Halloween Is Over

As I parked at McDruggie's the mighty, shirtless King Of Douche passed by with the shirtless Duke of Douche and his cousin the shirtless Earl of Douche and I knew this night would be a busted mess. Then I remembered that the time change happened at 2am...double whammy... I should have taken an unpaid day off to party...not to mention the gothically delicious full moon backed by clouds like something you would see in a Halloween cartoon chastising me for not following my dark side. And so it begins.


It was relatively quiet so we got warehouse totes put away then a call came in. My tech was laughing cuz he pretty much knew what I was going to say when he handed me the phone. A lady had a Levaquin 750mg stuck in her throat. On further questioning it was actually about half way down her esophagus so there was no danger of choking to death. She tried eating something, drinking something and gagging herself to no avail. She wanted ipecac but I haven't seen that in several months so it is probably on back order or no longer available so I told her the only other options were to continue drinking water, call the paramedics or go to the hospital. She opted to go to her doctor's house that was 2 doors down. I bet her doc was not ready for that "Trick or Treat" to show up on his doorstep. Want some candy, little girl?

I was reading an email about the decrease in controlled substances being filled and it reminded us that we are not to turn away every controlled substance that does not follow the new regulations in Florida. The law requires that the quantity must be written as a number and a word so as to prevent the temptation for a drug seeker to alter the numbers and we should call the doc offices to verify this. I fought the urge to send an email back letting them know that the decrease in controlled substance prescriptions was not due to this but due to many pill mill pain clinics being shut down and the refusal of many pharmacists to fill pain management rxs from similar clinics with patients from out of state. Hello, Mcfly?

Two older gentlemen with accents that place them as natives from the fjord lands were wanting to know if they could get Cialis, Levitra, or Viagra. I explained that in America you need a prescription for these items. They were disappointed but their accents reminded me of Alexander Skarsgard the sexy vampire Eric on True Blood and the only reason I watch the show... He would be my Trick and my Treat!

A real monster showed up in the form of shingles. It was not any shingles attack I had ever witnessed before. The guy's scalp and face were full of lesions and his left eye was extremely swollen. He was in severe pain and the ER had given him Demerol and gabapentin along with Valtrex. He had been given Demerol at the hospital 3 hours prior to his pharmacy visit and was still in great pain. I got them out in 5 minutes and advised him on when to start each med. He was happy to be leaving but noticed our sign for the shingles vaccine. He lamented that it would have been nice to know about the vaccine a few weeks ago.

It was sad but he reminded me of Sloth from the Goonies and that reminded me of high school. I had a friend who used to torture this guy because he was chubby and had a weird shaped skull so he kind of looked like Sloth. She would shove Baby Ruth wrappers through the slots in the top of his locker and whenever she saw him in the hall she would say "Baby Ruth...Sloth want Baby Ruth." I am actually surprised he didn't beat the crap out of her because that went on for several years. There was also a time in grade school when she had to apologize to a girl for making fun of her a lot because her hair was greasy and had a lot of dandruff so my friend would call her "fried chicken head." Misty water colored memories on the corners of my mind...

I also have to thank my boss for coming in and not making me stay for hour twelve due to the time change. One of his few redeeming qualities. So I got to go home and prepare to sit through the V marathon on Scyfy before the remake starts this week. So I leave you with this advice: If aliens show up that kind of look like us but talk funny we are gonna get eaten like snausages at a dog park!

Thanks Fellow RPh (more fan mail)

I enjoy reading your blogs. I've been in retail since 1963. Retired and doing some part time work at stores where I have a fun time only! I have also been doing medical missions to Haiti which are professionally rewarding.
Please keep the blogs coming!

Ed M

Fan Mail

Thanks CJ!

I just want to say I love all of you. I really do. When the weird world that is retail starts getting to me, I always feel better after reading your contributions. It just reminds me that weirdness abounds, wherever you go. Somehow, knowing that other people are dealing with the bizarre and often unreasonable demands required by "dealing with the public" makes me feel a lot better.

Thanks

Say What???

A guy came in to the pharmacy and was totally serious when he showed me a box of One A Day vitamins and asked me how to take them. I had to bite my tongue not to laugh as I explained that he should "take one tablet one time each day" like it says on the box.

A lady came in with a prescription for Tamiflu suspension. She didn't have the child's medicaid card but had 6 other family members' cards in her wallet. WTF did you give them at the ER? I was not having any of it. I was simply too busy to spend 45 minutes of my time getting the ID number from the automated system. So I told her the cash price and that I would fill it but she needed to get me the ID number. If you can't get your sh*t together when all you have to do is have a f*cking plastic card in your wallet I am not even going to go the extra mile. You don't deserve it! Of course this was too overwhelming for her so she took the rx back to go to Target the next morning. They probably have the time to waste on the call since they only do about 150/day at a busy store. (Can't help but say I am a bit jealous.)

I covered at another store that is an unholy nightmare to work at. The late shift tech and the next morning shift tech called in sick. Lucky me! At that same store one of the few techs who is very good at the job and would stay and help out got written up by the head store manager for working 30 minutes of overtime without his permission. What a douche! Why punish the only people willing to give up their free time to help your pharmacy which helps your bonus. Again, what a douche!

I had a lady with a Vicodin rx from the emergency room. I filled the rx and she was 24 cents short of the copay so she asked me if I could just take one tablet out and adjust the price. I told her not to worry about it and threw in a quarter that someone dropped on the floor earlier in the day. A junkie would have demanded we give the extra tab for free but I got a good chuckle out of her request because that is the first time I ever had someone tell me to take just one tablet out.

Just in time for your holiday shopping pleasure we got Chia pets, the Clapper, and Snoggies (Snuggies for small dogs).

A busted tranny with a UTI dropped off rxs in the drive thru. (By busted I mean that he wasn't really fooling anyone in to believing she wasn't a man underneath the face paint and overstuffed lips.) He/she then asked if I had a book of matches. Why on earth would I have matches in the pharmacy? I thought everyone knew I was not allowed to play with fire or sharp pointy objects.

A guy came in because his baby had a fever and he got some Tylenol infant drops. He asked if it would be okay to mix with Gatorade. NNNNNNOOOOOOOooooooo!!!!! Pedialyte, never Gatorade, because something formulated for a large sweaty sportsman is definitely not good to give to a teeny tiny infant.

A lady came in at 4am because her Medicaid denied the inhalers she had discharge rxs for from her most recent hospital stay as refill too soon until that particular date. She had severe COPD, was only in her early 40's, had a BIC lighter in hand, and reeked of cigarettes. Somebody didn't learn her lesson. When your lungs can't take in air to the point that it causes you great pain and keeps you from walking from your car to the pharmacy without having airway spasms and choking I don't feel sorry for you. You obviously "need" those cigarettes more than you "need" to breathe. Stupid. Stupid. Stupid.

They're Always After Me Lucky Charms!

My manager e-mailed this article to me.

Man Gets 15 Years for Stealing Cereal
by UPI [11:33 am et 10/6/09]

A homeless alcoholic has been sentenced to 15 years in prison for stealing milk and a box of Lucky Charms, authorities in Lakeland, Fla. said. Mark Griffin's sentence was influenced by previous felony convictions for burglary and grand theft, prosecutors told The (Lakeland, Fla.) Ledger.

Griffin's most recent arrest came April 19 for stealing a $4.49 box of Lucky Charms cereal and a $1.59 can of milk from a Walgreens, police said. Griffin had been banned from the store previously.

A jury in August convicted Griffin of robbery and trespassing after he rejected a plea deal in which prosecutors offered him a sentence of three years in prison and two years probation, The Ledger reported.

Acknowledging Griffin was a chronic alcoholic, Circuit Judge Donald Jacobsen said he was mandated by law to impose the 15-year prison sentence. "Personally, I think the money could have been better spent in treatment than incarceration for 15 years, but that is not my decision," Jacobsen said.

I find it tragic that someone lets addiction take them to the point of theft and homelessness. On the bright side he gets free food, a place to sleep, a toilet, bathing privileges, free cable, and workout time paid for by John and Jane Q. Taxpayer. Life is sweet! (and yes Lucky Charms are delicious!)

iPhone apps sent in by reader

Thanks man!

http://blog.onlinecollegeguru.com/health-care/best-iphone-apps-for-pharmacists/

Random Thoughts

Since once daily adult chewable multi-vitamins are good for you why can't the manufacturers come up with a better flavor besides rotten metallic orange?

I am once again amazed at the efficiency at which a rhinovirus hijacks your mucus production and sets it into overdrive. I remember the lady and her daughter that infected me 2 days ago...damn you! (shakes fist)

I am curious to know why the guy who's girlfriend made him get Viagra for their Bahamas vacation didn't realize that it wasn't just the alcohol inhibiting his erections but the combo of alcohol, Valium, and Vicodin.

Since the emotion of love is not actually in the heart can we change Valentine's stuff to little chocolate and candy brains and brain shaped boxes of assorted chocolates?

It amazes me the amount of prescriptions I fill for sleeping pills. How on earth did anyone sleep before this? I don't ever recommend sleeping pills as an alternative because you do not get the delta wave sleep that the body needs to reset and there is obviously an underlying medical or psychiatric issue that keeps you from sleeping. Not everyone needs 8 hours of sleep each day to function and anything that causes you to forget that you ate everything in the refrigerator or took a night drive can't possibly be good for you.

My birds sit in a large cage in my living room and are addicted to television. I watch a lot of splatter kill horror films. I often watch my birds peering intently at the screen and wonder if I am warping their fragile little minds or if they only notice sound, flashes of light, and movement. Since I have so far failed to completely teach them to whistle the Muppet Show theme song I will assume ignorance truly is bliss.

Who decided that patchouli was a good idea for a "deodorant?" It already smells like body funk then you put it on and add real body funk to it. Not a pleasant person to be stuck next to on an airplane. Now I know why they have barf bags.

Since everything we eat is processed into crap by the GI tract then we could technically say that everything we eat is crap or maybe a precursor to crap ie precrap.

Speaking of crap... On South Park this week they were poking fun at dead celebrities and had Billy Mays doing an ad for Chipotlaway to clean the blood out of your underwear after eating chipotle. Hahaha! I can say I have never crapped blood after eating something spicy but that was hilarious.

When the first major media coverage of H1N1 happened months ago and there were rumors of pandemic was anyone at Roche not paying attention? I would have quadrupled production of all Tamiflu formulations in the name of profit but since no one was paying attention we have to compound Tamiflu suspension.

If none of the other authors contribute to the blog anymore does that mean they have been excommunicated by the pope or are they dead of unknown foul play? I think maybe they are just lazy or forgot their passwords.

Friday Night Fun

So my store was doing a reset on the condom/sex lubricant section at the store and asked my overnight manager for suggestions. We thought the disposable plastic gloves, enemas, and sani-wipes were a good start but for the true "orgy" experience we also need to add painter's tarp (or yard size garbage bags), febreeze, paper towels, scented candles, and an advertisement for our discount card that covers Viagra, Levitra, and Cialis. We sell orgy fixins all the time. Hedonism and venereal diseases are alive and well in South Florida!

Speaking of venereal diseases.... I got to fill what is lovingly referred to as the "Oochie Koochie Special": 2gm Zithromax, 2gm Flagyl, 150mg Diflucan. It takes a special lady to get that trio and I am proud to say is something I never have and never will need because I use condoms and you should too!

I also got to make an "anal fissure cream." There are several different ones we make depending on the doctor's preference. The most common are nifedipine, diltiazem, and nitroglycerin creams. I giggle every time we make one and imagine what the patient did to rip open their anus. Was it a really huge dump? Was it overly eager anal sex? Was it some freak accident? So many possibilities!

Finally, the manager calls me around 5am to tell me that a homeless woman is sleeping between my car and the bushes around the store. He wanted to know if I wanted to call the police. I told him not to bother because she would probably leave when the buses start running again, which is what most of them do. She wasn't bothering anything and if she doesn't mind the rats that live under the bushes, sweet dreams. I told him he should have the police arrest Michael Bolton for the musical atrocities he committed against mankind that I have to be tortured with several times each work day. That would be a satisfying arrest, along with Hall & Oates, and various other "adult contemporary" artists that drive me to madness. Why don't I have any control over the music? Ugh, that is the worst part of the work day, trying to block out the easy listening.

More Late Night Anomalies

A girl came in to the pharmacy looking for a pregnancy test. She reeked of marijuana and had on a short top with second skin stretch pants on. She was glittery and looked like a "rave kid." She appeared to have a 12 week baby bump so I giggled to myself after she left cuz that pregnancy test is going to come up positive...and I feel sorry for the child...

I was moonlighting at another McDruggie's that has about the same staffing as my store but does about 300 more prescriptions per day than we do. Needless to say it was going to be a L-O-N-G night. I went in at 10PM and was still filling prescriptions that were supposed to be ready at 7PM. The drive-thru never stopped and hospice called to get 5 prescriptions on the fly. I asked them if I could have at least an hour before the courier showed up and they said no problem. So I threw that on top of the mountain of work I had to do and kept on plugging away.

This was a night that feels like "Groundhog Day" only there is nothing amusing about it. No matter what you do it seems like the mountain of labels never disappears. I took 3 minutes to inhale a Diet Mountain Dew and a small bag of chips because I really didn't have the time to spare for anything else and I forgot to pack my lunch.

Patients were grumpy and I had many many emergency room patients because in the poor neighborhood most people use the ER as a primary care physician. Ridiculous. Medicaid gives you doctor options. Use them instead of rolling your pathetic cow eyes at me when I have 12 other patients who left the ER ahead of you and came in to the pharmacy before you. First come first served, and yes you all came from the same ER. You probably all sat together and b*tched about the wait time cuz you use the ER instead of a primary care physician. Again Medicaid gives you plenty of doctor options. Use them!

On top of that is a magical thing called EBA which is an OTC cash credit that must be processed as a prescription so people bring in baskets and baskets, even shopping carts full of diapers, mouthwash, toothpaste, OTC meds, etc in the hopes that all of it will be covered. The problem with this wishful thinking is that we do not have a definitive list of what is covered because it keeps changing. One month a certain type of diaper may be covered then 2 months later Medicaid decides to cover a different one. This leads to many items not being covered so we have to process each item and see if it is covered, if we know what is covered instead or if a different package size is covered. Each item's processing time can take up more than 3 to 5 regular prescriptions to process so it really is the bottleneck in the prescription process. I spent 2 hours processing 2 shopping carts full and 3 shopping baskets full of stuff. Of course half of it was not covered so I had to attach a little list of what was not covered to the receipt of everything that was covered and then I got to spend an hour returning all the not covered crap back to the store shelves because I was sick of tripping over it in the pharmacy.

All this time I was under the impression that the purpose of the cash balance on EBT cards was to cover these expenses. Silly me thinking that people on welfare wouldn't want another handout for crapping out a baby of unknown daddy. Yes I am bitter and fed up. The system should cover one child only. If you didn't learn from that mistake then you shouldn't be allowed to suck the government teats dry. I would like my tax dollars spent on something worthwhile like public education...I am not bitter at all (sarcasm).

I had a lady come in who appeared in her late fifties, early sixites. She was mad that she paid cash for mirtazepine (antidepressant, mood stabilizer) and said the price was $25 cheaper at the grocer store and Wal-Mart. She wanted the number to corporate to complain because she took 2 pills and said it made her sick. I gave her the 1-800 number for complaints and the store manager looked up the corporate address so she could write them a letter.

She then purchased 3 boxes of baking soda and 4 packs of D batteries. I can tell you why the mirtazepine didn't work. First of all, medications like it need at least a week of continued therapy to reach full effect because they alter chemical concentrations in the brain. Second of all, her other purchases confirm my sneaky suspicion that she is hooked on methamphetamine which overloads the serotonin receptors in the brain and over years of meth use pretty much blows out the receptors so that no matter what you cannot experience emotions such as happiness, satiety, and fulfillment. LAY OFF THE METH SWEETIE CUZ YOUR PROFILE SAYS YOU ARE LOTS YOUNGER THAN YOU LOOK AND YOUR TEETH WILL BE THE NEXT THING TO GO...

Some people have no damn sense. This is why we need to spend more on education and less on bullsh*t.