If you’ve been trying to figure out the new prescription drug benefits, you can be sure of one thing: you’re going to be hearing a lot about your health plan’s “formulary.” I thought it was an ant farm. Oops, that would be formicary. Anyway, when I asked the pharmacist at Kaiser why the medicine he prescribed for osteoporosis is way more expensive than the old one, he said it was because of the formulary. Actonel (risedronate) at the Kaiser pharmacy is $88.74 for four 35 mg tablets, Fosamax (alendronate) is only $57.77 for four 70 mg tablets.
Formulary is just a fancy word for formula, or correctly, a collection of formulas. It’s how your HMO or Medicare Prescription Plan decides what to charge you, in relation to what the drug company charges them for each individual drug. According to that awful piece of legislation foisted on seniors by the administration (after lying to Congress about the program’s cost), Medicare is barred from negotiating prices with the drug companies.
Being rightfully suspicious of all prescription drugs, I inspected the Actonel package insert for a black box warning, none found, and for the list of possible side effects. Actonel’s reported side effects are: back pain, joint pain, headache, heartburn, stomach pain, nausea, diarrhea, constipation, gas. Yuck!
Fosamax lists similar side effects, along with muscle pain. Wait a minute. What kind of a trade-off is this?
My doctor said I might have fewer digestive problems with Actonel. But I’ve been complaining of severe muscle pain in my legs, which everyone seemed to think was caused by the accident that broke my hip last year. I kept insisting that those muscles, apparently disturbed and some actually cut during surgery, should have healed by now. We’re talking about one year and three months. The chiropractor who helps me by keeping my leg length even and improving range of motion in my lower extremities seems to think the muscles should have returned to normal. I’m thinking, could this be from Fosamax? Have I been gaining bone density at the expense of muscle strength?
The insert for Actonel, however, lists joint pain instead of muscle pain. Swell. Let’s see. Which would be worse? Aching hips and knees or calves, shins and thighs so tender that massage is excruciating? Actually, I have all of the above in varying degrees depending on how much I bend over, lift up my granddaughter, work in the garden or walk uphill. Still dealing with considerable joint pain following hip fracture and surgery, it would be hard to tell how much the drug contributes. Both drug makers caution to contact your doctor if you experience painful swallowing or severe heartburn. If one counts the pain from pills that get stuck sideways in the esophagus or the aftereffects of pizza and coffee, then I qualify for at least a review.
When NSAIDs got all that bad press after Vioxx and Celebrex went down in flames, I discovered Zyflamend, an herbal anti-inflammatory that seems to work over time, though not as fast as aspirin or Motrin. Given a choice, I suppose I’d rather have pain in a muscle that responds to deep massage. Joint pain is debilitating. Sometimes ice helps, but not always.
The larger point here is that I’d rather take nothing. Not because of the cost to my wallet, but more to the cost of my health. I’ve discovered over the years that I don’t do drugs well. Sometimes they do the exact opposite of their intended purpose. A doctor who took care of me through my childhood and adolescence once said I had the drug tolerance of a cat. In my pre-vet class, the teacher demonstrated this by giving an identical dose of pain killer (morphine, I think) to a cat and a dog of the same size and weight. The dog got sleepy and began to nod off. The cat blinked its eyes, arched its back, then screamed and ran up the drapes. Scary.
Anyway, I had run out of Fosamax and decided to delay starting the Actonel until I got the results of my liver function test. After a couple weeks, I noticed the muscle pains in my legs had eased considerably, at least to where I could actually enjoy massage. The chiropractor couldn’t account for the improvement but agreed it was significantly better.
Of course, this was not a scientific, double blind study, but it’s good enough for me to want to stay off the medication until proven, at least to me, that the drugs aren’t causing, or maybe just exacerbating, the problem.
Meanwhile, I’m enjoying the best days I’ve had since the accident. I can get up after sitting at the computer for an hour and walk without limping. I can climb the stairs without clinging to the hand rail. I upped my exercises to three sets of 12 reps each. And what’s even more significant, the optimism that had all but deserted me has returned. I’m cheerful as a robin in spring. And the shoes with two-inch heels I almost gave away? I wore them yesterday without so much as a wobble. I’m me again!
Better living without chemistry, I think.