How Changes in Routine Can Make Treatment Compliance More Difficult

Sticking to a schedule is easy for this columnist — until that schedule changes

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by Kristin Entler |

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Every day for countless years now, my routine has been the same. I take a handful of meds with breakfast and dinner, the cocktail of which ebbs and flows, and digestive enzymes with all of my meals. Like most people with a lifetime of chronic illness under their belt, I’m no stranger to sticking with and managing a medical routine. Not to brag, but I’d even say I’m pretty decent at managing a complex medical schedule, enough that I could nearly put it on my résumé as a transferable skill.


Because here’s my problem: When I’m outside of my normal routine, I struggle to maintain my medicine regimen.

The most obvious change that triggers a lapse in my routine is going out of town. Being outside of my normal living space and completely detached from my usual schedule make it difficult for me to remember to do normal things, especially taking medications on time.

I find this mostly affects my schedule when it comes to taking my CFTR modulator, Trikafta (elexacaftor, tezacaftor, and ivacaftor), on time. Sometimes I’ll realize I forgot my morning dose when I go to punch my nighttime dose out of its blister packet.

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For a long time, I assumed part of my vacation-related forgetfulness also stemmed from my desire to relinquish all responsibilities when exploring a new pocket of the world. But the more I pay attention to my natural habits and patterns of behavior, the more I realize that the underlying issue is that change is inherently stressful. It’s normal for our usual patterns to be jolted by change.

For instance, shifting our routines by an hour during daylight saving time has proven to make people forgetful, among a slew of other health concerns, so it stands to reason that other little alterations to our daily schedule would have their own domino effects.

The most consistent change I face as a perpetual graduate student is the cycle of the school year, weaving in and out of semesters, adjusting and readjusting to new 16-week class schedules.

As of this writing, I’m several weeks into the new semester, which means I’m once again readjusting to a slate of evening classes that interrupt my dinner schedule. I’m trying to figure out where — and how — to best carve out the routine I need to maintain to stay healthy.

Don’t get me wrong, I do feel a particular comfort within the academic schedule. Having periods where nothing is due gives me time to rest and focus on my physical health, to have a sort of reset period between the weeks of teaching and attending classes. I can build summer and winter breaks into my annual schedule as vacation time; this timing can also be serendipitous when I need tuneups for cystic fibrosis exacerbations, allowing me empty weeks on the calendar when I’m conveniently able to fit in these hospitalizations as needed.

But like every profession, the one I’ve chosen is far from perfect. So I’m on the hunt for solutions. I’ve tried setting an alarm on my phone. Sometimes it works, but after a while, it becomes too easy to silence and ignore.

The main thing I’ve learned so far, in all my years of cycling between ease and difficulty in treatment compliance, is to forgive myself and learn to listen to the patterns of my own behaviors. For now, I’ve set my medicines out on the counter where I can see them when I sit down to eat, and it’s helped keep me on track so far.

Note: Cystic Fibrosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Cystic Fibrosis News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to cystic fibrosis.


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