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Monday, November 14, 2011

random haps

One of my favorite things to do when someone calls on the phone to ask "Do I have refills on my hydrocodone?" is to look up their info (so they hear me typing) and then answer quickly "Oh, no." I usually get a squawk of rage- "Yes I do!"- to which my mental reply is "Then why the F&@k did you just ask me? Ask if it's too early, fool."
I kept having people ask me today to repeat things they just told me, or for doctor's offices, to resend requests for PAs. One nurse, when I repeated that we had sent it multiple times, just asked for the info again as if this couldn't possibly be an issue. Rage, I tell you.
One of my customers called to ask me what a doctor had written a script for. She said she was going to spell the drug, and then went "M-A-I-N-S-T-R-E-E-T. What drug is that?"
"Ma'am, I think you spelled Main Street."
"Oh yeah, that's my address."
She ended up never telling me the drug name- she skimmed the rest, figured out it was her Ambien, that it was too soon to refill and then hung up.
I had a guy get a flu shot, and he asked me to help him with his consent form. Being a soft touch (sometimes) I read him the questions, kinda begrudgingly, until he said, kinda to himself, "I haven't learned to write with the other hand yet, after the stroke."
Of course, then I was perky and helpful.
We have this one office that usually e-scripts nowadays, but sometimes they'll have to call something in. What do I hear when I answer the doctors' line "Hello, this is Hell Pharma, technician speaking?"
No hello, please, thanks or even attempt to be nothing but rude. Seriously, I tell every patient considering switching docs to avoid this office like the plague. I don't see why saying a greeting is taking up precious moments of your day.
January is fast approaching, or as I call it, Pharmacy Apocalypse Month. With the Express Scripts/Walgreens kerfluffle, everyone's going to see shifting people and it's gonna be nutty. I plan to stock up on sweet, sweet rum now.

Wednesday, October 5, 2011

Glucose Testing

I was looking at videos on YouTube of ideas for noninvasive blood glucose testing. There is a huge project looking at measuring glucose in human tears. I have a lot of issues with this.

The team working on this is making testing devices that are meant to touch the surface of the eye to get tears then analyze the glucose content. The device itself has way too many limitations to be clinically feasible. Any degree of Parkinsonism, tremors, many physical handicaps, contact lens wearers, visual difficulty, and poor hand-eye coordination will limit the ability to touch the testing device to the eye. The actual touching of the eye is quite disturbing in itself. Scratching they eye, poking the eye too hard and sterility of the device are all very real hazards.

The eye is very delicate. Please leave it alone and try to find a noninvasive way to measure blood glucose through the finger like a pulse oximeter measures oxygen saturation. There has to be something in the blood stream that will react with a different spectrum of light that will allow for quantifiable and reproducible results. It took about 40 years for the original pulse oximiter to be redesigned and put into widespread use but I believe somewhere out there in research land there is a team of scientists that can make this happen.

I want a viable noninvasive cost effective means of blood glucose measurement and like Veruca Salt "I want it now!"

Sunday, September 11, 2011

I Foresee A Misadventure

As I look into my crystal ball I see a bottle of Pradaxa opening and the capsules placed into a 7-day pill minder. The caregiver filling this pill minder does not know about the storage mandates for this medication leaving the patient open to drug failure and clots.

I am asking each and every practitioner to make sure to double or triple counsel each and every patient you are putting on Pradaxa and any caregiver(s) they are going to have involved in their drug routine.

Pradaxa is extremely sensitive to humidity and should be taken as prescribed every day for 30 days after the seal on the original bottle is broken. Pradaxa SHOULD ONLY BE DISPENSED AND STORED IN ITS ORIGINAL CONTAINER!!!!! Absolutely under no circumstances should this drug be taken out of the bottle or foil pack and put in a pill minder unless you have a foil pack and cut off the cap still in the sealed compartment and put that whole unit in the pill minder.

Pradaxa caps should NOT be opened and the pellets taken by themselves or sprinkled on food because the bioavailability goes from 3 to 7% from the intact capsule and increases another 75% with no capsule. This can lead to a potentially fatal bleed.

Please make sure to go over this info multiple times with each patient and caregiver(s) because this med can easily be misused and when it comes to clot fatality vs bleed out I believe everyone will benefit from some good old education.

Saturday, September 3, 2011

Let's Talk About Sex

I'm not going in to the freaky deaky stuff for the time being but I do want to address a growing and sad issue: Plan B. Multiple times each work week I see panicky scared little girls come in for Plan B or send in their boyfriends to buy it because they are TERRIFIED that their parents will find out what dumb ass little teenage loser they let wallow in their baby gutter. This needs to stop.

If you are so afraid or too embarrassed or too immature to have an open adult dialogue with your parents about sex then you have NO business f*cking!!! My parents failed to do this with my older sister who got pregnant in high school and hid it from the family until her last few months. They made sure I knew about baby making and venereal disease and got on birth control at an appropriate age. What is an appropriate age? That has been debated by religious and parent/teacher groups for years. I recommend operating on the "old enough to bleed, old enough to breed" paradigm.

Upon a girl's first menstruation it is imperative that parents have a discussion about dealing with blood, birth control, and venereal disease. Let's face it, being a girl is disgusting and it helps to have a good home support system. Parents should have the talk with boys when they start getting "morning wood" and "nocturnal emissions." It is up to the parents how detailed they want to get and if they want to take the mom tackles daughter, dad tackles son on the talks. They also need to agree on rules for dating for their children and please allow them to take the health course at school that goes over reproduction and social responsibility for their offspring. It seems this education has been lacking on all fronts worldwide.

Knowledge is power and with the potential to make a baby teens should have greater responsibility and knowledge for planning a baby at an appropriate time in life instead of having one and dropping it in a dumpster or using it for a welfare check. I guarantee many of your children are having sex and not telling you about it. Make sure you have a good little sit down chat. If you are uncomfortable with it there is a Planned Parenthood where you can make an appointment for your child to talk to a health care professional for any questions they are uncomfortable asking you. Let's take the fear out of growing up and bring RESPONSIBILITY back to our baby-making!

Oh No She Didn't!

Oh yes I did! Tasty now has a Twitter account for all the little things I want to say but just don't need a whole blog post.

Your new favorite thing is @FFPTastyTweets


Saturday, August 6, 2011

Clash of the Titans

In case you have been hiding in a bomb shelter for the last few months you missed the announcement that Walgreen's was not going to renew its contract with Express Scripts for prescription processing at the end of 2011. They have already dropped E.S. employee rx processing and are ready to give the rest of them the old "heave ho".

Why would a pharmacy business give up a ton of customers, including all military rx insured? Due to craptacularly low reimbursement rates from the processor (ie E.S.). Why lose a sh*tload of money if you don't have to. This is not the first time Walgreen's has gone toe to toe with an rx insurance provider. There have been many instances in the past with different state medicaid programs and other rx processors in which Walgreen's just said "No". Quite frankly I don't blame them one bit.

I say f*ck you Wal-Mart (and Sam's Club) with your $4 rx (and no charge to mail it to your house), and a smaller f*ck you to Target for jumping on the $4 band wagon (No hard feelings Target I still love you, it's just a matter of principle.) Oh yeah, I didn't forget you Costco, f*ck you too with $6 prescriptions and a "you don't have to be a member to use the pharmacy" policy, and a special lick my twat to all the grocery store pharmacies with the list of free antibiotics, and to any other rx chain that has such equally bastardizing low ball tactics to get business.

This pricing bullsh*t is what makes insurance providers believe they are entitled to craptacularly low reimbursement rates because if we can fill over 300 drugs for $4 then we must not really need AWP (average wholesale price) + a finger in your ass for reimbursement, which is the industry standard right now. This means we will get less than AWP and not even the uncomfortable "how you durin" of a finger in the ass for employee hours, supplies, drugs, utilities, patient counseling, vaccinations, etc. You know who gets the really short end of the stick? Independent pharmacies that are subjected to the same craptacular reimbursement rates with a much higher drug acquisition cost. Even being in a buying co-op isn't gonna save most of them.

As a "f*ck you" return serve to Walgreen's, Express Scripts is trying to buy Medco, which is another huge rx benefit provider. E.S. states that they will "save money by being a bigger company" but we all know they just want to bend Walgreen's over to get them to take the craptacularly low reimbursement rates and the rest of the retail pharmacies will have to bend over and take it too. This is a bitter pill to swallow indeed. The only hope is that the Federal Trade Commission prevents the buy because E.S. will then control about 40% of the prescription market and will have way too much control over the industry.

If the FTC does as wonderful a job as the Congressional budget fix then the pseudo-comfortable "we can make a few bucks and keep the lights on" days of retail pharmacy will be at an end. The new dawn will bring obliteration of what was once a landscape of semi-prosperous independent pharmacies to a place where only chain retail pharmacies remain. Just one more American dream shat upon by the greed of others. Go Team!

Saturday, July 23, 2011

...And Then I Don't Feel So Bad...

Sing along to the tune of "My Favorite Things" from The Sound of Music but for the love of Pete don't drink searing hot beverages whilst reading or singing along...

Opened abscesses stuffed full of packing
Burns bad enough for most skin to be lacking
Infected piercings that might have gangrene
Just a small taste of the gross things I've seen

Under-size tube tops on large whiskered women
Multiple ring worms on neglected children
Pants low and saggy on wanna-be thugs
Scarred by the things I see while counting drugs

Wads of gross money from dark sweaty places
Amphetamine junkies with scabs on their faces
The smelling and itching of frumunda cheese
These are all things that the summertime brings

When the narcs are, refill too soon
And the patient is mad
I simply remember
I'm off all next week
And then I don't feel so bad!

(repeat all one more time, with gusto!)

Thursday, July 21, 2011


Just wanted to post a friendly reminder that this blog in NO way reflects the views, opinions, operating paradigms, etc of our corporate paymasters, any board of pharmacy, or any pharmacy related organization. This blog is a group of people exercising their right to FREE SPEECH. We do not strap you into a chair, prop your eyes open, and force you to read our opinionated/asinine/ridiculous blog posts.
Have a wonderful day!

Friday, July 8, 2011

Crashin Your Party

I reached in my mailbox and came back with a letter from the Florida Board of Pharmacy. It was not license renewal time so I tore it open with wonderment and curiosity and was rewarded with fantastically amazing news: New legislature passed for pain clinics.

HB7095 and HB1319 were signed by Governor Scott and went into effect July 1st. The news says Gov Scott's approval ratings suck but I give him a happy two thumbs up! These house bills changed the guidelines for pain management clinics, prescribers, pharmacists, and pharmacies. Both bills, oops laws can be read in their entirety at www.doh.state.fl.us/mqa/Legislation/legis.htm along with updates and other pertinent info.

My favorite part:
***Prescribers no longer allowed to dispense CIIs out of their office. This means news crews won't be able to film people injecting oxycontin with insulin syringes in their cars outside the clinics...what will they do for news...

Keep up the good work Florida and hopefully other states will follow your lead!

Saturday, June 11, 2011

It's About Damn Time!!!

Thank you Mylan for taking the initiative and creating something palatable. A million Type 2 Diabetics sigh in relief that they no longer have to stuff some foul ass fishy tablet down their throat to control blood sugar and staffers like the change in smell also :)

Friday, June 10, 2011

I Hate F*#%ing Coupons

I always try to be helpful and tell people with high copays to "Google" the drug and usually there is a coupon/loyalty card/copay discount card/etc to be found on the company sponsored web page advertising whatever crap you just can't live without. So the lady I talked to on the phone dutifully printed out a coupon and sent it with her husband. Of course she printed the coupon for up to 75% off for cash paying customers instead of the one for a copay discount.

Upon hearing the bad news husband proceeds with a tantrum so the tech comes to me and I see that this is for the child of the lady I spoke to on the phone. I explain to man baby what the dealio is and write a note on the coupon to explain what they need to print out. Man baby throws his credit card in the drawer and gets mouthy about how "this crap happens every time I come here." Um yeah, had I not put foot in mouth about the coupons your whiney f&#%ing ass wouldn't have had any way of knowing beyond the insta-print copay what shit could cost.

To the issuers of said f#*%ing discount items: For the love of all things sane put the motherf#$&ing drug name or abbreviation of drug name in the group so when a patient has 5 or 6 of these turds in their profile we can find the right one faster than waiting for the patient to dig through a ton of useless crap they tote around to find the f#$&ing card!!!!

And I'm done...

Saturday, June 4, 2011

If It Ain't Broke Don't Fix It

I understand that a new allergy pill has gone over the counter. I also understand that your tiny little brain has been subliminally programmed by years of advertising campaigns that "new is better". I do not understand why you came in to debate the advantage of switching to the heavily advertised next big thing when you have complete symptom control and no adverse reactions to your current allergy pill. Use what works because if you do switch and have some weird reaction I am just gonna bust out the old "I TOLD YOU SO!" and you are not gonna like that dose of smug. This is me "Thank you for shopping at McDruggie's!" and this is you leaving "Buh-Bye!"

Monday, May 30, 2011


Jesus, Walgreens!


Drug Topics

I was flipping through drug topics and came across a couple things I would like for my fellow retail slaves to read.

In My View by Charles Phillips MD on page 18 of the May 2011 issue

The Perils of Pill-Splitting



Final Word by Tom Hanson BS Pharm on page 62

It's Always Been About The Staffing


Both pieces are in line with thoughts I have had for a very long time and all I have to add is Amen Brothers!

Friday, May 27, 2011

In Case You Wondered What I Want For My Birthday...

** Severed head of patron saint of genital disease goes on sale **
The severed head of the patron saint of genital disease goes on sale in County Meath
< http://www.bbc.co.uk/go/em/fr/-/news/uk-northern-ireland-13522546 >

Sunday, May 22, 2011

I Threw Them Away

So I get a phone call on 4/14. A lady is looking for refills on hydrocodone. I took a look in her profile: #56 tramadol 50mg on 4/12, #200 hydrocodone/APAP 10/325mg on 3/29, #160 hydrocodone/APAP 7.5/325 on 3/28, #60 tramadol 50mg on 3/8, and this repeats twice a month for the previous three months and once a month for two months prior to that. I asked her what happened to the hydro 7.5/325 and she told me she threw it away.

It seems we have a problem. She has repeatedly been getting both strengths of hydro and now she is lying. It is another case of pain patient turned addict. I hate this. We are manufacturing junkies because we have a great selection of pain pills from many manufacturers, multiple physicians that will write for anything, and pharmacists that just fill them because they don't care/don't have time to bother with it. This needs to stop. I am asking everyone in the medical system to be vigilant about addictive pain med prescriptions. These pills can kill just as easily as a loaded gun in a room of five year olds.

There is also a trend of prosecuting everyone in the case of overdose. The laws are being enforced and pharmacists and physicians can be brought in on criminal charges. We took an oath to do no harm and the way things are going we need to take that to heart no matter what the patient says.

Thursday, May 19, 2011

Everything Is Better With Bacon

I wonder if we could get children to take medication with bacon flavor? I know dogs and cats love this selection of flavors. I also have had parents tell me that some of the fruit flavors we use are gross. I know every child I have encountered loves bacon, even if it is turkey bacon. There is just something delicious and magical implicit in the word bacon. Hell, I even have a close up of the crispy bacon bottle as a screen saver because everything, even computers, is better with bacon.

Monday, May 16, 2011

Existential Dilemma

A few weeks ago my mother passed away. She didn't believe in going to the doctor and was adamant on not using medications if she didn't have to. Hell, we joked around about which nursing home she wanted to live in and what would she do after dad dies because statistically men die younger than women and my dad's father died in his mid fifties. She had a long family history of heart disease, multiple cancers, and Type 2 diabetes through several generations.

When her father went through his fight against heart disease and diabetes she watched him go through multiple doctor appointments, surgeries, and medications. He had heart bypasses, arterial plaque removals, and 2 strokes. The strokes left him unable to use the right side of his body without severe difficulty and a lot of physical therapy. He died in his sleep in his mid seventies from a ruptured aneurysm.

Her mother had a long hard fight with COPD that resulted in oxygen use, multiple daily breathing treatments, a ton of medications, a ton of doctor appointments, lung cancer, and eventually an untreatable brain tumor that finally killed her in her early eighties.

My mom died in her sleep from a ruptured aneurysm at the age of 61, peacefully, with eyes closed and no suffering to the great beyond. This leads to my dilemma. For all the good we think we do with surgical intervention, medications, and other therapies are we just making death painful and prolonged? Aren't we all supposed to go peacefully in our sleep instead of kicking and screaming to the very end?

How can I look at people and tell them the statistics and what to expect from treatments when all I want to say is that you will have many more years to suffer before you die a painful death? The healthcare industry is the patron saint of sadism that promises eternal life and wonderous results but only succeeds in torturing those who seek salvation and are willing to pay any price for any small glimmer of hope. It has become what snake oil salesman have preyed upon for years except now we take your money, give you the tonic, and poke you with a stick repeatedly until you finally die. I love modern society!

Tuesday, May 3, 2011

From the Makers of "Fukitol"

When I saw this Mother's Day card at Target, I immediately thought of Dr. Grumpy and Fukitol brand medication.

You know I had to pick this up for my MIL.

Friday, April 29, 2011

Sad times

Big N Tasty experienced an unfortunate event over Easter. I hope and pray she will be OK. To all her fans-please send her supportive and healing thoughts.

Thank you,


Wednesday, April 20, 2011

Lap Apron

A mighty protrusion of skin fold outcrop
Hanging out below your muffin top.

Creating friction and moisture for a minutiae of beast
Such as bacteria, fungus, and the opportunistic yeast.

I'm not talking about something worn when serving a patron
I'm talking about the voluminous reach of a skin fold lap apron.

For many aged* it's from caloric expansion with tonicity lost
For others the result of surgery/dieting with rapid weight loss.

Whatever the cause of your lap apron may be
Hygiene is important, keep it dry you see.

If your lap apron becomes a prohibitive part of your anatomy
Find a good surgeon who can perform a panniculectomy.

With a lap apron surgically and maybe permanently gone
We can begin to rip off the 30 Rock "Muffin Top" song.

*pronounced age-ed for the purpose of flow

Friday, April 15, 2011

Very Important

The trio of blood pressure medications on the other side of this prescription were so very important for survival that the patient walked all over it.

Wednesday, April 6, 2011

Allergy Wars

Spring has sprung and with it comes wonderful blooming flowers, trees, and their allergenic pollens. Allegra has made the jump to OTC and the ads on TV are now showing the polite fight to obtain OTC med sales. The funniest is a handful of people sitting around talking about their allergies and one guy is going to take Allegra then another guy pipes up "You can't take that with orange juice." I crack up every time I see it. Of course it is an ad for rival Zyrtec. Hopefully Claritin will join the fight and politely shame both of them..... Non-drowsy Zyrtec? You put me in a coma so I think Claritin will politely kick your ass.

Another great thing is a vaccine for cat dander/hair allergies currently in study. Just think if we can finally get a vaccine for cat allergies then we could adapt that vaccine for dog dander/hair, bird feathers, etc. The reign of pet allergies could be coming to an end in the next 5 years or so. I'm stoked! No more will I be unable to breathe and have to blow my nose a million times after my cat decided my pillow was an awesome sleeping place. No more will people have to shun goose down pillows and bedding. People won't have an excuse not to adopt pets from shelters because we will no longer be allergic to them. No more ads on Craig's list that we need to rehome a dog/cat because the child is allergic. A brave new world of pet ownership will prevail!

The future will be awesome!

Tuesday, April 5, 2011

Changing My Name To Captain Obvious

Late one night a lady and her teenage daughter come to the pharmacy. They had been in the emergency room because the daughter had occult abdominal pain. I'm not talking demons here, in medical terms occult means of unknown origin. I could pinpoint the most likely problem and solution just based upon observation of the daughter in the waiting room. She was morbidly obese, playing a video game on her phone, eating potato chips, and drinking a Pepsi.

To my keen sense of observation I am going with bowel obstruction. Looked at the rx and sure enough it was a laxative and pain med combo. The most likely reason: low fiber diet and not enough exercise or water.

Late one night a lady comes in with an emergency room rx for Fiorinal with codeine for migraines. When she checks out I just shake my head and wonder how long she has suffered. She buys 3 Hostess honey buns, 2 bags of Cheetos Puffs, 4 packs of salted sunflower seeds, and 2 Mountain Dews. It doesn't take a genius to see that she eats minimally nutritional things chock full of preservatives, color/flavor additives, and salt. All of these things can contribute to migraines.

She also had no previous history of any other medications except for Fiorinal with codeine to try and prevent migraine episodes so I made some suggestions to make her life easier but she didn't care because Medicaid will give her as many ER visits and Fiorinal with codeine as her little heart desires instead of her actually going to a physician and trying something daily to cut back on her discomfort.

Ugh, some people never learn...

Tuesday, March 22, 2011

Flounce Like You MEAN It!

I mean, if you're gonna announce, "I'm never coming to this store again!" as grandly as if Queen Liz was standing in front of Pick Up, make it count!
(Once you slink in the next week and you kinda feel like the whole pharmacy staff is smirking at you, know that we are.)
I had someone tell me they were leaving because I talked 'like I was a pharmacist'. I'm not sure what that means, other than counseling a patient and I wouldn't do that, so as usual I just brushed it off. Today, when this patient stood in front of me, I didn't comment, but my smile must have radiated pure evil, because she didn't even blink when I told her 15 minutes wasn't possible for a waiter at that moment.
I also don't hesitate when people say "Oh, you're higher than WalMart? What about the 4 dollar list?" Without a breath, I hand them their scripts back, give 'em a "We ain't WalMart, keep it moving" and go about my day. When you come back later sheepishly, I won't gloat aloud. I'll keep it cool.
Also, "We don't work on commission" is our battle cry. Not saying you want to deliberately piss off people, but thinking that your script for Vicodin from that pill mill down the street is directly paying my salary is making me laugh. Hard.

Sunday, March 20, 2011

Rush Job

Hate putting away totes of warehouse? Feel like it takes aaaaaaallllllllll day? I am going to let you in on my sure-fire method to efficiently put away those drugs/supplies!

***Tote of refrigerated items first*** This has nothing to do with how much or how little is in the tote, it has to do with drug stability.

***Miscellaneous small boxes of syringes, test strips, etc that come separate from the totes*** These are annoying, small, and the whole box of stuff goes in one spot on the shelf.

***Now the other totes***
1. Oversized items (bowel prep jugs, boxes of syringes, 500-1000 count bottles, pound jars of ointments, large liquid bottles, Spiriva, Advair, etc.)
2. Boxed items (anything in a box like eye drops, ointments, nasal sprays, inhalers, etc)
3. Any other liquids and recons.
4. square/rectangular/odd shaped stock bottles
5. round stock bottles

It helps to pull all the items of each step and group same drugs together then put them on the shelf before going to the next step. In a situation with two people have one person set them up while the other person puts them away and that massive mountain of drugs will be put away in not time flat!

Friday, March 18, 2011

Sleepy, Not Sleepy

Dear Torrent Pharmaceuticals,

I have several patients questioning the potency of your 10mg zolpidem tablets. One lady even took one and 1/2 tablets and still was wide awake 3 hours later. I had the pleasure of her multiple phone calls. Please take a few tablets and sample their actual active ingredient concentration to appease the doubters.

Thank you!


Nuclear Meltdown

Attention Public:

Calling the pharmacy and stopping by the pharmacy will not get you potassium iodide tablets. I do not know what you have heard on the news or read on the internet but potassium iodide will not save you from radiation poisoning. I repeat: Potassium Iodide Tablets Will NOT Save You From Radiation Poisoning!

Potassium iodide is only used to protect the thyroid gland. It does not protect anything else on or in you from radiation and its detrimental effects. In severe cases it will not even be enough to protect the thyroid gland so get over it.

The US government has stated that we (in the US) are in no danger from any radiation coming from Japan. However, there can be environmental consequences that would have widespread ramifications mainly involving sea life, shore life, and water supply contamination.

There is no point in getting yourself worked up over any potential nuclear meltdown. Let's not get all "Lord of the Flies" just yet. If it happens, it happens. We as a planet will deal with the consequences.

Tuesday, March 15, 2011

I Want A New Drug!

Feeling down? Well drop that bag of Cheetos, get off the couch and get ready to take control! We here at Fast Food Pharma have got a whopper for you!

Be a part of the latest and greatest drug ever created! Have the ability to heal yourself with your mind! Be the life of the party! Feel like a million dollar per episode sitcom king!

Our warlocks are working overtime to crank out our sacred proprietary blend of tiger blood and Adonis DNA. You can be the first to take the greatest drug on the planet: Charlie Sheen! So come on over and start "Winning!". What are you waiting for????

*Charlie Sheen may cause an uncontrollable urge to snort hellacious amounts of cocaine, collect a harem of porn star goddesses, trash hotels, threaten exes, wreck cars, ruin your career, and sporadic bouts of public insanity.

*Limited time offer as production of Charlie Sheen may abruptly stop if PETA ever figures out where we keep the tigers, the Adonis DNA becomes contaminated, or our warlocks die.

Wednesday, March 9, 2011

Speaking Of Fever

Why didn't I have these awesome little temp takers as a child? I believe that my fever time would be smiley and bright eyed too instead of feeling like Satan had finally come for me as a preemptive strike on the reign of terror to come.

Instead I had the old school mercury in glass thermometer. I hated those things because they were cold and hard and on more than two occasions I broke them in my mouth. That probably explains a lot of things...

Even the first "sticker" thermometers were those ugly old rectangular strips that changed color like a mood ring. I tossed one of them in boiling water once to see what it would do and of course the colors changed really fast then it went black and was a thermometer no more.

Along with the information age and better toys, kids these days just have it cuter, easier, and better. Damn, why couldn't I have been born about 20 years later. I guess I just have to stew in my jealousy.

Sunday, March 6, 2011

Bieber Fever

Aw yeah! Even the cosmetics department has Bieber fever, not to be confused with Beaver fever, although I wonder if they both need the same treatment. Oh well, since it is from OPI I will wear his light blue polish so I can be one less lonely girl...

Friday, March 4, 2011

A Case Of The Frownies

9:55PM on a Thursday:

I walk into the pharmacy and they are working on a copay discount coupon for Colcrys. The patient is difficult and argumentative. The coupon is not applicable because he is on Medicare Part D insurance. The tech has to explain this to him 5 times and he still doesn't get it. I hand the tech a yellow highlighter to mark the important "You can't use this coupon because" section. He decides to get a 30 day supply on his insurance and gripes about the $29 copay. I am with you there buddy! The new copays because colchicine now is a branded/certified/patented/researched/non-generic available is a crime against humanity. Frownie face.

10:45pm on a Thursday:

A lady talking on a hand-held cell phone pulls up in the drive-thru in a ginormous SUV. She tells her person on the phone to hold. She needs me to fill a prescription from a pharmacy that closed at 10PM. On further investigation Vyvanse is at the other store. This is not the first time this medication has been prescribed or purchased. I explain the legality of why I cannot transfer a Class II controlled substance so she will have to inconvenience herself and pick it up at 8AM the next day. I apologize for her inconvenience and dart away to avoid any argument. She sits in the drive-thru for 10 more minutes talking on her cell before she finally pulls away. Frownie face.

11pm on a Thursday:

A guy calls the pharmacy to see if we can start on his prescription before he drives all the way over because he doesn't want to wait a long time. I told him our policy is to not do anything with a prescription until we have the actual prescription. He was like "Well at least tell me if you have the drugs in stock." It was Zofran and Pepcid so what pharmacy doesn't have those in stock I thought... He shows up in the drive-thru 20 minutes later and hands me a credit card and prescription. It takes me all of 6 minutes to process, verify, fill, and complete the prescriptions then proceed to ring him out. He calls back 10 minutes later to see if he can get chewable pepcid. We didn't have it so I offered to order it but he said whatever. Frownie face.

Random Prescription on a Thursday:

Pharmacy staff tried to get an iPledge authorization for claravis. The patient has not filled out her survey so there is not a damn thing we can do. This is not the first time she has had this medication and is not the first time that she failed to complete her survey. Frownie face.

Random OTC Switch coming soon:

Allegra D and Allegra in all its strengths is going over the counter very soon. We have spaces ready on the shelf all portioned out and tagged. For prescription orders these meds will most likely reject Drug Not Covered or Prior Authorization. Either way I can guarantee Allegra will no longer be covered and that usually extends to the prescription generics but since FSA cards now require a prescription for OTCs anyway you still get to bug your physician. Frownie face.

Friday, February 18, 2011

Reminder To Warehouse Employees

Please stop pissing off Banner because "Hulk Smash!" when filling totes.


Monday, February 14, 2011

Showing Some Love

McDruggie's upper management, VPs, and CEO should all be ashamed of yourselves. You treat your store and pharmacy workers no better than if they were in a Chinese sweatshop. For all the massive profit reported for last year what investors are not told is how these "profits" were the result of extensive staffing and product cuts all across the boards. Not a single store was spared along with several upper management and VPs being cut loose with nice shiny silver parachutes.

With all departments' hourly employee cuts and a push for new services given by already overburdened pharmacists it is a wonder that all employees have not walked out. You would have an easier time getting fluffed (I mean frisked) by the TSA, flying to California and having a celebrity lick cocaine out of your butthole than waiting for a pharmacist to check your blood pressure/blood sugar/cholesterol/give a flu shot while attempting to get all their other work done (doctor calls, patient calls, consultations, data/product verification, insurance audits, drug orders, babysitting unqualified/undertrained managers working as technicians,etc) and the other 20 people waiting for the same services ahead of you. I have been told by several pharmacists that patients have walked out because their wait times were unacceptably long (meaning more than 5 minutes because we are an impatient society) and that people are unwilling to pay to have blood sugar/cholesterol measurements taken. They were mistakenly under the impression that those services were being offered for free like the blood pressure screenings for Feb, which patients are now going to expect 24/7 and all of these services are covered at their primary physician visit with one small copay versus multiple copays for different services at the pharmacy. What genius(s) came up with these programs? Maybe you should punch that one (those) in the face(s)...

Other complaints I have heard that are not being addressed by The Suits:

* Unfairness in holiday scheduling.

* The Suits use their blogs to blow smoke up the employees' asses and don't ever directly address ANY issue.

* The store brand Big Flats beer is terrible (watch YouTube reviews and Stephen Colbert's Tip of the Hat/Wag of the Finger segment that starts out talking about British Superman)...Hopefully the wine won't be as bad...

* All employees are treated like thieves under prison guard while at work.

* Having staff meetings when there is not enough staff to bother having a meeting.

* Floater pharmacists feel like they are treated like refugees/thieves/terrorists in every store they work at.

* Super low employee morale.

* Any questions to pharmacy supervisors are met with a standardized "yes man" corporate response.

* Assistant managers are treated like overpaid stock boys.

* Most stores don't have the hours to keep a cosmetician on duty, which is the highest and usually most expensive theft area.

* Under no circumstances is overtime pay okay in any department, even if you are left with only an assistant manager to play cashier.

* Not enough employee hours to properly train new employees in any department.

* Too many/too high performance goals for all departments working with a skeleton crew.

* The inability to meet the needs of all patients/customers due to all aforementioned factors.

* A deep sense of failure at not being able to meet every patient/customer need like they could in the old days.

* Complaints of record profit, execs taking huge salaries/bonuses, but employee retirement match considered too low compared to exec perks.

* Now touted as a "family of healthcare companies" but employees get the shaft when it comes to their healthcare plans and complaints that deductibles/copays are way too high for a healthcare company to justify.

The Suits may not be listening but the bloggers are. I hear others in your situations say "Be happy you have a job in this economy" but the truth is that you could hire on at a direct competitor that may or may not give you the satisfaction you are looking for. There are other job options in retail and non-retail for everyone. All you have to do is look around to see what is available and what you are qualified for. You must choose your path in this life and know that I admire each and every one of you that works like a chicken with it's head cut off because you are the backbone of the corporate machine, whether they appreciate all you do or not.

I am sure that Chuck Sr. is rolling in his grave. McDruggie's used to be a company about the people. I leave you all in the hopes that your corporate paymasters realize what a grave mistake they have made and make a 180 degree turn and come back to the roots of what this corporation stood for: the people!

Tuesday, February 8, 2011

Pray For Me

I worked at a 24 hour store in a poor neighborhood and was saddened by the lack of personal care. I had a girl call in because she got Suprax for gonorrhea but last time when she had trichomoniasis (a bacterial infection not to be confused with trichinosis which is a parisitic worm usually contracted from eating undercooked pork) she got Cipro. She wondered why the doctor didn't give her the same antibiotic as last time. She wondered why her boyfriend was given Flagyl when she had trich but was not given anything for gonorrhea. She wondered if Suprax would also kill chlamydia. She was happy for the information I gave her but seemed unbothered that this was neither her first nor second bout of venereal disease.

Which made me wonder why she was unbothered by a repeat of festering stinky baby gutter when there are are things far worse than chlamydia that can go symptomless for months or years before you even know there is a problem. Things like human papilloma virus (HPV) that can lead to genital warts, polyps, and cancer. Things like herpes that can infect the eyes, genitals, mouth, and cause blindness to babies during pregnancy (if untreated and in a small percentage of those being treated). Things like human immunodeficiency virus that leave you susceptible to several types of cancer, bacterial infection, fungal infection, viral infection, and horrible side effects from the medications that try to treat it, not to mention how much harder it is to treat the longer it has had to replicate in the body unchecked.

I had another guy who came in for a VD antibiotic and he seemed a bit more concerned and said "I am a nurse, I should know better than this but stuff happens." I chatted with him for a long time and somewhere along the lines church was mentioned so he asked me to pray for him. I don't think prayer is going to clear up your infection otherwise I know a whole bunch of AIDS patients who should be cured but alas religion has failed and chemical science has only fared a smidge better.

The point of all this is: Beyond saving you an embarrassing trip to the doc and the pharmacy for venereal disease, because yes I laugh at each and every unfortunate motherf*cker that comes in for venereal disease after they have left the pharmacy, condoms will save you from most of the horrible and currently impossible to cure sexually transmitted diseases. USE CONDOMS!!!! You can even get them for free from Planned Parenthood and other sexual awareness promoters.

Thursday, January 20, 2011

Take It To The Limit

This song parody is dedicated to all the disgusting filthy meth addicts that come into the pharmacies of Missouri in all states of f*cked up trying to buy sudafed containing products but get blocked by the state wide monitoring system. Hopefully the state legislature makes all sudafed containing products prescription only soon! I would much rather go out of my way to get a prescription than watch methamphetamine destroy thousands of lives.

Sing to "Take It To The Limit" by the Eagles

All alone at the end of the evening
Any my meth high crash is leaving me blue
I was thinking about another
Methamphetamine high, but I was out

You know i really need a picture ID
(Still getting the run around)
So I'll steal identities
(Need more ephedrine)
But meth is all I need
Keep on turning out and burning out
And turning out the same

So put me on a highway
And find a drugstore
And take it to the limit one more time

You can sell meth to make easy money
You can take meth to be high all the time
If it all fell to pieces tomorrow
Would I do jail time?

And when you're looking for Sudafed
(Pharmacists don't care)
And you can't buy no more
(Can't buy it anywhere)
When there's nothing to get high on
Still you're coming back, you're running back
You're coming back for more

So put me on a highway
And find a drugstore
And take it to the limit one more time

Take it to the limit
Take it to the limit
Take it to the limit
One more time

Take it to the limit
Take it to the limit
Take it to the limit
One more time

Take it to the limit
Take it to the limit
Take it to the limit
One more time

Tuesday, January 18, 2011

What Melts My Cheese

You know what melts my cheese? Patients that bitch and moan about the wait times at the emergency rooms and circumvent that by going to the quickie clinic at the pharmacy to get a prescription. Yet here I am seven days later returning that clinic prescription back to stock because you "were gonna die without it" so I just want to know: Did you die? No? Then why the f*ck did you even bother to go to the clinic?! Why the f*ck did you waste the practitioner's time? Why the f*ck did you waste the pharmacy staffs time? Why the f*ck didn't you take the medication that was going to keep you from "dying"? Why the f*ck didn't you get the prescription because it was covered at a super duper reasonable copay of $10?

It gets better. It wasn't just one patient that I returned a clinic prescription to stock, it was seventeen different patients. Some of them with multiple prescriptions. Only one patient's prescription wasn't covered on insurance. You got to be f*cking kidding me! This is why many people just don't deserve health insurance while the ones who sorely need it and would pick up and take their medications can't afford it. Stupid f*cking American medical sytem! Stupid f*cking ungrateful/irresponsible people! That doesn't just melt my cheese, it smoked the shit out of it!

Sunday, January 16, 2011

Extremely Limited Offer

I was flipping through the sale ads in the Sunday paper and stopped because I thought I was hallucinating. My favorite blood glucose meter is on sale. Yep S-A-L-E! Normally this glucometer is $74.99 but today (1/16/11) through Saturday (1/22/11) Walgreen's has it for a mere $9.99. Yep, you read right, $9.99. That my friends is a recession busting price if I ever saw one.

So if you are a tech savvy diabetic, know a tech savvy diabetic, or are the tech savvy caretaker of a diabetic I urge you to get this machine! For those who didn't read the original post about it the Contour glucometer is a USB device so you not only test your blood sugar but when you plug it in to your computer it uploads all of your readings with date, time, whether it was fasting/after meal/etc. and you can make a graph or chart to better visualize what your blood sugar is doing. It also gives you the option of emailing your results log to your physician or you can print it out for own personal perusal. It is also smaller than a cell phone so it is convenient to take with you.

I highly recommend you call your insurance provider now and see if they will cover the test strips with a doctor's/nurse practitioner's/physician assistant's prescription and buy this machine. I am not diabetic but I am buying one for myself because type 2 diabetes runs in the family and it is nice to check my fasting blood glucose periodically so I know if I am hitting close to diabetic levels or if I am A-ok plus I love anything I can plug into my computer.

**Disclaimer** I do not get ANY kickbacks, payments, etc for pimping this meter. It is just my personal favorite and it is damn cheap for a short period of time so "Get it while it's hot!"

Friday, January 14, 2011

Why States' Medicaid/Social Services Are Going Broke

1. EBT (food stamp) cards pay for junk food and sodas plus have a cash spending limit each month depending on what your level of benefits is.

2. For most patients Primary Care Physician = Emergency Room

3. Most patients have a complete lack of personal care/responsibility/hygiene

4. If meds are "free" why change eating habits and exercise?

5. Why stop smoking if inhalers are "free"?

6. Multiple patients with repeat trips to clinics/ERs for venereal disease treatment.

7. New baby = more benefits

8. Have a heart attack/stroke/other coronary event? The hospital will fix you up and give you meds for "free"!

9. Wreck your kidneys with poor self-care or drug abuse? Dialysis is "free" and so is the transport to and from the dialysis center.

10. Don't have a car? An ambulance ride is "free"!

11. Don't want to take responsibility for your kids or interact with them in any meaningful way? Psych meds and ADHD meds are "Free"! As an added bonus you and your new baby daddy can use these medical grade amphetamines to get high and sell some on the side for extra spending cash.

12. Want to be a 350 pound slob that smokes pot and eats Cheetos all day? Have a baby of unknown parentage and everything you need is "free"! (none of the states drug test for eligibility, all you have to do is say no one in your household is on illegal drugs)

13. Want to piss your pants and put on a crazy show for a social worker? Just do it and everything is "free"!

14. Have your daughter or granddaughter get pregnant from unknown parentage then call social services and tell them she is an unfit mother and that you will foster the child to keep it with the family and the state will give you over $100,000 in monetary compensation to "foster" the child income tax free plus you get food stamps and healthcare all free! (actual amount varies by state but it is is pretty close to a six figure tax free income in every state and it works with any foster not just one of blood relation)

15. Somebody turns you in for claiming two kids and no man living in your 3 bedroom state paid for apartment? Have your man crash at someone else's house for a few days and get both kids for a couple days to cover the case worker visit and lie lie lie about how you have no idea why someone would turn you in because you are the greatest mother on the planet!

16. Get a prescription for 100 count boxes of diabetic test strips and resell them on e-bay/craigslist/some other sale site or try to return them to a store that sells them without a receipt with some stupid story about how these aren't the right ones for your machine to get cash back.

17. Wanna get high? Go to the ER with a "hurt back", "pulled muscle", "other random terrible pain" and get a handful of narcotic pain pills. It's all "free"! Added bonus: this may be repeated multiple times at multiple ERs before the ER docs or pharmacy figure out your game and stop giving you narcotics.

18. When that trick stops working find a shady pain management clinic and claim you have "sciatica" so you can get an assload of oxycodone/morphine/hydromorphone for your pleasure and resale.

19. Don't want to pay for Tylenol or Motrin OTC products? Go to the ER and get a prescription because that way it is "free" at the pharmacy. Added bonus: Some states allow the billing of OTC items like toothpaste, diapers, baby wipes, shampoo, soap, deodorant, etc. at the pharmacy on your prescription card so you can get those items for free and resell them later depending on your level of benefits.

All of these examples are based on actual things I have witnessed in the grocery store and things I have heard people talking about at the grocery store, pharmacy, Wal-Mart, and Target while shopping.

Example 15 is a person I know that has been turned in to social services for fraud on 4, count em 4 separate occasions and each time she gets the kids, has the boyfriend stay at his mom' s for a few days, and schmoozes the case worker. She is always let off the hook and had the balls to tell one of her children she couldn't get married until he turned 18. What a cunt!

Example 14 is a lady that fosters 3 to 4 kids (no blood relation) at a time and uses the money from the foster program to buy and rent Section 8 housing. (Section 8 housing is welfare housing paid for by the state) I probably don't have to mention that all of the kids she fosters are on serious ADHD and antipsychotic meds. Turning her in to social services also yields no results.

One of the ER pain pill junkies was mentioned in a previous post about Ultram (tramadol) addiction.

These are just a few small examples of the atrocities that entitlement programs breed...and they do breed... This has not touched on fraud by unscrupulous medical offices, medical supply firms, etc. that also cost an assload of taxpayer dollars. These entitlement programs also breed stupidity because the kids only have to go to school one out of every 9 or 10 days depending on the state and I guarantee most of them only show up every 9 or 10 days. With "No Child Left Behind" policies this means that a lot of kids are being pushed through the system and are doomed to graduate high school (if they make it that far) and not be able to read beyond a fifth grade level. We as a society are doomed unless entitlement programs get military strict and stop paying for unnecessary bullshit like junk food and ER visits for Tylenol and Motrin prescriptions.

Friday, January 7, 2011

Breaking Up Is Hard To Do

This was passed along to me from a coworker of Anonymous who has left retail pharmacy for a better paying, less stressful life. Anonymous, I salute you! It would have been a 21 gun salute but we aren't allowed to carry weapons at work or even have them in our lockers.

Things I Won't Miss by Anonymous

*People walking up to the counter and shouting hello as though they've been waiting forever even though they JUST walked up to the counter and have barely been there for more than 12 nanoseconds.

*Running around like a crazy person from station to station because either (a) there's no one here or (b) because the people that are here are slow.

*The phone. Oh that f*cking phone.

*The customers. Should I name drop because I really f*cking want to.

*The words "I need a refill." or "I don't have the bottle." or "It says I have four refills until July 2011."

*Customers coming up to the CLOSED drop off window and completely ignoring and sometimes pushing aside the HUGE red sign that says "Proceed to Pickup Window" and then looking at me like I'm crazy when I tell them it's closed.

*Dirty prescriptions that seem as though they've been raped and shat on by homeless people. Is it so difficult to keep that piece of paper from becoming a victim of sodomy?

*The f*cking phone.

*Working the drop off window and having to deal with questions like "Where's the ice?", "Do you sell toenail clippers?" "Where are the pencils?", "I'm looking for lotion?". Not a f*cking customer service window and I obviously don't work the f*cking floor so how the f*ck would I know where icy toenail lotion pencils would be?

*This dusty ass allergen trap called a pharmacy. This is the health industry?

*Scrubs. Actually won't miss those because I never put those sleep bags on. And I was also under the impression that wearing pajamas to work was against the dress code.

*The drive thru. Everything about it. Every. Single. Thing. Deserves its own separate list.

*People that smell like bathrooms. People that smell like four month old sweaty cheese. People that smell like they've never heard of showers. People that smell like dead kittens soaked in vodka stuffed in a moldy barrel inside the asshole of the Loch Ness Monster.

*That f*cking drive thru bell and that fucking drive thru buzzer. And I realize I said that the drive thru deserves its own list which is totally true but when the hell am I ever gonna write that list?

*People that drive up with their f*cking arms/canes/tree branches/artificial limbs hanging out of the window so that they can press that damned button before they even park their fucking cars.

*Speaking of cars, if you come through the drive thru and your f*cking car door/window/trunk/sunroof does not open and the only way you can communicate is by getting out of your car then why the f*ck didn't you just come inside?

*People that don't hand you the money or toss the money or put the money on the counter five f*cking feet from where I am (I'm over here at THIS register, you f*cking douche)

*Some of those f*cking slow as shit nurses. It doesn't matter which one. I've offended them all just by saying this.

*People that ask "How are you?" Like you f*cking care.

*Broken printers/scales/computers/people. Yeah this can happen anywhere but I won't miss it happening here.

*Old people who call in prescriptions because they are afraid of technology then take up most of whatever is left of their life reading you one prescription number off the bottle. That is IF they can read it. "Oh wait, I'm sorry baby, that was a six." AAAARRRRGGGGHHHH!!!!

*People telling me how I should do my job. "You guys would be a lot faster if you did this." "It would be easier for the customer if you did that." Well, I don't come to your house and tell you how to beat your kids, watch TV, make meth and be a worthless asshole so stop telling me how to do my job.

*Old people in general. Just because you're old doesn't mean you can walk all over me like something that old people walk on. Orthopedic shoes perhaps? Eh, whatever. Old people blow with a few exceptions (you know who you are).

*People who live on their f*cking cell phones and refuse to get off them even in the midst of physical interactions with people standing right in front of them. "Sir, I realize that Rochelle shouldn't have done that to Kenny and that you need to get to the grocery store before they run out of peaches which by the way I really don't see happening but I need your address."

*The approach. You're at the counter, you're at the window, even drive thru and you see someone approaching and you pray to God they are not coming to bother you. But they always are.

*The question "Can I pay for this stuff back here?" even though you've already emptied your one hundred plus items on the counter.

*Questions. I hate questions now. They say there are no dumb ones but I can without a shadow of a doubt tell you that there are. "What should I do about dry lips?" Really??

*Those severely f*cked up names that not even Dan Brown himself could decipher. And I'm the one that gets crazy looks when I can't say them. "And what is....uhm...Kuh-taw-buh-tee-air-eesh-ma-jah's birthday?" "It's pronounced Elizabeth!"

*Smart counts. I will not miss those and they will not miss me because I think they are assholes and they think I'm black. Telxons are some racist sons of b*tches.

*Screaming and crying banshee children that only know how to cough and sneeze on every open surface and annoy the shit out of me. Yeah, this place makes me want to cry too but do you see me acting like that?

*Pharmacists with big heads. Usually the fresh out of school pill jockeys who think they're better than the people to their left. Get off your fucking high horse and ring out that lady's pantyhose.

*People who pull money out of their bras/shoes/underwear/rectums and then expect me to handle it, F*ck no! Go learn what the f*ck hygiene means and make it you life's purpose.

*Medicaid patients who complain about having to pay 50 cents to two bucks for their prescriptions but will pay any amount of money for a cheeseburger or a candy bar or whatever other f*cking pointless thing they don't need.

*When I tell you that something will be ready, for instance, after 4. Don't ask me when it's going to be ready and don't try to argue with me about the time I gave you either. "Does it mean 4:15, 4:30, 4:45???" Shut the f*ck up you dumb motherf*cker because I just told you that it will be after four so I don't give two f*cks about what time after 4 you come because it will either be done or it won't be which is another thing I couldn't give two f*cks about so go f*ck your f*cking self, bitch.

*It says Drop Off Window not Consultation Window, so why the f*ck are you in my face asking me what you should put on your rash?

*Benzonatate. A minor gripe but I will not miss your roly poly ass.

*Lazy motherf*ckers. You know who you are.

*Awesome motherf*ckers. You know who you are.

*In between motherf*ckers. Well, actually, you can only fall into one of the two groups above so, yeah, you know who you are.

*Wal-Act junkies. Vicodin junkies. Morphine junkies. Insulin junkies (those exist, right?). Junkies of all shapes and sizes.

Things are coming to a close around here so I leave you with these wise words of one Oliver Humperdinck, renowned author and indoor trumpeteer. "If any man hath his hands, he beateth with them slow time around the bolly bop tree when the weather is green and cheese is in bloom."

Powerful stuff.

Peace, bitches.

Wednesday, January 5, 2011

Open Letter To The FDA

I have noticed over the past several years that there is an increasing frequency of patients wanting refills for Ultram (tramadol) pain pills early. I am concerned that it is the new drug of choice for addiction because it relieves pain, makes you feel good, and is readily obtainable from practically any prescriber.

An extreme case I had was a lady who goes to a different emergency room every 3 or four days to get a prescription for Ultram. It is usually written with a muscle relaxer and naproxen. She always only fills the Ultram. On this particular evening her newest emergency prescription was one day too early for insurance to cover it. It is out policy to never fill pain pills early if the insurance company denies the claim. Our computer systems do not process next day insurance claims until after 3am. She sat in the pharmacy with 3 young children, one in diapers for 3 hours before the youngest kept screaming and fussing because it was way past bedtime for young children. She finally left the pharmacy at 12am with her children when she had planned to stay until she could get her pills as soon as possible because she was getting fidgety and cranky.

Please re-evaluate Ultram for its potential for abuse and addiction. At the least give it a Schedule V so we can try to prevent some of this personal and child abuse.

Thank you for your attention to this matter.

Big N Tasty RPh

Tuesday, January 4, 2011

One to One

I had a patient call concerned because she was having the "I'm gonna pass out" light headed feeling as she stands up from a sitting position. I asked her if she was on blood pressure medication and if she had any other changes recently. She was on Norvasc and had lost 60 pounds over the last few months. Bingo! We have a winner!

There is a lack of awareness for patients that significant weight loss will make major decreases in your blood pressure. This is especially important to know if you are on a blood pressure medication. As your weight and blood pressure goes down you will need to communicate with your physician and monitor your blood pressure. When blood pressure goes too low there can be complications far worse than falling down or passing out when standing up from a sitting position. Imagine if this happened while you were working with dangerous machinery or driving a 2000lb death machine, I mean automobile. Imagine if it dropped so low that you died from a chamber of the heart collapsing or got brain damage from lack of blood oxygenating the brain....crap, gonna get hate mail for that alarmist comment...

Reliable studies over several years have proven one significant finding in weight loss:

1kg = 1mmHg

For every 1 kilogram (2.2 pounds) of weight lost your blood pressure will drop approximately 1mmHg or one point on your reading. This correlation means that patients can see measurable results with only a 10 pound weight loss. As weight and blood pressure drop your blood pressure medications will need to be adjusted. Patients on multiple drug therapy can be dropped to single drug therapy and patients on single drug therapy can have their dose reduced. With enough weight loss and a good weight maintenance lifestyle change most patients can be MEDICATION FREE!

The added bonus: with significant weight loss in Type 2 diabetics we also see less insulin resistance and better beta cell function, which allows them to get off insulin and reduce their other medications and in many patients the same MEDICATION FREE status is achievable!

Another added bonus: with significant weight loss and better eating habits the same reductions can be seen in LDL and triglycerides with increases in HDL (the good cholesterol) and the same MEDICATION FREE status can be achieved by most cholesterol patients!

Long gone will be the days of patients bitching and moaning about taking multiple drugs and spending a lot on ever-climbing copays! Oh wait, reality check, this America... The land of high fructose corn syrup, ever present salty & sugary snacks, and a drive thru eatery on every other street corner! Optimism, I lay thee to rest. Say high to Jesus and Budda for me! I hear they throw great parties, I mean seriously, water into wine...How awesome is that?!

Please let your patients know the wonderful benefits of weight loss and healthy eating. Please let them know how to properly monitor their blood pressure at home at least on a weekly basis with any dietary and workout combo so they know to contact you when they are probably going to need that medication change to prevent any complications. And please only use optimism for them because making those changes should be done slowly and permanently. Slow and steady always finishes the race!