Sick and Tired of Being Sick and Tired

Strategies and alternatives for coping with fibromyalgia, bipolar disorder and other chronic illnesses

Managing Your Healthcare Team, Part I

Posted by wendyburnett on January 9, 2010

Living with chronic illnesses affects us in so many ways that it’s really impossible to even list them all. Each of us lives within our own little universe of illnesses, symptoms, and needs. The one thing that is the same for every one of us; no matter which diseases, syndromes, or disorders we have; is the need for medical treatment in some form.

Because we frequently have multiple illnesses which affect different parts of our bodies, we may need to see an array of specialists on a regular basis. This quite often causes major complications in our treatment, since many doctors try to treat in a vacuum, ignoring the effect of their medications and recommended procedures on any disorder that is not part of their specialty. (For example, part of my constellation of problems include fibromyalgia, a rheumatoid type arthritis, and bipolar disorder. At one point, my rheumatologist prescribed a medication that has a high rate of causing manic episodes in people who are NOT bipolar, and is almost guaranteed to cause mania in someone who is. If I had not checked for side effects and possible interactions, and called my psychiatrist for advice, I could easily have ended up in a mental hospital for weeks while the effects wore off.)

We must often perform a balancing act, trying to treat the symptoms of one disorder without making others worse, and comparing the benefits of of a medication for one disease against the possible negative effects on another disease. With multiple medications, the chances of interactions increase, and studies focus on interactions between two particular drugs, not multiples, so we sometimes find ourselves dealing with strange reactions to unstudied combinations as well. Prescription A has no known interactions with prescriptions B and C, and prescriptions B and C have no known interactions, but the three together may cause an interaction that no one knows about. Anyone care to be a guinea pig and test unusual drug combinations? If you have multiple illnesses, you may have been doing it for years without knowing it.

Our doctors are only human. They have hundreds of patients with thousands of possible illnesses, and millions of possible treatment combinations. It is impossible for them to know every side effect and interaction of every combination of drugs you may be taking, especially if some of those drugs are prescribed by other physicians. Throw in supplements you could be taking, different herbal teas you drink, and the foods you eat; any of which they may not know about, and the chances of a bad interaction multiply exponentially. (Yes, nutritional supplements, herbs, and foods all have known interactions, both with each other and with medications you take.)

These factors make it imperative that we take responsibility for managing our own treatment, learning all we can about our various issues and researching any drug prescribed before taking it. Abdicating that responsibility puts us at risk of combined treatments that can make us worse, give us new illnesses, and might even kill us.

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