It’s bad enough getting older without being medicated to death.
All medicines, even the best, have side effects, and some are pretty nasty! The good or beneficial effects of medication are the ones that treat disease or symptoms. The side effects can make you sick or kill you. For the patient there is always a price to pay in the delicate balancing act of benefits vs. risks. By applying the timely tincture of simple sense there are ways to reduce the risks.
Many patients, particularly seniors or semi-seniors, take a wide variety of medicine for heart disease, hypertension, elevated cholesterol, diabetes, obesity, arthritis, chronic lung disease, etc. Many also use nonprescription vitamin and dietary supplements.
Sometimes under the regulatory rush of managed care no one physician, pharmacist or even the patient knows all the medications being ingested, injected, applied by patch, liquid, ointment or cream. There’s the rub!
A survey of 1,000 adults was conducted last fall for the American Society of Health-System Pharmacists, which represents pharmacists who practice in hospitals and other health care institutions. As expected, more people tended to take more prescriptions as they grew older. Seventy-nine percent of respondents over age 65 reported taking at least one prescription drug each day, as opposed to 28 percent for those 44 or younger. The survey also found that about 8 percent of people entering a hospital don’t report to doctors or nurses what medications they’re taking.
Drugs, foods, emotions, exercise and just about everything else interact both positively and negatively with the body’s natural defense mechanisms. Each of these elements may make a medicine less or more effective — which can lead to medical problems from not enough or too much drug activity.
How many people know, for instance, as Dr. James F. Fries notes in his 1994 book, “Living Well,” that “antacids can decrease the effectiveness of antibiotics”? As it happens, a person on two medications will likely have fewer interactions than a patient on 10, who will have the potential for millions (factorial 10) of drug interactions. Needless to say, no physician can completely understand all the interactions possible when multiple drugs are used.
Diseases interact as well; for example, high blood pressure can cause kidney failure. And kidney failure can increase high blood pressure.
With seniors averaging over a dozen prescriptions every year, innumerable possible complications and interactions are possible. No wonder grandma or grandpa might seem a little sleepy for weeks or months on end.
Indeed, Dr. Fries estimates that “10% to 20% of hospitalizations for seniors are the result of drug side effects.”
Avoiding medication problems is better than managing them later, even though most people do have problems sooner or later. Fries’ book provides an excellent overview with detailed guidance and advice on drug usage. For example: “Seniors eliminate drugs from their body slowly and usually need only relatively low doses.”
- Be patient with your symptoms and your symptoms may become patient with you. “Instant relief” can lead to “instant complications”! Sometimes it’s better to endure the mild symptoms (such as mild cough, fever, runny nose or pain) than to try to feel better instantly. Give your normal bodily defense mechanisms a chance to work!
- Avoid sleeping pills, pain pills and nerve pills if at all possible. They have a lot of side effects and usually don’t cure the problem.
- Changing lifestyle is better than medication. For example, you may love pickles — which are loaded with salt. But if your body retains fluids, your life will be much less complicated if you cut down on pickles instead of taking a diuretic (water pill).
- Minimize the variety and quantity of optional, nonprescription drugs you take.
- Make a list of all medications, vitamins and supplements, and check it twice. The list should include name, use, dosage and how often you really take every pill, tablet, etc.
- Update your list every time you see a new doctor. Change, add, or subtract medications and alter dosages.
- Make sure your physician sees your list with each visit. Have it ready to save valuable time — particularly during the for-profit managed care eight-minute office visit.
- Your physician should likewise keep a copy of your medication list.
- Try to minimize the number of pharmacies used and keep your pharmacist up to date.
- Most pharmacists have a computer program which can check for drug interactions. Ask him or her to check every time you get a new prescription. However, if you use several pharmacies, the problem is that these computers presently do not connect to other chains — or even within their own network.
- Avoid overuse of alcohol. One dose (drink) per day may be healthful to most people. Although Irish playwright Brendan Behan once quipped,” There’s no such thing as a large whiskey,” his liver did give out before he was 40.
The good news is that Americans are living longer and better than ever before. By following these common sense rules, the patient, family, physician and pharmacist will benefit. Although most of us will ultimately require some type of medication there is no reason to be medicated to sleep or death! Prevention is healthier than cure.