When her doctor tore a sheet off the prescription pad and handed it to Alesandra at the end of her annual check-up, Alesandra never imagined that the treatment would lead to a 10-year nightmare she would be lucky to survive.

Before that doctor's visit Alesandra, age 35, was healthy. She was not taking any medicine. She didn't smoke. She didn't drink. Working for an engineering firm based in San Diego, she traveled extensively, handling clients around the world. Alesandra reported, "I was successful. I was doing quite well."

That life ended with her annual check-up. It wouldn't have occurred to Alesandra to have made an appointment to seek help for her insomnia, but when her doctor asked if she had any complaints, she mentioned it.

Her doctor did not ask if Alesandra wanted a drug to help with her trouble sleeping; she just handed Alesandra a prescription. Always one to follow the rules, Alesandra obediently took the prescription and stood in line at the pharmacy to get it filled, without thinking much about it.

Soon after, Alesandra recalled, "Everything began to come apart."

First, she developed bronchitis. She thought that this situation was strange, because she never got sick. However, she simply took the prescription she was given to treat the infection, not learning until much later that lung problems were a side effect of the sleeping pills. Then the potent antibiotic she was given for bronchitis caused bizarre heart arrhythmias. Because no one realized at the time that this condition was a side effect, it too was treated by adding another drug to her regimen.

And so it went, for 10 years.

Each of Alesandra's new medical problems was treated as if it had arisen in isolation. Alesandra was sent first to one specialist, and then to another. Each treated the new problem in yet another body part as if it were the only medical issue she had.

Each prescribed more drugs. None mentioned that drugs have side effects.

Eventually, Alesandra was taking more than 30 pills a day. For many years, she suffered from repeated seizures, lung infections, breathing problems, urinary tract infections, muscle weakness, back pain, insomnia and depression.

In the prime of life - her 30s and 40s - she ended up living on disability checks.

She didn't realize that all of her problems were caused by the drugs she was taking, because she didn't get sick right away when she started a new prescription. It was typically several weeks after she started taking a drug before a major new symptom developed.

Too frequently, doctors also don't realize the connection between drugs they've prescribed and new problems that crop up afterwards.

Dr. Beatrice Golomb at the University of California at San Diego identified patients who had talked with their doctors because the patients felt that they were experiencing side effects of a drug. She discovered:

1. In nearly 80 percent of the cases when patients thought that new symptoms they were experiencing might be side effects of a prescription drug, the scientific evidence strongly suggests that they were right.  
2. In up to 98 percent of the cases in which patients were experiencing side effects, it was patients - not doctors -- who suggested a possible connection between a drug they were taking and a new symptom.      
3. When patients were experiencing common and well- documented side effects, doctors acknowledged that there might be a link to a drug as infrequently as 19 percent of the time.

In about half of the cases when patients were experiencing common and well-reported side effects of a drug, doctors said things like:

• You're just getting old.  
• There's nothing wrong with you; it's all in your head.  
• These drugs don't have side effects.  
• It's impossible for this symptom to be caused by this drug.  
• There's no research linking this drug to this problem.

What happened to Alesandra? After 10 years of needless suffering, she rebelled. Through a near-fatal process she wouldn't recommend to anyone, she stopped taking all of the pills and reclaimed her life. (She has since learned better ways to transition from taking multiple drugs to taking none, and advises others how to do so. For more information, visit her website at www.pointofreturn.com.)

Now, she reports, "I am nearly 54. I am perfectly healthy. I can walk fine. I have no pain. Today I am not on any medicines - just nutrients and good food and exercise."

What can you do to avoid a nightmare like Alesandra's?

Ask questions. Do some research. Read the package insert. Never assume that a new symptom is just a coincidence, unrelated to medicines you are taking. Talk to your doctor or pharmacist. Be persistent.