Do I need to take medicine prescribed by a doctor?
The problem of patient adherence to treatment is not new. Up to 80% of patients of a neurologist confuse appointments, drink medications irregularly or do not drink them at all. “Well, the neurologist has completely patients with memory impairments, that’s the reason,” you say. And you will be wrong.
Different cognitive impairments take up only a small part of the admission, which means that these 80% are mostly adequate people who for some reason choose to treat themselves according to their understanding or not at all.
Tablets of happiness that no one wants to drink
Not bad with those who are treated with antidepressants. More than half of the patients do not dare to start taking pills of happiness with a prescription. Another small percentage buys the drug, reads the instructions, decides that the doctor has gone mad and decided to kill him, and never concerns the packaging of the medicine. Finally, there are certain losses of patients at the finish line: those who started taking the drug, felt his side effects in the form of drowsiness, confusion of attention, dry mouth, decreased libido and decided to stop taking.
But then, by the third week, the world blossoms for the patient on antidepressants with new paints. Remembering a world without tablets, which was a bleak gray, a sort of Orwellian reality, patients diligently take the entire prescribed dose for as many months as necessary. Because the difference between the mortal, colorless world and the world of pink ponies, laughter and joy is enormous.
Approximately the same story with anti-anxiety therapy. It is very difficult to make a patient worrying about any, even a little bit significant event in his life, to take some kind of hostile pills. A person is used to living in a sense of constant anxiety, it seems normal to him. He, in general, doesn’t complain to the doctor at all about anxiety, but about insomnia, weight loss, constant heartbeats, from which cardiologists shrug their shoulders, some mysterious thing in the chest that is constantly shaking, and so on.
To such people, by virtue of their personal characteristics, to start taking new pills means to bring one more cause for alarm to my full cares life (“What if I sleep all the time? And if I turn into a vegetable? And if the doctor gets kickbacks from the pharmacy? And on meWant to try a new drug? And if the side effects start? What if allergies? But how to drive a car? ”- and thousands more fascinating questions). But if the doctor, without haste, answers these thousand questions, gives the patient time to think everything over, the stars will come together in the right way and the first pill will be taken, another life will begin. The patient will understand what it is not to worry every second. So, it is very likely to be motivated to continue treatment.
Although it does not do without tricks. I had one patient who suffered from chest pains. Cardiologists examined him from and to, therapists shrugged, pulmonologists drove him out of their offices, saying that he was completely healthy. Finally, he decided to visit a neurologist - kind doctors suggested that “chondrosis” could be to blame.
I twirled it like this and did a little bit of it, I did not find any hint of problems with the spine or back muscles. But after talking with him, it became clear that there is anxiety and subdepressive state. Sending him to a psychiatrist was pointless - the well-known to every doctor song “I'm not crazy” began.Neurobird poultry neurologists, the prescription for antidepressants and tranquilizers can also be prescribed. For about a month, I persuaded this patient to begin treatment. During this time he was convinced that neither an orthopedic mattress, nor physiotherapy, nor dirt, nor vitaminchiki, nor painkillers help him. I kept repeating that antidepressants should be started, because the cause of the disturbing symptoms is different.
Finally, he decided. By the third week, his face brightened as expected. A month later, he said that he had stopped hurting, and that his sleep had improved and in general his life had become more pleasant. After three months, I gradually canceled the pills of happiness, and we did not see for half a year.
Then the life of this man again began to lose color. Ill loin and lower abdomen. Again a string of doctors: a therapist, a gastroenterologist, a proctologist, a surgeon, a urologist, and even a rheumatologist. They all shrug their shoulders again and nod in the direction of the neurologist, saying that your doctor won, go to him. I again twist the patient that way and I'll check it out and find nothing new. I explain to him that sometimes the neurotransmitters are disturbed in the brain and depression occurs, but it doesn’t manifest itself by sadness and sadness, but can be disguised as strange pains wandering the body and make the patient crazy, because doctors cannot find anything.He again begins the cycle of treatment with physiotherapy and vitamins. I wait patiently when he is convinced of their inefficiency.
Two days ago, he came to see me again, and I started talking again about antidepressants. But the problem is that he completely managed to forget how it is - to sleep normally, not to worry and not to listen to your feelings. Therefore, he continues to hope that the mud and massage will help. But I know for sure that no later than in a month he will come for the recipe, and in two he will be fine.
Back pain is not a reason to believe a doctor
But all records on non-binding and irresponsibility regarding treatment are beaten by patients with back pain. Most are people with nonspecific lower back pain. Someone overworked in the garden, someone raised in a rocking chair too much weight for themselves, someone wore a temperature-conscious child in his arms all night. In other words, most of these patients go to the neurologist for the first time. And they are sure that they know everything they need to know about their illness - tea, not idiots, they did not ban Google.
They are appointed by the NSAIDs, and they buy iplikator Kuznetsova. They are talking about physical therapy, and they begin to torture their ass with injections of vitamins of group B.And so on and so forth - until they bring an infection to the wounds ruined by excessive enthusiasm when using the Lyapko applicator, or Quincke edema from “vitaminchchiki” begins.
Why do patients not follow doctor's prescriptions? There are several reasons for this: this is a distrust of the owners of white coats, fueled by vile stories in the media about the triumph of the murderers and konovalov. It is a certainty that in the age of accessibility of any information, the functions of a doctor are reduced to issuing sick leave, and all treatment methods are beautifully described on the Internet. This is an excessive activity of pharmacy workers who need to carry out the sales plan for fuflomycin, as well as iron self-confidence, which is often a companion of insufficient education. Sometimes these are funny cases when a patient meets her aunt Klava's neighbor and learns a fascinating story about “how she had pressure, and only Corvalol helped,” and also begins to be treated with Corvalol - still a positive example of a familiar person motivates you more than a bore. in a white coat with its standards for the treatment of arterial hypertension.
One way or another, it is useful to remember that the effectiveness of your treatment is not only in the hands of a doctor. If you forget to drink prescribed pills or do not drink them at all, do not blame the doc- torine's unprofessionalism.
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