A STATE OF MIND: Toenail Fungus or Death!

by Larry Floersch

Lately I find myself sitting in front of the TV during the evening news hour longing to be afflicted by toenail fungus. The same is true for arthritis, psoriasis, fibromyalgia, diabetes, deep vein thrombosis and erectile dysfunction. It’s not because I really want toenail fungus or any of the other afflictions, but the pharmaceutical companies have convinced me through advertisements that having these conditions is the only way I can go to my doctor and tell him I want a drug that will make my life idyllic.

These ads are everywhere on TV and in magazines. They feature attractive, smiling people having wonderful experiences, such as jumping off boat docks into clear, cool lakes, playing in the rain with grandchildren, line dancing in Texas roadhouses, or sitting side by side in separate bathtubs on a mountaintop watching the sunset.

The brand names for these drugs are sexy and exotic and often seem interchangeable with the names of Japanese cars (“Introducing the all-new 2016 Toyota Cialis”). The pharmaceutical companies dream up these sexy and exotic brand names, of course, precisely because the real names for the drugs are unpronounceable and reminiscent of places you don’t want to visit, such as Adalimumab, which, if I remember my geography, is a small village in the eastern desert of Namibia.

Now, to be fair, the pharmaceutical companies probably would only show you the parts of the ads in which people are happily swimming in their bathtubs and stop right there were if not for the government. The government, no doubt concerned that we will spend all day swimming in our bathtubs instead of working and paying taxes, has stepped in and mandated the ads also include boring information to counteract the potential happiness. The drug companies, on the advice of their attorneys, happily comply by adding caveats. You know, details such as “Do not use this drug if you are pregnant, planning to become pregnant, are able to become pregnant, or are breastfeeding, or if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement, if you have allergies to medicines, foods, or other substances, or if you are a bipedal carbon-based life form who breathes air.”

If that boring information isn’t boring enough, they also include possible drug interactions: “Do NOT take this drug if you are taking abciximab, alteplase, enoxaparin, heparin, warfarin, bivalirudin, boceprevir, carbamazepine, cobicistat, conivaptan, dabigatran, desirudin, enzalutamide, eptifibatide, hydantoin, indinavir, itraconazole, ketoconazole, lopinavir, nelfinavir, phenobarbital, posaconazole, rifamycin, ritonavir, saquinavir, telaprevir, tirofiban, voriconazole, or St. John’s wort.” I was okay with most of these, but I had to look up St. John’s wort in my copy of the “Physicians’ Desk Reference.”

If the boring factor isn’t enough, they also encourage you to tell your doctor information that you have no way of knowing unless you have already taken the drug: “Tell your doctor if you are allergic to this drug or any of its ingredients.” I skip right over that part because it would force me to admit that I flunked pharmacology in fifth grade — twice — and have no idea what the ingredients are in these drugs, except for the inert ones. And, anyway, doesn’t my doctor get paid to tell me? And why would I be asking for a drug to which I am allergic?

They then move on to possible side effects: “Stop taking this drug if you develop a severe allergic reaction (rash; hives; itching; difficulty breathing or swallowing; tightness in the chest; swelling of the mouth, face, lips, throat, or tongue); a change in the amount of urine produced; coughing up blood; fever, chills, or persistent sore throat; pain, swelling, or new drainage at wound sites; red or swollen, blistered, or peeling skin; stiff, sore, hot, or painful joints; unusual paleness, severe or persistent headache, shortness of breath, fast heartbeat, chest pain, unusual tiredness or weakness; symptoms of bleeding in the brain; symptoms of low blood pressure; unexplained swelling; unusual or prolonged bruising or bleeding; or vomit that looks like coffee grounds.”

The makers of ED medications add the admonition to seek medical assistance if the effects of their pill last for more than four hours. This is obviously their feeble attempt at humor, when you consider that each of those little pills costs more than $40. Not that I need them, mind you, but for that kind of money I’d want the effects to last at least four days!

Occasionally, however, there is a statement in the boring information that does get my attention. “In some cases death from using this drug has been reported.” That sobers me up even if I’ve had 12 beers, and it leaves me with a difficult and painful choice: Do I want toenail fungus or do I want to risk dying with clear toenails. Hmmmm? It’s enough to make you want to vomit something that looks like coffee grounds.

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