Issue Date: July 1, 2007
When getting better is up to you
Get motivated. Take your medicine as directed. And don't let these obstacles hinder you.
Last week, I wrote about the problems that lead many of us to be less than consistent when taking medications. It's an important topic, because as our nation's population ages, many must rely on drug treatment to maintain their health. Today's medicines offer hope for staving off the ills of many chronic diseases that previous generations simply had to endure. As a result, anything we can do to remain compliant with therapy is a plus for our bodies.
What provides appropriate motivation to take medicine? First, there must be a sense of importance about treating a condition. Not all medical problems must be treated, even if available therapies are effective. That is where a conversation with your doctor is critical. For example, choosing to forgo treatment for your nagging allergies may mean you're miserable during ragweed season, but it won't kill you, either. On the other hand, not treating high blood pressure can have dire consequences, so forgoing therapy doesn't make sense.
Developing a game plan with your doctor can make seemingly insurmountable problems better.
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Your doctor can walk you through the risks related to your particular medical condition, which can help you decide how important it may or may not be to treat it. This approach is especially important for treating those chronic medical conditions that, while potentially devastating, often aren't symptomatic. High blood pressure, high cholesterol, diabetes, even heart disease all can occur in an individual who feels "normal." Nonetheless, when identified, they need to be treated. After all, like the saying goes, "It wasn't raining when Noah built the ark." By the time some of these illnesses become apparent, the results frequently are devastating (heart attack, stroke, kidney failure, blindness, etc.).
Once a person has developed the proper motivation, the next step is to remove any barriers to compliance. Financial barriers, the most important of which is cost of medication, are a big factor. But there are very few medical conditions that can't be treated with good generic drugs, which generally are much less expensive and quite effective. Even for the few times when a brand-name drug is all that is helpful, most pharmaceutical companies have programs to help patients with the cost of such treatments. Your doctor can work with you to implement the most cost-effective program possible.
Another barrier can be physical limitations. For example, visual problems make reading labels difficult. Dementia, even when it's mild, limits a person's ability to remember medication schedules. Swallowing pills is difficult for many adults, especially the elderly. Arthritis or other dexterity problems may make opening bottles problematic, too. But for each of these issues, there are available solutions (such as large print on labels; liquid forms of medicine, which are easier to swallow; easy-open bottles, etc.). Once again, developing a game plan with your doctor can make seemingly insurmountable problems better.
Medications are a mainstay of therapy for millions of Americans. The appropriate use of pharmaceuticals has been a major factor in improving our nation's health and longevity. To fully realize the benefits of these interventions, we must learn to make compliance a habit. Developing motivation and addressing obstacles are the first steps in making medication adherence a behavior. Two helpful websites are cmsa.org/CMAG (Case Management Society of America) and ascp.com (the American Society of Consultant Pharmacists).
Contributing Editor Tedd Mitchell, M.D., is president and medical director of the renowned Cooper Clinic in Dallas. He writes HealthSmart every week.
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Help to soothe your teen's migraine
Parents: If throbbing headaches disrupt your teen's life, the problem could be migraines, which affect about 10% of boys and 20% of girls, according to pediatric neurologist Kenneth J. Mack, Ph.D.
An upset stomach is often a symptom of a migraine headache, Mack says, and your teen also might be avoiding light, loud noises and certain odors, and desiring to sleep in a dark room.
The pain can be debilitating. But you can help.
"The body of a migraine person likes routine," says Mack, who is also associate professor of neurology at the Mayo Clinic College of Medicine. "It likes to get enough sleep, food, relaxation and exercise."
Ask your teen to follow Mack's advice. Managing migraines means she might reduce her risk of developing anxiety and depression, and improve her overall functioning.
Treatment tips:
For best effect, take an appropriate dose of medicine at the first sign of headache pain (over-the-counter non-steroidal anti-inflammatories or prescription triptans). "Pain begets pain," Mack says. "The longer you let the headache go on, the harder it is to control."
Ask your doctor about prevention to reduce the frequency: Over-the-counter daily riboflavin (vitamin B-2) helps about 50% of people who try it. Prescription remedies also are available.
Beware rebound headaches: Taking pain medicine more than twice a week for several weeks in a row can cause the body to become used to it, and going off can cause the body to crave it, Mack says. This puts people at risk for headaches. Talk to your doctor about going on a preventive medicine.
Techniques such as biofeedback and visual imagery can help those migraine sufferers who use them regularly.
-- By Susan T. Lennon
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