Dispensing Hope During COVID-19

Aislinn Antrim: Hi, this is Aislinn Antrim from Pharmacy Times. Before we get started, one of our top stories right now is about a study which found that an increase in pre-exposure prophylaxis is associated with a decrease in HIV diagnoses in the United States. So you can read more of that on Pharmacy Times, but today I'm interviewing Dr. Adam Martin, known as The Fit Pharmacist, about staying hopeful and taking care of yourself during the COVID-19 pandemic and beyond that. So Dr. Martin, pharmacists are invaluable right now, obviously. Can you discuss the importance of pharmacists and just some of the physical and mental health struggles that they might be dealing with right now?

Adam Martin, PharmD: Absolutely. Thank you so much for inviting me to be on. So, guys, a little about me: I’ve worked full time in the community setting since I graduated from pharmacy school at the University of Pittsburgh School of Pharmacy in 2012, so I am a frontline pharmacist in the community. I think that we have a tremendous responsibility, but we also have a tremendous gift to be not just medication providers, not just giving counseling on those important questions that our patients have, but also, we're in a role to dispense hope. So, I call

myself a hope dealer—you can see that hat in the background if you're watching the video—but that's what we're there to do. We are literally the most accessible healthcare provider and for many patients the last point of contact that they have in their care, so we have a tremendous opportunity to give our patients that sense of hope. And it does put us at a tremendous opportunity to do this with our PharmD and with that does come a lot of reward. But as you all

know, with everything going on right now, it does come also with a lot of risk, not just for our own health but also our mental health and how we're dealing and coping with everything going on in the world today.

Aislinn Antrim: Definitely. How are you just personally staying hopeful and motivated right now?

Adam Martin, PharmD: Absolutely. So I think it's what diet you're feeding yourself, and I'm not talking necessarily about food. What I'm talking about is what mental diet are you feeding yourself? Are you glued to the news and all the death statistics and everything else or are

you feeding yourself information that's going to support you? Now I'm not saying be blindly optimistic and just be blind to reality. Get all of your data and facts from the CDC, absolutely. But when it comes to what you're doing with all this extra time you have, what are you feeding that with? Are you feeding it with news and media and all the terrible stories or are you feeding it with how you can use this time? Because that's what we all have as a gift. Yes, there are

absolutely challenges, there's atrocities. I know people who have lost people through this COVID-19, I know small business owners and pharmacies that have been so impacted that they have had to declare bankruptcy. So this is reality. But you can't control necessarily what the

government imposes all the restrictions and everything else. You can't control those things. What you can control is how you respond to those things and what you can do to use this and view this as an opportunity to grow stronger as a team. Build your relationships with your patients, because now they see how integral pharmacists are in their care. So that's been one of the

blessings of this whole thing is the unsung heroes that have always been working the front lines are now having that opportunity for people to realize that, “Wow, these people actually have a huge impact on my life.” Some of these are pharmacists, but also other health care providers, nurses, Pas, physicians—everyone in health care. And teachers, so if you are a parent or

you know parents, you know that they've been riding the struggle bus super hard right now and they never really realized how amazing teachers have been in their life, in raising and being a part of literally raising their kids, and their education, everything else. So you've got a lot of parents that are now working from home and they've got to teach their kids from home, and now that they have to do that they're like, “Wow, I never realized how essential these professionals have been in my life.” Which a lot of times has happened in pharmacy as well, with patients coming in. I mean, guys, depending on where you are in your town, you're the only place open. Whether you're a pharmacy or a hospital, wherever, you're literally the only place people can go to, so that's a tremendous opportunity. And I think that you guys have noticed a lot more gratitude and compassion from your patients, saying things like “I'm so glad you're open,” “Thank you so much for all you've done,” “Stay healthy, stay safe,” things like that. So it's a tremendous opportunity and that's really fulfilling so really see and have that connection with your patients, to serve in this role where you may be the only point of contact that they have for weeks, months, however long this goes on for. So looking at how to stay healthy with that is something that I've been talking about for years. Writing my first book, Rx You that's available on Amazon, is all about how to prioritize your self-care, because all of us get into pharmacy for a specific reason, whether we pick a niche of a clinical pharmacist or we go into fellowship and industry or we work in community pharmacy—regardless of what your specific details are, the broader picture is that we're here to help other people. We're givers, we want to be healers and

helping our patients to get to that point of optimal care, but the thing that we often fall into is sacrificing our own self-care because we feel that doing that is selfish. But that's what I really

hoped would really become my central focus, is helping pharmacists and pharmacy students realize that this needs to be a priority, because eventually, down the road, just like we're in now, a crisis unexpectedly is going to come up, and if you don't have that groundwork laid, you know, that's going to be a huge struggle, which is what we're seeing in our profession right now. I run a

weekly podcast on all podcast platforms, “The Fit Pharmacist’s Healthcare Podcast,” and that's the content that I've been focusing on, is resources and strategies that are practical for pharmacists to get through this mentally. I mean, this is a traumatic event that

we're going through right now, so how to cope with that to be your optimal best because, guys, we're leading our pharmacy teams, we have to be strong, right? But when are we processing everything that's going on? So that's something to really ask yourself—are you making your self-care a priority? And that comes down to physical activity, that comes down to what you're feeding yourself. You've heard this: you are what you eat. What kind of food are you eating? Stress eating is huge right now, and what are you feeding your mindset? What's your mental diet? Are you feeding yourself inspirational podcasts or are you looking more at the down and the down and gloom of what's going on? Because regardless of any event, whether it's COVID or

anything, there's the good and there's the bad for every single event. Again, I'm not saying be blind and be a blind optimist. Get the facts from the CDC. But what are you feeding yourself in the meantime? Are you reconnecting with friends and family? We can't do it physically with limitations, but right now we're on Zoom, right? We're meeting awesome people, like you at

Pharmacy Times. We’re connecting with people you've lost touch with. Just because you have the time, right? So reconnecting with people, that's how I'm staying healthy and fostering those

relationships in my life, taking care of my self-care. I love doing workouts at home. If you follow me on Instagram @TheFitPharmacist I kind of give you my inside view on my Instagram stories to give people tips on what you can do simply in the comfort of your home to stay on track with your fitness. I’m keeping my nutrition up, but it's really a combination of those things. In terms of how to do that, that's one thing that Pharmacy Times has allowed me to do. Every Monday we're going over how to stay motivated and focused on the positive, even though there's all these

challenges that are going on. So that's what I really invite you guys to do @PharmacyTimes Instagram, check their stories every Monday. I do a takeover there to give you practical tips for

pharmacists that you can do to really set your mind right and elevate that so that you can truly dispense your full potential on the front lines.

Aislinn Antrim: Absolutely. Can you talk more about dealing in hope and how exactly you do that in your pharmacy?

Adam Martin, PharmD: I love this question, so thank you for asking that. So I do this in

three different ways. I looked at it in three different areas, that is taking care of yourself, which I just talked about. But it's really taking care of your team—so with your technicians, depending on what practice setting you're in. For me it's community pharmacy, so it's me and my phenomenal technicians. One thing that I realized is that, yes, pharmacists are on the front line. But pharmacy technicians most of the time are on the front front lines, working in pick-up, working at drop-off, really doing that as well. They're right alongside us and this is something that I tried to implement in my practice setting on a continual basis. And that’s being grateful and really showing appreciation that we are a team. We're here to work together, and while crisis can bring a lot of challenges, it can also bring a lot of unity. And while there is isolation, I would say we choose unity over isolation. Just because we have to separate ourselves doesn't mean we can't

grow stronger, and this is exactly what's happened in my practice. A lot of us have really become closer as a team. I've faced some challenges. So, real talk, I had two technicians quit as a result of COVID, because, you know, personal reasons and so forth. So that put a lot of extra stress and people might think like, that sucks and whatnot, but honestly, we've come closer together as a team. And I realize that all of my technicians have families. They have significant others and those people aren't in health care, but they see their loved ones going on the front lines, putting themselves and, in turn, their family at risk. So, what I thought would be a good idea is to show acknowledgement and appreciation for that. And I think that, you know, with social media and email a lot of times, that personal touch gets taken away. And while, again, that might be a challenge, that's also an opportunity to make that interaction even more special. So I wrote

a handwritten thank-you card, not to my technicians but to their family members, addressing it to them, to their significant other, to their children, saying thank you so much for allowing your wife, your mother to come and work on the front lines. I know it's a risk, but because of her

dedication she is providing care to people who need it at the most desperate time. She's literally providing hope to those who feel hopeless, so thank you for allowing her to be a part of our team. And that's what I did a few weeks ago, and the response was amazing. Just really feeling like, “Wow, he recognizes that, you know, I am putting my family at risk through this. He recognizes that we don't want to be exposed and all this, but we are called to deal with it, so we're stepping up to that challenge and coming together as a team.” So that's another area of staying strong. And dealing hope, as you asked, is really bringing your team stronger through this time. The other [part] is helping your patients to feel like they are taken care of, because they're scared. There is a ton of uncertainty, we have no idea nobody has any idea how long this social distancing thing is going to go, how long the businesses are going to be closed, all these restrictions. You know, it started with a few weeks, now it's a month, now it's two months. We have no idea. When there's a lot of uncertainty that breeds fear, and when you have fear you just don't know and that just can be a really negative and heavy emotion. So one thing that I like to do is I like to give not just medication counseling and support to my patients, but I also like to dispense hope. And that's why I call myself a hope dealer. So I got this idea a few years ago from

an interaction with a patient who came in, and she was just really feeling down, right? Her husband came in—to take a long story and make as short as possible—her husband came in because she was transferring, and he said “Hey, my wife is going be coming to your pharmacy.

She's a cancer patient so she's on some pain medication, which I know is sensitive to, you know, pharmacists and policies, and I respect that. But if you have an issue, please reach out to me instead of her. Because of everything she's going on, I don't want to add any more.” So, like, okay, I understand. Well, the next day she came in and she’s just the sweetest lady, right? And I try to do it, get the medication really quick, you know, accurate and everything else, but I just felt this need to make her feel special because she’s new to the pharmacy, everything else. So I looked around and tried to be resourceful, and I found something: these stickers. Smiley face stickers. I got a thousand of these for eight dollars, so a little less than a penny apiece, and the question I asked her was what's your favorite color? She said blue. So, okay, so after I did her prescription I got a blue smiley face sticker, took it off, put it on her prescription bag, and when she got that prescription, when my technician handed it to her, she just beamed and she just opened up, saying, “You have no idea how much this means to me. I've been going through this and that, I'm a stage four cancer patient.” She's like, “This might seem silly, but this made my

day and I am so glad that you are my pharmacist.” Now what pharmacist doesn't want to hear that, right? So this caught on, and I just started doing this. So I've been doing this for like three years now and it just makes people feel special. It takes some time to see when a patient is having an off day or when they could just use a perk up, or you just really have developed rapport and a relationship with that patient and you just kind of want to keep that going, so that's what I do. I just ask that question: what's your favorite color? And most of my patients act really confused, like what what does that have to do with anything? Well, it's okay, just put it on the bag. They get it and then it's like, oh! You have no idea. I've had tears, I've had hugs—now we can't hug folks, but back in the day when that was allowed—but, yeah, this is just a simple thing, guys. Very low-cost, but this is what I urge you to do. Yes, there's challenges right now, but how can you use that? Not why is this happening to me but how is this happening for me? If you change your question to that, that's where you're going to get this innovation of allowing your team to grow stronger as a unit. Because when you do that, not only are you going work better together, but your productivity is going to go up, your level of patient care is going to increase. When you shift the question to how can I be a hope dealer and step up for my patients—I'm not saying, like, spend all this money and do all this extra time and all that, but how can

you just use what you have? So ask yourself, how can you be resourceful with what you do have to give that extra care to your patients? And it could be as silly as smiley face stickers, but I'm

telling you, I’ve been doing this for like three years and the impact it's had is astounding. So those are some simple tips that I've used in my practice that literally are like zero or little cost

that have made a world of difference, not only in my practice but also in my patients’ lives. And that's just been an awesome unexpected blessing that I've had through this opportunity.

Aislinn Antrim: That's fantastic. I think there's a difference between long-term mental

health care, like you said processing what's going on, and a quick energy or mood booster that someone can do while they're at work, for instance. Do you have any tips or quick mood boosters

that pharmacists could do, just in the middle of a work day?

Adam Martin, PharmD: Absolutely. Music, right? If I were to right now play a jam I'm actually going to do it right now. So, if we were to play a beat, right, and you just play any song you want, any high BPM song, right? So, this is a beat, you’ve got some BPM, you've got some of that, you got any of the hot keys, he's fired up. So, music literally can snap you out of your state instantly. Questions are another thing. Just like I said, ask not why is this happening to me, but how is this happening for me? Shifting your perspective. I mean we all have rough days, right? We all have rough days where, you know, you come in, you had some bad stuff happen at home or the night before, you come in, and just one thing after another, you know. You hit all the red lights, someone cuts you off on your way and just puts you in a funk. So I literally created this free resource on Pandora, I don't pay, it's just totally free. I created a station called Happy Radio, so any time I start to notice that mood shifting I literally just put on Happy Radio and it shifts peoples’ state instantly. This is actually how I get in my mental peak state on my way to the pharmacy, which I actually call Club Pharmacy. I've been calling it that for years and it's caught on, it’s like a hashtag now. But if you shift your state, like “I'm going to work.” How does that make you feel? Versus “I'm going to Club Pharmacy.” How does that make you feel? So just the labels that you put on things can totally shift your perspective and your mental state.

So, yeah, playing music with high BPM beats helps. You know, keep it professional, watch out for the verbage and language and stuff, but if you just do high-BPM, happy type songs, that can shift your state so quickly, to the point where you'll see your techs tapping their feet to the beat, whether they realize it or not. And all of a sudden, it's like, oh, let's dance, right? So you can do that. You can literally have a party in your pharmacy. Follow policy and all that stuff but using music is a simple way to snap people out of that and can actually lift your mood almost instantly. So that's something that I use for myself and for my practice as an instant booster.

Aislinn Antrim: Fantastic. So that's a quick thing you can do. Long-term, obviously, people are going to be dealing with this. How should people go about processing this, even before it's all over, but especially once it's all over, processing what's happened?

Adam Martin, PharmD: Absolutely. So, you have to really realize that this is a traumatic event. This is a traumatic event, and you're either going to process it and deal with it now or you're going to try to put that under the rug. And it's going to manifest in many different ways, in different areas of your life: being short with people, anger, and you're just not sure why. Likewise, some people are going to process this totally differently. Okay, I'm not a therapist not, a psychiatrist, so what I really recommend is, if you feel like you're struggling and you feel like this is hard to process, is get a therapist. So, guys, you’re pharmacists, you know this stuff. When it comes to psychiatric medications, they've done study after study looking at just depression. Okay, I'm not saying that this is going to make people depressed, but just look at this one area, medications for depression. They did studies of just that, they also looked at therapy with CBT—cognitive based therapy—how effective was one versus the other. They’re almost identical, and when you combine both they’re amazing. Let's say you need to be on an anti-depression medication. I'm not saying you need to be in therapy, but what I'm saying is, if you feel like

you're struggling and this is really weighing on you, you really should consider getting therapy. And there's a lot of stigma on this, and on my podcast, I had a psychiatric pharmacist talk about

this. I actually have a therapist whose boyfriend is a pharmacist working in the ICU as the pharmacist on the front lines, and he has a lot of colleagues that are struggling. So having a therapist is huge, because this is a traumatic event. It's not something to be discounted, it's not something to ignore or put on the wayside, because this will manifest and if you don't process it it's going to be difficult. So think about this. You're working the front lines, okay? Everyone that is around you is scared, you're the only place that's open, you've got to step up and have this persona that you know, you're okay. And you want to be a source of hope for your patients. But then you go home and now your family wants time with you because they haven't seen you all day, so how are you going to process it when you’ve got to feel that way? You keep feeling that

you have to be this person that feels like it's all together, but inside you feel like, you know, this is terrible. Like, I see people dying, people are sick, people are scared. How am I going to process this? If you don't give yourself that time and allow yourself to be human, it's going to be difficult. So you can do this in many different ways. You can do it with your spouse, you can get a licensed therapist. Just find a qualified professional that's right for you. In that podcast it’s called The Fit Pharmacist’s Healthcare Podcast on all podcast platforms and the episode is called

Coping with COVID. It literally talks about these questions—is therapy a good option? How do you find a therapist? If that works well for you. Maybe you've tried therapy before and had a terrible experience and swore you'd never do it again. How to overcome that. There's a lot of stigma that if you go to therapy, there's something “wrong” with you or you’re “broken,” which is not true. It's a stigma, it's a misnomer, it's a label. This does not exist. it's actually healthy, it's actually a strength, it's actually a sign of strength, not weakness. So this is something that I really urge you to consider if you're struggling with this or down the road you know that there's something that comes up, you have anger, you’re not sure why you have these negative feelings. It's something that needs to be processed. And another thing to consider, too, is that all of us have been through trauma in our lives, whether that's in childhood or in pharmacy school or whenever. If that hasn't been dealt with when you're in a traumatic event that you can't control, like what's going on in the world right now, that's going to resurface all of that unprocessed emotion from the past and actually compound that with what's going on now. So I want whoever's listening to this to hear that if you feel this way, you're not weak, you're not broken, you're not damaged, there's nothing wrong with you. It's a sign that you need to process this. You might be a healthcare hero, you might be working the frontlines, but you're also a human being and you need to realize that if you want to serve your patients, if you want to show up fully for your family, you can't do that if you're not in a positive space. So getting help, getting therapy is not a sign of weakness. It's a sign of strength, and it's a sign of love, not just for yourself but for others. Because if you don't show up for yourself in processing all this, you're not going to be able to show up fully at your 100% for those that you serve in your personal and professional life. So that's just my message, is this is a difficult time, it's not something to ignore, it's not something to blow off. It's something to be taken seriously and really allow yourself to have that time to process. Medication is also a great step, and I talked about this and I practice, I preach it all the time. Meditation with your mindset, your physical activity, that's huge. What the body, what the mind believes, the body will achieve, right? You are what you eat, so you really have to look at what you're putting in your body. Stress eating, emotional eating, that's at a huge peak right now. A lot of times, we go and we grab for the salty snacks and sweets, and it works short-term to kind of swallow those emotions, but after that passes, now we feel guilty about what we ate. And what happens is we start eating more and then we feel even more guilty. The scale starts going up, we start to see this image in the mirror, and it's just a really negative cycle. So there's a lot of components to this. You don't have to solve everything; you don't have to do everything by yourself. That's why I created The Fit Pharmacist community. It's to help guide people through that. It's why I wrote the book, because it's practical stuff, specific for pharmacists to help you just get started. How you get started to meet you where you are, and that is the key. So don't try to be someone else or judge yourself that you should be farther along. Start with where you are, because where you are is exactly where you're supposed to be. And that's my message on that

Aislinn Antrim: Wonderful. Well thank you so much for joining us, and you're going to be back a couple times in the coming weeks to talk about health and success during COVID-19. But now we're going to hear from some of our other MJH Life Sciences brands on their latest headlines.