Friend who takes thyroxine seemed fine on 2 one day, 3 the next.
Is the stuff amenable to making into a suspension? So long as you can ensure an even suspension, you could ensure there was enough liquid to allow sensible splitting of doses. Obviously one would have to at a minimum shake before measuring, but some forms of insulin were done that way for years.
There are stories of people who take their dose for a whole week in one go. Classically this was done by district nurses and the like to older patients. But others are sensitive to tiny variations. I can certainly see the effect of partner taking as little as 12.5 (and possibly less). Similarly she can often tell the difference as she changes from one batch to another - even if the use by dates are quite close.
Suspensions do sound possible - I know she tried a prepared liquid thyroxine but did not get on with that. I was just trying to find a way of doing what she currently does but using a Fein rather than a Worx. Or a Festool rather than a Macallister. :-)
Thanks for that, Dennis.
Yes, I have checked with the practice nurse at the GP surgery. None of my pills is slow release - the local primary care trust refuses to pay the extra. So the only way to get a steady dose through the day, rather than one big hit, is to split the tablets.
But your point was well made and it is something to be aware of.
In australia, pills for pensioners etc are subsidised and if you get pills twice the dosage they cost the same,so split them and you get twice as many.
As he has mentioned 80mg, he is probably referring to Gliclazide, which is not a long lasting, slow release tab. It is a fairly quick acting diabetic med and it's perfectly OK to take in half tab doses. I have carte blanche to take anywhere between half and two twice daily, depending on my BMs. As Bruce pointed out, it can induce a hypo if not used with care, especially if you have to inject Exenatide, as I do. That can be a very volatile mix, so I have to check my BM and take what I judge to be the correct dose.
OK, busted! It is Gliclazide 80 mg. It is like using a sledgehammer to crack a nut. My first hypo was frightening; the Gliclazide had been prescribed by my GP but he gave no inkling at all of the side effects. Fortunately, the practice nurse warned me about hypos but not until I'd already had one.
The GP also failed to warn me about the side effects of other medication he prescribed, including a reaction to grapefruit or grapefruit juice and the loss of my skin's resistance to sunlight, necessitating copious application of Factor 50 sunscreen every time I went outside. Once again, the practice nurse advised me properly and my prescriptions were changed to other meds that do a similar job but without the adverse effects. She understands diabetes better than most because her husband is Type II.
I tackled the GP about it and he just shrugged. But like most GPs today, he's too busy counting his money to worry about the patients. What with all his bonuses for prescribing statins and getting people to attend diabetes clinics and get swine flu jabs, he's looking at an income of over £130,000 a year. Five years ago it was £73,000.
That's some rise in salary for a man who responds to reports of serious side effects of medication with a shrug.
Local diabetic clinic should be handling tricky bits of your case, not your GP. Any time I've had any problems, I've been referred straight away.
(though even the clinics have their limitations - a lot of this stuff is genuinely hard so expecting magic answers from the medical profession is foolish).
(caveat - actually my case is a lot simpler. Type I = complete failure, injections/pump or dead, no other variables, no other medication to consider).
The GP should not be prescribing meds whose side effects he does not know or care about. Instead, he is hell bent on earning his bonus for the percentage of patients diagnosed with diabetes who are prescribed statins.
One particular statin is the most prescribed drug in the world, in history. It is also the most profitable drug of any kind, ever. The NHS has been very enthusiastic about bribing doctors to prescribe it very widely without proper controlled studies on its efficacy and cost-effectiveness. There are cheaper statins available, some of which are equally or more effective with fewer side effects. But this one was chosen as the NHS's magic pill.
I have been refused a referral to a clinic. The GP would lose his bonus if he referred me. I wonder if there is any connection between those two statements.
Actually, between you and me, I don't. ;-)
Neither do I.
If you ring our local surgery for a non urgent appointment, for example you ring on a Monday & ask for an appointment on Thurs or Fri, you will be told to ring back on Thurs or Fri. The reason? A target that all patients requesting appointments will be given them within 48hrs. So they just fudge the figures - no real improvement in appointment times.
I wouldn't trust a GP as far as I could throw him.
Ref Statins. Ever read a book called Panic Nation? ISBN 1-84454-271-8.
We get that but my GP will do all she can to see me;)...
Wotcha go to the local witch doctor?..
That bang on the head isn't clouding Dave's thinking at all;?.....
Ah, yes. The target driven NHS. The one where a hospital can meet or exceed all its targets but see filth, squalor and incompetence cause the deaths of over 1000 people (Stafford).
Not since they have been "incentivised". My GP is very proud of his new Lexus hybrid.
No, but SWMBO has. Reckons it's a great book, a must read.
London Ambulance Service have a target of 8 minutes to respond to a Cat A call ( immediate threat to life - heart attack, serious bleeding, etc) . It was prompted by a report that was misunderstood by politicians - what a surprise.
If the crew arrive in 7 minutes & the patient dies - its a success. If they arrive in 9 minutes & the patient lives - its a failure. Go figure.
Much of the NHS is too busy treating the worried well (e.g. statins, aspirin, prescribed like jelly tots), rather than worrying about the sick.
MBQ
Actually the reason behind prescribing statins and other preventative medicine is to increase general health and reduce costs.
Waiting till people are actually sick is a bad move.
(note I'm not saying that statins are a good thing here, just explaining the reasoning.)
SWMBO takes thyroxine and the exact daily dose is not as critical as something like the diabetes meds talked about by another poster.
MBQ
"Worried well" is a stupid expression. It's called preventative medicine. A mate of mine caught his prostate cancer early because he bothered to go for checkups. And kids - they're well aren't they? Good, that means we don't have to bother immunising them.
I have no doubt what you wrote may well be true of your SWMBO. And according to standard theory, you are absolutely right.
But I have seen the difference tiny doses - or tiny variations in dose - can make. I have no explanation for this though I do suspect oddities in binding proteins, along with other things.
She also sometimes takes Cytomel - which requires even more care. (When needed she usually takes 2.5mcg. UK tri-iodothyronine is only available in 20mcg tablets. Luckily at present she has 5mcg US tablets.)
The problem is the people who are *made* sick by the over prescription of so called preventative meds. Statins being a case in point.
I have no problem with preventative medicine, just the direction it is currently taking.
MBQ
Exactly. The rush to prescribe statins to all and sundry has been so energetic that no-one bothered to look at the side effects. GPs are generously financially rewarded by the NHS according to how many prescriptions for statins they write. So it is no wonder that my GP suffers from selective dyslexia when I ask him about the side effects I have experienced.
Meanwhile, Lipitor is the most profitable drug in history.
No connection with the GP's selective dyslexia, obviously. Unless that is a side effect of prescribing statins and getting paid an incentive for doing so ...
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