“The drug has been known to cause skin to fall off,” the young doctor says as he adjusts his pink silk tie. “That’s extremely rare. I’ve never seen a case in all my years of practice.”
Art and I sit knee to knee with him in a closet-sized examining room in the hospital’s rheumatology department. I have just asked about the possible side effects of a medication he recommended that my husband try. A painful episode of gout, Art’s third, this time an attack to a finger long misshapen by osteoarthritis, has him looking for a preventative solution. He shoots me a look that says, Janet, let me deal with this. He and the newest specialist in our retinue of medical personnel agree to take a wait and see approach; I'm relieved, but I don’t have to tolerate the pain.
I’m afraid of the pharmaceutical industry’s influence over doctors and the public...
We live in Boston, within walking distance of world-class hospitals and physicians, a tangible advantage now that we’re in our 70s. But I’m ambivalent about all the tests and drugs available to people like us. I comply with the basics: mammograms and blood pressure readings; dental X-rays and root canals; full-body scans at the dermatologist and a colonoscopy every decade or two. But when it comes to medication, my attitude is that less is more. I’m afraid of the pharmaceutical industry’s influence over doctors and the public, the former recommending and the latter taking drugs as poisonous as they might be helpful. But I’m lucky to have few conditions requiring medication, and I decline drugs when I think the risks might outweigh the benefits.
For example, what had sounded too good to be true -- a new drug that could stimulate bone growth in post-menopausal women — is reportedly responsible for spontaneous fractures and horrific death of jawbones in some of the women taking it. The Internet is full of gruesome stories.
“Did you see the Times article?” I ask my friend, Carol. We’d both been taking this very same bisphosphonate drug for bone loss. Would I continue to put myself at risk because of fear that I might fall and fracture my hip someday? No. My doctor protests my decision until I ask, “What advice would you give to your mother if her bone scans looked like mine?”
“I’d tell her to take the medication.” Then he shrugs and adds, “She’d probably ignore me.”
I call my daughter-in-law, a physician in Portland, Oregon, read her my numbers from a recent bone scan, and ask the same question, “What would you tell your mother to do?”
“Mom’s so active, just like you are. What’s the point? If either of you breaks a bone, you’ll heal quickly enough,” she says. My shoulders relax; someone I trust has corroborated my decision. But how confusing. I also trust my PCP, even though he advocates taking the drug. I called Carol to tell her I'm quitting; she’s decided to continue, at least for the near term.
“Whoa, looks like you’ve got a CVS store here,” my son Kevin says after looking in the cabinet under Art’s bathroom sink for some cough medicine. His stepfather hoards medicines of all kinds. He wants to be prepared, just in case. He’s suffered from many more conditions than I have: high blood pressure and cholesterol, kidney stones, an eye infection, acid reflux, allergies, a recurring respiratory condition, osteoarthritis and, now, gout. The multitude of drugs makes me shudder. Morning pills. Evening pills. He’s got a system, augmented from time to time with Advil and Theraflu, Comtrex and nasal spray.
...I keep a close eye on my husband’s skin for symptoms of flaking that, thankfully, never appear. Seems my worrying is the only side effect this time round.
My experience is that stomach aches and sore muscles will feel better tomorrow — just let the body heal itself. Stay away from doctors — they can always find something wrong. But Art believes in a preventative approach to staving off disaster, one check-up at a time. We share the same PCP, dermatologist and dentist… and the list continues to grow. What we don’t share is my skepticism or his willingness to look for relief through the wonders of science. Maybe we’re both right in our different approaches to risk vs. reward when it comes to health and comfort.
When gout threatens another attack, Art calls the young rheumatologist and asks for a prescription for the drug they discussed. I don’t argue, but I keep a close eye on my husband’s skin for symptoms of flaking that, thankfully, never appear. Seems my worrying is the only side effect this time round.