Overmedication with cancer and other conditions

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

This could possibly be on another Mayo thread but this is my home base so I’ll start (I hope) a discussion here. 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?

@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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Try cosco for cheap cheap medication cost and pharmacy review free. You don’t have to be a member either to use drug service. I would like to shout it from the rooftops ‘ try this please

Liked by jodeej

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@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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Thanks for the information.  I have a prescription drug plan and can only use Walgreen's.  I'm an exec member at Costco.  Will Costco review my drugs if I don't get my prescriptions there?  I'm very surprised and somewhat appalled that Mayo requires a copy of prescriptions at each visit and then doesn't review them.

Judy Long

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@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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@jaler the nurse reviews them with you, or does with us anyway, but they don't know what interacts with what. That's a pharmacist's job.

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@gaybinator what a great idea! Mayo has given us copies to keep when we are there, but I like this better. Thank you!

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@jaler

Mayo requires that you update your list of prescriptions they have on file each time you go to your doctor there. I have several different doctors at Mayo in addition to my hematologist who prescribed various drugs for the side effects of chemo therapy. I would hope that a Mayo pharmacist would go over these drugs periodically to alleviate any problems. In addition to the cancer drugs, I also have medications for blood pressure, hypothyroidism, GERD, COPD, asthma, cholesterol, pain from torn rotator cuff, etc. I have no idea if there are adverse interactions from any of these medications. Does anyone know whether the Mayo Pharmacy Department reviews these lists of medications?

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Judy,
Mayo Clinic providers do screen for drug therapy issues. It is always a good idea to mention changes or concerns with your provider at your appointments in addition to documenting them. Pharmacists are available for consultation on complicated therapies, detailed reviews or questions. You can ask your pharmacy for more information about costs and availability of medication therapy management MTM or contact Mayo Clinic at the location you use https://www.mayoclinic.org/appointments

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@jaler

Mayo requires that you update your list of prescriptions they have on file each time you go to your doctor there. I have several different doctors at Mayo in addition to my hematologist who prescribed various drugs for the side effects of chemo therapy. I would hope that a Mayo pharmacist would go over these drugs periodically to alleviate any problems. In addition to the cancer drugs, I also have medications for blood pressure, hypothyroidism, GERD, COPD, asthma, cholesterol, pain from torn rotator cuff, etc. I have no idea if there are adverse interactions from any of these medications. Does anyone know whether the Mayo Pharmacy Department reviews these lists of medications?

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I think that the list is run through the computer at the Lymphoma Clinic I attend, and several providers review it with me also. It seems to be part of the charge for the visit, as far as I can tell. gp

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I thought members talking in this discussion would appreciate today's featured Member Spotlight and getting to know more about Maureen.

Who Can Resist Ice Cream With Chocolate on Top: Meet @alpaca https://connect.mayoclinic.org/newsfeed-post/who-can-resist-ice-cream-with-chocolate-on-top-meet-alpaca/

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I too am an older (78) with comorbities. Love that word. Tamoxifen, levothoxine, several blood pressure drugs for afib, avastin shots for wet AMD and probably more that I have forgotten However I am lucky with side effects but always worry that all those drugs will not know what they should be doing together when I swallow a handful.

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@jaler

Mayo requires that you update your list of prescriptions they have on file each time you go to your doctor there. I have several different doctors at Mayo in addition to my hematologist who prescribed various drugs for the side effects of chemo therapy. I would hope that a Mayo pharmacist would go over these drugs periodically to alleviate any problems. In addition to the cancer drugs, I also have medications for blood pressure, hypothyroidism, GERD, COPD, asthma, cholesterol, pain from torn rotator cuff, etc. I have no idea if there are adverse interactions from any of these medications. Does anyone know whether the Mayo Pharmacy Department reviews these lists of medications?

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In over 4 years at Mayo, no one has ever reviewed my meds. There have been meds on my list that I no longer took. It is up to us to inform them!

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@jaler

Mayo requires that you update your list of prescriptions they have on file each time you go to your doctor there. I have several different doctors at Mayo in addition to my hematologist who prescribed various drugs for the side effects of chemo therapy. I would hope that a Mayo pharmacist would go over these drugs periodically to alleviate any problems. In addition to the cancer drugs, I also have medications for blood pressure, hypothyroidism, GERD, COPD, asthma, cholesterol, pain from torn rotator cuff, etc. I have no idea if there are adverse interactions from any of these medications. Does anyone know whether the Mayo Pharmacy Department reviews these lists of medications?

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@seaspray really? Whenever we go for a check-up for my husband the nurse goes over them with us and asks if there are any changes. We go to Mayo in Rochester.

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I was on 16 medications and, besides feeling horrible, I also was mentally going downhill. I sat down and made an Excel spreadsheet, listed every drug, then tediously looked up interactions, reactions and allergies. It took,some looking and digging. It was so important to search every medication deeply, because there are interactions or reactions that occurred during trials and testing that were of such a low percentage that they weren’t listed on the basic medication leaflets, and some the pharmacist didn’t even know about…. I took him a copy and he spent a week going over it for me as well. That led to some changes in meds. Today I am on fewer prescriptions and feel better because of this little exercise. But any time a specialist tries to put me on something new, I know what questions to ask first, how to research side effects on my own, and have been able to be more involved in my healthcare.

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@stephend

Hello Stephen and welcome to Connect!

I read your first post and found it so encouraging. Regarding your meds, you certainly did your due diligence!

I always appreciate it when I hear of others who are advocating for themselves. I have often done the same. Persistence does pay big dividends.

I hope that you continue to post and share how you are actively involved with your healthcare.

Since you posted in this discussion about cancer meds I hope that you can share with us a bit about your cancer journey in whatever way you feel comfortable doing so. For example, how long ago were you diagnosed? What treatments (surgeries, chemo, etc.) have you had? How are you feeling these days?

Teresa

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@stephend

I was on 16 medications and, besides feeling horrible, I also was mentally going downhill. I sat down and made an Excel spreadsheet, listed every drug, then tediously looked up interactions, reactions and allergies. It took,some looking and digging. It was so important to search every medication deeply, because there are interactions or reactions that occurred during trials and testing that were of such a low percentage that they weren’t listed on the basic medication leaflets, and some the pharmacist didn’t even know about…. I took him a copy and he spent a week going over it for me as well. That led to some changes in meds. Today I am on fewer prescriptions and feel better because of this little exercise. But any time a specialist tries to put me on something new, I know what questions to ask first, how to research side effects on my own, and have been able to be more involved in my healthcare.

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@stephend,

Thank you so much for sharing how you did your own research and became a strong advocate for your own health. This is good advice for us all. Welcome to Connect!

I have done something similar but only for one drug – a statin that the doctor wanted me to take to "help" lower my cholesterol numbers. I had to tell her that when you have neuropathy, statins make it worse since one of the side effects is causing neuropathy. Since I have small fiber peripheral neuropathy, I told the doctor I will work on lowering the numbers through diet and exercise.

John

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@gaybinator

@colleenyoung Maybe you will want to cross post this to other groups.

My husband has fought Squamous Cell Carcinoma since summer 2015. He has had many surgeries, many rounds of radiation, Erbitux from September 2016 to June 2017 when a pet scan showed that while the Erbitux had worked on the cutaneous lesions, the cancer had metastasized to his liver, diaphragm and neck.

He was started on Keytruda in June 2017 and PET scans in October 2017 and February 2018 were clear. He continued having profound fatigue and it was always blamed on "chemo" and radiation. Sometimes he would fall asleep in mid sentence. The Keytruda took his transplanted kidney – that is why we waited so long to try it. Of course, hindsight is 20/20. We now do home hemo-dialysis four times a week. When we do the dialysis, we have to keep a record of his blood pressure and pulse every 30 minutes.

Last Friday we had an appointment with his Nephrologist, who also acts as his primary doctor. One of the nurses from the dialysis center was there. I had the records from our prior month's dialysis sessions, so I gave them to her. She leafed through them and said, "Why is his blood pressure falling into the 40's?" She brought it to the doctor's attention. Turns out that a legacy blood pressure medicine called Atenolol was the reason. My husband had been taking it for years. He stopped that day, and the change has been nothing short of miraculous. Today he got out in the yard and worked for the first time in a couple of years.

The reason I telling this is that you should question everything. The pharmacist is so right about knowing WHY you are taking what you are taking. That nurse gave my husband a chance to live again, instead of just existing. QUESTION EVERYTHING!!!

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Hi @gaybinator, I was thinking about you today and realized you haven't posted in a bit. How are you doing?

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@johnbishop

@stephend,

Thank you so much for sharing how you did your own research and became a strong advocate for your own health. This is good advice for us all. Welcome to Connect!

I have done something similar but only for one drug – a statin that the doctor wanted me to take to "help" lower my cholesterol numbers. I had to tell her that when you have neuropathy, statins make it worse since one of the side effects is causing neuropathy. Since I have small fiber peripheral neuropathy, I told the doctor I will work on lowering the numbers through diet and exercise.

John

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Good for you, John. I admire your self-discipline. How is your cholesterol now, if you do not mind sharing.

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