Those of you that read Waypoint's blogs know that we typically try to offer our knowledge (and a little wisdom!) to help you in a variety of ways. 

This post is a bit different.

It is a personal story about my grandfather. My hope is you will see how potentially important - crictically important in this case - community pharmacy is to patients.  It took me 6 months to finally be able to write this story.

My grandfather, Papa to us, was part of America's greatest generation. He proudly served our nation for over twenty years starting in World War Two. 

Like many World War Two veterans, after returning home, he found it difficult to deal with the horrors he saw in the European Theater and to quit some of the habits he picked up. The result was excessive smoking and drinking and poor eating habits for the next 40 years of his life.  It finally took the love of a good woman (Mickey), and her threatening to leave if he didn't change his ways, to get him to break these habits, but unfortunately the damage to his body was complete.

I am not sure how long Papa had type 2 diabetes and COPD, but I do know that he had them for as long as I can remember. These resulted in numerous trips (especially later in life) to the emergency room and a long list of prescriptions that he had to take just to keep his body functioning somewhat properly.

And, as the list grew longer, the more difficult it became managing his prescriptions. My mother and Aunt Margaret became his primary care givers which meant it was their responsibility to make sure he took his medications properly. This created a tremendous amount of stress on the two women because they knew one simple mistake could result in him ending up in the emergency room or even dying.

One simple mistake is what eventually led to Papa passing away last October. Fortunately, it was not the result of my mother or Aunt making a mistake. But, it was the result of mismanagement of his prescriptions. 

Sometime in the summer of last year, Papa developed an ingrown toenail. Now from what I gathered at the time, this is typically not good for someone afflicted with type 2 diabetes. The problem was not the toenail but the fact that he decided not to tell anyone that he had an ingrown toenail.

Because of the lack of blood flow to his feet, his toe started to die. He eventually came to the realization that something was terribly wrong and informed my Aunt of his situation. After another trip to the emergency room, he was instructed to see a podiatrist to see if the toe could be saved. After trying numerous treatments, it became evident that the toe would have to be amputated. This is where the story takes a tragic turn.

Being retired military, Papa was covered by TriCare for his entire. Along the way, Tricare switched to mail order and his prescriptions were sent to him by the United State Postal Service (this is why my mother or Aunt had to help him manage them). 

This meant that he did not have a relationship with a pharmacist. The only person he could talk to was someone at the end of a 1-800 number. And, as you probably have guessed by now, the process of having his toe amputated resulted in him seeing numerous specialists and subsequent changes to his medication.  

When this happened, the management of his medications became imperative as it becomes easier and easier to leave one off the list. This is exactly what happened to Papa; his blood pressure medicine somehow never made it on the list of final medications he needed to take.  Approximately two weeks after the toe amputation, Papa had a massive stroke that left him bed ridden until he ultimately passed away a month later.

Now you probably are wondering how all this relates to community pharmacy and community pharmacists. I have shared this story with many of our community pharmacist clients and friends, and I typically get the same response. They tell me, even though not guaranteed, that they probably would have noticed there was no blood pressure medicine on his final list if they had an ongoing relationship with him. 

Unfortunately, it is too late for Papa and we will forever question whether using an independent would have saved his life. 

Please share this story with everyone you can because the survival of community pharmacy is imperative to the overall health of our country and for loved ones like Papa.  I don't want anyone else to ever have to ask themselves "What could have been?"