So, I went to the MD over the weekend because of another staph infection.  I get the drug Levaquin.  I take one pill and then notice the big WARNING that says "may cause tenonitis or tendon rupture, risks increase significantly for those over 60.

Being an avid weight lifter, and just an active, physical person in general, this bothered me. Did some web research and find that this drug has caused lots of problems.  I spoke to a few MD's here on the board about it with mixed results.

I also got to thinking, right after my staph infection last year, I developed some severe tendonitis in both biceps, on all tendons.  It was painful, I couldn't sleep, I couldn't lift weights, I couldn't play golf and it hurt like hell to hold a rifle.  I chalked it up to over use from weight lifting.  I was eating crow from friends who told me that weight lifting was bad, yadda yadda yadda.

So yesterday morning I called the MD's office, wanting to have a quick consultation with my doctor to see if this was the same drug I was on last year and other alternatives.  The whole day went bye, no call.  So right before closing I called them up.  Turns out they have a policy that I can only do with with my Primary care physician.  My weekend trip was to an after hours clinic.

Fuck!  By the time I was able to call my PCP, he had already left.  So I called this morning.  The nurse said that I was over reacting and not to pay any attention to those warnings that they are really not needed, I insist on talking to the MD.  So after 3 hours of waiting I finally call them back.

The nurse practitioner said that I was over reacting and said that it was just my generalized anxiety disorder.  WTF?  I just want to know about the drug I was prescribed and about other, less harmful alternatives?  She kept being obtuse about what I took last year, finally she said that it was Levaquin that I took last year and she said they didn't really want to tell me about it because they wanted me to finish off the prescription that I was prescribed so as not to cause the bacteria to become resistant and that I was making way to big a deal of it.

Finally convinced them to change my prescription.  WTF?  Why were they being so invasive and condescending?  Hell, its my body, I think I should have the right to know what I'm taking, the risks and alternatives?

You, as a consumer, have the right to choose the service provider that is most willing to cater to your needs.  You should remind them of this.

Either you got horrible service and need a new doctor, or you're a nut and your doctor knows it.



ETA: Personally, I don't trust most medications or doctors who tell me they're safe –– because I don't believe that can even be determined until a drug has been in circulation for quite some time.

Ok......

Now just picture how this would have played out with socialized medicine.....

So what are the side effects of the new antibiotic?

I'd also find a new PCP.

Been diagnosed with general anxiety disorder.  However, that should not disqualify me from asking questions or having concerns about the medication that I take.

Kind of reminds me of the Seinfeld episode when Elaine wants her chart.

My heart doctor gave me a heart medication that was majorly contraindicated with a muscle relaxer I am on.  The pharmacy is the one that told me they would not fill it because of the contraindication.  

FWIW, I wasn't rude or panicked. Just hey this warning right here, along with the class action lawsuit involved, plus the fact that right after I had the same illness resulted in horrendous tendon pain for months makes me wonder about this drug, what can you tell me about it?

Not hard.

This part is true. Always finish the antibiotics you are given. She should have still been willing to give more info on the drug however. Second or third opinions are always good.

That has been weighing on my heavily.  Not to mention that now, on my chart has the suffers from "generalized anxiety" thing.  I wonder what the guberment would think about that condition along with gun ownership?

And on that note, I really don't think I have generalized anxiety,  I just think I'm too smart for my own good.  Sort of like anyone who asks penetrating questions is now a trouble maker.

Even at your own determent?

call the FDA

No point in  it.  With the testimonials I've seen about that drug...........

Besides, it has its purpose.  Just with a mild case of staph and my active lifestyle, I should have an alternative.

Did they act irritated and make a note on the clipboard?





 

Doctors and other "medical professionals" tend to be insufferably arrogant and don't like to be second guessed by peasants patients.

It is understandable to feel the way you do, after the run around you received...

However, you have a very serious infection...

The fluoroquinolone class of drugs can cause weakening of the tendons...  Yet you must do a risk/benefit analysis...

If a proper culture/sensitivity was done and Levaquin hit the bug effectively stay on this medication...

Continue to work out, yet decrease the weight and increase the reps... Possibly do a circuit routine for a ten to 14 day period.  This will not adversely affect your performance...

Consider the alternatives, (along with the large financial impact) a possible hospital stay, with long term outpatient infusions of vancomycin or treatment with an extremely expensive A/B called Zyvox which costs ~100 dollars per dose...

It is indeed a shame that your physician would not have this type of conversation with you concerning your therapy...

Good luck.

Ask your friendly neighborhood pharmacist...we don't bite too hard.

For now, anyway

I always knew you were a headcase!



Get better dude! And STOP getting staph infections.

Dude, last time I was on this medication, I couldn't hold a rifle for 2 months because of the pain.  All I wanted to know is if there was a drug that was equally effective that wouldn't cause me to put my life on hold for 2-3 months.

Like I said, I think they diagnosed my anxiety disorder because I ask questions and because I'm too smart for my own good.

Go the the pharmacy where you got the meds and discuss the alternatives with him/her. They more than docs understand the interactions and warnings and alternatives.  Get the recs from him and the pharmacist can either call the office and make a recommendation or you can provide them with a list.

Oh and find a new doc any NP that tells you to ignore the drug warnings is bad news.

Generalized Anxiety Disorder?

Many of the quinolones, like Levaquin, Cipro, Avelox, etc can cause this problem. Maybe you should stop working out while you are ill with an infection and under the influence of the medication. You're not doing your body any favors by exerting yourself strenuously while your body is fighting a serious infection.

ETA: if you were lifting like you are now while you were taking the med before, you probably injured yourself. There shouldn't be a need to take 2-3 months off if you don't jack yourself up while you're on the medication.

BTW, none of that excuses the lack of communication from the doctor's office.

Nor will I, I still have to work and cruise timber (when it stops raining)  My Achilles tendon is too important for me to risk anything happening to it.

No, I took the time off.  A week later I go into the gym and develop crushing tenonitis.  I stop.  I go back to the doctor and get put on steroidal anti-inflamitories, was told that I could go back in 3 weeks.  Two days into it, I hurt again.  It as damn near taken me 6 months to get back to where I was.

In fact, I had a doctor ask me back in Feb. after a rotator cuff injury if I had chronic tendon problems before last year. The dots connect.

I got a staph infection and was hospitalized for it while I was wearing my Halo brace after my neck fractures.

Staph infections are a no joke, holy shit I feel like I am dying kind of thing. Personally I'd rather stop working out and or risk tendon damage than go through that again. I have had a broken lower back, fractured C spine in several places 9 major surgeries to put me back together and left knee ACL replacement. I think I'd rather go through all of that again than what that staph infection did to me.

In other words treating the staph infection successfully should be your priority everything else comes a distant 2nd

I understand, but the purpose of giving you one of these strong antibiotics is to ensure that the staph infection is completely wiped out. I don't think there's really such a thing as a "mild" staph infection. That just means you caught it early.

I think, but am not absolutely sure, that Levaquin has some "dwell time" in the body. It's likely that the medication may have still been in your system when you started to work out again.

I don't know how long you're still under increased risk for tendinitis after taking a quinolone. That's one of the things that the doctor's office should certainly have discussed with you when you called in with your concerns.

All I wanted it to know was, a) was this the same medication I took last time, b) based on the culture and susceptibility was there another drug that I could take as an alternative.

Like I said, 3 months of painful tendonitis isn't fun, and if there was something else that would cure it, can I take it instead.

Staph is nothing to fuck with. My grandmother ignored a staph infection right up until her leg turned black. She lucked out and only lost her leg-the docs said that had she waited another 12 hours, she would have lost her life.

All of this I realize.  This isn't my first rodeo with staph.  I just about bit the farm the first time.

You mentioned that the prescription was changed...

If you do not mind, what medication was prescribed?

Went from Levaquin to Bactrum.  Which is odd, considering how run of the mill Bactrum is.

Look at the bright side...

I'm sure this will be handled much better in the future when our government is managing health care.

I work on software that doctor's offices use to manage billing and scheduling.  We have three cardiologist practices that use the new module that keeps-up with customer interactions.  Out of the three, it takes an average of almost four days before emergency calls are returned.  Aside: billing questions are almost never returned.  From their point of view, your calling back that very quickly makes you a problem.  Those of us in the real world, versus the government-protected monopoly of medicine, of course would never intentionally provide such abysmal customer service, but it is the norm in the medical industry.z

Actually, I suspected this would be what you are on...

SMZ/TMP generally hits staph well.

Its gonna be like the DMV, Post Office and the school nurse all rolled into one.

....FOR A LITTLE WHILE LONGER....

If you still need to find out what you were on previously, contact your pharmacy. They should have the records.

Also if you have problems with your script and you need the doctor to respond, sometimes it helps to have the pharmacist call instead (unless the RPh is a prick, they would do it if they can't help you)

Bactrim is one option for community acquired S. aureus recommended by the CDC

+1, but with the caveat that NP's aren't necessarily support staff.  That said, the fiance is an NP and I asked her about this.  She can't imagine just dismissing a patient's concerns in such a manner.