Things We Take for Granted

We Can’t Make Assumptions That Health Care Will Be There for Us

We walk into the kitchen, pick up a glass, and turn the tap on. What if nothing comes out? Or, worse, what if what comes out is polluted like the water in Flint, Michigan? What if we flush the toilet, and it just won’t go down because the sewer line is all backed up? What if the traffic signals just stop working? Or the telephone lines? Or the electricity?

Every day of our lives, we make casual assumptions that what has worked in the past will continue to work. I have this odd inkling that perhaps we are living at the start of a period in which things we assume will work, just won’t work.

I recently read an article on Salon.Com about how some 20% of rural hospitals are on the point of collapse. Given the money-grubbing nature of our healthcare system—especially on the part of pharmaceutical corporations and health insurers—I can see why there aren’t enough dollars in rural areas to motivate hospitals to remain in business.

This comes at a bad time, when the political divide between the urban areas on the coasts and what has come to be called “flyover country” has led to hard feelings. Much of Trump’s support is, I feel, based more on this urban/rural divide than any particular love for the orange-headed horror. Things can only get worse if Aunt Tillie dies trying to get to a distant hospital, but doesn’t make it.

Government can rectify this situation, but only if voters are willing to let government do the things that government does best. The nihilistic conservatism and Tea Party anarchy of the times makes this difficult.

 

(Don’t) Ask Your Doctor

So You Think You Can Second-Guess Your Physician?

You don’t have to watch a whole lot of television before you start running into a barrage of commercials attempting to influence you in “asking your physician” about the various nostrums that are being advertised. And you wonder why prescriptions cost so much?

Here is a brief survey of three such drugs I have seen lately together with a list of things that can happen to you if you were dumb enough to urge your doctor to prescribe them. Please note that while a sotto voce voice in the background warns you of impending disease and death, you are watching attractive actors indulging in an active, trouble-free lifestyle.

Humira (Adalimumab) – Abbvie Inc. – For Psoriatic Arthritis

Serious infections have happened in people taking HUMIRA. These serious infections include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some people have died from these infections. Your doctor should test you for TB before starting HUMIRA, and check you closely for signs and symptoms of TB during treatment with HUMIRA, even if your TB test was negative. If your doctor feels you are at risk, you may be treated with medicine for TB.

Cancer. For children and adults taking TNF blockers, including HUMIRA, the chance of getting lymphoma or other cancers may increase. There have been cases of unusual cancers in children, teenagers, and young adults using TNF blockers. Some people have developed a rare type of cancer called hepatosplenic T-cell lymphoma. This type of cancer often results in death. If using TNF blockers including HUMIRA, your chance of getting two types of skin cancer (basal cell and squamous cell) may increase. These types are generally not life-threatening if treated; tell your doctor if you have a bump or open sore that doesn’t heal.

Taltz (Ixekizumab) – Eli Lilly – Also for Psoriatic Arthritis

Taltz affects the immune system. It may increase your risk of infections, which can be serious. Do not use Taltz if you have any symptoms of infection, unless your doctor tells you to. If you have a symptom after starting Taltz, call your doctor right away.

Your doctor should check you for tuberculosis (TB) before you start Taltz, and watch you closely for signs of TB during and after treatment with Taltz.

If you have TB, or had it in the past, your doctor may treat you for it before you start Taltz.

Do not use Taltz if you have had a serious allergic reaction to ixekizumab or any other ingredient in Taltz , such as: swelling of your eyelids, lips, mouth, tongue or throat, trouble breathing, feeling faint, throat or chest tightness, or skin rash. Get emergency help right away if you have any of these reactions. See the Medication Guide that comes with Taltz for a list of ingredients.

Crohn’s disease or ulcerative colitis (inflammatory bowel disease) can start or get worse with Taltz use. Tell your doctor if you have any of these symptoms or if they get worse: stomach pain, diarrhea, and weight loss.

You should not get live vaccines while taking Taltz. You should get the vaccines you need before you start Taltz.

Chantix (Varenicline) – Pfizer – To Stop Smoking (This ad uses a pixillated turkey rather than live actors)

Some people have had new or worse mental health problems, such as changes in behavior or thinking, aggression, hostility, agitation, depressed mood, or suicidal thoughts or actions while taking or after stopping CHANTIX. These symptoms happened more often in people who had a history of mental health problems. Stop taking CHANTIX and call your healthcare provider right away if you, your family, or caregiver notice any of these symptoms. Before starting CHANTIX, tell your healthcare provider if you ever had depression or other mental health problems.

Some people have had seizures during treatment with CHANTIX. Tell your healthcare provider if you have a history of seizures. If you have a seizure, stop taking CHANTIX and contact your healthcare provider right away.

New or worse heart or blood vessel problems can happen with CHANTIX. Tell your healthcare provider if you have heart or blood vessel problems or experience any symptoms during treatment. Get emergency medical help right away if you have symptoms of a heart attack or stroke.

Sleepwalking can happen with CHANTIX, and can sometimes lead to harmful behavior. Stop taking CHANTIX and tell your healthcare provider if you start sleepwalking.

Do not take CHANTIX if you have had a serious allergic or skin reaction to it. These can happen with CHANTIX and can be life-threatening. Stop taking CHANTIX and get medical help right away if you develop swelling of the face, mouth, throat or neck; trouble breathing; rash with peeling skin, or blisters in your mouth.

Use caution when driving or operating machinery until you know how CHANTIX affects you. Decrease the amount of alcohol you drink while taking CHANTIX until you know if CHANTIX affects your ability to tolerate alcohol.

The most common side effects of CHANTIX include nausea (30%), sleep problems (trouble sleeping, vivid, unusual, or strange dreams), constipation, gas and/or vomiting. If you have side effects that bother you or don’t go away, tell your healthcare provider.

Now if you still want to tell your doctor what to prescribe for you, you’d be letting him off the hook. After all, he doesn’t have to research and find the best drug for your condition. And it’ll make you look smart, at the possible cost of discomfort, disease, or even death.

My advice? Mute all prescription commercials. The risks far outweigh the advantages.