Incompetant Bloody Doctor !!

[Deleted member 20280]

So, here's the rub.

I have been in therapy and learning as much as I can about PTSD for nearly three years now.

Diagnosed back in November as Epileptic, 260+ seizures later I suffer a Mini-Stroke. Medicated successfully for the seizures on Gabapentin, medicated successfully for my Alcohol Dependency on Omeprazole, medicated successfully for my Depression on Sertraline I also suffered a severe Duodenal Bleed in May this year, only 8 weeks ago.

So, I am referred to a Stroke Specialist who prescribes me Clopidogrel.

I, as instructed take the pill every day for five days, until I am Hospitalized yet again on Saturday. So I go to Google and research Clopidogrel as I am experiencing major weight gain, Heart palpitations, Swelling to my hands and feet, Vertigo, Dizziness, Severe Headaches, etc etc. My flashbacks have returned with avengence, I an constantly Paranoid and keep dissociating.

Upon my opening Google search engine and typing in "Adverse Reactions To Clopidogrel". I soon discover that patients on "Gabapentin,Omeprazole,Sertraline or have had a Stomach Ulcer that needed surgery"


Guess what !!! , I am on ALL the above mentioned medications, I have also had an operable Stomach Ulcer.

When I attended the Stroke Clinic last week I gave my Specialist Consultant a full list of my current medications.

So I am prescribed "Clopidogrel" What the f*ck !!!!

It clearly states that "Extreme Caution" is to be exercised when prescribing a patient with "Clopidogrel".

Being a "Stroke Specialist" it would be safe to assume he knows all about this particular medical condition, what drugs to prescribe and the contra-indications, adverse side effects. You would also be safe in assuming he would tell his patients about the possible side effects. WELL HE DIDN'T BLOODY TELL ME !!!!"

By taking this medication it has set me back nearly 2 years in Therapy. My Psychiatrist, Alcohol Counselor and GP are amazed that "Clopidogrel" was even considered what with my current medications.

Guess I was lucky because when I was in Hospital all weekend I was informed by the Consultant in the ER informed me that my Cardiograph was indicating I was heading for a "MAJOR CORONARY HEART ATTACK !!"

The doctors in the ER were fantastic with me all weekend and thankfully gave me the correct care and correct medication to combat the serious nature of the side effects.

Rant OVER !!!

 

[Deleted member 20280]

Sorry, forgot to mention the blackouts, change in Mental State and memory loss !!!

 

[mary1979]

They really are a joke aren't they :(

Seems a rather serious situation with you having been so unwell for sometime now, you'd think the specialist would have taken more care prescribing to someone in your condition.
We place too much faith in our doctors I believe.
Hope you will be giving him a piece of your mind at your next app?

Glad you are ok though @Mr Laurie.

 

[SeanCharles]

So sorry, Bro. I am beginning to distrust the whole practice of medicine! Yet another conflict! :( Oh well. Hopefully, you will come out of this without too much more scathing! I'm preparing to do battle once again and maybe I can get a specialist to analyze my own seizures to get the gross misdiagnosis rediagnosed correctly. :hug:s

 

[Anarchy]

IMO, it's good grounds for an official complaint

If he'd been an engineer he'd be facing expulsion from his professional body for that kind of mess up

however, engineers work is checked by other engineers before signing it off - so engineering eff ups usually get picked up long before they hurt people.

Medical doctors tend to become special little flowers when it comes to suggestions that their work should be checked by their peers.

 

[Deleted member 20280]

UPDATE

I have spent the last three hours in consultation with a local Solicitor. I have grounds for a medical negligence/malpractice case. Guess I will be suing then

 

[joeylittle]

@Mr Laurie - I'm curious where the interaction with Gabapentin is noted. I checked my usual go-to sources (just because I like learning med stuff) and can't find a warning for those two together.

The thing about anti-clotting agents (I'm on one, but not clopidogrel/Plavix) is that none of them come without problems; they are serious drugs. It's just a question of which problems are least impactful. Was your reaction while you were on a loading dose or after?

its good you caught it in time.

The studies on proton pump inhibitors (like omeprazole) and platelet drugs (like Plavix) are pretty disputed - the data can point in different directions. Good news is, there are other drugs that might work just as well for you as the omeprazole - I went through some switching with it as well when trying to address an acid reflux side effect from Latuda (psych med).

I do hope this all gets resolved for you safely and swiftly.

 

[Deleted member 20280]

@joeylittle I have not been on a loading dose. I primarily take Gabapentin for my epilepsy. Clopidogerol reacts against epilepsy medications in general in some patients.

 

[joeylittle]

Thanks - I understand now.

I hope that you and your docs can find a combo that works for you. Sorting out medications across diagnoses can get very frustrating.

 

[Suzetig]

Being a "Stroke Specialist" it would be safe to assume he knows all about this particular medical condition, what drugs to prescribe and the contra-indications, adverse side effects.

In my experience, doctors - even specialists - can miss complex drug interactions. They're usually diagnosticians specialised in working out what's wrong and what kind of treatment might be needed but adverse drug interactions tend to be caught by pharmacists, who are specialists in drug interactions. I'm related to a number of pharmacists who routinely catch prescribing issues for customers where doctors have prescribed the "go to" treatment and missed a possible clash with other drugs.

Glad you've caught the clash - have they changed your prescription now?

 

[Lucycat]

@Mr Laurie you have me baffled. In November you said you were diagnosed with PNES - Pseudo Non Epileptic Seizures. This is not Epilepsy. Unless the doctor has changed your diagnosis to one of Epilepsy then there is no reason why the doctor would consider your Non Epileptic Seizures as a contra indication for a prescription that lists Epilepsy as a contraindication. Does it list 'seizures' as a contraindication rather than 'epilepsy'?

Forgive me if I have missed something!

Also even when there is a definitive contraindication to a medication, there are times when it needs to be prescribed. Such as to treat the condition and improve wellbeing despite the risks of side-effects, or to leave a condition untreated and risk the consequences of non treatment. It is all a balance, although I appreciate you should be fully informed and a party to all discussions.

 

[joeylittle]

Thanks - I understand now.

It's been bugging me. Gabapentin specifically doesn't interact with Plavix (clopidogrel). Other anti-epilepsy meds do, but not that one. And something that reacts against a whole class of meds 'in general' 'in some' is not the same as guaranteed contraindication.

Since you had no loading dose, you would be on the anti-platelet med as a preventative against future clots. Aspirin is the most common prescription but because you have a history of stomach ulcer, aspirin is a bad idea - irritates the lining terribly. They gave you clopidogrel for the right reason.

The interaction with proton pump inhibitors (omeprazole in your case) is speculative; the theory is that the PPI will cause clopidogrel to not work as well - this has some data to support, but its not a major, accepted contraindication.

All anti-platelet and anti-coagulant meds carry many, many warnings. They are used cautiously in people who have had internal bleeding in the past. But they are also front-line for helping prevent acute MI, severe stroke.

The interaction with SSRIs can lead to the clopidogrel working too well, as many SSRIs (like sertaline) already can 'thin' the blood in some patients. This simply means that the dose needs to be monitored and sometimes personalized.

Basically: Gabapentin has no interaction. Omeprazole diminishes clopidogrel's effect. Sertaline magnifies clopidogrel's effect. You can't take aspirin with ulcers. There's no other platelet mono therapy.

Anticoagulants - the other option- are more difficult to maintain, and therefore, more dangerous. An anti-platelet is a smarter choice.

I'm not sure why your other docs were so shocked that you were put on an anti platelet - except that really, if you still drink, you are putting yourself in harms way by taking any kind of clotting medication. As in, better to risk developing a clot, than to increase your risk of bleed from drinking on an ulcerated stomach.

Having PNES is also very different from epilepsy. A non-epileptic seizure doesn't originate from electrical activity in the brain. This doesn't make it less of a medical occurrence - but it's a psychiatric condition, and is treated differently.