[Narrator]
 
Isabelle has a different problem. She lives alone and doesn't have very much formal education. In the past ten years, her health has gotten worse and it has gotten harder to manage. She's overwhelmed and needs someone else to help her solve her problems.

[Narrator]
 
Isabelle has had high blood pressure for almost ten years, and she takes three different pills for it every day. Then a year ago, she had early-stage breast cancer and is now on a drug for that. This year, her cholesterol was high and her family doctor prescribed a new pill for that. And, she has arthritis and needs a medicine for the pain. Let's listen to her story.

[Isabelle]
 
I'm taking so many pills that it's hard to keep them all straight. I have to take 10 everyday. I can't keep them straight - when to take them and how to take them. I can't understand the pages of instructions the pharmacists gave me. And, taking all these pills makes me feel sick to my stomach. My bowel problems also seem worse now since I started that new medicine for cholesterol.

[Isabelle]
 
Sometimes, I just can't stand to take all those pills everyday. I never miss my cancer medicine -- I know how important that is. But for some of the other pills, I take some one day and some the next. I try not to take my arthritis pill unless the pain is pretty bad or I have to go somewhere that I need to get in and out of the car or walk a distance. The nurse told me I should take my pain pills every day, but I don't want to overuse them. I'm afraid of getting addicted to them and I'm worried that if I use them too much, they won't work so well when I really need them.

[Isabelle]
 
I'm also having trouble paying for all these pills. Some months, I just can't get my refills until my next Social Security check comes in. It's been hard sometimes -- it makes me feel bad.

[Isabelle]

But then last week, I had to go for a check-up with my family doctor. He wanted me to have a test to make sure I was doing okay on the new cholesterol medicine. When I got there, there was a new nurse at the office. Her name was Gwyn, and she is what they called a "nurse practitioner." Gwyn asked me what medicines I was taking. I tried to remember all the names, but just couldn't. I told her I just call them by what they did -- like my water pill that helps me get rid of water I don't need. Gwyn asked me to come back later in the week and bring all of my medicines in a paper bag. She said I should bring everything I take in a week, even medicines I bought at the grocery store and my vitamins, too.

[Isabelle]

When I went back, Gwyn took a lot of time with me. She looked at each medicine and asked me about it. She wanted to know what time I took it, what I took it with -- like food and water -- and if I ever missed doses. I had to be honest and tell Gwyn that sometimes I got confused and that sometimes I couldn't afford to have my prescriptions filled on-time and that I had to do without some of my pills for a few days. I also told her I feel like these medicines take over my life -- it's just too much for me.

[Isabelle]

Well, guess what. Gwyn said it was a wonder that anyone could keep so many pills straight, and that we needed to make some changes. I never expected a nurse to say that. She talked with my doctor and they changed my blood pressure medicine so I only have to take one pill a day, not three. We also talked about my problem with constipation. Kind of hard for me to talk about that, but Gwyn was very easy to talk to. So, I was able to relax and talk honestly. She asked me about what I eat, and what we could do to help me be more regular. She said I should eat more fruit, drink a glass of prune juice every morning, and take a walk every day. That sounded good. But when I told her walking was hard some days because of my arthritis, she asked me about my pain medicine. I told her I'm afraid of getting addicted to it or having the effects wear off, so I only take it when I really needed it. She set me straight - she said getting addicted to pain medicine hardly ever happens and that the kind of medicine I'm taking is not one that you could even get addicted to. She also said that I have to take my pain pill every day to keep a certain level of it in my bloodstream. If I wait until the pain gets bad before taking the pill, it won't work too good. And, I might even end up using more medicine if I did it that way.
 
[Isabelle]

Gwyn did two other things for me. First, she helped me draw a medicine chart. It will help me remember when to take my pills and how I'm supposed to take them -- like one is on an empty stomach in the mornings, another one is with food, like with breakfast, lunch, and dinner, and one's at bedtime. This will sure help me keep track of my medicines and keep me from skipping doses. Best of all, Gwyn says this will help me control my arthritis pain better.

[Isabelle]

The last important thing Gwyn did for me was to tell me about a prescription program that I can enroll in and get help from the state to pay for my pills. She even had the forms there and helped me get started with them. I need to add some financial information and give the form to my pharmacist each month, but it will be a huge help for me. I might even have a little money left over at the end of the month. 

[Isabelle]

After talking with Gwyn, I had a feeling like a heavy weight was taken off my shoulders. I know I'll do a better job of keeping track of my pills and taking them right. Why didn't I get this information sooner?

[Narrator]

All good problem solving starts with information and knowledge. Think of a problem you're now facing. What kind of information do you need before you develop a plan for your problem? You may want to stop this audio program for a few minutes and get out a piece of paper and pencil. First, write down what the problem is that you want to solve. Be as specific as you can. Then, list all of the information you still need and where you can find that missing information. Next, list what kind of help you might need to make your plan work. Ask yourself: am I ready to accept that help? How can I get support for my plan?

[Narrator]

Approach your plan with the attitude that it will work. Once you've carried out the first few steps, you are likely to see progress and you will want to keep your plan moving. Keep setting small goals, and review your progress. If things aren't going as you would have hoped, check to see if some part of your plan needs adjusting. Have any circumstances changed? If so, make changes in your plan as necessary, and keep going. You can only solve problems one step at a time. And remember, you have been solving problems all of your life -- cancer-related problems can be solved, too. 105. Narrator: A big part of problem-solving is negotiating. If you have been diagnosed with cancer, you'll need to be prepared to negotiate at many times about your treatment and care. Let's look at Maria's situation.

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