Client Diagnosis and Recommendation



Client Diagnosis and Recommendation of Information Sources

Sandra L Kirk

Emporia State University

My client wanted information on the long term use of Lipitor. Her husband has taken Lipitor for over two years to lower and maintain his cholesterol level. Recently, he has developed a stutter and tinnitus. The stutter presents itself during times of stress and relaxation. She stated that it is occurring more often, almost daily. The tinnitus is constant. Within the last month, he has had an MRI. The test showed no abnormalities that could be the cause of these symptoms. My client is concerned that the long term use of Lipitor may be causing the symptoms to manifest.

I asked if he is taking other prescribed medications and if he took any over the counter medications on a regular basis. He does take Metformin for diabetes and Zestril for high blood pressure, both are prescribed by the same physician. Individually, she was very comfortable with the side effects and long term usage of these two prescriptions. However, she was unable to find any information on the usage of all three together. On the other hand, she had many concerns of the long term use of Lipitor. She had performed a quick search of Lipitor on WebMD. She feels that the site is biased in favor of drug companies. The site did provide a comprehensive list of severe and less severe reactions reported. It is a list only. The two symptoms that her husband is experiencing were not on the list. She read some of the User Reviews from the site finding that many users experienced severe muscle pain to the point of being unable to perform normal day to day activities. Many who had stopped taking Lipitor because of severe symptoms still suffered for months. Some never have recovered.

I asked if he had ever experienced tinnitus before. He had not. During military service, he had been on the bomb squad and had once had a bomb go off at a close enough range that shrapnel had been embedded in his face and neck. He had been wearing ear protection and did not experience tinnitus afterwards, as could be expected. He is a trained policeman and has worked at Topeka Public Schools in security for 15 years. He is assigned to Cap City where students who pose a threat in a normal classroom are assigned. Numerous times he has had to restrain a student who will scream and yell in his face. He feels that the tinnitus is caused from this exposure. She would like to rule out all other possibilities.

For a general understanding of all three prescriptions, I went to Wikipedia. Lipitor is a statin, a class of drugs. Statins have a history of some patients experiencing severe reactions that do not make the benefit of taking the drug worth the severe reactions. The generic name for Lipitor is Atorvastatin. Another well-known statin has been removed from the market because of severe reactions (same as in Lipitor), in the recent past. I also went to WebMD to read for myself what information was provided. It is not a site that I was familiar with.

I next visited the Mayo Clinic site. I have visited it often when searching for personal reasons and have found it a comprehensive informative site with knowledgeable sources. I was able to locate a list of medicine, prescribed and over the counter, which should not be taken with the specific drug searched. The list also included some foods that should be avoided and certain disorders that should be discussed with a physician before taking. I searched each of the three individually. I printed all three for the client. I then read user reviews and found the same complaints of severe reactions of users who had taken Lipitor. It became apparent that most users who experienced severe reactions took the 80 mg. once a day. I called my client to ask what mg. her husband takes. He takes a 20 mg. dose once a day. I did report to her that the majority of users who experience severe reactions are/were taking the higher dose. But, that a few users on the lower dose did report some issues.

My next step was the databases at ESU. I searched the Medline database, Medicine & Health by subject, and then BIOMed Central, BioOne, EBSCOHost, Health Reference Center-Academic, and Health Source Consumer Edition by Database by type. I found that the articles were either written for an audience of medical professionals, did not offer any new information, or was not accessible. I searched by Lipitor, statin, statin drugs, and Atorvastatin.

I went back to the web and searched Google Scholar and Google. I was able to find additional articles that I printed from a natural news site. This site provided some articles that discussed in detail some cases of users of Lipitor who had experienced severe side effects.

When next my client and I meet, I gave her the information that I had printed off for her. After reading them, she told me that she was very happy with the Mayo Clinic print outs that included the extensive list of other drugs that should not be taken with Lipitor. Many of them are very common antibiotics. She also appreciated the Natural News articles as none of them indicated what her husband is experiencing is within the range of symptoms that those users had experienced. She felt that the information had been very helpful to her.

I could find evidence of some having severe reactions after taking Lipitor for a long period but the majority of them was on a higher dose than what he is taking. I could not find any that was experiencing the same symptoms as her husband. I was able to find additional information that she plans on keeping for future information when and if he is given an additional prescriptions or uses an over the counter drug. During this time he saw his physician and has been advised to see a speech therapist for his stutter. She would like for him to stop taking Lipitor for a month or so to see if the symptoms improve. His physician does not recommend that he do that and her husband has chosen to follow his doctor’s advice.

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