The Menacing Mathematics of Multiple Meds

http://chetday.com/multipledruguse.htm

This is an article about the number of proper drug tests that is needed for the question that each and every one of you should ask your pharmacist, "Are there any interactions between my drugs?"

Patients were frustrated with my answer, "I don't know."
Some were quick to angrily respond, "I thought you were the damn pharmacist who is supposed to help me."
I tried to calmly explain that while I know about the side effects of the individual drugs; at best, I make interpolations based on what metabolic pathways the drugs might share and what elimination systems might be involved.

The author of this article, Gary Craig, does the math for how many proper tests would be required for drug combinations.
"Here's how the mathematics work: If you take three drugs then adequate safety testing of the various combinations require seven separate tests. If you take four drugs the combination requres 25 separate tests. If you take five drugs it amounts to 121 tests. If you take ten drugs the number of required safety tests total 362,881."
My math says 3,628,801. (10x9x8x7x6x5x4x3x2+1)

The most drugs I dispensed to an individual was eighteen (the number of tests required is a number with more digits than my calculator holds). This year Host dispensed twenty-three drugs to an individual. There are many scary things about these situations to us. One of which is that people are still making decisions for themselves despite the stress their body and mind must be under.

So please the next time you make an appointment with a physician, please ask the physician to prescribe only minimal amounts based on your body weight and not what is the average prescribed dose. Ask what medication can be deleted from your therapeutic regimen. Give the deleted medication sufficient time to get out of your system before you imagine that you really want it back. Change lifestyles, diet and exercises to repair and restore your health as much as possible. Even if you must maintain your level of medication, a change lifestyle, diet and exercise may postpone inevitable decline that requires more medication.

Hippocrates charge to physicians to "First, do no harm" is good advice for each individual. Stop hurting yourself.

2006 Reading List

As I look over my reading list for 2006, my reading seems purposeful and easily divided into categories. I invite your comments and your recommendations for my Reading Candidates List.
Health-Related Topics
8 Weeks to Optimal Health by Andrew Weil
Animals in Translation by Temple Grandin
UltraMemory by Bob Kittell
Healthy Aging by Andrew Weill
Simply Eat! by jon Benson
Moving Beyond Cardio by Jon Benson
The Toxin Fast by Jon Benson
Blink! by Malcolm Gladwell
The Power of Focus by Canfield, Hansen and Hewitt
The Tomorrow Trap by Karen Peterson
The Top Ten "Superfoods" by Jon Benson and David Eller
Investing
Rich Dad's Prophecy by Robert Kiyosaki with Sharon Lechter
Investing in IPOs: Version 2.0 by Tom Taulli
How I Made $2,000,000 in the Stock Market by Nicholas Darvas
Jim Cramer's Real Money by James J. Cramer
How to Trade in Stocks by Jesse Livermore (with updates and commentary by Richard Smitten)
Rule #1 by Phil Town
How to Make Money Selling Stocks Short by William O'Neil and Gil Morales
Development of Writing Skills
Michael Masterson's Accelerated Program for 6-Figure Copywriting
The Ultimate Travel Writer's Course
How to write Articles for Newspapers and Magazines by Dawn Sova
Publishing a Blog with Blogger by Elizabeth Castro
Blogging in a Snap by Julie C. Meloni
Telling Lies for Fun and Profit by Lawrence Block
Creative Nonfiction by Philip Gerard
Creative Nonfiction by Lee Gutkind
The Right to Write by Julia Cameron
The Wealthy Writer by Michael Meanwell
Travel-Related Topics
Jamaica Lonely Planet Guide
Dominican Republic and Haiti Lonely Planet Guide
Jamaica and the Caymen Islands Cadogan Guides
Yucatan and Mayan Mexico Cadogan Guides
Ohio: The Pleasures and Treasures of Warren County by Ralph Johnston
The Best American Travel Writing 2005, edited by Jamaica Kincaid
The Map that Changed the World by Simon Winchester
The Unofficial Guide to Cruises, 8th edition
Traveler's Companion: Mexico, 2nd edition
The Flaneur by Edmund White
Barcelona: The Great Enchantress by Robert Hughes
The Getty Center by Michael Brawne
Imagined London by Anna Quindlen
A Writer's Paris by Eric Maisel
A Writer's San Francisco by Eric Maisel
The Path Between the Seas by David McCullough
The Devil in the White City by Erik Larson
Fiction
The Best American Non-Required Reading
Fledgling by Octavia Butler
Warriors of the Plain by Karl Lassitier
The Time Traveler's Wife by Audrey Niffenger
Can't Wait to Get to Heaven by Fannie Flagg
To the Nines by Janet Evanovich
Twelve Mile Limit by Randy Wayne White
Armageddon's Children by Terry Brooks
Non-Fiction
Obsessive Genius: The Inner World of Marie Curie by Barbara Goldsmith
Digital Photography: 99 Easy Tips by Ken Milburn
Preserving Your Family Photographs by Maureen A. Taylor
Bait and Switch by Barbara Ehrenreich
Snakes in Suits: When Psychopaths go to Work by Babiak and Hare

Daughter Remembers 15th Anniversary

"Happy Anniversary!, 15 years ago can you believe it!? Thanks for always being there for me. Even when you were dealing with your own worries/anxieties you managed to teach me how to deal with difficult situations and come out of them a better person. So to honor this special anniversary, take some time to be grateful for how lucky and blessed we have been and to laugh a little bit today. Because laughter was always the best medicine. And dad, don't even think about spending all day stressed in front of the computer!!!I love you both very much!
Daughter"

Fifteen years ago Daughter had surgery to correct the scoliosis of her spine. More years have passed since the surgery than her age at the surgery. The surgery is in her background and she is better for having it. No longer are her ribs in such torsion that they could affect her heart or her lungs. This year she sought help from new doctors to prescribe some physical therapy so that she could get the physical training to do exercises properly to keep her back and core muscles strong despite sedentary desk work. Not only did she get them but she does them twice a day! You go, girl.

Cousin Marcia Had a Stroke or Aneurysm

Christy sends this urgent message.
I just wanted to let you know it looks like Marcia has had a massive stroke. I tried to email all of you before I left to go to N.C. but evidently our email was down.
Pat, her husband, called Dad late Friday afternoon, saying they were careflighting Marcia. At that time they thought she might have a brain aneurysm or a stroke.
Dad and I left Saturday mid morning for North Carolina. We got to see her at 8:00 p.m. that night.
She is paralyzed on her right side. She seems to know who you are, and can only say yes and no at this point. She can move her left side, kick her leg, move her arm and wrist and fingers of her left side. Her right side is completely paralyzed.
Dad and I got to see her again the next day (Sunday) before we had to leave as I had to get back to work. No change
Yesterday(Monday), Pat called and said they did a Probe. They went in through her groin and went into the brain. They said they would not have to fix anything in the brain. He also said they have moved her to the Neuro Unit, so she is out of the Neuro ICCU unit now. That is good news. He also went on to say that they got her up and with Jim's help she was able to stand for 2 to 3 seconds. She was able to brush her teeth with help too.
Time will tell, and she has a long row to hoe, but knowing how she has a lot of mom in her and dad's stubborness she will do it. We are so thankful she is left handed.
I have everyone at school praying for her and I know my friends have sent emails to scores of others, but more prayers for her couldn't hurt, I'm sure they would help. I think her son Jim is taking it the hardest, mainly because he is most like Marcia. Lori is there too, but she doesn't talk about what she feels, she holds it all in like Pat.
I will keep you all updated as we know more.

Mom's Heart Condition

The date for Mom's surgery will be Jan 9, 2007.
Mom is a candidate for surgery to replace a heart valve, repair two others and do one coronary artery bypass.
This summer she had several appointments with her cardiologist and participated in tests that the cardiologist suggested. She used Toprol XL as part of the treatment since the worst valve is the mitral valve. Her Florida cardiologist wanted yet another test before he sent her records to a heart surgeon. At the December 11 appointment with the heart surgeon, he told her that time had come to schedule the surgery.
I had not yet broadcast this information because more information was always forthcoming.
She has been feeling pretty good as long as she rests more frequently and limits stair climbing to essential travel. Dad is in good health.

Christmas with My In-Laws

The second weekend in December has become the traditional weekend for the Christmas weekend with Host's Family at the home of his parents. Son's family arrived on Friday night. Our carload arrived on Saturday in time to watch three basketball games while we caught up on family news and ate cookies. The rest of the family arrived in time for the 6PM traditional feast of tossed salad, baked chicken breasts, dressing, cheesy potatoes, green beans, and dinner rolls.
Host takes pictures of many combinations of family groups, even if his niece grows impatient with the delay of gift-opening. He used a tripod to get himself in the family shot but Grandson is hidden behind Daughter. The digital image on the camera could not reveal that problem until he downloaded it to the computer at home.
Gift-opening order was selected by the month of the birthdays. My Staples gift card paid for the photocopying of my Christmas letter this week.
Grandson looked adorable in his Santa bib and also in his Santa's Helper suit.
Dessert was cheesecake and a raspberry log.
Sunday activities was a gathering at home of Host's Sister. A 1500-piece puzzle was started and left incomplete by those of us who had to travel distances yet that day. We learned to play "Shut the Box" and had two good games of Left-Right-Center. She fixed a brunch-feast for twelve people. Her husband had to work but that empty chair was filled by Niece's Special Friend who happens to be a guy.
We arrived at our home by 9PM.

Cousin Andrew Graduates

Cousin(FC1R) Andrew graduates with a Bachelor of Science degree in Finance from University of South Florida on December 16.

Daughter Discovers a Waterfall

Late Saturday night, Daughter thought she heard water running and she went to the bathroom to see if the faucet dripped. She was horrified to see water pour through light fixtures and vents in her bathroom and storage closet.
She called Emergency Maintenance, and he arrived after midnight to check on it. That worker went to the upstairs apartment to turn off water supply. Water was ankle-deep in their bathroom. He shop-vacced up that water before he returned to shop-vac much of Daughter's problems wherewater also came through all vents in an additional closet and bedroom.
The crisis abated and the only damage to her stuff was to some cardboard boxes stored in her storage closet.
Fans were set up and professional carpet cleaners were scheduled. There is no schedule for the repair of the ceiling and walls.
She just thanks God that this happened while she was home. She was able to move her stuff out of the way of the waterfall.

Damage from Windstorm

The windstorm on Dec. 1 took out one and a half cedar trees along our driveway. They did not do any damage to anything else as they fell. They have been removed and chipped the following week.