April 22, 2014

Polypharmacy – How I Dislike You

You just can't make some doctors happy. Even though the doctor was smiling when he said I was a drug addict, I still took offense to the statement. Having had a doctor attempt to increase my dosage for several medications to bring me in line with the guidelines for recommendations for blood pressure medications and statins has left me with a sour taste in doctors. Add to this a great discussion with a VA doctor about eliminating one medication and reducing the dosage on another medication, I really can't understand why doctors are pushing to increase some medications so enthusiastically.

Admittedly, I would like to be off a few medications, but because of the lab reports and other tests, I know that I am where I should be for the results I am obtaining. I am lower than the guidelines for blood pressure readings, yet I have had to refuse to let the nurses take my blood pressure readings immediately after entering the exam room. Not only have they increased the pace from the waiting room to the exam room, but also taking the BP with the incorrect BP cuff is another trick they have used to bring my BP readings up.

Even my wife, who is a certified nurse aide, has the right cuff for me and my BP readings are consistently 115 to 125 over 60 to 75. Yet the doctors' nurses work to get my BP up to 140 (or higher) over 90 (or higher) so that the doctor will prescribe a higher dose of BP medication.

Now the cholesterol (lipid) panel seems to be all over the range. The latest test done at the VA showed everything within the normal range, but with a three day difference in blood draw, all my results done by the hospital lab were beyond the high limit of the range. I therefore have to wonder if the hospital lab reports are inflated for the doctors to enable them to increase the statin dosage. To check the hospital lab reports, on the same day, I went to the local hospital and paid out of my own pocket to have them do a blood draw and do a lipid panel. All the results were within the ranges and the ranges were the same as the VA and the regular hospital lab. All three blood draws were fasting and that is the reason I say that the results for the doctor were inflated.

I am beginning to think I need seriously to consider changing doctors and hospital labs. Not only would I save on distance traveled, but I may also save on frustrations. When it comes to my diabetes, I don't like the idea of leaving the endocrinologist I have, but I am tired of having the suggestion of letting my A1c get above 7.0 at every appointment.

Yes, they tell me that is because of my age that they make this suggestion. I tell them that until I am unable to prevent hypoglycemia, except for the rare episode, I will continue to manage my diabetes to the best of my abilities. Only three readings below 60 mg/dl in the last year and two were at times I suspected I would go low because of injecting the Novolog too close to the Lantus injection site and testing proved I was going low and the glucose tablets did their work. The lowest reading each time was 56 mg/dl and 58 mg/dl. I consider these low, but not severe lows. The third time I injected Novolog when I should have injected Lantus.

Now am concerned because I do not have the symptoms when I get below 70 mg/dl of sweating, being shaky, or the other symptoms. I seem to have become hypoglycemia unaware in the last year and that does concern me. As a person with type 2 diabetes on insulin, I always believed that only people with type 1 diabetes had this problem. This confirms that the analogue insulins can cause this condition in both types.

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