Wednesday, June 20, 2007
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It's time to present our preceptors - albeit very much delayed.
 Clockwise from back: Cheryl Cox (Exchange coordinator), Celine, Cheryl West (my preceptor), me and Bob (Celine's preceptor)
This is a photo taken after a patient care presentation, whereby we shared about one of our medication review experiences and reflected on it. It went pretty much smoothly, though I felt I could have done better if I had spent more time in my preparation for it.
We had the presentation after a buffet dinner at the faculty club. Interestingly, not only is the pharmacy practice different here, the manner in which they approach a buffet dinner is very different as well - very organised I must say. It is all coordinated: it starts off with salad so everyone just take a plate of salad first, then after finishing the salad, someone will suggest that it is now time for the hot meal, and so everyone goes to get their hot meals, returns to their seats, finish their food and repeats the cycle for desserts, followed by coffee or tea. Another observation worth mentioning is that people here eat in moderation even at a buffet. They do not go for second helpings, they do not fill their plates mountain high, and they do not walk out of the place in groans that their stomach is bursting, and so on so forth.
I do not mind the co-ordination of eating part; but for the eating in moderation part, well, I am quite upset by it. What better chance to eat heartily than at a buffet that you do not have to pay for?! considering the fact that we have been eating on budget all this while. I wanted so much to go back for second helpings on the pasta but because nobody did, I just remained in my seat, regrettably. Oh well, it is for the better anyways, because if I did go for second helpings, I would have gained all the weight that I lost the past 2 months in just one night. Now, THAT will be much to regret about.
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Monday, June 18, 2007
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I think there's a saying that goes something like this: He who laughs last laughs best. After I laughed at Celine's silly-ness yesterday, I had my share of stupidity today, of course setting celine off with a whole evening of laughter at my expense. As to how I brought this 'retribution' thing upon myself, I shall leave it to a first person account on celine's blog. I shall just write about my most unfortunate day - the consequences of laughing at others.
Having had a rather heavy lunch, we decided to go to Wendy's to grab caesar salad for dinner. After some deliberation, we each decided to get a combo, which includes a burger, the salad and drink. Initially, I was thinking of getting a cheeseburger, but due to the high amount of red meat intake the past few weeks, I decided to opt for the chicken nuggets. And so chicken nuggets it is! BUT! when I went to the counter, I subconsciously placed an order for a cheeseburger combo, absolutely not realising my mistake until I had my take-away in my hands. I was quite upset for a just a moment, but it was not too big a deal and so I let it pass.
As we were walking back to hall from Wendy's, we were chatting about our dinner plans when I apparently said an incoherent sentence, again unknowingly. Honestly, I can't quite remember what the sentence was, except for the 3 words " clean up it" instead of "clean it up". But of course, the very alert celine picked up my mistake and was highly amused by it. She actually repeated the phrase several times as we walked through the hospital, each time punctuating it with a chuckle. :(
Finally, we stepped back into hall. And little do I know that a finale awaits me. Having walked in my shoes for a whole day, I stepped into the shower area to wash my feet. I slowly turned the tap such that the water was just sufficient without causing an actual shower. However, just as I was to turn off the tap, a wrong direction brought me that whole stream of water that I had tried so hard to avoid, leaving me absolutely drenched in my tshirt and shorts. Unbelievable. Absolutely unbelievable. The odd thing was, it actually took me almost 3 secs to realise that I was getting wet and to turn off the tap! After trying to get myself dried as much as possible under the hand-dryer, I headed back to my room for dinner, still wet. To make things worse,
there was an encore. The Wendy's lady who packed my takeaway forgot to give me my favourite toasted garlic bread chunks to add to my caesar salad! I felt absolutely pathetic. Celine, well, I could see this big grin on her face though she generously offered to give me 2 pieces of her garlic bread chunks.
My most unfortunate evening - I would have scored full marks for content if I had written this for an essay. Moral of the story? Never laugh at others because that someone whom you laughed at, will laugh back at you four times more.
Darn it.
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Tuesday, June 12, 2007
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We were trekking along a trail, on the way to see the valley of the five lakes of Jasper. It was a long hike, and a stamina-stretching one to say the least. We were chatting rather happily with this guy we met along the way. It was just after about half hour to 45mins, we were about to get to a spot near one of the lakes, when we stopped. Leaving us rooted to the ground, what appeared before us were two huge black objects, the size of each of their heads three times that of mine, and their bodies towered over us as they stood on their two hind legs. The most feared black bears looked at us in the face. For a moment, the earth seemed to stop revolving as we held our breaths. Taking a huge gulp, we backed away slowly while keeping our eyes on the bears. Step by step, we inched ourselves towards safety...and almost spontaneously, all three of us turned and ran as fast as we could for about 5mins, stopping only when we were sure that the bears were not following after us. It is absolutely un-imaginable how relieved we felt.
Alright, confession time!: I lied. The only bear that I ever came close to is this:
 +The Jasper Bear - Mascot of Jasper Town+
BUT the above account is true! Just that the stars of the story were not us, but two groups of guys whom we met while we were on the trail and they on their escape from the bears they saw. We were about 10-15mins away from where the bears were, when the first group of 3 guys came by and warned us of the bears on the trail. We did not go any further, because that warning was sufficient to evoke fear enough for us to give up on our hike (seeing the bears themselves would have caused us to lose consciousness). We stayed in position and looked across, and saw two other guys running frantically towards us, only to be asked by them if we were the ones who were running away from the bears a little while ago. It is amazing what fear does to you eh?! Nevertheless, we thank God for these two group of guys who warned us of the bears, otherwise, we ourselves would have been in danger; though I must say the expressions on the faces of the guys before us were almost hilarious. Despite not being able to see the beauty of the valley of the five lakes, the journey is absolutely memorable.
Jasper is an incredible place. It is no wonder it is said that if you have not been to Jasper to see the rocky mountains, you have not been to Alberta, Canada. Thankfully armed with a car, we travelled a total of 1100km during the past 3 days, and though the journey was long, the sights along the road were just amazing. With each turn, the view before us is always different. As we traversed across the whole of Jasper, I am reminded again about how great our God is, and how privileged we are to be His children.
 
A night at the Professor's cabin.
Fiddle Creek
MedicineLake
Tangle Falls
I am definitely going back to Jasper again. I vote it as the best place for personal retreat - just looking at the mountains and hearing the mighty water rush transports you to almost another realm as the things of this world fades away.
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Thursday, June 07, 2007
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I conducted my second medication review with another patient today. This round of medication review, however, was a far cry from the first one - I left the home with a heart heavy with sadness for the patient and almost a feeling of injustice for her as well. I will try to share her story here, but due to patient confidentiality, I can only share this much. Let's call her Ms W; and as you read on, try to step into her world and I believe you will end off with a heart almost as heavy as mine.
Ms W is an elderly lady. In my eyes, she is a beautiful woman. Her smile is so genuine, so warm, and her eyes has this sparkle about them, and even a tinge of playfulness. A jovial lady, she talks and laughs with her neighbours at the lunch table, appearing almost as if she leads a happy life; but little do they know the silent cries of her heart that she has tucked away inside herself, the struggles she faces behind closed doors in her room.
Taking a total of 16 different medications everyday, she remains unable to free herself from the tie-downs of her medical conditions. With a medical condition for almost each system of the body, the main struggles she faces is that of pain (when I say pain, I mean severe pain that even a medication stronger than morphine is unable to alleviate) and having to visit the toilet frequently, which is affecting her sleep at night. Because of her pain, she takes almost 2 minutes to prop herself out of her seat, and a little longer to get out of bed. Because of her pain, she cannot stand for too long, and the use of her right arm is very limited. Because of her pain, she groans a groan that tugs at the strings of your heart, that made me very much want to be able to hand her a potion that can make her pain disappear. Unfortunately, her current condition has gone beyond medical discovery, and there is nothing more that can be done. The sad thing is not the fact that she needs to take so many medications, but seeing how taking that many medications is still unable to relieve all the discomfort that torments her each day. Because of her pain, she has to take a high dose of medication, with accompanying side effects of sedation and confusion. She finds herself sleepy most of the time: even while I was doing a review with her, she is not able to stop herself from dozing off once in a while although she tells herself that she needs to stay awake. In fact, she was telling me that most of the time, she sleeps the day away. I also notice that she is easily confused, repeating the few lines that she read over and over again because it is so hard for her to process the information she has just read not too long ago. Because of all these problems, she gets frustrated with herself; and as she tells me her story, my heart pains and I felt depressed. If even I, a by-stander, feel depressed, it is no wonder that Ms W herself suffers from depression.
Not only does she struggle with a poor quality of life due to her medical conditions, I believe there is also a lot of room for improvement in the quality of her emotional life. With difficulty in mobility, Ms W remains indoors all the time. She has a sad life history besides having to conquer several illnesses such as cancer. She lives alone in a studio room of the home for the elderly, and her two children visits her only once a week. In other words, except for times when she goes to the communal dining area for meals and on sunday mornings when her children visit, she leads a lonely life, struggling with all the pain and discomfort ALONE. Whilst as much as little can be done in terms of medical therapy, I believe that there is a whole lot more emotional support that can be rendered and that can go a long way. Unfortunately, it seems like nobody really cares that much.
Till this point as I am writing, whenever I picture the imagery of her smiling face in her room dotted with soft toys, I can't help but tear. She is such a lovely lady, yet there is such a sad story tied to her, and there is nothing that I can do to help. On one hand I believe that it is an issue that I have to learn to grapple with as I prepare to enter into the practice world where I will see many more such stories, yet on the other I refuse to enter into a state of de-sensitivity. In the meantime, while I am still here, I will strive to visit her more often, to spend some quality time with her. That is only as much as I can do.
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Wednesday, June 06, 2007
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"EDMONTON - First came the tornadoes, then a hail storm, reports of up to 50 millimetres of torrential rain, and floods." Just this evening, I heard over the news of the touchdown of a tornado in Edmonton. The sky was dark and a thunderstorm seemed imminent. The gusts of wind were strong and it seemed like the tornado was coming our way. It didn't, fortunately, and I was able to get back to hall safely and rather dry. Unfortunately for those places that were hit by the tornado and the heavy rains, which as reported were as much as 50mm in half an hour. How much rain that must have been?! I guess that must have been what Noah experienced when God decided to open the skies and flood the earth. My, how traumatizing! because right now, it seems like a thunderstorm is really coming my way. The winds are getting very strong, and my heart is saying: "Don't panic!" and "Dear God, please keep me safe! No fear!" Yikes! Looks like the storm is here! I shall snuggle up now. And trust me, it's way more dramatic than back home...
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Saturday, June 02, 2007
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I am still alive, thank you very much, although I can't quite say the same for my blog this past two weeks; but now that my own internet is up and going, I shall strive to blog more frequently.
A lot of things have been happening - at work that is (sightseeing now takes a backseat). And since a couple of people have asked me what this exchange program has installed for me, I shall attempt to summarise what I have done during the past 10 days at work, and hopefully this will shed a little light.
My day-to-day activities mainly revolve around filling of prescriptions, packing blister packs and dorsettes, both of which are patient compliance aids, and learning how to be effective in my patient counseling. Patient counseling is a skill that I really need to hone. While I have learnt in school what patient counseling encompasses, it is never quite the same when I am thrown into the deep blue sea with a few vials of medication, and left to tread water as I try to appear calm, composed and professional as I describe the important details of each medication, while fighting the jitteriness and trying to organise the jumble of information running in my mind. I thank God for a great preceptor who pushes me into the deep blue sea. Without her, I think I would never have gone out to even touch and have a feel of the water. Now, I am no longer that hesitant as before in approaching patients, although I still run through the main counseling points with my preceptor beforehand.
My three main projects for this preceptorship program is to conduct medication reviews for patients with chronic diseases, with my focus being on diabetes. A medication review is an extended period of time (usually about 1hr) spent with the patient for the purpose of finding out if they are having any problems with their medications and/or their medical condition; and for the problems to find or work out a solution. A medication review, in a nutshell, is a partnership between a pharmacist and a patient, for the purpose of achieving therapeutic outcomes and better quality of life for the patient. I completed my first medication review with a patient who was recently diagnosed with diabetes. It was a long process, from the preparation to the interview itself, and finally the report, which I am currently still trying to work on it; and my next medication review is already set at next week.
Pharmacists here in Alberta are very different, or should I say their role here is starkly different from that back home. Having dispensing rights, and recently prescription rights as well, the pharmacy profession is well-respected and highly regarded. Students apply for pharmacy school with a genuine desire to become pharmacists; and patients trust the pharmacists a great deal, so much so that they leave the management of their medications very much in the hands of their pharmacists, who will liaise with the doctors when applicable. Unfortunately, this culture has yet to be adopted back home.
That is generally a summary of what I do everyday. Though challenging and the amount of work is piling, I must say it has definitely been a great experience, and will continue to be as I learn more and more each day about what being a pharmacist truly means.
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Thursday, May 24, 2007
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I'm too lazy to post the pictures from more tours that I did on my last 2 days in Vancouver so I'll just leave them as photos in my camera.
Coming to Edmonton has been good on the whole. Nice people, nice programs, just that things are really expensive here due to the higher cost of living. To put things in perspective, a bus/LRT ticket costs CND2.50 each. So there! We try to cover distance by walking as much as possible but because my attachment place is across a river, I have to take a LRT. Alot of money is going to be spend on transport rather than feeding myself. sigh.
The weather has been a great challenge too. We go out in the morning, the sky blue and the sun shining; but the temperature is about 3-7 oC, which is much much colder than in Vancouver. Within less than a minute, my fingers are frozen stiff. No kidding. And the rain here is really solid...literally. It drizzled a little this afternoon, the next thing I knew, the prof told me it was snow and it was: small white specks from the sky, landed on my windbreaker as small bits of ice and landed on the ground as droplets of water. wow.
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1 John 4:9-10 |
This is how God showed his love among us:
He sent his one and only Son into the world
that we might live through him. This is
love: not that we loved God, but that he
loved us and sent his Son as an atoning
sacrifice for our sins.
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