Just what are we thinking?

We don't take our medicine correctly, we skip out of blood tests and doctors visits, we don't excercise and ignore diet guidelines. No wonder we're sick. Someone close to me recently passed away. Not a 97 year-old codger or an 85 year-old 'lived-a-full-life' type. Instead it was a middle aged man in his late fifties. His principal diagnosis was diabetes. For the past 10 years, we could see his battle with this insipient disease: first the heart attack, then the infections, later an amputation, a stroke, a second heart attack, and then only months later, a third and final heart attack. There was some indication that he wasn't taking all of his medication. Indeed, one prescription had been left unfilled for weeks. What's more, instead of losing weight as recommended for most overweight diabetics, his weight increased by more than 30 percent. On the plane, heading east for the funeral, I read about a study published in a recent issue of Archives of Internal Medicine. One third of all patients in the study who were prescribed medication, stopped taking that it within six months - without doctor approval. I wonder about my own health habits. Hadn't my own doctor told me to lose weight? Didn't he say get more exercise? Eat less? While I do make attempts at complying with my doctor's orders, I soon forget, rationalizing that I am thinner than I really am, or that the doctor really doesn't know the 'real' me. I simply move on to my regularly scheduled life, leaving his advice pretty much unattended. It's one thing to not take an aspirin for a simple headache or ignore a few extra pounds in an otherwise healthy person. It's a completely different thing to ignore medications that can save your life. Yet we seem to do it all the time. Countless studies show the ill effect of additional weight can have disastrous effects on many body organs if you have diabetes. Without rigorous monitoring, and compliance to diet and medications, diabetics can suffer a host of seemingly unrelated complications including blindness, kidney failure, infection, heart disease and ultimately, death. You'd think that list would be enough to put anybody with diabetes on the straight and narrow - amputations? Kidney failure? Blindness? Death? But the facts show that many people ignore doctors orders routinely. Research suggests that non-compliance (not taking your prescribed medicine) results in more than 125,000 deaths each year at a cost of $75 billion annually. Did you know that there are more than 2.5 million active epileptics in the United States? Epileptic seizures can be triggered by a number of causes including flashing lights, loud noises or other stimuli but according to Dr. Paul Van Ness at the UT Southwestern Epilepsy Center, the leading cause of epileptic seizures is not any of the conditions listed above, but rather that patients are not taking their prescribed medication. Other research suggests that simply having medical knowledge doesn't mean you automatically do better. In a study of diabetics, for example, knowing how the disease worked didn't necessarily mean that the patients took their medicine any more faithfully than those without the additional information-- which is very interesting when you consider that diabetics are twice as likely to have acute coronary complications than the general public. So why don't we take our medicine? Dr. Janice Buelow PHD, RN of the National Institute of Nursing Research Center for Enhancing Quality of Life at the Indiana University School of Nursing in Indianapolis says, "Patients are trying to fit medications into their lifestyles, and they cannot always do this." Another possible reason is expense. Having to choose between food and medicine is more common than one might think. Side effects seem to play a role in why we don't pop that prescribed pill or swallow that minty not-so-fresh sludge. We don't like the headaches, nausea or whatever else might result from taking it. So let's review: take the pill and get a headache; don't take the pill, have a stroke. Some people report that their doctor just made them mad, making them wait in the outer office for more than a half an hour, or simply acting indifferently or unconcerned during the appointment. "I'll show them, I won't take my medication!" Embarrassment is another problem. We human beings are a sensitive lot. We're embarrassed about our medical condition, about our financial situation, about feeling ignorant because we don't always understand what the doctor is telling us. Good reasons to not take our prescription medication? Goods reasons to not follow the doctors orders? Good reasons to let our kindly neighbor, the good-natured volunteer or the dedicated family member do just a bit more for us because we don't want to do for our selves? No one is going to force us to take anything we don't want to take. Doctor's orders, after all, are not really orders; only recommendations. We're not going to be 'locked up' for not following 'doctors orders.' Yet sometimes, ignoring them can bring about the ultimate penalty. So when we get prescribed a medication and suddenly find we're not taking it, maybe we should ask ourselves: What the heck am I thinking?