December 24, 2001
A Common Sense Approach to Chemotherapy and Prescription Drugs
A recent mass mail to the Inflammatory Breast Cancer Support Group listserv - IBC@ACOR.ORG suggested that we need a pharmacist on our oncology medical teams to bring state-of-the-art pharmacology knowledge to our treatments and to prevent the prescription of contradictory medications. This is a wonderful idea and one that could save discomfort, pain and even fatalities.
Given the reality of how medical organizations work, this excellent suggestion may become reality in the future, or it unfortunately may not, given the fact that everything in medicine as well as the rest of our world, seems to be cost driven.
As usual, we have to be proactive and take on the responsibility for our own medical care. There are three small but very important steps we can take to be sure that we are not taking contradicting medications.
- The first step is to have only one doctor write all your prescriptions.
- I have chosen my oncologist as that doctor since I'm still in chemotherapy. All other doctors you see should be advised that you are on chemotherapy. When I saw my orthopedist for knee pain, he suggested that I take Celebrex. I wrote down the name of the drug and then discussed it with my oncologist who then prescribed the drug for me. I also check with my oncologist before taking any over-the-counter meds, such as acidophilus which I wanted to try to counteract lower g.i. problems caused by Xeloda. Since this has worked for me, he is now suggesting it to other patients on Xeloda so I feel that I may be helping other patients as well as myself, a great secondary benefit.
- The second thing we can do while we are on treatment is to use only one pharmacy to fill all your prescriptions.
- Talk with the pharmacist and ask that they enter in your computer records what chemo you are taking as well as all the prescriptions they fill for you. Be sure to let them know if and when you change chemo drugs. I've done this with my pharmacy (my local Safeway) and they have worked as a unit to give me the best service possible. Most of the staff now knows me by name and I've even received a get-well card from them! Who says people don't care! They are extremely aware of the policies and restrictions of my medical coverage and work with my oncologist to come up with the best compromise when a prescribed medicine isn't on my insurance company's approved list. They have even submitted requests for half the amount prescribed when the insurance refused to pay for prescribed medication because the over all cost was over $1,000 for one prescription. This way the insurance approved the first half ($800 worth of medicine), then two days before I ran out of the medicine, the pharmacy put through the request for the remaining medicine and it was approved. When I had to go on coumadin because of blood clots from having a port implanted, the pharmacist took 15 minutes to talk with me, give me literature, explain all the problems I could encounter, tell me how important it was to get my blood tested frequently, and to eat the same amounts of the same food groups daily. It pays to get to know you pharmacy staff and treat them nicely, even when you are feeling like pond scum. A smile and a sincere, How are you today? can make a big difference in your life and theirs.
- The third step is to do your own research of the meds you are taking.
- Alexandra Andrews suggests using the web. Most drugs can be found by just typing in the name followed by .com (Xeloda.com for instance.) If this doesn't work, try a search engine. Alexandra suggests google.com and I've had excellent results with Ask.com. Another great source of information is the Physicians' Desk Reference. You can order it in paperback from Amazon.com for $6.99 plus tax and shipping. Amazon also carries a number of other drug reference books that may be of help or interest.
- I realize that these steps are not the same as having pharmacists on our medical teams, but until we do, these methods can provide a clearinghouse for all our medications, thus reducing our risk factors during treatment for cancer and other diseases. If any of your findings concern you or appear to contradict your treatment, be sure to bring them to the attention of your oncologist. Keep yourself informed, take responsibility for your treatment and insist on being heard. The only dumb questions are those that are not asked.