Tuesday, November 07, 2006

Hypertension 3: The First Pill

One pill makes you stronger, one pill makes you longer (wait, that's Viagra).

My first prescription medication—golly, I think I’m gonna get all weepy--was a diuretic. Basically, a diuretic makes you pee. A lot. Think Niagara Falls, but with flushing. And no, not the Flushing where the 1939 World’s Fair was held, stop being silly.

The idea behind a diuretic is to remove water from your blood, which in turn will decrease the volume of blood in your system, which in turn should decrease your blood pressure: less blood, less pressure. And it did. But, unfortunately, it also did a few other things….

Medical science ain’t perfect. Often it’s more art than science. Not so long ago, doctors bled patients (actually, sometimes that helped) and used leeches (actually, sometimes that helped) and used herbs and not artificial chemicals made in a laboratory (actually, sometimes….)

No one—patients or doctors or Nostradamus—has any idea how prescription medications will affect a person. You gotta swallow the pill and see what happens. Good-bye human being, hello guinea pig. There really is no other way. Surrender. Resistance is futile. Live long and Prospero (pills are really magic, aren’t they?)

Every prescription medication seems to come with a lengthy list of potential negative side effects. For some Hypertension, the side effects appear commonly accepted to the point where the tiny print notification does not even bother to ask you to tell your doctor about them (light headedness or dizziness, for example). No can tell you which side effects you will actually suffer, or how strongly. It's all a crap shoot (reference: "explosive bowel movements"). Basically, modern medical science says: drop the pill and see what happens: turn in, tune in, and see if you drop out.

Some of the side effects I had I did not realize occurred until well after the fact. The side effects are often not obvious (except in hindsight). Sometimes it can take months before you know something is not quite right. For example, how weak you’d become, how forgetful, how unfocussed, how irritable. Assuming you do realize it….

I knew little about side effects. Once I had rejected an anti-cholesterol medication because I also had to take regular blood tests to see if the medication was killing my liver. I like my liver. My liver is my friend. I’ve known it a long time. Why take a medication that could kill it?

So: I had never been particularly sick, except perhaps for my taste in movies (see Takashi Miike, Japanese director). While I do have a serious medical condition, sleep apnea, I’d never taken medication for it—the treatment involves having an air hose stuck to my nose every night (say goodbye handsome bedtime dude, and hello Elephant Man).

None of the doctors I have been involved with for Hypertension have dwelled on the negative side effects of prescription medications. Their interest is in “curing” my blood pressure. From their point of view, the side effects of prescription medications are not nearly as bad as a stroke or heart attack. This point of view simultaneously shows concern for and rejects the concerns of the patient.

My family doctor prescribed a diuretic, and it worked, bringing my systolic numbers down to a 'mild' 145 or so. It was great, apart from feeling dizzy.

Some people have said I’ve always been dizzy, hahahaha, but this was different. After a few weeks I realized I often felt dizzy. I was taking afternoons off work to go home and nap. At first I thought it might be related to my sleep apnea (but I’d been on the nose hose for four years, so that did not make sense). Being in the middle of it, I thought everything was normal. But it wasn’t. I began to forget appointments. I began to slow down at work. It was hard to remember the details of my investigations and to juggle all the cases. It was like being drunk or stoned--you think all's a-okay, but it ain't.

As soon as I told my family doctor about the dizziness he immediately took me off the diuretic and put me on something else. This was the first time my medication was changed--but it was far from the last. The medical merry-go-round had begun, I was riding the horse, but I had no idea what brass ring to reach for.

As the merry go round sped up and went out of control, I should have looked for Farley Granger and given him his lighter back.

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