What's in your health toolbox?

BY ADEOLA SONAIKE, PHD, MPH, CHES

In the Fall of 2016, Taylor's parents apprehensively moved their eldest daughter into her college dorm room filled with the same concerns as every other parent on campus that morning, and then some. Taylor, an incoming Freshman and straight A student with plans to pursue a career in medicine, had been diagnosed with epilepsy in the eighth grade. After numerous tests and trials, Taylor's medical team successfully controlled her seizures with a medication regimen that was closely monitored by her parents. In the Fall of 2016, Taylor had been seizure-free for three years. All of this changed however, in December of 2016 when Taylor experienced a breakthrough seizure.

Medication adherence continues to be a leading factor in the management of chronic medical conditions. However, research shows that 50% of patients do not take their medications as prescribed. While the same studies attribute this to limitations in health literacy and a subpar patient-physician relationship, I challenge each of us to look beyond the doctor's office, beyond the pharmacy counter, and ultimately beyond relying solely on a pill. With this perspective, we can view healing as a process, as opposed to simply a destination, allowing each of us the space to redefine what healing truly means to us. For Taylor, while medication adherence played a key role in the onset of her break through seizure, it is important that we address the root causes and behaviors that contributed to her drug non-compliance. Numerous cross-cultural studies have shown that modern society – despite its nearly miraculous advances in medicine, science, and technology – is afflicted with some of the highest rates of depression, schizophrenia, poor health, anxiety, and chronic loneliness in human history ~Excerpt from Tribe by Sebastian Junger.

Miraculous advances have allowed us to live longer, but are we living these longer days in health? Miraculous advances have allowed us to expand our horizons beyond earth, but are we protecting the health of our planet in the process? Miraculous advances have allowed us to communicate visually with family members across the country, but then, why is chronic loneliness a major public health issue? In previous articles, I have addressed the multiple dimensions of wellness that significantly impact our health; physical wellness, environmental wellness and social wellness are all part of that puzzle. Is it possible then, that these three dimensions of wellness may also play a significant role in the 50% of us who struggle with chronic disease self-management due to medication adherence?

As someone working for a voluntary health organization for individuals and families impacted by epilepsy and seizure disorders, I have witnessed first-hand the impact that overall poor health, anxiety, and chronic loneliness can have on an individuals' journey of healing. For over 48 years, Epilepsy Services of New Jersey (formerly Epilepsy Foundation of New Jersey) has joined families in their unique epilepsy journey, celebrating the seizure-free days and supporting them through the long hospital stays. While Taylor's epilepsy journey is unique to her, she is not alone in experiencing barriers to the self-management of a chronic condition when faced with a significant life change such as moving away for college. Significant life changes often take a toll on our health and subsequently impact our behaviors. However, with a personalized Health Toolbox in place filled with goals, solutions and partners in health/ accountability, we can all be empowered to redefine our pursuit of a healthy, happy and full life. •

Each of us has our own Health Toolbox which includes go-to tools that assist us with maintaining a healthy, full, and happy life. As you begin to detemine the tools, resources and people that are included in your Health Toolbox, it is important to note that the medications prescribed to you by your physician should always be a part of your Health Toolbox. The recommendations provided in this article are intended to supplement, not replace, your medication regimen. Incorporating some of these tools into your Health Toolbox will assist you with not only staying on track with your prescribed protocol, but will also guide you with redefining what healthy truly means to you.

Step 1: Know and understand your medication regimen: Self-management of chronic conditions can often be a daunting task, especially when doing so alone. It is okay to ask for clarification. You may either speak directly with your prescribing physician or the pharmacist, so that they may guide you through your medication regimen and prepare you for any side effects that may be experienced, such as drowsiness, increased appetite, mood changes, etc. Once you have a firm understanding of what medication-compliance looks like, it is time to look beyond the pill and address other factors and behaviors that may inhibit your adherence to your medication regimen.

Step 2: Address the elephant in the room: This is sometimes the hardest step in our wellness journey as it encourages us to selfidentify the factors and behaviors that are negatively impacting our health. Studies show that individuals who engage in positive health behaviors are more likely to remain committed to their health regimens and tend to experience better health outcomes. Such reports resulted in the development of the Exercise is Medicine campaign, during which physicians prescribed physical activity in efforts to encourage an overall improvement in health. Physical activity in any form, whether you're going for a morning run or an evening walk, whether you're taking a local Zumba class or following a YouTube Yoga series, has a significant positive effect on our mood and feelings of self-efficacy.

Step 3: Create an environment for success: We often underestimate the impact that our environment has on our health and wellness. Stress and sleep deprivation are often factors that result in feelings of self-doubt and increases our likelihood of forgetting important components to our daily routine. While there are many apps available today to remind you to take your medicine, I challenge you once again to look beyond the pill. What are factors within your environment that are contributing to your stress and sleep deprivation? Sometimes, a minor environmental change, such as turning your cell phone off before going to bed, can decrease your stress and ensure that you're attaining sufficient hours of uninterrupted rest.

Step 4: Build your personal accountability team: This is a practice people often use within the professional sector as a method to be held accountable for their career goals. However, it is also applicable with regards to being held accountable for your health goals. Your personal accountability team should not only be aware of your health goals, but they should be aware of your medication regimen and the factors and behaviors that often stand in the way of you reaching them. While you may be more comfortable with selecting your closest family members as your accountability team members, I encourage you to also include individuals that are around you throughout the day such as classmates, roommates and colleagues. Adding these individuals to your Health Toolbox will also prevent you from feeling isolated in the management of your chronic health condition.

ABOUT THE AUTHOR: Adeola Sonaike, PhD, MPH, CHES is the Senior Vice President of Health at The Family Resource Network, where she works to advance the health of people with special needs, chronic conditions, and family caregivers. Dr. Sonaike attended Rutgers University where she attained a Bachelor's in Biology, and Walden University where she attained a Master's in Public Health and a PhD in Public Health-Epidemiology. Dr. Sonaike is also a Robert Wood Johnson Foundation Culture of Health Leader and is dedicated to building an inclusive culture of health, nationwide. The Family Resource Network (FRN) is a comprehensive, family-focused, organization designed to meet the growing need for community-based programs and services for individuals and their families with continuing needs. For almost 50 years, FRN has helped thousands of New Jersey families with a variety of disabilities and chronic conditions connect with resources and support services they need to live full and happy lives. FRN's network agencies are: Autism Family Services of NJ, Caregivers of NJ, Epilepsy Services of NJ and the Family Support Center of NJ. Please visit familyresourcenet- work.org for more information or call (800) 376-2345.