BAV and ulcer issues

[Karen]

I have a question I didn't think to ask my PCP last week. I don't know if it belongs in this forum, but I'm hoping that someone has at least an opinion about this question... and maybe even some reliable information.

I have been taking Voltaren (diclofenac) for my costochondritis since Vioxx was pulled off the market in September. It has been very effective as far as pain management goes. But evidently, I now have an ulcer. I started taking Prevacid a week ago and the stomach pains are lessening somewhat, but I still am taking a lot of antacids. I'm not a chemist, but Tums are "calcium..." What are the dangers of taking more of these tablets than recommended on the bottle? And even at remmended levels, is there any worry about increased "calcification" on the valves? I'm hoping the ulcer issue is resolved quickly, but Voltaren looks to be in my future for the long-haul and so it could be a recurring concern.

Maybe the Lipitor I take every day will compensate some for the increased calcium intake? I asked a question earlier in this forum about the statins and BAV. When my cholesterol was checked a couple of weeks ago, my total cholesterol level was back up to 170 and the LDL and HDL levels were "perfect." I read a lot about studies that suggest that, in addition to having heart protective qualities, low doses of statins may actually decrease the risk of certain cancers: breast, prostate, pancreatic, esophogeal. My dad died of pancreatic cancer at an age younger than I am, so that sounds good to me... But I agree that it's important to keep an eye on your own cholesterol levels...

So should I be concerned about the antacids at all?

Karen

 

[bvdr]

Everything I have read has indicated that the calcium you ingest has nothing to do with the calcification of heart valves.

I've had those ulcer problems and take prevacid everyday. I'm on the prevacid solu-tabs that slowly disolve in your mouth. Very tasty..

I hope you get to feeling better.

 

[tobagotwo]

You might want to talk to your doctor about taking antacids along with Prevacid, which also reduces acid. Might not be a good combo long-term. Especially if you are taking more antacids than are recommended.

As far as I have found, the calcium itself has never been shown to affect calcification of a valve, despite the apparent logic of it. Calciuremia has not been shown to be a byproduct of the quantity of calcium. Even the tissue valve manufacturers stopped putting suggestions about not taking added calcium on their information sheets.

I am also leery of the whisper-campaign claims of statin manufacturers. They are not allowed to openly advertise or sell for uses other than lowering cholesterol, because they have not been able to prove a connection between their drug and any of the other claims made. In fact, if you read the paper that comes with it from the pharmacy, it has a statement to the effect that that even when used to lower cholesterol, statins have not been proven to lower the incidence of heart disease.

Statins are not without their side effects, either, possibilities including muscular pain/degeneration or loss of higher mental faculties.

The cancer claims (unproven) are related to the notion that statins can slightly lower the level of tissue irritability and inflammation responses. However, statins are not the most effective drugs for that purpose, either.

There will be more information coming out about the COX2 inhibitors over time, as intensive studies are showing that the increased risk is not apparent at all for some NSAIDs (non-steroidal antiinflammatory drugs), such as naproxen sodium (Alieve), and is not present in other NSAIDs unless the patient is taking more than a certain dosage of the drugs daily. Even Vioxx itself doesn't seem to cause the problem with lower doses, and doesn't seem to cause the effect until after 18 months of continuous use. Likely, it will return to the pharmacy shelves for lower-dose, short-term usage, if it is not too politically hot to handle.

I'm not saying COX2-inhibitors are wonderful or harmless, but they aren't panning out to be the criminally dangerous products the press had been pushing, to peddle their TV ads between news segments. Conversely, I'm not saying statins are bad, but they're also not nearly as wonderful or harmless as the press would also have us thinking. There is precious little in life that is all good or all bad.


Best wishes,

 

[Karen]

statins and Vioxx

statins and Vioxx

Betty and Bob, I appreciate your replies... Betty, I'm going to try those solu-tabs!

Bob, I agree that there are no easy answers as far as ANY medications go. Without question, if it had been an option for me, I would have continued using Vioxx even after Merck pulled it off the shelves. Now I'm not so sure. But I think that patients and doctors should be allowed to make those choices, understanding the best they can the risks that are involved. For many patients, the risks of taking Vioxx are far outweighed by the benefits offered by it. Because of an allergy to aspirin (and other OTC closely related i.g. Motrin, Advil, Aleve) I was very happy that Vioxx was an option for me. Interestingly, my PCP told me that there have been reports of people having sudden heart attacks after abruptly STOPPING the Vioxx. It would seem that you are doomed no matter what approach you take... Someone is going to die taking any drug, I suppose. But people also die every day driving in cars, but there's no legislation prohibiting the use of automobiles. So it's makes sense to me that doctors and patients should be allowed to weigh the risks and make their own choices concerning these drugs. The problem, of course, is that people will take the drugs, knowing the potential risks, and then still sue the pharmaceutical companies when things go bad for them.

About the statins... I admit that I'm still unsure how I feel about taking Lipitor. On the other hand, what if it DOES offer some cardiovascular benefit? (AND perhaps even reduce the risk of some cancers?) No doubt about it, Cardiologists are influenced by what they are told in "studies" and by the claims made by the drug manufacturers. But you can find numerous articles where cardiologists truly believe in the universal benefit for nearly everyone to be taking statins. My PCP assures me that we'll keep a close eye on the liver function tests. And my pharmacist tells me that the muscular difficulties would be difficult to ignore and that to stop taking the drug would eliminate the risk there. So, on the one hand, I feel like making a decision to NOT take this small dose of Lipitor is suggesting to my cardiologist that I don't believe him that it MIGHT delay the need for valve replacement surgery. With all the voices that there are out there, I feel like I'm in a difficult place if I have no confidence that my cardiologist is telling me something that should be good for me. On the other hand, it's MY life and feeling of well-being, and I do worry about taking ANY medication that isn't warranted -- but that's the tough call to make. You're right, "there is precious little in life that is all good or all bad."

So, I'm still thinking about statins. But I'll try not to worry about the calcium I'm taking in trying to feel better with the ulcer. (Actually NOT worrying about a lot of these issues would probably help the ulcer, huh...?) I do appreciate your input.

Thanks....
Karen

 

[char2mar]

My Two cents Worth

My Two cents Worth

Have you had a proper diagnotic test for your ulcer? I would recommend doing an urea breath test to rule out H pylori. If your ulcer is caused by the bacteria H pylori, taking tumms and previcade will relieve the symptoms but not heal the ulcer. Find out if you have H pylori and if you do they can cure your ulcer with a mixture of antibiotics (called the H pack) and then in the future there will be no need for those other drugs. I was diagnosed with an ulcer when I was 13. For years I took antacids to decrease the acid and stop the pain. It worked. 3 years ago I had a really bad episode of gastric ulcer pain. I had the urea breath test done and it came back positive. The doc put me on the H pack....4 days later I started to feel better. One month later I was pain free and have not experienced any pain since. I am now ulcer free. Worth checking out....that is if you already haven't done so.

Char