Duryce
Patient
Duryce rarely lets things get her down. She has handled various setbacks in her life, as well as experiencing noteworthy achievements, including her 3 children, 10 grandchildren and 9 great grandchildren. But at the age of 72, when her health problems began to mount, and the medications and treatments she was prescribed started to overwhelm her, Duryce fell into a funk.
She recalls how she felt about her medical care at the time. “They’re trying to tell you what to take and what not to take and what’s good for you.” However they couldn’t really understand the sum total of the burden she felt, “I just felt like I’m living on medication and not free to do what I want”.
Duryce’s 16 health problems included diabetes, hypertension, hyperlipidemia, asthma, reflux, back pain and insomnia, among others, resulting in 19 medications and myriad instructions from numerous specialists. Duryce suspected that some of those medications were doing more harm than good. She was on the verge of giving up on at least some of her medications completely.
“I know the medicine you are prescribing for me is not working, I’m not going to take it, I’m sorry,” she remembers thinking.
Someone to talk to who understands
It was then that Dr. Jeffrey Goldberg, her family doctor, suggested that Duryce participate in the Patient Priorities Care approach in order to help him learn what matters most to her and communicate about her healthcare better. Kizzy Hernandez-Bigos, a member of the healthcare team, had been trained in this approach, and on Dr. Goldberg’s recommendation she reached out to Duryce. Through that process, Kizzy helped Duryce identify what mattered most to her as key to guiding her health care. “It was like we clicked because of the questions she asked me,” says Duryce,“she understood what I was saying….I really didn’t have anybody really to talk to that would understand what I was saying and what I was going through.”
“It was like we clicked because of the questions
she asked me.” – Duryce
With the methods of the Patient Priorities Care approach, Duryce was able to express what mattered most to her: to reduce the burden of taking so many medications and stop taking the ones that made her miserable, to get out with her family more and feel freer to live her life. Armed with these specific insights, and through conversation with Duryce and Kizzy, Dr. Goldberg was able to align her treatment plan with her goals in a way that addressed the most important outcomes for Duryce.
Changes in her healthcare
The first thing Dr. Goldberg did was begin a trial intended to reduce the frequency of one of Duryce’s diabetes medications. His reasoning was that “A: these medications, that class…can make people feel lousy generally; and B: her blood sugar was pretty well controlled anyway, and she wanted to be on fewer meds. So I thought, well, why don’t we stop this one, see how she does. That gives her a sense of control over her medical care.”
“The first thing Dr. Goldberg did was begin a trial….” – Duryce
Had they not rethought Duryce’s treatment options through Patient Priorities Care, Dr. Goldberg feels the outcome would have been an increase of medications from 19 to 22, as well as a possible addition of a medication for anxiety, continued weight gain, and decreased mobility further exacerbating her arthritis.
Instead, with the decrease in medications and blood sugar tests as well as less rigid nutrition demands, Duryce feels more in control. This means she is more likely to take all of her prescribed medication and talk to her clinician if an issue arises. Dr. Goldberg feels better equipped to provide Duryce with the best care possible and work with her on her care decisions.
Back in the game
Since participating in Patient Priorities Care, Duryce is back to doing what she enjoys most–getting on her bicycle for a ride, taking an occasional dip in the local swimming pool, and seeing her three children, ten grandchildren and nine great grandchildren. She feels freer to go out to dinner and to invite them in for her home-made pies. Sweet potato pie is her specialty–and Duryce gets to share with a small slice. “If I hadn’t talked to Kizzy,” she says, “I think I’d still be home being depressed.”
