When Chronic Conditions Collide

Apr 1, 2018 by

You can have me read this article to you instead of reading it yourself…



Or you can read it the old-fashioned way below…



Welcome to the second part of my series on managing GI conditions along with other health issues.

Before, we talked about all of the ways that acute and chronic symptoms and conditions combined can wreak havoc. Now we’re going to talk about what happens when someone has more than one chronic condition.

I’ve spent a lot of time here writing about the ways that you can take a fresh look at your health and your health management. For the most part, those articles are focused on what to do in relation to having a chronic GI diagnosis. But what happens if you already have another chronic medical condition? Or you are diagnosed with another chronic medical condition down the road?

It can seem daunting enough to manage one health issue; handling multiple can quickly become overwhelming. All of the same concepts to managing one still apply –  it just becomes even more important to focus in on certain details.

(If you’re looking for an especially pharmacist-y article in which I discuss medications for different medical conditions, have no fear…it’s linked at the bottom of this article!)

When Chronic Conditions Collide

As I said, having more than one chronic condition can be incredibly overwhelming, both mentally and physically. Whether your GI condition came first, second, or fifth, it doesn’t matter – you still have to deal with each of those diagnoses, and deal with them together.

Knowing the Difference

This might sound idiotically basic, but it’s still the most important step! Knowing the difference between the different conditions – which condition causes which symptoms – is incredibly important. This may be very easy to do for many conditions but can actually be somewhat difficult for other conditions.

If you were diagnosed with the conditions separately at very different times, it becomes much easier to tell them apart. However, if you received multiple diagnoses at once, it can become a little bit murky. This one really comes down to researching and understanding your different conditions. If one of them is a GI condition, you can do that here. For any other conditions, I highly recommend the Mayo Clinic or NIH websites.

Know each condition as well as you can. Being able to list symptoms is one thing, but understanding why you are having those symptoms can take you to a whole new level in managing your health.

Understanding the Overlap

Just as acute and chronic conditions can overlap and wreak havoc, multiple chronic conditions can also have symptoms that overlap and wreak havoc. In fact, this is one of the things that makes it so difficult to manage multiple chronic conditions at once.

If each condition just kept to itself, it would be much easier to file each condition and its symptoms into tidy little boxes. Unfortunately, that’s typically not the case. A GI condition can make a heart condition worse. A psychiatric condition can make a GI condition worse. A kidney condition and a GI condition together could go back and forth, playing tug of war. We have complicated machinery in our bodies, and all of that machinery is tied together in sometimes unexpected ways.

I won’t even get into the ways that a GI condition can make it much harder to manage any other medical condition in this article. If you’re interested in learning more on that topic, I dig into it here.

It’s important to ask your doctor how one condition might impact the other. And if you have to pester them to get the answers that you need, then do it. Make sure that you fully understand where the overlap can be and WHY. The why is always the key!

Knowing that your fluid and nutrient intake can manage the tug-of-war between your kidneys and GI tract is the key to managing those symptoms. Knowing that your state of mind is the reason that your psychiatric condition makes your GI condition worse is the key to getting that under control. And so on.

Keeping the Treatments Straight

One of the biggest, and most dangerous, issues that I see in healthcare is when people with multiple chronic conditions don’t know which treatments are for which conditions. This can happen very easily, since doctors will often prescribe multiple medications or lifestyle changes at once, and the explanations for each of these treatments can be lacking.

When you know what each treatment is for, you are more able to evaluate whether or not it is working. This gives you the ability to make decisions about your own care, and to go to your doctor and ask for a better or different option if needed.

If you don’t know what each treatment is for, you may lose the ability to make sure you are receiving the best options for you. You can’t explain to your doctor why you think your treatments aren’t working, and when something serious does happen, the people that may be able to help have their hands tied. For instance…

If you are admitted to the hospital on a long list of medications and you don’t know for sure why you are taking them, neither does anyone else. This may sound ridiculous, but a lot of the medications that we have these days can be used for multiple purposes. If the doctor at the hospital isn’t familiar with you and doesn’t know much about your history, he’s going to look at your medications and say “Ok well I guess that’s what he’s on. We’ll just go with it.” This takes away the opportunity for the team to recognize something that may be hurting you or that isn’t being used correctly.

Whether we like to admit it or not, people with multiple health conditions are also the most difficult to manage. If a doctor sees multiple diagnoses and multiple medications, he is going to be much more hesitant to make changes, especially if you are not able to advocate for yourself (more on that here).

Managing Multiple Chronic Conditions

More is Not Better

If you’ve read any of my articles on simplifying your health, then you know that I strongly believe less is more.

In this article, I talk about why more is not always better, specifically from the perspective of the treatments that we are using to improve our health. Instead of tacking on treatment after treatment and hoping for a better outcome, we have a responsibility to ourselves to make sure that what we are doing is safe and helpful.

Doctors don’t often spend time telling their patients to re-evaluate whether a medication or therapy is working for them after X weeks or months. And that is truly an opportunity missed. If the doctor doesn’t tell you how long it should take for you to notice a benefit, then you are never clued into the idea that there are medications or treatments that may not be helping you at all.

For instance, starting a new diet to see if it improves GI symptoms should be a trial, not a permanent change. If a new diet hasn’t resulted in noticeable improvements within a couple of weeks, it’s pretty clear at that point that it’s not working. Continuing the diet at that point is just another treatment that is not helpful and could be preventing you from getting better nutrition or eating certain foods that WOULD improve your symptoms.

This concept becomes ever more important when you have multiple chronic conditions, because each condition requires treatments of its own. If you have a heart condition, you’re probably taking a number of medications for it. And if you develop a GI condition, you’re probably going to be prescribed even more medications. And when it comes to medications, more is absolutely NOT better.

More medications mean more risks of side effects, more risks of interactions between those medications, and so on. If you are taking anything that isn’t helping simply because someone thought you should try it at one point, you could be making your health worse for no good reason or keeping yourself from an option that might really help.

A Treatment is a Treatment is a Treatment

In my article on treatments, I pound home the point that treatments are treatments, no matter what they are called. In the last section, I just spoke about diets and medications in the same way, because they should be treated the same way – they are both treatments.

While each option you have available to you might go by its own name, it is still a treatment. Whether that be a medication, a nutritional supplement, a physical exercise, a dietary change, or something else entirely, it is still a treatment. And thinking about them as separate from each other is where we start to do ourselves a disservice.

If you place each of those treatments into buckets in your mind, you lose the ability to see the overlaps or the dangers. If you think through your health in terms of your “food” bucket, “drug” bucket, and “natural therapy” bucket, you will miss all kinds of opportunities!

Instead, we should be placing our treatments onto a level playing field so that they can be evaluated together. Why take a supplement when you can incorporate it into your diet? The answer is, you really shouldn’t. But we often miss simple opportunities like this because we don’t place everything together onto the same level and really evaluate what we are doing.

Or what if you are taking a medication simply to treat a side effect of your exercise regimen? Or you are taking a natural supplement to treat a side effect of a medication? These are the kinds of overlaps and possible dangers that are even more important to avoid when you are dealing with more than one medical condition.

I mentioned that handling more than one chronic condition can seem overwhelming. Having treatments galore that may be overlapping, not working, or making you worse is one such way to overwhelm you.

Dump all of the treatments out of their buckets and line them up side by side – make sure that every single one of them is truly helping, not hurting, and appropriate for each of your medical conditions.

And while you’re at it, take a look at this article that talks about why supplements, drugs, and herbs aren’t quite as different as we might like to think…

What Next?

As promised, one pharmacist-y article discussing the hiccups that come with taking medications with multiple chronic conditions, coming right up.

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