Talking About Side Effects Can Prevent Problems

If men are from Mars and women are from Venus, then doctors may be from Pluto. Communication is hard enough between men and women, but doctors and patients might as well be speaking different languages.
In fact, doctors do speak a different language, much of it based on Latin or Greek. Why use a simple word like headache when you can say cephalalgia? Ear wax is cerumen. Rapid heartbeat turns into tachycardia and a heart attack is a myocardial infarction.
Doctors argue that such terms are more precise and help avoid misunderstanding, but they also create barriers. A secret language understood only by the initiated makes the patient feel left out and intimidated.
Nowhere is this more apparent than in the world of prescription drugs. An arcane abbreviation like bid (bis in die) stands for take two times a day. When you see q6h (quaque 6 hora), do you immediately think, as the doctor does, every six hours? Perhaps, if you love watching medical shows on TV, you’ll recognize stat (for statim, meaning right now) or p.r.n. (pro re nata) for “as needed.” But is that really all you need to know?
Actually understanding what your doctor intends may mean asking questions, even if you know what the abbreviations mean. When the doctor writes q6h, for example, does that mean you need to get up in the middle of the night to take your medicine?
Does “before meals” mean 5 minutes before eating or an hour? The difference could be crucial for the medicine to work correctly.
The issue of drug side effects is even more complex. Many physicians are reluctant to warn a patient about a rare but potentially dangerous side effect. They worry that suggesting such a possibility might discourage a patient from taking needed medicine. They may also fear that some patients could experience symptoms due to psychological suggestion-a sort of psychosomatic reaction.
Without such information, however, patients may not realize a problem might be related to the medicine they are taking. A young woman who developed a series of sore throats did not realize that her infections were caused by a reaction to the thyroid medicine she was taking. By the time she ended up in the hospital with a urinary tract infection, she had no white blood cells left. The doctors were unable to save her life.
A recent study reveals that if patients tell their doctors about drug side effects and if the doctors listen attentively and adjust the treatment, many harmful reactions can be avoided. Conversely, reactions that are not recognized or reported can lead to serious adverse reactions (Archives of Internal Medicine, Jan. 24, 2005).
According to the researchers, nearly 8 million adverse events could be prevented “if patients and their physicians communicated better and if physicians acted more reliably to address medication symptoms.”
To help readers of this column communicate with their doctors, we offer our free Drug Safety Questionnaire and Medical History. Anyone who would like a copy, please send a long (no. 10) stamped, self-addressed envelope: Graedons’ People’s Pharmacy, No. QH-3, P. O. Box 52027, Durham, NC 27717-2027.