The Importance of Review and The Dangers of Self Medication

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Greetings to all and sundry,

It is a beautiful day today, March is moving quite fast to the delight of some of us and things have been great so far. I know it's been quite a while, I spend this weekend in Takoradi where I attended @anaman's wedding and so I was a bit off for a while, but now I am back in my region and my town, so we get to continue with our studies.

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The wedding was a blast though and I was so glad I got the chance to be present, @awuahbenjamin too was there alongside a few other friends, it was my first time as a groomsman and so I was really excited. Anyway, since I am not here to share my wedding experience let's move on to why we are here today.

Before then though, I do hope you are doing very well and having a good time, I trust the weekend was fruitful for you and that the week has been good to you so far. Today we would be looking at some of the dangers of self-medication and why having your reviews as a patient is important. I do hope you enjoy the read and that you get a thing or two out of what I have to share with you today.


Introduction


So yesterday someone shared a video with one of the groups for Optometrists in ghana, the video was from TikTok, and in the video, a man claimed that individuals who have been diagnosed with cataracts should grind or simply get the leaves of tomatoes and squeeze the juice out of it on to the eye and that it would help.

I was astounded when I saw this and was actually wondering if is a prank or a comedy channel because there are so many things wrong with that, aside from the fact the individual is exposing themselves to multiple dangers and possibly a sight-threatening effect should anyone try this on their eye, the person having the courage to put this on social media was a whole something else for me.

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A lot of us spoke about it for hours on the page on how best we could go about getting rid of some of this terrible content that is misleading people and causing lots of harm to our patients. Unfortunately, there would be patients who would find this content and give it a try only to come back later to the hospital with some infectious keratitis such as fungal or acanthamoeba which is very difficult to treat and in the worse cases, scenarios you end up with perforated corneas or something worse.

This is why self-medication is never advised especially when it comes to the eye, it is too delicate an organ and the chances of complication should things be done wrong when taken into one's own hands is high, I mean, someone spends about 7 years of their lives learning this particular organ and its intricacies as well as pathologies and pharmacology for your sake and you decide that what you found online after googling your symptoms is enough to get you sorted?


Reviews and Self Medication


Management of ocular conditions can be as simple as the use of topical drops once the diagnosis is confirmed and you may not have to come to the hospital for a while until maybe something else's pops up it can be complicated and quite intricate such that a certain duration may be warranted during which series of test may be needed as well as management procedures, even surgical intervention.

And so your Optometrist may ask that you come in at a particular date perhaps after your initial examination and treatment initiation to be able to confirm that things worked out quite well as expected and that you are probably good to go for now or that you may need an alteration in medication because of how you reacted to it or maybe the drug didn't even work well as expected. Each and every one of us has specific reactions to the use of some medications and until you report this to your caregiver we cannot know.

I always tell my patients that the fact that we are doctors doesn't mean we are magicians, we do not read minds and clearly, we do not have the gift of clairvoyance to predict or tell the future, taking care of you is a two-sided job, it is like being in a relationship, each faction has to do their part to ensure that the goal of the relationship is achieved and your faction as the patient is to report to us the effect of our work. And so when we ask you to come for review, it is not because we miss you, it is because we care about getting you better.

You may forget your review date, or perhaps even travel, I get patients who came in later than I was expecting them but they still came and that's the most important thing, we can't always be certain of the future, things happen but do not put your review on indefinite hold because you think everything is ok now, please let us know that everything is ok now so we know what works for you in the future.

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Unfortunately, some patients will now go and get the same kind of medication you may have given them when they came in for the first time after the drug finishes and they feel like they ain't completely healed. The dangers of self-medication are that not all of the drugs we give you are meant to be used continuously for more than a specified number of days or weeks, some of them are actually quite harmful and damaging should you continue to use them and the consequences could be dire.

Google is certainly a great tool but definitely not the best avenue for treatment, if it was then there would be any need for a doctor. Imagine you came to the hospital and you were given said eye drops which aint mean to be used continuously over a long period and because you are in pain you continue to buy more and more each time using it over months. You will just wake up one day to find that your cornea has melted and that the anterior chamber content is draining.

I know this may sound surreal to some of you but I meet these patients on a daily and so it is definitely not a tale. I quite remember how I met this old lady who went to the hospital once about 2 years back and because her pressure was so high when they checked her vitals she was admitted for a while and given nifedipine. Instead of coming back for review, she continued to buy the drug and use it continuously over the past two years without any checkups and when we checked her pressure it was so down we feared for her.

The body had gotten so used to the drug weaning her off became a headache. She is just lucky not to have collapsed and died from hypotension. I also had this patient who was given anti-glaucoma drugs because her pressure was very high during the time she came in however her diagnosis wasn't glaucoma but ocular hypertension and because she went to read about the drug on google thinking she had glaucoma, she continued using the drug for a very long time until her ocular pressure dropped so much taking her to a state of hypotony.

Eventually, she couldn't handle the pain and she came back, and thus when she learned she got it all wrong. I am citing these examples so you understand that self-medication could be dangerous and sight or life-threatening when I doubt you are to see your physician for care and explanation. I know illiteracy has a part to play in this however it shouldn't be an excuse and together we can spread the word and save lives and sight.


Conclusion


Do not believe everything you read online and please do not replace your doctor with an AI or google, the consequences could be dire, when you are in doubt always talk to your primary caregiver, and if you come across any new information perhaps from your personal research in an attempt to understand your condition better, do not resort to experimentation and self-medication.

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by @nattybongo

Instead, discuss it with your primary health provider, chances are that he already knows about it, may have already used the method, and could tell you if is safe or not or whether it is recommended or not, perhaps it may not be of help to you specifically due to an underlying condition or genotype, etc, I do hope that this helps someone out there reading and I do hope you had a great time today. Thanks for reading, cheers, and have a wonderful weekend.


Further Reading

Ruiz M. E. (2010). Risks of self-medication practices. Current drug safety, 5(4), 315–323. https://doi.org/10.2174/157488610792245966.

Sachdev, C., Anjankar, A., & Agrawal, J. (2022). Self-Medication With Antibiotics: An Element Increasing Resistance. Cureus, 14(10), e30844. https://doi.org/10.7759/cureus.30844.

Newell, S., & Jordan, Z. (2015). The patient experience of patient-centered communication with nurses in the hospital setting: a qualitative systematic review protocol. JBI database of systematic reviews and implementation reports, 13(1), 76–87. https://doi.org/10.11124/jbisrir-2015-1072.

Wright I. S. (1987). Keeping an eye on the rest of the body. Ophthalmology, 94(9), 1196–1198. https://doi.org/10.1016/s0161-6420(87)33307-x



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Sadly, there is a lot of misleading information on the internet these days, we can only get an accurate response to an ailment when we speak to a certified medical expert, that is the reason why I always advise patients to do the same.

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