Saturday 30 July 2011

Take Precautions when you get a prescription filled

Had an interesting week, but I hope that I will go on to having a more boring week next week.  On Monday evening, at around 7:30 p.m. I felt a very sharp pain (left kidney area) - well, excrutiating pain would be more accurate.  A friend called my husband to pick me up (I was at a Writing Group meeting at the time).  We swung by the hospital, but there was a full parking lot, so decided to wait until later - maybe through night when there would be less people in ER.  Went home but when I went to the bathroom, there was a lot of blood in my urine, so told my husband that we had better head to the ER.

At the ER, they took me into 'acute' because I am also taking Warfarin (a blood thinner where I have heart isues).  After 5+ hours, I must have passed the kidney stone (pain had moved from kidney area to groin area (common when passing a kidney stone).  A CT Scan had been ordered, I was on IV, hooked up to machines, blood work was done (altho to be noted here, doctor in ER had the full list of my meds and I did keep telling him (at least 2-3 times) that I was on blood thinner meds which was why I had come to ER - since blood in urine is never a good sign when on blood thinner. 

The CT Scan showed there was no stone.  Doctor told me I must have passed it (I was going to the washroom quite a bit during those hours b4 the CT Scan).  So doctor prescribed anti-biotics saying that sometimes a person will develop a urinary tract infection after passing a kidney stone.  I accepted this and went home (altho I felt I should have went home with a baby after all that pain - for those who have had labor pain, you will know the kind of pain involved when one passes a kidney stone).  A friend of mine who is male told me he had passed a kidney stone a while back, I told him that at least he now knew what a woman went through when having a baby - he told me he was going to go to the flower shop to buy her some flowers - never understood the amount of pain his wife had experinced before my saying this to him :o)

Anyway, on to my story.  The next day (Tuesday), I filled the prescription for the anti-biotics, trusting the ER doc knew what he was doing.  The pharmacist who I know very well as he has been my pharmacist for many years and knows all the other meds I am on for my heart,filled the prescription.  The page that was given with the anti-biotics did not mention any drug interactions.  So Itook the 2 per day anti-biotic.  On Wednesday, I went for my regular INR blood tests (which measures how thin my blood is - I am usually at 2.2-2.3).  The therapeutic range for someone on blood thinner is between 2-3 - anything over 3 is in a danger zone. 

Wednesday around supper time, I noticed a bit of blood in my urine.  I had a 'coffee date' with a friend that evening (she is a nurse).  I mentioned thtis to her and she told me that it can sometimes happen after someone has passed a kidney stone, as it can irritate the passageway, so I relaxed and thought this would pass. 

The next day, Thursday, there was a LOT of blood in my urine.  And it was getting worse.  I also noticed that althought I was drinking a lot of water (much more than I usually do because I knew this was a good thing after having a kidney stone), that my urine production was actually much decreased.  Not normal, I thought.  A nagging voice told me to contact someone, the oher voice told me not to worry.  But I thought 'better safe than sorry'.  So I called Tele-Care and talked to the nurse and told her the hisotry and also the names of all my meds.  She  told meto see a doctor within the next 3 hours - my family doc, the doctor on call, a doc at a clinic or a doc at the hospital (in that order) - but she INSISTED I see someone.  So, I called my family doc only to find out he was on holidays.  So called the doc on call who could see me at 4:45 p.m. (he worked until 5 p.m.). 

So off I went to see the doc on call.  He took a urine specimen and my history (and history of what had happened).  He seemed very concerned. He said there was indeed a lot of blood in my urine.  He then went to the computer and looked up what had happened at ER - results of CT Scan, blood work done at hospital, blood work done the previous day re my INR. 

He then  told me to stop taking the anti-biotics IMMEDIATELY.  And to stop taking my warfarin the next day (Friday).  To resume the warfarin on Saturday.  I did ask why and he said the anti-biotics that I had been prescribed was not to be taken with warfarin as it increased the effects of the warfarin and my blood tests at ER showed my INR to be in normal range but the blood test the previous day showed it to be 3.19 (way too high) - he said where I had taken the anti-biotics that day my INR was now likely close to 4. 

So I went home.  I decided to google the anti-biotic (which I normally do, but because I had not been feeling up to par, had not done so this particular time).  This is what I found when I googled it:

"/When combined with blood thinners like warfarin, sulfatrim increases your chance of experiencing uncontrollable bleeding.  Some patients develop a shortage of blood platelets. This shortage of platelets causes a number of problems, including easy bruising and even bleeding around your brain. Sulfatrim interferes with he functioning of your kidneys resulting in decreased production of urine and possible kidney faiture (to be noted here, I have had kidney problems 2 years ago, needing angioplasly of the main artery to my left kidney).  For some patients, sulfatrim causes gastrointestinal bleeding.  If you are on warfarin, your doctor is unlikely to prescribe sulfatrim for you due to its possible side effects."

Well, I was not exactly a happy camper when I read the above, so I called my regular pharmacist (the one who filled my prescription and who knows my medical history) (I had even told him I had gotten the prescription for the ER doc because I had passed a kidney stone).  Anyway, I asked him who would be responsible for informing someone about possible drug interations.  He said 'a phamacist, like me'.  Then I read him the above.  He said 'oh'.  I told him in no uncertain terms that he should have caught that.  He tried to blame the doctor at the ER and I told him, 'yes the doctor at the ER should have known better, but you told me that the responsibility to check for drug interactions was the pharmacist'.  He apologized.  I just told him I wanted a note put on my file that I was NOT to be prescribed sulfa meds where I was on warfarin.  I did tell him that he could have killed me.  He again said that he took full responsibility for not telling me of possible side effects.  I told him that as long as he made a note on his files to be careful with anti-biotics (especially sulfa based ones) for patients on warfarin, that he might not be sued if someone ended up bleeding to death.

So - this Blog is just to let you all know that we must be vigilant about our own health, to always google side effects of meds, drug interactions (especially if you are taking another or many other meds).  One can trust one's doctor(s), and pharmacist, but ultimately, it is YOUR life, YOUR health. 

I did well yestterday with the amount of blood in the urine decreasing, the amount of urine increasing - up to last night when my urine was clear (to me anyway).  This morning, I restarted my warfarin (I have stopped taking the anti-biotics compleely since Thursday when I saw the doc on call.  However, as of noon today (Saturday), I am seeing an increase of blood in my urine.  And I have a general feeling of malaise.  I will wait and see if the blood keeps increasing and i it does, I will go to the doc on call (yet another doc) and will inisist on blood work being done.  Something is not quite right (I know this in my heart) - but what I am not sure.  Things may change - either for the good or get worse - so will take things one hour at a time.

Just be careful.......... take your health into your own hands - you know more about your own body than anyone else...

1 comment:

  1. Hi Louise,

    I love you so much. I am so glad that you caught this and I hope that you are feeling better now. This is a very scary wake up call for everyone though - we have to be our own advocates or have an advocate with us... who will ask questions and make sure that mistakes like this don't happen. Sending you lots of love and looking forward to seeing you soon.

    ((((Big Hugs))))

    Karen

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