The PharmD Student

The future

2011-11-04T01:16:00.003-06:00

So I just finished reading Drugmonkey's latest on Walgreen's POWER program, and I had a few thoughts...

Do you know what's most annoying? I'm sitting in school today writing SOAP notes and making recommendations to doctors based on pre-written interviews with patients. I literally get a typed up interview of the patient and every lab and clinical value I could ever ask for.

Do I learn? Yes.

Is it practical? No.

As of now, I like it, because it strengthens my learning - but I seem to be one of the few who realize this type of stuff doesn't happen all too often in the actual workplace.

I also am required to counsel on random medications throughout the semester - I get to look at the script (and only the script) and I also get as much time as I want to collect my thoughts before I start counseling.

Real world application? 1 out of 10.

Will I have infinite time to "collect my thoughts", without being able to look anything up? No. I'll have seconds - minutes maybe, and numerous resources to glance at. (Should I need the resources? No, absolutely not - not for common drugs.) My time is limited. I understand this is a learning exercise though, so I'm giving a pass on all this.

HOWEVER, having the bottle right there improves consultation immensely. You can point out how many refills, when to take, how often to take ect. ect. blah blah blah. Most importantly, special considerations (take with food, refrigerate, or do not drink grapefruit juice ect.) are almost always included on the bottle, which is a great resource to both us and the patient.

Now, should we know the special considerations for common drugs? Of course! However, we're all human and forget things from time to time.

So throughout my education I've been given:

1. More information about a patient than can be expected in a community pharmacy

2. Adequate time to review the patient's medications and comorbidities.

3. Inadequate prescription information for counseling

As far as my experience goes and from what I've read - my school is doing the opposite of what happens in the real world in at least these three categories I arbitrarily came up with.

My future job scares me - I'm not going to lie. I want to help this stupid population of people, but I'd rather do nothing than start harming it - and I'm scared I'll be rushed and eventually harm it.

Crap.

So P3 year kinda blows

2011-10-25T00:17:00.003-06:00

Hello there,

This isn't exactly new to me, but I haven't posted much in the past year - mostly because I had no pharmacy news/too busy doing pharmacy/work stuff to write my opinions blah blah blah.

This year has been interesting - in that I'm busy *all the time* with school work. Yes, I have days off, but I have 2 jobs because someone has to pay tuition and well, let's face it, my roommates aren't gonna do it. It's been interesting because I've been doing everything I can to keep my life in balance - I still go hunting with my best friend on the weekends and I still talk to my girlfriend as much as I can.

But it's taken a toll on my grades. I've got a B in one class and a C in another. While this isn't a big deal at all, it's a bit of a wake-up call to me. I view this year as the year I decide what is actually important to me and what I can slack off on - and time and time again I choose my friends and girlfriend above my school-work.

Maybe it's because I know I'll be fine with school. It's not like I'm going to fail - I'm still getting A's in most my classes, it's just the classes that require extra work that I'm struggling a bit in - It's that I would rather spend my time shooting ducks with my roommate or Skyping with my girlfriend than memorizing chemo treatments for NSCLC (non-small cell lung cancer).

So... No, I'm not going to be the encyclopedia of knowledge my professors want me to be when I get out of school. However, I will know where to find/look up all that information, AND I'll still have my best friends and girlfriend in my life.

I think I'll be OK. Don't you?

There's gotta be a retarded centaur

2011-10-25T00:04:00.005-06:00

Think about it...

I was reading up on my diabetes notes and there's an actual brand-name drug named "Mixtard".

Tell me you don't read that and think of a retarded centaur and I'll give you a dollar. All I can picture is a horse with a human torso who just happens to have Down's syndrome trying to walk and yeah...

But realistically, if centaurs exist - as in humans with horse bodies - there's bound to be a mentally challenged one here and there, and as intelligent/caring creatures, they aren't going to make like lions and eat their retarded babies. So, eventually, there will be a fully grown mentally retarded centaur.

I believe one of those centaurs was diabetic, and the other centaurs figured out a drug to save him, and we humans discovered it from them. So, of course, we called it Mixtard, as a homage to the true genius who discovered it - the centaurs.

Or maybe we homo sapiens are just a bunch of fucking idiots.

Do you know what pisses me off?

2011-02-16T04:01:00.002-06:00

Shitty teachers.

We have all had them. We all know who they are and we knew it three years before we were going to have them because every single person we know in the classes above us complained about them.

I have had many shitty teachers in pharmacy school. I'm taking a course right now that focuses on drugs that treat blood clotting diseases and hyperlipidemia and chronic heart failure, among other things. Pretty interesting stuff, right?

I mean, just look at blood coagulation. There are 13 different factors in platelet aggregation (not counting PF3). They are almost all affected by at least one other factor. There are numerous receptors on each factor and the platelets themselves, which are bound by one of the other factors. And they all have to work for your wounds to heal properly.

It's amazing stuff, and we have drugs upon drugs that treat someone who has a problem with their platelets over-doing it. We have drugs specifically designed to target one little receptor in your body that screws up what your body wants to do so badly that you won't die from acute pulmonary thromboembolism.

It's crazy, and it's downright interesting, and yet, I cannot stay awake in class. Despite the absolute awesomeness of the material I cannot stay awake, and it's because my teacher is shitty. He is boring. He is unprepared for class. He is probably a genius and most likely makes a shit-load of money for my college with the amount of research he does, but when it comes to teaching, he doesn't know squat.

Yes, he is Asian and English is his second language but I don't think that's the problem. He's about 40 years old and he acts like teaching us is a waste of his time. He walks in, reads off his slides and answers almost every question with "uh, yeah... sure."

I can't stand it. I'm supposed to be learning from this guy and one kid in class once said that extra bile goes to the pancreas and the teacher just said "yeah," and moved on. For those of you who don't know, extra bile is stored in the gall bladder, not the pancreas.

I have had a few great teachers, just like all of you had, and I wish I could say that the majority of teachers in my pharmacy school are good teachers, but I can't. Most of my teachers suck. I usually end up learning, not studying, the night before a test.

I hate it.

Where are all the Finnish Fish?

2010-11-03T01:05:00.001-06:00

Think about it.

So You Want To Survive Your Second Year

2010-10-14T00:24:00.002-06:00

Good luck.

After your first year, with biochem and all those other seemingly pointless, ridiculously demanding, and let's face it, stupid classes that stress the importance of <797> and OBRA 90 when in practice those regulations are put on for show once in a while when the inspectors show up, you can almost guarantee you can bullshit your way through class, like you've done before.

Wrong. This year, the college will finally teach you about drugs. There's no bullshitting when it comes to drugs. Ah yes, you may think just any NSAID will work for gout, since that's what you read when you skimmed the notes, that NSAIDs are a treatment for gout. What you didn't read was that indomethacin is pretty much the only NSAID good at treating acute gout attacks, and that a xanthine oxidase inhibitor (allopurinol) can prevent pretty much any gout attack, as long as it's taken regularly.

Have fun trying to convince your professor that aspirin can treat gout, because they ain't happening. Besides, why the hell do you think aspirin is a traditional NSAID in the first place? Get your damn act together.

This is the world of second-year pharmacy. We get into pharmacy because we are Type-A folks who love black/white. Take this, not that. This will work, this won't. And yet, aspirin is an NSAID but kinda-sorta-not-really. Trust me, the aspirin example is bush-league. There are exceptions to every damn rule you'll ever learn.

Apparently pharmacy is more like English than I thought.

To survive your second year of pharmacy school, you'll probably have to put down the booze except on rare occasions, and study your ass off. This is the year the teachers finally decide you can learn about drugs, and they throw them all at you in quick succession. There's no warning, no "Hey we're going to teach you about real stuff now."

It's just a relentless bombardment of drug facts with grey areas, and you're expected to know everything about everything. No exceptions, no excuses.

Sure, you can still graduate with a C in a couple classes, as long as your cumulative GPA stays above 3.0, but let's face it, you're an obsessive, controlling neurotic that strives for perfection, and a C will probably send you into a shame spiral resulting in a nervous breakdown.

Put down the bottle, grab a packet of notes, and get reading. Your sanity depends on it.

Good luck.

Holy Shit I Forgot About My Blog

2010-10-14T00:20:00.002-06:00

Hello everyone,

I literally, totally forgot I had a blog. Does anyone want to guess why?

Ah, I see you guessed, "Because supporting yourself with two jobs while attending pharmacy school makes pretty much everything else in life irrelevant." You are correct sir/madam.

Ok, with that being said, look forward to my post about surviving the second year of pharmacy school (Protip: it involves NOT getting drunk... like... ever...).

It's a sad year.

The Difference

2010-05-26T00:42:00.002-06:00

Every single day, I wonder about how my life would turn out if I went into retail.

I read Drugmonkey's blog regularly, and I enjoy most of his posts. I read Jim Plagakis just as much, and I enjoy most of his posts. I read Angry and Angriest and Pharmacy Chick and Pharmacy Mike and I Want To Be A Pharmacist and around twenty other pharmacy blogs irregularly, but I don't think I've ever read a pharmacy blog about the experience of some pharmacist in any other position other than retail.

Of course, I understand why, retail is frustrating. It's infuriating . John Q. Public is either an asshole or ignorant, and it's hard to excuse either of those categories.

Fortunately for me, I got out of the retail business, at least temporarily. I now do research with Aspergillus fumigatus and the allergic response. I've done this for a few weeks now, and I can tell you that it is much better than retail. However, I'm a mere first-time research assistant so I get the shaft. A lot.

I spent three hours the other day washing mice containers. They do not smell good. They are not even remotely clean. They need scrubbing by hand. It takes effort.

Another day I spent four hours sitting on my ass doing nothing. I stared at the wall. I was waiting for the proteinases to do their job to help purify our DNA sample. It's literally a "hurry up and wait" type of business.

So far though, if asked if I would do the same thing again, if I would leave retail and go to research, I would. In both jobs I worked with smart people who care about what they are doing, and both jobs have their downfalls. However, research doesn't have the general public. I never have to explain to a woman who is hard of hearing that she needs to see her doctor because she's out of refills.

It's nice. I like it, so at the end of the day, when I think about how my life would be if I went into retail, I look at my past experiences and my current ones and the scales are tipped disproportionately toward research. Despite it's boring moments, there are absolutely zero frustrating encounters with the general public, and I love that.

When they don't listen to you, what do you do?

2010-03-27T00:11:00.004-06:00

Oh my fucking god I want to kill my girlfriend right now.

What do you think of when you hear these symptoms: eye pain, blurry peripheral vision (some of you have already figured it out), nausea, redness of the eye, and the big one: halos around lights?

These are all symptoms my girlfriend is experiencing right now. If you're thinking glaucoma right now, thank you. You have proven my point.

I know, she probably just needs a new prescription for the lenses she doesn't wear on a usual basis. But according to the pathophysiology class I'm forced to attend to learn about the causes of disease rather than the treatment of them (but that's a different post), all of those symptoms are completely classic for glaucoma.

If your girlfriend showed these signs and you didn't say anything, didn't make her go to the doctor, didn't try to help, and she wound up blind, how would you feel?

Now if you did show your concerns, showed her the evidence, showed her every possible thing you could to get her to go to the doctor, and she still didn't listen to you?

Exactly how would you feel?

Because I'm frustrated.

The Last Monday

2010-03-25T23:24:00.002-06:00

Last Monday I woke up to my alarm clock, and I instantly knew something was wrong. Normally when I wake up there’s a bright ray of just-risen sun shining through the edges of the Venetian blinds that cover the East-facing windows of my bedroom. Not on Monday though. No, my room was void of any bright light. However, a dull red light seeped through the cracks of the blinds.

I looked out my window to see what was the matter, and lo and behold, I saw what had become of this world. After passing health care reform, the now Socialist nation that was once the world’s only super-power had turned the world upside down. I should have known that allowing our government to levy taxes on its people to allow the less fortunate to purchase life-saving health insurance from private companies – the very definition of Socialism – would create the world I saw from my bedroom window.

What I saw was the beginning of The End. The Apocalypse had begun. The sky was blood red and had ripped open. I saw the Four Horsemen galloping through the sky, creating war, famine, death, and conquest in their wake. I should have known, for the very first sign that The Apocalypse was near would be the complete government take over of the freedoms of the American people.

I wept for my lost freedoms. I wept for my freedom to be booted from my health insurance the minute I contracted the HIV virus. I sobbed for my freedom to be denied coverage because my mother was so inconsiderate to let me be born with a cleft palate. I fell to my knees and shook, because I knew my freedom to file for bankruptcy because of health care expenses was no longer an option.

As I came to grips with the knowledge that the world was ending, all because some majority-elected officials decided they would like it if 32 million more people, people that could potentially vote for them in the future, were granted affordable access to one of the best health care systems in the world, I heard a ringing.

It was my cell phone, and the 7:15am alarm was ringing, telling me it was time to wake up for the day. The sun shone through the edges of my Venetian blinds straight into my eyes, and when I closed them against the harsh light of day the light still reached my retina, although stained red by my eyelids.

I rubbed the sleep from my eyes, and smiled, knowing I had lost the freedom to be forced off my parents’ insurance plan for four more years.

A sigh of relief

2010-02-26T11:18:00.000-06:00

I've never been so happy to hear about vaginal bleeding. That is all.

Planning

2010-02-22T21:46:00.004-06:00

I have found that whenever my life deals me a hefty dose of stress I tend to completely shut down and think out every single option I have and mentally travel through each option.

Notice I said "life." Not work or school. When work or school throw stress at me I start working faster and just power through what usually amounts to a bunch of repetetive tasks done on autopilot (counting pills, taking notes). My brain is completely focused on one thing: 5, 10, 15, 20, 25, 30; "children taking steroids can experience slower growth." Ok - Got it.

However, when life throws me problems my mind goes everywhere. Life isn't black and white, there are so many shades of grey they turn into colors, and my brain wants to know every color, now.

Anytime I have to make a big decision I talk about it with everyone I trust in my life, but in my head. I don't actually speak to them, but I definitely have conversations with them; they just don't know it. My parents and sister have given me an insane amount of advice that they never actually gave, and it seems to always lead me in the right direction.

Sometimes, if I have a seriously big issue, like "oh shit my girlfriend might be pregnant," I'll end up working out solutions in my sleep. I kid you not. I'll plan and figure out exactly how I'm going to solve each problem, all while I'm asleep. It's not a very good sleep; I constantly wake up and rehash things in my head, but I usually wake up in the morning feeling... great.

Not because I'm refreshed and ready to face the day, but because I've figured everything out. No situation is hopeless, and it seems like my sleeping brain can figure out the simplest solutions to the toughest problems.

Last night, I woke up around 15 times between midnight and 5am, and each time I seemed to have another piece of the absolute worst case senario worked out. If she is pregnant and if does does decide to keep it (which is completely her decision), I have a battle plan.

If I'm a father in 9 months, I know I will be prepared for the challenge. I know my parents, grandparents, and friends will help me in every way they can (because I asked them, in my head), and I know my kid will grow up right.

Of course, there are 1,000s of variables I can't even begin to identify, but if we keep the kid and raise it ourselves, I will know what to do. At least my brain thinks I do. I'll always be thankful that my brain can make quick decisions without me even knowing it.

Incidentally, sometimes my brain figures out plans of action to problems I didn't even know I had. One night, I jumped out of bed at 3am with a strategic plan with one end goal: buy gas. The gas station closest to my house was closed but the Holiday just a few more blocks away would be open. I threw on some clothes and was opening my car door before I realized it was 3am and I could literally buy gas at any other time of the day.

I can only hope that this pregnancy scare is exactly like my gasoline situation. Just a made-up problem my brain decided to fix on its own.

I'm worried

2010-02-21T22:50:00.003-06:00

If there's one thing that scares me the most, it's having a kid.

Don't get me wrong, I want to have kids someday, but just not anytime soon. I want to be able to go out to the bars or go to a movie whenever I want to. Once I graduate, I want to become some sort of pharmacist (not retail) and have more money than one person from a frugal background like mine could possibly know what to do with. I want to take vacations and see parts of the world I've always wanted to see (Ireland, London, Seal Island off South Africa).

I'm still young; I have plenty of time to raise kids.

Right now my girlfriend and I are having a bit of a pregnancy scare. She was supposed to have her period 2 weeks ago, but she started birth control 3 weeks ago. As a pharmacy student, I know that it can only take a couple days for birth control to be effective, but it can also take up to a month. Consequently, I have used condoms each and every time we've had sex.

It would seem that we did everything right, but last week she started having some pretty bad cramps, and she's been nauseous for the past couple days. I know all of you are thinking that these two symptoms don't mean jack, considering both are very common side effects of birth control. I agree, but they are also two very common side effects of being pregnant.

What makes it even worse is that I know the timing of periods can get a little funky once a woman starts on the pill. This means we might possibly have to worry about this for the week for even longer.

Everyone I have talked to told me not to worry about it. I've told myself not to worry about it. With birth control being around 95% effective (due to noncompliance) and condoms being something like 95% effective, the odds are absolutely astronomical that she's pregnant. My best pharmacy friend, who's a P3, told me she's had this same exact scare more than a few times with her husband. I shouldn't be worried.

But put yourself in my shoes. I've got 3.5 years left of school. Expensive school. I work 20-40 hours a week (depending on the weekend schedule). I don't have the time or money to raise a kid.

I shouldn't be worried, but my girlfriend is having bad cramps and puking.

I'm worried.

IPPE

2010-02-05T23:32:00.002-06:00

As part of the pharmacy curriculum, we have to do 100 hours of Introductory Pharmacy Practice Experience (IPPE) for the first two years of pharmacy school. This involves us students getting matched with a contracted practice site by some crazy algorithm program that not a single professor at our college can accurately describe.

The program allows us to choose which sites we want to go to in preferential order, but the problem is there's only a total of eight rotations in my college city. That means that less than 10% of my class will get to do their IPPE in our city this summer, which, if my math is correct, means over 90% of us will have to go out of town.

Not that that's a big deal, many of the practice sites are in or near our respective hometowns, but what peeves me is this - they asked us to tell them where we wanted to go, and that they would do everything in their power to get those sites available to us. They didn't though. The list of practice sites are the same as they were last year. Not a single new site was added.

Unfortunately for me, my hometown isn't one of the towns that was on the list last year. I told them about four different sites near my hometown that I would be willing to do my IPPE in this summer, and not a single one became a site that's available. This seems to be a tad bit insane, considering there really isn't another pharmacy school near my hometown, so it's not like those places need to reserve spots for other colleges. I really, truly think that the professor that was in charge of contacting these places really just didn't care one way or the other.

My guess would be that she sent an email to the HR department or something and then just waited for a response. If she didn't get one, oh well. If she did, cool. I'd be willing to bet her total amount of time and effort put into getting us practice sites amounted to the same effort I put into this blog.

It looks like I'm going to have to battle for one of those eight spots in my current city, and if my luck in the past is any indicator of how that will go, I'll end up in East-Jesus nowhere.

Top 200: Part 2

2010-01-03T15:02:00.002-06:00

I was going to write these down sooner, but I had some things I had to deal with. Well, no, I didn't, but that sounds better than saying I was lazy and didn't feel like it.

Plavix = clopidogrel "A vixen is a girl, and Vulpix is a horse thing Pokemon so it clops when it walks."

Seroquel = quetiapine "Sarah quelled rumors by being quiet."

Proscar = finasteride "The pro car finished on steroids"

Flomax = tamsulosin "Tamiflu flows to the max, and it's a sin."

Cardura = doxazosin "The durable car drove off the zoo's dock."

Tessalon = benzonatate "Ben and Tess zonked out after they ate them." I fucking hate counting this drug.

Actonel = risedronate "The drones rise when I act on them."

Evista = raloxifene "Relax and look at that beautiful vista."

Detrol LA = tolterodine "I'm totally in debt living in LA"

Aricept = donepezil "Don't nap in the air except with a Pez dispenser."

Namenda = mementine "NAMBLA (North American Man/Boy Love Association) = me + men."

Soma = carisoprodol "So, ma, can I have a car lease and a pro doll?"

My two favorite:
Viagra = sildenafil "Slide in and fill."

Cialis = tadalafil "TADA!"

That's about it. Even after all of this, I still screw up on the Top 200 tests. I somehow manage to switch around the vowels during the tests, and it annoys the bejesus out of me. If any of you out there have some tricks to remember the vowels of all these drugs, I'd gladly listen.

Winter Break is Finally Here

2009-12-20T12:03:00.003-06:00

Well, finals week is officially over. My transcript is going to show a GPA lower than ever, but a couple of Bs never hurt anyone, especially pharmacy students.

While my GPA may have suffered a bit this semester, every thing else in my life seems to be going abnormally well. I don't hate my job all the time, I've been getting in better shape, and I actually met someone.

Amazingly, this girl became interested in me not because of my extreme good looks or ridiculously hot body, but because of my writing. That's right people, I have started dating someone because of my writing skills.

Un-freaking-believable. I'm not complaining.

Now I can look forward to three weeks of reading for fun, being lazy, and hanging out with this girl while not trying to learn anything new.

Awesome.

A Complete Waste of Money

2009-12-04T01:41:00.003-06:00

As I watched the robot fill the 20th prescription for zolpidem for the day, I wondered exactly why so many members of the ever shrinking middle class insist on using it to fall asleep.

Granted, they aren't on the useless products of Zolpimist or Ambien CR, and they aren't spending an extra arm and a leg for Lunesta (eszopiclone - oh yeah, I've been studying up on the Top 200).

But still, why waste the money each month when, for a one-time payment of $180, a patient could get the best sleep aid I have ever come across? This sleep-aid can be used over and over again and never lose its effectiveness. Actually, I only paid $60 for mine, and it's even more effective at putting me to sleep than the $180 version.

That sleep aid is my Biochem textbook. I seriously believe that Lehninger could make much more money by marketing his book as a sleep aid.

He could even mark the international version (the one I own) as a fast-acting version, because nothing puts a person to sleep faster than an all black and white Biochem textbook.

I have a quiz tomorrow. I'm sure I'll be asleep in 20 minutes. Goodnight.

Misinformed Doctor

2009-12-01T00:42:00.003-06:00

We have one doctor in the children's clinic that seems to be a tad bit... slow. For one thing, she refuses to write for any amoxicillin strength except 250mg/5mL. Even if she wants 400mg PO BID 10D, she'll still write for amoxicillin 250mg/5ML, when every other doctor would write for 400mg/5mL.

I once called down and informed her that the 400mg/5mL existed, and she told me she knew that, but had been informed that the 250mg/5mL tasted better.

I informed her that we get the two different strengths from the same manufacturer and they taste exactly the same, but still to this day she still will not write for the 400.

While this is just a minor annoyance, seeing that we can fill the prescriptions with whatever strength we please, it is when the doctor writes incorrect instructions that obviously means she does not look at the prescription she writes that pisses me off. An example:

Zithromax 100mg/5mL
Take 6mL tsp today, then 3mL tsp days 2,3,4,and 5.

Now, anyone with a brain would know that she accidentally put the tsp in there, but according to the law I had to call and confirm the prescription. Unfortunately, that took about 10 minutes. 10 minutes I had to stand there and listen to the little kid cry and cry and cry and cry and cry while his mom tried without success to calm the little womb fruit down.

*Sigh*

Oh well, it really isn't anything to get all worked up about, but it still gets on my nerves when I have to listen to a screaming kid because some doctor does not check the prescriptions she writes.

Pulling It Back Together

2009-11-18T23:20:00.002-06:00

Well folks, it looks like the whole not getting wasted 3-4 times a week and actually applying myself to pharmacy school is working.

I'm happy to say I have an A in every class except Biochem, but after this last test, I'm hopeful I can scrape by with a low-low A if I do well on the final, and a 90% is the same as a 99% when it hits the transcript. I don't think I'll manage to pull off the A, but a B isn't bad either.

I would apologize for my lack of posts, but all the writing I've been doing has been for my school newspaper, because I get paid to do that.

So... I've got another batch of ways to remember the Top 200, and I'll get to that in a couple days.

Smart-Ass Comment of the Week

2009-10-28T23:44:00.004-06:00

I work on Friday, but I don't think I'll get a better chance to be a smart-ass than I did on Tuesday.

A mother comes in with a prescription for her daughter. I ask if we've filled for her before.

"Yes."

Awesome. I pull up the profile and see we haven't filled for her since 2007. I then ask if she got new insurance since then.

"No, it's the same."

Awesome. I enter in the prescription, it gets rejected by insurance claiming "FILLED AFTER COVERAGE TERMINATED."

Ok, the patient obviously has new insurance information. I ask to see her card. She hands me a card from a different state than her old one was from. I give her a look that I hope conveys my feelings toward her. It was my "You're a fucking idiot," look.

I'm about to enter in the information when the woman pipes up and says:

"In the past, most pharmacies have found that it only works when you don't put the letters in for the ID number."

Oh holy shit, by the time she was half finished with that sentence I was smiling my sarcastic I-want-you-to-be-hurt-by-what-I'm-going-to-say-next smile. I said:

"Oh, really? Huh, because -"
"Yeah we know all those little tricks," the pharmacist bursts out, completely interrupting me, which is probably a good thing.

I was planning on finishing the sentence with something like, "I've been working in this pharmacy for a while now, and I've never seen that. Weird."

Of course, the patient might still have thought that I was being serious. Oh well. Maybe I'll get another chance to ridicule a patient on Friday.

One can only hope.

The Filling Process

2009-10-28T23:12:00.003-06:00

For those of you out there that are unfamiliar with the process that happens behind the counter at the pharmacy (although I doubt anyone but pharmacy people read this), I'm going to go through a step by step guide to how it works.

1. You hand me the prescription. This is pretty simple stuff that 99% of people understand.

2. I look at the name on the prescription and ask "Have we filled for (name) before?" There are only two answers to this question.
1) "Yes." 2) "No."
A third possible answer, "I don't know," is not what I am looking for, but I can understand if you really do not know. That's ok.

If you answered "Yes," or "I don't know," skip down to #4

3. I will ask, "Do you have insurance?" This is always a tricky question, because some people will just say "Yes," and about 90% of the time it's "Yes, we have MA." They then stare at me until I say, "Well, can I see the card?"

This is when you have your first opportunity to either be a pain-in-the-ass customer or a good customer.

If you say, "No, I don't have the card on me, don't you have the number from when we checked in?" I will want to punch you. No, we do not have the number. My computer system is completely different than the clinic's system. I will then direct you out to the clinic to obtain the number from the receptionist. She will not be happy.

Of course, if it isn't my state's or any neighboring state's MA or BCBS number, you're fucked. There are too many different processors and BIN numbers and especially group numbers to keep track of them all. Go find your card and come back.

If you say "Yes," and hand me a card, I will not dislike you.

Skip to #5.

4. I will pull up the patient's profile; if I see we haven't filled anything for that person this year, I will ask if your insurance information has changed since then. If it has, you better hand me that card.

5. Once I have the profile all set up, I will ask if there are any allergies to medications. Do not tell me "pollen." We do not dispense pollen in my pharmacy.

6. This is all the information I need. I will tell you it will be a few minutes. Take a step back, sit in a chair, and wait. Do not hover around the drop-off area. I will be able to feel your eyes on me, and while it does not make me nervous like it did when I first started working in a pharmacy, it does make me want to choke you.

7. Once the prescription is entered and successfully made it through insurance, I will then fill the prescription while the pharmacist checks to make sure it is correct.

8. If everything is peachy-keen, the pharmacist or I will ring you up, get you through HIPPA, insurance signatures, and about 1/3 of OBRA 90 (maybe 1/4). You are then free to leave. Please do so.

Too Mean To Publish

2009-10-25T10:45:00.004-06:00

I wrote this article for my school newspaper, but I decided not to submit it. Mostly because it would just piss people off and I really don't need an extra source of stress in my life. Another reason is that the more I think about the entire subject I'm not even sure I agree with what I wrote. Red flags started popping up when I wrote "This is as Republican as I get, folks."

Of course, if we had universal healthcare this wouldn't be a problem...

It looks like the hospitals in this country are following the lead of the airline industry and charging obese people more for their services. Instead of charging them for an extra seat, hospitals are charging more for an ambulance ride. This really shouldn’t surprise anyone, considering an ambulance ride for an obese person is often double the cost of what the Associated Press calls “normal-weight” people.

I felt the need to quote the Associated Press on normal-weight because I am not sure it is fair to classify people with a healthy BMI as “normal,” knowing the fact that over 60 percent of this nation is overweight, according to the CDC. Actually, if someone described me as “normal American weight,” I would be offended.

The reason costs are so high to get obese people to the hospital is that many stretchers and ambulances just cannot hold the weight, and special equipment must be used. Equipment such as forklifts, flatbed trucks, and Sawzalls to cut open the obese person’s house because they just can’t squeeze out a normal doorway.

These are extreme, although real, examples, but the cost to purchase new stretchers and ambulances that can support an obese person will double in the coming years, which will contribute to the total cost of health care. We all know that the cost of health care really hasn’t been a big issue lately, but we should still address this issue as soon as possible. I bet Congress will get around to it in a couple years.

Of course, the obese of this nation think that charging more to haul their extra weight is a form of discrimination. Joseph Nadglowski, president of the Obesity Action Coalition, stated that "Ambulance services are a critical public service and should accommodate the needs of all of those who require them at a fair cost.”

I know what you are thinking: “There’s an Obesity Action Coalition?” I am here to tell you that yes, yes there is. Obese people have become so prevalent that they need a coalition to speak for them, presumably because they are too busy using their mouths for breathing instead of speaking.

The coalition states on their website that one of their proudest moments was when they organized 3,000 people on a “Walk From Obesity” march on the Capitol. According to my calculations, that is about .029 percent of all obese people in this nation. I’ll let you decide where the rest of them were. My guess is on the couch.

And here I was, thinking it was funny when my friend made fun of the Greek community for only getting 200 people to their pep rally. My calculations indicate that that is about 1.4 percent of the entire campus, so if his estimation was correct, Greek life is way better at organizing events than obese people. Now that is what I call an accomplishment.

I do agree with Nadglowski though; I believe we should accommodate the obese at a fair price. It would be fair to charge them more, right? If I need to get my car towed, and I have a strange model that requires a different, more expensive hitch, I should have to pay more to get my car towed. If I need to send a heavy package, I should have to pay more to cover the extra cost to transport it.

I would not be saying these things if people could not control their weight, but they can. An obese person has essential chosen their lifestyle by not staying fit, and they should have to pay for the costs that are directly increased by their choice. I don’t see how that is discrimination. I just see it as fair.

This is as Republican as I get, folks.

I understand that some people cannot control their weight. Genetic defects and certain medications can cause weight gain, and these irregularities should always be taken into consideration.

If someone does not want to put in the effort to overcome obesity, I do not have a problem with it. However, I think it is completely fair that they pay for the increased health care costs based on their decision.

If an obese person wants to roll up to the drive-thru pharmacy for their Lipitor, Benicar and NovoLog prescriptions, I honestly do not have a problem with that, just as long as they don’t complain about the co-pays.

So yeah, that's my article that decided not to publish in the newspaper. I figure the relative anonymity that blogger provides protects me from getting flamed by my campus.

How Do I Do It?

2009-10-24T02:40:00.002-06:00

I'm a busy fucking person. Between work and school, I was occupied 58 hours this week. That is just the hours I had to be in class, at the pharmacy, and at my other job. I also write for my school newspaper.

I also take labs that require extra studying and writing lab reports. My life is fucking hectic. I wonder why I accepted a TA job. I wonder why I said I'd write for my school newspaper (well, that was for the money).

My friends ask me how I do it.

To be honest, I'm not, I'm not doing it. I'm coasting by on my relatively intelligent brain, but in pharmacy school it just isn't enough. At least not for the A's that I'm used to. Yeah, I can squeak by with B's and the occasional C, but I'm not OK with that.

It's come to the big decision. Do I keep up my grades by studying all the time or do I keep blowing off steam by getting hammered 2-3 times a week? I think a comprimise is in order. I need to study more often, but just drink to forget the pain once a week... I think that's the solution.

That's a terrible solution.

I Hate School

2009-10-24T01:08:00.002-06:00

For the first time in my life, I'm struggling with school. Pharmacy school is fucking hard. The worst part of it all is I'm not doing well in classes that don't matter. At all. It's so hard to actually try in a class where I know I will never need the information ever again in my life. For instance, how many pharmacists know the pKa of the imidazole group on the histadine amino acid in the body? None? One?

Is it relevant?

Fuck pharmacy school.

Fuck it.

Tamiflu (You can too!)

2009-10-14T18:01:00.003-06:00

This week has been bonkers. I was working in the children's clinic pharmacy and I have never run around like that in my life. I spent about 3 of the 4 hours I worked on Monday doing one thing: compounding Tamiflu for oral suspension. I opened around 8 or 9 boxes of Tamiflu capsules just to make all the suspension we needed. The worst part about working in the only children's pharmacy in town is that every other pharmacy in town just assumes we have the Tamiflu suspension.

Newsflash people: there's a shortage everywhere, and our pharmacy is no different. To be fair though, my pharmacy probably stocks more solution than yours does. However, does anyone consider that our pharmacy goes through more Tamiflu solution in 3 hours than most will go through in 3 days. Luckily, we got in 72 bottles of the solution on Tuesday from our state's emergency stash. We ran out early Wednesday morning.

This is absolutely crazy, and on Tuesday night, I finally snapped. We filled 60 prescriptions in 3 hours. While you may think that's not too bad, remember that it's just me and the pharmacist at the pharmacy. That's an average of 1 prescription every 3 minutes, and we have to enter those, fill those, and then counsel them. Oh, and put them through the cash register. A 3 minute average under these circumstances is insane. We were working at break neck speed, all while being completely accurate and making zero mistakes.

At the end of the big rush, we had a father come in with 2 prescriptions, one for Tamiflu suspension (surprise!) and one for a cough medication (I don't remember what one, as I had never filled it before). Well, turns out Medicaid didn't cover it, so this is the conversation that ensued:

"Sir, I tried to bill the cough medication, but the insurance won't cover it."

"Cough medication?" the father asked, confused. "What's that for?"

"Probably for the cough," I replied. I immediately realized that that wasn't the most polite way to go about things, but after 3 hours I wasn't in the mood to be polite.

I thought I was going to be reprimanded for the my comment, the pharmacist later told me she was trying her hardest not to laugh when I had said that, which just goes to show I work with one of the most awesome pharmacist ever.

As a result of all this compounding and crazy days at the pharmacy, I've been drinking heavily, and I think it shows in the lack of continuity in this post...

I think all-in-all though, this just goes to show that I'm probably not going to be a good pharmacist. I really can't hold back my sarcasm when I'm stressed out, seeing as it's the only way I know how to deal with the stress. Oh well, I'm already on the path, and I'll finish up my education, and become a jaded pharmacist. Awesome.

I'm already looking forward to it.

Sometimes I Hate The Pharmacist

2009-10-06T01:17:00.002-06:00

Yeah, I said it. I get sick and tired of pharmacist that decides to check to make sure everything is done according to "the law" while she forces me to count benzonatate.

I'm sick of watching them check the prescription while I push little marbles around, trying count by five and hold on to my sanity at the same time. That isn't easy, and one of these days I'm going to snap. I don't care what you think your "job" entails, making me count out every single prescription for benzonatate is cruel, and one day you'll pay.

I can just imagine it, forcing a bottle's worth of pearls into the pharmacist's mouth and making her bite down on them. Oh, that would be sweet, sweet justice.

Finding Jesus

2009-10-02T00:17:00.006-06:00

I was talking to a friend of mine who has found Jesus. He told me he's never been happier since he's found Him, and that life is beautiful. At first I sort of just ignored my friend; I don't push my beliefs on him, he shouldn't push his beliefs on me. After a while though, I started to think about it. My friend has been happier lately, and much more fun to be around. The best part is that he doesn't have any Bible versus memorized so I don't have to listen to those all the time. But after hanging around him lately I've decided to see if I could find Jesus.

At first, I looked in the obvious places. I went to all the churches, but didn't feel His presence or encounter Him. I then went to the local prison, because I've heard a lot of criminals find Jesus in prison. Apparently, you need to actually be incarcerated to find Jesus in prison, because I didn't sense Him there either, although a couple of the inmates asked me if I wanted to "sense" them, and yes, they air-quoted when they said it.

After a long day of trying to find Jesus I had given up. Perhaps some other day I would see the light, and it would guide me toward Him. It was a little chilly, and I had worn a jacket, and as I opened the closet door to put my jacket away I heard, "Fuck! I'm so bad at this game!"

Startled, I jumped back. "Who are you?! What game?!" I shouted.

"I am the Alpha and the Omega. Hide and go Seek is the game," said the man walking out of my coat closet. There seemed to be a spotlight behind him.

"Wait, whoa, Jesus?! I've been looking for you today! You were here the whole time? Wait, did you just say 'Fuck?'"

"Ah yes, I did say 'Fuck,' didn't I? But what sin is committed in swearing?"

Jesus had a point. I couldn't think of a single reason why swearing would be a sin.

"Would you like some wine?" He asked, as he tapped the kitchen faucet. I watched, breathless, as red wine flowed out in to the sink.

"Uh, sure," I choked out, "Hide and Seek? You play Hide and Seek?"

"Duh, dude," he replied, "Why do you think people are always trying to 'find' me? I thought it was pretty obvious."

I was beginning to feel pretty stupid, and as I took a sip of wine it just got worse. "This tastes like iron!" I exclaimed as I spit the wine all over my hands.

"Well come on dude, this is my blood; I need oxygen too, you know."

His logic was overwhelming, I could see why people pray to Him. "I'm sorry, but who exactly do you play Hide and Seek with? I mean, if it's just me and you wouldn't you win all the time? Because you're always the last one to be found?"

"Ah, another common misconception," he said. I began to wonder how many times He's had this conversation. I began to feel ashamed of all the times I've gotten annoyed with someone who called to see what time we closed. "I play with the Easter Bunny and Santa Clause, but those fuckers cheat because they only come out once a year, where I have to be out all year round. It's bullshit."

"Wait, the Easter Bunny is real? And Santa?" My disbelief was palpable.

"Oh for My sake, of course they are. Me," Jesus said, obviously annoyed.

"Did you just use your name in vain?"

"Technically, no, asshole," Jesus spat back.

"Whoa sorry dude," I replied as I went to the sink to wash the wine off my hands. "Hey! This is still wine! Can you change it back to water?" I asked.

"I just performed a miracle, and you want me to undo it? Fuck you dude. I'm out."

And then He was gone.

Paranoia

2009-09-28T10:17:00.003-06:00

I was walking down the hallway today and saw a sign on a water fountain that said DONOT USE! Now, at first I thought that perhaps someone just forgot to put a space in between "DO" and "NOT." However, as the day passed I started to realize that perhaps they just misspelled "doughnut." It happens, spelling is hard, and often confusing.

I then wondered why doughnuts got their own water fountain. Yes, they are delicious, especially because they're pretty much a piece of cake shaped like a bagel with sugar coating the entire thing. That's pretty awesome, but why should that give them the sole right to a water fountain? The powers that be must be prejudiced against non-doughnut breakfast foods. They can't even argue "separate but equal," because the doughnut water fountain is closer to the bathroom and taller than the other. Can you imagine the strain bending over to drink from the smaller fountain will put on the average breakfast food's back? Do you think eggs can handle that when they can't even decide if they're healthy for you?

Cereal is completely screwed. Every time it wants a drink of water milk will spill out due to the increased angle it must dip to to receive the water, and we all know that milk is the life-blood of cereal. A couple drinks from water fountain and cereal will need a milk transfusion. Emergency rooms will need to stock more 1% milk, which is the universal donor of milk. The skyrocketing demand for 1% milk will cause hospitals to stockpile it, forcing them to use more energy to keep it refrigerated. Thus, more carbon will be spewed into the environment, causing more global warming.

Separate water fountains for breakfast foods is causing global warming. I brought this up to the Dean, and he gave me a blank look and told me to leave. I'm beginning to think that perhaps this is a conspiracy the doughnuts are using to destroy the world. Doughnuts are notoriously bad spellers, so it makes perfect sense.

Or maybe someone just forgot to hit the spacebar.

Our Role

2009-09-27T16:04:00.002-06:00

I recently had a drunken conversation with another pharmacy student about the role we will play once we are pharmacists. My friends know not to bring up pharmacy when I'm drunk, because I can go on, and on, and on about anything pharmacy. I was baffled by my fellow student's stance on what we will be once we obtain our PharmD. He maintained throughout the entire conversation that what the doctor says is what is best for the patient, and that if a patient wants to put something in their body it isn't any of our business. He literally said "We are just the middle man. We just count the pills."

Wow. Just... wow. I can honestly say I would never think a single pharmacist or pharmacy student, or anyone who's worked in a pharmacy would ever, ever, think that. These are fighting words, and I'm never one to back down from a fight, especially when I'm drunk.

Our role as pharmacists is to make sure the patient is getting the best care possible. We provide a service that takes at least 6 years of schooling to be able to do, and we are considered doctors when we are done. It is our responsibility to know everything about every drug. It is our responsibility to not give a patient a drug that will harm them. I asked him if he would give a patient Imdur and Viagra because "the patient wanted to take both, and he's just the middle man." Of course, he failed his Top 200 test so I had to tell him that Imdur was isosorbide mononitrate. I then had to tell him that taking Viagra and nitrates is a BAD IDEA. I wonder if his total lack of knowledge towards drugs is why he thinks pharmacists are middle men.

We are NOT middle men. We are professionals. We have the knowledge to help people, we have the knowledge to kill people.

He somehow related his entire argument to the Bible, and Jesus. Once religion popped up I stopped listening to him entirely. Religion has no place in pharmacy. I don't dispense pills because Jesus loves me. I argued with him for an hour and a half and he threw away his entire argument when he mentioned Jesus.

Oh, and his wife is a recovering drug addict. I can't figure out exactly how ironic it is that he thinks he should dispense anything the patient wants when he's seen what drugs can do to a person. I'm going with "groin-grabbingly ironic."

Top 200

2009-09-21T21:55:00.002-06:00

My first Top 200 test is coming up, and I've got a few ways to learn some of the weirder brand to generic names. Some are so crazy, like Micheal Scott crazy, that there's no way not to remember them once you make the connection. Here are some of them:

Lopid = gemfibrozil "I put some gem fibers on my low moped."

Altace = ramipril "You've got to ram that alt button when you're typing."

Diovan = valsartan "Val died in a van."

Depakote = divalproex sodium "Pro divers can dive deep with coats on."

Nasonex = mometasone "I want to meet Antonio Bendares' mom." Yeah, that one's a stretch.

Accupril = quinapril "Dr. Quinn, Medicine Woman, was accurate."

Lotensin = benazepril "Benzene groups have a low solubility in water, and water has a high surface tension." Yeah.

Novolog = aspart insulin "The Spartans went out like a Supernova in 300."

Xanax = alprazolam "Alprazolam kind of sounds like palindrome (no, it doesn't), which is what the word Xanax is."

Nasacort AQ = triamcinolone "I tried to court sin alone."

Dilantin = phenytoin "It would be funny to die lying in tin."

I have more, but I think you get the picture.

The Difference

2009-09-15T23:18:00.002-06:00

I had an epiphany the other day. It was about the extreme differences between the average 20-something-year-old "young man" and the 20-something-year-old "young woman." I put those terms in quotes because I don't believe anyone I know my age should be considered anything more than a teenager that... well... drinks as much as a teenager does, but in a different town. There's a subtle difference.

The difference between the 20-something sexes is their definition of "hanging out." Have any of you noticed that girls think guys want to hang out with them to just hang out? They honestly think we hang out with them because we enjoy their company. False. Guys my age do not, I repeat, do not, hang out just to hang out. We want something, and 99% of the time, that something is sex, or a good BJ, we're not too picky. Hell, a PB & J + HJ is usually enough. I have told this to a few girls recently and they just would not believe me. I tried to explain to them that, yes, if a guy wants to just "hang out," that means he wants to seduce you. There are a few exceptions to this, which I will get to.

These "young women" see things differently. If they don't find the male in question attractive, they assume that he doesn't find her attractive. Unless the "young woman" knows she's a bombshell, then she'll just assume everyone wants her. That's a given. But for some reason, most of these girls think that guys are just nice and caring people that don't want to explore the areas under their undergarments. This makes for some confusing and quite awkward moments when the guy goes for it and gets immediately rejected with a "What the fuck?!"

So let's just set the record straight here, and I'm going to be talking to the ladies out there from now on. When guys ask you to hang out, or to come over to his party, that means he's interested in you. The only exceptions are:

-He wants you to get with his friend, who is too cowardly to ask you himself.
-He wants to get with your friend, who he knows you'll bring along.
-He 's your relative (this exception is void in the south).
-You're his friend's girlfriend.

If you say yes and go to this guy's party, he thinks you like him. Period. That's how our brains work. It's not our fault. Now that the guy thinks you like him, this is where it gets messy, and sometimes sticky... (usually not...)

He will then ask you out on an honest-to-goodness date. This will be somewhat difficult for him, if he actually likes you. "What's the worst that could happen?" you ask, "A simple 'No,' and it's over."

Yeah, this is true, but it still fucking sucks. But wait, it's not over.

Now here comes the messy part, the part girls start to complain about. The guy won't give up. He will keep asking you out on dates. The terms "creeper," and "stalker," will be thrown around. For some awful, terrible reason, the guy will think you actually were busy that night, that you had to stay home with your sick dog, or go out with the girls, or even wash your hair. Because honestly, we know Friday nights are prime hair-washing nights.

Guys, I'm talking to you now. If you ask a girl on a date and she says "No," but doesn't say, "but maybe some other time, like this (specific day)?" It means she does not, I repeat, does not, want to date you. Tough luck dude, move on.

Guys don't understand that. A "No," is just a speed-bump. He'll keep building up the courage to ask the girl out and keep getting hit with the "No," for eternity, or until he finds someone better-looking than the girl in question. It's science. It's Darwinism.

The problem is with the perception of "hanging out." Guys refuse to believe girls don't want to fuck them. Girls refuse to believe that guys want to fuck them. This is a nation where most prescribed medications are for depression and pain. Coincidence?

OBRA 90

2009-09-12T14:59:00.002-06:00

Out of our 4 lab instructors, only 1 of them seems to know what it's like out in the real world of retail pharmacy, either that or she's just a damn good teacher.

This week we filled 3 prescriptions for a fake patient, one was for pills, one was eye drops, and one was a compound that we had to compound. We then pretended one of our classmates was that imaginary patient, and counseled them. This is always interesting because it's painfully obvious who has counseled before and who hasn't. It's hilarious when the book smart quiet girl who's never even seen a pharmacy has to counsel me. Watching her stutter and stammer her way through OBRA while avoiding eye contact is entertaining. It then gets frustrating and scary when I realize this person will actually be a pharmacist someday. *shudder*

I've been doing a lot of counseling lately, but like every pharmacist I know, I don't follow OBRA. OBRA can sometimes seem so redundant that you literally watch the patient's eyes glaze over as they stop paying attention. We're supposed to introduce ourselves, give them the name of the drug, the dosage, and a million of other things. I think we have to offer to give them our 1st born son somewhere in there too. It's in the fine print.

When the instructor came over to listen to us counsel each other, I didn't introduce myself or tell them the strength of the eye drop that I was counseling on. Whoops. The instructor seemed impressed with my interacting skills, as she said "Well I can tell you've worked in retail, and I'm sure you've counseled before, but remember you have to introduce yourself and give the strength, which would be 5% for this one."

I gave her a look that must have told her my feelings on the subject, which are "Really? I mean, like, I know... But Really?"

She responded to by saying, "I know, but it's the law, and we have to teach you do things correctly." I was sympathetic. She just wants to teach, and she's a good teacher. I won't forget to introduce myself ever again.

Reform/Salaries.

2009-09-07T14:26:00.004-06:00

I went to my uncle's cabin over Labor Day weekend to hang out at the lake and relax. My favorite part about hanging out with this certain family is that they're all staunchly republican, but occasionally they can see things from a different point of view, like mine, for example. My parents are both English teachers at the high school I graduated from, and I was raised as a democrat, although I am not exactly political. All politicians are corrupt in some way, shape, or form. Granted, it comes with the territory. I'm not here to bash any politicians, I'm just saying that it's not my type of thing. I like to be honest with people, which is probably why a lot of people think I'm an asshole.

My cousin asked me an interesting question as we were watching a town hall meeting where the senator was actually yelling at an average Joe in the audience for not following protocol and yelling obscenities. It was awesome. My cousin asked me what this health care reform was going to do to my job outlook. I told him absolutely nothing, people will always need their drugs, that will never change. He then asked me about my pay, if my salary would go down because of this reform.

Now that's an interesting question. I really didn't know what to say. I told him I would think about it and get back to him. I've done a little thinking, and I can honestly say that I think it won't affect our salaries one way or the other. The way I see it, it doesn't matter where the pharmacy's income comes from, that income is going to remain the same, or go up. I say go up because I've never had to call the Medicare or Medicaid office because they weren't paying enough on a claim. I've had to do that with private insurance claims. Erythromycin Ophthalmic ointment is the latest and greatest of these bang-my-head-against-the-wall calls. The price of the ointment went from $1.06 to $16.78 in the space of about 2 weeks, and Medicaid made it's adjustments, while not a single private insurance company did. They all seemed ignorant to the drug shortage, but I'm sure they'll know the minute the price goes down, and we'll be forced to unload the $16.78 ointment off our shelves at a loss.

Perhaps this is faulty reasoning. I will not even pretend to have a more than a basic knowledge of how insurance companies work and the various contracts they have with pharmacies and drug companies. If there's anyone out there who wants to shed some more light on the subject of reform and the possible effects it will have on pharmacist's salaries, I would like to hear all about it. Intelligent answers only, please.

When Will Teachers Learn?

2009-09-04T13:19:00.002-06:00

My least favorite class is Pharmacy Lab. My favorite class is also Pharmacy Lab.

The best part of school is going into lab and learning how to do things we'll actually be doing when we're honest-to-goodness pharmacists, and that's pretty cool. I particularly like the labs that teach me something new that I've never experienced before, like IV bags. Coming from retail, I didn't have a clue how to mix IV bags until we had that lesson in lab. That was a fun day.

However, when we do important, yet boring retail shit like filling prescriptions in lab for a "refresher" is when I want to just excuse myself from class. The worst is when they teach us to do things incorrectly, or tell us information that just doesn't happen in the real world. They showed us how to fill amoxicillin 250/5 for a non-existent pediatric. The directions were 1TSP PO BID 10D (for acute otitis media). My teacher told us that the doctor should include what the drug is being used for specifically on the prescription. I actually laughed out loud. Doctors write what the drug is for on maybe, maybe, 2% of prescriptions, and my teacher refused to believe that. I wanted to ask her exactly where she obtained the knowledge that doctors write what's wrong with their patients on every script, but I'm sure that would just have embarrassed her more than she already was. Turns out I can be a nice person occasionally. Weird.

She also didn't understand insurance. My friend screwed up the days supply on one of his scripts and I jokingly said "Don't forget to reverse that through insurance, we don't want to get audited." She asked me what I meant. I found it unsettling that the person who was supposed to be teaching us how to work in retail didn't have a clue what the legal ramifications would be if a pharmacist sent the wrong days supply to insurance companies. I believe it's called fraud. She understood that the days supply needed to be correct, but didn't understand that had my friend actually sent that to insurance, he would've had to delete the script, reverse the claim, and re-bill it with the correct days supply. I did my best to explain it, but it was really really hard to do it without making fun of her, so I felt it best to just give up on it. Once again, I took the high road. It made me feel uncomfortable to be so nice, so I kicked the nearest helpless animal I saw when I left lab. It was a squirrel; I offered the little guy an acorn then punted his ass across the lawn. My day was better after that.*

One more thing I hate about Pharm Lab: Our work stations are desks. We have desks where we sit down, enter the scripts, and then count them out. Sitting down. We have to wear dress pants, dress shirt, dress shoes, and a tie to look professional and yet they let us sit down. Nay, practically force us to sit down. I just can't do it. I've worked in retail way too long to be able to sit down and comfortably count by fives. It just doesn't feel right, the counting tray is too high when I'm sitting down, so I end up on my feet hunched over a Protonix tray, not minding the uncomfortable feeling in my upper back because I'm used to it. I welcome the familiar feeling, even though it's much more extreme at lab than when I'm at work. I bet there's a two foot difference, but that feeling is still more comfortable than sitting down. Strange, huh? I'm going to make for a nice little Nazi for some corpo-pharmacy chain someday.

*Relax, the whole squirrel kicking thing didn't happen.

Snooooooze

2009-08-31T19:45:00.004-06:00

Well the year has started in earnest, and I'm already having difficulty staying awake in class. We all know it can be difficult to stay awake for just 50 minutes when a professor is droning on and on about some nonsense review from the year before, but when the college refuses to turn the AC on and a student has 3 classes in a row in the same room, it becomes nearly impossible.

Picture this: It's 78 degrees, Ben Stein has been saying "Bueller, Bueller, Bueller, Ionic bond, Bueller..." etc. for the past 30 minutes, and you've been sitting in the same chair for 90 minutes. Sleepy yet?

I can't believe they expect us to learn like this. I was too busy focusing all my concentration on keeping my eyelids open rather than on my professor that I can't even recall what the hell the third lecture was about. I don't even know what class it was. I think it was pharmacuetics, but I could be wrong.

I'm going to have to start drinking coffee or something, because this is ridiculous.

Dear Drug Topics, Get Your Shit Together.

2009-08-29T13:11:00.003-06:00

I was looking through the August issue of Drug Topics today because I was eating lunch and didn't have access to a computer, and I happened to notice a few things that made me question not only the writers but the also editors of the magazine.

First off, they have a special insert about brand name drugs about to go generic, and whoever wrote it seemed to have a very limited vocabulary, plus no access to a thesaurus, or an internet connection (yes, the internet can be used for more than blogging and porn, who knew?). Seriously, the word "blockbuster" was used about 10-15 times. Now, I know some drugs are very popular, and occasionally our line of customers extends out our door, but in no way, shape, or form has a single drug ever caused a line to go around the block, which is quite literally what the word means. A lesson to you young ones out there: "blockbuster" was first coined to describe movies that were so popular that people would line up around the block just to see it. Think Harry Potter. Now it's used to describe anything popular. That's fine, but do you have to use it 12 times in one 4-page article?

Second off, they say that Imitrex is about to lose its patent and that GSK is working on approval for it's spin-off drug Trexima. As you know, there are three things wrong with that. Imitrex has already lost it's patent, and the spin-off drug is Treximet, not Trexima. Yes, originally it was called Trexima, but it's currently August 2009, and it's now called Treximet, probably because it sounds less pussy. Oh, and Treximet is already on the market, so obviously it's been approved.

Third and final thing, in the article about how technology will free up pharmacists to focus on MTM and counseling and blah blah blah, they show a pharmacist using a Parata machine that Parata doesn't even make anymore. My pharmacy has this robot, and there's a reason Parata discontinued making it. We get vial cap feed errors constantly, and it's filling error percentage is sometimes alarmingly high. Parata has other machines that are much newer and better than the one Drug Topics depicts in it's prestigious magazine, but apparently DT couldn't be bothered with locating pictures of one for their article about emerging technology.

Come on, Drug Topics, get your shit together.

Thanks, Fuckers.

2009-08-25T11:10:00.004-06:00

I'm sitting on campus right now with absolutely nothing to do but wait until 1:30 when my first class starts because the people in charge found it unnecessary to tell us that our lab doesn't start until the week of September 14th. About half of the class showed up and waited patiently for the lab doors to open at 11:30, but at 11:40 we saw no movement in the lab and decided to check with the office to see what's going on. The 10 minute rule is usually the main rule of thumb, but I've been screwed over before when the teacher showed up 20 minutes late and decided to throw a pop-quiz, so we went down to ask the powers that be.

"Oh, that lab doesn't start until September 14th," the secretary told us.

Now I know it's really hard to communicate now-a-days. It's not like we've got a series of tubes that Al Gore invented that can share information with a click of a rodent. Wait a minute...

So, instead of sleeping in until noon like I normally would've, I got up relatively early just to come sit and do nothing.

Thanks, fuckers.

A Letter To Watson

2009-08-14T17:29:00.002-06:00

Dear Watson,

Not to be a stickler, but why oh why do you manufacture BuPROPion 150mg SR with two different NDCs? Because of this, my robot will not let me add your drug into it until it runs out of that same drug with a different NDC. So as I wait for 3 or 4 more prescriptions of BuPROPion 150mg SR to come in, I stand and look at the other bottles of BuPROPion 150mg SR sitting on my shelf. They turn green with envy as I tell them I cannot dispense them until I have run out of the other NDC. It is obvious they do not like this.

Watson, why must you put this strain upon me and my drugs? I fear a civil war will break out amongst the BuPROPion 150mg SR species. I fear for the safety of my drugs as well as my coworkers. There could be much powder spilled. It does not need to be this way. You can stop this.

Please, please, for the sake of your children, make only one NDC. Many lives will be saved.

Sincerely,

PDS

A Call For Action

2009-08-14T00:46:00.002-06:00

I finally got my hands on the August issue of Drug Topics that I was waiting for since I read that the Drugmonkey was writing another article for profit. I cannot say that I was not disappointed, because I was. Here's the article for your reading pleasure.

Don't get me wrong, it's a great article. I know a good persuasive article when I see one, and this is one. The only problem with the article is that it identifies a problem, but doesn't provide a solution. All across the country pharmacists who are taking a shit will be inspired to do something to change their working conditions because of this article, but they won't know what to do. In Speech 101 they teach you to convince your audience there is a problem, then show them how to help solve it in a simple way. He did not show us how to solve it.

Of course, anyone who reads his blog would know that he has already shown us what we can do. We can donate to Bill Monning, who seems to be the only person close to Washington to give a shit about pharmacists. This is the easiest, simplest, most convenient way to show we care about our profession.

I assume Drug Topics would not allow Drugmonkey to ask people to donate money to an Assemblymember in its magazine, which is why he didn't. Either that, or he couldn't fit a call to action in the one sheet of paper he had to make his argument. I choose to believe Drug Topics didn't want to get politcal.

Donate. You'll feel better about yourself, knowing that you helped others and yourself.

Customer Service

2009-08-12T13:19:00.002-06:00

I love it when people from other aspects of my life recognize me in the pharmacy, especially when the people have been assholes to me and realize I now know potentially embarrassing information about them.

Recently my Mac crashed. It would turn on and show me a picture of a file with an exclamation mark next to it. I took it into The Computer Store (yes, it's an actual store), where they said they would look at it. As it turns out, my hard drive went to hell, or something. I asked the guy who worked on it why it crashed, was it something I did, or what? He had information that I wanted. His response, as he made a slight shrug, was "Apple got a bad batch."

"What do you mean?" I asked, "What happened? How did it fail?" I wanted to know what the fuck happened to my computer.

"It just failed," he told me.

I kept phrasing my question in different ways to see if I could get some sort of explanation out of him, and I got none. Now I'm pissed. I was already unhappy that my computer decided to commit suicide, but this guy didn't even explain what had happened. I just wanted to know exactly what had happened. I don't know the first thing about computers, but I wanted this guy to explain to me why I was paying $250 to him to give me my computer back with a new, blank hard drive. The most I got out of him was "It just failed."

The next day I see him come in to my pharmacy with a prescription for an antibiotic, and a big cut on his nose. I assumed some angry customer punched him in the face, because I know I wanted to do the same thing. I was running the cash register at the time and when we finished filling the prescription it was obvious that he did not know why he was taking the medication or even how to take it. I had information that he wanted. I saw the opportunity to repay the asshole who didn't give me the time of day the previous day, and I let it pass. Instead, I explained to him why he was taking the antibiotic, what it did, and how to take it. He stared at me, obviously grateful that I was giving him information about his medication and not unfolding the stapler and whacking a few staples in his face, which is what I wanted to do.

I showed him what it was like to give people the information they want. I gave him good customer service. I would like to think that he started treating his customers better, but since I'll never go back to that store again, except to possibly staple his face, I won't ever find out.

Oh Oxycodone

2009-08-05T08:46:00.002-06:00

I don't know how to present this story. I have tried a few times but cannot seem to translate what I feel into actual words, which usually means the story won't be interesting. I'll try though.

It was a day that I wish HIPPA would go fuck itself so I could stop a nice person from being taken advantage of. It was also a day I wish I had a license to kill. I don't remember the last time I've felt such hatred towards anyone. Well, actually I do, but that story is irrelevant.

We got a prescription for Oxycodone for a patient that is a well-known addict. This guy is on all the lists; everyone is watching him. We called the doctor to let him know. He knew, but still prescribed it. There isn't anything else we can do, so we fill it.

After filling it, the patient calls in to ask if it's finished. We tell him it's finished, and ready for him to pick up. Ok, good, he says. Oh, and I was wondering if I could get a copy of the prescription?

Well, yes, we say, but we're going to have to write VOID or COPY on it.

Oh, really? So it won't look exactly the same?

No, we cannot give you an identical copy of the presciption. That would be illegal.

Oh, well how much is it then?

$62.79 (or something like that).

Now, this is where I start having a problem with this guy. He got his prescription. He convinced his doctor to give it to him. If he wants to roll on Oxycodone every day without hurting anyone that's his own business. But the fact that he wanted a copy of the prescription tells me that he isn't necessarily using it. He's probably selling it. Maybe he isn't, maybe he just wants to use more, but that's not what I think. It gets worse.

We get another phone call. This one is from a church. They were wondering if a certain patient has a prescription with us, and also if they could pay for it. It just so happens to be our Oxy patient. We tell them that yes, we do have a prescription for him, but it's pretty expensive, around $60.

"Oh, the price doesn't matter, we just want to help him."

Now that is a direct quote from the person on the phone. I'm sure he just told them that he really needed his medication but couldn't afford it. All I wanted to do was tell them not to do this, that this man was taking advantage of their kindness in the worst possible way. I wanted to throw HIPPA out the window and explain the situation, but I couldn't.

I felt dirty as some nice, kind, caring lady came in to my pharmacy and paid for this man's "needed" medication. Notice that I said a lady paid. The church didn't pay. The lady wrote a personal check for this guy's Oxycodone. She unknowingly fueled his addiction, all because she wanted to help someone, and there was nothing I could do. That didn't stop me from feeling dirty.

When the man came in to get his prescription. I walked to the back. I couldn't give him the prescription. I asked the pharmacist to do it. I stood in the back of the store while the anger inside me welled up past critical mass for the second time in my life as I watched the man smile as he received his monkey for free. I wanted hurt him. I wanted him to feel the pain he says he has. But in the end, he won't. He took advantage of the kindness of others.

And there was nothing I could do.

The Little Notebook

2009-07-29T00:01:00.002-06:00

I was searching through some drawers looking for something or another the other day at the pharmacy when I happened upon a small notebook stashed away in the corner. I pulled the notebook out and found out it was full of quotes from patients at the pharmacy. I've picked the very best ones to share with you. So, without further ado, here they are.

"You've pissed me off now."

"I need my hydrochlorine refilled."

"Are you the druggist? You don't sound like him. (Spoken to a female pharmacist.)"

"I have ammonia." (Perhaps pneumonia?)

"I was really sad when I had to give up square dancing. I don't know which I miss the most - the square dancing or the sex."

"I think my prescription has perspired."

"I suppose this bladder infection has something to do with the terrorism."

"You mean I have to pay for the medicine?"

"What's the best pain reliever for my poop?"

Patient #1: "What's the best thing to give me the runs?"
Patient #2: "Chinese Food."

"I'll just go somewhere else, then, YOU BITCHES!"

"So, how old is your Peter?" (This is why you don't name your son Peter. Or Dick for that matter.)

"I've never had blood pressure before!"

"The doctor didn't know her ass from her butt."

And my personal favorite, spoken by a noticeably pregnant lady:

"My throat is dry. I suppose I'm coughing because the baby is breathing all the air."

Gelnique (TM), The Anti-Pissing Gel.

2009-07-27T11:12:00.003-06:00

Hey look! Oxybutynin comes in a topical now! Man, it was sure difficult to take that pill with a little water wasn't it? Not to mention counter-intuitive. Never fear though, we've created a topical! Just rub some on your tummy or shoulder and it makes you not have to wizz for a while. I know you want to put it on your penis, but please, that's not necessary. Although the sensation of the quick-drying gel that contains a good dose of alcohol would probably feel good, we advise against it. Oh, and once you use it, you're ready to go all Charlie's Angels on your bladder's ass. Or something like that. I mean seriously, check out that chick, she's ready to kick some ass.

The best part about this product is the overdose information.

Oral ingestion of 100 mg oxybutynin chloride in association with alcohol
has been reported in a 13-year-old boy who experienced memory loss, and in a
34-year-old woman who developed stupor, followed by disorientation and
agitation on awakening, dilated pupils, dry skin, cardiac arrhythmia, and
retention of urine.

Holy fuck! 13 years old and popping 10 pills (I'm assuming he took the 10mg pills, or maybe 20 of the 5mg ones) that say "oxy" on the bottle and then drinking alcohol. Suicide attempt, anyone? Fuck, I know I hated Jr. High, it wouldn't surprise me. I love how he "experienced memory loss." Sounds like my Saturday nights...

My all-time favorite line in all the literature is the fact that overdosing on oxybutynin caused "retention of urine." Uh, well... Duh.

Which brings me to this joke.

A man walks into a pharmacy, points a gun at the pharmacist and demands all the Oxy's. The robber sees the oxybutynin and demands those too. He's caught 3 days later when he walks into the emergency room and yells out "I CAN'T PISS OR SHIT!"

Sometimes I Wonder

2009-07-23T21:27:00.002-06:00

An old lady came into the pharmacy today, right around closing time (duh). She's got a list of about 20 medications, and explains to me that she lost some at the lake. She walks with a limp, and cannot stand for long, as she's resting her weight on the counter. She explains to me that she's going to try to get the medications she lost filled. I explained to her that if she's lost her medication, she'll most likely have to pay cash, unless she only had a couple days left.

So I ask her her name, she tells it to me. I can't find her in the computer system, so I ask her if she's filled here before. "No," is the answer I get. I ask her what pharmacy she normally goes to, and she tells me it's one down the road. Then she goes on and explains she tried to talk to her doctor blah blah blah, but the best part was this quote right here.

"Well I tried to get them filled at that pharmacy but they told me the refill was too soon."

I just stared at her, speechless.

I finally sputtered, "Well, it doesn't matter what pharmacy you filled them at, your insurance company is going to tell all of us that the refills are too soon, so you'll have to pay cash." I almost felt bad, because the only controlled substance on her list was Tramadol, so she obviously wasn't a seeker. Then I saw it, she had Seroquel on the list. A 90 day supply. Then I felt bad. That is one expensive mistake. Whoops.

She then asked me if she could get them cheaper here or at the other pharmacy. I told her there was no way I could know that, seeing that I don't know their prices. I then told her she would probably get the best deal at Wal*Mart. I then threw up a little in my mouth, said I was sorry, and she left. This was 10 minutes after we were supposed to close. The pharmacist was nowhere to be found. She let me handle this. So much for "Let me get a pharmacist for you," huh?

Now here is a lesson in responsibility. Take care of your medications. They are expensive. Don't drop them to the bottom of the lake.

Poison Ivy/Moondance

2009-07-20T17:13:00.003-06:00

I still have that poison ivy or poison oak or something, and it's spreading. It's dangerously close to my "sensitive" areas, so I went to the doctor (well, nurse practitioner, but whatever) to get it checked out. This weekend was a heavy weekend of camping and jamming up in Walker, MN for my annual vacation to Moondance Jam where I have family nearby. So when the nurse asked me if I had consumed any alcohol in the past 30 days, this is how the conversation went. Bold is what I actually said. Italics are what I'm thinking.

Have you consumed any alcohol in the past 30 days?
Yes Only a little... 2 cases in 3 days is a little, right?

And when you drank, how many drinks did you have?
Oh, somewhere between 14-18, I don't know exactly. 5. Oh shit, 5 is still considered binge drinking.

Ok, do you ever feel the need to drink first thing in the morning?
No Only during Moondance...

Has anyone told you about something you've said or done while drinking that you don't remember?
No Hell yes! Like that time I punched a Canadian in the ribs... Whoops.

Have you ever done something while drinking that you wouldn't normally do?
No Um, duh! Like dancing? I'm totally awesome at dancing when I drink. At least, I think so...

Has your performance in school or work ever been affected by your alcohol consumption?
No Whew, that one's actually true.

Have you ever woken up regretting your alcohol use?
No Oh hell no! Well, maybe that one time I drank Keystone Ice. Biggest headache EVER!

Have you ever felt depressed or "down?" (she actually made the air quote move)
No Only when I have to deal with customers.

So I'm not an alcoholic. Hah! By the way, Moondance is awesome, I totally recommend it. We get drunk before the early concerts, sober up during those, and let the big names rock our socks off. Then we get drunk again next to the fire, and then pass out in the tent. We do it all over again the next day. Awesome.

Bad Hair Day

2009-07-13T17:18:00.002-06:00

We got another new tech intern today. She seems nice. After saying that I almost feel bad about making fun of her. But dear lord, do you really think it's even remotely normal to wear your hair that way? I mean... Picture this combined with this, without the MC Hammer lines. Instead of that those, she has long hair there too. That's right, she has shaved the top of her head, but left the sides, back and front of her hair normal. Did I mention her hair is mostly gray? Yeah. I was almost speechless when I first saw her, but I managed to choke out a "Hi, I'm PDS."

I thought that was it. I was wrong. An hour after I arrived a very feminine-looking man came in with his head shaved and bangs longer than hers. He also had a chin-strap beard and mustache. I decided the reason he still looked quite womanly was due to the extremely thin plucked eyebrows. I just stared at him.

Then I saw his son. Mohawk-mullet. I shit you not. The kid had a mullet and a mohawk. I stared once more.

I don't know what it is about summer that make people make such bad decisions, but I hope I'm never that "creative."

****
I got poison ivy on my arm recently. I've never had poison ivy, so I scratched the shit out of it right away, and now it covers a relatively large portion of my arm. Instead of using calamine lotion or hydrocortisone, I just grabbed a "Poison" sticker from our collection of stickers and prescription taped it all up. This didn't help with the itchiness, but it made for some fun conversations at the register.

I'm starting to work a lot more 8 hour shifts as people take their vacations, and I noticed that we never sell any condoms, but we sure run out of them. So, I decided to have a little experiment. I put "For Anal Use ONLY" stickers on 1/3 of the condoms, "For Vaginal Use ONLY" on 1/3 of them, and "For External Use ONLY" on the remainder. We'll see if we've got more anal, vaginal, or masturbating patients who steal in a few days.

Some Happenings Of The Past Week

2009-07-08T22:08:00.002-06:00

I'm a big fan of summer. Especially when hot chicks with perky breasts don't feel the need to wear a bra, because it's so hot. When they walk into the pharmacy, which is kept at a nipple-popping 69 degrees, I enjoy summer even that much more. Now if she just wasn't picking up Acyclovir...

************

Patient calls the pharmacy.

"PDS pharmacy, this is PDS."

"Hi, my doctor was supposed to email a prescription to you, did you get it?"

"Well, first off, what's your last name?" I hold back a snigger at the "email" comment.

"Well it was for Vicodin, did you get it?"

"Well, we get a lot of scripts for Vicodin, what's your name?"

"The doctor was Dr. Johnson from the pain clinic."

AHHHHHHHHHHHHHHH!!!!! JUST TELL ME YOUR FUCKING NAME!!!!! I didn't scream. "Ma'am, Dr. Johnson sends us a lot of prescriptions for Vicodin, because he works in the pain clinic, now what is your name again?"

************

Two siblings, same exact insurance, same exact prescription. Different copays. What the fuck? The copays were off by 14 cents. What's the deal here Humana?

P.O.S. System

2009-07-04T22:42:00.002-06:00

Yeah, most of you thought what I thought when that acronym was first announced.

"Piece of Shit System? Why would we want that?"

I really don't know how many states had to change up their registers this year to accept Flex cards, but I know mine did, well, at least my store did, we used to have a ghetto-ass register - not anymore. It really stands for "Point of Sale System," but come on, who's names something P.O.S.? That's just old people being retarded. They're totally asking for it.

So, after making fun of the P.O.S. System and adding "For Anal Use ONLY" stickers to the condoms, I tried out the new register, just to be "mature" and all... I found out that the new system is pretty slick. After about an hour or so of getting the hang of it, the new register is faster than the old one. Of course, there are always bugs to be rid of in a new system, but for the most part, my day is headache free when I run the register. Well, besides the customers themselves, but with the new system, I get them out of my hair faster! Yahoo!

How To Get Into Pharmacy School: Sophomore Year

2009-07-02T12:00:00.000-06:00

Ok, so now that you've made it through Freshman year and the PCAT, now it's time to start your Sophomore year of pre-pharm. Here are some tips to getting through that year in one piece.

1. If you haven't already, get an apartment.
Don't do what I did and live in the dorms again. You have friends, you don't need to make new ones that'll just mooch off "your" lab reports and old tests. Get an apartment, pay the bills, and live a life independent of parents, hall directors, and RAs. Yeah, it kinda sucks having to make your own food, but that's what grilled cheese, pasta, and frozen pizzas are for.

2. Stop drinking every night.
Now that you're in classes that will actually teach you something worthwhile, you can't be hungover during them. Pay attention in Human A&P, well, not necessarily to the Anatomy part, but definitely the Physiology part, your brain will thank you for years to come. Drinking is now a weekend activity. Make up for the lost drinking during the week by consuming gargantuan amounts during the weekend. Some of my best stories are from wandering through my city, trying to find campus or a friend's apartment.

3. Sleep Through O. Chem I.
Actually, I don't recommend this, but honestly, this class sucks balls. I went to every class and slept through almost every class. It was so hard to stay awake just to hear my Asian professor ramble on about alkenes and alkynes and alkanes, all of them sounding the same coming from her mouth. The class isn't as hard as they make it sound, but it isn't easy. To top it all off, 90% of the information you learn will never be used again. You will know that dex and lev mean that the certain isomers rotate light positively and negatively, respectfully, but you won't give a shit. Well, that is until you learn that certain drugs contain both isomers, and the new, improved (read: original drug's patent is running out, quick, make a new one) drug has only one isomer, because the other isomer causes "side effects." Plus, who gives a fuck what DIBAL does to a double bond? (Hint: it makes an epoxide, another useless piece of information in my brain) I got a B in O. Chem I and called it good.

4. Get a job in a pharmacy.
Actually, I recommend getting one your first year if you can, but I waited until my second year. You will be able to counsel patients as soon as you apply for your student license, and it's nice to actually know something about drugs when you do that, so learn up on those easy drugs (antibiotics, pain meds) before you're allowed to counsel.

5. Take as many pharmacy school classes you can.
I finished all my microbiology and English requirements to graduate from pharmacy school before I was even in pharmacy school. It's comforting to know that you only have to take 16 credits a semester instead of the 20 the rest of your friends are taking. Then you can make fun of them when they're doing work you did 2 years before.

6. Find a hot pharmacy chick and date her.
And for fuck's sake, hold on to her. Ever notice that every good-looking P4 has a huge rock on their finger? Yeah, it's because hot, smart, successful women are damn hard to come by, and most guys are at least smart enough to realize that. I didn't have any luck with this, I still don't have a girlfriend, and guess what? Almost every single girl in my class is taken, and some are even engaged. Get them before they're in pharmacy school.

7. Apply to pharmacy school.
Yeah, I know this seems like a no-brainer, but out of the 80 or so kids that lived on the pharmacy floors I believe 10 applied and 8 got in. Hmm... so that one comment from Anonymous was pretty on track when "she" (I'm looking at you, Pharmgirl ;) ) told me I was giving out inappropriate advice, and that my advice would only work for 10% of the population. I guess I owe "her" an apology. Haha, sorry, but I'm just assuming Pharmgirl posted that; what is interesting though, if you'll look at my advice on the PCAT, and her advice on the NAPLEX, you'll realize they are quite similar. In fact, I'll link you to her advice here. Now look at the dates of my post compared to hers... Hmm... Haha I'm just fucking with you Pharmgirl, I like you.

8. No, seriously, apply to pharmacy school.
Because out of the 500 kids who started out in pharmacy your freshman year, only 100 of those kids have made it this far, and about 10 of them won't apply because they think their scores aren't good enough. SoOoOoO, you've got a pretty good chance of getting in, even with unremarkable scores. I just learned today that two of my friends got in with PCATs in the 50s.... I mean, wow. So for fuck's sake, APPLY!!!!

9. During the interview, avoid common subjects.
Don't talk about the donut hole, that is the most generic conversation ever. They won't remember you. Instead, talk about how evil drug companies are. I can honestly say that the Drugmonkey helped me get into pharmacy school. I didn't talk about the Part D plan or the North Dakota ownership law (which I know was a popular subject during the interviews this year). Talk about the isomer thing I mentioned before, or the fact that PBMs have a different MAC list for different pharmacies, or that drug companies will add two drugs together and call it a new drug, and charge insanely high prices for it. I'm looking at you, Treximet.

10. Once you get your acceptance letter, coast through the year.
Give your brain a rest. Hopefully you've accumulated enough points where you don't need to get an A on every test to maintain an A in the class. Just get your work done, learn a thing or two, and just be happy you got in. You may regret getting in when you look at your schedule for the next 3 years, but don't let that bother you now. Stop stressing, be happy, have fun, and live life.

2009-06-29T23:18:00.002-06:00

I'm still working on the sophomore year advice, I'm trying to decide what stories to tell now and what ones to save for their own posts... Anyway, here's a phone call from today.

-Doctor calls the pharmacy

"PDS Pharmacy, this is PDS."

"Hi did you get those scripts I faxed down for vicodin and Levaquin?"

"Well, what was the patient's name?"

"Joe Blow."

"Yeah, I have them right here."

"Ok, well should I give Joe the hard copy?"

"Well, only if you want him to have 2 copies, but considering you're giving him vicodin, I bet you don't want that," I say in a slighty smart-ass tone.

"Wait, what?"

It's at this point that I realize the doctor is either A) retarded B) drunk or C) retardedly drunk.
"Well since I have the prescription already you wouldn't want to give another script to him, because then he could get twice the amount that you prescribe for."

"OH, well what if he doesn't want to fill it at your pharmacy?"

"Well, we don't have to fill it, he could come pick it up from us, or you could tell us to destroy this copy and give him the hard copy, but why did you fax us if he didn't want to fill it here?"

"Well, he does, I just don't really understand this whole process."

Wow, you have got to be kidding me. I honestly never thought I'd have to deal with a doctor that didn't know how the prescription process worked. I mean, was there a class this "doctor" missed? I would never say that with my as yet unfinished schooling that I was smarter than a doctor, but...

How To Get Into Pharmacy School: The PCAT

2009-06-23T03:01:00.003-06:00

I've decided to make this a 3 post series, and today I'll be writing about the PCAT. Yeah, I know I'm a few days late for the June PCAT, but whatever.

Anywho, here are some tips on doing better on the PCAT!

Oh shit! Remember all that information you didn't learn freshman year? Turns out you're getting tested on it. Whoops.

1. Get the Kaplan book.
It's like $26, and has all the information that you forgot 10 minutes after they tested you on it in school. In fact, I would recommend buying the Kaplan book instead of your university chem or bio books (Actually, buying a Gen Chem book was the biggest waste of my money ever, I returned it still in the shrink wrap). Don't worry about reading all of it, just make sure you're up on your basic algebra and plant biology, they seem to love asking questions about plant biology.

2. Learn how to name compounds.
Yeah, I know you haven't taken O. Chem yet, but trust me, knowing how to name compounds will skyrocket your Chem score.

3. Take the practice test.
Yeah, it fucking sucks, but take the practice test, and time yourself. Make sure you know how fast you need to answer the questions. Try to finish each test with at least 5 minutes to spare, this will come in handy later.

4. Do not go to bed early.
Go to bed when you normally do, you will be groggy and out of it if you get too much sleep. Drink a few (3 max) beers in the hour before you go to bed, since you've built up a tolerance it's not going to even produce a buzz, but it will calm your nerves. Once again, no Everclear. I recommend doing this instead of taking a sleeping pill because alcohol doesn't stay in your system as long, and you'll get more normal sleep cycles.

5. Eat oatmeal.
Or something similar. Something with a lot of calories and volume. You'll need the calories for this test, and you don't want to be distracted by a growling stomach.

6. Arrive almost late.
There's nothing worse than sitting and waiting and waiting and waiting for it to be time to start. Plus, somebody will come late, forcing the test to be delayed anyway.

7. Try to distract others.
Remember, the PCAT is percentile, so the worse other's do, the better you do. Plus, most of the people taking the PCAT in your room will be applying to the same schools as you. I can spin pens and pencils around my thumb. This mesmerizes people, they stare at it like they're in a trance. If you can't master the pen spin, anything that makes a small amount of noise will do, but you may be asked to stop by a moderator.

8. Finish at least 5 minutes early.
This way, you can either look over your answers (I don't recommend this), or, use this time to start the next test. NO, don't turn the page dumbass, instead, flatten the book out so you can see through the paper to the next page and figure out the answers to those, and if you can read backwards you can do the other side too. This is not cheating. It's strategy, plus the chem test is fucking hard, you need extra time.

9. Don't worry about the essays.
They just grade those by having a drunk chimpanzee whack a keyboard anyway. A standard 5 paragraph 8th grade essay will suffice.

10. Don't worry about it!
Everyone takes it, but it really doesn't have a huge effect on your admission to pharmacy school. Two of my friends got into pharm school with PCATs in the 60s. My school was super-secretive about the admissions process, but I found out through someone in the know that most of the emphasis is put on your GPA, and a "good" GPA is considered 3.6. This is just a "good" GPA, an "acceptable" GPA is a 3.2. After the GPA, the interview is the next biggie, then the PCAT, then the ethics test. How did I pass an ethics test you ask? I don't have a fucking clue.

So that's what I did to take the PCAT. I fucking bombed the chemistry section the first time, but all my other scores were pretty good. Do not take the August test, wait until October to take it again. Your score will just be lower in August than it was in June because you forgot everything from freshman year. I fucking bombed the chemistry section again in October, I actually got the same score, but my other scores were much better than before, and my cumulative ended up 5 points higher my second time. Go out and celebrate with the rest of your little pharmacy friends afterward. Try to finish off half your 1.75 of plastic-bottle vodka. Find out you can actually drink more than half before you puke your guts out and come to the realization that you really can't. Now go draw on your friend's face. Ah, good times.

How To Get Into Pharmacy School: Freshman Year

2009-06-22T00:09:00.004-06:00

I was listening to my younger friends bitch about how ridiculous the PCAT was on Saturday and thought about how I got into pharmacy school, and further thought I should share my experiences with the world, or at least the 4 people that read this blog. So here's a list of suggestions on getting into pharmacy school.

1. Live in the dorms.
For fuck's sake, live in the dorms. If the college has a pharmacy floor, live there. Yeah, there will be a couple "nerds" that will think that the pharmacy floor is a place to be quiet and study all day. This is wrong. Our pharmacy floor was notorious on campus. We had more write-ups than any other floor on campus. Coincidentally, none of those write-ups came from our RA, they were always from RAs from a different floor, because pharmacy kids stick together.

2. Get out of your room.
Your room is for sleeping and masturbating. Get out there and meet people, they will come in handy for some of the later steps. If you don't, the people that do go out to the lounge will make fun of you and laugh when they do better than you on the tests.

3. Stop studying.
The test isn't for 2 weeks, why the hell are you even opening the book? In fact, why did you even buy that chemistry book? You wasted $180. Go out in the lounge and talk to people. Shoot the shit, this is your freshman year, the friendships you make now will last for at least the next 5 years. Studying is for the night before the test. Yeah, the test covers 7 chapters, but who cares? All information from freshman year is irrelevant, you will not need to know Boyle's law after this test. Learn it for 8 hours, then toss that information, your brain is put to better use memorizing the house rules for beer pong at different houses around campus.

4. Cheat.
There's a reason they let you use graphing calculators, use them in any way possible. This way, learning Boyle's law for even 8 hours is optional. In the real world, looking up stuff is not only accepted, it's expected. Writing lab reports is for the people who took that lab last semester, not you. Remember those people you met in the dorms? One of them has all their lab reports from the lab you're in now on their computer. Delete their name and date and slap yours on there. Saves 4 hours. Now go shoot some shit.

5. Drink. A lot.
Use your network of friends to find a buyer, and find out what's the cheapest beer and vodka and stock up. Anything that comes in a 30 pack and a plastic 1.75 liter bottle will suffice. Learn to love the burning of cheap vodka as it flows down your underage throat, you'll appreciate the good stuff more later in life. Avoid Everclear, you may feel like a total badass drinking it, but you'll forget that it's over twice as strong as that vodka you love so much and start thinking that taking shots is a good idea. It is not. I cannot even count how many times Everclear has blacked me out waaaaaaaaaay before I wanted to.

6. Get caught drinking. By the cops. On campus.
You'll never have a better story than the one where you ran from the cops in a drunken panic, only to realize you're right next to your dorm and you're essentially fucked. When this happens, throw your hands in the air, drop your backpack, and calmly apologize to the officer for running. Then after you've blown your .24 and been issued your ticket, go up to your room and crack another beer that you've stocked up on. The fact that you can function at that BAC is worth the celebration, it's a damn good thing you've followed step #5.

7. Tell the judge you puked. A lot.
Who gives a fuck if you didn't? He doesn't know that. He will empathize with you, and reduce your sentence, then laugh when your friend gets a minor the next week after blowing a .03 and gets the full sentence.

8. Stop going to class.
It's early, it's cold, it's a half-mile away. Get some sleep. Seriously, who gives a fuck about Punnett Squares? Not you, not anyone. Those notes are posted on the internet anyway.

9. Get an apartment.
This is something I didn't do until halfway through my sophomore year, and I regret not doing it sooner. Living at home during the summer sucks, and cuts into what should be drinking time. You have friends in your college town, stay with them.

10. Laugh when you make the Dean's List.
Laugh your ass off at the kids who stayed in their rooms and didn't make the Dean's List. They won't ask you how you made the Dean's List, but tell them anyway. Explain to them that they need to relax and blow off steam more often. They will deny that that is their problem. Do not let them weasel out of it, make sure they know that the human brain is not capable of learning all the time. Being drunk at the time is optional.

So this pretty much sums up my freshman year. Ah, the memories.

Update:

Ok people, this is obviously not the best way to get into pharm school. I'm just telling you all how my freshman year was. I obviously went to most classes, with the exception of chemistry and biology. The thing is, if you think your freshman year of college is really difficult, and you feel the need to study all the time, then you will not make it. You will not be able to survive pharmacy school. Yeah, calculus sucks balls, but that should be the only class you have much difficulty with. This is your freshman year, the rules change for sophomore year, which I will get to soon.

Wait, I'm Actually Going To Have To Try?

2009-06-18T04:59:00.002-06:00

Today I learned that one of the teachers I thought was going to teach me took a better job at a different pharmacy school. Normally, I would think this was a good thing, because new teachers are usually gung-ho and really try their best to get students to learn. That's been my experience, at least. However, this one I'm not too stoked about, seeing that I have every single test the previous teacher ever gave out in the past 10 years. Yeah, you read that right. 10 years worth of tests, the stack of papers is bigger than my Gen. Chem and O. Chem books combined. I even have the tests from a couple of the pharmacists I work with.

If the teacher hadn't moved out, his class would've been cake. Yeah, he writes new tests every year, but after looking over 10 years worth of tests I can get to know what kind of questions he asks and what kind of answers he's looking for. It's like the second time I took that PCAT; I knew what the Reading questions would be just by reading the article. It makes the test extremely easy and quick to do. Now I'm not only going to have to learn the material, I'm actually going to have to try.

Don't get me wrong, I do want to learn, I love learning. I just don't want to bust my balls doing it.

I fully expect most of you to be playing the world's smallest violin for my little sob story. Feel free to tell me to stop bitching. I really have nothing to complain about...

Brand/Generics

2009-06-15T10:50:00.002-06:00

I wish I knew my brand to generic names better. I haven't had to memorize the Top 200 yet, so my knowledge on them is pathetic at best. An example:

A nurse from a walk-in calls my pharmacy to call in a script.

"HiPharmDStudent, I'mcallinginascript," she said hurriedly.

"Ok what's the name and birthdate?" I asked.

"SallyParker, ohsixohseveneightyfour," she rushes, "It'sfor Diflucan, thedoctorisWiess."

"Ok," I say, trying to keep up with her, she almost hangs up the phone. "Whoa, hold on there, is there a strength on that, or an amount, or directions?"

"Uh, well isn't there just one strength?" she finally says at a normal speed, "And I know it's just one pill."

"Uh, no, there's at least 2 strengths, 100mg and 150mg, do you have any idea which one it is?" I ask.

"Um, no, I guess I'll have to talk to the doctor," she responded.

It's at this point that I think this nurse is an idiot for not getting this information in the first place, but if I had known that Diflucan was Fluconazole, this wouldn't have been a problem. I felt like the idiot when I looked up the generic and realized that it was obviously going to be the 150mg and the directions would be "Take 1 tablet by mouth." It's for a yeast infection, and I've filled hundreds of scripts for it. I should've known this, but I never knew the damn brand name.

Of course, the blame most certainly isn't all on me. The doctor is to blame for not writing a full script, or just telling his nurse 150mg. I mean come on, how hard is that? The blame can also partly rest on the nurse, who should've known that I needed more information than just a drug name. Maybe if the nurse hadn't been in such a rush to get back to her US magazine this could have been avoided.

I always take the blame when I've made a mistake, but on this one I think I'm fairly blame-free.

So This Guy...

2009-06-09T01:18:00.002-06:00

So this guy comes into our pharmacy the other day. He's a regular that we keep happy because he gives us good business. You know the deal, the man has 10 scripts and his wife has 12, we want to hold on to these customers. He came in to get the scripts he needs, which is only 2 of his total. I ring up his scripts and see that yes, these two scripts are over $100. This is the conversation that ensues:

Me: "Whoa, looks like you're breaking the bank on these ones."
Mr. Jolly: "Yeah holy shit, didn't my insurance cover them?"
Me: (Not knowing he's kidding) "Uh, well, yes, they did, but I can check to see if it's been covered better in the past."
Mr. J: "Yeah those bastards at the insurance company are really trying to fuck me over. I've been getting these pills for 15 fucking years, and my co-pays have only gone up. I'm gonna go sue those sons-of-bitches."
Me: "Uh... well..." I stutter, because I really don't know what to say at the moment.
Mr. J: "Yeah these pills have been keeping me alive for 15 years, which is good for me, but bad for my wife." His laughter fills the pharmacy, "She's gonna leave me one of these days... I can't wait!"

Now I get the joke. Now I'm laughing.

It's these type of people that make me think retail really isn't all that bad.

Slow Day, Part II

2009-05-29T00:51:00.003-06:00

Wow

That is the only word I can use to explain what I was feeling when I heard the pharmacist, good old Shayna, say this:

"You are a doctor, aren't you?"

Oh. My. God. I need to know this story. I know the beginning of it, but I need to know the end of it. Here is the beginning:

The fax machine rings, and starts pushing out paper, the usual warning sheet that is a practice in killing trees and destroying the rainforest tells me to not look at the next sheet unless I'm supposed to. Jesus wept. No, I'm sure he (He?) would.

It's for Musgushkatung something-or-another. It sounds racist but it isn't. Musgushkatung is the actual name (well, actually not, but similar, maybe). I take a look at the script and see that while it's for Musgushkatung, I see the quantity ordered is "enough for 3 family members."

You. Have. Got. To. Be. Kidding. Me. I make the pharmacist call the doctor so that I don't make the person who is probably twice my age feel like an 8-year-old. The pharmacist doesn't do much better than I would've. She did better, she did, good for her. She explained to the doctor that for insurance reasons she had to have 3 different prescriptions (I would've told her that she's a fucking moron of a doctor for thinking that she could prescribe 3 people with 1 prescription). Apparently the doctor asked if she, the doctor, could write the prescriptions for the rest of the family. The doctor should have felt like a 16-year-old, but I have a feeling the doc was a little too dumb to realize we were making fun of her.

The pharmacist's reponse? "Yes, your medical license allows you to prescribe medicine to any patient that you see, you are a doctor, aren't you?"

My response would've been "Are you fucking serious? Are you a doctor or not?!?!"

So the end of the story is this. It's really lack-luster, actually, I would describe it as "lacking luster,":

She prescribed the whole family, after the pharmacist explained to her that even though they were not in the computer system, they could be prescribed medications.

I mean fuck, what in the sand's hell am I getting into here?

Slow Day, Part I

2009-05-28T23:37:00.005-06:00

Craziness at the pharmacy today.

It was a very, very slow day today, I read about 50 pages from my book in my four hour shift, and I made 480 grams of Kay-Med 1% HC (I was working in the pharmacy that's in a children's clinic that just so happens to be owned by the same dude that owns the pharmacy I usually work in), all of this should say something to the average person who works in pharmacy. It was f-u-c-k-i-n-g slow.

However, we did not lack in the crazy people department of the day. The first lady, a patient, was not only ignorant but willfully ignorant, a trait that someone such as myself cannot stand.

She came in with an albuterol inhaler. She wanted a refill for her son, we're going to call her Bitcherson from now on. Alright, no problem. Wait, shit, she got this prescription at a pharmacy called ShittyService Clinic pharmacy. While our pharmacy is located in a ShittyService Clinic, it is not a ShittyService Clinic pharmacy. I explain to her that I'll have to call the ShittyService Clinic pharmacy to get a copy, because we are not affiliated with ShittyService, our owner just leases the property from them. She doesn't understand this and doesn't care, she just says "Fill the prescription."

"Ok, will do," I reply, "it will just take a little longer than usual, that's all."

"You seem inexperienced, I've never been told this at any pharmacy before," retorted Bitcherson.

"Well, since you did not get this prescription from this pharmacy, we're going to have to call the pharmacy you did get this prescription from and get all the information from them so we can fill it here," I tried to explain to her. She didn't get it, she didn't care. Her response? "Just fill it."

Ok, so I call ShittyService Clinic pharmacy (ok, it's not the pharmacy that's shitty, it the clinic, I have the tiniest bit of a grudge against them, but that's a story for later) and lo and behold, my friend picks up the phone.

"ShittyService Pharmacy, this is Max," says Max.

"Max! It's PDS over at PDS Pharmacy, I need a copy, fucker," I exclaim (soft enough on the 'fucker' to not be heard by the patient, the pharmacist, however, bursts out laughing). I give him the number blah blah blah.

"Ok, so you're looking at the inhaler right now?" asks Max. I tell him yes.

"Alright, I'll just give you the dates then, last filled 5-19-09 (alarms start ringing in my head, insurance is not gonna cover this) and original 5-19-08," Max states.

"Wait, 08 or 09?" I ask, cause I've already assumed it was 09, and had written that down, I needed to confirm.

"Oh shit, it's 08, so I guess it's expired," says Max.

"Yeah," I say, "Looks like she's trying to get her money's worth from the PRN refills huh?"

"Uh, I guess so?" questions Max. He's new to the pharmacy industry, he has yet to realize that people are generally trying to take advantage. He will learn, and I'm almost sad that he will. I learned, but I hated people before I started pharmacy. He didn't. Pharmacy will change him.

"Yeah, well nice talking to ya, see ya Saturday," I state (I'm seriously running out of ways to say 'say'). Then I hang up without waiting for him to say his little sign-off. Why? Because I don't care.

We explain to the woman that the script is expired and we can't refill it. Her response? "Yeah, I knew it was."

AHHHHHH Go. Fuck. Your. Self!!!!!!!!!!!!!!!! You made me call and try to jump threw/through/thru (I don't know which is the correct one at the moment) hoops even though you knew you last filled it on the last eligible date and still tried to fill it in my pharmacy?!??! How fucking stupid do you think I am? Fuck you Bitcherson. Never come back here again.

She left angry because I didn't know what I was talking about, after all, I was 'inexperienced.' What a cunt.

And why was she angry? Because she refused to listen to me or the pharmacist when we both tried to explain to her that we need to call the other pharmacy to get the prescription so we can fill it. We tried to explain to her the whole idea that one cannot bring a bottle or inhaler around and expect every pharmacy to magically fill every prescription. I don't believe that Bitcherson was stupid, I believe that she didn't want to know. That is worse, in my opinion. Willful ignorance is always worse than ignorance.

Day After The Holidays

2009-05-26T23:39:00.002-06:00

Holy shit was it busy today or what?

We had 200 new scripts today. I don't know exactly how many total scripts we filled today, but it was a hell of a lot more than 200. The worst part of the day? That I didn't get to fill any of them. Zero. Why? Because our cashier decided to schedule her doctor's appointment for 3 o'clock, and guess who has to run the register when the cashier goes away? You guessed it. The student.

We had patients lined up out the damn door today. You know why? Because every, well not every, but a good 80% of them had just called the pharmacy, assuming from their car 5 minutes before, for their refill. It was absolutely crazy, I actually had one lady say to me when I couldn't find her prescription tell me, in a very snotty tone, "Well, I dropped it off 10 minutes ago, it should be ready." I just looked at her, amazed. By this time, my mind was on cruise control, and could not fathom such idiocy. I replied to her, "As you can see, we are very busy at the moment, but I will find your prescription and make sure the pharmacist knows you're here." To my amazement, when I walked back to let the pharmacist know that Ms. Bitch was here and to bump up her prescription to the "Here" scripts, I noticed that she was just finishing up on the script, and bagging it. I grabbed the prescription and brought it up to the register.

"The pharmacist just finished with it, so here it is!" I said with a smile.

"Well, why wasn't it ready when I first got here?" replied Ms. Bitch.

I just stared at her, shocked. I didn't know what to say. So, I just said, "Well, it does take time to make sure everything is correct with your drugs."

"Well for heaven's sake it's just a refill," continued Ms. Bitch.

"Go fuck yourself," I didn't say. What I did say was "So I'm assuming you have no questions?"

"No, I just want to get out of here."

You and me both, bitch.

Perhaps I've Had One Too Much

2009-05-21T00:26:00.004-06:00

Nah... Drinking Grey Goose on the rocks and reading pharmacy blogs is what a normal person does on a, what day is this? Wednesday? ok, Wednesday night (fuck it, Thursday morning).

I finally happened upon JP's Too Adult postings. Holy fuck was I born in the wrong generation or what? Free love, amazing music, slutty bitches that do your bidding, no matter what their relation with any other guy? Um, yes please, I'll take two.

There have been a few girls I've "fallen" for. By "fallen," I mean, I really really really wanted to be with, not because they were extremely attractive, but because I could talk to them for hours upon hours and just not run out of material. Yes, most (read: all) these girls were attractive, but that's really just an added bonus (or requirement, one of the two).

The problem with the PDS is that he can't find a girl to "fall" for that isn't involved with someone else. One has a boyfriend, one is engaged, one has a husband, one is waiting for a military grunt to come back. I believe it's a curse. I don't know if it's that everyone that I like is involved, or that I only like involved people. Fuck me right?

I've tried to talk to the floozy chicks at the bar and found them extremely boring. Most dress up in some scandalous outfit that attracts the primitive part of the male brain, and I'm not about to argue with that part of my brain at the moment, but once they actually open their mouth, I realize that they have no common sense and no sense of humor beyond shitty romantic comedies. This I cannot handle. I'd rather be single my entire life than have to deal with that bullshit. What I need to do is go back in time and hang out with JP and get in on the swinger action. That way I get to be involved with involved chicks, which is apparently what I want. What do you say JP? Wanna invent a time machine?

New Intern

2009-05-20T19:24:00.003-06:00

Today I met our new intern. She's in college to get her tech degree, and just needs one two-week rotation in retail and one in hospital to get that degree. Compare that to the eight (I think it's eight, at least) 5-week different rotations I'm going to have to do. I don't have a problem with this; I'm going to make a hell of a lot more than her and have more responsibilities. What I do have a problem with is this:

She didn't even know what an NDC was. I'll admit, I didn't know about NDCs until I worked in a pharmacy, however, I hadn't taken a single college class at that time either. For those of you who don't know, an NDC is an 11 digit code that is specific to a certain drug, and every drug has one, even OTCs. I don't remember what drug it was, but it was one we had a couple different manufacturers for, because we usually choose to buy the cheaper generic. Anywho, the script came back and she went to go find the drug, looked at them, then turned to Steve and asked, "How do I know which one to choose?"

Steve replied, "Just check the NDC."

"What's an NDC?"

You have got to be kidding me. She went to college for two years to specifically become a pharmacy tech, and they didn't teach her what an NDC is? She's not stupid by any means, so I don't believe that she was taught it and forgot, I believe that she wasn't taught it at all. What the fuck? I guess this is why you have to do rotations before going out into the real world.

F.I.N.A.L.S. (Fuck I Never Actually Learned [this] Shit)

2009-05-14T15:22:00.003-06:00

Have you ever taken a test you weren't prepared for? I just did yesterday. Before this test, I had only failed one test in my entire life. That test was an O. Chem test that required the student to memorize about 100 different reactions and their mechanisms. I just memorized the reactions, and bombed all the mechanisms, but seriously, why do I need to know where all the electrons are moving in a chemical reaction? It's completely useless information to me. In fact, I think knowing all those reactions is useless information too. Not that I'm bitter or anything...

This test was testing how well we know a semester's worth of information of reactions. Just reactions. Here's a compound, what do you do to make it this other compound? 200 points of this crap, with 10 points about protein for some odd reason. I think the professor mentioned something about protein structure in class or something. Good thing I remembered alpha chains and beta sheets from my general biology class my freshman year.

I wasn't prepared. I may or may not have studied. I may or may not have been distracted until 3 in the morning by a girl. I sat in the large auditorium and stared blankly at my test, with the knowledge that I was not going to pass it slowly dawning on me. So I did some bullshitting, but of course you can't bullshit reactions. It's either right or wrong. No exceptions, no partial credit for a partial answer. After an hour of wanting to curl up into a ball and regretting not studying the night before, I turned in my test and went to work, depressed. Just as we were closing up at work, I received 4 texts from 4 different friends saying the test was up. I immediately went to the computer and checked my score. 123 out of 210. That's a solid 58.5%. After maintaining an A all semester, this one test was going to knock me down to a low B. Pissed off at myself, I went back to my apartment to sing my sad song to my roommates. I checked my email as I was talking to them, and had one from my professor. The message stated that the final was curved and would be out of 165, not 210. I'm up to a 74.5% now. Woo hoo! I recalculated my grade and realized I got 425 out of 500 for the semester. That's exactly 85%. 85% is an A. Fuck yes, kept my 4.0 alive baby!

So here's to knowing the bare minimum! Cheers!

Oh, and I got a date with the girl tomorrow night. Things are starting to look good for the PDS this summer.

Double Standard or a Tech Sticking it to The Man? You Decide.

2009-05-08T11:41:00.003-06:00

Well it's official. Spring has sprung. It's getting warm finally, and finals are fast approaching. My finals don't seem too difficult this semester, which is always good. Of course, they could bite me on the ass, but let's just hope that doesn't happen.

Anywho, with the seasonal change it's getting a tad bit stuffy in the PharmD Student Pharmacy, and so far the owner has yet to turn the AC on. This can become uncomfortable when I have to wear nice pants and a collared shirt (which usually means I'm wearing an undershirt also) along with my coat. I don't necessarily have to wear the coat, most of the techs and even some of the pharmacists don't wear theirs, but to me it symbolizes that I am not just a cashier or some high school student. I have seen people completely ignore me when I don't wear the coat, but no one ever ignores me when I wear it. The coat stays.

What I would really like is to not have the swamp ass feeling during the hours I work in the pharmacy. No need to further elaborate, it's just an uncomfortable feeling. I asked Steve if I was alright to wear nice khaki shorts to work, and was given an immediate "No" from both him, the other pharmacist, and both the techs that were working. They all answered in unison; I was impressed. Next time I ask a question I'm hoping to get an A Capella answer, that would be cool.

It's really not that big of a deal. I can see how wearing shorts can seem unprofessional in a weird way. However, the next day I worked I noticed that a tech was wearing a skirt, and not just any skirt, a denim skirt. My first instinct is to give her shit for it. "What? I can't wear khaki shorts but you can wear a jean skirt? That's real logical." I did not say this, I would have said it jokingly of course, but she's my favorite tech. I believe the term is "Keystone Tech." My apologies to the creator of that phrase, but it seems widely used and accepted in the blogosphere.

I thought about making a case that I should be able to wear shorts, and I could make a damn good one on why shorts should be allowed. I could make the argument that it's a sexist double standard. We all need to be equals you know. Maybe I should be a lawyer instead... But what if she's not supposed to be wearing this skirt? What if this is her little way of sticking it to "The Man?" I think she deserves to have that, and I sure don't want to take that away from her. So I'm going to keep my mouth shut for now. If anyone else comes in wearing a skirt or shorts, then I'll make myself heard.

Well I Have This Slip...

2009-05-05T17:21:00.003-06:00

I experienced a new level of ignorance today, I level I knew existed, but had never had the joy of experiencing.

I got a phone call from patient, who said his dentist had ordered him a prescription, and he was wondering if it was ready. I asked his name and birthday, pulled up his profile, and saw that the last script we had for him was filled in January. I asked him if the dentist was faxing it over today, and he replied "Oh, well I saw him like 2 weeks ago, and he ordered a prescription, but I kinda just forgot about it until now."

"Ok," I replied as I roll my eyes, "are you sure he sent us the prescription? Because I have no record of it."

"Well I know what it's for, can I just tell you and pick it up later today?"

"Uh... No, we need a prescription from the doctor to fill anything for you. Do you have any idea where the prescription is?"

"Well, I have this slip..."

"Is it the prescription?"

"Yes."

"Well if you just bring that on in with you, we can fill it while you wait."

"Well how long will that take?"

"It depends on how busy we are when we get the script."

"So like, 20 minutes?"

"I can't guarantee anything."

"Well can I just tell you what it's for so I can just pick it up?"

"No, we need to have the prescription before we can fill it."

"Well... Why?"

"Because it's the law."

"Well... I can talk to a pharmacist?"

"Yes, but they're both busy with patients right now (they weren't, I was just hoping this guy didn't have the time to wait), can you hold?"

"Yes." (Damn)

I put him on hold and say "Steve, call on line one. Have fun with this one."

I asked Steve how the call went after he hung up, and he just laughed. "Did he tell you what the script was for?" I asked.

"Yeah, vicodin."

Figures.

Tamiflu Ho!

2009-04-29T10:07:00.003-06:00

These past few days have been a wee bit crazy with this whole swine flu. I can't check the news without being bombarded by 7 out of 10 stories about the flu, most with the same information as the article before it, with one extra bit of info. They've identified patient zero, the first death in the U. S, a Mexican toddler occurred this morning etc...

All of this is happening in the South, and a little on the East coast, yet my pharmacy in the Midwest is ordering Tamiflu like gangbusters. I believe the closest case of this particular flu is a suspected case in Minnesota, so I think that ordering the maximum amounts from 3 different wholesalers is going a little overboard for us, but that's what we did yesterday. I'm sure Roche, the makers of Tamiflu, couldn't be happier.

I may end up eating my words later if this becomes a pandemic, but for now I think that my pharmacy is overreacting, and may end up watching the Tamiflu rot on the shelf, while it could be put to use somewhere. Like, oh, I don't know... Mexico?

I'm a Total Ladies Man

2009-04-25T18:08:00.004-06:00

... or not.

I will be studied in later years. Kids in 9th grade health will read about my mistakes and think to themselves, "What a dumbass!"

We all know that when a girl asks a guy if she looks good the response from the guy needs to be an automatic "Yes." There can be no delay, unless the guy wants to argue for another 10 minutes about it. This respose, of course, is the amateur response. A better answer would be "Baby, I don't think I can take my eyes off you, you look so good" The guy has to be careful with this though, because if she takes you literally (which she undoubtfully will), he can't look back at the TV until she's not paying attention.

This is all obvious stuff here. Every guy knows this.

Apparently the women-folk have grown bored with our resounding yesses and predictable responses, and now they are asking us in much more sneaky and sly ways if we think the look good. I am now going to teach you how to get in the "friend zone," which we all know has no potential to progress any further than that. Beware, this could be painful to read.

I'm a very blunt person. If I see someone being a total hypocrite or lying out of their asshole, I'm going to call them on it. A lot of my sentences start with "You're so full of shit!" I don't think about feelings, I just tell the truth. I'm also extremely scientific and analytical, to put it in layman's terms, I'm a nerd. These qualities are even more prevalent when my defenses are down, such as when I'm drunk, or just waking up.

It happened to be on a Wednesday afternoon when I missed my opportunity. Wednesday afternoons are almost always dedicated to a nap. It is the only day I consistently do not have to work. A buzzing from my cell phone awakes me from my nap. Annoyed, I take a look at this message from my very single, very attractive, fairly new friend. Fairly new as in I met her about a month ago and had been flirting with her at my other job frequently.

"I run 5 miles every day."

Instead of saying something like "Wow, impressive," I, in my nap induced fog, reply:

"And?"

"Well I run every day, but I want to look better in my bikini, so I'm trying to lose 5 pounds, but I haven't lost anything for a while. How can I do that?"

Many of you have predicted my mistake already. I didn't say "Seriously? You look great, you don't need to lose 5 pounds." I actually answered her damn question.

"Well you can start doing some weight training too, or you could run further, or just cut some calories every day."

Not surprisingly, I didn't get a response to that remark. An hour later I realized my mistake. She was fishing for compliments. She was testing the waters to see if I was in to her. What she got was a loud and clear "No," which couldn't be further from the truth. I texted her something along the lines of "I can't believe you want to lose 5 pounds," once I had my facepalm moment, but once again, no response.

We still talk, of course, but the relationship has already reached the "friend zone." I am now the guy she can ask for advice, not the one to give her compliments. Don't make the same mistake I did. Think about what her question is really asking, especially if you've got the luxury to do it over texts.

Did I mention that she had previously invited me to go swimming in her pool when it opened for the summer? Something tells me she's going to forget to mention it to me when that happens.

Step Away From The Counter

2009-04-21T17:54:00.002-06:00

Ok, I really thought I'd write more about school when I started this blog, but it turns out that school doesn't piss me off as much as working in retail. Something tells me I'm getting into the wrong profession.

I knew it was going to be a bad day when "Steve" asked me to get as much stuff done before 4 o'clock because our cashier had an appointment. I asked him if he knew the majority of my work occurred after 4, considering that's when the order comes in and the mail-outs have to go out. Oh, not to mention all the other things we students have to do. He replied yes, but there wasn't anything he could do about it. Not a huge deal, a tech took care of the order, but this means I have a good 2 hours to deal with the customers. Yay.

Things were going along fine until Mr. Dad came in. His son was in the clinic getting his pinkie re-broken and set correctly. He usually went to a pharmacy downtown, but he needed his son's inhaler now, and couldn't leave the building. Ok, we'll call your pharmacy and get a copy for you. Not a problem.

Now Mrs. Mom comes in. Different family. She's here to pick up her daughter's birth control. I can't find it in the bins, so I check the computer. On my way to the computer she informs me that she called yesterday and that she talked to a lady and the lady said if there was a problem we would call her. I type in the daughter's name and see we had to fax on the prescription, and haven't heard back from the doctor. I tell her this, and she gets angry because we were supposed to call her if there was a problem. This is where Steve comes in. I'm already annoyed with this lady, so I let him handle it. He tells her he'll call the doctor, but she'll have to wait because he has to make a few phone calls for other patients. Instead of calling the doctor herself, she waits at my counter, and waits, and waits. She waits right next to the cash register, causing confusion among the customers who come in. They think I'm waiting on her. No matter how many times I tell her it'll take awhile, she still doesn't budge from the register. I have to lean around her to wave people up to my counter. I didn't know what to tell her to make her sit down without being a huge prick, so I ignored her.

Dad gets his copy, about 20 other patients get their medications, with Mrs. Mom standing there the whole time. Finally, Steve gets hold of the doctor. Turns out, the daughter needs to see the doc before she can get a refill, and Mrs. Mom knew that. She's been told this. She starts in on Steve, trying to get him to convince the doc to give her the prescription for at least another month. It takes 20 minutes for me to get home now is her best argument, because of construction. Never mind the 30 minutes she stood there waiting. Steve caves, the doctor caves. She gets her month. That's why Steve is That One Pharmacist. He's a nice guy, people get what they want when they talk to him. Some would call him a pushover. Mrs. Mom is still a bitch.

If this is what I'll have to deal with the rest of my life, just shoot me now. Where's the vodka?

The Battle Within

2009-04-18T14:43:00.004-06:00

I can hear it now, the lone macrophage, calling out as he releases chemokines into his surroundings.

"Captain! I think we've got something here!"

Captain macrophage responds, following the trail of the chemokines.

"My God, we're going to need backup," replies the Captain, as he looks in awe at the rapidly reproducing bacteria that has invaded his territory, the inner ear. "call in the neutrophils, and where are those dendritic cells? We're going to need help."

Meanwhile, the complement cascade has begun. Huge holes appear in the membranes of the bacteria, but the mass continues to grow, and grow, and grow. The neutrophils arrive, releasing granules everywhere, causing inflammation and killing off some of the bacteria, but it's not enough.

"Don't worry," call the dendritic cells, "we're loaded up with antigens and we're off to the lymph nodes."

"Hurry up for God's sake," cries the Captain, "we're outnumbered and we need T-cell help now!"

The dendritic cells reach the lymph node, presenting the antigens to every possible T-cell they can, until one recognizes the specific antigen. It's time to proliferate.

"What's the problem?" asks the T-cell.

"It's an otitis media sir," replies the dendritic cell.

"Dear God, the Student hasn't had one of those in well over a decade! I don't think there are any memory B-cells left from back then. This is going to be a long fight," the T-cell responds, a slight panic in his voice.

******

Only time will tell what will happen with this ear infection. I found out I was allergic to amoxicillin when I had a really bad ear infection in kindergarten. I had many ear infections, I even had tubes put in... Twice. But I rarely went to the doctor and was only given antibiotics once. I can't remember what I was given after my skin broke out into huge red rashes, but I do remember it did not taste good. Something tells me I could handle getting a capsule now though...

However, I can't exactly go to the doctor, unless I want to pay full price, because my dad believes our insurance cards are good for 2 years. I tried to argue with him, but he would not budge. I know for a fact that the cards are invalid, because they definitely don't run through the same PBM as they did a year ago. I have a feeling he lost the new cards, and refuses to acknowledge the fact. So, I'm on my own until October when we will get new cards once again. Hopefully he won't lose them.

A Little Common Sense Goes A Long Way

2009-04-15T11:44:00.003-06:00

As a science nerd, like I imagine most pharmacists and Pharm D students are, I have to admit, sometimes it's difficult for me to see the woods because the damn trees are in the way. I enjoy breaking things down into the smallest parts possible to see how they work, which is probably why I enjoy learning about drugs so much. However, like most intelligent people, I possess enough common sense to get me through the day, much like the pharmacist I'm about to introduce you to.

We'll call her Shayna. Shayna got her Pharm. D. a few years back, so she's pretty new to the profession, but a great pharmacist none-the-less (easy on the eyes too). She's a lot like me, she wants to know exactly how everything works in minute detail. When I have a question, I always ask her, because I know she'll give me a 5 minute speech on exactly why a certain drug does a certain thing, and why it's used instead of this other drug. I love it; I learn more from her about drugs than anyone else. But, she too can miss the woods because of those damn trees. An example:

Patient comes up to the counter to ask why one form of contact lens cleaner costs more than another. Both are from the same company, both look relatively alike with slightely different designs. I see the obvious answer right away, but Shayna is in Pharmacist Mode (I think I'll trademark that phrase) and I feel like getting a laugh later, so I let her take care of it. As a pharmacist, the first thing she looked at was the active ingredients. After pouring over the two boxes for around 3 minutes, comparing the ingredients in each cleanser and their strengths. She eventually gives up and explains that both are idenitical products and that the new box design must be the reason the price went up. At this point, I had to intervene, because the patient was about to get ripped off by buying the cheaper cleaner. Can any of you guess why one was more expensive?

The cheaper box had a 12 oz bottle, the more expensive one had a 16 oz bottle. The sizes of the bottles were clearly printed on the top part of each box. I admit, the company made it a little more difficult to determine what the problem was when they decided to use the same size box for two different sized bottles, but a quick glance at the top half of the box would solve it easily.

So I lean over and say, "I think it's because this bottle has 4 more ounces in it." I wanted to say "Perhaps it's because this bottle has 4 more ounces, I think companies tend to charge more money when you buy more of their product," but that would've been unnecessarily mean, dickish, actually.

Shayna replies "Oh, yeah, I didn't even notice that."

Sometimes those trees can be a bitch...

Back From Break

2009-04-14T10:37:00.003-06:00

What is it about the week after Easter break that every single teacher feels the need to have a test? I'm not saying a few teachers are having tests, all my teachers are having tests, including lab. I just got out of a lab test, and I'm pretty sure I got a B. I gave myself a pat on the back and then realized I have 4 other tests this week. It's like a bad prequel to a movie that sucked in the first place "Finals Week: The Beginning."

Most teachers use the argument that the long weekend will give us more time to study. Um, no, the long weekend gives us more time to forget what we learned 2 weeks ago. Most of us students either go somewhere or have family over for Easter, and being a hermit and studying while family is around is usually frowned upon. The rest of the students, like me, just want to be lazy and eat Reese's Peanut Butter Eggs (they're soooooooooooo good) and watch the Master's or some other type of boob tube programming (I prefer the Master's). Oh, did I forget drinking? Yeah, we want to do that too.

I must now cram all the information from the past 3-4 weeks into a couple hours for my 2 tests tomorrow. Looks like I'll be putting the vodka down for a week or so...

An Introduction To A Co-worker

2009-04-10T19:15:00.004-06:00

Apparently I have a strange sense of humor. Either that, or one of the techs I work with, Gingersnaps (quite obviously not her real name, just thought I'd point that out), has no sense of humor. One of the two.

Students are, of course, in charge of putting the drugs we get delivered every day on the shelves and in the robot. Today, we got in a large amount of hydrocodone/APAP 5/500, because it's always good to have extra on hand. I'm sure everyone that reads this blog knows at least a little about pharmacy, since I got my first comments after the Drugmonkey gave me a shoutout. Thanks for that, by the way. Anywho, you all know that the docs prescribe that shit like it's candy, magical pain-relieving candy.

After filling the robot as full as possible with the magic candy, I went to put the rest of it on the shelf we reserve for robot drugs. However, there was no room on the shelf for it, so I threw it on top, thinking anyone would look up there, considering that's where we keep all the shit that comes in bottles too big to fit in the shelf.

In the next hour or so, we went through a shit-ton of magic candy. Yes, "shit-ton" is an actual measurement; it's between "crap-load" and "fuck-load," but I digress. So Gingersnaps comes up to me as I'm doing a refill for someone who wanted That One Pharmacist, and asks where the Vicodin is, because she wants to put more into the robot.

"I ate it," I say, then I try my best to glaze my eyes over. I then turned to her, and said "All of it."

She just stared at me, so I laughed and said it's on the top of the shelf. She replies "Oh," and walks away. No smile, no "Oh, that was a joke!" just "Oh."

I bombed. Took a swing and missed, but now I can make fun of her for not having a sense of humor, unless that wasn't as funny as I thought it was... hmm...

Damn, I'm glad I'm not this kid...

2009-04-08T22:20:00.004-06:00

Holy Jesus Christ! This kid is creepy. I type in "lab coat" into Google to possibly find a picture that I could use for my profile picture and this pops up on page 3. It looks like he could actually fly away on his dumbo ears, but I think his huge head might weigh him down. Perhaps I'm being too harsh, not everyone can look as good as me...

But that's not really the point. I took a look at where this picture came from and it's from the Advance Healthcare Shop. They're asking $17.99 for this "Toddler Lab Coat with Caduceus." What kind of parents would actually buy this for their kid? I mean shit, why don't you put some more pressure on your elementary school children?

Oh Bobby! Look what we got you! Now stop playing with your friends and put on this lab coat. Ah look at you! You're so cute! Let's get you inside where you can study for your MCATs, it's only 12 years away!

Is there anything Americans won't buy?

P.S. I still can't get over his ears... The hand in the pocket with the thumb hanging out is very stylish though.

Pointless Labs

2009-04-07T10:32:00.003-06:00

Ever sit in lab staring at some tissue trying to discern whether that one blob was a different color than the other? I just got done doing this, we will have a practical on it next week, and if I get a C, I will be happy (hey, C = PharmD). Why do we need to know this? For fuck's sake, we're going to be pharmacists, not doctors.

I understand the need to know how our bodies work. We need to know why certain drugs work, we need to know why taking X drug will affect Y drug. But, we do not need to know what the thyroid looks like, fuck, I don't even think we need to know where it's located. I feel we just need to know what it does. Am I wrong? Ever hear a couselling session go like this?

Pharmacist: Here's your levothyroxine. Oh, and your thyroid is located in your neck, just so you know. Also, it looks super cool under a microscope. It's pink and white. We call the white parts colloids. Are you paying attention? This is important information!

Patient: Huh? Wait, what?

Pharmacist: The white part of your thyroid is the colloid.

Patient: Oh, ok.

Pharmacist: Any other questions?

Patient: Why am I taking this?

Pharmacist: Not important, just remember 'colloid.'

Patient: Oh, ok.

No, you haven't. Because it doesn't fucking matter what a cross section of an endocrine gland looks like. Not to us at least. What matters to us is why you are taking the drug and if that drug will interact with another drug you're taking.

Phone Call

2009-04-05T10:52:00.002-06:00

Me - "The PharmD Student Pharmacy, this is Student."

"Ummm..... Yesh.... Herro?" Awkward pause.

Me - "Yes, hello."

"I... Haf... Queshion?"

Me - "Let me get a pharmacist for you."

Muuahahahahahahahaha. Karma's going to be a bitch when she gets me back for this one. Oh well, I'm waiting.

Why?

2009-04-04T14:14:00.002-06:00

Please explain something to me. How in the hell does someone just murder someone else? How can someone justify that? Kimberly Saenz was a nurse working in a dialysis clinic in Lufkin, Texas. She injected bleach into people's IVs. How sadistic is that? Have you ever got bleach in a cut? Think if that pain was in your whole body.

I have wracked my brain and I cannot think of a single reason for this type of action, except that maybe she was so sick and tired of working that she needed to kill off some of her work. I've been pissed off at work before, but I've never been pissed enough to start killing people. I could do it. I have the power and knowledge to fuck with someone's pills, but I couldn't do it. Ever. Actually, that probably wouldn't work because that person would come in the next day and bitch about how their pills look different, even though I had explained to you the day before that they are exactly the same, but made by a different manufacturer, but that's a whole different story.

I never thought I'd say this, but thank you Texas for having the death penalty. I suggest you use bleach instead of the normal lethal injection.

Read more here.

That One Pharmacist

2009-04-03T15:23:00.001-06:00

Does every pharmacy have that one pharmacist? You know, the one that every single patient wants to talk to, no matter what they need? My one pharmacist is Steve (not really, I'm trying to keep this relatively anonymous). This guy has obviously always been a people person. He astonishes me with his ability to talk to every single fucking patient that walks through the door. He can have a conversation with a slightly mentally handicapped, extremely loud and annoying individual, and enjoy it. I don't know if he's missing a gene, or has an extra one or what, but this guy is special.

Over 50% of the calls I answer go like this.
"PharmD Student Pharmacy, this is Student."
"Yeah is Steve there?"

Now, during my first couple months of working at my pharmacy I would say "Yes, one moment please," and thank my lucky stars I didn't have to, you know... work. Now I have learned that most of these people don't need to talk to a pharmacist. Now, I respond with "Yes, but he's on the phone right now (regardless of what he's actually doing), is there anything I can help you with?"

90% of the time it's something I am perfectly capable of doing. Like "Oh, well I just need a refill." Or, "Oh, well I don't have insurance, can you look up a price for me?" Sometimes I just bang my head on the counter when these calls come in. Of course I can do that, what do you think I'm here for? To twiddle my thumbs? Come on.

Does every pharmacy have that one pharmacist?

Birth Control: It's Covered Too!

2009-04-03T11:44:00.000-06:00

Something happened in my pharmacy recently that pissed me the hell off, for more than one reason. I was counting out some pills, most likely oxycodone or some other CII, when I heard it. Screaming. Kids screaming. Numerous kids screaming. A chill goes down my spine. Please, please for the love of whatever is out there, not in my pharmacy. Relief comes flooding in when they walk into the clinic. Good, they have an appointment, I have at least an hour or so to prepare myself for this shit show. Wrong. 45 minutes later I hear it again. Screaming. Fuuuuuuuuuck.

Ok, I tell myself, there's no way in hell all of these little brats have scripts. Not possible, no way the doctor had enough time to check out all the kids. Wrong again. They walk in and start tearing the pharmacy apart, and their mother hands me the scripts. 8 scripts. All for amoxicillin. AHHH! What. The. Fuck?!?!! One kid is pulling on his ear and you give them all antibiotics? Fuck you doctor, you just wanted to get these brats out of you office so someone else had to deal with them.

Have your children filled here before? "Oh yes, all of their information is in there," mother says as one of her little brats starts hitting her. No shit, this little 3 year old was punching her mom, and her mom was doing nothing to stop it. Well, I look up brat #1, nothing in the computer.

Ma'am? I don't have any information for brat #1, are you sure you've filled here before? "Oh, well maybe not," mother says as brat #2 knocks over the Ring Pops. (I completely forgot about Ring Pops until I worked in a retail pharmacy. Kids love those fucking things. Only 80 calories a Pop!)

Ok, do you have insurance you want this billed to? Oh boy, here it comes, I know 8 gold cards are coming out. Sure as shit, 8 Medicaid cards fly out.

Eventually I get all the scripts in the computer, filled, and waited as the pharmacist checked them. I watched as the mother sat in a chair while her children rolled on the floor screaming and knocking candy off the shelves. I am still uncomfortable with telling mothers to get their kids in check, I am still a student, remember. Someday I'll get the balls to do such things, I can't wait for that day.

What I really wanted to tell the mother was this. "You know something? I'm sick of paying taxes so you can sit on your ass and get pregnant. I'm not working my ass off so you can take a dick. Medicaid covers birth control, talk to your doctor and get your lazy ass on some birth control, for fuck's sake."

If I had said that, she probably would've responded, "It's against my religion."

*Sigh* Honestly...

Student Duties

2009-04-03T01:21:00.000-06:00

Ah to be a student. All of the fun of being a pharmacist, none of the real duties. Got a question regarding a prescription? Let me get a pharmacist for you. Want to bitch about what we have in stock for OTCs? Let me get a pharmacist for you. Want to be a total pain-in-the-ass? Let me get a pharmacist for you. 7 words I have learned to love. Yet, I can still send/receive copies, I can take a new script over the phone, I can call insurance for overrides, I can refill scripts, I can count out CIIs, I can fill the robot, receive orders, and update inventory. I can do it all, but the minute things get hairy, I can say those 7 magic words and all my problems disappear. I can go to the back and laaaaaaaaugh, and when the pharmacist gets back I can ask him/her all about it. Soon I'll be able to counsel, well, I can counsel now, but I only do it with amoxicillin and DNCB in pet, and when I can counsel more drugs those 7 words won't be as magic, and that will be a sad day.

But we students also get the shaft when it comes to bitch work. We do all of the bitch work. All of it. We empty all garbages, including the bathroom, boss's office, and the cashier's. We're in charge of washing all the dishes, so if a tech or pharmacist or student makes a compound or solution, guess who's in the kitchenette getting the ointment off the spatulas? Yeah, it's the student. We sort through and file all scripts according to number, and when the shit hits the fan, those can get out of order real quick-like, and with 100-300 new scripts a day, that's not fun. We fill the robot with vials and caps and drugs. We stock the shelves with all different dram sizes and caps. We wipe down the chairs and counters at the end of the day. We vaccuum. Oh boy do we vaccuum. This my friends, is the worst part of my day, especially now that the snow is melting. This means that all that dirt plow trucks throw on the road so your SUV doesn't slide off the road every time the mercury goes below 32 is piling up, and you walk on it. When that happens, it gets caught in your shoes and then you walk into my store, where it all somehow gets deposited in the big fucking grooves in the rug that my boss unwittingly bought. These grooves are fucking huge, making it impossible for the vaccuum to create a vaccuum on the rug, making my job of vaccuuming 10 minutes longer. I wonder how many times I can say vaccuum in one sentence? Hmm....

Which means on days like today I don't get out of the pharmacy until a half hour after I'm supposed to, because everyone seems to need their prescriptions filled 5 minutes before we close.

I'm New At This

2009-04-03T01:03:00.001-06:00

Welcome, you're reading my first ever post. Congratulations! Give yourself a pat on the back and let my words wash over you like a nice warm bath.

Let me tell you a little something about myself. I am a PharmD student somewhere in the Midwest. I currently hold a job at a retail pharmacy, and many of my posts will be inspired by the wackiness of what goes on at said pharmacy from a student's eyes. However, I get the feeling most of my posts will deal with school, seeing that JP, The Angry Pharmacist, The Angriest Pharmacist, and The Drugmonkey can and will cover pretty much everything about retail. Plus I go to school every day, and I do not work every day. So, let's get started!