Rant du Jour - Modern Medicine

I got a phone call from my sister last week that my mother fell and hit her head again at the assisted living for adults with dementia that my sister had moved her to, after my mother fell and hit her head and broke her wrist at the regular assisted living. This means that my mother's mental state has gotten to the point where she can not function at all without someone acting as a caretaker 24 hours a day. She no longer has the ability to protect herself or think about her own safety, to use a walker or a cane to move around her room. It means she will be probably tied into a wheelchair when no one can watch her, rolled around like furniture and planted someplace where she can't get hurt by trying to take care of herself.

All of those images of the worst that a nursing home has to offer, especially when viewed through the eyes of the able-bodied. All of those things that we all dread happening to us when we are elderly. And not what any of us ever think will happen to all that we've managed to accumulate in life, the money, the possessions, the memories. All gone. All disposed of. And all that's left is a stream of days sitting like a potted plant in front of a TV or moved from place to place to be "entertained", to receive "enrichment", and to be managed.

And this is the best that money gets us at the end of our lives, thanks to modern medicine and medications that keep us alive longer, well past the point where the rest of us is worn out and no longer working.

OK - here's my rant:

I have very mild hypertension - so mild that ten years ago, my blood pressure would have been considered in the range of normal for my age. Somewhere between 120 and 130 over 80 - just ten points (or whatever it is) over what someone has decided is normal for an over fifty woman.

Every time I go to the doctor, for whatever reason, I am given a script for medication for hypertension. Just like every post-menopausal woman is given a script for anti-osteoporosis medication, and/or a bone scan and is told to get a mamogram and other tests, most of which involve radiation exposure.

What percentage of those tested get cancer from that exposure? No one knows.

What percentage of high blood pressure leads to health problems and what percentage of medication leads to health problems? No one knows.

What percentage of post-menopausal women would benefit from more exercise and a better diet? All of them. So what to do? Give them more pills to take, of course, and tell them that it won't hurt, and they probably will not even know they are taking the medication. Well, someone exposed to low levels of anything probably won't know about it either, until it kills them. Or just cripples them.

When I was pregnant, I had a huge discussion with my OB/GYN about the particular medication he wanted to put me on for pre-eclampsia. When I used to go to my mother's Parkinson group, almost all the people there had been on Aldomet for their blood pressure. It's a drug that no one understands how it works but that it affects dopomine in the brain and lowers the blood pressure, and studies have never been able to link it to problems in pregnant women. So it is automatically assumed to be safe to give to them. Short-term, it might be. But no one has ever done a follow up study on the children born to these mothers. So we really DON'T know. But thousands of pregnant woman are told to take it every year.

So I did, and I worry about what I did to my children, and may never know the answer.

Anyway, there are no real studies out there to see what the long-term effects of anti-hypertensives do to the people that take them. Do they live longer? Do they have less problems because of their lowered blood pressure? You'd assume yes, but, guess what? There has never been a study of that, so we are ingesting all sorts of odd chemicals on the pretense that we are improving our health, but with no real idea if we really are. But someone in the pharmecutical industry is driving a BMW because they can sell a drug to more and more doctors, and someone who owns shares in a pharmacy is doing quite well because they can sell more and more drugs at a profit. But are we living longer, or feeling better, or even having a better life? The answer is statistically, no, not really - not in any way attributable to the drugs we are swallowing.

The question really is why are we allowing this to be done to us? Why aren't we fighting it? My next-door neighbor is going bankrupt because he has been told he needs to get a shot that costs $300 every two weeks because of his bloodpressure, and $300 worth of monthly medications to further control it, and the side effects of all these drugs. And he's nearly eighty years old. So he has a much longer potential lifespan, but he's living in near poverty to have it. And his real problem, the kidney disease that is raising his blood pressure, is not treated. Only the symptoms. My husband, who is about 80 pounds overweight, is on an injection created from gila monster venom twice a day, four different medications for diabetes, an anti-depressive, a chlorestoral lowering drug, a baby aspirin, and a couple more that I can't think of at the moment. If this wasn't covered by his health insurance, it is more than a thousand dollars a month in medications. And, honestly, if he lost the weight, he probably would not need the drugs - so why are insurors so willing to pay for them and not for a dietician and a health club to encourage him to improve his health?

I had a big argument with his GP over my blood pressure and my decision to monitor it rather than immediately starting the two different medications he decided I needed. I lost weight, and increased my level of exercise, and lowered my pressure from what it was to what it is. And I could walk outside and get hit by a bus, or die of a heart attack when I am eighty, without medication, or live to be a miserable, incontinent, demential eighty-five year old with twelve daily medications and a three thousand dollar a week room in a nursing home. My mother is there now, and she's just turned 75. I would not want her life, and she doesn't either, even if she really barely understands what is going on. At some point, we have to expect that just because we can extend life with medications a bit, no one lives forever, and there is a point where the benefits are not outweighed by the cost of propping up lives with drugs on the pretense of making them better.

When my dog was diagnosed with lymphoma, the vet told me the next thing to do would be to have her cancer "staged" and start chemo. So what did that involved? Major internal surgery for about $800 for the dog who would now have to recover from it, plus still have lymphoma. Then chemo, which, in animals, is not always a big deal - which might get her an additional six months of remission. Or might not, at all. At a cost of two or three thousand dollars more. At the end, tho, the cancer always wins. Meanwhile, she needed to be on comfort medications. And needed to be screened for other medical problems, at a cost, to us, of nearly another five hundred dollars.

What happened at the end? After eight weeks, Molly died of lymphoma, without the major surgery. Without the chemo, which would have allowed her another four months of life. Or possible not. Or she could have been hit by a car when she darted out the door, as she used to do all the time. No one will ever know. But we did what we thought was best for her, and she took her last breath where she was surrounded by her family and in a place where she was HOME. That's better than probably you or I will be allowed to have. Not tortured in an effort to stave off the unstoppable, not drugged into a stupor, not handled by strangers who don't care much, not in a place we don't know, with choices made for us by people that don't know us, have no idea of what we would want or how we lived. Molly got a better death than most humans are now allowed to have.

How sad is that for all of us?

Sometimes, medicine has to make difficult choices. The problem is no one is willing to do that anymore. And the government, the people we trust to make sure the best choices are made, isn't doing that either. So we slog along, being told absolutes that aren't anything, that have no facts to back them up - and we spend huge amonts of money on hopes that aren't based in anything real. We put hopelessly brain-damaged people on life support until their bodies literally decay, because the doctors won't tell us not to, and can - so they do. We treat diseases we might get - and get other diseases from the medication that kill us instead. And instead of just making a choice and saying that no one lives forever, but the quality of the here and now is what matters most.

And how really sad, and really, pathetic, is that? We are exploited to the end - and those that survive us, laden with guilt that they might not have done all they could, in the impossible effort to cheat death. Mortality always wins - but the greed in the culture can not and will not admit that, even to themselves. And never, ever, to us.

More Christmas

This one is from an actual photograph from one of last year's blizzards - the arbor vitea's belong to my neighbor across the street, so this is a close up view of what I see from my desk. These bushes are so pretty that they have become the backdrop for everyone's posed pictures - high school graduations, proms, christenings - everyone is walking over and posing the kids and the family in front of them all the time, including us, so I figured I might as well have them on my desktop. If you want 'em, right click and save them. I use a blue desktop to frame them rather than stretching the image out, but it works either way.

Another Christmas Window background, thanks to Paint Shop Pro. Sized at 800 x 600, you can swipe it by right clicking and saving.

More Molly

Molly, Ginger and Grendel (clockwise from left)

















Molly decides that Gren's ears aren't clean enough.











I miss my smiling dog - every time I'd come in the back door, she'd be grinning at me (as she plotted how to get outside and run away for a couple of hours). The day I took her to the vet, she stood on the metal table, looking out the window, and then cased the joint - standing up on the windowstill to see if she could open the window and peering into the wall vent looking for alternative means of escape.

She was sweet, but those wheels never stopped turning. One of the biggest things to hit me is the act of leaving the screen door open off the kitchen for fresh air. I haven't done that since June 2001 when I found out the hard way that Molly could force it open. And no one has peed in the living room for a week.

Wait a minute - just why do I miss that dog?