That's Rude....

You know what lady?  I'm here by myself....so yeah, I'm a little more cautious at night when it comes to opening the window.  I'm also a little busy sometimes, but I make sure you get greeted promptly.

What is it with people?  How about I come to YOUR work and bitch about you....oh wait, you are on medicaid.  That explains so much.....you've forgotten what it's like to be on the receiving end of pointless bitching because you don't have a job.  How about a little respect for the person whose taxes just bought your brand Concerta?  Too good for generic as long as I'm picking up the tab, huh?

Choke on it....

Sudafed

While I am burst out into song overjoyed that I no longer have to deal with Sudafed sales, it has spawned a whole new annoyance.

You see, when Sudafed went behind the pharmacy counter (bad meth heads!), the drug companies dug out phenylephrine, an old decongestant that had fallen out of favor....most likely because it doesn't work very well.  But it has the definite advantage of being a true over the counter product.  As in, you don't have to wait in line at the pharmacy counter or travel to another county that doesn't require a prescription.

I don't recommend phenylephrine.  It doesn't work.  At all.

So when you ask me for my recommendation, it is to drive to the next county and purchase pseudophed.  The company I work for is always happy to take your money, which is why they stock phenylephrine.  However, if that's what you are here to do, could I ask that you consider the charming, drowning in student loan debt pharmacist standing here in front of you?

And when I tell you that I don't recommend phenylephrine, could you at least pretend that you're listening?  Please?  It helps to build my self esteem and doesn't piss me off quite so much.

But I NEED it....what do you suggest I do?

Yes, I know you neeeeed it.  I guess I'd suggest that you go back to this morning, when you shook the last tablet out of your bottle.  Then, you could stop and, because you neeeeed it, you could call the pharmacy where you'd like to pick it up to have them fill it.  That way, when they tell you that they don't have your medicine in stock, you could call me and I'd be able to transfer it to my store.

Because you see, funny thing about the medicine that I dispense, I have to be in possession of your PRESCRIPTION in order to dispense it.  It's kind of a legal thing.  So when you prance off to do whatever it is that's so important and forget about your medicine until you neeeeed it, you run the risk of encountering an unsolvable problem.

If you were a regular at my pharmacy, maybe I'd be a little more trusting and I'd give you a single tablet to get you through the night.  I am nice like that.  But since I don't know you and you can't be bothered to even get out of your car to come in and talk to me like a health care professional instead of a fast food worker, I'm not sure I should put my license on the line to help you.

What do I suggest you do?  I'd suggest you grow up and take responsibility for yourself.

It's 4 AM....

And you want my input on which cough medication to give your child.  You ask, "Is Dimetapp the one that's ok to give to children with asthma?"

Who told you that?

His pediatrician.

Well, what was his concern?

Cough medicine?  With asthma?

Yea, I'm not sure what you're talking about.  I'm going to refer you back to your pediatrician.



If you want my input, don't look at me like I"m an idiot.  Also, it's 4 am....maybe I'm a little tired & slow?  Now, if the cough is due to cold, some doctors will tell you to avoid cough suppressants.  It's not that it's harmful, it's just better to get the gunk out.  Some doctors will tell you to avoid guafenasin.  Too much coughing can precipitate an attack.

So maybe if you would have wanted to talk to me, explain what you were trying to avoid instead of being an idiot bitch, I could have helped.  But as it is, I'm not touching it because I am not an asthma expert and you clearly don't want to discuss, you want an asthma expert who can read your doctor's mind.

Dumbass.

All that is necessary for the triumph of evil is for good men to do nothing...

Edmund Burke said that.  Or something like that.  It's now thought to be a paraphrase of something he wrote.  Whatever.

I was thinking about that today...

Something was off.  Her "husband" called me to fill her prescription (controlled substance, pretty fun one).  I asked that she be available at pick up.  He questioned me but I stood firm.  I need to see the patient.  At the very least.  So when he came into the drive thru, she was sitting next to him.  He asked me about it again and I explained that it was to her benefit, extra security for her, since she didn't call in the refill.  She signed for it but she never said a word.  Not one word.

I felt....weird about it, but let it go until another pharmacist called me tonight to ask me about them.  What did I think?

I can't put my finger on it.  But I thought of another girl.  Who called me early in the morning and told me, in a whisper, that her boyfriend was making her fill her prescription and taking it from her.  She wanted me, no matter what he said, to not fill it.  I promised her I wouldn't.

Later, when she called, I was on speaker.  I demanded to be taken off speaker phone.  I told her I wouldn't fill it, per her request.  I asked if she was ok.  She said she was.

He threw the fit of all fits in my drivethru but I held firm and I would have called the cops if wouldn't have left.

I wonder what happened to her.  Was this her one cry for help?  Did she manage to get away from this asshole?  Did I miss an opportunity to help someone?  What would I have done with her if she would have told me she needed help?  Should I have pushed her, offered her a safe place?  Told her she would be ok if she just got away?

Yeah, I'm kind of regretful about that one.  Maybe I could have done more....maybe not, but maybe I could have.

I thought of her after that phone call from the other pharmacist.  What if this girl is in trouble and has no one in her corner?

I wish I was working days....I might be able to do a little more behind the scenes, check out the situation a bit better.  I don't know.  I'm sure I'll meet many more like her before I'm done.  Unfortunately.  Maybe I'll actually be able to help a few along the way.  God I hope so.

The rest of the story

Remember Paul Harvey?  He had this radio show...The Rest of the Story.  He'd start out telling a story and you'd think you got it but there was always a twist at the end.  Kind of a feel good story told Law and Order style.

Let's play.

Man notices rash and swelling developing around his ankle.  Calls his doctor.  It's Friday morning and Doctor is booked all day.  Without even talking to the patient, he calls in an antibiotic for cellulitis (skin infection).

What do you think?  Is your spidey sense tingling?

What if I told you the rest of the story....patient is a diabetic....on Coumadin (a blood thinner).

If you are a medical person or just a well-informed lay person, you are probably downright squirming.  Because it COULD be something more.  We don't know...and more importantly, doctor doesn't know.  He's busy, it's Friday and the most likely diagnosis is cellulitis.  Why look for zebras when you hear hoofbeats, right?

This is why healthcare should piss you off and you should be demanding a better standard of care.  Because this patient took his antibiotic like a good boy.  And didn't think twice that the swelling didn't go down.  Or that it started to hurt.  In fact, he took his whole ten day course before he realized that it wasn't helping.  He didn't want to bother the doctor.  So he waited.  And nearly lost his leg.  He earned himself a week in the hospital because he trusted his doctor.

I told you so

There ARE people who should be glad I'm nosy and pushy.

Refill called in through the automated system.  3 tablets taken twice daily.  Insurance rejects.  I COULD just call and get an override....but I look at the refill history and he's getting it less frequently than he should...why is that?

Call the patient and it turns out, doctor put him on a high dose but he got confused and thought he was supposed to be taking 3 tablets daily.  Whoops!  But he just went in for a follow up visit and his numbers are great....he's doing great.  So I'm not going to fill it right now....we're going to call doctor to advise him and see what he wants to do.

The last two pharmacists that filled this prescription didn't stop to ask any questions....they just got the override and moved on.

I'm not that kind of girl.