Side Effects

Side effects.  Every medication has them.  Some are mild, some are annoying, and some are downright dangerous.

When doctors write a prescription, they mention that some people experience side effects, and if certain bizarre things happen, the patient should phone the doctor.

How do we keep track?

If you get one antibiotic to take for two weeks, it isn’t so hard.  First, because it’s for a short time period, and also because it’s only one prescription.  Multiple medications are a different story.  Different meds from different doctors over a number of different appointments for multiple years, and somewhere along the line, all those potential side effects start to blur together.

What makes a side effect serious enough to warrant a call to the doctor?  Cough.  That’s that big one I remember.  Surely there must be others, but I don’t recall any more what side effects I’m supposed to watch out for.

Then last week I noticed a couple bruises on my legs.  Wow!  Where did those come from?  The next day there was a huge bruise on my arm.  I sure think I’d remember doing something to get all these bruises, but I haven’t done anything.  Two days later, five more bruises on my legs.  What could I possibly have done… Wait a minute!… Is this listed on one of those medication side-effect sheets I got from the pharmacy?

Now I’m certainly not looking for more reasons to seek medical care, but I realized that aside from the dreaded cough that my doctor stressed would be urgent, I have no idea if any other side effects would warrant a phone call to the doctor’s office.  I realized that even though much of my information is very well organized, I haven’t done anything at all about keeping track of medication side effects.

Out came my file so that I could re-read information from the pharmacy.  Unusual bruising… Turns out that two of my medications list this as a side effect that should warrant contacting the doctor immediately.

There are others, too.  Just after commenting to a friend that it looks like I have athlete’s foot on my fingers, there on the patient information sheets I discovered that three of my prescriptions list peeling skin as a reason to call the doctor.

It was interesting reviewing all the information for all the meds at the same time.  Imagine my surprise when I found chest pain listed on the “call the doctor immediately” list of FIVE of my prescriptions.  Um… I think I mentioned this at my last appointment, and the doctor didn’t even give it a second’s thought.  If it wasn’t important in the office, I don’t think it warrants a phone call now.

If something I brought up at an appointment didn’t faze my doctor, it’s hard to disrupt her day for anything else that seems trivial in comparison.  Sorry to bother you, but this medication says to phone if… Then again, I really have no way of evaluating what’s serious and what isn’t;  all I know about the side effects is what’s in the patient info sheet distributed by my pharmacy.

There needs to be a way to keep track of potential side effects – and to know which of those are considered normal and which ones need to be addressed promptly.  I have a couple ideas about how I could keep track of things, but haven’t yet decided which one would work best.  Obviously this is something to which I’ll need to give more thought.

***

Still waiting on lab results from my daughter’s appointment.  I’ll post when I know more.  Thank you for all your kind thoughts and support.

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7 thoughts on “Side Effects

  1. I’ve wondered about this too, Socks. When you’re taking a lot of different medications, each with a long list of mild/dangerous side effects, it’s hard to remember them all and time consuming looking them up (although the Internet HAS made that much easier). More importantly, as you note, you wouldn’t necessarily think of a bruise as a medication side effect, so it’s easy to overlook.

    I’ve also wondered about how the various medication interact with one another and how that interaction might change the severity, etc. of individual side effects. It doesn’t surprise me that doctors might not react to reports of isolated symptoms (like chest pains, although you’d think THAT would get some attention!) when there are so many to keep track of in many, many different patients.

    I usually put the info sheets from the pharmacy into a three-ring binder where I can find them easily, should I have a concern about side effects. I also peruse them now and then just to keep myself familiar with them. And I tell myself that most side effects occur in a very small proportion of patients taking the medication; the ones I’ll get concerned about are the ones that are preceded by: “CALL YOUR DOCTOR IF…”

    If you can come up with a good way to keep track of this stuff, market it. You’ll be rich! ;o)

    • My problem is that when I started reading all those lists, I had four things on the CALL YOUR DOCTOR IF… lists :O

      I think I read (rxlist.com?) that drug interactions are based on only those two drugs. Nobody ever looks at polypharmacy issues, so we don’t really know. I figure my rheumy is using this combination of drugs on a lot of people and would know if there tended to be problems.

      Keeping the pharmacy info sheets in 3-ring binder for easy access is a good idea. I keep mine in the file folder with my EOBs.

  2. I agree that it is tough to keep track of all the side effects. As far as the drug interactions, if you have a good pharmacist they will let you know if one drug looks like it will interact poorly with another. The problem there is that you need a very good pharmacist.

    Sounds to me like your bruising problem should be called into the doctor. That sounds like an awful lot of unexplained bruises to me. If you have no idea where they are coming they could be a sign of liver problems.

    • I think I have a pretty good pharmacist. It’s worth it when you take as many drugs as we have to to fight this disease, isn’t it?

      Thank you. I did call the doctor about the bruises once I realized that it could be a problem. I stopped the NSAID to see if that’s a factor, and haven’t found any new bruises, so the question now is whether or not the two things are related. I have lab work again soon, too. With my PCP, if I call with any questions, they want to see me. With my rheumy, they try to handle as much as possible over the phone.

  3. Side effects can be a real pain in the neck, currently I’m taking something that makes me sleep all the time.

    I’d suggest perhaps taking the drugs leaflets, enlarging them on a photocopier (the local library should have one) and highlighting the “call doctor asap” effects and putting them in a folder so you can see at a glance what’s down as significant.

  4. stuff like this makes me so mad – I don’t expect my doctor to be all-knowing, but if I report symptoms such as chest pain they should take that seriously and perhaps check out the side effects of the meds they’ve prescribed. It’s a completely cavalier attitude towards medical care.

    It makes me sad to see that your doctor has succeeded in making you feel like you’re a bother when you need her help and that you’re concerned about calling to “disrupt our day”. She gets paid for treating you, just as the plumber gets paid for fixing your toilet. You pay for medical treatment, either directly yourself, through insurance or through government funding via your taxes. Too many doctors tend to forget this and act as if they’re doing you a favor.

    Call your doctor. And if she continues to make you feel like you are an inconvenience, find a doctor who will take you seriously.

    • Oh, thank you so much. Internet friends are wonderful. But, no, this rheumy doesn’t make me feel like I’m an inconvenience. It’s just that I know how busy they are, and hate to add even more to what they’re doing. They’ve always said, “That’s what we’re here for” and reassured me that it’s okay to call. (Unlike my first rheumy, who wouldn’t return calls and told me point-blank when I asked that there would never be any reason for me to call between appointments. Him I did leave.)

      Turns out that at my last appointment, when the doctor pulled out her stethescope, she listened to both my heart and my lungs to see if it sounded like there was a problem. She just did it without any fuss or making an issue of it that I didn’t realize what she was doing. So it was addressed immediately, after all.

      It seems like I experience weird symptoms, report them, and it turns out to not be med related after all. My bloodwork was all fine. And that makes me less likely to want to report future things because maybe they, too, will not be something that the doctor finds concerning. It turns out that the chest pain might be more inflammation. Apparently there are tendons everywhere, which I understand in theory, but it just seems weird that the tendons which attach muscles to the sternum would get inflamed.

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