Department of Human Resources

“Surviving the Cure”

by Tom Luddecke

In the movie Butch Cassidy and the Sundance Kid, there is a scene in which the two main characters are cornered high on a cliff overlooking a raging river and their only escape is to jump into the river far below.  The usually confident Sundance is more than a little reluctant to take the plunge, and when pressed by Butch finally confesses, “I can’t swim.”  Butch pauses and then says, “Why you crazy bastard, the fall will probably kill you!”

This is exactly how I feel watching the medicine commercials on television.  They claim to help us escape the ailment we have, but their side effects could cause us more harm.

If you have ever suffered the searing torment of daytime television from early morning until after the final Jeopardy question; the time when most seniors exit the demographic viewing pool, then you have seen all those ads for medications.  They are ubiquitous during those time slots and pretty much follow the same three-part script.  In the first part you are introduced to the gloomy, despairing, embarrassing, debilitating, or uncomfortable physical condition that could afflict us. In the second part of the commercial, the cheery, hopeful doctor or the overbearing, meddlesome neighbor informs you of the remedial properties of a salvation drug.  Both these parts occur in the first fifteen seconds of the commercial.  Then the remainder of the time is taken up by the final part that presents a laundry list of disclaimers which the legal departments of the major pharmaceutical companies insist on including.

Now I understand why this is done, but what is most unnerving is not only the number of possible side effects presented, but the severity of health risks they pose individually or collectively.  Without question many of these risks carry far greater consequences than the actual ailment they are meant to alleviate.  This is why these commercials always end with the warning that before taking this drug always consult with your physician or mortician whichever comes first.

I realize that these risks are intended only to be precautionary warnings and affect only a small percentage of patients, but the sobering reality is that someone, sometime or somehow, developed one of these side effects or how else would they have come to light?  As further proof of their existence is the plethora of ambulance chasing law firm ads soliciting calls from the victims of some of these drug side effects.

By way of example I am now going to use one of the medications I am currently taking and list its possible declared side effects.  Even though the list is mind-numbingly long, I’m afraid you are going to have to put up with it; after all, I am exposing my personal medical condition to you.  I am not going to specifically identify the drug or the pharmaceutical company, even though they themselves freely delineate these risks ad nauseam on their own ads, web sites, and products.  It’s just that I don’t want that big money coming after me.

The drug is a NSAID (non-steroidal anti-inflammatory drug) used primarily to treat rheumatoid arthritis.  The possible light, or as I’ve seen some medications call them, bothersome side effects are: (from this point on, my personal comments are the ones in parentheses) constipation, diarrhea (could possibly be the wonder drug that causes and cures all in one pill), dizziness, gas, headaches, heartburn, upset stomach, and stuffy nose.  I can live with most of these as long as the medication does what it is meant to do, although the constipation and diarrhea could be a real bitch.

The following is now a catalog of the more severe side effects: severe allergic reactions such as rash, hives, itching, trouble breathing, swelling of the mouth, face, lips, or tongue, bloody or black tarry stools (this one is especially unsettling if you have also exhibited one of the bothersome effects listed above), change in the amount of urine produced (this might not be such a bad thing as it could cut down on my adult diaper cost – there, I just admitted another of my medical circumstances to you- so keep reading. You owe me.), confusion (and just how do I recognize this?), dark urine ( traditionally used with red meats, pastas, and strong cheeses), depression (no kidding!), fainting, fast or irregular heartbeat, fever, chills, or persistent sore throat, hearing loss, mental or mood changes, numbness of arm or leg, one-sided weakness, red, swollen, blistered or peeling skin, ringing in the ears (however this will not be detected if suffering from the hearing loss side effect), seizures, severe headaches, or dizziness, severe or persistent stomach pain or nausea, severe vomiting, shortness of breath, sudden or unexplained weigh gain ( it’s the meds, honest!), swelling of hands, legs or feet, unusual bruising or bleeding, unusual joint or muscle pain ( now keep in mind those last two are symptoms that prompted the use of this drug in the first place), unusual tiredness or weakness, vision or speech changes ( I now speak fluent Uzbek), vomit that looks like coffee grounds ( which could describe any given Sunday morning after a raucous Saturday night), and yellowing of the skin or eyes (sounds a bit jaundice to me).

Then lastly, but most definitely not least, is this gem; may increase chance of heart attack or stroke that can lead to death.  This chance increases if you have heart disease (whoa…whoa…whoa, back it up – beep, beep, beep – can lead to death?!  I didn’t sign on for this.  I just wanted those old aches and pains relieved!) or risk factors for it, such as high blood pressure, or if taken for long periods ( I have been ingesting this, what now appears to be a death pill, for approximately fifteen to twenty years – is that considered a long period?).

Are you kidding?  The inventory of possible side effects for this one drug reads like the most wanted maladies on the World Health Organization’s hit list.  I mean it goes from constipation to death in one commercial.  After hearing all this, tell me who in their right mind would voluntarily opt for this medication?  Don’t you think you should get what you signed up for with this drug and not rheumatoid arthritis pain relief with a side order of apocalyptic pestilence!  I’m sure Socrates would have blanched at this logic. Socks, here’s your hemlock.  Now in the few minutes it will take to kill you, you might experience mood changes or a ringing in your ears.  Just so you know.

Just imagine if everyday food items, say Oreos®, came with a possible side effects warning as well:  eating of this delectable sandwich cookie may cause a rise in gluten levels, an increase in hyperactivity – especially in children, a craving for cold milk, unusual swelling in the butt or stomach areas, an unnatural impulse to twist things apart leading to separation anxieties, severe increase in sugar levels in diabetics or may cause the onset of Type 2 adult diabetes, or poor eating habits that can lead to milk spraying from nose – which could then lead to death by choking or embarrassment. 

Now this described NSAID is just one of the medications I am currently involved with.  Some of the side effects are repeated with the others, but some new ones noted on the labels are: irreversible damage to the retina of the eye, twitching or uncontrolled movement (which describes my dance form to a T), loss of balance or coordination (ditto the previous), light sensitivity, seeing halos around lights, pale skin (all vampiric traits), and unusual thoughts or behavior (which might be my main affliction according to my family and friends).

Apparently another side effect of many drugs is that you have a diminished capacity to operate heavy equipment, which in itself is a bit misleading and relative.  Are they talking here about a jack hammer or a M1A1 Abrams tank – neither of which I can effectively handle even without the meds.

Then there are some disclaimers that they warn you about which might cause one to pause and ponder why they are even there; such as the one for erections lasting longer than four hours please consult your physician.  I don’t think I’m out of bounds in stating that is the purpose of the drug.  Shouldn’t they perhaps be charging extra for such a benefit?  That’s like an aspirin company stating for periods without a headache lasting longer than four hours please consult your doctor.  And that begs yet another question.  Just why are you consulting your doctor about a marathon stiffy?  What’s he going to do, whack it with ruler to subdue the beast?

The obvious dilemma at hand is that after hearing a litany of adverse secondary effects, do we still want to risk taking the drug or would we rather live with the ailment we already have and know?  I suppose the answer lies in the nature and gravity of the ailment. Up until I reached upper, upper middle age, I even hated absorbing an aspirin into my mortal coil.  However, once I reached the AARP zone, all of a sudden things I previously ignored suddenly became cause célèbre for a new medication.  Even now I still try to rebel and continually ask my physicians if I really need to keep tethering myself to these drugs.  I express my concern over all the side effects and explain that they make me feel like I’m constantly playing Russian roulette.  My doctors all reassure me that the dosage I am on is not that high and as long as I get this or that checked out on a regular basis I should be fine.  I guess they must convince most of us because we just about all take our medications and knowing the disorder we have over the one we do not have and may not even come down with is further inducement.

By the way, in case you didn’t recall the movie scene referred to at the beginning of this piece, the Sundance Kid does jump anyway and does survive the fall, so I imagine I will stay the course, but I’ll be keeping that 1-800-NASTY MED law firm number on speed dial.  I have to stop now, because this whole thing is giving me a headache and I haven’t had one of those for hours.  I’m not sure but I think I’m supposed to call someone if that happens, but then again I suffer from confusion and unusual thoughts.

“Colonoscopy 101”

by Jim Upton

When I phoned to make my annual appointment at the clinic, the receptionist told me my doctor had retired.

“Retired?” There’d been no email or letter. “So who’s taken over her practice?”

“No one. But we have three doctors accepting new patients.”

I chose the woman because female doctors tend to be more understanding than their male colleagues.

At our meeting she proposed expanding the usual battery of tests.

“Why?”

“Well, I’m your doctor now and we’re making a fresh start. I want to have a number of things checked out.”

Among them was my colon. I had discussed a colonoscopy with my former doctor, but knowing my healthy eating habits and general physical condition, she hadn’t insisted on it. All that changed with my new physician. “Any man over 50 should have one,” she said, “and you’re well past the due date.”

She gave me a form requesting the procedure and told me to go to the hospital and make an appointment, “because you’ll never reach them by phone.”

Two months later, during my summer vacation, I headed over to the hospital where my broken foot had been treated 15 years before. Once I found the proper department and eased my way through the crowded waiting room, an overworked receptionist told me it would take months to even see a doctor, let alone have a colonoscopy.

I decided to try another hospital where I had my shoulder operation seven years ago and was directed to an office on the sixteenth floor. A woman took my request and said I’d be phoned in three months.

Five months later I was called and given an appointment with the doctor. When I met him in November he was in an upbeat mood and explained that after the lungs, cancer of the colon was the biggest killer of men in Canada. “Your case doesn’t look urgent,” he said, “so we’ll probably schedule you for the spring.”

“You mean like April?”

“More like June.” Then he lowered his voice. “Of course, if your employer covers this or you prefer to pay yourself, I can do it at a private clinic in a couple of weeks.” Since neither was the case, I declined his offer.

In May I was called, given an appointment, and told I’d receive further instructions by mail. In the weeks leading up to my colonoscopy, I discovered several colleagues at work had recently undergone the same procedure. While men are reluctant to talk about certain bodily functions, it turns out they enjoy sharing memories of prepping for a colonoscopy. Stan, a slim and muscular 50 year-old, described how he had “documented” the experience by taking photos of his bowel movements, while Martin explained that after drinking the cleansing solution, it’s not advisable to stray far from the toilet.

So I was surprised when a full two hours after swallowing the orange-flavored mixture with five ounces of water, I still felt no need to visit the bathroom. Shortly after, all that changed, and for the next 30 minutes I remained glued to the toilet seat.

The following day I went to the hospital and found the gastroenterology department. The receptionist took my medicare and hospital cards, slipped a plastic bracelet on my wrist, handed over a file folder, and told me to go through the double doors to room 400.

I found myself in a small reception area where several people in blue hospital gowns were sitting on straight-backed chairs. I wandered around until someone pointed down a short hallway and said “last door on the left.” When I peeked inside, a small woman dressed in green pants and matching top was working at a desk. She said hello, took my file folder, and began questioning me. The information I’d received by mail explained I would have to be accompanied by someone on my release and couldn’t drive a car home.

“So who is meeting you?” she asked.

“My friend is coming.”

“Coming here, to the seventh floor?”

“No, we agreed to meet on the ground floor, you know, on those benches where you wait to get your hospital card. He’s coming after work.”

“We don’t allow people to leave this floor unaccompanied after they’ve been medicated. What’s your friend’s name?”

“Peter.”

“Can you call him at work and tell him to come up here to the seventh floor?”

“He works in construction and doesn’t carry his cell phone on the job. He’ll meet me downstairs.”

“Uh huh. Well you can’t leave here unaccompanied.”

“I didn’t come by car so I’m not going to drive home. If I take the bus what’s the problem?”

“One of the effects of the medication is short-term amnesia. You might get lost.”

“So I can’t even take the bus home?”

“You can if someone is with you.”

She gave me a couple of blue hospital gowns and a piece of plastic, then directed me to an adjoining cubicle and said, “Take your clothes off and put them in this bag. Tie the first gown at the back and the second one in front. You can keep your shoes and socks on.”

Five minutes later I’m sitting on a chair wearing two hospital gowns and balancing my clothes in a plastic bag on my lap while wearing black socks and loafers. I glance up from my newspaper as the nurse returns and leans against the corner of the wall opposite me.

“I’ve consulted the doctor about your ‘problem,’” she says, looking at me like I’m a disobedient school boy. “He’s willing to let you do the procedure without medication. Then you can leave on your own.”

“Okay,” I say. “The medication, that’s just to relax you?”

“To relax you and reduce any pain you might feel. If you change your mind in there, they can give you medication. But then you won’t be able to leave on your own.”

“All right then. We’ll do it without medication.”

More people arrive as I sit in the waiting room. Some have file folders like mine. Others are there to meet those being discharged from the recovery room. If they look lost, I point down the hallway to the nurse’s cubbyhole and begin to feel useful.

Then another nurse dressed in blue calls my name. As I rise and move towards her all my clothes fall out of the bag and onto the floor. “Here,” she says, “we’ll put those back in the bag and tie it so nothing falls out.” I take an immediate liking to her. She’s obviously a practical woman.

She leads me into a small room with a hospital bed on wheels and tells me to put my clothes, backpack, and shoes on the plastic shelf under the bed and lie down on my back. As she sticks an oxygen tube up each nostril, I notice a large machine to the right with a long arm and a thin hose attached to it. Music is playing and there’s a computer screen to the left of the bed.

The doctor arrives, asks how I am, then explains the procedure in a few seconds, adding that there is a very slight risk of making a small hole in my colon and if that happens there will be an immediate operation to close it.

“Any questions?”  I shake my head. “Then I need you to sign this consent form stating everything I’ve just told you.” He hands me the form on a clipboard and gives me a pen. After I scrawl my name at the bottom of the sheet, he asks me to turn on my left side.

“Oookaaay,” he says, dragging the word out the way people do when they’re really into their work. “We’ve been having a good afternoon. Everything’s gone smoothly up to now. Boy what a contrast with this morning.” The nurse nods in agreement.

I don’t want to know what happened earlier so I change the subject. “How many of these do you do a day?”

“Sixteen,” he says and then I feel something poking up my behind.

Once the tube is inside I try not to look at the screen to my left where a pink fleshy thing is expanding and contracting. After a couple of minutes I feel something roaming around inside my mid-section. “Now I know what it must be like for pregnant women,” I say.

“Yep,” he replies, “you’ll notice some movement as we negotiate the curves.”

It’s all over in a few minutes, and as the nurse begins to wheel me out, I ask when I’ll know the results. “Right now,” she says and just then the doctor re-enters the room and hands me a sheet of paper with two color photos showing the inside of my colon.

“Here’s a memento for you and I’ll send a copy to your doctor. Everything is fine.” I thank him as the nurse pushes my bed across the hallway and deposits me in the recovery room.

“No meds,” she says to a nurse in green. “He can go home.”

The other nurse wraps a blood pressure band over my arm, checks the reading, pulls the curtains around my bed, and tells me I can change back into my clothes and skedaddle.

I’m out in the street 35 minutes after my scheduled appointment. By the time I arrive home I’m feeling so good I finish the spring cleaning of my apartment before breaking my fast.

After dinner I pull out the paper the doctor gave me and try not to look at the photos. Under recommendation it says, “Repeat colonoscopy in seven to ten years.”  I grab a post-it, write “take someone along next time,” and stick it on the sheet.

Then I go online and google dating services.