Playing With Fire: Seeing "Noncompliance" In A New Light

Great article Viva!!! When's that blog coming???

I used to get uncomfortable with anyone using "non compliant" I just GAGGED typing it!!

I don't recall using the word in my career; because of my clinical rotations at area hospitals in my area, our instructors drilled to NEVER use "non compliance" as a term at all; in my PN and my BSN program.

As one who knows how to be that "horrible pt"that can keep my fellow peer in their toes when they see that I am a nurse, and state it like "I should understand", I give them a lesson that they never forget an let them have it!

But I digress.

When I deal with me, as a patient, it has taken me YEARS to not toe near the heat.

When you have a doctor state "I know you don't like pills" and recall yourself saying that to a patient, you know you are in IT, at least I know.

It's a few days after going back on my regular AP dose, and all is well once more. I even had a co-worker tell me today how much she enjoys working with me, because I figure things out on my own (apparently a couple of the other admissions nurses don't have that ability) and I don't freak out when something goes sideways. Oh, if she only knew......well, she does because everybody in the building knows I'm bipolar, but she said she'd never have guessed that about me otherwise. Now THAT is some good medication, folks. I won't be messing with it anytime soon!

Whenever I have resident say, "Gee dolcebellaluna, that sure is a lot of pills. I don't like pills. Do I have to take them all?" I say, "Yeah aren't they yucky? I wish Big Pharma wouldn't charge so much for a large, chalky, nasty tasting thing that is supposed to help you! I'd like you to take them, but you're an adult and I can't force you to take it."

Whoeever decided that ABT should be giant horse pills that taste like monkey butt better have a good reason behind the madness!

I tried to resist, but I've gotta know: how do you know what monkey butt tastes like? HAHAHAHA!!!

Edited Sep 12, 2013 by VivaLasViejas

As I was leaving the pharmacy today with my $165/mo. Geodon capsules (which unfortunately for my wallet, have turned out to be the magic glue that holds Viva together), I got to thinking about this little essay again and wondering how much "noncompliance" is due to the sheer expense of some drugs.

Take this little blue-and-gray pill, which consists of a chemical powder packed into a gelcap. It probably costs pennies to make, and yet I pay over $5 each for the generic version. I don't even want to THINK about what the brand-name version costs! Unfortunately, it's one of those meds that I just can't skip when money's tight (and when isn't it these days?), so I sacrifice something else, like the trash bill or some desperately needed household item, in order to pay for this medication.

But at least I have the option to choose sanity over a new toaster; there are millions of people who can't afford medication AT ALL no matter how much they need it. There are too few programs to help them, and doctors often don't even know that the programs exist, so they don't recommend them to their patients who need it. It's also hard on peoples' dignity to tell their physician that they can't afford the meds he or she has prescribed for them.....just another way to get slapped with the label of "noncompliant".

Climbing down off soapbox now.

But at least I have the option to choose sanity over a new toaster; there are millions of people who can't afford medication AT ALL no matter how much they need it.

Climbing down off soapbox now.

This is the one that breaks my heart. I work on the "stroke floor" and I naturally see a lot of people come in with strokes because they couldn't afford their meds for a while. (not to be confused with the people who choose to not take their meds; I have a special speech for them).

I personally understand the horrible choice it is some months too: co-pay or gas/food. Forget about the utilities (those turn off notices are just flirting messages! lol).

However, working in the job that I do, I make the choice to make my health a priority.

My 70 y.o. neighbor was in miserable condition a few years ago when he made a very smart decision. He stopped taking all his meds. His health has improved since a lot. I beleave that the majority of elder-lies who are on 10 + meds will do much better if they stop taking all that garbage.

My 70 y.o. neighbor was in miserable condition a few years ago when he made a very smart decision. He stopped taking all his meds. His health has improved since a lot. I beleave that the majority of elder-lies who are on 10 + meds will do much better if they stop taking all that garbage.

Under normal circumstances, I would agree with you. Many of the elderly in this country are WAY overmedicated, IMHO. I pass meds sometimes in a nursing home, and it's ridiculous---not only 10+ prescriptions but as many as a dozen supplements, vitamins etc. And for what purpose? Are we going to cure them with CoQ10? No wonder so many of them balk at their morning cup of pills---we're overwhelming them with meds, and a lot of them are unnecessary.

OTOH, there are middle-aged and older people who need multiple medications to control a hard-to-manage condition. I'm pushing 55 and am on four different blood-pressure pills (although I've been able to cut way back on the doses since I've lost 60+ lbs.), fish oil, vitamin D, metformin, and melatonin as well as four separate kinds of "crazy pills". Well, without the vast majority of those, I'd be a hot mess! And anyone who takes him/herself off certain kinds of medication without the supervision of a doctor or NP is risking big trouble.

Your neighbor was lucky. I'm glad he's doing well.

This is the one that breaks my heart. I work on the "stroke floor" and I naturally see a lot of people come in with strokes because they couldn't afford their meds for a while. (not to be confused with the people who choose to not take their meds; I have a special speech for them).

I personally understand the horrible choice it is some months too: co-pay or gas/food. Forget about the utilities (those turn off notices are just flirting messages! lol).

However, working in the job that I do, I make the choice to make my health a priority.

Yes......it's amazing how seeing the effects of poor health decisions can change one's point of view.

Unfortunately, for some of us it takes a little more than that. With me, it took being diagnosed with diabetes in 2011 and bipolar illness in 2012 to make me straighten up and pay more attention to my health. Before these two events, I ate horribly, never exercised or moved around any more than I absolutely had to, skimped on sleep, and didn't take my blood-pressure meds regularly.

But the way I figure it, when a person gets handed two devastating diagnoses within a year of each other, it's time to listen to what God and the universe are saying and DO SOMETHING. So I've been religious about my blood-pressure and DM medications, and (except for the experiment) I've stopped regarding my psych meds as a punishment for some long-forgotten sin. I don't eat compulsively anymore or drink much soda; I have an active job and do more around the house than I used to; I struggle with sleep but do my best to make sure I get at least 6 hours/night; I've forced myself out of the rat race and into a low-stress job.

As a result, my weight's down over 60 lbs.in the past year, and my blood pressures have dropped into the normal range for the first time in decades. Random blood sugars are in the 95-105 range. I can handle stress better, and my moods are steady. Yes, I have some chronic health issues that will have to be dealt with every day for the rest of my life, and I still have a vast amount of room for improvement in my habits. But overall I'm a whole lot better off than I was two years ago, and I didn't even have to go vegan or train for a marathon to get here.