Effient

[anandbharti]

I was prescribed with Plavix after receiving a stent in my LAD last week . However, the physician quickly changed his mind after a test revealed that plavix had 0% inhibition effect on platelet aggregation for me. I was told  that this was due to my genes and 30% of the population similarly can not use Plavix. . Then the physician prescribed me with Effient. Since it was a new drug and Christmas eve with early closing, I had hard time locating a pharmacy which stocked Effient. Eventually, I did find a place which had the drug.

It is early days yet so I don't know how well the combination of this drug with 320 mg aspirin is going to work in stopping any blood clotting in the stent or cause any serious bleeding. in other parts of the body.

I would be interested to know experiences of other forum members with this drug. Since it was only approved in July 2009, I am aware that anyone taking this hasn't had longtime on this.

Thanks,

[toby45]

*sheepish grin*

Thanks for the additional info. Sounds like you've been thro far more than I have - far be it for me to "advise" others! :)

Yep - I've expressed similar frustrations, disappointments and anger at the med profession. In their rare moments they're life savers, but for the most part docs are like any other peddler of products/services. Worse, the majority of them are downright incompetent, not doing their homework, and more concerned about how they can work the least for the most.

The latest trend to maximize/leverage their time and increase ROI is the idea of a Physicians Asst. - honorable people no doubt - but an additional layer/variable to a rather bloated management structure for patient care. Your story only angers me all over again about the bloody poor accountability and the utter lack of a sense of professional responsibility exercised by doctors. They hide behind pharmas, lawyers and vendors, abdicating responsibility at the drop of a hat.

I'm in the computer/consumer electronics industry, and I've received better post-sales "care" for my computer than I did after emergency stenting for an acute MI which was initially misdiagnosed as a "pinched nerve"! And of course everyone got their money (over $700K over 3mts) ...just a bloody shame.

I've been thro 9 cardios/12 neuros - the moment they show a hint of not having done their preparatory work prior to my appointment I drop them like a hot potato! If I can make sure I'm ALWAYS doing my homework by reviewing their reports/financials/issues prior to meeting with them, I damn sure expect the same from my bloody cardiologist.

And as in your case where no one seems to "manage up" to a vendor of defective products that could kill, I only ask where are the voices of outrage amongst the docs/FDA/advocacy groups et al?! If your pacemaker was marketed as a "lead painted toy, Made in China" perhaps there might be better accountability! :)

Sorry for the tangent - but it touched a raw nerve to hear about your struggles.

I don't expect the docs to solve my medical problems, but I don't think it's asking too much of them to do their homework, see fewer patients and take care of the ones they do see. So they may make a few $100K less each year - is that such a bad thing?

Your suggestions are right on the money - I have become a vehement and vociferous advocate of my own health, always doing my research and demanding answers. Each of us as patients is a client of high cost, high end services and products and we too have to change our stance and become proactive in our care.

Best wishes and to our good health in 2010!
HNY!
Toby

[anandbharti]

Hello Toby,

Thank you very much for your advice. Yes, support is absolutely essential.

This is the second occasion  I had a stent put in. On the first occasion, eight years ago,  the stents failed ( RCA and circumflex) within weeks, gave me a serious MI with significant damage to the heart and need for a bypass. This time it was LAD which was occluded. I am also insulin dependent diabetic which increases the chances of reclogging. However, with drug eluting stents, that possibility is reduced but at the expense of increased risk of clots. Well, you reduce that possibility by taking blood thinners like plavix, aspirin or the new Effient. As I said in my previous post, I am unresponsive to Plavix which leaves me with Effient. It is a brand new drug  which gives me jitters ! Especially, when the label warns of serious bleeding as a side effect

I am also fitted with a ICD / pacemaker. The device shocked me without reason weeks after being placed. Then the manufacturer announced that the wires (eads) in the device were faulty and being withdrawn from the market however, there was not much they can do for those who had the device.

I used to be very relaxed about medical procedures / intervention and leave it to the the doctors to decide but not anymore. To the medical profession us patients ae just goods on a conveyor belt. Therefore everybody should realize that it is your body and knowing everything you can about your disease/ problem is the only way you can get the best treatment / outcome.
I understand this is a long message, however, it is important to give the complete background in order for people to offer appropriate advice.

Thanks.

Shakher

[toby45]

I cannot speak to the pharmacological aspects of your post, but just want to share that I walk in the same shoes. Had an acute MI in Jan of 08 - 100% blockage of the LAD that was stented. Still here, but not all there mentally and emotionally.

Please take it easy and don't get too anxious - not really in a position to advise others, but try and be gentle on yourself and hope you have a good support system of family and friends.

Your name indicates Indian ethnicity - have friends who're Indian, and they're finding out that the South Asian population has a particular predisposition for dyslipidemia and genetically narrow coronary arteries - a potentially explosive combination. So hang in there and do your research and take your time getting back into the "swing of things".

I didn't, and I'm paying a heavy price for it. You have to watch out for post MI depression and although you may not have had a "catastrophic event", you are not sensitized to all the messaging, worries and anxieties that go along with the trauma of heart problems.

That said, my frustration, turned to anger to depression...and it happened all too slowly that I was unaware of the seriousness and depth of the issues. So my suggestion is to do what they tell us...set micro goals, if you're analytical, use some Six Sigma techniques of achievable and relevant goal setting, data collection/management/analytics, and making sure you reward yourself in tangible and healthy ways.

Wish you the best in your recovery, and welcome to the forum, and lets all make sure 2010 is the year of renewal, restoration and balance!
Cheers,
Toby