This is how we treat our vets?

Okay, so I was at work today and an elderly gentleman brought in a prescription for Plavix. As it happened, he was retired from one branch or another of the US military so he had coverage through .... well let's just say it's a major company that handles the Department Of Defense prescription benefits. Also as it happens, a generic for Plavix just came out - "just" as in we got it in yesterday. So we try to fill the prescription and the insurange company doesn't recognize the generic as a valid product. That wasn't too surprising because sometimes it takes the plans a little while to catch on to a new generic. So naturally we tried to fill it for the brand. This is where it got tricky. The insurance company refused to pay for the brand name Plavix because there is a generic available. A generic - that it doesn't recognize. Now, that's pretty stupid in and of itself. So I called the insurance company and was told by the person at their help desk that they couldn't override the claim. Presumably since it's Saturday, there was no one there to add the generic drug to the system either. So the lady at the help desk gave me another option. She told me that the patient could pay out of pocket for the drug and then be reimbursed by the insurance company some time in the future when they put the generic into the system. Oh yeah that's a good plan......... the generic cost over $100 per month. (Imagine what the brand would have cost!) Now I understand the real reason why retired military personnel aren't permitted to keep their old weapons as souvenirs.....

Miss Cleo isn't your doctor either

Apparently there is an expectation that people in the medical profession have psychic powers. I guess some people figure that's part of the curriculum at medical school and pharmacy school.

The other night we got a phone call at about 8:30 PM from a mom who was asking about her daughter's medicine. The daughter was 16 and had received a prescription for an extended release antibiotic for a throat infection. Here's the problem. The 16 year old was unable to swallow tablets at the best of times and the throat infection was only compounding the problem. Plus the tablets she got were fairly large and because they are extended release, they can't be crushed. The mom wanted to know what to do to get this medicine into her daughter. All we could tell her is that if the daughter can't swallow, then there is nothing they could do until morning when the doctor's office was open. The daughter needed a liquid medication and that was that. But you would think one of them would have had the common sense to mention to the doctor at the time that the daughter can't swallow tablets. That would have saved them both some trouble and the daughter would have had an antibiotic she could actually use a little sooner. If you don't tell the doctor something, then how he he/she supposed to know???

Just once.......

People call us at the pharmacy all the time about drug interactions. Fortunately most of them think ahead and ask if they can take X with Y before they actually do anything. But every so often you get someone who calls and says, "I just took a dose of A and followed it with a dose of B. Is that okay?" Just ONCE I'd like to say - "You took A with B? You should be dead by now!"

Yes, I have a twisted mind......

Another driving adventure

There is a major intersection near my house. The North/South street has 2 straight through, 2 left turn and 1 right turn lane for each direction. The East/West street is the same right at the intersection although it does narrow about a block away in either direction.

One day I was sitting there at the intersection waiting for the light. (I was heading East.) There were a few cars ahead of me and a bunch in the left turn lanes also waiting for the light to change. As I'm sitting there, I see the guy at the head of the line in the left most straight through lane start to inch his way up like he's going to jump the light. I thought that would be a neat trick since the left turn lanes for both East and West get to go before the straight through lanes get the green light. Well, I had misjudges his plans. WHen the left turn arrows went green, the guy didn't attempt to go straight through at all. He decided that even though he as in a straight through lane, he was turning left. So he made a wide left turn and then forced a merge into the lane on the North South road - probably scaring the hell out of the drivers who had been correctly using the turn lane.

Now his move was dangerous and stupid to begin with, but the stupid part of it was compounded by one little detail that is apparent to anyone who drives those roads. Had the guy opted to safely go straight when the straight through lanes got the green, he could have driven up the road one block - just ONE block, made a left at that traffic light (a traffic light that is very visible from the major intersection we were at), gone another block and made another easy left, gone one last block and made a right (with the help of a traffic light that is also very visible from the major intersection we were at) on the North South road. AND he'd have entered the North South road at a point before ANYTHING he could have been planning to turn off on- so it's not like he would have missed an exit or a store or something. Maybe the guy just likes living dangerously? Too bad he forgot that the rest of the drivers on the road may not feel the same way.

A new sort of diet?

Since it was only about 8 million degrees out today, I decided to stop at the ice cream store and treat myself to a nice cold Italian ice. The place was packed (as expected) so I got to watch as other people got their orders ahead of me. One person in particular stood out. She ordered a cup of the lowfat vanilla ice cream, which didn't strike me as at all odd - until she had the counter person dump a ton of whipped cream on it. (And when I say a ton - I mean that there was at least as much whipped creap as there was ice cream.)

Now don't get me wrong - I've seen people go to McDonald's (or the like) and get a mega-calorie burger and a diet soda. That might make sense if the person was diabetic or something and was worried specifically about sugar rather than about calories in general. But the ice cream thing threw me. I mean, I can see watching your fat intake but still wanting a nice cold treat on day like today. But if you are watching your fat intake enough to want low fat ice cream (YUK), then WHY WHY WHY would you dump a ton of whipped cream on it which probably has more fat by itself then the regular ice cream would have had on its own? What are you thinking???

Strange kind of courtesy?

So I was driving home the other afternoon - or at least I was about to, when I ran into an unexpected show of kindness.

Let me see if I can draw you a picture. I was waiting to pull out of the side entrance to the shopping center where I work. That throws me out on to the main road less than half a block from an intersection with a traffic light. Now the intersection is to my right when I leave, and the right turn lane for that intersection starts just about at the side entrance to the parking lot. I was sitting there at a full stop waiting to make my right turn onto the main road, when a gentleman in the straight through lane took pity on me and stopped to let me in. That was very nice of him since traffic was pretty heavy at that moment.... but there was one small problem. I couldn't take advantage of his gesture because as he sat there stopped, there were people passing him on the right trying to use the right turn lane. So if I had pulled out into traffic, I'd have been slammed by one of those cars. Yet the guy sat there for a little while, perplexed as to why I wasn't taking advantage of his kindness. You would have thought he'd have noticed the other cars as he stared at me - but maybe they were invisible on one side? Anyway, the guy finally gave up on me and took off, and I sat as more cars passed in both the straight through and right turn lanes. Less than a minute later, another guy in the straight through lane stopped to let me in - equally oblivious to the right turn lane traffic. So that left me wondering if there is some new eye disease or something that allows you to see stopped cars but not moving ones?

Deja Vu

We have a regular customer, let's call her Agnes P. Ambien. She's an older lady gets a number of things from us, but her favorite medication is Ambien. For those of you who don't know what that it, it's a prescription sleeping aid....... and also a controlled substance. (That means it's regulated more strictly than say penicillin.) Every month Agnes gets her 30 day supply of Ambien and every month she comes back for an early refill - something we legally cannot do because of state and Federal laws. And every month we have the same conversation - she tells us that she took a couple extra tablets because the first one didn't help a couple of nights. We tell her that she can't do that and if the medicine isn't working she needs to speak to her doctor about other options (there are plenty). She promises to never ever take extra tablets again and then tells us that since she is out of medicine she won't be able to sleep again until we will refill her prescription. We tell her what date we will be able to fill it again and that we would be subjected to heavy fines from the state if we filled it early. Most of the time that's the end of the conversation until the next day. (She usually tries this every day until we can fill her prescription - you never know, maybe she'll get someone new!)

Well, she was in again the other day with that same old song and dance, so I reminded her AGAIN that it is ILLEGAL for us to refill that medication early. But she was a little more desperate this time to that wasn't the end of the conversation:

Me: I can't fill that early. It's against the law and we would face huge fines.

Agnes: But who would know?

Me: The state inspectors when they come in.

Agnes: Can't you tell them to get lost?

Me: Ummmm.... no. [I'm sure that would go down really well - "Hey Mr. Inspector - get out of my pharmacy!"]

Agnes: Can't you just change the date in your records?

Me: Ummmmm... how does no sound? [Let's see, she wants me to fill her controlled medicine early, tell the inspectors to go jump in the lake, and then I'm supposed to falsify the records on top of all that. Should I also go rob a bank for her so she'll have the money to pay for the drugs?]

If she pulled this kind of thing once, I would just chalk it up to her testing the boundaries - but come on. Every freaking month for the past several years? Especially when she's talking to one of the same seven people on a daily basis and we are all saying the exact same things to her? What the fuck is wrong with you? Take the hint already!