Dangerous Information

A patient left me a message earlier this week: \”I was reading the information on the drug that Dr. Rob prescribed, and I am really worried about it.\” He went on to say he was faxing me the prescribing information, just in case I didn\’t realize the risk of the medication.

I hate it when people do this. Do they realize that I studied for eight years and have practiced another thirteen? Why would I prescribe something for them that I don\’t know about? Why would I put my name behind a \”dangerous\” prescription? Why would they bother coming to me if they thought I did not know these things?

I don\’t really take it as a personal insult, and I do feel that it is fine to question the doctor. I am sure it has happened that I have given prescriptions with interactions and/or side effects that I did not think of, but there are some levels of questioning that cross the line. I am an internal medicine doctor, so medications are my tool. Would you ask a surgeon, \”Are you sure you should make a midline incision? Do you think that a lateral approach may be better?\” Do you tell a cardiologist, \”I read on the Internet that the non drug-eluting stents are better than the drug-eluting ones\”? Do you ask the radiologist, \”Don\’t you think that density could represent pleural plaque rather than an infiltrate?\” Probably not.

But somehow, the Internet has made second-guessing medications very easy. Websites have made experts out of everyone who can type. So let me make the following points very clear:

  1. I only prescribe drugs that I feel comfortable prescribing.
  2. I only feel comfortable prescribing drugs that I know the side effects, interactions, and contra-indications of. While there may be very rare side effects I do not consider, this is the exception, not the rule.
  3. My EMR allows me to check interactions, so I do this on every prescription I give.
  4. I do realize the potential danger of drugs, and weigh that out against the potential benefit in each circumstance. The benefit must significantly outweigh the risk for me to prescribe it.
  5. Drugs always have risk. That is why it takes an advanced degree and a license to be able to prescribe them. If they were not risky, then they would be put on the shelf next to peanut butter in the supermarket.

I hate to sound like I don\’t want to be questioned. I do my best to give each patient enough information that when they walk out of my office, they know why I have ordered each test and prescribed each drug. In that light, perhaps I failed this patient. Maybe I did not give enough information as to the risk/benefits of the drugs.

But then again, I don\’t get paid for taking more time with my patients. Plus, sometimes more information just increases the worry.

And there are some people who should probably stay away from the Internet.

40 thoughts on “Dangerous Information”

  1. I stopped reading those pages that come with drugs a long time ago. I just decided to trust my doctor. If I look something up on the internet it is because I want to know about it before I go into the office and question if it would be right for me…you know the ads make it sound like it would be :)I do have a question about a drug you mentioned in an earlier post though. I want to know the difference between nexium and prevacid. I have been prescribed prevacid for my Barrett’s esophagus and it works fine. I am just curious if nexium would work on the healing better, faster, etc. The reason I want to know is that their drug assistance program seems to be organized better that prevacid’s. If nexium is not much removed from prilosec then I might as well forget about it and go the otc route.
    The site looks great by the way πŸ™‚ I haven’t been over here in awhile because I have you in the reader. Have a good one!

  2. I stopped reading those pages that come with drugs a long time ago. I just decided to trust my doctor. If I look something up on the internet it is because I want to know about it before I go into the office and question if it would be right for me…you know the ads make it sound like it would be :)I do have a question about a drug you mentioned in an earlier post though. I want to know the difference between nexium and prevacid. I have been prescribed prevacid for my Barrett’s esophagus and it works fine. I am just curious if nexium would work on the healing better, faster, etc. The reason I want to know is that their drug assistance program seems to be organized better that prevacid’s. If nexium is not much removed from prilosec then I might as well forget about it and go the otc route.
    The site looks great by the way πŸ™‚ I haven’t been over here in awhile because I have you in the reader. Have a good one!

  3. I don’t think there is a substantial difference between Nexium and Prevacid. Either are OK. Nexium is not necessarily better, but if it is cheaper, then changing is OK.

  4. I don’t think there is a substantial difference between Nexium and Prevacid. Either are OK. Nexium is not necessarily better, but if it is cheaper, then changing is OK.

  5. Patients are confused – they are encouraged to be “medical care consumers” without really being told what that means. They are told they need to be a partner with their doctor; scared with stories about shared liability if they don’t do their own homework; and above all, bombarded with drug ads telling them to ask, ask, ask their doctors about this or that drug but watch out for [list of side effects spoken very quickly at the end of the ad]. Given that so many people selectively hear information (or selectively read information, in the case of drug paperwork), you can expect more calls from people who have just thoroughly frightened themselves by trying to be an informed consumer. Why they think you don’t know what you are prescribing can be easily explained – they know someone who knows someone whose wife’s sister almost died because some doctor prescribed the wrong thing. And if it can happen to someone’s wife’s sister, well it can happen to anyone, right?

  6. Patients are confused – they are encouraged to be “medical care consumers” without really being told what that means. They are told they need to be a partner with their doctor; scared with stories about shared liability if they don’t do their own homework; and above all, bombarded with drug ads telling them to ask, ask, ask their doctors about this or that drug but watch out for [list of side effects spoken very quickly at the end of the ad]. Given that so many people selectively hear information (or selectively read information, in the case of drug paperwork), you can expect more calls from people who have just thoroughly frightened themselves by trying to be an informed consumer. Why they think you don’t know what you are prescribing can be easily explained – they know someone who knows someone whose wife’s sister almost died because some doctor prescribed the wrong thing. And if it can happen to someone’s wife’s sister, well it can happen to anyone, right?

  7. I am one of those people who you don’t want to give too much info to and while I do ask questions i prefer not to read certain things in med reports or on line because with my limited knowledge I know I can misconstrue something that may not even apply to me.
    The 1st time I read about some drugs in the ER PDR book I was alarmed. The doc said that even if there is even the slightest chance of something happening they have to report it.

    Actually, I met a woman in the hospital recently who ended up there because her doctor prescribed an extremely strong antibiotic to get rid of a persistent sinus infection. She had a history of being allergic to some antibiotics and was his patient for 20 years. The whole family goes to him and likes him.

    I want to say Augmentin but I really don’t remember.

    The pharmacist said this is a strong antibiotic and he is giving you the strongest dose and I don’t think you should take this. i don’t remember why.

    She did take it and persisted in taking it..Fri-Sunday and anded up in isolation in the hospital because they thought her bloody stools were indicative of C-diff. She was one sick lady and they determined it wasn’t see diff but from the antibiotic and now she has to follow-up with a colonoscopy.

    I appreciated your post. I don’t question the drugs so much but more the condition or surgical aspects.

  8. I am one of those people who you don’t want to give too much info to and while I do ask questions i prefer not to read certain things in med reports or on line because with my limited knowledge I know I can misconstrue something that may not even apply to me.
    The 1st time I read about some drugs in the ER PDR book I was alarmed. The doc said that even if there is even the slightest chance of something happening they have to report it.

    Actually, I met a woman in the hospital recently who ended up there because her doctor prescribed an extremely strong antibiotic to get rid of a persistent sinus infection. She had a history of being allergic to some antibiotics and was his patient for 20 years. The whole family goes to him and likes him.

    I want to say Augmentin but I really don’t remember.

    The pharmacist said this is a strong antibiotic and he is giving you the strongest dose and I don’t think you should take this. i don’t remember why.

    She did take it and persisted in taking it..Fri-Sunday and anded up in isolation in the hospital because they thought her bloody stools were indicative of C-diff. She was one sick lady and they determined it wasn’t see diff but from the antibiotic and now she has to follow-up with a colonoscopy.

    I appreciated your post. I don’t question the drugs so much but more the condition or surgical aspects.

  9. Most patients are too suspicious these days. ‘Have had my share of patients doubting even the drug of choice I prescribed.

  10. Most patients are too suspicious these days. ‘Have had my share of patients doubting even the drug of choice I prescribed.

  11. I guess you are a far better doctor than the one I have, actually neither my GP or Cardio guy told me the side effects for Metoprolol. I was in Greece last year for two months and was feeling incredibly fatigued and depressed and almost suicidal. Everything sent me into tears for no apparent reason. My husband was frantic. I googled the drug and discovered that these are side effects and I wished I’d known. I tossed the drugs and when I returned to T-Dot I had heart ablation hence no need for these drugs. I just want to be told what to expect. Yup, the internet makes us all questions everything, but that’s not such a bad thing…ciao

  12. I guess you are a far better doctor than the one I have, actually neither my GP or Cardio guy told me the side effects for Metoprolol. I was in Greece last year for two months and was feeling incredibly fatigued and depressed and almost suicidal. Everything sent me into tears for no apparent reason. My husband was frantic. I googled the drug and discovered that these are side effects and I wished I’d known. I tossed the drugs and when I returned to T-Dot I had heart ablation hence no need for these drugs. I just want to be told what to expect. Yup, the internet makes us all questions everything, but that’s not such a bad thing…ciao

  13. Well Rositta, you give a compelling counterpoint. I don’t really think people shouldn’t use the Internet, I just am very bugged when I get the question: “do you know the side effects?”
    Sue: I agree that the confusion is real. The information deluge we are in is not easy from any perspective. Again, I don’t really mind being questioned, but for an internist to get this question often is annoying.

    Seaspray: Nearly any antibiotic can cause c. difficile. It is horrible, but it does not mean the antibiotic shouldn’t have been given. It just happens from time to time.

  14. Well Rositta, you give a compelling counterpoint. I don’t really think people shouldn’t use the Internet, I just am very bugged when I get the question: “do you know the side effects?”
    Sue: I agree that the confusion is real. The information deluge we are in is not easy from any perspective. Again, I don’t really mind being questioned, but for an internist to get this question often is annoying.

    Seaspray: Nearly any antibiotic can cause c. difficile. It is horrible, but it does not mean the antibiotic shouldn’t have been given. It just happens from time to time.

  15. I sometimes wondered why people didn’t ask their, um, PHARMACIST!!! I am a pharmacy school flunk out. So I thought, if I flunked out, that the pharmacist would know about the drugs I was taking (better than me).
    So I was having these shaking hands, after a bunch of my meds were changed (for depression, asthma, anxiety, back pain …yeah I have issues). And my “pharmacist” suggested that it “might be Serotonin syndrome.”
    My allergist actually figured out it was my asthma drugs, and that I was not dying.

    Anyways, mistakes can happen with anyone, but you need to trust your doc.
    I have alot of somatic symptoms that are caused by anxiety. I know that, my doctor knows that, and my doctor knows, that I know that.

    (imagine the hell of the anxious person with chest pain!, and how that can feed into itself)
    yikes

  16. I sometimes wondered why people didn’t ask their, um, PHARMACIST!!! I am a pharmacy school flunk out. So I thought, if I flunked out, that the pharmacist would know about the drugs I was taking (better than me).
    So I was having these shaking hands, after a bunch of my meds were changed (for depression, asthma, anxiety, back pain …yeah I have issues). And my “pharmacist” suggested that it “might be Serotonin syndrome.”
    My allergist actually figured out it was my asthma drugs, and that I was not dying.

    Anyways, mistakes can happen with anyone, but you need to trust your doc.
    I have alot of somatic symptoms that are caused by anxiety. I know that, my doctor knows that, and my doctor knows, that I know that.

    (imagine the hell of the anxious person with chest pain!, and how that can feed into itself)
    yikes

  17. Maybe I’m just unsympathetic (I know I have a warped, or possibly actively bent, SoH), but I find myself reading this entry, and thinking of old strip cartoons and “funny stories”, where a character convinced themself that they had a rare and exotic disease that you could only catch by visiting one specific tributary of the Amazon, and getting bitten by a specific species of mosquito by reading a medical dictionary and checking symptoms.
    Sum-up. Yes, you should be aware of the side effects of whatever’s prescribed for you, but more quantitiative explanations of the actual likelyhood of the various side effects of the specific formulation would be helpful for some people, and less for others (which I guess is back where Dr Rob started?)

  18. Maybe I’m just unsympathetic (I know I have a warped, or possibly actively bent, SoH), but I find myself reading this entry, and thinking of old strip cartoons and “funny stories”, where a character convinced themself that they had a rare and exotic disease that you could only catch by visiting one specific tributary of the Amazon, and getting bitten by a specific species of mosquito by reading a medical dictionary and checking symptoms.
    Sum-up. Yes, you should be aware of the side effects of whatever’s prescribed for you, but more quantitiative explanations of the actual likelyhood of the various side effects of the specific formulation would be helpful for some people, and less for others (which I guess is back where Dr Rob started?)

  19. Dr. Rob,
    It’s funny that you post this now – as we have gotten several calls and email regarding an article in Time magazine regarding Risperdal. (I work for a psychiatrist). We just thank them for the information and for taking such an active interest in their own healthcare.

    I will say, that there have been many times that I have seen a patient begin to have certain side effects after taking a prescribed medication – only to discover later that they “forgot to tell us” that they have also been prescribed another medication by another doctor – thereby causing an interaction or side effect. The doctor I work for would have prescribed a completely different medication had they known the patient was taking another prescription. While the patient is given numerious opportunities to completely share their medical history – it amazes me that they “don’t think about” telling a new doctor certain things regarding their health.

  20. Dr. Rob,
    It’s funny that you post this now – as we have gotten several calls and email regarding an article in Time magazine regarding Risperdal. (I work for a psychiatrist). We just thank them for the information and for taking such an active interest in their own healthcare.

    I will say, that there have been many times that I have seen a patient begin to have certain side effects after taking a prescribed medication – only to discover later that they “forgot to tell us” that they have also been prescribed another medication by another doctor – thereby causing an interaction or side effect. The doctor I work for would have prescribed a completely different medication had they known the patient was taking another prescription. While the patient is given numerious opportunities to completely share their medical history – it amazes me that they “don’t think about” telling a new doctor certain things regarding their health.

  21. Sure its important to trust one’s doctor, but I’m afraid that I don’t trust most people including doctors. Not because they are not good people who are completely professional and know their stuff. Doctors are busy – they sometimes make mistakes. How about pharmacists. They go to school for a long time to learn their profession too, not as long as you did, but consumers can assume that they know their stuff, right? However, my pharmacist has made two mistakes in the 10 years that I have been going to this pharmacy. One was a serious one – he gave me half the dosage of the medication that my doctor prescribed. I’m sorry it offends you when people question you, but in the end we all have to take care of ourselves and can’t depend on anyone else to be 100% accurate at all times.

  22. Sure its important to trust one’s doctor, but I’m afraid that I don’t trust most people including doctors. Not because they are not good people who are completely professional and know their stuff. Doctors are busy – they sometimes make mistakes. How about pharmacists. They go to school for a long time to learn their profession too, not as long as you did, but consumers can assume that they know their stuff, right? However, my pharmacist has made two mistakes in the 10 years that I have been going to this pharmacy. One was a serious one – he gave me half the dosage of the medication that my doctor prescribed. I’m sorry it offends you when people question you, but in the end we all have to take care of ourselves and can’t depend on anyone else to be 100% accurate at all times.

  23. My sister went on-line to read about the hazards of all 28 prescriptions she was taking and phoned her NICU-nurse sister to discuss the possibility that she has “long QT syndrome”
    Conversation went something like: “Didn’t you have an EKG last week? Don’t you think the doc would have noticed?”

    Oh, and if you think you’re taking too many meds, why don’t you gather the WHOLE list and discuss it with your primary care doc (meds from way more physicians than I’d see in a year).

    Later in the week, she let me know she’d spoken to her physician and was now on ‘only’ 21 medications and no, the EKG didn’t show long QT syndrome.

    I don’t know how you stand it. I really don’t.

  24. My sister went on-line to read about the hazards of all 28 prescriptions she was taking and phoned her NICU-nurse sister to discuss the possibility that she has “long QT syndrome”
    Conversation went something like: “Didn’t you have an EKG last week? Don’t you think the doc would have noticed?”

    Oh, and if you think you’re taking too many meds, why don’t you gather the WHOLE list and discuss it with your primary care doc (meds from way more physicians than I’d see in a year).

    Later in the week, she let me know she’d spoken to her physician and was now on ‘only’ 21 medications and no, the EKG didn’t show long QT syndrome.

    I don’t know how you stand it. I really don’t.

  25. I found this funny rah, rah debate between drug reps for prevacid and nexium during my travels looking for pain medicine…don’t ask me how πŸ™‚ it’s pretty funny. thought you might enjoy it…summertime light reading :)http://www.cafepharma.com/boards/archive/index.php/t-3654.html

  26. I found this funny rah, rah debate between drug reps for prevacid and nexium during my travels looking for pain medicine…don’t ask me how πŸ™‚ it’s pretty funny. thought you might enjoy it…summertime light reading :)http://www.cafepharma.com/boards/archive/index.php/t-3654.html

  27. I’m a patient, and I actually don’t see anything wrong with the patient asking about something alarming-sounding that they just heard about. Faxing the documentation? Makes sense: if I try to explain the alarming-sounding thing in my own words I’ll certainly get it wrong, and if I read it out loud I’ll probably pronounce it wrong.
    I’ve always been reassured by doctors who explain that yes, they know about [alarming-sounding thing] but they are recommending [test/ procedure/ medication] anyway because of [rationale].

    And besides, doctors often look drugs up before prescribing them. If they knew everything without being reminded, they wouldn’t have to do that, would they?

    If someone has heard something alarming, what do you think they should do? Stop thinking? Eliminate all thoughts except “I know Dr Rob is never distracted and knows me and my history completely from birth and understands everything about me, even stuff I think I didn’t express well, and I know there is only one acceptable medical opinion and that Dr Rob has it, therefore I will not think any further than knowing I can trust Dr Rob?”

    Your patient might lack tact, they might be clueless about what it is you do exactly, but in this example I can’t see that they were *wrong.*

  28. I’m a patient, and I actually don’t see anything wrong with the patient asking about something alarming-sounding that they just heard about. Faxing the documentation? Makes sense: if I try to explain the alarming-sounding thing in my own words I’ll certainly get it wrong, and if I read it out loud I’ll probably pronounce it wrong.
    I’ve always been reassured by doctors who explain that yes, they know about [alarming-sounding thing] but they are recommending [test/ procedure/ medication] anyway because of [rationale].

    And besides, doctors often look drugs up before prescribing them. If they knew everything without being reminded, they wouldn’t have to do that, would they?

    If someone has heard something alarming, what do you think they should do? Stop thinking? Eliminate all thoughts except “I know Dr Rob is never distracted and knows me and my history completely from birth and understands everything about me, even stuff I think I didn’t express well, and I know there is only one acceptable medical opinion and that Dr Rob has it, therefore I will not think any further than knowing I can trust Dr Rob?”

    Your patient might lack tact, they might be clueless about what it is you do exactly, but in this example I can’t see that they were *wrong.*

  29. Alison: I can’t say I disagree with you. I want my patients to ask questions, but I do get frustrated when they act like I will be as surprised as they are about the interactions and/or side effects. Some of it is in the delivery; if I give a prescription and someone asks me “Is this safe?” What am I supposed to say? “No, it’s real dangerous.” or “Jeez, I don’t really know. I had better look that one up.” Yes, patients should always be aware and question possible problems. People ask me all the time: “are there any side effects?” That is fine with me.
    If they hear something alarming, they are free to question. I don’t want someone taking something they hear is really dangerous. Again, all is in the delivery.

  30. Alison: I can’t say I disagree with you. I want my patients to ask questions, but I do get frustrated when they act like I will be as surprised as they are about the interactions and/or side effects. Some of it is in the delivery; if I give a prescription and someone asks me “Is this safe?” What am I supposed to say? “No, it’s real dangerous.” or “Jeez, I don’t really know. I had better look that one up.” Yes, patients should always be aware and question possible problems. People ask me all the time: “are there any side effects?” That is fine with me.
    If they hear something alarming, they are free to question. I don’t want someone taking something they hear is really dangerous. Again, all is in the delivery.

  31. I’m not sure most patients who question doctors’ prescriptions do so because they don’t trust the doctors. I think they do it for the same reason so many people are obsessed finding that miracle food (or avoiding that dangerous food) they imagine will prevent cancer. It has to do with loss of control.
    Unlike submitting to a surgeon’s decision on where to place the scalpel, popping a pill into our mouths is something we do have some small measure of control over. And so, some of us hang onto that tiny shred of control, even if it makes our doctors suspect, sometimes, we have no confidence in them.

    A great many illnesses happen regardless of how we choose to live our lives: and that truth is a hard one to absorb. We like to imagine the world is a fundamentally safe place for people who work hard and try to do the right thing, when in fact it’s not. Bad things do happen to good people. Most of us would rather cling to the illusion that we are masters of our own destinies.

    I’ve got non-Hodgkin lymphoma, a disease for which there are few known environmental or inherited causes. Some unlucky people just get NHL, and medical science doesn’t know why. A cancer like mesothelioma isn’t like that. Most cases of that disease, I’ve read, result from asbestos exposure. Luck has nothing to do with it (unless you count the decision to take a job in an insulation factory in the 1960s a matter of bad luck). The same goes for people with leukemia who were living downwind from Chernobyl when that nuclear power plant melted down. A person with asbestos-related or radiation-related cancer knows exactly where it came from. And there’s some small – admittedly, VERY small – comfort in that.

    So, next time one of your patients brings in some article from a wacky natural-health magazine about the benefits of some cactus extract, or starts questioning whether the prescription you’ve prescribed safely for hundreds of patients could make them sicker, consider this: it may be because your patient is struggling to absorb the harsh truth that some sickness just happens.

    Carl Wilton
    “A Pastor’s Cancer Diary”
    http://www.cewilton.blogspot.com

  32. I’m not sure most patients who question doctors’ prescriptions do so because they don’t trust the doctors. I think they do it for the same reason so many people are obsessed finding that miracle food (or avoiding that dangerous food) they imagine will prevent cancer. It has to do with loss of control.
    Unlike submitting to a surgeon’s decision on where to place the scalpel, popping a pill into our mouths is something we do have some small measure of control over. And so, some of us hang onto that tiny shred of control, even if it makes our doctors suspect, sometimes, we have no confidence in them.

    A great many illnesses happen regardless of how we choose to live our lives: and that truth is a hard one to absorb. We like to imagine the world is a fundamentally safe place for people who work hard and try to do the right thing, when in fact it’s not. Bad things do happen to good people. Most of us would rather cling to the illusion that we are masters of our own destinies.

    I’ve got non-Hodgkin lymphoma, a disease for which there are few known environmental or inherited causes. Some unlucky people just get NHL, and medical science doesn’t know why. A cancer like mesothelioma isn’t like that. Most cases of that disease, I’ve read, result from asbestos exposure. Luck has nothing to do with it (unless you count the decision to take a job in an insulation factory in the 1960s a matter of bad luck). The same goes for people with leukemia who were living downwind from Chernobyl when that nuclear power plant melted down. A person with asbestos-related or radiation-related cancer knows exactly where it came from. And there’s some small – admittedly, VERY small – comfort in that.

    So, next time one of your patients brings in some article from a wacky natural-health magazine about the benefits of some cactus extract, or starts questioning whether the prescription you’ve prescribed safely for hundreds of patients could make them sicker, consider this: it may be because your patient is struggling to absorb the harsh truth that some sickness just happens.

    Carl Wilton
    “A Pastor’s Cancer Diary”
    http://www.cewilton.blogspot.com

  33. I’m going to leave one more comment re drugs. I have had to take CIPRO off and on for the past 6 months, sometimes for three days and sometimes one tablet a couple of times a week for preventative. I have also been suffering incredibly foot pain and have seen my Rheumatologist, Podiatrist, two different Ortho surgeons and the GP. No one could tell me exactly why I couldn’t walk. I was told I need to take Methotrexate (chemo) for Rheumatoid arthritis or to just live with. Three days ago the FDA warned of tendon damage from the drug and yesterday Health Canada also put out a warning. My thumb has also been very tender but I put that down to too much knitting. I asked my GP about this yesterday and he didn’t seem convinced. Needless to say I asked for a different antibiotic just in case. Does my foot hurt from the Cipro? Oh yes, I also take Prednisone for 5 days from time to time and apparently that makes it worse. I didn’t check the internet for side effects. I should have though, they are all there…ciao

  34. I’m going to leave one more comment re drugs. I have had to take CIPRO off and on for the past 6 months, sometimes for three days and sometimes one tablet a couple of times a week for preventative. I have also been suffering incredibly foot pain and have seen my Rheumatologist, Podiatrist, two different Ortho surgeons and the GP. No one could tell me exactly why I couldn’t walk. I was told I need to take Methotrexate (chemo) for Rheumatoid arthritis or to just live with. Three days ago the FDA warned of tendon damage from the drug and yesterday Health Canada also put out a warning. My thumb has also been very tender but I put that down to too much knitting. I asked my GP about this yesterday and he didn’t seem convinced. Needless to say I asked for a different antibiotic just in case. Does my foot hurt from the Cipro? Oh yes, I also take Prednisone for 5 days from time to time and apparently that makes it worse. I didn’t check the internet for side effects. I should have though, they are all there…ciao

  35. hi Rob: I trust my doctor to the hilt, but I have long QT (as evidenced by an EKG), and twice in the last two years, medical professionals have unwittingly prescribed me meds that could have sent me into torsades. After those incidents, I don’t take any meds, OTC or prescribed, without checking the LTQ list of meds from arizona.cert. Now, with any new meds, I ask my doctors specifically if it’s ok to take with LQT. If I don’t ask my doctor, I ask my pharmacist.
    My inquiries, however, are not intended to question anyone’s professionalism; it’s intended to recognize the reality that my doctor has around 800 patients on his panel, and that it’s unrealistic of me to think that he remembers every little quirk of his every patient. So far, he seems ok with it; he and I both know that he’s the one with the med school training, and I very much respect his knowledge (and kindness and thoroughness) as an internist. I’m in good hands.

    I know also, however, that, should any prescription mistakes occur, I’m the one who will have to live with the effects. On that ground, therefore, I’m willing to ask the questions. It’s really not because I don’t believe in his expertise. It’s because of the fact that I’m only 1/800 of his patient load.

    AJ

  36. hi Rob: I trust my doctor to the hilt, but I have long QT (as evidenced by an EKG), and twice in the last two years, medical professionals have unwittingly prescribed me meds that could have sent me into torsades. After those incidents, I don’t take any meds, OTC or prescribed, without checking the LTQ list of meds from arizona.cert. Now, with any new meds, I ask my doctors specifically if it’s ok to take with LQT. If I don’t ask my doctor, I ask my pharmacist.
    My inquiries, however, are not intended to question anyone’s professionalism; it’s intended to recognize the reality that my doctor has around 800 patients on his panel, and that it’s unrealistic of me to think that he remembers every little quirk of his every patient. So far, he seems ok with it; he and I both know that he’s the one with the med school training, and I very much respect his knowledge (and kindness and thoroughness) as an internist. I’m in good hands.

    I know also, however, that, should any prescription mistakes occur, I’m the one who will have to live with the effects. On that ground, therefore, I’m willing to ask the questions. It’s really not because I don’t believe in his expertise. It’s because of the fact that I’m only 1/800 of his patient load.

    AJ

Comments are closed.