Living Well with Multiple Health Conditions

This article was written by Amanda Atkinson, MSN, RN.

Two of the most common questions that I hear from people with multiple health conditions (comorbidities) are, "How do I know what is wrong when I am not feeling well?" and "What can I do about it?" These can be hard questions to answer sometimes, especially when you have more than one health concern. Let's talk about some things that can help you find out which condition is causing your symptoms, and some tips for what you can do about it.

One of the most important things that help to identify what type of exacerbation (flare-up) is occurring, is knowing your body. While there are common symptoms to each condition, your body may not respond the same way your neighbor's does. For example, when my blood pressure is high, I will get short of breath with exercise, but when my daughter's blood pressure is high, she will get a bad headache. Both of us are showing symptoms of high blood pressure, but we don't experience the changes in blood pressure the same way. It is important to know how your body normally reacts.

It is also important to understand that your body's response to illness can change over time as conditions progress, so you need to be aware of the common symptoms of your conditions in case you begin to experience symptoms differently. For example, when you first receive a diagnosis of COPD you may have trouble walking around the mall because you are short of breath, but as the years pass when you try to walk to the mailbox you begin to feel chest tightness and are very short of breath. You also begin coughing up a lot of mucus that looks different than before. These are changes in the way you are experiencing symptoms of COPD and should not be ignored. As always, if you are not sure about what you are feeling or are experiencing new or changing symptoms reach out to your doctor.

It is a good idea to use some type of symptom tracker to keep up with what is going on in your body, especially if you have multiple conditions, and conditions with similar symptoms. Symptom tracking is also important when you have conditions that may affect each other. For example, as my colleague mentioned earlier this month, a flare-up in arthritis can impact movement, lack of movement can impact COPD symptoms. Some people like to keep a journal or write how they are feeling each day down on a calendar. Some keep a notebook with their medications and write down health information like daily blood sugar levels, or blood pressures. There are also apps like the COPD Foundation's Pocket Consultant Guide, or PCG app, that you can use on your phone or computer to track symptoms. The PCG app is free and can be used on Android and iOS.

Daily logs are very helpful because when you begin to notice that you are feeling poorly, or even just different, you can look back and see what has been going on. You can also see a trend and possibly catch a flare-up before it gets to the point that you are having increased symptoms. For example, I will keep track of my blood pressure which gives me an idea of what is going on internally. If I see that my numbers are going up, then I can take steps to make changes like reducing my salt intake, practicing stress reduction techniques, and making sure that I am taking my medication consistently and correctly. This may help me reduce my pressures before I even experience the shortness of breath with exercise. The same is true for blood sugar. By regularly checking my sugar, I can see the impact certain foods have on my blood sugar levels and plan my eating accordingly.

One main thing to remember is that if you notice changes in the way that you are feeling, don't "wait and see what happens", reach out to your health care provider. Sometimes small changes or adjustments to your care can help avoid flare-ups. I often hear from people that they feel like they are bothering their health care team when they reach out or ask questions. Let me just say, we would much rather you reach out than end up with worsening symptoms or even a stay in the hospital. You are not bothering your care team!

I also hear patients say that they don't want to make a big deal of something and that their provider would tell them if something was wrong. First, YOU are a big deal, and yes, your provider is an expert, but you are also an expert about your body. You are an important part of your health care team, and it is ok to reach out if you are noticing changes. Providers can only treat what they know is going on. It is important to let all of your physicians know what symptoms you are experiencing because as we talked about earlier, conditions can affect each other. Take the arthritis example, for instance. It would be important to let your lung doctor know that you are experiencing a flare-up in your arthritis so that they could help you figure out other ways to keep your activity level up. If you are moving around less, your COPD symptoms could become worse. Your health care provider may want to change your COPD treatment to help reduce the likelihood of a COPD flare-up.

One last thing to remember is to get all your medication filled at one pharmacy. Medications can sometimes interact with each other or can affect other health conditions. For example, taking steroids can affect your blood sugar and blood pressure. Some common over-the-counter cold medications can affect it too. It is also important to give every health care provider a complete list of all medications you are taking so that they can make sure your COPD medications won't interact with other medications or cause worsening symptoms for another health concern. Pay attention to how you are feeling when starting a new medication or a new dosage and report any changes to your health care team.

Remember, you are an important part of your health care team, know your body, and keep track of how you are feeling. These simple steps can help you to stay healthy and live your best life!