By Joe Graedon, MS, and Teresa Graedon, Ph.D.
King Features Syndicate
Q. My doctors treated my persistent acid reflux for years by prescribing various proton pump inhibitors (PPIs). They carefully tested my calcium levels, but never looked at potassium or magnesium.
I was admitted to the emergency room with severe pain and a surgeon recognized that I had undetectable levels of these minerals. The hospital gave them intravenously for three weeks and after I was discharged, the doctor told me I almost died.
During this time, the gastrologist kept me on PPI. After doing my own research, I realized the medication was the cause of the imbalance and stopped taking it. Years later, I learned that my father-in-law had almost died from the same reaction.
An article on the Food and Drug Administration website warns of this side effect of PPIs, but none of my doctors had read it. If people need to watch out for themselves, warnings should appear on the packaging of over-the-counter medications to alert them to this problem.
A. Thank you for sharing this scary experience. Although prescribing information for PPIs like Nexium or Prilosec warns doctors about dangerously low levels of magnesium and potassium, over-the-counter labels do not mention this problem.
People who want to learn more about the potential side effects of PPIs and alternative approaches to heartburn may be interested in our “E-Guide to Overcoming Digestive Disorders.” This online resource can be found under the Health eGuides tab on www.PeoplesPharmacy.com.
Q. I have had several slightly bothersome skin changes on my face and ears. My doctor says it’s precancerous lesions from sun exposure and shrugs.
In my opinion, “precancerous lesions” could become cancer. So when I found an article about diclofenac as an anti-cancer agent, I started applying Voltaren Gel to my actinic keratoses. Some are clearing up.
A. Thank you for providing the link to the article in eCancerMedicalScience (January 11, 2016). Dermatologists consider topical diclofenac less effective for actinic keratoses than some of their more powerful treatments, such as freezing, lasers, 5-fluorouracil, or photodynamic therapy (Archives of Dermatological Research, July 2023). On the other hand, Voltaren Gel is available without a prescription. Be sure to have your troublesome pimples examined by a dermatologist before you start treating them yourself.
Q. Doctors no longer give paper prescriptions to patients; everything is electronic. I rarely need prescription medications, but having paper is good for two reasons. First, I know what medication and dosage was prescribed and I can compare that with what I am given at the pharmacy. Second, it gives me time to find the pharmacy offering the best price without having to have pharmacists call each other to transfer scripts.
Are there any studies on the best method of prescription, paper or electronic?
A. There have been a few studies on this topic. Most focus on benefits to the healthcare system rather than the patient. One study found there was a learning curve of around two months (British Journal of Hospital Medicine, September 2, 2015). Initially, it took younger doctors more time to write electronic prescriptions. Later, they took about a minute less.
Additionally, a study conducted at a teaching hospital found that medication errors were less common (but more serious) with electronic prescribing (Journal of Evaluation in Clinical Practice, October 2016). However, we do not know if the practice will be able to provide you with a paper prescription once it switches to electronic prescription.
In their column, Joe and Teresa Graedon respond to letters from readers. Write to them at King Features, 628 Virginia Drive, Orlando, FL 32803, or email them through their website: www.PeoplesPharmacy.com. Their latest book is called “The Best Mistakes Doctors Make and How to Avoid Them.”
