According to the New York Times, the Zetia D's PCP just put him on to help control his now-ridiculously-high cholesterol is probably going to kill him instead. Alrighty then.
According to schizophrenia.com, there are some new studies out saying people who've gained a great deal of weight on atypical antipsychotics should be on Metformin, even if they don't have diabetes. Alrighty then.
According to the radiologist at North Shore Medical Center, D's got a fatty liver. (Mmmmm, pate.) Alrighty then.
According to everything on the internet that I could google with my mad googling skillz, millions of us are walking around with fatty livers without even knowing about it, and it's a harmless and reversible condition, except when for reasons unknown to current medical science, it in some people inexplicably turns to non-alcoholic cirrhosis. Alrighty then.
It's so hard to know what to do when the drugs that are so good for your brain are so bad for your body in other ways. We (he, I, the psych team) are all in favor of his being on what's going to keep him alive and safe now--the specter of the S-word from 18 months ago still being way way too fresh in my mind, thanks-- and screw twenty or thirty years down the line. New, better drugs all the time, blah blah blah, and if we can clone mice and invent the i-Pod (not to mention the gift bag or Tivo) and make HIV not quite the death sentence it used to be, who says we won't cure schizophrenia? (Other than the fact that it's not a pretty disease, or heart-warming, and nobody gives two shits about it if they don't happen to love someone who's been struck at the...wait for it...cusp of their potential with a brain that doesn't work right any more, except to maybe snicker at or cringe from the homeless guy talking to himself on the park bench or get all up in arms and yell for the death penalty for some unmedicated paranoic who commits a horrific senseless crime that made perfect sense to him. But, hey, I'm not bitter or angry or anything. No.)
So, yeah. What to do, what to do, and how much to worry.
xoxo
2 comments:
I gotta believe exercise can't hurt any of this... Not sure DDR is age-compelling, but that'd be just a sop to the problem anyway. It's a bitch that agoraphobia got mixed in with all the other crap--gotta get out and knock over some people to clear both the head and the arteries, I say.
Having worked in that whole drug analysis field, I sure know that those kind of interactions are really hard to study in a proper, double-blind long term study. There won't be enough people on the same combinations and you have to worry about dealing with the immediate acute issues far more than long term questions.
Just look at that Zetia study, with many millions taking it it still took several years to determine that 1) while it may lower cholesterol it doesn't seem to lower heart disease at all and 2) the combination with at least one statin actually can increase fatty deposits in the arteries. Plus the interesting point that noone knows if the positive heart disease outcome of the statins alone is actually due to lowering cholesterol or a completely different, not yet understood, effect.
When I worked with all AIDS clinical trials the interactions of different drug combinations were way, way different than taking the drugs individually, and sometimes treating a particular drug side effect would require a completely different approach than those same symptoms not drug related. And it took lots and lots of testing on lots of people to determine the right approach.
Which means that you're left with relying on doctor's intuitional knowledge and understanding... which sometimes is actually ahead of the science, and sometimes it's really not. Yeah, I know, that's reassuring.
Keeping D functioning well right now is the best thing, those other physical issues are just potential issues, by the time they're real issues maybe they'll have really determined the proper treatments.
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