Pills and Procedures

I recently had an adenoidectomy. For those of you who don't know what an adenoidectomy is, it is similar to getting your tonsils out, but is a relatively less invasive procedure. For the pain during recovery, my surgeon prescribed me Tylenol 3 with codeine. After going through a prescribed 28 pills in the course of three or four days after surgery, I called the surgeon for a refill of the script due to residual pain and discomfort. The surgeon agreed with little hesitation and called my local Walgreens to have the script filled. The pharmacist there was not as forgiving as my surgeon:

Pharm.: Can I help you?

Me: Yes, my surgeon just called in a script for me-a refill of Tylenol 3.

Pharm.: [With a condescending look] I just got off the phone with him. You got over here pretty quickly. [Leering at me over the frames of his glasses] It's going to take at least five to ten minutes to fill this.

Me: [With a raspy voice and tremendous earache] Okay, thanks.

I wandered around the pharmacy for a short while as the pharmacist moved through his library-looking aisles of drugs behind the white counter. While filling the prescription, the pharmacist began talking to me.

Pharm.: Did your doctor warn you about how much of this stuff you've been taking?

Me: [Surprised] No, sir. Not really.

Pharm.: The maximum amount of acetaminophen you should have in your system during one 24-hour period is 4000 mg-you are well over that.

Me: [Worried and speechless, I stare blankly at the pharmacist]

Pharm.: [Shaking his head] You really got to tone it down with these things. It will catch up to you when you're older. [Handing me the bag] Be careful.

Me: Um, thank you. [Scurrying away like a bad schoolboy after being yelled at by the principal]

I got home and was worried about the dosage my surgeon had prescribed me. After some research online, I found out that the pills I had been taking (generic Tylenol 3 pills: white pills with 93 150 on one side and 3 on the other) contained 300 mg of acetaminophen (the Tylenol part) and 30 mg of codeine (the painkiller part). Although I trust the pharmacist's advice, the numbers he gave me were just plain wrong. Since I had been taking about eight pills per day, the amount of Tylenol I would have had in my system would have been 2400 mg or less per day. I was relieved, but also confused. What's so bad about this stuff anyways?

Some more research online yielded information I was looking for-information I think anyone taking pain medications should be aware of when they are taking them. The main danger in pain medications tends not to be the codeine or actual pain medication itself, but rather the massive amounts of acetaminophen added as filler. Acetaminophen (also known as paracetamol or as the brand Tylenol) can cause acute liver failure if the maximum dosage of 4000 mg a day or 1000 mg a dose is exceeded (the pharmacist was right). When acetaminophen is broken down in the kidneys and liver, one of the elements created (called NAPQI for short) causes depletion in the natural antioxidant glutathione. Along with direct damage to cells, the depletion of glutathione causes cell death. In layman's terms: Tylenol is bad for your kidneys and liver.

Maximum dosages aside, pharmaceuticals can always have unforeseen effects on the body. We live in a pharmaceutical age in which we take one pill for pain, one pill to counter the effects of that pill, and another pill for recovery from both of those pills. We pop pills to combat depression, obesity, headaches, stomachaches, runny noses, pregnancy, and impotency. We take medications for every discomfort we have. We swallow doses for our health, but we are rarely informed on what those doses actually do to our body.

This adenoidectomy I recently had done was a choice that I made to make sure my body is running efficiently. It is just one procedure, but my future probably holds many more procedures that will necessitate medication. During my lifetime, I will probably have to take many more pills and medications for one thing or another. I'm not a pharmacist; I'm not a doctor; I'm not a medical student or an M.D. I'm just another person trying to live his life the way he knows how. Being informed about what I am taking is important to me. As uncomfortable as I felt in the pharmacy today, the pharmacist was right; I do need to watch what I put into my body. I need to be aware of the stress I am putting my body through and make sure the benefits outweigh the side effects. We only have one body in this life; we should make sure we treat it right.