Another Medication Concern

SheBuddy: I know it gets really crazy when our loved ones are on soooooo many meds. If you don't like her doc; find another that will work with you. Always ask for Samples when your at the doctors office. That will save u some $$. YOU need to request your Mom's medical records and have them sent to the Doc in her care. They aren't going to request them for u. Next appointment, discuss what u and Mom want and go together. As patients and POA we DO have rights. Stay UNITED with your mom and the Doctor needs to take your concerns seriously. Keep MOM involved in her care and I think she will be easier to manage.

I have been taking care of my mother for over 9 years now, and you have to have a doctor that you can talk to. I don't mean suggest this or that, but one you can say this is what my mother needs. I read a lot about medicines and their interactions with other meds. and conditions. I will talk with the doctor about them, and if he/she is good they will listen and 90% of the time go with that medicine, also if there is a generic find her one. If this is not happening for you, get away from that doctor. Doctors are there for YOU, and you have to remember that. I use to write down all my questions and high points before going. Because sometime you can get overwelmed with emotion when talking and not get all your questions in. And I have fired many a doctor in the past until now I have found my mother a team that works together and communicate with each other. When i took my mother over she was in diapers and babbling at times and now she is going to Art Shows and Music events and does not even takes naps that she had been doing for 20 years. It can be difficult, but make that appointment without her if that is what it takes and talk with the doctor or find a new one. They ARE out there. And a good doctor will give you samples, if the drug he is suggesting is a high priced one. So you can make sure your mother can tolerate.

I want to add to the helpful posts so far. It is great when we do learn and gather information. So right you all say we must change recalcitrant or arrogant doctors. It is in our best interests to do so and of those we advocate for. Some doctors are educable. We need to get in low key appealing for their help and incrementally raise our insistence they meet our request. If they refuse, politely ask their reason and record it. I paid heavily for blind trust in doctors before got disabused from this dangerous dependence. I also advocate (free of charge) for some others who are in need of it. using the "I statements" borrowed form counselling I say to them "how can you help me so I don't have to feel worried any longer?" I owe the problem and without blaming them (even if they are blameworthy) is less likely to draw a defensive response from them. Then follow on educating the doctor saying "I came across this interesting information I want to share with you and see if this can be incorporated into the treatment?" Again less likely to draw insecurity or hostility from the doctor. But it still may. Time to dump the unsafe practitioner. I hired my doctor some 8 years ago. We have an ongoing discussion as I educate him so long he lets me. Not an easy task but we need to consider the total framework in which we are forced to operate. His heart is in the right place, how ever he is captured by the medical industry run by big pharma and feels threatened by some confrontation both technical and ethical. He told me last time he won't risk practising outside the guidelines he is expected to adhere to, so as not to risk his licence to practice. I am trying to undermine incrementally his concern to practice defensive medicine. He was quite uncomfortable for the fact that he may do harm while thinking doing good sometimes. He said he must take notice of peer reviewed research findings. Problem is both research and peer reviews can be corrupted and evidence exist for both. A whole essay I would have to write just to encapsulate some of the issues around the topic. it is not easy for a doctor to think outside the square. But their malpractice insurance protects them mostly except form criminal negligence and such like. Other then that:"doctors bury their mistakes".- The mother of my daughter quipped that my doctor must be a dickhead allowing me to educate him! Yet it came to pass unfortunately what I tried to save her from for 43 years: heart attack and brest cancer. Yet I still have no credibility.-

Be well!

Joseph.

I need to talk to my Moms Doctor alone without my Mom because my Mom,70% of the time, doesn't think anything's wrong with her mentally.

This is the second Doctor who's ask me questions about her mental state right in front of her.

My Mom's mad at my Brother because she claims he told the Doctor that she's crazy and needs medication.I don't want to be the "Bad" guy, especially when she's living with me now.

I'll set up an appt. and if the Doctor doesn't work with me, then I'll shop around for a new doctor.

SheBuddy,

"I send you good vibes" which is my kind of praying so to say, trying to empower you and add to your energy to carry on caring for your mum.

This second doctor is insensitive, have no people skills and definitely not helpful.

If you sense that this guy still educable and can became good value then before you dump him (you may have to) give yourself permission to be more assertive. We patients give away our power to easily still that keeps entrenched attitude of doctors that they are in charge, "doctor's orders" is their expectations.

A mature doctor just as good therapists are self-aware and open for correction. If we don't speak up they won't be educated.

Try this way: " with respect doctor I find this question problematic and I rather we skip this. Should you request elaboration from me I shall write a note to you by all means." Yo may rephrase it to your preferences.

Alternatively could say: " doctor, could we discuss this next time? I have some concerns with the questions put right now and wish to protect the patient from anxiety and annoyance." And insist it is deferred. Not aggressive but assertive. And write a note promptly for his urgent attention highlighted on the envelope.

As you get your footing more secure you find your voice more and more often. I know it is not easy to start with how ever we better take charge of our issues and whose' we advocate for.

Shopping for a new doctor you may want to compose a list what and how you envisage the cooperation will take place between the doctor and you. List your needs and solicit his answers. I did this myself when hiring my present doctor. Also sent a list to a dentist who was going to attend to my daughter. I had 5 questions in a respectful but assertive tone saying I want to know what and how it will be carried out as the procedure was not a simple one. I did my homework prior and said must know if anyone touches the issue of my daughter. He did not answer my questions but did more: he sent me a book that explained the procedure and more and said I can keep it if I wanted to. I thanked him, been reassured, sent him the money for the book and he got the job which was expensive but he earned it. He also turned out to be a quality person and a kind of friend to my daughter, often not billing her for something. There was no ulterior motive. A rare gem like him we can find but we must be looking.

I wish you well, let me know how did you go, or reply to my comments. May your God go with you!

joseph.

begin with.."you have not obtained my mothers medical history and you are working on what you THINK, I however am working with what I KNOW" I used this with my mothers doctor, who took such huge offence at my challenging him that I went out and found another more receptive doctor for her. Some have the good old God syndrome, those you must avoid when it comes to the care of a loved one who can no longer take control. Get an irrevocable POA that includes medical decisions in the wording. also, no matter how old a patient is, having someone else in the room with the doctor, to actually listen and ask pertinent questions is something that must be done. How many times have you gone and not remembered half of what the doctor said? the privacy issue they might bring up is ridiculous as it is the HIPA rules and that protects the patient, not the doctor, so they can shove that argument. Any doctor who wont let another person in when the patient requires/wants it is hiding something.

This also happened to me. First you need to call your Mom's old Doctor and get them to release her medical records to a new Doctor. If you are the POA you can fax a request to them and give the new Doctors fax number.I would not keep this Doctor. Some Doctors don't have any geriatric experience. My Mom fell and this is how we found our new Doctor. The old Doctor refused to give her a CT scan for severe pelvic pain. Turned out she had a pelvic Fx. At the rehab skilled unit the house Doctor ordered it and that is how we found him. He is willing to work with our family to keep my Mom stable.He was willing to increase her Celexa for depression and addressed other concerns. Is there anyone you can talk to at a Senior Ctr/Assisted Living facility to find out who they like or who they use. Then you could do your homework to find out more about this Doctor. Good Luck!!

My mother's doctor has tried to make me feel guilty when I tell him I want to removed a medication. I listen to his argument, research a little more and do what is best for my mom. Some times these decisions are financial. My mom is in late stage Alzheimer's and taking Aricept. The cost is outrageous and I want to remove her. She could use the money for better dental care than a drug that may or may not improve her non existent memory.

I am lucky that I can keep her from the doctor too often. She has a heart doctor that is worse. I just keep the attitude that I am in charge and that's it and remind the doctor. They will either tell you find another doctor or leave you to make the decisions. I have found changing doctors doesn't always make it better. If you go to a doctor he assumes you are asking him to treat and he wants to do it how he wants it. It is very difficult to get some of them to listen. I don't care. I remind the doctor that my mother's treatment is not to make her live longer than her current 90 yrs but to keep her comfortable. So, no to the colonoscopy he keeps nagging me about, and no to the Aricept.

My mom made it clear very early in the game that she did not want to take any medications like Aricept. We tried it but she finally told us she did not want anything that would "prolong" what was inevitable. There are times I do not want to follow through with her wishes but then I think back to last year. She wandered off and cracked her ankle. The ER we took her to let her fall off the ER bed while they were doing x-rays and she ended up shattering her heel and breaking both bones in her arm. What would have been a fairly simple thing turned into a nightmare - 9 days in hospital, 5 1/2 hours of surgery and 3 months in a nursing home - during which time they kept her so doped up, she didn't know whether she was going or coming - not to mention the negligent treatment she received. Seems like most doctors just want to give MORE medicine - that's their answer. They are always trying to tell us we are doing wrong by not giving her the sedative medications but she is not combative and she follows instructions fairly well. We just explain that this is her wish and that is that. Either way, it was hard but every once in a while, we came across a good doctor.

Regarding MD's and medication -- we tend to forget that doctors are doctors of Medicine and that all some of them seem to know is medicines (pharmaceutical chemicals). More and more it has become up to the patient or the patient's representative to remind doctors to read the patients chart, to review medications, to take into account how medications are effecting the patient and to make adjustments as necessary. Doctor's need to learn to listen to us. We need to keep a written record of what the patient is taking (and when) and read from that record if necessary right to the doctor. We also should try to write down what the doctor says at visits. If that doesn't help then for the sake of everyone concerned change doctors.

On another note -- I have found that my pharmacist is a greater help to me than my doctor when it comes to medicine and preventive measures.

Dear Doro - my dad sure feels that way. He has been dealing with a very drug-resistant strain of E. Coli. The only drugs that would treat it were 3 IV-administered ones. Definitely resistant to Cipro. This was discovered by the ER on April 2 and when he returned to his physician, he was put BACK ON CIPRO. Dr could not have looked at records or he would have seen this. He was told about it and still rx'd Cipro. Ended up back in ER twice more and finally put in hospital (4/16/10 - two weeks after discovery of drug-resistance)ONLY because we INSISTED. He then is sent home with infusions for another week. We finished these up and he was told to start a mediication that should prevent another infection. A few days later (Tuesday), he was given another medication and told to take both concurrently. Pharmacist is the one who told us that there was a greater risk of crystals forming in the urine. Can you say painful? We will be changing Urologists after he gets well but most doctors will not take a new patient that another doctor has done surgery on.

There is a reason they call it the "practice" of medicine.

Hi everyone, I just wanted to let you know that I've been following this discussion and thought it was really interesting. Learning to advocate for ourselves with doctors and the medical system is one of my passions as an editor here at Caring.com. I wrote a short article about this for Caring Currents here:

http://www.caring.com/blogs/caring-currents/saying-no-to-the-doctor-or-getting-a-new-one

And I featured many of your comments and stories. I also offered some tips and resources. I'd really appreciate it if you'd take a look and offer comments and thoughts there too. It's so important for those of us caring for family to be taken seriously by doctors and to have the power to make all the hard decisions we have to make. Best, Melanie