Adler Apotheke

This morning, we headed to Adler Apotheke after breakfast for some time in the pharmacy!  We were split into two groups. 

My group started off with herbal teas.  Sebastian and one of the pharmacy technicians taught us about some different plants, which parts are used to make teas, and what the teas are used for.  We experienced many tea tastes and smells. 

Selam measuring out some tea ingredients

Herbal tea makers

Each of us got to prepare an herbal tea called Erkaltungstee (used for colds/cough).

With the finished product

A few of us headed back to the Burgerstube during lunch break, and then met back to Adler in the afternoon. 

Next up, we compounded a hand cream using the pharmacy's undulator machine.

Corey measuring up his cream ingredients

Product being mixed

Hand cream!

Traci and pharmacy tech testing out our product

Nic then led a discussion about herbal tea use in pharmacy. 

After our day in the pharmacy, it was time to listen to a presentation from Sebastian and then prepare for a surprise!  

Sebastian's presentation about technology at the University of Dusseldorf 

Distracting Sebastian with wine and cards

He has no idea he's about to be surprised!

Our last day is coming up, and Sebastian's birthday is in about 3 weeks, so we decided to throw him an early celebrate celebration.  After learning that early birthdays are bad luck in Germany, we decided this would be a really late birthday party instead. 

Something along the lines of "happy birthday greetings..."

Cutting the birthday cakes!

Happy Birthday, Sebastian!

Koln

Monday morning we had breakfast at Ms. Biester's with Sebastian, then headed for the bus and train with Preceptor Nic. 

Once we arrived in Cologne, we stopped at a McDonald's for lunch and then headed to the Deutscher Hausarzteverband for a meeting with Ulrich Weigeldt.  He is a general practitioner and elected representative and chairman of this organization. 

With Weigeldt at the DH

Weigeldt shared with us a presentation about strengthening primary care through contracts, using risk adjustment diagnoses for patients who need specialty care, and other topics regarding healthcare. 

After our visit, Nic took us into the city center of Cologne.  He led us on a "tour" of the Dom (Cologne's cathedral).  

The Dom in Koln

Nic teaching us a bit about the Dom

Modern art window, from early 2000s

Nic was handed a letter explaining how he can't talk to a group while inside the church, unless he becomes an official tour guide

The group scattered a bit; Nic led Sarah, Traci and I up the Dom to show us the city from up high!

Roman remains underneath the cathedral

Building progression of the Dom

533 steps of dizzying fun

Yes, the bell rang and scared the crap out of us

Props to Nic for this pic

We all met up at a brewery for some beer , then headed back on the train for dinner at The Buergerstube. 

Pharmacy Chamber in Dusseldorf

After a heated discussion during breakfast, we headed to Dusseldorf to visit their pharmacy chamber.  

Back in Dussesldorf

Made it to Dusseldorf Pharmacy Chamber

The Dusseldorf chamber President and Vice President introduced themselves and the chamber, as well as current projects they are working on.  The Chamber recently published results from a longitudinal study assessing medication risks for elderly patients in nursing homes.  A standardized risk management process was created to improve medication safety for elderly patients. 

The Chamber is also involved in a current project, Athina, which is a brown bag program focused on pharmacotherapy. 

The topic of continuing education for pharmacists in Germany was brought up.  Currently, continuing education is not required, but encouraged.  In the USA, pharmacists are required to complete 30 hours  of CE every two years.  Certificates are available for German pharmacists who complete CE every three years but this is not incentive enough. 

The Dusseldorf pharmacy chamber is supportive of further pharmacy research, in order to push the profession forward, but it has not been initiated. 

With the Dusseldorf Pharmacy Chamber President (2nd from right) and Vice President (left)

After discussion we headed to lunch at the oldest restaurant in Dusseldorf!

Off to Dresden Part 2

After breakfast, we had a discussion about what we learned during Berlin week (since Josh was not present in Berlin because he got sick from the botanical garden in Munster).  

Josh asked us to create a presentation comparing the G-BA (Germany's Federal Joint Commission) to systems in the United States, mainly PBMs (pharmacy benefit managers).  There are more differences than similarities, and we had an enjoyable discussion about how and if something similar to the G-BA could be implemented in the USA. 

Discussing the G-BA

After lunch from Ms Biester, we headed via 1-hour bus and 7-hour train to Dresden.  It was a lot of travel, ending with a near-sprint to the A&O hostel to check in and pass out for the night. 

Tuesday morning, we boarded a tram and bus for the University of Dresden Hospital Pharmacy to meet with clinical pharmacists.  After an introduction, we received a tour of the pharmacy.

Entrance to the pharmacy's clean room

Inpatient pharmacy

The next two hours we split into groups of two students with one pharmacist, to get a better feel for what the pharmacists do in a German hospital.  The pharmacist Julia, who Dipali and I spent time with in the urology unit, pointed out how much paper is used for documentation in the hospital (compared to more electronic records, profiles and prescribing she expects there is in the USA).  Julia spoke about the lack of infrastructure or reinforcement within hospital pharmacy regarding the way things are (like policies and protocols in the USA), as well as issues such as discharge medications from hospital setting, and not enough work being done to combat antibiotic resistance. 

Heading to the urology unit with pharmacist Julia

After two hours with the hospital pharmacists, we discussed more about hospital pharmacy, and then headed for lunch at a university hospital cafe. 

With the hospital pharmacists at Dresden University Hospital

Next came more trams, busses, and trains to get back to Velbert by around 10 PM. 

Dortmund Four Detour

Or so we thought our train ride was close to being over...

As we were almost to our transfer destination in Hannover at 7:30pm, a voice came over the loudspeaker- in German- telling us our train from Hannover to Wuppertal was cancelled, and we should stay on the current train.  Thanks to our friendly neighbors for translating. The train we were on would go to Wuppertal, but just take about a half hour longer. 

At around 9:00 pm, we started to see flashes of light in the sky, and some rain.  Once we stopped at the Dortmund train station, the rain and wind were incredible, nearly knocking over a girl with her suitcase.  When all those outside our train waiting headed for the stairs simultaneously, I knew something was up.  Another announcement on our train informed us that we had to wait on this train at the Dortmund train station until the storm passed. 

Storm ensues while we are stuck at the train station 

All was okay though...people were talking, even singing, and we met a new friend in the row next to us.  When we heard all trains in the state of North Rhine Westphalia were ceased until the storm passed, our train offered us all free drinks.  We were pleasantly surprised when we realized this included the adult beverages :)  At nearly midnight, some of us went into the train station to grab some food, knowing the train wasn't moving for awhile.  Right as we got back on the train, an announcement informed us that all trains in the state were cancelled for the rest of the he night, and we had to get off the train.  "Uuuuugh" is what we were thinking and feeling, but at least we could just go grab a taxi...or so we thought. 

Prost! Free wine for our train troubles

We waited in lines of a ridiculous amount of people trying to get taxis.  It was impossible to hail a cab, and they kept ignoring everyone.  After about an hour, we realized that some people actually getting cabs had pieces of paper they were handing over.  Heidi and I ran back into the train station to get one of those pieces of paper- a free taxi ticket from the Deutschebahn!!  We thought we hit the jackpot.  Turns out, all the taxis still did not want to drive us the hour and a half to Velbert.  We thought it was because they were jerks, but turns out they were jerks who didn't want to drive towards the storm and storm damage.  

At around 2:00 am, we decided we would take that hotel room Josh booked for us, but we felt bad because we turned it down 2 hours ago thinking we could easily get a cab ride home.  Two hotels nearby were completely full, so we got directions from Josh for the A&O hostel. They had vacancies, and said they would maybe take a free hotel ticket from the DB.  So Heidi and I ran back to the train station to get a ticket for a hotel.  The guy working said- "go to hotel espanada...50 free rooms, I called 20 minutes ago." And gave us a map.  Heidi and I basically started running, thinking this guy was crazy.  But it was already 3am, and this night couldn't get any more ridiculous.  We made it to Hotel Esplanade, where a very hardworking man was writing up tickets for people coming from the train station to stay there for the night.   We easily got 2 hotel rooms- FO FREE!!- and ran back to the A&O to get Sarah and Michelle.  The only damage done was a $12 fee at the hostel because Michelle had already made the beds...

Our savior in Dortmund

So off to Hotel Esplanade, where the line was now 20 people long. Thank god we'd gotten in 10 minutes before :) Sarah and I headed up to our room and opened the door.  Once inside, I had a strange feeling when I saw a bag in the entrance that was not there when Heidi and I checked it out before... And we sensed a strong malodor.  Turning on the lights revealed some train workers' stinking shoes and suits hanging up in the closet.  Turns out the hardworking man at the hotel lobby was accidentally double booking rooms!!! Aaah this happened to Michelle and Heidi too.  Once we got a new clean room, we locked the door behind us and finally settled in for the night. 

In the morning we received word from Josh that we should board a 9:06 am train to Essen and get a taxi from there to Velbert.  After 4 hours of sleep, we weren't too pumped to be back at the train station.  After the 9:06 train and 3 thereafter were cancelled, we decided to go back to that amazing Hotel Esplanade and stay another night, because all trains were cancelled towards Velbert for that day. Surprisingly, we got another free hotel ticket from the DB and another free night at the hotel!! #livinthegermandream 

The next morning, people still waiting for taxis

 2 free nights in a 4-star hotel

The rest of the day we spent napping, shopping, snacking, and dining in Dortmund.  We soon became recognized as the "Dortmund Four" by the rest of our group safe back in Velbert. 

Dortmund Four