Topic Overview

Many people have more than one long-term (chronic) health problem. You may be one of them. For example, you may have high blood pressure and diabetes, or you may have high blood pressure, diabetes, and heart failure. When you have more than one problem, doctors call the health problems co-morbidities.

One health problem may lead to another, causing the co-morbidity. For example, diabetes can damage the lining of your blood vessels. This can lead to hardening of the arteries (atherosclerosis) and a heart attack. And a heart attack can lead to heart failure.

You also may have health problems that are not linked to each other, such as COPD and diabetes.

When you have more than one health problem, you have different health care needs. One disease can make another disease worse, and the total effect of all the diseases may be more than each on its own.

You also may have more symptoms and may need more treatment and medicines. You most likely will have to do more to take care of your health.

You may need to see more than one doctor and may need more than one treatment and medicine.

This topic will explore what you can do to help yourself when you have more than one health problem.

Dealing With Medicines

When you have more than one health problem, it usually means that you need at least a few medicines. Dealing with medicines can be one of the harder parts of your care. Medicines can save your life, but they can also harm you. You have to track them, know how to take them, and perhaps deal with side effects.

You and all your doctors need to be aware of all the medicines you are taking. This makes it less likely that one doctor will give you a medicine that interacts with another medicine. For example, one medicine may cause side effects that create problems with other medicines. Or one medicine may make another medicine stronger or weaker.

Older adults have to be even more careful with medicine. As you age, your body becomes more sensitive to medicines. As a result, the medicines may build up in your body and affect you as if you had taken a larger dose than prescribed. This can be harmful. So make sure you know how to stay safe when taking several medicines.

It's a good idea to:

• Ask your doctor about your medicines.
• Take your medicine as prescribed.
• Organize your medicines.
• Learn to deal with side effects and medicine interactions.
• Learn how to lower the cost of medicine.

Here are some forms you can use to track your medicine:

• Master List of Medicines
• Daily Medicine Schedule
• New Medicines: Questions to Ask the Doctor

Working With Your Doctors

Good treatment depends on making sure that all of your doctors know about all of your health problems. Everyone you see for health care needs to know how you are being treated for each health problem you have.

Think of your doctors as your team. Tell each doctor that you expect him or her to talk with the other doctors about your care. If you feel comfortable doing so, bring a family member or friend with you to appointments so he or she can help you remember symptoms or problems that you want to talk about with the doctor.

Learn more about:

• How to work with more than one doctor.
• How to make the most of your doctor visit. This includes forms you can use to prepare for your doctor visit.
• How to work closely with your doctor.
• How to get a second opinion.
• How to make good health decisions.

Taking Care of Yourself

You can do a lot to help yourself. One of the most important things is to get support. This can be your partner, a family member, a close friend, or a group of people in the same situation you're in. These people can do a lot to make you feel better physically and emotionally.

You can also help yourself through lifestyle changes. Something as simple as eating healthy foods and staying active can help your overall health a lot.

Here are some ways to help yourself:

• Get support.
• Watch out for depression and anxiety.
• Eat right.
• Be active.
• Relieve and avoid stress.
• Deal with pain, if you have health problems that cause long-term pain.
• Get regular checkups from your doctor.

Another way you can help yourself is to keep a personal health record. This is a place where you keep all the information about your health, such as your medicines, past health problems, and allergies. This information can help your doctors. And it's valuable if you change doctors, move, get sick when you're away from home, or end up in an emergency room. If any of these things happen and you have your records, you may get treatment more quickly and your treatment will be safer.

Making Your Wishes Known

When you have many health problems, serious problems can come up. With them come hard decisions. For example, you might have to decide whether or not to use a ventilator or whether you want to continue treatment.

It's best to be prepared in advance. Write down what treatment you want or don't want, and find someone who can speak up for you in the event that you can't. This will make things easier for both you and your loved ones.

• Learn about advance care planning.
• Find out how to choose someone to speak for you.
• Learn about hospice palliative care and care at the end of life.

For Caregivers

Caring for someone who has long-term health problems can be stressful. You want to do as much as you can, but you also can get tired and have health problems of your own. You need to take care of yourself as well as your loved one.

These caregiver tips can help you:

• Take care of yourself so that you may continue to support and care for your loved one.
• Not help your loved one too much. Letting your loved one be as independent as possible will help both of you in the long run.
• Ask for help from others.