Follow-ups and maintenance
WHEN we’re unwell, we go to the doctor to get relief, whether the healing comes from just medications or with other treatments. Most of the time, we only need that one visit and all will be well after a few days. However, more often than not, doctors tell us to come back for a follow-up to make sure that all’s well so that we can be given a clean bill of health. Some short-term illnesses like diarrhoea or a urinary tract infection requires a follow-up after a few days or a week. Some illnesses require long-term follow-ups that go on for years and you, as a patient or caregiver, should follow instructions and the advice as best you can.
For some people, like my son Omar, who has been physically and mentally challenged from birth, a follow-up is like a life sentence. When Omar was going through critical moments after he was born and even a few times after that, he had to be admitted to the hospital so that he could be monitored 24/7.
Then we’d be told to come back after a week for a followup. If all was well, we’d go for a monthly check-up. If his condition continued without complications, the appointments dropped to three months, and then to six months. Just last week, Omar’s condition finally stabilised and the appointment is now once annually. That’s a great achievement for us! It has been nearly 30 years of hospital visits!
In the early years, whenever Omar was given a new medication, dosage or combination, we had to report in on a weekly basis. Doctors needed to monitor his progress. If it didn’t, then they’d have to figure out something else.
We’d also be told of the possible sideeffects of the medications and to return immediately if his reactions were alarming, like increased number of seizures, vomiting, diarrhoea and fever. If this happened, he would be brought in through the emergency department so he could get immediate attention and his doctors duly alerted.
I kept a diary of everything that was prescribed to Omar and how he reacted to the medications. This habit really helped us work out the best medicines and dosages for him. There was a time when the right medications were given but the dosages of the combination had to be adjusted accordingly.
Other than dealing with the benefits of the medication, we had to deal with their major side-effects. One drug increased his appetite; one made him drowsy and the other made him drool uncontrollably. Omar’s weight had to be managed. He couldn’t afford to be overweight as that would worsen his clubfoot or whatever little that was left of his mobility. He couldn’t afford to be bedridden — it would spiral everything else out of control.
If Omar was drowsy the whole day, he wouldn’t be able to do anything meaningful and could be a danger to himself and others. Being groggy could cause falls and injuries. If he held on to someone when he tripped, he could injure himself and others too.
As for him drooling, not only was it unsightly and unhygienic, it also meant that he had problems with his swallowing mechanism that could cause choking when he lay down. So we measured out the doses in different combinations. Some side-effects came on immediately and so we responded immediately too. Sometimes you think you’ve got it right but the side-effects kick in a week or two later. Most of the time whenever we think we had got it right, we’d have to wait for at least three months to be sure.
BE AWARE ALWAYS
It took us nearly four years to get this right. And when we finally did, we felt that we had a winning combination and have kept to it for a few years now.
When on long-term medication, have certain tests done to check the functions of your liver and kidneys. Your baseline data may change too according to age and weight. As such, certain adjustments may be required.
I was more than happy when Omar’s medications were whittled down from six to the current and final three. We can cope with that. However, as with any drug, there are side-effects to be aware of. If you read that fineprint of the leaflet that comes with the box of medication, you’d notice that the drug may affect certain organ functions. It can manifest in different and new illnesses like glaucoma, renal (kidney) failure, asthma and hypertension. Tests are accordingly done to check this.
The line I always hear is: the medication is recommended when the benefits outweigh the risks of side-effects. So the bottom line is that you must know your facts, be aware of what you’re doing and consuming, and always go for your scheduled follow-up appointments.