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Boggios: A healthy choice for your whole life

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Age-related Macular Degeneration (AMD) is the most common cause of vision loss in Canadians, especially after the age of 65. There are two types of AMD: wet and dry, with the latter being much more common. Dry AMD typically presents as a slow, painless loss of vision. Usually, the centre of the visual field blurs while the edges of your sight stay the same. In wet AMD however, vision loss is much more rapid.

The cause of AMD is still mostly unknown, but we do know that there is damage to parts of your eye that help send images to your brain. Development of AMD has been linked to genetics, smoking, blood pressure, heart health and diet.

How can you reduce your risk of developing AMD?

  • Stop smoking. Smoking is associated with up to 4 times higher risk of developing AMD. Speak to your pharmacist for help in quitting
  • Eat a balanced diet
  • Keep your blood pressure under control
  • Take your cholesterol and heart medications
  • Speak to your pharmacist for tools to monitor your vision. There are special, easy-to-use visual scales that you can use at home to detect if you are developing AMD.

What about vitamins and minerals?

You might have heard that certain supplements might be good to reduce the risk of getting AMD. At the moment, the best data suggest that supplements only help patients with at least intermediate-severity AMD – so if you don’t have a diagnosis of AMD or if your AMD is very minimal, taking a vitamin might not be the best choice. Talk to your pharmacist to see if a supplement is for you.

If you have been diagnosed with AMD with at least some moderate vision loss or more, a supplement might be a good idea. There are many formulations out there marketed for vision loss but not all of them are supported by best evidence. Your pharmacist can help you choose the best supplement for preserving your vision.

What about wet/severe AMD?

If you have been diagnosed with wet AMD, you will need to start prescription medication for AMD. These medications are usually injections that are administered to the eye by your eye specialist. Many of them work well not only to keep your AMD from progressing, but they can also help to restore vision that has been lost.

Many of these injectable medications can be quite expensive but they may be covered by your drug plan. Some of the drug companies that make these medications also offer assistance for patients in paying for these injections. Talk to your pharmacy team for more information regarding the most cost-effective way to purchase these medications and to save you money.

The most common side effects of these medications are minor eye pain and red spots on the eye near the injection site. These are normal side effects and they typically resolve a few days after administration. Very rarely, these medications may cause an infection in the eye called endophthalmitis which can cause permanent vision loss. Therefore, if you notice severe eye pain or vision loss after the injection, see a doctor immediately.

There are many common issues that pharmacy staff run into when trying to fill prescriptions that may delay your trip to the pharmacy, or even force you to come back for a second trip. At the Boggio Family of Pharmacies, we want to make your trip as quick and simple as possible. Here is a list of tips and tricks!

 

  1. Keep the pharmacy updated on all of your personal information. Often times a prescription that has been sent to us from a doctors office cannot be filled because we are missing information. For example, if we receive a prescription for “John Doe” we may have several patients with that name on file and if your patient record is not up to date, we may not be able to fill the prescription until you come into the store. All personal information is kept completely confidential and will never be shared. Some important pieces of information to keep up to date at the pharmacy include:

◦      Phone numbers, including mobile or work numbers that are appropriate to contact you at

◦      Address, especially when items are requested to be delivered

◦      Allergies and medical conditions. This will ensure that the pharmacists can properly evaluate the appropriateness of any new or existing medications.

◦      Drug coverage information. Did you receive a new insurance card from your employer? Confirming that this information is up to date can save yourself time when you come to pick up your medications.

  1. Always check if your prescription has repeats before you completely run out of medication. It may take us several days to hear back from doctors offices for repeats, especially if the office is closed, or if you come in on a weekend. Knowing how many repeats you have on a medication, and ensuring that the pharmacy has additional repeats on file before you run out can save you time and frustration. Under the pharmacists discretion certain chronic medications can be extended for short durations, but they must still attempt to contact the doctor for a prescription before they can do this. Narcotics, controlled substances and targeted substances cannot be extended under any circumstance due to the nature of this medication. For these medications, it is extremely important to be aware of how many repeats you have on file.
  2. Know if your medication has a dispensing interval. Some medications (not limited to but often narcotics and controlled substances fit into this category) are prescribed by the doctor with an interval between the dates that the medication can be filled. For example, if the doctor asks for the medication to be filled with a 30 day interval, the pharmacy has an obligation to dispense that medication every 30 days. You can save yourself a lot of headache by knowing what day your prescription is ok to be filled. Some private and government drug plans have intervals as well. Each plan can be a little bit different so ask one of our dispensary team members how this may affect you.

 

By using these tips and tricks, we feel that you should experience a much smoother trip to the pharmacy. As always, if you have any questions or concerns feel free to call or stop by one of our four Boggio Family of Pharmacies locations today!

It’s an uncomfortable topic of discussion for some, but it is a very important one that needs to be addressed. The words colon cancer screening and colonoscopy may not generate the best reaction, however, the intention of this article is to absolve your fears and reinforce the benefits of this screening procedure.

March is Colon Cancer Awareness Month and everyone could use a little update about the topic. Colon cancer is the second leading cause of cancer-related deaths in Canada for both men and women, but it is surprisingly treatable if detected early; hence the importance of the colorectal screening procedure. Beginning at 50 years of age for those at average risk of developing colorectal cancer, a simple at-home stool test – the Faecal Occult Blood Test (FOBT) – should be completed and repeated every two years. However, if you have a first-degree relative with colon cancer, your screening should begin about 10 years younger than the age at which they were diagnosed (For instance, if your close relative was 50 years old when diagnosed, you should begin screening when you turn 40) and it is advised that a colonoscopy be performed. At this point in time, colonoscopy is the gold standard for the detection of any abnormalities of the colon, such as polyps, that may eventually become cancerous if not appropriately treated or removed. It should be noted that most colonoscopies do not result in a diagnosis of cancer. The purpose of these screening procedures is to look for signs that could eventually progress to that and remove them before they pose a problem. It’s all about prevention!

Many people have the idea that a colonoscopy is a painful experience. This should not be the case. The patient is most often well-sedated and unaware of the procedure unless they request to be awake. Likely, the most discomfort the patient will experience is during the day before the procedure, because they are required to consume an all-liquid diet and then take a laxative to clear out the bowel. One day of hunger and slight discomfort is surely worth having the procedure done properly!  

There are some simple things that you can do to help reduce the chances of developing colon cancer. Eat a diet that is high in fibre and low in fat, try to avoid eating processed foods, stay active and maintain a healthy body weight. Talk to your doctor or pharmacist if you are unsure about what foods to eat or what a healthy weight is for you.

There are some signs and symptoms to be aware of that may indicate there is a problem in the colon. These include blood in the stool or black-coloured stool, long-narrow shaped stools, abdominal cramping, or unexplained weight loss. If you are currently experiencing any of these symptoms or you notice these changes, don’t delay talking to your doctor. They will be able to get to the bottom of it! 

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The practice of using vaccines to protect from infectious diseases goes back to the year 1000 AD. People have been researching, discovering, and improving vaccines for over one thousand years since then. During this time mankind has experienced many – often lethal – infections: small pox, diphtheria, tetanus, anthrax, cholera, plague, typhoid and tuberculosis to name a few. Fortunately, through the use of vaccines and antitoxins, many of these are no longer existent and those that have not been eradicated are under better control than ever.

There has, however, been considerable debate over the idea of vaccination. Many people are still not convinced that vaccines are a good idea despite the fact that every healthcare professional would agree that they are. There are very few risks associated with vaccinations and the side effects are generally mild. They may include:

  • Fatigue

  • Pain, redness, tenderness or swelling at injection site

  • Headache

  • Itching at injection site

  • Nausea

  • Dizziness or fainting (most common in adolescents)

  • Fever

  • Mild rash

More serious side effects from a vaccine may result from an allergy, but these are very rare (less than one in one million doses given). The important message is that there are far greater benefits to immunization than there are risks.

One of the most talked about vaccines in autumn is the flu vaccine. As we approach winter, it is time to prepare ourselves for Flu Season. What better way to prepare than to get the flu shot and prevent getting the flu in the first place? It is generally recommended that everyone over the age of 6 months get the flu shot. It is especially important for women who are pregnant or breastfeeding, people who work directly with the community, people who are at high risk of flu-related complications or hospitalization, and people with certain chronic health conditions. If you have questions or concerns about whether the flu shot is right for you, please speak to your doctor or pharmacist.

Trained pharmacists are now holding flu clinics in some pharmacies to increase awareness about the importance of getting immunized and provide greater ease of access to the flu shot for community members. This year the flu shot will be offered free of charge at each of the Boggio Family of Pharmacies locations. Come by one of our pharmacies to get your flu shot in a clean, comfortable, convenient setting.

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There has been some recent concern from patients taking the oral contraceptive pills Yaz and Yasmin regarding the pills’ safety. The concern stems from the release of media reports stating that these two brands of birth control pills (containing the ingredient, drospirenone) have been linked to the deaths of 23 Canadian women. The worry is that drospirenone – a type of progestin – carries a higher risk of developing a blood clot compared to other brands of birth control pills that do not contain this particular progestin. The purpose of this article is to discuss the reality of these risks and to alleviate any concerns patients may have.

Although many of the reported deaths resulted from blood clots, one cannot assume that the oral contraceptive is to blame. It is known that blood clots are a risk with birth control pills, but there are also many other reasons why someone could develop a clot. There has been no strong evidence to indicate that the contraceptive pills were the reason for these deaths. Health Canada has stated that the benefits of Yaz and Yasmin still outweigh the risks when used according to the labelling instructions.

There are warnings on the drug label about the risk of blood clots with these medications which may be 1.5 to 3-fold higher than with other contraceptive pills. To indicate this small difference, the FDA found that 6 women in 10 000 develop a blood clot while using other birth control pills in one year, and about 10 women in 10 000 using Yaz or Yasmin will develop a blood clot in one year. Yes, this is slightly higher, but to put it into perspective, up to 29 women in 10 000 will develop a blood clot during pregnancy. In other words the risk of blood clots is much higher if a women becomes pregnant than if they were using any form of birth control. Yaz and Yasmin are still considered to be safe and effective, so if you are using either of these medications, and are not experiencing any adverse effects, it is reasonable to continue their use.

Many factors come into play when deciding which birth control pill to take or even whether to take one at all. Some things to consider are a woman’s history of blood clots, heart attack or stroke; age; smoking status; and with Yaz and Yasmin, liver or kidney disease. It is important for women to discuss these details with their doctor in order to make the best decision.

As a result of new regulations governing the practice of pharmacy in Ontario, pharmacists are now able to be more deeply involved in your medications and management of your medical conditions. The new regulations came into effect last October allowing pharmacists to make use of their unique knowledge. This is great news for both pharmacists and you, their patients. It will allow pharmacists to be an even more integral part of your medication management and it will provide you with greater convenience as pharmacists are easily accessible in the community.

There are five main areas that these changes will affect:

  1. Pharmacists can prescribe several effective medications to help you quit smoking. Patients who may wish to try this method of quitting can now be assessed by their pharmacist – who will use their professional judgement to decide if it is right for you. This means that you will not have to wait to see your doctor in order to get on the path to becoming smoke-free and the pharmacist can be involved throughout this sometimes difficult process.
  1. Pharmacists may be able to renew your prescriptions without you having to see your doctor first. Your condition and your medications must be stable. For example, this may apply to patients who have well-managed chronic conditions like diabetes or high blood pressure. (This new regulation does not apply to narcotics and similar substances and does not eliminate the need to see your doctor for proper followup and monitoring).
  2. Pharmacists may also make certain changes/ adaptations to your doctor’s prescription if necessary based on professional judgement. For example, they may change the dosage form (tablet/capsule/liquid) or they could alter the dosing regimen and possibly even the dose to suit you better. As always, any changes would be done with your consent and the pharmacist would share them with your doctor.
  1. Pharmacists can now be of even greater assistance in helping to demonstrate how to use your devices. If you are a patient who uses an inhaler or has self-administered injections, your pharmacist can now use the real device to show you how to use it, rather than using a model one. Pharmacists who are able to administer injections in order to teach you how to use them have completed a training program.
  1. Specially trained pharmacists can administer the flu vaccine to patients five years and older. This will provide patients with more locations and greater ease of access to the vaccine.

As usual, your pharmacist will make these decisions based on your specific situation, so it is very important to give them as much information about yourself as you can. They need to know about all of the medications you are taking, including anything over-the-counter or any vitamins/minerals that you use. Also it is important to talk to your pharmacist about your lifestyle (eg. the foods you eat and the exercise you do) so they can get the full picture in order to make the best decisions for you

Pharmacists have always been a wonderful source of information and support for patients regarding how to best manage their medicines and their medical conditions. Now that the role of pharmacists has expanded to allow them to have more involvement with their patients, it will be easier than ever for patients to maintain good control of their conditions and medications. 

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Shingles is caused by the same virus that causes chickenpox (varicella-zoster virus). After the chickenpox blisters heal, the virus remains dormant in nerve cells in your body. It can become reactivated after many years resulting in shingles. It is not known exactly why the virus becomes reactivated, however it is thought that having a weakened immune system along with physical trauma, UV light or stress may play a role. The risk of developing shingles increases with age and people over 50 years old are at the greatest risk. The symptoms include a painful, blistering rash that often breaks out in one part of the body, usually the chest or upper back are involved. Sometimes the pain resulting from shingles can last for weeks, months, or rarely years, after the rash heals. This lasting pain has been described as burning, aching, throbbing or stabbing and can result from something as little as a breeze or the touch of clothing on the skin. Older people are again at greater risk. Shingles may also result in skin infections at the site of the rash or scarring following healing of the rash.

Fortunately, a vaccine is now available to boost your immune system and help to prevent shingles and its complications. It is called Zostavax and is available to adults over 50 years old. The vaccine cannot be used if you are already experiencing symptoms of shingles; it is only used for prevention. The vaccine is given as a single dose by injection just under the skin of the upper arm by a doctor or trained nurse. As all medicines and vaccines can have side effects, some people may experience redness, pain, swelling, or bruising at the site of injection or headache. These are the most common unwanted effects, but they are usually minor. This vaccine was found to reduce the risk of developing shingles by about 50-70% (depending on your age) within the first year after receiving the vaccine.

Zostavax must be stored frozen below -15 degrees Celsius until the day it is to be used. Only a few pharmacies currently have the correct storage facilities for this vaccine to be able to stock it. Zostavax is available from all of the Boggio Family of Pharmacy locations.

Zostavax is safe for most people, however it should not be used by anyone who:

  • is allergic to zoster vaccine or to any of the ingredients of the medication (including gelatin)

  • is pregnant

  • has a weakened immune system (e.g., due to cancer, HIV/AIDS, problems with bone marrow, or other immune system problems)

  • has active untreated tuberculosis

  • has had a serious allergic reaction (hives, face swelling, difficulty breathing) to neomycin

  • takes high doses of steroids (e.g., prednisone, methylprednisolone) by injection or by mouth

Since this is a relatively new vaccine, it is not known if it will provide protection from shingles for longer than 4 years.

Talk to your doctor or pharmacist for more information and advice about shingles and to find out if the Zostavax vaccine is right for you.

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