Living a Healthy Life with Chronic Pain (39 page)
Read Living a Healthy Life with Chronic Pain Online
Authors: Sandra M. LeFort,Lisa Webster,Kate Lorig,Halsted Holman,David Sobel,Diana Laurent,Virginia González,Marian Minor
No matter what the medication, it won’t do you any good if you don’t take it. Nearly half of all medicines are not taken as prescribed. There are many reasons why people don’t take their prescribed medication: forgetfulness, lack of clear instructions, complicated dosing schedules, bothersome side effects, cost, and so on. Whatever the reason, if you are having trouble taking your medications as prescribed, discuss this with your health care provider. Often simple adjustments can make it easier. For example, if you are taking many different medications, sometimes one or more can be eliminated. If you take one medication three times a day and another four times a day, your provider may be able to simplify the regimen. He or she may even prescribe medications that you need to take only once or twice a day. Understanding more about your medications, including how they can help you, may help motivate you to take them regularly.
If you are having trouble taking your medications, ask yourself the following questions and discuss your answers with your provider or pharmacist:
Do you tend to be forgetful?
Are you confused about the instructions for how and when to use the medications?
Is the schedule for taking your medications too complicated?
Do your medications have bothersome side effects?
A Special Word About Pharmacists
Pharmacists are an underutilized resource. These professionals have gone to school for many years to learn about medications. They know how drugs act in your body and how medications interact with each other. Your pharmacist is an expert and can readily answer questions face-to-face, over the phone, or even via e-mail. In addition, many hospitals, medical schools, and schools of pharmacy have medication information services that you can call to ask questions. As a self-manager, don’t forget pharmacists. They are important and helpful consultants.
Is your medicine too expensive?
Do you feel that your condition is not serious or bothersome enough to need regular medications? (With some diseases such as high blood pressure, high cholesterol, or early diabetes, you may not have any symptoms.)
Do you feel that the medication is unlikely to help?
Are you denying that you have a condition that needs medication?
Have you had a bad experience with the prescribed medicine or another medication?
Do you know someone who had a bad experience with the medication, and are you afraid that something similar will happen with you?
Are you afraid of becoming addicted to the medication?
Are you embarrassed about taking the medication, view it as a sign of weakness or failure, or fear you’ll be judged negatively if people know about it?
What are some of the benefits you might get if you take the medication as prescribed?
You may take nonprescription or over-thecounter (OTC) medications or herbs. In every two-week period, nearly 70 percent of people will take a nonprescription drug. Many OTC drugs are highly effective and may even be recommended by your health care provider. But if you self-medicate, you should know what you are taking, why you are taking it, how it works, and how to use the medication wisely.
More than 200,000 nonprescription drug products are offered for sale to the American public, representing about 500 active ingredients. In Canada, there are more than 15,000 nonprescription drug products available and 40,000 natural health products.
Nearly 75 percent of the public receives its education on OTC drugs solely from TV, radio, newspaper, and magazine advertising. The main message of drug advertising is that for every symptom, every ache and pain, and every problem, there is a pharmaceutical solution. While many OTC products are effective, many are simply a waste of your money. They may also keep you from using better ways to manage your condition.
Remembering to Take Your Medicines
The following are some suggestions to help you remember to take your medications:
Make it obvious
. Place the medication or a reminder next to your toothbrush, on the breakfast table, in your lunch box, or in some other place where you’re likely to “stumble over” it. (But be careful where you put the medication if children are around.) Or you might put a reminder note on the bathroom mirror, the refrigerator door, the coffee maker, the television, or some other conspicuous place. If you link taking the medication with some well-established habit such as meal times or watching the nightly news on television, you’ll be more likely to remember.Use a checklist or an organizer
. Make a medication chart listing each medication you are taking, the amount you take, and the time when you take it. Another option is to check off each medication on a calendar as you take it. You can purchase a medication organizer at the drugstore. This container separates pills according to the time of day you need to take them. You can fill the organizer once a week so that all your pills are ready to take at the proper time. A quick glance at the organizer lets you know if you have missed any doses and prevents double dosing. There are also websites that have printable charts to help you track your medications. PictureRx (
https://mypicturerx.com
) is one, but it requires a subscription. The American Chronic Pain Association (ACPA) is another (
theacpa.org/communication-tools
). See especially its MedCard and CARE Card.Use an electronic reminder
. Get a watch or mobile phone that you can set to beep at pill-taking time. There are also high-tech pill containers that beep at a preset time to remind you to take your medication. If you have a smartphone, you can download an app that reminds you to take your medication.Have others remind you
. Ask members of your household to remind you to take your medications at the appropriate times.Don’t run out
. Don’t let yourself run out of your medicines. When you get a new prescription, determine the day when the pills will run out and mark one week before that date on your calendar. This will serve as a reminder to order your next refill. Don’t wait until you take the last pill. Some mail-order pharmacies offer automatic refills, so your medications arrive when you need them.Plan before you travel
. If you plan to travel, put a note on your luggage reminding you to pack your pills. Also, take along an extra prescription in your carry-on bag in case you lose your pills or your checked luggage.
If you are taking prescribed medications or using OTC medications or herbs, here are some helpful suggestions:
If you are pregnant or nursing, have a chronic disease, or are already taking multiple medications, consult your doctor or nurse practitioner before self-medicating.
Your provider will know if the OTC remedy will interfere or interact badly with your condition or prescription medications.Always read labels and follow directions carefully.
Reading the label, including a review of the individual ingredients, may prevent you from taking medications that have caused problems for you in the past. It may also prevent double dosing on medications that you may already be taking. For example, aspirin and acetaminophen (Tylenol
®
) are popular medications for pain, but they are also ingredients in over-the-counter products such as cold remedies. If you don’t understand the information on the label, ask a pharmacist before buying it.
A Special Word About Alcohol and Recreational Drugs
The use of alcohol and recreational drugs (both illegal drugs and prescription medications used for nonmedicinal purposes) has been increasing in recent years, particularly among people over the age of 60. These drugs, whether legal or illegal, can cause problems. They can interact with prescription medications, making them less effective or even causing harm. They can fog judgment and cause problems with balance. This can in turn cause accidents and injure both you and others. In some cases, alcohol or recreational drugs can make existing long-term conditions worse. Alcohol use is associated with increased risk of hypertension, diabetes, gastrointestinal bleeding, sleep disorders, depression, erectile dysfunction, breast and other cancers, and injury.
Ideally, you should limit alcohol use to no more than two drinks per day. “At risk” alcohol use for women is drinking more than seven drinks per week or more than three drinks per day; for men it’s more than 14 drinks per week or more than four drinks in a day. This means that women of any age and anyone over age 65 should average no more than one drink per day and men under 65 should have no more than two drinks per day on average.
Consider the following two pieces of advice:
If you are at the “at risk” level for alcohol or are regularly using recreational drugs, seriously consider cutting down or stopping their use. For more information about medical marijuana and chronic pain, see
Chapters 16
,
page 275
.Talk to your doctor or nurse practitioner about your use of these drugs. Health care providers are often hesitant to raise the issue because they don’t want to embarrass you. It is up to you to bring up the subject. Providers will be very willing to talk about it. They have heard it all, and they will not think less of you. An honest conversation may save your life.
Do not exceed the recommended dosage or length of treatment.
Only do so if you have discussed the change with your doctor or nurse practitioner.Use caution if you are taking other medications.
Over-the-counter and prescription drugs can interact, either canceling or exaggerating the effects of the medications. If you have questions about drug interactions, ask your provider or pharmacist before mixing medicines.Try to select medications with a single active ingredient rather than combination (“all-in-one”) products.
When using a product with multiple ingredients, you are likely to be treating symptoms you don’t even have. Why risk the side effects of medications you don’t need? Single-ingredient products also allow you to adjust the dosage of each medication separately for optimal symptom relief with minimal side effects.When choosing medications, learn the ingredient names and try to buy generic products.
Generics contain the same active ingredient as the brand-name product, usually at a lower cost.Never take a drug from an unlabeled container or a container whose label you cannot read.
Keep your medications in their original labeled containers, or transfer them to a labeled medication organizer or pill dispenser. Do not mix different medications in the same container.Do not take medications that were prescribed for someone else.
Even if you have similar symptoms, this is never a safe practice.Drink at least a half glass of liquid with your pills.
After swallowing, remain standing or sitting upright for a short while. This can prevent the pills from getting stuck in your throat.Store your medications where children or young adults cannot find them.
Poisoning from unsecured medications is a common problem among young children. Teens and young adults sometimes steal prescription drugs from relatives or the relatives of friends for recreational use. Despite its name, the bathroom medicine cabinet is not usually an appropriate place to store medications. A kitchen cabinet or toolbox with a lock is a safer option.
Medications can help or harm. What often makes the difference is the care you exercise and the partnership you develop with your doctor.
Other Resources to Explore
American Chronic Pain Association:
www.theacpa.org/Communication-Tools
Health Canada—Drugs and Health Products:
www.hc-sc.gc.ca/dhp-mps/index-eng.php
Health Canada—Healthy Living: Safe Use of Natural Health Products.
www.hc-sc.gc.ca/hl-vs/iyh-vsv/med/nat-prod-eng.php
MedlinePlus—Drugs, Supplements, and Herbal Information:
www.nlm.nih.gov/medlineplus/druginformation.html
National Institutes of Health—Rethinking Drinking: Alcohol and Your Health:
www.rethinkingdrinking.niaaa.nih.gov
Natural Medicines Comprehensive Database:
www.naturaldatabaseconsumer.therapeuticresearch.com
Ontario Ministry of Health and Long Term Care—MedsCheck:
www.health.gov.on.ca/en//files/07/30/87/f073087/public/programs/drugs/medscheck
PictureRx:
https://mypicturerx.com
The National Center for Complementary and Alternative Medicine (NCCAM):
www.nccam.nih.gov
WebMD—Drugs and Medications A–Z:
www.webmd.com/drugs
To learn more about the topics discussed in this chapter, we suggest that you explore the following resources:
Castleman, Michael.
The New Healing Herbs: The Essential Guide to More Than 125 of Nature’s Most Potent Herbal Remedies
, 3rd ed. New York: Rodale, 2010.
Graedon, Joe, and Teresa Graedon.
Best Choices from the People’s Pharmacy
. New York: NAL, 2008.
Griffith, H. Winter, and Stephen W. Moore.
Complete Guide to Prescription and Nonprescription Drugs, 2014
. New York: Perigee Books, 2013.
Physicians’ Desk Reference.
The PDR Pocket Guide to Prescription Drugs
, 10th ed. Montvale, N.J.: PDR Network, 2012.
Raman-Wilms, Lalitha.
Practical Guide to Drugs in Canada: Understanding Prescription and Over-the-Counter Drug Treatments for Everyday Ailments and Diseases
, 1st ed. Toronto: Dorling Kindersley, 2011.
Shane-McWhorter, Laura.
The American Diabetes Association Guide to Herbs and Nutritional Supplements
. Alexandria, Va.: American Diabetes Association, 2009.
Silverman, Harold M.
The Pill Book
, 15th ed. New York: Bantam Books, 2012.