Why don't I notice any changes when I take my medications?

If you have a headache you take aspirin, Tylenol, or ibuprofen. If you have a really bad headache like a migraine you might need a prescription. The medication enters your system and relieves the symptoms and sometimes the cause. If you have an infection you take antibiotics. Again, the medication enters your system and treats the cause, although in this case you have to take the antibiotic for a prescribed number of days in order for it to be truly effective.

Some medications prescribed for symptoms of chronic illness are designed to relieve the symptoms. Others are designed to address the source of the symptoms. These medications are typically taken for long periods of time, even for life. Their effectiveness builds up over time. So, unlike a headache remedy that may provide relief in short order, these drugs need to be taken regularly over a period of time before you see any noticeable improvement. The improvement may be so subtle at first that you hardly notice it. Likewise, if you stop the medication it may take some time before your symptoms return. The goal here is to prevent or minimize problems before they become troublesome, rather that treat them after they occur.

There are some medications that you should NEVER alter the dose or stop without your doctor's supervision. These include steroids, diabetes medication, anti-depressants, blood pressure, and heart medications. Frequently, it is the patient who is most troubled by the possible risks of a treatment who is willing to gamble with the much higher risks of stopping or changing the dose willy-nilly. Deciding to play doctor, usually under the declaration of "I know my body better than anyone else," can very well mean that the morgue will know your body sooner rather than later.

Why does my doctor keep changing my medications and treatment plan? Is my doctor experimenting on me?

Patients often complain about how their doctors approach treatment. Doctors may change medications, increase or decrease doses, or add and subtract medications. Two patients with the same disease sitting in the doctor's waiting room may discover that their treatment plans are quite different. This ambiguity leaves patients wondering if the doctor knows what he or she is doing. Patients wonder if the doctor is guessing or, worse, experimenting. Nothing could be further from the truth.

No two patients experience the same chronic disease in exactly the same way.

No two patients experience the same chronic disease in exactly the same way. Because of that, there is no "cookie cutter" approach or single formula for treatment. There will certainly be similarities, but there will always be differences. Each person brings his or her own unique medical history and makeup to the disease. In addition, people who have one chronic condition will often have several different conditions that overlap. On top of all that confusion, your medical condition is not static—things are always changing. Since we have no cure for chronic illnesses yet, doctor and patient alike are saddled with the frustration of inadequate therapies. The bottom line is that the treatment plan must be individualized for each patient's unique medical circumstance. The treatment plan has to be adjusted with variations in disease activity and health.

One doctor likened the process to cooking. "We don't have a cookbook of recipes who telling us exactly what to use, how much, and how long to cook it. Instead we have a pretty good idea what can go in, but with any good cook, adjustments have to be made constantly until you get just the right combination."

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