1. < Head & Neck Cancer

Overmedication with cancer and other conditions

Posted by Maureen, Alumna Mentor @alpaca, Apr 17, 2018

A lot of us with cancer are getting older and have comorbidities (new word I have acquired on this journey), so a danger is that we need a lot of medications to control not only pain but blood pressure, thyroid etc. We can be caught up in a tangle of medications all with their side-effects and possibly interactions. Do you have any tips about how to manage this?

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cindylb | @cindylb | Apr 18, 2018

Indiana Scott - you bring up another interesting point regarding medications. When you have multiple doctors involved in the care of one patient meds can get confusing. Each doctor is 'tasked' with certain duties for a patient. In the case of cancer, it's curing cancer and sometimes that seems to be at the exclusion of other concerns (sometimes). It's their job and 'ego' to cure or get cancer in remission. At times that can be at the cost of side effects from drugs or other conditions that send you off to another type of doctor. Of course, not all doctors think so singularly.........some do consider the side effects and long term effects of treatments and medications. But I do believe any patient either needs a caretaker or support person in their corner or if they're on their own.....a group like this that gives them multiple perspectives. I liked your "Kramer v. Kramer" analogy. I've hit that point a couple of times myself!

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Gaybinator | @gaybinator | Apr 18, 2018

@jaler I keep my husband's drug list on the computer (sample attached). Anytime he adds/subtracts a med I can easily change the list. I print a few copies to keep with us and present it to the receptionist at every doctor's appt. While the Mayo Pharmacy would have safeguards for drug interactions for the prescriptions they fill, I wouldn't expect them to keep up with prescriptions filled elsewhere.

Shared files

Sample Drug List - 04-14-2018 (Sample-Drug-List-04-14-2018.pdf)

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5 replies
cindylb | @cindylb | Apr 18, 2018
In reply to @gaybinator "@jaler I keep my husband's drug list on the computer (sample attached). Anytime he adds/subtracts a..." + (show)
@gaybinator

@jaler I keep my husband's drug list on the computer (sample attached). Anytime he adds/subtracts a med I can easily change the list. I print a few copies to keep with us and present it to the receptionist at every doctor's appt. While the Mayo Pharmacy would have safeguards for drug interactions for the prescriptions they fill, I wouldn't expect them to keep up with prescriptions filled elsewhere.

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I am going to do this today! Great idea. I've been keeping it all in my head (less space up there all the time, ha ha). Also, this would help my husband so he would have access to his drug list. He relies on me but I wasn't at an appointment it could be dangerous. Thank you!

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lisakuehl | @lisakuehl | Apr 18, 2018

Is there any consensus that the effects of medications vary as persons lose weight, or are unable to normally metabolize medications as a person's health status declines?

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Judy | @jaler | Apr 18, 2018
In reply to @gaybinator "@jaler I keep my husband's drug list on the computer (sample attached). Anytime he adds/subtracts a..." + (show)
@gaybinator

@jaler I keep my husband's drug list on the computer (sample attached). Anytime he adds/subtracts a med I can easily change the list. I print a few copies to keep with us and present it to the receptionist at every doctor's appt. While the Mayo Pharmacy would have safeguards for drug interactions for the prescriptions they fill, I wouldn't expect them to keep up with prescriptions filled elsewhere.

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I keep ours on my hard drive, too,and check my list with the Mayo list at each visit but I don’t know whether anyone at Mayo ever looks at the list to determine drug interactions.

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Mentor
Scott, Volunteer Mentor | @IndianaScott | Apr 18, 2018
In reply to @cindylb "Indiana Scott - you bring up another interesting point regarding medications. When you have multiple doctors..." + (show)
@cindylb

Indiana Scott - you bring up another interesting point regarding medications. When you have multiple doctors involved in the care of one patient meds can get confusing. Each doctor is 'tasked' with certain duties for a patient. In the case of cancer, it's curing cancer and sometimes that seems to be at the exclusion of other concerns (sometimes). It's their job and 'ego' to cure or get cancer in remission. At times that can be at the cost of side effects from drugs or other conditions that send you off to another type of doctor. Of course, not all doctors think so singularly.........some do consider the side effects and long term effects of treatments and medications. But I do believe any patient either needs a caretaker or support person in their corner or if they're on their own.....a group like this that gives them multiple perspectives. I liked your "Kramer v. Kramer" analogy. I've hit that point a couple of times myself!

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Good points, @cindylb In one regard we were 'lucky' (I know it is an extremely odd word for me to use here) in that we all knew it was the brain cancer that would ultimate win the war my wife was waging. As such her neuro-oncologist took a strongly focused approach to her care based on this knowledge. That said, I will quickly add I know cancer is an incredibly unique disease, which effects each patient differently, and to which each patient responds in their own manner. One size definitely does not fit all when it comes to this beast.

Strength, courage, and peace!

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Mentor
Scott, Volunteer Mentor | @IndianaScott | Apr 18, 2018

Hi @lisakuehl I am not any kind of medical professional, but both my wife's weight and ability to eat, drink, etc. significantly effected her dosages. While she was unable to get on a scale and greatly disliked the chair-style weighing device, the docs had me continually take certain measurements of her to estimate body weight changes and to log her eating/drinking habits. Many dosage changes were made based on changes in her physical condition as was the format of several medications (changing from pill to liquid, from a suppository to an ointment, and others). Sorry I don't know more on this.

Strength, courage, and peace!

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Maureen, Alumna Mentor | @alpaca | Apr 18, 2018
In reply to @gaybinator "@jaler I keep my husband's drug list on the computer (sample attached). Anytime he adds/subtracts a..." + (show)
@gaybinator

@jaler I keep my husband's drug list on the computer (sample attached). Anytime he adds/subtracts a med I can easily change the list. I print a few copies to keep with us and present it to the receptionist at every doctor's appt. While the Mayo Pharmacy would have safeguards for drug interactions for the prescriptions they fill, I wouldn't expect them to keep up with prescriptions filled elsewhere.

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Excellent

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Gary, Alumni Mentor | @gman007 | Apr 18, 2018
In reply to @gaybinator "@jaler I keep my husband's drug list on the computer (sample attached). Anytime he adds/subtracts a..." + (show)
@gaybinator

@jaler I keep my husband's drug list on the computer (sample attached). Anytime he adds/subtracts a med I can easily change the list. I print a few copies to keep with us and present it to the receptionist at every doctor's appt. While the Mayo Pharmacy would have safeguards for drug interactions for the prescriptions they fill, I wouldn't expect them to keep up with prescriptions filled elsewhere.

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@gaybinator I do the same so that I don't have to drag bottles around to Dr.'s visits or try to remember and write it all out on their tiny spaced form. I do the same thing with all the procedures and surgeries I have had in the past dozen years as I could never remember dates and I would likely leave out some surgeries w/out my list. I have a similar drug list that I use to prepare my weekly drugs by the day/night every Saturday morning when not much else is happening. I would b=never get it right each day otherwise. If I happen to be medicated more than normal, my wife helps me make sure I get it right, so she does not have to worry about what I take while she is at work. I wish all of that was not necessary, but better safe than sorry.

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Mentor
Teresa, Volunteer Mentor | @hopeful33250 | Apr 18, 2018
In reply to @IndianaScott "Very interesting and useful thread there! Thanks @alpaca aka Maureen :-) In my wife's case she..." + (show)
@IndianaScott

Very interesting and useful thread there! Thanks @alpaca aka Maureen 🙂 In my wife's case she was on a constantly changing stream of medications as they struggled with the constantly altering effects of her tumor. Initially it was a tough balancing act between her neuro-oncologist at Mayo, her GP at home, and our pharmacist. Early on our pharmacist was a huge help until our local pharmacy was sold to a chain and it was never the same pharmacist twice. I cringe when I think back to how much time I wasted re-educating pharmacist after pharmacist on who my wife was, what her condition was, and why she was on the cocktail she was on at that specific time. Grr!

Then there was the issue of doctor vs doctor, which put Kramer vs. Kramer to shame! Finally after a grueling 'duel', where I felt as if I were some bizarre type of Second, the neuro-oncologist finally convenience our GP to get out of the mediations loop (other than to be informed of any changes in meds or dosages). One professional ego took a hit and the relationship never recovered, but it was for the good of my wife so I was happy to give up the relationship I had with the same GP.

My wife was on a medicinal cocktail of 32 doses a day. Keeping them straight required a spreadsheet to keep track of the time of day and doses. Luckily, once my wife went into home hospice, her nurse transferred all her meds to another smaller pharmacy with a more stable staff and who delivered. They worked together hand-in-glove. At this point her meds were often changing daily so it was crucial for there to be solid, knowledgeable communications between all the medical pros! This was also critical when we had to go from pill-tablet-capsule form to all liquids for her meds since the liquid form often caused them to act differently, on a different timeline, absorption rate, etc. Unfortunately for future patients in our area, this pharmacy was also swallowed by a national chain and no longer offers the same level of service.

With all the progress in technology I would think information sharing would be simpler regarding patients, their medications, and the providers involved. Hopefully this will improve quickly, but give the conflicting forces of the profit motive, I have my doubts.

Strength, courage, and peace to all.

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@IndianaScott What an incredible story about meds, pharmacies and egos! You are quite the veteran of medication challenges.

Teresa

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