apparently I'm not the only one since kili is apparently on a lot of
antibiotics and they haven't figured out which one is actually working for
her yet. Over-medicating definitely does happen. Whether you believe it or
not.

Jill

On Thu, 11 Dec 2008 13:56:18 -0600, Damsel in dis Dress wrote:

> On Thu, 11 Dec 2008 13:09:09 -0600, Omelet >
> wrote:
>
>>In article >,
>> Damsel in dis Dress > wrote:
>>
>>> I'm gonna stay neutral as long as I possibly can. Well see how it all
>>> shakes out. You haven't done anything within my line of vision that
>>> would warrant ending our friendship. If other people don't like that,
>>> it's their issue.
>>
>>I've actually found the ones that are worth it keep an open mind. :-)
>>They are mature enough to not end a friendship just because you like
>>someone that they don't...
>
> I sorta remember that stuff from junior high .....
>
> Carol

i was going to say...

your pal,
blake

jmcquown wrote:

>
> Fifteen wasn't enough for you? As I explained in my email to you, I
> probably threw away the other two prescriptions along with the package
> the hospice nurse brought home from the hospital for my mother. Forgot
> about that, didn't you?

Or I wondered if you just exaggerated? The 15 she did have certainly
covered a broad range of ills. Remind me again, is this about your
mother or...you?
>
> The other prescriptions accompanied her discharge instructions. I was
> also told to take her to physical therapy for 4 weeks, although how I
> was supposed to do that with a woman who couldn't walk and who was
> discharged from the PT/rehab unit as "not improving" I have no idea.

You either whine about it here or you ask (nicely, I hope?) for
assistance from a caseworker who may be able to offer solutions. One of
the best things my father had after his first stroke was in-home PT/OT.
They even were able to put him in his pool and worked with him there.
Did anyone suggest in-home PT/OT? Did you ask?

> Oh, and I was given information to have her eat only low-fat, low sodium
> foods. Drink skim or 1% milk, eat eat egg beaters, eat boneless
> skinkless chicken breast, ground turkey, etc. Since she weighed only 80
> lbs before she went in the hospital and we were trying to get her to eat
> more I found that ludicrous.

Standard discharge instructions <shrug> Since you weren't going to
comply with them anyway I'd not lose any sleep over it.

> Then of course, they put her back on
> coumadin when spinach was one of the few things I *could* get her to eat
> once she came back home. Her gerontologist immediated took her off
> coumadin and put her on low dose aspirin instead.

Again, non-compliance is an issue for some. Spinach isn't verbotten with
coumadin as long as one is consistent with its intake. FYI- aspirin and
coumadin don't do the same thing on the clotting cascade. Someone with
atrial fib is at higher risk for throwing a clot and causing themselves
a stroke. That's where the coumadin comes in, to help limit clot
development in that poorly working heart.
>
> My mother wasn't on pain medication. She got liquid (children's)
> tylenol here at home. And the "routine" physician she saw last year was
> one I told them to keep away from her while she was in the hospital.
> He's the guy who had her on the original nine prescriptions (three of
> which were taken three times a day) before I got a gerontologist to do
> home visits, do blood tests and urinalysis. He was very fond of writing
> prescriptions.

He might have mistakenly thought you wanted more aggressive care than
you did?
>
> That's the trouble with "medical people". They aren't the be all, end
> all simply because they went to medical school. At some point you have
> to step up and ask WHY are you giving her all of this?!

True nuff. Some people want all possible care offered, and some only
want palliative. And some want something in between. How exactly should
they determine what is wanted unless you discuss it with them? Hopefully
in a non-adversarial tone.
>
> Apparently I'm not the only one since kili is apparently on a lot of
> antibiotics and they haven't figured out which one is actually working
> for her yet. Over-medicating definitely does happen. Whether you
> believe it or not.
>
> Jill

Why bring her into this discussion? There has been so much
mis-information spouted about kili I don't want to get into it. I will
say that Allen's posts were accurate, logical and lucid. No drama-queen
there.

"Goomba" > wrote in message
...
> jmcquown wrote:
>
>>
> Or I wondered if you just exaggerated? The 15 she did have certainly
> covered a broad range of ills. Remind me again, is this about your mother
> or...you?
>>
What's the difference? I'm the one stuck dealing with her death. She
probably wouldn't have died this soon if she had never gone to the hospital
in the first place. Hospitals will kill you, sure enough.

>> The other prescriptions accompanied her discharge instructions. I was
>> also told to take her to physical therapy for 4 weeks, although how I was
>> supposed to do that with a woman who couldn't walk and who was discharged
>> from the PT/rehab unit as "not improving" I have no idea.
>
> You either whine about it here or you ask (nicely, I hope?) for assistance
> from a caseworker who may be able to offer solutions. One of the best
> things my father had after his first stroke was in-home PT/OT. They even
> were able to put him in his pool and worked with him there. Did anyone
> suggest in-home PT/OT? Did you ask?
>
She was getting at home PT and OT before she ever went to the hospital and
they let her fall and beak her hip. (I love your selective reading skills,
BTW.) She might still be alive were it not for the "care" they were giving
her.

> He might have mistakenly thought you wanted more aggressive care than you
> did?
>>

They "lost" the paperwork stating I had Heathcare POA and also her DNR
information. It was never entered into her chart. They also lost her false
teeth, they never made it home with her. I have little regard for the
"medical" profession after this experience. I do, however, have lots to say
about Tidewater Hospice and the excellent care they gave her in making her
comfortable when she finally did come home.

> True nuff. Some people want all possible care offered, and some only want
> palliative. And some want something in between. How exactly should they
> determine what is wanted unless you discuss it with them? Hopefully in a
> non-adversarial tone.

Palliative was the reason I chose hospice to come in and care for her at
home. After the doctors at the hospital got their hands and drugs off her.

> Why bring her into this discussion? There has been so much mis-information
> spouted about kili I don't want to get into it. I will say that Allen's
> posts were accurate, logical and lucid. No drama-queen there.

Gee, maybe I'm acutally still grieving for my mother so any discussion of
over-medicating someone has a negative affect on me?

Jill

jmcquown > wrote:

>That's the trouble with "medical people". They aren't the be all, end all
>simply because they went to medical school. At some point you have to step
>up and ask WHY are you giving her all of this?!

When I got up to I think nine prescriptions, I took a hard look
at all of them and decided I could quit two. I'm about to taper
off one more.

While it's clear that a person might be validly prescribed 9,
15, or 30 medications, it's also clear that they can't all be
equally important. It's reasonable to figure out which ones
are least important.

Steve

In article >,
(Steve Pope) wrote:

> jmcquown > wrote:
>
> >That's the trouble with "medical people". They aren't the be all, end all
> >simply because they went to medical school. At some point you have to step
> >up and ask WHY are you giving her all of this?!
>
> When I got up to I think nine prescriptions, I took a hard look
> at all of them and decided I could quit two. I'm about to taper
> off one more.
>
> While it's clear that a person might be validly prescribed 9,
> 15, or 30 medications, it's also clear that they can't all be
> equally important. It's reasonable to figure out which ones
> are least important.

I have an easy way of determining which medicines are least important.
It's those thousands of medicines that the doctor has not yet prescribed
for me. I'm on nine meds now, two non-prescription. Why would I drop
any of them unless I didn't need them anymore, or their risk increased
to more than their value?

--
Dan Abel
Petaluma, California USA

In article >,
"jmcquown" > wrote:

> Gee, maybe I'm acutally still grieving for my mother so any discussion of
> over-medicating someone has a negative affect on me?
>
> Jill

Sounds like you are going thru the Anger phase of mourning... Been there
done that.

Would you like me to call you? I'd be happy to talk if you need someone
to talk to. This e-mail works but my main one is Katra at century tel
dot net... I'll send you my cell number and make sure it's not on the
charger like it was for Allan. :-(

<hugs>
--
Peace! Om

"Love and compassion are necessities, not luxuries. Without them humanity cannot survive." -- Dalai Lama

In article >,
(Steve Pope) wrote:

> jmcquown > wrote:
>
> >That's the trouble with "medical people". They aren't the be all, end all
> >simply because they went to medical school. At some point you have to step
> >up and ask WHY are you giving her all of this?!
>
> When I got up to I think nine prescriptions, I took a hard look
> at all of them and decided I could quit two. I'm about to taper
> off one more.
>
> While it's clear that a person might be validly prescribed 9,
> 15, or 30 medications, it's also clear that they can't all be
> equally important. It's reasonable to figure out which ones
> are least important.
>
> Steve

I worry more about drug interaction which I discuss with my pharmacist.
Pharmacists are FAR better trained than docs are in pharmacology.

I'm blessed with a good one that actually LIKES to talk to customers so
is more than willing to discuss such things.
--
Peace! Om

"Love and compassion are necessities, not luxuries. Without them humanity cannot survive." -- Dalai Lama

Dan Abel > wrote:

> (Steve Pope) wrote:

>> While it's clear that a person might be validly prescribed 9,
>> 15, or 30 medications, it's also clear that they can't all be
>> equally important. It's reasonable to figure out which ones
>> are least important.

>I have an easy way of determining which medicines are least important.
>It's those thousands of medicines that the doctor has not yet prescribed
>for me. I'm on nine meds now, two non-prescription. Why would I drop
>any of them unless I didn't need them anymore, or their risk increased
>to more than their value?

So your position is that if it's prescribed to you, it's
as important as any other med that's been prescribed to you?

If so that is nuts. Er, at least, undiscriminating.

Steve

jmcquown wrote:

>
> Gee, maybe I'm acutally still grieving for my mother so any discussion
> of over-medicating someone has a negative affect on me?
>
> Jill

BS

-dk

On Fri, 12 Dec 2008 08:17:19 -0500, "cybercat" >
wrote:

>
>"Cheryl" > wrote:
>>
>> How do you know? One year we had a really bad ice storm and everything
>> was coated. The walkway I had to use to get to my basement apartment was
>> downhill and I slipped and the base of my spine has never been the same.
>> That was at least 15 years ago.
>
>That really hurts, I've fallen on ice that way years ago, with my arms full
>of paper grocery bags.
>I fell down a flight of steps while sleepwalking (after I quit smoking),
>head over heels, bounced off of a step right between L3 and L4 vertebrae
>(this is where the step-shaped bruise was) and then landed on my ass on the
>slate floor. I knew something was broken when I realized there were tears
>running down my face from the pain--really odd as I wasn't upset. I guess it
>is some sort of physical response to pain.
>
>There's nothing they can do but give you pain pills and a donut to sit on.
> You can't set the coccyx. The worst thing was, I developed sciatica, had
>it pretty bad for maybe five years before it went away.
>
>As for how they check, it's the same thing they do during the least pleasant
>of all the unpleasant things they do during the dreaded Glove Exam.
>
Be glad you're alive! I knew someone who died at 54, just slipping
and falling on the stairs. Head injury... brain swelled. You know
the end of that story.

I tripped over a tree trunk (long story, doesn't matter) and did a
complete (full body) belly flop on the sidewalk a couple of years ago.
I hurt like hell for weeks. Lots of soft tissue damage from head to
toe. My right side isn't the same, but at least I don't have a spinal
problem.

Looking skyward and counting my blessings.


--
I never worry about diets. The only carrots that
interest me are the number of carats in a diamond.

Mae West

On Fri, 12 Dec 2008 13:01:13 -0500, "jmcquown" >
wrote:

>Apparently I'm not the only one since kili is apparently on a lot of
>antibiotics and they haven't figured out which one is actually working for
>her yet. Over-medicating definitely does happen. Whether you believe it or
>not.

If Medicare or social security pays for it, hospitals will prescribe
it. That's the American way.


--
I never worry about diets. The only carrots that
interest me are the number of carats in a diamond.

Mae West

On Fri, 12 Dec 2008 23:05:56 -0500, D K >
wrote:

>jmcquown wrote:
>
>>
>> Gee, maybe I'm acutally still grieving for my mother so any discussion
>> of over-medicating someone has a negative affect on me?
>>
>> Jill
>
>BS
>
>-dk

Some people actually love their parents. Apparently you don't, no
biggie if you don't. Just keep yer yap shut.


--
I never worry about diets. The only carrots that
interest me are the number of carats in a diamond.

Mae West

On Fri, 12 Dec 2008 09:29:30 -0500, flitterbit >
wrote:

>I don't know, but I suspect you do now, and that it has something to do
>with applying pressure to tender areas until the recipient screams; you
>have my sympathy!

Having a broken bone, not tailbone examined that way.... the precursor
to an xray, I can say it doesn't take much pressure to make it hurt.


--
I never worry about diets. The only carrots that
interest me are the number of carats in a diamond.

Mae West

sf wrote:
> On Fri, 12 Dec 2008 09:29:30 -0500, flitterbit >
> wrote:
>
>> I don't know, but I suspect you do now, and that it has something to do
>> with applying pressure to tender areas until the recipient screams; you
>> have my sympathy!
>
> Having a broken bone, not tailbone examined that way.... the precursor
> to an xray, I can say it doesn't take much pressure to make it hurt.
>
>
I know that all too well! At 11 I fell out of a tree and broke my
collarbone; the doctor, on the pretext of "having a look", set it
without warning; I almost passed out.

In article >,
sf > wrote:

> Be glad you're alive! I knew someone who died at 54, just slipping
> and falling on the stairs. Head injury... brain swelled. You know
> the end of that story.
>
> I tripped over a tree trunk (long story, doesn't matter) and did a
> complete (full body) belly flop on the sidewalk a couple of years ago.
> I hurt like hell for weeks. Lots of soft tissue damage from head to
> toe. My right side isn't the same, but at least I don't have a spinal
> problem.
>
> Looking skyward and counting my blessings.

Ow... :-(

Find a good massage therapist. They can sometimes help with stuff like
that. Falling sucks. I've still not been the same since the end of
April. <sigh>

Getting myself back into lifting weights has helped more than anything
else except possibly swimming.
--
Peace! Om

"Love and compassion are necessities, not luxuries. Without them humanity cannot survive." -- Dalai Lama

On Fri, 12 Dec 2008 18:20:10 -0800, Dan Abel wrote:

> In article >,
> (Steve Pope) wrote:
>
>> jmcquown > wrote:
>>
>>>That's the trouble with "medical people". They aren't the be all, end all
>>>simply because they went to medical school. At some point you have to step
>>>up and ask WHY are you giving her all of this?!
>>
>> When I got up to I think nine prescriptions, I took a hard look
>> at all of them and decided I could quit two. I'm about to taper
>> off one more.
>>
>> While it's clear that a person might be validly prescribed 9,
>> 15, or 30 medications, it's also clear that they can't all be
>> equally important. It's reasonable to figure out which ones
>> are least important.
>
> I have an easy way of determining which medicines are least important.
> It's those thousands of medicines that the doctor has not yet prescribed
> for me. I'm on nine meds now, two non-prescription. Why would I drop
> any of them unless I didn't need them anymore, or their risk increased
> to more than their value?

doctors may not be gods, but it seems to me to be foolish to disregard
their advice, at least on the basis of 'there are too many prescriptions!'

your pal,
blake

On Sat, 13 Dec 2008 03:07:13 +0000 (UTC), Steve Pope wrote:

> Dan Abel > wrote:
>
>> (Steve Pope) wrote:
>
>>> While it's clear that a person might be validly prescribed 9,
>>> 15, or 30 medications, it's also clear that they can't all be
>>> equally important. It's reasonable to figure out which ones
>>> are least important.
>
>>I have an easy way of determining which medicines are least important.
>>It's those thousands of medicines that the doctor has not yet prescribed
>>for me. I'm on nine meds now, two non-prescription. Why would I drop
>>any of them unless I didn't need them anymore, or their risk increased
>>to more than their value?
>
> So your position is that if it's prescribed to you, it's
> as important as any other med that's been prescribed to you?
>
> If so that is nuts. Er, at least, undiscriminating.
>
> Steve

it's reasonable to discuss it with your doctor, not just decide 'i don't
really need this.' (people with bipolar disease are notorious for this,
with predictable results.) presumably, he learned a thing or two in med
school and afterwards that you may not know about.

your pal,
blake

On Sat, 13 Dec 2008 18:37:35 GMT, blake murphy
> wrote:

>it's reasonable to discuss it with your doctor, not just decide 'i don't
>really need this.' (people with bipolar disease are notorious for this,
>with predictable results.) presumably, he learned a thing or two in med
>school and afterwards that you may not know about.

I've seen that a lot in friends of mine. Personally, I consider my
medications a God-send, and only miss them when my memory is out of
whack. Fortunately, I have people around me who can tell instantly if
I've forgotten to take them, so I get a friendly reminder and am back
on track.

Carol

In article >,
blake murphy > wrote:

> On Fri, 12 Dec 2008 18:20:10 -0800, Dan Abel wrote:
>
> > In article >,
> > (Steve Pope) wrote:
> >
> >> jmcquown > wrote:
> >>
> >>>That's the trouble with "medical people". They aren't the be all, end all
> >>>simply because they went to medical school. At some point you have to
> >>>step
> >>>up and ask WHY are you giving her all of this?!
> >>
> >> When I got up to I think nine prescriptions, I took a hard look
> >> at all of them and decided I could quit two. I'm about to taper
> >> off one more.
> >>
> >> While it's clear that a person might be validly prescribed 9,
> >> 15, or 30 medications, it's also clear that they can't all be
> >> equally important. It's reasonable to figure out which ones
> >> are least important.
> >
> > I have an easy way of determining which medicines are least important.
> > It's those thousands of medicines that the doctor has not yet prescribed
> > for me. I'm on nine meds now, two non-prescription. Why would I drop
> > any of them unless I didn't need them anymore, or their risk increased
> > to more than their value?
>
> doctors may not be gods, but it seems to me to be foolish to disregard
> their advice, at least on the basis of 'there are too many prescriptions!'
>
> your pal,
> blake

I'd trust a pharmacist even more.
--
Peace! Om

"Love and compassion are necessities, not luxuries. Without them humanity cannot survive." -- Dalai Lama

In article >,
Damsel in dis Dress > wrote:

> On Sat, 13 Dec 2008 18:37:35 GMT, blake murphy
> > wrote:
>
> >it's reasonable to discuss it with your doctor, not just decide 'i don't
> >really need this.' (people with bipolar disease are notorious for this,
> >with predictable results.) presumably, he learned a thing or two in med
> >school and afterwards that you may not know about.
>
> I've seen that a lot in friends of mine. Personally, I consider my
> medications a God-send, and only miss them when my memory is out of
> whack. Fortunately, I have people around me who can tell instantly if
> I've forgotten to take them, so I get a friendly reminder and am back
> on track.
>
> Carol

I hate it when I run out of my thyroid meds and am too broke to buy
them. :-P
--
Peace! Om

"Love and compassion are necessities, not luxuries. Without them humanity cannot survive." -- Dalai Lama

Omelet > wrote:

> blake murphy > wrote:

>> On Fri, 12 Dec 2008 18:20:10 -0800, Dan Abel wrote:

>> > (Steve Pope) wrote:

>> >> When I got up to I think nine prescriptions, I took a hard look
>> >> at all of them and decided I could quit two. I'm about to taper
>> >> off one more.

>> >> While it's clear that a person might be validly prescribed 9,
>> >> 15, or 30 medications, it's also clear that they can't all be
>> >> equally important. It's reasonable to figure out which ones
>> >> are least important.

>> > I have an easy way of determining which medicines are least important.
>> > It's those thousands of medicines that the doctor has not yet prescribed
>> > for me. I'm on nine meds now, two non-prescription. Why would I drop
>> > any of them unless I didn't need them anymore, or their risk increased
>> > to more than their value?

>> doctors may not be gods, but it seems to me to be foolish to disregard
>> their advice, at least on the basis of 'there are too many prescriptions!'

Up to one-third of all medical treatment in the U.S. is unnecessary,
and some fraction of that is actively harmful. A person with
10 or more prescriptions who is not considering whether some
of them are unneeded is, in my opinion, not taking proper care
of themselves.

>I'd trust a pharmacist even more.

I'm often less than enthused with the consulting pharmacists
at my provider. Furthermore, I have to pay $10 more per prescription
to pick it up in person, so I am unlikely to physically talk
to any pharmacists anymore.

Steve

In article >,
(Steve Pope) wrote:

> I'm often less than enthused with the consulting pharmacists
> at my provider. Furthermore, I have to pay $10 more per prescription
> to pick it up in person, so I am unlikely to physically talk
> to any pharmacists anymore.
>
> Steve

Your loss. You need to meet mine. :-)

It costs me more sometimes to use a private pharmacy, but it's worth it.

Screw Walgreens, Walmart, etc.
--
Peace! Om

"Love and compassion are necessities, not luxuries. Without them humanity cannot survive." -- Dalai Lama

In article >,
(Steve Pope) wrote:

> Omelet > wrote:
>
> > blake murphy > wrote:
>
> >> On Fri, 12 Dec 2008 18:20:10 -0800, Dan Abel wrote:
>
> >> > (Steve Pope) wrote:
>
> >> >> When I got up to I think nine prescriptions, I took a hard look
> >> >> at all of them and decided I could quit two. I'm about to taper
> >> >> off one more.
>
> >> >> While it's clear that a person might be validly prescribed 9,
> >> >> 15, or 30 medications, it's also clear that they can't all be
> >> >> equally important. It's reasonable to figure out which ones
> >> >> are least important.
>
> >> > I have an easy way of determining which medicines are least important.
> >> > It's those thousands of medicines that the doctor has not yet prescribed
> >> > for me. I'm on nine meds now, two non-prescription. Why would I drop
> >> > any of them unless I didn't need them anymore, or their risk increased
> >> > to more than their value?
>
> >> doctors may not be gods, but it seems to me to be foolish to disregard
> >> their advice, at least on the basis of 'there are too many prescriptions!'
>
> Up to one-third of all medical treatment in the U.S. is unnecessary,

I used to work in advertising, and my boss's favorite saying was:

"Half of all advertising money is wasted. The problem is in determining
which half!".

> and some fraction of that is actively harmful. A person with
> 10 or more prescriptions who is not considering whether some
> of them are unneeded is, in my opinion, not taking proper care
> of themselves.

I think that advice is true whether it is one or thirty prescriptions.
My doctor always goes over my prescriptions at every annual visit, and
often at other visits also.

> >I'd trust a pharmacist even more.

We'll see how this works. I have a regular doctor, but I also have a
pharmacist (with additional training) who is responsible for much of my
health. I have not met her or talked to her yet, so far it's all snail
mail and Email.

> I'm often less than enthused with the consulting pharmacists
> at my provider.

I often feel like I'm interrupting their work. I'm happy with the
written material that is furnished with the prescription. If all the
consulting pharmacist is going to do is read that written material to
me, we are wasting our time. I have gotten some useful advice and even
asked a couple of questions over the last umpteen years.

> Furthermore, I have to pay $10 more per prescription
> to pick it up in person, so I am unlikely to physically talk
> to any pharmacists anymore.

I'd rather get my drugs by mail anyway. I get on the web, order it and
a week later it's in my mailbox. There is a phone number for that
pharmacy if I want a consult. The cost to me is the same, but I know
that my HMO is pushing hard to up the price for picking up prescriptions
in person.

I pick up my drugs at the pharmacy (about three miles away) for three
reasons:

1. My diabetes nurse told me not to get insulin through the mail, since
it is temperature dependent.

2. When I see the doctor, sometimes I need to start a medication (like
for an ear infection) right away. He can put it right into the
computer. By the time I finish talking to him, get my clothes on and
walk downstairs to the pharmacy, sometimes it's waiting for me there.
If I talk to my doctor by phone or exchange Emails, sometimes I need to
drive to the pharmacy to get something I need right now.

3. If I'm at the pharmacy anyway, I'll get non-prescription stuff
there, since it is cheaper than my local drug store, but not worth a
special trip.

--
Dan Abel
Petaluma, California USA

On Sat 13 Dec 2008 06:54:45p, Michael "Dog3" told us...

> blake murphy tossed this tasty morsel into the pot
> :
>
>> On Fri, 12 Dec 2008 18:20:10 -0800, Dan Abel wrote:
>>
>>> In article >,
>>> (Steve Pope) wrote:
>>>
>>>> jmcquown > wrote:
>>>>
>>>>>That's the trouble with "medical people". They aren't the be all,
>>>>>end all simply because they went to medical school. At some point
>>>>>you have to step up and ask WHY are you giving her all of this?!
>>>>
>>>> When I got up to I think nine prescriptions, I took a hard look
>>>> at all of them and decided I could quit two. I'm about to taper
>>>> off one more.
>>>>
>>>> While it's clear that a person might be validly prescribed 9,
>>>> 15, or 30 medications, it's also clear that they can't all be
>>>> equally important. It's reasonable to figure out which ones
>>>> are least important.
>>>
>>> I have an easy way of determining which medicines are least
>>> important. It's those thousands of medicines that the doctor has not
>>> yet prescribed for me. I'm on nine meds now, two non-prescription.
>>> Why would I drop any of them unless I didn't need them anymore, or
>>> their risk increased to more than their value?
>>
>> doctors may not be gods, but it seems to me to be foolish to disregard
>> their advice, at least on the basis of 'there are too many
>> prescriptions!'
>
> I take 9 scripts a day. Some for diabetes, some for heart disease
> related issues, some for glandular issues etc. The problem I was
> experiencing was not the number of medications but the mix of the meds.
> I have 4 docs and they don't always communicate amongst themselves, or
> if they do, the fax etc. gets lost in the shuffle, when one or the other
> wants to change a dosage. This can cause me problems since it sometimes
> takes a couple of weeks for the bod to adjust to these changes and
> sometimes there is a reaction when one of the dosages is lowered or
> increased. My insurance company has helped with this by assigning me a
> nursing coordinator. She helps coordinate this type of thing with all 4
> of my docs. Makes he a happier patient and it helps my doctors out
> because they don't have to worry so much about what the other is
> doing.This has been very helpful to me as a patient.
>
> Michael
>
>

I have a similar situation, Michael, also taking 9 meds, some for diabetes,
others for heart related issues, and 1 for anxiety. However, I'm only
involved with two physicians on a regular basis, my internist and my
cardiologist. Fortunately, both doctors' offices commuinicate well after a
visit to either of them. Still, there have been a couple of occasions
where my insurance company has caught a possible drug interaction and
notified the pharmacy at the time of my filling the prescription. I don't
have a nursing coordinator, although my insurance company would provide one
if I desired. At this point I don't think I need that much management. I
also do extensive research on all the medications I take, especially when
one is changed or added.

--
Wayne Boatwright
(correct the spelling of "geemail" to reply)
************************************************** **********************
Date: Saturday, 12(XII)/13(XIII)/08(MMVIII)
************************************************** **********************
Countdown till Christmas Day
1wks 4dys 4hrs 54mins
************************************************** **********************
If it was easy, the hardware people would take care of it.
************************************************** **********************

Michael \"Dog3\" > wrote:

>I take 9 scripts a day. Some for diabetes, some for heart disease
>related issues, some for glandular issues etc. The problem I was
>experiencing was not the number of medications but the mix of the meds.
>I have 4 docs and they don't always communicate amongst themselves, or
>if they do, the fax etc. gets lost in the shuffle, when one or the other
>wants to change a dosage. This can cause me problems since it sometimes
>takes a couple of weeks for the bod to adjust to these changes and
>sometimes there is a reaction when one of the dosages is lowered or
>increased. My insurance company has helped with this by assigning me a
>nursing coordinator. She helps coordinate this type of thing with all 4
>of my docs. Makes he a happier patient and it helps my doctors out
>because they don't have to worry so much about what the other is
>doing.This has been very helpful to me as a patient.

The nursing coordinator idea sounds good. I do not know if
my provider has such a thing. (I am satisfied with my
healthcare provider, but I am stuck with them..)

Mostly, I am able to track the necessary issues surrounding
medications myself, but I could see not being able to do this
without help, if circumstances were different.

Steve

In article
>,
Dan Abel > wrote:

> I often feel like I'm interrupting their work. I'm happy with the
> written material that is furnished with the prescription. If all the
> consulting pharmacist is going to do is read that written material to
> me, we are wasting our time. I have gotten some useful advice and even
> asked a couple of questions over the last umpteen years.

Charles and I are on a first name basis... We often end up chatting for
a good 20 minutes about subjects other than just the Rx's. :-)

He's given me a LOT of good advice over the years.

I like that.
--
Peace! Om

"Love and compassion are necessities, not luxuries. Without them humanity cannot survive." -- Dalai Lama

In article >,
"Michael \"Dog3\"" > wrote:

> I have 4 docs and they don't always communicate amongst themselves, or
> if they do, the fax etc. gets lost in the shuffle, when one or the other
> wants to change a dosage. This can cause me problems since it sometimes
> takes a couple of weeks for the bod to adjust to these changes and
> sometimes there is a reaction when one of the dosages is lowered or
> increased.

Seriously Michael, talk to the pharmacist. They are far more familiar
with drug interactions than the majority of doctors. Unless you have a
doc that actually pays attention to that sort of thing!
--
Peace! Om

"Love and compassion are necessities, not luxuries. Without them humanity cannot survive." -- Dalai Lama

On Sat, 13 Dec 2008 23:08:58 +0000 (UTC),
(Steve Pope) wrote:

>Omelet > wrote:
>
>> blake murphy > wrote:
>
>>> On Fri, 12 Dec 2008 18:20:10 -0800, Dan Abel wrote:
>
>>> > (Steve Pope) wrote:
>
>>> >> When I got up to I think nine prescriptions, I took a hard look
>>> >> at all of them and decided I could quit two. I'm about to taper
>>> >> off one more.
>
>>> >> While it's clear that a person might be validly prescribed 9,
>>> >> 15, or 30 medications, it's also clear that they can't all be
>>> >> equally important. It's reasonable to figure out which ones
>>> >> are least important.
>
>>> > I have an easy way of determining which medicines are least important.
>>> > It's those thousands of medicines that the doctor has not yet prescribed
>>> > for me. I'm on nine meds now, two non-prescription. Why would I drop
>>> > any of them unless I didn't need them anymore, or their risk increased
>>> > to more than their value?
>
>>> doctors may not be gods, but it seems to me to be foolish to disregard
>>> their advice, at least on the basis of 'there are too many prescriptions!'
>
>Up to one-third of all medical treatment in the U.S. is unnecessary,
>and some fraction of that is actively harmful. A person with
>10 or more prescriptions who is not considering whether some
>of them are unneeded is, in my opinion, not taking proper care
>of themselves.
>
>>I'd trust a pharmacist even more.
>
>I'm often less than enthused with the consulting pharmacists
>at my provider. Furthermore, I have to pay $10 more per prescription
>to pick it up in person, so I am unlikely to physically talk
>to any pharmacists anymore.
>
>Steve

I live in a small town. There are 3 chain drug stores and 3 locally
owned. We could also get meds from by mail from Tricare. We go to
one of the locally owned stores. The present owner/pharmacist is the
second generation. He knows just about everyone who comes in the
store. I have seen him go out to a parked car to explain the
prescription to a customer.

The doctors here ask on every visit what medications you are taking
and some ask that you bring in all of the containers. There are signs
in the doctors' offices that say something to the effect of "know what
you are taking and discuss it with your doctor, that you are also
responsible for you health."

When you have medications from several doctors it is good to use one
pharmacy so they can check for adverse interactions.

I have a list of problems and surgeries that I have had and treatments
for other conditions. My memory being what it is it helps a lot when
I go to a new doctor and have to give a history. It occurs to me that
keeping a copy in my wallet would be a good idea.

On Sat, 13 Dec 2008 12:56:34 -0600, Damsel in dis Dress wrote:

> On Sat, 13 Dec 2008 18:37:35 GMT, blake murphy
> > wrote:
>
>>it's reasonable to discuss it with your doctor, not just decide 'i don't
>>really need this.' (people with bipolar disease are notorious for this,
>>with predictable results.) presumably, he learned a thing or two in med
>>school and afterwards that you may not know about.
>
> I've seen that a lot in friends of mine. Personally, I consider my
> medications a God-send, and only miss them when my memory is out of
> whack. Fortunately, I have people around me who can tell instantly if
> I've forgotten to take them, so I get a friendly reminder and am back
> on track.
>
> Carol

it's very sad, but predictable. 'i feel fine now, no need to take this
damned stuff anymore,' then it's off to the ****ing races.

your pal,
blake

On Sat, 13 Dec 2008 14:49:58 -0600, Omelet wrote:

> In article >,
> blake murphy > wrote:
>
>> On Fri, 12 Dec 2008 18:20:10 -0800, Dan Abel wrote:
>>
>>> In article >,
>>> (Steve Pope) wrote:
>>>
>>>> jmcquown > wrote:
>>>>
>>>>>That's the trouble with "medical people". They aren't the be all, end all
>>>>>simply because they went to medical school. At some point you have to
>>>>>step
>>>>>up and ask WHY are you giving her all of this?!
>>>>
>>>> When I got up to I think nine prescriptions, I took a hard look
>>>> at all of them and decided I could quit two. I'm about to taper
>>>> off one more.
>>>>
>>>> While it's clear that a person might be validly prescribed 9,
>>>> 15, or 30 medications, it's also clear that they can't all be
>>>> equally important. It's reasonable to figure out which ones
>>>> are least important.
>>>
>>> I have an easy way of determining which medicines are least important.
>>> It's those thousands of medicines that the doctor has not yet prescribed
>>> for me. I'm on nine meds now, two non-prescription. Why would I drop
>>> any of them unless I didn't need them anymore, or their risk increased
>>> to more than their value?
>>
>> doctors may not be gods, but it seems to me to be foolish to disregard
>> their advice, at least on the basis of 'there are too many prescriptions!'
>>
>> your pal,
>> blake
>
> I'd trust a pharmacist even more.

they probably are sharper at drug interactions, especially if you have
multiple physicians.

your pal,
blake

On Sat, 13 Dec 2008 23:08:58 +0000 (UTC), Steve Pope wrote:

> Omelet > wrote:
>
>> blake murphy > wrote:
>
>>> On Fri, 12 Dec 2008 18:20:10 -0800, Dan Abel wrote:
>
>>> > (Steve Pope) wrote:
>
>>> >> When I got up to I think nine prescriptions, I took a hard look
>>> >> at all of them and decided I could quit two. I'm about to taper
>>> >> off one more.
>
>>> >> While it's clear that a person might be validly prescribed 9,
>>> >> 15, or 30 medications, it's also clear that they can't all be
>>> >> equally important. It's reasonable to figure out which ones
>>> >> are least important.
>
>>> > I have an easy way of determining which medicines are least important.
>>> > It's those thousands of medicines that the doctor has not yet prescribed
>>> > for me. I'm on nine meds now, two non-prescription. Why would I drop
>>> > any of them unless I didn't need them anymore, or their risk increased
>>> > to more than their value?
>
>>> doctors may not be gods, but it seems to me to be foolish to disregard
>>> their advice, at least on the basis of 'there are too many prescriptions!'
>
> Up to one-third of all medical treatment in the U.S. is unnecessary,
> and some fraction of that is actively harmful. A person with
> 10 or more prescriptions who is not considering whether some
> of them are unneeded is, in my opinion, not taking proper care
> of themselves.
>

and i'm saying the patient is not the most qualified person to make that
determination.

your pal,
blake

"blake murphy" > wrote
>> Up to one-third of all medical treatment in the U.S. is unnecessary,
>> and some fraction of that is actively harmful. A person with
>> 10 or more prescriptions who is not considering whether some
>> of them are unneeded is, in my opinion, not taking proper care
>> of themselves.
>>
>
> and i'm saying the patient is not the most qualified person to make that
> determination.
>

I agree with you, but I do think the patient had better keep his eyes open.
Doctors have a lot going on, and even the best I have had have forgotten
things, neglected to catch when I have not had an exam in years, that sort
of thing. And with someone who hates going to doctors, and hates exams, that
can be a bad combination. There's a middle ground between dictating to a
doctor and monitoring him as best you can.

In article >,
blake murphy > wrote:

> On Sat, 13 Dec 2008 14:49:58 -0600, Omelet wrote:
>
> > In article >,
> > blake murphy > wrote:
> >
> >> On Fri, 12 Dec 2008 18:20:10 -0800, Dan Abel wrote:
> >>
> >>> In article >,
> >>> (Steve Pope) wrote:
> >>>
> >>>> jmcquown > wrote:
> >>>>
> >>>>>That's the trouble with "medical people". They aren't the be all, end
> >>>>>all
> >>>>>simply because they went to medical school. At some point you have to
> >>>>>step
> >>>>>up and ask WHY are you giving her all of this?!
> >>>>
> >>>> When I got up to I think nine prescriptions, I took a hard look
> >>>> at all of them and decided I could quit two. I'm about to taper
> >>>> off one more.
> >>>>
> >>>> While it's clear that a person might be validly prescribed 9,
> >>>> 15, or 30 medications, it's also clear that they can't all be
> >>>> equally important. It's reasonable to figure out which ones
> >>>> are least important.
> >>>
> >>> I have an easy way of determining which medicines are least important.
> >>> It's those thousands of medicines that the doctor has not yet prescribed
> >>> for me. I'm on nine meds now, two non-prescription. Why would I drop
> >>> any of them unless I didn't need them anymore, or their risk increased
> >>> to more than their value?
> >>
> >> doctors may not be gods, but it seems to me to be foolish to disregard
> >> their advice, at least on the basis of 'there are too many prescriptions!'
> >>
> >> your pal,
> >> blake
> >
> > I'd trust a pharmacist even more.
>
> they probably are sharper at drug interactions, especially if you have
> multiple physicians.
>
> your pal,
> blake

Exactly. Thanks. :-)
--
Peace! Om

"Love and compassion are necessities, not luxuries. Without them humanity cannot survive." -- Dalai Lama

blake murphy > wrote:


>>>> >> While it's clear that a person might be validly prescribed 9,
>>>> >> 15, or 30 medications, it's also clear that they can't all be
>>>> >> equally important. It's reasonable to figure out which ones
>>>> >> are least important.

>and i'm saying the patient is not the most qualified person to make that
>determination.

Unless the patient is incompetent, the patient *is* the person
making the final determination of what meds to take. So the
only question is how actively they consider this decision.

Steve

In article >,
(Steve Pope) wrote:

> blake murphy > wrote:
>
>
> >>>> >> While it's clear that a person might be validly prescribed 9,
> >>>> >> 15, or 30 medications, it's also clear that they can't all be
> >>>> >> equally important. It's reasonable to figure out which ones
> >>>> >> are least important.
>
> >and i'm saying the patient is not the most qualified person to make that
> >determination.
>
> Unless the patient is incompetent, the patient *is* the person
> making the final determination of what meds to take. So the
> only question is how actively they consider this decision.
>
> Steve

And how well they research it.

Now with the internet, there is no excuse.
--
Peace! Om

"Love and compassion are necessities, not luxuries. Without them humanity cannot survive." -- Dalai Lama

On Sun, 14 Dec 2008 13:27:22 -0600, Omelet >
wrote:

>In article >,
> (Steve Pope) wrote:
>
>> blake murphy > wrote:
>>
>>
>> >>>> >> While it's clear that a person might be validly prescribed 9,
>> >>>> >> 15, or 30 medications, it's also clear that they can't all be
>> >>>> >> equally important. It's reasonable to figure out which ones
>> >>>> >> are least important.
>>
>> >and i'm saying the patient is not the most qualified person to make that
>> >determination.
>>
>> Unless the patient is incompetent, the patient *is* the person
>> making the final determination of what meds to take. So the
>> only question is how actively they consider this decision.
>>
>> Steve
>
>And how well they research it.
>
>Now with the internet, there is no excuse.


If they have Internet, know how and where to search and actually
understand what they read. If the patient is getting proper results
and no serious side effects there is probably no reason to change,
even if they are taking 15 pills a day. If it is getting too
expensive the doctor should be told.

The most important thing to do is discuss it with your doctor(s). Ask
questions. If you can't ask the doctor questions and get answers that
you understand, change doctors.

The Cook > wrote:

>If they have Internet, know how and where to search and actually
>understand what they read. If the patient is getting proper results
>and no serious side effects there is probably no reason to change,
>even if they are taking 15 pills a day.

I guess what this ignores is the possibility of side effects
that may not be immediately evident but are still serious.
Top of the list are hepatotoxic drugs, which are all over the
place. Acetaminophen, for example -- it should perhaps be off the
market entirely, much less over the counter. 50% of liver failures
in the U.S. are linked to acetaminophen.

When my mother was terminally ill, a doctor (a generally excellent
doctor) prescribed among other things acetaminophen, and I pointed
out to him her liver enzymes were high so maybe that was not
a great idea. He readily agreed and changed his order. But it
should have be obvious. It's mostly that some of these harmful
drugs are so ubiquitous that people do not consider the risks
anymore. They are confusing lack of liability for lack of risk.

Steve