Newsletter March 2007

Life is a Bicycle Ride
But before we click into the pedals, allow me to express my sincere shock at recent events like the tidal conditions that ravaged our coastline, and to everybody that suffered some sort of loss due to that, my condolences.
I am obviously as shocked as anybody else about the whole Woolmer issue and the implications thereof for professional sport. The world has gone money-crazy. Or just plain crazy! Period.
Then it is with palpable amazement that we saw Shaun Pollock went for 8 runs per over against our friends from down under. And the Sharks – “oh my goodness Doll, what went wông”?
As they say in the classics, ‘Winning isn’t everything. It is the only bloody thing’.

Which brings me to the topic; Life is a Bicycle Ride. “Huhh?”
Firstly, some (boring) background facts, necessary to create the analogy between a bicycle race and the true essence of life, life itself. It is also necessary to inform the reader of some of the more subtle nuances of the sport which will become evident when the comparison is made.
What is the purpose of competitive cycling? To win of cause. Yeah, I hear you say, when someone like myself competes in a big cycle race, who will I be winning? I will be winning thousands of other recreational but competitive cyclists and in turn will be beaten by thousands other and better cyclists. I will be racing against my own watch. To better our time, to better our position, to better our national seeding; those are the things that drive us.
How do you do this? You use other people. Yes, just like that. And you do not even have to ask permission. As one of the famous Sporting Equipment companies says; ‘Just do it’.
How? You ride with a fast group and you make use of the collective slipstream of say thirty or more fast moving cyclists. It more or less sucks you in and drags you along. It is called ‘Drafting’. This way you can conserve enough energy to see you through a tough race. All you need to do is be alert, (crashes, sometimes major, do happen), and try not to be dropped from this group (called a Peleton) on the hills. If you can stick with a fast group, suffer on the hills and sit tight in the flat and downhill areas, you can achieve excellent times. But as I said, be alert. You can also lose contact with the peleton if you are only watching the one or two persons immediately in front of you because they can in fact be losing ground and if you are not awake, you might suddenly find yourself in a little slower group of three cyclists with a awful gap of fifty meters to the main group. To catch them without the effect of drafting takes a tremendous effort.
Now that you have some of the background, the following sequence of events will make a bit more sense.
During the very recent Cape Argus Cycle Tour in Cape Town, the very same type of scenario happened to me and after the immense pain it caused me; I made the comparison mentioned earlier.

After the normal hectic start, the first climb out of the CBD caused the muscles to burn prematurely as everybody in the starting group jostled for a comfortable position in the peleton. From the top of the hill, going down into (aptly named) Hospital Bend, we passed a huge pile-up of tangled bicycles and cyclists lying on the road surface. Ambulances, choppers, emergency vehicles, officials screaming, marshals directing us through the carnage of more than twenty cyclists that crashed. Off we were over the next hill, but everybody subconsciously slowed down just a tad due to a certain sense of apprehension. This passed within five minutes and we were screaming through Muizenberg, Vishoek, and on to Smitswinkel, the first real tester of a hill. By now we were all more or less tucked into positions picked with great care.
Now, Freddy Mercury (late) from the band Queen (former) wrote two very apt songs, namely ‘Fat Bottomed Girls’ and ‘Bicycle Race’. So, I was positioned behind one of those girls in one of his races. Behind her for no reason other than the slightly wider slip stream she offered. She, lets call her Big Mama, in turn, was directly behind a very skinny fellow with big calf muscles and a very fancy and expensive bicycle. I suppose she thought that he will slice through the air? Who knows.
I got real comfortable just sitting there, getting pulled along and looking at nothing but the rear wheel of Big Mama’s bicycle. By now we have topped the hill and were heading into a slight headwind going towards Kommetjie on a long flat(ish) stretch. That is where it happened. I looked up, jerked out of my trance by the lack of noise so reminiscent of a huge peleton going at speed. It must have been a couple of minutes before I realised that something was amiss. Skinny lost contact with the peleton. We were now three solitary cyclists fifty meters behind the main group, and rapidly losing more ground. Sore Legs Naudé, Big Mama, and Skinny. I pulled out of Mama’s slipstream and rolled up to Skinny. “You lost them” I panted. (“You incompetent little Twit” I wanted to say.) “Help me catch them”. “Please” And I put the hammer down and started the worst fifteen minutes of the entire race. After only about two minutes I glanced back and they were not on my wheel! They were ten meters behind. “Come please” I begged, hoping that we can alternate the front position to maintain speed and conserve energy. Not today though. Mama is trying her best but without the peleton, she is just not able to keep up. Skinny, my friend Skinny, has discovered a new comfort zone behind Mama’s slightly enlarged frame. He is now drafting and nothing is going to pry him out of that spot. He is floating on air, getting propelled by the wind breaking abilities of someone not even closely on the same level of fitness that he is. But it is nice.
And that, is the story of life itself.
Let’s be honest, we all want to succeed in life, beat the Jones’s, better our ‘Life Seeding’, excel, win. Early in life you realise that you probably cannot do it all by yourself. You need people. You need partners. Team members. A peleton. All you have to do is make use of their collective momentum, expertise, knowledge, conserve your assets, and if it lasts and you can remain prominent in this society, you will have enough energy and abilities and the necessary means to make a final dash for the winning line and take the honours.
But you always get the like of Skinny and Mama. She tried but was not equipped. He lost contact with his group, labelled himself as a failure and immediately went into a new comfort zone. You get them in life and no amount of begging can get them to help you. They are what today’s youngsters refer to as losers. Learn from this analogue; If they are not contributing to your race through life and, most importantly, if they do not want your help, better leave them behind. They will always find a Big Mama to comfort them and lead them. They will also eventually reach the same finish line, albeit somewhat later. That is inevitable in life. As they say, ‘Life is a Terminal Disease – nobody gets out alive’. Some just ends better than others, but then again, some are happy to have a lower life-speed-seeding than others. The beauty lies in the fact that we are all so different yet we are all riding in the same Bicycle Race called LIFE. Make the most of it, make use of the collective drafting of your family, friends, colleagues, and when you finally make your sprint with energy conserved with their help, remember to thank them in your heart when you take the honours.
What happened with the rest of the race? I left the two of them behind, burnt up unnecessary energy and fuel to try and catch the peleton, and after fifteen minutes of pain could not get closer than an agonising twenty meters. I had to slow down and wait for the next big group from behind to preserve whatever energy I had left. They arrived soon after that and I managed to finish in that group in a respectable time. At the end, I lost almost twenty minutes to the initial group. And Skinny? I saw him finish by sheer luck (there are thousands of cyclists) – he was just ten minutes behind me. Without Mama. What happened to her I do not know. I hope she finished well because she tried so hard.
Last lesson? If you get thumped on the nose and you cannot keep up with your peers, make the necessary adjustments, reorganize, work hard and you will win old Skinny. If only just. And remember, comfort zones are never permanent. Greetings from the saddle,
Pieter & Renette Naudé.

Newsletter February 2007

Not a Heat Wave.
This was according to the SA Weather Bureau on the 7th of February. They also “promised” cooler weather. They also could not foresee any real danger to the Mozambican coastline due to the summer cyclone season.
I’m beginning to trust them as much as the Department of Health.
“Did I say that your Honour?”

Question: If you saw a heat wave, would you wave back?
OK. Yes it has been slightly warmer than expected. And why would three air conditioners decide to pack up in a relative short period of time, right in the middle of a supposedly non existing heat wave? I do not know the answer to these and other questions but what I do know is that this type of excessive heat combined with the high humidity experienced lately, is quite dangerous. Yes, not only is there a high discomfort index involved, there is actually a high risk index as well.
Apart from running out of beer halfway through the next Sharks game, there is a very real threat of Dehydration, Heat injury, Heat fatigue, and with those, the very dangerous possibility of Over-Hydration due to the wrong advice and subsequent incorrect ways to treat or prevent Heat related conditions.
So in the midst of this slight heat ripple (ala SA Weather), let me elaborate a bit on the body’s ways to handle or sometimes not handle such heat.

Core Temperature:
The body's dominant forms of heat loss in a hot environment are radiation and evaporation. However, when air temperature exceeds 35°C, radiation of heat from the body ceases and evaporation becomes the only means of heat loss. Evaporation is maximally efficient in a dry environment. If humidity reaches 100%, evaporation of sweat is no longer possible and the body loses its ability to dissipate heat. Now, to cool down, it becomes dependant on electric aids like fans and air conditioners, or riding on the back of a very fast and very tough Ford Bantam, or cycling downhill all day. If these are not available, your core temperature will gradually increase, dependant on the level of activity, until it reaches dangerous levels.
If one tries to keep your level of activity as low as possible, seek out cooler areas, and rehydrate correctly, the core temperature will not readily go to dangerous levels.

Dehydration:
Sweating is the way in which the body maintains its core temperature at 37 degrees centigrade. This also results in the loss of body fluid and electrolytes (minerals such as chloride, calcium, magnesium, sodium and potassium) and if unchecked will lead to dehydration and eventually circulatory collapse and heat stroke. The progressive effect of fluid and electrolyte loss on the body is as follows:
% body weight lost as sweat & the physiological effect:
2% - Impaired performance
4% - Capacity for muscular work declines
5% - Heat exhaustion
7% - Hallucinations
10% - Circulatory collapse and heat stroke
Electrolytes serve three general functions in the body: Many are essential minerals, they control movement of water between body compartments, and they help maintain the acid-base balance required for normal cellular activities. A liter of sweat typically contains 0.02g Calcium, 0.05g Magnesium, 1.15g Sodium, 0.23g Potassium and 1.48g Chloride. This composition will vary from person to person.
Elderly persons are at increased risk for heat-related problems because of underlying illness, medication use, declining adaptive thermoregulatory mechanisms, poor access to air-conditioning. Neonates have an increased risk of heat-related illness because of poorly developed thermoregulatory mechanisms and inability to make behavioural adjustments.
Chemical items that may affect the ability to regulate temperature are amongst others; Beta-blockers, Certain cold & flu medications, Diuretics, Ethanol, Antihistamines, Certain older antidepressants, Aspirin (regular use), etc.
Rehydration is the replenishment of water and electrolytes lost through dehydration. It can be performed by oral rehydration therapy (drinking an electrolyte solution) or by intravenous therapy (adding fluid and electrolytes directly into the blood stream).
As oral rehydration is less painful, less invasive, less expensive, and easier to provide, it is the treatment of choice for mild dehydration. Because severe dehydration can rapidly cause permanent injury or even death, intravenous rehydration is the ultimate treatment of choice for that condition.
Drinking plain water causes bloating, suppresses thirst and could lead to over hydration. It is a poor choice where high fluid intake is required. Water contains no carbohydrates or electrolytes.
Concerns about the potential risks of Over-hydration and consequential hyponatraemia (low blood sodium levels) for endurance athletes have been raised in several quarters following the death of a female runner during the 2002 Boston marathon.
The athlete, who died of hyponatraemic encephalopathy (swelling of the brain caused by severely reduced blood sodium), had reportedly ingested excessive amounts of fluids before, and during the race.
Hyponatraemia results from an abnormally low concentration of sodium in blood plasma. A sustained decrease in plasma sodium concentration disrupts the osmotic balance across the blood-brain barrier, leading to a rapid influx of water into the brain. This, in turn, leads to swelling of the brain, which can progress to confusion, seizure, coma and even death.
Various factors can lead to a fall in sodium concentration, including loss of sodium in sweat and decreased sodium intake. But the rapid intake of large quantities of fluids, which effectively dilutes the blood, appears to be the major cause of dangerous reductions.

Now that I have your attention, what am I trying to say? Only that when nature turns tough, our frailty becomes very evident. Temperature goes up, humidity goes way up, lawn needs a trim, out you go with your old army-issue green metal water bottle strapped to your locally made leather belt, filled with the goodness of H2O. Under the fig tree, there is the regulation Coleman cooler, filled with more water and lots of ice.
For two hours you toil away, all the time feeling thirsty and sweating like the proverbial Hog. Dizziness starts to bother you every time you take the sharp left turn around the bed of Malva parviflora,, nothing much, must be the new beta blocker you started last week. At the next turn, you will allow yourself ten minutes and enjoy a cold beer or two.
One hour later, the headache hits you. Extreme thirst! Drink more water. Take two, no, take three aspirins for the bloody headache!
You are in trouble. You went from high core temperature to hyponatraemia via dehydration and because of the wrong rehydration.
Making no sense?
In brief, and in conclusion:
Nothing wrong with mowing the lawn. Wrong time of the year / day though.
Nothing wrong with alcoholic refreshments. But not when you are already severely dehydrated.
Nothing wrong with drinking water. But it has NO ELECTROLYTES!
Drink the right stuff! Rehydrate with either a good sports drink, or even some rehydration preparations sold as conjunctive treatment for severe gastro-enteritis. Or contact me for a cheap homemade emergency recipe.
Most importantly, know your body and how much heat it can handle; know how much your body loses through perspiration.
We have less than a month for this heat to make way for the wonderful autumn weather we know so well and can only dream of at this moment.
Enough of the clammy stuff. Greetings from the pool,
Pieter & Renette Naudé Will be in Cape Town for the middle two weeks of March. Hopefully cooler down there! Keep healthy and hydrated! See soon.

Newsletter January 2007

“Listen to your Mother” must rank amongst the most frequently used pieces of instructive conversation anybody heard in their lifetime. How many times did you hear that phrase? What has she actually taught you?

Mothers taught us RELIGION; "You’d better pray that will come out of the carpet."
Mothers taught us about TIME TRAVEL; "If you don't straighten up, I'm going to knock you into the middle of next week!"
Mothers taught us FORESIGHT; "Make sure you wear clean underwear, in case you're in an accident."
Mothers taught us about BEHAVIOR MODIFICATION; "Stop acting like your father!"
Mothers taught us GENETICS; "You're just like your father."
Mothers taught us about JUSTICE "One day you'll have kids, and I hope they turn out just like you!"
But the most important thing she taught anyone of us is; “Wash your filthy hands before you touch anything.”

And that will be the theme for this newsletter: Contamination. I am going to inform you, to shock you, to wake you up. I don’t often do informative newsletters but this is very necessary and I will fail in my professional capacity if I do not share this with you.

Here goes.

The Six Common Household Items With the Most Germs
Germs in the home can show up where you least expect them, even if you diligently try to keep your home clean. Despite good efforts by most to keep their homes germ free, over 65 percent of colds, 50 percent of all cases of diarrhoea, and 50 percent to 80 percent of food-borne illnesses are caught in the home and common household items are often to blame.

So what is the most germ-ridden room in your house? It's not the bathroom--it's the kitchen. In fact, there could be up to 200 times more fecal bacteria on your kitchen cutting board than on your toilet seat. This is likely because people regularly disinfect their bathroom while kitchen items may be overlooked. (Wow you really needed to know that, don’t you?) (Hope you are not eating at the moment)

The following household items are commonly overlooked sources of contaminants that can easily be kept clean with a little elbow grease.

1. Kitchen Sponges and Rags:

The moist environment of sponges and rags is an ideal place for bacteria to flourish. Wiping your counters or dishes with a dirty sponge will only transfer the bacteria from one item to another.
Replace kitchen sponges and rags often. Ideally, this should be about once a week. Allow them to dry out between uses. Most bacteria can only survive a few hours on dry surfaces. Make sure that you remove all organic material from the sponge or rag before you leave it to dry.
Disinfect sponges regularly by putting them in the dishwasher. Rags should be washed in the washing machine and then dried on high heat. You can also sterilize sponges in the microwave. A dry sponge can be sterilized in the microwave in 30 seconds, a wet sponge in 60.

2. Cutting Boards:

The cracks and crevices in your cutting board provide plenty of space for bacteria to grow. Be careful of cross contamination. If you use your cutting board for raw meat or fish, be sure to sanitize it thoroughly before chopping vegetables! To clean the board, first hand-wash it using hot water and dish detergent to remove any food particles. You can then use an approved antiseptic surface spray and wipe dry with absorbent tissue.

3. Kitchen Surfaces

Kitchen countertops can still harbor germs even if they look clean. This is especially true if you've "cleaned" them with a dirty sponge or rag. The kitchen tap and handle is an often-overlooked source of potentially harmful bacteria.

4. Sink Drains

The drains in both your kitchen sink and bathtub provide yet another moist environment that bacteria love. Use baking soda and an old toothbrush to get rid of stains, grit and grime around drains. Disinfect drains regularly as you would any other surface.

5. Doorknobs

Bacteria can easily accumulate on doorknobs and other handles such as the particularly problematic refrigerator handle. Anyone can transfer bacteria from their hand to a doorknob, and these bacteria can cause illness, especially if the person is sick, doesn't wash their hands after going to the bathroom, or has touched raw food. When you touch the doorknob you may also pick up the bacteria, which can then enter your body if you touch your eyes, nose or mouth. Wash your hands frequently, even if they don't look dirty, but be careful not to overdo it. If you wash your hands too frequently, the fatty acids in your skin will be depleted, which leaves you susceptible to open wounds and sores that actually increase the risk of infection. Antibacterial soaps are completely unnecessary, and they cause far more harm than good. It would be wise to identify a simple chemical-free soap that you can switch your family to. Treat doorknobs and the refrigerator handle regularly with a good antiseptic surface spray.

6. Toothbrushes:

It's important to replace your toothbrush every three months not only because of bacterial accumulation but also due to bristle wear. Replace your toothbrush after you've had an infectious illness to avoid coming in contact with any lingering bacteria.

I'd like to mention that I don't recommend going through your home on an antibacterial cleaning frenzy. Doing so will disrupt the balance of bacteria in your home, wiping out both good and bad varieties, which could pave the way for harmful bacteria. You are better off using antibacterial/disinfectant cleaners on an item-by-item basis rather than as an all-purpose cleaner. Also be aware of the ingredients in commercial cleaners as many contain harsh chemicals that can be harmful to your health. Speak to us.

Germs are Easily Transferred From Everyday Objects To Hands

A new study has found everyday objects such as telephones and kitchen taps can transfer high levels of potentially dangerous bacteria to the hands. And from the hands, bacteria often end up on the lips. In one of the studies, the researchers looked at coliform bacteria, including fecal coliforms, on the palms of volunteers' hands after making dinner, cleaning the house, doing laundry, using a public restroom, petting a dog or a cat, or returning home from elementary school. The volunteers' hands were disinfected before the activity. Surprisingly, they found that people had the least amount of microorganisms on their hands after leaving a public restroom, while people had the most after making a meal. After making a meal, cleaning the house ranked next with transferring the most bacteria, next came petting a dog or a cat (dogs transmitted the most germs of the two) (However cuddly they may be, cats and dogs can bring a multitude of germs into your home. If your cat walks on the kitchen work surfaces make sure you clean them thoroughly before preparing food. Cats and dogs have also been found to be a source of salmonella!), then came returning home from school, then doing the laundry (because of handling underwear), and finally using a public restroom.

Some statistics:

Squeezing out a sponge transferred between 100,000 to a million organisms to the hands!
If somebody in the house is sick the toilet should be disinfected every time they use it. A typical trip to the loo can create up to 100 billion potentially disease causing organisms some of which end up in the air and on the toilet after flushing - even if the lid's put down.
When they added the mix of organisms to volunteers' fingertips, they found that 35% to 40% were transferred to the mouth. This is a dose large enough to cause infection with organisms that cause colds and diarrhea.

So what am I saying? “Listen to your Mother”: Wash your hands! And pay attention to contaminated surfaces in your environment without getting paranoid or obsessive or compulsive or plain hooked on washing!

What kind of germs are we talking about here? Well, anything, but commonly the most prevalent ones are those causing Food borne Diseases like Viral Gastroenteritis like Rotavirus, Bacterial Gastroenteritis like the Salmonellosis, Influenza, Colds, Inflammatory Bowel Disease, Arthritis, Kidney Failure, and many more.

To prevent harmful bacteria from growing in food, always:

· Refrigerate foods promptly. If you let prepared food stand at room temperature for more than 2 hours, it may not be safe to eat. Set your refrigerator correctly.

· Cook food to the appropriate temperature Foods are properly cooked only when they are heated long enough and at a high enough temperature to kill the harmful bacteria that cause illness.

· Prevent cross-contamination. Bacteria can spread from one food product to another throughout the kitchen and can get onto cutting boards, knives, sponges, and countertops. Keep raw meat, poultry, seafood, and their juices away from other foods that are ready to eat.

· Handle food properly. Always wash your hands before touching food and after using the bathroom, changing diapers, or handling pets, as well as after handling raw meat, poultry, fish, shellfish, or eggs.

· Clean surfaces well before preparing food on them.

·Keep cold food cold and hot food hot.

· Maintain hot cooked food at 60°C or higher.

· Reheat cooked food to at least 75°C. Refrigerate or freeze perishables, prepared food, and leftovers within two hours.

· Never defrost food on the kitchen counter. Use the refrigerator, cold running water, or the microwave oven.

· Never let food marinate at room temperature; refrigerate it.

· Divide large amounts of leftovers into small, shallow containers for quick cooling in the refrigerator.

· Remove the stuffing from poultry and other meats immediately and refrigerate it in a separate container.

· Do not pack the refrigerator. Cool air must circulate to keep food safe.

So why am I going on and on about disinfecting and cleaning and wiping and drying and hygiene and germs and what not?

Whoever was present during the past holiday season saw the desperation and suffering of these poor souls from far away that came here to relax and get some well deserved rest.

They got the dreaded Gastro instead. They could not relax (especially certain sphincter muscles), they could not rest (they had to stand in line with hundreds other victims to share overcrowded public bathrooms or wait patiently at the local pharmacy for some form of help).

What caused the outbreak? Nobody really knows, I don’t think there was enough time for any healthcare staff anywhere to run detailed microbiological diagnostics; everybody were just trying to plug holes (pun intended). What caused the condition to become so big and almost out of control? Let me tell you: Everything that you have read so far in this edition was ignored at some stage by someone and those individual cases blended into a panic-stricken sea of disease. Whole families were affected; whole buildings were affected, the whole coastal area became a quagmire of diarrhoea, vomiting, dehydration, spasms, fever, and total misery.

Were you part of this? Were you affected? I seem to think that the locals were immunological better prepared or maybe we were more confined to our own areas and did not share the public places with as many people as did the holiday makers. Whatever the reasons, I did not see many local people affected as bad as some of the visitors.

People were blaming the tap water, they were blaming the lagoons, and they were blaming the restaurants, the air that we breathe. They blamed the locals, the locals blamed them, they blamed the doctor’s surgeries, the hospitals, even the municipalities were implied, and all that was in fact wrong was they didn’t wash their hands! They didn’t listen to Mother.

Here is the bottom line: When you are near another human being, follow these rules, called the Naudé Paranoid Hand Rules:

When this other person approaches you, sneak a quick glance in the general direction of their hands.

If this other person is busy with some activity like preparing food, serving drinks, cleaning; sneak a longer glance in the direction of their hands. If this other person is attempting to touch you or indicating by way of gestures that you are about to be touched, take a long hard stare at their hands.

Why?

One reason only; look at the hands and ask yourself these simple questions: “Where were those hands just now? What did they touch? What are under those nails? From where did those fingers recently emerge?

Then follow those hands and see what and where they touch.

Be scared. Be very scared.

That is enough of the scary stuff.

Maybe on second thoughts, time for a quick commercial - seeing that it is now almost commonplace to do that; my manufacturing business called PeeCee has launched a product called PeeCee Protection Spray, born out of fear and frustration during the Gastro Epidemic. It is an extremely effective antiseptic surface spray. Pity it only came out off the development stage right at the end of the season, it could have saved a lot of people a lot of misery. We supplied a group of sports people in a bus with a couple of bottles of spray when they had 5 or 6 people already sick. They sprayed the grips and common surfaces in the bus and nobody else became sick during the remainder of their tour!

At the same time the germ spread like wildfire through even upmarket residential blocks.

We supplied a lot of people during those last weeks of the holiday season, and we obviously used the product liberally in the pharmacy where hundreds of people handled prescriptions, money, handbags, towels and what else on a daily basis.

We sprayed the counters, the toilets, the door handles, the cash drawers and on top of that we washed our hands every 2 hours. Result? During the entire 4 weeks, through contact with all those affected people, we had NO incidence of Gastro amongst my staff! Am I getting through to you now?

This situation can easily repeat itself in the future. Will you be prepared?

Wow, this was a long one. Wet of the Press (pun NOT intended).

Greetings and a show of clean hands,

Pieter and Renette Naudé

Newsletter December 2006

Grudge-Purchases versus Joys of Choices

So here we are again, it is Christmas day, it is HOT and it is time for the monthly newsletter. It was indeed another tough year and the recent developments around the professional fee as explained last month didn’t help much.

But life goes on, we will have to take some serious and lasting decisions in the New Year, there are going to be some rather dramatic changes to the face of Pharmacy in general but more so at Uvongo Pharmacy. Watch this space . . .

One thing that I cannot change because it is a part of the intricate nature of human beings; we just hate making Grudge-Purchases! The complete opposite is the wondrous Joys of Choice. “What are these two concepts”, I hear you ask yourself?
Let me give you two typical scenarios which will explain the above, but more importantly, will hopefully highlight why there is battle raging in certain type of shops. A battle? Yes, and you have probably fired some fiscal shots at the keeper yourself!

“Good evening Sir, welcome at WDC Exclusive Grill house”, the man in the Tuxedo purrs your way. “Table for two I presume?” he adds with a smile. A genuine smile; because he knows something that you don’t. In fact, he knows a lot of things that you would never even think about. He leads you through the dimly lit interior to a luxurious-looking, well set table, with the soothing sounds of a subtle water-feature nearby. You get comfortable; the man has now disappeared, but is quickly replaced by a reincarnation of James Dean, smiling as well, because he also knows something! “Good evening folks, my name is Philipe, I will be your absolute servant toning, your wish will be my command”.

By now can start to pick up the smell of some glorious dishes from tables around you. You can also see the texture of the food, you can almost feel it under your knife, and you can nearly not wait for Philipe to return with the wine list so that this wonderful experience can begin in earnest! Man, you can all but taste those last plates of food delivered to the smart looking couple in the corner. You want this food. You want this wine. You want this evening.
You are almost halfway through the bottle of Rubicon 2000 when two lovely young girls deliver the stuff dreams are made of; your perfectly prepared Swiss Trim Rump Steak with the Blue Cheese sauce and stuffed with Black Olives. Three hundred grams of Heaven! Right there on your plate. Streams of Amylase are released into your mouth by the Salivary glands in anticipation of the taste explosion and pure enjoyment that is to follow. You take your first bite. You really wanted this so much! You actually booked in advance!


Another time, another place: “Good evening Sir, welcome at WWFF Pharmacy”, the man in the white shirt sings in monotone. He looks tired, drained and his clothes a bit tatty. “Prescription, I presume?” he adds with a slight flash of terror in his eyes. True fear; because he knows something which you also know and he knows that you know and he knows what is coming.
You woke up that morning with a slight burning sensation in your chest. Didn’t think much of it, but by mid-morning you were doubled-up in pain and vomiting what seams to be Swiss Trim Rump with….
“No it is not the food, you had an Angina attack sir”, the doctor exclaimed while scribbling attentively on a piece of paper you immediately recognise as that much hated and ancient means of communication between different fields of the medical fraternity; the prescription!

Back at the pharmacy, your prescription to a scared looking reincarnation of Emily Hobhouse. Scared, because she also knows what you know.
The prescription is finally filled and brought back to you. You gladly take ownership of the medicine because you really want to get rid of the fear the doctor planted in you when he told you about your high cholesterol and the danger to your heart. You want this medicine. You want to prevent the pain.


Get the picture? Not yet? Here goes:
There are quite a few similarities here, but there are also some definite differences. It all comes to boil at an extremely crucial point in both scenarios: The handing over of the Bill of Account. That is where the capsule hits the stomach acid (or ze pooh-pooh hits the fan). You act out of defence, you act because of social experience, and you act because of a certain gut-feel, depending on what scenario you are paying for.

At WDC Grill house you open the bill, you immediately add at least ten percent to the amount (depending on how much Mr Dean impressed you), and you briefly scan the account to make sure that the R340 for a meal for two is acceptable. You do not realise that WDC is short for We Charge Double – they just made a gross profit of at least R200. You accept, making a bit of a grumbling noise while fishing out your Amex Gold. You can still taste that Chocolate Clafoutis when your receipt is handed over. Lovely!

At WWFF Pharmacy you open the bill, you immediately start swearing and asking for discount, threatening the poor assistant with the latest legal changes to the pricing structure of prescription medicines. You cannot believe that the three items for a potentially threatening situation can be as much as R340. You do not realise that WWFF is short for We Work For Free – they have just made a gross profit of R60 Reluctantly you fish out the card, make the payment, temporarily relieved of the fear, possibly from all the Adrenaline pumping through your body, brought on by the anger.

Why the difference in attitude? You wanted both products? Both products did something for you. The one tasted like heaven and added two points to your already elevated cholesterol levels; the other didn’t taste like anything and dropped your cholesterol level by ten points and will continue to do that for the next thirty days. But you wanted both?
You have just lived two scenarios;

1: You made the choice from a menu and decided how much you are prepared to pay for the pleasure. You actually planned to make this Choice-Purchase.
2: You had no choice from the prescription and did not want to purchase medicine. It wasn’t planned and you resented this Grudge-Purchase.

And you will resent that purchase every time, and because deep down you don’t really want it, you will feel entitled to knock down the price.
Lastly, why did the respective people who met you at both premises react the way they did? At WDC they knew that you will gladly pay, even more than the perceived price, without as much as a frown. At WWFF they knew that there was going to be a battle as soon as it came to the payment. Smile versus apprehension. Good news versus bad news.

As long as we keep on selling grudge-items, we will be on the receiving end of this wrath of the public and we will have other interested parties trying to undercut our professional fees. It is a way of life. As long as the public occasionally take a look at similar scenarios, realise that life is all about choice but that we, are not the reason for their ailments; we are just the persons in charge of the substance that will make them better.
Sometimes though, if we all make the right choices with our lifestyles, some of these ailments might never create the necessity of making a Grudge-Purchase.

Quick commercial? We perform Cholesterol tests. Affordable!
You can even add ten percent if you like the treatment. Just pay the man in the tatty white shirt. No discount. Appreciate his service.

Then again, if Manto keeps on applying the pressure, you might find Mr Dean-look-alike employed at number 5 Foster street at the MYCAP Seafood Grill and Dispensary. That is short for Make Your Choice And Pay.

Festive Greetings from the kitchen,

Pieter and Renette Naudé.

PS: I have nothing against the Restaurant fraternity. In fact, I spend way too much money at these fine establishments! They supply an excellent product accompanied by excellent service and should be paid well for it, don’t you agree? Till next time…….

New pricing regulations

It is with great relief that we read the following statement by The Pharmacy Stakeholders Forum (PSF):

It is with relief that we can announce that the dispensing fee published on 1 December 2006 will not come into operation on 1 January 2007.

Following an application challenging the dispensing fee brought by the applicants (Pharmaceutical Society of SA, South African Progressive Pharmacists’ Association and United South African Pharmacies) the Department of Health agreed to suspend the implementation of the dispensing fee. This agreement was formalised by an order issued by the High Court of South Africa (Transvaal provincial division). This order specifies that the dispensing fee will not come into operation on 1 January 2007, pending the outcome of the challenge to the dispensing fee regulations.

The Pharmacy Stakeholders Forum (PSF) thanks the Minister and the Department of Health for this relief and the PSF would like to recommit itself to finding a resolution to this matter as soon as possible. It would be welcomed if such a resolution can be found outside of the legal process.

The PSF would like to ensure the public that there is no reason to believe that pharmacists, who are members of an ethical profession, will seek to exploit the situation by charging excessive dispensing fees.