In modern healthcare and "medicine" we function largely based on one main intervention - "pharmacologic therapy". Call it what you will: pills, drugs, "medicine", remedies, interventions... when you do go to the doctor, don't you feel at least a little bit shafted if the physician doesn't deem you sick enough to take some kind of pill?
Even the old adage, "take two aspirin and call me in the morning" indicates that even when it might not be serious, we still take some magical pill to make us better. Ah, magic is it? A TV show that I've come to adore in fan-like proportions is the ABC series "Once upon a Time", a show very tangibly about magic, fantasy, and true love.
While it's entertainement value alone is applaudable, something one of the main characters, Rumplestiltskin, says on multiple occasions always holds my attention. Whenever tantalizing a desperate character to make a deal with him, Rumplestiltskin always warns at the last minute with a flourish of his hand, "Take care dearie! Magic always comes with a price."
Looking at, and working in, healthcare I understand how true that statement is. Greater than 10% of all people placed on ventilators to artificially prolong life, also develop drug-resistant bacterial pneumonia (Morris et al, 2011). And for every magic pill we give you, there are side effects, some with life altering consequences.
While we can thank government regulating agencies like the Food and Drug Administration (FDA) for making sure some medicines are more safe than magic, even common household items like Tylenol, Ibuprofen, Aspirin, and Baking Soda can cause problems like liver failure, gastrointestinal bleeding, brain bleeds, and hypokalemia leading to ventricular arrhythmias and death.
Thus, we, like the characters in "Once" must also be wise when making deals with magic, and death.
1.) This means reading EVERY line in the contract before we sign, or in our case imbibe it.
We always hear on television how we should all "talk with our doctors" about taking a new medication, or "seeing if this is right for us."
This is true! Most particularly if you have a predisposition or current medical condition that could be affected by medication.
Also, don't just start taking a new medication if you're not POSITIVE that it is not going to interact with another medication OR herbal pill you are taking.
Ex. Some people take coumadin (also known as warfarin) to "thin their blood" to prevent blood clots. However, they do not realize that when they take aspirin or ibuprofen for a backache, or garlic for their cholesterol, that they can increase the effects of coumadin and bleed too much.
2.) The more deals we make, the harder it is to avoid consequences.
The more medications we take together, the more potential there is for interactions and therefore the more vigilant you must be to what you take and when you are taking them.
3.) Always know what you're getting yourself into.
Always ask your doctor or healthcare provider exactly WHY they are giving you this medication.
Many drugs have multiple "therapeutic effects" (that is, many problems one drug can treat), and it is good for you to know what you're putting your body and to make sure it's a good reason.
Also, many times doctors give two pills - one drug to fix the real problem, and the other to fix the side effects of the first drug. Know how to take your meds.
Ex. Many people who have high blood pressure or heart problems get put on a "water pill". This is a laymen's term for a diuretic which is a drug that makes you urinate a lot.
The problem is: The more you urinate, the more potassium you lose, and potassium is important for your heart to function properly. So, doctors often give a diuretic pill with a potassium pill.
The problem? Often patients will run out of the diuretic pill (or just stop taking it because they don't like having to go to the bathroom so much), and will keep taking the potassium pill, thinking that they are still being "good patients".
The problem? They can kill themselves. Just taking potassium, without the diuretic to balance the potassium out, will make the heart go into serious arrhythmias (a= bad, rhythmia = rhythm) that can be deadly.
4.) Keep track of your contracts.
After about two or three pills, a daily vitamin, and a few herbals or natural products, it is hard to remember what you are taking when.
Anytime you go to visit a doctor (or doctors), bring a list of ALL the medications and remedies you take.
This includes:
Over the counter (OTC) drugs like: aspirin, tylenol, ibuprofen, robitussin, tums, claritin, and benadryl.
Herbal (botanicals) like: garlic, cranberry pills, red yeast rice, chamomile, ginko biloba, St. John's Wart, black cohash, valerian, ginseng tea.
Dietary supplements like: Daily vitamins, pre-natal vitamins, Co-Q10, iron, calcium, vitamin D, folic acid, B12.
Natural products like: fish oil, coconut oil, probiotics.
5.) Don't break a contract prematurely.
As a general rule, if it's a prescription medication (that is, a doctor wrote out a medication for you to take) take the drug exactly as you are told to, for as long as you're supposed to.
Ex. People are particularly notorious about stopping early when taking antibiotics. After day 4 out of 7, one may say, "Hey! I feel great! I'm not going to take the rest of this stuff and save it for later".
The problem? Doctors don't prescribe antibiotics for 10 days just for your benefit. Bacteria are smart, and can adapt and become resistant to antibiotics when they are exposed to them enough and not killed all the way. MRSA anyone?
[For those of you interested, MRSA stands for: Methicillin (an antibiotic) Resistant (don't get killed by) Staph Aureaus (a bacteria)].
6.) Remember, magic ALWAYS comes with a price.
As a rule, NO DRUG IS COMPLETELY SPECIFIC, and therefore ALL DRUGS HAVE SIDE EFFECTS. All of them.
Because drugs aren't specific, this means that a drug will affect other parts of the body in someway.
Ex. When a man takes a drug to decrease blood pressure, it also affects his extremities and can cause erectile dysfunction.
Did the drug not work? No, it did its job, but it directly influenced pressure in other parts of the body because it decreased the blood pressure in the blood vessels.
7.) Know the price you are paying.
Because of these side effects and potential interactions, it is you as the individual who needs to make informed decisions about your health.
This includes knowing:
who prescribed you a medication (was somebody from ER? Your cardiologist?)
why you're taking a medication
how long you should take it for
what it does to your body (including the mechanism of action and side effects)
what symptoms mean something is wrong
when to let your doctor know if there is a problem
Drugs will always, always have side effects. They may be slight, they might not be noticeable, they might even be good! But, like all consequences to magic, they are there, and therefore, please, please know about them.
Living in Light of Magic
Just as magic is by its very nature unnatural -though helpful and often pivotal to our heroes achieving their goals- so every drug is a foreign or unnatural substance to the body. Medications heal us of infections, help us breathe during asthma attacks, push the pain away after a surgery, alleviate headaches, manage our blood sugars, prevent us from having heart attacks, and prolong life in people who have otherwise a death sentence. Truly, healthcare has invented a new kind of magic.
Yet for this wizardry, like magic, all things come with a price. All drugs come with interactions, reactions, toxicities, overdoses, and death defying or death inducing properties. Drugs will always, always have side effects, and therefore, be more wise than a wizard in knowing how to deal with them.
Happy living.
Resources
Here are a few resources I thought were helpful in taking meds safely:
http://www.pfizer.com/files/health/medicine_safety/4-3_Avoiding_Medication_Errors.pdf.
http://www.partnershipforhealthcare.org/patients_and_caregivers/how_to_take_your_medications_safely/.
http://www.drugs.com/sfx/.
Also, two apps that I like are:
Epocrates. (Free). The iTunes free version should satisfy queries for the average layman. I think there are various levels of upgrades if you want more as well.
https://itunes.apple.com/us/app/epocrates/id281935788?mt=8.
Nursing Central. (Free). This also has upgrades but it is a lot more expensive.
https://itunes.apple.com/us/app/nursing-central/id300420397?mt=8.
Nursing central also has a website where you can look up up-to-date provider level information on drugs and diseases for free. I am indeed a fan.
http://nursing.unboundmedicine.com/nursingcentral/ub/.
References:
Morris, A., Hay, A., Swann, D., Everingham, K., McCulloch, C., McNulty, J., & Brooks, O. (2011). Reducing Ventilator-associated Pneumonia in Intensive Care. Critical Care Med, 39(10), 2218-2224. Retrieved from http://www.medscape.com/viewarticle/750575.
We always hear on television how we should all "talk with our doctors" about taking a new medication, or "seeing if this is right for us."
This is true! Most particularly if you have a predisposition or current medical condition that could be affected by medication.
Also, don't just start taking a new medication if you're not POSITIVE that it is not going to interact with another medication OR herbal pill you are taking.
Ex. Some people take coumadin (also known as warfarin) to "thin their blood" to prevent blood clots. However, they do not realize that when they take aspirin or ibuprofen for a backache, or garlic for their cholesterol, that they can increase the effects of coumadin and bleed too much.
2.) The more deals we make, the harder it is to avoid consequences.
The more medications we take together, the more potential there is for interactions and therefore the more vigilant you must be to what you take and when you are taking them.
3.) Always know what you're getting yourself into.
Always ask your doctor or healthcare provider exactly WHY they are giving you this medication.
Many drugs have multiple "therapeutic effects" (that is, many problems one drug can treat), and it is good for you to know what you're putting your body and to make sure it's a good reason.
Also, many times doctors give two pills - one drug to fix the real problem, and the other to fix the side effects of the first drug. Know how to take your meds.
Ex. Many people who have high blood pressure or heart problems get put on a "water pill". This is a laymen's term for a diuretic which is a drug that makes you urinate a lot.
The problem is: The more you urinate, the more potassium you lose, and potassium is important for your heart to function properly. So, doctors often give a diuretic pill with a potassium pill.
The problem? Often patients will run out of the diuretic pill (or just stop taking it because they don't like having to go to the bathroom so much), and will keep taking the potassium pill, thinking that they are still being "good patients".
The problem? They can kill themselves. Just taking potassium, without the diuretic to balance the potassium out, will make the heart go into serious arrhythmias (a= bad, rhythmia = rhythm) that can be deadly.
4.) Keep track of your contracts.
After about two or three pills, a daily vitamin, and a few herbals or natural products, it is hard to remember what you are taking when.
Anytime you go to visit a doctor (or doctors), bring a list of ALL the medications and remedies you take.
This includes:
Over the counter (OTC) drugs like: aspirin, tylenol, ibuprofen, robitussin, tums, claritin, and benadryl.
Herbal (botanicals) like: garlic, cranberry pills, red yeast rice, chamomile, ginko biloba, St. John's Wart, black cohash, valerian, ginseng tea.
Dietary supplements like: Daily vitamins, pre-natal vitamins, Co-Q10, iron, calcium, vitamin D, folic acid, B12.
Natural products like: fish oil, coconut oil, probiotics.
5.) Don't break a contract prematurely.
As a general rule, if it's a prescription medication (that is, a doctor wrote out a medication for you to take) take the drug exactly as you are told to, for as long as you're supposed to.
Ex. People are particularly notorious about stopping early when taking antibiotics. After day 4 out of 7, one may say, "Hey! I feel great! I'm not going to take the rest of this stuff and save it for later".
The problem? Doctors don't prescribe antibiotics for 10 days just for your benefit. Bacteria are smart, and can adapt and become resistant to antibiotics when they are exposed to them enough and not killed all the way. MRSA anyone?
[For those of you interested, MRSA stands for: Methicillin (an antibiotic) Resistant (don't get killed by) Staph Aureaus (a bacteria)].
6.) Remember, magic ALWAYS comes with a price.
As a rule, NO DRUG IS COMPLETELY SPECIFIC, and therefore ALL DRUGS HAVE SIDE EFFECTS. All of them.
Because drugs aren't specific, this means that a drug will affect other parts of the body in someway.
Ex. When a man takes a drug to decrease blood pressure, it also affects his extremities and can cause erectile dysfunction.
Did the drug not work? No, it did its job, but it directly influenced pressure in other parts of the body because it decreased the blood pressure in the blood vessels.
7.) Know the price you are paying.
Because of these side effects and potential interactions, it is you as the individual who needs to make informed decisions about your health.
This includes knowing:
who prescribed you a medication (was somebody from ER? Your cardiologist?)
why you're taking a medication
how long you should take it for
what it does to your body (including the mechanism of action and side effects)
what symptoms mean something is wrong
when to let your doctor know if there is a problem
Drugs will always, always have side effects. They may be slight, they might not be noticeable, they might even be good! But, like all consequences to magic, they are there, and therefore, please, please know about them.
Living in Light of Magic
Just as magic is by its very nature unnatural -though helpful and often pivotal to our heroes achieving their goals- so every drug is a foreign or unnatural substance to the body. Medications heal us of infections, help us breathe during asthma attacks, push the pain away after a surgery, alleviate headaches, manage our blood sugars, prevent us from having heart attacks, and prolong life in people who have otherwise a death sentence. Truly, healthcare has invented a new kind of magic.
Yet for this wizardry, like magic, all things come with a price. All drugs come with interactions, reactions, toxicities, overdoses, and death defying or death inducing properties. Drugs will always, always have side effects, and therefore, be more wise than a wizard in knowing how to deal with them.
Happy living.
Resources
Here are a few resources I thought were helpful in taking meds safely:
http://www.pfizer.com/files/health/medicine_safety/4-3_Avoiding_Medication_Errors.pdf.
http://www.partnershipforhealthcare.org/patients_and_caregivers/how_to_take_your_medications_safely/.
http://www.drugs.com/sfx/.
Also, two apps that I like are:
Epocrates. (Free). The iTunes free version should satisfy queries for the average layman. I think there are various levels of upgrades if you want more as well.
https://itunes.apple.com/us/app/epocrates/id281935788?mt=8.
Nursing Central. (Free). This also has upgrades but it is a lot more expensive.
https://itunes.apple.com/us/app/nursing-central/id300420397?mt=8.
Nursing central also has a website where you can look up up-to-date provider level information on drugs and diseases for free. I am indeed a fan.
http://nursing.unboundmedicine.com/nursingcentral/ub/.
References:
Morris, A., Hay, A., Swann, D., Everingham, K., McCulloch, C., McNulty, J., & Brooks, O. (2011). Reducing Ventilator-associated Pneumonia in Intensive Care. Critical Care Med, 39(10), 2218-2224. Retrieved from http://www.medscape.com/viewarticle/750575.
