Do Not Go Gently—

But DO go as much, as far, and as often as you can…

 

Both Carol and I vastly overused the medical system in January and February. It seems we had more than our share of medical maladies, slow recoveries, new pills, multiple tests, and it went on and on… We normally head south in early February to soak up some desert sun while the rain dominates our home in Oregon. This year we got away a month late, which is better than not leaving at all, and we have been basking in the Arizona sun for about a month now. We left the day after the last doctor gave us the last OK (or what we interpreted as an OK).

We are healthy, relaxed, tan, active, and have seen nary a doctor, clinic, or hospital in a while. Hooray! Of course, like so many of our friends, our life seems to revolve around the regular medical appointments we have for blood tests, med updates, exams, and the odd x-ray and scan. We accept that as part of our long term survival plan.

It’s those dratted unplanned health events that mess up our schedule. You can’t actually plan to get the flu a week from Tuesday, twist your ankle the day after the grandkids go home, or slip on the ice next month. All these things can, and do, happen whenever they jolly well please.

We are getting more stubborn (if that’s possible) about doing what we want, when we want, and finding ways to shortcut those medical procedures and that time consuming healing process. For example, we have learned to remove stitches (actually pretty simple) and perform other medical procedures that might otherwise keep us close to home. We haven’t mastered brain surgery yet, but never say never… 

As more and more health challenges can (and do) occur, it takes more and more planning to do what we need to stay alive and mostly healthy and at the same time live our life our way. So far so good, but it can sometimes require a bit of diabolical plotting. Isn’t life supposed to be challenging, exciting, and interesting?

axman

There is NO free lunch—and NO miracle drugs

Cancer treatments can have unintended side effects‑‑forever

 

Many of us have had treatments and taken multiple medications for all sorts of cancer related conditions. Many of these common and widely used treatments and meds have significant side effects—as you surely know by now, but were not necessarily aware of at the beginning of treatment. 

Revisiting this has been triggered by my recent bladder procedure (cystoscopy) to remove cancer cells and cauterize ‘bleeders’ from my bladder cystitis. The cancer is a continuation of my prostate cancer and the cystitis was likely caused by radiation therapy I had ten years ago, for prostate cancer diagnosed twelve years ago. I was unaware all these years that radiation could cause such a ‘side effect.’ 

On the medication side, one purpose of clinical trials is to determine if the side effects of the experimental medication is within tolerable limits. No one expects new drugs to be free of side effects but, in fact, different people have different levels of unintended results. If the side effect is worse than the disease the FDA won’t approve it (probably). I have had many medication side effects. My list of med side effects has included loss of body hair, growth of hair on my head, significant breast growth, joint pains, hot flashes, upset stomach, fatigue, etc. My wife says ‘crankiness’ is another side effect. 

Treatments such as Chemo and Radiation kill all the bad cells and all the good cells they come in contact with. The ‘bad’ (cancer) cells are supposed to stay dead and the ‘good’ cells are supposed to grow back, mostly. That works often enough for these treatments to be used regularly. These treatments may help, or not. But there will likely be side effects. In my case the radiation did not work and the long-term side effects have been significant. I probably should have done my ‘homework’ a little better and a little sooner.

Pills and injections are less traumatic treatments but if you read the fine print that comes with your prescription, you are at risk some for every disease and condition known to medical science. I take pills to counteract the side effect of other pills. You may be doing the same thing. Why do we do it over and over? It all has to do with our quest to stay alive a little longer.

Of course I will continue to undergo treatments, take pills, and have injections in the hope that I will stay alive and be able to manage the side effects…just a little longer. I also pledge to do more and better homework so I know what to expect.

axman

My 21st Century Cancer Tour—so far

Or, My Life is Getting Stranger and Stranger…

 

I made it through more than 60 years in the 20^th Century with nary a cancer—that I know about. There were aches and pains, broken bones, minor surgeries, stitches from time to time, and all was good. 

The kids were born, grew up, and had kids of their own. Carol and I aged gracefully (that’s our story), and all was good.

But then came Y2K and, although there was no Internet meltdown, my cancer cells decided to assert themselves. They did it very quietly at first and grew in a secret place in my prostate. A doctor or two was sure it was curable and I agreed to have it removed. Later I had radiation therapy because it turns out the prostate cancer was not all removed or curable. For some years after that hormones of one sort or another kept those pesky cells in check—still growing but very slowly. And all was pretty good.

I have read a lot of cancer research and discovered that having one cancer greatly increased your risk of getting other cancers. Turns out that was true for me. In less than six months I was diagnosed with a nasty melanoma on my back (October 2014), a carcinoma on my leg (January 2015) and (also January 2015) cancerous growths were found in my beleaguered bladder (technically still prostate cancer). Minor surgeries and a bladder cystoscopy have removed all of these (more or less). Some may grow back after a while, I'm told. 

While I really don’t much care for cancer in any form, there is an upside. I am doing my share (and more) to keep Big Pharma in the chips, to keep doctors and nurses fully employed, to add interesting scars to my body, and to continue to live longer than anyone has a right to. And that’s all good, too.

axman

The Devil You Know…

My wife, Carol, and I have a long list of diseases and conditions between us. In most cases we have a diagnosis, explanation, and some sort of treatment that helps manage whatever it is. Not the way we prefer life, but a reality we can, and do, live with it pretty well.

 

So when Carol recently came down with something really nasty—headaches, earaches, nausea, vomiting, dizziness, no appetite, and extreme weakness—we were off to the doctor for a diagnosis and a time-tested treatment. It was not to be. 

After numerous tests at two medical clinics and a hospital there was general agreement about what wasn’t the cause. Her heart, lungs, liver, and other organs were fine. Good. Her condition was caused by a virus (we had our flu shots), probably. Adult Viral Syndrome was the consensus; maybe related to the newest flu strains. The treatment was unanimous—“Go home and take it easy and in a while you’ll feel better.” Kind of a helpless feeling. No pills, no procedures, no miracle injection. Just wait. Hard to do. 

I discovered that not knowing what to do and not knowing when she would get better, or worse, was difficult for both of us. I hovered a lot, made sure she had water and a warm blanket, and mostly was a useless onlooker. Eventually, after more than five weeks, she is getting better. 

Will it (whatever it is) come back again? Could it be worse? What can we do to prevent it? I guess I’ll need to learn more tolerance for the unknown. But I’ll always feel more comfortable with the diseases I know than those mysterious ailments that can come and go.

axman

Generic Drug Prices Run AMOK!

And you probably thought you could still afford those ‘cheap’ generic drugs…

You may have noticed recent increases in generic drug prices. More than 85% of all prescriptions are for generic drugs. What is a generic drug? According to the FDA, generic drugs are copies of brand-name drugs and are the same as those brand name drugs in dosage form, safety, strength, quality, performance characteristics and intended use. And they have always been much cheaper than brand name drugs.

Truthfully, I had not paid much attention to this, although I saw some of the reports. But when it hit close to home… I have used a generic prescription ointment to treat my eczema. In October 2014 the retail cost of my prescription was about $47, and with my copay I paid much less. In January 2015 when I went to refill the prescription, I was told the retail price was now $500! That’s a 1,000% increase.

So I was off to Google to find out what’s going on. No problem—there were hundreds of articles, surveys, editorials and even an inquiry by The House Committee on Oversight & Government Reform, (created in 1816). You know we’re in good hands when you hear, “We’re from the government and we’re here to help you.”

Reports in The New York Times and an article in Slate Magazine titled Drug Bust, laid out some of the sad facts. It seems that in the past couple of years, many generic drugs have increased in price by 1,000%, 5,000%, or even 8,000%! 

Why, pray tell, is this happening? It seems there are several reasons, sort of. There have been shortages of some generic drugs and that always pushes prices up. With generic drugs the research and development costs have long since been recovered. I’m thinking that greed, a good thing according to Gordon Gekko, may also be a factor. But that’s just a cynical guess on my part.

Many common and necessary drugs are included in the long list of large price jumps. In addition to the 1,000% increase in my clobetasol, other increases include:

Digoxin, used since 1785, for heart failure and irregular heartbeat, has increased in price by 884%.

Albuterol Sulfate, used to treat asthma, has increased in price by more than 4,000%.

Pravastatin Sodium, used to control high cholesterol, has increased in price by more than 500%.

Doxycycline Hyclate, an antibiotic, has increased in price by more than 8,000%! There are many, many more examples.

What are the implications for consumers (like all of us)?

1 Individuals without drug coverage will be (and are) paying higher and higher prices for these formerly ‘cheap’ drugs. Some people will be priced out of even getting their prescriptions—not a good situation.

2 While the copays may still be small (mine, for example, is $8 for tier one meds) the insurance companies must now pay for the huge increase in generic drug costs. For those of us who have insurance and drug coverage, our copays and premiums are bound to go up and there will likely be higher insurance costs for all consumers.

3 There are no indications that the trend of rising generic drug prices will end soon.

Bottom Line

Your guess is as good as mine and I haven’t heard of any plan to resolve the situation. This is a serious situation that could have a major health impact on all of us.

axman