It was about half a year ago when dad underwent a minor surgery. He was 68 years of age and his eyesight was not all good anymore. Fortunately, the problem was not a big one. Like most elderly, cataract plagued his eyes.
Cataract occurs when the lens within the eye becomes cloudy thereby obstructing vision and cause the appearance of flares under bright light. Cataracts develop because of aging, and possibly due to excessive exposure to sunlight.
The treatment for cataracts is fairly simple. An ophthalmologist performs a surgery to remove the diseased lens and replace it with a brand-new synthetic one. The new lens can even correct far- or near-sightedness as it can be made-to-order to accommodate any correction that previously require the use of prescription glasses. The surgery is usually completed within an hour and is done under local anesthesia.
He can see well the following day, and it took him about a week to adjust to the new lens. His follow-up with his ophthalmologist a week after the surgery went well. As for me, I was with him on the day of the surgery but returned to another state thereafter where I currently reside.
Fast forward two months; Dad dropped by to visit me since he is meeting up with his clients in town. It was then that I noticed two bottles of eye drops sitting on the dining table. Those were not his usual eye drops. You see, dad complains of dry eyes from time to time, so he uses artificial tears as a lubricant and to keep his eyes moisturized. Those eye drops are harmless when used on a long-term basis. What I noticed on that day was something else. Something that can potentially lead to blindness when used excessively.
I saw a bottle of steroid and a bottle of antibiotic eye drops.
I recognize those eye drops because they were prescribed by his ophthalmologist after his surgery, and surgery, was two months ago. The steroid eye drop was prescribed to reduce any inflammation that may occur after the surgery. After all, the eye was cut open, though the incision was very small, its use was reasonable. The antibiotic was to prevent any potential infection that may occur. These are fairly common medications prescribed after an eye surgery and they are usually used for 2 weeks to a month at the most. By then the wound should have healed, and the medications are not required anymore.
When overused, steroids can cause a condition called glaucoma, where the pressure within the eye is overly high which may result in blindness in later stages. Antibiotics on the other will not cause blindness, but irrational use will cause bacteria resistance which is still bad in a long run.
So why was dad still using it? Were there any complications to his eye surgery that the medications had to be continued?
I had to ask him and his answer was not something I expected.
“I just continued them (the eye medications) since nobody told me to stop. I assumed that I had to continue with the medications.”
That was his answer. Innocent as it is, I cannot find fault with his reasoning. He was the patient, he does not know better, which is why we are here to help him.
As a doctor, I can understand that his ophthalmologist was not wrong. He prescribed and dispensed the medications to him, and the medications will run out in a months’ time. So, he assumed that once he run out, that would be it. He did not expect that dad would have purchased more.
Dad confessed that he went to the local pharmacy for a refill. He told the pharmacists that he just had his cataract surgery and needed those medications.
As a pharmacist, I understand why the local pharmacist supplied the medications to him. He/She must have assumed that his doctor wanted him to continue with the medications since he just had his cataract surgery.
Too many assumptions for my old man. The doctor assumed, dad assumed, and the pharmacist assumed.
Let’s fast forward another month. An elderly lady walked into a pharmacy where I was practicing. She showed me the exact same bottles and asked for a refill. Immediately I could feel my hairs standing. Upon further probing, it was for her husband who just had cataract surgery and they assumed…
Refusing to supply the medications, I advised her to speak to her husband’s ophthalmologist again. They did, and she came back to thank me the following week for the sound advice.
When patients lack understanding of their condition and medications, we, the healthcare professionals cannot escape responsibility. Assumptions are dangerous things in medicine. Assume and your patient may risk limb and life. Let us spend a little more time to understand and educate our patients. Educate, Empower and Encourage. These are the values Dr. Raymond Choy from Doc2Us imparted to me.
Last but not least, allow me to preach a little to our patients as well. Although your healthcare professionals are responsible for any lapses in treatment, you are ultimately responsible for your health. Do not hesitate to ask your doctors, pharmacists or nurses if you have any doubts. Contrary to what you believe, they are more than happy to help you.