side effect

Saw a different GI doctor today. The one I saw before christmas had gone on vacation over christmas. I'm sure it was a very much needed vacation, especially if all his patients dislike him as much as I do.

The new one was at least more likable. Also he doesn't look like a rat.

The new non-ratlike doctor recommended yoga, set up an endoscopy since the last time my stomach hurt like this I had some stomach polyps. God that sounds nasty, doesn't it?
He asked me "Did they find a lot of them?"
I said "The other guy didn't really say. I mean, who's gonna come in after the procedure and say 'hey I found a whole mess of polyps in there!' to a patient? He told me 'I found some polyps and removed them'."
This prompted him to confer with the chart. Apparently it was a whole mess of polyps.

He also gave me two scripts, one I will try because it's supposed to help me actually digest what I eat. The other I am a little apprehensive about because it is addictive.
"Isn't that addictive?" I asked when the doctor said the name of the drug.
"Hm? That? No, it's not addictive..." he said, sounding genuinely shocked.

But see, when this drug first came out I was engaged to Bob the ER doctor (then the ER resident) a.k.a. "Flounder". The drug was seriously pimped by the reps, I recall Flounder telling me at the time. It offered the pain control of opiates but it wasn't an opiate. Nor was it chemically similar to other (synthetic) opioids. Wonderful! So everyone promptly began prescribing it. Here you go. Here's some for you, and for you. I remember the sample boxes had a butterfly on them. I remember because Flounder, along with the other doctors at the drug rep lunch that week were given goodie bags of samples along with the usual drug schwag.

Then the bad news came. Turns out it was addictive. Oh yes indeed. No more samples of this drug, although the butterfly bedecked pens and note pads remained.

While I know it is a horrible thing to question one's doctors, I did look it up when I got home. Turns out it happens to bind to certain opioid receptors. I also found this article which I excerpted below.

A 74 year old man with lung cancer was referred to the palliative care team for symptom control. He had pain in the left side of his chest and was advised to take tramadol hydrochloride 50 mg four times daily at home. Soon after starting the tramadol, he began to experience auditory hallucinations. These were particularly vivid and took the form of “two voices singing, accompanied by an accordion and a banjo, singing songs, songs by Josef Locke—old songs.” They were distressing, making him feel as though he was going mad.

No offense to Josef Locke (whoever he is) but I'm quite sure I would also feel distressed by having vivid hallucinations of any duet accompanied by a banjo and accordion ensemble. Who wouldn't?

The addictive issue is more relevant if you take it long term. These days most doctors are more concerned with treating (or masking) symptoms rather than using them to diagnose whatever is causing them. I'm not a fan of adding a "take it for, well, um, let's see here... for ever. And see me when you need more" drug to my daily routine. I've already got a couple of those, but at least those are relatively benign and are meant to control the underlying problem rather than just make the symptoms tolerable.

I think I'll skip this drug. I'd like to say I'll skip it in favor of a diagnosis but that's probably not an option. So I'll skip it and hope the other one works, or at least works enough.