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A brief lesson in preventive health care

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Posted: Sunday, September 15, 2013 12:00 am

This was not my first rodeo. Last summer, I became acquainted with the organized chaos that is the annual Remote Area Medical (RAM) mission in southwest Virginia.

I knew what it felt like to wake up at 4:30 a.m. and see your first patient by 5:15. I knew it was going to be sweltering in July at the Wise County Fairgrounds and I knew there was a good chance I’d become hoarse. But I also knew how much joy it would bring me to see a patient smile despite his or her circumstances, and that is what brought me back.

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Because I was already familiar with the organization and flow of RAM, I was able to focus more on individualized patient care this year. Many of these uninsured and underinsured patients had been in line for up to 24 hours awaiting free health care, and I was looking forward to giving them my undivided attention.

I spent a majority of the Friday clinic at the A1C station — where patients’ blood sugar levels were being tested — with other student pharmacists and pharmacy preceptors. The A1C station actually gave me time to have meaningful conversations with patients about their knowledge of diabetes and its implications when it comes to their health.

Two of my most memorable patients were women who had never been diagnosed with diabetes. However, their blood glucose levels were slightly elevated and they had strong family histories of the disease. Both women knew what living with diabetes looked like and both knew of its devastating effects if it was not taken seriously.

We spent the five minutes it took for the test to run talking about their loved ones and their fear of the disease. Since they came from areas where unhealthy eating and little-to-no exercise were quite common, I was not surprised to hear that neither was doing much to prevent diabetes despite the known risk.

Both women were visibly nervous about what their numbers would imply and knew their lives could potentially be changed forever within the next five minutes.

The anxiety of the unknown created an opportunity to talk about how they could be taking better care of themselves. We discussed ways they could incorporate more exercise into their daily lives and how to make healthier food choices, even with a limited budget. I could tell that what they thought was completely impossible — like getting more exercise — might not be that far out of reach.

When the timer reached zero, even I was nervous. If the number read higher than 6.5 percent, I would be the one informing them they would need to see a physician at the medical tent for the official diagnosis of diabetes. I dreaded that conversation as much as they did.

Fortunately, both women had readings of less than 6.0 percent. Their relief was palpable. While they felt as if they were “off the hook,” I reminded them that even though they were in the clear today, one day the numbers could easily read differently.

When counseling patients, I am not typically a proponent of fear tactics. However, I think those long five minutes forced these women to give serious consideration to their risk of diabetes. Though nothing I told them was earth-shattering, I can only hope our conversation resonated and that they were motivated to make at least a few changes toward a healthier lifestyle.

While their outcomes were upbeat — for now — a handful of other patients did not get off the hook. Fortunately, all the necessary resources to guide these patients through the process of understanding and living with diabetes were right within their reach that weekend — and without any boundaries of insurance or finances.

The experience may have been hot and exhausting, but knowing I might have made a small impact on a patient’s life, just through five minutes of conversation, is what will bring me back next year. It’s also something I will continue to practice when I become a full-fledged pharmacist.

A little preventive health-care counseling can go a long way. It’s usually free and the results can change lives.

Erika Lambert, a third-year Pharm.D. student at Virginia Commonwealth University School of Pharmacy, is one of 21 pharmacy students, residents and faculty who participated in the Remote Area Medical mission (RAM) 2013 in July. She will serve as pharmacy student leader next year. She also is co-chairwoman of Project Chance, a student-designed community outreach program that promotes delivery of comprehensive pharmacy services to patients eligible for the 340B federal drug-pricing program. Contact her at lamberte@vcu.edu.

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  • Read more of Charles F. Bryan Jr.’s columns here

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