rX My Heart and Hope to Die

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 by: Phyllis Staff

This must be a mistake! How could his drug costs rise
from $150 a month to $1101 in just three weeks? My hands shook while I
read the pharmacy bill.

There was no mistake. The bill I held recorded the drugs
ordered by my fathers Alzheimers' care unit. In only three weeks at
this eldercare facility, his drug expenses had soared an incredible
734%. Ironically, his quality of life had plunged about the same
percent. Walking and talking when he entered, he now spent his days
confined to a wheelchair, unable to walk, drugged into a persistent
stupor.

"I've got to do something." The thought haunted me all day.

Then, that evening, an incidental trip to the grocery
delivered the help I needed. It came in the form of a thick paperback
book, The PDR Pocket Guide to Prescription Drugs (PDR Pocket Guide).

The PDR Pocket Guide provides tons of information for
all prescription drugs on the market when it was printed. Specifics
include:

• generic equivalents,
  

• why the drug is prescribed,
  

• how it should be taken,
  

• when it should not be taken,
  

• side effects and special warning, and
  

• possible interactions with other drugs and food.
  

The PDR Pocket Guide is available through Amazon.com, or you
might find a copy like I did at your local grocery or bookstore.
Jam-packed with almost 1700 pages of information, this paperback is a
surprisingly affordable $6.99.

Using the pharmacy's bill as a list of medications, I
read the PDR report for each drug my father was using. What I found
astonished me.

Two of fifteen drugs prescribed were being used
"off-label" (not FDA approved for the condition it is used to treat).
One of those was specifically contraindicated for use with Alzheimer's
patients. Two more were from drug families that I had previously
identified as causing allergic reactions in my father.

When I was young, my father used to kid me by saying,
"Up with this I will not put!" Up with this I wasn't about to put
either, so I called his doctor.

"My father is allergic to Furosemide."

He bristled. "Where did you get an idea like that?"

"Furosemide is a sulfa drug. He's allergic to sulfa drugs."

"I never heard anything like that about Furosemide," he barked. "Who told you that?"

"The PDR Pocket Guide."

"Well, the PDR has a lot of stuff you don't need to know." His arrogance grated on my nerves.

"No more Furosemide." Now I wasn't asking, I was
demanding. "You've seen his rash. He didn't have it when he came to the
care unit."

"You're not qualified to say what he should or should not have."

"What am I doing," I wondered, "arguing with a doctor who
should be helping?" I wish I'd spoken the words I thought next.
"Bye-bye! You're fired!"

But, in that moment, I resolved to be fully in control
of all my father's drugs. I would learn everything I could and provide
drugs direct to the facility. . .or not. There would be no more
ordering drugs without my specific authorization

I enlisted the expertise of a pharmacist I found just
down the street. She graciously took time from her crowded day to
answer all my questions and explain anything I didn't understand. She
took a brief history of my father's illness, made note of his
allergies, and offered money-saving suggestions. She focused on
providing excellent service. In short, she was, and is, an angel.

I immediately began to look for another physician to
take over my father's care, but I was too slow. Within a few weeks, my
father died of complications from a massive insulin overdose.

Was my experience unusual? Probably not, according to a
study from the Medical Expenditure Panel Survey (MEPS). On the subject
of the increased cost of pharmaceuticals for people over-65, the
study's author, Marie Stagnitti, MPA, reports:

Every year from 1997-2000, the average out of pocket
expense for prescription medicines for those with a purchase and age 65
and older was more than three times as high as the average out of
pocket expense on prescription medicines for those with a purchase and
under age 65.

The potential for overmedication in the elderly is clear
in Stagnitti's chart showing an average 23.5 prescriptions in both 1999
and 2000 for the over-65 group that used prescription drugs. The number
of prescription drugs used by the under-65 group seemed high to me as
well: 9.5 for 1999 and 10.1 prescriptions for the year 2000.

Overmedication is not only crushingly expensive for our
elderly, it represents a real and present danger. You can do something
about it. Please, learn about and oversee medications. You will help
elders save money. You might even save a life.

About the Author

A native Texas, Phyllis Staff lives in Dallas with her family. She is a writer and photographer whose work has appeared in scholarly journals and popular magazines. She is the CEO of thebestisyet.net (http://www.thebestisyet.net) and author of How to Find Great Senior Housing: A Roadmap for Elders and Those Who Love Them (2nd edition).

pando19@direcway.com

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