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By Maggie On 2009.08.02 13:06
My FIL called yesterday. He is 80, lives alone in another state and was diagnosed about two years ago. He was concerned about trying to create a list of each med with reason for the Rx. He wanted us to look them up and call him back. That is good news/bad news. It is good for him to have that list, but it means he probably is worried he hasn't been staying on top of things. He has a much harder time with focus/organizations skills, and he was super-organized before the PD diagnosis. He has been going to rehab/exercise 2Xweek and has not mentioned, yet, any worsening physical symptoms.

I am not asking for med advice/recommendations. I just need to sort out what questions we need to ask and how soon we need to make our next visit (this month or next). We wanted to email the list to him, but he can't figure out his computer anymore.

The Rx that is of concern is Atenelol which was prescribed this spring. He has had a long-term history of very good blood pressure, with only one recorded episode when it was high recently (probably when my MIL required in-home care before she passed). I have seen in some of your posts, that low blood pressure seems to be more of an issue. He doesn't have a history of the heart problems listed as other reasons for the Rx. We noticed it also may be used for migraine prevention (no history here), tremors (none, yet) and other unspecified conditions. He did have an episode the year before last when he passed out after standing up in the bathroom in the middle of the night. I am worried this med might make it more likely for that to happen again, particularly since he is alone now.

Suggestions? Thanks for being there.

By susger8 On 2009.08.02 14:18
My father takes Atenolol for his blood pressure. His pressure does tend to be low due to the PD meds, though he has not had a problem with orthostatic hypotension. He used to be on an additional BP med, but was able to stop taking it. He takes the Atenolol at bedtime to reduce the impact of any dizziness.

I wonder if you could get a visiting nurse to go over a few times and check his blood pressure? If he does not normally have high BP, he might not need the Atenolol. Of course, he shouldn't discontinue it without consulting the doctor who prescribed it.

By bandido1 On 2009.08.02 15:42
Maggie: from patient bob -low blood pressure is common among patients. In my case pressure varies almost immediately after morning medications. Usually it drops.and returns to normal after about 2 to 3 hours. Sometimes I get a normal reading and do nothing. Usually, I avoid standing and walking until the dizziness has subsided.

I keep a list of meds on my computer for reference purposes and Dr. Visits. though I do not recommend it, many sites provide detailed RX info. As each prescription is filled are refilled he should be getting that kind of information. bob c

By Maggie On 2009.08.02 18:32
So, is the dizziness a result of just the Parkinson's, or the other PD meds, or the blood pressure drop caused by any/all of the PD meds, or is this just one of those 'all of the above' or 'could be anything' kind of things?

When my MIL was very ill, it was apparent that there were gaps in the recall of things they were told in doctor's appointments. I am hoping we can either convince him to take a little notebook to make notes while in the doctor's office or pharmacy, or find him an easy-to-use tape recorder so he can make the notes when he is back at home.

I am sure they probably had a blood pressure cuff at home because my MIL had big problems with blood pressure. I think he will resist the concept of a visiting nurse at this point. I will ask him how often they check his bp when he goes for exercise. Would it also be a good suggestion that he should check his bp before getting in the car?

Thanks.

By Maggie On 2009.08.02 18:36
One other different question. After my MIL passed, there were a huge number of RX bottles with a lot of pills in them left over. I doubt if he has cleared those out, yet. Is there a way those can be donated so folks who cannot afford them can get them. I know it is probably unlikely because of safety concerns, but it just seems like a waste for them to go in the trash.

By mylove On 2009.08.02 19:26
Maggie;

Just as an aside note, call your local hospital to find out about how they dispose of leftover meds. As a governmental employee at the local level, I know that there are a lot of hazards associated with the practice of flushing meds down a septic or sewer system (including but not limited to them eventually making their way into your drinking water - I kid you not!! There have been many interesting studies on this issue.) There is usually a ban on 'recycling' meds, due to safety and quality issues, but many medical facilities have a policy on disposing meds, and usually will tell you where to take them to dispose of them safely. They typically discourage disposal in the normal trash, as there is too much chance either of someone picking them up or of them getting into a landfill, where they will be dissolved with rain or snowmelt and carried into the aquifer or into surface water, where I'm sure you can imagine it's a very bad thing. Start with your largest medical facility in the area, and if they cannot answer, try your local health district. They should have some answers.

Recycling all those 'dead' prescriptions is a big issue for me. It would seem, that with the propensity of physicians to prescribe 'trial' scrips of something that may not work (that you pay for anyway, and end up with a full month or so of), that there would either be a 'trade-in' sort of setup somewhere, or someplace to donate them where they could be furnished to people who cannot afford medications. (I'm not only thinking our own homeless, etc, but even third world countries, who otherwise might not have access to the meds we do) Waste not, want not... but it seems like a whole lot of these drugs go into incinerators (the preferred method) or into the trash daily. I understand the safety concerns (we wouldn't want to have the liability for something like the Tylenol tampering happening) but sheesh... it would seem that someone could come up with something.

Small wonder our health care premiums are so high. I remember reading "All Creatures Great And Small", and when one elderly woman passed away, leaving all of her pet's (who had also passed away) vast apothecary full of meds he had been taking to be disposed of, they called the vet to 'come round and pick them up'. I think they probably reused them, what do you think? Wish there were a way to do something like that with people-meds.

By Pearly4 On 2009.08.02 19:49
When my mom died we were left with multiple prescriptions too. I did a lot of research into it trying to figure out how to get the prescriptions to those who could use them. It just isn't possible. There is a local program to recycle unused meds -- but each must be individually wrapped as in a blister pack. They do recycle a lot of them -- usually donated from nursing homes because meds there are required to be blisted packed. They are recycled through free clinics. Our city occasionally has "hazardous waste" collection days and meds can be brought in -- but its a problem because they can't be disposed of with normal waste. Flushing them leaves some of them in our drinking water! The pharmacy refunded those that we hadn't picked up yet. I was finally told to mix them with coffee grounds or kitty litter and dispose of them with normal waste in small amounts at a time. Ok, I got rid of them, but such a waste!

I've worked in physicians offices and the amount of free samples that aren't used and are simply dumped after expiration is incredible. They're burned. We tried to find outlets for them -- even trying to ship them overseas with local physicians doing charity work -- it's impossible.

What a waste.


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