Saturday, March 25, 2017

Math Impaired MD

Having spent some time working on a pre-med major, before quitting college entirely for the hard knocks school, I'm aware of how much math is involved. Try taking quantitative or qualitative analysis without it, or just plain old organic chemistry. So my primary care physician's math skills level totally puzzles me.

He seems to do just fine with plain old multiples of 30 when he's writing out - well, actually emailing, these days - prescriptions to my pharmacy. If it's one a day, he gets 30, or 90 for a three month bottle. If two daily, he's got 60 and 180 down pat. Anything else in the dosage regimen, and he's hopeless.

A couple years ago we were fiddling with fluctuating warfarin dosages, before my cardiologist took me off the stuff, until I show symptoms that will require my going back on it. The pill schedules might be one, one and a half, or two pills, depending on days of the week and my last test results. Because it was fluctuating, he was only going for 30 days at a time. But he couldn't figure out what, say, one and a half pills a daily would translate to over a month. Heaven help us all if a couple days a week were just a single pill!

Somehow we managed. My INR levels never stabilized, but never killed me either.

Now my thyroid levels have slowly been dropping, so he started me on medication for that. The single pill dose wasn't quite high enough, so he told me to take two pills on weekend days.  He didn't change the prescription. That, of course, meant I'd go through them too fast and the insurance wouldn't pay for over the prescribed amount. Given a choice between staying with one a day or increasing the dosage, I stuck with taking one a day rather than upping the dose some days and running out early. At least there'd be some going into the system.

Refill time came this week. I called his assistant, reminding her that he wanted me to take extra pills but they needed to be prescribed in higher numbers. Nobody called back, other than the pharmacy telling me my pills were ready.

On the way home, I looked at the number of pills prescribed for the next 90 days. One every day would be 90. Add the extra two each weekend, assuming 12 weekends in 3 months, should be another 24 pills, or a total of 114 pills. I don't even need a calculator for that; I can figure that in my head. So the bottle has ... 98!

And most folks think that Grannies like me don't take enough pills because they're trying to save money?

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