My doc told me these

Sharon said:

Can you guys tell me, true or false on these? The second
one I've heard from several doctors now; I get different
stories from everyone.

Probably because you're asking people who don't know what
they're talking about.

Quoted message said:

1. Is Lodine aka Etodolac addictive? I know it's an
NSAID, and I thought that *non-steriodal* anti-
inflammatories were not addictive.

Neither NSAIDs nor steroids are addictive.

Quoted message said:

2. If a person has an artificial joint, metal screws or
plates in a bone, is it safe for that person to get an
MRI?

If all of the metal used is nonferrous, it's safe, since
nonferrous alloys are not magnetic and will not be affected
by an MRI. However, since many older implants are made of
stainless steel or another ferrous alloy, most doctors will
err on the side of caution and avoid an MRI unless it's
known with certainty that all implanted materials are
nonferrous (e.g, from surgical records, etc.)

"anon" <[email hidden]> wrote in message
news:2004040118035116807%anon@anoncom...

Quoted message said:

On 2004-04-01 12:35:05 -0500, "Sharon"
<[email hidden]>

Quoted message said:

Quoted message said:

Can you guys tell me, true or false on these? The second
one I've heard from several doctors now; I get different
stories from everyone.

Probably because you're asking people who don't know what
they're talking about.

The people I've been asking have all been MD's. It's soooo
hard to find one that doesn't either [censored] me or push
their own medical agenda. Only one doctor I've ever been
to in my life (40 years now) has treated me like an
intelligent adult and partner in my health care.

Quoted message said:

Quoted message said:

1. Is Lodine aka Etodolac addictive? I know it's an
NSAID, and I

thought

Quoted message said:

Quoted message said:

that *non-steriodal* anti-inflammatories were not
addictive.

Neither NSAIDs nor steroids are addictive.

Well, I thought steroids were. In any case, thanks. This
doctor is clearly pushing her own agenda. Drugs too. I do
very well on Lodine. She wants me off it and taking a
DMARD instead. She also said she may put me on Embrel, a
biologic injectible. Even creepier, she's literally
*pushing* ultraset on me.

Me: I only have pain if I don't take my anti-inflammatory.
Her: That's good. But take the ultraset anytime you
feel pain. You can take it with the anti-inflammatory
too. And you can take as much as 4 ultrasets a day if
you want to. (Gives me a month's worth of sample
ultraset packages on my way out the door, PLUS a
prescription.)

Quoted message said:

Quoted message said:

2. If a person has an artificial joint, metal screws or
plates in a

bone,

Quoted message said:

Quoted message said:

is it safe for that person to get an MRI?

If all of the metal used is nonferrous, it's safe, since
nonferrous alloys are not magnetic and will not be
affected by an MRI. However, since many older implants
are made of stainless steel or another ferrous alloy,
most doctors will err on the side of caution and avoid
an MRI unless it's known with certainty that all
implanted materials are nonferrous (e.g, from surgical
records, etc.)

Ok, I'll write to my surgeon and ask for the composition
of my implants. Reumatologists and GP's never believe me
since I'm obviously just an ignorant patient, maybe
they'll believe a letter from the surgeon. What I don't
get is for the past few years the media and medical
insurance companies have been telling us to be "partners
with your doctor in your health care". I'm all for that.
Why is it that doctors still seem to be dictators who
dismiss my concerns and questions?

--
Sharon, Lurking As Usual
To reply, replace spammersmustdie with jcwoman1963

Sharon said:

Quoted message said:

Neither NSAIDs nor steroids are addictive.

Well, I thought steroids were.

Nope.

Quoted message said:

I do very well on Lodine. She wants me off it and taking a
DMARD instead.

Well, in fairness, long-term NSAID use carries a risk of GI
bleeding, which can be fatal. There's also the potential for
nephrotoxicity ("kidney damage"😉, also not good. That's not
to say that alternative medications are risk-free, but
NSAIDs aren't completely benign agents either, despite their
over-the-counter status.

Quoted message said:

She also said she may put me on Embrel, a biologic
injectible. Even creepier, she's literally *pushing*
ultraset on me.

Unlike NSAIDs, Embrel and other DMARDs have the potential to
slow down the progression of rheumatoid arthritis, which can
ultimately be crippling. That's probably why she's fired up
about it, and less so about strictly pain-relieving
approaches, attractive (and inexpensive) though they may
appear. At some point, Lodine may cease to help you, and if
your disease has progressed significantly by that time,
you'll likely be in a much worse position than if you'd gone
for the DMARD earlier on. As for Ultracet, it's generally
considered to be more effective (and safer for the stomach
and kidneys) than chronic NSAIDs, and less habit-forming
than narcotics.

Quoted message said:

Why is it that doctors still seem to be dictators who
dismiss my concerns and questions?

Dunno...did you ask your doctors that question?

"anon" <[email hidden]> wrote in message
news:2004040214481138165%anon@anoncom...

Quoted message said:

On 2004-04-02 11:21:08 -0500, "Sharon"
<[email hidden]>

Quoted message said:

Well, in fairness, long-term NSAID use carries a risk of
GI bleeding, which can be fatal. There's also the
potential for nephrotoxicity ("kidney damage"😉, also not
good. That's not to say that alternative medications are
risk-free, but NSAIDs aren't completely benign agents
either, despite their over-the-counter status.

Yep, I know. But I read the booklet about biologics
(embrel) she gave
me. Possible side effects include cancer. I think I'll take
my chances with the GI bleeding, thankyouverymuch.
Since for all you know i'm decrepit with gnarly fingers
and heavy flaring, I'll just mention that I'm an adult
with JRA in remission. This will make you cringe, but I
literally grew up on heavy doses of aspirin. In my
teens they started making me sick so that's when I
switched to prescription NSAIDS which worked better at
much smaller doses. I've tried them all at this point,
and I know which ones work for me and which ones don't.
Amazingly despite the NSAID diet, I never developed
serious GI bleeding (only barely) and no ulcers. I seem
to have an iron GI. Which isn't to say that I'm
immortal and will NEVER get GI problems. I know it's a
possiblity. But I'm comparing a personal track record
with the unknown risk of other horrible side effects
that other drugs might cause. I feel that my condition
doesn't warrant taking those unknown risks right now.

Quoted message said:

Unlike NSAIDs, Embrel and other DMARDs have the potential
to slow down the progression of rheumatoid arthritis,
which can ultimately be crippling. That's probably why
she's fired up about it, and less so

I understand. I don't think I have any progression,
though. My physical condition has been stable since my
early twenties. I'm going to a rheumatologist only for
routine care, monitoring in case I DO start getting flare-
ups and reactivated RA. She's not paying any attention to
my history, only what she sees today. (This is a new
doctor.) I have some permanent joint damage from flareups
I had when I was a kid. She seems to be looking at these
as if they were current or ongoing damage.

Quoted message said:

earlier on. As for Ultracet, it's generally considered to
be more effective (and safer for the stomach and kidneys)
than chronic NSAIDs, and less habit-forming than
narcotics.

So daily use of Ultraset is better for me than daily use
of NSAIDS? I'm of the camp that you don't throw drugs at
every little problem. I think sometimes doctors get too
gung-ho with the medications. I've read the reports where
doctors say their patients practically demand drugs to
fix their problems. I'm sure that does happen. But then
when a patient like me who comes along who doesn't want
to take a daily pill cocktail, they push it on us too.
I've overdosed several times in my life and they've all
been on prescriptions under a doctor's supervision. I
managed somehow to not get Reyes Syndrome from all the
baby aspirin mom had to feed me, but I did discover that
in high enough doses aspirin is hallucinogenic! I often
wonder if this is the reason I never got into illegal
drugs much as a teenager.

Quoted message said:

Quoted message said:

Why is it that doctors still seem to be dictators who
dismiss my concerns and questions?

Dunno...did you ask your doctors that question?

I would love to, but wouldn't that make them instantly
defensive? Not a good way to start a relationship. I'm
still in the search for a GP for regular physicals and
such. Sometimes I wonder if I can walk into the exam room
and start the conversation by saying I'm looking for a
primary care physician who will be a partner in my health
care, who will listen to my concerns and treat me as an
intelligent adult. But then I think that they'd instantly
peg me as a troublemaker or difficult patient and refuse
to see me. I've obviously had bad experiences with doctors
in the past, so I'm wary. But I honestly don't want to be
a bad patient. I just want a doctor who won't make me feel
like I'm being bullshitted or condescended to or ignored.
Years ago a GP told me to get a mammogram and I told her
that I'd heard it was painful so I felt unsure about it. I
was trying to begin a conversation so that she would put
at rest my fears. The correct answer would have been to be
honest with me, whether it really did hurt or not. If it
did hurt, say so but then suggest some ideas for coping or
psyching myself out of it. It didn't have to take more
than 5 minutes or so. The WRONG answer and the one she
actually gave me was "oh, that's just what people say to
annoy me" and then walk out the door. BTW, Anon thank you
very much. I wish I could have this conversation with my
doctors! I hope you don't think i'm just arguing with you
for the fun of arguing. I am really interested in a
doctor's point of view. (I know, I'm *assuming* you're a
doctor.) I've been browsing this newsgroup for a while and
there seem to be some doctors on here. It would be great
if someone would give me hints in how to relate to the
doctors in such a way as to get that 'partner in health".
In my experience they don't really care to work with
intelligent adults who ask questions and discuss the pros
and cons of various treatments. If I'm wrong, I'd like
some suggestions.

Sharon

Sharon said:

Yep, I know. But I read the booklet about biologics
(embrel) she gave
me. Possible side effects include cancer. I think I'll
take my chances with the GI bleeding,
thankyouverymuch.

Fair enough. If I were your doctor, I'd just write that in
your chart, and that'd be that. After the usual discussion
regarding probabilties and such. ;-)

Quoted message said:

She's not paying any attention to my history, only what
she sees today. (This is a new doctor.) I have some
permanent joint damage from flareups I had when I was a
kid. She seems to be looking at these as if they were
current or ongoing damage.

You should let her know your history, of course, if you
haven't done so already.

Quoted message said:

So daily use of Ultraset is better for me than daily
use of NSAIDS?

I wouldn't say that. For one thing, Ultracet is pretty
expensive. NSAIDs (most of them, anyway) are
relatively cheap. Both have risks. Neither is "better"
or "worse" overall.

Quoted message said:

I'm of the camp that you don't throw drugs at every
little problem.

Well, neither am I. However, medications certainly have
their place, and in this day and age, many patients (not
necessarily you) expect a quick fix for every ailment.
Whether that's appropriate or whether we should indulge them
is subject to debate.

Quoted message said:

But then when a patient like me who comes along who
doesn't want to take a daily pill cocktail, they push it
on us too.

Depends on the person and the pill(s). For my diabetics, for
example, I most certainly "push" a baby aspirin, an ACE
inhibitor, and...in many cases...a statin and metformin. For
my cardiac patients, I "push" aspirin, beta blockers,
statins, etc. There is clear evidence that these medications
provide substantial benefits that far outweigh their risks.
They have literally become the standard of care, and to
*not* push them is essentially malpractice. Patients can
protest, but I do my best to educate them as to why I think
they need the medication(s), and if they continue to refuse,
I document their refusal and the reason for it in their
chart. This is what's known as "covering my ass." Sad, but
unfortunately necessary in these times. You can bet that
I'll keep bringing them up from time to time, too. Just like
smoking cessation.

Quoted message said:

Quoted message said:

Quoted message said:

Why is it that doctors still seem to be dictators who
dismiss my concerns and questions?

Dunno...did you ask your doctors that question?

I would love to, but wouldn't that make them instantly
defensive?

Depends how you phrase the question, I suppose. ;-)

Quoted message said:

I'm still in the search for a GP for regular physicals
and such.

I recommend a board-certified family physician. (Hint:
there's no such thing as "GPs" anymore, at least not in the
U.S. of A.)

Quoted message said:

Sometimes I wonder if I can walk into the exam room and
start the conversation by saying I'm looking for a primary
care physician who will be a partner in my health care,
who will listen to my concerns and treat me as an
intelligent adult.

I'd definitely mention the "partner in health care" part
(music to my ears, personally). I'd leave out the part about
listening and treating you as an adult, unless your doctor
doesn't. Saying something like that beforehand is like
stamping a scarlet "D" ("difficult"😉 on your forehead. ;-)

Quoted message said:

I've obviously had bad experiences
with doctors in the past, so I'm wary.

Fair enough, but keep in mind that I'm also going to be wary
of a patient who has a long history of not being satisfied
with any of their doctors or treatments. However, I'm
usually willing to give such patients the benefit of the
doubt, knowing that the real bad apples will show their true
colors eventually. Remember, doctors *can* fire their
patients. They just have to do it correctly.

Quoted message said:

Years ago a GP told me to get a mammogram and I told
her that I'd heard it was painful so I felt unsure
about it.

Screening tests aren't always painless, but they're
certainly tolerable. Few things are more painful than being
told you have metastatic cancer, and early detection can go
a long way toward preventing that in the case of breast CA.
There are ways to make a mammogram more comfortable
(choosing a good mammography center, for one). It's never
going to be something you look forward to, but don't risk
dying because of the fear of a little discomfort. It's
probably not as bad as you think, anyway. As for "horror
stories" from other people, *never* let these dissuade you
from doing the right thing for yourself. One person's
experience is just that; *one* person's experience. It
doesn't have to be yours.

Quoted message said:

The WRONG answer and the one she actually gave me was "oh,
that's just what people say to annoy me" and then walk out
the door.

I agree. That's totally inappropriate.

Quoted message said:

BTW, Anon thank you very much. I wish I could have this
conversation with my doctors!

You can. Just remember that the doctor-patient relationship
is a very unique thing. You're not a "customer" (a purchaser
of goods or services), and they're not a "provider"
(regardless of the HMO industry's adoption of that
terminology). If you treat your doctor as a partner, I think
you'll find that they will respond in kind. That doesn't
mean being overly solicitous or inappropriately familiar,
however. You don't have to be friends with your doctor in
order to have a good doctor-patient relationship. All you
need is a common goal: your good health. Most doctors
appreciate patients who take an active role in their health
rather than a passive one ("Fix me!"😉, so do your part, and
let your doctor do theirs. Also, if you want your doctor to
be flexible, don't *you* be rigid. "I'm not taking that
medicine" is rigid; "I'm not getting a mammogram because it
hurts" is rigid. Instead, say something like "I'm concerned
about the possible side effects of this medicine", or "I'm
afraid the mammogram will be painful". I virtually guarantee
your doctor will respond better if you at least indicate
that a subject is open to discussion.

Quoted message said:

(I know, I'm *assuming* you're a doctor.)

I'm a board-certified family physician.

Good luck!

anon said:

You can. Just remember that the doctor-patient relationship
is a very unique thing. You're not a "customer" (a
purchaser of goods or services), and they're not a
"provider" (regardless of the HMO industry's adoption of
that terminology). If you treat your doctor as a partner, I
think you'll find that they will respond in kind. That
doesn't mean being overly solicitous or inappropriately
familiar, however. You don't have to be friends with your
doctor in order to have a good doctor-patient relationship.
All you need is a common goal: your good health. Most
doctors appreciate patients who take an active role in
their health rather than a passive one ("Fix me!"😉, so do
your part, and let your doctor do theirs. Also, if you want
your doctor to be flexible, don't *you* be rigid. "I'm not
taking that medicine" is rigid; "I'm not getting a
mammogram because it hurts" is rigid. Instead, say
something like "I'm concerned about the possible side
effects of this medicine", or "I'm afraid the mammogram
will be painful". I virtually guarantee your doctor will
respond better if you at least indicate that a subject is
open to discussion.

Another of the "Just trust me" ploys we've heard from the
medical establishment for years. If you've got an
interesting disease and/or suck up to god, he might deign to
give you the benefit of his knowledge (for an inflated price
of course). Otherwise, tough!

Fortunately the capitalist system will eventually rid us of
anachronisms like anon.

prescriptions under a doctor's supervision. I managed
somehow to not get
: Reyes Syndrome from all the baby aspirin mom had to feed
: me, but I did discover that in high enough doses aspirin
: is hallucinogenic! I often
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^-
^^^^

Yep. You can get sounds, or ringing in the ears, and
such. A reversible tinnitus. This is called an "anion-
gap" disturbance. The Acid-Base balance is out of
whack. Bad news.

My BF likes to tell this story of working in the local ER:

A woman came in complaining of hearing sounds. The ER docs
were uninterested and passed this "crazy lady" onto the
psychiatry service, so they called him in to see her.

Fortunately, the BF didn't accept this acute onset as being
a reason to drug her up, or offer up a Dx, and went on to
investigate further.

Well, whaddya know...Turns out: the "crazy lady" had been
taking too much Aspirin. <!>

He said it was very disappointing that his detection of an
anion-gap made the other Residents and medical students
finally come running to look at her (so they could see an
"anion gap" in real life). *blah* A good case for those
interested in the nit-picking field of Internal
Medicine.(The other field that the BF had considered; that
may be why he picked up this teensy "little" detail of an
anion-gap problem <G>, while others didn't investigate.)🙂

Moral of the story: if someone is acutely "crazy" -- look
for something medical factor, or crisis.

PS. This has even happened to me. Last year the outpt team i
was on had a schiz. pt. who was well controlled with
meds. He started getting restless and
verbalizing/behaving in his usual prodromal-relapse way
-- i had no idea, but my RN had known him for over a
decade -- so knew RN he was re-lapsing.

(FWIW, most LT pts tend to show the same signs of relapse
when it is beginning to re-occur. e.g you will notice them
doing their own little odd behaviours, and/or their own
particular strange ideas ("fixed delusions"😉 mentioned. In
my rotation, i saw this play itself out a few times.

My RN got him to the hospital. The acute worsening of is
"usual" stomach problems weren't *entirely* a delusion. A
flat-plate Abd X-ray showed the fellow was backed-up full of
stool. No *wonder* he complained about increasingly
regarding his 'stomach', and had stopped eating!

Cheers, Emma
🙂

In article <[email hidden]>,

Emma Chase VanCott said:

: prescriptions under a doctor's supervision. I managed
: somehow to not get Reyes Syndrome from all the baby
: aspirin mom had to feed me, but I did discover that in
: high enough doses aspirin is hallucinogenic! I often
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^-
^^^^

Yep. You can get sounds, or ringing in the ears, and
such. A reversible tinnitus. This is called an "anion-
gap" disturbance. The Acid-Base balance is out of whack.
Bad news.

My BF likes to tell this story of working in the local ER:

A woman came in complaining of hearing sounds. The ER docs
were uninterested and passed this "crazy lady" onto the
psychiatry service, so they called him in to see her.

Fortunately, the BF didn't accept this acute onset as being
a reason to drug her up, or offer up a Dx, and went on to
investigate further.

Well, whaddya know...Turns out: the "crazy lady" had been
taking too much Aspirin. <!>

He said it was very disappointing that his detection of an
anion-gap made the other Residents and medical students
finally come running to look at her (so they could see an
"anion gap" in real life). *blah* A good case for those
interested in the nit-picking field of Internal
Medicine.(The other field that the BF had considered; that
may be why he picked up this teensy "little" detail of an
anion-gap problem <G>, while others didn't investigate.)🙂

Moral of the story: if someone is acutely "crazy" -- look
for something medical factor, or crisis.

PS. This has even happened to me. Last year the outpt team
i was on had a schiz. pt. who was well controlled with
meds. He started getting restless and
verbalizing/behaving in his usual prodromal-relapse way
-- i had no idea, but my RN had known him for over a
decade -- so knew RN he was re-lapsing.

(FWIW, most LT pts tend to show the same signs of relapse
when it is beginning to re-occur. e.g you will notice them
doing their own little odd behaviours, and/or their own
particular strange ideas ("fixed delusions"😉 mentioned. In
my rotation, i saw this play itself out a few times.

My RN got him to the hospital. The acute worsening of is
"usual" stomach problems weren't *entirely* a delusion. A
flat-plate Abd X-ray showed the fellow was backed-up full
of stool. No *wonder* he complained about increasingly
regarding his 'stomach', and had stopped eating!

William Nolen, MD, in his book "The Making of a Surgeon,"
writes about an ER patient who was brought in acting very
erratic, so he tried to turf her to the psych department.
The psych doc took one look at her and said "Bill, this
woman's no nut. I bet she's bleeding internally from a
ruptured ectopic [pregnancy]." Which was indeed the case;
once the bleeding was stemmed and she had been transfused,
she was perfectly rational.

-- David Wright :: alphabeta at prodigy.net These are my
opinions only, but they're almost always correct. "If I
have not seen as far as others, it is because giants were
standing on my shoulders." (Hal Abelson, MIT)