Children's Medication Safety Alert

Our children's health and well being is so important. Last week cold drugs for children under two were being pulled off the counter for safety issues. What surprises me most about this is that the actual harmful ingredients have been unnamed "antihistamines and decongestants" with brand names. Many of these are combination of two or more medications.

One of the several brands recalled lists the actual name of the drug causing the deaths. All the brands should have the offending drugs listed. When parents know the actual medication, they can check other medicines they may still have in their medicine cabinet, and on the drugstore counter. Though a "voluntary" recall the New York Post states, "...some small companies may continue selling the product". Safety reviewers in the FDA "considered" the ban on this cold medication two weeks ago.

The reasoning behind this decision surprises me, also. They are safe when taken as directed , but "rare patterns of misuse" can lead to death. Misuse of just about anything will lead to an adverse outcome. Does that warrant removing the items in question? With almost a thousand products that fit this description (some maybe under other names not on the list), it should be known what the actual medication are that are causing the problem. My research on the Internet yielded the following.

For instance, Dimetapp contains Brompheniramine (the antihistamine) and pseudoephedrine (the decongestant). Active ingredients in Robitussin include dextromethorphan (cough suppressant) and guaifenisin (mucolytic). These are made by Wyeth. Clicking on the medicines at their respective websites, reveals the active ingredients. The press release on JNJ's (Johnson & Johnson) website leaves the ingredients out. The Tylenol website lists some of the Pediacare formulas' ingredients, and omits those for Tylenol products. Novartis manufactures Triaminic. The press release section at it's web site fails to mention the recall. Further navigation to Triaminic home page yields front page notification of the recall. Clicking on the product reveals the ingredients. Prestige Brands division, Medtech, makes the Little Colds line. The warning is found under "Investor Relations" in the press section of Prestige's home page. The product home page lists no warning, or product ingredients. Again, clicking on the medication informs you about phenylephrine and dextromethorphan. Pediacare, made by Johnson and Johnson, lists its active ingredients as phenylephrine and pseudoepedrine in 4 of its 5 products on the CHPA, Consumer Healthcare Products Association, website (www.otcsafety.org). This organization represents the country's over the counter drug manufacturers and distributors. CHPA voiced its initial concern in a press release 8/16/07, and the voluntary recall was 10/11/07. That is almost two months ago.

The FDA meets this week with "outside" experts to decide if a ban or "voluntary" recall is necessary. In the meantime, parents are responsible for making sure that the 14 products listed are not used in children under two. They must also check other medication not on the list. It appears that pseudoephedrine, phenylephrine, and brompheniramine are the drugs causing the problems. Pseudoepedrine for adults went from over the counter to a "sign for" medication last year.


The websites of the drug manufacturers shows the medications being recalled; however, the actual ingredients in the medication were likely to be missing. It was rather inconsistent. Other drugs, with the ingredients, and some of the listed drugs advised for this age group were still listed here, and for sale on the web. It was somewhat reassuring to see that the companies gave phone numbers to contact for further information.

Hopefully, the FDA meeting will clarify the issue this week. Maybe you will see a press release that lists the drug ingredients, and more readily visibility on the web pages as well as television screens. TV stations now tend to pass this information off these days by telling you to check their website instead of listing it on TV (like they used to do). Everyone does not have access to the Internet. For our children, give us some type of continuity in reporting this type of information across the news wires. The biggest task is to get accurate, detailed information to every parent's mailbox in a timely manner.

by J.L. Richardson. MD, family medicine doctor, patient advocate, and author of Patient Handbook to Medical Care; Your Personal Health Guide, a Writer's Digest 14th International Self-Published Book Award winner in reference books.

http://www.mypatienthandbook.com/
www.blogtalkradio.com/drjfpmd
www.twitter.com/MD4U

Actual book excerpts on Google Books http://dld.bz/bZ39

Inflated Insurance Premiums

In response to the most recent 11% increase in my health insurance premium, I say please tell me how to decrease this humongous, hefty payment. After about seven years of stable prices and reasonable increases that were not higher than the average 3% cost of living per year, the last four years have been double digit increases.

My premium has gone from one of my smallest monthly bills, not even in the top ten, to the second. It follows my monthly mortgage (and interest, homeowners insurance, and windstorm
insurance in one bill). There is also flood and auto insurance. Together with the other home insurance protection mentioned, the total is about half of what my yearly health insurance will be. It used to be the other way around.

What is one to do? My initial thought was...well, my second and third thoughts were to call and write the insurance company, and to see what else I could trim from the monthly budget. My hundred dollar medication (not covered by insurance)? My weekly physical therapy treatment (not covered by insurance, but prescribed by my doctor)? My visits to the doctor? My grocery bill? My gas for the car? My windstorm (if you have a mortgage they say this can't be done),homeowners, and flood insurances? Postpone my new roof or keep the leaky one? At least I will get a discount on my windstorm and homeowners insurance premium for a new roof because of the preventive hurricane code application. For all the medical prevention I have done, it seems as if my insurance company could follow suit. I have saved them a lot of money, and continue to do so.

Well, I am considering all options. I wrote a letter to my insurance company via email last week. I am still waiting for a reply. I will call them if there is no response by tomorrow. Sometimes calling and getting a response can take just as long.

It makes me wonder what other patients are doing in response to increasing inflated insurance premiums. What price is too much for your most important asset - YOU?

DOCTOR, MAY I? GETTING PERMISSION TO SEE THE DOCTORS YOU WANT TO SEE

How would you feel if you were not able to call a doctor that you want to see and make an appointment for yourself or a loved one? If you think about this happening somewhere overseas, it may be, but it’s happening here, too. In fact you would probably have more success booking an operation abroad yourself than you would a doctor appointment here.

I had not even fathomed such a thing could ever occur. Last year I called and scheduled an appointment with a specialist I wanted to see. I did not have to contact a doctor, namely the gate keeping primary care physician, to make this possible. Nor did I have to “get permission” to get an appointment for my body scan. My HMO does not pay for some providers I seek, but I am able to make appointments that I think are best for me.

I found out something new today as I was scheduling appointments for my father. I called doctors that he wanted to see and some new ones. Some of his current doctors have lost (if they ever had any) common courtesy and kindness, plus they were below par to him. So he wanted to change to doctors with courtesy, kindness and expertise. Of the four doctor’s offices I called this Friday afternoon, only one allowed me to make an appointment for him without another doctor’s referral. Hmm...doctors accepting patients referred by doctors only.

This practice of “doctor referrals only” seems quite unethical and unhealthy and untimely for patients. I am at a loss for words. I’ll have to write more about this later. Doctor, may I?

BRAVO DR. OZ

BRAVO TO DR. OZ! ON TODAY'S OPRAH SHOW HIS MEDICAL REPORTS SHOWED US WHO WE REALLY ARE IN TIMES OF DISASTER AND TWO YEARS AFTERWARD. MEDICAL RESOURCES ARE LIMITED, ALMOST EXTINCT IN POST-DISASTER AREAS. ONE OF THE MOST IMPORTANT POINTS HE MADE WAS THE FACT THAT NO ONE IS IMMUNE.

MICHAEL MOORE'S FILM SICKO SHOWED US WHO WE REALLY ARE IN EVERY DAY LIFE. IT IS A VERY THIN LINE. SO THIN THAT IT IS NOT NUMBER ONE ON ANY PRESIDENTIAL CANDIDATE'S LIST. THE HEALTH OF A NATION DEPENDS ON THE HEALTH OF ALL OF ITS PEOPLE.

WE CAN HOPE MEDICAL CARE GETS BETTER, BUT AS ANDERSON COOPER SAID, HOPE IS NOT A PLAN.

THANKS AGAIN, OPRAH.

SUMMER VACATION - MEDICAL MECCA

I am back from summer vacation. Instead it turned out to be my distant and unexpected family medical mecca. Now it is time to catch up on my medical maladies - five specialist appointments to make! I had seen my primary care doctor (PCD) a few weeks prior to my presumed vacation. Since I had not heard anything from him, I figured all my test results were okay. I would check and get copies when I got back from summer vacation with the folks.

I had received referrals for all my routine medical tests and doctor visits before leaving. I would reschedule any that were scheduled during the time I was away. This turned out to be all of them. I had requested appointment times for late July.

Upon return I busied myself with my medical agenda. First, I called my PCD to discuss endocrine specialist appointment. It seems that the referral for this, the most important, is absent! It addresses abnormal test findings that have given no symptoms that I am aware are happening.

The endocrine appointment is important because it address several medical maladies that may be giving clues to other conditions. It all started with my first full body scan 6 years ago. Several abnormalities were found. All have proven benign except for the huge kidney stone blocking the inside of my kidney. It had caused no symptoms! It is the benign tumor that now may be stirring things up. It was an incidental finding. In medical terms this is called an "incidentaloma". The scary thing is that another incidentaloma in a different organ was detected during a routine heart stress test a couple of years ago!



What do you do when you have two supposedly benign incidental tumors noted on two different organs in your body? Of course you want to have it all checked out and probably taken out!



As medical tests become more sophisticated and pick up more things, we are faced with a surplus of incidentalomas. The medical profession is in a quandary as well. Often times the procedures, which may entail surgery, to check these out are risky and life threatening. Then again, the incidental finding may be as well. Or it may be incidental. This is where comprehensive testing and routine follow up are important.



For the next few weeks, join me on this blog journey to incidentolomas.