This week’s letter is about the importance of taking the medications your doctor orders for you.
Why is this important? Patients who take all the pills that their doctor orders are healthier, hospitalized less and live longer. Not taking pills as ordered can make you feel more ill, spend more time in the hospital and even be more likely to die. However, if you have a medication that you think makes you feel more ill, then please tell your doctor so a change in your medication can be made. Also, if you are not taking one of your medications for any reason such as its cost, please tell your doctor. It is always better if your doctor knows exactly what you are actually taking. Also, if a doctor outside of the dialysis unit gives you a new medication, please tell your dialysis doctor or nurse because sometimes doctors give dialysis patients the wrong medication or the wrong amount of the medicine that can make you sick.
Doctors often ask you if you are taking a certain medication. Please be completely truthful. We are often looking to see if a pill is helping you. If you say you are taking it when you actually are not, your doctor may make a change in your care that is not best for you.
Dialysis patients may take 12 or more medications a day depending on how many other illnesses you have. Commonly, medications are for dialysis related bone disease, anemia, heart disease, diabetes, congestive heart failure and high blood pressure. We know that the more medications we give you, the more difficult it will be for you to take them all. We know that there are lots of reasons for this. For many patients, the number of different pills you need to take are amazing and unfortunately some need to be taken several times a day and often more than one pill at a time. Lots of these pills are needed for the rest of your life which can be concerning and very costly. I’m sure that a lot of dialysis patients wonder if any of their symptoms are side effects from their pills.
Please discus any concerns with your doctor including asking for explanations about why certain pills are important. Your nurses and dietitians can also help.
What can you do to decrease the number of pills you need? The most important thing is following the dialysis diet. Some of the pills are actually used to make up for eating the wrong diet. Making sure that you come for all your dialysis treatments and stay for the entire treatment can decrease the number of pills you need. Patients who change to different types of dialysis such as home dialysis or nocturnal (overnight) dialysis often need less pills. Sometimes, taking all the pills you are told to take will prevent your doctor from ordering more pills. If cost is the problem, we may be able to help get help for you to pay for them or change to a cheaper pill. So, please speak up.
It is also very important for you to bring in your pills every month in their bottles to show your nurse. We want you to do this in case there are any missing pills or you are taking medications we do not know about. Sometimes your doctor can suggest ways you can decrease the number of pills you take. This takes working closely with your nurse, dietitian and doctor.