Solid Organ Transplant

I’ve never had to deal with a chronic ailment and as a result I feel I’ve taken my health for granted. Roll playing the part of a recent transplant patient in class this week helped me realize challenges that the newly diagnosed may face and to appreciate the fear associated with the lack of understanding of medications and procedures related to their disease. These issues assisted me in visualizing and establishing counseling points that I will be sure to cover with patients of new and chronic illnesses.

Of the many challenges that the newly diagnosed face; appreciating the effect drug regimens have on the activities of daily life was paramount. I found it surprising that the administration times and procedures became an obsession constantly on my mind. I perpetually worried about taking the right drug at the right time and continually fretted over following the written instructions to the letter, as I had received them. I felt the weight of the responsibility of the new liver that I received and protecting it at all cost. I have a better understanding now after this short roll playing activity how complicated regimens can affect a patient’s quality of life and the organization (or lack there-) of it. I can also see how some patients may become apathetic in their adherence when it takes such an emotional and temporal toll on their lives.

Going in to this activity I knew next to nothing about solid organ transplants or the medications used post-transplant. I found myself feeling slightly upset that I was literally handed a bag of drugs and told don’t miss a dose or your new liver will fail and we’ll have to do this all over again. I felt discouraged that I didn’t know what pills I was taking or how it was going to help me and my new organ. I grew to resent the medication because I spent so much of my day preparing, dosing, and thinking about them when I had no idea what they were doing inside of me. I specifically remember early on, a desire to throw them all away in an effort to prove that I was still running my life, not some doctor and his bag of pills; a feeling which was quickly allayed in the fear of losing my new tissue and disappointing those that worked on my behalf to get it.

The pearl of most importance that I gained from walking a mile in the moccasins of a recent transplant patient this week, was the way it will change my practice as a doctor of pharmacy. Now that I understand the fear, stress, and apathy that can ensue with a life-threatening new or chronic disease I can address these issues at the initiation of therapy and check up several times throughout. Truly, the best weapons to combat these negative feelings regarding treatment are knowledge and encouragement. If someone had only sat me down in post-op to explain what had been prescribed, provided a simple explanation of what each drug will do inside my body, and what I should expect to see while taking them; I would not have had the feelings of discouragement, fear or stress as much as I did. I will attempt, as I continue in my role as an intern pharmacist, to incorporate a simple metaphor or analogy that anyone can understand about how a drug works and what to expect from its use, in all of my patient counseling endeavors. Additionally, I believe that the stress of the daily regimen and a developing apathy towards it, that I experienced, might have been avoided with the encouragement of a health advocate. After this exercise I am determined to truly advocate for the health of my patients. No one is perfect, but sometimes a simple, “you’re doing a great job”; or, “keep up the good work”, is sufficient to sally someone in being more adherent to the stringent schedule of a complicated dosing regimen.