Throop Pharmacy

XARELTO® for the Insured—$1 a day, Uninsured—$15 a day 2019. Oil on canvas, 18 x 24"

I take drugs. I take drugs and fish oil to control hypertension and arrhythmia. I have a long history of heart disease on both sides of the family. If I continued my teen age love affair with fish fry and Stouffer’s macaroni and cheese® (and inordinate fear of doctors), I would have dropped dead a long time ago. Good thing an early change (for the better) in diet and a mid-twenties shift to moderate alcohol intake thwarted bad cholesterol’s evil plan to knock me off in the prime of life.

But it was the dental hygienist who got me to the cardiologist on time. In my late 30s, she took my off the charts blood pressure before a routine teeth cleaning I hadn’t had in 15 years. That was lucky for me, and others who wanted to celebrate my 40th birthday.

The cardiologist said high triglycerides had converted my blood to heavy cream. He prescribed concentrated fish oil to bring them down, and lisinopril®, an ACE inhibitor, to lower blood pressure. A side effect of both medications was arrhythmia, which I have now, on and off. This condition can cause stroke if left untreated. I have been prescribed new drugs to control it.

One of those drugs is metoprolol®, a beta-blocker, which, like lisinopril®, leads to excess potassium in the blood. Ergo more risk for arrhythmia. I also take XARELTO®, which is a brand name for rivaroxaban, an anticoagulant (blood thinner) that works by preventing blood clots. An irregular heartbeat leaves excess blood pooling in the upper chambers which can form clots that shoot up to the brain and cause stroke.

I need to mention that both my hypertension and arrhythmia go unnoticed by be. I can’t feel a thing. No chest pain, shortness of breath, hot face, etc. Presumably this is why heart disease is called the “silent killer”. Unfortunately aging has coincided with prescribed drug use, and I often wonder if the symptoms I am experiencing are more from the onset of senior citizenship than side effects to popping pills. Is there any old person out there free of a pill regimen? It wasn’t until I got prescribed drugs that I’ve experienced “problems” with my body. But then I’m getting old too. What should I expect? Have I ever known a person over 50 not on some drug pushed by white collar dealers? I really don’t think so.

Hence no control group to test a hypothesis: Some heart diseases can be healed without medication. Diet and exercise, and an active doctor/patient participation in rehabilitation may set the sinus rhythm back on a pace to normalcy and an inevitable death by old age. However I refuse to sign up as guinea pig for my own experiments. I can only wonder until I find an institute to invest in wondering with me. Presently, the Cleveland Clinic assumes that drug use is the way to a healthy heart. Here is a hodge-podge of side effects I have and have not yet experienced:

Easy bruising, nose bleeds, pink urine, tarry stools, difficulty swallowing, death, headache, dizziness, persistent cough, chest pain, lip swelling, shortness of breath, weight gain, stomach pain, nausea, yellowing of the whites of the eyes, tiredness, depression, gas, dry mouth, bloating, diarrhea, reduced interest in sex (not much), rash, heartburn, runny nose, cold hands and feet, wheezing, fainting, irregular heartbeat (duh!), visual disturbances, weakness, tremors, sinus arrest (heart stops beating), double vision, numbness and tingling, flushing, sweating, vertigo, ringing in the ears, insomnia, urinary retention, reduced sense of touch, anxiety, high blood pressure, (duh!) low blood pressure, decreased white blood cell count, itching, hair loss (I knew it!), twitching, low blood platelet count, change in taste, convulsions, speech disorder, near unconsciousness, nerve pain, amnesia, impotence, confusion, morbid dreams, and gout.

I suffer from another scary one that not even my pharmacist knows about. I call it “soul escaping”. A sudden weakness and in/out of body vertigo without the spinning. An inability to put one foot in front of the other, cold sweat, and sometimes an insatiable appetite for any food within reach. I lay down immediately to wait for death. Last summer I shortened my daily walk to a few hundred yards because it was occurring too often.

Also notice that irregular heartbeat and high blood pressure appear on my list of side effects from the drugs used to treat irregular heartbeat and high blood pressure. Is it possible that staying on these medications are prolonging the disease while causing other health problems too? If so, is it worth the trade off? And can it be proved if heart health researchers and doctors refuse to study alternative means to maintaining a healthy circulatory system? They say a healthy diet and regimented exercise can lower blood pressure, but have either ever been accused of causing it? Since 2010 not one cardiologist, PA, physician or nurse has asked about my eating and exercise habits (yet all agree have a hand in causing heart disease). The standard routine is to ask if I smoke, how much alcohol I drink, or cocaine I snort, but never a curious word about my dinner and snacking routine. I could sit on my ass all day eating fat cubes, but if I limit my alcohol to one tall glass of wine, I should be fine. I have known professional dishwashers and pizza makers with more nutrition knowledge than anyone who has ever been paid to doctor or dentist me. Oops. Scratch that. There was one doctor I visited twenty years ago for asthma. She was a gem. She asked if I wanted to be treated with alternative or conventional methods, or a mixture of both. She asked me, as if I had a say of what went into my body. What a grown up thing to do! I decided on both. She chose a steroid, an albuterol inhaler, and several prescriptions for foods, herbs, vitamins and teas. And one really hip(pie) prescription for asafoetida to be sewed up in fabric and worn around my neck at home. If you have ever smelled uncooked asafoetida you will understand why my wife remained a room away from me for the next month.

After a few weeks my asthma was under control. I was off the steroid. I lost twenty pounds, and felt and looked really good in my underwear. I swear my hair got darker and my skin less pallid. Mood and genius much improved. A very effective and creative medical response to a bummer condition.

I wish that doctor had legal entry into my circulatory system. Unfortunately, she has since been excommunicated from the medical industrial complex for keeping patients out of hospitals and free of the conventional drug scene. I miss her.

My cardiologist retired in 2020. She discovered the arrhythmia in October 2019 and over the winter zapped me twice back to normal sinus rhythm. I still keep the free hospital socks to remember the experience. To my pill regimen she ordered metoptolol®, the beta blocker, for blood pressure and XARELTO® the blood thinner for the possible clotting. In between zaps I was prescribed flecainide® to control the arrhythmia. Scary stuff. It works by blocking electrical signals in the heart that can cause irregular heartbeat. Sometimes it plays “stop the heart” for good, which is unfortunate according to Hippocrates and friends and family of the deceased. At a follow up visit after the second zap, my heart was beating normally, so the doctor suggested I stop taking the flecainide®. But first she wanted me to see another doctor about an ablation (to be discussed), and if he agreed with her diagnosis, then I would stop taking the scary drug that we both knew could kill me.

Then she retired.

Then COVID came.

Then the outpost of her practice closed and it took some time to get an appointment with the new doctor taking on her patients.

This was last March.

In the mean time I read about ablation which is a “procedure” that scars the heart tissue that triggers the arrhythmia. A catheter is inserted through a vein in the groin and guided to the heart to either heat or freeze the area missignalling.

Just writing that down makes me nauseous and terrified.

It’s not always successful the first time. Close to a third of people who have had the initial procedure will feel a new heart flutter, sometimes a more pronounced flutter, and will need a second ablation to keep from going insane. To add insult to a broken heart, medication may still be prescribed indefinitely. Ablation does not cure the arrhythmia, just controls it. That’s too many unknowns for me. I say no to ablation for the rest of my life.

So I finally got to the new doctor’s office in October. Amy the personable PA took my blood pressure (always high—I have “White Coat Syndrome”), felt around my ankles, and invited Martha the technician in to give me an EKG. My sinus rhythm was normal, hurrah! So I asked to be taken off the flecainide®, beta blocker, and perhaps the condensed fish oil. I even mentioned their side effects of possibly causing arrhythmia in the first place. I also refused further consult on ablation. Amy took up my concerns with the doctor in another room. Twenty minutes later he introduced himself and revealed his plan for my heart health. After 90 seconds, and zero questions about my habits and fears, an assessment was given. I would stay on my present course of medication indefinitely.

Thank you very much Mr. Throop, and we’ll see you in February.

Now for my assessment.

For the first 52 years of life, my heart pumped at normal rhythm. Suddenly it jumped off beat and syncopated like a Tom Waits song. I have good guesses as to how this happened. Years of fish oil overdosing compounded with my recent enthusiastic introduction to oil painting in an unventilated basement could have kick-started the anomaly. I don’t know. But neither do my doctors. They are professionals trained in diagnosis and treatment, and the Internet is everyone’s second opinion offering cheap advice. It provides answers when arrogant and/or inarticulate, gaslighting specialists are unable to. It gives the lay person ammunition to doubt and then to question. The suffering individual of no medical professional consequence suddenly has a counter system to propose to the authorities. Like Copernicus a new solar system to the Vatican. But why piss off the Pope, cardinal, bishop, parish priest, and the multitude of followers just because YOU don’t think it’s wise to push a flexible tube intravenously from groin to heart and zap a piece of its chamber into deep freeze?

Sufferers can be so impolite!

In A Wrinkle in Time, by Madeliene L’Engle, Camazotz is a planet that has succumbed to the Black Thing, revealing a carbon copy of modern American suburbia and inhabitants unwittingly living under the spell of extreme, enforced conformity. The houses line up in cookie-cutter cul-de-sacs and at first blush everything appears to be “normal”. It doesn’t take long, though, for the protagonists to sense the residents robotic behavior.

My wife and I have a word for new housing developments in the suburbs of Syracuse. Farmland purchased and rapidly converted into streets of square houses all looking exactly the same. Every time we pass by a new one being built, we point and say, “Camazotz!” To me these homes are very expensive expressions from the unhealthy minds building and living in them.

20% of Americans have a diagnosable mental health condition in any given year. Nearly half will meet the criteria at some time in their lives.

That means 1 out of every 5 licensed health care professionals are working through private issues of the mind, and at any point in time, up to 50% of them aren’t mentally functioning at par levels. Some even move into treeless Camazotz housing developments to self-enforce their extreme conformity. Not how I want my doctor positioned when we meet to talk about the rest of my life.

Our health care practitioners have been “Camazotzed” by the Black Thing—insurance and pharmaceutical conglomerates, and made to conform without even realizing it. Doctors are told how to prescribe for groups with conditions, but rarely on an individual case by case. An alternate reality Ron Throop, weighing in at 300 pounds would have received the exact same diagnosis and treatment regimen. Maybe a word or two about how important it is to maintain a healthy weight. But the drugs would be the same, as if all hearts were one.

Using cookie cutting medicine to maintain sound physical health will always have its winners and losers. Even with celebrity U.S. Presidents. George Washington was bled to death for strep throat because it was common practice to drain a patient of 40 ounces of blood in order to clear blocked airways caused by acute pneumonia. Several cups of ginger tea and Martha’s fingers crossed might have extended his retirement, at least until the next doctor visit.

On the other hand, Abraham Lincoln stopped taking his “blue pill” because he thought it made him “cross”, which was a typical Lincoln understatement. During the Lincoln-Douglas debates, he nearly took the head off an adversary by shaking him “until his teeth chattered”. The pill was supposed to treat his melancholy, but just made him mad while delivering a daily dose of mercury exceeding modern safety standards by nearly 9000 times.

Where in the wild is the heart doctor with the bravery and gumption to face the Black Thing? Will she treat the 190 pound eager-to-be-healthy me as an individual and not another Ted, the chain-smoking, pork rinds for breakfast, alcoholic coal miner? I want to get my weight down to 175. Are there any cardiologists up for the task? Is there a PA who hands out individual diet plans after the EKG stickers are yanked off? Or an EKG technician who bends down to a patient’s ear to whisper, “walking 5 miles a day can lower your blood pressure naturally”.

After ten years of paying for specialized heart care, no one has asked me if I suffer from any of the side effects caused by the medications prescribed. Not a single inquiry.

I was a restaurant cook for nearly twenty years. What if every entree on the menu listed the same side effects as my current drug prescriptions? Do you think I wouldn’t be curious if a customer was easy bruising, having difficulty swallowing, experiencing double vision, urinary retention, abominable hair loss and sometimes even death after eating my club sandwich? On several occasions I have expressed to doctors my concerns about side effects, but always receive the same brush off with “Well, we think the good outweighs the bad”.

Which means the good of taking pills for arrhythmia (with arrhythmia as known side effect) outweighs the bad of not taking pills for arrhythmia (arrhythmia possibly caused by side effects of pills taken for hypertension). Sounds like any mental strain exercise induced by the Black Thing. Good for Camazotz. Insane for sanity.

I fear I’ll never know what is right for me, and in the mean time, continue to succumb to the power and influence of the Black Thing. I don’t claim to have any scientific knowledge of the palpitations of the heart, but I do have a layman’s common sense enough to realize that death is a pretty crappy side effect to any drug use. Each morning I take these pills I anxiously dream an evening heart attack.

Dear Black Thing, may I suggest lacing my flecainide® with a little opium to welcome another model citizen of Camazotz?