Support and Encouragement - Play it Safe
You are not alone! Many people have struggled with keeping their medications or their loved ones medications straight. Here are some of the stories on 'Playing it Safe!' with medications. Do you have a medication story you would like to share? Here's how:
Stories from patients
I now take less medications
"Last year I had a straight talk with my doctor. I'm 85yo and I have young wife (wink) all these medications make me tired and well you know I just cannot do what I'd like to do. Plus I am sick of the Coumadin and all the visits and the bruises and I wanted off it. She encouraged me to see my cardiologist and my pulmonologist and ask about ALL the risks to going off my medications. So I did because my kids were against me going off any meds. I decided to stay on 2 meds only. (It was down to 1, but I have since added another because my heart rate went up and I got uncomfortable with it.) I know I have more chance of a stroke, a heart attack and I am OK with it. I have more energy now. I am in charge of my meds for the first time! But you know what the best thing is? Me and my lady are having some golden moments."(Male Vet 85yo)
I take my medications correctly
This is embarrassing; my cholesterol medication gave me gas so I went off it. It was 6 months before I got the nerve up to talk to my doctor about it. My brother and my father have had heart attacks. I smoked and have blood pressure so I know my cholesterol should be down. The good news is that there is another cholesterol medication that works just as well. My doctor put me on it, it's been 6 weeks, so good so far! I just have to say, "tell your doctor about your medications, all of it, there is no need to be embarrassed, or anything-it is your health we are talking about! (Male 48yo)
My sobriety is important to me and pain medication scared me, I tried to take the Percocet as it says on the bottle for my back injury. I am an addict in recovery now for 6 years. So I ran out early. I was a mess and in pain. At first I blamed everybody but that thing in my head that likes anything that gets me high. So, I sat down with my doctor and went through the whole story. My sobriety is too important to me. I went off the Percocet and on another pill that cannot make me high. It does not work as well, but I am doing PT now and other things for myself. (Patient 31yo)
This is not my medication... (Heard during a routine outpatient visit) "When I received my medications in the mail there was one medication that did not look right. My name is fairly common and I have a son with the same name. Sure enough, it was his anxiety pills. You know, I almost took it? Good thing I did not , I have my own anxiety pills!" (65yo Male Vet)
I learned I could take my medication so it did not interfere with my daily activities. "I had to be honest, I hardly ever take the Lasix because I am always running to the bathroom. When I told my doctor at the last visit, she did not get mad like I thought she would. We talked. I know Lasix helps me avoid a trip to the hospital. Now I take the Lasix after I come home from errands, so I do not have to be looking for a bathroom half the time. I weigh myself almost every day, and I let B. (Nurse case manager) know when it goes up and what I should do. I have been out of the hospital or ER for 3 months now, and that's pretty good for me!" (Male Vet 72yo)
Here is how I helped my Dad.
I was really at my wits end when I found all the extra pills my Dad had lying around the house. Now that my Mom has passed away, his apartment can get a bit untidy. She had his medications down to a science. I even found an old note in the bathroom sink cabinet reminding him to remember to take his pain pill at night. I was glad when he said it was OK that I help him with his pill box. I fill up his pill box with a seven day supply. I place them according to the type of pill and whether he takes it in the morning, lunch, or evening. I do this every week on Sunday now and I think it really has helped. He has less ankle swelling, his breathing is better, and he is getting out more. Last week we threw out most of the expired medications. Some day we will get to the rest of it. I even found myself leaving a note on the kitchen table reminding him to take his night time pain pill-just like Mom did. (Daughter of Male Veteran, 72yo)
I did not know herbals or supplements.
Recently, I have had to have my Coumadin checked every week. My level was just too low! Usually I have it checked once a month and it is perfect. My nurse practitioner and I sat down and put our heads together. "Any new herbals?" "No." " Any new supplements?" Wait a minute! The energy drink!! I had been taking this new vitamin energy drink every morning to help me lose weight and give me a boost. Turns out it is loaded with Vitamin K and that works against my Coumadin. I stopped it and now I am back to getting my Coumadin checked monthly again. (Male Veteran 62 yo)
Stories from the Healthcare Team
A Medication Review success story. Our pharmacy resident saw a walk-in patient in primary care yesterday. He came in because he was having trouble with his glucometer (blood sugar machine). She decided that it was a good opportunity to do medication reconciliation and discovered that he was on 2 beta-blockers, (Blood pressure and Heart rate lowering medication). She checked his blood pressure and heart rate both of which were fairly low. She brought this to the attention of his primary care provider who stated that he was share care and the outside cardiologist needed to be contacted. Long story short, he was only supposed to be on one of them plus it was discovered that he was on the wrong dose of another medication.
VA and Non-VA providers working together. Three days prior to a long holiday weekend, an 89-year old female VA patient was discharged from a nearby non-VA academic tertiary care hospital in the early evening for congestive heart failure/atrial fibrillation CHF/AFIB with rapid ventricular response. The patient's family, at the time of discharge, asked that the new medications be filled via the VA pharmacy. The new medication list included worrisome changes from the medication listed in the VA electronic health record, three times the dose of beta blocker, addition of coumadin, and addition of an ace inhibitor. As the newly assigned VA primary care provider of this patient, I called the Visiting Nurse Association (VNA) for clarification. They had not gotten the referral yet. I promised to find out what was going on. I called the daughter who informed me her mom spent the morning after discharge in the same hospital's emergency department with diarrhea and dehydration, she had not taken her meds, and her blood pressure was 90/60. The daughter asked if her mom should take her new medications. I said to hold on until I got more information. I called the non-VA primary care provider and told him the story. He was going to ask the VNA to go in that evening. He had not been aware of the admission because much of his and our patient's care was being delivered by the heart failure clinic. I then called the heart failure clinic and let them know about the patient's low blood pressure and my concern for her getting more beta blocker and the additional ace inhibitor. They were concerned as well but informed me that the patient was tolerating the higher dose of beta blocker in the hospital. I also found out that AFIB was a new diagnosis for our patient and that she had been on coumadin for 2 months. The ace inhibitor was held and the heart failure clinic case worker was going to take the lead in educating the family, VNA, and the patient about the medications and the vital sign parameters in which to use them.
Prepared by Maureen Layden, MD and Snyder, Barbara Hebert, MR in Primary Care, Patient Education in Primary Care, Volume 10 Issue 4 2007
Not a success! A 75 year old male with past medical history of hypertension, hypothyroidism, hypercholesterolemia, coronary artery disease, and chronic obstructive pulmonary disease has just completed a lengthy admission for fall induced right hip fracture with subsequent open-reduction-internal fixation. Post operative complications included, anemia, congestive heart failure, and later pneumonia. Upon his admission to rehabilitation, his new nurse reviews his medications. She discovers that the patient was on the generic Metoprolol (Lopressor)100mg BID from his VA primary care provider and Toprol XL (Metoprolol, extended release)200mg daily from his private sector primary care doctor's sample supply. When she asks the patient about this duplication medication, he said he did not know Toprol XL is the long acting form of Metoprolol. And yes, he had suffered some dizziness and light-headedness since starting it. He asks, "Did that cause me to fall and break my hip?"
My patient's blood pressure was high despite being on three blood pressure lowering medications. When I asked if she was taking the medications she said yes. I never thought to ask her how she took them, until yesterday. It turns out she took them only when she felt the "pressure". When she gets a headache and feels funny, she checks her blood pressure and if it is high then she takes her meds. It is only on those days that she takes the medication. As it turns out she takes her the blood pressure medications only two or three times a week. We went over how high blood pressure often has no symptoms at all and can cause heart, kidney, and eye disease to name just a few! When we talked further she said finally that she knew that but was afraid to take so many medications. We agreed on a goal to re-start with just one blood pressure medication daily and she will check her blood pressure daily too. (Wife of Veteran, 82yo)
Reviewed/Updated Date: May 2011
Clinical Advisory Board Sponsor: Rose Mary Pries, PhD
Clinical Subject Matter Experts: Maureen Layden, MD, MPH; Eric Spahn, PharmD
Patient Education Subject Matter Experts: Kathy Horvath, PhD