Why Don’t We Follow Doctors' Orders? - Part 2

I used to wonder why anyone wouldn't follow their doctor's orders, but since being diagnosed with COPD I’ve done it myself. In part 1 of this article, I laid out a few of the reasons I think this happens, and I wanted to continue with a few more reasons I've found:

Bad side-effects.

I once gained 8 pounds in a single week. It wasn't my ice cream habit – I swear – but because I was on Prednisone. When I'm in an exacerbation my doctor usually prescribes it help me get better. I am always so tempted not to take the steroid because I hate gaining weight. I follow my doctor's orders, though, because I know it will help.

The inhalers tend to make me sound like Louis Armstrong instead of Celine Dionne. Well, okay, I don't really sound like Celine Dionne. Actually, I sound more like a banshee giving birth when I sing, but I like to sing anyway. But having a hoarse voice and sore throat and coughing up extra mucus from the inhalers are not pleasant.

You may not like the taste of your medication. Or maybe you lose weight on them. Or they make you so tired you spend more time in bed. Or make you dizzy. Or you can't eat grapefruit when you take them and you really, really like to eat grapefruit. Whatever the bad side-effects, you may not want to take your meds so you don't have to go through them.

Doing the regimen is difficult or unfeasible.

My allergist's office is 90 miles away from me. When she first talked about allergy shots for me, it was supposed to be at her office every day for a few weeks. That's just not feasible for me. My primary doctor prescribed pulmonary rehab for me, but again, it was 90 miles away. Sometimes I think my town is a geographical oddity that's 90 miles away from everywhere.

The odds of me waking up at 3:00a.m. to take a pill are extremely low. The odds of me eating a prescribed diet without any chocolate or wine are extremely low. The odds of me doing a Buns of Steel program that includes jumping around or jogging in place are extremely low.

If what your specialist or doctor wants you to do is very difficult for you, you most likely won't do it.

Indifference.

This is a huge problem for patients with depression. If you're severely depressed or have an anxiety disorder, the thought of organizing all your medications and taking them all at the right time every day can be overwhelming. Some people may also believe since there is no cure for COPD they might as well not treat it. Why bother if you feel your diagnosis is a death sentence? Now, I can sympathize with people who feel this way but I sincerely hope these people change their minds. We really can treat our symptoms to feel better and live longer.

Lack of trust.

This one is probably pretty prevalent among non-compliant patients. They don't trust that the medications or exercise programs will work. They don't trust that they'll feel better. If their doctor or specialist doesn't spend much time with them, or listen to their complaints, patients feel discouraged and are less likely to follow prescribed treatments.

I once had an asthma specialist tell me that I did not have any allergies. I really doubted his declaration and then when he said, “We'll get you feeling much better,” but didn't prescribe anything or tell me exactly how I was going to feel better, I found a new specialist. I didn't trust him and if he'd actually done anything for me, I'm not sure I would've taken his advice. Oh, and it turns out I was allergic to everything they tested for and wound up getting injections for my asthma.

Remember my friend I mentioned in part 1? She didn't trust doctors as a rule and avoided going to one to help her.

So what do we do?

Well, if you recognize yourself in any of these descriptions, you very well could be non-compliant. Think about how you could improve following all your doctor's instructions. Consider making the decision to change what you're doing.

Realize that you are sick. Help your loved ones realize it. Then face it head on and learn how to take care of yourself.

Talk to your doctor or specialist and ask questions about any medication or program they want to put you on. Learn what it is, what it does, and how it will help you. Learn exactly how and when to take your inhalers or other medicine.

If you can, change doctors if you don't trust your current one. Not everyone can do this, but if you can, think about second opinions and new physicians.

As COPD patients we have to take charge of our illness. We have to advocate for ourselves and part of that is making sure you're doing everything you can to help yourself feel better. No, we cannot cure this sickness but we can sure make it progress as slowly as possible.

It's up to us. Let's do it.