Monthly Archives: April 2014

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The Lighter Side

Sometimes it’s just more fun to observe the pharmacy world day-to-day and let the posts write themselves 😀

1) ‘uid’ vs. ‘od’

When I started as a pharmacist in New Brunswick a decade or so ago, we had a family physician who probably graduated med school not long after the Second World War. To say his style was old-fashioned was definitely an understatement. One of his quirks was that he exclusively wrote ‘once daily’ as ‘u.i.d.’ Just try to Google it…you won’t find much. My best guess is that it was an extrapolation of the Latin abbreviations b.i.d. (bis in die = twice a day), t.i.d. (ter in die = thrice a day), etc. The Latin word for ‘one’ is ‘unus’ so perhaps this kindly gentleman wanted to differentiate his abbreviation from ‘u.d.’ (ut dictum = as directed). I don’t know how many phone calls he fielded, but as a new relief pharmacist, I thought I was losing my mind.

On a sidenote, the French way to write for ‘one tab orally once daily’ looks like ‘1 co po die’. The first time a doctor ran that together on a script, it took me 10 minutes to figure out what a ‘copodie’ was.

2) I had a good chuckle with a doctor a number of years back when I questioned why he was calling in ‘Trazadone 50mg, same as before, sixteen years refills’.

It didn’t immediately occur to me that he meant, ‘sixty, and a year’s refills.’ Say it fast, you’ll notice it sounds very similar.

3) Auxiliary labels come in a variety of colors and serve to remind consumers of more common instructions or warnings for their medications. Unfortunately, limited colors mean that in a pinch, users may on occasion grab the incorrect label for the prescription in hand. Not to make light of human error, but I would sincerely hope that proper counseling would cause someone with a chest infection to question if their clarithromycin prescription was ‘for rectal use’.

4) Erectile dysfunction is a sensitive topic but an important one. It predominantly affects older males, though sexual dysfunction is also diagnosed in women more often than people think. Common prescription medications used for depression may also create these problems. Even after practicing all this time, it’s difficult to know just how comfortable someone will be discussing their affliction the first time they pick up a prescription therapy. I give you a few simple ‘Do’s and Don’ts’ that I believe to be helpful from MY past experiences.

 

DO

– Treat as any other prescription: respect confidentiality, offer to counsel and answer questions.

– Offer a phone consultation if that would be more comfortable for the patient

– Ensure that they have discussed risks with their doctor with respect to cardiac troubles.

 

DON’T

– Get caught in a counseling session with a pen that looks like this:

the-spring-pen-514

(Image courtesy of http://www.custom-product.com/)

I wish I was making this up.

I was running out the door for an errand and as the only male pharmacist on staff that day, a patient requested I counsel him on his new ED medication. Since I did not have my lab coat on, I happened to seize a novelty pen dropped off on a recent drug rep visit on my way. The patient’s comment was something like, ‘looks like the pen needs this more than I do.’ We both had a great chuckle, though my embarrassment was definitely apparent.

 

Oh, the world of pharmacy…do we ever run out of stories?

 

Disclaimer: The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of any agency, employer or affiliation.

 

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Life Outside Work

The nature of a job in a health profession is that we care for a living. If you ask anyone in the health field to define their job, most definitions will include some iteration of “I take care of my patients.” This is the most rewarding and exciting part of our job. It can also be the part that wears us out the fastest.

I remember finding out that one of my patients had had a resurgence of breast cancer. Her partner came in to pick up her pain meds and told me the terrible news. I cried with her and hugged her and told her I’d be there through it all to help them both. When that patient passed away, I cried and hugged her partner again. This is the sort of stuff that I bring home. Third party issues, doctors calls, injections and med reviews can all be left at work;  it’s the emotional side of caring for my patients that often makes its way into my psyche and hitches a ride home with me at the end of the day.

It is well-documented that health professionals often put themselves last. We do a great job of caring for other people but are not so great of taking care of number one. I can also attest to the fact that if a pharmacist (i.e. myself) is not in top emotional and mental health, work will suffer. A bout of depression does not bode well for accuracy and enjoyment at work.

So, how can we wage war against burn out?

I would argue the answer to the question is not more vacation time or shorter work weeks. It’s having a hobby. Recently, I have taken up wine as a hobby. Not in the “come home and drink a bottle of wine” sense. I have been taking wine education classes and am currently enrolled in the sommelier program put on by the Canadian Association of Professional Sommeliers. Once a week I have a four-hour class on the history of wine, how grapes are grown, grape physiology, how wine is made, etc. I also have papers to write and exams for which to prepare. I love absolutely everything about this course. It is so very different from my daily work experience. It is giving me a totally new and different set of skills. I am meeting new, like-minded people who share my passion for the history, science, and art of wine making.

Now, you’re probably reading this and asking, “but Laura, what does this have to do with me?” No, dear readers, I do not suggest that the key to happiness at work is to enrol in wine school. The point of sharing my story with you is this: having a hobby gives you an out. It allows your mind to escape into a place that has nothing to do with the wonderful world of pharmacy.  As a bonus, pharmacists pride themselves on being lifelong learners. A hobby has the ability to massage a different part of the brain that has been left dormant for too long. New skills can be learned and enjoyed. It gives you something to look forward to that is different from the day to day grind of getting up and going to work.

Do you have a hobby? Do you like to cook, or go to karaoke, or take in Zumba classes twice a week? Do you paint? Is there something you’ve always wished you could do? If you are looking at this article and thinking that you’ve always wanted to take an art history class then I say do it, friends. Join the running club you’ve been thinking about. Sign up for the pottery class you’ve been eyeing. Yes, it will take extra time out of your schedule. Yes, you may have to miss a class every so often. But I can tell you from personal experience that the richness a hobby will add to your life is worth any investment.

Here is a link to HRM recreational programs: http://www.halifax.ca/rec/documents/online.pdf

This would be a great place to start if you’re looking for a new hobby. Programs tend to be inexpensive and cater to any ability level. So here’s to getting out there and having a life outside of work!

 

Disclaimer: The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of any agency, employer or affiliation.

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Innocent Bystanders

Receiving a diagnosis, especially one that has a poor prognosis, is devastating. It may have begun with a nondescript pain somewhere that doesn’t seem to go away. Perhaps there is seizure activity, or uncharacteristic behavior that prompts a deeper set of testing.

Once the doctor or specialist confirms their suspicions, it’s a game changer. There’s no going back, and although some treatments may slow progression of disease such as diabetes or cancer, or force it into remission, it’s now a part of the medical history. Health decisions from that point forward may carry risks that weren’t there before. Everything from insurance questions, to retirement planning, to travel considerations may be affected. For a person, even the diagnosis itself can have a profound impact on underlying mental health. Are they able to enjoy their favorite foods or hobbies? Has a reduced life expectancy caused a re-evaluation of a personal bucket list?

Below is a quote from an English writer who passed during the Depression era:

“The trouble with always trying to preserve the health of the body is that it is so difficult to do without destroying the health of the mind.” – Gilbert K. Chesterton

These words hold great wisdom but I propose an extension to this theory: this not only affects the individual with the affliction, but also that person’s support network of family and friends. Whose health of the body are we trying so hard to preserve? Whose health of the mind are we destroying?

Is it always the same answer?

When that diagnosis is confirmed, the game changes not only for the patient, but for everyone close to them as well. Behaviors change in order to support that preservation of health. The family now has to be wary of salt restrictions, or sugary foods in the pantry. Considerations are made for home care and mobility. Visitors may be restricted due to fatigue or risk of infection. In many ways, the support network would benefit from its own support network.

Quite some time ago, I had a lady approach the counter to pick up a prescription for a common Alzheimer’s medication. It was for a dosage increase and she had some basic questions about side effects and what dosing time was best as it had been increasingly difficult following her husband’s recent erratic behavior. It only took about a minute for me to get the sense that there was much more to this story. I asked if she would like to sit down and discuss things more in depth. Like many others, she had been from a generation where she looked after the household, from the cooking and cleaning, the finances, and all the daily planning. Unfortunately, her spouse’s condition had deteriorated to the point where she could not physically look after him anymore. She didn’t know where to turn and as much as she recognized the relief she would feel, it was accompanied by a profound sense of guilt to leave him in the care of someone else.

I realized during the interaction that my patient wasn’t only the person with the name on the prescription, it was also his loving partner who needed guidance to help cope with her own feelings. Thankfully, I was able to provide her information on community-based support groups and phone contacts for financial and legal aid. She certainly seemed appreciative and more at ease after the interaction.

In our practices, this happens countless times and we may not even be aware of it. The innocent bystanders that have their own lives turned upside-down may not realize at first just how or when they will be affected. Maybe if we ask the right question, we may just help them avoid getting overwhelmed.

 

Disclaimer: The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of any agency, employer or affiliation.