Aspirin

I have been through the gamut of pain killers, especially in the past few years with my back problems.   When I was young, over the counter, all we had was aspirin.  Later on, acetaminophen and ibuprofen came on the scene.   And later, naproxen.  I have been prescribed Vioxx, and Celebrex, for inflammation. 

Acetaminophen never did anything for me.  I liked ibuprofen for a while.  When I found naproxen, I decided that was the best over the counter medication for me.  But, in the last few years, I have gone back to using Aspirin.  I am on a low dose regimen as prescribed by my cardiologist.  So, rather than combine medications, I just take a larger dose of Aspirin for pain.  I can feel it start to work in about 20 minutes.  It is amazing to me that an older, basic medication can be so effective!  

Medical Care

My PCP is a nurse practitioner in whom I have absolute confidence. She has never hesitated to check with her supervising physician if she is unsure of something, she is practical, concerned about cost of medications and treatment, and not replicating costs by adding extra visits.  

A few years ago, because I have high blood pressure and a family history of heart problems, she referred me to a cardiologist, whom I initially liked.  I became a little disenchanted with him when he sent me for a carotid artery scan, and then not only did not contact me with the results, did not respond, nor did anyone in his office respond, when I called to ask about the results.  Well, that lead me to believe that there was no problem, and when I saw my PCP next, she told me the results were something she did not think she had ever seen before: 0-15% blockage.  When she told me this, I thought the cardiologist probably ordered a test I did not need.  

I asked the PCP what other tests I should expect from the cardiologist, and she said basically, none, given my labs and other results.  And, she was right.  The cardiologist not only has not ordered anything else, but has relegated me to the care of his nurse practitioner, which tells me I am there only for maintenance, not treatment.  Originally, the cardiologist wanted to see me every three months, but I objected, because that would put me seeing both the cardiologist and my PCP during the same month twice a year, so I changed that. 

So, I saw the cardiologist nurse practitioner last in January.  And this week, I received an explanation of benefits from the insurance company that my appointment was not covered, because they billed for the wrong diagnosis.  When I called the insurance company, they informed me that the bill had been resubmitted with the correct diagnosis, and took my explanation of the reason for the visit, which the representative said fit with the rebilling and would be considered when the bill was resubmitted. I have to say, this did not instill confidence in me regarding the support staff in my cardiologists office.  So, my confidence in this service has continued to diminish.

I have a cardiology appointment in July. I am tempted to cancel it, and just ask for an appointment in January, when they can renew a medication. I don't know, I will probably keep the appointment in July, and  If there is nothing new, I will be content to see the cardiologist again in January, when they need to renew one of my medications.  And, then, I will ask to change appointments to once a year, unless something has changed. 

I hate going to the doctor.  I am having health problems, and I recognize that, but I do not feel the cardiologist is particularly responsive to me.

The PCP, on the other hand, is sharp. In my well check in April, she asked about joint pain, and when I described my joint pain, she did a blood test that detected uric acid (or something) in my system that lead her to believe I am prone to attacks of gouty arthritis.  She added a medication, and it has helped to relieve some of the burning joint pain in my feet and ankles.  It does not last 24 hours, so I am thinking I should change it to the morning, and it can wear off at night while I am asleep.   Hmmm.

Changinge my pill dispensing system

So I am on a bunch of medication.  For years, most of the pills were in blister packs. Then slowly, they were dispensed in bottles.  The last time I had my medications refilled, they were all in bottles.  This has thrown me.  The shape and size of the blister packs, and the immediate identification of the shape, size and color of the pills in the blister pack made it easy for me to know exactly what medication I was taking.  

No so with the bottles.  I have been so rattled by the change that I took my morning medication in the evening the day I went to Big, Loud and Live.  I told my colleague my mistake and said if something happened to me that was why.  By the intermission, we agreed that if I was going to feel the effects, I would have by then, so it was no big problem.

But, I am trying to be very careful about what pills I take when so I will not make another mistake.  

Nap Time

I do not like taking naps.  I generally wake up confused, frightened, disoriented.  I recall doing so when I was in junior high, and it took me the rest of the evening to get oriented.  I have had a couple of similar experiences through the years.  So, I do not take naps.

Something has happened, though, the last few weeks.  Not so much during the work day, but sometimes in the early evening, and more frequently on a Saturday or Sunday, or when I have a day off, in the afternoon. If I sit back and relax, get comfortable, especially when I am reading, but maybe when I am knitting, I want to close my eyes and doze off. And sometimes, I do. Not for long. But this is something I have never experienced before.

I have been thinking about it. I was wondering if it could be attributed to a medication I am taking. That is possible. But I have been on most of the medications I take for more than a couple of years now.  Except the Amlodipine, which was added a couple of months ago.  Tiredness is a side effect of Amlodipine, but I take it at night, so I would think the tiredness would not still be affecting me the next afternoon, when these naps often occur. I wonder if it is an aging thing.  Hmmm.

Weird.

Opiod Induced Constipation -Get Real

So, I am hearing this TV  commercial for Movantik https://www.movantikhcp.com/, which is prescribed to relieve opiod induced constipation.  Get real guys. 

I had surgery in July and was prescribed some pain medications after surgery. I was told to get a stool softener to help with constipation. The friend who drove me home from the hospital, and I talked about stopping at a store to get the stool softener, but we were so busy talking, we forgot to do that. I got home, and thought about it and decided I could use mineral oil, which I kept on hand for the cats, if they had constipation. 

So, that is what I used.  It worked very well. It did not taste good, but it is simple, inexpensive and easy to use.

Why would anyone want to use an expensive medicine for a common problem, when something simple like mineral oil works. Granted, it does not taste good.  But consider the cost/benefit.  I will go with mineral oil any time.

Taking My Pills

I am on medication that I am supposed to take morning and night. Well, I have some, but little trouble remembering to take my morning medications.  But my night time medications have baffled me. I finally set a reminder on the computer to prompt me to take the night time medication. That has really helped me.  Tonight, for the very first time, I remembered to take my night time medication before the reminder prompted me. I am a slow learner, but I can learn.

Medication

I really do not like to take medication.  There have been times in my life when I have consistently taken medication, but really would rather not.  I am now advised to take calcium and vitamin D, and I try to remember to take it.  But, I forget.  I really try to take the blood pressure medication I am prescribed.  It helps, but my blood pressure is all over the place, from too high to too low.  I also try to remember to take the medication for high cholesterol.

Last year, I sprained my ankle, and when I went to the doctor, I did not ask for pain medication. I can effectively use over the counter medication for that kind of problem. I did ask for assistance in treatment, and confirmation it was not broken, although, I knew it was not.  Confirmation was what I got.

I did go back to the doctor for my lower back pain and sciatica.  I was given an anti-inflammatory, which made a major difference, and I was sent to physical therapy, but had little results. I gained some strength back, and range of movement, but no pain relief beyond what the non-steroidal anti-inflammatory drug (NSAID) provided.

Eventually, I went for pain management, and was sent for an epidural-steroidal-injection.  The first one helped some.  But a few weeks later, the pain returned.  The second injection resulted in my being in horrible pain after the injection, and then not being able to tell there was any benefit after that.

I was sent back to physical therapy, and we did water therapy.  It was like someone flipped a switch.  By the time the insurance was exhausted, I decided, at the advice of a co-worker, to go to an exercise program where I could continue the exercises. The physical therapist thought that was wonderful: he gave me a copy of my regimen, which I had laminated, and started using for my regular routine.

I was on an NSAID, but the insurance company did not want to pay high dollar for it, so, the nurse practitioner that I see prescribed something else that gave me no relief. So, then she suggested something else. It gave me a little tummy problem at first, but as time progressed, the stomach upset became increasingly uncomfortable. I stopped using the medication.

I could call my provider and tell her I cannot take the medication.  I have decided not to.  I am learning to manage my pain in other ways.  I do not want surgery.  I am currently at a point where I can manage my activity and stress and keep the pain to a minimum.  Also, the various physical exercises from physical therapy can relieve the pain.  I will go for that versus surgery. And, I do not want medication if I can avoid it.

Pill Packs

So, I take prescribed medication, morning and night.  When I first started taking these medications, they came in plastic pill packs that contain blister cards of medication.  The cards were sometimes a little difficult to pull out of the plastic case, but not too bad.

Now, the blister cards some in cardboard sleeves.  The cards are tough to pull out, and after several weeks, the cardboard cards get soft, and bent and become difficult to pull out.  So, quite unsafely, I pull the cards out and leave them on top of the sleeve.  I  know this is  not safe.  There is nothing identifying on the card, that I can see.  So, if I get them mixed up, I would have to be able to identify the pills some how. I do not have small children who can get into the medication, but if the cats decided to play with the cards, there could be a problem.

I am not sure why pharmaceutical companies do pill packs like this instead of pill bottles.  It is not more convenient for me, and in fact is less convenient.  I suspect there is an economic reason for this.

Interestingly, I discovered a pill identifier on line http://www.drugs.com/imprints.php?drugname=pack.  I tried it for one of my pills, and it worked!  This is really good to know!

Weather and Yard Work

We have had rain on and off now since last week.  I had thought to mow the yard last Sunday, but it was wet, and I hate to mow when it is wet.  And, on Saturday, I had done some serious housework, and my back was bothering me.  So, I let it go.  I thought I might mow one night during the week, as the temperatures were not suppose to be too high.

But, it continued to be wet.  And, my back still was bothering me.  I laid off on a couple of the exercises that I thought was aggravated the pain, as it felt more like muscle pain than the nerve pain I know I have, and that helped.  I also remembered to eat bananas, because some of the muscle pain was spasms, which might be due to low potassium.

I have kept to the schedule of water therapy regularly. I started feeling better by Wednesday.  But, when I left work, I saw lightning.  I did not check on the pool status.  I do not care if the pool was open, if I saw lightning, I did not need to go to the pool, so I did "dry exercises"instead.  Thursday, I did not exercise, and Friday, I was hurting.  But I was in a workshop most of the day, and went to the pool. And felt much better Friday night.

Today, I ran errands in the morning, and rested until later in the afternoon, then did housework and yard work! After the housework, which usually bothers my back, I was not hurting.  And, I was not hurting after the yard work!

I am hoping to do more yard work on Sunday.  I have to remember that I have to rest a lot.  But that is okay.

I am now taking Arthrotec http://www.rxlist.com/arthrotec-drug.htm as my nsaid http://en.wikipedia.org/wiki/Non-steroidal_anti-inflammatory_drug. I am not sure it is as good as Celebrex http://www.celebrex.com/default.aspx. But, it makes the insurance happy. I take the Arthrotec twice a day, which is helpful to me  I forget to take the pravastatin http://www.drugs.com/pro/pravastatin.html  at bedtime, but my provider agreed I could try it in the morning, or do as I had started doing, and take it before bedtime.  So, with taking the Arthrotec, I am reminded to take the pravastatin, too.

So, the sun came out late this afternoon for a while. We may have some weather blow in tonight, but I am hoping for some clearing so I can do some yard work. We shall see.

I Am So Mad At My Insurance Company

I am so mad at my insurance company, United Health Care http://www.uhc.com.  I wrote about needing to change prescriptions.  Talking to my doctor's office today, they switched me to Arthrotec, http://www.rxlist.com/arthrotec-drug.htm which can be had in generic, DICLOFENAC SODIUM AND MISOPROSTOL. I checked with the insurance, and they said it went through. 

So, I picked this up tonight.  It cost more for me than the Celebrex cost me.  The diclofenac is listed on the Wal-Mart $4 list, but not the combination medication.  The misoprostol helps to protect your stomach.

I don't get it.  The insurance will have me spend more money for a generic than I would spend with a brand name medication that was working.

I hope this works.  It will be worth it if it does.

Wonder Drug

I was limping severely at work today.  A co-worker, a physician's assistant, asked about the limp and what I took for it.  I told the PAs of the over the counter medications, I have taken naproxen and ibuprofen, but what works best is aspirin.  I just do not bring aspirin to work.  I should.  It would make a difference.

The PA told me that during school, they were told about this wonder drug that was an antipyretic, non-steroidal anti-inflammatory drug, pain reducer, and blood thinner for those who are at risk of heart disease due to blood thickening.   As the PA said, the class was amazed, but the drug is aspirin.  Before we had acetaminophen, naproxen, and ibuprofen, we had aspirin. The co-worker commented on heroic tough guys in novels chewing on aspirin.  Remember the lowly aspirin.  It does work.

I took some a while ago, and the pain in my hip has diminished drastically.