Not A Tough Pill To Swallow When It’s With This

So about 37% of 1,110 adults 60+ say they take their pills with food, literally putting the medicine right inside - smashing, blending, embedding pills in everything from Bumblebee tuna fish and tacos to corn flakes, grape nuts, and my favorite, Tom from Des Moines Iowa who says he takes his 11 daily pills with a few rasberry glazed donuts from Krispy Cream over on 86th Street. Talk about taking the pharmacist's instructions literally. My Aunt Mary used to take what she called her heart pills in her eggs. She'd mix them in with the ashes that fell from her dangling Newport Slims. "It's like pepper," she'd say in her raspy Dorchester Mass voice, coughing 3 times - always 3 times - after each bite. "It's a little crunchy but I get it down." Do you Mary? Do you? She was a nurse at the Mercy Hospital in Springfield for years but couldn't quit smoking. Other people, like Linda, take all of their pills in peanut butter. Linda was a classic problem for the healthcare industry - constantly needing ambulance trips to the hospital, to the tune of over $260K in one year alone according to Aetna paperwork I found on her kitchen table a few years back.  But in all those trips, all those admissions, not one person asked Linda how she took her meds. Turns out she was literally dumping all of them into crunchy Jiffy peanut butter, getting pills some days, sometimes 2 of the same one, sometimes just peanut butter. A nurse Lynn Veith finally figured it out after a home visit.  Don, 81, says he puts his 9 pills in his strawberry Dannon yogurt and Grape Nuts mixture. "Delicious," he mumbled as he worked down a spoonful at his breakfast table last week.  "It's better than the alternative," he said. "What's the alternative?" I asked.  He stared at me for a minute then smiled and said, "Being dead." Turns out folks like Don, Linda and my great Aunt Mary not only struggle to swallow pills, but honestly believe the instructions are telling them to take medicine with food. I'm pretty sure if you get instructions from the Peaky Blinders, you follow them like your life depends on it, but get instructions from a doctor or pharmacist or insurance company, maybe proceed with caution. Dad and I did after spending hours one time trying to decipher an order for his heart medications - one bottle read "EVERY NIGHT BEFORE FOOD ONCE DAILY TO BE TAKEN FOUR TIMES A DAY THREE TIMES A DAY EVERY THREE TIMES DAILY TAKE ONE TAKE TWO TAKE THREE ONE OR TWO." I'm not a fan of commas, but dear lord these would have helped. This is a particularly cruel run-on sentence that makes literally no sense. Sounds more like my dance instructor's orders. We had a good laugh but not as much as this one for Ventolin to treat an acute bout of bronchospasms -- INHALE 2 PUFFS BY MOUTH EVERY 4 HOURS RECTALLY....Swallowing pills and deciphering instructions are of course only part of the problem. I once got a $350 bill from my insurer for the colonoscopy prep drink my GI practice ordered, because it turned out the drink wasn't on the formulary - not covered by the insurer. I mean it tasted delicious, and it worked as intended, but $350, for a couple 12 ounce bottles, Dear Lord! My wife says I'm a dummy, that she could have made me a concoction for $5. Apparently I didn't read the instructions ahead of time. Maybe I should call the Peaky Blinders to argue my case.  All of these shenanigans have me wondering if the pharmaceutical industry needs a new campaign to educate folks. Because it seems to me people are desperate, confused or perhaps just too literal, and maybe all three. Though for what it's worth I am at least confident that people are resilient, creative and making the best of things...