Neel asks to see the blood pressure log Gifford has been keeping for the past couple of weeks at his request, along with all the medications she’s been taking. The woman reaches down, produces a plastic bag that’s bulging with prescription drugs, and places it on the table. Then comes another plastic bag, this one full of over-the-counter medications.
Too Many Drugs, Too Many Falls
Neel quizzes Gifford about the prescription drugs, one by one. He asks Gifford about Ultracet, a pain medication that she’s taking. "I never have headaches," she explains. "My aches are all from falls."
"Tell me about the falls," Neel says. "Tell me how long it was after taking this pill that it happened."
Neel gently guides Gifford through the entire inventory. He explains that Aldactone, the blood pressure medication she’s been taking, isn’t the drug of choice in her case and may in fact be responsible for some of her other health problems. As he looks through Gifford’s records, he sees that her doctor, in attempts to control her hypertension, has tried four different ACE inhibitors, two beta-blockers and two alpha-blockers. Nothing has worked, and Gifford has had allergic reactions to all of them. Neel seems stupefied.
"There wasn’t a need to go to the second one after the first one did you harm," he says. "They’re in the same family. You need a calcium channel blocker instead."
Next, Neel zeroes in on Mobic, the NSAID (nonsteroidal anti-inflammatory drug that Gifford’s doctor has prescribed for her osteoarthritis). "There are certain drugs you just don’t give old people," he explains, and NSAIDs are among them. It turns out that the doctor has ordered yet another NSAID, in the form of Voltaren eye drops. "There’s a newer product that’s better than this," Neel says.
Gifford seems relieved but at the same time disturbed. "I don’t want to go back to this doctor," she says. "She never checked anything before she gave it to me."
Neel promises to put everything in a written report by the end of the week. "Some of these things," he says, pointing to all the medications spread out on the table, "we might just chuck in the trash can."
Next: A rebel with a cause. >>