Drug Side Effects or Medical Conditions

DISCLAIMER:  What I am about to write is not an indictment of doctors or the medical profession.  It is a complicated issue to which I do not have an answer.  

Earlier today, I wrote a blog talking about my apnea, the sleeping pill I've been taking, and side effects it caused.  It was simple for me to determine it was the sleeping pill, because I only take one other medication and I've been taking it for close to 20 years with no side effects. It was a case where the healthcare system and the patient were able are work together to solve a problem. Unfortunately, it doesn't always work that way.  That seems to be the case with my wife's medical problems, which are more complicated than mine.


Earlier this year, she  passed out while shopping.  Thus begun a long and yet unfinished quest to determine the cause.  It has been a parade of specialists, EKGs, Ultrasounds, EEGs, stress tests, blood tests, and endless forms.  In each case she listed all her medications and all her symptoms.

She takes a total of seven prescription medications and two over the counter products.  These have been prescribed to her by a series of doctors over the years.  Because many of her symptoms have come on gradually they have been attributed to the gradual aging process. Right now, her major symptoms are headaches, dizziness, and constipation.  She also has joint pain and drowsiness, both of which I've noticed have increased in severity.

They haven't manifested themselves over night and are the kind of things that don't set off alarms.  The passing out was the alarm.  While her doctors are looking for a physical cause for her symptoms, my non-expert opinion is that they are the cumulative result of drug side effects and interactions.  While doctors may point to the fact that the list of side effects on drugs is long and people don't display the vast majority of those listed, I don't think nearly enough attention is given to these effects one the alarm has been sounded.

Consider these facts:

5 of her medications list headache as a side effect.  She says if she can go three days without a headache she considers it a good week.  Headaches were one of the symptoms of the sleeping pill I was taking.  Prior to taking it, I had a total of about three headaches in 20 years.

6 of her medications list constipation as a side effect.  She takes a laxative about once a week.  If I don't count the time I was cutting weight for wrestling in high school and college. If I averaged one laxative a year for the past 45 years, that is a lot.

3 of her medications list insomnia as side effect, yet she is taking a sleeping pill for insomnia and of course that pills lists dizziness and drowsiness as possible side effects.

She also has other symptoms whose side effects are listed for 2-3 other of the medications.

She is being treated for high blood pressure, high cholesterol, osteoporosis, hypothyroidism, insomnia, and an irregular heartbeat, all of which are serious conditions in the long or short term.  They are certainly of more concern than any of the individual side effects.  However, if the cumulative side effect over time result in fainting and falls, the results can be very serious.

In my mind her symptoms are a result of one or more of these medications. That most obvious conclusion which is not being addressed.  It is much more expedient, profitable, and safe to look for a physical cause through a long and expensive series of tests and specialists.

As a scientist, I know the most likely hypothesis is the side effects of the drugs, but the only way to determine that is to devise a series of controlled withdrawals and to observe the results. Through no fault of the doctors, that option is actually the least feasible. In today's litigious society dominated by for profit drug and medical companies that course of action doesn't add to the bottom line and could result in law suits.

With one visit per year to your primary care provider, there is no way they can devote the time and resources necessary to run the controlled study necessary to eliminate the side effects ANY treat the more serious issues for which medications are prescribed.  I understand that.

I know if they were to take the systematic approach to determining if side effects were responsible for her fainting and she were to die of a brain tumor or heart attack, one very well might expect a law suit.  So what is the solution?

It certainly isn't simple, but in this case I think one more specialist will eliminate all of the obvious reasons for her fainting. Assuming Gregory House is not going to be on the case,  I will be bringing what I have written to the attention of her primary care physician this week, in the hopes that we can develop a plan to determine if side effects are responsible for her most serious symptoms of fainting and sudden dizziness.  If we can do that, we can begin going after the headaches next.