We bring the FAST and laughs to pharmacy.

Friday, August 31, 2007

Cruel Intentions

I filled in at another store last night on the overnight. The last few times I worked there went smooth. I intended to sketch out the idea for a blog entry extolling admiration for the microscopic and sometimes deadly spirochete. Instead of the Stepford-like automaton function I intended to perform all night, I was greeted with a very disorganized rx disaster and a feeling of impending doom that could be the forebear of an ischemic event.

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

For this exercise you will be requested to give a list of words. If an ending is necessary or preferred it will be given. For example: past tense verb -ed. This means things such as burned, soaked, stitched, etc. The list of words will then be plugged in to a very very short story.

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.


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
past tense verb
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
different symptom
another different symptom
past tense verb -ed
different past tense verb -ed
random health provider or alternative to medicine provider (ie shaman)
noun (place or business)

Story 7 Words

past tense verb -ed
noun (anything goes for this one)
random body part
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)

Sunday morning

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!

By the time I return to overnights on Tuesday there will be impending doom brewing southeast of Florida. As tropical storm Dean approaches and grows stronger people will start to panic. Bottled water, batteries, ice, and any food stuff not refrigerated will disappear from shelves like the newest "must have for the holidays" children's toys. Prescription orders will quadruple in a matter of hours and our staff will be the "marathon runners" of prescription preparation.

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!

It started out as any overnight at McDruggie's: no help, a line of people, phones ringing off the hook, cars in the drive-thru. After that mess was cleaned up it was about 11PM. An SUV pulled in and I was getting his prescriptions while another SUV got in line behind him. I rang him out, was doing the counseling thing, everything was going smooth. The SUV behind him honked its horn several times. From the outside of the building you can CLEARLY see the pharmacist or tech talking to the first vehicle in line so the honking was unnecessary and rude.

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

The government came up with a food pyramid illustrating things you should get out of your diet and a reasonable proportion to represent each as a "step" or "building block" of this pyramid. It was a well thought out derivation of what the human body needs to survive based upon our omnivorous nature. It was pretty reliable source until the advent of "fast food" and overly processed pre-packaged meals became available.

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!