Take your medications inconsistently:
Almost half of the 31,750 people treated at Duke University for major heart problems in a seven-year study acknowledged that they were not taking beta blocker drugs, aspirin and cholesterol-lowering drugs exactly as their doctors had ordered, according to a report in the Jan. 10 issue of Circulation.
In fact, the study showed, the patients who would benefit most from drug therapy -- the elderly, those with heart failure, those with other diseases -- were the least likely to be using them as directed.
The study participants had all undergone at least one heart procedure, such as bypass surgery, or had at least 50 percent blockage of one coronary artery. Yet, while a majority did take the drugs now and then, many did not take them regularly.
For aspirin, presumably the easiest drug to take, 29 percent said they did not consistently use it as ordered. The compliance rate was much lower for other medications: 46 percent said they took beta blockers as ordered, and only 44 percent followed instructions for using lipid-lowering drugs such as statins.
The usage of ACE inhibitor drugs by people with heart failure, the progressive loss of ability to pump blood, were even lower: only 20 percent said they took the medication consistently.
The study authors say that cost may play a role, but that health care providers also need to make sure they educate patients.
I'll second that. I was put on beta blockers for high blood pressure. My gut said don't do it. I should have listened to my gut; as it turns out I have a bad reaction to beta blockers, and my blood pressure was in all probability a transitory problem related to extreme stress. But, my otherwise beloved Dr. Pete scared me into taking them and then no one explained to me just what would happen if I didn't take every single dose on time every day.
Oh sure, it says on the bottle take every dose at the same time every day. But all medications say that. What could happen if you miss a dose--not on purpose, but because you forgot? Eh, probably just wouldn't work as well. Right?
As it turns out, wrong. There are some medications, and beta blockers are among them, that will damn near kill you if you start taking them and then become irregular in their use. That's what happened to me. Read on.
I got my medication most days, but some days I just forgot. They didn't sit well with me, either, so it was easy to forget them. I didn't realize that if beta blockers don't make you feel better right away, something's wrong. I had had fibromyalgia for a while and was just used to feeling crappy; what's a little more crappy? Hardly noticeable.
No one will say it, but as far as I'm able to determine, my 2002 heart attack was caused by irregular use of beta blockers. There are no blockages in my heart; I had a cardiac spasm so severe it was still going on hours later--in fact it was misdiagnosed as two tiny blockages. And the solution was to put me on EVEN MORE beta blockers, that no one explained must be taken exactly on time and that I did a better job of getting but still missed one from time to time. Which resulted in more spasms and visits to the ER and still higher doses of beta blockers, until finally I had an angina attack so severe I thought I was dying.
They looked at my heart once again, expecting to find new blockages. They didn't. The old ones were gone--statistically impossible. There were no new ones. My heart was clear. Except that every time their probe touched it, my heart spasmed in agony.
Good news, Lynn! You have spasm. Good bye and good luck. No change in medication. No change in anything. It took my own research to discover that variant angina (what I have) and beta blockers are not a good fit, and what beta blockers can do to you if you don't take them exactly as prescribed. It took two months of pleading for the cardiologist to consider taking me off of them. It took two months of gradually reducing the dose and feeling like death warmed over before I was off of them completely. It's taken nearly four years since the heart attack for me to feel like I'm finally on the mend.
And then there was all the other crap I was on after the heart attack. From nine medications I'm now down to one. And a goal for 2006 is to get off of that one too.
Bottom line is this: If a doctor prescribes a drug, do the research. Ask questions of your doctor, your nurse, your pharmacist. Learn how you're supposed to feel on the drug, and what warning signs for adverse reactions there are. If, after you've done your due diligence, you decide to go on it, take it EXACTLY as prescribed. If you're absent-minded, like me, consider keeping a log book and writing down when you've taken your meds. I write that down along with when I open a new bottle of meds so that I can count backwards if I get so absent-minded I forget to write down a dose (it happens).
And most of all, be as pro-active and responsible for your own health care as possible. Don't leave it to the doctors; your life is too important.
Categories: medicine, heart, attack, howto
Technorati Tags: Healthy Living
