A Pharmiechick's Valentine Wish

I stumbled across this blurb of health news as I was eating my raisin bran this morning:

More women using morning-after pill, report finds

Considering the number of children I come across who are forced to bear the burden of being raised by completely incompetent parents, I appreciate the lowered restrictions on access to birth control and the morning-after pill.  I think it's great that women have a backup plan if their chosen method of birth control fails.  But I'm troubled by the National Center for Health Statistics study that indicates that 49% of women who have used the morning-after pill reported using after unprotected sex.  I would think that the fact that it is actually called PlanB would help clue in sexually active women that perhaps they should have a plan A in place before hooking up with guys that they would rather not procreate with.

With those thoughts still running through my mind, I moved on to my second bit of health news for the day:

 ’Ongoing, severe epidemic’ of STDs in US, report finds

Well, no kidding.  If you're hopping around looking for some action and don't already have an action plan in place to prevent pregnancy, obviously you don't have a plan A for STD prevention either.  And you know what plan B is for those?  An invigorating round of antibiotics.

No big deal, you say?  Then have a wander over here:

Untreatable gonorrhea threat rises in U.S., Canada

That's right, peeps.  In some cases, it appears that there is no plan B.  Yikes. 

I think it's alarming that, in a developed country like the US where casual sex has become so accepted since the advent of birth control, there is such a lack of knowledge of how safe sex actually works.  So let me put on my white coat so I can dole out some friendly pharmacist advice:

• If you're a chick and you're planning on hooking up with random guys, get yourself on some routine contraceptives beforehand.  Use PlanB as your backup, not your only method of birth control.
• Once you're on those contraceptives, unless you see a lab report saying they're absolutely disease free, you still need to use a condom with those random guys.  It's the only thing (besides abstinence) that is going to have a chance of stopping the spread of STDs.
• To the guys, sure, you're not going to get pregnant.  I guess if you do knock some chick up and don't mind being a dead-beat dad, you can pretend nothing ever happened.  But before you forget or "forget" to use a condom, just remember: the STD train goes both ways.
• In case I wasn't clear enough, condoms are cheaper than both babies and treatments for STDs.  They're also easier to obtain than the alcohol that is responsible for many of those babies and STDs.

I think it's a little strange that no one at NBCNews decided to have an original thought and combine the information from all three articles into something that could help educate a public that seems woefully uniformed.  I can't be the only person who recognized that the above topics are all related.  I know it is part of my job to educate my patients about contraception and STDs, but it seems that for a large number of women, the pharmacist can only counsel about birth control after the fact.  Because sex education seems to be neglected in some states, I think the media has an opportunity to help educate the public rather than just report.  I'm tired of reading articles like the one above concerning the STD epidemic, that explain studies but give no causes or solutions for the situation.  Would it have been so difficult for the journalist to mention that practicing safe sex would lower the risk of contracting an STD?  Even if he isn't capable of independent thought, there are tons of doctors that he could have approached for a quote.

Okay, the white coat is off and Doctor Sarah, advocate for the improvement of society through better education, has vanished.  As the off-duty Sarah Jane, I have to be honest and admit that, despite the seriousness of our country's ignorance of how diseases spread and what family planning requires to be effective, I find the combination of these articles showing up for me to enjoy on Valentine's Day kind of funny.  It's the little things that I appreciate the most.

Image courtesy of gubgib / FreeDigitalPhotos.net

Hope you have a happy (and STD-free) Valentine's Day!!!

Governor Cuomo's Emergency Flu Response

Because of the increased rate of influenza in New York, Governor Cuomo has issued a state of emergency for the next 30 days that allows pharmacists to administer flu vaccinations to anyone over 6 months old. While normally I appreciate any advancement of pharmacy practice, this sort of action could be putting community pharmacists at risk. 

Legislation such as this could cause a dramatic increase to a community pharmacist's daily workload. Without an accompanying increase in pharmacist coverage/overlap, this is a dangerous situation and has an incredibly negative impact on the health and safety of all pharmacy patients. An overstressed pharmacist is an absolute danger to his or her patients.  

The best way for community pharmacies to respond to this temporary change is legislation is to increase pharmacist coverage.  Organize flu clinics and schedule a pharmacist who will focus only on administering vaccines during that time.  Have the information advertised on the local news.  Radio, television, and websites can disseminate this sort of  news incredibly fast. This course of action would not only be quick and easy to execute, but also the responsible reaction to such a sudden situation.

Because I know that the average corporation running community pharmacies is slightly less focused on the stress levels of it's pharmacists and a little more towards the bottom line, I know that such a scenario is unlikely to occur.  Getting corporate approval would probably take longer than this emergency will last.  And spending extra cash on an additional pharmacist to cover a four hour clinic (probably about $250 in wages) would be deemed an unnecessary expense.

Such a response would be a great advertising opportunity for most companies, considering the potential for community outreach and awareness.  I can only hope that some of the more customer-oriented companies might have this thought process.  If a company was willing to address this issue quickly, it would prove that they were truly responsive to the needs of the public and willing to quickly execute plans that effect on their communities at a very local level and in a positive way. I look forward to seeing what company, if any, grabs this opportunity.

Beyond the business aspect, a response such as this would ensure that the public will have access to the appropriate vaccines but still maintain a less stressful working environment for community pharmacists.  Such a response would greatly reduce the potential of adversely impacting the other areas of patient care being offered by community pharmacists today. Patient safety should be the main goal of any pharmacy at all times, and this is the perfect opportunity to prove how pharmacists and their companies are dedicated to the care, safety, and well-being of all of their patients every day.

A Friendly Reminder From Your Neighborhood Pharmacist

The season for pharmacist-administered flu vaccines started in early September, and appears ready to wind down.  At this point, if you haven't gotten your flu shot, it's probably a good idea to head to your local pharmacy or doctor's office now.  

Remember, the flu shot takes about two weeks to be active.  During this time you could still become infected with the flu despite being vaccinated.  So it's important to get your shot BEFORE people starts getting sick and everyone starts to panic.  I can't be the only one who has memories of the H1N1 outbreak and the overwhelming media coverage and hysteria that ensued.  That was the first time I witnessed patients arguing in front of my pharmacy over who got the last injection, and I'd really like to make sure it was my last.  I am still looking for clarification regarding why, when you weren't worried about it when both your pharmacist and your doctor told you to get one, it suddenly become important to you when it shows up on the news

So please, get your flu shot ahead of time.  Go to the doctor or the pharmacist or your company's flu clinic today.  It's probably best to place your trust in a licensed healthcare professional's advice rather than the media.  If you didn't get your flu shot when they were first offered, the time to do it is now.  You'll be preventing illness rather than waiting to treat it.  And you also won't have to worry about fisticuffs while waiting in the immunization line after flu season starts. 

Reasons Why I am Exceptionally Grumpy Today

1. I spent 13 hours today in the pharmacy.  Okay, actually 12 hours and 58 minutes, since I did leave for two minutes to go to the bathroom.  I didn't get to go to lunch, surviving only on a handful of stale Cheetos, a Diet Pepsi, and a slice of Starbucks lemon pound cake.  As I type this, I am actually so hungry that I feel nauseated, so I can't eat.  My sugar levels are a little out of whack.  And I apologize to anyone who may have been on the receiving end of some sugar-high snark.

2. There was no toilet paper when I finally got to the bathroom.  Seriously, does no on in the community I work in go to the bathroom at home?  There are always lines waiting to use it, and never enough toilet paper.  I don't get it.  When I'm going out in public, I pee before I leave home.  Because public bathrooms are kind of gross, and I avoid them if at all possible.

3.  My first flu shot patient of the day sneezed directly in my face.  While I had the needle in her arm.  Cover your mouths when you cough or sneeze, people.  A flu shot won't protect you when you have the sanitary habits of a grizzly bear.

4.  My pharmacy water purifier LITERALLY exploded today.  We're talking a loud squealing noise and water shooting all over the pharmacy, and then soaking me while I tried to figure out how to turn the water off.  This all happened five minutes after I should have been at lunch, but wasn't because I had so many scripts to fill.  So I was kind of hungry and very wet, and probably would have cried if I hadn't been so angry.

5. Honey Boo Boo has her own show.  But Firefly was cancelled.  I still can't get over this.  Why, America, why?  I think I should move to Canada.  Then again, the Canadians are responsible for Justin Bieber.  Which brings my next issue...

6. Justin Bieber and Nicki Minaj are collaborating now.  Why?  If you want to kill me, just shoot me.  This is just pure, unadulterated torture.  And they are playing it on the radio.

7.  On my drive home, I actually heard both "Nookie" and "The Chemicals Between Us" on the radio.  Why is this a bad thing?  Because both songs were almost over by the time I tuned in, further depressing me.

8.  When I finally got home tonight, my dog totally ignored me.  There is nothing quite like a sulky chocolate lab.  Hurtful, Brown Dog.  Don't think I won't remember this next time I catch you on the couch.

9. I actually was supposed to have today off. I only worked as a favor to my awesome partner, who is in Myrtle Beach with his family this week.  I want to hate him, but he's pretty fabulous if you overlook him being on vacation and me working overtime.

10.  I kind of wish I was working tomorrow.  Not because I want to go back to work after today's awesomeness.  But because I worry about what happens in my pharmacy when my partner and I aren't there.  And then I worry about what I'm going to have to deal with the day after, when I am back again.

Get Your Flu Shot!

No, I am not pimping my own pharmacy. I don't care where you go to get your flu shot. I just care that you get one. Basically, the flu sucks. It kills lots of people each year, especially the very young and the very old. It hospitalizes even more. And you're way less likely to get it if you get immunized every year. So go to Target, Walgreens, your doctor, or a flu clinic and get your shot. Even if you aren't high risk for the flu, I bet you have a close friend or relative who is. And aren't they worth a little pinch and a sore arm the next day?

Back to College!

I have the good fortune of working in a town that doubles in size every fall when it's college students return to class. It is my apparent lack of good fortune that has resulted in my being scheduled to work every year on Move-In Weekend for the past four years. Let's just say the stars were particularly misaligned at my birth.

Working on Move-In Weekend is not much fun for a pharmacist in a discount-retailer environment. Our more intelligent regular patients know to get their refills either before or after this most glorious of weekends. Which means that the only patients I see on Move-In Weekend are generally my biggest PITAs.

Besides dealing with my (least) favorite patients all weekend, I also get to interact with not only the incoming freshman class, but their hovering, helicopter parents. I do transfers for forgotten prescriptions, give directions to home-improvement stores (I really don't know why so many students need to locate a Home Depot or Lowes...could someone explain this to me?), dispense advice on allergies, antifungal creams, headaches, and what to put in a first-aid kit. Oh, and once the parents finally go home, I dispense A LOT of Plan B.

Mostly, I answer questions about where items are located in the store. My technician (who has now seen NINE Move-In-Weekends) and I decided to keep track of the various items we were asked for this weekend, to see which was the most popular:


Clearly, the colleges in my town do not include manicure essentials on their list of what to bring to school. Or condoms. And as noted previously, Plan B. In a few months I'll have to update my pharmacy word cloud to include "directions to Planned Parenthood."

Four years ago, I considered the future of our civilization as bright and full of promise. Today, I am not so sure. Yesterday, a Sunday, I had the pleasure of filling prescriptions from an on-call pulmonologist in California...at 10am New York time. He was woken up because one of his asthma patients had left his Advair, Singulair, and last, but not least, his Ventolin rescue inhaler, at home. I noted to the (helicopter) parents that I often see incoming students who forget their medications when packing. "Oh, no," said his mother. "He didn't forget to pack them. We just didn't think he would have any asthma symptoms when he got to New York. The weather is so much different here than in California." I really think colleges should start requiring common sense as well as academic prowess to be admitted.

30 Days of Pictures

DAY 30 - My most treasured item:

I'm sure there are lots of things I have that are worth more, or are more valuable to me. But when it comes right down to it, after my dogs and cats, the first thing I'm grabbing if my house is on fire is going to be my Ventolin HFA. Photo albums are great, but they aren't going to save my life when I'm wheezing from smoke inhalation. I guess you could say I treasure my life, and thus, I treasure my inhaler.

30 Days of Pictures

DAY 25 - Something that means a lot to me:


It took a long time (13 years of public school, 6 years of pharmacy school, and 23 years of my life) to become a pharmacist. So I'm pretty proud of being part of America's most trusted profession. And as much as I complain, I actually love my job...mostly.

Public Service Announcement

WASH YOUR HANDS!

I was recently hospitalized for a severe asthma exacerbation due to pneumonia, which would be easily stopped if everyone could follow the CDC's recommendations concerning hand washing and the spread of disease. It seems that what is taught as a general rule to kids in preschool ("This is the way we wash our hands, wash our hands, wash our hands...") is very easily disregarded by adults.

Some general rules regarding good hygiene that you should have learned by age 5:

• If your hands are soiled, wash them.
• Cough/sneeze into a tissue or your elbow, never into your hand. If you cough/sneeze into your hand, and then don't wash it, you are gross. End of story.
• Wash your hands before and AFTER you eat. People usually wash their hands to get others' germs off before eating, but don't forget to get your own germs off your hands after eating and before interacting with others.
• If you are sick, stay home. There is no need to infect the general population with your cooties. Remember, some of us can't fight off infection as easily as others.
• When in doubt, use hand sanitizer. It's good stuff, I promise. Avon makes a tasty smelling peach concoction that I highly recommend

So now you have Sarah's general rules for good hygiene. Please don't make me sick again. After my near-death experience, I've realized that a large part of the general population have no idea about the spread of disease and good hygiene. Consider yourselves educated. And keep in mind that if you ever cough or sneeze in my face again, it's only my good manners keeping me from slapping you. There are some things that I don't like to share!

Pharmacy Rules to Live By

1. Drop your non-urgent prescriptions off, and then come back the next day. This cuts down on not only your wait time, but that of people with urgent prescription needs, like the kid screaming in the first aid aisle because his ear hurts and he wants to go home, but needs his antibiotic prescription.
   
2. Don't ask why it's going to take 15 minutes to fill a cream/ointment/tube of toothpaste because all we do is "slap a label on it." Your prescription is no more important than anyone elses, and despite not having to be counted, it still requires being entered into the computer, processed through your insurance, labeled, checked by the pharmacist, and then bagged. Your label doesn't miraculously print the instant you walk up to the counter, and you're really only offending your pharmacist and technicians by suggesting that their jobs are so simple.
   
3. Don't yell at the pharmacist/technician/cashier if your insurance isn't working. Save all that nastiness and call your insurance company up yourself, instead of demanding the pharmacy staff do it. Chances are, we won't get anywhere by telling the insurance representative that yes, our patient should be covered. But you might. And consider this - when you ask us to do this, it takes up a lot of our time that could be spent checking prescriptions for others. Same thing goes if someone else asks us to do it, and you are waiting for your prescription...that's why our wait times are so long.
4. Don't yell at the pharmacist/technician/cashier if your Vicodin, Soma, Oxycontin, or methadone prescription is too early to be filled. It's really no one's fault but yours that you took too much, and unless you are willing to pay my salary until 2045 when I reach retirement age, I'm not breaking any laws for you. If it's too early, shut up, go home, and wait it out. By acting up, you only made it harder on yourself, because now you have a note in your file warning everyone that you try to get early refills on controlled substances.
5. Don't bad mouth other pharmacies or pharmacists to us. It's almost guaranteed that we went to school with that pharmacist, are friends with his or her spouse, or used to work at that pharmacy. Our profession is very small, and we know everyone. Badmouthing someone only makes you look like a complainer, and make us hope that you find another pharmacy to go to.

My favorite blog

http://www.drugnazi.blogspot.com

Well, this is my favorite blog, besides my own! Seriously the DrugMonkey, formerly known as the DrugNazi, is like a liberal, older, male version of me. Except that I think he works for Rite Aid or CVS which would totally suck. I work for an awesome company, as long as I forget the fact that I have to wear an incredibly unflattering color shirt every single day that I work. But seriously, check this blog out...pharmacists will understand, maybe doctors will figure out why we're so unpleasant all the time, and to anyone who has called me twice a day for 14 days straight to find out when they can get their Soma script filled only to get the same answer 28 times, now you know how we really feel about you!