Gordon's story: Living with multiple medicines

Gordon is a retired builder who lives on his own in a rural area in south-western Queensland.

Some medicines are taken regularly; some are taken only as needed.

• Minipress (prazosin): reduces high blood pressure
  
• Hiprex (hexamine hippurate): suppresses urinary bacteria for chronic infection (naturopath recommended)
  
• Glucophage (metformin): increases body’s response to insulin
  
• Insulin: manages the effects of diabetes
  
• Gliclazide (diamicron): an oral hypoglycaemic
  
• Seretide (fluticasone propionate, salmeterol xinafoate): manages asthma and COPD
  
• Betaloc (metoprolol): used in the treatment of angina and hypertension
  
• Spiriva (tiotropium bromide): anticholinergic bronchodilator used in the management of COPD
  
• Fluconazole (diflucan): antifungal agent
  
• Lanoxin (digoxin): treats atrial fibrillation for arrhythmia
  
• Panadol Osteo (paracetamol): high-dose paracetamol for pain relief
  
• Macrogol (movicol): osmotic laxative to treat constipation
  
• Diflucan (fluconazole): treats and prevents fungal infections
  

• Morbid obesity
  
• Felodur (felodipine): used to reduce hypertension
  
• Uremide: diuretic, getting up hourly through the night
  
• Spironolactone (aldactone): diuretic, used in the treatment of oedema
  

Gordon is taking a large number of medicines to treat a combination of hypertension, renal disease, diabetes and osteoarthritis. At the time of our interview, he was awaiting the results of further tests for possible cancer. Over the years, his medical regimen has been complicated by his fluctuating weight, side effects and interactions between his various medications. He has recently had surgery to remove a kidney and is an insulin-dependent diabetic.

More about Gordon

Gordon feels that he has tried to live a healthy life and was quite active in his youth, having been a lifesaver, cricketer and keen footballer. He has never been a heavy drinker and gave up smoking more than 40 years ago.

In his later years, however, as his work and recreational activities slowed down, he battled with considerable weight gain and developed high blood pressure when he reached his 50s. He subsequently developed insulin-dependent diabetes. This was followed by severe renal disease, osteoarthritis, heart disease and oedema (fluid retention).

Gordon’s biggest challenge with his multiple medicines has been the development of a number of transient side effects and interactions between his medications, including depression, dizziness and headaches, urinary frequency, bleeding and intermittent sexual dysfunction. His fluctuating weight also resulted in regular changes to the dosage of his medicines, although in recent years some of his medical conditions have finally stabilised. This may be due to recent weight loss.

As Gordon lives in a rural area, it can be difficult for him to easily access medical services and he is often reliant on others for transport. He nonetheless makes the effort to see his regular doctors, as he has formed good relationships with them, which he considers to be the key to maintaining quality of life. Gordon looks to them to ensure he is not taking more medication than he needs and to be honest with him, so that he can manage his own expectations. He acknowledges that everyone responds differently to medications, and thus determining the best set of medication for him has to be an ongoing process of review, monitoring and testing. He saw the benefit of this first-hand when a pharmacist reviewed his medicines during a hospital admission and managed to streamline his regimen. He has also consulted a naturopath from time to time, who has provided some helpful assistance with symptom control. He is always careful to check naturopathic advice with his doctor in case of interactions with his conventional medicines.

Despite the large number of medications he is taking, Gordon has managed the practical side of taking medicines with few difficulties. He is aware, however, that a change in routine can be a problem. On one occasion, he took his morning medicines twice when he had an unscheduled nap and forgot that he had already taken them. He has also had to be a bit more organised when travelling and going out for the day, which he does regularly as part of his membership with a social group.

Gordon felt that that when he started his first medication it was ‘the beginning of the end’. However, he now believes that following his doctors’ orders and seeing the improvement in his overall health means that he feels better in both mind and body. He intends to continue with his medicines, as ‘I don’t want to die. It’s as simple as that.’

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