I'm at a new pharmacy this month- I'm on rotation #7 of 9 total rotations. I still just can't believe I'm this close to graduating- 101 days away, to be exact.
Anyway, the rotation I'm on right now is not at all what I expected it to be- and that's only 2 days in. Sounds like a bad thing, right? It's actually an AWESOME thing! My preceptor is very involved in the profession and anything that has to do with wellness. And here I thought I was going to be counting by 5 over and over and counseling when I got the chance.
A little background about me- I was very involved in high school. I even was the president of the KAYS club (a community service club) during my senior year. I played sports, I was in chorale and Classy Ladies (a dancing/singing group), I was part of some Spanish honors club I can't remember the name of, another that was just an honors club, and the list goes on and on. I just loved taking part in these clubs because we did things to improve our lives and the lives of other people. I got to be a part of something bigger. For me, it was just a perk that it made my college applications look nice.
When I got to college, I had a bunch of new friends back home that I really missed. If I was involved in clubs, I would lose touch with them, and I wanted to focus on being social for once and also get through my freshman year with my regular 4.0. For those reasons, I only joined a sorority and nothing else; and I wasn't even that involved in my sorority. I don't regret that decision for a second because it eventually led to me becoming as close to my friends as I did and to Alexey, of course.
But now that I'm here, I see that I'm unimpressed with myself. I feel like I've accomplished a lot- met so many of my goals- but there's just something missing. Today, at a meeting I went to with my preceptor, I realized what that was. I really miss being involved. On committees. By volunteering (other than my measly attempts to show up to the humane society once a month). As a member of a group. All of that. The group today was full of ladies that work together to improve the lives of their employees through wellness programs. I wasn't even aware that programs like that existed in Lawrence, or that they were going so well and doing so much.
It also made me realize something else. The speaker at this meeting was from Bert Nash, and she made me realize that A) I have not been taking good care of my mental health as of late and B) I've stopped talking about it. I'm, thankfully, not slipping back into a depression again, but I just haven't been preventing myself from that happening again. I also feel like I've stopped trying to break down the stigma of mental health, simply because I've lost track of time and haven't blogged about it in a while. It was incredibly easy to talk about depression when I was going through it, but now that I'm out of it, I just completely stopped talking about it. I suppose part of my reasoning for that is that it was a scary time, and I don't really want to revisit it, but it's mostly just about forgetting. But just like IBS- even when I feel good, I keep blogging about it. Because eventually I'm going to say something that someone out there needed to hear to help them or change their mind.
With that said, anyone want to attend the Mental Health First Aid classes with me? I can't go until probably May or sometime after that. But it's $30 (currently) for 4 3hr sessions. Here's a link with more info.
Showing posts with label the more you know. Show all posts
Showing posts with label the more you know. Show all posts
Thursday, February 2, 2012
Sunday, September 25, 2011
Decoding the Cold & Flu aisle
Disclaimer: I'm only trying to help you be better informed about cold & flu medication. You should always talk to your pharmacist or doctor about any concerns. Do not take medication you may be allergic to. Any choices you make when choosing medication are your own.
You wake up feeling like crap- you know the feeling- achey all over, exhausted, stuffed up, snotty, and slightly disoriented- so you roll out of bed and trek down to the pharmacy. You get to the Cold & Flu aisle, take a look at all of your options, and decide to just grab the nearest box because that will get you back to bed the quickest. Any idea what you just grabbed?
While you may be a little more informed than that, the Cold & Flu aisle can be tricky for anyone- even me, and it's my duty to know what's in that multitude of boxes. Drug companies come out with new products all the time, but they also remarket their current drugs to make things more confus-er to increase their sales. Hopefully, this post will be a good guide for you as we enter cold & flu season.
Malaise
As far as I know, there isn't a medication you can take to decrease that tired-all-over achey feeling. When I'm feeling like this I make sure to get as much sleep as possible, and I drink a ton of water. I usually feel refreshed for a few hours after I wake up, then it gradually gets worse as the day goes on.
Allergy-type symptoms
This includes a runny nose, sneezing, itchy, watery eyes, burning eyes and/or nose. It can also include a sore throat which isn't something you'd think is due to allergy-type symptoms, but when your nose runs, it doesn't just run out of your nose through the front, it also runs out the back and down your throat. That can cause irritation and land you with a sore throat. It's called post-nasal drip.
For these symptoms you need what we call an antihistamine or anti-allergy medicine. Yes, they're marketed toward allergies because those last year-round for a lot of people. Drug companies make more money marketing them this way. An antihistamine is used to dry up your secretions (mucus). For a cold it should make you less runny and gross. It's usually not potent enough to dry you up completely; THIS DOES NOT MEAN YOU SHOULD TAKE MORE.
*Some of these meds are:
Congestion: nasal/head
This feels like pressure in your face and head. You can't breath well through your nose, and usually when you blow your nose, it's not very productive. For this symptom, you'll need a nasal decongestant to help open up those nasal passages.
You can go two routes with this- topical (sprays) or oral (tablets). The oral medication you have to choose from includes Sudafed (psuedoephedrine) and Sudafed PE (phenylephrine). These two are similar, but there is a difference you should know about. People make meth with Sudafed, so you'll need to purchase it from behind the pharmacy counter, be over 18 years old, and show them your valid and current drivers license. Sudafed PE is out on the shelves and should work just as well as Sudafed.
This medication comes separate (Sudafed, Sudafed PE and generics) as well as in combo products (Zyrtec-D, Claritin-D, Allegra-D). It's included in other combinations, but that can get a little complicated. Just ask your pharmacist.
If you don't want to take a tablet, or if the tablet just isn't quite doing it for you, there are topical nasal sprays that help with congestion. These are sprays like Afrin and Vicks Sinex (oxymetazoline HCl) and Neo Synephrine and Dristan (phenylephrine HCl). One important note: do NOT use these for more than 5 to 7 days as they can cause rebound congestion and make your congestion worse.
So, your choices are:
Congestion: chest (or productive cough)
When your congestion is in your chest, you'll feel fluid in your lungs when you breath in and out, and when you cough you'll often cough up mucus. When this happens, you need what's called an expectorant, or something to help you cough all of that goo out of your lungs. It works to thin all of that mucus so it's easier to cough out. Some products that help with this are: Mucinex and Robitussin. These contain guaifenesin, the expectorant.
Make sure to check the label on these two because there are many combination products made by the makers of these drugs. For plain old chest congestion, get the blue box.
Choices here are:
Cough: dry
When you're coughing but not coughing much of anything up, you need a cough suppressant- something to stop that cough. You can go two routes with this one. Like I mentioned above, you may need that antihistamine to dry up your secretions and stop post nasal drip which can not only cause that sore throat, it can also cause you to cough as well.
If you've tried the antihistamine and it's not working, there is a cough suppressant you can use. It's called dextromethorphan.
Meds that contain this:
Sore Throat:
This is the symptom that makes me laugh the most when talking to patients. They'll always come in and say, "My throat hurts." When I ask them what they've tried they'll say cough drops and nothing else. My response is always, "What do you take when your head hurts? Or when your back hurts?" Pain is pain, and those meds that take care of your other pain will help with a sore throat. You can take Tylenol (acetaminophen), Advil (ibuprofen), or Aleve (naproxen). I personally recommend tylenol because people with sore throats often have fevers and tylenol is better when it comes to reducing fevers, but you can take any of them and get some relief. Note: don't forget to take Advil and Aleve after food!
Meds:
Fever:
I'm not sure what other people think about this, so this is my personal opinion. It's nothing anyone has told me specifically in class before, but I've come to this conclusion based on what I've learned about our immune system. You get a fever when your body is actively fighting off something that doesn't belong inside of it- usually bacteria or a virus. Your immune system is doing what it what made to do; it's actively searching out the invader and killing it or getting it out of your system.
With that said, there are two types of fevers in my eyes- a low-grade fever and a high fever. If you have a high fever, you should be doing everything you can to bring it down. Fevers can cause long-lasting damage when they get too high. The fever I'm talking about is a low-grade fever...like 1 degree higher than normal. Personally, I think that suppressing that low of a fever is only setting back your body's natural defense and may allow you to either get sick or become more sick. I don't take medicine until it gets to be in the upper 99s or higher. You may think differently.
Anyway, like I said before, tylenol is usually the best medicine for this. You can also use ice packs on your head or a cold bath to lower your temperature if the tylenol isn't taking care of it. Ibuprofen is also a possible treatment for fever if the tylenol isn't working. Make sure to take (or give) it with food.
Meds:
There are limits to how much you can take of all of these medications. Pay attention to the labeling on the package- READ it all- and remember that the pharmacist and pharmacy interns are always right behind the counter to help you out.
You wake up feeling like crap- you know the feeling- achey all over, exhausted, stuffed up, snotty, and slightly disoriented- so you roll out of bed and trek down to the pharmacy. You get to the Cold & Flu aisle, take a look at all of your options, and decide to just grab the nearest box because that will get you back to bed the quickest. Any idea what you just grabbed?
While you may be a little more informed than that, the Cold & Flu aisle can be tricky for anyone- even me, and it's my duty to know what's in that multitude of boxes. Drug companies come out with new products all the time, but they also remarket their current drugs to make things more confus-er to increase their sales. Hopefully, this post will be a good guide for you as we enter cold & flu season.
Malaise
As far as I know, there isn't a medication you can take to decrease that tired-all-over achey feeling. When I'm feeling like this I make sure to get as much sleep as possible, and I drink a ton of water. I usually feel refreshed for a few hours after I wake up, then it gradually gets worse as the day goes on.
Allergy-type symptoms
This includes a runny nose, sneezing, itchy, watery eyes, burning eyes and/or nose. It can also include a sore throat which isn't something you'd think is due to allergy-type symptoms, but when your nose runs, it doesn't just run out of your nose through the front, it also runs out the back and down your throat. That can cause irritation and land you with a sore throat. It's called post-nasal drip.
For these symptoms you need what we call an antihistamine or anti-allergy medicine. Yes, they're marketed toward allergies because those last year-round for a lot of people. Drug companies make more money marketing them this way. An antihistamine is used to dry up your secretions (mucus). For a cold it should make you less runny and gross. It's usually not potent enough to dry you up completely; THIS DOES NOT MEAN YOU SHOULD TAKE MORE.
*Some of these meds are:
- Zyrtec (cetirizine)
- Claritin (loratadine)
- Allegra (fexofenadine)
- You can also use Benadryl (diphenhydramine), but as it can make you very drowsy, I would only use it at bedtime or if you're at home for the day.
Congestion: nasal/head
This feels like pressure in your face and head. You can't breath well through your nose, and usually when you blow your nose, it's not very productive. For this symptom, you'll need a nasal decongestant to help open up those nasal passages.
You can go two routes with this- topical (sprays) or oral (tablets). The oral medication you have to choose from includes Sudafed (psuedoephedrine) and Sudafed PE (phenylephrine). These two are similar, but there is a difference you should know about. People make meth with Sudafed, so you'll need to purchase it from behind the pharmacy counter, be over 18 years old, and show them your valid and current drivers license. Sudafed PE is out on the shelves and should work just as well as Sudafed.
This medication comes separate (Sudafed, Sudafed PE and generics) as well as in combo products (Zyrtec-D, Claritin-D, Allegra-D). It's included in other combinations, but that can get a little complicated. Just ask your pharmacist.
If you don't want to take a tablet, or if the tablet just isn't quite doing it for you, there are topical nasal sprays that help with congestion. These are sprays like Afrin and Vicks Sinex (oxymetazoline HCl) and Neo Synephrine and Dristan (phenylephrine HCl). One important note: do NOT use these for more than 5 to 7 days as they can cause rebound congestion and make your congestion worse.
So, your choices are:
- Sudafed
- Sudafed PE
- Zyrtec-D, Claritin-D, Allegra-D
- Afrin or Vicks Sinex nasal spray (for only 5-7 days)
- Neo Synephrine or Dristan nasal spray (for only 5-7 days)
- Other combo products
Congestion: chest (or productive cough)
When your congestion is in your chest, you'll feel fluid in your lungs when you breath in and out, and when you cough you'll often cough up mucus. When this happens, you need what's called an expectorant, or something to help you cough all of that goo out of your lungs. It works to thin all of that mucus so it's easier to cough out. Some products that help with this are: Mucinex and Robitussin. These contain guaifenesin, the expectorant.
Make sure to check the label on these two because there are many combination products made by the makers of these drugs. For plain old chest congestion, get the blue box.
Choices here are:
- Mucinex
- Robitussin
- Combo products with guaifenesin
Cough: dry
When you're coughing but not coughing much of anything up, you need a cough suppressant- something to stop that cough. You can go two routes with this one. Like I mentioned above, you may need that antihistamine to dry up your secretions and stop post nasal drip which can not only cause that sore throat, it can also cause you to cough as well.
If you've tried the antihistamine and it's not working, there is a cough suppressant you can use. It's called dextromethorphan.
Meds that contain this:
- Delsym
- Robitussin Cough and Cough Gels
- DayQuil Cough
- Tylenol Simply Cough
- There are a LOT of combo products that contain this in it with other cold medications, so just look closely at the back of the box.
Sore Throat:
This is the symptom that makes me laugh the most when talking to patients. They'll always come in and say, "My throat hurts." When I ask them what they've tried they'll say cough drops and nothing else. My response is always, "What do you take when your head hurts? Or when your back hurts?" Pain is pain, and those meds that take care of your other pain will help with a sore throat. You can take Tylenol (acetaminophen), Advil (ibuprofen), or Aleve (naproxen). I personally recommend tylenol because people with sore throats often have fevers and tylenol is better when it comes to reducing fevers, but you can take any of them and get some relief. Note: don't forget to take Advil and Aleve after food!
Meds:
- Tylenol
- Advil (with food)
- Aleve (with food)
Fever:
I'm not sure what other people think about this, so this is my personal opinion. It's nothing anyone has told me specifically in class before, but I've come to this conclusion based on what I've learned about our immune system. You get a fever when your body is actively fighting off something that doesn't belong inside of it- usually bacteria or a virus. Your immune system is doing what it what made to do; it's actively searching out the invader and killing it or getting it out of your system.
With that said, there are two types of fevers in my eyes- a low-grade fever and a high fever. If you have a high fever, you should be doing everything you can to bring it down. Fevers can cause long-lasting damage when they get too high. The fever I'm talking about is a low-grade fever...like 1 degree higher than normal. Personally, I think that suppressing that low of a fever is only setting back your body's natural defense and may allow you to either get sick or become more sick. I don't take medicine until it gets to be in the upper 99s or higher. You may think differently.
Anyway, like I said before, tylenol is usually the best medicine for this. You can also use ice packs on your head or a cold bath to lower your temperature if the tylenol isn't taking care of it. Ibuprofen is also a possible treatment for fever if the tylenol isn't working. Make sure to take (or give) it with food.
Meds:
- Tylenol
- Ibuprofen
- Cold packs/cold bath
There are limits to how much you can take of all of these medications. Pay attention to the labeling on the package- READ it all- and remember that the pharmacist and pharmacy interns are always right behind the counter to help you out.
Saturday, January 22, 2011
A cute asthma
Yesterday, my baby girl was diagnosed with a cute asthma...good thing it wasn't ugly asthma ;) All giggles aside, I have been pretty worried about her lately. Every few months she'll get wheezing fits, but it's usually after we've opened the windows. After a quick trip to the vet for a shot of methylprednisolone, she's good as new for quite a while. Those shots usually last her about 5-6 months. This last one only lasted 2.
A couple of nights ago she wouldn't stop wheezing. She'd do it for about a minute straight, stop for a minute or two and start all over again. I didn't know what to do, so I tried massaging her lungs for some reason and she ended up being able to fall asleep for the rest of the night with no more wheezing. Before we had always just assumed that she had allergies to something outside and it would cause her lungs to act up, but this time we hadn't had the windows open at all.
The vet said that she has an acute case of asthma and gave her steroids that she'll be on for the next few weeks. I'm really hoping that she just has cases of it here and there and that it doesn't turn into a chronic problem for her. She gets really jumpy when this happens and it really seems to scare her. I of course am a wreck because I think she can't breathe! She's been on the prednisone for a whole day now & since she started it she's been wheeze-free! I'm so thankful it seems to be working. I kind of wonder if she's ever even breathed this well in her life.
Anyway, I wanted to blog about this for anyone who might have cats. Apparently cat asthma is more common than I thought, and a lot of times it's mistaken as furballs. It does look like when a cat tries to cough up furballs, but they never actually produce anything and they do this neck-stretching-out thing as they heave. If you see your cat doing this, try a furball remedy first to make sure it's not something that's easy to fix, but if it continues get them into the vet!
Here's what she looks like when she wheezes. Usually it's more wheezing & fewer coughs, but you get the idea...
A couple of nights ago she wouldn't stop wheezing. She'd do it for about a minute straight, stop for a minute or two and start all over again. I didn't know what to do, so I tried massaging her lungs for some reason and she ended up being able to fall asleep for the rest of the night with no more wheezing. Before we had always just assumed that she had allergies to something outside and it would cause her lungs to act up, but this time we hadn't had the windows open at all.
The vet said that she has an acute case of asthma and gave her steroids that she'll be on for the next few weeks. I'm really hoping that she just has cases of it here and there and that it doesn't turn into a chronic problem for her. She gets really jumpy when this happens and it really seems to scare her. I of course am a wreck because I think she can't breathe! She's been on the prednisone for a whole day now & since she started it she's been wheeze-free! I'm so thankful it seems to be working. I kind of wonder if she's ever even breathed this well in her life.
Anyway, I wanted to blog about this for anyone who might have cats. Apparently cat asthma is more common than I thought, and a lot of times it's mistaken as furballs. It does look like when a cat tries to cough up furballs, but they never actually produce anything and they do this neck-stretching-out thing as they heave. If you see your cat doing this, try a furball remedy first to make sure it's not something that's easy to fix, but if it continues get them into the vet!
Here's what she looks like when she wheezes. Usually it's more wheezing & fewer coughs, but you get the idea...
Wednesday, November 3, 2010
Worry
I tweeted last week about a book I bought that is all about controlling your worry. It might be the best damn purchase I've ever made.
I'm about halfway through it right now, and I've already cut my worrying in half. If you're a chronic worrier, you know how bothersome it can get. It seemed like I was always amped up and so tense. I'd constantly have thoughts going through my head that would make me anxious. Don't get turned off by that word- anxious.
When I first went to see this therapist, she called what I was feeling "anxiety." Everyone knows that there's a stigma attached to anxiety, so I kind of pushed it away and ignored her. I kept calling it stressed instead of anxious. She must have noticed this and pulled out her DSM IV. Welp- it's definitely anxiety. Whatever it's called doesn't matter. I feel how I feel and that's that.
Anyway, since she suggested these books (there's a stress one too), I decided to order them. I started the one about worry the first day I got it. It has a lot of exercises to help you implement what you're learning. One of the first things it has you do is start a worry journal. I started keeping mine on Google Calendar so I could track it more easily and not have to dig out a notebook every time I worried.
I was SHOCKED after the first day. I worry so much more than I had realized! The first step to decreasing my worry and eventually my stress level was just being aware of how much it happens. The next step was actively thinking about what I was worrying about- was it productive or unproductive? Almost all of my worry was unproductive and completely worthless.
I'm now getting to the part where it starts telling me how to control my worry, and I'm really excited. I can't believe how calm I feel compared to this time last week. The best thing about it is that you don't even need to see a therapist to stop worrying. This book, as long as you really do the exercises, can help you decrease your worrying.
If you ever wish you could just shut your brain off for a second or that you could worry less, this book is definitely something to think about. It's cheap- about $11 and about 140 pages long. Here's a link, or just ask me if you can borrow it when I'm done.
I'm about halfway through it right now, and I've already cut my worrying in half. If you're a chronic worrier, you know how bothersome it can get. It seemed like I was always amped up and so tense. I'd constantly have thoughts going through my head that would make me anxious. Don't get turned off by that word- anxious.
When I first went to see this therapist, she called what I was feeling "anxiety." Everyone knows that there's a stigma attached to anxiety, so I kind of pushed it away and ignored her. I kept calling it stressed instead of anxious. She must have noticed this and pulled out her DSM IV. Welp- it's definitely anxiety. Whatever it's called doesn't matter. I feel how I feel and that's that.
Anyway, since she suggested these books (there's a stress one too), I decided to order them. I started the one about worry the first day I got it. It has a lot of exercises to help you implement what you're learning. One of the first things it has you do is start a worry journal. I started keeping mine on Google Calendar so I could track it more easily and not have to dig out a notebook every time I worried.
I was SHOCKED after the first day. I worry so much more than I had realized! The first step to decreasing my worry and eventually my stress level was just being aware of how much it happens. The next step was actively thinking about what I was worrying about- was it productive or unproductive? Almost all of my worry was unproductive and completely worthless.
I'm now getting to the part where it starts telling me how to control my worry, and I'm really excited. I can't believe how calm I feel compared to this time last week. The best thing about it is that you don't even need to see a therapist to stop worrying. This book, as long as you really do the exercises, can help you decrease your worrying.
If you ever wish you could just shut your brain off for a second or that you could worry less, this book is definitely something to think about. It's cheap- about $11 and about 140 pages long. Here's a link, or just ask me if you can borrow it when I'm done.
Thursday, June 24, 2010
Health Literacy
Restaurant workers say "on the fly" and "86" on a daily basis. Others have no idea what that means. Every field has their own lingo, but the use of most of that lingo never affects anyone in a bad way. If a server says "86 the mayo," no one will be any worse off because of it.
In health care, however, it's a different story. There is a medical language that takes years of school to fully understand. Since most health care professionals have been through all of the schooling necessary to learn the lingo, it is commonplace to them and they use it in day-to-day interactions.
The problem with this is when they forget to translate what they're saying into something their patients can understand. Most health care professionals forget that this is even an issue because they have forgotten what it's like to listen to someone spout off something at them and have no idea what was just said. It's hard to go back to before they had the knowledge they do, and explain what they have to say in a manner that will make it easy for anyone to understand.
So how can we solve this problem? It's obvious that patients and doctors/pharmacists/nurses/surgeons/etc need to be able to communicate and fully understand each other. Without a full understanding, there will continue to be a high number of mistakes and misunderstanding that could majorly affect a patient's life. Even the relationship between manufacturer and patient can be difficult. Instructions on bottles often make little sense or are so dense with information that the necessary information can't even be located.
One thing I know it that health care professionals need to continually work on that most important word: care. They need to take time to listen to their patients' complaints and acknowledge their worries. The need to come up with a plan to take care of the patients' medical problems, but in doing that they must make certain the patient fully understands certain things like how they should take it, what they're taking it for, and how long they're expected to stay on it.
Imagine two people. Both are 25 years old. One has played basketball competitively for many years; the other has never seen a basketball before. One is going to fly through a basketball drill with ease while the other one will fumble around foolishly. One will leave with a great sense of accomplishment; another will leave embarrassed and discouraged. One will have known exactly what was going on during the drill; the other will still be confused and never really understand what happened during the drill.
Apply this analogy to a patient and a doctor. Can you see how a doctor's visit can be experienced in two very different ways by different people? Obviously navigating health care won't be as difficult for some people as it is for others, but that doesn't mean we can just overlook it.
A friend linked me to this video that talks about this topic. While it's a bit dated, we still face the same problems they show.
As a patient, what do YOU feel can be changed to make health care make more sense? What are some times that you feel like a complete health care klutz? Is there anyone that is a part of your care team (doctor/nurse/pharmacist/etc) that you feel can help you understand if you have problems?
If you have time, I'd really like to know your answers. As a student, I have obviously seen health care professionals go from driven young people to overworked workers in a matter of years. It's no different from other careers- people get burnt out doing what they do. But as health care professional we can't let our level of care slip because we have forgotten what it's like to really care if our message gets through. I'd love it if you can offer me some insight. Thanks!
In health care, however, it's a different story. There is a medical language that takes years of school to fully understand. Since most health care professionals have been through all of the schooling necessary to learn the lingo, it is commonplace to them and they use it in day-to-day interactions.
The problem with this is when they forget to translate what they're saying into something their patients can understand. Most health care professionals forget that this is even an issue because they have forgotten what it's like to listen to someone spout off something at them and have no idea what was just said. It's hard to go back to before they had the knowledge they do, and explain what they have to say in a manner that will make it easy for anyone to understand.
So how can we solve this problem? It's obvious that patients and doctors/pharmacists/nurses/surgeons/etc need to be able to communicate and fully understand each other. Without a full understanding, there will continue to be a high number of mistakes and misunderstanding that could majorly affect a patient's life. Even the relationship between manufacturer and patient can be difficult. Instructions on bottles often make little sense or are so dense with information that the necessary information can't even be located.
One thing I know it that health care professionals need to continually work on that most important word: care. They need to take time to listen to their patients' complaints and acknowledge their worries. The need to come up with a plan to take care of the patients' medical problems, but in doing that they must make certain the patient fully understands certain things like how they should take it, what they're taking it for, and how long they're expected to stay on it.
Imagine two people. Both are 25 years old. One has played basketball competitively for many years; the other has never seen a basketball before. One is going to fly through a basketball drill with ease while the other one will fumble around foolishly. One will leave with a great sense of accomplishment; another will leave embarrassed and discouraged. One will have known exactly what was going on during the drill; the other will still be confused and never really understand what happened during the drill.
Apply this analogy to a patient and a doctor. Can you see how a doctor's visit can be experienced in two very different ways by different people? Obviously navigating health care won't be as difficult for some people as it is for others, but that doesn't mean we can just overlook it.
A friend linked me to this video that talks about this topic. While it's a bit dated, we still face the same problems they show.
As a patient, what do YOU feel can be changed to make health care make more sense? What are some times that you feel like a complete health care klutz? Is there anyone that is a part of your care team (doctor/nurse/pharmacist/etc) that you feel can help you understand if you have problems?
If you have time, I'd really like to know your answers. As a student, I have obviously seen health care professionals go from driven young people to overworked workers in a matter of years. It's no different from other careers- people get burnt out doing what they do. But as health care professional we can't let our level of care slip because we have forgotten what it's like to really care if our message gets through. I'd love it if you can offer me some insight. Thanks!
Tuesday, December 22, 2009
"You definitely don't have cancer"
I know I post plenty of sarcastic blog posts, but this is not one of those.
My great grandma has had many, many types of cancer throughout her 94 years of life, and I recently heard that she's battling it once again. My grandma has also had breast cancer 3 different times. After she found out the first time, she had a double mastectomy. As if that wasn't enough to go through to try and get rid of it forever, it came back 2 more times. I just learned over the weekend that she has it for the 3rd time and that it has now spread to her colon. My mom called me a couple of weeks ago and said that in her latest breast exam, the doctor found a few different lumps. She had a biopsy that showed abnormal cells, so she had to have surgery to remove as much as they could. She just got a call that said it was not malignant yet, but that it would have been if they didn't find it when they did.
With all of the history of cancer in my family, I have spent the last 1-2 months freaking the fuck out. About 2 months ago, I found a lump in my breast. As my family does, I have fibrocystic breasts. This just means they are lumpy from fibrous tissue. But this lump was unlike anything I'd ever felt. It was very prominent and had definitely not been there during my last self check. I instantly freaked and began stressing about it. What else did I do? Deny that it was even there. I avoided bumping into the lump or ever having to touch it. If I never felt it, it wasn't there.
I failed tests because of that lump. The mind is an evil thing, and every time I'd sit down to study, my mind would jump straight to the lump- no matter how hard I tried to push those thoughts away. I told myself that it would just go away, just like the swollen lymph nodes I sometimes get with periods. After a month, it had not gone away.
I finally found the courage to make it real and tell my boyfriend about it. His response: go see a doctor. I couldn't explain why that wasn't an option for me, but I just didn't want to. If it was cancer, I didn't want to know. I just wanted to finish school, graduate, and start making enough money that I would be able to pay off medical bills and my student loans. I knew that if I found out I had cancer before I finished school, I wouldn't even be able to afford being sick. He told me that waiting would only make it worse. I knew he was right, but I still couldn't bring myself to make an appointment. I promised him that I'd make an appointment after finals were over so that I could "focus" on those.
I kept my promise and did go see my gynecologist after finals ended. I also immediately felt stupid for being so freaked out about. "I'd fall over on the floor if you had cancer," she said. Even with my family history, it would be highly unlikely for someone my age to have cancer. I didn't know that! She told me to have an ultrasound of the lump & see what that showed.
I made my appointment for 7 freakin AM on Monday at the Goppert Breast Center of St. Luke's. I'd had ultrasounds before when doctors were trying to diagnose my stomach issues, so I wasn't nervous for the actual "procedure." That was easy. I was nervous that the radiologist would see something my gynecologist couldn't feel.
After the tech rolled the ultrasound thing around forever, she brought the radiologist in and he said, "Well you definitely don't have cancer." I let out a huge sigh of relief. But he wasn't finished. He stood in the room with me for probably longer than any other doctor I've ever seen, explaining things to me. I want to share some of what he told me with you because a lot of it was things I'd never heard before. Hopefully this information helps you know what to do if you ever discover a lump.
1. Don't freak out! He said that 99% of lumps are benign. (I don't know how true this is, I'm just typing what he said.)
2. Breasts grow until about 25, and then start to decline in mass.
3. If you have lots of fibrous tissue, the tissue and fat content can twist around each other to form lumps. This can be the same for people without lots of fibrous tissue.
4. If you do feel a lump in your monthly self checks, don't go to the doctor right away. He said it's best to not worry and continue to monitor the lump on your own. He said that if it changes in size, go see a doctor, but if it stays the same size, it is most likely nothing to worry about.
5. If you are really worried that it is something, go see your doctor. If it turns out to be cancer, it really is better the sooner it's caught. You can get started on treatment and hopefully knock it out. If it's not cancer, your fears will be calmed.
My greatest regret about the whole thing is that I waited so long to go see a doctor. I created so much stress by avoiding the whole situation. Make sure you are doing self checks monthly and keeping an eye on changes. If you notice changes, tell someone close to you. Letting other people know about it helped me calm down somewhat. It was like they shared the burden of feeling the lump with me.
Well, I expected this to be a short post, but- like always- it's turned into a long one again and I've got to get ready for work. One last thing (again): do your monthly self exams!
My great grandma has had many, many types of cancer throughout her 94 years of life, and I recently heard that she's battling it once again. My grandma has also had breast cancer 3 different times. After she found out the first time, she had a double mastectomy. As if that wasn't enough to go through to try and get rid of it forever, it came back 2 more times. I just learned over the weekend that she has it for the 3rd time and that it has now spread to her colon. My mom called me a couple of weeks ago and said that in her latest breast exam, the doctor found a few different lumps. She had a biopsy that showed abnormal cells, so she had to have surgery to remove as much as they could. She just got a call that said it was not malignant yet, but that it would have been if they didn't find it when they did.
With all of the history of cancer in my family, I have spent the last 1-2 months freaking the fuck out. About 2 months ago, I found a lump in my breast. As my family does, I have fibrocystic breasts. This just means they are lumpy from fibrous tissue. But this lump was unlike anything I'd ever felt. It was very prominent and had definitely not been there during my last self check. I instantly freaked and began stressing about it. What else did I do? Deny that it was even there. I avoided bumping into the lump or ever having to touch it. If I never felt it, it wasn't there.
I failed tests because of that lump. The mind is an evil thing, and every time I'd sit down to study, my mind would jump straight to the lump- no matter how hard I tried to push those thoughts away. I told myself that it would just go away, just like the swollen lymph nodes I sometimes get with periods. After a month, it had not gone away.
I finally found the courage to make it real and tell my boyfriend about it. His response: go see a doctor. I couldn't explain why that wasn't an option for me, but I just didn't want to. If it was cancer, I didn't want to know. I just wanted to finish school, graduate, and start making enough money that I would be able to pay off medical bills and my student loans. I knew that if I found out I had cancer before I finished school, I wouldn't even be able to afford being sick. He told me that waiting would only make it worse. I knew he was right, but I still couldn't bring myself to make an appointment. I promised him that I'd make an appointment after finals were over so that I could "focus" on those.
I kept my promise and did go see my gynecologist after finals ended. I also immediately felt stupid for being so freaked out about. "I'd fall over on the floor if you had cancer," she said. Even with my family history, it would be highly unlikely for someone my age to have cancer. I didn't know that! She told me to have an ultrasound of the lump & see what that showed.
I made my appointment for 7 freakin AM on Monday at the Goppert Breast Center of St. Luke's. I'd had ultrasounds before when doctors were trying to diagnose my stomach issues, so I wasn't nervous for the actual "procedure." That was easy. I was nervous that the radiologist would see something my gynecologist couldn't feel.
After the tech rolled the ultrasound thing around forever, she brought the radiologist in and he said, "Well you definitely don't have cancer." I let out a huge sigh of relief. But he wasn't finished. He stood in the room with me for probably longer than any other doctor I've ever seen, explaining things to me. I want to share some of what he told me with you because a lot of it was things I'd never heard before. Hopefully this information helps you know what to do if you ever discover a lump.
1. Don't freak out! He said that 99% of lumps are benign. (I don't know how true this is, I'm just typing what he said.)
2. Breasts grow until about 25, and then start to decline in mass.
3. If you have lots of fibrous tissue, the tissue and fat content can twist around each other to form lumps. This can be the same for people without lots of fibrous tissue.
4. If you do feel a lump in your monthly self checks, don't go to the doctor right away. He said it's best to not worry and continue to monitor the lump on your own. He said that if it changes in size, go see a doctor, but if it stays the same size, it is most likely nothing to worry about.
5. If you are really worried that it is something, go see your doctor. If it turns out to be cancer, it really is better the sooner it's caught. You can get started on treatment and hopefully knock it out. If it's not cancer, your fears will be calmed.
My greatest regret about the whole thing is that I waited so long to go see a doctor. I created so much stress by avoiding the whole situation. Make sure you are doing self checks monthly and keeping an eye on changes. If you notice changes, tell someone close to you. Letting other people know about it helped me calm down somewhat. It was like they shared the burden of feeling the lump with me.
Well, I expected this to be a short post, but- like always- it's turned into a long one again and I've got to get ready for work. One last thing (again): do your monthly self exams!
Friday, November 13, 2009
Increase Your Pharmacy Knowledge!
I have realized by working in a pharmacy that many people don't know very much about pharmacy. That's totally understandable- where would you learn it? So I decided to write a blog about it with some information you should know about pharmacy. I've created a quiz below so you can test how much you know! Before you take the quiz though, there are a couple of things not in the quiz that I think you should know.
If you are on chronic medication, make sure you know what each one is used for. Also know at least one of the names of the drug(s) (brand or generic)you are taking. Be able to associate the color/shape of the pill with its name and use.
Read the instructions written on the bottle. REALLY read them. Many people think they've read them, but there are a lot of people who are taking their medication incorrectly. Your doctor has often written the instructions so they are tailored to you and your condition, so if you're taking them a different way than prescribed, your condition may not be controlled. I see this most often with antibiotics. A lot of people assume that they are all to be taken once a day, but many antibiotics are taken differently. If you don't take them as prescribed, you will most likely be sick for a longer period of time.
Take responsibility for your medicine. Make sure you know when you are almost of it pills, when your refills will run out, how to take them, etc. The pharmacy can usually help you with a lot of this, but you should take responsibility for your health. Before you take your medication from the pharmacy, read the labels or pamphlet and make sure you are getting the right medication and the strength you are usually on. If anything has changed, ask the pharmacist.
One more thing- many patients come in, drop their prescription off and get very angry when we tell them it will be 15 minutes. I wanted to give you a glimpse into the process that happens once you drop off your prescription so you know what to expect.
-You drop your prescription off.
-If you haven't filled at that pharmacy before, they will need to get basic information from you including any allergies to medication and your insurance card.
-Once entering you into their computer system or finding your profile, they will enter the prescription into the computer.
-Once it's entered, they check to see if insurance accepts or rejects the claim. Unlike most doctor's offices, pharmacies usually communicate electronically with insurance companies so it takes less than a minute to see this.
-Once they get the claim back from the insurance they either begin the filling process or they have to figure out why it was rejected. If they have to call insurance, you might have to add 30 minutes or so onto your wait time.
-Once the prescription is entered and is approved by your insurance, the techs will print the label for your drug. The correct drug is pulled and it is checked against the drug that it lists on the label.
-The drug is counted and put into a pill bottle. If it is a controlled drug, it is counted a second time.
-A label is put on the pill bottle and handed to the pharmacist.
-The pharmacist begins the verification procedure and makes any changes if needed.
-The prescription is ok'ed and sold to the patient.
Throughout this whole process, many other things happen- the phone rings, people are picking up prescriptions in the store and at drive thru, doctors & nurses are calling in prescriptions and responding to questions, patients are asking questions about over the counter meds, and insurance rejections are being taken care of. All of these things add to the time you have to wait for your prescription.
The important thing to remember is that we know you have been waiting at the doctor for a long time and that you don't feel well. We want you to have your prescription as fast as possible. We also hate it when you have to wait longer than you think you should. If you can, try to be as patient as possible. Waiting is easier if you aren't mad. And remember: we (the pharmacy staff) are here to help you!
Ok, enough babbling: take the quiz!! (You have to put your cursor on the question to see the whole thing)
If you are on chronic medication, make sure you know what each one is used for. Also know at least one of the names of the drug(s) (brand or generic)you are taking. Be able to associate the color/shape of the pill with its name and use.
Read the instructions written on the bottle. REALLY read them. Many people think they've read them, but there are a lot of people who are taking their medication incorrectly. Your doctor has often written the instructions so they are tailored to you and your condition, so if you're taking them a different way than prescribed, your condition may not be controlled. I see this most often with antibiotics. A lot of people assume that they are all to be taken once a day, but many antibiotics are taken differently. If you don't take them as prescribed, you will most likely be sick for a longer period of time.
Take responsibility for your medicine. Make sure you know when you are almost of it pills, when your refills will run out, how to take them, etc. The pharmacy can usually help you with a lot of this, but you should take responsibility for your health. Before you take your medication from the pharmacy, read the labels or pamphlet and make sure you are getting the right medication and the strength you are usually on. If anything has changed, ask the pharmacist.
One more thing- many patients come in, drop their prescription off and get very angry when we tell them it will be 15 minutes. I wanted to give you a glimpse into the process that happens once you drop off your prescription so you know what to expect.
-You drop your prescription off.
-If you haven't filled at that pharmacy before, they will need to get basic information from you including any allergies to medication and your insurance card.
-Once entering you into their computer system or finding your profile, they will enter the prescription into the computer.
-Once it's entered, they check to see if insurance accepts or rejects the claim. Unlike most doctor's offices, pharmacies usually communicate electronically with insurance companies so it takes less than a minute to see this.
-Once they get the claim back from the insurance they either begin the filling process or they have to figure out why it was rejected. If they have to call insurance, you might have to add 30 minutes or so onto your wait time.
-Once the prescription is entered and is approved by your insurance, the techs will print the label for your drug. The correct drug is pulled and it is checked against the drug that it lists on the label.
-The drug is counted and put into a pill bottle. If it is a controlled drug, it is counted a second time.
-A label is put on the pill bottle and handed to the pharmacist.
-The pharmacist begins the verification procedure and makes any changes if needed.
-The prescription is ok'ed and sold to the patient.
Throughout this whole process, many other things happen- the phone rings, people are picking up prescriptions in the store and at drive thru, doctors & nurses are calling in prescriptions and responding to questions, patients are asking questions about over the counter meds, and insurance rejections are being taken care of. All of these things add to the time you have to wait for your prescription.
The important thing to remember is that we know you have been waiting at the doctor for a long time and that you don't feel well. We want you to have your prescription as fast as possible. We also hate it when you have to wait longer than you think you should. If you can, try to be as patient as possible. Waiting is easier if you aren't mad. And remember: we (the pharmacy staff) are here to help you!
Ok, enough babbling: take the quiz!! (You have to put your cursor on the question to see the whole thing)
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