Medication Reminder Apps That Think Outside The (Pill)Box

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We start new medications and treatments with the greatest of intentions, but everyday life often has other plans. Remembering to take meds and monitor their effects is an important responsibility for every patient. But we all have those oops moments where we can’t quite remember if it was yesterday that we washed down that pill after breakfast or today. And that’s before we factor in whether we should be taking them with food in the first place. Patient adherence, or managing to remember to take those pesky pills and how they should be taken, is a huge concern in the healthcare community. The simple fact is, drugs don’t work if patients don’t take them and it’s estimated that 50% of the 2 billion prescriptions filled each year are not taken correctly [1]. Lucky for us, there’s an app for that, there are hundreds of medication reminder apps, in fact. Here, we round-up our favorite six that will help you avoid those oops days and stay on track with your treatment.

Please note: nothing can replace the care of your clinician or doctor. Please do not make changes to your treatment or schedules without first consulting your healthcare providers. These apps are not intended to diagnose or treat illness.

Mango Health Medication Reminder

iPhone, free. Android, free.

Taking medication isn’t a whole heap of fun, but that hasn’t stopped the folks at Mango Health who have put a gaming spin on the conventional reminder app with great success. The app features a schedule for creating reminders, drug interaction warnings, refill alerts, and a diary. But the real standout is the gamified points system; take your medication and earn points, earn enough and you could win prizes. Yes, we thought that might get your attention.

Round Pill Tracker and Medication Reminder

iPhone, free. Android, not available. 

Life doesn’t stop just because your phone is doing the marimba. Instead of choosing a precise minute of the day at which you’d like to take your pills, Round allows you to choose a ‘reminder window’ and gently nudges you throughout that hour (or so) until you tell it to stop. Add to that it’s eye-wateringly beautiful design and simple interface and you’ve got the perfect app for minimalists.

MyMeds Medication Management

iPhone, free. Android, free.

MyMeds can send you reminders by email and text, as well as push notifications, which is handy if you’d rather receive info in your inbox. It also has a feature that helps you become more informed about why you are on certain treatments (and you know we like patients to be informed). But perhaps the biggest plus is that it enables you to invite family, friends and your healthcare team to view and help with your progress. We can see a lot of people finding that level of support hugely beneficial to their day-to-day health routine.

MediSafe Meds and Pills Reminder

iPhone, free. Android, free.

Another app that hopes to motivate adherence and keep patients involved in their own care by informing them, MediSafe can be integrated with HealthKit (iPhone) to keep track of blood glucose, blood pressure, and weight and can even save reports as PDFs. The app also helps you discover more about food and drug interactions, something the general public is not so well informed of [2]. There’s a playful side to this offering too, though. How about setting your alert tones so Darth Vader or Austin Powers tell you when to take your meds? Yeah, baby.

Dosecast Medication Reminder

iPhone, free. Android, free.

A pretty run-of-the-mill reminder, Dosecast’s standout feature is its live sync function. Download the app to all your devices and each one will be kept up-to-date instantly. So tell your tablet that you took your tablets, and you won’t be reminded by your mobile. Tech addicts, you are served.

Drug.com Pill Reminder

iPhone, free. Android, not available. 

If you’ve done any kind of online research into treatments, you’ve probably found yourself on Drugs.com, the internet’s most visited independent medicine information site. So it won’t surprise you that Drugs.com’s reminder app makes use of its widely trusted database to help you manage any combination medications, vitamins, and supplements. The in-app pin lock will appeal to anyone who is concerned about privacy.

The story of Danny van Brenk – Cancer fighter

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“Every year that I’m still around is priceless”

There were no more treatments left for Danny van Brenk in the Netherlands. His cancer had metastasised and untreatable. They could treat him in New York, however. But the treatments are expensive.

The first diagnosis came in the winter and the last week of spring Danny van Brenk was told he only had a few more months to live. Bile duct cancer in the liver, with metastases. No more treatment options. But Danny (33), father of two little kids, didn’t give up. He contacted one of the best cancer hospitals of the world and was told that he could be treated there, although the costs wouldn’t be reimbursed, and he succeeded in raising over 150.000 euros in 10 days with crowdfunding. At the end of the summer, he was operated in New York.

One year after this operation, Danny looks happy and fit: he gained 30 pounds, just came back from New York, recovering from a new chemotherapy. He pulls his shirt up: next to his belly button, just under his skin, is a small pump, that every two months for two weeks pumps high doses of chemotherapy through the arteries of his liver. This way more of the chemotherapy is delivered to the tumour than with normal chemotherapy. But the effect of this treatment for his specific type of cancer, which is a rare cancer, has not yet been proven, and therefore the insurance won’t reimburse a penny. The operation, the scans, the investigations, the medical support, the tickets to New York, the stay there, and that every month again: He calculated that for the first two years he would need 300,000 euros.

An online auction was set up, friends organised a charity run, hairdressers worked a day for him, his old soccer club, GVVV, organised a charity match, their rivals, Spakenburg, also collected several thousand euros, and strangers donated money, lots of money. And, as astonished as he was by all this, Danny van Brenk was able to prolong the few months he had left to a couple of years and maybe even more. 

This is translated from an article published in the Dutch newspaper De Volkskrant on Saturday 8 August 2015. This is about one of our very first patients, Danny van Brenk. If you are interested in the whole article, please click here.

*Update: Danny passed away in 2017 after having spent valuable additional years with his family.

Dealing with a Diagnosis

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Online counsellor Nicole Hind shares how to help our brains and bodies deal with a diagnosis

You’ve just received a shocking diagnosis. You’re reeling and you aren’t sure what to do or how to take it in, let alone respond to the news. Suddenly you’re being asked to take in enormous amounts of information and make life-changing decisions. It’s expected, of course, that you will have to follow treatment plans and you know you should get on board right away, but you just can’t. You’re struggling and unable to climb out of the hole and it’s just getting deeper.

It turns out that trauma diagnosis could very well be affecting a large number of people, and it’s having an impact not only on our emotional well being but on our entire wellness and treatment plans. This study found that patients are far more likely to follow their doctor’s treatment plan when they feel like he/she has really listened to them with empathy and respect. And it seems this can be addressed right from the beginning if we all better understand the impacts of diagnosis.                             

What is trauma (or Post Traumatic Stress Disorder- PTSD)?

Little is mentioned in the study of medicine about ‘diagnosis trauma or ‘medical trauma’, however it can be understood as trauma a person may experience at the diagnosis of a serious illness, and/or the ongoing impact of dealing with a diagnosis.

The DSM V defines trauma as ‘a direct personal experience of an event that involves actual or threatened death or serious injury, with the response involving fear, helplessness, or horror’ (p. 463). Dr Judith Herman, an expert in trauma, would describe it, simply, as ‘a normal response to abnormal circumstances’. However it doesn’t ‘feel’ very normal.

Trauma is a bit like a short-circuiting of the way the mind usually sends messages around the brain. When we can’t totally make sense of something – typically when we are in danger and we have no control over the situation – the brain goes into hyper drive trying to ‘protect’ us, sending adrenalin and cortisol (and additionally for women oxytocin) flying around our bodies to get us to react, to get out of the crisis, to reject what is happening.

Of course it is not possible to get out of a diagnosis situation. 

What happens in the brain when trauma occurs?

The amygdala (the reptile brain where our instinct reactions live and our stress responses come from) basically shuts off from our pre-frontal cortex (where our thinking and logic live: where the ways we make sense of the world are created over our lifetime as we form memories). If we can’t fix the situation or come to some sort of resolution around it, then we can be propelled into the reactive danger zone constantly. This can have pretty major impacts the entire functioning of your brain. 

What does it feel like?

You might experience some kind of trauma when you first hear a diagnosis. What it looks like can be numbness or emptiness, an inability to take in information, to think clearly or make decisions, an overwhelming sense of fear or even terror, a strong desire to run away, to argue, a strong sense of being out of control, or somewhat weirdly to touch someone. Or you can suddenly be accompanied by a number of seemingly unrelated physical symptoms: heat in the face, excess energy, tingling fingers or scalp, deep sick feeling in the stomach, tightness across the chest, inner churnings.

Another presentation of trauma is that once you stop ‘the doing’ – once everything practical is taken care of – a whole bunch of the above symptoms can suddenly hit you. This can happen months or even years later. The ongoing trauma of dealing with a diagnosis of a life-threatening condition, or a later impact from the initial shock to the system of the news can have a profound impact on your physical wellbeing as well as your emotional and mental state.

In fact, prolonged exposure to trauma (referred to as C-PTSD, the C standing for Complex) can present in severe physical presentations: gut problems, heart conditions, back issues, headaches etc. It can also affect your ability to relate to other people, and influence your behaviour in ways you might not prefer.


Grief and Loss: what happens when you toss that in?

Grief and loss reactions are not just reserved for when a person dies. When we experience a loss of any kind – including a loss of a vision of the future – it can knock us for six. Basically our brains like our bodies to be safe and secure. When it becomes apparent that we cannot necessarily control that, a whole bunch of funny stuff can happen. Insomnia moves in and interrupts your previously restful nights sleep. Nightmares ruin your dreams.

I myself had a series of intense ‘flashes’ of people I loved dying in horrible ways when I was going through a loss some time ago. Experiences like this can be seemingly unrelated to your diagnosis, but it’s important not to underestimate the power of our minds when it comes to, in all it’s peculiar ways, protecting us and figuring things out.

It’s confusing and troubling and painful.

The last thing you need.

The first (or more accurately, second) thing that a medical practitioner should be looking for.  I don’t think it takes too much to be human with each other, no matter what our profession. Grief and loss reactions are not just reserved for when a person dies. When we experience a loss of any kind – including a loss of a vision of the future – it can knock us for six.

Just understanding diagnosis trauma might help doctors provide more effective and supportive treatment, and patients to be slightly less terrified when dealing with a diagnosis.

What can I do about Medical Trauma?

If you think you or your loved ones may be experiencing some kind of trauma or are struggling to deal with a diagnosis, here are some ways to think and talk about what is happening:

  •      Cross-examine the diagnosis

It may seem obvious, but allow yourself to spend some time reflecting on the meaning of your experience. If there is a sense of loss, what does this loss speak to about what is important in your life? Is there a way to hold onto what is important even under the strain of illness? When the intensity of The Diagnosis is present, what does it have you doing (or not doing)? Are you ok or not ok with that? Does anything become more available to you when The Diagnosis is shrunk a little in your mind?

  •      Love yourself through another’s eyes

When you genuinely look at yourself through a specific loved ones’ eyes what do you see? Remind yourself of who you are and what you mean to the people in your life. How are you going to hold onto your identity (and ask others to help you do that) in times of great pressure when it seems little is available? 

  •      Take a position- stand up for something- rather than ‘fighting’ it

We often expect people to ‘fight’ illness. In fact, we demand it. We say they ‘need to stay strong’ and describe it as ‘losing the fight’ when someone is dying, or if someone chooses to stop treatment we might say they’ve ‘given up hope’. But what does ‘standing up for Hope’ look like? Does it have to look the same for everybody? Is it possible to find other things to stand up for, ways of being that don’t involve fighting metaphors: can you see yourself as ‘standing up for love’ or ‘taking a position against an inhuman culture’? Can you make peace with a diagnosis without ‘giving up’ on yourself? If so, what does that look like? 

  •      Spend some time with Yourself

We can find ways to honour the parts of ourselves and others that are not specific to illness or diagnosis: Asking ‘Who Am I’ as a person, as someone who is part of a bigger picture, who contributes in any way that you can to this society and your people. Maintaining and actually growing your sense of identity via what is meaningful to you can help bring together what becomes fragmented by trauma.

Can you make peace with a diagnosis without ‘giving up’ on yourself? If so, what does that look like? 

  •      Be there for your loved one with a diagnosis. Just Be.

If you are supporting someone who has received a diagnosis, don’t launch into advice on how to feel better. Instead, offer your acceptance of what they are feeling. Acknowledgment. Support. It can be hard to sit with someone else’s pain and just let it be, but there is little more powerfully human than simply being with one another.

Are there practical things I can do to reduce the impacts of trauma?

By feeling more in control of your body, safer and more connected there is a lot of research to show that there is a positive, physical impact on the brain. In particular if you can calm anxiety you create the conditions that allow neural passages to open up, send messages, and possibly even regrow.

Recently I saw Dr Gregory Willis of The Bronowski Institute speak. He is an expert in Parkinson’s disease. With over 20 years of medical and scientific research and literally thousands of patients he is showing that if you treat the depression and anxiety that comes along with the brain changes + diagnosis trauma of Parkinson’s then you reduce the need for high levels of medication (research not embraced by many pharmaceutical companies). What THAT means is a longer and more fulfilling life with Parkinson’s and less chance of overdose. He supports the use of light retina treatment and anxiety-reducing practices alongside medication in treatment. Those anxiety-reducing practices are things like: 

  •      Mindfulness techniques

Mindfulness can assist to put you ‘in the moment’ and not trailing off on thought processes that are not serving you. You can practice with a professional or via a podcast or alongside a video on YouTube.

  •      Deep breathing

Many of my own clients find controlled techniques such as 4262 breathing help them sleep. Bear in mind the out breath is the calming one, so it’s breathe in for 4, hold for 2, out for 6, hold for 2, repeat (adjust slightly to your own breathing rhythms, just making sure the out breath is longer).

  •      Specialised yoga classes for addressing trauma

There are also yoga classes for people who have illnesses and the teacher can adjust practice in accordance with your needs. Additionally it can be a safe space to connect with others who understand your story.

Because guess what? You are allowed to be: Furious. Confused. Terrified. Sorrowful. Or even Numb.

  • Soothe your emotions creatively

As a matter of priority, make time for any kind of activity you find soothing, such as journaling, art, making wooden furniture, cycling…or embrace the opposite of soothing by using the activity to express your emotions. Because guess what? You are allowed to be: Furious. Confused. Terrified. Sorrowful. Or even Numb. We have this tendency to be frightened of strong emotions. We shut them down: in each other, our children and ourselves. But it’s not healthy. If you’re not a talker, or you don’t buy into all this sharing nonsense, then finding some way to express yourself is vital for your health. When you pay attention to your body, when to soothe and when to express becomes much more clear.

Feeling that they had to be ‘strong’ in only one way (e.g.: silence by not ‘burdening others’) is actually one of the biggest regrets most people I work with share, at some time of their lives.

  •      Talk about it, share it, reflect on what it means

On a similar note, finding ways to express your emotions, finding someone who can listen to them, handle them, places to yell and scream and cry can be very important for healing trauma and also for a strong brain. If this frightens you, it might help to ask yourself: Why do I feel so strongly about this diagnosis? What has been taken away from me, and why do I hold it so dearly? What am I standing up for when I let my emotions be, as they are, without attacking anyone or myself for feeling this way? 

  •      It’s OK to be vulnerable

Lastly, when it comes to diagnosis, or anything in life, it’s ok to be vulnerable and ask for help. Feeling that they had to be ‘strong’ in only one way (e.g.: silence by not ‘burdening others’) is actually one of the biggest regrets most people I work with share, at some time of their lives. We all struggle to get more of what we need from others, so practicing at it, even though it doesn’t feel natural, is an art. You’ll often be surprised about how much more you get from folks when you bravely share your own vulnerability.  

Dr Judith Herman herself says that trauma recovery can only take place within the context of relationship. If we don’t see ourselves or each other as worthy of having a say in relationships: with friends, family and our doctor who is making life-changing decisions for us, then we will, as a society confronting life threatening diagnoses every day, continue to struggle with this vital understanding of the relationship between the body, the mind and ultimately our own wellness. Dealing with a diagnosis can be traumatic, but it doesn’t have to be. 

Nicole Hind is an Australian Online Counsellor who fiercely believes that we all have stories that deserve to be wrenched out of the shadows, increase a sense of hope, of self-worth, and provide clarity on how to approach challenges for the rest of our lives. You can get in touch with her or read more of her blogs at www.unveiledstories.com.

Telling your child you have cancer

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Suggestions from cancer survivors and their children

Telling your child that you have cancer can be a very daunting task – it can be difficult to know how much or little to say, and when to say it. Thankfully these days there are plenty of online resources written by health and child specialists.

Professional advice aside, it can also be nice to hear firsthand from other parents – how did they to go about it? What worked for their family, and what would they do differently?

Here are some thoughts, reflections and suggestions from other parents in the online world who have already braved the task of telling their children about their cancer diagnosis:

‘Give your child the freedom to give cancer their own name’

Ann Marie Otis talks about how her four year old son Jack referred to her diagnosis as ‘stupid dumb breast cancer’ (which also inspired the name of her website). These words, usually considered naughty in their household, were in this instance allowed because Otis felt it was important that Jack be free to articulate himself and his feelings in his own way.

‘Consider waiting until you have a treatment plan’

Gabby Spear and her husband decided to wait to tell her three and six year old until a month after her diagnosis because they wanted be able to have a clear plan in place first. They wanted to be able to say, “this is what I have, this is what it means, and this is what we are going to do about it.”

‘Involve your child’s school’

Australian bloggerJo Wallaceapproached her seven year old Charlie’s teacher after being diagnosed with stage 4 cervical cancer. They ended up inviting her doctor to talk about cancer to Charlie’s entire class; about what it is and isn’t, about how it isn’t contagious, and if how detected early, it can be treated. This not only empowered the school community to support Charlie – it also opened up the opportunity for other children to talk about cancer and played an important role in demystifying the disease for them as well.

‘Keep some things normal’

WhenJen Singer asked her two sons (eight and ten years old at the time) what they had found helpful during her lymphoma, they said that hanging out with their usual friends had been meaningful, because they felt like families whose homes they had never been to before tried hard to be extra nice, and it made them feel pitied.

‘Let your child help out if they want to’

Pancreatic cancer survivorTonia Smith recommends giving your children chores that they can do around the house because it can help them feel like they have control over the situation, and doing something to help you fight your disease.

‘Don’t censor your child’

April Steams shares how her four year old told everyone she met that her mother had cancer. From people at the park, to clerks at the grocery store, to other moms at the library, “she wasn’t looking for sympathy – she simply needed to talk about it.”

‘It’s OK for your child to see you vulnerable’

Breast cancer survivor and former educator Nancy Stordahl feels that overprotecting children could be more harmful in the long run. Allowing your children to see your vulnerable side from time to time can help them to feel like it’s OK to express their own feelings of sadness and frustration.

And finally…

‘Remember that every child is different’

As with every child, there is no one size fits all approach, and you as their parent know your child best.Emma Young told each of her children of varying ages different things:“You have to do what feels right for you and your family, there’s never a textbook answer.”

Further resources

Articles by various cancer organisations

American Cancer Society

Dana-Farber Cancer institute

Cancer Council NSW

Websites

Parenting with cancer – A website with resources and articles written for parents with cancer by parents who are cancer survivors themselves.

Further resources

Articles by various cancer organisations

American Cancer Society

Dana-Farber Cancer institute

Cancer Council NSW

Websites

Parenting with cancer – A website with resources and articles written for parents with cancer by parents who are cancer survivors themselves.

Canteen – This Australian organisation has a specific section on their website especially for teenagers whose parents have been diagnosed with cancer, with easy to understand information.

Canteen – This Australian organisation has a specific section on their website especially for teenagers whose parents have been diagnosed with cancer, with easy to understand information.

For those who are searching: hop online

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My friend’s mother Jill* was diagnosed with cancer a few years ago. Recently she told me that her mother was receiving further treatment in Queensland. It was a fairly new treatment that wasn’t on offer yet in her home state. “It’s really helping her,” she told me. “I’m so glad that we found out about it.”

Thankfully Jill* only has to travel a few hours every couple of months, and her husband and two daughters have the capacity to take time off of work, taking turns to travel with Jill and be by her side to provide care and support.

But what if the medicine had only been available overseas—a long 30 hour plane trip away? Or what if the drug existed, but wasn’t available to her at all?

This scenario is the very reason for buycancermedicine existence. We live in an age where you can hop online to order a new brand of lipstick if it hasn’t been released yet in your country. It seems nonsensical that you have to wait months, even years for a FDA approved, potentially live-saving medication to become available in Australia.

Our aim is to put patients in the driver’s seat. If a patient decides to explore new pathways and there is a new, well-reviewed, approved innovative treatment out there that could help them, we want to help them to access it; and as quickly as possible. It can be difficult to learn about the latest treatments available, all in the one place. We want to bridge this gap as well; to be a platform that doctors, health providers and patients can go to for information and access.

This month, thousands around the world will gather for various breakfasts and events to raise awareness about the most common cancer affecting women: breast cancer. buycancermedicine honours those whose lives were tragically cut short by breast cancer, and stand in solidarity with those who are fighting this devastating disease.

*Name changed to preserve privacy.

DISCLAIMER: Nothing can replace the care of your clinician or doctor. Please do not make changes to your treatment or schedules without first consulting your healthcare providers. This article is not intended to diagnose or treat illness.