I ordered some Chinese for dinner at work last night. Awesome. Some good Chinese can make the stinking 'I don't believe in grooming' patient you just had to deal with seem like last year. Plus it covers up any lingering smell. Everybody wins!
After I finished eating I fished the fortune cookie out of the condiments-forks-fortune cookie bag. It contained probably the most accurate fortune in the history of the world:
'Rarely do great beauty and virtue dwell together as they do in you.'
I know just how it happened at the fortune cookie factory in China...
Many men are sitting at a long table. The factory is dark and murky save for the overly bright spot lamps that hang over the work space. The lights all emit much heat, the workers are covered in sweat and grime. They have all been at work many hours.
Every worker has a large roll of paper. Each roll is covered in identical fortunes. The workers hurriedly cut fortunes from the rolls and stuff them into cookies. A foreman surveys the workers, shrewdly eying the mob for thievery. Suddenly, he stops and points one of them out. He screams urgently:
"Halt!"
3 ninjas fly from dark corners of the factory. They set upon the worker just as he's stuffing a cookie with a fortune like all the rest. One of the ninjas holds a tanto dagger to his throat. He freezes with the fortune cookie in his hands.
The foreman approaches the terrified worker. He bends down to be at eye level says,
"This fortune cookie going to great man. Great man require... great fortune."
17 April 2008
09 April 2008
YouTube: A Paragon of Drug Information
The phone rang. I expect the worst every time the phone rings. Sassy answered the call and spoke for a seconds.
Sassy: Spiffy, this lady on the phone says that she wants to know of something else her kid can take for allergies. She says he's taking Singulair and that she's afraid it will make him want to kill himself.
You may have heard in the news lately that the FDA is initiating studies investigating Singulair and suicide risk in children. I got on the phone.
Mom: Yeah, I want to know if there's anything else that my kid can take for his allergies.
Having just got on the phone, I played dumb.
Me: Anything else? Other than what?
Mom: Right now he's taking Singulair.
Me: Is he having any problems with it?
Mom: No.
Me: So why do you want to switch?
Mom: I heard something about kids taking it and then comiting suicide.
Me: Where did you hear that?
Mom: Ummm... I saw something about it on Youtube.
I thought back to my first semester of pharmacy school. I was attempting to search Pubmed for some primary literature when an instructor saw me and gave me a little talk. 'Spiffy, Spiffy' she said. 'Why waste time searching for unbiased, randomized, controlled trials when you can just use Youtube?' she asked. 'Why, just type in your keywords and you'll have hundreds of thousands of videos to choose from. Look, kitties!'
I'm sure you can find drug information on Youtube. Do you know what else you can find? Dramatic Prairie Dog Vs. Machine Gun Cat. You can also watch people getting hit in genitals. How informative.
This is the problem with the general public. They read the newspaper or watch the news and suddenly think they can make informed decisions about their medications, not to mention a myriad of other subjects they don't know shit about. The same thing happened a few months ago when the Enhance trial showed that taking Zetia in combination with Zocor didn't decrease a certain cardiovascular health risk. Another phone call:
Old guy: I just saw on the TV that Zetia is banned!!!
Me: Uh, nope. It's still here.
Old guy: No it isn't! The TV says it's illegal now!
Me: I have a bottle in my hand. I'm a pharmacist. Don't you think I would know about this?
Please, please, please don't make decisions about your health care based on the evening news.
Sassy: Spiffy, this lady on the phone says that she wants to know of something else her kid can take for allergies. She says he's taking Singulair and that she's afraid it will make him want to kill himself.
You may have heard in the news lately that the FDA is initiating studies investigating Singulair and suicide risk in children. I got on the phone.
Mom: Yeah, I want to know if there's anything else that my kid can take for his allergies.
Having just got on the phone, I played dumb.
Me: Anything else? Other than what?
Mom: Right now he's taking Singulair.
Me: Is he having any problems with it?
Mom: No.
Me: So why do you want to switch?
Mom: I heard something about kids taking it and then comiting suicide.
Me: Where did you hear that?
Mom: Ummm... I saw something about it on Youtube.
I thought back to my first semester of pharmacy school. I was attempting to search Pubmed for some primary literature when an instructor saw me and gave me a little talk. 'Spiffy, Spiffy' she said. 'Why waste time searching for unbiased, randomized, controlled trials when you can just use Youtube?' she asked. 'Why, just type in your keywords and you'll have hundreds of thousands of videos to choose from. Look, kitties!'
I'm sure you can find drug information on Youtube. Do you know what else you can find? Dramatic Prairie Dog Vs. Machine Gun Cat. You can also watch people getting hit in genitals. How informative.
This is the problem with the general public. They read the newspaper or watch the news and suddenly think they can make informed decisions about their medications, not to mention a myriad of other subjects they don't know shit about. The same thing happened a few months ago when the Enhance trial showed that taking Zetia in combination with Zocor didn't decrease a certain cardiovascular health risk. Another phone call:
Old guy: I just saw on the TV that Zetia is banned!!!
Me: Uh, nope. It's still here.
Old guy: No it isn't! The TV says it's illegal now!
Me: I have a bottle in my hand. I'm a pharmacist. Don't you think I would know about this?
Please, please, please don't make decisions about your health care based on the evening news.
07 April 2008
Wrong
I get told I'm wrong or that I've made a horrible mistake almost every day. That is not an exaggeration.
I overheard the argument start at my drive through today between one of my technicians and a pharmacy patron. After a while, Sassy invited the man to speak with the PIC (pharmacist in charge). From listening in, I got the picture that they didn't share the same world view.
Sassy: Spiffy, this guy says that he came by on Saturday after the pharmacy closed and that they were supposed to be holding his Rx at the front of the store.
Me: Oh dear.
I took the phone from her (at our drive through, there is no opening in the window and you have to communicate through handsets). The patron told me the same thing that Sassy just told me.
Me: I think there was a communication error. Once the pharmacy closes and the pharmacist leaves, no medications can be dispensed. That's the law. We never keep scripts anywhere but the pharmacy.
Patron: You're wrong.
I have to admire him, he cut right through the bullshit and told me exactly what he thought. This didn't make him any less crazy in my book. I had absolutely nothing to say for a few seconds.
Me: Uhhh... Like I said, we don't keep any scripts up front. I don't know who told you that, but we've never done that and never will.
Patron: You're wrong. I went up there and asked them for my script on Saturday, and the girl up there checked through a whole pile of 'em that were sitting there waiting to be picked up!
This guy was taking it ever further now, suggesting that not only his script had been taken from the pharmacy after closing, but many other scripts had also left the pharmacy. I performed a cursory visual examination of his car, looking for empty liquor bottles, crack pipes, anything that would explain his hallucination. There was nothing. The thing he was suggesting was ludicrous. Pharmacy law strictly states that no medication may be dispensed when the pharmacist is not present. Any pharmacist allowing such a thing would lose their license faster than Brittany Spears' credibility.
Me: I don't know what to tell you.
Patron: Do I need to talk to the Bob about this?
Bob is the front store manager of the corpopharm where I work. He has about as much jurisdiction over the pharmacy as the Pope does over Yankee Stadium. This guy apparently knows him. Some of the regulars at my corpopharm think that since they know Bob that their treatment in the pharmacy will somehow be upgraded. I have no idea why. I love it when people threaten me with talking to manager. One reason is the manager is not even my boss. The other is that no one governs the action of a pharmacist other than the state board of pharmacy and laws created thereby. God himself can come down from heaven and tell me to fill a script, but that doesn't mean it will happen.
Me: You're more than welcome to talk to Bob, but he's going to tell you the same thing I just did.
The guy just threw his hand up and drove away. Another satisfied customer. I think I deserve a raise.
I overheard the argument start at my drive through today between one of my technicians and a pharmacy patron. After a while, Sassy invited the man to speak with the PIC (pharmacist in charge). From listening in, I got the picture that they didn't share the same world view.
Sassy: Spiffy, this guy says that he came by on Saturday after the pharmacy closed and that they were supposed to be holding his Rx at the front of the store.
Me: Oh dear.
I took the phone from her (at our drive through, there is no opening in the window and you have to communicate through handsets). The patron told me the same thing that Sassy just told me.
Me: I think there was a communication error. Once the pharmacy closes and the pharmacist leaves, no medications can be dispensed. That's the law. We never keep scripts anywhere but the pharmacy.
Patron: You're wrong.
I have to admire him, he cut right through the bullshit and told me exactly what he thought. This didn't make him any less crazy in my book. I had absolutely nothing to say for a few seconds.
Me: Uhhh... Like I said, we don't keep any scripts up front. I don't know who told you that, but we've never done that and never will.
Patron: You're wrong. I went up there and asked them for my script on Saturday, and the girl up there checked through a whole pile of 'em that were sitting there waiting to be picked up!
This guy was taking it ever further now, suggesting that not only his script had been taken from the pharmacy after closing, but many other scripts had also left the pharmacy. I performed a cursory visual examination of his car, looking for empty liquor bottles, crack pipes, anything that would explain his hallucination. There was nothing. The thing he was suggesting was ludicrous. Pharmacy law strictly states that no medication may be dispensed when the pharmacist is not present. Any pharmacist allowing such a thing would lose their license faster than Brittany Spears' credibility.
Me: I don't know what to tell you.
Patron: Do I need to talk to the Bob about this?
Bob is the front store manager of the corpopharm where I work. He has about as much jurisdiction over the pharmacy as the Pope does over Yankee Stadium. This guy apparently knows him. Some of the regulars at my corpopharm think that since they know Bob that their treatment in the pharmacy will somehow be upgraded. I have no idea why. I love it when people threaten me with talking to manager. One reason is the manager is not even my boss. The other is that no one governs the action of a pharmacist other than the state board of pharmacy and laws created thereby. God himself can come down from heaven and tell me to fill a script, but that doesn't mean it will happen.
Me: You're more than welcome to talk to Bob, but he's going to tell you the same thing I just did.
The guy just threw his hand up and drove away. Another satisfied customer. I think I deserve a raise.
04 April 2008
Grandma's Strep Throat Prevention Happy Fun Time
A grandma approached me at work the other day. One of her grandchildren had strep throat. She was 5000 percent sure the other grandchild was going to get it and came to me for a recommendation.
Grandma: Hey! Hey! My gran-baby has strep and I can't have the other gettin' it. I can give 'em some Tylenol and that'll keep 'em from gettin' it, right?
Me: No, ma'am, Tylenol will not stop your grandchild from getting strep throat. Also, just because one of them has it doesn't mean the other will get it. The Tylenol will help for the throat soreness, though.
She said nothing for a few seconds. Her eyes narrowed skeptically.
Grandma: So, Tylenol, right?
Me: No, ma'am. There is nothing made to prevent strep throat. Just make sure the sick child isn't getting in direct contact with the other child, keep them from getting mucus on each other...
Grandma (cutting me off): Well, I got the kids this weekend and if I take 'em back to Mom sick she's goan' be all pissed at me. What am I supposed to do?
It's at this point of the conversation with brick walls like Grandma that you have to make a judgment call. You tell them what they want to hear, or repeat your last statement and walk away. I'm willing to let most people talk themselves into anything. When a minor's health who is under the supervision of a guardian is at risk, I usually try harder.
Me: Listen: if your sick grandchild has strep, she needs antibiotics. Go the the doctor and get an Rx. If your other grandchild is not yet sick, keep them apart as much as possible and you should be fine. Excuse me, I have a call from a doctor I need to take.
Using the old doctor call excuse is a great way to get out of conversations. She wandered away. About 10 minutes later I saw her in the child care section looking at the liquid Tylenol products.
Grandma: Hey! Hey! My gran-baby has strep and I can't have the other gettin' it. I can give 'em some Tylenol and that'll keep 'em from gettin' it, right?
Me: No, ma'am, Tylenol will not stop your grandchild from getting strep throat. Also, just because one of them has it doesn't mean the other will get it. The Tylenol will help for the throat soreness, though.
She said nothing for a few seconds. Her eyes narrowed skeptically.
Grandma: So, Tylenol, right?
Me: No, ma'am. There is nothing made to prevent strep throat. Just make sure the sick child isn't getting in direct contact with the other child, keep them from getting mucus on each other...
Grandma (cutting me off): Well, I got the kids this weekend and if I take 'em back to Mom sick she's goan' be all pissed at me. What am I supposed to do?
It's at this point of the conversation with brick walls like Grandma that you have to make a judgment call. You tell them what they want to hear, or repeat your last statement and walk away. I'm willing to let most people talk themselves into anything. When a minor's health who is under the supervision of a guardian is at risk, I usually try harder.
Me: Listen: if your sick grandchild has strep, she needs antibiotics. Go the the doctor and get an Rx. If your other grandchild is not yet sick, keep them apart as much as possible and you should be fine. Excuse me, I have a call from a doctor I need to take.
Using the old doctor call excuse is a great way to get out of conversations. She wandered away. About 10 minutes later I saw her in the child care section looking at the liquid Tylenol products.
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