I am not talking about McDonalds. Nor am I talking about the day before a public holiday which is always very very busy. It was raining heavily this morning. In fact it woke me up at about 6am. Usually I love morning rain. But this morning, my first thought was "How on earth I am gonna reach my workplace without getting all wet??!". Kinda ironic eh? Lol.. Usually I love rain because it deters people from going out to get their medical treatment. While the rain did its magic in the early morning, it started to rain patients at 10am onwards.
Instead of the usual irritating "I-know-it-all" ya-ya-papaya patients, today I got more of the nicer ones, the ones who really need explanation about their condition and advise about their medications. The first one was a 85 years old uncle. For his age, I would say that he is still very sharp and healthy. He knew his medication well and he spoke English! He could even be able to walk unaided! Anyway, his main query was about TCM vs Western medicine. Apparently he went to TCM practitioner and was told that he had a weak heart which resulted in swellings on the legs, stomach, around the eyes, and difficulty breathing. Ginseng was recommended for his "weak heart". Thus he wanted to know whether there is a similar "magic pill" for his "weak heart" from the Western medicine. Upon checking his history, from Western medicine side, we call it "heart failure". So I spent a lot of time to explain his conditions and how the medicines he currently taking for hypertension are also helping his heart. In addition, his shortness of breath might also be due to COPD and hence he was given salbutamol.
After a good 30 over minutes, he seemed satisfied and after that I discussed things with my preceptor. I learnt a few important things: I am still lousy in terms of getting patient history right and it is actually alright to stop/discourage people from taking TCM. I thought patient was already taking ginseng (but after confirming with him again, I found out that he hasn't started, he was only thinking of starting it). And I thought the approach to people taking traditional medicine is similar to those taking supplements: if you feel it works (even by placebo effects), then go ahead! It seems like for people on long term medications, it is best to avoid and discourage traditional medicine since nobody knows how the things will result when used together.
I am glad for these learning points because at the next second, I had another patient who asked about combining his medication with Indian herbs! So I immediately used my new knowledge: 1) Are you already taking or thinking to start taking? 2) No! Better don't use in combination. If you really insist on that, must let your doctor know first. Lol. Anyway good for this patient to ask about his herbs because from that I discovered that he was not aware that there is an increased dose in his medication.
These 2 patients actually shook hands to thank me after our conversation. Wow! Very rare occasion. In fact, the Indian man insisted on filling a feedback form to thank me. That really touched me! Lol.. although it would be better if he could write it himself instead of asking me to write down what he wanted to say. It felt as if I was complimenting myself. Haha..
In the afternoon, for P-item, there was someone who previously bought something from me. I vaguely remembered her but she remembered me! Wow that was really touching. She even remembers that I don't understand mandarin. Haha.. Too bad after her there were 2 other people so I was a bit in a hurry and irritated cause she talked a bit too much :p If nobody else behind her, I would be happy to talk longer. After her, I managed to intervene a father from giving a nasal drop for his son's runny nose.
On Tuesday, I gave information about supplements. I felt a bit bad because at that point of time, I was not sure normal sodium intake. The person was going to take Brands' Essence of Chicken which contains 80mg of sodium. In light of her Na+ value, hypertension, and kidneys, I told her not too. After that I found out that recommended sodium for normal people is 1000-3000mg. For people like her, something less than 2.4g would be good. That means 80mg actually does nothing and she should be fine with that. Haiz.. A bit sad for not being 100% accurate. And what makes me more ashamed is that the person actually trusted me to the point that on Wednesday, she tried to look for me on the phone. But on Wednesday, I was somewhere else for attachment =x Of course my first thought was: oh shit, what if she realised about the salt intake thingy!
So yeah, overall it has been a great week. Too bad these kind of people form only the minority. If only the majority of the patients are like these, things would be much more encouraging for everyone :)
For now, I should enjoy the break and no matter what FINISH THAT ASSIGNMENT THIS WEEKEND!