Archive for April 8th, 2009|Daily archive page

No more Lipitor

I stopped Mom’s Lipitor. I didn’t really intend to, though I had wondered for awhile what the point is of treating something like high cholesterol at this stage of Mom’s life. The nurse called in a bunch of refills for Mom, and when I went to pick them up, the pharmacist said the insurance company hadn’t approved the renewal of Lipitor. Probably a timing issue. So when I took the rest of the meds to the nurse, I told her what the pharmacist said. And we agreed it was not a big deal, that the renewal would be approved soon enough. And then I sort of flippantly said, “I don’t even think she should bother taking it anymore. I wouldn’t care if she didn’t.” And the nurse agreed. She said she would mention it to the doctor. I sort of gulped, glad that a health-care practitioner thought my logic made sense in this regard and simultaneously full of guilt for saying such a thing out loud.

A day or so later, the chief day nurse left a voice mail for me that the doctor said it was OK for Mom to stop the Lipitor. I am assuming he considers it ethical and sensible at this point to eliminate at least one drug from the collection she takes every day. It is also a cost savings, another thing to think about these days. So I just looked up Lipitor online to see exactly what its claims are. It increases good cholesterol just a little bit and can decrease bad cholesterol by 40-60 percent. OK, then what? Mom smoked for, I’m guessing, a good 40 years, or at least close to that. She was a heavy drinker for about 15 years that I am aware of. She didn’t seem particularly concerned about her diet, as I recall. As an adult, she was sedentary – she went through a period of walking to work or to and from a bus stop, but beyond that, she did not participate in any form of exercise. Except a brief try at tap dancing – and just remembering that makes me smile. And yet, until she was diagnosed with Alzheimer’s, she experienced no significant health problems. No cancer, no heart problems, no diabetes, nothing that I am aware of beyond her high cholesterol. She did have growths removed from her thyroid about 20 years ago, and has taken medicine to replace that lost function ever since. She is almost 72 years old. I consider her damn lucky as far as her health is concerned, given her history. And now that luck pisses me off sometimes.

I do not want my Mom to just die. But I certainly don’t want her to suffer, either. And I hope, I really, really hope, that she has reached the point beyond suffering with her dementia, that she isn’t frustrated, or afraid, or anxious. Or, worst of all, concerned that she seems stupid – when she conveyed those kinds of worries to me early in her illness, it broke my heart. That said, I also don’t see benefits in prolonging her life through the use of preventive medicine, either. I didn’t take her for the last mammogram that was recommended by her primary care physician. I don’t think protecting her from heart disease with Lipitor makes much sense. I frankly don’t know how my siblings feel about this, but I am hopeful that they agree. At this point in Mom’s disease, there is no bright side. True, she is still able to experience the pleasures of eating, limited social activity, cuddling her cat. But she is already spending more and more time sleeping. Or sitting quietly. She is shutting down, bit by bit. Materials I have read give me a sense of what the future holds. The patient loses all physical functions. Urinary continence is joined by bowel incontinence. She stops talking, and walking. Eventually can’t swallow solid food. Presumably, her addled brain will protect her from awareness of any of this. But those of us around her will be keenly aware. It just strikes me as so senseless. I don’t know what the solution is. I am figuring it out as I go. That’s the only choice we’ve got.

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