Monday, July 23, 2012

Get Medicated....If Needed

Psychiatric drugs are in the news again. 

Some people are imagining there's a link between an antidepressant called Efexor and gambling problems.

Clinical studies haven't been done yet.

We'll see what happens there. 

But now I have another excuse to ramble on about the subject.

I'm still struggling with the whole issue.

I continue to struggle with the issue of mental illness, and I struggle with the issue of treating it.

I definitely know that I'm weary of psychiatric drugs.  I feel they're over-prescribed, and that some people are diagnosed as sick so drug companies can sell more drugs. Yet I don't feel the drugs are all bad, and I don't doubt that they're a lifesaver for some people.  

I thought of a story that kind of illustrates my feelings, and it actually doesn't involve psychiatric illness.  It involves a throat problem.

Last September Jack had a weird feeling in his throat. We did a layperson parental examination and saw that his uvula was touching his tonsil.  It looked like it was stuck.  It looked really strange.

I did research on the internet. Some stuff freaked me out and worried me.  Other stuff made me relax a bit.  By the time the weekend was over, and we had a doctor's appointment, I was under the impression that Jack would probably be fine.

Still we had him examined for our own piece of mind.

The doctor let us know that it wasn't overly rare. She had seen it before.  She didn't seem overly concerned.  

Now let me add here.  Jack was feeling fine.  His throat felt a bit funny sometimes, but it didn't hurt.  He was in a fine mood. He was eating okay.  He was sleeping okay.  He didn't feel bad.   He just looked a bit disgusting...but only if you asked him to open wide and say Ah......

Still the doctor prescribed us medication.  I think it was steroids?  And she gave us free samples.   She guessed that his problems were related to allergies and that if we treated the allergies, the throat would go back to looking normal.

Later I read up on the medication, and I didn't like what I was reading.  The side effects scared me.   There was something about having a fatal reaction to chicken pox.   Now Jack is vaccinated. But there is some question of whether or not he missed one of the chicken pox doses. I think he got it.   I'm not 100% sure.  I have cousins, we see on a regular basis, that are anti-vaccine, so if Jack was on the drug I'd be really scared to be around these cousins.  And I'd probably be nervous about taking him out in public....period.  

Then there were side effects related to growth. The drug sometimes stunts the growth of children.

The risks weren't huge.  No.  But they were there.  And it didn't seem worth it to me to take those risks for a child who was feeling fine.

I talked it over with Tim, and he agreed we'd wait and see.

After several weeks, Jack's throat looked fine again. This might have been nature-taking it's course; or it might have been due to the Costco allergy pills (with less scary side effects) that the three of us had already been taking for awhile. 

This is not the only time something like this has happened. In the last year or so, Jack has been prescribed medications three other times, and I don't think any of those prescriptions were necessary.  

I think maybe it's a miscommunication between patient and doctor.  When I go to the doctor, I don't really do it to relieve minor not-too-annoying symptoms.   I do it so we can make sure we don't have a fatal illness or something that can go from mild to horrible. 

I think I need to be upfront with the doctor.  We're fine with the symptoms.   It's not causing us too much grief.  Can we let this go and let nature deal with it, or does it need to be treated? 

Then again, speaking out like this doesn't always help.

We took Jack to a doc-in-the-box because his ear felt funny.  From what I had learned in my medical reading, most doctors no longer automatically prescribe antibiotics for ear infections.

Because of this knowledge, in most cases, I'd probably just wait and see.  But I was convinced that Jack had swimmer's ear...a totally different story.    From what I gathered, that illness did usually need treatment, and if we avoided it, Jack would be in horrible pain within the next few days. 

It turned out, though, to be a normal ear infection though, one that could possibly clear up on it's own without antibiotics.  

Besides the odd ear feeling...(I won't call it pain because Jack wasn't crying and didn't seem uncomfortable).  Again, he was in a happy energetic mood.   He was eating well and sleeping well.

We had just recently had a negative antibiotic experience—another doctor-patient miscommunication.   I didn't want to put Jack through that again if it wasn't necessary.

I tried talking to the doctor about this, and he seemed annoyed. He seemed to see me as an irresponsible parent who didn't care enough to get medical treatment for her child.  

We took the prescription with the idea we'd get it filled if Jack felt worse in the next few days.  

I'm all for medical treatment, including that which helps people with psychiatric problems. 

I'm against suffering.

I'm against untimely death.

Thank goodness we have medication that prevents some of these things.

But I think we have to weigh the pros and cons. 

How bad are the symptoms?  Are they bothersome because they cause pain and discomfort.   Or are they bothersome because they make us worry?  If we know they're not going to kill us or get worse, would we mind living with the symptoms?

What are the side effect of the medication?  How rare are the side-effects?   How bad are the side-effects?  Could they be worse than the original problem?  

Sometimes we REALLY need a drug and the drug has side effects or the risk of side-effects. That's shitty, but life. 

Other times I think people are prescribed drugs and they don't really need them.   This is really unfair if the drug causes side effects that are worse than the actual original problem. 

Sometimes people get really depressed, anxious, or psychotic. Their life has gone to hell.   They need those drugs, and they'll have to deal with the side-effects. Hopefully the side effects won't be too awful, or hopefully they won't be long-lasting.

But if they have a relatively minor mental issue, or they have a problem that will fade with time.....

Then I'd say maybe they should consider not taking the drugs.   Or at least they should go beyond the doctor's advice and do a lot of independent research.    Each person has to make their own decision.    I'd just hope it's an informed decision.  


5 comments:

Kate Sparkles said...

I've been thinking about this a lot lately as well. After my horrifying experience with anti-depressants last year, I'm pretty against them and would never again take them without the consultation of a specialist.
I disliked being pushed into them, as though they were magic pills that would change everything.
Then months later having a doctor prescribe them as a pain killer..
I hate that at 23 I am immune to certain strains if anti-biotics because they were pumped into me so frequently in my teens. Why was I so afraid to just spend a week in bed? Why did I believe I needed a pill to treat every ailment? But worse still, why do doctors continue to prescribe pills they know aren't doing anything?
It's all very worrying.

Megan said...

I really like this post. I hate taking meds of any kind, mostly, I do feel that unless I truely need it because I feel completely miserable or I have a serious infection that my body will handle things, I don't even take pain killers(i.e. advil) when I have a headache unless I can't function. Now I know meds have a place but I think you make goods points on that it is not every time you feel a little under the weather and end up with a minor aliment that can be treated with drugs.

Dina said...

Kate Sparkles: I was pushed to take anti-depressants as a teen; so I can relate.

Medicine can be okay, but people shouldn't be pushed into them unless they're going to die without them.

You're right about antibiotics. I don't even think I was thinking of that at the time. I was thinking more short-term...that I didn't want Jack to experience more nasty side-effects.

It's sad that you're immune to certain antibiotics. When I read medical stuff online it seems the general practice is to avoid prescribing them. Yet when I deal with doctors in real life, they seem eager to write the prescription.

Megan: You're better than me with all that. I'm often too quick to take stuff like Advil. I think it's because I worry my small headache is going to turn into something big. Or maybe I'm just a baby. It's probably a bad attitude to have.

Big Dog Talking said...

I am not a doctor or a pharmacist, however I do work in the area of mental health and I do know a bit about drugs generally living with a pharmacist (who by the way shares your concerns)

Please be really careful before deciding for yourself what medical treatment to discontinue. Most of it works and works well. I am well aware of the controversy surrounding anti depressants but they do work well for a lot of people. (you need other support as well as drugs by the way)

Yes drugs have side effects, so does being sick which can include death. Sadly especially with mental illness.

If your doctor prescribes antiboitics for the flu get a new doctor. If they don't know that much how much can you trust them with your health.

Dina said...

Big Dog Talking.

Yes, being sick has side effects.

What I was trying to say in my post is that people need to look at the problem carefully and decide which is worse...the side effects of the original problem, or the side effects of the medication.

I too would advise people to talk to their doctors. But I don't think their decision making should stop there. I think they should do their own thinking and their own independent research.