Coming to the Clinic - Part 5

Last week, I told you my tale of woe regarding my foot and a little bit of what it's like to be on the receiving end of health care. There will be more of that story to come, but since things are up in the air right now as I await the MRI results, I'm going to plow forward with the next installment of my series on how to be the perfect patient.

Today's topic will be your medication.

Oftentimes when you make your appointment or receive your reminder call or letter, you will be instructed to bring in all of your medications in their original containers. Today you'll find out why that is important.

 

1) When do you really need to bring all of your medications?

a) If you are new to the provider you are seeing or new to the clinic.

b) If it is your yearly physical.

c) If you have seen anyone else anywhere else since you saw this provider, such as you saw your cardiologist last week or were in the ER the week before. You may have forgotten that they changed one of your meds at that visit, giving you something totally different or taking you off of something.

2) When do you not need to bring your medications?

a) If you just saw this provider less than a month ago and absolutely nothing has changed.

b) If you are on absolutely no medications.

3) What medications am I referring to anyway?

a) I'm talking about pretty much anything you ingest, inject or put on your body that is not food, drink, clothes, deodorant or makeup.

b) This includes all prescription medication, including pills, patches, inhalers, gum, suppositories and insulin. A note on insulin and other items which need refrigeration: I get it that you don't want this stuff sitting in the car in the hot sun while you run in the store to pick up a gallon of milk on your way home from your appointment. It's okay to leave some stuff home in the frig, but then bring an empty box or the label from the pharmacy. You'll find out why later.  

c) Medications we want to know about also include all over the counter supplements and other drugs, such as tylenol, ibuprofen, multivitamin, fish oil, probiotics, that weird pill your sister-in-law recommended for hair loss, that powder your best friend gave you to mix in your water that is supposed to enhance your concentration. Pretty much anything that can or does change anything about how you act, feel, think, talk, metabolize food, etc.

4) Why do we need to know this stuff?

a) If you want us to fill any of these prescriptions, we need to know exactly what you’re taking and exactly how you’re taking it. If you aren’t taking it like the bottle says, you better know why and what you really are doing.

b) And all of those supplements you are taking? Most of those things are okay to take (a lot of them only offer the placebo effect and drain your bank account, but that’s your choice). We do need to know about these things however, because sometimes they can react with what we prescribe and once in a while they may even be the cause of your symptoms. 

c) Prescription medications are only prescribed by licensed practitioners because they are not candy. They are drugs, that can severe side effects and can react with each other in some interesting ways. If we don’t know everything that you are taking, we may end up breaking the Hippocratic oath – you know, the one that says “first do no harm.”

5) But you are on a grocery bag full of meds and don’t want to drag them around.

1) Again, having those bottles in front of us allows us to be sure we know what you are doing. If you have an accurate list on you, one that you up date every time you leave a medical facility, that is wonderful. In fact, you really need to keep an accurate list in your wallet at all times. You may get in a car accident on your way to Green Bay to a Packer’s game and the hospital they take you to does not have any of your records. You can download nice templates off the internet which have columns for the name of the drug, how you take it, when you take, when you last got it filled and even what the drug looks like. If you keep that list up to date, I will give you a gold star.

2) I have had people who have pictures of all their pill bottles in their cell phones. Not the worst idea; it’s better than nothing, but not as good as bringing your bottles or having the gold-star list.  

3) We may ask you if you need refills, and ta-da, it will say that on your bottles if you bring them with you!

4) Lastly, if we change how you take one of your medications, we can write that change right on your bottle, such as we increased your water pill to taking two in the morning and told you to hold that newest blood pressure pill. (Or if you have the gold-star list, we can always change it on there.)

6)  What not to say when we ask you what medications you are.

1) One of the things which drives all health care professionals bonkers is when we ask our patients what medications they are on and they reply, “Well, you should know, you have my list.” I am sooo sorry if someone reading this has said that to their health care professional. But I don’t live in your house, I don’t fill your pill organizer once a week, I don’t pick up your prescriptions at your pharmacy. I am only looking at the list that is in front of me on my computer. There is no way that I know how accurate that list is.

2) “I take a little pink pill every morning and a big white horse pill every night”. Not helpful, not helpful at all. That’s all I have to say about that.

7) Closing Thoughts - I really care about you and your health. Your provider really cares about you. We really want what is best for you. And that includes being sure that you are on the right medications, the ones that will make you the best that you can be.