Thursday, August 21, 2014


    I have been seeing more more demand for making the pot smoking 'legal' or as some would like to say 'decriminalise'.There are good people who argue tat it would make money ans save money for the state.But the main things that they are missing is that no drug is 'safe', not even legal 'drug' alcohol.Does that mean that I would like to go back to days of prohibition?NO ,not really.But we need to do something about the rapid growth of use of legal and illegal drugs . I have been medical practice for long time and I believe that the use of narcotics and illegal drugs is at it's higher level and the part that bothers me is that we all think it is OK. This thought came to me , which prompted me to wright this blog.
      I had seen this patient may be year and half or so ago.She was a 79 years old patient who was referred to me for the evaluation of the abnormal CT scan. She had a history of breast cancer and had routine chest X-ray and it showed some abnormality and so a CT scan was done . The CT scan showed number of tiny nodule .So she was referred to me .The patient was quite anxious and had a hard time with the situation and was scared, like anybody else would have been with concerned for recurrence of the cancer.The nodules were very small .So the usual procedures like bronchoscopy or needle biopsy or PET scan or open biopsy were not great option. But I decided to do bronchoscopy as the possibility of atypical TB called MAC was there, in my mind it was high on the list of possibilities.I also told her that if these are cancerous nodules,,nothing could be done to 'cure' them and if they were benign ,then nothing was needed to be done. So if the bronchoscopy was OK we will do follow up CT scan . I did the bronchoscopy .And I had thought it came positive for MAC -the atypical TB . This needs treatment with 3 drugs for a year.We also need to do monthly liver function blood test , and need to check eyes periodically .She was not happy with all this , but was 'relieved' that at least it was not cancer.
      Her follow ups continued to be OK as she was tolerating the medicines quite well, after initial problems. She was doing fine and the blood tests were normal. She had no problems and was very pleasant. So I was surprised when I saw her and she appeared to be mad . When I walked in the examination room, she told me that she was done with all the tests and medicines .I looked at her and then the chart . She was about to be completing her treatment in next month and her last CT scan had shown the improvement in the nodules.Then when I started talking to her the real cause of her frustration came out. Her son ,more than 50 years of age, had dies of drug overdose. it was overdose of methadone , which was prescribed to him . Again I don't know the details and he may have taken some more drugs , but methadone was main cause according to her. She has a daughter and she also has drug problem and is no help to this elderly patient and felt no remorse, when she told patient that 'every body dies one day'.
     Under the name of pain control we are giving more medicines and I am afraid that we will get more addicts.

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