Month: November 2021

Wednesday Wonderings … Their house is kinda dirty, what is going on?

Posted on November 24, 2021 by Pat - Uncategorized

November 24, 2021

Signs your aging parent needs help

It is that time of year. We go to visit our parents and/or other family members for more than three hours. Maybe you haven’t seen them for a few months or since last year. Sure, everyone is on their best behavior, for a while. “For a while,” is the key. Covering up and hiding things can be done for a few hours. The conversations are general. The house is clean (in the living room, dining room and probably kitchen). What about the rest of the house? What do the cars look like?

When you haven’t seen someone every week, you notice things that are amiss much better. Nothing major, but a lot of little things. I get it. Holidays, family dynamics, travel, cleaning, cooking, pressures at work, etc. It is stressful. Even if it is a good and loving family time, it is still stressful.

Look and Observe

This is also a good time to stealthily check things out and observe. This is not the time to be rapid fire questioning or even questioning at all. Just look, listen and observe. It is troubling when our loved ones begin to lose their independence due to a health condition or aging. It is a big stressor for us when we realize what is happening. No matter how hard it is to look for possible issues, it will be even harder to ignore them and get blindsided at the most inopportune time. You are looking for warning signs that your parent may need some kind of home care.

Physical heath changes

Have they lost weight?

Have there been any changes to their medications?

Are the taking their medications correctly?

Are they walking differently?

Are they hesitant to get up and walk?

Does it seem they are unsteady or have a fear of falling?

Do you notice any cuts or bruises on forearms or legs especially?

Behavior changes

Have they lost interest in things they used to enjoy?

Have sleep patterns changed? Napping more, less or sleeping more or less

Do they seem to be sad or angry? They may deny it, but how do they look?

Are they repeating the same stories?

Are they giving money to things or people that they have not done before?

Are they not bathing regularly?

Are they wearing the same clothes day after day?

Are they losing track of time?

Are they showing an increase in agitation?

Are you noticing verbally or physically abusive behaviors?

Environment

Is there a lot of unopened mail laying around?

Is there more clutter than you remember before?

Do you see spoiled food or past expiration date food in the refrigerator?

Are there any small things undone? Ex. Burnt out light bulbs, laundry overflowing, crumbs or grime on counter tops?

Are there any dings in the car? Scratches?

Is the yardwork being kept up?

Does the cookware have burn marks in it or on the outside?

The exterior of the house is not being maintained. Gutters, spigots, painting, etc.

Cognition, Memory or Judgement

Missing appointments?

Getting lost while walking or driving?

Trouble finding the right words?

Unable to complete sentences?

Unable to recall names of familiar people or objects?

Unless they are in immediate danger, do not make a fuss. Plan for a time to meet later and talk. When you meet, express your concerns and your observations, they will probably become defensive. Do not get personal. Re-state your observations and how all of you can work together for solutions. Maybe they need a check-up with their doctor? Maybe they are having issues or problems with their medications?

They may not lie, but they are not going to offer any information either

Your aging parents are not going to share things with you. They may not lie, but they are keeping secrets. Spouses will cover for each other. What one may no longer be able to do or handle the other one will step in and handle it.

High on the priority list will be an eyesight check-up and a hearing test. They may not be able to clean as well, because they cannot see as well. They may have fights or spats because they cannot hear each other and neither of them understands what is wrong with the other. Hearing also affects their balance.

Some secrets that they keep – They are falling sometimes

They are in pain

They are short on money

They may go on spending sprees

They may be drinking more

Someone is financially abusing them

Someone is physically or emotionally abusing them

NEVER Blame them

These conversations can be very awkward and they may deny that anything is happening to them. Tread lightly. You want them to trust you to help and not to blame them or hurt them further by how you act towards them. Ask them if you can talk about XYZ. Share an article with them about it happening to someone else and ask their opinion and insight. If they refuse to talk or share with you then you may want to find someone else that they will talk to. Their doctor, pastor, a friend of theirs, someone they will be comfortable talking with.

You may not get anywhere with them. They may stub up and say no to your help. You can’t make them; you can only try to help them. If they are of sound mind, they get to make the decisions, even if they are the wrong decisions.

How can I tell people what I need? Learning better communication skills.

Posted on November 18, 2021 by Pat - #alzheimers, #caregiver, #caregivers, #ms, #parkinsons

November 17, 2021

It would be so much easier if other people just knew what you needed and wanted and did it! No one can read your mind. No one can really understand what you are going through. Even if they have helped take care of a loved one of their own, their needs may have been completely different from your needs. You have to become a more effective communicator. Misunderstandings will occur/ Look, communication is a skill so it can be learned and you can improve communication skills.

Communi-friggin’-cation! It is the key to everything. That is my own word for communication. Did you know that other folks communicate totally different from you, well, maybe it is the understanding that is different? You know what you need, inside of your head, but how do you communicate that need so that others will understand? There are different ways to communicate and people learn differently. Learn to speak in a way that the other person can understand.

Are you one that thinks …
Well, if they knew me…they would know what I need?

I have told them how tired I am and I need a break.

Well, if they could help me, I guess they would.

I talk about how hard it is, all the time. It has taken over my whole life.

No, I’m good, I can just handle it all.

Hey, I need you to be here on Saturday the 8^th from 9 am until 6pm.

I need you to do the laundry, change the sheet and provide dinner on Sunday.

How many different styles of communication are there? Four major ones. Body language is another style, but that is for another day. We are talking about being verbal and asking for what you need or want. Wants are okay to ask for too.

Types of Communication Styles

Passive

Passive communicators go with the flow and are sometimes seen as wallflowers. No muss, no fuss. Sometimes they may be unaware of their thoughts or feelings, but more than likely they ignore their own feelings, wants and even their thoughts. They may seem to be easygoing, but underneath anxiety rules. They fear disapproval.

Passive communicators bottle things up. They hardly ever fight and usually cede everything. They stuff and they stuff their feelings and wants. You can stuff things for so long, but they will eventually bubble to the surface. Resentment, here I come!

Aggressive

Aggressive communicators dominate the conversations and state their opinions often overriding others’ opinions. They use direct eye contact, leaning forward, staring at you and moving towards you sometimes. They are very poor listeners and use a harsh tone, even if they don’t mean to be using a harsh tone.

Aggressive communicators are not quiet and yes, they are the ones that yell. They almost never back down. Your feelings will not be considered. Think more of a “win” type personality and not the “win-win” type.

Passive-Aggressive

A passive-aggressive communicator will confuse the hell out of you. Why? Because they cannot get all of their thoughts, and meanings outside of their heads in a cohesive manner or in a way that makes sense to others. They may be easily frustrated. They can become quite irritable and resentful. They will use sarcasm, talk to another person instead of the person that they need to be talking to. They will criticize others. I don’t get this one, but I have seen it happen. They show oppositional behavior. They will be the one that states, “I will help.” They will help and they will Complain the Whole Time. These folks are angry and their words do not match their body language. Gritting their teeth, making their hands into a fist all the while either being indifferent or smiling.

Passive-aggressive communicators are angry and they know that they are angry, but will deny that they are angry or that anything is wrong. Sarcastic barbs coming your way or maybe you will get the silent treatment.

They silently seethe and the other person has no idea what in the world is wrong.

Assertive

An assertive communicator is confident. They are open to discussions and clarifying whatever may be unclear or confusing without being an ass. They are usually calm and will state what they want or need without imposing their requests on others. This type will look for a consensus, if possible. They usually listen and seem to care about others. You may have healthy and loud discussions but it does not feel like you are having an argument. They will share their thoughts, opinions and how they feel about something. They are open to you doing the same. Not only are they able to listen, they are able to hear.

What communication style to you have? What communication style do others in your life have? Can you see how things get all messed up when everyone is talking and no one is listening or hearing?

Improve your communication skills

We have all heard it before, seek to understand first. Understand where the other person is coming from, try to put yourself in their shoes. You may not be able to fully, but try as best you can. We all have our own peculiar ways. We are different people with different experiences and we look at things differently. It isn’t wrong, it is just different. Search for common ground. What can you agree on? What is best for the care receiver? What is best for all involved as care givers? Each of us have strengths and each of us have things we don’t do very well. Effective communication decreases stress and helps all of us get on the same page.

Let your empathy and compassion for others help you in moving towards being an assertive communicator. A good sense of humor helps too. Practice active listening and work on communicating clearly.

What strengths help you become a better caregiver?

Resilience – The ability to withstand or recover quickly from difficult conditions; I can negotiate for what I need and navigate systems.
Patience – The capacity to accept or tolerate delay, trouble, or suffering without getting angry or upset.
Flexibility – Ready and able to change so as to adapt to different circumstances; accept what is happening in the moment.
Compassion – The ability to translate empathic feelings into action (desire to alleviate suffering).
Optimism – Expect a favorable or positive outcome.
Confidence – Sure of one’s self and one’s abilities.
Organization – Methodical and efficient in arrangement or function.
Ability to Laugh – To easily see and appreciate the humor in the situation.

Use these to rate yourself on the above strengths:

1 – Always
2 – Sometimes
3 – Hardly ever or Never

Be honest and help yourself to know what you are good at and what you are not so good at… Hopefully, you will find that others have different strengths than you and will be a good helper.

To identify and acknowledge your personal caregiver strengths, set aside a few minutes for personal reflection. Ask yourself the following questions:

What gives me energy?
What am I good at? What do I do best? What do I do well?
What am I naturally good at? What comes naturally to me?
What are my best character traits?
What things do I look forward to doing?
When faced with challenges or adversity, what strengths do I bring to these challenges?
What do I handle well?

Communicate Effectively

When you ask for things, be specific. Have a list at the ready. You may need things done at your house instead of at the care receiver’s house. Be as flexible as you can. You must agree to a day and time or it will not get done. Never a “whenever” or a “sometime next week.” Pick a day and time, negotiate for another day and time, if necessary. Keep a running list of things that need to be handled. Heck, place it on the refrigerator for folks to sign-up.

Headings for the list include: What action or Task, Where (care receiver’s house or care giver’s house), What day, Alternate day, Who will handle this

You will have to be direct. Not an ass, but state what your Mom/Dad and/or you need their help. Are you willing to step-up, pitch-in and help? If they say yes, then pull out the ready-made list and get to work. If it is a task that takes time and they do not have time, then by all means suggest a less time-consuming task or request a specific amount of money (be fair and reasonable) to hire out the task. If that doesn’t work then ask them what they can contribute and shut your mouth until they begin figuring out things, Yes, it will be uncomfortable, but just be still and quiet. Be open to brainstorming sessions. Try to make your “ask” into statements. For example, instead of saying, “Can you do some things for me?” state that “I need XYZ from the store today.” “I need you to provide dinner on Friday.”

What if you ask and get told “no” to your direct request? You may even get brushed off or told off, where do you go from there? You still need back-up and help. It is going to suck, but you will move forward as if you are an only child. You may need to hire outside help, ideally with the care receiver’s money.

I have seen a family of 4 siblings work it out to care for their aging parents at separate times. They all stepped up and did whatever was needed. They were all professionals and very busy with their careers, but they made their parents the priority. They communicated, worked together, had a list and each of them used their strengths to the fullest. Their parents we never alone.

I have also seen a family with 3 siblings leave it all to one sister. No help, no money, just bitching and “trying” to run things. It was horrible. That one sister realized she would have to handle her mom on her own. She did and her mom was well cared for. It did take some of the sisters’ own money, to help with outside care, but they managed and she had a good experience with her mom for the time her mom had left. She also told me that she had no regrets and that her conscious was clear. She is civil to her siblings, but not really much of a relationship with them now. Of course, it wasn’t much of a relationship before either.

Maybe you will have to say your piece to those that will not contribute in order to let go of your anger or resentment at them. Do let go of your anger, you don’t have the time or energy for it.

There may come a time when you have to say “No” to caregiving.

Communicate your limits

You may find that you must set limits on caregiving responsibilities. You are exhausted, overwhelmed and your own health is suffering. It most often happens to those that do not take care of themselves during the care giving process. You do count. You do matter. Add your needs in to the mix.

What does saying “no” mean to you? Could it mean that you leave the loved one to fend for himself?

Maybe it means that you are tired, isolated and depressed and you have to stop, possibly “no” means that you need to take a breather and you realize that some things will have to change if you are going to proceed and help as a care giver. Boundaries is not a dirty word. Emotional limits are reached quickly when either a crisis happens or you have taken no breaks.

Practice your “I” statements to work on your boundaries.

“I can no longer drive you to all of your medical appointments due to my work schedule and my limited time off. I know this will be a change for you. I suggest we look into other transportation options such as the Busy Bee Medical Transport Service.”
“Mother, I am unable to continue with the responsibility of cleaning the house weekly. I want to spend my time with you on other matters. I know it’s hard to let newcomers help, but I think it is time to hire a homemaker service you would be comfortable with.”
“Dad, I can no longer assist you down the outside stairs. I am worried about your safety and mine. I believe we need to build a ramp for easier access to your home. I have found a carpenter who has reasonable rates for construction.”

In each of the above statements, there is a presentation of what the speaker cannot continue to do, an acknowledgement that the change will have a consequence for the elder and a suggested solution. No attempt is made to make the elder feel guilty about the effort the caregiver is expending or the caregiver’s stress level. It is understood the elder knows the caregiver is working hard.

Setting the boundary is the caregiver’s responsibility. Deborah Colgan, MA, M.Ed., NCC

You can state what you need. You can be direct. You can set boundaries.

Pat

When things don’t go as planned, how do you cope and what do you do to solve the problem?

Posted on November 11, 2021 by Pat - #alzheimers, #caregivers, #ms, #parkinsons, #seniorcare

November 10, 2021

You worked and you thought and you worked some more. By golly, you have a plan. It is a good plan. You are so proud (and relieved). Now, it is time to work the plan. I mean you are so excited and you just know that this is the right plan and the “right way” to do this thing. Granted, it was all in your head of how it would all play out, but still, it worked.

Then reality set in. A few fits and starts at the beginning, but you were still on your way. And then, out of nowhere whoa, the brakes get slammed on … hard. What the hell? Why all this resistance? Why is this not working? Why the melt downs? All of these things are running through your mind. You are replaying what happened. You are confused. This should have worked. I saw it work in my mind. We Are Trying This Again!

Things are not going the way you planned

You do and the brakes get slammed on again. Hmmm, are you ready to look at what did not work? Are you ready to ask others why this did not work or are you still the Lone Ranger? Are you ready to accept that it might not have been a good plan? If you aren’t, then look up the definition of insanity, you know, the one that states that you keep doing the same things over and over again, in the same way and you expect different results,

This scenario plays over and over again in all of our lives. At work, at home and with loved ones that we are helping. Think back to your own experiences at work when you had the most brilliant idea for a way to handle an issue. I mean it was win-win for everyone. You had everything in place and began implementing the plan. It was okay and there were a few folks that balked, but you were determined to push on. Soon, the plan was not working as you had envisioned and the situation became more unstable and somehow it was not a win-win for everyone. Dang it! What happened? Maybe, you did not have buy-in from the start from the others that were going to be impacted by the plan. Maybe, the plan was not fleshed out enough for consistent implementation? Maybe, you had one or two people that did not like the plan because they were not consulted on something that would impact them? What do you do? Do you scrap the plan and start over? Do you look at what worked well and make adjustments on what did not work well? Do you bulldoze over others objections? Do you seek input from others who will be impacted with the plan?

Things happen, how does that make you feel?

What a pickle! Can you see how these things happen in caregiving or helping others? I can. I have a plan and I think it is the greatest plan to help all involved. But, I did not even talk to all involved to see what they thought about the plan. I only thought about what I thought would work the best. My own perspectives, my own wants and my own…everything. I did not realize that at the time, I just thought that I knew best. I did not know best. How can I make a plan for others and not include their wants, needs or ideas?

I felt that if I was handling things, then I get to decide everything. That did not work at all. You talk about stress, strife, fighting, anger, even a lack of trust. I only thought that I knew best. I didn’t know jack. I had to realize that we needed to work together to make a plan that would work for all of us. All Of Us! Not just the care receiver, but the care giver, too. It was not easy to realize that I did not have all of the answers. I had the knowledge and I had the contacts, but I did not have my mom or dad’s perspective. Don’t make the same mistakes that I made. It was much easier than I had anticipated. It was so much easier once I knew what they needed and wanted help with. It was so much easier to work around my schedule when I shared my schedule with them. I am all about less stress and more effective ways of doing things. I am a life long learner and I like learn new things. One of the new things that I learned is that it is okay to be a recovering perfectionist. I learned that progress beats perfection every time. So much less stress too. Perfection keeps us stuck. We don’t have time to feel or be stuck.

Next steps

What if you could provide better care AND get your life back? Sometimes, you can do it on your own and sometimes you will need my services.

When making a plan involve all the people that will be affected by the plan. (There may come a time in a dementia patient that they can no longer participate, but while they can, let them participate.)

1. List the issue

1. List who may be impacted by this issue

1. Does this issue need to be done/handled at a certain time?

1. Who can best handle this issue?

1. If this does not work, what can be tried next?

1. Brainstorm – write everything down (pare down later)

1. Reevaluate and update, if needed

1. Be flexible

1. Come to a consensus or an agreement

1. Implement the plan

The above tips will help to keep you on track. If you are a person that goes to worst case scenarios then you must act as if the worst has happened and make a plan for what you will do, you have to move past the worst-case scenario into what you will do next.

Remember, you only have so much brain energy to use on difficult situations every day. It is about two and a half hours. If it is important enough to make a plan then it is important enough to be at your best when your make the plan. Sleep, eat, and hydrate.

One thing that I want you to realize is that there will be important and urgent things and there will be not important and not urgent things. Don’t let yourself waste your time, efforts and energy on the things that are not important and nor urgent.

Handle only three things at a time, that is all you will be able to handle well anyway.

Pat

Wednesday Wonderings … How can I know if my medications are working?

Posted on November 3, 2021 by Pat - #alzheimers, #caregivers, #multiplesclerosis, #parkinsons, Medications not working

November 3, 2021

Are my prescription medications helping me or hurting me?

Have you ever wondered if the medications that you are taking or someone that you love is taking are helping you, hurting you or even working at all? Have you ever wondered if you are having an unexpected reaction or side effect to your meds?

What is pharmacogenomics?

Pharmacogenomics is the study of how genes affect a person’s response to drugs. This relatively new field combines pharmacology (the science of drugs) and genomics (the study of genes and their functions) to develop effective, safe medications and doses that will be tailored to a person’s genetic makeup.

This definition is from the U.S. National Library of Medicine

Basically, your genes affect how and if certain medications are metabolized in your body. And why is that important? Because you need a medication to be therapeutic (to do its job well). Some drugs, called prodrugs, are inactive when administered (taken) and then they are metabolized into the active form to provide benefits. What happens if you cannot metabolize that medication into its active form? It will be like taking water. It won’t do anything because your body cannot change it into its active form. What if you take a medication and your body rapidly metabolizes it too quickly? You will not get the benefits of an Effective therapeutic dose. You are burning through it too quickly. What happens if you metabolize the medication very slowly? It can build up inside your body and cause more and more problems along with more intense side effects. Most medications are metabolized in the liver and excreted through the kidneys.

Metabolism, liver, kidneys, liver enzymes, excretion rates, inactive and active metabolites, metabolism rates, phases of metabolism, blood flow, changes in liver volume, etc. all of these things come in to play. What I want you to know is that you can find out how you metabolize certain medications and you and your doctor can decide what medications are best for you and your particular needs. You can also find out if you need more or less of a certain medication. Do the test once and use the information the rest of your life.

What are some of the benefits to having this test?

Helps your doctor find the medications that may work best for you

Helps you to know which medications to avoid

Helps you to know which medications dosage may need to be increased or decreased

Severe drug reactions can be reduced or eliminated

Stops the trial-and-error method that usually takes months to see if it helps or not

May help decrease opioid dependency

May increase pain relief

Bothersome side effects may be decreased or avoided

Do it once and use the information the rest of your life

Who can truly benefit from this test?

If you have been diagnosed with:

Depression

Anxiety disorders

Obsessive-compulsive disorder

Dementia

Autism

Insomnia

ADHD

Schizophrenia

Pain

Lipid disorders (high cholesterol)

Alzheimer’s disease

Parkinson’s disease

Multiple Sclerosis

Breast cancer

Epilepsy

Cardiovascular disease

Asthma

HIV/AIDS

Autoimmune disorders

Check-out the Medications that are impacted by your genes.

To see the medications list, go to WWW.EmpoweringHealthOptions.com

Click on the Products tab

Go about midway down the page and click on the blue bar that has the RightMed® Medication List

**Remember, some physicians prescribe medications for off-label use, which means they are using it for something other than what the medication is approved to treat. **

My own experience with pain medications has led me to encourage others to take this test. I had arthroscopic shoulder surgery in the early 1990’s. They sent me home with Percocet® (Oxycodone and acetaminophen) and Phenergan® (promethazine). I get home, ice and take my medications. I am out like a light in about 45 minutes. Now, I had never had any type of pain medications before and I don’t remember having any anti-nausea medications as an adult. After two hours, I am apparently whining in my sleep. I am awakened and I am hurting, but I am so sleepy. The promethazine is kicking my ass and I cannot wake up. The pain is fairly intense. Over the next 24 hours I am taking my pain medications as directed and only taking half of the promethazine. I do believe that the only thing that was helping me was being knocked out by the promethazine. I called my doctor and told him that the Percocet® was not working. He told me that was the strongest that they have. I know that’s a lie, I am a pharmacist. I understand that doctors are concerned about drug seekers, but hell, I just had surgery the previous day. He called in Tylenol#3 (acetaminophen and codeine). I took that and guess what? It did not work either. I knew that I was screwed and would have to deal with this on my own. I iced, I breathed deeply and I took a half a tab of promethazine every 8 hours and Ibuprofen 800mg every four hours. I am thinking that I never ever want another surgery in my lifetime! After about 5 days, I could stand it. Then came physical therapy. You do what you have to do. I cannot imagine what I would have gone through if I had anything other than an arthroscopic surgery.

As a pharmacist I knew that not every medication worked for every person. We all knew that; we just did not know why. We knew it had to be something inside our body make-up, but what? We knew that when Ultram® (tramadol) came out that it worked for some people and it did not work for others. I believed people when they told me that certain medications were not working for them, and I would have them ask their doctor to try X, Y, or Z. Just because something is “supposed” to work does not mean that it does work for all people.

Funny how when we don’t really have the answers, that we tend Not to believe it could be happening. We doubt the person and not the medication. Well, no more! Now we know that some medications are impacted by our genes. I now know that I cannot metabolize Percocet®. My body cannot metabolize Tylenol#3® nor can it metabolize tramadol. They are pro-drugs which means they need to be converted into the active form inside the body in order to work. So, I was taking sugar pills for my body. I have a genetic “defect” for CYP-2D6. But, by God, I now know what will work for me and the dosage that I will need. I have the tests to prove it for all the skeptical physician’s worried about drug seekers. My primary care physician has a copy of it in my records and now I tell them to call him for the results, if they want.

So, if you are going to have a planned surgery and you don’t know what pain meds work for you, it might be worth it to have this test. I know that it is expensive and it is going up after the first of the year (in 2022). Only you can decide what is of value to you. It was valuable information for me and I can use it the rest of my life. No more waiting and hoping. No more wondering for months on end. No more wasting money and time.

Have you been diagnosed with depression? Have you been started on a medication? What did your doctor and pharmacist tell you? Hopefully, they told you to take it at the same time each day, do not miss doses and give it 3 months. You do. It doesn’t seem to have helped very much, maybe a little. You return to your doctor and he or she takes you off of that medication and you begin again with another medication for 3 months. Nope, this one is not helping and you are now dealing with sexual arousal dysfunction. You return a third time, maybe or you stop going back and just suffer. You are 6 months down the road with no real results to speak of. Six months of your life that you will never get back. You tell me, what is that worth to you and your family?

Are you a chronic pain patient that want the best quality of life possible? Let’s find the medications that will work for you and not wipe you out. Let’s find the right combination to help you to get back to living. I know that you will not be pain free, but you have every right to expect it to be manageable.

Everyone deserves the best quality of life possible for them.

Do it now, before the price goes up in January 2022.

Most HSA’s and Flexible Spending plans allow coverage for this in-home test.

Pat

The 5 different types of metabolizer status are described below.

- A person who is a “Poor Metabolizer” for a medicine will process that medicine very slowly. The medicine might not work if it is processed slowly, or it could put them at risk for side-effects.

- A person who is an “Intermediate Metabolizer” for a medicine will process that drug slowly, but not as slowly as a poor metabolizer. This means that the normal amount (or dosage) of certain medicines may not work for them, or may cause side-effects.

- A “Normal Metabolizer” for a medicine usually benefits from the normal amount (or dosage) of the medicine. This means the metabolizer status does not put them at increased risk for side-effects.

A person who is a “Rapid Metabolizer” or “Ultrarapid Metabolizer” for a medicine can process the medicine very quickly. A medicine might not work if it is processed very quickly, or it could put the person at risk for side-effects.