Author: Beth

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Since many questions about drug interactions and side effects come up, I wanted to let everyone know about ePocrates Rx for handhelds. It’s a free program you can download for your PDA. I can look up a drug on my Palm Pilot and see how it’s covered by my insurance, whether it interacts with any other meds I’m taking and what the possible side effects could be. It’s really amazing, especially since it’s free.

I may subscribe to the Pro version, which is about $60 a year. It includes monographs for alternative remedies.

Here’s the URL:
http://www.epocrates.com/

Labs

In October I had blood drawn at my local clinic, rather than at UNC, since my doctor was out of the country. The local clinic folks couldn’t find the report when I was there for my appointiment, but said everything “looked ok!” At first I didn’t think it mattered that much to me, since I feel pretty well, and another appointment is just around the corner for me. When I saw my explanation of benefits from BCBS of NC come in the mail though, I decided I need to have the lab reports! My insurance company was charged about $225 for those tests! I’ll call today and ask for them again. Even if they can’t find the reports, I’m sure they can easily get a duplicate. The results are all in a computer someplace, right?

Blood glucose level

Dex can cause increases in your blood glucose levels, which can wreak havoc for diabetics. I stopped over at my mom’s house today and used her monitor to check mine. It was a-okay on day 4 of my dex pulse. I’ll continue to check when I’m on dex. So far, no problems.

Drawing blood

This is a good response to a question about preparing to have blood drawn if you have problems getting a good sample.

Some steps that can definitely be taken to decrease your discomfort. You might try one at a time

before the phlebotomy –

  1. Drink lots of fluid on the day of the phlebotomy.
  2. Wet some paper towels or whatever is handy with warm water and place them on the arm site. This is little more convenient than keeping your arm under the hot water faucet but the running water is actually a little better since it also applies ‘pressure’.
  3. TELL the person that you allow 1 attempt. If that is not successful, then you require a more experienced person.
  4. TELL each person where the last successful attempt was and point to it.

At the time of the phlebotomy –

  1. Ask (demand) that a smaller needle be used. The smallest that can be used to collect a specimen that is not hemolyzed is a 23 gauge butterfly needle.
  2. Ask that the specimen be drawn either through a syringe or in a pediatric tube. One distinct possibility is that your internal venous pressure is too low to withstand the ‘force’ of the vacuum in the collection tube. When that happens, the vein will collapsed on itself only to re-establish itself after the vacuum is withdrawn.
  3. The tourniquet can be drawn as tightly as you can stand it but cannot be left on for a prolonged period of time. Usually most folks think that 1-2 minutes is tops. After that, there are both chemical and cellular changes that alter test results.
  4. Gravity helps with finer stick more than it does phlebotomy since vacuum is the principle here.

Some things to avoid

  1. Don’t keep flexing the arm muscles. It too alters chemical balances which could skew test results.
  2. DON’T let the phlebotomist slap the site. All this does is increase inflammatory responses and messes up any coagulation testing.
  3. When you make that fist – don’t do it too tightly. A firm fist rather than an overtight one is best. One of the more frustrating things is that sometimes veins will “roll” because there is not enough supportive tissue to keep them in one place. So, you put the needle in at the exact place you saw the vein and it moves an inch or more to the side. Rolling occurs more frequently when fists are overtight than when they are a little more relaxed.

Complete response to a treatment/further use of treatment

I got some really good answers to a question I posted on the ACOR mailing list. They’re here, in case you missed them. My question was:
I have been wondering about complete response to a treatment, whether it be SCT or use of chemo, and the need for continued use of drugs or other treatment afterwards. I’ve noticed that some people have just Zometa or Aredia, while others will stay on a steroid or some other drugs. Once you have total remission, is it necessary to stay on drugs? My goal is to not have to take anything for as long as possible. Will that be a possibility for me?

Part 1
Part 2
Part 3

Dex day one

Here we go again. It’s the first day of four days of dex for me (at 40 mg/day).

When I take dex, I feel really speedy. I notice a more rapid heart rate, I feel very jittery, I talk a lot, have trouble sleeping and become easily agitated. My knee joints want to stop working too. They seem really weak. It all gets better a few days after I’ve finished the 4 days.

To combat most of the symptoms I take xanax and I do acupuncture twice a week instead of once. Acupuncture really helps me to relax, so I recommend it for that, if for no other reason.