Summer Fun

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

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

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

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

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

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

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

6. Sometimes windows do get broken by baseballs.

7. Homeowners insurance is great.

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

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

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

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

Why am I Still Here???

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

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

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

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

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

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

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

Sushi Paranoia

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

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

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

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

Fun in the Sun

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

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

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

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

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

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

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

Something To Try

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

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

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

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

Inner Workings Of My Brain

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

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

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

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

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

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

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

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

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

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

Edumacation

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

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

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

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

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