After a chronic illness is diagnosed, how should you manage it over the long run and spend less?
Tips from this section that apply in the United States. This section is about health and medicines. It is general information, not a substitute for a doctor’s diagnosis or prescription.
People who take their medicine fully as the doctor said are about half as likely to die over the same period as people who take it on and off. Take that number with a grain of salt. People who take even a fake pill faithfully also die less often, which shows that part of the benefit comes from "people who can stick with their medicine already look after their health more." But the harm of stopping is certain, especially with blood-pressure drugs, blood thinners and anti-rejection drugs.
With a chronic illness, what matters is the change over a period of time, not a single reading. Measuring your blood pressure at home on your own does not bring it down. Blood pressure drops more when you bring the readings to your doctor and the doctor adjusts your medicine by them. When you switch hospitals, a hospital should not make you repeat a test whose result carries the mutual-recognition mark.
For cancers that could have been treated, people who used only alternative therapy and skipped proper treatment had 2.5 times the risk of death of those who got proper treatment. People who used complementary therapy alongside treatment more often refused chemotherapy and radiotherapy partway through, and the extra deaths come from there. Some herbs also weaken anti-rejection drugs and blood thinners, so ask your doctor in charge before taking any.
Diabetes damages the back of the eye and the feet, and you feel almost nothing until the damage reaches blindness or sores. Caught early, it can still be treated. With type 2 diabetes, get a dilated eye-ground exam at the time of diagnosis. With type 1, start 5 years after onset. If one or two exams were clear and your blood sugar is on target, the interval can stretch to once every one or two years. Have your feet checked every year.
For someone who has had a first calcium stone, if they do nothing, about a quarter will get another within five years. Among people who drank enough water every day, only a little over 10% had a recurrence in five years, more than half fewer. The British guideline gives the amount as 2.5 to 3 liters of water a day and no more than 6 grams of salt.
Gout needs a urate-lowering drug long term to bring uric acid below 360 µmol/L, not painkillers only when it hurts. When a nurse adjusted patients' doses according to lab results, 95% reached the target after two years, versus 30% with usual care. Once the target is reached, you still can't stop. Avoiding certain foods does not get you down to that line, and giving up alcohol lowers it by only 1.6 mg/dL.
Moderate value
Evidence A
Buys life
Disputed
Mainland China only 3 tips
These tips describe mainland-China rules and do not apply in the United States; they are here for people living in China.
For high blood pressure, diabetes, outpatient chemo and radiotherapy for malignant tumors, dialysis for uremia, and anti-rejection drugs after an organ transplant, these 5 kinds of care can be paid directly with your medical insurance (医保) even when you see a doctor in another place. You don't have to pay up front and then claim reimbursement where your insurance is registered. But you first have to get the outpatient chronic-and-special-disease status approved where you are insured, and then register for out-of-area care. It only works once both are done.
If your condition is stable and your medicines haven't changed, a community health service center (社区卫生服务中心) can give you a full 12 weeks of medicine at a time. That saves the half day of traveling to a big hospital and queuing to register every month. Within the same place where you are insured, the reimbursement rate at a primary-level hospital is also usually about 10 percentage points higher than at the next level up.
The basic service package of the sign-up is covered by medical insurance under the rules. For personalized service packages, you pay the whole cost yourself. When someone pushes an "upgrade package," first ask whether it is the basic package or a personalized one, whether it is on file with the authorities, and how much it costs a year.
