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Medical Forum / Diseases and Disorders / Breast Cancer / December 2003

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Femara, Reduced Doses?

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su-texas@webtv.net - 05 Dec 2003 13:27 GMT
Tests?

Are there any tests that can show exactly, if Femara is reducing the
estrogen in the body?  

If there are, then this test could be used to determine the exact dose
of Femara necessary, to keep the estrogen production suppressed.  

Not everyone should have to take the same dosage, in order to get the
same results.

I'm very sensitive to the effects of medicine, so a reduced dose would
probably work OK for me.  

I shouldn't have to take a dose which disables, incapacitates, weakens &
sickens me, & completely destroys my quality of life, ... for five
years.  And with the added worry/concern (as repeatedly told me by the
doctors), that it probably won't work anyway.

Is there a test to measure the exact results, of Femara's reducing
estrogen production in the body?

Susan, Su_Texas  my opinions

PS  I really do dislike the way that drugs are tested & approved, & then
prescribed, ... without there being any tests to measure if they
actually work or not, or how well they work.

I feel that PHARMA-lobby & the major drug companies have really
screwed-up (& basically ruined) our medical system now, ... & have made
medical "care" an issue of greed & abuse-of-power only.

If enough people complain to their elected politicians, every week for
many years, ... & if we refuse to accept any more combined-issue-type
bills (plus, make the combination-type bills illegal), ... then I
believe we can get better medical care, & will get some enforceable
legal rights back.

It's also important to learn the law, to bring your own lawsuits, ... &
to cost these sadistic & predatory criminals some big money, over &
over, ... since the lawyers won't help us (esp. in states like Texas &
Louisiana).

When the penalties for wrongdoing are set high enough, & are
enforceable, ... then it can cause people ("professionals") to change
for the better, to behave some & to actually work.
Tim Jackson - 05 Dec 2003 16:48 GMT
> Tests?
>
[quoted text clipped - 6 lines]
> Not everyone should have to take the same dosage, in order to get the
> same results.

Yes it's possible to measure the estrogen levels in the blood.

But most of the side effects of estrogen suppressing drugs is due to
estrogen deprivation, similar to the symptoms of the menopause.  So reducing
the dosage of the drug wouldn't have much effect unless it was failing to
suppress the estrogen.

Incidentally there has been something of a debate on HRT and bc here lately.
Revisiting the recent results and considering the implications of thousands
of women coming off HRT, the recommendations have been changed a bit.  While
there is clearly a problem with long term use of HRT causing increased bc
and other conditions, it is now being said that in most cases of natural or
induced menopause, the symptoms can be alleviated by short term HRT without
an unacceptable increase in risks.

The principle is that most major symptoms of the menopause (esp. hot
flushes) disappear after a couple of years as the body gets used to the
lower levels of estrogen.  There is a sensible argument that HRT can safely
be used to soften the rate of loss of the hormone and so reduce the
symptoms.  Used this way, any increase in risk of serious consequences is
undetectable against the background level of these events which happen
anyway.

Tim Jackson
Kaye301 - 05 Dec 2003 17:00 GMT
Su wrote: << It's also important to learn the law, to bring your own lawsuits,
... &
to cost these sadistic & predatory criminals some big money, over &
over, ... since the lawyers won't help us (esp. in states like Texas &
Louisiana).>>

The problem with that is that by doing that it complicates the process of
researching and getting new medications on the market would take even longer.
That is already happening within the medical community directly.  Doctors are
not prescribing medications that show great promise, because if they have not
yet been approved--because the process has been made so much harder--and if
that medication doesn't happen to work on all or forever (which is very likely
the case with cancer meds), than that person, even if in the minority, is much
more likely to bring suit.  That in turn has made dr's less likely to deviate
from prescribing the standard which is taking longer and longer to adopt new
treatments into 'standard' protocol because of that.  In other words better and
more effective treatments are and have been developed but researching them is
becoming so much more difficult and taking longer.  That further drives up the
cost of the medication.
Kaye301 - 05 Dec 2003 17:17 GMT
Su wrote: << Are there any tests that can show exactly, if Femara is reducing
the
estrogen in the body? ...I'm very sensitive to the effects of medicine, so a
reduced dose would
probably work OK for me. >>>

Okay, if you check the abstracts (I posed the address on another thread) there
is one article that rates the antiestrogen drugs on the market in terms of
strength.  I can't recall all 5 but the second strongest is Femara and the
weakest is Arimidex.  Femara appears to be more effective and it may be because
of its strength.   So, if you take a reduced dose it may be less effective or
not result in the desired effect.  However, the different aromatase inhibitors
also have somewhat different chemical structures from what I recall
seeing/reading in the PDR a few years ago.
su-texas@webtv.net - 05 Dec 2003 22:18 GMT
I much prefer the side-effects from Femara, to those from Arimidex.  

At least I can walk around some, without feeling like I'm going to faint
& hit the ground every second.  And I don't feel deathly weak & ill all
the time.

The odd short-term memory loss that Femara causes, is difficult to deal
with.  

The short-term memory loss from Arimidex, was similar to that caused by
traumatic head & neck injuries (which I've had & have), ... so I could
handle that kind a bit better.

I'm still trying (working very hard daily!) to adjust to this different
kind of short-term memory loss (which seems to be increasing ???), ... &
am trying to increase my level of functioning & ability to perform
chores.

It's tough.

Susan, Su_Texas  my opinions
Kaye301 - 05 Dec 2003 23:01 GMT
Su wrote: << I'm still trying (working very hard daily!) to adjust to this
different
kind of short-term memory loss (which seems to be increasing ???), ... &
am trying to increase my level of functioning & ability to perform
chores.
It's tough. >>

Hmm, what you might be experiencing is also ADHD  (attention deficit
hyperactivity disorder--with or without hyperactivity) which can be related to
the reduced estrogen levels which is what the medication is supposed to be
doing.  Dr's are beginning to prescribe medications that help with attention as
a result of this from aromatase inhibitors and/or chemo.  Some of the more
common meds used to help with ADHD include Ritalin, Adderall, and Concerta.
You might want to speak to the dr. about such.   However, in some health care
systems  the only physicians who treat adult ADHD are in psychiatry so it may
require you to see a psychiatrist.
I did that before there was a medication for M.S.   I was experiencing extreme
fatigue.  One of the medications used for that was Cylert.  I found that it
gave me a case of ADHD, if I didn't already have it to some degree, when it
wore off.  I couldn't get from step A to step B.  It was scarey.  So, my
neurologist then recommended I try Ritalin which was also used for fatigue.
However, he was not able to prescribe it, so I had to have it done through
psychiatry.  That worked without any difficulty and did not involve any
diagnostic label other than fatigue from M.S. from what  I remember.
I found that the Ritalin very much helped with chemo brain, and they are now
starting to prescribe it for some who request assistance with difficulty in
this area from such.
su-texas@webtv.net - 06 Dec 2003 01:11 GMT
Not Ritalin

After I was badly injured in 1998, a doctor (WO) insisted I try Ritalin
(even though I super didn't want to).  [I wanted good testing &
diagnosis of injuries, instead of drugs.],   And the results was
terrible & scary.  

I took a small amount of Ritalin, in Houston while I was waiting for the
bus to come (for the long trip back to East Texas), ... & I ended up
almost unable to move, function, or think, ... which was a dangerous
thing to have happen in the bus station.  

-----------------

At that time (Dec. 1998), I was still seeking (& not finding) Emergency
medical care for the injuries I'd gotten from hitting pavement & sliding
in Jan. 1998.

In mid-Dec. 1998, the medical appt I'd had at Baylor Neurology in
Houston with Dr. WO, had gone very badly.  I'd been lied to (again!).  

He wasn't "the best injury specialist in Houston", like the Longview
neurologist RH had said, ... & like Baylor had repeatedly confirmed to
me, over the phone for months.  He was a Parkinson's doctor.  

He refused to work or to refer.  He said he wasn't interested in
injuries, that I shouldn't have been sent to him, & that he refused to
refer.  

He insisted I try Ritalin, even though he was very aware that I'd had
severe adverse reactions to many drugs.  He insisted that Ritalin would
work good for me.  ???  He lied.

He was super-interested in getting paid, for his doing nothing, which is
called "Medical Fraud".  Plus, I had to get a hotel room & stay in
Houston for several days ($$$), ... because no testing had been arranged
like it was supposed to be, & like I'd been repeatedly reassured over
the phone that it would be.  And he insisted I wait, while he thought
about maybe arranging some, even though he didn't want to.  ???

[Sometimes I wonder where the Texas & Louisiana medical schools can find
so many doctors, who are willing to compete so hard to be Dumb & Dumber,
.. & to harm their patients, plus cost them the maximum time & money
possible.]

The testing that was finally arranged, was the ineffective & old EMG/NCV
tests, that can't show most spine & body injuries.  

[Plus, I had to wait about a month for the test results, even though it
was an emergency situation.  Every day of waiting, during that December
& January, was total pain & agony.]  

-------------

Christmas 1998 was the very worst, partly because of the waiting, ...
partly because it was so cold, & I was so injured & frightened (with
ongoing concussion & loss of consciousness), ... partly because I was so
hopeful that some test would show something (because I was investing
everything I had in this, over & over, & I kept having nothing left),
.. & I was so hopeful this time, that I would finally get some
much-needed medical explanations, some basic medical care, & some care
for injuries, but I didn't, ... & partly because I got snake-bit when it
warmed up one day that December.  

[I do intend to put those doctors (WO & RH, as well as other doctors) in
prison one day, for the harm they've done, for the suffering they cause,
& for their obvious enjoyment of it.  I've repeatedly promised myself
that.]

Now every Christmas is a horrible reminder, that I have no enforceable
legal rights, have been deliberately & seriously harmed/injured, am
still in the cold, am still in poverty & hardship, am still being abused
& harmed, ...

Every year, Christmas is a measuring point, of how far I haven't come
yet, because of the very failed systems (govt, legal, medical) here in
Texas & Louisiana.  

I stop often to pray for justice without mercy, for those people who
choose to do harm.  And I scream out loud, because of the pain &
suffering they've chosen to cause me, & because it hurts so much.

By next year, I will have Christmas!  I will force this failed &
chicken-sh*t system in Texas to work, no matter what it takes.

I refuse to give up hope, & I will keep trying.

Even if I don't get to have or live a life (that is, if the cancer &
injuries, the lack of medical care, the ongoing abuse & hardship, do
kill me), ... I intend that no one else should have to suffer this
badly, in this way.  

I intend that other people have the knowledge, savvy, & skills
necessary, to live a better life.  

I'm trying to pass on any knowledge & information I have, & life
experniece.

-----------

After taking the Ritalin, I collapsed onto the floor.  I remember
staring at a clock.  I was terrified & wondering what had happened to
me. In other words, I had an adverse reaction to the Ritalin, & would
never consider taking it again.

I have adverse reactions to most drugs like that, including
antidepressants, most tranquilizers (I can take Tranxene, but would
rather not), pain killers, blood pressure meds, muscle relaxers, etc.

It can take me weeks or months to start to recover some, from trying a
new medicine & having a bad reaction to it, ... so for the most part,
I'd rather not try them, especially when I feel this sick & weak from
Femara.

Adverse drug reactions are very serious things, which can kill, ... even
though most doctors here treat them like a joke, & refuse to take them
seriously.

--------------

I wish there were some tests, to determine which drugs would work for
us, ... so we wouldn't have to buy & try so many bad ones, get so sick
from them, etc.

If there were such tests (DNA maybe?), then the doctor could prescribe
the right meds, that would be sure to work the first time, without many
if any serious side effects.  

Hmmm.  That would mean no endless round of expensive, time &
resource-consuming doctor visits (in cities & clinics far away).  

No more endless streams of clueless doctors, who don't seem to know
anything, & can't get anything right.  

Wouldn't that be nice?  

And we could live much healthier lives.  Get more done.  Plus save a lot
of time & money.  

The govt could save a lot of money this way.

Susan, Su_Texas  my opinions
bartalo@webtv.net - 06 Dec 2003 00:55 GMT
Su - Did you try Tamoxifen yet?  I talked to some ladies at a local
support group who are on it and they seem to function quite well.  It
seems that the body needs a few weeks to adjust to it.    However, as we
all know, drugs work very differently in each of us.  I have a very
difficult time convincing my doctors that my body is overly sensitive to
drugs so I can understand what you must be going through.  I also am
very concerned about my body's reaction to the Tamoxifen when I need to
start it soon.  However,  it's not like I have a choice.

BTW, I live in one of your "favorite" states.   I survive by convincing
myself that "all" states probably have their share of good and bad
doctors and my biggest goal is to "try" to find some of the "good" ones.    

Bea
su-texas@webtv.net - 11 Dec 2003 19:03 GMT
Time

I'm taking the Femara at about 6 PM now, so the worst effects from it
will happen during the night while I'm asleep.

When I take it in the morning, I feel groggy & ill, & can't function all
day.

Susan, Su_Texas  my opinions
 
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