Close-ups

A Patient's Perspective

A Better Day Tomorrow



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Am Fam Physician. 2012 Aug 1;86(3):268.

I am almost 73 years old. I have six children, two of whom are adopted. Having had one child die of lung cancer and a sister pass from breast cancer, there is a lot of pain in my life. Watching my son, who is 51 years old, live with Crohn's disease has also caused me a lot of sorrow.

I have health troubles myself, including a continuing nerve condition, a heart attack, renal failure, stress with high blood pressure, fibromyalgia, and consistent back pain. The struggle is so hard.

The available assistance programs have let me down in a lot of ways. When you get Medicare, they don't want to give you Medicaid, even if you live on such a low income that just being able to buy medicine is the best you can do sometimes. You might be on a list for five or six years waiting for help, but all they ever say is “Call back.” What can you do? Without access to affordable housing, you pay the $1,200 for rent. Sometimes you don't make it, but sometimes you do. The main thing is that you are always feeling frustrated with the system. It works on the body. It works on your nerves. You never know what's going to happen next. It's a long road.

Nonetheless, I always look for a better day tomorrow. That's just the way I am. I read a lot, and since I like the outdoors, I go out to the park and walk down by the river, too. Enjoying these little things in life helps me get rid of some of the stress. I'm not a person who believes in giving up.

Having a doctor I like also helps. If you have confidence in your doctor, the battle is halfway won. You can express yourself—your emotions, your ups and downs, your ins and outs. I have a doctor who listens. She is concerned, and that definitely makes it easier.—r.h.

COMMENTARY

Understanding R.H.'s personal narrative has helped me provide better care. After learning the struggles R.H. and her family had been through, I began to see that her chronic medical conditions, especially her chronic pain, were greatly influenced by the social and emotional struggles of her life. Knowing this made me more aware that during stressful periods R.H. did not need more pain medication or a higher dose of antihypertensives, she simply needed me to listen longer.

RESOURCES

For patients

FamilyDoctor.org

http://familydoctor.org/familydoctor/en/healthcare-management/insurance-bills/resources-for-affordable-prescription-medicine.html

For physicians

Sagall RJ. Can your patients afford the medications you prescribe? Fam Pract Manag. 2006;13(4):67-69.

Administration on Aging

http://www.aoa.gov/

Association of Clinicians for the Underserved

http://clinicians.org/our-issues/medication-access-management/

Close-ups is coordinated by Caroline Wellbery, MD, associate deputy editor, with assistance from Amy Crawford-Faucher, MD; Jo Marie Reilly, MD; and Sanaz Sara Majd, MD. Questions about this department may be sent to Dr. Wellbery at afpjournal@aafp.org.

A collection of Close-ups published in AFP is available at http://www.aafp.org/afp/closeups.

The editors of AFP welcome submissions for Close-ups. Guidelines for contributing to this feature can be found in the Authors' Guide at http://www.aafp.org/afp/authors.



Copyright © 2012 by the American Academy of Family Physicians.
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