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Glenn Thiel: Managing medications for better health

Whether it’s from the pharmacy, Chinese herbs, or a homeopathic remedy, all medications have both a regimen and a purpose. The regimen is simply how much to take and how often. The purpose is to improve your physical or mental health.

Naturally, what medication you eventually receive depends on your age, gender, size and what’s covered by your medical plan. In addition, you have some say in what you get. Whatever the circumstances, the initial goal for you is to get the most benefit out of the least amount of medication. Given all medications have side effects, the overall goal is not to be on anything.

This is especially true with medications that have potentially significant, adverse side-effects and with medications that have a high addiction potential. For example, high doses of Tylenol can cause liver failure and medications such as Xanax and Norco can be both quite sedating and addictive.



Often, medications do not work right away; some take days, or weeks or even months.

Managing your medications is a complex task. As such, it requires a joint and open effort by you and your health care provider. Doing so leads to an effective, patient-provider partnership that results in better health.

As a result, you need to have patience, stick to the regimen and follow-up as directed; assuming there are no adverse effects. Otherwise, your health care provider cannot assess whether you are benefiting from it or not.




Of course, if there are adverse effects, we encourage you to stop the medicine and call your provider right away to discuss what to do next.

What makes determining whether or not a medication is beneficial to you more difficult are the times when more than one medication is added or subtracted or not disclosed. For example, many patients with diabetes are on multiple medications.

If they also have high blood pressure, more medications may be present. Consequently, it’s best to change one medication at a time if possible. It is also best to let your health care provider know what you might be taking over-the-counter such as aspirin or vitamins or something off the street. This way, your provider has the whole picture and can make the best assessment.

Naturally, some conditions and diseases are more difficult to treat than others. And, even our best and most trusted medications can fall short of what we wish to accomplish — a cure. Chronic conditions and diseases, such as asthma and arthritis, are by definition items that we cannot cure. Thus, the best we can do is to manage them and mitigate their consequences. This often requires other interventions — from regular exercise and physical therapy to bracing and a referral to a surgeon — to make us feel better and be more functional.

There are times when, irrespective of any medication change, our asthma is better from breathing in the moist air at the beach, our anxiety is up due to a family crisis, or our arthritis pain is worse from helping a friend move their belongings.

When this happens, it does not necessarily mean that medications need to be changed; it may simply be that our environment and activity level has changed. And, given time, things will improve on their own. Of course, if we move to the beach, or family issues become chronic, or the increased pain from helping a friend move does not get better, then we do need to check in with our provider to discuss possible medication changes.

Managing your medications is a complex task. As such, it requires a joint and open effort by you and your health care provider. Doing so leads to an effective, patient- provider partnership that results in better health.

Dr. Glenn Thiel, DO, is chief medical officer and Lora Lee Grutkowski is a family nurse practitioner at Western Sierra Medical Center in Grass Valley.


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I guess I am getting old and grumpy. What is with the “good job” expression being so commonly used in very unexpected settings?



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