Sticks and Stones May Break Your Bones…

 

Today, I got to see one of my favorite patients. It helped make the otherwise hectic day a bit easier. There’s a funny story about how I connected with this person that I must explain first.

Not long after I started working at my pharmacy, this woman came in to get her husband’s medication. She was very rude to all of our staff, so I took note to remember her name, so I knew when I needed to be extra nice and calm. Then one night, she came in to get some inhalers filled and had no idea how to use them. I took the time to explain the technique, and, ever since, we’ve been on great terms. She looks for me and trusts me.

Back to the present… She came in to get her husband’s meds filled and shared a shocking story with me. Almost two years ago, he had extensive surgery in multiple areas of his body. Ever since, he has been nearly bed bound due to the pain resulting from the surgery. They told him he just handled the procedure poorly, and that his only option was pain management. So, for the past 18 months, the poor man has been on and off all different pain regimens.

Desperate for any answers, the couple decided to get a second opinion because he did not like being on all the pain meds. His wife told me today that the other facility he went to informed him some of the rods, pins, and screws were placed incorrectly during his original surgery. She told me the original surgeons refused to go back and fix it. She stated they were going to go out of the area to try to get it fixed.

I was appalled by her story! This man has such a poor quality of life right now, and the surgeons won’t attempt to fix the mistakes they made? That screams unethical to me. It also has “potential lawsuit” written all over it. Even if they don’t feel comfortable opening him up again, they should have at least told the man the truth about the surgery outcome instead of covering it up. According to his wife, the second facility needed only to look at basic imaging studies to know that the hardware was placed incorrectly, so the original surgeons should have been able to tell a mistake had been made.

Lying to a patient is bad and unethical, yet healthcare professionals do it. It usually comes back to bite you in the end. My only hope is that this man can get the mistakes fixed to a point where he can have a decent quality of life again. =/

 

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Keep Out of the Reach of Children

 

I have found that one of the things I do while it’s not too busy at work take note of how parents handle their children’s antics. Not to pick on them or snicker. Just out of curiosity, since every parent handles it differently. But, today, I couldn’t help but shake my head and chuckle.

Meet the “parent of the year”…

The mother had just picked up her albuterol inhaler right after we opened. Later on, we get a phone call from her asking for a refill. We ask why she needs it refilled again on the same day. Her answer is as follows:

“Well, I let my son play with it because his squirt gun broke. Now, it’s all gone.”

It was so difficult to keep a calm, serious sounding demeanor because I wanted to laugh so hard. I have never heard something so ridiculous. She then asked if we could get an override from the insurance for a new one. Her insurance didn’t allow for lost/spilled medication overrides, so we offered her an in-store discount. Even so, the price was still $30, which she couldn’t afford. She said she’d get it filled again when she had the money.

After the phone call ended, I burst out laughing. Why on earth would you willingly allow your child to play with your medication?? Not only will that leave you without medication, but more importantly that could be dangerous to your child! It’s just an all around bad situation, which should have never happened.

*shakes head*

Moral of the story — There is a reason all medications say keep out of the reach of children on them.

 

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Stuttering

 

Today, I ran into a very interesting, unusual situation. I had someone come to the pharmacy with a speech disorder that makes him stutter very badly. I have dealt with language barriers in the past, but this one was new to me today.

He had come in for a new medication that he had never taken before. At the pharmacy I work in, our computer system flags prescriptions that have never been filled for the patient. It then prompts the person ringing register to bring over the pharmacist so he/she can discuss side effects and such with the patient. It’s a pretty good system and one I feel is important. Anyway, it flagged me to talk to him about a blood pressure medication. I went over and started my spiel. After I finished, I asked him what questions he had. That’s when I realized he was a stutterer.

For whatever reason, this doesn’t bother me. Not at all. I have all the patience in the world for people who stutter. Maybe it’s because I tend to fill most of my sentences with, “Um,” and backtrack my statements when I’m in the middle of them. It’s not stuttering, but I’m sure it’s annoying. But, I digress. Whatever the reasoning, stuttering doesn’t bother me. He was very appreciative of this. After we talked about the medication, he told me about a visit he had to another pharmacy in another state. He told me the pharmacy staff was rude and didn’t let him talk or explain himself. He thanked me and told me he would definitely come back to our pharmacy again. Sure, the conversation took five minutes when it should have taken two, but it was important, and I made a connection with another patient. It’s things like this that make me proud to be a pharmacist and make it all worth it. =)

The one thing that really aggravated me, though, was the looks he got from the other patients in the pharmacy. As he was talking to me, everybody else stared at him with disapproving expressions. I even saw a person snicker and hide a chuckle. How horribly rude some people can be! He can’t help stuttering. It’s not like he chose to have a speech impediment. Have some compassion and respect!

Anywho, that’s it for today. Sorry about the massive entry upload. I backdated the ones from over the weekend because I was exceedingly busy and didn’t get time to upload them. They were written; they just needed to be pasted to here (and a nifty picture needed to be added). I hope everyone is well!

 

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Aspirin

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This was going to be a relatively boring entry today about generic vs. brand name medications. That can wait until a day when nothing super interesting happens because today was not one of those days.

So, I receive a phone call about 2 minutes before closing. I groan because this phenomenon always happens, and it’s almost always a question about what time we close. I almost didn’t want to pick it up, but I was so glad I did because this phone call may have literally saved a woman’s life.

The woman I was talking to was just put on an aspirin regimen within the past few weeks. She told me she noticed whenever she bumps herself, she gets a huge bruise. She asks me if this is normal and if it means shes bleeding internally. I tell her that bruising is a common occurrence with any blood thinning agents, aspirin included. I tell her the main thing to watch is her stool consistency because this is one of the only ways you can tell outside of a medical setting if you’re having upper GI bleeding.

I tell her seeing bright red blood could just be a hemorrhoid, but if she saw this for a few days in a row to contact her doctor. I tell her to watch more for coffee ground consistency in her stool because this signifies a more significant bleed. She tells me the coffee ground consistency has been going on in her stools for a few days now and that she has accompanying stomach pain and stomach bruising with it. She tells me she just saw her doctor yesterday and told him about it, but he brushed it off, telling her it was normal. My eyes almost bulged out of my head. I’ve never actually heard anybody in the community setting tell me they were having signs of what could be major bleeding. When I asked her how bad the stomach pain was, she rated it an 8 on the 1-10 pain scale

I told her to get to the emergency room because that was not a normal side effect of aspirin. I told her to be very specific to the triage nurses and ER docs about what kind of stools she was passing and what kind of pain she was experiencing. She started to become nervous, so I told her not to panic. I just emphasized that she get to the hospital after hanging up the phone. She thanked me and hung up.

Maybe I was a bit too cautious with her, but from the description she provided over the phone, it was like reading a page out of a textbook on GI bleeding. I wanted to slap her doctor over the head. Having just put her on an aspirin regimen, I would think he would be more concerned hearing about this. I can only hope she doesn’t have a serious GI bleed. I pray I was too cautious and that her visit to the ER is a relatively short one. I somehow think she won’t be on her aspirin regimen for a bit, though.

It’s moments like these that I realize what a huge impact pharmacists have on people’s lives.

 

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Vitamins and Minerals

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Today was a horribly busy day because I had a tech call off sick. But, all was okay in the end. This, unfortunately, left me with very little time to counsel. I felt rushed, which I hate, because I know my patients can feel it too. Oh well. That’s the way it goes some days.

Today’s story is based off a phone call I received shortly before closing. A mother called and started listing what prescriptions her 14 year old daughter takes on a daily basis. I was expecting to hear her ask if they are okay to take together, but what surprised by what followed. She asked if she could take fish oil and calcium supplements at the same time. Truthfully, there were no interactions with any of the teen’s medications, but that was not the most important issue here.

I asked the mom if her daughter’s pediatrician had recommended the use of either of these. She replied no. She said the girl came home from visiting her grandma with a bottle of each. I guess the grandmother had heard somewhere that fish oil was important for immune development and that anyone of the female sex should be taking extra calcium. I told the mom taking fish oil was completely unnecessary for a healthy teenager and that calcium absorption shouldn’t be a problem in most people under the age of 18, as long as they consume healthy amounts of milk and dairy. I finally told the mother that if she did want to give her daughter any supplement, it should be a multivitamin. I also told her to talk with her daughter’s physician before starting anything. She thanked me and hung up.

That phone call was a new experience for me. I’ve heard of parents becoming very health conscious with their kids and having them take all kinds of natural supplements. I never heard of a grandparent overstepping the parents and just giving a grandchild a bottle of vitamins, though. This situation was very wrong for several reasons, the most important being that no one (adult and child alike) should ever start a regular over the counter (OTC) regimen without talking to a healthcare professional first.

What many people don’t realize is that products that are OTC are still “drugs”. They still have side effects and interactions, regardless of how “natural” they are. Many OTC products act in similar ways to prescription medications and can cause the person to essentially “overdose”, even though it may not be a toxic overdose. This can cause health problems and extra side effects. A good example of this is people who decide to take Red Yeast Rice in addition to their “statin” cholesterol medications. Both work in similar fashions, so taking them together increases the risk of side effects.

Another issue that needs to be addressed here is information sources. People today feel that because they read something online, it’s automatically true. Well, guess what? Just because the URL name says iamadoctor.com or everythingmedical.net doesn’t mean it’s accurate. I have seen people on blogs and other user edited websites promoting things that could harm someone. The amount of “likes” and friendly comments scare me because that means people are listening to someone whose medical knowledge probably doesn’t extend past what they’ve seen walking down the vitamin aisle in the grocery store. Listen up readers, if you’re going to listen to somebody, listen to an ACTUAL PERSON unless you know which websites are reliable and backed by good medical studies. Talk to somebody who actually holds a license to tell you the things they are telling you.

To make a long explanation short, if you are ever curious about a supplement or hear that it may be beneficial, talk to a healthcare professional before starting it. Tell them what you already take and what health conditions you have. They can tell you if it’s a good decision to start the supplement. Don’t have time to visit your physician and not sure who to ask? Just look behind the pharmacy counter. You’ll find a medication “expert” who is willing to help you understand and sort through the crazy world of drugs.

 

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Constipation

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So many people today had all kinds of tummy troubles! I couldn’t help but wonder if their holiday eatings had anything to do with it. (I live in the United States, and we just celebrated Memorial Day over here.) The most common complaint was constipation. Definitely no fun for anyone.

The story that sticks out most is one of a mother who came in to get something to help with constipation that her daughter was experiencing. She told me her daughter has physical handicaps and runs into this problem from time to time. Normally, the gentle laxatives and stool softeners work, but they haven’t this time. She asked about a recommendation for something stronger, so I begin to point her in the direction of the stronger Senokot tablets. That’s when she tells me the girl hasn’t been able to go for four days.

There is a difference between being constipated for a day or two and being constipated for four days or more. If you’re constipated for a day, usually you’re in no real trouble and a stool softener or a gentle overnight laxative will do the trick. If you’re constipated for four days or more, you’re at risk for a bowel impaction, which may need to be manually resolved by a healthcare professional. My recommendation for this woman was to have her daughter use magnesium citrate (an oldie, but goodie). I told her if she didn’t have any bowel movements after using it, to take her to the hospital to check for an impaction.

It’s funny how often I find myself recommending products for stomach ailments. There’s at least one person a day who asks for help choosing a product for bowel regulation and other related things. Generally speaking, when the tummy is happy, the person is happy.

 

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Word Salad

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Today was an interesting day at the pharmacy. It was slightly busy, but not in a bad way. There was one thing that made the day a bit more trying than others like it.

About an hour after opening, the pharmacy received a phone call from a man who could not be understood. The technician who answered the phone tried to get him to repeat himself several times, and then the call was disconnected from the caller’s end. About five minutes later, I pick up the phone to hear this man. The only way I can describe what his voice sounded like was that of a stroke victim experiencing “word salad”. His words were so jumbled together I couldn’t understand anything he was trying to tell me. I tried asking yes or no questions, which only caused him to hang up.

The same person continued to call on and off all day. He called the pharmacy. He called the front store. He called through on the physician only line (a pet peeve of mine). He must have called upwards of 20 times today. At first, I felt bad. My techs and I tried to find all different ways to ask him what he needed. We read off the hours we were open as well, in case that’s what he was calling about. Meanwhile, our patients in the store and in the drive-thru were slowly becoming more and more impatient. Finally, we asked him to either physically come to the store or stop calling. The message must have stuck because he did not call again.

I don’t even know what to think about this. It was one of the strangest things I have ever experienced while working in the pharmacy.

 

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