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Q&A
#105
MEDICINE CAN
KILL
By Carol Abaya, M.A.
Question: My mother
is taking three different medicines every day and often forgets to take
them or takes them twice. I can’t keep calling her from work to remind
her. What can I do?
Answer: Mistaking
prescription medicine and/or adverse drug reaction are on top of the list
of why older people end up in hospital emergency rooms.
Recent studies also
indicate that adverse drug reaction is one of the leading causes of death
of those over 65.
So making sure medicine
is taken properly is very important.
You should first talk
with your mother’s doctor and establish on-going communications with him.
Ask what each medicine is for and why your mother needs it. Often a person
is given medicine for a particular illness and just keeps taking it even
though he may no longer need it. Often an older person does not tell
the doctor about all of the other medicine he is taking. Make sure all
are really necessary at this time.
To help your mother
take the pills properly, there are various pill containers that are available.
Some can be used for daily doses. Others can be set up ahead of time
for several days or a week at a time.
If memory lapses are
minor, such a simple plastic pill holder can be used, with the day of
the week and the time the pill needs to be taken clearly marked on the
appropriate compartment. Then if the pill is no longer in the compartment,
your mother knows she has taken it.
If mental confusion
is more severe, there are containers with time release mechanisms. This
way, the person cannot take too much.
If you do not live
nearby, it is important you identify and arrange for someone reliable
to set up these containers on a regular basis. Also make sure your mother
does not have access to the drug store pill bottles.
Besides asking the
doctor whether all pills are necessary, ask him if any foods will interfere
with the effectiveness of the drug. For example, if a person is taking
blood-thinning medicine, he should not eat broccoli or spinach, which
help thicken the blood.
Question: My father
has had high blood pressure for years and has now developed heart problems.
However, he loves Chinese food. The doctor says he shouldn’t eat Chinese
food at all: but he refuses to listen. How can we get him to watch what
he eats?
Answer: Many
older people (my mother was one of them) refuse to accept their illness.
They become stubborn and turn a deaf ear to something they may not like
to hear.
Sit down with him
and talk with him in simple terminology and explain why salt is so bad
for him. Explain that if his body has too much salt that water can accumulate
in his lungs. He will have trouble breathing and can experience severe
pain across his chest and upper arm areas. He can develop congestive
heart failure, which if not watched carefully can lead to death.
Remember that beside
Chinese food, all kinds of cold cuts, frozen foods and salads on buffets
in restaurants are all loaded with salt. All can contribute to water
accumulating in the lungs. A minimum amount of salt should be in the
diet of someone with high blood pressure and heart disease. Guideline
of 1,500 mg or less a day is advisable. More than 250 grams in any one
food or service should be used as a maximum guideline.
If your father insists
on eating Chinese food and has a favorite restaurant, talk to the owner.
Arrange for your father’s food to be made without any salt or MSG.
Also go through your
father’s pantry, freezer and refrigerator and point out all the foods
with high salt content.
Question: I am
73 (male), go to the chiropractor once a month, and take a number of vitamins
and herbal supplements. Although I take a prescription medicine for high
blood pressure, my pressure continues to be high. What should I do?
Answer: I
am not a doctor, but that is where you need to start - with a geriatric
primary care physician who is also knowledgeable about alternative medicine.
If your current doctor dismisses your questions and concerns about vitamins
and herbs, seek another doctor. Comfortable communication and trust is
critical in patient-doctor relationships.
More people, like
yourself, are using alternative medicine to keep themselves healthy.
Latest studies show more visits to alternative practitioners than regular
medical doctors. However, at least 40% don’t discuss everything
with their regular doctor. This can be dangerous.
While the chiropractor
visit is very helpful in keeping up body functioning and is not dangerous
to one’s health, certain vitamins and herbs can be counterproductive.
This is even more true if you take prescription medicines. One or more
of the vitamins or herbs may be preventing the blood pressure medicine
from working effectively.
For example, taking
coumadin or aspirin together with ginkgo, feverfein, or bromelain to reduce
blood clotting after a stroke, for example, can be dangerous.
Combining antidepressants
and St. John’s Wort can also be dangerous. And combining certain herbal
laxatives with other medications, if for high blood pressure, can deplete
the body of important minerals and has resulted in death.
Best advice is to
talk to your doctor and the person recommending vitamins and herbs,
research interactions and identify potential problems.
Question: I’m
84 (male) and in good health, but worry about memory loss. I’ve read
about various herbs to help. What’s your opinion?
Answer: If
you don’t have any chronic illness that interferes with blood circulation,
memory generally stays intact. At the same time, a certain amount of
forgetfulness is common among any age group. Is there anyone who has
not left something cooking, walked away and forgot about it?
A sound diet, moderate
exercise, and some basic vitamins (like C, E, B-complex, zinc) can be
helpful. If you’re not on any prescription medicines, some herbs can
be helpful. But in many cases, like ginkos, positive results have yet
to be scientifically verified.
Both my parents went
to a chiropractor regularly and took some basic vitamins. My father did
two to three miles a day on a stationary bike, until he was 92, and my
mother did water exercises until she was 90.
Even more important
is eating nutritious meals regularly. Food fuels the brain. And don’t
diet.
Question: I was
shocked to see all the medicines in my parents’ medicine chest. They
(both in their 80’s) live 500 miles away, and we don’t visit that often.
When I asked why they were taking them, their answer was very vague.
My mother has had high blood pressure for years, and my father has had
several mini-strokes. But the number of pills seems too large. Should
I call their doctor?
Answer: Yes,
you should call their doctors and develop an on-going dialogue. Before
you call, make a list of the prescriptions you found. It may well be
that they are taking too many different medicines, and are taking them
incorrectly.
Ask the following
questions:
- What illness is
each pill for?
- What is it supposed
to do?
- How should it
be taken?
- How long have
they been taking it?
- Should they continue
taking it and why?
- What other medicines
(both prescription and over-the-counter) and foods should be
avoided?
- What are the side
effects? (Look especially at balance and mental confusion elements).
- What are the interactions
between the various medicines?
Too often people just
continue taking medicine even though they may not really need it. The
problem is complicated if the person goes to several different doctors,
who may - or may not - confer with each other.
It
is important that medicine be taken properly to be effective. Missed
dosages of certain heart medicine can result, e.g., in cardiac arrest.
Certain common foods render certain medicine ineffective.
Question: My mother,
76, takes various medicine at different times during the day. She does
a lot of volunteer work, and is gone from the house for long periods of
time. So she takes with her the day’s supply, putting them all in one
container. Should she be mixing all these pills together?
Answer: Probably
not! Many pills have negative interaction, thereby affecting their effectiveness.
Certain pills are also impacted by the kind of container or body heat.
(Many men will carry a small pill container in their pocket, and the pills
may be affected by body heat).
Talk to the pharmacist
to determine the best way for your mother to carry her pills.
Question: I recently
had a stroke, but have returned to work. I get so involved with work,
I often forget to take my pills. How can I make sure I take them on time?
Answer: There
are all kinds of compartmentalized containers that can help. Some even
beep when it’s time for a dose. The National Council on Patient Information
and Education in Washington, D.C. has a catalog. Their telephone number
is 202-347-6711.
This material is
copyrighted by Carol Abaya Associates and cannot be reproduced in any
manner, print, or electronically.
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