Peter S's story: Living with multiple medicines

Peter is an ex-nurse who worked as an occupational health and safety advisor until 2000, when he left the paid workforce and is now receiving income from workers compensation insurance and a disability support pension. He lives on his own in the outer western suburbs of Sydney.

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

• Humalog insulin: type 1 diabetes (administered via insulin pump)
  
• Lasix (furosemide [frusemide]): diuretic (for cardiac conditions)
  
• Irbesartan Hydrochlorothiazide: diuretic (for cardiac conditions)
  
• Slow K (potassium chloride): potassium supplement (for cardiac conditions)
  
• Dilatrend (carvedilol): beta blocker (for cardiac conditions)
  
• Prinivil/Zestril (lisinopril): ACE inhibitor (for cardiac conditions)
  
• Duride (isosorbide mononitrate): anti-angina agent
  
• Plavix (clopidogrel): anticoagulant to prevent blood clots
  
• Cartia (aspirin): anticoagulant to prevent blood clots
  
• Coumadin (warfarin): anticoagulant to prevent blood clots
  
• Pravachol (pravastatin): lowers cholesterol
  
• Ezetrol (ezetimibe): lowers cholesterol
  
• Cipramil (citalopram): depression
  
• Oroxine (thyroxine): controls thyroid function
  
• Motilium (domperidone): gastroparesis (delayed gastric emptying)
  
• Acimax (omeprazole): reflux
  
• Omega 3 fish oil: improves brain function
  
• Temaze (temazepam): for sleep.
  

Sleep apnoea: recently diagnosed, uses sleep apnoea machine.

Pacemaker; neurostimulator for chest pain.

Peter has a complex medical history with his major health issues currently being type 1 diabetes, a number of cardiac (heart) conditions and depression.

Eleven of the medicines Peter takes regularly are for his various heart conditions. Despite having coronary bypass surgery and subsequent stents, Peter still experiences chest pain. At one stage he became dependent on morphine for pain relief.

Peter used to find it difficult to manage his diabetes when he was feeling very down with depression. His diabetes is no longer an issue now that his depression is well controlled. He has also started using an insulin pump after having used needles and syringes for many years. 

More about Peter S

After being diagnosed with type 1 diabetes when he was 36, Peter started giving himself insulin using a needle. About 12 years ago he started using an insulin pump, which has greatly simplified his diabetes management and means his diabetes is no longer an issue. The pump can download reports so Peter and his diabetes educator can see how his blood sugars and insulin are going.

Peter has a number of cardiac conditions. Peter was diagnosed with cardiomyopathy in 1992 and later developed congestive heart failure and hypertension. He underwent coronary bypass surgery in 2000 and in 2003 had a pacemaker inserted. About 10 years ago he had a pulmonary embolus and was started on warfarin to prevent further clots developing, which he still takes. Over a number of years he developed refractory angina (angina not relieved by medicines or surgical procedures) and had a neurostimulator inserted to help manage his chest pain. In 2011 he had three cardiac stents inserted.

Eleven of the medicines Peter takes regularly are for his various heart conditions. Peter was assessed for a heart transplant but was not considered suitable due to his diabetes. However, not long after starting on Dilatrend his heart condition improved somewhat, although he still experiences chest pain despite the coronary bypass operation and subsequent stents.

At one stage Peter was prescribed morphine mixture and injections to use at home for severe chest pain not relieved by the neurostimulator. He became very scared and alerted his doctors when he realised he had a dependency problem when he wasn’t sure if he was using the morphine for chest pain or because he needed another fix. Now when his chest pain is bad, he gets help at the local hospital and will only agree to having morphine as a last resort.

Peter was diagnosed with depression and anxiety in 1998 after his family noticed changes in his behaviour. Because he was on so many cardiac medicines, it took a while to find an antidepressant that would not interact with his other medicines. He thinks he might have developed early stages of depression around the time he was diagnosed with diabetes. Before his depression was well controlled, Peter used to find it difficult to manage his diabetes properly, especially when he was feeling very down. Now that his depression is well controlled he is better able to manage his diabetes.

Because of his nursing background, Peter has relatively good knowledge of most of his medicines. Over the years he has found information on his medicines from MIMS medicine information books, from his doctors and pharmacist, and from reputable internet sites like drug company sites or NPS MedicineWise. He thinks it’s important for people to ask their doctor what each medicine is for and how it works, and never to be afraid to ask for help. He has found having a good relationship and forming a team with his doctors and health professionals to be very important in managing his chronic health conditions.

Peter has been having his medicines packed into Webster-paks for many years, which makes taking his medicines very easy. He carries a comprehensive summary of his medical conditions and medicines with him at all times in case of an emergency so that medical staff are aware of the treatments for his complex problems.

Peter’s family has been a great support throughout his illnesses. He has kept his now adult daughters fully informed of his medicines and medical conditions since they were little. Peter aims to be at his newborn grandson’s 18th birthday and is grateful his medicines can help him to achieve this goal.

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