by Cathy Milne APRN, MSN, BC-ANP/CS, CWOCN
A lovely elderly woman came into the office last week with perfectly coiffed silver hair and a sparkle in her steel blue eyes. She said to me, "Dear, I love that commercial with the copper pipes!" Thinking that I missed the latest and greatest TV event, I asked her to describe it to me. "It doesn't really matter that it was creative. I am those copper pipes." Aha! A psychotic patient, I thought. She zeroed in on her goal. "I want that pill that helped the copper pipes! May I have a prescription for that today, Honey?"
My stomach went in knots and the emotion began to bubble up. I hate being called "Honey" or "Dear". This patient wasn't going to get what she wants today, I thought. Returning quickly to professional mode, I choked back the reaction to concentrate on the matter at hand. It is as unpleasant to me as these terms of endearment--the TV commercial acting as health care provider. Yes, we all make jokes about the legal statements the pharmaceutical companies are required to provide during these commercials (e.g. Four hours! Are you kidding me? ) And, to Pharma's credit, they ask the listener to discuss the issue with their health care provider. So it did get me thinking. This is a patient who is following all the rules.
There is always a Yin to a Yang. On one hand, I had been seeing this patient for a non-incontinence related issue. During her initial history and physical one month ago, she denied any urinary symptoms of urgency or incontinence. So I was a bit surprised she brought this to my attention. I went through a review of symptoms and I diligently performed a comprehensive exam. I collected a urine specimen. The good news? Yes, she has an overactive bladder. She thought that these symptoms were normal because, in her words, "my old age". She didn't think they were important when I first started treating her. But since she saw these commercials, she now knew it wasn't because of maturity. Score one for Big Pharma! I'm glad they are bringing incontinence to the forefront of treatable issues. For every one person who brings this issue up with their provider, there are scores who do not. They are the ones using napkins, toilet paper, menstrual pads, and paper towels stuffed into their undergarments to get through the day.
For the other side of the coin, it now was up to me to try to change her lifestyle - a lifestyle 86 years in the making. Habits ground into her cerebral synapses that will require all that she can muster to retool them. We discuss these. I ask her to do a bladder diary. She agrees, but adds, "Honey, it is so much easier to take the pill. I'll get it when I come back, right?" Ummm...Yeah, right. There is so much gray in the black and white management of patient care. What are your thoughts on how advertisements affect our management of patients?
About the Author
Catherine T. Milne is the Clinical Editor of IncontinenceSource, and is the co-owner of Connecticut Clinical Nursing Associates, a practice focusing on direct patient care, consultation, education and research in the fields of wound, ostomy and continence care.
The views and opinions expressed in this blog are solely those of the author, and do not represent the views of PERSONALLYDELIVERD, IncontinenceSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.