Saturday, November 29, 2008

I battled the Beast... and won!

It was a lovely evening one week ago, was being the keyword, as the my fiance and I were relaxing on the couch enjoying a movie. Suddenly, out of the bedroom and through the kitchen, came the soaring beast. With fangs drawn and red eyes glowing it swooped down into living room in which we were sitting. Making a hasty exit, I shortly thereafter peeked my head back in the living room to track the beast. The little bastard made a kamikaze move and dove into my leg, probably attempting to bite its target. I jumped back and left the room once again.

And then the beast was gone, nowhere to be seen despite seeking the beast for many a hour. It was then decided that it must have left from which it came and we went to bed for the night.

Three nights later, this time watching a movie in the bedroom, a fluttering was noticed in the kitchen. The beast was back. This time more prepared, I dressed in my gear and prepared for battle. Sketcher boots, jeans, hoodie, leather globes, LED flashlight, towel... I was set to destroy the beast. Venturing out into the kitchen, the beast was nowhere to be seen. I thorough search was conducted, but the beast had escaped once again. This attack by the beast meant only one other option... war.

Backup was brought it in with far more weapons: a corn broom, a plastic broom, ladder, moth balls, heavy duty flashlight and the most powerful weapon of them all, a pellet gun. The backup kept a vigilant eye out for the beast all day while I was at work, but to no avail. Upon arriving home I too kept a look at but saw nothing. The beast had continued to elude us.

After now six days it was decided the beast must be dead. The only possible entry/exit had been plugged and there was little source for food. Life could continue on as it had been. Or so we thought.

Again, while enjoying the seasonal classic "The Nightmare Before Christmas" the beast appeared from the bedroom and swooped down into the kitchen. Immediate action was taken with my fiance heading for a safer position as I grabbed my gear. I found the beast perched on the floor directly in front of my dresser and covered it with the towel. The beast used the strength of a thousand men and worked its way free before I could capture him. This time I was able to track the beast, right to the corner of the window in our bedroom.

Distance and position of the bat inhibited the use of the pellet gun. Damn! I decided I shall use the next most powerful weapon, the deadly corn broom, to knock the little bastard off his perch. The beast took off in a flurry heading directly into our living room once again. Again it took a stand on the floor, this time directly in front of the closet. I shot the towel at again, once again trapping it beneath it. This time I would employ the most legendary of battle gear, a bathroom trash can, to capture it. Alas as I went to place the gear over the beast it had escaped again! It had crawled into the closet to disappear behind the boxes and other various items. After searching valiantly I dejectedly called it a night. The beast had outsmarted me again. Or so I had thought.

While laying in bed I heard a thud at the door. The beast was trying to mount a counteract in my own room! Quickly the battle gear was reapplied and readied. Peering out into the kitchen, the beast made a diving move for the bedroom, but I managed to block its path. I declared that the beast must now die, there is no time left for humanity.

Stealthily, I worked my way into a dark corner in the living room to await its reappearance. After some time I heard a squeaking coming from a few feet away from me and the beast appeared. It crawled to a point barely a foot in front of me and raised its red, glowing eyes to me. With the reflex of a ninja, the broom came swooping down on the beast, finally killing it. The War was over and I was victorious. Tonight I could finally enjoy the peace which I sought for the last week.

Note: I really wasn't as heroic as this sounds as bats scare the living shit out of me. I jumped and ran nearly as much as I stalked the damn thing. Actually I think my fiance was the tougher one of the two of us, so I guess I am a wimp. I hadn't intended on killing it, but after humanely trying to remove it, and out of sheer frustration, I did what I did. I am just happy we can now sleep in peace. And there may have been some slight exaggerations about the beast...

Friday, November 28, 2008

Why so serious?

I take a bit of pride in how I treat customers, and people in general, on a daily basis. At some point someone explained to me that often that we are often the only interaction a patient will have during the course of a day. Due to that, it’s a good idea to be pleasant and thoughtful when you are speaking with a person. Most of the other people I work with, well those who actually have a personality, have a difficult time to grasp this. I make it a point to ask a patient how they’re doing at least a half dozen times a day. Not only do some of the patients really enjoy it, it also develops a relationship with them so when there is an actual problem they can be far more understanding.

After a while this kind of progressed over into my daily life. I don’t care who you are, I’ll always smile and say hi to you when you’re in the store. You can be just picking up Tylenol or perhaps be in a wheel chair or maybe have suffered a stroke and are unable to talk and I’ll treat you the same as anyone else. I do this for everyone except for the asshole patients. I allot that people have bad days so I don’t hold it against them if one day they are snippy and they usually apologize at a future date to make up for it.

What I find fascinating, though, is the reaction of people in public. If you want to try an interesting experiment go to a mall and say hi to a little old woman as you’re walking buy. I guarantee she’ll grab her purse and run to the other side of the walk way. Just today I was at my fianc├ęs work and I said hi to a woman who was standing in an aisle and she just glared at me. How is it so impossible for someone to accept a hello or general politeness? I have never been able to fathom that and it makes you wonder what has happened to society as a whole that makes that the normal reaction?

I’m not going to stop saying hi or being polite to random strangers I meet because, in my mind, it’s just the thing to do. To show that there is some good in the world, despite what one sees on the television. Maybe that old adage ‘Nice Guys Finish Last’ really is true..

Tuesday, November 25, 2008

My Dream Job

I was trying to see how high I could stack hydrochlorothiazide last night, and you can stack those buggers pretty high, when I decided what my dream job would be. I want to name drugs and/or medical procedures. What was my inspiration? Golytely.

For those non-pharmacy geeks, Golytely (pronounced: Go-Lightly) is a liquid you drink prior to a colonoscopy to clean you out. The thing is, there's nothing lightly about it. It's more like a rocket ship which lasts for hours and hours. Such a sweet sounding name leads to an entire night spent on the Throne, praying to God that it all ends.

How fucking hard do you think the guy who thought that name up laughed? Seriously, I bet he pissed himself all over his corner office.

I've already have some ideas:

Gondola - It gives you images of a beautiful and serene journey along the canals of Venice. In reality I'm gonna shove a camera with a light up as your ass and take a look at your colon.

Paintbpee - Sounds like some kinda colorful kids artwork... ok kids don't paint with pee, but humor me. In reality it's a sulfa drug causing your urine to turn pretty colors. Always was jealous of that one

Loverocket - Every man's dream, to have a loveeeeeeeeeeeee rocket for his ladies. In reality, it's similar to muse and you get to shove a suppository (rocket shaped) up your urethra. Can you say sexy?

I mean I can think of this type of shit all day long. I think it's time to start a journal and maybe I'll send it to Abbott or Pfizer or something. Then perhaps my dream can come true!

Monday, November 24, 2008

Pharmacy Terms: Homeopathic

Today I had a woman who wanted a homeopathic version of Tylenol and was arguing with me over the fact that I told her they don't make a version of Tylenol that is homeopathic. After a little bit, I snapped and gave her the history of homeopathic medicine.

As I have mentioned previously homeopathic medicines are as effective as eating the box they come in. They are nothing more than placebos, with ingredients so diluted a Coke fiend couldn't snort anything fun out of it. So why do people believe so much in such a load of shit? Let's begin our history lesson...

Prior to the birth of modern Microbiology and antiseptic techniques, medical professionals often did more harm than good. During the Civil War, the death rate among injured officers was higher than the death rate among infantry men on the field of battle. How can that be you may ask? On the field, it was far less likely that a doctor would get to you.

This is a complete reversal from our thinking of today, but doctors in that day often killed their patients. There is evidence to suggest that part of the reason Abraham Lincoln died was due to the care given to him by his doctor. They would conduct exploratory surgeries, not only with out anesthesia, but without care to pathogens. One can not blame them for this as they did not know or fully understand how pathogens worked. They would bleed patients to cure their illnesses or given them 'medication' that was in fact far more harmful than the illness itself. Very often the patient would die simply from these procedures.

Now in walks the homeopathic doctor. Having little, or no, actual medical knowledge, the doctor would concoct various treatments for the condition being treated. Usually these were highly diluted concentrations of whatever the doctor could find. The strange thing is... this usually worked. Well it worked compared to being seen from by an actual doctor. No surgeries were done, no bodily fluids removed, no toxins were added. Thus the patient had a much higher survival rate.

So you see, the only reason homeopathic medicine 'worked' is because it was less dangerous than actual medical care of the time. Those old home remedy's that have been passed down which claim to be 'far better than any medical treatment' are only thought to be so because of this exact reason. Occasionally a remedy will actually be found to have a therapeutic effect, but usually it's just the placebo effect.

The next time someone tells you about a long lost homeopathic remedy which is better than any modern treatment, listen with high skepticism. Chances are it's nothing more than a big steaming pile of bullshit. And no one likes to eat bullshit... well accept maybe dung beetles.

Thursday, November 20, 2008

You Must Read This

I have been trying to find this thread on a message board for about six months now. I have the PDF file saved to my laptop, but I wanted to post this as a link for you guys to read at some point. Hands down one of the funniest things I have ever read in my life and it makes me want to work 3rd shift sweeping streets.

I thus present to you... The Street Sweeper Tales

Sunday, November 16, 2008

The Holy Grail

Over the past year or two I have noticed a trend with new employees to the company I work for. Before everyone, from tech to clerk, was a bit on the skittish side, always erring on being cautions at first. Honestly, with what we do, that's a good way to start because being a clerk in a pharmacy is not quite like being a clerk in a grocery store, nor is being a tech similar to being a stocker in that same store.

Now our new employees jump into everything all at once, with completely disregard to our system. It doesn't help my company doesn't really train anymore (they don't even go over HIPPA procedures), but you can only put so much blame on that. What should you do when a clerk ignores a large 'SEE ID' note on a drug seeker's bag? What should you do when a clerk doesn't always remember to have people sign for scripts? Sad thing is, we aren't allowed to do anything. Last time I tried to correct a clerk I was bitched at for 'under cutting the store manager'.

Tech's have become even worse. For some reason, these new people come in and think the Holy Grail is to process proscriptions. They'll count for one day and then I'll find them trying to run a refill or fill a new Rx. Even if I tell them not to, they'll still find they're way back there. I tell them, after working barely a month in the pharmacy, you don't have the immedate knowledge to jump into running scripts, but they don't listen.

I believe in scaring them a bit when they first come in to give them a proper understanding of their surroundings. My manager does not agree with such a method, but then again they make no effort to properly train and tutor people. So I took the ambitious tech under my wing for an hour to give him a feel for what things are like.

Script came in for Augmentin 875 tablets for an seven year old girl. He starts to fill it, but I stop him. He asks me why and I tell him there's no way a seven year old girl can swallow those sized tablets and that we should contact the doctor to get another script just in case. How would he know that and why do we need to get another script he asks. Well, for those of you who don't know, Augmentin tablets are rather large and after dispensing them for a while, you just know this. You also get another script handy because it's a seven year old girl, chances are she's going to be in a rather foul mood since she is sick and it is better to get her on her way home.

Prescription comes in for Hydroxyzine 25mg and he starts filling that one. I notice though that he had picked Hydralzine 25mg (this is one of my favorites). I point that out on him and he goes, eh it happens. I tell him, no it does not just happen and you just switched an antihistamine with a vasodilator which can kill the right patient. His eye's start to get a little wider.

Another prescription comes in for Amoxicillin 500mg that he starts filling for a woman in her mid 20s. He cruises through some of the warnings and starts filling it, but I stop him. I ask him if he looked at any of those warnings (I hate this part of our system) and he says no. I then asked if she happened to be on birth control, with her age it's highly likely, and he said he didn't know. I informed him the effects the drug can have on birth control and if he filled it like that it's possible he could have just brought an unplanned baby in the world. His eyes became even wider.

Is it cruel to go through something like this? Perhaps it is a little bit, but I really don't care. These new techs have cost of tons in money (kickin out a Lovenox script because you don't know how to clear the reject is real cool) and have endangered patients. Personally I'd like to go through steps like this with every new tech.

At least I know he won't mosey on over to that computer for a while now...

Something Fun

We'll give this a shot and see how it works. I personally like changing things up a little bit every once in a while. I'm the type of guy who has a different wallpaper and color scheme every month. I thought it would be fun to ask you guys on the next color scheme for the blog. Obviously the base will be black, but the rest of it is open to change. We'll go month by month for now and see how it turns out.

Poll is in the sidebar (along with another I created). Enjoy!

Saturday, November 15, 2008

The W Word

I made a fatal mistake the other night while explaining a situation to a patient. A mistake that I instantly regretted and, after eight years, should know now to say. I mentioned the dreaded W word to a patient. Let's set the story up a bit:

A guy comes in with a Rx for his girlfriend for Hydrocodone 10/500. We've filled four things for her in eight years, but I decided to give her insurance a shot anyway. Strangely enough it works, but it comes back with a reject of 'Refill Too Soon - Last Filled 11/10/08.' I relay this message to the man and he thanked me for his time and left. I thought that would be the extent of my excitement for the day.

About a half hour later I receive a call from a woman asking why I wouldn't fill her prescription. After a bit of thinking I figure out that this is the same woman who's script was too soon to fill. I tell her that when I ran it through her insurance and it came back saying she just had the same drug filled a few days ago at a different pharmacy. She replied that this didn't matter because it was a different prescription from a different doctor.

I know, I know, y'all are getting the flashing red lights in your head just like I did.

Anywho I explain to her that her insurance won't cover it, so she asks if she can pay cash for it. I tell her no as we have a moral obligation to regulate dispensation of medications for the patient and public's safety. She replies, "Well you have to fill it, it's an ORDER from the doctor." After explaining to her that a prescription is not 'an order' and we are not legally obligated to fill every script that is presented to us. "Well I'm going out of town," she states. "Isn't there away you can just fill it or get an insurance override?"

More red lights... and it was next that I stated the word which I avoid using the most out of any other word at work...

"Ma'am when your under insurance through Welfare, they do not allow any overrides"

Note: Part of the reason I used that dreaded word is how our insurances are named in our system. Medicaid is split up through several different processors and each billcode is named for that processor. One of them, what is called straight Medicaid, is called 'Welfare' in our system. Thus, had it said "Purple Dildo", I would have used that term instead of Welfare.

After hearing this she went ballistic, screaming at me that I just said I wouldn't fill her script because she was on welfare. Furthermore she stated she was going to sue my ass and bring the police down to the store to force me to fill it. She continued to scream obscenities at me (while I held the phone about three feet away from my ear) for another two minutes before she hung up.

I then made the obligatory call to my manager to inform her of the situation, just in case she would follow through with her threat, and informed her of my mistake which caused the situation.

I know better than that, but I really wasn't thinking about it in that terms when I stated it. It was funny for a while, but I started to feel like a dumbass for such a simple oversight. Oh well, it was the most interesting phone call I've gotten in weeks and it broke up a relatively slow day.

And George Carlin was wrong, there's not seven dirty words, there's eight. And now you know why.

Monday, November 10, 2008

I feel safe!

For those newer readers, or those who just stumbled upon this, the pharmacy I work at has been robbed a couple times since I've been there. Ya know, hostages, Oxy, police, all that jazz. I come into work today after having a three-day mini-vacation and see the following sign posted on our pharmacy door which faces the public:

Cute isn't it? I can already see future events...

Shit-For-Brains #1: Aight, let's go knock of this place and get us our shit
Shit-For-Brains #2: Damn straight, we makin a fuck-load of money tonight
*Both walk in the front door of the pharmacy*
SFB#1: You go around and take the side door while I cover the front
SFB#2: Fo sho...... ah shit man
SFB#1: What is it?
SFB#2: Look at this sign man. Did you know we could get 20 years in prison for doin' this?
SFB#1: No shit? I thought they'd just like tell you not to do it again.
SFB#2: Maybe we shouldn't do this then
SFB#1: You know what, you're right. And maybe we should stop doin' shit like this. Maybe go back to school and start going to church and stuff.
SFB#2: Yeah! That's a great idea! Good thing they put that sign on the door!
SFB#1: No kidding! Now let's ride our unicorns back to our homes and think about what we almost did.

And that is exactly what would happen if you were trippin' on acid when you put up that sign. Are you fucking kidding me? I'll be sure the next time we're robbed I'll point out that sign. Maybe they'll change their mind then.

Saturday, November 8, 2008

Late Night Drug Slingin'

Perhaps one of the coolest aspects of SiteMeter, whom monitors view counts, is seeing how and where people are reading from. I'm a number fiend, so I check it about once a day to see who has stumbled upon this craptacular blog.

One of the things I have noticed of late is a surge between midnight and 3am of viewings. And where are these viewers coming from? Kroger, HyVee, Walgreens and the likes. It looks as if our fellow late night brethern are bored and looking for something entertaining to read.

So to you late night drug slingers I say welcome, and I am glad to help keep you awake on your lonely nights. In fact, I shall give you a string of comics to break up the silence which may lie in your respective pharmacies...

Thursday, November 6, 2008

Paging Dr. Opie

I was going to take a week off posting due to an upcoming weekend trip and the fallout from this year's election. During my Micro lab today my professor mentioned something which completely floored me. One of the Medical Schools in our region recently adjusted their admissions requirements. Then now look like the following:

Aside from how short the list is, are there can courses that you see which are missing? How about Physics, Calc and Organic Chemistry? Yes, it says you can take those as additional courses, but they are no longer requirements.

Calc I can understand somewhat most aren't going to need to use that logic, but it's still good to be familiar with summations and limits. Physics, again, is somewhat understandable, but the properties which you learn can be immensely helpful when thinking of certain bodily functions.

And then we get to Organic Chemistry... for those of you who have no idea what this class is about, ask any science or medical major what they think of O Chem and everyone of them will shudder. As one of my biology professors so eloquently stated one day, "Organic Chemistry separates the men from the boys." By the time I finished the year long course at least 60% of my class had dropped or failed. It is your first experience at truly how difficult and all encompassing course work can be... you know, the kind you get in medical school. It is the most difficult course I have taken (it only beats Biochemistry because that was merely a semester) and it really causes you to rethink if you really want to continue on this path.

Even without that, the knowledge you gain in the class is far more useful than most of your other undergrad courses. It lays the groundwork for Biochemistry, Microbiology, Cell Biology and others. You may not remember how to change an aldehyde into an ester, but you'll understand the movement of protons in aerobic respiration.

It seems unfathomable that the college would choose to move to such standards. Granted the MCAT will still test on the previous requirements, but apparently the school is going to start pushing the MCAT folks to follow their ideals. Lord knows if that will work, but it's a scary thought.

I realize we have become a nation of somewhat lethargic people, but when I go to a clinic to have a doc look at something, I would like to know that he was top of his game. I want the best of the best treating me, same goes for pharmacists and all other professionals, and I don't want standards dumbed down. It can't be to increase enrollment as, from what I have gathered, there were a half million applications to medical schools across the nation. Granted, applicants apply to more than one, but it's still a large number of individuals.

What are your thoughts on this item? Would you feel comfortable going to a doctor in eight years knowing they were admitted on this practice?

Saturday, November 1, 2008

Maybe I'm Perverted

But has anyone noticed that Diltiazem capsules look like little penises? I really don't understand the color scheme of them because, in my mind, that's exactly what they end up looking like. I have way too much free time today. Oh well, time to go take a nap in the drug bays hehe

New Colors

Been monkeying with the XML for a while on the site to adjust the colors and I finally wrapped it up tonight. Will probably switch the colors every month or two and, if I can get the poll working, might have the readers design on the next one.

Having an issue with the category list which I hope to remedy soon. Otherwise I welcome any feedback.