Awards for Pharmaceutical Ads?!

Damn. I knew I should have taped it on my Brighthouse DVR! I never knew an awards ceremony could be so dramatic.

Side Effects May Include.....
Yes, they give out awards for pharmaceutical ads.

By Seth StevensonPosted Monday, Nov. 16, 2009, at 2:11 PM ET

"Imagine," said one attendee of the first-ever Clio Healthcare Awards, held in Manhattan on Friday night, "that you're making a TV commercial for a new Nike sneaker. But you aren't allowed to talk freely about the sneaker. Instead, you have to show a pair of bare feet, and then tell the viewer he can solve his barefoot-ness by asking his doctor about Nike. That's the challenge for most pharmaceutical advertising."

In fact, the challenges don't end there. To further the analogy: The barefoot viewer might not remember which shoe brand he was supposed to ask about. The doctor might decide he'd rather prescribe a pair of Adidas. And, upon arriving at the shoe store, the sneakerless man might discover that his insurance plan only covers Reeboks.

None of these obstacles have stopped pharmaceutical companies from spending billions of dollars each year on ads. In the first quarter of 2009, only the automotive and fast food categories spent more, while Hollywood and wireless phone service providers spent less. In fact, there is so much advertising touting the efficacy of pills these days that some researchers suspect it may be making the placebo effect stronger. To watch a network news broadcast on a weekday evening is to be made aware of pills that treat sleep disorders, sexual dysfunctions, balky bladders, and countless other maladies—be they physical or mental, serious or trifling, well-established or newly minted.

The advertising creatives who write these ads deserve to win silly industry awards at least as much as their peers who write ads for sports cars and flat-screen TVs. But it's nearly impossible for pharmaceutical ads to achieve victories in the regular Clios competition. Pharma ads face special regulation from the FDA, their subject matter is often inherently grave, and half their airtime is eaten up by lists of gnarly-sounding side effects. They're at a disadvantage from the get-go. It's only fair to rank them against their own kind.

Enter the Clio Healthcare Awards. A sort of Paralympics of advertising, taking the form of a cocktail party occasionally interrupted by trophy presentations. The bartenders wore medical scrubs. The vodka drinks were labeled "flu shots." And sobering thoughts about profit-sapping health care reforms were set aside—perhaps because the pharma executives in the crowd were aware of the ongoing, industry-wide drug price hike.

Among the big winners in this year's inaugural event (click here to see a complete list):

The top prize in the television category went to Ambien's "Silence Your Rooster" campaign, in which insomniacs are shown silently confronting an ominous cock in the wee hours of the night. These 15-second spots won awe and respect less for their content than for the content that they're missing. They never once mention the product's intended benefit or even its name, instead directing curious viewers to the Web site SilenceYourRooster.com. Because no medical claims are made, the ads sidestep FDA requirements regarding disclosure of side effects. Which in Ambien's case include a few doozies: hallucinations, sleep-eating, and an increased risk of suicide.

Ad execs I spoke to marveled at how brave Ambien was to spend money airing ads that contain no product name or logo. I agree it's a gamble. And I think the rooster metaphor is effective, if facile. But given that they've freed themselves from all those constraints that limit other prescription drug ads (for good reason—it's no surprise they're less than eager to talk up the hallucination and suicide angles), shouldn't these Ambien spots be every bit as funny, clever, and memorable as the better ads for traditional consumer products? Because they're not. And my one-word review is: yawn.

A silver Clio, in the "Devices and Diagnostics" category, went to two GE television spots for medical equipment. In one, a doctor travels to rural India, carrying along a compact electrocardiogram machine in his briefcase. In the other, a man and woman in a small Chinese village meet cute when she reads his X-rays to the strains of an enchanting backing track by Chinese pop singer Cao Fang. Both ads are harmless. Even a little bit charming. But I disagree with the Clios' categorization here: These seem less like ads designed to sell electrocardiogram and X-ray machines, and more like feel-good, corporate-image spots for GE. (And I would note that the bar is set fairly low for these: A previous GE ad—featuring sexy coal miners—was among the more offensive ads I've ever seen.)

Another silver Clio went to NuvaRing's ad for a contraceptive vaginal insert. Ad Report Card has previously reviewed this ad, in which synchronized swimmers illustrate the wearying repetition of swallowing a birth control pill every day. A major complaint about health care ads in general is that the mandatory recitation of a product's list of unsavory side effects is almost always accompanied by pleasant, distracting visuals—the better to steer the viewer's mind away from thoughts of abdominal cramping and "loss of scalp hair." I must congratulate NuvaRing for hitting on what is perhaps the ultimate distraction strategy: women in bikinis. But bikini-clad gals seem improperly utilized if the plan is to distract women (who are the target audience for NuvaRing ads). They should have saved this brilliant tactic for obfuscating the side effects of a prostate drug.

A bronze Clio went to an ad for VESIcare—a pill that combats bladder leaks. The people in the ad are made of copper pipes with what look to be pressure gauges where their crotches should be. By not using human actors, and by portraying untamed bladders as leaky pipes that simply need to be patched (as opposed to symptoms of the viewer's inexorable, fleshy decrepitude), the ad diffuses some of the emotion and embarrassment that go hand-in-hand with treating a bladder problem. It emphasizes the notion that a pill can offer a simple, straightforward, almost mechanical fix—which has always been the most powerful pharmaceutical promise.

My vote for the ickiest winner of the evening? A Takeda Pharmaceuticals print ad that directs us to the Takeda-owned Web site Gout.com (and more indirectly toward Takeda's gout drug, called Uloric). The ad shows us a pair of feet. The left foot is normal. The right, instead of toes, has five emergency flares—one of them lit. This visual concept, which I'd prefer not to dwell on for longer than I have to, apparently addresses the fact that gout can cause excruciatingly painful "flares" in your feet. The target audience here is people already suffering from gout. But the imagery is so powerful that I, a non-gout-sufferer, clicked through Gout.com in a terrified frenzy, desperately hoping to eliminate my own risk factors. Goodbye, purine-rich foods!

My favorite winner? A print campaign for a hearing aid called Vibe, made by Siemens. The device wedges into the folds of your ear and comes with interchangeable covers in different bright colors and patterns. The idea is not to conceal the hearing aid, as manufacturers have done in the past, but rather to embrace the hearing aid's potential as a fashion accessory. With baby boomers entering their deafer years, I expect that hearing loss will soon become less a private shame (how mortifying that I can't hear anyone—I'll just nod and smile) and more a badge of pride (I blew these suckers out at Woodstock, man! So speak up!). The Vibe seems poised to capitalize on demographic trends. And the print executions are simple and arresting, with profile shots of attractive, confident people matching their Vibes to their outfits and personalities.

The honorary Clio went to Dr. Mehmet Oz, who became famous as a frequent guest on Oprah Winfrey's show and is now launching a syndicated daytime program of his own. I asked him if, in his medical opinion, he thinks pharmaceutical advertising is effective. "Well, people don't come to my office asking for statins," he said, invoking the generic term for cholesterol-lowering drugs. "They ask for Lipitor. So I guess the ads work in that sense."

No doubt they do. It's worth recalling, though, that former Lipitor spokesman Robert Jarvik was dismissed from Pfizer's campaign when it came to light that he wasn't a cardiologist, wasn't licensed to practice medicine, and didn't actually know how to pilot a rowing shell across a glassy lake. The moral of the story: Ads can be deceptive, whether for statins or for Shamwows.

Ramblings

Not feeling too terribly talkative the past few weeks, folks. As a matter of fact I "deleted" the blog for a while. Stills scratching my head about exactly how I wound up with more Followers .... Blogger is a bit strange.

In any case, I apologize for disappearing so suddenly and I welcome the newest Followers. I know you will learn a lot by browsing around this immense beast called Fibromyalgia-Journal. If you have any questions about guai- hit me with 'em!

So why did I disappear? There was a big blow up over at the WeAreFibro forums and let's just say that I am thoroughly disgusted with a few people over there. I'm leaving my guaifenesin community up and running in order to educate the curious, but I am not involving myself any more in the main forums. Too much drama. I directly quoted someone off of a research site and all of a sudden I'm "plagiarizing" ?!!! wtf?! Sheesh. I always give credit where it's due. Always. All I did was disagree with the person I quoted. Whoops. My bad. My only consolation is that the person who started name-calling is no longer on WeAreFibro. It was really ridiculous and got blown out of proportion.

I guess I'll have to save my radical thoughts for my personal blog.

Freedom of speech is such a bitch. You only have the freedom to speak in your own house.

I think that I'm done browsing around the fibro forums. It's getting boring at this point. Unless some spiffy new product or research comes out I'm not going to be making any appearances elsewhere. All the stuff I've seen on fibro-forums now is just rehashing the same old crap over and over and over again.

Update: I got married on the 16th of October to my sweetheart of ... six? years. My two stepsons were the ring-bearers. It was a nice little black-tie affair.

Other than that I think I'm doing alright. Same med doses. Had to really cut back on the physical activity because of some hellacious cycles with fatigue. Still recovering. Had a bad couple of days last week where I couldn't sleep at all. This is simply cycling of the sleep area of the brain. I'm not at all surprised by it. Typical guai craziness. After a few tense(and truly miserable sleepless days) I finally recovered and am sleeping good again. I didn't have to resort to Ambien this time around. I simply wore myself out cleaning house, read, watched TV, and took my meds at my normal times. My brain simply shut down and went to sleep when it was ready.

I hope all my American blog Followers had a nice Thanksgiving with their loved ones. We did. Smithfield ham and some... egg-cheese-broccoli casserole .. concoction I made up. The hubby suffered but ate it with smile on his face. The store bought triple chocolate cake was delicious as a desert. *lol*

Cheers!

Progress Update

It's official. I have declared myself physically capable of doing strenuous exercise.

I started JOGGING. Nope. I'm not high. The crack pipe was never raised to my lips to begin with. And no I'm not sleepwalking or wishfully dreaming. I can jog! Granted, it's on a treadmill and therefore a great deal cushier than hard ass pavement but ya know what- I'm too busy patting myself on the back to care about those details. My muscle tone is coming back. The 'jiggle' is slowly disappearing.

Since I was nineteen I believed that my knees were shot. That's what multiple docs told me, even as they wrote out scripts for Naproxin and a multitude of other nasty chemicals to eat up the lining of my stomach and esophagus. Turns out it was just fibromyalgia making the nerves and tendons in my knees spaz out. The past few weeks my knees have been feeling increasingly more... fluid. Mobile. NORMAL. Not cranky and stiff. I acknowledge that Winter is hardly upon us yet but I'm not going to let that deter me from exercising or pushing myself. I know I do have a bit of arthritis in my knees, but it's not anywhere near as bad as what Docs believed it was.

Besides the jogging news, I'm doing pretty good all the way around. My meds are the same as what I was taking in my last Update. 600mg guaifenesin three times a day, 25mg Elavil at night before bed, and 10mg Baclofen three times a day. I've noticed the past week that I can't resist my bed anymore after my morning dose of meds. I guess the five hours of sleep I get just isn't quite enough. Two kids, their homework and other woes, spending time with the hubby, and other projects.... I don't typically get into bed until anywhere between 11:30 and 1:00am. Then the kids are up at 6:00am. .... yeah. I need the extra sleep after they're dropped off at the busstop. My body deserves it. And it's GOOD sleep, too! No more interrupted sleep patterns. That is a major milestone in recovery.

I think the only problematic areas in my life right now physically would be my periods. IBS + fibromyalgia can really kick a lady in the gut around that time of the month. That is one physical ouchie that is going to take a while to get worked out with the guaifenesin, I think. And for those not in the know- yes, having extraordinarily painful periods is a part of fibromyalgia. We can land in the bed for an entire week at times. Moderation is going to be key, I believe, in getting through it. Running or the ellipse machine is completely out during that time, but that doesn't mean I can't lay my hurting butt on the floor and stretch out and do yoga. The kids love doing yoga with me. Especially Bending/Balancing Stick asana, shown above. They practically fall over themselves trying to stick that one foot to the floor. Good fun.



PS. The chick in pink above? That's not me.

IBS-- Coeliac Disease in Disguise??

A Reader (Paul) commented on a post yesterday and it led me to new thinking concerning Irritable Bowl Syndrome. I'd like to share some research and thoughts on the matter.

He said, "I don't mean to assume you haven't investigated all things regarding the fibromyalgia, but I've heard so much these days regarding gluten intolerance I was just wondering if this is something you've checked out?"

I replied, "IBS is the one main symptom of it. Now, not all fibromyalgics have IBS. But a large percentage do. All of my vitamins and minerals have been tested for absorption rates. I'm fine. The interesting thing to note here, however, is that if guaifenesin didn't work as well as it does(+ yogurt every day) I would be dragging my ass into the doctor's office demanding new tests because of your suggestion!"

Here is a link to Wiki's definition and explanation of Coeliac Disease(gluten intolerance).

Here are a few tidbits from that Wiki article which I immediately honed in on.

"There are various theories as to what determines whether a genetically susceptible individual will go on to develop coeliac disease. Major theories include infection by rotavirus^[54] or human intestinal adenovirus.^[55] Some research has suggested that smoking is protective against adult-onset coeliac disease.^[56] A 2005 prospective and observational study found that timing of the exposure to gluten in childhood was an important risk modifier. People exposed to wheat, barley, or rye before the gut barrier has fully developed (within the first three months after birth) had five times the risk of developing coeliac disease relative to those exposed at four to six months after birth. Those exposed even later than six months after birth were found to have only a slightly increased risk relative to those exposed at four to six months after birth.<sup>[57]"

and</sup>

"Even while on a diet, health-related quality of life (HRQOL) may be lower in people with coeliac disease. Studies in the United States have found that quality of life becomes comparable to the general population after staying on the diet, while studies in Europe have found that quality of life remains lower, although the surveys are not quite the same.^[71] Men tend to report more improvement than women.^[72] Some have persisting digestive symptoms or dermatitis herpetiformis, mouth ulcers, osteoporosis and resultant fractures. Symptoms suggestive of irritable bowel syndrome may be present, and there is an increased rate of anxiety, fatigue, dyspepsia and musculoskeletal pain.^[73]

Everyone is different, but many people with coeliac disease also have one or more^[74] additional food allergies or food intolerances, which may include milk protein (casein),^[75] corn (maize),^[76][77] soy,^[74]amines,^[74] or salicylates.^[74]"

***************************

There are several experimental treatments mentioned as well as ongoing research. The only proven way to stop this disease in it's tracks is through a strict gluten-free diet.

The last two paragraphs I quoted are the most interesting to me because of the correlation between a few symptoms and fibromyalgia and/or chronic fatigue. The salicylate intolerance has my brain twisted in a knot. As part of the guaifenesin protocol the only salicylates we are told to watch out for are externally applied. Food with salicylates(which is just about EVERYTHING plant based!) are fine to consume since the salicylic acid is broken down during digestion before it reaches the kidneys.

Personally, I have never blocked my guaifenesin by consuming salicylate laden foods. I have, however, blocked by cutting onions with bare hands and having hand sanitizer laced with aloe extract splashed on me by accident. Not fun.

I'm starting to wonder if the salicylate intolerance the researchers of coeliac disease are speaking of happens further up in the digestive tract instead of in the intestines.

Point being- get tested. Have a full blood panel done. This includes liver enzyme testing and renal function. Also, if you have a family member who has coeliac disease you are more likely to have it. Working on that Family Tree project could be beneficial in more ways than finding out what so-and-so did for a living. It may help to properly diagnose you.

Personal Responsibility is Extinct?

Thesauruas.com's take on the word 'extinct':

Definition:	in the past
Synonyms:	ancient, antiquated, archaic, belated, dated, dead, defunct, departed, down memory lane, erstwhile, extinct, forgotten, former, gone, gone by, in oblivion, late, lost, of old, of yore, old-fashioned, old-time, olden, oldfangled, one-time, out-of-date, previous, quondam, sometime, vanished, water over the dam, water under the bridge

I'm writing about responsibility on two fronts- as a parent and as a fibromyalgic who takes medicine daily for her illness.

When exactly did it become ok for a parent to think that it was the school's job to raise our children and cram every little thing they should know into their heads?

And when exactly did it become ok for you to pick up your prescription from a pharmacy and just blithely go on your merry way not thinking of possible drug interactions or side effects?

I say the two are related because one of my stepsons has ADHD. He was taking Ritalin and Concerta. Today he was switched to Adderall. He's eight years old, gaining some weight and filling out; it was time. The old meds weren't quite helping him as much as they used to. I could start an entirely new blog devoted to nothing but what we've dealt with in his short life regarding his ADHD, meds, doctors, and teachers, however that's not going to happen. I have enough on my plate. Suffice it to say the change in his medication was necessary and we do believe in medicating our ADHD child. We want to give him the best possible tools to succeed.

Two things happened today which made my brain stumble a bit and the more I thought about it the more it made realize what a sign of the times it was. I'm not pissed off at my child's doctor, teachers, or anyone who he has contact with. I'm pissed off at the general masses. Parents. Specifically, parents who don't seem to give a rat's ass about their child's welfare. When it comes to having a child with a learning, cognitive, or behavioral impairment/disability you have to stick to them like white on rice. You have to. It's the only way to ensure they do what they're supposed to do when they should be doing it. When it comes to their medications it seems to me that the same would apply, wouldn't you think?

My son's doctor (Sweet lady. Really great.) told me after I was done explaining how his behavior had changed lately, "It is very nice to see you so involved with him. Most parents think it's the school's fault or just ignore it. But you are right on top of the situation and I can see that you really will fight for him to help him succeed."

The first three seconds after she said this I was pleased as punch. I thought, "Hey! She said that I'm a good Mom! YAY!" After the three second adrenalin rush of elation came the sense of bewilderment. Because the way I saw it, isn't that part of being a parent? I mean, fighting for your kids' right to a good education, learning good social skills, and getting prepared to live life on their own?? Was what I was doing for him really so unusual?

When I stopped by the pharmacy to pick up his meds I talked briefly to the pharmacist on staff to ask what the differences were between his new and old meds as well as if there were any warning signs I should be look for in the beginning if he was having a bad reaction to the change. The pharmacist acted as if he'd never had a patient ask such a question before. All he kept saying was, "It's similar to the old one. Nothing to worry about." Nice, man. So glad you're confident in the medication. But that still doesn't answer my damn question.

Both of these conversations made me think about certain themes I've seen in health forums. Yes, AND fibromyalgia forums!!

There is a certain .... apathy? or would that be neglectful? attitude when it comes to healthcare and education.

Why am I looked at strangely if I find it imperative to know what the possible reactions are to a medication? Or that somebody is doing their job? At first, people might say, "it's nothing personal, man. She just wants to know." But that's where you're wrong. It is personal. It affects a person on a personal level. It affects them directly.

So when I see threads about people moaning and groaning, "This med made my ankles swell up and now I'm short of breath. Can anyone tell me why?" It makes steam blow out my damn ears. It's like there is a cognitive breakdown in people's heads nowadays. It's impossible for people to research issues on their own. What happened to people reading the information they were given with the medications? Why would you not? You're putting chemicals into your body which will change how your body senses things. Why wouldn't you keep notes about how certain medications make you feel and then describe these things to your doctor? And furthermore, why are some people so gosh darn scared to call their doctor to ask for clarification on a medication? Doctors are only as scary as you make them out to be. If you treat them like normal human beings then they will talk to YOU like a human being- even if you have to raise your voice and growl at them to get your point across. If there is a communication breakdown then the fault is the patient's for not speaking up. Doctors can't help and can't give advice if the patient doesn't open their mouth.

I guess my point is: if you don't care about it then nobody will. So when stuff breaks who can you really blame?