February 4, 2019--Warning Labels

Don't ask, but the other day I was looking at the yellow warning labels on my ladder. Things have come to that. 

I promise this is not an oblique route to talking about Trump. Tomorrow, State of the Union day, will be time enough for that.

My ladder is an 8-footer and has at least ten stick-on labels--

Maximum Load Capacity 225 LBS.
Walk Down Steps Backwards
Do Not Use Ladder Near Power Lines
Ensure Ladder is Fully Open and Locked Before Climbing
Do Not Overreach
Do Not Stand On Top Step
Do Not Use Top Step As a Little Table to Eat Pizza
Do Not . . .

Some of these warnings are required by OSHA. Others, Rona says, are written by the ladder companies' lawyers. If you fall on a power line and get electrocuted (mine is an aluminum ladder) you were forewarned and thus are not likely to be able to sue successfully for damages. 

It would be my own damn fault--didn't I see the warning label? I could, after all, have bought a wooden ladder. Then I'd have to be instructed not to use it near an open fire. Though probably it would be good to be advised about that even with an aluminum ladder. 

Later in the day, at dinner, we had glasses of Tormaresca, a nice Puglian Chardonnay. 

Reading the label, Rona said, "Did you ever notice this before?"

"What's the 'this'?"

"The warning label."

"I have seen the warning to women that drinking wine during pregnancy can cause birth defects."

"There's more." Rona rolled her eyes. "Let me read it to you because I too only remember the warning to pregnant women. It says, 'Consumption of alcoholic beverages impairs your ability to drive a car or operate machinery and may cause health problems.'"

"Duh," I said, "This means don't have a glass or two of wine at lunch and then expect to be able to use your backhoe to drive home. On the other hand when we go to Cafe Boulud for our once-a-year lunch and have a Super Tuscan we're unlikely to use our backhoe to get there. There's always Uber."

"And what kind of health problems are they warning about? Shouldn't they list the medical problems as they do on the TV ads for, say, Xarelto?"

"Let me look them up." Rona googled Xarelto. "It's a long list but let me read a few of the possible side effects. I'll leave out the goriest ones."

"Thanks in advance for that. I don't want to lose my appetite"

She read--

• Blood in urine
• Coughing up blood
• Nosebleeds
• Bleeding gums
• Dizziness or fainting
• Blurry vision
• Numbness or tingling in the legs
• Rash
• Itching
• Trouble breathing or swallowing

"Sounds scary," I said.

"That's the point," Rona said, "Actually, it's also to cover their behinds, legally speaking."

(Full disclosure--I made up the pizza warning.)

March 6, 2014--Chantix

When you watch a lot of cable news (guilty!), considering the demographics of viewers, it is no surprise that you are bombarded with drug commercials. They may even be targeting me because half of them are for Cialis and Viagra.

Last Sunday morning, checking out Up on MSNBC so I could continue to follow the endlessly unfolding Chris Christie saga, there was an ad for Chantix, medication that purports to help many break the smoking habit. I don't smoke, thankfully never did, but for some reason I paid close attention to it, including my usual favorite part where they list the most frequent side effects.

In Chantix's case, most commonly (5% of the time), these include nausea, constipation, flatulence, and vomiting. Less common possible side effects include depression, hostility, panic, mania, and suicidal thoughts.

Then, of course, there is the familiar warning that when taking Chantix one should avoid using heavy equipment. I thought, don't all the guys who use heavy equipment smoke? Oh well.

Most interesting in the fine print where the side effects are listed were the results of tests done to determine Chantix's effectiveness. Forty-four percent, they said, after nine weeks were helped to stop smoking. Sounds good. But, fascinating, 18% stopped in double-blind tests when given sugar-pill placebos.

Why then, I thought, would a physician initially give anyone Chantix rather than starting patients off on the sugar pills since they are nearly half as effective as the prescription drugs that, in a few cases, lead to thoughts of suicide.

Prescribe the placebos, tell patients to come back in nine weeks and then, if they haven't stopped smoking, switch to Chantix. Why put nearly a fifth of patients on pills they could do without and get the same results? And all the while they'd be able to drive backhoes.

As a general rule, in non-emergency situations, wouldn't it make sense to start people off with sugar pills if the data show that in at least 10% of the cases they'd get the same results.

But at hundreds or even thousands of dollars a month for the prescription drugs, it's pretty easy to figure out why this isn't routine practice.