Date Posted

Dr. Makover, Chief Medical Officer JIB


Solutions for those who want total and complete freedom from all possible risk:
Problem 1: The CDC (Centers for Disease Control and Prevention) estimates that foodborne diseases each year sicken roughly 1 in 6 Americans (or 48 million people), send 128,000 to the hospital and kill 3,000 people.
‰ÛÄSolution 1: Stop eating.
‰ÛÄProblem 2: Americans are exposed to countless contaminates in even the cleanest drinking water. Americans have very worrisome levels of chemicals in their blood and in mother’s milk, most of which are inadequately studied but many have been shown to be capable of causing cancer, heart disease and other serious diseases.
‰ÛÄSolution 2: stop drinking anything.
‰ÛÄProblem 3: Air pollution leads to or significantly contributes to far too much lung, heart and other disease.
‰ÛÄSolution 3: stop breathing.
‰ÛÄProblem 4: Medications that can control or cure serious diseases as long as they keep being taken as directed all have small risks and side effects that could cause discomfort or even harm (much, much less than the harm that results if the medicines are not continued when they need to be).
‰ÛÄSolution 4: Stop taking the medicines.
Well, no one would be scared enough to follow solutions 1, 2, 3, but far too many people choose Solution 4 and suffer needlessly because of it.
The correct solutions?
1.‰ÛâFood: Be careful and prudent about what you eat and help support clean environment efforts.
2.‰ÛâWater: Make reasonable efforts to make sure your water is reasonably safe and help support clean environment efforts.
3.‰ÛâAir: Avoid polluted areas when you can and help support clean environment efforts
4.‰ÛâMedicines: Continue to use your medicines, which most of the time will not cause adverse or side effects. If problems occur, discuss it with your doctor before giving up on the medicine (most problems can be solved). Do not get questionable information from well-meaning friends, the Internet, health food stores, etc., but ask your doctor when needed. You hired an expert (your doctor), so get your money’s worth!
‰ÛÄLife without medicine: Prior to modern medicine, people suffered helplessly from infections, cancers, heart disease, rashes and many other terrible disorders that today are either no longer not even a threat or are at least far better controlled with medications.
‰ÛÄFalse information: Despite this, too often people hear rumors about medicines, or see or hear of an individual case or are misled by false information published in print, online or broadcast and they stop their medications despite the fact that they are at much, much greater risk from the disease not being treated than from the medication used to control it.
‰ÛÄPeople also misunderstand the dif‰ÛÒference between an adverse effect and a side effect.
‰ÛÄAdverse effect means that a treatment might cause damage, sometimes temporary, sometimes permanent.
‰ÛÄSide effect means that a treatment might cause temporary symptoms or problems that go away when the treatment is stopped.
‰ÛÄWhy does the FDA approves medicines that can have adverse effects or side effects?
There are two answers:
1.‰ÛâNothing is perfect. There are no perfect medicines (nor perfect anything in life).
2.‰ÛâThe need outweighs the risk: If a medication’s need and benefit far outweigh its risk, it is worth using.
a.‰ÛâWe all drive in cars even though they kill 33,000 people a year. We do so because we have made the sensible decision that having a fuller life is worth the risk.
b.‰ÛâCancer patients use very high risk drugs because if they do not they will die of the cancer.
c.‰ÛâDying from a heart attack or stroke might seem less obvious until it happens, but you are just as dead. Fortunately, the medicines to prevent heart disease from atherosclerosis are very low risk and very high benefit. They work very, very well and very few people suffer serious permanent damage from them, whereas millions are better and even alive, because of them.
‰ÛÄHow to decide: It depends on the answers to one or both of these questions:
1.‰ÛâIs the benefit of this medicine worth the risk?
2.‰ÛâIs the risk of not taking the medicine greater than the risk of taking it?
‰ÛÄSome people say, “I’m just not a medicine-taking kind of person.”
If your child announces to you that “I’m just not a going-to-school type of person,” it’s unlikely you’d say that was OK and go play.
This seems a lot more sensible: “I will take medicines only when I am sure that I really need them (using the rules and concepts outlined above).” Good doctors prescribe medicines only when you really, really need them.
‰ÛÄThe FDA (US Food and Drug Administration) goes to great lengths to ensure that they only approve medicines that have very few adverse effects. However, they do list long lists of possible adverse effects on their package inserts, even though most are likely not connected to the drug or occur only very rarely, just to be sure doctors are aware of even the most unlikely and remote possibilities.
‰ÛÄThe mandated warnings at the end of broadcast commercials for drugs are very scary, but those are the things that rarely occur. How do we know that? If they occurred more often than rarely, the medicines would likely not have been approved by the FDA in the first place.
‰ÛÄIf a medicine might have even a small chance of an adverse effect, you and your doctor will decide whether the need for the medicine or the risk of not using it justifies the small risk.
‰ÛÄIf a side effect worries you: remember that most people do not get that side effect (or it would not have been approved by the FDA) and if it does occur it will almost always go away by adjusting or, if really necessary, stopping the medicine.
‰ÛÄA better choice: Imagine that you might be dying from a terrible pneumonia. Then your doctor rushes in with great news ‰ÛÒ he has an antibiotic that will cure you! You are happy, but ask if the antibiotic has any side effects. The doctor says that some people get an upset stomach from it. Would you reply that then you certainly would not take it, cough, cough, cough? I hope not!
‰ÛÄStatin medicines (like Lipitor and Crestor) are the wonder drugs of our age, as antibiotics were in the past. Statins and full treatment of cholesterol and other factors that cause atherosclerosis (hardening of the arteries) have saved many millions of lives and can save far more if people will follow their doctors’ instructions fully and continuously!
‰ÛÄThe next time you worry about the medicines you take for important things, talk to your doctor first, read the many articles on our website and do your best not to deprive yourself of what are so often miracles of modern medicine.