We bring the FAST and laughs to pharmacy.

Tuesday, May 25, 2010

Laziest.Doctor.Ever

Hey lazy bones, MD!

I cannot believe you refused to dose your patient's cefuroxime suspension, you LAZY POS (piece of shit in case you don't know the lingo). Good GOD! Why in the hell did you become a doctor? Not only did you make me pick the drug, you refused to look up the dosing in mg/kg, didn't know the child's weight, nor did you give me the duration plus you got totally got pissed off when I asked for your name. YOU SUCK! I hope you get sick and I get to dispense your medicine b/c believe me-you are going to get quite a verbal lashing that I should have given you today but I was too damn frustrated with your douchery so you are super lucky I just hung up on you.

FUCK YOU on behalf of all pharmacists and your patient.

No love this time,

Filet

About blister packs

Just once, I would like to be caught up on the blister pack schedule. Or even ahead, for a change. But even though I don't interact with the regular customers while I'm in the back processing blister packs, there are always some kind of pitfalls or drama or both. I have a nice caregiver come in one weekend that I work and ask if her client can transfer his blister packs from his current pharmacy to us. Sure, no problem, as long as he has refills, it's all good. Monday morning comes and the caregiver calls for those blister packs. Hmm, let's call the other pharmacy for that transfer. No refills, you say? Ok let's call the Dr. and ask for a new med list. And you want these 15 meds done when? In an hour??? Considering that I'm off in 10 minutes, and there is no hope of that getting finished in time, I get to leave a detailed note for the next victim who is lucky to do blister packs. Next day, I heard that we got the blister packs done in record time for this client, and the caregiver comes to pick them up, and asks "Where's the rest of it?" We generally fill 1 month or less at a time, with about 2 months of refills on file. Apparently they were expecting all 3 months of his medication to be blister packed at one time. My boss said no, here's one month for you now, come back next month for the next set. They refused to take the blister packs, so now I get to return it all back to stock. That's 1 hour out of my life that I will not get back, thanks to them. Oh yeah, three guesses which shift I get to work tomorrow?? Let the games begin!

Monday, May 24, 2010

Pharmacy Hotties quote

makes me laugh every time I read it!!

"Pharmacists are little minxs. They are super intelligent, but not nerdy enough to be doctors. So, that means they have an untamed wild side. Dirty little pill poppers. Apparently they also have big tits (who knew). You’d better believe they take drugs. They see how effective they are on a daily basis. They also get to see people just before they kick the bucket so they know that they have to make the most out of life. Never underestimate a smart chick."

I am sure a Mr. VR would agree!!

xo xo

Filet...

Dear Cheap Ass doctors-do NOT do this unless you enjoy pissing me off!!

Hey you know who you are special MD's who like to boss us low life pharmacists around,

Do NOT put what the cost of the medication on the prescription. We have our own prices set by corporate. DO NOT ever write $4 on the script unless you are sending your patient to a pharmacy that definitely does not care about being a pharmacy and are strictly a factory drug farm. Even then how can you guarantee that pharmacy is going to honor that price?

What kind of bullshit is this?! How about I write "no copay" on their prescription, send their happy ass back to your office and demand a refund for their visit?

Stop playing games! I don't have time for that!! I spend too much time explaining why YOU chose to do something so incredibly stupid! Who does this? Total douchebags screwing over the pharmacist again and again.

THANKS for nothing!!

Filet

Bad Doctors

Perhaps it is the hormones speaking, but I have just had it with doctors today. First script problem today, a doctor wrote for Macrobid 200mg. Three phone calls put on hold for around 20 minutes by the office and finally received a call back to clarify that is in fact Macrobid 100mg. Duh.


Second issue was with a doctor who either wrote the quantity wrong or the directions and his office number at the hospital goes straight to voice mail. After three attempts I call the main desk to have him paged. Do you know what the genius of all doctors says to me? Is there a direct line because he doesn't like to push buttons and usually won't even bother calling a pharmacy back. SERIOUSLY? Is he kidding? Nope, so I didn't hold back and let him know it is the same thing as calling his office number and not being able to speak to a human over his inability to write a script right.


ARGHHHHH!

Saturday, May 22, 2010

Summertime Summertime Sum Sum Summertime!

Oh kids, it's once again that glorious time when school is out for summer and the days of unstructured time lie ahead! Woohoo! I want to give you some small pointers to enjoy yourself and come out unscathed.

If you have asthma you should have your "rescue" inhaler with you at ALL times! If you have severe insect sting allergies you should always have an Epi-pen with you at ALL times! It may seem a little dorky but it will save your life! You don't get to play video games or sports in the grave...what a bummer...not to mention your family and friends would be really really sad to say goodbye one last time.

Enjoy the daylight hours outdoors. Save the video games for rainy days and evenings when the mosquitoes are out because who wants to risk getting West Nile Virus when the stunningly absorbing worlds of God of War or Mario Galaxy 2 await to cripple your fragile little fingers with hour upon hour of button mashing joy. You know what else is really fun getting family and/or friends together and "kicking it old school" with a board game. You can't beat an evening with Hasbro or Milton Bradley and a small crowd. I know you find it difficult to believe the world was without electronic gaming but there are a lot of classic board games with silly phrases like "You sank my battleship!", "Yahtzee!", and "Go to jail, go directly to jail. Do not pass Go, do not collect $200." to be enjoyed over and over and over again.

Speaking of being outside, don't forget sunscreen. This is one of the most important fundamentals for fun in the sun. Each and every little sunburn accumulates over your lifetime and not only leads to dark "liver" spots but can lead to different types of skin cancer not to mention the excruciating pain and itching resulting from a sun scorched carcass.

Keep yourself hydrated! Drink plenty of water instead of sugary Kool-Aid, disgusting adult sports drinks and sodas. You won't be able to play at full tilt if your body is screaming out for moisture. You can't just soak it in like Sponge Bob you have to drink it.

Enjoy sports, playgrounds, parks, your yard, and anywhere you can interact with the beauty and serenity of nature. Play fetch with your dog, ride a bike, skateboard, join a summer sports league, swim, theme parks, etc to fend off obesity and so the kids are worn out at the end of the day which allows parents some quality down time for a little adult enjoyment...brown chicken brown cow...if you catch my drift... Better yet adults, summer camp can give you and your honey plenty of quality alone time this summer, wink wink.

So whatever it is that you do this summer (I am headed to Universal Studios & Disney for Star Wars weekends with my brother and nephew) make sure to take a few small precautions to ensure maximum enjoyment with minimal annoyance because it is all good and fun until someone ends up in the emergency room!

Sunday, May 16, 2010

Contest winner

Holy slacker I am! Sorry peeps but I forgot about the contest until Tasty reminded me.

Here is the winner of the Amazon gift certificate. Please contact me so that I can get that out to you.

the RPh said...

So I was working at "Big Chain Pharmacy" and called a Dr's office to verify a very iffy control Rx. I left the message on the "urgent" line. About 20 minutes later the nurse/office manager called back and asked my tech what our address was so she could send 911. I got on the phone and told her we didn't need 911, that we were a pharmacy. She said that since I left a message on their "emergency" line, I must need 911 and asked for the address once again. After two more attempts to tell her my reason for calling and her insisting that I must need 911...we got into an arguement and I told her she change her voicemail message to make it clear that they would call 911. She told me she would relay the message to the Dr and I said for her to try to not be a b*tch wehn she did. Long story short, I no longer work for "Big Chain Pharmacy"...but I'm proud of myself for standing up against rudeness!

A shorter line to our counters soon? (please!)

Successfully treating chronic pain with opioids such as morphine and oxycodone — minus the side effects (such as euphoria) — may soon become a reality, bringing relief to millions of people who suffer from debilitating pain, according to Distinguished Professor Linda Watkins of the University of Colorado at Boulder….

(And also put and end to opioid abuse, once and for all: no buzz=no reason to abuse, sorta like advil)

Recent work by Dr. Watkins, a neuroscientist, and others has shown that glial cells in the central nervous system act as key players in pain enhancement by exciting neurons that transmit pain signals. They also found that glial cells hinder the ability of opioids to suppress pain.

Now they believe they have figured out how morphine affects glial cells and neurons. “We’ve found that different receptors are involved in how morphine suppresses pain through its actions on neurons versus how morphine activates glial cells,” Watkins said. “What this means is that you should be able to separate the suppressive effects of morphine — its pain-reducing effects through its action on neurons — from all of its bad effects when it excites glial cells.”

A paper on the topic was published online in August in the journal Brain, Behavior and Immunity.

Under normal circumstances glial cells are thought to be like housekeepers, said Watkins. They essentially clean up debris and provide support for neurons.

“What’s become evident is that glial cells have a Dr. Jekyll and Mr. Hyde personality,” Watkins said. “Under normal circumstances they do all these really good things for the neurons, but when they shift into the Mr. Hyde formation they release a whole host of chemicals that cause problems like neuropathic pain and other chronic pain conditions.”

The challenge was to figure out how to let morphine do its work on the neurons, without alerting the glial cells, which are known to suppress morphine’s ability to kill pain, she said.

To keep the glial cells quiet, the team used a type of drug called naloxone to turn off what is called a toll-like receptor, which is found only on glial cells and not on neurons. Doing this blocks morphine’s effects on glia but not on neurons, resulting in effective pain relief without addiction and other side effects.

The team found a particular receptor, called TLR4, not only is important in driving pain but also detects all clinically relevant classes of opioids.

“So if you block this receptor, this should not only block chronic pain, but also make opioids work much better by suppressing pain, while avoiding the bad actions of glial cell activation,” Watkins said

Thursday, May 13, 2010

Insurance?

I have a terminal patient whose lovely insurance has decided to not cover her Roxanol. I am so appalled right now, I can barely speak.

Luckily, I have a little discretion in the pricing, so I was able to make it bearable, but still, I cannot help but hope that reform will eliminate such arbitrarty idiocies.

Wednesday, May 12, 2010

Will sombody please burn my C-V sig book?

My store is one of the very few in Alaska that still has the old C-V signature log. Which of course creates a super-funnel to the front door of every Chera-Tussin chugger within 100 miles. The main reason we have it is because of the cruise ship passengers from who-knows-where are usually coughing up their guts by the time they get here. We literally cannot keep it in stock because of the local codeine junkies. Besides the obvious, any imput as to curbing the flow? I'm needing some creative ideas here! I remember that my father used to limit the regulars to 4oz./wk., but the flow up here is too damn distracting.

Tuesday, May 11, 2010

Phentermine!

Does anyone else apparently have a weight loss clinic right around the corner? I swear we must do a half-dozen Rx's/day for phentermine+citalopram from the same guy.

And when he wants generic Fastin, it's always Sandoz brand, not that we carry any others.

At least we finally got the walk-in clinic doctor to stop writing Phenergan w/Codeine #240mL to everyone who walked through the door. We called to verify an Rx from someone from out-of-state who saw him, and apparently he was writing 20-30 of them a day. He's an ex-orthopedic doctor, and apparently had no idea why he had a dozen people in his waiting room at a time all with a cough.

Happy Spring?

Yet another whine about the vagaries of the weather and the evil drive-thru window that opens into the wind.

You warm, safe, patients drive up in your mostly sealed-up, into the lee of the wind car, and can't understand why we shudder, squint, and spit out rain, sleet or snow.

But, if we close the window for our own warmth and sanity, you stomp in, complaining all the while at being "forced" out into the weather.

Where, oh where, is Spring?

Monday, May 10, 2010

Nice Try Jackass


A man in his 40's walked up to me, a customer we'll just call "Mr. Seeker", and thrust his bottle at me, demanding to know why his Oxycontin wasn't working. So, upon investigating the pills that were left, at first glance they appeared to be 20mg. Oxycontin. But when I checked the pill I.D., it turned out to be a generic (AURO) simvastatin. When I informed Mr. Seeker of this, he seemed enraged that we could mess this up so bad, and demanded that I fix the problem. Since I was the only one filling the CII's here the day it was filled, the possibility of a tech or someone else tampering was not a reality, especially since Mr. Seeker told me that he waited on the Oxycontin to be filled that day. It never even hit the 'will-call' box. "I'm sorry Mr. Seeker, but I filled this prescription personally, and I can guarantee you that that bottle was filled with 60 Oxycontin when it left here." Of course he just stared at me, wondering what to do next. So I told him that if he would be able to wait for a spell, I could do some checking to 'verify' this. Not that I have anything else to do, jackass. "Good, you do that", Mr. Seeker said, with hope in his eyes. Well, when I pulled up his file, guess what other drug (among many) that Mr. Seeker takes? You guessed it, simvastatin 20mg filled two weeks before the Oxycontin. For the hell of it, I ran a quick inventory of my Oxycontin 20's, and as I thought, it was tight on the spot right-on. "Mr Seeker, I'm sorry, but it looks as if you might have gotten your pills mixed up. Do you ever remove all of the pills from one bottle and mistakenly put them in another? Because these pills here are your simvastatin 20mg." He looked hurt and pointed at me and shouted,"I'll have your job for this!!!!".
Sighhhhhhhh. Mr.Seeker, you can have it right about now.
Well, my 15 minute lunch is over. Errrrrrrrrrrrrrrr.

I Don't Pay For That!

To keep life schlepping pills for the man interesting I will on occasion fill in at other locations during the day. It is like going to the zoo except we are the animals in the cage and the patrons are usually hostiles.

One day I worked at a busy store in a relatively sketchy north Miami neighborhood that I had covered a few overnights previously. I am not sure why people don't like working there. I rather enjoyed it. The rapid pace made the time fly and I actually had 2 techs to talk to so that I didn't have to talk to myself and look schizophrenic. I was also amused one night when I covered because a police car was in front of the store and had a flat but the officers didn't know how to change a tire so they had to call for someone to fix it. I took an extra few minutes to drink my Red Bull and giggle at the evening's entertainment. Poor little piggies...

I have never had a problem or been yelled at by a patient there until this glorious day when a lady pulled in the drive thru. You could see from the window that all 3 of us were busy helping patients inside and one tech told her on the drive thru phone that we would be with her in a moment. The lady starts honking her horn repeatedly then knocks on the window like a jackass. Before anyone has a chance to assist her she pulls away.

The smack-smack-smack of flip-flop shod feet trumpeted her majesty's arrival followed by a purse being slammed down on the counter and a jingle of keys. She then proceeded to chew us out for making her wait all of 2 minutes in the drive thru before she decided to come in the store. In the time it took her to park and walk in we could have assisted her at the drive thru.

I pull her prescriptions from the bin and let her majesty know that one of them was not covered for 360 pills of SOMA. She loudly rebuked and said "I don't pay for that!" She said she would come back at the beginning of the month when her Medicaid would pay for it. She then proceeded to pull the upper part of her dress down to show me her shoulder and how badly warped it was so that she really needed those pills. I had to bite my tongue not to laugh at her.

Her majesty was the poster child for someone who becomes an addict and it was even funnier that her addiction induced emaciated ass had been out on a date and her consort was another poster child for addiction. He even inquired into the next refill day for his 240 pills of Xanax even though he knew it was 2 weeks to soon. Such a charming pair. Ain't love grand?

Wednesday, May 5, 2010

Open Letter To The Self Rightous Cunt At The Counter

Dear Self Righteous Cunt At The Counter Screaming At My Day Staff,

I overheard you screaming because your medication was not in stock and you were pissed off that no one called you to explain what "back order" means. There is in fact an automated computer dialer that will call and leave a message saying "This is Walgreen's calling to let you know there will be a delay with your prescription. Please contact {store info here} if you have any questions." You obviously didn't even bother to listen to the message and assume Walgreen's on the caller ID means your prescription is ready.

The other problem is that some phone services will call block corporate numbers, so unless you have put Walgreen's in as a business to not call block you will never get a message, the same applies to the spam filter on your e-mail.

A consequence of screaming that the solution to letting her know was to call (954) xxx-xxxx (I won't publish out of privacy concerns) was stupid on your part. When not on the clock I have a penchant for evil and the will to see it through. I remembered your home phone number and have since given it to the Mormons, the Jehovah's Witnesses, and a couple of fringe religious groups so your immortal soul can be "saved."

The reality is that screaming at people who know your personal info can be damn annoying if not lethal. Have some common courtesy for the staff that has to do 400 prescriptions with 1 pharmacist and 2 technicians. They are way overworked and if you are lucky don't miss fill your prescription and kill you. Actually they would probably be doing the world a favor.

I also hope you overheard me talking to the store manager about how self righteous hateful bitches like you were the reason I quit. That was my intention after all just so you are aware that everyone knows you are a cunt. I think the gentleman standing in line behind you was ready to punch you in the face so it would not have made any difference if I did it or not.

If you are lucky the only other consequence will be that the day staff transfers your shit to CVS so they can deal with you. I have a feeling CVS would be quick to transfer your shit back to us because you are a total cunt! The end result of this is usually that the ones who do get sent back to McDuggie's are a lot nicer after the entire profile transfer fiasco. It has been a tried and true system for the last 16 patients I have done it to. I believe the Dog Whisperer would approve with this method of dealing with bitches. I hope this works for you!

Sincerely,

Big N Tasty

Sunday, May 2, 2010

Mayday! Mayday!

I am a pain junkie which ensures that I will never be a pain pill junkie. My latest foray into pain is a multi-session tattoo that pretty much covers my whole back. I was lucky enough on my last session to be entertained by a newbie who was getting a black/gray portrait done on his upper left chest.

For the unanointed-tattoos hurt. It is a fact that having a needle jammed repeatedly into flesh really fires up those nerve endings and they are definitely not happy about it. So when newbie asked if it hurts I just giggled and said "Of course it does but after a while you just notice the sound and the vibration more than the pain." It also helps if you engage in conversation so that you are not concentrating on the needle and where it is going.

He was having a rough go. It was highly entertaining to watch him squirm and moan while I am trying to not move from laughing as an 11 gauge needle is ripping through my back. The other problem is that my tattoo guy was laughing and I had a friend with me and as he laughed harder so did I while trying not to move. It is damn near impossible not to move when in the midst of a giggle fit.

When he was finally done we left him with some parting advice along with a few tasty bites I threw in here for my sick little monkeys:

1. Be sure to tip or the next one is gonna give you an intensely bad experience for a definition of the word "hurty."

2. It's not rocket science, it's basic wound care. You don't need anything fancy. Washing a tat with your household Dial antibacterial or antibacterial hand soap is enough to keep it from getting infected.

3. DO NOT SCRATCH!! This can lead to chunks of skin coming out and taking the ink with it. I have a small spot that I did that to and will have to have it fixed.

4. It rubs the lotion on its skin or else it gets the hose again. You don't need to slather a thick ointment all over it for healing. Lubriderm lotion with no perfume is perfect to keep the tat moist so it doesn't scar as it heals. Apply multiple times per day. I apply at least four times and more if it gets itchy. I f*cking despise itchy! Again you don't need to slather a whole lot on. We are not greasing pigs we are healing a series of puncture wounds.

5. Tattoo artists tend to be a disgruntled lot because they deal with many of the same ill-planned/ill-chosen/ill-mannered/uninformed/irresponsible people that we deal with at the pharmacy. Don't be a douche because that Japanese character for "strength" is just a few needle pricks away from being the Japanese character for "retarded." Caveat douche! (translation: douche beware)

6. It hurts a million times worse to have that tattoo lasered off (doesn't it Filet) than to have it put on. Make damn sure that when you get Satan's face tattooed at the base of your penis with the shaft of said penis tattooed as Satan's tongue it is forever! (To clarify it wasn't Filet that had Satan it was a guy at a gay bar that got his jollies showing it off. It happens sometimes that's why they call me the penis whisperer. For reasons unknown many gay and straight men have been compelled to show their penis for my amusement be it Mardi Gras, tattoo, piercing, or a pitiful attempt to let me see that they are a shower not a grower. Great power comes with great responsibility and as such none of you will see my tattoo as to protect my secret identity except for a small select group of close buddies who already know about my secret power.)

I leave you with my favorite advice: When it comes to ink and penises, go big or go home! (unless you are taking it up the ass then you might want to go small on the penis but I'm not judging, I'm just saying.) Always keep it classy and drink with your pinkies out b*tches!