Joe,
I started writing a response, and then I decided to reread your last post, to see if I had missed something. (I hadn't.) In all honesty, this is getting a little silly, and frankly, I have work that I need to do, and I really don't see the value in wasting any more of my time (nor your time) on this. We can argue until the cows come home, and unfortunately, it's not going to do anything to improve the standard of GI care in this country for patients who have MC, nor will it do anything to degrade it.
Other than your addition of a little nitpicking about semantics, I can't see that your last post offers anything new to your argument, so I think it's time to hang it up, don't you? If it makes you happy to think that the GI docs of this country are doing everything they can to offer the best possible care to their patients, and that they are absolutely powerless in the politics of drug approvals, then it's certainly your right to do so, and I would be the first to defend your right to feel that way. Please don't expect me to share your enthusiasm, however, because that's not going to happen.
Tex
U. S. GI Docs Are Only 40 Years Behind The Rest Of The World
Moderators: Rosie, Stanz, Jean, CAMary, moremuscle, JFR, Dee, xet, Peggy, Matthew, Gabes-Apg, grannyh, Gloria, Mars, starfire, Polly, Joefnh
Along these lines, why do U.S. doctors refuse to recommend Strontium for osteoporosis, which is widely used in Europe, but promote bisphosphonates, which have been shown to cause fractures and do not stimulate bone replacement? I can understand that strontium isn't promoted by the pharmaceuticals because it's an OTC product. But my osteo doc said he couldn't recommend it because it hasn't been studied in the U.S. We know that will never happen here because there's no money in it for pharma. But it has been studied pretty extensively in Europe because it's given as a prescription.
I believe the answer is potential lawsuits. I had the distinct impression that my osteo doc (and my PCP) both realize that it's a good treatment for osteoporosis, but they don't dare say so. I suspect that fear of lawsuits restrain many doctors from practicing the way they would like to.
Gloria
I believe the answer is potential lawsuits. I had the distinct impression that my osteo doc (and my PCP) both realize that it's a good treatment for osteoporosis, but they don't dare say so. I suspect that fear of lawsuits restrain many doctors from practicing the way they would like to.
Gloria
You never know what you can do until you have to do it.
-
guitarlover
- Posts: 11
- Joined: Sat Jan 26, 2013 1:41 am
Hi Zizzle,Zizzle wrote:Incidentally, a friend sent me this article after her pediatrician suggested she give her child Miralax EVERY DAY to address his constipation. She was freaked out. Is there truth to this? Could PEG be this toxic???
Miralax is practically given to kids like candy!!
http://www.gutsense.org/gutsense/the-ro ... eimer.html
Wow, this is a lifesaver! Thank you!
I'm also sitting here with kidney disease that is no longer mild. The last thing on earth I need is to be taking a kidney poison for my constipation problem, but that's exactly what I would have done if not for you, Zizzle. Thankfully I read your post in time to avoid taking that poison.
That www.gutsense.org is also a website I think I'll end up going back to. I watched a video linked on the homepage:
WHAT IS SO MENACING ABOUT DIETARY FIBER?
http://www.gutsense.org/fibermenace/fm_transcript.html.
My goodness, everything I thought I knew for sure has certainly been upended recently! Psyllium husk capsules were my old standbys, but psyllium just isn't cutting it right now with my dietary changes. I was figuring on turning to the laxative approach.
I'm sitting here now drinking prune juice, that old-fashioned idea... though the carbs are less than ideal for a diabetic.
Best wishes, Mary
Hi Good Buddies,
I'm late weighing in on this, but just wanted to say that the scenario outlined by Joe (re the MD's role in getting new drugs approved) is accurate, in my experience. The bulk of the problem lies with the FDA/approval process, and practicing MDs are virtually powerless in that process. I myself have written letters about promising drugs, to no avail. Tex, I do take issue with your assumption that docs don't care about the comfort of their patients. Sure, there are a few bad apples, as in any profession, but a blanket statement like that is simply not fair. And the fact remains...... the GI doc is an important and necessary part of the treatment team for MC - they are the ones who must diagnose it in the first place, prescribe Entocort or other meds, etc.
I just don't see how anything is to be gained by constantly pointing the finger at physicians. Clinicians (practicing MDs) see patients virtually 100% of the time - in their role, they do not have the time/authority/capability to monitor or push along promising new research/drugs. It is daunting just trying to keep up with the voluminous literature and changing treatment protocols.
Hi Gloria! Yes, lawsuits are a problem, but the main issue is that, if a doc is sued and has not followed the established medical protocols for treating the condition in question, she would have her license revoked. And can you imagine the reaction if she had prescribed a drug not approved by the FDA? I know it's frustrating - as much for the doc as the patient in many cases. The biggest problem, I believe, is the gap between emerging medical knowledge and when that knowledge becomes an established treatment method - it usually takes YEARS.
Z, I have the same concerns about Miralax. I used it for my last colonoscopy - it was much easier to drink than the old swamp water, but the photos of my colon that my GI doc gave me after the procedure showed an extremely inflamed, angy red colon. Since the biopsy was negative for MC, I know the inflammation was solely due to the Miralax. I will not use it the next time.
Love,
Polly
I'm late weighing in on this, but just wanted to say that the scenario outlined by Joe (re the MD's role in getting new drugs approved) is accurate, in my experience. The bulk of the problem lies with the FDA/approval process, and practicing MDs are virtually powerless in that process. I myself have written letters about promising drugs, to no avail. Tex, I do take issue with your assumption that docs don't care about the comfort of their patients. Sure, there are a few bad apples, as in any profession, but a blanket statement like that is simply not fair. And the fact remains...... the GI doc is an important and necessary part of the treatment team for MC - they are the ones who must diagnose it in the first place, prescribe Entocort or other meds, etc.
I just don't see how anything is to be gained by constantly pointing the finger at physicians. Clinicians (practicing MDs) see patients virtually 100% of the time - in their role, they do not have the time/authority/capability to monitor or push along promising new research/drugs. It is daunting just trying to keep up with the voluminous literature and changing treatment protocols.
Hi Gloria! Yes, lawsuits are a problem, but the main issue is that, if a doc is sued and has not followed the established medical protocols for treating the condition in question, she would have her license revoked. And can you imagine the reaction if she had prescribed a drug not approved by the FDA? I know it's frustrating - as much for the doc as the patient in many cases. The biggest problem, I believe, is the gap between emerging medical knowledge and when that knowledge becomes an established treatment method - it usually takes YEARS.
Z, I have the same concerns about Miralax. I used it for my last colonoscopy - it was much easier to drink than the old swamp water, but the photos of my colon that my GI doc gave me after the procedure showed an extremely inflamed, angy red colon. Since the biopsy was negative for MC, I know the inflammation was solely due to the Miralax. I will not use it the next time.
Love,
Polly
Blessed are they who can laugh at themselves, for they shall never cease to be amused.
Hi Polly,
I apologize if you feel that I was unfairly criticizing all GI specialists, because I thought that I pointed out several times in this thread that there are many excellent GI specialists who are exceptions to my concerns about the general attitude of this group of specialists as a whole. Exceptions aside, there are far too many GI specialists you do such callous acts as informing their patients of a diagnosis of MC, and then telling them that it's nothing to be concerned about, or come see me in about a month and we'll discuss your options, etc.
The archives of this board are loaded with complaints of that type, and others. That's clearly a sign of a cold indifference to the comfort and well-being of their patients. The worrisome part is that there appear to be more posts here about the bad apples than about good apples. While that could be due to a "squeaky wheel" effect, it's also possible that the bad apples just might outnumber the good apples in this case.
Regarding the legal implications, that's clearly always a primary consideration in issues of this sort, but I'm not so sure that is the case in this particular situation. Both sodium picosulfate and magnesium citrate have been available OTC for many years. So they could have been used, without additional FDA action. In fact, the FDA also has a process whereby OTC ingredients marketed overseas can be introduced into the U.S. market via what is known as a "drug monograph" under a Time and Extent Application (TEA).
So in essence, all that has happened here is that the FDA has now approved a specific combination of these two OTC drugs, so that the resulting product can now be sold as a prescription-only drug (at a much higher cost to patients). That's kind of sad, when you consider that GI docs could have been using the OTC versions all this time, without risk (the existing legal OTC status of the individual drugs would preempt any adverse legal liability).
Wow! I didn't realize that you had used Miralax prior to that last exam. So that explains it.
Those photos constitute some mighty powerful evidence against the safety of that product. I suppose one would have to rate that discovery as serendipitous, but it's a shame to have to experience that kind of damage in order to accomplish it.
Love,
Tex
I apologize if you feel that I was unfairly criticizing all GI specialists, because I thought that I pointed out several times in this thread that there are many excellent GI specialists who are exceptions to my concerns about the general attitude of this group of specialists as a whole. Exceptions aside, there are far too many GI specialists you do such callous acts as informing their patients of a diagnosis of MC, and then telling them that it's nothing to be concerned about, or come see me in about a month and we'll discuss your options, etc.
The archives of this board are loaded with complaints of that type, and others. That's clearly a sign of a cold indifference to the comfort and well-being of their patients. The worrisome part is that there appear to be more posts here about the bad apples than about good apples. While that could be due to a "squeaky wheel" effect, it's also possible that the bad apples just might outnumber the good apples in this case.
Regarding the legal implications, that's clearly always a primary consideration in issues of this sort, but I'm not so sure that is the case in this particular situation. Both sodium picosulfate and magnesium citrate have been available OTC for many years. So they could have been used, without additional FDA action. In fact, the FDA also has a process whereby OTC ingredients marketed overseas can be introduced into the U.S. market via what is known as a "drug monograph" under a Time and Extent Application (TEA).
So in essence, all that has happened here is that the FDA has now approved a specific combination of these two OTC drugs, so that the resulting product can now be sold as a prescription-only drug (at a much higher cost to patients). That's kind of sad, when you consider that GI docs could have been using the OTC versions all this time, without risk (the existing legal OTC status of the individual drugs would preempt any adverse legal liability).
Wow! I didn't realize that you had used Miralax prior to that last exam. So that explains it.
Those photos constitute some mighty powerful evidence against the safety of that product. I suppose one would have to rate that discovery as serendipitous, but it's a shame to have to experience that kind of damage in order to accomplish it.Love,
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Mary,
I gave my mother-in-law 1/2 the recommended dose mixed in a cup of water once, and she was happily going within an hour.
Why not try magnesium as a natural laxative? We're all deficient anyway. Magnesium sulfate (Epsom salts) is supposed to work the best for laxative effect and is cheap and easy to find.I'm sitting here now drinking prune juice, that old-fashioned idea... though the carbs are less than ideal for a diabetic.
I gave my mother-in-law 1/2 the recommended dose mixed in a cup of water once, and she was happily going within an hour.