POLYPHARMACY

With all my knowledge about medicine and Parkinson’s. I’m still amazed at how one minute I can be fairly normal and the next, completely abnormal.  Today is my worst day yet.  Not only am I miserable, but it started that way at 4:15 a.m. and is just now improving (2:00 p.m.).

So, what’s miserable?  Miserable is when every muscle in my body is stiff and my legs don’t want to walk.  I stutter step and feel like I’m going to fall. Usually, within 20 minutes of taking my pills, I’m better.  Today was as if I hadn’t taken my medication.

As a doc, I know how easy it is to make medication errors.  To guard against taking too many or too few pills, one day a month I set up my pill dispensers.  They have 4 slots for pills; morning, noon, midafternoon and night.   Each day I take out a full day’s worth of pills and if there are pills in a given slot, then I haven’t taken them. If the slot is empty, I took them.

As you age, it’s critical that you develop a means of monitoring your use of medications.  I set a recurring alarm on my phone and watch to remind me it’s time to take my medication.  Renee carries a back-up set of pills wherever we go just in case my CRS is active. Yep, I feel older than Methuselah.

Are you old enough to be on multiple medications?  If so, do you have a system set up to protect you from overdosing or of underdosing?  If not, please set one up.  Amazon has a large variety of pill dispensers.  Find one that fits your needs.  If your memory sucks, have a family member take over the task of loading your pill dispenser on a monthly basis.  If you are computer savy, set up a recurring alarm on your phone or watch.  If not, have your grandchildren program your devices.

When you pick up your medication at the pharmacy, make sure the directions on the bottle are the same as the directions given to you by your doctor.  Any discrepancies should be handled immediately. It’s important that you learn the names and doses of your medication. “Doc, I’m taking 2 white footballs, 3 yellow round pills and a beige triangular pill,” just doesn’t cut it.  There are lots of white football shaped pills and yellow round pills.  If you can, take a picture of each pill bottle and store it on your phone.

Unfortunately, medication errors are a persistent problem in our country, many leading to death or disability.  Being an active member of your medical team is essential.  Mistakes can occur in the doctor’s office, the pharmacy or in your own home.   It’s your responsibility to find them and have them corrected.  You are the end user.  You are the one who actually swallows the pill so if you think something is not right, don’t swallow the pill.  Talk to your doc and the pharmacist as soon as you’ve identified a problem.

Epocrates is an app that I’ve used for years.  It tells me everything about the medication I’m taking, including a physical description of the pill and the number embossed on the pill.  I believe the basic version of Epocrates is still free.  You will also need to download GoodRX.  GoodRX will give oney saving coupons to use in buying your medications.  The program is especially helpful when you are in the donut hole.

Lastly, on a yearly basis, it’s wise to verify that you still need your medications. As a resident, I used to be blown away by the number of unneeded medications the older docs had their patients on.  It seemed like once a medication was prescribed, its need was never reassessed.  I swore I would never do that to my patients.  Then I got older and found I was falling into the same trap my predecessors fell for.  Once started, there is a tremendous clinical inertia pulling on the patient and the doc.

“Doc, I feel good.  I’m afraid to stop ABC medication.  I don’t want to relapse and I’m so busy at work that, if I relapsed, it would be a catastrophe.  When things settle down, we can try stopping ABC.”

Invariably, the doc goes along with the patient’s request.  Things never settle down at work and the medication is never stopped. And that, my friends, is how you end up on 12 medications a day.

Here’s your song for the day and a joke.

An old woman walked into a dentist’s office, took off all her clothes, and spread her legs. The dentist said, “I think you have the wrong room.” “You put in my husband’s teeth last week,” she replied. “Now you have to remove them.”

Please follow and like us:

Leave a Reply

Your email address will not be published. Required fields are marked *