The side effects and complications caused by drugs and devices may lead to serious health problems. Sometimes, these complications are worse than the original illness or injury that led to the use of the drug or device in the first place. Treating the side effects of drugs and devices may require a doctor who has expertise with these specific conditions.
Finding the right type of doctor can save time and money and help avoid more health problems down the line.
For example, if a person suffers complications from a hip, hernia mesh or Essure birth control implant, a skilled surgeon may need to remove it. The physician will also need to be able to replace the implant or perform reconstructive surgery. If a person took a fluoroquinolone antibiotic such as Cipro (ciprofloxacin) or Levaquin (levofloxacin) and suffered nerve damage, he or she would need a neurologist.
Finding the right type of doctor can save time and money and help avoid more health problems down the line. Most importantly, it may even save the patient’s life and get him or her back on the road to recovery.
Primary Care or Emergency Physician
Primary care (PCP) and emergency (ER) physicians are usually the first doctors a patient encounters when they suffer a condition caused by a drug or device. These doctors have a broad general knowledge of a wide variety of conditions and may be able to help diagnose or treat an illness or injury.
When it comes to general side effects such as dizziness, cold and flu symptoms or pain in joints, these doctors may be able to treat basic symptoms and refer patients to specialists for more testing.
They will also help determine if the problem may be caused by a drug or device.
Primary Care Physicians
PCPs have the patient’s treatment history. This allows them to prevent or treat non-emergency drug interactions or adjust medication dosage. If a drug isn’t working for a patient or causes side effects, they can stop a medication and find an alternative.
PCPs are also able to refer patients to specialists. Many primary care doctors work in a group with specialists. This makes it easy for the doctors to share information and tailor treatment plans.
PCPs can help patients with:
- Preventing medication interactions
- Diagnosing non-emergency illnesses or injuries
- Changing medication dosage
- Finding alternative medications that work better for a patient
- Differentiating side effects from other illnesses
- Stopping or weaning off a medication
- Referring to a specialist
When a patient suffers serious side effects, they may end up in the ER. In fact, ER visits and hospitalizations because of drug-related adverse events are increasing each year, especially among seniors.
One 2016 study published in JAMA by Chad Kessler and colleagues identified data showing about 1.3 million ER visits related to adverse events in 2013-2014. People 65 and older accounted for about 34.5 percent of those visits, and nearly half (43.6 percent) of those visits led to hospitalization.
The majority of ER adverse events came from anticoagulants, antibiotics, diabetes medications and opioids. And a number of side effects from medications may be fatal if not treated immediately.
Some drug and device injuries that may require emergency care include:
- Medication overdose
- Severe allergic reaction – such as hives, swelling of face, lips or tongue and trouble breathing
- Internal bleeding – from blood thinners such as warfarin or Xarelto (rivaroxaban)
- Diabetic ketoacidosis — a buildup of toxins in the blood — from diabetes medications such as Invokana (canagliflozin)
- Low blood sugar – from diabetes medications
- Heart complications – ones that are linked to IVC filter migration
- Aortic aneurysm — rupture of the blood vessel wall — that may be caused by proton pump inhibitor (PPIs) such as Nexium (esomeprazole) or Prilosec (omeprazole)
- Acute kidney failure – such as ones from PPIs or other prescription medication
- Spontaneous fractures for a bad hip implant or drug – such as Fosamax (alendronic acid)
- Lactic acidosis — too much lactic acid in the blood — from metformin
- Serious drug interactions
- Heart attacks – ones caused by medication such as testosterone therapy or Avandia (rosiglitazone)
Orthopaedic surgeons are doctors who specialize in the diagnosis and treatment of musculoskeletal disorders and diseases. These physicians handle issues with tendons, nerves, ligaments, joints and bones. They specialize in different parts of the body such as the hip, knee, spine, ankle, shoulder or hand. Although they are surgeons, they can also recommend nonsurgical treatments.
Before and after any type of joint replacement or surgery, patients have a consultation with an orthopedic surgeon. Hip and knee implants are the most common types of joint replacements. If there are issues with these implants, an orthopedic surgeon can diagnose and treat the problem.
Revision surgery is a procedure to replace a faulty or failed implant. Some orthopedic surgeons may have more expertise in revision surgery than others.
Hip and knee implant complications orthopedic surgeons may treat include:
- Infection around the implant
- Pain or swelling around the implant
- Metallosis (excessive metal in the blood and tissues that can cause tissue death, bone death, swelling, pain and loosening)
- Loosening of the implant
- Fracture of a bone or implant component
- Implant failure
An endocrinologist specializes in the glands of the endocrine system, including the pancreas — the gland that releases insulin, the hormone that controls blood sugar. Endocrinologists treat Type 1 and Type 2 diabetes and their complications.
These doctors specialize in diabetes and its complications and have more expertise than a primary care doctor has. For example, endocrinologists have specialized training to treat diabetic ketoacidosis (DKA). One 2005 study published in Diabetes Care showed patients with DKA treated by endocrinologists spent an average of 3.3 days in the hospital, while patients treated by general physicians spent almost 5 days in the hospital.
People with diabetes may need an endocrinologist if they:
- Suffer DKA from diabetes drugs
- Need more help self-managing their disease
- Have frequent low blood sugar (hypoglycemia) attacks from medications
- Need multiple medications to control blood sugar
- Suffer other diabetes complications such as neuropathy
- Need to change diabetes medications or add insulin to an oral medication regimen
Vascular surgeons treat diseases that affect the blood vessels. They perform surgeries to repair damaged vessels, but they can also use medication and exercise to treat these issues.
If a patient suffers an aortic aneurysm that may be linked to fluoroquinolone antibiotic use, these doctors can repair the tear in the aorta. They can also monitor weak spots in the blood vessels to prevent aneurysms in the future.
Vascular surgeons also place and remove IVC filters. IVC filters are small, spider-like implants in the inferior vena cava that catch blood clots in people who cannot tolerate anticoagulants. If the filter moves or perforates a blood vessel, a vascular surgeon repairs the damage.
Patients with diabetes, peripheral artery disease or blocked carotid arteries will likely have to see a vascular surgeon.
A neurologist can help patients who are dealing with any kind of nerve damage or pain. While there are diseases such as diabetes that may lead to nerve damage called peripheral neuropathy, medication may also cause this condition. In most cases, patients who stop taking the offending medication recover. However, sometimes the damage lasts many years and may even be permanent.
Medical devices and surgeries may also cause nerve damage that leads to a neurologist visit.
Neurologists can diagnose the type of neuropathy and its cause and recommend a treatment plan. Treatments include corticosteroids, wearing special shoes or undergoing physical therapy.
Medications and devices that can cause nerve damage include:
- Hip implants
- Knee implants
- Transvaginal mesh for prolapse or stress urinary incontinence
- Hernia mesh
- Fluoroquinolone antibiotics (Cipro, Levaquin, Avelox and others)
- Chemotherapy (Cisplatin, Taxotere)
- Anti-alcohol drugs (Disulfiram)
- Anticonvulsants (Dilantin)
- Heart or blood pressure medications
- Skin condition drugs (Dapsone)
Laparoscopic surgeons specialize in minimally invasive surgery.
These doctors perform operations through small incisions or tiny pinholes using a laparoscope, a long fiber-optic cable with a small camera at the end of it, and special instruments. The surgeon uses this camera to look inside the body so he or she doesn’t have to make a larger incision.
Some types of laparoscopic surgery include hysterectomy, hernia repair, and pelvic prolapse repair as well as gastrointestinal surgery and surgeries to remove parts of the colon or kidney.
Laparoscopic surgeons are the most qualified to remove hernia mesh implants and repair damage to internal organs caused by the implant.
Urogynecologists are specialists who deal with female pelvic and sexual health. They have special training in the female anatomy and some are laparoscopic surgeons who specialize in pelvic surgery.
Unlike obstetricians, urogynecologists don’t typically deliver babies. They also have more training than regular gynecologists do, particularly when it comes to surgery.
These doctors are specialists who can treat pelvic organ prolapse, stress urinary incontinence and vaginal disorders. They can also perform surgeries to correct complications from transvaginal mesh and other pelvic implants.
Urogynecologists can remove the following problematic implants:
- Transvaginal mesh implants
- Mirena IUDs
- Mesh bladder slings
- Essure Permanent Birth Control System
A number of drugs and devices may increase the risk of cancer. Oncologists are doctors who specialize in treating cancer. Oncologists may specialize in specific body parts or age groups of patients.
Some cancers linked to drugs or devices in studies include:
Cardiologists can help manage heart damage or perform surgery to treat heart problems. One of the most serious side effects from a medication is heart problems. These can range from irregular heartbeats to heart failure.
Medications linked to heart problems include:
- Testosterone therapy such as AndroGel or Testim (heart attacks, strokes)
- Actos (congestive heart failure, heart attack, stroke)
- Avandia (congestive heart failure, heart attack, stroke)
- Vioxx (heart attack)
- Onglyza (heart failure, heart attack)
- Proton pump inhibitors such as Nexium or Prilosec (heart attack)
- GranuFlo and NaturaLyte (heart attack)
- Yaz and Yasmin (heart attack, stroke)
- Risperdal (irregular heartbeat)
- Celexa (irregular heartbeat)
Choosing a Doctor
Now that you’re ready to choose a doctor, what’s next? With all the choices available, it can get confusing. Here are some tips to help narrow down your choices.
- Ask Your Primary Care Doctor
Some people feel restricted when they must choose a primary care doctor. But these physicians can help you keep track of your health and treatment history, keep a record of your health history and have a strong handle on bad drugs, updated medications and other special considerations you may have.
Primary care physicians often know about local doctors who can help people with your condition. They can usually recommend a good doctor for you to see. However, make sure they are not simply recommending a specialist who is in the same doctor group as they are. If you want more than one recommendation, simply ask for more.
- Check Your Insurance Company
This is important: Make sure the doctor you are interested in seeing is covered by your insurance. If not, some doctor’s offices may take you anyway and offer to treat you on a sliding fee scale.
- Consider Hospital Affiliation
The doctor you choose may also determine the hospital you will be admitted to if needed. Make sure you check to see what hospital the doctor partners with.
- Online Reviews
Check the Internet for doctor reviews. How well is the doctor liked by the patients? This is a good barometer of quality of care. If you like what you read and the doctor is nearby, visit the office and ask more questions.
- Bedside Manner
A doctor should be open to listening to your concerns and support you to make good decisions. Doctors are people, too, and sometimes you might not get along. It’s important to find a doctor whom you trust and with whom you are comfortable.
- Office Staff
Often patients may spend more time with nurses or assistants than the doctor. Are they friendly, efficient and respectful of patients?
- Ask About Office Policies
Make sure you find out what sort of policies a doctor’s office has. For example, does the office make same-day appointments? What is the policy on cancelled appointments? How long are patients in the waiting room before seeing your doctor? Sometimes, you might not know how all of this works until you are already a patient. If the policies don’t fit your needs, find another doctor.
- Drug Reps in the Office
Ask the doctor’s office if they have pharmaceutical reps in their offices to pitch new drugs. Sometimes this can influence the drugs the doctor prescribes in the office. You want a doctor with the patient’s best interest in mind, not a pharmaceutical company’s.
- Red Flags
Has the doctor been through any disciplinary actions? Make sure the doctor you are considering has a clean record. Unfortunately, many government databases for malpractice such as the National Practitioner Data Bank do not identify doctors to the public. But hospitals and health care companies can check to see if a doctor is in good standing, so you can ask your insurer if they have information on a physician’s standing. Some states, such as New York and Illinois have some databases available to consumers. Try a Google search to see if there is a state database or search for your doctor’s name along with “malpractice” or “lawsuit.”