Two recent events reminded me of the importance of taking a list of my medications when I go to the doctor. I waited at the clinic in my drug store to get my flu shot while the nurse-practitioner went through my medical records on her computer.
I said, “It must be a lot easier with computerized medical records.”
“Actually, you would be surprised. Now people tend to assume that we have everything right here and don’t keep track for themselves,” she said.
Within thirty seconds we found out why patients need to keep their own list. Although this is the drugstore where I get all of my prescriptions filled, my medical record had several mistakes. There wasn’t even a pattern to what was wrong. One of my eyedrops from the ophthalmologist was there, but the other one wasn’t. It was the same for the other two doctors who prescribe for me. The nurse said these kinds of errors are common. Fortunately, I was able to give her the list of medications I keep on my phone.
With this fiasco in mind, I decided it was time that I learn to use the computerized “patient portal” for my doctors, which I had been ignoring as I thought it was too much trouble. After my visit to the ophthalmologist, I went in to see my records. Once again there were errors. Medications I no longer take were listed, and the dosages for others were wildly off.
Why does this matter? Drugs can interact with each other. Sometimes they cancel each other out - in other cases one can multiply the effect of another and cause problems. Breast cancer patients usually see more than one doctor. If your primary care doctor has you on a medication to lower blood pressure, your oncologist will think twice before suggesting a medication that might raise it.
Your list could save your life
Every medical person you see needs to have a current list of all your medications. On Tuesday your dentist needs to know if you are on a bone strengthener that can cause dental problems. On Thursday, your oncologist needs to know that the dentist prescribed a prophylactic antibiotic after a root canal.
I don’t take very many medications, but when I used to try to remember them at medical appointments, I usually left something out. So I typed up a list of my medical history with the major illnesses, surgeries and treatments I have had and the dates for each. I included chronic issues like lymphedema and neuropathy. On that list I also had a list of medications. I put the prescriptions in one section and the over-the-counter medications, vitamins and supplements in another. I listed the dosages for each and made sure to indicate which I take only occasionally, such as an anti-histamine in allergy season.
My paper list worked well for me for years, but it took some attention to maintain when prescriptions changed. It was scribbled on and wrinkled from being in my messy purse. When I remembered to update it and print a new one before an appointment, the printer always seemed to run out of ink. Sometimes I forgot it and left it at home.
For the past few years, I have kept my medication list on my phone in the notes section. My phone is always with me and it is easy to make changes. Once I am at the doctor’s office, I can email the list if they want a paper copy, or hand the phone to the nurse if she wants to put the information directly into the computer. Staff people almost always comment about how helpful it is to have this kind of list.** Crafting your list**
What should go on your list? Every medication you take whether it is over-the-counter or prescription. Ask your doctor for the generic and trade name of each drug you receive by infusion in the office and add them to the list. All the vitamins, herbs, and supplements you take need to be mentioned as well. Any herb strong enough to help you is strong enough to possibly cause a drug interaction. That home remedy your friend suggested for hot flashes might interfere with a hormonal treatment your oncologist has prescribed. Some supplements like fish oil are blood thinners, so your doctor wants to know if your blood will clot properly after a procedure.
Be sure to list the dosages and the condition for which each medication was prescribed. If you just take a drug now and then, put it at the bottom of your list in a section labeled seasonal or occasional - list it. When my doctor found out I was taking a certain decongestant for colds, she told me that what I was taking could raise my blood pressure and suggested a different remedy.
If you use a smart phone, you can keep your list on it. If not, you can type up your list on paper. A hand-written list is fine too. Another idea is to ask your pharmacist to print off a list of your medications. Then you can add the non-prescription ones to it. My insurer sends me a monthly list of prescriptions I have filled. That list wouldn’t be perfectly accurate for me to take to a doctor since I don’t have every prescription filled every month, but it could be a good starting point.
Knowing the name of every medication you take is vital to your health. Too often people tell me that their doctor has them on a “strong chemo” and they wonder if it will interfere with the “little yellow pill” their primary care doctor gave them. Be proactive. Take charge of your health. Know what is going into your body and have a method to let all the medical people you see know too.
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