Too many medications? Speak with your physician

In these pandemic times, I am sure many people who live with health concerns have had conversations with their doctor about the drugs they are taking to manage the day to day. It’s important to have another conversation  - “Am I taking too many medications?; how many of the drugs I take interact with each other and I may not even know it?”

Polypharmacy occurs when a patient takes too many medications. It is most common among seniors and individuals with multiple medical conditions. Since older people metabolize drugs differently, the combined effects of numerous medications can be especially harmful. It’s the simultaneous use of multiple medications. While this may not seem like a bad thing, being on too many medications can lead to potentially dangerous drug interactions and exposure to many different side effects all at once. The same is true for  over-the-counter (OTC) medications and various supplements, which patients often use as needed without informing doctors.

It is vital to have an honest conversation with your doctor. Without that, they cannot give fully informed advice; that does no one any good and it’s actually an insult to a professional’s credibility. Think about that.

Treating only one chronic medical condition may require several prescriptions, but for seniors who often have several ailments, medication regimens can be complex, getting to the point where the patient does not know all the drugs they are taking, why they are needed, or how to take them properly. Medication errors are more likely with complex regimens and can be dangerous as well. What is worse is that physicians may not be aware of all the medications their patients are taking.

‘Brown bag’ appointments is a way to clean out the cabinet as it were. If an elderly person lives with an adult child or other provider of help, include that individual in all discussions. Armed with a list of all  drugs taken and names of prescribing physicians allows for a dialogue about why, for example, a pain management drug prescribed for a fixed number of days  for an issue that’s been resolved for years, is still being used.  How many other drugs are used for conditions that no longer exist?

The average older adult is thought to take four or more prescription drugs each day, but a whopping 39 percent of seniors take five or more prescriptions each day. While each one was created to treat or manage a specific medical problem, each also comes with its own risks and side effects. The more medications a person takes, the higher the chances are for experiencing adverse reactions, negative side effects and even life-threatening conditions. Overall, polypharmacy in the elderly is a major contributor to disability, frailty, falls, long-term care placement and a decreased quality of life.

I’m still having difficulty wrapping my brain around the reality that I am a senior. Wow! When did that happen? Living on my own and  only taking one script medication for a thyroid disorder, I am fortunate that I never got into a cycle of taking drugs just because a doctor or specialist said I must because they’re glued to that  bulky blue book aka The Compendium of Pharmaceuticals and Specialties. While in university, when  I was prescribed a combo of drugs to manage CP, I browsed through Dad’s CPS to learn about the medications I was taking. Up that point, I took no CP-management protocols. I was concerned about one, Dantrium, a muscle relaxant. Over time it can cause liver issues. I took the trio of meds for a few more years and then stopped, using only one, Tylenol #3 ‘as required’ rather than ‘as directed’. I typically take that when my spine hurts  but I don’t take it during the day, always at night at bedtime, so I’ll be safe in my bed and not roaming around loose risking a fall down and go boom episode. Been there, done that!

Key to successful management is to have an effective ‘hall monitor’; someone to police the flow of drugs and who is knowledgeable about interactions and will confer with physicians if there is a concern about a patient’s use or mis-use. Sticking with  one pharmacy reduces the paper trail and minimizes the potential for patient self-harm.

So far, I’m able to self-care. Let’s hope it continues for some time to come.

Carla MacInnis Rockwell is a freelance writer and disability rights advocate living outside Fredericton, NB with Miss Lexie, a rambunctious Maltese and Mr. Malcolm, the boisterous Havanese. She can be reached via email at  Carla MacInnis Rockwell

Casual COVID clothing is here to stay

Long before ‘pandemic PJs’ became a thing, I embraced the wearing of this comfortable clothing item. Since 2007, after my husband passed away, Mr. Jake the Cairn terrier and I were home alone. Since I don’t drive, I didn’t have the ability nor the desire to go out and about on a regular basis. Aging in place with cerebral palsy and living with the implications of fibromyalgia and a cardiac defect, I had little energy to ‘dress to impress’; the daily going out to work grind had long passed and my labour is now being done from home. So, why not be comfortable doing it, and fashionable, too. I have an assortment of what I call stylin’ jammies, in plaids, in prints, with bears, with rabbits, with teddy bears, oh my! The PJ pants lack one thing. Pockets! 

The word pajama comes from the Hindi "pae jama" or "pai jama," meaning leg clothing, and its usage dates back to the Ottoman Empire. 

Ah, yes, the spelling. The word “pajamas” wasn’t always spelled that way. In fact, in England, they are still pyjamas. The word pajama comes from the words pae jama in Hindi which means leg clothing or leg garment. I spell it ‘pyjamas’. What about you?

Middle Ages PJs were shapeless with simple trimmings; only royalty and those of noble birth wore pyjamas that were more than a simple long dress. Fabrics chosen were in keeping with the climate, often silk. Being a frugal Scot and all about comfort, I prefer flannel PJ pants with a loose cotton top. Velcro is a popular closing instead of buttons if custom designing clothing items for the elderly or bedridden. 

In the 1800s, many people started wearing pyjamas as a matter of practicality; the poor couldn’t afford to heat their homes so layering with long tops and close fitting bottoms allowed them some measure of warmth which contributed to health and wellness. The rich, on the other hand, were more inclined to wear ‘designer’ pyjamas fashioned from exotic material. I browsed around online and found a few high-end styles that I liked and suited my quirky tastes while at the same time being  compatible with the way I live and move about my home.

Historically, pyjamas were tight the full length of the leg, or wide at the waist and tight at the ankles. People with orthopaedic challenges that involved limited movement of the legs, such as I experience, benefit from drawstring PJs with a bit of elastic waist as we’re often quite thin. I came across a clothing line for those living with dementia; they were designed in such a way that the wearer couldn’t disrobe. PJs that are ‘escape proof’ would be ideally suited in care homes where some patients are able to move about freely but may have mental lapses and disrobe inappropriately

In the early 1900s, PJs were becoming more decorative, with the introduction of bows and lace on pyjamas moving them into the realm of style, going beyond function. Glamour was taking center stage with The Roaring Twenties. Were I living in those times, I would have preferred the manly smoking jacket with co-ordinating pyjama pants. Instead of an ascot, perhaps pearls, for that touch of class. Did I just have a Coco Chanel moment? I doubt I’d dare wear something like that out and about, but who knows. I’ve been wearing jeans out in public in recent years. I got my first pair in my 30s. I now own two pair. Just two!  

Pandemic PJs are here to stay for  some time to come so it’s important that folks be comfortable as they make their way through these challenging days ahead. Working from home, though isolating from the routine of the day-to-day we previously enjoyed, can be made more palatable when we embrace our inner child and wear those bright green PJs with ducks. Fuzzy socks are a must. Make sure to get a few pair to mix n match to really make a statement, even if only the cat or dog sees it. Surprising how liberating it is to bring out your inner child to dress you.

Carla MacInnis Rockwell is a freelance writer and disability rights advocate living outside Fredericton, NB with Miss Lexie, a rambunctious Maltese and Mr. Malcolm, the boisterous Havanese. She can be reached via email at  Carla MacInnis Rockwell