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Wednesday, December 17, 2008

Rectotab - A 100% All-Natural, Clinically Proved Rectal Prolapse Treatment


Rectotab - A 100% All-Natural, Clinically Proved Rectal Prolapse Treatment:

OK, so now that you are familiar with Rectotab I can explain how I found it. Of course I am a fan of any and all grotesqueries the human body can produce. I was giggling to myself about a patient I had a few days ago. I have been soooooo busy I completely blacked out about it until today.

It was around 10:30PM on Saturday night. A gentleman asks for the pharmacist for a question.

Patient: I am pretty sure I have thread worms. I don't know if I should be asking a woman because this is kind of embarrassing. I can feel them crawling around and I need to know what to use for the itching. I have been using Vaseline but I am looking for something stronger. I know I need to wash my sheets and everything but what can I do about the itching?

Brain: (AAAAAAGGGGGGHHHHHHH!!!!!) For reals????? He has an army of worms overpopulating his poop chute and he is only worried about the itching when Ponce De Squirm-on and his merry band of explorers escape from the Fountain of Poop?????? WTF???

Me: There is an over the counter product available that will get rid of the worms so you don't have to worry about the itching anymore. Let me show you.

By the time I had given him Reese's Pinworm Medicine and reaffirmed the home cleaning regimen he went on his merry way to exterminate the explorers. It also reminded me of another patient I talked to fresh out of pharmacy school.

She came to the pharmacy because she had a prolapsed rectum. For the uninitiated, a prolapsed rectum is where the rectum is actually protruding from the anal opening and causes a great deal of discomfort until repaired surgically, not to mention awkward social situations. The most common causes are chronic intestinal parasite infestations (mostly documented in third world countries), lifting way too much weight, and in some cases from rough anal sex.

She had a surgery scheduled for the next morning but was having a very uncomfortable time and kept grabbing at her behind like she was trying to push it back in with her hand as she spoke to me so I told her to call the hospital where the surgery was to be performed and see if they could admit her early and start the pain meds now. They took her in early. Another rectum saved....

So after I thought about that I remembered a video I saw a few years ago of a weight lifter that had a huge amount of weight to lift and actually blew his rectum out and covered the camera crew behind him with feces. It was classic so I plugged "rectal prolapse" into my Google search and what to mine eyes did appear but a "guaranteed remedy" for that situation called Rectotab.

Hmmm, my curiosity was peaked. I read the magical claims of Rectotab and assumed if it worked the $79.99 was far cheaper than surgery but alas the ingredient list was not promising. I am sorry, but if my rectum is protruding from my anal sphincter I am not taking these crappy tablets I am going to do something useful for society and make a YouTube video of it wriggling and undulating to that Rick Astley song that was so horrible in the 80's then go to the nearest hospital for surgery. Another rectum saved....

"Never gonna give you up. Never gonna let you down. Never gonna run around and desert you. Never gonna make you cry. Never gonna say goodbye. Never gonna tell a lie and hurt you"....ooooooohhhhh......never gonna give, never gonna give....give you up......damn you McDruggie's muzak!

Wednesday, December 10, 2008

Chalk One Up To House

I was flipping through mind-numbing programming and stopped to watch House for a few minutes. If you have never heard of it the show focuses on the demented, crippled, and pain-killer addicted doctor House as he fumbles his way through "mystery" illnesses and tortures his medical team as much as possible.

There was a scene where Dr. House is seeing clinic patients and he has a female patient who says she is using one inhaler a week and her breathing is not getting any better. He asked her if she knew how to use her inhaler and she replies "Do I look like an idiot?" He says she does not but asks her to demonstrate how she is using the inhaler. The lady sprays it on the left and right sides of her neck like perfume. I almost wet myself I was laughing so hard. It was a wonderful laugh at an unfortunately common problem: inhaler misuse.

Please do not assume that telling a patient how to use the inhaler ensures that they will actually use the inhaler properly. This includes discharge from the emergency room because an even more common problem is that a patient will say they weren't told anything at the hospital when I know for a fact the nurse discharging the patient goes through all the paperwork with them including medication use.

Make the patient go through the motions as you describe it to them then discuss the medication, see if they have any questions or concerns, then have them demonstrate again how they are going to use the inhaler. This may not ensure proper use but it is the best we can do even with instructions in the inhaler packaging.

If there is anything the medical world teaches you is that most people have no common sense. This leads the U.S. government to over regulate things that are available without a prescription in other countries. Basically, most Americans are idiots, including the ones in power. It is with shame I hang my head and seek a mail-order husband from another country...

Wednesday, December 3, 2008

Holiday Wish List Part 2

You know Santa, there are several things we need that I don't really need to explain why. These are: universal health care coverage, better education systems, better libraries, more family time, less violence against each other, an end to telemarketing, a cure for all viruses transmitted through genital fun time, renewable alternatives to fossil fuel energy, cost effective stylish transportation, responsible personal spending and savings, and better entertainment programming.

I would also be forever indebted to you if you grant me one wish.....that someone of such great intelligence that I feel like I only had a 3rd grade education comes up with a definitive and infallible way to measure and treat pain. I vision a neuro scan that can locate the area of origin of the pain signals and the intensity at which the brain translates this signal into "pain." This would allow us to effectively treat pain while avoiding drug seekers who pretend to be in pain so they can get "high."

If that is too complicated then maybe you could grant me a drug or implant that deadens the receptors that contribute to addiction. Our current treatments for addiction all focus on weaning the patient off the addictive substance by using a different addictive substance. It almost always fails. I have seen so many people go into rehab programs only to be right back on the addict wagon a few months later. It is sad and terrible because these are the people who are "f*cked up" all the time and cause fatal auto accidents that kill the innocent and destroy the lives of their surviving relatives. There needs to be a change made.

I also want people to take a look at themselves and see that there is more to life than being stuck with a loser. Why are some people so mentally damaged and devalue themselves to the point where they feel the need to stick by a total douche bag instead of finding someone that truly cares about them? Please give them the strength to take a look in the mirror and like the character Stuart Smalley realize that "I'm good enough, I'm smart enough, and gosh darn it, people like me." I can't stand it when a woman is beaten and stays with the man and tells lies to cover up the cuts and bruises. I tell those people that the beatings will never stop unless they walk away. There are shelters specifically for this purpose if a person is unwilling to ask their family for help. There are counseling programs to help work through the feelings that keep them in danger and help them to become whole again. It scares me to think that so many of these women and gays (yes it happens to some of them also) do not reach out for help. That is no way to live...please help them to overcome the fear and escape for a chance to start over.

Santa, I need to ask that you inspire prescribers to minimize the amount of drugs used to treat any one disease state with maximum results. For example, I see hundreds of patients who take more than 5 drugs for blood pressure and heart problems. There is no need for all of that. With combination drugs on the market and several drugs used for blood pressure that do other things like regulate heart rhythm and conduction that there is always a better choice for each patient's problems.

I try to tell doctors that "new" does not mean "better." Why risk your patient's life on a drug that has not been out in the market enough to know all the bad things it can do and not have a proven track record? How many patients suffered from all of the drugs that were pulled off market less than 5 years out of the gate? Why would you base treatment on what a drug "salesman" tells you or what money the drug company is giving you under the table than on a person's health and well-being?

Maybe it would just take prescribers to remember that these are real people with real lives and real problems, not just cattle to be penned in a waiting room for 4 hours while you get schmoozed by drug reps, only to get 5 minutes of face time with your P.A. and none or almost none with you so the dollar signs in their bank account get bigger and patients get piss poor health care. I hate that. I really hate that. It makes American modern medicine a bigger joke than the "war" in Iraq that was supposed to be an "occupation" to restore a government of the people, by the people, and for the people. You need at least an hour per patient to really address all issues and questions a patient has. I am sorry that you may not be able to afford the gold swimming pool you wanted to put behind your McMansion but it is about the patient's health not your wallet. The guilty ones know who they are...

Ugh, I guess that one is a losing battle until medicine gets "socialized." So I will ask for one last wish. Santa, this is a very very important wish. It is an easy one to fulfill and could actually be done by almost every person alive today. Instead of wallowing in the gluttony of commercial expenditures this holiday, I want everyone to celebrate the greatest gifts of all, life and love. These are things that go beyond religious barriers and petty disputes.

I want children and animals to be adopted. What better way to celebrate than to open you heart and home to a new child or a new pet. I want everyone to celebrate life not stuff because at the end of the day the most precious thing we have is life. In the words of John Lennon "All you need is love." and that is how I intend to celebrate the holidays. Won't everyone celebrate with me????

Thanks Santa!

Tuesday, December 2, 2008

Holiday Wish List Part 1

Dear Santa,

This year I think I will embrace the possibilities of hope and change and ask for the impossible. If we are ready for a non elderly white guy to lead the nation we are ready for some super special wishes to be granted.

First, I would love people to stop being rude. I don't understand why one miserable son-of-a-b*tch has to ruin the day for the rest of us. What happened to peace and good will towards men when people are getting trampled to death trying to get a bargain at Wal-Mart? Seriously, it is just some piece of cheaply built crap that is getting returned a day or so after it gets opened anyway.

Next, I would LOVE a world where people put careful thought in a piece of artwork that is going on their body instead of picking a pic off a wall and having it inked. It is also stupid to tattoo the neck, hands and face where it can't be covered up by hair or clothing. You really just look like a smack hound instead of a respectable citizen. I have a few large relatively involved pieces that took years of planning before I was sure I wanted them on me permanently and they can all be covered up at work so people don't question my advice like it came from a box of Cracker Jacks.

I would also love it if people got their tattoos while completely sober. Seriously, if you can't take the pain then you don't need the ink you f*cking p*ssy! I suffered through every prick of my ink and you should too.

Next, I want everyone in the world to examine their eating and exercise habits and make changes as necessary to prevent the need for specialty clinics serving people who had to be crane lifted out of their homes because they have a refrigerator and microwave within arm's reach of their beds and haven't seen their feet since 1972...

We have serious problems when gastric bypass surgery and liposuction procedures are becoming as common as impacted wisdom tooth extractions because we are overrun with people weighing in excess of 400lbs. That may be normal for a 7 foot tall linebacker but not for John and Jane Q. Public who struggle to move throughout the day because most transportation and public facilities were not built to accommodate those of massively excessive girth. Yes, I know that about 5% of them have legitimate hormonal and metabolic disorders that cause the weight gain but the other 95% are just plain irresponsible for their own well being and need a Christmas miracle to fix whatever underlying mental issue fuels their desire to shovel food in their gullets and just keep on going...

Friday, November 28, 2008

Holiday Wish List

The end of the year is nigh. The mad dash for gifts people will return or leave in a closet to re-gift to someone else later is here. It started off with people coming into McDrugggie's ever so often to use the restroom. No purchases, just restroom trips. These nut-jobs had been in line at Best Buy since 4pm on Thanksgiving so that they could get the magic coupon that got special prices on certain items. I hate to break their plates but all of the items in the ad were available on-line at the sale prices without the magic coupon.....could have shopped at home and enjoyed your family instead of sitting in a 200 people line all night long....I will never understand....

A lady that calls all the time called asking if there was a virus going around because she will only take a Xanax but never anything for her allergies because medicine makes her "sick." She always asks me if I am seeing patents with colds or flu symptoms and if I am sick because I sound sick. I told her I had some allergy related congestion and she told me she had the cure for that....a nettie pot. I let her know ever so politely that if I wanted warm saline in my nose I would go to the beach and play in the waves because inevitably a big one comes along, knocks you down, and cleans your sinuses for you. I of course was joking but seriously do not like the sensation of any liquid in my nose, no matter how congested if may be.

The opposite week manager was filling in for the regular manager and was telling me stories of how the other pharmacist refuses to recommend OTC products because "The body makes snot for a reason and if you take OTC meds it just prolongs the illness." She then told me that he always tells people that none of the OTC vitamin products are regulated and each bottle contains a different potency and concoction than the one before so you shouldn't take any of them.

He also told a pregnant lady one night that she shouldn't take Sudafed because it is what junkies use to get high and did she really think that was a good idea for the baby. That was hilarious. I would never say that to a pregnant lady. I would tell her to use saline nasal spray until she talked to her OB/GYN. He also likes to tell people to ask me questions when I am back on duty. I have had several of those patients but in his defense when he went to pharmacy school they had to compound everything and aspirin was the only real drug. On the other hand he is a pharmacist and should be up to date and comfortable with most of the medications on the market and health issues patients have questions about.

So for the rest of the evening I fed the robot with pills, cleaned, and restocked supplies for a lack of anything medical to do. Then I had a patient come in with a prescription for Duragesic 75mcg patches. For those who don't know, this is a powerful pain patch used in patients who don't tolerate opiate pain relievers like morphine or oxycodone. So I ran it and to my surprise he picked up Oxycontin 60mg (twice daily dosing) from CVS a couple of days ago. These DUR notifications are about the only good thing insurance companies do anymore because without them I would have no idea about the other prescription. Now I am concerned because I have NEVER seen or heard of these two medications being used together. So I had to have a serious conversation with the patient.

He said he had been on the combination before but I told him we needed to consult with the physician to make sure the doses had been properly titrated and the physician was aware of complications that could result from the combination. The patient really had no problem with taking both together. Because I have no recent prescription history to prove the doctor was aware of the situation I told the patient they are both powerful meds that are never used together in high doses because of breathing complications that could result in death. He left the prescription for me to call on and still was not concerned about any complications. What I really wanted to say to him was "Sir, I cannot dispense these without talking to your doctor because Murder One is not on my Holiday Wish List." Alas, I could not vocalize but merely ruminate on that which my brain wanted to scream out...

On the bright side the day was easy and over before I was completely bored stupid. On to the next day...

Wednesday, November 26, 2008

Pass The Turducken!

It that time of year again when families gather to feast upon that most magical of beasts, the turducken. Not technically a creature of the natural world but the design of some culinary dementia where a turkey just wasn't enough so a duck gets stuck up its hole where intestines and organs used to lie. This foodie contraption is dressed and cooked in various not-at-all healthy ways, combined with other unhealthy abominations of foodie dreams to be devoured by family and friends at a rate that would astonish the starved inhabitants of a remote tribal village that only sees a "full" meal once daily if lucky.

Wow.....Happy Turducken Day! or if you are vegan Happy Tof*cken Day! (where a tofu mass shaped like a duck is stuffed into the hole of a tofu mass shaped like a turkey and sounds dirty when you say it out loud...). Don't forget to gather around the table and switch the salt with a Lipitor shaker so you can pretend that cholesterol won't be the catalyst for your ultimate demise.

Don't forget to be thankful for all the things you love like "clean rooms" and antibacterial soaps, birth control and lubricant, or whatever floats your boat. I am thankful for laundry machines because washing a large load by hand would suck more than having fecal impaction...or so I imagine it to be.

And Remember: If you have a roof over your head, money in the bank, and money in your pocket (no matter how small the amounts), you are part of the richest 8% of the world population! Yay!

Thursday, October 30, 2008

Pickled Pink

I think back to Biology 101 and the little pickled animals and parts we dissected, poked, and prodded to "learn" what insides look like and get an idea of how structure and function relate to the electrochemical magic we call "life." It is fascinating but are we pickling ourselves?

Since the dawn of the TV dinner science has produced chemicals that make food stay in an edible form for periods of months to years. We have also seen a steady rise in neurological disease and gastrointestinal cancers. Sure, skeptics would say that the rise in many diseases of aging happen simply because our life expectancy has greatly increased beyond that of people from 200 years ago. I am not so sure.

I looked through a catalog of government approved food additives. There is a whole lot more than color going into those Pop-Tarts, kids. There are pages and pages of protein, fat and sugar substitutes, colors, flavors, antimicrobials, texture stabilizers, etc. I don't even think Kosher hot dogs are "Kosher" anymore because several additives are derived from animal and bacterial origin. I was taken aback by the practically unending array of things you can put in food to make it appeal visually, odoriferously, and tastefully.

Consider colon cancer. The colon is basically the sewer system of the human body. The upper digestive tract breaks down food so nutrients can be absorbed and passes the rest of the material to the small intestine for further processing. The intestines have secretory cells that coat the lining with a mucus layer that assists in moving waste out while bacteria finish processing waste. While the waste is moving out some things get stuck in the mucus layer. If you don't eat enough fiber these trapped wastes can lead to irritation or infection in the intestinal lining. These irritations sometimes form polyps that eventually have the potential to become cancerous years down the road.

The real problem with colon cancer is that you can be asymptomatic for years after the cancer starts. Once it has spread to other areas of the body and you start showing symptoms it can be damn tough to treat and often fatal. This is where routine screenings for certain age groups come in. Sure the test is very uncomfortable but if you can catch it early you can stop it early. How many of the additives in food contribute to this? We have no idea.

Another problem we see more and more is Alzheimer's disease. This neurobiological breakdown of brain tissue leads to serious problems relating to being able to care for one's self or becoming a burden on the family. The saddest statistic is that most of these patient's end up in long term care facilities on a chemical cocktail that keeps them "manageable". It is a horrifying sight to behold and I will die in a well orchestrated "accident" before I let that happen to me. It does run in my family so I will more than likely be afflicted. Tick tock...not sure how long but I know my brain is waiting to turn to useless mush in about another 50 years... Pudding, it is turning into pudding...

Another neurobiological issue is Autism. There are many degrees of cognitive failure in Autism. For the lucky ones the damage is minor and they appear to function on a time delay. Others are not so lucky and seemed trapped in a repetitive nightmare that makes them a burden on the family. Could it be from food additives during a baby's time in the womb that cause this?

I like to think there are many contributing factors. First, neurological problems can be inherited. Alzheimer's, seizure disorders, and several forms of mental retardation are known to be inherited. We all have a "crazy" relative somewhere in the family tree. That one relative is evidence that your genetic stew can go bad when it comes to cooking up a new member of the family.

Second, diet plays a major role in fetal development. There are certain nutrients we know pregnant women need to prevent specific developmental problems. There are also certain foods pregnant women should not eat because they are in a state of decreased immunologic function. I am curious to see what women ate the entire time they were pregnant if the child was diagnosed with autism. I doubt that would be a good study though because people always lie about eating better to scientists or medical personnel.

Third, certain medications are known to cause birth defects and increase the risk of birth defects. I would like to know what prescription and OTC medications women were on along with vitamins, herbal supplements, health drinks, etc. the entire time they were pregnant if their child had neurological problems.

I don't know what the answer is as I have written myself into a vortex of practically unanswerable questions. I think I have to side with the Vegans on this one. Unprocessed foods seem like the best choice to me. Beyond foods, I don't think I will use any medications unless 100% necessary during pregnancy. Not that I am planning on children but you never know when an accident will happen....

Sunday, October 26, 2008

Shame On You, CNN

So I am in Orlando, Florida for a fun weekend of theme park rides and I flip through the channels to find something to amuse until we leave for the parks again. I stop on CNN hoping to get some of "The Most Trusted Name In News" and see a lady (I don't remember her name) talking about how medical doctors are notorious for prescribing placebos when they don't know what is wrong with a patient.

Here is her list of "placebos":

*sugar pills

This is the definition of placebo:

pla⋅ce⋅bo   /pləˈsiboʊ for 1; plɑˈtʃeɪboʊ for 2/ Show Spelled Pronunciation [pluh-see-boh for 1; plah-chey-boh for 2]

–noun, plural -bos, -boes. 1. Medicine/Medical, Pharmacology. a. a substance having no pharmacological effect but given merely to satisfy a patient who supposes it to be a medicine.
b. a substance having no pharmacological effect but administered as a control in testing experimentally or clinically the efficacy of a biologically active preparation.

2. Roman Catholic Church. the vespers of the office for the dead: so called from the initial word of the first antiphon, taken from Psalm 114:9 of the Vulgate.
1175–1225 for def. 2; 1775–85 for def. 1; ME < L placēbō I shall be pleasing, acceptable

To set this lady on the right path anti-inflammatories, antibiotics and vitamins cannot be placebos because they actually are chemicals that perform a specific function in the body. The case can also be argued for saline. It performs as a tear replacement in eye drops and a fluid replacement intravenously for volume deficiency (ie dehydration) and as a vehicle for medication delivery. So technically saline does have activity in the body so it is not technically a placebo.

Should I go as far as to say that sugar pills can be argued to not be a placebo.... For diabetic patients on insulin therapy drops in blood sugar can be dangerous to the point of being deadly. These people take sugar pills to help in the regulation of blood sugar so in specific cases sugar pills do not count as a placebo unless they are being used as a "control" in an experimental evaluation.

The lady further went on to breed mistrust between patients and physicians when the "interviewer" asked if this was "legal" and she replied that the practice of giving placebos is "..legal but unethical." How do you like them apples...now the "most trusted name in news" wants you to revolt against your primary care physician. Is this how the government plants seeds to discourage "socialized" medicine or is this lady just another ill-informed media puppet?

This post just proves two things: CNN should not be the self-proclaimed "most trusted name in news" and I am an opinionated, angry c*nt.

Monday, October 20, 2008

No Good Deed Goes Unpunished

So I get a call at McDruggies's and a lady wants to know if the rash she has is from her cat. She is elderly and has a "feral" rescued cat that she keeps in her house and has had for a long time. It lets her pet it when it feels like letting her pet it. Other than that she is the "food giver" and "poo box cleaner" in the one-sided relationship. She said sometimes the cat likes to sleep with her on the bed and lounge on the couch. So I ask for more details about the rash.

She has a lot of swelling from the knees down and on her arms. It started this morning and is getting worse. She also has a lot of itching and some "spots" on her upper arms and a couple of "spots" on her face. I ask for more details.

It turns out she was going to be a sort of half-way house and that another "rescue" cat had been left with her two days ago and the rescue worker told her to take a towel and rub the new cat then rub her cat so they would recognize each other's scent. One teeny tiny problem.....the new cat has ringworm (a fungal infection of the skin) that no one told her about. This means that the resident cat has been thoroughly rubbed with the towel from the new cat with the skin infection. You know what happened next...

The last two days played like an outbreak movie in motion where the infected kitty and resident-now-infected kitty have rubbed against the lady's legs and arms from where she wrangled them to put antibiotic ointment around where they had scratched their ears raw. She then took two showers to try and soothe the rash, which makes the skin dry and makes the rash more irritating. The new kitty had gone to another half-way house.

At the point in the evening when I talked to her the new kitty was at a different home and may be coming back to her in a couple of days. I told her to call them in the morning and tell them "No." She now has to treat her infected "feral" cat, treat herself and do some significant cleaning everywhere infected cats have rubbed. That will be a daunting task because my cats are not "feral" and they are on e-v-e-r-y-t-h-i-n-g in the house.

Her next few days will involve a trip to the vet with an angry kitty, a trip to the drugstore/urgent care for her, and a lot of itching. I would rather be in pain than itch and there is only so much OTC products can do. After I talked to her a few times over the course of the evening to reassure her that it is a treatable condition I suffered some psychosomatic empathy itching.

The moral to the story is when taking in "rescue" animals, be sure to ask if there are any medical problems the animal may need treated. Have a vet give all necessary vaccinations, check for ringworm/heartworm/etc., and look for signs of skin infection, parasites, or open wounds. It is also a very good idea not to introduce your pet to a rescue animal without isolating the new animal for at least 48 hours to make sure it does not have anything that could pose a health threat to you or your pet.

Isolation is especially important with birds. They can carry many different respiratory illnesses and parasites that readily jump from bird to bird. When birds get sick they stop eating which leads to dangerous drops in body weight. Birds are like newborn humans, when things go bad they go bad fast and can easily be fatal.

Following these precautions can lead to a very rewarding new addition to your animal family. I know I love each of my little ani-pals like they were my own babies and wouldn't give them up for the world! ....an NO, I am not an animal horder. I have 2 cats that roam the house like they own it and 5 small birds that live in a large metal aviary (mainly to avoid becoming kitty treats). Happy adopting!

Friday, October 17, 2008

Think Happy Thoughts, Warm Safe Place

Sung to the tune of "Witch Doctor"

I told the politician I need some health care
I told the politician life was so unfair
And then the politician, he told me what to do
He said that....

Ooo eee, ooo ah ah ting tang
Walla walla, bing bang
Ooo eee, ooo ah ah ting tang
Walla walla, bing bang
Ooo eee, ooo ah ah ting tang
Walla walla, bing bang
Ooo eee, ooo ah ah ting tang
Walla walla, bing bang

I told the politician my home would soon be lost
I told the politician I could not bear the cost
And then the politician, he gave me this advice
He said to....

Ooo eee, ooo ah ah ting tang
Walla walla, bing bang
Ooo eee, ooo ah ah ting tang
Walla walla, bing bang
Ooo eee, ooo ah ah ting tang
Walla walla, bing bang
Ooo eee, ooo ah ah ting tang
Walla walla, bing bang

Now, you've been suffering like me
Just like you were homeless
And I'll admit I don't feel so well
So I went out and found myself
A guy that's so much wiser
And he bought me a bottle of Cuervo

My friend the politician, he took that bottle too
My friend the politician, he beat me black and blue
I know that he will smile while wiping me off his shoe
Oh, baby....

Ooo eee, ooo ah ah ting tang
Walla walla, bing bang
Ooo eee, ooo ah ah ting tang
Walla walla, bing bang
Ooo eee, ooo ah ah ting tang
Walla walla, bing bang
Ooo eee, ooo ah ah ting tang
Walla walla, bing bang

****Ugh**** No happy thoughts left... Maybe Zach and Miri have it right, the only joy left is making a porno...

Monday, October 13, 2008

Off Topic: Do Not Use Travelocity For A Trip

I have had a terrible, terrible time with Travelocity and changing reservations. You will get f*cked really good because in order to change anything on your reservation after you have booked they will charge the FULL PRICE you paid again for the change. If you cancel the reservation they will also charge you double for a cancellation fee. What douche bags! The only customer service you get from them is rape.

Oh yes, their advertising makes it sound like you are getting a good deal and getting first class service, when in fact they are just greedy bastards taking your money and then fisting you for more later if something happens to need changing.


Wednesday, October 8, 2008

Even More Political Nonsense and Affordable Health Care for All

I was planning another blog when a comment from my last Political Nonsense blog from "flyryan" wanted me to watch a You-Tube video of John Mccain's solution to emergency medical care. My response and then some:

Mccain's plan to have a medical facility in retail outlets has already been put in place by retail establishments with a big pharmacy business. He is just generalizing what private industry figured out many years ago: cheap, quick, readily available health care for everyone. What Mccain fails to see is that these clinics are very limited in scope as to what they can treat, screening equipment, and surgical capabilities. He fails to see that this is not the ultimate answer for emergency care but, as I stated before, it can help to ease the burden on the emergency room to medical care that needs surgical resolution, bone resetting, etc. instead of a six hour wait time because of 300 people with easily diagnosable and treatable ailments are waiting because they do not have a primary medical doctor due to lack of insurance or feel like sh*t and can't wait 3 weeks for an appointment with their primary physician.

Both presidential candidates have fatal flaws in their medical plans because their advisers are so removed from the medical fields they used to practice that they cannot see the forest for the trees. Both candidates need to sit down with emergency workers from poor inner city hospitals, over-crowded and understaffed VA hospitals, nurses that can fully enlighten them to the fallibility of an entire ward with only one or two nurses per shift to care for them all, physicians who are so over booked that patients get very little face time with them, pharmacists who can fully explain the issues and ramifications of non-compliance when copays skyrocket at the beginning of each new year, and patients who have to make a choice between paying for food, a mortgage/rent, gas, utilities, and medications. Only then will they see a small part of what is really happening in the rich country with the worst health care system.

During our last Democratic presidency Hillary Clinton tried to get legislation passed that would ensure every child had health care. Many in Congress fought her because they felt the First Lady had no business trying to enact legislation and was supposed to be a fashion accessory to the President. That just plain sucks! I have a simple solution for Congress. Take a few hundred million in "pork barrel" programs that only benefit a handful of people and fund Medicaid to cover health care for everyone under the age of 18. Medicaid is already subsidized by third party insurers so they won't be losing any money, children will have health care, and it will help out families by cutting costs on their health care plans by dropping coverage for children, not to mention ensuring that insurance lobbyist payouts keep coming so the bureaucrats still get what they want.

I only have to ensure myself because I have no spouse or children and I only pay about $50 per month for decent health/prescription insurance because my employer pays most of the premium. I have seen the premiums for family coverage and spouse coverage. They are far higher than mine, even with the company paying part of it. Independent family plans can go up to $700 or more per month depending on the coverage and the insurer with only the family to cover the premium. Families could save hundreds of dollars per month on health care just by not having to pay family premiums. This is a simple, painless solution to a very important problem. How much easier can it get??? But I have more!

The same can be said for Medicare and its heinous monstrosity of Part D medication coverage. Again, take a few hundred million in pork barrel spending and fund Medicare Part D in such a way as to give every citizen over the age of 55 zero monthly premiums for the program, zero copays for generic medications and a reasonable copay, such as $5 for brand name drugs that have no generic.

This former "pork barrel" money can also be used to ensure faster reimbursement for all Medicare and Medicaid services to pharmacies, medical providers, and hospitals so that independent pharmacies and medical offices no longer have to struggle to pay operating and/or drug replacement costs while waiting years for the government to pay them back and hospitals will have a bigger budget for nursing/medical staff and equipment/supplies, thus increasing quality of patient care and outcomes. This funding will keep jobs, generate jobs, prevent businesses from collapsing, and increase quality and access to medical services in tough economic times. Can there still be more???

My solution does not cover everyone but does ensure health care for those most at risk for medical problems and complications resulting in death. My solution also has the easiest and greatest effective solution for health care that this nation has seen in many years. This is the closest I can get us to nationalized health care that will keep ALL parties happy. In summary, my not so crazy plan accomplishes this:

* Health care for all children under 18 years old.
* Cheaper medications for all people over 55 years old.
* Faster and better reimbursement for all medical goods and service providers.
* Cheaper health care insurance costs for families.
* Insurers still make money.
* Bureaucrats still get perks.
* Job are saved.
* Jobs are created.
* "Pork Barrel" spending is reduced.
* People are healthier.
* People are happier.

And greatest of all:

* Accomplishing "Change we can believe in!"

"The only change we can believe in starts with our ideas and government actually listening to and implementing the mutually beneficial ones!" Big N Tasty, RPh

Saturday, September 27, 2008

Political Nonsense

Another American Presidential debate season is upon us. The air is filled with promises and hope of magical things like nationally regulated health care, affordable drugs, greater access to doctors, happy little bunnies hop-hop-hopping at your feet and cute little birds extolling the virtues of daily life in our wonderful nation. I inhale big lung-fulls of hope and promises until I notice the cancer starting to choke my lungs as the lies in disguise poison me like so many chlorofluorocarbons nibbling away at the ozone layer. That reminds me, I need to buy more sunscreen....

Some promises are being fulfilled by el corpo pharmacia. Easy access to urgent medical care has been a rising trend for all retail pharmacy outlets. Sure there are limits to what can be treated at these urgent care outlets but they help ease the strain on an already overstressed emergency room system. Keep the emergency room for those who really need it: the mangled, the attacked, the coronary events needing immediate attention, broken bones, torn muscles and ligaments, etc. Applause for the initiative, although profit driven but what isn't these days, to ease the pressures on overflowing ERs nationwide.

Another promise being fulfilled by el corpo pharmacia is affordable medications. On the one hand many corporations are offering various pricing incentives or discount plans for cash paying consumers. On the other hand this is choking the life out of the mom and pop pharmacies who cannot survive the competition, piss poor insurance reimbursement rates, super slow payments from medicare and medicaid, and higher replacement costs for medications. Even buying co-ops don't make much of a dent in replacement costs. It is very disheartening that in the "land of opportunity" we slowly but surely cannibalize every independent business. I have worked with several pharmacists who sold their business and now work for McDruggie's. It is a disheartening sacrifice for job security in a rapidly crashing economy.

My favorite thing to hear from politicians that makes me pee my pants with laughter is not to buy drugs from anywhere other than the U.S. of A. This comes right off of the Food and Drug Administration's Website:

FDA's Main concern: Safety
A growing number of Americans obtain their medications from foreign locations, often seeking out suppliers in Canada. But FDA cannot ensure the safety of drugs bought from these sources.

Such a broad statement gives me a fit of the giggles. It should have been worded better. I have no doubt that legitimate pharmacies in Canada are dispensing the same medications that my pharmacy is. The FDA statement conjures the image of Snidely Whiplash in a lab coat pouring tablets from a bottle with a skull and crossbones on it into a medication vial then Dudley Doright rides in on his trusty steed to bust up the operation and somewhere along the line has to avoid a train. Damn, that reminds me how old I am but the Dudley Doright Ripsaw Falls theme ride at Universal Studios in Orlando sure is fun...if you go sit in the front...and take a lot of quarters...it will all become clear when you ride the ride...here's a hint...water cannons...but I digress...and need to take a minute to plan a trip to Universal Studios. Thankfully I am within a reasonable driving distance and the Incredible Hulk roller coaster rocks!

Back to buying drugs from other sources. I am skeptical of most Internet sites that sell drugs, especially the ones only selling Viagra, Levitra, and Cialis. The FDA has a task force systematically investigating and shutting down illegitimate operations. The problem here is that as soon as one is shut down one hundred more pop up. I would not purchase medications from ANY site that is not a legitimate pharmacy operation. Do your research before you buy.

Another way to combat counterfeit drugs entering the market is radio frequency identification tags. This technology is still in the research and testing phases but promises to put a big stop on illegitimate chemicals entering the retail pharmacy system. I am putting my faith in technology because it has never failed me where politicians always have.

Another reason the FDA statement and ill-informed politicians make me laugh is that many pharmaceutical companies are manufacturing their drugs in other countries and importing them back into the U.S. I have seen several bottles from Pfizer labeled Italy, Ambien labeled France, and an ever increasing number of brand and generic drugs labeled India. Maybe the politicians haven't seen the world travel FDA inspection itinerary or maybe big pharma has paid them to be ill-informed. Don't drink the political Kool-Aid kids, more and more drugs are manufactured elsewhere due to cheap labor and tax breaks from the Free Trade Agreement.

There have been warnings, such as the recent Ranbaxy debacle because their factory fell short of FDA standards and practices and is not allowed to import anything from one particular factory until standards and practices are proven to meet FDA guidelines. The point is that these factories still have to meet FDA guidelines in order to be imported back into the U.S. so the drugs are monitored but sometimes the system fails.

The moral to the rambling story is this: An ounce of prevention is worth a pound of cure (Ben Franklin) and I also like to add worth it's weight in platinum (like the credit card you went over limit on to pay for your meds) so eat healthier, take time to exercise by playing sports or other family activities with your children and friends, and adopt a pet because they can help you relax and bring you great happiness and one day you may eliminate your need for blood pressure and Type II diabetes meds which will make your life suck a little less than it did the day before.

Friday, August 29, 2008

Children Can Be So Cute

It's Saturday night and my technician and I are finishing up our current workload. A couple of adorable little boys peek their heads in the pharmacy. We ever so proudly told them we have a robot. They looked, shook their heads in disbelief, and said "That's not a robot."

Oh the insult. It's no Transformer but inside that ugly cabinet is a robot who's arms do all the work to fill prescriptions. It's not cute like an AIBO or robot puppy but it does make my job a lot easier. It is the "fill technician" when I am by myself and very busy.

It is amusing to see the disbelief of a child because the word "robot" evokes the cartoon images of Voltron, Transformers, Zords, and whatever crazy robot cartoon creations populate children's TV. As they get older they will understand the "robot" can cover many different creations like my Parata prescription filling machine.

Children are cute sometimes.

Monday, August 25, 2008

Mmm, Tea

I was enjoying an Arizona Diet Green Tea with Ginseng when I noticed a curious little warning under the Sue Bee Honey logo:

Contains a small amount of honey. Not for use by diabetics without advice of a physician.

Hmmm...the honey additive in a product with less than 1 gram of carbohydrate and a net caloric content of zero needs a warning about diabetes? I would like to know what lawsuit prompted this or has our litigious society pushed manufacturers to the brink of putting a warning on EVERYTHING. What's next? A warning on bottled water letting you know that it only takes 2 tablespoonfuls of water in the lungs to drown you? ...Product not intended for nebulization or inhalation. For drinking only. The surgeon general says inhaling water could result in choking, birth defects, coma, and death...

I would have put the diabetes warning under the ginseng. The Natural Standard: Herb & Supplement Reference lists warnings for diabetics under ginseng. Apparently ginseng causes big drops of glucose levels when taken in combination with oral hypoglycemic meds. Funny. I haven't seen a lot of this type of warning on ginseng-containing products and there are a lot of them out there.

This is just one more example of why you shouldn't take herbs without doing a little research when you are on medications, Whole Foods employees be damned...

Sunday, August 3, 2008

Teen Dies After Father Gives Him Pills To Party, Police Say

This tiny article came from The Associated Press in my Sunday paper this morning:

Teen dies after father gives him pills to party, police say

Spring Hill. A Gulf Coast man says in a taped conversation that he gave his 15-year-old son powerful prescription drugs because he wanted the boy to know "how to party right," police said.
Steven Alfano is now charged with third-degree murder after son Vincent died of an accidental overdose in June. Witnesses say the 47-year-old Spring Hill man showed his son how to crush and snort pills like the pain-killer oxycodone and the heroin substitute methadone.
Alfano was arrested Friday and is being held without bail. Officials did not know if he had a lawyer. The father initially told police he kept the medications locked away so no one else could get them. Alfano later told two of Vincent's friends that he knowingly gave the drugs to his son to teach him to party. The conversation was recorded by police.

I was utterly speechless and disgusted that this douche-bag had not a single thought about the safety of his child. He just wanted to show his son how to be just as douche-y as himself resulting in the kid's death. Unfortunately this is a dangerously increasing trend. Prescription drugs are becoming the top notch street drugs, even more popular than cocaine used to be in the 70's. I turn away many many questionable pain management prescriptions for this reason, especially if they took the time to drive down from Kentucky to get them. That state continues to have higher rates of prescription narcotic overdoses than most other states.

On the one hand I say "Let them overdose." On the other hand, logic kicks in and I realize these "dealers" have absolutely no idea what they are doing when they sell or give these drugs to treatment naive people on the street. Opiates have a tolerance that is seemingly limitless depending on the length and extent of exposure. You hear all the time about someone who has been in rehab for heroin, they get out and fall off the wagon in a bad way. They mistakenly use the amount of heroin they were used to before rehab. Since their body is no longer accustomed to such high doses of heroin it is fatal for approximately 8 out of 10 former junkies who return to junk and then unwittingly end up meeting Jesus...I hear he is a lot shorter than I thought he would be...

There was also a story several months ago about a high school kid and his friend who bought methadone 40mg tablets from another kid at school, went to a football game with the kid's mom, took the pills and died in their sleep. The mother thought nothing was wrong because both boys were in good spirits and appeared fine when they went to bed. Late the next afternoon the mother goes to wake them up only to find them dead. She is now an advocate against prescription drug abuse, as are many others who have been thrust into an unfortunate and emotionally crippling fiasco.

This dirty little problem has gotten so bad that there are now anti-drug ads that show a street dealer complaining because kids don't buy from him anymore because they are getting high out of the medicine cabinet at home. "So if something goes wrong don't blame me (ie the drug dealer) because they are getting the drugs at home." There is even another ad that shows two dead teens, one from illegal substances and one from prescription drugs with the tag line "Which one seems more dead?".

I am calling on our dear self-important legislators to squeeze the life out of this illegal and lethal trade. We need to take control of the war on prescription drugs which is proving to be an even tougher battle than the war on illegal substances. Mandatory death penalties for ALL person(s) who were prescribed a controlled substance and are guilty of selling or distributing prescription controlled substances that resulted in the death or vegetative state of ANY other person. Send the message. Enforce the message. No plea bargains, no side deals, just DEATH! ...And I am not talking about sentencing with the death penalty and then using taxpayer money to keep the douche-bag comfy and fed, I am talking sentence and execution all within 30 days. While we are at it the same penalty should apply to all person(s) who commit armed robbery, child molestation, and knowingly bankrupting a corporation....Yeah that is for you ENRON douche-bags because you ruined more lives than any drug czar ever has.

Wow, now that I have that off my chest I feel like an enormous weight of hate has been lifted from my shoulders and I may now resume a normal life. Onward medical soldiers and remember to keep the patient's best health in mind whether they like your treatment or not.

Wednesday, July 30, 2008

What A Weekend.....

Friday and Saturday were abnormally slow but by Sunday everything had gone tragically awry.

A guy gave my tech an rx for Percocet 5/325mg from the emergency room. The insurance rejected it "refill too soon" so the tech calls me over to look at the profile.

This guy has taken enough Tylenol/codeine #3, Vicodin ES, and Percocet 5/325mg in the last 25 days to kill a horse. The most recent prescription he filled was for a 5day supply of Percocet that he had conveniently already eaten in less than 48 hours then returned to the emergency room for another round. I refused to fill it because all of the previous prescriptions except #100 acetaminophen with codeine were from different emergency room physicians and filled at different McDruggie's each time.

Here's the icing on the cake: another pharmacist had driven him to my store because he closed his store at 10pm. How rude! Don't push an overdose risk onto another pharmacist because you either didn't want to fill it but didn't have the balls to say it or because you were too f*cking lazy to stay an extra ten minutes to fill the rx. McDruggie's policy is to serve the patient not yourself. The world will not end if you keep the pharmacy open until 10:10pm if you were really going to fill it.

So now I have the distinct honor of refusing to fill the rx and explaining to the patient that I cannot fill it based upon the recent rx history and that I do not want my name on the bottle that sends him to meet Jesus. So he tries to talk his way into the rx by saying "Don't you guys always give a 3 day early fill for pain meds?" Shot down again. "I thought I was supposed to take 5 tabs per day." The tech shot him down on that one because even at 5 tabs a day he should still have 2 days worth of pills left and no need for the emergency room because he could have seen his primary physician in the morning (Monday) for proper pain management. I have never met a primary care physician who could not squeeze in a patient in need for an infection or pain emergency. For all my courtesy I get a "Fuck You" from the patient. So I responded with an equally courteous "Eat me" and hoped they left so I did not need to have the manager throw both of them out.

F*cking rediculous!

So Monday rolls around and I am 10 hours from a week of freedom. Then it again gets a little weird. A patient I had not seen in 3 years shows up out of the blue. He used to see us for his pain management and diabetes prescriptions. He would come in on his motor scooter at night every 4 weeks for his meds and to hang out til midnight. He was struck by a car while on his scooter one night and disappeared from our pharmacy for a very long time.

He told me he now weighs 410lbs (he had lost 80lbs since the last time I saw him) but he is a petite 48 inch waist where normally a 400lb man should have a 60 inch waist. I guess it is all in the way you carry it... He also wanted to know if I knew a doctor that would give him female hormones because he wanted his breasts bigger and his waist smaller. I told him I didn't think female hormones would give him the exact results he was looking for but a plastic surgeon could. I told him to consult with a few doctors though and see what they thought.

I also told him female hormones might cause impotence but he said he was a "bottom" and hadn't been able to get an erection for many years because of his diabetic neuropathy and pitting edema so it didn't really matter to him. Then he asked me about how long before he could take his piercings out. Another patient walked up as he was stroking his nipple ring and saying that it was the most painful. I told him to wait at least 3 months because it needs time to heal completely. He then asked if it was midnight so he could go. It was so he left.

The customer that caught the end of the conversation wanted to know why he couldn't leave til midnight. I told her she didn't want to know. She really wanted to know so I told her. He was waiting for the discount cover charge at the bath house. She regretted that little tidbit of knowledge. I don't know about her but the thought of a 400lb naked man in a steam room with dark purple legs looking for someone to mount him made me sterile and a little nauseus...

Later in the evening I get "too much plastic surgery" elderly woman who needs her Betapace 80mg because she is getting atrial fibrillation from taking the Betapace AF that she had begged the doctor for two weeks ago because it has the letters AF for atrial fibrillation on it so it has to work better. She also swears she cannot take sotalol because it makes her sick.

Hmmmmm, let me see if I understand this. Betapace is the brand name of sotalol. Betapace AF 80mg is the same active ingredient and strength as Betapace 80mg just like the doctor told her but nooooooooo she has to have the one that says AF because that makes it work better. Her insurance obviously agrees with the doctor because they will not cover the Betapace for another 12 days because she got the AF not too long ago.

While I am dealing with her a guy on a bicycle pulls into the drive thru. I tell him I will be there in just a moment. While I am telling him this the lady's dog that has patiently been sitting in a shopping cart tries to attack the store manager and another employee while they are moving chairs and displays out of the waiting room so the floor guys can wash and wax. So now she is screaming for her son to come get the dog. I am through. I give her a couple of tablets of the Betapace that we will deduct from the approved fill and leave a note for someone to call and beg her insurance company to cover it so she doesn't "end up in the hospital" then send her and the dog on their merry way.

Finally I get to the guy on the bicycle and apologize for the wait. He just needed Cialis. He got his pills and went on his merry way also. Now I get to stay in the pharmacy and get slow poisoned by the floor chemicals while the other employees get to sit outside, poison free. I am so glad that weekend is o.v.e.r.

Saturday, July 26, 2008

The Economy Sucks When...

* We still have Diet Mountain Dew, or any soda for that matter, in stock by Saturday morning.

* The drive-thru line is only 2 cars long instead of the usual 10.

* Brand co pays skyrocket...

* Rx volumes plummet...

* The pharmacy is so quiet at night it feels like a zombie attack is imminent.

* Taxis and police sit in the parking lot with the engine off until they are called into action.

* The overnight staff has time to reenact the entire World Cup series (that's soccer) in the toy aisle.

* Someone stole the Drug Monkey's scotch.

* You didn't even notice staff cut backs because we still aren't busy...

* There are no more freebie drug rep pens...Where will my drug ad writing utensils come from now? (shaking fists at heaven) "Don't touch my pens you damn dirty cut backs!!" (Emmy nomination moment)

* Instead of eating at Burger King people are buying a $0.99 bag of "Whopper" flavored potato chips....I have witnessed them on the shelf at McDruggie's, they do exist and I fear them...and their "French Fries with Ketchup" counterpart...

* Fewer customers = shorter wait times!!!

* Hit and run accidents occur in the parking lot. We are so happy they finally got a digital surveillance system...hit and run is a felony...

* The phones are silent during the day.....the day the phones stood still....creepy stuff...

* You only put $30 worth of gasoline in your car at a time and are tempted to siphon the lawnmower and get a pet sheep. (To eat the grass, duh.)

* Fewer and fewer out of state, cash paying cuz they got a 30 day supply on insurance yesterday, oxycodone junkies are bothering you.

* E-prescribing finally takes off because it saves money on paper. Go green! Go legible!

* New bums (some of them aren't homeless) are begging for change in the parking lot. Move over guy who thinks he is Jesus, the competition is fierce. Stinky guy in a moo moo is taking over your 'hood and schizophrenic guy that lives across the street is taking over your racket for free cigarettes.

* People come inside wearing a crusty dusty pair of flip flops and walk out wearing a brand spanking new glittery pair they just swapped off the shelf...hobo chic is back...

* Employees don't call in sick.

* People are more adamant about paging their primary physician at all hours of the night instead of spending the copay to visit the emergency room. Note to physicians: I hope you remember what sleep was like.

* Everyone L.O.V.E.S. generics!!!!!!

* No more Hummers or Escalades pass through the drive-up.

* You consider walking to work at night in the ghetto.

* Every inch of the pharmacy is spotless.

* The doctor finally laid off that b*tch secretary with no education that treats you like fecal matter on the bottom of her shoe when she calls in a prescription and can't even pronounce the drug so you make her spell it and she throws attitude like it's your fault she only got the job because she had big boobs then lost it because she has the intelligence, personality, and likability of powdered milk.

* You actually get to talk to the doctor instead of having to call back with questions.

* Everyone pays with a credit card instead of a debit card.

* You only see 5 patients in 8 of your 10 hours on shift.

* You start singing Hall & Oates...

* Sales of Viagra are flaccid....and thus the weenies that need it are too...

* You have the time to discuss the nuances of The Dark Knight and why it is the BEST Batman film EVER!

* Medicare Part D patients expire before their "donut hole" does....

Thursday, July 17, 2008

Fear Factor

As the Olympics Games kick off in Beijing there will be millions of extra people to feed. Traditional Chinese street vendor fare contains some items other cultures, predominately U.S. cultures, would be disgusted to eat.

I have eaten some things other people may find gross. I was raised on a variety of German and Southern American cooking. We also ate "game" meats as many family members and friends were hunters. Some of the "game" included deer, geese, ducks, squirrels, rabbits, and pheasants. I remember one time my father brought home two pheasants he shot and my brother and I called him a murderer. He didn't bring home any kills for a long time after that. I was 5 and had a pet parakeet so it was terrible to see pretty birds that my father had killed. I got over it as I got older and realized the values of conservation versus overpopulation plus they were delicious. (I can hear the howls of outrage from my PETA friends...)

Other things people might find weird are blood sausage, fried chicken livers and hearts, or pretty much anything in sausage form that definitely contained non-Kosher parts. I had friends in school who ate pickled pigs feet, chitterlings, tripe, head cheese, etc. I also remember my great-grandmother and great-aunt would eat scrambled calf brains and eggs. It sounds weird but is a fantastic source of protein.

A lot of our food prejudices come from how we were raised. Older generations grew up in a time when we raised and slaughtered our own meat. They had no problem swinging a cleaver to remove the head from a chicken then boil it to remove the feathers, take out the guts, quarter it and fry it up for a homemade fried chicken dinner, yum, yum. The advent of slaughterhouses and grocery stores have removed the common man from his food. Most people would not be able to kill or clean their own meat. Hell, most people won't even fish because they don't want to have to clean and prepare it before cooking. It is considered a disgusting and unclean practice but I notice that most people still have not turned to veganism. For all their hoity-toity ideals they still eat meat.

I have no problem eating meat. I don't have a problem eating veal or fois gras even though the practices of raising and feeding animals for those two products stirs up quite a controversy. I do have a problem with raw flesh and things with a rubbery consistency, which is why I never did like the taste of squid even when my friends tell me it was the best squid they have ordered so far. I love fish but only if it is not overcooked, flaky and delicious is the best. I also eat lobster and crab depending on how they are prepared, not rubbery is delicious. But back to Beijing..

Much of the fare at street vendors is eels, starfish, insects, sharks (seriously, they are just fish), all types of fish, snakes, dog (something Americans would be abhorred to eat when they spend thousands on pet treats, toys, and spa treatments for them each year), brains and intestines of various creatures, etc. For the people raised in the "Far East" these items are normal treats and delicacies. When you are raised on something you have no problem eating it.

Thinking about it, it goes back to the old Native American way of not wasting any of the animal that you kill. It is conservation and recycling at its finest. The original "green" way of life. Think about how much edible animal parts we throw away on a daily basis because we think it is gross. Enough to feed a small country.

If we ate insects, amphibians, and reptiles we could diversify to things that would be cheaper to farm than pigs, cows, fowl, and fish. If we could just get over the "fear factor" of eating other things we could drastically reduce farming expenses and maybe appease some PETA efforts to end herd animal cruelty. I have eaten sauteed meal worms and they didn't really have a flavor to them they were just crunchy on the outside and chewy on the inside. They would be a nice high protein, low calorie crouton substitute on a salad. Another thing that would be great on a salad is wasabi coated edamame. They have a spicy kick with a satisfying crunch and they do a great job at opening up the sinuses.

In effect we need to be more in tune with our food, where it comes from, how we get it, and its impact on the environment and economy. I have friends who grow their own vegetables when weather permits and have chickens for fresh eggs. It is a growing trend that may expand as grocery prices are on the rise. Be adventurous. You never know what you might like and it could help you win a reality show challenge in the future.

Monday, July 14, 2008

Open Letter to Seth MacFarlane

I thoroughly enjoy the "Petarded" antics of your Family Guy characters. Some days random comedy does the trick after being frustrated dealing with a bunch of drug-seeking douche bags looking for Oxycontin, Roxicodone, and other fun items to get f*cked up on.

You seem to understand the plight of the lowly pharmacist. I was immediately charmed by the character Mort who does not really fit the new pharmacist module but does totally fit the old stereotype of what a pharmacist used to be.

I was charmed with his violation of patient privacy at Career Day when he told a story of how a boy's father had hemorrhoids so bad he got the cream and applied it with a sock in the car. I was equally charmed when Peter and his band of "hardies" pillaged the pharmacy and destroyed the toys sold there. We actually sell licensed name brand toys now in addition to the traditional busted fare.

My favorite pharmacy moment came from the ipecac incident where Peter, Stewie, Chris, and Brian were having a contest to see who puked last in order to get the final piece of pie. I love those kind of contests because it wallows in the stupidity and self-deprecation that makes humanity destined for failure.

If you need ideas for future skits just ask any pharmacist. We all have crazy stories that would be not-so-wholesome animated fun. You might even want to use McRPH's story of the lady that came in early on Easter Sunday with a Zip-Lock bag of feces in to see if it was abnormal for someone taking antibiotics. I would love to see Mort's reaction to that....

Mad props and I can't wait to see what future seasons hold!

Your tireless fan,

Big N Tasty

Saturday, July 12, 2008

Random Thoughts

If you are buying gifts for someone older than 6 years at McDruggie's do you really like that person?

Cheap flip flops fall apart in salt water and sand.

Why the F are you buying footwear at McDruggie's???

Honking the horn does not guarantee speedy smiling service.

Sometimes credit card companies cut you off because you are irresponsible with your credit not because your medications are expensive.

That song by Hall and Oates that talks about how "You're the only one I love and you can't change that." was either inspired by or resulted in a restraining order. Seriously, listen to the lyrics just once and see how creepy it is compared to the bouncy annoying music...."No you can't change that..."

The regular overnight manager is on vacation. The fill-in manager is supposed to clean the bathrooms. There has been a used tampon applicator sitting on top of the sh*t ticket dispenser for 4 days now and he has cleaned the bathroom every night. Is it going to be there forever?

If your "pain management" doctor's office is a 600 square foot building with a line around it and down the block, including a scuzzy woman with an infant on her arm, what are the odds any pharmacist is going to fill that roxicodone 30mg #270?

Mmmmmm, Diet Mountain Dew is delicious!

Why do I itch every time I get handed an rx for permethrin?

Some nights become easy listening karaoke.

Some nights we dedicate each other's least favorite songs over the intercom when they start to play....ie "BnT, this one's for you!" and the song playing is Hall and Oates "Man on a Mission."

Is is assault for punching a male tech for singing the aforementioned auditory torture to you?

Is it wrong to amuse oneself by repeating the poorly pronounced drug name exactly the same way when you confirm the order with the patient?

Is it wrong to amuse oneself by pronouncing the same drug a different way each time someone orders it?

Is it wrong to amuse ER physicians who call for a recommendation on what to do with a drug seeker at the hospital and you tell them to give a shot of Toradol in the arse because it hurts really bad and they think they are getting something really good?

The people who come up with formularies, input parameters, and copays should all go to hell. That's right, you go to hell and you die...die, die, die!!!

More hot policemen should come and hang out with me at work. I have had a gun in my face while there, it is the least the city could do to make me feel safe and have lots of fodder for dirty fantasies.

My dream man really exists. He is a policeman. I have met him and probably scared the crap out of him because I am intimidating and weird. Maybe "The Secret" will make him come to me or maybe just a call to 911 cuz "The Secret" is a load of horse sh*t...I wish I had written that...

I like to joke around with my patients who I know like a good joke.

You came in at 10pm and told the tech that you were coming back in the morning then get pissed off and scream 2 hours later when your prescription is not ready. Well a*s-hat, you said tomorrow morning. Ocho de manana, motherf*cker, it is written on your scrip. What the hell made you think it would be a priority? Perhaps next time you could explain the space-time continuum flux you live in when I am not ready to smack you for stupidity.

I like to joke around with people who take me completely serious.

Why did the manufacturers change again???? McDruggie's buyer, you can go to hell and die too! Did you really save that much money cuz if you did I would like a tech 7 on/7 off with me. I get busy and lonely all in the same shift.

I babysit machines.

Food poisoning calls and consults make me sympathetic. Puking and crapping at the same instant is no fun because most people don't keep a bucket or have a sink in front of the sh*tter.

Oh Diet Mountain Dew, if you were a small furry creature I would keep you as a pet and treat you like my princess kitty-kitty. She is more spoiled than Paris Hilton and has a better singing voice.

Spell check does not like the word "formularies" either.

When you are working, always park in good view of the security cameras. You never know when a drunken city employee in a street sweeper will smash your precious Beamer Z4 convertible, stumble over to look at it, crawl back in the city truck and drive off. It happened to a friend of mine 2 weeks ago. He is really happy we have digital surveillance. The city gets to pay for his bumper and quarter panel.

Why do I hate Hall and Oates so much?

Oh yeah, their greatest hits album poisoning the muzak ten times a day for the last 5 years...and that god-forsaken boat song from Titanic.....n-e-a-r-r f-a-r-r where-e-e-ver you are....I think I just threw up in my mouth a little...

Would stand-up comedy be a more fulfilling career?

I need a nap.

Friday, July 4, 2008

Summer Fun

It's that time of year again! The kids are out of school and you have to find something to do with them to keep your sanity until August rolls around to save you.

Summer sports are a great way to wear them out so they go to bed and you get some adult quiet time. Family trips may also be fun. A few small things to remember:

1. Sunscreen, so your kids don't end up looking like the lobster dinner you could afford before you had kids, unless you go to Red Lobster but they have magically ruined my food every time I ate there with my parents so I quit going. How do you ruin fried catfish????? They found a way.

2. Plenty of clear fluids like Pedialyte and water so they don't get dehydrated and end up like the kid I watched bagged (bagged = hooked up to a saline IV) and carted away at a concert the other day. Seriously. Soda, fruit juice, anything with alcohol in it is a no-no and in some cases I would not give children younger than 12 Gatorade because it has a lot of sugar and salt which causes diarrhea in children and leads to severe dehydration.

3. With a little pre-treating grass stains and blood do wash out of children's clothes.

4. The pedophile in the clown suit should be shot. Watch out, sex offenders like to attract children. Don't think for a second leaving kids unsupervised with Bozo is a good idea. Behind that happy fun makeup could be a child-killing devil. It may not be just clowns. If you don't want your family ending up as a movie of the week or an episode of Law and Order watch your kids at all times or make sure they are being supervised by someone trustworthy with children. Kids only die once...

5. Scrapes heal with a little cleaning, a band-aid, and a kiss. Mental scars may take a lifetime to heal.

6. Sometimes windows do get broken by baseballs.

7. Homeowners insurance is great.

8. Medical insurance is great too cuz sometimes arms, like windows, get broken.

9. Kids + fireworks = disaster waiting to happen. Please, please, please supervise kids with small explosives because stem cell research has not gotten to a place where where we can regrow an eyeball or a finger.

10. Swimming is dangerous. It takes less than five minutes for a child's lungs to fill with water. You went in the house to take a whiz, no one's watching, come back out and little Jimmy is at the bottom of the pool but you don't see him standing by the barbecue grill and little Jimmy has gone to meet Jesus. Little Jimmy could have survived if someone else had been watching the pool while you took a whiz. Trust me, you will see it on the news several times this summer. "I just turned away for a minute and then my baby was gone..." Don't let that be you and don't trust the teenager at the public pool because they are more interested in the bikini-clad teens than your little swimmer.

Now that I have ruined any hope of a peaceful summer with paranoia enjoy!

Friday, June 13, 2008

Why am I Still Here???

After a 10 hour shift one may mistakenly believe that I am still "nice" and cuddly like a fluffy kitten. I was hopeful when a girl I didn't know came to the pharmacy. I thought I was home free, but no. She is a new intern here to train with the district trainer. Damn the luck. It gets even worse when my relief calls and says he is on his way from Miami which means I am stuck in a drowsy hell waiting and waiting and waiting. The evil b*tch-monster starts to take over, kind of like when the Hulk starts to appear...."Pharmacist smash!"

He then calls to say he got lost and may be about 10 more minutes. When he shows up all of the techs are like "Oh sh*t, not him again." I never worked with the guy but I guarantee the sh*t will hit the fan when the boss gets in at 2PM because the pharmacy will be a complete mess. Well, at least I fixed an insurance/vacation auth for a couple who live here part time and Canada part time. They had 3 take-home-a-sacks full of drugs for their 4 month journey. I guess their insurance doesn't work in Canada even though the cash price on most meds is always cheaper than here. Just ask those chartered prescription tours to Canada. It's an adventure and your pills are cheaper because Canada's government wants its people healthy. I wish mine did...damn lobbyists...damn kickbacks...but I digress...

I laugh to myself when my boss has a bad day because he reminds everyone over and over and over about "...that one time he stayed late on Christmas because the overnighter had a flat tire..." and other assorted stories like the world has in fact decided to sh*t in his Wheaties as many times as it can. It wasn't even the fact that it was Christmas that made him mad, it was because he had to stay late. I came in Wednesday night and he was sitting in the waiting room chair because he thought I was gonna be 10 minutes late but I showed up 2 minutes late. Take that. I may even throw him off and come in 4 minutes early one day. He won't know what to do with himself....whatever will he complain about...

I warned the technicians that the person covering for me this weekend got really bad reviews from another pharmacy she covered for. The techs there hated her and said she was mean. If she mouths off to my techs they will all walk out. It is the weekend and they will find other things to do. The kids I work with on the weekends are fun. They got suckered into staying until 11PM on Saturdays and Sundays but we always have a good time and I feel bad that they may have a bad couple of days but I am going to see The Cure (yes, they still tour) with McRPH and raise a little hell at the bars.

Meanwhile, back at the pill rodeo, my floater will sit and do no work...no supplies...no filling...no cleaning...no take out the trash...piss off my boss when he comes in Sunday and Monday morning.....hahaha... I will hear all the gory details Tuesday morning and laugh, laugh, laugh because if she doesn't do enough work he will make her stay a couple of hours unpaid to do the work she should have done when she was being paid to do it. The funnier thing is that he has done this to another floater before. Freaking hilarious...and they say I am the lazy one but my work seems to miraculously get done every night and I don't leave them more than a couple of rxs to fill or more than a couple totes of warehouse if at all possible. It must be the Keebler elves or the tooth fairy or something. I get no respect.

The boss also likes to remind everyone that every time they call the district supervisor about the tardiness of floaters, many of whom are notorious for showing up an hour or more late, the supervisor assures him that each and every floater is just as good as his full time staffers. That really pisses him off. It makes me laugh every time he tells a story about someone showing up an hour late, which happened to me this morning, and lets the supervisor know to no avail.

So I raise my glass to the veritable sh*tstorm that is appropriately happening after I am long gone on Friday the 13th. Salute!

Thursday, June 5, 2008

Sushi Paranoia

Sushi and sashemi style eateries flourish in eastern and western culture. Most dishes consist of raw seafood either as is fresh from the carcass or treated with "sauces" that kill parasites. I just can't eat it.

I have always been paranoid about parasites. I had a dog with tapeworms once but luckily you can buy pills to get rid of the tapeworm at any pet store. I have watched the shows on the Discovery Channel about human parasite infestations and read articles about human parasite infestation in other countries. All of them gross me out.

I don't even think I could deal with lice, be they head or pubic, scabies, or anything that gets in the gut and stays there. Hell, I get paranoid and itchy just filling an rx for lice or scabies. I couldn't imagine the freak out from finding tapeworm segments in my feces. I have the chills...

For the rest of my life I will always eat fully cooked meats and well cleaned vegetables. I don't want to end up as a case study on the Discovery Channel...

Monday, June 2, 2008

Fun in the Sun

I have many little dark brown spots on my arms and a small mole on my chin. I look up at them every day wondering when they will turn on me and become cancerous. Oh little spots, I lovingly coat you with SPF 45 if I go out in the sun or keep you hidden under fabric so as not to expose you to the horrible UV rays that will ultimately mutate your fragile DNA and turn you against me.

Little spots will you let me have decades to live or just a few more years? Remember little spots, I protect you as best I can and stay out of the sun to keep you safe. Please don't hurt me.

Inevitably one of them will turn on me. With ozone depletion and living in a tropical zone it is pretty much guaranteed that one little spot or more will run rampant and maybe metastasize. Sad, but at least I do not use a tanning bed. Exposure to concentrated UVs would make it happen faster.

Have you noticed the increasing rates of cancer in teens who frequent tanning beds? I went to high school with two sisters who owned a tanning bed. They were always an unnaturally dark shade of brown all year long. They were both fair skinned with freckles prior to tanning bed use. Years of tanning add up.

Sadly, the younger sister developed a malignant skin tumor during pregnancy that metastasised. She carried the baby to term but died shortly after. I can't help but think the years of tanning bed use caused such a painful tragedy. She was in her early 20s. Much too young to have skin cancer in my book.

Manufacturers of tanning beds proclaim that their product is completely safe and does not lead to cancer. I think a retroactive study and a well controlled study following tanning bed users who start under the age of 18 and continue throughout life would prove them wrong.

Please be responsible with your skin. UV rays have a profoundly damaging cumulative effect on our skin cells. I definitely recommend at least SPF 45. I use it on regular skin, face, and any exposed skin if I am going out in the sun. I also use facial SPF daily. I am going to fight skin cancer every step of the way and you should too!

Saturday, May 24, 2008

Something To Try

You have had it happen to you. Your least favorite song is stuck in your head for days, tormenting you, causing loss of sleep, making you want to tear your hair out. It happens to me quite frequently.

It has come to my attention that this is due to a glitch in the auditory cortex (the part of the brain that processes sounds and stores them for remembering later). This cortex has an itchy trigger finger and can put a painful musical cap in your ass with replay of your least favorite tunes after only a few notes.

This just proves that my brain hates me. It likes to taunt me with Hall and Oates, Celine Dion, etc. I don't even have to be at work for this to happen because most retail stores use similarly programmed music. The theory is that enjoyable relaxing music makes you want to stay in the store and spend money. I reject the music selections provided by the retail industry as most of them cause me mental pain and ruin my shopping experience.

There is actually a simple solution. This glitch can be overridden by either listening to the entire song or doing mathematical computation. This cortex will forget the damning song if you do math. I am going to try math the next time I am tortured because the thought of listening to the entire boat song (My Heart Will Go On by Celine Dion) makes me want to throw up.....

Wednesday, May 21, 2008

Inner Workings Of My Brain

To let you in on some of the things that make me who I am I will let you in on last night. Keep one thing in mind. My friends and I clung to one idea throughout school that is still my personal mantra: "Pharmacists by day, dirt rockers by night." This duality is what keeps me from wanting to slit my wrists in a bathtub after a bad night of work realizing that this is the job I will have until the day I die because I just can't bear the thought of going back to school.

So I got off my 72 hour straight work week and took a nap. Got up, blasted some music for motivation and got ready for the show. Flew out the door and picked up my gay concert buddy so we could make our ritual stop at 7-11 for large drinks to mix pints of liquor in and drink in the parking lot before the show. We went to the liquor store at my work and got our preferred adult beverages of choice and went to the car to make road soda magic and head to the venue. On the way to the car a gentleman with huge balls walked passed us (I wasn't paying attention but my gay friend told me so I have to believe that a conniseur of male genitalia knows what he is talking about). We spent the next 20 minutes making jokes about tea-bagging and how a man with elephantitis could possibly kill someone or cause a concussion from a well placed tea-bagging hit.

Tea-bagging: the act of plopping tighty whities (men's undie briefs) full of male genitalia on another individual's head. To see this act watch the movie Pecker. It is quite hilarious for so many of the wrong reasons in the eyes of polite society..."Full of grace!"...somehow I laugh every time...

While the first band was performing we laughed at how they seemed to be stuck in 1982 hair metal and had the receding hairlines to prove it except their drummer looked like he was all of 15. Weird because he reminded me of the Sherminator from American Pie which made me laugh harder.

The singer of the second band is a cancer survivor. He looked like crap but chemo is a b**ch when you tour a lot, even resting between gigs won't help. This turned into a discussion on how testicular cancer seems to pop up in guitar and bass players. I would like to see a study based upon the assumption that chronic exposure to the electromagnetic field generated by the instruments (because they are generally held in close proximity to the genitalia during performance) leads to the genetic mutations that result in sperm mutation and cancerous growth in the testicles.

The final band played and the aggressive herd mentality known as a mosh pit appears. My friend and I watched from the balcony and noticed that most of the men in the pit were underage, ie. not old enough to drink due to the lack of armbands present designating drinkers from non. There were the token handful of girls in the pit because we are tough too and parents with their children. After checking out all the shirtless men who would end in my jail sentence because they were at the least under 21 and at the most under 18 I once again came to the realization that if I do have children I will be the mosh pit mom making sure my kids don't get mortally wounded and beating the crap out of the a**hole that thinks he can get away with it.

To round out the evening, no concert night is complete without fast food. Nothing tastes better when you are full of liquor than nachos, burritos, and large fountain sodas. Thanks Taco Bell for staying open late. I dropped off my friend with his Taco Bell delights and chauffeured my own home. I changed into shorts and a t-shirt and watched Hell's Kitchen and the Reaper season finale on TIVO while enjoying my nachos. At some point I passed out.

Upon waking the first thing I hear is how the average human colon has a 9 inch diameter and when fully coated with mucus it can cause you to hold an extra 20 pounds of weight. Damn, not this infomercial again. The 7-day colon cleanse really pisses me off. Seriously, there is no documentation that states you must poop once per day to be normal. Depending on how much you eat, what you eat, medications, and your normal bowel habits you may go anywhere from more than once per day to once every 3 or 4 days. This magic colon cleanse is not necessary. Especially not for the exorbitant price they ask. If I want to sit in the bathroom for 7 days I will make some chili with lots of jalapenos, chilies, and Tabasco sauce. It works every time.

So now I am angry at the infomercial that clearly states at the bottom of the screen that the creator and salesman for this product has no medical background and severely dehydrated and nauseated from drinking all night. Good times, good times.

In the end a well-placed kidney shot will knock down the strongest of men and every activity I participate in results in some medically relevant discussion. Once medical training gets in it defines everything that you do and tries to rewrite who you are, hence the desire and need for duality.

Wednesday, May 7, 2008


I was counseling an elderly lady on the phone. My boss was standing next to me working on the computer. He heard "We did not all go to the same school at the same time so our training may be a little different." He is cracking up and I have to bite my tongue not to laugh.

What he didn't hear of the conversation was what a different pharmacist had answered to the same question I just answered and she wanted to know why the two were different. So you don't have to ask in "comments" she wanted to suck on a piece of candy to help with irritation in her throat because she took an 8 ounce glass of water with a heaping teaspoonful of metamucil in it the night before and her throat is kind of dry and rough this morning. Then she wanted to know if drinking water would be better or if she should call her doctor because of the irritation. I told her to either try both or whichever she was more comfortable with but she didn't necessarily need to call the doctor unless the throat irritation got worse throughout the day or she had a fever with it which could be something other than metamucil irritation. She thought maybe she had taken too much metamucil and overdosed. I told her it is not absorbed by the body so it is not a problem for the little over the teaspoonful that she used. It does have several warnings about choking on the package.

The reality of modern medicine is similar to that of technology. The advances are coming faster and cheaper as time goes on. It can be baffling to keep up with it all. I don't think any one person could possibly process and effectively use ALL of the information available and becoming available at any given time. The best we can do in pharmacy is keep up with the latest on newly documented bad problems with medications, everything we had been taught previously, and keep up with new treatment protocols and monitoring parameters for better patient outcomes. I would say we need to keep up with new drugs coming out but since most of them have been slight modifications of existing drugs with the same side effects, efficacy, safety, etc. there really isn't any "new drug" info to learn.

I always encourage patients to get second and even third or fourth opinions if it is something serious. Hospitals have teams and divisions that treat specific problems. There are even divisions within teams like an infectious disease team having another team that exclusively treats immunocompromised patients. This is necessary because there is a lot to process and a life in the balance. At the end of the day we want every patient to get better and eventually go home OK.

I like to complain that the continuing education system in place is not sufficient to supplement our knowledge necessary to give patients the best possible care. Some institutions and chains sponsor their own education programs. Many professional medical groups have yearly meetings that include a variety of continuing education lectures. Is it enough? I am not sure it is. No great all-encompassing solution easily presents itself so keep up with what you can and save some lives.

Wednesday, April 30, 2008

A Tragic Happening

For the few men who are forced to use Caverject (penile injectable for erectile dysfunction) a tragedy has occurred. The once plentiful injection kits have been on back order for quite some time now. I have patients calling on a weekly basis, "When will my caverject come in?, Is it in yet?, Have you been given a release date?" Sadly for you we have no release date. We order and it does not come in. Yet somehow, I feel no sympathy, empathy, or other mama bird needing to smother you in her warm feathers feelings.

If the only bad thing in your life is the lack of a hard on then you have nothing to worry about. In 121 countries food prices have risen so high that a family of 3 has to go without breakfast and work at menial jobs under unsanitary and what we would consider inhumane conditions to afford something to eat when they get home. In our own country there are families who lose their homes to excruciatingly high property taxes and mortgage interest rates. Rapidly rising food and fuel costs are strangling the life out of the middle class with no end in sight.

Your limp weenie is not a problem. So deal with it.

Tuesday, April 22, 2008

Penicillin Shenanigans

I get to work and the pharmacist I am relieving shows me a prescription that was left on the voicemail. It was for penicillin VK 500mg, three times daily for 10 days. He said the person that left the message didn't sound like they knew what they were talking about. The doctor name and phone number left on it were the tip off. The doctor name is not listed anywhere in out database. The phone number is a residential number and no one answers when you call. Fishy because if a doctor leaves his/her personal number with a prescription he/she will answer when you call with a question right after he/she left the message. When the lady called to find out if her prescription was ready the pharmacist told her we could not reach the doctor and we didn't have him listed so we needed his info before we could fill the prescription.

A little bit later I get a call from a lady that wants me to call the CVS in Michigan that she usually gets prescriptions filled because her doctor called in a penicillin prescription. I get the store number and her name and number and call to get the prescription. Guess what story I hear from CVS....penicillin rx, didn't sound like the person on voicemail knew what they were talking about, doctor name was the same as a clothing designer, phone number not working, etc. I also like that designer's clothing but coincidentally there is a specialist with that name who is not on call for anything because she is works with hormones and you just don't get emergencies for that. I checked with the hospital she works at. So I called the patient back to figure out what the hell is going on.

I told her we could not get hold of the doctor because she is not on call this weekend and is a specialist who would not be calling this in anyway. So the lady tells me that they must have written down the wrong doctor name because this was her family doctor. I told her to page the doctor and have her call me since we had questions about the prescription. She wanted to argue because the other pharmacy gave me the prescription so she wanted me to transfer it back I told her I would gladly transfer it back if she thought the pharmacy would fill it when she got home. After I transferred it back I figured she was done with us.

So I was telling the story to a pharmacist at another store and coincidentally he had the same penicillin rx called in under a different name and doc but they all had the same birth date. Give me a break. No one is going to fill a prescription left on the voicemail where the person does not know what they are talking about and the doctor (or their office number) is nowhere to be found.

The lady shows up at my pharmacy. She tells me who she is and demands to know why she can't get her penicillin. Of course, there are a l-o-t of people standing in line waiting because it is Saturday night and there is just a technician and myself to battle the mayhem. She wants a showdown at the McDruggie's Corrall and I am about to shoot her down again.

She tells me that she has a "sinus infection" because she is congested and has a runny nose. So I tell her the exact same thing I told her on the phone. The she tries to play the lawsuit card "I have fluid in my ears and what if my head explodes?" Frankly, I would love to see a fluid induced head explosion in real life but I just don't think it would be that spectacular and the store manager on duty never wants to hear "Wet clean-up by the pharmacy..." because it could involve many different bodily fluids or products, usually vomit. I told her to page the "doctor" and have her call us back or go to the emergency room if it is that bad but penicillin is not going to clear up congestion and fluid anyway but the OTC products she had purchased would over the next few days if she followed the package instructions.

I didn't hear anything from her or about penicillin for the rest of the week. Maybe she finally got the message: pharmacists are not stupid, go to a doctor instead of trying to call in your own prescriptions.