FLQs: Fluoroquinolone Antibiotic Side Effects can Include Damaged Tendons
Cipro: a Medication with Unexpected Side Effect Warnings
A recent medical crisis took me to an emergency room, then surgery, all within 24 hours. I plan to write about that experience, but have decided to put the cart before the horse due to the side effects of a common medication I was given, often simply called Cipro.
In the hospital the surgeon ordered a form of this fluoroquinolone class of antibiotic to be given by IV along with the pain meds during and after surgery. Needless to say, I was feeling no pain at that time.
On the day I was released from the hospital I was given a large Cipro pill to swallow. Doing so was difficult due to the condition of my throat after surgery, partially because I was dehydrated before even going to the ER.
That caused the surgeon to refrain from giving me the Cipro prescription he initially intended me to fill for at-home use. He felt I had enough of the antibiotic at the time and being aware of some of the dangers of antibiotic use I was fine with that decision, but little did I know what a mercy it turned out to be.
At home that night I used one dose of the prescribed pain medication, but then decided it was time to get that junk out of my system. Make no mistake, by the end of the day I went to the emergency room I was begging for pain medication, and it was very useful those 3 three days I took it, but I've seen the dangers of using it in others' lives.
It was the next day after going off the pain medication that I noticed generalized joint pain, and my right ankle was particularly tender. Throughout the day it spread to my foot and up to the knee. The swelling made the entire area feel cold and tight.
Thinking I had somehow wrenched that ankle in the hospital while taking pain meds I shrugged off the pain. The ankle has a 5-year-old tendon injury that I am careful with, and I was resting anyway so elevating it was easy. Joint pain increased all over for a few days, but I was doing just as the doctor had ordered because I wanted to get well as fast as possible.
Much of the pain I had been hit with from the illness, the surgery and then the tissue/joint pain subsided over the next two weeks and I felt that I was doing really well when I could carefully begin building my strength after eating right and resting by starting approved exercises to strengthen my lungs and weakened muscles.
A Setback Because of Ciprofloxacin
At the post op appointment it was decided that I was dealing with a UTI--not a great surprise after being in the hospital. Yuk can describe some of what happens in those places, then there’s worse. It’s no wonder we have superbugs spreading among us, but we will stay on topic for now. I was given a prescription for Cipro, 1 pill per day, to take for 5 days.
At home that evening I took the first dose and went to sleep as usual. In the night I woke to joint pain, however, and the next morning my ankle was as bad as after first coming home from the hospital. The pain throughout the day and the next night increased and there was little rest. I was miserable and began trying to put two and two together.
On going back to read the prescription’s patient info material, including a medication guide, I saw that first on the list was tendon rupture or swelling of the tendon (tendinitis). Reading the warnings over while experiencing pain was alarming, but I understood both the side effects of Cipro and my symptoms better.
Determining what I should do next became a priority. My decision is, I'm sure, not doctor approved but, hopefully, I’ll be able to tell my general physician about the experience after the fact and not have to make a call for help. The surgeon referred me to him at the post op if I had concerns other than what would be directly related to the recent surgery.
There could be some risk in my decision, but I was too sick at the time to go to another appointment unless absolutely necessary. I’m pretty sure I had some of the other side effects, (such as a strong reaction to caffeine after going off the antibiotic, including insomnia--still can't drink my morning cup of coffee) and I just did not feel like dealing with seeing a doctor.
After reading several articles on how to treat the tender leg, ankle, and foot, and what to look out for in case things did not go well with my plan, I decided not to take anymore Cipro and to self treat for the UTI, while being watchful for symptoms that would indicate I in fact did need to call my doctor.
A Fluoroquinolone Induced Tendon Rupture Case
Using extra vitamin C each day and taking D-Mannose (a supplement I have used successfully in the past), staying extra hydrated, and getting more rest that included elevating the painful tendons was my own prescription, though as I mentioned, watching carefully for any sign that I had made the wrong decision and needed professional help was crucial.
I initially had to deal with anger over the situation so I could settle myself into the Cipro setback. After all, I had worked hard to make good progress after the surgery and was making plans to go forward with the next 4 weeks of recovery. Getting to the point of documenting the experience via writing a hub has been helpful as well as educational.
A week out from the post op now, I am still dealing with symptoms in both ankles and other joints and soft tissue areas, including hands and shoulders. The option of taking more medication to reduce swelling (NSAIDs, steroids) is not one I want to risk due to the side effects associated with those drugs, so I'm working to be patient with my treatment plan.
Whether doctors would agree, I'm not sure, but already having some side effects makes me wary that I may be at increased risk for more from other meds at this time. Since I am resting and elevating, I am going to take time to heal and see whether I have to address the issues in the future.
Learning about other side effects may be useful, but most importantly I am reading about how others have addressed these symptoms on their own. The healing process for most of them is based on practical advice--getting healing rest, eating right, taking quality supplements--but the comments have me planning to do more research in the future.
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How Could the Surgeon have Helped the Situation?
Though I know it now, when I was in the hospital I had no idea that the ankle pain was being covered by pain meds, nor did I have any clue that the ankle and joint pain after coming home could be related to the antibiotic.
At the time, no warning was given to me about these or other issues I faced even though the FDA has placed a boxed warning on the family of fluoroquinolones, Cipro being one of the brands in this class of antibiotics.
Before leaving the hospital a patient should be given information on the side-effects of medications they have been given and they should have in writing what they should do if they experience the side effects, just as if they had received medication from a pharmacy with patient information inserts.
In the surgeon’s office at the post op appointment there was no discussion about Cipro’s side effects, no questions about whether I had experienced any of the associated problems, just a new prescription for the product.
After buying the prescription a medication guide tells patients to tell their doctor if they have had tendon problems, but that's too late. No one gets to talk to the doctor about such things after the appointment. The doctor should ask patients if they have any tendon problems.
No information provided at the time of the appointment gave me a warning on what I would face in the next few days. It would have been prudent for the surgeon to have asked questions that I had no knowledge of the need for before prescribing that medication again so soon.
He could have mentioned that among other things, fluoroquinolone induced tendon ruptures and tendinitis can be a serious side effect and that I was close to the age when the warnings issued for all ages become more critical.
He could have explained something of how experience indicates that this medication may cause ischemia resulting in tendon ruptures, and that there is the possibility of the drug directly attacking tendons' collagen fibers, even after only a single dose.
He could have also, in all fairness, mentioned that there are a number of other reasons not to take fluoroquinolones if an infection is not life-threatening unless I was willing to risk toxicity that could possibly be life-changing or worse. I have to wonder if he is even aware of these issues.
It was my responsibility to read all of the paperwork that came with the prescription, and I accept that (not that I would have understood most of it at the time), but when a person is sick, medical professionals have a responsibility to reasonably discuss possible issues with what they prescribe to the person trusting them.
Being considered a hypochondriac has patients fearful of expressing concerns, but pain medicines and antibiotics can work together to put patients in a fog. Professionals should recognize that their patient's thinking is likely fuzzy and take the lead in discussing concerns, especially when there are known issues.
Have you, a family member, or a friend experienced side effects from Cipro?
Understanding Cipro Related Tendinitis and Doctors' Thinking on the Topic
Beyond My Experience
My experience is wrapped up in various details. The problem ankle flares up once in a while so it took me some time to make connections to the medication. I was not in a position to do my best thinking and I expected the surgeon to know the wisest course of action.
There is more to it all, but on this end I’m reminded again that patients need to sound alarms to their doctors and to each other about their experiences with medications.
The list of FDA warnings on fluoroquinolones, aka Cipro in my case, is alarming. Additional problems with medicines that have such warnings are that health care professionals either
1) dismiss the warnings outright or
2) they will not have an advisory discussion with patients but rather approach them with an aloof attitude that puts the responsibility for the decision on whether to take the medication on the patient who most often does not know the risks or what is best and has no chance to do research at the moment of decision.
After talking to friends over the last few days who have taken this medication in the past I have come to some conclusions:
• These responses may well be rooted in a lack of knowledge on the part of the very people that patients are trusting to know best.
• The side effects mentioned in the patient information leaflets are not minimal, nor are they uncommon.
From another state, one friend described her nightmare experience with this medication and the effort to try to get help from her health care professionals. Clearly, she was dealing with people who did not know what the problem was and did not care to help her find the right solutions. She suffered for months due to several of the side effects of Cipro.
There is help and hope for people who suffer from ongoing side effects of fluoroquinolone drugs. Exploring the schools of thought on the topic is interesting and useful. You might like to begin with the following sites:
Children and Cipro
In the 50s scientists and doctors promoted the idea that disease would be eradicated by antibiotics and vaccines. While there is no doubt that lives have been saved by the efforts of men like Fleming and Salk, we now know that there are dangers from these drugs that we need to take into account.
When I was growing up, children were glibly given antibiotics, but times have changed. Anytime a child needs an antibiotic the directions and cautions should be taken seriously. Cipro is not ordinarily prescribed for children, but it is sometimes given to them.
The following sites offer information for parents who want to be prepared to deal with health care professionals who may prescribe flouroquinolone drugs to their children:
Learn More About the Side Effects
From this Point Forward
After realizing that the antibiotic I was given created new health concerns I called the number listed for the FDA on a patient insert that came with my prescription. It reads, “You may report side effects to FDA at 1-800-FDA-1088” and a real person answered after I punched through the recorded directions.
On this end I wish I had asked the lady about herself, but I am sure she must have been a health care professional of some sort, and she was truly interested, kind, and patient. She directed me on how best to report the side effects, then began a conversation about my immediate condition that was very useful to me.
Also, I have opened a note file on my phone and titled it NoNo Meds, listing Cipro and the side effects I’ve experienced. As well, putting a note about that in my wallet would be a good idea. This recent emergency has taught me more about the need to be ready with vital health information.
I’m studying more about how to help the healing along, but if the tendonitis continues it may be that I wind up seeking help. I will give updates in comment responses below if readers ask for them. While I am hoping that I will be able to take care and heal from this point on, I have also learned more about how one never knows what a day will bring.
On a personal note, I am thankful that I can pray about the issues I face. The rest time over the next few weeks is an opportunity to study God's Word more and trust that He is at work in the situation. My heart goes out to sufferers who do not have the confidence of His help that comes from a relationship with Him according to His Word.
Join the Fight for Awareness
Questioning My Husband's Experience
About 10 years ago my husband had surgery to repair his right shoulder's rotator cuff. It was a successful out patient procedure that he was grateful for, especially once he had pain-free use of his again.
During his initial recovery he displayed unusual behavior that I blamed on pain medications which are much needed in the first couple of days after this surgery. He chose to go off those meds as soon as possible and his recovery and therapy went well.
Interestingly, about 5 months after the surgery he reached out to start moving a small bag of mulch and felt a snap in his arm. On examining it, he found that a muscle was bunched up in his upper arm making him look like Popeye, but he only had mild tenderness from the event.
That meant a new appointment with the surgeon who did a thorough investigation of the problem. He was very puzzled because he had examined that muscle's tendon at the time of surgery and found it to be intact and in no need of intervention.
He offered to repair it but did not recommend the procedure because there are risks with surgery and the surrounding muscles would compensate for the loss of that one. Though we live in a fallen world with danger, illness and accidents always a risk, we are amazingly designed! My husband agreed for he did not want surgery again.
Now, after my experience with surgery and consequent side effects from the fluoroquinolone antibiotics, we are wondering 1) if the tendon for that muscle was damaged by the antibiotic he received during surgery, and 2) if his orthopedic surgeon had any idea of the risks involved with using that antibiotic.
This far out it is difficult to know for sure, but even though many health care professionals mock anecdotal evidence, my husband's incident is certainly food for thought if one is willing to take a serious look at the side effects of these antibiotics. Patients are complaining, and we can't help but wonder if others experienced what my husband experienced after rotator cuff surgery.
Fluoroquinolones: An Interesting Study
Researching the problems associated with the side effects caused by the fluoroquinolones has been sobering. I have learned important information about how to take care of myself during the healing process, learned that sensitivity to this class of medications runs in families, and more.
Periodically researching this topic is important for anyone who has taken these drugs because symptoms can surface months after finishing prescribed courses of it. Sufferers are sharing what helps and what hurts their attempts to find healing for the benefit of others.
Discussions on the pros and cons of using fluoroquinolones are useful, but it is important to read a balance of information. Articles like this from a doctor are followed by comments from people with experience.
Another post mockingly comments about anecdotal evidence of side effects while victims' reports range from the highly emotional (certainly understandable in some cases) to the matter of fact. Remember to remain balanced as you wade through information to find truth.
If you have ever taken any of the fluoroquinolone drugs and would be willing to share your experience with it, please do so in the comments section below. Taking advantage of the opportunity to communicate about issues online is a chance to learn more and help others think through the concerns.
Danger in the Hospital
Medical Advances: What does the Future Hold?
Reading up on the various and complex side effects that fluoroquinolones can cause has provoked too many questions about what is happening in our society. That some drug stores offer Cipro free with a prescription (it's very inexpensive anyway) would make some patients thoughtlessly prefer it over other antibiotics.
Even scarier is that I discovered how this powerful antibiotic can be purchased without a prescription online. It is available in other countries without a prescription, as well. What the easy availability of these medications has done to the health of modern society is yet to be determined. History may one day tell a sad tale.
Since side effects can include confusion at best and severe kinds of anxiety, seizures, and psychiatric events I wonder about some of the horrific acts of violence we've seen, I wonder if any one else is asking whether instigators have taken this class of antimicrobial meds. Some things can't be explained except to say that evil exists, but how these meds affect some people gives pause for thought. That they are combined with other scary meds makes the questions even bigger.
Eye issues should be looked at twice if there is a history of fluoroquinolone use. Also, considering the body of evidence causing scientists to question these drugs, are they why we are seeing a rise in liver function abnormalities, renal disorders, dermatologic reactions, hepatic issues considered mild and reversible (except by the patients having a different experience), specific heart conditions, mysterious immune system disorders and more?
Having dealt with the many issues that come up when trying to help a relative in a nursing home, I have some experience in watching the medication lists stack up. I have loads of questions about the changes I've seen in some of the patients I've come in contact with, but in my own relative's case the questions are quite specific.
Preventable Dangers: Experience with System Failures
Being in a nursing home means that antibiotics will be periodically prescribed. In those settings, infections are common, and they can be rampant. Due to my experience I am just now connecting some of what I've seen in my relative to the antibiotics she has been given, and I plan to do more research on the interaction of fluoroquinolones and other meds on her list.
For instance, a doctor told me that she does not have dementia, so I've questioned what causes some of the behaviors I've seen, but there are no answers. Do they know what they are doing by mixing these meds, or are they ignorant of the side effects, overwhelmed with what they face, and just adding more meds to treat the conditions they are presented with on a day to day, week to week, month to month basis?
Many questions come to mind, but getting healthy and staying healthy is the best thing for me to focus on. No big news there, of course, but after a major medical event and the resulting side effects I find that I am even more inclined to take care of myself so I can stay away from the medical community as much as possible.
I'll close with an abbreviated example from a friend in yet another state. She was in a serious automobile accident, taken to the ER for initial treatment, had surgery, and spent time in ICU. As her body tried to heal in the unit, her mental condition deteriorated. She was aware and tried to communicate her concerns, but she was up against the opinion of medical professionals.
Useful Information on Antibiotic Use:
• Benefit from a discussion on using antibiotics.
Her sister questioned what was happening, but the professionals told her that they sometimes see this, that it was an ICU syndrome, and that they might have to send her to a psych ward. Her sister knew nothing more than to trust the professionals, but this patient fought to communicate that she knew the medications were working against her.
As a result, thankfully, her sister demanded an investigation in which it was discovered that not only had wrong medications been administered, but that there are side effects when some of what was prescribed for her was mixed together, fluoroquinolones being one of her prescriptions.
After this patient was home and her regular physician discussed her records with shock, there was thankfulness that she survived the events that occurred during her hospitalization. She was too weak to pursue a suggested lawsuit (imagine how bad it is when a doctor recommends that).
Doing so would have highlighted the truth about what can happen, but we should all be wondering how many people have suffered while medical professionals ignored or were ignorant of the side effects of medications.
There are times when the benefits outweigh the risks, but in those cases, it is not okay to ignore the fact that the side effects are the cause of symptoms causing a patient to suffer. Approaching symptoms from the right perspective is crucial to solving the problems.
We are indeed grateful for help from health care professionals and all their tools when we need them, but we need family members or friends to be personal advocates if in a medical crises. They must be watchful, willing to question and then check out everything happening to the patient, especially as political policy becomes more ingrained in the medical system.
By educating ourselves along the way we can help educate professionals who may not even be aware of the the facts on the drugs they prescribe and be personal advocates for family and friends who are at the mercy of what they face in a medical crisis at the hands of the medical system.
• Important Note:
I am not a health care professional. This post cannot replace your health care provider’s advice. If you have a health concern, you are responsible to consult a doctor. Discuss this information with your doctor and do not use this information to diagnose or treat yourself.
Medication Overdose: When will Nurses and Residents Speak Up?
Fluoroquinolone Damages Tendons
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