Today is the first day of August, and that’s a good thing. First of all, this is the last month of winter, my least-favourite season of the year. Better still, July is over, and I’m not sorry to see the back of it: I had a terrible month, caused by my old “friend”, side effects from a new prescription. That’s not a new story, of course, but there’s something else: I took action, and that’s why the month ended better than it otherwise would’ve.
The story begins in early June when I saw my doctor after my most recent routine annual blood tests. The results were fine, however, my doctor wanted me to begin a drug called Ezetimibe to further lower my LDL cholesterol (this is in addition to Atorvastatin, the statin that I’ve been on for several years). My test results hadn’t changed, and my LDL level was still at what had always been an acceptable level, BUT, the official medical recommendation had changed to reduce the acceptable level for someone with my history by a few tenths of a point, and that, in turn, meant my LDL levels were suddenly “too high”—even though those levels were still in the same range as they have been for a very long time.
I was sceptical about whether the drug was needed, mainly because I thought the drop in the new guidelines was probably an overreaction. Even so, I told my GP I’d go along with it, adding that even though I admit statins are wonder drugs, though I don’t like them, either (for many reasons), though I nevertheless take one. He reiterated that the new drug wasn’t a statin, and added it’s generally well-tolerated. Yeah, well, I have a history of not “well-tolerating” drugs others have no problem with. This turned out to be one of those times.
I began taking the drug on July 1. Within days, fatigue (a common side effect) became nearly debilitating, to the point that I couldn’t do any task that took longer than 10 minutes without sitting down to rest (while several of my medications also can cause fatigue, the new fatigue was noticeably worse). A few days later, I started feeling sleepy in the early afternoon, and one day I dozed off in my chair, something that never happened to me before that.
Two weeks ago, I began a DIY project, one that I’ve done MANY times before, so I knew it should take 2—maybe 3—days. Eleven days after I started, it still wasn’t done. My back lawn needed to be mowed (it was around half a week overdue, though partly because of weather), but that takes around 20 minutes and is physical, obviously. I couldn’t face even trying to do it.
As this continued, it became increasingly obvious to me that it was the medication causing all that. And yet: I nevertheless spent (too much) time blaming myself, that I was just being lazy, that I should just suck it up and get on with it, or even that maybe I’m too old to do this sort of project anymore (even though it’s similar to ones I did in this house twice before). Beginning a week ago, I started getting somewhat lightheaded, then I started getting low-grade headaches, too. All are also possible reactions.
Despite the growing list of problems, and how miserable I was, I didn’t act immediately. I’m generally conflict-averse, and, like a lot of folks in my age group, I tend to not want to disagree with my doctor. At the same time, however, I always read up on medications I’m prescribed using reputable sources like New Zealand’s “Medicines and Medical Devices Safety Authority”, MedSafe (among other things, MedSafe posts PDFs called “Consumer Medicine Information” on approved medications, and I always download the relevant CMI sheets). On the other hand, getting access to the particular “recommendations” that prescribing is based wasn’t easy, and getting access to the actual studies underlying “recommendation” can be even harder. That reality makes me doubt the thoroughness of my own research—and also more inclined to “give it a bit more time”.
This past Wednesday was the start of my next 28-day allotment of medications (it was delivered a week or so earlier). That morning, I was beside myself: What should I do? I had 28 more days of the drug in my house, and another 28 days would be shipped in a few weeks. I thought that maybe I could continue, and contact my doctor about stopping. Then I got clarity.
I knew that if Nigel was here, he’d have been telling me—coaching me, actually—on how to change the bad situation, just like he did in 2017 when beta blockers turned me into a “zombie” (Nigel’s actual word for it). I also knew that he never hesitated when he reacted badly to a drug he was on, including a statin at one point, which he stopped (his “need” for them having been borderline to begin with). I thought about all of that and resolved I would do what he had always done and just stop taking the drug.
When I took my medication Wednesday morning, I did not take the Ezetimibe, but I put the pill aside. Then, I sent a secure message to the practice nurse (because they took away the ability to send a message to GPs), letting them know I’d stopped the drug and why. For me, stopping the drug was non-negotiable, but I realised that it might need to be a managed process, and so, they needed to know.
I later spoke with the nurse on the phone, and she said she told my doctor about my action, and he said it was okay to stop. She also said that she’d contact the pharmacy to have them remove the drug from my next delivery (so it won’t be wasted, like this current month’s supply will be). I’ll go see my doctor next month, and I intend to begin a review of all my medications, to look for ones that may produce as good or better results with fewer side effects (especially less fatigue).
The nurse later rang back to say my GP was fine with my move, and that later one I can try a different drug—making me think to myself, “not bloody likely!” But she also said that, ultimately, the decision is mine, which I thought was refreshing.
Thursday morning, the pharmacy rang me to make sure I knew the drug was being stopped and wouldn’t be in the packet, which was great. But this is a good spot to say why the drug I have in my hime is being wasted: It’s because it’s in my house, and it can’t be reused, so it must be destroyed. The pharmacy sent me an email about a week after I’d received the previous allotment to tell me it was on its way. However, due to accumulated missed doses over the past several years, I start each 28-day alottment around a week after the scheduled start date. What this means is that I’d barely started the drug when I go the email, and the worst was yet to come: At that point, I had absolutely no reason to expect I’d have such a bad reaction. In fact, the worst effecys weren’t present until after I received my current 28-day allotment. So, there’s no way I could’ve known what would happen in order to stop it earlier. Not surprisingly, I nevertheless feel guilty about the doses of the drug that will be wasted. Of course.
This particular tale began with my somewhat reluctant willingness to go along with a medical recommendation I was sceptical about, and probably with a false sense of confidence that it’d be okay (because I haven’t had a problem with a prescription in a long time). Then it became a tale of misery and woe before becoming one of a new resolve to do what I know to be right for me, and to advocate for myself, since no one else will.
Thursday morning, I woke up feeling better than I have in several weeks—though part of me was frightened it was an illusion that would pass. However, that was 48 hours since I last took the drug, and it was leaving my system, so the misery didn’t return. In fact, I later mowed the back lawn, and it went well, though my recovery time was a bit longer than usual.
Is this a new era for me? Maybe. But it’s also possible that I’ll forget this latest bad prescription experience and repeat the mistake (unless I check this blog, as I often do: By sharing it here, I may be reminded about all this). I was also reminded, yet again, that even now Nigel can still help me find my way through difficult times, especially when I’m feeling the most miserable. That will help me again in the future.
Right now, though, I’m just glad for the end of the headaches, lightheadedness, and extra fatigue on top of the existing fatigue that other medications seem to have given me. After all, I still have to finish that DIY project, do other ones, and then in a couple weeks the back lawn will need to be mowed again. For the first time in a month, all of that genuinely feels possible.
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