Echoes of absurdity in drug regimes
‘There is, of course, a simpler solution, which is not to prescribe these pills in the first place’
Doctors, it is reported, are concerned that their patients are not taking their medication as and when required. This is known as the problem of compliance, compounded by the complexities of drug regimes that so many are expected to follow now.
Thus, consider the not-unusual situation of a woman in her late 70s who might feel well enough for her age, but has been identified as having several age-related medical conditions. These might include hypertension and diabetes (or, at least, her blood pressure and sugar level are above the recommended “threshold”), thinning of the bones or osteoporosis (diagnosed on a bone scan), arthritis of the knees and a bit breathless on exertion from her chronic obstructive pulmonary disease (COPD).
If her family doctor were to be treating her according to current guidelines, this would entail her taking 19 doses of a dozen different drugs at five timed points during the day. Little wonder, perhaps, that she might not be fully “compliant”.
Hence, the important initiative reported last week where Hampshire County Council plans to provide a select group of older residents with a device known as an Amazon Echo, which can apparently remind them with a voice message about when they need to take their pills. The technical details are a bit hazy, but one might anticipate this will soon be seen as indispensable.
There is, of course, a simpler solution to the compliance problem, which is not to prescribe all these pills in the first place. But that would be absurd, wouldn’t it?
Needle sorcery?
Anne Pilkington, honorary secretary of the Croydon Medical Society, has taken me to task for my recent sceptical comments about the legendary Angelina Jolie’s widely reported choice of acupuncture as treatment for her Bell’s palsy. From personal experience, Dr Pilkington describes how “within hours” of her first session, she had recovered some degree of facial movement, and within four weeks, “people whom I had not seen for a while could not tell I had recently had the palsy”.
Several others are similarly impressed, including a woman with severe stabbing sciatic pains that promptly returned following a major spinal decompression operation intended to relieve them. Her physiotherapist inserted a single needle into the piriformis muscle in the buttock – which straddles the sciatic nerve – this, unlike the operation, did the trick.
This direct effect of the needle in relaxing muscle spasm-induced pain is easy to explain. More difficult, from a reader who had always thought acupuncture to be “hocus-pocus”, is his wife’s experience as a long-term hay fever sufferer. Years ago, when working as a practice nurse, she had a particularly bad attack, prompting one GP, a trained acupuncturist, to suggest a trial of the needling treatment. “She has never suffered from hay fever since,” he writes. Hard to believe, but there you are.
Insect irritation
This week’s medical query comes courtesy of Mrs AP from Sussex, afflicted, when sitting in her garden this summer, by insect stings of such intense, irritating itchiness to prevent her sleeping. She suspects the culprit may be some tiny, “very black” bugs – though surprisingly there is no visible “core”, where their sting might have penetrated the skin. Any suggestions from informed entomological readers would be appreciated.
Sock it to tired legs
Finally, further to the many inquiries concerning the woollen compression socks mentioned last week, which a reader found so useful in allowing him, for example, to mow the grass of his largish garden in a single session without having to take a break. These work by improving the flow of blood from the legs back up towards the heart, combating the aching tiredness that comes from standing for any length of time. He purchased his from Clifford James (£15 for two pairs, clifford-james. co.uk). Sock Shop (sockshop.co.uk) has a range of similar merino wool stockings for women. Email medical questions confidentially to Dr James Le Fanu at drjames @telegraph.co.uk