Archive for the ‘Medications’ Category
17
Jan
Written by Mike on January 17th, 2011
So here we are, one week after my visit with my primary care doctor, and I’m just now getting around to writing about how it went. Better late than never, or some bovine fecal matter like that.
This was a follow up appointment, and I was to receive the results of my latest A1C. And I went into it expecting to hear bad news. And, as I expected, that’s what I got.
The result was 7.1 this time around. And despite how prepared I thought I was for hearing that my A1c was back above 7.0, it still came as a shock. Considering where I started out at two years ago though, at 9.6, that 7.1 is still looking pretty good. And that’s how I’m trying to look at it. POSITIVELY! I have my good friends in the D-OC to thank for helping me out with that.
Thankfully, my doctor was rather understanding about the situation, and I didn’t receive the posterior chewing that I was expecting. When she asked what had happened, my reply was simply “life with diabetes happened”. I explained the situations that I’ve been dealing with over the last few months, and left it at that.
We agreed that it would be best to switch my medications, and I’m now taking Janumet 50-500 twice a day to see if that will work better than metformin and januvia did separately. And thankfully, just in a weeks time, I’m seeing a big difference in my blood glucose readings.
We also discussed anti-depression and anti-anxiety medications as well. More on that later.
And finally, the sinus infection I’ve been battling was addressed. My prescription from the last SI I had was refilled, and fortunately, it’s finally working. Feeling much better today than I have the last week. Still a few sniffles though.
Now, if you’ll excuse me, I must go catch my nose before it runs off.
30
Jun
Written by Mike on June 30th, 2010
Well, this post is definitely more than a day late, but better late than never. Here goes.
I went to the doctor last Thursday to get the results of all the lab work that was done last month. You know, the lab work that I had a hell of a time fasting for. Anyway, the results of those tests were a mix of good and bad.
My A1C, which had been 6.0 the last couple of times it was check, was up to 6.4. Not a bad number in the grand scheme of things, but certainly not the third 6.0 in a row that I was going for. In reviewing blood glucose logs I gave her, the doctor noted the increasing number of highs in my logs. In light of those, and the A1C results, she concluded that the Metformin that I had been taking just wasn’t as effective as it had been.
And as if the Metformin not working anymore wasn’t enough, she also concluded that it was also the culprit behind all of the stomach cramps, nausea, and diarrhea that I’ve been dealing with for the last few months. All side effects that I had been warned about when I started taking the medication a year ago, but that never appeared. So, as a result, I’m no longer taking Metformin. I’m now taking Januvia, and the jury has just started deliberating on whether this will work or not. I’ll keep everyone posted.
The results of the microalbumin tests noted some abnormalities, too. There was apparently quite a bit of protein in the urine sample they took, which could mean any number of things. Not the least of which being possible kidney problems. More tests are being scheduled to determine the cause, but in the doctor went ahead and adjusted one of the medication I’m taking as a precaution. I’ll keep everyone posted on this as well.
My blood pressure was on the high side as well, so that medication was adjusted, too.
Oh, and one other change made at this appointment came in the form of a prescription for Ambien. I’ve been having a terrible time sleeping with the BiPAP machine I use for treating sleep apnea, and asked the doctor about something that might help me get some sleep and be able to use the machine at the same time. So, we’re going to try the Ambien for a while, and hope to God it actually helps.
All for now. Keep hanging in there.
26
Apr
Written by Guest Writer on April 26th, 2010
This post is a special one, as it is the first guest post written for My Diabetic Heart. The post was written by fellow DOC member & D-blogger Casey Washington, host of the blog Pumping through Life. Thanks Casey!
Mike asked me to provide some insight into what is required for a prescription to be filled and how you can help prescribers (IE physicians, nurse practitioners, dentists) and pharmacists.
I am a registered pharmacist in Ohio and Virginia. I have a Doctorate of Pharmacy and am a Board Certified Pharmacotherapy Specialist. I do not provide medical advice online. Please check with your health care team before making any changes to your health care management. My blog writings are strictly my perspective which includes living life as a person with Type 1 diabetes. You can check out my blog at http://pumpingthroughlife.blogspot.com
First, let me encourage you to get to know your pharmacist. Pharmacists are easily accessible health care practitioners. Pharmacies can be found almost everywhere and some are open 24 hours. You can call, walk in, or even drive through without an appointment. If you always go to the same pharmacy, the pharmacists can get to know you and may be better equipped to help you. The information the pharmacist knows is limited to what the prescribers write on the prescription pad and what you share with them.
To help prevent potential problems with your prescription, you may want to check your prescriptions for accuracy when they are handed to you. Each prescription must contain:
1. Date written – including month, day, and year. Depending on what medication is prescribed, the expiration of the prescription can vary. Most prescriptions must be filled with in 6 months – 1 year of being written (there are exceptions, like controlled substances).
2. Patient name – most pharmacies will ask for another identifier such as date of birth/phone number to help make sure the prescription is filled for the correct person.
3. Name of the Medication (IE metformin)
4. Strength of the medication (IE 500mg)
5. Directions – including route (PO = by mouth), dose (2 tablets), and frequency (BID = twice daily).
6. Quantity – often written as 30 or 90 days supply. If your insurance covers a 90 day supply, make sure to tell your physician.
7. Refills – this can be left blank which means there are no refills. But if you aren’t seeing the physician/nurse practitioner for several months, make sure you have enough to get you through. Refills are usually valid for 1 year.
8. Signature of clinician prescribing (Physician/nurse practitioner)
These requirements are in general. There are some regulations related to specific medications (controlled substances) as well as some state requirements. Check with your pharmacist for more information regarding your medications.
Just because the above criteria are met, doesn’t mean you won’t run into a problem. One of the required items could be written incorrectly requiring the pharmacist to call the physician office. Also, there could be interactions with the medication. It is important to go to the same pharmacy for all medications so the pharmacist can catch if any prescription medications (maybe from another doctor/urgent care/dentist) interact with other medications you take.
Another helpful action could be to have a list of formulary medications for your insurance. This way your physician can write the prescription for a cost effective medication. Usually this list is available online or you can request a printout from your insurance company.
I hope your next visit to the pharmacy is pain free.
2
Mar
Written by Mike on March 2nd, 2010
For the last several years, I’ve dealt with Migraine Headaches on a fairly regular basis. The intensity and duration has varied but they have always left me wiped out and wondering what the hell happened. And save for some over the counter remedies, the migraines went untreated as far as drugs go, because I’ve never had good enough insurance or enough money on hand to be able to go to the doctor for help.
Well, things have changed a lot in my life, as anyone who reads this blog knows. I have a little bit of money now, and thankfully have insurance to help cover the medical bills that I’ve had over the last year. And that knowledge made my decision to finally try to do something about the Migraines all the more easier when I went to see my doctor at the end of January.
After talking to Dr. Cabe about the situation, she prescribed a medication called Topamax. Now, I had heard both good and bad things about this particular drug, but I was willing to give it a try to see if it would help me. And boy was that ever a mistake.
In my case, I’ve found the side effects of Topamax to be far worse than Migraine Headaches that I’m trying to remedy. I mean this shit has really messed me up. Below are excerpts from www.relieve-migraine-headache.com on the side effects of Topamax. The ones I’ve experienced are in bold.
“Topamax will slow you down, or make you feel like you’re in a fog. This includes slower reflexes, trouble thinking or concentrating, trouble thinking of the right word (and other speech problems), tiredness, poor coordination, and dizziness.
Topiramate may also cause tingling in your hands or feet, shakiness, depression, nausea, memory problems, and visual problems (such as double vision). It has also been known to bring on respiratory infections.
Some of the less common Topamax side effects include: pain (ie chest, leg), mood changes (ie aggression, restlessness), rash, body odour, appetite loss and weight loss, constipation, hearing loss, and menstrual disorders.” – http://www.relieve-migraine-headache.com/topamax-side-effects.html
In short, in just a months time, the side effects of this one medication have seriously impacted every aspect of my life. I’m not the same person that I was before I started taking the medication, and more than one person has told me so.
So, all that being said, I called Dr. Cabe’s office Monday morning, and told them I was having a major problem with the Topamax, and I needed to stop taking it ASAP! They were busy, and it took all day for me to hear back from them, but I got the response that I was wanting. The doctor agreed that I should discontinue the medication, and provided instructions for weaning myself off of the medication. They were as follows:
- Take 1 pill per day for 4 days.
- Skip a day, then take 1 pill.
- Skip 2 days, then take 1 pill.
- Skip 3 days, then take 1 pill,
- And then stop!
Apparently, you have to gradually stop taking this medication, because stopping suddenly can cause serious problems. Fine, what ever it takes to get this shit out of my system is OK with me. As I told the doctor, and everyone else I’ve talked to about this problem, given the choice between living with the migraines or dealing with the bullshit side effects of the Topamax: I’ll take the Migraines!
