Making an Informed Decision

I posed the question the other day about the dilemma of mixed messages for consumers about medications to take or not take, a la Vioxx, Celebrex and aleve. How is a consumer to know what decision is the best for them to take given the official and unofficial results.

A quick web review found three interesting sites; the official Lipitor site sponsored by Pfizer which provides everything from official studies to a consumer oriented web portal where you can take an assessment test and get daily email reminders.

The counter view was provided by the statinalert.org who posited the idea that cholesterol is not a risk factor for heart disease and that statins are the biggest scam of the century (20th that is)

The third site was the consumer report view of the best value for medication and Liptior was named one the best buys although pure generics were even better. The web site even suggested increasing the dosage from 10-20-even 40 mgs which was one of my basic questions.

Now it could be said that I've not done enough research to make a "well informed decision" but given time and other constraint factors, I can say that I feel sufficiently satisfied to pursue this medical strategy for myself

How would you approach this issue

These are the nasties!! 

Whom are we to believe...Our pain or the FDA

The recent spate of news about the harmful side effects of cox-2 inhibitors (vioxx, celebrex) and even aleve, an over the counter pain medication leaves all consumers wondering about whether there is any safety in drug information.

For patients who trust their physicians and believe that the FDA is truly responsible for drug review and management are left feeling that noone really knows what the heck they are doing.

At least one truth of this matter is that regardless of efforts to determine long time side effects of medications, only time can help resolve how a particular drug may respond over time. Yet, as consumers, we want to have effective medication out in the marketplace as soon as possible, so did the early results of these studies indicate that they were safe enough to be placed on the market. Appearently they did!.

So where does that leave consumers who now look at studies stating that these medications are now responsible for coronary complications even leading to death. Well, for better or worse, the FDA pulled the drug, correctly determining that the potential benefit of the medication was significantly deminished with the potential side effects.

Now, my wife took vioxx and has even "horded" her vioxx following its removal from the marketplace. She is a dancer and looks to vioxx to keep the arthritis in her big toe down to a managable level while she is dancing. Much like Elaine Bennis's (Seinfeld) determination of a "sponge worthy" date, she decides whether or not to use her limited supply of Vioxx for the diminishment of her arthritis pain. For her, the potential benefits of the medication exceeds the risk of any major side effects of the medication.

While we all want the FDA to monitor medications for us, we also want to be relieved of our pain, discomfort, and worry about aches, pains and even more complicated conditions for which we hope we can get relief for our medical symptoms.

What is the role of the patient and consumer in determining whether or not we can make the decision about the side effects of drugs. Certainly with these cox-2 inhibitors we would probably all agree that they should be off the market, but what is the next drug that we don't yet know about waiting to be pulled due to long term side effects. For example, my physician wants me to be conservative about cholesterol lowering drugs while a physician friend of mine tells me to be aggressive about taking Lipitor. I've not even started my own investigation of the risk/reward of this drug and I'm not even certain that I could calculate that ratio to a point that I would decide whether or not to pursue either option.

But in my next post, I'll alert you to my research and how a consumer can begin to make those kinds of decisions

How do we take charge of our health

I am a psychologist specializing in issues related to how people interact with the health care system and am interested in understanding the successes and failures that people may have experienced in working with physicians, nurses and other health care professionals.

I am not only interested in this topic from a professional position but also from a personal perspective...

My daughter was diagnosed with breast cancer over two years ago and has undergone medical treatment during this time with little success. Her tumor is "non-responsive" and she is in the final throws of dealing with chemo treatments that are less and less successful. While she has been courageous in her battle against her cancer, the experiences she's had with the health care system is what set the stage for her failed treatment.

She suspected that she had problems with her breasts over 10 years ago when she was in her early 30's. Her breasts were "lumpy" and spoke to her doctors about her concerns. They did mammograms and she was examined on a regular basis, all leading to a diagnosis of "you can't have breast cancer". It wasn't until she insisted on a blind biopsy that the medical specialists were able to confirm the diagnosis.

While we can't necessarily complain about her care following diagnosis, it is very clear that the prediagnosis care set the stage for the challenges and pain that she and her family have had to suffer.

Now she is a pretty bright, assertive and competent young woman and the fact that she was unable to efficiently use the system to identify a life threatening illness does not bode well, in my mind, for how most "regular" people deal with the health care system.

And it is not just the patients...it is also the physicians and other health care professionals who are reporting significant unhappiness about the state of their own health care experiences.

What has been your experience and what have you learned that can help others