Medical Lifeboat Part 2

Medical Lifeboat Part 2

Welcome back to Medical Lifeboat with Doc Contrarian, a drug related version of the cruel party game where you decide what (or who) you really want to keep…

Last time we set up some parameters, and nominated a broad spectrum antibiotic and aspirin for our top two medications to be shipwrecked with.

What should be our third choice? This one may surprise you, but I’m going to say…Valium.

Valium! What do we need mother’s little helper for? So everyone can get high? Well, I agree that insomnia and anxiety are often worried-well, first world complaints or the cause or result of already using the wrong substances, but that’s not why I picked it.

Valium is a highly effective and fairly safe (very safe if used as directed) seizure medication. If someone gets manic or really disturbed it’s an excellent tranquilizer, and believe me, if you were trapped on a desert island with a hyperactive, delusional individual you’d appreciate how much that means. Also remember, cruise ship, so if one of the passengers goes into alcohol withdrawal you can treat that.

Drug number 4, prednisone. Similar to the NSAID story, there are any number of steroid variants: different drugs, doses, or delivery methods, but they are all corticosteroids and no different in terms of impact/side effects per dose than this ur-medicine. Prednisone will be useful for any acute allergy problems or long standing arthritis and/or autoimmune diseases and also for treating asthma and COPD. It’s arguable, BTW whether tiny doses of prednisone have any more side effects than using an inhaler for most people.

So now we’ve covered treating bacterial infections, pain, allergic reactions, COPD, asthma, seizure disorder, arthritis, mania, hysteria and substance withdrawal. Odd, isn’t it, how we only needed four medications to do it?

That’s because I can’t emphasize enough how duplicative or useless most prescription drugs are.  Doctors are just as vulnerable as anyone else to advertising, generalizing unscientifically, misunderstanding causes and habit as anyone else. Thus the dozens of different brands that do the same thing. In addition there are a lot of drugs that don’t actually do anything, like Mucinex, or cough medicines, or Colace, or they might do something but most of the people on them don’t need them or can’t benefit from them, like Aricept or Zantac.

My next choice also might surprise some of you. It’s birth control pills. Woo, Doc, you’re planning quite an orgy on that island with the Valium and the BCPs! Or you’re thinking, OK, don’t want anyone to get pregnant so that makes sense. Well, that’s true enough, but the BCPs are actually for dysfunctional uterine bleeding. Women are not the weaker sex, but they are the sex that bears the physical burden of reproducing the species. Victorian ladies didn’t lie around fainting and being pale and weak because they were fools, it was because they were dangerously anemic or had massive tears in the vaginas, urinary tracts and rectal areas from childbirth or later life bleeding from hormonal changes. Mother Nature can be such a bitch. For a variety of complicated reasons our society has entered a period of denial about certain women’s health issues. Long story short, women can easily bleed to death from their vaginas under certain conditions and birth control pills can offer a temporary way to staunch the flow with their hormonal action.

Now, at 5 of proposed 10 medications we are reaching the end of what any one can do without more tools. I can tell if you are feverish, delirious, delusional, manic, bleeding, in pain, have a massive boil or an asthma attack. But I can tell what your blood sugar is, or your blood pressure. Next installment, we need to change up our conditions a bit, if we are going to get all the way to 10.