By G. Falk. Philander Smith College. 2018.
That was uh buy 30 caps npxl fast delivery herbals for arthritis, covered the 200 symptoms of the illness well, but left me that tired, I couldn’t uh, I’d probably only have 6 hours a day worth of activity, the rest of the time was sleep. That’s an older medication I believe, it’s not used as much at all, or much anymore. So they, uh, I was on the strongest dose of that and they weaned me off it to try to match, to give me a bit more L: More energy? But um, I’ve been quite, I can only have a low dose because my body’s quite sensitive to it. When you’re on a higher dose you notice negative side effects, so you have to be on a lower dose. R: Yep, this dosage, the amount you take over the years and that, it’s gotta be able to uh, combat the symptoms of the illness. L: So it’s like you’ve finally found that perfect level then, where it combats your symptoms but you’re still functional. With reference to his “first” medication, Modacate, Ryan evaluates it in terms of how it “covered the symptoms” and its side effect profile. Despite constructing his medication positively with regard to symptom relief, the use of “but” preceding emphasis on the sedating side effects associated with the medication functions as a disclaimer; that is, the efficacy of the medication is constructed as being compromised by, or overshadowed by, sedating side effects. Whilst he does not attribute the side effect profile of Modacate to his non-adherence, he elaborates that his dosage was lowered as a result. Ryan 201 highlights the importance of tailoring the medication and dosage to the individual consumer, by adding that when lowering the dosage to reduce side effects, it remained important that the medication can still “combat the symptoms of the illness”. For many interviewees, finding the optimum dosage of medication, whereby symptoms were managed and side effects were tolerable, reportedly took a considerable amount of experimentation and time, as becomes more apparent in subsequent extracts. In the following extract, Travis talks about how the experience of side effects and of medication not treating symptoms can lead to non-adherence: Travis, 19/02/2009 T: No one-, if someone’s taking their tablets and they’re getting all the side effects and none of the benefits, of course they’re not gonna take the tablets. Um, it’s-, the thing is, they lose patience because the tablets take a long time to start working as well and they think, nah, I can’t do this anymore, these tablets, whatever, you know and that’s when things get a bit hairy and things can go way off the tracks, you know what I mean? T: It’s never, you know, it may happen one in a million but you never say, right, you’ve got this illness, have this tablet and you’re perfect, you know. L: Your body’s gotta get used to it and especially then if you’re trying out multiple ones. T: Yeah and you can’t-, just I know that one day, you know, you’re on a tablet for a month and then you get off it for a month and then you try this 202 one for a few weeks and stuff. Above, Travis points out that consumers who are “taking their tablets” are likely to become non-adherent (“of course they’re not gonna take the tablets... He appears to be referring to the efficacy of medication in treating symptoms when he refers to the “benefits” of medication, as he later elaborates to talk about the experience of medication “working”. Travis suggests that consumers may become disillusioned with their medication when it does not alleviate their symptoms promptly (“they lose patience because the tablets take a long time to start working”) and become non-adherent. He thus indicates that the time that it takes for medication to start to effectively treat symptoms may additionally exert an impact on adherence. According to Travis’ account, as side effects may be experienced before the medication starts to treat symptoms, this may represent a critical period for potential non-adherence amongst consumers. It could be assumed that consumers who lack awareness of the time-frames within which to expect responsiveness to medication may be particularly vulnerable to non-adherence during this period, such as newly diagnosed consumers. Travis adds that the experience of changing medications following poor responsiveness can compound negative experiences for consumers and implies that this can lead to poorer rates of adherence (“people get very, very impatient with it”). Thus, he highlights how the process of finding the right medication can be fraught with difficulties for the consumer and, therefore, challenges adherence. Below, Steve also highlights how the process of finding a suitable medication can be 203 difficult for consumers, but indicates that once found, adherence facilitates consumers: Steve, 04/02/2009 L: So um, what are some of your beliefs then about antipsychotic medication? S: If they-, if you can find the right one that um produces the right serotonin, like increase the serotonin in your brain. As you’ve seen, I’ve been on like 3 or 4 different types of medication myself, trying to find the right one. So I guess maybe that process of finding the right one is probably the hardest part, like when you’re taking this stuff and you’re getting side effects or- S: Yeah, or it’s not working. When asked about his opinion of antipsychotic medication, Steve provides a hedged response relating to its efficacy (“I think that they, they do help people”). He constructs medication’s helpfulness as contingent upon its suitability to the consumer, however (“if you can find the right one...
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