There’s more Americans who die from accidental prescription drug overdoses than in motor vehicle accidents, and there’s about 100 drug-related deaths that happen every day. Dr. Louise Achey, has been a practicing pharmacist for over 40 years and she’s also the author of Why Dogs Can’t Eat Chocolate: How Medicines Work and How You can Take them Safely. She joins us to discuss the importance of keeping a list of drugs, using a local pharmacy and what to do when you're prescribed a new medication.
There’s more Americans who die from accidental prescription drug overdoses than in motor vehicle accidents, and there’s about 100 drug-related deaths that happen every day. Dr. Louise Achey, has been a practicing pharmacist for over 40 years and she’s also the author of Why Dogs Can’t Eat Chocolate: How Medicines Work and How You can Take them Safely. She joins us to discuss the importance of keeping a list of drugs, using a local pharmacy and what to do when you're prescribed a new medication.
Hello and welcome to The Senior Bulletin Podcast. There's more Americans who die from accidental prescription drug overdoses than they do in motor vehicle accidents. And there's about 100 drug related deaths that happen every day. Dr. Louise Achey has been a practicing pharmacist for over 40 years. And she's also the author of why dogs can't eat chocolate, how medicines work, and how you can take them safely. And she says it's not what drugs you take, but how you take them back can endanger your life. My name is Darren. This is the senior bulletin podcast where we discuss issues and topics that matter to seniors.
Unknown Speaker :You're listening to the senior bulletin podcast with Darren Marlow. The podcast where we discuss it issues that matter to seniors.
Unknown Speaker :You help clear up misconceptions about how medicine works, and how to take it safely. Tell us how you do that.
Unknown Speaker :Well, one of the things that I see over and over again is people think that you swallow a medicine, it dissolves in your stomach, and then it floats away. But once you swallow a medicine or a supplement, and your body has to figure out what to do with it, and what happens is your body then responds to what you've taken. It goes to wherever it needs to go to do what you want it to do, or what the doctor is intending it for it to do for you. And to do that, it has power, and anything powerful enough to help you also has enough power to harm you, if it's combined with the wrong thing, or given to the wrong person or the wrong dose. And I see that in my practice and my my mission is to help people get to benefit from their medicine and avoid the downside.
Unknown Speaker :Okay, perfect. There's more and more Americans who die from accidental prescription drug overdoses than in motor vehicle accidents. And there's about 100 drug related deaths that happens every day. Can you tell us what can we do to prevent these types of tragedies?
Unknown Speaker :Well, one of the things I want to tell your listeners is two things that they can do right now. To make medicine safer for them and their family and their loved ones. And the first one and the most important thing is to make a list to make a complete list of every medicine and every supplement that you take. And you keep it up to date and you show it and give it to every doctor. You see. Every dentist you see if you go to the emergency room. You have it with you. I the biggest misconception that I see is that with electronic records, they think that the doctors actually talk to each other. And that doesn't happen, especially now with COVID. information isn't flowing. It is not flowing from your specialists that you see the cardiologists that you see. And your other doctors, they don't know what the other ones are doing. And without a list that has everything on it that you're currently taking. They're in the dark and the very best doctor can really harm you. If they aren't in the know if they're working blind or if they're guessing what you're on. So making a list is the most critical thing. If they don't carry around a current list of their medicine. They are an accident, really, from medicine waiting to happen.
Unknown Speaker :I know how important it is to carry a list of medicine. My sister and I we both we we care for my mom. I have all of her medicine on my phone. I've made sure my sister as has offered medicine on her phone. My niece has it on her phone. That way, whenever my mom goes to the doctor, or if she's ever, you know, asked what medications he takes, you know, we both have those lists available right there, you know, on our telephones.
Unknown Speaker :Oh, that is so much you get so much better care, it is absolutely no comparison. And the other thing that that list needs to have is any medicine that has not worked well for you that you've already either allergic to, or you've had a bad reaction to, because if you don't give that to the doctor, they could turn around and give it to you again. And you may not recognize that until it happens again to you. And so it's very important to have your allergies and the list of your medicines that you're currently are taking.
Unknown Speaker :I know that one of the questions that's quite often asked on medical forums is Are you allergic to any medications? And many of us haven't taken many medications. So we're not sure if we're allergic to certain medications. How would we want to answer that question?
Unknown Speaker :If you know that there's a medicine that has caused you problems in the past, you need to put that down. Let's say when you take amoxicillin, it gives you diarrhea, or or you vomit it back up. A lot of people actually are sensitive to pain medicines, causing nausea and vomiting. So that's important to put down so that the doctor realizes what you've tried and then they can decide and design something for you. Instead of trial and error trial and error trial and error if nobody kept track of the things you've been tried on and you go over that over and over again. That is very frustrating as well. There is one other thing and be You don't know for sure who's going to react to medicines. The second thing that I want your audience to do right away is to be willing to speak up when something is not feeling right after they've been started on a new medicine. I can't tell you how many times I've seen people suffer for months and even years with side effects that Well, my doctor put me on that medicine. So it must be good for me now, and that's this medicine is causing them problems that could be solved with another medicine. I saw a patient of she was a retired she was in her mid 70s. She'd always wanted to ranch so when she retired as a school teacher in her mid 60s, she bought a farm and she had horses and miniature horses and llamas and dogs. She just loved it and she was so happy. Then I noticed when she came in, she hands down. I said what's wrong and she says what Louise, Dr. Louise, I'm going to have to sell my farm. I said, Why? She says, I just can't handle it anymore. I can't lift the feed buckets and carry them like I used to. I said, Really? You seem pretty good just a few months ago. Well, I just can't do it anymore. And my daughter suggests, well, you know, Mom, you're getting old. You're in your late 70s. And I said, well, hang on a second. Have you had any medicine started in the past couple months? Well, yeah. I said, When did you get started on the medicine? Well, late February, I think my cardiologist started me on something for my cholesterol, said, Okay, so when did these wouldn't you notice that you're getting weak? I'm late February, said, Okay. I said one of the main side effects of cholesterol medicines can be muscle weakness. So I want you to talk call your doctor call the doctor's office of your cardiologist and this is what I want. You just tell them. Dr. So and so can I have a trial off of my Staton medicine? Okay, if you go off of it, and you call them up and say, Oh, I didn't like that medicine, it didn't like me. I'm not taking it anymore. Now your doctor is no longer on your side. Okay? They don't really want to work with you. But if you call up and say, I've been having weakness in my arms, and I'm not sure if it's related to the medicine, can I do a trial off the medicine to see what happens? Now they're on your side, because there isn't a single doctor I know who wouldn't say yes, no problem. And there are many other cholesterol medicines that can be tried. And for her within a week, she was back to her usual strength, and she did not have to sell her farm. And we had a happy ending. But I just worry about how many times people are taking the idea that all I'm just not able to do things anymore. I must be getting old. And taking that and assuming that that's what it is, when it could be an might be a medication issue.
Unknown Speaker :That's very useful.
Unknown Speaker :I want your your listeners to be willing to speak up. So I call it in my book, I call it be a squeaky wheel. It whenever you start a new medicine, you want to be extra careful to monitor what's going on, so that if something happens, you can get back to your doctor because doctors went to medical school. They didn't go to mind reading school. So if no nothing, no news is good news. When they start you on a medicine. They don't hear back, they assume everything's going fine. They have no idea. And some of my patients have been suffering for years with side effects that could have been taken care of more quickly.
Unknown Speaker :Well, but a lot of people find this information very useful, and probably just evaluating themselves isn't realizing Oh, maybe I should Ask my doctor a few questions.
Unknown Speaker :Yes. Another thing that I third thing that I'm hoping that I can give to your listeners is if there's any way you can use a local pharmacy rather than a mail order pharmacy, you, you really need to cultivate a relationship with a pharmacist, a face to face relationship. So you can bring up questions that are bothering you. It's harder to get to the doctor's office these days. And oftentimes your pharmacist is up on your medicines or more tuned into medicines than even your doctor is. But a lot of people have mail order and the if they're just don't they don't feel comfortable picking up the phone waiting on hold for 20 minutes. And that's just to talk to somebody, they talk themselves out of it. So they have questions, but the questions are not always getting answers to.
Unknown Speaker :Mm hmm. Now speaking of new medicines and things like that, what are some of the questions that we should be asking our doctors when we're prescribed new medications?
Unknown Speaker :Oh, The most important thing is, What is this for? What am I taking this for? And that way, you'll be able to tell anybody that that needs to know what you're on it for. And if you're already on medicine, is this in addition to what I'm taking? Or am I taking this in place of something else? Is this a substitute for a medicine that I'm currently on? Because many times people will get will, they'll send the prescription to a mail order pharmacy, and then a week and a half after the doctor's visit, it comes in the mail, and you go, oh, there's my new medicine and they start taking it not realizing that the doctor wanted them to switch one medicine for a different medicine, but they didn't want them to stop the old medicine until the new medicine got there. But it's not obvious. And so they end up on two medicines when they really only needed one. And that adds to problems, too. So what what is it for? Is this in addition to what I'm taking, or is this to replace something and if so, If it's replaced something, what do I stop? And then what do I need to know? What do you need to hear about if something happens? Okay, so doctors these days, don't have a lot of time with people. And sometimes they don't have a lot of time to explain this. And if you go to your regular pharmacy, they usually will try to tell you some main things like with the cholesterol medicine of my friend who had the farm, one of the things that they needed to be watching for was muscle weakness. So she didn't realize that but it's, I'll have be honest with you, it isn't always easy to recognize that as well. My dad was having problems getting up and going to the bathroom, he's 91. He just turned 92 but back around Christmas time, he was having lots of trouble getting up at night. And so his doctor started him on a medicine called flomax for his urine stream. And the first night everything went really well. You only had to go up get up once or twice, but the second night, when he got up, the second time he fell down. And so he ended up in the emergency room. They checked him out. Everything was fine. He went home. Two days later, he doesn't even remember falling. His wife mice, my stepmother found him on the floor confused and called 911 because he couldn't get up. And it was like he was admitted the day before my daughter's wedding. So I couldn't even go to to the hospital to check on him or anything. So afterwards, he'd been in the hospital about four days when I got there. And he was still on the flomax. Still confused, still shaky. And they were thinking about discharging him to a nursing home. You know, they're thinking he's old. He's, you know, this happens when you get old and I and I said to the hospital Doc, I said, you know, this all started when, like, within a couple days after he started his new medicine, flomax, and the hospital doctor looked at me said what? I thought he'd been on that for months. Another example of lack of good communication and not everybody has all the information I said no. And, and I looked over at my dad, they were nodding their head. Yeah, we've only he's only been on it for barely a week and a half. And the hospital doc goes, Oh my goodness. I said, Yeah, that's dizziness and, and lightheadedness and confusion are the side effects that we often see with that medicine. And then I turned to the doctor and said, Can we do a trial off of the medicine and see how he does and doc said, Absolutely. And within two days, Dad was back to his old self. He had no problems with balance. He was been home, and he's been able to get back on his feet and do whatever he needs to do. And when I think about how close we came to writing him off, it scares me and I want your listeners to realize that if they don't pay attention to what happens after starting a medicine, then they might end up being written off. By Oh, that's just old age, it might not be and blaming the medicine or at least doing a trial off the medicine could be a very valuable thing. But again, it's best if you work with your doctor, the magic words are, can we do a trial off the medicine? And they will be on your side every time?
Unknown Speaker :Can we do a trial off the medicine? Is the magical question
Unknown Speaker :on your own, and then tell them Oh, I didn't like that medicine. I didn't take you know that because that's an almost an insult to the doctor. And then they don't want to work with you. But if you ask them, can we do this, then not only are they tuned into number one, you've got a problem with the medicine possibly. Number two is they want you to succeed too. So if if you are better off the medicine, they're going to help you find another solution instead of suffering and silence for potentially years. I just don't want any of your listeners to end up in a nursing facility just because their medicines did not agree with them. There's more of that than you realize. And what's part of my mission is to help people take their medicine and get the benefit without the downside.
Unknown Speaker :Now, quite often, when we get medications, there's a big, bold, fluorescent colored sticker on it that says, Do not take with alcohol Do not use alcohol while taking this medication stuff to that nature. What does alcohol do when it's mixed with prescription drugs?
Unknown Speaker :Okay. What alcohol does is it's a central nervous system suppressant a depressant, so it makes it harder for you to think and it Fix your balance. And when you mix it with a medication that does the same thing. It's almost supercharges or turbocharges. That effect. I remember, back in pharmacy school, we had one of my friends we were, we had a really bad allergy. And he was taking some kind of a deal contact medicine for allergies, and it causes drowsiness. And so he was taking it. It was a time release. And we were down at the pub celebrating the end of the testing cycle. And I remember looking over at him, and he had one beer, he was barely through one beer, and he slid off the bar stool into the side of the floor. And we were all going wow. But it was the combination of that beer and the contact and a histamine medicine that he put on, and it just boom, and it's unpredictable. And so that's a big challenge. What alcohol also does is it slows down Your body's ability to detoxify the medicine. So it builds up. And it causes problems with the medicine. So one of the things that we see with the pain medicine, combination with alcohol is that the pain medicine, your body's used to it, your body gets used to a certain level of it and it it, it takes it in and detoxifies it, and it gets rid of it and everything's in perfect balance. Then if you add alcohol or some anti anxiety medicines, then that that they use the same pathway of detoxification in the liver as the pain medicine, so it's like going trying to get on a interstate at the very busiest time of the day. It's all full and you've got to wait your turn. So what happens when you have alcohol with this is that the pain medicine has to wait. It has to wait its turn and the Alcohol and the pain medicine slowed down the whole detoxification process, which means that the level of pain medicine in your body goes up because it backs up. And that's how people die is that backs up and they stopped breathing because they they now have an overdose when they weren't before they were able to keep up with it, because it was the same dose and their body was used to it, but then they dump this alcohol on top of that, and all of a sudden, it slows the whole detoxification process down almost like throwing a monkey wrench in it, and then they can't their body can't handle it.
Unknown Speaker :No, just to change the the subject just a little bit. What about supplements? I know there's a lot of supplements on the market and the FDA doesn't necessarily regulate a lot of them. Does that mean that they're not good for us? Or how should we look at non regulated supplements
Unknown Speaker :Well, it's a it's a wild wild west in a way out there. Getting benefit from supplements is a trickier business and getting benefit from a prescription medicine over the or an over the counter medicine because before you can market a medicine, whether it's prescription or over the counter, you have to prove to the FDA that it's effective and it's safe. Not so much Not so with the supplements. If it's an unsafe supplements, and the FDA gets enough complaints, then they pull it off the market and there have been a couple of supplements that they've done that with. Okay, but my, my experience with supplements is that they can help you but so many times when I asked somebody Okay, you take fish oil, is it working for you? Well, I don't know. What What do you want the fish oil to do? Well, I don't know. They have no clue. They're just taking it hoping that it might make them feel better, but they haven't idea. My suggestion that I asked all my patients to do is to do a diary, a symptom diary before and after? Because then you'll be able to tell whether or not the supplements doing anything for you. Because frankly, if it's not, why are you spending 30 $40 a month buying it? Most supplements do not do very much at all, which is a good thing, because the FDA doesn't have to yank them off the market because they hurt people. But supplements are not necessarily proven. And many of them are not tested to have the same or the same amount of medication in them. Some of the supplements coming out to have little or none of what they say they have. But the FDA doesn't have any way of regulating it. And frankly, they don't care as long as it doesn't hurt people. But if you're paying for it, it's a different story. So my suggestion that I asked people to do is go Do you want it to do, if you're not clear about what you want it to do, then think again about whether you want to spend your money. And then what I ask people to do is at least two or three times, do some symptom diaries. If, for example, you want it to give you more energy, or to help you sleep, how is your sleep now before you try it, then after you've been on it, at least a week, or so, you know, think about how you're doing and then write down how you're doing because writing it down is so much more accurate than trying to remember what you were before. And it gives you that feeling that okay, it is working or it isn't working, because I can tell you that not every prescription medicine works in people. There are people that have no place for that medicine to go in their body. No, no special place for it to to be attaching and doing what it needs to do. So it doesn't work at all. And we see that with supplements as well. But if Have a diary where you're writing down your before, and then you're after, you can then tell, gee, I am getting better sleep. I'm not waking up as much, or Oh, I've got my energy levels now eight out of 10 instead of five out of 10, or three out of 10. That's a good. So when that makes things as it's helping you, I don't have any problem with people taking supplements, if they're helping them, but I really feel bad for people who are buying supplements and paying for the month after month, and they're not doing anything.
Unknown Speaker :So for people who you mentioned that prescriptions don't work for, what are some of the recommendations that you offer for those folks?
Unknown Speaker :Well, if one, for example, blood pressure medicines and medicines for depression, they're not not everybody gets a benefit from getting a medicine for their depression. In fact, about 30% of people with sick, serious depression, no matter And seems to help them which is a sad thing. And D I've been, I've had depression, I've been on medication for depression. And I was grateful. I was really grateful for that. So it just all depends if most of the time there's more than one type of medicine, we even have when you go to surgery, even when you go to surgery, your anesthesiologist or the anesthetist, who's going to put you under has at least three different medicines to try. Because the first one they tried might not work. And frankly, they don't really want to do surgery on you if you're not anesthetized, as you can imagine, so they're going to make sure that you are where you need to be, but they may it may take them a couple medicines to find out that right one for you. So that's the same thing with blood pressure medicine, with medicines for depression, even with cholesterol medicines. There's other options for those who have side effects from cholesterol medicines. And we try those first to see if they were another One is easily more easily tolerated.
Unknown Speaker :Okay? If a product says that it's all natural doesn't necessarily mean there's good force.
Unknown Speaker :Ah, all natural. Some of our most potent poisons are all natural. You know, arsenic. strychnine.
Unknown Speaker :Wow. And
Unknown Speaker :digitalis is actually poisonous. foxglove is made into a medicine for the heart. But if you try to drink it as tea, yeah, kick into trouble. And of course, mushrooms, some mushrooms are absolutely deadly as well. Those are all natural products. So be natural doesn't necessarily mean safety. One of the main things I mentioned before with supplements is most of them are to dilute or to really do a lot of stuff. So that means they are unlikely to do much harm, but there are people that believe that if they're it's all natural and a little and one pill that's recommended isn't doing it? Well, it's all natural. I'll just take three pills. You know, if one isn't doing it, well, I'll just crank it up. And maybe that might work, but maybe that might give them problems. So not everybody gets benefit from everything. And natural just means where the source of the medicine came from. And many of our medicines that we use today originally came from natural sources, originally, and then we improve.
Unknown Speaker :Okay, so you also earn the author of a book. Yes, why dogs can't eat chocolate, and how medicines work and how you can take them safely Tell us about it.
Unknown Speaker :That was my way of trying to explain to people how to how medicines work so that they can keep themselves safer. Again, many people believe that when you when you swallow a pill and it goes into your stomach and it dissolves, it magically does what it does, and then it floats away, and no problem. And that's not true. Medicines have to do something in order to be do it in order to lower your blood pressure. In order to provide pain relief, or anxiety relief or depression relief, it has to go somewhere and change something in your body. And then your body has to figure out how to get rid of it. Okay. And so, when you take medicines, that when they act at the same time, they cause unexpected or unintended things, or like with the alcohol and the pain medicine, when they fight for the same way out, they overwhelm the body's ability to detoxify them, then you can get overdoses or very severe side effects or adverse reactions to medicines. So The white dogs candy chocolate is explaining that for example, the reason I titled it why dogs candy chocolate is because a natural product in chocolate. theobromine is very similar to caffeine. In fact, it's very, very close. And with dogs, they can't metabolize it. We metabolize caffeine and theobromine very rapidly, most of us do. Now, the few of us that don't tend to avoid coffee because it gives them the jitters and makes them feel agitated. But with dogs, they can't detoxify it. Their bodies are different than ours. And so even small amounts of chocolate can be have lethal consequences, causing seizures and death from overstimulation. It's like the biggest caffeine burst ever all at once. So something that's simple, could be so he is again so so so For people, but so dangerous for dogs, we all are a little different in how we handle medications. And those differences can be a source of benefit, but they can also be a significant source of harm. That's why when I say pills can kill, yes, they can, because I can't look at you and say, Oh, you need just this amount of medicine and this medicine will be perfect for you. It's a trial and error process every single time. Every time a doctor prescribes you a medicine every time you pick a over the counter medicine from the counter from the shelf and take it home and take it you're doing that, that experiment on yourself. You can't print. Yeah,
Unknown Speaker :so definitely please you also have a website. Tell us about it.
Unknown Speaker :Yes, I do. I've been writing a column for a newspaper for about five years. And I I write about things that come up Like how to treat a nosebleed? Um, what do you do to get rid of your medicines? How do you dispose of medicine safely? What types of medicines are used for osteoporosis? What's in a B complex vitamin? And why do people like bag bomb? Just things like that? And I've put them on a website called medication Insider. And it's at medication insider.com. It's a blog that has all kinds of interesting articles that talk about medicines, supplements and drug safety, and also how to treat nosebleed.
Unknown Speaker :Alright, and is there anything else you'd like to share with the audience?
Unknown Speaker :Yes, I have a free gift for your for your listeners at medication insider.com. It's a special report called the top 10 pitfalls of a male of using mail order pharmacies, and how to avoid them. And it's on the website many of us do use mail order pharmacies. There's some certain things patterns of problems that I've seen over the years. And this is to help them understand and have to avoid getting caught with that.
Unknown Speaker :That's awesome. Thank you in advance for that.
Unknown Speaker :Dr. Louise. It's a pleasure having you on the show today as a guest, thank you so much for your time.
Unknown Speaker :Thank you, Darren.
Unknown Speaker :I hope you enjoyed this podcast. And if you would, please subscribe. And that way you can enjoy all of our future podcasts. Be sure to visit the senior bulletin comm where you can sign up for our newsletter, connect with our former guests, learn about Medicare and also get quotes and apply for life insurance. Take care and I'll talk to you next episode.