People’s Pharmacy on statins, chronic pain and swimmer’s ear.
Q: I am 76. At my recent checkup, all my blood tests were within normal range, including triglycerides, HDL, LDL, total cholesterol and glucose. I take lisinopril for blood pressure and metformin for diabetes.
My doctor prescribed simvastatin “as a preventative to heart attack and/or stroke.” I’ve heard statins can have bad side effects, such as liver damage or muscle pains, and I do not want to take any more medication than is necessary. If all my numbers are within normal range, is it necessary to take a statin because my doctor said he “prescribes this to all his senior patients”?
A: People who have had a heart attack or a diagnosis of heart disease may need a statin, but there is a great deal of controversy over whether healthy older people such as yourself benefit from such medications.
A review of research on statins and survival reveals that otherwise healthy people taking drugs like atorvastatin, pravastatin and simvastatin live roughly three extra days after several years of treatment (BMJ Open, Vol. 5, Issue 9, 2015).
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The statistics on this are a bit complicated, but suffice it to say the benefits for older people may not be as great as your doctor thinks. We are sending you our Guide to Cholesterol Control and Heart Health so you can discuss other approaches to maximizing your heart health. It can be downloaded for $2 from our website: peoplespharmacy.com.
Q: After much trial and error, my doctor and I finally found a medication (Vicodin) that helps my severe neck arthritis as well as my debilitating migraines. I had to change doctors when mine retired. The new one initially had no problem prescribing the Vicodin that I have been using cautiously for at least five years.
Then out of the blue, with no explanation, he said he would not give me any additional scripts for Vicodin, and I had to find someone else who would.
I went to a rheumatologist who won’t give me Vicodin but is injecting me with cortisone and has given me three more prescriptions that I never had before and do not work. I have never abused Vicodin in any way. I feel that, like so many others, I am suffering because of the ones who do abuse opioids.
A: We have heard from hundreds of people like you who are in chronic pain that was well-controlled on an opioid medication like hydrocodone (Lortab, Norco, Vicodin). When the Drug Enforcement Administration moved such medications from Schedule III to Schedule II, it became far more difficult for people to get these pain relievers.
The goal was noble: to prevent abuse and deaths from narcotic overdose. Other federal agencies, such as the Food and Drug Administration and the Centers for Disease Control and Prevention, also have come out against long-term opioid use for chronic pain.
As a result, many physicians have become reluctant to prescribe these drugs, even when patients are in excruciating pain.
Unfortunately, there are not a lot of alternatives. NSAIDs like ibuprofen and naproxen can be useful in some cases, but may not alleviate severe pain. They also come with their own serious side effects. You may need to consult a pain specialist to see if there is a strategy that can help you function.
Q: I swim every day for exercise and frequently get swimmer’s ear infections. I tried making my own remedy of half vinegar and half alcohol, but it didn’t work well. A product called Swim-EAR solved the problem. It is 95 percent alcohol and 5 percent anhydrous glycerin.
A: Thanks for the tip. Others may benefit from your experience.