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