Sometimes my best contribution to the topic of the dysfunction of the American health care system has more to do with asking questions that can’t be answered than providing answers. Remember — I’m not a medical professional. I’m simply an empowered patient who reflects on this dysfunction daily.
This week there was a sudden flurry of concern about cold medicines for children. These are medicines that have existed for years and years — I gave them to my daughters when they were young children, and they are adults now! However, now parents are being told these drugs may be dangerous, and some drugmakers are withdrawing cold medicines for infants from store shelves.
This week I interviewed Dr. Thomas Welch, a pediatrician from University Hospital in Syracuse for my radio show. He talked about the evidence which seems to show no benefit to these medicines for children, and even suggested they may not be effective for adults. I inquired about my own experience — when one of my children would begin a coughing spasm in the middle of the night, I could give her some medicine and she would stop coughing and eventually go back to sleep. Dr. Welch suggested it worked because I was interrupting her sleep, giving her hugs and kisses, perhaps a glass of water to go along with the medicine; in short, because it was an interruption in the coughing pattern, her coughing stopped. It wasn’t the medicine, according the Dr. Welch.
The fact that these medicines have been sold for so long begins to raise some questions about all kinds of assumptions we, as patients, need to be concerned with.
1. Why have we continued to assume that drugs tested and approved for adults would be just as good for kids? Dr. Welch explained that because childrens’ physiology is different, then the drugs’ effects would be different, too. that makes perfect sense — so why hasn’t anyone questioned this before?
2. So doesn’t this mean, then, that cold medicines are just the beginning? What other drugs are we giving to children, not really knowing how children will be affected, and in what different kinds of ways from adults? I know that there are big questions about drugs related to mental health. It seems like this will be the tip of the iceberg.
3. Doesn’t this also bring to mind the question of what drugs and other treatments (and symptoms and everything else) that have been studied and followed in men, do not affect women in the same ways? I wonder if we should now be looking at cold medicine that has been tested on men — should it now be tested separately on women?
4. And then, too, whether girl children react differently from boy children?
5. What about people from different cultures? Do they react differently from each other?
6. So now we’re learning not only that these cold drugs may be ineffectual, but in some cases they may be harmful, too. Isn’t it interesting that as long as they were simply harmless, the drug companies were more than willing to let us keep spending those billions of dollars for their profits — but now that they may be considered harmful (as in — now that they fear a lawsuit over some of the deaths that have occurred) — NOW they want to back them off the shelves?
And for heaven’s sake — why is it that a patient is asking these questions? Why isn’t the FDA asking these questions? I’m not the scientist, and I’m not the manufacturer — but now I wonder just what drugs I can trust!
What does all this mean for patients?
It means we must begin to examine the drugs we decide to take, whether they are prescription or over the counter. If you are female, and are prescribed a drug that can be given to either gender, you should be asking the gender of the people it was tested on. If all the tests were run on men? Well then — don’t let your doctor suggest to you that it will work on you, too — because your doctor can’t know that for sure. That may be true for heart drugs — we’ve read quite a bit in recent years about the assumptions for women being based on testing for men, and that they are not the same.
And men — same thing. Many osteoporosis drugs, for example, have been tested extensively on women. Do you know if the drug you’re taking for bone loss was also tested on men? What makes you think it will work?
And for all of us — if you need to give your child a drug, find out if it has been tested and approved specifically for children (and perhaps, if necessary for children who match your child’s gender.)
You know what they say about assuming things, right? Well guess what. We’ve all been caught in this one.
I’ve said it before: Trust, but verify.
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