While we bailout other businesses...

... why isn't our government taking a look at our healthcare system? I mean we all know it's seriously fucked. We all know that we as a nation could literally save billions of taxpayers dollars a year if some common sense was used.

Case in point, Albuterol CFC is almost officially dead (obit coming later this week) being replaced by it's step-brothers and sisters of the HFA family. The cost has gone from roughly $12 per CFC inhaler (that's prior to the shortage) to about $27 per HFA inhaler.

Now one would assume that medicaid would switch to paying for one of the albuterol HFA inhalers (either ProAir, Ventolin or Proventil). The most expensive of these is about $35 bucks or so. I mean, c'mon, that would be the logical thing to do right? So you know there is no way in hell they would do that. What do they pay for instead? Xopenex HFA.

They will pay for one of the most expensive inhalers out there instead of the cheapest.

The kicker? They have tried telling us that Xopenex and albuterol are the same things. Um...... no the fuck they are not. Advil and Motrin, that's the same thing. Vicodin and Lortab 5, that's the same thing. Xopenex and albuterol are NOT the same fucking thing. One is albuterol the other is levalbuterol. Sure they're in the same class and they do the same thing, but they are in no way the same medication. And then to tell me I can just switch it without the doc's ok? This little fuckin high school dropout running the phones, because ya know she's had oh so much schooling on medications, is trying to convince me I can do this. I finally hung up on the twat once I realized I wasn't going to get anywhere with her. And yes, I just used the word twat, sue me.

You have to wonder how many mindless techs she told this too who went ahead and did just what she suggested. That's downright scary. Luckily I had written her name down and was intending to report her until I heard similar stories from others whom had talked to other medicaid reps. Oh joy.

So while we give out billions do businesses who fucked themselves on their own, it's nice to know that our government is doing the same thing to themselves. Only problem is, who the hell is gonna bail them out?

Ridin' the Short Bus

I'm going to quiz those of you who travel to this spectacular, yes I'm ego-building, blog. I would like for you to look at the picture below and pick one of the options below. That is all, no strings attached.



You drive up to your local pharmacy and notice this sign on the drive thru window (ignore the glare). You then proceed to do which of the following:

A) Sit in front of the window for 15 minutes hoping someone will notice

B) Ring the bell and then sit in front of the window for 15 minutes

C) Ring the bell a minimum of a dozen times in under two minutes, then sit there for 15 minutes

D) Bang on the window with your fist, and then sit there for 15 minutes

E) Honk your horn, and then sit at the window for 15 minutes.

Got your answer? Good. Now post it in the comments section. Make sure you post your address too. Why you may ask? So I can drive to your house, knock on your door, and smack you upside of the head with a 2x4. You are with the other 18 dumbfucks that followed one of these options the other day. Darwinism does not apply to you. When your giggling to yourself and playing with your belly button on a daily basis I really hope your content with yourself.

Whew I feel better

My Yearly Christmas Warning

I designated myself as the person who must give the yearly Christmas warning that so many people are unaware of. I mentioned it in passing last year, but I shall reiterate my point again this year.

Santa is a pedophile.

Right now you're going, "He is so full of shit" or "What the fuck is he thinking?" or "Someone got into the Lortabs today...", but hear my argument out before you judge.

First off he is a strange old fat man who caters only to children. Go google images for pedophile, I betcha 89% of the pics that pop up fit that description. Then he wants you to hop up in his lap and whisper in his ear what it would take for them to be happy. And he does this in a mall nonetheless. Eleven other months of the year, parents would scream pedophile and run like hell away from him. Yet for that one month a year it is perfectly acceptable.

Now think of some of the songs about him.

"He sees you when you're sleeping." So the creepy old man who likes to have kids on his lap is watching said child while he sleeps? What, is he sitting in the closet with rubber gloves and some KY?

"He knows if you've been bad or good." Once again, the sick son of a bitch is stalking your kid. He's probably got a satellite dedicated just to track his 'favorites' to see if they've been 'bad or good'.

But that's not all. You must leave a plate of cookies and milk out for him. You might think that may be innocent, but there is more sinister motives here. He uses the cookies to lure the kids to him. Then he heats the milk, a la warm milk toddy, in order to get them to fall asleep so he can have his way with him. I mean the man likes to go up and down chimneys, what does that say about him.

And the elves... don't get me fuckin started on the elves. The only adults he is around are little people? C'mon! I mean all he's missing is Bobo the monkey and he'd be Michael-freakin'-Jackson.

The moral of the story is... watch out for this sick pervert. Keep your kids away from him and check for cameras. Only you can stop this travesty from happening year after year!

Feel like pimpin'

I try not to pimp other website as that would make me no better than the advertisers were are inundated with on a regular basis. Then again, I do love bein' a pimp.

In any case, I have belong to a website for several years that creates some of the most remarkable wallpapers I have found. It is just one guy who is lucky enough to be doing this for a living from his home. You can get a glimpse of his work in the free gallery in the link below. Perhaps the most attractive part of the place is that he listens to the comments of members and incorporates their thoughts into adjustments or entire new wallpapers.

If you work for a business with a forward facing computer terminal, I personally use his wallpapers as a slide show to entertain customers. I've actually had a few join the site after the fact.

In any case, I think it's something that should definitely be checked out.

Digital Blasphemy

I Gotz Skillz

I was training some fresh meat... er a new tech earlier today and I happened to mention the bad ass skills you inadvertently acquire throughout the years. They are not anything one would normally think about, but they are tricks which may impress your friends.

1) Letter folding. I can tri-fold any paper to fit in an envelope like nobody's business. I would kick so much ass at a letter folding company, they would fire every one else leaving only me.

2) Opening child proof bottles with one hand. I'm like fucking Houdini when it comes to this one. It will occasionally shock people when they see it done. Surprised clowns don't do this trick at birthday parties.

3) I can visually ID damn near any tablet/capsule. This may be pathetic, but I generally have a photographic memory of the look of meds. I can tell you that its Levothyroxine 112mcg Lannett brand without consulting Ident-a-drug or any manual.

4) I can spot a bullshitter/druggie from a mile away. This is really handy when meeting people for the first time, especially a friend's significant other.

Yes I know you're highly impressed, and I'm sure that there are more that I am forgetting at the moment. Now aren't you all jealous of my fiance?

I write too much

Just realized as I glanced at my blogger dashboard that I am nearing two hundred posts. Think about that, that is 200 rambling, bitching, nonsensical posts. I never thought this would last more than a dozen posts personally. Blogging, contrary to what some may believe, is not as easy as it seems. It is quite difficult to come up with an original posting as I have often partially written a post, only to realize I posted the same thing nine months back. I'll actually get ideas for posts while at work or in class and will jot down the ideas on some scrap paper for later. I'm sure my fiance wonders just what the hell some of these things are when she sees them floating around.

And writers block... it bites you in the ass every couple months. Plus you have to make the posts entertaining and relevant for the readers. I don't just spew off whatever I want here, I do my best to entertain and educate the readers. It seems to be paying off as in recent weeks the readership has more than doubled, go me.

This has also become a good place to blow off steam. I read an unofficial study a few weeks back that said those in pharmacy have one of, if not the highest, incidences of alcoholism. Lord knows I can understand why.

It's also been interesting to keep a bit of anonymity while writing this. Another reason this blog was created was to cut down on the e-mails of my adventures at work. Several people who come here know who I am, and several times I have had to edit comments so as not to reveal specifics about me. That part has been interesting as well. I actually just got around to adding my disclaimer to the site, oops.

I could bitch and moan about the system more. I could go into the politics behind the industry and how we readily get reamed up the ass. I save those for Jim and TAP and TAestP and Drug Monkey as they are more experienced and more eloquent than I am at the moment. I am merely a college student on a long and arduous ride which sometimes proves to be immensely interesting. Ironically enough some of us do communicate back and forth regarding certain posts and issues.

It is currently Saturday night. This is my break from studying vaccines and immune responses for one of my finals next week. Ironic to think that the place I created to blow off steam is where I now come to relax now.

Time to get off the soap box and get back to work... and eventually write two hundred more posts.

The Beast.... Continued

Apparently the bat story is giving the testicle story a run for the most popular post on the blog. Funny how that posts involving me looking like a jackass are the most popular, but I digress.

My mother sent the bat story to one of the larger radio stations in the region. Apparently they liked it so much they sent me a sizable gift certificate and supposedly read it on the air. The latter I am still waiting to get a copy of from the radio station.

In any case I did some math and discovered that hunting the back amounted to $6.25 an hour. The moral of the story is, stay in school. It doesn't pay to hunt bats.

Ball Buster

I needn't say anymore...

Jingle Jingle Jingle

Christmas is the season of giving, being kind to your fellow man, and feeling like shit whenever you're out shopping. What's with the latter you may be asking? Everywhere you go you hear the 'jingle jingle jingle' of the Salvation Army Collection bins. And every time you walk right past one you either get a look from the person ringing the bell or just generally feel like a doofus.

Now I have nothing against what they do, I think it's a great endeavor. The thing is I went to a few places after work and ran into four of those. I hardly ever have cash on me normally, yet alone enough to cover four donation bins. If I had the money, I would most certainly give it to them.

Instead you get looks from the other three. They remind me of the looks your parents would give you when you did something bad when you were younger. The, "I'm disappointed in you look" when all you really wanted was for them to scream at you. Ya know, that look.

Perhaps they should start handing out stickers when you donate each time so they'll at least know you're not a chump. Plus I'm a poor college student as it is, so it's not like I have cash flowin outta my ass.

Just a random musing at the end of a long day...

MRSA shall be defeated!

A few months ago the major public presses were going wild with a rise in MRSA infections. For those who don't remember, MRSA, methicillin-resistant staphylococcus aureus, is an infection which is resistant to most forms of treatment. There are several strains which have been isolated which are resistant to virtually all known forms of treatment. Essentially if are infected with MRSA, which usually happens in communal settings (mainly a hospital), chances are the docs may have a hell of a time getting rid of it.

It is a very serious problem which will only becoming worse over the coming years. Over prescribing of antibiotics and generally lack of understanding of bacteria has effectively left only the strongest of the strains remaining. Most of these are gram negative bacteria, which are even harder to fight due to their double membranes.

In recent years the mechanism behind resistance in bacteria has begun to be understood. There are several factors regarding it, the permeability of the outer membrane, side chains of the antibiotics, polarity, etc, but the big bad boy have been the efflux pumps. Efflux pumps remove antibiotics from the cell once they finally make their way in. Think of them like a bilge pump on a ship. Except that these pumps, in the most resistant strains, move EVERYTHING out. It's like the mother of all shop vacs in a cell. And it's a huge pain in the ass when trying to kill it.

There are several options on how to combat this, none of which are viable at the moment. You can increase the permeability of the bacteria (basically let the antibiotics in faster than they can be pumped out), bind a substrate to the pump (pretty much put a plug in it) and the last option is to alter what the pumps push out. While reading through all these studies, most of which read like a thick ass pound cake, I came across a treatment in the later option that was rather intriguing. They have found that Verapmil and Reserpine inhibit the pumps and allow antibiotic concentrations to rise.

Think about that now. How long have those drugs existed? How many people the world over have been on such a regiment? That's pretty damn cool if you ask me, that something which has been used for years and years has yet another viable function.

They will never be used in humans as a treatment as the levels needed to inhibit the pumps are highly neurotoxic. There is also issues with purification of the needed amounts of the compounds. What they are doing instead is using those two drugs as a start point to construct new, less toxic variations to inhibit pump function. It is one of the most promising fields of micro and molecular biology at the moment.

Stumbled across this while writing a paper on antibiotic resistance in bacteria for my microbiology class. Was a vastly interesting tidbit that I thought all the other pharmacy nerds would enjoy.

Now back to my macroeconomics paper on universal health care :D

Another what would you do...

Let's say you're the owner of several pharmacies. Let's also say that over the past few years you have caught several employees stealing drugs from you, namely hydrocodone, and selling them on the street. Additionally one of those persons was a store manager who attempted to sell 4,000 tablets to an undercover federal agent.

Now let's also assume that you know a clerk in one of your stores is stealing the same items. Would you then order nearly 30,000 tablets to keep on hand for that store?

If you answer yes, you are the owner of the place I work for. Bunch of fuckin dumbasses...

A 'Me First' Society

If there is one thing I have learned over the past year it is how immensely selfish and greedy people are in this country. In pharmacy you see it on a regular basis, people want their medications right now and for no cost, despite the fact there is considerable cost and time put into their medications. It is a 'Me First' and 'Right Now' mentality that causes the majority of the problems on a daily basis.

It appears as if this has moved into every aspect of our lives. The majority of the reason we are in this economic crisis is that businesses often put their own goals ahead of the country's, and everyone else's, goals. They became extremely greedy and we are now paying the price for it. Greed is not a bad thing, it is what causes us to strive to become better than what we are, but in excess it is crippling.

One of the items which bothers me the most about elections is the emphasis on tax cuts. To the common man, a tax cut appears at instant cash in their pocket. But think of what one is giving up by not paying those taxes. Education, for one, loses funding as does several other areas of government. What happens then? People whine that their streets aren’t being fixed or that there’s too many students per teachers, yet they aren’t willing to pay more to get what they want. The local school district is facing such a crisis that they are considering closing school for January, moving to a 4 day week, closing one of the schools and eradicating classes such as Music, Gym, Art and other ‘non-essential’ classes. Everyone knows that those aforementioned classes are really what sparks creativity in young students and helps to encourage them to learn more.

Using education cuts as an example, the quality of education will decrease even farther. Today we are well behind the education of virtually every other developed nation in the world and are, in fact, dangerously close to dropping below that of some undeveloped nations. Even the brightest individual will not be able to succeed without a proper education.

Now those without kids are thinking this won’t affect them and they’ll still have that extra money from the cash cuts. Then consider this, lower education standards results in a lower quality worker. Do you want the person working on your car or building your house or perhaps even your doctor have insufficient skills compared to their counterparts in other nations? It will in fact cost more in the long run to make up for these deficiencies. Yes you have your $1,000 today, but you may wind up paying far far more than that over the coming years.

Then again no one seems to think about the big picture. Education was just an example, there are numerous other areas which would suffer. Already we have doled out trillions of dollars to big business, another debate for another post, yet we are still promising tax cuts. How the hell does that make any sense?

Detractors state that an individual should be able to keep as much of their income as possible as that was what the country was founded for. That is true, except for the fact that 21st century America has a far deeper infrastructure than 18th century America. Those days are long gone, and one needs to contribute to ‘Big Government’ to maintain our standard of living. There is one simple solution though…

We as a people must stop being so selfish. Take my education example, the amount needed to rid the district of the deficit, per person, is comparatively miniscule. I would have to give up a month of cable, PER YEAR, to rid the deficit. Think about that of a minute. Think of all the non-essential items we purchase which could be put to such better use. Those items of which we don’t need, but make us feel warm and fuzzy inside. Sure you might have five plasma tv’s in your house, but your kids won’t be able to read. God forbid you might actually feel a little difficulty in one's life (note: that statement was overly generalized).

I say tax me more, I feel I pay too little as it is. I am willing to give up the ability to purchase a few DVDs per month or that PS3 game if it means the quality of life in America will be better. And, not to sound arrogant, but you should be able to. We are the most powerful, and richest, country in the world and there is no reason we should have these problems.

It takes more of a man to help others than to help one’s self. Perhaps we need to remind the American public of that. And perhaps I’ll start by posting that right outside the pharmacy.

First Act as President

After good ole W was elected I realize that truly anybody, even the mentally disabled, can become president. I therefore decided that some day I shall run for president and will, in fact, win.

Today, I decided what my first act will be. I shall standardize all insurance cars. No more throwing on labels for UHC, Express Scripts, WHI, all on the same goddamn card so you don't know who to bill it under. No more having 3 different 'group' numbers on the card, only to have none of them work. No more fancy designs on them with the needed information in tiny type on the back. And most of all, no more waiting until six weeks after coverage starts to issue said cards. If you can print the letter saying coverage is changing, you can print the damn card at the same time. It ain't rocket science.

All new cards will have the following

* Processor name clearly identified at the top along with active date
* RXPCN and RXBIN in bold type below that
* Patients name, ID number and Rx group number CLEARLY labeled
* Phone number for me to call and bitch at them when they still fuck this up
* No fancy designs with other logos and needless information on it. If you do so, I will personally go to the insurances headquarters and kick every person there square in the nuts
* You will send the card to the patient one month prior to service being activated. No exceptions
* If you do change mid month you will give the pharmacy the new info in the reject. No more calling the help desk and talking for 40 min to Skahewrwea Dododobop from India who can speak three words of English.

That's it. That's all I want on the card is some clear information. They did it for credit cards, why the hell can't they do it for insurance cards.

I will be one helluva president, just you wait...

I wanna be Dr. House

I have become enamored with the show House over the past year. While I had watched it off and on its first season, it wasn't until a few months ago that I truly got into it. Now it is one of the few shows I watch on a daily basis. Part of what makes it fun is that he is a complete ass to his patients, much like we would all like to be asses when they deserve it. It is also fun to kind of play along and try to guess what the condition is.

Via Wikipedia I stumbled upon a blog which analyzes the medical aspect of the episodes. I personally love this kind of stuff and often he picks out the same miscues I noticed.

For those of you who have not seen the show, try to catch an episode the next chance you'll get. It's absolutely brilliant.

For those of you who do watch it, check out the blog that analyzes it, Polite Dissent

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...

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 fiancés 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..

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!

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.

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

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!

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.

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.

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...

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?

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.

That's not my Doctor

Phone Rings

"Hi there, I just picked up one of my meds and I want to know why you put the wrong doctor on my bottle. I don't know who this guy is and he's not my doctor and I don't want him on my bottle because he's not my doctor. He could be trying to kill me because he's not my doctor so I why did you put his name on my bottle?"

And what did it say on her bottle? Dr. Reddy's. Gotta love workin in the ghetto.

On that note, Happy Halloween everyone!

Note: For those not in the field, Dr Reddy's is one of the drug manufactures, which by law has to be on the bottle...

You know what's fun?

I'm a college student and thus a part time employee at the shithole local chain I work for. For much of my college career though I have been working between 25-40 hours a week during the school year to pay bills. I have asked my manager numerous times if I was eligible for full time status. That way I could get vacation, paid holidays and all those other luxuries. Every time I was shot down.

I was bored today, it was nice out so the Vic-fiends were going for a walk.... oh I'm just kidding they were probably passed out in the yard, but I digress.. anywho I decided to call the woman who runs our payroll to see what my average has been the last year. She tells me it's 31.26 hours (30 hours means you're full time). I asked her how long have I've been eligible, she goes through the records and tells me 'About two years or so."

Now I've mentioned before how many different ways I've taken it up the ass from this place. How I've covered for gross negligence from their pharmacists and looked the other way when multiple federal laws were broken on one script. My manager is well aware of these facts as I bitch to her quite often about them. And come to find out this is how she repays me? By lying to me and withholding what I have rightfully earned?

Oh tomorrow shall be a very very fun Halloween at work....

But I Need Them!

About a week ago The Angriest Pharmacist posted a story about the creativity some patients had in phoning in a fake script. At the time I somewhat applauded the ingenious nature of this plan and thought that perhaps the druggies were becoming slightly more intelligent.

Ladies and Gentleman I am dismayed to inform you that I was wrong. I was very very wrong. Cuddle up next to the fire, have a warm milk toddy (does that sound dirty to anyone else) and enjoy this lovely tale.

Yesterday a gentleman... a man... this druggie comes in asking to pick up his mother's hydrocodone. We can't find it anywhere and check our signature logs and it shows that his sister was in the day before and had picked it up. He became furious and said that she was not allowed to pick up meds for his mother (they are regulars, but this was news to us.) Next he called his mother and confirmed that the daughter had never brought her the drugs. He then demanded that we fill them again since his sister picked them up. Do you want to know why?

Note: Now I have worked in pharmacy for over eight years now with half of that time being spent in the ghetto. I have been robbed, I have had things thrown at me, I have been threatened and I have had to ask a 400lb woman to exit the store because she was wearing a size small tube top and, what I hope, where short shorts but really looked like a thong. I have seen and heard damn near everything until yesterday.

His reason for wanting another refill was that his sister didn't give him his 'cut' of the tablets. Yes, he wants us to fill it again because his sister sold them and didn't give him any money. In fact he even stated that he needed to sell them to 'make some money' this weekend. Suppressing a laugh I suggested maybe he should contact his mother's doctor with that explanation and see if he could get an early refill.

And the dumbass did it. I came to work today and found out that he had called her doctor and told them the exact same story he told us. Now think about this for a moment. He asked to have pain meds filled early so he could sell them. I mean I've seen people a few fries short of a happy meal before, but this guy was missing the goddamn box the happy meal comes in.

Needless to say he did not get his early refill and I am left even more dismayed with mankind than I once was. I thought the TAestP offered a hope that maybe their intelligence was rising, but alas that hypothesis has been shot to hell. How sad.

Don't Mess With My Mountain Dew

I've mentioned before I'm a Mountain Dew fiend. I have postulated that there is nicotine or some other addictive chemical in it which causes me to crave it. Even though I have switched mainly to Diet Dew (getting older means eating healthier) it is still my biggest vice.

I am also a logo fiend. I was originally going to go to school for graphic design, until I realized how over saturated that market is, and have developed an admiration for logos. One of my favorite blogs, listed above, is Uni Watch simply because the site analyzes logos and colors on sports teams. It's also a part of the reason I love NASCAR so much. Over the years I have developed a sort of understanding in the design and use of logos. Additionally I understand name and product branding in a market. Hell I notice tiny little changes on drug bottles (I hated when Femara switched their logo).

Now these two worlds have combined and I am severely pissed off. Not only have they taken one of the coolest looking, and most fitting logo for it's clientele, and changed it into something you would find on an AARP card, but they have also changed the name of the product.

Mtn Dew? Are you fucking kidding me?

And I won't even get into the new Pepsi logo....er logos and how they make literally no sense. Plus changing one of the most famous logos in the world just seems like a bad idea. I shall say a prayer today that PepsiCo will not fuck up my beloved addiction. If they do I may just have to switch to Vault.... uck.

Links to the new PepsiCo logos:
Bottles
Logos

HIPPA is getting out of hand...

The local chain I work for is about to go through a Medicare accreditation program over the next several weeks. Earlier this week we were given today the 'revised' HIPPA rules we will soon have to follow. They are some of the most assine rules I have ever read. The kicker? We're no longer allowed to have notes on our computer stations. No NPIs, no diagnosis codes, no phone numbers, no program cheat sheets, nada.

The reasoning? So if someone breaks in they can't steal all of that 'important' information. We all know that the first thing someone does when they break into a pharmacy is to go and copy down an NPI number or the fax number to our bookkeeping. I mean this is a critical area that requires the uptmost protection! Plus now they'll know how to restart our laser printer! It's an even bigger annoyance to me because I had just made neat little lists of all NPIs, ICD-9 codes, computer short cuts and etc for all the stations in the business. Hell we can't even have the id's that tell us what screens are what on our monitors.

And the solution to this? Keeping it in a little notebook next to the terminal. Instead of writing down that diagnosis code for GERD, they can't just take the whole damned book with them.

I've always thought HIPPA does have it's good points. In hindsight, it probably wasn't a good idea to go "Mr. Johnson, your pain medication is ready" over the intercom. And I can understand the need to shred pertinent patient information rather than just dumping it in the trash like we used to. This takes it to a whole new level though.

Our job just got a little big harder for really no logical reason. And people wonder why pharmacy employees are so bitter at times...

I Am Politcally Incorrect

Anyone who personally knows me, knows this to be true. I often laugh at things that probably shouldn't be laughed at. I like to push people's buttons. My close friend's call me the biggest, most polite asshole they've ever met. And I take that as a compliment.

In honor of me being politically incorrect I thought I would share a website I frequent. Some of you may be offended by it, some of you may laugh your ass off. I personally own a couple of shirts from this site.

Without further ado I present to you... T-Shirt Hell

Brain power is not required

Woman came to the drive-thru window today to pick up her scripts. Her window doesn't roll down, so naturally she parks a few feet away, gets out, and walks up to the DRIVE-thru window. I should mention that it is currently 49 degrees and she was wearing a t-shirt and jeans.

Naturally I took my time getting it ready. I figured it would be a good life lesson for this 40-something woman. After I leisurely strolled back to the window and gave her the bag, she commented,

"Boy it sure is chilly out here today."

To which I responded with a big smile,

"Yeah, but it's toasty warm in here today."

I'm hoping it dawned on her then, but the expression on her face told me it didn't. Oh well, I'll try again next time.

LiceMD

NOTE: I realized a few months after posting this how completely and utterly incorrect my statements are. As such there is no need to call me names, question my 'brain power' or question my sexuality. I ask that the emails and comments pertaining to this please stop.

If you had a bunch of insects crawling upon your head would you not want to rid yourself of such a problem as quickly as possible? I mean I know I sure as hell would dump Nix, Lindane and Ovide all over my head. Burn the fuckers to death, that's my motto.

If you do not wish to use such 'pesticides' on your, or your child's, head there's always LiceMD. What is LiceMD you may ask? Why it's an all natural solution to your lice infestation! Brought to you by the company whom markets such great homeopathic products as SleepMD, JointMD, HeartburnMD and others. With MD in the name, it's gotta be a great product!

I'll let some of you layman know what homeopathic medications really are. Hold on lemme consult the pharmacy lexicon:

ho·me·o·path·ic . n. def: Substance so watered down with fillers and other worthless garbage that eating the box has more therapeutic effect than taking said medication

There ya have it, it's generally a pile a crap. Usually it's some 'ancient' remedy recently rediscovered which has some how escaped all scientific study and is suddenly better than anything else in the world. Airborne comes to mind. And everyone now knows, much like I did when it first came out, what a load of shit that product is. Anyone who doesn't go google 'Airborn lawsuit' and have your mind blown away.

And now they've come out with LiceMD. It contains dimethicone which sound's like a fancy lice killing machine. I'm sure they were attempted to incorporate some impressive looking picture of dimethicone squashing lice. What dimethicone is really used for is in lotions and shampoos, generally as a lubricant. So those little lice, who are so tightly gripping your hair follicles, are being covered with the equivalent of Crisco. Hell I betcha Crisco works just as good, if not better, than LiceMD.

When your child is sent home from school from lice, as is the general practice today, are you going to go for the 'safe and natural' LiceMD and make the annoying bastards a little slippery? Or are you going to go to the proven chemicals that will actually rid your child of the infestation? Yes I have seen cases of chemical burns due to some of these products, Ovide comes to mind, but that has always been from some woman on Medicaid who picked up nine Rx's for Ovide for her nine kids and then let them bathe in it all day. Granted, LiceMD will prevent this, but so will rubbing my head with animal feces. And personally, I don't like shit on my head, but to each their own.

Let's have a review of what we have learned today;

1) Homeopathic products are generally as good as the box they came in. Actually just eat the box, a little roughage will be good for you

2) Crisco will work as well as LiceMD. Hell, if you don't believe me I'll send you a can marked CriscoMD and you'll swear it's the most amazing scientific discovery this side of the moon!

3) Once again, homeopathic items are as worthless as promise to payback a Medicaid copay

Now that you have been enlightened, you shall be able to sleep easily tonight and without the need to scratch your head. No SleepMD or LiceMD for you!

I will say CriscoMD on pubic lice could be a messy endeavor and I do not condone that. Just use KY, that's what it's made for!

On November 4th...

While you go to the polls I want you to remember this face....



I bet Drug Monkey is laughing his ass off at the moment...

I'm a 100% Nerd

You know how you can tell when you're a nerd? I just got a reminder email from Amazon earlier today and I was a happy as a junkie getting his Lortab. It was a reminder that The Universe comes out on Blu-Ray soon. What's The Universe you may ask? Well...



It's a show on The History Channel (although I guess it's just History now) about, you guessed it, the Universe. You see not only am I a pharmacy nerd, I'm also a nerd in general. I usually dig through Charter On-Demand to find something on Nat Geo or The Science Channel or History that I haven't seen yet. Usually something about space or science history or shit like that. Big fan of Naked Science on Nat Geo too. I used to watch How It's Made a lot too until I bored the fiance to death by explaining how cardboard boxes were made. For some reason she didn't find that as interesting as I did.

So I can admit, I'm a nerd. Hell I actually once looked for a pocket protector for my lab coat. Not too long ago my glasses were held together with tape. Odd thing is I don't belong to the science club on campus. Perhaps everyone should send their condolences to my future missus. She shall have to put up with this for the rest of her life. Poor her.

Ooooh look what else is on my list...



Yea yea stop laughing, I'll go back to the nerd cave now....

They're out to get you..

I'm studying Microbio tonight in my campus's student center for a test I have on Wednesday. Amazingly wicked class by the way, anyone who has a remote interest in pharmacy should take this course even if it's not required. Anywho I was on a stretch of getting up to do research at 7:30am, did that to 10am, then class from 10-2pm, then work from 2-6pm, then studying after that. It was about 9:30pm and I was tired, but still kickin ass.

Was reading about proton motile force, ATP production, all sorts of fun stuff like that. Was kind of confused when reading a few sections because they kept mentioning words that they hadn't defined earlier (big pet peeve of mine regarding textbooks). After studying it for about 45 minutes it dawned on me.

The Citric Acid Cycle = The Krebs Cycle = the Tricarboxylic Acid Cycle (TCA Cycle)

I shit you not in the chapter they would switch off between using these terms and actually defined as The Citric Acid Cycle. Apparently the authors thought it would be fun to fuck with my exhausted mind by switching the names around. Pretty sure I'd like to send a flaming bag of dog shit in their direction.

It's now 1:30am, I've switched from Microbio to Econ since I can't sleep and felt the need to vent about that. Still gonna mail them that bag of dog shit. Just have to figure out how to light it remotely now...

Argus/Humana Ride the Short Bus

Mysterious Voice - "Thank you for calling Argus, my name is Cletus can I have your NPI, DEA, Social Security number, State registration number, Astrological sign, turn ons, turn offs and your favorite color please?"

Me - "Gives them all the info they want plus the last time I took a piss just as a little bonus for them"

Cletus - "And what can I do for you today ma'am?"

Me - (That's a good way to piss me off) "I'm trying to process a claim for a Humana member but am getting a DUR reject that I cannot clear"

Cletus - Asks for patient info and drug

Me - "... drug is Lunesta 3mg, 20 tablets for 20 days. Patient had been getting 30 tablets for 30 days for the last nine months with no issues."

Cletus - "Well let's see here...." (Page's flipping) "Well I think you... I think you need to get a prior auth on that drug"

Me - "But we have had no issues in the past with it, and I just filled a similar one for another patient under the same plan today. Has it gone off formulary?"

Cletus - "I can't tell you that, the member would have to call us."

Me - "Ok... if it needs a PA then, why is my reject saying 'Suboptimal Regimen'?

Cletus - "Uh...."

Me - "Seems to me that it would be helpful if you needed a PA for that script to have the reject say, oh I don't know, 'PA Required for this drug'?"

Cletus - "Well... uh... the patient's just going to have to call to find out."

Me - "So you want me to have a 93 year old woman with dementia call you because you can't give me a proper reject nor give me a single replacement option?"

Cletus - "That is correct. Is there anything else I can help you with today?"

Me - *Click*

First who gives you a reject that isn't actually the reject? I mean we have one insurance that will occasionally reject saying 'Drug not covered for sex' when all it wants is a new NDC. This was just crazy.

Second, why the hell couldn't they at least give me an option. Shit they usually give you various options with the reject.

And that's how my week started...

Weird Search Terms

Not sure if I mentioned this, but if you google 'midget transvestite porn' for some reason my blog is the first link to show up. Disturbing is it not? It due to this post here but I find it even more disturbing that at least once a week I see that that particular search term brought someone to my blog. That means someone out there really is looking for midget transvestite porn. Ugh

Other fun search terms to find my blog

Lost Testicles
Will my testacles explode?
Hobble Testicles
Can nitroquick fuck you up?
my girlfriend want to see my balls
I love tramadol
in bed problem girlfriend testicles
testicle gets twisted around?
testicle spaghetti

Obviously there is a theme here. I also get a ton of hits off of 'U-500 Insulin' and 'Qualquin'. So if you're looking for testicle information, I guess this is the place to come to. Just call me the testicle king...

Research Sucks

Since the start of this semester I have been doing research with my microbiology professor. I've always considered myself open to research at some point in my life, and I figured this would look good on pharmacy school apps. After four weeks of it do you know what I have realized?

I hate research.

This is one of the most tidious things I have ever done. The whole concept we're working on is quite interesting (we're trying to prove a factor of evolution via bacteria) but the procedure is mind-numbingly boring. The worst part is, you get pissed off at least twice a week because of it.

Example, I needed to amplify some DNA to run a gel to figure out how many kilobases this fragment of DNA has. You amplify using a PCR which takes 2-3 hours. The gel itself takes about 1-2 hours to run. All together to get the data you need, you must wait up to 5 hours, not including all the prep work. After all of this, you go to look at the gel under UV and what do you see? Absoutly nothing. Fuckin' gel did not work for some reason. All that work for jack shit.

Really doesn't help I'm doing this at 8 in the morning (I am NOT a morning person). And the fact that my day usually doesn't end until 7pm due to classes/work. As of today I have decided to give research a big ole screw you as I shall not be doing this ever again. Now to squeeze in a short nap before stats....

I Shall Kill Your Brain Cells

I like stupid things. They make me laugh. I'm young, I'm male, it happens. First time I saw this I nearly wet myself. Plus you'll find yourself doing the voice anytime you meet someone named Charlie....

This Is So Sexy

I know I'm a nerd (I mean c'mon I have a neon Valu-Rite sign) but there is nothing better than all the drugs in the drug bays being faced. Had a ton of free time on Friday so I decided to redo them all and yank outdates. It is so bloody beautiful..

Maybe I'm Anal

Was updating a prescription today for refills and came across this sig:

Tizanidine 2mg
Take 1 tablet by mouth daily
(Replaces Vioxx)

Honestly now, Vioxx has been off the market for four years now. During those four years there were at a minimum of four updates to that particular Rx and, seeing as what kind of drug it is, there were far more than four updates to the script. In all that time no one thought that maybe that little note in the directions was perhaps out of date. This just seems exceedingly lazy to me. Perhaps I'm being a little too anal though.

And what is the deal with patients calling in refills, showing up in literally three minutes and bitching that they are done? Is this a new fad I'm not aware of? Was there an article in Good Housekeeping or Time or something that stated this was the cool thing to do? I had that exact situation happen five times on Saturday. By the fifth time I told the person it was going to take at least two to three hours and have them swing by later (it was for a Lisinopril script which was six days early, so don't get huffy-puffy with me).

I swear people are getting more pissy and demanding every day. Actually had someone, after I filled his albuterol inhaler in about three minutes, bitch because we weren't fast enough. Seriously? Go to Walgreens or Wal-Mart and try and get anything filled in under five minutes. If you do it, I'll give you a free sixty count bottle of Lortab. You know why I offer that? Because you can't do it that's why.

I take it back, I'm not an anal. I'm an asshole. Wait, isn't that same thing?...

So I think I may be a genius...

When I'm bored in class, which is usually quite often (seriously take some business classes after dealing with biochem, it's a breeze) I come up with these killer ideas for if I ran a business. At times they are of genius quality and I astound those around me. Other times I just sound like a jackass, but I still think they're a damned good idea. I thought it would be a good idea to share my genius with the rest of the world...

Pharmacy/Strip Joint
The busiest pharmacy I have ever worked in shared a building with a strip joint. Coincidence? I think not! Think about it, you can get your Viagra, condoms, KY, Acyclovir and lap dance all in a one stop shop! Shit Wal-Mart hasn't even thought of something like that yet. Hell maybe we could run a deal where for every four prescriptions you get filled you get a free lap dance. I'm telling you it would work, you'll see.

Bar Additions
I like to drink, but then again who doesn't. I also like to eat when I drink. I see a need to own a bar at some point and my life and to join these two needs. Why isn't there a bar with a mini donut machine? Seriously how the hell has someone not thought of this? We could sell corn dogs, nachos, Pizza Rolls, brownies, all sorts of good shit like that. And you know most of that stuff would be sold out every night. Next time you're hammered at a bar, think of how nice it would be to have a bag of mini donuts in front of you and you'll understand.

Karaoke Paintball
Sure karaoke can be fun if you're hammered. It can also be down right painful at times. Why not give the audience an option of shooting the singer if they can't sing? It sure as hell would give drunk people more ambition to sing the actual lines and sound good. Plus it would be fun as hell, who doesn't like paintballs?

These are but a few of the multitude of genius thoughts in my head. You can admit it, you're nodding your head going 'My God those are some damn fine ideas." My deed is done for the day now

One Year Anniversary

Well it's been one year since I started this intrepid little blog. Doesn't seem like it's been that long to be honest. This is my second attempt at a blog and I honestly didn't think I would keep on doing it the second time around. Alas it has proved to be a good stress relief some day and at times I'm surprised how many people actually read this thing.

In any case, on to yet another a year! Bring on the Lortab, Chemistry and crazy ass customers!

Love Your Trees

These are the kind of people I see on a fairly regular basis... except they wail for Lortab

The Bathroom Conundrum

It never fails. Hell I would bet on it more than the sun rising on a daily basis. You see every time I have to call an insurance company to sort out some random fuck up I realize I have this insane urge to piss.

During the day, since it's so busy, I'll often forget to go to the bathroom. I guess after several years, and being young, I am accustomed to holding it in set period of time. In fact I try not to drink as much water during the busier days just for that reason. What happens, though, is when you are stuck on the phone haggling with an insurance rep for 10-15 minutes you begin to remember just how bad you have to piss. You, in a way, lose the ability to hold it in.

Now this always occurs on the longest of the calls we have to make. Everyone in the field knows them, the ones where you're on the phone for thirty minutes listening to some god awful music. About midway through you start doing what my mother called 'The Potty Dance'. You know, where you just kinda start shifting your weight on your feet just because you have to piss so bad. I've honestly contemplated using one of the four ounce bottles during one of my more dire moments.

Sometimes I think it would be easier to have a catheter. Hell we have them in the pharmacy, I might as well just take one when I know I'm going to be on a long call. I mean, my balls are already busted, so whats the harm?

So the next time you head to your local pharmacy and you see someone doing 'The Potty Dance' while on the phone? Be kind and let them piss before they fill your prescription. Truly it's all I ask.

Wow...

187 prescriptions in two hours with two techs and one pharmacists. My god do we kick ass

Pet Peeves for the month

How hard is it to remove the foil after you open a bottle? Seriously, just tear the lil fucker off. It's such a pain in the ass when someone just folds it in and you have a waiter and you can't dump the shit out.

While we're on it, I'm gonna kill the person who's putting empty bottles back on the shelf. Nothing better than going to grab some Lisinopril/HCTZ only to pick up the capped vial and find out its empty. To the jackass who does this (and I know who you are) here's what I'm gonna do. I'm gonna go to your house, find all your condoms and then carefully remove them from the package. Then when you're getting your freak on and you reach for your 'sealed' condoms you'll find them empty. How's that for a cock block.

Then there's the pharmacist who constantly undercuts me. Patient calls in his Trazodone 22 days early tell him no because, now here's the shocker, its 22 days early! Patient asks to speaks to the pharmacist who okay's it 'just this time'. Never mind the fact that he does this every month, but what the hell do I know.

Fuck Phil Collins. We have to listen to light rock at work. No idea why as personally I think we should be listening to some metal or something to keep our asses pumped up, but I digress... Anywho the station we listen to plays, on average, six Phil Collin songs an hour. I know I counted one weekend. The only thing I hate more than Phil Collins is U2. Thank GOD they don't play much U2.

Amerisource can flat out go to hell too. When I order Ibuprofen 800mg Amneal brand, and you confirm that's what I'm getting, I better damn well get Amneal brand Ibu 800mg. No Interpharm, no Par, I want the fucking brand I order. I click No-Sub, and then I'll get Qualitest brand. Retards.

And finally fuck nursing homes/docs who send discharge orders five minutes before close. The pisser is we do the meds for the nursing homes so we know precisely when they leave the facility. They could leave at 8am, but we'll still get the order at 7:55pm. And the one time you don't do them, that's when they actually need them. Typical.

Ok I feel tons better now... oh shit Phil Collins just came on the radio...

Condense those Directions!

Alrighty we'll play a game from an actual script I received today.

Drug: Nitroquick 0.4mg Tablets SL
Directions: Take one tablet under tongue and lay down. Take a second tablet
in 5 minutes if the symptoms are not relieved. If symptoms are not gone in 5
minutes, take the third tablet and call 911. Do not take more than 3 tablets
without calling 911.

Now you have 3 lines with 30 characters per line to condense this (spaces count). Good luck<

Politeness and Patience

I was asked the other day by a manager of Walgreen's, ugh I feel dirty for saying that, what one my strongest aspects was. This is a total bullshit question as they have no idea who you are so you could say 'well I can cure cancer with my farts' and they'd have to take you at your word. For some reason my mind cleared and the first thing that came out of my mouth was my ability to have patience and to always be polite.

Now think how many times you'll call another pharmacy or doctors office and you'll have someone answer the phone with their spiel. Now think of how many times you'll hear someone kind of snarl or reluctantly pass off the call as if you just asked them to name the contraindications of Viagra and Nitrates. We've all done it, even on our worst days.

Now think of what happens when you call some place and the other person is polite and lighthearted. How much easier is it to talk to a person whom is like that? Every time I answer the phone, no matter what kind of shit we're dealing with, I do it in a happy and pleasant voice. If you're going to call and bitch at me because you're copay went up, I'll calmly and patiently discuss with you that it is not our fault but rather your insurance company.

A few weeks ago I had a gentleman literally screaming at the pharmacist and I calling us a racist and several other derogatory terms (speaking of which I need to blog about that) while calmly and politely took his abuse. Afterwords our newest future pharmacist asked me how I could take such abuse and still treat the man with respect. I replied that there would be no point in arguing with him as his point was set in his mind and it really wasn't worth my effort to try and change it.

I have had good patients come in who, this one time, are completely shitfaced and unreasonable. The next time I see them often they will thank me for not 'biting their head off' while they were like that. Every one makes a mistake and I generally allow patients one fuck up. Usually if you remain calm and patient you can eventually break through whatever problem you are working on and everyone is happy.

Obviously this does not work all the time. I have been very firm with patients, I have been very cross with patients. Usually this is only when it is warranted (i.e. telling me its not my business what medical condition you have when your insurance requires an ICD-9 code). There's a time and a place for such actions and when you know when to use them they are quite effective.

So those of you whom are embarking in the pharmacy world for the first time, take note. These two little things can make your life a helluva lot easier. Then you can start a blog and bitch about it when you get home like me! :)

What is it with...

What is it with news outlets and tropical storms this year? On the front page of CNN.com right now the headline article is:

New Orleans keeps wary eye on Gustav

Seriously? Then they go on to say:

Tropical Storm Gustav could hit New Orleans area by weekend -- or nowhere near

So they kind of contradict themselves in the same article. Its the same thing with Fay. I remember an article about it last week that in big letters said:

Deadly Storm: Fay could strengthen to a Hurricane 1 status before landfal

Ooooh it could strength to a Cat 1 storm, batten down the hatches! It was a monster thunderstorm. Whoopy do (no offense to those who were affected by it, just using it as a point) It's not as if it was a category 5 storm, it was a friggin' Tropical Storm. It didn't destroy Flordia, as some media outlets in inadvertently suggested. It was a nasty storm, yes, but not the mankind killer it was made out to be.

Pretty soon you'll see headlines like:

Cloudy skies could signal deadly hurricane on the horizon

Speakin of which the sun just went behind the clouds, I should go board up my windows!

Tastes Like Candy

A comment in my most recent thread has brought up a question that we often wonder while at work. Just why are Tramadol and Carisoprodol not controlled substances?

You can't use the 'well the abuse potential is lower' bullshit because anyone who deals with it knows it's a load of crock. Our worst patients are the tramadol customers who are often verbally and physically abusive while in the store. The Lortab patients, while can be equally bitchy, usually just try and sneak in an early fill, but generally don't get pissed at us.

We once had a patient who was getting 300 Carisoprodol every three weeks. 300 fucking tablets. Granted we should not have been dispensing those to him (that's another story), but that is utterly amazing. The guy would come in and would be higher than a fucking kite.

And yet these are not controlled by the government. Sweden has yanked Carisoprodol off the market. The EU is in the process of doing the same thing. In America though its only slightly more restricted than the candy on our shelves (heavy on the sarcasm here). Then again this is the same country that allowed drugs like Vioxx and Baycol to find their way to the marketplace. Shit maybe I should just move to Sweden.

If anyone can give me a logical explanation to this, my ears are open.