I Hope This Patient is Okay…

ChronicHeartFailure

 

So, I have an interesting story from today. It’s one that worries me, but also makes me shake my head.

I had a woman call me, asking if I could give her a few pills to tide her over until Monday when she can call the doctor for more refills. I ask her name and find that she hasn’t been to our pharmacy for over a year. I ask what she’s looking for and she tells me it’s a heart medication that is for 40mg. I notice there is a very old script for furosemide, so I ask if that’s what she’s looking for, she says no and that it starts with a “car” sound. I ask her if it’s carvedilol, and she says yes. The most recent script is for a low strength. I ask if she’s gotten it filled since the previous time she was here. She tells me her cardiologist has been directly dispensing it from his office. (I wasn’t aware they did this for things other than controls or samples of brand name medications, but I didn’t question it.)

She states she really needs it because she’s out of town and very far away from home. I tell her that there’s not much I can do, since the dose she’s asking for is not on record with us. I also tell her that since she hasn’t been to our pharmacy in so long, I don’t fell comfortable providing the medication. She suddenly tells me she has retained 15 pounds worth of fluid in the past few days and her skin is yellowing. I tell her that’s quite serious and that she should be seen right away. She starts asking what she should do, since she’s worried about her condition. I tell her that the best option is to head to the ER. I told her that even if we did have a current prescription on file, I’d still suggest going to the ER because she could be going into congestive heart failure. She tells me she doesn’t want to because “the ER sucks big time”. I tell her that even though ERs are usually a pain, this situation requires action be taken soon. She continues to tell me I should just give her the medication. I again tell her no. She asks what will happen if she doesn’t go to the ER. I tell her that she could possibly go into heart failure, which has very poor outcomes when left untreated.

“Oh well. I guess that will have to do. I don’t have time to go to the ER.” –Click–

I did try to call her back right after she hung up, thinking maybe I could calm her down and get her to see my reasoning. Her number on file was invalid. I don’t know what else I could have done. I will gladly give people a few pills for a maintenance medication if they run out on the weekend or the prescriber hasn’t replied to our refill request by Friday evening. Seeing as how this woman had not been to our pharmacy in so long and how the dose she claims to take didn’t match up with the one she used to take, I didn’t feel comfortable giving her any. In all honesty, she probably needs some IV diuretics and a few diagnostic tests. The way she described herself is not something that should be left alone. I am worried that she will start experiencing organ failure, especially considering the jaundiced skin.

It’s people like her that make me both sad and confused. If she’s seeing a cardiologist, then she obviously has heart problems. I am sure he explained to her the difference between emergent and non-emergent problems. Most do. For her to refuse to go to the ER like that is very stubborn. It’s sad because she doesn’t seem to understand the gravity of her situation, but it’s also frustrating. People need to be more involved in their own health care. If you see your skin suddenly turn yellow, that means your liver is probably not doing so well. It’s not something you wait around to see if it gets better. If you gain more than 10 pounds in a day or two, that is water weight. It takes a lot longer to gain weight due to fat accumulation. Lots of water weight usually indicates your heart isn’t working right. It is also not something to be taken lightly. Both require at least a call in to the doctor. He will probably either have you come in to the office that day or go to the hospital. Regardless, a physician should be involved as soon as the symptoms start.

-Sigh- I hope that woman is okay. =(

 

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Stole Our Hearts

 

Today’s story is a sad and difficult one.

One of our pharmacy’s favorite patients stopped by today. He’s a man in his nineties and loves to make us laugh. He didn’t have a prescription, but he said he had some other shopping to do. He stopped by and said hi to everyone. We all smiled and were glad to see him, as always.

Our smiles quickly faded, though, because we were informed by our store manager that she caught him stealing candy and a few other items. We didn’t want to believe it. We asked if it was just forgetfulness or senility, and we were told it wasn’t, as he had stuff shoved in his pants and jacket pockets and began walking out the doors without purchasing anything else. It made us wonder how many times he had done this before. =(

This is probably once of the most difficult things I have come across at this pharmacy. Luckily, I was not the one who had to approach him about it. Now, our trust in him as a patient and a person is gone. I wonder if he was stealing due to a lack of money, but still, none of the items he attempted to steal were necessities. Overall, it’s just so disheartening.

 

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Loss

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Today’s theme seemed to be loss of a loved one. Multiple people came in to the pharmacy to inform us that their husband, wife, father, mother, child, or friend had passed away. Each person seemed to be handling it well considering the circumstances. Nonetheless, it’s always a sad topic.

The person who’s story stuck out most is that of a middle-aged man, whose father passed away a few months ago. This was very hard on the whole family, as he was the patriarch and the elder. Not long after his father passed away, his mother needed to be placed in a nursing home for reasons he did not elaborate on. All he told us was that her condition had been ongoing for some time, and that his father had been able to care for her at home. After his passing, it was only a matter of time until she required some sort of assisted living. He informed us that her condition has deteriorated even more since entering the facility.

His sad tale did not end there. Though this man does have a brother, but his brother is mentally handicapped. He is unable to live by himself. His brother had been living with his parents, but after his father passed away, the man felt obligated to pick up where they had left off. Now, he has assumed the role of a primary caretaker, which is no easy task for anyone. The man also has no spouse or children. It just seems like everything is so very wrong for him right now. My heart broke upon hearing his story.

The thing that got me most, though, wasn’t the sad circumstances or how every aspect of his life changed so quickly, but rather, the man’s demeanor and outlook. There is no doubt he is hurting, but he persists on with his life and does not mope about. A person walking down the street would never know the pain he must be feeling. He stays strong in the face of adversity. That is a quality I admire. I don’t know if I could compose myself so well if I were in his situation.

Readers, if you are lucky enough to have friends and family that you care about very much, take this opportunity to tell them you love them. Tell them often, and never take them for granted.

If you are going through a grieving period because you have lost someone dear, my thoughts and prayers are with you. It’s never easy, and nothing can prepare us for it. Cling to the others you love, and support each other during this hard time.

If you have been thrust into a situation you did not want nor choose, have faith. Whether it be faith in a religious sense or faith in another person, having a sense of faith is the strength and backbone you need in order to carry on with your life even when the tides have dramatically shifted.

I hope you all have a great day.

 

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