Now, keep up to date
with daily feeds of newly posted stories
about America's Seniors...click on the box
Side Effects: When Silence Isn't Golden
7, 2011--Side effects may occur with any new
treatment, including new medications,
placement of a new medical device, surgery,
or even physical or occupational therapy.
We usually think of side effects when we
begin to experience bad changes-when the
treatment introduces new worrisome symptoms
Most treatments have some sort of side
effect associated with them, and many of us
may wonder if side effects are simply the
price we must pay for a necessary treatment.
But side effects shouldn't be taken lightly,
for a number of reasons.
At their most extreme, side effects raise
the alarm when you are having harmful and
even potentially fatal treatment reactions.
Even somewhat mild side effects like a dry
mouth, sleepiness, or minor muscle aches may
still interfere with your daily life.
Sometimes side effects bother some people so
much that they skip doses or give up a
treatment altogether, which can derail care
and put them at risk for both short- and
Before treatment begins, here are a few
questions you can discuss with your health
What are the common side effects of this
Are there any serious side effects that
I should be aware of?
When would any side effects start? Are
they likely to get stronger or weaken
Can I do anything to prevent these side
Are there other treatments I can take
that don't carry these side effects?
How might this treatment interact with
any of my other treatments?
Do I need any tests to detect "silent"
Who should I notify if I experience
unusual or unexpected side effects?
"I cannot overemphasize the need to discuss
side effects, no matter how minor they
seem," says Vicki Koenig, M.D., a retired
family physician in Exmore, Va.
She recalled several experiences with a new
blood pressure medication used by her
patients-and the warning signs caught by
One woman, she says, "came in more than week
early for a blood-thinner check because her
urine didn't look right. She was
extremely sensitive to the drug and was
bleeding internally. Had she waited, she
would have had dire consequences."
Not sure if it's a side effect that your
care provider should hear about? Here are
some signs to consider:
Your daily life is noticeably disrupted
by the side effects.
Your symptoms seem to be getting worse.
Others around you are expressing
concerns about changes they see in you.
Past experience with treatments leads
you to think this treatment is
exceptionally difficult or troublesome.
You are thinking of stopping treatment
because of side effects.
Mike Hawker, a 25-year old Californian,
takes medication for obsessive-compulsive
disorder, but last year he "began to feel
some really strange side effects...that were
like nothing I have ever felt and I had no
idea in the world how to describe them," he
"The only thing I could come up with is it
felt like my mind would 'blink' for a short
second. Also, at time I would feel like the
ground had just shaken. These two things
were extremely difficult to describe to my
The unusual feelings bothered him so much
that he called his doctor while out of town,
and he and the doctor decided to wean him
off the medication immediately. The side
effects soon disappeared.
"I find that many patients are not even sure
if what they are experiencing is indeed a
side effect or just caused by the disorder
itself," says Donna Barsky, D.Ph., a
pharmacist in Plano, Texas.
"Sometimes, a side effect may not even show
up immediately, but in a period of time
after they start taking the medication."
Barsky had a patient with diabetes who
developed breathing problems a year after he
started on a certain medication.
After discussing his concerns, she recalled,
"we reviewed what medications he had started
in the last year. One of his medications,
which was controlling his diabetes, has a
rare side effect of pulmonary edema which
can be fatal if left unaddressed."
Even if a side effect doesn't appear to be
severe or harmful, discussing side effects
can help you and your health care team zero
in on a therapy that treats your condition
while preserving your quality of life.
Rachael Bender, a consultant from California
who has taken anticonvulsants for mood
disorders, brings up any side effects "which
are in any way annoying" during her doctor's
"What I've found is some side effects I will
not tolerate at all, but some side effects
are dose-dependent, and with a small change
of dosage the side effect will disappear,"
"If you don't mention a side effect to the
doctor, you would never know this."
Share your side effects with your health
care team in the same way that you might
describe symptoms: give them a basic, but
descriptive summary of the side effect; tell
them when and how often you experience it;
let them know if anything makes you better
or worse; and share whether the side effect
has changed over time.
If possible, make a note of the side effects
as you experience them, so that you will
have a written record to jog your memory and
share with your doctor during your next
Learning More About Side Effects
The provider who prescribed a treatment
should be able to answer your questions
about side effects, but it doesn't hurt to
seek information from other members of your
health care team as well.
"I have learned that it is much easier and
more informative to discuss drug side
effects and interactions with other
medications with my pharmacist, says Brenda
Jones, a 52-year-old woman in New Jersey.
"I get more information from him and I do
not have to deal with talking to the back of
a doctor's head as he is rushing off to the
One of the newest ways to learn about side
effects from your treatment is from other
patients with the same condition-linked
together on sites like
www.PatientsLikeMe.org and other
These sites draw information from
participating patients with certain
conditions ranging from multiple sclerosis
to HIV/AIDS. Individuals share reports on
their health status, their treatments and
their side effects over time.
While these community reports can be useful,
the information on them should always be
verified using other trusted sources.
The more you know about your side effects,
the more easily you can weigh the trade-off
between the usefulness of the treatment and
the discomfort or even risks of the
accompanying side effects.
"If the side effect is tolerable and not
dangerous, the doctor and the patient will
often agree to put up with it," Koenig says.
"But if it's bothersome to the patient, then
it's perfectly OK to say something. The
doctor doesn't live with you, you do."
"For years I stuck with a medication that
caused excessive weight gain and fatigue.
Finally when my hair started falling out, I
had had enough," Bender says.
"After switching medications I realized how
unhappy I was and how I suffered on a
medication that fixed one problem while
causing a huge impact on the rest of my
In some cases, the side effects of a
treatment may be so unacceptable that you
decide to stop the treatment entirely.
If this seems like the best course of action
to you, it is important to talk through the
decision with your health care team rather
than immediately quit the treatment.
They can help you work through the pros and
cons of stopping treatment, and perhaps
point you toward alternative care.
Even if you decide to stop treatment against
the advice of your team, the discussion can
go a long way toward preserving a good
working relationship with your health care
providers and alerting you and your family
to the consequences of an untreated