Pharmacist Becomes the Patient and Learns How to Use Eye Medications

A Real Eye Opener

Diana Jason , PharmD Candidate 2009
Southern Illinois University Edwardsville 
Prepared during Consumer Health Information Corporation Clerkship
McLean, VA

Have you ever gone to the doctor’s office and forgot half of the information you were given?

Healthcare professionals are trained to tell patients how to take their medications correctly. However, stress and anxiety levels can increase in the doctor’s office. This can make it difficult for patients to remember everything that was said. It is suggested for patients to take notes in the doctor’s office, so that they do not forget anything. Patients are also encouraged to ask questions if they do not understand.

Do as I say not As I do

As a student in my last year of pharmacy school, it is easy for me to tell patients about their medicines and what they SHOULD be doing. My whole world flipped upside down when I became the patient. I would like to share a story with you of something that happened to me recently. I learned the hard way, but I hope that patients can learn these lessons through my mistakes.

The Student Pharmacist becomes the Patient

I was at work when my right eye started hurting. I took out my contact lens. After lunch, it became red and swollen. I could not see as well, and I hurried to the nearest clinic. I was told by the nurse that I was to have an eye exam. I asked how I was supposed to have an eye exam when I can’t see! She said she would just go and get the doctor then. I anxiously waited for what seemed like forever. The doctor finally arrived. He examined my eye and told me I had a corneal abrasion from my contact lens.

He gave me a prescription for an eye ointment that contained an antibiotic for the infection as well as something for the pain. When I returned to work about 15 minutes later, I was asked what the doctor told me. I recalled that he said to wash my eyes 3-4 times per day with “ionized water” that I could pick up at the pharmacy. I also said I had a prescription for an eye ointment but could not recall how often or how to use it.   

Lessons Learned

  • When I became a patient, my anxiety level went up because I was concerned about my eye  and  vision. I was in so much pain and so anxious that I could not remember what the doctor told me. I should have been more prepared and realized that this is absolutely normal.
  • I should have asked questions when I did not understand the information I was given. I thought the doctor told me to use “ionized water” but he probably said “distilled water.” Ionized water is not even sold in a pharmacy.
  • It doesn’t matter how smart you are or what you know. When you become sick, it’s hard to focus on anything besides the pain and wanting to feel better.
  • A corneal abrasion results from cutting or scratching the thin, protective outer layer of the eye. In this case, it may have occurred from wearing the contact lens for too long.
  • I had not been taught yet how to administer eye ointments. I should have asked either the doctor or pharmacist. These are the instructions:

    1. Wash your hands with soap and water before and after using this medicine.

    2. Remove the protective cap.

    3. Tilt your head back slightly and pull your lower eyelid down with your index finger to form a pouch.

    4. Using your other hand, place the tube as near as possible to your eyelid. Do NOT touch the tip of the ointment tube to the eye because bacteria from the skin could enter the ointment tube.

    5. Squeeze the end of the tube to apply a thin layer of the ointment to the pouch made by the lower lid and the eye. A ½ inch strip of ointment usually is enough.

    6. Close the eye gently for 1-2 minutes to allow the medication to be absorbed.

    7. Replace and tighten the cap right away.

    8. Wipe off any excess ointment from your eyelids and lashes with a clean tissue.

    9. This medicine may cause blurred vision when you first put it in your eye . Do NOT drive or do anything else that might be dangerous unless you can see clearly. 

Applying the Lessons Learned

When you are feeling sick, it can be hard to remember what the doctor said. Here are some tips if you ever find yourself in a situation like mine:

  • Ask for written instructions. They will come in handy when you arrive home and cannot remember the instructions you were given.
  • Ask for patient handouts about your condition or medications.
  • Have all your prescriptions filled by one pharmacy. This is the only way your pharmacist can check to make sure all your prescription drugs do not interact with each other. You will also get to know your pharmacist better and feel comfortable asking more questions.
  • Make sure that the pharmacist explains what the medicine you are receiving is used to treat, how to take it and what side effects it may cause.
  • Bring along a family member or friend. If you miss something the doctor said, they can help you recall.

Remember that prescription medicines cannot work unless you take them correctly. Follow the above strategies and always feel free to ask your pharmacist if you have any questions. Do not be embarrassed if you forget what was said in the doctor’s office. Even student pharmacists occasionally do that.

 

© 2008 Consumer health Information Corporation. All rights reserved.

 

ALZHEIMER’s QUIZ

Alzheimer’s quiz: Diagnostic clues

Many people fret needlessly when they misplace their reading glasses or car keys — worried that this forgetfulness might be an early sign of Alzheimer’s disease.

While this type of memory loss is not related to Alzheimer’s, there are definite clues that doctors look for when diagnosing this disease.

Take our quiz to see if you can separate fact from fiction about diagnosing Alzheimer’s disease.

 http://www.mayoclinic.com/health/alzheimers/QZ00017

Losing Your Personal Bubble When Pregnant

By Mary Murry, R.N., C.N.M.

There are some interesting things that happen to you when you’re pregnant. It seems to begin as soon as people know you are pregnant.

Personal boundaries seem to melt away. You have no more personal bubble. Your belly is fair game for everyone from your great aunt May to the greeter at Wal-Mart.

I myself never had a problem with any family member giving my tummy a rub or pat. It was when people outside of the family reached for it that I cringed. I have to admit that with 9 and 10 pound babies, my tummy made a tempting target. I got very good at noticing the telltale signs; rapidly approaching, hands outstretched, the words “Oh you don’t mind …” uttered with a smile after her hands were already patting my tummy.

I would try to get my hands on it first and block the planned assault. Rarely was I successful. The little old ladies were the fastest of them all I think.

Another amazing phenomenon is the loss of discretion or sensitivity for your feelings. This takes different forms and the results are not nice. It causes people, friends, family, neighbors and complete strangers to comment on how big you are or aren’t.

They ask if you are having twins because you are so big. This loosening of tongues and sensitivities causes some people to feel free to comment on the amount of weight they think you have gained. I won’t even repeat some of the comments I have heard.

The third part to this unique experience is the one that baffles me the most. This is where all the women you know (and some you don’t) tell you all the horrible experiences they or a friend of theirs had or a relative, near or distant, had. We are so vulnerable, especially with our first baby and yet these well-meaning women strike terror into our souls with tales of 92-hour labors, epidurals that paralyzed them for 2 days, forced natural childbirth, bottoms that were never the same after episiotomies or stitches.

Let me not forget a subset of this group, the women who tell you how painful, uncomfortable and time-consuming breastfeeding is.

I, of course, have recommendations. Look at the woman talking to you. Does she have only one child? Is she still breastfeeding her 9-month-old? Don’t believe everything you hear. Take everything with a grain of salt. My strongest recommendation to everyone is don’t become one of these people. If you feel the phenomena starting to suck you in, resist! We can break the cycle.

Please share your experiences

Immunization of Children Who Travel to Other Countries.

Immunization Issues in Pediatric Travelers.

Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. [email protected]

An increasing number of children are traveling internationally. In preparation for their journeys, special attention must be given to immunizations. Providers should understand ‘routine’ vaccine schedules to ensure that pediatric travelers are up to date. Prematurely born and young children do not respond as well to some vaccines and require adjustment of timing and dosing. Vaccination of immunocompromised children requires consideration of their degree of immunodeficiency and the cause of their altered immunity. Accelerated vaccine schedules can be used when travel is imminent. Based on current scientific evidence, specific vaccine decisions can be customized related to the age, health and itinerary of individual travelers

What is Parkinson’s Disease?

Source: the National Institute of Neurological Disorders and Stroke – NINDS

Parkinson’s disease (PD) belongs to a group of conditions called motor system disorders, which are the result of the loss of dopamine-producing brain cells. The four primary symptoms of PD are tremor, or trembling in hands, arms, legs, jaw, and face; rigidity, or stiffness of the limbs and trunk; bradykinesia, or slowness of movement; and postural instability, or impaired balance and coordination. As these symptoms become more pronounced, patients may have difficulty walking, talking, or completing other simple tasks. PD usually affects people over the age of 50.  Early symptoms of PD are subtle and occur gradually.  In some people the disease progresses more quickly than in others.  As the disease progresses, the shaking, or tremor, which affects the majority of PD patients may begin to interfere with daily activities.  Other symptoms may include depression and other emotional changes; difficulty in swallowing, chewing, and speaking; urinary problems or constipation; skin problems; and sleep disruptions.  There are currently no blood or laboratory tests that have been proven to help in diagnosing sporadic PD.  Therefore the diagnosis is based on medical history and a neurological examination.  The disease can be difficult to diagnose accurately.   Doctors may sometimes request brain scans or laboratory tests in order to rule out other diseases.

 

Is there any treatment?

At present, there is no cure for PD, but a variety of medications provide dramatic relief from the symptoms.  Usually, patients are given levodopa combined with carbidopa.  Carbidopa delays the conversion of levodopa into dopamine until it reaches the brain.  Nerve cells can use levodopa to make dopamine and replenish the brain’s dwindling supply.  Although levodopa helps at least three-quarters of parkinsonian cases, not all symptoms respond equally to the drug. Bradykinesia and rigidity respond best, while tremor may be only marginally reduced. Problems with balance and other symptoms may not be alleviated at all.  Anticholinergics may help control tremor and rigidity.  Other drugs, such as bromocriptine, pramipexole, and ropinirole, mimic the role of dopamine in the brain, causing the neurons to react as they would to dopamine.  An antiviral drug, amantadine, also appears to reduce symptoms.  In May 2006, the FDA approved rasagiline to be used along with levodopa for patients with advanced PD or as a single-drug treatment for early PD. 

In some cases, surgery may be appropriate if the disease doesn’t respond to drugs. A therapy called deep brain stimulation (DBS) has now been approved by the U.S. Food and Drug Administration. In DBS, electrodes are implanted into the brain and connected to a small electrical device called a pulse generator that can be externally programmed. DBS can reduce the need for levodopa and related drugs, which in turn decreases the involuntary movements called dyskinesias that are a common side effect of levodopa. It also helps to alleviate fluctuations of symptoms and to reduce tremors, slowness of movements, and gait problems. DBS requires careful programming of the stimulator device in order to work correctly.

For more information about Parkinson’s Disease