General Medical issues thread

[JohnK]

I got it last month.

The flu shot or the flu itself? If you've only just started the flu shots this could be related.

 

[Hvr]

The flu shot or the flu itself? If you've only just started the flu shots this could be related.

The flu shot last month.

 

[Pushka]

We are watching a bit of tv here in California and the drug advertisements are simply incredible. I don't think advertisements like this are allowed in Australia.....thank goodness.

And full of legals no doubt. When we caught up with our Canadian friends a couple of weeks ago they knew all about the medication I was on and they are not medicoes, because their TV channels were running lots of ads from Lawyers seeking patients who had suffered adversely from taking the drug.

 

[whatmeworry]

If your erection doe not subside after eight hours, please contact your Doctor.

 

[Timtammi]

The drug ads in the USA are hilarious. Especially all the side effects they obviously have to reel off which in most cases are much worse that what it is trying to Treat!

 

[JohnK]

I can't locate the website now, but I have it bookmarked at home. I'll post it when I get back (or if I forget and you're still interested, just remind me).

The Thai dentist? Yes please. I have other more important things to do right now but I'd like to research and prepare for implants and crowns.

 

[Milboo]

As amusing as the drug TVCs are the ones in magazines - they run to 3-4 pages due to the Regulations around providing all the consumer info.

Under the TGA here prescription meds can only be advertised to HCPs and not consumers.

 

[MEL_Traveller]

The Thai dentist? Yes please. I have other more important things to do right now but I'd like to research and prepare for implants and crowns.

The bookmark all about crowns and root canals. It's good reading and prepares you for everything. The interesting thing is that they have data on things like the 'life expectancy' of crowns, root canals and all sorts of related stuff. Things like 'if you have a crown without a root canal, 75% of people will require a root canal within 5 years'. They then tell you how they do a root canal over a tooth with an existing crown (etc etc).

 

[MEL_Traveller]

We are watching a bit of tv here in California and the drug advertisements are simply incredible. I don't think advertisements like this are allowed in Australia.....thank goodness.

But on a serious note, they do inform the consumer. A family member has a serious condition for which, thankfully, I remembered there being a drug available after having seen it on tv in the states. The drug works, and improves quality of life. On diagnosis I was able to talk to the doctor, mentioned the drug, and they prescribed it. Would the doctor have prescribed it without me asking? I dunno.

Ads for things like single daily dose blood thinners... meaning you may be able to go off warfarin (with regular testing) to a single - no testing required - alternative.

So those ads might be lengthy, but I consider them valuable. I didn't know for example that you can now cure Hep C (99% cure rate). There are also drug patches to take after chemo to cut infection rates. These are drugs which, knowing they exist, can turn a terrible diagnosis in to one that at least has a tiny bit more hope because you know there may be treatment available.

 

[Quickstatus]

Yes some exciting developments in HepC. Cure rates very high though not 99%
New antivirals on PBS since Jan 2017 with few restrictions
see here:

Treatment for Hep C — Hepatitis Australia

 

[Quickstatus]

I think patients are much better off if they are informed as much as possible when consulting Dr.
Always go with a support person.

Google and Wiki is not where medical info resides.

 

[Cynicor]

Sure, but it's the doctor's job to know about these drugs and most do.

The "alternatives" to warfarin have multiple issues and questions around the studies used to approve them.

Direct marketing to consumers is a terrible idea.

 

[Pushka]

Sure, but it's the doctor's job to know about these drugs and most do.

The "alternatives" to warfarin have multiple issues and questions around the studies used to approve them.

Direct marketing to consumers is a terrible idea.

I'd never use warfarin. My mother died from a stroke/brain bleed after 18 months on it. No major issues for me on Xarelto and they've been approved overseas for APS where only DVT was presentation (not stroke).

 

[MEL_Traveller]

Yes some exciting developments in HepC. Cure rates very high though not 99%

Accept that. The 99% is being advertised here in the states. Amazing if true. Actually come to think of it they're saying the 99% is for those eligible to take it in the first place.

Google and Wiki is not where medical info resides.

I think both of these have a role to play. Reading other's experiences, what they may have tried, and things like side-effects can be reassuring (or serve to raise flags to discuss with your doctor).

Sure, but it's the doctor's job to know about these drugs and most do.

The "alternatives" to warfarin have multiple issues and questions around the studies used to approve them.

Direct marketing to consumers is a terrible idea.

It may be the doctor's job... if they do it properly. One of our specialists hadn't even heard about a particular drug (not available in Australia). And there isn't much information because it isn't approved for use in Australia. But it is the only drug that works for the person concerned, even though there are about four other similar drugs approved for use in AU. Direct marketing can certainly serve a purpose.

I'd never use warfarin. My mother died from a stroke/brain bleed after 18 months on it. No major issues for me on Xarelto and they've been approved overseas for APS where only DVT was presentation (not stroke).

Xarelto is widely advertised in the USA. Knowing there is an alternative to warfarin means people can have that discussion with their doctor.

 

[cove]

Cynicor I don't disagree with you at all. I think all the hypochondriacs would get way too many ideas from these adverts.
I rely on my cardiologist for my heart medication and it is about 23 years since I had an operation so I am happy with that.

 

[MEL_Traveller]

Cynicor I don't disagree with you at all. I think all the hypochondriacs would get way too many ideas from these adverts.
I rely on my cardiologist for my heart medication and it is about 23 years since I had an operation so I am happy with that.

What if your cardiologist isn't familiar with every drug available? or the best drugs for a particular person can only be obtained overseas? A patient knowing the full range of options should theoretically be in a better position to have optimal care.

 

[cove]

If I watched all these tv adverts I could start thinking wrongly about what medication I should take. I had to get my coronary risk ratio down and keep it down and I check my blood pressure every fortnight or so.
I spend over 7 hours a week on exercise and I found that helps a lot.

 

[drron]

Unfortunately things are not as clear cut as some appear to believe.
Cerebral haemorrhage can occur with the newer anticoagulants though studies suggest not as severe.Once over 75 the chance is much higher but older studies show that over 75 the rate of cerebral haemorrhage is between 1 in 150 to 1 in 400 even when not taking an anticoagulant.

Side effects as listed in the leaflets given out with drugs are not necessarily due to the drug.By law drug companies must report any effect reported as a possible side effect even if it cant be proven-

Spontaneous reports of suspected ARs must be reported in accordance with this document even if the sponsor does not agree with the reporter's assessment of a possible causal association, or if the reporter has not provided a causal assessment. Therefore all spontaneous reports notified by healthcare professionals, patients or consumers to the sponsor are considered suspected ARs and reportable in accordance with this document, since they convey the suspicions of the primary source[SUP]22[/SUP], unless the person reporting to the sponsor specifically states that they believe the events to be unrelated or that a causal relationship can be excluded, and the sponsor agrees with this assessment

https://www.tga.gov.au/book/2-reporting-requirements

And remember these are side effects that usually affect a minority of patients.Having practised now for 47 years it is unbelievable the amount of times I have been accused of prescribing a drug knowing it would cause that particular side effect in that patient.The most extreme example was a young woman with epilepsy who reported a long list of side effects.In fact she had memorised the patient information leaflet.Now I could accept that you can get diarrhoea and constipation at different times.Drowsiness and agitation,possibly but increased libido plus loss of sexual desire at the same time I found hard to accept.

Also if a drug is not available in Australia why should the doctor know all about it particularly when there are acceptable alternatives.There are though many people who are convinced only 1 drug in a class works for them.I have been told by a couple of patients things such as digoxin is the only thing that helps.Lanoxin was useless.

So just saying there are at least 2 sides to every story.

 

[love_the_life]

The patient must take an active role in managing their disease/health issue especially if it is a long or chronic condition. Mr LtL (and his sister) had out of control hypertension for many years. A succession of GPs and specialists would have a go but nothing really worked. He started to feel that 178 over 120 was pretty good. He used to studiously read reports and the findings of research to try and get a handle on his condition as both his mother and grandmother had died at 50 from massive strokes. Finally someone (not sure who along the line) decided to try spironolactone which worked amazingly well. It seems that no one had found that his hypertension and that of his sister (who also has had excellent results) was linked to high aldosterone. He has been on it for about 8 years now and has never been more well.

 

[Pushka]

Agree that as patients we must become our own advocates for our health. I don't think it's possible to expect GP's to be on top of every single health issue for every person. And the world of medicine is constantly evolving.

I use research portals like researchgate for latest info plus relevant medical sources (not wiki) where professional journals are cited and abstracts provided for non members. Surprisingly some Facebook groups quote medical literature and citations for info but obviously some members deal with more simplistic info but sifting through the noise is important.

Research is my job. So naturally I've applied it to health but it's very easy to run amok. Especially when the Drs are also scratching their heads

I've found the GP is much more receptive to properly discussing such issues now and I don't tend to raise side effect issues unless I'm experiencing issues myself. The specialist, knowing I also see a haematologist and dermatologist has asked me for an opinion about medication and a test result which was refreshing and shows she is open to an opinion. She has realised that some of her patients, after a couple of appointments, can also assist her professional decisions.

Just heard my (PhD) niece has had her patient/Doctor relationship research paper accepted for publication in a Lupus journal so I guess it's not a surprise that our shared Rheumatologist listens. She knows of our familial connection and while not discussing particular personal details we have both given our consent for her to do so. My niece suffers the opposite blood issues to me - excessive bleeding eg nose bleeds - such is the wacky world of auto immune illness. But her blood tests are so far negative for APS but the specialist has said given my history that she is testing for it more rigorously than in her other patients. And expects 'conversion' in the next couple of years.