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.