Garth Rattray | Don’t allow fear to kill you

The feeling of fear is perfectly natural. It is hardwired into our nervous system as a protective measure. It’s an unpleasant subjective emotional state arising in response to perceived dangers or threats and which, when experienced, is typically associated with physiological and psychological changes”. The key word here is “perceived”. How we perceive something can cause us to fear it unnecessarily.

Many patients fear taking medications or subjecting themselves to medical intervention (even if the intervention is intended to save their life). The most common fear is the fear of [possible] side effects. People constantly tell me that all medications have side effects; however, it is far more accurate to say that all medications [might] have side effects.

Side-effects (unintended reactions) are uncommon. Based on how the drug works, they may be predictable. They are unintended, often unpleasant, secondary reactions that occur alongside the desired therapeutic effect of a medication. They are variable and are usually mild although they can also be moderate or severe. There is a timing to when they appear and how long they last. They cease once the medication is terminated. Not everyone will experience the same side effects with any given drug.

Interestingly, the same people who fear possible side effects from prescribed medications will swallow a wide variety of ‘natural products’, because they believe that they do not have side effects. This belief is flawed. If a natural product can do something for you, it must first do something [to] you. It must perform some kind of chemical change within you and can therefore also have side effects.

Many tell me that they do not want to be ‘dependent’ or ‘addicted’ to their blood pressure medications, diabetes medications, or other medications for their Non-Communicable Diseases (NCDs). However, ‘dependence’ and ‘addiction’ only apply to mind-altering drugs like cocaine, alcohol, or pain pills. People with dependency will continue using the drug even if it is causing problems.

Addiction is a chronic, relapsing brain disease characterised by compulsion and drug-seeking behaviour despite devastating health, financial, social, and functional consequences. It alters the neuropathways in the brain and leads to intense cravings, impulsive behaviour and physical dependence. Indubitably, the essential medications used for treating NCDs cannot cause dependency or addiction.

ALLERGIC REACTIONS

Medications can cause allergic reactions, but so do many of the things that we eat or drink. Rarely, the allergic reactions can be intense and dangerous. On extremely rare occasions, medications surprise with an idiosyncratic reaction that have nothing to do with how the drug works or the dose.

Some people hate the very idea of having to take medications. They believe that it is indicative of a flaw and they find it embarrassing. Several are afraid of [possible] problems with their sexual function arising from taking medications, especially anti-hypertensive medications. I know of several men who have suffered kidney failure, stroke, serious heart problems and even death, all because they believed that ‘blood pressure medications’ cause impotence.

Nowadays, blood pressure medications rarely cause impotence. And, if that happens, simply changing the medication will set things right. The real cause of impotence is the hypertension, not the medications used to treat it. Obviously, it is infinitely better to take anti-hypertensive medication to preserve your erections and save your life.

Regarding cancer therapy: I saw a middle-aged lady who discovered a lump in her breast. She had gone to a health centre and was eventually diagnosed with stage 1 breast cancer. It is very treatable, but she feared adjuvant radiotherapy so much that she refused surgery and any traditional treatment. She resorted to oils, poultices, bush teas, roots, and juices for years. The cancer became a raw, oozing, purulent, bleeding, protruding, smelly, ulcerated mass (a fungating tumour) and replaced her breast and invaded her nearby chest. She died painfully and prematurely all because of her fear of medical treatment.

I often see young, middle-aged and elderly people with type II diabetes mellitus. Some of them hate taking tablets, adhering to restrictive diets, and refuse add-on insulin if it’s prescribed. They end up with damage to their major organs. Because of their fear of medications, they end up incapacitated and/or dying prematurely.

TOO MANY TABLETS

I have repeatedly heard patients complain “too many tablets doc! Too many tablets!” I empathise with them but whenever their numbers are too high, we must use multiple and combination pharmaceuticals to achieve control. Over more than four decades at the job makes me know what is going to happen to those who don’t adhere to their treatment … they always experience serious complications, suffer, and their lives are cut short.

Patients also fear having to “live on medications for the rest of their lives”. Most people with NCDs that require pharmaceutical intervention, when lifestyle changes can’t get control of their NCD, should remain on their prescription medications indefinitely or until a physician asks them to stop.

People with serious medical problems who fear and/or loathe intervention so much that they refuse treatment are not giving themselves any chance at a quality life or living out their days. Yet they undertake risky behaviour every day. They brave our crazy roads and eat from various restaurants without much concern.

When it comes to something as crucial as our health, we should always ask ourselves: What are the risks of taking this treatment (medication or surgical intervention)? What are the benefits of taking this treatment (medication or surgical intervention). If the benefits outweigh the risks, it’s best to take the treatment.

Garth Rattray is a medical doctor with a family practice, and author of ‘The Long and Short of Thick and Thin’. Send feedback to columns@gleanerjm.com and garthrattray@gmail.com.