Medical Management

The five days of five meds experiment is over, and I surprisingly did very well.  I didn't end up missing a single dose of any med.  I am certain though that I would not have such a high compliance if I had to continue the project for more than five days.

What made taking the medications easier was that I wrote out a schedule as soon as I got home.  I knew that I had to take one pill at 8am, three at 10am with breakfast, two at 6pm with dinner, and one at 10pm.  Having that schedule established allowed me to not have to keep track of all of the specifics of the medications (12hrs apart, with food, without food, etc)

I found that the hardest medication for me to take was one that I had to take in the morning on an empty stomach.  The reason why it was difficult was not an issue of remembering, but rather I just didn't want to take it because it interfered with my established routine.  I'm in the habit of going for a caffeinated beverage as soon as I get up (we all have our vices), and I had to wait at least thirty minutes after taking the med before I could eat or drink anything.  If I woke up especially tired, I seriously contemplated just skipping the medication.  I held in there, partly because I knew I had to report how I did and partly because I knew it was only for five days.

I also think that it was easier to take the medications than it normally would be because the project happened to be just before an exam, which meant that I was at my desk studying much more than normal and was out doing things much less than normal.  Had I been going out to meetings, dinners and other events more, it would have been much more difficult to stick to my medication schedule.

Lessons learned:

• Discuss with patients if a medication schedule may conflict with a routine they have and talk with them about ways to make compliance easier
• Be sure patients fully understand how to take their medications and help them with easier ways of remembering, such as writing out a schedule.
• Help patients figure out ways to work the medications into their routine, rather than expecting them to miss out on their routine because of their medications.
• Most important: make sure patients understand the instructions that come with the medications.  If they don't understand how to take the medications, the treatment cannot be successful.

Overall, while inconvenient at times, I do think this exercise was extremely helpful in giving us more of the patients' perspective.  I have a much greater understanding of how difficult it can be for patients who are taking multiple medications.

Mystifying Medications

I’m a Type 2 diabetic with hypothyroidism, high cholesterol, heart problems and inflammation requiring steroid treatment.

At least, I have to act as though I am and take the medications appropriate for these conditions for the next few days. We recently were assigned a project for class that aims to try and help us understand how difficult it can be for patients to take multiple medications correctly when they all have different instructions.

 

We were given five different medications (placebo versions labeled as real medications) to take for these conditions and each one had very different instructions. Some have to be taken with meals, others not. Some need to be taken twice a day while others are only once a day. Most are only one pill a day, but one has a different number of pills for each day. Several of the medications have to be taken in the morning while others have to be taken at night.

Here's a summary of the medications and instructions (none of these are real medications):

• Glucozide (for blood sugar): 1 capsule twice daily with meals
• Cardiolol (heart): 1 capsule twice daily, roughly 12 hours apart
• Prednitab (steroid): 4 capsules on day 1, 3 capsules on day 2, 2 capsules on day 3, 1 capsule on day 4; all in the morning with food
• Lipistatin (cholesterol): 1 capsule every evening
• Thinsroid (thyroid): 1 capsule every morning on an empty stomach (at least 30mins before a meal)

I'm sure you can see how challenging it will be at times to correctly take all of these medications every day. In real life, I have two medications that I take every day that don't have any specific instructions and I have a hard time even remembering those - let alone adding the new five medications. I'll post again once I am done with this project as a report of how I did with taking all of the medications correctly.

The real value of this project, in my opinion, will be the reminder of what some patients have to go through just to take their medications correctly and why it is so frequent that medications aren't taken correctly or at all.  In all reality, if I truly had all of those health problems, I would be taking a lot more than five medications. Many patients are on 15+ medications, all with different requirements for how they should be taken. As future doctors, it's so important that we understand the difficulties patients can go through and not be quick to judge them for not following instructions perfectly. Many doctors don't even explain to patients just how to take their medications.

In modern medicine, with all of the incredible advancements we have, nothing will be treated effectively if the method of treatment is not understood and can't be followed. Simply taking a few extra minutes to be sure patients can follow medication instructions could make a world of difference in their treatment and effective care.

We're studying the GI system...

Excuse the language, but this picture is just so appropriate for the block that we're in. :)

A sign of [dis]respect?

I know I haven’t written in a long time, but I often don’t have any new updates that I feel are worth writing about since most of my days aren’t any different from the day before. I should have more interesting stories and thoughts once I deal with patients more regularly.

An observation from today…

While walking through the medical center courtyard this afternoon, I noticed that the flags were at half mast. I honestly have no idea why the flags have been lowered specifically, but it struck me as odd and quite disrespectful. I recognize that often businesses will lower their flags as a sign of respect for someone that has passed, but it really bothered me that a hospital had done it. While most would probably view flags at half mast as honoring or respecting whomever it was intended for, I felt as though it was incredibly disrespectful to the families that had recently lost a loved one at the hospital. Lowering the flag for one person and not others implies superiority of that person’s life over others’ lives or more implicit value in one life over another. People die every day in hospitals, and the flag is not normally at half mast. Do those lives not also deserve respect and honor? I think flags at hospitals should either be permanently lowered or never lowered. Lowering the flag based on the perceived value or celebrity of a particular loss over others seems quite unjust and unfit for a hospital to do.

Perhaps I was thinking too much into a simple attempted sign of respect, or perhaps some people weren’t thinking enough into it.