Upcoming Festive Overindulgence? Try These 4 Tips to Overcome

If you're a part of the majority, you've already set off on the overindulgence 'ke Decemba' train. The month of December is inherently filled with weddings, birthdays, funerals, holidays which all equate to food, food and more food!

There's no need to panic, here are four tips to avoid bloating,  weight gain (water retention), tummy upsets and toxins buildup which can trigger joint pain and other inflammatory conditions.

All suggested medicine are available OTC from your local pharmacy and do not require a prescription. Ask your pharmacist for advice if in doubt or taking other medication concurently. 

 Firstly, liver support - whether you plan to drink or eat more than usual, substantiate your levels of essential phospholipids  with supplements  to assist your liver in its metabolic functions. 1 or 2 tablets up to three time (8hly) a day with food will do. 

Secondly, consider a hydration supplement.  In the heat of the summer, we tend to sweat  (salts are lost) and lose water a lot more than in winter. Increasing our water (fluid) intake is great but a step further is replenishing our electrolytes along with it. This keeps the "thirsty" feeling away and curves more subsequent cravings by maintaining feelings of satiety. One sachet dissolved in a liter of water as required on very hot days will do.

Next, lets consider excess acid levels. PH levels are critical to healthy body tissue states. Alkaline states help your system to better prevent cellular inflammation and  tissue injury/disease. Take an alkaline powder (7.5g) once or twice a day with a glass of water for a good week or so before and during the festivities to curb over acidity in the entire body. 

Lastly, its a good idea to add fiber to your diet. By sprinkling some on your food or in your drink, you ensure your gut remains regular and eliminates waste timeously.  Constipation often results from overindulgence of high sugar, high fat and low fruits/veg diets typical of party foods. Try soluble fibres to avoid this.

Whatever you decide to eat and indulge in, always keep moderation at the back of your mind. Portion sizes matter. Start with the salads and the greens before heading for the meats and the desserts.  Drink water before you leave the house as a prep to redu8ce your overall appetite, while conditioning your digestive enzymes for incoming food. 

Prevention is always better than cure. 

Enjoy your holidays, have a merry Christmas and a happy new Year 2020. 

Stay safe. 

Pharmers 

www.pharmers.co.za 

Antimicrobial Resistance; What's the big deal?

Imaging getting to the hospital for a severe bacterial infection and being told:

Sorry we don't have any effective treatment to give for this stain anymore!

That's where the world is heading;

We are dangerously close!

Listen up: in as little as 10 years we could have run out of options to treat all the super bugs currently being mishandled.

How exactly is antimicrobial misuse linked to resistant strains and treatment failure?

I'm glad you asked;  every time you take an antimicrobial medication incorrectly (dose, duration, frequency, type, or treatment option) you actually give that bug, or others around it a taste of what was supposed to kill it; but instead with this "taste", the bug incorporates the drug in its DNA and subsequently becomes enhanced, empowered and immune to it. 

This simplified explanation is to tell you to be very careful with your medication. When in doubt, ALWAYS ask your pharmacist to explain and confirm your treatment. 

Unfortunately, power struggles in the medical sphere sees a rise in patients demand towards their prescribers (every condition is a suspected infection that requires antibiotics), as well as many prescribers' carelessness in prescribing patterns. With many taking shortcuts when it comes to correctly identifying causative agents. These compounded tragedies are leading us to a point of no return. 

The 4rth industrial revolution is bringing along an unimaginable microbial disaster; if nothing is done. 

Prescribers: be careful. Resort to antimicrobials under extraordinary precaution and care. 

Dispensers: be careful. Counsel and warn your patients with utmost clarity, providing treatment assistance and reminders.  

Patients: be careful. Do not demand from experts what you think you know. They will provide the best treatment option if you remove your "paying-customer-is-king" pressures from their sworn responsibilities, lengthy degrees, and daily clinical experiences. 

Let's all work together in care and respect.  

#Pharmers

#pharmacy 

#antimicrobials 

#stewards

#healthCare 

NATION HEALTH INSURANCE - Should SA Panic?!

Since the signing of the bill and the declaration by government to go ahead with the NHI plans, many have been gripped with fear and consequently have been spreading it to others like wild fire. There seems to be a general negative connotation within the South African environment at the moment with regards to universal health coverage. 

  

A few myths have crept up which we can quickly put to rest: 

-Will the 20% fund the 80% ? 

-How can a system which is already struggling stretch any further? 

-Will the funds be squandered or the entity managed like Eskom and others?

To begin, let's establish a few truths!  

-No health care fund/ system or reform ever began once the nation was "ready" or in an overall "better/good state". The UK for example implemented their NHS after the war when the country was poor and struggling. 

- Neither the current public nor private sectors are doing well. A system change is inevitably needed and a new funding model is a great tool for that change to begin.

- Already 8% of the current GDP is spent on health, how much more can they inject  into health, being at the upper threshold already?  An efficient system is encouraged.

- Most of those who spread fear and negativity have not actually taken the time to read the bill nor have they made contributions to the open documents that exist for commenting:

(https://dearsouthafrica.co.za/national-health-insurance-bill-2019/) 

The NHI is a fund; which will be managed as a schedule 3A public entity and therefore a lot more strictly regulated as opposed to Eskom and the likes which are schedule 2 entities. This means centralize admin,  specific committees,  monthly rationing etc  This fund will also not solely come from tax payer increases as some imagine but mostly from a pool of tax shifts, payroll tax, medical schemes, and surcharges on PIT among others. The "20% cannot and will not fund the 80%"! Everyone is contributing proportionately. 29% of unemployed youth do not represent 80% of the population and payroll tax is only one source of funding as mentioned above. 

Additionally, with the concerns around implementation, phases are being rolled out until the official 2026 full implementation.  Therefore, the "readiness" will inadvertently be ironed out progressively through each phase. For example medical aids will continue as usual until legislation (about 12 of them in total) changes and their new scopes are redefined. 

The issue of staff shortage, is also going to improved. Currently, for every medical practitioner in the public there are five in the private sector; they are concentrated in certain urban areas. By allowing public and private to mix, this ratio can shift resulting in a wider population reached and serviced.  A similar story can be told about facilities where the majority of public facilities are flooded with patients while in private, many institutions have for instance 30% occupancy thus waste resources, charge more to make up for them and hence treat populations inefficiently. Sharing workforce and infrastructure to all patients  will improve efficiency. Of course a point to upgrade and train adequately should be made and is included in the model for sustaining health care services. 

Many have also raised the question on pilots failing? First of all pilots don't fail! They are a testing tool to assess a new avenue. Therefore the "failed" reports can only serve to improve each phase design and implementation onward.  Also, the NHI in itself could not have been "piloted" as the fund setup and other details around it require legislation changes first. Rather, the pilot sites used for testing have had mixed reviews due to poorly documented techniques and results, thus revealing poor  research strategies (copy and pasted plans did not get necessary tailoring per district) as opposed to poor concepts. To understand the value of the roll outs (pilot sites), just ask the primary beneficiaries: the patients who previously had to queue the night before or the full day of collection to receive their chronic medication;  who have already began to receive their chronic medication parcels in many external pick up points of rolled out districts and they are overflowing with gratitude at their new found efficient access to health care.   

One more thing to consider is the majority.  let's put ourselves in the shoes of the poorest; those who have no option, and no alternative. As the privileged bunch, let's not think that attempting to provide for others, is an oppressive attack on ourselves. The search for equity is primordial.
The more we empower people to contribute, the more we also enable them to consume and have options. The right to access quality efficient health care should immediately be followed by the responsibility to contribute towards it. The new health care system will thrive as more patients escape the poor / unemployed / uneducated pool, take on employment and healthy lifestyles which decrease disease burden overall.  Patient education is key. 

 No system is perfect. Any alternative model (suggestions rather than complaints are welcomed) would also have flaws. However this is the option that was chosen and government should now run concurrent models (for example the voucher model) in various districts to establish which model variants work best, confirming their choice. 

It's also important to note that universal health care is not a SA concept. The rest of the world has already fought for decades to try and reach it. The WHO is mandating for the rest to follow suit in their vision 203p for the whole world.

Affordable care and quality care seem to be at opposites of the spectrum. How can they both exist unless some win and some lose? How does equality and equity factor in together? Until we stop viewing the fund as an all or nothing ideal, we will miss the many nuances in between. Being for the NHI doesn't have to be at the expense of precautionary scrutiny and acknowledging evident complexities. 

 SA should definitely NOT panic, rather shake the fear, toss the negativity and get involved in the deep understanding of the great need, the many benefits, and mitigating the flaws, while actively participating in the shaping of the NHI and the ideal health care system which is envisage for all.


#NHI
#Equity
#transparency
#joinTheConvo

#HEALTHCARE
#universalhealth


#PHARMERS by www.pharmers.co.za 

Pharmacy - Cornerstone of Health Care!

Whatever disease, illness or condition you may come across (go ahead and think of at least 3), part or the entire treatment protocol will require medicines. And who says medicine says: PHARMACY!

Who's in charge and running (around in) the pharmacy? Pharmacists of course! With the help of their assistants. 

But that's overly simplified you might think. Medicines being sold in a pharmacy don't quite illustrate the entire health care scenery does it? So why is pharmacy cornerstone?

Well they give you the final products. The end valuable result of the complex pharmacy machine! That's not all! You see,  health care in essence is the organized provision of medical care to individuals or communities. As each component of care giving requires either consumables, medicines or tools; pharmacists are the only licensed, sworn in, and responsible authorities for safely providing these to everyone else.  

To provide quality health care, rigorous investigations must be done. Diseases, their cause and progression, their treatment or management etc is studied with the aim of curing or at least controlling the condition. Pharmacists do that. Any agent which causes a desired physiological response can be deemed a drug, how it works and should be administered to treat and cure diseases is the pharmacists' prerogative! If you're still not convinced,  consider the following concluding points.

5 ways pharmacists are the cornerstones of health care: 

○They manufacture ALL available drugs; no pharmacist, no medication. 

○They understand both sides of diseases: etiologies vs therapies; no pharmacist, no prescription, disease & drug gate keeping. 

○They have basic and advanced knowledge regarding Primary, Emergency and Secondary/ Tertiary health care; no pharmacists, no adequate intermediate resources connecting all treatment levels. 

○They ensure quality treatments from obtaining raw materials, to maintaining quality through storage, manufacturing, packaging, distribution, prescribed indications and patient use. No pharmacist, no quality treatment. 

○they are the ultimate health care multitaskers: making the actual medications, ordering and controlling supply, supervising staff, consulting & counselling patients, intervening in patient therapies, mediating between prescribers and insurance providers, referring or initiating care, teaching and educating communities, while running profitable businesses among many others! No pharmacist, no cross-disciplinary, functional health care system!

You just can't beat them.

Pharmacists remain the undefeated,  unprecedented but ultimately undermined,  health care professionals!

Love and respect your pharmacist. Be patient while your community pharmacist helps you. They are there to optimize your treatment (outcomes) and improve your quality of life but if you rush them and they make a mistake it could really harm you.




Brought to you by: www.pharmers.co.za

Pharmacy Blog 

Flu Virus - to vaccinate or not?

So you know by now every year when flu season is about to start,  (roughly a 13 weeks duration spanning from March to July) the influenza vaccine gets promoted through advertisement everywhere! So is this a sales gimmick or is there some real benefit to it?

Well it depends! Who's asking?

Young children (from 12months), pregnant mothers up to 2 weeks post partum, the elderly or the immuno-compromised ( esp HIV/TB), lung/chronic disease and co morbid patients, certainly will benefit from it. The advantage isn't as directly observable as one would think (not catching any virus/not getting sick for the entire season etc). It is more of a "lessening of risk" , or aversion of exacerbation from a viral infection, which is key! After vaccination, the special groups (those mentioned above) patient drastically reduces their risk of landing up in hospital due to severe infection and secondary complications (cardiovascular, pulmonary, etc). The burden of the influenza related hospitalizations depends on the transmission and virulence of the strain each year.

Let's mention the three strains which cause illness. Influenza A - most usual cause of epidemics or yearly outbreaks, Influenza B - less severe outbreaks and illness, mostly burdensome on children and the immuno-compromised individuals. Lastly, Influenza C - which caused minor respiratory illnesses.

However the influenza virus (including all infectious strains) is not the only flu-like virus in the air.
Rhinoviruses which cause the common cold are another huge culprit; the adenovirus, coronavirus and other viruses all thrive during the colder months as indoor ventilation decreases and human clusters (viral harbouring and sharing) increase. So you may still get a cold, or another viral infection or even allergies, which all involve sneezing, rhinorea and sinus congestion among others. NB: the flu has a sudden onset of symptoms, includes fever and body aches, git disturbances in children, sore throat, and running nose as differential.

The question remains, do you vaccinate or not?

Considering the above information. If you fall within this special group, the safe advise to receive is: vaccinate.

If you live or work (especially health care workers) with this special group including newborns/infants, avoid becoming a source of infection to them: vaccinate

If you fall outside of this group, are a healthy individual and have no additional risk: you can skip the vaccine

The trivalent vaccine (TIV) in itself is not a live attenuated strain (it contains three dead/inactivated strains of 2 different A strains & 1 B strain) , therefore the rumors of it causing the flu or other diseases are unfounded/unrelated. However, after vaccination, a mild localized irritation might occur which clears quickly.

Lastly, it is worth mentioning that since the flu vaccine is not long lasting (6 months longevity), it should be re-administered annually at the start of flu season (in SA it's March/April). This also means that if you've had the flu at the beginning of the season, you may still get it again towards the end even if you vaccinate.

Look at this table which shows reduction in severity of disease and morbidity in those who vaccinate vs not:

Heads up, Now you know.

ALWAYS ask your pharmacist for sound pharmacy related advise.

Happy flu aversion

Have pharmacists given up their power?

One of the biggest mistake people make is to give their power away by thinking they don't have any!

This couldn't be more true for most pharmacists it seems. As observed in the retail setting, patients increasingly tend to push their luck and demands towards pharmacists. While entitlement isn't right, times have changed and in this day and age, your professional identity has to marry your personal conviction of who you are in a way you may not have ever experienced before. You have to know who you are and what your strengths and weaknesses might mean to your workplace. Your authority, your jurisdiction, your territory can never be threatened. Don't allow it. On the flip side, you can't rely on your mere title or name tag to suffice in the respect department anymore that's for sure. Patients are notoriously earning their instant online degrees after a few google quick searches and are ready to challenge you - the professionally trained pharmacists with a plethora of misguided, misinformed and misleading statements, questions or comments amongst other atrocities.

The guts!

For such a climate, the winning pharmacists are those who not only know who they are and what their roles, duties, responsibilities and rights are, down to the T! But can equally voice them unafraid. Your pharmacy degrees are no longer enough! You need wit, confidence and a lot of assertiveness to add to the community pharmacy scene. Being nice was often a trait which meant bending rules, doing favours and being "understanding" for many dispensaries. To the point where often, this leniency happens at the expense of the pharmacy's rules, policies and even the law! 

Fast forward to today and community pharmacists are all paying for having given their power away and allowed their dispensaries to become fast-meds pubs on steroids. So what has being "overly nice" got to do with professional power? Everything! If you're familiar with the phrase "familiarity breeds contempt" then you know that when you repeatedly show soft kindness over any other traits such as sternness or even assertiveness, it often is mistaken for weakness...

What do opportunists do when they perceive weakness? Take advantage of course! 

*Wait an hour at the doctors, but if you spend more than 5 minutes at the pharmacy... someone has to apologize! 

*Ask how they know how to read a prescription but never understand nor value the scrutiny involved in cross checking each item for safety. 

*Worry about asking your doctor if you can switch to a generic, while you ignore the one who actually studied your medication's various formulations  kinetics and dynamics.

*The list is very long...

Patients keep asking the wrong questions while pharmacists keep giving their power away... 

Before they ask, tell them. Before they stray, restrain them. Before they run off to their prescriber, educate them. Unfortunately the damage is done and the only way to fix it now is to overcompensate.  Over explain. Have readily available guidelines policies or laws, provide overflowing therapy information, do superfluous continuous self study, and be astoundingly resourceful. You cannot be caught slipping, or not knowing.

In short, always add and verbalize value to your patients (and other health care professionals whom we haven't touched on in this particular blog) during usual services. They will start understanding and respecting your work better. 

Become aware of such gaps. Fill them.

Go the extra mile in your supervision and training. 

Be excellent.

Just a thought.

Fix your face!

We often discussed the issues surrounding pharmacy practice, but never in a progressive or helpful manner. It's easy to see what's wrong in a situation but we seldom find ways to improve issues or "fix our faces". A particular problem, and one that requires immediate attention is that of the public perception and resulting interaction with pharmacists. Now, many reasons exist for the cause and escalation of this problem but that's a discussion for a different day. 

For now let's look at some "common sense" tips pharmacists (and assistants) can implement to improve patient perception and value added/superior (retail) service:

Using the following scenario, notice the type of questioning and the rationale behind each. Much of the work pharmacists do is internal (screening, medication option selection, prescription reviews, dosage adjustments, comorbidities assessments, double checking etc) which can be mistaken for not doing anything at all so to make it more evident to patients, it needs to be voiced and brought to their attention in every way possible.

- don't let a session, no matter how quick, start and end without asking any questions. Questioning shows knowledge (which translates into more respect for the profession) and it opens doors for deeper interrogations on patient history which is required for optimal service and therapy initiation.

The mistake most dispensers make is that when patients request a product by name, they think the patient knows all about it. Sometimes this is true but often it's not. A friend, colleague or family member who isn't a health care professional might have recommended the product without putting much thought into it. It is our duty to check if it is warranted and safe for that particular person. 

When a patient isn't "engaged with" they assume they are automatically correct in their selection and the need or perception of requiring counselling is quenched. They might not realise that medicine is potentially dangerous. It always needs assessing, dosage monitoring and contraindication checks.  Always remind them that we are here to assist in medication selection amongst other things.  Even with repeat buyers (otc or chronic scripts), make sure to inquire about: who is it for? ( even when sent, the messenger's perception of that "pharmacist " will change)

What the need/problem is (establish it if new) and if there are any co-morbidities/ contraindications, allergies etc (dangerous factors to consider before initiating therapy). 

For repeat patients, inquire about the progress of therapy, is it helping, any side effects or noticeable changes etc?  

All these will let them know that you care, and are able & willing to assist further if need be. Boosting the "fix" to your face!

Scenario Example:  

Patient: good day

Medicine's Expert (ME): good day, how can I help you? 

Patient: I'd like some Mybulen please.

ME: sure, is it for you or someone else?

Patient: it's for my wife. She's in pain.

ME: where is the pain located and how sever is it sir? Does she have asthma, stomach ulcers or any kidney issues? Is she pregnant? 

Patient: hmm it's her neck, she slept wrong last night. No she doesn't have any of those things. But she has diabetes. The pain is average..

ME: alright, because she has diabetes, just be mindful that mybulen has antiinflammatories which further accelerate kidney damage in the long run. Therefore when possible opt for local pain relief such as Voltaren gel or transact patches which bypass systemic absorption and hence renal excretion.  

For now I can suggest you take a muscle relaxant combination like Uniflex if you really want tablets but rubbing it with an antiinflammatory gel should be sufficient. It relieves localized muscular pain, avoids codeine which can quickly become habit forming and provides a safer alternative. 

Patient: oh wow I didn't know that, thanks a lot. I'll take the uniflex and gel but also give me a mybulen just in case she shouts at me. 

ME: ok, just let her know that there are options next time she has pain. She should always inquire with the pharmacist for the best alternatives.

Patient: ok, you've been helpful. Bye now. 

Patient thoughts: 

*Wow they're really thorough!*

*they checked if the medication is safe for her!*

*they're really knowledgeable*

*maybe they can recommend something for my nom's illness* 

*I'll bring my script here next time*

Obviously this scenario is simplified and can escalate or be more complex but the idea is to always be inquisitive.  Fix your face, and we fix our profession. 

Hope this helps even one person and makes sense. What are your thoughts?

www.pharmers.co.za