Dearest:   My guest tonight, Julie Catalano, is an award-winning writer whose 
articles on women's health and fitness have appeared in national publications for 
20 years. She is a member of the American Society of Journalists and Authors and 
is the author of the new book, "The Women's Pharmacy: An Essential Guide to What 
Women Should Know About Prescription Drugs".

Welcome to Power Surge, Julie. It's mind boggling that 2.4 billion prescriptions 
are written for women every year. How can your book be of help to women using 
prescription medications? 


Julie Catalano:   Hello all! I'm really glad to be here tonight and hope I can be of 
some help to other women. I wrote TWP in order to help women get sort of a "head 
start" when dealing with their doctors and/or pharmacists concerning their drug 
regimens. Actually, the correct statistics is that two thirds of all prescriptions 
are written for women. So that would be 2/3 of 2.4 billion total. Of course there 
are no actual figures, which is disturbing in itself.


Dearest:   That's still too much.  Ok, Kim, go ahead.


Julie Catalano:   I could ask a question myself. When was the last time you cleaned 
out your medicine cabinets? :-)


Dearest:   Don't ask. I think last century <g>


Julie Catalano:   There are some lethal substances lurking in there. I just threw 
out my Seldane.


Dearest:    How come they give you an expiration date on the medication, but 
oftentimes the doctor or pharmacist will tell you the drug is still good 
after it's expired? 


Julie Catalano:   It's a good idea to go through them immediately, discard all 
expired and old drugs. Also drugs you've borrowed from others, which you're not 
supposed to do. I don't know, Dearest. Probably because it depends on the drug. 
It's a good idea to follow the drug expiration date, but don't confuse it with 
the prescription expiration date, which is different. 


kimberely57: I was taking Accolate for 2 years and then went through an early 
menopause. Could that have caused it?


Julie Catalano:   Kimberly, accolate is an asthma medication. Did your doctor link 
it to early menopause? If he did, I'd like to know the connection too.


kimberely57: I never really asked him


Julie Catalano:    That's why I wrote my book!! Seriously, I should have subtitled it 
Speak UP to Your Doctor Before he Talks DOWN to you.


Dearest:   Kim, did you know that hormones are affected by our histamine levels in 
our bodies?


kimberely57: Really?


Dearest:    That's why many women develop asthma, allergies and sinus problems during 
menopause. Yes, really. Who knows, the asthma med might have affected your hormone 
levels. 


Julie Catalano:   And vice versa. 


kimberely57: I stopped the medicine about 8 months before i went into meno


MaryO: If it's a steroid it could.


kimberely57: But i never thought about it till later


Dearest:    Exactly, if our histamine levels can be affected by our hormones, than 
vice versa. Exactly, Mary.


Julie Catalano:   Hormone changes during menopause can affect drugs, and it works 
the other way around too. That's what makes taking drugs during menopause so 
"challenging."


Dearest:    Kim, ask your doctor about that and tell him you learned it in Power 
Surge (not from him) :) Julie, what specific questions should a woman should 
ask when her doctor prescribes a new medication? Too many shoulds in there.


Julie Catalano:   Believe it or not, ask the name of the drug. I spoke to a woman 
the other day who told me her doctor gave her a new drug. I asked what it was. She 
said, "I don't know. Begins with an M..."


Dearest:   So true.


Julie Catalano:    So that's the first question. Then, ask how long it has to be 
taken before you see any effects.


Dearest:    Good question!


Julie Catalano:    If you are menopausal, ask SPECIFICALLY if there is any data (even 
anecdotal, don't forget to ask that, they won't volunteer) to suggest that the 
drug works differently in menopausal women. In fact, it's a good idea to ask in 
general if the drug works differently in women. Many drugs do.


Dearest:    By the way, ladies, I have a copy of Julie's book in front of me and it's 
*chock a block* full of important information about prescription meds!


Julie Catalano:   Then be sure to provide a complete list of ALL the drugs you are 
taking, prescription, OTC, vitamins, herbal supplements, vitamins, everything. 
Also ask what foods and/or drinks (especially alcohol) might interfere.


Dearest:    Very important. What else?


Julie Catalano:    And last but not least, ask what side effects are most common, and 
which of them signal a drug allergy or overdose problem.


Dearest:    Excellent, Julie. Thank you. Such important information... and 
everyone can find it in Julie's book, The Women's Pharmacy
Venus, go ahead, please :)


venusrose9: I question if I am taking too much Premarin, I now take 1.25 mg., night 
sweats have subsided though, but had one small one last week. Do you think I am 
taking too much? I am also substituting tofu in my foods, and drinking soy if no 
tofu.


Julie Catalano:   What I find that doctors will do is start with a "recommended 
dose." This usually means nothing to the patient, and you find out quickly if it's 
too much or too little. What I would advise, Venus, is to keep what I call a 
Medication Journal. Write down every symptom and side effect, the time, the date, 
etc.


venusrose9: Well, I started on .625, but had major night sweats so she upped it to 
1.25


Dearest:   That may be too much, Venus. .625 is the usual dose and many more enlightened
doctors are starting women off with even half the traditional dose.


Julie Catalano:   I know it's a pain. Who needs more lists, right? But take that to 
your doctor. Also keep a diet journal. There may be a drug/food combining problem 
going on. So much of prescribing is trial and error, as I'm sure you have all found 
out the hard way, as I have. 


Dearest:    Especially with hormones. 


MaryO:  Hi. This is a kind of general question. I normally take 2 or 3 
prescription drugs. Last week, I had an awful bug and took some OTC drugs. I 
stopped all the prescriptions because I wasn't sure what the mix would do. Was 
that the right thing to do? 


Julie Catalano:   Some drugs can be stopped safely with no withdrawal effects. It's 
usually not a good idea to stop cold turkey. If you ever have a question about a 
prescription/OTC mix, head for the phone and call the pharmacist. Any pharmacist. 
But preferably your own. 


MaryO: I didn't feel well enough to even call. I've resumed my normal schedule 
now - Thanks 


Dearest:    Julie, is there a universal rule about what to do if you can't remember 
if you took your morning dose of medication? Do you skip it? Take it later? What 
happens if you take two? Or does it depend upon the individual drug? 


Julie Catalano:   It depends on the individual drug. The general rule of thumb is to 
take the missed dose as soon as you remember it. Unless you don't remember it 
until it's time to take your next dose. Taking two of a sustained release drug, 
for example, would be a pretty bad idea. If you're in doubt at all, I say skip it. 
Better to be safe. 

I have one scary statistic that might spur some talk. More than 1,000,000 Americans 
are hospitalized each year for prescription drug problems. More than 100,000 of 
them die. 


Dearest:   I've read that most visits to hospitals' ER's are due to drug reactions.


ute110: Can prolonged use (more then a year) of a prescription diet pill (fastin, 
prelude) cause a women to go into premature menopause? 


Julie Catalano:   Again, I have to ask: What did your doctor say? While we're waiting 
for Ute's answer, I think you should ask your doctors if ANY of the drugs you're 
on can trigger premature menopause. 


ute110: I did not ask my Doctor?


Julie Catalano:   I know I'll be asking that on my next visit to the doctor. By the 
way, take a tape recorder to your exams. 


Dearest:    And with a weight loss medication, shouldn't they ask if it could spur 
heart problems? Shouldn't doctors especially caution women about weight loss 
medications? 


Julie Catalano:   As for weight loss meds, as you know the most dangerous were 
recalled--Redux, Pondimin. The remaining ones do not seem to have the problems 
associated with cardiac problems. It is always a good idea for women to have 
cardiac function tested regularly.


Julie Catalano:   Doctors are not known to caution women much about anything, 
especially weight loss drugs. There's too much of a demand for them, and they're 
fairly profitable. It's up to the woman to look for side effects and ask about 
interactions. 



Rhonda: How does your book differ from prescription drug reference books? 
Incidentally, although I have issues I am almost afraid to go to the dr. Seems all 
they want to do is hand you pills!


Dearest:   How true!


Julie Catalano:   Rhonda, I hear you. That's why two thirds of those 2.4 billion 
prescriptions are written for women. My book differs, I think, in that it's 
written by a woman patient. I wanted to write it from a consumer standpoint. Also 
it's shorter and easier to use. I tell women to tuck it in their purse and take it 
to their doctors, make notes in the margins, fold the corners, highlight passages. 
Just use the heck out of it. 


Julie Catalano:   BTW, Rhonda, if the doctor just hands you a scrip, ask all of the 
questions above. So many times we walk out of there with a prescription form and 
have no idea what's really on it.


venusrose9: I suffer from mild depression once in a while, what can I do to deter 
it? Anything? 


Dearest:    Remember, Julie isn't a pharmacist or doctor. She can't prescribe or 
recommend you take any particular medication.


Julie Catalano:   If you have been diagnosed with mild depression, there are any 
number of prescription medicines for that. A mild form of depression is called 
dysthymic depression.


venusrose9: I never really would just feel depressed for no reason.


Dearest:   You can also try a mild herb called St. John's Wort which is excellent in 
helping depression (those already on anti-depressants should not use it).


venusrose9: I hate taking pills though. 


Dearest:   I personally used SJW and it worked great! Also my Revival soy works 
great for depression.


venusrose9: I did and it was great except it made me my face break out in a rash. 


Dearest:   Really? 


Julie Catalano:   That is another common problem I hear--hate taking pills. Don't we 
all! Yes, St. John's Wort is excellent. Just be sure to check for possible 
interactions with prescription and OTC drugs. 


Dearest:   I react to everything.. found SJW very mild.


venusrose9: Unfortunately, yes. 


Dearest:   Very true, Julie.. and especially NEVER use SJW with an anti-depressant.


venusrose9: Is there any other herb I might try? 


Julie Catalano:   Maybe you could adjust the dosage downward? I'd still check with 
the pharmacist. You don't always have to ask a doctor. 


Dearest:   Venus, write to me at Dearest@aol.com. Mary, go ahead :)


MaryO: With that bug I had, I got a new antibiotic (Zithromax) which seems to work 
very well. Are there any other new wonder drugs coming out soon? 


Julie Catalano:   There are almost 350 new drugs in the pipeline, MaryO.


MaryO: Wow!


Dearest:   My word! Why do women need 350 new drugs? Don't we have enough?


Julie Catalano:   Those are just for women, BTW.


Dearest:   Why?


MaryO: Incredible, why would we possibly need that many more?


Dearest:    From all the drugs we take. They cause problems that require more drugs.
Good grief, Julie. I can't believe those numbers.


Julie Catalano:   I'll break it down for you, if you like. 24 for rheumatoid 
arthritis, 60 for breast cancer, 38 for ovarian cancer, 19 for diabetes, 23 for 
Alzheimer's, 18 for depression, 24 for osteoporosis, and on and on. Email me at 
womenspharmacy@aol.com if you want the complete list and details.


Dearest:   Is that info in the book, too, Julie?


Julie Catalano:   Yes, unfortunately, we do often end up taking drugs to combat the 
side effects of the other drugs.

Yes, Dearest, but not in as great a detail as I would have liked. Maybe next 
revision! :)


Dearest:    I love  "The Women's Pharmacy" as a reference book - it's very handy and 
well written. Hormonequeen, please ask your question. Thanks.


Julie Catalano:   Women's health is a goldmine. The pharmaceutical companies are in 
heaven, or their version of it anyway. BTW, just because I wrote a book on 
prescription drugs, I am also a firm believer in alternative therapies. I think 
they should work hand in hand. 


Dearest:   Thanks, Julie :)


hormonequeen956: Why do you suggest woman have regular cardiac function tests 
done? I Have also heard that estrogens are going to be put on the list of common 
cancer causers. What is your view on that?


Julie Catalano:    Estrogens are on a roller coaster ride like so many drugs. I think 
it's absolutely imperative that women have regular cardiac function tests. I went 
undiagnosed with mitral valve prolapse for 10 years. Because the doctor said that 
no 35 year old woman could have heart problems. GRRR.


Dearest:   <I won't say it>


hormonequeen956: I can understand that. I had been on the diet pills that were 
recalled and they don't even want to do an echo because of my age.


Julie Catalano:   If the data supports that estrogen is contributing to cancer, and 
I think it is showing that in some studies, then it should be on a list. However, 
not every woman taking it would agree. Dearest, such uncharacteristic restraint.!! :-) 


Dearest:   Won't last long, trust me :)


hormonequeen956: I am very much thinking of going off the estrogen. It scares me.


Julie Catalano:   DEMAND AN ECHO. I mean it, hormonequeen. That's the only way to 
diagnose it. 


Dearest:   Exactly, Julie, tell them. Doctors perform a service for which we HIRE 
them, right?


Julie Catalano:   If a drug truly scares you, then sit your doctor down and talk 
turkey. Learn everything you can. 


hormonequeen956: Thanks so much.


Dearest:   They are not Gods. They are professionals we hire like any other 
professionals.


Julie Catalano:   I had to ask for an MRI, if you can believe that. 
Yes. Unfortunately, when we enter their "kingdoms" we often act like loyal 
subjects instead of the paying public. Women have got to speak up. We are 
literally dying out here. Some doctors are excellent. Find one who believes 
in the internet. 


MaryO: Amen!


Dearest:   Very true, Julie.. very true. Thanks. Ute, go ahead, please.


ute110:  With all the new drug on the market and Doctors always trying to promote 
the latest how do we know which method of HRT would be safest? Doctors don't seem 
to know!


Julie Catalano:   Great question! Unfortunately, we're back to the "every woman is 
different" answer. Personally, I am leery of new drugs.

I would ask the doctor for specific clinical trial information, not just 
prescribing info. That should perk his/her ears up. Be careful of getting scrips 
for every drug you just saw a commercial on. That's always a dead giveaway for me. 


ute110: Specific clinical trial? Will we be able to understand/read it?


Julie Catalano:   Well, you can certainly find someone who can! Seriously, if you 
look up the papers on Medscape, you'd be surprised how much you understand. 
PowerSurge women are very, very knowledgeable. :-) 


Dearest:   Lori, you can ask your question :)


Lori: Which cardiac function tests do you suggest?


Julie Catalano:   The usual EKG, which they should be doing anyway. But that doesn't 
tell you much. An echocardiogram is the next best.


Lori: Thank you. I recently had one.


Julie Catalano:   Then a stress test. After that, you get into invasive procedures 
which should only be recommended by a doctor.


Dearest:   Julie, what is the #1 prescribed drug in this country? 


Julie Catalano:   You know the answer to that, Dearest. Premarin! Although I predict 
that Viagra will overtake it in the next survey. 


Dearest:   <God save us>


linkaloo: I had a doctor tell me that taking Prevacid would not cause me to be 
anemic, yet the PDR states it can happen. I've been anemic three times since 
starting on PPI's for GERD. He actually had to go look it up for himself and then 
still denied that he felt it was causing my anemia!


Julie Catalano:   Okay, good example of "time to get a second opinion."


linkaloo: I think we have to rely on how we feel, now I know when I'm feeling wore 
out, and sure enough, my iron levels are low...I trust me! HA


Julie Catalano:   If you have anemia, are taking a drug linked to anemia, and have a 
doctor telling you otherwise, then head for another doctor. Ntt permanently, 
maybe, just as a double check. 


Dearest:   Link remember to Email me at Dearest@aol.com. You should also get in 
touch with Meryl <Menobud> who's had similar problems and just found a 
resolution. E.mail me that question, Link.


linkaloo: Great, thanks! 


Julie Catalano:   Your instincts are often more on target than you think. Women have 
to learn to trust and listen to their bodies. 


Dearest:   Julie, thanks for the great answer. Aren't the questions great? 


Julie Catalano:   Yes, they really keep me thinking!! Great audience. I'm going to 
go to them when I have a health problem! When new drugs are manufactured and put 
on the market, how much research does the government require the FDA to do first? 


Julie Catalano:   Oh my gosh, the FDA goes through roughly 10 to 15 years of research.


Dearest:   Does that always happen, Julie? 10-15 years of research on every new 
medication? 


Julie Catalano:   Although there is currently a lot of pressure to speed up that 
timeline, and that's why so many drugs have been recalled.


Dearest:   And how can they talk about long-term results of drugs when they don't 
have them.


Julie Catalano:    It's a long and complicated process. Check out the FDA website if 
you want all the gory details.


Dearest:    Unfortunately, I don't hold the FDA in very high esteem :( I feel the 
same way about our new president <g>


MaryO: <there was just a Premarin recall last week!>


Dearest:   Right, Mary


Julie Catalano:   BTW, I have to mention the FDA program called MedWatch. That's the 
reporting system for the public (and doctors) to let the FDA know of any side 
effects or adverse drug reactions you have experienced. 


Dearest:   Yes, I've had a link to Medscape on the Web site for years now.


linkaloo:  Do you recommend anything specific for those of us who suffer with heart 
palpitations that are benign? 


Julie Catalano:   Linkaloo, join the club. I have heart palpitations. I can only 
tell you my own drug regimen and can't recommend, but ask your doctor about 
Isoptin (generic verapamil). It's a calcium channel blocker.


Dearest:   Is that better than the beta blocker, Atenolol - Tenormin? 


Julie Catalano:   They can make your life miserable, but they are usually not 
dangerous. 


linkaloo: Thanks, I appreciate that. 


Julie Catalano:   I had a bad reaction to Tenormin, but there are several drugs that 
are used to calm palpitations. First they try to find the cause. Does it happen 
often in menopause? I'm not there yet. 


Dearest:   Oh, yes. But I had it long before menopause, too.


Julie Catalano:   Something else to look forward to! 


Dearest:   I am just such a fine tuned gal :) <ducking before someone shoots 
me>
Also, remember "magesium" is excellent for palpitations. 500 mg.
Mary, your turn now :)


MaryO: I'm curious (read nosey). How did you decided to write on this topic? Did 
you have a medical background before you started research on this book? GA


Julie Catalano:   Drugs are so very complicated, and frustrating. That's the word of 
the year--frustrating. Hi Mary, I get asked that a lot. I've been a health and 
fitness writer for 20 years. Also a ballet dancer and teacher. I got trapped in 
the health care system shuffle about two years ago and was so terribly frustrated, 
panicky, and at my wit's end. I realized how many women have NO background, don't 
know what questions to ask, are scared and mad and yet depending on doctors to get 
answers, which often don't come.

The bottom line is, most of us ARE going to end up taking drugs, like it or not. 
And so I started researching women's health studies, drug studies, etc. 


MaryO: Thanks 


Dearest:   This book is great because it has so many things I've never seen in drug 
reference books, lists of medical conditions and related medications, a list of 
resources, questions to ask your doctor and your pharmacist. I highly recommend 
"The Women's Pharmacy" by Julie Catalano :)


Julie Catalano:   And then I decided to write an easier version of the long drug 
guides. And so I wrote this book, and then really lost my mind! 


ute110: Why are the Europeans so much more advanced in their drug research? Is it 
perhaps a political issue? Or are there just less restrictions? Thanks


Julie Catalano:   I like the women's resource directory myself. I think of women 
going out into the world asking about a million questions. 


Dearest:   Yes, but in the revised edition, I hope you add Power Surge to your 
menopause resources. It's in so many women's health books :)


Julie Catalano:   Oh definitely, Dearest.


Dearest:   And Health Magazine named Power Surge one of "The 25 Best Health Sites 
for Women" <shameless self-promotion>


Julie Catalano:   Ute, that's a good question. I don't really know, but I would 
guess it's political and economic. 


ute110: It's a shame is it not! Thank you 


Dearest:   Ute, I also don't think it's *all* of Europe that's so advanced. I think 
it's certain countries like Germany, if I'm not mistaken.


Julie Catalano:   Pharmaceutical companies, I'm guessing here, may have more clout 
in the US than in other countries, by simple virtue of the numbers of people 
taking drugs here. England, for example, relies heavily on homeopathy and 
alternative treatments. No money there, huh? 


GRAN: Can you tell me anything about evista and actonel - I'm taking for 
osteoporosis. I'm having terrible hot flashes and night sweats. I was taken off 
premarin after 16 years.


Dearest:   Gran, I can tell you that HRT only "postpones" menopause, it doesn't 
prevent it.


Julie Catalano:   Are you taking any other drugs that might cause interactions? 


GRAN: No, only calcium and I've tried black kohosh. I'm 51.


Julie Catalano:   Watch the dosage on the black cohosh. It can intensify the effects 
of some medications.


GRAN: How much should I take?


Dearest:   Especially hormones. And Evista doesn't stop hot flashes, unfortunately.


Julie Catalano:   I can't tell you, Gran. You'll have to ask a pharmacist. 
Experiment downward with what you're taking now. Keep notes of when you have the 
worst symptoms. 


GRAN: What about "Healthy Woman" by Monistat?


Julie Catalano:   Check on the Monistat product with the pharmacist, too. In fact, 
take the whole list of everything you're taking and get a consultation.


Dearest:   Julie, a final question about something that's concerned me are the 
"perks" doctors get for handing out "samples" of drugs given them by manufacturer 
reps. I often wonder if a doctor is giving a medication so he can get a trip to 
Bermuda, or because the patient needs it. Any thoughts? 


Julie Catalano:   Dearest, I can tell you from personal experience that perks are a 
huge part of the game. No one talks about it, but it's there. That's why it is SO 
important to know why you are being given a medication.

It's not that drugs are bad, but they can be 'abused' at many levels, starting 
with the doctors. (Who aren't all bad either.) 


Dearest:   We talk very openly about it in Power Surge, Julie :)


Lori: HRT actually postpones meno. When we come off we will still go thru it? 
AHHH! Thank you!


Dearest:   Uh huh :(


Lori: I agree


Julie Catalano:   I hate to bash the pharmaceutical companies. They're not 
necessarily the villains. But it demands a higher level of consumer awareness. And 
an unprecedented amount of awareness for women. 


Dearest:   Unfortunately


Lori: Thank you


Dearest:   That's what I've been trying to do here for 7 years, Julie. I know we've 
educated lots of women about how to talk to their doctors without being afraid.

Well.. what a great chat! Julie, thanks so much for the very informative and 
stimulating chat.


Julie Catalano:   I think you can't repeat that message often enough. WRITE your 
questions down. 


Dearest:   Everyone joins me in thanking Julie Catalano for being such a 
super guest! And don't forget to pick up your copy of THE WOMEN'S PHARMACY: AN 
ESSENTIAL GUIDE TO WHAT WOMEN SHOULD KNOW ABOUT PRESCRIPTION DRUGS BY JULIE 
CATALANO


Julie Catalano:   Thanks for the great questions. Go out there and ask your doctors 
everything and report back to Dearest. :-)


Dearest:   Julie. Excellent information. Goodnight, everyone.



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Dearest
aka Alice Stamm
Power Surge
Founder, Facilitator, Host


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