Advertising medications

Currently the AMA wants the US government to stop allowing manufacturers to advertise prescription medications and medical devices directly to consumers. Why? Because it makes patients ask for unnecessary medications. And those advertising campaigns aren't cheap - they cost millions - adding unnecessary amounts to the industry.

The FDA allowed this kind of advertising starting in 1997. The first ad for a prescription medication was in 1983 and was pulled after a few days.

The US and New Zealand are the only countries which allow this kind of advertising. Personally I wouldn't mind reading a magazine which was not full of pages of fine print of disclosures of side effects and watching TV without commercials with the soft voice over of potential issues.

I think its a complete waste of money for all these ads. If you see a medication advertised, you have no way of knowing if it will work for you or is really needed even if you have that condition. I just ignore those ads anyway and would be happy never to see one again.

21st Century Cures Act

This is a looming problem as the pharmaceutical industry lobbies its way through Congress. The Act would enable the pharma industry to postpone longer availability of generics, allow fewer safeguards for new drug development which will supposedly enable faster cures. But would do nothing to stop even higher prices on new drugs.

" Rather than simply charging less, the industry is pushing for watered-down safeguards it claims will lower development costs and get patented drugs to market sooner and cheaper. It will deploy 1,200 lobbyists to try to pass the 21st Century Cures Act. This bill has already passed the U.S. House of Representatives and will have its companion bill introduced in the Senate."

"This initiative is being sold as enabling new cures to treat rare and difficult-to-treat diseases by increasing funding for biomedical research at the National Institutes of Health. But, at the same time, the pharmaceutical industry will be able to use this bill to undermine FDA safety requirements by making it easier to get their drugs approved more quickly. The industry blames rising drug development costs on the FDA's drug approval process, which it says is too lengthy."

The FDA is not there to slow approvals but to keep American's safe. Using Vioxx as an example, this drug was approved and then found to cause thousands of heart attacks and deaths. 

"Investing in scientific research is, of course, a no-brainer. But the Cures Act will not only do that. Under the bill, research funding would be increased at the expense of lowering patient protections and reducing access for affordable medicines.

A key responsibility of the FDA is oversight to ensure that the risks of new drugs and medical devices don't outweigh the benefits.

Well-designed Phase III clinical trials conducted by pharmaceutical companies to get their drugs approved by the FDA are critical for weeding out unsafe and ineffective drugs. More than a third of the drugs that enter Phase III testing fail to gain FDA approval for this reason.

One of the main advocates behind the 21st Century Cures Act, The Manhattan Institute, cites drug development costs of Phase III clinical trials as a barrier to medical innovation and rising costs."

But the problem isn't with the FDA approval process. Its that 1/3 of the drugs going through Phase III trials fail because the drugs don't work. Where is the patient safety if the drug doesn't work or has too any side effects?

"...the pharmaceutical industry will make exaggerated claims and call for reforms gutting safeguards in the name of reducing drug prices. It will contest how its products save lives, extolling the virtues of their government-backed monopoly pricing power that in reality exploits our poor and sick. The 21st Century Cures Act will be included in this campaign."

I thought it was under control

Obviously its not. Last spring after coping with multiple colds that would last for two weeks and getting them every 8 weeks, we cut my methotrexate dose down. Some of the colds turned into ear infections.  With the lower MTX dose my immune system would not be as suppressed and I was less likely to have as many colds.

I haven't had a cold since last February. Until today.

Last week I was feeling crappy so I hibernated for a day and didn't feel that bad, for a few days. I also skipped my weekly MTX injection.

This week I had my weekly injection on Wednesday night. Yesterday I was getting tired and I thought I had done too much. But I woke up at 3 am, sleeping on my right side, because my left ear hurt enough to wake me up. I then rolled on my back and decided that both ears hurt. Even with all the pain meds I am on, my ears hurt.

When I got up at 8, I called my doctor's office and got a 9 am appointment. There I learned that while it looked like I had two ear infections but there was also a virus going around with similar symptoms. But with my medical history, they need to be sure. (I hate that line.) Maybe I had the virus last week which got worse.

But I did think this was under control and I wasn't going to get as many colds any more. Since I haven't had a cold since the end of February, I guess it is better. But I hate having a cold. And being on antibiotics, again. Grrr.

Support Group Please!

I have been a long time fan of support groups, well only since my second cancer diagnosis. Before that, I thought they were for 'old people'. Now I do not consider myself old, but I have learned the benefits of discussing issues with your peers who understand how you feel.

I used to belong to a breast cancer support group which I attended for several years. It still meets monthly in the evenings but I don't do evening anything anymore.

I also used to attend a new patient breast cancer support group when I was first diagnosed and I still call the members friends and we still get together when we can and are in touch regularly.

Recently I have been trying a fibromyalgia support group. So far, my jury is still out. Yesterday was a decent meeting as the attendees actually participated. But one of the people who participated was trying it out and I am not sure she will return.

I have heard of a chronic illness support group that I might try. It really depends on what kinds of chronic illnesses are there and what the participants are like.

There is a post treatment breast cancer support group I might try in January. But it is my understanding that most of the attendees are much closer to the end of their treatment so I am not sure how that would work.

And there is a chronic pain support group which meets monthly that I attended once three years ago. I plan to attend again on this Friday. I'll have to see how that goes too.

Support groups are like dating - what a horrible analog but its true. You have to kiss a lot of frogs before you find the prince. I feel as part of taking better care of me, I would like to find a group of people where we can talk about issues with dealing with multiple medical issues. There are many people like me with medical issues but finding ones to talk to can be harder. I was offered the opportunity to start a knitting group at a cancer support center. That may be a solution.

I'll keep trying. But I need to get through moving first.

He's walking the walk, not just talking the talk

Here's an example of someone who is really walking the walk. A former NHL (Non Hodgkin Lymphoma) patient, Robert Bazemore, is now the CEO of Epizyme which is developing a drug targetting NHL (which is not just a hockey league for some with cancer).

This is huge to me.  I greatly hope that this means the company will focus on the patients and not just on the bottom line.  The article mentions that he did not mention his medical history when interviewing for the board but did reveal it after learning about the focus of the company.

As a cancer person it is very difficult not to let a disease define you and what you do. Often we keep it hidden from co-workers because we do not want to be labeled or thought of as being sick. This can be a huge detriment to one's career path. If others think we aren't physically up to a job or we might n need too much time off and would be a burden to the company and therefore would not get a job offer.

But now that we have a CEO, openly a cancer person, running a company which is developing a drug that might help him and others with his same cancer. I am a huge fan.

I wish more people could do this and society would not shame people for medical issues.

How RA (and other ailments) change your feet

In addition to the pain and fatigue that came into my life with my degenerating disks in my back, RA, and fibromyalgia, my foot wear has taken a big hit.

I have never been a fan of high heels, well not since my 20's and 30's when I was going out dancing regularly. My favorite work shoes were low to  moderate heels for years. I had no real problems with my feet.

Since my RA diagnosis, my feet are a big part of my conversations with my rheumatologist. RA frequently affects the small joints in your hands and feet at first. I can tell you my RA did start that way. I get painful hands and feet. Also, I have to use toe separators on my right foot to stop my toes from curling under each other.

I don't shop for shoes by looks or heel height. My shoe choices are no longer low or medium heels. I get to wear flats. I get to wear supportive flats with a big toe box - meaning no points. I get to put expensive inserts ($50/pair) in my shoes that aren't supportive enough. And my feet are now wider and 1/2 size longer.

Shoe brands that I now look for are Merrell's and Clark's. Naturalizer shoes, a good brand of shoes with structure, no longer are an acceptable choice. While they are supportive they do not provide enough support.

I got rid of most of the shoes in my closet as a result of these changes. Yesterday I found I wasn't alone with this. Lisa wrote about this in her blog as well. (I met Lisa a few years before my RA diagnosis and have been reading her blog for a while now.)

Back to my feet. Foot pain sucks. Because your feet are involved in things like walking and standing. Its hard to do much without using your feet. And sometimes they hurt when I am sitting or lying down.

You never think about some body parts until they stop cooperating with the rest of you. I don't miss my gall bladder much now that I no longer have it. My gall stones made things difficult for a while. I also don't miss my left ovary and uterus since they have been gone for more than ten years.

But my hands and feet are a real problem. They are too important to remove. I am stuck with them as they are and hope they don't get too much worse. And wear ugly supportive shoes.

Perceptions of cancer

After living with cancer for so long, I think I have a slightly different perception of cancer than many others.

On Saturday I had a table with a craft show. I started chatting with the couple at the next table. The husband said something along the lines of  'if you have your health, you  have everything'. To which I replied, well I don't have my health. He said he didn't either because he had had cancer three times. I asked him what kinds (because if you are a cancer person, you can ask other cancer people these questions). He said he had had prostate cancer and then basal skin cancer in two places.

My first thought was basal cell skin cancer? Is that very bad? Is it life threatening? Could it become life threatening? I don't know how bad it really is. I do not mean to dis his medical history but basal cell cancer doesn't strike me as being that bad. I think he was just more scared of the word 'cancer' than me at this point.

When I was first diagnosed with breast cancer, a group of us used to joke about what the worst thing a doctor could say to us. That we had cancer. But since we had all previously heard this, there was nothing worse they could tell us.

I have since learned that being told you have chronic, incurable, progressive diseases, cancer still is the worst thing you can be told but other things can come a close second. And I am not sure how I would react to another cancer diagnosis.

I am watching GMA as they talk about how former president Carter just announced that his melanoma which had spread to his liver in brain this summer, is no longer detectable after treatment. How does that sound? Cancer which had previously metastasized is no longer detectable? So is this a cure? Or has it become a chronic disease and not a terminal one?

So why does the word cancer continue to be so scary to some people? I used to work with a woman who would say that once she heard the word cancer, she would write people off and  consider them done for as cancer was such a killer. I felt I should speak up to her and ask if she would write me off since I had cancer twice.

It is time our perceptions of cancer changed. Yes it is a killer still and will still continue to kill until a full cure is discovered. But now many people live for years and decades after a diagnosis. Before there were treatments such as chemotherapy and radiation, it was a death sentence. But now there is hope.

And we need to remember that.