Spring Into Action!

Spring is in the air saying "Hey little plants it's time to make some chlorophyll and get cooking with your pretty petaled reproductive parts!"  Everyone is enjoying the allergy nightmare caused by this regrowth and going gung-ho on their annual household deep cleaning but there seems to be a great disconnect with spring cleaning and your health.  I have a new spring cleaning routine for you, your family members, your friends, your healthcare providers, and just everyone everywhere who needs to deep clean their health and medication routine!

Clear off a table and let's get started.

1. Line up all of your prescriptions, vitamins, herbal supplements, and topical treatments.

2. Get something to write on and something to write with.

3.  Make a chart with a few columns labeled: item name, what is it for, and how often do I use this

4. Fill in the chart for each item.

Anything you couldn't fill in under "what is it for" you either don't really need to be on it or you need to Google it and reconsider if you really need it. There are huge issues with overprescribing things a patient doesn't really need because the patient demanded it.  Did you tell your doc you wanted to try a specific drug?  Did you get the result you were expecting from the direct to consumer advert or web forum you heard about it from? No? Then you don't need it.  Talk to your doc about getting off of it.  Some medications have a weaning period to prevent a slew of unpleasant ill effects when they are stopped.

How many medications are you using for the same problem?  If you are on more than Two medications for any One problem it is time for some serious reevaluation as to why you are on a slew of meds for diabetes or mood disorders or blood pressure and heart problems or anything else.  Are you getting these meds from multiple prescribers?  If so you need to talk to all of them about simplifying your regimen and swapping your current meds.  The more meds you take the more likely you will have an issue with taking the wrong drug at the wrong time, forgetting to take them, taking too much, taking the wrong drug because they are similar in shape/size/color, risk of interactions with over the counter drugs/other prescription drugs/herbal supplements/food, etc.  Everything you take ends up in the blood stream where your circulatory system mixes and pushes it to all areas of your body like some chemical soup through millions of multi size crazy straws.  The more components to this live action gumbo could stew up some horrifiying problems and you do not want to be hospitalized by an attack of those Killer Tomatoes!  Simplicity and maximum efficacy are your best friends in the prescription kingdom!

Vitamin supplements are another stickler where people take a lot of things they really don't need.  Anything beyond a once daily multi-vitamin that your doc didn't find a deficiency in your blood work for is a waste of money.  Stop taking expensive supplements and eat better foods.  It's that simple and you get the added benefit of weight loss and not feeling tired all the time.  A lot of people who go on the gluten free diets are like "Oh I was fat and tired because I'm allergic to gluten."  Wrong!  Unless you are in the less than 1% of the world population with a specific inflammatory marker that reacts to gluten you lost weight because you stopped eating carb dense, preservative, fat, and sugar laden foods.

This is not an all inclusive list but it is a great start to a better life. Take action! Your health and well being should always be priority 1!



  

What Flame Broils My Patty

You know what flame broils my patty? This broken ass health care system that allows most prescription companies to give patients oral contraceptives for free but immediately life saving medications are prohibitively expensive.

Glucagon Emergency kits should be $0 copay because they immediately treat low blood sugar that can result in LOSS OF CONSCIOUSNESS, COMA, and DEATH.

Epipens and Auvi-Q should be $0 copay because they immediately treat severe allergic reactions that can lead to CLOSURE OF BREATHING AIRWAYS and DEATH.

Rescue inhalers such as Proair, Ventolin HFA, Proventil HFA, and Xopenex HFA should be $0 copay because they immediately treat asthma attacks which can lead to CLOSURE OF BREATHING AIRWAYS, HEART FAILURE via arrhythmia, and DEATH.

This $0 copay should be required for ALL discount programs including the $4 copay programs some retailers use to get people to buy a cart load of mediocre foreign produced bullshit they don't need, paid discount programs such as the one my corporate paymasters force us to offer, and those shady little drug discount cards people like to flaunt when their copays are high but the discount card is more expensive than their copays.

"Murica! We can prevent a baby for free but we're not gonna save your life without $$$.

Alaska has nothing on Congo

Just returned from a 13-month stay in Africa. I thought Alaska had flies.(!) my heart tells me to go back and help the children but getting held at gunpoint for drugs 7 times make the father think. now I have Obamacare to deal with. I should have become an airline pilot. Sorry, my wife still sick of hearing me rant.

Blame It On Obamacare

Oh yes, it's super easy to blame all your healthcare woes on Obamacare!  I'm not gonna let you do that in 2014 because there are certain truths that will always be:

Drug copays increase January 1
Deductibles reset January 1


I am going to preemptively set out a cheese plate in the waiting room so you have accompaniment for your whine.  Your copays go up every January and you are still gonna bitch and moan like a 5 year old that didn't get a balloon at the birthday party.  Well suck it up cupcake because I am gonna get all grinchy poo on your whiney ass when the first syllable of Obamacare bounces off your pathetic little lips.

Why would I not be sympathetic to your plight? You or your spouse chose that insurance plan. Like 99.9% of the nation you didn't read the fine print in the contract that says copays can increase periodically without notice.  You also went el cheapo on your monthly payment and chose the high deductible plan so your drugs will only be slightly discounted until you meet the $5000 deductible.  On top of that after meeting the deductible you will still have copays so don't give me that stupid doe eyed stare of disbelief when a copay pops up.

The formulary also changes periodically without notice (again it's in the fine print you didn't bother to read) so that ridiculously overpriced brand new super duper awesome drug will cost you $55 or more and heaven help you if you bring in a copay discount coupon that you didn't call the toll free number to activate!  I hate coupons and even worse the moron that does not activate it then throws a tantrum when it doesn't work!

Moral to the story: a verbal smackdown awaits anyone who blames the inevitable on Obamacare!

Shots!

Apologies for the long absence! I have been super busy completely gutting and remodeling the short sale property I purchased to stay in until the day I die. I have also been under the spell of Candy Crush saga and the easy randomness of Twitter... To make up for this terrible slight I gift you with a seasonal song of my retail pharmacy people. 

Sing to "Shots" by LMFAO


If you not immunized ladies and gents
Get ready to get pricked up
Let's stab it, Haha
LMFAO

You know what
Providers
Yeah
All the pharmacists
Where you at
Let's go

When I walk in the store
All eyes on me
I'm with the pharmacy crew
Get shots from me
We got Fluvirin
We got Fluzone
We came to immunize
Everybody it's on

Shots shots shots shots shots shots
Shots shots shots shots shots
Shots shots shots shots shots shots

Everybody

Shots shots shots shots shots shots
Shots shots shots shots shots
Shots shots shots shots shots shots

Everybody

The patients love us
When we give shots
They need it now
So we have lots
I came to give shots
How 'bout you
Needles up
Let's go round two

Shots shots shots shots shots shots
Shots shots shots shots shots
Shots shots shots shots shots shots

Everybody

Shots shots shots shots shots shots
Shots shots shots shots shots
Shots shots shots shots shots shots

Everybody

If you ain't immunized get the frak in the store
If you got your copay get the frak in the store
If you need some drugs get the frak in the store
Now where my pharmacists let me see you glove up

What you shootin in?
Zostavax
Pneumovax
Recombivax
Gardasil
Boostrix
Menactra
Needled all that shit
Get me some in

Drugs in hot and I'm ready to give shots
Supervisor happy every time I give shots
So needles in the air pharmacists let's give shots
If you giving shots put your hands in the air
Now say I'm immunizing (I'm immunizing)
I'm immunizing (I'm immunizing)
I'm immunizing (I'm immunizing)
I'm immunizing (I'm immunizing)

Shots

Fluzone in the fridge and I'm ready to give shots
Patients come in here every time I'm giving shots
It's a quick turn around every time I give shots
Flu scare in the air pharmacists let's give shots

I needled up

La dad a da
La dad a dad a da
La dad a da
La dad a dad a da
La dad a da
La dad a dad a da
La dad a da
La dad a dad a da
La dad a da
La dad a dad a da
La dad a da
La dad a dad a da
La dad a da
La dad a dad a da
La dad a da
La dad a dad a da

Gummy Tummy

A morbidly obese middle age male came to the pharmacy to get an rx for Reglan.  He was telling me about how he had problems with his stomach emptying but his physician was sure the issue could be fixed with bariatric surgery. He then complained that one lady at the office told him he wouldn't have to follow any diet plan then a different lady told him he would have to follow a diet plan.  He also complained that the surgery needed to happen soon because he was losing health insurance coverage at the end of the year.  He purchased five boxes of $1 movie theater candy (Mike & Ikes, Gummy Lifesavers, etc) with his rx.

So I'm thinking to myself "Self, in what world does waxy, gooey candy help with stomach motility?  What a whiney dumbass.  I know when I open my mouth to tell him about the woes of gummy candy and surgical complications he's gonna look at me with stinkface."

Anything I tried to tell him about diet restrictions with his surgery were just plain wrong. What would a pharmacist know about post-surgical care?   This patient is gonna have complications after surgery and eventually will gain back any weight lost in the first few months.

One of the main criteria for bariatric surgery is that the patient is "Committed to lifelong healthy eating and physical activity, medical follow up, and the need to take extra vitamins and minerals." (from Medline Plus website)

Fail #1  Not gonna follow a diet

Fail #2  Not gonna do physical activity

Fail#3  Not gonna follow up due to loss of insurance

Fail #4  Not gonna take extra vitamins/minerals when he won't take a multi-vite anyway

Fail Fail Fail Fail Fail Fail Fail Fail Fail Fail Fail Fail Fail

Um Houston, We Have Problem!

Our world is full of amazing and wondrous things that like to hijack our cells and reproduce themselves.  They also have the ability to mutate rapidly in response to outside threats and maintain their stealthy lives.  These things are viruses.

My concern is with the H1N1 virus.  It has been prominent in the news for a few years now and since 2008 a small amount of cases have popped up that are the A(H1N1) pdm09 virus with H2754 neuraminidase substitution.  So you are like "What does this mean for me?"  For all of us this particular little beastie is immune to the effects of Tamiflu (oseltamivir) which has been the preferred first line treatment for the past few years.  There was a point in time where every child that went to the ER got tamiflu and amoxicillin which I find completely ridiculous.  Test for it don't guess and just prescribe shit and pat yourself on the back to feel like you treated the patient.  Antibiotic over prescribing is just as big a problem for bacterial resistance and also perpetuates the populace myth that antibiotics treat the common cold.

If this strain becomes prominent and resistant to all of the currently available antivirals we will run out of viable treatments and have to rely on vaccination as the only means of defense.  I pose the question "Will we ever reach a point in time where vaccination is no longer a viable preventative for H1N1?"  Can a virus mutate enough that our immune system cannot make a viable weapon out of its vaccine formulation to protect us? I probably need to consult with the CDC for that answer because if anyone would know it would be them.

The future could hold a worldwide population decline greater than when Bubonic plague wiped out most of Europe.  Could this be the tipping point for humanity?  Sweet dreams!