I got an amazing thank-you card from a dear friend yesterday. At the end of the note, she made mention of how we became acquainted more than 20 years ago. She had applied for a position with my company and I hired her. This led to some other connections and, even though we’ve all gone off on other tangents, through these connections, we have built a close-knit group of friends. We’ve watched each other’s kids grow up and helped each other through divorces, deaths, serious illness as well as celebrate the happy times.

It’s amazing to me how that one chance encounter has affected the course of our lives in so many ways as time has passed. There are those major turning points in life (which college, which mate, when/if to have children), but often, it’s the small things that can make a long-term difference. (I met my husband at the Houston airport as we were waiting for the same plane back to Dallas.)

Unfortunately, not all long-term effects have happy endings.

The other day I refilled my husband’s and my prescriptions for the month and actually separated out the “disclosure” forms that come with each one, describing the side effects and cautions with the thought of filing them in a binder for future reference. As I leafed through them, I became more concerned. It’s enough to make you want to swear off drugs completely.

Neither my husband nor I appear to be suffering any side effects from the several drugs we take. But, like the first cigarette you smoke doesn’t kill you, I can’t help but wonder about the long-term effects are of drugs that you take for years.

I understand that not taking the drugs can have more, immediate, and severe consequences — like blood pressure medication.  But I look at drugs like Arava that have a long half-life (two to four weeks, with medication still in the body for months), and it gives me pause.

I don’t know the answer. What I do know is that the long-term effects of uncontrolled RA are disastrous, as are the impacts of other chronic diseases. Like many patients I am grateful for the medical science that improves the quality (and quantity) of my life. On the other hand, I can only wonder what the long-term implications of these medical decisions are.

I hope that whatever comes into your life today gives you long-term happiness. Thanks for checking in.