Some Daily Musings...

Was reading about the first new CNS analgesic, tapentadol, during a short break yesterday. I also happened to notice that they are calling the drug Nucynta.

Really?

Does this come from Larry, Curly and Moe Pharmaceuticals? Seems like they could have picked a better name. Plus when you're on the street buying this shit, you're gonna sound like a sissy.

"Yeah man... you got any nuc on you?"

*********

Gentleman came in to our store today for the first time. While taking his information, he handed me his insurance card. Nothing out of the ordinary... until I went to input it in the system. His ID number was 18 characters long. Three letters and 15 numbers.

Let's do a little math here, there's roughly 6 billion people in the world, or 6 x 10^9. Using the possible combinations on that card ID, there are a total (mind you this is quick) 1.00 x 10^15 different combinations possible.

Or roughly 166,667 ID numbers for each person on the planet. Little over kill don't ya think?

*********

I have decided that we are trying to make Americans fat. I was strolling through our food aisles, looking for something to munch on, when I eyed the Pringles. Since I was drooling I moseyed on over there. I then went to grab one of the snack cans and stopped.

They seemed... larger. Puzzled I retreated to the pharmacy bunker and, because I am a loser, checked out an old snack can we use to hold zip ties. Sure enough, the snack can size had doubled recently. I later snapped this picture at a different store as confirmation.



Do we really need our 'snack sizes' doubled? I mean I was quite content with just one of those little cans. I don't want double that amount. And you know that if I were to purchase that, and open it, most likely I would eat the entire thing.

Just seems kinda asinine don't ya think?

I'm Bringing Sexy Back

Check out the new digs.... pretty snazzy eh? Since I fubared the previous layout, I finally fished up this bad boy. Hopefully it's not too drastic of a change, but I have a lot more control over the look over this layout than before.

First off, if you see anything that looks funky or just plain stupid, please let me know. I'll do my best to fix it in a timely manner.

Second I'd like to thank my XML buddy who was kind enough to help me with every annoying little question I had here. The header is by Ryan Bliss from Digital Blasphemy, a site I highly recommend you check out.

Now to the nitty gritty. One of the things I lost was several blog links I had. If you know which ones are missing, please post them here and I'll re-add them.

Now for the grand tour.... cue the music!

Up top you have a list of websites I visit on a daily basis to either vent or get a good laugh after a rough day. I suggest checking each of them out, if you haven't already, as they prove to have plenty of good reading material on a slow weekend day in a pharmacy.

You'll see I've brought back the e-mail me option. Since I'm going to be starting the pharmacy school application process, and judging from the journey I've gone through these last five years, I thought it would be the prudent thing to do.

RSS feed should be working just fine now. There were some hiccups in the past, for those of you who used it, but those should be hammered out now.

There is a fancier search feature to dig though my 200+ posts. Assuming any are worth rereading that is. The blog archive is now much more condensed and user friendly as well.

Favorite posts are reposted and if anyone does have some suggestions I am all ears. It is kinda arbitrary how I decided them, but alas that is the joy of running this blog.

In essence that is. Probably not all that exciting, but I think it's awful purdy. If the colors are too difficult to read or you just think it looks like a piece of shit, let me know. I'm open to suggestions and what have you.

Otherwise sit back, relax and enjoy Version 4 of this stupendous blog

Let's do the time warp!

Long time readers, if I have any of those, may remember this layout. Why is this back you may ask?

Well you see, I had been working on a new layout off and on for the last two months. As such I have a test blog I have been working with. In my moment of ingenunity I mistakenly uploaded my in-progress layout to the actual blog. Since I cannot find the XML file for the original layout I've had to revert even farther back.

I apologize for this, but I suppose this will light a fire under my ass to finally finish the newer layout. Beers are on me folks.

So You Think You're a Nurse

Anyone who works in pharmacy invariably develops disdain for nurses. I shouldn't say this is for all nurses, because there are some truly great ones out there. I'm referring to the other 90% of nurses out there.

Side note: Ran into a group of nursing students at Dave and Busters a few weeks back. I asked them how they decided to become nursing and all of them said they only got a 20 on the MCAT so they thought nursing would be better for them.... yikes

Anywho I received a call from a nurse who was taking over the home care duties of one of our patients. This patient is very well known to us to the point that when we answer the phone she recognizes our voice and asks us how we're doing. That being said she is on a lot of drugs. I'd say about 20 or so a month.

The nurse I was talking to was probably the most dense nurse I have talked to in a long, long time. By the end of the conversation I was tempted to ask if she went to nursing school in Honduras only to realize that that would be a disgrace to the nursing schools in Honduras.

Some excerpts:

Nurse Ratchet: Ok, so do you have a Di-O-Van-uh 80mg on your list?
Me: Yes, we have a Diovan 80mg which was last filled on 6/18/09
Nurse: Ok... so do you take that like everyday?
Me: (No, it's just whenever you feel like it. Not like its an important drug) Yes, the directions are one tablet daily

Nurse: What about hydrozine 25mg?
Me: Do you mean HydrOXYzine 25mg or HydrALAzine 25mg?
Nurse: Um... I dunno, aren't they the same?
Me: Well Hydroxyzine is an antihistamine while Hydralazine is a vasodilator
Nurse: I see... well let's go with Hydroxyzine
Me: (Let's go with? Are you serious? Do you not understand that these are not even remotely in the same area code)

Me: I also I have a recurring Rx for Darvocet on file
Nurse: Oh ok, what strength
Me: 100/650mg Tablets
Nurse: 100/650mg? There's two?
Me: No, there's 100mg of Propoxyphene and 650mg of Acetaminophen
Nurse: Oh ok. So do you take that orally?
Me: Yes (What else would you do, shove the tablets up your ass? Although your shit may come out bright pink...)

Me: The doctor also updated her Metformin 500mg and changed it to Metformin XR 500mg last month
Nurse: Metformin XR... so that's the same isn't it?
Me: No, it's the extended release version
Nurse: Ok, so the directions are like what, four times a day?
Me: No... just twice daily (With all of the diabetics out there, how do you not know Metformin XR dosing?)

Those are just some of the gems I was asked during this 35 minute phone conversation. My head literally began to throb by the end of it.

Oh and she wanted start dates for all the meds. I don't know how some other pharmacies work, but we do not track initial start dates of drugs. In fact, I can only see about 12 drugs at a time on a patients screen. I went back to mid-2004 to find the start date on her lipitor and hadn't found it yet, but she insisted I give her the exact date.

Seriously, if she's been on something for the past five years, I'm pretty sure the exact start date doesn't really matter.

Needless to say my head hurt afterwards and I was forced to sit down and read some Fark to re-energize my mind.

Honestly, what the hell do they teach in nursing school? Are you that unaware of the simplest medications out there? I mean there wasn't any Tikosyn or Temodar or Procrit involved, these were all very very basic meds.

I rue the day I have to go into a hospital and be treated by some of these numbskulls. Maybe I'll just have to tough it out.

A Sign of the Downfall of our Society

I was flipping through the channels this afternoon looking for something to watch before the NASCAR race came on. I stumbled upon the name of a show on TLC which caused me to do a double take. The name?

I Didn't Know I Was Pregnant

Ladies and gentleman, let me present to you another sign that our society is going down the proverbial shitter. Even more depressing is that this is an actual series on the channel. Yes, there are enough dumbasses out there for a series to exist.

From the TLC website:

I Didn’t Know I Was Pregnant is a compelling series that explores the fascinating and utterly surprising phenomenon of women who were completely unaware that they were pregnant...until they went into labor!

From the bathroom floor to a North Woods cabin or from a bridal shower turned baby shower, I Didn’t Know I Was Pregnant will take you into the intense and potentially life-threatening true stories of surprise births. Through reenactments backed up with patient and expert interviews that help shed light on this unique phenomenon, the program will address the many dangers that can be present for both mom and baby. From women who had no pre-natal care and smoked cigarettes, to those who rode bikes in dangerous terrain, they all have one thing in common—sudden labor pains and a baby! One woman even gets the surprise of her life when she unknowingly gives birth to twins!

The one I watched involved a 29 year old woman working at a fast food restaurant, shocker, who was already the mother of 3 kids, another shocker. She started bleeding during her shift and thought she was getting her period until she noticed the head of her crotch fruit sticking out of her fun hole.

Now all the people that are interviewing that were there for this 'experience' are smiling and giggling as if it was some cute little story. No this is not cute, this is fucking pathetic.

She 'thought' she had been getting her period for 8 months for one. Seriously, I'm not female, but how do you 'think' you've been getting your period for 8 months. Obviously it would have been irregular enough to notice. Plus, you've already fucking had 3 kids. Wouldn't you think something may be up despite the whole 2 pregnancy tests you took came back negative.

Oh, but it gets better.

She does give birth in the bathroom of her work... while standing above the toilet. Naturally, the baby went head first into the toilet bowl. Then the 911 dispatcher, whom they were on the phone with during the ordeal, had to actually tell them to take the baby out of the bowl.

Here's the thing, the baby is pretty much waving to you as it's coming out. You know by now you're giving birth. Why the hell are you standing above a toilet? Are you that fucking stupid? And I understand shock becomes a factor, but wouldn't you want to immediately remove a newborn from the shitter it just fell in? Jesus Christ....

And again everyone is still smiling and giggling.. oblivious to the fact that there is nothing cute and funny about the situation. You are a dumbass and should have your uterus removed.

I knew TLC had little class judging by the crap they put on that channel now. But honestly, this is a new low.

PCAT... Round 2!

I take the PCAT again on June 20th. I am still slightly bitter about my damned headache which screwed up my first one, but there's not much I can do about it now.

If anything I am far better prepared for it this time. Still don't want to take it though. Between taking this stupid chem class again, studying for the PCAT, getting stuff ready for pharmacy school apps and my upcoming wedding I feel like I'm being tugged in twenty directions.

I'm pretty sure when I'm done at about 1pm this Saturday, I will skip out of the building, happy with the notion that I can finally start enjoying this summer.

I went to visit some friends in another city the other just to relax. Going to a Dave and Busters (perhaps the greatest place ever created) and chill out for a night. Then it's back for a week of studying.

At least I can see the light at the end of the tunnel...

Can Everyone Calm The Fuck Down For A Moment?

I have a problem with the citizens of this country at the moment. Nearly everyone has their proverbial panties in a wad over how our country is being run right now. I hear people talk about secession, getting rid of the government as a whole or perhaps getting rid of a specific individual in office.

How about everyone just calm the fuck down for a moment ok? Part of our problem with this nation is our gung ho attitude. If something happens that we think may wrong us, emphasis on think here, immediately our defense are up and we start spewing senseless garbage.

So our economy is in the shitter right now and we're bailing everyone out left and right. Do I agree with it? In most instances, I do not. Do I think it needs to be done? At first, yes it did.

Earlier today I read something that brought some calm into my otherwise cluttered and stressed mind. The president mentioned looking into reforming the health care industry to help save costs for businesses.

Already I see people flipping out talking about how the government is intervening in our daily lives again and we're becoming socialists. Never mind the fact that socialist countries have the best health care systems in the world along with the happiest population in the world...

So once again, calm the fuck down.

If there is any industry in this nation that seriously needs a dick slap upside the head, it's the health care industry. They blatantly deceive the public in order to get them to pay 10x as much for a product or service than they really need.

They are using the public's lack of knowledge against them. I understand that not every person can understand something such as the fluid mosaic theory. I do not expect them to. Yet they, and by them I mean particular corporations, use this fact to exploit the public.

Our new drug is the greatest thing since Jesus created slice bread. It'll cure erectile dysfunction, acne, muscle pain and grow you a full head of hair.

But when you read the actual information, you learn it's really just the same drug with naproxen added onto it (I'm looking at you Treximet) or maybe it's just the isolated L-enantiomer which was the only active enantiomer anyway (I'm looking at you Xyzal) or maybe we'll just combine to drugs and say it works better when in fact it doesn't (I'm looking at you Vytorin).

In every case the patient could receive the same treatment for a much lower cost. Is the public led to know this though? Of course not. And don't give me that bullshit that the cooperation needs to recoup their initial investment. First off, they didn't research anything to create this anyone. Second, everyone knows the majority of the cost of medications is related to its advertising.

And then there are the PBMs... Let's pay only for Lipitor and ignore simvastatin. How about we won't cover Ventolin, but we'll cover Xopenex. How the fuck does that make sense?

In a capitalist society the public keeps prices in check by being aware of the product in question. It's honesty, in a certain level, which keeps everything running smoothly.

Yet in our industry's case, honesty is not a word you hear very often. Hell, I think it may be a taboo word.

Do you think the public would find it curious that drug reps, once a fountain of information, are no longer pharmacists for the most part, but rather business oriented individuals? It's because pharmacists, depending on the company, realized what a crock of shit they were up to and told them to fuck off.

So here's the deal people. If the government gets involved, yes it's scary and we could all be communists who rape and pillage your neighbor's house.

Or, in reality, this case of intervention could better our country in more ways one can imagine. Could it be we could have an efficient industry capable of dispersing the truth to the public?

Personally I think it's more likely that Rozerem beaver will fly out of my ass to play some cards with Lincoln... actually that may be quite interesting...

A Real Shitty New Addicition

Never underestimate the ingenuity of mankind..

It's called Jenkem and originated in Africa.

It's a homemade substance actually made from human sewage. Kids take feces and urine and put it into a bottle or jar, then cover it with a balloon. The containers put in a sunny area for a couple days until fermented. The sewage releases a gas, captured in the balloon that kids later inhale.

It's said to give off a euphoric feeling and some start hallucinating.

Authorities are now warning parents to keep an eye out.

From wifr.com

Yes kids are resorting to inhaling shit now to get high. Is this due to our slumping economy? Perhaps a crack down on drug trade?

Honestly who the hell knows. First we had cokeheads, then methheads and now we have shitheads. Life's just full of ironies isn't it?

Betty White is the greatest 87 year old ever

Seriously, why can't all older people be like her?

Happy Birthday To You...

Friday's kind of have their own category during a work week. The same ratio of things you dispense Saturday-Thursday are not the same as what you dispense on Friday's. Friday has, what I like to call, the fun ratio of drugs. On top of that one is blessed with sordid and hilarious tales to start the weekend.

Case in point:

We get a refill called in for a patient for Viagra. It was a female voice. Slightly unusual, but not unheard of. It was about five minutes after opening the store.

Seeing as I was still energetic for the day, I typed the number into the system as she gave to me (side note, ever notice how you don't do this kinda shit at like 4pm?). As I did that I noticed that it was out of refills, which I conveyed to her.

"Oh no," she goes, then pauses for a few seconds. "Well how long will it take for the doctor to get back to you?"

Sympathetically I replied, "It usually takes the office 3 to 4 business days to get back to us on refill authorizations."

"Oh" goes the meek little voice on the other line. A few more seconds of silence is followed by the mother of all questions. "Do you think maybe you could spot him one if the doctor doesn't get back to you today... cause it's kind of his birthday."

Almost immediately my eyes welled up and my sides started to ache. It was a struggle to keep composure as I stammered out that I'm sure we could work out something for her.

She hung up and we went about our day. We debated for a while if we should wrap it in a pretty little package in a bow or perhaps start singing Happy Birthday. She came about 4:30pm and, as expected, the refill was not back from the doc so the pharmacist spotted her a tablet. That was the end of it... or so we thought.

As I'm leaving at 6pm, I grab the latest batch of faxes to give to the pharmacist. I notice, right on top, is our guy's Viagra script. The pharmacist and I chuckled and thought how ironic that that particular medication was okay'd in just a few hours.

Then I noticed something. I looked at his birthday.

2/14/57

Today was not February 14th. Today (at that time) was June 5th. Had we been scammed? Would our delightful little story have a sad ending?

On a whim, I brought up her profile. Her birth date?

6/5/60

Well then. Turns out it was HER birthday and not his. Funny how that works, especially since she called it in. I hope she had one helluva birthday celebration.

MENSA? What's MENSA?

You ever have one of those days? Where every single person who walks through the door appears to have eaten paint chips as a kid? As of they are attempting to prove Darwin wrong in that evolution is not possible?

Case in point;

Patient #1 calls in asking about the status of her faxed refill. I mention that we haven't heard back yet. She then goes, but I only have eight tablets left and I'll be out for tomorrow! Looking down I see the directions state 1 Tablet Twice Daily. Ok.....

Patient #2 comes in asking if her insurance is active yet (of course its a Medicaid patient). I check and say no. She then goes, verbatim, "Can't you like... just give it to me and stuff? And then like maybe like have my insurance pay for it later?

When I mention we need to ensure we're going to get paid for the med, she looked at me in the eyes (well her's were a bit on the glazed side) and asked, "Ohhhhh....Why?"

Patient #3 starts screaming that we didn't fill his insulin like he asked and we are trying to kill him. I asked him when he called it and he replied last night. Realizing I talked to him, I reply back "Last night you only asked if we carried Speghettios...."

Patient #4 calls in, "Yea I need to check on my script before you close in a bit here." Puzzled I ask back "You do realize we close at 7pm and it is currently a quarter after 1..."

I shit you not, this has all occurred within the last two hours of work. I feel for humanity. I really, truly do.

Plus our clerk reeks of booze. Not like booze from last night, but more like "I drank a fifth of whiskey before work and this gum will cover it up" smell.

I love my job.