Have you ever experienced misunderstanding with someone?  Did that lead you to make a bad decision?  If you had understood the original message, would you have made a different decision?

I have had two client examples this week.

Misunderstanding what the doctor said

In one instance, the doctor had said something about the pain medicine and the stomach acid medicine should not be taken together.  This person has had a long history of Barrett’s Esophagus – a severe inflammation of the esophagus cause by extreme gastroesophageal reflux disease (GERD).  To break that down, this person’s stomach acid was going back up the esophagus – the tube from the mouth to the stomach.  Normally there is a sphincter that closes to keep the acid safely in the stomach.  In many of us, that sphincter can become loose or have a condition that keeps it from completely closing.  When that happens, the acid can go back up the esophagus. Indigestion, burping, pain and/or burning in the mid chest area can result.  The acid inflames the esophagus lining.  When that inflammation becomes severe, the inflammation can lead to Barrett’s Esophagus.  So the stomach acid medicine was VERY important!

This person’s other issue was low back pain due to a herniated (bulging) disk and sciatic pain. Sciatic pain results in pain and burning from the lower back and spreading through the buttocks and the leg. It is caused by irritation of the sciatic nerve, common with lower back issues.

When this person heard the doctor say the stomach acid medicine and the pain medicine shouldn’t be taken together, the person decided to STOP the stomach acid medicine.  The sciatic pain was the ‘bigger issue’, so if both couldn’t be taken, the pain medicine took priority.  The doctor was not told.

The client heard ’these medicines shouldn’t be taken together’.  The more complete answer is, the pain medicine will make the stomach acid and esophagus irritation even worse.  There are safer pain medicine options that won’t make the Barrett’s Esophagus worse.  The person should DEFINITELY be on both a stomach acid medicine and a pain medicine. The pain medicine should just be changed to a safer option.

This was explained, and this person is now on a safer medication regimen for both conditions.

Another Misunderstanding Example

Another recent example was a man with severe vascular issues and lung cancer.

The lung and cancer doctors had together told him and his family there is no more they could do. They recommended hospice care. Hospice care was accepted.

The vascular issues caused very little blood flow to the feet.  As a result, one foot and lower leg had been amputated a few months ago. The second leg and foot are now very infected.  The foot infection is causing severe pain.  Hospice is treating the pain with morphine.  The morphine makes the patient’s stomach upset and dulls his thinking.

His wife understands that the hospice doctor is now his doctor rather than his specialists and primary doctor from before.  The hospice nurses visits regularly, but the doctor has not.  His wife is very upset that the doctor is doing nothing to heal the infection.  She also feels he is very overmedicated since his memory and decision making are slowed due to the morphine.

When we discussed goals – quality vs quantity of life – they each indicated the specialists who recommended hospice had asked that.  They chose quality.  However, they didn’t understand that this would mean a rather rapid decline with the untreated lung cancer and foot infection.  They thought he would be able to back to the things he loves like working on projects around the house and cooking.   They see a decline in quality of life rather than the expected increase.

Now they want to go back to the specialists and change their minds.  It has been six months of no curative treatment.  There is most likely no way to alter the pending outcome.

Essential Clear Communication

Healthcare visits can feel fast and pressured.  Any time there is bad news involved, it is hard to fully hear and process all that is being communicated.  These and other communication issues lead to misunderstanding of healthcare information. This is NOT an uncommon problem.

Another contributing factor is difficulty reaching the doctor after getting home to request clarification.  Most doctors are given schedules that make it difficult to squeeze in phone calls.  So, it is always best to receive, process, and fully understand the information while you have the doctor’s full attention during an appointment.

At Meds MASH and Retirement Wellness Strategies, we are your advocate.  You have guidance to prepare for medical visits by assuring you have your questions ready and the information your doctor needs organized and clear.  We also attend the visit with you by video when you want that.

After the visit, we can provide a wealth of information to further explain any new conditions or medications.  We can even contact your doctor(s) on your behalf to obtain any needed clarification.

Call today at 410-472-5078 and ask for Michelle Fritsch, Pharm.D.  Or e-mail at michelle@medsmash.com.   Check out more at www.medsmash.comor www.retirewellness.com.

BIBLICAL APPLICATION

Miscommunication and misunderstanding can lead to so many preventable problems.  I often ask this question of students in the health professions. ‘Tell me about a time miscommunication led to a bad outcome.’  Usually the answers involve people going to different restaurants or friends having an argument.  One time, while teaching active duty military healthcare providers, the example was of an international hunt for a notorious terrorist.  The terrorist had been found and surrounded, but a delay in the order to detain him resulted in his escape.  What an example!

The Bible has much instruction about good communication.

This Psalmist knows exactly how much trouble our words can cause:

Psalm 141:3 ESV

Set a guard, O Lord, over my mouth; keep watch over the door of my lips!

Our communication is instructed to build people up and turn them to Christ.

Ephesians 4:29 ESV

Let no corrupting talk come out of your mouths, but only such as is good for building up, as fits the occasion, that it may give grace to those who hear.

Colossians 4:6 ESV

Let your speech always be gracious, seasoned with salt, so that you may know how you ought to answer each person.

I know I have spoken in frustration and said words I regretted.  I know I have neglected to speak up when my support could have been very helpful to someone else.  I know I have said the wrong thing and caused more harm than good, usually out of complete ignorance or insensitivity.

Proverbs 15:2 ESV / 176 helpful votes

The tongue of the wise commends knowledge, but the mouths of fools pour out folly.

One of my frequent prayers in the morning is, ‘Lord please fill me up and pour me out today.’  I ask to be poured out with the Lord’s words and attitudes and sensitivities.

Psalm 19:14 ESV

Let the words of my mouth and the meditation of my heart be acceptable in your sight, O Lord, my rock and my redeemer.

I certainly can’t be trusted to do this on my own, but with the Lord’s guidance, excellent communication can make a huge positive difference in the lives we meet!

Blessings,

Michelle