20 July 2009

'we are all on drugs.' -weezer

i've been feeling incredibly energetic recently. i have no doubt that this has all to do with my recently stopping migraine prophylaxis medication. luckily, i have had few migraines this summer and have come off the twice daily regime with my "if i get one" medicine on standby. i can't explain the difference this makes other than to say: i played tennis for an hour and a half with my dad and henry two nights ago, and today i was able to jog 2 miles without tiring too badly. i haven't done either of these activities since before i started the migraine prophylaxis a year and a half ago.

i've been grappling with this whole situation - especially in light of the fact that i'm about to hit the clinic and start prescribing this sort of stuff to people. it's troubling. the migraine prophylaxis that i took wasn't 100%, but it did decrease frequency -- and trust me, decreasing the frequency of migraines is worth millions to those who get them. even so, on this medicine in those migraine-free intervals, i was too exhausted to work out. it's a give-and-take, i guess. prescriptions seem magical to people ("just take this pill, and you'll be better!"), but they don't come without side effects. antibiotics, some of our most "magical" of drugs, can cause GI upset, oral contraceptives to be dysfunctional, and bacteria to become resistant (among other things).

don't get me wrong: drugs rock! they are just entirely more complicated than we all realize. i'm glad (being on this side of it) that i've had some personal experience, and i hope that this will make me a better doctor. maybe i'll be a little less quick to pull out the prescription pad? here's hoping!

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