Do I have the right

to demand that my Doctor change my diabetes medication ?

I have been taking Rezulin for type 2 diabetes for a couple of years now.

There was a story in the newspaper this morning on Rezulin being linked to liver failure, leading to death.

This is very frightening to me. I was diagnosed with Hep. C a couple of years ago.
I just finished a 2 year treatment of interferon in December.

I tossed a coin on where to post this one, mipsims won. GQ lost. If the moderator want to move this it’s fine with me.


" The opposite of love isn’t hate, it’s indifference."
Elie Wiesel

Winner SDMB Biggest Flirt (Female) and Least Shy (No Mom, I have no idea why they think that)

You can demand anything that you want. For example, I demand that Congress eliminate the income tax. Too bad they don’t heed my demands.

No one is holding a gun to your head. If you don’t want to take the medicine, don’t. I do believe, however, that the doctor is under no obligation to issue you a prescription based upon your orders. If they could, many a drug addict would “demand” heroin as the medicine-of-choice for athelete’s foot.

Sounds like you need to talk to your MD about your concerns. You can’t force him to give you a different prescription, but you certainly don’t have to use the one you have. Most MD’s are willing to work with you to find a medication that controls your condition AND gives you peace of mind.


“There are more things you don’t know than there are things that I do know. I despair of the imbalance.” – Dr. Morgenes, The Dragonbone Chair

Of course you have the right, Ayesha. If you have concerns about the medication you’re taking now, talk to your doctor about them. I saw a report on Dateline or 20/20 (can’t remember which) on that drug. It seems the drug company was not notifying doctors of the severity of the side effects. Your doctor may not know about the recent questions that have arisen about this drug.

If I were you and I went to my doctor and he acted like what I was saying wasn’t worthwhile/valid/etc., I would go get a second opinion from someone else.

It’s your body and your health…a lot of doctors are overworked and overbooked and they are not infallible. NEVER let your concerns about your health go unanswered.

Ayesha,
Pull up a chair, girlie. We need to chat a bit :slight_smile:

You have the right to refuse ANY AND ALL treatements prescribed by your Dr. both in and out of the hospital. I do mean any and all. I found this out when I was hospitalized for back surgery. They said I was getting an enema. I said “no fucking way” or something to that effect. They simply noted in my chart that I refused- end of story.

(I base the following on my own experience looking for a good pain killer to take daily for my chronic pain)

The same holds true for your regular Dr. You are concerned about how this drug will affect your liver- and rightfully so. It sounds to me like you’re anticipating a “fight” from him/her. This is a bad thing. If your doctor isn’t willing to take your opinion into account along with his/her own, shop for a new one. Taking any drug long term is a calculated risk, and you have the right to decide what ones to take.

I had several doctors that implied that I should “tough it out”, and that it was “in my head”. Needless to say, I dropped them. It was not in my head and I needed help.

In the end, your doctor/patient relationship should be open enough that you don’t feel nervous asking about taking a different drug. They are there to help you, and if you feel chastised or wrong for asking questions, look for a new doc.

Zette
PS- don’t stop taking your blood sugar drug BEFORE asking, as you could end up sick. Get in there and chat with him/her and get on a new drug BEFORE stopping the old one. :slight_smile:


“If I had to live your life, I’d be begging to have someone pop out both my eyes. Just in case I came across a mirror.” - android209 (in the Pit)
Zettecity
Voted “Most Empathetic”- can you believe that?

Short answer: Yes, but it probably isn’t the most constructive way of handling the situation.

Long answer:

  1. I’m somewhat surprized anyone taking Rezulin (troglitazone) hasn’t already heard about this. Rezulin was approved for treating diabetes in March 1997. Around Oct/Nov 1997, reports of liver failure necessitating liver transplant or proving fatal first were released. This is not anything new.

  2. The good news is that almost all of the cases of liver toxicity occurred early in treatment. This is reflected in FDA & manufacturer recommendations for monitoring liver lab tests monthly for 8 months, bimonthly for the next 4 months, and after a year of therapy “periodically thereafter”.

  3. Rezulin, it turns out, is actually a very good drug for treatment of type 2 diabetes because it improves the body’s ability to respond to insulin rather than drowning the body in more insulin like many older drugs. It gets at the insulin resistance which is the root cause of type 2 diabetes.

  4. There are 2 new drugs available in the same class, called Avandia (rosiglitazone) and Actos (pioglitazone). To date, Avandia has been reported to have been associated with two cases of reversible liver toxicity. At least one of these was later determined to probably NOT have been caused by the Avandia. These cases, btw, are out of about 300,000 patients taking Avandia. Actos has, to date, not been associated with any liver toxicity, but has not been heavily marketed until about 2 months ago.

  5. Bottom line, Ayesha, is that if you’ve been taking Rezulin for a few years & have had no trouble, you are unlikely to now. Also the fact that you are still on it would suggest that you & your doctor are happy with it’s effect on the diabetes. Logically, it probably does make sense to stay on it.

  6. BUT if you feel like you’re putting poison in your mouth every time you’re taking it, no amount of facts or reason are going to change your mind. Make sure, if this is the case, that you let your doc know just how strongly you feel about this. There are alternatives.

  7. OTOH, if this is mainly a shocked reaction to learning that a medicine you’re taking could cause problems since you also have Hepatitis C, get informed.
    http://www.diabetes.com/news/20000225-3500.html
    http://www.diabetes.org/ada/diabetesinfo.asp

  8. If your Hep C is not currently active, it probably is quite safe to stay on the Rezulin, but this is something for you & your doc to ultimately decide. Hope this helps!


Sue from El Paso

Experience is what you get when you didn’t get what you wanted.

If your doctor is not receptive and/or responsive to your concerns about controlling your diabetes and related medications, I’d go hunting for a new doctor and ask such direct questions. Ultimately, it is YOUR life, and you cannot afford to sit back and let the doctors run the show alone.

Thanks everyone. Yes Majormd, that did help .

I am so freaked out about this because my last liver test results were high.

I had blood drawn for new tests Tuesday, it will be at least 10 days before I hear from the doctor again.

This does concern me, but I will talk to her, if I feel she doesn’t take my concerns seriously I will find a new doctor.


" The opposite of love isn’t hate, it’s indifference."
Elie Wiesel

Winner SDMB Biggest Flirt (Female) and Least Shy (No Mom, I have no idea why they think that)

You should explore different modalities, as well. Advice often tends to be the same, between various doctors, within one tight modality.
One trend is for a marriage of different modalities–or WAYS of addressing the body.

Ayesha - Just wanted to make sure you knew that Rezulin had been recalled as of 3/21 & that you need to talk to talk with your doctor ASAP about changing meds.

There is not really any new bad news about Rezulin; just that in spite of labelling & testing requirements, there are still liver toxicity problems occurring. I’m not sure how many are due to poor follow-up/inadequate monitoring, but whatever it is, deaths are still occurring in some cases.

The withdrawal of Rezulin from the market is less about problems with Rezulin however (believe it or not, the benefit of good sugar control DOES outweigh the risk of liver problems when it is used in the right patients) as it is about the availability of newer safer alternatives that provide the same benefit.

Ayesha, keep taking the Rezulin until you can talk to your doc, but do talk to her soon, Okay? And e-mail me, please with any questions. I’m off the board after this…

Here’s a copy of an e-mail I got from the Endocrine Society today - it has some links:


Sue from El Paso

Experience is what you get when you didn’t get what you wanted.

UnBan Melin

Thanks Sue, I saw this in the news paper, I will be calling my doctor Monday morning.


" The opposite of love isn’t hate, it’s indifference."
Elie Wiesel

Voted SDMB Biggest Flirt (Female) and Least Shy (No Mom, I have no idea why they think that)