We bring the FAST and laughs to pharmacy.
Thursday, December 27, 2007
Ionically Yours
Some days I am glad I wasted thousands of dollars taking chemistry and physics courses so you can call and ask me about ionic function on your hair dryer. Really? You didn't read the blurb on the box where it told you what the button did?
You probably bought it because it said this on the box:
Dries 50% faster with 1/2 the heat
Helps prevent split ends and frizzies
Makes your hair fuller, shinier and softer
Makes styling and drying your hair easy
Leaves hair healthier & more manageable
Preserves natural oils and seals in moisture
1875 Watts of drying power
Then you had to bother me because you did not read this on the box:
How does it work?
Charged ions delivered with warm air, break down water molecules, which are then easily absorbed by your hair.
Charged ions bond water droplets onto the hair shaft. Water molecules are broken down into 1/50 their normal size. Moisture is then easily absorbed by the hair shaft, making each one plumper & fuller.
The Ionic Hair Dryer was developed to help restore, fortify and beautify your hair. It emits millions of charged particles called ions that bond to your hair, breaking down moisture molecules with very little heat.
It utilizes 1/2 the heat in 1/2 the time leaving your hair up to twice as shiny as before. Your hair absorbs the smaller molecules and cell damage is reduced while nutrients are sealed inside each hair shaft. The moisturizing effect makes even thinner hair look fuller, shinier and softer.
I will tell you from experience that it does not deliver on the package's promise. I hope you did not waste an exorbitant amount of your hard earned money on this sales gimmick. If you did, I suggest returning it for a full refund or exchange for a nice regular hair dryer.
In the future I hope you will only present me with queries of a medical nature.
Ionically Yours,
Big N Tasty
Wednesday, December 26, 2007
I've Got Your Code Right Here
While on my holiday adventure with friends and family, my rhinovirus made some very powerful friends of its own. The multi-state adventure brought about a multi-state, multi-virus party and I was the guest of honor. I am still amazed at how much snot the human body can produce and is still producing. I can say that my besties this year were Dayquil, Nyquil, Puffs pocket packs, and Hall's strawberry cough drops (Dear companies aforementioned. Feel free to send me free samples as I am still sick and still using your products. They may be sent to Patient Zero.)
So I bade my family farewell as I drove to the airport with my besties and luggage in tow. Christmas day is not the best day for travel but my overnights started that night so I had to get back because my corporate paymasters would not give me the day off even though all the higher ups were not in the office....bastards...
Airport security makes me ditch the diet Mountain Dew that is keeping me mobile because I did not get the memo that 8 ounces of soda is enough to blow up a plane. Maybe I should stop drinking it because if it can destroy a plane I owe my liver and kidneys a sincere apology. Then my flight is changed. Doom. I feel like I have been digested and shat out by Jabba the Hutt and I see a swarm of people with small children at the gate to my plane.
Dear God, what have I done to offend thee? I just did what your church wants and celebrated your son's birthday with my family and friends. Is that not enough? Was I supposed to sacrifice a goat or something? Was it because I forgot the frankincense? I brought gold and Spider-man toys. Isn't that enough? Oh yeah, it is because I think organized religion is cultist bullshit so I am blessed with the ever so wonderfully relaxing screaming baby flight. Not just one screaming baby but two that are loud enough to be heard over noise cancelling headphones with the volume at eardrum shattering levels. That is an accomplishment. The connecting flight is no better but mercifully shorter.
I collect my luggage, pay the exorbitant parking fee to retrieve my car, and head home to feed the animals, bury any that have died, grab my work jacket, and pretend to give a f**k as my rhino friends beat my ass to the sound of Code Orange. I owe the annoying little c**t that does that commercial a punch in the face and a foot up the ass. Every time I hear it my will to live shrivels and cries.
So I am at work after not sleeping for 2 days, suffering viral meltdown, listening to bullshit commercials and having fueled this excursion with pop-tarts that I ate 10 hours ago and otc meds. I am starving and F**king exhausted. So I have my own Code Orange consisting of Cheetos and a Butterfinger. That is by no means helping me as the Cheetos make me want to vomit about an hour later and I don't have my iPOD because in my delirium I forgot to grab it as I dashed to work to help the 3 f**king non-emergency customers that I had all night. I should have called in sick and put in my 2 weeks notice. F**k this. I can hire on with another company tomorrow and get a sign-on bonus. Don't think the thought hasn't crossed my mind many many times. I am really not feeling it right now and the corporate paymasters care not. I am just a body filling a space to be shat upon at their leisure and told what to do.
At this point I am a full grown Grumpalumpagus.
Grumpalumpagus: noun, a person who is inhabited by a really really mean spirited and uncaring alien that leads to a rapidly deteriorating disposition, kind of like how Scientologists believe our souls are aliens inhabiting our monkey bodies, again religion is cultist bullshit
So all I want now is a Nyquil nap and some Thai red curry and panang sauces with chicken and rice to obliterate the viral army invading my system and give me a shot at nourishment before I get another round of diarrhea from the dextromethorphan I have been using for a week. Take that germs!
So to tie it all together, I would not mind if today's Code Orange was poisoned Kool-Aid. Oh yeah!
****Since I believe in magic, Santa brought me the bestest Christmas present in the whole wide world. I guarantee nobody got a better gift! The douche bag that stuck a gun in my face got arrested with his little robber buddies because one of them pissed off a girlfriend and she told the police. You can look it up on the Miami Herald web site. Happy Holidays!
****Disclaimer, God had nothing to do with the screaming children on the plane. It was Christmas Day and the flight was to Orlando. Duh, it was going to be full of screaming holiday, taking you to Disney even though you are too young to remember it bullshit. I just use God for dramatic flair and he uses me for endless hours of viewing entertaiment like a sitcom.
Tuesday, December 18, 2007
A Stupid Human Trick
The tech hands me the prescription. I told him to give it back to her and explain that we cannot fill it because it is from a podiatrist (foot doctor). She was pissed off. My tech laughed as he walked out the door to go home....."I think she is coming in....have a good night..."
She stomped her way back to the pharmacy wielding her cell phone like a gladiator. She proceeds to call the other store (pharmacy not 24 hours but the store is) and tears the assistant manager (who has absolutely nothing to do with prescriptions) a new asshole while glaring at me like I am a child to be dismissed. I am not amused.
After yelling at him for 10 minutes she wants me to fill the prescription so I tell her again that it is illegal for a foot doctor to write a prescription for a class two (highly controlled because of its addictive properties) psychiatric medication. I had to break it down 5th grade cuz she was obviously not a bright crayon in any box.
She yells and wants my manager so I explain that the pharmacy manager will be in Monday morning and that the store manager has nothing to do with prescriptions. She still wants him so I page. I explain the situation and she starts to yell. I am helping other customers while she throws a tantrum. The other customers are laughing and for that I envy them because I am already in trouble for getting in a shouting match with another douche-bag because he pushed me too far. (I can't even blog about that one because it is a board of pharmacy investigation in progress. If we can't bow down and lick your feet then try to get us fired. I hate douche bags...)
Anyway, all the other customers are long gone and still she yells so I have to give her a verbal bitch-slap. "Mam, what you are not understanding is that this prescription is illegal. I do not care if the other pharmacy is willing to break the law for you but I will not." So she starts yelling at me to look in her profile and see that she has been on this for years. I tell her no because that has nothing to do with this prescription.
Then she throws her foot up on the counter to show me her walking cast and bandaged toes. I again reiterate: no psyche drugs from a foot doc. So she screams about how she had to get a ride over here and she can't walk (she sure stomped her mangled foot back to the pharmacy faster than I even walk from the front of the store to the pharmacy so she isn't hurting that bad she is just being a drama queen because our society has adopted the "if they scream they can have it policy" which is total bullshit when it comes to pharmacy law). I again reiterate: no psyche drugs from a foot doc.
Then she gives a sob story about how she cannot get to her doctor to get an Adderall prescription so this doctor talked to him about writing it for her. (Bullshit...he just wrote that prescription to get that crazy bitch out of his office as I have found many docs have done in the past, even had a few tell me that if I was not comfortable with it not to fill it because they did not care either way... That just proves that docs put up with as much or more bullshit than we do. We all know that most patients lie to their docs anyway out of some doggy desire to appear obedient and not be told that they need a diet and exercise regimen...but I digress)
We are at the point in the scream-fest where I toy with the idea of hitting the magic shiny red candy like button that summons ye ol' swat team. Wouldn't that be a glorious sight to behold......twenty of police's finest armed to the teeth, covered in helmets and body armor, pointing assault rifles at this crazy bitch and scaring the bejesus out of her.....I smile a little inside because that mental picture calms me and instills a little bit of joy...
I finally tell her that her doc that she sees for psychiatric meds can write the prescription and mail it to her. She screams at me that that is illegal. I laugh at her and the manager tells her it is time to go or we will have her escorted from the store.
Damn the pharmacist to hell that sent that one to me. I HATE it when a pharmacist does not have the balls to tell a patient that we either cannot fill it because it is illegal or because their have been fakes out of that office. The only good thing is that the crazy bitch will be stomping to that pharmacy to tear that pharmacist and the pharmacy manager both new assholes.
Seriously, honesty is the best policy. This includes situations where you know the patient is going to scream or threaten to find you when you get off work. Don't just tell them you don't have it in stock. That message has even been sent down from the corporate office several times in the past and makes me want to contact the regional supervisor but I won't because I know the crazy bitch will do that for me.
Saturday, December 15, 2007
Best Product Title Ever!
Kitty Diggin's
If you have not seen the product or have no idea why I find it soooooo funny, it is cat litter. You can laugh now.
Kitty Diggin's
It makes me laugh like a complete brain dead moron or a young school girl before she finds out about the real world and all the real horrors it contains.
So just keep this one in your back pocket for a really harsh day of retail and when people ask you why you can't stop laughing. Give them these two words of comedic wisdom:
Kitty Diggin's
.....and tell them it is cat litter....can't you just picture a cat digging around in there, not to mention that dogs find Kitty Diggin's coated surprises delicious...
hahahahahahahahahahahahahahahahahahahahaha
Monday, December 10, 2007
Frownie Face
It is especially trying with the holiday venom spewed by the shopping public. No longer is cheer and good will towards others the norm. These happy sentiments have been replaced by the "I shopped all day to please people I don't really like that well and added to my hellacious credit card debt that I will never be able to pay back and I am going to take it out on you" public. To those people I wish "Peace and Brotherly Love" because they are the ones who need it most. (Even if I say it sarcastically as I flip them the bird while they walk away after a most unholy confrontation.)
With copay increases imminent after January 1, the epidemic of Frownie Face grows. Remember to be courteous to your neighborhood pill counter. We don't want to break out the old school hoodoo but we might if you push us too far.
*****Disclaimer*****I do not have a great deal of experience with hoodoo but I am a quick study. I do realize that even with the disclaimer some dumb ass will be offended. Tell it to Jesus because I don't care what you think and it is his birthday that you shame with your obsessive commercialism not mine.
Saturday, December 8, 2007
The Most Wonderful Time of the Year
A tablet here, an elixir there
Alchemical monstrosities
Become corporate overlords
A sniffle, a tumor, a sneeze
You are programmed
To seek them in need
Bow to your new masters
For you cannot survive
The germs without them
An unnecessary need to fight
Your ills and woes with
The latest chemical concoction
Financially strapped
In the pursuit of health and perfection
No cries for help answered
Fall to your knees and see your doom
Oh yeah, it is the countdown to January 1, 2008. That is the magical doomsday for prescription copays to increase across the boards. I can hear it now....."they didn't send me any notice"....."you are charging too much"...."you need to tell your computer that the price is too high"...."I am going to another pharmacy"...."you need to call my insurance"... I can't wait! This year I am changing my name from Big N Tasty to Gloom N Doom. That ain't no happy meal!
I will be dashing all your little New Year's Resolutions, hopes, and dreams with your new copays on your antidepressants along with formulary changes necessitating the ever-lengthy prior authorization process! Oh noooo, many companies are dropping Viagra, Levitra, and Cialis all together....that will make for some sad limping soldiers. I hope your children weren't planning on going to college.....and don't forget to cancel that fabulous vacation you have been planning and saving for these past 5 years cuz it is all gonna be coming up copays!
And that's not all.....you will probably be paying even higher premiums based on the lazy fat-asses and smokers on your plan because they pose the risk of lengthy expensive hospital stays and multiple medication bills! It's time to drop Alli in everything in the vending machine and appetite supressants the water cooler! You could even make a game out of pouring water over everyone who lights up a smoke on their break. Even better, spray them with a non-toxic fire extinguisher and film it. It will be a You-Tube classic for sure! How's that for an interesting office...
So with all that, my retail bretheren, stock up on the Alka-Seltzer and energy drinks and strap yourself in for a bumpy ride!
Happy New Year!
Sunday, December 2, 2007
Drive Thru Bell Rock
Drive-thru bell, drive-thru bell, drive-thru bell ring
Along with the phones among other things
Filling and checking you drugs is not fun
Now the drive-thru hop has begun.
Drive-thru bell, drive-thru bell, drive-thru bell ring
Drive-thru bells chime for crazy me time
Filling and checking your drive-thru fare
In the pharmacy.
What a hard time, it's a bad time
To work the night away
Drive-thru bell time is a hell time
To glide through my lane in an Escalade
Questions about your pills? Have a nice day!
Go home to your family
So I can have lunch and get off my sore feet
That's the drive-thru bell
That's the drive-thru bell
That's the drive-thru bell rock!
Tuesday, November 27, 2007
Saying 'No' to Counseling
You don't have to receive a consultation from a Pharmacist when buying a prescription; you may deny consultation. However, Oregon law requires that the patient deny consultation directly to the Pharmacist for any prescription that is not a refill. This means that even though you say "no" you may have wait in line to say "no" to the pharmacist.
Complaints
Last night and tonight, I had patients that flipped out about having to wait to give me their denial. In each case, they only waited half a minute at most and spent more time yelling at my technician, trying to say that she doesn't know the law than it would have taken to talk to me. Actually, I could've given a complete consultation in the time it took tonight's nimrod to finish bitching.
Consequences
If a Pharmacy Technician is caught releasing a non-refill without having the patient speak with the pharmacist, they are assessed a $500 personal fine and the Pharmacist on duty is assessed a $1,000 personal fine. So, getting bitched at is still better than the potential fine. Yet, sometimes, I'm tempted to 'run the red light' and let my technicians just get them out.
Message to the Oregon Board of Pharmacy
Come on, if you can't trust a tech to tell the truth about a denial of consultation, why even allow them to work in the Pharmacy? Oregon (along with most other states) has decided to waste Pharmacist and patient time with an impractical, pointless rule.
Message to Patients
Just, suck it up. It's the law. Our goal is to get you out as fast as possible. Why would we hold you up, if it were not the law? Save yourself and us a huge hassle and just wait patiently and tell the Pharmacist you've had it before and have no questions when it's your turn. Every minute you spend complaining is another minute other patients have to wait.
Monday, November 19, 2007
I am not trained for that!
A ninety-five year old man who thinks he might have a hernia above his testicles has a lot of pain and wants me to talk him through a scrotal examination. I kindly explain to him that I have no formal training in that type of physical examination. I can tell you what problem symptoms may point to but the definitive exam and diagnosis must be performed by a doctor. He is not having ANY part of that answer and is very upset so I refer him to a male colleague at another location who gives him the same explanation.
The patient calls me back about thirty minutes later. He is upset that no pharmacist was able to instruct his exam. Duh, the pharm part comes from pharmaceutical meaning drug. Maybe if my title was exapharmacist (exa for exam) I would have been trained to do such but even better would be ex-pharmacist when I decide that I can no longer bear the burden of helping those who cannot or refuse to help themselves. That is when I dive head first into a downward spiral of despair and fully embrace alcoholism while skating in the wizard suit for Grublets on Ice and having sex for money. Oh fantasy life, when wilst thou become reality?? Oh to shed this festering mortal coil we call humanity and live like the lowly street wretch....but I digress.
He wants to know if he can sleep in a jock strap because it seems to help ease his pain. I told him that was fine but he REALLY should call his doctor's office when they open and see if they can get him in before the holiday because he is in pain. He said he would call them but I know deep down in my heart that he will be calling me again tonight because I talk to him a couple of times a month whenever he feels a doctor is unnecessary.
***On another note, there was a complaint in the e-mails that we are unprofessional. I assure you we are top notch empathetic professionals on the job. We save our sarcasm, anger, frustration, etc. solely for the blog and entertainment of our readership. If we only had nice things to say no one would read us. It is the tabloid effect, we all like "dirty laundry."
***Now go stuff your face and be happy you have a job, family and friends, a roof over your head, and food to eat. Happy Thanksgiving!
Sunday, November 18, 2007
Hate Mail
October 24, 2007
Dear Blogging Pharmacists,
I'm having a hard time finding boric acid, which I was able to just
walk in and buy only a few short months ago. It seems to have
disappeared from Chicago drug stores. Dissolving it in some hot water
to soak an infected finger or toe was really the best, most
successful, and most importantly, non-antibiotic, way to relieve some
pain and unbearable swelling. This treatment has worked many times
for me and my family.
So, while curiously investigating the disappearance online I happened
upon your blog. I'd like you to know that I was saddened by the
comments I found. It's clear to me from what I read, that your job is
a strain beyond words at times.
While some come to you needing some sober medical direction, or a
trustworthy source for preparing and handling their medicine, my
guess is that most, including myself on occasion, come to you for
some compassion because we are feeling confused, afraid, or are in
pain. A bunch of crabs we all are, limping and sniffling up to the
counter.
While I realize it takes a different kind of education to dispense
empathy, it is most certainly more in demand than pharmaceuticals for
relieving what truly ails people and for addressing the fears,
financial limitations, and concern for the well-being of our loved
ones, that truly exacerbate the most minor of physical discomforts.
The next time someone comes to you with a less than desirable
disposition, would you be willing to dispense with some professional
distance and see beyond the bitching to the pain and frustration
behind it? I know it's not your job, and, more often than not, it's
what's needed most.
Fan Mail
The answer to the question you haven't asked yet is, yes, you can become a hospital pharmacist. I made the change 14 years ago, and never looked back. Would I dare? Drive-thrus, cell phones, the scholarly journal called the Internet (bet they throw that in your face, too), and quadruple the amount of drug abuse are a few of the things I wouldn't want to subject myself to.
I believe that you, more than most people in U.S. society, are looking directly into the face of our collapse as a nation. Our enemies are hungry and angry, and we are fat and happy. Whom do you think will win? I'd move to Australia, but after my visit in March, I think the Aussies have already caught the American plagues.
THANKS for the story Ms. N
I work at a big corpo chain pharmacy in Fl. Tonight we were dead slow and just waiting for the ER across town to empty their waiting room into ours. My favorite out of the entire evening was a 45ish gentleman. Gentleman is much too nice a word actually. More along the lines of white trash addict. Now, we're talking no shoes-black holey tshirt-cut off jean shorts-unwashed hair. But even better, he has the front half of the left side of his head completely shaved. A large noticable scar that has been stapled shut. He hands me his Rx. There's just one for lortab. (SHOCKER!!) I ask him if there is more than one. He says no. Now, our hospitals in town are hardcore strict about only filling controls with a antibiotic and staple them all together. Now...immediately I'm suspicious about it and look harder at the Rx. There's a staple still attached to the hardcopy and two little pink corners of paper under the staple...hence, two more prescriptions. I ask him to go get them and he says "How'd you know that?"
I'm a genius...
So he goes out to the car and brings them in. One of the other techs types them in and we get to filling them. He is adamant about only getting the lortab because he "lost his wallet" and cant afford them. He's on Medicaid. I'm practically paying for his Rx's. He's getting all three of them whether he likes it or not.
Doxycycline, Augmentin XR, generic Augmentin 875, and the Lortab....those are the 4 Rx's. So of course we call to verify the fact that he's taking an exceedingly large amount of Augmentin. He's freaking out the whole time at the counter about how long it's taking and says he's in a hurry. The pharmacist says "Well im not going to be held liable so he's going to wait." Apparently he has a very very bad infection and must take them or he will be admitted to the hospital...or so the doctor says.
Crackhead says "Im not going to take the antibiotics anyways so i might as well just get them how they are".
He goes the the cooler down the aisle, gets a Mountain Dew, and begins to drink it. Finally the Rx's are done and everything's been taken care of. We ring him up. Tell him it's $1.50 for the Mountain Dew and the Rx's are free.
"Oh, my wallet was stolen. I dont have the money for it," says the Crazy Crackhead.
It wasnt even worth bothering with. It's not coming out of my paycheck.
I was clocking out to go home while he was being rung up. I follow him out the door...he opened the Rx bag. Takes out the lortab bottle...throws everything else in the trash can outside the front door.
I love our tax money paying for other people's stupidity.
Thursday, November 15, 2007
Condom Conundrum
"How do we know it will fit?"
The question asked since the invention of the condom. It's too tight is the excuse many men will use to try and get out of wearing one. A regular sized latex condom can be stretched to fit over an adult cranium so it should pretty much fit any wiener. If he complains it is too tight or it cuts off sensation he is either putting it on improperly or just a huge fucking baby that deserves to be left to service himself.
Well ladies, unless his wiener looks like a baby's arm holding an apple any condom should fit. Although I must say that many a time I have sold Plan B to a girl who had sex with a guy who needed "magnums" and the condom slipped off during sex......guess he wasn't as big as he said he was.....so sorry lady. That must have been a HUGE disappointment, pun intended. If it is a beanie weenie then you might want finger cots (again, they look like tiny condoms and have been incorporated in many gag items through the years). Then again, if it is that small you might just want to skip the man and get a good vibrator.....
Back to our elderly couple. The manager told her that the regular condoms should fit and we all had a good laugh. It leaves me to wonder if a little blue pill and a broken hip was in the near future for one of them.....
Monday, November 12, 2007
Tablet Identification
"I found this pill in my daughter's backpack and I want to know what it is."
Your child is experiencing the wonderful world of chemistry by trying out every little tablet she can get her hands on. I love these calls. I can't say I feel the tiniest bit of remorse for the child. I know there will be groundings, lectures, beatings, etc. I like tears and torture. It puts a spring in my step like nothing else.
This particular call was funny because the tablet was Atenolol 50mg. That dizziness and floaty feeling she gets isn't a "high" it is actually from the "low" her blood pressure hits from it. I told her mom it was not a controlled substance, not addictive, etc. but it was dangerous in that low blood pressure can lead to organ failure, coma, death, i.e. the not so fun stuff because she had normal blood pressure and it is a prescription drug so she shouldn't have it anyway. Mom was pissed. Hahahahaha, I want to hear the fallout from that!
Another concerned parent could not wake her son up and he had some tablets that turned out to be Methadone 10mg. I told her to call 911 because he may never wake up from that one. She did and called back the next evening to thank me for saving the life of her ungrateful little bastard of a son who racked up an expensive hospital bill of gastric lavage, IV's, and critical care.
Kids are stupid when it comes to drugs. They think it is "cool" or "fun" but many times they introduce substances to their body that are lethal. Look at the news. There is always an overdose story of a teenager who didn't think before taking pills. They don't give a single thought to what anguish they can cause a concerned parent or family when the shit goes wrong or what damage they can do to themselves. I like vegetables but I don't want to live like one. Want to get high?.........
Many of the calls I field are "Is this Oxycontin/Valium/Percocet/Tylox/oxycodone/equally strong substance to fuck your shit up/etc.?" For those callers I realize you want to rocket off into oblivion and you don't want to get ripped off by some shady dealer. I can respect that you want to know you are getting all the bang for your buck. There is a recession looming for all of us, even low paid or jobless junkies. By the way, if you haven't been on any of those substances before I may never hear from you again....might not be a bad thing for the rest of society but don't you think there is a relative who dearly misses you? Maybe a puppy or something? I'm just saying, don't you have anything left to live for?
On a sad note, my tablet identification software does not list any of the designer tablets or ecstasy tablet markings. I have no idea what is in that tablet... I can't help you with that one. Until the government decides to let someone market them there will be no standard markings or monikers. It also may not be a good idea to "roll" with the whole person to person contact leading to potentially deadly MRSA infections. I know you "love" everyone and want every millimeter of your body touched or licked and every orifice filled but it may turn out to be a bad time. Vaporub and face masks are in aisle 11, blow-pops are in aisle 5, have a nice night......
Other fun calls involve the police. Bag a perp, take him/her for booking, find a few tablets in his/her pockets/purse, call the pharmacy. Do we have an illegal substance? Can I add additional charges to the bookee? Awesome! Oh, by the way, I think that guy/girl may have called earlier to see what those were he/she was buying from his/her dealer......might want to follow up on that.....
Listen to D.A.R.E. and Mr. McAfee (from South Park), "Drugs are bad, m'kay?"
Thursday, November 8, 2007
ER is still worth watching
ER is the main place in television where they show realistic ambiguity about what the right decision is. In healthcare, the right answer isn't always easy to determine(e.g. Is this prescription a forgery made by a talented drug addict or is it from a stressed out doctor who got sloppy in trying to write it quickly for a patient screaming in pain). Sometimes the right answer is very complicated and unsatisfying to the patient (e.g. Sudafed PE works just as well as old Sudafed for some patients while others get nowhere near the same effect).
ER also shows just how busy things can get in healthcare and how you have to strike a difficult balance between being thorough enough to catch errors and fast enough to avoid drowning in work. This month I've had to deal with a woman who was hospitalized for an error made by another pharmacist. However, this same month, I found out that one of my technicians complained to management that I should work faster.
Finally, ER shows healthcare mistakes in perspective. No matter how good you are and how hard you try, mistakes will happen and patients will be angry. ER shows people beating themselves up over the mistakes they make and doing their best to prevent them in the future and deal with the consequences. This is exactly what happens in real life; you tell yourself there's no point in beating yourself up, but it's just what you do.
I know that ER is not realistic in many ways, but the emotions and the situations are realistic. It really comforts me to know that someone who writes for that show knows the experiences I go through.
Tuesday, November 6, 2007
Testing....testing....one...two.......Three?
***********************************************************
A fun "experiment" to entertain your drinking age friends: Purchase a Breathalyzer at McDruggie's and take your friends to "Happy Hour" or go to someone's house and play a drinking game like 3-Man or The Star Wars Drinking game. Damn those bad guys for wearing white and damn those dice for always hitting 3!
Yes, McDruggie's has a Breathalyzer but it warns you not to use as a sure-fire way to know you can drive after enjoying a "liquid" lunch. It also helps if you wait until the police dining at a table near you are long gone before you settle up and leave. It always happens to me so I know a few of you have experienced that fun game.
Drink, drink, drink and take turns blowing...the breathalyzer, that is, you perv. Oh, and make sure none of your friends have lip herpes before you all use it. Wouldn't that be a nasty surprise......a wicked hangover and a mouth blister.....ew...
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A woman in her late forties came to the pharmacy late last night. She can't sleep because she thinks she might be pregnant. She tried a digital test that says "pregnant" in the display. Guess what it said. So she tried a "plus" sign positive test and it came out negative. She explained to me that she may have messed up the second test so she wanted to try another one.
It gets better. After her test selection, purchase, and a dozen questions she leaves. I help the next patient and she comes back. She has a few more questions and she needs me to go as humanly far from the other patient as possible because she is embarrassed to ask these questions. I am utterly intrigued. What Jerry Springer shenanigans am I about to experience???
She already has two teenage children. She has no insurance. She is afraid that she does not know which of two men is the father. Awesome! She wants to know how early the doctor can do a DNA test and how much it would cost. I told her to take it one situation at a time. Find out for sure if you are pregnant first. If the doctor can give a close estimate of conception, that should eliminate the need for the DNA test. She left again pretty sure she would be able to sleep.
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My store manager walks up to the counter and asks me if I can pass a drug test. I said sure, why? He throws two boxes on the counter. Some super smart criminal stole the contents of two opiate drug tests. They were the tests that have to be mailed in for the results. Duh, should have stolen the one you pee in and tilt on its side that gives instant results. P.S. You are not going to pee out cocaine in time for your job interview and test tomorrow.
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A patient brought in his One Touch Ultra because he was getting weird blood sugar levels. He said it was an old machine so he probably needed a new one. I looked at the display and saw the "low battery" indicator on the screen. Gee, I wonder why it wasn't working properly....so I got him some new batteries, changed them for him, and sent him on his merry way.
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Isn't it amazing what the walking talking chem lab that is the human body can do!
Sunday, November 4, 2007
Overtime in Cootie Town
1. A pregnant lady calls to get a suggestion for a yeast infection. I told her to call her OB/GYN because the OTC products we have are not recommended in pregnancy. A couple minutes later she calls back saying she "talked" to her doctor and he told her to get some of that "gyne" stuff.
How stupid did this lady think I am? There is no way she paged the doctor at 12am Saturday and got a response within 3 minutes. If she is not having the baby or in a dire emergency situation the answering service is not bothering the doc til a more reasonable hour. Itchy stinky crotch can wait til 8am. She didn't page the doctor she just wanted to weasel out a quick fix. I don't do "quick fix" for a pregnant lady.
I told her the only "safe" yeast infection cream inserted during pregnancy is a prescription item. Maybe you want to call your doctor or go to the ER like I told you the first time.
2. Scabies patrol! I get psychosomatic itching for the rest of the night, every time. This parade was luckily short but involved a bit of a Springer-esque revelation. I h.a.t.e. touching anything a scabies patient has to offer from the original prescription to the money.....ew...
The process was further complicated by the cash price of Lindane lotion. No insurance. Latino homosexual with his mom..... That could not have been an easy trip to the ER with mom. The Latinos I know do not approve of two major things: pregnancy out of wedlock and homosexuality.
I felt bad for him. Not only did he get scabies but there might have been a nuclear grade fallout at home after the pharmacy visit. Good luck! Argentina may not cry for you but maybe I will.
3. Doxy here! Come get your Doxycycline here! I felt like a carnival barker was standing outside or waving people in from the ER. I have not filled that much Doxycycline in one evening ever......I mean ever! I thought it was a fluke. The prescriptions just kept coming in and coming in and coming in. There were at least 10 prescriptions. I kind of lost count as the hilarity of the phrase "scrotal infestation" kept running through my mind.
I wondered if they were all screwing the same spirochetal funbag of doom cuz this was just crazy! Maybe they should all sit down and figure out which ho they were tapping and beat her senseless then force feed her antibiotics and maybe pee in her eye to teach her a lesson in vaginal hygiene.
I should have pointed out the condom aisle and gave my soapbox presentation on how a HAZMAT suit for your wiener is a good idea in all sexual situations.
4. Pregnancy test nightmare. How embarrassing is it when your mom picks out your pregnancy test for you based on the $9.99 price tag for the dual pack because she doesn't want you spending all her money. Even more embarrassing is that you are not old enough to hold gainful employment and dress like a boy.
It was humorous. Does dressing like a boy really get you more action? Maybe I should try that some time.
I have HAZMAT suits at the ready for any forgetful male encounter, along with an axe and a drop cloth in case there is a messy cleanup! Sometimes we mate and then we kill. I love spiders! Yeah, I stole that idea from a movie....life imitating art or something...
5. Condom conundrum. You send your lady in to buy condoms. She calls you on the cell phone to make sure she buys the ones you will use. I had to listen in on this one because it was so damn funny!
We didn't have his "brand." We didn't have his "size." I would have had her take home a pack of finger cots (they look like miniature condoms) just to piss him off.
If you want to tap some ass buy your own condoms or get them from the free clinic. Don't make her do all the spending and work because in the end you are probably a disappointment in the sack and she will have to finish off with a "rabbit."
6. The ole' bladder infection. Many times sex introduces anal bacteria in to the vaginal and urethral areas. It is not because you are nasty, the act of sex is messy, juicy, and invasive. The number one cause of bladder infections is e. coli. Yes, the same e.coli that live in your intestines, on your body, and occasionally infect slaughtered and processed meats and improperly cleaned vegetables.
Some helpful tips to prevent these bladder infections are: no anal before vaginal (the same goes for sex toys), always use a condom, wipe from front to back when using the bathroom, and bathe on a regular basis (this means wash your ass like Martin Lawrence got in trouble for saying at an awards show).
Just remember, "Cleanliness is next to Godliness." This includes your naughty parts. They aren't just for breeding anymore.
Wednesday, October 24, 2007
Infant Protection
Things all parents/guardians should know about infants and medication:
1. Their organs are not fully functional or resistant to the effects of chemicals like an adult.
2. Their brains and nerve systems are still developing.
3. A major cause of diarrhea in infants is high sugar fruit juices. Many of these juices also contribute to cavities when children start to get their "baby" teeth by wearing down enamel with natural fruit acids. All things in moderation.
4. Gatorade it NOT formulated for an infant. Pedialyte IS. Too many times a patient tells me they were giving an infant Gatorade but the diarrhea won't stop. Duh, Gatorade is full of sugar and high concentrations of electrolytes. It was designed for fully grown athletes. Give them Pedialyte. If the diarrhea has been going on for more than a day call your pediatrician or go to the ER. Maybe your infant will survive your inherent lack of common sense.
5. Tablet formulations are not meant to be broken into pieces to give to an infant. Liquid formulations developed and dosed for an infant are. I had a woman who wanted to give an infant an Imodium tablet because every time she used the liquid the infant ended up in the hospital because she got diarrhea from the sugar in the liquid. I explained to her that there was no way a 2mg tablet could be broken into a 0.4mg dose. She would be poisoning her child. She reluctantly took the liquid PRESCRIBED BY HER PEDIATRICIAN.
6. Smoking during pregnancy and exposure to smoke, mold, mildew, and vermin after birth increases the frequency and intensity of asthma and allergy attacks, even if a child is on medication treating these conditions. This breaks down to basic cleanliness of the home environment. It is not that hard and there are many cleaning products recommended for use in homes with small children.
7. Child safety packaging does not mean that it is 100% child proof. You still need to put locking mechanisms on cabinets with cleaning products and medications in them. This also applies to pets. Several cases of pet death occur in dogs that ate a bottle of medication that was left sitting on a counter or nightstand. Many of these cabinet "locks" are merely a piece of plastic that latches so that the cabinet cannot be opened more than a couple of inches. They are cheap and can prevent a lot of calls to 911.
Come on people.........this is getting ridiculous. Perhaps a part of every high schooler's education needs to be on home safety and basic pet and child care. Even better, instead of having an occasional assembly to discuss not putting things in your mouth that appear to be candy with young children, it should be part of every curriculum. Start young and educate children to keep themselves out of every day dangers. There are more dangerous things out there than pedophiles and many can be found in your own home.
Sunday, October 21, 2007
Peep Show Protocol
Saturday afternoon at McDruggie's a gentleman in short shorts comes in (yeah it really happened Sat Oct 12) and shops like everyone else. A cashier noticed that his periscope had come down and was looking out from the leg of his shorts. Some choices you must now face:
A. Point and laugh hysterically.
B. Nonchalantly inform him to checkity check himself.
C. Try to resist its gravitational pull on your optic nerve.
D. Go to another aisle and laugh hysterically.
E. Point it out to another employee with a big mouth who will inapropriately shout aaaaahhhhhh, aaaaahhhhhhh, aaaaaaaahhhhhhh.
F. All of the above.
I would have chosen F in this situation because I thoroughly approve of toilet humor. Since I was not there option E occurred and then all other employees were told about the incident as a break room joke. Note to self, don't wear a push-up bra with a low cut shirt under the magic white jacket while at work unless it is time for your hot police officer you want to fulfill your dirty bad-cop sexual fantasies to come in for a refill.
Thursday, October 18, 2007
Poop Soup
She has had a scene from the "Exorcist" spraying out her pooper for a week and is JUST NOW concerned.....I am baffled. If I have a touch of the squirts for more than a day and cannot pinpoint what I ate and/or drank (usually it is drank) that would have been a major causative factor I am calling a doctor or squirting my way through the ER, undies and pride be damned. Man...a whole week...need some Tucks pads for the burning, honey? I am still baffled.
I explained to her several times that it is of GREAT importance that she goes to a doctor as soon as possible. I can think of several not so pleasant causes of severe diarrhea like cancer, infectious organisms, parasites, etc. Don't forget dehydration and all of its lovely little complications (my favorites being organ failure and dementia). She wants to wait til she flies back home on Saturday (3 more days from this conversation...). I had to bite my tongue not to remind her that the carry-on flight limit for all containers of liquid is 3 ounces...maybe it was dementia setting in on her part or maybe the situation just turned into an episode of South Park that I found really really funny...either way a medical visit was muy necesito!
She still balked at the idea because she had no insurance. I hooked her up with a clinic she could visit at 8am that specialized in helping people with no insurance. She asked me if it was a dirty clinic. A "dirty" clinic? No, this isn't where all the crack heads and homeless go for services, if that is what you mean by "dirty." This clinic mainly assists foreign travelers who might not be able to afford medical care while on vacation or recently relocated and have no insurance yet. You are a traveler with no insurance.(...duh...) They can help you.
She still was not satisfied and did not like further suggestions like Metamucil capsules to help soak up some of her internal seepage. It is called a "bulk forming" laxative for a reason. It soaks up liquid to form a solid mass and may afford you a little bit of relief, especially if you really really plan to get on a plane in 3 days instead of see a doctor until you get home. She hung up on me. One unsatisfied customer.
Don't ask the questions if you know you are going to ignore the answers. Oh yeah, and if you ever ignore my suggestion in favor of "little know-it-all that knows nothing medical" that walks in off the street, you deserve every bit of the bad outcome(s) that will happen. You can't sue the pharmacy for something the pharmacist didn't recommend, especially if they advise you not to take the suggestion from that person and your dumb ass does it anyway. Poop soup for you!
Monday, October 15, 2007
A Cure for Radiation Sickness?
The list of side effects for many chemotherapy agents reads like a large volume of Encyclopedia Britannica (do they still publish those?). This list contains things far scarier than the dust bunnies under your bed and far more painful than being pistol whipped at retail on the 3rd shift (I am waiting for that one to happen but I am sure it is not as painful as chemo and radiation...).
Funding for many types of medical research is hard to get. Charities can only do so much and the government is currently more worried about funding a war and getting their annual pay raise. It is disgusting to see what selfish little piggies run this country. Our health care system sucks and all government efforts have gone belly up like an overfed goldfish. I am not even going to start on the Medicare Part D debacle...but instead I want to talk about radiation.
Radiation along with chemo kills cancer dead. Radiation also makes your hair fall out, your bones brittle, and a million other not so fun things. It makes you feel like a scene out of a Monty Python sketch where little parts of you keep falling off but your still alive and wilting like a funeral bouquet. Since almost every person will get cancer before they die unless something else kills them first (diabetic complications, coronary artery disease, accidents, murder, etc.) we need something to combat the ills of radiation.
Oooh, the threat of a "dirty" bomb (ie home made radiation deployer) to our troops and countrymen occurs and poof, funding for radiation sickness suddenly appears. That was a big f***ing rabbit you pulled out of your hat Uncle Sam. Thanks for finally getting around to it. Sam has spent $6 million so far and plans to commit another $82 million over the next three years (this is from "Surviving Side Effects" in Scientific American, October 2007).
Progress is being made and there are several shining stars on the rise for future treatment. It is a sad state of humanity when fear equals funding for valuable research that should have been started and maybe completed twenty years ago. Let's see what the feds think will get them elected next time around since they are all looking bad on the "going green" but still flying in a private jet to appearances thing and they still hate homosexuals getting "married".
Monday, October 8, 2007
Late Night Priapism
I am not paid by the minute to talk dirty to you. I did find it hysterically funny when you asked if you came in and showed it to me if I could do anything for you. I would have laughed at you because I had already told you there was nothing I would be able to do for it, perhaps you should try some form of sexual activity or the emergency room. I had to hang up on you when you asked if I like to suck dick. I am not going there at work. The last time I saw anything near the penis in the pharmacy was a guy that pulled his pants down to show me what appeared to be syphillitic lesions. I told that guy to get an antibiotic from his doctor a.s.a.p. because there was no over the counter cream to treat his lesions and his problem would get worse without treatment (ew).
This caller has a history. The last few times he called it was because his "girlfriend" was using Nuvaring. He wanted to know why it made her horny because she wanted sex all the time. Quite frankly, I think you aren't getting any lovin' and that is why you are calling me at 3AM looking for a stimulating voice to wank off to. Well sir, you can fire away all you want with those knuckle children of yours, but please don't bother the pharmacist unless you have a legitimate concern that requires immediate medical attention.
Sunday, October 7, 2007
Three Minutes or Your Order is Free
When you bring in an insurance card, make sure it says "prescription" somewhere on it. I don't need the one that says MD, Mental Health, Emergency, etc. I need the one that says "prescription." No, your car insurance is not going to let me electronically bill for that prescription from your accident and neither will the card that says "dental" because it just covers your "dental" visit, procedures, etc., not the prescription written as a result of it.
If you have Medicaid and you have a third party payor for "prescriptions" it would be great if you had that card or at the least, the payor name, ID number, and group number. I can work with that.
If you have Medicare Part D I would love to see the "prescription" card for that. There are so many plans currently available it has become impossible to use my extrasensory perception to pick your brain and figure out what paperwork you filled out and what the card says. I am not the Great Kruskan. I am just a lowly paper processor and pill pusher for "the man."
I also will not call the insurance company to ask why a drug is not covered. I can tell you right now it was left off the formulary for budgetary reasons. They can't afford to pay for everything. I am nice enough to call your doctor to find a suitable substitute to treat your ills, eventhough you feel the need to take out your anger and disappointment on me.
I will not call to get ID numbers. Your body, your insurance, your problem. They sent you a nice little paper or plastic card to carry with you. I have approximately 1000 other things to do and patients to take care of in my immediate surroundings, not hold your hand while you pee. You are an adult. I will not babysit you. If you cannot possibly handle that one tiny detail in your life I hope you do not have children to supervise and raise. If you do, I weep for them and hope that they never get into an accident and need you to have the proper insurance cards handy.
If you just came from the emergency room, I promise to fill your prescriptions with all the other folks who came from the emergency room before you. I cannot do this in 3 minutes as they are also sick, tired, grumpy, and waiting. There is no reason to poke at the sleeping infant and make it cry. I will not push your prescription out any faster. You are just a douche bag and a terrible parent for doing that. Ten to fifteen minutes means ten to fifteen minutes. That baby was sleeping just fine til you thought it would get you out faster if it was crying. Child and family services should do it a favor and find it a more responsible and loving home.
All because a medication comes in a box does not mean I can "slap a label on it" and get you out of here fast. There are lots of boxes in the pharmacy. Many of them look similar. I can put a label on any box and send you on your merry way so you don't have to wait ten minutes but it could be wrong and kill you. It's the lady or the tiger. I am forcing you to pick the lady because I am not risking your life or my livelihood on the tiger. Tigers look cute and cuddly and I like to see them humanely kept at the zoo but their claws will rip through human flesh like a machete through hot butter. It's not pretty, ask Sigfried....
The optimal way to get a prescription for a maintenance medication (the stuff you take every day, week, month, etc.) is drop off at the drive-thru on your way to work and pick it up either on your way home or the next morning on your way back to work. This gives us time to resolve any issues such as "drug not covered", clarification of handwriting, verifying high dosages or interactions with your physician, etc.
There are some things that do not resolve as easily as that. Out of stocks do happen occassionally. This is especially true for injectables, meds that are not routinely prescribed, and meds that need special authorization from insurance or regulatory requirements before they can be ordered (because they are terribly expensive, highly regulated, and go out of date pretty quickly... You wouldn't keep something like that in your refrigerator unless you were going to use it and neither should we.).
The main reason we give you a time for completion of your prescription is safety. You should thank us for that. Being a deathdealer is only suitable for gaming or prison executioners not pharmacists. We don't want to kill you. We may not like some of you but we really really really don't want to kill you. So the next time you are "inconvenienced" and yell at me, just remember I made you wait because I C.A.R.E!
Thursday, September 20, 2007
The Price is Right
The show is in reruns until the new season starts. It won't be the same without Bob at the helm but I am sure the advertising will remain the same. Ads for the elderly abound. There are various ads for hearing aids, dental implants, medical supplies, "Help me. I've fallen and I can't get up." alert buttons, accident help lines, car insurance, and prescription assistance.
The Partnership for Prescription Assistance has Montel Williams telling you how to get drugs if you don't have insurance. If you see the fine print, they can't help you if you are in the Medicare donut hole or if you have Medicaid or even a prescription discount card. They show all these people who say they wouldn't be around if it weren't for the PPA. Bullocks! Just another tax write-off for big pharma.
Liberty Medical touts the ease of having medical and diabetic supplies delivered to your house. I thought Wilfred Brimley was dead.... My favorite role he played was the doc that got digested and replaced by an alien in "The Thing" and built a space ship in a tool shed. Awesome! That sure beats the pants off hawking diabetic supplies during daytime TV.
Why haven't the Jitterbug cell phones reared their overinflated digits and extremely overinflated pricey service plans? I was sure they would prey upon those with poor vision just as fast as I could remember that super gay neon video Wham! did for that song.....jitterbug.......jitterbug........wake me up before you go go.....don't leave me hanging on going solo.....damn, now I am going to be singing that all day!
"Wake me up before you go go. Now, take me dancing tonight.....I wanna hit that hiiiiiiiiiiiiiiiigh yeeeaaah yeeeaaah yeeaaah baby.......(kill me now)... With a 1000 minute plan for $150 (eeek!) it is cheaper to go through a regular cell service provider and deal with tiny buttons, especially if you have budgetary restrictions.
My favorite commercial during the Price is Right has to be Hoveround scooters. I applaud the devious jingle master that came up with that one. It will soon drown out George Micheal and I will sing along all day. "I go go go in my Hoveround!" Not only do they have a wickedly catchy theme, they also portray a beautiful ballet of elderly in their Hoveround scooters. Not since the Olympic gold medal synchronized swimming have I seen such awkwardly graceful and disturbingly choreographed movement. The only problem I had is that for some reason not all chair drivers were wearing their seatbelt. Shame shame on you! Accidents, like a messy fall, can be prevented with seatbelts. Mayhaps a "Click it or Ticket" mandate could be enforced....nope.
"I go go go in my Hoveround!"
Friday, September 14, 2007
Life in a Petri Dish
A friend of a friend is probably far filthier than anyone else I know. His apartment is a veritable swamp. The air conditioner leaks water onto the floor, which is completely saturated. There is so much moisture that the wooden door frame is rotting away and hanging on by a prayer. It reeks of mold and mildew. I am surprised he doesn't have a rare mold infection in the lungs.
At one point in the swamp his cat did get a lung infection. The cat refuses to enter the apartment. When the cat has had enough, you should probably call in a HAZMAT team and call it a day. He still lives on. We are sure he has adapted the coping skills of a cockroach and will never succumb to the swamp.
I do not have anywhere NEAR the filthiest house in all the lands. In fact, I don't even come close. I know this because I watch "How Clean Is Your House" on BBC America. The people on that show are all fighting tooth and nail for the "Filthiest House In All the Lands" award.
The two hosts used to work at the royal palace as maids. They specialize in simple cleaning techniques, utensils, and products that anyone with the intelligence of a 7 year old would be able to follow.
My favorite part of the show is when they take swabs of different parts of the house to see what grows in a petri dish. During the cleaning process the homeowner is shown pictures of the organisms and some of the diseases they can cause. A few houses were so chock full of "germs" that the hosts were surprised that no one had been sick yet.
After the horrific experience the hosts return 2 weeks later to view the progress. There have been a few that do no cleaning. I want to see the one year follow up. That would be hilarious. I know several of the houses are probably in their original state of filth. I don't think I could ever let my house be that gross.
Sexual Healing
You can even still find reprints of ancient catalogs from all cultures featuring man-made erotica from as early as the 1800's. Some erotica items do look like torture devices and may have caused more damage than pleasure, but to each his own.
Which brings me into the present. A manager friend from Mc Druggie's told me to look on their website. There is a menu tab labeled Sexual Wellness. Curiosity piqued, I went in for a look see.
There it was in all its shiny red candy-like glory. I had to click it, you are always obligated to hit the shiny red candy-like button. I explored the wonders of sexual wellness. Most of it is lubricants, condoms, family planning items, etc. and there are small vibrating devices.
Some of the items were funny, some were standard mini-vibes you would find at a porn store, and some of them were just weird. The Cone was just a pink vibrating cone. I could not imagine that it was that great but the ad said it was a top-seller in Europe. I read some of the reviews for it and almost choked on my soda. One review claimed it was "The BEST thing since sliced bread!" I disagree, not even having to try out the product. I am still sticking with air conditioning, microwaves, and tampons.
This excursion led me to explore other McDruggie's company websites (all retail pharmacies are McDruggie's, after all) for sexual healing. Most didn't have anything beyond family planning, condoms, lube, and the yeast infection test kit. The last McDruggie's I checked had a link to Drugstore.com. There I found a wonderland of sexual toys, the usual condoms and stuff, and even bachelorette gifts. The Uncommon Drugstore, indeed.
Their vibrator selection rivals that of Ye Olde Porne Shoppe that can be found in every city on almost every 3rd street corner (maybe that is just Florida). It even had many of the things you would find on a sex toy website, except the religious vibrators. I have only seen those on one specialty website. If you believe in hell or purgatory I am sure that site can get you a first class ticket.
The good thing is that Drugstore.com reminds users to wash toys before and after use and to never use them on inflamed/raw areas or on open sores. They are at least responsible about that. More than I can say from some sex toy sites.
My favorite item under bachelorette gifts is a penis and balls shaped cake pan and matching penis candles. I know a lot of birthdays coming up. If you mysteriously receive a penis cake with matching candles you can take a pretty good guess where it came from.
Who wants wiener cake??!!
Friday, September 7, 2007
Shenanigans!
I passed the NABP beastie on the first try. I took law a second time. I failed law by one stinking point. Maybe that was where the doom came from. Note to grads, take them on separate days so your brain does not turn into runny discombobulated mush.
Now some shenanigans have ensued. Some douche-bag that cheated his/her way through college has managed to procure a copy of the NABP exam. This means that several deserving grads have to wait even longer to take their exam. The person(s) responsible for the exam content theft should not EVER be allowed to take it or practice medicine in any way, shape, or form. This is like using steroids in professional sports----utter abomination!
Is public hanging or stoning allowed?
Sorry grads, you will just have to hold that nauseating dread for a bit longer!
Friday, August 31, 2007
Cruel Intentions
Phones ring and ring.
Cars honk.
New orders come in from the ER.
Piles of labels lay untouched.
Bottles of drugs occupy every inch of counter space.
Finished rx hard copies overflow from the file sorter.
People keep coming in and calling.
Everyone else in the pharmacy has gone home.
Labels keep printing and printing and p-r-i-n-t-i-n-g and P-R-I-N-T-I-N-G....
Then silence.
My sanity has cracked.
I have to fix this mess.....
Step 1: iPOD to the rescue!
Retail music sucks! I whip out my trusty musical robot friend and attempt to reclaim my sanity while I wrestle with the giant paper beast that threatens my very existence.
Step 2: Take a memo!
I gingerly part with my musical mojo long enough to take the messages that have been resting in the furthest reaches of the voicemail-space-time-continuum. With my purple gel-ink they take shape on perfect white rectangular canvases, each one an artistic representation of healing waiting to begin.
Step 3: Type O Negative (it came up on random, kinda like lil'-i was thinking of helping me out...)
I hammer the keyboard like I am setting each nail of the paper beast's coffin. Peter Steele's moaning plants fear in it's heart and the paper beast rustles with excitement of the attack tempered with uncertainty of its victory.
Step 4: Snowballing
The paper beast grows larger with every order entered and verified. It bares massive paper claws and takes a swipe at my delicate silky skin. Flesh parts and a perfect drop of my blood is spilled upon the counter. Like a slow-motion shot in a great noir, I watch it drift downward in mournful disbelief.
Step 5: Get it Together!
I take a step back to clean the damage and snarl in rage at the paper beast. I fall back to reinvigorate and nourish. Revenge! (>>>Thanks are in order for my other sidekick, Pepsi Max. Extra caffeine and ginseng is a bouncing-off-the-walls, teeth-chattering dream...)
Step 6: The Pharmacist Strikes Back!
I use my newfound energy to fill, fill, fill! Pills are going into labeled vials in record time and numbers! Layer upon layer of the paper beast is ripped away until it is decimated like a bag of Pull'N Peel Twizzlers (yummy). Files are put away and compounds are made.
The beast has been defeated and I stand to fight another day! The pen is far mightier than the sword when you are trapped in a little room all night...typing more than 60 words per minute helps too...
Wednesday, August 29, 2007
Pharm Libs
Yes, this is a rip off of ad libs but it is a fun stress reliever you can do with your entire staff. No patients were harmed in the writing of these stories. These stories may sound familiar but are in no way linked to an identifiable person or persons that you would know.
Now I know you will be tempted to read ahead but I guarantee it will be funnier if you make the word list first then plug them into the story in the order they were requested.
Enjoy!
Story 1 Words
your favorite color
random body part
random relative (ie aunt, grandma, etc.)
present tense verb
random cleaning solution or implement
different present tense verb
different random cleaning solution or implement
Story 2 Words
random number
skin lesion (plural)
random body part
past tense verb
different past tense verb
present tense verb
Story 3 Words
past tense verb
noun (something edible or sort of edible)
random body part
random OTC product (does not necessarily have to be a medication)
present tense verb
Story 4 Words
random controlled rx product
animal
past tense verb
noun
different past tense verb
different noun
another different past tense verb
another different noun (preferably a place or location)
Story 5 Words
OTC medicine or "cure" (Did you read the Head-On chapstick blog?)
retail store name (ie Target, Costco, Rite-Aid, etc.)
present tense verb
random ailment or disease (Can you see where this is heading...?)
Story 6 Words
random ailment or disease
random body part
past tense verb -ing
different past tense verb -ing
symptom
different symptom
another different symptom
past tense verb -ed
different past tense verb -ed
noun
random health provider or alternative to medicine provider (ie shaman)
noun (place or business)
Story 7 Words
gender
past tense verb -ed
noun (anything goes for this one)
random body part
adjective
different adjective
another different adjective
yet another different adjective
*****At this point you should have your handy word list ready.
*****Put down ANY and ALL hot beverages before reading your story. I take no responsibility for technical or physical damage from this point on!
Story 1
I have a {color} rash on my {body part}. My {relative} told me to {verb} with {cleaner} but it got worse. Can I {verb} it with {cleaner}?
Story 2
I counted {number} {lesions} on my {body part} last night. I {verb -ed} and {verb -ed} all night long! I just could not {verb}. Help!
Story 3
I {verb -ed} a bowl of {noun}. Now my {body part} smells weird and burns. I tried taking {OTC} but it made me {verb}. What should I do?
Story 4
I need a refill on my {rx} because my {animal} {verb -ed} it down the {noun}. Oh, wait, that's not what happened. I {verb -ed} it in the {noun}. No, I {verb -ed} it at the {noun}. Can you fill it for me?
Story 5
I saw a commercial for {OTC}. It said {store} carries it but I could not find it on your shelf. Does it {verb} {ailment} like it says on TV?
Story 6
I think I have {ailment} in my {body part}. I was {verb -ing} and {verb -ing} all night. Last year I had {symptom}, {symptom} and {symptom} for a whole week. This time it {verb -ed} after I {verb -ed} a {noun}. Should I see a {healthcare provider} or just spend a day at the {place}?
Story 7
Paramedics brought a {gender} in to the ER. The doctors were {verb -ed}. How could a {noun} end up in a {body part}? The procedure for removal was {adjective} and {adjective}. When the patient woke he/she was {adjective}. That was a {adjective} situation!
Ha! Ha!
Wednesday, August 15, 2007
A Late Night Out (I forgot about this til today)
5AM
I am up front getting a soda and a newspaper. A guy walks in to get some gatorade. A girl walks in behind him and asks where the restroom is so I point her in the right directon.
She turned to go to the restroom and it is apparent that she already peed in the seat of her man's car. The entire back of her denim skirt is soaked.
I am afraid for her the evening did not end well. I wonder what his reaction was after he realized what had happened. If he did not know and the car sat out in the 100 degree plus heat the smell would be unbearable. If the seats were leather it might even bleach out their color.
A friendly reminder to everyone. If you are going home from the bar it is probably a good idea to use the restroom first. Just to be on the safe side....
Yeah, a Storm!
As the storm gets close enough for them to project a hit on Florida I wait to see if I will get a magical paid day off due to Dean. When the city announces it is time for curfew all the McDruggie's shut down too (no matter which chain you refer to as McDruggie's, we are all closed).
Emergency situations are stressful. Many staffers live a hefty commute away so they usually don't come in. The rest of us end up driving around to the next closest 4 stores to assist with shut-down procedures and getting the rest of the patients home. It is not fun. It is also not easy to calm people down.
Many have fears that they will not have power for a month or so (it has happened before) and are afraid that even with their medications they may not be okay in the heat and humidity. I have some patient's that buy generators, some who pay extra to stay in nursing homes that have generators, and others that leave the state completely.
Gasoline runs short, even at $3 a gallon, and no one goes out for a couple of days because there will be downed power lines and various pieces of debris from houses and foliage. It is weird the first hurricane when you haven't been in one before but after the first it is just preparation and patience that are needed. Oh, and a good book or two unless you charged all of your electric toys.
****This prescription quadrupling phenomenon happens for snow storms too!
Saturday, August 11, 2007
The Heat Makes 'em Crazy!
As I finished with the first SUV and he started pulling out, the SUV behind was still laying on the horn. The guy in SUV-1 yelled at SUV-2 that he needed to ask the pharmacist some questions. The passenger in SUV-2 yelled back and told him to go f**k himself, then SUV-1 yelled back and threw a plastic cup at SUV-2. The passenger from SUV-2 with the eloquent linguistic skills jumped out of the vehicle and hauled ass to SUV-1 and was in his face screaming. I paged for a manager.
The driver parked SUV-2 and got out to pull his woman back from SUV-1. The phone rings, HOLD PLEASE! I page again for a manager. The driver told me the name for the prescription they were picking up, meanwhile SUV-1 and SUV-2p are still yelling at each other. "MANAGER TO PHARMACY, THERE ARE PEOPLE FIGHTING IN THE DRIVE-THRU!"
Finally two managers show up and I tell them never mind cuz SUV-1 is pulling out. Then SUV-1 pulls in next to SUV-2. Shit, "MANAGER TO THE PARKING LOT PEOPLE ARE FIGHTING!" So a manager and a camera employee run out to the side lot while the driver of SUV-2 pays for the prescription and his passenger is on the phone calling the police. "Any questions? Okay, thanks."
Then I get back to the customer on the phone. I am trying not to laugh and he is like, "What's wrong, is everything alright?" He knows we were robbed a little while ago and is concerned so I told him it was no biggie, just people fighting in the parking lot. I take care of him and wonder if he is really going to pick this up or switch to a different McDruggie's to avoid drama.
SUV-1 and 2 are still blocking the drive-thru 45 minutes later. I have a patient come in the store because he couldn't drive thru. We laugh about it and I get him taken care of. The police were there taking statements. I think they probably got a good laugh out of that later. There was no "crime" committed, just a war of words. I think if I were police I would rather have taken that call than a robbery any day.
I would like to blame global warming on such catastrophies. Oh, and alcohol, cuz SUV-2's inhabitants were very intoxicated. I wonder if the police made them take a sobriety test.....
Sunday, August 5, 2007
The Dreaded Fifth Food Group
These handsome delectible devils first arrived in the form of frozen TV dinners, pre-cooked lasagna, pot pies, etc. They were touted as the "futuristic" savior of the busy American family and the "modern" housewives' best friend. Many companies adopted and turned these frozen miracles into big bucks.
Later came pioneers of the "fast food" nation offering fast cheap alternatives to cooking at home. You could take the family out for an intimate meal in the car or you could pick up a fast meal to take home. Soon these drive-ins changed the face of America's youth. Not only were drive-ins a popular teenage hangout but everyone could afford a little slice of the new "Americana."
It didn't stop there. Other companies came up with variations of "fast food" that went from easy dips to meals in a box (just add the meat) to the lowly instant no-bake cheesecake. Cheap, easy and fast became the new American way of dining. From that point on new problems reared their ugly heads.
Have you ever stopped to read the contents of that prepackaged miracle you fed your kids? Many of the "ingredients" are practically unpronounceable preservatives or salt additives, colors, and flavors. There are thickening agents and antimicrobials that you would not normally eat if you knew what they were, let alone feed them to your kids.
We are the fattest nation on earth. With a staggering obesity rate of 80% of our entire population it makes one wonder where we find any skinny people to be celebrities. No wonder many of our popular actors come from other countries. Who could fit in those size 0 dresses? Definitely not us.
We in the medical community are all to intimate with the complications of obesity and improper nutrition (or malnutrition but the common person on the street believes malnutrition to only be a disease of the anorexic). High blood pressure, type II diabetes, coronary artery disease, and increased risks associated with many types cancer, osteoporosis, respiratory diseases, and arthritic complicatons are topping lists for common causes of morbidity and mortality.
"Common" is a word that should not be associated with ANY of these disease states. The medical community, the government, and even special interest groups are spreading the word that in many cases all of these things can be prevented, treated, or even REVERSED with proper diet and moderate exercise.
A good example, although extreme, is the show "The Biggest Loser." It takes a group of obese to morbidly obese men and women and teaches them how to make better food choices, reasonably estimate fat and calorie content, control portion size, and set exercise goals including tips on how to work exercise into a busy day even if that activity does not necessarily seem like exercise. All of the people are seen by a physician that reviews their medical history, takes their current full physical (including a lipid panel, blood sugar reading, and HbA1c) and discusses goals and health risks associated with their current status and family history. They are broken into teams that each get a personal trainer to act as a mentor and motivator for each days workout or challenge. Sure the ultimate goal is to win the money at the end of the show but it also shows America that it can be done through follow up with contestants who were voted off the show. They even check up on former winners and contestants years after the show to see how they maintain their health.
I am just taking a drawn out long way of saying it can be done. We need to motivate people with taking charge of their health with lower insurance premiums for non-obese patients, mandatory yearly physicals for every person in the nation (it could be used as mandatory to get welfare assistance--I will get into a welfare rant later, school entrance--it is a mandatory free government service to the public and their physical ed requirements need to be revamped, and a federal tax break for healthy families that are no more than 20 pounds over their ideal body weight. Yes, I know there are downsides to all of these suggestions but it is surely a step in the right direction to use government programs to educate and motivate people to take care of themselves.
Medication is not the way. It is like putting a band-aid over arterial spray. It may stop a little bleeding but the patient dies from it anyway. I am suggesting the creation of a fifth food group, the "danger" food group or "impending doom" food group. It should have a symbol like Mr. Yuckmouth to let the public know that it is not the best healthy alternative for nutrition. There would need to be regulations for the warnings. My suggestions are:
1. anything with greater than 35mg of salt per serving size
2. anything with added sugar, high fructose corn syrup, or similar sweeteners
3. anything prepared with more added fat than a pat of whole butter
4. anything that has added man-made chemical color
5. anything that has added man-made chemical flavor
6. anything that has added man-made chemical preservatives
I am not saying we should all be eating completely organic or that food preservatives are causing cancer (or am I, cancer rates, mainly upper and lower digestive tracts, are steadily on the rise). I am saying that our packaged food and fast food industries are selling our health down the river in the name of profit. YOU need to take care in food selection and preparation. YOU need to make healthy choices for yourself and your family. YOU need to live happier, healthier, and longer! So don't forget to tell your patients!
Monday, July 30, 2007
Continuing Education Credits
The proper way to "educate" the already educated is a well-structured, non-biased module that contains diagnosis, treatment options (chemical, physical, and mental where applicable), and monitoring parameters for the disease state and treatments.
I do not need a bunch of boring statistical, historical, or trivial factoids sprawled out in an article, especially if these are the things you are asking about in the "test." I need the facts and only the facts that apply to treating patients in the real world. The rest is a waste of my precious time that is devoted mainly to answering the difficult and potentially life threatening questions about how to start or stop poop (or in the heated debate with a manager last night: Who got more tail? Kenny Loggins or Peter Cetera? We came up with Kenny Loggins because he had songs in Top Gun and Footloose but I digress...).
To sum it up, I want my CEs to read like a chapter in The Handbook of Applied Therapeutics with the excess left off. Remember, we just need the facts.
Sunday, July 29, 2007
It's a Miracle!
I don't have a problem with homeless people as long as they are not harrassing shoppers and patients. I had a couple who came in at 2 or 3 am at another location to use the bathroom for hygenic purposes. They never stole anything, they just wanted to clean up. I applaud their honesty and devotion to resembling and smelling like "normal folks."
I do have a problem with overly aggressive beggars. I had a guy one night that was following people to their cars and asking for money. Not cool! That is a car-jacking waiting to happen. He was escorted off the premises by the friendly neighborhood police.
I thought it was funny when this guy came in and sat in the pharmacy waiting room and ate candy bars. He looked crocked out of his gourd and highly uncoordinated as he ripped open a Reese's peanut butter cups (those are the greatest thing since sliced bread, I like them sober or crocked). I told the assistant manager to go check on his friend. Apparently this guy comes in about 3 times a week and does this so they finally got a trespassing warrant put out against him.
Crazy stuff happens every day at McDruggie's!
On a final note, homeless people are homeless for a reason. They made the life choices that got them where they are. I don't feel sorry for them. Your drug habit destroyed your life. Your piss poor money management destroyed your life. Don't ask me for a dollar cuz I have mortgage, insurance, student loan, utility, and car payments to make every month. I don't have "spare" change.
Monday, July 16, 2007
Children of the Scorn
I was perfectly content this weekend to spend the wee hours of the morning pouring through In Touch magazine. While not a huge fan of pop culture, I find it a miracle of nature that Nicole Ritchie is able to have a human life inside of her (that doesn't also happen to be the person ass-fucking her at the time). But I digress...
My literary sojourn was interrupted with a tap tap tapping at the counter. It was a mother/daughter combo who had just gotten out of the ER. Apparently, the 8 year old girl had been suffering from a bit of constipation (no doubt brought on by a diet of macaroni & cheese smothered with a generous helping of couch potato). Her prescription was for Miralax - a laxative that has recently moved to over-the-counter status.
She was a medicaid patient. Since I had little else to do, I humored her and tried submitting the claim electronically so that I would have a rejection to drive my next point home. Alas, Miralax is no longer covered by our state's medicaid program as a prescription drug. Ever the helpful expert on drugs, I was able to quickly produce a small bottle of the OTC equivalent that was exactly enough for what her prescription required. It was also on sale (a rarity at McDruggie's) for the bargain basement colon blowout price of $5!
Of course mom wasn't real happy with that. Number one, she would have to pay for the medication. But two (and what I suspect really got her), she spent who knows how long in the ER for a prescription for an OTC product. I love to see our taxpayer dollars at work. If only she had bothered to come to the pharmacy in the first place. I could have fixed her daughter's problem rather expeditiously.
Mother and daughter were walking away when the real kicker happened. The eight year old girl turned to me and said "You're a meanie!"... and stuck her tongue out at me. Mom saw it, and did nothing to reprimand her.
Back when I was a little McRPh, I actually feared my parents enough to behave in public. If I had acted out as this small child did, it would soon become apparent that I would not need a laxative to fix my constipation. Indeed, my mother would have beaten the shit out of me - audience or not.
Never one to be outdone, especially by a child... I yelled after her - "You are an awful little girl! Normally I give boys and girls coloring books when they are sick. You get nothing because you are so rude!". Was it my place to do this? Apparently so, since she obviously wasn't getting the discipline at home. I almost followed it up with "If you stick that disgusting little tongue out at me again, I'll fill your mouth up with spiders"... but I refrained. I guess I'm just an old softy.
Phone-y Bologna (that's bo-lo-nee not bo-log-na)
1. Pharmacist: "The insurance card you brought in says the coverage expired on the 30th of last month."
Moron dialing cell: "Moooomm, my medicaid card isn't working. The lady said it expired or something and she won't give me my Accutane."
Boo Hoo....acne is lethal, you know...should have updated the info on your 4 children so I don't have to hear the whining from your 16 year old son who could pass for castrati. (castrati: young boys who were castrated to preserve their angelic singing voices into adulthood)
2. Pharmacist: "The refills on this prescription have expired. We will need to call the doctor in the morning."
Moron dialing cell: "{insert moron's wife's name here}, the lady said my refills expired on my Lunesta. Aren't there still refills listed on the bottle?"
Moron hands me his cell phone so his wife can tell me that the bottle says 2 refills before 6/03/07. I ever so politely let her know that today is 7/12/07 and that the refills are expired so we will have to call the doctor. I hand the phone back to Moron.
Moron: "Can I get a couple to hold me over?"
You can guess where this is going.....Denied.
3. Pharmacist: "Your copay is $100.57."
Moron: "My dad has Medicare to cover that. It was a lot cheaper last month." Moron dials his dad. "Dad they are trying to charge me $100.57 for your Lipitor. It wasn't this much last month." ...conversation drags on...
Obviously their handy dandy insurance agent signed pops up for Medicare Part D and never explained the "Donut hole." Lucky me. Guess what I spent the next 30, count 'em, 30 minutes explaining. Thank you government!
There really needs to be a cellular dead zone encompassing my workplace. Not only do cellular phones violate HIPPA they irritate the shit out of the pharmacy staff. I do not like touching your oil-smeared crusty phone. Who knows where you and it have been. Call me on the store line, Assclown!!! I will be appreciative and you will actually be able to hear what I am saying.
CAN YOU HEAR ME NOW????