Comments on: The Cascade Effect http://easydiagnosis.com/blog/2007/09/the-cascade-effect/ Comments about Medical News and Controversies Mon, 01 Apr 2013 15:05:15 +0000 hourly 1 http://wordpress.org/?v=3.4.1 By: Martin Sturman http://easydiagnosis.com/blog/2007/09/the-cascade-effect/#comment-19713 Martin Sturman Sun, 26 Jul 2009 19:53:52 +0000 http://easydiagnosis.com/blog/?p=31#comment-19713 Susan, thanks so much for your fascinating, if painful, dangerous, and expensive experiences with the cascade syndrome. Your story is one of the most convoluted, yet piercing example of what can, and too often does happen with puzzling clinical presentations and the all too frequent reliance on imaging and other studies to rule out disease. There are at least two or three interpretations of what happened and how this series of events could have been avoided, but this is not the place to speculate. I am most grateful for your comments, and hope other visitors and patients will read your story. Again, many thanks. Martin Sturman, MD Susan, thanks so much for your fascinating, if painful, dangerous, and expensive experiences with the cascade syndrome. Your story is one of the most convoluted, yet piercing example of what can, and too often does happen with puzzling clinical presentations and the all too frequent reliance on imaging and other studies to rule out disease. There are at least two or three interpretations of what happened and how this series of events could have been avoided, but this is not the place to speculate. I am most grateful for your comments, and hope other visitors and patients will read your story.

Again, many thanks.

Martin Sturman, MD

]]> By: Susan http://easydiagnosis.com/blog/2007/09/the-cascade-effect/#comment-19704 Susan Sun, 26 Jul 2009 12:33:08 +0000 http://easydiagnosis.com/blog/?p=31#comment-19704 <p>Similar incident happened to me. I must take a thyroid replacement prescription due to hypothyroidism. About a year and a half ago I slowly started feeling worse. After two months went by, I refilled my thyroid medication, and after a couple days I started feeling a little better. I asked my pharmacist about the medication and he said two months ago my thyroid replacement prescription had been changed to a generic. The pharmacist said he did not change it, and it had to be my doctor. I was already upset with my current doctor because she had become angry when I rescheduled a prior appointment (apparently she was too rigid about setting her appointments). So I scheduled an appointment with another physician. I explained to her about the generic medication , but because my symptoms were so severe, heart palpitations and shortness of breath, she referred me to a cardiologist. I then started a series of tests, Echo Cardiogram, Thalium Stress test with CT Scan. This showed an abnormality so I had to have a Heart Catheterization. Turned out that the abnormality in the CT Scan was due to a rib shadow. Meanwhile, my new doctor had prescribed a name brand thyroid prescription, and after a while I was beginning to feel much better. As it turns out, all this happened because my previous doctor prescribed a generic medication. Thyroid medication has a very narrow therapeutic range and a generic does not always maintain that narrow range. A very expensive error of decision on my previous doctor's part.</p> Similar incident happened to me. I must take a thyroid replacement prescription due to hypothyroidism. About a year and a half ago I slowly started feeling worse. After two months went by, I refilled my thyroid medication, and after a couple days I started feeling a little better. I asked my pharmacist about the medication and he said two months ago my thyroid replacement prescription had been changed to a generic. The pharmacist said he did not change it, and it had to be my doctor. I was already upset with my current doctor because she had become angry when I rescheduled a prior appointment (apparently she was too rigid about setting her appointments). So I scheduled an appointment with another physician. I explained to her about the generic medication , but because my symptoms were so severe, heart palpitations and shortness of breath, she referred me to a cardiologist. I then started a series of tests, Echo Cardiogram, Thalium Stress test with CT Scan. This showed an abnormality so I had to have a Heart Catheterization. Turned out that the abnormality in the CT Scan was due to a rib shadow. Meanwhile, my new doctor had prescribed a name brand thyroid prescription, and after a while I was beginning to feel much better. As it turns out, all this happened because my previous doctor prescribed a generic medication. Thyroid medication has a very narrow therapeutic range and a generic does not always maintain that narrow range. A very expensive error of decision on my previous doctor’s part.

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