Do you have multiple illnesses at the same time? Let's talk about comorbidity!

When you go to see a doctor, have you ever heard someone say something like, "You not only have high blood pressure, but you also have diabetes, so you can't give me this medicine"? Or do you worry that when you take medicine for one condition, it will interfere with another? In fact, it is very common to have more than one medical condition at the same time. In medicine, we have a special name for this. That's what we are going to talk about today.

Simply put, what is comorbidity?

You may have heard the word comorbidity from a doctor. The simplest definition of this is that a person has two or more different medical conditions at the same time. These are usually long-term, or what we call chronic diseases . These diseases may or may not be related to each other.

Doctors use this term to help you understand and explain how these conditions, together and separately, affect your physical and mental health. Sometimes this is also called 'coexisting conditions' or 'multimorbidity'.

Think about it this way. A person has diabetes . After a while, they find out that they also have high blood pressure. Then we say that there is a comorbidity between these two diseases. The symptoms of both these diseases can affect your quality of life. So when you are being treated for diabetes , the doctor should always be concerned about your blood pressure.

What is the difference between comorbidity and a complication?

This is where many people get confused. Comorbidity is not a complication .

However, comorbidity is something different. It means that in addition to your main disease, there is a separate medical condition that exists simultaneously with it. For example, if someone with diabetes develops arthritis without any connection to it, that is a comorbidity. Do you understand the difference?

Who is most likely to see this condition?

Older people are more likely to have several of these diseases at the same time, because as we age, the likelihood of various health problems in our bodies increases.

However, this is not limited to the elderly. Comorbidities can also occur in younger people. Research has found that there are several factors that contribute to a person developing multiple diseases at the same time.

• Type of illness (physical or mental)
• Gender
• Age
• Socioeconomic status

What these studies have shown is that people with low economic status and high levels of stress in their daily lives are at risk of developing several of these diseases 10-15 years earlier than those with better access. Also, the more chronic diseases a person has, the higher their risk of developing a mental illness (e.g., depression ).

How does comorbidity affect my treatment plan?

When you have multiple conditions, treatment can be a little more complicated. This is because each condition has its own unique symptoms, triggers, and requires different treatment plans .

Some medical conditions can also increase the risk of developing other diseases. For example, arthritis is more common in people with chronic conditions such as obesity , heart disease, or diabetes. When multiple conditions, whether related or unrelated, come together, it can be challenging to manage them all at once.

Taking multiple medications (Polypharmacy)

When you have multiple illnesses, you have to take multiple medications. We call this polypharmacy . There is a big risk here.

In fact, a person with comorbidities is at higher risk of developing other health problems unrelated to the primary disease. This increases the risk of emergency department (ETU) visits, adverse drug reactions, preventable hospitalizations, and in some cases, even death.

Important tips for managing comorbidities

Although living with multiple illnesses like these can be challenging, it can be well managed if you work with a plan.

1. Tell your doctor about all your medical conditions: Even if you are seeing a specialist for one condition, tell him about all your other medical conditions and medications you are taking . This will allow him to consider your overall health and develop the most appropriate treatment plan for you.

2. Have a primary care physician: Have a primary care physician, such as your family doctor or GP. He or she can understand all of your medical conditions, refer you to the necessary specialists, and coordinate your treatment with them.

3. Prioritize: You may not be able to discuss all of your concerns in the 15-20 minutes you have with your doctor. So, before you go, think, "What is the issue that is bothering me the most today, the one that is affecting my daily life the most?" Prioritize that and discuss it.

4. Take a medication list with you: This is very important. Write down the name of every medication you take, the dose, and how many times a day you take it. Include any vitamins or painkillers (e.g. Panadol) that you buy from the pharmacy. Take this book with you to every doctor's appointment.

5. Take care of your lifestyle: Living with multiple chronic diseases can be physically and mentally exhausting. A healthy diet rich in fruits and vegetables, daily exercise, and good sleep can help boost your energy levels and minimize side effects. Talk to your doctor about this.