SUPERmarket PHARMACIST

A pharmacist's look at the supermarket and beyond

Month: May 2015

Fiddleheads

fiddleheads
Fiddleheads! Loved and appreciated by many, scorned by a few.

I’m back from vacation! We visited family and friends in the great state of Maine and had many opportunities to sample the local food. The land is quite bountiful! We had lobster gathered from the sea, along with clams and scallops. These paired very nicely with fiddleheads which were in season, lucky for us. A salad of tender young greens from a nearby farm made for a complete dinner. Many of the foods that we ate were from local sources and so were incredibly fresh. We could taste the difference.

Fiddleheads don’t appeal to everyone. My wife, who usually counts five green peas as a serving, had as many as six fiddleheads each time they were served. Props for her! My daughter, on the other hand, calls them disgusting and would not even try one.

My brother's serving compared to my wife's

My brother’s serving compared to my wife’s

I have great memories of our family driving out the the banks of the Sandy River and harvesting buckets of these young ferns. There are many species of ferns that show up in Maine and across the country, but this fern, the ostrich fern, is the only one that is edible, to my knowledge. It is certainly the tastiest one. You have to get right down on your hands and knees to get them, as they are ferns still furled, in a brown, papery, natural “wrapper.” Clumps of them are found, picked one by one, and the fern coils are washed to remove the husks and then boiled or steamed. My sister-in-law, Ginny’s secret was to boil them with a chunk of salt pork. Fiddlehead-lovers, like friends Brian and Janet, raved about the taste. Delicious! Nutritionally, they are light on calories, about 10 per ounce, and a good source of potassium, vitamins A and C, and fiber.

I found it extremely satisfying to enjoy the foods produced from around my birthplace. A vacation is always good for mind, body, and spirit, and the wonderful foods that I consumed seemed to make everything even better. I am recharged and renewed!

A lobster roll (lobster out of Belfast), with fiddleheads from Farmington, and young greens from 47 daisies farm in Vassalboro.

A lobster roll (lobster out of Belfast), with fiddleheads from Farmington, and young greens from 47 daisies farm in Vassalboro.

Thoughts About Type Two

I have nearly completed the APhA’s certificate program on patient-centered diabetes care. I was reviewing the drugs in the American Diabetes Association algorithm for the management of Type 2 diabetes, which took a while because many new drugs have entered the market since my last comprehensive look and these treatment options. What struck me was the entire algorithm was framed by the classic “healthy eating, weight control, increased physical activity and diabetes education. Then come the drugs, starting with metformin, and quickly moving towards these new agents if A1c goals are not me within 3 months. I wondered if we couldn’t find a way to better encourage type 2 patients to work on the framework principles before relying on pills and more pills or even injections. Do you or your type 2 patients have health coverage for nutrition counseling? For a personal trainer? How much diabetes education is provided to these patients?

“You’re the pharmacist,” you might say, “you do it!”

I’d love to have the time to spend with my diabetes patients to work on some attainable personal health goals. Wouldn’t it be great if a pharmacist or nutritionist could accompany a diabetic patient for their entire grocery shopping trip? Wouldn’t it be worth it to have that be a paid service? Working in a supermarket and seeing what my patients are putting in their carts can be disheartening. In a more perfect world, perhaps that is happening, I just don’t see it in my world.

My point is we seem to spend little time or effort on the bedrock, personal lifestyle changes that should be made and our health care system is set up to just keep pumping more drugs into patients. Expensive drugs,even dangerous drugs. Oh, and lots of big words and lots of expensive advertising! The thing that concerns me is that many of these newer agents really have a modest effect on A1c and many of them carry some pretty nasty baggage as far as adverse effect go. Perhaps this new age of pharmacist provided, patient-centered care will eventually lead us to a wiser approach to disease management. The challenge for us pharmacists will be to think outside the bottle of pills.