Assalamualaikum, first entry for this year. Hehe. Well, hello, currently I am at work, hence, this post is created. Because typing in my house, will be a battle with them, kids. haha. someone will jump on my lap , the other one shout at me, asking me to see whatever things he is doing ( which he thinks super amazing eg, arranging the blocks). Yeah, that is mummy of two look like, I wonder, what mummy of three would look like thou, haha!
Today's topic is about work, how to counsel patient to comply to medications or probably to start new treatment for eg antihpt, insulin, antilipids , in which majority is usually is already comfortable with the common things they have been going through, typical answer from patient that I usually get as KKMO,
" Saya nak cuba diet- kontrol la doktor, saya rasa susah nak makan ubat, sebab tak mau makan ubat selamanya."
" Saya dah biasa makan ubat doktor, saya kadang amik kadang tak, la ni saya janji nak sepenuhnya makan ubat ikut masa."
" Saya takutla doktor nak cucuk insulin! saya takut jarum."
" Saya x mampu doktor, nak beli jarum tak mampu, nak cucuk insulin x dak duit."
" Saya takmaula doctor makan ubat, saya rasa tekanan darah tinggi ni pasai tak lena semalam." - and this patient came with high bp all along.
Whoever thinks that being a healthcare doctor is easy, please think before saying and please be in our shoes at least a day. You really need a very good rapport with patients, good communication skills to counsel them. Because majority of patients - especially chronic patients are elderly, and being elderly, of course they have their own stand, which you, as a young doctor needs to break in order to maintain their good health or to start treatment to particular disease they are having. It's hard, really. You really need to have a lot of patience to cousel, again and again without being bored. and please document every single thing eventhough they refused them so many times! You can give them time period to think ( in case of antilipid if not that high , or in case of to commence insulin) explain properly to the patients regarding the complications they possibly can have if they dont control lipid level or blood pressure, or sugar level. Explain to them about sudden death causing by heart attack ,or stroke, bed- ridden one. Try to give them situation. What if, they have stroke, who is going to take care of them, who is going to take care of their small children, in case younger patients having hypertension? You give the worst scenario that possibly can happen, not to scare them but more of, to teach them and for them to prepare for the worst. Some patients can get soften when you explain in a good manner, and with confidence. Explain to them that you don't benefit a thing, you just actually do your job as a doctor, trying to educate people for them to take care of their own health!
In case of insulin, it's very infrequent to find patients who is agreeable to insulin during single consultations. usually, we keep repeating and informing the patients who are at high chance of converting to insulin, those who have uncontrolled bsp and hba1c. Keep bothering them, keep telling them until they say yes for insulin. offer them help and let them know that they wont be left behind once they start on insulin treatment, offer them to come to clinic anytime for consultation if they have any queries on insulin, about techniques. Pursuate them that insulin needle is as small they cant even see by their naked eyes.
All in all, it depends on our ways on telling patients and consulting them. Together we control sugar, blood pressure and lipid in our body. Eat clean and be healthy people!
