Several months ago I was visiting with a friend. He is in his 70s and had some medical problems which were being successfully treated with multiple medications though he still had some issues.
In fact, he felt that some of the issues had gotten worse.
He lived for golf, easily plays 18 holes, five days a week. When I saw him he had given up golf because he couldn’t even finish the front nine.
In med school we were taught that anyone on 3 – 4 different medications has a minimal chance of having conflicts between the medications. But, if the number of medications rose to 5 there would be a 50 % chance of having a conflict and for anyone taking more than 8 medications there is a 100% chance of conflicts.
All conflicts have some effect, some minor, some serious. Some have enormous consequences. It is a problem I ran into frequently during my 31 years in the ER. It was often the side effects that brought the patient to see me, not the underlying problem.Many people attend several doctors for various problems.
Each one of these specialists may prescribe one, two or more medications aimed at relieving some problem in their area of expertise.
Very often the patient is taking a polypharmacy of medications not knowing what they are or what they are for.
They take them because the doctor tells them to and often there isn’t anyone at the helm coordinating everything. Back to my friend, he was taking nine different medications from three different doctors.
All competent physicians but too busy to give the conflict issue the attention it deserves. In his case there were 17 different potential conflicts, two of which were important enough to need attention in the near future and one of which was potentially exceptionally serious and in need of immediate intervention.
His level of activity and quality of life had already changed as a result. The list of symptoms from medication conflicts is endless but just a few of the most common problems I saw in the ER were swelling, especially the lower legs, shortness of breath, joint pain, dizziness, faintness, fatigue out of proportion to exertion, either slow or rapid heart beat, low blood pressure, headache, visual problems, rashes, hypersensitivity to the sun and numbness, pain or strange feelings in the extremities.
The list goes on and on but you get the gist.
Most, if not all of these symptoms have causes other than medication conflicts but if the other causes have been looked into without a diagnosis, you and your doctor must explore the possibility of medication conflict.
We need to once again assume responsibility for our own health. Some simple ways we can do this is by:
• Keeping an up to date list of all the medications we are taking – both prescription and non-prescription. Conflicts are not limited only to prescription products.
• Knowing basically why you are taking each drug. Many people taking multiple medications for various problems legitimately get confused over which is for what.
Not long ago I had occasion to be visiting with a friend who mentioned that he was suddenly quite under the weather.
Meddling being in my nature I asked a few questions and discovered that he was under the impression that his heart medications were for his platelets and vice versa.
Acting on his doctor’s instructions to “decrease his platelet medications by half”, he inadvertently cut his heart medication in half with the predictable result.
• Being very aware of what foods must be avoided when taking certain medications. Some serious conflicts involve food.
For instance, did you know that people taking a certain class of medication should be very cautious about eating grapefruit; also certain types of wine and cheese can actually kill someone taking another class of drug.
• Do not be reticent to bring up any questions or concerns with your doctor.
My friend? He talked to his primary care doctor, was able to stop four of his meds and is back to playing 18 holes as often as he wants.
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