Coping With Chronic Illness: What Goes Wrong
When it comes to self-managing chronic conditions, patients often make mistakes.
Medication errors are not limited to people with asthma. Arthritis sufferers make them too, according to Hayes Wilson, MD, chief of rheumatology at Piedmont Hospital in Atlanta. "Some people get their prescription filled but never take it. Or they think to themselves, 'That sounds like an awful lot [of medicine]; maybe I'll just take it occasionally,'" Wilson tells WebMD.
Arthritis is one of the main reasons people limit their physical activity. However, certain types of exercise have been shown to be beneficial to people with arthritis. Unfortunately, advice to exercise frequently goes unheeded.
People with arthritis tend to avoid exercise because they think it will hurt, explains Wilson. While he admits that engaging in exercise that applies pressure to an arthritic joint does seem counterintuitive, Wilson insists that not using the affected joint only makes it worse. So how can someone with painfully arthritic joints exercise effectively? "Having the guidance of a doctor and a physical therapist to help direct an exercise program for someone with arthritis can be quite helpful," Wilson says.
Thinking that pain is an acceptable part of arthritis results in poor control of the condition. "Most of my patients have pain. But some patients think there's nothing they can do about it," Wilson tells WebMD. That's not so, he counters. "There are always things to do. If you have pain in a joint, see a doctor, get it diagnosed, and get on a treatment plan," Wilson advises.
Low-impact exercises such as walking, swimming, or water aerobics are good choices for people with arthritis. Exercise improves strength, flexibility and allows someone with arthritis to better perform daily tasks.
Like other sufferers of chronic conditions, people with depression tend to make medication errors. "They may discontinue their medications too soon or not take them regularly," says Douglas G. Jacobs, MD, associate clinical professor of psychiatry at Harvard Medical School. Or they stop taking them when they begin to feel better, he explains.
Not fully understanding the recovery process is a mistake that can negatively impact self-management. "Patients may think of recovery as a straight line rather than a zigzagging one," Jacobs says. While setbacks are normal, he explains, patients sometimes think that by backsliding they have failed. "People often expect too much of themselves early in the treatment process," Jacobs says.
Withholding important information from doctors is an all-too-often, and extremely dangerous, mistake. "They [patients] don't let their doctor know when they have suicidal thoughts," Jacobs tells WebMD. Plus, some patients fail to tell their psychiatrist about other medications they're taking. "This could lead to possible harmful interactions," Jacobs warns.
Like other chronic conditions, diabetes doesn't allow for any slack in treatment adherence. But according to certified diabetes educator Michelle C. Sheldon-Rubio, RN, CDE, it happens a lot. "Some patients think management leads to control [of diabetes] and control leads to cure. So then they think, 'I can go back to my old habits'," says Sheldon-Rubio, education coordinator at the Joslin Diabetes Center at University of Maryland Medicine.