Side Effects
My recovery continues . On Sunday I walked two-and-a-half miles. That’s not a big deal for someone who used to run marathons, but for four weeks out from bypass surgery it’s not bad.
I left the hospital with prescriptions for all sorts of medicines. So many, in fact, that to keep things straight I got one of those plastic boxes with individual slots for each day of the week. Now, one thing to remember about all these medications—medicines for blood pressure, for cholesterol, for heart rhythms, and my favorite, for pain—is that they are really powerful chemicals. The have effects and they have side effects.
Some of the effects are predictable. The blood pressure medicine, atenolol, makes me a bit light-headed when I stand up. Other effects are not predictable. Is it medicine that’s making me have a runny nose? Is it a medicine that’s making me have weird dreams? I’m not sure, but I’ll bet some of the strangeness I’m experiencing is because of the pharmacological stew that’s coursing through my veins.
Today I got to discontinue one of the medicines—amiodarone—that was stared in the hospital when I had a brief run of atrial fibrillation. Now, the experience of having a heart bypass operation is probably sufficient to engender weird dreams, but I’m holding out for the possibility that it might be the amiodarone. One thing my patients have taught me over the years that I’ve been in practice is that not every side effect is listed on the package insert. If a patient tells me that he or she is having a funny reaction to a medicine, I’m inclined to believe it. These are, after all, very powerful substances.
It’s probably not utopian to think that in a few more years our knowledge of pharmacogenetics will have expanded to the point that we will have reasonably priced tests that will screen for hundreds of genetically mediated drug effects and side effects. Already some researchers are talking about a chip that can help determine an entire human genome and do it for $1000 or less.
The shadows are getting long. It’s time to turn on the porch light and get ready for the trick-or-treaters. I’ll let you know how my dreams go.
Technorati Tags: side effects, bypass, pharmacogenetics
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November 7th, 2006 at 8:06 am
Dr. E,
I hope all is well and that your on your way to a fast recovery. I’ve been doing some research and came across your blog. I am working with Genzyme to spread awareness of Pompe disease and feel that you might be interested in receiving important information and updates behind the disease.
As you may know Pompe disease is a rare neuromuscular disease which many physicians are still unfamiliar with. It is a progressive disease that gets worse overtime and can be fatal within the first year of an infants life if not diagnosed properly. Your blog has a strong audience and I feel that it would be beneficial to your readers if they too were educated on the severity of Pompe. Please feel free to contact me if you have any questions or would like wore information.
Best,
Scott Ludwig
Digital Influence Group
November 10th, 2006 at 3:35 pm
Thanks Scott. For those (like me) who don’t recall all the features of Pompe Disease, here’s a link to the discussion of Pompe’s on the Wesb site of National Institute of Neurological Disease and Stroke: http://www.ninds.nih.gov/disorders/pompe/pompe.htm.
IsGenzyme working on anew test for the disorder?