Keeping all your doctors in sync

Every treatment or medication is a two edged sword, which can help but also may possibly cause harm. It is the doctor’s duty to bring his best judgment, knowledge and experience into play in deciding what is wisest for the patient.

Many of today’s wonder drugs can accomplish things that were not possible 25 or 50 years ago. However, every drug we take into our bodies must have a way of getting out. Some drugs are broken down in the liver and excreted in the bile, some are filtered out by the kidneys and leave in the urine, some are exhaled in the breathe, some go out the stool, others by way of the sweat glands, tears or nasal secretions.

Not infrequently, drugs can cause adverse side effects, often involving the liver, kidneys or bone marrow. It is only by doing periodic blood tests that the doctor can evaluate whether the drug in question is causing more harm than good or whether the dose must be adjusted.

Patients often take a combination of drugs prescribed by a variety of doctors, which makes the task even more difficult. Today, the use of numbered and bar coded prescriptions together with increasing electronic prescription writing are major steps forward in keeping all the doctors a patient may be using “in sync” as far as medications are concerned.

One of the most valuable and accurate ways of following a patient’s progress is by doing blood tests at periodic intervals to check for possible toxicity of drugs on the patient’s liver, kidneys or bone marrow. The cholesterol lowering drugs are excellent in terms of lowering the cholesterol level but the potential adverse side effect on the liver must be diligently checked by doing blood tests so when your doctor advises that you need a blood test, don’t put up a fuss; have the blood test.

Screening blood tests such as PSA for prostate cancer are advisable to have done once a year for men over 40 even if there is no history of prostate cancer, no symptoms, no findings on physical examination including a digital rectal examination, and no family history of prostate cancer. If any combination of these conditions and/or findings should be present, it is perfectly proper for your doctor to do the PSA test at more frequent intervals than annually; listen to your doctor’s advice.

If you have a benign prostate enlargement causing slowing of the stream, frequent and urgent urinations day and night, an intermittent or interrupted stream, interference with your sex life and a feeling of incomplete emptying, try medication at first and then should the medications fail to give you relief or if the side effects become intolerable, the next step would be to consider TherMatrx microwave thermotherapy treatment of the prostate. Surgery should be reserved as the court of last resort.

Have a Question? Call Dr. Okun at 718-241-6767

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