Tuesday, August 29, 2017

Quantity?

Here's a script for Doxycycline 100mg, written to take one twice daily...


But uh oh, what's the quantity? Is that 20? 26? Just what the hell is that?


A call to the prescriber's office revealed that this new symbolism represents "# 20."

Who knew?



Monday, August 28, 2017

Foil Hat Lady and the A1C test

"The nurse told me I don't have to fast for my A1c test next week," she said.

This is Foil Hat Lady, one of our patients that's been a constant source of head-shaking for the pharmacy staff.

"Yes, that's correct," I said.

"But it's a blood sugar test. I always fasted before."

"This is different. It doesn't measure the amount of sugar in your blood stream. It measures the amount of sugar that's become stuck to your red blood cells over the past three months."

"I don't understand," she said. "I always fasted before. Are you sure I don't need to fast?" she asked.

I then tried to explain it to her the best I could. I told her how when you buy a new set of tires for your car... and how by the time you get home they're a little dirty with dust and dirt, but still look brand new. Then after time they get really dirty. I said our red blood cells are kind of like that. New red blood cells are only coated with a little bit of sugar whereas older ones have a lot more. By averaging that all out we can determine your A1c level and your diabetes status.

I thought it was a nice analogy since tires and red blood cells are round. I wanted to pat myself on the back.

"Well I'll fast anyway. I don't want to mess up the test," she said, then walked away.


Friday, August 25, 2017

Thursday, August 24, 2017

Flu Shot Observations from the Past


These are observations of mine from the past... now as flu shot season is upon us, let's see what's different this year:

People will see me, the pharmacist, alone in the pharmacy, running around like a crazy man with people in line at both the drop off and pick up windows, yet will still ask, "Is now a good time to get a flu shot?"

People either WANT to watch me give them the shot with an unusually weird enjoyment, or turn their head and/or cover their eyes trying to pretend it is not happening. There doesn't seem to be a third type.

Grandparents, at the request of the new parents, run down to the pharmacy to get a flu shot so they can be allowed to hold the new baby. The 10-14 days to "kick in" is not a message that anyone seems to get.

Just by the way I phrase how I say it, I can usually get the flu shot patron to agree to get the shot in their left arm (which is easier for me because of how I have the room set up). It is mind control extraordinaire.

Most (almost all) people that are aware of our discount coupon for getting a flu shot act like they only get a flu shot so they can get the coupon.


Most (almost all) people who are getting a flu shot as a healthy measure are unaware they will get a coupon (despite all the signage and advertising).

At least three people come in toward the end of the year (every year) and claim they lost their coupon for getting a flu shot and expect me to just hand them another one.

Almost 33% of our flu shot patrons do not get any prescriptions at our pharmacy but admit to getting prescriptions somewhere else on a regular basis. Why they choose to come to our pharmacy is a mystery to me.

Many of our regulars wait until they have paid for a new prescription then belt out, "Oh, can I get a flu shot now?"

I purposefully do not promote FluMist simply because the drug rep for the product was such an annoying ass last year. That's what you get, butthead.

When I give a flu shot to a little old lady with old weathered skin, the skin "pops" like poking through rice paper when I puncture it. Ewwww.

No matter how many times you tell the flu shot patron that they only need to answer questions 1-8 on the consent and release form, almost half will still answer all the questions.




People who are reluctant to get a flu shot often tell me they know for a fact that the flu shot gave them the flu before. No manner of explaining seems to change their mind.

Way too many parents do not force their kids to get a flu shot because the child is scared of needles. Instead they get a flu shot and have the child watch to see how easy and painless it is. This never seems to work.

Hitting the bone with the tip of the needle in a skinny arm is freaky. Freaky, I tell you.

Some 10 year old girls are a lot braver than 15 year old boys. I had one 15 year old boy cry. I'm still stunned.

No matter how many times our script count goes up during this time of year, The Authorities never seem to get it that they need to hire more technicians to cover this time period.


I can never get a glove to fit right. It's very annoying and I look stupid every time.

Tuesday, August 22, 2017

The New Boy Scout Motto

Anyone associated with scouting knows the boy scout motto: 

Be Prepared

But apparently it needs to be updated.


Yesterday a lady from Canada comes up the pharmacy window with a question about her son. It was one of those typical mom questions we get all the time. Little Ricky has the beginnings of a cold and she wants to know what I can give to the young man to help him out. We're actually trained to deal with these questions. As I'm telling her what I think she should do, a man, walking by, interrupts...

"I'm a scout master. What he needs is Airborne. I give it to all my scouts when they're feeling ill. It fixes them right up."

The amazing scout master proudly walks away, having done his good deed for the day.

I explain my thoughts on Airborne and why it isn't magic. The lady chooses to heed my advice.

Now don't get me wrong. I have boys that are scouts and one of them earned the Eagle Scout award. I think scouting is great for young men.

But I think this scout master needs to adopt a new scout motto:

Be Prepared to MIND YOUR OWN BUSINESS!

Monday, August 21, 2017

Clindamycin 2% Vaginal Cream


We receive an e-Script for Clindamycin 2% Vaginal Cream.

"Apply to face and neck at bedtime."

Ok, what?

I call the prescriber to get clarification. I have to leave a message. Later they call to change it to the 1% cream. 

During overlap, I tell Mickey about the e-Script. He tells me this is the second time this office has done this.

I think if you're going to prescribe medication, it might be helpful to know what you're doing.

Just a thought.