DEAR DR. GOTT:
Numerous times you have mentioned that you feel a particular patient is taking too many medications. I am curious as to what your thoughts might be regarding my situation. I am a fit and trim 62-year-old woman. I am five feet tall and weigh 105 pounds. Female longevity runs on both sides of my family. Both my grandmothers lived into their nineties and my mother is in excellent health at 87. My brother and grandfather both died from ruptured aneurysms.
I am trying not to be an exception to that trend. I exercise daily within the limits of my health status. To look at me no one would ever guess I have several health issues.
In 1992 I was diagnosed with acute myelogenous leukemia and after induction and two consolidation treatments went into remission. The treatment damaged my immune system, kidneys, heart, and thyroid gland. I now have dilated cardiomyopathy, congestive heart failure, hypothyroidism, and kidney issues. I also have lupus (SLE), IBS and two cerebral aneurysms (no treatment thus far).
I take a lot of medications and often wonder if they are helping me or doing more harm. I am doing very well despite my health restrictions and am not complaining. I am just curious of your opinion about my situation.
My prescription medications include Coumadin, Coreg, Synthroid, Plaquenil, prednisone, Spironolactone, and HyoMax ER. My over-the-counter medications and supplements are Coenzyme Q10, an 81 mg aspirin, a probiotic, a multivitamin, calcium plus magnesium, vitamin D3, and glucosamine/chondroitin.
DEAR READER:
You have a plethora of medical problems and, thus, medications.
The Coumadin, Coreg, aspirin, and Co-Q10 are for your heart and/or aneurysms. The spironolactone is probably for your kidneys as well as your heart. Synthroid is for your underactive thyroid gland. The Plaquenil and prednisone are for your lupus. The HyoMax ER is for your irritable bowel syndrome. I assume you are taking the probiotic for the IBS, the multivitamin for general health, the glucosamine/chondroitin for joint pain (likely from the lupus), and the calcium, magnesium and vitamin D for osteopenia, osteoporosis or as a preventive for these conditions.
When broken down into categories, your medications appear to be appropriate. While there are several (14 in total), it is important to take into account that you are also dealing with seven disorders (most of which are potentially serious).
Lupus is a chronic autoimmune disorder that causes inflammation which can affect the skin, joints, kidneys and other organs. Autoimmune diseases may appear when the body mistakenly attacks its own tissues as foreign.
Congestive heart failure is a life-threatening condition that occurs when the heart cannot pump enough oxygenated blood to the body. It can be caused by dilated cardiomyopathy which is a condition that causes the heart to enlarge and weaken.
Brain aneurysms are areas of blood vessels in the brain that weaken causing that area to balloon out. There are several types but in any variety there is a risk of rupture, leak or damage to surrounding areas. Ruptured or burst cerebral aneurysms are very often deadly (as you know). One quarter of individuals with a rupture die within 24 hours, another quarter die within three months and of the surviving 50%, half will have some sort of permanent disability. Because of the risk of damage or death most physicians recommend non-surgical treatment such as lowering blood pressure. If the aneurysm causes severe symptoms surgical repair may be attempted.
Your hypothyroidism and IBS are the least of your worries. As long as your supplemental thyroid hormone keeps your level within normal range, you should not experience any symptoms. IBS is not harmful but often needs to be treated to prevent dehydration and rectal damage caused by the diarrhea type and intestinal blockage by the constipation type.
As for your kidney issues, I am unsure what these are. You are currently taking a diuretic and lupus treatment so further damage is likely kept to a minimum.
I know in most cases, I recommend individuals speak to their physicians about reducing their prescription medications but in your case, I feel they are beneficial or vital to your wellbeing. If you wanted to reduce your number of non-prescriptions meds, I would recommend you drop the multivitamin and switch to a calcium plus D supplement rather than a calcium plus magnesium supplement and a separate vitamin D pill. If you eat a healthful diet with high calcium foods and do not have any bone loss issues you may want to postpone the supplements but they are not harming you as far as I can tell. You can also use topical joint pain relievers such as castor oil or Castiva rather than the glucosamine/chondroitin.
To give you related information, I am sending you copies of my Health Reports “Coronary Artery Disease”, “Kidney Disorders” and “Consumer Tips on Medicine”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 per report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).
About Dr. Gott