Monday, August 17, 2009

More Healthcare Hijinks!

As a healthcare consumer advocate I always marvel at how little knowledge - even common sense - exists among so-called "health professionals." I think I'll devote series of blogs to some of my most recent "healthcare hijinks" experiences.

I get a great deal of my healthcare at a local clinic which in the past six-months has really taken great strides to improve customer service. They are very friendly, aggressive about getting back to patients about their healthcare (they even have a new online system where you can check test results as they become available), and the improvement is noticeable. But this is more a tale of inability to think on your feet - a skill that I feel is basic to the notion of healthcare.

I had some crazy TSH readings (typical of anyone with early Hashimoto's Thyroiditis) so my endocrinologist was tweaking my meds over a series of weeks. It is common for a doctor to relay information to one of their nurses who, in turn, (keep in mind these are college graduates experienced with medications and patient care) interfaces with the patient on issues such as dosage adjustments.

Let me first preface my diatribe with the fact that the nurse I am about to take to task was friendly, courteous, and worked hard to follow up with me (I am often difficult to reach because of my crazy schedule). Maybe it was just a "bad day." Nonetheless, I was left wondering just how competent the person on the other end of the phone was.

The nurse called to say the doc wanted to up my dose of Armour thyroid from 1/2 grain to 3/4 grains twice per day and the nurse asked if I wanted a new prescription. I said we could proabably still use my current prescription but would have to renew it much earlier as I will be using a 50% bigger dose. This is where the keystone cops episode begins.

The nurse remarked, "But your prescription is for 1 grain." I explained that since my dosage changes so frequently (and because it is far cheaper to do it this way) I use 1 grain pills that I simply split into 1/2 grain doses. At that she remarked, "But the doctor wants you to take 3/4 of grain." My retort was, "Yes, but I can also split the 1/2 grain pieces into 1/4 grain pieces. I could even take three 1/2 doses three times per day (which I believe would be the superior way to take any thyroid preparation containing T3)." At that point she was completely befuddled. After a short course in remedial math (which I am still not certain she comprehended) I convinced her that 1/2 grain plus 1/4 grain equaled 3/4 grains and that three 1/2 grain doses was the same amount of medicine as two 3/4 grain doses.

Afterwards, we laughed it off and she ended with,"Well, I am really not familar Armour Thyroid". What a shame for the doctor's thyroid patients! Now, even in the "far out" world of Armour Thyroid (sarcasm intended) basic math (like 1/4 plus 1/2 equals 3/4) still holds true!

As I mentioned, perhaps it was just a bad day with a little brain fog (I guess that is scary in itself). But it made me both laugh . . . and think! Of course this is not as bad as when I went to the pharmacy with a prescription for therapeutic vitamins and walked away with a prescription for coumadin - but that's another story (i.e. always read your labels)!

Looking out for your health,



Anonymous said...

Doc's earn 10% of all medication they talk patients into purchasing - she didn't have a brain fog, she simply wanted more $.

Anonymous said...

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Rick said...

I can't help thinking there might be a simpler explanation, based on different and unexpressed assumptions. Perhaps she thought that you were given one-grain _doses_, and that once you'd opened up 1 dose, whether you took half a grain or three quarters of a grain or a whole grain, that was the end of the dose, i.e. you can't wrap it up safely again. If that were so, then the math becomes irrelevant and the nurse's "But your prescription is for 1 grain" makes perfect sense.

Bear in mind that I know nothing about Armour Thyroid and don't know what exactly a "grain" is, nor the container(s)/wrapping(s) the medication comes in, so apologies if my comment is also nonsensical.

Rick said...

BTW, I hope you accept the invitation from For the most part, their articles lack detail to the point of being useless, though recently I think I detect a drive to offer more depth. Perhaps the invitation is part of that drive?

HeartHawk said...


Thanks for the info. The Armour comes in small pills like many medications and I use a pill splitter to divide dose. Much more cost effective!


AED Cabinets said...

This is true. I have noticed that if not all but many doctors do such silly things.

Highest CD Rates said...

May, be it was a bad day but it ended with laughter. So, take your medicine and control your disease.

Anonymous said...

Yea! I can't believe someone out there is telling these phonies off about a bogus product. Cheese and rice, you saved me some big $$$ by posting the message about ANGIOPRIM. Sounds to good to be true, usually is. Thanks for your research efforts.

ray said...

as health clinics should have a friendly on the patient, the patient happy to visit and treatment.

Anonymous said...

My wife has hashimoto's thyroiditis. The first two years were miserable. When it was diagnosed, she asked the endocrinologist if there was any diet or lifestyle change, and was told no.

Then we came across a study that suggested that in some people with hashimoto's, there is an autoimmune response in the thyroid trigged by gluten. She went gluten-free, and within a week, the coldness had receded, as had the pressure on the top of the head. Over time, her T3, T4, and TSH numbers went back into the reference range, and her anti-thyroid antibody level has dropped to near normal. She isn't cured by any means - a trace of wheat can quickly bring back the symptoms, and she still gets scans for a couple of nodules that bear watching. But that one change has made a huge difference in her daily life.

HeartHawk said...


Thanks for the story about your wife's experience with Hashimoto's and wheat. The really get after wheat for a number of conditons over at I'll also check in on those studies you provided.



Pat said...

Okay, after reading this I just had to leave a comment. I got a great chuckle after reading your post. I am a clinical pharmacist working in a hospital, and have been so for many years. I am sad to say you have NO idea how many clinical staff in a hospital cannot do simple math of that variety! These sorts of situations occur on a much too regular basis. I find it both sad and scary.

Keep up the great work with your blog posts. I may be a pharmacist, but I am probably a bit of an anomaly in the profession because I am so anti-pharmaceuticals.... unless in situations where they are clearly needed and nothing else will do. Of course, those situations do arise and modern pharmaceuticals are life-saving. BUT for treating many of modern society's chronic diseases, like CAD, DM, and PVD, it's not the first way to go!! Thanks, HeartHawk

HeartHawk said...


Thanks! Been busy over at TYP ( so I am not posting as frequently but the "hijinks" never change. I am certain you have your share of stories!

Once TYP has the new site up I think there will be some sort of special (Free?) membership for healthcare professionals (probably near the end of August). The forum there is where the REAL action is and where I get a lot of my ideas for blog posts. We even have an undercover tech that works in a cath lab. Talk about your 'Tales from the Crypt' - LOL!



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