Provide Ms. Tyler with printed literature about fibromyalgia. Explain that this disease is difficult to diagnose and that this medication has recently been approved by the Food and Drug Administration (FDA) to treat fibromyalgia. Tell Ms. Tyler that the doctor may adjust her dose depending on how she tolerates the medicine and what kind of results she is getting from the drug. Caution her that dizziness and blurred vision may occur as side effects. Tell her if she has any signs of an allergic reaction, she should immediately stop taking the medication and report this to the physician. Inform her that she should avoid alcohol consumption while taking Lyrica and not to drive if she experiences any dizzi- ness and blurred vision. Explain to her that the doctor may prescribe additional therapies to help her deal with reha- bilitation as she recovers from this disease. Encourage Ms. Tyler when she returns for her next visit to be prepared to ask her physician the following questions: • What is my main problem? • What do I need to do? • Why is it important for me to do this? • What can you do if this new medication is not working? • What else can you or I do to treat my pain? What additional measures can you take to help maintain health literacy in this patient? What other measures would be helpful if Ms. Tyler did not speak English, could not read, or had other learning deficits?
Jennifer Tyler, 44, has had several visits to her primary
physician about her pain. She told the office nurse that
she “doesn’t know how much more of this I can take.” Her
history reveals that she has had an “aching pain, literally
all over my body” for the last 3 months. Jennifer states that
“It’s taking over my life now. Everything I do hurts, and to
make it worse, I don’t sleep well at night and I can’t even
think straight.” Additional symptoms she reported include
fatigue, occasional muscle spasms in her legs, headaches
that are occurring on a more frequent basis, and general
anxiety about her health. Jennifer reports that initially she
tried Advil off and on with some mild relief and even admits
taking some “old muscle relaxants” that her husband
had from a back injury. Despite the antidepressants and
sleeping pills that were prescribed for her, she has not
been able to get much in the way of pain relief. After his
initial examination, her physician has ordered a variety
of laboratory studies to try and determine exactly what is
causing Ms. Tyler’s pain. At this visit, he told Ms. Tyler that
he suspects fibromyalgia may be the cause of her pain
and other symptoms. He prescribes pregabalin (Lyrica)
and wants to see her again in 3 weeks to see how this
medication is working for her. As she is making the next
appointment, Jennifer tells the nurse, “I sure hope this new
medicine works. I’m running out of hope here. What kind of
a life is this?”
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