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The night felt slower, and I developed insomnia from the fright of the uncertainty of the exams I had to embark on.
It was not the first time I had written an exam, but this one was different; it stood as the gap between crossing over to the next level and staying back. Things had also taken a different turn in the faculty, as power was given over to another set of individuals, and speculations of different kinds were on the rise too.
I would have been less frightened if I had not been among those who would start the exams; there were no previous histories or news to take heart in. So I spent the night re-reading every page of my books, getting through them the best way I could. In the early hours of the morning, I forced myself to bed and could barely sleep for an hour.
Still, I did the proper preparations and embarked for my exams. I did get to write it well too; few of the speculations were true, and I gained victory.
On my way back, I boarded a transit with a variety of people on it, including those trying to make a living. Among them was an old man advertising different medications, and because of my field of study, I paid close attention to what he was going to say. He spoke on a few balms, Vitamin C in the form of sweets, herbal blood tonics and Diclofenac.
To me, the rest were kind of safe; Diclofenac was the exception. He sold it under the brand name Lofnac, and the directions for use and the advice during usage were things I had never read or been taught medically in my whole existence. He asked them to drink lots of water after swallowing the medication for pains, and assured them that it cures any kind of pain and that the pain would disappear almost immediately.
The only person who showed interest was an elderly man; he must have been battling pains, maybe due to arthritis. The cost was affordable, and he felt his battles were over, so he quickly purchased it.
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I felt pity for him at that moment, because Diclofenac must be used with great caution in the elderly, and he might be taking home more problems than he had budgeted.
I wished I could tell him that in the elderly it can cause peptic ulcer, and that this risk is increased when it is not taken with enough food. If he kept on depending on it for the relief he got, it could increase his risk of a fatal heart attack or stroke. It may also cause stomach or intestinal bleeding, which can be fatal and can occur without warning.
I wished I could know his medication history, because this medication should be avoided after heart bypass surgery or a recent heart attack, and by anyone who is allergic to it or has ever had an asthma attack or severe allergic reaction after taking aspirin or an NSAID. I wished he knew that a proper medication history was needed, even though he considered the drug minor.
Another concern was the storage, who could have access to it and who could take the medication. He may decide to give some to his wife for one pain or the other that it is not meant for. In women, it could delay ovulation, which may delay pregnancy when it is wanted, and it could cause serious heart problems in an unborn baby. He also needed to report to a pharmacist if there were any unusual side effects while taking the drug.
I realised how much of my patient-centred medicine side kicked in, but there was no way I could talk him out of buying the medication at that moment.
For the public, purchasing drugs by the roadside is not healthy because you do not get the proper information; and for the elderly, topical diclofenac is safer than systemic diclofenac.