Living with multiple health problems

Interactions between different symptoms, conditions and medicines

The people we spoke to commonly pointed to confusion around whether the symptoms they experienced were the result of:

•    a particular health problem, 
•    the side effects of a (perhaps new) medicine, 
•    some kind of interaction between a medicine and an existing health problem or 
•    interactions between one medicine and another. 

Some diseases had the ability to complicate things more than others e.g. epilepsy and diabetes. Pat described how her diabetes was made worse by other conditions and drugs, although she was unsure whether high blood pressure was a cause of her diabetes or a result of it. David was taken off a beta-blocker that he was prescribed in hospital because diabetes staff were concerned that it could shield the symptoms of a diabetic “hypo” which could put his life at risk.
People with diabetes and epilepsy also frequently brought up issues of medicines having side effects or not seeming to work (see ‘Different views on prescribed medicines’).
Fiona and Derrick described having learned how to tell between (perhaps similar) symptoms of different conditions or medicine effects. Fiona learnt how to distinguish between medicine effects and the symptoms of diabetes. Whilst Derrick was still not clear about which condition was causing shortness of breath, he had learned to control his symptoms using trial and error of the alternative treatments. He had also come to believe that he recognised the symptoms of his Chronic Obstructive Pulmonary Disease (COPD) as different to his asthma.
There are many ways in which medicines and conditions could interact with one another:

•    One condition might make another worse e.g. somebody with arthritis who finds it too difficult to exercise in order to manage a heart or lung problem. 
•    One condition could lead to another, as in diabetes contributing to cardio-vascular disease or high blood pressure leading to a heart attack or stroke.
•    Medicines might clash with each other, making one ineffective or producing side effects. 
•    A treatment for one condition might make the symptoms of another worse or 
•    Produce a new or previously hidden condition (such as “latent TB” in Gog’s case). 

Michael Y had been misdiagnosed due to existing problems, leading to prescription of a medicine that caused memory problems and an increased fear of falling over. Jean could not take a recommended treatment for a heart condition because of other health problems.
Cross medicine-condition issues seem to happen more often when each condition is treated separately due to their own ‘specialist model of care’. Nigel describes how his treatments are complicated by other ones and again stresses the complicating nature of diabetes when it comes to routine operations. For Nigel, GPs are best placed to provide an overall consideration of a patient’s management and wellbeing.
For some people, the confusion, limitations and uncertainty around apparent cross medicine-condition issues led them to re-visit their ideas about what caused their health problems (see ‘Causes of health problems: certain and uncertain’) in the first place. There were lots of examples where people could not have a treatment, or a recommended treatment, because it would interfere with an existing health problem or medicine already being taken.


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