THE FULL MEDICAL

Like everybody, I take all my serious medical advice from people who never took a single science class in college, and garnered every scrap of precious expertise either by word of mouth or reading secret articles on the internet.
Because medicine is just a big conspiracy!

In the last two weeks, I have been told that my medications are all a money making scheme by big pharma and/or the Illuminati, and I should consume wheat grass, more steak, apple cider vinegar, only tofu, no gluten, some plant that grows deep in the rainforest, and turmeric.

Plus put complete trust in the deity of some Christian cult.

If I do so, my blood pressure will return to normal.
Any heart or arterial problems will be gone.

One person even suggested that some of the pills I take everyday are only cheap shit; what I need to do is demand that my doctor (who went to medical school for a number of years, then did an internship for more years, and has been practicing for years) prescribe the Rolls Royce of medicine.

Marijuana cures everything.

Green tea extract.

Yoghurt.


I've also been told that lab tests are notoriously false, and not to rely on them.


Naturally I appreciate all this unprompted and unwelcome medical advice from the wise people who have such great faith in their knowledge.


What I am taking, on a daily basis, are Amlodipine Besylate, Losartan-hctz, Metoprolol Succinate. Plus Clopidogrel (Plavix), so that the coronary stent doesn't plug up, as well as baby aspirin and Atorvastatin.
And two dietary supplements.


Let's look at the bloodpressure meds first.


AMLODIPINE

Per Wikipedia:
Amlodipine, sold under the brand name Norvasc among others, is a medication used to treat high blood pressure and coronary artery disease. While not typically recommended in heart failure, amlodipine may be used if other medications are not sufficient for treating high blood pressure or heart-related chest pain.

Common side effects include swelling, feeling tired, abdominal pain, and nausea. Serious side effects may include low blood pressure or heart attack. Whether use is safe during pregnancy or breastfeeding is unclear. When used by people with liver problems, and in elderly individuals, doses should be reduced. Amlodipine works partly by increasing the size of arteries. It is a long-acting calcium channel blocker of the dihydropyridine type.

Amlodipine was patented in 1982 and approved for medical use in 1990. It is on the World Health Organization's List of Essential Medicines, which lists the most effective and safe medicines needed in a health system. It is available as a generic medication.

In the United States, a month's supply costs less than $25.

The only absolute contraindication to amlodipine is an allergy to amlodipine or any other dihydropyridines.

Other situations occur, however, where amlodipine generally should not be used. In patients with cardiogenic shock, where the heart's ventricles are not able to pump enough blood, calcium channel blockers exacerbate the situation by preventing the flow of calcium ions into cardiac cells, which is required for the heart to pump. While use in patients with aortic stenosis (narrowing of the aorta where it meets the left ventricle) since it does not inhibit the ventricle's function is generally safe, it can still cause collapse in cases of severe stenosis. In unstable angina (excluding variant angina), amlodipine can cause a reflex increase in cardiac contractility (how hard the ventricles squeeze) and heart rate, which together increase the demand for oxygen by the heart itself.
Patients with severe hypotension can have their low blood pressure exacerbated, and patients in heart failure can get pulmonary edema. Those with impaired liver function are unable to metabolize amlodipine to its full extent, giving it a longer half-life than typical.

Amlodipine's safety in pregnancy has not been established, although reproductive toxicity at high doses is known. Whether amlodipine enters the milk of breastfeeding mothers is also unknown.

Those who have heart failure or recently had a heart attack, should take amlodipine with caution.

Some common dose-dependent adverse effects of amolodipine include vasodilatory effects, peripheral edema, dizziness, palpitations, and flushing. Peripheral edema (fluid accumulation in the tissues) occurs at rate of 10.8% at a 10-mg dose (versus 0.6% for placebos), and is three times more likely in women than in men. It causes more dilation in the arterioles and precapillary vessels than the postcapillary vessels and venules. The increased dilation allows for more blood, which is unable to push through to the relatively constricted postcapillary venules and vessels; the pressure causes much of the plasma to move into the interstitial space. Amlodipine-association edema can be avoided by adding ACE inhibitors or angiontensin II receptor antagonist. Of the other dose-dependent side effects, palpitations (4.5% at 10 mg vs. 0.6% in placebos) and flushing (2.6% vs. 0%) occurred more often in women; dizziness (3.4% vs. 1.5%) had no sex bias.

Common but not dose-related adverse effects are fatigue (4.5% vs. 2.8% with a placebo), nausea (2.9% vs. 1.9%), abdominal pain (1.6% vs. 0.3%), and somnolence (1.4% vs. 0.6%). Side effects occurring less than 1% of the time include: blood disorders, impotence, depression, peripheral neuropathy, insomnia, tachycardia, gingival enlargement, hepatitis, and jaundice.

Amlodipine may increase the risk of worsening angina or acute myocardium infraction, especially in those with severe obstructive coronary artery disease, upon dosage initiation or increase. However, depending on the situation, Amlodipine inhibits constriction and restores blood flow in coronary arteries as a result of its property that works directly on vascular smooth muscle causing reduction in peripheral vascular resistance and consequent reduction in blood pressure.

[Source: Wikipedia - some text omitted.]


For an exhaustive (and entertaining) list of all possible side effects, please see Amlodipine (Oral Route) Side Effects from the Mayo Clinic. And do please note "Incidence not known: Swelling of the breasts or breast soreness in both females and males". Gosh, that's a relief.



LOSARTAN

Per Wikipedia:
Losartan, sold under the trade name Cozaar among others, is a medication mainly used to treat high blood pressure. It is also used for diabetic kidney disease, heart failure, and left ventricular enlargement. It is taken by mouth. It may be used alone or in addition to other blood pressure medication. Up to six weeks may be required for the full effects to occur.

Common side effects include muscle cramps, stuffy nose, cough, and high blood potassium. Severe side effects may include angioedema, low blood pressure, and kidney problems. Use during pregnancy may result in harm to the baby. Use is not recommended during breastfeeding. It is in the angiotensin receptor blocker family of medication.
It works by blocking angiotensin II.

Losartan was patented in 1986 and approved for medical use in the United States in 1995. It is on the World Health Organization's List of Essential Medicines, which lists the most effective and safe medicines needed in a health system. It is available as a generic medication. The wholesale cost in the developing world is about US$0.28–3.45 per month as of 2015. In the United States, as of 2017, the wholesale cost of a typical dose is $1.13 per month.

In January 2014, the FDA issued a black box warning that losartan can cause fetal toxicity, and should be discontinued as soon as pregnancy is detected. Using losartan while pregnant could result in fetal injury or death.

The most common side effects for losartan are upper respiratory infections or stuffy nose, dizziness, and back pain. Type 2 diabetics with diabetic kidney disease may experience diarrhea, fatigue, low blood pressure, low blood glucose, elevated potassium, and chest pain.

More serious side effects include low blood pressure and allergic reaction.

Losartan should not be taken by people who are diabetic and taking aliskiren.

[Source: Wikipedia - some text omitted.]



METOPROLOL

Per Wikipedia:
Metoprolol, marketed under the tradename Lopressor among others, is a medication of the selective β1 receptor blocker type. It is used to treat high blood pressure, chest pain due to poor blood flow to the heart, and a number of conditions involving an abnormally fast heart rate. It is also used to prevent further heart problems after myocardial infarction and to prevent headaches in those with migraines.

Metoprolol is sold in formulations that can be taken by mouth or given intravenously. The medication is often taken twice a day. The extended-release formulation is taken once per day. Metoprolol may be combined with hydrochlorothiazide (a diuretic) in a single tablet.

Common side effects include trouble sleeping, feeling tired, feeling faint, and abdominal discomfort. Large doses may cause serious toxicity. Risk in pregnancy has not been ruled out. It appears to be safe in breastfeeding. Greater care is required with use in those with liver problems or asthma. Stopping this drug should be done slowly to decrease the risk of further health problems.

Metoprolol was first made in 1969, patented in 1970, and approved for medical use in 1982. It is on the World Health Organization's List of Essential Medicines, the most important medications needed in a basic health system. It is available as a generic drug. In 2016, it was the 6th most prescribed medication in the United States, with more than 74 million prescriptions.

Side effects, especially with higher doses, include dizziness, drowsiness, fatigue, diarrhea, unusual dreams, trouble sleeping, depression, and vision problems. Metoprolol may also reduce blood flow to the hands or feet, causing them to feel numb and cold; smoking may worsen this effect. Due to the high penetration across the blood-brain barrier, lipophilic beta blockers such as propranolol and metoprolol are more likely than other less lipophilic beta blockers to cause sleep disturbances such as insomnia and vivid dreams and nightmares.

Serious side effects that are advised to be reported immediately include symptoms of bradycardia (resting heart rate slower than 60 beats per minute), persistent symptoms of dizziness, fainting and unusual fatigue, bluish discoloration of the fingers and toes, numbness/tingling/swelling of the hands or feet, sexual dysfunction, erectile dysfunction, hair loss, mental/mood changes, depression, breathing difficulty, cough, dyslipidemia and increased thirst. Consuming alcohol while taking metoprolol may cause mild body rashes and is not advised.

[Source: Wikipedia - some text omitted.]



With antihypertensive and lipid-lowering treatments there may be an increased risk of gastro-intestinal bleeding. Comparatively speaking, patients on amlodipine do not have an increased risk of GI bleeding (haemorrhage) that would necessitate hospitalization.


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Next, the other two essentials. The statin is, more or less, preventative of further adverse developments, because my cholesterol is a bit high. The anti-platelet medication (clopidogrel) is to keep me from dying.


ATORVASTATIN

Per Wikipedia:
Atorvastatin, sold under the trade name Lipitor among others, is a statin medication used to prevent cardiovascular disease in those at high risk and treat abnormal lipid levels. For the prevention of cardiovascular disease, statins are a first-line treatment. It is taken by mouth.

Common side effects include joint pain, diarrhea, heart burn, nausea, and muscle pains. Serious side effects may include rhabdomyolysis, liver problems, and diabetes. Use during pregnancy may harm the baby. Like all statins, atorvastatin works by inhibiting HMG-CoA reductase, an enzyme found in the liver that plays a role in producing cholesterol.

Atorvastatin was patented in 1986 and approved for medical use in the United States in 1996. It is available as a generic medication. In the United States, the wholesale cost per month is about 3.80 USD as of 2018.

Statins, including atorvastatin, have a small, but significant beneficial effect on preventing the loss of kidney function and on reducing loss of protein in urine in people with cardiovascular disease.

[Source: Wikipedia - some text omitted.]



CLOPIDOGREL

Per Wikipedia:
Clopidogrel, sold under the trade name Plavix among others, is an antiplatelet medication used to reduce the risk of heart disease and stroke in those at high risk. It is also used together with aspirin in heart attacks and following the placement of a coronary artery stent (dual antiplatelet therapy). It is taken by mouth. Onset of effects is about 2 hours and lasts for 5 days.

Common side effects include headache, nausea, easy bruising, itching, and heartburn. More severe side effects include bleeding and thrombotic thrombocytopenic purpura. While there is no evidence of harm from use during pregnancy, such use has not been well studied. Clopidogrel is in the thienopyridine-class of antiplatelets. It works by irreversibly inhibiting a receptor called P2Y12 on platelets.

Clopidogrel was patented in 1982 and approved for medical use in 1998. It is on the World Health Organization's List of Essential Medicines, which lists the most effective and safe medicines needed in a health system.
The wholesale cost in the developing world is about US$0.77–31.59 per month. In the United States, a month of treatment costs less than US$25.

Clopidogrel is used to prevent heart attack and stroke in people who are at high risk of these events, including those with a history of myocardial infarction and other forms of acute coronary syndrome, stroke, and those with peripheral artery disease.

Serious adverse drug reactions associated with clopidogrel therapy include: Thrombotic thrombocytopenic purpura (incidence: four per million patients treated). Hemorrhage – the annual incidence of hemorrhage may be increased by the coadministration of aspirin. Any major bleeding: clopidogrel 3.7%, placebo 2.7%. Life-threatening bleeding: clopidogrel 2.2%, placebo 1.8%. Hemorrhagic stroke: clopidogrel 0.1%, placebo 0.1%.

[Source: Wikipedia - some text omitted.]



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AFTER WORD

Okay, so among the possible side effects of this array of pills are œdema, liver damage, vertigo, nausea, random bleeding, depression, mood swings, fœtal death, diarrhea, constipation, fatigue, itchiness, sexual dysfunction, cough, sleepiness, insomnia, bad dreams, rashes, and a runny nose.
Above all, while on most of these, I shouldn't get pregnant.

The only one I seem to have is a slight stuffiness.
Plus my Raynaud's syndrome is worse.
Pregnancy won't be an issue.
Too old and male.


I've also had a flu shot recently, as well as a pneumococcal polysaccharide vaccine, both of which I've reliably been told will cause impotence, brain damage, and autism.

Now, because both my doctor and my cardiologist are Chinese American, and the staff at the hospital where I have my appointments (Chinese Hospital, in Chinatown) are either local or foreign born Chinese Americans, one or two people have told me that I cannot possibly be getting decent care, I should seek help from Stanford Medical ("they're the best!").
"Real professionals", somebody white, and a local shaman.


In all honesty, I am convinced that many people have shit for brains. I am surprised that they are still alive. Surely by now they would've played in traffic, or put something dangerous in their mouths or up their arses?


My doctor and my cardiologist know what they're doing.
And so do the staff at Chinese Hospital.
I will continue to trust them.



PS: The number of folks I have met who are seriously sick because they stopped taking their medication is quite appalling. Often the reason they stopped is because the medicine alleviated their condition.




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