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Our Profile in Personalized Medicine highlights Neda Debassige Toeg, BSP, RPh, founder and owner of Sweetgrass Pharmacy & Compounding in Manitoulin Island, Ontario, Canada. Neda shares her experience as the first Indigenous-owned and operated pharmacy on a reserve in Canada, highlighting the impact on her community and patients. She also shares what motivated her to become a compounding pharmacist, the special role compounders hold in healthcare and more. Nada has been a proud PCCA member since 2019.
Compounding is very personal, as well as personalized. This is not just a business. The services and products that come from Sweetgrass Pharmacy & Compounding are for members of my family, my community, my people. It is very important, on a personal basis, that we provide effective care. I take their health and wellness personally. Patients come in and tell me, “I'm just popping in to tell you that you've changed my life. Thank you for all you do.” That's a gift — the most important gift.
Going beyond the community aspect, it is important to recognize that pain is subjective and a one-size-fits-all solution will not work. To get results, each medication needs to be matched and personalized to the individual who uses it.
I wanted to make a difference in my community. I was studying to be an MD and took a side trip into pharmacy and ended up loving it. The foremost reason that I decided to specialize in compounding is that it allows me to individualize patient care and patient dosing. Compounding and the ability to individualize the medications in pain treatments allows me to assist people more effectively and safely in managing their pain. My background in pain and addiction management, as well as in autoimmune diseases and cancer, allows us to help patients — especially in a rural setting — that might not get the healthcare that they need.
To achieve my vision of an integrated healthcare environment that provides high-quality solutions for medical issues within my community and beyond, I need access to quality pharmaceutical products, training opportunities for staff, and a receptive and active community of like-minded professionals. I have found that PCCA delivers all three components. Their products consistently deliver high-quality results and work better than other products I have tried. The PCCA training courses are highly effective and a key aspect of our business model. For example, within their first year of employment, each pharmacy assistant at Sweetgrass attends PCCA Canada’s Comprehensive Compounding Course (C3) and brings that knowledge back to the pharmacy and to the rest of the team. Staff who attend benefit from increased skills in compounding, as well as their confidence. The training also creates, at the ground level, a network that goes beyond the pharmacy. The PCCA community, which exists at all levels, provides the ability to share and gather solutions for the medical issues we face on a regular basis.
Compounding is the future of health care. By personalizing care through individualized compounds instead of “one-size-fits-all” medications, we are able to truly fulfill our fundamental principle of “doing no harm.” As this concept is more fully understood and the paradigm shifts, patient care will improve, new solutions to pain management will be developed and used. I firmly believe that we can use compounds to help address the continuing opioid crisis by providing strategic pain management to support the withdrawal process.
It is also important as we move into this future that we embrace our traditional roots. My dream is to bring traditional, natural Indigenous ingredients and knowledge into today’s products. For example, in the Indigenous community, bear grease can be used for skin ailments (rashes, sunburns, etc.), ligament problems (arthritis, tendonitis, sprains, etc.) and as a hair conditioner.
A young Indigenous woman had severe psoriasis for more than eight years. Her mother had taken her to countless specialists and tried several creams, but without success. The young woman had low self-esteem, missed a lot of school and experienced considerable pain. Working with her practitioner, we provided a topical low-dose naltrexone (LDN) cream with XemaTop™; after just one week, we saw incredible results as her skin cleared up and the pain subsided. She is now on oral LDN and is stable. Far beyond the physical benefits are the emotional and social ones. The patient’s self-esteem has increased and she’s developed a desire to help others. She now works at Sweetgrass, regularly interacting with the public, and is training to be a pharmaceutical assistant.
Be open to sharing your knowledge with other compounders. PCCA provides an excellent community and resources for information sharing. Don’t be afraid to ask for help. This is a hard thing to do; it's a scary thing to do. But in the end, it's absolutely worth it. Someone else may have dealt with the same issue. Share what you have developed with others. By building on what we learn, we can create an even stronger community.
NataTroche® is an excellent base. Working with prescribers, we compound troches that help people wean off opioids and start on low-dose naltrexone without loss of pain management.