Counseling points for Diabetes management

People with diabetes need a lot of discipline in terms of diet, exercise and adherence to their medications. Not having a good balance of any one of these can complicate the disease and may lead to severe consequences. So as a healthcare provider and a certified diabetes education, I present the following tips helpful for caregivers:

  • Type 1 Diabetics must test blood sugar at least 3 times per day in addition to testing before meals for insulin dosage determination as directed by your physician. First reading must be fasting (right after you wake up), the other 2 or 3 readings (postprandial) must be taken 2 hours after breakfast, lunch and/or dinner.
  • Continuous glucose monitoring or CGM is recommended in most cases of diabetes 1, especially kids. This set of devices measure sugar throughout the day and can alert the patient or parents if blood glucose goes beyond the set range. Most insurances cover them and most patients get copay assistance from manufacturers. Talk to your doctor for a prescription. Ask your pharmacist about copays. Dexcom for example, is growing popularity simply because of its ease of use and once daily calibration requirement.
  • Type 2 Diabetics must test blood at least 1-2 times per day. Fasting and one post-prandial.
  • People on insulin pump or severe cases of juvenile diabetes must test more frequently as directed by your doctor. These are ideal cases for CGM.
  • Keep a log of your blood sugar readings. Use “Daily blood glucose monitoring” function in Glucocious app to email your results to yourself or your doctor.
  • Know your A1C value. It is important to test A1C every 3, 6 or 12 months depending on the severity of the condition.
  • Always carry Glucagon Kit with you, especially school going kids or juveniles.
  • Keep glucose tablets or other form of immediate sugar in your pocket as a rescue in case you feel dizziness, palpitations, sweating, headache or have other symptoms of hypoglycemia.
  • You should eat smaller meals but can eat more frequently. Make sure your meals are consistent every day.
  • Please record any discrepancies in your diet or physical activity in the blood sugar log.For example: If you ate a Pizza today, write it down on the log sheet. Or if you ate an ice cream after dinner, document it. It is important to note these irregularities so your doctor can relate the significantly different glucose readings to these diet changes.
  • Scientific studies have proven that brisk walking is one of the top most calorie burning exercise besides sprinting. Brisk walking for 15-20 minues per day will help you control your diabetes on a long run.
    Please note that people with heart disease, respiratory disease, chest pain and shortness of breath must be cautious while exercising. Do not continue if symptoms present.
  • Measure ketones in urine. Do not exercise if ketones are high. Learn more about Ketoacidosis in Glucocious app or any good diabetes literature.
  • It is very important to be adherent to your medications daily on time. Missing a single dose can shoot up the blood sugar and may even become life-threatening.
  • It may be harder to control your blood sugar during times of stress, illness or infection. Make a note of abnormal readings in your log about your illness so your doctor can understand the reason.
  • Ask your doctor if you are or going to be pregnant or breastfeeding. Benefits/risks need to be evaluated with your doctor. Avoid alcohol in diabetes.
  • It is very important to consult a cardiologist, nephrologist, podiatrist, ophthalmologist and a nutritionist to prevent any complications from diabetes. Ulcers in feet or other extremities have led to amputations. Damages in retina have led to blindness. Kidney failure is also a big concern for uncontrolled blood sugar.
  • Prevent conditions like FLU, Pneumonia, Tetanus, Diphtheria, Whooping cough, Shingles, etc by getting these vaccines from your pharmacist or doctors. All of these vaccines are covered by your insurances in countries like US. These vaccines are considered as part wellness visits. I hope there could be similar awareness in India where providers are not very proactive in immunization.
  • Learn proper injection techniques from your pharmacist. Check CONSULT A PHARMACIST section in Glucocious app.

Is diabetes an Inflammatory condition?

Source: Getty images

Diabetes is such a widespread disease and is talked about so much everyday and everywhere. And still, I see patients on a daily basis who don’t take it seriously. Diabetes should be dealt with a lot of discipline . I am not gonna describe what diabetes is, what the symptoms are, keto acidosis, etc, etc. All of this info is available in a lot of published literature, books or online. What I want to talk about, is Diabetes type 2 and Inflammation! Yes, diabetes type 2 is also an inflammatory disease.

Diabetes type 2 is a condition where insulin resistance develops because of inflammatory conditions. This inflammation is in turn linked to obesity. According to a study, metabolic disorders range from a spectrum of undernourished to overnourished conditions. Undernourished people get susceptible to infections due to low immunity. Whereas over nourishment can lead to obesity which in turn can lead to inflammatory response, insulin resistance, diabetes, atherosclerosis and many more. Other factors like sedentary life style and mental stress can also lead to obesity.

People with chronic inflammatory diseases like rheumatoid arthritis, psoriasis, hepatitis C or other conditions may have more susceptibility towards developing diabetes type 2. These conditions combined with obesity and stress can all stimulate cytokines, macrophages and other inflammatory mediators which can inhibit Insulin sensitivity of insulin receptors. Cancer is another condition which is linked to development of diabetes type 2.

More on inflammation: https://pharmacist4u.info/what-is-inflammation/

Your diabetes coach- Glucocious app

Glucocious is an app that highlights the importance of moderating inflammation. Use of supplements like Omega-3, foods rich in omega-3 like “mung beans” and other anti-inflammatory supplements is detailed in this app. The app mentions some anti-oxidants that also play an important role in controlling inflammation. The app also provides handy consultation from a homeopath for managing diabetes and other chronic conditions. Glucocious helps you keep track of your numbers with the blood pressure- blood sugar log tracker.

Overall, striking a good balance in nutrition, regular physical exercise, education on diabetes, knowing your numbers, use of anti-inflammatory supplements and regular check up with your doctor are some of the good habits that will prevent obesity, stress and inflammation. Controlling inflammation will prevent diabetes type 2 and a lot of other inflammatory conditions.

Mental disorders- a wake up call!

It’s okay to talk about it- please don’t gossip!

Source: Mental disorder- Wikipedia

Back in the days, a person mumbling to himself or herself or depressed or schizophrenic or even having bed-wetting (nocturnal enuresis) problem used to become a subject of gossip or sympathy. And that person had to deal with embarrassment on a day to day life. Several other psychiatric problems like anxiety, bipolar disorder, GAD etc were never taken seriously. This is back in the days when there wasn’t enough research, diagnostic tools or awareness. What’s shameful is the fact that it’s still a STIGMA in certain societies! That makes me wonder about the uneducated behavior of the otherwise educated societies.

A personal s..t…t…tory!

Source: huffpost.com

Are you serious? I am so happy to see this that there is a day called “International Stuttering Awareness Day”. I wish people were aware when I was in high school and in my speech on Mother’s Day, I went berserk with my speech: “All mothers are g…o…o…o..o…d mothers”. And my friends who were also competitors broke out into thunderous laugh. I saw them blow out their laughs and I almost had tears in my eyes but I had to finish the speech. Later I found 2 friends in freshman year of college who were also stutterers and for the first time, I felt better that there are people like me. I am eager to get their reactions after they read this blog.

A piece from psychcentral.com: “The idea that stuttering is a brain disorder in the same category as schizophrenia and bipolar disorder is very controversial,” says Gerald Maguire, M.D., assistant clinical professor and director of residency training in the department of psychiatry at the University of California at Irvine. , a stutterer. In fact, there has been a push to recategorize stuttering as something other than psychiatric. “Some feel it attaches a stigma to a disorder that’s already very misunderstood by most,” Maguire said.

Some stats….

1 in 5 U.S. adults experience mental illness each year

1 in 5 Indians May suffer from depression in their lifetime. Due to the stigma associated with mental illness, a lack of awareness, and limited access to professional help, only 10-12% of these sufferers will seek help. (Source: https://www.weforum.org/agenda/2018/04/5-charts-that-reveal-how-india-sees-mental-health/)


1 in 25 U.S. adults experience serious mental illness each year

1 out of 8 emergency department visits are due to mental illness or substance abuse

Suicidal rates are 4 times in Lesbian, gays and bisexual individuals.


Suicide is the 2nd leading cause of death among people aged 10-34

Read more on: https://www.nami.org/learn-more/mental-health-by-the-numbers

These are some mind-blowing stats and facts. Please take mental disorders seriously before they become ominous and threatening.

Ripple effect

As mentioned in the article from National Alliance on Mental Illness, people with mental disorders can have:

  • Increased risk of cardiovascular and metabolic disorders
  • Substance abuse disorder
  • Higher rate of unemployment
  • High school students dropping out
  • Suicide in youths

Celebrities vow to reduce stigma

Source: zedge.net

It’s so cool when Virat Kohli backed up Glenn Maxwell’s decision to take a break from his job on grounds of mental health issues. What Glenn did is remarkable….Kohli says. That he didn’t hide from the world and why should he! Glen wants to take care of his health issue and then come back stronger! Read this link:

https://www.indiatoday.in/sports/cricket/story/virat-kohli-mental-health-glenn-maxwell-break-2014-england-tour-1618452-2019-11-13

A top Bollywood actress, Deepika Padukone runs a foundation called “The Live Love Laugh Foundation” that aims to create awareness of mental illness and reduce the stigma associated with it, with a particular focus on stress, anxiety and depression.

To summarize….

Mental disorders are on the rise. Why do you think the suicidal tendencies keep going up since 2001? Is it due to the pressure created by corporates to perform more and more? Is it due to schools demanding more and more from students? Is is due to the peer pressure of societies? Or is it the due to loneliness or self-centered culture that prohibits people to interact with people?

A few questions to answer to get solutions to improve our mental status. Are we mentally fit to live in this world with ever growing expectations? How can we prevent tragedies where mentally unstable people take on arms and claim lives? Can we take steps to spread awareness so people with mental disorders can come forward to get help? Modern research and studies have proven that counseling helps. Medications may be added to supplement counseling to help treat the mental disorders.

Please show vigilance, empathy and support to cure mental illnesses.

https://www.nami.org/Blogs/NAMI-Blog/November-2019/Things-Not-to-Say-to-a-Parent-of-a-Child-with-Ment

What’s your screen time!

Demon of the 21st century- A self inflicted pain

Source: healthhub.sg

Let’s not talk about decades when we used to play outdoors the whole day and there were only 2 TV channels to watch. We looked forward to every Saturday to watch SpiderMan and Star Trek on Sunday. Just a few years ago, before the invention of smart phones, parents used to play “Little Einstein” or “Sesame Street” or “Mickey’s Clubhouse” for their little children and would love watching themselves too. Parents and children both watched the TV together and laughed together. During this TV hour, they interacted with each other, discussed and had a great family time. Then there were these board games that kept the entire family engaged in playing and exercising their intelligence. And then of course, the famous bedtime stories from story books! Fast forward a few years and today, looks like a different and weird world!

Today, parents and children are both found submerged in this mania! Cell phones and tablets have become the norm of keeping children quiet in restaurants, public places or even social events. In fact, adults too are found deeply dived into their social media pages updating about their current statuses….lol! I mean who cares, what dish you ate today, what place you visited today or what clothes you wore! What a show off! What a breach of your own privacy! Why don’t we instead have that social interaction amongst ourselves and teach kids how to enjoy life without depending on these gadgets.

Do our kids use gadgets as Phones or multi-media?

Nowadays, every parent wants to gift their 5th graders a flashy smart phone for their protection in case of emergencies. But, why do we let kids play games for hours? Why do they have phones next to them at home? Why so many text messages? Why should teenagers have social media accounts? They don’t have time to finish their homework and assignments but……! Do you ever monitor their screen times? Don’t be shocked because we are the ones who taught them all this and giving them the access to these dangerous toys in their vulnerable ages.

Why do we let these electronic devices enslave us? We spent hours poking on “likes” without reading the posts, giving “thumbs” and even copy-paste birthday and anniversary wishes but we do not have time to call a friend in months. And the millions of games that we all get addicted to…wow! Where is the time to call our family and friends? Look at this picture….hahaha!

Source: https://images.app.goo.gl/yMdJ5WF7hAPcFP9CA

‘Smartphone Blindness,’ And Other Health Hazards Of Our Favorite Gadgets

Alice G. Walton, Senior Contributor, Healthcare

Source: https://www.forbes.com/sites/alicegwalton/2016/06/24/smartphone-blindness-and-other-health-hazards-of-our-favorite-gadgets/

Serious health and behavioral hazards:

1) Depression- due to Lack of social activity

2) Eye strain, Headache, Fatigue and Stress- due to Overworking of cranial and optic nerves

3) Poor sleep patterns- due to Abusing gadgets for long hours

4) Muscle stiffness and in-coordination- due to Sitting in one position for hours

4) Car accidents- due to Texting while driving

5) Obesity, Diabetes and Cardiovascular- due to physical inactivity, sofa-ridden life style and irregular eating

6) Other researched developmental and psycho-neurological disorders like awkwardness in public, shyness to talk, incompatibility issues with others, inability to focus in school, fear of exams, fear of dealing with challenges, etc

While I personally love the technology and the convenience they offer, they should not be abused. Even the makers of these gadgets didn’t intend to cause health hazards and alarming developmental issues in children and adults. I urge my audience to practice resistance to these machines, lead their kids by example so they can live a better life and independent of any gadget.

And for God’s sake, don’t take your million selfies while walking down the hallways…😂

Epidemics of Preventable diseases???

Get immunized or hospitalized, your choice!

Source: Indiatoday.in

So! It took the great Big B to campaign against Polio and now India is literally Polio free. But that’s just one disease. What about children still being hospitalized for FLU, pneumonia, tetanus, diphtheria, meningitis? What about adults and elderly who cough up to death? Who to blame? People or doctors!

People are admitted to hospitals for FLU, pneumonia, shingles, diphtheria, meningitis! They refuse to get the vaccine and then agree to spend hundreds of thousands in hospitals. Even after this, there is no guarantee of survival depending on how severe the condition and the complications! In most cases, people are responsible for this adamant behavior but in some cases, people aren’t even educated by their healthcare providers. They don’t know that one shot can prevent the suffering, hospitalization and even death.

An article published by NIH states that Pneumococcal disease is like a burden and it’s prevention is urgent. There is a lot of cost and stress associated with pneumonia. And if not controlled, can infect the patient’s family members.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6503715/

Almost everyone (including me) got chicken pox in their childhoods. Guess what! They are all susceptible to get Shingles, a painful condition which affects eyes, face or even other parts of the body. Most of these diseases cause enormous pain, trauma, hospitalizations and even deaths. Not only patients are affected, but since they are contagious, family members can get sick too! It’s so important to get adults vaccinated with Tdap in households where a baby is going to be born because infants do not get this vaccine till 2 months after birth.

Initiative from healthcare providers

Source: https://m.timesofindia.com/life-style/health-fitness/health-news/the-importance-of-flu-vaccination-and-associated-myths/articleshow/70316540.cms

In India, education and awareness are a big opportunity. This is where primary care or family doctors must play a vital role. In India, the concept of annual check up almost doesn’t exist. So there is nothing like wellness visit where doctors can offer them the vaccines. Patients visit the doctors only when they get sick….period! And that’s why a mass campaigning about primary care and immunization is a must in India. Meanwhile, the doctors or healthcare providers must take it to themselves to educate every sick patient that comes to see them.

India and the world

Source: times of India.com

Unlike people in countries like US, people of India are not aware of vaccines to prevent several diseases. Rural or urban, the ideology of prevention is not as prevalent as in other countries. As a matter of fact, India is behind Bangladesh or China in this aspect. So it’s not about being Western or Eastern, it’s all about prioritizing. As we all saw, when India prioritized eradicating Polio, they were successful. They need to figure out how to educate masses on immunizations.There are countries that create so much awareness and educate the masses about preventing something like HPV infections which are so dreadful in growing adolescents. There is so much research going on to create vaccines for conditions like HIV, cancer and even diabetes! So there is a lot of opportunity for India to cope up with developed nations in this aspect. India, being an emerging global leader, must develop strategy towards Prevention of communicable diseases.

In US, access to vaccines has dramatically improved since the retail pharmacy giants like Walgreens got themselves in the business of Immunization. FLU shots are offered as early as August till end of FLU season and other vaccines are offered all year around. So, millions of people are vaccinated everyday with one or the other vaccine. There are a lot of government clinics where people can get their shots for free.

Myths and Barriers….hmm

Source: rati-fi.com

Many myths and barriers around immunizations:

1) Vaccines don’t work- Trying to defy science

2) Vaccines are not safe- Rumors

3) Vaccines cause bowel disease – https://www.ibms.org/resources/news/vaccine-preventable-diseases-on-the-rise/- This claim was debunked by the scientific community

4) Vaccines cause Autism- Vaccine Autism Scandal from decades ago

5) Vaccines can actually make someone sick- How? On the contrary, vaccines activate your immune system to store immunity and use it when needed.

6) Religious barriers- No comments!

Because of all these myths and barriers, a lot a anti-vaxxers started propagandizing against vaccines. Hence, there has been a significant rise in preventable diseases lately. The WHO has reported that the number of measles cases reported in the first three months of 2019 has quadrupled in comparison to cases reported at the same time in 2018, with the Ukraine, India and Madagascar being the worst affected.

So, to sum up, do not be a anti-vaxxer. Talk to your doctor or pharmacist and get your shots today!

“The ideal thing would be to have a 100 percent effective AIDS vaccine. And to have broad usage of that vaccine. That would literally break the epidemic.”- Bill Gates

Health care, Seriously!!!

“A bitter pill to swallow”

Source: the statesman.com

I am a vital part of the healthcare system of America and we often blame the system for so many things and rightly so! Talking about the Medicare coverage gap, deductibles and coinsurances, restrictions of choices of doctors, access of primary care and the inflated costs of medical care as well as medications- am I right?May be missed a few other things! But when I experienced the healthcare in the world’s biggest democracy, I was so shocked and frustrated! Yes I am talking about Indian healthcare system. Today’s blog will discuss only about lack of empathy by some doctors and not cover the entire healthcare system.

Till a couple decades ago we used to hear in the news about kidneys being robbed. But in today’s age , for me to hear that needles are being reused on several patients in highly reputed hospitals is quite shocking.

An elderly woman,who is a patient of COPD, diabetes and Congestive heart failure got contracted with influenza. She went to a doctor who also confirmed FLU on basis on signs and symptoms but he decided not to prescribe her anything. Two days later , she was rushed to ER. Her FLU got worse, complicated her COPD and her Oxygen saturation got so low that she was breathless. Don’t ask me what happened in the hospital (that’s another story for another day) but the woman is fine now!

A Chronic Obstructive Pulmonary Disease (COPD) Patient:

http://sphweb.bumc.bu.edu/otlt/MPH-Modules/PH/RespiratoryHealth/RespiratoryHealth5.html

For me, as a healthcare provider or as a pharmacist, it’s so vital that COPD patients must have an inhaler of corticosteroid/bronchodilator and an inhaler of short acting bronchodilator. But I guess, some doctors on India do not think so! I have researched the medical standards and protocols of Indian medical care and they too run parallel with the protocols in US. So what are these doctors doing? Shame on their medical practice! And what about the doctor who didn’t prescribe Tamiflu in the first place, waited for the patient to get critical and be hospitalized and then eventually administer Tamiflu for Influenza! Is this intentional or ignorance? If intentional, then I am not shy of calling it greed or corruption.

Duplicate medications from different manufacturers:

Source: Squawkfox.com

So this is another chapter of the “chapter doctors”. One will write Nodosis and other will write Sobisis- both are different brands for sodium bicarbonate. The funny part is that the first doctor referred the second one and yet both prescribe their own brands knowing that the patient already has the other one! This is a white collar loot! They get cuts from Pharma and pharmacies for prescribing their brands besides getting the referral cuts from the original doctor (that used to be a staggering 40%!). Imagine how can poor and low middle class people tackle these! A recent example that came to my attention was Septa Q 10(Co Q 10). It costs Rs 5000 odd for 50 pills whereas there are so many other generics of this supplement ranging from Rs 500 to Rs 1000 for 60 capsules. Even in US, which is thought of being the most expensive country for medicines, it costs about $15 for a bottle of 60 capsules which is equivalent to be about Rs 1000 in Indian currency. Doctors need to be empathetic with patients’ socioeconomic statuses. Please stop being self centered, arrogant and careless.

India- a country known for medical tourism! A lot to do with a great leader in place!

http://www.eturbonews.com

India, known for all of its good reputation, is a known global medical tourism spot for various reasons. India has produced world renowned doctors, researchers, procedures and treatments. I am proud to see so many Indian doctors doing so well in US and other countries. They have a strong work ethic and very pragmatic in their approach which I think makes them great Practitioners. Above all, the cost of treatments, surgeries and procedures is so affordable for people in western world that they often are willing to opt to go to Indian hospitals. Indian 5-star hospitals are so inexpensive as compared to a regular hospital in western world especially to people who have no health insurance.

Source: http://www.indiatoday.in

Today, India has got such a great leader who has brought such dramatic changes in a matter of few years. Today, corruption is being brought under control. Remember it’s a country of 1.3 billion people, so you cannot eradicate corruption right away. It will take another decade of Modi administration to have a good control on corruption but I can definitely feel that it’s a lot better than what it used to be in 6 decades of independent India. Mr Modi has been instrumental in optimizing Indian healthcare in several ways. Poor people have got most incentives. They can get their treatments for free! This is a dream come true because for a country to be a successful entity, the poor people must be given the first consideration.

So, coming back to our discussion of our so-called doctors, it’s so important that why realize their role in this modern India and forget their traditional ways of practicing medicine. India cannot tolerate a black sheep or gamble at stake it’s reputation of being a global medical tourist spot, because of such careless and arrogant doctors. Do not make us ashamed but make us feel proud! This is coming straight from the heart of an NRI (non-resident Indian). “Vande Materam and I will continue swallowing these bitter pills till I get some sweet ones.”

http://www.pinterest.com

Happy Diwali to all my Indian brothers and sisters!

Drug operated society: Humans or guineapigs!

‘Performance-enhancing drugs have become the key to bulging biceps and on-screen six-packs, as the pressure for stars to shape up fast leads actors (but not “Man of Steel’s” Henry Cavill, who bulked up naturally) to opt for a “shortcut.”’

Source: https://www.hollywoodreporter.com/news/hollywood-steroid-use-a-list-609091

Decades ago, when people faced some psychological problems, performance issues or other minor health concerns, they sorted them out through non-pharmacological methods. By practicing self-control, discipline in food, drinks and physical activities, refraining from indulgence in bad habits, a lot of socio-psychological, obesity and performance issues were cured or controlled! What about this age? People are educated and hence there is a lot of awareness of medical conditions and treatments. That’s supposed to be good but are we trending in the right direction!

CNS Stimulants (ADD/ ADHD drugs’ abuse)

Source: American addiction center

This is a big problem! Students are seeking CNS stimulants like Amphetamines to stay awake to help them study for longer hours during exams and help them concentrate. Some students even take caffeine tablets which are sold over the counter in pharmacies for that purpose. These drugs are supposed to cure serious Attention deficit problems in patients affected by this condition. So why do these students abuse them? Do the prescribers educate them about the potential side effects before prescribing them? Do doctors counsel them about practicing good habits needed for studying or concentrating? If these students can manage their time well, then do they need to stay awake during nights?

I don’t want to sound too “old school” but I guess, parents are too modern to find time for their kids these days! I remember, back in those days, I used to wake up early in the mornings to study for exams. My mother used to wake me up, make me breakfast and tea while I was brushing my teeth, saw me getting breakfast and then made sure I started studying. This was the care and attention in those days about a few decades ago! I didn’t know what ADD or ADHD meant!

Source: Adderall addiction support

Anorexiants’ abuse

This is the world where everyone wants to show off their outer beauty, isn’t it! Most women and men want to cut down their waists and get that perfect shape….lol! Sorry for the lol but again, I mean, why would they not have control on what they eat, how they eat and do physical activity and rather choose short cuts of taking pills! These anorexiant pills are also CNS stimulants like Amphetamines. These pills can make you starve and malnourished. But I guess, the competition for outer beauty has overtaken wisdom or constitutional approach!

Source: indiatimes.com

Anabolic steroids’ abuse (Machomania!)

Yes! I call it machomania! These men wanna be like Rambo or Terminator…..hilarious! They pursue this dream to an extent that they even start taking something that completely shocked me when I first saw it…..Anastrazole! Anastrazole is an anti-estrogen drug used to be treat breast cancer in women. It was mind- boggling when I first saw a cocktail or testosterone and Anastrazole. I first thought that it’s a serious mistake, so I called doctor’s office to clarify it. I was told that he is prescribed the two to enhance his testosterone and gave me a diagnosis of hypogonadism.

I couldn’t understand the logic here and I kept wondering why this person is trying to boost testosterone production with Anastrazole when the person looks perfectly normal. I could see that his muscles were tearing off his clothes so how is he hypogonadic! Then I saw more prescriptions coming and this trend continued from a few doctors’s offices. It doesn’t take too much for such trends to gain popularity but thanks to our pharmacists who create that check point and try to control this macho-mania! This treatment can literally kill men in a few years. Performance enhancement short cuts can cut short your life.

To summarize, pills are not necessarily the solution for everything. Taking pills without considering long-term harmful effects can be detrimental. Ask your grandparents for some “old school” methods to overcome some of the psychological issues which we think are psychiatric. After all: “man made drugs so use them humanely”.

Drugs in need are drugs indeed!

Give me my pills…..! How often did we hear this in our pharmacies? Most of the responses were: “we don’t have this in stock”! A dark chapter of greed, abuse and insanity- Opioid overdose/ drug diversion!

A true story…..

Courtesy: http://www.CDC.gov

Katie grew up with a mother, June, who struggled for years with addiction. She never knew when she would see her mom again, or in what condition she would be. June began using drugs and alcohol recreationally at the age of 14, and as she grew older, it developed into opioid use disorder.

June made a few attempts at voluntary treatment, but she would just walk right out. Later, when she was arrested, she was given the choice of going to jail or going into treatment—thankfully, she chose treatment. June finally was able to work with counselors to help her on her journey to recovery.

Katie didn’t understand what her mother was going through when she was young, and she carried a lot of resentment towards her. It was hard to separate her mother from her addiction, and from who her addiction made her into. She was able to learn that substance use disorder is a disease. It wasn’t her mother’s personality or who she was as a human being – it was just the chemical that made her body feel like she needed the drugs. Now, Katie feels that it is important to share her perspective of loving someone with opioid use disorder.

Read more at…….

https://www.cdc.gov/rxawareness/stories/katie.html

A decade ago: As I walked into my pharmacy at 8 am, I used to see a mob of people waiting for me. Some of them with walking canes and others with no walking canes. As soon as they saw me, “hi doctor”, “good morning doctor”, “how are you”! The common thing about these people in the mob was that they all had the same prescriptions to be filled. They all had: one prescription for oxycodone, one for Soma, one for Xanax and guess what….one more for Ibuprofen…..lol!

Another thing that was common was the fact that they all came from the same or similar clinic from 60 miles away from my pharmacy. The last common thing was the same diagnosis of pain, already written on the prescription: Lumbar radiculopathy or herniated disc!

Such was the scenario those days. Unfortunately, this was growing into an epidemic! It all started with “pill mills” or pain clinics getting greedy and offering to write serious narcotic drugs to anybody who wants to make money off drug diversion. These doctors would have fake x-rays, MRIs to prove the pain diagnosis (remember….herniated disc…..lol). These so-called patients would then bombard all pharmacies to get these prescriptions filled.

The strange thing was once a pharmacist filled one patient’s prescription, there would a set of patients walking in right after the first left. Same prescriptions, same prescription pads and of course……same diagnosis; I hope you remember by now! Sometimes, the entire household had the same prescriptions……that’s freak’in hilarious! How could all members of the same family have “herniated discs”……😂

There were a lot of creative ways of how to inject Oxycodone into the body! And interestingly, there is a vocabulary too for these drugs. Here are some of them:

Hillybilly heroin- Oxycodone

Ecstasy- MDMA

Bar- Xanax

Courtesy: https://www.swissinfo.ch/eng/opioid-case_drug-addicts-entitled-to-disability-insurance–says-court/45141752

Sad thing to this was that genuine patients were denied access to pain medications. A lot of patients suffer from excruciating pain from cancers, surgeries, accidents, etc. But because of this whole species of “drug traffickers” and “pill- mills”, the true patients still suffer a lot.

Dear audience, I juts want to pull your attentions towards opioid epidemic. Today, in America, there are thousands of deaths related to opioid toxicity due to overdose. Not only deaths occur, but millions of lives are also ruined. Imagine, these dangerous drugs falling into hands of our own kids. It not only destroys the individual but also drowns the entire family. The careers are doomed, the reputations are damaged and all that’s left is sadness, tragedy and hopelessness.

Courtesy: http://www.CDC.gov

Thanks to the efforts of DEA and other organizations to combat this serious issue of opioid epidemic! Today, there are a lot of check points and measures to be exercised by Practioners and pharmacists before dispensing any narcotic. Rigid requirements of IDs, validation of a controlled substance prescription, vigilance about patient’s prescriptions history from eForce and exercising professional judgment- are all legal and ethical requirements that are implemented by health care team.

Remember to use drugs to cure medical conditions only and not abuse them because after all- “Drugs in need are drugs indeed”!

2 cents from Tom Hanks!

“I was heavy. You have seen me in movies, you know what I looked like. I was a total idiot”: Tom Hanks

By Jamie McCarthy/Getty Images

I have been wondering what should I do for my first ever blog. While I was so excited to present to the world my first blog, I was equally worried too. The first impression matters, right! After a lot of due diligence and research, I came across this article about none other than my favorite superstar actor, Tom Hanks.

Cast Away just blew my mind. The actor who has always displayed so much versatility  from “Apollo 13” to “Catch Me If You Can” to “Terminal” and what a cast in “Cast Away” is a perfectionist according to me and a lot of his fans. So, for him to admit that he was an idiot is bound to have a lot of weightage. Why is he saying so? 

Tom Hanks was diagnosed Diabetes Mellitus type 2 in 2013. He mentioned to the media that he is responsible for acquiring diabetes. He blamed his diet and inability to control weight. He thought avoiding buns from harburgers would be enough but later he realized that it would take a bit more to control his diabetes.  

So, what I am trying to come up to is: If Tom Hanks admitted openly to the world that he is responsible to get diabetes, why can’t we do the same? The first step towards progress in life is owning the responsibility. You can’t blame others for acquiring DIabetes type 2. Once you recognize the mistakes and careless attitude towards life, there occurs the birth of realization. The famous quote “God helps those who help themselves” is applicable in our lives very much. 

I mean let’s be honest. We all take our health for granted. Don’t we fall for that dessert, don’t we get enticed with that big barbeque party, don’t we chug in a few bottles of beer here and there, how irregular are our meal times often? Most importantly, don’t we place our jobs on top of our health. What’s the number 1 killer, guys? Any guesses…………STRESS, it is! A lot of these things can be controlled, some are just out of our control these days. What an irony! The more we have these days, the more diseases we have acquired. Back in the good old days, there was less money, less resources, less access to modern devices and guess what, LESS STRESS and HEALTHIER LIVES prevailed. 

There is so much advanced medical care these days and so much emphasis on prevention of diseases but still, we are on the rise of getting less healthier day by day. Can we do anything in such circumstances? If so, what and how? 

1)The first step is KNOWLEDGE of the disease and ways to control, if too late to prevent it: The prerequisite to this step is admission that only you are responsible and no one else for your diabetes-just like Tom Hanks did. 

Consult your doctor and your pharmacist to get all the information needed about diabetes and its treatment. Know your medicines, how to take them, any precaution while taking the medicine, side effects, drug-drug or drug-food interactions, etc 

Glucocious app can come handy for people diagnosed with diabetes and for caregivers too. Download it from your app store or google play.

http://www.glucocious.com

2) Plan your action to control Diabetes: Make a winning action plan with respect to your meals, medication, sports and monitoring glucose. Remember, you can still enjoy your delicacies and be spoilt occasionally as long as you have a good game plan. Have a team around you, usually family members or friends, to be part of your game plan. It does require a good team work to win this game of diabetes.

Miami heat Winning 2013 NBA championship

3) Perseverance and follow up: It’s so easy to make a plan tonight and forget it tomorrow…lol! That’s how most of us do. And that’s why it’s important to have a team that can check whether the plan is being implemented or not. Perseverance is one thing that goes a long way throughout the life and of course,  management of diabetes is much more relevant to it. Make sure you follow up on your doctor’s appointments to see whether his treatment and your plans are working or not. And lastly, be happy, be positive and enjoy yourselves! That is my “2 cents” to all readers.